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Sample records for factor tsrf1 improves

  1. Improved Balanced Incomplete Factorization

    Czech Academy of Sciences Publication Activity Database

    Bru, R.; Marín, J.; Mas, J.; Tůma, Miroslav

    2010-01-01

    Roč. 31, č. 5 (2010), s. 2431-2452 ISSN 0895-4798 R&D Projects: GA AV ČR IAA100300802 Grant - others:GA AV ČR(CZ) M100300902 Institutional research plan: CEZ:AV0Z10300504 Source of funding: I - inštitucionálna podpora na rozvoj VO Keywords : preconditioned iterative methods * sparse matrices * incomplete decompositions * approximate inverses * Sherman-Morrison formula * nonsymmetric matrices Subject RIV: BA - General Mathematics Impact factor: 1.725, year: 2010

  2. Improved multivariate polynomial factoring algorithm

    International Nuclear Information System (INIS)

    Wang, P.S.

    1978-01-01

    A new algorithm for factoring multivariate polynomials over the integers based on an algorithm by Wang and Rothschild is described. The new algorithm has improved strategies for dealing with the known problems of the original algorithm, namely, the leading coefficient problem, the bad-zero problem and the occurrence of extraneous factors. It has an algorithm for correctly predetermining leading coefficients of the factors. A new and efficient p-adic algorithm named EEZ is described. Bascially it is a linearly convergent variable-by-variable parallel construction. The improved algorithm is generally faster and requires less store then the original algorithm. Machine examples with comparative timing are included

  3. Contextual factors and effective school improvement

    NARCIS (Netherlands)

    Sun, Hechuan; Creemers, Bert P. M.; de Jong, Rob

    This research provides policy-makers, researchers, and educators at all levels with a glimpse of the contextual influence on effective school improvement (ESI) in 8 European countries. What are the factors at the contextual level, particularly at the national level, which influence ESI? Are there

  4. Organizational factors influencing improvements in safety

    International Nuclear Information System (INIS)

    Marcus, A.; Nichols, M.L.; Olson, J.; Osborn, R.; Thurber, J.

    1992-01-01

    Research reported here seeks to identify the key organizational factors that influence safety-related performance indicators in nuclear power plants over time. It builds upon organizational factors identified in NUREG/CR-5437, and begins to develop a theory of safety-related performance and performance improvement based on economic and behavioral theories of the firm. Central to the theory are concepts of past performance, problem recognition, resource availability, resource allocation, and business strategies that focus attention. Variables which reflect those concepts are combined in statistical models and tested for their ability to explain scrams, safety system actuations, significant events, safety system failures, radiation exposure, and critical hours. Results show the performance indicators differ with respect to the sets of variables which serve as the best predictors of future performance, and past performance is the most consistent predictor of future performance

  5. Organizational factors influencing improvements in safety

    International Nuclear Information System (INIS)

    Marcus, A.; Nichols, M.L.; Olson, J.; Osborn, R.; Thurber, J.

    1991-01-01

    Results of conceptual and empirical research conducted by this research team, and published in NUREG-CR 5437, suggested that processes of organizational problem solving and learning provide a promising area for understanding improvement in safety-related performance in nuclear power plants. In this paper the authors describe the way in which they have built upon that work and gone much further in empirically examining a range of potentially important organizational factors related to safety. The paper describes (1) overall trends in plant performance over time on the Nuclear Regulatory Commission performance indicators, (2) the major elements in the conceptual framework guiding the current work, which seeks among other things to explain those trends, (3) the specific variables used as measures of the central concepts, (4) the results to date of the quantitative empirical work and qualitative work in progress, and (5) conclusions from the research

  6. Bicycling to school improves the cardiometabolic risk factor profile

    DEFF Research Database (Denmark)

    Ostergaard, Lars; Børrestad, Line A B; Tarp, Jakob

    2012-01-01

    To investigate whether bicycling to school improves cardiometabolic risk factor profile and cardiorespiratory fitness among children.......To investigate whether bicycling to school improves cardiometabolic risk factor profile and cardiorespiratory fitness among children....

  7. Factors for successful improvement of Swedish healthcare

    OpenAIRE

    Olsson, Jesper

    2005-01-01

    The Swedish OCM, developed by an Integrative Group Process, was found to be a valid model able to distinguish successful from unsuccessful organizations in terms of improvement. A majority of healthcare organizations applied the Internal Collaborative strategy which lacks the patient centered task alignment characterizing those organizations predicted to be successful by their relatively superior Swedish OCM score. Managers tend to overestimate the prospects of organizationa...

  8. Improving Safety through Human Factors Engineering.

    Science.gov (United States)

    Siewert, Bettina; Hochman, Mary G

    2015-10-01

    Human factors engineering (HFE) focuses on the design and analysis of interactive systems that involve people, technical equipment, and work environment. HFE is informed by knowledge of human characteristics. It complements existing patient safety efforts by specifically taking into consideration that, as humans, frontline staff will inevitably make mistakes. Therefore, the systems with which they interact should be designed for the anticipation and mitigation of human errors. The goal of HFE is to optimize the interaction of humans with their work environment and technical equipment to maximize safety and efficiency. Special safeguards include usability testing, standardization of processes, and use of checklists and forcing functions. However, the effectiveness of the safety program and resiliency of the organization depend on timely reporting of all safety events independent of patient harm, including perceived potential risks, bad outcomes that occur even when proper protocols have been followed, and episodes of "improvisation" when formal guidelines are found not to exist. Therefore, an institution must adopt a robust culture of safety, where the focus is shifted from blaming individuals for errors to preventing future errors, and where barriers to speaking up-including barriers introduced by steep authority gradients-are minimized. This requires creation of formal guidelines to address safety concerns, establishment of unified teams with open communication and shared responsibility for patient safety, and education of managers and senior physicians to perceive the reporting of safety concerns as a benefit rather than a threat. © RSNA, 2015.

  9. Development of a Field Management Standard for Improving Human Factors

    International Nuclear Information System (INIS)

    Yun, Young Su; Son, Il Moon; Son, Byung Chang; Kwak, Hyo Yean

    2009-07-01

    This project is to develop a management guideline for improving human performances as a part of the Human Factors Management System of Kori unit 1 which is managing all of human factors items such as man-machine system interfaces, work procedures, work environments, and human reliabilities in nuclear power plants. Human factors engineering includes an human factors suitability analysis and improvement of human works, an analysis of accidents by human error, an improvement of work environment, an establishment of human factors management rules and a development of human resources to manage and perform those things consistently. For assisting these human factors engineering tasks, we developed human factors management guidelines, checklists and work procedures to be used in staffing, qualification, training, and human information requirements and workload. We also provided a software tool for managing the above items. Additionally, contents and an item pool for a human factors qualifying examination and training programs were developed. A procedures improvement and a human factors V and V on the Kori unit 1 have been completed as a part of this project, too

  10. Chapter 7. Assessing soil factors in wildland improvement programs

    Science.gov (United States)

    Arthur R. Tiedemann; Carlos F. Lopez

    2004-01-01

    Soil factors are an important consideration for successful wildland range development or improvement programs. Even though many soil improvement and amelioration practices are not realistic for wildlands, their evaluation is an important step in selection of adapted plant materials for revegetation. This chapter presents information for wildland managers on: the...

  11. [Factors influencing research activity of Andalusian nurses and improvement strategies].

    Science.gov (United States)

    López Alonso, Sergio R; Gálvez González, María; Amezcua, Manuel

    2013-04-01

    To identify factors influencing research activity of Andalusian nurses and to find improvement strategies. Qualitative research using SWOT analysis (weaknesses, threats, strengths, opportunities). Nurses were selected deliberately in eight groups according to predetermined criteria. Analysis included categorization and relationship of factors and strategies. 81 participants were included in groups of 7-12 range. 45 categories were identified with 212 factors: 12 weaknesses (50 factors), 10 strengths (44 factors), 12 threats (68 factors) and 11 opportunities (50 factors). In addition, 32 categories were identified with 53 strategies: 14 categories of W-T strategies (42 strategies), 3 categories of S-T strategies (11 strategies), 5 categories of W-O strategies (13 strategies) and 10 categories of S-O strategies (41 strategies). Nurses identified numerous factors, mainly threats. The strategies are focused on W-T but they also suggest many but weak 5-0 strategies due to the low potential of the opportunities and strengths perceived.

  12. Factor analysis improves the selection of prescribing indicators

    DEFF Research Database (Denmark)

    Rasmussen, Hanne Marie Skyggedal; Søndergaard, Jens; Sokolowski, Ineta

    2006-01-01

    OBJECTIVE: To test a method for improving the selection of indicators of general practitioners' prescribing. METHODS: We conducted a prescription database study including all 180 general practices in the County of Funen, Denmark, approximately 472,000 inhabitants. Principal factor analysis was us...... appropriate and inappropriate prescribing, as revealed by the correlation of the indicators in the first factor. CONCLUSION: Correlation and factor analysis is a feasible method that assists the selection of indicators and gives better insight into prescribing patterns....

  13. Improving human performance: Industry factors influencing the ability to perform

    OpenAIRE

    Güera Massyn Romo

    2013-01-01

    Learning interventions and new technologies that aim to improve human performance must take cognisance of industry factors inhibiting human performance. The dynamic and fast pace nature of the Information and Communication Technologies (ICT) and the engineering industries do not lend themselves to proper skills planning and management. These industries experience real skills gaps, to some of which they contribute by themselves. This study reports on these performance-inhibiting factors such a...

  14. Factors Affecting the Adoption of Improved Rice Varieties in Borno ...

    African Journals Online (AJOL)

    USER

    The study investigated the factors that affect adoption of improved rice varieties in the ... give a good results and also a threat to food security. Keywords: ..... decision of the farmers, however, inappropriate chain of supply/distributing the input or ...

  15. Endurance Factors Improve Hippocampal Neurogenesis and Spatial Memory in Mice

    Science.gov (United States)

    Kobilo, Tali; Yuan, Chunyan; van Praag, Henriette

    2011-01-01

    Physical activity improves learning and hippocampal neurogenesis. It is unknown whether compounds that increase endurance in muscle also enhance cognition. We investigated the effects of endurance factors, peroxisome proliferator-activated receptor [delta] agonist GW501516 and AICAR, activator of AMP-activated protein kinase on memory and…

  16. Improvements in fitness are not obligatory for exercise training-induced improvements in CV risk factors.

    Science.gov (United States)

    Hartman, Yvonne A W; Hopman, Maria T E; Schreuder, Tim H; Verheggen, Rebecca J H M; Scholten, Ralph R; Oudegeest-Sander, Madelijn H; Poelkens, Fleur; Maiorana, Andrew J; Naylor, Louise H; Willems, Peter H; Tack, Cees J; Thijssen, Dick H J; Green, Daniel J

    2018-02-01

    The purpose of this study was to assess whether changes in physical fitness relate to changes in cardiovascular risk factors following standardized, center-based and supervised exercise training programs in subjects with increased cardiovascular risk. We pooled data from exercise training studies of subjects with increased cardiovascular risk (n = 166) who underwent 8-52 weeks endurance training. We determined fitness (i.e., peak oxygen uptake) and traditional cardiovascular risk factors (body mass index, blood pressure, total cholesterol, high-density lipoprotein cholesterol), before and after training. We divided subjects into quartiles based on improvement in fitness, and examined whether these groups differed in terms of risk factors. Associations between changes in fitness and in cardiovascular risk factors were further tested using Pearson correlations. Significant heterogeneity was apparent in the improvement of fitness and individual risk factors, with nonresponder rates of 17% for fitness, 44% for body mass index, 33% for mean arterial pressure, 49% for total cholesterol, and 49% for high-density lipoprotein cholesterol. Neither the number, nor the magnitude, of change in cardiovascular risk factors differed significantly between quartiles of fitness change. Changes in fitness were not correlated with changes in cardiovascular risk factors (all P > 0.05). Our data suggest that significant heterogeneity exists in changes in peak oxygen uptake after training, while improvement in fitness did not relate to improvement in cardiovascular risk factors. In subjects with increased cardiovascular risk, improvements in fitness are not obligatory for training-induced improvements in cardiovascular risk factors. © 2018 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

  17. Improved SVR Model for Multi-Layer Buildup Factor Calculation

    International Nuclear Information System (INIS)

    Trontl, K.; Pevec, D.; Smuc, T.

    2006-01-01

    The accuracy of point kernel method applied in gamma ray dose rate calculations in shielding design and radiation safety analysis is limited by the accuracy of buildup factors used in calculations. Although buildup factors for single-layer shields are well defined and understood, buildup factors for stratified shields represent a complex physical problem that is hard to express in mathematical terms. The traditional approach for expressing buildup factors of multi-layer shields is through semi-empirical formulas obtained by fitting the results of transport theory or Monte Carlo calculations. Such an approach requires an ad-hoc definition of the fitting function and often results with numerous and usually inadequately explained and defined correction factors added to the final empirical formula. Even more, finally obtained formulas are generally limited to a small number of predefined combinations of materials within relatively small range of gamma ray energies and shield thicknesses. Recently, a new approach has been suggested by the authors involving one of machine learning techniques called Support Vector Machines, i.e., Support Vector Regression (SVR). Preliminary investigations performed for double-layer shields revealed great potential of the method, but also pointed out some drawbacks of the developed model, mostly related to the selection of one of the parameters describing the problem (material atomic number), and the method in which the model was designed to evolve during the learning process. It is the aim of this paper to introduce a new parameter (single material buildup factor) that is to replace the existing material atomic number as an input parameter. The comparison of two models generated by different input parameters has been performed. The second goal is to improve the evolution process of learning, i.e., the experimental computational procedure that provides a framework for automated construction of complex regression models of predefined

  18. Improvements in a four factor formula recipe for educational purposes

    International Nuclear Information System (INIS)

    Oelgaard, P.L.

    1995-05-01

    In introductory reactor physics courses the four-factor-formula and two-group theory is normally used to demonstrate to students in a quantitative way the physics of nuclear reactors. However, the agreement obtained between lattice calculations with such simple recipes and measurements is not very good. This is in particular the case for light water reactors. To improve this situation it has been investigated whether it is possible by relative simple modifications of such a recipe to obtain better agreement between theory and measurements. The results obtained from this investigation are presented in this paper. It is seen from the results that significant improvements in the agreement between measurements and theory have been obtained. This report was presented to the meeting on Reactor Physics Calculations in the Nordic Countries, Helsinki, May 8-9, 1995. (au)

  19. Improving human performance: Industry factors influencing the ability to perform

    Directory of Open Access Journals (Sweden)

    Güera Massyn Romo

    2013-03-01

    Full Text Available Learning interventions and new technologies that aim to improve human performance must take cognisance of industry factors inhibiting human performance. The dynamic and fast pace nature of the Information and Communication Technologies (ICT and the engineering industries do not lend themselves to proper skills planning and management. These industries experience real skills gaps, to some of which they contribute by themselves. This study reports on these performance-inhibiting factors such as the underutilisation of available skills, tolerance for individual preferences, and dynamically, and informally refining a role objective while an employee is occupying a certain role. The important professional skills required by individuals to cope with these real life factors are also explored in the skills gaps management context. Moreover, these industries need a profile they refer to as Special Forces, which denotes a high calibre of worker that possesses well-developed professional skills whilst having advanced technical expertise and sufficient experience. This resource profile is required largely due to the poor management of human resource processes in practice and the current reported lack of adequate skills. Furthermore, this study refers to the recent lack of a working definition for these Special Forces leading to the omitted active development of these profiles in industry today, which appears to become a key human performance inhibiting factor.

  20. National plan to enhance aviation safety through human factors improvements

    Science.gov (United States)

    Foushee, Clay

    1990-01-01

    The purpose of this section of the plan is to establish a development and implementation strategy plan for improving safety and efficiency in the Air Traffic Control (ATC) system. These improvements will be achieved through the proper applications of human factors considerations to the present and future systems. The program will have four basic goals: (1) prepare for the future system through proper hiring and training; (2) develop a controller work station team concept (managing human errors); (3) understand and address the human factors implications of negative system results; and (4) define the proper division of responsibilities and interactions between the human and the machine in ATC systems. This plan addresses six program elements which together address the overall purpose. The six program elements are: (1) determine principles of human-centered automation that will enhance aviation safety and the efficiency of the air traffic controller; (2) provide new and/or enhanced methods and techniques to measure, assess, and improve human performance in the ATC environment; (3) determine system needs and methods for information transfer between and within controller teams and between controller teams and the cockpit; (4) determine how new controller work station technology can optimally be applied and integrated to enhance safety and efficiency; (5) assess training needs and develop improved techniques and strategies for selection, training, and evaluation of controllers; and (6) develop standards, methods, and procedures for the certification and validation of human engineering in the design, testing, and implementation of any hardware or software system element which affects information flow to or from the human.

  1. [Job satisfaction and improvement factors in primary care professionals].

    Science.gov (United States)

    Pérez-Ciordia, I; Guillén-Grima, F; Brugos, A; Aguinaga, I

    2013-09-06

    The quality of services in a health system is related to the level of satisfaction of its professionals. The aim of this article is to determine job satisfaction in primary care professionals and rank those factors capable of improving it. Descriptive study carried out in Navarre in 2010. A validated questionnaire was sent by post to the population of the study: primary care doctors, pediatricians and nurses. Variables on socio-demographic data were collected and job satisfaction was self-evaluated on a scale of 1 to 10. Respondents were asked to rank 10 factors that could improve the previously mentioned satisfaction. Averages were compared and bivariate analysis was carried out using the chi-square test, studying the association between variables through the Odds Ratio (OR). The adjusted analysis was realized through unconditional logistic regression. We collected 432 questionnaires (77.5%). Average satisfaction was 6.7 (scale of 1 to 10), higher in nursing. Women showed a higher average than men (6.90:6.34). The workers at urban health centers (OR: 1.71; CI: 1.10-2.65) showed a higher risk of dissatisfaction with respect to professionals at rural centers. The training activities of the professional is the most highly valued item, followed by economic questions and questions of care pressure, with no differences found by profession. Job satisfaction is a dimension of quality management in primary care and its study enables identification of problems or opportunities for improvement with an impact on the quality of the services offered.

  2. [Human factors and crisis resource management: improving patient safety].

    Science.gov (United States)

    Rall, M; Oberfrank, S

    2013-10-01

    A continuing high number of patients suffer harm from medical treatment. In 60-70% of the cases the sources of harm can be attributed to the field of human factors (HFs) and teamwork; nevertheless, those topics are still neither part of medical education nor of basic and advanced training even though it has been known for many years and it has meanwhile also been demonstrated for surgical specialties that training in human factors and teamwork considerably reduces surgical mortality.Besides the medical field, the concept of crisis resource management (CRM) has already proven its worth in many other industries by improving teamwork and reducing errors in the domain of human factors. One of the best ways to learn about CRM and HFs is realistic simulation team training with well-trained instructors in CRM and HF. The educational concept of the HOTT (hand over team training) courses for trauma room training offered by the DGU integrates these elements based on the current state of science. It is time to establish such training for all medical teams in emergency medicine and operative care. Accompanying safety measures, such as the development of a positive culture of safety in every department and the use of effective critical incident reporting systems (CIRs) should be pursued.

  3. Factors influencing improved attendance in the UK fire service.

    Science.gov (United States)

    Litchfield, I; Hinckley, P

    2016-12-01

    Sickness absence rates in the UK continue to exceed those in much of the developed world, with an annual cost to employers of £29 billion. Rates of sickness absence in the public sector are higher than those in the private sector, with the exception of the fire service where they are consistently lower. To understand the influences that increase attendance among operational firefighters. A series of semi-structured interviews undertaken with operational staff to explore their attitudes to sickness absence. Review and analysis of participant responses identified a number of key themes, namely employee well-being, including physical fitness and mental health; employee engagement with the fire service as manifested by culture, experience, nature of the job and leadership; organizational factors including the staffing model and relationship with occupational health services and policy, which describes both refinements to and implementation of targeted policies. Previously observed factors such as improved fitness and the distinct firefighter culture play a role, yet other factors emerged that could explain the differences. These include the greater work-life balance offered by their shift patterns, the terms and conditions of employment and perhaps most importantly the evolution of precisely targeted policies that understand the unique nature of the operational fire service. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine.

  4. Perceived Factors Associated with Sustained Improvement Following Participation in a Multicenter Quality Improvement Collaborative.

    Science.gov (United States)

    Stone, Sohini; Lee, Henry C; Sharek, Paul J

    2016-07-01

    The California Perinatal Quality Care Collaborative led the Breastmilk Nutrition Quality Improvement Collaborative from October 2009 to September 2010 to increase the percentage of very low birth weight infants receiving breast milk at discharge in 11 collaborative neonatal ICUs (NICUs). Observed increases in breast milk feeding and decreases in necrotizing enterocolitis persisted for 6 months after the collaborative ended. Eighteen to 24 months after the end of the collaborative, some sites maintained or further increased their gains, while others trended back toward baseline. A study was conducted to assess the qualitative factors that affect sustained improvement following participation. Collaborative leaders at each of the 11 NICUs that participated in the Breastmilk Nutrition Quality Improvement Collaborative were invited to participate in a site-specific one-hour phone interview. Interviews were recorded and transcribed and then analyzed using qualitative research analysis software to identify themes associated with sustained improvement. Eight of 11 invited centers agreed to participate in the interviews. Thematic saturation was achieved by the sixth interview, so further interviews were not pursued. Factors contributing to sustainability included physician involvement within the multidisciplinary teams, continuous education, incorporation of interventions into the daily work flow, and integration of a data-driven feedback system. Early consideration by site leaders of how to integrate best-practice interventions into the daily work flow, and ensuring physician commitment and ongoing education based in continuous data review, should enhance the likelihood of sustaining improvements. To maximize sustained success, future collaborative design should consider proactively identifying and supporting these factors at participating sites.

  5. Availability improvement factors at Taipower's nuclear power plant system

    International Nuclear Information System (INIS)

    Chen, J.H.

    1985-01-01

    Sufficient electricity to meet the needs of a growing industrial economy, is one of the most important factors in the total economic development of a nation. Currently, nuclear power is considered one of the most economical and available sources of energy. To keep pace with Taiwan's rapid economic development, while also observing our government's policy of diversifying the requirements for imported forms of energy, Taiwan Power Company has embarked upon an ambitious of nuclear power plant construction. This paper discusses the improvement of Taiwan's nuclear power plants. At the present time, Taipower has completed three nuclear power plants. Two of these are located in northern Taiwan, along the East China Sea, while the third is on the southern tip of Taiwan, bordering the South China Sea. These three plants, each with two nuclear generating units, comprise a total nuclear generating capacity of 5144 MWe

  6. An Improved Reinforcement Learning System Using Affective Factors

    Directory of Open Access Journals (Sweden)

    Takashi Kuremoto

    2013-07-01

    Full Text Available As a powerful and intelligent machine learning method, reinforcement learning (RL has been widely used in many fields such as game theory, adaptive control, multi-agent system, nonlinear forecasting, and so on. The main contribution of this technique is its exploration and exploitation approaches to find the optimal solution or semi-optimal solution of goal-directed problems. However, when RL is applied to multi-agent systems (MASs, problems such as “curse of dimension”, “perceptual aliasing problem”, and uncertainty of the environment constitute high hurdles to RL. Meanwhile, although RL is inspired by behavioral psychology and reward/punishment from the environment is used, higher mental factors such as affects, emotions, and motivations are rarely adopted in the learning procedure of RL. In this paper, to challenge agents learning in MASs, we propose a computational motivation function, which adopts two principle affective factors “Arousal” and “Pleasure” of Russell’s circumplex model of affects, to improve the learning performance of a conventional RL algorithm named Q-learning (QL. Compared with the conventional QL, computer simulations of pursuit problems with static and dynamic preys were carried out, and the results showed that the proposed method results in agents having a faster and more stable learning performance.

  7. Improving English Speaking Fluency: The Role of Six Factors

    Directory of Open Access Journals (Sweden)

    Gholamhossein Shahini

    2017-12-01

    Full Text Available This qualitative study, using an open interview, set out to investigate the roles six factors, including age, university education, teachers of English Language institutes, teaching English, dictionary, and note-taking, played in improving English speaking fluency of seventeen fluent Iranian EFL speakers. The participants were chosen purposefully based on the speaking scale of Common European Framework of Reference for Languages (CEFRL. The findings indicated that early age had a great impact on the participants’ speaking fluency. They mentioned that they could not pick up fluency if they had started learning English at older ages. Moreover, university education had no effect on enhancing their fluency. They stated that not having enough opportunities to speak English in classrooms, being exposed to wrong amounts of input from their classmates or even from some university instructors, having no access to English native speakers in English Language Departments, professors’ talking in native language out of classes, in their offices or even sometimes in classes all led to their losing motivation after entering the university. In contrast, teachers in English language institutes had a supportive role in increasing the participants’ English learning. Although two participants quit teaching English since it had a negative influence on their speaking, it had a positive impact on improving speaking ability of the rest. And finally, fruitful strategies were suggested on how to use dictionaries and note-takings.

  8. Improving Your Exploratory Factor Analysis for Ordinal Data: A Demonstration Using FACTOR

    Directory of Open Access Journals (Sweden)

    James Baglin

    2014-06-01

    Full Text Available Exploratory factor analysis (EFA methods are used extensively in the field of assessment and evaluation. Due to EFA's widespread use, common methods and practices have come under close scrutiny. A substantial body of literature has been compiled highlighting problems with many of the methods and practices used in EFA, and, in response, many guidelines have been proposed with the aim to improve application. Unfortunately, implementing recommended EFA practices has been restricted by the range of options available in commercial statistical packages and, perhaps, due to an absence of clear, practical - how-to' demonstrations. Consequently, this article describes the application of methods recommended to get the most out of your EFA. The article focuses on dealing with the common situation of analysing ordinal data as derived from Likert-type scales. These methods are demonstrated using the free, stand-alone, easy-to-use and powerful EFA package FACTOR (http://psico.fcep.urv.es/utilitats/factor/, Lorenzo-Seva & Ferrando, 2006. The demonstration applies the recommended techniques using an accompanying dataset, based on the Big 5 personality test. The outcomes obtained by the EFA using the recommended procedures through FACTOR are compared to the default techniques currently available in SPSS.

  9. A Multivariate Analysis of Factors Affecting Adoption of Improved ...

    African Journals Online (AJOL)

    may compete for scarce household resources such as draft power, labor and chemical ..... The probability distribution of the joint adoption probabilities of improved .... would be that improved varieties being divisible and scale neutral may.

  10. Quality factor improvement of silicon nitride micro string resonators

    DEFF Research Database (Denmark)

    Schmid, Silvan; Malm, Bjarke; Boisen, Anja

    2011-01-01

    Resonant micro and nano strings are of interest for sensor applications due to their extraordinary high quality factors, low mass and tunable resonant frequency. It has been found that the quality factor of strings is usually limited by clamping loss. In this work, clamping loss has been addressed...... by varying the clamping design and string geometry. We present silicon nitride micro strings with quality factors (Q) of up to 4 million in high vacuum achieved by minimizing clamping loss. For applications such as for chemical sensing, strings need to vibrate at atmospheric pressure. Maximal quality factor...

  11. Multiplicity in supervision relationships: A factor in improving ...

    African Journals Online (AJOL)

    Supervision has been identified as an important factor in the success of postgraduate students, even as the most significant variable and a large number of studies have been conducted to identify factors that contribute to supervision success. However the dependent variable in these studies – supervision success – has ...

  12. Factors Influencing the Adoption of Improved Sorghum Varieties in ...

    African Journals Online (AJOL)

    The findings of the study indicated that age and distance to input market were negatively and significantly related to improved sorghum varieties whereas farm size and type of house owned were found to have been positively and significantly related to improved sorghum varieties. The results of the study confirm that ...

  13. A multivariate analysis of factors affecting adoption of improved ...

    African Journals Online (AJOL)

    This paper analyzes the synergies/tradeoffs involved in the adoption of improved varieties of multiple crops in the mixed crop-livestock production systems of the highlands of Ethiopia A multivariate probit (MVP) model involving a system of four equations for the adoption decision of improved varieties of barley, potatoes, ...

  14. Directions of improvement of account of factoring operations

    Directory of Open Access Journals (Sweden)

    V.I. Kuz

    2015-06-01

    Full Text Available With the height of competition on commodity markets the suppliers of commodities and services for bringing in of new and maintenance of present clients are forced to give certain privileges to them, including postponement or arranging on the installment system of payment. In these terms one of perspective instruments of financing of enterprises of the real sector is factoring. Factoring plays an important role in a market economy. He provides to the enterprises and organizations of height of volume of turnover means and acceleration of circulating of capital; assists more rapid redemption a debtor and creditor debts and as a result, height of rates of production and circulating of commodities, works or services; assists expansion of production. How a process of development of factoring operations is intensive enough, a necessity grows for the detailed consideration of methodology of record-keeping of factoring operations. Methodology of record-keeping of factoring operations offered in the article for a supplier, at a factor and debtor, on the basis of operating card of accounts can be used in practice of commercial organizations-participants of agreement of factoring.

  15. Improvements on Cardiovascular Diseases Risk Factors in Obese Adolescents

    DEFF Research Database (Denmark)

    Gomes Silva, Humberto José; Andersen, Lars Bo; Lofrano-Prado, Mara Cristina

    2015-01-01

    BACKGROUND: It is unclear how different exercise intensities affect cardiovascular disease (CVD) risk factors in obese adolescents. The aim of this study was to compare the effects of high intensity (HIT) vs. low intensity (LIT) aerobic training on CVD risk factors in obese adolescents. METHODS......: Forty-three obese adolescents (age: 15.7±1.3y, BMI: 34.3±4.1kg/m2) participated this study either HIT (corresponding to ventilatory threshold-I, VT1; N=20) or LIT (20% below VT1; N=23) for 12 weeks (12W). All sessions were isocaloric (350 kcal). All participants received the same nutritional......, psychological and clinical counseling. Subjects were assessed in fatness, fitness, lipid profile and glucose at baseline and after 12W. The CVD risk factors assessed were waist circumference (WC), total cholesterol (TC), HDL, glucose and fitness, which were single and clustered analyzed (Z-scores sum). RESULTS...

  16. Convergence Improvement of Response Matrix Method with Large Discontinuity Factors

    International Nuclear Information System (INIS)

    Yamamoto, Akio

    2003-01-01

    In the response matrix method, a numerical divergence problem has been reported when extremely small or large discontinuity factors are utilized in the calculations. In this paper, an alternative response matrix formulation to solve the divergence problem is discussed, and properties of iteration matrixes are investigated through eigenvalue analyses. In the conventional response matrix formulation, partial currents between adjacent nodes are assumed to be discontinuous, and outgoing partial currents are converted into incoming partial currents by the discontinuity factor matrix. Namely, the partial currents of the homogeneous system (i.e., homogeneous partial currents) are treated in the conventional response matrix formulation. In this approach, the spectral radius of an iteration matrix for the partial currents may exceed unity when an extremely small or large discontinuity factor is used. Contrary to this, an alternative response matrix formulation using heterogeneous partial currents is discussed in this paper. In the latter approach, partial currents are assumed to be continuous between adjacent nodes, and discontinuity factors are directly considered in the coefficients of a response matrix. From the eigenvalue analysis of the iteration matrix for the one-group, one-dimensional problem, the spectral radius for the heterogeneous partial current formulation does not exceed unity even if an extremely small or large discontinuity factor is used in the calculation; numerical stability of the alternative formulation is superior to the conventional one. The numerical stability of the heterogeneous partial current formulation is also confirmed by the two-dimensional light water reactor core analysis. Since the heterogeneous partial current formulation does not require any approximation, the converged solution exactly reproduces the reference solution when the discontinuity factors are directly derived from the reference calculation

  17. Improving the Optical Quality Factor of the WGM Resonator

    Science.gov (United States)

    Savchenkov, Anatoliy; Matsko, Andrey; Iltchenko, Vladimir

    2008-01-01

    Resonators usually are characterized with two partially dependent values: finesse (F) and quality factor (Q). The finesse of an empty Fabry-Perot (FP) resonator is defined solely by the quality of its mirrors and is calculated as F=piR(exp 1/2)/(1-R). The maximum up-to-date value of reflectivity R approximately equal to 1 - 1.6 x 10(exp -6) is achieved with dielectric mirrors. An FP resonator made with the mirrors has finesse F=1.9 x 10(exp 6). Further practical increase of the finesse of FP resonators is problematic because of the absorption and the scattering of light in the mirror material through fundamental limit on the reflection losses given by the internal material losses and by thermodynamic density fluctuations on the order of parts in 109. The quality factor of a resonator depends on both its finesse and its geometrical size. A one-dimensional FP resonator has Q=2 F L/lambda, where L is the distance between the mirrors and lambda is the wavelength. It is easy to see that the quality factor of the resonator is unlimited because L is unlimited. F and Q are equally important. In some cases, finesse is technically more valuable than the quality factor. For instance, buildup of the optical power inside the resonator, as well as the Purcell factor, is proportional to finesse. Sometimes, however, the quality factor is more valuable. For example, inverse threshold power of intracavity hyperparametric oscillation is proportional to Q(exp 2) and efficiency of parametric frequency mixing is proportional to Q(exp 3). Therefore, it is important to know both the maximally achievable finesse and quality factor values of a resonator. Whispering gallery mode (WGM) resonators are capable of achieving larger finesse compared to FP resonators. For instance, fused silica resonators with finesse 2.3 x 10(exp 6) and 2.8 x 10(exp 6) have been demonstrated. Crystalline WGM resonators reveal even larger finesse values, F=6.3 x 10(exp 6), because of low attenuation of light in the

  18. Power factor improvement in three-phase networks with unbalanced inductive loads using the Roederstein ESTAmat RPR power factor controller

    Science.gov (United States)

    Diniş, C. M.; Cunţan, C. D.; Rob, R. O. S.; Popa, G. N.

    2018-01-01

    The paper presents the analysis of a power factor with capacitors banks, without series coils, used for improving power factor for a three-phase and single-phase inductive loads. In the experimental measurements, to improve the power factor, the Roederstein ESTAmat RPR power factor controller can command up to twelve capacitors banks, while experimenting using only six capacitors banks. Six delta capacitors banks with approximately equal reactive powers were used for experimentation. The experimental measurements were carried out with a three-phase power quality analyser which worked in three cases: a case without a controller with all capacitors banks permanently parallel connected with network, and two other cases with power factor controller (one with setting power factor at 0.92 and the other one at 1). When performing experiments with the power factor controller, a current transformer was used to measure the current on one phase (at a more charged or less loaded phase).

  19. Chromogenic Factor VIII Assays for Improved Diagnosis of Hemophilia A.

    Science.gov (United States)

    Rodgers, Susan; Duncan, Elizabeth

    2017-01-01

    Hemophilia A is an inherited bleeding disorder caused by a reduced level of factor VIII coagulant activity (FVIII:C) in blood. Bleeding episodes may occur spontaneously in the severe form of hemophilia or after trauma in the milder forms. It is important that patients are diagnosed correctly, which includes placing them into the correct severity category of the disorder so that appropriate treatment can be given. Diagnosis is made by determination of the amount of FVIII:C in the blood, usually using a one-stage factor VIII:C assay. However, approximately one third of patients with mild or moderate hemophilia will have much lower results by the chromogenic assay, with some of them having normal results by the one-stage assay. The chromogenic factor VIII assay is used in some specialized hemophilia reference centers and is recommended for the diagnosis of mild hemophilia A, as this assay is considered to better reflect the severity status of hemophilia patients than the one-stage assay.

  20. Improving classroom practices: the impact of leadership, school organizational conditions, and teacher factors

    NARCIS (Netherlands)

    Thoonen, E.E.J.

    2012-01-01

    Schools are challenged to improve classroom practices as they are expected to enhance students’ motivation. While leadership, school organizational conditions and teacher factors are considered essential for improving classroom practices, more should be known about the interplay between school

  1. Three success factors for continual improvement in healthcare: an analysis of the reports of improvement team members.

    Science.gov (United States)

    Brandrud, Aleidis Skard; Schreiner, Ada; Hjortdahl, Per; Helljesen, Gro Sævil; Nyen, Bjørnar; Nelson, Eugene C

    2011-03-01

    The objectives of the Breakthrough Series Collaborative are to close the gap between what we know and what we do, and to contribute to continuous quality improvement (CQI) of healthcare through collaborative learning. The improvement efforts are guided by a systematic approach, combining professional and improvement knowledge. To explore what the improvement teams have learnt from participating in the collaborative and from dealing with promoting and inhibiting factors encountered. Qualitative interviews with 19 team members were conducted in four focus groups, using the Critical Incident Technique. A critical incident is one that makes significant contributions, either positively or negatively, to an activity. The elements of a culture of improvement are revealed by the critical incidents, and reflect the eight domains of knowledge, as a product of collaborative learning. The improvement knowledge and skills of individuals are important elements, but not enough to achieve sustainable changes. 90% of the material reflects the need for a system of CQI to solve the problems that organisations experience in trying to make lasting improvements. A pattern of three success factors for CQI emerges: (1) continuous and reliable information, including measurement, about best and current practice; (2) engagement of everybody in all phases of the improvement work: the patient and family, the leadership, the professional environment and the staff; and (3) an infrastructure based on improvement knowledge, with multidisciplinary teams, available coaching, learning systems and sustainability systems.

  2. A search for improved technique factors in paediatric fluoroscopy

    International Nuclear Information System (INIS)

    Tapiovaara, M.J.; Sandborg, M.; Dance, D.R.

    1999-01-01

    A Monte Carlo computational model of a fluoroscopic imaging chain was used for deriving optimal technique factors for paediatric fluoroscopy. The optimal technique was defined as the one that minimizes the absorbed dose (or dose rate) in the patient with a constraint of constant image quality. Image quality was assessed for the task of detecting a detail in the image of a patient-simulating phantom, and was expressed in terms of the ideal observer's signal-to-noise ratio (SNR) for static images and in terms of the accumulating rate of the square of SNR for dynamic imaging. The entrance air kerma (or air kerma rate) and the mean absorbed dose (or dose rate) in the phantom quantified radiation detriment. The calculations were made for homogeneous phantoms simulating newborn, 3-, 10- and 15-year-old patients, barium and iodine contrast material details, several x-ray spectra, and for imaging with or without an antiscatter grid. The image receptor was modelled as a CsI x-ray image intensifier (XRII). For the task of detecting low- or moderate-contrast iodine details, the optimal spectrum can be obtained by using an x-ray tube potential near 50 kV and filtering the x-ray beam heavily. The optimal tube potential is near 60 kV for low- or moderate-contrast barium details, and 80-100 kV for high-contrast details. The low-potential spectra above require a high tube load, but this should be acceptable in paediatric fluoroscopy. A reasonable choice of filtration is the use of an additional 0.25 mm Cu, or a suitable K-edge filter. No increase in the optimal tube potential was found as phantom thickness increased. With the constraint of constant low-contrast detail detectability, the mean absorbed doses obtained with the above spectra are approximately 50% lower than those obtained with the reference conditions of 70 kV and 2.7 mm Al filter. For the smallest patient and x-ray field size, not using a grid was slightly more dose-efficient than using a grid, but when the patient

  3. Supplier selection or collaboration? Determining factors of performance improvement when outsourcing manufacturing

    OpenAIRE

    Dabhilkar, Mandar; Bengtsson, Lars; Haartman, Robin von; Åhlström, Pär

    2009-01-01

    An empirical study was designed to determine factors of performance improvement when outsourcing manufacturing. Findings from a survey of 136 manufacturing plants in Sweden show that most of them achieve their outsourcing motives, but not without trade-offs. Factors of performance improvements such as economies of scale or operations in low-cost countries can improve one performance dimension, such as product cost, yet negatively impact volume flexibility, speed or product innovation. The res...

  4. Power Factor Improvement Using Automatic Power Factor Compensation (APFC Device for Medical Industries in Malaysia

    Directory of Open Access Journals (Sweden)

    Zaidi Maryam Nabihah

    2018-01-01

    Full Text Available This paper present the project designed to correcting power factor for medical industries in Malaysia automatically. Which with hope to make the cost and energy usage efficient, because the energy source are depleting due to increase in population. Power factor is the ratio of real power and apparent power. This definition is mathematically represented as kW/kVA where kW is active power and kVA is apparent power (active + reactive. Reactive power is the non-working power generated by the magnetic and inductive load to generate magnetic flux. The increase in reactive power increase the apparent power so the power factor will decrease. Low pF will cause the industry to meet high demand thus making it less efficient. The main aim of this project is to increasing the current power factor of medical industries from 0.85 to 0.90. Power factor compensation contribute to reduction in current-dependent losses and increase energy efficiency while expanding the reliability of planning for future energy network. As technology develops, the gradual cost and efficiency penalty should reduce. Therefore, automatic power factor compensation device should become cost-effective and smaller device over time. That is the reason this project is using programmable device as it is a miniature architecture device.

  5. Improvements in fitness are not obligatory for exercise training-induced improvements in CV risk factors

    NARCIS (Netherlands)

    Hartman, Yvonne A.W.; Hopman, Maria T.E.; Schreuder, Tim H.; Verheggen, Rebecca J.H.M.; Scholten, Ralph R.; Oudegeest-Sander, Madelijn H.; Poelkens, Fleur; Maiorana, Andrew J.; Naylor, Louise H.; Willems, Peter H.; Tack, Cees J.; Thijssen, Dick H.J.; Green, Daniel J.

    2018-01-01

    The purpose of this study was to assess whether changes in physical fitness relate to changes in cardiovascular risk factors following standardized, center-based and supervised exercise training programs in subjects with increased cardiovascular risk. We pooled data from exercise training studies of

  6. Power Factor Improvement Using Automatic Power Factor Compensation (APFC) Device for Medical Industries in Malaysia

    OpenAIRE

    Zaidi Maryam Nabihah; Ali Adlan

    2018-01-01

    This paper present the project designed to correcting power factor for medical industries in Malaysia automatically. Which with hope to make the cost and energy usage efficient, because the energy source are depleting due to increase in population. Power factor is the ratio of real power and apparent power. This definition is mathematically represented as kW/kVA where kW is active power and kVA is apparent power (active + reactive). Reactive power is the non-working power generated by the mag...

  7. An improvement of the applicability of human factors guidelines for coping with human factors issues in nuclear power plants

    International Nuclear Information System (INIS)

    Lee, Y. H.; Lee, J. Y.

    2003-01-01

    Human factors have been well known as one of the key factors to the system effectiveness as well as the efficiency and safety of nuclear power plants(NPPs). Human factors engineering(HFE) are included in periodic safety review(PSR) on the existing NPPs and the formal safety assessment for the new ones. However, HFE for NPPs is still neither popular in practice nor concrete in methodology. Especially, the human factors guidelines, which are the most frequent form of human factors engineering in practice, reveal the limitations in their applications. We discuss the limitations and their casual factors found in human factors guidelines in order to lesson the workload of HFE practitioners and to improve the applicability of human factors guidelines. According to the purposes and the phases of HFE for NPPs, more selective items and specified criteria should be prepared carefully in the human factors guidelines for the each HFE applications in practice. These finding on the human factors guidelines can be transferred to the other HFE application field, such as military, aviation, telecommunication, HCI, and product safety

  8. The Impact of Soft Factors on Quality Improvement in Manufacturing Industry

    Science.gov (United States)

    Chan, Shiau Wei; Fauzi Ahmad, Md; Kong, Mei Wan

    2017-08-01

    Nowadays, soft factors have become the key factors of success in quality improvement of an organisation. Many organisations have neglected the importance of soft factors, this may influence the organisational performance. Hence, the purpose of this research is to examine the impact of soft factors on quality improvement in manufacturing industries. Six hypotheses were examined while considering six dimensions of soft factors including management commitment, customer focus, supplier relationship, employee involvement, training and education, and reward and recognition that have a positive impact on quality improvement. In this study, eighty one managers from the quality department were randomly selected in the manufacturing industry in Batu Pahat, Johor. The questionnaires were distributed to them. The researcher analysed the quantitatively collected data using descriptive analysis and correlation analysis. The findings of this study revealed that all soft factors are correlated to the quality improvement in an organisation with a high significant value but the regression analysis shows that the supplier relationship and employee involvement has more significant impact on quality improvement as compared to other soft factors which contributes of this study.

  9. Electronic mode of control to obtain increased torque and improved power factor from an asynchronous machine

    NARCIS (Netherlands)

    Wyk, van J.D.

    1970-01-01

    It is indicated that, by changing the electronic switching mode of the rotor current of an induction machine, it is possible to operate the machine at improved (capacitive) power factors and increased torque, or conversely at lower effective current and capacitive power factors at rated torque.

  10. Analysis of Academic Administrators' Attitudes: Annual Evaluations and Factors That Improve Teaching

    Science.gov (United States)

    Cherry, Brian D.; Grasse, Nathan; Kapla, Dale; Hamel, Brad

    2017-01-01

    This article examines academic administrators' attitudes towards the academic evaluation process in the US and those factors that are utilised to improve teaching. We use path regressions to examine satisfaction with evaluation procedures, as well as the direct and indirect effects of these factors on perceptions of whether the evaluation process…

  11. Improving performance of high risk organizations Spanish nuclear sector from the analysis of organizational culture factors

    International Nuclear Information System (INIS)

    La Salabarnada, E.; German, S.; Silla, I.; Navajas, J.

    2012-01-01

    This paper presents the research project funded by UNESA and conducted by the CISOT-CIEMAT that aims to contribute to improving the operating performance of the Spanish nuclear power plants. This paper aims to identify the factors and key organizational processes to improve efficiency, in order to advance knowledge about the influence of organizational culture on the safety of high reliability organizations.

  12. Factors to Consider in Selecting an Organisational Improvement Initiative: Survey Results

    Directory of Open Access Journals (Sweden)

    Mohammad Musli

    2017-01-01

    Full Text Available Organisations should select the appropriate improvement initiative that will fit with the context of organisation and provide value to the organisation. This paper presents 18 factors to be considered when selecting an organisational improvement initiative. Organisational improvement initiatives are approaches, management systems, tools and/or techniques that can be used for managing and improving organisations, such as Lean, ISO9001, Six Sigma and Improvement Team. A survey was conducted to identify the level of importance of these 18 factors as criteria for selecting an improvement initiative. Purposive sampling was used for this survey involving practitioners, managers, engineers, executives, consultants and/or academicians, who have been involved in the selection and/or implementation of organisational improvement initiatives in Malaysia. Two factors were rated as ‘very high importance’, which involve: (1 The ability to gain top management commitment and support to introduce and implement the initiative successfully, and (2 The initiative is aligned to the vision, mission and/or purpose of the organisation. All these factors can be adopted by the organisations as decision criteria to assist in the selection of the most appropriate improvement initiative based on rational decision making.

  13. The Sustainable Office. An exploration of the potential for factor 20 environmental improvement of office accommodation

    OpenAIRE

    Van den Dobbelsteen, A.A.J.F.

    2004-01-01

    Sustainable development is the goal of a balance between economy and the environment, whilst establishing a better spread prosperity across the world. In order to make this possible, the environmental load of our commodities needs to be reduced by a factor of 20. This factor 20 can also be translated to the office market. The PhD research presented in this thesis focussed on finding solutions effectively contributing to factor 20 environmental improvement of office accommodation. In order to ...

  14. Nucleon form factors in dispersively improved chiral effective field theory. II. Electromagnetic form factors

    Science.gov (United States)

    Alarcón, J. M.; Weiss, C.

    2018-05-01

    We study the nucleon electromagnetic form factors (EM FFs) using a recently developed method combining chiral effective field theory (χ EFT ) and dispersion analysis. The spectral functions on the two-pion cut at t >4 Mπ2 are constructed using the elastic unitarity relation and an N /D representation. χ EFT is used to calculate the real functions J±1(t ) =f±1(t ) /Fπ(t ) (ratios of the complex π π →N N ¯ partial-wave amplitudes and the timelike pion FF), which are free of π π rescattering. Rescattering effects are included through the empirical timelike pion FF | Fπ(t) | 2 . The method allows us to compute the isovector EM spectral functions up to t ˜1 GeV2 with controlled accuracy (leading order, next-to-leading order, and partial next-to-next-to-leading order). With the spectral functions we calculate the isovector nucleon EM FFs and their derivatives at t =0 (EM radii, moments) using subtracted dispersion relations. We predict the values of higher FF derivatives, which are not affected by higher-order chiral corrections and are obtained almost parameter-free in our approach, and explain their collective behavior. We estimate the individual proton and neutron FFs by adding an empirical parametrization of the isoscalar sector. Excellent agreement with the present low-Q2 FF data is achieved up to ˜0.5 GeV2 for GE, and up to ˜0.2 GeV2 for GM. Our results can be used to guide the analysis of low-Q2 elastic scattering data and the extraction of the proton charge radius.

