Sample records for current results provide

  1. Prior doctor shopping resulting from differential treatment correlates with differences in current patient-provider relationships. (United States)

    Gudzune, Kimberly A; Bennett, Wendy L; Cooper, Lisa A; Clark, Jeanne M; Bleich, Sara N


    To determine the prevalence of doctor shopping resulting from differential treatment and to examine associations between this shopping and current primary care relationships. In 2012, a national internet-based survey of 600 adults receiving primary care in the past year with a BMI ≥ 25 kg/m(2) was conducted. Our independent variable was "switching doctors because I felt treated differently because of my weight." Logistic regression models to examine the association of prior doctor shopping with characteristics of current primary care relationships: duration, trust in primary care provider (PCP), and perceived PCP weight-related judgment, adjusted for patient factors were used. Overall, 13% of adults with overweight/obesity reported previously doctor shopping resulting from differential treatment. Prior shoppers were more likely to report shorter durations of their current relationships [73% vs. 52%; p = 0.01] or perceive that their current PCP judged them because of their weight [74% vs. 11%; p shop resulting from perceived differential treatment. These prior negative experiences have no association with trust in current relationships, but our results suggest that patients may remain sensitive to provider weight bias. © 2014 The Obesity Society.

  2. Some observational results of sea storm current

    Institute of Scientific and Technical Information of China (English)


    @@ INTRODUCTION Dr. Hollister, a marine geologist of the Woods Hole Oceanographic Institution, first pointed out that there was ocean storm current in the ocean. He found out the wavy texture in the seabed core samples, and suggested that this wavy texture was caused by the high speed sea current in remote antiquity. He then suggested a bold hypothesis that there existed a benthic storm current near the ocean bottom, and presented this hypothesis at the IUGG conference held at San Francisco in 1963. Unfortunately, the attention was not drawn to the hypothesis at the conference, and the hypothesis was criticized as a sheer nonsense.

  3. Joint voltages resulting from lightning currents.

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, William Arthur; Warne, Larry Kevin; Merewether, Kimball O.; Chen, Kenneth C.


    Simple formulas are given for the interior voltages appearing across bolted joints from exterior lightning currents. External slot and bolt inductances as well as internal slot and bolt diffusion effects are included. Both linear and ferromagnetic wall materials are considered. A useful simplification of the slot current distribution into linear stripline and cylindrical parts (near the bolts) allows the nonlinear voltages to be estimated in closed form.

  4. Provider confidence in opioid prescribing and chronic pain management: results of the Opioid Therapy Provider Survey. (United States)

    Pearson, Amy Cs; Moman, Rajat N; Moeschler, Susan M; Eldrige, Jason S; Hooten, W Michael


    Many providers report lack of confidence in managing patients with chronic pain. Thus, the primary aim of this study was to investigate the associations of provider confidence in managing chronic pain with their practice behaviors and demographics. The primary outcome measure was the results of the Opioid Therapy Provider Survey, which was administered to clinicians attending a pain-focused continuing medical education conference. Nonparametric correlations were assessed using Spearman's rho. Of the respondents, 55.0% were women, 92.8% were white, and 56.5% were physicians. Primary care providers accounted for 56.5% of the total respondents. The majority of respondents (60.8%) did not feel confident managing patients with chronic pain. Provider confidence in managing chronic pain was positively correlated with 1) following an opioid therapy protocol (P=0.001), 2) the perceived ability to identify patients at risk for opioid misuse (P=0.006), and 3) using a consistent practice-based approach to improve their comfort level with prescribing opioids (Pconfidence was negatively correlated with the perception that treating pain patients was a "problem in my practice" (P=0.005). In this study, the majority of providers did not feel confident managing chronic pain. However, provider confidence was associated with a protocolized and consistent practice-based approach toward managing opioids and the perceived ability to identify patients at risk for opioid misuse. Future studies should investigate whether provider confidence is associated with measurable competence in managing chronic pain and explore approaches to enhance appropriate levels of confidence in caring for patients with chronic pain.

  5. Current results and trends in platform switching

    Directory of Open Access Journals (Sweden)

    Hadi Salimi


    Full Text Available The platform switching (PLS concept was introduced in the literature in 2005. The biological benefits and clinical effectiveness of the PLS technique have been established by several studies. In this article different aspects of PLS concept are discussed. Crestal bone loss, biologic width, and stress distribution in this concept are comprehensively reviewed. In this article the relative published articles from 1990 to 2011 have been evaluated by electronic search. Because of controversial results especially in immediate loading and animal studies, further modified research is needed to establish the mechanism and effect of the PLS technique. Essential changes in studies including using the control group for accurate interpretation of results and long-term observation, particularly through, randomized, prospective, multicenter trials with large numbers of participants, and implants are necessary.

  6. Pediatric Primary Care Providers' Relationships with Mental Health Care Providers: Survey Results (United States)

    Pidano, Anne E.; Honigfeld, Lisa; Bar-Halpern, Miri; Vivian, James E.


    Background: As many as 20 % of children have diagnosable mental health conditions and nearly all of them receive pediatric primary health care. However, most children with serious mental health concerns do not receive mental health services. This study tested hypotheses that pediatric primary care providers (PPCPs) in relationships with mental…

  7. Recent experimental results of KSTAR RF heating and current drive

    Energy Technology Data Exchange (ETDEWEB)

    Wang, S. J., E-mail:; Kim, J.; Jeong, J. H.; Kim, H. J.; Joung, M.; Bae, Y. S.; Kwak, J. G. [National Fusion Research Institute, Daejoen, 305-806 (Korea, Republic of)


    The overview of KSTAR activities on ICRH, LHCD and ECH/CD including the last experimental results and future plan aiming for long-pulse high-beta plasma will be presented. Recently we achieved reasonable coupling of ICRF power to H-mode plasma through several efforts to increase system reliability. Power balance will be discussed on this experiment. LHCD is still struggling in the low power regime. Review of antenna spectrum for the higher coupling in H-mode plasma will be tried. ECH/CD provides 41 sec, 0.8 MW of heating power to support high-performance long-pulse discharge. Also, 170 GHz ECH system is integrated with the Plasma Control System (PCS) for the feedback controlling of NTM. Status and plan of ECH/CD will be discussed. Finally, helicon current drive is being prepared for the next stage of KSTAR operation. The hardware preparation and the calculation results of helicon current drive in KSTAR plasma will be discussed.

  8. Westinghouse accident tolerant fuel program. Current results and future plans

    Energy Technology Data Exchange (ETDEWEB)

    Ray, Sumit; Xu, Peng; Lahoda, Edward; Hallstadius, Lars; Boylan, Frank [Westinghouse Electric Company LLC, Hopkins, SC (United States)


    This paper discusses the current status, results from initial tests, as well as the future direction of the Westinghouse's Accident Tolerant Fuel (ATF) program. The current preliminary testing is addressed that is being performed on these samples at the Massachusetts Institute of Technology (MIT) test reactor, initial results from these tests, as well as the technical learning from these test results. In the Westinghouse ATF approach, higher density pellets play a significant role in the development of an integrated fuel system.

  9. Current Trends in Nursing Informatics: Results of an International Survey. (United States)

    Peltonen, Laura-Maria; Alhuwail, Dari; Ali, Samira; Badger, Martha K; Eler, Gabrielle Jacklin; Georgsson, Mattias; Islam, Tasneem; Jeon, Eunjoo; Jung, Hyunggu; Kuo, Chiu-Hsiang; Lewis, Adrienne; Pruinelli, Lisiane; Ronquillo, Charlene; Sarmiento, Raymond Francis; Sommer, Janine; Tayaben, Jude L; Topaz, Maxim


    Nursing informatics (NI) can help provide effective and safe healthcare. This study aimed to describe current research trends in NI. In the summer 2015, the IMIA-NI Students Working Group created and distributed an online international survey of the current NI trends. A total of 402 responses were submitted from 44 countries. We identified a top five NI research areas: standardized terminologies, mobile health, clinical decision support, patient safety and big data research. NI research funding was considered to be difficult to acquire by the respondents. Overall, current NI research on education, clinical practice, administration and theory is still scarce, with theory being the least common. Further research is needed to explain the impact of these trends and the needs from clinical practice.

  10. A Self-Oscillating Control Scheme for a Boost Converter Providing a Controlled Output Current

    DEFF Research Database (Denmark)

    Knott, Arnold; Pfaffinger, Gerhard R.; Andersen, Michael A. E.


    Most switched mode power supplies provide a regulated voltage at their output. However, there are applications requiring a controlled current. Among others are battery chargers, test equipment for converters driven by solar cells, and LED drivers. This paper describes a dc–dc power converter real...

  11. Bilateral cochlear implantation: current concepts, indications, and results. (United States)

    Basura, Gregory J; Eapen, Rose; Buchman, Craig A


    The optimal treatment for bilateral hearing loss continues to evolve as cochlear implant (CI) and hearing aid technologies advance, as does our understanding of the central auditory system. Ongoing discussions continue on the validity and feasibility of bilateral CI in terms of performance, justification of need, medical/surgical safety concerns, and economics. The purpose of this review article is to provide an update on the advantages and disadvantages of bilateral CI and to provide a discussion on timing (simultaneous vs. sequential), technology (bimodal vs. binaural) and feasibility. Binaural advantages are found in both adult and pediatric bilateral CI recipients, the greatest being the head shadow effect and improvements in localization and loudness summation. This theoretically offers an advantage over their unilateral implanted counterparts in terms of improved sound localization and enhanced speech perception under noisy conditions. Most investigators agree that bilateral stimulation during critical periods of development is paramount for optimizing auditory functioning in children. Currently, bilateral CI is widely accepted as a safe and effective means of bilateral auditory stimulation.

  12. Route toward high-speed nano-magnonics provided by pure spin currents (United States)

    Divinskiy, B.; Demidov, V. E.; Demokritov, S. O.; Rinkevich, A. B.; Urazhdin, S.


    We study experimentally the possibility to utilize pulses of pure spin current, produced via the nonlocal spin injection mechanism, to generate short packets of spin waves propagating in nanoscale magnetic waveguides. Spatially and time-resolved micro-focus Brillouin light scattering spectroscopy measurements demonstrate that the excitation by spin current results in extremely fast transient response, enabling efficient generation of short spin-wave packets with duration down to a few nanoseconds. The proposed method opens a route for the implementation of high-speed magnonic systems for transmission and processing of information on the nanoscale.

  13. Fever and Pain Management in Childhood: Healthcare Providers' and Parents' Adherence to Current Recommendations. (United States)

    Raffaeli, Genny; Orenti, Annalisa; Gambino, Monia; Peves Rios, Walter; Bosis, Samantha; Bianchini, Sonia; Tagliabue, Claudia; Esposito, Susanna


    In order to evaluate the adherence of healthcare providers and parents to the current recommendations concerning fever and pain management, randomized samples of 500 healthcare providers caring for children and 500 families were asked to complete an anonymous questionnaire. The 378 health care providers (HCPs) responding to the survey (75.6%) included 144 primary care pediatricians (38.1%), 98 hospital pediatricians (25.9%), 62 pediatric residents (16.4%), and 71 pediatric nurses (19.6%); the 464 responding parents (92.8%) included 175 whose youngest (or only) child was ≤5 years old (37.7%), 175 whose youngest (or only) child was aged 6-10 years (37.7%), and 114 whose youngest (or only) child was aged 11-14 years (24.6%). There were gaps in the knowledge of both healthcare providers and parents. Global adherence to the guidelines was lower among the pediatric nurses than the other healthcare providers (odds ratio 0.875; 95% confidence interval 0.795-0.964). Among the parents, those of children aged 6-10 and 11-14 years old, those who were older, and those without a degree answered the questions correctly significantly less frequently than the others. These findings suggest that there is an urgent need to improve the dissemination of the current recommendations concerning fever and pain management among healthcare providers and parents in order to avoid mistaken and sometimes risky attitudes, common therapeutic errors, and the unnecessary overloading of emergency department resources. Pediatric nurses and parents with older children, those who are older, and those with a lower educational level should be the priority targets of educational programmes.

  14. Recent results on current profile shaping on tore supra

    Energy Technology Data Exchange (ETDEWEB)

    Becoulet, A.


    The link between the current profile and the confinement is studied, involving various regimes: high power minority ion cyclotron resonant heating, high power lower hybrid current drive, fast wave direct electron heating and current drive and pellet enhanced performance. It is shown that the electron heat diffusivity decreases when the magnetic shear increases in the confinement zone and/or when it decreases in the plasma centre. (authors). 13 refs., 6 figs.

  15. Surface conductivity of Mercury provides current closure and may affect magnetospheric symmetry

    Directory of Open Access Journals (Sweden)

    P. Janhunen


    Full Text Available We study what effect a possible surface conductivity of Mercury has on the closure of magnetospheric currents by making six runs with a quasi-neutral hybrid simulation. The runs are otherwise identical but use different synthetic conductivity models: run 1 has a fully conducting planet, run 2 has a poorly conducting planet ( $sigma{=}10^{-8} Omega^{-1}$ m$^{-1}$ and runs 3-6 have one of the hemispheres either in the dawn-dusk or day-night directions, conducting well, the other one being conducting poorly. Although the surface conductivity is not known from observations, educated guesses easily give such conductivity values that magnetospheric currents may close partly within the planet, and as the conductivity depends heavily on the mineral composition of the surface, the possibility of significant horizontal variations cannot be easily excluded. The simulation results show that strong horizontal variations may produce modest magnetospheric asymmetries. Beyond the hybrid simulation, we also briefly discuss the possibility that in the nightside there may be a lack of surface electrons to carry downward current, which may act as a further source of surface-related magnetospheric asymmetry.

    Key words. Magnetospheric physics (planetary magnetospheres; current systems; solar wind-magnetosphere interactions.6

  16. Immobilized cell technology in beer brewing: Current experience and results

    Directory of Open Access Journals (Sweden)

    Leskošek-Čukalov Ida J.


    Full Text Available Immobilized cell technology (ICT has been attracting continual attention in the brewing industry over the past 30 years. Some of the reasons are: faster fermentation rates and increased volumetric productivity, compared to those of traditional beer production based on freely suspended cells, as well as the possibility of continuous operation. Nowadays, ICT technology is well established in secondary fermentation and alcohol- free and low-alcohol beer production. In main fermentation, the situation is more complex and this process is still under scrutiny on both the lab and pilot levels. The paper outlines the most important ICT processes developed for beer brewing and provides an overview of carrier materials, bioreactor design and examples of their industrial applications, as well as some recent results obtained by our research group. We investigated the possible applications of polyvinyl alcohol in the form of LentiKats®, as a potential porous matrices carrier for beer fermentation. Given are the results of growth studies of immobilized brewer's yeast Saccharomyces uvarum and the kinetic parameters obtained by using alginate microbeads with immobilized yeast cells and suspension of yeast cells as controls. The results indicate that the immobilization procedure in LentiKat® carriers has a negligible effect on cell viability and growth. The apparent specific growth rate of cells released in medium was comparable to that of freely suspended cells, implying preserved cell vitality. A series of batch fermentations performed in shaken flasks and an air-lift bioreactor indicated that the immobilized cells retained high fermentation activity. The full attenuation in green beer was reached after 48 hours in shaken flasks and less than 24 hours of fermentation in gas-lift bioreactors.

  17. Rainforest pharmacopeia in Madagascar provides high value for current local and prospective global uses.

    Directory of Open Access Journals (Sweden)

    Christopher D Golden

    Full Text Available Botanical diversity provides value to humans through carbon sequestration, air and water purification, and the provisioning of wild foods and ethnomedicines. Here we calculate the value of botanical ethnomedicines in a rainforest region of Madagascar, the Makira Protected Area, using a substitution method that combines replacement costs and choice modeling. The Makira watershed may comprise approximately 0.8% of global botanical diversity and possesses enormous value both in its ability to provision botanical ethnomedicines to local people and as a source of potentially novel pharmaceutical drugs for society as a whole. Approximately 241 locally-recognized species are used as ethnomedicines, including 113 agricultural or weed species. We equated each ethnomedicinal treatment to the monetary value of a comparable pharmaceutical treatment adjusted by personal preferences in perceived efficacy (rather than from known or assumed medicinal equivalency. The benefit value of these botanical ethnomedicines per individual is $5.40-7.90 per year when using the value of highly subsidized Malagasy pharmaceuticals and $100.60-287.40 when using the value of American pharmaceuticals. Using local pharmaceuticals as substitutes, the value per household is $30.24-44.30 per year, equivalent to 43-63% of median annual household income, demonstrating their local importance. Using the value of American pharmaceuticals, the amount is equivalent to 22-63% of the median annual health care expenditures for American adults under 45 in 2006. The potential for developing novel biomedicines from the Makira watershed's unique flora ranges in untapped benefit value from $0.3-5.7 billion for American pharmaceutical companies, non-inclusive of the importance of providing novel medicines and improved healthcare to society. This study provides evidence of the tremendous current local and prospective global value of botanical ethnomedicines and furthers arguments for the

  18. San Juan Fracture Characterization Project: Status and current results

    Energy Technology Data Exchange (ETDEWEB)

    Majer, E.L.; Daley, T.M.; Myer, L.R.; Nihei, K.; Queen, J.; Sinton, J.; Murphy, J.; Fortuna, M.; Lynn, H.B.; Imhoff, M.A.; Wilson, R.


    The overall objectives of this report are to extend current state-of-the-art 3-D imaging to extract the optimal information for fracture quantification and to develop next generation capability in fracture imaging for true 3-D imaging of the static and dynamic fracture properties.

  19. Effect of a laboratory result pager on provider behavior in a neonatal intensive care unit. (United States)

    Samal, L; Stavroudis, Ta; Miller, Re; Lehmann, Hp; Lehmann, Cu


    A computerized laboratory result paging system (LRPS) that alerts providers about abnormal results ("push") may improve upon active laboratory result review ("pull"). However, implementing such a system in the intensive care setting may be hindered by low signal-to-noise ratio, which may lead to alert fatigue. To evaluate the impact of an LRPS in a Neonatal Intensive Care Unit. Utilizing paper chart review, we tallied provider orders following an abnormal laboratory result before and after implementation of an LRPS. Orders were compared with a predefined set of appropriate orders for such an abnormal result. The likelihood of a provider response in the post-implementation period as compared to the pre-implementation period was analyzed using logistic regression. The provider responses were analyzed using logistic regression to control for potential confounders. The likelihood of a provider response to an abnormal laboratory result did not change significantly after implementation of an LRPS. (Odds Ratio 0.90, 95% CI 0.63-1.30, p-value 0.58) However, when providers did respond to an alert, the type of response was different. The proportion of repeat laboratory tests increased. (26/378 vs. 7/278, p-value = 0.02). Although the laboratory result pager altered healthcare provider behavior in the Neonatal Intensive Care Unit, it did not increase the overall likelihood of provider response.

  20. Deep penetrating eddy current for copper canister inspection. Main results

    Energy Technology Data Exchange (ETDEWEB)

    Tadeusz Stepinski [TSonic, Uppsala (Sweden)


    The aim of this project was to optimize the detection and characterization of deep flaws (voids) in copper plates. Two types of voids were investigated and compared: circular and rectangular. The circular voids had the form of cylindrical cavities while the rectangular ones were cavities with a rectangular cross section. All probes were of the same type, transmit-receive transducers with four pick-ups connected in a double differential configuration. Comparison of the EC responses to circular and rectangular voids obtained using the MDF12 probe has shown that both types of voids can be characterized using phase and amplitude of their responses in the complex impedance plane. Phase of the response in the impedance plane appeared to be a reliable measure of void depth. Phase dependence on the void depth is linear (which agrees with the theory) and its slope is approx -37 deg/mm. Magnitude of the EC response contains information on the void size provided that the void depth is known. It has been shown that magnitude of the EC responses is correlated to the lengths of the rectangular voids and hole diameter, this is, similar lengths and diameters result in similar response magnitudes. It should be noted, however, that multi-differential MDF probes generate responses with different shapes for circular and rectangular voids. First, shapes of the MDF probe responses in the impedance plane depend on the probe's orientation with respect to scanning direction. Second, they also depend upon the direction of scanning with respect to the void orientation. The measurements presented in this report were performed for the probe axis aligned along with the scanning direction and, in case of rectangular voids, for scanning direction along the void lengths. Comparison of the responses obtained from flat bottom holes in copper material taken from different canister parts has not shown any essential differences between the material samples. Conductivity measurement performed using

  1. Characteristics of genomic test consumers who spontaneously share results with their health care provider. (United States)

    Darst, Burcu F; Madlensky, Lisa; Schork, Nicholas J; Topol, Eric J; Bloss, Cinnamon S


    The purpose of this study was to evaluate the characteristics of direct-to-consumer (DTC) genomic test consumers who spontaneously shared their test results with their health care provider. Utilizing data from the Scripps Genomic Health Initiative, we compared demographic, behavioral, and attitudinal characteristics of DTC genomic test consumers who shared their results with their physician or health care provider versus those who did not share. We also compared genomic risk estimates between the two groups. Of 2,024 individuals assessed at approximately 6 months post testing, 540 individuals (26.5%) reported sharing their results with their physician or health care provider. Those who shared were older (p consumers.

  2. Test results of the 18 kA EDIPO HTS current leads

    Energy Technology Data Exchange (ETDEWEB)

    Wesche, Rainer, E-mail: [Ecole Polytechnique Federale de Lausanne (EPFL), Centre de Recherches en Physique des Plasmas (CRPP), Association Euratom - Confederation Suisse, 5232 Villigen PSI (Switzerland); Bagnasco, Maurizio; Bruzzone, Pierluigi; Felder, Roland; Guetg, Marc; Holenstein, Manuel; Jenni, Markus; March, Stephen; Roth, Felix; Vogel, Martin [Ecole Polytechnique Federale de Lausanne (EPFL), Centre de Recherches en Physique des Plasmas (CRPP), Association Euratom - Confederation Suisse, 5232 Villigen PSI (Switzerland)


    For the new test facility EDIPO (European DIPOle), to be hosted by CRPP, two 18 kA HTS current leads were manufactured and successfully tested. The HTS module, made of AgMgAu/Bi-2223 tapes, is cooled only by heat conduction to the cold end, while the copper part is cooled by forced flow helium gas. The current leads were tested at low voltage up to the maximum current of 18 kA. The helium mass flow rates required for stable operation at various currents were determined. In addition to the steady state operation, the transient behavior in the case of a loss of flow was studied experimentally. The test results provide an estimate of the operational limits of the EDIPO HTS current leads.

  3. Current concepts, classification, and results in short stem hip arthroplasty. (United States)

    Falez, Francesco; Casella, Filippo; Papalia, Matteo


    Various short hip stems have been introduced with differing implant concepts of femoral fixation and implant length. There is a lack of proper classification for short hip stems, with a clear and accepted definition for implant length and extent of bone preservation in the metaphyseal and diaphyseal femur. This study analyzed the length of short hip stems. Stems were divided into collum, partial collum, and trochanter-sparing implants. An additional category was added, trochanter harming, which was defined as interruption of the circumferential integrity of the femoral neck. For all of the femoral components described, the designs were compared, excluding stems with insufficient clinical data. The 15 finally selected stems were classified as collum (1 stem), partial collum (7 stems), trochanter sparing (4 stems), and trochanter harming (3 stems). Mid-term results (>5 years of follow-up) were available for only 3 designs in the partial collum group. Taking into account the results of short-term studies (<5 years of follow-up), the femoral revision rate per 100 observed component years was <1 for most total hip arthroplasties. However, the studies varied greatly regarding level of significance, and short hip stems without published results are available commercially. Short hip stems cannot be circumscribed by a simple length limit. For some designs, clinical data collected from large patient cohorts showed a survivorship comparable to traditional stems. In cases that must be revised, this often can be performed with a conventional primary stem, fulfilling the promise to preserve bone for potential future revisions in younger patients.

  4. New results on inclusive nu Fe charged current interactions

    CERN Document Server

    Abramowicz, H; De Groot, J G H; Dydak, F; Eisele, F; Flottmann, T; Geweniger, C; Guyot, C; He, J T; Klasen, H; Kleinknecht, K; Knobloch, J; Królikowski, J; Lierl, H; May, J; Merlo, J P; Palazzi, P; Para, A; Peyaud, B; Pszola, B; Rander, J; Ranjard, F; Rothberg, J E; Ruan, T Z; Schlatter, W D; Schuller, J P; Steinberger, J; Tittel, K; Turlay, René; von Rüden, Wolfgang; Wahl, H; Willutzki, H J; Wotschack, J; Wu, W M


    Based on 60000(25000) nu ( nu ) events obtained recently in the CERN 200 GeV narrow band neutrino beam, the authors present new results on the nucleon structure functions F/sub 2/(x, Q/sup 2/) and xF/sub 3/(x, Q/sup 2/) and on the Callan Gross relation. The observed scaling violations of F/sub 2/ and xF/sub 3/ are interpreted in terms of QCD. The strong coupling constant alpha /sub s/ is measured in agreement with the QCD predicted behaviour. (8 refs).

  5. Primary care providers' knowledge, beliefs and treatment practices for gout: results of a physician questionnaire. (United States)

    Harrold, Leslie R; Mazor, Kathleen M; Negron, Amarie; Ogarek, Jessica; Firneno, Cassandra; Yood, Robert A


    We sought to examine primary care providers' gout knowledge and reported treatment patterns in comparison with current treatment recommendations. We conducted a national survey of a random sample of US primary care physicians to assess their treatment of acute, intercritical and tophaceous gout using published European and American gout treatment recommendations and guidelines as a gold standard. There were 838 respondents (response rate of 41%), most of whom worked in private practice (63%) with >16 years experience (52%). Inappropriate dosing of medications in the setting of renal disease and lack of prophylaxis when initiating urate-lowering therapy (ULT) accounted for much of the lack of compliance with treatment recommendations. Specifically for acute podagra, 53% reported avoidance of anti-inflammatory drugs in the setting of renal insufficiency, use of colchicine at a dose of ≤2.4 mg/day and no initiation of a ULT during an acute attack. For intercritical gout in the setting of renal disease, 3% would provide care consistent with the recommendations, including initiating a ULT at the appropriate dose with dosing titration to a serum urate level of ≤6 mg/dl and providing prophylaxis. For tophaceous gout, 17% reported care consistent with the recommendations, including ULT use with dosing titration to a serum urate level of ≤6 mg/dl and prophylaxis. Only half of primary care providers reported optimal treatment practices for the management of acute gout and gout, suggesting that care deficiencies are common.

  6. Stemless shoulder arthroplasty-current results and designs. (United States)

    Churchill, R Sean; Athwal, George S


    Stemless shoulder arthroplasty was originally introduced in 2004 by a single manufacturer. Now, over a decade later, numerous designs are available outside the USA, but as yet, only one implant has been cleared by the Food and Drug Administration (FDA) and is available for use within the USA. Often referred to as "canal sparing," these implants are designed for metaphyseal fixation to minimize humeral bone removal, avoid intraoperative and postoperative humeral fracture complications, and to decrease morbidity associated with revision operations. Recently, the second generation of stemless arthroplasty, a convertible implant allowing use in either anatomic or reverse arthroplasty configuration, was released for use outside the USA. This paper will review the available designs, reported results, and raise potential concerns for this emerging technology.

  7. Patient and provider perceptions of care for diabetes: results of the cross-national DAWN Study

    DEFF Research Database (Denmark)

    Peyrol, Mark; Rubin, Richard R.; Lauritzen, Torsten


    Aims/hypothesis We assessed country-level and individual-level patterns in patient and provider perceptions of diabetes care. Methods The study used a cross-sectional design with face-to-face or telephone interviews of diabetic patients and healthcare providers in 13 countries from Asia, Australia......, Europe and North America. Participants were randomly selected adults with type 1 or type 2 diabetes (n=5,104), and randomly selected diabetes-care providers, including primary-care physicians (n=2,070), diabetes specialist physicians (n=635) and nurses (n=1,122). Multivariate analysis was used to examine...... the relationships between outcomes and both country and respondent characteristics, and the interaction between these two factors. Results Providers rated chronic-care systems and remuneration for chronic care as mediocre. Patients reported that ease of access to care was high, but not without financial barriers...

  8. Diagnostic imaging, a "parallel" discipline. Can current technology provide a reliable digital diagnostic radiology department? (United States)

    Moore, C J; Eddleston, B


    Only recently has any detailed criticism been voiced about the practicalities of the introduction of generalised, digital, imaging complexes in diagnostic radiology. Although attendant technological problems are highlighted we argue that the fundamental causes of current difficulties are not in the generation but in the processing, filing and subsequent retrieval for display of digital image records. In the real world, looking at images is a parallel process of some complexity and so it is perhaps untimely to expect versatile handling of vast image data bases by existing computer hardware and software which, by their current nature, perform tasks serially. Successes in applying new imaging devices using digital technology, numerical methods and more easily available computing power are directing radiology towards the concept of all-digital departmental complexes. Hence a critical discussion of fundamental problems should be encouraged, to promote a thorough understanding of what may be involved (Gray et al, 1984) in following such a course. It is equally important to gain some perspective about the development possibilities for existing, commercially available equipment being offered to the medical community.

  9. Prominent medical journals often provide insufficient information to assess the validity of studies with negative results

    Directory of Open Access Journals (Sweden)

    Dittus Robert S


    Full Text Available Abstract Background Physicians reading the medical literature attempt to determine whether research studies are valid. However, articles with negative results may not provide sufficient information to allow physicians to properly assess validity. Methods We analyzed all original research articles with negative results published in 1997 in the weekly journals BMJ, JAMA, Lancet, and New England Journal of Medicine as well as those published in the 1997 and 1998 issues of the bimonthly Annals of Internal Medicine (N = 234. Our primary objective was to quantify the proportion of studies with negative results that comment on power and present confidence intervals. Secondary outcomes were to quantify the proportion of these studies with a specified effect size and a defined primary outcome. Stratified analyses by study design were also performed. Results Only 30% of the articles with negative results comment on power. The reporting of power (range: 15%-52% and confidence intervals (range: 55–81% varied significantly among journals. Observational studies of etiology/risk factors addressed power less frequently (15%, 95% CI, 8–21% than did clinical trials (56%, 95% CI, 46–67%, p Conclusion Prominent medical journals often provide insufficient information to assess the validity of studies with negative results.

  10. Assessment of community healthcare providers ability and willingness to respond to emergencies resulting from bioterrorist attacks

    Directory of Open Access Journals (Sweden)

    Crane Jeffery


    Full Text Available Introduction: Previous findings have demonstrated that preparedness and planning within the public health system are inadequately developed to respond to an act of biological or chemical terrorism. Methods:This investigation used Internet-based surveys to assess the level of preparedness (PL and willingness to respond (WTR to a bioterrorism attack, and identify factors that predict PL and WTR among Florida community healthcare providers. Invitations were sent to 22,800 healthcare providers in Florida, which resulted in 2,279 respondents. Results: Respondents included physicians (n=604, nurses (n=1,152, and pharmacists (n=486. The results indicated that only 32% of Florida healthcare providers were competent and willing to respond to a bioterrorism attack, 82.7% of providers were willing to respond in their local community, and 53.6% within the State. Respondents were more competent in administrative skills than clinical knowledge (62.8% vs. 45%. Areas in which respondents had the highest competency were the initiation of treatment and recognition of their clinical and administrative roles. Areas in which respondents showed the lowest competency were the ability to identify cases and the ability to communicate risk to others. About 55% of the subjects had previous bioterrorism training and 31.5% had conducted emergency drills. Gender, race, previous training and drills, perceived threats of bioterrorism attack, perceived benefits of training and drills, and feeling prepared were all predictors of overall preparedness. Conclusions: The findings suggest that only one-third of Florida community healthcare providers were prepared for a bioterrorism attack, which is an insufficient response rate to effectively respond to a bioterrorism incident.

  11. A structured assessment of emergency and acute care providers in Afghanistan during the current conflict. (United States)

    Rashid, Leeda; Afzali, Edris; Donaldson, Ross; Lazar, Paul; Bundesmann, Raghnild; Rashid, Samra


    Afghanistan has struggled with several decades of well-documented conflict, increasing the importance of providing emergency services to its citizens. However, little is known about the country's capacity to provide such care. Three native-speaking Afghan-American physicians performed an assessment of emergency care via combined quantitative and qualitative survey tools. Hospitals in Kabul, Afghanistan were selected based on probability proportional to size methodology, in which size was derived from prior work in the country and permission granted by the administering agency and the Ministry of Health. A written survey was given to physicians and nurses, followed by structured focus groups, and multiple days of observation per facility. A descriptive analysis was performed and data analyzed through a combination of variables in eight overarching categories relevant to emergency care. One hundred twenty-five surveys were completed from 9 hospitals. One third of respondents (32.8 %) worked full time in the emergency departments, with another 28.8 % working there at least three quarters of the time. Over 63 % of providers believed that the greatest delay for care in emergencies was in the prehospital setting. Differences were noted among the various types of facilities when looking at specific components of emergency care such as skill level of workers, frequencies of assaults in the hospitals, and other domains of service provision. Sum of squares between the different facility types were highest for areas of skill (SS = 210.3; p = .001), confidence in the system (SS = 156.5; p < .005), assault (SS = 487.6; p < .005), and feeling safe in the emergency departments (SS = 193.1, p < .005). Confidence negatively correlated to frequency of assaults (Pearson r = -.33; p < .005) but positively correlated with feeling safe (Pearson r = .51; p < .005) and reliability of equipment (Pearson r = .48; p < .005). The only correlation for access to services was prehospital care

  12. S'COOL Provides Research Opportunities and Current Data for Today's Technological Classroom (United States)

    Green, Carolyn J.; Chambers, Lin H.; Racel, Anne M.


    NASA's Students' Cloud Observations On-Line (S'COOL) project, a hands-on educational project, was an innovative idea conceived by the scientists in the Radiation Sciences Branch at NASA Langley Research Center, Hampton, Virginia, in 1996. It came about after a local teacher expressed the idea that she wanted her students to be involved in real-life science. S'COOL supports NASA's Clouds and the Earth's Radiant Energy System (CERES) instrument, which was launched on the Tropical Rainforest Measuring Mission (TRMM) in November, 1997, as part of NASA's Earth Science Enterprise. With the S'COOL project students observe clouds and related weather conditions, compute data and note vital information while obtaining ground truth observations for the CERES instrument. The observations can then be used to help validate the CERES measurements, particularly detection of clear sky from space. In addition to meeting math, science and geography standards, students are engaged in using the computer to obtain, report and analyze current data, thus bringing modern technology into the realm of classroom, a paradigm that demands our attention.

  13. Training pediatric health care providers in prevention of dental decay: results from a randomized controlled trial

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    Zeldin Leslie P


    Full Text Available Abstract Background Physicians report willingness to provide preventive dental care, but optimal methods for their training and support in such procedures are not known. This study aimed to evaluate the effect of three forms of continuing medical education (CME on provision of preventive dental services to Medicaid-enrolled children by medical personnel in primary care physician offices. Methods Practice-based, randomized controlled trial. Setting: 1,400 pediatric and family physician practices in North Carolina providing care to an estimated 240,000 Medicaid-eligible children aged 0–3 years. Interventions: Group A practices (n = 39 received didactic training and course materials in oral health screening, referral, counseling and application of fluoride varnish. Group B practices (n = 41 received the same as Group A and were offered weekly conference calls providing advice and support. Group C practices (n = 41 received the same as Group B and were offered in-office visit providing hands-on advice and support. In all groups, physicians were reimbursed $38–$43 per preventive dental visit. Outcome measures were computed from reimbursement claims submitted to NC Division of Medical Assistance. Primary outcome measure: rate of preventive dental services provision per 100 well-child visits. Secondary outcome measure: % of practices providing 20 or more preventive dental visits. Results 121 practices were randomized, and 107 provided data for analysis. Only one half of Group B and C practices took part in conference calls or in-office visits. Using intention-to-treat analysis, rates of preventive dental visits did not differ significantly among CME groups: GroupA = 9.4, GroupB = 12.9 and GroupC = 8.5 (P = 0.32. Twenty or more preventive dental visits were provided by 38–49% of practices in the three study groups (P = 0.64. Conclusion A relatively high proportion of medical practices appear capable of adopting these preventive dental services

  14. Legal and regulatory challenges currently facing diabetes treatment providers and related durable medical equipment suppliers. (United States)

    Liles, Robert


    It has been estimated that 24 million Americans have diabetes, many of whom are Medicare beneficiaries. These individuals carefully monitor their blood glucose levels primarily through the use of in-home blood glucose testing kits. Although the test is relatively simple, the cumulative expense of providing glucose test strips and lancets to patients is ever increasing, both to the Medicare program and to uninsured individuals who must pay out-of-pocket for these testing supplies. This article discusses the diabetes durable medical equipment (DME) coverage under Part B Medicare, the establishment and role of DME Medicare administrative contractors, and national and local coverage requirements for diabetes DME suppliers. This article also discusses the federal government's ongoing concerns regarding the improper billing of diabetes testing supplies. To protect the Medicare Trust Fund, the federal government has contracted with multiple private entities to conduct reviews and audits of questionable Medicare claims. These private sector contractors have conducted unannounced site visits of DME supplier offices, interviewed patients and their families, placed suppliers on prepayment review, and conducted extensive postpayment audits of prior paid Medicare claims. In more egregious administrative cases, Medicare contractors have recommended that problematic providers and/or DME suppliers have their Medicare numbers suspended or, in some instances, revoked. More serious infractions can lead to civil or criminal liability. In the final part of this article, we will examine the future of enforcement efforts by law enforcement and Medicare contractors and the importance of understanding and complying with federal laws when ordering and supplying diabetes testing strips and lancets.

  15. Becoming a health literate organization: Formative research results from healthcare organizations providing care for undeserved communities. (United States)

    Adsul, Prajakta; Wray, Ricardo; Gautam, Kanak; Jupka, Keri; Weaver, Nancy; Wilson, Kristin


    Background Integrating health literacy into primary care institutional policy and practice is critical to effective, patient centered health care. While attributes of health literate organizations have been proposed, approaches for strengthening them in healthcare systems with limited resources have not been fully detailed. Methods We conducted key informant interviews with individuals from 11 low resourced health care organizations serving uninsured, underinsured, and government-insured patients across Missouri. The qualitative inquiry explored concepts of impetus to transform, leadership commitment, engaging staff, alignment to organization wide goals, and integration of health literacy with current practices. Findings Several health care organizations reported carrying out health literacy related activities including implementing patient portals, selecting easy to read patient materials, offering community education and outreach programs, and improving discharge and medication distribution processes. The need for change presented itself through data or anecdotal staff experience. For any change to be undertaken, administrators and medical directors had to be supportive; most often a champion facilitated these changes in the organization. Staff and providers were often resistant to change and worried they would be saddled with additional work. Lack of time and funding were the most common barriers reported for integration and sustainability. To overcome these barriers, managers supported changes by working one on one with staff, seeking external funding, utilizing existing resources, planning for stepwise implementation, including members from all staff levels and clear communication. Conclusion Even though barriers exist, resource scarce clinical settings can successfully plan, implement, and sustain organizational changes to support health literacy.

  16. The role of kaizen in creating radical performance results in a logistics service provider

    Directory of Open Access Journals (Sweden)

    Erez Agmoni


    Full Text Available Background: This study investigates the role of an incremental change in organizational process in creating radical performance results in a service provider company. The role of Kaizen is established prominently in manufacturing, but is nascent in service applications. This study examines the impact of introducing Kaizen as an ODI tool-how it is applied, how it works, and whether participants believe it helps service groups form more effective working relationships that result in significant performance improvements. Methods: Exploring the evolving role of Kaizen in service contexts, this study explores a variety of facets of human communication in the context of continuous improvement and teamwork inter-organizationally. The paper consists of an archival study and an action research case study. A pre-intervention study consisting of observations, interviews, and submission of questionnaires to employees of a manufacturing and air-sea freight firm was conducted. A Kaizen intervention occurred subsequently, and a post-intervention study was then conducted. Results: Radical improvements in both companies such as 30% financial growth, 81% productivity improvement and more are demonstrated in this paper. Conclusions: Findings offer unique insights into the effects of Kaizen in creating radical performance improvements in a service company and its customer. Both qualitative and quantitative results of business, satisfaction, and productivity suggest time invested in introducing Kaizen into a service organization helps the companies improve relationships and improve the bottom line dramatically.

  17. Seascape genomics provides evidence for thermal adaptation and current-mediated population structure in American lobster (Homarus americanus). (United States)

    Benestan, Laura; Quinn, Brady K; Maaroufi, Halim; Laporte, Martin; Clark, Fraser K; Greenwood, Spencer J; Rochette, Rémy; Bernatchez, Louis


    Investigating how environmental features shape the genetic structure of populations is crucial for understanding how they are potentially adapted to their habitats, as well as for sound management. In this study, we assessed the relative importance of spatial distribution, ocean currents and sea surface temperature (SST) on patterns of putatively neutral and adaptive genetic variation among American lobster from 19 locations using population differentiation (PD) approaches combined with environmental association (EA) analyses. First, PD approaches (using bayescan, arlequin and outflank) found 28 outlier SNPs putatively under divergent selection and 9770 neutral SNPs in common. Redundancy analysis revealed that spatial distribution, ocean current-mediated larval connectivity and SST explained 31.7% of the neutral genetic differentiation, with ocean currents driving the majority of this relationship (21.0%). After removing the influence of spatial distribution, no SST were significant for putatively neutral genetic variation whereas minimum annual SST still had a significant impact and explained 8.1% of the putatively adaptive genetic variation. Second, EA analyses (using Pearson correlation tests, bayescenv and lfmm) jointly identified seven SNPs as candidates for thermal adaptation. Covariation at these SNPs was assessed with a spatial multivariate analysis that highlighted a significant temperature association, after accounting for the influence of spatial distribution. Among the 505 candidate SNPs detected by at least one of the three approaches, we discovered three polymorphisms located in genes previously shown to play a role in thermal adaptation. Our results have implications for the management of the American lobster and provide a foundation on which to predict how this species will cope with climate change.

  18. Preferences for results from genomic microarrays: comparing parents and health care providers. (United States)

    Turbitt, E; Halliday, J L; Amor, D J; Metcalfe, S A


    Chromosomal microarray (CMA) testing is now performed frequently in paediatric care. Although CMAs improve diagnostic yields, they increase detection of variants of unknown and uncertain clinical significance (VUS). Understanding parents', paediatricians' and genetic health professionals' (GHPs) views regarding variant disclosure may reduce the potential for communication of unwanted information. A questionnaire was designed to compare disclosure preferences of these three groups in Australia. One hundred and forty-seven parents, 159 paediatricians and 69 GHPs hold similar views with at least 89% of respondents certainly or probably favouring disclosure of all categories of variants. However, some differences were observed between health care providers (HCPs: paediatricians and GHPs) and parents, who were less sure of their disclosure preferences. There was consensus among respondent groups that knowledge of a variant of certain clinical significance would provide more practical and emotional utility compared to VUS. Compared to HCPs, parents placed more emphasis on using knowledge of a VUS when considering future pregnancies (p exome/genome sequencing is integrated into clinical practice, the potential for differing views of parents and HCPs should be considered when developing guidelines for result disclosure.

  19. The state of multiple sclerosis: current insight into the patient/health care provider relationship, treatment challenges, and satisfaction

    Directory of Open Access Journals (Sweden)

    Tintoré M


    Full Text Available Mar Tintoré,1 Maggie Alexander,2 Kathleen Costello,3 Martin Duddy,4 David E Jones,5 Nancy Law,6 Gilmore O’Neill,7 Antonio Uccelli,8 Robert Weissert,9 Sibyl Wray10 1Multiple Sclerosis Centre of Catalonia, Hospital Vall d’Hebron, Barcelona, Spain; 2European Multiple Sclerosis Platform, Brussels, Belgium; 3National Multiple Sclerosis Society, Denver, CO, USA; 4Royal Victoria Infirmary, Newcastle-upon-Tyne, UK; 5Department of Neurology, University of Virginia, Charlottesville, VA, USA; 6Nancy Law Consulting LLC, Parker, CO, USA; 7Biogen, Cambridge, MA, USA; 8Centre of Excellence for Biomedical Research, University of Genoa, Genoa, Italy; 9Department of Neurology, University of Regensburg, Regensburg, Germany; 10Hope Neurology Multiple Sclerosis Center, Knoxville, TN, USA Background: Managing multiple sclerosis (MS treatment presents challenges for both patients and health care professionals. Effective communication between patients with MS and their neurologist is important for improving clinical outcomes and quality of life. Methods: A closed-ended online market research survey was used to assess the current state of MS care from the perspective of both patients with MS (≥18 years of age and neurologists who treat MS from Europe and the US and to gain insight into perceptions of treatment expectations/goals, treatment decisions, treatment challenges, communication, and satisfaction with care, based on current clinical practice. Results: A total of 900 neurologists and 982 patients completed the survey, of whom 46% self-identified as having remitting-relapsing MS, 29% secondary progressive MS, and 11% primary progressive MS. Overall, patients felt satisfied with their disease-modifying therapy (DMT; satisfaction related to comfort in speaking with their neurologist and participation in their DMT decision-making process. Patients who self-identified as having relapsing-remitting MS were more likely to be very satisfied with their treatment

  20. The state of multiple sclerosis: current insight into the patient/health care provider relationship, treatment challenges, and satisfaction (United States)

    Tintoré, Mar; Alexander, Maggie; Costello, Kathleen; Duddy, Martin; Jones, David E; Law, Nancy; O’Neill, Gilmore; Uccelli, Antonio; Weissert, Robert; Wray, Sibyl


    Background Managing multiple sclerosis (MS) treatment presents challenges for both patients and health care professionals. Effective communication between patients with MS and their neurologist is important for improving clinical outcomes and quality of life. Methods A closed-ended online market research survey was used to assess the current state of MS care from the perspective of both patients with MS (≥18 years of age) and neurologists who treat MS from Europe and the US and to gain insight into perceptions of treatment expectations/goals, treatment decisions, treatment challenges, communication, and satisfaction with care, based on current clinical practice. Results A total of 900 neurologists and 982 patients completed the survey, of whom 46% self-identified as having remitting-relapsing MS, 29% secondary progressive MS, and 11% primary progressive MS. Overall, patients felt satisfied with their disease-modifying therapy (DMT); satisfaction related to comfort in speaking with their neurologist and participation in their DMT decision-making process. Patients who self-identified as having relapsing-remitting MS were more likely to be very satisfied with their treatment. Top challenges identified by patients in managing their DMT were cost, side effects/tolerability of treatment, and uncertainty if treatment was working. Half of the patients reported skipping doses, but only 68% told their health care provider that they did so. Conclusion Several important differences in perception were identified between patients and neurologists concerning treatment selection, satisfaction, expectations, goals, and comfort discussing symptoms, as well as treatment challenges and skipped doses. The study results emphasize that patient/neurologist communication and patient input into the treatment decision-making process likely influence patient satisfaction with treatment. PMID:28053511

  1. Results of an Iridium-Based Data Communication System Providing Internet Access to Polar Expeditions (United States)

    Mohammad, A.; Frost, V.; Braaten, D.


    ' W) from June 23-July 17, 2003. We measured the reliability, throughput and general performance of this system over periods of up to 24 hours. This included delay, loss, throughput, call drops/up-time, relative signal strengths, connection time and number of connection retries. The system was also successfully tested while moving across the ice sheet at speeds of up to 30 km/h. We were successful in uploading and downloading large files (.2MB to 7.2MB) to the Internet. In combination with a modified Wi-Fi deployment, wireless Internet access was also provided to the entire NorthGRIP camp for a few days. The field experiments have shown that standard Internet protocols combined with MLPPP and Iridium modems can provide Internet access for polar expeditions at useful data rates. The 4-modem configuration we tested was observed to be >90 % efficient, e.g., a 2.5 MB video file was transferred in 35 min. at 9.524 Kb/s. The system had an average up-time of over 90 % and thus is stable and suitable for autonomous operation. Mobile performance results were very similar to that of stationary systems. While the end-to-end network architecture developed to provide Internet access worked well, the system round trip time is significant ( ˜ 1.8 seconds), which can impair real time interactions.

  2. Design and initial results from a supported education initiative: the Kansas Consumer as Provider program. (United States)

    McDiarmid, Diane; Rapp, Charles; Ratzlaff, Sarah


    Despite increased attention to consumer-providers, there remains a lack of models that prepare, support, and sustain consumers in provider roles. This article describes the Consumer as Provider (CAP) Training program at the University of Kansas School of Social Welfare, which creates opportunities for individuals with severe psychiatric disabilities to develop knowledge and skills to be effective as human service providers. CAP fosters a partnership between colleges and community mental health centers where students experience classroom and internship activities. Outcome from a 2-year longitudinal study on CAP graduates indicates increased employability, especially in social services field, and higher post-secondary educational involvement.

  3. Results of Current Density Distribution Mapping in PEM Fuel Cells Dependent on Operation Parameters

    Directory of Open Access Journals (Sweden)

    Zbigniew A. Styczynski


    Full Text Available This paper presents in situ measurements of a newly developed current density measurement system for proton exchange membrane fuel cells (PEMFC. While the functional principle and technical evaluation of the measurement system were presented in a previous paper, this paper analyzes the influence of various operation parameters, including multiple start-stop operation, at the anode, cathode and cooling locations on the distribution and long-term development of the current density. The system was operated for 500 h over two years with long periods of inactivity between measurements. The measurement results are evaluated and provide additional information on how to optimize the operation modes of fuel cells, including the start and stop of such systems as well as the water balance.

  4. Spinal Cord Stimulation Provides Pain Relief with Improved Psychosocial Function: Results from EMP3OWER. (United States)

    Rosenberg, Jason; Fabi, Alain; Candido, Kenneth; Knezevic, Nick; Creamer, Michael; Carayannopoulos, Alexios; Ghodsi, Abdi; Nelson, Christopher; Bennett, Matthew


    The EMP(3)OWER™ study evaluated spinal cord stimulation (SCS) safety and efficacy and the associated changes in psychosocial and functional outcomes. Upon informed consent and IRB approval, 620 eligible subjects were enrolled prior to SCS trial evaluation and were assessed at baseline, 3, 6 and 12 months post-implant. Patient-reported pain relief (PRP), numerical rating scale (NRS), satisfaction, quality of life (QOL), and pain disability index (PDI) were assessed at all follow-up visits while the pain catastrophizing scale (PCS), short form-36 (SF-36), short form-McGill pain questionnaire version 2 (SF-MPQ-2), and the state-trait anxiety inventory (STAI) were assessed at the 6- and 12-month follow-up visits. Device and/or procedure-related adverse events were also recorded and reported. Subjects reporting a PRP ≥ 50% were considered responders. Repeated measures analysis of variance (RMANOVA) examined the changes across time for all continuous measures. A total of 401 (71%) subjects received a permanent implant. Mean (±SD) patient-reported pain relief was 59.3% (±26.2), 59.2% (±28.9), and 58.2% (±32.0) at 3, 6, and 12 months, respectively. A majority of enrolled subjects were responders at 3 (75.5%), 6 (74.7%), and 12 months (69.7%). RMANOVA revealed a statistically significant change for NRS, PCS, PDI, SF-36, SF-MPQ-2, and STAI scores. At 3 months, the majority of subjects (85.7%) were either very satisfied or satisfied with their device, with similar results at 6 and 12 months. At 3 months, the majority of subjects (73.3%) reported greatly improved or improved QOL with similar results at 6 and 12 months. Spinal cord stimulation provided pain relief and significant improvement of patient psychological and functional outcome measures. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail:

  5. Measuring Physical Inactivity: Do Current Measures Provide an Accurate View of “Sedentary” Video Game Time?

    Directory of Open Access Journals (Sweden)

    Simon Fullerton


    Full Text Available Background. Measures of screen time are often used to assess sedentary behaviour. Participation in activity-based video games (exergames can contribute to estimates of screen time, as current practices of measuring it do not consider the growing evidence that playing exergames can provide light to moderate levels of physical activity. This study aimed to determine what proportion of time spent playing video games was actually spent playing exergames. Methods. Data were collected via a cross-sectional telephone survey in South Australia. Participants aged 18 years and above (n=2026 were asked about their video game habits, as well as demographic and socioeconomic factors. In cases where children were in the household, the video game habits of a randomly selected child were also questioned. Results. Overall, 31.3% of adults and 79.9% of children spend at least some time playing video games. Of these, 24.1% of adults and 42.1% of children play exergames, with these types of games accounting for a third of all time that adults spend playing video games and nearly 20% of children’s video game time. Conclusions. A substantial proportion of time that would usually be classified as “sedentary” may actually be spent participating in light to moderate physical activity.

  6. School health promotion providers' roles in practice and theory: results from a case study. (United States)

    Teutsch, Friedrich; Gugglberger, Lisa; Dür, Wolfgang


    Implementation is critical to the success of health promotion (HP) in schools, but little is known about how schools can best be assisted during this process. This article focuses on Austrian HP providers and aspects their roles incorporate. To investigate the providers' role in the practice of HP implementation and how it differs from its official description. On the basis of these findings, implications are suggested. The data were gathered within the framework of an explorative case study of complex HP interventions. We draw on four interviews with HP organisation staff, five documents from the providers' organisations and seven interviews with school staff from three schools. In practice, providers took up different responsibilities, e.g., acting as emotional support to school staff and supporting the documentation of projects, guided more by the schools' needs than by the programmes they are helping to implement. Providers focused mostly on the implementation of single activities and did little to emphasize the necessity of organisational change. Our findings suggest that providers' background in health should be complemented by a deeper understanding of the importance of organisational change to further support HP implementation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  7. Colorectal cancer screening practices of primary care providers: results of a national survey in Malaysia. (United States)

    Norwati, Daud; Harmy, Mohamed Yusoff; Norhayati, Mohd Noor; Amry, Abdul Rahim


    The incidence of colorectal cancer has been increasing in many Asian countries including Malaysia during the past few decades. A physician recommendation has been shown to be a major factor that motivates patients to undergo screening. The present study objectives were to describe the practice of colorectal cancer screening by primary care providers in Malaysia and to determine the barriers for not following recommendations. In this cross sectional study involving 132 primary care providers from 44 Primary Care clinics in West Malaysia, self-administered questionnaires which consisted of demographic data, qualification, background on the primary care clinic, practices on colorectal cancer screening and barriers to colorectal cancer screening were distributed. A total of 116 primary care providers responded making a response rate of 87.9%. About 21% recommended faecal occult blood test (FOBT) in more than 50% of their patients who were eligible. The most common barrier was "unavailability of the test". The two most common patient factors are "patient in a hurry" and "poor patient awareness". This study indicates that colorectal cancer preventive activities among primary care providers are still poor in Malaysia. This may be related to the low availability of the test in the primary care setting and poor awareness and understanding of the importance of colorectal cancer screening among patients. More awareness programmes are required for the public. In addition, primary care providers should be kept abreast with the latest recommendations and policy makers need to improve colorectal cancer screening services in health clinics.

  8. Treatment of gastric outlet obstruction that results fromunresectable gastric cancer: Current evidence

    Institute of Scientific and Technical Information of China (English)


    Malignant gastric outlet obstruction (GOO) is a commoncondition that results from locally advanced malignanciesin the upper gastrointestinal tract, such aspancreatic, gastric, and other carcinomas. Two typesof procedures for malignant GOO, namely, gastrojejunostomy(GJ) with laparotomy or a laparoscopicapproach and endoscopic stenting (ES), are currentlyavailable. Although numerous previous reports haveclarified the benefits and drawbacks of each procedure,whether GJ or ES should be used in patients with GOOthat results from gastric cancer who may have a longerlife expectancy than patients with other malignancieshas not been determined. In this review, which focuseson gastric cancer-induced GOO, we analyzed the twosystematic reviews and a meta-analysis that comparedGJ and ES and outlined the current status of GOOtreatment. We also provide an updated review thatincludes laparoscopic GJ. Various data from 13 studiesin one review and 6 studies in another review wereanalyzed. Although the main results of the presentreview indicated that both GJ and ES were efficacioustreatments in patients with GOO that resulted fromgastric cancer, current evidence suggests that GJ maybe the preferable procedure given its good performancestatus and improved prognosis in gastric cancer patients.

  9. HIV knowledge and attitudes among providers in aging: results from a national survey. (United States)

    Hughes, Anne K


    Within 5 years, half the U.S. HIV-infected population will be over age 50, and providers caring for older adults must deal with this reality. This study assessed attitudes toward people with HIV/AIDS and knowledge of HIV/AIDS among physicians with a geriatrics specialty, and nurses and social workers who specialize in gerontology. A survey mailed in 2008 to a random sample of U.S. providers yielded a 60% response rate. Main outcome measures included: Knowledge of HIV/AIDS, attitudes toward people with HIV/AIDS, and knowledge of issues related to HIV in older adults. General knowledge of HIV/AIDS was good with scores of 89%, 84%, and 81% for physicians, nurses, and social workers, respectively; groups differed significantly (F(2, 483)=18.626, page 50 varied widely; few answered correctly, with no significant differences by professional group (F(2,319)=2.82, p=0.06). These findings highlight the need for further education among providers who specialize in aging.

  10. Who continues to stock oral artemisinin monotherapy? Results of a provider survey in Myanmar. (United States)

    Thein, Si Thu; Sudhinaraset, May; Khin, Hnin Su Su; McFarland, Willi; Aung, Tin


    Artemisinin-based combination therapy (ACT) is a key strategy for global malaria elimination efforts. However, the development of artemisinin-resistant malaria parasites threatens progress and continued usage of oral artemisinin monotherapies (AMT) predisposes the selection of drug resistant strains. This is particularly a problem along the Myanmar/Thailand border. The artemisinin monotherapy replacement programme (AMTR) was established in 2012 to remove oral AMT from stocks in Myanmar, specifically by replacing oral AMT with quality-assured ACT and conducting behavioural change communication activities to the outlets dispensing anti-malarial medications. This study attempts to quantify the characteristics of outlet providers who continue to stock oral AMT despite these concerted efforts. A cross-sectional survey of all types of private sector outlets that were stocking anti-malarial drugs in 13 townships of Eastern Myanmar was implemented from July to August 2014. A total of 573 outlets were included. Bivariate and multivariable logistic regressions were conducted to assess outlet and provider-level characteristics associated with stocking oral AMT. In total, 2939 outlets in Eastern Myanmar were screened for presence of any anti-malarial drugs in August 2014. The study found that 573 (19.5 %) had some kind of oral anti-malarial drug in stock at the time of survey and among them, 96 (16.8 %) stocked oral AMT. In bivariate analyses, compared to health care facilities, itinerant drug vendors, retailers and health workers were less likely to stock oral AMT (33.3 vs 12.9, 10.0, 8.1 %, OR = 0.30, 0.22, 0.18, respectively). Providers who cut blister pack or sell partial courses (40.6 vs 11.7 %, OR 5.18, CI 3.18-8.44) and those who based their stock decision on consumer demand (32.8 vs 12.1 %, OR 3.54, CI 2.21-5.63) were more likely to stock oAMT. Multivariate logistic regressions produced similar significant associations. Private healthcare facilities and drug

  11. Test Results For a 25-m Prototype Fault Current Limiting HTS Cable for Project Hydra

    Energy Technology Data Exchange (ETDEWEB)

    Rey, Christopher M [ORNL; Duckworth, Robert C [ORNL; Demko, Jonathan A [ORNL; Ellis, Alvin R [ORNL; Gouge, Michael J [ORNL; James, David Randy [ORNL; Tuncer, Enis [ORNL


    The Oak Ridge National Laboratory (ORNL) has tested a 25-m long prototype High Temperature Superconducting (HTS) cable with inherent Fault-Current Limiting (FCL) capability at its recently upgraded HTS cable test facility in Oak Ridge, TN. The HTS-FCL cable and terminations were designed and fabricated by Ultera, which is a joint venture of Southwire and nkt cables with FCL features and HTS wire provided by American Superconductor Corporation. The overall project is sponsored by the U.S. Department of Homeland Security. The ultimate goal of the 25-m HTS-FCL cable test program was to verify the design and ensure the operational integrity for the eventual installation of a ~ 200-m fully functional HTS-FCL cable in the Consolidated Edison electric grid located in downtown New York City. The 25-m HTS-FCL cable consisted of a three-phase (3- ) Triax design with a cold dielectric between the phases. The HTS-FCL cable had an operational voltage of 13.8 kV phase-to-phase and an operating current of 4000 Arms per phase, which is the highest operating current to date of any HTS cable. The 25-m HTS-FCL cable was subjected to a series of cryogenic and electrical tests. Test results from the 25-m HTS-FCL cable are presented and discussed.

  12. Education in naturopathy and western herbal medicine in Australia: results of a survey of education providers. (United States)

    McCabe, Pauline


    Questions about the risks and regulatory requirements of naturopathy and western herbal medicine (WHM) in Australia prompted research by the Department of Human Services Victoria. This article offers findings from a survey of education providers, which was one of several studies carried out for the report. (The full report can be found at Questionnaires were sent to 43 Australian providers of naturopathy and WHM education. Unsustainable variation was found in award types, contact hours, clinical education, length of courses, and course content. Naturopaths and WHM practitioners are primary contact health professionals but educational standards vary widely, with some practitioners not likely to be adequately prepared. The degree of risk in their practice, and the need for better integration of complementary care with mainstream healthcare, require education at least to the level of a bachelor degree. Courses should be subject to independent external accreditation. However, attempts to determine appropriate minimum educational standards are unlikely to succeed without the support of a regulatory system that can mandate those minimum requirements.

  13. Technological insights: Combined impedance manometry for esophageal motility testing-current results and further implications

    Institute of Scientific and Technical Information of China (English)

    Huan Nam Nguyen; Gerson Ricardo Souza Domingues; Frank Lammert


    This review focuses on current aspects of the novel technology of combined impedance manometry for esophageal motility testing. It presents methodological features, summarizes current results and discusses implications for further research. The combined technique assesses simultaneously bolus transport and associated peristalsis, thus allowing detailed analysis of the relationships between bolus transit and esophageal motility. Recent studies demonstrate that combined impedance manometry provides important additional information about esophageal motility as compared to conventional manometry: (1) monitoring of bolus transport patterns, (2) calculation of bolus transit parameters, (3) evaluation of bolus clearance,(4) monitoring of swallow associated events such as air movement and reflux, and (5) investigation of the relationships between bolus transit and LES relaxation.Studies with healthy subjects have identified several useful parameters for comprehensive assessment of eosphageal function. These parameters were found to be pathological in patients with classical achalasia,mild GERD, and ineffective esophageal motility. The technology of combined impedance manometry provides an important new tool for esophageal function testing,advancing both clinical and basic research. However,several important issues remain to be standardized to make the technique suitable for widely clinical use.

  14. The changing health care marketplace: current industry trends, new provider organizational structures, and effects on plastic surgeons. (United States)

    Krieger, L M


    Current market forces are driving the health care industry in new directions. The managed care industry is currently undergoing a market shakeout, as manifested by consolidation, increased competition, and lower profits. Medicare is fighting to remain solvent by lowering fees paid to providers, driving patients into managed care plans, and cracking down on billing irregularities. For providers, the combined effect of these trends is lower fees, increased risk-sharing, and increased overhead. Plastic surgeons face new demands in this environment. They must increase their efficiency and form new alliances with other providers. These alliances allow plastic surgeons to maintain a steady stream of patients, to manage risk, to negotiate more lucrative contracts with managed care organizations, and to increase efficiency. To achieve these alliances, plastic surgeons must alter the organizational structure of their practices. Several corporate practice models are becoming more prevalent; these include large group practices, physician practice management companies, and integrated delivery systems. Each structure has advantages for plastic surgeons, but each also requires plastic surgeons to trade varying degrees of financial and professional autonomy for market strength.

  15. A modifiable microarray-based universal sensor: providing sample-to-results automation. (United States)

    Yasmin, Rubina; Zhu, Hui; Chen, Zongyuan; Montagna, Richard A


    A microfluidic system consisting of generic single use cartridges which interface with a workstation allows the automatic performance of all necessary sample preparation, PCR analysis and interpretation of multiplex PCR assays. The cartridges contain a DNA array with 20 different 16mer DNA "universal" probes immobilized at defined locations. PCR amplicons can be detected via hybridization of user-defined "reporter" probes that are complementary at their 3' termini to one or more of the universal probes and complementary to the target amplicons at their 5' termini. The system was able to detect single-plex and multiplex PCR amplicons from various infectious agents as well as wild type and mutant alleles of single nucleotide polymorphisms. The system's ease of use was further demonstrated by converting a published PCR assay for the detection of Mycobacterium genitalium in a fully automated manner. Excellent correlation between traditional manual methods and the automated analysis performed by the workstation suggests that the system can provide a means to easily design and implement a variety of customized PCR-based assays. The system will be useful to researchers or clinical investigators seeking to develop their own user defined assays. As the U.S. FDA continues to pursue regulatory oversight of LDTs, the system would also allow labs to continue to develop compliant assays.

  16. Direct Measurement of Tree Height Provides Different Results on the Assessment of LiDAR Accuracy

    Directory of Open Access Journals (Sweden)

    Emanuele Sibona


    Full Text Available In this study, airborne laser scanning-based and traditional field-based survey methods for tree heights estimation are assessed by using one hundred felled trees as a reference dataset. Comparisons between remote sensing and field-based methods were applied to four circular permanent plots located in the western Italian Alps and established within the Alpine Space project NewFor. Remote sensing (Airborne Laser Scanning, ALS, traditional field-based (indirect measurement, IND, and direct measurement of felled trees (DIR methods were compared by using summary statistics, linear regression models, and variation partitioning. Our results show that tree height estimates by Airborne Laser Scanning (ALS approximated to real heights (DIR of felled trees. Considering the species separately, Larix decidua was the species that showed the smaller mean absolute difference (0.95 m between remote sensing (ALS and direct field (DIR data, followed by Picea abies and Pinus sylvestris (1.13 m and 1.04 m, respectively. Our results cannot be generalized to ALS surveys with low pulses density (<5/m2 and with view angles far from zero (nadir. We observed that the tree heights estimation by laser scanner is closer to actual tree heights (DIR than traditional field-based survey, and this was particularly valid for tall trees with conical shape crowns.

  17. Tree Mortality Undercuts Ability of Tree-Planting Programs to Provide Benefits: Results of a Three-City Study

    Directory of Open Access Journals (Sweden)

    Sarah Widney


    Full Text Available Trees provide numerous benefits for urban residents, including reduced energy usage, improved air quality, stormwater management, carbon sequestration, and increased property values. Quantifying these benefits can help justify the costs of planting trees. In this paper, we use i-Tree Streets to quantify the benefits of street trees planted by nonprofits in three U.S. cities (Detroit, Michigan; Indianapolis, Indiana, and Philadelphia, Pennsylvania from 2009 to 2011. We also use both measured and modeled survival and growth rates to “grow” the tree populations 5 and 10 years into the future to project the future benefits of the trees under different survival and growth scenarios. The 4059 re-inventoried trees (2864 of which are living currently provide almost $40,000 (USD in estimated annual benefits ($9–$20/tree depending on the city, the majority (75% of which are increased property values. The trees can be expected to provide increasing annual benefits during the 10 years after planting if the annual survival rate is higher than the 93% annual survival measured during the establishment period. However, our projections show that with continued 93% or lower annual survival, the increase in annual benefits from tree growth will not be able to make up for the loss of benefits as trees die. This means that estimated total annual benefits from a cohort of planted trees will decrease between the 5-year projection and the 10-year projection. The results of this study indicate that without early intervention to ensure survival of planted street trees, tree mortality may be significantly undercutting the ability of tree-planting programs to provide benefits to neighborhood residents.

  18. Effect of the semi-conductive properties of the passive layer on the current provided by stainless steel microbial cathodes

    Energy Technology Data Exchange (ETDEWEB)

    Pons, Liz; Delia, Marie-Line; Basseguy, Regine [Laboratoire de Genie Chimique, CNRS - Universite de Toulouse, 4 allee Emile Monso BP 84234, 31030 Toulouse (France); Bergel, Alain, E-mail: alain.bergel@ensiacet.f [Laboratoire de Genie Chimique, CNRS - Universite de Toulouse, 4 allee Emile Monso BP 84234, 31030 Toulouse (France)


    Geobacter sulfurreducens biofilms were formed under constant polarisation at -0.6 V vs. Ag/AgCl on stainless steel cathodes to catalyse the reduction of fumarate. The time-evolution of the current strongly depended on the quality of the inoculum. Inoculating with young cells significantly shortened the initial lag-phase and using the same inoculum improved the reproducibility of the current-time curves. The whole set of experiments showed that 254SMO stainless steel provided higher current densities (on average 14.1 A/m{sup 2}) than biofilms formed on 316L stainless steel (on average 4.5 A/m{sup 2}). Biofilm coverage assessed by epifluorescent microscopy showed that coverage ratios were generally higher for 316L than for 254SMO. It must be concluded that 254SMO is more efficient in transferring electrons to bacterial cells than 316L. Mott-Schottky diagrams recorded on both materials under conditions of electrolysis in the absence of microorganisms showed that the surface oxide layers had similar n-type semi-conductive behaviour for potential values higher than the flat band potential. In contrast, 316L exhibited slight p-type behaviour at potential lower than the flat band potential, while 254SMO did not. The higher electrochemical performances of biocathodes formed on 254SMO are explained by semi-conductive properties of its passive layer, which prevented the p-type behaviour occurring in cathodic electrolysis conditions.

  19. Providing health information to the general public: a survey of current practices in academic health sciences libraries* (United States)

    Hollander, Sue M.


    A questionnaire was mailed to 148 publicly and privately supported academic health sciences libraries affiliated with Association of American Medical Colleges (AAMC)–accredited medical schools in the United States and Canada to determine level of access and services provided to the general public. For purposes of this study, “general public” was defined as nonaffiliated students or health care professionals, attorneys and other nonhealth-related professionals, patients from affiliated or other hospitals or clinics, and general consumers. One hundred five (71%) libraries responded. Results showed 98% of publicly supported libraries and 88% of privately supported libraries provided access to some or all of the general public. Publicly supported libraries saw greater numbers of public patrons, often provided more services, and were more likely to circulate materials from their collections than were privately supported libraries. A significant number of academic health sciences libraries housed a collection of consumer-oriented materials and many provided some level of document delivery service, usually for a fee. Most allowed the public to use some or all library computers. Results of this study indicated that academic health sciences libraries played a significant role in serving the information-seeking public and suggested a need to develop written policies or guidelines covering the services that will be provided to minimize the impact of this service on primary clientele. PMID:10658965

  20. Providing health information to the general public: a survey of current practices in academic health sciences libraries. (United States)

    Hollander, S M


    A questionnaire was mailed to 148 publicly and privately supported academic health sciences libraries affiliated with Association of American Medical Colleges (AAMC-accredited medical schools in the United States and Canada to determine level of access and services provided to the general public. For purposes of this study, "general public" was defined as nonaffiliated students or health care professionals, attorneys and other nonhealth-related professionals, patients from affiliated or other hospitals or clinics, and general consumers. One hundred five (71%) libraries responded. Results showed 98% of publicly supported libraries and 88% of privately supported libraries provided access to some or all of the general public. Publicly supported libraries saw greater numbers of public patrons, often provided more services, and were more likely to circulate materials from their collections than were privately supported libraries. A significant number of academic health sciences libraries housed a collection of consumer-oriented materials and many provided some level of document delivery service, usually for a fee. Most allowed the public to use some or all library computers. Results of this study indicated that academic health sciences libraries played a significant role in serving the information-seeking public and suggested a need to develop written policies or guidelines covering the services that will be provided to minimize the impact of this service on primary clientele.

