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Sample records for ed philadelphia elsevier

  1. Undergraduate Program: Philadelphia

    Betsock, Lori

    2008-08-01

    Undergraduate chemical science students—join us in Philadelphia on August 17 and 18, 2008, for an educational and career-oriented program designed specifically for you. Attend symposia about global climate change and clean energy; hear Nobel Laureate F. Sherwood Rowland speak about his fascinating career, "A Life in Tracer Chemistry". Weigh options for your future by attending the Graduate School Reality Check and graduate school recruiting events. All events will take place in the Sheraton Philadelphia City Center at 17th and Race Streets, except the Undergraduate Poster Sessions and Sci-Mix, which will be held in the Pennsylvania Convention Center.

  2. Philadelphia and the Tomato.

    Smith, Andrew F.; Kling, Tatiana

    This booklet describes for elementary students the many contributions of people, traveling many places, over many years to bring the tomato to Philadelphia. The booklet includes the following: (1) "Introduction to the Tomato"; (2) "Where Does the Tomato Come From?"; (3) "The Spanish Tomato"; (4) "The Philadelphia…

  3. School Closings in Philadelphia

    Jack, James; Sludden, John

    2013-01-01

    In 2012, the School District of Philadelphia closed six schools. In 2013, it closed 24. The closure of 30 schools has occurred amid a financial crisis, headlined by the district's $1.35 billion deficit. School closures are one piece of the district's plan to cut expenditures and close its budget gap. The closures are also intended to make…

  4. 10 years of Elsevier/JQSRT awards

    Stoop, José; Bernath, Peter F.; Mengüç, M. Pinar; Mishchenko, Michael I.; Rothman, Laurence S.

    2017-10-01

    The Elsevier award program administered by the Editorial Board of the Journal of Quantitative Spectroscopy and Radiative Transfer (JQSRT) was conceived in June of 2006 at the 9th Electromagnetic and Light Scattering Conference in St. Petersburg, Russia. Initially the program included three annual Elsevier/JQSRT awards for exceptional early-career scientists working in the main research fields covered by JQSRT: quantitative spectroscopy, radiative transfer, and electromagnetic scattering. In June of 2010 at the 12th Electromagnetic and Light Scattering Conference in Helsinki, Finland, it was decided to expand the award program to include three biennial Elsevier awards intended to celebrate fundamental life-time achievements of internationally recognized leaders in the same research fields. Finally, in 2013 the Elsevier award program was augmented to include a fourth annual early-career award in the category of atmospheric radiation and remote sensing.

  5. The Reed Elsevier stock price gap

    Kamp, B.

    1995-01-01

    This is the report of a limited study on the structural stock price differences between Reed and Elsevier. The purpose of this study is to provide an overview of the problem area and to formulate and discuss several hypotheses regarding the causes of this gap. The research was performed by

  6. ELSEVIER SCIENTIFIC JOURNALS AVAILABLE ON YOUR DESKTOP

    1999-01-01

    Elsevier Science Publishers have for decades distributed renowned journals in science and technology, which are now accessible on the Web through their Science Direct service. CERN has been granted a site licence trial period until the end of 1999.Included among the titles are: Astroparticle physics, Computer physics communications, Nuclear instruments and methods in physics research A and B, Nuclear physics A and B, Physics letters A and B, Physics reports, Surface science and Thin solid films.Links to the individual titles appear in our electronic journals list at:http://wwwas.cern.ch/library/electronic_journals/ejAH.htmlThe Library invites all readers to search and download articles of the journals currently subscribed to. You can also access the full Science Direct site at: http://www.sciencedirect.com/(Choose 'group-wide login' or, for a 'personal login' registration, please contact us)All questions and comments are welcome and can be addressed to: library.desk@cern.ch

  7. IBM, Elsevier Science, and academic freedom.

    Bailar, John C; Cicolella, Andre; Harrison, Robert; LaDou, Joseph; Levy, Barry S; Rohm, Timothy; Teitelbaum, Daniel T; Wang, Yung-Der; Watterson, Andrew; Yoshida, Fumikazu

    2007-01-01

    Elsevier Science refused to publish a study of IBM workers that IBM sought to keep from public view. Occupational and environmental health (OEH) suffers from the absence of a level playing field on which science can thrive. Industry pays for a substantial portion of OEH research. Studies done by private consulting firms or academic institutions may be published if the results suit the sponsoring companies, or they may be censored. OEH journals often reflect the dominance of industry influence on research in the papers they publish, sometimes withdrawing or modifying papers in line with industry and advertising agendas. Although such practices are widely recognized, no fundamental change is supported by government and industry or by professional organizations.

  8. The urban forests of Philadelphia

    David J. Nowak; Allison R. Bodine; Robert Hoehn; Alexis Ellis; Sarah C. Low; Lara A. Roman; Jason G. Henning; Emily Stephan; Tom Taggert; Ted. Endreny

    2016-01-01

    An analysis of the urban forest in Philadelphia, Pennsylvania, reveals that this city has an estimated 2.9 million trees (encompassing all woody plants greater than 1 inch diameter at breast height [d.b.h]) with tree canopy that covers 20 percent of the city. The most common tree species are spicebush, black cherry, ash, tree-of-heaven, and boxelder, but the most...

  9. Molecular Analysis Research at Community College of Philadelphia

    2015-09-21

    YOUR FORM TO THE ABOVE ADDRESS. Community College of Philadelphia Community College of Philadelphia 1700 Spring Garden Street Philadelphia, PA 19130...Approved for Public Release; Distribution Unlimited Final Report: Molecular Analysis Research at Community College of Philadelphia The views, opinions...Molecular Analysis Research at Community College of Philadelphia Report Title AXIMA Assurance mass spectrometer, Leica DMI-8 fluorescent microscope

  10. Comprehensive District Reform: Philadelphia's Grand Experiment.

    Useem, Elizabeth; Balfanz, Robert

    2002-01-01

    This report describes "Philadelphia's Grand Experiment" in comprehensive school district reform, from its conception through its initial months of implementation. In 2001, as part of the remedy for low student performance, the governor ordered the state to take over governance of the Philadelphia School District, with a substantial…

  11. Maximizing Green Infrastructure in a Philadelphia Neighborhood

    Kate Zidar; Timothy A. Bartrand; Charles H. Loomis; Chariss A. McAfee; Juliet M. Geldi; Gavin J. Rigall; Franco Montalto

    2017-01-01

    While the Philadelphia Water Department (PWD) is counting on Green Stormwater Infrastructure (GI) as a key component of its long-term plan for reducing combined sewer overflows, many community stakeholders are also hoping that investment in greening can help meet other ancillary goals, collectively referred to as sustainable redevelopment. This study investigates the challenges associated with implementation of GI in Point Breeze, a residential neighborhood of South Philadelphia. The project ...

  12. Nutrition environments in corner stores in Philadelphia.

    Cavanaugh, Erica; Mallya, Giridhar; Brensinger, Colleen; Tierney, Ann; Glanz, Karen

    2013-02-01

    To examine the availability, quality, and price of key types of healthy and less-healthy foods found in corner stores in low-income urban neighborhoods and the associations between store characteristics and store food environments. A sample of 246 corner stores was selected from all corner stores participating in the Philadelphia Healthy Corner Store Initiative (HCSI). The Nutrition Environment Measures Survey for Corner Stores (NEMS-CS) was used to assess the availability, quality, and price of foods and beverages in 11 common categories between February and May, 2011. NEMS-CS measures were completed in 233 stores, 94.7% of the 246 stores approached. The healthier options were significantly less available in all food categories and often more expensive. Baked goods, bread, chips and cereals were sold at nearly all stores, with significantly fewer offering low-fat baked goods (5.7%, pbread (56.2%, pfood environment and dietary choices among low-income urban populations. Availability of certain healthier foods could be improved. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Elsevier/Spectrochimica Acta atomic spectroscopy award 2015

    Omenetto, Nicolo; de Loos-Vollebregt, Margaretha

    2016-12-01

    This is to announce the 2015 Elsevier/Spectrochimica Acta award, the annual award honoring the most significant article(s) published in a volume. Elsevier makes this award on behalf of Spectrochimica Acta, Part B, to encourage the publication of top articles in this journal. All papers published during one year are considered for this award and the Editorial Advisory Board and the Guest Editor(s) of the special issue(s) are responsible for the selection. The award consists of a monetary prize of 1000 together with a presentation certificate.

  14. Elsevier/Spectrochimica Acta Atomic Spectroscopy Award 2014

    Omenetto, Nicolo'; de Loos, Greet

    2016-03-01

    This is to announce the 2014 Elsevier/Spectrochimica Acta Award, the annual award honoring the most significant article(s) published in a volume. Elsevier makes this award on behalf of Spectrochimica Acta, Part B, to encourage the publication of top articles in this journal. All papers published during one year are considered for this award and the Editorial Advisory Board and the Guest Editor(s) of the special issue(s) are responsible for the selection. The award consists of a monetary prize of 1000 together with a presentation certificate.

  15. The visualization and availability of experimental research data at Elsevier

    Keall, Bethan

    2014-05-01

    In the digital age, the visualization and availability of experimental research data is an increasingly prominent aspect of the research process and of the scientific output that researchers generate. We expect that the importance of data will continue to grow, driven by technological advancements, requirements from funding bodies to make research data available, and a developing research data infrastructure that is supported by data repositories, science publishers, and other stakeholders. Elsevier is actively contributing to these efforts, for example by setting up bidirectional links between online articles on ScienceDirect and relevant data sets on trusted data repositories. A key aspect of Elsevier's "Article of the Future" program, these links enrich the online article and make it easier for researchers to find relevant data and articles and help place data in the right context for re-use. Recently, we have set up such links with some of the leading data repositories in Earth Sciences, including the British Geological Survey, Integrated Earth Data Applications, the UK Natural Environment Research Council, and the Oak Ridge National Laboratory DAAC. Building on these links, Elsevier has also developed a number of data integration and visualization tools, such as an interactive map viewer that displays the locations of relevant data from PANGAEA next to articles on ScienceDirect. In this presentation we will give an overview of these and other capabilities of the Article of the Future, focusing on how they help advance communication of research in the digital age.

  16. African Diaspora Movement Arts in Philadelphia: A Beginning Resource List. Philadelphia Folklore Project Working Papers #10.

    Brown-Danquah, Benita Binta

    This guide provides history, format, contact names, addresses, and phone numbers of some African dance and African American marching units in Philadelphia (Pennsylvania). The working papers are divided into two categories. "Part One: Movements of African Dance in Philadelphia" begins with a sensitive, detailed explanation of the…

  17. Risk of Fall-Related Injury due to Adverse Weather Events, Philadelphia, Pennsylvania, 2006-2011.

    Gevitz, Kathryn; Madera, Robbie; Newbern, Claire; Lojo, José; Johnson, Caroline C

    Following a surge in fall-related visits to local hospital emergency departments (EDs) after a severe ice storm, the Philadelphia Department of Public Health examined the association between inclement winter weather events and fall-related ED visits during a 5-year period. Using a standardized set of keywords, we identified fall-related injuries in ED chief complaint logs submitted as part of Philadelphia Department of Public Health's syndromic surveillance from December 2006 through March 2011. We compared days when falls exceeded the winter fall threshold (ie, "high-fall days") with control days within the same winter season. We then conducted matched case-control analysis to identify weather and patient characteristics related to increased fall-related ED visits. Fifteen high-fall days occurred during winter months in the 5-year period. In multivariable analysis, 18- to 64-year-olds were twice as likely to receive ED care for fall-related injuries on high-fall days than on control days. The crude odds of ED visits occurring from 7:00 am to 10:59 am were 70% higher on high-fall days vs control days. Snow was a predictor of a high-fall day: the adjusted odds of snow before a high-fall day as compared with snow before a control day was 13.4. The association between the number of fall-related ED visits and weather-related fall injuries, age, and timing suggests that many events occurred en route to work in the morning. Promoting work closures or delaying openings after severe winter weather would allow time for better snow or ice removal, and including "fall risk" in winter weather advisories might effectively warn morning commuters. Both strategies could help reduce the number of weather-related fall injuries.

  18. Making Health Easier: Active Living in Philadelphia, PA PSA (:60)

    Making communities bike-friendly can help reduce traffic congestion and increase the physical activity of residents. Learn how one Philadelphia resident worked with his community to make Philadelphia a more bike-friendly city.

  19. Nightmares

    ... T, Dement WC, eds. Principles and Practice of Sleep Medicine . 6th ed. Philadelphia, PA: Elsevier; 2016:chap 104. ... T, Dement WC, eds. Principles and Practice of Sleep Medicine . 6th ed. Philadelphia, PA: Elsevier; 2016:chap 55. ...

  20. Antibody

    ... AK, Litchman AH, Pillai S, eds. Cellular and Molecular Immunology . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap ... D, Brostoff J, Roth DB, Roitt IM, eds. Immunology . 8th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap ...

  1. Daily bowel care program

    ... eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 136. Koyle MA, Lorenzo AJ. ... eds. Campbell-Walsh Urology . 11th ed. Philadelphia, PA: Elsevier; 2016:chap 144. Lembo AJ. Constipation. In: Feldman ...

  2. Meperidine hydrochloride overdose

    ... JG, ed. Emergency Medicine . 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 147. Lank PM, Kusin S. Ethanol ... JG, ed. Emergency Medicine . 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 154. Nikolaides JK, Thompson TM. ...

  3. Arteriogram

    ... eds. Rutherford's Vascular Surgery . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 102. Goldstein LB. Approach to ... eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 406. Kern M. Catheterization and ...

  4. Raynaud phenomenon

    ... eds. Current Surgical Therapy . 12th ed. Philadelphia, PA: Elsevier; 2017:1047-1052. Herrick AL, Muir L. Raynaud's ... eds. Rutherford's Vascular Surgery. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 122. James WD, Elston DM, ...

  5. Cedar leaf oil poisoning

    ... eds. Auerbach's Wilderness Medicine . 7th ed. Philadelphia, PA: Elsevier; 2017:chap 45. Graeme KA. Toxic plant ingestions. ... eds. Auerbach's Wilderness Medicine . 7th ed. Philadelphia, PA: Elsevier; 2017:chap 65. Meehan TJ. Approach to the ...

  6. Philadelphia's Renaissance Schools Initiative after Four Years

    Stratos, Kati; Wolford, Tonya; Reitano, Adrienne

    2015-01-01

    In 2010-2011, the School District of Philadelphia (the District) launched its Renaissance Schools Initiative, a program designed to dramatically improve student achievement in the District's lowest performing schools. Some schools became Promise Academies, based on the federal turnaround model, and remained District-operated neighborhood schools.…

  7. Inform@ed space

    Bjerrum, Peter; Olsen, Kasper Nefer

    2001-01-01

    Inform@ed space Sensorial Perception And Computer Enchancement - bidrag til Nordisk Arkitekturforskningsforenings IT-konference, AAA april 2001.......Inform@ed space Sensorial Perception And Computer Enchancement - bidrag til Nordisk Arkitekturforskningsforenings IT-konference, AAA april 2001....

  8. Serum globulin electrophoresis

    ... plasma proteins. In: Baynes JW, Dominiczak MH, eds. Medical Biochemistry . 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 4. Rajkumar SV. Plasma cell disorders. In: Goldman L, Schafer AI, ... . 25th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 187.

  9. Smear of duodenal fluid aspirate

    ... Management by Laboratory Methods . 23rd ed. Philadelphia, PA: Elsevier; 2017:chap 64. Dupont HL. Approach to the ... eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 283. Fritsche TR, Pritt BS. ...

  10. Henoch-Schönlein purpura

    ... FF, eds. Ferri's Clinical Advisor 2017 . Philadelphia, PA: Elsevier; 2017:562.e1-563.e1. Hahn D, Hodson ... JG, ed. Emergency Medicine . 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 22. Jennette JC, Falk RJ, ...

  11. Hemolysis

    ... eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 161. Gallagher PG. Red blood ... Basic Principles and Practice . 6th ed. Philadelphia, PA: Elsevier; 2013:chap 43. Michel M. Autoimmune and intravascular ...

  12. Hepatitis

    ... Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 90. Pawlotsky J-M. Chronic ... eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 149. Sjogren MH, Bassett JT. ...

  13. Fibromyalgia

    ... eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 274. Mbuyi N. Fibromyalgia. In: ... FF, ed. Ferri's Clinical Advisor 2018 . Philadelphia, PA: Elsevier; 2017:491-492. Selfridge NJ. Fibromyalgia. In: Rakel ...

  14. Nabothian cyst

    ... Procedures for Primary Care . 3rd ed. Philadelphia, PA: Elsevier Mosby; 2011:chap 135. Dolan MS, Hill C, ... FA, eds. Comprehensive Gynecology . 7th ed. Philadelphia, PA: Elsevier; 2017:chap 18. Hertzberg BS, Middleton WD. Pelvis ...

  15. Culture - colonic tissue

    ... Management by Laboratory Methods . 23rd ed. Philadelphia, PA: Elsevier; 2017:chap 64. DuPont HL. Approach to the ... eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 283. Hall GS, Woods GL. ...

  16. Giardia infection

    ... eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 283. Haines CF, Sears CL. ... Gastrointestinal and Liver Disease . 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 110. Nash TE, Hill DR. ...

  17. Hemoglobin derivatives

    ... Basic Principles and Practice. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 43. Bunn HF. Approach to the ... eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 158. Christiani DC. Physical and ...

  18. Shigellosis

    ... Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 340. DuPont HL. Approach to the ... eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 283. Haines CF, Sears CL. ...

  19. Drug-induced lupus erythematosus

    ... Tsokos GC, ed. Systemic Lupus Erythematosus . Philadelphia, PA: Elsevier; 2016:chap 54. Habif TP. Connective tissue diseases. ... TP, ed. Clinical Dermatology . 6th ed. Philadelphia, PA: Elsevier; 2016:chap 17. Kumar V, Abbas AK, Aster ...

  20. Abdominal pain

    ... Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 27. MacGilchrist A, Iredale J, ... eds. Macleod's Clinical Examination . 13th ed. Philadelphia, PA: Elsevier; 2013:chap 8. McQuaid KR. Approach to the ...

  1. Molecular diagnostic of the philadelphia chromosome

    Campos Rudin, M.; Cuenca Berger, P.; Gutierrez Espeleta, G.; Jimenez Cruz, G.; Montero Umana, C.; Vazquez Castillo, L.; Ramon Ortiz, M.

    1998-01-01

    The importance that has to confirm the presence or absence of the chromosome Philadelphia in the diagnostic and follow up of the patient affected with chronic myeloid leukemia and other leukemia. It is considered necessary to implement the molecular diagnostic in Costa Rica. They studied 32 patient affected by Chronic Myeloid Leukemia, 7 by other Myeloproliferative Chronic Disorders and 2 by Myelodysplastic Syndrome. It utilized the sound Trans probe-1 (Oncogene Science, Inc), which was marked with radioactivity ( 32 P) or chemiluminescence (digoxigenin). Of the 32 cases affected by L mc, in 28 it was possible to carry out the molecular analysis detecting the characteristic translocation of the chromosome Philadelphia among the Mbcr/c-ABL genes in 21 (75%) of the patients, in 7 (25%) the rearrangement was not found. In seven of the nine affected by other sufferings it was possible to obtain results, 3 that turned out to be positive for the rearrangement among Mbcr/c-ABL and 4 normal. In all the cases, they obtained results marking the sound with radioactivity. However, they tested the marks with digoxigenin in seven of the patients, as an methodological alternative for the laboratories that lacks the requirements to work with radiation. The results obtained were identical. (S. Grainger) [es

  2. Maximizing Green Infrastructure in a Philadelphia Neighborhood

    Kate Zidar

    2017-10-01

    Full Text Available While the Philadelphia Water Department (PWD is counting on Green Stormwater Infrastructure (GI as a key component of its long-term plan for reducing combined sewer overflows, many community stakeholders are also hoping that investment in greening can help meet other ancillary goals, collectively referred to as sustainable redevelopment. This study investigates the challenges associated with implementation of GI in Point Breeze, a residential neighborhood of South Philadelphia. The project team performed a detailed study of physical, social, legal, and economic conditions in the pilot neighborhood over the course of several years, culminating in the development of an agent-based model simulation of GI implementation. The model evaluates a whether PWD’s GI goals can be met in a timely manner, b what kinds of assumptions regarding participation would be needed under different theoretical GI policies, and c the extent to which GI could promote sustainable redevelopment. The model outcomes underscore the importance of private land in helping PWD achieve its GI goals in Point Breeze. Achieving a meaningful density of GI in the neighborhoods most in need of sustainable redevelopment may require new and creative strategies for GI implementation tailored for the types of land present in those particular communities.

  3. Making Health Easier: Active Living in Philadelphia, PA PSA (:60)

    2013-06-07

    Making communities bike-friendly can help reduce traffic congestion and increase the physical activity of residents. Learn how one Philadelphia resident worked with his community to make Philadelphia a more bike-friendly city.  Created: 6/7/2013 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 6/7/2013.

  4. Time's Up: Applying Teacher Management Skills to Solving Philadelphia's Problems

    Lax, Zach

    2013-01-01

    Teachers are natural problem solvers, and they should be using this quality to their advantage when it comes to solving the systemic issues that plague Philadelphia's education system. Many of the articles in this issue have already gone into great detail about what is happening in Philadelphia. Torch Lytle has provided a summary of the recent…

  5. Strategies for Talent Management: Greater Philadelphia Companies in Action

    Council for Adult and Experiential Learning (NJ1), 2008

    2008-01-01

    Human capital is one of the critical issues that impacts the Greater Philadelphia region's ability to grow and prosper. The CEO Council for Growth (CEO Council) is committed to ensuring a steady and talented supply of quality workers for this region. "Strategies for Talent Management: Greater Philadelphia Companies in Action" provides…

  6. The Philadelphia Glaucoma Detection and Treatment Project

    Waisbourd, Michael; Pruzan, Noelle L.; Johnson, Deiana; Ugorets, Angela; Crews, John E.; Saaddine, Jinan B.; Henderer, Jeffery D.; Hark, Lisa A.; Katz, L. Jay

    2016-01-01

    Purpose To evaluate the detection rates of glaucoma-related diagnoses and the initial treatments received in the Philadelphia Glaucoma Detection and Treatment Project, a community-based initiative aimed at improving the detection, treatment, and follow-up care of individuals at risk for glaucoma. Design Retrospective analysis. Participants A total of 1649 individuals at risk for glaucoma who were examined and treated in 43 community centers located in underserved communities of Philadelphia. Methods Individuals were enrolled if they were African American aged ≥50 years, were any other adult aged ≥60 years, or had a family history of glaucoma. After attending an informational glaucoma workshop, participants underwent a targeted glaucoma examination including an ocular, medical, and family history; visual acuity testing, intraocular pressure (IOP) measurement, and corneal pachymetry; slit-lamp and optic nerve examination; automated visual field testing; and fundus color photography. If indicated, treatments included selective laser trabeculoplasty (SLT), laser peripheral iridotomy (LPI), or IOP-lowering medications. Follow-up examinations were scheduled at the community sites after 4 to 6 weeks or 4 to 6 months, depending on the clinical scenario. Main Outcome Measures Detection rates of glaucoma-related diagnoses and types of treatments administered. Results Of the 1649 individuals enrolled, 645 (39.1%) received a glaucoma-related diagnosis; 20.0% (n = 330) were identified as open-angle glaucoma (OAG) suspects, 9.2% (n = 151) were identified as having narrow angles (or as a primary angle closure/suspect), and 10.0% (n = 164) were diagnosed with glaucoma, including 9.0% (n = 148) with OAG and 1.0% (n = 16) with angle-closure glaucoma. Overall, 39.0% (n = 64 of 164) of those diagnosed with glaucoma were unaware of their diagnosis. A total of 196 patients (11.9%) received glaucoma-related treatment, including 84 (5.1%) who underwent LPI, 13 (0.8%) who underwent SLT

  7. Gentrification and Residential Mobility in Philadelphia.

    Ding, Lei; Hwang, Jackelyn; Divringi, Eileen

    2016-11-01

    Gentrification has provoked considerable controversy surrounding its effects on residential displacement. Using a unique individual-level, longitudinal data set, this study examines mobility rates and residential destinations of residents in gentrifying neighborhoods during the recent housing boom and bust in Philadelphia for various strata of residents and different types of gentrification. We find that vulnerable residents, those with low credit scores and without mortgages, are generally no more likely to move from gentrifying neighborhoods compared with their counterparts in nongentrifying neighborhoods. When they do move, however, they are more likely to move to lower-income neighborhoods. Residents in gentrifying neighborhoods at the aggregate level have slightly higher mobility rates, but these rates are largely driven by more advantaged residents. These findings shed new light on the heterogeneity in mobility patterns across residents in gentrifying neighborhoods and suggest that researchers should focus more attention on the quality of residential moves and nonmoves for less advantaged residents, rather than mobility rates alone.

  8. TechEdSat

    National Aeronautics and Space Administration — TechEdSat is a 1U CubeSat built by San Jose State University in partnership with NASA Ames Research Center and AAC Microtec. Its mission is to evaluate Space...

  9. PREFACE: EDS2010 Preface

    Heggie, Malcolm I.

    2011-03-01

    The biennial international conference on Extended Defects in Semiconductors started in 1978 with a meeting in Hünfeld, Germany. Subsequent meetings rotated between Poland, France, Great Britain, Germany, Russia and Italy, culminating in EDS2004 in Chernogolovka, EDS2006 in Halle and EDS2008 in Poitiers. EDS2010 was held at the University of Sussex at Brighton, UK from September 19th to 24th. An extension of the tabulation of this history, which first appeared on the EDS2006 website, is given in the attached PDF. It is with sadness that we note one of the founders of the series, Prof. Dr Helmut Alexander, passed away on 3 December 2009 and we were proud to dedicate EDS2010 to his memory. It has become a tradition to make an award in his name, and this year it was made to Ivan Isacov for his poster "Electrical levels of dislocation networks in p- and n-type silicon". A short and warm celebration of Prof. Dr Alexander's life by his friends and colleagues, Prof. Drs Helmut Gottschalk, Eicke Weber and Wolfgang Schröter, is included in this volume. The conference was a forum for the state-of-the-art of investigation and modelling of extended defects in semiconductors. Scientists from universities, research institutes and industry made contributions to a deeper understanding of extended defects, their interaction with point defects and their role in the development of semiconductor technology. The remit of the conference included extended defects, nanostructures, nanoparticles, quantum dots and interfaces within semiconducting materials ranging from narrow to wide band gaps, including graphene-derived materials and diamond. Scientific interests range from defect geometry, electronic structure, dynamics, spectroscopy, microscopy, reactions and chemistry to introduction mechanisms, such as implantation and strained layers and the operation of devices such as integrated circuits, heterostructures, and solar cells. The organisers were confronted with a long period between

  10. Erectile Dysfunction (ED)

    ... Talking to Your Kids About VirginityTalking to Your Kids About Sex Home Diseases and Conditions Erectile Dysfunction (ED) Condition ... Well-Being Mental Health Sex and Birth Control Sex and Sexuality Birth Control ... and Toddlers Kids and Teens Pregnancy and Childbirth Women Men Seniors ...

  11. Hydrocele

    ... Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 346. Elder JS. Disorders and anomalies ... Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 545. Ferri FF. Hydrocele. In: Ferri ...

  12. Ankle pain

    ... Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 58. Irwin TA. Tendon injuries ... Drez's Orthopaedic Sports Medicine . 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 117. Molloy A, Selvan D. ...

  13. Bacterial gastroenteritis

    ... Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 340. Craig SA. Gastroenteritis. In: Marx ... Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 94. Mody RK, Griffin PM. ...

  14. Cardiac event monitors

    ... From Cell to Bedside . 6th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 64. Maron BJ. Ventricular arrhythmias ... From Cell to Bedside . 6th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 86. Mathur N, Seutter R, ...

  15. Alcoholic liver disease

    ... FF, ed. Ferri's Clinical Advisor 2018 . Philadelphia, PA: Elsevier; 2018:59-60. Carithers RL, McClain C. Alcoholic ... Gastrointestinal and Liver Disease . 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 86. Haines EJ, Oyama LC. ...

  16. Fecal smear

    ... Management by Laboratory Methods . 23rd ed. Philadelphia, PA: Elsevier; 2017:chap 64. DuPont HL. Approach to the ... AI, eds. Goldman's Cecil Medicine . 25thed. Philadelphia, PA: Elsevier Saunders; 2016:chap 283. Haines CF, Sears CL. ...

  17. Miscarriage

    ... Normal and Problem Pregnancies . 7th ed. Philadelphia, PA: Elsevier; 2017:chap 41. Ellenson LH, Pirog EC. The ... Pathologic Basis of Disease . 9th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 22. Hobel CJ, Williams J. ...

  18. Foreign object - swallowed

    ... Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 327. Pfau PR, Hancock SM. Foreign ... Gastrointestinal and Liver Disease . 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 27. Schoem SR, Rosbe KW, ...

  19. Deciding about an IUD

    ... RD, eds. Conn's Current Therapy 2017 . Philadelphia, PA: Elsevier; 2016:chap 17. Copper T IUD. Association of ... Endocrinology: Adult and Pediatric . 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 134. Hormonal IUD. Association of ...

  20. Radioiodine therapy

    ... FF ed. Ferri's Clinical Advisor 2017. Philadelphia, PA: Elsevier; 2017:644-645. Kaplan EL, Angelos P, James ... Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 96. Lai SY, Mandel SJ, ...

  1. String test

    ... Management by Laboratory Methods . 23rd ed. Philadelphia, PA: Elsevier; 2017:chap 64. Bope ET, Kellerman RD. The ... ET, ed. Conn's Current Therapy 2016 . Philadelphia, PA: Elsevier; 2016:chap 3. Haines CF, Sears CL. Infectious ...

  2. Nose fracture

    ... Head and Neck Surgery . 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 33. Christophel JJ. Facial, eye, ... Drez's Orthopaedic Sports Medicine . 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 27. Mayersak RJ. Facial trauma. ...

  3. Deodorant poisoning

    ... Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 100. Farmer B, Seger DL. ... Textbook of Critical Care . 7th ed. Philadelphia, PA: Elsevier; 2017:chap 153. Meehan TJ. Approach to the ...

  4. Digitalis toxicity

    ... Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 152. Goldberger AL, Goldberger ZD, ... Electrocardiography: A Simplified Approach . 8th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 18. Nelson LS, Ford MD. ...

  5. Fecal culture

    ... Management by Laboratory Methods . 23rd ed. Philadelphia, PA: Elsevier; 2017:chap 64. DuPont HL. Approach to the ... AI, eds. Goldman's Cecil Medicine . 25thed. Philadelphia, PA: Elsevier Saunders; 2016:chap 283. Haines CF, Sears CL. ...

  6. Galactosemia

    ... and Rector's The Kidney. 10th ed. Philadelphia, PA: Elsevier; 2016:chap 45. Broomfield A, Brain C, Grunewald S. ... Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 91. Kishnani PS, Chen Y-T. ...

  7. Rheumatoid arthritis

    ... Firestein's Textbook of Rheumatology . 10th ed. Philadelphia, PA: Elsevier; 2017:chap 70. Garneau E. Rheumatoid arthritis. In: ... FF, ed. Ferri's Clinical Advisor 2018 . Philadelphia, PA: Elsevier; 2017:1125-1128. June RR, Moreland LW. Rheumatoid ...

  8. Ectodermal dysplasia (ED) syndrome.

    Chee, Siew-Yin; Wanga, Chung-Hsing; Lina, Wei-De; Tsaia, Fuu-Jen

    2014-01-01

    Ectodermal dysplasia (ED) syndrome comprises a large, heterogeneous group of inherited disorders that are defined by primary defects in the development of 2 or more tissues derived from the embryonic ectoderm. The tissues primarily involved are the skin and its appendages (including hair follicles, eccrine glands, sebaceous glands, nails) and teeth. The clinical features include sparse hair, abnormal or missing teeth, and an inability to sweat due to lack of sweat glands. One such case report of ectodermal dysplasia is presented here.

  9. The long road back for a reborn Philadelphia Electric

    Anon.

    1990-01-01

    On 31 March 1987, the US NRC ordered Philadelphia Electric to shut down its Peach Bottom BWR station because of operator inattentiveness. Since then Philadelphia Electric has undergone the most complete transformation of corporate and nuclear management of any US utility. Everyone in direct line supervision was replaced, from the chairman of the board down to shift supervisors. Nuclear operations were completely reorganized and a dedicated nuclear group formed. Procedures were rewritten and operator training and career development upgraded. Plant maintenance and housekeeping have been raised to new levels of excellence. It has been a long road back for Philadelphia Electric. But all major goals are now being met and a corporate culture is being developed focused on excellence in nuclear operations. (author)

  10. Low incidence of painless thyroiditis in the Philadelphia area

    Schorr, A.B.; Miller, J.L.; Shtasel, P.; Rose, L.I.

    1986-01-01

    Publications from the midwestern region of the United States have demonstrated an incidence of 14-23% of painless thyroiditis in hyperthyroid individuals. This possibly could represent a local phenomenon, and perhaps is not typical for other areas of the country. The 24 hour radioactive iodine uptakes in 152 consecutive hyperthyroid individuals in the Philadelphia area were evaluated. No patient in the series, with clinical and biochemical evidence of hyperthyroidism, had painless thyroiditis. It is concluded that the incidence of painless thyroiditis is markedly lower in the Philadelphia area than in the Midwest regions of the United States

  11. Treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia.

    Milone, Jorge H; Enrico, Alicia

    2009-12-01

    The presence of the Philadelphia chromosome is a poor prognosis factor in acute lymphoblastic leukemia (ALL), in both children and adults. Using molecular techniques of the gen bcr/abl, it is possible to detect the abnormality, in up to the 40% of adult patients. The unsatisfactory results with conventional chemotherapy schemes have determined the intensification of the treatments and the consideration of allogenic bone marrow transplants as the best therapeutic instance. The development of tyrosine kinase inhibitors have become a therapeutic improvement in the treatment of Philadelphia chromosome-positive ALL, being combined with chemotherapy schemes, only in a selected group of patients, even in therapeutic programs that include transplant.

  12. 77 FR 43369 - Lexisnexis, a Subsidiary of Reed Elsevier Customer Service Department and Fulfillment Department...

    2012-07-24

    ..., a Subsidiary of Reed Elsevier Customer Service Department and Fulfillment Department, Including On... Including Remote Workers in New York Reporting to Miamisburg, OH; Lexisnexis, a Subsidiary of Reed Elsevier... subsidiary of Reed Elsevier, Inc., Customer Service Department and Fulfillment Department, including on-site...

  13. (Dis)empowerment: The Implementation of Corrective Mathematics in Philadelphia Empowerment Schools

    Connor, Hannah

    2011-01-01

    The need to improve math education around the country has been well documented, especially in urban school systems like Philadelphia. In Spring 2010, only 56.6% of students in Philadelphia Public schools scored proficient or advanced on the Pennsylvania State Standardized Assessment (PSSA). In Philadelphia Empowerment Schools, the 107 lowest…

  14. The Implementation of CRM at FISC Norfolk Detachment Philadelphia

    2003-06-01

    Customer Relationship Management system. [28] If FISC decides to implement a CRM system, the decision will impact the duties of the...distribution is unlimited 12b. DISTRIBUTION CODE 13. ABSTRACT (maximum 200 words) Customer Relations Management ( CRM ) can be defined in many ways. In...Norfolk Philadelphia Mission Statement. 15. NUMBER OF PAGES 91 14. SUBJECT TERMS Customer Relations Management System, CRM ,

  15. GATEWAY Report Brief: SSL Evaluation: Philadelphia International Airport Apron Lighting

    None, None

    2015-10-30

    Summary of report that documents a trial installation of LED apron lighting that replaced the existing high-pressure sodium luminaires at Philadelphia International Airport. Such high-mast applications remain challenging for LED technology, and the lessons learned from this project may help facility managers and LED product manufacturers better meet those challenges.

  16. Item Response Theory Modeling of the Philadelphia Naming Test

    Fergadiotis, Gerasimos; Kellough, Stacey; Hula, William D.

    2015-01-01

    Purpose: In this study, we investigated the fit of the Philadelphia Naming Test (PNT; Roach, Schwartz, Martin, Grewal, & Brecher, 1996) to an item-response-theory measurement model, estimated the precision of the resulting scores and item parameters, and provided a theoretical rationale for the interpretation of PNT overall scores by relating…

  17. Systemwide Implementation of Project-Based Learning: The Philadelphia Approach

    Schwalm, Jason; Tylek, Karen Smuck

    2012-01-01

    Citywide implementation of project-based learning highlights the benefits--and the challenges--of promoting exemplary practices across an entire out-of-school time (OST) network. In summer 2009, the City of Philadelphia and its intermediary, the Public Health Management Corporation (PHMC), introduced project-based learning to a network of more…

  18. The Post-Revolutionary Woman Idealized: Philadelphia Media's "Republican Mother."

    List, Karen K.

    1989-01-01

    Examines eighteenth-century periodical literature published in Philadelphia to explore the major shift of women's roles in the United States during the period following the American Revolution. Notes that independence remained a male prerogative in periodicals, while women's issues and movements toward self-realization were ignored. (MM)

  19. Faith Partnerships and Public Schools in Philadelphia: Rewards and Perils.

    Mundell, Leah

    In 1999, Philadelphia (Pennsylvania) school superintendent David Hornbeck introduced educators and religious leaders to his requirement that each public school in the city develop a relationship with a faith partner, a religious institution that could share facilities and resources with the school. Hornbeck saw religious institutions and schools…

  20. The Short-Term Impacts of the Philadelphia Beverage Tax on Beverage Consumption.

    Zhong, Yichen; Auchincloss, Amy H; Lee, Brian K; Kanter, Genevieve P

    2018-04-11

    On January 1, 2017, Philadelphia implemented a beverage tax of $0.015/ounce on sugar ("regular") and sugar-substitute ("diet") beverages. The purpose of this study was to evaluate the immediate impact of the tax on residents' consumption of soda, fruit drinks, energy drinks, and bottled water. A repeat cross-sectional study design used data from a random-digit-dialing phone survey during a no-tax period (December 6-31, 2016) and a tax period (January 15-February 31, 2017) among 899 respondents in Philadelphia, Pennsylvania, and 878 respondents in three nearby comparison cities. Survey questions included frequency and volume of bottled water and beverages. Outcomes were daily consumption, and 30-day consumption frequency and volume. Propensity score-weighted difference-in-differences regression was used to control for secular time trend and confounding. Covariates were sociodemographics, BMI, health status, smoking, and alcohol use. Analyses were conducted in 2017. Within the first 2 months of tax implementation, relative to the comparison cities, in Philadelphia the odds of daily consumption of regular soda was 40% lower (OR=0.6, 95% CI=0.37, 0.97); energy drink was 64% lower (OR=0.36, 95% CI=0.17, 0.76); bottled water was 58% higher (OR=1.58, 95% CI=1.13, 2.20); and the 30-day regular soda consumption frequency was 38% lower (ratio of consumption frequency=0.62, 95% CI=0.40, 0.98). Early results suggest that the tax influenced daily consumption of regular soda, energy drinks, and bottled water. Future studies are needed to evaluate longer-term impact of the tax on sugared beverage consumption and substitutions. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  1. CriticalEd

    Kjellberg, Caspar Mølholt; Meredith, David

    2014-01-01

    . Since the comments are not input sequentially, with regard to position, but in arbitrary order, this list must be sorted by copy/pasting the rows into place—an error-prone and time-consuming process. Scholars who produce critical editions typically use off-the-shelf music notation software......The best text method is commonly applied among music scholars engaged in producing critical editions. In this method, a comment list is compiled, consisting of variant readings and editorial emendations. This list is maintained by inserting the comments into a document as the changes are made......, consisting of a Sibelius plug-in, a cross-platform application, called CriticalEd, and a REST-based solution, which handles data storage/retrieval. A prototype has been tested at the Danish Centre for Music Publication, and the results suggest that the system could greatly improve the efficiency...

  2. Facial trauma

    Maxillofacial injury; Midface trauma; Facial injury; LeFort injuries ... Hockberger RS, Walls RM, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier ...

  3. EDS becoms CERN Openlab contributor

    2007-01-01

    "EDS announced that it has become an official contributor to CERN openlab. The purpose of the joint project beteween CERN and EDS is to carry out research and development in the field of monitoring, management and operation of grid services." (1 page)

  4. Demonstration Assessment of LED Roadway Lighting: Philadelphia, PA

    Royer, Michael P.; Tuenge, Jason R.; Poplawski, Michael E.

    2012-09-01

    For this demonstration assessment, 10 different groups of LED luminaires were installed at three sites in Philadelphia, PA. Each of the three sites represented a different set of conditions, most importantly with regard to the incumbent HPS luminaires, which were nominally 100 W, 150 W, and 250 W. The performance of each product was evaluated based on manufacturer data, illuminance calculations, field measurements of illuminance, and the subjective impressions of both regular and expert observers.

  5. Tijdschriften na 1 januari 2005. Elsevier Science, Wiley, Springer/Kluwer

    Klugkist, A.C.; Laarhoven, Peter van

    2004-01-01

    In aflevering 3 van deze jaargang van Pictogram hebben wij de aandacht gericht op de toen komende onderhandelingen met Elsevier Science, Wiley en Springer/Kluwer over de verlenging van de zogenaamde pakketlicenties. Zoals de meesten bekend is, zijn de faculteiten en de UB sinds 2000/2001 geabonneerd

  6. EDS operator and control software

    Ott, L.L.

    1985-04-01

    The Enrichment Diagnostic System (EDS) was developed at Lawrence Livermore National Laboratory (LLNL) to acquire, display and analyze large quantities of transient data for a real-time Advanced Vapor Laser Isotope Separation (AVLIS) experiment. Major topics discussed in this paper are the EDS operator interface (SHELL) program, the data acquisition and analysis scheduling software, and the graphics software. The workstation concept used in EDS, the software used to configure a user's workstation, and the ownership and management of a diagnostic are described. An EDS diagnostic is a combination of hardware and software designed to study specific aspects of the process. Overall system performance is discussed from the standpoint of scheduling techniques, evaluation tools, optimization techniques, and program-to-program communication methods. EDS is based on a data driven design which keeps the need to modify software to a minimum. This design requires a fast and reliable data base management system. A third party data base management product, Berkeley Software System Database, written explicitly for HP1000's, is used for all EDS data bases. All graphics is done with an in-house graphics product, Device Independent Graphics Library (DIGLIB). Examples of devices supported by DIGLIB are: Versatec printer/plotters, Raster Technologies Graphic Display Controllers, and HP terminals (HP264x and HP262x). The benefits derived by using HP hardware and software as well as obstacles imposed by the HP environment are presented in relation to EDS development and implementation

  7. ScienceDirect through SciVerse: a new way to approach Elsevier.

    Bengtson, Jason

    2011-01-01

    SciVerse is the new combined portal from Elsevier that services their ScienceDirect collection, SciTopics, and their Scopus database. Using SciVerse to access ScienceDirect is the specific focus of this review. Along with advanced keyword searching and citation searching options, SciVerse also incorporates a very useful image search feature. The aim seems to be not only to create an interface that provides broad functionality on par with other database search tools that many searchers use regularly but also to create an open platform that could be changed to respond effectively to the needs of customers.

  8. [The "best" hospitals in the Netherlands; comments on results from the Elsevier survey].

    van Everdingen, J J

    2000-12-30

    Health care workers are increasingly asked to disclose the achievements and failures of their medical interventions. Comparative evaluation of hospitals seems to be inevitable. In July 2000 about 6000 health care workers in the Netherlands received a questionnaire from the general lay weekly Elsevier asking them to grade the hospitals in their area: specialists, general practitioners, heads of departments in hospitals, nursing staff and hospital directors. The questionnaire has serious methodological flaws, e.g. regarding the items included (such as 'press sensitivity' and 'waiting lists'), the way in which the score was determined (hospitals that were scored by less than 14 respondents were excluded), the way the questions were formulated (there was no way respondents could indicate their level of experience with the hospitals involved) and the very low response rate (13%). In addition there were no data to determine the accuracy of the questionnaire, the distribution of the respondents, or whether the answers had been adjusted. The questionnaire appears to be primarily aimed at creating sensation. It received little attention in the health care sector, probably because the results were contrary to the expectations. Hospital care will undoubtedly benefit from surveys applying a limited number of well-designed indicators for quality of service, but a questionable public qualification based on a competitive model such as the Elsevier questionnaire will probably do more harm than good.

  9. CME1003Pg023ED

    Chantel

    resistance alone or severe defects in ... skeletal muscle and liver, decreased ... weight loss through calorie-restrict- ed diets .... carbohydrate and lipid metabolism.12 ... and a variable effect on low-density ... months of therapy.18 Comparison.

  10. SJP0704Pg001ED

    Enrique

    and an updated overview of newer research in this field. It also gives practical ... schizophrenia, manic episodes, major depressive disorder sec- ondary to schizophrenia ..... of Cerebral Disorder. 3rd ed. London: Blackwell Science, 1998. 16.

  11. How Elsevier's Article of the Future supports researchers in the digital era

    Keall, B.

    2012-04-01

    The first phase of Elsevier's Article of the Future article format was released on SciVerse ScienceDirect in January 2012. While this new format for online scholarly articles brings a significantly improved online presentation, it also enables further enhancements in terms of domain-specific content and contextualization of research results. Of particular interest to the Earth Sciences research community are the seamless integration of an interactive map viewer that displays author-submitted KML files inside the article, and real-time links to leading research data portals like Pangaea and Earthchem. These enhancements allow for a richer form of communication between authors and readers, and present researchers with valuable additional information in the context of the article. In this presentaion I will review these ongoing efforts to enhance online articles in the digital era.

  12. Elsevier's Article of the Future enhancing the user experience and integrating data through applications

    IJsbrand Jan Aalbersberg

    2012-03-01

    Full Text Available In a world where our levels of knowledge advance rapidly, so should the communication of research. In partnership with the world's research community, Elsevier investigates the future of research communication with the ‘Article of the Future’. An intuitive online article format, this proposes the next generation in research publishing, with a simple-to-read online layout and enriched content, allowing true immersion in the subject matter. In addition, through the use of SciVerse® Applications, the Article of the Future connects the formal scientific record with associated external data sets and other contextual information that is available elsewhere on the web. In this article, we present the outcomes of the second phase of the Article of the Future project, with an emphasis on its final designs, user feedback collected, and how the Article of the Future handles the rising need of connecting the formal scientific record with associated discipline-specific data sets.

  13. Elsevier Trophoblast Research Award lecture: The multifaceted role of Nodal signaling during mammalian reproduction.

    Park, C B; Dufort, D

    2011-03-01

    Nodal, a secreted signaling protein in the transforming growth factor-beta (TGF-β) superfamily, has established roles in vertebrate development. However, components of the Nodal signaling pathway are also expressed at the maternal-fetal interface and have been implicated in many processes of mammalian reproduction. Emerging evidence indicates that Nodal and its extracellular inhibitor Lefty are expressed in the uterus and complex interactions between the two proteins mediate menstruation, decidualization and embryo implantation. Furthermore, several studies have shown that Nodal from both fetal and maternal sources may regulate trophoblast cell fate and facilitate placentation as both embryonic and uterine-specific Nodal knockout mouse strains exhibit disrupted placenta morphology. Here we review the established and prospective roles of Nodal signaling in facilitating successful pregnancy, including recent evidence supporting a potential link to parturition and preterm birth. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Acute, fatal Sarcocystis calchasi-associated hepatitis in Roller pigeons (Columba livia f. dom.) at Philadelphia Zoo.

    Trupkiewicz, J G; Calero-Bernal, R; Verma, S K; Mowery, J; Davison, S; Habecker, P; Georoff, T A; Ialeggio, D M; Dubey, J P

    2016-01-30

    Four Roller pigeons (Columba livia f. dom.) at the Philadelphia Zoo died suddenly. Necropsy examination revealed macroscopic hepatitis. Microscopically, the predominant lesions were in liver, characterized with necrosis and mixed cell inflammatory response. Sarcocystis calchasi-like schizonts and free merozoites were identified in liver. Transmission electron microscopy confirmed that schizonts were in hepatocytes. A few schizonts were in spleen. PCR using S. calchasi-specific primers confirmed the diagnosis. Neither lesions nor protozoa were found in brain and muscles. This is the first report of acute visceral S. calchasi-associated sarcocystosis in naturally infected avian hosts. Published by Elsevier B.V.

  15. Elsevier Trophoblast Research Award Lecture: origin, evolution and future of placenta miRNAs.

    Morales-Prieto, D M; Ospina-Prieto, S; Schmidt, A; Chaiwangyen, W; Markert, U R

    2014-02-01

    MicroRNAs (miRNAs) regulate the expression of a large number of genes in plants and animals. Placental miRNAs appeared late in evolution and can be found only in mammals. Nevertheless, these miRNAs are constantly under evolutionary pressure. As a consequence, miRNA sequences and their mRNA targets may differ between species, and some miRNAs can only be found in humans. Their expression can be tissue- or cell-specific and can vary time-dependently. Human placenta tissue exhibits a specific miRNA expression pattern that dynamically changes during pregnancy and is reflected in the maternal plasma. Some placental miRNAs are involved in or associated with major pregnancy disorders, such as preeclampsia, intrauterine growth restriction or preterm delivery and, therefore, have a strong potential for usage as sensitive and specific biomarkers. In this review we summarize current knowledge on the origin of placental miRNAs, their expression in humans with special regard to trophoblast cells, interspecies differences, and their future as biomarkers. It can be concluded that animal models for human reproduction have a different panel of miRNAs and targets, and can only partly reflect or predict the situation in humans. Copyright © 2013. Published by Elsevier Ltd.

  16. Uncovering Clinical Features of De Novo Philadelphia Positive Myelodysplasia.

    Armas, Aristides; Chen, Chen; Mims, Martha; Rivero, Gustavo

    2017-01-01

    Myelodysplastic syndrome (MDS) is cytogenetically heterogeneous and retains variable risk for acute myeloid leukemia transformation. Though not yet fully understood, there is an association between genetic abnormalities and defects in gene expression. The functional role for infrequent cytogenetic alteration remains unclear. An uncommon chromosomic abnormality is the presence of the Philadelphia (Ph) chromosome. Here, we report a patient with Ph+ MDS treated with low dose Dasatinib who achieved hematologic response for 7 months. In addition, we also examined the English literature on all de novo Ph + MDS cases between 1996 and 2015 to gain insight into clinical features and outcome.

  17. Progress in mind: focus on alcohol use disorders, an elsevier resource centre.

    Nutt, D J; Rehm, J; van den Brink, W; Gorwood, P; Buchsbaum, M S

    2015-04-30

    Elsevier Ireland Ltd.

  18. Persistence of chromosomal abnormalities additional to the Philadelphia chromosome after Philadelphia chromosome disappearance during imatinib therapy for chronic myeloid leukemia.

    Zaccaria, Alfonso; Valenti, Anna Maria; Donti, Emilio; Gozzetti, Alessandro; Ronconi, Sonia; Spedicato, Francesco

    2007-04-01

    Five Philadelphia chromosome positive (Ph+) chronic myeloid leukemia (CML) patients with additional chromosome abnormalities at diagnosis have been followed during Imatinib therapy. In all, the Ph chromosome disappeared, while the 5 cases, additional abnormalities [dup(1); del(5), +8 (2 patients) and +14] persisted in the subsequent studies, performed over a period of 11 to 49 months, either alone or together with a karyotypically normal cell population. This finding is consistent with a secondary origin of the Ph chromosome in these patients. It is still to early to evaluate the possible prognostic value of these additional abnormalities.