  15. Analysis on nuclear power plant control room system design and improvement based on human factor engineering

    International Nuclear Information System (INIS)

    Gao Feng; Liu Yanzi; Sun Yongbin

    2014-01-01

    The design of nuclear power plant control room system is a process of improvement with the implementation of human factor engineering theory and guidance. The method of implementation human factor engineering principles into the nuclear power plant control room system design and improvement was discussed in this paper. It is recommended that comprehensive address should be done from control room system function, human machine interface, digital procedure, control room layout and environment design based on the human factor engineering theory and experience. The main issues which should be paid more attention during the control room system design and improvement also were addressed in this paper, and then advices and notices for the design and improvement of the nuclear power plant control room system were afforded. (authors)

  16. The scalar and electromagnetic form factors of the nucleon in dispersively improved Chiral EFT

    Energy Technology Data Exchange (ETDEWEB)

    Alarcon, Jose Manuel [Thomas Jefferson National Accelerator Facility (TJNAF), Newport News, VA (United States)

    2018-04-01

    We present a method for calculating the nucleon form factors of G-parity-even operators. This method combines chiral effective field theory (χEFT) and dispersion theory. Through unitarity we factorize the imaginary part of the form factors into a perturbative part, calculable with χEFT, and a non-perturbative part, obtained through other methods. We consider the scalar and electromagnetic (EM) form factors of the nucleon. The results show an important improvement compared to standard chiral calculations, and can be used in analysis of the low-energy properties of the nucleon.

  17. Extracellular Matrix and Growth Factors Improve the Efficacy of Intramuscular Islet Transplantation.

    Directory of Open Access Journals (Sweden)

    Haruyuki Tsuchiya

    Full Text Available The efficacy of intramuscular islet transplantation is poor despite being technically simple, safe, and associated with reduced rates of severe complications. We evaluated the efficacy of combined treatment with extracellular matrix (ECM and growth factors in intramuscular islet transplantation.Male BALB/C mice were used for the in vitro and transplantation studies. The following three groups were evaluated: islets without treatment (islets-only group, islets embedded in ECM with growth factors (Matrigel group, and islets embedded in ECM without growth factors [growth factor-reduced (GFR Matrigel group]. The viability and insulin-releasing function of islets cultured for 96 h were significantly improved in Matrigel and GFR Matrigel groups compared with the islets-only group.Blood glucose and serum insulin levels immediately following transplantation were significantly improved in the Matrigel and GFR Matrigel groups and remained significantly improved in the Matrigel group at postoperative day (POD 28. On histological examination, significantly decreased numbers of TdT-mediated deoxyuridine triphosphate-biotin nick end labeling-positive islet cells and significantly increased numbers of Ki67-positive cells were observed in the Matrigel and GFR Matrigel groups at POD 3. Peri-islet revascularization was most prominent in the Matrigel group at POD 14.The efficacy of intramuscular islet transplantation was improved by combination treatment with ECM and growth factors through the inhibition of apoptosis, increased proliferation of islet cells, and promotion of revascularization.

  18. Extracellular Matrix and Growth Factors Improve the Efficacy of Intramuscular Islet Transplantation.

    Science.gov (United States)

    Tsuchiya, Haruyuki; Sakata, Naoaki; Yoshimatsu, Gumpei; Fukase, Masahiko; Aoki, Takeshi; Ishida, Masaharu; Katayose, Yu; Egawa, Shinichi; Unno, Michiaki

    2015-01-01

    The efficacy of intramuscular islet transplantation is poor despite being technically simple, safe, and associated with reduced rates of severe complications. We evaluated the efficacy of combined treatment with extracellular matrix (ECM) and growth factors in intramuscular islet transplantation. Male BALB/C mice were used for the in vitro and transplantation studies. The following three groups were evaluated: islets without treatment (islets-only group), islets embedded in ECM with growth factors (Matrigel group), and islets embedded in ECM without growth factors [growth factor-reduced (GFR) Matrigel group]. The viability and insulin-releasing function of islets cultured for 96 h were significantly improved in Matrigel and GFR Matrigel groups compared with the islets-only group. Blood glucose and serum insulin levels immediately following transplantation were significantly improved in the Matrigel and GFR Matrigel groups and remained significantly improved in the Matrigel group at postoperative day (POD) 28. On histological examination, significantly decreased numbers of TdT-mediated deoxyuridine triphosphate-biotin nick end labeling-positive islet cells and significantly increased numbers of Ki67-positive cells were observed in the Matrigel and GFR Matrigel groups at POD 3. Peri-islet revascularization was most prominent in the Matrigel group at POD 14. The efficacy of intramuscular islet transplantation was improved by combination treatment with ECM and growth factors through the inhibition of apoptosis, increased proliferation of islet cells, and promotion of revascularization.

  19. Improvements to the Chebyshev expansion of attenuation correction factors for cylindrical samples

    International Nuclear Information System (INIS)

    Mildner, D.F.R.; Carpenter, J.M.

    1990-01-01

    The accuracy of the Chebyshev expansion coefficients used for the calculation of attenuation correction factors for cylinderical samples has been improved. An increased order of expansion allows the method to be useful over a greater range of attenuation. It is shown that many of these coefficients are exactly zero, others are rational numbers, and others are rational frations of π -1 . The assumptions of Sears in his asymptotic expression of the attenuation correction factor are also examined. (orig.)

  20. Application of thermal sterilization regimes simulation for improvement of canned foods quality factors

    Directory of Open Access Journals (Sweden)

    Stolyanov A.V.

    2015-03-01

    Full Text Available Results of comparison of optimization methods of thermal sterilization temperature-time regimes have been described. It has been shown that due to simulation the final canned foods’ quality factors are significantly improved, sterilization process time is decreased and energy consumption is reduced without sacrificing actual final lethality value

  1. [Factors affecting the ability of caffeine to improve the short-term memory in man].

    Science.gov (United States)

    Arushanian, E B; Baĭda, O A; Mastiagin, S S; Popova, A P; Shikina, I B

    2003-01-01

    Caffeine is known to improve both visual and aural memory in healthy humans. This caffeine effect correlates with the mental work capacity and depends on a number of variable factors. In particular, the effect is more pronounced in the evening and in females.

  2. Factors Associated With Worsened or Improved Mental Health in the Great East Japan Earthquake Survivors.

    Science.gov (United States)

    Yamanouchi, Tomoko; Hiroshima, Mayo; Takeuchi, Yumiko; Sawada, Yumiko; Takahashi, Makiko; Amagai, Manami

    2018-02-01

    The aim of this study was to identify factors contributing to the worsening or improved mental health of long-term evacuees over three years following the Great East Japan Earthquake. The Japanese version of the K6 questionnaire was used as a measure of mental health. The first- and third-year survey results were compared and differences in mental health status calculated. Respondents were then divided into two groups according to worsening or improved mental health status. Differences in stress factors, stress relief methods, and demographics were compared between the two groups. Factors associated with exacerbation of poor mental health were the stress factors "Uncertainty about future" (p=0.048) and "Loss of purpose in life" (p=0.023). Multivariable analysis identified two factors associated with improved mental health, the stress relief methods "Accepting myself" (odds ratio (OR): 2.15, 95% confidence interval (CI): 1.02-4.51) and "Interactions with others" (OR: 3.34, 95% CI: 1.43-7.79). While motivation and hope of livelihood reconstruction have gradually risen in the three years since the disaster, anxieties about an uncertain future, loss of purpose in life, and disruption of social networks continue adversely to affect the mental health of survivors. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Improvement of Power Flow Calculation with Optimization Factor Based on Current Injection Method

    Directory of Open Access Journals (Sweden)

    Lei Wang

    2014-01-01

    Full Text Available This paper presents an improvement in power flow calculation based on current injection method by introducing optimization factor. In the method proposed by this paper, the PQ buses are represented by current mismatches while the PV buses are represented by power mismatches. It is different from the representations in conventional current injection power flow equations. By using the combined power and current injection mismatches method, the number of the equations required can be decreased to only one for each PV bus. The optimization factor is used to improve the iteration process and to ensure the effectiveness of the improved method proposed when the system is ill-conditioned. To verify the effectiveness of the method, the IEEE test systems are tested by conventional current injection method and the improved method proposed separately. Then the results are compared. The comparisons show that the optimization factor improves the convergence character effectively, especially that when the system is at high loading level and R/X ratio, the iteration number is one or two times less than the conventional current injection method. When the overloading condition of the system is serious, the iteration number in this paper appears 4 times less than the conventional current injection method.

  4. Using human factors engineering to improve the effectiveness of infection prevention and control.

    Science.gov (United States)

    Anderson, Judith; Gosbee, Laura Lin; Bessesen, Mary; Williams, Linda

    2010-08-01

    Human factors engineering is a discipline that studies the capabilities and limitations of humans and the design of devices and systems for improved performance. The principles of human factors engineering can be applied to infection prevention and control to study the interaction between the healthcare worker and the system that he or she is working with, including the use of devices, the built environment, and the demands and complexities of patient care. Some key challenges in infection prevention, such as delayed feedback to healthcare workers, high cognitive workload, and poor ergonomic design, are explained, as is how human factors engineering can be used for improvement and increased compliance with practices to prevent hospital-acquired infections.

  5. Factors predicting visual improvement post pars plana vitrectomy for proliferative diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Evelyn Tai Li Min

    2017-08-01

    Full Text Available AIM: To identify factors predicting visual improvement post vitrectomy for sequelae of proliferative diabetic retinopathy(PDR.METHODS: This was a retrospective analysis of pars plana vitrectomy indicated for sequelae of PDR from Jan. to Dec. 2014 in Hospital Sultanah Bahiyah, Alor Star, Kedah, Malaysia. Data collected included patient demographics, baseline visual acuity(VAand post-operative logMAR best corrected VA at 1y. Data analysis was performed with IBM SPSS Statistics Version 22.0. RESULTS: A total of 103 patients were included. The mean age was 51.2y. On multivariable analysis, each pre-operative positive deviation of 1 logMAR from a baseline VA of 0 logMAR was associated with a post-operative improvement of 0.859 logMAR(P0.001. Likewise, an attached macula pre-operatively was associated with a 0.374(P=0.003logMAR improvement post vitrectomy. Absence of iris neovascularisation and absence of post-operative complications were associated with a post vitrectomy improvement in logMAR by 1.126(P=0.001and 0.377(P=0.005respectively. Absence of long-acting intraocular tamponade was associated with a 0.302(P=0.010improvement of logMAR post vitrectomy.CONCLUSION: Factors associated with visual improvement after vitrectomy are poor pre-operative VA, an attached macula, absence of iris neovascularisation, absence of post-operative complications and abstaining from use of long-acting intraocular tamponade. A thorough understanding of the factors predicting visual improvement will facilitate decision-making in vitreoretinal surgery.

  6. Optimization of factors to obtain cassava starch films with improved mechanical properties

    Science.gov (United States)

    Monteiro, Mayra; Oliveira, Victor; Santos, Francisco; Barros Neto, Eduardo; Silva, Karyn; Silva, Rayane; Henrique, João; Chibério, Abimaelle

    2017-08-01

    In this study, was investigated the optimization of the factors that significantly influenced the mechanical property improvement of cassava starch films through complete factorial design 23. The factors to be analyzed were cassava starch, glycerol and modified clay contents. A regression model was proposed by the factorial analysis, aiming to estimate the condition of the individual factors investigated in the optimum state of the mechanical properties of the biofilm, using the following statistical tool: desirability function and response surface. The response variable that delimits the improvement of the mechanical property of the biofilm is the tensile strength, such improvement is obtained by maximizing the response variable. The factorial analysis showed that the best combination of factor configurations to reach the best response was found to be: with 5g of cassava starch, 10% of glycerol and 5% of modified clay, both percentages in relation to the dry mass of starch used. In addition, the starch biofilm showing the lowest response contained 2g of cassava starch, 0% of modified clay and 30% of glycerol, and was consequently considered the worst biofilm.

  7. Residency factors that influence pediatric in-training examination score improvement.

    Science.gov (United States)

    Chase, Lindsay H; Highbaugh-Battle, Angela P; Buchter, Susie

    2012-10-01

    The goal of this study was to determine which measurable factors of resident training experience contribute to improvement of in-training examination (ITE) and certifying examination (CE) scores. This is a descriptive retrospective study analyzing data from July 2003 through June 2006 at a large academic pediatric training program. Pediatric categorical residents beginning residency in July 2003 were included. Regression analyses were used to determine if the number of admissions performed, core lectures attended, acute care topics heard, grand rounds attended, continuity clinic patients encountered, or procedures performed correlated with improvement of ITE scores. These factors were then analyzed in relation to CE scores. Seventeen residents were included in this study. The number of general pediatric admissions was the only factor found to correlate with an increase in ITE score (P = .04). Scores for the ITE at pediatric levels 1 and 3 were predictive of CE scores. No other factors measured were found to influence CE scores. Although all experiences of pediatric residents likely contribute to professional competence, some experiences may have more effect on ITE and CE scores. In this study, only general pediatric admissions correlated significantly with an improvement in ITE scores from year 1 to year 3. Further study is needed to identify which elements of the residency experience contribute most to CE success. This would be helpful in optimizing residency program structure and curriculum within the limitations of duty hour regulations.

  8. Improved vascularization of planar membrane diffusion devices following continuous infusion of vascular endothelial growth factor.

    Science.gov (United States)

    Trivedi, N; Steil, G M; Colton, C K; Bonner-Weir, S; Weir, G C

    2000-01-01

    Improving blood vessel formation around an immunobarrier device should improve the survival of the encapsulated tissue. In the present study we investigated the formation of new blood vessels around a planar membrane diffusion device (the Baxter Theracyte System) undergoing a continuous infusion of vascular endothelial growth factor through the membranes and into the surrounding tissue. Each device (20 microl) had both an inner immunoisolation membrane and an outer vascularizing membrane. Human recombinant vascular endothelial growth factor-165 was infused at 100 ng/day (low dose: n = 6) and 500 ng/day (high dose: n = 7) for 10 days into devices implanted s.c. in Sprague-Dawley rats; noninfused devices transplanted for an identical period were used as controls (n = 5). Two days following the termination of VEGF infusion, devices were loaded with 20 microl of Lispro insulin (1 U/kg) and the kinetics of insulin release from the lumen of the device was assessed. Devices were then explanted and the number of blood vessels (capillary and noncapillary) was quantified using morphometry. High-dose vascular endothelial growth factor infusion resulted in two- to threefold more blood vessels around the device than that obtained with the noninfused devices and devices infused with low-dose vascular endothelial growth factor. This increase in the number of blood vessels was accompanied by a modest increase in insulin diffusion from the device in the high-dose vascular endothelial growth factor infusion group. We conclude that vascular endothelial growth factor can be used to improve blood vessel formation adjacent to planar membrane diffusion devices.

  9. Hepatocyte nuclear factor 4A improves hepatic differentiation of immortalized adult human hepatocytes and improves liver function and survival.

    Science.gov (United States)

    Hang, Hua-Lian; Liu, Xin-Yu; Wang, Hai-Tian; Xu, Ning; Bian, Jian-Min; Zhang, Jian-Jun; Xia, Lei; Xia, Qiang

    2017-11-15

    Immortalized human hepatocytes (IHH) could provide an unlimited supply of hepatocytes, but insufficient differentiation and phenotypic instability restrict their clinical application. This study aimed to determine the role of hepatocyte nuclear factor 4A (HNF4A) in hepatic differentiation of IHH, and whether encapsulation of IHH overexpressing HNF4A could improve liver function and survival in rats with acute liver failure (ALF). Primary human hepatocytes were transduced with lentivirus-mediated catalytic subunit of human telomerase reverse transcriptase (hTERT) to establish IHH. Cells were analyzed for telomerase activity, proliferative capacity, hepatocyte markers, and tumorigenicity (c-myc) expression. Hepatocyte markers, hepatocellular functions, and morphology were studied in the HNF4A-overexpressing IHH. Hepatocyte markers and karyotype analysis were completed in the primary hepatocytes using shRNA knockdown of HNF4A. Nuclear translocation of β-catenin was assessed. Rat models of ALF were treated with encapsulated IHH or HNF4A-overexpressing IHH. A HNF4A-positive IHH line was established, which was non-tumorigenic and conserved properties of primary hepatocytes. HNF4A overexpression significantly enhanced mRNA levels of genes related to hepatic differentiation in IHH. Urea levels were increased by the overexpression of HNF4A, as measured 24h after ammonium chloride addition, similar to that of primary hepatocytes. Chromosomal abnormalities were observed in primary hepatocytes transfected with HNF4A shRNA. HNF4α overexpression could significantly promote β-catenin activation. Transplantation of HNF4A overexpressing IHH resulted in better liver function and survival of rats with ALF compared with IHH. HNF4A improved hepatic differentiation of IHH. Transplantation of HNF4A-overexpressing IHH could improve the liver function and survival in a rat model of ALF. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Factors of Quality Improvement of the Foreign Language Teaching in Technical University

    Directory of Open Access Journals (Sweden)

    Ira R. Agasieva

    2017-03-01

    Full Text Available In the article the problem of quality of teaching and knowledge of the English language has been considered. The factors that influence the improvement of the quality of teaching and knowledge of the English language in a technical college, the use of various methods of enhancing the quality of teaching and knowledge of the English language has been analyzed. It has been distinguished the necessity of taking into account the factors such as emotional maturity of the student, the desire for success, student cognitive style, its consistency and independence.

  11. Critical success factors simplified implementing the powerful drivers of dramatic business improvement

    CERN Document Server

    Howell, Marvin T

    2010-01-01

    Critical-to-success factors (CSFs) have become essential elements to strategic planning and no business can achieve consistent success without effectively adopting them. To take full advantage of CSFs, however, an organization must first understand what they are and how they can be used to drive organizational initiatives and processes. Critical Success Factors Simplified: Implementing the Powerful Drivers of Dramatic Business Improvement provides a concise manual on CSFs that will teach you how to identify and select the right CSFs, measure their impact, and adjust them as needed to reach your goals.

  12. Space Vector Modulation for an Indirect Matrix Converter with Improved Input Power Factor

    Directory of Open Access Journals (Sweden)

    Nguyen Dinh Tuyen

    2017-04-01

    Full Text Available Pulse width modulation strategies have been developed for indirect matrix converters (IMCs in order to improve their performance. In indirect matrix converters, the LC input filter is used to remove input current harmonics and electromagnetic interference problems. Unfortunately, due to the existence of the input filter, the input power factor is diminished, especially during operation at low voltage outputs. In this paper, a new space vector modulation (SVM is proposed to compensate for the input power factor of the indirect matrix converter. Both computer simulation and experimental studies through hardware implementation were performed to verify the effectiveness of the proposed modulation strategy.

  13. IMPROVING CONTROL ROOM DESIGN AND OPERATIONS BASED ON HUMAN FACTORS ANALYSES OR HOW MUCH HUMAN FACTORS UPGRADE IS ENOUGH ?

    Energy Technology Data Exchange (ETDEWEB)

    HIGGINS,J.C.; OHARA,J.M.; ALMEIDA,P.

    2002-09-19

    THE JOSE CABRERA NUCLEAR POWER PLANT IS A ONE LOOP WESTINGHOUSE PRESSURIZED WATER REACTOR. IN THE CONTROL ROOM, THE DISPLAYS AND CONTROLS USED BY OPERATORS FOR THE EMERGENCY OPERATING PROCEDURES ARE DISTRIBUTED ON FRONT AND BACK PANELS. THIS CONFIGURATION CONTRIBUTED TO RISK IN THE PROBABILISTIC SAFETY ASSESSMENT WHERE IMPORTANT OPERATOR ACTIONS ARE REQUIRED. THIS STUDY WAS UNDERTAKEN TO EVALUATE THE IMPACT OF THE DESIGN ON CREW PERFORMANCE AND PLANT SAFETY AND TO DEVELOP DESIGN IMPROVEMENTS.FIVE POTENTIAL EFFECTS WERE IDENTIFIED. THEN NUREG-0711 [1], PROGRAMMATIC, HUMAN FACTORS, ANALYSES WERE CONDUCTED TO SYSTEMATICALLY EVALUATE THE CR-LA YOUT TO DETERMINE IF THERE WAS EVIDENCE OF THE POTENTIAL EFFECTS. THESE ANALYSES INCLUDED OPERATING EXPERIENCE REVIEW, PSA REVIEW, TASK ANALYSES, AND WALKTHROUGH SIMULATIONS. BASED ON THE RESULTS OF THESE ANALYSES, A VARIETY OF CONTROL ROOM MODIFICATIONS WERE IDENTIFIED. FROM THE ALTERNATIVES, A SELECTION WAS MADE THAT PROVIDED A REASONABLEBALANCE BE TWEEN PERFORMANCE, RISK AND ECONOMICS, AND MODIFICATIONS WERE MADE TO THE PLANT.

  14. Factors affecting the use of patient survey data for quality improvement in the Veterans Health Administration

    Directory of Open Access Journals (Sweden)

    Davies Elizabeth A

    2011-12-01

    Full Text Available Abstract Background Little is known about how to use patient feedback to improve experiences of health care. The Veterans Health Administration (VA conducts regular patient surveys that have indicated improved care experiences over the past decade. The goal of this study was to assess factors that were barriers to, or promoters of, efforts to improve care experiences in VA facilities. Methods We conducted case studies at two VA facilities, one with stable high scores on inpatient reports of emotional support between 2002 and 2006, and one with stable low scores over the same period. A semi-structured interview was used to gather information from staff who worked with patient survey data at the study facilities. Data were analyzed using a previously developed qualitative framework describing organizational, professional and data-related barriers and promoters to data use. Results Respondents reported more promoters than barriers to using survey data, and particularly support for improvement efforts. Themes included developing patient-centered cultures, quality improvement structures such as regular data review, and training staff in patient-centered behaviors. The influence of incentives, the role of nursing leadership, and triangulating survey data with other data on patients' views also emerged as important. It was easier to collect data on current organization and practice than those in the past and this made it difficult to deduce which factors might influence differing facility performance. Conclusions Interviews with VA staff provided promising examples of how systematic processes for using survey data can be implemented as part of wider quality improvement efforts. However, prospective studies are needed to identify the most effective strategies for using patient feedback to improve specific aspects of patient-centered care.

  15. Q-factor improvement of degenerate four-wave-mixing regenerators for ASE degraded signals

    Science.gov (United States)

    Lu, Hang; Wu, Bao-jian; Geng, Yong; Zhou, Xing-yu; Sun, Fan

    2017-11-01

    All-optical regenerators can be used to suppress amplified spontaneous emission (ASE) noise introduced by cascaded erbium doped fiber amplifiers (EDFAs) in optical fiber communication systems and lead to the improvement of optical receiver sensitivity. By introducing the Q-factor transfer function (QTF), we evaluate the Q-factor performance of degenerate four-wave mixing (DFWM) regenerators with clock pump and reveal the differences between the optimal input powers determined from the static and dynamic power tranfer function (PTF) and the QTF curves. Our simulation shows that the clock-pump regnerator is capable of improving the Q-facor and receiver sensitivity for 40 Gbit/s ASE-degraded return-to-zero on-off keying (RZ-OOK) signal by 2.58 dB and 4.2 dB, respectively.

  16. A New V2G Control Strategy for Load Factor Improvement Using Smoothing Technique

    Directory of Open Access Journals (Sweden)

    CHANHOM, P.

    2017-08-01

    Full Text Available This paper proposes a new vehicle-to-grid (V2G control strategy for improving the load factor in the power network. To operate the proposed strategy, the available storage capacity of the PEVs’ batteries is considered as a battery energy storage system (BESS for charging and discharging an amount of power corresponding to the V2G power command. Due to the remarkable advantages of the technique so-called simple moving average, it is selected for applying in the proposed V2G control strategy. In this research, for investigating the load factor improvement, the essential data including the daily-load profiles with 7-day and 14-day periods are used for the 3 studied cases. These 3 studied cases present the power network with variation of the PEVs locations for describing the PEVs usage and charging or discharging behavior. The performance of the proposed strategy is simulated and verified by the MATPOWER software. The simulation results show that the load factors of the 3 studied cases are improved. Moreover, the encouragement of energy arbitrage for the PEVs owners is also discussed in this paper.

  17. Opportunities to improve the conversion of food waste to lactate: Fine-tuning secondary factors.

    Science.gov (United States)

    RedCorn, Raymond; Engelberth, Abigail S

    2017-11-01

    Extensive research has demonstrated the potential for bioconversion of food waste to lactate, with major emphasis on adjusting temperature, pH, and loading rate of the fermentation. Each of these factors has a significant effect on lactate production; however, additional secondary factors have received little attention. Here we investigate three additional factors where opportunities exist for process improvement: freezing of samples during storage, discontinuous pH control, and holdover of fermentation broth between fermentations. Freezing samples prior to fermentation was shown to reduce the production rate of lactate by 8%, indicating freeze-thaw should be avoided in experiments. Prior work indicated a trade-off in pH control strategies, where discontinuous pH control correlated with higher lactate accumulation while continuous pH control correlated with higher production rate. Here we demonstrate that continuous pH control can achieve both higher lactate accumulation and higher production rate. Finally, holding over fermentation broth was shown to be a simple method to improve production rate (by 18%) at high food waste loading rates (>140 g volatile solids L -1 ) but resulted in lower lactate accumulation (by 17%). The results inform continued process improvements within the waste treatment of food waste through fermentation to lactic acid.

  18. Changes in serum growth factors in stroke rehabilitation patients and their relation to hemiparesis improvement.

    Science.gov (United States)

    Okazaki, Hideto; Beppu, Hidehiko; Mizutani, Kenmei; Okamoto, Sayaka; Sonoda, Shigeru

    2014-07-01

    Predicting recovery from hemiparesis after stroke is important for rehabilitation. A few recent studies reported that the levels of some growth factors shortly after stroke were positively correlated with the clinical outcomes during the chronic phase. The aim of this study was to examine the relationships between the serum levels of growth factors (vascular endothelial growth factor [VEGF], insulin-like growth factor-I [IGF-I], and hepatocyte growth factor [HGF]) and improvement in hemiparesis in stroke patients who received rehabilitation in a postacute rehabilitation hospital. Subjects were 32 stroke patients (cerebral infarction: 21 and intracerebral hemorrhage [ICH]: 11). We measured serum levels of VEGF, IGF-I, and HGF and 5 items of the Stroke Impairment Assessment Set (SIAS) for hemiparesis on admission and at discharge. Age-matched healthy subjects (n=15) served as controls. Serum levels of VEGF and HGF in cerebral infarct patients on admission were higher than those in control subjects, and the serum levels of IGF-I in stroke patients were lower than those in controls. The level of HGF in ICH patients on admission was negatively correlated with gains in SIAS, and higher outliers in HGF concentration were correlated with lower gains in SIAS. Focusing on the extremely high levels of these factors may be a predictor of the low recovery from hemiparesis after stroke. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  19. Improving risk assessment in schizophrenia: epidemiological investigation of criminal history factors.

    Science.gov (United States)

    Witt, Katrina; Lichtenstein, Paul; Fazel, Seena

    2015-05-01

    Violence risk assessment in schizophrenia relies heavily on criminal history factors. To investigate which criminal history factors are most strongly associated with violent crime in schizophrenia. A total of 13 806 individuals (8891 men and 4915 women) with two or more hospital admissions for schizophrenia were followed up for violent convictions. Multivariate hazard ratios for 15 criminal history factors included in different risk assessment tools were calculated. The incremental predictive validity of these factors was estimated using tests of discrimination, calibration and reclassification. Over a mean follow-up of 12.0 years, 17.3% of men (n = 1535) and 5.7% of women (n = 281) were convicted of a violent offence. Criminal history factors most strongly associated with subsequent violence for both men and women were a previous conviction for a violent offence; for assault, illegal threats and/or intimidation; and imprisonment. However, only a previous conviction for a violent offence was associated with incremental predictive validity in both genders following adjustment for young age and comorbid substance use disorder. Clinical and actuarial approaches to assess violence risk can be improved if included risk factors are tested using multiple measures of performance. © The Royal College of Psychiatrists 2015.

  20. Quantifying surgical complexity with machine learning: looking beyond patient factors to improve surgical models.

    Science.gov (United States)

    Van Esbroeck, Alexander; Rubinfeld, Ilan; Hall, Bruce; Syed, Zeeshan

    2014-11-01

    To investigate the use of machine learning to empirically determine the risk of individual surgical procedures and to improve surgical models with this information. American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data from 2005 to 2009 were used to train support vector machine (SVM) classifiers to learn the relationship between textual constructs in current procedural terminology (CPT) descriptions and mortality, morbidity, Clavien 4 complications, and surgical-site infections (SSI) within 30 days of surgery. The procedural risk scores produced by the SVM classifiers were validated on data from 2010 in univariate and multivariate analyses. The procedural risk scores produced by the SVM classifiers achieved moderate-to-high levels of discrimination in univariate analyses (area under receiver operating characteristic curve: 0.871 for mortality, 0.789 for morbidity, 0.791 for SSI, 0.845 for Clavien 4 complications). Addition of these scores also substantially improved multivariate models comprising patient factors and previously proposed correlates of procedural risk (net reclassification improvement and integrated discrimination improvement: 0.54 and 0.001 for mortality, 0.46 and 0.011 for morbidity, 0.68 and 0.022 for SSI, 0.44 and 0.001 for Clavien 4 complications; P risk for individual procedures. This information can be measured in an entirely data-driven manner and substantially improves multifactorial models to predict postoperative complications. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Improving poor fill factors for solar cells via light-induced plating

    International Nuclear Information System (INIS)

    Xing Zhao; Jia Rui; Ding Wuchang; Meng Yanlong; Jin Zhi; Liu Xinyu

    2012-01-01

    Silicon solar cells are prepared following the conventional fabrication processes, except for the metallization firing process. The cells are divided into two groups with higher and lower fill factors, respectively. After light-induced plating (LIP), the fill factors of the solar cells in both groups with different initial values reach the same level. Scanning electron microscope (SEM) images are taken under the bulk silver electrodes, which prove that the improvement for cells with a poor factor after LIP should benefit from sufficient exploitation of the high density silver crystals formed during the firing process. Moreover, the application of LIP to cells with poor electrode contact performance, such as nanowire cells and radial junction solar cells, is proposed. (semiconductor devices)

  2. Factors influencing the uptake of a mass media intervention to improve child feeding in Bangladesh.

    Science.gov (United States)

    Kim, Sunny S; Roopnaraine, Terry; Nguyen, Phuong H; Saha, Kuntal K; Bhuiyan, Mahbubul I; Menon, Purnima

    2018-04-11

    Mass media are increasingly used to deliver health messages to promote social and behaviour change, but there has been little evidence of mass media use for improving a set of child feeding practices, other than campaigns to promote breastfeeding. This study aimed to examine the factors influencing the uptake of infant and young child feeding messages promoted in TV spots that were launched and aired nationwide in Bangladesh. We conducted a mixed-methods study, using household surveys (n = 2,000) and semistructured interviews (n = 251) with mothers of children 0-23.9 months and other household members. Factors associated with TV spot viewing and comprehension were analysed using multivariable logistic regression models, and interview transcripts were analysed by systematic coding and iterative summaries. Exposure ranged from 36% to 62% across 6 TV spots, with comprehension ranging from 33% to 96% among those who viewed the spots. Factors associated with comprehension of TV spot messages included younger maternal age and receipt of home visits by frontline health workers. Three direct narrative spots showed correct message recall and strong believability, identification, and feasibility of practicing the recommended behaviours. Two spots that used a metaphorical and indirect narrative style were not well understood by respondents. Understanding the differences in the uptake factors may help to explain variability of impacts and ways to improve the design and implementation of mass media strategies. © 2018 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.

  3. Statistical analysis of the factors that influenced the mechanical properties improvement of cassava starch films

    Science.gov (United States)

    Monteiro, Mayra; Oliveira, Victor; Santos, Francisco; Barros Neto, Eduardo; Silva, Karyn; Silva, Rayane; Henrique, João; Chibério, Abimaelle

    2017-08-01

    In order to obtain cassava starch films with improved mechanical properties in relation to the synthetic polymer in the packaging production, a complete factorial design 23 was carried out in order to investigate which factor significantly influences the tensile strength of the biofilm. The factors to be investigated were cassava starch, glycerol and modified clay contents. Modified bentonite clay was used as a filling material of the biofilm. Glycerol was the plasticizer used to thermoplastify cassava starch. The factorial analysis suggested a regression model capable of predicting the optimal mechanical property of the cassava starch film from the maximization of the tensile strength. The reliability of the regression model was tested by the correlation established with the experimental data through the following statistical analyse: Pareto graph. The modified clay was the factor of greater statistical significance on the observed response variable, being the factor that contributed most to the improvement of the mechanical property of the starch film. The factorial experiments showed that the interaction of glycerol with both modified clay and cassava starch was significant for the reduction of biofilm ductility. Modified clay and cassava starch contributed to the maximization of biofilm ductility, while glycerol contributed to the minimization.

  4. Factorization and resummation: A new paradigm to improve gravitational wave amplitudes. II. The higher multipolar modes

    Science.gov (United States)

    Messina, Francesco; Maldarella, Alberto; Nagar, Alessandro

    2018-04-01

    The factorization and resummation approach of Nagar and Shah [Phys. Rev. D 94, 104017 (2016), 10.1103/PhysRevD.94.104017], designed to improve the strong-field behavior of the post-Newtonian (PN) residual waveform amplitudes fℓm's entering the effective-one-body, circularized, gravitational waveform for spinning coalescing binaries, is improved and generalized here to all multipoles up to ℓ=6 . For a test particle orbiting a Kerr black hole, each multipolar amplitude is truncated at relative 6 PN order, both for the orbital (nonspinning) and spin factors. By taking a certain Padé approximant (typically the P24 one) of the orbital factor in conjunction with the inverse Taylor (iResum) representation of the spin factor, it is possible to push the analytical/numerical agreement of the energy flux at the level of 5% at the last-stable orbit for a quasimaximally spinning black hole with dimensionless spin parameter +0.99 . When the procedure is generalized to comparable-mass binaries, each orbital factor is kept at relative 3+3 PN order; i.e., the globally 3 PN-accurate comparable-mass terms are hybridized with higher-PN test-particle terms up to 6 PN relative order in each mode. The same Padé resummation is used for continuity. By contrast, the spin factor is only kept at the highest comparable-mass PN order currently available. We illustrate that the consistency between different truncations in the spin content of the waveform amplitudes is more marked in the resummed case than when using the standard Taylor-expanded form of Pan et al. [Phys. Rev. D 83, 064003 (2011), 10.1103/PhysRevD.83.064003]. We finally introduce a method to consistently hybridize comparable-mass and test-particle information also in the presence of spin (including the spin of the particle), discussing it explicitly for the ℓ=m =2 spin-orbit and spin-square terms. The improved, factorized and resummed, multipolar waveform amplitudes presented here are expected to set a new standard for

  5. Risk factors associated with recurrent hemorrhage after the initial improvement of colonic diverticular bleeding.

    Science.gov (United States)

    Nishikawa, Hiroki; Maruo, Takanori; Tsumura, Takehiko; Sekikawa, Akira; Kanesaka, Takashi; Osaki, Yukio

    2013-03-01

    We elucidated risk factors contributing to recurrent hemorrhage after initial improvement of colonic diverticular bleeding. 172 consecutive hospitalized patients diagnosed with colonic diverticular bleeding were analyzed. Recurrent hemorrhage after initial improvement of colonic diverticular bleeding is main outcome measure. We analyzed factors contributing to recurrent hemorrhage risk in univariate and multivariate analyses. The length of the observation period after improvement of colonic diverticular bleeding was 26.4 +/- 14.6 months (range, 1-79 months). The cumulative recurrent hemorrhage rate in all patients at 1 and 2 years was 34.8% and 41.8%, respectively. By univariate analysis, age > 70 years (P = 0.021), BMI > 25 kg/m2 (P = 0.013), the use of anticoagulant drugs (P = 0.034), the use of NSAIDs (P = 0.040), history of hypertension (P = 0.011), history of smoking (P = 0.030) and serum creatinine level > 1.5 mg/dL (P bleeding. By multivariate analysis, age > 70 years (Hazard ratio (HR), 1.905, 95% confidence interval (CI), 1.067-3.403, P = 0.029), history of hypertension (HR, 0.493, 95% CI, 0.245-0.993, P = 0.048) and serum creatinine level > 1.5 mg/dL (HR, 95% CI, 0.288-0.964, P = 0.044) were shown to be significant independent risk factors. Close observation after the initial improvement of colonic diverticular bleeding is needed, especially in elderly patients or patients with history of hypertension or renal deficiency.

  6. A Dynamic Momentum Compaction Factor Lattice for Improvements to Stochastic Cooling in Storage Rings

    Energy Technology Data Exchange (ETDEWEB)

    Olivieri, David Nicholas [Massachusetts U., Amherst

    1996-01-01

    A dynamic momentum compaction factor, also referred to as a dynamic $\\Delta \\gamma \\tau$, lattice for the FNAL Antiproton Source Debuncher Storage Ring is studied, both theoretically and experimentally, for the purpose of improving stochastic precooling, and hence, improving the global antiproton production and stacking performance. A dynamic $\\Delta \\gamma \\tau$ lattice is proposed due to the competing requirements inherent within the Debuncher storage ring upon $\\gamma \\tau$· Specifically, the Debuncher storage ring performs two disparate functions, $(i)$ accepting and debunching a large number of $\\overline{p}$s/pulse at the outset of the production cycle, which would perform ideally with a large value of $\\gamma\\tau$, and $(ii)$ subsequently employing stochastic cooling throughout the remainder of the $\\overline{p}$ production cycle for improved transfer and stacking efficiency into the Accumulator, for which a small value $\\gamma \\tau$ is ideal in order to reduce the diffusive heating caused by the mixing factor. In the initial design of the Debuncher optical lattice, an intermediate value of $\\gamma \\tau$ was chosen as a compromise between the two functional requirements. The goal of the thesis is to improve stochastic precooling by changing $\\gamma \\tau$ between two desired values during each p production cycle. In particular, the dynamic $\\Delta \\gamma \\tau$ lattice accomplishes a reduction in $\\gamma \\tau$, and hence the mixing factor, through an uniform increase to the dispersion throughout the arc sections of the storage ring. Experimental measurements of cooling rates and system performance parameters, with the implementation of the dynamic $\\Delta \\gamma \\tau$ lattice, are in agreement with theoretical predictions based upon a detailed integration of the stochastic cooling Fokker Planck equations. Based upon the consistency between theory and experiment, predictions of cooling rates are presented for future operational

  7. The use of patient factors to improve the prediction of operative duration using laparoscopic cholecystectomy.

    Science.gov (United States)

    Thiels, Cornelius A; Yu, Denny; Abdelrahman, Amro M; Habermann, Elizabeth B; Hallbeck, Susan; Pasupathy, Kalyan S; Bingener, Juliane

    2017-01-01

    Reliable prediction of operative duration is essential for improving patient and care team satisfaction, optimizing resource utilization and reducing cost. Current operative scheduling systems are unreliable and contribute to costly over- and underestimation of operative time. We hypothesized that the inclusion of patient-specific factors would improve the accuracy in predicting operative duration. We reviewed all elective laparoscopic cholecystectomies performed at a single institution between 01/2007 and 06/2013. Concurrent procedures were excluded. Univariate analysis evaluated the effect of age, gender, BMI, ASA, laboratory values, smoking, and comorbidities on operative duration. Multivariable linear regression models were constructed using the significant factors (p historical surgeon-specific and procedure-specific operative duration. External validation was done using the ACS-NSQIP database (n = 11,842). A total of 1801 laparoscopic cholecystectomy patients met inclusion criteria. Female sex was associated with reduced operative duration (-7.5 min, p < 0.001 vs. male sex) while increasing BMI (+5.1 min BMI 25-29.9, +6.9 min BMI 30-34.9, +10.4 min BMI 35-39.9, +17.0 min BMI 40 + , all p < 0.05 vs. normal BMI), increasing ASA (+7.4 min ASA III, +38.3 min ASA IV, all p < 0.01 vs. ASA I), and elevated liver function tests (+7.9 min, p < 0.01 vs. normal) were predictive of increased operative duration on univariate analysis. A model was then constructed using these predictive factors. The traditional surgical scheduling system was poorly predictive of actual operative duration (R 2  = 0.001) compared to the patient factors model (R 2  = 0.08). The model remained predictive on external validation (R 2  = 0.14).The addition of surgeon as a variable in the institutional model further improved predictive ability of the model (R 2  = 0.18). The use of routinely available pre-operative patient factors improves the prediction of operative

  8. Factors influencing source separation intention and willingness to pay for improving waste management in Bangkok, Thailand

    Directory of Open Access Journals (Sweden)

    Sujitra Vassanadumrongdee

    2018-03-01

    Full Text Available Source separation for recycling has been recognized as a way to achieve sustainable municipal solid waste (MSW management. However, most developing countries including Thailand have been facing with lack of recycling facilities and low level of source separation practice. By employing questionnaire surveys, this study investigated Bangkok residents' source separation intention and willingness to pay (WTP for improving MSW service and recycling facilities (n = 1076. This research extended the theory of planned behavior to explore the effects of both internal and external factors. The survey highlighted perceived inconvenience and mistrust on MSW collection being major barriers to carrying out source separation in Bangkok. Promoting source separation at workplace may possibly create spill-over effect to people's intention to recycle their waste at home. Both subjective norms and knowledge on MSW situation were found to be a positive correlation with Bangkok residents' source separation intention and WTP (p < 0.001. Besides, the average WTP values are higher than the existing rate of waste collection service, which shows that Bangkok residents have preference for recycling programs. However, the WTP figures are still much lower than the average MSW management cost. These findings suggest that Bangkok Metropolitan Administration targets improving people knowledge on waste problems that could have adverse impact on the economy and well-being of Bangkok residents and improve its MSW collection service as these factors have positive influence on residents' WTP.

  9. Improvements on the calculation of the epithermal disadvantage factor for thermal nuclear reactors

    Energy Technology Data Exchange (ETDEWEB)

    Aboustta, Mohamed A.; Martinez, Aquilino S. [Universidade Federal, Rio de Janeiro, RJ (Brazil). Coordenacao dos Programas de Pos-graduacao de Engenharia

    1997-12-01

    The disadvantage factor takes into account the neutron flux variation through the fuel cell. In the fuel the flux is depressed in relation to its level in the moderator region. In order to avoid detailed calculations for each different set of cell dimensions, which turns out necessary the development of problem-dependent neutron cross section libraries, a disadvantage factor based on a two-region equivalence theory was proposed for the EPRI-CELL code. However, it uses a rational approximation to the neutron escape probability to describe the neutron transport between cell regions. Such approximation allows the use of the equivalence principals but introduces a non negligible error which results in an underestimation of the cell neutron fluxes. A new proposed treatment, that will be presented in this work, remarkably improves the numerical calculation and reduces the error of the above mentioned method. (author). 4 refs., 2 figs.

  10. An improved correlated sampling method for calculating correction factor of detector

    International Nuclear Information System (INIS)

    Wu Zhen; Li Junli; Cheng Jianping

    2006-01-01

    In the case of a small size detector lying inside a bulk of medium, there are two problems in the correction factors calculation of the detectors. One is that the detector is too small for the particles to arrive at and collide in; the other is that the ratio of two quantities is not accurate enough. The method discussed in this paper, which combines correlated sampling with modified particle collision auto-importance sampling, and has been realized on the MCNP-4C platform, can solve these two problems. Besides, other 3 variance reduction techniques are also combined with correlated sampling respectively to calculate a simple calculating model of the correction factors of detectors. The results prove that, although all the variance reduction techniques combined with correlated sampling can improve the calculating efficiency, the method combining the modified particle collision auto-importance sampling with the correlated sampling is the most efficient one. (authors)

  11. Improvements on the calculation of the epithermal disadvantage factor for thermal nuclear reactors

    International Nuclear Information System (INIS)

    Aboustta, Mohamed A.; Martinez, Aquilino S.

    1997-01-01

    The disadvantage factor takes into account the neutron flux variation through the fuel cell. In the fuel the flux is depressed in relation to its level in the moderator region. In order to avoid detailed calculations for each different set of cell dimensions, which turns out necessary the development of problem-dependent neutron cross section libraries, a disadvantage factor based on a two-region equivalence theory was proposed for the EPRI-CELL code. However, it uses a rational approximation to the neutron escape probability to describe the neutron transport between cell regions. Such approximation allows the use of the equivalence principals but introduces a non negligible error which results in an underestimation of the cell neutron fluxes. A new proposed treatment, that will be presented in this work, remarkably improves the numerical calculation and reduces the error of the above mentioned method. (author). 4 refs., 2 figs

  12. Resident Workflow and Psychiatric Emergency Consultation: Identifying Factors for Quality Improvement in a Training Environment.

    Science.gov (United States)

    Blair, Thomas; Wiener, Zev; Seroussi, Ariel; Tang, Lingqi; O'Hora, Jennifer; Cheung, Erick

    2017-06-01

    Quality improvement to optimize workflow has the potential to mitigate resident burnout and enhance patient care. This study applied mixed methods to identify factors that enhance or impede workflow for residents performing emergency psychiatric consultations. The study population consisted of all psychiatry program residents (55 eligible, 42 participating) at the Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles. The authors developed a survey through iterative piloting, surveyed all residents, and then conducted a focus group. The survey included elements hypothesized to enhance or impede workflow, and measures pertaining to self-rated efficiency and stress. Distributional and bivariate analyses were performed. Survey findings were clarified in focus group discussion. This study identified several factors subjectively associated with enhanced or impeded workflow, including difficulty with documentation, the value of personal organization systems, and struggles to communicate with patients' families. Implications for resident education are discussed.

  13. Reluctance motor of new design with improved efficiency and power factor

    Energy Technology Data Exchange (ETDEWEB)

    Hansen-Goos, P; Pieper, W

    1981-09-01

    Improvement of operating conditions and efficiency by development of new configurations of lamination and production methods for reluctance motors. Investigations during the starting-up period and of the operating behaviour in connection with variable frequency. Reluctance motors are designed in the range from 0,6-4kW with 4-pole winding. They are due to the following identification: 1. The power of motors is in accordance with VDE 42673. 2. The volume of lamination is equal to asynchronous motors of the same IED size. 3. Synchronous pull-out torque is in compliance with VDE 0530: Msub(K)sub(S) > 1,35 Mn (nominal torque). As against standard reluctance motors the following improvements with the new ones have been realized: 4. Increase of nominal power by approx. 100%. 5. Increase of quality factor by approx. 50%. 6. The efficiency is equal to asynchronous motors of the same IEC size.

  14. Functions and Application of the AP2/ERF Transcription Factor Family in Crop Improvement

    Institute of Scientific and Technical Information of China (English)

    Zhao-Shi Xu; Ming Chen; Lian-Cheng Li; You-Zhi Ma

    2011-01-01

    Plants have acquired sophisticated stress response systems to adapt to changing environments. It is important to understand plants' stress response mechanisms in the effort to improve crop productivity under stressful conditions. The AP2/ERF transcription factors are known to regulate diverse processes of plant development and stress responses.In this study, the molecular characteristics and biological functions of AP2/ERFs in a variety of plant species were analyzed. AP2/ERFs,especially those in DREB and ERF subfamilies, are ideal candidates for crop improvement because their overexpression enhances tolerances to drought, salt, freezing, as well as resistances to multiple diseases in the transgenic plants. The comprehensive analysis of physiological functions is useful in elucidating the biological roles of AP2/ERF family genes in gene interaction, pathway regulation, and defense response under stress environments, which should provide new opportunities for the crop tolerance engineering.