  1. Test results of 12/18 kA ReBCO coated conductor current leads (United States)

    Kovalev, I. A.; Surin, M. I.; Naumov, A. V.; Novikov, M. S.; Novikov, S. I.; Ilin, A. A.; Polyakov, A. V.; Scherbakov, V. I.; Shutova, D. I.


    A pair of hybrid current leads (brass + stacked & soldered ReBCO tapes) rated for 12 kA in steady state and for up to 18 kA at pulsed over current conditions was designed, developed and tested at NRC ;Kurchatov Institute; (NRC ;KI;). During the experiment at LN2 temperature, the current leads (CLs) were successfully charged with 18 kA at 100 A/s ramp rate. To date, as far as we know, this is the highest current capacity achieved for 2G HTS current leads. The feasibility of ;stack-and-soldering technique; for 10 kA+ class coated conductor CLs for accelerators and fusion was demonstrated. This paper gives an overview of the leads design and presents the preliminary test results. Detailed studies of magnetic properties and current sharing process for the stacked and staggered HTS joints are also reported.

  2. Parathyroid scintigraphy protocols in Finland in 2010. Results of the query and current status

    Energy Technology Data Exchange (ETDEWEB)

    Tunninen, V. [The Dept. of Nuclear Medicine, Satakunta Central Hospital, Pori (Finland); Kauppinen, T. [HUS Helsinki Medical Imaging Centre, Helsinki Univ. Hospital (Finland); Eskola, H. [The Dept. of Biomedical Engineering, Tampere Univ. of Technology (Finland); Koskinen, M.O. [Medical Imaging Centre, Tampere Univ. Hospital (Finland)


    The goal of this study was to describe current clinical parathyroid scintigraphy (PS) protocols in Finland. Methods: All departments of nuclear medicine in Finland were contacted, and instructions regarding PS were requested. Results: Instructions regarding PS were received from all of the departments that perform PS (n = 19). Seven hundred and sixty-nine PS studies were performed in 2009 (between 7 and 209 per hospital). Three methods of PS were used. The dual-phase method with {sup 99m}Tc-sestamibi is used in seven hospitals, the dual-tracer method with {sup 123}I/{sup 99m}Tc-sestamibi in eleven, and {sup 99m}TcO{sub 4}/{sup 99m}Tc-sestamibi in one hospital. The activities of {sup 99m}Tc-sestamibi, {sup 123}I and {sup 99m}TcO{sub 4} were 150-800 MBq, 10-30 MBq and 50 MBq, respectively. The anterior image with parallel-hole collimators, the anterior image with pinhole collimator, the oblique angles with pinhole collimator, SPECT and hybrid CT with SPECT were acquired in 84%, 26%, 16%, 63%, and 42% of the hospitals, respectively. Because the imaging techniques were combined, one to four acquisitions were performed per patient. Scatter and attenuation correction were used in five protocols. A correction for crosstalk of {sup 123}I and {sup 99m}Tc gamma energies was not used, but the amount of crosstalk was decreased by using narrow or asymmetric energy windows in all dual isotope protocols. Conclusion: 19 hospitals used 18 different study protocols. Thus, significant variability exists in the current practice of PS in Finland. The protocols should be tested with known phantoms to determine any differences in sensitivities for detecting small active structures. Further studies with phantoms are needed to determine the optimal imaging techniques. The results of these phantom studies will provide guidelines for proposing national recommendations for PS. (orig.)

  3. Chronic ischaemic mitral regurgitation. Current treatment results and new mechanism-based surgical approaches

    NARCIS (Netherlands)

    Bouma, Wobbe; van der Horst, Iwan C. C.; Wijdh-den Hamer, Inez J.; Erasmus, Michiel E.; Zijlstra, Felix; Mariani, Massimo A.; Ebels, Tjark


    Chronic ischaemic mitral regurgitation (CIMR) remains one of the most complex and unresolved aspects in the management of ischaemic heart disease. This review provides an overview of the present knowledge about the different aspects of CIMR with an emphasis on mechanisms, current surgical treatment

  4. First experimental results with the Current Limit Avoidance System at the JET tokamak

    Energy Technology Data Exchange (ETDEWEB)

    De Tommasi, G. [Associazione EURATOM-ENEA-CREATE, Università di Napoli Federico II, Via Claudio 21, 80125 Napoli (Italy); Galeani, S. [Dipartimento di Informatica, Sistemi e Produzione, Università di Roma, Tor Vergata, Rome (Italy); Jachmich, S. [Association EURATOM-Belgian State, Koninklijke Militaire School - Ecole Royale Militaire, B-1000 Brussels (Belgium); Joffrin, E. [IRFM-CEA, Centre de Cadarache, 13108 Saint-paul-lez-Durance (France); Lennholm, M. [EFDA Close Support Unit, Culham Science Centre, OX14 3DB Abingdon (United Kingdom); European Commission, B-1049 Brussels (Belgium); Lomas, P.J. [Euratom-CCFE, Culham Science Centre, OX14 3DB Abingdon (United Kingdom); Neto, A.C. [Associazione EURATOM-IST, Instituto de Plasmas e Fusao Nuclear, IST, 1049-001 Lisboa (Portugal); Maviglia, F. [Associazione EURATOM-ENEA-CREATE, Via Claudio 21, 80125 Napoli (Italy); McCullen, P. [Euratom-CCFE, Culham Science Centre, OX14 3DB Abingdon (United Kingdom); Pironti, A. [Associazione EURATOM-ENEA-CREATE, Università di Napoli Federico II, Via Claudio 21, 80125 Napoli (Italy); Rimini, F.G. [Euratom-CCFE, Culham Science Centre, OX14 3DB Abingdon (United Kingdom); Sips, A.C.C. [European Commission, B-1049 Brussels (Belgium); Varano, G.; Vitelli, R. [Dipartimento di Informatica, Sistemi e Produzione, Università di Roma, Tor Vergata, Rome (Italy); Zaccarian, L. [CNRS, LAAS, 7 Avenue du Colonel Roche, F-31400 Toulouse (France); Universitè de Toulouse, LAAS, F-31400 Toulouse (France)


    The Current Limit Avoidance System (CLA) has been recently deployed at the JET tokamak to avoid current saturations in the poloidal field (PF) coils when the eXtreme Shape Controller is used to control the plasma shape. In order to cope with the current saturation limits, the CLA exploits the redundancy of the PF coils system to automatically obtain almost the same plasma shape using a different combination of currents in the PF coils. In the presence of disturbances it tries to avoid the current saturations by relaxing the constraints on the plasma shape control. The CLA system has been successfully implemented on the JET tokamak and fully commissioned in 2011. This paper presents the first experimental results achieved in 2011–2012 during the restart and the ITER-like wall campaigns at JET.

  5. Provision of contraceptive services to homeless women: results of a survey of health care for the homeless providers. (United States)

    Saver, Barry G; Weinreb, Linda; Gelberg, Lillian; Zerger, Suzanne


    Homeless women have both a higher rate of pregnancy and a higher proportion of unintended pregnancies than other American women. The authors sought to learn about contraception services offered by providers of health care to homeless women and barriers to provision of long-acting, reversible contraception in these settings. A survey of the 31 member organizations in the national Health Care for the Homeless Practice-Based Research Network was conducted, inquiring about services provided and barriers to service provision. Among the 20 responding organizations (65% response rate), 17 directly provided contraceptive services; two referred patients elsewhere, and one provided no contraceptive services. All 17 that provided such services provided condoms; 15 provided oral contraceptives; 14 provided injectable contraception; 6 provided intrauterine devices, and 2 provided contraceptive implants. Barriers to providing the last two methods included lack of provider training, lack of resources for placement, costs, and concerns about complications. The present survey results suggested very limited access for homeless women across the country to the two most effective means of long-acting, reversible contraception. Modest investments of resources could reduce a number of barriers to providing these services.


    Directory of Open Access Journals (Sweden)

    U. Batygin


    Full Text Available The technique of numerical processing of measurement results of pulse currents by means of Rogovsky belt application is offered in the given work. It is shown that at measurement of signals by digital oscillographs and further numerical transformation of target signals, the possibilities of Rogovsky belt without the application of additional devices that in turn allows to define parameters of pulse currents with any peak-time characteristics essentially expand.

  7. Stochastic slowly adapting ionic currents may provide a decorrelation mechanism for neural oscillators by causing wander in the intrinsic period. (United States)

    Norman, Sharon E; Butera, Robert J; Canavier, Carmen C


    Oscillatory neurons integrate their synaptic inputs in fundamentally different ways than normally quiescent neurons. We show that the oscillation period of invertebrate endogenous pacemaker neurons wanders, producing random fluctuations in the interspike intervals (ISI) on a time scale of seconds to minutes, which decorrelates pairs of neurons in hybrid circuits constructed using the dynamic clamp. The autocorrelation of the ISI sequence remained high for many ISIs, but the autocorrelation of the ΔISI series had on average a single nonzero value, which was negative at a lag of one interval. We reproduced these results using a simple integrate and fire (IF) model with a stochastic population of channels carrying an adaptation current with a stochastic component that was integrated with a slow time scale, suggesting that a similar population of channels underlies the observed wander in the period. Using autoregressive integrated moving average (ARIMA) models, we found that a single integrator and a single moving average with a negative coefficient could simulate both the experimental data and the IF model. Feeding white noise into an integrator with a slow time constant is sufficient to produce the autocorrelation structure of the ISI series. Moreover, the moving average clearly accounted for the autocorrelation structure of the ΔISI series and is biophysically implemented in the IF model using slow stochastic adaptation. The observed autocorrelation structure may be a neural signature of slow stochastic adaptation, and wander generated in this manner may be a general mechanism for limiting episodes of synchronized activity in the nervous system.

  8. Current Practices in Home Management of Nasogastric Tube Placement in Pediatric Patients: A Survey of Parents and Homecare Providers. (United States)

    Northington, LaDonna; Lyman, Beth; Guenter, Peggi; Irving, Sharon Y; Duesing, Lori

    Enteral feeding tubes are used in pediatric patients to deliver nutrition, fluids or medications. The literature related to short-term feeding tube (nasogastric [NG], hereafter known as NGT, or orogastric [OGT],) use in pediatric homecare patients is sparse. This descriptive study sought to gather baseline information about these children and how their feeding tubes are managed at home. Specifically, we sought to better understand how the tubes are placed and the method(s) used for tube placement verification. Two surveys were distributed: one to parents and one to homecare providers who have direct patient contact. Responses were obtained from 144 parents and 66 homecare providers. Over half of the children were 12months of age or younger and had a 6 Fr feeding tube. Over 75% (108) had an NGT for 1year or less. Predominantly parents replaced the NGT but a few children self-inserted their tubes. Feeding tube placement was verified by auscultation (44%) or measurement of gastric pH (25%) in the parent's survey. Twenty-six percent of parents indicated they had misplaced an NGT at least once and 35 parents described symptoms of pulmonary misplacement. The homecare provider data indicated auscultation (39%) and pH measurement of gastric contents (28%) to verify NG tube placement location. Study results confirms a need for consistency of practice among health care professionals and in parent education for those children who require NGTs at home. It is troubling that auscultation is still widely used for NGT location confirmation despite practice alerts that warn against its use. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. The α-gliadin genes from Brachypodium distachyon L. provide evidence for a significant gap in the current genome assembly. (United States)

    Chen, G X; Lv, D W; Li, W D; Subburaj, S; Yu, Z T; Wang, Y J; Li, X H; Wang, K; Ye, X G; Ma, Wujun; Yan, Y M


    Brachypodium distachyon, is a new model plant for most cereal crops while gliadin is a class of wheat storage proteins related with wheat quality attributes. In the published B. distachyon genome sequence databases, no gliadin gene is found. In the current study, a number of gliadin genes in B. distachyon were isolated, which is contradictory to the results of genome sequencing projects. In our study, the B. distachyon seeds were found to have no gliadin protein expression by gel electrophoresis, reversed-phase high-performance liquid chromatography and Western blotting analysis. However, Southern blotting revealed a presence of more than ten copies of α-gliadin coding genes in B. distachyon. By means of AS-PCR amplification, four novel full-ORF α-gliadin genes, and 26 pseudogenes with at least one stop codon as well as their promoter regions were cloned and sequenced from different Brachypodium accessions. Sequence analysis revealed a few of single-nucleotide polymorphisms among these genes. Most pseudogenes were resulted from a C to T change, leading to the generation of TAG or TAA in-frame stop codon. To compare both the full-ORFs and the pseudogenes among Triticum and Triticum-related species, their structural characteristics were analyzed. Based on the four T cell stimulatory toxic epitopes and two ployglutamine domains, Aegilops, Triticum, and Brachypodium species were found to be more closely related. The phylogenetic analysis further revealed that B. distachyon was more closely related to Aegilops tauschii, Aegilops umbellulata, and the A or D genome of Triticum aestivum. The α-gliadin genes were able to express successfully in E. coli using the functional T7 promoter. The relative and absolute quantification of the transcripts of α-gliadin genes in wheat was much higher than that in B. distachyon. The abundant pseudogenes may affect the transcriptional and/or posttranscriptional level of the α-gliadin in B. distachyon.

  10. Participation in a trauma-focused epidemiological investigation may result in sensitization for current health problems

    NARCIS (Netherlands)

    Verschuur, M.J.; Spinhoven, Ph.; van Emmerik, A.A.P.; Rosendaal, F.R.


    Objectives - Participation in health survey research may result in a worsening of self-assessed health status and enhanced service-use by increasing self-awareness of current health status. The present study investigated whether participation in a traumafocused epidemiological study sensitized parti

  11. Harmonic Analysis of Currents and Voltages Obtained in the Result of Computational Experiment

    Directory of Open Access Journals (Sweden)

    I. V. Novash


    Full Text Available The paper considers a methodology for execution of a harmonic analysis of current and voltage numerical values obtained in the result of a computational experiment and saved in an external data file. The harmonic analysis has been carried out in the Mathcad mathematical packet environment.

  12. Current Arabian Plate Motion From Campaign GPS Measurements in Saudi Arabia: Preliminary Results (United States)

    Almuslmani, B.; Teferle, F. N.; Bingley, R. M.; Moore, T.


    Current investigations of the motions of the Arabian and its neighboring plates are primarily based on GPS measurements obtained in the surrounding areas of the Arabian plate, with few stations actually located on the Arabian plate itself in the Kingdom of Saudi Arabia. In order to advance the knowledge of the dynamics of the Arabian plate and its intra-plate deformations, the General Directorate of Military Survey (GDMS), through collaboration with the Institute of Engineering Surveying and Space Geodesy (IESSG), densified the GPS network in Saudi Arabia, covering nearly two thirds of the tectonic plate. Since July 2002, a network of 32 GPS stations has been established at locations of the Saudi Arabia geodetic network. At all of these GPS stations a concrete pillar has been used as the monument and the locations have been selected in order to give the broadest distribution of observing sites. During 2005, 27 additional GPS stations in the Hejaz and Asser Mountains, and the Farasan Islands, all in south-western Saudi Arabia, have been established, for which the past and future campaign GPS measurements will provide valuable data for investigations of crustal deformations close to the plate boundaries between the Nubia, Somalian and Arabian plates. In this presentation we will show results in the form of velocity field and plate motion estimates based on data from at least three campaigns occupying the initial 32 GDMS GPS network stations, but also from a number of IGS stations in the region. Our reference frame is aligned to ITRF2005 and uses approximately 40 IGS reference frame stations located on all major tectonic plates, e.g. Nubia and Somalia, surrounding the Arabian plate. Furthermore, we apply absolute satellite and receiver antenna phase center models together with newly available GPS products from a recent global re-processing effort.

  13. Targeting adults who provide alcohol to underage youth: results from a national survey of local law enforcement agencies. (United States)

    Jones-Webb, Rhonda; Toomey, Traci L; Lenk, Kathleen M; Nelson, Toben F; Erickson, Darin J


    We investigated what local enforcement agencies are doing to target adults who provide alcohol to underage youth; what types of enforcement activities are being conducted to target adult providers; and factors that encourage enforcement activities that target adult providers. We surveyed 1,056 local law enforcement agencies in the US and measured whether or not the agency conducted enforcement activities that target adults who provide alcohol to underage youth. We also measured whether certain agency and jurisdiction characteristics were associated with enforcement activities that target adults who provide alcohol to underage youth. Less than half (42%) of local enforcement agencies conducted enforcement efforts targeting adults who provide alcohol to underage youth. Agencies that conducted the enforcement activities targeting adult providers were significantly more likely to have a full time officer specific to alcohol enforcement, a division specific to alcohol enforcement, a social host law, and to perceive underage drinking was very common. Results suggest that targeting social providers (i.e., adults over 21 years of age) will require greater law enforcement resources, implementation of underage drinking laws (e.g., social host policies), and changing perceptions among law enforcement regarding underage drinking. Future studies are needed to identify the most effective enforcement efforts and to examine how enforcement efforts are prospectively linked to alcohol consumption.

  14. Current research and future directions in pattern identification: Results of an international symposium. (United States)

    Lee, Myeong Soo; Lee, Ju Ah; Alraek, Terje; Bian, Zhao-Xiang; Birch, Stephen; Goto, Hirozo; Jung, Jeeyoun; Kao, Shung-Te; Moon, Sang-Kwan; Park, Bongki; Park, Kyung-Mo; You, Sooseong; Yun, Kyung-Jin; Zaslawski, Chris


    A symposium on pattern identification (PI) was held at the Korea Institute of Oriental Medicine (KIOM) on October 2, 2013, in Daejeon, South Korea. This symposium was convened to provide information on the current research in PI as well as suggest future research directions. The participants discussed the nature of PI, possible research questions, strategies and future international collaborations in pattern research. With eight presentations and an extensive panel discussion, the symposium allowed participants to discuss research methods in traditional medicine for PI. One speaker presented the topic, 'Clinical pattern differentiation and contemporary research in PI.' Two speakers presented current trends in research on blood stasis while the remaining five other delegates discussed the research methods and future directions of PI research. The participants engaged in in-depth discussions regarding the nature of PI, potential research questions, strategies and future international collaborations in pattern research.

  15. Business Intelligence. A Presentation of the Current Lead Solutions and a Comparative Analysis of the Main Providers

    Directory of Open Access Journals (Sweden)

    Bogdan-Andrei IONESCU


    Full Text Available The aim of this paper is to synthesize the concepts behind Business Intelligence, by studying the solutions available on the market provided by the main players. We will present the software solutions already provided by them emphasizing the main advantages and benefits of each of them, but also as a comparative analysis, designed to reveal the area in which each provider is more remarkable than the others.

  16. A Failure Mode in Dense Infrared Detector Arrays Resulting in Increased Dark Current (United States)

    Pinkie, Benjamin; Bellotti, Enrico


    In this paper, we investigate a failure mode that arises in dense infrared focal plane detector arrays as a consequence of the interactions of neighboring pixels through the minority carrier profiles in the common absorber layer. We consider the situation in which one pixel in a hexagonal array becomes de-biased relative to its neighbors and show that the dark current in the six neighboring pixels increases exponentially as a function of the difference between the nominal and anomalous biases. Moreover, we show that the current increase in the six nearest-neighbor pixels is in total larger than that by which the current in the affected pixel decreases, causing a net increase in the dark current. The physical origins of this effect are explained as being due to increased lateral diffusion currents that arise as a consequence of breaking the symmetry of the minority carrier profiles. We then perform a parametric study to quantify the magnitude of this effect for a number of detector geometric parameters, operating temperatures, and spectral bands. Particularly, numerical simulations are carried out for short-, mid-, and long-wavelength HgCdTe infrared detectors operating between 77 K and 210 K. We show that this effect is most prevalent in architectures for which the lateral diffusion current is the largest component of the total dark current—high operating temperature devices with narrow epitaxial absorber thicknesses and pitches small compared to the diffusion length of minority carriers. These results could prove significant particularly for short- and mid-wave infrared detectors, which are typically designed to fit these conditions.

  17. Experimental results of current distribution in Rutherford-type LHC cables

    CERN Document Server

    Verweij, A P


    Current distribution among the wires of multi-strand superconducting cables is an important item for accelerator magnets. A non-uniform distribution could cause additional field distortions in the magnet bore and can as well be one of the reasons of premature quenching. Since two years electrical measurements on superconducting Rutherford-type cables are performed at CERN as part of the reception tests for the Large Hadron Collider (LHC). Cable samples of 2.4 m length are tested at currents up to 32 kA, temperatures around 1.9 and 4.3 K, and fields up to 10 T, applied perpendicularly as well as parallel to the broad face of the cable. Last year, an array of 24 Hall probes was installed in the test set-up in order to measure the self-field of the cable samples along one cable pitch. Each of the probes measures the local field generated by the current in the strands close by, and the results of the all probes reflect therefore the distribution of the strand currents. Experiments are done varying the applied fie...

  18. Current treatment for venom-induced consumption coagulopathy resulting from snakebite.

    Directory of Open Access Journals (Sweden)

    Kalana Maduwage


    Full Text Available Venomous snakebite is considered the single most important cause of human injury from venomous animals worldwide. Coagulopathy is one of the commonest important systemic clinical syndromes and can be complicated by serious and life-threatening haemorrhage. Venom-induced consumption coagulopathy (VICC is the commonest coagulopathy resulting from snakebite and occurs in envenoming by Viperid snakes, certain elapids, including Australian elapids, and a few Colubrid (rear fang snakes. Procoagulant toxins activate the clotting pathway, causing a broad range of factor deficiencies depending on the particular procoagulant toxin in the snake venom. Diagnosis and monitoring of coagulopathy is problematic, particularly in resource-poor countries where further research is required to develop more reliable, cheap clotting tests. MEDLINE and EMBASE up to September 2013 were searched to identify clinical studies of snake envenoming with VICC. The UniPort database was searched for coagulant snake toxins. Despite preclinical studies demonstrating antivenom binding toxins (efficacy, there was less evidence to support clinical effectiveness of antivenom for VICC. There were no placebo-controlled trials of antivenom for VICC. There were 25 randomised comparative trials of antivenom for VICC, which compared two different antivenoms (ten studies, three different antivenoms (four, two or three different doses or repeat doses of antivenom (five, heparin treatment and antivenom (five, and intravenous immunoglobulin treatment and antivenom (one. There were 13 studies that compared two groups in which there was no randomisation, including studies with historical controls. There have been numerous observational studies of antivenom in VICC but with no comparison group. Most of the controlled trials were small, did not use the same method for assessing coagulopathy, varied the dose of antivenom, and did not provide complete details of the study design (primary outcomes

  19. Results of many-year subsatellite measurements of current fine structure in northeastern Black Sea (United States)

    Lavrova, Olga; Krayushkin, Evgeny; Kalashnikova, Nina

    Results of subsatellite measurements of coastal currents in the shelf zone of northeastern Black Sea are presented. The measurements have been performed every year since 2006 in June and September-October months near the Gelendzhik Bay. The main instruments used are Acoustic Doppler Current Profilers (ADCP) and CTD probes. Ground and ship measurements were conducted simultaneously with satellite imaging in microwave (ASAR Envisat, ERS-2, RADARSAT-2, TerraSAR-X), visible and infrared (OLI Landsat-8, ETM+ Landsat-7, TM Landsat-5, MODIS Terra/Aqua, AVHRR NOAA) ranges. The investigations performed revealed spatial, depth and temporal variability of current direction and velocity in the shelf zone. Multiple instances of counter-currents opposing to the Ring Current were registered. In our view, they are associated with a passage of small-scale anticyclonic eddies across the region of interest. The 3D structure of the eddies in the upper quasi-uniform layer was analyzed based on ADCP data. The use of high resolution (3 m) SAR data in combination with ADCP measurements at the resolution of 0.5 m allowed us to detect a number of internal wave trains. Form ADCP and thermistors records, their amplitudes were estimated to reach 5-8 m. Joint analysis of satellite SAR and subsatellite data gave an assessment of their typical wavelength at 90-100 m. Generation mechanisms of these internal waves are suggested. Another phenomenon of interest observed in the region of the measurements is surface manifestations of ring waves near localized natural and anthropogenic generation sources. Such ring waves are most frequently found in the anchor area for ships, whose oscillations can be the source of their generation. The work was in part supported by the Russian Foundation for Basic Research (projects #14-05-00520-а, and 13-07-12017-ofi_m). SAR data from RADARSAT-2 and TerraSAR-X were obtained under SOAR RADARSAT-2/TerraSAR-X Project #5074.

  20. Current situation of depression healthcare in Spain: results of a psychiatrists' survey

    Directory of Open Access Journals (Sweden)

    Belén Martín-Águeda


    Full Text Available Objective: To analyze the current situation of healthcare for depression in Spain, according to psychiatrists opinion, and how it has evolved over the last 20 years, comparativily with the results reported in previous studies of our group. Methods: Throughout 2002, we recorded the opinions of 101 specialists in psychiatry after asking them to fill out structured questionnaires in which they rated care, clinical, therapeutic and care quality. Results: The presence of depressive disorders in healthcare is substantial, despite the high figures for "concealed epidemiology", with an increase in these last 20 years of disorders comorbid with anxiety. Currently, most patients arrive at the psychiatrist having been referred by their general practitioners (GP, as there is now less reluctance in depressive patients to such referral. In the last years there has been an increase in pharmacological treatment, with adverse effects of the drugs representing the major obstacle to non-adherence to such treatment. Selective serotonin reuptake inhibitors (SSRIs constitute the pharmacological group of choice, and are the drugs most commonly used in the treatment of depression, together with venlafaxine. Areas where there is a need for improvement are time devoted to consultation, coordination between GPs and psychiatrists, waiting lists, and resources available to Mental Health Units. Conclusions: Current situation of depression healthcare in Spain has substantially changed in recent years, improving in some aspects, thanks, in part, to the attitudes of GPs with this disorder and to evolution of pharmacological treatment.

  1. Quality metrics currently used in academic radiology departments: results of the QUALMET survey. (United States)

    Walker, Eric A; Petscavage-Thomas, Jonelle M; Fotos, Joseph S; Bruno, Michael A


    We present the results of the 2015 quality metrics (QUALMET) survey, which was designed to assess the commonalities and variability of selected quality and productivity metrics currently employed by a large sample of academic radiology departments representing all regions in the USA. The survey of key radiology metrics was distributed in March-April of 2015 via personal e-mail to 112 academic radiology departments. There was a 34.8% institutional response rate. We found that most academic departments of radiology commonly utilize metrics of hand hygiene, report turn around time (RTAT), relative value unit (RVU) productivity, patient satisfaction and participation in peer review. RTAT targets were found to vary widely. The implementation of radiology peer review and the variety of ways in which peer review results are used within academic radiology departments, the use of clinical decision support tools and requirements for radiologist participation in Maintenance of Certification also varied. Policies for hand hygiene and critical results communication were very similar across all institutions reporting, and most departments utilized some form of missed case/difficult case conference as part of their quality and safety programme, as well as some form of periodic radiologist performance reviews. Results of the QUALMET survey suggest many similarities in tracking and utilization of the selected quality and productivity metrics included in our survey. Use of quality indicators is not a fully standardized process among academic radiology departments. Advances in knowledge: This article examines the current quality and productivity metrics in academic radiology.

  2. Iterative reconstruction for quantitative computed tomography analysis of emphysema: consistent results using different tube currents

    Directory of Open Access Journals (Sweden)

    Yamashiro T


    Full Text Available Tsuneo Yamashiro,1 Tetsuhiro Miyara,1 Osamu Honda,2 Noriyuki Tomiyama,2 Yoshiharu Ohno,3 Satoshi Noma,4 Sadayuki Murayama1 On behalf of the ACTIve Study Group 1Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Okinawa, Japan; 2Department of Radiology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan; 3Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan; 4Department of Radiology, Tenri Hospital, Tenri, Nara, Japan Purpose: To assess the advantages of iterative reconstruction for quantitative computed tomography (CT analysis of pulmonary emphysema. Materials and methods: Twenty-two patients with pulmonary emphysema underwent chest CT imaging using identical scanners with three different tube currents: 240, 120, and 60 mA. Scan data were converted to CT images using Adaptive Iterative Dose Reduction using Three Dimensional Processing (AIDR3D and a conventional filtered-back projection mode. Thus, six scans with and without AIDR3D were generated per patient. All other scanning and reconstruction settings were fixed. The percent low attenuation area (LAA%; < -950 Hounsfield units and the lung density 15th percentile were automatically measured using a commercial workstation. Comparisons of LAA% and 15th percentile results between scans with and without using AIDR3D were made by Wilcoxon signed-rank tests. Associations between body weight and measurement errors among these scans were evaluated by Spearman rank correlation analysis. Results: Overall, scan series without AIDR3D had higher LAA% and lower 15th percentile values than those with AIDR3D at each tube current (P<0.0001. For scan series without AIDR3D, lower tube currents resulted in higher LAA% values and lower 15th percentiles. The extent of emphysema was significantly different between each pair among scans when not using AIDR3D (LAA%, P<0.0001; 15th percentile, P<0.01, but was not

  3. Test result communication in primary care: a survey of current practice. (United States)

    Litchfield, Ian; Bentham, Louise; Lilford, Richard; McManus, Richard J; Hill, Ann; Greenfield, Sheila


    The number of blood tests ordered in primary care continues to increase and the timely and appropriate communication of results remains essential. However, the testing and result communication process includes a number of participants in a variety of settings and is both complicated to manage and vulnerable to human error. In the UK, guidelines for the process are absent and research in this area is surprisingly scarce; so before we can begin to address potential areas of weakness there is a need to more precisely understand the strengths and weaknesses of current systems used by general practices and testing facilities. We conducted a telephone survey of practices across England to determine the methods of managing the testing and result communication process. In order to gain insight into the perspectives from staff at a large hospital laboratory we conducted paired interviews with senior managers, which we used to inform a service blueprint demonstrating the interaction between practices and laboratories and identifying potential sources of delay and failure. Staff at 80% of practices reported that the default method for communicating normal results required patients to telephone the practice and 40% of practices required that patients also call for abnormal results. Over 80% had no fail-safe system for ensuring that results had been returned to the practice from laboratories; practices would otherwise only be aware that results were missing or delayed when patients requested results. Persistent sources of missing results were identified by laboratory staff and included sample handling, misidentification of samples and the inefficient system for collating and resending misdirected results. The success of the current system relies on patients both to retrieve results and in so doing alert staff to missing and delayed results. Practices appear slow to adopt available technological solutions despite their potential for reducing the impact of recurring errors in the

  4. Personnel Certification and Specialized Service Providers for Autism Spectrum Disorders. Queries: An Occasional Paper Compiling States' Approaches to Current Topics (United States)

    Danaher, Joan, Comp.; Shaw, Evelyn, Comp.; Lazara, Alex, Comp.


    In response to states' interest, NECTAC (National Early Childhood Technical Assistance Center) queried Part C and Section 619 Coordinators regarding certification or endorsements for personnel working with children diagnosed with Autism Spectrum Disorder (ASD) and how states provide services for children diagnosed with ASD. Responses were received…

  5. Nondisclosure of Smoking Status to Health Care Providers among Current and Former Smokers in the United States (United States)

    Curry, Laurel Erin; Richardson, Amanda; Xiao, Haijun; Niaura, Raymond S.


    An unintended consequence of tobacco control's success in marginalizing smoking is that smokers may conceal their smoking from those who are best positioned to help them quit: health care providers (HCPs). The purpose of this study was to identify the prevalence of, and factors related to, nondisclosure of smoking to HCPs. Data were obtained from…

  6. Current regional stress field and the resultant crustal deformation in SE Korea and their tectonic implication (United States)

    Kim, M. C.; Cho, H.; Son, M.


    To determine current regional stress field and to characterize the resultant crustal deformation in SE Korea, Quaternary fault, focal mechanism, and geotechnical in-situ stress data were synthetically analyzed. The Quaternary faults are extensively observed along major inherited fault zones and show compatible orientations with general trends of the inherited faults. Most of the Quaternary faults have a top-to-the-west thrust geometry and kinematics and show a tendency of upward-decreasing dip angle and upward-narrowing gouge zone. Slip-sense indicators and paleo-stress field reconstructions indicate that the faults resulted from reverse or transpressional faulting under an E-W compression. All the magnetic fabrics (AMS) of the fault gouges also indicate the prevailing reverse-slip faulting under an ENE-WNW compression. The dominant oblate magnetic fabrics parallel to fault plane and the degrees of anisotropy increasing in proportion to their oblatenesses indicate that the fabrics have formed by a progressive deformation due to continuous simple shear during the last reactivation stage as reverse faulting. The focal mechanism study in and around the Korean Peninsula show the horizontally clustered P-axes in ENE-WSW direction and the girdle-distributed T-axes in NNW trend. The geotechnical in-situ stress data in south Korea also show NE- or ENE-trending maximum horizontal stress. The current crustal deformation in Korea thus can be characterized by contractional structures produced under a regional E-W or ENE-WSW compression stress field, and most of the Quaternary faults resulted from the local re-activation of appropriately oriented inherited major faults. Considering the tectonic setting and structural features in Asia during the Neogene, the current stress regime is interpreted to have been caused by the cooperation of westward shallow subduction of Pacific Plate and collision of Indian and Eurasian continents since about 5-3.5 Ma.

  7. Continuous Renal Replacement Therapy: Reviewing Current Best Practice to Provide High-Quality Extracorporeal Therapy to Critically Ill Patients. (United States)

    Connor, Michael J; Karakala, Nithin


    Continuous renal replacement therapy (CRRT) use continues to expand globally. Despite improving technology, CRRT remains a complex intervention. Delivery of high-quality CRRT requires close collaboration of a multidisciplinary team including members of the critical care medicine, nephrology, nursing, pharmacy, and nutrition support teams. While significant gaps in medical evidence regarding CRRT persist, the growing evidence base supports evolving best practice and consensus to define high-quality CRRT. Unfortunately, there is wide variability in CRRT operating characteristics and limited uptake of these best practices. This article will briefly review the current best practice on important aspects of CRRT delivery including CRRT dose, anticoagulation, dialysis vascular access, fluid management, and drug dosing in CRRT. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  8. Making non-discrimination and equal opportunity a reality in Kenya's health provider education system: results of a gender analysis. (United States)

    Newman, Constance; Kimeu, Anastasiah; Shamblin, Leigh; Penders, Christopher; McQuide, Pamela A; Bwonya, Judith


    IntraHealth International's USAID-funded Capacity Kenya project conducted a performance needs assessment of the Kenya health provider education system in 2010. Various stakeholders shared their understandings of the role played by gender and identified opportunities to improve gender equality in health provider education. Findings suggest that occupational segregation, sexual harassment and discrimination based on pregnancy and family responsibilities present problems, especially for female students and faculty. To grow and sustain its workforce over the long term, Kenyan human resource leaders and managers must act to eliminate gender-based obstacles by implementing existing non-discrimination and equal opportunity policies and laws to increase the entry, retention and productivity of students and faculty. Families and communities must support girls' schooling and defer early marriage. All this will result in a fuller pool of students, faculty and matriculated health workers and, ultimately, a more robust health workforce to meet Kenya's health challenges.

  9. Living with fibromyalgia: results from the functioning with fibro survey highlight patients' experiences and relationships with health care providers

    Directory of Open Access Journals (Sweden)

    Golden A


    Full Text Available Angela Golden,1 Yvonne D'Arcy,2 Elizabeth T Masters,3 Andrew Clair3 1NP from Home, LLC, Munds Park, AZ, 2Pain Management and Palliative Care, Suburban Hospital-Johns Hopkins Medicine, Bethesda, MD, 3Pfizer, New York, NY, USA Abstract: Fibromyalgia (FM is a chronic disorder characterized by widespread pain, which can limit patients' physical function and daily activities. FM can be challenging to treat, and the treatment approach could benefit from a greater understanding of patients' perspectives on their condition and their care. Patients with FM participated in an online survey conducted in the USA that sought to identify the symptoms that had the greatest impact on patients' daily lives. The purpose of the survey was to facilitate efforts toward improving care of patients by nurse practitioners, primary care providers, and specialists, in addition to contributing to the development of new outcome measures in both clinical trials and general practice. A total of 1,228 patients with FM completed the survey, responding to specific questions pertaining to symptoms, impact of symptoms, management of FM, and the relationship with health care providers. Chronic pain was identified as the key FM symptom, affecting personal and professional relationships, and restricting physical activity, work, and social commitments. Patients felt that the severity of their condition was underestimated by family, friends, and health care providers. The results of this survey highlight the need for nurse practitioners, primary care providers, and specialists to provide understanding and support to patients as they work together to enable effective diagnosis and management of FM. Keywords: fibromyalgia, pain, survey, impact, support

  10. Overview of HIT-SI3 experiment: Simulations, Diagnostics, and Summary of Current Results (United States)

    Penna, James; Jarboe, Thomas; Nelson, Brian; Hossack, Aaron; Sutherland, Derek; Morgan, Kyle; Hansen, Chris; Benedett, Thomas; Everson, Chris; Victor, Brian


    The Helicity Injected Torus - Steady Inductive 3(HIT-SI3)experiment forms and maintains spheromaks via Steady Inductive Helicity Injection (SIHI). Three injector units allow for continuous injection of helicity into a copper flux conserver in order to sustain a spheromak. Firing of the injectors with a phase difference allows finite rotation of the plasma to provide a stabilizing effect. Simulations in the MHD code NIMROD and the fluid-model code PSI-TET provide validation and a basis for interpretation of the observed experimental data. Thompson Scattering (TS) and Far Infrared (FIR) Interferometer systems allow temperature and line-averaged density measurements to be taken. An Ion Doppler Spectroscopy (IDS) system allows measurement of the plasma rotation and velocity. HIT-SI3 data has been used for validation of IDCD predictions, in particular the projected impedance of helicity injectors according to the theory. The experimental impedances have been calculated here for the first time for different HIT-SI3 regimes. Such experimental evidence will contribute to the design of future experiments employing IDCD as a current-drive mechanism. Work supported by the D.O.E., Office of Science, Office of Fusion Science.

  11. Recombinant envelope protein (rgp90) ELISA for equine infectious anemia virus provides comparable results to the agar gel immunodiffusion. (United States)

    Reis, Jenner K P; Diniz, Rejane S; Haddad, João P A; Ferraz, Isabella B F; Carvalho, Alex F; Kroon, Erna G; Ferreira, Paulo C P; Leite, Rômulo C


    Equine infectious anemia (EIA) is an important viral infection affecting horses worldwide. The course of infection is accompanied generally by three characteristic stages: acute, chronic and inapparent. There is no effective EIA vaccine or treatment, and the control of the disease is based currently on identification of EIAV inapparent carriers by laboratory tests. Recombinant envelope protein (rgp90) was expressed in Escherichia coli and evaluated via enzyme-linked immunosorbent assay (ELISA). There was an excellent agreement (95.42%) between the ELISA results using rgp90 and agar gel immunodiffusion test results. AGID is considered the "gold-standard" serologic test for equine infectious anemia (EIA). After 1160 serum samples were tested, the relative sensitivity and specificity of the ELISA were 96.1% and 96.4%, respectively. Moreover, analysis diagnostic accuracy of the ELISA was performed. The ELISA proved robust. Furthermore, good reproducibility was observed for the negative controls and, positive controls for all plates tested. Copyright © 2011 Elsevier B.V. All rights reserved.

  12. A decade of progress providing safe abortion services in Ethiopia: results of national assessments in 2008 and 2014. (United States)

    Dibaba, Yohannes; Dijkerman, Sally; Fetters, Tamara; Moore, Ann; Gebreselassie, Hailemichael; Gebrehiwot, Yirgu; Benson, Janie


    Ethiopia has one of the highest maternal mortality ratios in the world (420 per 100,000 live births in 2013), and unsafe abortion continues to be one of the major causes. To reduce deaths and disabilities from unsafe abortion, Ethiopia liberalized its abortion law in 2005 to allow safe abortion under certain conditions. This study aimed to measure how availability and utilization of safe abortion services has changed in the last decade in Ethiopia. This paper draws on results from nationally representative health facility studies conducted in Ethiopia in 2008 and 2014. The data come from three sources at two points in time: 1) interviews with 335 health providers in 2008 and 822 health care providers in 2014, 2) review of facility logbooks, and 3) prospective data on 3092 women in 2008 and 5604 women in 2014 seeking treatment for abortion complications or induced abortion over a one month period. The Safe Abortion Care Model was used as a framework of analysis. There has been a rapid expansion of health facilities eligible to provide legal abortion services in Ethiopia since 2008. Between 2008 and 2014, the number of facilities reporting basic and comprehensive signal functions for abortion care increased. In 2014, access to basic abortion care services exceeded the recommended level of available facilities providing the service, increasing from 25 to 117%, with more than half of regions meeting the recommended level. Comprehensive abortion services increased from 20% of the recommended level in 2008 to 38% in 2014. Smaller regions and city administrations achieved or exceeded the recommended level of comprehensive service facilities, yet larger regions fall short. Between 2008 and 2014, the use of appropriate technology for conducting first and second trimester abortion and the provision of post abortion family planning has increased at the same time that abortion-related obstetric complications have decreased. Ten years after the change in abortion law, service

  13. Bad results obtained from the current public health policies and recommendations of hydration

    Directory of Open Access Journals (Sweden)

    Ismael San Mauro Martín

    Full Text Available Introduction: Achieving an adequate intake of water is crucial within a balanced diet. For that purpose, dietary guidelines for healthy eating and drinking are an important consideration and need to be updated and disseminated to the population. Aim: We aimed to evaluate the liquid intake habits of a Mediterranean and Latin American population (Spain-Portugal and Mexico-Uruguay and if they support the current recommendations of hydration by the EFSA. Methods: A record of fluid intake was obtained from 1,168 participants from 4 countries above; and then compared with current consensus about hydration 1,600 mL/day (female and 2,000 mL/day (male. Results: The average fluid intake slightly surpassed the recommended: mean of 2,049 mL/day (2,223 mL in males, 1,938 mL in females. Portugal stood out due to its lower intake (mean of 1,365 mL/day. Water contributed the largest part to total fluid intake (37% in all countries (mean of 1,365 mL/day. Hot beverages (18% and milk and derivates (17% follow water in highest consumption. The 20% of males and only 0.3% of females knew recommendations of hydration, while 63.3% of males and 62% of females followed them. Only 8.4% of people who follow the recommendations know them. Conclusion: The people studied surpassed the recommendation, although the majority did not realize. Future research should examine actual beverage consumption patterns and evaluate if the current consensuses are correctly adapted to the population needs. Hydration's policies should be transmitted to the population for their knowledge and adequate compliance.

  14. Labeling programs and efficiency standards to control the energy consumption of household appliances: current situation, main results and recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Menanteau, Ph.


    To control the rise in electricity consumption for specific uses, the industrialized countries started by introducing special programs aimed at improving energy efficiency. Among the different instruments available, labeling programs and minimum energy performance standards (MEPS) have proved to be very effective. The first part of this document presents the current situation, the main results and recommendations concerning the labeling programs and efficiency standards to control the energy consumption of household appliances. This analyze is done for each country in details providing the name of the program or measure, the date of implementation, the objective and the main characteristics of the program, the impacts and evaluation. (A.L.B.)

  15. Current IGEX Results for Neutrinoless Double-Beta Decay of {sup 76}Ge

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez, D.; Aalseth, C.E.; Avignone, F.T.; Brodzinski, R.L.; Cebrian, S.; Garcia, E.; Hensley, W.K.; Irastorza, I.G.; Kirpichnikov, I.V.; Klimenko, A.A.; Miley, H.S.; Morales, A.; Morales, J.; Ortiz de Solorzano, A.; Osetrov, S.B.; Pogosov, V.S.; Puimedon, J.; Reeves, J.H.; Sarsa, M.L.; Scopel, S.; Smolnikov, A.A.; Tamanyan, A.G.; Vasenko, A.A.; Vasiliev, S.I.; Villar, J.A


    The International Germanium Experiment (IGEX) is currently operating three 2-kg enriched germanium detectors in the Canfranc Underground Laboratory (Spain) at 2450 mwe, in a search for the neutrinoless double-beta decay of {sup 76}Ge. The detectors are equipped with Pulse Shape Analysis electronics. This implementation of Pulse Shape Discrimination results in a rejection of 60%-80% of the background in the 2.0-2.5 MeV energy interval. Analysis of 116.75 mole-years of data yields a lower bound {>=} 1.57 x 10{sup 25}y (or T{sup 0{nu}}{sub 1/2} {>=} 1.13 x 10{sup 25}y without PSD) (90% C.L.) corresponding to (m{sub {nu}}) < (0.33 - 1.31) eV, depending on the theoretical nuclear matrix elements used to extract the neutrino mass parameter.

  16. Current IGEX Results for Neutrinoless Double-Beta Decay of 76Ge (United States)

    González, D.; Aalseth, C. E.; Avignone, F. T., Jr.; Brodzinski, R. L.; Cebrián, S.; García, E.; Hensley, W. K.; Irastorza, I. G.; Kirpichnikov, I. V.; Klimenko, A. A.; Miley, H. S.; Morales, A.; Morales, J.; Ortiz de Solórzano, A.; Osetrov, S. B.; Pogosov, V. S.; Puimedón, J.; Reeves, J. H.; Sarsa, M. L.; Scopel, S.; Smolnikov, A. A.; Tamanyan, A. G.; Vasenko, A. A.; Vasiliev, S. I.; Villar, J. A.


    The International Germanium Experiment (IGEX) is currently operating three 2-kg enriched germanium detectors in the Canfranc Underground Laboratory (Spain) at 2450 mwe, in a search for the neutrinoless double- beta decay of 76Ge. The detectors are equipped with Pulse Shape Analysis electronics. This implementation of Pulse Shape Discrimination results in a rejection of 60%-80% of the background in the 2.0-2.5 MeV energy interval. Analysis of 116.75 mole-years of data yields a lower bound ≥ 1.57 × 10 25y ( or T {1}/{2}0ν ≥ 1.13 × 10 25y without PSD) (90% C.L.) corresponding to < (0.33 - 1.31) eV, depending on the theoretical nuclear matrix elements used to extract the neutrino mass parameter.

  17. Hip resurfacing arthroplasty: mid-term results in 486 cases and current indication in our institution. (United States)

    Ribas, Manuel; Cardenas, Carlomagno; Astarita, Emanuele; Moya, Esther; Bellotti, Vittorio


    In the previous decade, metal-on-metal hip resurfacing has been considered an attractive option and theoretically advantageous over conventional total hip arthroplasty, especially in young active patients. Different authors have reported favourable mid-term clinical and functional results with acceptable survival rates. Proper indication and planning, as accurate technical execution have been advocated to be crucial elements for success.Concerns regarding serum metal ion levels and possible clinical implications have led in the last years to a decline in the use of metal-on-metal hip resurfacing and metal-on-metal bearings in general.The aim of this study is to present the results of our first 486 cases of hybrid hip resurfacing arthroplasties with a second generation cementing technique, and to describe our current restricted indication of this type of prosthesis, in the light of recent findings in the literature about the possible complications related to metallosis or improper patient selection. Global survivorship of our series was 97.9% at a mean follow-up of 7.2 years.In the second season of our experience the indication is restrictive. The candidate for a resurfacing hip replacement is a young and active male patient, with good bone quality, that has been made aware of the risks and benefits of this type of prosthesis.

  18. 454 Pyrosequencing and Sanger sequencing of tropical mycorrhizal fungi provide similar results but reveal substantial methodological biases. (United States)

    Tedersoo, Leho; Nilsson, R Henrik; Abarenkov, Kessy; Jairus, Teele; Sadam, Ave; Saar, Irja; Bahram, Mohammad; Bechem, Eneke; Chuyong, George; Kõljalg, Urmas


    • Compared with Sanger sequencing-based methods, pyrosequencing provides orders of magnitude more data on the diversity of organisms in their natural habitat, but its technological biases and relative accuracy remain poorly understood. • This study compares the performance of pyrosequencing and traditional sequencing for species' recovery of ectomycorrhizal fungi on root tips in a Cameroonian rain forest and addresses biases related to multi-template PCR and pyrosequencing analyses. • Pyrosequencing and the traditional method yielded qualitatively similar results, but there were slight, but significant, differences that affected the taxonomic view of the fungal community. We found that most pyrosequencing singletons were artifactual and contained a strongly elevated proportion of insertions compared with natural intra- and interspecific variation. The alternative primers, DNA extraction methods and PCR replicates strongly influenced the richness and community composition as recovered by pyrosequencing. • Pyrosequencing offers a powerful alternative for the identification of ectomycorrhizal fungi in pooled root samples, but requires careful selection of molecular tools. A well-populated backbone database facilitates the detection of biological and technical artifacts. The pyrosequencing pipeline is available at

  19. Photospheric Current Spikes and Their Possible Association with Flares - Results from an HMI Data Driven Model (United States)

    Goodman, Michael; Kwan, Chiman; Ayhan, Bulent; Shang, Eric L.


    A data driven, near photospheric magnetohydrodynamic model predicts spikes in the horizontal current density, and associated resistive heating rate per unit volume Q. The spikes appear as increases by orders of magnitude above background values in neutral line regions (NLRs) of active regions (ARs). The largest spikes typically occur a few hours to a few days prior to M or X flares. The spikes correspond to large vertical derivatives of the horizontal magnetic field. The model takes as input the photospheric magnetic field observed by the Helioseismic & Magnetic Imager (HMI) on the Solar Dynamics Observatory (SDO) satellite. This 2.5 D field is used to determine an analytic expression for a 3 D magnetic field, from which the current density, vector potential, and electric field are computed in every AR pixel for 14 ARs. The field is not assumed to be force-free. The spurious 6, 12, and 24 hour Doppler periods due to SDO orbital motion are filtered out of the time series of the HMI magnetic field for each pixel using a band pass filter. The subset of spikes analyzed at the pixel level are found to occur on HMI and granulation scales of 1 arcsec and 12 minutes. Spikes are found in ARs with and without M or X flares, and outside as well as inside NLRs, but the largest spikes are localized in the NLRs of ARs with M or X flares. The energy to drive the heating associated with the largest current spikes comes from bulk flow kinetic energy, not the electromagnetic field, and the current density is highly non-force free. The results suggest that, in combination with the model, HMI is revealing strong, convection driven, non-force free heating events on granulation scales, and that it is plausible these events are correlated with subsequent M or X flares. More and longer time series need to be analyzed to determine if such a correlation exists. Above an AR dependent threshold value of Q, the number of events N(Q) with heating rates greater than or equal to Q obeys a scale

  20. Carbon Dioxide Sequestration by Direct Mineral Carbonation: Results from Recent Studies and Current Status

    Energy Technology Data Exchange (ETDEWEB)

    O' Connor, William K.; Dahlin, David C.; Nilsen, David N.; Rush, G.E.; Walters, Richard P.; Turner, Paul C.


    Direct mineral carbonation has been investigated as a process to convert gaseous CO2 into a geologically stable, solid final form. The process utilizes a solution of sodium bicarbonate (NaHCO3), sodium chloride (NaCl), and water, mixed with a mineral reactant, such as olivine (Mg2SiO4) or serpentine [Mg3Si2O5(OH)4]. Carbon dioxide is dissolved into this slurry, by diffusion through the surface and gas dispersion within the aqueous phase. The process includes dissolution of the mineral and precipitation of magnesium carbonate (MgCO3) in a single unit operation. Optimum results have been achieved using heat pretreated serpentine feed material, with a surface area of roughly 19 m2 per gram, and high partial pressure of CO2 (PCO2). Specific conditions include: 155?C; PCO2=185 atm; 15% solids. Under these conditions, 78% stoichiometric conversion of the silicate to the carbonate was achieved in 30 minutes. Studies suggest that the mineral dissolution rate is primarily surface controlled, while the carbonate precipitation rate is primarily dependent on the bicarbonate concentration of the slurry. Current studies include further examination of the reaction pathways, and an evaluation of the resource potential for the magnesium silicate reactant, particularly olivine. Additional studies include the examination of various pretreatment options, the development of a continuous flow reactor, and an evaluation of the economic feasibility of the process.

  1. Estimation of the yield of poplars in plantations of fast-growing species within current results

    Directory of Open Access Journals (Sweden)

    Martin Fajman


    Full Text Available Current results are presented of allometric yield estimates of the poplar short rotation coppice. According to a literature review it is obvious that yield estimates, based on measurable quantities of a growing stand, depend not only on the selected tree specie or its clone, but also on the site location. The Jap-105 poplar clone (P. nigra x P. maximowiczii allometric relations were analyzed by regression methods aimed at the creation of the yield estimation methodology at a testing site in Domanínek. Altogether, the twelve polynomial dependences of particular measured quantities approved the high empirical data conformity with the tested regression model (correlation index from 0.9033 to 0.9967. Within the forward stepwise regression, factors were selected, which explain best examined estimates of the total biomass DM; i.e. d.b.h. and stem height. Furthermore, the KESTEMONT’s (1971 mo­del was verified with a satisfying conformity as well. Approving presented yield estimation methods, the presented models will be checked in a large-scale field trial.

  2. Current and future delivery of diagnostic electron microscopy in the UK: results of a national survey. (United States)

    de Haro, Tracey; Furness, Peter


    Electron microscopy (EM) remains essential to delivering several specialist areas of diagnosis, especially the interpretation of native renal biopsies. However, there is anecdotal evidence of EM units struggling to survive, for a variety of reasons. The authors sought to obtain objective evidence of the extent and the causes of this problem. An online survey was undertaken of Fellows of the Royal College of Pathologists who use EM in diagnosis. A significant number of EM units anticipate having to close and hence outsource their EM work in the coming years. Yet most existing units are working to full capacity and would be unable to take on the substantial amounts of extra work implied by other units outsourcing their needs. Equipment and staffing are identified by most EM units as the major barriers to growth and are also the main reasons cited for units facing potential closure. In the current financial climate it seems unlikely that units will be willing to make the large investment in equipment and staff needed to take on extra work, unless they can be reasonably confident of an acceptable financial return as a result of increased external referral rates. The case is thus made for a degree of national coordination of the future provision of this specialist service, possibly through the National Commissioning Group or the new National Commissioning Board. Without this, the future of diagnostic EM services in the UK is uncertain. Its failure would pose a threat to good patient care.


    Directory of Open Access Journals (Sweden)

    Florentina DINESCU


    Full Text Available The purpose of this work is to present a relevant aspect of marketing approach of the activities carried by universities, respectively knowing, understanding and satisfying students’ needs, the main consumer category of the university product, in the conditions of current market of high education institutions. The universities are put in the position to find solutions to the problems caused by the stakeholders’ characteristics and by the existing competition on the educational market. The approach of marketing orientation in the university implies adapting the educational and scientific research step to create for the institution a brand image as a warranty of its sustainability on a competitive market by considering the needs and expectations of students. The conclusion is that there is a wide specialized literature that shows models that allow an adequate quantification of the students’ satisfaction as a resultant of concerning the insurance of high education quality by using univeristy marketing tools. Starting from the specialized literature, in the work was handled the quantification of the students’ satisfaction that have completed Bachelor and Master cycle in order to improve the activity of the university

  4. HIV-1 Tat protein increases microglial outward K(+ current and resultant neurotoxic activity.

    Directory of Open Access Journals (Sweden)

    Jianuo Liu

    Full Text Available Microglia plays a crucial role in the pathogenesis of HIV-1-associated neurocognitive disorders. Increasing evidence indicates the voltage-gated potassium (Kv channels are involved in the regulation of microglia function, prompting us to hypothesize Kv channels may also be involved in microglia-mediated neurotoxic activity in HIV-1-infected brain. To test this hypothesis, we investigated the involvement of Kv channels in the response of microglia to HIV-1 Tat protein. Treatment of rat microglia with HIV-1 Tat protein (200 ng/ml resulted in pro-inflammatory microglial activation, as indicated by increases in TNF-α, IL-1β, reactive oxygen species, and nitric oxide, which were accompanied by enhanced outward K(+ current and Kv1.3 channel expression. Suppression of microglial Kv1.3 channel activity, either with Kv1.3 channel blockers Margatoxin, 5-(4-Phenoxybutoxypsoralen, or broad-spectrum K(+ channel blocker 4-Aminopyridine, or by knockdown of Kv1.3 expression via transfection of microglia with Kv1.3 siRNA, was found to abrogate the neurotoxic activity of microglia resulting from HIV-1 Tat exposure. Furthermore, HIV-1 Tat-induced neuronal apoptosis was attenuated with the application of supernatant collected from K(+ channel blocker-treated microglia. Lastly, the intracellular signaling pathways associated with Kv1.3 were investigated and enhancement of microglial Kv1.3 was found to correspond with an increase in Erk1/2 mitogen-activated protein kinase activation. These data suggest targeting microglial Kv1.3 channels may be a potential new avenue of therapy for inflammation-mediated neurological disorders.

  5. HAMLET -Human Model MATROSHKA for Radiation Exposure Determination of Astronauts -Current status and results (United States)

    Reitz, Guenther; Berger, Thomas; Bilski, Pawel; Burmeister, Soenke; Labrenz, Johannes; Hager, Luke; Palfalvi, Jozsef K.; Hajek, Michael; Puchalska, Monika; Sihver, Lembit

    contribute essentially to radiation risk estimations for future interplanetary space exploration by humans, putting them on a solid experimental and theoretical basis. The talk will give an overview of the current status of the MATROSHKA data evaluation and results and comparisons of the first three MTR experimental phases (MTR-1, 2A and 2B). The HAMLET project is funded by the European Commission under the EUs Seventh Frame-work Programme (FP7) under Project Nr: 218817 and coordinated by the German Aerospace Center (DLR)

  6. Is Current CMBR Temperature: The Scale Independent Quantum Gravitational Result of Black Hole Cosmology? (United States)

    Seshavatharam, U. V. S.; Lakshminarayana, S.

    If one is willing to consider the current cosmic microwave back ground temperature as a quantum gravitational effect of the evolving primordial cosmic black hole (universe that constitutes dynamic space-time and exhibits quantum behavior) automatically general theory of relativity and quantum mechanics can be combined into a `scale independent' true unified model of quantum gravity. By considering the `Planck mass' as the initial mass of the baby Hubble volume, past and current physical and thermal parameters of the cosmic black hole can be understood. Current rate of cosmic black hole expansion is being stopped by the microscopic quantum mechanical lengths. In this new direction authors observed 5 important quantum mechanical methods for understanding the current cosmic deceleration. To understand the ground reality of current cosmic rate of expansion, sensitivity and accuracy of current methods of estimating the magnitudes of current CMBR temperature and current Hubble constant must be improved and alternative methods must be developed. If it is true that galaxy constitutes so many stars, each star constitutes so many hydrogen atoms and light is coming from the excited electron of galactic hydrogen atom, then considering redshift as an index of `whole galaxy' receding may not be reasonable. During cosmic evolution, at any time in the past, in hydrogen atom emitted photon energy was always inversely proportional to the CMBR temperature. Thus past light emitted from older galaxy's excited hydrogen atom will show redshift with reference to the current laboratory data. As cosmic time passes, in future, the absolute rate of cosmic expansion can be understood by observing the rate of increase in the magnitude of photon energy emitted from laboratory hydrogen atom. Aged super novae dimming may be due to the effect of high cosmic back ground temperature. Need of new mathematical methods & techniques, computer simulations, advanced engineering skills seem to be essential

  7. Prediction of SFL Interruption Performance from the Results of Arc Simulation during High-Current Phase (United States)

    Lee, Jong-Chul; Lee, Won-Ho; Kim, Woun-Jea


    The design and development procedures of SF6 gas circuit breakers are still largely based on trial and error through testing although the development costs go higher every year. The computation cannot cover the testing satisfactorily because all the real processes arc not taken into account. But the knowledge of the arc behavior and the prediction of the thermal-flow inside the interrupters by numerical simulations are more useful than those by experiments due to the difficulties to obtain physical quantities experimentally and the reduction of computational costs in recent years. In this paper, in order to get further information into the interruption process of a SF6 self-blast interrupter, which is based on a combination of thermal expansion and the arc rotation principle, gas flow simulations with a CFD-arc modeling are performed during the whole switching process such as high-current period, pre-current zero period, and current-zero period. Through the complete work, the pressure-rise and the ramp of the pressure inside the chamber before current zero as well as the post-arc current after current zero should be a good criterion to predict the short-line fault interruption performance of interrupters.


    Energy Technology Data Exchange (ETDEWEB)

    Turick, C.; Ekechukwu, A.; Milliken, C.


    The presence of melanin pigments in organisms is implicated in radioprotection and in some cases, enhanced growth in the presence of high levels of ionizing radiation. An understanding of this phenomenon will be useful in the design of radioprotective materials. However, the protective mechanism of microbial melanin in ionizing radiation fields has not yet been elucidated. Here we demonstrate through the electrochemical techniques of chronoamperometry, chronopotentiometry and cyclic voltammetry that microbial melanin is continuously oxidized in the presence of gamma radiation. Our findings establish that ionizing radiation interacts with melanin to alter its oxidation-reduction potential. Sustained oxidation resulted in electric current production and was most pronounced in the presence of a reductant, which extended the redox cycling capacity of melanin. This work is the first to establish that gamma radiation alters the oxidation-reduction behavior of melanin, resulting in electric current production. The significance of the work is that it provides the first step in understanding the initial interactions between melanin and ionizing radiation taking place and offers some insight for production of biomimetic radioprotective materials.

  9. Effect of current mode on PEO treatment of magnesium in Ca- and P-containing electrolyte and resulting coatings (United States)

    Gao, Yonghao; Yerokhin, Aleksey; Matthews, Allan


    Plasma electrolytic oxidation (PEO) coatings were produced on commercially pure magnesium in a biologically friendly electrolyte composed of 2 g L-1 Ca(OH)2 and 12 g L-1 Na3PO4·12H2O using pulsed unipolar and bipolar current regimes with negative biasing varying from 0 to 20 mA cm-2. Analysis of voltage transients was performed to characterise the PEO processes. The coating morphology and phase composition were studied by scanning electron microscopy and X-ray diffraction technique, respectively. In vitro corrosion performance of the coatings was evaluated in a simulated body fluid at 37 ± 1 °C, using electrochemical techniques including open circuit potential monitoring, electrochemical impedance spectroscopy and potentiodynamic polarisation scans. The influence of the negative biasing on the PEO process and resulting coating characteristics is discussed. Unlike generally recognised beneficial effects of the negative biasing in PEO treatments of some other metal-electrolyte systems, it was found that detrimental effects are induced to the coatings on cp-Mg produced in the studied electrolyte when the negative current amplitude increases, which may be attributed to hydrogen liberation at the coating/substrate interface during the negative biasing cycles. As a result, a deterioration of vitro corrosion performance was observed for the pulsed bipolar PEO coatings compared to those produced using the pulsed unipolar regime which provides better quality coatings.

  10. Water-waves on linear shear currents. A comparison of experimental and numerical results. (United States)

    Simon, Bruno; Seez, William; Touboul, Julien; Rey, Vincent; Abid, Malek; Kharif, Christian


    Propagation of water waves can be described for uniformly sheared current conditions. Indeed, some mathematical simplifications remain applicable in the study of waves whether there is no current or a linearly sheared current. However, the widespread use of mathematical wave theories including shear has rarely been backed by experimental studies of such flows. New experimental and numerical methods were both recently developed to study wave current interactions for constant vorticity. On one hand, the numerical code can simulate, in two dimensions, arbitrary non-linear waves. On the other hand, the experimental methods can be used to generate waves with various shear conditions. Taking advantage of the simplicity of the experimental protocol and versatility of the numerical code, comparisons between experimental and numerical data are discussed and compared with linear theory for validation of the methods. ACKNOWLEDGEMENTS The DGA (Direction Générale de l'Armement, France) is acknowledged for its financial support through the ANR grant N° ANR-13-ASTR-0007.

  11. Experimental Results on Current-Driven Turbulence in Plasmas - a Survey

    NARCIS (Netherlands)

    Dekluiver, H.; Perepelkin, N. F.; Hirose, A.


    The experimental consequences of plasma turbulence driven by a current parallel to a magnetic field and concurrent anomalous plasma heating are reviewed, with an attempt to deduce universalities in key parameters such as the anomalous electrical conductivities observed in diverse devices. It has

  12. Current models of care for disorders of sex development - results from an International survey of specialist centres

    DEFF Research Database (Denmark)

    Kyriakou, Andreas; Dessens, Arianne; Bryce, Jillian


    BACKGROUND: To explore the current models of practice in centres delivering specialist care for children with disorders of sex development (DSD), an international survey of 124 clinicians, identified through DSDnet and the I-DSD Registry, was performed in the last quarter of 2014. RESULTS: A total...... a local DSD registry and 40 (53 %) shared their data in a multicentre DSD registry. Attendance in local, national and international DSD-related educational programs was reported by 69, 78 and 84 % clinicians, respectively. Participation in audits/quality improvement exercises in DSD care was reported...... hydroxysteroid dehydrogenase 3 deficiency by 50 and 55 % clinicians, respectively. CONCLUSION: DSD centres report a high level of interaction at an international level, have access to specialist staff and are increasingly relying on molecular genetics for routine diagnostics. The quality of care provided...

  13. Free Access to Point of Care Resource Results in Increased Use and Satisfaction by Rural Healthcare Providers

    Directory of Open Access Journals (Sweden)

    Lindsay Alcock


    Full Text Available A Review of: Eldredge, J. D., Hall, L. J., McElfresh, K. R., Warner, T. D., Stromberg, T. L., Trost, J. T., & Jelinek, D. A. (2016. Rural providers’ access to online resources: A randomized controlled trial. Journal of the Medical Library Association, 104(1, 33-41. Objective – To determine whether free access to the point of care (PoC resource Dynamed or the electronic book collection AccessMedicine was more useful to rural health care providers in answering clinical questions in terms of usage and satisfaction. Design – Randomized controlled trial. Setting – Rural New Mexico. Subjects – Twenty-eight health care providers (physicians, nurses, physician assistants, and pharmacists with no reported access to PoC resources, (specifically Dynamed and AccessMedicine or electronic textbook collections prior to enrollment.

  14. Knowledge of Healthcare Coverage for Refugee Claimants: Results from a Survey of Health Service Providers in Montreal.

    Directory of Open Access Journals (Sweden)

    Mónica Ruiz-Casares

    Full Text Available Following changes to the Interim Federal Health (IFH program in Canada in 2012, this study investigates health service providers' knowledge of the healthcare coverage for refugee claimants living in Quebec. An online questionnaire was completed by 1,772 staff and physicians from five hospitals and two primary care centres in Montreal. Low levels of knowledge and significant associations between knowledge and occupational group, age, and contact with refugees were documented. Social workers, respondents aged 40-49 years, and those who reported previous contact with refugee claimants seeking healthcare were significantly more likely to have 2 or more correct responses. Rapid and multiple changes to the complex IFH policy have generated a high level of confusion among healthcare providers. Simplification of the system and a knowledge transfer strategy aimed at improving healthcare delivery for IFH patients are urgently needed, proposing easy avenues to access rapidly updated information and emphasizing ethical and clinical issues.

  15. Knowledge of Healthcare Coverage for Refugee Claimants: Results from a Survey of Health Service Providers in Montreal. (United States)

    Ruiz-Casares, Mónica; Cleveland, Janet; Oulhote, Youssef; Dunkley-Hickin, Catherine; Rousseau, Cécile


    Following changes to the Interim Federal Health (IFH) program in Canada in 2012, this study investigates health service providers' knowledge of the healthcare coverage for refugee claimants living in Quebec. An online questionnaire was completed by 1,772 staff and physicians from five hospitals and two primary care centres in Montreal. Low levels of knowledge and significant associations between knowledge and occupational group, age, and contact with refugees were documented. Social workers, respondents aged 40-49 years, and those who reported previous contact with refugee claimants seeking healthcare were significantly more likely to have 2 or more correct responses. Rapid and multiple changes to the complex IFH policy have generated a high level of confusion among healthcare providers. Simplification of the system and a knowledge transfer strategy aimed at improving healthcare delivery for IFH patients are urgently needed, proposing easy avenues to access rapidly updated information and emphasizing ethical and clinical issues.

  16. Current Situation of AFREF and First Results from GNSS Networks in Africa (United States)

    Mahmoud, Salah; Farah, Hussein; Wonnacott, Richard


    The African Geodetic Reference Frame (AFREF) is conceived as a unified geodetic reference frame for Africa. It will be the fundamental basis for the national three-dimensional reference networks fully consistent and homogeneous with the International Terrestrial Reference Frame (ITRF). When fully implemented, its backbone will consist of a network of continuous, permanent GPS stations such that a user anywhere in Africa would have free access to, and would be at most 1000km from, such stations. Full implementation will include a unified vertical datum and support for efforts to establish a precise African geoid, in concert with the African Geoid project activities. The realization of AFREF has vast potentials for geodesy, mapping, surveying, geoinformation, natural hazards mitigation, earth sciences, etc. Its implementation will provide a major springboard for the transfer and enhancement of skills in surveying and geodesy and especially GPS technology and applications. AFREF is, therefore, an African initiative to unify the geodetic reference frames of Africa based on the ITRF through a network of GNSS base stations at a spacing such users will be at most within ~1000 km of a base station. First Reference Frame Solution of about 80 geodetic GPS stations in Africa has been started in February 2013 at some processing centers in Europe and Africa. Results of independent solutions being developed by various African scientific teams: Hart RAO, South Africa; Ardhi University, Tanzania and SEGAL, University of Beria Interior, Portugal, show an accuracy of aligned ITRF 2008 using 42 IGS stations in E and N components with 3.0 mm and in U component 7.5 mm.

  17. Elbow hemiarthroplasty for the management of distal humeral fractures: current technique, indications and results


    Phadnis, Joideep; Adam C. Watts; Bain, Gregory I


    There has been a growing recent interest in the use of elbow hemiarthroplasty for the treatment of distal humeral trauma in select patients. However, the current available evidence regarding outcome after elbow hemiarthroplasty is limited to case series and biomechanical data. Consequently, the procedure remains unfamiliar to many surgeons. The aim of the present review is to outline the evidence regarding elbow hemiarthroplasty and to use this, along with the author’s experience, to better d...