  19. Defining the next generation journal: The NLM–Elsevier interactive publications experiment*

    Siegel, Elliot R.; Lindberg, Donald A.B.; Campbell, Glen P.; Harless, William G.; Goodwin, C. Rory

    2010-01-01

    Objective A unique collaborative project to identify interactive enhancements to conventional-print journal articles, and to evaluate their contribution to readers’ learning and satisfaction. Hypothesis It was hypothesized that (a) the enhanced article would yield more knowledge acquisition than the original article; (b) the interactivity aspects of the enhanced article would measurably contribute to the acquisition of knowledge; and (c) the enhancements to the original article would increase reader acceptance. Methods Fifteen SNMA medical students, assumed to have a greater generational familiarity and comfort level with interactive electronic media, reviewed 12 articles published in three Elsevier clinical and basic science journals. They used the Student National Medical Association’s asynchronous online discussion forum over a four month period to suggest desired enhancements to improve learning. “Prognostic Factors in Stage T1 Bladder Cancer”, published in the journal Urology was selected by the investigators as presenting the best opportunity to incorporate many of the students’ suggested interactive and presentational enhancements in the limited timeframe available prior to the established test date. Educational, statistical, and medical consultants assisted in designing a test protocol in which 51 second to fourth year medical students were randomly assigned to experimental and control conditions, and were administered either the original or enhanced interactive version of the article on individual computer workstations. Test subjects consisted of 23 participants in the control group (8 males, 15 females) and 28 participants in the experimental group (9 males, 19 females). All subjects completed pre- and post-test instruments which measured their knowledge gain on 30 true-false and multiple-choice questions, along with 7 Likert-type questions measuring acceptance of the articles’ format. Time to completion was recorded with the experimental

  20. Defining the next generation journal: The NLM-Elsevier interactive publications experiment.

    Siegel, Elliot R; Lindberg, Donald A B; Campbell, Glen P; Harless, William G; Goodwin, C Rory

    2010-01-01

    A unique collaborative project to identify interactive enhancements to conventional-print journal articles, and to evaluate their contribution to readers' learning and satisfaction. It was hypothesized that (a) the enhanced article would yield more knowledge acquisition than the original article; (b) the interactivity aspects of the enhanced article would measurably contribute to the acquisition of knowledge; and (c) the enhancements to the original article would increase reader acceptance. Fifteen SNMA medical students, assumed to have a greater generational familiarity and comfort level with interactive electronic media, reviewed 12 articles published in three Elsevier clinical and basic science journals. They used the Student National Medical Association's asynchronous online discussion forum over a four month period to suggest desired enhancements to improve learning. "Prognostic Factors in Stage T1 Bladder Cancer", published in the journal Urology was selected by the investigators as presenting the best opportunity to incorporate many of the students' suggested interactive and presentational enhancements in the limited timeframe available prior to the established test date. Educational, statistical, and medical consultants assisted in designing a test protocol in which 51 second to fourth year medical students were randomly assigned to experimental and control conditions, and were administered either the original or enhanced interactive version of the article on individual computer workstations. Test subjects consisted of 23 participants in the control group (8 males, 15 females) and 28 participants in the experimental group (9 males, 19 females). All subjects completed pre- and post-test instruments which measured their knowledge gain on 30 true-false and multiple-choice questions, along with 7 Likert-type questions measuring acceptance of the articles' format. Time to completion was recorded with the experimental group taking 22 min on average compared to 18

  1. Philadelphia (1993: las claves de un icono cultural

    José Aijón Oliva

    2008-10-01

    Full Text Available Philadelphia responde a la razón fundamental del cine comercial de los últimos tiempos: darle al público aquello que quiere ver. A medida que van surgiendo los problemas en la sociedad, el cine se interesa por ellos y realiza películas centradas en ese tema. A principios de los años 90 la alarma social ante el virus del SIDA era tan importante que surgieron muchas películas que trataban este tema. Philadelphia es la más popular de todas ellas y la más accesible (y probablemente la de mayor calidad cinematográfica, aunque su planteamiento es bastante engañoso: no es tanto una película sobre el SIDA como del rechazo al colectivo homosexual. No obstante, desmitifica algunos aspectos del SIDA y da algunas respuestas que se pueden considerar pedagógicas.             Un gran director, un reparto muy acertado, un guión (de estructura clásica de categoría, una música muy bien seleccionada y unos juegos de luces y cámara muy cuidados son los ingredientes que convierten a esta película en uno de los iconos de la cultura popular de los 90.

  2. Philadelphia chromosome-positive acute lymphoblastic leukemia in childhood

    Hong Hoe Koo

    2011-03-01

    Full Text Available In pediatric patients with acute lymphoblastic leukemia (ALL, the Philadelphia chromosome translocation is uncommon, with a frequency of less than 5%. However, it is classified as a high or very high risk, and only 20‒30% of Philadelphia chromosome-positive (Ph+ children with ALL are cured with chemotherapy alone. Allogeneic hematopoietic stem cell transplantation from a closely matched donor cures 60% of patients in first complete remission. Recent data suggest that chemotherapy plus tyrosine kinase inhibitors (TKIs may be the initial treatment of choice for Ph+ ALL in children. However, longer observation is required to determine whether long-term outcome with intensive imatinib and chemotherapy is indeed equivalent to that with allogeneic related or alternative donor hematopoietic stem cell transplantation (HSCT. Reports on the use of second-generation TKIs in children with Ph+ ALL are limited. A few case reports have indicated the feasibility and clinical benefit of using dasatinib as salvage therapy enabling HSCT. However, more extensive data from clinical trials are needed to determine whether the administration of secondgeneration TKIs in children is comparable to that in adults. Because Ph+ ALL is rare in children, the question of whether HSCT could be a dispensable part of their therapy may not be answered for some time. An international multicenter study is needed to answer the question of whether imatinib plus chemotherapy could replace sibling allogeneic HSCT in children with Ph+ ALL.

  3. Urban ecosystem services and decision making for a green Philadelphia

    Hogan, Dianna M.; Shapiro, Carl D.; Karp, David N.; Wachter, Susan M.

    2014-01-01

    Traditional approaches to urban development often do not account for, or recognize, the role of ecosystem services and the benefits these services provide to the health and well-being of city residents. Without such accounting, urban ecosystem services are likely to be degraded over time, with negative consequences for the sustainability of cities and the well-being of their residents (Millennium Ecosystem Assessment, 2005; Hirsch, 2008). On May 23, 2013, the Spatial Integration Laboratory for Urban Systems (SILUS), a collaboration between the U.S. Geological Survey (USGS) Science and Decisions Center and the Wharton GIS Lab, convened a one-day symposium—Urban Ecosystem Services and Decision Making: A Green Philadelphia—at the University of Pennsylvania in Philadelphia, Pennsylvania, to examine the role of green infrastructure in the environmental, economic, and social well-being of cities. Cosponsored by the USGS and the Penn Institute for Urban Research (Penn IUR), the symposium brought together policymakers, practitioners, and researchers from a range of disciplines to advance a research agenda on the use of science in public decision making to inform investment in green infrastructure and ecosystem services in urban areas. The city of Philadelphia has recently implemented a program designed to sustain urban ecosystem services and advance the use of green infrastructure. In 2009, the Philadelphia Mayor’s Office of Sustainability launched its Greenworks plan, establishing a citywide sustainability strategy. Major contributions towards its goals are being implemented in coordination with the Philadelphia Water Department (PWD). The Green City, Clean Waters initiative, the city’s nationally recognized stormwater management plan, was signed into action with the U.S. Environmental Protection Agency (EPA) in April 2012. The plan outlines a 25-year strategy to use green infrastructure to protect and improve the city’s watershed. Widespread support for the

  4. 78 FR 75902 - Approval and Promulgation of Air Quality Implementation Plans; Pennsylvania; Philadelphia County...

    2013-12-13

    ... to EPA. See NRDC v. EPA, 571 F.3d 1245 (D.C. Cir. 2009). Since the Philadelphia County 2006 SIP... Call constitutes RACT for EGU sources in Philadelphia County. Thus, AMS needs to perform a NO X RACT... 52.2020(d)(1)) continue to represent adequately RACT for the 1997 8-hour ozone NAAQS; or (2) perform...

  5. Ferritin blood test

    ... and minerals. In: Baynes JW, Dominiczak MH, eds. Medical Biochemistry . 4th ed. Elsevier Saunders; 2014:chap 11. Ginder GD. Microcytic and hypochromic anemias. In: Goldman L, Schafer AI, ... . 25th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 159.

  6. Vaginal dryness

    ... to Physical Examination . 8th ed. St Louis, MO: Elsevier Mosby; 2015:chap 18. Gardella C, Eckert LO, ... FA, eds. Comprehensive Gynecology . 7th ed. Philadelphia, PA: Elsevier; 2017:chap 23. Grady D, Barrett-Connor E. ...

  7. Mitigating Higher Ed Cyber Attacks

    Rogers, Gary; Ashford, Tina

    2015-01-01

    In this presentation we will discuss the many and varied cyber attacks that have recently occurred in the higher ed community. We will discuss the perpetrators, the victims, the impact and how these institutions have evolved to meet this threat. Mitigation techniques and defense strategies will be covered as will a discussion of effective security…

  8. Seasonal dependence of aerosol processing in urban Philadelphia

    Avery, A. M.; Waring, M. S.; DeCarlo, P. F.

    2017-12-01

    Urban aerosols pose an important threat to human health due to the conflation of emissions and concentrated population exposed. Winter and summer aerosol and trace gas measurements were taken in downtown Philadelphia in 2016. Measurements included aerosol composition and size with an Aerodyne Aerosol Mass Spectrometer (AMS), particle size distributions with an SMPS, and an aethalometer. Trace gas measurements of O3, NO, CH4, CO, and CO2 were taken concurrently. Sampling in seasonal extremes provided contrast in aerosol and trace gas composition, aerosol processing, and emission factors. Inorganic aerosol components contributed approximately 60% of the submicron aerosol mass, while summertime aerosol composition was roughly 70% organic matter. Positive Matrix Factorization (PMF) on the organic aerosol (OA) matrix revealed three factors in common in each season, including an oxygenated organic aerosol (OOA) factor with different temporal behavior in each season. In summertime, OOA varied diurnally with ozone and daytime temperature, but in the wintertime, it was anti-correlated with ozone and temperature, and instead trended with calculated liquid water, indicating a seasonally-dependent processing of organic aerosol in Philadelphia's urban environment. Due to the inorganic dominant winter aerosol, liquid water much higher (2.65 μg/m3) in winter than in summer (1.54 μg/m3). Diurnally varying concentrations of background gas phase species (CH4, CO2) were higher in winter and varied less as a result of boundary layer conditions; ozone was also higher in background in winter than summer. Winter stagnation events with low windspeed showed large buildup of trace gases CH4, CO, CO2, and NO. Traffic related aerosol was also elevated with black carbon and hydrocarbon-like OA (HOA) plumes of each at 3-5 times higher than the winter the average value for each. Winter ratios of HOA to black carbon were significantly higher in the winter than the summer due to lower

  9. Moments of disaster response in the emergency department (ED).

    Hammad, Karen S; Arbon, Paul; Gebbie, Kristine; Hutton, Alison

    2017-11-01

    We experience our lives as a series of memorable moments, some good and some bad. Undoubtedly, the experience of participating in disaster response, is likely to stand out as a memorable moment in a nurses' career. This presentation will describe five distinct moments of nursing in the emergency department (ED) during a disaster response. A Hermeneutic Phenomenological approach informed by van Manen underpins the research process. Thirteen nurses from different countries around the world participated in interviews about their experience of working in the ED during a disaster. Thematic analysis resulted in five moments of disaster response which are common to the collective participant experience. The 5 themes emerge as Notification (as a nurse finds out that the ED will be receiving casualties), Waiting (waiting for the patients to arrive to the ED), Patient Arrival (the arrival of the first patients to the ED), Caring for patients (caring for people affected by the disaster) and Reflection (the moment the disaster response comes to an end). This paper provides an in-depth insight into the experience of nursing in the ED during a disaster response which can help generate awareness and inform future disaster preparedness of emergency nurses. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  10. Learning From Philadelphia: Topographies of HIV/AIDS Media Assemblages.

    Cartwright, Lisa

    2016-01-01

    For this contribution to the special issue on "Mapping Queer Bioethics," the author employs an array of public health and popular media texts (especially Jonathan Demme's film Philadelphia) to challenge the construction and reconstruction of HIV-positive bodies as sites of bioethical concern. In outlining notions of "digital restoration," the author argues that there has been of late a remapping of the first decade of the HIV/AIDS pandemic through media projects assembled from archived materials. Accordingly, the author suggests that in the first decades of the 2000s, we have witnessed a media-archaeological turn, whereby old materials have been reassembled for commemorative purposes that oftentimes perform a reshaping of the topography of the first decade of the AIDS pandemic.

  11. Volunteer Environmental Stewardship and Affective Labour in Philadelphia

    Alec Foster

    2018-01-01

    Full Text Available Recent research has critically evaluated the rapid growth of volunteer urban environmental stewardship. Framings of this phenomenon have largely focused upon environmentality and/or neoliberal environments, unfortunately often presenting a totalising picture of the state and/or market utilising power from above to create environmental subjects with limited agency available to local citizens. Based upon qualitative research with volunteer urban environmental stewards in Philadelphia, affective labour is proposed as an alternative explanation for participation. Stewards volunteered their time and labour due to the intense emotional attachments they formed with their neighbourhoods, neighbours, and nonhuman others in relationships of affective labour. Volunteer urban environmental stewardship as affective labour provides room for agency on the part of individuals and groups involved in volunteer urban environmental reproduction and opens up new ways of relating to and being with human and nonhuman others.

  12. Cabaña ED

    Lorena Troncoso Valencia

    2018-01-01

    Full Text Available Este proyecto denominado Cabaña Ed, de la arquitecta chilena Lorena Troncoso Valencia, es parte de una serie de obras emplazadas en la comuna de Pinto, Región de Ñuble de Chile. Zona de frondosa vegetación de árboles autóctonos y con fugas visuales hacia la cordillera de los Andes. La Cabaña Ed, donde predomina el uso de la madera, se integra muy sutilmente con ese entorno natural. Cabin ED, by the Chilean architect Lorena Troncoso Valencia, is part of a series of works located in the commune of Pinto, Ñuble Region, Chile. This area is characterized by lush vegetation of native trees and visual towards the Andes leaks. In this project the use of wood predominates, which is subtly integrated with the natural environment. In the edition of REVISTARQUIS 11, another project of the architect, located in that same zone of tourist development was presented.

  13. Ed Watson 1940-2006

    2006-01-01

    Ed Watson arrived at CERN in March 1973 to work on digital electronics and CAMAC systems under Bob Dobinson, after many years at Rolls Royce in Scotland. He joined the European Muon Collaboration in 1976, where he played a major role in the design, deployment and running of its data acquisition system (DAQ) with David Botterill, Bob Dobinson, and Vicky White. The CAMAC-ROMULUS system was by far the largest and most advanced of its time, and it became a defining standard for DAQ systems for years to come. Ed was deeply involved in the detailed planning of the control rooms and the experiment cabling, as well as sharing the responsibility for the CAMAC readout system. He had a real talent for trouble shooting and played a vital part in supporting the experiment throughout its lifetime. He offered great moral support to the younger members of the collaboration and helped them a great deal with their work. The EMC had a wonderful social life to which Ed was a major contributor - who can forget its barbecues?  In...

  14. Ed Watson - 1940-2006

    2006-01-01

    Ed Watson passed away suddenly on 1 August in Geneva, he was 66. He leaves his wife and two children. Ed Watson arrived at CERN in March 1973 to work on digital electronics and CAMAC systems under Bob Dobinson, after many years at Rolls Royce in Scotland. He joined the European Muon Collaboration in 1976, where he played a major role in the design, deployment and running of its data acquisition system (DAQ) with David Botterill, Bob Dobinson, and Vicky White. The CAMAC-ROMULUS system was by far the largest and most advanced of its time, and it became a defining standard for DAQ systems for years to come. Ed was deeply involved in the detailed planning of the control rooms and the experiment cabling, as well as sharing the responsibility for the CAMAC readout system. He had a real talent for trouble shooting and played a vital part in supporting the experiment throughout its lifetime. He offered great moral support to the younger members of the collaboration and helped them a great deal with their work. The...

  15. SAJS SAJS

    Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Text- book of Surgery. 17th ed. Philadelphia: Elsevier Saunders, 2004: 852-854. 5. Teknos TN. Salivary gland neoplasms. In: Greenfield LJ, ed. Surgery: Scientific Principles and Practice. 3rd ed. Philadelphia: Lippincott Williams &. Wilkins, 2001: 650-652.

  16. Assessment of Child Lead Exposure in a Philadelphia Community, 2014.

    Dignam, Timothy; Pomales, Ana; Werner, Lora; Newbern, E Claire; Hodge, James; Nielsen, Jay; Grober, Aaron; Scruton, Karen; Young, Rand; Kelly, Jack; Brown, Mary Jean

    2018-01-10

    Several urban neighborhoods in Philadelphia, Pennsylvania, have a history of soil, household lead paint, and potential lead-emitting industry contamination. To (1) describe blood lead levels (BLLs) in target neighborhoods, (2) identify risk factors and sources of lead exposure, (3) describe household environmental lead levels, and (4) compare results with existing data. A simple, random, cross-sectional sampling strategy was used to enroll children 8 years or younger living in selected Philadelphia neighborhoods with a history of lead-emitting industry during July 2014. Geometric mean of child BLLs and prevalence of BLLs of 5 μg/dL or more were calculated. Linear and logistic regression analyses were used to ascertain risk factors for elevated BLLs. Among 104 children tested for blood lead, 13 (12.4%; 95% confidence interval [CI], 7.5-20.2) had BLLs of 5 μg/dL or more. The geometric mean BLL was 2.0 μg/dL (95% CI, 1.7-2.3 μg/dL). Higher geometric mean BLLs were significantly associated with front door entryway dust lead content, residence built prior to 1900, and a child currently or ever receiving Medicaid. Seventy-one percent of households exceeded the screening level for soil, 25% had an elevated front door floor dust lead level, 28% had an elevated child play area floor dust lead level, and 14% had an elevated interior window dust lead level. Children in households with 2 to 3 elevated environmental lead samples were more likely to have BLLs of 5 μg/dL or more. A spatial relationship between household proximity to historic lead-emitting facilities and child BLL was not identified. Entryway floor dust lead levels were strongly associated with blood lead levels in participants. Results underscore the importance to make housing lead safe by addressing all lead hazards in and around the home. Reduction of child lead exposure is crucial, and continued blood lead surveillance, testing, and inspection of homes of children with BLLs of 5 μg/dL or more to identify

  17. 78 FR 14359 - Verizon Business Networks Services, Inc., Specialist-Tech Customer Service, Philadelphia, PA...

    2013-03-05

    ... Business Networks Services, Inc., Specialist-Tech Customer Service, Philadelphia, PA; Verizon Business Networks Services, Inc., Specialist-Tech Customer Service, Tampa, Florida; Amended Certification Regarding... should [[Page 14360

  18. Settlement to Improve Water Quality in Delaware River, Philadelphia-Area Creeks

    EPA and the U.S. Department of Justice have reached agreement with a major water utility in the greater Philadelphia area to significantly reduce sewage discharges to the Delaware River and local creeks.

  19. Relationship Between Total and Biaccessible Lead on Children's Blood Lead Levles in Urban Residential Philadelphia Soils.

    U.S. Environmental Protection Agency — Relationship Between Total and Biaccessible Lead on Children's Blood Lead Levles in Urban Residential Philadelphia Soils. This dataset is not publicly accessible...

  20. SEASONAL ABUNDANCE OF ORGANIC MOLECULAR MARKERS IN URBAN PARTICULATE MATTER FROM PHILADELPHIA, PA

    Organic molecular markers were measured in airborne particulate matter (PM10) from the City of Philadelphia North Broad Street air quality monitoring site to identify the seasonal abundances of key tracer compounds together with their dominant sources. Daily PM10...

  1. Increased gene expression of histone deacetylases in patients with Philadelphia-negative chronic myeloproliferative neoplasms

    Skov, Vibe; Larsen, Thomas Stauffer; Thomassen, Mads

    2012-01-01

    Abstract Myeloproliferation, myeloaccumulation (decreased apoptosis), inflammation, bone marrow fibrosis and angiogenesis are cardinal features of the Philadelphia-negative chronic myeloproliferative neoplasms: essential thrombocythemia (ET), polycythemia vera (PV) and primary myelofibrosis (PMF...

  2. AdvancED Flex 4

    Tiwari, Shashank; Schulze, Charlie

    2010-01-01

    AdvancED Flex 4 makes advanced Flex 4 concepts and techniques easy. Ajax, RIA, Web 2.0, mashups, mobile applications, the most sophisticated web tools, and the coolest interactive web applications are all covered with practical, visually oriented recipes. * Completely updated for the new tools in Flex 4* Demonstrates how to use Flex 4 to create robust and scalable enterprise-grade Rich Internet Applications.* Teaches you to build high-performance web applications with interactivity that really engages your users.* What you'll learn Practiced beginners and intermediate users of Flex, especially

  3. Developing a Community-Wide Initiative to Address Childhood Adversity and Toxic Stress: A Case Study of The Philadelphia ACE Task Force.

    Pachter, Lee M; Lieberman, Leslie; Bloom, Sandra L; Fein, Joel A

    The Philadelphia ACE Task Force is a community based collaborative of health care providers, researchers, community-based organizations, funders, and public sector representatives. The mission of the task force is to provide a venue to address childhood adversity and its consequences in the Philadelphia metropolitan region. In this article we describe the origins and metamorphosis of the Philadelphia ACE Task Force, which initially was narrowly focused on screening for adverse childhood experiences (ACEs) in health care settings but expanded its focus to better represent a true community-based approach to sharing experiences with addressing childhood adversity in multiple sectors of the city and region. The task force has been successful in developing a research agenda and conducting research on ACEs in the urban context, and has identified foci of local activity in the areas of professional training and workforce development, community education, and local practical interventions around adversity, trauma, and resiliency. In this article we also address the lessons learned over the first 5 years of the task force's existence and offers recommendations for future efforts to build a local community-based ACEs collaborative. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  4. Cuts and puncture wounds

    ... 2014:chap 34. Simon BC, Hern HG. Wound management principles. In: Walls RM, Hockberger RS, Gausche-Hill M, eds, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 9th ed. Philadelphia, PA: Elsevier Saunders; 2018:chap ...

  5. Hyperparathyroidism

    ... LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric . 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 63. Thakker RV. The parathyroid glands, hypercalcemia and hypocalcemia. In: Goldman L, Schafer AI, eds. Goldman's Cecil ...

  6. Parathyroid hyperplasia

    ... LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric . 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 63. Thakker R. The parathyroid glands, hypercalcemia and hypocalcemia. In: Goldman L, Schafer AI, eds. Goldman's Cecil ...

  7. Parathyroid adenoma

    ... LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric . 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 63. Thakker RV. The parathyroid glands, hypercalcemia, and hypocalcemia. In: Goldman L, Schafer AI, eds. Goldman's Cecil ...

  8. Osteitis fibrosa

    ... LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric . 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 63. Thakker RV. The parathyroid glands, hypercalcemia and hypocalcemia. In: Goldman L, Schafer AI, eds. Goldman's Cecil ...

  9. Electrical injury

    ... RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 134. Price LA, Loiacono LA. Electrical and lightning injury. In: Cameron JL, Cameron AM, eds. Current Surgical ...

  10. Sex differences in brain and behavior in adolescence: Findings from the Philadelphia Neurodevelopmental Cohort.

    Gur, Raquel E; Gur, Ruben C

    2016-11-01

    Sex differences in brain and behavior were investigated across the lifespan. Parameters include neurobehavioral measures linkable to neuroanatomic and neurophysiologic indicators of brain structure and function. Sexual differentiation of behavior has been related to organizational factors during sensitive periods of development, with adolescence and puberty gaining increased attention. Adolescence is a critical developmental period where transition to adulthood is impacted by multiple factors that can enhance vulnerability to brain dysfunction. Here we highlight sex differences in neurobehavioral measures in adolescence that are linked to brain function. We summarize neuroimaging studies examining brain structure, connectivity and perfusion, underscoring the relationship to sex differences in behavioral measures and commenting on hormonal findings. We focus on relevant data from the Philadelphia Neurodevelopmental Cohort (PNC), a community-based sample of nearly 10,000 clinically and neurocognitively phenotyped youths age 8-21 of whom 1600 have received multimodal neuroimaging. These data indicate early and pervasive sexual differentiation in neurocognitive measures that is linkable to brain parameters. We conclude by describing possible clinical implications. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Imatinib Intolerance Is Associated With Blastic Phase Development in Philadelphia Chromosome-Positive Chronic Myeloid Leukemia.

    Ángeles-Velázquez, Jorge Luis; Hurtado-Monroy, Rafael; Vargas-Viveros, Pablo; Carrillo-Muñoz, Silvia; Candelaria-Hernández, Myrna

    2016-08-01

    Over the past years, the survival of patients with Philadelphia-positive chronic myeloid leukemia (CML Ph(+)) has increased as a result of therapy with tyrosin kinase inhibitors (TKIs). Intolerance to TKIs has been described in approximately 20% of patients receiving treatment. We studied the incidence of imatinib intolerance in patients with CML Ph(+) and their outcome in our CML reference site, as there is no information about the evolution of patients intolerant to TKIs. A group of 86 patients with CML Ph(+) receiving imatinib monotherapy who abandoned treatment were the basis for this study. We present the trends of their disease evolution. The median of age at diagnosis was 42 years. Within a year, 19 (22%) of 86 patients developed imatinib intolerance, all of them with grade III or IV disease that required imatinib dose reduction or discontinuation. Of these patients, 16 (84%) of 19 developed transformation to blastic phase. The cumulative incidences of blastic phase development were 47% in the nonintolerant group and 84% in the intolerant group. There was a relative risk for those with imatinib intolerance to develop blastic phase of 1.78 (95% confidence interval, 1.28 to 2.42) (P treatment is available. Future research should to determine whether the origin of this evolution is really due to the intolerance itself or whether it is due to a more aggressive form of the disease, perhaps related to genetic transformation. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Philadelphia chromosome-negative myeloproliferative disorders: biology and treatment.

    Hoffman, Ronald; Prchal, Josef T; Samuelson, Scott; Ciurea, Stefan O; Rondelli, Damiano

    2007-01-01

    The Philadelphia chromosome (Ph)-negative myeloproliferative disorders (MPDs) include essential thrombocythemia (ET), idiopathic myelofibrosis (IMF), and polycythemia vera (PV). All of these disorders are clonal hematologic malignancies originating at the level of the pluripotent hematopoietic stem cell. Recently, activating mutations of the intracellular cytokine-signaling molecule JAK2 have been identified in > 90% of patients with PV and in 50% of those with IMF and ET. In addition, a mutation of the thrombopoietin receptor, MPLW515L, has been documented in some patients with IMF. Both mutations activate JAK-STAT signaling pathways and likely play a role in disease progression. Both ET and PV are associated with prolonged clinical courses associated with frequent thrombotic and hemorrhagic events, and progression to myelofibrosis and acute leukemia. IMF has a much poorer prognosis and is associated with cytopenias, splenomegaly, extramedullary hematopoiesis, and bone marrow fibrosis. Stratification of risk for the development of complications from Ph-negative MPDs has guided the identification of appropriate therapies for this population. Intermediate/high-risk IMF or myelofibrosis after ET or PV is associated with a sufficiently poor prognosis to justify the use of allogeneic stem cell transplantation, which is capable of curing such patients. Reduced-intensity conditioning in preparation for allogeneic stem cell transplantation has permitted older patients with IMF to undergo transplantation with increasing success.

  13. Defensible Spaces in Philadelphia: Exploring Neighborhood Boundaries Through Spatial Analysis

    Rory Kramer

    2017-02-01

    Full Text Available Few spatial scales are as important to individual outcomes as the neighborhood. However, it is nearly impossible to define neighborhoods in a generalizable way. This article proposes that by shifting the focus to measuring neighborhood boundaries rather than neighborhoods, scholars can avoid the problem of the indefinable neighborhood and better approach questions of what predicts racial segregation across areas. By quantifying an externality space theory of neighborhood boundaries, this article introduces a novel form of spatial analysis to test where potential physical markers of neighborhood boundaries (major roads, rivers, railroads, and the like are associated with persistent racial boundaries between 1990 and 2010. Using Philadelphia as a case study, the paper identifies neighborhoods with persistent racial boundaries. It theorizes that local histories of white reactions to black in-migration explain which boundaries persistently resisted racial turnover, unlike the majority of Philadelphia’s neighborhoods, and that those racial boundaries shape the location, progress, and reaction to new residential development in those neighborhoods.

  14. Real time analysis under EDS

    Schneberk, D.

    1985-07-01

    This paper describes the analysis component of the Enrichment Diagnostic System (EDS) developed for the Atomic Vapor Laser Isotope Separation Program (AVLIS) at Lawrence Livermore National Laboratory (LLNL). Four different types of analysis are performed on data acquired through EDS: (1) absorption spectroscopy on laser-generated spectral lines, (2) mass spectrometer analysis, (3) general purpose waveform analysis, and (4) separation performance calculations. The information produced from this data includes: measures of particle density and velocity, partial pressures of residual gases, and overall measures of isotope enrichment. The analysis component supports a variety of real-time modeling tasks, a means for broadcasting data to other nodes, and a great degree of flexibility for tailoring computations to the exact needs of the process. A particular data base structure and program flow is common to all types of analysis. Key elements of the analysis component are: (1) a fast access data base which can configure all types of analysis, (2) a selected set of analysis routines, (3) a general purpose data manipulation and graphics package for the results of real time analysis. Each of these components are described with an emphasis upon how each contributes to overall system capability. 3 figs

  15. Comparison of geographic methods to assess travel patterns of persons diagnosed with HIV in Philadelphia: how close is close enough?

    Eberhart, Michael G; Share, Amanda M; Shpaner, Mark; Brady, Kathleen A

    2015-02-01

    Travel distance to medical care has been assessed using a variety of geographic methods. Network analyses are less common, but may generate more accurate estimates of travel costs. We compared straight-line distances and driving distance, as well as average drive time and travel time on a public transit network for 1789 persons diagnosed with HIV between 2010 and 2012 to identify differences overall, and by distinct geographic areas of Philadelphia. Paired t-tests were used to assess differences across methods, and analysis of variance was used to assess between-group differences. Driving distances were significantly longer than straight-line distances (ptravel costs, and may improve models to predict medical care outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Operational and financial impact of physician screening in the ED.

    Soremekun, Olanrewaju A; Biddinger, Paul D; White, Benjamin A; Sinclair, Julia R; Chang, Yuchiao; Carignan, Sarah B; Brown, David F M

    2012-05-01

    Physician screening is one of many front-end interventions being implemented to improve emergency department (ED) efficiency. We aimed to quantify the operational and financial impact of this intervention at an urban tertiary academic center. We conducted a 2-year before-after analysis of a physician screening system at an urban tertiary academic center with 90 000 annual visits. Financial impact consisted of the ED and inpatient revenue generated from the incremental capacity and the reduction in left without being seen (LWBS) rates. The ED and inpatient margin contribution as well as capital expenditure were based on available published data. We summarized the financial impact using net present value of future cash flows performing sensitivity analysis on the assumptions. Operational outcome measures were ED length of stay and percentage of LWBS. During the first year, we estimate the contribution margin of the screening system to be $2.71 million and the incremental operational cost to be $1.86 million. Estimated capital expenditure for the system was $1 200 000. The NPV of this investment was $2.82 million, and time to break even from the initial investment was 13 months. Operationally, despite a 16.7% increase in patient volume and no decrease in boarding hours, there was a 7.4% decrease in ED length of stay and a reduction in LWBS from 3.3% to 1.8%. In addition to improving operational measures, the implementation of a physician screening program in the ED allowed for an incremental increase in patient care capacity leading to an overall positive financial impact. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. New EdF's three challenges

    Lepetit, V.

    2005-01-01

    The opening of 15% of Electricite de France (EdF) capital to the private sector will allow the first world electric utility to raise 7 billions of euros of cash flow. EdF will have also to face the new European situation: a strained market, several consolidations to come and many competitors to deal with. EdF has to re-launch its production tool and to reinforce its interconnection capacities if it wants to stay the number one of power exports in Europe. The integration of Edison company (Italy) by EdF gives access to new gas capacities but other resources have to be found if EdF wants to enlarge its gas offer. A new concentration era is foreseen in Europe and EdF will have to seize the economic growth opportunities in particular in Europe and China. (J.S.)

  18. ED pharmacist monitoring of provider antibiotic selection aids appropriate treatment for outpatient UTI.

    Lingenfelter, Erin; Drapkin, Zachary; Fritz, Kelly; Youngquist, Scott; Madsen, Troy; Fix, Megan

    2016-08-01

    We sought to determine whether an emergency department (ED) pharmacist could aid in the monitoring and correction of inappropriate empiric antibiotic selection for urinary tract infections in an outpatient ED population. Urine cultures with greater than 100 000 CFU/mL bacteria from the University of Utah Emergency Department over 1 year (October 2011-Sept 2012) were identified using our electronic medical record system. Per ED protocol, an ED pharmacist reviews all cultures and performs a chart review of patient symptoms, diagnosis, and discharge antibiotics to determine whether the treatment was appropriate. A retrospective review of this process was performed to identify how often inappropriate treatment was recognized and intervened on by an ED pharmacist. Of the 180 cultures included, a total of 42 (23%) of empiric discharge treatments were considered inappropriate and required intervention. In 35 (83%) of 42 patients, the ED pharmacist was able to contact the patient and make appropriate changes; the remaining 7 patients were unable to be contacted, and no change could be made in their treatment. A chart review of all urine cultures with greater than 100 000 CFU/mL performed by an ED pharmacist helped identify inappropriate treatment in 23% of patients discharged to home with the diagnosis of urinary tract infection. Of these patients who had received inappropriate treatment, an ED pharmacist was able to intervene in 83% of cases. These data highlight the role of ED pharmacists in improving patient care after discharge. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. A preliminary examination of Loss of Control Eating Disorder (LOC-ED) in middle childhood.

    Matherne, Camden E; Tanofsky-Kraff, Marian; Altschul, Anne M; Shank, Lisa M; Schvey, Natasha A; Brady, Sheila M; Galescu, Ovidiu; Demidowich, Andrew P; Yanovski, Susan Z; Yanovski, Jack A

    2015-08-01

    Loss of Control Eating Disorder (LOC-ED) has been proposed as a diagnostic category for children 6-12years with binge-type eating. However, characteristics of youth with LOC-ED have not been examined. We tested the hypothesis that the proposed criteria for LOC-ED would identify children with greater adiposity, more disordered eating attitudes, and greater mood disturbance than those without LOC-ED. Participants were 251 youth (10.29years±1.54, 53.8% female, 57.8% White, 35.5% Black, 2.0% Asian, 4.8% Hispanic, 53.0% overweight). Youth were interviewed regarding eating attitudes and behaviors, completed questionnaires to assess general psychopathology, and underwent measurements of body fat mass. Using previously proposed criteria for LOC-ED, children were classified as LOC-ED (n=19), LOC in the absence of the full disorder (subLOC, n=33), and youth not reporting LOC (noLOC, n=199). LOC-ED youth had higher BMIz (p=0.001) and adiposity (p=0.003) and reported greater disordered eating concerns (pdisordered eating attitudes (p=0.02). SubLOC youth had greater disordered eating concerns (pdisordered eating cognitions and anthropometric measures compared to youth without LOC-ED. Longitudinal studies are needed to determine if those with LOC-ED are at particularly increased risk for progression of disordered eating and excess weight gain. Published by Elsevier Ltd.

  20. Hand-held ultrasound serving three EDs.

    2007-02-01

    Having a portable ultrasound available to your ED will enable you to perform scans during the nighttime hours, instead of having patients wait for several hours until the radiology department opens. Additional time can be saved by having a technologist read the scans, which frees your ED physicians for other duties. Having ED docs contact the technologist directly, rather than going through a resident, also saves valuable time. Arriving at a diagnosis more quickly provides a boost to patient safety.

  1. Estrogen overdose

    ... treated. Treatment may include: Activated charcoal (in extreme cases) Blood and urine ... Rosen's Emergency Medicine: Concepts and Clinical Practice . 9th ed. Philadelphia, PA: Elsevier; 2018:chap ...

  2. Peripheral neuropathy

    ... peripheral; Neuritis - peripheral; Nerve disease; Polyneuropathy; Chronic pain - peripheral neuropathy ... Philadelphia, PA: Elsevier; 2016:chap 107. Shy ME. Peripheral neuropathies. In: Goldman L, Schafer AI, eds. Goldman's Cecil ...

  3. Shutdown risk management applied at Philadelphia Electric Company

    Dagan, William J.; True, Douglas E.; Wilson, Thomas; Truax, William

    2004-01-01

    The development and implementation of an effective risk management program requires basic risk or safety knowledge and the conversion of such information into effective management tools. ERIN Engineering and Research, Inc., under contract to the Electric Power Research Institute, has developed an effective program. Outage Risk Assessment and Management (ORAM), to provide plant and management personnel with understandable results of shutdown risk studies. With this tool, the impact of plans and decision options can be readily determined and displayed for the decision maker. This paper describes these methods and their application to the Limerick Nuclear Station of Philadelphia Electric Company. It also sets forth a broader application of these methods to include support of management decisions at-power and following forced outages. The result is an integrated risk management framework which can allow management and technical personnel to utilize readily available and understandable risk insights to optimize each activity. This paper addresses the resolution of several key issues in detail: How was the ORAM risk management method employed to represent the existing plant shutdown procedures and policies? How did the ORAM risk management method enhance the decision-making ability of the outage management staff? How was the ORAM software efficiently integrated with the outage scheduling software? How is quantitative risk information generated and used for outage planning and control? The ORAM risk management philosophy utilizes a series of colors to depict various risk configurations. Each such configuration has associated with it clear guidance. By modifying the conditions existing in the plant it is possible to impact the type of risk being encountered as well as the guidance which is appropriate for that period. In addition, the duration of a particular configuration can be effectively managed to reduce the overall risk impact. These are achieved with minimal

  4. Epigenetics in adaptive evolution and development: the interplay between evolving species and epigenetic mechanisms: extract from Trygve Tollefsbol (ed.) (2011) Handbook of epigenetics--the new molecular and medical genetics. Chapter 26. Amsterdam, USA: Elsevier, pp. 423-446.

    House, Simon H

    2013-04-01

    By comparing epigenetics of current species with fossil records across evolutionary transitions, we can gauge the moment of emergence of some novel mechanisms in evolution, and recognize that epigenetic mechanisms have a bearing on mutation. Understanding the complexity and changeability of these mechanisms, as well as the changes they can effect, is both fascinating and of vital practical benefit. Our most serious pandemics of so-called 'non-communicable' diseases - mental and cardiovascular disorders, obesity and diabetes, rooted in the 'metabolic syndrome' - are evidently related to effects on our evolutionary mechanisms of agricultural and food industrialization, modern lifestyle and diet. Pollution affects us directly as well as indirectly by its destruction of ecologically essential biosystems. Evidently such powerful conditions of existence have epigenetic effects on both our health and our continuing evolution. Such effects are most profound during reproductive and developmental processes, when levels of hormones, as affected by stress particularly, may be due to modern cultures in childbearing such as excessive intervention, separation, maternal distress and disruption of bonding. Mechanisms of genomic imprinting seem likely to throw light on problems in assisted reproductive technology, among other transgenerational effects. © The Author(s) 2014.

  5. The Impact of "ED" on Educational Research.

    Florio, David H.

    1980-01-01

    The purposes, structure, and component parts of the newly formed Department of Education (ED) organizations from which educational research programs will be administered are discussed. As the climate surrounding ED changes, opportunities to take advantage of the elevated status of research will be presented. (Author/RL)

  6. Over-the-counter pain relievers

    ... Waltham, MA: Elsevier; 2016:236-272. Dinakar P. Principles of pain management. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice . 7th ed. Philadelphia, PA: Elsevier; 2016:chap 54.

  7. Transurethral resection of the prostate

    ... and Treatment in Prostate Pathology . San Diego, CA: Elsevier Academic Press; 2016:chap 2. Han M, Partin ... eds. Campbell-Walsh Urology . 11th ed. Philadelphia, PA: Elsevier; 2016:chap 106. Kaplan SA. Benign prostatic hyperplasia ...

  8. Effects of Bosutinib Treatment on Renal Function in Patients With Philadelphia Chromosome-Positive Leukemias.

    Cortes, Jorge E; Gambacorti-Passerini, Carlo; Kim, Dong-Wook; Kantarjian, Hagop M; Lipton, Jeff H; Lahoti, Amit; Talpaz, Moshe; Matczak, Ewa; Barry, Elly; Leip, Eric; Brümmendorf, Tim H; Khoury, H Jean

    2017-10-01

    The purpose of the study was to assess renal function in patients with Philadelphia chromosome-positive leukemias receiving bosutinib or imatinib. Patients received first-line bosutinib (n = 248) or imatinib (n = 251; phase III trial), or second-line or later bosutinib (phase I/II trial; n = 570). Adverse events (AEs) and changes from baseline in estimated glomerular filtration rate (eGFR) and serum creatinine were assessed. Time from the last patient's first dose to data cutoff was ≥ 48 months. Renal AEs were reported in 73/570 patients (13%) receiving second-line or later bosutinib, and in 22/248 (9%) and 16/251 (6%) receiving first-line bosutinib and imatinib, respectively. eGFR in patients receiving bosutinib declined over time with more patients developing Grade ≥ 3b eGFR (570, 24%) compared with first-line bosutinib (26/248, 10%) and imatinib (25/251, 10%); time to Grade ≥ 3b eGFR was shortest with second-line or later bosutinib. Similar proportions of patients receiving second-line or later bosutinib (74/139, 53%), first-line bosutinib (15/26, 58%), and first-line imatinib (15/25, 60%) improved to ≥ 45 mL/min/1.73 m 2 eGFR as of the last follow-up. In a regression analysis, first-line treatment with bosutinib versus imatinib was not a significant predictor of Grade ≥ 3b eGFR. Long-term bosutinib treatment is associated with an apparently reversible decline in renal function with frequency and characteristics similar to renal decline observed with long-term imatinib treatment. Patients with risk factors for Grade ≥ 3b eGFR should be monitored closely. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Philadelphia obtains useful information from its customers about taste and odour quality.

    Burlingame, G A; Mackey, E D

    2007-01-01

    Customers are sensitive to the flavour of water. Customers evaluate drinking water based on their expectations, on experiences with their usual drinking water and on experiences with alternative waters. The Philadelphia Water Department provides one example of success in developing a better understanding of customer perceptions and attitudes about tap water taste and odour. Philadelphia found that customers do communicate in ways that water utilities can understand. Water utilities can enhance that communication and collect useful data. In addition, water utilities can characterise their tap water flavour, track it for changes and correlate changes to customer complaints.

  10. Elsevier's Vanishing Act: To the Dismay of Scholars, the Publishing Giant Quietly Purges Articles from Its Database.

    Foster, Andrea L.

    2003-01-01

    Elsevier, the largest publisher of scientific journals, has removed journal articles from its database, often without providing reasons. The usual reason for removing an article is fear of copyright litigation, but critics of the policy fear that information gaps or misleading lack of data will develop. (SLD)

  11. Hospitality and Inclusion Logistics of a Spotlight Event: An Insiders Look at the 2016 DNC in Philadelphia

    Leora Halpern Lanz

    2016-10-01

    Full Text Available The 2016 Democratic National Convention held in Philadelphia, Pennsylvania prioritized hospitality efforts and incorporated inclusion and diversity as its theme. These strategies helped to create a successful spotlight event, benefiting the city of Philadelphia and its hospitality industry.

  12. Safe Handling of Snakes in an ED Setting.

    Cockrell, Melanie; Swanson, Kristofer; Sanders, April; Prater, Samuel; von Wenckstern, Toni; Mick, JoAnn

    2017-01-01

    Efforts to improve consistency in management of snakes and venomous snake bites in the emergency department (ED) can improve patient and staff safety and outcomes, as well as improve surveillance data accuracy. The emergency department at a large academic medical center identified an opportunity to implement a standardized process for snake disposal and identification to reduce staff risk exposure to snake venom from snakes patients brought with them to the ED. A local snake consultation vendor and zoo Herpetologist assisted with development of a process for snake identification and disposal. All snakes have been identified and securely disposed of using the newly implemented process and no safety incidents have been reported. Other emergency department settings may consider developing a standardized process for snake disposal using listed specialized consultants combined with local resources and suppliers to promote employee and patient safety. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  13. Protesta dei ricercatori contro gli editori: politiche di prezzo insostenibili per la ricerca. Nel mirino Elsevier e Springer

    Maria Chiara Pievatolo

    2012-02-01

    Full Text Available Ricopio, per chi non segue il nostro servizio Twitter, la notizia uscita ieri su Ciber Newsletter, su PLEIADI e altrove.  I mostruosi margini di profitto delle multinazionali dell’editoria scientifica sono riportati qui. Aggiornamento 2/2/2012:  la risposta di Springer è visibile qui; quella di Elsevier qui.  Qui c’è un’analisi dei loro argomenti. Aggiornamento 3/2/2012:  l’Economist si [...

  14. 'Zoo kunstenaar, zoo atelier.' De weergave van het atelier in Elsevier's Geïllustreerd Maandschrift (1891-1897

    Lisa Smit

    2012-12-01

    Full Text Available According to nineteenth-century convictions, the studio reflected the soul of the artist. In the 1850s reporters started to write about visits to artists' studios. Every month, the Dutch magazine Elsevier's Geïllustreerd Maandschrift published a story about a visit to the studio of an artist from the The Hague School. The aim of this article is to define what the editorial views were during the first seven years of its publication (1891-1898 on the relation between the artist and his studio. Like Emile Zola, the editors of Elsevier's believed that an artist's disposition is manifest in his work. And because the studio was supposed to reflect this disposition, they believed a description or depiction of an artist's studio would provide insight in his personality and work. Thus, an account of a visit to an artist's studio satisfied the curiosity of the public about the artist's 'true nature'. According to Elsevier's, an artist's studio embodied his personality: 'Like studio, like artist'.

  15. How Elsevier is supporting the value and usefulness of data with Cross-linking and Research Data Services.

    Keall, Bethan; Koers, Hylke; Marques, David

    2013-04-01

    Research in the Earth & Planetary Sciences is characterized by a wealth of observational data - ranging from observations by satellites orbiting the Earth, to borehole measurements at the bottom of the ocean, and also includes data from projects like the Rover Curiosity Landing. Thanks to technological advancements, it has become much easier for researchers over the last few decades to gather large volumes of data, analyze, and share with other researchers inside and outside the lab. With data serving such an important role in the way research is carried out, it becomes a crucial task to archive, maintain, organize, and disseminate research data in a dependable and structured manner. Subject-specific data repositories, often driven by the scientific community, are taking an increasingly prominent role in this domain, getting traction amongst researchers as the go-to place to deposit raw research data. At the same time, the scientific article remains an essential resource of scientific information. At Elsevier, we strive to continuously adapt the article format to meet the needs of modern-day researchers. This includes better support for digital content (see, e.g., http://www.elsevier.com/googlemaps), but also bidirectional linking between online articles and data repositories. In this spirit, Elsevier is collaborating with several leading data repositories, such as PANGAEA, IEDA, and NERC, to interlink articles and data for improved visibility and discoverability of both primary research data and research articles. In addition, Elsevier has formed a new group, Research Data Services, with three primary goals: • help increase the sharing and archiving of research data in discipline-specific repositories • help increase the value of shared data, particularly with annotation and provenance metadata and linking discipline-specific datasets together • help create a credit and impact assessment infrastructure to make research data independently important in its own

  16. ED breast cases and other breast emergencies.

    Khadem, Nasim; Reddy, Sravanthi; Lee, Sandy; Larsen, Linda; Walker, Daphne

    2016-02-01

    Patients with pathologic processes of the breast commonly present in the Emergency Department (ED). Familiarity with the imaging and management of the most common entities is essential for the radiologist. Additionally, it is important to understand the limitations of ED imaging and management in the acute setting and to recognize when referrals to a specialty breast center are necessary. The goal of this article is to review the clinical presentations, pathophysiology, imaging, and management of emergency breast cases and common breast pathology seen in the ED.

  17. GATEWAY Demonstrations: Philadelphia International Airport Apron Lighting: LED System Performance in a Trial Installation

    Davis, Robert G. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Wilkerson, Andrea M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-10-30

    This report documents a trial installation of LED apron lighting that replaced the existing high-pressure sodium luminaires at Philadelphia International Airport. Such high-mast applications remain challenging for LED technology, and the lessons learned from this project may help facility managers and LED product manufacturers better meet those challenges.

  18. Assessing Vulnerability to Heat: A Geospatial Analysis for the City of Philadelphia

    Laura Barron

    2018-04-01

    Full Text Available Urban heat island (UHI effect is an increasingly prominent health and environmental hazard that is linked to urbanization and climate change. Greening reduces the negative impacts of UHI; trees specifically are the most effective in ambient temperature reduction. This paper investigates vulnerability to heat in the Philadelphia, Pennsylvania and identifies where street trees can be planted as a public intervention. We used geospatial information systems (GIS software to map a validated Heat Vulnerability Index to identify vulnerability at the block level. Using a high-low geospatial cluster analysis, we assessed where the City of Philadelphia can most effectively plant street trees to address UHI. This information was then aggregated to the neighborhood level for more effective citizen communication and policymaking. We identified that 26 of 48 (54% neighborhoods that were vulnerable to heat also lacked street trees. Of 158 Philadelphia neighborhoods, 63 (40% contained block groups of high vulnerability to either heat or street tree infrastructure. Neighborhoods that were ranked highest in both classifications were identified in two adjacent West Philadelphia neighborhoods. Planting street trees is a public service a city can potentially reduce the negative health impacts of UHI. GIS can be used to identify and recommend street tree plantings to reduce urban heat.

  19. 78 FR 76779 - Proposed Modification of the Philadelphia, PA, Class B Airspace Area

    2013-12-19

    ... regulatory and informational requirements to the scale of the businesses, organizations, and governmental... businesses, not-for-profit organizations, and small governmental jurisdictions. Agencies must perform a... southeast than intended from the Philadelphia International Airport. This was caused by the miscalculation...

  20. Heterogeneity of genomic fusion of BCR and ABL in Philadelphia chromosome-positive acute lymphoblastic leukemia

    Rubin, C.M.; Carrino, J.J.; Dickler, M.N.; Leibowitz, D.; Smith, S.D.; Westbrook, C.A.

    1988-01-01

    Philadelphia chromosome-positive acute lymphoblastic leukemia occurs in two molecular forms, those with and those without rearrangement of the breakpoint cluster region on chromosome 22. The molecular abnormality in the former group is similar to that found in chronic myelogenous leukemia. To characterize the abnormality in the breakpoint cluster region-unrearranged form, the authors have mapped a 9; 22 translocation from the Philadelphia chromosome-positive acute lymphoblastic leukemia cell line SUP-B13 by using pulsed-field gel electrophoresis and have cloned the DNA at the translocation junctions. They demonstrate a BCR-ABL fusion gene on the Philadelphia chromosome. The exons from ABL are the same. Analysis of leukemic cells from four other patients with breakpoint cluster region-unrearranged Philadelphia chromosome-positive acute lymphoblastic leukemia revealed a rearrangement on chromosome 22 close to the breakpoint in SUP-B13 in only one patient. These data indicate that breakpoints do not cluster tightly in this region but are scattered, possibly in a large intron. Given the large size of BCR and the heterogeneity in breakpoint location, detection of BCR rearrangement by standard Southern blot analysis is difficult. Pulsed-field gel electrophoresis should allow detection at the DNA level in every patient and thus will permit clinical correlation of the breakpoint location with prognosis

  1. A Survey of Automotive Mechanics Programs in the Philadelphia Public Schools. Report No. 8701.

    Chern, Hermine J.; And Others

    During March and April of 1986, the three members of the Career Education Evaluation Unit of the Philadelphia (Pennsylvania) School District interviewed 29 automotive mechanics teachers working at nine comprehensive high schools, two vocational technical schools, and two skills centers. The interviews focused on the implementation of standardized…

  2. 75 FR 25010 - Self-Regulatory Organizations; Stock Clearing Corporation of Philadelphia; Notice of Filing and...

    2010-05-06

    ...-025, The NASDAQ Stock Market LLC (``NASDAQ Exchange'') sought and received Commission approval to... requirements apply to elections of directors and were not amended. Each share of common stock has one vote,\\8...-Regulatory Organizations; Stock Clearing Corporation of Philadelphia; Notice of Filing and Immediate...

  3. 78 FR 39601 - Safety Zone, Sugar House Casino Fireworks Display, Delaware River; Philadelphia, PA

    2013-07-02

    ...-AA00 Safety Zone, Sugar House Casino Fireworks Display, Delaware River; Philadelphia, PA AGENCY: Coast... the Delaware River. Sugar House Casino has contracted with Pyrotecnico Fireworks to arrange for this display. The Captain of the Port, Sector Delaware Bay, has determined that the Sugar House Casino...