  15. Modelling of safety barriers including human and organisational factors to improve process safety

    DEFF Research Database (Denmark)

    Markert, Frank; Duijm, Nijs Jan; Thommesen, Jacob

    2013-01-01

    It is believed that traditional safety management needs to be improved on the aspect of preparedness for coping with expected and unexpected deviations, avoiding an overly optimistic reliance on safety systems. Remembering recent major accidents, such as the Deep Water Horizon, the Texas City....... A valuable approach is the inclusion of human and organisational factors into the simulation of the reliability of the technical system using event trees and fault trees and the concept of safety barriers. This has been demonstrated e.g. in the former European research project ARAMIS (Accidental Risk...

  16. Pro-region engineering for improved yeast display and secretion of brain derived neurotrophic factor.

    Science.gov (United States)

    Burns, Michael L; Malott, Thomas M; Metcalf, Kevin J; Puguh, Arthya; Chan, Jonah R; Shusta, Eric V

    2016-03-01

    Brain derived neurotrophic factor (BDNF) is a promising therapeutic candidate for a variety of neurological diseases. However, it is difficult to produce as a recombinant protein. In its native mammalian context, BDNF is first produced as a pro-protein with subsequent proteolytic removal of the pro-region to yield mature BDNF protein. Therefore, in an attempt to improve yeast as a host for heterologous BDNF production, the BDNF pro-region was first evaluated for its effects on BDNF surface display and secretion. Addition of the wild-type pro-region to yeast BDNF production constructs improved BDNF folding both as a surface-displayed and secreted protein in terms of binding its natural receptors TrkB and p75, but titers remained low. Looking to further enhance the chaperone-like functions provided by the pro-region, two rounds of directed evolution were performed, yielding mutated pro-regions that further improved the display and secretion properties of BDNF. Subsequent optimization of the protease recognition site was used to control whether the produced protein was in pro- or mature BDNF forms. Taken together, we have demonstrated an effective strategy for improving BDNF compatibility with yeast protein engineering and secretion platforms. Copyright © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  17. An Improvement of Cardiovascular Risk Factors by Omega-3 Polyunsaturated Fatty Acids.

    Science.gov (United States)

    Yanai, Hidekatsu; Masui, Yoshinori; Katsuyama, Hisayuki; Adachi, Hiroki; Kawaguchi, Akiko; Hakoshima, Mariko; Waragai, Yoko; Harigae, Tadanao; Sako, Akahito

    2018-04-01

    An epidemiological survey in the Northwest Greenland reported that the Greenlanders have a lower frequency of acute myocardial infarction and diabetes mellitus. The very low incidence of ischemic heart disease in the Greenlanders was explained by consumption of a diet rich in omega-3 polyunsaturated fatty acids (PUFAs). Possible anti-atherothrombotic effects of omega-3 PUFA include an improvement of lipid metabolism such as a reduction of triglyceride and an increase of high-density lipoprotein-cholesterol (HDL-C), and glucose metabolism, anti-platelet activity, anti-inflammatory effects, an improvement of endothelial function and stabilization of atherosclerotic plaque. The present study reviews an improvement of cardiovascular risk factors such as dyslipidemia and diabetes due to consumption of omega-3 PUFA. A sufficient number of studies suggest that omega-3 PUFA supplementation reduces serum triglyceride and increases HDL-cholesterol. The mechanisms for omega-3 PUFA-mediated improvements of lipid metabolism have been partially elucidated. The studies using experimental animals, part of trials in humans, have shown the beneficial effects of omega-3 PUFA on glucose metabolism and insulin sensitivity. The meta-analysis showed that omega-3 PUFA might prevent development of diabetes in part of population. Further studies should be performed to elucidate the association of omega-3 PUFA supplementation with diabetes, in the future.

  18. Epidermal Growth Factor Improves Intestinal Integrity and Survival in Murine Sepsis Following Chronic Alcohol Ingestion.

    Science.gov (United States)

    Klingensmith, Nathan J; Yoseph, Benyam P; Liang, Zhe; Lyons, John D; Burd, Eileen M; Margoles, Lindsay M; Koval, Michael; Ford, Mandy L; Coopersmith, Craig M

    2017-02-01

    Epidermal growth factor (EGF) is a cytoprotective protein that improves survival in preclinical models of sepsis through its beneficial effects on intestinal integrity. Alcohol use disorder worsens intestinal integrity and is associated with increased morbidity and mortality in critical illness. We sought to determine whether chronic alcohol ingestion alters the host response to systemic administration of EGF in sepsis. Six-week-old FVB/N mice were randomized to receive 20% alcohol or water for 12 weeks. All mice then underwent cecal ligation and puncture to induce polymicrobial sepsis. Mice were then randomized to receive either intraperitoneal injection of EGF (150 μg/kg/day) or normal saline. Water-fed mice given EGF had decreased 7-day mortality compared with water-fed mice (18% vs. 55%). Alcohol-fed mice given EGF also had decreased 7-day mortality compared with alcohol-fed mice (48% vs. 79%). Notably, while systemic EGF improved absolute survival to a similar degree in both water-fed and alcohol-fed mice, mortality was significantly higher in alcohol+EGF mice compared with water+EGF mice. Compared with water-fed septic mice, alcohol-fed septic mice had worsened intestinal integrity with intestinal hyperpermeability, increased intestinal epithelial apoptosis, decreased proliferation and shorter villus length. Systemic administration of EGF to septic alcohol-fed mice decreased intestinal permeability compared with septic alcohol-fed mice given vehicle, with increased levels of the tight junction mediators claudin-5 and JAM-A. Systemic administration of EGF to septic alcohol-fed mice also decreased intestinal apoptosis with an improvement in the Bax/Bcl-2 ratio. EGF also improved both crypt proliferation and villus length in septic alcohol-fed mice. EGF administration resulted in lower levels of both pro- and anti-inflammatory cytokines monocyte chemoattractant protein-1, tumor necrosis factor, and interleukin 10 in alcohol-fed mice. EGF is therefore

  19. Factors influencing variation in physician adenoma detection rates: a theory-based approach for performance improvement.

    Science.gov (United States)

    Atkins, Louise; Hunkeler, Enid M; Jensen, Christopher D; Michie, Susan; Lee, Jeffrey K; Doubeni, Chyke A; Zauber, Ann G; Levin, Theodore R; Quinn, Virginia P; Corley, Douglas A

    2016-03-01

    Interventions to improve physician adenoma detection rates for colonoscopy have generally not been successful, and there are little data on the factors contributing to variation that may be appropriate targets for intervention. We sought to identify factors that may influence variation in detection rates by using theory-based tools for understanding behavior. We separately studied gastroenterologists and endoscopy nurses at 3 Kaiser Permanente Northern California medical centers to identify potentially modifiable factors relevant to physician adenoma detection rate variability by using structured group interviews (focus groups) and theory-based tools for understanding behavior and eliciting behavior change: the Capability, Opportunity, and Motivation behavior model; the Theoretical Domains Framework; and the Behavior Change Wheel. Nine factors potentially associated with adenoma detection rate variability were identified, including 6 related to capability (uncertainty about which types of polyps to remove, style of endoscopy team leadership, compromised ability to focus during an examination due to distractions, examination technique during withdrawal, difficulty detecting certain types of adenomas, and examiner fatigue and pain), 2 related to opportunity (perceived pressure due to the number of examinations expected per shift and social pressure to finish examinations before scheduled breaks or the end of a shift), and 1 related to motivation (valuing a meticulous examination as the top priority). Examples of potential intervention strategies are provided. By using theory-based tools, this study identified several novel and potentially modifiable factors relating to capability, opportunity, and motivation that may contribute to adenoma detection rate variability and be appropriate targets for future intervention trials. Copyright © 2016 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  20. Influential Factors for the Improvement of Peer Education in Adolescents: A Narrative Review

    Directory of Open Access Journals (Sweden)

    Marzieh Azizi

    2016-09-01

    Full Text Available Context Peer education is an effective strategy for improving adolescents’ health. It focuses on the improvement of knowledge, attitudes and beliefs among adolescents with regards to different healthcare issues and empowers them to make informed decisions. This review study aimed to determine factors that promote peer education among adolescents. Evidence Acquisition In this narrative review, electronic databases including Google Scholar, Science Direct, PubMed (including Medline, Web of Science, Scientific Information Database, and Scopus were searched. Articles published between 1991 and 2016 were retrieved and undergone abstract and full-text appraisal. Lastly, 53 articles were selected and used to write this review. Results The factors influencing the promotion of peer education among adolescents were classified as follow: ‘characteristics of peer educators’: personal, skills and communication characteristics; ‘characteristics of the educational program’: theoretical foundations, program transparency, program sustainability, adolescents’ comprehensive participation, and evaluation and monitoring; and ‘structural characteristics of the educational program’: supportive structure, and financial-official structure. Conclusions Taking into account the importance of adolescence and issues surrounding this period, the important role of peer education in the promotion of adolescents’ health should be emphasized.

  1. Some strategies to improve performance in school chemistry, based on two cognitive factors

    Science.gov (United States)

    Danili, Eleni; Reid, Norman

    2004-02-01

    The background to this study are the difficulties facing the majority of Greek pupils in understanding chemistry concepts and, therefore, performing well in the National Examinations. The aim was to explore the problems and to suggest ways in which the situation might be improved. Working with 105 Greek pupils aged 15 to 16, the first stage of the enquiry confirmed that both working memory space and extent of field dependency were two psychological factors affecting performance. This is at least part of the nature of the problem. In the second stage, an attempt was made to explore how the problems might be reduced. New teaching materials were constructed to minimize any limitations to learning caused by working memory space and problems associated with being field dependent. The use of the new materials was compared to the normal teaching process working with 210 Greek pupils aged 15 to16. It was found that there was a significant difference in the average improvement of the experimental group and the control group, in favour of the experimental group. This result was independent of the effect of the teacher, and of the interaction of teaching method and teacher. It is suggested that approaches to learning must take into account cognitive factors in the learners in the context of information processing understandings of learning. If this is done, learning is much more effective.

  2. Cryptanalysis and Security Improvements of ‘Two-Factor User Authentication in Wireless Sensor Networks’

    Directory of Open Access Journals (Sweden)

    Muhammad Khurram Khan

    2010-03-01

    Full Text Available User authentication in wireless sensor networks (WSN is a critical security issue due to their unattended and hostile deployment in the field. Since sensor nodes are equipped with limited computing power, storage, and communication modules; authenticating remote users in such resource-constrained environments is a paramount security concern. Recently, M.L. Das proposed a two-factor user authentication scheme in WSNs and claimed that his scheme is secure against different kinds of attack. However, in this paper, we show that the M.L. Das-scheme has some critical security pitfalls and cannot be recommended for real applications. We point out that in his scheme: users cannot change/update their passwords, it does not provide mutual authentication between gateway node and sensor node, and is vulnerable to gateway node bypassing attack and privileged-insider attack. To overcome the inherent security weaknesses of the M.L. Das-scheme, we propose improvements and security patches that attempt to fix the susceptibilities of his scheme. The proposed security improvements can be incorporated in the M.L. Das-scheme for achieving a more secure and robust two-factor user authentication in WSNs.

  3. B→π form factor with 2 flavours of O(a) improved Wilson quarks

    International Nuclear Information System (INIS)

    Bahr, Felix; Bernardoni, Fabio; Ramos, Alberto; Simma, Hubert; Sommer, Rainer; Bulava, John

    2012-10-01

    The determinations of vertical stroke V ub vertical stroke from the exclusive branching ratios of B→τν and B→πlν tend to show a tension at the level of 3σ. On the theoretical side they depend on the lattice computation of the hadronic matrix elements f B and the B →>π form factor f + (q 2 ). To understand the tension, improved precision and a careful analysis of the systematics involved are necessary. Working towards this goal, we present preliminary lattice results of the ALPHA collaboration for the B→ π form factor f + (q 2 ) with N f =2 flavours of O(a)-improved Wilson fermions. Our computation uses HQET in the static limit, pion masses ranging down to ∼250 MeV, large volumes with m π L>4, three lattice spacings, and non-perturbative renormalization. We describe the techniques adopted to reduce the statistical noise (stochastic all-to-all with full time dilution) and the contamination from excited states (smearing for the B and the pion). We estimate the size of the chiral and continuum extrapolations. We discuss the impact our result could have to clarify the above mentioned discrepancy in the determination of vertical stroke V ub vertical stroke.

  4. Brain-derived neurotrophic factor mediates cognitive improvements following acute exercise.

    Science.gov (United States)

    Borror, Andrew

    2017-09-01

    The mechanisms causing improved cognition following acute exercise are poorly understood. This article proposes that brain-derived neurotrophic factor (BDNF) is the main factor contributing to improved cognition following exercise. Additionally, it argues that cerebral blood flow (CBF) and oxidative stress explain the release of BDNF from cerebral endothelial cells. One way to test these hypotheses is to block endothelial function and measure the effect on BDNF levels and cognitive performance. The CBF and oxidative stress can also be examined in relationship to BDNF using a multiple linear regression. If these hypotheses are true, there would be a linear relationship between CBF+oxidative stress and BDNF levels as well as between BDNF levels and cognitive performance. The novelty of these hypotheses comes from the emphasis on the cerebral endothelium and the interplay between BDNF, CBF, and oxidative stress. If found to be valid, these hypotheses would draw attention to the cerebral endothelium and provide direction for future research regarding methods to optimize BDNF release and enhance cognition. Elucidating these mechanisms would provide direction for expediting recovery in clinical populations, such as stroke, and maintaining quality of life in the elderly. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Cryptanalysis and security improvements of 'two-factor user authentication in wireless sensor networks'.

    Science.gov (United States)

    Khan, Muhammad Khurram; Alghathbar, Khaled

    2010-01-01

    User authentication in wireless sensor networks (WSN) is a critical security issue due to their unattended and hostile deployment in the field. Since sensor nodes are equipped with limited computing power, storage, and communication modules; authenticating remote users in such resource-constrained environments is a paramount security concern. Recently, M.L. Das proposed a two-factor user authentication scheme in WSNs and claimed that his scheme is secure against different kinds of attack. However, in this paper, we show that the M.L. Das-scheme has some critical security pitfalls and cannot be recommended for real applications. We point out that in his scheme: users cannot change/update their passwords, it does not provide mutual authentication between gateway node and sensor node, and is vulnerable to gateway node bypassing attack and privileged-insider attack. To overcome the inherent security weaknesses of the M.L. Das-scheme, we propose improvements and security patches that attempt to fix the susceptibilities of his scheme. The proposed security improvements can be incorporated in the M.L. Das-scheme for achieving a more secure and robust two-factor user authentication in WSNs.

  6. Improving the Quality of Ward-based Surgical Care With a Human Factors Intervention Bundle.

    Science.gov (United States)

    Johnston, Maximilian J; Arora, Sonal; King, Dominic; Darzi, Ara

    2018-01-01

    This study aimed to explore the impact of a human factors intervention bundle on the quality of ward-based surgical care in a UK hospital. Improving the culture of a surgical team is a difficult task. Engagement with stakeholders before intervention is key. Studies have shown that appropriate supervision can enhance surgical ward safety. A pre-post intervention study was conducted. The intervention bundle consisted of twice-daily attending ward rounds, a "chief resident of the week" available at all times on the ward, an escalation of care protocol and team contact cards. Twenty-seven junior and senior surgeons completed validated questionnaires assessing supervision, escalation of care, and safety culture pre and post-intervention along with interviews to further explore the impact of the intervention. Patient outcomes pre and postintervention were also analyzed. Questionnaires revealed significant improvements in supervision postintervention (senior median pre 5 vs post 7, P = 0.002 and junior 4 vs 6, P = 0.039) and senior surgeon approachability (junior 5 vs 6, P = 0.047). Both groups agreed that they would feel safer as a patient in their hospital postintervention (senior 3 vs 4.5, P = 0.021 and junior 3 vs 4, P = 0.034). The interviews confirmed that the safety culture of the department had improved. There were no differences in inpatient mortality, cardiac arrest, reoperation, or readmission rates pre and postintervention. Improving supervision and introducing clear protocols can improve safety culture on the surgical ward. Future work should evaluate the effect these measures have on patient outcomes in multiple institutions.

  7. Interventions for improving modifiable risk factor control in the secondary prevention of stroke.

    Science.gov (United States)

    Lager, Kate E; Mistri, Amit K; Khunti, Kamlesh; Haunton, Victoria J; Sett, Aung K; Wilson, Andrew D

    2014-05-02

    People with stroke or transient ischaemic attack (TIA) are at increased risk of future stroke and other cardiovascular events. Evidence-based strategies for secondary stroke prevention have been established. However, the implementation of prevention strategies could be improved. To assess the effects of stroke service interventions for implementing secondary stroke prevention strategies on modifiable risk factor control, including patient adherence to prescribed medications, and the occurrence of secondary cardiovascular events. We searched the Cochrane Stroke Group Trials Register (April 2013), the Cochrane Effective Practice and Organisation of Care Group Trials Register (April 2013), CENTRAL (The Cochrane Library 2013, issue 3), MEDLINE (1950 to April 2013), EMBASE (1981 to April 2013) and 10 additional databases. We located further studies by searching reference lists of articles and contacting authors of included studies. We included randomised controlled trials (RCTs) that evaluated the effects of organisational or educational and behavioural interventions (compared with usual care) on modifiable risk factor control for secondary stroke prevention. Two review authors selected studies for inclusion and independently extracted data. One review author assessed the risk of bias for the included studies. We sought missing data from trialists. This review included 26 studies involving 8021 participants. Overall the studies were of reasonable quality, but one study was considered at high risk of bias. Fifteen studies evaluated predominantly organisational interventions and 11 studies evaluated educational and behavioural interventions for patients. Results were pooled where appropriate, although some clinical and methodological heterogeneity was present. The estimated effects of organisational interventions were compatible with improvements and no differences in the modifiable risk factors mean systolic blood pressure (mean difference (MD) -2.57 mmHg; 95% confidence

  8. Factors associated with the impact of quality improvement collaboratives in mental healthcare: An exploratory study

    Directory of Open Access Journals (Sweden)

    Versteeg Marleen H

    2012-01-01

    Full Text Available Abstract Background Quality improvement collaboratives (QICs bring together groups of healthcare professionals to work in a structured manner to improve the quality of healthcare delivery within particular domains. We explored which characteristics of the composition, participation, functioning, and organization of these collaboratives related to changes in the healthcare for patients with anxiety disorders, dual diagnosis, or schizophrenia. Methods We studied three QICs involving 29 quality improvement (QI teams representing a number of mental healthcare organizations in the Netherlands. The aims of the three QICs were the implementation of multidisciplinary practice guidelines in the domains of anxiety disorders, dual diagnosis, and schizophrenia, respectively. We used eight performance indicators to assess the impact of the QI teams on self-reported patient outcomes and process of care outcomes for 1,346 patients. The QI team members completed a questionnaire on the characteristics of the composition, participation in a national program, functioning, and organizational context for their teams. It was expected that an association would be found between these team characteristics and the quality of care for patients with anxiety disorders, dual diagnosis, and schizophrenia. Results No consistent patterns of association emerged. Theory-based factors did not perform better than practice-based factors. However, QI teams that received support from their management and both active and inspirational team leadership showed better results. Rather surprisingly, a lower average level of education among the team members was associated with better results, although less consistently than the management and leadership characteristics. Team views with regard to the QI goals of the team and attitudes towards multidisciplinary practice guidelines did not correlate with team success. Conclusions No general conclusions about the impact of the characteristics of

  9. Improved USLE-K factor prediction: A case study on water erosion areas in China

    Directory of Open Access Journals (Sweden)

    Bin Wang

    2016-09-01

    Full Text Available Soil erodibility (K-factor is an essential factor in soil erosion prediction and conservation practises. The major obstacles to any accurate, large-scale soil erodibility estimation are the lack of necessary data on soil characteristics and the misuse of variable K-factor calculators. In this study, we assessed the performance of available erodibility estimators Universal Soil Loss Equation (USLE, Revised Universal Soil Loss Equation (RUSLE, Erosion Productivity Impact Calculator (EPIC and the Geometric Mean Diameter based (Dg model for different geographic regions based on the Chinese soil erodibility database (CSED. Results showed that previous estimators overestimated almost all K-values. Furthermore, only the USLE and Dg approaches could be directly and reliably applicable to black and loess soil regions. Based on the nonlinear best fitting techniques, we improved soil erodibility prediction by combining Dg and soil organic matter (SOM. The NSE, R2 and RE values were 0.94, 0.67 and 9.5% after calibrating the results independently; similar model performance was showed for the validation process. The results obtained via the proposed approach were more accurate that the former K-value predictions. Moreover, those improvements allowed us to effectively establish a regional soil erodibility map (1:250,000 scale of water erosion areas in China. The mean K-value of Chinese water erosion regions was 0.0321 (t ha h·(ha MJ mm−1 with a standard deviation of 0.0107 (t ha h·(ha MJ mm−1; K-values present a decreasing trend from North to South in water erosion areas in China. The yield soil erodibility dataset also satisfactorily corresponded to former K-values from different scales (local, regional, and national.

  10. Growth Factor Stimulation Improves the Structure and Properties of Scaffold-Free Engineered Auricular Cartilage Constructs

    Science.gov (United States)

    Rosa, Renata G.; Joazeiro, Paulo P.; Bianco, Juares; Kunz, Manuela; Weber, Joanna F.; Waldman, Stephen D.

    2014-01-01

    The reconstruction of the external ear to correct congenital deformities or repair following trauma remains a significant challenge in reconstructive surgery. Previously, we have developed a novel approach to create scaffold-free, tissue engineering elastic cartilage constructs directly from a small population of donor cells. Although the developed constructs appeared to adopt the structural appearance of native auricular cartilage, the constructs displayed limited expression and poor localization of elastin. In the present study, the effect of growth factor supplementation (insulin, IGF-1, or TGF-β1) was investigated to stimulate elastogenesis as well as to improve overall tissue formation. Using rabbit auricular chondrocytes, bioreactor-cultivated constructs supplemented with either insulin or IGF-1 displayed increased deposition of cartilaginous ECM, improved mechanical properties, and thicknesses comparable to native auricular cartilage after 4 weeks of growth. Similarly, growth factor supplementation resulted in increased expression and improved localization of elastin, primarily restricted within the cartilaginous region of the tissue construct. Additional studies were conducted to determine whether scaffold-free engineered auricular cartilage constructs could be developed in the 3D shape of the external ear. Isolated auricular chondrocytes were grown in rapid-prototyped tissue culture molds with additional insulin or IGF-1 supplementation during bioreactor cultivation. Using this approach, the developed tissue constructs were flexible and had a 3D shape in very good agreement to the culture mold (average error tissue structure and 3D shape of the external ear, future studies will be aimed assessing potential changes in construct shape and properties after subcutaneous implantation. PMID:25126941

  11. Bordetella Pertussis virulence factors in the continuing evolution of whooping cough vaccines for improved performance.

    Science.gov (United States)

    Dorji, Dorji; Mooi, Frits; Yantorno, Osvaldo; Deora, Rajendar; Graham, Ross M; Mukkur, Trilochan K

    2018-02-01

    Despite high vaccine coverage, whooping cough caused by Bordetella pertussis remains one of the most common vaccine-preventable diseases worldwide. Introduction of whole-cell pertussis (wP) vaccines in the 1940s and acellular pertussis (aP) vaccines in 1990s reduced the mortality due to pertussis. Despite induction of both antibody and cell-mediated immune (CMI) responses by aP and wP vaccines, there has been resurgence of pertussis in many countries in recent years. Possible reasons hypothesised for resurgence have ranged from incompliance with the recommended vaccination programmes with the currently used aP vaccine to infection with a resurged clinical isolates characterised by mutations in the virulence factors, resulting in antigenic divergence with vaccine strain, and increased production of pertussis toxin, resulting in dampening of immune responses. While use of these vaccines provide varying degrees of protection against whooping cough, protection against infection and transmission appears to be less effective, warranting continuation of efforts in the development of an improved pertussis vaccine formulations capable of achieving this objective. Major approaches currently under evaluation for the development of an improved pertussis vaccine include identification of novel biofilm-associated antigens for incorporation in current aP vaccine formulations, development of live attenuated vaccines and discovery of novel non-toxic adjuvants capable of inducing both antibody and CMI. In this review, the potential roles of different accredited virulence factors, including novel biofilm-associated antigens, of B. pertussis in the evolution, formulation and delivery of improved pertussis vaccines, with potential to block the transmission of whooping cough in the community, are discussed.

  12. Growth factor stimulation improves the structure and properties of scaffold-free engineered auricular cartilage constructs.

    Directory of Open Access Journals (Sweden)

    Renata G Rosa

    Full Text Available The reconstruction of the external ear to correct congenital deformities or repair following trauma remains a significant challenge in reconstructive surgery. Previously, we have developed a novel approach to create scaffold-free, tissue engineering elastic cartilage constructs directly from a small population of donor cells. Although the developed constructs appeared to adopt the structural appearance of native auricular cartilage, the constructs displayed limited expression and poor localization of elastin. In the present study, the effect of growth factor supplementation (insulin, IGF-1, or TGF-β1 was investigated to stimulate elastogenesis as well as to improve overall tissue formation. Using rabbit auricular chondrocytes, bioreactor-cultivated constructs supplemented with either insulin or IGF-1 displayed increased deposition of cartilaginous ECM, improved mechanical properties, and thicknesses comparable to native auricular cartilage after 4 weeks of growth. Similarly, growth factor supplementation resulted in increased expression and improved localization of elastin, primarily restricted within the cartilaginous region of the tissue construct. Additional studies were conducted to determine whether scaffold-free engineered auricular cartilage constructs could be developed in the 3D shape of the external ear. Isolated auricular chondrocytes were grown in rapid-prototyped tissue culture molds with additional insulin or IGF-1 supplementation during bioreactor cultivation. Using this approach, the developed tissue constructs were flexible and had a 3D shape in very good agreement to the culture mold (average error <400 µm. While scaffold-free, engineered auricular cartilage constructs can be created with both the appropriate tissue structure and 3D shape of the external ear, future studies will be aimed assessing potential changes in construct shape and properties after subcutaneous implantation.

  13. Recent advances in utilizing transcription factors to improve plant abiotic stress tolerance by transgenic technology

    Directory of Open Access Journals (Sweden)

    Hongyan eWang

    2016-02-01

    Full Text Available Agricultural production and quality are adversely affected by various abiotic stresses worldwide and this will be exacerbated by the deterioration of global climate. To feed a growing world population, it is very urgent to breed stress-tolerant crops with higher yields and improved qualities against multiple environmental stresses. Since conventional breeding approaches had marginal success due to the complexity of stress tolerance traits, the transgenic approach is now being popularly used to breed stress-tolerant crops. So identifying and characterizing the the critical genes involved in plant stress responses is an essential prerequisite for engineering stress-tolerant crops. Far beyond the manipulation of single functional gene, engineering certain regulatory genes has emerged as an effective strategy now for controlling the expression of many stress-responsive genes. Transcription factors (TFs are good candidates for genetic engineering to breed stress-tolerant crop because of their role as master regulators of many stress-responsive genes. Many TFs belonging to families AP2/EREBP, MYB, WRKY, NAC, bZIP have been found to be involved in various abiotic stresses and some TF genes have also been engineered to improve stress tolerance in model and crop plants. In this review, we take five large families of TFs as examples and review the recent progress of TFs involved in plant abiotic stress responses and their potential utilization to improve multiple stress tolerance of crops in the field conditions.

  14. A two-factor method for appraising building renovation and energy efficiency improvement projects

    International Nuclear Information System (INIS)

    Martinaitis, Vytautas; Kazakevicius, Eduardas; Vitkauskas, Aloyzas

    2007-01-01

    The renovation of residential buildings usually involves a variety of measures aiming at reducing energy and building maintenance bills, increasing safety and market value, and improving comfort and aesthetics. A significant number of project appraisal methods in current use-such as calculations of payback time, net present value, internal rate of return or cost of conserved energy (CCE)-only quantify energy efficiency gains. These approaches are relatively easy to use, but offer a distorted view of complex modernization projects. On the other hand, various methods using multiple criteria take a much wider perspective but are usually time-consuming, based on sometimes uncertain assumptions and require sophisticated tools. A 'two-factor' appraisal method offers a compromise between these two approaches. The main idea of the method is to separate investments into those related to energy efficiency improvements, and those related to building renovation. Costs and benefits of complex measures, which both influence energy consumption and improve building constructions, are separated by using a building rehabilitation coefficient. The CCE is used for the appraisal of energy efficiency investments, while investments in building renovation are appraised using standard tools for the assessment of investments in maintenance, repair and rehabilitation

  15. Education to a Healthy Lifestyle Improves Symptoms and Cardiovascular Risk Factors – AsuRiesgo Study

    Directory of Open Access Journals (Sweden)

    Graciela Chaves

    2015-05-01

    Full Text Available Background: Cardiovascular diseases are the current leading causes of death and disability globally. Objective: To assess the effects of a basic educational program for cardiovascular prevention in an unselected outpatient population. Methods: All participants received an educational program to change to a healthy lifestyle. Assessments were conducted at study enrollment and during follow-up. Symptoms, habits, ATP III parameters for metabolic syndrome, and American Heart Association’s 2020 parameters of cardiovascular health were assessed. Results: A total of 15,073 participants aged ≥ 18 years entered the study. Data analysis was conducted in 3,009 patients who completed a second assessment. An improvement in weight (from 76.6 ± 15.3 to 76.4 ± 15.3 kg, p = 0.002, dyspnea on exertion NYHA grade II (from 23.4% to 21.0% and grade III (from 15.8% to 14.0% and a decrease in the proportion of current active smokers (from 3.6% to 2.9%, p = 0.002 could be documented. The proportion of patients with levels of triglycerides > 150 mg/dL (from 46.3% to 42.4%, p 100 mg/dL (from 69.3% to 65.5%, p < 0.001 improved. A ≥ 20% improvement of AHA 2020 metrics at the level graded as poor was found for smoking (-21.1%, diet (-29.8%, and cholesterol level (-23.6%. A large dropout as a surrogate indicator for low patient adherence was documented throughout the first 5 visits, 80% between the first and second assessments, 55.6% between the second and third assessments, 43.6% between the third and fourth assessments, and 38% between the fourth and fifth assessments. Conclusion: A simple, basic educational program may improve symptoms and modifiable cardiovascular risk factors, but shows low patient adherence.

  16. Does strabismus surgery improve quality and mood, and what factors influence this?

    Science.gov (United States)

    McBain, H B; MacKenzie, K A; Hancox, J; Ezra, D G; Adams, G G W; Newman, S P

    2016-05-01

    AimsTo establish the impact of adult strabismus surgery on clinical and psychosocial well-being and determine who experiences the greatest benefit from surgery and how one could intervene to improve quality of life post-surgery.MethodsA longitudinal study, with measurements taken pre-surgery and at 3 and 6 months post-surgery. All participants completed the AS-20 a disease specific quality of life scale, along with measures of mood, strabismus and appearance-related beliefs and cognitions and perceived social support. Participants also underwent a full orthoptic assessment at their preoperative visit and again 3 months postoperatively. Clinical outcomes of surgery were classified as success, partial success or failure, using the largest angle of deviation, diplopia and requirement for further therapy.Results210 participants took part in the study. Strabismus surgery led to statistically significant improvements in psychosocial and functional quality of life. Those whose surgery was deemed a partial success did however experience a deterioration in quality of life. A combination of clinical variables, high expectations, and negative beliefs about the illness and appearance pre-surgery were significant predictors of change in quality of life from pre- to post-surgery.ConclusionsStrabismus surgery leads to significant improvements in quality of life up to 6 months postoperatively. There are however a group of patients who do not experience these benefits. A series of clinical and psychosocial factors have now been identified, which will enable clinicians to identify patients who may be vulnerable to poorer outcomes post-surgery and allow for the development of interventions to improve quality of life after surgery.

  17. Coagulation factor XI improves host defence during murine pneumonia-derived sepsis independent of factor XII activation

    NARCIS (Netherlands)

    Stroo, Ingrid; Zeerleder, Sacha; Ding, Chao; Luken, Brenda M.; Roelofs, Joris J. T. H.; de Boer, Onno J.; Meijers, Joost C. M.; Castellino, Francis J.; van 't Veer, Cornelis; van der Poll, Tom

    2017-01-01

    Bacterial pneumonia, the most common cause of sepsis, is associated with activation of coagulation. Factor XI (FXI), the key component of the intrinsic pathway, can be activated via factor XII (FXII), part of the contact system, or via thrombin. To determine whether intrinsic coagulation is involved

  18. Process for improving the load factor of an electricity generating power station

    International Nuclear Information System (INIS)

    Rostaing, Michel.

    1974-01-01

    A description is given of a process for improving the load factor of an electricity generating power station feeding a supply network in which all or part of the power not required by the network during off-peak hours is used for producing hydrogen which is then stored. The stored hydrogen is then burned and the heat generated is employed for superheating the steam generated by the nuclear reactor of the power plant. This combustion is carried out permanently. The hydrogen is produced by water electrolysis. The oxygen also produced in this manner is used as a comburent in the combustion of the hydrogen. The reactor is of the pressurized water type [fr

  19. Factors affecting the stability of drug-loaded polymeric micelles and strategies for improvement

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Weisai; Li, Caibin; Wang, Zhiyu; Zhang, Wenli, E-mail: zwllz@163.com; Liu, Jianping, E-mail: liujianpingljp@hotmail.com [China Pharmaceutical University, Department of Pharmaceutics (China)

    2016-09-15

    Polymeric micelles (PMs) self-assembled by amphiphilic block copolymers have been used as promising nanocarriers for tumor-targeted delivery due to their favorable properties, such as excellent biocompatibility, prolonged circulation time, favorable particle sizes (10–100 nm) to utilize enhanced permeability and retention effect and the possibility for functionalization. However, PMs can be easily destroyed due to dilution of body fluid and the absorption of proteins in system circulation, which may induce drug leakage from these micelles before reaching the target sites and compromise the therapeutic effect. This paper reviewed the factors that influence stability of micelles in terms of thermodynamics and kinetics consist of the critical micelle concentration of block copolymers, glass transition temperature of hydrophobic segments and polymer–polymer and polymer–cargo interaction. In addition, some effective strategies to improve the stability of micelles were also summarized.Graphical Abstract.

  20. Identifying factors to improve oral cancer screening uptake: a qualitative study.

    Directory of Open Access Journals (Sweden)

    Fatemeh Vida Zohoori

    Full Text Available To engage with high risk groups to identify knowledge and awareness of oral cancer signs and symptoms and the factors likely to contribute to improved screening uptake.Focus group discussions were undertaken with 18 males; 40+ years of age; smokers and/or drinkers (15+ cigarettes per day and/or 15+ units of alcohol per week, irregular dental attenders living in economically deprived areas of Teesside.There was a striking reported lack of knowledge and awareness of oral cancer and its signs and symptoms among the participants. When oral/mouth cancer leaflets produced by Cancer Research UK were presented to the participants, they claimed that they would seek help on noticing such a condition. There was a preference to seek help from their general practitioner rather than their dentist due to perceptions that a dentist is 'inaccessible' on a physical and psychological level, costly, a 'tooth specialist' not a 'mouth specialist', and also not able to prescribe medication and make referrals to specialists. Interestingly, none of the 18 participants who were offered a free oral cancer examination at a dental practice took up this offer.The uptake of oral cancer screening may be improved by increasing knowledge of the existence and signs and symptoms of oral cancer. Other factors that may increase uptake are increased awareness of the role of dentists in diagnosing oral cancer, promotion of oral cancer screening by health professionals during routine health checks, and the use of a "health" screening setting as opposed to a "dental" setting for such checks.

  1. Epidermal growth factor treatment decreases mortality and is associated with improved gut integrity in sepsis.

    Science.gov (United States)

    Clark, Jessica A; Clark, Andrew T; Hotchkiss, Richard S; Buchman, Timothy G; Coopersmith, Craig M

    2008-07-01

    Epidermal growth factor (EGF) is a cytoprotective peptide that has healing effects on the intestinal mucosa. We sought to determine whether systemic administration of EGF after the onset of sepsis improved intestinal integrity and decreased mortality. FVB/N mice were subjected to either sham laparotomy or 2 x 23 cecal ligation and puncture (CLP). Septic mice were further randomized to receive injection of either 150 microg kg(-1) d(-1) (i.p.) EGF or 0.9% saline (i.p.). Circulating EGF levels were decreased after CLP compared with sham animals but were unaffected by giving exogenous EGF treatment. In contrast, intestinal EGF levels increased after CLP and were further augmented by exogenous EGF treatment. Intestinal EGF receptor was increased after CLP, whether assayed by immunohistochemistry, real-time polymerase chain reaction, or Western blot, and exogenous EGF treatment decreased intestinal EGF receptor. Villus length decreased 2-fold between sham and septic animals, and EGF treatment resulted in near total restitution of villus length. Sepsis decreased intestinal proliferation and increased intestinal apoptosis. This was accompanied by increased expression of the proapoptotic proteins Bid and Fas-associated death domain, as well as the cyclin-dependent kinase inhibitor p21 cip1/waf Epidermal growth factor treatment after the onset of sepsis restored both proliferation and apoptosis to levels seen in sham animals and normalized expression of Bid, Fas-associated death domain, and p21 cip1/waf . To determine whether improvements in gut homeostasis were associated with a decrease in sepsis-induced mortality, septic mice with or without EGF treatment after CLP were followed 7 days for survival. Mortality decreased from 60% to 30% in mice treated with EGF after the onset of sepsis (P < 0.05). Thus, EGF may be a potential therapeutic agent for the treatment of sepsis in part due to its ability to protect intestinal integrity.

  2. Optical Molecular Imaging of Epidermal Growth Factor Receptor Expression to Improve Detection of Oral Neoplasia

    Directory of Open Access Journals (Sweden)

    Nitin Nitin

    2009-06-01

    Full Text Available Background: The development of noninvasive molecular imaging approaches has the potential to improve management of cancer. Methods: In this study, we demonstrate the potential of noninvasive topical delivery of an epidermal growth factor-Alexa 647 (EGF-Alexa 647 conjugate to image changes in epidermal growth factor receptor expression associated with oral neoplasia. We report a series of preclinical analyses to evaluate the optical contrast achieved after topical delivery of EGF-Alexa 647 in a variety of model systems, including cells, three-dimensional tissue cultures, and intact human tissue specimens using wide-field and high-resolution fluorescence imaging. Data were collected from 17 different oral cancer patients: eight pairs of normal and abnormal biopsies and nine resected tumors were examined. Results: The EGF-dye conjugate can be uniformly delivered throughout the oral epithelium with a penetration depth exceeding 500 µm and incubation time of less than 30 minutes. After EGF-Alexa 647 incubation, the presence of oral neoplasia is associated with a 1.5- to 6.9-fold increase in fluorescence contrast compared with grossly normal mucosa from the same patient with both wide-field and high-resolution fluorescence imaging. Conclusions: Results illustrate the potential of EGF-targeted fluorescent agents for in vivo molecular imaging, a technique that may aid in the diagnosis and characterization of oral neoplasia and allow real-time detection of tumor margins.

  3. Scientist impact factor (SIF): a new metric for improving scientists' evaluation?

    Science.gov (United States)

    Lippi, Giuseppe; Mattiuzzi, Camilla

    2017-08-01

    The publication of scientific research is the mainstay for knowledge dissemination, but is also an essential criterion of scientists' evaluation for recruiting funds and career progression. Although the most widespread approach for evaluating scientists is currently based on the H-index, the total impact factor (IF) and the overall number of citations, these metrics are plagued by some well-known drawbacks. Therefore, with the aim to improve the process of scientists' evaluation, we developed a new and potentially useful indicator of recent scientific output. The new metric scientist impact factor (SIF) was calculated as all citations of articles published in the two years following the publication year of the articles, divided by the overall number of articles published in that year. The metrics was then tested by analyzing data of the 40 top scientists of the local University. No correlation was found between SIF and H-index (r=0.15; P=0.367) or 2 years H-index (r=-0.01; P=0.933), whereas the H-index and 2 years H-index values were found to be highly correlated (r=0.57; Particles published in one year and the total number of citations to these articles in the two following years (r=0.62; Pscientists, wherein the SIF reflects the scientific output over the past two years thus increasing their chances to apply to and obtain competitive funding.

  4. Initial management of pneumonia and sepsis: factors associated with improved outcome.

    Science.gov (United States)

    Menéndez, R; Torres, A; Reyes, S; Zalacain, R; Capelastegui, A; Aspa, J; Borderías, L; Martín-Villasclaras, J J; Bello, S; Alfageme, I; de Castro, F R; Rello, J; Molinos, L; Ruiz-Manzano, J

    2012-01-01

    Processes of care and adherence to guidelines have been associated with improved survival in community-acquired pneumonia (CAP). In sepsis, bundles of processes of care have also increased survival. We aimed to audit compliance with guideline-recommended processes of care and its impact on outcome in hospitalised CAP patients with sepsis. We prospectively studied 4,137 patients hospitalised with CAP in 13 hospitals. The processes of care evaluated were adherence to antibiotic prescription guidelines, first dose within 6 h and oxygen assessment. Outcome measures were mortality and length of stay (LOS). Oxygen assessment was measured in 3,745 (90.5%) patients; 3,024 (73.1%) patients received antibiotics according to guidelines and 3,053 (73.8%) received antibiotics within 6 h. In CAP patients with sepsis, the strongest independent factor for survival was antibiotic adherence (OR 0.4). In severe sepsis, only compliance to antibiotic adherence plus first dose within 6 h was associated with lower mortality (OR 0.60), adjusted for fine prognostic scale and hospital. Antibiotic adherence was related to shorter hospital stay. In sepsis, antibiotic adherence is the strongest protective factor of care associated with survival and LOS. In severe sepsis, combined antibiotic adherence and first dose within 6 h may reduce mortality.

  5. Clindamycin Affects Group A Streptococcus Virulence Factors and Improves Clinical Outcome.

    Science.gov (United States)

    Andreoni, Federica; Zürcher, Claudia; Tarnutzer, Andrea; Schilcher, Katrin; Neff, Andrina; Keller, Nadia; Marques Maggio, Ewerton; Poyart, Claire; Schuepbach, Reto A; Zinkernagel, Annelies S

    2017-01-15

    Group A Streptococcus (GAS) has acquired an arsenal of virulence factors, promoting life-threatening invasive infections such as necrotizing fasciitis. Current therapeutic regimens for necrotizing fasciitis include surgical debridement and treatment with cell wall-active antibiotics. Addition of clindamycin (CLI) is recommended, although clinical evidence is lacking. Reflecting the current clinical dilemma, an observational study showed that only 63% of the patients with severe invasive GAS infection received CLI. This work thus aimed to address whether CLI improves necrotizing fasciitis outcome by modulating virulence factors of CLI-susceptible and CLI-resistant GAS in vitro and in vivo. Treatment with CLI reduced extracellular DNase Sda1 and streptolysin O (SLO) activity in vivo, whereas subinhibitory CLI concentrations induced expression and activity of SLO, DNase, and Streptococcus pyogenes cell envelope protease in vitro. Our in vivo results suggest that CLI should be administered as soon as possible to patients with necrotizing fasciitis, while our in vitro studies emphasize that a high dosage of CLI is essential. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  6. Factors associated with timing of early neurological improvement after thrombolysis for ischaemic stroke.

    Science.gov (United States)

    Guettier, S; Cogez, J; Bonnet, A-L; Dean, P; Apoil, M; Tchoumi, T; Dubuc, L; Arzur, J; de la Sayette, V; Kouassi, L-K; Viader, F; Touzé, E

    2016-03-01

    Early neurological improvement (ENI) after fibrinolysis for ischaemic stroke is strongly associated with recanalization and favourable outcome. However, it remains unknown why some patients recover within the first hour after treatment (very ENI, VENI) whereas others recover later within 24 h. The factors associated with the timing of ENI were assessed. Consecutive stroke patients treated with intravenous recombinant tissue plasminogen activator (rt-PA) within 4.5 h after onset in four stroke centres of our geographical area were retrospectively studied. VENI assessed at 1 h and ENI assessed at 24 h post-treatment were defined by National Institutes of Health Stroke Scale (NIHSS) improvement by 40% from baseline. Of 421 patients, 65 (15%) had VENI and 110 (26%) had ENI. Patients with VENI had significantly lower serum creatinine level than patients with ENI (79 ± 19 vs. 91 ± 35 μmol/l; P = 0.01). After adjustment for age, sex, baseline NIHSS, hypertension and blood glucose level, patients with low serum creatinine level were more likely to have VENI (lowest tertile, odds ratio 3.8, 95% confidence interval 1.5-9.7; intermediate tertile, odds ratio 1.8, 95% confidence interval 0.8-4.3; P for trend ENI patients to have a modified Rankin scale score ≤2 at 3 months. Low serum creatinine levels are associated with VENI, suggesting that swiftness of the efficacy of rt-PA or of neurological recovery may depend on renal function. © 2016 EAN.

  7. Improving furfural tolerance of Zymomonas mobilis by rewiring a sigma factor RpoD protein.

    Science.gov (United States)

    Tan, Fu-Rong; Dai, Li-Chun; Wu, Bo; Qin, Han; Shui, Zong-Xia; Wang, Jing-Li; Zhu, Qi-Li; Hu, Qi-Chun; Ruan, Zhi-Yong; He, Ming-Xiong

    2015-06-01

    Furfural from lignocellulosic hydrolysates is the key inhibitor for bio-ethanol fermentation. In this study, we report a strategy of improving the furfural tolerance in Zymomonas mobilis on the transcriptional level by engineering its global transcription sigma factor (σ(70), RpoD) protein. Three furfural tolerance RpoD mutants (ZM4-MF1, ZM4-MF2, and ZM4-MF3) were identified from error-prone PCR libraries. The best furfural-tolerance strain ZM4-MF2 reached to the maximal cell density (OD600) about 2.0 after approximately 30 h, while control strain ZM4-rpoD reached its highest cell density of about 1.3 under the same conditions. ZM4-MF2 also consumed glucose faster and yield higher ethanol; expression levels and key Entner-Doudoroff (ED) pathway enzymatic activities were also compared to control strain under furfural stress condition. Our results suggest that global transcription machinery engineering could potentially be used to improve stress tolerance and ethanol production in Z. mobilis.

  8. Factors Influencing Continuous Quality Improvement Programme In Government Hospitals Of Sri Lanka

    Directory of Open Access Journals (Sweden)

    Somatunga L C

    2015-06-01

    Full Text Available Abstract Health care systems are accountable to their patients and society to provide quality cost effective care and to seek ways to improve that care. By doing this positive patient outcomes are ensured. Those factors which affect the delivery of a good service have to be identified. It is important to determine whether the environment of an organization type of hospitals plays an important role in determining the implementation of quality improvement programmes Methodology This was a hospital-based descriptive cross-sectional survey carried out in selected hospitals in Sri Lanka. Sixteen Line Ministry Hospitals where Quality Management Units are already in place were selected for the study. Staff working in these hospitals including doctors nurses and allied health staff was included. The data was collected using a self-administered questionnaire. The questionnaire was repeated after three weeks. Findings A total of 378 participants responded in the study. This study identified top management commitment training teamwork physical structure and monitoring system as independent variables that influence the CQI implementation programme. All the participants rated lower for teamwork and felt that teamwork had little influence on CQI programme implementation. The type of hospital has not influenced the implementation of CQI programme.

  9. A novel method for improved accuracy of transcription factor binding site prediction

    KAUST Repository

    Khamis, Abdullah M.; Motwalli, Olaa Amin; Oliva, Romina; Jankovic, Boris R.; Medvedeva, Yulia; Ashoor, Haitham; Essack, Magbubah; Gao, Xin; Bajic, Vladimir B.