  18. Counselor-Versus Provider-Based HIV Screening in the Emergency Department: Results From the Universal Screening for HIV Infection in the Emergency Room (USHER) Randomized Controlled Trial (United States)

    Walensky, Rochelle P.; Reichmann, William M.; Arbelaez, Christian; Wright, Elizabeth; Katz, Jeffrey N.; Seage, George R.; Safren, Steven A.; Hare, Anna Q.; Novais, Anna; Losina, Elena


    Objective We compare rates of rapid HIV testing, test offer, and acceptance in an urban emergency department (ED) when conducted by dedicated HIV counselors versus current members of the ED staff. Methods The Universal Screening for HIV Infection in the Emergency Room [USHER] trial is a prospective randomized controlled trial that implemented an HIV screening program in the ED of an urban tertiary medical center. ED patients were screened and consented for trial enrollment by an USHER research assistant. Eligible subjects were randomized to rapid HIV testing (oral OraQuick) offered by a dedicated counselor (counselor arm) or by an ED provider (provider arm). In the counselor arm, counselors—without other clinical responsibilities—assumed nearly all testing-related activities (consent, counseling, delivery of test results). In the provider arm, trained ED emergency service assistants (nursing assistants) consented and tested the participant in the context of other ED-related responsibilities. In this arm, ED house officers, physician assistants, or attending physicians provided HIV test results to trial participants. Outcome measures were rates of HIV testing and test offer among individuals consenting for study participation. Among individuals offered the test, test acceptance was also measured. Results From February 2007 through July 2008, 8,187 eligible patients were approached in the ED, and 4,855 (59%) consented and were randomized to trial participation. The mean age was 37 years, 65% were women, and 42% were white. The overall testing rate favored the counselor arm (57% versus 27%; P < .001); 80% (1,959/2,446) of subjects in the counselor arm were offered an HIV test compared with 36% (861/2,409) in the provider arm (P < .001). HIV test acceptance was slightly higher in the provider arm (counselor arm 71% versus provider arm 75%; P = .025). Conclusion Routine rapid HIV testing in the ED was accomplished more frequently by dedicated HIV counselors than by

  19. The WiFeS S7 AGN survey: Current status and recent results on NGC 6300

    CERN Document Server

    Scharwächter, J; Shastri, P; Davies, R; Kewley, L; Hampton, E; Sutherland, R; Kharb, P; Jose, J; Bhatt, H; Ramya, S; Jin, C; Banfield, J; Zaw, I; Juneau, S; James, B; Srivastava, S


    The Siding Spring Southern Seyfert Spectroscopic Snapshot Survey (S7) is a targeted survey probing the narrow-line regions (NLRs) of a representative sample of ~140 nearby (z<0.02) Seyfert galaxies by means of optical integral field spectroscopy. The survey is based on a homogeneous data set observed using the Wide Field Spectrograph WiFeS. The data provide a 25x38 arcsec$^2$ field-of-view around the galaxy centre at typically ~1.5 arcsec spatial resolution and cover a wavelength range between ~3400 - 7100 $\\AA$ at spectral resolutions of ~100 km s$^{-1}$ and ~50 km s$^{-1}$ in the blue and red parts, respectively. The survey is primarily designed to study gas excitation and star formation around AGN, with a special focus on the shape of the AGN ionising continuum, the interaction between radio jets and the NLR gas, and the nature of nuclear LINER emission. We provide an overview of the current status of S7-based results and present new results for NGC 6300.

  20. Soil structure modeling with different correlation functions: current results and future perspectives (United States)

    Karsanina, M.; Gerke, K.; Vasilyev, R.; Skvortsova, E.


    One of the main factors defining numerous flow phenomena in soils and other porous media, including fluid and solute movements, is pore structure, e.g., pore volume and its connectivity. In recent decades different numerical methods were developed to quantify single and multi-phase flow in such media on microscale. Among most popular ones are: 1) a wide range of finite difference/element/volume solutions of Navier-Stokes equations and its simplifications; 2) lattice-Boltzmann method; 3) pore-network models. Each method has some advantages and weak sides, so that different research teams usually utilize more than one, depending on the study case. Recent progress in X-ray tomography and some other techniques allows precise determination of soil three-dimensional structure, however, a trade-off between resolution and sample size is usually unavoidable. There are situations then only standard two-dimensional information of porous structure is known due to tomography high cost or resolution limitations. But physical modeling on microscale, there most interfacial processes take place requires 3D information. There are three main approaches to reconstruct (using 2D cut(s) or some other limited information/properties) porous media: 1) statistical methods (correlation functions and simulated annealing, multi-point statistics, entropy methods), 2) sequential methods (sphere or other granular packs) and 3) morphological methods. Multi-point statistical method is believed to excel others due to its simplicity with respect to practical applications and better results (in particular pore space connectivity and anisotropy issues). Recently it was shown that cluster function implication significantly improve reconstruction quality, especially in comparison with original Yeong-Torquato technique based on two-point probability and linear functions. Another possible reason for these correlation functions poorer performance is computer power limitations of that time, e.g., high energy

  1. Providing HIV results via SMS one day after testing: more popular than rapid point-of-care tests. (United States)

    Davies, Stephen C; Koh, Andrew; Lindsay, Heather E; Fulton, Richard B; Fernando, Suran L


    An inner Sydney sexual health service introduced the option to gay and bisexual men of receiving a negative HIV result by SMS to mobile phone one business day after venipuncture (rapid SMS). Men could also choose one of the other options: a point-of-care-test (POCT), by phone, or in-person (clinicians could also require in-person). We followed-up patients choosing the rapid SMS method to ascertain their satisfaction. During 12 months, 473 men had 591 HIV tests. Of these tests, 5.4% were POCTs, 9.1% were in-person, 24% were by phone, and 62% were rapid SMS. HIV POCTs declined from being 22% of result methods in the pre-study period to 5.4% during the rapid SMS intervention period (odds ratio 0.20, 95% CI 0.13-0.32, P rapid SMS result rather than having another POCT. The higher accuracy of conventional serology was commonly expressed as the reason for choosing rapid SMS for results.

  2. Test beam results of a heavily irradiated Current Injected Detector (CID)

    CERN Document Server

    Harkonen, J; Tuominen, E; Moilanen, H; Maenpaa, T; Verbitskaya, E; Eremin, V; Czellar, S; Dierlamm, A; Tuovinen, E; Lampen, T; Frey, M; Li, Z; Luukka, P


    A heavily irradiated (3 x 10(15) 1 MeV n(eq)/cm(2)) Current Injected Detector (CID) was tested with 225 GeV muon beam at CERN H2 beam line. In the CID concept the current is limited by the space charge. The injected carriers will be trapped by the deep levels and this induces a stable electric field through the entire bulk regardless of the irradiation fluence the detector has been exposed to. The steady-state density of the trapped charge is defined by the balance between the trapping and the emission rates of charge carriers (detrapping). Thus, the amount of charge injection needed for the electric field stabilization depends on the temperature. AC-coupled 16 cm(2) detector was processed on high resistivity n-type magnetic Czochralski silicon, and it had 768 strips, 50 mu m pitch, 10 mu m strip width and 3.9 cm strip length. The beam test was carried out using a silicon beam telescope that is based on the CMS detector readout prototype components, APV25 readout chips, and eight strip sensors made by Hamamat...

  3. Current status of a hepatitis C vaccine: encouraging results but significant challenges ahead

    DEFF Research Database (Denmark)

    Mikkelsen, Marianne; Bukh, Jens


    Persistent hepatitis C virus (HCV) infection affects 170 million people worldwide. Acute HCV infection is often asymptomatic, but many infected individuals develop persistent infections that may lead to development of end-stage liver diseases, including liver cirrhosis and hepatocellular carcinoma....... Thus, an HCV vaccine that could significantly lower the chronicity rate would have a major impact on the disease burden. Unfortunately, HCV is a highly mutable virus, and escape mutations can undermine vaccine-induced virus-specific immunity. Also, HCV exists as multiple genotypes, and so genotype......-specific vaccines might be required to achieve broad protection. Finally, vaccine development has been hampered by the lack of a small animal model and cell culture systems, but these are currently being established. Despite these obstacles, several vaccine candidates tested in the chimpanzee HCV model have shown...

  4. Current status of a hepatitis C vaccine: encouraging results but significant challenges ahead

    DEFF Research Database (Denmark)

    Mikkelsen, Marianne; Bukh, Jens


    -specific vaccines might be required to achieve broad protection. Finally, vaccine development has been hampered by the lack of a small animal model and cell culture systems, but these are currently being established. Despite these obstacles, several vaccine candidates tested in the chimpanzee HCV model have shown......Persistent hepatitis C virus (HCV) infection affects 170 million people worldwide. Acute HCV infection is often asymptomatic, but many infected individuals develop persistent infections that may lead to development of end-stage liver diseases, including liver cirrhosis and hepatocellular carcinoma....... Thus, an HCV vaccine that could significantly lower the chronicity rate would have a major impact on the disease burden. Unfortunately, HCV is a highly mutable virus, and escape mutations can undermine vaccine-induced virus-specific immunity. Also, HCV exists as multiple genotypes, and so genotype...

  5. Studies of Short Time Response Options for Potentially Hazardous Objects: Current and Forthcoming Results (United States)

    Barbee, Brent W.; Greenaugh, Kevin C.; Seery, Bernard D.; Bambacus, Myra; Leung, Ronald Y.; Finewood, Lee; Dearborn, David S. P.; Miller, Paul L.; Weaver, Robert P.; Plesko, Catherine; hide


    NASA's Goddard Space Flight Center (GSFC) and the National Nuclear Security Administration (NNSA), Department of Energy (DOE) National Laboratories, Lawrence Livermore National Laboratory (LLNL), Los Alamos National Laboratory(LANL), and Sandia National Laboratory (SNL) are collaborating on Planetary Defense Research. The research program is organized around three case studies: 1. Deflection of the Potentially Hazardous Asteroid (PHA) 101955 Bennu (1999 RQ36)[OSIRIS-REx mission target], 2. Deflection of the secondary member of the PHA 65803 Didymos (1996 GT) [DART mission target], 3. Deflection of a scaled-down version of the comet 67PChuryumov-Gerasimenko [Rosetta mission target]. NASAGSFC is providing astrodynamics and spacecraft mission design expertise, while NNSA, DOE, LLNL, LANL and SNL are providing expertise in modeling the effects of kinetic impactor spacecraft and nuclear explosive devices on the target objects.

  6. Logistic support provided to Australian disaster medical assistance teams: results of a national survey of team members

    Directory of Open Access Journals (Sweden)

    Peter Aitken


    Full Text Available It is likely that calls for disaster medical assistance teams (DMATs continue in response to international disasters. As part of a national survey, the present study was designed to evaluate the Australian DMAT experience and the need for logistic support.Data were collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 Asian Tsunami disaster.The response rate for this survey was 50% (59/118. Most of the personnel had deployed to the South East Asian Tsunami affected areas. The DMAT members had significant clinical and international experience. There was unanimous support for dedicated logistic support with 80% (47/59 strongly agreeing. Only one respondent (2% disagreed with teams being self sufficient for a minimum of 72 hours. Most felt that transport around the site was not a problem (59%; 35/59, however, 34% (20/59 felt that transport to the site itself was problematic. Only 37% (22/59 felt that pre-deployment information was accurate. Communication with local health providers and other agencies was felt to be adequate by 53% (31/59 and 47% (28/59 respectively, while only 28% (17/59 felt that documentation methods were easy to use and reliable. Less than half (47%; 28/59 felt that equipment could be moved easily between areas by team members and 37% (22/59 that packaging enabled materials to be found easily. The maximum safe container weight was felt to be between 20 and 40 kg by 58% (34/59.This study emphasises the importance of dedicated logistic support for DMAT and the need for teams to be self sufficient for a minimum period of 72 hours. There is a need for accurate pre deployment information to guide resource prioritisation with clearly labelled pre packaging to assist access on site. Container weights should be restricted to between 20 and 40 kg, which would assist

  7. Support Services for Informal Caregivers: First Results of Expert Interviews with Providers in the City of Vienna. (United States)

    Hensely-Schinkinger, Susanne


    The burden of informal caregivers can be potentially reduced with support services targeting them primarily. But when it comes to the utilization of such services, there are still barriers on the side of suppliers and demanders that leads to the fact that too less concerned people are making use of it. Expert interviews were done with offering institutions in the City of Vienna to find out more about the types of offered support services, consideration of special circumstances, utilization behavior, awareness, benefit, costs and future development. This paper is presenting the preliminary results of the data analysis of the first round of interviews that shows the status quo of utilization of support services for informal caregivers in the City of Vienna.

  8. Lost opportunities to identify and treat HIV-positive patients: results from a baseline assessment of provider-initiated HIV testing and counselling (PITC) in Malawi. (United States)

    Ahmed, Saeed; Schwarz, Monica; Flick, Robert J; Rees, Chris A; Harawa, Mwelura; Simon, Katie; Robison, Jeff A; Kazembe, Peter N; Kim, Maria H


    To assess implementation of provider-initiated testing and counselling (PITC) for HIV in Malawi. A review of PITC practices within 118 departments in 12 Ministry of Health (MoH) facilities across Malawi was conducted. Information on PITC practices was collected via a health facility survey. Data describing patient visits and HIV tests were abstracted from routinely collected programme data. Reported PITC practices were highly variable. Most providers practiced symptom-based PITC. Antenatal clinics and maternity wards reported widespread use of routine opt-out PITC. In 2014, there was approximately 1 HIV test for every 15 clinic visits. HIV status was ascertained in 94.3% (5293/5615) of patients at tuberculosis clinics, 92.6% (30,675/33,142) of patients at antenatal clinics and 49.4% (6871/13,914) of patients at sexually transmitted infection clinics. Reported challenges to delivering PITC included test kit shortages (71/71 providers), insufficient physical space (58/71) and inadequate number of HIV counsellors (32/71) while providers from inpatient units cited the inability to test on weekends. Various models of PITC currently exist at MoH facilities in Malawi. Only antenatal and maternity clinics demonstrated high rates of routine opt-out PITC. The low ratio of facility visits to HIV tests suggests missed opportunities for HIV testing. However, the high proportion of patients at TB and antenatal clinics with known HIV status suggests that routine PITC is feasible. These results underscore the need to develop clear, standardised PITC policy and protocols, and to address obstacles of limited health commodities, infrastructure and human resources. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  9. Current practices in percutaneous nephrolithotomy in Mexico: results of a nation-wide electronic survey. (United States)

    Sandoval, Christian I Villeda; Roca, Benjamin E Montaño; Molina, Ricardo A Castillejos; Mendez-Probst, Carlos E


    Practice patterns and choice of technological instruments in PCNL are not always standardized. There are no previous reports on the PCNL practice tendencies and patterns in Latin America. The aim of the study is to describe the current practice patterns of PCNL among the members of the Mexican Society of Urology ("Sociedad Mexicana de Urologia"). Observational and descriptive study. A 9-item closed questionnaire on PCNL practice patterns was answered by members of the Mexican Society of Urology in a secure website hosted survey after e-mail invitation. A descriptive numerical and graphical analysis was performed. A total of 90 contestants were registered out of 492 potential participants. PCNL is performed by 80% of the participants, with an average of 16 procedures per year. Percutaneous tracts are commonly obtained by urologists on the same day of the procedure. Sequential and telescopic dilators are equally preferred over balloons. The pneumatic litotriptor is the most common choice and CT scan and X-ray are equally used as follow-up. The practice patterns of PCNL from Mexican urologists are different from other international reports. Influence of socio-economic circumstances is inferred.

  10. Current inverter interferences - test results of the SIDENA research project; Wechselrichterwechselwirkungen - Testergebnisse aus dem Forschungsprojekt SIDENA

    Energy Technology Data Exchange (ETDEWEB)

    Bendel, C.; Funtan, P.; Kirchhof, J.; Nestle, D. [Institut fuer Solare Energieversorgungstechnik (ISET), Kassel (Germany)


    Integration of decentral power supply systems in the electricity grid requires new safety and availability problems. The SIDENA project investigated interferences at the connection point and tested the integration of, at present, a maximum of 22 PV current inverters both on the AC and on the DC side. (orig.) [German] Mit zunehmender Einbindung von dezentralen netzgekoppelten Energieerzeugungsanlagen (DEA), z.B. PV-Anlagen, BHKW's, Brennstoffzellen u.a. in das elektrische Energieversorgungsnetz muessen die Fragen der Personen- und Anlagensicherheit sowie der Netzzuverlaessigkeit und -qualitaet neu ueberdacht werden. Die dezentralen Energieerzeugungsanlagen (DEA), die beispielhaft ueber Wechselrichter ins oeffentliche Netz einspeisen, verursachen und erfahren Wirkungen an der Netzanschlussstelle, deren stoerende Ursachen zu klaeren sind. Bei diesen stoerenden Ursachen handelt es sich um Kompatibilitaetsprobleme der Netzabschalteinrichtungen (ENS) zum Netz, aber auch bei groesserer Anzahl an einem Netzanschlusspunkt untereinander. Die nachteiligen Wirkungen sind in der Mehrzahl zu haeufige unbegruendete Abschaltungen und damit eine unzuverlaessige Betriebsweise. Bei einer hoeheren Durchdringung der Netze mit DEA ist das von zunehmender Bedeutung. Im Rahmen des Projektes SIDENA ('Sicherheitsaspekte bei dezentralen netzgekoppelten Energieerzeugungsanlagen') werden daher unterschiedliche Wechselwirkungen am Netzanschlusspunkt untersucht und der Betrieb von derzeitig max. 22 PV-Wechselrichtern sowohl AC- als auch DC-seitig geprueft. (orig.)

  11. Rotational Acetabular Osteotomy for Pre- and Early Osteoarthritis Secondary to Dysplasia Provides Durable Results at 20 Years. (United States)

    Yasunaga, Yuji; Ochi, Mitsuo; Yamasaki, Takuma; Shoji, Takeshi; Izumi, Sotaro


    Hip dysplasia is a common cause of secondary osteoarthritis (OA). Periacetabular osteotomy or rotational acetabular osteotomy has been used as joint-preserving procedures. However, only a few reports of long-term results with these operations have been reported. (1) Would satisfactory clinical and radiographic outcomes be maintained at a mean duration of 20 years after rotational acetabular osteotomy for pre- and early-stage OA; and (2) could we identify risk factors for radiographic progression of OA? Between 1987 and 2001, we treated 159 patients (173 hips) with rotational acetabular osteotomies for the diagnosis of pre-OA or early-stage OA according to the technique of Ninomiya and Tagawa. During that period, our general indications for this approach were age younger than 60 years, center-edge angle less than 20°, and improved femoral head coverage and joint congruency on preoperative AP plain radiographs of the hip in abduction; we did not use this approach when joint congruency was not improved or no widening of the joint space was noted on preoperative AP plain radiographs of the hip in abduction. Of those patients, 21 patients with pre-OA (followup rate: 84% [27 hips]) and 110 patients in the early-stage group (followup rate: 82% [118 hips]) were available at a minimum of 15 years for a total patient group of 131 (followup rate: 82% [145 hips]). The mean age at the time of surgery was 22 years in the pre-OA group and 38 years in the early-stage group. The mean followup was 21 years in the pre-OA group and 20 years in the early-stage group. Clinical evaluation was performed with the Merle d'Aubigne and Postel rating scale, and radiographic analyses included measurements of the center-edge angle, acetabular roof angle, and head lateralization index on preoperative and postoperative AP radiographs of the pelvis. Postoperative joint congruency was also evaluated. The cumulative probabilities of radiographic signs of OA progression were estimated with use of the

  12. "Amazing Space": Creating Educational Resources from Current Scientific Research Results from the Hubble Space Telescope. (United States)

    Christian, C. A.; Eisenhamer, B.; Eisenhamer, Jonathan; Teays, Terry


    Introduces the Amazing Space program which is designed to enhance student mathematics, science, and technology skills using recent data and results from the National Aeronautics and Space Administration's (NASA) Hubble Space Telescope mission. Explains the process of designing multi-media resources in a five-week summer workshop that partners…

  13. The RooPfs study to assess whether improved housing provides additional protection against clinical malaria over current best practice in The Gambia

    DEFF Research Database (Denmark)

    Pinder, Margeret; Conteh, Lesong; Jeffries, David


    economic and social science studies will undertake a cost-effectiveness analysis and use qualitative and participatory methods to explore the acceptability of the housing modifications and to design strategies for scaling-up housing interventions. Discussion The study is the first of its kind to measure......Background In malaria-endemic areas, residents of modern houses have less malaria than those living in traditional houses. This study will determine if modern housing provides incremental protection against clinical malaria over the current best practice of long-lasting insecticidal nets (LLINs......) and prompt treatment in The Gambia, determine the incremental cost-effectiveness of the interventions, and analyze the housing market in The Gambia. Methods/design A two-armed, household, cluster-randomized, controlled study will be conducted to assess whether improved housing and LLINs combine to provide...

  14. Effect of current mode on PEO treatment of magnesium in Ca- and P-containing electrolyte and resulting coatings

    Energy Technology Data Exchange (ETDEWEB)

    Gao, Yonghao [Department of Materials Science and Engineering, University of Sheffield, Mappin Street, Sheffield S1 3JD (United Kingdom); Yerokhin, Aleksey, E-mail: [Department of Materials Science and Engineering, University of Sheffield, Mappin Street, Sheffield S1 3JD (United Kingdom); National University of Science and Technology “MISIS”, Leninsky Prospect, 4, Moscow 119049 (Russian Federation); Matthews, Allan [Department of Materials Science and Engineering, University of Sheffield, Mappin Street, Sheffield S1 3JD (United Kingdom)


    Highlights: • MgO-Na{sub 4}Ca(PO{sub 3}){sub 6} coatings produced on cp-Mg in both PUP- and PBP-PEO modes. • Negative biasing affects PEO processing of cp-Mg in Ca(OH){sub 2}-Na{sub 3}PO{sub 4} electrolyte. • Thicker and macro defect-free PUP-PEO coatings provide better corrosion protection. • Corrosion mechanisms of PEO-treated cp-Mg in SBF discussed. - Abstract: Plasma electrolytic oxidation (PEO) coatings were produced on commercially pure magnesium in a biologically friendly electrolyte composed of 2 g L{sup −1} Ca(OH){sub 2} and 12 g L{sup −1} Na{sub 3}PO{sub 4}·12H{sub 2}O using pulsed unipolar and bipolar current regimes with negative biasing varying from 0 to 20 mA cm{sup −2}. Analysis of voltage transients was performed to characterise the PEO processes. The coating morphology and phase composition were studied by scanning electron microscopy and X-ray diffraction technique, respectively. In vitro corrosion performance of the coatings was evaluated in a simulated body fluid at 37 ± 1 °C, using electrochemical techniques including open circuit potential monitoring, electrochemical impedance spectroscopy and potentiodynamic polarisation scans. The influence of the negative biasing on the PEO process and resulting coating characteristics is discussed. Unlike generally recognised beneficial effects of the negative biasing in PEO treatments of some other metal-electrolyte systems, it was found that detrimental effects are induced to the coatings on cp-Mg produced in the studied electrolyte when the negative current amplitude increases, which may be attributed to hydrogen liberation at the coating/substrate interface during the negative biasing cycles. As a result, a deterioration of vitro corrosion performance was observed for the pulsed bipolar PEO coatings compared to those produced using the pulsed unipolar regime which provides better quality coatings.

  15. Experimental studies on benzene carcinogenicity at the Bologna Institute of Oncology: current results and ongoing research. (United States)

    Maltoni, C; Conti, B; Cotti, G; Belpoggi, F


    In 1977 Maltoni and Scarnato were the first to demonstrate that benzene is an experimental carcinogen in rats. With that and other experiments, Maltoni et al have shown that benzene administered by ingestion (stomach tube) or inhalation is a multipotential carcinogen in rats (of two different strains) and mice and produces a variety of tumors, namely: Zymbal gland carcinomas, oral and nasal cavity carcinomas, skin carcinomas, acanthomas, dysplasias and carcinomas of forestomach, mammary malignant tumors, hepatomas, liver angiosarcomas, hemolymphoreticular neoplasias, and pulmonary tumors. The incidence of Zymbal gland carcinomas and carcinomas of the oral and nasal cavities is affected by the length of treatment by inhalation and by the age of animals. However, the available epidemiological and experimental data at present do not provide precise information on the risk of doses around or below 10 ppm. Long-term carcinogenicity bioassays at 50, 25, 10, 5 and 1 ppm may be helpful for scientific risk assessment. In addition, these experiments have shown that toluene, xylene, and ethylbenzene, at high concentrations, cause an increase in the number of total malignant tumors.


    Energy Technology Data Exchange (ETDEWEB)

    Seitz, R.


    The U.S. Department of Energy (USDOE) Office of Environmental Management (EM), Office of Soil and Groundwater, is supporting development of the Advanced Simulation Capability for Environmental Management (ASCEM). ASCEM is a state-of-the-art scientific tool and approach for understanding and predicting contaminant fate and transport in natural and engineered systems. The modular and open source high-performance computing tool facilitates integrated approaches to modeling and site characterization that enable robust and standardized assessments of performance and risk for EM cleanup and closure activities. The ASCEM project continues to make significant progress in development of computer software capabilities with an emphasis on integration of capabilities in FY12. Capability development is occurring for both the Platform and Integrated Toolsets and High-Performance Computing (HPC) Multiprocess Simulator. The Platform capabilities provide the user interface and tools for end-to-end model development, starting with definition of the conceptual model, management of data for model input, model calibration and uncertainty analysis, and processing of model output, including visualization. The HPC capabilities target increased functionality of process model representations, toolsets for interaction with Platform, and verification and model confidence testing. The Platform and HPC capabilities are being tested and evaluated for EM applications in a set of demonstrations as part of Site Applications Thrust Area activities. The Phase I demonstration focusing on individual capabilities of the initial toolsets was completed in 2010. The Phase II demonstration completed in 2012 focused on showcasing integrated ASCEM capabilities. For Phase II, the Hanford Site deep vadose zone (BC Cribs) served as an application site for an end-to-end demonstration of capabilities, with emphasis on integration and linkages between the Platform and HPC components. Other demonstrations

  17. The prevalence of chromium allergy in Denmark is currently increasing as a result of leather exposure

    DEFF Research Database (Denmark)

    Thyssen, J P; Jensen, P; Carlsen, B C;


    previously been demonstrated among Danish construction workers. OBJECTIVES: To investigate the development of chromium allergy among patients with dermatitis tested between 1985 and 2007 in Denmark. Furthermore, to determine causative exposures in patients with chromium allergy. PATIENTS AND METHODS......: A retrospective analysis of patch test data was performed (n = 16,228) and charts from patients with chromium allergy were reviewed. Comparisons were made using a chi(2) test. Logistic regression analyses were used to test for associations. RESULTS: The prevalence of chromium allergy decreased significantly from...

  18. Behavior of a DC zero-flux current sensor; Magnetic field analysis and comparison with experimental results

    Energy Technology Data Exchange (ETDEWEB)

    Campostrini, P.; Sonato, P. (Istituto Gas Ionizzati del CNR, Padova (IT))


    In this paper the magnetic section of the finite-element ANSYS code, and in particular its optimization feature has been used to predict the behaviour of a zero-flux current sensor, briefly described, which is intended to be used in a fusion experiment to measure pulsed currents up to 50 kA, over a bandwidth from DC to 10 k Hz. The computed results fit well with those coming from experimental tests performed on a prototype.

  19. Results of operation and current safety performance of nuclear facilities located in the Russian Federation (United States)

    Kuznetsov, V. M.; Khvostova, M. S.


    After the NPP radiation accidents in Russia and Japan, a safety statu of Russian nuclear power plants causes concern. A repeated life time extension of power unit reactor plants, designed at the dawn of the nuclear power engineering in the Soviet Union, power augmentation of the plants to 104-109%, operation of power units in a daily power mode in the range of 100-70-100%, the use of untypical for NPP remixed nuclear fuel without a careful study of the results of its application (at least after two operating periods of the research nuclear installations), the aging of operating personnel, and many other management actions of the State Corporation "Rosatom", should attract the attention of the Federal Service for Ecological, Technical and Atomic Supervision (RosTekhNadzor), but this doesn't happen. The paper considers safety issues of nuclear power plants operating in the Russian Federation. The authors collected statistical information on violations in NPP operation over the past 25 years, which shows that even after repeated relaxation over this period of time of safety regulation requirements in nuclear industry and highly expensive NPP modernization, the latter have not become more safe, and the statistics confirms this. At a lower utilization factor high-power pressure-tube reactors RBMK-1000, compared to light water reactors VVER-440 and 1000, have a greater number of violations and that after annual overhauls. A number of direct and root causes of NPP mulfunctions is still high and remains stable for decades. The paper reveals bottlenecks in ensuring nuclear and radiation safety of nuclear facilities. Main outstanding issues on the storage of spent nuclear fuel are defined. Information on emissions and discharges of radioactive substances, as well as fullness of storages of solid and liquid radioactive waste, located at the NPP sites are presented. Russian NPPs stress test results are submitted, as well as data on the coming removal from operation of NPP

  20. Myocardial perfusion scintigraphy in Germany. Results of the 2005 query and current status

    Energy Technology Data Exchange (ETDEWEB)

    Lindner, O. [Inst. fuer Radiologie, Nuklearmedizin und Molekulare Bildgebung, Herz- und Diabeteszentrum NRW, Bad Oeynhausen (Germany); Burchert, W. [Inst. fuer Radiologie, Nuklearmedizin und Molekulare Bildgebung, Herz- und Diabeteszentrum NRW, Bad Oeynhausen (Germany); Arbeitsgemeinschaft ' ' Kardiovaskulaere Nuklearmedizin' ' der Deutschen Gesellschaft fuer Nuklearmedizin (Germany); Bengel, F.M. [Cardiovascular Nuclear Medicine, Johns Hopkins Medical Insts., Baltimore (United States); Arbeitsgruppe ' ' Nuklearkardiologische Diagnostik' ' der Deutschen Gesellschaft fuer Kardiologie (Germany); Zimmermann, R. [Arbeitsgruppe ' ' Nuklearkardiologische Diagnostik' ' der Deutschen Gesellschaft fuer Kardiologie (Germany); Medizinische Klinik, Klinikum Pforzheim GmbH (Germany); Dahl, J. vom [Klinik fuer Kardiologie, Kliniken Maria Hilf GmbH, Moenchengladbach (Germany); Schaefer, W.; Buell, U. [Klinik fuer Nuklearmedizin, Universitaetsklinikum Aachen (Germany); Schober, O. [Klinik und Poliklinik fuer Nuklearmedizin, Universitaetsklinikum Muenster (Germany); Schwaiger, M. [Nuklearmedizinische Klinik, Klinikum Rechts der Isar, Muenchen (Germany); Kluge, R. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Leipzig (Germany); Schaefers, M. [Arbeitsgemeinschaft ' ' Kardiovaskulaere Nuklearmedizin' ' der Deutschen Gesellschaft fuer Nuklearmedizin (Germany); Klinik und Poliklinik fuer Nuklearmedizin, Universitaetsklinikum Muenster (Germany)


    The working group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine (DGN), in cooperation with the working group Nuclear Cardiology of the German Cardiac Society (DGK), decided to conduct a national survey on myocardial perfusion scintigraphy (MPS). Method: a questionnaire to evaluate MPS for the year 2005 was sent. Results: 346 completed questionnaires had been returned (213 private practices, 99 hospitals and 33 university hospitals). MPS of 112 707 patients were reported with 110 747 stress and 95 878 rest studies. The majority (> 75%) was performed with {sup 99m}Tc-MIBI or tetrofosmin. {sup 201}Tl stress-redistribution was used in 22 637 patients (20%). The types of stress were exercise in 78%, vasodilation with adenosine or dipyridamol in 21% and dobutamine in 1%. 99.97% of all MPS were SPECT studies. Gated SPECT was performed in 36% of the stress and in 32% of the rest studies. An attenuation correction was used in 21%. 29 institutions (8%) performed gated SPECT (stress and rest) and attenuation correction. 47% of all MPS were requested by ambulatory care cardiologists, 17% by internists, 12% by primary care physicians, 21% by hospital departments and 2% by others. Conclusion: in Germany, MPS is predominantly performed with {sup 99m}Tc-perfusion agents. The common type of stress is ergometry. Gated SPECT and attenuation correction do not yet represent standards of MPS practice in Germany, which indicates some potential of optimization. (orig.)

  1. Myocardial perfusion scintigraphy 2007 in Germany. Results of the query and current status

    Energy Technology Data Exchange (ETDEWEB)

    Lindner, O. [Inst. fuer Radiologie, Nuklearmedizin und Molekulare Bildgebung, Herz- und Diabeteszentrum NRW, Bad Oeynhausen (Germany); Burchert, W. [Inst. fuer Radiologie, Nuklearmedizin und Molekulare Bildgebung, Herz- und Diabeteszentrum NRW, Bad Oeynhausen (Germany); Arbeitsgemeinschaft Kardiovaskulaere Nuklearmedizin der Deutschen Gesellschaft fuer Nuklearmedizin (Germany); Bengel, F.M. [Cardiovascular Nuclear Medicine, Johns Hopkins Medical Institutions, Baltimore (United States); Arbeitsgruppe Nuklearkardiologische Diagnostik der Deutschen Gesellschaft fuer Kardiologie (Germany); Zimmermann, R. [Arbeitsgruppe Nuklearkardiologische Diagnostik der Deutschen Gesellschaft fuer Kardiologie (Germany); Medizinische Klinik, Klinikum Pforzheim GmbH, Pforzheim (Germany); Dahl, J. vom [Klinik fuer Kardiologie, Kliniken Maria Hilf GmbH, Moenchengladbach (Germany); Schaefer, W. [Klinik fuer Nuklearmedizin, Universitaetsklinikum Aachen (Germany); Schober, O. [Klinik und Poliklinik fuer Nuklearmedizin, Universitaetsklinikum Muenster UKM (Germany); Schaefers, M. [Arbeitsgemeinschaft Kardiovaskulaere Nuklearmedizin der Deutschen Gesellschaft fuer Nuklearmedizin (Germany); Klinik und Poliklinik fuer Nuklearmedizin, Universitaetsklinikum Muenster UKM (Germany)


    Aim: This third survey of the working group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine in cooperation with the working group Nuclear Cardiology of the German Cardiac Society was to deliver information on the procedures and in particular on the development of myocardial perfusion scintigraphy (MPS) from 2005 to 2007. Method: 370 questionnaires (222 private practices (PP), 117 hospitals (HO), 31 university hospitals (UH)) were evaluated. Results: MPS of 114,374 patients were reported, 83% were investigated with {sup 99m}Tc-perfusion tracers. 76% [2006=74%] were performed in PP, 15% [2006=17%] in HO and 9% [2006=9%] in UH. Diabetics represented 21% of all MPS patients in 2007. Data of 215 institutions which participated all from 2005 to 2007 showed an increase in MPS of 2.3% (PP +6.8%, HO -4.5%, UH -18.2%). The type of stress was pharmacological in 27% [2006 = 27%]; 67% adenosine (of these 25% with exercise), 31% dipyridamole (of these 55% with exercise), and 2% dobutamine. Gated SPECT was performed in 47% [2006 = 42%] of all rest and in 44% [2006 = 39%] of all stress MPS. 61% [2006 = 83%] of all institutions did not apply perfusion scores. 20% [2006 = 24%] of the institutions reported changes in the use of MPS by competing methods. Conclusion: There is a small increase of MPS between 2005 and 2007 despite competing methods. Gated SPECT has experienced more acceptance, but is still underrepresented. As compared to the European average and general standards of MPS a considerable backlog accounts to pharmacological stress tests, gated SPECT and perfusion scores. (orig.)

  2. Current regimen of pulse therapy for pemphigus: Minor modifications, improved results

    Directory of Open Access Journals (Sweden)

    Pasricha J


    Full Text Available Background: If administered properly, dexamethasone cyclophosphamide pulse (DCP therapy has the potential to effect lifelong recovery from pemphigus. Aims: The objective of this paper is to highlight various parameters of DCP therapy and also, to report the effects of a few modifications in the regimen. Methods: An analysis of 123 patients treated with the DCP/DP regimen over a period of five years (1998 to 2002 is presented here. Seventeen patients who did not start/continue the treatment and three patients who died during the treatment have been excluded from the analysis. Twenty patients who had not yet started families were given only dexamethasone pulses (DPs while 103 patients received DCPs. Low dose (50 mg/day cyclophosphamide was used as in the standard regimen. The three modifications introduced into the regimen were: (1 an additional daily dose of oral betamethasone sufficient to control the disease activity during phase I, which was progressively tapered off completely as the patient recovered, (2 use of systemic antibiotics if the patient had skin lesions, and oral anti-candida drugs if the patient had oral ulcers until complete healing, and (3 insistence on thorough cleaning of the skin and scalp with a normal soap and shampoo, and proper maintenance of oral hygiene in spite of skin/mucosal lesions. The regimen consisted of DCP/DP repeated in exactly 28-day cycles, along with 50 mg cyclophosphamide per day, insistence on completing the treatment and avoiding irregular pulses in all patients. The number of DCPs/DPs during phase I varied in different patients depending upon the dose of betamethasone used and the rate of recovery, but phase II (nine DCPs/DPs in exactly 28-day cycles along with 50 mg cyclophosphamide per day and phase III (only 50 mg cyclophosphamide per day was fixed at nine months each. This was followed by posttreatment follow-up (phase IV. Results: At present, all the patients are in complete remission. The

  3. Historical and cultural aspects of the pineal gland: comparison between the theories provided by Spiritism in the 1940s and the current scientific evidence. (United States)

    Lucchetti, Giancarlo; Daher, Jorge C; Iandoli, Decio; Gonçalves, Juliane P B; Lucchetti, Alessandra L G


    Significance has been attached to the pineal gland in numerous different cultures and beliefs. One religion that has advanced the role of the pineal gland is Spiritism. The objective of the present study was to compile information on the pineal gland drawing on the books of Francisco Cândido Xavier written through psychography and to carry out a critical analysis of their scientific bases by comparing against evidence in the current scientific literature. A systematic search using the terms "pineal gland" and "epiphysis" was conducted of 12 works allegedly dictated by the spirit "André Luiz". All information on the pineal having potential correlation with the field of medicine and current studies was included. Specialists in the area were recruited to compile the information and draw parallels with the scientific literature. The themes related to the pineal gland were: mental health, reproductive function, endocrinology, relationship with physical activity, spiritual connection, criticism of the theory that the organ exerts no function, and description of a hormone secreted by the gland (reference alluding to melatonin, isolated 13 years later). The historical background for each theme was outlined, together with the theories present in the Spiritist books and in the relevant scientific literature. The present article provides an analysis of the knowledge the scientific community can acquire from the history of humanity and from science itself. The process of formulating hypotheses and scientific theories can benefit by drawing on the cultural aspects of civilization, taking into account so-called non-traditional reports and theories.

  4. EPAct Alternative Fuel Transportation Program: State and Alternative Fuel Provider Fleet Compliance Annual Report, Fleet Compliance Results for MY 2014/ FY 2015

    Energy Technology Data Exchange (ETDEWEB)


    This annual report of the Alternative Fuel Transportation Program, which ensures compliance with DOE regulations covering state government and alternative fuel provider fleets pursuant to the Energy Policy Act of 1992 (EPAct), as amended, provides fleet compliance results for manufacturing year 2014 / fiscal year 2015.

  5. Influence of the Dermis Thickness on the Results of the Skin Treatment with Monopolar and Bipolar Radiofrequency Currents

    Directory of Open Access Journals (Sweden)

    Ilja L. Kruglikov


    Full Text Available Electrically layered tissue structure significantly modifies distribution of radiofrequency (RF current in the dermis and in the subcutaneous adipose tissue comparing to that in a homogeneous medium. On the basis of the simple model of RF current distribution in a two-layer skin containing dermis and subcutis, we assess the influence of the dermal thickness on the current density in different skin layers. Under other equal conditions, current density in the dermis is higher for the skin having thinner dermis. This contradicts the main paradigm of the RF theory stating that treatment results are mainly dependent on the maximal temperature reached in a target tissue, since the best short- and long-term clinical results of RF application to the skin were reported in the areas having thicker dermis. To resolve this contradiction, it is proposed that the long-term effect of RF can be realized through a structural modification of the subcutaneous fat depot adjacent to the treated skin area. Stimulation of these cells located near the interface dermis/subcutis will demand the concentration of applied RF energy in this area and will require the optimal arrangement of RF electrodes on the skin surface.

  6. Presal36: a high resolution ocean current model for Brazilian pre-salt area: implementation and validation results

    Energy Technology Data Exchange (ETDEWEB)

    Schoellkopf, Jacques P. [Advanced Subsea do Brasil Ltda., Rio de Janeiro, RJ (Brazil)


    The PRESAL 36 JIP is a project for the development of a powerful Ocean Current Model of 1/36 of a degree resolution, nested in an existing Global Ocean global Model, Mercator PSY4 (1/12-a-degree resolution ), with tide corrections, improved bathymetry accuracy and high frequency atmospheric forcing (every 3 hours). The simulation outputs will be the 3 dimensional structure of the velocity fields (u,v,w) at 50 vertical levels over the water column, including geostrophic, Ekman and tidal currents, together with Temperature, Salinity and sea surface height at a sub-mesoscale spatial resolution. Simulations will run in hindcast, nowcast and forecast modes, with a temporal resolution of 3 hours . This Ocean current model will allow to perform detailed statistical studies on various areas using conditions analysed using hindcast mode, short term operational condition prediction for various surface and sub sea operations using realtime and Forecast modes. The paper presents a publication of significant results of the project, in term of pre-sal zoomed model implementation, and high resolution model validation. It demonstrate the capability to properly describe ocean current phenomenon at beyond mesoscale frontier. This project demonstrate the feasibility of obtaining accurate information for engineering studies and operational conditions, based on a 'zoom technique' starting from global ocean models. (author)

  7. Late sodium current block for drug-induced long QT syndrome: Results from a prospective clinical trial. (United States)

    Johannesen, L; Vicente, J; Mason, J W; Erato, C; Sanabria, C; Waite-Labott, K; Hong, M; Lin, J; Guo, P; Mutlib, A; Wang, J; Crumb, W J; Blinova, K; Chan, D; Stohlman, J; Florian, J; Ugander, M; Stockbridge, N; Strauss, D G


    Drug-induced long QT syndrome has resulted in many drugs being withdrawn from the market. At the same time, the current regulatory paradigm for screening new drugs causing long QT syndrome is preventing drugs from reaching the market, sometimes inappropriately. In this study, we report the results of a first-of-a-kind clinical trial studying late sodium (mexiletine and lidocaine) and calcium (diltiazem) current blocking drugs to counteract the effects of hERG potassium channel blocking drugs (dofetilide and moxifloxacin). We demonstrate that both mexiletine and lidocaine substantially reduce heart-rate corrected QT (QTc) prolongation from dofetilide by 20 ms. Furthermore, all QTc shortening occurs in the heart-rate corrected J-Tpeak (J-Tpeak c) interval, the biomarker we identified as a sign of late sodium current block. This clinical trial demonstrates that late sodium blocking drugs can substantially reduce QTc prolongation from hERG potassium channel block and assessment of J-Tpeak c may add value beyond only assessing QTc.

  8. Electron-beam-induced current measurements with applied bias provide insight to locally resolved acceptor concentrations at p-n junctions

    Energy Technology Data Exchange (ETDEWEB)

    Abou-Ras, D., E-mail:; Schäfer, N.; Baldaz, N.; Brunken, S. [Helmholtz-Zentrum Berlin für Materialien und Energie, Hahn-Meitner-Platz 1, 14109 Berlin (Germany); Boit, C. [Technische Universität Berlin, Department of Semiconductor Devices, Einsteinufer 19, 10587 Berlin (Germany)


    Electron-beam-induced current (EBIC) measurements have been employed for the investigation of the local electrical properties existing at various types of electrical junctions during the past decades. In the standard configuration, the device under investigation is analyzed under short-circuit conditions. Further insight into the function of the electrical junction can be obtained when applying a bias voltage. The present work gives insight into how EBIC measurements at applied bias can be conducted at the submicrometer level, at the example of CuInSe{sub 2} solar cells. From the EBIC profiles acquired across ZnO/CdS/CuInSe{sub 2}/Mo stacks exhibiting p-n junctions with different net doping densities in the CuInSe{sub 2} layers, values for the width of the space-charge region, w, were extracted. For all net doping densities, these values decreased with increasing applied voltage. Assuming a linear relationship between w{sup 2} and the applied voltage, the resulting net doping densities agreed well with the ones obtained by means of capacitance-voltage measurements.

  9. Rapid and reliable seismic source characterization in earthquake early warning systems: current methodologies, results, and new perspectives (United States)

    Colombelli, Simona; Zollo, Aldo


    In the present paper, we provided a review of the main principles and methodologies on which the current earthquake early warning systems are grounded and will also provide a perspective view for next future developments and improvements. First, we introduce the standard methodologies for the source characterization in earthquake early warning, with a special focus on the real-time earthquake magnitude determination. We discuss the suitability of existent methodologies and empirical regression laws for very large events. We then present the different approaches for the rapid prediction of the ground shaking and of the potential damaged zone, both based on traditional seismic data and on the use of continuous GPS data. Finally, the last part of the paper provides the perspective view toward a next generation of early warning systems, linking new research achievements about the earthquake rupture nucleation and the development of new methods/technologies aimed at a fast and high-resolution, real-time modeling of the ongoing source process and accurate prediction of the quake shaking at the regional and local scale.

  10. The determinants of logistics cooperation in the supply chain - selected results of the opinion poll within logistics service providers and their customers

    Directory of Open Access Journals (Sweden)

    Marcin Świtała


    Full Text Available Introduction: The paper is focused on some selected aspects of the cooperation between logistics service providers and their customers and considers the results of comparative analysis of importance assessment of the variables determining: the scope and nature of that cooperation, quality of providers' sales offer as well as changes in their customer service policy. Methods: To analyze the underlying problem direct research was conducted, i.e. a survey based on a questionnaire among 50 logistics service providers and 50 shippers. The sample was determined on special purpose. In the statistical analysis chi-square independence test, U Mann-Whitney's test as well as Cramer's V and Spearman's rho correlation ratios were used. Results: There were observed significant statistical differences between analyzed groups in the way the cooperation is perceived. The most vital discrepancies are related to customers' satisfaction degree and the assessment of the influence the providers' prices and competencies have on the cooperation. For the customers, declaring higher degree of the satisfaction from the cooperation, service quality was the most important factor. However, for the service providers, price factor was the most important one. Moreover, some differences in the answers related to changes in the service were observed, mainly with reference to: logistics capacity, out-of-loss shipments and communication. Conclusions: The group of customers revealed to be little demanding about logistics service. They tended to order mainly routine services, not demanding special skills from the service providers. This is the most probable reason why customers/providers preferred cooperation with greater number of entities. The customers, unlike service providers, also didn't have the need to develop more advanced forms of cooperation. Moreover, the observed differences related to the importance hierarchy of the cooperation determinants as well as service standards

  11. Current Practice vs. Guideline Based Imaging in Abdominal Radiology in the German Speaking Area: Results of an Online Survey. (United States)

    Schreyer, A G; Wessling, J; Grenacher, L


    The working group for abdominal imaging within the German Roentgen Society (DRG) performed an online survey amongst radiologist concerning the current status of techniques for abdominal imaging. The results of this survey were compared with the most recent guidelines. We performed an online survey open for all members of the DRG during a 76-day period with 65 questions and an overall estimated time for finishing the questionnaire of 15 minutes concerning technical specifications for abdominal radiological imaging. The results were evaluated using descriptive statistics. 90 of all participants, who filled out the survey covering more than 80% of the questions, were included in the statistical evaluation. 27% of all participants were registered radiologists while 73% represented radiologists working in a hospital. Most participants worked in a managerial position. The participants gave detailed information regarding the radiological techniques used in dedicated organ systems (esophagus, stomach, pancreas, liver, small intestines, colon) regarding acquired contrast phases and oral and intravenous administration of contrast medium. The results confirm that most radiologists participating in this survey perform their examinations and choose their modalities in conformity with the current existing clinical guidelines. Because most clinical guidelines do not specify radiological examinations in detail, there is a noteworthy heterogeneity of the acquired contrast phases and major divergence in terms of technical parameters. Therefore a joint radiological effort should be initiated for developing and publishing updated radiological parameters for abdominal imaging. • In German speaking countries indications for abdominal radiological examinations are performed with a high compliance to published guidelines. • There is a significant heterogeneity regarding the acquisition of different contrast phases for parenchymal abdominal organs. • There is an urgent need to

  12. Challenges to the provision of diabetes care in first nations communities: results from a national survey of healthcare providers in Canada

    Directory of Open Access Journals (Sweden)

    Macaulay Ann C


    Full Text Available Abstract Background Aboriginal peoples globally, and First Nations peoples in Canada particularly, suffer from high rates of type 2 diabetes and related complications compared with the general population. Research into the unique barriers faced by healthcare providers working in on-reserve First Nations communities is essential for developing effective quality improvement strategies. Methods In Phase I of this two-phased study, semi-structured interviews and focus groups were held with 24 healthcare providers in the Sioux Lookout Zone in north-western Ontario. A follow-up survey was conducted in Phase II as part of a larger project, the Canadian First Nations Diabetes Clinical Management and Epidemiologic (CIRCLE study. The survey was completed with 244 healthcare providers in 19 First Nations communities in 7 Canadian provinces, representing three isolation levels (isolated, semi-isolated, non-isolated. Interviews, focus groups and survey questions all related to barriers to providing optimal diabetes care in First Nations communities. Results the key factors emerging from interviews and focus group discussions were at the patient, provider, and systemic level. Survey results indicated that, across three isolation levels, healthcare providers' perceived patient factors as having the largest impact on diabetes care. However, physicians and nurses were more likely to rank patient factors as having a large impact on care than community health representatives (CHRs and physicians were significantly less likely to rank patient-provider communication as having a large impact than CHRs. Conclusions Addressing patient factors was considered the highest impact strategy for improving diabetes care. While this may reflect "patient blaming," it also suggests that self-management strategies may be well-suited for this context. Program planning should focus on training programs for CHRs, who provide a unique link between patients and clinical services

  13. First results of Indian - Current meter moorings along The equator: Vertical current structure variability at equator, 93 degrees E during February-December, 2000

    Digital Repository Service at National Institute of Oceanography (India)

    Murty, V.S.N.; Suryanarayana, A.; Sarma, M.S.S.; Tilvi, V.; Fernando, V.; Nampoothiri, G.; Sardar, A.; Gracias, D.; Khalap, S.

    are weak while the low pass filtered (49-hour) current data show considerable meso-scale variability, comprising of Intraseasonal Oscillations (ISO) of period 10-20 day and 40.5 day. The 10-20 day ISO is associated with similar variability in surface wind...

  14. Age at menarche and current substance use among Canadian adolescent girls: results of a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Al-Sahab Ban


    Full Text Available Abstract Background Substance use is among the key public health threats that find its genesis during adolescence. Timing of puberty has been lately researched as a potential predictor of subsequent substance abuse. The present study, therefore, aims to assess the effect of age at menarche on current practices of smoking, alcohol drinking and drug use among 14-15 year old Canadian girls. Methods The analysis of the study was based on all female respondents aged 14 to 15 years during Cycle 4 (2000/2001 of the National Longitudinal Survey of Children & Youth (NLSCY. The main independent variable was age at menarche assessed as the month and year of the occurrence of the first menstrual cycle. The dependent variables were current smoking, heavy alcohol drinking in the past 12 months and drug use in the past 12 months. Three logistic regression models were performed to investigate the association between age at menarche and each of the substance use outcomes, adjusting for possible confounders. Bootstrapping was performed to account for the complex sampling design. Results The total weighted sample included in the analysis represented 295,042 Canadian girls. The prevalence of current smokers, heavy drinkers (drunk in the past 12 months and drug users in the past 12 months was approximately 22%, 38% and 26%, respectively. After adjusting of all potential confounders, no association was found between age at menarche and any of the substance use outcomes. School performance and relationship with the father, however, stood out as the main variables to be associated with smoking, heavy drinking and drug use. Conclusions Qualitative studies understanding the social and psychological changes experienced by early maturing Canadian adolescents are warranted to identify other correlates or pathways to substance use in this higher risk population.

  15. Hydrodynamic processes, velocity structure and stratification in natural turbidity currents: Results inferred from field data in the Var Turbidite System (United States)

    Migeon, Sébastien; Mulder, Thierry; Savoye, Bruno; Sage, Françoise


    The Var Turbidite System (NW Mediterranean Sea) is fed during the present-day highstand sea level by large earthquake-induced ignitive turbidity currents, low-density turbidity currents resulting from retrogressive failures triggered on the upper continental slope, and hyperpycnal flows related to the Var River floods. Using a large dataset including bathymetric data, side-scan sonar images, seismic-reflection profiles, cores and photographs of the seafloor, this paper attempts to better constrain the hydrodynamic behaviour of debris flows and turbidity currents along the Upper and Middle Valley of the Var Turbidite System. The drastic change of the seafloor morphology between the Upper and the Middle Valley suggests that gravity flows undergo rapid transformation from cohesive to fully turbulent behaviour. This transformation is related to a hydraulic jump caused by an abrupt decrease in slope angle at the transition between the Upper and the Middle Valley and is associated with en masse deposition and elevation of the seafloor. Strong seafloor erosion prevails in the Middle Valley, suggesting that, for a low and constant slope angle, turbulent flows must regain a balance between concentration and flow thickness rapidly after they experience hydraulic jump. The internal stratification and vertical grain-size distribution within turbulent flows are inferred from the distribution of fine- to coarse-grained turbidites found in cores located along the crest of the Var Sedimentary Ridge with a decreasing elevation above the floor of the Middle Valley. The theoretical vertical velocity profile deduced from the vertical grain-size distribution exhibits a general trend and an inflection of the gradient curve different from those of the velocity profiles classically obtained using numerical modelling.

  16. Experimental Results of a DC Bus Voltage Level Control for a Load-Controlled Marine Current Energy Converter

    Directory of Open Access Journals (Sweden)

    Johan Forslund


    Full Text Available This paper investigates three load control methods for a  marine current energy converter using a vertical axis current  turbine (VACT mounted on a permanent magnet synchronous generator  (PMSG. The three cases are; a fixed AC load, a fixed pulse width  modulated (PWM DC load and DC bus voltage control of a DC  load. Experimental results show that the DC bus voltage control  reduces the variations of rotational speed by a factor of 3.5 at the cost  of slightly increased losses in the generator and transmission lines.  For all three cases, the tip speed ratio \\(\\lambda\\ can be kept close to  the expected \\(\\lambda_{opt}\\. The power coefficient is estimated to be  0.36 at \\(\\lambda_{opt}\\; however, for all three cases, the average  extracted power was about \\(\\sim 19\\\\%. A maximum power point  tracking (MPPT system, with or without water velocity measurement,  could increase the average extracted power.

  17. The results of a survey highlighting issues with feedback on medical training in the United Kingdom and how a Smartphone App could provide a solution. (United States)

    Gray, Thomas G; Hood, Gill; Farrell, Tom


    Feedback drives learning in medical education. Healthcare Supervision Logbook (HSL) is a Smartphone App developed at Sheffield Teaching Hospitals for providing feedback on medical training, from both a trainee's and a supervisor's perspective. In order to establish a mandate for the role of HSL in clinical practice, a large survey was carried out. Two surveys (one for doctors undertaking specialty training and a second for consultants supervising their training) were designed. The survey for doctors-in-training was distributed to all specialty trainees in the South and West localities of the Health Education Yorkshire and the Humber UK region. The survey for supervisors was distributed to all consultants involved in educational and clinical supervision of specialty trainees at Sheffield Teaching Hospitals. The results confirm that specialty trainees provide feedback on their training infrequently-66 % do so only annually. 96 % of the specialty trainees owned a Smartphone and 45 % said that they would be willing to use a Smartphone App to provide daily feedback on the clinical and educational supervision they receive. Consultant supervisors do not receive regular feedback on the educational and clinical supervision they provide to trainees-56 % said they never received such feedback and 33 % said it was only on an annual basis. 86 % of consultants surveyed owned a Smartphone and 41 % said they would be willing to use a Smartphone App to provide feedback on the performance of trainees they were supervising. Feedback on medical training is recorded by specialty trainees infrequently and consultants providing educational and clinical supervision often do not receive any feedback on their performance in this area. HSL is a simple, quick and efficient way to collect and collate feedback on medical training to improve this situation. Good support and education needs to be provided when implementing this new technology.

  18. Providing of marketing innovation in the competitive advantages of the management system in the mineral waters producer companies: concept, organizational resource, results


    N.P. Tarnavska; O.S. Golodniuk


    The aim of article. The article aims to develop and study the conceptual model of marketing innovations provision in competitive advantage management system of mineral waters producer companies to form a innovation portfolio for a particular company. The results of the analysis. The necessity to provide on innovative orientation to manage the competitive advantages through the development and implementation of marketing practices in innovation on the basis of the multidisciplinary approach...

  19. Summary of Recent Results from NASA's Space Solar Power (SSP) Programs and the Current Capabilities of Microwave WPT Technology (United States)

    McSpadden, James; Mankins, John C.; Howell, Joe T. (Technical Monitor)


    The concept of placing enormous solar power satellite (SPS) systems in space represents one of a handful of new technological options that might provide large-scale, environmentally clean base load power into terrestrial markets. In the US, the SPS concept was examined extensively during the late 1970s by the U.S. Department of Energy (DOE) and the National Aeronautics and Space Administration (NASA). More recently, the subject of space solar power (SSP) was reexamined by NASA from 1995-1997 in the "fresh look" study, and during 1998 in an SSP "concept definition study". As a result of these efforts, in 1999-2000, NASA undertook the SSP Exploratory Research and Technology (SERT) program which pursued preliminary strategic technology research and development to enable large, multi-megawatt SSP systems and wireless power transmission (WPT) for government missions and commercial markets (in-space and terrestrial). During 2001-2002, NASA has been pursuing an SSP Concept and Technology Maturation (SCTM) program follow-on to the SERT, with special emphasis on identifying new, high-leverage technologies that might advanced the feasibility of future SSP systems. In addition, in 2001, the U.S. National Research Council (NRC) released a major report providing the results of a peer review of NASA's SSP strategic research and technology (R&T) road maps. One of the key technologies needed to enable the future feasibility of SSP/SPS is that of wireless power transmission. Advances in phased array antennas and rectennas have provided the building blocks for a realizable WPT system. These key components include the dc-RF converters in the transmitter, the retrodirective beam control system, and the receiving rectenna. Each subject is briefly covered, and results from the SERT program that studied a 5.8 GHz SPS system are presented. This paper presents a summary results from NASA's SSP efforts, along with a summary of the status of microwave WPT technology development.

  20. The current status of interventional radiology in Canada: results of a survey by the Canadian Interventional Radiology Association

    Energy Technology Data Exchange (ETDEWEB)

    Millward, S.F.; Holley, M.L. [Univ. of Western Ontario, London Health Sciences Centre, Dept. of Radiology, London, Ontario (Canada)


    To evaluate the current status of interventional radiology in Canada. A questionnaire was sent to 28 Canadian interventional radiologists (defined as a physician who performs any type of interventional procedure, including biopsies, but excluding interventional neuroradiology) practising in both tertiary and community hospitals in the major centres in all provinces except Prince Edward Island. Twenty-two (79%) of 28 surveys were completed and returned, providing data about 86 interventional radiologists (IRs). IRs were performing almost all of the following procedures at their institutions: inferior vena cava filter placement, venous angioplasty, dialysis fistula angioplasty, diagnostic and therapeutic pulmonary and bronchial artery procedures, diagnostic and therapeutic procedures of the lower extremity and renal arteries, percutaneous abscess and biliary drainage procedures, percutaneous nephrostomy, and fibroid embolization. A second group of procedures, performed by both IRs and non-radiologists in most institutions, included: all types of central venous catheter placements, pleural drainage, and gastrostomy tube placement. Procedures not being performed by anyone in a number of institutions included: dialysis graft thrombolysis, varicocele embolization, transjugular intrahepatic portosystemic shunts, palliative stenting of the gastrointestinal tract, fallopian tube recannalization, and liver and prostate tumour treatments. The factors most often limiting the respondents' ability to provide a comprehensive interventional service were the interventional radiology inventory budget and the availability of interventional radiology rooms; 50% of respondents indicated the number of available nurses, technologists and IRs was also an important limiting factor. IRs in Canada still play a major role in many of the most commonly performed procedures. However, limited availability of resources and personnel in many institutions may be hampering the ability of IRs to

  1. Current trends of management of respiratory diseases by pulmonologists: Results of National Conference of Pulmonary Disease - 2015 survey

    Directory of Open Access Journals (Sweden)

    Sheetu Singh


    Full Text Available Context: Respiratory diseases are a common problem in our country and these are associated with significant morbidity and mortality. Aims: The aim of the paper was to analyze the pattern of diagnostic tests used and treatment prescribed for common respiratory diseases. Settings and Design: A total of 1028 pulmonologists, either member of Indian Chest Society or delegate attending the National Conference of Pulmonary Diseases (NAPCON 2015, participated in the online survey. Subjects and Methods: The survey included questions pertinent to common respiratory diseases such as pulmonary tuberculosis (PTB, bronchial asthma, chronic obstructive pulmonary disease (COPD, idiopathic pulmonary fibrosis (IPF, and pneumonia. Results: Investigation used for severity assessment and diagnosis of PTB, was sputum for acid-fast bacilli (83.5%, for IPF was high-resolution computed tomography chest (85.6%, for severe pneumonia was arterial blood gas analysis (69.3%, for asthma was spirometery and peak flow (96.8% and for COPDs was spirometry (87.2%. The most popular choice of treatment for PTB was directly observed treatment short course (55.7%, for bronchial asthma, it was long-acting beta agonist with inhaled corticosteroids (LABA + ICSs (41.1%, for COPD, it was LABA, ICS, and long-acting muscarinic antagonist (LABA + ICS + long-acting muscarinic antagonist (32.4% and for IPF, it was pirfenidone and N acetyl cysteine (38.3%. About 67.5% of doctors preferred hospitalization for patients with severe pneumonia. About 84.5% pulmonologists ordered diagnostic tests and 55.5% prescribed treatment as per current guidelines. Conclusions: The majority of doctors (70.1% in our survey followed recommended guidelines for respiratory disease diagnosis and treatment. However, there is a need for upgradation of treatment strategies currently used by doctors.

  2. Current trends of management of respiratory diseases by pulmonologists: Results of National Conference of Pulmonary Disease - 2015 survey (United States)

    Singh, Sheetu; Singh, Nishtha


    Context: Respiratory diseases are a common problem in our country and these are associated with significant morbidity and mortality. Aims: The aim of the paper was to analyze the pattern of diagnostic tests used and treatment prescribed for common respiratory diseases. Settings and Design: A total of 1028 pulmonologists, either member of Indian Chest Society or delegate attending the National Conference of Pulmonary Diseases (NAPCON) 2015, participated in the online survey. Subjects and Methods: The survey included questions pertinent to common respiratory diseases such as pulmonary tuberculosis (PTB), bronchial asthma, chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), and pneumonia. Results: Investigation used for severity assessment and diagnosis of PTB, was sputum for acid-fast bacilli (83.5%), for IPF was high-resolution computed tomography chest (85.6%), for severe pneumonia was arterial blood gas analysis (69.3%), for asthma was spirometery and peak flow (96.8%) and for COPDs was spirometry (87.2%). The most popular choice of treatment for PTB was directly observed treatment short course (55.7%), for bronchial asthma, it was long-acting beta agonist with inhaled corticosteroids (LABA + ICSs) (41.1%), for COPD, it was LABA, ICS, and long-acting muscarinic antagonist (LABA + ICS + long-acting muscarinic antagonist) (32.4%) and for IPF, it was pirfenidone and N acetyl cysteine (38.3%). About 67.5% of doctors preferred hospitalization for patients with severe pneumonia. About 84.5% pulmonologists ordered diagnostic tests and 55.5% prescribed treatment as per current guidelines. Conclusions: The majority of doctors (70.1%) in our survey followed recommended guidelines for respiratory disease diagnosis and treatment. However, there is a need for upgradation of treatment strategies currently used by doctors. PMID:28144054

  3. Semi-inclusive DIS Experiments Using Transversely Polarized Targets in Hall-A: Current Results and Future Plans

    Directory of Open Access Journals (Sweden)

    Allada Kalyan


    Full Text Available Measurement of single (SSA and double spin asymmetries (DSA in semiinclusive DIS reactions using polarized targets provide a powerful method to probe transverse momentum dependent parton distribution functions (TMDs. In particular, the experimentally measured SSA on nucleon targets can help in extracting the transversity and Sivers distribution functions of u and d-quarks. Similarly, the measured DSA are sensitive to the quark spin-orbital correlations, and provide an access to the TMD parton distribution function (g1T. A recent experiment conducted in Hall-A Jefferson Lab using transversely polarized 3He provide first such measurements on “effective” neutron target. The measurement was performed using 5.9 GeV beam from CEBAF and measured the target SSA/DSA in the SIDIS reaction 3He↑(e, e′π±X. The kinematical range, x = 0.19 ~ 0.34, at Q2 = 1.77 ~ 2.73 (GeV/c2, was focused on the valence quark region. The results from this measurement along with our plans for future high precision measurements in Hall-A are presented.

  4. Challenges faced by health-care providers offering infant-feeding counseling to HIV-positive women in sub-Saharan Africa: a review of current research. (United States)

    Tuthill, Emily L; Chan, Jessica; Butler, Lisa M


    Exclusive breastfeeding (EBF) has been identified as the optimal nutrition and critical behavior in attaining human immunodeficiency virus (HIV)-free infant survival in resource-limited settings. Health-care providers (HCPs) in clinic- and community-settings throughout sub-Saharan Africa (sSA) provide infant-feeding counseling. However, rates of EBF at 6 months of age are suboptimal. HCPs are uniquely positioned to educate HIV-positive mothers and provide support by addressing known barriers to EBF. However, limited evidence exists on the experiences faced by HCPs in providing counseling on infant feeding to HIV-positive women. Our objective is to describe experiences faced by HCPs when delivering infant-feeding counseling in the context of HIV in program settings in sSA. We searched a range of electronic databases, including PubMed, CINAHL, and PsycINFO from January 1990 to February 2013, in addition to hand-searching, cross-reference searching, and personal communications. The search was limited to publications in English. Empirical studies of HCP experiences providing infant-feeding counseling in the prevention of mother-to-child transmission (PMTCT) of HIV programs in sSA were selected. We identified 10 peer-reviewed articles reporting HCP challenges in infant-feeding counseling that met inclusion criteria. Articles included qualitative, cross-sectional and mixed-method studies, and cumulatively reported 31 challenges faced by HCPs. Among the challenges identified, the most commonly reported were personal beliefs held by the HCPs toward infant feeding in the context of HIV, contradictory messages, staff workload, directive counseling styles, and a lack of practical strategies to offer mothers, often leading to improvised counseling approaches. Counseling strategies need to be developed that are relevant, meaningful, and responsive to the needs of both HCPs and mothers.

  5. Current state of musculoskeletal ultrasound training and implementation in Europe: results of a survey of experts and scientific societies

    DEFF Research Database (Denmark)

    Naredo, Esperanza; D'Agostino, Maria A; Conaghan, Philip G


    To document the current state of musculoskeletal US (MSUS) training and extent of implementation among rheumatologists in the member countries of EULAR.......To document the current state of musculoskeletal US (MSUS) training and extent of implementation among rheumatologists in the member countries of EULAR....

  6. Contact allergy to fragrances: current patch test results (2005-2008) from the Information Network of Departments of Dermatology. (United States)

    Uter, Wolfgang; Geier, Johannes; Frosch, Peter; Schnuch, Axel


    Contact sensitization to fragrances is common both in clinical and in population samples. The spectrum of allergens is broad and diverse, and to some extent covered by a set of screening agents. To examine the current frequency of contact sensitization to fragrance allergens in patients routinely patch tested for suspected allergic contact dermatitis with the baseline series and special series. Between 2005 and 2008, 40 709 patients were patch tested in the departments of the Information Network of Departments of Dermatology ( Results with selected fragrances were analysed. Of all patients tested with the German baseline series, 15.1% reacted positively to fragrance mix (FM) I (6.6% positive), FM II (4.6% positive) or Myroxylon pereirae resin (balsam of Peru, 6.8% positive). Among the single constituents of FM I, Evernia prunastri [oak moss absolute (abs.)] was the leading allergen, and amyl cinnamal the least frequent allergen. Among fragrances not included in FM I or FM II, Evernia furfuracea (tree moss abs.) was the most common allergen. For diagnostic purposes, it is necessary to combine several screening agents. The frequency of contact sensitization differs greatly between single fragrances. © 2010 John Wiley & Sons A/S.

  7. Determination of High-Frequency Current Distribution Using EMTP-Based Transmission Line Models with Resulting Radiated Electromagnetic Fields

    Energy Technology Data Exchange (ETDEWEB)

    Mork, B; Nelson, R; Kirkendall, B; Stenvig, N


    Application of BPL technologies to existing overhead high-voltage power lines would benefit greatly from improved simulation tools capable of predicting performance - such as the electromagnetic fields radiated from such lines. Existing EMTP-based frequency-dependent line models are attractive since their parameters are derived from physical design dimensions which are easily obtained. However, to calculate the radiated electromagnetic fields, detailed current distributions need to be determined. This paper presents a method of using EMTP line models to determine the current distribution on the lines, as well as a technique for using these current distributions to determine the radiated electromagnetic fields.

  8. Gerontechnology: Providing a Helping Hand When Caring for Cognitively Impaired Older Adults—Intermediate Results from a Controlled Study on the Satisfaction and Acceptance of Informal Caregivers

    Directory of Open Access Journals (Sweden)

    Anelia Mitseva


    Full Text Available The incidence of cognitive impairment in older age is increasing, as is the number of cognitively impaired older adults living in their own homes. Due to lack of social care resources for these adults and their desires to remain in their own homes and live as independently as possible, research shows that the current standard care provisions are inadequate. Promising opportunities exist in using home assistive technology services to foster healthy aging and to realize the unmet needs of these groups of citizens in a user-centered manner. ISISEMD project has designed, implemented, verified, and assessed an assistive technology platform of personalized home care (telecare for the elderly with cognitive impairments and their caregivers by offering intelligent home support services. Regions from four European countries have carried out long-term pilot-controlled study in real-life conditions. This paper presents the outcomes from intermediate evaluations pertaining to user satisfaction with the system, acceptance of the technology and the services, and quality of life outcomes as a result of utilizing the services.