  4. Elements of Success: WorkReady Philadelphia Program Year 2011-2012 Report

    Philadelphia Youth Network, 2012

    2012-01-01

    What does it take to deliver WorkReady Philadelphia's high-quality career-connected programming? In short, it's all about the "elements"--those essential components of the system that combine to produce success for young people. This 2011-12 WorkReady report reinforces this theme by using visual aspects of the "Periodic Table of…

  5. Interferon-alpha in the treatment of Philadelphia-negative chronic myeloproliferative neoplasms. Status and perspectives

    Hasselbalch, Hans Carl; Larsen, Thomas Stauffer; Riley, Caroline Hasselbalch

    2011-01-01

    The Philadelphia-negative chronic myeloproliferative neoplasms encompass essential thrombocythemia (ET), polycythemia vera (PV) and primary myelofibrosis (PMF). A major break-through in the understanding of the pathogenesis of these neoplasms occurred in 2005 by the discovery of the JAK2 V617F...

  6. Unfulfilled Promise: The Dimensions and Characteristics of Philadelphia's Dropout Crisis, 2000-2005

    Neild, Ruth Curran; Balfanz, Robert

    2006-01-01

    This report uses a unique set of data obtained from the Kids Integrated Data System (KIDS), which is housed at the University of Pennsylvania's Cartographic Modeling Laboratory. The KIDS system merges individual-level data on young people from the School District of Philadelphia and the city's social service agencies, including the Department of…

  7. Educating English Language Learners: Instructional Approaches and Teacher Collaboration in Philadelphia Public Schools. PERC Research Brief

    Reumann-Moore, Rebecca; Rowland, Jeannette; Hughes, Rosemary; Lin, Joshua

    2016-01-01

    Districts, charter management organizations, and individual schools can learn a great deal from each other about strategies for creating robust and supportive learning environments for English Language Learners (ELLS). This brief highlights key findings about how Philadelphia public schools were crafting instructional approaches to serve their…

  8. Contracting Out Schools: The First Year of the Philadelphia Diverse Provider Model

    Bulkley, Katrina; Mundell, Leah; Riffer, Morgan

    2004-01-01

    Educators nationwide focused on Philadelphia in the summer of 2001 as politicians and policy makers explored the possibility of a state takeover of the city's school system, a seismic power shift that would produce the largest privatization of a public school district in American history. The findings reported in this document are based on…

  9. MicroED data collection and processing

    Hattne, Johan; Reyes, Francis E.; Nannenga, Brent L.; Shi, Dan; Cruz, M. Jason de la [Janelia Research Campus, Howard Hughes Medical Institute, Ashburn, VA 20147 (United States); Leslie, Andrew G. W. [Medical Research Council Laboratory of Molecular Biology, Cambridge (United Kingdom); Gonen, Tamir, E-mail: gonent@janelia.hhmi.org [Janelia Research Campus, Howard Hughes Medical Institute, Ashburn, VA 20147 (United States)

    2015-07-01

    The collection and processing of MicroED data are presented. MicroED, a method at the intersection of X-ray crystallography and electron cryo-microscopy, has rapidly progressed by exploiting advances in both fields and has already been successfully employed to determine the atomic structures of several proteins from sub-micron-sized, three-dimensional crystals. A major limiting factor in X-ray crystallography is the requirement for large and well ordered crystals. By permitting electron diffraction patterns to be collected from much smaller crystals, or even single well ordered domains of large crystals composed of several small mosaic blocks, MicroED has the potential to overcome the limiting size requirement and enable structural studies on difficult-to-crystallize samples. This communication details the steps for sample preparation, data collection and reduction necessary to obtain refined, high-resolution, three-dimensional models by MicroED, and presents some of its unique challenges.

  10. Elsevier Trophoblast Research Award Lecture: Searching for an early pregnancy 3-D morphometric ultrasound marker to predict fetal growth restriction.

    Collins, S L; Stevenson, G N; Noble, J A; Impey, L

    2013-03-01

    Fetal growth restriction (FGR) is a major cause of perinatal morbidity and mortality, even in term babies. An effective screening test to identify pregnancies at risk of FGR, leading to increased antenatal surveillance with timely delivery, could decrease perinatal mortality and morbidity. Placental volume, measured with commercially available packages and a novel, semi-automated technique, has been shown to predict small for gestational age babies. Placental morphology measured in 2-D in the second trimester and ex-vivo post delivery, correlates with FGR. This has also been investigated using 2-D estimates of diameter and site of cord insertion obtained using the Virtual Organ Computer-aided AnaLysis (VOCAL) software. Data is presented describing a pilot study of a novel 3-D method for defining compactness of placental shape. We prospectively recruited women with a singleton pregnancy and BMI of Elsevier Ltd. All rights reserved.

  11. Elsevier Trophoblast Research Award Lecture: Unique properties of decidual T cells and their role in immune regulation during human pregnancy.

    Tilburgs, T; Claas, F H J; Scherjon, S A

    2010-03-01

    Maternal lymphocytes at the fetal-maternal interface play a key role in the immune acceptance of the allogeneic fetus. Most studies focus on decidual NK cells and their interaction with fetal trophoblasts, whereas limited data are available on the mechanisms of fetus specific immune recognition and immune regulation by decidual T cells at the fetal-maternal interface. The aim of this review is to describe the phenotypic characteristics of decidual T cell subsets present at the fetal-maternal interface, their interaction with HLA-C expressed by fetal trophoblasts and their role in immune recognition and regulation at the fetal-maternal interface during human pregnancy. Copyright 2010 Elsevier Ltd. All rights reserved.

  12. Active Intervention Can Decrease Burnout In Ed Nurses.

    Wei, Rong; Ji, Hong; Li, Jianxin; Zhang, Liyao

    2017-03-01

    The aim of this study was to evaluate whether active intervention can decrease job burnout and improve performance among ED nurses. This study was carried out in the emergency departments of 3 hospitals randomly selected from 8 comprehensive high-level hospitals in Jinan, China. A total of 102 nurses were enrolled and randomly divided into control and intervention groups. For 6 months, nurses in intervention groups were treated with ordinary treatment plus comprehensive management, whereas nurses in the control group were treated with ordinary management, respectively. Questionnaires were sent and collected at baseline and at the end of the study. The Student t test was used to evaluate the effect of comprehensive management in decreasing burnout. All ED nurses showed symptoms of job burnout at different levels. Our data indicated that comprehensive management significantly decreased emotional exhaustion and depersonalization (P burnout in ED nurses and contribute to relieving work-related stress and may further protect against potential mental health problems. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  13. The implementation of Mask-Ed: reflections of academic participants.

    Reid-Searl, Kerry; Levett-Jones, Tracy; Cooper, Simon; Happell, Brenda

    2014-09-01

    This paper profiles the findings from a study that explored the perspectives and experiences of nurse educators who implemented a novel simulation approach termed Mask-Ed. The technique involves the educator wearing a silicone mask and or body parts and transforming into a character. The premise of this approach is that the masked educator has domain specific knowledge related to the simulation scenario and can transmit this to learners in a way that is engaging, realistic, spontaneous and humanistic. Nurse educators charged with the responsibility of implementing Mask-Ed in three universities were invited to participate in the study by attending an introductory workshop, implementing the technique and then journaling their experiences, insights and perspectives over a 12 month period. The journal entries were then thematically analysed. Key themes were categorised under the headings of Preparation, Implementation and Impact; Reflexivity and Responsiveness; Student Engagement and Ownership; and Teaching and Learning. Mask-Ed is a simulation approach which allows students to interact with the 'characters' in humanistic ways that promote person-centred care and therapeutic communication. This simulation approach holds previously untapped potential for a range of learning experiences, however, to be effective, adequate resourcing, training, preparation and practice is required. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Elsevier Trophoblast Research Award lecture: Molecular mechanisms underlying estrogen functions in trophoblastic cells--focus on leptin expression.

    Gambino, Y P; Maymó, J L; Pérez Pérez, A; Calvo, J C; Sánchez-Margalet, V; Varone, C L

    2012-02-01

    The steroid hormone 17β-estradiol is an estrogen that influences multiple aspects of placental function and fetal development in humans. During early pregnancy it plays a role in the regulation of blastocyst implantation, trophoblast differentiation and invasiveness, remodeling of uterine arteries, immunology and trophoblast production of hormones such as leptin. Estradiol exerts some effects through the action of classical estrogen receptors ERα and ERβ, which act as ligand-activated transcription factors and regulate gene expression. In addition, estradiol can elicit rapid responses from membrane-associated receptors, like activation of protein-kinase pathways. Thus, the cellular effects of estradiol will depend on the specific receptors expressed and the integration of their signaling events. Leptin, the 16,000MW protein product of the obese gene, was originally considered an adipocyte-derived signaling molecule for the central control of metabolism. However, pleiotropic effects of leptin have been identified in reproduction and pregnancy. The leptin gene is expressed in placenta, where leptin promotes proliferation and survival of trophoblastic cells. Expression of leptin in placenta is highly regulated by key pregnancy molecules as hCG and estradiol. The aim of this paper is to review the molecular mechanisms underlying estrogen functions in trophoblastic cells; focusing on mechanisms involved in estradiol regulation of placental leptin expression. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. On the quantitativeness of EDS STEM

    Lugg, N.R. [Institute of Engineering Innovation, The University of Tokyo, 2-11-16, Yayoi, Bunkyo-ku, Tokyo 113-8656 (Japan); Kothleitner, G. [Institute for Electron Microscopy and Nanoanalysis, Graz University of Technology, Steyrergasse 17, 8010 Graz (Austria); Centre for Electron Microscopy, Steyrergasse 17, 8010 Graz (Austria); Shibata, N.; Ikuhara, Y. [Institute of Engineering Innovation, The University of Tokyo, 2-11-16, Yayoi, Bunkyo-ku, Tokyo 113-8656 (Japan)

    2015-04-15

    Chemical mapping using energy dispersive X-ray spectroscopy (EDS) in scanning transmission electron microscopy (STEM) has recently shown to be a powerful technique in analyzing the elemental identity and location of atomic columns in materials at atomic resolution. However, most applications of EDS STEM have been used only to qualitatively map whether elements are present at specific sites. Obtaining calibrated EDS STEM maps so that they are on an absolute scale is a difficult task and even if one achieves this, extracting quantitative information about the specimen – such as the number or density of atoms under the probe – adds yet another layer of complexity to the analysis due to the multiple elastic and inelastic scattering of the electron probe. Quantitative information may be obtained by comparing calibrated EDS STEM with theoretical simulations, but in this case a model of the structure must be assumed a priori. Here we first theoretically explore how exactly elastic and thermal scattering of the probe confounds the quantitative information one is able to extract about the specimen from an EDS STEM map. We then show using simulation how tilting the specimen (or incident probe) can reduce the effects of scattering and how it can provide quantitative information about the specimen. We then discuss drawbacks of this method – such as the loss of atomic resolution along the tilt direction – but follow this with a possible remedy: precession averaged EDS STEM mapping. - Highlights: • Signal obtained in EDS STEM maps (of STO) compared to non-channelling signal. • Deviation from non-channelling signal occurs in on-axis experiments. • Tilting specimen: signal close to non-channelling case but atomic resolution is lost. • Tilt-precession series: non-channelling signal and atomic-resolution features obtained. • Associated issues are discussed.

  16. The Elsevier trophoblast research award lecture: Impacts of placental growth factor and preeclampsia on brain development, behaviour, and cognition.

    Rätsep, Matthew T; Hickman, Andrew F; Croy, B Anne

    2016-12-01

    Preeclampsia (PE) is a significant gestational disorder affecting 3-5% of all human pregnancies. In many PE pregnancies, maternal plasma is deficient in placental growth factor (PGF), a placentally-produced angiokine. Beyond immediate fetal risks associated with acute termination of the pregnancy, offspring of PE pregnancies (PE-F1) have higher long-term risks for hypertension, stroke, and cognitive impairment compared to F1s from uncomplicated pregnancies. At present, mechanisms that explain PE-F1 gains in postpartum risks are poorly understood. Our laboratory found that mice genetically-deleted for Pgf have altered fetal and adult brain vascular development. This is accompanied by sexually dimorphic alterations in anatomic structure in the adult Pgf -/- brain and impaired cognitive functions. We hypothesize that cerebrovascular and neurological aberrations occur in fetuses exposed to the progressive development of PE and that these brain changes impair cognitive functioning, enhance risk for stroke, elevate severity of stroke, and lead to worse stroke outcomes. These brain and placental outcomes may be linked to down-regulated PGF gene expression in early pre-implantation embryos, prior to gastrulation. This review explores our hypothesis that there are mechanistic links between low PGF detection in maternal plasma prodromal to PE, PE, and altered brain vascular, structural, and functional development amongst PE-F1s. We also include a summary of preliminary outcomes from a pilot study of 7-10 year old children that is the first to report magnetic resonance imaging, magnetic resonance angiography, and functional brain region assessment by eye movement control studies in PE-F1s. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Transient data acquisition techniques under EDS

    Telford, S.

    1985-06-01

    This paper is the first of a series which describes the Enrichment Diagnostic System (EDS) developed for the MARS project at Lawrence Livermore National Laboratory. Although EDS was developed for use on AVLIS, the functional requirements, overall design, and specific techniques are applicable to any experimental data acquisition system involving large quantities of transient data. In particular this paper will discuss the techniques and equipment used to do the data acquisition. Included are what types of hardware are used and how that hardware (CAMAC, digital oscilloscopes) is interfaced to the HP computers. In this discussion the author will address the problems encountered and the solutions used, as well as the performance of the instrument/computer interfaces. The second topic the author will discuss is how the acquired data is associated to graphics and analysis portions of EDS through efficient real time data bases. This discussion will include how the acquired data is folded into the overall structure of EDS providing the user immediate access to raw and analyzed data. By example you will see how easily a new diagnostic can be added to the EDS structure without modifying the other parts of the system. 8 figs

  18. Nutrition and athletic performance

    Exercise - nutrition; Exercise - fluids; Exercise - hydration ... Bird R. Nutrition. In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine . 4th ed. Philadelphia, PA: Elsevier Saunders; ...

  19. Brown recluse spider

    ... of the skin and whites of the eyes (jaundice) Kidney failure Seizures ... RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 9th ed. Philadelphia, PA: Elsevier; ...

  20. Naphthalene poisoning

    ... the urine) Shortness of breath Yellowing of skin (jaundice) NOTE: People with a condition called glucose-6- ... Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier ...

  1. Jaundice

    ... Saunders; 2016:chap 21. Wheatley MA, Heilpern KL. Jaundice. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier ...

  2. Methanol poisoning

    ... tests Chest x-ray CT (computerized tomography, or advanced imaging) scan EKG (electrocardiogram, or heart tracing) Fluids ... Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; ...

  3. Abdominal pain - children under age 12

    ... urine, and stool tests CT (computerized tomography, or advanced imaging) scan Ultrasound of the abdomen X-rays ... Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; ...

  4. Windshield washer fluid

    ... tests Chest x-ray CT (computerized tomography, or advanced imaging) scan EKG (electrocardiogram, or heart tracing) Fluids ... Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; ...

  5. Tooth anatomy

    ... whole tooth. This area is known as the "pulp" of the tooth. The jawbone is attached to ... JC, eds. Robbins and Cotran Pathologic Basis of Disease . 9th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap ...

  6. Diet - full liquid

    ... Water Fruit juices, including nectars and juices with pulp Butter, margarine, oil, cream, custard, and pudding Plain ... LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management . 10th ed. Philadelphia, PA: Elsevier ...

  7. Lacerations - liquid bandage

    ... 2011:chap 28. Simon BC, Hern HG. Wound management principles. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap ...

  8. Asthma - control drugs

    ... Accessed February 28, 2018. Durrani SR, Busse WW. Management of asthma in adolescents and adults. In: Adkinson NF Jr, Bochner BS, Burks AW, et al, eds. Middleton's Allergy: Principles and Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap ...

  9. Laceration - sutures or staples - at home

    ... 2016:chap 28. Simon BC, Hern HG. Wound management principles. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap ...

  10. Asthma - quick-relief drugs

    ... Accessed February 28, 2018. Durrani SR, Busse WW. Management of asthma in adolescents and adults. In: Adkinson NF Jr, Bochner BS, Burks AW, et al, eds. Middleton's Allergy: Principles and Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap ...

  11. Disseminated intravascular coagulation (DIC)

    ... Jr, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice . 6th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 141. Thachil J, Toh CH. Current concepts in the management of disseminated intravascular coagulation. Thromb Res . 2012;129 ...

  12. Taking narcotics for back pain

    ... ncbi.nlm.nih.gov/pubmed/24480962 . Dinakar P. Principles of pain management. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice . 7th ed. Philadelphia, PA: Elsevier; 2016:chap 54. ...

  13. Night terrors in children

    ... eye movement parasomnias: clinical spectrum, diagnostic features, and management. In: Kryger M, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine. 6th ed. Philadelphia, PA: Elsevier; ...

  14. Bleeding

    ... gov/pubmed/24641269 . Simon BC, Hern HG. Wound management principles. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 52. ...

  15. Overcoming breastfeeding problems

    ... MF, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice . 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 9. Newton ER. Lactation and breastfeeding. In: Gabbe SG, Niebyl ...

  16. Breast milk - pumping and storing

    ... MF, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice . 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 9. Newton ER. Lactation and breastfeeding. In: Gabbe SG, Niebyl ...

  17. Breastfeeding vs. Formula Feeding

    ... MF, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice . 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 9. Newton ER. Lactation and breastfeeding. In: Gabbe SG, Niebyl ...

  18. Salads and nutrients

    ... calories and fat. Try to use a darker lettuce. Light green Iceberg has fiber but not as ... JE, ed. Guyton and Hall Textbook of Medical Physiology . 13th ed. Philadelphia, PA: Elsevier; 2016:chap 72. ...

  19. Pediatric heart surgery - discharge

    ... discharge; Heart valve surgery - children - discharge; Heart surgery - pediatric - discharge; Heart transplant - pediatric - discharge ... Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 434. ...

  20. Changing your sleep habits

    ... falling asleep; Sleep hygiene References American Academy of Sleep Medicine. Insomnia. Updated March 4, 2015. SleepEducation.org. sleepeducation. ... T, Dement WC, eds. Principles and Practice of Sleep Medicine . 6th ed. Philadelphia, PA: Elsevier; 2017:chap 86. ...

  1. Idiopathic hypersomnia

    ... T, Dement WC, eds. Principles and Practice of Sleep Medicine. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 91. ... Blaivas, DO, Division of Pulmonary, Critical Care, and Sleep Medicine, VA New Jersey Health Care System, Clinical Assistant ...

  2. Isolated sleep paralysis

    ... T, Dement WC, eds. Principles and Practice of Sleep Medicine. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 103. ... Blaivas, DO, Division of Pulmonary, Critical Care, and Sleep Medicine, VA New Jersey Health Care System, Clinical Assistant ...

  3. Problems sleeping during pregnancy

    ... T, Dement WC, eds. Principles and Practice of Sleep Medicine . 6th ed. Philadelphia, PA: Elsevier; 2017:chap 156. Ibrahim S, Foldvary-Shaefer N. Sleep disorders in pregnancy: implications, evaluation, and treatment. Neurologic ...

  4. Snoring - adults

    ... T, Dement WC, eds. Principles and Practice of Sleep Medicine . 6th ed. Philadelphia, PA: Elsevier; 2017:chap 112. Wakefield TL, Lam DJ, Ishman SL. Sleep apnea and sleep disorders. In: Flint PW, Haughey ...

  5. Retinitis pigmentosa

    ... treatments for retinitis pigmentosa, including the use of DHA, which is an omega-3 fatty acid. Other ... Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 630. ...

  6. Hydatidiform mole

    ... avoid another pregnancy and to use a reliable contraceptive for 6 to 12 months after treatment for ... Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014: ...

  7. Poliomyelitis

    ... poliomyelitis in most people (immunization is over 90% effective). Alternative Names ... S, Arnold WD. Motor neuron diseases. In: Cifu DX, ed. Braddom's Physical Medicine and Rehabilitation . 5th ed. Philadelphia, PA: Elsevier; 2016: ...

  8. Sciatica

    ... is required and recovery occurs on its own. Conservative (non-surgical) treatment is best in many cases. ... In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine . 9th ed. Philadelphia, PA: Elsevier Saunders; 2016: ...

  9. Getting your home ready - knee or hip surgery

    Hip or knee surgery - getting your home ready; Osteoarthritis - knee ... Cabrera JA, Cabrera AL. Total hip replacement. In: Frontera WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation . 3rd ed. Philadelphia, PA: Elsevier Saunders; ...

  10. Growth hormone suppression test

    ... Acromegaly - blood test; Gigantism - blood test Images Blood test References Kaiser U, Ho KKY. Pituitary physiology and diagnostic evaluation. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology . 13th ed. Philadelphia, PA: Elsevier; ...

  11. Home health care

    ... or walker Walk between your bedroom, bathroom, and kitchen Go up and down stairs ... EJ, Fitz JG, eds. Andreoli and Carpenter's Cecil Essentials of Medicine . 9th ed. Philadelphia, PA: Elsevier Saunders; ...

  12. Concussion - what to ask your doctor - adult

    ... When can I start contact sports, such as football or soccer? When can I begin skiing or ... Traumatic brain injury (adult). In: Adams JG, ed. Emergency Medicine . 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013: ...

  13. Sturge-Weber syndrome

    ... the person's signs and symptoms, and may include: Anticonvulsant medicines for seizures Eye drops or surgery to ... JW III, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 596.

  14. Diabetes and exercise

    ... MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice . 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 21. Read More Type 1 diabetes Type 2 diabetes Patient Instructions ACE ...

  15. Respiratory

    The words "respiratory" and "respiration" refer to the lungs and breathing. ... Boron WF. Organization of the respiratory system. In: Boron WF, Boulpaep EL, eds. Medical Physiology . 3rd ed. Philadelphia, PA: Elsevier; 2017:chap 26.

  16. Clean catch urine sample

    ... JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 99. Nicolle LE, Norrby SR. Approach to the patient with urinary ...

  17. Immune response

    ... AK, Lichtman AH, Pillai S, eds. Cellular and Molecular Immunology. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap ... Associate Clinical Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, Georgetown University Medical School, Washington, DC. ...

  18. Transplant rejection

    ... Antibodies References Abbas AK, Lichtman AH, Pillai S. Transplantation immunology. In: Abbas AK, Lichtman AH, Pillai S, eds. Cellular and Molecular Immunology. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 17. ...

  19. Immunodeficiency disorders

    ... AK, Lichtman AH, Pillai S, eds. Cellular and Molecular Immunology . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap ... Associate Clinical Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, Georgetown University Medical School, Washington, DC. ...

  20. Chronic granulomatous disease

    ... Fleisher TA, Shearer WT, et al, eds. Clinical Immunology . 4th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap ... Read more NIH MedlinePlus Magazine Read more Health Topics A-Z Read more A.D.A.M., ...

  1. Eyes - bulging

    ... different ages. In: Lambert SR, Lyons CJ, eds. Taylor and Hoyt's Pediatric Ophthalmology and Strabismus . 5th ed. Philadelphia, PA: Elsevier; 2017:chap 96. Orge FH, Grigorian F. Examination and common problems of the neonatal eye. ...

  2. Osteomyelitis - children

    ... 13th ed. Philadelphia, PA: Elsevier; 2017:chap 21. Kaplan SL. Osteomyelitis. In: Kliegman RM, Stanton BF, St. ... Krogstad P. Osteomyelitis. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. Feigin and ...

  3. Thyrotoxic periodic paralysis

    ... speaking, or swallowing Falls due to muscle weakness Prevention ... . 13th ed. Philadelphia, PA: Elsevier; 2016:chap 12. Ferri FF. Hyperthyroidism. In: Ferri FF, ed. Ferri's Clinical Advisor 2016 . ...

  4. Cardiac tamponade

    ... test may be done at the bedside in emergency cases. A physical exam may show: Blood pressure that ... Pericardiocentesis. In: Roberts JR, ed. Roberts and Hedges' Clinical Procedures in Emergency Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2014: ...

  5. Tenosynovitis

    ... away. Your provider will prescribe antibiotics. In severe cases, emergency surgery is needed to release the pus around ... Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014: ...

  6. Exercise stress test

    ... sodas, even ones that are labeled caffeine-free Chocolates Certain pain relievers that contain caffeine ... P, Bonow RO, Braunwald E, eds. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, PA: Elsevier Saunders; 2015: ...

  7. Carbuncle

    ... to determine the bacteria causing the infection (bacterial culture). The test result helps your provider determine the ... Miller MD, Thompson SR, eds. DeLee & Drez's Orthopaedic Sports Medicine . 4th ed. Philadelphia, PA: Elsevier Saunders; 2015: ...

  8. Spinal fusion

    ... remove some bone from the back of the rim of the pelvis. From a bone bank. This ... eds. Benzel's Spine Surgery: Techniques, Complication Avoidance, and Management . 4th ed. Philadelphia, PA: Elsevier; 2017:chap 58. ...

  9. Ham test

    Acid hemolysin test; Paroxysmal nocturnal hemoglobinuria - Ham test; PNH - Ham test ... BJ. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures . 6th ed. Philadelphia, PA: Elsevier ...

  10. Diverticulitis - what to ask your doctor

    Bhuket TP, Stollman NH. Diverticular disease of the colon. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease . 10th ed. Philadelphia, PA: Elsevier Saunders; ...

  11. Diverticulosis

    Bhuket TP, Stollman NH. Diverticular disease of the colon. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease . 10th ed. Philadelphia, PA: Elsevier ...

  12. Diverticulitis and diverticulosis - discharge

    Bhuket TP, Stollman NH. Diverticular disease of the colon. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease . 10th ed. Philadelphia, PA: Elsevier ...

  13. Diverticulitis

    Bhuket TP, Stollman NH. Diverticular disease of the colon. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease . 10th ed. Philadelphia, PA: Elsevier ...

  14. Body temperature norms

    Normal body temperature; Temperature - normal ... Morrison SF. Regulation of body temperature. In: Boron WF, Boulpaep EL, eds. Medical Physiology . 3rd ed. Philadelphia, PA: Elsevier; 2017:chap 59. Sajadi MM, Mackowiak ...

  15. Decorticate posture

    ... 2016:chap 59. Heegaard WG, Biros MH. Head injury. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier ...

  16. Periventricular leukomalacia

    ... nih.gov/pubmed/15635108 . Volpe JJ. Hypoxic-ischemic encephalopathy: neuropathology and pathogenesis. In: Volpe JJ, ed. Neurology of the Newborn . 5th ed. Philadelphia, PA: Elsevier Saunders; 2008:chap ...

  17. Pancreatitis - children

    ... if your child has these symptoms: Intense, constant abdominal pain Develops other symptoms of acute ... St Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 351. ...

  18. Periosteum

    ... anatomy of the musculoskeletal system. In: Standring S, ed. Gray's Anatomy: The Anatomical Basis of Clinical Practice . 41st ed. Philadelphia, PA: Elsevier; 2016:chap 5. Silverstein JA, Moeller ...

  19. Femoral hernia repair

    Dunbar KB, Jeyarajah DR. Abdominal hernias and gastric volvulus. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease . 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap ...

  20. Vaginal cancer

    Hacker NF. Vulvar and vaginal cancer. In: Hacker NF, Gambone JC, Hobel CJ, eds. Hacker and Moore's Essentials of Obstetrics and Gynecology . 6th ed. Philadelphia, PA: Elsevier; 2016:chap 40. Jhingran ...

  1. Asherman syndrome

    ... 6th ed. Philadelphia, PA: Elsevier; 2012:chap 18. Simpson JL, Jauniaux ERM. Early pregnancy loss and stillbirth. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem ...

  2. When your baby is stillborn

    ... ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 45. Simpson JL, Jauniaux ERM. Early pregnancy loss and stillbirth. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem ...

  3. Polyarteritis nodosa

    ... Possible Complications Complications may include: Heart attack Intestinal necrosis and perforation Kidney failure Stroke When to Contact ... arteriopathies. In: Cronenwett JL, Johnston KW, eds. Rutherford's Vascular Surgery . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014: ...

  4. Taking medicines to treat tuberculosis

    Tuberculosis - medicines; DOT; Directly observed therapy; TB - medicines ... Ellner JJ. Tuberculosis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 324. ...

  5. Amniotic fluid

    Burton GJ, Sibley CP, Jauniaux ERM. Placental anatomy and physiology. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies . 7th ed. Philadelphia, PA: Elsevier; 2017:chap 1. ...

  6. Sheehan syndrome

    Burton GJ, Sibley CP, Jauniaux ERM. Placental anatomy and physiology. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies . 7th ed. Philadelphia, PA: Elsevier; 2017:chap 1. ...

  7. Women and sexual problems

    ... Your provider may recommend that you use estrogen tablets or cream to put in and around your ... Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology . 13th ed. Philadelphia, PA: Elsevier; 2016: ...

  8. Iron overdose

    ... tracing) X-ray to detect and track iron tablets through the stomach and intestines Treatment may include: ... BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016: ...

  9. Heart failure - palliative care

    ... It is available as a pill, liquid, or tablet that dissolves under the tongue. Your provider will ... RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, PA: Elsevier ...

  10. Chills

    ... the child to be uncomfortable, give pain-relieving tablets or liquid. Non-aspirin pain-relievers such as ... fever. In: Hall JE, ed. Guyton and Hall Textbook of Medical Physiology . 13th ed. Philadelphia, PA: Elsevier; ...

  11. Magnetic resonance angiography

    ... Saunders; 2015:chap 17. Litt H, Carpenter JP. Magnetic resonance imaging. In: Cronenwett JL, Johnston KW, eds. Rutherford's Vascular Surgery . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap ...

  12. Cocaine withdrawal

    ... RE, Rakel DP, eds. Textbook of Family Medicine . 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 50. National Institute on Drug Abuse. What is cocaine? Updated May 2016. www.drugabuse.gov/publications/research-reports/cocaine/ ...

  13. TED-Ed lessons & TED-Ed clubs: Educational activities to amplify students' voices

    Villias, Georgios

    2017-04-01

    TED-Ed lessons and TED-Ed clubs are two powerful educational tools that can be used in today's school classrooms in order to create an educational environment that is engaging for the students and favors their active participation, created and fostered by TED-Ed. TED-Ed is TED's educational initiative, committed to create lessons worth sharing and amplify the voices and ideas of teachers and students around the world. TED-Ed animated lessons are fully organized lessons structured around an animated video that introduces new topics to learners in an exciting, thought-provoking way. These lessons have been created as a result of the cooperation between expert educators and animators and have been uploaded at the TED-Ed platform (http://ed.ted.com). On the other hand, TED-Ed Clubs are also an interesting way to offer students the chance, the voice and the opportunity to express their thoughts, engage actively on these matters and connect with each other, both at a local, as well as at an international level (http://ed.ted.com/clubs). By developing new TED-Ed lessons or by customizing appropriately existing animated TED-Ed lessons (translating, modifying the questions asked, introducing new discussion topics), I have created and implemented in my student-centered, didactic approach, a series of TED-ED animated lessons directly connected with the Greek national science syllabus that were used to spark students curiosity and initiate a further analytical discussion or introduce other relevant educational activities (http://gvillias.wixsite.com/education). Furthermore, at my school, we established Varvakeio TED-Ed Club, an environment that supports and empowers our students to research, develop and disseminate their own personal ideas that worth spreading. During the year, our members were inspired by watching TED talks presented by experts on their field on various different areas, including social, economical, environmental and technological-scientific issues. Our aim

  14. Acute, fatal Sarcocystis calchasi-associated hepatitis in Roller pigeons (Columbia livia f. dom.) at Philadelphia Zoo

    Four Roller pigeons (Columba livia f. dom.) at the Philadelphia Zoo died suddenly. Necropsy examination revealed macroscopic hepatitis. Microscopically, the predominant lesions were in liver, characterized with necrosis and mixed cell inflammatory response. Sarcocystis calchasi-like schizonts and fr...

  15. Relationship Between Total and Bioaccessible Lead on Children’s Blood Lead Levels in Urban Residential Philadelphia Soils

    Relationships between total soil or bioaccessible lead (Pb), measured using an in vitro bioaccessibility assay, and children’s blood lead levels (BLL) were investigated in an urban neighborhood in Philadelphia, Pennsylvania, USA, with a history of soil Pb contamination....

  16. Buying Program of the Standard Automated Materiel Management System. Automated Small Purchase System: Defense Supply Center Philadelphia

    2001-01-01

    The Standard Automated Materiel Management System Automated Small Purchase System is a fully automated micro-purchases system used by the General and Industrial Directorate at the Defense Supply Center Philadelphia...

  17. Association of ED with chronic periodontal disease.

    Matsumoto, S; Matsuda, M; Takekawa, M; Okada, M; Hashizume, K; Wada, N; Hori, J; Tamaki, G; Kita, M; Iwata, T; Kakizaki, H

    2014-01-01

    To examine the relationship between chronic periodontal disease (CPD) and ED, the interview sheet including the CPD self-checklist (CPD score) and the five-item version of the International Index of Erectile Function (IIEF-5) was distributed to 300 adult men who received a comprehensive dental examination. Statistical analyses were performed by the Spearman's rank correlation coefficient and other methods. Statistical significance was accepted at the level of Pdysfunction and the systematic inflammatory changes associated with CPD. The present study also suggests that dental health is important as a preventive medicine for ED.

  18. Pediatric radiology in the Philadelphia region: a history of pedigrees and legacies

    Markowitz, Richard I.

    2009-01-01

    The specialty of pediatric radiology in the Philadelphia region has grown and evolved over the past eight decades originating from early ''visiting'' radiologists to Drs. Hope and Kirkpatrick, the ''giants'' of the 1950s and 1960s, to over 40 actively practicing pediatric radiologists. Clinical excellence, commitment to teaching, and advancement of knowledge through research remain the goals and ideals, much as they were many years ago. Philadelphia has been a fertile home and environment for this development, mostly because of outstanding leaders and role models who have trained and influenced generations of pediatric radiologists. The purpose of this article is to tell the story of this growth and development and to explore the intellectual origins, professional ''genealogy,'' and legacies left by those who created this tradition. (orig.)

  19. Pediatric radiology in the Philadelphia region: a history of pedigrees and legacies

    Markowitz, Richard I. [University of Pennsylvania School of Medicine, Department of Radiology, Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

    2009-09-15

    The specialty of pediatric radiology in the Philadelphia region has grown and evolved over the past eight decades originating from early ''visiting'' radiologists to Drs. Hope and Kirkpatrick, the ''giants'' of the 1950s and 1960s, to over 40 actively practicing pediatric radiologists. Clinical excellence, commitment to teaching, and advancement of knowledge through research remain the goals and ideals, much as they were many years ago. Philadelphia has been a fertile home and environment for this development, mostly because of outstanding leaders and role models who have trained and influenced generations of pediatric radiologists. The purpose of this article is to tell the story of this growth and development and to explore the intellectual origins, professional ''genealogy,'' and legacies left by those who created this tradition. (orig.)

  20. Pediatric radiology in the Philadelphia region: a history of pedigrees and legacies.

    Markowitz, Richard I

    2009-09-01

    The specialty of pediatric radiology in the Philadelphia region has grown and evolved over the past eight decades originating from early "visiting" radiologists to Drs. Hope and Kirkpatrick, the "giants" of the 1950s and 1960s, to over 40 actively practicing pediatric radiologists. Clinical excellence, commitment to teaching, and advancement of knowledge through research remain the goals and ideals, much as they were many years ago. Philadelphia has been a fertile home and environment for this development, mostly because of outstanding leaders and role models who have trained and influenced generations of pediatric radiologists. The purpose of this article is to tell the story of this growth and development and to explore the intellectual origins, professional "genealogy," and legacies left by those who created this tradition.

  1. Why support a women's medical college? Philadelphia's early male medical pro-feminists.

    Peitzman, Steven J

    2003-01-01

    The male founders and early faculty of Philadelphia's Woman's Medical College were mostly abolitionist physicians, zealous moralists for whom medical feminism formed only one of the cherished causes they could "manfully" and righteously defend. Male faculty of the late nineteenth century comprised "self-made" men, mostly new specialists, for whom strict sexism probably seemed inconsistent with progressive medicine. For some of these physicians-obviously a small minority-defending medical women and breaking the barriers of fraternity could be consistent with "manly" responsibility. The outcome of the collaboration of women and the dissident men physicians in nineteenth-century Philadelphia amounted to another seeming paradox: the majority of the male medical profession, both locally and nationally, tyrannically hindered women's entry into the profession, yet medicine opened its doors in advance of law and the clergy; and where this first occurred, such as in the community centered on Woman's Medical College, a novel gender rearrangement arose based on collaboration and friendship.

  2. Trend Analyses of Users of a Syringe Exchange Program in Philadelphia, Pennsylvania: 1999-2014.

    Maurer, Laurie A; Bass, Sarah Bauerle; Ye, Du; Benitez, José; Mazzella, Silvana; Krafty, Robert

    2016-12-01

    This study examines trends of injection drug users' (IDUs) use of a Philadelphia, Pennsylvania, syringe exchange program (SEP) from 1999 to 2014, including changes in demographics, drug use, substance abuse treatment, geographic indicators, and SEP use. Prevention Point Philadelphia's SEP registration data were analyzed using linear regression, Pearson's Chi square, and t-tests. Over time new SEP registrants have become younger, more racially diverse, and geographically more concentrated in specific areas of the city, corresponding to urban demographic shifts. The number of new registrants per year has decreased, however syringes exchanged have increased. Gentrification, cultural norms, and changes in risk perception are believed to have contributed to the changes in SEP registration. Demographic changes indicate outreach strategies for IDUs may need adjusting to address unique barriers for younger, more racially diverse users. Implications for SEPs are discussed, including policy and continued ability to address current public health threats.

  3. Health and housing collaboration at LAST: the Philadelphia Lead Abatement Strike Team.

    Campbell, Carla; Himmelsbach, Robert; Palermo, Peter; Tobin, Richard

    2005-01-01

    The Lead Abatement Strike Team (LAST) was developed in 2002 by the Philadelphia Department of Public Health (PDPH) in response to community concern about management of children with elevated blood lead levels (EBLLs). Fourteen hundred backlog properties (housing at least one child with EBLLs) were identified through inspection as having housing-based lead hazards for which no satisfactory environmental remediation (control of lead hazards) had been achieved. In the first two years of LAST, 83...

  4. [Acute transformation of chronic myeloid leukemia: disappearance of the Philadelphia chromosome after autograft].

    Reiffers, J; David, B; Bernard, P; Vezon, G; Marit, G; Moulinier, J; Broustet, A

    1984-04-12

    Two patients with chronic granulocytic leukemia (C.G.L.) undergoing transformation were treated by high dose chemotherapy and total body irradiation followed by autografting of hematopoietic stem cells collected and cryo-preserved at the time of diagnosis. Recovery of hematopoiesis was characterized by disappearance of the Philadelphia chromosome in most metaphases. A new approach of the management of C.G.L. is discussed.

  5. Impact of prospective verification of intravenous antibiotics in an ED.

    Hunt, Allyson; Nakajima, Steven; Hall Zimmerman, Lisa; Patel, Manav

    2016-12-01

    Delay in appropriate antibiotic therapy is associated with an increase in mortality and prolonged length of stay. Automatic dispensing machines decrease the delivery time of intravenous (IV) antibiotics to patients in the emergency department (ED). However, when IV antibiotics are not reviewed by pharmacists before being administered, patients are at risk for receiving inappropriate antibiotic therapy. The objective of this study was to determine if a difference exists in the time to administration of appropriate antibiotic therapy before and after implementation of prospective verification of antibiotics in the ED. This retrospective, institutional review board-approved preimplementation vs postimplementation study evaluated patients 18years or older who were started on IV antibiotics in the ED. Patients were excluded if pregnant, if the patient is a prisoner, if no cultures were drawn, or if the patient was transferred from an outside facility. Appropriate antibiotic therapy was based on empiric source-specific evidence-based guidelines, appropriate pharmacokinetic and pharmacodynamic properties, and microbiologic data. The primary end point was the time from ED arrival to administration of appropriate antibiotic therapy. Of the 1628 evaluated, 128 patients met the inclusion criteria (64 pre vs 64 post). Patients were aged 65.2±17.0years, with most of infections being pneumonia (44%) and urinary tract infections (18%) and most patients being noncritically ill. Time to appropriate antibiotic therapy was reduced in the postgroup vs pregroup (8.1±8.6 vs 15.2±22.8hours, respectively, P=.03). In addition, appropriate empiric antibiotics were initiated more frequently after the implementation (92% post vs 66% pre; P=.0001). There was no difference in mortality or length of stay between the 2 groups. Prompt administration of the appropriate antibiotics is imperative in patients with infections presenting to the ED. The impact of prospective verification of

  6. Analysis of microtraces in invasive traumas using SEM/EDS.

    Vermeij, E J; Zoon, P D; Chang, S B C G; Keereweer, I; Pieterman, R; Gerretsen, R R R

    2012-01-10

    Scanning electron microscopy in combination with energy-dispersive X-ray spectrometry (SEM/EDS) is a proven forensic tool and has been used to analyze several kinds of trace evidence. A forensic application of SEM/EDS is the examination of morphological characteristics of tool marks that tools and instruments leave on bone. The microtraces that are left behind by these tools and instruments on the bone are, however, often ignored or not noticed at all. In this paper we will describe the use of SEM/EDS for the analysis of microtraces in invasive sharp-force, blunt-force and bone-hacking traumas in bone. This research is part of a larger multi-disciplinary approach in which pathologists, forensic anthropologists, toolmark and microtrace experts work together to link observed injuries to a suspected weapon or, in case of an unknown weapon, to indicate a group of objects that could have been used as a weapon. Although there are a few difficulties one have to consider, the method itself is rather simple and straightforward to apply. A sample of dry and clean bone is placed into the SEM sample chamber and brightness and contrast are set such that bone appears grey, metal appears white and organic material appears black. The sample is then searched manually to find relevant features. Once features are found their elemental composition is measured by an energy dispersive X-ray spectrometer (EDS). This method is illustrated using several cases. It is shown that SEM/EDS analysis of microtraces in bone is a valuable tool to get clues about an unknown weapon and can associate a specific weapon with injuries on the basis of appearance and elemental composition. In particular the separate results from the various disciplines are complementary and may be combined to reach a conclusion with a stronger probative value. This is not only useful in the courtroom but above all in criminal investigations when one have to know for what weapon or object to look for. Copyright © 2011

  7. Chromosome abnormalities additional to the Philadelphia chromosome at the diagnosis of chronic myelogenous leukemia: pathogenetic and prognostic implications.

    Zaccaria, Alfonso; Testoni, Nicoletta; Valenti, Anna Maria; Luatti, Simona; Tonelli, Michela; Marzocchi, Giulia; Cipriani, Raffaella; Baldazzi, Carmen; Giannini, Barbara; Stacchini, Monica; Gamberini, Carla; Castagnetti, Fausto; Rosti, Gianantonio; Azzena, Annalisa; Cavazzini, Francesco; Cianciulli, Anna Maria; Dalsass, Alessia; Donti, Emilio; Giugliano, Emilia; Gozzetti, Alessandro; Grimoldi, Maria Grazia; Ronconi, Sonia; Santoro, Alessandra; Spedicato, Francesco; Zanatta, Lucia; Baccarani, Michele

    2010-06-01

    Additional chromosome abnormalities (ACAs) occur in less than 10% of cases at diagnosis of Philadelphia chromosome (Ph)-positive chronic myelogenous leukemia (CML). In some cases, on the basis of the persistence of the ACAs in Ph-negative cells after response to imatinib, a secondary origin of the Ph chromosome has been demonstrated. In this study, the possible prognostic value of this phenomenon was evaluated. Thirty-six Ph-positive CML patients were included in the study. In six patients, ACAs persisted after the disappearance of the Ph. A complete cytogenetic response (CCR) was obtained in five of these six patients, and five of six also had a high Sokal score. In all the other cases, ACAs disappeared together (in cases of response to therapy with imatinib) or persisted with the Ph (in cases of no response to imatinib). In the former cases, the primary origin of the Ph was demonstrated. CCR was obtained in 22 cases (17 with low to intermediate Sokal scores), while no response was observed in 8 patients (5 with a high Sokal score). Sokal score seems to maintain its prognostic value for patients in whom the Ph occurs as a primary event, but not in those in whom it occurs as a secondary one. Copyright 2010 Elsevier Inc. All rights reserved.

  8. Herbarium specimens, photographs, and field observations show Philadelphia area plants are responding to climate change.

    Panchen, Zoe A; Primack, Richard B; Anisko, Tomasz; Lyons, Robert E

    2012-04-01

    The global climate is changing rapidly and is expected to continue changing in coming decades. Studying changes in plant flowering times during a historical period of warming temperatures gives us a way to examine the impacts of climate change and allows us to predict further changes in coming decades. The Greater Philadelphia region has a long and rich history of botanical study and documentation, with abundant herbarium specimens, field observations, and botanical photographs from the mid-1800s onward. These extensive records also provide an opportunity to validate methodologies employed by other climate change researchers at a different biogeographical area and with a different group of species. Data for 2539 flowering records from 1840 to 2010 were assessed to examine changes in flowering response over time and in relation to monthly minimum temperatures of 28 Piedmont species native to the Greater Philadelphia region. Regression analysis of the date of flowering with year or with temperature showed that, on average, the Greater Philadelphia species studied are flowering 16 d earlier over the 170-yr period and 2.7 d earlier per 1°C rise in monthly minimum temperature. Of the species studied, woody plants with short flowering duration are the best indicators of a warming climate. For monthly minimum temperatures, temperatures 1 or 2 mo prior to flowering are most significantly correlated with flowering time. Studies combining herbarium specimens, photographs, and field observations are an effective method for detecting the effects of climate change on flowering times.

  9. Using Multispectral Analysis in GIS to Model the Potential for Urban Agriculture in Philadelphia

    Dmochowski, J. E.; Cooper, W. P.

    2010-12-01

    In the context of growing concerns about the international food system’s dependence on fossil fuels, soil degradation, climate change, and other diverse issues, a number of initiatives have arisen to develop and implement sustainable agricultural practices. Many seeking to reform the food system look to urban agriculture as a means to create localized, sustainable agricultural production, while simultaneously providing a locus for community building, encouraging better nutrition, and promoting the rebirth of depressed urban areas. The actual impact of such system, however, is not well understood, and many critics of urban agriculture regard its implementation as impractical and unrealistic. This project uses multispectral imagery from United States Department of Agriculture’s National Agricultural Imagery Program with a one-meter resolution to quantify the potential for increasing urban agriculture in an effort to create a sustainable food system in Philadelphia. Color infrared images are classified with a minimum distance algorithm in ArcGIS to generate baseline data on vegetative cover in Philadelphia. These data, in addition to mapping on the ground, form the basis of a model of land suitable for conversion to agriculture in Philadelphia, which will help address questions related to potential yields, workforce, and energy requirements. This research will help city planners, entrepreneurs, community leaders, and citizens understand how urban agriculture can contribute to creating a sustainable food system in a major North American city.

  10. I Failed the edTPA

    Kuranishi, Adam; Oyler, Celia

    2017-01-01

    In this article, co-written by a teacher and a professor, the authors examine possible explanations for why Adam (first author), a New York City public school special educator, failed the edTPA, a teacher performance assessment required by all candidates for state certification. Adam completed a yearlong teaching residency where he was the special…

  11. Electrostatic-Dipole (ED) Fusion Confinement Studies

    Miley, George H.; Shrestha, Prajakti J.; Yang, Yang; Thomas, Robert

    2004-11-01

    The Electrostatic-Dipole (ED) concept significantly differs from a "pure" dipole confinement device [1] in that the charged particles are preferentially confined to the high-pressure region interior of the dipole coil by the assistance of a surrounding spherical electrostatic grid. In present ED experiments, a current carrying coil is embedded inside the grid of an IEC such as to produce a magnetic dipole field. Charged particles are injected axisymmetrically from an ion gun (or duo-plasmatron) into the center of the ED confinement grid/dipole ring where they oscillate along the magnetic field lines and pass the peak field region at the center of the dipole region. As particles begin accelerating away from the center region towards the outer electrostatic grid region, they encounter a strong electrostatic potential (order of 10's of kilovolts) retarding force. The particles then decelerate, reverse direction and re-enter the dipole field region where again magnetic confinement dominates. This process continues, emulating a complex harmonic oscillator motion. The resulting pressure profile averaged over the field curvature offers good plasma stability in the ED configuration. The basic concept and results from preliminary experiments will be described. [1] M.E. Mauel, et al. "Dipole Equilibrium and Stability," 18th IAEA Conference of Plasma Phys. and Control. Nuclear Fusion, Varenna, Italy 2000, IAEA-F1-CN-70/TH

  12. A 5-year comparison of ED visits by homeless and nonhomeless patients.

    Tadros, Allison; Layman, Shelley M; Brewer, Marissa Pantaleone; Davis, Stephen M

    2016-05-01

    A 2005 study examined emergency department (ED) utilization by homeless patients in the United States. Within the following 5 years, unemployment increased by 5%. The objective was to analyze changes in ED utilization between 2005 and 2010 by homeless patients and compare with nonhomeless visits. Data from the 2010 National Hospital Ambulatory Medical Care Survey were evaluated. Approximately 679854 visits were made by homeless patients, the majority of which were made by men (72.3%) and patients between the ages of 45 and 64 (50.5%). Homeless patients were twice as likely to be uninsured. ED visits by homeless patients had increased by 44% during the 5-year period. Arrival to the ED by ambulance increased by 14% between the study years, and homeless patients were less likely to be admitted. The number of visits by homeless patients in the ED increased proportionally to an overall increase in ED visits between 2005 and 2010. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Bio-EdIP: An automatic approach for in vitro cell confluence images quantification.

    Cardona, Andrés; Ariza-Jiménez, Leandro; Uribe, Diego; Arroyave, Johanna C; Galeano, July; Cortés-Mancera, Fabian M

    2017-07-01

    Cell imaging is a widely-employed technique to analyze multiple biological processes. Therefore, simple, accurate and quantitative tools are needed to understand cellular events. For this purpose, Bio-EdIP was developed as a user-friendly tool to quantify confluence levels using cell culture images. The proposed algorithm combines a pre-processing step with subsequent stages that involve local processing techniques and a morphological reconstruction-based segmentation algorithm. Segmentation performance was assessed in three constructed image sets, comparing F-measure scores and AUC values (ROC analysis) for Bio-EdIP, its previous version and TScratch. Furthermore, segmentation results were compared with published algorithms using eight public benchmarks. Bio-EdIP automatically segmented cell-free regions from images of in vitro cell culture. Based on mean F-measure scores and ROC analysis, Bio-EdIP conserved a high performance regardless of image characteristics of the constructed dataset, when compared with its previous version and TScratch. Although acquisition quality of the public dataset affected Bio-EdIP segmentation, performance was better in two out of eight public sets. Bio-EdIP is a user-friendly interface, which is useful for the automatic analysis of confluence levels and cell growth processes using in vitro cell culture images. Here, we also presented new manually annotated data for algorithms evaluation. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Point-of-Care Ultrasonography for Evaluation of Acute Dyspnea in the ED.

    Zanobetti, Maurizio; Scorpiniti, Margherita; Gigli, Chiara; Nazerian, Peiman; Vanni, Simone; Innocenti, Francesca; Stefanone, Valerio T; Savinelli, Caterina; Coppa, Alessandro; Bigiarini, Sofia; Caldi, Francesca; Tassinari, Irene; Conti, Alberto; Grifoni, Stefano; Pini, Riccardo

    2017-06-01

    Acute dyspnea is a common symptom in the ED. The standard approach to dyspnea often relies on radiologic and laboratory results, causing excessive delay before adequate therapy is started. Use of an integrated point-of-care ultrasonography (PoCUS) approach can shorten the time needed to formulate a diagnosis, while maintaining an acceptable safety profile. Consecutive adult patients presenting with dyspnea and admitted after ED evaluation were prospectively enrolled. The gold standard was the final diagnosis assessed by two expert reviewers. Two physicians independently evaluated the patient; a sonographer performed an ultrasound evaluation of the lung, heart, and inferior vena cava, while the treating physician requested traditional tests as needed. Time needed to formulate the ultrasound and the ED diagnoses was recorded and compared. Accuracy and concordance of the ultrasound and the ED diagnoses were calculated. A total of 2,683 patients were enrolled. The average time needed to formulate the ultrasound diagnosis was significantly lower than that required for ED diagnosis (24 ± 10 min vs 186 ± 72 min; P = .025). The ultrasound and the ED diagnoses showed good overall concordance (κ = 0.71). There were no statistically significant differences in the accuracy of PoCUS and the standard ED evaluation for the diagnosis of acute coronary syndrome, pneumonia, pleural effusion, pericardial effusion, pneumothorax, and dyspnea from other causes. PoCUS was significantly more sensitive for the diagnosis of heart failure, whereas a standard ED evaluation performed better in the diagnosis of COPD/asthma and pulmonary embolism. PoCUS represents a feasible and reliable diagnostic approach to the patient with dyspnea, allowing a reduction in time to diagnosis. This protocol could help to stratify patients who should undergo a more detailed evaluation. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  15. [Disappearance of a Philadelphia chromosome-positive clone and appearance of a -negative clone following treatment with imatinib mesylate in acute myelomonocytic leukemia].