    2018-01-01

    Identifying transcription factor (TF) binding sites (TFBSs) is important in the computational inference of gene regulation. Widely used computational methods of TFBS prediction based on position weight matrices (PWMs) usually have high false positive rates. Moreover, computational studies of transcription regulation in eukaryotes frequently require numerous PWM models of TFBSs due to a large number of TFs involved. To overcome these problems we developed DRAF, a novel method for TFBS prediction that requires only 14 prediction models for 232 human TFs, while at the same time significantly improves prediction accuracy. DRAF models use more features than PWM models, as they combine information from TFBS sequences and physicochemical properties of TF DNA-binding domains into machine learning models. Evaluation of DRAF on 98 human ChIP-seq datasets shows on average 1.54-, 1.96- and 5.19-fold reduction of false positives at the same sensitivities compared to models from HOCOMOCO, TRANSFAC and DeepBind, respectively. This observation suggests that one can efficiently replace the PWM models for TFBS prediction by a small number of DRAF models that significantly improve prediction accuracy. The DRAF method is implemented in a web tool and in a stand-alone software freely available at http://cbrc.kaust.edu.sa/DRAF.

  10. A novel method for improved accuracy of transcription factor binding site prediction

    KAUST Repository

    Khamis, Abdullah M.

    2018-03-20

    Identifying transcription factor (TF) binding sites (TFBSs) is important in the computational inference of gene regulation. Widely used computational methods of TFBS prediction based on position weight matrices (PWMs) usually have high false positive rates. Moreover, computational studies of transcription regulation in eukaryotes frequently require numerous PWM models of TFBSs due to a large number of TFs involved. To overcome these problems we developed DRAF, a novel method for TFBS prediction that requires only 14 prediction models for 232 human TFs, while at the same time significantly improves prediction accuracy. DRAF models use more features than PWM models, as they combine information from TFBS sequences and physicochemical properties of TF DNA-binding domains into machine learning models. Evaluation of DRAF on 98 human ChIP-seq datasets shows on average 1.54-, 1.96- and 5.19-fold reduction of false positives at the same sensitivities compared to models from HOCOMOCO, TRANSFAC and DeepBind, respectively. This observation suggests that one can efficiently replace the PWM models for TFBS prediction by a small number of DRAF models that significantly improve prediction accuracy. The DRAF method is implemented in a web tool and in a stand-alone software freely available at http://cbrc.kaust.edu.sa/DRAF.

  11. Ticagrelor Improves Endothelial Function by Decreasing Circulating Epidermal Growth Factor (EGF

    Directory of Open Access Journals (Sweden)

    Francesco Vieceli Dalla Sega

    2018-04-01

    Full Text Available Ticagrelor is one of the most powerful P2Y12 inhibitor. We have recently reported that, in patients with concomitant Stable Coronary Artery Disease (SCAD and Chronic Obstructive Pulmonary Disease (COPD undergoing percutaneous coronary intervention (PCI, treatment with ticagrelor, as compared to clopidogrel, is associated with an improvement of the endothelial function (Clinical Trial NCT02519608. In the present study, we showed that, in the same population, after 1 month treatment with ticagrelor, but not with clopidogrel, there is a decrease of the circulating levels of epidermal growth factor (EGF and that these changes in circulating levels of EGF correlate with on-treatment platelet reactivity. Furthermore, in human umbilical vein endothelial cells (HUVEC incubated with sera of the patients treated with ticagrelor, but not with clopidogrel there is an increase of p-eNOS levels. Finally, analyzing the changes in EGF and p-eNOS levels after treatment, we observed an inverse correlation between p-eNOS and EGF changes only in the ticagrelor group. Causality between EGF and eNOS activation was assessed in vitro in HUVEC where we showed that EGF decreases eNOS activity in a dose dependent manner. Taken together our data indicate that ticagrelor improves endothelial function by lowering circulating EGF that results in the activation of eNOS in the vascular endothelium.

  12. Improved scatter correction with factor analysis for planar and SPECT imaging

    Science.gov (United States)

    Knoll, Peter; Rahmim, Arman; Gültekin, Selma; Šámal, Martin; Ljungberg, Michael; Mirzaei, Siroos; Segars, Paul; Szczupak, Boguslaw

    2017-09-01

    Quantitative nuclear medicine imaging is an increasingly important frontier. In order to achieve quantitative imaging, various interactions of photons with matter have to be modeled and compensated. Although correction for photon attenuation has been addressed by including x-ray CT scans (accurate), correction for Compton scatter remains an open issue. The inclusion of scattered photons within the energy window used for planar or SPECT data acquisition decreases the contrast of the image. While a number of methods for scatter correction have been proposed in the past, in this work, we propose and assess a novel, user-independent framework applying factor analysis (FA). Extensive Monte Carlo simulations for planar and tomographic imaging were performed using the SIMIND software. Furthermore, planar acquisition of two Petri dishes filled with 99mTc solutions and a Jaszczak phantom study (Data Spectrum Corporation, Durham, NC, USA) using a dual head gamma camera were performed. In order to use FA for scatter correction, we subdivided the applied energy window into a number of sub-windows, serving as input data. FA results in two factor images (photo-peak, scatter) and two corresponding factor curves (energy spectra). Planar and tomographic Jaszczak phantom gamma camera measurements were recorded. The tomographic data (simulations and measurements) were processed for each angular position resulting in a photo-peak and a scatter data set. The reconstructed transaxial slices of the Jaszczak phantom were quantified using an ImageJ plugin. The data obtained by FA showed good agreement with the energy spectra, photo-peak, and scatter images obtained in all Monte Carlo simulated data sets. For comparison, the standard dual-energy window (DEW) approach was additionally applied for scatter correction. FA in comparison with the DEW method results in significant improvements in image accuracy for both planar and tomographic data sets. FA can be used as a user

  13. Financial incentives improve recognition but not treatment of cardiovascular risk factors in severe mental illness.

    Directory of Open Access Journals (Sweden)

    Carol L Wilson

    Full Text Available Severe mental illness (SMI is associated with premature cardiovascular disease, prompting the UK primary care payment-for-performance system (Quality and Outcomes Framework, QOF to incentivise annual physical health reviews. This study aimed to assess the QOF's impact on detection and treatment of cardiovascular risk factors in people with SMI.A retrospective open cohort study of UK general practice was conducted between 1996 and 2014, using segmented logistic regression with 2004 and 2011 as break points, reflecting the introduction of relevant QOF incentives in these years. 67239 SMI cases and 359951 randomly-selected unmatched controls were extracted from the Clinical Practice Research Datalink (CPRD.There was strong evidence (p≤0.015 the 2004 QOF indicator (general health resulted in an immediate increase in recording of elevated cholesterol (odds ratio 1.37 (95% confidence interval 1.24 to 1.51; obesity (OR 1.21 (1.06 to 1.38; and hypertension (OR 1.19 (1.04 to 1.38 in the SMI group compared with the control group, which was sustained in subsequent years. Similar findings were found for diabetes, although the evidence was weaker (p = 0.059; OR 1.21 (0.99 to 1.49. There was evidence (p<0.001 of a further, but unsustained, increase in recording of elevated cholesterol and obesity in the SMI group following the 2011 QOF indicator (cardiovascular specific. There was no clear evidence that the QOF indicators affected the prescribing of lipid modifying medications or anti-diabetic medications.Incentivising general physical health review for SMI improves identification of cardiovascular risk factors, although the additional value of specifically incentivising cardiovascular risk factor assessment is unclear. However, incentives do not affect pharmacological management of these risks.

  14. Improvement of force factor of magnetostrictive vibration power generator for high efficiency

    International Nuclear Information System (INIS)

    Kita, Shota; Ueno, Toshiyuki; Yamada, Sotoshi

    2015-01-01

    We develop high power magnetostrictive vibration power generator for battery-free wireless electronics. The generator is based on a cantilever of parallel beam structure consisting of coil-wound Galfenol and stainless plates with permanent magnet for bias. Oscillating force exerted on the tip bends the cantilever in vibration yields stress variation of Galfenol plate, which causes flux variation and generates voltage on coil due to the law of induction. This generator has advantages over conventional, such as piezoelectric or moving magnet types, in the point of high efficiency, highly robust, and low electrical impedance. Our concern is the improvement of energy conversion efficiency dependent on the dimension. Especially, force factor, the conversion ratio of the electromotive force (voltage) on the tip velocity in vibration, has an important role in energy conversion process. First, the theoretical value of the force factor is formulated and then the validity was verified by experiments, where we compare four types of prototype with parameters of the dimension using 7.0 × 1.5 × 50 mm beams of Galfenol with 1606-turn wound coil. In addition, the energy conversion efficiency of the prototypes depending on load resistance was measured. The most efficient prototype exhibits the maximum instantaneous power of 0.73 W and energy of 4.7 mJ at a free vibration of frequency of 202 Hz in the case of applied force is 25 N. Further, it was found that energy conversion efficiency depends not only on the force factor but also on the damping (mechanical loss) of the vibration

  15. The role of psychological factors in the adoption of improved natural grassland by Brazilian cattle farmers in Biome Pampa

    NARCIS (Netherlands)

    Rossi Borges, J.A.

    2015-01-01

    The objective of the research was to explore factors determining cattle farmers' intention to adopt improved natural grassland in Brazil. The research was carried out in the state of Rio Grande do Sul, in the south of Brazil.

  16. Factors Affecting Adoption of Improved Rice Varieties among Rural Farm Households in Central Nepal

    Directory of Open Access Journals (Sweden)

    Raju Ghimire

    2015-01-01

    Full Text Available The use of improved high yielding crop varieties is an important avenue for reducing hunger and food insecurity in developing countries. Using cross-sectional data obtained from a survey conducted during 2013 crop season, we performed a probit model (plot-level analysis to determine the probability of adopting new improved rice varieties (NIRVs by smallholder farmers particularly from two main agro-ecological regions (hills and tropical plain terai regions of Central Nepal. The results revealed that education, extension services and seed access play significant roles in adoption decisions. Additionally, farm and field characteristic variables such as farm size, endowment of favorable land type (e.g. lowlands, and animal power (e.g. oxen are the key factors influencing the probability of adopting NIRVs. The results showed that technology specific variables (e.g. yield potential and acceptability are significant for explaining adoption behavior, implying that it is important to take farmers’ preferences to varietal characteristics into consideration in the design of a research and development program. Given the significant role played by extension and access related variables, increased emphasis on information dissemination, field demonstration, and farmers’ participatory research and training programs to popularize new rice varieties and enhance their adoption rate are required. This also suggests that policy intervention should be made on improving the educational status of farming households, and developing programs on varietal package of rice seed which offer farmers a variety of choices among the appropriate pools of germplasm. Such programs ultimately help farmers develop more profit-oriented behavior which are necessary to enhance adoption rate, production and food security in the long run.

  17. Confirmatory factor analysis and recommendations for improvement of the Autonomy-Preference-Index (API).

    Science.gov (United States)

    Simon, Daniela; Kriston, Levente; Loh, Andreas; Spies, Claudia; Scheibler, Fueloep; Wills, Celia; Härter, Martin

    2010-09-01

    Validation of the German version of the Autonomy-Preference-Index (API), a measure of patients' preferences for decision making and information seeking. Stepwise confirmatory factor analysis was conducted on a sample of patients (n = 1592) treated in primary care for depression (n = 186), surgical and internal medicine inpatients (n = 811) and patients with minor trauma treated in an emergency department (n = 595). An initial test of the model was done on calculation and validation halves of the sample. Both local and global indexes-of-fit suggested modifications to the scale. The scale was modified and re-tested in the calculation sample and confirmed in the validation sample. Subgroup analyses for age, gender and type of treatment setting were also performed. The confirmatory analysis led to a modified version of the API with better local and global indexes-of-fit for samples of German-speaking patients. Two items of the sub-scale, 'preference for decision-making', and one item of the sub-scale, 'preference for information seeking', showed very low reliability scores and were deleted. Thus, several global indexes-of-fit clearly improved significantly. The modified scale was confirmed on the validation sample with acceptable to good indices of fit. Results of subgroup analyses indicated that no adaptations were necessary. This first confirmatory analysis for a German-speaking population showed that the API was improved by the removal of several items. There were theoretically plausible explanations for this improvement suggesting that the modifications might also be appropriate in English and other language versions.

  18. Improved survival and renal prognosis of patients with type 2 diabetes and nephropathy with improved control of risk factors

    DEFF Research Database (Denmark)

    Andrésdóttir, Gudbjörg; Jensen, Majken; Carstensen, Bendix

    2014-01-01

    OBJECTIVE: To evaluate long-term survival, development of renal end points, and decline in glomerular filtration rate (GFR) in patients with type 2 diabetes and diabetic nephropathy (DN) after renin-angiotensin system (RAS) inhibition and multifactorial treatment of cardiovascular risk factors ha...

  19. Opioid growth factor improves clinical benefit and survival in patients with advanced pancreatic cancer

    Directory of Open Access Journals (Sweden)

    Jill P Smith

    2010-03-01

    Full Text Available Jill P Smith1, Sandra I Bingaman1, David T Mauger2, Harold H Harvey1, Laurence M Demers3, Ian S Zagon41Departments of Medicine, 2Public Health Sciences, 3Pathology, and 4Neurosciences and Anatomy, Pennsylvania State University, College of Medicine, Hershey Medical Center, Hershey, PA, USABackground: Advanced pancreatic cancer carries the poorest prognosis of all gastrointestinal malignancies. Once the tumor has spread beyond the margins of the pancreas, chemotherapy is the major treatment modality offered to patients; however, chemotherapy does not significantly improve survival.Objective: Opioid growth factor (OGF; [Met5]-enkephalin is a natural peptide that has been shown to inhibit growth of pancreatic cancer in cell culture and in nude mice. The purpose of this study was to evaluate the effects of OGF biotherapy on subjects with advanced pancreatic cancer who failed chemotherapy.Methods: In a prospective phase II open-labeled clinical trial, 24 subjects who failed standard chemotherapy for advanced pancreatic cancer were treated weekly with OGF 250 μg/kg intravenously. Outcomes measured included clinical benefit, tumor response by radiographic imaging, quality of life, and survival.Results: Clinical benefit response was experienced by 53% of OGF-treated patients compared to historical controls of 23.8% and 4.8% for gemcitabine and 5-fluorouracil (5-FU, respectively. Of the subjects surviving more than eight weeks, 62% showed either a decrease or stabilization in tumor size by computed tomography. The median survival time for OGF-treated patients was three times that of untreated patients (65.5 versus 21 days, p < 0.001. No adverse effects on hematologic or chemistry parameters were noted, and quality of life surveys suggested improvement with OGF. Limitations: Measurements other than survival were not allowed in control patients, and clinical benefit comparisons were made to historical controls.Conclusion: OGF biotherapy improves the

  20. Can Male Fertility Be Improved Prior to Assisted Reproduction through The Control of Uncommonly Considered Factors?

    Directory of Open Access Journals (Sweden)

    Daniel M.Campagne

    2013-01-01

    Full Text Available Male factor infertility or subfertility is responsible for up to 50% of infertility cases. A considerablebody of recent studies indicates that lifestyle as well as environmental and psychological factorscan negatively affect male fertility, more than previously thought. These negative effects have beenshown in many cases to be reversible. This review aims to provide a rationale for early clinicalattention to these factors and presents a non-exhaustive evidence-based collection of primaryrelevant conditions and recommendations, specifically with a view to making first line diagnosticsand recommendations. The presently available evidence suggests that considering the high cost,success rates, and possible side effects of assisted reproduction techniques (ART, such as in vitrofertilization (IVF and intracytoplasmic sperm injection (ICSI, early efforts to improve malefertility appear to be an attainable and worthwhile primary goal.A series of searches was conducted of Medline, Cochrane and related databases from November14th, 2010 to January 26th, 2012 with the following keywords: male, fertility, infertility, spermdefects, IVF, ICSI, healthy habits, and lifestyle. Subsequent follow-up searches were performed forupcoming links. The total number of studies contemplated were 1265; of these, 296 studies werereviewed with criteria of relevance; the date of study or review; study sample size and study type;and publishing journal impact status. Data were abstracted based upon probable general clinicalrelevancy and use. Only a selection of the references has been reflected here because of spacelimitations. The main results obtained were evidence-supported indications as to the other causes ofmale infertility, their early detection, and treatment.

  1. Simulator training and non-technical factors improve laparoscopic performance among OBGYN trainees.

    Science.gov (United States)

    Ahlborg, Liv; Hedman, Leif; Nisell, Henry; Felländer-Tsai, Li; Enochsson, Lars

    2013-10-01

    To investigate how simulator training and non-technical factors affect laparoscopic performance among residents in obstetrics and gynecology. In this prospective study, trainees were randomized into three groups. The first group was allocated to proficiency-based training in the LapSimGyn(®) virtual reality simulator. The second group received additional structured mentorship during subsequent laparoscopies. The third group served as control group. At baseline an operation was performed and visuospatial ability, flow and self-efficacy were assessed. All groups subsequently performed three tubal occlusions. Self-efficacy and flow were assessed before and/or after each operation. Simulator training was conducted at the Center for Advanced Medical Simulation and Training, Karolinska University Hospital. Sterilizations were performed at each trainee's home clinic. Twenty-eight trainees/residents from 21 hospitals in Sweden were included. Visuospatial ability was tested by the Mental Rotation Test-A. Flow and self-efficacy were assessed by validated scales and questionnaires. Laparoscopic performance was measured as the duration of surgery. Visuospatial ability, self-efficacy and flow were correlated to the laparoscopic performance using Spearman's correlations. Differences between groups were analyzed by the Mann-Whitney U-test. No differences across groups were detected at baseline. Self-efficacy scores before and flow scores after the third operation were significantly higher in the trained groups. Duration of surgery was significantly shorter in the trained groups. Flow and self-efficacy correlate positively with laparoscopic performance. Simulator training and non-technical factors appear to improve the laparoscopic performance among trainees/residents in obstetrics and gynecology. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

  2. Fifteen years of GH replacement improves body composition and cardiovascular risk factors.

    Science.gov (United States)

    Elbornsson, Mariam; Götherström, Galina; Bosæus, Ingvar; Bengtsson, Bengt-Åke; Johannsson, Gudmundur; Svensson, Johan

    2013-05-01

    Few studies have determined the effects of more than 5-10 years of GH replacement in adults on body composition and cardiovascular risk factors. In this prospective, single-center, open-label study, the effects of 15 years of GH replacement on body composition and cardiovascular risk factors were determined in 156 hypopituitary adults (93 men) with adult-onset GH deficiency (GHD). Mean age was 50.5 (range 22-74) years at study start. Body composition was measured using dual-energy X-ray absorptiometry. The mean initial GH dose of 0.55 (S.E.M. 0.03) mg/day was gradually lowered to 0.40 (0.01) mg/day after 15 years. The mean serum IGF1 SDS increased from -1.53 (0.10) at baseline to 0.74 (0.13) at study end (Plevel at study end (Pbody fat (BF) started to increase and had returned to the baseline level after 15 years. Serum levels of total cholesterol and LDL-cholesterol decreased and serum HDL-cholesterol level increased. Fasting plasma glucose increased from 4.4 (0.1) at baseline to 4.8 (0.1) mmol/l at study end (P<0.001). However, blood HbA1c decreased from 5.0 (0.1) to 4.6 (0.1) % (P<0.001). Fifteen-year GH replacement in GHD adults induced a transient decrease in BF and sustained improvements of LST and serum lipid profile. Fasting plasma glucose increased whereas blood HbA1c was reduced.

  3. Assurance of Myeloid Growth Factor Administration in an Infusion Center: Pilot Quality Improvement Initiative.

    Science.gov (United States)

    Ramirez, Pamela Maree; Peterson, Barry; Holtshopple, Christine; Borja, Kristina; Torres, Vincent; Valdivia-Peppers, Lucille; Harriague, Julio; Joe, Melanie D

    2017-12-01

    Four incident reports involving missed doses of myeloid growth factors (MGFs) triggered the need for an outcome-driven initiative. From March 1, 2015, to February 29, 2016, at University of California Irvine Health Chao Infusion Center, 116 of 3,300 MGF doses were missed (3.52%), including pegfilgrastim, filgrastim, and sargramostim. We hypothesized that with the application of Lean Six Sigma methodology, we would achieve our primary objective of reducing the number of missed MGF doses to < 0.5%. This quality improvement initiative was conducted at Chao Infusion Center as part of a Lean Six Sigma Green Belt Certification Program. Therefore, Lean Six Sigma principles and tools were used throughout each phase of the project. Retrospective and prospective medical record reviews and data analyses were performed to evaluate the extent of the identified problem and impact of the process changes. Improvements included systems applications, practice changes, process modifications, and safety-net procedures. Preintervention, 24 missed doses (20.7%) required patient supportive care measures, resulting in increased hospital costs and decreased quality of care. Postintervention, from June 8, 2016, to August 7, 2016, zero of 489 MGF doses were missed after 2 months of intervention ( P < .001). Chao Infusion Center reduced missed doses from 3.52% to 0%, reaching the goal of < 0.5%. The establishment of simplified and standardized processes with safety checks for error prevention increased quality of care. Lean Six Sigma methodology can be applied by other institutions to produce positive outcomes and implement similar practice changes.

  4. Enterocyte-specific epidermal growth factor prevents barrier dysfunction and improves mortality in murine peritonitis.

    Science.gov (United States)

    Clark, Jessica A; Gan, Heng; Samocha, Alexandr J; Fox, Amy C; Buchman, Timothy G; Coopersmith, Craig M

    2009-09-01

    Systemic administration of epidermal growth factor (EGF) decreases mortality in a murine model of septic peritonitis. Although EGF can have direct healing effects on the intestinal mucosa, it is unknown whether the benefits of systemic EGF in peritonitis are mediated through the intestine. Here, we demonstrate that enterocyte-specific overexpression of EGF is sufficient to prevent intestinal barrier dysfunction and improve survival in peritonitis. Transgenic FVB/N mice that overexpress EGF exclusively in enterocytes (IFABP-EGF) and wild-type (WT) mice were subjected to either sham laparotomy or cecal ligation and puncture (CLP). Intestinal permeability, expression of the tight junction proteins claudins-1, -2, -3, -4, -5, -7, and -8, occludin, and zonula occludens-1; villus length; intestinal epithelial proliferation; and epithelial apoptosis were evaluated. A separate cohort of mice was followed for survival. Peritonitis induced a threefold increase in intestinal permeability in WT mice. This was associated with increased claudin-2 expression and a change in subcellular localization. Permeability decreased to basal levels in IFABP-EGF septic mice, and claudin-2 expression and localization were similar to those of sham animals. Claudin-4 expression was decreased following CLP but was not different between WT septic mice and IFABP-EGF septic mice. Peritonitis-induced decreases in villus length and proliferation and increases in apoptosis seen in WT septic mice did not occur in IFABP-EGF septic mice. IFABP-EGF mice had improved 7-day mortality compared with WT septic mice (6% vs. 64%). Since enterocyte-specific overexpression of EGF is sufficient to prevent peritonitis-induced intestinal barrier dysfunction and confers a survival advantage, the protective effects of systemic EGF in septic peritonitis appear to be mediated in an intestine-specific fashion.

  5. An Empirical Study of Critical Soft Factors for Quality Improvement in The Electrical and Electronics Firms in Malaysia

    Directory of Open Access Journals (Sweden)

    Muhammad Madi Abdullah

    2009-03-01

    Full Text Available Soft factors are important aspect that sustains the organizations in their efforts towards continuous quality improvement (QI and customer satisfaction. The conventional wisdom states that quality improvement in organizations increases profits and productivity. Therefore, the aim of the paper is to examine the influence of critical soft factors (CSF on quality improvement (QI. For that purpose, this study examine: (i the relationship between the CSF and QI and (ii to what extent the six CSF explain QI. The study used survey data from 255 electrical and electronics (E&E firms in Malaysia. The individual managers representing the each firm made the unit of analysis of the study. The finding reveals that QI was significantly influenced by the following soft factors: management commitment, customer focus, employee involvement, training & education, and reward & recognition. Supplier relationship was not a significant predictor of quality improvement. Finally, this study has empirically shown that quality improvement will increase when the organizations emphasize more on soft factors.Keywords: Critical soft factors, quality improvement, Electrical and Electronics firms

  6. Enabling factors for the improvement of nitride-based LED efficiency

    International Nuclear Information System (INIS)

    Laubsch, Ansgar; Bergbauer, Werner; Sabathil, Matthias; Peter, Matthias; Meyer, Tobias; Bruederl, Georg; Linder, Norbert; Streubel, Klaus; Oberschmid, Raimund; Hahn, Berthold; Wagner, Joachim

    2008-01-01

    Recent progress in the epitaxial growth of LEDs with InGaN/GaN quantum-well heterostructures has led to a significant enhancement of output power. In this talk, we will discuss the mechanisms limiting the devices' internal efficiency and identify enabling factors for further improvements. We compare samples with different Indium content as well as different design of the active layer. Although heteroepitaxial growth of GaN on sapphire generates high defect densities, non-radiative defect-related Shockley-Read-Hall recombination does not seem to substantially limit the efficiency of standard InGaN/GaN LED structures. We rather discuss a supplemental Auger-like non-radiative path for carrier recombination that becomes dominant at quantum-well carrier densities typical for LED operation. Additionally, the piezo-field induced reduced overlap of electron and hole wavefunction in standard c-plane grown InGaN quantum wells reduces the radiative recombination rate

  7. Dark chocolate consumption improves leukocyte adhesion factors and vascular function in overweight men.

    Science.gov (United States)

    Esser, Diederik; Mars, Monica; Oosterink, Els; Stalmach, Angelique; Müller, Michael; Afman, Lydia A

    2014-03-01

    Flavanol-enriched chocolate consumption increases endothelium-dependent vasodilation. Most research so far has focused on flow-mediated dilation (FMD) only; the effects on other factors relevant to endothelial health, such as inflammation and leukocyte adhesion, have hardly been addressed. We investigated whether consumption of regular dark chocolate also affects other markers of endothelial health, and whether chocolate enrichment with flavanols has additional benefits. In a randomized double-blind crossover study, the effects of acute and of 4 wk daily consumption of high flavanol chocolate (HFC) and normal flavanol chocolate (NFC) on FMD, augmentation index (AIX), leukocyte count, plasma cytokines, and leukocyte cell surface molecules in overweight men (age 45-70 yr) were investigated. Sensory profiles and motivation scores to eat chocolate were also collected. Findings showed that a 4 wk chocolate intake increased FMD by 1%, which was paralleled by a decreased AIX of 1%, decreased leukocyte cell count, decreased plasma sICAM1 and sICAM3, and decreased leukocyte adhesion marker expression (Peffect), with no difference between HFC and NFC consumption. Flavanol enrichment did affect taste and negatively affected motivation to consume chocolate. This study provides new insights on how chocolate affects endothelial health by demonstrating that chocolate consumption, besides improving vascular function, also lowers the adherence capacity of leukocytes in the circulation.

  8. Improved Dynamic Modeling of the Cascade Distillation Subsystem and Analysis of Factors Affecting Its Performance

    Science.gov (United States)

    Perry, Bruce A.; Anderson, Molly S.

    2015-01-01

    The Cascade Distillation Subsystem (CDS) is a rotary multistage distiller being developed to serve as the primary processor for wastewater recovery during long-duration space missions. The CDS could be integrated with a system similar to the International Space Station Water Processor Assembly to form a complete water recovery system for future missions. A preliminary chemical process simulation was previously developed using Aspen Custom Modeler® (ACM), but it could not simulate thermal startup and lacked detailed analysis of several key internal processes, including heat transfer between stages. This paper describes modifications to the ACM simulation of the CDS that improve its capabilities and the accuracy of its predictions. Notably, the modified version can be used to model thermal startup and predicts the total energy consumption of the CDS. The simulation has been validated for both NaC1 solution and pretreated urine feeds and no longer requires retuning when operating parameters change. The simulation was also used to predict how internal processes and operating conditions of the CDS affect its performance. In particular, it is shown that the coefficient of performance of the thermoelectric heat pump used to provide heating and cooling for the CDS is the largest factor in determining CDS efficiency. Intrastage heat transfer affects CDS performance indirectly through effects on the coefficient of performance.

  9. A combined continuous and interval aerobic training improves metabolic syndrome risk factors in men

    Directory of Open Access Journals (Sweden)

    Sari-Sarraf V

    2015-05-01

    Full Text Available Vahid Sari-Sarraf,1 Akbar Aliasgarzadeh,2 Mohammad-Mahdi Naderali,3 Hamid Esmaeili,1 Ebrahim K Naderali4 1Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tabriz, 2Bone Research Centre, Endocrine Unit, Department of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran; 3The School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, 4Faculty of Science, Liverpool Hope University, Liverpool, UK Abstract: Individuals with metabolic syndrome have significantly higher risk of cardiovascular disease and type 2 diabetes leading to premature death mortality. Metabolic syndrome has a complex etiology; thus, it may require a combined and multi-targeted aerobic exercise regimen to improve risk factors associated with it. Therefore, the aim of this study was to evaluate the effect of combined continuous and interval aerobic training on patients with metabolic syndrome. Thirty adult male with metabolic syndrome (54±8 years were randomly divided into two groups: test training group (TTG; n=15 and control group (CG; n=15. Subjects in TTG performed combined continuous and interval aerobic training using a motorized treadmill three times per week for 16 weeks. Subjects in CG were advised to continue with their normal activities of life. Twenty-two men completed the study (eleven men in each group. At the end of the study, in TTG, there were significant (for all, P<0.05 reductions in total body weight (-3.2%, waist circumference (-3.43 cm, blood pressure (up to -12.7 mmHg, and plasma insulin, glucose, and triacylglyceride levels. Moreover, there were significant (for all, P<0.05 increases VO2max (-15.3% and isometric strength of thigh muscle (28.1% and high-density lipoprotein in TTG. None of the above indices were changed in CG at the end of 16-week study period. Our study suggests that adoption of a 16-week combined continuous and interval aerobic training regimen in men

  10. Factors associated with the impact of quality improvement collaboratives in mental healthcare: an exploratory study.

    NARCIS (Netherlands)

    Versteeg, M.H.; Laurant, M.G.H.; Franx, G.C.; Jacobs, A.J.M; Wensing, M.J.P.

    2012-01-01

    BACKGROUND: Quality improvement collaboratives (QICs) bring together groups of healthcare professionals to work in a structured manner to improve the quality of healthcare delivery within particular domains. We explored which characteristics of the composition, participation, functioning, and

  11. Factors influencing patient satisfaction with dental appearance and treatments they desire to improve aesthetics

    Directory of Open Access Journals (Sweden)

    Hassan Nurhidayati

    2011-02-01

    Full Text Available Abstract Background We assessed factors influencing patients' satisfaction with their dental appearance and the treatments they desired to improve dental aesthetics. Methods A cross-sectional study was performed out among 235 adult patients who visited the Hospital Universiti Sains Malaysia dental clinic. A structured, interviewer-guided questionnaire was used to identify patient satisfaction with their general dental appearance, cosmetic elements and desired treatments. Results The 235 patients consisted of 70 males (29.8% and 165 females (70.2%, of mean age 31.5 years (SD 13.0. Of these patients, 124 (52.8% were not satisfied with their general dental appearance. In addition, 132 patients (56.2% were not happy with the color of their teeth, 76 (32.3%, regarded their teeth were poorly aligned, 62 (26.4%, as crowded and 56 (23.4% protruded. Dissatisfaction with tooth color was significantly higher in female than in male patients (odds ratio [OR] of 1.99 (95% confidence interval [CI] 1.13-3.50. Tooth whitening was the treatment most desired by patients (48.1%. Results of multiple logistic regression analysis showed that patient dissatisfaction with general dental appearance was significantly associated with female gender (OR = 2.18; 95% CI: 1.18-4.03, unhappiness with tooth color (OR = 3.05; 95% CI: 1.74-5.34 and the opinion that their teeth protruded (OR = 2.91, 95% CI: 1.44-5.91. Conclusions Most patients in this study were not satisfied with their dental appearance with a greater percentage of females expressing dissatisfaction than males. An age was not associated with satisfaction. Unhappiness with tooth color and feelings of having protruding teeth also had a significant negative influence on patient satisfaction with general dental appearance.

  12. CONCEPTUAL FRAMEWORK FOR IMPROVING BUSINESS PERFORMANCE WITH LEAN MANUFACTURING AND SUCCESSFUL HUMAN FACTORS INTERVENTIONS-A CASE STUD

    Directory of Open Access Journals (Sweden)

    Rajiv Sharm

    2012-09-01

    Full Text Available Nowadays organizations compete between themselves in various categories such as faster delivery, price tags, state of art - technology and higher quality dimensio ns. A Conceptual framework with lean manufacturing and hum an factors interventions for improving business performance in terms of improved quality, reduced cost and faster de livery is presented and example s from literature are given to illustrate the desir ed situation in which ergonomics is considered as an integrated part of performance strategy . A case from an industry engaged in manufacturing shafts using lean manufacturing practices with successful ergonomic or human factors interventions is also inves tigated.

  13. Kaon semileptonic decay form factors from Nf = 2 non-perturbatively O(a)-improved Wilson fermions

    International Nuclear Information System (INIS)

    Broemmel, D.; Nakamura, Y.; Pleiter, D.

    2007-10-01

    We present first results from the QCDSF collaboration for the kaon semileptonic decay form factors at zero momentum transfer, using two flavours of non-perturbatively O(a)-improved Wilson quarks. A lattice determination of these form factors is of particular interest to improve the accuracy on the CKM matrix element vertical stroke V us vertical stroke. Calculations are performed on lattices with lattice spacing of about 0.08 fm with different values of light and strange quark masses, which allows us to extrapolate to chiral limit. Employing double ratio techniques, we are able to get small statistical errors. (orig.)

  14. Predictive Factors for Subjective Improvement in Lumbar Spinal Stenosis Patients with Nonsurgical Treatment: A 3-Year Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Ko Matsudaira

    Full Text Available To assess the predictive factors for subjective improvement with nonsurgical treatment in consecutive patients with lumbar spinal stenosis (LSS.Patients with LSS were enrolled from 17 medical centres in Japan. We followed up 274 patients (151 men; mean age, 71 ± 7.4 years for 3 years. A multivariable logistic regression model was used to assess the predictive factors for subjective symptom improvement with nonsurgical treatment.In 30% of patients, conservative treatment led to a subjective improvement in the symptoms; in 70% of patients, the symptoms remained unchanged, worsened, or required surgical treatment. The multivariable analysis of predictive factors for subjective improvement with nonsurgical treatment showed that the absence of cauda equina symptoms (only radicular symptoms had an odds ratio (OR of 3.31 (95% confidence interval [CI]: 1.50-7.31; absence of degenerative spondylolisthesis/scoliosis had an OR of 2.53 (95% CI: 1.13-5.65; <1-year duration of illness had an OR of 3.81 (95% CI: 1.46-9.98; and hypertension had an OR of 2.09 (95% CI: 0.92-4.78.The predictive factors for subjective symptom improvement with nonsurgical treatment in LSS patients were the presence of only radicular symptoms, absence of degenerative spondylolisthesis/scoliosis, and an illness duration of <1 year.

  15. The Sustainable Office. An exploration of the potential for factor 20 environmental improvement of office accommodation

    NARCIS (Netherlands)

    Van den Dobbelsteen, A.A.J.F.

    2004-01-01

    Sustainable development is the goal of a balance between economy and the environment, whilst establishing a better spread prosperity across the world. In order to make this possible, the environmental load of our commodities needs to be reduced by a factor of 20. This factor 20 can also be

  16. Not So Fast: Inflation in Impact Factors Contributes to Apparent Improvements in Journal Quality

    Science.gov (United States)

    Neff, Bryan D.; Olden, Julian D.

    2010-01-01

    The Institute for Scientific Information (ISI) impact factor has become an important standard for assessing journal quality. Here we propose that impact factors may be subject to inflation analogous to changes in monetary prices in economics. The possibility of inflation came to light as a result of the observation that papers published today tend…

  17. Is preoperative brain midline shift a determinant factor for neurological improvement after cranioplasty?

    Directory of Open Access Journals (Sweden)

    Chun-Hsien Lin

    2015-07-01

    Conclusion: For patients who underwent craniectomy, an improvement in neurological function 1 year after cranioplasty was observed. The patients with brain midline shift showed more improvement in consciousness after cranioplasty than those without a brain midline shift. The presence of a preoperative brain midline shift may be an isolated determinant for the prediction of the outcome after cranioplasty.

  18. Factors for analysing and improving performance of R&D in Malaysian universities

    NARCIS (Netherlands)

    Ramli, Mohammad Shakir; de Boer, S.J.; de Bruijn, E.J.

    2004-01-01

    This paper presents a model for analysing and improving performance of R&D in Malaysian universities. There are various general models for R&D analysis, but none is specific for improving the performance of R&D in Malaysian universities. This research attempts to fill a gap in the body of knowledge

  19. Factors That Contribute to the Improvement in Maternal Parenting after Separation from a Violent Husband or Partner

    Science.gov (United States)

    Fujiwara, Takeo; Okuyama, Makiko; Izumi, Mayuko

    2012-01-01

    The authors test the hypothesis that separation from a violent husband or partner improves maternal parenting in Japan and examine how childhood abuse history (CAH), experience of domestic violence (DV), mental health problems, husband or partner's child maltreatment, and other demographic factors affect maternal parenting after such separation. A…

  20. Iranian staff nurses' views of their productivity and human resource factors improving and impeding it: a qualitative study

    Directory of Open Access Journals (Sweden)

    Salsali Mahvash

    2005-10-01

    Full Text Available Abstract Background Nurses, as the largest human resource element of health care systems, have a major role in providing ongoing, high-quality care to patients. Productivity is a significant indicator of professional development within any professional group, including nurses. The human resource element has been identified as the most important factor affecting productivity. This research aimed to explore nurses' perceptions and experiences of productivity and human resource factors improving or impeding it. Method A qualitative approach was used to obtain rich data; open, semi-structured interviews were also conducted. The sampling was based on the maximum variant approach; data analysis was carried out by content analysis, with the constant comparative method. Results Participants indicated that human resources issues are the most important factor in promoting or impeding their productivity. They suggested that the factors influencing effectiveness of human resource elements include: systematic evaluation of staff numbers; a sound selection process based on verifiable criteria; provision of an adequate staffing level throughout the year; full involvement of the ward sister in the process of admitting patients; and sound communication within the care team. Paying attention to these factors creates a suitable background for improved productivity and decreases negative impacts of human resource shortages, whereas ignoring or interfering with them would result in lowering of nurses' productivity. Conclusion Participants maintained that satisfactory human resources can improve nurses' productivity and the quality of care they provide; thereby fulfilling the core objective of the health care system.

  1. Three-dimensional flow analysis and improvement of slip factor model for forward-curved blades centrifugal fan

    International Nuclear Information System (INIS)

    Guo, En Min; Kim, Kwang Yong

    2004-01-01

    This work developed improved slip factor model and correction method to predict flow through impeller in forward-curved centrifugal fan. Both steady and unsteady three-dimensional CFD analyses were performed to validate the slip factor model and the correction method. The results show that the improved slip factor model presented in this paper could provide more accurate predictions for forward-curved centrifugal impeller than the other slip factor models since the present model takes into account the effect of blade curvature. The correction method is provided to predict mass-averaged absolute circumferential velocity at the exit of impeller by taking account of blockage effects induced by the large-scale backflow near the front plate and flow separation within blade passage. The comparison with CFD results also shows that the improved slip factor model coupled with the present correction method provides accurate predictions for mass-averaged absolute circumferential velocity at the exit of impeller near and above the flow rate of peak total pressure coefficient

  2. Interleaved segment correction achieves higher improvement factors in using genetic algorithm to optimize light focusing through scattering media

    Science.gov (United States)

    Li, Runze; Peng, Tong; Liang, Yansheng; Yang, Yanlong; Yao, Baoli; Yu, Xianghua; Min, Junwei; Lei, Ming; Yan, Shaohui; Zhang, Chunmin; Ye, Tong

    2017-10-01

    Focusing and imaging through scattering media has been proved possible with high resolution wavefront shaping. A completely scrambled scattering field can be corrected by applying a correction phase mask on a phase only spatial light modulator (SLM) and thereby the focusing quality can be improved. The correction phase is often found by global searching algorithms, among which Genetic Algorithm (GA) stands out for its parallel optimization process and high performance in noisy environment. However, the convergence of GA slows down gradually with the progression of optimization, causing the improvement factor of optimization to reach a plateau eventually. In this report, we propose an interleaved segment correction (ISC) method that can significantly boost the improvement factor with the same number of iterations comparing with the conventional all segment correction method. In the ISC method, all the phase segments are divided into a number of interleaved groups; GA optimization procedures are performed individually and sequentially among each group of segments. The final correction phase mask is formed by applying correction phases of all interleaved groups together on the SLM. The ISC method has been proved significantly useful in practice because of its ability to achieve better improvement factors when noise is present in the system. We have also demonstrated that the imaging quality is improved as better correction phases are found and applied on the SLM. Additionally, the ISC method lowers the demand of dynamic ranges of detection devices. The proposed method holds potential in applications, such as high-resolution imaging in deep tissue.

  3. Formulating the strength factor α for improved predictability of radiation hardening

    Energy Technology Data Exchange (ETDEWEB)

    Tan, L., E-mail: tanl@ornl.gov; Busby, J.T.

    2015-10-15

    Analytical equations were developed to calculate the strength factors of precipitates, Frank loops, and cavities in austenitic alloys, which strongly depend on barrier type, size, geometry and density, as well as temperature. Calculated strength factors were successfully used to estimate radiation hardening using the broadly employed dispersed barrier-hardening model, leading to good agreement with experimentally measured hardening in neutron-irradiated type 304 and 316 stainless steel variants. The formulated strength factor provides a route for more reliable hardening predictions and can be easily incorporated into component simulations and design.

  4. Myeloid differentiation factor 88-deficient bone marrow cells improve Alzheimer's disease-related symptoms and pathology

    NARCIS (Netherlands)

    Hao, W.; Liu, Y.; Liu, S.; Walter, S.; Grimm, M.O.; Kiliaan, A.J.; Penke, B.; Hartmann, T.; Rube, C.E.; Menger, M.D.; Fassbender, K.

    2011-01-01

    Alzheimer's disease is characterized by extracellular deposits of amyloid beta peptide in the brain. Increasing evidence suggests that amyloid beta peptide injures neurons both directly and indirectly by triggering neurotoxic innate immune responses. Myeloid differentiation factor 88 is the key

  5. THE POWER FACTOR IMPROVING OF THE MOTORS IN ENTERPRISES WITH REPAIR OF RAILWAY EQUIPMENT

    Directory of Open Access Journals (Sweden)

    O. L. Marenych

    2008-03-01

    Full Text Available In this article the following problem has been considered: ways of power factor increase for electric drives installed at the railway machinery repair enterprises with taking into account the specific conditions of technological processes.

  6. The effects of risk factors on the improvement of hypothermia neonatal using fuzzy transition

    OpenAIRE

    Fatemeh Salmani; Alireza Abadi; S. Mahmoud Taheri; Hamid Alavi Majd; Fatemeh Nayeri

    2016-01-01

    Background and aim: Neonatal hypothermia is a major risk factor for mortality after delivery. This study aims to identify the risk factors associated with transition in hypothermia state with new definition of hypothermia states.Methods:  Four hundred and seventy nine (479) neonates hospitalized in NICU of Valiasr in Tehran, Iran in 2005 participated in this study. The rectal temperature of neonatal was measured immediately after delivery and every 30 min afterwards, until neonates became nor...

  7. How to improve teaching practices: the role of teacher motivation, organizational factors and leadership practices

    NARCIS (Netherlands)

    Thoonen, E.E.J.; Sleegers, P.J.C.; Oort, F.J.; Peetsma, T.T.D.; Geijsel, F.P.

    2011-01-01

    Purpose: Although it is expected that building schoolwide capacity for teacher learning will improve teaching practices, there is little systematic evidence to support this claim. This study aimed to examine the relative impact of transformational leadership practices, school organizational

  8. Theoretical study on new bias factor methods to effectively use critical experiments for improvement of prediction accuracy of neutronic characteristics

    International Nuclear Information System (INIS)

    Kugo, Teruhiko; Mori, Takamasa; Takeda, Toshikazu

    2007-01-01

    Extended bias factor methods are proposed with two new concepts, the LC method and the PE method, in order to effectively use critical experiments and to enhance the applicability of the bias factor method for the improvement of the prediction accuracy of neutronic characteristics of a target core. Both methods utilize a number of critical experimental results and produce a semifictitious experimental value with them. The LC and PE methods define the semifictitious experimental values by a linear combination of experimental values and the product of exponentiated experimental values, respectively, and the corresponding semifictitious calculation values by those of calculation values. A bias factor is defined by the ratio of the semifictitious experimental value to the semifictitious calculation value in both methods. We formulate how to determine weights for the LC method and exponents for the PE method in order to minimize the variance of the design prediction value obtained by multiplying the design calculation value by the bias factor. From a theoretical comparison of these new methods with the conventional method which utilizes a single experimental result and the generalized bias factor method which was previously proposed to utilize a number of experimental results, it is concluded that the PE method is the most useful method for improving the prediction accuracy. The main advantages of the PE method are summarized as follows. The prediction accuracy is necessarily improved compared with the design calculation value even when experimental results include large experimental errors. This is a special feature that the other methods do not have. The prediction accuracy is most effectively improved by utilizing all the experimental results. From these facts, it can be said that the PE method effectively utilizes all the experimental results and has a possibility to make a full-scale-mockup experiment unnecessary with the use of existing and future benchmark

  9. Improved cognition after control of risk factors for multi-infarct dementia

    International Nuclear Information System (INIS)

    Meyer, J.S.; Judd, B.W.; Tawaklna, T.; Rogers, R.L.; Mortel, K.F.

    1986-01-01

    A cohort of 52 patients (30 men and 22 women) with multi-infarct dementia (MID) has been followed up prospectively for a mean interval of 22.2 months. Clinical course has been documented by serial history taking and interviews and neurological, medical, and psychological examinations, and correlated with measurements of cerebral blood flow. The clinical course and cognitive performance have been compared with those of age-matched normal volunteers and patients with Alzheimer's disease. Patients with MID were subdivided into hypertensive and normotensive groups, and also into those displaying stabilized or improved cognition and those whose condition deteriorated. Among hypertensive patients with MID, improved cognition and clinical course correlated with control of systolic blood pressure within upper limits of normalf (135 to 150 mm Hg), but if systolic blood pressure was reduced below this level, patients with MID deteriorated. Among normotensive patients with MID, improved cognition was associated with cessation of smoking cigarettes

  10. Impact of psychosocial factors on functional improvement in Latino older adults after Tai Chi exercise.

    Science.gov (United States)

    Siu, Ka-Chun; Rajaram, Shireen S; Padilla, Carolina

    2015-01-01

    Increasing evidence underscores the health benefits of Tai Chi (TC), although there is limited evidence of benefits among racial and ethnic minorities. This study investigated the impact of psychosocial status on balance among 23 Latino seniors after a twice-a-week, 12-week TC exercise program. Functional status was measured at baseline, immediately after, and three months following the TC exercise program, using the Timed Up and Go Test and Tinetti Falls Efficacy Scale. Psychosocial status was measured at baseline by the Center for Epidemiologic Studies Depression Scale and Norbeck Social Support Questionnaire. Both measures of functional status improved and were sustained after three months of TC. Greater improvement was significantly related to a higher level of baseline social support. More depressed seniors reported less fear of falling after TC. Depression and social support are important moderators of functional improvement after TC among Latino seniors.