  9. The impact of paying treatment providers for outcomes: difference-in-differences analysis of the 'payment by results for drugs recovery' pilot. (United States)

    Mason, Thomas; Sutton, Matthew; Whittaker, William; McSweeney, Tim; Millar, Tim; Donmall, Michael; Jones, Andrew; Pierce, Matthias


    To estimate the effect on drug misuse treatment completion of a pilot scheme to pay service providers according to rates of recovery. A controlled, quasi-experimental (difference-in-differences) observational study using multi-level random effects logistic regression. Drug misuse treatment providers in all 149 commissioning areas in England in the financial years 2011-12 and 2012-13. Service users treated in England in 2011-12 and 2012-13. Linkage of provider payments to performance indicators in eight pilot commissioning areas in England compared with all 141 non-pilot commissioning areas in England. Recovery was measured by successful completion of treatment (free from drugs of dependence) and engagement with services was measured by rates of declining to continue with treatment. Following the introduction of the pilot scheme, service users treated in pilot areas were 1.3 percentage points [odds ratio (OR) = 0.859; 95% confidence interval (CI) = 0.788, 0.937] less likely to complete treatment compared with those treated in comparison areas. Service users treated in pilot areas were 0.9 percentage points (OR = 2.934; 95% CI = 2.094, 4.113) more likely to decline to continue with treatment compared with those treated in comparison areas. In the first year of the pilot 'Payment by Results for Drugs Recovery' scheme in England, linking payments to outcomes reduced the probability of completing drug misuse treatment and increased the proportion service users declining to continue with treatment. © 2015 Society for the Study of Addiction.

  10. [Results of QC vs QL study (quality of care vs quality of life) 2006-2009. The way of providing hemodialysis and a concomitant therapy]. (United States)

    Rutkowski, Bolesław; Nowaczyk, Ryszard; Rutkowski, Przemysław; Mierzicki, Piotr


    Healthcare development is the fact in the present world. Because of this the improvement of the quality of care and life of patients is of great importance. Since six years in our country, the study concerning quality of life and care of hemodialysed patients (QC vs QL) is performed annually. In three subsequent papers results of studies performed between 2006 and 2009 are summarised. Almost 7000 patients were studies in the analysed period. This was more than 10% of dialysed patients in every year. In the present paper we focused on the hemodialysis modalities and concomitant therapy. The increase of high-flux hemodialysis usage as well as plasmapheresis but not hemodiafiltration was noticed in the analysed period. Adequacy of the therapy was evaluated as Kt/V and was stable in the whole study. Treatment with erythropoesis stimulating agents (ESA) was provided in 100% of dialysis units, the dosage frequency was connected with long acting ESA. Because of changed trends and the payer requirements apart from frequency the route has also changed. The average haemoglobin level reflected European and county guidelines and changed during the observation. Additional help from psychologist and dietician is available in too small number of dialysis units. Summarizing, based on performed analysis the development of hemodialysis treatment and a high level of provided therapy comparable to other European countries was observed in Poland. Support for further development and improvement of renal replacement therapy is needed to achieve also better quality of life of our patients.

  11. Pharmaceutical Market Access: current state of affairs and key challenges – results of the Market Access Launch Excellence Inventory (MALEI

    Directory of Open Access Journals (Sweden)

    Marcus A. Koch


    Full Text Available Objectives: To take inventory of the current state of affairs of Market Access Launch Excellence in the life sciences industry. To identify key gaps and challenges for Market Access (MA and discuss how they can be addressed. To generate a baseline for benchmarking MA launch excellence. Methodology: An online survey was conducted with pharmaceutical executives primarily working in MA, marketing, or general management. The survey aimed to evaluate MA excellence prerequisites across the product life cycle (rated by importance and level of implementation and to describe MA activity models in the respective companies. Composite scores were calculated from respondents’ ratings and answers. Results: Implementation levels of MA excellence prerequisites generally lagged behind their perceived importance. Item importance and the respective level of implementation correlated well, which can be interpreted as proof of the validity of the questionnaire. The following areas were shown to be particularly underimplemented: 1 early integration of MA and health economic considerations in research and development decision making, 2 developing true partnerships with payers, including the development of services ‘beyond the pill’, and 3 consideration of human resource and talent management. The concept of importance-adjusted implementation levels as a hybrid parameter was introduced and shown to be a viable tool for benchmarking purposes. More than 70% of respondents indicated that their companies will invest broadly in MA in terms of capital and headcount within the next 3 years. Conclusions: MA (launch excellence needs to be further developed in order to close implementation gaps across the entire product life cycle. As MA is a comparatively young pharmaceutical discipline in a complex and dynamic environment, this effort will require strategic focus and dedication. The Market Access Launch Excellence Inventory benchmarking tool may help guide decision

  12. TeleWound care – providing remote wound assessment and treatment in the home care setting: current status and future directions

    Directory of Open Access Journals (Sweden)

    Santamaria N


    Full Text Available Nick Santamaria,1 Suzanne Kapp2 1University of Melbourne and Melbourne Health, Royal Melbourne Hospital, Melbourne, VIC, Australia; 2Royal District Nursing Service Institute, Melbourne, VIC, Australia Abstract: The use of wound telemedicine systems in the home care environment has been expanding for the last decade. These systems can generally be grouped into two main types: store and forward systems and video conference type systems; additionally, there are also hybrid systems available that include elements of both. Evidence to date suggests that these systems provide significant benefits to patients, clinicians, and to the health care system generally. Reductions in resource use, visit substitution, costs, and high patient and clinician satisfaction have been reported; however, there is a lack of integration with existing health care technology and no clearly defined technical or clinical standards as yet. Similarly, the legalities associated with wound telemedicine and remote consultation remain unclear. As wound telemedicine systems continue to evolve and be deployed in different locations, there remains significant potential to harness their power to benefit patients being treated at home. Keywords: telemedicine, home care, e-health

  13. [Standardization of measurement of catalytic activity concentration of enzymes--current situation regarding the external quality assessment program provided by the Japan Medical Association]. (United States)

    Maekawa, Masato


    Measurement of the catalytic activity concentration of enzymes has been standardized using a traceability chain, consisting a reference measurement system for enzyme catalytic activity and reference standard-JSCC enzyme. The Japan Medical Association (JMA) has provided an external quality assessment (EQA) survey program for clinical laboratory testing. More than 3,100 clinical laboratories participated in 2008. The EQA program indicated that standardization of the measurement of the catalytic activity concentration of enzymes has been completed for AST, ALT, LD, ALP, gammaGT, and CK in more than 90% laboratories, and for Amy and ChE in nearly 80% of laboratories. Because such a large survey program must use artificial specimens, a matrix effect cannot be avoided, especially in dry chemistry. However, the bias produced by a matrix effect usually has a predictable tendency: it can be corrected. Next, after standardization of the measurement of the catalytic activity concentration of enzymes, we should develop and use common reference intervals. On completing the standardization, we can make standard medical decisions using reference measurement systems and rules.

  14. Magnetic field structure of Saturn's dayside magnetosphere and its mapping to the ionosphere: Results from ring current modeling (United States)

    Bunce, E. J.; Arridge, C. S.; Cowley, S. W. H.; Dougherty, M. K.


    Ring current modeling in Saturn's magnetosphere using Pioneer-11, Voyager, and Cassini data has shown that the size and strength of the current system grows with the extension of the magnetosphere, governed by the solar wind dynamic pressure. Here we show that the consequent middle magnetosphere field is quasi-dipolar in form when the magnetosphere is strongly compressed, but extends into a magnetodisc when it is strongly expanded. We also show that the region occupied by the modeled ring current corresponds to an essentially fixed shell of field lines that expands and contracts with the size of the system, thus mapping to an almost fixed co-latitude range in Saturn's ionosphere, between ~14° and ~20° in the northern hemisphere, and ~16° and ~22° in the southern hemisphere. The median dayside UV auroral oval is found to map from near the poleward edge of the modeled ring current toward the boundary of open field lines at smaller co-latitudes. In the equatorial plane this corresponds to a layer ~2-5 Saturn radius wide (depending on magnetosphere size), extending from near the outer edge of the ring current to the vicinity of the magnetopause.

  15. Providing of marketing innovation in the competitive advantages of the management system in the mineral waters producer companies: concept, organizational resource, results

    Directory of Open Access Journals (Sweden)

    N.P. Tarnavska


    Full Text Available The aim of article. The article aims to develop and study the conceptual model of marketing innovations provision in competitive advantage management system of mineral waters producer companies to form a innovation portfolio for a particular company. The results of the analysis. The necessity to provide on innovative orientation to manage the competitive advantages through the development and implementation of marketing practices in innovation on the basis of the multidisciplinary approach was substantiated. Scientific novelty of the research includes the formulation of marketing innovations in management competitive advantage concept as an ordered set of scientific statements and related methodological guidelines and provision of innovative marketing competitive advantage that creates the highest potential for successful operation of the business entity in a dynamic market environment. The authors offered the definition of marketing innovations in management competitive advantage provision as the process of ideas, scientific knowledge and competencies of marketing trends transformation into the innovative product that is used in an enterprise or is monetized to increase innovator’s business value on the basis of the growing share of latent competitive advantages held by the company. The transition from the set of empirical data to the synthesis of the market trends on mineral waters market of Ukraine was provided within the developed concept. The national market was divided into two groups (due to global economic processes and the national character to define environmental research challenges of the market. A classification feature «hierarchy of innovations» with the further its division into conceptual and applied was distinguished. A business model as the one that is central for the successful operation of any enterprise in a dynamic market environment changes was singled out. It was proved that marketing innovation should be considered

  16. LabPush: a pilot study of providing remote clinics with laboratory results via short message service (SMS) in Swaziland, Africa - a qualitative study. (United States)

    Hao, Wen-Rui; Hsu, Yi-Hsin; Chen, Kuan-Chen; Li, Hsien-Chang; Iqbal, Usman; Nguyen, Phung-Anh; Huang, Chih-Wei; Yang, Hsuan-Chia; Lee, Peisan; Li, Mei-Hsuan; Hlatshwayo, Sharoon Lungile; Li, Yu-Chuan Jack; Jian, Wen-Shan


    Developing countries are confronting a steady growth in the prevalence of the infectious diseases. Mobile technologies are widely available and can play an important role in health care at the regional, community, and individual levels. Although labs usually able to accomplish the requested blood test and produce the results within two days after receiving the samples, but the time for the results to be delivered back to clinics is quite variable depending on how often the motorbike transport makes trips between the clinic and the lab. In this study, we seek to assess factors facilitating as well as factors hindering the adoption of mobile devices in the Swazi healthcare through evaluating the end-users of the LabPush system. A qualitative study with semi-structured and in-depth one on one interviews were conducted over two month period July-August 2012. Purposive sampling was used; participants were those operating and using the LabPush system at the remote clinics, at the national laboratory and the supervisors of users at Swaziland. Interview questions were focused on perceived of ease of use and usefulness of the system. All interviews were recorded and then transcribed. This study had aimed its primary focus on reducing TAT, prompt patient care, reducing bouncing of patients and defaulting of patients which were challenges that the clinicians have always had. Therefore, the results revealed several barriers and facilitators to the adoption of mobile device by healthcare providers in the Swaziland. The themes Shortens TAT, Technical support, Patient-centered care, Mindset, Improved communication, Missing Reports, Workload, Workflow, Security of smart phone, Human error and Ownership are sorted by facilitators to barriers. Thus the end-users perspective, prompt patient care, reduced bouncing of patients, technical support, better communication, willing participant and social influence were facilitators of the adoption m-health in the Swazi healthcare. Copyright

  17. A Study of Current Trends and Issues for Graphics Education: Results from a Five-Year Follow-Up Survey (United States)

    Clark, Aaron C.; Scales, Alice Y.


    During the 1998-1999 academic year, a survey was conducted to look at current trends and issues in the profession of graphics education (Clark & Scales, 1999). The survey solicited information from the membership of the Engineering Design Graphics Division of the American Society for Engineering Education related to their view of future areas of…

  18. Prenatal protein malnutrition results in increased frequency of miniature inhibitory postsynaptic currents in rat CA3 interneurons. (United States)

    Chang, Yu-Ming; Galler, Janina R; Luebke, Jennifer I


    Electrophysiological studies have revealed an increase in the level of tonic inhibition in the hippocampus following prenatal protein malnutrition in rats. In the present study, whole cell patch clamp recordings of bipolar interneurons in the stratum radiatum of the CA3 subfield were used to determine whether this increase in inhibition can be accounted for by a change in the electrophysiological properties of GABAergic interneurons. Hippocampal slices were prepared from juvenile rats whose dams were fed either a normal (25% casein) or low (6% casein) protein diet throughout pregnancy. Intrinsic membrane and action potential properties were unaltered by the prenatal nutritional insult. In most respects the characteristics of GABAA receptor-mediated inhibitory postsynaptic currents (IPSCs) and the modulation of such currents by the benzodiazepine agonist zolpidem were also similar in cells from the two nutritional groups. While the frequency of spontaneous inhibitory currents was unaltered, miniature (Tetrodotoxin resistant) inhibitory currents occurred at a significantly increased frequency in interneurons from prenatally protein malnourished rats. Thus, while the basic membrane properties of interneurons are preserved, there is a significant increase in the probability of GABA release from interneurons following prenatal protein malnutrition.

  19. The current state of physical activity and exercise programs in German-speaking, Swiss psychiatric hospitals: results from a brief online survey (United States)

    Brand, Serge; Colledge, Flora; Beeler, Nadja; Pühse, Uwe; Kalak, Nadeem; Sadeghi Bahmani, Dena; Mikoteit, Thorsten; Holsboer-Trachsler, Edith; Gerber, Markus


    Background Physical activity and exercise programs (PAEPs) are an important factor in increasing and maintaining physical and mental health. This holds particularly true for patients with psychiatric disorders undergoing treatment in a psychiatric hospital. To understand whether the benefits reported in the literature are mirrored in current treatment modalities, the aim of the present study was to assess the current state of PAEPs in psychiatric hospitals in the German-speaking part of Switzerland. Methods All psychiatric hospitals (N=55) in the German-speaking part of Switzerland were contacted in spring 2014. Staff responsible for PAEPs were asked to complete an online questionnaire covering questions related to PAEPs such as type, frequency, staff training, treatment rationale, importance of PAEPs within the treatment strategy, and possible avenues to increase PAEPs. Results Staff members of 48 different psychiatric hospitals completed the survey. Hospitals provided the following therapeutic treatments: relaxation techniques (100%), sports therapy (97%), activity-related psychotherapeutic interventions (95%), physiotherapy (85%), body therapies (59%), far-east techniques (57%), and hippotherapy (22%). Frequencies ranged from once/week to five times/week. Approximately 25% of patients participated in the PAEPs. Interventions were offered irrespective of psychiatric disorders. PAEP providers wanted and needed more vocational training. Conclusion All participating psychiatric hospitals offer a broad variety of PAEPs in their treatment curricula. However, the majority of inpatients do not participate in PAEPs. Furthermore, those who do participate cannot continue to do so following discharge. PAEP providers need specific extended vocational trainings and believe that the potential of PA should be improved. PMID:27350748

  20. Prevalence, Recurrence, and Incidence of Current Depressive Symptoms among People Living with HIV in Ontario, Canada: Results from the Ontario HIV Treatment Network Cohort Study (United States)

    Choi, Stephanie K. Y.; Boyle, Eleanor; Cairney, John; Collins, Evan J.; Gardner, Sandra; Bacon, Jean; Rourke, Sean B.


    Introduction Current studies of depression among people living with HIV focus on describing its point prevalence. Given the fluctuating nature of depression and its profound impacts on clinical and quality-of-life outcomes, this study aimed to examine the prevalence, recurrence and incidence of current depressive symptoms and its underlying catalysts longitudinally and systematically among these individuals. Methods We conducted a prospective cohort study between October 1, 2007 and December 31, 2012 using longitudinal linked data sources. Current depressive symptoms was identified using the Centre for Epidemiologic Studies Depression Scale or the Kessler Psychological Distress Scale, first at baseline and again during follow-up interviews. Multivariable regressions were used to characterize the three outcomes. Results Of the 3,816 HIV-positive participants, the point prevalence of depressive symptoms was estimated at 28%. Of the 957 participants who were identified with depressive symptoms at baseline and who had at least two years of follow-up, 43% had a recurrent episode. The cumulative incidence among 1,745 previously depressive symptoms free participants (at or prior to baseline) was 14%. During the five-year follow-up, our multivariable models showed that participants with greater risk of recurrent cases were more likely to feel worried about their housing situation. Participants at risk of developing incident cases were also likely to be younger, gay or bisexual, and unable to afford housing-related expenses. Conclusions Depressive symptoms are prevalent and likely to recur among people living with HIV. Our results support the direction of Ontario’s HIV/AIDS Strategy to 2026, which addresses medical concerns associated with HIV (such as depression) and the social drivers of health in order to enhance the overall well-being of people living with or at risk of HIV. Our findings reinforce the importance of providing effective mental health care and

  1. Home visits by neighborhood Mentor Mothers provide timely recovery from childhood malnutrition in South Africa: results from a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Mbewu Nokwanele


    Full Text Available Abstract Background Child and infant malnourishment is a significant and growing problem in the developing world. Malnourished children are at high risk for negative health outcomes over their lifespans. Philani, a paraprofessional home visiting program, was developed to improve childhood nourishment. The objective of this study is to evaluate whether the Philani program can rehabilitate malnourished children in a timely manner. Methods Mentor Mothers were trained to conduct home visits. Mentor Mothers went from house to house in assigned neighborhoods, weighed children age 5 and younger, and recruited mother-child dyads where there was an underweight child. Participating dyads were assigned in a 2:1 random sequence to the Philani intervention condition (n = 536 or a control condition (n = 252. Mentor Mothers visited dyads in the intervention condition for one year, supporting mothers' problem-solving around nutrition. All children were weighed by Mentor Mothers at baseline and three, six, nine and twelve month follow-ups. Results By three months, children in the intervention condition were five times more likely to rehabilitate (reach a healthy weight for their ages than children in the control condition. Throughout the course of the study, 43% (n = 233 of 536 of children in the intervention condition were rehabilitated while 31% (n = 78 of 252 of children in the control condition were rehabilitated. Conclusions Paraprofessional Mentor Mothers are an effective strategy for delivering home visiting programs by providing the knowledge and support necessary to change the behavior of families at risk.

  2. Providing critical laboratory results on time, every time to help reduce emergency department length of stay: how our laboratory achieved a Six Sigma level of performance. (United States)

    Blick, Kenneth E


    To develop a fully automated core laboratory, handling samples on a "first in, first out" real-time basis with Lean/Six Sigma management tools. Our primary goal was to provide services to critical care areas, eliminating turnaround time outlier percentage (TAT-OP) as a factor in patient length of stay (LOS). A secondary goal was to achieve a better laboratory return on investment. In 2011, we reached our primary goal when we calculated the TAT-OP distribution and found we had achieved a Six Sigma level of performance, ensuring that our laboratory service can be essentially eliminated as a factor in emergency department patient LOS. We also measured return on investment, showing a productivity improvement of 35%, keeping pace with our increased testing volume. As a result of our Lean process improvements and Six Sigma initiatives, in part through (1) strategic deployment of point-of-care testing and (2) core laboratory total automation with robotics, middleware, and expert system technology, physicians and nurses at the Oklahoma University Medical Center can more effectively deliver lifesaving health care using evidence-based protocols that depend heavily on "on time, every time" laboratory services.

  3. Medicare Provider Data - Hospice Providers (United States)

    U.S. Department of Health & Human Services — The Hospice Utilization and Payment Public Use File provides information on services provided to Medicare beneficiaries by hospice providers. The Hospice PUF...

  4. Provider Info (United States)

    U.S. Department of Health & Human Services — General information on currently active nursing homes, including number of certified beds, quality measure scores, staffing and other information used in the...

  5. Preliminary results concerning the simulation of beam profiles from extracted ion current distributions for mini-STRIKE

    Energy Technology Data Exchange (ETDEWEB)

    Agostinetti, P., E-mail:; Serianni, G.; Veltri, P. [Consorzio RFX (CNR, ENEA, INFN, Università di Padova, Acciaierie Venete SpA), Corso Stati Uniti 4, 35127 Padova (Italy); Giacomin, M. [Physics Department, Università di Padova, via F. Marzolo 8, 35131 Padova (Italy); Bonomo, F.; Schiesko, L. [Max-Planck-Institut für Plasmaphysik, Boltzmannstrasse 2, D-85748 Garching (Germany)


    The Radio Frequency (RF) negative hydrogen ion source prototype has been chosen for the ITER neutral beam injectors due to its optimal performances and easier maintenance demonstrated at Max-Planck-Institut für Plasmaphysik, Garching in hydrogen and deuterium. One of the key information to better understand the operating behavior of the RF ion sources is the extracted negative ion current density distribution. This distribution—influenced by several factors like source geometry, particle drifts inside the source, cesium distribution, and layout of cesium ovens—is not straightforward to be evaluated. The main outcome of the present contribution is the development of a minimization method to estimate the extracted current distribution using the footprint of the beam recorded with mini-STRIKE (Short-Time Retractable Instrumented Kalorimeter). To accomplish this, a series of four computational models have been set up, where the output of a model is the input of the following one. These models compute the optics of the ion beam, evaluate the distribution of the heat deposited on the mini-STRIKE diagnostic calorimeter, and finally give an estimate of the temperature distribution on the back of mini-STRIKE. Several iterations with different extracted current profiles are necessary to give an estimate of the profile most compatible with the experimental data. A first test of the application of the method to the BAvarian Test Machine for Negative ions beam is given.

  6. Can Tidal Current Energy Provide Base Load?

    Directory of Open Access Journals (Sweden)

    Simone Giorgi


    Full Text Available Tidal energy belongs to the class of intermittent but predictable renewable energy sources. In this paper, we consider a compact set of geographically diverse locations, which have been assessed to have significant tidal stream energy, and attempt to find the degree to which the resource in each location should be exploited so that the aggregate power from all locations has a low variance. An important characteristic of the locations chosen is that there is a good spread in the peak tidal flow times, though the geographical spread is relatively small. We assume that the locations, all on the island of Ireland, can be connected together and also assume a modular set of tidal turbines. We employ multi-objective optimisation to simultaneously minimise variance, maximise mean power and maximise minimum power. A Pareto front of optimal solutions in the form of a set of coefficients determining the degree of tidal energy penetration in each location is generated using a genetic algorithm. While for the example chosen the total mean power generated is not great (circa 100 MW, the case study demonstrated a methodology that can be applied to other location sets that exhibit similar delays between peak tidal flow times.

  7. Experiences of health care providers managing sexual assault victims in the emergency unit Part 2: Discussion of results and literature control

    Directory of Open Access Journals (Sweden)

    Rebecca M. Skhosana


    medekodeerder geanaliseer. Hoofkategorieë, subkategorieë en temas is geïdentifiseer. Deelnemers het uitdrukking gegee aan hulle emosies, uitdagings, die houding en gedrag van polisiebeamptes, teenstrydighede in riglyne en behoefte-identifikasie. Aanbevelings is dat multidissiplinêre spanlede betrokke moet wees by gemeenskapsaktiwiteite en dat die gemeenskap moet deelneem aan sake wat verband hou met seksuele aanranding. Die regering moet duidelike riglyne ontwikkel wat op landelike en stedelike Suid-Afrika van toepassing is. Gesondheidsorgwetenskappe moet daarop gerig wees om meer forensiese verpleegkundiges op te lei. Alle toepaslike departemente moet saamwerk om die komplikasies te verlig wat deur voorvalle van seksuele aanranding veroorsaak word.

    How to cite this article:

    Skhosana, R.M. & Peu, M.D., 2009, 'Experiences of health care providers managing sexual assault victims in an emergency unit Part 2: Discussion of results and literature control', Health SA Gesondheid 14(1, Art. #481, 5 pages. DOI: 10.4102/hsag.v14i1.481

  8. Massless correlators of vector, scalar and tensor currents in position space at orders alpha_s^3 and alpha_s^4: explicit analytical results


    Chetyrkin, K. G.; Maier, A


    We present analytical results both in momentum and position space for the massless correlators of the vector and scalar currents to order alpha_s^4 as well as for the tensor currents to order alpha_s^3. The evolution equations for the correlators together with all relevant anomalous dimensions are discussed in detail. As an application we present explicit conversion formulas relating the MSbar-renormalized vector, scalar and tensor currents to their counterparts renormalized in the X-space re...

  9. EPAct Alternative Fuel Transportation Program: State and Alternative Fuel Provider Fleet Compliance Annual Report; Fleet Compliance Results for MY 2013/FY 2014

    Energy Technology Data Exchange (ETDEWEB)


    Compliance rates for covered state government and alternative fuel provider fleets under the Alternative Fuel Transportation Program (pursuant to the Energy Policy Act or EPAct) are reported for MY 2013/FY 2014 in this publication.

  10. Acceptability, feasibility and challenges of implementing an HIV prevention intervention for people living with HIV/AIDS among healthcare providers in Mozambique: results of a qualitative study. (United States)

    Jaiantilal, Prafulta; Gutin, Sarah A; Cummings, Beverley; Mbofana, Francisco; Rose, Carol Dawson


    Despite the Mozambique government's efforts to curb human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), national prevalence is 11.5% and support is needed to expand HIV-related services and improve program quality. Positive prevention (PP) programs, which prioritize HIV prevention with people living with HIV and AIDS (PLHIV), have been recognized as an important intervention for preventing new HIV infections. To address this, an evidence-based PP training intervention was implemented with HIV healthcare providers in Mozambique. This study focuses on the acceptability and feasibility of a PP intervention in HIV clinics from the healthcare provider perspective. In-depth interviews were conducted with 31 healthcare providers from three provinces who participated in PP trainings in Mozambique. Interview data were coded using content analysis. Study data suggest that healthcare providers found PP acceptable, feasible to implement in their HIV work in clinic settings, and valued this strategy to improve HIV prevention. The PP training also led providers to feel more comfortable counseling their patients about prevention, with a more holistic approach that included HIV testing, treatment and encouraging PLHIV to live positively. While overall acceptance of the PP training was positive, several barriers to feasibility surfaced in the data. Patient-level barriers included resistance to disclosing HIV status due to fear of stigma and discrimination, difficulty negotiating for condom use, difficulty engaging men in testing and treatment, and the effects of poverty on accessing care. Providers also identified work environment barriers including high patient load, time constraints, and frequent staff turnover. Recognizing PP as an important intervention, healthcare providers should be trained to provide comprehensive prevention, care and treatment for PLHIV. Further work is needed to explore the complex social dynamics and cultural challenges such as

  11. Molecular dynamics simulations of metallic friction and of its dependence on electric currents - development and first results (United States)

    Meintanis, Evangelos Anastasios

    We have extended the HOLA molecular dynamics (MD) code to run slider-on-block friction experiments for Al and Cu. Both objects are allowed to evolve freely and show marked deformation despite the hardness difference. We recover realistic coefficients of friction and verify the importance of cold-welding and plastic deformations in dry sliding friction. Our first data also show a mechanism for decoupling between load and friction at high velocities. Such a mechanism can explain an increase in the coefficient of friction of metals with velocity. The study of the effects of currents on our system required the development of a suitable electrodynamic (ED) solver, as the disparity of MD and ED time scales threatened the efficiency of our code. Our first simulations combining ED and MD are presented.

  12. Self-Consistent Model of Magnetospheric Electric Field, Ring Current, Plasmasphere, and Electromagnetic Ion Cyclotron Waves: Initial Results (United States)

    Gamayunov, K. V.; Khazanov, G. V.; Liemohn, M. W.; Fok, M.-C.; Ridley, A. J.


    Further development of our self-consistent model of interacting ring current (RC) ions and electromagnetic ion cyclotron (EMIC) waves is presented. This model incorporates large scale magnetosphere-ionosphere coupling and treats self-consistently not only EMIC waves and RC ions, but also the magnetospheric electric field, RC, and plasmasphere. Initial simulations indicate that the region beyond geostationary orbit should be included in the simulation of the magnetosphere-ionosphere coupling. Additionally, a self-consistent description, based on first principles, of the ionospheric conductance is required. These initial simulations further show that in order to model the EMIC wave distribution and wave spectral properties accurately, the plasmasphere should also be simulated self-consistently, since its fine structure requires as much care as that of the RC. Finally, an effect of the finite time needed to reestablish a new potential pattern throughout the ionosphere and to communicate between the ionosphere and the equatorial magnetosphere cannot be ignored.

  13. Engineering change management report 2012: Survey results on causes and effects, current practice, problems, and strategies in Brazil

    DEFF Research Database (Denmark)

    Chucholowski, Nepomuk; Langer, Stefan; Ferreira, Marcelo Gitirana Gomes

    management of engineering changes is a crucial precondition for Brazilian companies to successfully compete not only on the fast growing Brazilian market, but also on the world market which becomes more interesting due to the rising industrial power of Brazil. To achieve improvements in engineering change...... management practice, industry and universities need to work together. In this report the main findings of our study on Engineering Change Management (ECM) in Brazilian companies are presented, which indicate possible solution strategies and further research needs. Our survey aimed on the investigation...... of current practice, the biggest challenges and potential strategies of engineering change management. A total of 55 Brazilian companies from a broad range of industry sectors and company sizes participated from December 2011 until January 2012 in the survey which was elaborated and conducted by members...

  14. Recent experimental results of effects of perfluoroalkyl substances in laboratory animals - Relation to current regulations and guidance values. (United States)

    Lilienthal, Hellmuth; Dieter, Hermann H; Hölzer, Jürgen; Wilhelm, Michael


    The detection of perfluoroalkyl substances (PFAS) in surface and drinking water from various countries raised the attention to the presence of these chemicals in environmental probes and led to several regulatory actions to limit exposure in human beings. There was particular concern about perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), due to their former wide-spread use. Recently, several institutions published revisions of former regulatory or recommended maximum concentrations in drinking water and food, which are markedly lower than the former values. The present short overview describes the current regulations for PFAS and compares them with the outcome of several experimental studies in laboratory animals at low-level exposure to PFOA and PFOS. In addition, regulations for short-chain PFAS are presented which, due to lack of toxicological information, are evaluated according to the concepts of Threshold of Toxicological Concern (TTC) or the Health-related Indication Values (HRIV).

  15. The value of the internship for radiation oncology training: results of a survey of current and recent trainees. (United States)

    Baker, Stephen R; Romero, Michelle J; Geannette, Christian; Patel, Amish


    Although a 12-month clinical internship is the traditional precursor to a radiation oncology residency, the continuance of this mandated training sequence has been questioned. This study was performed to evaluate the perceptions of current radiation oncology residents with respect to the value of their internship experience. A survey was sent to all US radiation oncology residents. Each was queried about whether they considered the internship to be a necessary prerequisite for a career as a radiation oncologist and as a physician. Preferences were listed on a Likert scale (1 = not at all necessary to 5 = absolutely necessary). Seventy-one percent considered the internship year mostly (Likert Scale 4) or absolutely necessary (Likert Scale 5) for their development as a radiation oncologist, whereas 19.1% answered hardly or not at all (Likert Scale 2 and 1, respectively). With respect to their collective considerations about the impact of the internship year on their development as a physician, 89% had a positive response, 5.8% had a negative response, and 4.7% had no opinion. Although both deemed the preliminary year favorably, affirmative answers were more frequent among erstwhile internal medicine interns than former transitional program interns. A majority of radiation oncology residents positively acknowledged their internship for their development as a specialist and an even greater majority valued it for their development as a physician. This affirmative opinion was registered more frequently by those completing an internal medicine internship compared with a transitional internship.

  16. The first Italian Superconducting Fault Current Limiter: Results of the field testing experience after one year operation (United States)

    Martini, L.; Bocchi, M.; Ascade, M.; Valzasina, A.; Rossi, V.; Ravetta, C.; Angeli, G.


    Ricerca sul Sistema Energetico S.p.A. (RSE) has been gaining a relevant experience in the simulation, design and installation of resistive-type Superconducting Fault Current Limiter (SFCL) devices for more than five years in the framework of a R&D national project funded by the Ricerca di Sistema (RdS). The most recent outcome of this research activity is the installation of a resistive-type BSCCO-based 9 kV / 3.4 MVA SFCL device in a single feeder branch of the Medium Voltage (MV) distribution network managed by A2A Reti Elettriche S.p.A (A2A) in the Milano area. This installation represents the first SFCL successfully installed in Italy. In this paper, we report on the main outcomes after a more than 1-year long steady-state field testing activity. The design of an upgraded device to be installed in the same substation has already been initiated: the new SFCL will allow to protect four different feeders, therefore implying a device upgrade up to 15.6 MVA.

  17. Variability in wave refraction and resultant nearshore current patterns: Exposed versus sheltered beaches along north Karnataka, west coast of India

    Digital Repository Service at National Institute of Oceanography (India)

    Veerayya, M.; Pankajakshan, T.

    For predominant waves approaching from directions varying between SW and WNW and periods varying from 6 to 11 sec, the refraction function (Kd) shows amplification of wave heights resulting in concentration of wave energy on headlands and reduction...

  18. Results of an intervention for individuals and families with BRCA mutations: a model for providing medical updates and psychosocial support following genetic testing. (United States)

    McKinnon, Wendy; Naud, Shelly; Ashikaga, Taka; Colletti, Rose; Wood, Marie


    : Providing medical management updates and long-term support to families with hereditary cancer syndromes in rural areas is a challenge. To address this, we designed a one-day retreat for BRCA1/2 carriers in our region. The retreat included educational updates about medical management, genetic privacy and discrimination, and addressed psychological and family issues. Evaluations completed at the conclusion of the retreat were overwhelmingly positive with requests for a similar event in the future. The impact of this retreat on a variety of health behaviors was assessed. Eligible participants completed questionnaires before and 6 months after the retreat. Questionnaires focused on lifestyle, cancer screening and prevention practices, psychological history and distress, decision-making regarding genetic testing, and family communication issues. For individuals who completed both the pre and post retreat questionnaires, one-half made lifestyle changes and nearly two-thirds increased cancer screening, initiated chemoprevention, completed or planned to complete preventative surgery in the future. We conclude that this type of forum provides a valuable opportunity for BRCA carriers and their families to receive updated medical information, share personal experiences, provide and receive support, as well as change health behaviors.

  19. The current state of physical activity and exercise programs in German-speaking, Swiss psychiatric hospitals: results from a brief online survey

    Directory of Open Access Journals (Sweden)



    Full Text Available Serge Brand,1,2 Flora Colledge,2 Nadja Beeler,2 Uwe Pühse,2 Nadeem Kalak,1 Dena Sadeghi Bahmani,1 Thorsten Mikoteit,1 Edith Holsboer-Trachsler,1 Markus Gerber2 1Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders, 2Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland Background: Physical activity and exercise programs (PAEPs are an important factor in increasing and maintaining physical and mental health. This holds particularly true for patients with psychiatric disorders undergoing treatment in a psychiatric hospital. To understand whether the benefits reported in the literature are mirrored in current treatment modalities, the aim of the present study was to assess the current state of PAEPs in psychiatric hospitals in the German-speaking part of Switzerland. Methods: All psychiatric hospitals (N=55 in the German-speaking part of Switzerland were contacted in spring 2014. Staff responsible for PAEPs were asked to complete an online questionnaire covering questions related to PAEPs such as type, frequency, staff training, treatment rationale, importance of PAEPs within the treatment strategy, and possible avenues to increase PAEPs. Results: Staff members of 48 different psychiatric hospitals completed the survey. Hospitals provided the following therapeutic treatments: relaxation techniques (100%, sports therapy (97%, activity-related psychotherapeutic interventions (95%, physiotherapy (85%, body therapies (59%, far-east techniques (57%, and hippotherapy (22%. Frequencies ranged from once/week to five times/week. Approximately 25% of patients participated in the PAEPs. Interventions were offered irrespective of psychiatric disorders. PAEP providers wanted and needed more vocational training. Conclusion: All participating psychiatric hospitals offer a broad variety of PAEPs in their treatment curricula. However, the majority of inpatients do not

  20. Thermodiffusion in concentrated ferrofluids: A review and current experimental and numerical results on non-magnetic thermodiffusion

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    Sprenger, Lisa, E-mail:; Lange, Adrian; Odenbach, Stefan [Institute of Fluid Mechanics, Chair of Magnetofluiddynamics, Measuring and Automation Technology, TU Dresden, 01062 Dresden (Germany)


    Ferrofluids are colloidal suspensions consisting of magnetic nanoparticles dispersed in a carrier liquid. Their thermodiffusive behaviour is rather strong compared to molecular binary mixtures, leading to a Soret coefficient (S{sub T}) of 0.16 K{sup −1}. Former experiments with dilute magnetic fluids have been done with thermogravitational columns or horizontal thermodiffusion cells by different research groups. Considering the horizontal thermodiffusion cell, a former analytical approach has been used to solve the phenomenological diffusion equation in one dimension assuming a constant concentration gradient over the cell's height. The current experimental work is based on the horizontal separation cell and emphasises the comparison of the concentration development in different concentrated magnetic fluids and at different temperature gradients. The ferrofluid investigated is the kerosene-based EMG905 (Ferrotec) to be compared with the APG513A (Ferrotec), both containing magnetite nanoparticles. The experiments prove that the separation process linearly depends on the temperature gradient and that a constant concentration gradient develops in the setup due to the separation. Analytical one dimensional and numerical three dimensional approaches to solve the diffusion equation are derived to be compared with the solution used so far for dilute fluids to see if formerly made assumptions also hold for higher concentrated fluids. Both, the analytical and numerical solutions, either in a phenomenological or a thermodynamic description, are able to reproduce the separation signal gained from the experiments. The Soret coefficient can then be determined to 0.184 K{sup −1} in the analytical case and 0.29 K{sup −1} in the numerical case. Former theoretical approaches for dilute magnetic fluids underestimate the strength of the separation in the case of a concentrated ferrofluid.

  1. Transcorneal alternating current stimulation after severe axon damage in rats results in "long-term silent survivor" neurons. (United States)

    Henrich-Noack, Petra; Lazik, Stefanie; Sergeeva, Elena; Wagner, Sebastian; Voigt, Nadine; Prilloff, Sylvia; Fedorov, Anton; Sabel, Bernhard A


    Transcorneal alternating current stimulation (tACS) was proposed to decrease acute death of retinal ganglion cells after optic nerve transection in rats, but it is not known if cell survival is long-term and associated with functional restoration. We therefore evaluated the effects of tACS in a rat model of optic nerve crush using anatomical, electrophysiological and behavioural measures. Rats were trained in a brightness discrimination visual task and the retinal ganglion cell number was quantified with in vivo confocal neuroimaging. Thereafter, severe optic nerve crush or sham crush was performed and rats were treated under anaesthesia either with tACS or sham stimulation immediately after the lesion and on day 3, 7, 11, 15, 19 and 23. Brightness discrimination was evaluated for 6 weeks and retinal ganglion cells were counted in vivo on post-crush days 7 and 28. In additional rats we studied the influence of tACS on bioelectrical activity. On post-lesion day 28, the tACS-treated group showed a neuronal survival of 28.2% which was significantly greater than in sham operates (8.6%). All animals with optic nerve crush were significantly impaired in brightness discrimination and did not recover performance, irrespective to which group they belonged. In accordance with this, there was no significant influence of the stimulation on EEG power spectra. In conclusion, tACS induced long-term neuronal protection from delayed retrograde cell death, but in this case of severe axonal damage tACS did not influence functional restoration and EEG signals recorded over the visual cortex.

  2. LabPush: a pilot study of providing remote clinics with laboratory results via short message service (SMS in Swaziland, Africa.

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    Wen-Shan Jian

    Full Text Available BACKGROUND: Turnaround time (TAT is an important indicator of laboratory performance. It is often difficult to achieve fast TAT for blood tests conducted at clinics in developing countries. This is because clinics where the patient is treated are often far away from the laboratory, and transporting blood samples and test results between the two locations creates significant delay. Recent efforts have sought to mitigate this problem by using Short Message Service (SMS to reduce TAT. Studies reporting the impact of this technique have not been published in scientific literature however. In this paper we present a study of LabPush, a system developed to test whether SMS delivery of HIV related laboratory results to clinics could shorten TAT time significantly. METHOD: LapPush was implemented in six clinics of the Kingdom of Swaziland. SMS results were sent out from the laboratory as a supplement to normal transport of paper results. Each clinic was equipped with a mobile phone to receive SMS results. The laboratory that processes the blood tests was equipped with a system for digital input of results, and transmission of results via SMS to the clinics. RESULTS: Laboratory results were received for 1041 different clinical cases. The total number of SMS records received (1032 was higher than that of paper records (965, indicating a higher loss rate for paper records. A statistical comparison of TAT for SMS and paper reports indicates a statistically significant improvement for SMS. Results were more positive for more rural clinics, and an urban clinic with high workload. CONCLUSION: SMS can be used to reduce TAT for blood tests taken at clinics in developing countries. Benefits are likely to be greater at clinics that are further away from laboratories, due to the difficulties this imposes on transport of paper records.

  3. LabPush: A Pilot Study of Providing Remote Clinics with Laboratory Results via Short Message Service (SMS) in Swaziland, Africa (United States)

    Jian, Wen-Shan; Hsu, Min-Huei; Sukati, Hosea; Syed-Abdul, Shabbir; Scholl, Jeremiah; Dube, Nduduzo; Hsu, Chun-Kung; Wu, Tai-jung; Lin, Vera; Chi, Tex; Chang, Peter; Li, Yu-Chuan


    Background Turnaround time (TAT) is an important indicator of laboratory performance. It is often difficult to achieve fast TAT for blood tests conducted at clinics in developing countries. This is because clinics where the patient is treated are often far away from the laboratory, and transporting blood samples and test results between the two locations creates significant delay. Recent efforts have sought to mitigate this problem by using Short Message Service (SMS) to reduce TAT. Studies reporting the impact of this technique have not been published in scientific literature however. In this paper we present a study of LabPush, a system developed to test whether SMS delivery of HIV related laboratory results to clinics could shorten TAT time significantly. Method LapPush was implemented in six clinics of the Kingdom of Swaziland. SMS results were sent out from the laboratory as a supplement to normal transport of paper results. Each clinic was equipped with a mobile phone to receive SMS results. The laboratory that processes the blood tests was equipped with a system for digital input of results, and transmission of results via SMS to the clinics. Results Laboratory results were received for 1041 different clinical cases. The total number of SMS records received (1032) was higher than that of paper records (965), indicating a higher loss rate for paper records. A statistical comparison of TAT for SMS and paper reports indicates a statistically significant improvement for SMS. Results were more positive for more rural clinics, and an urban clinic with high workload. Conclusion SMS can be used to reduce TAT for blood tests taken at clinics in developing countries. Benefits are likely to be greater at clinics that are further away from laboratories, due to the difficulties this imposes on transport of paper records. PMID:23028543


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    V.O. Mansimova


    Full Text Available A brief historical background of development of the assisted reproductive technologies (ART is presented. The works of russian and foreign authors about the neonatal period, the health of babies born in result of different methods of ART (in vitro fertilization using ICSI were analyzed. After discussion there were indicated new approaches for prevention of perinatal morbidity and ensuring harmonious development and quality of life for these children. The necessity of a national multicenter study of the status of children born in result of induced pregnancy was proved.Key words: assisted reproductive technologies, IVF, ICSI technique, newborns, health.

  5. Use of vitamin K antagonists for secondary stroke prevention depends on the treating healthcare provider in Germany - results from the German AFNET registry. (United States)

    Haeusler, Karl Georg; Gerth, Andrea; Limbourg, Tobias; Tebbe, Ulrich; Oeff, Michael; Wegscheider, Karl; Treszl, András; Ravens, Ursula; Meinertz, Thomas; Kirchhof, Paulus; Breithardt, Günter; Steinbeck, Gerhard; Nabauer, Michael


    Anticoagulation using vitamin K antagonists (VKAs) significantly reduces the risk of recurrent stroke in stroke patients with atrial fibrillation (AF) and is recommended by guidelines. The German Competence NETwork on Atrial Fibrillation established a nationwide prospective registry including 9,574 AF patients, providing the opportunity to analyse AF management according to German healthcare providers. On enrolment, 896 (9.4 %) patients reported a prior ischaemic stroke or transient ischaemic attack. Stroke patients were significantly older, more likely to be female, had a higher rate of cardiovascular risk factors, and more frequently received anticoagulation (almost exclusively VKA) than patients without prior stroke history. Following enrolment, 76.4 % of all stroke patients without VKA contraindications received anticoagulation, which inversely associated with age (OR 0.95 per year; 95 % CI 0.92-0.97). General practitioners/internists (OR 0.40; 95 % CI 0.21-0.77) and physicians working in regional hospitals (OR 0.47; 95 % CI 0.29-0.77) prescribed anticoagulation for secondary stroke prevention less frequently than physicians working at university hospitals (reference) and office-based cardiologists (OR 1.40; 95 % CI 0.76-2.60). The impact of the treating healthcare provider was less evident in registry patients without prior stroke. In the AFNET registry, anticoagulation for secondary stroke prevention was prescribed in roughly three-quarters of AF patients, a significantly higher rate than in primary prevention. We identified two factors associated with withholding oral anticoagulation in stroke survivors, namely higher age and-most prominently-treatment by a general practitioner/internist or physicians working at regional hospitals.

  6. [The results of a trial in the Socialist Republic of Vietnam of clothing providing mechanical protection against the bites of blood-sucking Diptera]. (United States)

    Gornostaeva, R M; Zhukova, L I


    The tested overalls for protection in hot climate may be recommended only for the protection of people engaged in work involving little movement (fishermen, watchmen, etc.). For wider use of such overalls in hot regions the design should be changed, the alterations are described in the paper. Further trials of the overalls should be carried out with its modified design; this costume provides adequate mechanical protection from the bites of mosquitoes and other blood-sucking Diptera and it will be widely used in the tropics, where blood-sucking Diptera contribute much to infection transmission.

  7. Augmentation of spelling therapy with transcranial direct current stimulation in primary progressive aphasia: Preliminary results and challenges. (United States)

    Tsapkini, Kyrana; Frangakis, Constantine; Gomez, Yessenia; Davis, Cameron; Hillis, Argye E

    Primary progressive aphasia (PPA) is a neurodegenerative disease that primarily affects language functions and often begins in the fifth or sixth decade of life. The devastating effects on work and family life call for the investigation of treatment alternatives. In this article, we present new data indicating that neuromodulatory treatment, using transcranial direct current stimulation (tDCS) combined with a spelling intervention, shows some promise for maintaining or even improving language, at least temporarily, in PPA. The main aim of the present article is to determine whether tDCS plus spelling intervention is more effective than spelling intervention alone in treating written language in PPA. We also asked whether the effects of tDCS are sustained longer than the effects of spelling intervention alone. We present data from six PPA participants who underwent anodal tDCS or sham plus spelling intervention in a within-subject crossover design. Each stimulation condition lasted 3 weeks or a total of 15 sessions with a 2-month interval in between. Participants were evaluated on treatment tasks as well as on other language and cognitive tasks at 2-week and 2-month follow-up intervals after each stimulation condition. All participants showed improvement in spelling (with sham or tDCS). There was no difference in the treated items between the two conditions. There was, however, consistent and significant improvement for untrained items only in the tDCS plus spelling intervention condition. Furthermore, the improvement lasted longer in the tDCS plus spelling intervention condition compared to sham plus spelling intervention condition. Neuromodulation with tDCS offers promise as a means of augmenting language therapy to improve written language function at least temporarily in PPA. The consistent finding of generalisation of treatment benefits to untreated items and the superior sustainability of treatment effects with tDCS justifies further investigations. However

  8. The Current State of U.S. Geropsychiatric Graduate Nursing Education: Results of the National Geropsychiatric Graduate Nursing Education Survey. (United States)

    Stephens, Caroline E; Harris, Melodee; Buron, Bill


    Advanced Practice Registered Nurses (APRNs) must be prepared to care for the rapidly increasing numbers of older adults with mental health needs. All 363 graduate nursing programs in the United States were surveyed regarding the nature and extent of geropsychiatric nursing (GPN) content across program curricula and their perceptions of the influence that the APRN Consensus Model has exerted on preparing the next generation of APRNs to meet the growing needs of the older adult population. Of the 202 schools responding, 138 reported GPN content in one or more clinical programs, with the majority of content in non-PMHNP programs. Only 17 schools reported offering a GPN program, track, or minor. The majority of schools (n = 169) perceived that they were adequately well-prepared to meet the APRN Consensus Model's guidelines regarding inclusion of aging-related didactic and clinical educational experiences in all APRN education programs; nearly two thirds (n = 132) perceived a moderate to significant influence of the Consensus Model on institutional infusion of GPN into curricula. Compared with a similar survey 10 years ago, there was little change in the proportion of schools reporting GPN in clinical programs and few schools provide GPN programs, tracks, or minors. Implications for nursing education and practice are discussed.

  9. Experiences and meanings of integration of TCAM (Traditional, Complementary and Alternative Medical) providers in three Indian states: results from a cross-sectional, qualitative implementation research study. (United States)

    Nambiar, D; Narayan, V V; Josyula, L K; Porter, J D H; Sathyanarayana, T N; Sheikh, K


    Efforts to engage Traditional, Complementary and Alternative Medical (TCAM) practitioners in the public health workforce have growing relevance for India's path to universal health coverage. We used an action-centred framework to understand how policy prescriptions related to integration were being implemented in three distinct Indian states. Health departments and district-level primary care facilities in the states of Kerala, Meghalaya and Delhi. In each state, two or three districts were chosen that represented a variation in accessibility and distribution across TCAM providers (eg, small or large proportions of local health practitioners, Homoeopaths, Ayurvedic and/or Unani practitioners). Per district, two blocks or geographical units were selected. TCAM and allopathic practitioners, administrators and representatives of the community at the district and state levels were chosen based on publicly available records from state and municipal authorities. A total of 196 interviews were carried out: 74 in Kerala, and 61 each in Delhi and Meghalaya. We sought to understand experiences and meanings associated with integration across stakeholders, as well as barriers and facilitators to implementing policies related to integration of Traditional, Complementary and Alternative (TCA) providers at the systems level. We found that individual and interpersonal attributes tended to facilitate integration, while system features and processes tended to hinder it. Collegiality, recognition of stature, as well as exercise of individual personal initiative among TCA practitioners and of personal experience of TCAM among allopaths enabled integration. The system, on the other hand, was characterised by the fragmentation of jurisdiction and facilities, intersystem isolation, lack of trust in and awareness of TCA systems, and inadequate infrastructure and resources for TCA service delivery. State-tailored strategies that routinise interaction, reward individual and system

  10. Current research results on the technical basis for environmental qualification of safety-related digital I and C systems

    Energy Technology Data Exchange (ETDEWEB)

    Korsah, K.; Ewing, P.D.; Kercel, S.; Wood, R.T. [Oak Ridge National Lab., TN (United States); Hassan, M. [Brookhaven National Lab., Upton, NY (United States); Tanaka, T. [Sandia National Labs., Albuquerque, NM (United States); Antonescu, C. [Nuclear Regulatory Commission, Rockville, MD (United States)


    This paper presents results to date of an NRC-sponsored confirmatory research program initiated at three national laboratories to address environmental compatibility/qualification concerns associated with the use of microprocessor-based safety-related instrumentation and control (I and C) systems in nuclear power plants. The research approach involved evaluating existing military and industrial guidance, identifying the most significant environmental stressors and, for advanced I and C systems in a nuclear power plant, investigating the likely failure modes--both at the integrated circuit and system level--for digital technologies under varying levels of environmental stress (such as smoke exposure and electromagnetic and radio-frequency interference). The insights gained from these studies are being used to recommend appropriate methods for qualifying safety-related digital equipment in nuclear power plants.

  11. What score on the Vancouver Scar Scale constitutes a hypertrophic scar? Results from a survey of North American burn-care providers. (United States)

    Thompson, Callie M; Sood, Ravi F; Honari, Shari; Carrougher, Gretchen J; Gibran, Nicole S


    Reliable characterization of a hypertrophic scar (HTS) is integral to epidemiologic studies designed to identify clinical and genetic risk factors for HTS. The Vancouver Scar Scale (VSS) has been widely used for this purpose; however, no publication has defined what score on this scale corresponds to a clinical diagnosis of HTS. In a survey of 1000 burn care providers, we asked respondents what VSS score indicates a HTS and asked them to score scar photos using the VSS. We used receiver-operating-characteristic (ROC) curves to evaluate VSS sub-scores and their combinations in diagnosis of HTS. Of 130 responses (13.5%), most were physicians (43.9%) who had worked in burn care for over 10 years (63.1%) and did not use the VSS in clinical practice (58.5%). There was no consensus as to what VSS score indicates a diagnosis of HTS. VSS height score (0-3) performed best for diagnosis of HTS; using a cut-off of ≥1, height score was 99.5% sensitive and 85.9% specific for HTS. Burn clinicians do not routinely use the VSS and perceptions vary widely regarding what constitutes a HTS. When a dichotomous variable is needed, the VSS height score with a cut-off of ≥1 may be optimal. Our findings underscore the need for an objective tool to reproducibly characterize HTS across burn centers. Published by Elsevier Ltd.

  12. Patient Perceptions of Prejudice and Discrimination by Health Care Providers and its Relationship with Mental Disorders: Results from the 2012 Canadian Community Health-Mental Health Survey Data. (United States)

    Marchand, Kirsten; Palis, Heather; Oviedo-Joekes, Eugenia


    Using data from a nationally representative survey, the Canadian Community Health Survey-Mental Health, this secondary analysis aimed to determine the prevalence of perceived prejudice by health care providers (HCPs) and its relationship with mental disorders. Respondents accessing HCPs in the prior year were asked if they experienced HCP prejudice. A hypothesis driven multivariable logistic regression analysis was conducted to determine the relationship between type of mental disorders and HCP prejudice. Among the 3006 respondents, 10.9 % perceived HCP prejudice, 62.4 % of whom reported a mental disorder. The adjusted odds of prejudice was highest for respondents with anxiety (OR 3.12; 95 % CI 1.60, 6.07), concurrent mood or anxiety and substance disorders (OR 3.08; 95 % CI 1.59, 5.95) and co-occurring mood and anxiety disorders (OR 2.89; 95 % CI 1.68, 4.97) compared to respondents without any mental disorders. These findings are timely for informing discussions regarding policies to address HCP prejudice towards people with mental disorders.

  13. Energy+ pumps - Technology procurement for very energy efficient circulation pumps, first results of the current IEE-project

    Energy Technology Data Exchange (ETDEWEB)

    Barthel, Claus; Thomas, Stefan [Wuppertal Inst. for Climate, Environment, Energy (Germany); Benke, Georg; Schaeppi, Bernd [Austrian Energy Agency A.E.A (Austria); Forfori, Fabio [Politecnico di Milano, Dept. di Energetica (Italy); Guisson, Ruben [Flemisch Inst. for technological research (Vito) (Belgium); Papamikrouli, Louiza [Centre for Renewable Energy Sources (CRES) (Greece); Puente, Margarita [ESCAN, S.A. (Spain); Spirek, Tomas [SEVEn, Stredisko pro efektivni vyuzivani energie, o.p.s. (Czech Republic); Rautiainen, Kimmo [Motiva Oy (Finland); Koehl, Joerg [Deutsche Energie-Agentur GmbH (Germany); Anglade, Alain [ADEME (France); Nipkow, Juerg [ARENA (Switzerland)


    About 2 % of the overall electricity consumption of the EU is caused by circulators in single or double family homes and flats. A new technology of pumps with electronically commutated (EC) motor pumps is available now; it is one possible way to achieve a reduction in circulator annual electricity use by 60 % or more.The project's objective is a market transformation towards this new very energy-efficient pump technologies - Energy+ pumps - for circulators in heating systems, both stand alone and integrated in boilers. Only few manufacturers have so far introduced the new pump technology to the market for single or double family homes and flats.To bring more products to the market from all major manufacturers, the project will adapt and apply the technology procurement methodology as it was very successfully tested in the European Energy+ project on energy-efficient cold appliances [5] [6]. Large buyers will be aggregated, to activate the pump and boiler manufacturers. Sales and training materials and a sizing spreadsheet software for installation contractors will be developed and applied. A competition both for energy-efficient products and marketing campaigns will be organised and the information on the Energy+ pumps will be disseminated widely through website, newsletter, media, and fairs.This paper gives a short overview of this project and presents the results of the first project phases: a European wide market study on circulators and heating systems, and the first Energy+ lists for circulators, buyers and supporters.

  14. Current evaluation of sonography of the meniscus. Results of a comparative study of sonographic and arthroscopic findings. (United States)

    Casser, H R; Sohn, C; Kiekenbeck, A


    Sonography of the knee has gained in significance in the diagnosis of the meniscus; experimental and clinical studies have demonstrated that the normal and pathological anatomy of the meniscus can be visualized on a sonogram. The aim of this comparative investigation is to evaluate sonographic lesion diagnosis in comparison with arthroscopic findings, using a standardized examination method. Two hundred and six knee joints were first scanned sonographically using a 7.5 MHz sector transducer. The examining doctor had neither anamnestic nor clinical information in advance. On the following day, the joints were examined arthroscopically, without the findings of the day before being available to the examiner. When the findings were compared, the sensitivity of sonographic diagnosis of lesions was found to be 82.2% and its specificity 87.6%. The patients were of varying ages and had varying anamneses. The results show that sonography of the meniscus is a valuable diagnostic help when the knee-joint symptoms are not clear, given that the correct technical equipment and sufficient experience with this form of examination are at hand. The advantage of sonography is that, in contrast to arthroscopy, it is noninvasive and easily available.

  15. An Assessment of the Current US Radiation Oncology Workforce: Methodology and Global Results of the American Society for Radiation Oncology 2012 Workforce Study

    Energy Technology Data Exchange (ETDEWEB)

    Vichare, Anushree; Washington, Raynard; Patton, Caroline; Arnone, Anna [ASTRO, Fairfax, Virginia (United States); Olsen, Christine [Massachusetts General Hospital, Boston, Massachusetts, (United States); Fung, Claire Y. [Commonwealth Newburyport Cancer Center, Newburyport, Massachusetts (United States); Hopkins, Shane [William R. Bliss Cancer Center, Ames, Iowa (United States); Pohar, Surjeet, E-mail: [Indiana University Health Cancer Center East, Indiana University, Indianapolis, Indiana (United States)


    Purpose: To determine the characteristics, needs, and concerns of the current radiation oncology workforce, evaluate best practices and opportunities for improving quality and safety, and assess what we can predict about the future workforce. Methods and Materials: An online survey was distributed to 35,204 respondents from all segments of the radiation oncology workforce, including radiation oncologists, residents, medical dosimetrists, radiation therapists, medical physicists, nurse practitioners, nurses, physician assistants, and practice managers/administrators. The survey was disseminated by the American Society for Radiation Oncology (ASTRO) together with specialty societies representing other workforce segments. An overview of the methods and global results is presented in this paper. Results: A total of 6765 completed surveys were received, a response rate of 19%, and the final analysis included 5257 respondents. Three-quarters of the radiation oncologists, residents, and physicists who responded were male, in contrast to the other segments in which two-thirds or more were female. The majority of respondents (58%) indicated they were hospital-based, whereas 40% practiced in a free-standing/satellite clinic and 2% in another setting. Among the practices represented in the survey, 21.5% were academic, 25.2% were hospital, and 53.3% were private. A perceived oversupply of professionals relative to demand was reported by the physicist, dosimetrist, and radiation therapist segments. An undersupply was perceived by physician's assistants, nurse practitioners, and nurses. The supply of radiation oncologists and residents was considered balanced. Conclusions: This survey was unique as it attempted to comprehensively assess the radiation oncology workforce by directly surveying each segment. The results suggest there is potential to improve the diversity of the workforce and optimize the supply of the workforce segments. The survey also provides a benchmark for

  16. Repellent plants provide affordable natural screening to prevent mosquito house entry in tropical rural settings--results from a pilot efficacy study.

    Directory of Open Access Journals (Sweden)

    Frank C Mng'ong'o

    Full Text Available Sustained malaria control is underway using a combination of vector control, prompt diagnosis and treatment of malaria cases. Progress is excellent, but for long-term control, low-cost, sustainable tools that supplement existing control programs are needed. Conventional vector control tools such as indoor residual spraying and house screening are highly effective, but difficult to deliver in rural areas. Therefore, an additional means of reducing mosquito house entry was evaluated: the screening of mosquito house entry points by planting the tall and densely foliated repellent plant Lantana camara L. around houses. A pilot efficacy study was performed in Kagera Region, Tanzania in an area of high seasonal malaria transmission, where consenting families within the study village planted L. camara (Lantana around their homes and were responsible for maintaining the plants. Questionnaire data on house design, socioeconomic status, malaria prevention knowledge, attitude and practices was collected from 231 houses with Lantana planted around them 90 houses without repellent plants. Mosquitoes were collected using CDC Light Traps between September 2008 and July 2009. Data were analysed with generalised negative binomial regression, controlling for the effect of sampling period. Indoor catches of mosquitoes in houses with Lantana were compared using the Incidence Rate Ratio (IRR relative to houses without plants in an adjusted analysis. There were 56% fewer Anopheles gambiae s.s. (IRR 0.44, 95% CI 0.28-0.68, p<0.0001; 83% fewer Anopheles funestus s.s. (IRR 0.17, 95% CI 0.09-0.32, p<0.0001, and 50% fewer mosquitoes of any kind (IRR 0.50, 95% CI 0.38-0.67, p<0.0001 in houses with Lantana relative to controls. House screening using Lantana reduced indoor densities of malaria vectors and nuisance mosquitoes with broad community acceptance. Providing sufficient plants for one home costs US $1.50 including maintenance and labour costs, (30 cents per person. L

  17. Numerical evaluation of currents induced in a worker by ELF non-uniform electric fields in high voltage substations and comparison with experimental results. (United States)

    Tarao, Hiroo; Korpinen, Leena H; Kuisti, Harri A; Hayashi, Noriyuki; Elovaara, Jarmo A; Isaka, Katsuo


    An ungrounded human, such as a substation worker, receives contact currents when touching a grounded object in electric fields. In this article, contact currents and internal electric fields induced in the human when exposed to non-uniform electric fields at 50 Hz are numerically calculated. This is done using a realistic human model standing at a distance of 0.1-0.5 m from the grounded conductive object. We found that the relationship between the external electric field strength and the contact current obtained by calculation is in good agreement with previous measurements. Calculated results show that the contact currents largely depend on the distance, and that the induced electric fields in the tissues are proportional to the contact current regardless of the non-uniformity of the external electric field. Therefore, it is concluded that the contact current, rather than the spatial average of the external electric field, is more suitable for evaluating electric field dosimetry of tissues. The maximum induced electric field appears in the spinal cord in the central nervous system tissues, with the induced electric field in the spinal cord approaching the basic restriction (100 mV/m) of the new 2010 International Commission on Non-Ionizing Radiation Protection guidelines for occupational exposure, if the contact current is 0.5 mA. Copyright © 2012 Wiley Periodicals, Inc.

  18. Providing researchers with online access to NHLBI biospecimen collections: The results of the first six years of the NHLBI BioLINCC program. (United States)

    Giffen, Carol A; Wagner, Elizabeth L; Adams, John T; Hitchcock, Denise M; Welniak, Lisbeth A; Brennan, Sean P; Carroll, Leslie E


    The National Heart, Lung, and Blood Institute (NHLBI), within the United States' National Institutes of Health (NIH), established the Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC) in 2008 to develop the infrastructure needed to link the contents of the NHLBI Biorepository and the NHLBI Data Repository, and to promote the utilization of these scientific resources by the broader research community. Program utilization metrics were developed to measure the impact of BioLINCC on Biorepository access by researchers, including visibility, program efficiency, user characteristics, scientific impact, and research types. Input data elements were defined and are continually populated as requests move through the process of initiation through fulfillment and publication. This paper reviews the elements of the tracking metrics which were developed for BioLINCC and reports the results for the first six on-line years of the program.

  19. Providing a diet containing only maintenance levels of energy and protein during the latter stages of pregnancy resulted in a prolonged delivery time during parturition in rats. (United States)

    Tanaka, Y; Kadokawa, H


    In mammals, a prolonged delivery time during parturition is dangerous for both mother and fetus, although the mechanisms that prolong delivery are unclear. To investigate whether nutrition affects delivery time, we administered two feeds containing maintenance (L-feed) or higher (H-feed) levels of energy and protein at different points during the latter half of pregnancy and compared the effects of the various treatments on delivery time in rats. After the rats had been maintained on the L-feed and then copulated on pro-oestrus (Day 0), pregnant females were randomly allocated to one of three groups: (1) the no-improvement group, which was fed L-feed throughout gestation; (2) the early group, which was fed L-feed until Day 11 of gestation and then switched to H-feed; and (3) the late group, which was fed L-feed until Day 16 of gestation and then switched to H-feed. There was no significant difference in the number of pups among the three groups. However, delivery time was significantly longer in the no-improvement group (73.7±5.2 min) than the early (46.9±5.6 min) and late (55.4±5.5 min) groups. Consuming a maintenance diet during the latter half of pregnancy resulted in a prolonged delivery time.

  20. BAP1 immunohistochemistry and p16 FISH results in combination provide higher confidence in malignant pleural mesothelioma diagnosis: ROC analysis of the two tests. (United States)

    Hida, Tomoyuki; Hamasaki, Makoto; Matsumoto, Shinji; Sato, Ayuko; Tsujimura, Tohru; Kawahara, Kunimitsu; Iwasaki, Akinori; Okamoto, Tatsuro; Oda, Yoshinao; Honda, Hiroshi; Nabeshima, Kazuki


    Differentiation of malignant pleural mesothelioma (MPM) from benign mesothelial proliferation remains problematic. Loss of nuclear staining of BRCA1-associated protein 1 (BAP1; detected using immunohistochemistry (IHC)) and homozygous deletion (HD) of p16 (detected using fluorescence in situ hybridization (FISH)) are useful for differentiation of MPM from reactive mesothelial hyperplasia (RMH), but the correlation between BAP1 expression loss and p16 HD has not been fully described. We performed BAP1 IHC and p16-specific FISH for 40 MPM and 20 RMH cases, and measured proportions of cells showing BAP1 expression and p16 HD for each case. The diagnostic accuracy for MPM and the cut-off values of the two methods were assessed using receiver operating characteristic (ROC) analysis. BAP1 expression loss, p16 HD and coexistence of both were present in 27 (67.5 %), 27 (67.5 %) and 17 (42.5 %) MPM cases, respectively. Three MPM cases (7.5 %) and all 20 RMH cases had neither BAP1 loss nor p16 HD. There was no correlation between the results of the two methods. Their combination showed higher sensitivity (92.5 %, 37/40) and estimated probability than BAP1 IHC and p16-specific FISH used alone. BAP1 IHC and p16-specific FISH have independent diagnostic value, and have increased reliability when used in combination, for MPM diagnosis.

  1. Adamtsl2 deletion results in bronchial fibrillin microfibril accumulation and bronchial epithelial dysplasia – a novel mouse model providing insights into geleophysic dysplasia

    Directory of Open Access Journals (Sweden)

    Dirk Hubmacher


    Full Text Available Mutations in the secreted glycoprotein ADAMTSL2 cause recessive geleophysic dysplasia (GD in humans and Musladin–Lueke syndrome (MLS in dogs. GD is a severe, often lethal, condition presenting with short stature, brachydactyly, stiff skin, joint contractures, tracheal-bronchial stenosis and cardiac valve anomalies, whereas MLS is non-lethal and characterized by short stature and severe skin fibrosis. Although most mutations in fibrillin-1 (FBN1 cause Marfan syndrome (MFS, a microfibril disorder leading to transforming growth factor-β (TGFβ dysregulation, domain-specific FBN1 mutations result in dominant GD. ADAMTSL2 has been previously shown to bind FBN1 and latent TGFβ-binding protein-1 (LTBP1. Here, we investigated mice with targeted Adamtsl2 inactivation as a new model for GD (Adamtsl2−/− mice. An intragenic lacZ reporter in these mice showed that ADAMTSL2 was produced exclusively by bronchial smooth muscle cells during embryonic lung development. Adamtsl2−/− mice, which died at birth, had severe bronchial epithelial dysplasia with abnormal glycogen-rich inclusions in bronchial epithelium resembling the cellular anomalies described previously in GD. An increase in microfibrils in the bronchial wall was associated with increased FBN2 and microfibril-associated glycoprotein-1 (MAGP1 staining, whereas LTBP1 staining was increased in bronchial epithelium. ADAMTSL2 was shown to bind directly to FBN2 with an affinity comparable to FBN1. The observed extracellular matrix (ECM alterations were associated with increased bronchial epithelial TGFβ signaling at 17.5 days of gestation; however, treatment with TGFβ-neutralizing antibody did not correct the epithelial dysplasia. These investigations reveal a new function of ADAMTSL2 in modulating microfibril formation, and a previously unsuspected association with FBN2. Our studies suggest that the bronchial epithelial dysplasia accompanying microfibril dysregulation in Adamtsl2−/− mice


    Directory of Open Access Journals (Sweden)

    M.I. Baranov


    Full Text Available Purpose. Calculation and experimental researches of the electro-thermal resistibility of the steel sheet samples to action standard pulse current components of the artificial lightning with amplitude-time parameters (ATP, corresponded the requirements of normative documents of USA for SAE ARP 5412 & SAE ARP 5416. Methodology. Electrophysics bases of technique of high tensions and large impulsive currents (LIC, and also scientific and technical bases of planning of devices of high-voltage impulsive technique and measuring in them LIC. Сurrent amplitude ImA=±200 kA (with a tolerance of ±10 %; current action integral JA=2∙106 A2•s (with a tolerance of ±20 %; time, corresponding to the amplitude of the current ImA, tmA≤50 microseconds; the duration of the current flow τpA≤500 microseconds. Results. The results of the evaluation of the calculated and experimental studies of electro-thermal resistance of the samples of plates measuring 0,5 m  0,5 m stainless steel 1 mm thickness to the action on them artificial lightning impulse currents with rationed ATP on the requirements of normative documents of USA for SAE ARP 5412 & SAE ARP 5416. A pulse A- component have a first amplitude 192 kA, the corresponding time of 34 μs, and the duration aperiodic component amplitude 804 A, corresponding to the time 9 ms. It has been shown that the long C- component current of artificial lightning can lead to keyhole these samples. The diameter of the holes in this thin steel sheet, which is formed during the flow of current C- components can reach 15 mm. The results of calculation and experiment agree within 28 %. Originality. For the first time in world practice on the generator large pulsed currents experimental studies of resistibility of sheet steel samples to the action of artificial lightning currents with critical parameters. Practical value. Using the results obtained in the practice of lightning protection will significantly improve the

  3. Cell Phones: Current Research Results (United States)

    ... Potential Biological or Adverse Health Effects of Wireless Communication Devices World Health Organization: Electromagnetic Fields and Public Health: Mobile Phones International Agency for Research on Cancer Press ...