    Takahashi, Wataru; Arai, Yukihiro; Tadokoro, Jiro; Takeuchi, Kengo; Yamagata, Tetsuya; Mitani, Kinuko

    2006-02-01

    A 63-year-old female was diagnosed as having Philadelphia chromosome-positive acute myelomonocytic leukemia in June 2002. The patient received monotherapy with imatinib mesylate or combination therapy with DCM and idarubicin/cytarabine, both of which failed in attaining disease remission. However, the second imatinib administration plus CAG therapy resulted in disappearance of the Philadelphia chromosome-positive clone and increase of Philadelphia chromosome-negative cells. During a therapy-withholding period due to fungal infection, the Philadelphia chromosome-positive clone expanded and the patient died of cerebral hemorrhage in February 2003. The transient suppression of the Philadelphia chromosome-positive clone may have brought about amplification of the Philadelphia chromosome-negative cells after the secondary imatinib treatment.

  16. The Buried Past: An Archaeological History of Philadelphia, by John L. Cotter, Daniel G. Roberts, and Michael Parrington. University of Pennsylvania Press, Philadelphia. 1992

    James A. Delle

    1995-05-01

    Full Text Available Having been involved in both contract and academic archaeology in recent years, I have heard (and sympathized with a pervasive lament. It seems increasingly common that even the best contract archaeology is rarely published, but compiled into reports that disappear into state repositories and contract firm offices, never again to be thought of except (maybe when it comes time to write the next report. There is an increasing body of both gray literature and gray excavation: work that is done in compliance with state and federal laws but which never reaches an audience of more than a dozen or so readers. Given this discouraging trend, the compendious The Buried Past is a welcomed synthesis of several generations of aca­demic and CRM investigations into the historical archaeology of the Greater Philadelphia region.

  17. Improving Access to Eye Care among Persons at High-Risk of Glaucoma in Philadelphia — Design and Methodology: The Philadelphia Glaucoma Detection and Treatment Project

    Myers, Jonathan S.; Henderer, Jeffrey; Crews, John E.; Saaddine, Jinan B.; Molineaux, Jeanne; Johnson, Deiana; Sembhi, Harjeet; Stratford, Shayla; Suleiman, Ayman; Pizzi, Laura; Spaeth, George L.; Katz, L. Jay

    2016-01-01

    Purpose The Wills Eye Glaucoma Research Center initiated a 2-year demonstration project to develop and implement a community-based intervention to improve detection and management of glaucoma in Philadelphia. Methods The glaucoma detection examination consisted of: ocular, medical, and family history; visual acuity testing; corneal pachymetry; biomicroscopy of the anterior segment; intraocular pressure (IOP) measurement; gonioscopy; funduscopy; automated visual field testing; and fundus-color photography. Treatment included laser surgery and/or IOP-lowering medication. A cost analysis was conducted to understand resource requirements. Outcome measures included; prevalence of glaucoma-related pathology and other eye diseases among high-risk populations; the impact of educational workshops on level of knowledge about glaucoma (assessed by pre- and post-test evaluation); and patient satisfaction of the glaucoma detection examinations in the community (assessed by satisfaction survey). Treatment outcome measures were change in IOP at 4–6 weeks and 4–6 months following selective laser trabeculoplasty treatment, deepening of the anterior chamber angle following laser-peripheral iridotomy treatment, and rate of adherence to recommended follow-up examinations. Cost outcomes included total program costs, cost per case of glaucoma detected, and cost per case of ocular disease detected. Results This project enrolled 1649 participants (African Americans aged 50+ years, adults 60+ years and individuals with a family history of glaucoma). A total of 1074 individuals attended a glaucoma educational workshop and 1508 scheduled glaucoma detection examination appointments in the community setting. Conclusions The Philadelphia Glaucoma Detection and Treatment Project aimed to improve access and use of eye care and to provide a model for a targeted community-based glaucoma program. PMID:26950056

  18. Improving Access to Eye Care among Persons at High-Risk of Glaucoma in Philadelphia--Design and Methodology: The Philadelphia Glaucoma Detection and Treatment Project.

    Hark, Lisa; Waisbourd, Michael; Myers, Jonathan S; Henderer, Jeffrey; Crews, John E; Saaddine, Jinan B; Molineaux, Jeanne; Johnson, Deiana; Sembhi, Harjeet; Stratford, Shayla; Suleiman, Ayman; Pizzi, Laura; Spaeth, George L; Katz, L Jay

    2016-01-01

    The Wills Eye Glaucoma Research Center initiated a 2-year demonstration project to develop and implement a community-based intervention to improve detection and management of glaucoma in Philadelphia. The glaucoma detection examination consisted of: ocular, medical, and family history; visual acuity testing; corneal pachymetry; biomicroscopy of the anterior segment; intraocular pressure (IOP) measurement; gonioscopy; funduscopy; automated visual field testing; and fundus-color photography. Treatment included laser surgery and/or IOP-lowering medication. A cost analysis was conducted to understand resource requirements. Outcome measures included; prevalence of glaucoma-related pathology and other eye diseases among high-risk populations; the impact of educational workshops on level of knowledge about glaucoma (assessed by pre- and post-test evaluation); and patient satisfaction of the glaucoma detection examinations in the community (assessed by satisfaction survey). Treatment outcome measures were change in IOP at 4-6 weeks and 4-6 months following selective laser trabeculoplasty treatment, deepening of the anterior chamber angle following laser-peripheral iridotomy treatment, and rate of adherence to recommended follow-up examinations. Cost outcomes included total program costs, cost per case of glaucoma detected, and cost per case of ocular disease detected. This project enrolled 1649 participants (African Americans aged 50+ years, adults 60+ years and individuals with a family history of glaucoma). A total of 1074 individuals attended a glaucoma educational workshop and 1508 scheduled glaucoma detection examination appointments in the community setting. The Philadelphia Glaucoma Detection and Treatment Project aimed to improve access and use of eye care and to provide a model for a targeted community-based glaucoma program.

  19. Cytoplasmic Streaming - Skylab Student Experiment ED-63

    1973-01-01

    This chart describes the Skylab student experiment (ED-63), Cytoplasmic Streaming, proposed by Cheryl A. Peitz of Arapahoe High School, Littleton, Colorado. Experiment ED-63 was to observe the effect of zero-gravity on cytoplasmic streaming in the aquatic plant named Elodea, commonly called water weed or water thyme. The phenomenon of cytoplasmic streaming is not well understood, but it is recognized as the circulation mechanism of the internal materials or cytoplasm of a cell. Cytoplasm is a gelatinous substance that has the ability to change its viscosity and flow, carrying various cell materials with it. The activity can be stimulated by sunlight or heat. In March 1972, NASA and the National Science Teachers Association selected 25 experiment proposals for flight on Skylab. Science advisors from the Marshall Space Flight Center aided and assisted the students in developing the proposals for flight on Skylab.

  20. The relative contribution of provider and ED-level factors to variation among the top 15 reasons for ED admission.

    Khojah, Imad; Li, Suhui; Luo, Qian; Davis, Griffin; Galarraga, Jessica E; Granovsky, Michael; Litvak, Ori; Davis, Samuel; Shesser, Robert; Pines, Jesse M

    2017-09-01

    We examine adult emergency department (ED) admission rates for the top 15 most frequently admitted conditions, and assess the relative contribution in admission rate variation attributable to the provider and hospital. This was a retrospective, cross-sectional study of ED encounters (≥18years) from 19 EDs and 603 providers (January 2012-December 2013), linked to the Area Health Resources File for county-level information on healthcare resources. "Hospital admission" was the outcome, a composite of inpatient, observation, or intra-hospital transfer. We studied the 15 most commonly admitted conditions, and calculated condition-specific risk-standardized hospital admission rates (RSARs) using multi-level hierarchical generalized linear models. We then decomposed the relative contribution of provider-level and hospital-level variation for each condition. The top 15 conditions made up 34% of encounters and 49% of admissions. After adjustment, the eight conditions with the highest hospital-level variation were: 1) injuries, 2) extremity fracture (except hip fracture), 3) skin infection, 4) lower respiratory disease, 5) asthma/chronic obstructive pulmonary disease (A&C), 6) abdominal pain, 7) fluid/electrolyte disorders, and 8) chest pain. Hospital-level intra-class correlation coefficients (ICC) ranged from 0.042 for A&C to 0.167 for extremity fractures. Provider-level ICCs ranged from 0.026 for abdominal pain to 0.104 for chest pain. Several patient, hospital, and community factors were associated with admission rates, but these varied across conditions. For different conditions, there were different contributions to variation at the hospital- and provider-level. These findings deserve consideration when designing interventions to optimize admission decisions and in value-based payment programs. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Regional Energy Deployment System (ReEDS)

    Short, W.; Sullivan, P.; Mai, T.; Mowers, M.; Uriarte, C.; Blair, N.; Heimiller, D.; Martinez, A.

    2011-12-01

    The Regional Energy Deployment System (ReEDS) is a deterministic optimization model of the deployment of electric power generation technologies and transmission infrastructure throughout the contiguous United States into the future. The model, developed by the National Renewable Energy Laboratory's Strategic Energy Analysis Center, is designed to analyze the critical energy issues in the electric sector, especially with respect to potential energy policies, such as clean energy and renewable energy standards or carbon restrictions. ReEDS provides a detailed treatment of electricity-generating and electrical storage technologies and specifically addresses a variety of issues related to renewable energy technologies, including accessibility and cost of transmission, regional quality of renewable resources, seasonal and diurnal generation profiles, variability of wind and solar power, and the influence of variability on the reliability of the electrical grid. ReEDS addresses these issues through a highly discretized regional structure, explicit statistical treatment of the variability in wind and solar output over time, and consideration of ancillary services' requirements and costs.

  2. Phylogenetic reconstruction of the Legionella pneumophila Philadelphia-1 laboratory strains through comparative genomics.

    Chitong Rao

    Full Text Available Over 20 years ago, two groups independently domesticated Legionella pneumophila from a clinical isolate of bacteria collected during the first recognized outbreak of Legionnaires' disease (at the 1976 American Legion's convention in Philadelphia. These two laboratory strains, JR32 and Lp01, along with their derivatives, have been disseminated to a number of laboratories around the world and form the cornerstone of much of the research conducted on this important pathogen to date. Nevertheless, no exhaustive examination of the genetic distance between these strains and their clinical progenitor has been performed thus far. Such information is of paramount importance for making sense of several phenotypic differences observed between these strains. As environmental replication of L. pneumophila is thought to exclusively occur within natural protozoan hosts, retrospective analysis of the domestication and axenic culture of the Philadelphia-1 progenitor strain by two independent groups also provides an excellent opportunity to uncover evidence of adaptation to the laboratory environment. To reconstruct the phylogenetic relationships between the common laboratory strains of L. pneumophila Philadelphia-1 and their clinical ancestor, we performed whole-genome Illumina resequencing of the two founders of each laboratory lineage: JR32 and Lp01. As expected from earlier, targeted studies, Lp01 and JR32 contain large deletions in the lvh and tra regions, respectively. By sequencing additional strains derived from Lp01 (Lp02 and Lp03, we retraced the phylogeny of these strains relative to their reported ancestor, thereby reconstructing the evolutionary dynamics of each laboratory lineage from genomic data.

  3. Second malignancies in hydroxyurea and interferon-treated Philadelphia-negative myeloproliferative neoplasms

    Hansen, Iben Onsberg; Sørensen, Anders Lindholm; Hasselbalch, Hans Carl

    2017-01-01

    OBJECTIVE: In an era of controversy in regard to 'hydroxyurea-leukaemogenicity' and when interferon-alfa2 (IFN) is being revived in the treatment of Philadelphia-negative myeloproliferative neoplasms (MPNs), we aim in this single-centre observational study to describe the frequencies of second...... malignancies in a cohort of MPN patients treated with hydroxyurea (HU) or IFN monotherapy or the combination of these agents. PATIENTS AND METHODS: Records of a MPN cohort of 196 patients were reviewed, and a retrospective analysis was performed on 90 patients treated with HU, 38 patients treated with IFN...

  4. [Control discourses and power relations of yellow fever: Philadelphia in 1793].

    Kim, Seohyung

    2014-12-01

    1793 Yellow fever in Philadelphia was the most severe epidemics in the late 18th century in the United States. More than 10% of the population in the city died and many people fled to other cities. The cause of yellow fever in the United States had close relationship with slaves and sugar in Philadelphia. Sugarcane plantation had needed many labors to produce sugar and lots of Africans had to move to America as slaves. In this process, Aëdes aegypti, the vector of yellow fever had migrated to America and the circumstances of ships or cities provided appropriate conditions for its breeding. In this period, the cause of yellow fever could not be established exactly, so suggestions of doctors became entangled in political and intellectual discourses in American society. There was a critical conflict between Jeffersonian Republicanism and Federalism about the origin and treatment of yellow fever. Benjamin Rush, a Jeffersonian Republican, suggested urban sanitation reform and bloodletting. He believed the infectious disease happened because of unsanitary city condition, so he thought the United States could be a healthy nation by improvement of the public health and sanitation. He would like to cope with national crisis and develop American society on the basis of republicanism. While Rush suggested the improvement of public health and sanitation, the city government of Philadelphia suggested isolation of yellow fever patients and quarantine. City government isolated the patients from healthy people and it reconstructed space of hospital. Also, it built orphanages to take care of children who lost their parents during the epidemic and implemented power to control people put in the state of exception. Of course, city government tried to protect the city and nation by quarantine of every ship to Philadelphia. Control policies of yellow fever in 1793 showed different conflicts and interactions. Through the yellow fever, Jeffersonian Republicanism and Federalism had

  5. Ed overcrowding – matematic models for integrated solutions and decisions

    ROTARU, LUCIANA TEODORA; BĂNICIOIU - COVEI, MIHAI

    2017-01-01

    Dear Editor In Chief, We are writing to You in line with an very interesting point of view regarding the Emergency Department (ED) development. The paper titled Improving Emergency Department Capacity Efficiency, published in your Journal 2016; 12(1): 52- 57, as an original articles, spotlight solution for ED crowding. So we are proposing a mathematics models for reciprocal accommodation of patients flows to the response capacity of the ED. ED overcrowding ...

  6. edX e-learning course development

    Gilbert, Matthew A

    2015-01-01

    If you are an educator creating a course for edX or a corporate trainer using Open edX for large-scale learning and development initiatives, then edX E-Learning Course Development is the ideal book for you.

  7. Initial mechanical ventilator settings and lung protective ventilation in the ED.

    Wilcox, Susan R; Richards, Jeremy B; Fisher, Daniel F; Sankoff, Jeffrey; Seigel, Todd A

    2016-08-01

    Mechanical ventilation with low tidal volumes has been shown to improve outcomes for patients both with and without acute respiratory distress syndrome. This study aims to characterize mechanically ventilated patients in the emergency department (ED), describe the initial ED ventilator settings, and assess for associations between lung protective ventilation strategies in the ED and outcomes. This was a multicenter, prospective, observational study of mechanical ventilation at 3 academic EDs. We defined lung protective ventilation as a tidal volume of less than or equal to 8 mL/kg of predicted body weight and compared outcomes for patients ventilated with lung protective vs non-lung protective ventilation, including inhospital mortality, ventilator days, intensive care unit length of stay, and hospital length of stay. Data from 433 patients were analyzed. Altered mental status without respiratory pathology was the most common reason for intubation, followed by trauma and respiratory failure. Two hundred sixty-one patients (60.3%) received lung protective ventilation, but most patients were ventilated with a low positive end-expiratory pressure, high fraction of inspired oxygen strategy. Patients were ventilated in the ED for a mean of 5 hours and 7 minutes but had few ventilator adjustments. Outcomes were not significantly different between patients receiving lung protective vs non-lung protective ventilation. Nearly 40% of ED patients were ventilated with non-lung protective ventilation as well as with low positive end-expiratory pressure and high fraction of inspired oxygen. Despite a mean ED ventilation time of more than 5 hours, few patients had adjustments made to their ventilators. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Electroencephalography findings in patients presenting to the ED for evaluation of seizures.

    Kadambi, Pooja; Hart, Kimberly W; Adeoye, Opeolu M; Lindsell, Christopher J; Knight, William A

    2015-01-01

    Status epilepticus is a life-threatening, time-sensitive emergency. Acquiring an electroencephalogram (EEG) in the emergency department (ED) could impact therapeutic and disposition decisions for patients with suspected status epilepticus. The objective of this study is to estimate the proportion of EEGs diagnostic for seizures in patients presenting to an ED with a complaint of seizures. This retrospective chart review included adults presenting to the ED of an urban, academic, tertiary care hospital with suspected seizures or status epilepticus, who received an EEG within 24 hours of hospital admission. Data abstraction was performed by a single, trained, nonblinded abstractor. Seizures were defined as an epileptologist's diagnosis of either seizures or status epilepticus on EEG. The proportion of patients with seizures is given with confidence interval95 (CI95). Of 120 included patients, 67 (56%) had a history of epilepsy. Mean age was 52 years (SD, 16), 58% were White, and 61% were male. Within 24 hours, 3% had an EEG diagnostic for seizures. Electroencephalogram was obtained in the ED in 32 (27%) of 120 (CI95, 19%-35%), and 2 (6%) of 32 (CI95, 1%-19%) had seizures. Electroencephalogram was performed inpatient for 88 (73%) of 120 (CI95, 65%-81%), and 2 (2%) of 88 (CI95, 0.5%-7.1%) had seizures. Only 3% of ED patients with suspected seizures or status epilepticus had EEG confirmation of seizures within 24 hours. Early EEG acquisition in the ED may identify a group of patients amenable to ED observation and subsequent discharge from the hospital. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Improved Early Detection of Sepsis in the ED With a Novel Monocyte Distribution Width Biomarker.

    Crouser, Elliott D; Parrillo, Joseph E; Seymour, Christopher; Angus, Derek C; Bicking, Keri; Tejidor, Liliana; Magari, Robert; Careaga, Diana; Williams, JoAnna; Closser, Douglas R; Samoszuk, Michael; Herren, Luke; Robart, Emily; Chaves, Fernando

    2017-09-01

    Sepsis most often presents to the ED, and delayed detection is harmful. WBC count is often used to detect sepsis, but changes in WBC count size also correspond to sepsis. We sought to determine if volume increases of circulating immune cells add value to the WBC count for early sepsis detection in the ED. A blinded, prospective cohort study was conducted in two different ED populations within a large academic hospital. Neutrophil and monocyte volume parameters were measured in conjunction with routine CBC testing on a UniCel DxH 800 analyzer at the time of ED admission and were evaluated for the detection of sepsis. There were 1,320 subjects in the ED consecutively enrolled and categorized as control subjects (n = 879) and those with systemic inflammatory response syndrome (SIRS) (n = 203), infection (n = 140), or sepsis (n = 98). Compared with other parameters, monocyte distribution width (MDW) best discriminated sepsis from all other conditions (area under the curve [AUC], 0.79; 95% CI, 0.73-0.84; sensitivity, 0.77; specificity, 0.73; MDW threshold, 20.50), sepsis from SIRS (AUC, 0.74; 95% CI, 0.67-0.84), and severe sepsis from noninfected patients in the ED (AUC, 0.88; 95% CI, 0.75-0.99; negative predictive value, 99%). The added value of MDW to WBC count was statistically significant (AUC, 0.89 for MDW + WBC vs 0.81 for WBC alone; P sepsis compared with WBC count alone at the time of admission in the ED. ClinicalTrials.gov; No.: NCT02232750; URL: www.clinicaltrials.gov. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  10. EDS Coal Liquefaction Process Development. Phase V. Laboratory evaluation of the characteristics of EDS Illinois bottoms

    Lao, T C; Levasseur, A A

    1984-02-01

    This interim report documents work carried out by Combustion Engineering, Inc. under a contract to Exxon Research and Engineering Company to develop a conceptual Hybrid Boiler design fueled by the vacuum distillation residue (vacuum bottoms) derived from Illinois No. 6 coal in the EDS Coal Liquefaction Process. This report was prepared by Combustion Engineering, Inc., and is the first of two reports on the predevelopment phase of the Hybrid Boiler program. This report covers the results of a laboratory investigation to assess the fuel and ash properties of EDS vacuum bottoms. The results of the laboratory testing reported here were used in conjunction with Combustion Engineering's design experience to predict fuel performance and to develop appropriate boiler design parameters. These boiler design parameters were used to prepare the engineering design study reported in EDS Interim Report FE-2893-113, the second of the two reports on the predevelopment phase of the Hybrid Boiler Program. 46 figures, 29 tables.

  11. Using Google Flu Trends data in forecasting influenza-like-illness related ED visits in Omaha, Nebraska.

    Araz, Ozgur M; Bentley, Dan; Muelleman, Robert L

    2014-09-01

    statistically improve the performance of predicting ILI-related ED visits in Douglas County, and this result can be generalized to other communities. Timely and accurate estimates of ED volume during the influenza season, as well as during pandemic outbreaks, can help hospitals plan their ED resources accordingly and lower their costs by optimizing supplies and staffing and can improve service quality by decreasing ED wait times and overcrowding. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Secondhand Smoke Exposure and Smoke-free Policy in Philadelphia Public Housing.

    Klassen, Ann C; Lee, Nora L; Pankiewicz, Aaron; Ward, Rikki; Shuster, Michelle; Ogbenna, Bethany Townsend; Wade, Anita; Boamah, Maxwell; Osayameh, Olufunlayo; Rule, Ana M; Szymkowiak, Dorota; Coffman, Ryan; Bragg, Virginius; Mallya, Giridhar

    2017-04-01

    Multi-unit housing environments remain significant sources of secondhand smoke (SHS) exposure, especially for vulnerable populations in subsidized housing. In Philadelphia, the largest US housing authority to implement smoke-free policies, we measured baseline resident smoking-related behaviors and attitudes, and longitudinal exposures to airborne nicotine, during policy development and implementation. In 4 communities, we collected data in 2013, 2014, and 2016, before and after introduction of comprehensive smoke-free policies, interviewing persons in 172 households, and monitoring air-borne nicotine in non-smoking homes and public areas. Average nicotine level differences across years were estimated with multi-level models. Fifty-six percent of respondents smoked. Only 37% of households were smoke-free, with another 41% restricting smoking by area or time of day. The number of locations with detectable nicotine did not differ before and after policy implementation, with approximately 20% of non-smoking homes and 70%-80% of public areas having detectable nicotine. However, public area nicotine levels were lower in 2016, after policy implementation, than in 2013 and 2014 (-0.19 μg/m 3 , p = .03). Findings suggest that initial policy implementation was associated with reduced SHS exposure in Philadelphia. As HUD strengthens smoke-free policies, SHS monitoring can be useful to educate stakeholders and build support for policy enforcement.

  13. OZONE PRODUCTION IN THE PHILADELPHIA URBAN AREA DURING NE-OPS 99

    KLEINMAN, L.I.; DAUM, P.H.; BRECHTEL, F.; LEE, Y.N.; NUNNERMACKER, L.J.; SPRINGSTON, S.R.; WEINSTEIN-LLOYD, J.

    2001-01-01

    As part of the 1999 NARSTO Northeast Oxidant and Particulate Study (NE-OPS) field campaign, the DOE G-1 aircraft sampled trace gases and aerosols in and around the Philadelphia metropolitan area. Twenty research flights were conducted between July 25 and August 11. The overall goals of these flights were to obtain a mechanistic understanding of O(sub 3) production; to characterize the spatial and temporal behavior of photo-oxidants and aerosols; and to study the evolution of aerosol size distributions, including the process of new particle formation. Within the NE-OPS program, other groups provided additional trace gas, aerosol, and meteorological observations using aircraft, balloon, remote sensing, and surface based instruments (Phillbrick et al., 2000). In this article we provide an overview of the G-1 observations related to O(sub 3) production, focusing on the vertical distribution of pollutants. Ozone production rates are calculated using a box model that is constrained by observed trace gas concentrations. Highest O(sub 3) concentrations were observed on July 31, which we present as a case study. On that day, O(sub 3) concentrations above the 1-hour 120 ppb standard were observed downwind of Philadelphia and also in the plume of a single industrial facility located on the Delaware River south of the city

  14. Young People Take Their Rightful Places as Full and Contributing Members of a World Class Workforce: Philadelphia Youth Network Annual Report 2006

    Philadelphia Youth Network, 2006

    2006-01-01

    The title of this year's annual report has particular meaning for all of the staff at the Philadelphia Youth Network. The phrase derives from Philadelphia Youth Network's (PYN's) new vision statement, developed as part of its recent strategic planning process, which reads: All of our city's young people take their rightful places as full and…

  15. Perceptions of empowerment among ED nurses.

    DeVivo, Diane; Quinn Griffin, Mary T; Donahue, Moreen; Fitzpatrick, Joyce J

    2013-11-01

    Nurses' perceptions of empowerment have been linked to a number of variables in the hospital workplace, including job satisfaction, autonomy, and work effectiveness. Yet there have been no previous studies of perceptions of empowerment specifically among emergency department (ED) nurses. Registered nurses (RNs) employed in the EDs of 6 hospitals in a major health care system in the eastern United States were surveyed regarding their perceptions of empowerment. Of the 240 RNs eligible to participate, there were 167 usable surveys. There was a moderate level of empowerment among the RNs who participated, consistent with the level of empowerment reported in several other studies of staff nurses and nurses in other positions. The moderate level of empowerment in this sample may be attributed to the many opportunities for RN involvement in the hospitals within this health care system. Nurse leaders can initiate programs focused on enhancing RN perceptions of empowerment. In addition, there is a need for further research among RNs with different specialty preparation. Copyright © 2013. Published by Mosby, Inc.

  16. Adaptation of Lorke's method to determine and compare ED50 values: the cases of two anticonvulsants drugs.

    Garrido-Acosta, Osvaldo; Meza-Toledo, Sergio Enrique; Anguiano-Robledo, Liliana; Valencia-Hernández, Ignacio; Chamorro-Cevallos, Germán

    2014-01-01

    We determined the median effective dose (ED50) values for the anticonvulsants phenobarbital and sodium valproate using a modification of Lorke's method. This modification allowed appropriate statistical analysis and the use of a smaller number of mice per compound tested. The anticonvulsant activities of phenobarbital and sodium valproate were evaluated in male CD1 mice by maximal electroshock (MES) and intraperitoneal administration of pentylenetetrazole (PTZ). The anticonvulsant ED50 values were obtained through modifications of Lorke's method that involved changes in the selection of the three first doses in the initial test and the fourth dose in the second test. Furthermore, a test was added to evaluate the ED50 calculated by the modified Lorke's method, allowing statistical analysis of the data and determination of the confidence limits for ED50. The ED50 for phenobarbital against MES- and PTZ-induced seizures was 16.3mg/kg and 12.7mg/kg, respectively. The sodium valproate values were 261.2mg/kg and 159.7mg/kg, respectively. These results are similar to those found using the traditional methods of finding ED50, suggesting that the modifications made to Lorke's method generate equal results using fewer mice while increasing confidence in the statistical analysis. This adaptation of Lorke's method can be used to determine median letal dose (LD50) or ED50 for compounds with other pharmacological activities. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Softball injuries treated in US EDs, 1994 to 2010.

    Birchak, John C; Rochette, Lynne M; Smith, Gary A

    2013-06-01

    Softball is a popular participant sport in the United States. This study investigated the epidemiology of softball injuries with comparisons between children and adults. Data from the National Electronic Injury Surveillance System for patients 7 years and older treated in an emergency department (ED) for a softball injury from 1994 through 2010 were analyzed. An estimated 2107823 (95% confidence interval [CI], 1736417-2479229) patients were treated in US EDs for a softball injury during the 17-year study period. The annual number of injuries decreased by 23.0% from 1994 to 2010 (P softball injuries increased significantly during the study period (P = .035). The most commonly injured body regions were the hand/wrist (22.2%) and face (19.3%). Being hit by a ball was the most common mechanism of injury (52.4%) and accounted for most of face (89.6%) and head (75.7%) injuries. Injuries associated with running (relative risk, 2.36; 95% CI, 1.97-2.82) and diving for a ball (relative risk, 4.61; 95% CI, 3.50-6.09) were more likely to occur among adult than pediatric patients. To our knowledge, this is the first study to investigate softball injuries using a nationally representative sample. Softball is a common source of injury among children and adults. Increased efforts are needed to promote safety measures, such as face guards, mouth guards, safety softballs, and break-away bases, to decrease these injuries. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Giocare, tra violenza ed ecologia della mente.

    Enrico Euli

    2008-07-01

    Full Text Available L'articolo riflette sulle relazioni tra comunicazione, violenza e gioco, nel tentativo di rintracciare tra loro convergenze, affinità e contrasti. Le nostre relazioni, infatti, ci immettono inerzialmente in dilemmi e paradossi di così alta complessità da rendere spesso inadeguati gli strumenti 'logici' ed 'analitici': dal che può derivare un senso di impotenza, rabbia, paralisi, ma anche un desiderio potente di controllo e di soluzione degli eventi. Entrambe queste strade ci conducono dentro le false alternative della violenza. La cultura del gioco, invece, ci propone (attraverso le sue pratiche, ma anche negli scritti teorici di Freud, Winnicott, Bateson, qui riassunti e rivisitati una modalità più creativa e nonviolenta, più prossima ad un' ecologia della mente e ad un'estetica delle emozioni.

  19. Structural and Functional Characterization of a New Double Variant Haemoglobin (HbG-Philadelphia/Duarte α(2)β(2)).

    Fais, Antonella; Casu, Mariano; Ruggerone, Paolo; Ceccarelli, Matteo; Porcu, Simona; Era, Benedetta; Anedda, Roberto; Sollaino, Maria Carla; Galanello, Renzo; Corda, Marcella

    2011-01-01

    WE REPORT THE FIRST CASE OF COSEGREGATION OF TWO HAEMOGLOBINS (HBS): HbG-Philadelphia [α68(E17)Asn → Lys] and HbDuarte [β62(E6)Ala → Pro]. The proband is a young patient heterozygous also for β°-thalassaemia. We detected exclusively two haemoglobin variants: HbDuarte and HbG-Philadelphia/Duarte. Functional study of the new double variant HbG-Philadelphia/Duarte exhibited an increase in oxygen affinity, with a slight decrease of cooperativity and Bohr effect. This functional behaviour is attributed to β62Ala → Pro instead of α68Asn → Lys substitution. Indeed, HbG-Philadelphia isolated in our laboratory from blood cells donor carrier for this variant is not affected by any functional modification, whereas purified Hb Duarte showed functional properties very similar to the double variant. NMR and MD simulation studies confirmed that the presence of Pro instead of Ala at the β62 position produces displacement of the E helix and modifications of the tertiary structure. The substitution α68(E17)Asn → Lys does not cause significant structural and dynamical modifications of the protein. A possible structure-based rational of substitution effects is suggested.

  20. Dasatinib crosses the blood-brain barrier and is an efficient therapy for central nervous system philadelphia chromosome positive leukemia

    K. Porkka (Kimmo); P. Koskenvesa (Perttu); T. Lundan (Tuija); J. Rimpiläinen (Johanna); S. Mustjoki (Satu); R. Smykla (Richard); R. Wild (Robert); R. Luo (Roger); M. Arnan (Montserrat); B. Brethon (Benoit); L. Eccersley (Lydia); H. Hjorth-Hansen (Henrik); M. Höglund (Martin); H. Klamova (Hana); H. Knutsen (Håvar); S. Parikh (Suhag); E. Raffoux (Emmanuel); F. Gruber (Franz); F. Brito-Babapulle (Finella); H. Dombret (Hervé); R.F. Duarte (Rafael); E. Elonen (Erkki); R. Paquette (Ron); C.M. Zwaan (Christian Michel); F.Y.F. Lee (Francis)

    2008-01-01

    textabstractAlthough imatinib, a BCR-ABL tyrosine kinase inhibitor, is used to treat acute Philadelphia chromosome-positive (Ph+) leukemia, it does not prevent central nervous system (CNS) relapses resulting from poor drug penetration through the blood-brain barrier. Imatinib and dasatinib (a

  1. 3-D Scanning of Headstones at the U.S. Naval Plot, Mount Moriah Cemetery, Philadelphia, PA

    2017-11-17

    unrecognizable because these monuments of history provide a record of the heroes who served this country with honor and distinction. The naval plot at Mount...Eventually, 1 History of Philadelphia, 1609-1884, by John Thomas Scharf and Thompson...digital imaging requires natural or artificial light to work effec- tively. The point cloud is the most important aspect of this technology for

  2. Correlates to Human Papillomavirus Vaccination Status and Willingness to Vaccinate in Low-Income Philadelphia High School Students

    Bass, Sarah B.; Leader, Amy; Shwarz, Michelle; Greener, Judith; Patterson, Freda

    2015-01-01

    Background: Little is known about the correlates of human papillomavirus (HPV) vaccination or willingness to be vaccinated in urban, minority adolescents. Methods: Using responses to the 2013 Youth Risk Behavior Survey in Philadelphia, a random sample of high schools provided weighted data representing 20,941 9th to 12th graders. Stratified by…

  3. NCI Helps Children’s Hospital of Philadelphia to Identify and Treat New Target in Pediatric Cancer | Poster

    There may be a new, more effective method for treating high-risk neuroblastoma, according to scientists at the Children’s Hospital of Philadelphia and collaborators in the Cancer and Inflammation Program at NCI at Frederick. Together, the groups published a study describing a previously unrecognized protein on neuroblastoma cells, called GPC2, as well as the creation of a

  4. School Autonomy and District Support: How Principals Respond to a Tiered Autonomy Initiative in Philadelphia Public Schools

    Steinberg, Matthew P.; Cox, Amanda Barrett

    2017-01-01

    A tiered autonomy policy was recently implemented in Philadelphia, where select principals were granted autonomy to manage school operations while others were promised greater district support to improve school functioning. This article provides evidence on how principals used their autonomy and the extent of district support for non-autonomous…

  5. Localization of preferential sites of rearrangement within the BCR gene in Philadelphia chromosome-positive acute lymphoblastic leukemia

    Denny, C.T.; Shah, N.P.; Ogden, S.; Willman, C.; McConnell, T.; Crist, W.; Carroll, A.; Witte, O.N.

    1989-01-01

    The Philadelphia chromosome associated with acute lymphoblastic leukemia (ALL) has been linked to a hybrid BCR/ABL protein product that differs from that found in chronic myelogenous leukemia. This implies that the molecular structures of the two chromosomal translocations also differ. Localization of translocation breakpoints in Philadelphia chromosome-positive ALL has been impeded due to the only partial characterization of the BCR locus. The authors have isolated the entire 130-kilobase BCR genomic locus from a human cosmid library. They have demonstrated that these breakpoints are all located at the 3' end of the intron around an unusual restriction fragment length polymorphism caused by deletion of a 1-kilobase fragment containing Alu family reiterated sequences. This clustering is unexpected in light of previous theories of rearrangement in Philadelphia chromosome-positive chronic myelogenous leukemia that would have predicted a random dispersion of breakpoints in the first intron in Philadelphia chromosome-positive ALL. The proximity of the translocation breakpoints to this constitutive deletion may indicate shared mechanisms of rearrangement or that such polymorphisms mark areas of the genome prone to recombination

  6. Pareto vs Simmel: residui ed emozioni

    Silvia Fornari

    2017-08-01

    Full Text Available A cento anni dalla pubblicazione del Trattato di sociologia generale (Pareto 1988 siamo a mantenere vivo ed attuale lo studio paretiano con una rilettura contemporanea del suo pensiero. Ricordato per la grande versatilità intellettuale dagli economisti, rimane lo scienziato rigoroso ed analitico i cui contributi sono ancora discussi a livello internazionale. Noi ne analizzeremo gli aspetti che l’hanno portato ad avvicinarsi all’approccio sociologico, con l’introduzione della nota distinzione dell’azione sociale: logica e non-logica. Una dicotomia utilizzata per dare conto dei cambiamenti sociali riguardanti le modalità d’azione degli uomini e delle donne. Com’è noto le azioni logiche sono quelle che riguardano comportamenti mossi da logicità e raziocinio, in cui vi è una diretta relazione causa-effetto, azioni oggetto di studio degli economisti, e di cui non si occupano i sociologi. Le azioni non-logiche riguardano tutte le tipologie di agire umano che rientrano nel novero delle scienze sociali, e che rappresentano la parte più ampia dell’agire sociale. Sono le azioni guidate dai sentimenti, dall’emotività, dalla superstizione, ecc., illustrate da Pareto nel Trattato di sociologia generale e in saggi successivi, dove riprende anche il concetto di eterogenesi dei fini, formulato per la prima volta da Giambattista Vico. Concetto secondo il quale la storia umana, pur conservando in potenza la realizzazione di certi fini, non è lineare e lungo il suo percorso evolutivo può accadere che l’uomo nel tentativo di raggiungere una finalità arrivi a conclusioni opposte. Pareto collega la definizione del filosofo napoletano alle tipologie di azione sociale e alla loro distinzione (logiche, non-logiche. L’eterogenesi dei fini per Pareto è dunque l’esito di un particolare tipo di azione non-logica dell’essere umano e della collettività.

  7. Effect of advanced age and vital signs on admission from an ED observation unit.

    Caterino, Jeffrey M; Hoover, Emily M; Moseley, Mark G

    2013-01-01

    The primary objective was to determine the relationship between advanced age and need for admission from an emergency department (ED) observation unit. The secondary objective was to determine the relationship between initial ED vital signs and admission. We conducted a prospective, observational cohort study of ED patients placed in an ED-based observation unit. Multivariable penalized maximum likelihood logistic regression was used to identify independent predictors of need for hospital admission. Age was examined continuously and at a cutoff of 65 years or more. Vital signs were examined continuously and at commonly accepted cutoffs.We additionally controlled for demographics, comorbid conditions, laboratory values, and observation protocol. Three hundred patients were enrolled, 12% (n = 35) were 65 years or older, and 11% (n = 33) required admission. Admission rates were 2.9% (95% confidence interval [CI], 0.07%-14.9%) in older adults and 12.1% (95% CI, 8.4%-16.6%) in younger adults. In multivariable analysis, age was not associated with admission (odds ratio [OR], 0.30; 95% CI, 0.05-1.67). Predictors of admission included systolic pressure 180 mm Hg or greater (OR, 4.19; 95% CI, 1.08-16.30), log Charlson comorbidity score (OR, 2.93; 95% CI, 1.57-5.46), and white blood cell count 14,000/mm(3) or greater (OR, 11.35; 95% CI, 3.42-37.72). Among patients placed in an ED observation unit, age 65 years or more is not associated with need for admission. Older adults can successfully be discharged from these units. Systolic pressure 180 mm Hg or greater was the only predictive vital sign. In determining appropriateness of patients selected for an ED observation unit, advanced age should not be an automatic disqualifying criterion. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Are triage questions sufficient to assign fall risk precautions in the ED?

    Southerland, Lauren T; Slattery, Lauren; Rosenthal, Joseph A; Kegelmeyer, Deborah; Kloos, Anne

    2017-02-01

    The American College of Emergency Physicians Geriatric Emergency Department (ED) Guidelines and the Center for Disease Control recommend that older adults be assessed for risk of falls. The standard ED assessment is a verbal query of fall risk factors, which may be inadequate. We hypothesized that the addition of a functional balance test endorsed by the Center for Disease Control Stop Elderly Accidents, Deaths, and Injuries Falls Prevention Guidelines, the 4-Stage Balance Test (4SBT), would improve the detection of patients at risk for falls. Prospective pilot study of a convenience sample of ambulatory adults 65 years and older in the ED. All participants received the standard nursing triage fall risk assessment. After patients were stabilized in their ED room, the 4SBT was administered. The 58 participants had an average age of 74.1 years (range, 65-94), 40.0% were women, and 98% were community dwelling. Five (8.6%) presented to the ED for a fall-related chief complaint. The nursing triage screen identified 39.7% (n=23) as at risk for falls, whereas the 4SBT identified 43% (n=25). Combining triage questions with the 4SBT identified 60.3% (n=35) as at high risk for falls, as compared with 39.7% (n=23) with triage questions alone (Ppatients at high risk by 4SBT and missed by triage questions were inpatients unaware that they were at risk for falls (new diagnoses). Incorporating a quick functional test of balance into the ED assessment for fall risk is feasible and significantly increases the detection of older adults at risk for falls. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. A Successful ED Fall Risk Program Using the KINDER 1 Fall RiskAssessment Tool.

    Townsend, Ann B; Valle-Ortiz, Marisol; Sansweet, Tracy

    2016-11-01

    Emergency nurses did not perform falls risk assessments routinely on our ED patients; the instrument used was aimed at inpatients. We identified a need to revise fall assessment practices specific to our emergency department. The purpose of the performance improvement project was to reduce ED falls and evaluate the use of an ED-specific fall risk tool, the KINDER 1 Fall Risk Assessment. The plan was to establish fall risk assessment practices at point of ED entry and to decrease total falls. We retrospectively reviewed ED fall data for each quarter of 2013, which included risk assessments scores, the total number of falls, and the circumstances of each fall. Using Kotter's framework to guide a successful change process, we implemented the KINDER 1 to assess fall risk. During the first 4 weeks of the project, 937 patients (27%) were identified as high risk for falls using the KINDER 1. During the subsequent 3 quarters, the total number of falls decreased; reported falls without injuries dropped from 0.21 to 0.07 per 1000 patients, and falls with injuries were reduced from 0.21 to 0.0 per 1000 patients. The results of this project represented a valuable step toward achieving our goal to keep ED patients safe from injuries as a result of falls. The findings add to the body of nursing knowledge on the application of clinical-based performance improvement projects to improve patient outcomes and to provide data on the use of the KINDER 1 tool, which has not been extensively tested. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  10. Paid sick leave is associated with fewer ED visits among US private sector working adults.

    Bhuyan, Soumitra S; Wang, Yang; Bhatt, Jay; Dismuke, S Edward; Carlton, Erik L; Gentry, Dan; LaGrange, Chad; Chang, Cyril F

    2016-05-01

    The United States (US) is the only developed country that does not guarantee short-term or longer-term paid sick leave. This study used a multiyear nationally representative database to examine the association between availability of paid sick leave and frequency of emergency department (ED) use among US private sector employees. We used the National Health Interview Survey data (2012-2014). The final study sample consists of 42,460 US adults between 18 and 64years of age and working in nongovernmental private sector. Our results suggest that availability of paid sick leave is significantly associated with lower likelihood of ED use, for both moderate (1-3 times/year) and repeated users (4 or more times/year). After controlling for confounding factors, respondents with paid sick leave are 14% less likely to be moderate ED users (adjusted odds ratio, 0.86; 95% CI, 0.79-0.93) and 32% less likely to be repeated ED users (adjusted odds ratio, 0.68; 95% CI, 0.50-0.91). Although expansion of health insurance coverage under the Affordable Care Act has not been shown to reduce utilization of high cost health care services such as the ED, our study suggests other factors such as the availability of paid sick leave may do so, by allowing patients to seek care through other more cost-effective mechanisms (eg, primary care providers). To reduce ED utilization, health policymakers should consider alternative reforms including paid sick leave. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Variants forms of Philadelphia translocation in two patients with chronic myeloid leukemia

    Valent, A.; Zamecnikova, A.; Krizan, P.; Karlic, H.; Nowotny, H.

    1996-01-01

    During a 4-year period (December 1990-December 1994), among other diagnoses hundred cases of chronic myeloid leukemia (CML) were analyzed in our departments. We focused our attention on two cases with a variant form of Philadelphia translocation. Cytogenetic and molecular genetic studies were performed to resolve the status of BCR and ABL in the bone marrow or peripheral blood cells of the two CML patients with complex translocations involving chromosomes, 3, 9, 22 and 9, 12, 22 respectively. In the first case the presence of Ph chromosome was detected cytogenetically, BCR-ABL translocation was detected by Southern hybridization. In the second phase, only the PCR method showed BCR-ABL rearrangement. The second case, with a random variant form of Ph translocation, could be detected using different methods of clinical molecular genetics. (author)

  12. Staying in the Hood: Black Lesbian and Transgender Women and Identity Management in North Philadelphia.

    Brooks, Siobhan

    2016-12-01

    The concept Don't Ask, Don't Tell regarding Black LGBT sexuality in Black communities has been an acceptable form of identity management for Black LGBT people. In other words, Black LGBT people are accepted as long as they are not vocal about their sexuality. However, this is changing with the issue of gay marriage, which is creating a space where Black LGBT people are more open about their gender identity and sexuality in heterosexual Black spaces. This new form of openness allows Black LGBT people to "stay in" their communities, as opposed to coming out. In this article I examine how Black LGBT women in North Philadelphia stay in their communities: being politically active regarding LGBT issues, disengaging from LGBT issues, passing, and educating straight Black people about issues affecting the Black LGBT community. I conclude with implications of staying in and intersectionality among Black heterosexual and LGBT women fighting for social change.

  13. [Hungarian Philadelphia negative chronic myeloproliferative neoplasia registry. Evaluation of the Polycythemia vera patients].

    Dombi, Péter; Illés, Árpád; Demeter, Judit; Homor, Lajos; Simon, Zsófia; Kellner, Ádám; Karádi, Éva; Valasinyószki, Erika; Udvardy, Miklós; Egyed, Miklós

    2017-06-01

    Intruduction and aim: The Hungarian National Registry for Philadelphia chromosome negative myeloproliferative neoplasms has been developed. The aim of the recent study is to assess the clinical characteristics of Hungarian patients with polycythemia vera. Data of 351 JAK2 V617F and exon 12 mutation positive polycythemia vera patients were collected online from 15 haematology centres reporting epidemiologic, clinical characteristics, diagnostic tools, therapeutic interventions, thromboembolic complications, disease transformations. Vascular events prior to and after diagnosis were evaluated upon the Landolfi risk assessment scale. 116 thromboembolic events were reported in 106 PV patients prior to diagnosis and 152 occasions in 102 patients during follow-up. The frequency of major arterial events were significantly reduced (ppolycythemia vera. The Landolfi risk stratification was proven to be useful. Based on evaluated data, accuracy of diagnostic criteria and compliance to risk-adapted therapeutic guidelines are needed. Orv Hetil. 2017; 158(23): 901-909.

  14. Incidental detection of congenital Robertsonian translocation at diagnosis of Philadelphia chromosome-positive acute lymphocytic leukemia.

    Yamaguchi, Tsukasa; Igarashi, Aiko; Kawamura, Machiko; Ozasa, Yuka; Yoshida, Masayuki; Kakihana, Kazuhiko; Sakamaki, Hisashi; Ohashi, Kazuteru

    2015-05-01

    A man in his early forties who had undergone 3 years of unsuccessful treatment for infertility due to oligospermia and asthenospermia developed fever and bone pain in December 20XX. He was subsequently diagnosed with acute lymphocytic leukemia. Conventional cytogenetic analysis revealed Robertsonian translocation (RT) with der(13;14)(q10;q10) in addition to the Philadelphia (Ph) chromosome. Dasatinib and prednisolone induced complete remission (CR) with disappearance of the Ph chromosome. However, RT persisted despite achieving CR. We speculate that RT is possibly congenital in our present case and might also have been responsible for the aforementioned infertility. Hematologists should be aware of the possibility that congenital chromosomal disorders might be found incidentally through diagnostic chromosome analysis for leukemia.

  15. Emergency Department (ED, ED Observation, Day Hospital, and Hospital Admissions for Adults with Sickle Cell Disease

    Susan Silva

    2018-02-01

    Full Text Available Introduction: Use of alternative venues to manage uncomplicated vaso-occlusive crisis (VOC, such as a day hospital (DH or ED observation unit, for patients with sickle cell anemia, may significantly reduce admission rates, which may subsequently reduce 30-day readmission rates. Methods: In the context of a two-institution quality improvement project to implement best practices for management of patients with sickle cell disease (SCD VOC, we prospectively compared acute care encounters for utilization of 1 emergency department (ED; 2 ED observation unit; 3 DH, and 4 hospital admission, of two different patient cohorts with SCD presenting to our two study sites. Using a representative sample of patients from each institution, we also tabulated SCD patient visits or admissions to outside hospitals within 20 miles of the patients’ home institutions. Results: Over 30 months 427 patients (297 at Site 1 and 130 at Site 2 initiated 4,740 institutional visits, totaling 6,627 different acute care encounters, including combinations of encounters. The range of encounters varied from a low of 0 (203 of 500 patients [40.6%] at Site 1; 65 of 195 patients [33.3%] at Site 2, and a high of 152 (5/month acute care encounters for one patient at Site 2. Patients at Site 2 were more likely to be admitted to the hospital during the study period (88.4% vs. 74.4%, p=0.0011 and have an ED visit (96.9% vs. 85.5%, p=0.0002. DH was used more frequently at Site 1 (1.207 encounters for 297 patients at Site 1, vs. 199 encounters for 130 patients at Site 2, and ED observation was used at Site 1 only. Thirty-five percent of patients visited hospitals outside their home academic center. Conclusion: In this 30-month assessment of two sickle cell cohorts, healthcare utilization varied dramatically between individual patients. One cohort had more hospital admissions and ED encounters, while the other cohort had more day hospital encounters and used a sickle cell disease

  16. Hearing of Mr. Francois Roussely, President of EdF

    Roussely, F.

    2005-01-01

    This document is the proceedings of the hearing of F. Roussely, President of Electricite de France (EdF), at the commission of economic affairs of the French house of commons, about the advisability of the construction of the EPR (European pressurized reactor) demonstration plant and about its possible financing by EdF. In a first part, F. Roussely recalls the European context of deregulation of energy markets and its impact of the French electric power industry (opening of the French market, industrial and social actions of EdF, need of a new generation of nuclear reactor, preservation of EdF's energy mix, warranty of public utility, un-bundling between energy trade and distribution, EdF's turnover and profitability, EdF's foreign daughter companies). In a second part, F. Roussely answers a series of questions asked by the different members of the commission concerning the different points presented in the first part. (J.S.)

  17. Adherence to Follow-up Recommendations Among Individuals in the Philadelphia Glaucoma Detection and Treatment Project.

    Hark, Lisa A; Leiby, Benjamin E; Waisbourd, Michael; Myers, Jonathan S; Fudemberg, Scott J; Mantravadi, Anand V; Dai, Yang; Gilligan, John P; Resende, Arthur F; Katz, L Jay

    2017-08-01

    To evaluate rates of adherence to free follow-up eye exam appointments among participants in the Philadelphia Glaucoma Detection and Treatment Project. Ophthalmologists and testing equipment were brought directly to participants at risk for glaucoma at 43 community sites in Philadelphia. Those diagnosed with glaucoma-related pathology were recommended to return for follow-up to be reexamined on site. Rates of adherence and clinical and demographic risk factors for adherence were evaluated. Five hundred thirty-one participants were diagnosed with glaucoma-related conditions and recommended to attend community-based follow-up exams. Follow-up adherence rate was 61.2% (n=325/531). Significant factors associated with greater eye exam appointment adherence, based on our univariable analysis, included final diagnosis of glaucoma (risk ratio [RR]=1.33; 95% confidence interval [CI], 1.13-1.57), male sex (RR=1.19; 95% CI, 1.04-1.36), white race (RR=1.26; 95% CI, 1.08-1.48), age (RR=1.17; 95% CI, 1.00-1.37) recommendation for glaucoma medication (RR=1.52; 95% CI, 1.35-1.71), recommendation for laser peripheral iridotomy (RR=1.18; 95% CI, 1.02-1.35), diagnosis of age-related macular degeneration (RR=1.42; 95% CI, 1.13-1.77) and an increased intraocular pressure (>22 mm Hg in the worse eye) (RR=1.23; 95% CI, 1.06-1.42). On the basis of our multivariable model, diagnosis, sex, and recommended glaucoma medications were significantly associated with follow-up adherence. This study demonstrates that individuals living in underserved urban communities would take advantage of free eye exams in community sites and return for follow-up eye exams in these same settings. Future studies could investigate interventions to improve eye exam appointment adherence in community-based settings to detect glaucoma-eye conditions.