  11. Improving the Stability and Robustness of Incomplete Symmetric Indefinite Factorization Preconditioners

    Czech Academy of Sciences Publication Activity Database

    Scott, J.; Tůma, Miroslav

    2017-01-01

    Roč. 24, č. 5 (2017), č. článku e2099. ISSN 1070-5325 Grant - others:GA ČR(CZ) GC17-04150J; GA ČR(CZ) GC17-04150J; EPSRC(GB) EP/I013067/1 Institutional support: RVO:67985807 Keywords : incomplete factorizations * indefinite symmetric systems * iterative solvers * pivoting * preconditioning * sparse linear systems * sparse matrices Subject RIV: BA - General Mathematics OBOR OECD: Applied mathematics Impact factor: 1.303, year: 2016

  12. Does work-site physical activity improve self-reported psychosocial workplace factors and job satisfaction?

    DEFF Research Database (Denmark)

    Roessler, K K; Rugulies, R; Bilberg, R

    2013-01-01

    PURPOSE: To investigate whether a work-site strength-training program has a positive effect on self-reported psychosocial workplace factors and job satisfaction. METHODS: We conducted a randomized controlled trial among laboratory technicians implementing neck and shoulder exercises for pain relief......, with 199 participants in the training group and 228 in the control group. Influence at work, sense of community, time pressure, and job satisfaction were measured with the Copenhagen Psychosocial Questionnaire at baseline and post-intervention after 20 weeks. RESULTS: There was no statistically significant...... of a work-site strength-training program on self-reported psychosocial workplace factors and job satisfaction....

  13. Farmers' preferences and the factors affecting their decision to improve maize crops in Mexico

    OpenAIRE

    Sánchez Toledano, Blanca Isabel

    2017-01-01

    Mexico is one of the countries with the highest corn production in the world (24.6 million tons) (FAOSTAT, 2016). However, in some regions, the yields are very low (2.0 Tn.ha-1) compared to the national average (9.39 Tn.ha-1). Among the different strategies to improve productivity, the adoption of improved maize seeds can play an important role. However, the adoption of this type of seed in Mexico is still limited. The development of a seed sector that meets the needs of farmers is an opportu...

  14. SPATIAL VARIETY AND DISTRIBUTION OF TRADITIONAL MARKETS IN SURAKARTA AS POTENTIAL FACTORS IN IMPROVING SPATIAL-BASED MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Istijabatul Aliyah

    2017-02-01

    Full Text Available Traditional markets function as trading place, socio-culture interaction, and recreation facility either in regional or urban scope. Distribution and variety of spatial condition influence traditional markets’ planning both physically and non-physically. Therefore, this research aimed to conduct a mapping of traditional markets’ spatial distribution and variety as potential factors to improve spatial-based management. Analysis methods including: (1 Mapping by employing Geographic Information System, (2 Category Based Analysis (CBA, and (3 Interactive Analysis were applied in Surakarta City as the research location. The result of this research signifies that spatial variety and distribution of traditional markets in Surakarta had similar pattern between one market to others; overlapping service function; specific commodity types in accordance with the market’s characteristics; diverse operating hours. Spatial variety and distribution could be potential factors to improve traditional market management as shopping service. This result was contrasted with Central Place Theory by Christaller and NÆss & Jensen’s research finding stating that distance became a key factor influencing accessibility to a number of activity facilities. Therefore, distance toward the service center is not considered as the main factor in traditional market management. The main factor in managing and controlling traditional markets’ development includes service function, commodity specification, and operating hour’s flexibility.

  15. A ChIP-Seq benchmark shows that sequence conservation mainly improves detection of strong transcription factor binding sites.

    Directory of Open Access Journals (Sweden)

    Tony Håndstad

    Full Text Available BACKGROUND: Transcription factors are important controllers of gene expression and mapping transcription factor binding sites (TFBS is key to inferring transcription factor regulatory networks. Several methods for predicting TFBS exist, but there are no standard genome-wide datasets on which to assess the performance of these prediction methods. Also, it is believed that information about sequence conservation across different genomes can generally improve accuracy of motif-based predictors, but it is not clear under what circumstances use of conservation is most beneficial. RESULTS: Here we use published ChIP-seq data and an improved peak detection method to create comprehensive benchmark datasets for prediction methods which use known descriptors or binding motifs to detect TFBS in genomic sequences. We use this benchmark to assess the performance of five different prediction methods and find that the methods that use information about sequence conservation generally perform better than simpler motif-scanning methods. The difference is greater on high-affinity peaks and when using short and information-poor motifs. However, if the motifs are specific and information-rich, we find that simple motif-scanning methods can perform better than conservation-based methods. CONCLUSIONS: Our benchmark provides a comprehensive test that can be used to rank the relative performance of transcription factor binding site prediction methods. Moreover, our results show that, contrary to previous reports, sequence conservation is better suited for predicting strong than weak transcription factor binding sites.

  16. Factors influencing change in clinical practice: A qualitative evaluation of the implementation of the quality improvement in colonoscopy study.

    Science.gov (United States)

    Rajasekhar, Praveen T; Rees, Colin J; Nixon, Catherine; East, James E; Brown, Sally

    2016-01-01

    The quality improvement in colonoscopy study was a region wide service improvement study to improve adenoma detection rate at colonoscopy by implementing evidence into routine colonoscopy practice. Implementing evidence into clinical practice can be challenging. The purpose of this paper is to perform a qualitative interview study to evaluate factors that influenced implementation within the study. Semi-structured interviews were conducted with staff in endoscopy units taking part in the quality improvement in colonoscopy study, after study completion. Units and interviewees were purposefully sampled to ensure a range of experiences was represented. Interviews were conducted with 11 participants. Key themes influencing uptake of the quality improvement in colonoscopy evidence bundle included time, study promotion, training, engagement, positive outcomes and modifications. Areas within themes were increased awareness of quality in colonoscopy (QIC), emphasis on withdrawal time and empowerment of endoscopy nurses to encourage the use of quality measures were positive outcomes of the study. The simple, visible study posters were reported as useful in aiding study promotion. Feedback sessions improved engagement. Challenges included difficulty arranging set-up meetings and engaging certain speciality groups. This evaluation suggests that methods to implement evidence into clinical practice should include identification and empowerment of team members who can positively influence engagement, simple, visible reminders and feedback. Emphasis on timing of meetings and strategies to engage speciality groups should also be given consideration. Qualitative evaluations can provide important insights into why quality improvement initiatives are successful or not, across different sites.

  17. Level-3 Cholesky Factorization Routines Improve Performance of Many Cholesky Algorithms

    DEFF Research Database (Denmark)

    Gustavson, Fred G.; Wasniewski, Jerzy; Dongarra, Jack J.

    2013-01-01

    Four routines called DPOTF3i, i = a,b,c,d, are presented. DPOTF3i are a novel type of level-3 BLAS for use by BPF (Blocked Packed Format) Cholesky factorization and LAPACK routine DPOTRF. Performance of routines DPOTF3i are still increasing when the performance of Level-2 routine DPOTF2 of LAPACK...

  18. Analysis Supporting Factors and Constraints LPMP Performance in Improving the Quality of Education in Jambi Province

    Science.gov (United States)

    Rosadi, Kemas Imron

    2015-01-01

    Development of education in Indonesia is based on three aspects, namely equity and expansion, quality and relevance, as well as good governance. Quality education is influenced by several factors related to quality education managerial leaders, limited funds, facilities, educational facilities, media, learning resources, tools and training…

  19. Three Phase Six-Switch PWM Buck Rectifier with Power Factor Improvement

    DEFF Research Database (Denmark)

    Zafar Ullah Khan, M; Mohsin Naveed, M.; Hussain, Dil Muhammad Akbar

    2013-01-01

    Conventional Phase Controlled Rectifier injects low order current harmonics into the AC mains. Large size filtering components are required to attenuate these harmonics. In this paper, Three Phase Six-Switch PWM Buck Rectifier[1] is presented which operates at nearly unity power factor and provides...

  20. Dark chocolate consumption improves leukocyte adhesion factors and vascular function in overweight men

    NARCIS (Netherlands)

    Esser, D.; Mars, M.; Oosterink, E.; Stalmach, A.; Müller, M.R.; Afman, L.A.

    2014-01-01

    Flavanol-enriched chocolate consumption increases endothelium-dependent vasodilation. Most research so far has focused on flow-mediated dilation (FMD) only; the effects on other factors relevant to endothelial health, such as inflammation and leukocyte adhesion, have hardly been addressed. We

  1. Factors associated with duration of breastfeeding in ireland: potential areas for improvement.

    LENUS (Irish Health Repository)

    Tarrant, R C

    2011-08-01

    There is a need to comprehensively examine why mothers in Ireland discontinue breastfeeding early and to explore the factors influencing duration of breastfeeding during the first 6 months postpartum. Findings from this study provide valuable direction for future strategies and interventions aimed at increasing breastfeeding duration rates in Ireland.

  2. Growth Factor Supplementation Improves Native and Engineered Meniscus Repair in Vitro

    Science.gov (United States)

    Ionescu, Lara C.; Lee, Gregory C.; Huang, Kevin L.; Mauck, Robert L.

    2012-01-01

    Few therapeutic options exist for meniscus repair after injury. Local delivery of growth factors may stimulate repair and create a favorable environment for engineered replacement materials. In this study, we assessed the effect of basic fibroblast growth factor (bFGF) (a pro-mitotic agent) and transforming growth factor beta 3 (TGF-β3) (a pro-matrix formation agent) on meniscus repair and the integration/maturation of electrospun poly(ε-caprolactone) (PCL) scaffolds for meniscus tissue engineering. Circular meniscus repair constructs were formed and refilled with either native tissue or scaffolds. Repair constructs were cultured in serum-containing media for 4 and 8 weeks with various growth factor formulations, and assessed for mechanical strength, biochemical content, and histological appearance. Results showed that either short-term delivery of bFGF or sustained delivery of TGF-β3 increased integration strength for both juvenile and adult bovine tissue, with similar findings for engineered materials. While TGF-β3 increased proteoglycan content in the explants, bFGF did not increase DNA content after 8 weeks. This work suggests that in vivo delivery of bFGF or TGF-β3 may stimulate meniscus repair, but that the time course of delivery will strongly influence success. Further, this study demonstrates that electrospun scaffolds are a promising material for meniscus tissue engineering, achieving comparable or superior integration compared to native tissue. PMID:22698946

  3. Bilirubin modulated cytokines, growth factors and angiogenesis to improve cutaneous wound healing process in diabetic rats.

    Science.gov (United States)

    Ram, Mahendra; Singh, Vishakha; Kumawat, Sanjay; Kant, Vinay; Tandan, Surendra Kumar; Kumar, Dinesh

    2016-01-01

    Bilirubin has shown cutaneous wound healing potential in some preliminary studies. Here we hypothesize that bilirubin facilitates wound healing in diabetic rats by modulating important healing factors/candidates and antioxidant parameters in a time-dependent manner. Diabetes was induced in male Wistar rats by streptozotocin. In all diabetic rats wounds were created under pentobarbitone anesthesia. All the rats were divided into two groups, of which one (control) was treated with ointment base and other with bilirubin ointment (0.3%). Wound closer measurement and tissue collection were done on days 3, 7, 14 and 19 post-wounding. The relative expressions of hypoxia inducible factor-1 alpha (HIF-1α), vascular endothelial growth factor (VEGF), stromal cell-derived factor-1 alpha (SDF-1α), transforming growth factor- beta1 (TGF-β1()), tumor necrosis factor-α (TNF-α) and interlukin-10 (IL-10) mRNA and proteins and the mRNA of interlukin-1 beta (IL-1β) and matrix metalloprteinase-9 (MMP-9) were determined in the wound tissues. CD-31 staining and collagen content were evaluated by immunohistochemistry and picrosirius red staining, respectively. Histopathological changes were assessed by H&E staining. The per cent wound closer was significantly higher from day 7 onwards in bilirubin-treated rats. HIF-1α, VEGF, SDF-1α, TGF-β1, IL-10 mRNA and protein levels were significantly higher on days 3, 7 and 14 in bilirubin-treated rats. The mRNA expression and protein level of TNF-α and the mRNA of IL-1β and MMP-9 were progressively and markedly reduced in bilirubin-treated rats. The collagen deposition and formation of blood vessels were greater in bilirubin-treated rats. Bilirubin markedly facilitated cutaneous wound healing in diabetic rats by modulating growth factors, cytokines, neovasculogenesis and collagen contents to the wound site. Topical application of bilirubin ointment might be of great use in cutaneous wound healing in diabetic patients. Copyright © 2015

  4. Granulocyte-colony stimulating factor (G-CSF improves motor recovery in the rat impactor model for spinal cord injury.

    Directory of Open Access Journals (Sweden)

    Tanjew Dittgen

    Full Text Available Granulocyte-colony stimulating factor (G-CSF improves outcome after experimental SCI by counteracting apoptosis, and enhancing connectivity in the injured spinal cord. Previously we have employed the mouse hemisection SCI model and studied motor function after subcutaneous or transgenic delivery of the protein. To further broaden confidence in animal efficacy data we sought to determine efficacy in a different model and a different species. Here we investigated the effects of G-CSF in Wistar rats using the New York University Impactor. In this model, corroborating our previous data, rats treated subcutaneously with G-CSF over 2 weeks show significant improvement of motor function.

  5. Using human factors engineering to improve patient safety in the cardiovascular operating room.

    Science.gov (United States)

    Gurses, Ayse P; Martinez, Elizabeth A; Bauer, Laura; Kim, George; Lubomski, Lisa H; Marsteller, Jill A; Pennathur, Priyadarshini R; Goeschel, Chris; Pronovost, Peter J; Thompson, David

    2012-01-01

    Despite significant medical advances, cardiac surgery remains a high risk procedure. Sub-optimal work system design characteristics can contribute to the risks associated with cardiac surgery. However, hazards due to work system characteristics have not been identified in the cardiovascular operating room (CVOR) in sufficient detail to guide improvement efforts. The purpose of this study was to identify and categorize hazards (anything that has the potential to cause a preventable adverse patient safety event) in the CVOR. An interdisciplinary research team used prospective hazard identification methods including direct observations, contextual inquiry, and photographing to collect data in 5 hospitals for a total 22 cardiac surgeries. We performed thematic analysis of the qualitative data guided by a work system model. 60 categories of hazards such as practice variations, high workload, non-compliance with evidence-based guidelines, not including clinicians' in medical device purchasing decisions were found. Results indicated that hazards are common in cardiac surgery and should be eliminated or mitigated to improve patient safety. To improve patient safety in the CVOR, efforts should focus on creating a culture of safety, increasing compliance with evidence based infection control practices, improving communication and teamwork, and designing better tools and technologies through partnership among all stakeholders.

  6. Factors Influencing Team Performance in a Continuous Quality Improvement Process in the Wisconsin Technical College System

    Science.gov (United States)

    Pietz, Victoria Lynn

    2014-01-01

    Continuous Quality Improvement (CQI) programs are growing in popularity in higher education settings and a key component is the use of work groups, which require active employee involvement. The problem addressed in this research was the lack of employee engagement in the Quality Review Process (QRP), which is a statewide CQI model developed by…

  7. Factors Associated with Technology Integration to Improve Instructional Abilities: A Path Model

    Science.gov (United States)

    Uslu, Öner

    2018-01-01

    Today, students are expected to access, analyse and synthesise information, and work cooperatively. Their learning environment, therefore, should be equipped with appropriate tools and materials, and teachers should have instructional abilities to use them effectively. This study aims to propose a model to improve teachers' instructional abilities…

  8. Leadership for School Improvement: Exploring Factors and Practices in the Process of Curriculum Change

    Science.gov (United States)

    Ho, Dora Choi Wa

    2010-01-01

    Research Findings: This article describes research into leadership practice for school improvement in Hong Kong preschools at a time when there was a move toward increased accountability. Two schools were selected for study, both of which were rated as excellent in the quality assurance inspections of the Education Bureau. Leadership practice for…

  9. Designing and Implementing an Ergonomics Inventory to Improve Management of Human Factors Programs.

    Science.gov (United States)

    Johnson, Kenneth A.

    Self-report ergometric inventories can provide valuable information to employers and can serve as a means of intervention to improve employee attributes. Based on the science of ergonomics (a science that studies the natural laws of work in order to maximize human efficiency in job performance), such an inventory focuses on the interaction of the…

  10. Contextual Factors in Education: Improving Science and Mathematics Education for Minorities and Women.

    Science.gov (United States)

    Cole, Michael, Ed.; Griffin, Peg, Ed.

    This book summarizes research on the various ways that students' cultural backgrounds and innate ways of learning affect academic achievement. It also offers descriptions and recommendations for improving science and mathematics education for minorities and women, based on successful programs, that take these differences into account. The focus is…

  11. Identification of influencing factors and strategies to improve communication between general practitioners and community nurses: a qualitative focus group study.

    Science.gov (United States)

    Nieuwboer, Minke S; Perry, Marieke; van der Sande, Rob; Maassen, Irma T H M; Olde Rikkert, Marcel G M; van der Marck, Marjolein A

    2018-02-26

    As the number of patients with complex healthcare needs grows, inter-professional collaboration between primary care professionals must be constantly optimized. General practitioners (GPs) and community nurses (CNs) are key professions in primary care; however, poor GP-CN communication is common, and research into the factors influencing its quality is limited. To explore patient-related GP-CN communication and facilitating and hindering factors, and to identify strategies to enhance this communication. A qualitative focus group design was used to identify the facilitating and hindering factors and strategies for improvement. In a Dutch primary care setting, 6 mono-professional focus group interviews (3 meetings of 13 GPs; 3 meetings of 18 CNs) were organized between June 2015 and April 2016, recorded and transcribed verbatim. Two independent researchers performed the coding of these interviews, identifying their categories and themes. Results show that, despite the regular contact between GPs and CNs, communication was generally perceived as poor in effectiveness and efficiency by both professions. Mutual trust was considered the most important facilitating factor for effective communication. Profession-specific factors (e.g. differences in responsibility and profession-specific language) and organizational factors (e.g. lack of shared care plans, no in-person communication, lack of time) may be of influence on communication. Participants' suggestions for improvement included organizing well-structured and reimbursed team meetings and facilitating face-to-face contact. GP-CN patient-related communication benefits most from trusting inter-personal relationships. Inter-professional training programmes should address both professional and organizational factors and should be evaluated for their effect on quality of care.

  12. A protocol improves GP recording of long-term sickness absence risk factors.

    Science.gov (United States)

    van Dijk, Paul; Hogervorst, Wouter; ter Riet, Gerben; van Dijk, Frank

    2008-06-01

    If general practitioners (GPs) were better informed about patients' risks of long-term sickness absence (LTSA), they could incorporate these risk assessments into their patient management plans and cooperate more with occupational physicians to prevent LTSA. To evaluate the effectiveness of a protocol helping GPs in recording risks of LTSA and in co-operating with occupational physicians (OPs). Twenty-six GPs (co-operating in four groups) in Amsterdam, The Netherlands, participated in a controlled intervention study. Fourteen GPs were the protocol-supported intervention group and twelve GPs were the reference group. Outcome measures were consultations containing work-related information, information about two risk factors for LTSA, referrals to OPs and contacts of OPs with GPs and patients. Outcomes were identified through an electronic search in the GPs' information systems. Entries containing information were independently scored by two investigators. The proportions of patients with consultations documenting LTSA-pertinent items were compared between the groups, accounting for differences at baseline. There was no increase in consultations containing work-related information. Recording of risk factor information increased in the intervention group; the difference was 4.5% [95% CI 1.5-7.6] and 1.8% (95% CI -0.8 to 4.4) for the two risk factors. The referral rate to the OP increased by 2.9% (95% CI 1.2-4.5). There was no effect on contacts of OPs with GPs or with patients. Protocol-supported consultations may lead to a modest increase in information regarding two risk factors for LTSA in GPs' electronic records and to more referrals to OPs.

  13. Continuous Release of Tumor-Derived Factors Improves the Modeling of Cachexia in Muscle Cell Culture

    Directory of Open Access Journals (Sweden)

    Robert W. Jackman

    2017-09-01

    Full Text Available Cachexia is strongly associated with a poor prognosis in cancer patients but the biological trigger is unknown and therefore no therapeutics exist. The loss of skeletal muscle is the most deleterious aspect of cachexia and it appears to depend on secretions from tumor cells. Models for studying wasting in cell culture consist of experiments where skeletal muscle cells are incubated with medium conditioned by tumor cells. This has led to candidates for cachectic factors but some of the features of cachexia in vivo are not yet well-modeled in cell culture experiments. Mouse myotube atrophy measured by myotube diameter in response to medium conditioned by mouse colon carcinoma cells (C26 is consistently less than what is seen in muscles of mice bearing C26 tumors with moderate to severe cachexia. One possible reason for this discrepancy is that in vivo the C26 tumor and skeletal muscle share a circulatory system exposing the muscle to tumor factors in a constant and increasing way. We have applied Transwell®-adapted cell culture conditions to more closely simulate conditions found in vivo where muscle is exposed to the ongoing kinetics of constant tumor secretion of active factors. C26 cells were incubated on a microporous membrane (a Transwell® insert that constitutes the upper compartment of wells containing plated myotubes. In this model, myotubes are exposed to a constant supply of cancer cell secretions in the medium but without direct contact with the cancer cells, analogous to a shared circulation of muscle and cancer cells in tumor-bearing animals. The results for myotube diameter support the idea that the use of Transwell® inserts serves as a more physiological model of the muscle wasting associated with cancer cachexia than the bolus addition of cancer cell conditioned medium. The Transwell® model supports the notion that the dose and kinetics of cachectic factor delivery to muscle play a significant role in the extent of pathology.

  14. Improved survival of mesenchymal stem cells by macrophage migration inhibitory factor

    OpenAIRE

    Xia, Wenzheng; Xie, Congying; Jiang, Miaomiao; Hou, Meng

    2015-01-01

    Macrophage migration inhibitory factor (MIF) is a critical inflammatory cytokine that was recently associated with progenitor cell survival and potently inhibits apoptosis. We examined the protective effect of MIF on hypoxia/serum deprivation (SD)-induced apoptosis of mesenchymal stem cells (MSCs), as well as the possible mechanisms. MSCs were obtained from rat bone marrow and cultured in vitro. Apoptosis was induced by culturing MSCs under hypoxia/SD conditions for up to 24?h and assessed by...

  15. Global Trends of "Green" Economy Development as a Factor for Improvement of Economical and Social Prosperity

    OpenAIRE

    Egorova, Mariya Sergeevna; Pluzhnik, Marina Vladimirovna; Glik, P.

    2015-01-01

    The article covers main reasons of emerging a new type of economy, the "green" economy. The aims and objectives of developing green economy were analyzed. The significance of an economy reform carried out on both national and global levels was evaluated. We analyzed both speed and level of the green economy development in the world and in the most developed countries of the world. An influence of institutional and investment factors on the process of greening economy was studied. The authors ...

  16. Influence Factors and Improvement Recommendations for Core Competency of Township Enterprises

    OpenAIRE

    Zhang, Chengjun

    2014-01-01

    Core competency of township enterprises may be influenced from the property right, technology, scale operation, financial management and talent. In view of these influence factors, township enterprises should conduct technological innovation, bring into full play functions of talents, promote corporate culture of township enterprises, attach great importance to development of core products and innovation of relevant systems, and establish market information platform for township enterprises.

  17. The effects of risk factors on the improvement of hypothermia neonatal using fuzzy transition

    Directory of Open Access Journals (Sweden)

    Fatemeh Salmani

    2016-04-01

    Full Text Available Background and aim: Neonatal hypothermia is a major risk factor for mortality after delivery. This study aims to identify the risk factors associated with transition in hypothermia state with new definition of hypothermia states.Methods:  Four hundred and seventy nine (479 neonates hospitalized in NICU of Valiasr in Tehran, Iran in 2005 participated in this study. The rectal temperature of neonatal was measured immediately after delivery and every 30 min afterwards, until neonates became normal.Results: The mean weight of neonatal was 2580±882.9 g and mean of delivery room temperature was 29.2±1.45 °C. Most of the neonatal were mild hypothermia. There were significant associations between weight of neonatal, cardiopulmonary resuscitation (CPR and Apgar score with hypothermia state (P<0.05.  Death of neonatal was related to hypothermia state.Conclusion: The findings of this study indicated that a major risk factor for hypothermia was low weight of neonatal.

  18. Project JOINTS: what factors affect bundle adoption in a voluntary quality improvement campaign?

    Science.gov (United States)

    Khodyakov, Dmitry; Ridgely, M Susan; Huang, Christina; DeBartolo, Katherine O; Sorbero, Melony E; Schneider, Eric C

    2015-01-01

    Diffusion and adoption of effective evidence-based clinical practices can be slow, especially if complex changes are required to implement new practices. To examine how hospital adherence to quality improvement (QI) methods and hospital engagement with a large-scale QI campaign could facilitate the adoption of an enhanced prevention bundle designed to reduce surgical site infection (SSI) rates after orthopaedic surgery (hip and knee arthroplasty). We conducted telephone interviews with hospital QI leaders from 73 of the 109 hospitals (67% response rate) in five states that participated in Project JOINTS (Joining Organizations IN Tackling SSIs), a QI campaign run by Institute for Healthcare Improvement (IHI). Using QI methods grounded in the IHI Model for Improvement, this campaign encouraged hospitals to implement an enhanced SSI prevention bundle. Hospital QI leaders reported on their hospital's adherence to the Project JOINTS QI methods; their level of engagement with Project JOINTS activities; and adoption of the SSI prevention bundle components. Interview data were analysed quantitatively and qualitatively. Both adherence to the QI methods and hospital engagement were positively associated with complete bundle adoption. Hospital engagement, especially the use of project materials and tools, was also positively associated with the initiation of and improved adherence to individual bundle components. Our findings suggest that greater adherence to the QI methods and active hospital engagement in a QI campaign facilitate adoption of evidence-based patient safety bundles in orthopaedic practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. Factors of U.S. Hospitals Associated with Improved Profit Margins: An Observational Study.

    Science.gov (United States)

    Ly, Dan P; Cutler, David M

    2018-02-14

    Hospitals face financial pressure from decreased margins from Medicare and Medicaid and lower reimbursement from consolidating insurers. The objectives of this study are to determine whether hospitals that became more profitable increased revenues or decreased costs more and to examine characteristics associated with improved financial performance over time. The design of this study is retrospective analyses of U.S. non-federal acute care hospitals between 2003 and 2013. There are 2824 hospitals as subjects of this study. The main measures of this study are the change in clinical operating margin, change in revenues per bed, and change in expenses per bed between 2003 and 2013. Hospitals that became more profitable had a larger magnitude of increases in revenue per bed (about $113,000 per year [95% confidence interval: $93,132 to $133,401]) than of decreases in costs per bed (about - $10,000 per year [95% confidence interval: - $28,956 to $9617]), largely driven by higher non-Medicare reimbursement. Hospitals that improved their margins were larger or joined a hospital system. Not-for-profit status was associated with increases in operating margin, while rural status and having a larger share of Medicare patients were associated with decreases in operating margin. There was no association between improved hospital profitability and changes in diagnosis related group weight, in number of profitable services, or in payer mix. Hospitals that became more profitable were more likely to increase their admissions per bed per year. Differential price increases have led to improved margins for some hospitals over time. Where significant price increases are not possible, hospitals will have to become more efficient to maintain profitability.

  20. Improving and disaggregating N_2O emission factors for ruminant excreta on temperate pasture soils

    International Nuclear Information System (INIS)

    Krol, D.J.; Carolan, R.; Minet, E.; McGeough, K.L.; Watson, C.J.; Forrestal, P.J.; Lanigan, G.J.; Richards, K.G.

    2016-01-01

    Cattle excreta deposited on grazed grasslands are a major source of the greenhouse gas (GHG) nitrous oxide (N_2O). Currently, many countries use the IPCC default emission factor (EF) of 2% to estimate excreta-derived N_2O emissions. However, emissions can vary greatly depending on the type of excreta (dung or urine), soil type and timing of application. Therefore three experiments were conducted to quantify excreta-derived N_2O emissions and their associated EFs, and to assess the effect of soil type, season of application and type of excreta on the magnitude of losses. Cattle dung, urine and artificial urine treatments were applied in spring, summer and autumn to three temperate grassland sites with varying soil and weather conditions. Nitrous oxide emissions were measured from the three experiments over 12 months to generate annual N_2O emission factors. The EFs from urine treated soil was greater (0.30–4.81% for real urine and 0.13–3.82% for synthetic urine) when compared with dung (− 0.02–1.48%) treatments. Nitrous oxide emissions were driven by environmental conditions and could be predicted by rainfall and temperature before, and soil moisture deficit after application; highlighting the potential for a decision support tool to reduce N_2O emissions by modifying grazing management based on these parameters. Emission factors varied seasonally with the highest EFs in autumn and were also dependent on soil type, with the lowest EFs observed from well-drained and the highest from imperfectly drained soil. The EFs averaged 0.31 and 1.18% for cattle dung and urine, respectively, both of which were considerably lower than the IPCC default value of 2%. These results support both lowering and disaggregating EFs by excreta type. - Highlights: • N_2O emissions were measured from cattle excreta applied to pasture. • N_2O was universally higher from urine compared with dung. • N_2O was driven by rainfall, temperature and soil moisture deficit. • Emission

  1. Factors Related to Significant Improvement of Estimated Glomerular Filtration Rates in Chronic Hepatitis B Patients Receiving Telbivudine Therapy

    Directory of Open Access Journals (Sweden)

    Te-Fu Lin

    2017-01-01

    Full Text Available Background and Aim. The improvement of estimated glomerular filtration rates (eGFRs in chronic hepatitis B (CHB patients receiving telbivudine therapy is well known. The aim of this study was to clarify the kinetics of eGFRs and to identify the significant factors related to the improvement of eGFRs in telbivudine-treated CHB patients in a real-world setting. Methods. Serial eGFRs were calculated every 3 months using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI equation. The patients were classified as CKD-1, -2, or -3 according to a baseline eGFR of ≥90, 60–89, or <60 mL/min/1.73 m2, respectively. A significant improvement of eGFR was defined as a more than 10% increase from the baseline. Results. A total of 129 patients were enrolled, of whom 36% had significantly improved eGFRs. According to a multivariate analysis, diabetes mellitus (DM (p=0.028 and CKD-3 (p=0.043 were both significantly related to such improvement. The rates of significant improvement of eGFR were about 73% and 77% in patients with DM and CKD-3, respectively. Conclusions. Telbivudine is an alternative drug of choice for the treatment of hepatitis B patients for whom renal safety is a concern, especially patients with DM and CKD-3.

  2. Training complexity is not decisive factor for improving adaptation to visual sensory conflict.

    Science.gov (United States)

    Yang, Yang; Pu, Fang; Li, Shuyu; Li, Yan; Li, Deyu; Fan, Yubo

    2012-01-01

    Ground-based preflight training utilizing unusual visual stimuli is useful for decreasing the susceptibility to space motion sickness (SMS). The effectiveness of the sensorimotor adaptation training is affected by the training tasks, but what kind of task is more effective remains unknown. Whether the complexity is the decisive factor to consider for designing the training and if other factors are more important need to be analyzed. The results from the analysis can help to optimize the preflight training tasks for astronauts. Twenty right-handed subjects were asked to draw the right path of 45° rotated maze before and after 30 min training. Subjects wore an up-down reversing prism spectacle in test and training sessions. Two training tasks were performed: drawing the right path of the horizontal maze (complex task but with different orientation feature) and drawing the L-shape lines (easy task with same orientation feature). The error rate and the executing time were measured during the test. Paired samples t test was used to compare the effects of the two training tasks. After each training, the error rate and the executing time were significantly decreased. However, the training effectiveness of the easy task was better as the test was finished more quickly and accurately. The complexity is not always the decisive factor for designing the adaptation training task, e.g. the orientation feature is more important in this study. In order to accelerate the adaptation and to counter SMS, the task for astronauts preflight adaptation training could be simple activities with the key features.

  3. Soccer improves fitness and attenuates cardiovascular risk factors in hypertensive men

    DEFF Research Database (Denmark)

    Krustrup, Peter; Randers, Morten Bredsgaard; Andersen, Lars Juel

    2013-01-01

    INTRODUCTION: The present study investigated the fitness and health effects of medium-term soccer training for untrained hypertensive middle-aged men. METHODS: Thirty-three untrained males (31-54 y) with mild-to-moderate hypertension were randomised 2:1 to a soccer training group (STG, two 1-h...... sessions per week, n=22, 68% on medication) and a doctor advice group receiving traditional physician-guided recommendations on cardiovascular risk factor modification (DAG, n=11, 73% on medication). Two-way repeated-measurement ANOVA time-group statistics was applied. RESULTS: During soccer training...

  4. Prognostic factors for short-term improvement in acute and persistent musculoskeletal pain consulters in primary care

    Directory of Open Access Journals (Sweden)

    Bolton Jennifer E

    2011-11-01

    Full Text Available Abstract Background Given the costs associated with the management of musculoskeletal pain in primary care, predicting the course of these conditions remains a research priority. Much of the research into prognostic indicators however considers musculoskeletal conditions in terms of single pain sites whereas in reality, many patients present with pain in more than one site. The aim of this study was to identify prognostic factors for early improvement in primary care consulters with acute and persistent musculoskeletal conditions across a range of pain sites. Methods Consecutive patients with a new episode of musculoskeletal pain completed self-report questionnaires at baseline, and then again at the 4/5th treatment visit, and if they were still consulting, at the 10th visit. The outcome was defined as patient self-report improvement sufficient to make a meaningful difference. Independent predictors of outcome were identified using multivariate regression analyses. Results Acute (th visit. Several variables at baseline were associated with improvement at the 4/5th visit, but the predictive models were weak and unable to discriminate between patients who were improved and those who were not. In contrast, it was possible to elicit a predictive model for improvement later on at the 10th visit, but only in patients with persistent pain. Being employed, reporting a decline in work fear-avoidance behaviour at the 4/5th visit, and being better by the 4/5th visit, were all independently associated with improvement. This model accounted for 34.3% (p Conclusions We were unable to identify baseline characteristics that predicted early outcome in musculoskeletal pain patients. However, early self-reported improvement and decline in work fear-avoidance behaviour as predictors of later improvement highlighted the importance of speedy recovery in persistent musculoskeletal pain consulters. Our findings reinforce the elusive nature of baseline predictors, and

  5. The Improvement of Screening the Significant Factors of Oil Blends as Bio lubricant Base Stock

    International Nuclear Information System (INIS)

    Noor Hajarul Ashikin Shamsuddin; Rozaini Abdullah; Zainab Hamzah; Siti Jamilah Hanim Mohd Yusof

    2015-01-01

    A new formulation bio lubricant base stock was developed by blending of waste cooking oil (WCO) with Jatropha curcas oil (JCO). The objective of this research is to evaluate significant factors contributing to the production of oil blends for bio lubricant application. The significant factors used in this study were oil ratio (WCO:JCO), agitation times (min) and agitation speed (rpm). The blended oil bio based lubricant was used to determine the saponification, acid, peroxide and iodine values. The experimental design used in this study was the 2 level-factorial design. In this experiment, it was found that the effect of oil ratio and interaction of oil ratio and agitation speed gave the most significant effect in oil blends as bio lubricant base stock. The highest ratio of oil blend 80 %:20 % WCO:JCO, with low agitation speed of 300 rpm and low agitation time of 30 minutes gave the optimum results. The acid, saponification, peroxide and iodine values obtained were 0.517±0.08 mg KOH/ g, 126.23±1.62 mg/ g, 7.5±2.0 m eq/ kg and 50.42±2.85 mg/ g respectively. A higher ratio of waste cooking oil blends was found to be favourable as bio lubricant base stock. (author)

  6. Planning to improve the mechanical quality factor in the transducer impedance matchers for Mario Schenberg detector

    International Nuclear Information System (INIS)

    Frajuca, Carlos; Silva Bortoli, Fabio da

    2006-01-01

    Mario Schenberg is a spherical resonant-mass gravitational wave (GW) detector that will be part of a GW detection array of two detectors. Another one is been built in The Netherlands. Their resonant frequencies will be around 3.2 kHz with a bandwidth of about 200 Hz. This range of frequencies is new in a field where the typical frequencies lay below 1 kHz, making the transducer development much more complex. Some studies indicated that using low mass mechanical resonators (used for impedance matching to the parametric transducer, in a cold damping regime) allow the detector to reach the standard quantum limit. In this work we describe the procedures that are being developed to quickly test the mechanical quality factor of a very small resonator in the quest to find the best machining method and thermal annealing for the impedance matching resonator, one key part that makes a good coupling between the sphere and the transducer. The main goal is to optimize the mechanical quality factor in a reasonable time

  7. Direct compression of chitosan: process and formulation factors to improve powder flow and tablet performance.

    Science.gov (United States)

    Buys, Gerhard M; du Plessis, Lissinda H; Marais, Andries F; Kotze, Awie F; Hamman, Josias H

    2013-06-01

    Chitosan is a polymer derived from chitin that is widely available at relatively low cost, but due to compression challenges it has limited application for the production of direct compression tablets. The aim of this study was to use certain process and formulation variables to improve manufacturing of tablets containing chitosan as bulking agent. Chitosan particle size and flow properties were determined, which included bulk density, tapped density, compressibility and moisture uptake. The effect of process variables (i.e. compression force, punch depth, percentage compaction in a novel double fill compression process) and formulation variables (i.e. type of glidant, citric acid, pectin, coating with Eudragit S®) on chitosan tablet performance (i.e. mass variation, tensile strength, dissolution) was investigated. Moisture content of the chitosan powder, particle size and the inclusion of glidants had a pronounced effect on its flow ability. Varying the percentage compaction during the first cycle of a double fill compression process produced chitosan tablets with more acceptable tensile strength and dissolution rate properties. The inclusion of citric acid and pectin into the formulation significantly decreased the dissolution rate of isoniazid from the tablets due to gel formation. Direct compression of chitosan powder into tablets can be significantly improved by the investigated process and formulation variables as well as applying a double fill compression process.

  8. Actual problems of environmental factors risk assessment on human health and ways to improve it

    Directory of Open Access Journals (Sweden)

    Y.A. Rakhmanin

    2015-06-01

    Full Text Available The article provides an analysis of global trends and new areas of health risk assessment and analysis methodology caused by exposure to chemicals, environmental pollutants, and the contemporary issues of national assessment methodology. Most details are considered: risk assessment evidence base, modern methods and problems of carcinogenic risk assessment, hygienic regulation based on risk assessment, the economic aspects of the methodology. Particular attention is paid to reasons of recent years perceived gaps in the Russian methodological basis of the best foreign samples. The urgent measures to improve the national risk assessment methodology are proposed, the main of which are: legislative consolidation of the basic concepts of risk assessment, a further update of the methodology and the practice of hygienic regulation on the basis of risk assessment, improving the valuation of damage to human health, the tightening of the requirements to the developed regulatory guidance documents on risk assessment, as well as to the training and retraining of personnel in the risk assessment.

  9. Improving cluster-based methods for investigating potential for insect pest species establishment: region-specific risk factors

    Directory of Open Access Journals (Sweden)

    Michael J. Watts

    2011-09-01

    Full Text Available Existing cluster-based methods for investigating insect species assemblages or profiles of a region to indicate the risk of new insect pest invasion have a major limitation in that they assign the same species risk factors to each region in a cluster. Clearly regions assigned to the same cluster have different degrees of similarity with respect to their species profile or assemblage. This study addresses this concern by applying weighting factors to the cluster elements used to calculate regional risk factors, thereby producing region-specific risk factors. Using a database of the global distribution of crop insect pest species, we found that we were able to produce highly differentiated region-specific risk factors for insect pests. We did this by weighting cluster elements by their Euclidean distance from the target region. Using this approach meant that risk weightings were derived that were more realistic, as they were specific to the pest profile or species assemblage of each region. This weighting method provides an improved tool for estimating the potential invasion risk posed by exotic species given that they have an opportunity to establish in a target region.

  10. Hematologic improvement in dogs with parvovirus infection treated with recombinant canine granulocyte-colony stimulating factor.

    Science.gov (United States)

    Duffy, A; Dow, S; Ogilvie, G; Rao, S; Hackett, T

    2010-08-01

    Previously, dogs with canine parvovirus-induced neutropenia have not responded to treatment with recombinant human granulocyte-colony stimulating factor (rhG-CSF). However, recombinant canine G-CSF (rcG-CSF) has not been previously evaluated for treatment of parvovirus-induced neutropenia in dogs. We assessed the effectiveness of rcG-CSF in dogs with parvovirus-induced neutropenia with a prospective, open-label, nonrandomized clinical trial. Endpoints of our study were time to recovery of WBC and neutrophil counts, and duration of hospitalization. 28 dogs with parvovirus and neutropenia were treated with rcG-CSF and outcomes were compared to those of 34 dogs with parvovirus and neutropenia not treated with rcG-CSF. We found that mean WBC and neutrophil counts were significantly higher (P parvovirus infection, but indicate the need for additional studies to evaluate overall safety of the treatment.

  11. Risk Factors and Options to Improve Engraftment in Unrelated Cord Blood Transplantation

    Directory of Open Access Journals (Sweden)

    Anna D. Petropoulou

    2011-01-01

    Full Text Available Use of umbilical unrelated cord-blood (UCB cells as an alternative source of hematopoietic cell transplantation has been widely used mainly for patients lacking an HLA-matched donor. UCB present many advantages over bone marrow or mobilized peripheral blood from volunteer donors, such as rapid availability, absence of risk for the donor, and decreased incidence of acute graft-versus-host disease. However, a significant clinical problem is delayed engraftment that is directly correlated with the number of hematopoietic stem cells in a cord-blood unit. The identification of prognostic factors associated with engraftment that can be easily modified (e.g., strategies for donor choice and the development of new approaches including use of multiple donors, intrabone injection of UCB, ex vivo expansion, and cotransplantation with accessory cells are of crucial importance in order to circumvent the problem of delayed engraftment after UCB transplantation. Those approaches may increase the quality and availability of UCB for transplantation.

  12. Transcription factors as targets for improving Aspergillus niger as cell factory

    DEFF Research Database (Denmark)

    Poulsen, Lars; Bruno, K.S.; Thykær, Jette

    for gene knockout. The resulting mutants were first exposed to screening experiments including morphological studies and investigation of acid profile and protease activity. Among others an interesting finding was that one mutant had an oxalic acid overproducing phenotype (OOP). In the screening...... experiments the OOP mutant showed a 30 % (± 5%) increase in oxalic acid titer. The OOP mutant was further characterized in 2L scale bioreactors, and a 90 % (±30%) increase of the overall yield coefficient of oxalic acid on glucose was seen. Further data on the OOP mutant will be presented and results from......). In the present study the effect of modulation of transcription factors in Aspergillus niger, which is an industrially important micro-organism used in various processes including organic acid and enzyme production, was investigated. The strategy described in this work focuses on regulation connected to p...

  13. Improving Aspergillus niger as a production host through manipulation of pH responding transcription factors

    DEFF Research Database (Denmark)

    Poulsen, Lars; Bruno, K.S.; Thykær, Jette

    for gene knockout. The resulting mutants were first exposed to screening experiments including morphological studies and investigation of acid profile and protease activity. Among others an interesting finding was that one mutant had an oxalic acid overproducing phenotype (OOP). In the screening...... experiments the OOP mutant showed a 30 % (± 5%) increase in oxalic acid titer. The OOP mutant was further characterized in 2L scale bioreactors, and a 90 % (±30%) increase of the overall yield coefficient of oxalic acid on glucose was seen. Further data on the OOP mutant will be presented and results from......). In the present study the effect of modulation of transcription factors in Aspergillus niger, which is an industrially important micro-organism used in various processes including organic acid and enzyme production, was investigated. The strategy described in this work focuses on regulation connected to p...

  14. Human factors interventions to reduce human errors and improve productivity in maintenance tasks

    International Nuclear Information System (INIS)

    Isoda, Hachiro; Yasutake, J.Y.

    1992-01-01

    This paper describes work in progress to develop interventions to reduce human errors and increase maintenance productivity in nuclear power plants. The effort is part of a two-phased Human Factors research program being conducted jointly by the Central Research Institute of Electric Power Industry (CRIEPI) in Japan and the Electric Power Research Institute (EPRI) in the United States. The overall objective of this joint research program is to identify critical maintenance tasks and to develop, implement and evaluate interventions which have high potential for reducing human errors or increasing maintenance productivity. As a result of the Phase 1 effort, ten critical maintenance tasks were identified. For these tasks, over 25 candidate interventions were identified for potential development. After careful analysis, seven interventions were selected for development during Phase 2. This paper describes the methodology used to analyze and identify the most critical tasks, the process of identifying and developing selected interventions and some of the initial results. (author)

  15. Improving regulatory effectiveness in Federal/State siting actions. Success factor evaluation panel. Final report

    International Nuclear Information System (INIS)

    Haggard, J.

    1977-06-01

    An independent appraisal of the factors that determine efficiency in reaching environmental decisions with respect to nuclear facilities was addressed. The Panel recommended to substitute 'effectiveness' for 'efficiency.' Thus, an effective decision is: 'A timely final decision, that provides for necessary change, consistent with societal objectives and law, and which is equitable and practical, and is based upon fully and candidly expressed premises utilizing a commonly available data base.' The measurement criteria for evaluating the effectiveness of the environmental decision making process are: timely decision, final decision, provision for change, consistency with societal goals and law, equitable, practical, fully and candidly expressed premises, commonly available data base, and public confidence. The Panel evaluated the 8 policies proposed by NRC staff as essential to licensing reform: national fuels policy, regional review, early disclosure, State role, technical assistance to State, role of utilities, radiation health and safety, and modification of the Atomic Energy Act. The five NRC scenarios were evaluated in terms of regulatory effectiveness

  16. Improvements of fill factor in solar cells based on blends of polyfluorene copolymers as electron donors

    International Nuclear Information System (INIS)

    Gadisa, Abay; Zhang, Fengling; Sharma, Deepak; Svensson, Mattias; Andersson, Mats R.; Inganaes, Olle

    2007-01-01

    The photovoltaic characteristics of solar cells based on alternating polyfluorene copolymers, poly(2,7-(9,9-dioctyl-fluorene)-alt-5,5-(4',7'-di-2-thienyl-2',1',3' -benzothia diazole)) (APFO-3), and poly(2,7-(9,9-didodecyl-fluorene)-alt-5,5-(4',7'-di-2-thienyl-2',1',3' -benzothiadiazole)) (APFO-4), blended with an electron acceptor fullerene molecule [6,6]-phenyl-C 61 -butyric acid methyl ester (PCBM), have been investigated and compared. The two copolymers have the same aromatic backbone structure but differ by the length of their alkyl side chain. The overall photovoltaic performance of the solar cells is comparable irrespective of the copolymer used in the active layer. However, the fill factor (FF) values of the devices are strongly affected by the copolymer type. Higher FF values were realized in solar cells with APFO-4 (with longer alkyl side chain)/PCBM bulk heterojunction active layer. On the other hand, devices with blends of APFO-3/APFO-4/PCBM were found to render fill factor values that are intermediate between the values obtained in solar cells with APFO-3/PCBM and APFO-4/PCBM active film. Upon using APFO-3/APFO-4 blends as electron donors, the cell efficiency can be enhanced by about 16% as compared to cells with either APFO-3 or APFO-4. The transport of holes in each polymer obeys the model of hopping transport in disordered media. However, the degree of energetic barrier against hopping was found to be larger in APFO-3. The tuning of the photovoltaic parameters will be discussed based on studies of hole transport in the pure polymer films, and morphology of blend layers. The effect of bipolar transport in PCBM will also be discussed

  17. A study on improvement of scaling factor prediction using artificial neural network

    International Nuclear Information System (INIS)

    Lee, Sang Chul; Hwang, Ki Ha; Kang, Sang Hee; Lee, Kun Jai

    2003-01-01

    Final disposal of radioactive waste generated from Nuclear Power Plant (NPP) requires the detailed knowledge of the natures and quantities of radionuclides in waste package. Many of these radionuclides are difficult to measure and expensive to assay. Thus it is suggested to the indirect method by which the concentrations of DTM (Difficult-to Measure) nuclide is decided using the relation of concentrations (Scaling Factor) between Key (Easy-to-Measure) nuclide and DTM nuclide with measured concentrations of Key nuclide. In general, scaling factor is determined by using of log mean average (LMA) and regression. These methods are adequate to apply most corrosion product nuclides. But in case of fission product nuclides and some corrosion product nuclides, the predicted values aren't well matched with the original values. In this study, the models using artificial neural network (ANN) for C-14 and Sr-90 are compared with those using LMA and regression. The assessment of models is executed in the two parts divided by a training part and a validation part. For all of two nuclides in the training part, the predicted values using ANN are well matched with the measured values compared with those using LMA and regression. In the validation part, the accuracy of the predicted values using ANN is better than that using LMA and is similar to or better than that using regression. It is concluded that the predicted values using ANN model are better than those using conventional model in some nuclides and ANN model can be used as the complement of LMA and regression model

  18. Factoring economic costs into conservation planning may not improve agreement over priorities for protection.

    Science.gov (United States)

    Armsworth, Paul R; Jackson, Heather B; Cho, Seong-Hoon; Clark, Melissa; Fargione, Joseph E; Iacona, Gwenllian D; Kim, Taeyoung; Larson, Eric R; Minney, Thomas; Sutton, Nathan A

    2017-12-21

    Conservation organizations must redouble efforts to protect habitat given continuing biodiversity declines. Prioritization of future areas for protection is hampered by disagreements over what the ecological targets of conservation should be. Here we test the claim that such disagreements will become less important as conservation moves away from prioritizing areas for protection based only on ecological considerations and accounts for varying costs of protection using return-on-investment (ROI) methods. We combine a simulation approach with a case study of forests in the eastern United States, paying particular attention to how covariation between ecological benefits and economic costs influences agreement levels. For many conservation goals, agreement over spatial priorities improves with ROI methods. However, we also show that a reliance on ROI-based prioritization can sometimes exacerbate disagreements over priorities. As such, accounting for costs in conservation planning does not enable society to sidestep careful consideration of the ecological goals of conservation.