  4. Factors Associated With Current Smoking Among Off-Reserve First Nations and Métis Youth: Results From the 2012 Aboriginal Peoples Survey. (United States)

    Ryan, Christopher; Leatherdale, Scott; Cooke, Martin


    First Nations and Métis, two of Canada's constitutionally recognized Indigenous groups, suffer from poorer overall health than non-Indigenous Canadians. Current smoking, a known predictor of chronic health conditions, is close to twice as prevalent among Indigenous youth as it is among non-Indigenous Canadian youth. However, little population-level research has examined the correlates of current smoking among this population. Guided by a health framework centered on Indigenous-specific determinants, we used data from the 2012 Aboriginal Peoples Survey to examine the correlates of current smoking among First Nations and Métis youth aged 15-17 years living outside of First Nations reserves. Using binary logistic regression, we investigated how culturally specific factors, namely knowledge of an Indigenous language, participation in traditional activities, and family members' attendance at residential schools, were correlated with current smoking. We also considered demographic, geographic, socioeconomic and health-related correlates. Overall, an estimated 20.6% of First Nations and Métis youth reported current smoking. We found no significant associations between culturally specific activities and current smoking in the multivariate analyses, although those who spoke an Indigenous language were more likely to smoke. Those who participated in sports more often were less likely to smoke, and respondents who reported heavy drinking and who were from families with lower income were more likely to smoke. Gender, body mass index, urban/rural geography and regional geography, and mother's highest level of education were not significantly correlated with smoking. The results of our study support prior research that has found a disturbingly high prevalence of current smoking among Indigenous youth, compared to their non-Indigenous counterparts. Our results highlight the importance of considering sports participation, co-occurring health-risk behaviours and socioeconomic

  5. Disease Severity in Never Smokers, Ex-Smokers, and Current Smokers With Axial Spondyloarthritis: Results From the Scotland Registry for Ankylosing Spondylitis. (United States)

    Jones, Gareth T; Ratz, Tiara; Dean, Linda E; Macfarlane, Gary J; Atzeni, Fabiola


    To examine the relationship between smoking, smoking cessation, and disease characteristics and quality of life (QoL) in spondyloarthritis. The Scotland Registry for Ankylosing Spondylitis collects data from clinically diagnosed patients with spondyloarthritis. Clinical data, including Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) scores, were obtained from medical records. Mailed questionnaires contained information on smoking status and QoL (Ankylosing Spondylitis QoL questionnaire [ASQoL]). Linear and logistic regression were used to quantify the effect of smoking, and smoking cessation, on various disease-specific and QoL outcomes, with adjustments for age, sex, deprivation, education level, and alcohol use. Results are presented as regression coefficients (β) or odds ratios (ORs) with 95% confidence intervals (95% CIs). Data were obtained from 946 participants (73.5% male, mean age 52 years). Current smoking was reported by 22%, and 38% were ex-smokers. Ever smokers had poorer BASDAI (β = 0.5 [95% CI 0.2, 0.9]) and BASFI scores (β = 0.8 [95% CI 0.4, 1.2]), and reported worse QoL (ASQoL β = 1.5 [95% CI 0.7, 2.3]). Compared to current smokers, ex-smokers reported less disease activity (BASDAI β = -0.5 [95% CI -1.0, -0.04]) and significantly better QoL (ASQoL β = -1.2 [95% CI -2.3, -0.2]). They also were more likely to have a history of uveitis (OR 2.4 [95% CI 1.5, 3.8]). Smokers with spondyloarthritis experience worse disease than those who are never smokers. However, this study provides new evidence that, among smokers, smoking cessation is associated with lower disease activity and better physical function and QoL. Clinicians should specifically promote smoking cessation as an adjunct to usual therapy in patients with spondyloarthritis. © 2016, American College of Rheumatology.

  6. Spin current

    CERN Document Server

    Valenzuela, Sergio O; Saitoh, Eiji; Kimura, Takashi


    In a new branch of physics and technology called spin-electronics or spintronics, the flow of electrical charge (usual current) as well as the flow of electron spin, the so-called 'spin current', are manipulated and controlled together. This book provides an introduction and guide to the new physics and application of spin current.

  7. Morphology and flow fields of three-dimensional dunes, Rio Paraná, Argentina: Results from simultaneous multibeam echo sounding and acoustic Doppler current profiling (United States)

    Parsons, D. R.; Best, J. L.; Orfeo, O.; Hardy, R. J.; Kostaschuk, R.; Lane, S. N.


    Most past studies of river dune dynamics have concentrated on two-dimensional (2-D) bed forms, with constant heights and straight crest lines transverse to the flow, and their associated turbulent flow structure. This morphological simplification imposes inherent limitations on the interpretation and understanding of dune form and flow dynamics in natural channels, where dune form is predominantly three-dimensional. For example, studies over 2-D forms neglect the significant influence that lateral flows and secondary circulation may have on the flow structure and thus dune morphology. This paper details a field study of a swath of 3-D dunes in the Rio Paraná, Argentina. A large (0.35 km wide, 1.2 km long) area of dunes was surveyed using a multibeam echo sounder (MBES) that provided high-resolution 3-D detail of the river bed. Simultaneous with the MBES survey, 3-D flow information was obtained with an acoustic Doppler current profiler (ADCP), revealing a complicated pattern of dune morphology and associated flow structure within the swath. Dune three-dimensionality appears intimately connected to the morphology of the upstream dune, with changes in crest line curvature and crest line bifurcations/junctions significantly influencing the downstream dune form. Dunes with lobe or saddle-shaped crest lines were found to have larger, more structured regions of vertical velocity with smaller separation zones than more 2-D straight-crested dunes. These results represent the first integrated study of 3-D dune form and mean flow structure from the field and show several similarities to recent laboratory models of flow over 3-D dunes.

  8. To assess whether indoor residual spraying can provide additional protection against clinical malaria over current best practice of long-lasting insecticidal mosquito nets in The Gambia: study protocol for a two-armed cluster-randomised trial

    Directory of Open Access Journals (Sweden)

    Parker David


    Full Text Available Abstract Background Recently, there has been mounting interest in scaling-up vector control against malaria in Africa. It needs to be determined if indoor residual spraying (IRS with DDT will provide significant marginal protection against malaria over current best practice of long-lasting insecticidal nets (LLINs and prompt treatment in a controlled trial, given that DDT is currently the most persistent insecticide for IRS. Methods A 2 armed cluster-randomised controlled trial will be conducted to assess whether DDT IRS and LLINs combined provide better protection against clinical malaria in children than LLINs alone in rural Gambia. Each cluster will be a village, or a group of small adjacent villages; all clusters will receive LLINs and half will receive IRS in addition. Study children, aged 6 months to 13 years, will be enrolled from all clusters and followed for clinical malaria using passive case detection to estimate malaria incidence for 2 malaria transmission seasons in 2010 and 2011. This will be the primary endpoint. Exposure to malaria parasites will be assessed using light and exit traps followed by detection of Anopheles gambiae species and sporozoite infection. Study children will be surveyed at the end of each transmission season to estimate the prevalence of Plasmodium falciparum infection and the prevalence of anaemia. Discussion Practical issues concerning intervention implementation, as well as the potential benefits and risks of the study, are discussed. Trial Registration ISRCTN01738840 - Spraying And Nets Towards malaria Elimination (SANTE

  9. The current state of physical activity and exercise programs in German-speaking, Swiss psychiatric hospitals: results from a brief online survey. (United States)

    Brand, Serge; Colledge, Flora; Beeler, Nadja; Pühse, Uwe; Kalak, Nadeem; Sadeghi Bahmani, Dena; Mikoteit, Thorsten; Holsboer-Trachsler, Edith; Gerber, Markus


    Physical activity and exercise programs (PAEPs) are an important factor in increasing and maintaining physical and mental health. This holds particularly true for patients with psychiatric disorders undergoing treatment in a psychiatric hospital. To understand whether the benefits reported in the literature are mirrored in current treatment modalities, the aim of the present study was to assess the current state of PAEPs in psychiatric hospitals in the German-speaking part of Switzerland. All psychiatric hospitals (N=55) in the German-speaking part of Switzerland were contacted in spring 2014. Staff responsible for PAEPs were asked to complete an online questionnaire covering questions related to PAEPs such as type, frequency, staff training, treatment rationale, importance of PAEPs within the treatment strategy, and possible avenues to increase PAEPs. Staff members of 48 different psychiatric hospitals completed the survey. Hospitals provided the following therapeutic treatments: relaxation techniques (100%), sports therapy (97%), activity-related psychotherapeutic interventions (95%), physiotherapy (85%), body therapies (59%), far-east techniques (57%), and hippotherapy (22%). Frequencies ranged from once/week to five times/week. Approximately 25% of patients participated in the PAEPs. Interventions were offered irrespective of psychiatric disorders. PAEP providers wanted and needed more vocational training. All participating psychiatric hospitals offer a broad variety of PAEPs in their treatment curricula. However, the majority of inpatients do not participate in PAEPs. Furthermore, those who do participate cannot continue to do so following discharge. PAEP providers need specific extended vocational trainings and believe that the potential of PA should be improved.

  10. Initial results on the correlation between the magnetic and electric fields observed from the DE-2 satellite in the field-aligned current regions (United States)

    Sugiura, M.; Maynard, N. C.; Farthing, W. H.; Heppner, J. P.; Ledley, B. G.; Cahill, L. J., Jr.


    Initial results of the electric and magnetic field observations from the DE-2 satellite show a remarkably good correlation between the north-south component of the electric field and the east-west component of the magnetic field in many passes of the field-aligned current regions. For a dayside cusp pass on August 15, 1981 the coefficient of correlation between these components was 0.996. A preliminary inspection of the available data from the first 6 months of the DE operation indicates that the similarity between the electric and magnetic field signatures of the field-aligned currents is a commonly observed feature at all local times. This high correlation is interpreted to be an indication that the closure of the field-aligned current is essentially meridional. When the correlation between these components is not good, the closure current is likely to be flowing along the auroral belt. When the correlation between the electric and magnetic fields is high, it is possible to estimate the height-integrated Pedersen conductivity from the observed field components.

  11. Current Issues Affecting the Practice of Pediatric Orthopaedic Surgeons: Results of the 2014 Workforce Survey of American Academy of Pediatrics Section on Orthopaedics. (United States)

    Hosseinzadeh, Pooya; Copley, Lawson; Ruch-Ross, Holly; Schwend, Richard M; Sawyer, Jeffrey R


    The opinions of the pediatric orthopaedic workforce are shaped by market forces, regulatory processes, and local experience. The purpose of this report is to summarize the findings of the recent Workforce Survey of the American Academy of Pediatrics (AAP) Section on Orthopaedics (SOOr). This submission has been reviewed and approved by the Board of Directors of the Pediatric Orthopaedic Society of North America (POSNA). In 2014, the AAP generated a survey to assess perceptions of pediatric orthopaedic surgeons about current issues that affect practice. The survey was sent to 856 POSNA and 141 AAP-SOOr members. Responses were topically organized to report current workforce composition, practice patterns, and perceptions about electronic medical records (EMRs). Responses were collected from August to December, 2014, from 496 (50%) survey recipients including 83 of 141 (59%) AAP-SOOr members and 413 of 856 (48%) POSNA members. Analyses were restricted to the 397 respondents who reported that they are currently practicing pediatric orthopaedics. Nearly all of these (390/391, 100%) indicated that they provide direct patient care and work an average of 60 hours per week. Many (105/378, 28%) indicated that they would soon limit their practice or retire. A majority (299/394, 76%) indicated that they face competition in their geographic area, predominantly due to pediatric orthopaedic subspecialists (269/299, 90%). Major business changes had recently occurred or were anticipated by 21% of participants. Respondents reported that use of EMR makes them less efficient (252/397, 63%) and interferes with the patient-physician relationship (172/397, 43%). This workforce survey suggests that pediatric orthopaedic surgeons are concerned with challenges of competition despite concurrent increasing volume and complexity of referrals. External processes such as EMR changes are perceived to negatively impact practice efficiency and satisfaction.

  12. First field test of the theory of ignition and dissipation in sediment density currents - results from Squamish prodelta, British Columbia, Canada. (United States)

    Hizzett, Jamie; Hughes Clarke, John; Cartigny, Matthieu; Talling, Peter; Clare, Michael; Sumner, Esther


    seafloor gradient falls below 3o; causing the flow to wane before reaching the lobe. Two of the three turbidity currents analysed ignite thus supporting the 'ignition-dissipation' hypothesis. The present analysis shows that ignition is not related to the flow trigger and that relatively large failures do not necessarily result in long run out flows. Perhaps it is the case that the largest dissipative flows lead to the largest ignitive flows, resulting from a greater supply of unconsolidated sediment for the ignition process. Completion of the analysis of the remaining 133 flows in this dataset will enable a more thorough test of the 'ignition-dissipation' hypothesis.

  13. Ionic size effects to molecular solvation energy and to ion current across a channel resulted from the nonuniform size-modified PNP equations. (United States)

    Qiao, Yu; Tu, Bin; Lu, Benzhuo


    Ionic finite size can impose considerable effects to both the equilibrium and non-equilibrium properties of a solvated molecular system, such as the solvation energy, ionic concentration, and transport in a channel. As discussed in our former work [B. Lu and Y. C. Zhou, Biophys. J. 100, 2475 (2011)], a class of size-modified Poisson-Boltzmann (PB)/Poisson-Nernst-Planck (PNP) models can be uniformly studied through the general nonuniform size-modified PNP (SMPNP) equations deduced from the extended free energy functional of Borukhov et al. [I. Borukhov, D. Andelman, and H. Orland, Phys. Rev. Lett. 79, 435 (1997)] This work focuses on the nonuniform size effects to molecular solvation energy and to ion current across a channel for real biomolecular systems. The main contributions are: (1) we prove that for solvation energy calculation with nonuniform size effects (through equilibrium SMPNP simulation), there exists a simplified approximation formulation which is the same as the widely used one in PB community. This approximate form avoids integration over the whole domain and makes energy calculations convenient. (2) Numerical calculations show that ionic size effects tend to negate the solvation effects, which indicates that a higher molecular solvation energy (lower absolute value) is to be predicted when ionic size effects are considered. For both calculations on a protein and a DNA fragment systems in a 0.5M 1:1 ionic solution, a difference about 10 kcal/mol in solvation energies is found between the PB and the SMPNP predictions. Moreover, it is observed that the solvation energy decreases as ionic strength increases, which behavior is similar as those predicted by the traditional PB equation (without size effect) and by the uniform size-modified Poisson-Boltzmann equation. (3) Nonequilibrium SMPNP simulations of ion permeation through a gramicidin A channel show that the ionic size effects lead to reduced ion current inside the channel compared with the results

  14. Identification of steel bars immersed in reinforced concrete based on experimental results of eddy current testing and artificial neural network analysis (United States)

    de Alcantara, Naasson


    This paper presents an experimental research on the use of eddy current testing (ECT) and artificial neural networks (ANNs) in order to identify the gauge and position of steel bars immersed in concrete structures. The paper presents details of the ECT probe and concrete specimens constructed for the tests, and a study about the influence of the concrete on the values of measured voltages. After this, new measurements were done with a greater number of specimens, simulating a field condition and the results were used to generate training and validation vectors for multilayer perceptron ANNs. The results show a high percentage of correct identification with respect to both, the gauge of the bar and of the thickness of the concrete cover.

  15. [Current controversies in glycemic control targets. What do the results of the latest clinical trials tell us about the approach to type 2 diabetes mellitus?]. (United States)

    Mauricio, Dídac; Rius, Ferran


    The aim of this article is to discuss the implications of the results obtained in the latest large-scale clinical trials designed to evaluate the effect of intensive glycemic control on the vascular complications associated with type 2 diabetes mellitus. The current scientific evidence is reviewed and the implications of the ACCORD (The Action to Control Cardiovascular Risk in Diabetes study group), ADVANCE (Action in Diabetes and Vascular disease: Preterax and Diamicron Modified Release Control Evaluation) and VADT (Veterans Affairs Diabetes Trial) clinical trials are discussed. General concerns of the studies and their implications for clinical practice and the management of type 2 diabetes, as well as the questions which still need to be answered by future clinical research are discussed.

  16. Modeling and stabilization results for a charge or current-actuated active constrained layer (ACL) beam model with the electrostatic assumption (United States)

    Özer, Ahmet Özkan


    An infinite dimensional model for a three-layer active constrained layer (ACL) beam model, consisting of a piezoelectric elastic layer at the top and an elastic host layer at the bottom constraining a viscoelastic layer in the middle, is obtained for clamped-free boundary conditions by using a thorough variational approach. The Rao-Nakra thin compliant layer approximation is adopted to model the sandwich structure, and the electrostatic approach (magnetic effects are ignored) is assumed for the piezoelectric layer. Instead of the voltage actuation of the piezoelectric layer, the piezoelectric layer is proposed to be activated by a charge (or current) source. We show that, the closed-loop system with all mechanical feedback is shown to be uniformly exponentially stable. Our result is the outcome of the compact perturbation argument and a unique continuation result for the spectral problem which relies on the multipliers method. Finally, the modeling methodology of the paper is generalized to the multilayer ACL beams, and the uniform exponential stabilizability result is established analogously.

  17. Provider Health and Wellness. (United States)

    Nanda, Anil; Wasan, Anita; Sussman, James


    Provider health and wellness is a significant issue and can impact patient care, including patient satisfaction, quality of care, medical errors, malpractice risk, as well as provider and office staff turnover and early retirement. Health and wellness encompasses various areas including burnout, depression, divorce, and suicide and affects providers of all specialties and at all levels of training. Providers deal with many everyday stresses, including electronic health records, office politics, insurance and billing issues, dissatisfied patients, and their own personal and family issues. Approximately half of all physicians suffer from burnout, and the rate of burnout among physicians of all specialties is increasing. An important first step in dealing with burnout is recognition and then seeking assistance. Strategies to prevent and treat burnout include increasing provider resiliency as well as implementing practical changes in the everyday practice of medicine. There is currently very little data regarding health and wellness specifically in the field of allergy and immunology, and studies are necessary to determine the prevalence of burnout and related issues in this field. Many medical specialties as well as state and national medical associations have health and wellness committees and other resources, which are essential for providers. Health and wellness programs should be introduced early in a provider's training and continued throughout a provider's career. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  18. Very low dose fetal exposure to Chernobyl contamination resulted in increases in infant leukemia in Europe and raises questions about current radiation risk models. (United States)

    Busby, Christopher C


    Following contamination from the Chernobyl accident in April 1986 excess infant leukemia (0-1 y) was reported from five different countries, Scotland, Greece, Germany, Belarus and Wales and Scotland combined. The cumulative absorbed doses to the fetus, as conventionally assessed, varied from 0.02 mSv in the UK through 0.06 mSv in Germany, 0.2 mSv in Greece and 2 mSv in Belarus, where it was highest. Nevertheless, the effect was real and given the specificity of the cohort raised questions about the safety of applying the current radiation risk model of the International Commission on Radiological Protection (ICRP) to these internal exposures, a matter which was discussed in 2000 by Busby and Cato and also in the reports of the UK Committee examining Radiation Risk from Internal Emitters. Data on infant leukemia in the United Kingdom, chosen on the basis of the cohorts defined by the study of Greece were supplied by the UK Childhood Cancer Research Group. This has enabled a study of leukemia in the combined infant population of 15,466,845 born in the UK, Greece, and Germany between 1980 and 1990. Results show a statistically significant excess risk RR = 1.43 (95% CI 1.13 < RR < 1.80 (2-tailed); p = 0.0025) in those born during the defined peak exposure period of 01/07/86 to 31/12/87 compared with those born between 01/01/80 and 31/12/85 and 01/01/88 and 31/12/90. The excess risks in individual countries do not increase monotonically with the conventionally calculated doses, the relation being biphasic, increasing sharply at low doses and falling at high doses. This result is discussed in relation to fetal/cell death at higher doses and also to induction of DNA repair. Since the cohort is chosen specifically on the basis of exposure to internal radionuclides, the result can be expressed as evidence for a significant error in the conventional modeling for such internal fetal exposures.

  19. Very Low Dose Fetal Exposure to Chernobyl Contamination Resulted in Increases in Infant Leukemia in Europe and Raises Questions about Current Radiation Risk Models

    Directory of Open Access Journals (Sweden)

    Christopher C. Busby


    Full Text Available Following contamination from the Chernobyl accident in April 1986 excess infant leukemia (0–1 y was reported from five different countries, Scotland, Greece, Germany, Belarus and Wales and Scotland combined. The cumulative absorbed doses to the fetus, as conventionally assessed, varied from 0.02 mSv in the UK through 0.06 mSv in Germany, 0.2 mSv in Greece and 2 mSv in Belarus, where it was highest. Nevertheless, the effect was real and given the specificity of the cohort raised questions about the safety of applying the current radiation risk model of the International Commission on Radiological Protection (ICRP to these internal exposures, a matter which was discussed in 2000 by Busby and Cato [7,8] and also in the reports of the UK Committee examining Radiation Risk from Internal Emitters. Data on infant leukemia in the United Kingdom, chosen on the basis of the cohorts defined by the study of Greece were supplied by the UK Childhood Cancer Research Group. This has enabled a study of leukemia in the combined infant population of 15,466,845 born in the UK, Greece, and Germany between 1980 and 1990. Results show a statistically significant excess risk RR = 1.43 (95% CI 1.13 < RR < 1.80 (2-tailed; p = 0.0025 in those born during the defined peak exposure period of 01/07/86 to 31/12/87 compared with those born between 01/01/80 and 31/12/85 and 01/01/88 and 31/12/90. The excess risks in individual countries do not increase monotonically with the conventionally calculated doses, the relation being biphasic, increasing sharply at low doses and falling at high doses. This result is discussed in relation to fetal/cell death at higher doses and also to induction of DNA repair. Since the cohort is chosen specifically on the basis of exposure to internal radionuclides, the result can be expressed as evidence for a significant error in the conventional modeling for such internal fetal exposures.

  20. Current worldwide nuclear cardiology practices and radiation exposure: results from the 65 country IAEA Nuclear Cardiology Protocols Cross-Sectional Study (INCAPS) (United States)

    Einstein, Andrew J.; Pascual, Thomas N. B.; Mercuri, Mathew; Karthikeyan, Ganesan; Vitola, João V.; Mahmarian, John J.; Better, Nathan; Bouyoucef, Salah E.; Hee-Seung Bom, Henry; Lele, Vikram; Magboo, V. Peter C.; Alexánderson, Erick; Allam, Adel H.; Al-Mallah, Mouaz H.; Flotats, Albert; Jerome, Scott; Kaufmann, Philipp A.; Luxenburg, Osnat; Shaw, Leslee J.; Underwood, S. Richard; Rehani, Madan M.; Kashyap, Ravi; Paez, Diana; Dondi, Maurizio


    Aims To characterize patient radiation doses from nuclear myocardial perfusion imaging (MPI) and the use of radiation-optimizing ‘best practices’ worldwide, and to evaluate the relationship between laboratory use of best practices and patient radiation dose. Methods and results We conducted an observational cross-sectional study of protocols used for all 7911 MPI studies performed in 308 nuclear cardiology laboratories in 65 countries for a single week in March–April 2013. Eight ‘best practices’ relating to radiation exposure were identified a priori by an expert committee, and a radiation-related quality index (QI) devised indicating the number of best practices used by a laboratory. Patient radiation effective dose (ED) ranged between 0.8 and 35.6 mSv (median 10.0 mSv). Average laboratory ED ranged from 2.2 to 24.4 mSv (median 10.4 mSv); only 91 (30%) laboratories achieved the median ED ≤ 9 mSv recommended by guidelines. Laboratory QIs ranged from 2 to 8 (median 5). Both ED and QI differed significantly between laboratories, countries, and world regions. The lowest median ED (8.0 mSv), in Europe, coincided with high best-practice adherence (mean laboratory QI 6.2). The highest doses (median 12.1 mSv) and low QI (4.9) occurred in Latin America. In hierarchical regression modelling, patients undergoing MPI at laboratories following more ‘best practices’ had lower EDs. Conclusion Marked worldwide variation exists in radiation safety practices pertaining to MPI, with targeted EDs currently achieved in a minority of laboratories. The significant relationship between best-practice implementation and lower doses indicates numerous opportunities to reduce radiation exposure from MPI globally. PMID:25898845

  1. Substance use among women receiving post-rape medical care, associated post-assault concerns and current substance abuse: Results from a national telephone household probability sample (United States)

    McCauley, Jenna L.; Kilpatrick, Dean G.; Walsh, Kate; Resnick, Heidi S.


    Objective To examine post-rape substance use, associated post rape medical and social concern variables, and past year substance abuse among women reporting having received medical care following a most recent or only lifetime incident of rape. Method Using a subsample of women who received post-rape medical care following a most recent or only rape incident (n=104) drawn from a national household probability sample of U.S. women, the current study described the extent of peritraumatic substance use, past year substance misuse behaviors, post-rape HIV and pregnancy concerns, and lifetime mental health service utilization as a function of substance use at time of incident. Results One-third (33%) of women seeking post-rape medical attention reported consuming alcohol or drugs at the time of their rape incident. Nearly one in four (24.7%) and one in seven (15%) women seeking medical attention following their most recent rape incident endorsed drug (marijuana, illicit, non-medical use of prescription drugs, or club drug) use or met substance abuse criteria, respectively, in the past year. One in twelve (8.4%) women reported at least monthly binge drinking in the past year. Approximately two-thirds of women reported seeking services for mental health needs in their lifetime. Post-rape concerns among women reporting peritraumatic substance use were not significantly different from those of women not reporting such use. Conclusions Substance use was reported by approximately one-third of women and past year substance abuse was common among those seeking post-rape medical care. Implications for service delivery, intervention implementation, and future research are discussed. PMID:23380490

  2. Current limiters

    Energy Technology Data Exchange (ETDEWEB)

    Loescher, D.H. [Sandia National Labs., Albuquerque, NM (United States). Systems Surety Assessment Dept.; Noren, K. [Univ. of Idaho, Moscow, ID (United States). Dept. of Electrical Engineering


    The current that flows between the electrical test equipment and the nuclear explosive must be limited to safe levels during electrical tests conducted on nuclear explosives at the DOE Pantex facility. The safest way to limit the current is to use batteries that can provide only acceptably low current into a short circuit; unfortunately this is not always possible. When it is not possible, current limiters, along with other design features, are used to limit the current. Three types of current limiters, the fuse blower, the resistor limiter, and the MOSFET-pass-transistor limiters, are used extensively in Pantex test equipment. Detailed failure mode and effects analyses were conducted on these limiters. Two other types of limiters were also analyzed. It was found that there is no best type of limiter that should be used in all applications. The fuse blower has advantages when many circuits must be monitored, a low insertion voltage drop is important, and size and weight must be kept low. However, this limiter has many failure modes that can lead to the loss of over current protection. The resistor limiter is simple and inexpensive, but is normally usable only on circuits for which the nominal current is less than a few tens of milliamperes. The MOSFET limiter can be used on high current circuits, but it has a number of single point failure modes that can lead to a loss of protective action. Because bad component placement or poor wire routing can defeat any limiter, placement and routing must be designed carefully and documented thoroughly.

  3. Providing Compassion through Flow

    Directory of Open Access Journals (Sweden)

    Lydia Royeen


    Full Text Available Meg Kral, MS, OTR/L, CLT, is the cover artist for the Summer 2015 issue of The Open Journal of Occupational Therapy. Her untitled piece of art is an oil painting and is a re-creation of a photograph taken while on vacation. Meg is currently supervisor of outpatient services at Rush University Medical Center. She is lymphedema certified and has a specific interest in breast cancer lymphedema. Art and occupational therapy serve similar purposes for Meg: both provide a sense of flow. She values the outcomes, whether it is a piece of art or improved functional status

  4. The development of Korea's new long-term care service infrastructure and its results: focusing on the market-friendly policy used for expansion of the numbers of service providers and personal care workers. (United States)

    Chon, Yongho


    One of the main reasons for reforming long-term care systems is a deficient existing service infrastructure for the elderly. This article provides an overview of why and how the Korean government expanded long-term care infrastructure through the introduction of a new compulsory insurance system, with a particular focus on the market-friendly policies used to expand the infrastructure. Then, the positive results of the expansion of the long-term care infrastructure and the challenges that have emerged are examined. Finally, it is argued that the Korean government should actively implement a range of practical policies and interventions within the new system.

  5. 南京市养老地产的供需现状及开发对策%Study on the Current Supply and Demand Situation and Development Strategy of the Real Estate Provided for the Aged

    Institute of Scientific and Technical Information of China (English)



    Nanjing city is one of the country's aging population with higher levels of city, the rapid pace of development, facing a severe test of the pension problem. Based on the current situation of Nanjing city housing supply and housing demand in the elderly elderly as the starting point,analysis of the current situation of the pension real estate development in Nanjing city and the development trend in the future. Through the questionnaire survey and the current situation of housing, Nanjing city elderly and elderly housing demand, there is a summary of Nanjing city at present endowment real estate development problems; try to judge the pension real estate market in Nanjing city and Nanjing city development stage, the three kinds of Pension --home care, community care and institutional care in the future the proportion of pension modechanges, which constitute the system of endowment real estate; national and internationalendowment of successful real estate development case, combined with China's pension policyinitiatives, from various measures more comprehensive perspective of Nanjing city pensionreal estate development.%以南京市老年住房的供给现状以及中老年住房需求为切入点,分析南京市养老地产开发的现状以及未来的发展趋势。通过问卷调查的形式分析南京市老年住房的现状及中老年住房需求,总结南京市目前养老地产开发过程中存在的问题。借鉴国外养老地产成功开发的案例,结合我国养老政策举措,研究南京市养老地产开发的对策。

  6. Evaluation of JSAF EM Propagation Prediction Methods for Navy Continuous Training Environment/Fleet Synthetic Training Results and Recommendations: Part 1 - Evaluation of Current JSAF EM Propagation Modeling (United States)


    FFACTR” which is a part of the Engineers Refractive Index Prediction System (EREPS) Tactical Decision Aid ( TDA ) developed by what is now SPAWARS SSC San...currently used in JSAF is “FFACTR” which is a part of the Engineers Refractive Index Prediction System (EREPS) Tactical Decision Aid ( TDA ) developed by what...Decision Aid ( TDA ) developed by what is now SPAWARS SSC San Diego in 1988. This model is no longer supported by SPAWARS or any other group and has been

  7. Results of provider-initiated HIV testing and counselling in health facility in Nanshan District of Shenzhen%深圳市医务人员艾滋病检测咨询效果分析

    Institute of Scientific and Technical Information of China (English)

    罗珍胄; 李岚; 李真; 袁军; 杨祖庆; 周国茂; 田丽闪


    Objective To evaluate the results of provider-initiated HIV testing and counselling (PITC) by medical workers in Nanshan District of Shenzhen. Methods Based on the technical guideline of provider-initiated HIV testing and counselling (PITC), health providers offered PITC services to all patients. The information of counselling and testing obtained from the clinics were statistically analyzed and evaluated. Results A total of 74 076 (11.2%)patients were provided with PITC services,and 47.0% (34784/74076)of them accepted HIV testing,the HIV testing rate was 5.2%. Of those tested, 11 were identified as HIV positives, with a positive rate of 0.32‰. Compared with the baseline, the rate of patients offered information about HIV testing and HIV testing rate were significantly higher (P<0.05). And they were significant different within the different types of health facility and the different types of clinical departments (P<0.001), Conclusion The provider-initiated HIV testing and counselling carried out in Nanshan District is,to a certain extent, fruitful and the practice be further promoted in sexual outpatient departments.%目的 对医疗机构医务人员主动提供艾滋病检测咨询(PITC)项目工作情况进行评价,以期为PITC服务的广范推广提供依据.方法 按照PITC工作指南,在项目科室对就诊者主动提供艾滋病检测和咨询(PITC)服务,并对咨询和检测相关数据进行统计分析和评价.结果 共对74 076名就诊者提供了艾滋病检测和咨询(PITC)服务,提供信息率为112%,其中47.0%(34 784/74 076)就诊者接受了HIV检测,HIV检测率为5.2%,检出阳性者11例,阳性率检出率为0.32%;与基线相比较,提供HIV检测信息率、HIV检测率均显著提高(x2=1456.96,P<0.001;x2=6.33,P<0.05).不同类型医疗机构之间以及不同科室之间医务人员主动提供HIV检测信息率、HIV检测率的差异具有统计学意义(x2=316124,P<0.001; x2=1809.46,P<0.001).结论 PITC

  8. 上海市透析登记及其结果分析%Current status of dialysis therapy in Shanghai (results from Shanghai Renal Registry, 2011)

    Institute of Scientific and Technical Information of China (English)

    张伟明; 钱家麒


    目的 通过上海市透析登记及其结果分析,反映上海市终末期肾病患者透析治疗的总体现状. 方法 上海市血液透析质量控制中心通过上海市“透析登记网络”系统, 将2010年1月1日到2010年12月31日接受到的全市60家医院登记资料(其中开展血液透析共60所医院63家血液透析室,开展腹膜透析共38家医院),对所登记的资料进行统计分析. 结果 2010年全年新增透析患者1621例(每百万人口发病率114.8pmp),较上一年度增加9.2%;其中血液透析占75.8%,腹膜透析占24.2%.2010年12月31日年末透析患者10 508例(每百万人口点治疗率744.0pmp),较上一年度增加14.6%;其中血液透析占80.6%,腹膜透析占19.4%.透析患者主要原发病因仍然是慢性肾小球肾炎(46.2%),新增透析患者中,糖尿病占第2位(19.5%).全年透析患者主要死亡原因依次为脑血管意外(22.4%)、感染(19.6%)和心血管事件(15.2%);年末透析患者中透析龄5年以上的占30.8%.患者透析充分性、贫血治疗状况、乙型肝炎和丙型肝炎病毒感染控制不断改善和提高.结论 上海市终末期肾脏病(ESRD)透析患者逐年增加,主要原发病因为肾小球肾炎,新增患者中,糖尿病患者逐年增加,血液透析仍是目前上海市ESRD患者主要透析治疗模式.%Objective This report is based on the data (up to December 31, 2010) from Shanghai Renal Registry Network. Our aim is to explore the current status of dialysis in Shanghai. Methods Data are collected from Shanghai Renal Registry Network in 2010. All of dialysis centers (n=63) in Shanghai enter the registry system. Results The incidence of new dialysis patients was 1621 (114.8 patients per million), of which 75.8% were on hemodiaiysis (HD) and 24.2% on peritoneal dialysis (PD). The point prevalence of dialysis patients on Dec 31, 2010 is 10 SOS (744.0 patients per million), of which 80.6% were on hemodiaiysis (HD) and 19

  9. [The Current State of Intercultural Opening in Psychosocial Services--The Results of an Assessment in an Inner-City District of Berlin]. (United States)

    Penka, Simone; Faißt, Hanna; Vardar, Azra; Borde, Theda; Mösko, Mike Oliver; Dingoyan, Demet; Schulz, Holger; Koch, Uwe; Kluge, Ulrike; Heinz, Andreas


    The need for intercultural opening of supply facilities for improving access and treatment of people with migration background is acknowledged in Germany. The purpose of the survey was to determine the current state of intercultural opening of psychosocial services in one Berlin district. 127 representatives of institutions were interviewed using a semi-structured assessment tool. The response rate was very high. The cross-cultural opening was implemented on a small scale. Staff as well as users with migration background were underrepresented. Varying and missing standardized documentation as well as problems in assessing users with migration background might be responsible for their low utilization rates. The use of professional interpreters was often not implemented. To judge the low level of implementation of cross-cultural opening in the psychosocial supply system in general, a review of responsible causes is required. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Internet Medline providers. (United States)

    Vine, D L; Coady, T R


    Each database in this review has features that will appeal to some users. Each provides a credible interface to information available within the Medline database. The major differences are pricing and interface design. In this context, features that cost more and might seem trivial to the occasional searcher may actually save time and money when used by the professional. Internet Grateful Med is free, but Ms. Coady and I agree the availability of only three ANDable search fields is a major functional limitation. PubMed is also free but much more powerful. The command line interface that permits very sophisticated searches requires a commitment that casual users will find intimidating. Ms. Coady did not believe the feedback currently provided during a search was sufficient for sustained professional use. Paper Chase and Knowledge Finder are mature, modestly priced Medline search services. Paper Chase provides a menu-driven interface that is very easy to use, yet permits the user to search virtually all of Medline's data fields. Knowledge Finder emphasizes the use of natural language queries but fully supports more traditional search strategies. The impact of the tradeoff between fuzzy and Boolean strategies offered by Knowledge Finder is unclear and beyond the scope of this review. Additional software must be downloaded to use all of Knowledge Finders' features. Other providers required no software beyond the basic Internet browser, and this requirement prevented Ms. Coady from evaluating Knowledge Finder. Ovid and Silver Platter offer well-designed interfaces that simplify the construction of complex queries. These are clearly services designed for professional users. While pricing eliminates these for casual use, it should be emphasized that Medline citation access is only a portion of the service provided by these high-end vendors. Finally, we should comment that each of the vendors and government-sponsored services provided prompt and useful feedback to e

  11. First results from Acoustic Doppler Current Profiler measurements of meltwater flux in a large supraglacial river in western Greenland compared with downstream proglacial river outflow (United States)

    Pitcher, L. H.; Smith, L. C.; Overstreet, B. T.; Chu, V. W.; Rennermalm, A. K.; Cooper, M. G.; Gleason, C. J.; Yang, K.


    A vast network of seasonally evolving, thermally eroding supraglacial rivers on the southwestern Greenland Ice Sheet (GrIS) is the preeminent transporter of meltwater across this area of the ablation zone. Supraglacial rivers are important for estimating surface water storage and transport into moulins and into the en-, sub-, and proglacial environments. Yet, little is known about their role in the GrIS cryo-hydrologic system. To that end, supraglacial river discharge in a large river, the "Rio Behar" (67.05°, -49.02°; ~75 km from the Kangerlussuaq International Airport), was measured in situ over 300 times: approximately four times per hour over three consecutive days from July 19 - 22, 2015. The Rio Behar drains a ~ 70 km2 ice catchment and enters a large moulin in the Watson River land-ice watershed in western Greenland. River discharge was measured using a Sontek M9 Acoustic Doppler Current Profiler. Each profile records water temperature, depth-integrated velocity, channel width and channel bathymetry. This novel dataset can be used to assess diurnal variations in river discharge, slope, velocity, stream power, and channel incision in order to enhance process-level understanding of GrIS meltwater routing, storage and transport. Future work will compare supraglacial river discharge in the Rio Behar with in situ estimates of proglacial river outflow upstream of the Watson River bridge in Kangerlussuaq, Greenland.

  12. The currently used commercial DNA-extraction methods give different results of clostridial and actinobacterial populations derived from human fecal samples. (United States)

    Maukonen, Johanna; Simões, Catarina; Saarela, Maria


    Recently several human health-related microbiota studies have had partly contradictory results. As some differences may be explained by methodologies applied, we evaluated how different storage conditions and commonly used DNA-extraction kits affect bacterial composition, diversity, and numbers of human fecal microbiota. According to our results, the DNA-extraction did not affect the diversity, composition, or quantity of Bacteroides spp., whereas after a week's storage at -20 °C, the numbers of Bacteroides spp. were 1.6-2.5 log units lower (P bacteria, Eubacterium rectale (Erec)-group, Clostridium leptum group, bifidobacteria, and Atopobium group were 0.5-4 log units higher (P DNA-extraction as detected with qPCR, regardless of storage. Furthermore, the bacterial composition of Erec-group differed significantly after different DNA-extractions; after enzymatic DNA-extraction, the most prevalent genera detected were Roseburia (39% of clones) and Coprococcus (10%), whereas after mechanical DNA-extraction, the most prevalent genera were Blautia (30%), Coprococcus (13%), and Dorea (10%). According to our results, rigorous mechanical lysis enables detection of higher bacterial numbers and diversity from human fecal samples. As it was shown that the results of clostridial and actinobacterial populations are highly dependent on the DNA-extraction methods applied, the use of different DNA-extraction protocols may explain the contradictory results previously obtained. © 2011 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.

  13. Current interruption transients calculation

    CERN Document Server

    Peelo, David F


    Provides an original, detailed and practical description of current interruption transients, origins, and the circuits involved, and how they can be calculated Current Interruption Transients Calculationis a comprehensive resource for the understanding, calculation and analysis of the transient recovery voltages (TRVs) and related re-ignition or re-striking transients associated with fault current interruption and the switching of inductive and capacitive load currents in circuits. This book provides an original, detailed and practical description of current interruption transients, origins,

  14. Characterising the Actual Thermal Performance of Buildings: Current Results of Common Exercises Performed in the Framework of the IEA EBC Annex 58-Project

    DEFF Research Database (Denmark)

    Roels, Staf; Bacher, Peder; Bauwens, Geert


    Several studies have shown that actual thermal performance of buildings after construction may deviate significantly from that anticipated at design stage. As a result, there is growing interest in full scale testing of components and whole buildings. The IEA EBC Annex 58-project ‘Reliable Buildi...

  15. Self-consistent kinetic simulations of lower hybrid drift instability resulting in electron current driven by fusion products in tokamak plasmas

    CERN Document Server

    Cook, J W S; Dendy, R O


    We present particle-in-cell (PIC) simulations of minority energetic protons in deuterium plasmas, which demonstrate a collective instability responsible for emission near the lower hybrid frequency and its harmonics. The simulations capture the lower hybrid drift instability in a regime relevant to tokamak fusion plasmas, and show further that the excited electromagnetic fields collectively and collisionlessly couple free energy from the protons to directed electron motion. This results in an asymmetric tail antiparallel to the magnetic field. We focus on obliquely propagating modes under conditions approximating the outer mid-plane edge in a large tokamak, through which there pass confined centrally born fusion products on banana orbits that have large radial excursions. A fully self-consistent electromagnetic relativistic PIC code representing all vector field quantities and particle velocities in three dimensions as functions of a single spatial dimension is used to model this situation, by evolving the in...

  16. Preliminary results of sero-conversion of kids and lambs vaccinated with Brucella melitensis rev -1 strain. Current achievements and feature challenges on brucellosis

    Directory of Open Access Journals (Sweden)



    Full Text Available Sheep and goat brucellosis is an endemic and most important infectious disease of livestock in Albania. It continues to remain a frequent zoonotic disease and an important public health issue. Among available strategies, mass vaccination is an acceptable, cost effective approach, and is a widely used strategy in many countries including some neighbouring Balkan countries. Albanian veterinary services supported by the European Union-funded PAZA project (Protection Against Zoonotic diseases, Albania applied two successive annual mass vaccination campaigns that aimed to vaccinate all small ruminants in the country. These two campaigns aimed at significantly reducing disease spread, however, a small number of infection foci could remain and persist in some parts of country. Post-vaccination surveillance is essential for early detection and proper control of cases of brucellosis that might re-emerge. Limitation major complication arising from mass vaccination is the difficulty of interpretation of the results of serological tests conducted to diagnose the disease. The aim of this study was to evaluate the proportion of vaccinated animals that showed sero-conversion and the duration of detectable levels of agglutinins (antibody against brucellosis in vaccinated animals. Methods. In total, 69 individual animals, 23 lambs and 46 kids aged from 4 to 7 months, were sampled at monthly intervals. Jugular blood was collected before vaccination and at intervals thereafter and tested by means of the Rose Bengal test. All animals were serologically negative before vaccination with modified live Brucella melitensis Rev.1 strain vaccine. Rose Bengal test was performed before vaccination, 18 days, 2, 3 and 4 months after vaccination. Results. Eighteen days after vaccination, 63 out of 69 animals (91.3% 82.6% of lambs (19 out of 23 lambs and 95.6% of goat kids (44 out of 46 showed strong sero-conversion in Rose Bengal test. The proportion of positive vaccinated

  17. Ring current and radiation belts (United States)

    Williams, D. J.


    Studies performed during 1983-1986 on the ring current, the injection boundary model, and the radiation belts are discussed. The results of these studies yielded the first observations on the composition and charge state of the ring current throughout the ring-current energy range, and strong observational support for an injection-boundary model accounting for the origins of radiation-belt particles, the ring current, and substorm particles observed at R less than about 7 earth radii. In addition, the results have demonstrated that the detection of energetic neutral atoms generated by charge-exchange interactions between the ring current and the hydrogen geocorona can provide global images of the earth's ring current and its spatial and temporal evolution.

  18. Positron emission tomography 2008 in Germany. Results of the query and current status; Positronenemissionstomographie 2008 in Deutschland. Ergebnisse der Erhebung und Standortbestimmung

    Energy Technology Data Exchange (ETDEWEB)

    Kotzerke, J.; Oehme, L. [Universitaetsklinikum Carl Gustav Carus, Technische Univ. Dresden (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Lindner, O. [Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen (Germany). Inst. fuer Radiologie, Nuklearmedizin und Molekulare Bildgebung; Hellwig, D. [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Klinik fuer Nuklearmedizin


    Aim: The working group on positron emission tomography (PET) of the DGN (German Society of Nuclear Medicine) initiated this first survey to collect and analyse information on the practise of PET in Germany in the year 2008. Methods: A questionnaire was sent to PET performing facilities (medical practices, hospitals, university hospitals and others) for retrospective data acquisition. Details regarding the equipment and examination procedures were examined as well as indications and number of studies. In addition, the role of PET within the diagnostic process was evaluated. Results: Responses from 65 sites were analysed. Their technical equipment consisted of 77 PET scanners (40 of them were combined PET/CT devices). About 63 500 PET studies had been performed with 86% in the field of oncology, 8% in neurology and 3% in cardiology. The radiotracers were labelled with {sup 18}F in 91% of the studies, whereas {sup 68}Ga was used in 4% and {sup 11}C in 3%. The analyses revealed lung tumours as the most investigated tumour entity, followed by malignant lymphoma, tumours of the gastro-intestinal tract and prostate cancer (about 14 000, 6000, 5000 and 2000). Corresponding to the new scanners and software procedures, the number of studies with attenuation correction by CT was high (68%) and nearly all studies were reconstructed iteratively (99%). The PET images were analysed quantitatively in the majority of cases (91%). The clinical reports, which included image documentation for the greater part, were posted regularly within 3 days. However, in 70% of the sites electronic transfer possibilities were used additionally to speed up the diagnostic process. The high standard of quality was demonstrated by the fact, that 40 facilities were engaged in a tumour board. Further on, one third of the physicians had gained a PET certification awarded by the DGN. Conclusion: Relative to the high general standard of diagnostic instrumentation in Germany, PET is less established, in

  19. Current measurement apparatus (United States)

    Umans, Stephen D.


    Apparatus and methods are provided for a system for measurement of a current in a conductor such that the conductor current may be momentarily directed to a current measurement element in order to maintain proper current without significantly increasing an amount of power dissipation attributable to the current measurement element or adding resistance to assist in current measurement. The apparatus and methods described herein are useful in superconducting circuits where it is necessary to monitor current carried by the superconducting elements while minimizing the effects of power dissipation attributable to the current measurement element.

  20. Therapy Provider Phase Information (United States)

    U.S. Department of Health & Human Services — The Therapy Provider Phase Information dataset is a tool for providers to search by their National Provider Identifier (NPI) number to determine their phase for...


    Directory of Open Access Journals (Sweden)

    M. I. Baranov


    Full Text Available Purpose. Calculation and experimental researches of electro-thermal resistibility of the pre-production thin-walled sheet models of outward roof of height technical buildings from stainless steel are easily soiled 12Х18Н10Т to direct action on them rationed by the International Standard IEC 62305-1-2010 aperiodic impulse of current of short bow of artificial lightning of temporal form 10/350 μs with the proper admittances on his peak-temporal parameters (PTP. Methodology. Electrophysics bases of technique of high voltage and large impulsive currents (LIC, and also scientific and technical bases of planning of high-voltage impulsive devices and measuring methods in them LIC with followings below extreme PTP: amplitude of impulse of current of ImL=200 кА (with admittance ±10 %; integral of action of impulse of current of JL=10·106 A2·s (with admittance ±35 %; %; duration of wavefront current of T1=10 μs (with admittance ±20 %; time, proper amplitude of impulse of current of ImL, tmL≤24 μs (with admittance ±20 %; duration of flowing of impulse of current of T2=350 μs (with admittance ±10 %. Results. The results of evaluation calculation and experimental researches of electro-thermal resistibility of the indicated pre-production sheet models are resulted measuring in the plan of 0,5 x 0,5 m from stainless steel are easily soiled the 12Х18Н10Т thickness of 1 mm to action on them of aperiodic impulse of current of short blow of artificial lightning with rationed PTP on the requirements of the International Standard IEC 62305-1-2010. In high current experiments amplitude of ImL of the aperiodic rationed impulse of current of artificial lightning of temporal form of T1/T2=15 μs/315 μs changed in the range of (100-184 кА. The integral of action of JL of impulse of current for I-IV of levels of protection of lightning of technical objects (TO numeral made from 2,32·106 А2·s to 7,88·106 А2·s, and the flowing through the

  2. Brief training in patient-centered counseling for healthy weight management increases counseling self-efficacy and goal setting among pediatric primary care providers: results of a pilot program. (United States)

    Welsh, Jean A; Nelson, Jennifer M; Walsh, Stephanie; Sealer, Holly; Palmer, Wendy; Vos, Miriam B


    We hypothesized that training in patient-centered counseling would improve self-efficacy and quality of weight management-related counseling provided by pediatric primary care physicians (PCPs). A total of 36 PCPs attended a brief (2-hour) training and consented to participate in an evaluation. Training impact was assessed using self-administered, pretraining and posttraining surveys and a review of patient charts from prior to and from 6 and 12 months after training for a random subsample of 19 PCPs (10 charts/timepoint per PCP). Self-reported effectiveness at obesity prevention and treatment increased from 16.7% to 44.4% (P = .01) and from 19.4% to 55.6% (P < .001), respectively. Self-efficacy in counseling and motivating patients increased from 44.4% to 80.6% (P < .001) and 27.8% to 63.9% (P < .001), respectively. Goal documentation increased from 3.9% to 16.4% and 57.9% at 6 months and 12 months posttraining, respectively. Brief training in patient-centered counseling appears to increase self-efficacy and the frequency and quality of weight-related counseling provided by PCPs. © The Author(s) 2014.

  3. Unmet expectations of medications and care providers among patients with heart failure assessed to be poorly adherent: results from the Chronic Heart Failure Intervention to Improve MEdication Adherence (CHIME) study. (United States)

    Ekman, Inger; Wolf, Axel; Vaughan Dickson, Victoria; Bosworth, Hayden B; Granger, Bradi B


    Ineffective medication management contributes to repeated hospitalisation and death among patients with heart failure. The meaning ascribed to medications and the influence of meaning on how patients manage medications is unknown. The purpose of this study was to explore the meaning and expectations associated with medication use in high-risk, non-adherent patients with heart failure. Patients ( n=265) with heart failure were screened for adherence to prescribed medication using the Morisky medication adherence scale (MMAS). Patients (MMAS score <6; n=44) participated in semistructured interviews, analysed using qualitative content analysis. Of 17 initial themes (223 representative segments), the overarching theme 'unmet expectations' consisted of two subthemes 'working to be heard' by professionals and 'resignation' to both the illness and medications. Patients' expectations were challenged by unexpected work to communicate with providers in general (72 representative segments), and specifically regarding medications (118 representative segments) and feelings of resignation regarding the medication regimen (33 representative segments). These findings suggest that unmet expectations contribute to poor medication management. Improved listening and communication by providers, to establish a common understanding and plan for managing medications may strengthen patient beliefs, resolve feelings of resignation and improve patients' ability to manage medications effectively.

  4. TRAP laws and the invisible labor of US abortion providers


    Mercier, Rebecca J.; Buchbinder, Mara; Bryant, Amy


    Targeted Regulations of Abortion Providers (TRAP laws) are proliferating in the United States and have increased barriers to abortion access. In order to comply with these laws, abortion providers make significant changes to facilities and clinical practices. In this article, we draw attention to an often unacknowledged area of public health threat: how providers adapt to increasing regulation, and the resultant strains on the abortion provider workforce. Current US legal standards for aborti...

  5. Current ornithology

    CERN Document Server


    The appearance of the first volume of a projected series is the occasion for comment on scope, aims, and genesis of the work. The scope of Current Ornithology is all of the biology of birds. Ornithology, as a whole-organism science, is concerned with birds at every level of bi­ ological organization, from the molecular to the community, at least from the Jurassic to the present time, and over every scholarly discipline in which bird biology is done; to say this is merely to expand a dic­ tionary definition of "ornithology. " The aim of the work, to be realized over several volumes, is to present reviews or position statements con­ cerning the active fields of ornithological research. The reviews will be relatively short, and often will be done from the viewpoint of a readily­ identified group or school. Such a work could have come into being at any time within the past fifty years, but that Current Ornithology appears now is a result of events that are only seven to eight years old. One important event wa...

  6. Left atrial thrombus resolution in atrial fibrillation or flutter: Results of a prospective study with rivaroxaban (X-TRA) and a retrospective observational registry providing baseline data (CLOT-AF). (United States)

    Lip, Gregory Y H; Hammerstingl, Christoph; Marin, Francisco; Cappato, Riccardo; Meng, Isabelle Ling; Kirsch, Bodo; van Eickels, Martin; Cohen, Ariel


    Data on left atrial/left atrial appendage (LA/LAA) thrombus resolution after non-vitamin K antagonist (VKA) oral anticoagulant treatment are scarce. The primary objective of X-TRA was to explore the use of rivaroxaban for the resolution of LA/LAA thrombi in patients with nonvalvular atrial fibrillation (AF) or atrial flutter, with the CLOT-AF registry providing retrospective data after standard-of-care therapy in this setting. X-TRA was a prospective, single-arm, open-label, multicenter study that investigated rivaroxaban treatment for 6 weeks for LA/LAA thrombus resolution in patients with nonvalvular AF or atrial flutter and LA/LAA thrombus confirmed at baseline on a transesophageal echocardiogram (TEE). CLOT-AF retrospectively collected thrombus-related patient outcome data after standard-of-care anticoagulant treatment for 3 to 12 weeks in patients with nonvalvular AF or atrial flutter who had LA/LAA thrombi on TEE recorded in their medical file. In X-TRA, patients were predominantly (95.0%) from Eastern European countries. The adjudicated thrombus resolution rate was 41.5% (22/53 modified intention-to-treat [mITT] patients, 95% CI 28.1%-55.9%) based on central TEE assessments. Resolved or reduced thrombus was evident in 60.4% (32/53 mITT patients, 95% CI 46.0%-73.6%) of patients. In CLOT-AF, the reported thrombus resolution rate was 62.5% (60/96 mITT patients, 95% CI 52.0%-72.2%) and appeared better in Western European countries (34/50; 68.0%) than in Eastern European countries (26/46; 56.5%). X-TRA is the first prospective, multicenter study examining LA/LAA thrombus resolution with a non-VKA oral anticoagulant in VKA-naïve patients or in patients with suboptimal VKA therapy. Rivaroxaban could be a potential option for the treatment of LA/LAA thrombi. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  7. Pitavastatin 4 mg Provides Significantly Greater Reduction in Remnant Lipoprotein Cholesterol Compared With Pravastatin 40 mg: Results from the Short-term Phase IV PREVAIL US Trial in Patients With Primary Hyperlipidemia or Mixed Dyslipidemia. (United States)

    Miller, P Elliott; Martin, Seth S; Joshi, Parag H; Jones, Steven R; Massaro, Joseph M; D'Agostino, Ralph B; Sponseller, Craig A; Toth, Peter P


    Remnants are partially hydrolyzed, triglyceride-rich lipoproteins that are implicated in atherosclerosis. We assessed the adequacy of pitavastatin 4 mg and pravastatin 40 mg in reducing atherogenic lipid parameters beyond LDL-C, in particular remnant lipoprotein cholesterol (RLP-C). From the Phase IV, multicenter, randomized, double-blind PREVAIL US (A Study of Pitavastatin 4 mg Vs. Pravastatin 40 mg in Patients With Primary Hyperlipidemia or Mixed Dyslipidemia) trial, we examined lipoprotein cholesterol subfractions using Vertical Auto Profile testing and apolipoproteins B and A-I at baseline and 12 weeks. Participants with primary hyperlipidemia or mixed dyslipidemia had LDL-C levels of 130 to 220 mg/dL and triglyceride levels ≤ 400 mg/dL. In this post hoc analysis, changes in lipid parameters were compared by using ANCOVA. Lipoprotein subfraction data were available in 312 patients (pitavastatin, n = 157; pravastatin, n = 155). Pitavastatin promoted a greater reduction in RLP-C than pravastatin (-13.6 [8.7] vs -9.3 [9.5] mg/dL). Furthermore, the pitavastatin group reported greater reductions in both components of RLP-C (both, P lipoprotein cholesterol (-9.5 [6.3] vs -6.4 [6.6] mg/dL) and very low-density lipoprotein cholesterol subfraction 3 (-4.1 [3.5] vs -2.9 [3.8] mg/dL). There were also greater reductions in the major ratios of risk (apolipoprotein B/apolipoprotein A-I and total cholesterol/HDL-C) (both, P lipoprotein(a)-cholesterol. The mean age was 58.8 ± 8.9 years in the pitavastatin group and 57.0 ± 10.2 years in the pravastatin group. Compared with pravastatin 40 mg daily, pitavastatin 4 mg provided superior reductions in atherogenic lipid parameters beyond LDL-C, including RLP-C. Future studies are needed investigate the clinical implications of lowering directly measured RLP-C as the principal target. identifier: NCT01256476. Copyright © 2016 Elsevier HS Journals, Inc. All rights reserved.

  8. Dependent rational providers. (United States)

    Brothers, Kyle B


    Provider claims to conscientious objection have generated a great deal of heated debate in recent years. However, the conflicts that arise when providers make claims to the "conscience" are only a subset of the more fundamental challenges that arise in health care practice when patients and providers come into conflict. In this piece, the author provides an account of patient-provider conflict from within the moral tradition of St. Thomas Aquinas. He argues that the practice of health care providers should be understood as a form of practical reasoning and that this practical reasoning must necessarily incorporate both "moral" and "professional" commitments. In order to understand how the practical reasoning of provider should account for the needs and commitments of the patient and vice versa, he explores the account of dependence provided by Alasdair MacIntyre in his book Dependent Rational Animals. MacIntyre argues that St. Thomas' account of practical reasoning should be extended and adapted to account for the embodied vulnerability of all humans. In light of this insight, providers must view patients not only as the subjects of their moral reflection but also as fellow humans upon whom the provider depends for feedback on the effectiveness and relevance of her practical reasoning. The author argues that this account precludes responsive providers from adopting either moral or professional conclusions on the appropriateness of interventions outside the individual circumstances that arise in particular situations. The adoption of this orientation toward patients will neither eradicate provider-patient conflict nor compel providers to perform interventions to which they object. But this account does require that providers attend meaningfully to the suffering of patients and seek feedback on whether their intervention has effectively addressed that suffering.

  9. Associations of quality of life, pain, and self-reported arthritis with age, employment, bleed rate, and utilization of hemophilia treatment center and health care provider services: results in adults with hemophilia in the HERO study

    Directory of Open Access Journals (Sweden)

    Forsyth AL


    Full Text Available Angela L Forsyth,1 Michelle Witkop,2 Angela Lambing,3 Cesar Garrido,4 Spencer Dunn,5 David L Cooper,6 Diane J Nugent7 1BioRx, Cincinnati, OH, USA; 2Munson Medical Center, Traverse City, MI, USA; 3Henry Ford Hospital, Detroit, MI, USA; 4Asociacion Venezolana para la Hemofilia, Caracas, Venezuela; 5Center for Inherited Blood Disorders, Orange, CA, USA; 6Novo Nordisk Inc., Plainsboro, NJ, USA; 7Children’s Hospital of Orange County, Center for Inherited Blood Disorders, Orange, CA, USA Introduction: Severe hemophilia and subsequent hemophilic arthropathy result in joint pain and impaired health-related quality of life (HRQoL. Assessment of HRQoL in persons with hemophilia (PWH, including underlying factors that drive HRQoL differences, is important in determining health care resource allocation and in making individualized clinical decisions.Aim: To examine potential associations between HRQoL, pain interference, and self-reported arthritis and age, employment, activity, bleed frequency, and hemophilia treatment center and health care professional utilization.Methods: PWH (age ≥18 years from ten countries completed a 5-point Likert scale on pain interference over the previous 4 weeks, the EQ-5D-3L scale (mobility, usual activities, self-care, pain/discomfort, anxiety/depression including a health-related visual analog scale (0–100, coded as an 11-point categorical response.Results: Pain interference (extreme/a lot was higher in PWH aged >40 years (31% compared to those aged 31–40 years (27% or ≤30 years (21%. In an analysis of eight countries with home treatment, PWH who reported EQ-5D mobility issues were less likely to be employed (53% vs 79%, with no mobility issues. Median annual bleed frequency increased with worsening EQ-5D pain or discomfort. The percentage of PWH with inhibitors reporting visual analog scale scores of 80–90–100 was lower (20% than those without inhibitors (34%. Median bleed frequency increased with pain

  10. What HERA May Provide?

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Hannes; /DESY; De Roeck, Albert; /CERN; Bartels, Jochen; /Hamburg U., Inst. Theor. Phys. II; Behnke, Olaf; Blumlein, Johannes; /DESY; Brodsky, Stanley; /SLAC /Durham U., IPPP; Cooper-Sarkar, Amanda; /Oxford U.; Deak, Michal; /DESY; Devenish, Robin; /Oxford U.; Diehl, Markus; /DESY; Gehrmann, Thomas; /Zurich U.; Grindhammer, Guenter; /Munich, Max Planck Inst.; Gustafson, Gosta; /CERN /Lund U., Dept. Theor. Phys.; Khoze, Valery; /Durham U., IPPP; Knutsson, Albert; /DESY; Klein, Max; /Liverpool U.; Krauss, Frank; /Durham U., IPPP; Kutak, Krzysztof; /DESY; Laenen, Eric; /NIKHEF, Amsterdam; Lonnblad, Leif; /Lund U., Dept. Theor. Phys.; Motyka, Leszek; /Hamburg U., Inst. Theor. Phys. II /Birmingham U. /Southern Methodist U. /DESY /Piemonte Orientale U., Novara /CERN /Paris, LPTHE /Hamburg U. /Penn State U.


    More than 100 people participated in a discussion session at the DIS08 workshop on the topic What HERA may provide. A summary of the discussion with a structured outlook and list of desirable measurements and theory calculations is given. The HERA accelerator and the HERA experiments H1, HERMES and ZEUS stopped running in the end of June 2007. This was after 15 years of very successful operation since the first collisions in 1992. A total luminosity of {approx} 500 pb{sup -1} has been accumulated by each of the collider experiments H1 and ZEUS. During the years the increasingly better understood and upgraded detectors and HERA accelerator have contributed significantly to this success. The physics program remains in full swing and plenty of new results were presented at DIS08 which are approaching the anticipated final precision, fulfilling and exceeding the physics plans and the previsions of the upgrade program. Most of the analyses presented at DIS08 were still based on the so called HERA I data sample, i.e. data taken until 2000, before the shutdown for the luminosity upgrade. This sample has an integrated luminosity of {approx} 100 pb{sup -1}, and the four times larger statistics sample from HERA II is still in the process of being analyzed.

  11. Forest cover change in the upper Midwestern United States results from both climate and land use change following European settlement: Historical survey and weather records provide robust support for modeling applications (United States)

    Goring, S. J.; Williams, J. W.; McLachlan, J. S.; Dawson, A.; Dietze, M.; Paciorek, C. J.; Mladenoff, D. J.; Record, S.; Cogbill, C. V.; Hooten, M.; Ruid, M.; Jackson, S. T.


    Since European settlement, both climate and human land use have acted on forests in the upper Midwestern United States resulting in changes in forest structure and composition. The extent of these changes has been examined locally and at the state level by examining forest records from the Public Lands Survey System (PLSS), but here we bring together records of changing forest composition with weather records from the mid to late 19th century from the 19th Century Forts and Observer's Database. We are able to assign attribution for taxon range and composition shifts in the region to either land use, climate or both. We see that much of the range contraction in the region seen when comparing Forest Inventory and Analysis data with Public Land Survey System data occurs along the prairie margin, with northern forests showing greater stability in both range and composition suggesting a dominant role for land use in structuring regional vegetation. Modern forests are often less diverse than PLSS forests and the mean minimum dissimilarity between modern and PLSS-era forests is significantly higher than the minimum dissimilarity within either the PLSS-era forests or the modern (FIA) forests, indicating the possiblity that our modern forests have already become 'no-analogue' ecosystems.

  12. Early hCG addition to rFSH for ovarian stimulation in IVF provides better results and the cDNA copies of the hCG receptor may be an indicator of successful stimulation

    Directory of Open Access Journals (Sweden)

    Paraskevis Dimitris


    Full Text Available Abstract A simple, safe and cost-effective treatment protocol in ovarian stimulation is of great importance in IVF practice, especially in the case of previous unsuccessful attempts. hCG has been used as a substitute of LH because of the degree of homology between the two hormones. The main aim of this prospective randomized study was to determine, for the first time, whether low dose hCG added to rFSH for ovarian stimulation could produce better results compared to the addition of rLH in women entering IVF-ET, especially in those women that had previous IVF failures. An additional aim was to find an indicator that would allow us to follow-up ovarian stimulation and, possibly, modify it in order to achieve a better IVF outcome; and that indicator may be the cDNA copies of the LH/hCG receptor. Group A patients (n = 58 were administered hCG and Group B rLH (n = 56 in addition to rFSH in the first days of ovarian stimulation. The number of follicles and oocytes and, most importantly, implantation and pregnancy rates were shown to be statistically significantly higher in the hCG group. This study has also determined, for the first time to our best knowledge, m-RNA for LH/hCG receptors in the lymphocytes of peripheral blood 40 h before ovum pick-up. cDNA levels of the hCG receptor after ovarian stimulation were significantly higher among women receiving hCG compared to those receiving LH. In addition, higher levels were encountered among women with pregnancy compared to those without, although this was not statistically significant due to the small number of pregnancies. It seems that hCG permits a highly effective and more stable occupancy of rLH/hCG receptors and gives more follicles and more oocytes. The determination of cDNA copies could be, in the future, a marker during ovulation induction protocols and of course a predictor for the outcome of ART in the special subgroup of patients with previous failures.

  13. Magnetic current sensor (United States)

    Black, Jr., William C. (Inventor); Hermann, Theodore M. (Inventor)


    A current determiner having an output at which representations of input currents are provided having an input conductor for the input current and a current sensor supported on a substrate electrically isolated from one another but with the sensor positioned in the magnetic fields arising about the input conductor due to any input currents. The sensor extends along the substrate in a direction primarily perpendicular to the extent of the input conductor and is formed of at least a pair of thin-film ferromagnetic layers separated by a non-magnetic conductive layer. The sensor can be electrically connected to a electronic circuitry formed in the substrate including a nonlinearity adaptation circuit to provide representations of the input currents of increased accuracy despite nonlinearities in the current sensor, and can include further current sensors in bridge circuits.

  14. Current noise in tunnel junctions

    Energy Technology Data Exchange (ETDEWEB)

    Frey, Moritz; Grabert, Hermann [Physikalisches Institut, Universitaet Freiburg, Hermann-Herder-Strasse 3, 79104, Freiburg (Germany)


    We study current fluctuations in tunnel junctions driven by a voltage source. The voltage is applied to the tunneling element via an impedance providing an electromagnetic environment of the junction. We use circuit theory to relate the fluctuations of the current flowing in the leads of the junction with the voltage fluctuations generated by the environmental impedance and the fluctuations of the tunneling current. The spectrum of current fluctuations is found to consist of three parts: a term arising from the environmental Johnson-Nyquist noise, a term due to the shot noise of the tunneling current and a third term describing the cross-correlation between these two noise sources. Our phenomenological theory reproduces previous results based on the Hamiltonian model for the dynamical Coulomb blockade and provides a simple understanding of the current fluctuation spectrum in terms of circuit theory and properties of the average current. Specific results are given for a tunnel junction driven through a resonator. (copyright 2016 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  15. Provider of Services File (United States)

    U.S. Department of Health & Human Services — The POS file consists of two data files, one for CLIA labs and one for 18 other provider types. The file names are CLIA and OTHER. If downloading the file, note it...

  16. What HERA may provide?

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Hannes [DESY, Hamburg (Germany); De Roeck, Albert [CERN, Genf (Switzerland); Bartles, Jochen [Univ. Hamburg (DE). Institut fuer Theoretische Physik II] (and others)


    More than 100 people participated in a discussion session at the DIS08 workshop on the topic What HERA may provide. A summary of the discussion with a structured outlook and list of desirable measurements and theory calculations is given. (orig.)


    Directory of Open Access Journals (Sweden)

    M.I. Baranov


    Full Text Available Purpose. Test in obedience to the requirements of row of operating foreign standards of round metallic lightning-rods with the flat metallic universal clamps of the special type on firmness to direct action of аperiodic impulses of current of temporal form 10/350 μs by amplitude of 50 кА (N− class and 100 кА (H− class. Methodology. The order of leadthrough of these tests is certain the followings normative documents: International IEC 62305-1: 2010, Russian national GOST R IEC 62305-1-2010 and German national DIN EN 50164-1:2008 Standards. Results. Conducted on a powerful high-voltage pulsed current of artificial linear lightning with the peak-temporal parameters and admittances of test rationed on the indicated foreign standards rationed that all of the lightning-rods tested in collection with universal clamps, isolating holders and ceramic elements of roof of technical building were survive electrodynamics and electrothermal action of in-use single short blow of an artificial storm digit. Originality. First in domestic practice the similar model tests of lightning-rods are conducted with universal clamps, executed from different explorer materials, on firmness to flowing to on by it the indicated large impulsive currents of artificial lightning. Practical value. Real firmness to lightning of round copper and zincked steel lightning-rods is certain with the flat copper, zincked steel and non-rusting steel universal clamps of the special execution.

  18. Current practice vs. guideline based imaging in abdominal radiology in the German speaking area. Results of an online survey; Versorgungsrealitaet vs. leitliniengerechte Bildgebung in der Abdominalradiologie im deutschsprachigen Raum. Ergebnisse einer Online-Umfrage

    Energy Technology Data Exchange (ETDEWEB)

    Schreyer, A.G. [University Hospital Regenburg (Germany). Dept. of Radiology; Wessling, J. [Clemens Hospital Muenchen (Germany). Dept. of Radiology; Grenacher, L. [Diagnostic Muenchen (Germany). Diagnostic Imaging Center


    The working group for abdominal imaging within the German Roentgen Society (DRG) performed an online survey amongst radiologist concerning the current status of techniques for abdominal imaging. The results of this survey were compared with the most recent guidelines. We performed an online survey open for all members of the DRG during a 76-day period with 65 questions and an overall estimated time for finishing the questionnaire of 15 minutes concerning technical specifications for abdominal radiological imaging. The results were evaluated using descriptive statistics. 90 of all participants, who filled out the survey covering more than 80 % of the questions, were included in the statistical evaluation. 27 % of all participants were registered radiologists while 73 % represented radiologists working in a hospital. Most participants worked in a managerial position. The participants gave detailed information regarding the radiological techniques used in dedicated organ systems (esophagus, stomach, pancreas, liver, small intestines, colon) regarding acquired contrast phases and oral and intravenous administration of contrast medium. The results confirm that most radiologists participating in this survey perform their examinations and choose their modalities in conformity with the current existing clinical guidelines. Because most clinical guidelines do not specify radiological examinations in detail, there is a noteworthy heterogeneity of the acquired contrast phases and major divergence in terms of technical parameters. Therefore a joint radiological effort should be initiated for developing and publishing updated radiological parameters for abdominal imaging.