  18. Cross-sectional analysis of fouled SWRO membranes by STEM-EDS

    Aubry, Cyril

    2014-01-01

    The intact cross-section of two fouled reverse osmosis membranes was characterized using a scanning transmission electron microscope (STEM) equipped with an electron energy dispersive spectroscope (EDS). Focused ion beam (FIB) was used to prepare a thin lamella of each membrane. These lamellas were then attached to a TEM grid for further STEM/EDS analysis. The foulant in sample A was mainly inorganic in nature and predominantly composed of alumino-silicate particles. These particles were surrounded by carbon at high concentrations, indicating the presence of organic materials. Iron was diffusely present in the cake layer and this could have enhanced the fouling process. The cake layer of membrane B was mainly consisted of organic matter (C, O, and N representing 95% of the total elemental composition) and organized in thin parallel layers. Small concentrations of Si, F, Na, Mg, and Cl were detected inside the active layer and support layer of the membrane. Due to the high sensitivity of the cake layer of membrane A to the electron beam, STEM/EDS line analyses might have been performed on large areas. On the other hand, the cake layer of sample B was resistant to the electron beam and the resolution of STEM/EDS was gradually improved until obtaining a resolution of 25. nm. © 2013 Elsevier B.V.

  19. Anisakiasis presenting to the ED: clinical manifestations, time course, hematologic tests, computed tomographic findings, and treatment.

    Takabayashi, Takeshi; Mochizuki, Toshiaki; Otani, Norio; Nishiyama, Kei; Ishimatsu, Shinichi

    2014-12-01

    The prevalence of anisakiasis is rare in the United States and Europe compared with that in Japan, with few reports of its presentation in the emergency department (ED). This study describes the clinical, hematologic, computed tomographic (CT) characteristics, and treatment in gastric and small intestinal anisakiasis patients in the ED. We retrospectively reviewed the data of 83 consecutive anisakiasis presentations in our ED between 2003 and 2012. Gastric anisakiasis was endoscopically diagnosed with the Anisakis polypide. Small intestinal anisakiasis was diagnosed based on both hematologic (Anisakis antibody) and CT findings. Of the 83 cases, 39 had gastric anisakiasis and 44 had small intestinal anisakiasis based on our diagnostic criteria. Although all patients had abdominal pain, the gastric anisakiasis group developed symptoms significantly earlier (peaking within 6 hours) than the small intestinal anisakiasis group (peaking within 48 hours), and fewer patients with gastric anisakiasis needed admission therapy (5% vs 57%, Pfindings revealed edematous wall thickening in all patients, and ascites and phlegmon of the mesenteric fat were more frequently observed in the small intestinal anisakiasis group. In the ED, early and accurate diagnosis of anisakiasis is important to treat and explain to the patient, and diagnosis can be facilitated by a history of raw seafood ingestion, evaluation of the time-to-symptom development, and classic CT findings. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Minor injury attendance times to the ED.

    Conlon, Ciaran

    2009-07-01

    The Health Service Executive (HSE) highlights the need for effective patient throughput and management, whilst providing appropriate staffing and therapeutic interventions. It acknowledges that patient need is integral to the development of a nurse led service and advocates planning staffing levels to reflect arrival times of patients. An observational study of all patients who presented to the emergency department in July 2005 and February 2006 was undertaken (n=7768). The study identified 1577 patients suitable for treatment by the Advanced Nurse Practitioner (ANP) in these two months, which represents 20% of all patient attendances to the ED in this time period. A data collection tool was devised collectively by the ANPs to identify appropriate patients. The findings of the study revealed that 73% of patients suitable for the ANP service presented between the hours of 0800 and 2000, of which 54% attended between 0800 and 1600 h. Sunday emerged as the busiest day in July 2005 whereas Monday was found to be the busiest day in February 2006. Friday was found to be consistently busy for both months.

  1. ExpandED Options: Learning beyond High School Walls

    ExpandED Schools, 2014

    2014-01-01

    Through ExpandED Options by TASC, New York City high school students get academic credit for learning career-related skills that lead to paid summer jobs. Too many high school students--including those most likely to drop out--are bored or see classroom learning as irrelevant. ExpandED Options students live the connection between mastering new…

  2. Gum biopsy

    ... Hupp JR, Ellis E, Tucker MR, eds. Contemporary Oral and Maxillofacial Surgery . 6th ed. St Louis, MO: Elsevier Mosby; 2014: ... Wein RO, Weber RS. Malignant neoplasms of the oral cavity. In: Flint PW, ... & Neck Surgery . 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap ...

  3. Tooth extraction

    ... In: Kademani D, Tiwana PS, eds. Atlas of Oral and Maxillofacial Surgery . St Louis, MO: Elsevier Saunders; 2016:chap 10. ... Hupp JR, Ellis E, Tucker MR, eds. Contemporary Oral and Maxillofacial Surgery . 6th ed. Philadelphia, PA: Elsevier Mosby; 2014:chap ...

  4. TechEdSat Nano-Satellite Series Fact Sheet

    Murbach, Marcus; Martinez, Andres; Guarneros Luna, Ali

    2014-01-01

    TechEdSat-3p is the second generation in the TechEdSat-X series. The TechEdSat Series uses the CubeSat standards established by the California Polytechnic State University Cal Poly), San Luis Obispo. With typical blocks being constructed from 1-unit (1U 10x10x10 cm) increments, the TechEdSat-3p has a 3U volume with a 30 cm length. The project uniquely pairs advanced university students with NASA researchers in a rapid design-to-flight experience lasting 1-2 semesters.The TechEdSat Nano-Satellite Series provides a rapid platform for testing technologies for future NASA Earth and planetary missions, as well as providing students with an early exposure to flight hardware development and management.

  5. ED leadership competency matrix: an administrative management tool.

    Propp, Douglas A; Glickman, Seth; Uehara, Dennis T

    2003-10-01

    A successful ED relies on its leaders to master and demonstrate core competencies to be effective in the many arenas in which they interact and are responsible. A unique matrix model for the assessment of an ED leadership's key administrative skill sets is presented. The model incorporates capabilities related to the individual's cognitive aptitude, experience, acquired technical skills, behavioral characteristics, as well as the ability to manage relationships effectively. Based on the personnel inventory using the matrix, focused evaluation, development, and recruitment of ED key leaders occurs. This dynamic tool has provided a unique perspective for the evaluation and enhancement of overall ED leadership performance. It is hoped that incorporation of such a model will similarly improve the accomplishments of EDs at other institutions.

  6. Urban sustainable energy development: A case study of the city of Philadelphia

    Argyriou, Iraklis

    This study explores the role of cities in sustainable energy development through a governance-informed analysis. Despite the leading position of municipalities in energy sustainability, cities have been mostly conceptualized as sites where energy development is shaped by external policy scales, i.e. the national level. A growing body of research, however, critiques this analytical perspective, and seeks to better understand the type of factors and dynamics that influence energy sustainability within a multi-level policy context for urban energy. Given that particular circumstances are applicable across cities, a context-specific analysis can provide insight regarding how sustainable energy development takes place in urban areas. In applying such an analytical perspective on urban energy sustainability, this study undertakes a qualitative case study analysis for the city of Philadelphia, Pennsylvania, by looking at four key local policy initiatives relevant to building energy efficiency and solar electricity development at the municipal government and city-wide level. The evaluation of the initiatives suggests that renewable electricity use has increased substantially in the city over the last years but the installed capacity of local renewable electricity systems, including solar photovoltaics, is low. On the other hand, although the city has made little progress in meeting its building energy efficiency targets, more comprehensive action is taken in this area. The study finds that the above outcomes have been shaped mainly by four factors. The first is the city government's incremental policy approach aiming to develop a facilitative context for local action. The second is the role that a diverse set of stakeholders have in local sustainable energy development. The third is the constraints that systemic policy barriers create for solar power development. The fourth is the ways through which the relevant multi-level policy environment structures the city

  7. Molecular diagnostic of the philadelphia chromosome; Diagnostico molecular del cromosoma filadelfia

    Campos Rudin, M [Instituto de Investigaciones en Salud (INISA), Costa Rica (Costa Rica) and Escuela de Biologia; Cuenca Berger, P [Instituto de Investigaciones en Salud (INISA), Costa Rica (Costa Rica) and Escuela de Biologia; Gutierrez Espeleta, G [Instituto de Investigaciones en Salud (INISA), Costa Rica (Costa Rica) and Escuela de Biologia; Jimenez Cruz, G [Hospital Mexico, Costa Rica (Costa Rica). Seccion Hematologia; Montero Umana, C [Hospital Mexico, Costa Rica (Costa Rica). Seccion Hematologia; Vazquez Castillo, L [Hospital San Juan de Dios, Costa Rica (Costa Rica). Seccion de Hematologia; Ramon Ortiz, M [Hospital San Juan de Dios, Costa Rica (Costa Rica). Seccion de Hematologia

    1998-07-01

    The importance that has to confirm the presence or absence of the chromosome Philadelphia in the diagnostic and follow up of the patient affected with chronic myeloid leukemia and other leukemia. It is considered necessary to implement the molecular diagnostic in Costa Rica. They studied 32 patient affected by Chronic Myeloid Leukemia, 7 by other Myeloproliferative Chronic Disorders and 2 by Myelodysplastic Syndrome. It utilized the sound Trans probe-1 (Oncogene Science, Inc), which was marked with radioactivity ({sup 32}P) or chemiluminescence (digoxigenin). Of the 32 cases affected by L mc, in 28 it was possible to carry out the molecular analysis detecting the characteristic translocation of the chromosome Philadelphia among the Mbcr/c-ABL genes in 21 (75%) of the patients, in 7 (25%) the rearrangement was not found. In seven of the nine affected by other sufferings it was possible to obtain results, 3 that turned out to be positive for the rearrangement among Mbcr/c-ABL and 4 normal. In all the cases, they obtained results marking the sound with radioactivity. However, they tested the marks with digoxigenin in seven of the patients, as an methodological alternative for the laboratories that lacks the requirements to work with radiation. The results obtained were identical. (S. Grainger) [Spanish] La relevancia que tiene confirmar la presencia o ausencia del cromosoma Filadelfia en el diagnostico y seguimiento de los pacientes afectados con leucemia mieloide cronica y otras leucemias, se considero necesario implementar el diagnostico molecular en Costa Rica. Se estudiaron 32 pacientes afectados por Leucemia Mieloide Cronica, 7 por otros Desordenes Mieloproleferativos Cronicos y 2 por Sindromes Mielodisplasicos. Se utilizo la sonda Transprobe-1 (Oncogene Science, Inc), la cual fue marcada con radioactividad ({sup 32}P) o quimioluminiscencia (digoxigenina). De los 32 casos afectados por LMC, en 28 se logro realizar el analisis molecular detectandose la

  8. The World's Approach toward Publishing in Springer and Elsevier's APC-Funded Open Access Journals

    Sotudeh, Hajar; Ghasempour, Zahra

    2018-01-01

    Purpose: The present study explored tendencies of the world's countries--at individual and scientific development levels--toward publishing in APC-funded open access journals. Design/Methodology/Approach: Using a bibliometric method, it studied OA and NOA articles issued in Springer and Elsevier's APC journals? during 2007-2011. The data were…

  9. Exploring personality clusters among parents of ED subjects. Relationship with parents' psychopathology, attachment, and family dynamics.

    Amianto, Federico; Daga, Giovanni Abbate; Bertorello, Antonella; Fassino, Secondo

    2013-10-01

    prototypical mothers and fathers of EDs. Parents not disturbed as regards personality traits are not exceptions. Since EDs are multifactor disorders family dynamics related to parents' personality may be very relevant or even marginal in their pathogenesis. Conversely, parenting may be negatively influenced by relatively marginal personality malfunctions of parents. The clustering approach to the complexity of personality-related dynamics of ED families improves the picture of ED parents. Psychoeducational, counseling and psychotherapeutic family interventions should consider the specific underlying personality of parents. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. Tackling causes and costs of ED presentation for American football injuries: a population-level study.

    Smart, Blair J; Haring, R Sterling; Asemota, Anthony O; Scott, John W; Canner, Joseph K; Nejim, Besma J; George, Benjamin P; Alsulaim, Hatim; Kirsch, Thomas D; Schneider, Eric B

    2016-07-01

    injury type-specific variability. Overall, at the US population, estimated total charges of $771299862 were incurred over the 2-year period. In this nationally representative sample, most ED-treated injuries associated with football were not acutely life threatening and very few required major therapeutic intervention. This study provides a cross-sectional overview of ED presentation for acute football-related injury across age groups at the population level in recent years. Longitudinal studies may be warranted to examine associations between the patterns of injury observed in this study and long-term outcomes among American tackle football players. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Muusikamaailm : Philadelphia Orkester Euroopas. Lloyd Webber La Scalasse? Algas Glyndebourne'i ooperifestival. Kolm kompositsioonipreemiat / Priit Kuusk

    Kuusk, Priit, 1938-

    2000-01-01

    Philadelphia Orchestra 100. aastapäevale pühendatud Euroopa turneest. Milano La Scala plaanitavast uuslavastuste sarjast "Mõistes XX sajandit ئ sisse elades XXI sajandisse", kus oleks kesksel kohal nelja elava helilooja lavateosed XX sajandist. Glyndebourne'i ooperifestivalist Inglismaal, A. Davise tegevusest. Kolme kompositsioonipreemia kätteandmisest : Salzburgi Osterfestspiele kompositsioonipreemia, Teatro Lirico Sperimentale kammerooperi konkursi preemia ja fondi Stiftung Christoph Delz kompositsioonikonkursi preemia

  12. A Case Study of the Philadelphia Sugar-Sweetened Beverage Tax Policymaking Process: Implications for Policy Development and Advocacy.

    Purtle, Jonathan; Langellier, Brent; Lê-Scherban, Félice

    Policymakers are increasingly proposing sugar-sweetened beverage (SSB) taxes as an evidence-based strategy to reduce chronic disease risk; and local health departments (LHDs) are well-positioned to play a role in SSB policy development and advocacy. However, most SSB tax proposals fail to become law and limited empiric guidance exists to inform advocacy efforts. In June 2016, Philadelphia, Pennsylvania, passed an SSB tax. To identify features of the Philadelphia SSB tax policymaking process that contributed to the proposal's passage. Qualitative case study. Semistructured interviews were conducted with key informants closely involved with the policymaking process. Interviews were audio-recorded and transcribed. Local news media about the SSB tax proposal were analyzed to triangulate interview findings. Analysis was conducted in NVivo 10 using inductive qualitative content analysis. Philadelphia, Pennsylvania, during the SSB tax policymaking in process. Nine key informants (2 city councilpersons, 4 city agency officials, 1 community-based advocate, 1 news reporter, and 1 researcher). The Philadelphia SSB tax proposal was introduced with the explicit goal of financing universal prekindergarten and deliberately not framed as a health intervention. This framing shifted contentious debates about government involvement in individual behavior toward discussions about how to finance universal prekindergarten, a goal for which broad support existed. The LHD played an important role in communicating research evidence about potential health benefits of the SSB tax proposal at the end of the policymaking process. During local SSB tax policy development processes, LHD officials and other advocates should encourage policymakers to design SSB tax policies so that revenue is directed toward community investments for which broad public support exists. When communicating with policymakers and the public, LHDs should consider emphasizing how SSB tax revenue will be used in addition

  13. Prevalence, Disparities, and Trends in Obesity and Severe Obesity Among Students in the Philadelphia, Pennsylvania, School District, 2006–2010

    Robbins, Jessica M.; Mallya, Giridhar; Polansky, Marcia; Schwarz, Donald F.

    2012-01-01

    Introduction Epidemic increases in obesity negatively affect the health of US children, individually and at the population level. Although surveillance of childhood obesity at the local level is challenging, height and weight data routinely collected by school districts are valuable and often underused public health resources. Methods We analyzed data from the School District of Philadelphia for 4 school years (2006–2007 through 2009–2010) to assess the prevalence of and trends in obesity and...

  14. Storing Empty Calories and Chronic Disease Risk: Snack-Food Products, Nutritive Content, and Manufacturers in Philadelphia Corner Stores

    Lucan, Sean C.; Karpyn, Allison; Sherman, Sandy

    2010-01-01

    Corner stores are part of the urban food environment that may contribute to obesity and diet-related diseases, particularly for low-income and minority children. The snack foods available in corner stores may be a particularly important aspect of an urban child’s food environment. Unfortunately, there is little data on exactly what snack foods corner stores stock, or where these foods come from. We evaluated snack foods in 17 Philadelphia corner stores, located in three ethnically distinct, l...

  15. Characterization and Prognosis Significance of JAK2 (V617F), MPL, and CALR Mutations in Philadelphia-Negative Myeloproliferative Neoplasms

    Singdong, Roongrudee; Siriboonpiputtana, Teerapong; Chareonsirisuthigul, Takol; Kongruang, Adcharee; Limsuwanachot, Nittaya; Sirirat, Tanasan; Chuncharunee, Suporn; Rerkamnuaychoke, Budsaba

    2016-01-01

    Background: The discovery of somatic acquired mutations of JAK2 (V617F) in Philadelphia-negative myeloproliferative neoplasms (Ph-negative MPNs) including polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF) has not only improved rational disease classification and prognostication but also brings new understanding insight into the pathogenesis of diseases. Dosage effects of the JAK2 (V617F) allelic burden in Ph-negative MPNs may partially influence clinical ...

  16. Characterising non-urgent users of the emergency department (ED): A retrospective analysis of routine ED data.

    O'Keeffe, Colin; Mason, Suzanne; Jacques, Richard; Nicholl, Jon

    2018-01-01

    The pressures of patient demand on emergency departments (EDs) continue to be reported worldwide, with an associated negative impact on ED crowding and waiting times. It has also been reported that a proportion of attendances to EDs in different international systems could be managed in settings such as primary care. This study used routine ED data to define, measure and profile non-urgent ED attendances that were suitable for management in alternative, non-emergency settings. We undertook a retrospective analysis of three years of Hospital Episode and Statistics Accident Emergency (HES A&E) data for one large region in England, United Kingdom (April 1st 2011 to March 31st 2014). Data was collected on all adult (>16 years) ED attendances from each of the 19 EDs in the region. A validated process based definition of non-urgent attendance was refined for this study and applied to the data. Using summary statistics non-urgent attenders were examined by variables hypothesised to influence them as follows: age at arrival, time of day and day of week and mode of arrival. Odds ratios were calculated to compare non-urgent attenders between groups. There were 3,667,601 first time attendances to EDs, of which 554,564 were defined as non-urgent (15.1%). Non-urgent attendances were significantly more likely to present out of hours than in hours (OR = 1.19, 95% CI: 1.18 to 1.20, Paged 16-44) compared to those aged 45-64 (odds ratio: 1.42, 95% CI: 1.41 to 1.43, Puse the ED to obtain healthcare that could be provided in a less urgent setting and also more likely to do this out of hours. Alternative services are required to manage non-urgent demand, currently being borne by the ED and the ambulance service, particularly in out of hours.

  17. Predicting tularemia with clinical, laboratory and demographical findings in the ED.

    Yapar, Derya; Erenler, Ali Kemal; Terzi, Özlem; Akdoğan, Özlem; Ece, Yasemin; Baykam, Nurcan

    2016-02-01

    We aimed to determine clinical, laboratory and demographical characteristics of tularemia on admission to Emergency Department (ED). Medical data of 317 patients admitted to ED and subsequently hospitalized with suspected tularemia between January 1, 2011, and May 31, 2015, were collected. Patients were divided into 2 groups according to microagglutination test results, as tularemia (+) and tularemia (-). Of the 317 patients involved, 49 were found to be tularemia (+) and 268 were tularemia (-). Mean age of the tularemia (+) patients was found to be higher than that of tularemia (-) patients. When compared to tularemia (-) patients, a significant portion of patients in tularemia (+) patients were elderly, living in rural areas and had contact with rodents. When clinical and laboratory findings of the 2 groups were compared, any statistical significance could not be determined. Tularemia is a disease of elderly people living in rural areas. Contact with rodents also increases risk of tularemia in suspected patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Exploring the role of gender norms in nutrition and sexual health promotion in a piloted school-based intervention: The Philadelphia Ujima™ experience.

    Núñez, Ana; Robertson-James, Candace; Reels, Serita; Jeter, Janay; Rivera, Hilda; Yusuf, Zena; Liu

    2015-08-01

    Perceptions of masculinity and femininity influence behaviors and can be identified in young children and adolescents (Brannon, 2004). Thus, adolescents' engagement in health risk or promoting behaviors is influenced by perceptions of masculinity and femininity and the differences in expectations, norms and responsibilities for girls and boys (WHO, 2007). Girls and boys have different needs, and gender-based interventions that consider similarities as well as differences are needed. A gender-based nutrition and sexual health promotion program was developed and piloted by the Philadelphia Ujima Coalition in a high school setting. To explore the gender differences in adolescents' perceptions of the influence of gender norms on weight, nutrition, physical activity, and sexual health and the implication of these differences in future gender-integrated health promotion programming for youth, a content analysis of student and facilitator debriefing forms were implemented for the participating schools. The content analysis was used to identify central themes, concepts gained, and overall impact of the intervention sessions. Overall, gender norms influence healthy eating practices and activity through influencing perceptions of body type in adolescents. Gender norms also influence sexual activity and decision making through influencing perceptions of beauty, masculinity, femininity, pressures and popular concepts related to sexual activity. Thus, interventions that address gender may more effectively promote health and wellness in adolescents. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Low frequency of c-MPL gene mutations in Iranian patients with Philadelphia-negative myeloproliferative disorders.

    Ghotaslou, A; Nadali, F; Chahardouli, B; Alizad Ghandforosh, N; Rostami, S H; Alimoghaddam, K; Ghavamzadeh, A

    2015-01-01

    Myeloproliferative disorders are a group of diseases characterized by increased proliferation of myeloid lineage. In addition to JAK2V617F mutation, several mutations in the c-MPL gene have been reported in patients with philadelphia-negative chronic myeloproliferative disorders that could be important in the pathogenesis of diseases. The aim of the present study was to investigate the frequency of c-MPL and JAK2V617F mutations in Iranian patients with Philadelphia-negativemyeloproliferative disorders. Peripheral blood samples were collected from 60 patients with Philadelphia-negative MPD) Subgroups ET and PMF) and 25 healthy subjects as control group. The mutation status of c-MPL and Jak2V617F were investigated by using Amplification-refractory mutation system (ARMS) and Allele-Specific PCR (AS-PCR), respectively. The results were confirmed by sequencing. Among 60 patients, 34 (56.6%) and 1(1.7%) had Jak2V617F and c-MPL mutation, respectively. Patients with Jak2V617F mutation had higher WBC counts and hemoglobin concentration than those without the mutation (p= 0.005, p=0.003). In addition, for all healthy subjects in control group, mutations were negative. The present study revealed that the c-MPL mutations unlike the Jak2V617F mutations are rare in Iranian patients with Ph-negative MPNs and the low mutation rate should be considered in the design of screening strategies of MPD patients.

  20. EdF: high tension(s) metamorphosis

    Roussely, F.; Arnoux, P.; Baritault, A.; Alto, P.; Castets, C.; Secondi, J.

    2003-01-01

    Electricite de France, the French electric utility, has to face a formidable mutation. The deregulation of the power market will lead to a social, commercial, judicial, financial and international 'big-bang'. The company has been weakened by disappointing results and by an embarrassing running into debts. This dossier analyzes the consequences of the deregulation of the French power market on the future evolution of EdF. It includes the analysis made by a French economist, E. Cohen, an interview and a portrait of F. Roussely, head of EdF, a presentation of Easenergy, a start-up of EdF which makes partnerships with US energy-related companies, the worries of EdF's employees and the redistribution of the syndicates power inside the company, the controversy around EdF's 2002 results and the points that remained in the shade, EdF's European competitors and the progressive opening of the French power market, EDF's production tool and its availability (58 nuclear reactors, 538 hydroelectric power plants and 26 thermal power plants), the costly foreign markets strategy of EdF and the under-capitalization of the company. (J.S.)

  1. Ready or not: analysis of a no-notice mass vaccination field response in Philadelphia.

    Caum, Jessica; Alles, Steven

    2013-12-01

    Local health departments typically rely on exercises to test preparedness capacity; however, pre-scripted drills often lack the sense of urgency that a real event would engender. No-notice, unscripted exercises that challenge staff to think critically under pressure may provide a mechanism for a more realistic assessment of preparedness capacity. The very active influenza season of 2012-13 presented the Public Health Preparedness Program at the Philadelphia Department of Public Health with the opportunity to conduct an influenza vaccination clinic at a local boarding school. Program leaders used this opportunity to design a no-notice exercise to test the ability of staff to effectively coordinate an emergency field response while simultaneously delivering a real public health intervention. On the day of the exercise, staff members were given 6 hours to plan and execute a vaccination clinic without any guidance from program leaders. Best practices observed during the exercise included: (1) early identification and mitigation of rate-limiting steps, and (2) successful implementation of a previously untested high-throughput vaccination model. Although the primary intent of the exercise was to assess the ability of staff to respond to a no-notice event, this vaccination clinic also functioned as a microcosm of a larger response, revealing several considerations related to vaccine ordering, staff resources, and throughput rates that have broader implications for public health responses to large-scale biological attacks or pandemics.

  2. The genetic architecture of pediatric cognitive abilities in the Philadelphia Neurodevelopmental Cohort

    Robinson, Elise B.; Kirby, Andrew; Ruparel, Kosha; Yang, Jian; McGrath, Lauren; Anttila, Verneri; Neale, Benjamin M.; Merikangas, Kathleen; Lehner, Thomas; Sleiman, Patrick M.A.; Daly, Mark J.; Gur, Ruben; Gur, Raquel; Hakonarson, Hakon

    2014-01-01

    The objective of this analysis was to examine the genetic architecture of diverse cognitive abilities in children and adolescents, including the magnitude of common genetic effects and patterns of shared and unique genetic influences. Subjects included 3,689 members of the Philadelphia Neurodevelopmental Cohort, a general population sample of ages 8-21 years who completed an extensive battery of cognitive tests. We used genome-wide complex trait analysis (GCTA) to estimate the SNP-based heritability of each domain, as well as the genetic correlation between all domains that showed significant genetic influence. Several of the individual domains suggested strong influence of common genetic variants (e.g. reading ability, h2g=0.43, p=4e-06; emotion identification, h2g=0.36, p=1e-05; verbal memory, h2g=0.24, p=0.005). The genetic correlations highlighted trait domains that are candidates for joint interrogation in future genetic studies (e.g. language reasoning and spatial reasoning, r(g)=0.72, p=0.007). These results can be used to structure future genetic and neuropsychiatric investigations of diverse cognitive abilities. PMID:25023143

  3. The perils of healthcare workforce forecasting: a case study of the Philadelphia metropolitan area.

    Smith, David Barton; Aaronson, William

    2003-01-01

    In 1996, a widely circulated and influential forecast for the Philadelphia Metropolitan Area stated that a decline in hospital and healthcare employment in the region would occur over the next five years. It also suggested that this decline would exacerbate the problem of an oversupply of nurses seeking hospital employment. The forecast reflected a regional leadership and expert consensus on the impact of the managed care transformation on workforce needs and was supported by short-term statistical trends in regional utilization and employment. Confounding these predictions was the fact that hospital and healthcare employment actually grew. By the end of 2001, hospitals in the region were experiencing problems in recruiting sufficient numbers of nurses, pharmacists, and technicians. The forecast failed to anticipate the impact of a strong regional economy on supply and underestimated the resilience of underlying forces that have driven the long-term growth in healthcare workforce demand. More effective ongoing monitoring can help moderate the fluctuation of workforce shortages and surpluses.

  4. Involvement of mast cells by the malignant process in patients with Philadelphia chromosome negative myeloproliferative neoplasms.

    Wang, J; Ishii, T; Zhang, W; Sozer, S; Dai, Y; Mascarenhas, J; Najfeld, V; Zhao, Z J; Hoffman, R; Wisch, N; Xu, M

    2009-09-01

    The Philadelphia chromosome negative myeloproliferative neoplasms (MPNs) are clonal hematologic malignancies frequently characterized by a mutation in JAK2 (JAK2V617F). Peripheral blood (PB) CD34(+) cells from patients with polycythemia vera (PV) and primary myelofibrosis (PMF) generated in vitro significantly fewer mast cells (MCs) than normal PB CD34(+) cells. The numbers of MC progenitors assayed from MPN CD34(+) cells were, however, similar to that assayed from normal CD34(+) cells. A higher percentage of the cultured MPN MCs expressed FcvarepsilonRIalpha, CD63 and CD69 than normal MCs, suggesting that cultured MPN MCs are associated with an increased state of MC activation. Further analysis showed that a higher proportion of cultured PV and PMF MCs underwent apoptosis in vitro. By using JAK2V617F, MplW515L and chromosomal abnormalities as clonality markers, we showed that the malignant process involved MPN MCs. JAK2V617F-positive MC colonies were assayable from the PB CD34(+) cells of each of the 17 JAK2V617F positive MPN patients studied. Furthermore, erlotinib, a JAK2 inhibitor, was able to inhibit JAK2V617F-positive PV MC progenitor cells, indicating that malignant MC progenitor cells are a potential cellular target for such JAK2 inhibitor-directed therapy.

  5. Concurrent sexual partnerships among African American women in Philadelphia: results from a qualitative study.

    Nunn, Amy; Dickman, Samuel; Cornwall, Alexandra; Kwakwa, Helena; Mayer, Kenneth H; Rana, Aadia; Rosengard, Cynthia

    2012-07-01

    African American women are disproportionately affected by HIV/AIDS. Concurrent sexual partnerships may contribute to racial disparities in HIV infection. Little is known about attitudes and practices related to concurrency among African American women, or the social, structural and behavioural factors influencing concurrency. We recruited 19 heterosexual African American women engaging in concurrent sexual partnerships from a public clinic in Philadelphia in 2009. We conducted interviews exploring social norms, attitudes and practices about concurrency, and the structural, social and behavioural factors influencing concurrent sexual partnerships, guided by grounded theory. Seventeen women reported one main and one or more non-main partners; two reported no main partners. Many women used condoms more frequently with non-main than main partners, noting they trust main partners more than non-main partners. Social factors included social normalisation of concurrency, inability to negotiate partners' concurrent partnerships, being unmarried, and not trusting partners. Lack of trust was the most commonly cited reason that women engaged in concurrent partnerships. Structural factors included economic dependence on partners, partners' dependence on women for economic support and incarceration that interrupted partnerships. Behavioural factors included alcohol and cocaine use. Social, structural and behavioural factors strongly influenced these African American women's concurrent sexual partnerships. Many HIV interventions disseminated by the CDC focus largely on behavioural factors and may fail to address the social and structural factors influencing African American women's sexual networks. Novel HIV prevention interventions that address the social determinants of African American women's HIV risks are urgently needed.

  6. Proceedings of the 34th International Conference in High Energy Physics (ICHEP08), Philadelphia, PA, 2008

    Lockyer, Nigel S.; Smith, A.J. Stewart

    2008-01-01

    In 2004 a team from the University of Pennsylvania, Princeton University, and the Institute for Advanced Study proposed to host the 2008 International Conference on High Energy Physics (ICHEP) on the campus of the University of Pennsylvania in Philadelphia. The proposal was approved later that year by the C-11 committee of the International Union of Pure and Applied Physics. The Co-Chairs were Nigel S. Lockyer (U. Penn/TRIUMF) and A.J. Stewart Smith (Princeton); Joe Kroll of U. Penn served as Deputy Chair from 2007 on. Highlights of the proposal included 1. greatly increased participation of young scientists, women scientists, and graduate students 2. new emphasis on formal theory 3. increased focus on astrophysics and cosmology 4. large informal poster session (170 posters) in prime time 5. convenient, contiguous venues for all sessions and lodging 6. landmark locations for the reception and banquet. The conference program consisted of three days of parallel sessions and three days of plenary talks.

  7. Emissions inventories for urban airshed model application in the Philadelphia Aqcr (Air Quality Control Region)

    1982-04-01

    This report documents the procedures used to develop emissions input required by the Urban Airshed photochemical oxidant model. Ambient air quality data were gathered as part of another effort during the summer of 1979 in Philadelphia to be used in the model validation effort. For 1979 and the 1987 projection year, ES compiled hour by hour emissions data for a representative weekday in the oxidant season. The pollutants inventoried are five categories of VOC required by the Airshed model, four categories of VOC defined in RAPS, NO, NO2, CO, SO2, and TSP. Point and area sources were considered with the highway vehicle portion of the inventory being subcontracted to DVRPC. County level area source data were allocated to a 502-cell grid system. Projections were made so that ozone air quality in 1987 could be investigated. ES developed annualized EIS/PandR data and data files containing temporal and VOC/NOx profiles in order to generate the data packets required by the Airshed model.

  8. Thromboembolism prophylaxis in patients with Philadelphia-negative myeloproliferative neoplasms-Clinical practice among Nordic specialists.

    Bjerrum, Ole Weis; Samuelsson, Jan; Ghanima, Waleed; Kauppila, Marjut; Andersen, Christen Lykkegaard

    2018-05-01

    Patients with Philadelphia chromosome-negative myeloproliferative neoplasms (MPNs) have higher risks of developing thromboembolisms compared to the general population. International guidelines on the management of MPNs therefore include recommendations concerning thromboembolism prophylaxis. In clinical practice, strict adherence to guidelines may be challenging and dependent on factors such as physician experience, outpatient clinic setting, and access to therapy; however, no data exist on physician adherence or patient compliance to thromboembolism prophylaxis in MPNs. The Nordic Myeloproliferative Neoplasm Study Group (NMPN) performed a survey among Nordic hematology specialists with the aim of documenting the implementation of international recommendations in a region of Northern Europe with similar healthcare systems. The study showed that Nordic specialists managed their patients in accordance with international guidelines concerning medical intervention, but to a lesser degree regarding the management of additional cardiovascular risk factors. The survey also drew attention to the common clinical dilemma of combining antiaggregatory agents with vitamin K antagonists (VKA), or novel oral anticoagulants (NOAC), as well as phlebotomy limits in female polycythemia vera patients. The results of this study highlight the importance of considering all risk factors for thrombosis and an optimal collaboration with the primary healthcare sector. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Abrupt evolution of Philadelphia chromosome-positive acute myeloid leukemia in myelodysplastic syndrome.

    Fukunaga, Akiko; Sakoda, Hiroto; Iwamoto, Yoshihiro; Inano, Shojiro; Sueki, Yuki; Yanagida, Soshi; Arima, Nobuyoshi

    2013-03-01

    Myelodysplastic syndrome (MDS) is a clonal disorder arising from an alteration in multipotent stem cells, which lose the ability of normal proliferation and differentiation. Disease progression occurs in approximately 30% MDS cases. Specific chromosomal alterations seem responsible for each step in the evolution of acute myeloid leukemia (AML). Multiple genetic aberrations occur during the clonal evolution of MDS; however, few studies report the presence of the Philadelphia (Ph) chromosome. We report a rare case of Ph-positive AML, which evolved during the course of low-risk MDS. The patient, a 76-year-old man with mild leukocytopenia, was diagnosed with MDS, refractory neutropenia (RN). After 1.5 yr, his peripheral blood and bone marrow were suddenly occupied by immature basophils and myeloblasts, indicating the onset of AML. A bone marrow smear showed multilineage dysplasia, consistent with MDS evolution. Chromosomal analysis showed an additional t(9;22)(q34;q11) translocation. Because progression occurred concurrently with emergence of the Ph chromosome, we diagnosed this case as Ph-positive AML with basophilia arising from the clonal evolution of MDS. The patient was initially treated with nilotinib. A hematological response was soon achieved with disappearance of the Ph chromosome in the bone marrow. Emergence of Ph-positive AML in the course of low-risk MDS has rarely been reported. We report this case as a rare clinical course of MDS. © 2012 John Wiley & Sons A/S.

  10. Creating a business environment in inventory management - The Philadelphia Electric Company experiences

    Franks, A.J.; Birch, H.

    1992-01-01

    Philadelphia Electric Company's (PECo's) Nuclear Engineering and Services Department was asked to develop a (non-fuel) inventory management philosophy that will optimize inventory dollars at Peach Bottom atomic power station and Limerick generating station. The ultimate goal of the project is to maximize the potential for the correct parts being available at the lowest possible level of investment. There are many factors that make the management of maintenance, repair, and operating (MRO) supply inventories more complicated than managing finished goods, work-in-progress, or raw materials. Determining correct inventory levels for nuclear power plants is complicated by the irregular demand for spare parts and the cyclic nature of demand caused by refueling outages. Based on the information collected, it was determined that PECo's nuclear group needed to develop policies and strategies to address the following issues: (1) inventory classification based on part criticality, usage, and demand forecast; (2) item level ordering policies based on classification system; (3) inventory performance management; and (4) management of obsolete/surplus parts. Currently, policies are being developed to manage surplus and obsolete materials. Opportunities are being explored regarding the potential capitalization of critical components and parts. The policies established for classification, ordering policies, and performance management are being translated into work processes via common procedures and guidelines

  11. MANY MEN USED ED TREATMENT WITHOUT THEIR PARTNERS’ KNOWLEDGE

    Tan HM; Choo WY; Ng CJ; Low WY

    2007-01-01

    This paper aimed to identify and explore the understanding and perception of erectile dysfunction (ED) using exploratory qualitative approaches. This study was conducted in Klang Valley, Malaysia. Purposive sampling was used to recruit 17 urban men aged 40-75 years. A semi-structural interview guide was used to explore men’s understanding of ED, impacts on their well-being and experiences with treatments. The focus groups revealed that ED was perceived to be an important loss in men’s lives ...

  12. Platelet indices in Philadelphia-negative chronic myeloproliferative neoplasms / Indicii plachetari de volum în neoplasmele mieloproliferative cronice Philadelphia-negative

    Olteanu Ariela-Ligia

    2015-06-01

    Full Text Available Introducere: Neoplasmele mieloproliferative cronice cromozom Philadelphia negative (Ph-MPN -policitemia vera (PV, trombocitemia esenţială (TE şi mielofibroza primară (MP - sunt caracterizate de o rată mare de complicaţii trombotice, parţial date de activarea trombocitară. Trombocitele mari sunt mai active, cu o funcţie procoagulantă crescută şi au rol patogenic demonstrat în tromboza arterială şi venoasă. În studiul nostru am încercat să stabilim dacă indicii trombocitari (MPV, PDW, P-LCR, furnizaţi de analizoarele de hematologie în hemoleucograma completă, sunt modificaţi la pacienţii diagnosticaţi cu Ph-MPN comparativ cu subiecţii sănătoşi. Material şi metodă: Hemoleucograma, ce a inclus şi indicii trombocitari, a fost determinată la 102 pacienţi Ph- MPN şi la 102 subiecţi sănătoşi cu ajutorul analizorului de hematologie Sysmex XS 1000i (metoda impedanţei, iar testele biochimice (glucoza şi parametrii metabolismului lipidic, pe analizorul Architect c8000. Prezenţa mutaţiei JAK2 V617F, la pacienţii cu Ph-MPN, a fost evidenţiată prin tehnica ARMS-PCR. Rezultate: Indicii de volum plachetari (IVP măsuraţi prin metoda impedanţei, nu au fost semnificativ modificaţi la pacienţii cu Ph-MPN comparativ cu cei ai subiecţilor sănătoşi. Totuşi, am observat o moderată corelaţie între valoarea acestor indici şi prezenţa mutaţiei JAK2V617F, fără însă a se atinge o diferenţă semnificativă din punct de vedere statistic. IVP au fost crescuţi la micul subgrup de pacienţi trataţi cu anagrelide şi scăzuţi la cei trataţi cu simvastatin, comparativ cu pacienţii care nu au primit aceste terapii. Concluzii: Folosind metoda impedanţei în determinarea indicilor trombocitari, în studiul nostru nu am demonstrat o diferenţă semnificativă între valorile indicilor trombocitari la pacienţii cu Ph- MPN comparativ cu subiecţii sănătoşi. Sunt necesare studii ulterioare pentru a demonstra o

  13. How Philadelphia is Integrating Climate Science and Policy: Changing Capital Planning Processes and Developing Flood-Depth Tools

    Bhat, C.; Dix, B.; Choate, A.; Wong, A.; Asam, S.; Schultz, P. A.

    2016-12-01

    Policy makers can implement more effective climate change adaptation programs if they are provided with two tools: accessible information on the impacts that they need to prepare for, and clear guidance on how to integrate climate change considerations into their work. This presentation will highlight recent and ongoing efforts at the City of Philadelphia to integrate climate science into their decision-making. These efforts include developing a climate change information visualization tool, climate change risk assessments across the city, and processes to integrate climate change into routine planning and budgeting practices. The goal of these efforts is to make climate change science highly targeted to decision maker needs, non-political, easily accessible, and actionable. While sea level rise inundation maps have been available to communities for years, the maps do not effectively communicate how the design of a building or a piece of infrastructure would need to be modified to protect it. The Philadelphia Flood Risk Viewer is an interactive planning tool that allows Philadelphia to identify projected depths of flooding for any location within the City, for a variety of sea level rise and storm surge scenarios. Users can also determine whether a location is located in a FEMA floodplain. By having access to information on the projected depth of flooding at a given location, the City can determine what flood protection measures may be effective, or even inform the long-term viability of developing a particular area. With an understanding of climate vulnerabilities, cities have the opportunity to make smart, climate-resilient investments with their capital budgets that will yield multiple benefits for years to come. Few, however, have established protocols for doing so. Philadelphia, with support from ICF, developed a guidance document that identifies recommendations for integrating climate change considerations throughout the Capital Program and capital budgeting

  14. Book Review: Review Manual for Massachusetts General Hospital ...

    Abstract. Book Title: Review Manual for Massachusetts General Hospital Handbook of. General Hospital Psychiatry. 5th ed. Book Author: Theodore A. Stern. Pp 121. Philadelphia: Elsevier Mosby. 2004. ISBN 0-323-02768-7.

  15. Losing weight after pregnancy

    ... 7th ed. Philadelphia, PA: Elsevier; 2017:chap 23. Newton ER. Lactation and breastfeeding. In: Gabbe SG, Niebyl ... member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www. ...

  16. Gallstones

    ... ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 155. Jackson PG, Evans SRT. Biliary system. In: Townsend CM ... 65. Review Date 4/19/2017 Updated by: Michael M. Phillips, MD, Clinical Professor of Medicine, The ...

  17. Acute cholecystitis

    ... ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 66. Jackson PG, Evans SRT. Biliary system. In: Townsend CM ... 65. Review Date 7/10/2017 Updated by: Michael M. Phillips, MD, Clinical Professor of Medicine, The ...

  18. Kidney stones

    ... ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 126. Fink HA, Wilt TJ, Eidman KE, et al. Medical ... 23546565 www.ncbi.nlm.nih.gov/pubmed/23546565 . Fink HA, Wilt TJ, Eidman KE, et al. Recurrent ...

  19. Epithelium

    The term "epithelium" refers to layers of cells that line hollow organs and glands. It is also those cells that make ... Kierszenbaum AL, Tres LL. Epithelium. In: Kierszenbaum AL, Tres LL, ... to Pathology . 4th ed. Philadelphia, PA: Elsevier Saunders; ...

  20. Endocardial cushion defect

    ... Philadelphia, PA: Elsevier; 2016:chap 426. Kouchoukos NT, Blackstone EH, Hanley FL, Kirklin JK. Atrioventricular septal defect. In: Kouchoukos NT, Blackstone EH, Hanley FL, Kirklin JK, eds. Kirklin/Barratt- ...

  1. When your child's treatment stops working

    ... a child. This may mean watching TV, playing games, or sending texts. Encourage your child to stay ... and Oski's Hematology and Oncology of Infancy and Childhood . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap ...

  2. Cast Care: Do's and Don'ts

    ... al. Cast care. In: Instructions for Sports Medicine Patients. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2012. https://www.clinicalkey.com. Accessed Jan. 25, 2018. Pfenninger JL, et al. Casts immobilization and upper extremity splinting. In: Pfenninger and Fowler's ...

  3. Management of cystic lymphangioma: experience of two referral ...

    Annals of Pediatric Surgery 2012, 8:123–128. Keywords: cystic lymphangioma, management, sclerotherapy. aPediatric Surgery Unit ..... Murphy P, editors. Ashcraft's Pediatric Surgery. 5th ed. Philadelphia, USA: Saunders-Elsevier. pp.

  4. Down syndrome

    ... Philadelphia, PA: Elsevier; 2016:chap 81. Driscoll DA, Simpson JL, Holzgreve W, Otano L. Genetic screening and prenatal genetic diagnosis. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem ...

  5. Fibrocystic breast disease

    ... women believe that eating less fat, caffeine, or chocolate helps with their symptoms. There is no evidence ... In: Bope ET, Kellerman RD, eds. Conn's Current Therapy 2016 . Philadelphia, PA: Elsevier; 2016:chap 17. Hunt ...

  6. Osler-Weber-Rendu syndrome

    ... ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 98. McDonald J, Wooderchak-Donahue W, VanSant Webb C, Whitehead ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  7. Bunion removal

    Bunionectomy; Hallux valgus correction; Bunion excision; Osteotomy - bunion; Exostomy - bunion; Arthrodesis - bunion ... Coughlin MJ, Anderson RB. Hallux valgus. In: Coughlin MJ, Saltzman CL, ... of the Foot and Ankle . 9th ed. Philadelphia, PA: Elsevier ...

  8. Prednisone and Other Corticosteroids: Balance the Risks and Benefits

    ... transplant recipients. You can take corticosteroids: By mouth. Tablets, capsules or syrups help treat the inflammation and ... Firestein GS, et al. Glucocorticoid therapy. In: Kelley's Textbook of Rheumatology. 9th ed. Philadelphia, Pa.: Saunders Elsevier; ...

  9. Tick paralysis

    ... do not show symptoms right away, and you may forget the incident by the time your child becomes sick with ... and Clinical Practice . 9th ed. Philadelphia, PA: Elsevier Saunders; 2018:chap 126. ...

  10. Should we fear "flu fear" itself? Effects of H1N1 influenza fear on ED use.

    McDonnell, William M; Nelson, Douglas S; Schunk, Jeff E

    2012-02-01

    Surges in patient volumes compromise emergency departments' (EDs') ability to deliver care, as shown by the recent H1N1 influenza (flu) epidemic. Media reports are important in informing the public about health threats, but the effects of media-induced anxiety on ED volumes are unclear. The aim of this study is to examine the effect of widespread public concern about flu on ED use. We reviewed ED data from an integrated health system operating 18 hospital EDs. We compared ED visits during three 1-week periods: (a) a period of heightened public concern regarding flu before the disease was present ("Fear Week"), (b) a subsequent period of active disease ("Flu Week"), and (c) a week before widespread concern ("Control Week"). Fear Week was identified from an analysis of statewide Google electronic searches for "swine flu" and from media announcements about flu. Flu Week was identified from statewide epidemiological data. Data were reviewed from 22 608 visits during the study periods. Fear Week (n = 7712) and Flu Week (n = 7687) were compared to Control Week (n = 7209). Fear Week showed a 7.0% increase in visits (95% confidence interval, 6-8). Pediatric visits increased by 19.7%, whereas adult visits increased by 1%. Flu Week showed an increase over Control Week of 6.6% (95% confidence interval, 6-7). Pediatric visits increased by 10.6%, whereas adult visits increased by 4.8%. At a time of heightened public concern regarding flu but little disease prevalence, EDs experienced substantial increases in patient volumes. These increases were significant and comparable to the increases experienced during the subsequent epidemic of actual disease. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Use of a midstream clean catch mobile application did not lower urine contamination rates in an ED.

    Jacob, Mary S; Kulie, Paige; Benedict, Cameron; Ordoobadi, Alexander J; Sikka, Neal; Steinmetz, Erika; McCarthy, Melissa L

    2018-01-01

    Urine microscopy is a common test performed in emergency departments (EDs). Urine specimens can easily become contaminated by different factors, including the collection method. The midstream clean-catch (MSCC) collection technique is commonly used to reduce urine contamination. The urine culture contamination rate from specimens collected in our ED is 30%. We developed an instructional application (app) to show ED patients how to provide a MSCC urine sample. We hypothesized that ED patients who viewed our instructional app would have significantly lower urine contamination rates compared to patients who did not. We prospectively enrolled 257 subjects with a urinalysis and/or urine culture test ordered in the ED and asked them to watch our MSCC instructional app. After prospective enrollment was complete, we retrospectively matched each enrolled subject to an ED patient who did not watch the instructional app. Controls were matched to cases based on gender, type of urine specimen provided, ED visit date and shift. Urinalysis and urine culture contamination results were compared between the matched pairs using McNemar's test. The overall urine culture contamination rate of the 514 subjects was 38%. The majority of the matched pairs had a urinalysis (63%) or urinalysis plus urine culture (35%) test done. There were no significant differences in our urine contamination rates between the matched pairs overall or when stratified by gender, by prior knowledge of the clean catch process or by type of urine specimen. We did not see a lower contamination rate for patients who viewed our instructional app compared to patients who did not. It is possible that MSCC is not effective for decreasing urine specimen contamination. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Note critiche sui rapporti tra diritto ed economia

    Tuzet, Giovanni

    2017-01-01

    Il saggio inquadra teoricamente i principali rapporti fra diritto ed economia e analizza i vari metodi e approcci dell'analisi economica del diritto, rilvandone gli aspetti critici e discutendo infine gli approcci comportamentali e la "nudge theory".

  13. Structure of catalase determined by MicroED

    Nannenga, Brent L; Shi, Dan; Hattne, Johan; Reyes, Francis E; Gonen, Tamir

    2014-01-01

    MicroED is a recently developed method that uses electron diffraction for structure determination from very small three-dimensional crystals of biological material. Previously we used a series of still diffraction patterns to determine the structure of lysozyme at 2.9 Å resolution with MicroED (Shi et al., 2013). Here we present the structure of bovine liver catalase determined from a single crystal at 3.2 Å resolution by MicroED. The data were collected by continuous rotation of the sample under constant exposure and were processed and refined using standard programs for X-ray crystallography. The ability of MicroED to determine the structure of bovine liver catalase, a protein that has long resisted atomic analysis by traditional electron crystallography, demonstrates the potential of this method for structure determination. DOI: http://dx.doi.org/10.7554/eLife.03600.001 PMID:25303172

  14. Elementi ed esercizi di geometria analitica e proiettiva

    Francia, Giovanni

    1950-01-01

    La retta : preliminario ; coordinate cartesiane nel piano, equazioni della retta, distanze ed angoli ; cambiamento delle coordinate, coordinate polari ; il cerchio ; le coniche come luoghi geometrici : l'ellisse, l'iperbole, parabola.

  15. 2003 annual results of EdF group

    2004-03-01

    The Electricite de France (EdF) group Board of Directors, meeting on March 11, 2004, under the Chairmanship of Francois Roussely, reviewed the audited consolidated financial statements for the year ended 12/31/2003. This document presents the consolidated results of EdF group for 2003: consolidated financial statements, highlights of the year, focus on 2003 events, commercial results, EDF in Europe and worldwide, EDF France highlights, key figures. (J.S.)