  19. msCentipede: Modeling Heterogeneity across Genomic Sites and Replicates Improves Accuracy in the Inference of Transcription Factor Binding.

    Directory of Open Access Journals (Sweden)

    Anil Raj

    Full Text Available Understanding global gene regulation depends critically on accurate annotation of regulatory elements that are functional in a given cell type. CENTIPEDE, a powerful, probabilistic framework for identifying transcription factor binding sites from tissue-specific DNase I cleavage patterns and genomic sequence content, leverages the hypersensitivity of factor-bound chromatin and the information in the DNase I spatial cleavage profile characteristic of each DNA binding protein to accurately infer functional factor binding sites. However, the model for the spatial profile in this framework fails to account for the substantial variation in the DNase I cleavage profiles across different binding sites. Neither does it account for variation in the profiles at the same binding site across multiple replicate DNase I experiments, which are increasingly available. In this work, we introduce new methods, based on multi-scale models for inhomogeneous Poisson processes, to account for such variation in DNase I cleavage patterns both within and across binding sites. These models account for the spatial structure in the heterogeneity in DNase I cleavage patterns for each factor. Using DNase-seq measurements assayed in a lymphoblastoid cell line, we demonstrate the improved performance of this model for several transcription factors by comparing against the Chip-seq peaks for those factors. Finally, we explore the effects of DNase I sequence bias on inference of factor binding using a simple extension to our framework that allows for a more flexible background model. The proposed model can also be easily applied to paired-end ATAC-seq and DNase-seq data. msCentipede, a Python implementation of our algorithm, is available at http://rajanil.github.io/msCentipede.

  20. msCentipede: Modeling Heterogeneity across Genomic Sites and Replicates Improves Accuracy in the Inference of Transcription Factor Binding.

    Science.gov (United States)

    Raj, Anil; Shim, Heejung; Gilad, Yoav; Pritchard, Jonathan K; Stephens, Matthew

    2015-01-01

    Understanding global gene regulation depends critically on accurate annotation of regulatory elements that are functional in a given cell type. CENTIPEDE, a powerful, probabilistic framework for identifying transcription factor binding sites from tissue-specific DNase I cleavage patterns and genomic sequence content, leverages the hypersensitivity of factor-bound chromatin and the information in the DNase I spatial cleavage profile characteristic of each DNA binding protein to accurately infer functional factor binding sites. However, the model for the spatial profile in this framework fails to account for the substantial variation in the DNase I cleavage profiles across different binding sites. Neither does it account for variation in the profiles at the same binding site across multiple replicate DNase I experiments, which are increasingly available. In this work, we introduce new methods, based on multi-scale models for inhomogeneous Poisson processes, to account for such variation in DNase I cleavage patterns both within and across binding sites. These models account for the spatial structure in the heterogeneity in DNase I cleavage patterns for each factor. Using DNase-seq measurements assayed in a lymphoblastoid cell line, we demonstrate the improved performance of this model for several transcription factors by comparing against the Chip-seq peaks for those factors. Finally, we explore the effects of DNase I sequence bias on inference of factor binding using a simple extension to our framework that allows for a more flexible background model. The proposed model can also be easily applied to paired-end ATAC-seq and DNase-seq data. msCentipede, a Python implementation of our algorithm, is available at http://rajanil.github.io/msCentipede.

  1. Factors and values of willingness to pay for improved construction waste management--a perspective of Malaysian contractors.

    Science.gov (United States)

    Begum, Rawshan Ara; Siwar, Chamhuri; Pereira, Joy Jacqueline; Jaafar, Abdul Hamid

    2007-01-01

    Malaysia is facing an increase in the generation of waste and of accompanying problems with the disposal of this waste. In the last two decades, extensive building and infrastructure development projects have led to an increase in the generation of construction waste material. The construction industry has a substantial impact on the environment, and its environmental effects are in direct relation to the quality and quantity of the waste it generates. This paper discusses general characteristics of the construction contractors, the contractors' willingness to pay (WTP) for improved construction waste management, determining factors which affect the amount of their willingness to pay, and suggestions and policy implications in the perspective of construction waste management in Malaysia. The data in this study is based on contractors registered with the construction industry development board (CIDB) of Malaysia. Employing the open ended contingent valuation method, the study assessed the contractors' average maximum WTP for improved construction waste management to be RM69.88 (1US$=3.6 RM) per tonne of waste. The result shows that the average maximum WTP is higher for large contractors than for medium and small contractors. The highest average maximum WTP value is RM88.00 for Group A (large contractors) RM78.25 for Group B (medium-size contractors) and RM55.80 for Group C (small contractors). One of the contributions of this study is to highlight the difference of CIDB registration grade in the WTP for improved construction waste management. It is found that contractors' WTP for improved waste collection and disposal services increases with the increase in contractors' current paid up capital. The identified factors and determinants of the WTP will assist the formulation of appropriate policies in addressing the construction waste problem in Malaysia and indirectly improve the quality of construction in the country.

  2. Predictive factors for a one-year improvement in nontuberculous mycobacterial pulmonary disease: An 11-year retrospective and multicenter study.

    Science.gov (United States)

    Cadelis, Gilbert; Ducrot, Rodolphe; Bourdin, Arnaud; Rastogi, Nalin

    2017-08-01

    Nontuberculous mycobacterial pulmonary disease (NTM-PD) has become an emerging infectious disease and is responsible for more deaths than tuberculosis in industrialized countries. NTM-PD mortality remains high in some series reportedly ranging from 25% to 40% at five years and often due to unfavorable evolution of NTM-PD despite established treatment. The purpose of our study was to search for early factors that could predict the favorable or unfavorable evolution of NTM-PD at the first year of treatment. In this retrospective and multicenter study, we selected 119 patients based on clinical, radiological and microbiological data from 2002 to 2012 from three French university hospitals (Guadeloupe, Martinique, Montpellier) with definite (meeting the criteria of the American Thoracic Society and the Infectious Disease Society of America in 2007; ATS/IDSA) or probable (one positive sputum culture) NTM-PD. We compared two patient groups: those who improved at one year (clinical symptoms, radiological lesions and microbiology data) and those who did not improve at one year. The data were analyzed for all patients as well as for subgroups by gender, HIV-positive patients, and Mycobacterium avium complex (MAC) infection. The average patient age was 50 years ± 19.4; 58% had respiratory comorbidities, 24% were HIV positive and 19% had cystic fibrosis. Coughing concerned 66% of patients and bronchiectasis concerned 45%. The most frequently isolated NTM were MAC (46%). 57% (n = 68) of patients met the ATS criteria and improved status concerned 38.6% (n = 46). The improvement factors at one year of NTM-PD were associated with the duration of ethambutol treatment: (Odds ratio adjusted [ORa]: 2.24, 95% Confidence interval [CI]; 2.11-3.41), HIV-positive status: (ORa: 3.23, 95% CI; 1.27-8.45), and male gender: (ORa: 2.34, 95% CI; 1.26-8.16). For the group with NTM-PD due to MAC, improvement was associated with the duration of macrolide treatment (ORa: 3.27, 95% CI; 1

  3. Predictive factors for a one-year improvement in nontuberculous mycobacterial pulmonary disease: An 11-year retrospective and multicenter study.

    Directory of Open Access Journals (Sweden)

    Gilbert Cadelis

    2017-08-01

    Full Text Available Nontuberculous mycobacterial pulmonary disease (NTM-PD has become an emerging infectious disease and is responsible for more deaths than tuberculosis in industrialized countries. NTM-PD mortality remains high in some series reportedly ranging from 25% to 40% at five years and often due to unfavorable evolution of NTM-PD despite established treatment. The purpose of our study was to search for early factors that could predict the favorable or unfavorable evolution of NTM-PD at the first year of treatment.In this retrospective and multicenter study, we selected 119 patients based on clinical, radiological and microbiological data from 2002 to 2012 from three French university hospitals (Guadeloupe, Martinique, Montpellier with definite (meeting the criteria of the American Thoracic Society and the Infectious Disease Society of America in 2007; ATS/IDSA or probable (one positive sputum culture NTM-PD. We compared two patient groups: those who improved at one year (clinical symptoms, radiological lesions and microbiology data and those who did not improve at one year. The data were analyzed for all patients as well as for subgroups by gender, HIV-positive patients, and Mycobacterium avium complex (MAC infection.The average patient age was 50 years ± 19.4; 58% had respiratory comorbidities, 24% were HIV positive and 19% had cystic fibrosis. Coughing concerned 66% of patients and bronchiectasis concerned 45%. The most frequently isolated NTM were MAC (46%. 57% (n = 68 of patients met the ATS criteria and improved status concerned 38.6% (n = 46. The improvement factors at one year of NTM-PD were associated with the duration of ethambutol treatment: (Odds ratio adjusted [ORa]: 2.24, 95% Confidence interval [CI]; 2.11-3.41, HIV-positive status: (ORa: 3.23, 95% CI; 1.27-8.45, and male gender: (ORa: 2.34, 95% CI; 1.26-8.16. For the group with NTM-PD due to MAC, improvement was associated with the duration of macrolide treatment (ORa: 3.27, 95% CI; 1

  4. Improving Predictions with Reliable Extrapolation Schemes and Better Understanding of Factorization

    Science.gov (United States)

    More, Sushant N.

    New insights into the inter-nucleon interactions, developments in many-body technology, and the surge in computational capabilities has led to phenomenal progress in low-energy nuclear physics in the past few years. Nonetheless, many calculations still lack a robust uncertainty quantification which is essential for making reliable predictions. In this work we investigate two distinct sources of uncertainty and develop ways to account for them. Harmonic oscillator basis expansions are widely used in ab-initio nuclear structure calculations. Finite computational resources usually require that the basis be truncated before observables are fully converged, necessitating reliable extrapolation schemes. It has been demonstrated recently that errors introduced from basis truncation can be taken into account by focusing on the infrared and ultraviolet cutoffs induced by a truncated basis. We show that a finite oscillator basis effectively imposes a hard-wall boundary condition in coordinate space. We accurately determine the position of the hard-wall as a function of oscillator space parameters, derive infrared extrapolation formulas for the energy and other observables, and discuss the extension of this approach to higher angular momentum and to other localized bases. We exploit the duality of the harmonic oscillator to account for the errors introduced by a finite ultraviolet cutoff. Nucleon knockout reactions have been widely used to study and understand nuclear properties. Such an analysis implicitly assumes that the effects of the probe can be separated from the physics of the target nucleus. This factorization between nuclear structure and reaction components depends on the renormalization scale and scheme, and has not been well understood. But it is potentially critical for interpreting experiments and for extracting process-independent nuclear properties. We use a class of unitary transformations called the similarity renormalization group (SRG) transformations to

  5. Vascular endothelial growth factor receptor-3 is a novel target to improve net ultrafiltration in methylglyoxal-induced peritoneal injury.

    Science.gov (United States)

    Terabayashi, Takeshi; Ito, Yasuhiko; Mizuno, Masashi; Suzuki, Yasuhiro; Kinashi, Hiroshi; Sakata, Fumiko; Tomita, Takako; Iguchi, Daiki; Tawada, Mitsuhiro; Nishio, Ryosuke; Maruyama, Shoichi; Imai, Enyu; Matsuo, Seiichi; Takei, Yoshifumi

    2015-09-01

    Appropriate fluid balance is important for good clinical outcomes and survival in patients on peritoneal dialysis. We recently reported that lymphangiogenesis associated with fibrosis developed in the peritoneal cavity via the transforming growth factor-β1-vascular endothelial growth factor-C (VEGF-C) pathway. We investigated whether VEGF receptor-3 (VEGFR-3), the receptor for VEGF-C and -D, might be a new target to improve net ultrafiltration by using adenovirus-expressing soluble VEGFR-3 (Adeno-sVEGFR-3) in rodent models of peritoneal injury induced by methylglyoxal (MGO). We demonstrated that lymphangiogenesis developed in these MGO models, especially in the diaphragm, indicating that lymphangiogenesis is a common feature in the peritoneal cavity with inflammation and fibrosis. In MGO models, VEGF-D was significantly increased in the diaphragm; however, VEGF-C was not significantly upregulated. Adeno-sVEGFR-3, which was detected on day 50 after administration via tail vein injections, successfully suppressed lymphangiogenesis in the diaphragm and parietal peritoneum in mouse MGO models without significant effects on fibrosis, inflammation, or neoangiogenesis. Drained volume in the peritoneal equilibration test using a 7.5% icodextrin peritoneal dialysis solution (the 7.5% icodextrin peritoneal equilibration test) was improved by Adeno-sVEGFR-3 on day 22 (Ptarget to improve net ultrafiltration by suppressing lymphatic absorption and that the 7.5% icodextrin peritoneal equilibration test is useful for estimation of lymphatic absorption.

  6. Suppression of a NAC-like transcription factor gene improves boron-toxicity tolerance in rice.

    Science.gov (United States)

    Ochiai, Kumiko; Shimizu, Akifumi; Okumoto, Yutaka; Fujiwara, Toru; Matoh, Toru

    2011-07-01

    We identified a gene responsible for tolerance to boron (B) toxicity in rice (Oryza sativa), named BORON EXCESS TOLERANT1. Using recombinant inbred lines derived from the B-toxicity-sensitive indica-ecotype cultivar IR36 and the tolerant japonica-ecotype cultivar Nekken 1, the region responsible for tolerance to B toxicity was narrowed to 49 kb on chromosome 4. Eight genes are annotated in this region. The DNA sequence in this region was compared between the B-toxicity-sensitive japonica cultivar Wataribune and the B-toxicity-tolerant japonica cultivar Nipponbare by eco-TILLING analysis and revealed a one-base insertion mutation in the open reading frame sequence of the gene Os04g0477300. The gene encodes a NAC (NAM, ATAF, and CUC)-like transcription factor and the function of the transcript is abolished in B-toxicity-tolerant cultivars. Transgenic plants in which the expression of Os04g0477300 is abolished by RNA interference gain tolerance to B toxicity.

  7. Neoindustrialization as a factor in improving economic security of old-industrial regions

    Directory of Open Access Journals (Sweden)

    Ol’ga Aleksandrovna Romanova

    2012-06-01

    Full Text Available This paper proves that the paradigm of the world of the XXIcentury is neoindustrialization on the basis of alternativestrategic goals of the global economy associated with the formation of post-industrial society and financialization neoindustrialization. A systematic proposal for the driving forces and mechanisms for its implementation is suggested. It is shown that target-oriented approach can be successfully used at the regional level as a mechanism for economic neoindustrialization of an old-industrial region. Conceptual approach to developing comprehensive program of industrial development in the industrial region that implements the ideas of neoindustrialization in relation to industry of Sverdlovsk region is presented. It was found that the regional technology platform can be an effective tool for combining the interests of territorial and sectoral development. It is proved that the idea of neoindustrialization can be realized only as a result of wise industrial policy and road map formation for the movement to an entirely new high-tech based industrial development. In the process of forming, the problem of neoindustrialization of a «pure» market as a factor in increasing the economic security is actualized.

  8. Improved simulation design factors for unconventional crude vacuum units : cracked gas make and stripping section performance

    Energy Technology Data Exchange (ETDEWEB)

    Remesat, D. [Koch-Glitsch Canada LP, Calgary, AB (Canada)

    2008-10-15

    Operating data for unconventional heavy oil vacuum crude units were reviewed in order to optimize the design of vacuum columns. Operational data from heavy crude vacuum units operating with stripping and velocity were used to investigate the application of a proven vacuum distillation tower simulation topology designed for use with heavy oil and bitumen upgrader feeds. Design factors included a characterization of the crude oils or bitumens processed in the facility; the selection of thermodynamic models; and the non-equilibrium simulation topology. Amounts of generated cracked gas were calculated, and entrainment and stripping section performance was evaluated. Heater designs for ensuring the even distribution of heat flux were discussed. Data sets from vacuum units processing crude oils demonstrated that the amount of offgas flow increased as the transfer line temperature increased. The resulting instability caused increased coke generation and light hydrocarbon formation. Results also indicated that overhead vacuum ejector design and size as well as heat transfer capabilities of quench and pumparound zones must be considered when designing vacuum column units. Steam stripping lowered hydrocarbon partial pressure to allow materials to boil at lower temperatures. It was concluded that setting appropriate entrainment values will ensure the accuracy of sensitivity analyses for transfer line designs, inlet feed devices, and wash bed configurations. 9 refs., figs.

  9. Factors Influencing Time Resolution of Scintillators and Ways to Improve Them

    CERN Document Server

    Lecoq, P; Brunner, S; Meyer, T; Auffray, E; Knapitsch, A; Jarron, P

    2010-01-01

    The renewal of interest in Time of Flight Positron Emission Tomography (TOF-PET), as well as the necessity to precisely tag events in high energy physics (HEP) experiments at future colliders are pushing for an optimization of all factors affecting the time resolution of the whole acquisition chain comprising the crystal, the photo detector, and the electronics. The time resolution of a scintillator-based detection system is determined by the rate of photo electrons at the detection threshold, which depends on the time distribution of photons being converted in the photo detector. The possibility to achieve time resolution of about 100 ps Full Width at Half Maximum (FWHM) requires an optimization of the light production in the scintillator, the light transport and its transfer from the scintillator to the photo detector. In order to maximize the light yield, and in particular the density of photons in the first nanosecond, while minimizing the rise time and decay time, particular attention must be paid to the...

  10. France's Financial (Eco)system. Improving the integration of sustainability factors

    International Nuclear Information System (INIS)

    Morel, Romain; Cochran, Ian; Robins, Nick

    2015-11-01

    In the run-up of the COP21, much international attention is focused on France. While mainly related to climate change negotiations, this creates an opportunity to take a broader look at French domestic policies and practices on sustainability. This report presents the French financial system and draws lessons from the French ongoing experience in improving the integration of sustainability issues that could be shared with other countries. The present report summarizes and analyses the key initiatives and dynamics at stake in France. It focuses on both the climate-related issues that have recently received significant attention and the development of broader Environmental, Social and Governance (ESG) issues over the past twenty years. The dynamics that have shaped the last two decades have both led to and been influenced by the emergence of an 'ecosystem' of commercial, public and non-profit actors and experts involved in the appropriation and integration of sustainability issues across the sector. Using the framework of analysis presented in the UNEP Inquiry global report, this case study examines the landscape of actors, private initiatives and public policy that has driven the emergence of this ecosystem and helped foster capacity building and the acquisition of expertise among sectoral actors. (authors)

  11. Coating of human decay accelerating factor (hDAF) onto medical devices to improve biocompatibility.

    Science.gov (United States)

    Watkins, N J; Braidley, P; Bray, C J; Savill, C M; White, D J

    1997-12-01

    In passing blood through an artificial circulatory system, the blood is exposed to surfaces that result in activation of the complement system. The consequences of the activation of complement can be extremely serious for the patient ranging from mild discomfort to respiratory distress and even anaphylaxis. An entirely novel approach was to express recombinant GPI anchored human decay accelerating factor (hDAF) using the baculovirus system and then coat the recombinant protein onto the surfaces of these materials to reduce complement activation. Expression of hDAF in Sf9 cells was shown by ELISA, FACS analysis, and Western blot. Functional activity was tested by CH50 assay. For the coating experiments a small scale model of a cardiovascular bypass circuit constructed from COBE tubing was used. hDAF was either coated onto the circuit using adsorption or covalently linked via the photoreactive crosslinker, p-azidobenzoyl hydrazide. After coating, heparinised human blood was pumped around the circuit and samples were collected into EDTA collection tubes at different time points. Complement activation was measured using a Quidel C3a-des-arg EIA. The photolinked circuits gave a reduction in C3a production of 20-50%, compared to 10-20% seen with an absorbed hDAF circuit. Furthermore, the inhibition of complement was seen over the whole time scale of the photolinked circuit, 60-90 min, whilst in the adsorbed circuit inhibition was not seen to a significant degree after 60 min. The time scale of a standard cardiac bypass is 45-90 min, therefore, the photolinked circuit results are encouraging, as significant inhibition of complement activation is seen within this time frame.

  12. Tests for improvement of decontamination factors on RWTP technological line of precipitation

    International Nuclear Information System (INIS)

    Popovici, C.

    1998-01-01

    Low and intermediate level radioactive wastes are produced from diverse applications of radionuclides and radioactive materials in industry, medicine, agriculture and research. Many of the liquid wastes need treatment for safe management. Chemical precipitation process is well established for the removal of radioactive from LLW and ILW. The precipitation of insoluble compounds is one of the oldest and most used process for the treatment of aqueous waste. The precipitation can be performed either in a simple step or by combined chemical treatment which mainly includes as radioactive carries iron oxo-hydroxides, iron phosphate, calcium phosphate and cooper ferrocyanide. The contaminants are removed from LLW and ILW during precipitation by different mechanisms such as: coagulation and flocculation process, precipitation and co-precipitation, adsorption on the coagulant aid, ion exchange and physical enmeshment by coagulant aid. All these processes are directly dependent on the precipitate properties and its structure which are connected with the initial system composition and the precipitation procedure. Chemical precipitation method for treatment of LLW and ILW by co-precipitation of caesium with cooper ferrocyanide was employed on the real radioactive wastes where the volumes were 3 m 3 , 24 m 3 and 30 m 3 . The percentage removals of Cs-137 from 2285 Bq, 1310 Bq and 1232 Bq per litre of real effluents were 98.8%, 98.9% and 99.1%, respectively. Test runs for removal of Cs-137 from the wastes varied from 90% to 95%. High decontamination factors were observed in the pH range of 9 to 10.5. (author)

  13. IMPROVED PARAMETERIZATION OF WATER CLOUD MODEL FOR HYBRID-POLARIZED BACKSCATTER SIMULATION USING INTERACTION FACTOR

    Directory of Open Access Journals (Sweden)

    S. Chauhan

    2017-07-01

    Full Text Available The prime aim of this study was to assess the potential of semi-empirical water cloud model (WCM in simulating hybrid-polarized SAR backscatter signatures (RH and RV retrieved from RISAT-1 data and integrate the results into a graphical user interface (GUI to facilitate easy comprehension and interpretation. A predominant agricultural wheat growing area was selected in Mathura and Bharatpur districts located in the Indian states of Uttar Pradesh and Rajasthan respectively to carry out the study. The three-date datasets were acquired covering the crucial growth stages of the wheat crop. In synchrony, the fieldwork was organized to measure crop/soil parameters. The RH and RV backscattering coefficient images were extracted from the SAR data for all the three dates. The effect of four combinations of vegetation descriptors (V1 and V2 viz., LAI-LAI, LAI-Plant water content (PWC, Leaf water area index (LWAI-LWAI, and LAI-Interaction factor (IF on the total RH and RV backscatter was analyzed. The results revealed that WCM calibrated with LAI and IF as the two vegetation descriptors simulated the total RH and RV backscatter values with highest R2 of 0.90 and 0.85 while the RMSE was lowest among the other tested models (1.18 and 1.25 dB, respectively. The theoretical considerations and interpretations have been discussed and examined in the paper. The novelty of this work emanates from the fact that it is a first step towards the modeling of hybrid-polarized backscatter data using an accurately parameterized semi-empirical approach.

  14. Psychological Support as a Factor of the Training Process Quality Improvement

    Directory of Open Access Journals (Sweden)

    Jan Kosendiak

    2017-06-01

    Full Text Available Supportive activities may be one of the ways of the training process optimization. Support involves both components of the training process, i.e. training and rest. The training support is aimed at the training load increase or at such orientation of the adaptation processes to meet the training goals as closely as possible. The different aims lay behind the methods that support the rest mechanisms. It is about increasing the peace of the regeneration and recovery processes. This term describes all activities aimed at restoring the full exercise capacity of the athlete after work. The psychological support of the training process can be one of the ways to minimize training disturbances and it should therefore be an essential part of the training process management in case of the top ranked athletes. To improve the psychological support system of the training process and to improve the system quality, it is necessary to analyze the current situation. That’s why, authors of the paper decided to ask the members of the Polish Olympic team competed at the 2016 Olympic Games in Rio de Janeiro on types of relaxation techniques they accepted and used before the competition. The relaxation techniques were deliberately limited to the pre-start relaxation techniques as the study was treated as a pilot study dedicated to the problem identification. Therefore, the authors of the paper formulated its aim, as the identification of the pre-start relaxation preferences of the Olympic team members. The following research questions were formulated to meet the aim of the study:  •     What types of the pre-start relaxation techniques are declared and accepted by the Olympians? •     Could the preferred pre-start relaxation techniques be considered rational, planned, and consciously implemented? A written interview with an online questionnaire was used as a research method. The study was conducted before the 2016 Olympic Games in Rio de

  15. Form factors and charge radii in a quantum chromodynamics-inspired potential model using variationally improved perturbation theory

    International Nuclear Information System (INIS)

    Hazarika, Bhaskar Jyoti; Choudhury, D.K.

    2015-01-01

    We use variationally improved perturbation theory (VIPT) for calculating the elastic form factors and charge radii of D, D s , B, B s and B c mesons in a quantum chromodynamics (QCD)-inspired potential model. For that, we use linear-cum-Coulombic potential and opt the Coulombic part first as parent and then the linear part as parent. The results show that charge radii and form factors are quite small for the Coulombic parent compared to the linear parent. Also, the analysis leads to a lower as well as upper bounds on the four-momentum transfer Q 2 , hinting at a workable range of Q 2 within this approach, which may be useful in future experimental analyses. Comparison of both the options shows that the linear parent is the better option. (author)

  16. Restraining Factors and Improving Paths for the Operation Mechanism of New Rural Cooperative Medical System in China

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    The new rural cooperative medical system has achieved periodical achievements since its establishment.Nevertheless,there are many factors hampering the development of the new system,such as the high cost,the difficulties in fund procurement,the lack of management,the narrow coverage of benefit,the ineffective constraint to the designated medical institutions,the high fund balance rate,and the poor medical facilities and services in rural areas.Countermeasures are put forward to solve these problems,including improving the system design,expanding the coverage of the system,expanding the fund sources,reducing the financing costs,strengthening the fund supervision,enhancing the supervision of designated medical institutions,and improving the capacity of health services in rural areas.

  17. Improvement of Atrophic Acne Scars in Skin of Color Using Topical Synthetic Epidermal Growth Factor (EGF) Serum: A Pilot Study.

    Science.gov (United States)

    Stoddard, Marie Alexia; Herrmann, Jennifer; Moy, Lauren; Moy, Ronald

    2017-04-01

    BACKGROUND: Atrophic scarring in skin of color is a common, permanent, and distressing result of uncontrolled acne vulgaris. Ablative lasers and chemical peels are frequently used to improve the appearance of atrophic scars, primarily through the stimulation of collagen and elastin; however, these treatment modalities are associated with risks, such as dyspigmentation and hypertrophic scarring, especially in patients with darker skin. OBJECTIVE: We evaluated the efficacy of topically applied synthetic epidermal growth factor (EGF) serum in reducing the appearance of atrophic acne scars in skin of color. METHODS: A single-center clinical trial was performed on twelve healthy men and women (average age 32.5) with Fitzpatrick Type IV-V skin and evidence of facial grade II-IV atrophic acne scars. Subjects applied topical EGF serum to the full-face twice daily for 12 weeks. Scar improvement was investigated at each visit using an Investigator Global Assessment (IGA), a Goodman grade, clinical photography, and patient self-assessment. RESULTS: Eleven subjects completed the trial. Compared to baseline, there was an improvement in mean IGA score from 3.36 (SEM = 0.15) to 2.18 (SEM = 0.33). Mean Goodman grade was reduced from 2.73 (SEM = 0.19) to 2.55 (SEM = 0.21). Of the eleven pairs of before and after photographs, nine were correctly chosen as the post-treatment image by a blind investigator. On self-assessment, 81% reported a "good" to "excellent" improvement in their scars compared to baseline (P = 0.004). CONCLUSION: Topical EGF may improve the appearance of atrophic acne scars in skin of color. Additional, larger studies should be conducted to better characterize improvement. J Drugs Dermatol. 2017;16(4):322-326..

  18. Factors influencing the long-term sustainment of quality improvements made in addiction treatment facilities: a qualitative study

    Directory of Open Access Journals (Sweden)

    Scott P. Stumbo

    2017-11-01

    Full Text Available Abstract Background A greater understanding of the factors that influence long-term sustainment of quality improvement (QI initiatives is needed to promote organizational ability to sustain QI practices over time, help improve future interventions, and increase the value of QI investments. Methods We approached 83 of 201 executive sponsors or change leaders at addiction treatment organizations that participated in the 2007–2009 NIATx200 QI intervention. We completed semi-structured interviews with 33 individuals between November 2015 and April 2016. NIATx200 goals were to decrease wait time, increase admissions and improve retention in treatment. Interviews sought to understand factors that either facilitated or impeded long-term sustainment of organizational QI practices made during the intervention. We used thematic analysis to organize the data and group patterns of responses. We assessed available quantitative outcome data and intervention engagement data to corroborate qualitative results. Results We used narrative analysis to group four important themes related to long-term sustainment of QI practices: (1 finding alignment between business- and client-centered practices; (2 staff engagement early in QI process added legitimacy which facilitated sustainment; (3 commitment to integrating data into monitoring practices and the identification of a data champion; and (4 adequate organizational human resources devoted to sustainment. We found four corollary factors among agencies which did not sustain practices: (1 lack of evidence of impact on business practices led to discontinuation; (2 disengaged staff and lack of organizational capacity during implementation period led to lack of sustainment; (3 no data integration into overall business practices and no identified data champion; and (4 high staff turnover. In addition, we found that many agencies’ current use of NIATx methods and tools suggested a legacy effect that might improve

  19. A new method to improve multiplication factor in micro-pixel avalanche photodiodes with high pixel density

    Energy Technology Data Exchange (ETDEWEB)

    Sadygov, Z. [National Nuclear Research Center, Baku (Azerbaijan); Joint Institute for Nuclear Research, Dubna (Russian Federation); Ahmadov, F. [National Nuclear Research Center, Baku (Azerbaijan); Khorev, S. [Zecotek Photonics Inc., Vancouver (Canada); Sadigov, A., E-mail: saazik@yandex.ru [National Nuclear Research Center, Baku (Azerbaijan); Suleymanov, S. [National Nuclear Research Center, Baku (Azerbaijan); Madatov, R.; Mehdiyeva, R. [Institute of Radiation Problems, Baku (Azerbaijan); Zerrouk, F. [Zecotek Photonics Inc., Vancouver (Canada)

    2016-07-11

    Presented is a new model describing development of the avalanche process in time, taking into account the dynamics of electric field within the depleted region of the diode and the effect of parasitic capacitance shunting individual quenching micro-resistors on device parameters. Simulations show that the effective capacitance of a single pixel, which defines the multiplication factor, is the sum of the pixel capacitance and a parasitic capacitance shunting its quenching micro-resistor. Conclusions obtained as a result of modeling open possibilities of improving the pixel gain in micropixel avalanche photodiodes with high pixel density (or low pixel capacitance).

  20. Factors influencing the long-term sustainment of quality improvements made in addiction treatment facilities: a qualitative study.

    Science.gov (United States)

    Stumbo, Scott P; Ford, James H; Green, Carla A

    2017-11-01

    A greater understanding of the factors that influence long-term sustainment of quality improvement (QI) initiatives is needed to promote organizational ability to sustain QI practices over time, help improve future interventions, and increase the value of QI investments. We approached 83 of 201 executive sponsors or change leaders at addiction treatment organizations that participated in the 2007-2009 NIATx200 QI intervention. We completed semi-structured interviews with 33 individuals between November 2015 and April 2016. NIATx200 goals were to decrease wait time, increase admissions and improve retention in treatment. Interviews sought to understand factors that either facilitated or impeded long-term sustainment of organizational QI practices made during the intervention. We used thematic analysis to organize the data and group patterns of responses. We assessed available quantitative outcome data and intervention engagement data to corroborate qualitative results. We used narrative analysis to group four important themes related to long-term sustainment of QI practices: (1) finding alignment between business- and client-centered practices; (2) staff engagement early in QI process added legitimacy which facilitated sustainment; (3) commitment to integrating data into monitoring practices and the identification of a data champion; and (4) adequate organizational human resources devoted to sustainment. We found four corollary factors among agencies which did not sustain practices: (1) lack of evidence of impact on business practices led to discontinuation; (2) disengaged staff and lack of organizational capacity during implementation period led to lack of sustainment; (3) no data integration into overall business practices and no identified data champion; and (4) high staff turnover. In addition, we found that many agencies' current use of NIATx methods and tools suggested a legacy effect that might improve quality elsewhere, even absent overall sustainment of

  1. Factors associated with frequency of abortions recorded through Dairy Herd Improvement test plans.

    Science.gov (United States)

    Norman, H D; Miller, R H; Wright, J R; Hutchison, J L; Olson, K M

    2012-07-01

    Frequency of abortions recorded through Dairy Herd Improvement (DHI) testing was summarized for cows with lactations completed from 2001 through 2009. For 8.5 million DHI lactations of cows that had recorded breeding dates and were >151 d pregnant at lactation termination, the frequency of recorded abortions was 1.31%. Effects of year, herd-year, month, and pregnancy stage at lactation termination; parity; breed; milk yield; herd size; geographic region; and state within region associated with DHI-recorded abortion were examined. Abortions recorded through DHI (minimum gestation of 152 d required) were more frequent during early gestation; least squares means (LSM) were 4.38, 3.27, 1.19, and 0.59% for 152 to 175, 176 to 200, 201 to 225, and 226 to 250 d pregnant, respectively. Frequency of DHI-recorded abortions was 1.40% for parity 1 and 1.01% for parity ≥ 8. Abortion frequency was highest from May through August (1.42 to 1.53%) and lowest from October through February (1.09 to 1.21%). Frequency of DHI-recorded abortions was higher for Holsteins (1.32%) than for Jerseys (1.10%) and other breeds (1.27%). Little relationship was found between DHI-recorded abortions and herd size. Abortion frequencies for effects should be considered to be underestimated because many abortions, especially those caused by genetic recessives, go undetected. Therefore, various nonreturn rates (NRR; 60, 80, …, 200 d) were calculated to document pregnancy loss confirmed by the absence of homozygotes in the population. Breeding records for April 2011 US Department of Agriculture sire conception rate evaluations were analyzed with the model used for official evaluations with the addition of an interaction between carrier status of the service sire (embryo's sire) and cow sire (embryo's maternal grandsire). Over 13 million matings were examined using various NRR for Holstein lethal recessive traits (brachyspina and complex vertebral malformation) and undesirable recessive haplotypes (HH1

  2. Improvement of enzymatic saccharification yield in Arabidopsis thaliana by ectopic expression of the rice SUB1A-1 transcription factor

    Directory of Open Access Journals (Sweden)

    Lizeth Núñez-López

    2015-03-01

    Full Text Available Saccharification of polysaccharides releases monosaccharides that can be used by ethanol-producing microorganisms in biofuel production. To improve plant biomass as a raw material for saccharification, factors controlling the accumulation and structure of carbohydrates must be identified. Rice SUB1A-1 is a transcription factor that represses the turnover of starch and postpones energy-consuming growth processes under submergence stress. Arabidopsis was employed to test if heterologous expression of SUB1A-1 or SUB1C-1 (a related gene can be used to improve saccharification. Cellulolytic and amylolytic enzymatic treatments confirmed that SUB1A-1 transgenics had better saccharification yield than wild-type (Col-0, mainly from accumulated starch. This improved saccharification yield was developmentally controlled; when compared to Col-0, young transgenic vegetative plants yielded 200–300% more glucose, adult vegetative plants yielded 40–90% more glucose and plants in reproductive stage had no difference in yield. We measured photosynthetic parameters, starch granule microstructure, and transcript abundance of genes involved in starch degradation (SEX4, GWD1, juvenile transition (SPL3-5 and meristematic identity (FUL, SOC1 but found no differences to Col-0, indicating that starch accumulation may be controlled by down-regulation of CONSTANS and FLOWERING LOCUS T by SUB1A-1 as previously reported. SUB1A-1 transgenics also offered less resistance to deformation than wild-type concomitant to up-regulation of AtEXP2 expansin and BGL2 glucan-1,3,-beta-glucosidase. We conclude that heterologous SUB1A-1 expression can improve saccharification yield and softness, two traits needed in bioethanol production.

  3. Exploration of contextual factors in a successful quality improvement collaborative in English ambulance services: cross‐sectional survey

    Science.gov (United States)

    Phung, Viet‐Hai; Essam, Nadya; Asghar, Zahid; Spaight, Anne

    2015-01-01

    Abstract Rationale, aims and objectives Clinical leadership and organizational culture are important contextual factors for quality improvement (QI) but the relationship between these and with organizational change is complex and poorly understood. We aimed to explore the relationship between clinical leadership, culture of innovation and clinical engagement in QI within a national ambulance QI Collaborative (QIC). Methods We used a self‐administered online questionnaire survey sent to front‐line clinicians in all 12 English ambulance services. We conducted a cross‐sectional analysis of quantitative data and qualitative analysis of free‐text responses. Results There were 2743 (12% of 22 117) responses from 11 of the 12 participating ambulance services. In the 3% of responders that were directly involved with the QIC, leadership behaviour was significantly higher than for those not directly involved. QIC involvement made no significant difference to responders' perceptions of the culture of innovation in their organization, which was generally considered poor. Although uptake of QI methods was low overall, QIC members were significantly more likely to use QI methods, which were also significantly associated with leadership behaviour. Conclusions Despite a limited organizational culture of innovation, clinical leadership and use of QI methods in ambulance services generally, the QIC achieved its aims to significantly improve pre‐hospital care for acute myocardial infarction and stroke. We postulate that this was mediated through an improvement subculture, linked to the QIC, which facilitated large‐scale improvement by stimulating leadership and QI methods. Further research is needed to understand success factors for QI in complex health care environments. PMID:26303398

  4. Double overexpression of DREB and PIF transcription factors improves drought stress tolerance and cell elongation in transgenic plants.

    Science.gov (United States)

    Kudo, Madoka; Kidokoro, Satoshi; Yoshida, Takuya; Mizoi, Junya; Todaka, Daisuke; Fernie, Alisdair R; Shinozaki, Kazuo; Yamaguchi-Shinozaki, Kazuko

    2017-04-01

    Although a variety of transgenic plants that are tolerant to drought stress have been generated, many of these plants show growth retardation. To improve drought tolerance and plant growth, we applied a gene-stacking approach using two transcription factor genes: DEHYDRATION-RESPONSIVE ELEMENT-BINDING 1A (DREB1A) and rice PHYTOCHROME-INTERACTING FACTOR-LIKE 1 (OsPIL1). The overexpression of DREB1A has been reported to improve drought stress tolerance in various crops, although it also causes a severe dwarf phenotype. OsPIL1 is a rice homologue of Arabidopsis PHYTOCHROME-INTERACTING FACTOR 4 (PIF4), and it enhances cell elongation by activating cell wall-related gene expression. We found that the OsPIL1 protein was more stable than PIF4 under light conditions in Arabidopsis protoplasts. Transactivation analyses revealed that DREB1A and OsPIL1 did not negatively affect each other's transcriptional activities. The transgenic plants overexpressing both OsPIL1 and DREB1A showed the improved drought stress tolerance similar to that of DREB1A overexpressors. Furthermore, double overexpressors showed the enhanced hypocotyl elongation and floral induction compared with the DREB1A overexpressors. Metabolome analyses indicated that compatible solutes, such as sugars and amino acids, accumulated in the double overexpressors, which was similar to the observations of the DREB1A overexpressors. Transcriptome analyses showed an increased expression of abiotic stress-inducible DREB1A downstream genes and cell elongation-related OsPIL1 downstream genes in the double overexpressors, which suggests that these two transcription factors function independently in the transgenic plants despite the trade-offs required to balance plant growth and stress tolerance. Our study provides a basis for plant genetic engineering designed to overcome growth retardation in drought-tolerant transgenic plants. © 2016 The Authors. Plant Biotechnology Journal published by Society for Experimental Biology

  5. Local delivery of glial cell line-derived neurotrophic factor improves facial nerve regeneration after late repair.

    Science.gov (United States)

    Barras, Florian M; Kuntzer, Thierry; Zurn, Anne D; Pasche, Philippe

    2009-05-01

    Facial nerve regeneration is limited in some clinical situations: in long grafts, by aged patients, and when the delay between nerve lesion and repair is prolonged. This deficient regeneration is due to the limited number of regenerating nerve fibers, their immaturity and the unresponsiveness of Schwann cells after a long period of denervation. This study proposes to apply glial cell line-derived neurotrophic factor (GDNF) on facial nerve grafts via nerve guidance channels to improve the regeneration. Two situations were evaluated: immediate and delayed grafts (repair 7 months after the lesion). Each group contained three subgroups: a) graft without channel, b) graft with a channel without neurotrophic factor; and c) graft with a GDNF-releasing channel. A functional analysis was performed with clinical observation of facial nerve function, and nerve conduction study at 6 weeks. Histological analysis was performed with the count of number of myelinated fibers within the graft, and distally to the graft. Central evaluation was assessed with Fluoro-Ruby retrograde labeling and Nissl staining. This study showed that GDNF allowed an increase in the number and the maturation of nerve fibers, as well as the number of retrogradely labeled neurons in delayed anastomoses. On the contrary, after immediate repair, the regenerated nerves in the presence of GDNF showed inferior results compared to the other groups. GDNF is a potent neurotrophic factor to improve facial nerve regeneration in grafts performed several months after the nerve lesion. However, GDNF should not be used for immediate repair, as it possibly inhibits the nerve regeneration.

  6. Fasxiator, a novel factor XIa inhibitor from snake venom, and its site-specific mutagenesis to improve potency and selectivity.

    Science.gov (United States)

    Chen, W; Carvalho, L P D; Chan, M Y; Kini, R M; Kang, T S

    2015-02-01

    Bleeding remains a major limitation of standard anticoagulant drugs that target the extrinsic and common coagulation pathways. Recently, intrinsic coagulation factors are increasingly being investigated as alternative targets for developing anticoagulant drugs with lower bleeding risk. Goals were to (i) identify novel anticoagulants selectively targeting intrinsic coagulation pathway and (ii) characterize and further improve the properties of the identified anticoagulants. We have isolated and sequenced a specific factor XIa (FXIa) inhibitor, henceforth named Fasxiator, from the venom of the banded krait snake, Bungarus fasciatus. It is a Kunitz-type protease inhibitor that prolonged activated partial thromboplastin time without significant effects on prothrombin time. Fasxiator was recombinantly expressed (rFasxiator), purified, and characterized to be a slow-type inhibitor of FXIa that exerts its anticoagulant activities (doubled activated partial thromboplastin time at ~ 3 μmol L(-1) ) by selectively inhibiting human FXIa in in vitro assays. A series of mutants were subsequently generated to improve the potency and selectivity of recombinant rFasxiator. rFasxiatorN17R,L19E showed the best balance between potency (IC50 ~ 1 nmol L(-1) ) and selectivity (> 100 times). rFasxiatorN17R,L19E is a competitive slow-type inhibitor of FXIa (Ki  = 0.86 nmol L(-1) ), possesses anticoagulant activity that is ~ 10 times stronger in human plasma than in murine plasma, and prolonged the occlusion time of mice carotid artery in FeCl3 -induced thrombosis models. We have isolated an exogenous FXIa specific inhibitor, engineered it to improve its potency by ~ 1000 times and demonstrated its in vitro and in vivo efficacy. These proof-of-principle data supported the further development of Fasxiator as a novel anticoagulant candidate. © 2014 International Society on Thrombosis and Haemostasis.

  7. Factors Influencing Household Uptake of Improved Solid Fuel Stoves in Low- and Middle-Income Countries: A Qualitative Systematic Review

    Directory of Open Access Journals (Sweden)

    Stanistreet Debbi

    2014-08-01

    Full Text Available Household burning of solid fuels in traditional stoves is detrimental to health, the environment and development. A range of improved solid fuel stoves (IS are available but little is known about successful approaches to dissemination. This qualitative systematic review aimed to identify factors that influence household uptake of IS in low- and middle-income countries. Extensive searches were carried out and studies were screened and extracted using established systematic review methods. Fourteen qualitative studies from Asia, Africa and Latin-America met the inclusion criteria. Thematic synthesis was used to synthesise data and findings are presented under seven framework domains. Findings relate to user and stakeholder perceptions and highlight the importance of cost, good stove design, fuel and time savings, health benefits, being able to cook traditional dishes and cleanliness in relation to uptake. Creating demand, appropriate approaches to business, and community involvement, are also discussed. Achieving and sustaining uptake is complex and requires consideration of a broad range of factors, which operate at household, community, regional and national levels. Initiatives aimed at IS scale up should include quantitative evaluations of effectiveness, supplemented with qualitative studies to assess factors affecting uptake, with an equity focus.

  8. ABI-like transcription factor gene TaABL1 from wheat improves multiple abiotic stress tolerances in transgenic plants.

    Science.gov (United States)

    Xu, Dong-Bei; Gao, Shi-Qing; Ma, You-Zhi; Xu, Zhao-Shi; Zhao, Chang-Ping; Tang, Yi-Miao; Li, Xue-Yin; Li, Lian-Cheng; Chen, Yao-Feng; Chen, Ming

    2014-12-01

    The phytohormone abscisic acid (ABA) plays crucial roles in adaptive responses of plants to abiotic stresses. ABA-responsive element binding proteins (AREBs) are basic leucine zipper transcription factors that regulate the expression of downstream genes containing ABA-responsive elements (ABREs) in promoter regions. A novel ABI-like (ABA-insensitive) transcription factor gene, named TaABL1, containing a conserved basic leucine zipper (bZIP) domain was cloned from wheat. Southern blotting showed that three copies were present in the wheat genome. Phylogenetic analyses indicated that TaABL1 belonged to the AREB subfamily of the bZIP transcription factor family and was most closely related to ZmABI5 in maize and OsAREB2 in rice. Expression of TaABL1 was highly induced in wheat roots, stems, and leaves by ABA, drought, high salt, and low temperature stresses. TaABL1 was localized inside the nuclei of transformed wheat mesophyll protoplast. Overexpression of TaABL1 enhanced responses of transgenic plants to ABA and hastened stomatal closure under stress, thereby improving tolerance to multiple abiotic stresses. Furthermore, overexpression of TaABL1 upregulated or downregulated the expression of some stress-related genes controlling stomatal closure in transgenic plants under ABA and drought stress conditions, suggesting that TaABL1 might be a valuable genetic resource for transgenic molecular breeding.

  9. Mortality after percutaneous coronary revascularization: Prior cardiovascular risk factor control and improved outcomes in patients with diabetes mellitus.