  19. Building Service Provider Capabilities

    DEFF Research Database (Denmark)

    Brandl, Kristin; Jaura, Manya; Ørberg Jensen, Peter D.

    In this paper we study whether and how the interaction between clients and the service providers contributes to the development of capabilities in service provider firms. In situations where such a contribution occurs, we analyze how different types of activities in the production process...... of the services, such as sequential or reciprocal task activities, influence the development of different types of capabilities. We study five cases of offshore-outsourced knowledge-intensive business services that are distinguished according to their reciprocal or sequential task activities in their production...... process. We find that clients influence the development of human capital capabilities and management capabilities in reciprocally produced services. While in sequential produced services clients influence the development of organizational capital capabilities and management capital capabilities....

  20. Achieving Provider Engagement (United States)

    Greenfield, Geva; Pappas, Yannis; Car, Josip; Majeed, Azeem; Harris, Matthew


    The literature on integrated care is limited with respect to practical learning and experience. Although some attention has been paid to organizational processes and structures, not enough is paid to people, relationships, and the importance of these in bringing about integration. Little is known, for example, about provider engagement in the organizational change process, how to obtain and maintain it, and how it is demonstrated in the delivery of integrated care. Based on qualitative data from the evaluation of a large-scale integrated care initiative in London, United Kingdom, we explored the role of provider engagement in effective integration of services. Using thematic analysis, we identified an evolving engagement narrative with three distinct phases: enthusiasm, antipathy, and ambivalence, and argue that health care managers need to be aware of the impact of professional engagement to succeed in advancing the integrated care agenda. PMID:25212855

  1. Pharmacist provider status legislation: Projections and prospects. (United States)

    Harper, Patrick C


    To compare legislation at the federal level that would recognize pharmacists as health care providers under Medicare Part B with similar state-level efforts in an attempt to identify the strengths and weaknesses of these options and forecast outcomes. The current primary care provider shortage poses a significant threat to public health in the United States. The effort to achieve federal provider status for pharmacists, currently in the form of identical bills introduced in January 2015 into the U.S. House of Representatives and the U.S. Senate as the Pharmacy and Medically Underserved Areas Enhancement Act (H.R. 592 and S. 314), would amend the Social Security Act to recognize pharmacists as health care providers in sections of Medicare Part B that specify coverage and reimbursement. This action has budgetary implications owing to the compensation that would accrue to pharmacists caring for Medicare beneficiaries. Passage of these bills into law could improve public health by sustainably increasing access to pharmacists' patient care services in medically underserved areas. In this article, the legislation's strengths and weaknesses are analyzed. The resulting information may be used to forecast the bills' fate as well as plan strategies to help support their success. Comparison of the bills with existing, state-level efforts is used as a framework for such policy analysis. While the current political climate benefits the bills in the U.S. Congress, established legislative precedents suggest that parts of H.R. 592/S. 314, specifically those regarding compensation mechanisms, may require negotiated amendment to improve their chances of success.

  2. Is the current pertussis incidence only the results of testing? A spatial and space-time analysis of pertussis surveillance data using cluster detection methods and geographically weighted regression modelling (United States)

    Kauhl, Boris; Heil, Jeanne; Hoebe, Christian J. P. A.; Schweikart, Jürgen; Krafft, Thomas; Dukers-Muijrers, Nicole H. T. M.


    Background Despite high vaccination coverage, pertussis incidence in the Netherlands is amongst the highest in Europe with a shifting tendency towards adults and elderly. Early detection of outbreaks and preventive actions are necessary to prevent severe complications in infants. Efficient pertussis control requires additional background knowledge about the determinants of testing and possible determinants of the current pertussis incidence. Therefore, the aim of our study is to examine the possibility of locating possible pertussis outbreaks using space-time cluster detection and to examine the determinants of pertussis testing and incidence using geographically weighted regression models. Methods We analysed laboratory registry data including all geocoded pertussis tests in the southern area of the Netherlands between 2007 and 2013. Socio-demographic and infrastructure-related population data were matched to the geo-coded laboratory data. The spatial scan statistic was applied to detect spatial and space-time clusters of testing, incidence and test-positivity. Geographically weighted Poisson regression (GWPR) models were then constructed to model the associations between the age-specific rates of testing and incidence and possible population-based determinants. Results Space-time clusters for pertussis incidence overlapped with space-time clusters for testing, reflecting a strong relationship between testing and incidence, irrespective of the examined age group. Testing for pertussis itself was overall associated with lower socio-economic status, multi-person-households, proximity to primary school and availability of healthcare. The current incidence in contradiction is mainly determined by testing and is not associated with a lower socioeconomic status. Discussion Testing for pertussis follows to an extent the general healthcare seeking behaviour for common respiratory infections, whereas the current pertussis incidence is largely the result of testing. More

  3. Electric current locator (United States)

    King, Paul E [Corvallis, OR; Woodside, Charles Rigel [Corvallis, OR


    The disclosure herein provides an apparatus for location of a quantity of current vectors in an electrical device, where the current vector has a known direction and a known relative magnitude to an input current supplied to the electrical device. Mathematical constants used in Biot-Savart superposition equations are determined for the electrical device, the orientation of the apparatus, and relative magnitude of the current vector and the input current, and the apparatus utilizes magnetic field sensors oriented to a sensing plane to provide current vector location based on the solution of the Biot-Savart superposition equations. Description of required orientations between the apparatus and the electrical device are disclosed and various methods of determining the mathematical constants are presented.

  4. Risk behaviors, prevalence of HIV and hepatitis C virus infection and population size of current injection drug users in a China-Myanmar border city: results from a Respondent-Driven Sampling Survey in 2012.

    Directory of Open Access Journals (Sweden)

    Lei Li

    Full Text Available BACKGROUND: Injection drug use has been the major cause of HIV/AIDS in China in the past two decades. We measured the prevalences of HIV and hepatitis C virus (HCV prevalence and their associated risk factors among current injection drug users (IDUs in Ruili city, a border region connecting China with Myanmar that has been undergoing serious drug use and HIV spread problems. An estimate of the number of current IDUs is also presented. METHODS: In 2012, Chinese IDUs who had injected within the past six months and aged ≥ 18 years were recruited using a respondent-driven sampling (RDS technique. Participants underwent interviews and serological testing for HIV, HBV, HCV and syphilis. Logistic regression indentified factors associated with HIV and HCV infections. Multiplier method was used to obtain an estimate of the size of the current IDU population via combining available service data and findings from our survey. RESULTS: Among 370 IDUs recruited, the prevalence of HIV and HCV was 18.3% and 41.5%, respectively. 27.1% of participants had shared a needle/syringe in their lifetime. Consistent condom use rates were low among both regular (6.8% and non-regular (30.4% partners. Factors independently associated with being HIV positive included HCV infection, having a longer history of injection drug use and experience of needle/syringe sharing. Participants with HCV infection were more likely to be HIV positive, have injected more types of drugs, have shared other injection equipments and have unprotected sex with regular sex partners. The estimated number of current IDUs in Ruili city was 2,714 (95% CI: 1,617-5,846. CONCLUSIONS: IDUs may continue to be a critical subpopulation for transmission of HIV and other infections in this region because of the increasing population and persistent high risk of injection and sexual behaviours. Developing innovative strategies that can improve accessibility of current harm reduction services and incorporate

  5. Uncertainty of Voltage Measurement Results of Leakage Current Tester%泄漏电流测试仪试验电压测量结果的不确定度评估

    Institute of Scientific and Technical Information of China (English)



    介绍了泄漏电流测试仪试验电压测量结果的不确定度评估,详细分析了影响测量不确定度的原因,计算了各不确定度分量并给出合成标准不确定度。为校准结果的准确性提供了可靠保证。%The uncertainty of voltage measurement results of leakage current tester is roduced in this paper. The paper analyzes the reasons that affects the uncertainty of measurement, calculates the every kind of uncertainty components and gives the combined standard uncertainty. This work assures the accuracy of calibration result.

  6. The criterion for blanking-off heat-transfer tubes in the steam generators at VVER-based nuclear power plants based on the results of eddy-current examination (United States)

    Lunin, V. P.; Zhdanov, A. G.; Chegodaev, V. V.; Stolyarov, A. A.


    The problem of defining the criterion for blanking off heat-transfer tubes in the steam generators at nuclear power plants on the basis of signals obtained from the standard multifrequency eddy-current examination is considered. The decision about blanking off one or another tube is presently made with reference to one parameter of the relevant signal at the working frequency, namely, with reference to its phase, which directly depends on the depth of the flaw being detected, i.e., a crack in the tube. The crack depth equal to 60% of the tube wall thickness is regarded to be the critical one, at which a decision about withdrawing such a tube out from operation (blanking off) must be taken. However, since mechanical tensile rupture tests of heat-transfer tubes show the possibility of their further use with such flaws, the secondary parameter of the signal, namely, its amplitude, must be used for determining the blanking-off criterion. The signals produced by the standard flow-type transducers in response to flaws in the form of a longitudinal crack having the depth and length within the limits permitted by the relevant regulations were calculated using 3D finite-element modeling. Based on the obtained results, the values of the eddy-current signal amplitude were determined, which, together with the signal phase value, form a new amplitude-phase criterion for blanking off heat-transfer tubes. For confirming the effectiveness of this technique, the algorithm for revealing the signal indications satisfying the proposed amplitude-phase criterion was tested on real signals obtained from operational eddy-current examination of the state of steam generator heat-transfer tubes carried out within the framework of planned preventive repair.

  7. Obstetric Provider Maldistribution: Georgia, USA, 2011. (United States)

    Spelke, Bridget; Zertuche, Adrienne D; Rochat, Roger


    Objectives In 2010, Georgia had the nation's highest maternal mortality rate, sixteenth highest infant mortality rate, and a waning obstetrician/gynecologist (ob/gyn) workforce. Statewide ob/gyn workforce data, however, masked obstetric-specific care shortages and regional variation in obstetric services. The Georgia Maternal and Infant Health Research Group thereby assessed each Georgia region's obstetric provider workforce to identify service-deficient areas. Methods We identified 63 birthing facilities in the 82 Primary Care Service Areas (PCSAs) outside metropolitan Atlanta and interviewed nurse managers and others to assess the age, sex, and expected departure year of each delivering professional. Using accepted annual delivery rates of 155 per obstetrician (OB), 100 per certified nurse midwife (CNM), and 70 per family medicine physician (FP) we converted obstetric providers into "OB equivalents" to standardize obstetric services available in any given area. Using facility births and computed OB equivalents (contemporary and 2020 estimates), we calculated current and projected average annual births per provider (AABP) for each PCSA, categorizing its obstetric provider workforce as "adequate" (AABP  166). We mapped results using ArcGIS. Results Of 82 surveyed PCSAs, 52 % (43) were deficient in obstetric care; 16 % (13) had a shortage and 37 % (30) lacked obstetric providers entirely. There were no delivering FPs in 89 % (73) of PCSAs and no CNMs in 70 % (56). If Georgia fails to recruit delivering providers, 72 % (58/77) of PCSAs will have deficient or no obstetric care by 2020. Conclusions Obstetric provider shortages in Georgia hinder access to prenatal and delivery services. Care-deficient areas will expand if recruitment and retention of delivering professionals does not improve.

  8. Current Titles

    Energy Technology Data Exchange (ETDEWEB)



    This booklet is published for those interested in current research being conducted at the National Center for Electron Microscopy. The NCEM is a DOE-designated national user facility and is available at no charge to qualified researchers. Access is controlled by an external steering committee. Interested researchers may contact Jane Cavlina, Administrator, at 510/486-6036.

  9. Turbulent current drive mechanisms (United States)

    McDevitt, Christopher J.; Tang, Xian-Zhu; Guo, Zehua


    Mechanisms through which plasma microturbulence can drive a mean electron plasma current are derived. The efficiency through which these turbulent contributions can drive deviations from neoclassical predictions of the electron current profile is computed by employing a linearized Coulomb collision operator. It is found that a non-diffusive contribution to the electron momentum flux as well as an anomalous electron-ion momentum exchange term provide the most efficient means through which turbulence can modify the mean electron current for the cases considered. Such turbulent contributions appear as an effective EMF within Ohm's law and hence provide an ideal means for driving deviations from neoclassical predictions.

  10. Global Education Review is a publication of The School of Education at Mercy College, New York. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Citation: Romano, Vincent A., Jr. (2014. Secondary teachers’ and their supervisors’ perceptions of current and desired observation practices. Global Education Review, 1 (3. 135-146. Secondary Teachers’ and Their Supervisors’ Perceptions of Current and Desired Observation Practices

    Directory of Open Access Journals (Sweden)

    Vincent A. Romano Jr.


    Full Text Available The purpose of this research is to provide insight on how to improve current classroom observation practices in order to meet the needs of teachers, promote professional growth, and develop effective supervision practices. This study built upon previous research which identified four key components of a classroom observation process that promotes instructional growth and development: instructional improvement practice, purpose of observation, professional trust, and reflective thinking (Ginsberg, 2003; Card 2006. These dimensions were used in this study and results were analyzed by teacher, by supervisor, and then compared by teacher and supervisor. The participants in this study consisted of 263 faculty from one junior-senior high school district in Nassau County, New York grades 7-12. Subjects were asked to respond to a 38 question survey, which asked teachers and supervisors to respond to how frequently they experienced a specific behavior, and how desirable or important they believed that behavior was as an action that would help improve teacher performance. The research showed that teachers and supervisors agreed on important practices that promote instructional improvement of teachers, but they disagreed on the extent to which it existed in their current process. Supervisors demonstrated higher scores for existence of practice when compared to teachers. Professional trust represented the largest mean change score for existing practice.

  11. Inrush Current Control Circuit (United States)

    Cole, Steven W. (Inventor)


    An inrush current control circuit having an input terminal connected to a DC power supply and an output terminal connected to a load capacitor limits the inrush current that charges up the load capacitor during power up of a system. When the DC power supply applies a DC voltage to the input terminal, the inrush current control circuit produces a voltage ramp at the load capacitor instead of an abrupt DC voltage. The voltage ramp results in a constant low level current to charge up the load capacitor, greatly reducing the current drain on the DC power supply.

  12. Submesoscale cyclones in the Agulhas current (United States)

    Krug, M.; Swart, S.; Gula, J.


    Gliders were deployed for the first time in the Agulhas Current region to investigate processes of interactions between western boundary currents and shelf waters. Continuous observations from the gliders in water depths of 100-1000 m and over a period of 1 month provide the first high-resolution observations of the Agulhas Current's inshore front. The observations collected in a nonmeandering Agulhas Current show the presence of submesoscale cyclonic eddies, generated at the inshore boundary of the Agulhas Current. The submesoscale cyclones are often associated with warm water plumes, which extend from their western edge and exhibit strong northeastward currents. These features are a result of shear instabilities and extract their energy from the mean Agulhas Current jet.

  13. Equatorial potassium currents in lenses. (United States)

    Wind, B E; Walsh, S; Patterson, J W


    Earlier work with the vibrating probe demonstrated the existence of outward potassium currents at the equator and inward sodium currents at the optical poles of the lens. By adding microelectrodes to the system, it is possible to relate steady currents (J) to the potential difference (PD) measured with a microelectrode. By injecting an outward current (I), it is possible to determine resistances and also the PD at which the steady outward potassium current becomes zero (PDJ = 0). At this PD the concentration gradient for potassium efflux and the electrical gradient for potassium influx are balanced so that there is no net flow of potassium across the membranes associated with the production of J. The PDJ = 0 for 18 rat lenses was 86 mV and that for 12 frogs lenses was -95 mV. This agrees with the potassium equilibrium potential and provides strong evidence to support the view that the outward equatorial current, J, is a potassium current. With the injection of outward current, I, the PD becomes more negative, the outward equatorial current, J, decreases, and the inward current at the optical poles increases. This suggests that there are separate electrical loops for K+ and Na+ that are partially linked by the Na, K-pump. Using Ohm's law, it is possible to calculate the input resistance (R = delta PD/I), the resistance related to the production of J (RJ = delta PD/delta J), and the effect of the combined resistances (delta J/I). The driving force for J can be estimated (PDJ = 0-PD). The relationships among currents, voltages and resistance can be used to determine the characteristics of the membranes that are associated with the outward potassium current observed at the equator. The effects of graded deformation of the lens were determined. The effects were reversible. The sites of inward and outward currents were not altered. Following deformation, the equatorial current, J, increased, and the PD became less negative. The PDJ = 0 remains the same so the ratio of K

  14. Current and Current Fluctuations in Quantum Shuttles

    DEFF Research Database (Denmark)

    Jauho, Antti-Pekka; Flindt, Christian; Novotny, Tomas


    theoretical tools needed for the analysis, e.g., generalized master equations and Wigner functions, and we outline the methods how the resulting large numerical problems can be handled. Illustrative results are given for current, noise, and full counting statistics for a number of model systems. Throughout...

  15. Current major depressive syndrome measured with the Patient Health Questionnaire-9 (PHQ-9) and the Composite International Diagnostic Interview (CIDI): results from a cross-sectional population-based study of adults in Germany. (United States)

    Maske, Ulrike E; Busch, Markus A; Jacobi, Frank; Beesdo-Baum, Katja; Seiffert, Ingeburg; Wittchen, Hans-Ulrich; Riedel-Heller, Steffi; Hapke, Ulfert


    Prevalence estimates for depression vary considerably by the type of assessment instrument, and there is limited information on their overlap in population-based samples. Our aim was to compare the Patient Health Questionnaire-9 (PHQ-9) with the Composite International Diagnostic Interview (CIDI) as measures for current major depressive syndrome (MDS) in a large population-based sample. Data derived from the mental health module of the nationwide cross-sectional German Health Interview and Examination Survey for Adults (DEGS1-MH) (n = 4483; age 18-79 years). MDS in the past two weeks was assessed (a) using the PHQ-9 diagnostic algorithm (PHQ-MDS) and (b) based on CIDI information about the latest symptom occurrence (recency) (CIDI-MDS). Prevalences, overall concordance and percentages of overlap of both MDS measures were determined. Prevalences of affirmed PHQ-9 depression symptoms and the mean and median PHQ-9 sum scores were analyzed per measure. Prevalence of current MDS was 2.7% (95% CI: 2.0-3.6) for PHQ-MDS and 3.9% (95% CI: 3.1-5.0) for CIDI-MDS. The overall agreement between both measures was moderate (kappa: 0.43). Of all the participants, 1.5% (95% CI: 1.0-2.2) were classified as MDS cases by both measures, with 54.5% (95% CI: 42.7-65.9) of PHQ-MDS cases and 37.9% (95% CI: 27.8-49.1) of CIDI-MDS cases also being classified as MDS by the respective other MDS measure. However, 94.8% (95% CI: 93.6-95.8) of the participants were classified as non-MDS by both measures, with 97.5% (95% CI: 96.6-98.1) of non-PHQ-MDS and 98.7% (95% CI: 98.2-99.1) of non-CIDI-MDS being classified as non-MDS by the respective other MDS measure. The mean and median PHQ-9 sum score was higher in those with PHQ-MDS than in those with CIDI-MDS. Both measures have a high level of agreement for ruling out current MDS, but the overlap in their classification of cases is moderate. Our results indicate that they cannot be interpreted as equal measures of the same construct, suggesting

  16. Current titles

    Energy Technology Data Exchange (ETDEWEB)



    This booklet is published for those interested in current research being conducted at the National Center for Electron Microscopy. The NCEM is a DOE-designated national user facility and is available at no charge to qualified researchers. Access is controlled by an external steering committee. Interested researchers may contact Gretchen Hermes at (510) 486-5006 or address below for a User`s Guide. Copies of available papers can be ordered from: Theda Crawford National Center for Electron Microscopy, Lawrence Berkeley Laboratory, One Cyclotron Rd., MS72, Berkeley, California, USA 94720.

  17. Current state of peatland soils as an effect of long-term drainage – preliminary results of peatland ecosystems investigation in the Grójecka Valley (central Poland

    Directory of Open Access Journals (Sweden)

    Glina Bartłomiej


    Full Text Available Understanding the effect of long-term drainage of peatland areas is helpful in future peatland management and regulations of water conditions. The aim of this work was to assess the current state of fen peatland soils in the Grójecka Valley (eastern part of the Wielkopolskie voivodeship, central Poland, affected by long-term agricultural use (pastures, meadows since the 1960s and potentially by lignite open pit mining industry (KWB Konin since 1980s. Field studies were carried out in 2015 in selected fen peatland areas. Soil material for laboratory analysis was collected from genetic horizons from four soil profiles. The surface horizons of studied organic and organo-mineral soils were built with well-developed moorsh material. They were classified as medium moorshiefied – MtII (profile 1, 3 and 4 and strongly moorshiefied – MtIII (profile 2. Obtained results of physical and physico-chemical analysis indicate that long-term peatland utilization connected with potential impact of the lignite mining, transformed mainly the upper horizons of studied organic and organo-mineral soils. However, despite obvious strong human impact on peatlands ecosystems, we cannot exclude the climate variables, what should be confirmed by long-term monitoring program. Furthermore, presented paper indicated that new subtype moorsh-muddy soils (in Polish: gleby murszowo-mułowe within the type of gleyic soils should be implemented in the next version of Polish Soil Classification.

  18. Stressful life events and current psychological distress are associated with self-reported hypertension but not with true hypertension: results from a cross-sectional population-based study

    Directory of Open Access Journals (Sweden)

    Fuchs Flávio D


    Full Text Available Abstract Background The evidence linking stress to hypertension has been scarcely documented in population-based studies. Methods Participants were selected through a multi-stage probability sampling and interviewed at home, being submitted to measures of demographics, anthropometrics, blood pressure (BP, and risk factors for hypertension. Hypertension was defined as BP ≥ 140/90 mm Hg or use of BP-lowering drugs or as self-reported hypertension. Stressful life events were investigated through an inventory of nine major life events occurring in the year preceding the interview. Psychological distress was evaluated through a facial scale of expression of emotion in the last month. Results In the total, 1,484 adult individuals were investigated. Prevalence of hypertension was lower in individuals who reported any stressful life event in comparison with individuals who did not reported an event (34.3 versus 44.2%, P Conclusion Recent stressful life events and current psychological distress are not associated with hypertension. Associations between stress events and distress with self-reported hypertension are not intermediated by effects of stress on blood pressure, and may be ascribed to negative feeling about disease and not to the disease itself.

  19. Transport critical current of MgB2 wires: pulsed current of varying rate compared to direct current method (United States)

    See, K. W.; Xu, X.; Horvat, J.; Cook, C. D.; Dou, S. X.


    The measurement of transport critical current (Ic) for MgB2 wires and tapes has been investigated with two different techniques, the conventional four-probe arrangement with direct current (DC) power source, and a tailored triangle pulse at different rates of current change. The DC method has been widely used and practiced by various groups, but suffers from inevitable heating effects when high currents are used at low magnetic fields. The pulsed current method has no heating effects, but the critical current can depend on the rate of the current change (dI/dt) in the pulse. Our pulsed current measurements with varying dI/dt show that the same values of Ic are obtained as with the DC method, but without the artifacts of heating. Our method is particularly useful at low field regions which are often inaccessible by DC methods. We also performed a finite element method (FEM) analysis to obtain the time dependent heat distribution in MgB2 due to the electric potential produced at the current contacts to the superconducting sample and its gradient around the contacts. This gradient is defined as the current transfer length (CTL) of the samples and leads to Joule heating of the wire near the contacts. The FEM results provide further evidence of the limitation of the DC method in obtaining high transport critical current.

  20. Providing better indoor environmental quality brings economicbenefits

    Energy Technology Data Exchange (ETDEWEB)

    Fisk, William; Seppanen, Olli


    This paper summarizes the current scientific evidence that improved indoor environmental quality can improve work performance and health. The review indicates that work and school work performance is affected by indoor temperature and ventilation rate. Pollutant source removal can sometimes improve work performance. Based on formal statistical analyses of existing research results, quantitative relationships are provided for the linkages of work performance with indoor temperature and outdoor air ventilation rate. The review also indicates that improved health and related financial savings are obtainable from reduced indoor tobacco smoking, prevention and remediation of building dampness, and increased ventilation. Example cost-benefit analyses indicate that many measures to improve indoor temperature control and increase ventilation rates will be highly cost effective, with benefit-cost ratios as high as 80 and annual economic benefits as high as $700 per person.

  1. Development of Model for Providing Feasible Scholarship

    Directory of Open Access Journals (Sweden)

    Harry Dhika


    Full Text Available The current work focuses on the development of a model to determine a feasible scholarship recipient on the basis of the naiv¨e Bayes’ method using very simple and limited attributes. Those attributes are the applicants academic year, represented by their semester, academic performance, represented by their GPa, socioeconomic ability, which represented the economic capability to attend a higher education institution, and their level of social involvement. To establish and evaluate the model performance, empirical data are collected, and the data of 100 students are divided into 80 student data for the model training and the remaining of 20 student data are for the model testing. The results suggest that the model is capable to provide recommendations for the potential scholarship recipient at the level of accuracy of 95%.

  2. Flat norm decomposition of integral currents

    Directory of Open Access Journals (Sweden)

    Sharif Ibrahim


    Full Text Available Currents represent generalized surfaces studied in geometric measure theory. They range from relatively tame integral currents representing oriented compact manifolds with boundary and integer multiplicities, to arbitrary elements of the dual space of differential forms. The flat norm provides a natural distance in the space of currents, and works by decomposing a $d$-dimensional current into $d$- and (the boundary of $(d+1$-dimensional pieces in an optimal way.Given an integral current, can we expect its at norm decomposition to be integral as well? This is not known in general, except in the case of $d$-currents that are boundaries of $(d+1$-currents in $\\mathbb{R}^{d+1}$ (following results from a corresponding problem on the $L^1$ total variation ($L^1$TV of functionals. On the other hand, for a discretized at norm on a finite simplicial complex, the analogous statement holds even when the inputs are not boundaries. This simplicial version relies on the total unimodularity of the boundary matrix of the simplicial complex; a result distinct from the $L^1$TV approach.We develop an analysis framework that extends the result in the simplicial setting to one for $d$-currents in $\\mathbb{R}^{d+1}$, provided a suitable triangulation result holds. In $\\mathbb{R}^2$, we use a triangulation result of Shewchuk (bounding both the size and location of small angles, and apply the framework to show that the discrete result implies the continuous result for $1$-currents in $\\mathbb{R}^2$ .

  3. Current Research. (United States)

    Hunt, Mary Alice


    Describes a doctoral dissertation entitled "World-Future Images in Childrens Literature" which analyzed books on science fiction or utopian fiction by 43 authors of children's literature to determine whether presentations were optimistic or pessimistic. Results indicating generally optimistic stories are discussed, as well as strengths and…

  4. Current efficiency in the chlorate cell process

    Directory of Open Access Journals (Sweden)

    Spasojević Miroslav D.


    Full Text Available A mathematical model has been set up for current efficiency in a chlorate cell acting as an ideal electrochemical tubular reactor with a linear increase in hypochlorite concentration from the entrance to the exit. Good agreement was found between the results on current efficiency experimentally obtained under simulated industrial chlorate production conditions and the theoretical values provided by the mathematical model. [Projekat Ministarstva nauke Republike Srbije, br. 172057 i br. 172062

  5. Electronically Tunable Current-Mode Quadrature Oscillator Using Single MCDTA

    Directory of Open Access Journals (Sweden)

    Y. Li


    Full Text Available This paper presents a modified current differencing transconductance amlpifier (MCDTA and the MCDTA based quadrature oscillator. The oscillator is current-mode and provides current output from high output impedance terminals. The circuit uses only one MCDTA and two grounded capacitors, and is easy to be integrated. Its oscillation frequency can be tuned electronically by tuning bias currents of MCDTA. Finally, frequency error is analyzed. The results of circuit simulations are in agreement with theory.

  6. Application of fault current limiters

    Energy Technology Data Exchange (ETDEWEB)

    Neumann, A.


    This report presents the results of a study commissioned by the Department for Business, Enterprise and Industry (BERR; formerly the Department of Trade and Industry) into the application of fault current limiters in the UK. The study reviewed the current state of fault current limiter (FCL) technology and regulatory position in relation to all types of current limiters. It identified significant research and development work with respect to medium voltage FCLs and a move to high voltage. Appropriate FCL technologies being developed include: solid state breakers; superconducting FCLs (including superconducting transformers); magnetic FCLs; and active network controllers. Commercialisation of these products depends on successful field tests and experience, plus material development in the case of high temperature superconducting FCL technologies. The report describes FCL techniques, the current state of FCL technologies, practical applications and future outlook for FCL technologies, distribution fault level analysis and an outline methodology for assessing the materiality of the fault level problem. A roadmap is presented that provides an 'action agenda' to advance the fault level issues associated with low carbon networks.

  7. Efficient and lightweight current leads (United States)

    Bromberg, L.; Dietz, A. J.; Michael, P. C.; Gold, C.; Cheadle, M.


    Current leads generate substantial cryogenic heat loads in short length High Temperature Superconductor (HTS) distribution systems. Thermal conduction, as well as Joule losses (I2R) along the current leads, comprises the largest cryogenic loads for short distribution systems. Current leads with two temperature stages have been designed, constructed and tested, with the goal of minimizing the electrical power consumption, and to provide thermal margin for the cable. We present the design of a two-stage current lead system, operating at 140 K and 55 K. This design is very attractive when implemented with a turbo-Brayton cycle refrigerator (two-stage), with substantial power and weight reduction. A heat exchanger is used at each temperature station, with conduction-cooled stages in-between. Compact, efficient heat exchangers are challenging, because of the gaseous coolant. Design, optimization and performance of the heat exchangers used for the current leads will be presented. We have made extensive use of CFD models for optimizing hydraulic and thermal performance of the heat exchangers. The methodology and the results of the optimization process will be discussed. The use of demountable connections between the cable and the terminations allows for ease of assembly, but require means of aggressively cooling the region of the joint. We will also discuss the cooling of the joint. We have fabricated a 7 m, 5 kA cable with second generation HTS tapes. The performance of the system will be described.

  8. Detection of magnetising inrush current using real time integration method (United States)

    Ling, P. C. Y.; Basak, A.


    A technique of predicting magnetising inrush currents in transformers is described. Computed results show an inconsistency in second harmonic decay resulting detection failure while using conventional second harmonic techniques. A new detection scheme using real time integration values of the inrush current is proposed to provide reliable relay operation.

  9. Internet Provider Facilities, Published in Not Provided, US Army. (United States)

    NSGIC GIS Inventory (aka Ramona) — This Internet Provider Facilities dataset as of Not Provided. Data by this publisher are often provided in Not Applicable coordinate system; in a Not Applicable...

  10. The evolution of doses in the IEA-R1 reactor environment and tendencies based on the current results; Evolucao das doses no ambiente do Reator IEA-R1 e tendencias com base nos resultados atuais

    Energy Technology Data Exchange (ETDEWEB)

    Toyoda, Eduardo Yoshio


    The IPEN / CNEN-SP have a Nuclear Research Reactor-NRR named IEA-R1, in operation from 1957. It is an open swimming pool reactor using light water as shielding, moderator and as cooling, the volume of this pool is 273m{sup 3}.Until 1995 the reactor operated daily at a power of 2,0 MW. From June of that year, after a few safety modifications the reactor began operating in continuous way from Monday to Wednesday without shutdown totalizing 64 hours per week and the power was increased to 4,5MW also. Because of these changes, continuous operation and increased power, workers' doses would tend to increase. In the past several studies were conducted seeking ways to reduce the workers' doses. A study was made on the possibility to introduce a shielding at the top of the reactor core with a hot water layer. Studies have shown that a major limitation for operating a reactor at high power comes from the gamma radiation emitted by the sodium-24. Other elements such as magnesium-27, aluminum-28, Argon-51, contribute considerably to the water activity of the pool. The introduction of a hot water layer on the swimming pool would form a layer of surface, stable and free of radioactive elements with a 1.5m to 2m thickness creates a shielding to radiation from radioactive elements dissolved in water. Optimization studies proved that the installation of the hot layer was not necessary for the regime and the current power reactor operation, because other procedures adopted were more effective. From this decision the Radiological Protection Reactor Team, set up a dose assessment program to ensure them remained in low values based on principles established in national and international standards. The purpose of this paper is to analyze the individual doses of OEI (Occupationally Exposed Individual), which will be checked increasing doses resulting from recent changes in reactor operation regime and suggested viable safety and protection options, in the first instance to

  11. 超高频雷达海洋表面流的探测结果与分析%Results and analysis of surface current based on UHF radar

    Institute of Scientific and Technical Information of China (English)

    文必洋; 李艳; 侯义东; 杨静


    近岸海域地形、海流复杂,而超高频雷达系统具有较高距离分辨率、小发射功率的特点,波长介于高频电磁波和微波之间,能同时提取海浪毛细波与重力波信息,与波浪作用比较敏感,能实现近海海洋动力参数的精细测量.不同于高频雷达回波谱,超高频雷达回波中一阶峰、二阶峰展宽严重并混叠在一起,难以划分一阶峰区域,因此,文中系统设计采用数字波束形成进行流速方位提取.雷达反演的流速结果与浮标数据的相关系数为0.88,但是均方根误差很大.通过分析,得出海洋表面流速不仅受到潮汐效应、地球自转的影响,当地风速在很大程度上也会影响表面流速的结论.%Ultra high frequency(UHF)radar has the characteristics of high range resolution and low-power,which can extract information of both capillary wave and gravity wave with the wavelength be-tween high frequency and microwave.It is possible to obtain precise monitoring of the coastal ocean dy-namics parameters by UHF radar,though the offshore topography and ocean surface current are complex. UHF radar is different from HF radar,since the first-order peak and second-order spectrum are indistin-guishable in the sea echo spectrum.It is difficult to extract first-order peak,therefore,multiple signal classification algorithm (MUSIC)is unavailable and digital beam-forming(DBF)is used in extracting the radial velocity.After a month,the radar and buoy datais highly correlated with a coefficient of 0.88,how-ever,the root mean square error is large.The results show that the velocity of the ocean surface is influ-enced not only by the tidal effect and the rotationof the earth,but also by the local wind speed.

  12. Threatened corals provide underexplored microbial habitats.

    Directory of Open Access Journals (Sweden)

    Shinichi Sunagawa

    Full Text Available Contemporary in-depth sequencing of environmental samples has provided novel insights into microbial community structures, revealing that their diversity had been previously underestimated. Communities in marine environments are commonly composed of a few dominant taxa and a high number of taxonomically diverse, low-abundance organisms. However, studying the roles and genomic information of these "rare" organisms remains challenging, because little is known about their ecological niches and the environmental conditions to which they respond. Given the current threat to coral reef ecosystems, we investigated the potential of corals to provide highly specialized habitats for bacterial taxa including those that are rarely detected or absent in surrounding reef waters. The analysis of more than 350,000 small subunit ribosomal RNA (16S rRNA sequence tags and almost 2,000 nearly full-length 16S rRNA gene sequences revealed that rare seawater biosphere members are highly abundant or even dominant in diverse Caribbean corals. Closely related corals (in the same genus/family harbored similar bacterial communities. At higher taxonomic levels, however, the similarities of these communities did not correlate with the phylogenetic relationships among corals, opening novel questions about the evolutionary stability of coral-microbial associations. Large proportions of OTUs (28.7-49.1% were unique to the coral species of origin. Analysis of the most dominant ribotypes suggests that many uncovered bacterial taxa exist in coral habitats and await future exploration. Our results indicate that coral species, and by extension other animal hosts, act as specialized habitats of otherwise rare microbes in marine ecosystems. Here, deep sequencing provided insights into coral microbiota at an unparalleled resolution and revealed that corals harbor many bacterial taxa previously not known. Given that two of the coral species investigated are listed as threatened under

  13. A quasilinear formulation of turbulence driven current

    Energy Technology Data Exchange (ETDEWEB)

    McDevitt, C. J.; Tang, Xian-Zhu; Guo, Zehua [Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico 87545 (United States)


    Non-inductive current drive mechanisms, such as the familiar neoclassical bootstrap current correspond to an essential component to the realization of steady state tokamak operation. In this work, we discuss a novel collisionless mechanism through which a mean plasma current may be driven in the presence of microturbulence. In analogy with the traditional neoclassical bootstrap current drive mechanism, in which the collisional equilibrium established between trapped and passing electrons results in the formation of a steady state plasma current, here we show that resonant scattering of electrons by drift wave microturbulence provides an additional means of determining the equilibrium between trapped and passing electrons. The resulting collisionless equilibrium is shown to result in the formation of an equilibrium current whose magnitude is a function of the thermodynamic forces. A mean field formulation is utilized to incorporate the above components into a unified framework through which both collisional as well as collisionless current drive mechanisms may be self-consistently treated. Utilizing a linearized Fokker-Planck collision operator, the plasma current in the presence of both collisions as well as turbulent stresses is computed, allowing for the relative strength of these two mechanisms to be quantified as a function of collisionality and fluctuation amplitude.

  14. 中国ST段抬高急性冠状动脉综合征诊疗现况调查%Current clinical practice patterns and outcome for acute coronary syndromes in China: results of BRIG project

    Institute of Scientific and Technical Information of China (English)

    刘群; 赵冬; 刘军; 王薇; 刘静; 代表中国冠心病二级预防架桥工程研究协作组


    Objective To analyze current clinical management patterns and outcome of inpatients with ST segment elevation acute coronary syndromes (ACS) in China. Methods Totally 1304 in-patients with ST segment elevation ACS from 64 hospitals across China were recruited and a standard questionnaire was used to get information of the patients including demographic, treatments and in-hospital outcomes. Results (1) There were no significant differences in baseline characteristics between the patients from tertiary hospitals and that from the secondary hospitals. (2) Reperfusion therapy was applied more often in tertiary hospitals (57.9%) than in secondary hospitals (42.3%). Thrombolysis was more often used in secondary hospitals than that in tertiary hospitals (37.4% vs. 14.5%). The median time from pain onset to hospital was 240 min, the median time from admission to reperfusion was 60 min for thromhalysis and 110 min for PCI. (3) Statias and glycoprotein Ⅱb/Ⅲa antagonists were given more frequently in tertiary hospitals. (4) Major in-hospital events and death rates were significantly higher in secondary hospitals than in tertiary hospitals. Multivariate logistic regression analysis showed that age ≥ 75 years, hypertension, diabetes, reperfusion, aspirin, β-blocker and ACE/ARB inhibitor use were associated independently with in-hospital mortality. Conclusions There is a big gap between guidelines and current management of ST segment elevation ACS in China, especially in secondary hospitals.%目的 了解目前我国ST段抬高急性冠状动脉综合征(ACS)临床治疗及二级预防措施的实施状况.方法 在中国31个省市自治区选择33家三级医院和32家二级医院,每家医院选择住院患者50例,共计3323例,其中1304例(39.2%)为ST段抬高的ACS.采用问卷回顾形式收集住院患者临床治疗及二级预防信息.结果 (1)三级医院在人员及设备方面均优于二级医院,仅33.3%的二级医院拥有心脏导管检查设备;

  15. Induction motor starting current

    Energy Technology Data Exchange (ETDEWEB)

    Arneaud, J.M.; Langman, R.A. [Tasmania Univ., Hobart, TAS (Australia)


    Large errors may occur if leakage path saturation is neglected when reduced-voltage test results are used to predict the direct-on-line starting current of induction motors. The results of applying three existing and two new methods for starting current prediction are compared with test data from 52 motors. A quantitative assessment is made of the probable reduction in error that would be achieved by increasing the number of available sets of reduced-voltage, locked rotor test results or by including slot design data. Guidelines are given for selecting an appropriate predictive method. (author). 4 tabs., 1 fig., 6 refs.

  16. Progress report on new results of the study of multi-planar and compact cylindrical wire arrays at 0.8-1.3 MA current at UNR Zebra generator (United States)

    Kantsyrev, V. L.; Safronova, A. S.; Esaulov, A. A.; Presura, R.; Williamson, K. M.; Shrestha, I.; Ouart, N. D.; Yilmaz, M. F.; Wilcox, P. G.; Osborne, G. C.; Weller, M. E.; Shlyaptseva, V.; Rudakov, L. I.


    The studies that include the measurements of radiation yields, time-gated spectra and images, streak camera and laser probing images, spectral modeling, and magnetostatic and MHD simulations focus on Z-pinch plasma implosion and radiation features (including bright spots properties). The experiments with small size (3-10 mm) single-, double-, triple-, cross- planar, and compact cylindrical wire arrays from various materials at nominal as well as enhanced currents up to 1.3 MA were performed on the Zebra generator. The largest x-ray yields and powers were ranged for W and Mo. Observed multi-step precursor formation in multi-planar arrays may open new paths for radiation pulses shaping. Implosion and spectroscopic features specific for enhanced currents are discussed.

  17. Current status of rotavirus vaccines

    Institute of Scientific and Technical Information of China (English)

    Ching-Min Wang; Shou-Chien Chen; Kow-Tong Chen


    Background: Rotaviruses remain the major cause of childhood diarrheal disease worldwide and of diarrheal deaths of infants and children in developing countries. The huge burden of childhood rotavirus-related diarrhea in the world continues to drive the remarkable pace of vaccine development. Data sources: Research articles were searched using terms "rotavirus" and "rotavirus vaccine" in MEDLINE and PubMed. Articles not published in the English language, articles without abstracts, and opinion articles were excluded from the review. After preliminary screening, all articles were reviewed and synthesized to provide an overview of current vaccines and vaccination programs. Results: In this review of the global rotavirus vaccines and vaccination programs, the principles of rotavirus vaccine development and the efficacy of the currently licensed vaccines from both developed and developing countries were summarized. Conclusions: Rotavirus is a common cause of diarrhea in children in both developed and developing countries. Rotavirus vaccination is a cost-effective measure to prevent rotavirus diarrhea.

  18. The Bransfield Gravity Current (United States)

    Sangrà, Pablo; Stegner, Alexander; Hernández-Arencibia, Mónica; Marrero-Díaz, Ángeles; Salinas, Carolina; Aguiar-González, Borja; Henríquez-Pastene, Cristian; Mouriño-Carballido, Beatriz


    Using in situ data and laboratory experiments, we show that the circulation of the Bransfield Current (BC) around the South Shetland Islands (SSI) may be characterized in terms of a propagating buoyant gravity current. First, we describe the SSI hydrography and some drifter trajectories, paying special attention to the recirculation of the BC at the northeastern tip and northern slopes of the SSI. We observed that when the northeastward-flowing BC reaches the northeastern tip of the SSI, it recirculates around an anticyclonic mesoscale eddy that has not previously been reported in this region. Part of this recirculating water then proceeds southwest along the northern SSI shelf break as a narrow baroclinic jet and another part join the Antarctic Circumpolar Current. Consequently, the cross-slope gradients of properties strengthen, and the southern boundary of the Antarctic Circumpolar Current becomes a nearly submesoscale ( 10 km) front. Second, we compare the observations with buoyant gravity current laboratory experiments in an open basin setup where the SSI topographic barrier is represented by a central wall. The resulting circulation of the buoyant gravity current around the wall mirrors our in situ observations. First, a narrow buoyant gravity current flows northeastward along the southern boundary of the wall. Once the head of the buoyant gravity current reaches the tip of the wall, a recirculating anticyclonic vortex is generated, and the buoyant gravity current then proceeds westward along the north side of the wall. This circulation of the BC around the SSI as a buoyant gravity current may contribute to the fertilization of the waters around the SSI, as suggested by previously reported distributions of nutrients and phytoplankton.

  19. Shorelines, Current, Rhode Island, Connecticut, New York, and New Jersey ESI: Environmental Sensitivity Index Shoreline Types-Polygons and Lines; This data set contains vector lines and polygons representing the shoreline and coastal habitats classified to ESI system, Published in 2001, 1:24000 (1in=2000ft) scale, State of Rhode Island and Providence Plantations. (United States)

    NSGIC GIS Inventory (aka Ramona) — This Shorelines, Current dataset, published at 1:24000 (1in=2000ft) scale, was produced all or in part from Hardcopy Maps information as of 2001. It is described as...

  20. Do Dogs Provide Information Helpfully? (United States)

    Piotti, Patrizia; Kaminski, Juliane


    Dogs are particularly skilful during communicative interactions with humans. Dogs’ abilities to use human communicative cues in cooperative contexts outcompete those of other species, and might be the result of selection pressures during domestication. Dogs also produce signals to direct the attention of humans towards outside entities, a behaviour often referred to as showing behaviour. This showing behaviour in dogs is thought to be something dogs use intentionally and referentially. However, there is currently no evidence that dogs communicate helpfully, i.e. to inform an ignorant human about a target that is of interest to the human but not to the dog. Communicating with a helpful motive is particularly interesting because it might suggest that dogs understand the human’s goals and need for information. In study 1, we assessed whether dogs would abandon an object that they find interesting in favour of an object useful for their human partner, a random novel distractor, or an empty container. Results showed that it was mainly self-interest that was driving the dogs’ behaviour. The dogs mainly directed their behaviour towards the object they had an interest in, but dogs were more persistent when showing the object relevant to the human, suggesting that to some extent they took the humans interest into account. Another possibility is that dogs’ behaviour was driven by an egocentric motivation to interact with novel targets and that the dogs’ neophila might have masked their helpful tendencies. Therefore, in study 2 the dogs had initial access to both objects, and were expected to indicate only one (relevant or distractor). The human partner interacted with the dog using vocal communication in half of the trials, and remaining silent in the other half. Dogs from both experimental groups, i.e. indicating the relevant object or indicating the distractor, established joint attention with the human. However, the human’s vocal communication and the presence

  1. Current concepts in osteolysis. (United States)

    Ollivere, B; Wimhurst, J A; Clark, I M; Donell, S T


    The most frequent cause of failure after total hip replacement in all reported arthroplasty registries is peri-prosthetic osteolysis. Osteolysis is an active biological process initiated in response to wear debris. The eventual response to this process is the activation of macrophages and loss of bone. Activation of macrophages initiates a complex biological cascade resulting in the final common pathway of an increase in osteolytic activity. The biological initiators, mechanisms for and regulation of this process are beginning to be understood. This article explores current concepts in the causes of, and underlying biological mechanism resulting in peri-prosthetic osteolysis, reviewing the current basic science and clinical literature surrounding the topic.

  2. Reply to "Comment on 'A Self-Consistent Model of the Interacting Ring Current Ions and Electromagnetic Ion Cyclotron Waves, Initial Results: Waves and Precipitation Fluxes' and 'Self-Consistent Model of the Magnetospheric Ring Current and Propagating Electromagnetic Ion Cyclotron Waves: Waves in Multi-Ion Magnetosphere' by Khazanov et al. et al." (United States)

    Khazanov, G. V.; Gamayunov, K. V.; Gallagher, D. L.; Kozyra, J. W.


    It is well-known that the effects of electromagnetic ion cyclotron (EMIC) waves on ring current (RC) ion and radiation belt (RB) electron dynamics strongly depend on such particle/wave characteristics as the phase-space distribution function, frequency, wavenormal angle, wave energy, and the form of wave spectral energy density. The consequence is that accurate modeling of EMIC waves and RC particles requires robust inclusion of the interdependent dynamics of wave growth/damping, wave propagation, and[ particles. Such a self-consistent model is being progressively developed by Khazanov et al. [2002, 2006, 2007]. This model is based on a system of coupled kinetic equations for the RC and EMIC wave power spectral density along with the ray tracing equations. Thome and Home [2007] (hereafter referred to as TH2007) call the Khazanov et al. [2002, 2006] results into question in their Comment. The points in contention can be summarized as follows. TH2007 claim that: (1) "the important damping of waves by thermal heavy ions is completely ignored", and Landau damping during resonant interaction with thermal electrons is not included in our model; (2) EMIC wave damping due to RC O + is not included in our simulation; (3) non-linear processes limiting EMIC wave amplitude are not included in our model; (4) growth of the background fluctuations to a physically significantamplitude"must occur during a single transit of the unstable region" with subsequent damping below bi-ion latitudes,and consequently"the bounce averaged wave kinetic equation employed in the code contains a physically erroneous 'assumption". Our reply will address each of these points as well as other criticisms mentioned in the Comment. TH2007 are focused on two of our papers that are separated by four years. Significant progress in the self-consistent treatment of the RC-EMIC wave system has been achieved during those years. The paper by Khazanov et al. [2006] presents the latest version of our model, and in


    Directory of Open Access Journals (Sweden)



    Full Text Available Accounting for current assets mainly aims to obtain useful information on the management of their best in order to make management decisions. Counting efficiency of these assets, their importance, provides improved performance of the entity. In this paper we want to study the degree of implementation of policies and accounting treatments on the current assets in the specific construction economic entities, the problems of implementation and thus better addressing their theoretical and procedural to improve the information provided by financial statements. Due to the importance of proper conduct of business owned entities, accounting current assets should result in optimal and efficient control of current assets.


    Directory of Open Access Journals (Sweden)



    Full Text Available Accounting for current assets mainly aims to obtain useful information on the management of their best in order to make management decisions. Counting efficiency of these assets, their importance, provides improved performance of the entity. In this paper we want to study the degree of implementation of policies and accounting treatments on the current assets in the specific construction economic entities, the problems of implementation and thus better addressing their theoretical and procedural to improve the information provided by financial statements. Due to the importance of proper conduct of business owned entities, accounting current assets should result in optimal and efficient control of current assets.

  5. Current limiting remote power control module (United States)

    Hopkins, Douglas C.


    The power source for the Space Station Freedom will be fully utilized nearly all of the time. As such, any loads on the system will need to operate within expected limits. Should any load draw an inordinate amount of power, the bus voltage for the system may sag and disrupt the operation of other loads. To protect the bus and loads some type of power interface between the bus and each load must be provided. This interface is most crucial when load faults occur. A possible system configuration is presented. The proposed interface is the Current Limiting Remote Power Controller (CL-RPC). Such an interface should provide the following power functions: limit overloading and resulting undervoltage; prevent catastrophic failure and still provide for redundancy management within the load; minimize cable heating; and provide accurate current measurement. A functional block diagram of the power processing stage of a CL-RPC is included. There are four functions that drive the circuit design: rate control of current; current sensing; the variable conductance switch (VCS) technology; and the algorithm used for current limiting. Each function is discussed separately.

  6. The perspective of rural physicians providing abortion in Canada: qualitative findings of the BC Abortion Providers Survey (BCAPS.

    Directory of Open Access Journals (Sweden)

    Jennifer Dressler

    Full Text Available BACKGROUND: An increasing proportion of Canadian induced abortions are performed in large urban areas. For unknown reasons the number of rural abortion providers in Canadian provinces, such as British Columbia (BC, has declined substantially. This study explored the experiences of BC rural and urban physicians providing abortion services. METHODS: The mixed methods BC Abortion Providers Survey employed self-administered questionnaires, distributed to all known current and some past BC abortion providers in 2011. The optional semi-structured interviews are the focus of this analysis. Interview questions probed the experiences, facilitators and challenges faced by abortion providers, and their future intentions. Interviews were transcribed and analyzed using cross-case and thematic analysis. RESULTS: Twenty interviews were completed and transcribed, representing 13/27 (48.1% rural abortion providers, and 7/19 (36.8% of urban providers in BC. Emerging themes differed between urban and rural providers. Most urban providers worked within clinics and reported a supportive environment. Rural physicians, all providing surgical abortions within hospitals, reported challenging barriers to provision including operating room scheduling, anesthetist and nursing logistical issues, high demand for services, professional isolation, and scarcity of replacement abortion providers. Many rural providers identified a need to "fly under the radar" in their small community. DISCUSSION: This first study of experiences among rural and urban abortion providers in Canada identifies addressable challenges faced by rural physicians. Rural providers expressed a need for increased support from hospital administration and policy. Further challenges identified include a desire for continuing professional education opportunities, and for available replacement providers.


    Directory of Open Access Journals (Sweden)

    L. Xiang


    Full Text Available Supporting large amounts of spatial data is a significant characteristic of modern databases. However, unlike some mature relational databases, such as Oracle and PostgreSQL, most of current burgeoning NoSQL databases are not well designed for storing geospatial data, which is becoming increasingly important in various fields. In this paper, we propose a novel method to provide R-tree index, as well as corresponding spatial range query and nearest neighbour query functions, for MongoDB, one of the most prevalent NoSQL databases. First, after in-depth analysis of MongoDB’s features, we devise an efficient tabular document structure which flattens R-tree index into MongoDB collections. Further, relevant mechanisms of R-tree operations are issued, and then we discuss in detail how to integrate R-tree into MongoDB. Finally, we present the experimental results which show that our proposed method out-performs the built-in spatial index of MongoDB. Our research will greatly facilitate big data management issues with MongoDB in a variety of geospatial information applications.

  8. Providing R-Tree Support for Mongodb (United States)

    Xiang, Longgang; Shao, Xiaotian; Wang, Dehao


    Supporting large amounts of spatial data is a significant characteristic of modern databases. However, unlike some mature relational databases, such as Oracle and PostgreSQL, most of current burgeoning NoSQL databases are not well designed for storing geospatial data, which is becoming increasingly important in various fields. In this paper, we propose a novel method to provide R-tree index, as well as corresponding spatial range query and nearest neighbour query functions, for MongoDB, one of the most prevalent NoSQL databases. First, after in-depth analysis of MongoDB's features, we devise an efficient tabular document structure which flattens R-tree index into MongoDB collections. Further, relevant mechanisms of R-tree operations are issued, and then we discuss in detail how to integrate R-tree into MongoDB. Finally, we present the experimental results which show that our proposed method out-performs the built-in spatial index of MongoDB. Our research will greatly facilitate big data management issues with MongoDB in a variety of geospatial information applications.

  9. BOOK REVIEW: The Current Comparator (United States)

    Petersons, Oskars


    . One would hardly find a standards laboratory today without an instrument employing a current comparator. The NRC program, now nearing the end of its third decade, has resulted in a large number of papers in technical journals. The fact that the results of the current-comparator program are now documented in a well-written book is a most welcome development. The material in the book is well organized and divided into seven chapters. Chapter 1 deals very briefly with the historical aspects of the development, including related work in other organizations. Chapter 2 is the longest, occupying one third of the book. It presents the background theory; the definitions and origins of the errors; and the related concepts and devices including two-stage current transformers, electronic methods for improving the performance of current transformers, and null detectors. The idea of the current comparator is developed starting from Ampere's law; and then progressing to the practical realization of measuring the line integral of the magnetic field surrounding an electric current. Such an approach, as opposed to the more common methods of analyzing transformers, has a tutorial value in explaining how the current balance is achieved. Such analysis is intuitive for air-core sensing coils with infinitesimal cross-sections and uniform winding densities. The intuitive understanding, however, becomes less obvious when high-permeability magnetic cores are used. The subject of errors is discussed thoroughly. For errors of magnetic origin, ample experimental data are provided to support the hypothesis for the cause of such errors. The cause is discussed in a macroscopic sense (non-uniform effective permeability along the torus) without going into design and processing details which could be responsible for the non-uniformities. For capacitive errors, equations have been developed to compute them from geometrical considerations. Techniques are presented to reduce both types of errors shielding

  10. Electromagnetic currents induced by color fields

    CERN Document Server

    Tanji, Naoto


    The quark production in classical color fields is investigated with a focus on the induction of an electromagnetic current by produced quarks. We show that the SU(2) and the SU(3) theories lead significantly different results for the electromagnetic current. In uniform SU(2) color fields, the net electromagnetic current is not generated, while for SU(3) the net current is induced depending on the color direction of background fields. Also the numerical study of the quark production in inhomogeneous color fields is done. Motivated by gauge field configurations provided by the color glass condensate framework, we introduce an ensemble of randomly distributed color electric fluxtubes. The spectrum of photons emitted from the quarks by a classical process is shown.

  11. [Survey of analytical works for drugs at emergency and critical care centers with high-performance instruments provided by the Ministry of Health and Welfare (at present: Ministry of Health, Labour, and Welfare) in fiscal 1998--continuation of survey with 2008 survey results as point of reference]. (United States)

    Saito, Takeshi; Tominaga, Aya; Nozawa, Mayu; Unei, Hiroko; Hatano, Yayoi; Fujita, Yuji; Iseki, Ken; Hori, Yasushi


    In a 2008 survey of the 73 emergency and critical care centers around the nation that were equipped with the drug and chemical analytical instrument provided by the Ministry of Welfare (currently the Ministry of Health, Labour, and Welfare) in 1998, 36 of those facilities were using the analytical instruments. Of these 36 facilities, a follow-up survey of the 17 facilities that recorded 50 or analyses per year. Responses were gained from 16 of the facilities and we learned that of those, 14 facilities (87.5%) were conducting analyses using the instrument. There was a positive mutual correlation between the annual number of cases of the 14 facilities conducting analyses with the instrument and the number of work hours. Depending on the instrument in use, average analytical instrument parts and maintenance expenses were roughly three million yen and consumables required a maximum three million yen for analysis of 51-200 cases per year. From this, we calculate that such expenses can be covered under the allowed budget for advanced emergency and critical care centers of 5,000 NHI points (1 point = 10 yen). We found there were few facilities using the instrument for all 15 of the toxic substances recommended for testing by the Japanese Society for Clinical Toxicology. There tended to be no use of the analytical instrument for compounds with no toxicology cases. However, flexible responses were noted at each facility in relation to frequently analyzed compounds. It is thought that a reevaluation of compounds subject to analysis is required.

  12. Babesiosis for Health Care Providers

    Centers for Disease Control (CDC) Podcasts


    This podcast will educate health care providers on diagnosing babesiosis and providing patients at risk with tick bite prevention messages.  Created: 4/25/2012 by Center for Global Health, Division of Parasitic Diseases and Malaria.   Date Released: 4/25/2012.

  13. HMO partnering: the provider dilemma. (United States)

    Ayers, J; Benson, L; Bonhag, R


    While the growth of HMOs has slowed patient visits to doctors, it also has created a deluge of press clippings. On July 16, 1996, three articles on the subject appeared in the Wall Street Journal, front section. The headlines painted a vivid picture of the forces acting on HMOs and providers alike (Figure 1). The articles portended more change for healthcare. The "shake-out," a term applied to industries in serious transformation, brings shedding of excess capacity and loss of jobs and income. Providers, in particular, find themselves in a difficult dilemma. They must not only cut costs as reimbursement drops, but also retain patients with good outcomes and high quality service. Patient retention means keeping the individual patient from switching to another provider and keeping the insurer's group of patients as an authorized provider for that insurer. The relationship between provider and HMO lies at the heart of the provider dilemma. The HMO structure, which shifts financial risk for care, is quickly setting the standard, for healthcare pricing, medical standards, and management practices. Understanding and responding to HMO needs are vital to competitive advantage and survival. The article discusses the inherent dilemma of HMO and provider partnering and suggests provider responses.

  14. Current distribution among layers of single phase HTS cable conductor (United States)

    Zheng, Y. B.; Wang, Y. S.; Pi, W.; Ju, P.; Wang, Y. S.


    High temperature superconducting (HTS) power cable shows high application prospect in modern power transmission, as it is superior over conventional transmission lines in high engineering current density and environmental friendliness. Its configuration is generally composed of several HTS layers designed with the principle of uniform current distribution, but there are few experimental results to verify the distribution. In this paper, a HTS cable model was designed based on the principle of uniform current, and the current distributions among layers in an HTS cable model were measured by Rogowski coils. The results provide an important basis for design of multi-layer HTS cable.

  15. Current status of natural fibres

    CSIR Research Space (South Africa)

    Anandjiwala, RD


    Full Text Available , automotive, aerospace, marine, electronic, leisure and household uses. This paper will provide an overview of the current status of research and development. It will also deal with future drivers for the growth and competitiveness of natural fibres...

  16. Logistics Service Providers in the Czech Republic


    HRNEČKOVÁ, Kateřina


    The main purpose of the thesis is to analyze the developement of providing logistics services in the Czech Republic and analyze the current situation and expected trends in the near future. The thesis presents the implementation process of logistics outsourcing and follows up the influence of the outsourcing at the level of logistics costs. Manufacturing companies see in logistics the potential tool to improve the efficiency in their operations and they include the logistics in their strategi...

  17. Current management of presbyopia

    Directory of Open Access Journals (Sweden)

    Pandelis A Papadopoulos


    Full Text Available Presbyopia is a physiologic inevitability that causes gradual loss of accommodation during the fifth decade of life. The correction of presbyopia and the restoration of accommodation are considered the final frontier of refractive surgery. Different approaches on the cornea, the crystalline lens and the sclera are being pursued to achieve surgical correction of this disability. There are however, a number of limitations and considerations that have prevented widespread acceptance of surgical correction for presbyopia. The quality of vision, optical and visual distortions, regression of effect, complications such as corneal ectasia and haze, anisometropia after monovision correction, impaired distance vision and the invasive nature of the currently techniques have limited the utilization of presbyopia surgery. The purpose of this paper is to provide an update of current procedures available for presbyopia correction and their limitations.

  18. Hospitals, providers collaborate on transitions. (United States)


    Baystate Health, a three-hospital system with headquarters in Springfield, MA, is partnering with post-acute providers to improve transitions as patients move through the continuum of care. A multidisciplinary post-acute performance team partnered with post-acute providers to determine why patients are readmitted to the hospital and to work on ways to avoid readmissions. Facilities share information with the hospitals how they operate and what they need to ensure patients receive the care they need. The health system's director of post-acute services holds regular meetings with providers to brainstorm on improving patient care.


    Directory of Open Access Journals (Sweden)

    Veysel Karagol


    Full Text Available In last years with the impact of rapid globalization and financiallisation current account deficit became a major problem for Turkish economy. Hence, many studies have been conducted foreseeing for policy recommendations and precautions against the current deficit. In this study, by considering determinants of current account deficit and implemented policies, it is intended to provide policy recommendations for closing the deficit. As part of this goal, the determinants of current account deficit and impacts of the determinantsa re discussed. Also, by mentioning monetary and fiscal policies during the period 2003-2015 overall assessment of the policies and a set of policiy recommendations for the next periods were presented. The most important result achieved by the study is applying discussed structural reforms in able to have quick progress in dealing with the current account deficit would have a great effect.

  20. Narratives of Ghanaian abortion providers

    African Journals Online (AJOL)

    AJRH Managing Editor

    Keywords: Abortion, providers, law, access, reproductive health care ... administrative materials) into the decision-making process between a ... training, research, and outreach efforts of these ..... additional economic factors influence abortion.


    Federal Emergency Management Agency, Department of Homeland Security — The Providence AOI consists of the costal portion of the county, and meshes up seamlessly with the Kent county AOI directly south. Ground Control is collected...

  2. Medicare Referring Provider DMEPOS PUF (United States)

    U.S. Department of Health & Human Services — This dataset, which is part of CMSs Medicare Provider Utilization and Payment Data, details information on Durable Medical Equipment, Prosthetics, Orthotics and...

  3. Applications and limitations of thermobarometry in migmatites and granulites using as an example rocks of the Araçuaí Orogen in southern Bahia, including a discussion on the tectonic meaning of the current results

    Directory of Open Access Journals (Sweden)

    Renato Moraes

    Full Text Available In southern Bahia, there are outcrops of migmatites and granulites in the Jequitinhonha Complex, which is part of the northern portion of the Araçuaí Orogen. Migmatites (garnet-cordierite diatexite dominate the metamorphic rocks and host lenses and layers of felsic garnet granulite. The conditions of temperature and pressure of metamorphism were calculated using conventional thermobarometry and the software THERMOCALC. Values around 850 °C and 7 kbar were obtained with THERMOCALC. The calculations for the garnet-cordierite diatexite were made considering aH2O equal to 1, but the best results of calculations for the granulites are obtained with aH2O values of 0.3. Pressure values obtained with GAPES resulted in consistent values with THERMOCALC, but the pair garnet-orthopyroxene always produces low values for temperature and high ones for pressure. The results are consistent with the presence of the pair garnet and cordierite in diatexite and orthopyroxene in felsic granulite. From the tectonic point of view, the setting in which metamorphism of these rocks occurred requires high heat flow with a thermal anomaly in mid continental crust, as indicated by values of 7 kbar. Recent studies have favored the closure of a back-arc basin for this tectonic setting, but it does not solve the problem that the time span between metamorphic peak and the end of granite intrusions, involving large bodies of charnockite, is more than 80 million years. The model of tectonic switching is suggested here as it can explain the maintenance of high temperatures for a more extended interval of time.

  4. Current practice in the management of acute/unstable slipped capital femoral epiphyses in the United Kingdom and the Netherlands: results of a survey of the membership of the British Society of Children's Orthopaedic Surgery and the Werkgroep Kinder Orthopaedie. (United States)

    Witbreuk, Melinda; Besselaar, Philip; Eastwood, Deborah


    A questionnaire was sent to all members of the British Society for Children's Orthopaedic Surgery and the Werkgroep Kinder Orthopaedie to identify points of agreement/disagreement on the management of the acute unstable slip of the upper femoral epiphysis and to compare these European results with those from a similar North American survey. Sixty-five per cent responded. Overall, both countries evaluated cases similarly and believed in their urgent management. Sixty-six per cent did not reposition the slip. Significant differences were observed in attitude towards single screw usage, prophylactic pinning and metalwork removal both between the two countries and in comparison with North America.

  5. Lodging Update: Providence, Rhode Island

    Directory of Open Access Journals (Sweden)

    Ragel Roginsky


    Full Text Available Each quarter, Pinnacle Advisory Group prepares an analysis of the New England lodging industry, which provides a regional summary and then focuses in depth on a particular market. These reviews look at recent and proposed supply changes, factors affecting demand and growth rates, and the effects of interactions between such supply and demand trends. In this issue, the authors spotlight the lodging market in Providence, Rhode Island.

  6. Current Trends in and Indications for Endoscopy-Assisted Breast Surgery for Breast Cancer: Results from a Six-Year Study Conducted by the Taiwan Endoscopic Breast Surgery Cooperative Group.

    Directory of Open Access Journals (Sweden)

    Hung-Wen Lai

    Full Text Available Endoscopy-assisted breast surgery (EABS performed through minimal axillary and/or periareolar incisions is a possible alternative to open surgery for certain patients with breast cancer. In this study, we report the early results of an EABS program in Taiwan.The medical records of patients who underwent EABS for breast cancer during the period May 2009 to December 2014 were collected from the Taiwan Endoscopic Breast Surgery Cooperative Group database. Data on clinicopathologic characteristics, type of surgery, method of breast reconstruction, complications and recurrence were analyzed to determine the effectiveness and oncologic safety of EABS in Taiwan.A total of 315 EABS procedures were performed in 292 patients with breast cancer, including 23 (7.8% patients with bilateral disease. The number of breast cancer patients who underwent EABS increased initially from 2009 to 2012 and then stabilized during the period 2012-2014. The most commonly performed EABS was endoscopy-assisted total mastectomy (EATM (85.4% followed by endoscopy-assisted partial mastectomy (EAPM (14.6%. Approximately 74% of the EATM procedures involved breast reconstruction, with the most common types of reconstruction being implant insertion and autologous pedicled TRAM flap surgery. During the six-year study period, there was an increasing trend in the performance of EABS for the management of breast cancer when total mastectomy was indicated. The positive surgical margin rate was 1.9%. Overall, the rate of complications associated with EABS was 15.2% and all were minor and wound-related. During a median follow-up of 26.8 (3.3-68.6 months, there were 3 (1% cases of local recurrence, 1 (0.3% case of distant metastasis and 1 (0.3% death.The preliminary results from the EABS program in Taiwan show that EABS is a safe procedure and results in acceptable cosmetic outcome. These findings could help to promote this under-used surgical technique in the field of breast cancer.

  7. Ancillary Services Provided from DER

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, J.B.


    Distributed energy resources (DER) are quickly making their way to industry primarily as backup generation. They are effective at starting and then producing full-load power within a few seconds. The distribution system is aging and transmission system development has not kept up with the growth in load and generation. The nation's transmission system is stressed with heavy power flows over long distances, and many areas are experiencing problems in providing the power quality needed to satisfy customers. Thus, a new market for DER is beginning to emerge. DER can alleviate the burden on the distribution system by providing ancillary services while providing a cost adjustment for the DER owner. This report describes 10 types of ancillary services that distributed generation (DG) can provide to the distribution system. Of these 10 services the feasibility, control strategy, effectiveness, and cost benefits are all analyzed as in the context of a future utility-power market. In this market, services will be provided at a local level that will benefit the customer, the distribution utility, and the transmission company.

  8. Ecosystem services provided by waterbirds. (United States)

    Green, Andy J; Elmberg, Johan


    Ecosystem services are ecosystem processes that directly or indirectly benefit human well-being. There has been much recent literature identifying different services and the communities and species that provide them. This is a vital first step towards management and maintenance of these services. In this review, we specifically address the waterbirds, which play key functional roles in many aquatic ecosystems, including as predators, herbivores and vectors of seeds, invertebrates and nutrients, although these roles have often been overlooked. Waterbirds can maintain the diversity of other organisms, control pests, be effective bioindicators of ecological conditions, and act as sentinels of potential disease outbreaks. They also provide important provisioning (meat, feathers, eggs, etc.) and cultural services to both indigenous and westernized societies. We identify key gaps in the understanding of ecosystem services provided by waterbirds and areas for future research required to clarify their functional role in ecosystems and the services they provide. We consider how the economic value of these services could be calculated, giving some examples. Such valuation will provide powerful arguments for waterbird conservation.

  9. Direct Current and Pulsed Direct Current Plasma Nitriding of Ferrous Materials a Critical Review

    Directory of Open Access Journals (Sweden)

    Łępicka Magdalena


    Full Text Available Nowadays, the improvement of ferrous materials performance is a problem of high interest. One of well-known wear- and corrosion properties improving technique is plasma nitriding, in which elemental nitrogen is introduced to the surface of a metal part for subsequent diffusion into the material. As a result, a compound, “white” layer and a diffusion zone are formed at the detail’s surface. Most of the authors positively describe the effects of surface ion nitiding. On the other hand, there are also reports on adverse effects of direct current and pulsed direct current plasma nitriding on ferrous materials performance. Therefore, an attempt to provide comprehensive summary on direct current and pulsed direct current ion nitriding and its influence on ferrous materials’ mechanical and corrosion properties has been made. According to the results, some of the technique drawbacks are hard to avoid in mass production.

  10. Library Users Expect Link Resolvers to Provide Full Text While Librarians Expect Accurate Results. A review of: Wakimoto, Jina Choi, David S. Walker, and Katherine S. Dabbour. “The Myths and Realities of SFX in Academic Libraries.” The Journal of Academic Librarianship 32.2 (Mar. 2006: 127‐ 36.