  16. Sex and age differences in ED patients with mental and behavioral disorders due to psychoactive substance use.

    Le Querrec, Fanny; Bounes, Vincent; Mestre, Maryse Lapeyre; Azema, Olivier; Longeaux, Nicolas; Gallart, Jean-Christophe

    2015-11-01

    The objectives of this study are to describe an emergency department (ED) adult population with the chief complaint of mental and behavioral disorders due to psychoactive substance use and to investigate sex- and age-related differences. We analyzed data (2009-2011) from the Regional Observatory of Emergency Medicine ORU-MiP (700000 patients per year) for all patients with a primary diagnosis of mental and behavioral disorders due to psychoactive substance use. Day data were weighted by the number of days in the year and expressed for 100000 inhabitants of the area. Pearson χ(2) test and Fisher tests were used. The Brown-Mood test was used to compare medians. Of the 1411597 ED visits analyzed, 20838 consults (1.3%) were for primary diagnosis of mental and behavioral disorders due to psychoactive substance use. The median age (interquartile range) was 41 (28-51) years; 69.5% were men. More women consulted the ED for sedative or hypnotic use (4.9% vs 1.5%, P consumption (93.5% vs 90%, P psychoactive substance use account for 1.3% of ED visits. Older people should be screened for chronic alcohol consumption. Our findings underscore the opportunity provided by the ED for screening and brief intervention in drug- and alcohol-related problems. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. The value of a poison control center in preventing unnecessary ED visits and hospital charges: A multi-year analysis.

    Tak, Casey R; Malheiro, Marty C; Bennett, Heather K W; Crouch, Barbara I

    2017-03-01

    The purpose of this study is to determine the economic value of the Utah Poison Control Center (UPCC) by examining its contribution to the reduction of unnecessary emergency department (ED) visits and associated charges across multiple years. A multi-year (2009-2014) analysis of cross-sectional data was performed. Callers were asked what they would do for a poison emergency if the UPCC was not available. Healthcare charges for ED visits averted were calculated according to insurance status using charges obtained from a statewide database. Of the 10,656 survey attempts, 5018 were completed. Over 30,000 cases were managed on-site each year. Using the proportion of callers who noted they would call 911, visit an ED, or call a physician's office, between 20.0 and 24.2 thousand ED visits were potentially prevented each year of the survey. Between $16.6 and $24.4 million dollars in unnecessary healthcare charges were potentially averted annually. Compared to the cost of operation, the service UPCC provides demonstrates economic value by reducing ED visits and associated charges. As the majority of patients have private insurance, the largest benefit falls to private payers. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Ethane dimethanesulfonate (EDS) perturbs epididymal epithelial cell function in vitro

    Klinefelter, G.

    1990-01-01

    The formation of sperm granulomas in the epididymis following exposure to EDS, a Leydig cell toxicant, was reported by Cooper and Jackson in 1970. Recent work suggests that EDS may effect the epididymis directly. An in vitro system was developed to determine the nature of any direct effect. The caput epididymis from adult rats was dissected free of connective tissue and small pieces of the tissue were enzymatically digested until plaques of epididymal epithelial cells were obtained. Plaques were cultured on an extracellular matrix gelled on top of a semipermeable filter creating dual-compartment environments. The epithelial cells maintained typical morphology and protein secretion in this culture system for several days. Beginning on day 3, EDS (1 mM) was added to the basal compartment, with or without 35 S-methionine. After 24 hours, 35 S-labelled culture medium was taken from the apical compartment and analyzed by SDS-PAGE and fluorography. EDS caused decreased secretion of several proteins, including a 39 Kd molecule. Interestingly, a 39 Kd protein was also shown to disappear from sperm taken from the caput epididymidis following in vivo exposure to EDS. Unlabelled cultures were fixed and processed for light microscopy. No alterations in morphological integrity were observed. Thus, epididymal epithelial cell function is directly altered by EDS exposure

  19. Concentration of Tobacco Advertisements at SNAP and WIC Stores, Philadelphia, Pennsylvania, 2012

    Chilton, Mariana; Zhao, Qian-Wei; Szymkowiak, Dorota; Coffman, Ryan; Mallya, Giridhar

    2015-01-01

    Introduction Tobacco advertising is widespread in urban areas with racial/ethnic minority and low-income households that participate in nutrition assistance programs. Tobacco sales and advertising are linked to smoking behavior, which may complicate matters for low-income families struggling with disparate health risks relating to nutrition and chronic disease. We investigated the relationship between the amount and type of tobacco advertisements on tobacco outlets and the outlet type and location. Methods By using field visits and online images, we inspected all licensed tobacco retail outlets in Philadelphia (N = 4,639). Point pattern analyses were used to identify significant clustering of tobacco outlets and outlets with exterior tobacco advertisements. Logistic regression was used to analyze the relationship between the outlet’s acceptance of Supplemental Nutrition Assistance Program (SNAP) and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the presence of tobacco advertisements. Results Tobacco outlets with exterior tobacco advertisements were significantly clustered in several high-poverty areas. Controlling for racial/ethnic and income composition and land use, SNAP and WIC vendors were significantly more likely to have exterior (SNAP odds ratio [OR], 2.11; WIC OR, 1.59) and interior (SNAP OR, 3.43; WIC OR, 1.69) tobacco advertisements than other types of tobacco outlets. Conclusion Tobacco advertising is widespread at retail outlets, particularly in low-income and racial/ethnic minority neighborhoods. Policy makers may be able to mitigate the effects of this disparate exposure through tobacco retail licensing, local sign control rules, and SNAP and WIC authorization. PMID:25654220

  20. Green Infrastructure Simulation and Optimization to Achieve Combined Sewer Overflow Reductions in Philadelphia's Mill Creek Sewershed

    Cohen, J. S.; McGarity, A. E.

    2017-12-01

    The ability for mass deployment of green stormwater infrastructure (GSI) to intercept significant amounts of urban runoff has the potential to reduce the frequency of a city's combined sewer overflows (CSOs). This study was performed to aid in the Overbrook Environmental Education Center's vision of applying this concept to create a Green Commercial Corridor in Philadelphia's Overbrook Neighborhood, which lies in the Mill Creek Sewershed. In an attempt to further implement physical and social reality into previous work using simulation-optimization techniques to produce GSI deployment strategies (McGarity, et al., 2016), this study's models incorporated land use types and a specific neighborhood in the sewershed. The low impact development (LID) feature in EPA's Storm Water Management Model (SWMM) was used to simulate various geographic configurations of GSI in Overbrook. The results from these simulations were used to obtain formulas describing the annual CSO reduction in the sewershed based on the deployed GSI practices. These non-linear hydrologic response formulas were then implemented into the Storm Water Investment Strategy Evaluation (StormWISE) model (McGarity, 2012), a constrained optimization model used to develop optimal stormwater management practices on the watershed scale. By saturating the avenue with GSI, not only will CSOs from the sewershed into the Schuylkill River be reduced, but ancillary social and economic benefits of GSI will also be achieved. The effectiveness of these ancillary benefits changes based on the type of GSI practice and the type of land use in which the GSI is implemented. Thus, the simulation and optimization processes were repeated while delimiting GSI deployment by land use (residential, commercial, industrial, and transportation). The results give a GSI deployment strategy that achieves desired annual CSO reductions at a minimum cost based on the locations of tree trenches, rain gardens, and rain barrels in specified land

  1. Current Concepts in Pediatric Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia

    Bernt, Kathrin M.; Hunger, Stephen P.

    2014-01-01

    The t(9;22)(q34;q11) or Philadelphia chromosome creates a BCR–ABL1 fusion gene encoding for a chimeric BCR–ABL1 protein. It is present in 3–4% of pediatric acute lymphoblastic leukemia (Ph+ ALL), and about 25% of adult ALL cases. Prior to the advent of tyrosine kinase inhibitors (TKI), Ph+ ALL was associated with a very poor prognosis despite the use of intensive chemotherapy and frequently hematopoietic stem-cell transplantation (HSCT) in first remission. The development of TKIs revolutionized the therapy of Ph+ ALL. Addition of the first generation ABL1 class TKI imatinib to intensive chemotherapy dramatically increased the survival for children with Ph+ ALL and established that many patients can be cured without HSCT. In parallel, the mechanistic understanding of Ph+ ALL expanded exponentially through careful mapping of pathways downstream of BCR–ABL1, the discovery of mutations in master regulators of B-cell development such as IKZF1 (Ikaros), PAX5, and early B-cell factor (EBF), the recognition of the complex clonal architecture of Ph+ ALL, and the delineation of genomic, epigenetic, and signaling abnormalities contributing to relapse and resistance. Still, many important basic and clinical questions remain unanswered. Current clinical trials are testing second generation TKIs in patients with newly diagnosed Ph+ ALL. Neither the optimal duration of therapy nor the optimal chemotherapy backbone are currently defined. The role of HSCT in first remission and post-transplant TKI therapy also require further study. In addition, it will be crucial to continue to dig deeper into understanding Ph+ ALL at a mechanistic level, and translate findings into complementary targeted approaches. Expanding targeted therapies hold great promise to decrease toxicity and improve survival in this high-risk disease, which provides a paradigm for how targeted therapies can be incorporated into treatment of other high-risk leukemias. PMID:24724051

  2. Mechatronics Engineers’ Perception of Code Mixing: Philadelphia University and Hashemite University as a Case Study

    Mustafa Al-Khawaldeh

    2016-11-01

    Full Text Available It has recently been widely recognized that code-switching is prevalent in Jordanians' daily conversation in various situations such as home, cafés, universities, restaurants and clubs. Abalhassan and Alshalawi (2000: 183 made a very related observation on code switching behavior among Arab speakers of English that “without exception, all respondents switched into English to some degree”. This could be referred to the increase number of technological advances and people travelling across countries for pleasure or for pursuing further education. In light of this observation, the crucial role of language in people's life, ambivalent attitudes towards code-switching (Akbar, 2007, the dearth of research in this area, such a present study is required to explore Jordanian university students’ and instructors’ perceptions of code-switching in their daily classroom conversation and its expected impact on their language proficiency. In particular, it investigates the factors leading them to code mix and their underlying attitudes towards its expected future impact on their language proficiency. To the best knowledge of the present researcher, this study is the first of its kind in Jordan. Data was collected via semi-structured interviews and a questionnaire from 70 university students and 30 instructors from both Philadelphia University and the Hashemite University. Data revealed that code mixing between English and Arabic is a common phenomenon in lectures they have attended in their academic institutions. The participants also show that they find code mixing fascinating and believe that though code switching might have a positive impact on their learning as it helps them better understand the topic. The instructors revealed that code mixing fulfill a set of functions that serve the educational process.

  3. Philadelphia chromosome-negative classical myeloproliferative neoplasms: revised management recommendations from European LeukemiaNet.

    Barbui, Tiziano; Tefferi, Ayalew; Vannucchi, Alessandro M; Passamonti, Francesco; Silver, Richard T; Hoffman, Ronald; Verstovsek, Srdan; Mesa, Ruben; Kiladjian, Jean-Jacques; Hehlmann, Rȕdiger; Reiter, Andreas; Cervantes, Francisco; Harrison, Claire; Mc Mullin, Mary Frances; Hasselbalch, Hans Carl; Koschmieder, Steffen; Marchetti, Monia; Bacigalupo, Andrea; Finazzi, Guido; Kroeger, Nicolaus; Griesshammer, Martin; Birgegard, Gunnar; Barosi, Giovanni

    2018-05-01

    This document updates the recommendations on the management of Philadelphia chromosome-negative myeloproliferative neoplasms (Ph-neg MPNs) published in 2011 by the European LeukemiaNet (ELN) consortium. Recommendations were produced by multiple-step formalized procedures of group discussion. A critical appraisal of evidence by using Grades of Recommendation, Assessment, Development and Evaluation (GRADE) methodology was performed in the areas where at least one randomized clinical trial was published. Seven randomized controlled trials provided the evidence base; earlier phase trials also informed recommendation development. Key differences from the 2011 diagnostic recommendations included: lower threshold values for hemoglobin and hematocrit and bone marrow examination for diagnosis of polycythemia vera (PV), according to the revised WHO criteria; the search for complementary clonal markers, such as ASXL1, EZH2, IDH1/IDH2, and SRSF2 for the diagnosis of myelofibrosis (MF) in patients who test negative for JAK2V617, CALR or MPL driver mutations. Regarding key differences of therapy recommendations, both recombinant interferon alpha and the JAK1/JAK2 inhibitor ruxolitinib are recommended as second-line therapies for PV patients who are intolerant or have inadequate response to hydroxyurea. Ruxolitinib is recommended as first-line approach for MF-associated splenomegaly in patients with intermediate-2 or high-risk disease; in case of intermediate-1 disease, ruxolitinib is recommended in highly symptomatic splenomegaly. Allogeneic stem cell transplantation is recommended for transplant-eligible MF patients with high or intermediate-2 risk score. Allogeneic stem cell transplantation is also recommended for transplant-eligible MF patients with intermediate-1 risk score who present with either refractory, transfusion-dependent anemia, blasts in peripheral blood > 2%, adverse cytogenetics, or high-risk mutations. In these situations, the transplant procedure should be

  4. Philadelphia-negative classical myeloproliferative neoplasms: critical concepts and management recommendations from European LeukemiaNet.

    Barbui, Tiziano; Barosi, Giovanni; Birgegard, Gunnar; Cervantes, Francisco; Finazzi, Guido; Griesshammer, Martin; Harrison, Claire; Hasselbalch, Hans Carl; Hehlmann, Rudiger; Hoffman, Ronald; Kiladjian, Jean-Jacques; Kröger, Nicolaus; Mesa, Ruben; McMullin, Mary F; Pardanani, Animesh; Passamonti, Francesco; Vannucchi, Alessandro M; Reiter, Andreas; Silver, Richard T; Verstovsek, Srdan; Tefferi, Ayalew

    2011-02-20

    We present a review of critical concepts and produce recommendations on the management of Philadelphia-negative classical myeloproliferative neoplasms, including monitoring, response definition, first- and second-line therapy, and therapy for special issues. Key questions were selected according the criterion of clinical relevance. Statements were produced using a Delphi process, and two consensus conferences involving a panel of 21 experts appointed by the European LeukemiaNet (ELN) were convened. Patients with polycythemia vera (PV) and essential thrombocythemia (ET) should be defined as high risk if age is greater than 60 years or there is a history of previous thrombosis. Risk stratification in primary myelofibrosis (PMF) should start with the International Prognostic Scoring System (IPSS) for newly diagnosed patients and dynamic IPSS for patients being seen during their disease course, with the addition of cytogenetics evaluation and transfusion status. High-risk patients with PV should be managed with phlebotomy, low-dose aspirin, and cytoreduction, with either hydroxyurea or interferon at any age. High-risk patients with ET should be managed with cytoreduction, using hydroxyurea at any age. Monitoring response in PV and ET should use the ELN clinicohematologic criteria. Corticosteroids, androgens, erythropoiesis-stimulating agents, and immunomodulators are recommended to treat anemia of PMF, whereas hydroxyurea is the first-line treatment of PMF-associated splenomegaly. Indications for splenectomy include symptomatic portal hypertension, drug-refractory painful splenomegaly, and frequent RBC transfusions. The risk of allogeneic stem-cell transplantation-related complications is justified in transplantation-eligible patients whose median survival time is expected to be less than 5 years.

  5. A new e-learning platform for radiology education (RadEd).

    Xiberta, Pau; Boada, Imma

    2016-04-01

    One of the key elements of e-learning platforms is the content provided to the students. Content creation is a time demanding task that requires teachers to prepare material taking into account that it will be accessed on-line. Moreover, the teacher is restricted by the functionalities provided by the e-learning platforms. In contexts such as radiology where images have a key role, the required functionalities are still more specific and difficult to be provided by these platforms. Our purpose is to create a framework to make teacher's tasks easier, specially when he has to deal with contents where images have a main role. In this paper, we present RadEd, a new web-based teaching framework that integrates a smart editor to create case-based exercises that support image interaction such as changing the window width and the grey scale used to render the image, taking measurements on the image, attaching labels to images and selecting parts of the images, amongst others. It also provides functionalities to prepare courses with different topics, exercises and theory material, and also functionalities to control students' work. Different experts have used RadEd and all of them have considered it a very useful and valuable tool to prepare courses where radiological images are the main component. RadEd provides teachers functionalities to prepare more realistic cases and students the ability to make a more specific diagnosis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. The impact of an ED-only full-capacity protocol.

    Watase, Taketo; Fu, Rongwei; Foster, Denise; Langley, Denise; Handel, Daniel A

    2012-10-01

    The objective of this study was to assess the impact of an emergency department (ED)-only full-capacity protocol and diversion, controlling for patient volumes and other potential confounding factors. This was a preintervention and postintervention cohort study using data 12 months before and 12 months after the implementation of the protocol. During the implementation period, attending physicians and charge nurses were educated with clear and simple figures on the criteria for the initiation of the new protocol. A multiple logistic regression model was used to compare ambulance diversion between the 2 periods. The proportion of days when the ED went on diversion at least once during a 24-hour period was 60.4% during the preimplementation period and 20% in the postimplementation periods (P model, the use of the new protocol was significantly associated with decreased odds of diversion rate in the postimplementation period (odds ratio, 0.32; 95% confidence interval, 0.21-0.48). Our predivert/full-capacity protocol is a simple and generalizable strategy that can be implemented within the boundaries of the ED and is significantly associated with a decreased diversion rate. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. SEM/EDS and optical microscopy analyses of microplastics in ocean trawl and fish guts.

    Wang, Zhong-Min; Wagner, Jeff; Ghosal, Sutapa; Bedi, Gagandeep; Wall, Stephen

    2017-12-15

    Microplastic particles from Atlantic and Pacific Ocean trawls, lab-fed fish guts and ocean fish guts have been characterized using optical microscopy and SEM/EDS in terms of size, morphology, and chemistry. We assessed whether these measurements could serve as a rapid screening process for subsequent identification of the likely microplastic candidates by micro-spectroscopy. Optical microscopy enabled morphological classification of the types of particles or fibers present in the sample, as well as the quantification of particle size ranges and fiber lengths. SEM/EDS analysis was used to rule out non-plastic particles and screen the prepared samples for potential microplastic, based on their element signatures and surface characteristics. Chlorinated plastics such as polyvinyl chloride (PVC) could be easily identified with SEM/EDS due to their unique elemental signatures including chlorine, as could mineral species that are falsely identified as plastics by optical microscopy. Particle morphology determined by optical microscopy and SEM suggests the fish ingested particles contained both degradation fragments from larger plastic pieces and also manufactured microplastics. SEM images of microplastic particle surfaces revealed characteristic cracks consistent with environmental exposure, as well as pigment particles consistent with manufactured materials. Most of the microplastic surfaces in the fish guts and ocean trawls were covered with biofilms, radiolarians, and crustaceans. Many of the fish stomachs contained micro-shell pieces which visually resembled microplastics. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Coverage of Acta Dermatovenerologica Alpina, Pannonica et Adriatica in Elsevier's CiteScore index: a new tool for measuring the citation impact of academic journals.

    Poljak, Mario

    2017-03-01

    In December 2016, Elsevier launched a new tool that helps measure the citation impact of academic journals, called the CiteScore index. The CiteScore index values for 2015 confirmed the status of Acta Dermatovenerologica Alpina, Pannonica et Adriatica (Acta Dermatovenerol APA) as the leading journal in dermatology and sexually transmitted infections in the region. Sixty-five articles published in Acta Dermatovenerol APA from 2012 to 2014 received a total of 77 citations in 2015, resulting in a CiteScore index value of 1.18 for the journal. More than half of the articles published from 2012 to 2014 received at least one citation in 2015. Acta Dermatovenerol APA performed well in all three categories listed because it is ranked 384th out of 1,549 journals in the category General Medicine (75th percentile), 53rd out of 122 journals in the category Dermatology (56th percentile), and 142nd out of 246 journals in the category Infectious Diseases (42nd percentile).

  9. The Elsevier Trophoblast Research Award Lecture: Importance of metzincin proteases in trophoblast biology and placental development: a focus on ADAM12.

    Aghababaei, Mahroo; Beristain, Alexander G

    2015-04-01

    Placental development is a highly regulated process requiring signals from both fetal and maternal uterine compartments. Within this complex system, trophoblasts, placental cells of epithelial lineage, form the maternal-fetal interface controlling nutrient, gas and waste exchange. The commitment of progenitor villous cytotrophoblasts to differentiate into diverse trophoblast subsets is a fundamental process in placental development. Differentiation of trophoblasts into invasive stromal- and vascular-remodeling subtypes is essential for uterine arterial remodeling and placental function. Inadequate placentation, characterized by defects in trophoblast differentiation, may underlie the earliest cellular events driving pregnancy disorders such as preeclampsia and fetal growth restriction. Molecularly, invasive trophoblasts acquire characteristics defined by profound alterations in cell-cell and cell-matrix adhesion, cytoskeletal reorganization and production of proteolytic factors. To date, most studies have investigated the importance of the matrix metalloproteinases (MMPs) and their ability to efficiently remodel components of the extracellular matrix (ECM). However, it is now becoming clear that besides MMPs, other related proteases regulate trophoblast invasion via mechanisms other than ECM turnover. In this review, we will summarize the current knowledge on the regulation of trophoblast invasion by members of the metzincin family of metalloproteinases. Specifically, we will discuss the emerging roles that A Disintegrin and Metalloproteinases (ADAMs) play in placental development, with a particular focus on the ADAM subtype, ADAM12. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Urine culture guided antibiotic interventions: A pharmacist driven antimicrobial stewardship effort in the ED.

    Zhang, Xi; Rowan, Nicole; Pflugeisen, Bethann Mangel; Alajbegovic, Sanjin

    2017-04-01

    Antibiotics are overprescribed for abnormal urine tests including asymptomatic bacteriuria (AB), contributing to rising antimicrobial resistance rates. Pharmacists reviewed urine cultures daily from emergency department (ED) encounters to assess antibiotic appropriateness. We studied antibiotic prescribing practices and assessed compliance to national guidelines, correlations with urine analysis (UA) components, and opportunities for antimicrobial stewardship in the ED. This quality improvement project (QIP) was a prospective cohort study at a community hospital ED, with data collected from finalized urine cultures resulting October 30, 2014 through January 5, 2015. Analyses were conducted using Chi-squared and Fisher Exact tests and stepwise multiple logistic regression. Urine cultures from 457 encounters were reviewed, of which 136 met the inclusion criteria as non-pregnant and asymptomatic for urinary tract infection (UTI). 43% of 136 patients were treated with antibiotics, for a total of 426 antibiotic days. Pharmacist interventions for these patients resulted in 122/426 (29%) of potential antibiotic days saved. Factors found to significantly increase the odds of antibiotic prescribing in asymptomatic patients included presence of leukocyte esterase (OR=4.5, 95% CI: 1.2-17.2; p=0.03) or nitrites (OR=10.8, 95% CI: 1.7-68.1; p=0.01) in the urine and age≥75 (OR=3.5, 95% CI: 1.2-9.6, p=0.02). Pharmacist intervention in discontinuing or modifying antibiotics for asymptomatic patients with urine cultures reduced unnecessary antibiotic exposure and was a first step in antimicrobial stewardship efforts in the ED. Future work includes limiting urine tests and subsequent antibiotic therapy for non-pregnant asymptomatic patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Snow shovel-related injuries and medical emergencies treated in US EDs, 1990 to 2006.

    Watson, Daniel S; Shields, Brenda J; Smith, Gary A

    2011-01-01

    Injuries and medical emergencies associated with snow shovel use are common in the United States. This is a retrospective analysis of data from the National Electronic Injury Surveillance System. This study analyzes the epidemiologic features of snow shovel-related injuries and medical emergencies treated in US emergency departments (EDs) from 1990 to 2006. An estimated 195 100 individuals (95% confidence interval, 140 400-249 800) were treated in US EDs for snow shovel-related incidents during the 17-year study period, averaging 11 500 individuals annually (SD, 5300). The average annual rate of snow shovel-related injuries and medical emergencies was 4.15 per 100 000 population. Approximately two thirds (67.5%) of these incidents occurred among males. Children younger than 18 years comprised 15.3% of the cases, whereas older adults (55 years and older) accounted for 21.8%. The most common diagnosis was soft tissue injury (54.7%). Injuries to the lower back accounted for 34.3% of the cases. The most common mechanism of injury/nature of medical emergency was acute musculoskeletal exertion (53.9%) followed by slips and falls (20.0%) and being struck by a snow shovel (15.0%). Cardiac-related ED visits accounted for 6.7% of the cases, including all of the 1647 deaths in the study. Patients required hospitalization in 5.8% of the cases. Most snow shovel-related incidents (95.6%) occurred in and around the home. This is the first study to comprehensively examine snow shovel-related injuries and medical emergencies in the United States using a nationally representative sample. There are an estimated 11 500 snow shovel-related injuries and medical emergencies treated annually in US EDs. Copyright © 2011 Elsevier Inc. All rights reserved.

  12. A novel multidimensional geriatric screening tool in the ED: evaluation of feasibility and clinical relevance.

    Schoenenberger, Andreas W; Bieri, Christoph; Özgüler, Onur; Moser, André; Haberkern, Monika; Zimmermann, Heinz; Stuck, Andreas E; Exadaktylos, Aristomenis

    2014-06-01

    Geriatric problems frequently go undetected in older patients in emergency departments (EDs), thus increasing their risk of adverse outcomes. We evaluated a novel emergency geriatric screening (EGS) tool designed to detect geriatric problems. The EGS tool consisted of short validated instruments used to screen 4 domains (cognition, falls, mobility, and activities of daily living). Emergency geriatric screening was introduced for ED patients 75 years or older throughout a 4-month period. We analyzed the prevalence of abnormal EGS and whether EGS increased the number of EGS-related diagnoses in the ED during the screening, as compared with a preceding control period. Emergency geriatric screening was performed on 338 (42.5%) of 795 patients presenting during screening. Emergency geriatric screening was unfeasible in 175 patients (22.0%) because of life-threatening conditions and was not performed in 282 (35.5%) for logistical reasons. Emergency geriatric screening took less than 5 minutes to perform in most (85.8%) cases. Among screened patients, 285 (84.3%) had at least 1 abnormal EGS finding. In 270 of these patients, at least 1 abnormal EGS finding did not result in a diagnosis in the ED and was reported for further workup to subsequent care. During screening, 142 patients (42.0%) had at least 1 diagnosis listed within the 4 EGS domains, significantly more than the 29.3% in the control period (odds ratio 1.75; 95% confidence interval, 1.34-2.29; Pdeterminants of subsequent care. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Predictors of 30-day mortality in patients admitted to ED for acute heart failure.

    Marchetti, Matthieu; Benedetti, Antoine; Mimoz, Olivier; Lardeur, Jean-Yves; Guenezan, Jérémy; Marjanovic, Nicolas

    2017-03-01

    Acute heart failure (AHF) is a leading cause of admission in emergency departments (ED). It is associated with significant in-hospital mortality, suggesting that there is room for improvement of care. Our aims were to investigate clinical patterns, biological characteristics and determinants of 30-day mortality. We conducted a single site, retrospective review of adult patients (≥18years) admitted to ED for AHF over a 12-month period. Data collected included demographics, clinical, biological and outcomes data. Epidemiologic data were collected at baseline, and patients were followed up during a 30-day period. There were a total of 322 patients. Mean age was 83.9±9.1years, and 47% of the patients were men. Among them, 59 patients (18.3%) died within 30days of admission to the ED. The following three characteristics were associated with increased mortality: age>85years (OR=1.5[95%CI:0.8-2.7], p=0.01), creatinine clearance 5000pg/mL (OR=2.2[95%CI:1.2-4], p<0.001). The best Nt-proBNP cut-off value to predict first-day mortality was 9000pg/mL (area under the curve (AUC) [95%CI] of 0.790 [0.634-0.935], p<0.001). For 7-day mortality, it was 7900pg/mL (0.698 [0.578-0.819], p<0.001) and for 30-day mortality, 5000pg/mL (0.667 [0.576-0.758], p<0.001). Nt-proBNP level on admission, age and creatinine clearance, are predictive of 30-day mortality in adult patients admitted to ED for AHF. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. MANY MEN USED ED TREATMENT WITHOUT THEIR PARTNERS’ KNOWLEDGE

    Tan HM

    2007-01-01

    Full Text Available This paper aimed to identify and explore the understanding and perception of erectile dysfunction (ED using exploratory qualitative approaches. This study was conducted in Klang Valley, Malaysia. Purposive sampling was used to recruit 17 urban men aged 40-75 years. A semi-structural interview guide was used to explore men’s understanding of ED, impacts on their well-being and experiences with treatments. The focus groups revealed that ED was perceived to be an important loss in men’s lives as sexual performance was closely related to manhood. The men associated ED with a loss of masculinity and self-esteem. Men’s understanding of ED treatments was restricted to phophodiesterase type 5 inhibitors (PDE-5 inhibitors and traditional therapies. Although PDE-5 inhibitors were perceived to be effective, they were concerned about their safety and costs. Some of the men have learned to cope with ED rather than to seek help, particularly among older men, who attributed their decreased sexual capacities and erection difficulties to aging, and therefore conditioned themselves to accepting it. In contrast, younger men who have erectile difficulties are considered as ‘abnormal’, and are more likely to seek help and receive treatment for their sexual problem. Men’s knowledge of and experience with modern treatments of ED were mainly associated with PDE-5 inhibitors. Their perception towards PDE-5 inhibitors was largely influenced by personal experience, information from mass media and friends. The high cost and fear of side effects were two main deterrents in the use of PDE-5 inhibitors. Many men had conceded their use of PDE-5 inhibitors without their partners’ knowledge. They worried that their partners would view the matter with suspicion and mistrust.

  15. Resuscitating the tracheostomy patient in the ED.

    Long, Brit; Koyfman, Alex

    2016-06-01

    Emergency physicians must be masters of the airway. The patient with tracheostomy can present with complications, and because of anatomy, airway and resuscitation measures can present several unique challenges. Understanding tracheostomy basics, features, and complications will assist in the emergency medicine management of these patients. The aim of this review is to provide an overview of the basics and features of the tracheostomy, along with an approach to managing tracheostomy complications. This review provides background on the reasons for tracheostomy placement, basics of tracheostomy, and tracheostomy tube features. Emergency physicians will be faced with complications from these airway devices, including tracheostomy obstruction, decannulation or tube dislodgement, stenosis, tracheoinnominate fistula, and tracheoesophageal fistula. Critical patients should be evaluated in the resuscitation bay, and consultation with ENT should be completed while the patient is in the department. This review provides several algorithms for management of complications. Understanding these complications and an approach to airway management during cardiac arrest resuscitation is essential to optimizing patient care. Tracheostomy patients can present unique challenges for emergency physicians. Knowledge of the basics and features of tracheostomy tubes can assist physicians in managing life-threatening complications including tube obstruction, decannulation, bleeding, stenosis, and fistula. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Otto Rank, the Rankian circle in Philadelphia, and the origins of Carl Rogers' person-centered psychotherapy.

    deCarvalho, R J

    1999-05-01

    Otto Rank's will therapy helped shape the ideas and techniques of relationship therapy developed by the Philadelphia social workers Jessie Taft, Virginia Robinson, and Frederick Allen in the 1930s. Rank's work and these ideas and techniques in turn strongly influenced the formulation of Carl Rogers' person-centered psychotherapy. This article compares and contrasts will, relationship, and person-centered approaches to psychotherapy and discusses the social factors--primarily the professional conflicts between a male-dominated psychiatry and female social workers over the independent practice of psychotherapy--that were crucial in the dissemination of Rank's psychological thought and the early popularity of Rogers.

  17. Variant Philadelphia translocations with different breakpoints in six chronic myeloid leukemia patients

    Dilhan Kuru

    2011-09-01

    Full Text Available Objective: The Philadelphia (Ph chromosome, consisting of the t(9;22(q34;q11 translocation, is observed in ~90% of patients with chronic myeloid leukemia (CML. Variant Ph translocations are observed in 5%-10% of CML patients. In variant translocations 3 and possibly more chromosomes are involved. Herein we report 6 CML patients with variant Ph translocations.Materials and Methods: Bone marrow samples were examined using conventional cytogenetic meth ods. Fluorescence in situ hybridization (FISH with whole-chromosome paints and BCR-ABL 1D probes were used to confirm and/or complement the findings, and identify rearrangements beyond the resolution of conventional cytogenetic methods. Results: Variant Ph translocations in the 6 patients were as follows: t(7;22(p22;q11, t(9;22;15(q34;q11;q22, t(15;22(p11;q11, t(1;9;22;3(q24;q34;q11;q21, t(12;22(p13;q11, and t(4;8;9;22(q11;q13;q34;q11.Conclusion: Among the patients, 3 had simple and 3 had complex variant Ph translocations. Two of the presented cases had variant Ph chromosomes not previously described, 1 of which had a new complex Ph translocation involving chromosomes 1, 3, 9, 22, and t(1;9;22;3(q24;q34;q11;q21 apart from a clone with a classical Ph, and the other case had variant Ph translocation with chromosomes 4, 8, 9, and 22, and t(4;8;9;22(q11;q13;q34;q11 full complex translocation. Number of studies reported that some patients with variant Ph translocation were poor responders to imatinib. All of our patients with variant Ph translocations had suboptimal responses to imatinib, denoting a poor prognosis also. Variant Ph translocations may be important as they are associated with prognosis and therapy for CML patients.

  18. Philadelphia's community based drug abuse program: broader medical and social concepts.

    Schut, J

    1975-06-01

    The rehabilitation of drug dependent people has undergone drastic changes since first attempts were made to curb the abuse of illegal drugs. The isolated law-enforcement model proved to be of no use in this area. So, too, the medical model, the psychological model and the public health model proved disappointingly low in their results. During the last ten years, a so-called "metabolic replacement model" has had its upsurge, creating a controversy still under discussion. The Drug Abuse Rehabilitation Programs of the West Philadelphia Community Mental Health Consortium, Inc. have been in the forefront with its treatment models. Established in 1968 as a purely methadone maintenance program, it has evolved into becoming a model, applying community mental health principles. This paper will explore this model further, describing the mechanics of its changes. From a municipal hospital-based methadone dispensing station, the program has developed into a multi-modality project. Three decentralized drug-free outpatient services are located in the midst of the community where the drug abuse problem is more accute. Outreach is emphasized and case-funding is applied. A possibly unique river-front motel was just acquired for the development of a community-based treatment modality. The 94 rooms were converted into a first-floor alcoholism program which also has a "highway safety program" and an intermediate care facility for alcoholics. The second floor of this facility contains outpatient services for the treatment of drug addicts, including a methadone maintenance program, counselling, family therapy and group therapy. The place where most of the emphasis has been placed is the Work Rehabilitation Center (a novel approach whereby patients will spend up to six hours in "partial hospitalization"). Clients will be tested for vocational aptitude and four workshops will be developed on the premises - carpentry, automotive, electricity and clerical. A huge cafeteria with a semi

  19. Met Ed gets reprieve: banks lend tax money

    Utroska, D.

    1981-01-01

    A consortium of banks agreed to loan Metropolitan Edison $23 million to pay its April 15 state taxes and temporarily relieve a cash-flow problem that is leading to default after the Pennsylvania Public Utility Commission expedited a rate request. The continued solvency of Met Ed is a matter of speculation because the present credit formula is based on liquid assets which the PUC did not address. While the action taken by the bankers gives Met Ed a reprieve, it does not provide a long-term solution. The Revolving Credit Agreement will expire on October 1. Met Ed is still faced with the problem of relicensing Three Mile Island-1 unit and the cost of underwriting the cleanup of the No. 2 unit

  20. The impact of age and gender on resource utilization and profitability in ED patients seen and released.

    Henneman, Philip L; Nathanson, Brian H; Ribeiro, Kara; Balasubramanian, Hari

    2014-10-01

    To determine how age and gender impact resource utilization and profitability in patients seen and released from an Emergency Department (ED). Billing data for patients seen and released from an Emergency Department (ED) with >100,000 annual visits between 2003 and 2009 were collected. Resource utilization was measured by length of stay (placement in ED bed to leaving the bed) and direct clinical costs (e.g., ED nursing salary and benefits, pharmacy and supply costs, etc.) estimated using relative value unit cost accounting. The primary outcome of profitability was defined as contribution margin per hour. A patient's contribution margin by insurance type (excluding self-pay) was determined by subtracting direct clinical costs from facility contractual revenue. Results are expressed as medians and US dollars. In 523 882 outpatient ED encounters, as patients' aged, length of stay and direct clinical cost increased while the contribution margin and contribution margin by hour decreased. Women of childbearing age (15-44) had higher median length of stay (2.1 hours), direct clinical cost ($149), and contribution margin per hour ($103/hour) than men of same age (1.7, $131, $85/hour, respectively). Resource utilization and profitability by gender were similar in children and adults over 45. Resource utilization increased and profitability decreased with increasing age in patients seen and released from an ED. The care of women of childbearing age resulted in higher resource utilization and higher profitability than men of the same age. No differences in resource utilization or profitability by gender were observed in children and adults over 45. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Performance of the modified Richmond Agitation Sedation Scale in identifying delirium  in older ED patients.

    Grossmann, Florian F; Hasemann, Wolfgang; Kressig, Reto W; Bingisser, Roland; Nickel, Christian H

    2017-09-01

    Delirium in older emergency department (ED) patients is associated with severe negative patient outcomes and its detection is challenging for ED clinicians. ED clinicians need easy tools for delirium detection. We aimed to test the performance criteria of the modified Richmond Agitation Sedation Scale (mRASS) in identifying delirium in older ED patients. The mRASS was applied to a sample of consecutive ED patients aged 65 or older by specially trained nurses during an 11-day period in November 2015. Reference standard delirium diagnosis was based on Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria, and was established by geriatricians. Performance criteria were computed. Analyses were repeated in the subsamples of patients with and without dementia. Of 285 patients, 20 (7.0%) had delirium and 41 (14.4%) had dementia. The sensitivity of an mRASS other than 0 to detect delirium was 0.70 (95% confidence interval, CI, 0.48; 0.85), specificity 0.93 (95% CI 0.90; 0.96), positive likelihood ratio 10.31 (95% CI 6.06; 17.51), negative likelihood ratio 0.32 (95% CI 0.16; 0.63). In the sub-sample of patients with dementia, sensitivity was 0.55 (95% CI 0.28; 0.79), specificity 0.83 (95% CI 0.66; 0.93), positive likelihood ratio 3.27 (95% CI 1.25; 8.59), negative likelihood ratio 0.55 (95% CI 0.28; 1.06). The sensitivity of the mRASS to detect delirium in older ED patients was low, especially in patients with dementia. Therefore its usefulness as a stand-alone screening tool is limited. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. The effect of Philadelphia and Pennsylvania Clean Indoor Air Act on food services and drinking places sales and numbers, 1998-2011.

    Ma, Zhen-Qiang; Fisher, Monica A

    2013-11-27

    Philadelphia enacted its Clean Indoor Air Act (CIAA) nearly 2 years before the statewide CIAA. In this study, we assessed the economic impact of CIAAs on 4 types of food services and drinking places and addressed the predominant limitation of previous pre-post ban studies, namely the lack of control for confounders and changes in secular trends over time. We analyzed data from Pennsylvania Department of Revenue Quarterly 1998-2011 taxable county-level revenue sales and number of food services and drinking places. Region-specific and type-specific adjusted sales and number of food services and drinking places accounted for consumer spending as a general economic indicator. Segmented regression analysis of interrupted time-series methodology assessed changes in trend and level. Pennsylvania CIAA had no significant effect on adjusted sales or numbers except for an increase in sales in Philadelphia for limited-service eating places and in the surrounding 4 counties for special food services. Philadelphia CIAA was associated with an increase in adjusted numbers of full-service restaurants in Philadelphia and the rest of the state, special food services in Philadelphia, and drinking places in the rest of the state, and a decrease in the number of special food services in the surrounding counties. Philadelphia CIAA had no significant effect on adjusted sales except for an increase in special food services in the rest of the state. Overall, CIAAs had no negative business-related impact and, for the most part, suggest a positive impact on restaurant sales and numbers. Our results provide further support for comprehensive CIAA ordinance for restaurants.

  3. A comparison of the prevalence of lead-contaminated imported Chinese ceramic dinnerware purchased inside versus outside Philadelphia's Chinatown.

    Gilmore, Thomas; O'Malley, Gerald F; Lau, Wayne Bond; Vann, David R; Bromberg, Adam; Martin, Aaron; Gibbons, Andrea; Rimmer, Evan

    2013-03-01

    Lead-contaminated ceramics can be a clinically significant source of lead poisoning, with the potential to cause illness in children and adults; one death in a child has been described. We hypothesized that the prevalence of lead-contaminated ceramics would be higher within Chinatown versus outside of Chinatown. The study was a prospective observational cross-sectional study. Two areas were defined geographically as being within and outside of Philadelphia's Chinatown, and a predefined number of items were purchased in each area. Each item was screened for lead utilizing a colorimetric testing swab. Positive items were leached for lead using the ASTM C738-94 protocol for lead level quantification. The primary outcome was the prevalence of ceramics not compliant with the FDA standard for leachable lead within and outside of Philadelphia's Chinatown. A total of 132 items were purchased, 46 outside of and 86 within Chinatown. More lead-positive items originated within Chinatown than outside of Chinatown [five positive items, 5.8 % prevalence within Chinatown (95 % confidence interval, CI, 2.5-12.9 %), and zero positive, 0 % prevalence outside of Chinatown (95 % CI 0-7.5 %)]. However, this difference was not found to be statistically significant (P = 0.1624). The leachable lead-positive items were up to 40-fold the acceptable FDA levels. Testing a larger number of items may demonstrate a significant source of lead exposure.

  4. Teaching Russian Via Distance Learning, the EdNet Experience.

    Zsiray, Stephen W., Jr.; And Others

    In Utah, the statewide distance education network (EdNet) enables students from five rural and suburban high schools to learn Russian and earn college credits. Courses in Russian are offered through a partnership involving the Cache County School District, Utah State University, and the Utah State Office of Education. Classes are taught on one…

  5. EdF-Gaz de France. No merger without dismembering

    Lepetit, V.

    2007-01-01

    Gathering together the two historical French energy monopolies, Electricite de France (EdF) and Gaz de France (GdF), and warranting low electricity and gas prices is still an attractive idea for some political and syndicate representatives. However, such a merger would create a dominating position which is forbidden with respect to Brussels criteria. (J.S.)

  6. Mai alguses linastub dokfilm "Sinimäed" / Andris Feldmanis

    Feldmanis, Andris, 1982-

    2006-01-01

    Valminud on 6-osalise ajaloodokumentaalide sarja "Kuum külm sõda" teine film "Sinimäed" : stsenaristid Kiur Aarma, Mart Laar, Eerik-Niiles Kross, Raimo Jõerand : režissöör Raimo Jõerand : Ruut Pictures

  7. lsnjbhakta@gmail.com A Comparative SEM-EDS Elemental

    Michael Horsfall

    effect on food production in terrestrial and aquatic compartment in ... Processing and SEM-EDS analysis of mud: In the laboratory, the ... and for SEM image observation was 15 kV, applying .... by weathering in the Omi acid clay deposit, Japan.

  8. Murray Pittock, ed., The Edinburgh Companion to Scottish Romanticism.

    Manfred Malzahn

    2013-10-01

    Full Text Available Murray Pittock, ed., The Edinburgh Companion to Scottish Romanticism. Edinburgh: Edinburgh University Press, 2011. Pp. 251. ISBN 978-0-7486-3845-1 (hardback. £ 65.00. ISBN 978-0-7486-3846-8 (paperback. £ 21.99.

  9. Review: Sanya Osha (ed.), The Social Contract in Africa (2014)

    Damian Chukwudi Ukwandu

    2014-01-01

    Review of the edited volume:Sanya Osha (ed.), The Social Contract in Africa, Pretoria: Africa Institute for South Africa, 2014, ISBN 978-0-7983-0444-3, 200 pages Besprechung des Sammelbandes:Sanya Osha (Hrsg.), The Social Contract in Africa, Pretoria: Africa Institute for South Africa, 2014, ISBN 978-0-7983-0444-3, 200 Seiten

  10. Psychological and psychopathological variables associated with eating disorders (ED

    Antonio Fernández-Delgado

    2016-07-01

    Full Text Available Objective: The aim of this study was to compare some psychological and psychopathological variables usually associated with different types of patients with eating disorders (ED. A total of 22 variables (psychological, psychopathological and specifically related to TCA were analyzed in three groups of patients with anorexia nervosa (AN, bulimia nervosa (BN and eating disorders not otherwise specified (EDNOS. Method: The sample consisted of 76 patients diagnosed with ED (mean age 20.13 ± 6.28 years; 69 women and 7 men. The following questionnaires were administered: Rosenberg's Self-Esteem Scale (SES, Symptom Checklist-90-Revised (SCL-90-R, Beck's Depression Inventory (BDI, State-Trait Anxiety Inventory (STAI, Body Shape Questionnaire (BSQ, Body Appreciation Scale (BAS, Eating Disorder Inventory-2 (EDI-2 and Body Image Quality of Life Inventory (BIQLI-SP. Results: Generally no significant differences between groups, except for the variables related to the BSQ and EDI-2 questionnaires, were found. The study of the correlations among the different variables specifically related to eating disorders and others, showed differences between groups. Conclusions: The present study shows few differences with respect to psychopathological symptoms among the different types of ED. Bearing in mind future studies, it would be interesting to use a bigger sample size, to include more men, and to distinguish between restricted/purging types of ED.

  11. Using Telemedicine to Address Crowding in the ED.

    Guss, Benjamin; Mishkin, David; Sharma, Rahul

    2016-11-01

    Some health systems are piloting telemedicine solutions in the ED to address crowding and decrease patient wait times. One new program, implemented at the Lisa Perry Emergency Center at New York Presbyterian (NYP) Weill Cornell Medical Center in New York, involves offering low-acuity patients the option of visiting an off-site physician via telemedicine hookup. Administrators note that the approach can get patients in and out of the ED within 30 minutes, and patients have thus far been highly satisfied with the approach. However, an earlier telemedicine program piloted at the University of San Diego Health System’s (UCSD) Hillcrest Hospital in 2013 got bogged down due to administrative and insurance reimbursement hurdles, although the approach showed enough promise that there is interest in restarting the program. In the NYP program, patients are identified as appropriate candidates for the program at triage. They can opt to be seen remotely or through traditional means in the ED’s fast-track section. Administrators note that patients with complex problems requiring extensive workups are not suitable for the telemedicine approach. The most challenging aspect of implementing a successful telemedicine program in the ED is getting the workflows right, according to administrators. An earlier ED-based telemedicine program piloted at UCSD ran into difficulties because the model required the involvement of two physicians, and some insurers did not want to pay for the telemedicine visits. However, patients were receptive.

  12. Validation of the Children's Hospital of Philadelphia Retinopathy of Prematurity (CHOP ROP) Model.

    Binenbaum, Gil; Ying, Gui-Shuang; Tomlinson, Lauren A

    2017-08-01

    The Children's Hospital of Philadelphia Retinopathy of Prematurity (CHOP ROP) model uses birth weight (BW), gestational age at birth (GA), and weight gain rate to predict the risk of severe retinopathy of prematurity (ROP). In a model development study, it predicted all infants requiring treatment, while greatly reducing the number of examinations compared with current screening guidelines. To validate the CHOP ROP model in a multicenter cohort that is large enough to obtain a precise estimate of the model's sensitivity for treatment-requiring ROP. This investigation was a secondary analysis of data from the Postnatal Growth and Retinopathy of Prematurity (G-ROP) Study. The setting was 30 hospitals in the United States and Canada between January 1, 2006, and June 30, 2012. The dates of analysis were September 28 to October 5, 2015. Participants were premature infants at risk for ROP with a known ROP outcome. Sensitivity for Early Treatment of Retinopathy of Prematurity type 1 ROP and potential reduction in the number of infants requiring examinations. In the primary analysis, the CHOP ROP model was applied weekly to predict the risk of ROP. If the risk was above a cut-point level (high risk), examinations were indicated, while low-risk infants received no examinations. In a secondary analysis, low-risk infants received fewer examinations rather than no examinations. Participants included 7483 premature infants at risk for ROP with a known ROP outcome. Their median BW was 1070 g (range, 310-3000 g), and their median GA was 28 weeks (range, 22-35 weeks). Among them, 3575 (47.8%) were female, and their race/ethnicity was 3615 white (48.3%), 2310 black (30.9%), 233 Asian (3.1%), 93 Pacific Islander (1.2%), and 40 American Indian/Alaskan native (0.5%). The original CHOP ROP model correctly predicted 452 of 459 infants who developed type 1 ROP (sensitivity, 98.5%; 95% CI, 96.9%-99.3%), reducing the number of infants requiring examinations by 34.3% if only high

  13. Occupational stress in the ED: a systematic literature review.

    Basu, Subhashis; Qayyum, Hasan; Mason, Suzanne

    2017-07-01

    Occupational stress is a major modern health and safety challenges. While the ED is known to be a high-pressure environment, the specific organisational stressors which affect ED staff have not been established. We conducted a systematic review of literature examining the sources of organisational stress in the ED, their link to adverse health outcomes and interventions designed to address them. A narrative review of contextual factors that may contribute to occupational stress was also performed. All articles written in English, French or Spanish were eligible for conclusion. Study quality was graded using a modified version of the Newcastle-Ottawa Scale. Twenty-five full-text articles were eligible for inclusion in our systematic review. Most were of moderate quality, with two low-quality and two high-quality studies, respectively. While high demand and low job control were commonly featured, other studies demonstrated the role of insufficient support at work, effort-reward imbalance and organisational injustice in the development of adverse health and occupational outcomes. We found only one intervention in a peer-reviewed journal evaluating a stress reduction programme in ED staff. Our review provides a guide to developing interventions that target the origins of stress in the ED. It suggests that those which reduce demand and increase workers' control over their job, improve managerial support, establish better working relationships and make workers' feel more valued for their efforts could be beneficial. We have detailed examples of successful interventions from other fields which may be applicable to this setting. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. TrED: the Trichophyton rubrum Expression Database

    Liu Tao

    2007-07-01

    Full Text Available Abstract Background Trichophyton rubrum is the most common dermatophyte species and the most frequent cause of fungal skin infections in humans worldwide. It's a major concern because feet and nail infections caused by this organism is extremely difficult to cure. A large set of expression data including expressed sequence tags (ESTs and transcriptional profiles of this important fungal pathogen are now available. Careful analysis of these data can give valuable information about potential virulence factors, antigens and novel metabolic pathways. We intend to create an integrated database TrED to facilitate the study of dermatophytes, and enhance the development of effective diagnostic and treatment strategies. Description All publicly available ESTs and expression profiles of T. rubrum during conidial germination in time-course experiments and challenged with antifungal agents are deposited in the database. In addition, comparative genomics hybridization results of 22 dermatophytic fungi strains from three genera, Trichophyton, Microsporum and Epidermophyton, are also included. ESTs are clustered and assembled to elongate the sequence length and abate redundancy. TrED provides functional analysis based on GenBank, Pfam, and KOG databases, along with KEGG pathway and GO vocabulary. It is integrated with a suite of custom web-based tools that facilitate querying and retrieving various EST properties, visualization and comparison of transcriptional profiles, and sequence-similarity searching by BLAST. Conclusion TrED is built upon a relational database, with a web interface offering analytic functions, to provide integrated access to various expression data of T. rubrum and comparative results of dermatophytes. It is devoted to be a comprehensive resource and platform to assist functional genomic studies in dermatophytes. TrED is available from URL: http://www.mgc.ac.cn/TrED/.