    Science.gov (United States)

    Noman, Awsan; Balasubramaniam, Karthik; Alhous, M Hafez A; Lee, Kelvin; Jesudason, Peter; Rashid, Muhammad; Mamas, Mamas A; Zaman, Azfar G

    2017-06-01

    To assess the mortality in patients with diabetes mellitus (DM) following percutaneous coronary intervention (PCI) according to their insulin requirement and PCI setting (elective, urgent, and emergency). DM is a major risk factor to develop coronary artery disease (CAD). It is unclear if meticulous glycemic control and aggressive risk factor management in patients with DM has improved outcomes following PCI. Retrospective analysis of prospectively collected data on 9,224 patients treated with PCI at a regional tertiary center between 2008 and 2011. About 7,652 patients were nondiabetics (non-DM), 1,116 had non-insulin treated diabetes mellitus (NITDM) and 456 had ITDM. Multi-vessel coronary artery disease, renal impairment and non-coronary vascular disease were more prevalent in DM patients. Overall 30-day mortality rate was 2.4%. In a logistic regression model, the adjusted odds ratios (95% confidence intervals [CI]) for 30-day mortality were 1.28 (0.81-2.03, P = 0.34) in NITDM and 2.82 (1.61-4.94, P diabetes, this study reveals higher mortality only in insulin-treated diabetic patients following PCI for stable coronary artery disease and acute coronary syndrome. Importantly, diabetic patients with good risk factor control and managed on diet or oral hypoglycemics have similar outcomes to the non-diabetic population. © 2016 The Authors Catheterization and Cardiovascular Interventions Published by Wiley Periodicals, Inc. © 2016 The Authors Catheterization and Cardiovascular Interventions Published by Wiley Periodicals, Inc.

  10. Evaluation of a multicomponent workplace health promotion program conducted in Japan for improving employees' cardiovascular disease risk factors.

    Science.gov (United States)

    Muto, T; Yamauchi, K

    2001-12-01

    The long-term effectiveness of multicomponent worksite health promotion programs targeting cardiovascular disease risk factors remains unclear in Japan. This study was conducted to evaluate the effectiveness of such a health promotion program consisting of a main program provided over 4 days and a follow-up program provided over 1 year. The subjects of this randomized controlled trial were male employees working for a building maintenance company in Japan. The intervention group (n = 152) and the control group (n = 150) consisted of employees having abnormal findings in at least one of the following items at baseline health examination: body mass index (BMI), systolic (SBP) or diastolic blood pressure, total cholesterol, HDL cholesterol, triglycerides, and fasting blood glucose. Evaluation was conducted at 18 months after the main program. BMI, SBP, total cholesterol, and triglycerides improved significantly in the intervention group compared with the control group (P < 0.05). When comparisons were limited to those who showed abnormality at baseline, BMI, total cholesterol, and triglycerides improved significantly in the intervention group (P < 0.05). The multicomponent health promotion program provided to employees was shown to be effective in improving obesity, high blood pressure, and hyperlipidemia when evaluated 18 months after the main intervention program. Copyright 2001 American Health Foundation and Elsevier Science.

  11. The wheat transcription factor, TabHLH39, improves tolerance to multiple abiotic stressors in transgenic plants.

    Science.gov (United States)

    Zhai, Yiqian; Zhang, Lichao; Xia, Chuan; Fu, Silu; Zhao, Guangyao; Jia, Jizeng; Kong, Xiuying

    2016-05-13

    Although bHLH transcription factors play important roles regulating plant development and abiotic stress response and tolerance, few functional studies have been performed in wheat. In this study, we isolated and characterized a bHLH gene, TabHLH39, from wheat. The TabHLH39 gene is located on wheat chromosome 5DL, and the protein localized to the nucleus and activated transcription. TabHLH39 showed variable expression in roots, stems, leaves, glumes, pistils and stamens and was induced by polyethylene glycol, salt and cold treatments. Further analysis revealed that TabHLH39 overexpression in Arabidopsis significantly enhanced tolerance to drought, salt and freezing stress during the seedling stage, which was also demonstrated by enhanced abiotic stress-response gene expression and changes to several physiological indices. Therefore, TabHLH39 has potential in transgenic breeding applications to improve abiotic stress tolerance in crops. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Security analysis and improvements of two-factor mutual authentication with key agreement in wireless sensor networks.

    Science.gov (United States)

    Kim, Jiye; Lee, Donghoon; Jeon, Woongryul; Lee, Youngsook; Won, Dongho

    2014-04-09

    User authentication and key management are two important security issues in WSNs (Wireless Sensor Networks). In WSNs, for some applications, the user needs to obtain real-time data directly from sensors and several user authentication schemes have been recently proposed for this case. We found that a two-factor mutual authentication scheme with key agreement in WSNs is vulnerable to gateway node bypassing attacks and user impersonation attacks using secret data stored in sensor nodes or an attacker's own smart card. In this paper, we propose an improved scheme to overcome these security weaknesses by storing secret data in unique ciphertext form in each node. In addition, our proposed scheme should provide not only security, but also efficiency since sensors in a WSN operate with resource constraints such as limited power, computation, and storage space. Therefore, we also analyze the performance of the proposed scheme by comparing its computation and communication costs with those of other schemes.

  13. Improved Detection of Common Variants Associated with Schizophrenia by Leveraging Pleiotropy with Cardiovascular-Disease Risk Factors

    DEFF Research Database (Denmark)

    Andreassen, Ole A; Djurovic, Srdjan; Thompson, Wesley K

    2013-01-01

    Several lines of evidence suggest that genome-wide association studies (GWASs) have the potential to explain more of the "missing heritability" of common complex phenotypes. However, reliable methods for identifying a larger proportion of SNPs are currently lacking. Here, we present a genetic......-pleiotropy-informed method for improving gene discovery with the use of GWAS summary-statistics data. We applied this methodology to identify additional loci associated with schizophrenia (SCZ), a highly heritable disorder with significant missing heritability. Epidemiological and clinical studies suggest comorbidity...... of the association with several CVD risk factors and a corresponding reduction in false discovery rate (FDR). We validate this "pleiotropic enrichment" by demonstrating increased replication rate across independent SCZ substudies. Applying the stratified FDR method, we identified 25 loci associated with SCZ...

  14. Insulation Coordination of Arcing Horns on HVDC Electrode Lines: Protection Performance Evaluation, Influence Factors and Improvement Method

    Directory of Open Access Journals (Sweden)

    Xiandong Li

    2018-02-01

    Full Text Available Arcing horns are widely used in high voltage overhead lines to protect insulator strings from being destroyed by the free burning arcs caused by lightening faults. In this paper, we focus on the insulation coordination of arcing horns on the electrode lines of a 5000 MW, ±800 kV high voltage direct current (HVDC system. The protection performance of arcing horns are determined by the characteristics of not only the external system but also the fault arc. Therefore, the behaviors and characteristics of long free burning arcs are investigated by the experiments at first. In order to evaluate the protection performance of arcing horns, the static stability criterion U-I characteristic method is introduced. The influence factors on the protection performance of arcing horns are analyzed theoretically. Finally, the improvement methods for the protection performance of arcing horns are proposed, and the diversified configuration strategy of arcing horns is recommended for cost saving.

  15. Beyond Framingham risk factors and coronary calcification: does aortic valve calcification improve risk prediction? The Heinz Nixdorf Recall Study.

    Science.gov (United States)

    Kälsch, Hagen; Lehmann, Nils; Mahabadi, Amir A; Bauer, Marcus; Kara, Kaffer; Hüppe, Patricia; Moebus, Susanne; Möhlenkamp, Stefan; Dragano, Nico; Schmermund, Axel; Stang, Andreas; Jöckel, Karl-Heinz; Erbel, Raimund

    2014-06-01

    Aortic valve calcification (AVC) is considered a manifestation of atherosclerosis. In this study, we investigated whether AVC adds to cardiovascular risk prediction beyond Framingham risk factors and coronary artery calcification (CAC). A total of 3944 subjects from the population based Heinz Nixdorf Recall Study (59.3±7.7 years; 53% females) were evaluated for coronary events, stroke, and cardiovascular disease (CVD) events (including all plus CV death) over 9.1±1.9 years. CT scans were performed to quantify AVC. Cox proportional hazards regressions and Harrell's C were used to examine AVC as event predictor in addition to risk factors and CAC. During follow-up, 138 (3.5%) subjects experienced coronary events, 101 (2.6%) had a stroke, and 257 (6.5%) experienced CVD events. In subjects with AVC>0 versus AVC=0 the incidence of coronary events was 8.0% versus 3.0% (pAVC scores (pAVC scores (3rd tertile) remained independently associated with coronary events (HR 2.21, 95% CI 1.28 to 3.81) and CVD events (HR 1.67, 95% CI 1.08 to 2.58). After further adjustment for CAC score, HRs were attenuated (coronary events 1.55, 95% CI 0.89 to 2.69; CVD events 1.29, 95% CI 0.83 to 2.00). When adding AVC to the model containing traditional risk factors and CAC, Harrell's C indices did not increase for coronary events (from 0.744 to 0.744) or CVD events (from 0.759 to 0.759). AVC is associated with incident coronary and CVD events independent of Framingham risk factors. However, AVC fails to improve cardiovascular event prediction over Framingham risk factors and CAC. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. Improved Formula for the Stress Intensity Factor of Semi-Elliptical Surface Cracks in Welded Joints under Bending Stress

    Science.gov (United States)

    Peng, Yang; Wu, Chao; Zheng, Yifu; Dong, Jun

    2017-01-01

    Welded joints are prone to fatigue cracking with the existence of welding defects and bending stress. Fracture mechanics is a useful approach in which the fatigue life of the welded joint can be predicted. The key challenge of such predictions using fracture mechanics is how to accurately calculate the stress intensity factor (SIF). An empirical formula for calculating the SIF of welded joints under bending stress was developed by Baik, Yamada and Ishikawa based on the hybrid method. However, when calculating the SIF of a semi-elliptical crack, this study found that the accuracy of the Baik-Yamada formula was poor when comparing the benchmark results, experimental data and numerical results. The reasons for the reduced accuracy of the Baik-Yamada formula were identified and discussed in this paper. Furthermore, a new correction factor was developed and added to the Baik-Yamada formula by using theoretical analysis and numerical regression. Finally, the predictions using the modified Baik-Yamada formula were compared with the benchmark results, experimental data and numerical results. It was found that the accuracy of the modified Baik-Yamada formula was greatly improved. Therefore, it is proposed that this modified formula is used to conveniently and accurately calculate the SIF of semi-elliptical cracks in welded joints under bending stress. PMID:28772527

  17. Improved efficacy of soluble human receptor activator of nuclear factor kappa B (RANK) fusion protein by site-directed mutagenesis.

    Science.gov (United States)

    Son, Young Jun; Han, Jihye; Lee, Jae Yeon; Kim, HaHyung; Chun, Taehoon

    2015-06-01

    Soluble human receptor activator of nuclear factor kappa B fusion immunoglobulin (hRANK-Ig) has been considered as one of the therapeutic agents to treat osteoporosis or diseases associated with bone destruction by blocking the interaction between RANK and the receptor activator of nuclear factor kappa B ligand (RANKL). However, no scientific record showing critical amino acid residues within the structural interface between the human RANKL and RANK complex is yet available. In this study, we produced several mutants of hRANK-Ig by replacement of amino acid residue(s) and tested whether the mutants had increased binding affinity to human RANKL. Based on the results from flow cytometry and surface plasmon resonance analyses, the replacement of E(125) with D(125), or E(125) and C(127) with D(125) and F(127) within loop 3 of cysteine-rich domain 3 of hRANK-Ig increases binding affinity to human RANKL over the wild-type hRANK-Ig. This result may provide the first example of improvement in the efficacy of hRANK-Ig by protein engineering and may give additional information to understand a more defined structural interface between hRANK and RANKL.

  18. Dietary levels of pure flavonoids improve spatial memory performance and increase hippocampal brain-derived neurotrophic factor.

    Directory of Open Access Journals (Sweden)

    Catarina Rendeiro

    Full Text Available Evidence suggests that flavonoid-rich foods are capable of inducing improvements in memory and cognition in animals and humans. However, there is a lack of clarity concerning whether flavonoids are the causal agents in inducing such behavioral responses. Here we show that supplementation with pure anthocyanins or pure flavanols for 6 weeks, at levels similar to that found in blueberry (2% w/w, results in an enhancement of spatial memory in 18 month old rats. Pure flavanols and pure anthocyanins were observed to induce significant improvements in spatial working memory (p = 0.002 and p = 0.006 respectively, to a similar extent to that following blueberry supplementation (p = 0.002. These behavioral changes were paralleled by increases in hippocampal brain-derived neurotrophic factor (R = 0.46, p<0.01, suggesting a common mechanism for the enhancement of memory. However, unlike protein levels of BDNF, the regional enhancement of BDNF mRNA expression in the hippocampus appeared to be predominantly enhanced by anthocyanins. Our data support the claim that flavonoids are likely causal agents in mediating the cognitive effects of flavonoid-rich foods.

  19. Intranasal Nerve Growth Factor administration improves cerebral functions in a child with severe traumatic brain injury: A case report.

    Science.gov (United States)

    Chiaretti, Antonio; Conti, Giorgio; Falsini, Benedetto; Buonsenso, Danilo; Crasti, Matteo; Manni, Luigi; Soligo, Marzia; Fantacci, Claudia; Genovese, Orazio; Calcagni, Maria Lucia; Di Giuda, Daniela; Mattoli, Maria Vittoria; Cocciolillo, Fabrizio; Ferrara, Pietro; Ruggiero, Antonio; Staccioli, Susanna; Colafati, Giovanna Stefania; Riccardi, Riccardo

    2017-01-01

    Nerve growth factor (NGF) promotes neural recovery after experimental traumatic brain injury (TBI) supporting neuronal growth, differentiation and survival of brain cells and up-regulating the neurogenesis-associated protein Doublecortin (DCX). Only a few studies reported NGF administration in paediatric patients with severe TBI. A four-year-old boy in a persistent unresponsive wakefulness syndrome (UWS) was treated with intranasal murine NGF administration 6 months after severe TBI. The patient received four cycles of intranasal NGF (0.1 mg/kg, twice a day for 10 consecutive days). NGF administration improved functional [Positron Emission Tomography/Computed Tomography (PET/CT); Single photon emission/Computed Tomography (SPECT/CT) and Magnetic Resonance Imaging (MRI)] assessment, electrophysiological [Electroencephalogram (EEG) and Visual Evoked Potential (VEP)] studies and clinical conditions. He showed improvements in voluntary movements, facial mimicry, phonation, attention and verbal comprehension, ability to cry, cough reflex, oral motility, feeding capacity, and bowel and urinary functions. After NGF administration, raised levels of both NGF and DCX were found in the cerebrospinal fluid of the patient. No side effects were reported. Although further studies are needed for better understanding the neuroprotective role of this neurotrophin, intranasal NGF administration appears to be a promising and safe rescuing strategy treatment in children with neurological impairment after TBI.

  20. Educational system factors that engage resident physicians in an integrated quality improvement curriculum at a VA hospital: a realist evaluation.

    Science.gov (United States)

    Ogrinc, Greg; Ercolano, Ellyn; Cohen, Emily S; Harwood, Beth; Baum, Karyn; van Aalst, Robertus; Jones, Anne C; Davies, Louise

    2014-10-01

    Learning about quality improvement (QI) in resident physician training is often relegated to elective or noncore clinical activities. The authors integrated teaching, learning, and doing QI into the routine clinical work of inpatient internal medicine teams at a Veterans Affairs (VA) hospital. This study describes the design factors that facilitated and inhibited the integration of a QI curriculum-including real QI work-into the routine work of inpatient internal medicine teams. A realist evaluation framework used three data sources: field notes from QI faculty; semistructured interviews with resident physicians; and a group interview with QI faculty and staff. From April 2011 to July 2012, resident physician teams at the White River Junction VA Medical Center used the Model for Improvement for their QI work and analyzed data using statistical process control charts. Three domains affected the delivery of the QI curriculum and engagement of residents in QI work: setting, learner, and teacher. The constant presence of the QI material on a public space in the team workroom was a facilitating mechanism in the setting. Explicit sign-out of QI work to the next resident team formalized the handoff in the learner domain. QI teachers who were respected clinical leaders with QI expertise provided role modeling and local system knowledge. Integrating QI teaching into the routine clinical and educational systems of an inpatient service is challenging. Identifiable, concrete strategies in the setting, learner, and teacher domains helped integrate QI into the clinical and educational systems.

  1. Factors associated with persistent poorly controlled diabetes mellitus: clues to improving management in patients with resistant poor control.

    Science.gov (United States)

    Crowley, Matthew J; Holleman, Rob; Klamerus, Mandi L; Bosworth, Hayden B; Edelman, David; Heisler, Michele

    2014-12-01

    Patients with persistent poorly controlled diabetes mellitus (PPDM), defined as an uninterrupted hemoglobin A1c >8.0% for ≥1 year despite standard care, are at high risk for complications. Additional research to define patient factors associated with PPDM could suggest barriers to improvement in this group and inform the development of targeted strategies to address these patients' resistant diabetes. We analyzed patients with type 2 diabetes from a multi-site randomized trial. We characterized patients with PPDM relative to other patients using detailed survey data and multivariable modeling. Of 963 patients, 118 (12%) had PPDM, 265 (28%) were intermittently poorly controlled, and 580 (60%) were well-controlled. Patients with PPDM had younger age, earlier diabetes diagnosis, insulin use, higher antihypertensive burden, higher low-density lipoprotein cholesterol, and lower statin use relative to well-controlled patients. Among patients with objective adherence data (Veterans Affairs patients), a larger oral diabetes medication refill gap was associated with PPDM. Strategies are needed to target-specific barriers to improvement among patients whose diabetes is resistant to standard diabetes care. Our data suggest that strategies for targeting PPDM should accommodate younger patients' lifestyles, include medication management for insulin titration and comorbid disease conditions, and address barriers to self-management adherence. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  2. A checklist for identifying determinants of practice: a systematic review and synthesis of frameworks and taxonomies of factors that prevent or enable improvements in healthcare professional practice

    NARCIS (Netherlands)

    Flottorp, S.A.; Oxman, A.D.; Krause, J.; Musila, N.R.; Wensing, M.; Godycki-Cwirko, M.; Baker, R.; Eccles, M.P.

    2013-01-01

    BACKGROUND: Determinants of practice are factors that might prevent or enable improvements. Several checklists, frameworks, taxonomies, and classifications of determinants of healthcare professional practice have been published. In this paper, we describe the development of a comprehensive,

  3. Granulocyte Colony-Stimulating Factor Combined with Methylprednisolone Improves Functional Outcomes in Rats with Experimental Acute Spinal Cord Injury

    Directory of Open Access Journals (Sweden)

    William Gemio Jacobsen Teixeira

    2018-02-01

    Full Text Available OBJECTIVES: To evaluate the effects of combined treatment with granulocyte colony-stimulating factor (G-CSF and methylprednisolone in rats subjected to experimental spinal cord injury. METHODS: Forty Wistar rats received a moderate spinal cord injury and were divided into four groups: control (no treatment; G-CSF (G-CSF at the time of injury and daily over the next five days; methylprednisolone (methylprednisolone for 24 h; and G-CSF/Methylprednisolone (methylprednisolone for 24 h and G-CSF at the time of injury and daily over the next five days. Functional evaluation was performed using the Basso, Beattie and Bresnahan score on days 2, 7, 14, 21, 28, 35 and 42 following injury. Motor-evoked potentials were evaluated. Histological examination of the spinal cord lesion was performed immediately after euthanasia on day 42. RESULTS: Eight animals were excluded (2 from each group due to infection, a normal Basso, Beattie and Bresnahan score at their first evaluation, or autophagy, and 32 were evaluated. The combination of methylprednisolone and G-CSF promoted greater functional improvement than methylprednisolone or G-CSF alone (p<0.001. This combination also exhibited a synergistic effect, with improvements in hyperemia and cellular infiltration at the injury site (p<0.001. The groups displayed no neurophysiological differences (latency p=0.85; amplitude p=0.75. CONCLUSION: Methylprednisolone plus G-CSF promotes functional and histological improvements superior to those achieved by either of these drugs alone when treating spinal cord contusion injuries in rats. Combining the two drugs did have a synergistic effect.

  4. Evidence for fibroblast growth factor-2 as a mediator of amphetamine-enhanced motor improvement following stroke.

    Directory of Open Access Journals (Sweden)

    William A Wolf

    Full Text Available Previously we have shown that addition of amphetamine to physical therapy results in enhanced motor improvement following stroke in rats, which was associated with the formation of new motor pathways from cortical projection neurons of the contralesional cortex. It is unclear what mechanisms are involved, but amphetamine is known to induce the neuronal release of catecholamines as well as upregulate fibroblast growth factor-2 (FGF-2 expression in the brain. Since FGF-2 has been widely documented to stimulate neurite outgrowth, the present studies were undertaken to provide evidence for FGF-2 as a neurobiological mechanism underlying amphetamine-induced neuroplasticity. In the present study rats that received amphetamine plus physical therapy following permanent middle cerebral artery occlusion exhibited significantly greater motor improvement over animals receiving physical therapy alone. Amphetamine plus physical therapy also significantly increased the number of FGF-2 expressing pyramidal neurons of the contralesional cortex at 2 weeks post-stroke and resulted in significant axonal outgrowth from these neurons at 8 weeks post-stroke. Since amphetamine is a known releaser of norepinephrine, in vitro analyses focused on whether noradrenergic stimulation could lead to neurite outgrowth in a manner requiring FGF-2 activity. Primary cortical neurons did not respond to direct stimulation by norepinephrine or amphetamine with increased neurite outgrowth. However, conditioned media from astrocytes exposed to norepinephrine or isoproterenol (a beta adrenergic agonist significantly increased neurite outgrowth when applied to neuronal cultures. Adrenergic agonists also upregulated FGF-2 expression in astrocytes. Pharmacological analysis indicated that beta receptors and alpha1, but not alpha2, receptors were involved in both effects. Antibody neutralization studies demonstrated that FGF-2 was a critical contributor to neurite outgrowth induced by

  5. Improvements of the Regulatory Framework for Nuclear Installations in the Areas of Human and Organizational Factors and Safety Culture

    International Nuclear Information System (INIS)

    Tronea, M.; Ciurea, C.

    2016-01-01

    The paper presents the development of regulatory requirements in the area of human and organizational factors taking account of the lessons learned from major accidents in the nuclear industry and in particular of the factors that contributed to the Fukushima Daiichi accident and the improvement of the regulatory oversight of nuclear safety culture. New requirements have been elaborated by the National Commission for Nuclear Activities Control (CNCAN) on the nuclear safety policy of licencees for nuclear installations, on independent nuclear safety oversight, on safety conscious work environment and on the assessment of nuclear safety culture. The regulatory process for the oversight of nuclear safety culture within licencees’ organizations operating nuclear installations and the associated procedure and guidelines, based on the IAEA Safety Standards, have been developed in 2010-2011. CNCAN has used the 37 IAEA attributes for a strong safety culture, grouped into five areas corresponding to safety culture characteristics, as the basis for its regulatory guidelines providing support to the reviewers and inspectors, in their routine activities, for recognising and gathering information relevant to safety culture. The safety culture oversight process, procedure and guidelines are in process of being reviewed and revised to improve their effectiveness and to align with the current international practices, using lessons learned from the Fukushima Daiichi accident. Starting with July 2014, Romania has a National Strategy for Nuclear Safety and Security, which includes strategic objectives, associated directions for action and concrete actions for promoting nuclear safety culture in all the organizations in the nuclear sector. The progress with the implementation of this strategy with regard to nuclear safety culture is described in the paper. CNCAN started to define its own organizational culture model and identifying the elements that promote and support safety

  6. Citation trend and suggestions for improvement of impact factor of Journal of Korean Therapeutic Radiology and Oncology

    International Nuclear Information System (INIS)

    Kim, Seong Hwan; Hwang, Seong Su; Ahn, Myeong Im; Jeong, So Na

    2006-01-01

    To analyze the recent citation trend and to find a way to improve impact factor (IF) of the Journal of Korean Therapeutic Radiology and Oncology (JKSTRO) by analysis of Korean Medical Citation index (KoMCI) citation data of JKSTRO and comparison with that of mean citation data of all journals enlisted on KoMCI (KoMCI journals) during 2000-2005. All citation data of entire journals enlisted on KoMCI and JKSTRO from 2000 to 2005 were obtained from KoMCI. The trend of total and annual number of published articles and reference citations, total citations and self-citations per paper, IF and impact factor excluding self-citations (ZIF) were described and compared on both KoMCI journals an JKSTRO. Annual number of published articles was decreased for 6 years on both KoMCI journals and JKSTRO (32% and 38% reduction rate). The number of Korean journal references per article is 1.6 papers of JKSTRO comparing to 2.0 papers on KoMCI journals. The percentage of Korean references/total references increased from 5.0% in 2000 to 7.7% in 2005 on JKSTRO and from 8.5% in 2000 to 10.1% on KoMCI journals. The number of total citations received/paper on JKSTRO (average 1.333) is smaller than that of KoMCI journals (average 1.694), there was an increased rate of 67% in 2005 comparing to 2000. The percentage of self-citations/total citations (average 72%) on JKSTRO is slightly higher than that of KoMCI journals (average 61%)/ IF of JKSTRO was gradually improved and 0.144, 0.125, 0.088, 0.107, 0.187 and 0.203 in 2000-2005 respectively. However, ZIF of JKSTRO is steadily decreased from 0.038 in 2000 to 0.013 in 2005 except 0.044 in 2004. IF of JKSTRO was slightly improved but had some innate problem of smaller number of citations received . To make JKSTRO as a highly cited journal, the awareness of academic status of JKSTRO and active participation of every member of JKSTRO including encouraging self-citations of papers published recent 2 years and submission of English written papers, and

  7. Establishing partnership with traditional birth attendants for improved maternal and newborn health: a review of factors influencing implementation.

    Science.gov (United States)

    Miller, Tina; Smith, Helen

    2017-10-19

    Recent World Health Organization recommendations recognize the important role Traditional Birth Attendants (TBAs) can play in supporting the health of women and newborns. This paper provides an analysis of key factors that affect the implementation of interventions to develop partnerships with TBAs to promote improved access to skilled care at birth. We conducted a secondary analysis of 20 papers identified through two systematic reviews that examined the effectiveness of interventions to find new roles for TBAs on maternal and newborn health outcomes, as well as papers identified through a systematic mapping of the maternal health literature. The Supporting the Use of Research Evidence framework (SURE) guided the thematic analysis to explore the perceptions of various stakeholders and implementation barriers and facilitators, as well as other contextual issues. This analysis identified countries that have implemented interventions to support the transition from birth with a TBA to birth with a skilled birth attendant. Drawing on the experiences of these countries, the analysis highlights factors that are important to consider when designing and implementing such interventions. Barriers to implementation included resistance to change in more traditional communities, negative attitudes between TBAs and skilled attendants and TBAs concerns about the financial implications of assuming new roles. Facilitating factors included stakeholder involvement in devising and implementing interventions, knowledge sharing between TBAs and skilled birth attendants, and formalised roles and responsibilities and remuneration for TBAs. The implementation barriers identified in this analysis could, if not addressed, prevent or discourage TBAs from carrying out newly defined roles supporting women in pregnancy and childbirth and linking them to the formal health system. This paper also identifies the factors that seem critical to success, which new programmes could consider adopting

  8. Improving performance of high risk organizations Spanish nuclear sector from the analysis of organizational culture factors; Mejora del desempeno de las organizaciones de alto riesgo del sector nuclear espanol a partir del analisis de los factores de cultura organizativa

    Energy Technology Data Exchange (ETDEWEB)

    La Salabarnada, E.; German, S.; Silla, I.; Navajas, J.

    2012-07-01

    This paper presents the research project funded by UNESA and conducted by the CISOT-CIEMAT that aims to contribute to improving the operating performance of the Spanish nuclear power plants. This paper aims to identify the factors and key organizational processes to improve efficiency, in order to advance knowledge about the influence of organizational culture on the safety of high reliability organizations.

  9. Joint Dictionary Learning-Based Non-Negative Matrix Factorization for Voice Conversion to Improve Speech Intelligibility After Oral Surgery.

    Science.gov (United States)

    Fu, Szu-Wei; Li, Pei-Chun; Lai, Ying-Hui; Yang, Cheng-Chien; Hsieh, Li-Chun; Tsao, Yu

    2017-11-01

    Objective: This paper focuses on machine learning based voice conversion (VC) techniques for improving the speech intelligibility of surgical patients who have had parts of their articulators removed. Because of the removal of parts of the articulator, a patient's speech may be distorted and difficult to understand. To overcome this problem, VC methods can be applied to convert the distorted speech such that it is clear and more intelligible. To design an effective VC method, two key points must be considered: 1) the amount of training data may be limited (because speaking for a long time is usually difficult for postoperative patients); 2) rapid conversion is desirable (for better communication). Methods: We propose a novel joint dictionary learning based non-negative matrix factorization (JD-NMF) algorithm. Compared to conventional VC techniques, JD-NMF can perform VC efficiently and effectively with only a small amount of training data. Results: The experimental results demonstrate that the proposed JD-NMF method not only achieves notably higher short-time objective intelligibility (STOI) scores (a standardized objective intelligibility evaluation metric) than those obtained using the original unconverted speech but is also significantly more efficient and effective than a conventional exemplar-based NMF VC method. Conclusion: The proposed JD-NMF method may outperform the state-of-the-art exemplar-based NMF VC method in terms of STOI scores under the desired scenario. Significance: We confirmed the advantages of the proposed joint training criterion for the NMF-based VC. Moreover, we verified that the proposed JD-NMF can effectively improve the speech intelligibility scores of oral surgery patients. Objective: This paper focuses on machine learning based voice conversion (VC) techniques for improving the speech intelligibility of surgical patients who have had parts of their articulators removed. Because of the removal of parts of the articulator, a patient

  10. The South Asian Heart Lifestyle Intervention (SAHELI) study to improve cardiovascular risk factors in a community setting: design and methods.

    Science.gov (United States)

    Kandula, Namratha R; Patel, Yasin; Dave, Swapna; Seguil, Paola; Kumar, Santosh; Baker, David W; Spring, Bonnie; Siddique, Juned

    2013-11-01

    Disseminating and implementing evidence-based, cardiovascular disease (CVD) prevention lifestyle interventions in community settings and in ethnic minority populations is a challenge. We describe the design and methods for the South Asian Heart Lifestyle Intervention (SAHELI) study, a pilot study designed to determine the feasibility and initial efficacy of a culturally-targeted, community-based lifestyle intervention to improve physical activity and diet behaviors among medically underserved South Asians (SAs). Participants with at least one CVD risk factor will be randomized to either a lifestyle intervention or a control group. Participants in both groups will be screened in a community setting and receive a primary care referral after randomization. Intervention participants will receive 6weeks of group classes, followed by 12weeks of individual telephone support where they will be encouraged to initiate and maintain a healthy lifestyle goal. Control participants will receive their screening results and monthly mailings on CVD prevention. Primary outcomes will be changes in moderate/vigorous physical activity and saturated fat intake between baseline, 3-, and 6-month follow-up. Secondary outcomes will be changes in weight, clinical risk factors, primary care visits, self-efficacy, and social support. This study will be one of the first to pilot-test a lifestyle intervention for SAs, one of the fastest growing racial/ethnic groups in the U.S. and one with disparate CVD risk. Results of this pilot study will provide preliminary data about the efficacy of a lifestyle intervention on CVD risk in SAs and inform community-engaged CVD prevention efforts in an increasingly diverse U.S. population. © 2013.

  11. Improvement of macrophage dysfunction by administration of anti-transforming growth factor-beta antibody in EL4-bearing hosts.

    Science.gov (United States)

    Maeda, H; Tsuru, S; Shiraishi, A

    1994-11-01

    An experimental therapy for improvement of macrophage dysfunction caused by transforming growth factor-beta (TGF-beta) was tried in EL4 tumor-bearing mice. TGF-beta was detected in cell-free ascitic fluid from EL4-bearers, but not in that from normal mice, by western blot analysis. The ascites also showed growth-suppressive activity against Mv1Lu cells, and the suppressive activity was potentiated by transient acidification. To investigate whether the functions of peritoneal macrophages were suppressed in EL4-bearers, the abilities to produce nitric oxide and tumor necrosis factor-alpha (TNF-alpha) upon lipopolysaccharide (LPS) stimulation were measured. Both abilities of macrophages in EL4-bearing mice were suppressed remarkably on day 9, and decreased further by day 14, compared with non-tumor-bearing controls. TGF-beta activity was abrogated by administration of anti-TGF-beta antibody to EL4-bearing mice. While a large amount of TGF-beta was detected in ascitic fluid from control EL4-bearers, little TGF-beta was detectable in ascites from EL4-bearers given anti-TGF-beta antibody. Furthermore, while control macrophages exhibited little or no production of nitric oxide and TNF-alpha on LPS stimulation in vitro, macrophages from EL4-bearers administered with anti-TGF-beta antibody showed the same ability as normal macrophages. These results clearly indicate that TGF-beta contributes to macrophage dysfunction and that the administration of specific antibody for TGF-beta reverses macrophage dysfunction in EL4-bearing hosts.

  12. Ectopic Expression of Pumpkin NAC Transcription Factor CmNAC1 Improves Multiple Abiotic Stress Tolerance in Arabidopsis

    Directory of Open Access Journals (Sweden)

    Haishun Cao

    2017-11-01

    Full Text Available Drought, cold and salinity are the major environmental stresses that limit agricultural productivity. NAC transcription factors regulate the stress response in plants. Pumpkin (Cucurbita moschata is an important cucurbit vegetable crop and it has strong resistance to abiotic stress; however, the biological functions of stress-related NAC genes in this crop are largely unknown. This study reports the function of CmNAC1, a stress-responsive pumpkin NAC domain protein. The CmNAC1-GFP fusion protein was transiently expressed in tobacco leaves for subcellular localization analysis, and we found that CmNAC1 is localized in the nucleus. Transactivation assay in yeast cells revealed that CmNAC1 functions as a transcription activator, and its transactivation domain is located in the C-terminus. CmNAC1 was ubiquitously expressed in different organs, and its transcript was induced by salinity, cold, dehydration, H2O2, and abscisic acid (ABA treatment. Furthermore, the ectopic expression (EE of CmNAC1 in Arabidopsis led to ABA hypersensitivity and enhanced tolerance to salinity, drought and cold stress. In addition, five ABA-responsive elements were enriched in CmNAC1 promoter. The CmNAC1-EE plants exhibited different root architecture, leaf morphology, and significantly high concentration of ABA compared with WT Arabidopsis under normal conditions. Our results indicated that CmNAC1 is a critical factor in ABA signaling pathways and it can be utilized in transgenic breeding to improve the abiotic stress tolerance of crops.

  13. Color-coding and human factors engineering to improve patient safety characteristics of paper-based emergency department clinical documentation.

    Science.gov (United States)

    Kobayashi, Leo; Boss, Robert M; Gibbs, Frantz J; Goldlust, Eric; Hennedy, Michelle M; Monti, James E; Siegel, Nathan A

    2011-01-01

    Investigators studied an emergency department (ED) physical chart system and identified inconsistent, small font labeling; a single-color scheme; and an absence of human factors engineering (HFE) cues. A case study and description of the methodology with which surrogate measures of chart-related patient safety were studied and subsequently used to reduce latent hazards are presented. Medical records present a challenge to patient safety in EDs. Application of HFE can improve specific aspects of existing medical chart organization systems as they pertain to patient safety in acute care environments. During 10 random audits over 5 consecutive days (573 data points), 56 (9.8%) chart binders (range 0.0-23%) were found to be either misplaced or improperly positioned relative to other chart binders; 12 (21%) were in the critical care area. HFE principles were applied to develop an experimental chart binder system with alternating color-based chart groupings, simple and prominent identifiers, and embedded visual cues. Post-intervention audits revealed significant reductions in chart binder location problems overall (p < 0.01), for Urgent Care A and B pods (6.4% to 1.2%; p < 0.05), Fast Track C pod (19.3% to 0.0%; p < 0.05) and Behavioral/Substance Abuse D pod (15.7% to 0.0%; p < 0.05) areas of the ED. The critical care room area did not display an improvement (11.4% to 13.2%; p = 0.40). Application of HFE methods may aid the development, assessment, and modification of acute care clinical environments through evidence-based design methodologies and contribute to safe patient care delivery.

  14. Safety-factor profile tailoring by improved electron cyclotron system for sawtooth control and reverse shear scenarios in ITER

    International Nuclear Information System (INIS)

    Zucca, C.; Sauter, O.; Fable, E.; Henderson, M. A.; Polevoi, A.; Farina, D.; Ramponi, G.; Saibene, G.; Zohm, H.

    2008-01-01

    The effect of the predicted local electron cyclotron current driven by the optimized electron cyclotron system on ITER is discussed. A design variant was recently proposed to enlarge the physics program covered by the upper and equatorial launchers. By extending the functionality range of the upper launcher, significant control capabilities of the sawtooth period can be obtained. The upper launcher improvement still allows enough margin to exceed the requirements for neoclassical tearing mode stabilization, for which it was originally designed. The analysis of the sawtooth control is carried on with the ASTRA transport code, coupled with the threshold model by Por-celli, to study the control capabilities of the improved upper launcher on the sawtooth instability. The simulations take into account the significant stabilizing effect of the fusion alpha particles. The sawtooth period can be increased by a factor of 1.5 with co-ECCD outside the q = 1 surface, and decreased by at least 30% with co-ECCD inside q = 1. The present ITER base-line design has the electron cyclotron launchers providing only co-ECCD. The variant for the equatorial launcher proposes the possibility to drive counter-ECCD with 1 of the 3 rows of mirrors: the counter-ECCD can then be balanced with co-ECCD and provide pure ECH with no net driven current. The difference between full co-ECCD off-axis using all 20MW from the equatorial launcher and 20MW co-ECCD driven by 2/3 from the equatorial launcher and 1/3 from the upper launcher is shown to be negligible. Cnt-ECCD also offers greater control of the plasma current density, therefore this analysis addresses the performance of the equatorial launcher to control the central q profile. The equatorial launcher is shown to control very efficiently the value of q 0.2 -q min in advanced scenarios, if one row provides counter-ECCD.

  15. Epidermal growth factor improves survival and prevents intestinal injury in a murine model of pseudomonas aeruginosa pneumonia.

    Science.gov (United States)

    Dominguez, Jessica A; Vithayathil, Paul J; Khailova, Ludmila; Lawrance, Christopher P; Samocha, Alexandr J; Jung, Enjae; Leathersich, Ann M; Dunne, W Michael; Coopersmith, Craig M

    2011-10-01

    Mortality from pneumonia is mediated, in part, through extrapulmonary causes. Epidermal growth factor (EGF) has broad cytoprotective effects, including potent restorative properties in the injured intestine. The purpose of this study was to determine the efficacy of EGF treatment following Pseudomonas aeruginosa pneumonia. FVB/N mice underwent intratracheal injection of either P. aeruginosa or saline and were then randomized to receive either systemic EGF or vehicle beginning immediately or 24 h after the onset of pneumonia. Systemic EGF decreased 7-day mortality from 65% to 10% when initiated immediately after the onset of pneumonia and to 27% when initiated 24 h after the onset of pneumonia. Even though injury in pneumonia is initiated in the lungs, the survival advantage conferred by EGF was not associated with improvements in pulmonary pathology. In contrast, EGF prevented intestinal injury by reversing pneumonia-induced increases in intestinal epithelial apoptosis and decreases in intestinal proliferation and villus length. Systemic cytokines and kidney and liver function were unaffected by EGF therapy, although EGF decreased pneumonia-induced splenocyte apoptosis. To determine whether the intestine was sufficient to account for extrapulmonary effects induced by EGF, a separate set of experiments was done using transgenic mice with enterocyte-specific overexpression of EGF (IFABP-EGF [intestinal fatty acid-binding protein linked to mouse EGF] mice), which were compared with wild-type mice subjected to pneumonia. IFABP-EGF mice had improved survival compared with wild-type mice following pneumonia (50% vs. 28%, respectively, P < 0.05) and were protected from pneumonia-induced intestinal injury. Thus, EGF may be a potential adjunctive therapy for pneumonia, mediated in part by its effects on the intestine.

  16. Improving the quality factor of an RF spiral inductor with non-uniform metal width and non-uniform coil spacing

    International Nuclear Information System (INIS)

    Shen Pei; Zhang Wanrong; Huang Lu; Jin Dongyue; Xie Hongyun

    2011-01-01

    An improved inductor layout with non-uniform metal width and non-uniform spacing is proposed to increase the quality factor (Q factor). For this inductor layout, from outer coil to inner coil, the metal width is reduced by an arithmetic-progression step, while the metal spacing is increased by a geometric-progression step. An improved layout with variable width and changed spacing is of benefit to the Q factor of RF spiral inductor improvement (approximately 42.86%), mainly due to the suppression of eddy-current loss by weakening the current crowding effect in the center of the spiral inductor. In order to increase the Q factor further, for the novel inductor, a patterned ground shield is used with optimized layout together. The results indicate that, in the range of 0.5 to 16 GHz, the Q factor of the novel inductor is at an optimum, which improves by 67% more than conventional inductors with uniform geometry dimensions (equal width and equal spacing), is enhanced by nearly 23% more than a PGS inductor with uniform geometry dimensions, and improves by almost 20% more than an inductor with an improved layout. (semiconductor devices)

  17. Novel factor VIII variants with a modified furin cleavage site improve the efficacy of gene therapy for hemophilia A.

    Science.gov (United States)

    Nguyen, G N; George, L A; Siner, J I; Davidson, R J; Zander, C B; Zheng, X L; Arruda, V R; Camire, R M; Sabatino, D E

    2017-01-01

    Essentials Factor (F) VIII is an inefficiently expressed protein. Furin deletion FVIII variants were purified and characterized using in vitro and in vivo assays. These minimally modified novel FVIII variants have enhanced function. These variants provide a strategy for increasing FVIII expression in hemophilia A gene therapy. Background The major challenge for developing gene-based therapies for hemophilia A is that human factor VIII (hFVIII) has intrinsic properties that result in inefficient biosynthesis. During intracellular processing, hFVIII is predominantly cleaved at a paired basic amino acid cleaving enzyme (PACE) or furin cleavage site to yield a heterodimer that is the major form of secreted protein. Previous studies with B-domain-deleted (BDD) canine FVIII and hFVIII-R1645H, both differing from hFVIII by a single amino acid at this site, suggested that these proteins are secreted mainly in a single polypeptide chain (SC) form and exhibit enhanced function. Objective We hypothesized that deletion(s) of the furin site modulates FVIII biology and may enhance its function. Methods A series of recombinant hFVIII-furin deletion variants were introduced into hFVIII-BDD [Δ1645, 1645-46(Δ2), 1645-47(Δ3), 1645-48(Δ4), or Δ1648] and characterized. Results In vitro, recombinant purified Δ3 and Δ4 were primarily SC and, interestingly, had 2-fold higher procoagulant activity compared with FVIII-BDD. In vivo, the variants also have improved hemostatic function. After adeno-associated viral (AAV) vector delivery, the expression of these variants is 2-4-fold higher than hFVIII-BDD. Protein challenges of each variant in mice tolerant to hFVIII-BDD showed no anti-FVIII immune response. Conclusions These data suggest that the furin deletion hFVIII variants are superior to hFVIII-BDD without increased immunogenicity. In the setting of gene-based therapeutics, these novel variants provide a unique strategy to increase FVIII expression, thus lowering the vector dose, a

  18. Canagliflozin improves risk factors of metabolic syndrome in patients with type 2 diabetes mellitus and metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Davies MJ

    2017-01-01

    Full Text Available Michael J Davies,1 Katherine W Merton,1 Ujjwala Vijapurkar,2 Dainius A Balis,2 Mehul Desai2 1Janssen Scientific Affairs, LLC, Titusville, NJ, USA; 2Janssen Research & Development, LLC, Raritan, NJ, USA Objective: Metabolic syndrome refers to a collection of risk factors associated with the development of cardiovascular disease and type 2 diabetes mellitus (T2DM. Canagliflozin, a sodium glucose co-transporter 2 inhibitor, improves glycemic control and reduces body weight and blood pressure (BP in a broad range of patients with T2DM. This post hoc analysis assessed the effects of canagliflozin on the components of metabolic syndrome in patients with T2DM and metabolic syndrome.Methods: This analysis was based on data from 2 head-to-head studies of canagliflozin in patients with T2DM on background metformin versus glimepiride (study 1 and background metformin plus sulfonylurea versus sitagliptin 100 mg (study 2. Changes from baseline in glycemic efficacy, anthropometric measures, BP, and lipids were evaluated with canagliflozin versus glimepiride and sitagliptin at week 52 in patients who met ≥2 of the criteria for metabolic syndrome (in addition to T2DM: triglycerides ≥1.7 mmol/L; high-density lipoprotein cholesterol (HDL-C <1.0 mmol/L (men or <1.3 mmol/L (women; waist circumference ≥102 cm (non-Asian men, ≥88 cm (non-Asian women, >90 cm (Asian men, or >80 cm (Asian women; diagnosis of hypertension or meeting BP-related criteria (systolic BP ≥130 mmHg or diastolic BP ≥85 mmHg. Safety was assessed based on adverse event reports.Results: In study 1, canagliflozin 100 and 300 mg provided similar and greater HbA1c reductions versus glimepiride, respectively. In study 2, canagliflozin 300 mg provided greater HbA1c lowering versus sitagliptin 100 mg. Canagliflozin also reduced fasting plasma glucose, body weight, body mass index, waist circumference, BP, and triglycerides, and increased HDL-C and low-density lipoprotein cholesterol versus

  19. Factors associated with improved survival among older colorectal cancer patients in the US: a population-based analysis

    Directory of Open Access Journals (Sweden)

    Earle Craig C

    2009-07-01

    Full Text Available Abstract Background The purpose of this study was to estimate the relative impact of changes in demographics, stage at detection, treatment mix, and medical technology on 5-year survival among older colorectal cancer (CRC patients. Methods We selected older patients diagnosed with CRC between 1992 and 2000 from the SEER-Medicare database and followed them through 2005. Trends in demographic characteristics, stage at detection and initial treatment mix were evaluated descriptively. Separate multivariate logistic regression models for colon (CC and rectal cancer (RC patients were estimated to isolate the independent effects of these factors along with technological change (proxied by cohort year on 5-year survival. Results Our sample included 37,808 CC and 13,619 RC patients (combined mean ± SD age: 77.2 ± 7.0 years; 55% female; 87% white. In recent years, more CC patients were diagnosed at Stage I and fewer at Stages II and IV, and more RC patients were diagnosed at Stage I and fewer at Stages II and III. CC and RC patients diagnosed in later years were slightly older with somewhat better Charlson scores and were more likely to be female, from the Northeast, and from areas with higher average education levels. Surgery alone was more common in later years for CC patients while combined surgery, chemotherapy, and radiotherapy was more common for RC patients. Between 1992 and 2000, 5-year observed survival improved from 43.0% to 46.3% for CC patients and from 39.4% to 42.2% for RC patients. Multivariate logistic regressions indicate that patients diagnosed in 2000 had significantly greater odds of 5-year survival than those diagnosed in 1992 (OR: 1.35 for CC, 1.38 for RC. Our decomposition suggests that early detection had little impact on survival; rather, technological improvements (e.g., new medical technologies or more effective use of existing technologies and changing demographics were responsible for the largest share of the change in 5

  20. Fluoxetine Increases Hippocampal Neurogenesis and Induces Epigenetic Factors But Does Not Improve Functional Recovery after Traumatic Brain Injury

    Science.gov (United States)

    Wang, Yonggang; Neumann, Melanie; Hansen, Katharina; Hong, Shuwhey M.; Kim, Sharon; Noble-Haeusslein, Linda J.