    Directory of Open Access Journals (Sweden)

    Wendy Furlan


    Full Text Available Objective – To determine how successfulthe link resolver, SFX, is in meeting the expectations of library users and librarians.Design – Analysis of an online user survey, library staff focus groups, retrospective analysis of system statistics, and test searches.Setting – Two California State University campus libraries in the United States: Northbridge, with over 31,000 students on campus, and San Marcos, with over 7,300 students on campus.Subjects – A total of 453 online survey responses were submitted from library users, 421 from Northbridge and 32 from SanMarcos. Twenty librarians took part in the focus groups conducted with library staff consisting of 14 of the 23 librarians from Northbridge (2 from technical services and 12 from public services, and 6 of the 10 San Marcos librarians (3 from technical services and 3 from public services. No further information was provided on the characteristics of the subjects.Methods – An online survey was offered to users of the two campus libraries for a two week period in May 2004. The survey consisted of 8 questions, 7 fixed response and 1 free text. Survey distribution was enabled via a different mechanism at each campus. The Northbridge library offered the survey to users via a pop‐up window each time the SFX service was clicked on, while the San Marcos library presented the survey as a link from the library’s home page. Survey responses from both campuses were combined and analysed together. Focus groups were conducted with librarians from each campus library on April 20th, 21st, and 29th, 2004. Librarians attended focus groups only with others from their own campus. Statistics were gathered from each campus’ local SFX system for the 3‐month period from September 14, 2004, to December 14,2004. Statistics from each campus were combined for analysis. The authors also conducted 224 test searches over the 3‐month period from July to September, 2004.Main results – Analysis of the

  11. Teaching antenatal counseling skills to neonatal providers. (United States)

    Stokes, Theophil A; Watson, Katie L; Boss, Renee D


    Counseling a family confronted with the birth of a periviable neonate is one of the most difficult tasks that a neonatologist must perform. The neonatologist's goal is to facilitate an informed, collaborative decision about whether life-sustaining therapies are in the best interest of this baby. Neonatologists are trained to provide families with a detailed account of the morbidity and mortality data they believe are necessary to facilitate a truly informed decision. Yet these complicated and intensely emotional conversations require advanced communication and counseling skills that our current fellowship-training strategies are not adequately providing. We review educational models for training neonatology fellows to provide antenatal counseling at the threshold of viability. We believe that training aimed at teaching these skills should be incorporated into the neonatal-perinatal medicine fellowship. The optimal approaches for teaching these skills remain uncertain, and there is a need for continued innovation and outcomes-based research.

  12. Turbulent current drive (United States)

    Garbet, X.; Esteve, D.; Sarazin, Y.; Dif-Pradalier, G.; Ghendrih, P.; Grandgirard, V.; Latu, G.; Smolyakov, A.


    The Ohm's law is modified when turbulent processes are accounted for. Besides an hyper-resistivity, already well known, pinch terms appear in the electron momentum flux. Moreover it appears that turbulence is responsible for a source term in the Ohm's law, called here turbulent current drive. Two terms contribute to this source. The first term is a residual stress in the momentum flux, while the second contribution is an electro-motive force. A non zero average parallel wave number is needed to get a finite source term. Hence a symmetry breaking mechanism must be invoked, as for ion momentum transport. E × B shear flows and turbulence intensity gradients are shown to provide similar contributions. Moreover this source term has to compete with the collision friction term (resistivity). The effect is found to be significant for a large scale turbulence in spite of an unfavorable scaling with the ratio of the electron to ion mass. Turbulent current drive appears to be a weak effect in the plasma core, but could be substantial in the plasma edge where it may produce up to 10 % of the local current density.

  13. Implante transcateter de valva aórtica: resultados atuais do desenvolvimento e implante de um nova prótese brasileira Transcatheter aortic valve implantation: results of the current development and implantation of a new Brazilian prosthesis

    Directory of Open Access Journals (Sweden)

    Diego Felipe Gaia


    . Minimally invasive transcatheter aortic valve implantation has emerged as an alternative, with lower morbidity and mortality. The aim of this study was clinical, safety and efficacy assessment. METHODS: Thirty-three high risk patients underwent transcatheter balloon expandable aortic valve implantation. Mean Logistic EuroScore risk was 39.30% and STS score 30.28%. Eight patients presented with dysfunctional bioprosthesis, remaining ones presented calcified aortic stenosis. Procedures were performed in a hybrid OR under fluoroscopic and echocardiography guidance. Using a left minithoracotomy the prosthesis were implanted trough the ventricular apex under rapid ventricular pacing or hemorrhagic shock. Echocardiographic and angiographic controls were performed. RESULTS: Implant was feasible in 30 cases. Three conversions occured. There was only one case of operative death. Median transvalvular aortic gradient reduced from 43.58 mmHg to 10.54 mmHg. Left ventricular function improved in the first 7 postoperative days. Paravalvular aortic regurgitation was mild and present in 30.30%. One case presented major vascular complication and another one permanent pacemaker implant. One major stroke case occurred. Overall 30-day mortality was 18.18%. CONCLUSION: The transapical implantation of catheter mounted bioprosthesis is a safe procedure with acceptable midterm results. Long term follow-up with increased sample power is mandatory in order to access hemodynamic, life quality and survival

  14. Knudsen Gas Provides Nanobubble Stability

    NARCIS (Netherlands)

    Seddon, James Richard Thorley; Zandvliet, Henricus J.W.; Lohse, Detlef


    We provide a model for the remarkable stability of surface nanobubbles to bulk dissolution. The key to the solution is that the gas in a nanobubble is of Knudsen type. This leads to the generation of a bulk liquid flow which effectively forces the diffusive gas to remain local. Our model predicts

  15. Twitter for travel medicine providers. (United States)

    Mills, Deborah J; Kohl, Sarah E


    Travel medicine practitioners, perhaps more so than medical practitioners working in other areas of medicine, require a constant flow of information to stay up-to-date, and provide best practice information and care to their patients. Many travel medicine providers are unaware of the popularity and potential of the Twitter platform. Twitter use among our travellers, as well as by physicians and health providers, is growing exponentially. There is a rapidly expanding body of published literature on this information tool. This review provides a brief overview of the ways Twitter is being used by health practitioners, the advantages that are peculiar to Twitter as a platform of social media, and how the interested practitioner can get started. Some key points about the dark side of Twitter are highlighted, as well as the potential benefits of using Twitter as a way to disseminate accurate medical information to the public. This article will help readers develop an increased understanding of Twitter as a tool for extracting useful facts and insights from the ever increasing volume of health information. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail:

  16. Current-Driven Switch-Mode Audio Power Amplifiers

    DEFF Research Database (Denmark)

    Knott, Arnold; Buhl, Niels Christian; Andersen, Michael A. E.


    The conversion of electrical energy into sound waves by electromechanical transducers is proportional to the current through the coil of the transducer. However virtually all audio power amplifiers provide a controlled voltage through the interface to the transducer. This paper is presenting...... a switch-mode audio power amplifier not only providing controlled current but also being supplied by current. This results in an output filter size reduction by a factor of 6. The implemented prototype shows decent audio performance with THD + N below 0.1 %....

  17. Service Provider DevOps


    John, Wolfgang; Marchetto, Guido; Németh, Felicián; Sköldström, Pontus; Steinert, Rebecca; Meirosu, Catalin; Papafili, Ioanna; Pentikousis, Kostas


    Although there is consensus that software defined networking and network functions virtualization overhaul service provisioning and deployment, the community still lacks a definite answer on how carrier-grade operations praxis needs to evolve. This article presents what lies beyond the first evolutionary steps in network management, identifies the challenges in service verification, observability, and troubleshooting, and explains how to address them using our Service Provider DevOps (SP-DevO...

  18. Community dental clinics: providers' perspectives. (United States)

    Wallace, Bruce B; MacEntee, Michael I; Harrison, Rosamund; Hole, Rachelle; Mitton, Craig


    Not-for-profit community dental clinics attempt to address the inequities of oral health care for disadvantaged communities, but there is little information about how they operate. The objective of this article is to explain from the perspective of senior staff how five community dental clinics in British Columbia, Canada, provide services. The mixed-methods case study included the five not-for-profit dental clinics with full-time staff who provided a wide range of dental services. We conducted open-ended interviews to saturation with eight senior administrative staff selected purposefully because of their comprehensive knowledge of the development and operation of the clinics and supplemented their information with a year's aggregated data on patients, treatments, and operating costs. The interview participants described the benefits of integrating dentistry with other health and social services usually within community health centres, although they doubted the sustainability of the clinics without reliable financial support from public funds. Aggregated data showed that 75% of the patients had either publically funded or no coverage for dental services, while the others had employer-sponsored dental insurance. Financial subsidies from regional health authorities allowed two of the clinics to treat only patients who are economically vulnerable and provide all services at reduced costs. Clinics without government subsidies used the fees paid by some patients to subsidize treatment for others who could not afford treatment. Not-for-profit dental clinics provide dental services beyond pain relief for underserved communities. Dental services are integrated with other health and community services and located in accessible locations. However, all of the participants expressed concerns about the sustainability of the clinics without reliable public revenues. © 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Results and current trends of nuclear methods used in agriculture

    Energy Technology Data Exchange (ETDEWEB)

    Horacek, P. (Ceskoslovenska Komise pro Atomovou Energii, Prague)


    The significance is evaluated of nuclear methods for agricultural research. The number of breeds induced by radiation mutations is increasing. The main importance of radiation mutation breeding consists in obtaining sources of the desired genetic properties for further hybridization. Radiostimulation is conducted with the aim of increasing yields. The irradiation of foods has not substantially increased worldwide. Very important is the irradiation of excrements and sludges which after such inactivation of pathogenic microorganisms may be used as humus-forming manure or as feed additives. In some countries the method is successfully being used of sexual sterilization for eradication of insect pests. The application of labelled compounds in the nutrition, physiology and protection of plants, farm animals and in food hygiene makes it possible to acquire new and accurate knowledge very quickly. Radioimmunoassay is a highly promising method in this respect. Labelling compounds with the stable /sup 15/N isotope is used for the research of nitrogen metabolism.

  20. Wave-current interactions: model development and preliminary results (United States)

    Mayet, Clement; Lyard, Florent; Ardhuin, Fabrice


    The coastal area concentrates many uses that require integrated management based on diagnostic and predictive tools to understand and anticipate the future of pollution from land or sea, and learn more about natural hazards at sea or activity on the coast. The realistic modelling of coastal hydrodynamics needs to take into account various processes which interact, including tides, surges, and sea state (Wolf [2008]). These processes act at different spatial scales. Unstructured-grid models have shown the ability to satisfy these needs, given that a good mesh resolution criterion is used. We worked on adding a sea state forcing in a hydrodynamic circulation model. The sea state model is the unstructured version of WAVEWATCH III c (Tolman [2008]) (which version is developed at IFREMER, Brest (Ardhuin et al. [2010]) ), and the hydrodynamic model is the 2D barotropic module of the unstructured-grid finite element model T-UGOm (Le Bars et al. [2010]). We chose to use the radiation stress approach (Longuet-Higgins and Stewart [1964]) to represent the effect of surface waves (wind waves and swell) in the barotropic model, as previously done by Mastenbroek et al. [1993]and others. We present here some validation of the model against academic cases : a 2D plane beach (Haas and Warner [2009]) and a simple bathymetric step with analytic solution for waves (Ardhuin et al. [2008]). In a second part we present realistic application in the Ushant Sea during extreme event. References Ardhuin, F., N. Rascle, and K. Belibassakis, Explicit wave-averaged primitive equations using a generalized Lagrangian mean, Ocean Modelling, 20 (1), 35-60, doi:10.1016/j.ocemod.2007.07.001, 2008. Ardhuin, F., et al., Semiempirical Dissipation Source Functions for Ocean Waves. Part I: Definition, Calibration, and Validation, J. Phys. Oceanogr., 40 (9), 1917-1941, doi:10.1175/2010JPO4324.1, 2010. Haas, K. A., and J. C. Warner, Comparing a quasi-3D to a full 3D nearshore circulation model: SHORECIRC and ROMS, Ocean Modelling, 26 (1-2), 91-103, 2009. Le Bars, Y., F. Lyard, C. Jeandel, and L. Dardengo, The AMANDES tidal model for the Amazon estuary and shelf, Ocean Modelling, 31 (3-4), 132-149, 2010. Longuet-Higgins, M., and R. Stewart, Radiation stresses in water waves; a physical discussion, with applications, Deep Sea Research and Oceanographic Abstracts, 11 (4), 529-562, 1964. Mastenbroek, C., G. Burgers, and P. A. E. M. Janssen, The Dynamical Coupling of a Wave Model and a Storm Surge Model through the Atmospheric Boundary Layer, pp. -, 1993. Tolman, H. L., A mosaic approach to wind wave modeling, Ocean Modelling, 25 (1-2), 35-47, 2008. Wolf, J., Coastal flooding: impacts of coupled wave-surge-tide models, Nat Hazards, 49 (2), 241-260, 2008.

  1. Report on results of current and future metal casting

    Energy Technology Data Exchange (ETDEWEB)

    Unal, Cetin [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Carlson, Neil N. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)


    New modeling capabilities needed to simulate the casting of metallic fuels are added to Truchas code. In this report we summarize improvements we made in FY2015 in three areas; (1) Analysis of new casting experiments conducted with BCS and EFL designs, (2) the simulation of INL’s U-Zr casting experiments with Flow3D computer program, (3) the implementation of surface tension model into Truchas for unstructured mesh required to run U-Zr casting.

  2. Current Results and Future Directions of the Pulsar Search Collaboratory (United States)

    Heatherly, Sue Ann; Rosen, R.; McLaughlin, M.; Lorimer, D.


    The Pulsar Search Collaboratory (PSC) is a joint partnership between the National Radio Astronomy Observatory (NRAO) and West Virginia University (WVU). The ultimate goal of the PSC is to interest students in science, technology, engineering, mathematics (STEM) fields by engaging them in conducting authentic scientific research-specifically the search for new pulsars. Of the 33 schools in the original PSC program, 13 come from rural school districts; one third of these are from schools where over 50% participate in the Free/Reduced School Lunch program. We are reaching first generation college-goers. For students, the program succeeds in building confidence in students, rapport with the scientists involved in the project, and greater comfort with team-work. We see additional gains in girls, as they see themselves more as scientists after participating in the PSC program, which is an important predictor of success in STEM fields. The PSC has had several scientific successes as well. To date, PSC students have made two astronomical discoveries: a 4.8-s pulsar and bright radio burst of astrophysical origin, most likely from a sporadic neutron star. We will report on the status of the project including new evaluation data. We will also describe PSC-West, an experiment to involve schools in Illinois and Wisconsin using primarily online tools for professional development of teachers and coaching of students. Knowledge gained through our efforts with PSC-West will assist the PSC team in scaling up the project.

  3. Positron Computed Tomography: Current State, Clinical Results and Future Trends (United States)

    Schelbert, H. R.; Phelps, M. E.; Kuhl, D. E.


    An overview is presented of positron computed tomography: its advantages over single photon emission tomography, its use in metabolic studies of the heart and chemical investigation of the brain, and future trends. (ACR)

  4. Data Service Provider Cost Estimation Tool (United States)

    Fontaine, Kathy; Hunolt, Greg; Booth, Arthur L.; Banks, Mel


    The Data Service Provider Cost Estimation Tool (CET) and Comparables Database (CDB) package provides to NASA s Earth Science Enterprise (ESE) the ability to estimate the full range of year-by-year lifecycle cost estimates for the implementation and operation of data service providers required by ESE to support its science and applications programs. The CET can make estimates dealing with staffing costs, supplies, facility costs, network services, hardware and maintenance, commercial off-the-shelf (COTS) software licenses, software development and sustaining engineering, and the changes in costs that result from changes in workload. Data Service Providers may be stand-alone or embedded in flight projects, field campaigns, research or applications projects, or other activities. The CET and CDB package employs a cost-estimation-by-analogy approach. It is based on a new, general data service provider reference model that provides a framework for construction of a database by describing existing data service providers that are analogs (or comparables) to planned, new ESE data service providers. The CET implements the staff effort and cost estimation algorithms that access the CDB and generates the lifecycle cost estimate for a new data services provider. This data creates a common basis for an ESE proposal evaluator for considering projected data service provider costs.

  5. Zika Virus: Critical Information for Emergency Providers. (United States)

    Shastry, Siri; Koenig, Kristi L; Hirshon, Jon Mark


    Zika virus is an arbovirus of the Flaviviridae family. It is primarily a minimally symptomatic mosquito-borne infection. However, with Zika's 2015 to 2016 introduction into the Western Hemisphere and its dramatic and rapid spread, it has become a public health concern, in large part due to congenital abnormalities associated with infection in pregnant women. In early 2016, the World Health Organization declared the microcephaly and other neurologic conditions associated with Zika virus infection a public health emergency of international concern. This article discusses the current epidemiologic and clinical understanding of Zika virus, focusing on critical information needed by emergency providers.

  6. Gravity current jump conditions, revisited (United States)

    Ungarish, Marius; Hogg, Andrew J.


    Consider the flow of a high-Reynolds-number gravity current of density ρc in an ambient fluid of density ρa in a horizontal channel z ∈ [ 0 , H ] , with gravity in - z direction. The motion is often modeled by a two-layer formulation which displays jumps (shocks) in the height of the interface, in particular at the leading front of the dense layer. Various theoretical models have been advanced to predict the dimensionless speed of the jump, Fr = U /√{g' h } ; g' , h are reduced gravity and jump height. We revisit this problem and using the Navier-Stokes equations, integrated over a control volume embedding the jump, derive balances of mass and momentum fluxes. We focus on understanding the closures needed to complete this model and we show the vital need to understand the pressure head losses over the jump, which we show can be related to the vorticity fluxes at the boundaries of the control volume. Our formulation leads to two governing equations for three dimensionless quantities. Closure requires one further assumption, depending on which we demonstrate that previous models for gravity current fronts and internal bores can be recovered. This analysis yield new insights into existing results, and also provides constraints for potential new formulae.

  7. An Alternative to Maxwell's Displacement Current

    CERN Document Server

    Wolsky, Alan M


    Though sufficient for local conservation of charge, we show that Maxwells displacement current is not necessary. An alternative to the Ampere Maxwell equation is exhibited and the alternative s electric and magnetic fields and scalar and vector potentials are expressed in terms of the charge and current densities. The alternative describes a theory in which action is instantaneous and so may provide a good approximation to Maxwells equations where and when the finite speed of light can be neglected. The result is reminiscent of the Darwin approximation which arose from the study classical charged point particles to order (v/c)2 in the Lagrangian. Unlike Darwin, this approach does not depend on the constitution of the electric current. Instead, this approach grows from a straightforward revision of the Ampere Equation which revision enforces the local conservation of charge.

  8. Overview of MAST results (United States)

    Chapman, I. T.; Adamek, J.; Akers, R. J.; Allan, S.; Appel, L.; Asunta, O.; Barnes, M.; Ben Ayed, N.; Bigelow, T.; Boeglin, W.; Bradley, J.; Brünner, J.; Cahyna, P.; Carr, M.; Caughman, J.; Cecconello, M.; Challis, C.; Chapman, S.; Chorley, J.; Colyer, G.; Conway, N.; Cooper, W. A.; Cox, M.; Crocker, N.; Crowley, B.; Cunningham, G.; Danilov, A.; Darrow, D.; Dendy, R.; Diallo, A.; Dickinson, D.; Diem, S.; Dorland, W.; Dudson, B.; Dunai, D.; Easy, L.; Elmore, S.; Field, A.; Fishpool, G.; Fox, M.; Fredrickson, E.; Freethy, S.; Garzotti, L.; Ghim, Y. C.; Gibson, K.; Graves, J.; Gurl, C.; Guttenfelder, W.; Ham, C.; Harrison, J.; Harting, D.; Havlickova, E.; Hawke, J.; Hawkes, N.; Hender, T.; Henderson, S.; Highcock, E.; Hillesheim, J.; Hnat, B.; Holgate, J.; Horacek, J.; Howard, J.; Huang, B.; Imada, K.; Jones, O.; Kaye, S.; Keeling, D.; Kirk, A.; Klimek, I.; Kocan, M.; Leggate, H.; Lilley, M.; Lipschultz, B.; Lisgo, S.; Liu, Y. Q.; Lloyd, B.; Lomanowski, B.; Lupelli, I.; Maddison, G.; Mailloux, J.; Martin, R.; McArdle, G.; McClements, K.; McMillan, B.; Meakins, A.; Meyer, H.; Michael, C.; Militello, F.; Milnes, J.; Morris, A. W.; Motojima, G.; Muir, D.; Nardon, E.; Naulin, V.; Naylor, G.; Nielsen, A.; O'Brien, M.; O'Gorman, T.; Ono, Y.; Oliver, H.; Pamela, S.; Pangione, L.; Parra, F.; Patel, A.; Peebles, W.; Peng, M.; Perez, R.; Pinches, S.; Piron, L.; Podesta, M.; Price, M.; Reinke, M.; Ren, Y.; Roach, C.; Robinson, J.; Romanelli, M.; Rozhansky, V.; Saarelma, S.; Sangaroon, S.; Saveliev, A.; Scannell, R.; Schekochihin, A.; Sharapov, S.; Sharples, R.; Shevchenko, V.; Silburn, S.; Simpson, J.; Storrs, J.; Takase, Y.; Tanabe, H.; Tanaka, H.; Taylor, D.; Taylor, G.; Thomas, D.; Thomas-Davies, N.; Thornton, A.; Turnyanskiy, M.; Valovic, M.; Vann, R.; Walkden, N.; Wilson, H.; van Wyk, F.; Yamada, T.; Zoletnik, S.; MAST; MAST Upgrade Teams


    The Mega Ampère Spherical Tokamak (MAST) programme is strongly focused on addressing key physics issues in preparation for operation of ITER as well as providing solutions for DEMO design choices. In this regard, MAST has provided key results in understanding and optimizing H-mode confinement, operating with smaller edge localized modes (ELMs), predicting and handling plasma exhaust and tailoring auxiliary current drive. In all cases, the high-resolution diagnostic capability on MAST is complemented by sophisticated numerical modelling to facilitate a deeper understanding. Mitigation of ELMs with resonant magnetic perturbations (RMPs) with toroidal mode number nRMP = 2, 3, 4, 6 has been demonstrated: at high and low collisionality; for the first ELM following the transition to high confinement operation; during the current ramp-up; and with rotating nRMP = 3 RMPs. nRMP = 4, 6 fields cause less rotation braking whilst the power to access H-mode is less with nRMP = 4 than nRMP = 3, 6. Refuelling with gas or pellets gives plasmas with mitigated ELMs and reduced peak heat flux at the same time as achieving good confinement. A synergy exists between pellet fuelling and RMPs, since mitigated ELMs remove fewer particles. Inter-ELM instabilities observed with Doppler backscattering are consistent with gyrokinetic simulations of micro-tearing modes in the pedestal. Meanwhile, ELM precursors have been strikingly observed with beam emission spectroscopy (BES) measurements. A scan in beta at the L-H transition shows that pedestal height scales strongly with core pressure. Gyro-Bohm normalized turbulent ion heat flux (as estimated from the BES data) is observed to decrease with increasing tilt of the turbulent eddies. Fast ion redistribution by energetic particle modes depends on density, and access to a quiescent domain with ‘classical’ fast ion transport is found above a critical density. Highly efficient electron Bernstein wave current drive (1 A W-1) has been achieved

  9. Informed consent - Providing information about prenatal examinations

    DEFF Research Database (Denmark)

    Dahl, Katja; Kesmodel, Ulrik; Hvidman, Lone

    Prenatal care has gradually moved away from paternalism, to a state where patient autonomy and information is vital. It is known from other health care settings that the way information is presented affects understanding.The objective is to summarize current knowledge on aspects of informing...... pregnant women about prenatal examinations. Women's knowledge, decisional conflict, satisfaction and anxiety will be explored as compared with different ways and different groups of health professionals providing information. To what extent information empowers informed decision making will be explored......, individual sessions and by way of written materials. None of the interventions leads to a raise in anxiety scores or influence up-take rates. Satisfaction with information provided is found unrelated to level of knowledge, but associated with having expectations for information met. Information does not seem...

  10. Client Provider Collaboration for Service Bundling

    Directory of Open Access Journals (Sweden)

    LETIA, I. A.


    Full Text Available The key requirement for a service industry organization to reach competitive advantages through product diversification is the existence of a well defined method for building service bundles. Based on the idea that the quality of a service or its value is given by the difference between expectations and perceptions, we draw the main components of a frame that aims to support the client and the provider agent in an active collaboration meant to co-create service bundles. Following e3-value model, we structure the supporting knowledge around the relation between needs and satisfying services. We deal with different perspectives about quality through an ontological extension of Value Based Argumentation. The dialog between the client and the provider takes the form of a persuasion whose dynamic object is the current best configuration. Our approach for building service packages is a demand driven approach, allowing progressive disclosure of private knowledge.

  11. Robotics Algorithms Provide Nutritional Guidelines (United States)


    On July 5, 1997, a small robot emerged from its lander like an insect from an egg, crawling out onto the rocky surface of Mars. About the size of a child s wagon, NASA s Sojourner robot was the first successful rover mission to the Red Planet. For 83 sols (Martian days, typically about 40 minutes longer than Earth days), Sojourner - largely remote controlled by NASA operators on Earth - transmitted photos and data unlike any previously collected. Sojourner was perhaps the crowning achievement of the NASA Space Telerobotics Program, an Agency initiative designed to push the limits of robotics in space. Telerobotics - devices that merge the autonomy of robotics with the direct human control of teleoperators - was already a part of NASA s efforts; probes like the Viking landers that preceded Sojourner on Mars, for example, were telerobotic applications. The Space Telerobotics Program, a collaboration between Ames Research Center, Johnson Space Center, Jet Propulsion Laboratory (JPL), and multiple universities, focused on developing remote-controlled robotics for three main purposes: on-orbit assembly and servicing, science payload tending, and planetary surface robotics. The overarching goal was to create robots that could be guided to build structures in space, monitor scientific experiments, and, like Sojourner, scout distant planets in advance of human explorers. While telerobotics remains a significant aspect of NASA s efforts, as evidenced by the currently operating Spirit and Opportunity Mars rovers, the Hubble Space Telescope, and many others - the Space Telerobotics Program was dissolved and redistributed within the Agency the same year as Sojourner s success. The program produced a host of remarkable technologies and surprising inspirations, including one that is changing the way people eat

  12. With Climate Change Expanding Trade Routes in the Arctic and the Resultant Pursuit of Resources, it is Crucial that the Eight Arctic Nations Find Paths Towards Sustainability and Peace in the Region. Traditional Arctic Games are an Essential Scenario that Provide an Important Scale for Analysis Aimed at Medium-long term Sustainability in the Arctic. (United States)

    Kilbourne, J. R.


    With climate change expanding trade routes in the Arctic and the resultant pursuit of oil, gas, mineral deposits, and fish, it is imperative that the eight Arctic countries find paths towards sustainability and peace in the region. Revisiting and understanding the traditional games of the indigenous people of these regions can go a long way towards helping those determining the region's future to work cooperatively towards these goals. Traditional games are an essential scenario that provide an important scale for analysis aimed at medium-long term sustainability in the Arctic. Throughout history the games we have played have been a testament about who we were, and are. From early Inuit bone and hunting games, to the gladiator contests of Ancient Rome, to the modern American game of baseball, the games we play have served as a statement of and a rehearsal for the life-world of that period and place. By reconnecting with and understanding the games of our past, we can build meaningful bridges between our past and present, and hopefully gain a better understanding of our modern world. The aforesaid are timely and important, especially as they relate to indigenous people throughout the world who are trying to preserve their traditions in a fast changing modern world. This presentation/paper will offer, based on my research and experiences in the Arctic, lessons learned from traditional Sámi and Inuit games that may help promote sustainability and peace in the Arctic world. Hopefully by acknowledging these lessons we can pursue a path forward, together reconnecting with the traditional games of the Arctic with the hope of building meaningful bridges between the past and present and moreover, helping to enhance our understanding of the important role traditional games can play in shaping an Arctic where sustainability and peace flourish.

  13. Wind Turbine Providing Grid Support

    DEFF Research Database (Denmark)


    A variable speed wind turbine is arranged to provide additional electrical power to counteract non-periodic disturbances in an electrical grid. A controller monitors events indicating a need to increase the electrical output power from the wind turbine to the electrical grid. The controller...... is arranged to control the wind turbine as follows: after an indicating event has been detected, the wind turbine enters an overproduction period in which the electrical output power is increased, wherein the additional electrical output power is taken from kinetic energy stored in the rotor and without...... changing the operation of the wind turbine to a more efficient working point.; When the rotational speed of the rotor reaches a minimum value, the wind turbine enters a recovery period to re-accelerate the rotor to the nominal rotational speed while further contributing to the stability of the electrical...

  14. Using of Automatic Metadata Providing

    Directory of Open Access Journals (Sweden)

    P. Šimek


    Full Text Available The paper deals with the necessity of systemic solution for metadata providing by local archives into central repositories and its subsequent implementatiton by the Department of Information Technologies, Faculty of Economics and Management, Czech University of Life Sciences in Prague, for the needs of the agrarian WWW AGRIS portal. The system supports the OAI-PMH (Open Archive Initiative – Protocol for Metadata Harvesting protocol, several metadata formats and thesauri and meets the quality requirements: functionality, high level of reliability, applicability, sustainability and transferability. The SW application for the OAI-PMH requests’ servicing is run in the setting of the WWW Apache server using an efficient PHP framework Nette and database dibi layer.

  15. Sirio.NET: A new tool for managing results in eddy current inspection of steam generators and heat exchangers; Sirio.NET: Una nueva herramienta para la gestion de resultados en las inspecciones por Corrientes Inducidas de los Generadores de Vapor y Cambiadores de Calor

    Energy Technology Data Exchange (ETDEWEB)

    Mendez, M.; Marquez, A.; Rodriguez, A. L.


    The results management and control of the inspections by currents induced of tube bundles of components such as steam generators, heat exchangers, etc., by the large volume of data generated, requires the use of highly specialized tools of information management, based on database structures. (Author)

  16. Stability analysis of direct current control in current source rectifier

    DEFF Research Database (Denmark)

    Lu, Dapeng; Wang, Xiongfei; Blaabjerg, Frede


    Current source rectifier with high switching frequency has a great potential for improving the power efficiency and power density in ac-dc power conversion. This paper analyzes the stability of direct current control based on the time delay effect. Small signal model including dynamic behaviors...... of dc link is developed to identify the control plants of grid ac current control and dc current control. Analysis on the poles and zeros under dq frame is carried out. Base on this model, it turns out that the phase lag caused by the time delay can stabilized the grid ac current control while reduces...... the stable region for dc current control. Simulation and experimental results are presented to validate the theoretical analysis....

  17. Perspectives from Marketing Internship Providers (United States)

    Swanson, Scott R.; Tomkovick, Chuck


    Internship research published in marketing and business education journals primarily examine student perspectives about internships or reports results based on other business disciplines. To more accurately understand how employers perceive marketing interns and internships, 352 managers located in the Midwestern United States were surveyed.…

  18. Perspectives from Marketing Internship Providers (United States)

    Swanson, Scott R.; Tomkovick, Chuck


    Internship research published in marketing and business education journals primarily examine student perspectives about internships or reports results based on other business disciplines. To more accurately understand how employers perceive marketing interns and internships, 352 managers located in the Midwestern United States were surveyed.…

  19. EAMJ Provider April 10.indd

    African Journals Online (AJOL)


    Apr 4, 2010 ... with breast cancer is known to result in more adverse outcomes (1). ... TREATMENT FOR BREAST CANCER PATIENTS. E.S. OTIENO, J.N. .... students at the time. ... Richards, M.A. Women's knowledge and belief regarding ...

  20. The Current Status of the WARP Experiment (United States)

    Szelc, A. M.; Benetti, P.; Calligarich, E.; Calaprice, F.; Cambiaghi, M.; Carbonara, F.; Cavanna, F.; Cocco, A. G.; Dipompeo, F.; Ferrari, N.; Fiorillo, G.; Galbiati, C.; Grandi, L.; Mangano, G.; Montanari, C.; Palamara, O.; Pandola, L.; Rappoldi, A.; Raselli, G. L.; Roncadelli, M.; Rossella, M.; Rubbia, C.; Santorelli, R.; Vignoli, C.; Zhao, Y.


    The WARP detector is a new idea in Dark Matter detection using liquid noble gases, specifically argon. We believe that argon is the medium best suited to detect nuclear recoils coming from interactions with the so called WIMPs (Weakly Interacting Massive Particles). The detection technique, using two different discrimination methods, is capable of an identification power as high as one event in 108. During the second half of the year 2006 the next, 100 liter, detector will be constructed with an active veto shield to further suppress the background, while currently a 2.3 liter prototype, installed in the Gran Sasso Laboratory (Italy), has been taking data since May 2004. The small version of the detector is able to not only provide insight on the operation of a two-phase liquid argon chamber but is also able to provide physics results competitive with the current leading edge experiments.

  1. Multispacecraft current estimates at swarm

    DEFF Research Database (Denmark)

    Dunlop, M. W.; Yang, Y.-Y.; Yang, J.-Y.


    During the first several months of the three-spacecraft Swarm mission all three spacecraft camerepeatedly into close alignment, providing an ideal opportunity for validating the proposed dual-spacecraftmethod for estimating current density from the Swarm magnetic field data. Two of the Swarm...... orbit the use oftime-shifted positions allow stable estimates of current density to be made and can verify temporal effects aswell as validating the interpretation of the current components as arising predominantly from field-alignedcurrents. In the case of four-spacecraft configurations we can resolve...... the full vector current and therefore cancheck the perpendicular as well as parallel current density components directly, together with the qualityfactor for the estimates directly (for the first time in situ at low Earth orbit)....

  2. Low-Power Magnetic Current Sensor (United States)

    Mclyman, W. T.


    Direct current sensed via saturable-core reactor. Transducer senses direct current magnetically, providing isolation between input and output. Detecting-and-isolating element saturable reactor, where input current passes through one-turn control coil. Provides output of 0 to 3 Vdc for input current of 0 to 15 Adc and consumes power of 22 mW at 10 Adc input. Input sensed magnetically, output electrically isolated from input.

  3. Brain abscess: Current management (United States)

    Alvis Miranda, Hernando; Castellar-Leones, Sandra Milena; Elzain, Mohammed Awad; Moscote-Salazar, Luis Rafael


    Brain abscess (BA) is defined as a focal infection within the brain parenchyma, which starts as a localized area of cerebritis, which is subsequently converted into a collection of pus within a well-vascularized capsule. BA must be differentiated from parameningeal infections, including epidural abscess and subdural empyema. The BA is a challenge for the neurosurgeon because it is needed good clinical, pharmacological, and surgical skills for providing good clinical outcomes and prognosis to BA patients. Considered an infrequent brain infection, BA could be a devastator entity that easily left the patient into dead. The aim of this work is to review the current concepts regarding epidemiology, pathophysiology, etiology, clinical presentation, diagnosis, and management of BA. PMID:24174804

  4. Brain abscess: Current management

    Directory of Open Access Journals (Sweden)

    Hernando Alvis-Miranda


    Full Text Available Brain abscess (BA is defined as a focal infection within the brain parenchyma, which starts as a localized area of cerebritis, which is subsequently converted into a collection of pus within a well-vascularized capsule. BA must be differentiated from parameningeal infections, including epidural abscess and subdural empyema. The BA is a challenge for the neurosurgeon because it is needed good clinical, pharmacological, and surgical skills for providing good clinical outcomes and prognosis to BA patients. Considered an infrequent brain infection, BA could be a devastator entity that easily left the patient into dead. The aim of this work is to review the current concepts regarding epidemiology, pathophysiology, etiology, clinical presentation, diagnosis, and management of BA.

  5. Saturn's Other Ring Current (United States)

    Crary, F. J.


    Saturn's main rings orbit the planet within an atmosphere and ionosphere of water, oxygen and hydrogen, produced by meteoritic impacts on and ultraviolet photodesorbtion of the ring particles [Johnson et al., 2006; Luhmann et al., 2006; Tseng et al., 2010]. The neutral atmosphere itself has only been tentatively detected through ultraviolet fluorescents of OH [Hall et al., 1996] while the ionosphere was observed in situ by the Cassini spacecraft shortly after orbital insertion [Coates et al.,2005; Tokar et al. 2005, Waite et al. 2005]. Although the plasma flow velocity of this ionosphere is not well-constrained, but the close association with the rings suggests that its speed would be couppled to the keplarian velocity of the rings themselves. As a result, the motion of the plasma through Saturn's magnetic field would produce an induced voltage, oriented away from the planet outside synchronous orbit and towards the planet inside synchronous orbit. Such a potential could result in currents flowing across the ring plane and closeing along magnetic field lines and through Saturn's ionosphere at latitudes between 36o and 48o. Cassini observations of whistler-mode plasma wave emissions [Xin et al.,2006] centered on synchronous orbit (1.76 Rs, mapping to 41o latitude) have been interpreted as a product of field-aligned electron beams associated with such a current. This presentation will investigate the magnitude of these currents and the resulting Joule heating of the ionosphere. An important constraint is that no auroral ultraviolet emissions have been observed at the relevant latitudes. In contrast, Joule heating could affect infrared emissions from H3+. Variations in H3+ emission associated with Saturn's rings have been reported by O'Donoghue et al., 2013, and interpreted as a result of ring "rain", i.e. precipitating water group species from the rings which alter ionosphereic chemistry and H3+ densities. As noted by O'Donoghue et al., this interpretation may be

  6. Marketing in the business activity of logistics service providers

    Directory of Open Access Journals (Sweden)

    Marcin Świtała


    Full Text Available Background: This article is a discussion on the role of marketing in the activity of logistics service providers. The strong competition and changing purchasing preferences should motivate the transport, forwarding and logistics sector managers to apply the marketing approach in practice. Methods: Results of direct research, conducted among a targeted group of 100 companies from the transport, forwarding and logistics sector, constitute the source basis. The sample group was divided into three categories of logistics providers: 2PL, 3PL and 4PL. The statistical analysis was based on three different non-parametric tests (Kruskal-Wallis, Chi-square and V Kramer.  Results and conclusions:  Currently, marketing does not play a key role in the activity of logistics services providers. The prevailing opinion is that importance of marketing in the company is average. The respondents have assessed in a similar way their activity compared to the activities of the competition. However, it was found that with the increase of the level of specialization (2PL-4PL, the awareness of impact of marketing on the logistics services sector also increased. The logistics services providers, who offer a wide range of logistics services, asses their competitive position in a better light.  

  7. Are Anesthesia Providers Ready for Hypnosis? Anesthesia Providers' Attitudes Toward Hypnotherapy. (United States)

    Stone, Alexander B; Sheinberg, Rosanne; Bertram, Amanda; Seymour, Anastasia Rowland


    This study sought to measure current attitudes toward hypnosis among anesthesia providers using an in-person survey distributed at a single grand rounds at a single academic teaching hospital. One hundred twenty-six anesthesia providers (anesthesiologists and nurse anesthetists) were included in this study. A 10-question Institutional Review Board (IRB)-approved questionnaire was developed. One hundred twenty-six (73% of providers at the meeting) anesthesia providers completed the survey. Of the respondents, 54 (43%) were anesthesiologists, 42 (33%) were trainees (interns/residents/fellows) in anesthesia, and 30 (24%) were nurse anesthetists. Over 70% of providers, at each level of training, rated their knowledge of hypnosis as either below average or having no knowledge. Fifty-two (42%) providers agreed or strongly agreed that hypnotherapy has a place in the clinical practice of anesthesia, while 103 (83%) believed that positive suggestion has a place in the clinical practice of anesthesia (p hypnosis were that it is too time consuming (41%) and requires special training (34%). Only three respondents (2%) believed that there were no reasons for using hypnosis in their practice. These data suggest that there is a self-reported lack of knowledge about hypnosis among anesthesia providers, although many anesthesia providers are open to the use of hypnosis in their clinical practice. Anesthesia providers are more likely to support the use of positive suggestion in their practice than hypnosis. Practical concerns should be addressed if hypnosis and therapeutic verbal techniques are to gain more widespread use.

  8. Computer Simulation of Transport Driven Current in Tokamaks (United States)

    Nunan, William Joseph, III


    Plasma transport phenomena can drive large currents parallel to an externally applied magnetic field. The Bootstrap Current Theory accounts for the effect of Banana Diffusion on toroidal current, but the effect is not confined to that transport regime, or even to toroidal geometry. Our electromagnetic particle simulations have demonstrated that Maxwellian plasmas in static toroidal and vertical fields spontaneously develop significant toroidal current, even in the absence of the "seed current" which the Bootstrap Theory requires. Other simulations, in both cylindrical and toroidal geometries, and without any externally imposed electric field, show that if the plasma column is centrally fueled, then an initial toroidal current grows steadily, apparently due to a dynamo effect. The straight cylinder does not exhibit kink instabilities because k_ {z} = 0 in this 2 + 1/2 dimensional model. When the plasma is fueled at the edge rather than the center, the effect is diminished. Fueling at an intermediate radius should produce a level of current drive in between these two limits, because the key to the current drive seems to be the amount of total poloidal flux which the plasma crosses in the process of escaping. In a reactor, injected (cold) fuel ions must reach the center, and be heated up in order to burn; therefore, central fueling is needed anyway, and the resulting influx of cold plasma and outflux of hot plasma drives the toroidal current. Our simulations indicate that central fueling, coupled with the central heating due to fusion reactions may provide all of the required toroidal current. The Neoclassical Theory predicts that the Bootstrap Current approaches zero as the aspect ratio approaches infinity; however, in straight cylindrical plasma simulations, axial current increases over time at nearly the same rate as in the toroidal case. These results indicate that a centrally fueled and heated tokamak may sustain its own toroidal current, even in the absence of

  9. Organizational culture associated with provider satisfaction (United States)

    Scammon, Debra L.; Tabler, Jennifer; Brunisholz, Kimberly; Gren, Lisa H.; Kim, Jaewhan; Tomoaia-Cotisel, Andrada; Day, Julie; Farrell, Timothy W.; Waitzman, Norman J.; Magill, Michael K.


    Objectives Assess 1) provider satisfaction with specific elements of PCMH; 2) clinic organizational cultures; 3) associations between provider satisfaction and clinic culture. Methods Cross sectional study with surveys conducted in 2011 with providers and staff in 10 primary care clinics implementing their version of a PCMH: Care by Design™. Measures included the Organizational Culture Assessment Instrument (OCAI) and the American Medical Group Association provider satisfaction survey. Results Providers were most satisfied with quality of care (M=4.14; scale=1–5) and interactions with patients (M=4.12) and least satisfied with time spent working (M=3.47), paper work (M =3.45) and compensation (M=3.35). Culture profiles differed across clinics with family/clan and hierarchical the most common. Significant correlations (p ≤ 0.05) between provider satisfaction and clinic culture archetypes included: family/clan negatively correlated with administrative work; entrepreneurial positively correlated with the Time Spent Working dimension; market/rational positively correlated with how practices were facing economic and strategic challenges; and hierarchical negatively correlated with Relationships with Staff and Resource dimensions. Discussion Provider satisfaction is an important metric for assessing experiences with features of a PCMH model. Conclusions Identification of clinic-specific culture archetypes and archetype associations with provider satisfaction can help inform practice redesign. Attention to effective methods for changing organizational culture is recommended. PMID:24610184

  10. An isolated current monitor for iontophoresis. (United States)

    Hauser, S E; Cohen, S A


    An inexpensive isolated current monitor has been developed as an effort to minimize stimulus artifact in experimental systems which include iontophoresis as the source of stimulus. The monitor becomes an element of the iontophoresis circuit, but provides an output voltage isolated from the iontophoresis current. The voltage is proportional to the iontophoresis current and will represent currents of 1/2 nA to 5 muA. It is this ability to detect minute currents that is valuable in iontophoresis measurements.

  11. Vaccine hesitancy and healthcare providers. (United States)

    Paterson, Pauline; Meurice, François; Stanberry, Lawrence R; Glismann, Steffen; Rosenthal, Susan L; Larson, Heidi J


    While most people vaccinate according to the recommended schedule, this success is challenged by individuals and groups who delay or refuse vaccines. The aim of this article is to review studies on vaccine hesitancy among healthcare providers (HCPs), and the influences of their own vaccine confidence and vaccination behaviour on their vaccination recommendations to others. The search strategy was developed in Medline and then adapted across several multidisciplinary mainstream databases including Embase Classic & Embase, and PschInfo. All foreign language articles were included if the abstract was available in English. A total of 185 articles were included in the literature review. 66% studied the vaccine hesitancy among HCPs, 17% analysed concerns, attitudes and/or behaviour of HCPs towards vaccinating others, and 9% were about evaluating intervention(s). Overall, knowledge about particular vaccines, their efficacy and safety, helped to build HCPs own confidence in vaccines and their willingness to recommend vaccines to others. The importance of societal endorsement and support from colleagues was also reported. In the face of emerging vaccine hesitancy, HCPs still remain the most trusted advisor and influencer of vaccination decisions. The capacity and confidence of HCPs, though, are stretched as they are faced with time constraints, increased workload and limited resources, and often have inadequate information or training support to address parents' questions. Overall, HCPs need more support to manage the quickly evolving vaccine environment as well as changing public, especially those who are reluctant or refuse vaccination. Some recommended strategies included strengthening trust between HCPs, health authorities and policymakers, through more shared involvement in the establishment of vaccine recommendations. Copyright © 2016. Published by Elsevier Ltd.

  12. Stochastic longshore current dynamics (United States)

    Restrepo, Juan M.; Venkataramani, Shankar


    We develop a stochastic parametrization, based on a 'simple' deterministic model for the dynamics of steady longshore currents, that produces ensembles that are statistically consistent with field observations of these currents. Unlike deterministic models, stochastic parameterization incorporates randomness and hence can only match the observations in a statistical sense. Unlike statistical emulators, in which the model is tuned to the statistical structure of the observation, stochastic parametrization are not directly tuned to match the statistics of the observations. Rather, stochastic parameterization combines deterministic, i.e physics based models with stochastic models for the "missing physics" to create hybrid models, that are stochastic, but yet can be used for making predictions, especially in the context of data assimilation. We introduce a novel measure of the utility of stochastic models of complex processes, that we call consistency of sensitivity. A model with poor consistency of sensitivity requires a great deal of tuning of parameters and has a very narrow range of realistic parameters leading to outcomes consistent with a reasonable spectrum of physical outcomes. We apply this metric to our stochastic parametrization and show that, the loss of certainty inherent in model due to its stochastic nature is offset by the model's resulting consistency of sensitivity. In particular, the stochastic model still retains the forward sensitivity of the deterministic model and hence respects important structural/physical constraints, yet has a broader range of parameters capable of producing outcomes consistent with the field data used in evaluating the model. This leads to an expanded range of model applicability. We show, in the context of data assimilation, the stochastic parametrization of longshore currents achieves good results in capturing the statistics of observation that were not used in tuning the model.

  13. Cryogenic current leads

    Energy Technology Data Exchange (ETDEWEB)

    Zizek, F.


    Theoretical, technical and design questions are examined of cryogenic current leads for SP of magnetic systems. Simplified mathematical models are presented for the current leads. To illustrate modeling, the calculation is made of the real current leads for 500 A and three variants of current leads for 1500 A for the enterprise ''Shkoda.''

  14. Improved Energy-Momentum Currents in Metric-Affine Spacetime

    CERN Document Server

    Hecht, R D; McCrea, J D; Mielke, E W; Ne'eman, Yuval; Hecht, Ralf; Hehl, Friedrich W.; Mielke, Eckehard W.; Ne'eman, Yuval


    In Minkowski spacetime it is well-known that the canonical energy-momentum current is involved in the construction of the globally conserved currents of energy-momentum and total angular momentum. For the construction of conserved currents corresponding to (approximate) scale and proper conformal symmetries, however, an improved energy-momentum current is needed. By extending the Minkowskian framework to a genuine metric-affine spacetime, we find that the affine Noether identities and the conformal Killing equations enforce this improvement in a rather natural way. So far, no gravitational dynamics is involved in our construction. The resulting dilation and proper conformal currents are conserved provided the trace of the energy-momentum current satisfies a (mild) scaling relation or even vanishes.

  15. Testing of 3-meter Prototype Fault Current Limiting Cables

    Energy Technology Data Exchange (ETDEWEB)

    Gouge, Michael J [ORNL; Duckworth, Robert C [ORNL; Demko, Jonathan A [ORNL; Rey, Christopher M [ORNL; Thompson, James R [ORNL; Lindsay, David T [ORNL; Tolbert, Jerry Carlton [ORNL; Willen, Dag [Ultera; Lentge, Heidi [Ultera; Thidemann, Carsten [Ultera; Carter, Bill [AMSC


    Two 3-m long, single-phase cables have been fabricated by Ultera from second generation (2G) superconductor supplied by American Superconductor. The first cable was made with two layers of 2G tape conductor and had a critical current of 5,750 A while the second cable had four layers and a critical current of 8,500 A. AC loss was measured for both cables at ac currents of up to 4 kArms. Ultera performed initial fault current studies of both cables in Denmark with limited currents in the range from 9.1 to 44 kA. Results from these tests will provide a basis for a 25-m long, three-phase, prototype cable to be tested at ORNL early next year and a 300-m long, fault current limiting, superconducting cable to be installed in a ConEd substation in New York City.

  16. Intraoperative patient information handover between anesthesia providers (United States)

    Choromanski, Dominik; Frederick, Joel; McKelvey, George Michael; Wang, Hong


    Abstract Currently, no reported studies have evaluated intraoperative handover among anesthesia providers. Studies on anesthetic handover in the US recovery room setting observed that handover processes are insufficient and, in many instances, significant intraoperative events are disregarded. An online survey tool was sent to anesthesia providers at US anesthesia residency programs nationwide (120 out of the 132 US programs encompassing around 4500 residents and their academic MDAs) and a smaller survey selection of CRNAs (10 institutions about 300 CRNAs in the metropolitan area of Detroit, MI, USA) to collect information on handover practices. The response rate to this survey (n = 216) was comprised of approximately 5% (n = 71) of the resident population in US anesthesia programs, 5% (n = 87) of MDAs , and 20% (n = 58) of the CRNAs. Out of all respondents (n = 212), 49.1 % had no hand-over protocol at their institution and 88% of respondents who did have institutional handover protocols believed them insufficient for effective patient handover. In addiiton, 84.8% of all responders reported situations where there was insufficient information received during a patient handover. Only 7% of the respondents reported never experiencing complications or mismanagement due to poor or incomplete hand-overs. In contrast, 60% reported rarely having complications, 31% reported sometimes having complications, and 3% reported frequent complications. In conclusion, handover transition of patient care is a vulnerable and potentially life-threatening event in the operating room. Our preliminary study suggests that current intraoperatvive handover practices among anesthesia providers are suboptimal and that national patient handover guidelines are required to improve patient safety. PMID:25332710

  17. Turbidity Current Head Mixing (United States)

    Hernandez, David; Sanchez, Miguel Angel; Medina, Pablo


    A laboratory experimental set - up for studying the behaviour of sediment in presence of a turbulent field with zero mean flow is compared with the behaviour of turbidity currents [1] . Particular interest is shown on the initiation of sediment motion and in the sediment lift - off. The behaviour of the turbidity current in a flat ground is compared with the zero mean flow oscilating grid generated turbulence as when wave flow lifts off suspended sediments [2,3]. Some examples of the results obtained with this set-up relating the height of the head of the turbidity current to the equilibrium level of stirred lutoclines are shown. A turbulent velocity u' lower than that estimated by the Shield diagram is required to start sediment motion. The minimum u' required to start sediment lift - off, is a function of sediment size, cohesivity and resting time. The lutocline height depends on u', and the vorticity at the lutocline seems constant for a fixed sediment size [1,3]. Combining grid stirring and turbidty current head shapes analyzed by means of advanced image analysis, sediment vertical fluxes and settling speeds can be measured [4,5]. [1] D. Hernandez Turbulent structure of turbidity currents and sediment transport Ms Thesis ETSECCPB, UPC. Barcelona 2009. [2] A. Sánchez-Arcilla; A. Rodríguez; J.C. Santás; J.M. Redondo; V. Gracia; R. K'Osyan; S. Kuznetsov; C. Mösso. Delta'96 Surf-zone and nearshore measurements at the Ebro Delta. A: International Conference on Coastal Research through large Scale Experiments (Coastal Dynamics '97). University of Plymouth, 1997, p. 186-187. [3] P. Medina, M. A. Sánchez and J. M. Redondo. Grid stirred turbulence: applications to the initiation of sediment motion and lift-off studies Physics and Chemistry of the Earth, Part B: Hydrology, Oceans and Atmosphere. 26, Issue 4, 2001, Pages 299-304 [4] M.O. Bezerra, M. Diez, C. Medeiros, A. Rodriguez, E. Bahia., A. Sanchez-Arcilla and J.M. Redondo. Study on the influence of waves on


    Energy Technology Data Exchange (ETDEWEB)

    CHU, M.S.; PARKS, P.B.


    OAK B202 TOKAMAK EQUILIBRIA WITH CENTRAL CURRENT HOLES AND NEGATIVE CURRENT DRIVE. Several tokamak experiments have reported the development of a central region with vanishing currents (the current hole). Straightforward application of results from the work of Greene, Johnson and Weimer [Phys. Fluids, 3, 67 (1971)] on tokamak equilibrium to these plasmas leads to apparent singularities in several physical quantities including the Shafranov shift and casts doubts on the existence of this type of equilibria. In this paper, the above quoted equilibrium theory is re-examined and extended to include equilibria with a current hole. It is shown that singularities can be circumvented and that equilibria with a central current hole do satisfy the magnetohydrodynamic equilibrium condition with regular behavior for all the physical quantities and do not lead to infinitely large Shafranov shifts. Isolated equilibria with negative current in the central region could exist. But equilibria with negative currents in general do not have neighboring equilibria and thus cannot have experimental realization, i.e. no negative currents can be driven in the central region.

  19. [Current management of epilepsy]. (United States)

    Mizobuchi, Masahiro


    Epilepsy is one of the most common neurological disorders. Global neurological knowledge is essential for differential diagnosis of epileptic syndromes due to the diversity of ictal semiology, causes and syndromes. Neurologists play an important role in planning the medical care for patients with epilepsy, as medication is the most fundamental therapeutic strategy. Some patients with early-onset epilepsy require joint care by pediatric neurologists, those with intractable epilepsy by neurosurgeons, and those with psychological comorbidity by psychiatrists, and neurologists should play a coordinating role. While there is a great need for neurologists to participate in epilepsy care, neurologists in Japan currently do not participate substantially in the epilepsy management system. It is necessary to train more neurologists who can provide epilepsy care and conduct basic and clinical research on epilepsy by providing continuous education on epilepsy for general neurologists as well as pre- and post-graduate medical students. Most of the patients who require long-term treatment experience many medical problems and social handicaps, such as adverse effects of medication, social stigma, educational disadvantages and difficulties in obtaining driver's license. To improve the quality of life of patients with epilepsy, it is desirable to build broad medical-social networks participated by patients, doctors, neurological nurses, psychologists, social workers, school teachers, managers of employment support facilities and care givers.

  20. Cancer Treatment - Cancer Currents Blog (United States)

    A catalog of posts from NCI’s Cancer Currents blog on cancer treatment research. Includes posts on new treatments for cancer and their effects, clinical trial results, and overcoming treatment resistance.

  1. Research Results (United States)


    In situ Oxidation Study of Pt (110) and Its Interaction with CO Chinese Scientists Published a Paper on Prevention of Drug Craving and Relapse by Memory Retrieval-extinction Procedure in Science Series Papers Published in Energy Policy: Modeling Energy Use of China's Road Transport and Policy Evaluation Breakthrough in the Ambient Catalytic Destruction of Formaldehyde Novel Findings for High Altitude Adaptation from the Yak Genome Binary Colloidal Structures Assembled through Ising Interactions Reemergence of superconductivity at 48K in Compressed Iron Selenide Based Superconductors Nucleosomes Suppress Spontaneous Mutations Base-Specifically in Eukaryotes Single-Chain Fragmented Antibodies Guided SiRNA Delivery in Breast Cancer Does Yeast Suicide? China Scientists Developed Important Methodologies for Spatiotemporal Detecting and Manipulating of Cellular Activities Scorpions Inspire Chinese Scientists in Making Bionic Non-eroding Surfaces for Machinery Research on Phylogenetic Placement of Borthwickia and Description of a New Family of Angiosperms, Borthwickiaceae Plasmoid Ejection and Secondary Current Sheet Generation from Magnetic Reconnection in Laser-plasma Interaction Cotton Bollworm Adapts to Bt Cotton via Diverse Mutations A Histone Acetyltransferase Regulates Active DNA Demethylation in Arabidopsis

  2. Enceladus Results (United States)

    National Aeronautics and Space Administration — Here are some results from the Spectra Decomposition Algorithm on infrared spectral images of Saturn's moon Enceladus. Figure 1 is the spatial contribution of the...

  3. Eddy current pulsed phase thermography and feature extraction (United States)

    He, Yunze; Tian, GuiYun; Pan, Mengchun; Chen, Dixiang


    This letter proposed an eddy current pulsed phase thermography technique combing eddy current excitation, infrared imaging, and phase analysis. One steel sample is selected as the material under test to avoid the influence of skin depth, which provides subsurface defects with different depths. The experimental results show that this proposed method can eliminate non-uniform heating and improve defect detectability. Several features are extracted from differential phase spectra and the preliminary linear relationships are built to measure these subsurface defects' depth.

  4. New concept of current switch based on high-temperature superconductor

    CERN Document Server

    Ovchinnikov, S G; Balaev, D A; Gokhfel'd, D M; Kharlamova, S A; Shajkhutdinov, K A; Kirko, V I; Ivanov, V V; Militsyn, S V; Mamalis, A G


    A new concept of alternating current circuit protection device on the basis of combination of a superconducting short circuit (SC) current limiter and an electric circuit breaker was suggested. High-temperature superconductor as a stack of plane rings was used as active element in the superconducting current limiter. Test results of the limiter mock-up under stationary short circuit conditions are provided. Characteristics of composite materials, that do not contain silver, which are used for current breaker designing, are presented

  5. Extensive IT outsourcing: advice from providers. (United States)

    Smith, Mike; Whiting, Stacilee


    In summary, providers are reporting some benefits related to resources and knowledge, improved service levels/performance and stronger IT staff/leadership. Also, on average, providers are reporting satisfactory experiences with application support and CIO outsourcing. However, not all of their expectations are being met, and some providers have discontinued outsourcing due to unmet expectations. Clearly, outsourcing is an option one must research in depth--it is not for everyone. When one evaluates the results of extensive IT outsourcing, it becomes easier to see what outsourcing mix and firm may be a good match for your organization's needs and expected outcomes. As you decide upon the outsourcing mix and firm that is right for you, providers advise you to pay special attention to contractual arrangements. With adequate research and contractual provisions, organizations can find the outsourcing mix that is right for them.

  6. Unifying concept of serotonin transporter-associated currents. (United States)

    Schicker, Klaus; Uzelac, Zeljko; Gesmonde, Joan; Bulling, Simon; Stockner, Thomas; Freissmuth, Michael; Boehm, Stefan; Rudnick, Gary; Sitte, Harald H; Sandtner, Walter


    Serotonin (5-HT) uptake by the human serotonin transporter (hSERT) is driven by ion gradients. The stoichiometry of transported 5-HT and ions is predicted to result in electroneutral charge movement. However, hSERT mediates a current when challenged with 5-HT. This discrepancy can be accounted for by an uncoupled ion flux. Here, we investigated the mechanistic basis of the uncoupled currents and its relation to the conformational cycle of hSERT. Our observations support the conclusion that the conducting state underlying the uncoupled ion flux is in equilibrium with an inward facing state of the transporter with K+ bound. We identified conditions associated with accumulation of the transporter in inward facing conformations. Manipulations that increased the abundance of inward facing states resulted in enhanced steady-state currents. We present a comprehensive kinetic model of the transport cycle, which recapitulates salient features of the recorded currents. This study provides a framework for exploring transporter-associated currents.

  7. The Relationship Between Provider Competence, Content Exposure, and Consumer Outcomes in Illness Management and Recovery Programs. (United States)

    McGuire, Alan B; White, Dominique A; Bartholomew, Tom; Flanagan, Mindy E; McGrew, John H; Rollins, Angela L; Mueser, Kim T; Salyers, Michelle P


    Provider competence may affect the impact of a practice. The current study examined this relationship in sixty-three providers engaging in Illness Management and Recovery with 236 consumers. Improving upon previous research, the present study utilized a psychometrically validated competence measure in the ratings of multiple Illness Management and Recovery sessions from community providers, and mapped outcomes onto the theory underlying the practice. Provider competence was positively associated with illness self-management and adaptive coping. Results also indicated baseline self-management skills and working alliance may affect the relationship between competence and outcomes.

  8. Antitrust and affiliations among healthcare providers: the need for a level playing field. (United States)

    Heightchew, A


    Under pressure to remain competitive in the rapidly changing healthcare industry, policy leaders and healthcare administrators face the challenge of resolving antitrust matters arising from the creation of innovative healthcare provider affiliations. Although guidance from the Federal Trade Commission (FTC) is available, development of new affiliations is hindered due to contradictory rulings and ambiguous guidelines. Provider associations are further disadvantaged by a federal act granting insurance companies antitrust exemption, which enables insurance companies to affiliate more easily. Current antitrust regulations create unequal market powers, resulting in the development of inefficient systems. Softening antitrust laws in favor of provider-sponsored healthcare affiliations will provide for the flexibility necessary for effective healthcare reform.

  9. Megavolt nanosecond generator with semiconductor current breaker

    CERN Document Server

    Bushlyakov, A I; Rukin, S N; Slovikovskij, B G; Timoshenkov, S P


    The heavy-current nanosecond generator with the pulse capacity up to 1.6 GW and output voltage of 0.5-1 MW is described. The generator contains four capacity storages, one induction storage and six solid body commutators: one thyristor, four magnetic commutators and a semiconductor current breaker on the SOS-diodes. The results of studies on the energy change-over efficiency through a semiconductor breaker by various external resistance loads as well as the results of the thermal and frequency tests are presented. It is established that selection of the optimal cooling system provides for the generator continuous mode of operation with the pulse sequence frequency from 300 Hz up to 850 Hz

  10. Using Coaching to Provide Ongoing Support and Supervision to Out-of-School Time Staff. Part 3 in a Series on Implementing Evidence-Based Practices in Out-of-School Time Programs: The Role of Frontline Staff. Research-to-Results Brief. Publication #2009-06 (United States)

    Burkhauser, Mary; Metz, Allison J. R.


    Although skills needed by out-of-school time practitioners can be introduced during training, many skills can only really be learned on the job with ongoing support and supervision provided by a "coach." Research from both the education and out-of-school time fields supports the value of staff coaching as a professional development tool, and staff…

  11. Electric current characteristic of anodic bonding (United States)

    He, Jun; Yang, Fang; Wang, Wei; Zhang, Li; Huang, Xian; Zhang, Dacheng


    In this paper, a novel current-time model of anodic bonding is proposed and verified experimentally in order to investigate underlying mechanisms of anodic bonding and to achieve real-time monitoring of bonding procedure. The proposed model provides a thorough explanation for the electric current characteristic of anodic bonding. More significantly, it explains two issues which other models cannot explain. One is the sharp rise in current when a voltage is initially applied during anodic bonding. The other is the unexpected large width of depletion layers. In addition, enlargement of the intimately contacted area during anodic bonding can be obtained from the proposed model, which can be utilized to monitor the bonding process. To verify the proposed model, Borofloat33 glass and silicon wafers were adopted in bonding experiments in SUSS SB6 with five different bonding conditions (350 °C 1200 V 370 °C 1200 V 380 °C 1200 V 380 °C 1000 V and 380 °C 1400 V). The results indicate that the observed current data highly coincide with the proposed current-time model. For widths of depletion layers, depth profiling using secondary ion mass spectrometry demonstrates that the calculated values by the model are basically consistent with the experimental values as well.

  12. Could innovative teams provide the necessary flexibility to compete in the current context?

    Directory of Open Access Journals (Sweden)

    Mercedes Rubio Andrés


    Full Text Available In the modern era firms should look for a sustainable and profitable business model. They operate in highly volatile and competitive markets. Innovation is a key element that allows firms to survive in these complex environments. Accordingly, some companies are developing human resource models that align to the actual competitive context. For instance, they establish democratic systems, flexible work practices, they focus on responsibility and initiative and increase the self-control of team members. In this framework, firms tend to use resources such as creativity, capacity for innovation or development of human talent. Therefore, innovative teams are able to adapt and react to turbulent, complex and dynamic environments, which allow them to handle in a more efficient way several subtasks. This fact gives rise to a higher effectiveness in the activities of firms. This paper analyze the characteristics and performance of multifunctional teams, virtual teams, open-innovation teams and self-managing teams. It also study the case of Semco, a company that is characterized by its innovative practices in human resources management and focus on responsibility and initiative and increase the self-control of team members.

  13. Dosing of ACE inhibitors in left ventricular dysfunction : Does current clinical dosing provide optimal benefit?

    NARCIS (Netherlands)

    Pinto, YM; van Geel, PP; Alkfaji, H; van Veldhuisen, DJ; van Gilst, WH


    In the present review, we discuss the role of clinical dosing of angiotensin converting enzyme (ACE) inhibitors in the treatment of left ventricular dysfunction. Although the precise mechanism of action of ACE inhibitors is still unresolved, the clinical efficacy of ACE inhibitors in the treatment o

  14. Current challenges in providing bariatric surgery in France: A nationwide study. (United States)

    Czernichow, Sébastien; Paita, Michel; Nocca, David; Msika, Simon; Basdevant, Arnaud; Millat, Bertrand; Fagot-Campagna, Anne


    Bariatric surgery is a well-accepted procedure for severe and massive obesity management. We aimed to determine trends, geographical variations, and factors influencing bariatric surgery and the choice of procedure in France in a large observational study.The Health Insurance Fund for Salaried Workers (Caisse National Assurance Maladie Travailleurs Salariés) covers about 86% of the French population. The Système National d'Information Inter-régimes de l'Assurance Maladie database contains individualized and anonymized patient data on all reimbursements for healthcare expenditure. All types of primary bariatric procedures (Roux-en-Y gastric bypass [RYGB] or omega loop, adjustable gastric banding [AGB], or longitudinal sleeve gastrectomy [LSG]) performed during 2011 to 2013 were systematically recorded. Surgical techniques performed by region of residence and age-range relative risks with 95% confidence intervals of undergoing LSG or RYGB versus AGB were computed.In 2013, LSG was performed more frequently than RYGB and AGB (57% vs 31% and 13%, respectively). A total of 41,648 patients underwent a bariatric procedure; they were predominantly female (82%) with a mean (±standard deviation) age of 40 (±12) years and a body mass index ≥40 kg/m for 68% of them. A total of 114 procedures were performed in patients younger than 18 years and 2381 procedures were performed in patients aged 60 years and older. Beneficiaries of the French universal health insurance coverage for low-income patients were more likely to undergo surgery than the general population. Large nationwide variations were observed in the type choice of bariatric surgical procedures. Significant positive predictors for undergoing RYGB compared to those for undergoing AGB were as follows: referral to a center performing a large number of surgeries or to a public hospital, older age, female gender, body mass index ≥50 kg/m, and treatment for obstructive sleep apnea syndrome, diabetes, or depression. Universal health insurance coverage for low-income patients was inversely correlated with the probability of RYGB.Differences in access to surgery have been observed in terms of the patient's profile, geographical variations, and predictors of types of procedures. Several challenges must be met when organizing the medical care of this growing number of patients, when delivering surgery through qualified centers while assuring the quality of long-term follow-up for all patients.

  15. Current Practices for Providing School Field Trip Meals: Perspectives of School Nutrition Managers and Teachers (United States)

    Sneed, Jeannie; Vaterlaus Patten, Emily


    Purpose/Objectives: The Healthy, Hunger Free Kids Act of 2010 extended the requirements for a school food safety program to wherever food is stored, prepared, or served, including meals for field trips. The purpose of this study was to determine what foods are used for field trip meals, how those foods are transported and stored, and what standard…

  16. Review of Current Data Exchange Practices: Providing Descriptive Data to Assist with Building Operations Decisions

    Energy Technology Data Exchange (ETDEWEB)

    Livingood, W.; Stein, J.; Considine, T.; Sloup, C.


    Retailers who participate in the U.S. Department of Energy Commercial Building Energy Alliances (CBEA) identified the need to enhance communication standards. The means are available to collect massive numbers of buildings operational data, but CBEA members have difficulty transforming the data into usable information and energy-saving actions. Implementing algorithms for automated fault detection and diagnostics and linking building operational data to computerized maintenance management systems are important steps in the right direction, but have limited scalability for large building portfolios because the algorithms must be configured for each building.

  17. Promoting wellness of peer providers through coaching. (United States)

    Brice, George H; Swarbrick, Margaret A; Gill, Kenneth J


    Peer wellness coaching is workforce innovation that empowers individuals with mental and substance use disorders to achieve recovery. This article briefly describes how this approach can help peer providers develop self-care skills to improve job tenure and promote satisfaction. Promising results of this new approach are presented.

  18. The impact of triggering mechanism on flow dynamics and depositional geometry: results from an experimental study of non-conservative density currents; Influencia do mecanismo de iniciacao na dinamica dos fluxos e na geometria dos depositos gerados: observacoes obtidas a partir de estudo experimental de correntes de densidade nao-conservativas

    Energy Technology Data Exchange (ETDEWEB)

    Manica, Rafael [Rio Grande do Sul Univ., Porto Alegre (Brazil). Inst. de Pesquisas Hidraulicas. Nucleo de Estudos de Correntes de Densidade]. E-mail:; Del Rey, Antonio Cosme; Maestri, Rogerio Dornelles; Borges, Ana Luiza de Oliveira; Viana, Adriano Roessler


    This study presents 28 physical simulations of non-conservative density currents used to evaluate their depositional patterns. Two different triggering mechanisms were used: lock gate and fluid injection. The impact of specific gravity, material type and grain size on the mixture were also checked. Dynamic and geometric features, such as head velocity and head/body height, were recorded. Results show flow velocity increase as concentration grows; deposition volumes present a general tendency to exponential decline with distance; the grain size range of the deposits decreases towards the distal portion of the channel. The results obtained have showed the efficiency of physical modeling in the study of turbidites in allowing correlations to be defined between currents and deposition patterns. (author)

  19. Results from SNO

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Yuen-dat


    The Sudbury Neutrino Observatory (SNO) is an underground heavy water Cherenkov detector for studying solar neutrinos. SNO is capable of performing both flavor sensitive and flavor blind measurements of the solar neutrino flux. The first charged current (CC) measurement is found to be: {psi}{sub SNO}{sup CC}({nu}{sub e}) = 1.75 {+-} 0.07(stat.){sub -0.11}{sup +0.12}(sys.) {+-} 0.05 (theor.) x 10{sup 6} cm{sup -2}s{sup -1} and the elastic scattering fluxes (ES) is: {psi}{sub SNO}{sup ES}({nu}{sub x}) = 2.39 {+-} 0.34(stat.){sub -0.14}{sup +0.16} (sys.) x 10{sup 6} cm{sup -2}s{sup -1}. The {psi}{sub SNO}{sup CC}({nu}{sub e}) result, when combined with the high statistics elastic scattering (ES) measurement from Super-Kamiokande, provide a strong evidence for solar neutrino flavor transformation (3.3{sigma}). The deduced total solar neutrino flux is in good agreement with standard solar model predictions. No significant distortion in the energy spectrum is observed.