  15. Characterising non-urgent users of the emergency department (ED: A retrospective analysis of routine ED data.

    Colin O'Keeffe

    Full Text Available The pressures of patient demand on emergency departments (EDs continue to be reported worldwide, with an associated negative impact on ED crowding and waiting times. It has also been reported that a proportion of attendances to EDs in different international systems could be managed in settings such as primary care. This study used routine ED data to define, measure and profile non-urgent ED attendances that were suitable for management in alternative, non-emergency settings.We undertook a retrospective analysis of three years of Hospital Episode and Statistics Accident Emergency (HES A&E data for one large region in England, United Kingdom (April 1st 2011 to March 31st 2014. Data was collected on all adult (>16 years ED attendances from each of the 19 EDs in the region. A validated process based definition of non-urgent attendance was refined for this study and applied to the data. Using summary statistics non-urgent attenders were examined by variables hypothesised to influence them as follows: age at arrival, time of day and day of week and mode of arrival. Odds ratios were calculated to compare non-urgent attenders between groups.There were 3,667,601 first time attendances to EDs, of which 554,564 were defined as non-urgent (15.1%. Non-urgent attendances were significantly more likely to present out of hours than in hours (OR = 1.19, 95% CI: 1.18 to 1.20, P<0.001. The odds of a non-urgent attendance were significantly higher for younger patients (aged 16-44 compared to those aged 45-64 (odds ratio: 1.42, 95% CI: 1.41 to 1.43, P<0.001 and the over 65's (odds ratio: 3.81, 95% CI: 3.78 to 3.85, P<0.001. Younger patients were significantly more likely to attend non-urgently out of hours compared to the 45-64's (OR = 1.24, 95% CI: 1.22 to 1.25, P<0.001 and the 65+'s (OR = 1.38, 95% CI: 1.35 to 1.40, P<0.001. 110,605/554,564 (19.9% of the non-urgent attendances arrived by ambulance, increasing significantly out of hours versus in hours (OR = 2

  16. Tamsulosin does not increase 1-week passage rate of ureteral stones in ED patients.

    Berger, David A; Ross, Michael A; Hollander, Jay B; Ziadeh, James; Chen, Charity; Jackson, Raymond E; Swor, Robert A

    2015-12-01

    The objective of the study is to determine if tamsulosin initiated in the emergency department (ED) decreases the time to ureteral stone passage at 1 week or time to pain resolution, compared to placebo. We performed a prospective, randomized, double-blinded, placebo-controlled trial of tamsulosin vs placebo in ED patients with ureterolithiasis on computed tomography. Patients were identified and enrolled between April 2007 and February 2009 and were randomized to either 0.4 mg of tamsulosin or placebo for 1 week. We contacted participants using a telephone survey on post-ED visit days 1, 2, 3, and 7. The primary outcome was time to stone passage, with secondary outcomes being maximum pain score and amount of pain medication required. Of the 127 patients enrolled during this study, 15 were lost to follow-up, and 12 required surgical interventions before the 7-day mark, leaving 100 patients for analysis. Of the 100 patients, 53 received tamsulosin and 47 received placebo. There was no difference between groups in percentage of male, mean age, initial serum creatinine, average stone size, stone location, and history of prior stone. The probability that the patient did not pass a stone at 7 days was not different between tamsulosin and placebo, 62.1% (95% confidence interval, 49.1%-75.1%) vs 54.4% (95% confidence interval, 40.3%-68.6%; P = .58). There was no significant difference in the high pain score (P = .12) or hydrocodone/acetaminophen intake (P = .76) between treatment groups at any of the time points. This study reveals no difference in the proportion of stone passage or high pain score and pain medication utilization at 7 days between tamsulosin and placebo. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. The JAK2 V617F mutation involves B- and T-lymphocyte lineages in a subgroup of patients with Philadelphia-chromosome negative chronic myeloproliferative disorders

    Larsen, Thomas Stauffer; Christensen, Jacob Haaber; Hasselbalch, Hans Carl

    2007-01-01

    The JAK2 V617F mutation is a frequent genetic event in the three classical Philadelphia-chromosome negative chronic myeloproliferative disorders (Ph(neg.)-CMPD), polycythemia vera (PV), essential thrombocythemia (ET) and idiopathic myelofibrosis (IMF). Its occurrence varies in frequency in regards...

  18. Muusikamaailm : Rostropovitsh Berliini müüri juures. Philadelphia Curtis Institute ئ 75. Lahti Linnaorkester Jaapanis ja USAs. Domingo taas Washingtonis / Priit Kuusk

    Kuusk, Priit, 1938-

    1999-01-01

    Berliini müüri langemise 10. aastapäevale pühendatud kontserdist 9. nov. Berliinis. Ameerika muusikakõrgkoolist Philadelphia Curtis Institute. Lahti Linnaorkestri kontserdireisist Jaapanisse ja USAsse. P. Domingo on sügishooajal esinenud erinevates Ameerika ooperiteatrites

  19. Muusikamaailm : Uus muusikasaal Philadelphias. Elgari teostekogu jätkatakse. Mortier tuleb ka Pariisi. Salonen loovutas Suomi-palkinto. Uusooper Dallases / Priit Kuusk

    Kuusk, Priit, 1938-

    2001-01-01

    Philadelphia sai uue kontserdisaali. Londoni kirjastus Novello jätkab Edward Elgari kogutud teoste väljaandmist. Belgia teatrimees ja ooperiadministraator Gerard Mortierist saab Ruhri kunstidetriennaali juht. Esa-Pekka Salonen loovutas oma 100 000margalise preemia kolmele noorele soome heliloojale. Dallase Ooperis tuli maailmaesiettekandele USA helilooja Tobias Pickeri ooper "Therese Raquin"

  20. Microgrid Controller Design, Implementation, and Deployment: A Journey from Conception to Implementation at the Philadelphia Navy Yard

    Uluski, R.; Kumar, J.; Venkata, S. S. Mani; Vishwakarma, D.; Schneider, K.; Mehrizi-Sani, Ali; Terry, Rudy; Agate, Will

    2017-07-01

    The Philadelphia Navy Yard is a fast-evolving community microgrid, currently home to over 150 companies and four Navy activity centers occupying nearly 7 million ft2 of buildings in which approximately 12,000 people are employed. The Navy Yard (TNY) is a national center of excellence for energy research, education, and commercialization, focused specifically on community microgrid design and development. TNY microgrid is equipped with the most cost-effective and sustainable means for meeting electric capacity and energy needs through renewable resources, energy efficiency, and distribution grid infrastructure. This article briefly describes how the community microgrid was conceived and planned to produce a great success story of microgrid implementation and the details of the design, development, and implementation of the TNY microgrid controller.

  1. Promoting good health in the age of reform: the medical publications of Henry H. Porter of Philadelphia, 1829-32.

    Horrocks, T A

    1995-01-01

    In the early 1830s, the Philadelphia publisher Henry H. Porter rapidly published five journals, six books, and an almanac, works having a particular emphasis on health and personal hygiene. Porter's health publications linked the traditional message about the importance of personal hygiene to health to the messages conveyed by the flourishing American reform movements at the time, and his Journal of Health was among the first American medically oriented periodicals published for the layperson. Yet Porter did not survive in the intensely competitive and financially unstable book trade. This study examines Porter's health publications, attempting to explain why he chose to publish what he did, the message(s) his works contained, the audience(s) he tried to reach, and the failure of his business.

  2. Filadelfia y la botánica en Norteamérica Philadelphia and the Botany in North America

    Alina Freire-Fierro

    2008-07-01

    Full Text Available El establecimiento y el desarrollo de la investigación botánica en Norteamérica se inician con la fundación de tres instituciones de Filadelfia, la American Philosophical Society en 1743, el Departamento de Botánica de la Universidad de Pennsylvania en 1768 y la Academia de Ciencias Naturales (PH en 1812. Algunos de los botánicos más influyentes durante los últimos cuatro siglos y en particular durante los siglos XVIII y XIX, vivieron en Filadelfia, entre ellos William Bartram (1699-1777, fundador del primer jardín botánico de Norteamérica, Benjamin Smith Barton (1766-1815, escritor del primer libro de texto de botánica en Estados Unidos y posiblemente en toda América, Federico Pursh (1774-1820, autor de una de las floras norteamericanas más completas del siglo XIX, Thomas Nuttall (1786-1859, autor de la primera flora norteamericana a nivel continental y Lewis David von Schweinitz (1780-1834, ampliamente reconocido como el padre de la micología norteamericana. Aunque la botánica alcanzó su cenit en Filadelfia durante el siglo XIX, continúa hoy contribuyendo al desarrollo de la botánica, gracias al aporte de muchas instituciones. El Herbario PH con sus más de 1,4 millones de especímenes y con la proporción más alta de tipos/totalidad de especímenes de todos los herbarios en los Estados Unidos, continúa siendo una fuente importante para estudios sistemáticos, no solo de taxones norteamericanos, sino también de otras regiones del mundo.The establishment and development of botanical research in North America began with the foundation of three Philadelphian institutions: The American Philosophical Society in 1743, the Botany Department at University of Pennsylvania in 1768 and the Academy of Natural Sciences of Philadelphia in 1812. Some of the most influential botanists of the last four centuries, and in particular, the 18th and 19th centuries lived in Philadelphia, including William Bartram (1699-1777, founder of the

  3. Lengths of stay for involuntarily held psychiatric patients in the ED are affected by both patient characteristics and medication use.

    Wilson, Michael P; Brennan, Jesse J; Modesti, Lucia; Deen, James; Anderson, Laura; Vilke, Gary M; Castillo, Edward M

    2015-04-01

    Psychiatric patients experience longer treatment times (length of stay [LOS]) in the emergency department (ED) compared to nonpsychiatric patients. Although patients on involuntary mental health holds are relatively understudied, common wisdom would hold that times for these patients can only be affected by addressing systems issues because they are not free to leave. The objective of this study was to determine whether both selected ED and patient-specific factors were associated with longer LOS. We hypothesized that nonmodifiable factors (age, sex, agitation, presentation during evenings/nights, presentation during weekends, suicidal ideation) would prolong LOS but that potentially modifiable factors (such as use of medication) would reduce LOS. A historical cohort of patients (January 1, 2009-August 16, 2010) placed on involuntary mental health holds was studied in 2 general EDs. A regression model was used to calculate the effects of modifiable and nonmodifiable factors on LOS. Six hundred forty patient visits met all inclusion/exclusion criteria. Longer LOSs were significantly associated with suicidal ideation, use of antipsychotics, and use of benzodiazepines, although agitation did not predict longer LOSs. Longer LOSs were also longer with presentation on the weekends. Lengths of stay for patients on involuntary mental health holds are associated with several factors outside the control of the typical ED clinician such as the ability to clear holds quickly due to day of week or placement of the hold for suicidal ideation. Lengths of stay are also increased by factors within the control of the typical ED clinician, such as administration of calming medication. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Testing the effects of educational toilet posters: a novel way of reducing haemolysis of blood samples within ED.

    Corkill, David

    2012-02-01

    Haemolysed blood samples are an unnecessary burden on Emergency Departments (ED) as they increase workloads and drive down efficiencies. Little empirical data exists that demonstrates the effectiveness of educational posters displayed in staff toilet cubicles. This study explored the impact educational toilet posters have on reducing haemolysis rates within the ED. A time series study of the clinical effect of educational toilet posters on reducing haemolysis rates throughout a 12 month period at the Gold Coast Hospital ED was undertaken. The GCH ED is a tertiary emergency service that has approximately 66,000 patient presentations per year. Data was collected prospectively. Analysis was undertaken to investigate the effects on total number of haemolysed samples and those clinically significant samples with a haemolytic index >3. Further investigation explored the specific effects on medical and nursing staff. Analysis undertaken using an independent t-test found that the pre-intervention data demonstrates a medium haemolysis rate of 4.92% (SD=1.04). This is a statistically significantly different (t=3.56, df=50, p=0.001) from the median post intervention data of 3.95% (SD=0.84). The difference of 0.97% (95%CI=0.42, 1.52) represents a 19.72% reduction in clinically significant haemolysed samples over the study period. This study reveals that the use of educational toilet posters had a positive impact on reducing the rates of haemolysed samples collected within the ED. This simple and cost effective educational initiative changed the behaviour of clinical staff. Further investigation is warranted to examine the impact of educational toilet posters on additional clinical scenarios. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  5. The detection of metallic residues in skin stab wounds by means of SEM-EDS: A pilot study.

    Palazzo, Elisa; Amadasi, Alberto; Boracchi, Michele; Gentile, Guendalina; Maciocco, Francesca; Marchesi, Matteo; Zoja, Riccardo

    2018-05-01

    The morphological analysis of stab wounds may often not be accurate enough to link it with the type of wounding weapon, but a further evaluation may be performed with the search for metallic residues left during the contact between the instrument and the skin. In this study, Scanning Electron Microscopy-Energy Dispersive Spectroscopy (SEM-EDS) was applied to the study of cadaveric stab wounds performed with kitchen knives composed of iron, chromium and nickel, in order to verify the presence of metallic residues on the wound's edge. Two groups of 10 corpses were selected: group A, including victims of stab wounds and a control group B (died of natural causes). Samplings were performed on the lesions and in intact areas of group A, whereas in group B sampling were performed in non-exposed intact skin. Samples were then analysed with optical microscopy and SEM-EDS. In group A, optical microscopic analysis showed the presence of vital haemorrhagic infiltration, while SEM-EDS showed evidence of microscopic metal traces, isolated or clustered, consisting of iron, chromium and nickel. Moreover, in two cases organic residues of calcium and phosphate were detected, as a probable sign of bone lesion. Control samples (group A in intact areas and group B), were negative for the search of exogenous material to optical microscopy and SEM-EDS. The results show the utility and possible application of the SEM-EDS in theidentification of metallic residues from sharp weapons on the skin. Copyright © 2017 The Chartered Society of Forensic Sciences. Published by Elsevier B.V. All rights reserved.

  6. Characteristics of Black Men Who Have Sex With Men in Baltimore, Philadelphia, and Washington, D.C.: Geographic Diversity in Socio-Demographics and HIV Transmission Risk.

    German, Danielle; Brady, Kathleen; Kuo, Irene; Opoku, Jenevieve; Flynn, Colin; Patrick, Rudy; Park, Ju Nyeong; Adams, Joella; Carroll, Makeda; Simmons, Ron; Smith, Carlton R; Davis, Wendy W

    2017-07-01

    Baltimore, Philadelphia, and Washington, DC are geographically proximate cities with high HIV prevalence, including among black men who have sex with men (BMSM). Using data collected among BMSM in CDC's National HIV Behavioral Surveillance project, we compared socio-demographic characteristics, HIV risk behaviors, and service utilization to explore similarities and differences that could inform local and regional HIV intervention approaches. BMSM were recruited through venue time location sampling, June-December, 2011. Participants completed identical socio-behavioral surveys and voluntary HIV testing. Analyses were conducted among the full sample and those aged 18-24. Participants included 159 (DC), 364 (Baltimore), and 331 (Philadelphia) eligible BMSM. HIV prevalence was 23.1% (DC), 48.0% (Baltimore), 14.6% (Philadelphia) with 30.6%, 69.0%, 33.3% unrecognized HIV infection, respectively. Among BMSM 18-24, HIV prevalence was 11.1% (DC), 38.9% (Baltimore), 9.6% (Philadelphia) with unrecognized HIV infection 0.0%, 73.8%, 60.0% respectively. Compared with the other 2 cities, Baltimore participants were less likely to identify as gay/homosexual; more likely to report unemployment, incarceration, homelessness, sex exchange; and least likely to use the internet for partners. DC participants were more likely to have a college degree and employment. Philadelphia participants were more likely to report gay/homosexual identity, receptive condomless anal sex, having only main partners, and bars/clubs as partner meeting places. Sexually transmitted disease testing was universally low. Analyses showed especially high HIV prevalence among BMSM in Baltimore including among young BMSM. Socio-demographic characteristics and HIV infection correlates differed across cities but unrecognized HIV infection and unknown partner status were universally high.

  7. Funding quality pre-kindergarten slots with Philadelphia's new 'sugary drink tax': simulating effects of using an excise tax to address a social determinant of health.

    Langellier, Brent A; Lê-Scherban, Félice; Purtle, Jonathan

    2017-09-01

    Philadelphia passed a 1·5-cent-per-ounce sweetened beverage tax (SBT). Revenue will fund 10 000 quality pre-kindergarten slots for poor children. It is imperative to understand how revenue from SBT can be used to fund programmes to address education and other social determinants of health. The objective of the present study was to simulate quality pre-kindergarten attendance, educational achievement and sugar-sweetened beverage (SSB) consumption among Philadelphia children and adolescents under six intervention scenarios: (i) no intervention; (ii) 10 000 additional quality pre-kindergarten slots; (iii) a 1·5-cent-per-ounce SBT; (iv) expanded pre-kindergarten and 1·5-cent-per-ounce SBT; (v) a 3-cent-per-ounce SBT; and (vi) expanded pre-kindergarten and 3-cent-per-ounce SBT. We used an agent-based model to estimate pre-kindergarten enrolment, educational achievement and SSB consumption under the six policy scenarios. We identified key parameters in the model from the published literature and secondary analyses of the Panel Study of Income Dynamics - Child Development Supplement. Philadelphia, Pennsylvania, USA. Philadelphia children and adolescents aged 4-18 years. A 1·5-cents-per-ounce tax would reduce SSB consumption by 1·3 drinks/week among Philadelphia children and adolescents relative to no intervention, with larger effects among children below the poverty level. Quality pre-kindergarten expansion magnifies the effect of the SBT by 8 %, but has the largest effect on moderate-income children just above the poverty level. The SBT and quality pre-kindergarten programme each reduce SSB consumption, but primarily benefit different children and adolescents. Pairing an excise tax with a complementary programme to improve a social determinant of health represents a progressive strategy to combat obesity, a disease regressive in its social patterning.

  8. Voluntary Medication Error Reporting by ED Nurses: Examining the Association With Work Environment and Social Capital.

    Farag, Amany; Blegen, Mary; Gedney-Lose, Amalia; Lose, Daniel; Perkhounkova, Yelena

    2017-05-01

    Medication errors are one of the most frequently occurring errors in health care settings. The complexity of the ED work environment places patients at risk for medication errors. Most hospitals rely on nurses' voluntary medication error reporting, but these errors are under-reported. The purpose of this study was to examine the relationship among work environment (nurse manager leadership style and safety climate), social capital (warmth and belonging relationships and organizational trust), and nurses' willingness to report medication errors. A cross-sectional descriptive design using a questionnaire with a convenience sample of emergency nurses was used. Data were analyzed using descriptive, correlation, Mann-Whitney U, and Kruskal-Wallis statistics. A total of 71 emergency nurses were included in the study. Emergency nurses' willingness to report errors decreased as the nurses' years of experience increased (r = -0.25, P = .03). Their willingness to report errors increased when they received more feedback about errors (r = 0.25, P = .03) and when their managers used a transactional leadership style (r = 0.28, P = .01). ED nurse managers can modify their leadership style to encourage error reporting. Timely feedback after an error report is particularly important. Engaging experienced nurses to understand error root causes could increase voluntary error reporting. Published by Elsevier Inc.

  9. Ultrasound-guided axillary nerve block for ED incision and drainage of deltoid abscess.

    Lyons, Claire; Herring, Andrew A

    2017-07-01

    Deltoid abscesses are common and painful, often a consequence of injection drug use and seen frequently in emergency departments (EDs). The required incision and drainage can be completed successfully with effective pain relief using a peripheral nerve block. The brachial plexus nerve block works well, however it is technically complex with a low, but potentially serious, risk of complications such as phrenic nerve paralysis. Selective blockade of the axillary nerve eliminates the risks associated with a brachial plexus block, while providing more specific anesthesia for the deltoid region. Our initial experience suggests that the axillary nerve block (ANB) is a technically simple, safe, and effective way to manage the pain of deltoid abscesses and the necessary incision and drainage (I&D). The block involves using ultrasound guidance to inject a 20mL bolus of local anesthetic into the quadrangular space surrounding the axillary nerve (inferior to the posterolateral aspect of the acromion, near the overlap of the long head of triceps brachii and teres minor). Once injected the local will anesthetize the axillary nerve resulting in analgesia of the cutaneous area of the lateral shoulder and the deeper tissues including the deltoid muscle. Further research will clarify questions about the volume and concentration of local anesthetic, the role of injected adjuncts, and expected duration of analgesia and anesthesia. Herein we present a description of an axillary nerve block successfully used for deltoid abscess I&D in the ED. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. MobilED: a step backwards to look ahead

    Van Den Berg, M

    2008-10-01

    Full Text Available Psychology, 52(3), 476-485. Gamache, P. (2002). University Students as Creators of Personal Knowledge: an alternative epistemological view. Teaching in Higher Education, 7(3), 277. Garcia, L., & Quek, F. (1997). Qualitative research in information systems... Kenney & N. Nieveen (Eds.), Educational Design Research (pp. 52-67). London: Routledge. Reeves, T. C., Herrington, J., & Olivier, R. (2005). Design Research: A Socially Responsible Approach to Instructional Technology Research in Higher Education...

  11. Attività antimicrobica, antivirale ed immunomodulante di peptidi anticorpali

    Ciociola, Tecla

    2011-01-01

    Il progetto complessivo si è proposto di studiare le potenzialità immunoterapeutiche ed immunomodulanti di peptidi sintetici di derivazione anticorpale. I peptidi correlati ai CDR e molti decapeptidi, rappresentanti la regione variabile di un Ab anti-idiotipico ricombinante immagine interna di una tossina killer di lievito, hanno esibito attività fungicida in vitro nei confronti di Candida albicans. Un derivato alaninico di un decapeptide candidacida ha mostrato una incrementata efficacia ter...

  12. Azione citodifferenziante ed antitumorale dell'acido ellagico

    Vanella, Luca

    2011-01-01

    Il lavoro ha lo scopo di valutare l'effetto citodifferenziante ed antitumorale dell'acido ellagico in tre diverse linee cellulari prostatiche a diverso grado di invasivita' (DU145, LnCap, BPH1). I risultati della Cromogranina A e della P75 NGRF, ottenuti mediante immunofluorescenza, evidenziano un'azione citodifferenziante dell'acido ellagico in maniera dose dipendente. Inoltre i risultati dimostrano come l'acido ellagico abbia la capacita' di ridurre, in maniera dose dipendente, sia l'espres...

  13. ED utilization trends in sports-related traumatic brain injury.

    Hanson, Holly R; Pomerantz, Wendy J; Gittelman, Mike

    2013-10-01

    Emergency department (ED) visits for sports-related traumatic brain injuries (TBIs) have risen. This study evaluated how the number and severity of admissions have changed as ED visits for sports-related TBIs have increased. A retrospective study of children aged 0 to 19 years at a level 1 trauma center was performed. Patients from 2002 to 2011 with a primary or secondary diagnosis of TBI were identified from the hospital's inpatient and outpatient trauma registries. Frequencies were used to characterize the population, χ(2) analysis was performed to determine differences between groups, and regression analysis looked at relationship between year and injury severity score or length of stay. Sport was responsible for injury in 3878 (15.4%) cases during the study period; 3506 (90.4%) were discharged from the hospital, and 372 (9.6%) were admitted. Seventy-three percent were male patients and 78% Caucasian; mean age was 13 ± 3.5 years. ED visits for sports-related TBIs increased 92% over the study period, yet there was no significant change (χ(2) = 9.8, df = 9, P = .37) in the percentage of children admitted. Mean injury severity score for those admitted decreased from 7.8 to 4.8 (β = -0.46; P = .006); length of stay trended downward (β = -0.05; P = .05). The percentage of children being admitted from the ED with sports-related TBI has not changed over the past 10 years. The severity of admitted sports-related TBI is decreasing. Additional research is needed to correlate these trends with other TBI mechanisms.

  14. A comparison of the analysis of REE-bearing phosphates by standardless EDS and standardised EDS and WDS

    Griffin, B.J.; Hancock, R.C.; Trautman, R.L.

    2002-01-01

    Full text: Current generation energy dispersive X-ray analysis systems EDS on SEM are user-friendly with 'simple' software interfaces. Minimal training is considered necessary for operation. One aim of this study was to test this hypothesis. The second aim, as a part of other studies, was to compare the results of the x-ray microanalysis of a suite of rare earth element (REE) bearing standard glasses and also a suite of rare earth element (REE) bearing phosphate mineral grains using different analytical systems. Our results from the same sample mounts have been obtained using three analytical systems: an Oxford Instruments ISIS EDS on a JEOL 6400 SEM, a Noran Voyager EDS on a JEOL 6400 SEM and a Moran Scientific WDS package on a JEOL 6400 SEM. A total of forty nine natural mineral grains have been analysed for twenty-two elements, including the REE, Ca, P and F (where possible) by each analytical system. Additional analyses were obtained from simple REE-bearing glass standards, each containing only one REE at around 11 wt %. The natural mineral grain results obtained from the different analytical systems show a number of significant variations. The two EDS datasets are comparable in terms of total REE but generally are a factor of two less than the WDS dataset. Internally the EDS datasets differ in that one set shows consistently a strong negative yttrium oxide result (typically -1 wt %) due to an excessive correction for a strong phosphorus overlap (Ka on La) whereas the second dataset shows the reverse with typically 1 wt % yttrium oxide reported, as a result of inadequate correction of the phosphorus overlap. Major elements are comparable between the standard-based datasets but not with the standardless dataset although all show similar reproducibility. The standard glass results are more coherent and consistent, as would be expected from the simpler composition and higher abundances. One clear outcome from these data is that complex compositions where

  15. Isolation of flow and nonflow correlations by two- and four-particle cumulant measurements of azimuthal harmonics in elsevier.com/xml/xocs/dtd" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://www.elsevier.com/xml/ja/dtd" xmlns:ja="http://www.elsevier.com/xml/ja/dtd" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:tb="http://www.elsevier.com/xml/common/table/dtd" xmlns:sb="http://www.elsevier.com/xml/common/struct-bib/dtd" xmlns:ce="http://www.elsevier.com/xml/common/dtd" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:cals="http://www.elsevier.com/xml/common/cals/dtd" xmlns:sa="http://www.elsevier.com/xml/common/struct-aff/dtd">sNN=200 GeV Au+Au collisions

    Abdelwahab, N. M.; Adamczyk, L.; Adkins, J. K.; Agakishiev, G.; Aggarwal, M. M.; Ahammed, Z.; Alekseev, I.; Alford, J.; Anson, C. D.; Aparin, A.; Arkhipkin, D.; Aschenauer, E. C.; Averichev, G. S.; Banerjee, A.; Beavis, D. R.; Bellwied, R.; Bhasin, A.; Bhati, A. K.; Bhattarai, P.; Bielcik, J.; Bielcikova, J.; Bland, L. C.; Bordyuzhin, I. G.; Borowski, W.; Bouchet, J.; Brandin, A. V.; Brovko, S. G.; Bültmann, S.; Bunzarov, I.; Burton, T. P.; Butterworth, J.; Caines, H.; Calderón de la Barca Sánchez, M.; Campbell, J. M.; Cebra, D.; Cendejas, R.; Cervantes, M. C.; Chaloupka, P.; Chang, Z.; Chattopadhyay, S.; Chen, H. F.; Chen, J. H.; Chen, L.; Cheng, J.; Cherney, M.; Chikanian, A.; Christie, W.; Codrington, M. J. M.; Contin, G.; Cramer, J. G.; Crawford, H. J.; Cui, X.; Das, S.; Davila Leyva, A.; De Silva, L. C.; Debbe, R. R.; Dedovich, T. G.; Deng, J.; Derevschikov, A. A.; Derradi de Souza, R.; di Ruzza, B.; Didenko, L.; Dilks, C.; Ding, F.; Djawotho, P.; Dong, X.; Drachenberg, J. L.; Draper, J. E.; Du, C. M.; Dunkelberger, L. E.; Dunlop, J. C.; Efimov, L. G.; Engelage, J.; Engle, K. S.; Eppley, G.; Eun, L.; Evdokimov, O.; Eyser, O.; Fatemi, R.; Fazio, S.; Fedorisin, J.; Filip, P.; Fisyak, Y.; Flores, C. E.; Gagliardi, C. A.; Gangadharan, D. R.; Garand, D.; Geurts, F.; Gibson, A.; Girard, M.; Gliske, S.; Greiner, L.; Grosnick, D.; Gunarathne, D. S.; Guo, Y.; Gupta, A.; Gupta, S.; Guryn, W.; Haag, B.; Hamed, A.; Han, L-X.; Haque, R.; Harris, J. W.; Heppelmann, S.; Hirsch, A.; Hoffmann, G. W.; Hofman, D. J.; Horvat, S.; Huang, B.; Huang, H. Z.; Huang, X.; Huck, P.; Humanic, T. J.; Igo, G.; Jacobs, W. W.; Jang, H.; Judd, E. G.; Kabana, S.; Kalinkin, D.; Kang, K.; Kauder, K.; Ke, H. W.; Keane, D.; Kechechyan, A.; Kesich, A.; Khan, Z. H.; Kikola, D. P.; Kisel, I.; Kisiel, A.; Koetke, D. D.; Kollegger, T.; Konzer, J.; Koralt, I.; Kosarzewski, L. K.; Kotchenda, L.; Kraishan, A. F.; Kravtsov, P.; Krueger, K.; Kulakov, I.; Kumar, L.; Kycia, R. A.; Lamont, M. A. C.; Landgraf, J. M.; Landry, K. D.; Lauret, J.; Lebedev, A.; Lednicky, R.; Lee, J. H.; Li, C.; Li, W.; Li, X.; Li, X.; Li, Y.; Li, Z. M.; Lisa, M. A.; Liu, F.; Ljubicic, T.; Llope, W. J.; Lomnitz, M.; Longacre, R. S.; Luo, X.; Ma, G. L.; Ma, Y. G.; Mahapatra, D. P.; Majka, R.; Margetis, S.; Markert, C.; Masui, H.; Matis, H. S.; McDonald, D.; McShane, T. S.; Minaev, N. G.; Mioduszewski, S.; Mohanty, B.; Mondal, M. M.; Morozov, D. A.; Mustafa, M. K.; Nandi, B. K.; Nasim, Md.; Nayak, T. K.; Nelson, J. M.; Nigmatkulov, G.; Nogach, L. V.; Noh, S. Y.; Novak, J.; Nurushev, S. B.; Odyniec, G.; Ogawa, A.; Oh, K.; Ohlson, A.; Okorokov, V.; Oldag, E. W.; Olvitt, D. L.; Page, B. S.; Pan, Y. X.; Pandit, Y.; Panebratsev, Y.; Pawlak, T.; Pawlik, B.; Pei, H.; Perkins, C.; Pile, P.; Planinic, M.; Pluta, J.; Poljak, N.; Poniatowska, K.; Porter, J.; Poskanzer, A. M.; Pruthi, N. K.; Przybycien, M.; Putschke, J.; Qiu, H.; Quintero, A.; Ramachandran, S.; Raniwala, R.; Raniwala, S.; Ray, R. L.; Riley, C. K.; Ritter, H. G.; Roberts, J. B.; Rogachevskiy, O. V.; Romero, J. L.; Ross, J. F.; Roy, A.; Ruan, L.; Rusnak, J.; Rusnakova, O.; Sahoo, N. R.; Sahu, P. K.; Sakrejda, I.; Salur, S.; Sandacz, A.; Sandweiss, J.; Sangaline, E.; Sarkar, A.; Schambach, J.; Scharenberg, R. P.; Schmah, A. M.; Schmidke, W. B.; Schmitz, N.; Seger, J.; Seyboth, P.; Shah, N.; Shahaliev, E.; Shanmuganathan, P. V.; Shao, M.; Sharma, B.; Shen, W. Q.; Shi, S. S.; Shou, Q. Y.; Sichtermann, E. P.; Simko, M.; Skoby, M. J.; Smirnov, D.; Smirnov, N.; Solanki, D.; Sorensen, P.; Spinka, H. M.; Srivastava, B.; Stanislaus, T. D. S.; Stevens, J. R.; Stock, R.; Strikhanov, M.; Stringfellow, B.; Sumbera, M.; Sun, X.; Sun, X. M.; Sun, Y.; Sun, Z.; Surrow, B.; Svirida, D. N.; Symons, T. J. M.; Szelezniak, M. A.; Takahashi, J.; Tang, A. H.; Tang, Z.; Tarnowsky, T.; Thomas, J. H.; Timmins, A. R.; Tlusty, D.; Tokarev, M.; Trentalange, S.; Tribble, R. E.; Tribedy, P.; Trzeciak, B. A.; Tsai, O. D.; Turnau, J.; Ullrich, T.; Underwood, D. G.; Van Buren, G.; van Nieuwenhuizen, G.; Vandenbroucke, M.; Vanfossen, J. A.; Varma, R.; Vasconcelos, G. M. S.; Vasiliev, A. N.; Vertesi, R.; Videbæk, F.; Viyogi, Y. P.; Vokal, S.; Vossen, A.; Wada, M.; Wang, F.; Wang, G.; Wang, H.; Wang, J. S.; Wang, X. L.; Wang, Y.; Wang, Y.; Webb, G.; Webb, J. C.; Westfall, G. D.; Wieman, H.; Wissink, S. W.; Wu, Y. F.; Xiao, Z.; Xie, W.; Xin, K.; Xu, H.; Xu, J.; Xu, N.; Xu, Q. H.; Xu, Y.; Xu, Z.; Yan, W.; Yang, C.; Yang, Y.; Yang, Y.; Ye, Z.; Yepes, P.; Yi, L.; Yip, K.; Yoo, I-K.; Yu, N.; Zbroszczyk, H.; Zha, W.; Zhang, J. B.; Zhang, J. L.; Zhang, S.; Zhang, X. P.; Zhang, Y.; Zhang, Z. P.; Zhao, F.; Zhao, J.; Zhong, C.; Zhu, X.; Zhu, Y. H.; Zoulkarneeva, Y.; Zyzak, M.

    2015-05-01

    A data-driven method was applied to Au+Au collisions at root S-NN = 200 GeV made with the STAR detector at RHIC to isolate pseudorapidity distance Delta eta-dependent and Delta eta-independent correlations by using two- and four-particle azimuthal cumulant measurements. We identified a Delta eta-independent component of the correlation, which is dominated by anisotropic flow and flow fluctuations. It was also found to be independent of. within the measured range of pseudorapidity vertical bar eta vertical bar < 1. In 20-30% central Au+Au collisions, the relative flow fluctuation was found to be 34% +/- 2%(stat.) +/- 3%(sys.) for particles with transverse momentum p(T) less than 2 GeV/c. The Delta eta-dependent part, attributed to nonflow correlations, is found to be 5% +/- 2%(sys.) relative to the flow of the measured second harmonic cumulant at vertical bar Delta eta vertical bar > 0.7. (C) 2015 The Authors. Published by Elsevier B.V.

  16. Self-Esteem and Emotional Intelligence among B.Ed Trainees of Tsunami Affected Coastal Belt

    Babu M, Sameer

    2008-01-01

    Through this study the author investigates the relationship between self-esteem and emotional intelligence among B.Ed trainees of Tsunami affected coastal belt of Alappey district of Kerala, India. Stream of study, marital status and age based comparisons were made among the B.Ed trainees. 92 B.Ed trainees were the participants in the study. It…

  17. 34 CFR 110.1 - What is the purpose of ED's age discrimination regulations?

    2010-07-01

    ... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE General § 110.1 What is the purpose of ED's age discrimination regulations? The purpose of these regulations is to set out ED's rules for implementing the Age... 34 Education 1 2010-07-01 2010-07-01 false What is the purpose of ED's age discrimination...

  18. Mortal waiting for EdF and Gaz de France

    Jemain, A.

    2003-01-01

    Electricite de France (EdF) and Gaz de France (GdF) utilities have announced important investment programs for the forthcoming opening of gas and electricity markets to 2.5 millions of professionals by July 1, 2004. However, nothing can be done before the approval of the French government has been given for the change of their statuses (from the industrial and commercial public company status to the anonymous company status) and for the opening of their capital. Short paper. (J.S.)

  19. Open digital badges in Open edX

    Hickey, Daniel T.; Barba, Lorena A.; Lemoie, Kerri; Amigot, Michael; Ewens, Damian

    2014-01-01

    Slides for the presentation at the Open edX Conference, Cambridge, MA 2014.   This talk presented the first public update of our collaboration to implement open digital badges in Dr. Barba's new MOOC, "Practical Numerical Methods with Python." It's a collaboration between Indiana University's Center for Research on Learning and Technology (led by Prof. Daniel T. Hickey);  Prof. Lorena Barba and her team at George Washington University, with her partners at IBL Studios Education, and...

  20. Esther Schor, ed. The Cambridge Companion to Mary Shelley

    Anne BERTON

    2006-06-01

    Full Text Available “Today, whether she is found between staid cloth covers, in paperback, on the screen or in cyberspace, Mary Shelley is everywhere,” writes Esther Schor in her Introduction to this collection of essays (2. Interest in “the Author of Frankenstein” and of other works has grown steadily over the last twenty years, thanks notably to the publication of her Journals (The Journals of Mary Shelley, 1814-1844, ed. Paula R. Feldman and Diana Scott-Kilvert, 2 vols, Oxford: Clarendon, 1987, of her Lette...

  1. Bacteraemia in the ED: Are We Meeting Targets?

    Borhan, N

    2018-03-01

    When sepsis is identified early in the Emergency Department (ED) and its severe form is treated aggressively with the protocolised care bundle of early goal directed therapy (EGDT), improvements in mortality are significant1,2. Surviving sepsis guidelines recommend the administration of effective intravenous antimicrobials within the first hour of recognition of septic shock and severe sepsis without septic shock3. The Mater University Hospital has antimicrobial guidelines to guide empiric prescribing in adult sepsis available on the hospital intranet and on a smartphone app.

  2. The law that threatens EdF's monopoly

    Dupin, L.

    2010-01-01

    The French house of commons has examined the bill about the new organisation of the French electricity market (Nome in French). Its goal is to reform the actual market and to create a real competition. The bill has five stakes: to put an end to the European dispute, to give to EdF's competitors an access to its nuclear production, to improve the management of consumption peaks, to harmonize the generation and the consumption prices, to prepare the French market to the real competition. (J.S.)

  3. Offensive strategy: Suez wants to hustle EdF

    Jemain, A.

    2003-01-01

    Using Electrabel, its new energy pole, the private company Suez is looking for multiple ways of entry to reinforce its positions in France in the gas and electric power sectors in the prospect of the complete opening of energy markets in 2004. This article analyzes the strategy of Suez to become the most credible challenger of EdF, the French historical national electric utility: reorganization of its industrial and commercial activities, gain of new clients and definition of a new strategy for the gas market. (J.S.)

  4. TaEDS1 genes positively regulate resistance to powdery mildew in wheat.

    Chen, Guiping; Wei, Bo; Li, Guoliang; Gong, Caiyan; Fan, Renchun; Zhang, Xiangqi

    2018-04-01

    Three EDS1 genes were cloned from common wheat and were demonstrated to positively regulate resistance to powdery mildew in wheat. The EDS1 proteins play important roles in plant basal resistance and TIR-NB-LRR protein-triggered resistance in dicots. Until now, there have been very few studies on EDS1 in monocots, and none in wheat. Here, we report on three common wheat orthologous genes of EDS1 family (TaEDS1-5A, 5B and 5D) and their function in powdery mildew resistance. Comparisons of these genes with their orthologs in diploid ancestors revealed that EDS1 is a conserved gene family in Triticeae. The cDNA sequence similarity among the three TaEDS1 genes was greater than 96.5%, and they shared sequence similarities of more than 99.6% with the respective orthologs from diploid ancestors. The phylogenetic analysis revealed that the EDS1 family originated prior to the differentiation of monocots and dicots, and EDS1 members have since undergone clear structural differentiation. The transcriptional levels of TaEDS1 genes in the leaves were obviously higher than those of the other organs, and they were induced by Blumeria graminis f. sp. tritici (Bgt) infection and salicylic acid (SA) treatment. The BSMV-VIGS experiments indicated that knock-down the transcriptional levels of the TaEDS1 genes in a powdery mildew-resistant variety of common wheat compromised resistance. Contrarily, transient overexpression of TaEDS1 genes in a susceptible common wheat variety significantly reduced the haustorium index and attenuated the growth of Bgt. Furthermore, the expression of TaEDS1 genes in the Arabidopsis mutant eds1-1 complemented its susceptible phenotype to powdery mildew. The above evidences strongly suggest that TaEDS1 acts as a positive regulator and confers resistance against powdery mildew in common wheat.

  5. The ED use and non-urgent visits of elderly patients

    Gulacti, Umut; Lok, Ugur; Celik, Murat; Aktas, Nurettin; Polat, Haci

    2016-01-01

    Objective: To evaluate the use of the emergency department (ED) by elderly patients, their non-urgent visits and the prevalence of main disease for ED visits. Methods: This cross-sectional study was conducted on patients aged 65 years and over who visited the ED of a tertiary care university hospital in Turkey between January 2015 and January 2016 retrospectively. Results: A total of 36,369 elderly patients who visited the ED were included in the study. The rate of ED visits by elderly patien...

  6. The Effect of Selected Cleaning Techniques on Berkshire Lee Marble: A Scientific Study at Philadelphia City Hall

    Mossotti, Victor G.; Eldeeb, A. Raouf; Fries, Terry L.; Coombs, Mary Jane; Naude, Virginia N.; Soderberg, Lisa; Wheeler, George S.

    2002-01-01

    This report describes a scientific investigation of the effects of eight different cleaning techniques on the Berkshire Lee marble component of the facade of the East Center Pavilion at Philadelphia City Hall; the study was commissioned by the city of Philadelphia. The eight cleaning techniques evaluated in this study were power wash (proprietary gel detergent followed by water rinse under pressure), misting (treatment with potable, nebulized water for 24-36 hours), gommage (proprietary Thomann-Hanry low-pressure, air-driven, small-particle, dry abrasion), combination (gommage followed by misting), Armax (sodium bicarbonate delivered under pressure in a water wash), JOS (dolomite powder delivered in a low-pressure, rotary-vortex water wash), laser (thermal ablation), and dry ice (powdered-dry-ice abrasion delivered under pressure). In our study approximately 160 cores were removed from the building for laboratory analysis. We developed a computer program to analyze scanning-electron-micrograph images for the microscale surface roughness and other morphologic parameters of the stone surface, including the near-surface fracture density of the stone. An analysis of more than 1,100 samples cut from the cores provided a statistical basis for crafting the essential elements of a reduced-form, mixed-kinetics conceptual model that represents the deterioration of calcareous stone in terms of self-organized soiling and erosion patterns. This model, in turn, provided a basis for identifying the variables that are affected by the cleaning techniques and for evaluating the extent to which such variables influence the stability of the stone. The model recognizes three classes of variables that may influence the soiling load on the stone, including such exogenous environmental variables as airborne moisture, pollutant concentrations, and local aerodynamics, and such endogenous stone variables as surface chemistry and microstructure (fracturing, roughness, and so on). This study

  7. The ED use and non-urgent visits of elderly patients.

    Gulacti, Umut; Lok, Ugur; Celik, Murat; Aktas, Nurettin; Polat, Haci

    2016-12-01

    To evaluate the use of the emergency department (ED) by elderly patients, their non-urgent visits and the prevalence of main disease for ED visits. This cross-sectional study was conducted on patients aged 65 years and over who visited the ED of a tertiary care university hospital in Turkey between January 2015 and January 2016 retrospectively. A total of 36,369 elderly patients who visited the ED were included in the study. The rate of ED visits by elderly patients was higher than their representation within the general population (p elderly patients visiting polyclinics was 15.8%, the rate of elderly patients visiting the ED was 24.3% (p elderly age groups (p elderly population (17.5%, CI: 17.1-17.9). The proportion of ED visits for non-urgent conditions was 23.4%. Most of the ED visits were during the non-business hours (51.1%), and they were highest in the winter season (25.9%) and in January (10.2%). The hospitalization rate was 9.4%, and 37.9% of hospitalized patients were admitted to intensive care units. The proportion of ED visits by elderly patients was higher than their representation within the general population. Elderly patients often visited the ED instead of a polyclinic. The rate of inappropriate ED use by elderly patients in this hospital was higher than in other countries.

  8. Improving ED specimen TAT using Lean Six Sigma.

    Sanders, Janet H; Karr, Tedd

    2015-01-01

    Lean and Six Sigma are continuous improvement methodologies that have garnered international fame for improving manufacturing and service processes. Increasingly these methodologies are demonstrating their power to also improve healthcare processes. The purpose of this paper is to discuss a case study for the application of Lean and Six Sigma tools in the reduction of turnaround time (TAT) for Emergency Department (ED) specimens. This application of the scientific methodologies uncovered opportunities to improve the entire ED to lab system for the specimens. This case study provides details on the completion of a Lean Six Sigma project in a 1,000 bed tertiary care teaching hospital. Six Sigma's Define, Measure, Analyze, Improve, and Control methodology is very similar to good medical practice: first, relevant information is obtained and assembled; second, a careful and thorough diagnosis is completed; third, a treatment is proposed and implemented; and fourth, checks are made to determine if the treatment was effective. Lean's primary goal is to do more with less work and waste. The Lean methodology was used to identify and eliminate waste through rapid implementation of change. The initial focus of this project was the reduction of turn-around-times for ED specimens. However, the results led to better processes for both the internal and external customers of this and other processes. The project results included: a 50 percent decrease in vials used for testing, a 50 percent decrease in unused or extra specimens, a 90 percent decrease in ED specimens without orders, a 30 percent decrease in complete blood count analysis (CBCA) Median TAT, a 50 percent decrease in CBCA TAT Variation, a 10 percent decrease in Troponin TAT Variation, a 18.2 percent decrease in URPN TAT Variation, and a 2-5 minute decrease in ED registered nurses rainbow draw time. This case study demonstrated how the quantitative power of Six Sigma and the speed of Lean worked in harmony to improve

  9. EdF let Germans manage Stredoslovenska Energetika

    Janoska, J.

    2003-01-01

    According to provisions of privatisation and shareholders agreement Stredoslovenska energetika (SSE), a.s., Zilina should be managed by the largest European power concern Electricite de France (EdF). But so far, one year after the acquisition, the only French member of the Supervisory board is its Chairman Patrick Luccioni. The Board has 5 members and two of them are German - Peter Weis and Martin Konerman. The latter joined in September this year. He came to Slovakia after years spent in Boards of Hungarian distribution companies - Elmu in Budapest and Emasz in Miskolcz. The name of Peter Weis still can be found on the web page of Emasz on the list of members of Supervisory Board. Strategic partner in both the mentioned Hungarian distribution companies is the third largest player on the German energy market - Energie Baden-Wurttemberg (EnBW). The French concern with its 35-percent stake is the biggest individual shareholder of the EnBW. EdF is reassessing its international projects. Due to an investment embargo the French will not be among the prospects interested in acquisition of Slovenske elektrarne, a.s., Bratislava but the company management has also announced its intention to sell its minority stakes in northern and eastern Europe. The Paris head office of EdF announced its decision in the time when privatisation of Slovak distribution companies was culminating. And so in order to maintain its influence the 49-percent stake in SSE together with management control over the company will be transferred to EnBW. Spokeswoman of EnBW, Petra Wollmer did not say the company would not plan any acquisitions in area of its core business but stressed that these would have to be thoroughly examined. She did not wish to comment on any potential plans the company may have in Slovakia or that would relate to changes in the management bodies of SSE. Not even the Head of Communication Department of the Slovak distribution company, Pavel Muller was allowed to publish any

  10. Acculturation and Post-Migration Stress in Middle-Aged Chinese Immigrant Women in Philadelphia: Variation between the Fujianese and the non-Fujianese women

    Ying, Yu-Wen; Han, Meekyung; Tseng, Marilyn

    2012-01-01

    The experience of acculturation in Chinese immigrant women from the rural coastal province of Fujian has not been well studied despite of their growing numbers in American cities. This exploratory study is an attempt to examine the experience of acculturation and post-migration stress in Fujianese immigrant women as compared to those from other parts of China. The study is based on a convenience sample 240 Fujianese and 162 non-Fujianese Chinese immigrant women living in Philadelphia.

  11. Recurrent gastrointestinal hemorrhage in treatment with dasatinib in a patient showing SMAD4 mutation with acute lymphoblastic leukemia Philadelphia positive and juvenile polyposis hereditary hemorrhagic telangiectasia syndrome

    Chiara Sartor

    2013-07-01

    Full Text Available We report a case of a patient affected by juvenile polyposis and hereditary hemorrhagic telangiectasia linked to a SMAD4 mutation who developed acute lymphoblastic leukemia positive for the Philadelphia chromosome translocation and with a complex karyotype. During the treatment with the tyrosine kinase inhibitor dasatinib the patient presented recurrent severe gastrointestinal hemorrhages linked to the genetic background and aggravated by thrombocytopenia.

  12. Prerenal azotemia

    ... failure. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 97. Review Date 10/22/2016 Updated by: Walead Latif, MD, Nephrologist and Clinical Associate Professor, Rutgers Medical ...

  13. Renal vein thrombosis

    ... Chertow GM, Marsden PA, Taal MW, Yu ASL, et al, eds. Brenner and Rector's The Kidney . 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 35. Review Date 4/14/2017 Updated by: Walead Latif, MD, Nephrologist and Clinical Associate Professor, Rutgers Medical ...

  14. Spinal and epidural anesthesia

    ... 2015:chap 56. Hernandez A, Sherwood ER. Anesthesiology principles, pain management, and conscious sedation. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice . 20th ed. Philadelphia, PA: Elsevier; 2017:chap 14. ...

  15. Asthma - children

    ... BS, Burks AW, et al, eds. Middleton's Allergy Principles and Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 53. Lugogo N, Que LG, Gilstrap DL, Kraft M. Asthma: clinical diagnosis and management. In: Broaddus VC, Mason RJ, Ernst JD, et ...

  16. Asthma

    ... BS, Burks AW, et al, eds. Middleton's Allergy Principles and Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 55. Lugogo N, Que LG, Gilstrap DL, Kraft M. Asthma: clinical diagnosis and management. In: Broaddus VC, Mason RJ, Ernst JD, et ...

  17. Sleep walking

    ... Sleepwalking. In: Chokroverty S, Thomas RJ, eds. Atlas of Sleep Medicine . 2nd ed. Philadelphia, PA: Elsevier Saunders; 2014:380- ... of Clinical Neurology, SUNY Stony Brook, School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare ... NIH MedlinePlus Magazine Read more ...

  18. Calcium - urine

    ... Female urinary tract Male urinary tract Calcium urine test References Bringhurst FR, Demay MB, Kronenberg HM. Hormones and disorders of mineral metabolism. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology . 13th ed. Philadelphia, PA: Elsevier; ...

  19. CA-125 blood test

    ... Morgan M, Boyd J, Drapking R, Seiden MV. Cancers arising in the ovary. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology . 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 89. ... Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by ...

  20. Testicular torsion repair

    ... the Procedure is Performed Testicular torsion is an emergency. In most cases, surgery is needed right away to relieve pain ... RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 9th ed. Philadelphia, PA: Elsevier; 2018:chap ...

  1. UPJ obstruction

    ... junction obstruction; Obstruction of the ureteropelvic junction Images Kidney anatomy References Elder JS. Obstruction of the urinary tract. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, St. Geme JW, Schor NF, eds. ... The Kidney . 10th ed. Philadelphia, PA: Elsevier; 2016:chap 38. ...

  2. Parainfluenza

    ... SL, Steinbach WJ, Hotez PJ, eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases . 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 178. Review Date 8/21/2016 Updated by: Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Associate Professor of Medicine, Pulmonary, ...

  3. Age but not Philadelphia positivity impairs outcome in older/elderly patients with acute lymphoblastic leukemia in Sweden.

    Kozlowski, Piotr; Lennmyr, Emma; Ahlberg, Lucia; Bernell, Per; Hulegårdh, Erik; Karbach, Holger; Karlsson, Karin; Tomaszewska-Toporska, Beata; Åström, Maria; Hallböök, Heléne

    2017-08-01

    Older/elderly patients with acute lymphoblastic leukemia (ALL) are poorly represented in clinical trials. Using Swedish national leukemia registries, we investigated disease/patient characteristics, treatment choices, outcome, and the impact of an age-adapted protocol (introduced in 2009) in this population-based study of patients aged 55-85 years, diagnosed with ALL 2005-2012. Of 174 patients, 82% had B-phenotype, 11% Burkitt leukemia (excluded), and 7% T-phenotype. Philadelphia chromosome positivity (Ph+) occurred in 35%. Of the 155 B- and T-ALL patients, 80% were treated with intensive protocols, and 20% with a palliative approach. Higher age and WHO performance status ≥2 influenced the choice of palliation. Intensive, palliative, and both approaches resulted in complete remission rate 83/16/70% and 3-year overall survival (OS) 32/3/26%. The age-adapted protocol did not improve outcome. With intensive treatment, platelet count ≤35×10 9 /L and age ≥75 years were adverse prognostic factors for OS, Ph+ was not. Male sex was an adverse prognostic factor in the 55-64 year age-group. We report a high frequency of Ph+ in older/elderly patients, with no evidence of poorer outcome compared to Ph-negative disease. Overall prognosis for elderly patients with ALL remains dismal, despite the use of age-adapted treatment. © 2017 The Authors. European Journal of Haematology Published by John Wiley & Sons Ltd.