  20. Airborne Internet Providing Tethered Balloon System

    Directory of Open Access Journals (Sweden)

    Suvriti Dhawan1


    Full Text Available In this paper we shall introduce a new system for providing wireless network communication over a specified area using ’lighter than air’ balloons. This technology will replace the existing fiber optic network system. This will be done by using a tethered balloon along with the payload (containing a receiver, a transmitter and a radio communication device.This payload will be suspended from the ground at an altitude (depending on the area of coverage required. Users under this area will be able to access this system directly for internet connectivity. This system can be used over large areas like universities, companies and societies to provide internet facility to their users through Wi-Fi or over an area where the user is specified (commercial purposes. Currently Google is working on similar idea called the ’Google Loon’ in which they use high altitude balloons which float at an altitude twice as high as air planes and the weather. They recently tested this system over New-Zealand by providing internet to their pilot testers on ground. Their balloons not being stationary, move with directional winds and have to be replaced one after the other to maintain consistency. This can be a huge problem over the areas where upper atmospheric winds are not in favorable direction. We can resolve this problem by using our stationary tethered balloon system which can communicate with the loon balloons to provide internet facility over a desired area. Moreover when our balloon will communicate with the loon balloon it will increase the coverage area as the loon balloon has to communicate to a point which is above the ground. Our system will not only replace the existing fiber optic system but it will also be selfsustaining i.e. It will generate its own power using solar panels.

  1. Providing Real Research Opoportunities to Undergraduates (United States)

    Ragozzine, Darin


    The current approach to undergraduate education focuses on teaching classes which provide the foundational knowledge for more applied experiences such as scientific research. Like most programs, Florida Institute of Technology (Florida Tech or FIT) strongly encourages undergraduate research, but is dominated by content-focused courses (e.g., "Physical Mechanics"). Research-like experiences are generally offered through "lab" classes, but these are almost always reproductions of past experiments: contrived, formulaic, and lacking the "heart" of real (i.e., potentially publishable) scientific research. Real research opportunities 1) provide students with realistic insight into the actual scientific process; 2) excite students far more than end-of-chapter problems; 3) provide context for the importance of learning math, physics, and astrophysics concepts; and 4) allow unique research progress for well-chosen problems. I have provided real research opportunities as an "Exoplanet Lab" component of my Introduction to Space Science (SPS1020) class at Florida Tech, generally taken by first-year majors in our Physics, Astronomy & Astrophysics, Planetary Science, and Astrobiology degree programs. These labs are a hybrid between citizen science (e.g., PlanetHunters) and simultaneously mentoring ~60 undergraduates in similar small research projects. These projects focus on problems that can be understood in the context of the course, but which benefit from "crowdsourcing". Examples include: dividing up the known planetary systems and developing a classification scheme and organizing them into populations (Fall 2013); searching through folded light curves to discover new exoplanets missed by previous pipelines (Fall 2014); and fitting n-body models to all exoplanets with known Transit Timing Variations to estimate planet masses (Fall 2015). The students love the fact that they are doing real potentially publishable research: not many undergraduates can claim to have discovered

  2. Oxidation of organic pollutants on BDD anodes using modulated current electrolysis

    Energy Technology Data Exchange (ETDEWEB)

    Panizza, M. [Department of Chemical and Process Engineering, University of Genoa, P.le J.F. Kennedy 1, 16129 Genova (Italy)], E-mail:; Kapalka, Agnieszka [Institute of Chemical Sciences and Engineering, Ecole Polytechnique Federale de Lausanne (EPFL), CH-1015 Lausanne (Switzerland); Comninellis, Ch. [Institute of Chemical Sciences and Engineering, Ecole Polytechnique Federale de Lausanne (EPFL), CH-1015 Lausanne (Switzerland)], E-mail:


    In this paper, a theoretical model is presented for organic pollutants mineralization at high current efficiency (close to 100%) and low energy consumption on boron-doped diamond electrodes. The model is formulated for a perfect mixed electrochemical reactor operated as a batch recirculation system under multiple current steps, in which the applied current is adjusted during the electrolysis to be close to the limiting value. An experimental validation with the anodic oxidation of 3,4,5-trihydroxybenzoic acid is also provided. The results have shown that multiple current steps electrolysis and continuous current control allowed obtaining high oxidation rate and current efficiency.

  3. Currents for Arbitrary Helicity

    CERN Document Server

    Dragon, Norbert


    Using Mackey's classification of unitary representations of the Poincar\\'e group on massles states of arbitrary helicity we disprove the claim that states with helicity |h|>=1 cannot couple to a conserved current by constructing such a current.

  4. Magnesium Diboride Current Leads (United States)

    Panek, John


    A recently discovered superconductor, magnesium diboride (MgB2), can be used to fabricate conducting leads used in cryogenic applications. Dis covered to be superconducting in 2001, MgB2 has the advantage of remaining superconducting at higher temperatures than the previously used material, NbTi. The purpose of these leads is to provide 2 A of electricity to motors located in a 1.3 K environment. The providing environment is a relatively warm 17 K. Requirements for these leads are to survive temperature fluctuations in the 5 K and 11 K heat sinks, and not conduct excessive heat into the 1.3 K environment. Test data showed that each lead in the assembly could conduct 5 A at 4 K, which, when scaled to 17 K, still provided more than the required 2 A. The lead assembly consists of 12 steelclad MgB2 wires, a tensioned Kevlar support, a thermal heat sink interface at 4 K, and base plates. The wires are soldered to heavy copper leads at the 17 K end, and to thin copper-clad NbTi leads at the 1.3 K end. The leads were designed, fabricated, and tested at the Forschungszentrum Karlsruhe - Institut foer Technische Physik before inclusion in Goddard's XRS (X-Ray Spectrometer) instrument onboard the Astro-E2 spacecraft. A key factor is that MgB2 remains superconducting up to 30 K, which means that it does not introduce joule heating as a resistive wire would. Because the required temperature ranges are 1.3-17 K, this provides a large margin of safety. Previous designs lost superconductivity at around 8 K. The disadvantage to MgB2 is that it is a brittle ceramic, and making thin wires from it is challenging. The solution was to encase the leads in thin steel tubes for strength. Previous designs were so brittle as to risk instrument survival. MgB2 leads can be used in any cryogenic application where small currents need to be conducted at below 30 K. Because previous designs would superconduct only at up to 8 K, this new design would be ideal for the 8-30 K range.

  5. Temperature compensated and self-calibrated current sensor using reference current (United States)

    Yakymyshyn, Christopher Paul; Brubaker, Michael Allen; Yakymyshyn, Pamela Jane


    A method is described to provide temperature compensation and self-calibration of a current sensor based on a plurality of magnetic field sensors positioned around a current carrying conductor. A reference electrical current carried by a conductor positioned within the sensing window of the current sensor is used to correct variations in the output signal due to temperature variations and aging.

  6. Current Automotive Holometry Studies (United States)

    Marchi, Mitchell M.; Snyder, D. S.


    Holometry studies of automotive body and powertrain components have become a very useful high resolution test methodology to knowledgeable Ford engineering personnel. Current examples of studies that represent the static or dynamic operational conditions of the automotive test component are presented. Continuous wave laser holometry, computer aided holometry (CAH) and pulsed laser holometry were the holometric techniques used to study the following subjects: (1) body in prime (BIP) vibration modes, (2) transmission flexplate stud-torque converter deformation due to engine torque pulses, (3) engine cylinder head and camshaft support structure deformation due to cylinder pressure and (4) engine connecting rod/cap lift-off. Static and dynamic component loading and laboratory techniques required to produce usable and valid test results are discussed along with possible conclusions for the engineering concerns.

  7. Current distribution among layers of single phase HTS cable conductor

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Y.B., E-mail: [Key Laboratory of HV and EMC Beijing, State Key Laboratory for Alternate Electrical Power System with Renewable Energy Sources, North China Electric Power University, No. 2 Beinong Road, Changping District, Beijing 102206 (China); Wang, Y.S., E-mail: [Key Laboratory of HV and EMC Beijing, State Key Laboratory for Alternate Electrical Power System with Renewable Energy Sources, North China Electric Power University, No. 2 Beinong Road, Changping District, Beijing 102206 (China); Pi, W., E-mail: [Key Laboratory of HV and EMC Beijing, State Key Laboratory for Alternate Electrical Power System with Renewable Energy Sources, North China Electric Power University, No. 2 Beinong Road, Changping District, Beijing 102206 (China); Ju, P., E-mail: [Key Laboratory of HV and EMC Beijing, State Key Laboratory for Alternate Electrical Power System with Renewable Energy Sources, North China Electric Power University, No. 2 Beinong Road, Changping District, Beijing 102206 (China); Wang, Y.S., E-mail: [Power System Department, China Electric Power Research Institute, No. 15 Qinghexiaoying East Road, Haidian District, Beijing 100198 (China)


    Highlights: • A 1.5 m long HTS model cable with 4 layers designed by the uniform current principle has been built. • It is testified that the current distribution is influenced by the proximity effect. • The magnetic flux density and current density have been analyzed. • AC losses of tested current are larger than those of uniform current. - Abstract: High temperature superconducting (HTS) power cable shows high application prospect in modern power transmission, as it is superior over conventional transmission lines in high engineering current density and environmental friendliness. Its configuration is generally composed of several HTS layers designed with the principle of uniform current distribution, but there are few experimental results to verify the distribution. In this paper, a HTS cable model was designed based on the principle of uniform current, and the current distributions among layers in an HTS cable model were measured by Rogowski coils. The results provide an important basis for design of multi-layer HTS cable.

  8. Controlled current inductors (United States)

    Thaler, S.


    Magnetic permeability and shape of special core inserts are varied to produce desired changes in saturation characteristics of current dependent inductor, thus improving its inductance-to-current properties. Materials and saturation levels of the core pieces are selected to permit a wide variety of relationships between inductance and current.

  9. Priority Based Prediction Mechanism for Ranking Providers in Federated Cloud Architecture

    Directory of Open Access Journals (Sweden)



    Full Text Available In Current trends the Cloud computing has a lot of potential to help hospitals cut costs, a new report says. Here‟s some help overcoming some of the challenges hiding in the cloud. Previously there several methods are available for this like Broker based trust architecture and etc. Health care framework which are patient, doctor, symptom and disease. In this paper we are going to discuss the broker based architecture for federated cloud and its Service Measurement Index considered for evaluating the providers,construction of Grade Distribution Table(GDT,concept of ranking the providers based on prediction weights comparison, optimal service provider selection and results discussion compared with existing techniques available for ranking the providers. In this paper we are going to propose, two different ranking mechanisms to sort the providers and select the optimal provider automatically. Grade distribution ranking model is proposed by assigning the grade for the providers based on the values of SMI attributes, based on the total grade value, providers falls on either Gold, Silver or Bronze. Each category applies the quick sort to sort the providers and find the provider at the top is optimal. If there is more than one provider at the top, apply priority feedback based decision tree and find the optimal provider for the request. In the second ranking mechanism, joint probability distribution mechanism is used to rank the providers, two providers having same score, apply priority feedback based decision tree and find the optimal provider for the request.

  10. GAUSS Project Trials Results (United States)

    Di Fazio, Antonella; Vernucci, Antonio; Rossini, Eugenio


    the Consortium Partners. The former ones constitute the ground and space segments, the latter ones include the advanced user terminal and the applications. The assembled system was used as test-bed during the trail campaign, to validate and prove the provided services and developed applications.The GAUSS Demonstrator includes the following components:ß The Mobile User Terminal installed on a car (van) or on a boat. An innovative multi-mode user equipment was developed, consisting of the following main components:- An integrated NAV / COM digital receive front-end (DFRE), able to de-multiplex the NAV signals (the current GNSS1 band and the simulated Galileo bands), and the COM signal in the S-UMTS band;- For COM: a transmit front-end, and a baseband & control section operating in CDMA and supporting the upper protocol layers (UMTS packet transmission standard based - for short packet); a RF subsystem, including the L→S bands conversion;- For NAV: a GNSS (GPS, EGNOS) navigation receiver, the GNSS1 System (MTB - Mediterranean Test bed, ESTB / EGNOS System Test Bed) for navigation;* The Communication capacity on the INMARSAT 3F5 Satellite* The Gateway, located in LARIO Telespazio premises* The Lario07 Station* The Service Centre* The Service Provider.The GAUSS Demonstrator reflects all the main elements of a complete user platform for service provisioning: mobility assistance, safety and transport efficient management are the core of the developed applications. Applications were developed, specifically to provide reliable and effective services to the citizens: road info-mobility and fleet management, inland waterways vessel traffic management and information, port/terminals appointment monitoring & control, dangerous goods transhipment supervision, emergency assistance.A trial campaign, run into real environments, was performed in Summer 2002. GAUSS Demonstrator performances and benefits were validated with the direct involvement of an inter-modal transport user

  11. Current phase relation in nanowire based Josephson junctions (United States)

    Szombati, Daniel; Nadj-Perge, Stevan; Geresdi, Attila; Mourik, Vincent; Zuo, Kun; Woerkom, David; Car, Diana; Bakkers, Erik; Kouwenhoven, Leo


    Junctions based on small band-gap nanowires are convenient platform for studying Josephson effect in the presence of strong spin-orbit coupling. As predicted by theory, due to the interplay between strong Zeeman interaction and large spin orbing coupling in these nanowires, the critical current and in particular current phase relation exhibits rich set of features in the presence of external magnetic field and electrostatic gating. We study supercurrent transport through Indium Antimonide nanowires contacted using Niobium-Titanium-Nitride leads using both current and phase bias measurements. Our results provide useful insights into superconductor/semiconductor hybrid systems capable of hosting Majorana fermions, potential building blocks for topological quantum computing.

  12. Decomposition of residue currents


    Andersson, Mats; Wulcan, Elizabeth


    Given a submodule $J\\subset \\mathcal O_0^{\\oplus r}$ and a free resolution of $J$ one can define a certain vector valued residue current whose annihilator is $J$. We make a decomposition of the current with respect to Ass$(J)$ that correspond to a primary decomposition of $J$. As a tool we introduce a class of currents that includes usual residue and principal value currents; in particular these currents admit a certain type of restriction to analytic varieties and more generally to construct...

  13. Bioartificial liver: current status. (United States)

    Pless, G; Sauer, I M


    Liver failure remains a life-threatening syndrome. With the growing disparity between the number of suitable donor organs and the number of patients awaiting transplantation, efforts have been made to optimize the allocation of organs, to find alternatives to cadaveric liver transplantation, and to develop extracorporeal methods to support or replace the function of the failing organ. An extracorporeal liver support system has to provide the main functions of the liver: detoxification, synthesis, and regulation. The understanding that the critical issue of the clinical syndrome in liver failure is the accumulation of toxins not cleared by the failing liver led to the development of artificial filtration and adsorption devices (artificial liver support). Based on this hypothesis, the removal of lipophilic, albumin-bound substances, such as bilirubin, bile acids, metabolites of aromatic amino acids, medium-chain fatty acids, and cytokines, should be beneficial to the clinical course of a patient in liver failure. Artificial detoxification devices currently under clinical evaluation include the Molecular Adsorbent Recirculating System (MARS), Single-Pass Albumin Dialysis (SPAD), and the Prometheus system. The complex tasks of regulation and synthesis remain to be addressed by the use of liver cells (bioartificial liver support). The Extracorporeal Liver Assist Device (ELAD), HepatAssist, Modular Extracorporeal Liver Support system (MELS), and the Amsterdam Medical Center Bioartificial Liver (AMC-BAL) are bioartificial systems. This article gives a brief overview on these artificial and bioartificial devices and discusses remaining obstacles.

  14. Renal autotransplantation: current perspectives. (United States)

    Stewart, B H; Banowsky, L H; Hewitt, C B; Straffon, R A


    Autotransplantation, with or without an extracorporeal renal operation, has been done 39 times in 37 patients. Indications for the procedure included severe ureteral injury in 4 patients, failed supravesical diversion in 2, renal carcinoma in a solitary kidney in 1, renovascular hypertension in 1 and donor arterial reconstruction before renal transplantation in 29. Success was obtained in all but 2 procedures, both of which involved previously operated kidneys with severe inflammation and adhesions involving the renal pelvis and pedicle. Based on our experience and a review of currently available literature we believe that renal autotransplantation and extracorporeal reconstruction can provide the best solution for patients with severe renovascular and ureteral disease not correctable by conventional operative techniques. The technique can be of particular value in removing centrally located tumors in solitary kidneys and in preparing donor kidneys with abnormal arteries for renal transplantation. The role of autotransplantation in the management of advanced renal trauma and calculus disease is less clear. A long-term comparison of patients treated by extracorporeal nephrolithotomy versus conventional lithotomy techniques will be necessary before a conclusion is reached in these disease categories.

  15. Investigation on a new inducer of pulsed eddy current thermography (United States)

    He, Min; Zhang, Laibin; Zheng, Wenpei; Feng, Yijing


    In this paper, a new inducer of pulsed eddy current thermography (PECT) is presented. The use of the inducer can help avoid the problem of blocking the infrared (IR) camera's view in eddy current thermography technique. The inducer can also provide even heating of the test specimen. This paper is concerned with the temperature distribution law around the crack on a specimen when utilizing the new inducer. Firstly, relative mathematical models are provided. In the following section, eddy current distribution and temperature distribution around the crack are studied using the numerical simulation method. The best separation distance between the inducer and the specimen is also determined. Then, results of temperature distribution around the crack stimulated by the inducer are gained by experiments. Effect of current value on temperature rise is studied as well in the experiments. Based on temperature data, temperature features of the crack are discussed.

  16. Investigation on a new inducer of pulsed eddy current thermography

    Directory of Open Access Journals (Sweden)

    Min He


    Full Text Available In this paper, a new inducer of pulsed eddy current thermography (PECT is presented. The use of the inducer can help avoid the problem of blocking the infrared (IR camera’s view in eddy current thermography technique. The inducer can also provide even heating of the test specimen. This paper is concerned with the temperature distribution law around the crack on a specimen when utilizing the new inducer. Firstly, relative mathematical models are provided. In the following section, eddy current distribution and temperature distribution around the crack are studied using the numerical simulation method. The best separation distance between the inducer and the specimen is also determined. Then, results of temperature distribution around the crack stimulated by the inducer are gained by experiments. Effect of current value on temperature rise is studied as well in the experiments. Based on temperature data, temperature features of the crack are discussed.

  17. Logistic service providers and sustainable physical distribution

    Directory of Open Access Journals (Sweden)

    Stef Weijers


    Full Text Available Background: Logistic Service Providers main concern was to ensure reliability for a low price (Christopher, 2005. Dutch Logistic Service Providers still have these two aspects at the top of their list, but also have to take in a new aspect: sustainability. 88% Of the investigated Logistic Service Providers have included sustainability in the company's goals. These Logistic Service Providers have developed different strategies to achieve a higher level of sustainability. This paper presents the results of a study into what Logistic Service Providers say what they are doing, or intend to do, to improve sustainability for their transport services. In this way insight is given in the attitude of Dutch Logistic Service Providers towards sustainability and how they intend to translate this into business practise: internal solutions or new methods incorporating external partners. Methods: Various methods of the investigations were used, among which the analysis of the statements about the sustainabilityon the websites of various companies as well as the questionnaire per Internet. The research covered 50 largest logistics companies operating in the Netherlands and 60 companies that competed for the award "Lean and Green" advertised in the Netherlands. In addition, the Internet survey was answered by 41 companies that belong to the network of our university. Results: The investigation has shown that sustainability is handled by the logistics company as an integral part of the corporate strategy. In contrast, shippers depend in the choice of logistics services primarily on such classical aspects as the reliability or the price and the sustainability play a minor role. Conclusions: Trying to find methods to improve the sustainability, Dutch logistics service providers, in the first place, look for solutions that increase the efficiency and therefore the cost reduction potential. Solutions, which require the involvement of clients, were less often

  18. On current termination in rotamak discharges

    Energy Technology Data Exchange (ETDEWEB)

    Donaldson, N.; Euripides, P.; Jones, I.R.; Xu, S. [Flinders Univ. of South Australia, Bedford Park, SA (Australia). School of Physical Sciences


    A new series of rotamak experiments conducted in a 50 litre spherical pyrex discharge vessel is described. An analysis of the results, together with that of previous results from a smaller, 10 litre vessel, provides an explanation for the current termination phenomenon which is such a noteworthy and characteristic feature of all rotamak discharges studied to date. It is shown that the amplitude of the applied rotating magnetic field, B{sub {omega}}, has to be greater than a certain critical value, B{sub {omega}}{sup crit}, for the rotamak discharge to be maintained. Provided B{sub {omega}} {>=} B{sub {omega}}{sup crit}, the properties of the discharge are then determined by the behaviour of the circuit used to couple the RF generators to the plasma load. The conditions necessary for the production of a compact toroidal magnetic configuration are presented. (author).

  19. Compassion fatigue among pediatric healthcare providers. (United States)

    Branch, Carole; Klinkenberg, Dean


    Compassion fatigue is a term used to describe the unique stressors affecting people in caregiving professions. For nurses and other direct care providers, the impact of compassion fatigue may result in stress-related symptoms, job dissatisfaction, decreased productivity, decreased patient satisfaction scores, safety issues, and job turnover. Those who care for seriously ill children and their families are at increased risk for compassion fatigue. Constant exposure to children who are suffering, in combination with work place stressors and personal issues, may contribute to the development of compassion fatigue. The Professional Quality of Life Scale Version 5 was used to determine the risk for compassion fatigue among 296 direct care providers at St. Louis Children's Hospital. Compassion satisfaction, burnout, and secondary traumatic stress scores did not differ by age, work category, level of education, or work experience. There were, however, significant differences in scores as a function of nursing unit. Nurses who work in the pediatric intensive care unit reported lower compassion satisfaction scores, and higher burnout and secondary traumatic stress scores. Results demonstrated the risk for compassion fatigue and provided data necessary to support development of a compassion fatigue program for direct care providers.

  20. High Temperature, Through the Case Eddy Current Sensor for Blade Vibration Measurements Project (United States)

    National Aeronautics and Space Administration — Preliminary results have shown that low temperature eddy current sensors can provide excellent resolution for blade tip timing, and have the ability to see ?through...

  1. Integrating data converters for picoampere currents from electrochemical transducers

    DEFF Research Database (Denmark)

    Breten, Madalina; Lehmann, Torsten; Bruun, Erik


    This paper describes a current mode A/D converter designed for a maximum input current range of 5 nA and a resolution of the order of 1 pA. The converter is designed for a potentiostat for amperometric chemical sensors and provides a constant polarization voltage for the measuring electrode....... A prototype chip using the dual slope conversion method has been fabricated in a 0.7 μm CMOS process. Experimental results from this converter are reported. Design problems and limitations of the converter are discussed and a new conversion technique providing a larger dynamic range and easy calibration...

  2. Current evidence for osteoarthritis treatments. (United States)

    Anandacoomarasamy, Ananthila; March, Lyn


    Osteoarthritis (OA) is the most common form of arthritis and the leading cause of chronic disability among older people. The burden of the disease is expected to rise with an aging population and the increasing prevalence of obesity. Despite this, there is as yet no cure for OA. However, in recent years, a number of potential therapeutic advances have been made, in part due to improved understanding of the underlying pathophysiology. This review provides the current evidence for symptomatic management of OA including nonpharmacological, pharmacological and surgical approaches. The current state of evidence for disease-modifying therapy in OA is also reviewed.

  3. Cartography and Population Geography as Current Events: A Case Study (United States)

    Comenetz, Joshua


    The Sanders housing lawsuit in Pennsylvania provides a case study of how to incorporate current events into the teaching of cartography or population geography at the high school or college level. Settlement of the Sanders case resulted in the release of information about the segregation of public housing by race in the Pittsburgh area. The issues…

  4. Quality Business Service Provider in Community Enterprise

    Directory of Open Access Journals (Sweden)

    Chalard Chantarasombat


    Full Text Available Problem statement: The development of community enterprises focuses on the development of service providers for commercial industries and community enterprises and it is necessary to create and extend the development according to the changing global conditions. The department of industrial promotion and industry promotion center region 5, Khon Kaen must create and develop the quality of service providers in community enterprises as an exclusive course to find a model and development guideline in effective operations that is efficient and appropriate according to the particular community. Approach: The objectives of this research were: (1 to recruit and select at least 15 individuals to participate in the training of service providers in community enterprise in Kalasin province. (2 To define the structure, content, create a curriculum and development of service providers in community enterprise. (3 To develop the participants basic skills training, create motivation, learning experience through on the job training and business management and capability in the diagnosing the cause of problems. (4 To develop the participants understanding of community product standards and provide advice and consultation on the preparation and application of manufacturing standard certification of community products, community enterprise management and provide advice in the implementation of management standards of community enterprises. (5 Satisfaction of the participants training in service providers in community enterprise. Results: 29 people applied for the training program and 26 passed evaluation which was higher than the target of 15 individuals. The theoretical training courses prior to the training had an overall average of 5.06 and after the training had an average of 15.80, the average progress was 10.74. The exercise training through on the job training was regarded as a vocational skill and hand an average of 5.27 before the training. After the

  5. Effect of current density on the morphology of Zn electrodeposits

    Institute of Scientific and Technical Information of China (English)

    Ailing Fan; Wenhuai Tian; M. Kurosaki


    The effect of current density on the morphology of Zn electrodeposits prepared by a flow-channel cell was investigated by scanning electron microscopy (SEM). It was found that the morphology of Zn electrodeposits evolves from thin-layered hexagonal η-phase crystals to pyramidal η-phase particles with increasing the current density. The morphological evolution at various flow rates was also examined and the results show that the morphological evolution at a lower flow rate is more remarkable than that at a higher flow rate with increasing the current density. To reveal the mechanism of the morphological evolution in detail, the atomic configuration on both (0001)η and { 1100 }η planes under different current densities was investigated, it was noted that a specify current density could provide a good condition for the layered epitaxial growth of hexagonal η-phase.

  6. Microbiome engineering: Current applications and its future. (United States)

    Foo, Jee Loon; Ling, Hua; Lee, Yung Seng; Chang, Matthew Wook


    Microbiomes exist in all ecosystems and are composed of diverse microbial communities. Perturbation to microbiomes brings about undesirable phenotypes in the hosts, resulting in diseases and disorders, and disturbs the balance of the associated ecosystems. Engineering of microbiomes can be used to modify structures of the microbiota and restore ecological balance. Consequently, microbiome engineering has been employed for improving human health and agricultural productivity. The importance and current applications of microbiome engineering, particularly in humans, animals, plants and soil is reviewed. Furthermore, we explore the challenges in engineering microbiome and the future of this field, thus providing perspectives and outlook of microbiome engineering.

  7. Ocular tuberculosis: current perspectives

    Directory of Open Access Journals (Sweden)

    Shakarchi FI


    Full Text Available Faiz I Shakarchi1,21Ibn Al-Haetham Teaching Eye Hospital, 2Department of Opthalmology, Medical College, Al-Mustansiriya University, Baghdad, IraqAbstract: The World Health Organization currently estimates that nearly two billion people, or one-third of the world’s population, are infected by tuberculosis, and that roughly 10% of the infected people are symptomatic. Tuberculosis affects the lungs in 80% of patients, while in the remaining 20% the disease may affect other organs, including the eye. Uveitis can be seen concurrently with tuberculosis, but a direct association is difficult to prove. Ocular tuberculosis is usually not associated with clinical evidence of pulmonary tuberculosis, as up to 60% of extrapulmonary tuberculosis patients may not have pulmonary disease. The diagnosis of tuberculous uveitis is often problematic and in nearly all reported cases, the diagnosis was only presumptive. Tuberculous uveitis is a great mimicker of various uveitis entities and it can be considered in the differential diagnosis of any type of intraocular inflammation. It is still unknown if ocular manifestations result from a direct mycobacterium infection or hypersensitivity reaction and this is reflected on the management of tuberculous uveitis. Prevalence of tuberculosis as an etiology of uveitis may reach up to 10% in endemic areas. Tuberculous uveitis is a vision-threatening disease that inevitably leads to blindness if not properly diagnosed and treated. The aim of this review is to illustrate the various clinical features and management of presumed tuberculous uveitis. The current review focuses on the diagnostic criteria, significance of tuberculin skin test, and use of systemic corticosteroids in the management of tuberculous uveitis as recommended in recent publications.Keywords: tuberculosis, uveitis, choroiditis, tuberculin skin test

  8. A Hepatitis C Educational Needs Assessment of Canadian Healthcare Providers. (United States)

    Naghdi, Reza; Seto, Karen; Klassen, Carolyn; Emokpare, Didi; Conway, Brian; Kelley, Melissa; Yoshida, Eric; Shah, Hemant A


    Background and Aim. Despite advances in the treatment of chronic hepatitis C infection (CHC), it remains a major public health problem in Canada and globally. The knowledge of healthcare providers (HCPs) is critical to improve the care of CHC in Canada. To assess the current knowledge and educational needs of healthcare providers (HCPs) in the area of CHC management a national online survey was conducted. Method. An interprofessional steering committee designed a 29-question survey distributed through various direct and electronic routes. The survey assessed several domains (e.g., participant and practice demographics, access to resources, knowledge of new treatments, and educational preferences). Results. A total of 163 HCPs responded to the survey. All hepatologists and 8% of primary care providers (PCPs) reported involvement in treatment of CHC. Physicians most frequently screened patients who had abnormal liver enzymes, while nurses tended to screen based on lifestyle factors. More than 70% of PCPs were not aware of new medications and their mechanisms. Conclusion. Overall, the needs assessment demonstrated that there was a need for further education, particularly for primary care physicians, to maximize the role that they can play in screening, testing, and treatment of hepatitis C in Canada.

  9. Current trends in minilaparoscopy. (United States)

    Small Layne, Alyssa; Pinkard, Lauren; Shepherd, Jessica


    The purpose of this review is to understand the current use of minilaparoscopy in the field and how minilaparoscopy compares with traditional laparoscopy in terms of operative times, complications, pain, and cosmesis. Although there are few randomized controlled trials comparing minilaparoscopy with traditional laparoscopy in gynecologic procedures, the results suggest that minilaparoscopy can be performed safely with improved cosmetic outcomes and similar complication rates and operating times. Postoperative pain may be decreased with minimizing incisions sizes. Recently, case reports and case series have been published demonstrating the use of minilaparoscopy across many subtypes of gynecologic surgery. Traditional laparoscopic surgery has become common practice in gynecology as it has been found to be a well tolerated procedure with improved outcomes and decreased morbidity when compared with laparotomy. Although minilaparoscopy has been used for over 2 decades, its role in gynecology is continuing to evolve. Minilaparoscopy is a growing surgical option in gynecology as we try to minimize the impact of surgery. Results of minilaparoscopy in gynecology mirror those found in urology and general surgery. Although research is limited, minilaparoscopy has proven to be a well tolerated alternative for gynecology.

  10. Analysis of current state and prospects of steel production development (United States)

    Protopopov, E. V.; Feyler, S. V.


    Data on world production of steel in the XXI century are provided. Analysis of current state and prospects of ferrous metallurgy development in the Russian Federation is carried out. Results of national steel production performance during 10 months of the year 2015 are given for different countries. Analysis of the main directions of metallurgical equipment import substitution aimed at technological independence in the industry is made. Russian ferrous metallurgy development predictions in its’ main directions up to 2030 is provided.

  11. The LHC Fast Beam Current change Monitor

    CERN Document Server

    Belohrad, D; Jensen, L; Krupa, M; Topaloudis, A


    The modularity of the Large Hadron Collider’s (LHC) machine protection system (MPS) allows for the integration of several beam diagnostic instruments. These instruments have not necessarily been designed to have protection functionality, but MPS can still use them to increase the redundancy and reliability of the machine. The LHC fast beam current change monitor (FBCCM) is an example. It is based on analogue signals from fast beam current transformers (FBCT) used nominally to measure the LHC bunch intensities. The FBCCM calculates the magnitude of the beam signal provided by the FBCT, looks for a change over specific time intervals, and triggers a beam dump interlock if losses exceed an energy-dependent threshold. The first prototype of the FBCCM was installed in the LHC during the 2012-2013 run. The aim of this article is to present the FBCCM system and the results obtained, analyse its current performance and provide an outlook for the final system which is expected to be operational after the long LHC sh...

  12. Ecosystem function and services provided by the deep sea (United States)

    Thurber, A. R.; Sweetman, A. K.; Narayanaswamy, B. E.; Jones, D. O. B.; Ingels, J.; Hansman, R. L.


    The deep sea is often viewed as a vast, dark, remote, and inhospitable environment, yet the deep ocean and seafloor are crucial to our lives through the services that they provide. Our understanding of how the deep sea functions remains limited, but when treated synoptically, a diversity of supporting, provisioning, regulating and cultural services becomes apparent. The biological pump transports carbon from the atmosphere into deep-ocean water masses that are separated over prolonged periods, reducing the impact of anthropogenic carbon release. Microbial oxidation of methane keeps another potent greenhouse gas out of the atmosphere while trapping carbon in authigenic carbonates. Nutrient regeneration by all faunal size classes provides the elements necessary for fueling surface productivity and fisheries, and microbial processes detoxify a diversity of compounds. Each of these processes occur on a very small scale, yet considering the vast area over which they occur they become important for the global functioning of the ocean. The deep sea also provides a wealth of resources, including fish stocks, enormous bioprospecting potential, and elements and energy reserves that are currently being extracted and will be increasingly important in the near future. Society benefits from the intrigue and mystery, the strange life forms, and the great unknown that has acted as a muse for inspiration and imagination since near the beginning of civilization. While many functions occur on the scale of microns to meters and timescales up to years, the derived services that result are only useful after centuries of integrated activity. This vast dark habitat, which covers the majority of the globe, harbors processes that directly impact humans in a variety of ways; however, the same traits that differentiate it from terrestrial or shallow marine systems also result in a greater need for integrated spatial and temporal understanding as it experiences increased use by society. In

  13. Current limiter circuit system

    Energy Technology Data Exchange (ETDEWEB)

    Witcher, Joseph Brandon; Bredemann, Michael V.


    An apparatus comprising a steady state sensing circuit, a switching circuit, and a detection circuit. The steady state sensing circuit is connected to a first, a second and a third node. The first node is connected to a first device, the second node is connected to a second device, and the steady state sensing circuit causes a scaled current to flow at the third node. The scaled current is proportional to a voltage difference between the first and second node. The switching circuit limits an amount of current that flows between the first and second device. The detection circuit is connected to the third node and the switching circuit. The detection circuit monitors the scaled current at the third node and controls the switching circuit to limit the amount of the current that flows between the first and second device when the scaled current is greater than a desired level.

  14. Current-Mode CMOS A/D Converter for pA to nA Input Currents

    DEFF Research Database (Denmark)

    Breten, Madalina; Lehmann, Torsten; Bruun, Erik


    . A prototype chip using the dual slope conversion method has been fabricated in a 0.7micron CMOS process. Experimental results from this converter are reported. Design problems and limitations of the converter are discussed and a new conversion technique providing a larger dynamic range and easy calibration......This paper describes a current mode A/D converter designed for a maximum input current range of 5nA and a resolution of the order of 1pA. The converter is designed for a potentiostat for amperometric chemical sensors and provides a constant polarization voltage for the measuring electrode...

  15. Parents? perceptions of provider communication regarding adolescent vaccines


    Dempsey, Amanda F; Pyrzanowski, Jennifer; Lockhart, Steven; Campagna, Elizabeth; Barnard, Juliana; O'Leary, Sean T.


    Strong provider recommendations for adolescent vaccines are critical for achieving high vaccination levels.? However, little is known about parents? preferred provider communication strategies for adolescent vaccines in general, and for human papillomavirus (HPV) vaccines specifically. We performed a cross-sectional survey of 800 parents of 9-14 year olds in April 2014 to assess current adolescent vaccine communication practices by providers, parents? preferred HPV vaccine-specific communicat...

  16. Metagenomes provide valuable comparative information on soil microeukaryotes

    DEFF Research Database (Denmark)

    Jacquiod, Samuel Jehan Auguste; Stenbæk, Jonas; Santos, Susana


    , providing microbiologists with substantial amounts of accessible information. We took advantage of public metagenomes in order to investigate microeukaryote communities in a well characterized grassland soil. The data gathered allowed the evaluation of several factors impacting the community structure...... has been identified. Our analyses suggest that publicly available metagenome data can provide valuable information on soil microeukaryotes for comparative purposes when handled appropriately, complementing the current view provided by ribosomal amplicon sequencing methods....

  17. Quantization of interface currents

    Energy Technology Data Exchange (ETDEWEB)

    Kotani, Motoko [AIMR, Tohoku University, Sendai (Japan); Schulz-Baldes, Hermann [Department Mathematik, Universität Erlangen-Nürnberg, Erlangen (Germany); Villegas-Blas, Carlos [Instituto de Matematicas, Cuernavaca, UNAM, Cuernavaca (Mexico)


    At the interface of two two-dimensional quantum systems, there may exist interface currents similar to edge currents in quantum Hall systems. It is proved that these interface currents are macroscopically quantized by an integer that is given by the difference of the Chern numbers of the two systems. It is also argued that at the interface between two time-reversal invariant systems with half-integer spin, one of which is trivial and the other non-trivial, there are dissipationless spin-polarized interface currents.

  18. Low current beam techniques

    Energy Technology Data Exchange (ETDEWEB)

    Saint, A.; Laird, J.S.; Bardos, R.A.; Legge, G.J.F. [Melbourne Univ., Parkville, VIC (Australia). School of Physics; Nishijima, T.; Sekiguchi, H. [Electrotechnical Laboratory, Tsukuba (Japan).


    Since the development of Scanning Transmission Microscopy (STIM) imaging in 1983 many low current beam techniques have been developed for the scanning (ion) microprobe. These include STIM tomography, Ion Beam Induced Current, Ion Beam Micromachining and Microlithography and Ionoluminense. Most of these techniques utilise beam currents of 10{sup -15} A down to single ions controlled by beam switching techniques This paper will discuss some of the low beam current techniques mentioned above, and indicate, some of their recent applications at MARC. A new STIM technique will be introduced that can be used to obtain Z-contrast with STIM resolution. 4 refs., 3 figs.

  19. Surveying rip current survivors: preliminary insights into the experiences of being caught in rip currents (United States)

    Drozdzewski, D.; Shaw, W.; Dominey-Howes, D.; Brander, R.; Walton, T.; Gero, A.; Sherker, S.; Goff, J.; Edwick, B.


    This paper begins a process of addressing a significant gap in knowledge about people's responses to being caught in rip currents. While rip currents are the primary hazard facing recreational ocean swimmers in Australia, debate exists about the best advice to give swimmers caught in rip currents. Such surf rescue advice - on what to do and how to respond when caught in a rip - relies on empirical evidence. However, at present, knowledge about swimmers reactions and responses to rip currents is limited. This gap is a considerable barrier to providing effective advice to beach goers and to understanding how this advice is utilised (or not) when actually caught in the rip current. This paper reports the findings of a pilot study that focussed on garnering a better understanding of swimmers' experiences when caught in rip currents. A large scale questionnaire survey instrument generated data about rip current survivors' demographics, knowledge of beach safety and their reactions and responses when caught in a rip current. A mix of online and paper surveys produced a total of 671 completed surveys. Respondents were predominantly an informed group in terms of rip current knowledge, beach experience and had a high self-rated swimming ability. Preliminary insights from the survey show that most respondents recalled a "swim across the rip/parallel to the beach" message when caught in the rip and most escaped unassisted by acting on this message. However, while nearly a quarter of respondents recalled a message of "not to panic", short answer responses revealed that the onset of panic inhibited some respondents from recalling or enacting any other type of beach safety message when caught in the rip current. Results also showed that despite the research sample being younger, competent and frequent ocean swimmers, they were more likely to swim at unpatrolled beaches and outside of the red and yellow safety flags. Moreover, they were still caught in a rip current and they

  20. Surveying rip current survivors: preliminary insights into the experiences of being caught in rip currents

    Directory of Open Access Journals (Sweden)

    D. Drozdzewski


    Full Text Available This paper begins a process of addressing a significant gap in knowledge about people's responses to being caught in rip currents. While rip currents are the primary hazard facing recreational ocean swimmers in Australia, debate exists about the best advice to give swimmers caught in rip currents. Such surf rescue advice – on what to do and how to respond when caught in a rip – relies on empirical evidence. However, at present, knowledge about swimmers reactions and responses to rip currents is limited. This gap is a considerable barrier to providing effective advice to beach goers and to understanding how this advice is utilised (or not when actually caught in the rip current.

    This paper reports the findings of a pilot study that focussed on garnering a better understanding of swimmers' experiences when caught in rip currents. A large scale questionnaire survey instrument generated data about rip current survivors' demographics, knowledge of beach safety and their reactions and responses when caught in a rip current. A mix of online and paper surveys produced a total of 671 completed surveys. Respondents were predominantly an informed group in terms of rip current knowledge, beach experience and had a high self-rated swimming ability. Preliminary insights from the survey show that most respondents recalled a "swim across the rip/parallel to the beach" message when caught in the rip and most escaped unassisted by acting on this message. However, while nearly a quarter of respondents recalled a message of "not to panic", short answer responses revealed that the onset of panic inhibited some respondents from recalling or enacting any other type of beach safety message when caught in the rip current. Results also showed that despite the research sample being younger, competent and frequent ocean swimmers, they were more likely to swim at unpatrolled beaches and outside of the red and yellow safety flags. Moreover, they were still

  1. Overview of MAST results (United States)

    Counsell, G. F.; Akers, R. J.; Appel, L. C.; Applegate, D.; Axon, K. B.; Baranov, Y.; Brickley, C.; Bunting, C.; Buttery, R. J.; Carolan, P. G.; Challis, C.; Ciric, D.; Conway, N. J.; Cox, M.; Cunningham, G.; Darke, A.; Dnestrovskij, A.; Dowling, J.; Dudson, B.; Dunstan, M. R.; Delchambre, E.; Field, A. R.; Foster, A.; Gee, S.; Gryaznevich, M. P.; Helander, P.; Hender, T. C.; Hole, M.; Howell, D. H.; Joiner, N.; Keeling, D.; Kirk, A.; Lehane, I. P.; Lisgo, S.; Lloyd, B.; Lott, F.; Maddison, G. P.; Manhood, S. J.; Martin, R.; McArdle, G. J.; McClements, K. G.; Meyer, H.; Morris, A. W.; Nelson, M.; O'Brien, M. R.; Patel, A.; Pinfold, T.; Preinhaelter, J.; Price, M. N.; Roach, C. M.; Rozhansky, V.; Saarelma, S.; Saveliev, A.; Scannell, R.; Sharapov, S.; Shevchenko, V.; Shibaev, S.; Stammers, K.; Storrs, J.; Sykes, A.; Tabasso, A.; Tallents, S.; Taylor, D.; Tournianski, M. R.; Turner, A.; Turri, G.; Valovic, M.; Volpe, F.; Voss, G.; Walsh, M. J.; Watkins, J. R.; Wilson, H. R.; Wisse, M.; MAST, the; NBI; ECRH Teams


    . Early edge localized mode activity on MAST is associated with the formation of narrow filamentary structures following field lines in the edge. These filaments rotate toroidally with the edge plasma and, away from the X-points, accelerate radially outwards from the edge up to 20 cm. Studies of disruptions on MAST demonstrate a complex evolution of core energy loss and resultant divertor power loads, including phases where the target heat flux width is broadened by a factor of 8. Observations of energetic particle modes driven by super-Alfvénic beam ions provide support for a model for the non-linear evolution of toroidal Alfvén eigenmodes (AEs) forming Bernstein-Green-Krushal waves. The AE activity reduces to low levels with increasing β. Plasma start-up without a central solenoid and in a manner compatible with future large spherical tokamak (ST) devices has been demonstrated using breakdown at a quadrupole magnetic null. Closed flux surface plasmas with peak plasma currents up to 370 kA have been generated and sustained for 0.3 s. New error field correction coils have extended the operational space for low density plasmas and enabled scaling studies of error field induced locked mode formation in the ST.

  2. Final results from the $\

    CERN Document Server

    Vidal-Sitjes, G


    An updated analysis of the full NOMAD data corresponding to approx 1.35 x 10 sup 6 charged current interactions has been performed to search for neutrino oscillations through nu subtau appearance. This document updates the recently published results on the nu submu -> nu subtau and nu submu -> nu sub e oscillations search in NOMAD with a unified analysis of the hadronic channels.

  3. Outpatient Provider Concentration and Commercial Colonoscopy Prices

    Directory of Open Access Journals (Sweden)

    Alexis Pozen PhD


    Full Text Available The objective was to evaluate the magnitude of various contributors to outpatient commercial colonoscopy prices, including market- and provider-level factors, especially market share. We used adjudicated fee-for-service facility claims from a large commercial insurer for colonoscopies occurring in hospital outpatient department or ambulatory surgery center from October 2005 to December 2012. Claims were matched to provider- and market-level data. Linear fixed effects regressions of negotiated colonoscopy price were run on provider, system, and market characteristics. Markets were defined as counties. There were 178 433 claims from 169 providers (104 systems. The mean system market share was 76% (SD = 0.34 and the mean real (deflated price was US$1363 (SD = 374, ranging from US$169 to US$2748. For every percentage point increase in a system or individual facility’s bed share, relative price increased by 2 to 4 percentage points; this result was stable across a number of specifications. Market population and price were also consistently positively related, though this relation was small in magnitude. No other factor explained price as strongly as market share. Price variation for colonoscopy was driven primarily by market share, of particular concern as the number of mergers increases in wake of the recession and the Affordable Care Act. Whether variation is justified by better quality care requires further research to determine whether quality is subsumed in prices.

  4. Outpatient provider concentration and commercial colonoscopy prices. (United States)

    Pozen, Alexis


    The objective was to evaluate the magnitude of various contributors to outpatient commercial colonoscopy prices, including market- and provider-level factors, especially market share. We used adjudicated fee-for-service facility claims from a large commercial insurer for colonoscopies occurring in hospital outpatient department or ambulatory surgery center from October 2005 to December 2012. Claims were matched to provider- and market-level data. Linear fixed effects regressions of negotiated colonoscopy price were run on provider, system, and market characteristics. Markets were defined as counties. There were 178,433 claims from 169 providers (104 systems). The mean system market share was 76% (SD = 0.34) and the mean real (deflated) price was US$1363 (SD = 374), ranging from US$169 to US$2748. For every percentage point increase in a system or individual facility's bed share, relative price increased by 2 to 4 percentage points; this result was stable across a number of specifications. Market population and price were also consistently positively related, though this relation was small in magnitude. No other factor explained price as strongly as market share. Price variation for colonoscopy was driven primarily by market share, of particular concern as the number of mergers increases in wake of the recession and the Affordable Care Act. Whether variation is justified by better quality care requires further research to determine whether quality is subsumed in prices.

  5. Optimal Current Transfer in Dendrites (United States)

    Bird, Alex D.


    Integration of synaptic currents across an extensive dendritic tree is a prerequisite for computation in the brain. Dendritic tapering away from the soma has been suggested to both equalise contributions from synapses at different locations and maximise the current transfer to the soma. To find out how this is achieved precisely, an analytical solution for the current transfer in dendrites with arbitrary taper is required. We derive here an asymptotic approximation that accurately matches results from numerical simulations. From this we then determine the diameter profile that maximises the current transfer to the soma. We find a simple quadratic form that matches diameters obtained experimentally, indicating a fundamental architectural principle of the brain that links dendritic diameters to signal transmission. PMID:27145441

  6. Minimax Current Density Coil Design

    CERN Document Server

    Poole, Michael; Lopez, Hector Sanchez; Ng, Michael; Crozier, Stuart; 10.1088/0022-3727/43/9/095001


    'Coil design' is an inverse problem in which arrangements of wire are designed to generate a prescribed magnetic field when energized with electric current. The design of gradient and shim coils for magnetic resonance imaging (MRI) are important examples of coil design. The magnetic fields that these coils generate are usually required to be both strong and accurate. Other electromagnetic properties of the coils, such as inductance, may be considered in the design process, which becomes an optimization problem. The maximum current density is additionally optimized in this work and the resultant coils are investigated for performance and practicality. Coils with minimax current density were found to exhibit maximally spread wires and may help disperse localized regions of Joule heating. They also produce the highest possible magnetic field strength per unit current for any given surface and wire size. Three different flavours of boundary element method that employ different basis functions (triangular elements...

  7. National Provider Identifier (NPI) planning and implementation fundamentals for providers and payers. (United States)

    Pickens, Scott; Solak, Jamie


    Federal HIPAA legislation mandates that the National Provider Identifier (NPI) be fully implemented across all healthcare entities between May 2005 and May 2007, or 2008 for small payers. Starting May 2005, healthcare providers will be eligible to obtain an NPI and use these numbers to submit claims or conduct other transactions specified by HIPAA. By 2007, the NPI must be used in connection with the electronic transactions identified in HIPAA. Today, individual payers assign unique identification numbers to healthcare providers, and, in most cases, payers assign multiple identification numbers to healthcare providers and their "subparts." As a result, providers have multiple payer-specific identification numbers. The NPI is a unique, 10-digit federal healthcare provider identification number that will be used by all healthcare providers and payers and other healthcare entities involved in administrative and financial transactions associated with health service events and related activities. This article will use software and data experts' knowledge as well as the authors' NPI implementation readiness assessment work to review the impact to both payers and providers, including hospitals, clinics, and other service entities. The authors will suggest planning, budgeting, architecting, and data management solutions for payers and providers to achieve the optimal administrative simplification goals intended by the NPI, without compromising data integrity and interoperability objectives across the service spectrum of the healthcare enterprise.

  8. Electron cyclotron heating and current drive

    NARCIS (Netherlands)

    Westerhof, E.


    Plasma heating and non-inductive current drive by waves in the electron cyclotron range of frequencies are reviewed. Both theoretical aspects concerning wave properties, heating and current drive mechanisms, as well as the major experimental results are summarized.

  9. The effect of provider- and workflow-focused strategies for guideline implementation on provider acceptance

    Directory of Open Access Journals (Sweden)

    Ramanujam Rangaraj


    Full Text Available Abstract Background The effective implementation of clinical practice guidelines (CPGs depends critically on the extent to which the strategies that are deployed for implementing the guidelines promote provider acceptance of CPGs. Such implementation strategies can be classified into two types based on whether they primarily target providers (e.g., academic detailing, grand rounds presentations or the work context (e.g., computer reminders, modifications to forms. This study investigated the independent and joint effects of these two types of implementation strategies on provider acceptance of CPGs. Methods Surveys were mailed to a national sample of providers (primary care physicians, physician assistants, nurses, and nurse practitioners and quality managers selected from Veterans Affairs Medical Centers (VAMCs. A total of 2,438 providers and 242 quality managers from 123 VAMCs participated. Survey items measured implementation strategies and provider acceptance (e.g., guideline-related knowledge, attitudes, and adherence for three sets of CPGs--chronic obstructive pulmonary disease, chronic heart failure, and major depressive disorder. The relationships between implementation strategy types and provider acceptance were tested using multi-level analytic models. Results For all three CPGs, provider acceptance increased with the number of implementation strategies of either type. Moreover, the number of workflow-focused strategies compensated (contributing more strongly to provider acceptance when few provider-focused strategies were used. Conclusion Provider acceptance of CPGs depends on the type of implementation strategies used. Implementation effectiveness can be improved by using both workflow-focused as well as provider-focused strategies.

  10. Axial Current and Noether Charge

    CERN Document Server

    Mahato, Prasanta


    A decade ago, a Lagrangian density has been proposed by the author where only the local symmetries of the Lorentz subgroup of (A)ds group is retained. This formalism has been found to produce some results encompassing that of standard Einstein-Hilbert formalism. In the present article, the conserved axial vector matter currents, constructed in some earlier paper, have been found to be a result of Noether's theorem. PACS: 04.20.Fy, 04.20.Cv, 11.40.-q Keywords: Torsion, Axial Current, Noether's Theorem

  11. Merging of plasma currents

    NARCIS (Netherlands)

    Bergmans, J.; Schep, T. J.


    The merging process of current filaments in a strongly magnetized plasma is described. The evolution is calculated using a contour dynamics method, which accurately tracks piecewise constant distributions of the conserved quantities. In the interaction of two screened currents, both develop dipolar

  12. The Bransfield Gravity Current

    NARCIS (Netherlands)

    Sangrà, P.; Stegner, A.; Hernández-Arencibia, Mónica; Márrero-Díaz, A.; Salinas, C.; Aguiar-González, B.; Henríquez-Pastene, C.H.; Mouriño-Carballido, B.


    Using in situ data and laboratory experiments, we show that the circulation of the Bransfield Current (BC) around the South Shetland Islands (SSI) may be characterized in terms of a propagating buoyant gravity current. First, we describe the SSI hydrography and some drifter trajectories, paying spec

  13. Discrete Noether Currents

    CERN Document Server

    Seidl, Gerhart


    We present a simple generalization of Noether's theorem for discrete symmetries in relativistic continuum field theories. We calculate explicitly the conserved current for several discrete spacetime and internal symmetries. In addition, we formulate an analogue of the Ward-Takahashi identity for the Noether current associated with a discrete symmetry.

  14. Direct current transformer (United States)

    Khanna, S. M.; Urban, E. W. (Inventor)


    A direct current transformer in which the primary consists of an elongated strip of superconductive material, across the ends of which is direct current potential is described. Parallel and closely spaced to the primary is positioned a transformer secondary consisting of a thin strip of magnetoresistive material.

  15. Electric Current Solves Mazes (United States)

    Ayrinhac, Simon


    We present in this work a demonstration of the maze-solving problem with electricity. Electric current flowing in a maze as a printed circuit produces Joule heating and the right way is instantaneously revealed with infrared thermal imaging. The basic properties of electric current can be discussed in this context, with this challenging question:…

  16. The Bransfield Gravity Current

    NARCIS (Netherlands)

    Sangrà, P.; Stegner, A.; Hernández-Arencibia, Mónica; Márrero-Díaz, A.; Salinas, C.; Aguiar-González, B.; Henríquez-Pastene, C.H.; Mouriño-Carballido, B.


    Using in situ data and laboratory experiments, we show that the circulation of the Bransfield Current (BC) around the South Shetland Islands (SSI) may be characterized in terms of a propagating buoyant gravity current. First, we describe the SSI hydrography and some drifter trajectories, paying

  17. Current Epidemiology of Genitourinary Trauma (United States)

    McGeady, James B.; Breyer, Benjamin N.


    Synopsis This article reviews recent publications evaluating the current epidemiology of urologic trauma. It begins by providing a brief explanation of databases that have been recently used to study this patient population, then proceeds to discuss each genitourinary organ individually, discussing the most relevant and up to date information published for each one. The conclusion of the article briefly discusses possible future research and development areas pertaining to the topic. PMID:23905930

  18. Chronic prostatitis: Current concepts

    Directory of Open Access Journals (Sweden)

    Ram Vaidyanathan


    Full Text Available Purpose: Chronic prostatitis (CP is a common condition. It causes significant suffering to the patients and constitutes a sizeable workload for the urologists. The purpose of this review is to describe the currently accepted concepts regarding the aspects of CP. Materials and Methods: Relevant papers on the epidemiology, etiology, diagnosis, evaluation and management of CP were identified through a search of MEDLINE using text terms "prostatitis", "chronic prostatitis" and "chronic pelvic pain syndrome". The list of articles thus obtained was supplemented by manual search of bibliographies of the identified articles and also by exploring the MEDLINE option "Related Articles". Results: The salient points of the relevant articles on each aspect of CP have been summarized in the form of a non-systematic narrative review. Conclusion: Chronic prostatitis is caused by a variety of infective and non-infective factors and is characterized by a rather long remitting and relapsing clinical course. The diagnosis is based on symptoms comprising pain and nonspecific urinary and/or ejaculatory disturbances and microbiological tests to localize bacteria and/or leucocytes in segmented urinary tract specimens. The contemporary classification was proposed by the National Institutes of Health/National Institute of Diabetes Digestive Kidney Diseases (NIH/NIDDK. National Institutes of Health - Chronic Prostatitis Symptom Index (NIH-CPSI is the patient evaluation tool used extensively in clinical practice and research. Management should be individualized, multimodal and of an appropriate duration.

  19. Umbilical metastases: current viewpoint

    Directory of Open Access Journals (Sweden)

    Egidi Federico


    Full Text Available Abstract Background Umbilical metastases from a malignant neoplasm, also termed Sister Mary Joseph's nodule, are not commonly reported in the English literature, and they have usually been considered as a sign of a poor prognosis for the patient. The present article reports on the current view point on umbilical metastasis besides discussing the epidemiology, clinical presentation, pathophysiology and treatment. Method A search of Pubmed was carried out using the term 'umblic*' and 'metastases' or metastasis' revealed no references. Another search was made using the term "Sister Joseph's nodule" or sister Joseph nodule" that revealed 99 references. Of these there were 14 review articles, however when the search was limited to English language it yielded only 20 articles. Articles selected from these form the basis of this report along with cross references. Results The primary lesions usually arise from gastrointestinal or genitourinary tract malignancies and may be the presenting symptom or sign of a primary tumour in an unknown site. Conclusion A careful evaluation of all umbilical lesions, including an early biopsy if appropriate, is recommended. Recent studies suggest an aggressive surgical approach combined with chemotherapy for such patients may improve survival.

  20. Geomagnetically Induced Currents: Principles (United States)

    Oliveira, Denny M.; Ngwira, Chigomezyo M.


    The geospace, or the space environment near Earth, is constantly subjected to changes in the solar wind flow generated at the Sun. The study of this environment variability is called Space Weather. Examples of effects resulting from this variability are the occurrence of powerful solar disturbances, such as coronal mass ejections (CMEs). The impact of CMEs on the Earth's magnetosphere very often greatly perturbs the geomagnetic field causing the occurrence of geomagnetic storms. Such extremely variable geomagnetic fields trigger geomagnetic effects measurable not only in the geospace but also in the ionosphere, upper atmosphere, and on and in the ground. For example, during extreme cases, rapidly changing geomagnetic fields generate intense geomagnetically induced currents (GICs). Intense GICs can cause dramatic effects on man-made technological systems, such as damage to high-voltage power transmission transformers leading to interruption of power supply, and/or corrosion of oil and gas pipelines. These space weather effects can in turn lead to severe economic losses. In this paper, we supply the reader with theoretical concepts related to GICs as well as their general consequences. As an example, we discuss the GIC effects on a North American power grid located in mid-latitude regions during the 13-14 March 1989 extreme geomagnetic storm. That was the most extreme storm that occurred in the space era age.

  1. 手术室对提供骨科手术植入物代理商进行满意度调查的效果分析%Operation room department of orthopedics to provide operation implants agents satisfaction survey results analysis

    Institute of Scientific and Technical Information of China (English)



    目的:手术室对提供骨科手术植入物的代理商进行满意度调查,为手术安全提供更有力保障.方法:手术室设计满意度调查表,对提供骨科手术植入物的代理商进行满意度调查.结果:手术室经过满意度调查,两组各项比较,差异均有统计学意义(P<0.05).结论:手术室对代理商进行满意度调查,是对骨科植入物管理的补充与完善,促使代理商对存在问题进行持续质量改进,避免医疗器械不良事件发生,保证医疗安全.%Objective To further ensure the safety of implant in orthopaedic surgery, the operating department conducted a satisfaction inspection regarding their bone implant's supplier agent. Methods The operating department has designed a satisfaction questionnaire for their bone implant's supplier agent. Results When compared to pre -inspection data, the two separate sets of data hold statistical significance.(P<0.05). Conclusion The satisfaction inspection conducted by the operating department is supplementary to the improvement of the managing of bone implants. It urges the supplier agent to conduct ongoing quality improvements to avoid the occurrence of defective medical equipment and ensures the safety of medical treatment.

  2. Recent Results from MINERvA

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Jonathan [Santa Maria U., Valparaiso


    MINERvA (Main INjector ExpeRiment for v-A) is a few-GeV neutrino nucleus scattering experiment at Fermilab using various nuclei as targets. The experiment provides measurements of neutrino and anti-neutrino cross sections off of nuclear targets which are important for neutrino oscillation experiments and the probing of the nuclear medium.Presented are recent results from MINERvA on quasi-elastic, inclusive charged-current neutrino scattering, and pion production processes.

  3. High-temperature superconducting current leads (United States)

    Hull, J. R.


    The use of high-temperature superconductors (HTSs) for current leads to deliver power to devices at liquid helium temperature is near commercial realization. The use of HTSs in this application has the potential to reduce refrigeration requirements and helium boiloff to values significantly lower than the theoretical best achievable with conventional leads. Considerable advantage is achieved by operating these leads with an intermediate temperature heat sink. The HTS part of the lead can be made from pressed and sintered powder. Powder-in-tube fabrication is also possible, however, the normal metal part of the lead acts as a thermal short and cannot provide much stabilization without increasing the refrigeration required. Lead stability favors designs with low current density. Such leads can be manufactured with today's technology, and lower refrigeration results from the same allowable burnout time. Higher current densities result in lower boiloff for the same lead length, but bumout times can be very short. In comparing experiment to theory, the density of helium vapor needs to be accounted for in calculating the expected boiloff. For very low-loss leads, two-dimensional heat transfer and the state of the dewar near the leads may play a dominant role in lead performance.

  4. Multidecadal Variability of the North Brazil Current (United States)

    Zhang, D.; McPhaden, M.


    The North Brazil Current (NBC) flowing northward in the tropical south Atlantic is one of the strongest western boundary currents in the world ocean. It's unique location, straddling the tropical Atlantic where currents are predominately zonal, suggests that it is a major component of the Atlantic Meridional Overturning Circulation (AMOC). Fritz Schott was one of the first to suggest using the NBC as an index for AMOC transport, which is difficult to simulate accurately in models and data assimilation systems due to a lack of observational constraints. Here, we calculate an NBC transport time series based on five decades of historical ocean observations near the western boundary off the coast of Brazil between 6° and 11°S. Results reveal a large magnitude NBC variation on multidecadal time scales that is coherent with the Atlantic Multidecadal Oscillation in sea surface temperature, multidecadal swings in Sahel Drought and Atlantic hurricane activity, as well as the subtropical and subpolar upper ocean salinity anomalies. All of these multidecadal variations have been linked to the AMOC in a number of modelling studies, suggesting that our observed multidecadal NBC variability is an useful indicator of the AMOC. Concerning the possible slowdown of AMOC under global warming and the debate about whether a slowdown has already occurred, our NBC transport time series shows no significant trend over the last half century. The results provide important constraints on climate models used for climate change projections and decadal time scale climate predictions.

  5. Ocean current mapping using networked distributed sensors (United States)

    Huang, Chen-Fen; Yang, T. C.; Liu, Jin-Yuan; Burchfield, Tom; Schindall, Jeff


    Distributed underwater sensors are expected to provide environmental (oceanographic) monitoring over large areas. As fabrication technology advances, low cost sensors will be available for many applications. The sensors communicate to each other and are networked using acoustic communications. This paper proposes a method for ocean current tomography using distributed networked sensors and presents preliminary experimental results by this approach. Conventional acoustic tomography uses the acoustic sensors distributed on the periphery of an area of interest. Environmental reconstruction requires solving a challenging high dimensional inverse problem, typically requiring substantial computational effort. Given distributed sensors, currents can be constructed locally based on data from neighboring sensors. It is shown using simulated data that results obtained by the proposed method are similar to those obtained by a conventional tomographic method based on peripheral sensors. In addition, one finds that the distributed sensors consume much less energy than that by the conventional tomographic approach. An acoustic communication and networking experiment was conducted near the Sizihwan Bay in Kaohsiung, Taiwan, in May 2011. The communication signals are analyzed to measure currents as a function of space and time. The procedure is simple and can be implemented in real-time using in-buoy processing.

  6. Microenterprise Results Reporting (United States)

    US Agency for International Development — Microenterprise Results Reporting (MRR) is an annual report to the U.S. Congress providing funding and program data on USAID's microenterprise activities. The MRR...

  7. Review of current and emerging treatment options in acromegaly. (United States)

    Muhammad, A; van der Lely, A J; Neggers, S J C M M


    In almost every patient, acromegaly is caused by a growth hormone secreting pituitary adenoma. Clinical features are the result of excessive growth hormone secretion and the consecutive excess in insulin-like growth factor I levels. This results in somatic overgrowth and metabolic disturbances with a higher morbidity and mortality than in the general population. With optimal disease management, mortality can be reduced to that seen in the general population. The current treatment of acromegaly is based on a combination of surgery, radiotherapy and medical therapy. This review provides an overview of the current and upcoming therapies with a focus on medical therapy.

  8. Current metabolomics: technological advances. (United States)

    Putri, Sastia P; Yamamoto, Shinya; Tsugawa, Hiroshi; Fukusaki, Eiichiro


    Metabolomics, the global quantitative assessment of metabolites in a biological system, has played a pivotal role in various fields of science in the post-genomic era. Metabolites are the result of the interaction of the system's genome with its environment and are not merely the end product of gene expression, but also form part of the regulatory system in an integrated manner. Therefore, metabolomics is often considered a powerful tool to provide an instantaneous snapshot of the physiology of a cell. The power of metabolomics lies on the acquisition of analytical data in which metabolites in a cellular system are quantified, and the extraction of the most meaningful elements of the data by using various data analysis tool. In this review, we discuss the latest development of analytical techniques and data analyses methods in metabolomics study.

  9. Surface Current Measurements In Terra Nova Bay By Hf Radar (United States)

    Flocco, D.; Falco, P.; Wadhams, P.; Spezie, G.

    We present the preliminary results of a field experiment carried out within frame- work of the CLIMA project of the Italian National Programme for Antarctic Research (PNRA) and in cooperation with the Scott Polar Research Institute of Cambridge. Dur- ing the second period (02/12/1999-23/01/2000) of the XV Italian expedition a coastal radar was used to characterize the current field in the area of Terra Nova Bay (TNB). One of the aims of the CLIMA (Climatic Long-term Interactions for the Mass balance in Antarctica) project is to determine the role of the polynya in the sea ice mass bal- ance, water structure and local climate. The OSCR-II experiment was planned in order to provide surface current measurements in the area of TNB polynya, one of the most important coastal polynya of the Ross Sea. OSCR (Ocean Surface Current Radar) is a shore based, remote sensing system designed to measure sea surface currents in coastal waters. Two radar sites (a master and a slave) provide with radial current mea- surements; data combined from both sites yield the total current vector. Unfortunately the master and slave stations did not work together throughout the whole period of the experiment. A description of the experiment and a discussion of the results, will be proposed.

  10. Ancillary services provided by PV power plants

    Directory of Open Access Journals (Sweden)

    Antonio PIERNO


    Full Text Available Renewable energy sources are widely utilized in distributed generation systems, and, recently, they are also considered for providing ancillary services. The paper is focused on PV plants, a survey of the most interesting papers published in the literature in the last decade is reported and the main characteristics of the technical proposals, with their advantages and limits, are evidenced. The results are schematically shown in a table that immediately gives the opportunity to be aware of what was already done, representing a reference tool.

  11. Defining and resolving current systems in geospace (United States)

    Ganushkina, N. Y.; Liemohn, M. W.; Dubyagin, S.; Daglis, I. A.; Dandouras, I.; De Zeeuw, D. L.; Ebihara, Y.; Ilie, R.; Katus, R.; Kubyshkina, M.; Milan, S. E.; Ohtani, S.; Ostgaard, N.; Reistad, J. P.; Tenfjord, P.; Toffoletto, F.; Zaharia, S.; Amariutei, O.


    Electric currents flowing through near-Earth space (R ≤ 12 RE) can support a highly distorted magnetic field topology, changing particle drift paths and therefore having a nonlinear feedback on the currents themselves. A number of current systems exist in the magnetosphere, most commonly defined as (1) the dayside magnetopause Chapman-Ferraro currents, (2) the Birkeland field-aligned currents with high-latitude "region 1" and lower-latitude "region 2" currents connected to the partial ring current, (3) the magnetotail currents, and (4) the symmetric ring current. In the near-Earth nightside region, however, several of these current systems flow in close proximity to each other. Moreover, the existence of other temporal current systems, such as the substorm current wedge or "banana" current, has been reported. It is very difficult to identify a local measurement as belonging to a specific system. Such identification is important, however, because how the current closes and how these loops change in space and time governs the magnetic topology of the magnetosphere and therefore controls the physical processes of geospace. Furthermore, many methods exist for identifying the regions of near-Earth space carrying each type of current. This study presents a robust collection of these definitions of current systems in geospace, particularly in the near-Earth nightside magnetosphere, as viewed from a variety of observational and computational analysis techniques. The influence of definitional choice on the resulting interpretation of physical processes governing geospace dynamics is presented and discussed.

  12. Correlation character of ionic current fluctuations: analysis of ion current through a voltage-dependent potassium single channel. (United States)

    Tong-Han, Lan; Huang, Xi; Jia-Rui, Lin


    The gating of ion channels has widely been modeled by assuming the transition between open and closed states is a memoryless process. Nevertheless, the statistical analysis of an ionic current signal recorded from voltage dependence K(+) single channel is presented. Calculating the sample auto-correlation function of the ionic current based on the digitized signals, rather than the sequence of open and closed states duration time. The results provide evidence for the existence of memory. For different voltages, the ion channel current fluctuation has different correlation attributions. The correlations in data generated by simulation of two Markov models, on one hand, auto-correlation function of the ionic current shows a weaker memory, after a delayed period of time, the attribute of memory does not exist; on the other hand, the correlation depends on the number of states in the Markov model. For V(p)=-60 mV pipette potential, spectral analysis of ion channel current was conducted, the result indicates that the spectrum is not a flat spectrum, the data set from ionic current fluctuations shows considerable variability with a broad 1/f -like spectrum, alpha=1.261+/-0.24. Thus the ion current fluctuations give information about the kinetics of the channel protein, the results suggest the correlation character of ion channel protein nonlinear kinetics regardless of whether the channel is in open or closed state.

  13. Noise Properties of CMOS Current Conv