  4. An Unsuspected Finding of t(9;22: A Rare Case of Philadelphia Chromosome-Positive B-Lymphoblastic Lymphoma

    Prajwal Boddu

    2017-01-01

    Full Text Available While rare, cases of isolated extramedullary disease of B-cell Lymphoblastic Lymphoma (B-LBL without morphologic bone marrow involvement have been described. In this report, we illustrate the case of an elderly gentleman who presented with isolated testicular and vertebral LBL involvement but had no morphologic bone marrow involvement. The initial plan of treatment was to treat along the lines of Philadelphia negative B-ALL/LBL. During this time, fluorescence in situ hybridization (FISH and PCR testing for BCR-ABL1 rearrangements were being performed on the marrow specimens as a part of routine diagnostic workup. While the FISH returned negative, PCR testing unexpectedly detected BCR-ABL1 fusion transcripts at a low level of 0.48%. Given their presence, we performed FISH for BCR/ABL1 rearrangement in both testicular and L5 vertebral specimens which were 80–90% positive. He subsequently received rituximab, hyper-CVAD, and dasatinib, along with prophylactic intrathecal prophylactic chemotherapy. The patient achieved a prolonged remission but eventually relapsed, 4 years later. Had it not been for this fortuitous discovery, the patient would not have been treated with tyrosine kinase inhibitors. We emphasize that FISH and PCR testing for BCR-ABL1 rearrangement are integral to arriving at an accurate diagnosis and should be routinely tested on B-LBL biopsy specimens.

  5. The insight and challenge of reflexive practice in an ethnographic study of black traumatically injured patients in Philadelphia.

    Jacoby, Sara F

    2017-07-01

    The integrity of critical ethnography requires engagement in reflexive practice at all phases of the research process. In this discussion paper, I explore the insights and challenges of reflexive practice in an ethnographic study of the recovery experiences of black trauma patients in a Philadelphia hospital. Observation and interviews were conducted with twelve patients who were admitted to trauma-designated units of the hospital over the course of a year. During fieldwork, I learned the ways that my background as a professional nurse structured my way of being in clinical space and facilitated a particular interpretation of clinical culture. In analysis, reflection on subjectivities through which I designed this ethnographic research allowed me to see beyond my preconceived and theoretically informed perspective to permit unexpected features of the field to emerge. Reflexive practice also guided my reconciliation of key practical and epistemological differences between clinical ethnographic research and the anthropologic tradition in which it is rooted. I conclude that with careful reflection to the subjectivities that influence the research process, interdisciplinary clinically relevant applied interpretations of critical ethnographic work can be used to generate detailed knowledge across contexts in clinical care, nursing practice, and patient experiences. © 2016 John Wiley & Sons Ltd.

  6. Frequency of JAK2 V617F mutation in patients with Philadelphia positive Chronic Myeloid Leukemia in Pakistan.

    Tabassum, Najia; Saboor, Mohammed; Ghani, Rubina; Moinuddin, Moinuddin

    2014-01-01

    Co-existence of myeloproliferative disorders (MPD) and Janus associated kinase 2 mutation (JAK2 V617F) is a well-established fact. Only few case reports are available showing presence of JAK2 V617F mutation in chronic myeloid leukemia (CML). Purpose of this study was to determine the frequency of JAK2 V617F mutation in Philadelphia Chromosome positive (Ph (+)) CML patients in Pakistan. The study was conducted from August 2009 to July 2010 at Civil Hospital and Baqai Institute of Hematology (BIH) Karachi. Blood samples from 25 patients with CML were collected. Multiplex reverse transcription polymerase chain reaction (RT-PCR) was performed for Breakpoint Cluster Region - Abelson (BCR-ABL) rearrangement. Conventional PCR was performed for JAK2 V617F mutation on BCR-ABL positive samples. All 25 samples showed BCR-ABL rearrangement. Out of these 11 samples (44%) had JAK2 V617F mutation; the remaining 14 (56%) cases showed JAK2 617V wild type. It is concluded that the co-existence of Ph (+)CML and JAK2 V617F mutation is possible.

  7. Inspection Frequency, Sociodemographic Factors, and Food Safety Violations in Chain and Nonchain Restaurants, Philadelphia, Pennsylvania, 2013-2014.

    Leinwand, Sarah E; Glanz, Karen; Keenan, Brendan T; Branas, Charles C

    We explored how restaurant inspection frequency and restaurant neighborhood sociodemographic characteristics are related to food safety inspection outcomes in chain and nonchain restaurants to better understand external factors that may influence inspection outcomes. We categorized the results of restaurant inspections in Philadelphia, Pennsylvania, in 2013 and 2014 by restaurant type (chain or nonchain), inspection frequency (1, 2, or ≥3 per 2-year study period), and violation type (total number of violations, foodborne-illness risk factor violation, or good retail practice violation). We collected 2013 US Census block group sociodemographic data for each restaurant neighborhood. We used nested mixed-effects regression analyses to determine the association between restaurant inspection frequency and inspection violations, as well as between inspection violations and restaurant neighborhood sociodemographic variables, stratified by restaurant type. Compared with nonchain restaurants, chain restaurants had significantly fewer total violations per inspection (mean [SD]: 6.5 [4.6] vs 9.6 [6.8] violations, P chain restaurants. For nonchain restaurants, a higher proportion of black residents in a restaurant neighborhood was associated with 0.6 ( P food safety inspection frequency, based on whether or not restaurants are part of chains, could reduce the frequency of violations, particularly in restaurants with the most violations.

  8. Hemodynamic changes after propacetamol administration in patients with febrile UTI in the ED.

    Kang, Soo; Durey, Areum; Suh, Young Ju; Kim, Ah Jin

    2018-06-01

    Clinical studies have indicated that transient hypotension can occur after propacetamol administration. This study aimed to analyze the hemodynamic changes after propacetamol administration in patients visiting the ED due to febrile UTI. We also examined the incidence of propacetamol-induced hypotension and compared the clinical characteristics of patients with persistent hypotension, defined as requiring additional fluids or vasopressors, to those with transient hypotension. A retrospective analysis of the electronic medical records of patients who visited the ED between June 2015 and May 2016, were diagnosed with febrile UTI, and treated with propacetamol, was conducted. We included 195 patients in this study; of these, 87 (44.6%) showed hypotension. In all patients, significant decreases in systolic blood pressure (SBP; 135.06±20.45mmHg vs 117.70±16.41mmHg), diastolic blood pressure (DBP; 79.74±12.17mmHg vs 69.69±10.96mmHg), and heart rate (97.46±17.14mmHg vs 90.72±14.90mmHg) were observed after propacetamol administration. The basal SBP and DBP were higher in the hypotension than in the non-hypotension group (basal SBP: 144.4±22.3mmHg vs 127.6±15.3mmHg; basal DBP: 83.3±12.6mmHg vs 76.9±11.0mmHg). Patients with persistent hypotension had a lower baseline BP, which was not elevated despite fever, and a higher rate of bacteremia than those with transient hypotension. Although febrile UTI patients treated with propacetamol in the ED showed hemodynamic changes, these changes did not have a large effect on their prognosis. However, in patients who showed bacteremia or a normal initial BP despite fever, the possibility of developing persistent hypotension should be considered. Copyright © 2017. Published by Elsevier Inc.

  9. Effectiveness of granisetron in controlling pediatric gastroenteritis-related vomiting after discharge from the ED.

    Qazi, Khajista; BinSalleeh, Hashim M; Shah, Ubaid H; AlGhamedi, Najwa; Tamim, Hani; Mubasher, Mohamed; Alrasheed, Faris; Alkanhal, Abdulrahman; AlTamimi, Saleh A

    2014-09-01

    The objective of the study is to determine the efficacy of oral granisetron (a long-acting 5-HT3 receptor antagonist) in stopping vomiting subsequent to discharge from emergency department (ED), in 6-month-old to 8-year-old patients with gastroenteritis-related vomiting and dehydration, who had failed an initial trial of oral rehydration (ORT). Eligible patients were offered ORT on a slowly advancing schedule. Patients who tolerated the initial ORT were discharged home. Patients who vomited were randomized to receive either 40 μg/kg of granisetron or placebo, and ORT was resumed. Patients who tolerated the postrandomization ORT were discharged home with another dose of the study drug. Parents were contacted by telephone every 24 hours until complete resolution of symptoms. The primary outcome was the proportion of patients with vomiting at 24 hours. Of the 900 eligible patients, 537 (60%) tolerated the initial ORT and were discharged home. Of the patients who vomited during the initial ORT, 165 were included in the final study sample (placebo, n = 82; granisetron, n = 83). There was no statistically significant difference in the proportion of patients with vomiting at 24 hours (granisetron, n = 38; placebo, n = 45; odds ratio, 0.64; 95% confidence interval, 0.34-1.19; P = .16). A similar trend in the proportion of patients with vomiting was noted for the entire follow-up period (granisetron, n = 43; placebo, n = 47; odds ratio, 0.73; P = .33; 95% confidence interval, 0.39-1.36). Granisetron was not effective in controlling gastroenteritis-related vomiting subsequent to discharge from ED. It did not change the expected course of the illness. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Proteste ed emancipazione alla frontiera europea. Il caso di Lampedusa

    Annalisa Lendaro

    Full Text Available Riassunto Questo articolo si propone di approfondire a livello teorico i legami tra proteste ed emancipazione dei migranti senza status legale, che si trovano in situazione di detenzione amministrativa sull’isola italiana di Lampedusa. Il presente contributo mette in evidenza il fatto che l’agency dei migranti, seppur privi di libertà e di uno status legale, è determinante per sbloccare una situazione di crisi in un contesto simile allo stato di eccezione descritto da Agamben. Più precisamente, la protesta dei migranti di Lampedusa mostra in che modo la sospensione dello stato di diritto apra degli spiragli per, non solo denunciare l’ingiustizia di alcune norme, ma anche per agire.

  11. Expert knowledge in radiation protection. 2. rev. ed.

    Spang, A.

    1990-01-01

    This revised version of the first edition, which was published in 1983, incorporates the full scale of developments and changes made since then, as e.g.: the new Radiation Protection Ordinance, which introduces the concept and definition of effective dose, ED, and limits the maximum permissible occupational exposure to 400 mSv. Changes have become effective for instance in the transport regulations, in the regulations for radioactive waste delivery and collection, in the field of health physics, and with regard to activities under outside contract; b) the EURATOM basic standards and the new SI units: Becquerel and Sievert have replaced Curie and Rem; c) a number of ICRP recommendations, events and scientific results, which frequently make radiation protection more plausible, or sometimes even necessary; d) the new DIN standards and BMU regulations, which also are a valuable source of reference for the radiation protection officer. (orig./HP) [de

  12. EDS V25 containment vessel explosive qualification test report.

    Rudolphi, John Joseph

    2012-04-01

    The V25 containment vessel was procured by the Project Manager, Non-Stockpile Chemical Materiel (PMNSCM) as a replacement vessel for use on the P2 Explosive Destruction Systems. It is the first EDS vessel to be fabricated under Code Case 2564 of the ASME Boiler and Pressure Vessel Code, which provides rules for the design of impulsively loaded vessels. The explosive rating for the vessel based on the Code Case is nine (9) pounds TNT-equivalent for up to 637 detonations. This limit is an increase from the 4.8 pounds TNT-equivalency rating for previous vessels. This report describes the explosive qualification tests that were performed in the vessel as part of the process for qualifying the vessel for explosive use. The tests consisted of a 11.25 pound TNT equivalent bare charge detonation followed by a 9 pound TNT equivalent detonation.

  13. EDS'09: 13th International Conference on Elastic & Diffractive Scattering

    CERN. Geneva

    2009-01-01

    The series of International Conferences on Elastic and Diffractive Scattering was founded in 1985 in the picturesque old French town of Blois, famous for its XIV - XVIIth century château, inside of which the first meeting took place. Since then, meetings have been organised every two years in different places of the world: New York (1987), Evanston (1989), Isola d'Elba (1991), Providence (1993), Blois (1995), Seoul (1997), Protvino (1999), Prague (2001), Helsinki (2003), Blois (2005) and Hamburg (2007). The conference will focus on the most recent experimental and theoretical results in particle physics with an emphasis on Quantum Chromodynamics (QCD). http://cern.ch/eds09/ The conference agenda is now full. No further contributions can be accepted.

  14. Multiple metamorphoses for EdF and GdF

    Jemain, A.

    2004-01-01

    The draft of law, modifying the statute of the French electric and gas utilities, Electricite de France (EdF) and Gaz de France (GdF), that the French government has presented to the Council of State, mixes some European and French preoccupations. The reason is the urgency of the planning and the date line of July 1, 2004 with the opening of the gas and power markets to 3.5 millions of professionals. The draft includes the obligations and missions of public utility of both companies, the transposition of the European directives, the conclusions of the negotiation of retirement pensions with the syndicate organizations, and the transformation of both public companies into anonymous companies. Short paper. (J.S.)

  15. Competition at the attack of EdF's dams

    James, O.; Gateaud, P.; Dupin, L.

    2010-01-01

    The exploitation of French hydroelectric dams is at the eve of a big upheaval. EdF, the historical operator, and GdF Suez the French number two of hydropower generation are going to face the strong competition of the big European energy groups. France will open 20% of its hydroelectric potential to competition in order to be in agreement with the opening of energy markets imposed by the European Union, and to increase by 10% the hydroelectric power as requested by the French government policy. The candidates will have to fulfill 3 criteria: investing to increase production, reducing the environmental impacts, and accepting the principle of paying fees. However, some of the French dams suffer from serious pathologies and the health of thousands of small dams remains unknown because of the lack of available data. (J.S.)

  16. ED services: the impact of caring behaviors on patient loyalty.

    Liu, Sandra S; Franz, David; Allen, Monette; Chang, En-Chung; Janowiak, Dana; Mayne, Patricia; White, Ruth

    2010-09-01

    This article describes an observational study of caring behaviors in the emergency departments of 4 Ascension Health hospitals and the impact of these behaviors on patient loyalty to the associated hospital. These hospitals were diverse in size and geography, representing 3 large urban community hospitals in metropolitan areas and 1 in a midsized city. Research assistants from Purdue University (West Lafayette, IN) conducted observations at the first study site and validated survey instruments. The Purdue research assistants trained contracted observers at the subsequent study sites. The research assistants conducted observational studies of caregivers in the emergency departments at 4 study sites using convenience sampling of patients. Caring behaviors were rated from 0 (did not occur) to 5 (high intensity). The observation included additional information, for example, caregiver roles, timing, and type of visit. Observed and unobserved patients completed exit surveys that recorded patient responses to the likelihood-to-recommend (loyalty) questions, patient perceptions of care, and demographic information. Common themes across all study sites emerged, including (1) the area that patients considered most important to an ED experience (prompt attention to their needs upon arrival to the emergency department); (2) the area that patients rated as least positive in their actual ED experience (prompt attention to their needs upon arrival to the emergency department); (3) caring behaviors that significantly affected patient loyalty (eg, making sure that the patient is aware of care-related details, working with a caring touch, and making the treatment procedure clearly understood by the patient); and (4) the impact of wait time to see a caregiver on patient loyalty. A number of correlations between caring behaviors and patient loyalty were statistically significant (P loyalty but that occurred least frequently. The study showed through factor analysis that some caring

  17. Associations of Physical and Psychologic Symptom Burden in Patients With Philadelphia Chromosome-Negative Myeloproliferative Neoplasms.

    McFarland, Daniel C; Shaffer, Kelly M; Polizzi, Heather; Mascarenhas, John; Kremyanskaya, Marina; Holland, Jimmie; Hoffman, Ronald

    2018-01-31

    The physical symptom burden of patients with myeloproliferative neoplasms (MPNs) may last for extended periods during their disease trajectories and lead to psychologic distress, anxiety, or depression or all of these. This study evaluated the relationship between physical symptom burden captured by the Physical Problem List (PPL) on the Distress Thermometer and Problem List and psychologic outcomes (distress, anxiety, and depression) in the MPN setting. Patients (N = 117) with MPNs completed questionnaires containing the Distress Thermometer and Problem List and the Hospital Anxiety and Depression Scale in a dedicated MPN clinic within an academic medical center. They reported symptoms from any of 22 physical problems on the PPL. Items endorsed by more than 10% of participants were assessed for their associations with distress (Distress Thermometer and Problem List), anxiety (Hospital Anxiety and Depression Scale-Anxiety), and depression (Hospital Anxiety and Depression Scale-Depression). The total number of endorsed PPL items per participant was also evaluated. Nine of 22 PPL items (fatigue, sleep, pain, dry skin/pruritus, memory/concentration, feeling swollen, breathing, and sexual) were reported by >10% of participants. In univariate analyses, all PPL items but one were associated with distress and depression, and all but 2 were associated with anxiety. In multivariate analyses, the total number of PPL items was associated with depression only (p symptom burden in MPN patients was clearly associated with psychologic symptoms. Depression was uniquely associated with overall physical symptom burden. As such, the endorsement of multiple PPL items on the Distress Thermometer and Problem List should prompt an evaluation for psychologic symptoms to improve MPN patients' overall morbidity and quality of life. Copyright © 2018 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  18. SED-ED, a workflow editor for computational biology experiments written in SED-ML.

    Adams, Richard R

    2012-04-15

    The simulation experiment description markup language (SED-ML) is a new community data standard to encode computational biology experiments in a computer-readable XML format. Its widespread adoption will require the development of software support to work with SED-ML files. Here, we describe a software tool, SED-ED, to view, edit, validate and annotate SED-ML documents while shielding end-users from the underlying XML representation. SED-ED supports modellers who wish to create, understand and further develop a simulation description provided in SED-ML format. SED-ED is available as a standalone Java application, as an Eclipse plug-in and as an SBSI (www.sbsi.ed.ac.uk) plug-in, all under an MIT open-source license. Source code is at https://sed-ed-sedmleditor.googlecode.com/svn. The application itself is available from https://sourceforge.net/projects/jlibsedml/files/SED-ED/.

  19. RT-PCR Analysis of ED-A,ED-B, and IIICS Fibronectin Domains: A New Screening Marker For Bladder Cancer

    M Ahmadi Javid

    2004-12-01

    Full Text Available Background: Fibronectin seems to play a very important role in the progression and invasion of bladder cancer. EDA, EDB, and IIICS domains of fibronectin are not expressed in the adult persons but they’re expressed in different cancers. The aim of this study is to investigate the mRNA of fibronectin in transitional carcinoma cells (TCC of bladder to study these domains. Methods: A total of 20 patients with known bladder cancer were studied. Two of them excluded since their excised tissues were not enough for both the pathological examination and RNA study. Another 20 (control group were normal volunteers who needed bladder operations. The excised tissue was immediately transferred to RNAlater (Ambion,TX. RNA was extracted via RNAWIZ (Ambion, TX. cDNA was made via RevertAid First Strand cDNA Synthesis Kit (Fermentas. PCR of the cDNAs was performed using primers for EDA, EDB, and IIICS (Eurogentec,Belgium. Results: For the first time, we present the expression of the oncofetal fibronectin mRNA in the transitional cell carcinoma of bladder. The high grade muscle invasive (G3T2 tumor, expressed ED-A, ED-B, and IIICS. Expression of ED-A, ED-B, and IIICS was confirmed in the two patients with G3T1 TCC. The four patients with G2Ta and G3Ta expressed both ED-A and ED-B. The four patients with G1T1 tumor expressed ED-A only, similar to the nine patients with G1Ta tumor. None of the normal volunteers expressed the oncofetal extra domains. The sensitivity of ED-A positive fibronectin RNA for detecting TCC of any kind is 100%, and of ED-B was only 35%. The specificity of ED-B positive fibronectin RNA for the high grade TCC is 100%. Conclusion: ED-A, ED-B, and IIICS could be used as useful markers for the diagnosis and following up of bladder carcinoma. Keywords: Transitional Cell Carcinoma, bladder cancer, fibronectin, RT-PCR, oncofetal.

  20. The ED use and non-urgent visits of elderly patients

    Umut Gulacti

    2016-12-01

    Full Text Available Objective: To evaluate the use of the emergency department (ED by elderly patients, their non-urgent visits and the prevalence of main disease for ED visits. Methods: This cross-sectional study was conducted on patients aged 65 years and over who visited the ED of a tertiary care university hospital in Turkey between January 2015 and January 2016 retrospectively. Results: A total of 36,369 elderly patients who visited the ED were included in the study. The rate of ED visits by elderly patients was higher than their representation within the general population (p < 0.001. While the rate of elderly patients visiting polyclinics was 15.8%, the rate of elderly patients visiting the ED was 24.3% (p < 0.001. For both genders, the rates of ED visits for patients between 65 and 74 years old was higher than for other elderly age groups (p < 0.001. The prevalence of upper respiratory tract infection (URTI was the highest within the elderly population (17.5%, CI: 17.1–17.9. The proportion of ED visits for non-urgent conditions was 23.4%. Most of the ED visits were during the non-business hours (51.1%, and they were highest in the winter season (25.9% and in January (10.2%. The hospitalization rate was 9.4%, and 37.9% of hospitalized patients were admitted to intensive care units. Conclusion: The proportion of ED visits by elderly patients was higher than their representation within the general population. Elderly patients often visited the ED instead of a polyclinic. The rate of inappropriate ED use by elderly patients in this hospital was higher than in other countries. Keywords: Non-urgent, Prevalence, Visit, Main disease, Elderly patient, Emergency department

  1. Philadelphia chromosome-positive adult acute leukemia with monosomy of chromosome number seven: a subgroup with poor response to therapy.

    Maddox, A M; Keating, M J; Trujillo, J; Cork, A; Youness, E; Ahearn, M J; McCredie, K B; Freireich, E J

    1983-01-01

    Thirty-four adult patients were seen at the University of Texas M. D. Anderson Hospital and Tumor Institute at Houston, Texas between 1969 and 1980 with acute leukemia (AL) and a deleted G-group chromosome that was shown by Giemsa banding to be a Philadelphia (Ph1) chromosome t(9;22) in 21 patients. Fourteen had the Ph1 chromosome as the sole abnormality, 12 had the Ph1 chromosome and loss of one chromosome of the C-group (identified by Giemsa banding analysis as number 7 in eight patients), while eight had the Ph1 chromosome and other changes. These three groups were similar in sex, age distribution and hematologic parameters. The median age of 40 was lower than usually seen in AL. The distribution of the morphologic subtypes was similar to that seen at this institution, with 50% being acute myeloblastic, 12% acute myelomonocytic, 20% lymphoblastic and 18% acute undifferentiated. The complete remission rate with chemotherapy was low: 25% in the Ph1 +/- 7, 50% in the Ph1 +/other group and 43% in the Ph1 +/other group. Median survival time was 8 months for the Ph1 +/- 7 group, 5.5 months for the Ph1 +/other group and 9.0 months for the Ph1 +/alone group. These patients with Ph1 + AL had higher white blood cell counts, increased extramedullary disease and poorer responses to therapy than usual for patients with AL. The deletion of chromosome 7 and the acquisition of the Ph1 chromosome identifies a group of patients with characteristics similar to all the patients with Ph1 + AL but a poor response to therapy and short remission duration.

  2. Knowledge, perceptions, and behaviors related to salt use among Philadelphia Chinese take-out restaurant owners and chefs.

    Ma, Grace X; Shive, Steve; Zhang, Yolanda; Aquilante, Jennifer; Tan, Yin; Zhao, Mei; Solomon, Sara; Zhu, Steven; Toubbeh, Jamil; Colby, Lisa; Mallya, Giridhar; Zeng, Qiaoling

    2014-09-01

    Most of the sodium Americans consume comes from processed and restaurant foods. An upstream global strategy to promote health is to work with local restaurants to reduce sodium content in their food offerings, while accounting for food taste and economic considerations. In urban communities, Chinese take-out restaurants serve meals with large amounts of sodium and are clustered in low-income, racial/ethnic minority communities with a high prevalence of hypertension. The objective of this study is to assess baseline knowledge, attitudes, and behaviors related to sodium use/consumption among Chinese take-out owners and chefs recruited to participate in the Philadelphia Healthy Chinese Take-Out Initiative. A cross-sectional study of 221 Chinese take-out restaurants was conducted from August 2012 to February 2013. Items measured knowledge, attitudes, and behaviors related to salt use, salt consumption, and health. Most owners/chefs knew that excess sodium consumption contributes to high blood pressure but were less aware of other health effects and of major sources of sodium in the U.S. diet. The majority were willing and able to reduce sodium content in meals if customer demand could be maintained, and they desired training in food preparation, procurement, and marketing. Findings show a need to provide education, strategies, and support to Chinese take-out owners/chefs in preparing low-salt dishes. The results of this and future studies to reduce sodium content in meals by working with restaurant owners and chefs have global health promotion implications. © 2014 Society for Public Health Education.

  3. Sales of healthy snacks and beverages following the implementation of healthy vending standards in City of Philadelphia vending machines.

    Pharis, Meagan L; Colby, Lisa; Wagner, Amanda; Mallya, Giridhar

    2018-02-01

    We examined outcomes following the implementation of employer-wide vending standards, designed to increase healthy snack and beverage options, on the proportion of healthy v. less healthy sales, sales volume and revenue for snack and beverage vending machines. A single-arm evaluation of a policy utilizing monthly sales volume and revenue data provided by the contracted vendor during baseline, machine conversion and post-conversion time periods. Study time periods are full calendar years unless otherwise noted. Property owned or leased by the City of Philadelphia, USA. Approximately 250 vending machines over a 4-year period (2010-2013). At post-conversion, the proportion of sales attributable to healthy items was 40 % for snacks and 46 % for beverages. Healthy snack sales were 323 % higher (38·4 to 162·5 items sold per machine per month) and total snack sales were 17 % lower (486·8 to 402·1 items sold per machine per month). Healthy beverage sales were 33 % higher (68·2 to 90·6 items sold per machine per month) and there was no significant change in total beverage sales (213·2 to 209·6 items sold per machine per month). Revenue was 11 % lower for snacks ($US 468·30 to $US 415·70 per machine per month) and 21 % lower for beverages ($US 344·00 to $US 270·70 per machine per month). Sales of healthy vending items were significantly higher following the implementation of employer-wide vending standards for snack and beverage vending machines. Entities receiving revenue-based commission payments from vending machines should employ strategies to minimize potential revenue losses.

  4. Methylation profiling of SOCS1, SOCS2, SOCS3, CISH and SHP1 in Philadelphia-negative myeloproliferative neoplasm.

    Zhang, Min Yue; Fung, Tsz Kin; Chen, Fang Yuan; Chim, Chor Sang

    2013-10-01

    Janus kinase-signal transducer and activator of transcription (JAK/STAT) signalling, pivotal in Philadelphia-negative (Ph-ve) myeloproliferative neoplasm (MPN), is negatively regulated by molecules including SOCSs, CISH and SHP1. SOCS1, SOCS2 and SOCS3 methylation have been studied in MPN with discordant results. Herein, we studied the methylation status of SOCS1, SOCS2 and SOCS3, CISH and SHP1 by methylation-specific polymerase chain reaction (MSP) in cell lines and 45 diagnostic marrow samples of Ph-ve MPN. Moreover, we attempted to explain the discordance of methylation frequency by mapping the studied MSP primers to the respective genes. Methylation was detected in normal controls using SOCS2 MSP primers in the 3'translated exonic sequence, but not primers around the transcription start site in the 5' untranslated regions (5'UTR). SOCS1, SOCS2, SOCS3 and CISH were completely unmethylated in primary MPN samples and cell lines. In contrast, methylation of SHP1 was detected in 8.9% primary marrow samples. Moreover, SHP1 was completely methylated in K562 cell line, leading to reversible SHP1 silencing. A review of methylation studies of SOCS1 and SOCS3 showed that spuriously high rates of SOCS methylation had been reported using MSP primers targeting CpG sites in the 3'translated exonic sequence, which is also methylated in normal controls. However, using MSP primers localized to the 5'UTR, methylation of SOCS1, SOCS2 and SOCS3 is infrequent across all studies. In summary, methylation of SOCS1, SOCS2, SOCS3 and CISH is infrequent in Ph-ve MPN. Appropriate MSP primers are important for accurate estimation of the methylation frequency. The role of SHP1 methylation in the pathogenesis of MPN warrants further investigation. © 2013 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

  5. Storing empty calories and chronic disease risk: snack-food products, nutritive content, and manufacturers in Philadelphia corner stores.

    Lucan, Sean C; Karpyn, Allison; Sherman, Sandy

    2010-05-01

    Corner stores are part of the urban food environment that may contribute to obesity and diet-related diseases, particularly for low-income and minority children. The snack foods available in corner stores may be a particularly important aspect of an urban child's food environment. Unfortunately, there is little data on exactly what snack foods corner stores stock, or where these foods come from. We evaluated snack foods in 17 Philadelphia corner stores, located in three ethnically distinct, low-income school neighborhoods. We recorded the manufacturer, calories, fat, sugar, and sodium for all snack items, excluding candy and prepared foods. We then compared the nutritive content of assessed snack items to established dietary recommendations and a school nutrition standard. In total, stores stocked 452 kinds of snacks, with only 15% of items common between all three neighborhoods. Total and unique snacks and snack food manufacturers varied by neighborhood, but distributions in snack type varied negligibly: overall, there were no fruit snacks, no vegetable snacks, and only 3.6% of all snacks (by liberal definition) were whole grain. The remainder (96.4% of snacks) was highly processed foods. Five of 65 manufacturers supplied 73.4% of all kinds of snack foods. Depending on serving size definition, 80.0-91.5% of snack foods were "unhealthy" (by the school nutrition standard), including seven of 11 wholegrain products. A single snack item could supply 6-14% of a day's recommended calories, fat, sugar, and sodium on average (or 56-169% at the extreme) for a "typical" child. We conclude that corner store snack food inventories are almost entirely unhealthful, and we discuss possible implications and next steps for research and intervention.

  6. Improving fruit and vegetable consumption among low-income customers at farmers markets: Philly Food Bucks, Philadelphia, Pennsylvania, 2011.

    Young, Candace R; Aquilante, Jennifer L; Solomon, Sara; Colby, Lisa; Kawinzi, Mukethe A; Uy, Nicky; Mallya, Giridhar

    2013-10-03

    We evaluated whether Philly Food Bucks, a bonus incentive program at farmers markets, is associated with increased fruit and vegetable consumption and Supplemental Nutrition Assistance Program (SNAP) sales at farmers markets in low-income areas. A convenience sample of 662 customers at 22 farmers markets in low-income neighborhoods in Philadelphia, Pennsylvania, was surveyed via face-to-face interviews. Questions addressed shopping characteristics, self-reported change in fruit and vegetable consumption, whether customers tried new fruits or vegetables, use of Philly Food Bucks, and demographic information. Market-level SNAP sales and Philly Food Bucks redemption data were also collected to monitor sales patterns. Philly Food Bucks users were significantly more likely than nonusers to report increasing fruit and vegetable consumption (OR, 2.4; 95% CI, 1.6-3.7; P < .001) and to report trying new fruits or vegetables (OR 1.8; 95% CI, 1.2-2.7; P = .006). At the market level, average SNAP sales more than doubled at farmers markets in low-income areas in the first 2 years of the Philly Food Bucks program. At the city's largest farmers market in a low-income area, the program was associated with an almost 5-fold higher increase in annual SNAP sales compared with baseline. Results from this study demonstrate that a bonus incentive program tied to SNAP was associated with self-reported increases in fruit and vegetable consumption and increased SNAP sales at participating farmers markets in low-income communities. More research is warranted to evaluate the long-term impact of bonus incentives on farmers market use, dietary behaviors, and health outcomes.

  7. Characterization and Prognosis Significance of JAK2 (V617F), MPL, and CALR Mutations in Philadelphia-Negative Myeloproliferative Neoplasms

    Singdong, Roongrudee; Siriboonpiputtana, Teerapong; Chareonsirisuthigul, Takol; Kongruang, Adcharee; Limsuwanachot, Nittaya; Sirirat, Tanasan; Chuncharunee, Suporn; Rerkamnuaychoke, Budsaba

    2016-10-01

    Background: The discovery of somatic acquired mutations of JAK2 (V617F) in Philadelphia-negative myeloproliferative neoplasms (Ph-negative MPNs) including polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF) has not only improved rational disease classification and prognostication but also brings new understanding insight into the pathogenesis of diseases. Dosage effects of the JAK2 (V617F) allelic burden in Ph-negative MPNs may partially influence clinical presentation, disease progression, and treatment outcome. Material and Methods: Pyrosequencing was performed to detect JAK2 (V617F) and MPL (W515K/L) and capillary electrophoresis to identify CALR exon 9.0 mutations in 100.0 samples of Ph-negative MPNs (38.0 PV, 55 ET, 4 PMF, and 3 MPN-U). Results: The results showed somatic mutations of JAK2 (V617F) in 94.7% of PV, 74.5% of ET, 25.0% of PMF, and all MPN-U. A high proportion of JAK2 (V617F) mutant allele burden (mutational load > 50.0%) was predominantly observed in PV when compared with ET. Although a high level of JAK2 (V617F) allele burden was strongly associated with high WBC counts in both PV and ET, several hematological parameters (hemoglobin, hematocrit, and platelet count) were independent of JAK2 (V617F) mutational load. MPL (W515K/L) mutations could not be detected whereas CALR exon 9.0 mutations were identified in 35.7% of patients with JAK2 negative ET and 33.3% with JAK2 negative PMF. Conclusions: The JAK2 (V617F) allele burden may be involved in progression of MPNs. Furthermore, a high level of JAK2 (V617F) mutant allele appears strongly associated with leukocytosis in both PV and ET. Creative Commons Attribution License

  8. Costs of a community-based glaucoma detection programme: analysis of the Philadelphia Glaucoma Detection and Treatment Project.

    Pizzi, Laura T; Waisbourd, Michael; Hark, Lisa; Sembhi, Harjeet; Lee, Paul; Crews, John E; Saaddine, Jinan B; Steele, Deon; Katz, L Jay

    2018-02-01

    Glaucoma is the foremost cause of irreversible blindness, and more than 50% of cases remain undiagnosed. Our objective was to report the costs of a glaucoma detection programme operationalised through Philadelphia community centres. The analysis was performed using a healthcare system perspective in 2013 US dollars. Costs of examination and educational workshops were captured. Measures were total programme costs, cost/case of glaucoma detected and cost/case of any ocular disease detected (including glaucoma). Diagnoses are reported at the individual level (therefore representing a diagnosis made in one or both eyes). Staff time was captured during site visits to 15 of 43 sites and included time to deliver examinations and workshops, supervision, training and travel. Staff time was converted to costs by applying wage and fringe benefit costs from the US Bureau of Labor Statistics. Non-staff costs (equipment and mileage) were collected using study logs. Participants with previously diagnosed glaucoma were excluded. 1649 participants were examined. Mean total per-participant examination time was 56 min (SD 4). Mean total examination cost/participant was $139. The cost/case of glaucoma newly identified (open-angle glaucoma, angle-closure glaucoma, glaucoma suspect, or primary angle closure) was $420 and cost/case for any ocular disease identified was $273. Glaucoma examinations delivered through this programme provided significant health benefit to hard-to-reach communities. On a per-person basis, examinations were fairly low cost, though opportunities exist to improve efficiency. Findings serve as an important benchmark for planning future community-based glaucoma examination programmes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Allogeneic hematopoietic cell transplantation (allogeneic HCT) for treatment of pediatric Philadelphia chromosome-positive acute lymphoblastic leukemia (ALL).

    Burke, Michael J; Cao, Qing; Trotz, Barb; Weigel, Brenda; Kumar, Ashish; Smith, Angela; Verneris, Michael R

    2009-12-15

    Allogeneic hematopoietic cell transplant (HCT) with best available donor for children with Philadelphia positive (Ph+) acute lymphoblastic leukemia (ALL) has previously been considered standard practice. Since the introduction of imatinib into the treatment of this disease, the role of allogeneic HCT is more uncertain. We investigated the impact of remission status, graft source, and imatinib use on transplant outcomes for 37 children with Ph+ ALL who received an allogeneic HCT at the University of Minnesota between 1990 and 2006. The median age at HCT was 7.47 (range; 1.4-16.4) years. Thirteen patients received imatinib therapy pre- and/or post-HCT (imatinib group) and 24 patients, received either no imatinib (n = 23) or only post-HCT relapse (n = 1) (non-imatinib group). There was no difference in disease-free survival (DFS) or relapse between the imatinib and non-imatinib groups at 3 years (62%/15% vs. 53%/26%; P = 0.99; 0.81, respectively). There was no significant difference in transplant outcomes between matched related donor or unrelated donor (umbilical cord blood or matched unrelated marrow) recipients whereas patients receiving allogeneic HCT in first remission (CR1) had superior DFS and less relapse compared to patients transplanted in >or=CR2 (71%/16% vs. 29%/36%; P = 0.01; P = 0.05). Based on this retrospective analysis at a single institution, the use of imatinib either pre- and/or post-transplant does not appear to significantly impact outcomes for children with Ph+ ALL and allogeneic HCT with the best available donor should be encouraged in CR1.

  10. Patient characteristics and outcomes in adolescents and young adults with classical Philadelphia chromosome-negative myeloproliferative neoplasms.

    Boddu, Prajwal; Masarova, Lucia; Verstovsek, Srdan; Strati, Paolo; Kantarjian, Hagop; Cortes, Jorge; Estrov, Zeev; Pierce, Sherry; Pemmaraju, Naveen

    2018-01-01

    Little is known about the outcomes of Philadelphia-negative myeloproliferative neoplasms (MPNs) in adolescents and young adults (AYA). We reviewed all patients with essential thrombocythemia (ET), polycythemia vera (PV), and myelofibrosis (MF) treated at our institution from 1988 to 2016 who were aged 16 to 39 years (AYA) and described their outcomes in comparison to older MPN population. Of 2206 patients, 185 (8.3%) were identified as AYA: 105 (57%) ET, 43 (23%) PV, and 37 (20%) MF. The median age was 33 years [range, 16-39], and median follow-up time 3 years [range, 0.04-25]. JAK2 allele burdens were significantly lower among AYA JAK2V617F-mutated patients in both PV (p = 0.001) and MF (p = 0.005). Seven percent of MPN AYA patients were diagnosed with a thrombotic event at, or prior to, diagnosis. Over the short median follow-up, 4 thrombotic (PV = 1, MF = 3) and 3 leukemia (ET = 2, MF = 1) events occurred. In multivariate analysis, AYA did not predict for thrombotic or transformational events across three cohorts. In the MF cohort, there was a reduced frequency of negative prognostic variables of anemia (p = 0.011) and leukocytosis (p = 0.048) in AYA when compared with non-AYA. Overall survival was significantly superior in the AYA cohorts in all three MPN groups, namely MF (p < 0.001), PV (p < 0.001), and ET (p = 0.002). Our findings suggest that MPN AYA patients exhibit an indolent clinical phenotype characterized by favorable survival outcomes.

  11. 8 Different approaches needed to manage ED demand among different age-groups.

    Rimmer, Melanie; Ablard, Suzanne; O'Keeffe, Colin; Mason, Suzanne

    2017-12-01

    A variety of interventions have been proposed to manage rising demand for Emergency and Urgent Care, described by an NHS England review as unsustainable in the long term. However it is unlikely that any suggested approach will be equally suitable for the diverse population of ED users.We aimed to understand the patterns of demand amongst different types of patients attending ED. We also sought to understand the intended and unintended effects of demand management initiatives. Our study combined insights from routine data, a survey of ED patients, and qualitative interviews with ED staff. This paper describes the results of our analysis of the interviews. We conducted semi-structured interviews with 25 ED and Urgent Care Centre staff across 7 hospital sites in Yorkshire and Humber between 25 April and 11 July 2016. The interview topic guide asked about 4 broad areas; job role, description of patients and their impact on demand, description of inappropriate attendance, and current/future initiatives to deal with rising demand. Interviews were transcribed verbatim and analysed using framework analysis. We analysed the results to identify groups of patients with different patterns of use of ED services. We also explored ED staff experiences of demand management initiatives, and their suggestions for future initiatives. Although we did not ask specifically about patients' age, our analysis revealed that ED staff categorised attenders as children and young people, working age people, and older people. These groups had different reasons for attendance, different routes to the ED, different rate of non-urgent attendance, and different issues driving demand. Staff also described variation in the time taken to treat patients of different ages, with the oldest and youngest patients described as requiring the most time.There was no consensus amongst staff about the effectiveness of initiatives for managing demand. A strikingly wide variety of initiatives were mentioned

  12. A Preliminary Examination of Loss of Control Eating Disorder (LOC-ED) in Middle Childhood

    Matherne, Camden E.; Tanofsky-Kraff, Marian; Altschul, Anne M.; Shank, Lisa M.; Schvey, Natasha A.; Brady, Sheila M.; Galescu, Ovidiu; Demidowich, Andrew P.; Yanovski, Susan Z.; Yanovski, Jack A.

    2015-01-01

    Loss of Control Eating Disorder (LOC-ED) has been proposed as a diagnostic category for children 6–12y with binge-type eating. However, characteristics of youth with LOC-ED have not been examined. We tested the hypothesis that the proposed criteria for LOC-ED would identify children with greater adiposity, more disordered eating attitudes, and greater mood disturbance than those without LOC-ED. Participants were 251 youth (10.29y ± 1.54, 53.8% female, 57.8 % White, 35.5% Black, 2.0% Asian, 4.8% Hispanic, 53.0% overweight). Youth were interviewed regarding eating attitudes and behaviors, completed questionnaires to assess general psychopathology, and underwent measurements of body fat mass. Using previously proposed criteria for LOC-ED, children were classified as LOC-ED (n = 19), LOC in the absence of the full disorder (subLOC, n = 33), and youth not reporting LOC (noLOC, n = 199). LOC-ED youth had higher BMIz (p = 0.001) and adiposity (p = 0.003) and reported greater disordered eating concerns (p eating attitudes (p = 0.02). SubLOC youth had greater disordered eating concerns (p eating cognitions and anthropometric measures compared to youth without LOC-ED. Longitudinal studies are needed to determine if those with LOC-ED are at particularly increased risk for progression of disordered eating and excess weight gain. PMID:25913008

  13. EBSD and EDS of nickel sulfide inclusions in glass

    Miflin, G.E.; Barry, J.C.

    2002-01-01

    Full text: A delayed phase transformation in small nickel sulfide inclusions can cause spontaneous fracture in toughened glass. Typically, a phase transformation within a 5 ?g nickel sulphide inclusion may break a window which weighs more than 50 kg. In most cases the nickel sulfide inclusions are detected only after window failure, although it is possible to detect the inclusions within intact glass. It is known that only type three nickel sulphide inclusions, that is, inclusions with a composition in the range Ni 7 S 6 to NiS 1.03 , break the glass. The solid-state phase transformation of alpha Ni 1-x S to beta NiS which induces a 2.5% volume increase has been given as the main reason for the spontaneous fracture. The aim of this present study is to investigate the crystal structure of phases within the type three inclusions using scanning electron microscopy (SEM) and electron backscatter diffraction (EBSD). With EBSD it is possible to map regions of alpha Ni 1-x S and to distinguish those regions from regions with beta Ni 1-x S when the elemental compositions of the two regions are identical. The inclusions of this study came from two sources. One set of inclusions were found at initiation-of-fracture in glass windows that had failed by spontaneous fracture, while the other set were found in intact windows. All of the inclusions came from windows on buildings in the Brisbane area. The EBSD analysis was done at 20kV with the stage tilted to 70 degrees on a Philips XL30 SEM with LaB 6 filament, and with attached Oxford/Link Opal camera and software. EBSD mapping was done for alpha nickel sulfide (Ni 1-x S), beta nickel sulphide (NiS), heazelwoodite (Ni 3 S 2 ), and godlevskite (Ni 9 S 8 ). The integration time was 1.3 seconds for each point. Colour coded crystal phase and grain orientation maps were produced. EDS analysis was also done on the Philips XL30 with attached EDAX EDS detector. We found that although the EBSD technique is successful in identifying alpha

  14. Examining Internet Access and Social Media Application Use for Online Nutrition Education in SNAP-Ed Participants in Rural Illinois.

    Loehmer, Emily; Smith, Sylvia; McCaffrey, Jennifer; Davis, Jeremy

    2018-01-01

    To examine Internet access and interest in receiving nutrition education via social media applications among low-income adults participating in the Supplemental Nutrition Assistance Program Education (SNAP-Ed). A cross-sectional survey was distributed during 25 SNAP-Ed classes throughout the 16 southernmost counties of Illinois. From 188 responses, the majority of participants had Internet access (76%). Among participants aged 18-32 years (n = 51), 92% owned a smartphone with Internet access and 57% indicated that they would use online nutrition education, with most interest in e-mail (41%), Facebook (40%), and text messaging (35%). There was little interest in using blogs, Vine, Twitter, Tumblr, and Pinterest. Overall, 49% of middle-aged adults aged 33-64 years and 87% of seniors aged ≥65 years reported they would not use online nutrition education. Results indicated similar Internet accessibility in southern Illinois among low-income populations compared with national rural rates. Interest in using online nutrition education varied among SNAP-Ed participants according to age. Young adults appeared to be the most captive audience regarding online nutrition education. Results may be useful to agencies implementing SNAP-Ed to supplement current curriculum with online nutrition education for audiences aged ≤32 years. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  15. Hearing of Mr. Francois Roussely, President of EdF; Audition de M. Francois Roussely, President d'EdF

    Roussely, F. [Electricite de France (EDF), 75 - Paris (France)

    2005-07-01

    This document is the proceedings of the hearing of F. Roussely, President of Electricite de France (EdF), at the commission of economic affairs of the French house of commons, about the advisability of the construction of the EPR (European pressurized reactor) demonstration plant and about its possible financing by EdF. In a first part, F. Roussely recalls the European context of deregulation of energy markets and its impact of the French electric power industry (opening of the French market, industrial and social actions of EdF, need of a new generation of nuclear reactor, preservation of EdF's energy mix, warranty of public utility, un-bundling between energy trade and distribution, EdF's turnover and profitability, EdF's foreign daughter companies). In a second part, F. Roussely answers a series of questions asked by the different members of the commission concerning the different points presented in the first part. (J.S.)

  16. Etica ed evoluzionismo: la proposta di Marc Hauser

    Irene Pilloni

    2013-11-01

    Full Text Available Le recenti scoperte nell’ambito della psicologia evoluzionistica potrebbero offrire una risposta al dibattito sull’origine evoluzionistica della facoltà morale dell’Homo sapiens. In passato, il tentativo di spiegare il comportamento morale a partire dalla teoria dell’evoluzione è stato intrapreso dal padre fondatore dell’evoluzionismo Charles Darwin, successivamente da T.H. Huxley e da H. Spencer e infine dal sociobiologo E. Wilson a metà degli anni ‘70 del Novecento. Oggi questa impresa è stata ereditata dallo psicologo evoluzionista Marc Hauser, le cui indagini prendono avvio da un’analogia tra facoltà morale e facoltà linguistica. Questa analogia gli consente di affermare che la pluralità di codici morali adottati dagli uomini nelle differenti culture dipende da un numero limitato di principi morali, nello stesso modo in cui la varietà di lingue con cui gli uomini si esprimono, dipende da un numero limitato di principi linguistici universali. Dunque, sembrerebbe che l’evoluzione biologica abbia plasmato dei principi morali universali e uniformi che si presentano costanti in tutti gli uomini a prescindere dalla loro appartenenza culturale. Come vadano intesi i principi morali universali e quale rapporto intercorre tra di essi e i vari codici morali sarà l’argomento di questo saggio, il quale tenterà di analizzare la proposta di Marc Hauser all’interno della cornice dei rapporti tra etica ed evoluzionismo.

  17. Estimation of lens dose of radioactive isotopes using ED3

    Song, Ha Jin; Ju, Yong Jin; Jang, Han; Kang, Kyeong Won; Chung, Woon Kwan [Chosun University, Gwangju (Korea, Republic of); Dong, Kyung Rae [Gwangju Health University, Gwangju (Korea, Republic of); Choi, Eun Jin; Kwak, Jong Gil [Dongshin University Graduate School, Naju (Korea, Republic of); Ryu, Jae Kwang [Asan Medical Center, Seoul (Korea, Republic of)

    2017-03-15

    It is suggested that the dose limit recommended in the Enforcement Decree of Korea's Nuclear Safety Act should not exceed 150 mSv per year for radiation workers. Recently, however, ICRP 118 report has suggested that the threshold dose of the lens should be reduced to 0.2⁓0.5 Gy and the mean dose should not exceed 50 mSv per year for an average of 20 mSv over 5 years. Based on these contents, '1'2'3I, '9'9mTc, and '1'8F-FDG, which are radioisotope drugs that are used directly by radiation workers in the nuclear medicine department in Korea are expected to receive a large dose of radiation in the lens in distribution and injection jobs to administer them to patients. The ED3 Active Extremity Dosimeter was used to measure the dose of the lens in the nuclear medicine and radiation workers and how much of the dose was received per 1 mCi.

  18. Verbo come elemento della frase in friulano ed in frances

    David Bizjak

    2003-12-01

    Full Text Available Il presente lavoro e dedicato a una parte della sfera del verbo nel friulano  lettera­ rio della seconda meta del ventesimo secolo, alla perifrasi verbale e alla locuzione verbale. Nella definizione della perifrasi verbale (PV ho seguito il modello dei lin­ guisti spagnoli Javier Garcia Gonzales, Fernandez de Castro e Leonard Gomez Torrego, essendo ilpunto di partenza ilmio postulato che la PV rappresenti in friu­ lano una categoria grammaticale a parte o, almeno, una categoria in via di gramma­ ticalizzazione. Parallelamente alla situazione in friulano osservo quella nel francese scritto contemporaneo, con lo scopo di constatare delle eventuali somiglianze e diffe­ renze. Tenendo in considerazione la realta linguistica nella regione Friuli-Venezia Giulia, dove le interferenze fra l'italiano, il friulano ed il veneto sono tali che un non-friulanofono non riesce facilmente a distinguere quando si tratta di un sintag­ ma di origine friulana e quando di un calco sintattico sull'italiano, sembra oppor­ tuno, in numerosi casi, confrontare ilsintagma friulano e quello francese anche con la variante corrispondente in italiano letterario moderno; inoltre, nel capitolo in cui sono trattati i cosiddetti tempi bicomposti, vengono citati alcuni esempi nelle diver­ se varieta venete.

  19. Spazio, movimento, prospettiva ed empatia: un prototipo di videogame didattico

    Pio Alfredo Di Tore

    2014-09-01

    Full Text Available Questo lavoro presenta la cornice teorica che sta alla base della progettazione di un videogame didattico pensato per valutare le abilità di perspective taking (capacità di adottare la prospettiva altrui e di mental rotation (rotazione mentale dei giocatori. Lo studio mira a rilevare come tali abilità siano coinvolte nella relazione empatica e a verificarne le implicazioni in campo educativo. Il lavoro adotta la definizione di empatia riconducibile ad Alain Berthoz ed alla teoria spaziale dell’empatia qui presentata con i relativi sistemi di riferimento spaziale. È inoltre fornita una rapida revisione della letteratura sulla rappresentazione dello spazio nel bambino e sulla rappresentazione dello spazio nel gioco (su base visiva. Infine, il lavoro descrive il prototipo di gioco – realizzato presso l’Università di Salerno – in cui il giocatore si trova alle prese con tre differenti compiti di cui due progettati per misurare le abilità di perspective taking mentre il terzo è calibrato sulle abilità di mental rotation.

  20. 'Sharing things with people that I don't even know': help-seeking for psychological symptoms in injured Black men in Philadelphia.

    Jacoby, Sara F; Rich, John A; Webster, Jessica L; Richmond, Therese S

    2018-04-01

    Psychological distress is common in survivors of traumatic injury, yet across United States' trauma systems, it is rare that standard injury care integrates psychological evaluation and professional mental healthcare. The purpose of this study was to explore help-seeking for psychological symptoms in injured Black men living in Philadelphia. A subset of a cohort of 551 injured Black men admitted to a Trauma Center in Philadelphia participated in qualitative interviews that explored their perceptions of psychological symptoms after injury and the factors that guided their decision to seek professional mental health help. Data from 32 participants were analyzed for narrative and thematic content. Three overarching themes emerged: (1) facilitators of help-seeking, (2) barriers to help-seeking, and (3) factors underlying the decision not to consider professional help. Five participants felt that their injury-related psychological distress was severe enough to merit professional help despite any perceived barriers. Seventeen participants identified systemic and interpersonal obstacles to professional help that prevented them from seeking this kind of care. These included: financial constraints, limited access to mental healthcare services, and fear of the judgments of mental healthcare professionals. Ten participants would not consider professional help; these men perceived a lack of need and sufficiency in their existing social support networks. Research is needed to inform or identify interventions that diminish the impact of barriers to care, and identify from whom, where, and how professional mental health help might be more effectively offered to injured Black men in recovery environments like Philadelphia.