    2011-01-01

    Abstract The selective serotonin reuptake inhibitor fluoxetine induces hippocampal neurogenesis, stimulates maturation and synaptic plasticity of adult hippocampal neurons, and reduces motor/sensory and memory impairments in several CNS disorders. In the setting of traumatic brain injury (TBI), its effects on neuroplasticity and function have yet to be thoroughly investigated. Here we examined the efficacy of fluoxetine after a moderate to severe TBI, produced by a controlled cortical impact. Three days after TBI or sham surgery, mice were treated with fluoxetine (10 mg/kg/d) or vehicle for 4 weeks. To evaluate the effects of fluoxetine on neuroplasticity, hippocampal neurogenesis and epigenetic modification were studied. Stereologic analysis of the dentate gyrus revealed a significant increase in doublecortin-positive cells in brain-injured animals treated with fluoxetine relative to controls, a finding consistent with enhanced hippocampal neurogenesis. Epigenetic modifications, including an increase in histone 3 acetylation and induction of methyl-CpG-binding protein, a transcription factor involved in DNA methylation, were likewise seen by immunohistochemistry and quantitative Western immunoblots, respectively, in brain-injured animals treated with fluoxetine. To determine if fluoxetine improves neurological outcomes after TBI, gait function and spatial learning and memory were assessed by the CatWalk-assisted gait test and Barnes maze test, respectively. No differences in these parameters were seen between fluoxetine- and vehicle-treated animals. Thus while fluoxetine enhanced neuroplasticity in the hippocampus after TBI, its chronic administration did not restore locomotor function or ameliorate memory deficits. PMID:21175261

  1. Decontamination factor Improvement and Waste Reduction of Full-scaled Evaporation System for Liquid Radioactive Waste Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ki Tae; Ju, Young Jong; Seol, Jeung Gun; Cho, Nam Chan [KNF, Daejeon (Korea, Republic of); Ha, Dong Hwan; Kim, Yun Kwan [Jeontech Co., Suwon (Korea, Republic of)

    2016-05-15

    Liquid radioactive waste is produced from nuclear power plants, nuclear research centers, radiopharmaceuticals and nuclear fuel fabrication plants, etc. Ion-exchange, chemical precipitation, evaporation, filtration, liquid/solid extraction and centrifugal are applied to treat the liquid waste. Chemical precipitation requires low capital and operation cost. However, it produces large amount of secondary waste and has low DF (decontamination factor). Evaporation process removes variety of radionuclides in high DF. But, it also has problems in scaling and foaming [3, 4]. In this study, it is investigated that the effect of switching lime precipitation and centrifugal processes to evaporation system for improvement of removal efficiency and decrease of waste in full-scaled radioactive wastewater treatment plant. By swapping full-scaled wastewater treatment system from the centrifugal and the lime precipitation to the evaporator and the crystallizer in the nuclear fuel fabrication plant, it was possible to increase removal efficiency and to minimize waste productivity. Radioactivity concentration of effluent is decreased from 0.01 Bq/mL to ND level. Besides, waste production was reduced from 15 drums/yr to 2 drums/yr (87%).

  2. Forward di-jet production in p+Pb collisions in the small-x improved TMD factorization framework

    Energy Technology Data Exchange (ETDEWEB)

    Hameren, A. van [The H. Niewodniczański Institute of Nuclear Physics PAN,Radzikowskiego 152, 31-342 Kraków (Poland); Kotko, P. [Department of Physics, Penn State University,University Park, 16803 PA (United States); Kutak, K. [The H. Niewodniczański Institute of Nuclear Physics PAN,Radzikowskiego 152, 31-342 Kraków (Poland); Marquet, C. [Centre de Physique Théorique, École Polytechnique,CNRS, Université Paris-Saclay,91128 Palaiseau (France); Petreska, E. [Centre de Physique Théorique, École Polytechnique,CNRS, Université Paris-Saclay,91128 Palaiseau (France); Departamento de Física de Partículas and IGFAE,Universidade de Santiago de Compostela,15782 Santiago de Compostela (Spain); Sapeta, S. [Theoretical Physics Department, CERN,Geneva (Switzerland); The H. Niewodniczański Institute of Nuclear Physics PAN,Radzikowskiego 152, 31-342 Kraków (Poland)

    2016-12-12

    We study the production of forward di-jets in proton-lead and proton-proton collisions at the Large Hadron Collider. Such configurations, with both jets produced in the forward direction, impose a dilute-dense asymmetry which allows to probe the gluon density of the lead or proton target at small longitudinal momentum fractions. Even though the jet momenta are always much bigger than the saturation scale of the target, Q{sub s}, the transverse momentum imbalance of the di-jet system may be either also much larger than Q{sub s}, or of the order Q{sub s}, implying that the small-x QCD dynamics involved is either linear or non-linear, respectively. The small-x improved TMD factorization framework deals with both situations in the same formalism. In the latter case, which corresponds to nearly back-to-back jets, we find that saturation effects induce a significant suppression of the forward di-jet azimuthal correlations in proton-lead versus proton-proton collisions.

  3. Improvements in scaling of counter-current imbibition recovery curves using a shape factor including permeability anisotropy

    Science.gov (United States)

    Abbasi, Jassem; Sarafrazi, Shiva; Riazi, Masoud; Ghaedi, Mojtaba

    2018-02-01

    Spontaneous imbibition is the main oil production mechanism in the water invaded zone of a naturally fractured reservoir (NFR). Different scaling equations have been presented in the literature for upscaling of core scale imbibition recovery curves to field scale matrix blocks. Various scale dependent parameters such as gravity effects and boundary influences are required to be considered in the upscaling process. Fluid flow from matrix blocks to the fracture system is highly dependent on the permeability value in the horizontal and vertical directions. The purpose of this study is to include permeability anisotropy in the available scaling equations to improve the prediction of imbibition assisted oil production in NFRs. In this paper, a commercial reservoir simulator was used to obtain imbibition recovery curves for different scenarios. Then, the effect of permeability anisotropy on imbibition recovery curves was investigated, and the weakness of the existing scaling equations for anisotropic rocks was demonstrated. Consequently, an analytical shape factor was introduced that can better scale all the curves related to anisotropic matrix blocks.

  4. Forward di-jet production in p+Pb collisions in the small-x improved TMD factorization framework

    CERN Document Server

    van Hameren, A.; Kutak, K.; Marquet, C.; Petreska, E.; Sapeta, S.

    2016-01-01

    We study the production of forward di-jets in proton-lead and proton-proton collisions at the Large Hadron Collider. Such configurations, with both jets produced in the forward direction, impose a dilute-dense asymmetry which allows to probe the gluon density of the lead or proton target at small longitudinal momentum fractions. Even though the jet momenta are always much bigger than the saturation scale of the target, $Q_s$, the transverse momentum imbalance of the di-jet system may be either also much larger than $Q_s$, or of the order $Q_s$, implying that the small-$x$ QCD dynamics involved is either linear or non-linear, respectively. The small-$x$ improved TMD factorization framework deals with both situation in the same formalism. In the latter case, which corresponds to nearly back-to-back jets, we find that saturation effects induce a significant suppression of the forward di-jet azimuthal correlations in proton-lead versus proton-proton collisions.

  5. Security Analysis and Improvements of Two-Factor Mutual Authentication with Key Agreement in Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Jiye Kim

    2014-04-01

    Full Text Available User authentication and key management are two important security issues in WSNs (Wireless Sensor Networks. In WSNs, for some applications, the user needs to obtain real-time data directly from sensors and several user authentication schemes have been recently proposed for this case. We found that a two-factor mutual authentication scheme with key agreement in WSNs is vulnerable to gateway node bypassing attacks and user impersonation attacks using secret data stored in sensor nodes or an attacker’s own smart card. In this paper, we propose an improved scheme to overcome these security weaknesses by storing secret data in unique ciphertext form in each node. In addition, our proposed scheme should provide not only security, but also efficiency since sensors in a WSN operate with resource constraints such as limited power, computation, and storage space. Therefore, we also analyze the performance of the proposed scheme by comparing its computation and communication costs with those of other schemes.

  6. Ethacrynic acid improves the antitumor effects of irreversible epidermal growth factor receptor tyrosine kinase inhibitors in breast cancer.

    Science.gov (United States)

    Liu, Bing; Huang, XinPing; Hu, YunLong; Chen, TingTing; Peng, BoYa; Gao, NingNing; Jin, ZhenChao; Jia, TieLiu; Zhang, Na; Wang, ZhuLin; Jin, GuangYi

    2016-09-06

    Prolonged treatment of breast cancer with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) often results in acquired resistance and a narrow therapeutic index. One strategy to improve the therapeutic effects of EGFR TKIs is to combine them with drugs used for other clinical indications. Ethacrynic acid (EA) is an FDA approved drug that may have antitumor effects and may enhance the cytotoxicity of chemotherapeutic agents by binding to glutathione and inhibiting WNT signaling. While the α,β-unsaturated-keto structure of EA is similar to that of irreversible TKIs, the mechanism of action of EA when combined with irreversible EGFR TKIs in breast cancer remains unknown. We therefore investigated the combination of irreversible EGFR TKIs and EA. We found that irreversible EGFR TKIs and EA synergistically inhibit breast cancer both in vitro and in vivo. The combination of EGFR TKIs and EA induces necrosis and cell cycle arrest and represses WNT/β-catenin signaling as well as MAPK-ERK1/2 signaling. We conclude that EA synergistically enhances the antitumor effects of irreversible EGFR TKIs in breast cancer.

  7. Simultaneous improvement in short circuit current, open circuit voltage, and fill factor of polymer solar cells through ternary strategy.

    Science.gov (United States)

    An, Qiaoshi; Zhang, Fujun; Li, Lingliang; Wang, Jian; Sun, Qianqian; Zhang, Jian; Tang, Weihua; Deng, Zhenbo

    2015-02-18

    We present a smart strategy to simultaneously increase the short circuit current (Jsc), the open circuit voltage (Voc), and the fill factor (FF) of polymer solar cells (PSCs). A two-dimensional conjugated small molecule photovoltaic material (SMPV1), as the second electron donor, was doped into the blend system of poly(3-hexylthiophene) (P3HT) and [6,6]-phenyl-C71-butyric acid methyl (PC71BM) to form ternary PSCs. The ternary PSCs with 5 wt % SMPV1 doping ratio in donors achieve 4.06% champion power conversion efficiency (PCE), corresponding to about 21.2% enhancement compared with the 3.35% PCE of P3HT:PC71BM-based PSCs. The underlying mechanism on performance improvement of ternary PSCs can be summarized as (i) harvesting more photons in the longer wavelength region to increase Jsc; (ii) obtaining the lower mixed highest occupied molecular orbital (HOMO) energy level by incorporating SMPV1 to increase Voc; (iii) forming the better charge carrier transport channels through the cascade energy level structure and optimizing phase separation of donor/acceptor materials to increase Jsc and FF.

  8. Stroke acute management with urgent risk-factor assessment and improvement (SAMURAI) rt-PA registry. General results and subanalyses

    International Nuclear Information System (INIS)

    Toyoda, Kazunori; Koga, Masatoshi; Shiokawa, Yoshiaki

    2010-01-01

    Stroke Acute Management with Urgent Risk-factor Assessment and Improvement [SAMURAI] rt-PA Registry is a multicenter retrospective observational study from 10 Japanese stroke centers. A total of 600 patients (223 women, 72±12 years old) treated with intravenous alteplase (0.6 mg/kg) were studied. Symptomatic intracerebral hemorrhage within 36 hours with ≥4 point-increase from the baseline National Institutes of Health (NIH) Stroke Scale score developed in 8 patients (1.3%, 95% confidence interval (CI) 0.7-2.6%). At 3 months, 199 patients (33.2%, 29.5-37.0%) had a modified Rankin Scale (mRS) score ≤1. Analysis of 399 patients with a premorbid mRS score ≤1 who met the criteria of the European license (≤80 years old, an initial NIHSS score ≤24, etc.) showed that 40.6% (35.9-45.5%) had a 3-month mRS ≤1. In the subanalyses from this registry, early ischemic change on diffusion-weighted imaging assessed by the Alberta Stroke Programme Early CT Score, as well as reduced estimated glomerular filtration rate, was associated with early intracerebral hemorrhage and 3-month outcomes of patients. (author)

  9. Stroke acute management with urgent risk-factor assessment and improvement (SAMURAI) rt-PA registry. General results and subanalyses

    Energy Technology Data Exchange (ETDEWEB)

    Toyoda, Kazunori; Koga, Masatoshi [National Cerebral and Cardiovascular Center, Suita, Osaka (Japan); Shiokawa, Yoshiaki [Kyorin Univ., School of Medicine, Mitaka, Tokyo (Japan)

    2010-11-15

    Stroke Acute Management with Urgent Risk-factor Assessment and Improvement [SAMURAI] rt-PA Registry is a multicenter retrospective observational study from 10 Japanese stroke centers. A total of 600 patients (223 women, 72{+-}12 years old) treated with intravenous alteplase (0.6 mg/kg) were studied. Symptomatic intracerebral hemorrhage within 36 hours with {>=}4 point-increase from the baseline National Institutes of Health (NIH) Stroke Scale score developed in 8 patients (1.3%, 95% confidence interval (CI) 0.7-2.6%). At 3 months, 199 patients (33.2%, 29.5-37.0%) had a modified Rankin Scale (mRS) score {<=}1. Analysis of 399 patients with a premorbid mRS score {<=}1 who met the criteria of the European license ({<=}80 years old, an initial NIHSS score {<=}24, etc.) showed that 40.6% (35.9-45.5%) had a 3-month mRS {<=}1. In the subanalyses from this registry, early ischemic change on diffusion-weighted imaging assessed by the Alberta Stroke Programme Early CT Score, as well as reduced estimated glomerular filtration rate, was associated with early intracerebral hemorrhage and 3-month outcomes of patients. (author)

  10. Improved Insulin Sensitivity despite Increased Visceral Adiposity in Mice Deficient for the Immune Cell Transcription Factor T-bet

    Science.gov (United States)

    Stolarczyk, Emilie; Vong, Chi Teng; Perucha, Esperanza; Jackson, Ian; Cawthorne, Michael A.; Wargent, Edward T.; Powell, Nick; Canavan, James B.; Lord, Graham M.; Howard, Jane K.

    2013-01-01

    Summary Low-grade inflammation in fat is associated with insulin resistance, although the mechanisms are unclear. We report that mice deficient in the immune cell transcription factor T-bet have lower energy expenditure and increased visceral fat compared with wild-type mice, yet paradoxically are more insulin sensitive. This striking phenotype, present in young T-bet−/− mice, persisted with high-fat diet and increasing host age and was associated with altered immune cell numbers and cytokine secretion specifically in visceral adipose tissue. However, the favorable metabolic phenotype observed in T-bet-deficient hosts was lost in T-bet−/− mice also lacking adaptive immunity (T-bet−/−xRag2−/−), demonstrating that T-bet expression in the adaptive rather than the innate immune system impacts host glucose homeostasis. Indeed, adoptive transfer of T-bet-deficient, but not wild-type, CD4+ T cells to Rag2−/− mice improved insulin sensitivity. Our results reveal a role for T-bet in metabolic physiology and obesity-associated insulin resistance. PMID:23562076

  11. The sunflower transcription factor HaHB11 improves yield, biomass and tolerance to flooding in transgenic Arabidopsis plants.

    Science.gov (United States)

    Cabello, Julieta V; Giacomelli, Jorge I; Piattoni, Claudia V; Iglesias, Alberto A; Chan, Raquel L

    2016-03-20

    HaHB11 is a member of the sunflower homeodomain-leucine zipper I subfamily of transcription factors. The analysis of a sunflower microarray hybridized with RNA from HaHB11-transformed leaf-disks indicated the regulation of many genes encoding enzymes from glycolisis and fermentative pathways. A 1300bp promoter sequence, fused to the GUS reporter gene, was used to transform Arabidopsis plants showing an induction of expression after flooding treatments, concurrently with HaHB11 regulation by submergence in sunflower. Arabidopsis transgenic plants expressing HaHB11 under the control of the CaMV 35S promoter and its own promoter were obtained and these plants exhibited significant increases in rosette and stem biomass. All the lines produced more seeds than controls and particularly, those of high expression level doubled seeds yield. Transgenic plants also showed tolerance to flooding stress, both to submergence and waterlogging. Carbohydrates contents were higher in the transgenics compared to wild type and decreased less after submergence treatments. Finally, transcript levels of selected genes involved in glycolisis and fermentative pathways as well as the corresponding enzymatic activities were assessed both, in sunflower and transgenic Arabidopsis plants, before and after submergence. Altogether, the present work leads us to propose HaHB11 as a biotechnological tool to improve crops yield, biomass and flooding tolerance. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Development of Improved Graphical Displays for an Advanced Outage Control Center, Employing Human Factors Principles for Outage Schedule Management

    Energy Technology Data Exchange (ETDEWEB)

    St Germain, Shawn Walter [Idaho National Lab. (INL), Idaho Falls, ID (United States); Farris, Ronald Keith [Idaho National Lab. (INL), Idaho Falls, ID (United States); Thomas, Kenneth David [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-09-01

    The long-term viability of existing nuclear power plants in the United States (U.S.) is dependent upon a number of factors, including maintaining high capacity factors, maintaining nuclear safety, and reducing operating costs, particularly those associated with refueling outages. Refueling outages typically take 20-30 days, and for existing light water NPPs in the U.S., the reactor cannot be in operation during the outage. Furthermore, given that many NPPs generate between $1-1.5 million/day in revenue when in operation, there is considerable interest in shortening the length of refueling outages. Yet refueling outages are highly complex operations, involving multiple concurrent and dependent activities that are somewhat challenging to coordinate; therefore, finding ways to improve refueling outage performance, while maintaining nuclear safety has proven to be difficult. The Advanced Outage Control Center (AOCC) project is a research and development (R&D) demonstration activity under the LWRS Program. LWRS is an R&D program that works closely with industry R&D programs to establish technical foundations for the licensing and managing of long-term, safe, and economical operation of current fleet of NPPs. As such, the LWRS Advanced Outage Control Center project has the goal of improving the management of commercial NPP refueling outages. To accomplish this goal, INL is developing an advanced outage control center (OCC) that is specifically designed to maximize the usefulness of communication and collaboration technologies for outage coordination and problem resolution activities. The overall focus is on developing an AOCC with the following capabilities that enables plant and OCC staff to; Collaborate in real-time to address emergent issues; Effectively communicate outage status to all workers involved in the outage; Effectively communicate discovered conditions in the field to the OCC; Provide real-time work status; Provide automatic pending support notifications

  13. Development of Improved Graphical Displays for an Advanced Outage Control Center, Employing Human Factors Principles for Outage Schedule Management

    International Nuclear Information System (INIS)

    St Germain, Shawn Walter; Farris, Ronald Keith; Thomas, Kenneth David

    2015-01-01

    The long-term viability of existing nuclear power plants in the United States (U.S.) is dependent upon a number of factors, including maintaining high capacity factors, maintaining nuclear safety, and reducing operating costs, particularly those associated with refueling outages. Refueling outages typically take 20-30 days, and for existing light water NPPs in the U.S., the reactor cannot be in operation during the outage. Furthermore, given that many NPPs generate between $1-1.5 million/day in revenue when in operation, there is considerable interest in shortening the length of refueling outages. Yet refueling outages are highly complex operations, involving multiple concurrent and dependent activities that are somewhat challenging to coordinate; therefore, finding ways to improve refueling outage performance, while maintaining nuclear safety has proven to be difficult. The Advanced Outage Control Center (AOCC) project is a research and development (R&D) demonstration activity under the LWRS Program. LWRS is an R&D program that works closely with industry R&D programs to establish technical foundations for the licensing and managing of long-term, safe, and economical operation of current fleet of NPPs. As such, the LWRS Advanced Outage Control Center project has the goal of improving the management of commercial NPP refueling outages. To accomplish this goal, INL is developing an advanced outage control center (OCC) that is specifically designed to maximize the usefulness of communication and collaboration technologies for outage coordination and problem resolution activities. The overall focus is on developing an AOCC with the following capabilities that enables plant and OCC staff to; Collaborate in real-time to address emergent issues; Effectively communicate outage status to all workers involved in the outage; Effectively communicate discovered conditions in the field to the OCC; Provide real-time work status; Provide automatic pending support notifications

  14. Enhanced systems for measuring and monitoring REDD+: Opportunities to improve the accuracy of emission factor and activity data in Indonesia

    Science.gov (United States)

    Solichin

    the existing local equations, with lower bias and higher precision of the AGB estimates. This study also highlights the potential advantages and challenges of using terrestrial lidar and the acoustic velocity tool for non-destructive sampling of tree biomass to enable more sample collection without the felling of trees. Further, I explored whether existing forest inventories and permanent sample plot datasets can be integrated into Indonesia's existing carbon accounting system. My investigation of these existing datasets found that through quality assurance tests these datasets are essential to be integrated into national and provincial forest monitoring and carbon accounting systems. Integration of this information would eventually improve the accuracy of the estimates of forest carbon stocks, biomass growth, mortality and emission factors from deforestation and forest degradation. At landscape scale, this study demonstrates the capability of airborne lidar for forest monitoring and forest cover classification in tropical peat swamp ecosystems. The mapping application using airborne lidar showed a more accurate and precise classification of land and forest cover when compared with mapping using optical and active sensors. To reduce the cost of lidar acquisition, this study assessed the optimum lidar return density for forest monitoring. I found that the density of lidar return could be reduced to at least 1 return per 4 m2. Overall, this study provides essential scientific background to improve the accuracy of forest AGB estimates. Therefore, the described results and techniques should be integrated into the existing monitoring systems to assess emission reduction targets and the impact of REDD+ implementation.

  15. Improving medication safety and cardiovascular risk factor control to mitigate disparities in African-American kidney transplant recipients: Design and methods

    Directory of Open Access Journals (Sweden)

    Andrew J. Cole

    2018-03-01

    Full Text Available There is a lack of data analyzing the influence of cardiovascular disease (CVD risk factor control on graft survival disparities in African-American kidney transplant recipients. Studies in the general population indicate that CVD risk factor control is poor in African-Americans, leading to higher rates of renal failure and major acute cardiovascular events. However, with the exception of hypertension, there is no data demonstrating similar results within transplant recipients. Recent analyses conducted by our investigator group indicate that CVD risk factors, especially diabetes, are poorly controlled in African-American recipients, which likely impacts graft loss. This study protocol describes a prospective interventional clinical trial with the goal of demonstrating improved medication safety and CVD risk factor control in adult solitary kidney transplant recipients at least one-year post-transplant with a functioning graft. This is a prospective, interventional, 6-month, pharmacist-led and technology enabled study in adult kidney transplant recipients with the goal of improving CVD risk factor outcomes by improving medication safety and patient self-efficacy. This papers describes the issues related to racial disparities in transplant, the details of this intervention and how we expect this intervention to improve CVD risk factor control in kidney transplant recipients, particularly within African-Americans.

  16. A SCHOOL-BASED INTERVENTION PROGRAM FOR IMPROVING THE RISK FACTORS FOR CARDIOVASCULAR DISEASE AT AGES 12 TO 16.

    Directory of Open Access Journals (Sweden)

    Konstantinos Laparidis

    2010-06-01

    Full Text Available Background. Cardiovascular disease begins in childhood and this can be correlated with the presence of risk factors in adults. It is reasonable to initiate healthful lifestyle training in childhood to promote improved cardiovascular health in adult life. The purpose of the study was to evaluate the effectiveness of a school-basedprogram designed to reduce specific modifiable risk factors for preventing cardiovascular diseases.Methods. The sample was 343 students (160 boys, 183 girls aged 12–16 years from the prefecture of Larissa, Greece. The duration of intervention was 1 school year. The practical part of intervention took place during the class of physical education, while the theoretical part took place in the classroom. Measurements weretaken at the beginning, in the middle and at the end of the intervention. The following parameters were measured: weight, height, blood pressure, heart rate, components of the Healthy Eating Index, VO2max,Fitnessgram test battery (1 mile run-walk, trunk lift, push up, curl up, back saver sit and reach.Results. There were significant differences between the school-groups in the 1 mile run walk (p<0,001,90o push up test (p<0,001, Healthy Eating Index (p<0,001, fruit component (p<0,001, saturated fat intake(p<0,05 and variety component (p<0,001. In the intervention group there was significant increase in VO2max(p<0,05, in the weight (p<0,001, in the Healthy Eating Index (p<0,05, in the trunk lift test (p<0,001, in the push up test (p<0,05, in the sit and reach test (p<0,001 and in the component of fruits (p<0,001, while there was significant reduction in the 1 mile run walk test (p<0,001, in the body mass index (p<0,05 and in the component of saturated fat (p<0,05.Conclusion. The intervention program was successfully implemented in schools and there were many significant and positive effects. These results highlight the importance of multicomponent programs for theprevention of CVD in schools. Additional

  17. Building school-wide capacity for improvement: the role of leadership, school organizational conditions, and teacher factors

    NARCIS (Netherlands)

    Thoonen, E.E.J.; Sleegers, P.J.C.; Oort, F.J.; Peetsma, T.T.D.

    2012-01-01

    Education policies for greater accountability of schools assume that schools are capable of building their capacity for continuous improvement. While policy-makers, scholars, and practitioners acknowledge the importance of building school-wide capacity for continuous improvement, empirical evidence

  18. Building school-wide capacity for improvement: the role of leadership, school organizational conditions and teacher factors

    NARCIS (Netherlands)

    Thoonen, E.E.J.; Thoonen, E.E.J.; Sleegers, P.J.C.; Oort, F.J.; Peetsma, T.T.D.

    2012-01-01

    Education policies for greater accountability of schools assume that schools are capable of building their capacity for continuous improvement. While policy-makers, scholars, and practitioners acknowledge the importance of building school-wide capacity for continuous improvement, empirical evidence

  19. Hypoxia-Inducible Factor Pathway Inhibition Resolves Tumor Hypoxia and Improves Local Tumor Control After Single-Dose Irradiation

    International Nuclear Information System (INIS)

    Helbig, Linda; Koi, Lydia; Brüchner, Kerstin; Gurtner, Kristin; Hess-Stumpp, Holger; Unterschemmann, Kerstin; Pruschy, Martin

    2014-01-01

    Purpose: To study the effects of BAY-84-7296, a novel orally bioavailable inhibitor of mitochondrial complex I and hypoxia-inducible factor 1 (HIF-1) activity, on hypoxia, microenvironment, and radiation response of tumors. Methods and Materials: UT-SCC-5 and UT-SCC-14 human squamous cell carcinomas were transplanted subcutaneously in nude mice. When tumors reached 4 mm in diameter BAY-84-7296 (Bayer Pharma AG) or carrier was daily administered to the animals. At 7 mm tumors were either excised for Western blot and immunohistologic investigations or were irradiated with single doses. After irradiation animals were randomized to receive BAY-84-7296 maintenance or carrier. Local tumor control was evaluated 150 days after irradiation, and the dose to control 50% of tumors (TCD 50 ) was calculated. Results: BAY-84-7296 decreased nuclear HIF-1α expression. Daily administration of inhibitor for approximately 2 weeks resulted in a marked decrease of pimonidazole hypoxic fraction in UT-SCC-5 (0.5% vs 21%, P 50 , with an enhancement ratio of 1.37 (95% confidence interval [CI] 1.13-1.72) in UT-SCC-5 and of 1.55 (95% CI 1.26-1.94) in UT-SCC-14. BAY-84-7296 maintenance after irradiation did not further decrease TCD 50 . Conclusions: BAY-84-7296 resulted in a marked decrease in tumor hypoxia and substantially reduced radioresistance of tumor cells with the capacity to cause a local recurrence after irradiation. The data suggest that reduction of cellular hypoxia tolerance by BAY-84-7296 may represent the primary biological mechanism underlying the observed enhancement of radiation response. Whether this mechanism contributes to the improved outcome of fractionated chemoradiation therapy warrants further investigation

  20. Locomotor activity of rats with SCI is improved by dexmedetomidine by targeting the expression of inflammatory factors.

    Science.gov (United States)

    Wang, Wei-Guo; Wang, Lin; Jiao, Zhen-Hua; Xue, Bin; Xu, Zhan-Wang

    2018-04-26

    Dexmedetomidine, a well‑known selective α‑2 adrenoceptor agonist, inhibits the apoptosis of neurons and protects other organs from oxidative damage. In the present study, the effect of dexmedetomidine on spinal cord injury (SCI) in a rat model was investigated. The SCI rat model was prepared using the weight‑drop method, and the effect of dexmedetomidine on locomotor activity was analyzed using the Basso, Beattie and Bresnahan (BBB) rating scale. Western blot analysis was used to observe changes in the expression of apoptosis‑related proteins, including B‑cell lymphoma 2 (Bcl‑2) and Bcl‑2‑associated X protein (Bax). The results revealed that treatment of the SCI rats with dexmedetomidine at a dose of 50 mg/kg significantly prevented the formation of edema in the tissues of the spinal cord. Dexmedetomidine also inhibited the SCI‑induced accumulation of neutrophils in the spinal cord. The BBB scores were significantly increased (PSCI treated with dexmedetomidine after 10 days. The results of grid walking test revealed a marked decrease in the number of missteps following 10 days of dexmedetomidine treatment. The expression levels of tumor necrosis factor (TNF)‑α and interleukin (IL)‑1β were significantly reduced (PSCI exerted an inhibitory effect on the SCI‑induced increase in the expression of Bax. The expression of Bcl‑2 was increased in the dexmedetomidine treated rats, compared with that in the control group. Taken together, dexmedetomidine improved the locomotor activity of the rats through the inhibition of edema, reduction in the expression levels of TNF‑α and IL‑1β, and inhibition of the induction of apoptosis. Therefore, dexmedetomidine may be of therapeutic importance for patients with SCI.

  1. Identification and overexpression of a Knotted1-like transcription factor in switchgrass (Panicum virgatum L. for lignocellulosic feedstock improvement

    Directory of Open Access Journals (Sweden)

    Wegi eWuddineh

    2016-04-01

    Full Text Available High biomass production and wide adaptation has made switchgrass (Panicum virgatum L. an important candidate lignocellulosic bioenergy crop. One major limitation of this and other lignocellulosic feedstocks is the recalcitrance of complex carbohydrates to hydrolysis for conversion to biofuels. Lignin is the major contributor to recalcitrance as it limits the accessibility of cell wall carbohydrates to enzymatic breakdown into fermentable sugars. Therefore, genetic manipulation of the lignin biosynthesis pathway is one strategy to reduce recalcitrance. Here, we identified a switchgrass Knotted1 transcription factor, PvKN1, with the aim of genetically engineering switchgrass for reduced biomass recalcitrance for biofuel production. Gene expression of the endogenous PvKN1 gene was observed to be highest in young inflorescences and stems. Ectopic overexpression of PvKN1 in switchgrass altered growth, especially in early developmental stages. Transgenic lines had reduced expression of most lignin biosynthetic genes accompanied by a reduction in lignin content suggesting the involvement of PvKN1 in the broad regulation of the lignin biosynthesis pathway. Moreover, the reduced expression of the Gibberellin 20-oxidase (GA20ox gene in tandem with the increased expression of Gibberellin 2-oxidase (GA2ox genes in transgenic PvKN1 lines suggest that PvKN1 may exert regulatory effects via modulation of GA signalling. Furthermore, overexpression of PvKN1 altered the expression of cellulose and hemicellulose biosynthetic genes and increased sugar release efficiency in transgenic lines. Our results demonstrated that switchgrass PvKN1 is a putative ortholog of maize KN1 that is linked to plant lignification and cell wall and development traits as a major regulatory gene. Therefore, targeted overexpression of PvKN1 in bioenergy feedstocks may provide one feasible strategy for reducing biomass recalcitrance and simultaneously improving plant growth characteristics.

  2. Improving Fall Risk Factor Identification and Documentation of Risk Reduction Strategies by Rehabilitation Therapists through Continuing Education

    Science.gov (United States)

    Karnes, Michele J.

    2011-01-01

    This static group comparison study determined that an educational intervention was effective in increasing fall risk factor assessment, documentation of fall risk factors, and strategies devised to reduce fall risk factors by rehabilitation therapists for their older adult outpatients in clinics. Results showed that experimental group identified…

  3. The effects of improved metabolic risk factors on bone turnover markers after 12 weeks of simvastatin treatment with or without exercise.

    Science.gov (United States)

    Jiang, Jun; Boyle, Leryn J; Mikus, Catherine R; Oberlin, Douglas J; Fletcher, Justin A; Thyfault, John P; Hinton, Pamela S

    2014-11-01

    Emerging evidence supports an association between metabolic risk factors and bone turnover. Statins and exercise independently improve metabolic risk factors; however whether improvements in metabolic risk factor affects bone turnover is unknown. The purpose of the present study was to: 1) evaluate the relationship between metabolic risk factors and bone turnover; and 2) determine if improvements in metabolic risk factors after 12 weeks of statin treatment, exercise or the combination affect bone turnover. Fifty participants with ≥2 metabolic syndrome defining characteristics were randomly assigned to one of three groups: statin (STAT: simvastatin, 40 mg/day), exercise (EX: brisk walking and/or slow jogging, 45 minutes/day, 5 days/week), or the combination (STAT+EX). Body composition and whole body bone mineral density were measured with dual energy X-ray absorptiometry. Serum markers of bone formation (bone specific alkaline phosphatase, BAP; osteocalcin, OC), resorption (C-terminal peptide of type I collagen, CTX) and metabolic risk factors were determined. Two-factor (time, group) repeated-measures ANCOVA was used to examine changes of metabolic risk factors and bone turnover. General linear models were used to determine the effect of pre-treatment metabolic risk factors on post-treatment bone turnover marker outcomes. Participants with ≥4 metabolic syndrome defining characteristics had lower pre-treatment OC than those with 3 or fewer. OC was negatively correlated with glucose, and CTX was positively correlated with cholesterol. STAT or STAT+EX lowered total and LDL cholesterol. The OC to CTX ratio decreased in all groups with no other significant changes in bone turnover. Higher pre-treatment insulin or body fat predicted a greater CTX reduction and a greater BAP/CTX increase. Metabolic risk factors were negatively associated with bone turnover markers. Short-term statin treatment with or without exercise lowered cholesterol and all treatments had a small

  4. Longitudinal Household Trends in Access to Improved Water Sources and Sanitation in Chi Linh Town, Hai Duong Province, Viet Nam and Associated Factors.

    Science.gov (United States)

    Tuyet-Hanh, Tran Thi; Long, Tran Khanh; Van Minh, Hoang; Huong, Le Thi Thanh

    2016-01-01

    This study aims to characterize household trends in access to improved water sources and sanitaton in Chi Linh Town, Hai Duong Province, Vietnam, and to identify factors affecting those trends. Data were extracted from the Chi Linh Health and Demographic Surveillance System (CHILILAB HDSS) database from 2004-2014, which included household access to improved water sources, household access to improved sanitation, and household demographic data. Descriptive statistical analysis and multinominal logistic regression were used. The results showed that over a 10-year period (2004-2014), the proportion of households with access to improved water and improved sanitation increased by 3.7% and 28.3%, respectively. As such, the 2015 Millennium Development Goal targets for safe drinking water and basic sanitation were met. However, 13.5% of households still had unimproved water and sanitation. People who are retired, work in trade or services, or other occupations were 1.49, 1.97, and 1.34 times more likely to have access to improved water and sanitation facilities than farming households, respectively ( p < 0.001). Households living in urban areas were 1.84 times more likely than those living in rural areas to have access to improved water sources and improved sanitation facilities (OR =1.84; 95% CI = 1.73-1.96). Non-poor households were 2.12 times more likely to have access to improved water sources and improved sanitation facilities compared to the poor group (OR = 2.12; 95% CI = 2.00-2.25). More efforts are required to increase household access to both improved water and sanitation in Chi Linh Town, focusing on the 13.5% of households currently without access. Similar to situations observed elsewhere in Vietnam and other low- and middle- income countries, there is a need to address socio-economic factors that are associated with inadequate access to improved water sources and sanitation facilities.

  5. Longitudinal Household Trends in Access to Improved Water Sources and Sanitation in Chi Linh Town, Hai Duong Province, Viet Nam and Associated Factors

    Directory of Open Access Journals (Sweden)

    Tran Thi Tuyet-Hanh

    2016-10-01

    Full Text Available Objective: This study aims to characterize household trends in access to improved water sources and sanitaton in Chi Linh Town, Hai Duong Province, Vietnam, and to identify factors affecting those trends. Method: Data were extracted from the Chi Linh Health and Demographic Surveillance System (CHILILAB HDSS database from 2004–2014, which included household access to improved water sources, household access to improved sanitation, and household demographic data. Descriptive statistical analysis and multinominal logistic regression were used. The results showed that over a 10-year period (2004–2014, the proportion of households with access to improved water and improved sanitation increased by 3.7% and 28.3%, respectively. As such, the 2015 Millennium Development Goal targets for safe drinking water and basic sanitation were met. However, 13.5% of households still had unimproved water and sanitation. People who are retired, work in trade or services, or other occupations were 1.49, 1.97, and 1.34 times more likely to have access to improved water and sanitation facilities than farming households, respectively (p < 0.001. Households living in urban areas were 1.84 times more likely than those living in rural areas to have access to improved water sources and improved sanitation facilities (OR =1.84; 95% CI = 1.73–1.96. Non-poor households were 2.12 times more likely to have access to improved water sources and improved sanitation facilities compared to the poor group (OR = 2.12; 95% CI = 2.00–2.25. More efforts are required to increase household access to both improved water and sanitation in Chi Linh Town, focusing on the 13.5% of households currently without access. Similar to situations observed elsewhere in Vietnam and other low- and middle- income countries, there is a need to address socio-economic factors that are associated with inadequate access to improved water sources and sanitation facilities.

  6. Hypoxia-Inducible Factor Pathway Inhibition Resolves Tumor Hypoxia and Improves Local Tumor Control After Single-Dose Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Helbig, Linda [OncoRay–National Center for Radiation Research in Oncology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden (Germany); Department of Radiation Oncology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden (Germany); Koi, Lydia [OncoRay–National Center for Radiation Research in Oncology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden (Germany); Department of Radiation Oncology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden (Germany); Deutsches Konsortium für Translationale Krebsforschung, Site Dresden, Dresden (Germany); Brüchner, Kerstin [Department of Radiation Oncology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden (Germany); Institute of Radiooncology Helmholtz-Zentrum Dresden-Rossendorf, Dresden (Germany); Gurtner, Kristin [Department of Radiation Oncology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden (Germany); Hess-Stumpp, Holger; Unterschemmann, Kerstin [Global Drug Discovery, Bayer Pharma, Berlin (Germany); Pruschy, Martin [Radiation Oncology, University of Zurich, Zurich (Switzerland); and others

    2014-01-01

    Purpose: To study the effects of BAY-84-7296, a novel orally bioavailable inhibitor of mitochondrial complex I and hypoxia-inducible factor 1 (HIF-1) activity, on hypoxia, microenvironment, and radiation response of tumors. Methods and Materials: UT-SCC-5 and UT-SCC-14 human squamous cell carcinomas were transplanted subcutaneously in nude mice. When tumors reached 4 mm in diameter BAY-84-7296 (Bayer Pharma AG) or carrier was daily administered to the animals. At 7 mm tumors were either excised for Western blot and immunohistologic investigations or were irradiated with single doses. After irradiation animals were randomized to receive BAY-84-7296 maintenance or carrier. Local tumor control was evaluated 150 days after irradiation, and the dose to control 50% of tumors (TCD{sub 50}) was calculated. Results: BAY-84-7296 decreased nuclear HIF-1α expression. Daily administration of inhibitor for approximately 2 weeks resulted in a marked decrease of pimonidazole hypoxic fraction in UT-SCC-5 (0.5% vs 21%, P<.0001) and in UT-SCC-14 (0.3% vs 19%, P<.0001). This decrease was accompanied by a significant increase in fraction of perfused vessels in UT-SCC-14 but not in UT-SCC-5. Bromodeoxyuridine and Ki67 labeling indices were significantly reduced only in UT-SCC-5. No significant changes were observed in vascular area or necrosis. BAY-84-7296 before single-dose irradiation significantly decreased TCD{sub 50}, with an enhancement ratio of 1.37 (95% confidence interval [CI] 1.13-1.72) in UT-SCC-5 and of 1.55 (95% CI 1.26-1.94) in UT-SCC-14. BAY-84-7296 maintenance after irradiation did not further decrease TCD{sub 50}. Conclusions: BAY-84-7296 resulted in a marked decrease in tumor hypoxia and substantially reduced radioresistance of tumor cells with the capacity to cause a local recurrence after irradiation. The data suggest that reduction of cellular hypoxia tolerance by BAY-84-7296 may represent the primary biological mechanism underlying the observed enhancement of

  7. Interaction of ionizing radiation with other physical and chemical factors in improving the safety and storage stability of foods

    International Nuclear Information System (INIS)

    Farkas, J.; Adrassy, E.; Nanati, D.; Horti, K.; Meszaros, L.; Reichart, O.

    1998-01-01

    qualitative assessment of the interactions. The results demonstrated that combinations of a sensorially acceptable radurization dose and further anti-microbial stress factors may not only extent the shelf-life of specific refrigerated products such as those studied but also improve the microbiological safety, for example, in the event of temperature abuse. The results demonstrated that combining individually ineffective environmental stresses with low dose irradiation also efficiently controls the growth of L. monocytogenes. (author)

  8. Improved prediction of gestational hypertension by inclusion of placental growth factor and pregnancy associated plasma protein-a in a sample of Ghanaian women

    NARCIS (Netherlands)

    Antwi, Edward; Klipstein-Grobusch, Kerstin; Browne, Joyce L; Schielen, Peter C; Koram, Kwadwo A; Agyepong, Irene A; Grobbee, Diederick E

    2018-01-01

    BACKGROUND: We assessed whether adding the biomarkers Pregnancy Associated Plasma Protein-A (PAPP-A) and Placental Growth Factor (PlGF) to maternal clinical characteristics improved the prediction of a previously developed model for gestational hypertension in a cohort of Ghanaian pregnant women.

  9. Impact of Contextual Factors on the Effect of Interventions to Improve Health Worker Performance in Sub-Saharan Africa: Review of Randomised Clinical Trials.

    Science.gov (United States)

    Blacklock, Claire; Gonçalves Bradley, Daniela C; Mickan, Sharon; Willcox, Merlin; Roberts, Nia; Bergström, Anna; Mant, David

    2016-01-01

    Africa bears 24% of the global burden of disease but has only 3% of the world's health workers. Substantial variation in health worker performance adds to the negative impact of this significant shortfall. We therefore sought to identify interventions implemented in sub-Saharan African aiming to improve health worker performance and the contextual factors likely to influence local effectiveness. A systematic search for randomised controlled trials of interventions to improve health worker performance undertaken in sub-Saharan Africa identified 41 eligible trials. Data were extracted to define the interventions' components, calculate the absolute improvement in performance achieved, and document the likelihood of bias. Within-study variability in effect was extracted where reported. Statements about contextual factors likely to have modified effect were subjected to thematic analysis. Interventions to improve health worker performance can be very effective. Two of the three trials assessing mortality impact showed significant reductions in death rates (age<5 case fatality 5% versus 10%, p<0.01; maternal in-hospital mortality 6.8/1000 versus 10.3/1000; p<0.05). Eight of twelve trials focusing on prescribing had a statistically significant positive effect, achieving an absolute improvement varying from 9% to 48%. However, reported range of improvement between centres within trials varied substantially, in many cases exceeding the mean effect. Nine contextual themes were identified as modifiers of intervention effect across studies; most frequently cited were supply-line failures, inadequate supervision or management, and failure to follow-up training interventions with ongoing support, in addition to staff turnover. Interventions to improve performance of existing staff and service quality have the potential to improve patient care in underserved settings. But in order to implement interventions effectively, policy makers need to understand and address the contextual

  10. Human Factors in Coast Guard Computer Security - An Analysis of Current Awareness and Potential Techniques to Improve Security Program Viability

    National Research Council Canada - National Science Library

    Whalen, Timothy

    2001-01-01

    .... This thesis attempts to identify both the susceptibility of Coast Guard information systems to human factors-based security risks and possible means for increasing user awareness of those risks...

  11. Endometrial signals improve embryo outcome: functional role of vascular endothelial growth factor isoforms on embryo development and implantation in mice.

    Science.gov (United States)

    Binder, N K; Evans, J; Gardner, D K; Salamonsen, L A; Hannan, N J

    2014-10-10

    Does vascular endothelial growth factor (VEGF) have important roles during early embryo development and implantation? VEGF plays key roles during mouse preimplantation embryo development, with beneficial effects on time to cavitation, blastocyst cell number and outgrowth, as well as implantation rate and fetal limb development. Embryo implantation requires synchronized dialog between maternal cells and those of the conceptus. Following ovulation, secretions from endometrial glands increase and accumulate in the uterine lumen. These secretions contain important mediators that support the conceptus during the peri-implantation phase. Previously, we demonstrated a significant reduction of VEGFA in the uterine cavity of women with unexplained infertility. Functional studies demonstrated that VEGF significantly enhanced endometrial epithelial cell adhesive properties and embryo outgrowth. Human endometrial lavages (n = 6) were obtained from women of proven fertility. Four-week old Swiss mice were superovulated and mated with Swiss males to obtain embryos for treatment with VEGF in vitro. Preimplantation embryo development was assessed prior to embryo transfer (n = 19-30/treatment group/output). Recipient F1 female mice (8-12 weeks of age) were mated with vasectomized males to induce pseudopregnancy and embryos were transferred. On Day 14.5 of pregnancy, uterine horns were collected for analysis of implantation rates as well as placental and fetal development (n = 14-19/treatment). Lavage fluid was assessed by western immunoblot analysis to determine the VEGF isoforms present. Mouse embryos were treated with either recombinant human (rh)VEGF, or VEGF isoforms 121 and 165. Preimplantation embryo development was quantified using time-lapse microscopy. Blastocysts were (i) stained for cell number, (ii) transferred to wells coated with fibronectin to examine trophoblast outgrowth or (iii) transferred to pseudo pregnant recipients to analyze implantation rates, placental and

  12. Impact of Contextual Factors on the Effect of Interventions to Improve Health Worker Performance in Sub-Saharan Africa: Review of Randomised Clinical Trials

    Science.gov (United States)

    Mickan, Sharon; Willcox, Merlin; Roberts, Nia; Bergström, Anna; Mant, David

    2016-01-01

    Background Africa bears 24% of the global burden of disease but has only 3% of the world’s health workers. Substantial variation in health worker performance adds to the negative impact of this significant shortfall. We therefore sought to identify interventions implemented in sub-Saharan African aiming to improve health worker performance and the contextual factors likely to influence local effectiveness. Methods and Findings A systematic search for randomised controlled trials of interventions to improve health worker performance undertaken in sub-Saharan Africa identified 41 eligible trials. Data were extracted to define the interventions’ components, calculate the absolute improvement in performance achieved, and document the likelihood of bias. Within-study variability in effect was extracted where reported. Statements about contextual factors likely to have modified effect were subjected to thematic analysis. Interventions to improve health worker performance can be very effective. Two of the three trials assessing mortality impact showed significant reductions in death rates (agematernal in-hospital mortality 6.8/1000 versus 10.3/1000; pimprovement varying from 9% to 48%. However, reported range of improvement between centres within trials varied substantially, in many cases exceeding the mean effect. Nine contextual themes were identified as modifiers of intervention effect across studies; most frequently cited were supply-line failures, inadequate supervision or management, and failure to follow-up training interventions with ongoing support, in addition to staff turnover. Conclusions Interventions to improve performance of existing staff and service quality have the potential to improve patient care in underserved settings. But in order to implement interventions effectively, policy makers need to understand and address the contextual factors which can contribute to differences in local effect. Researchers therefore must recognise the importance of

  13. Introduction of Endophytic Pseudomonas rhodesiae and Acinetobacter sp. Effective on Seed Germination and Cucumber Growth Factors Improvement

    Directory of Open Access Journals (Sweden)

    Farkhondeh Amini

    2017-03-01

    Full Text Available Introduction: Some bacteria are capable of entering the plant as endophytes that do not cause harm and could establish a mutualistic association with host plants. Endophytic bacteria are bacteria that live in plant tissues without doing substantive harm. They enter plant tissue primarily through different plant zones. Both Gram-positive and Gram-negative bacteria have been isolated from several tissue types in several plant species. In addition, several different bacterial species have been isolated from a single plant. Variation in endophytic bacteria populations referred to the time of sampling, type of plant tissue, age and environment conditions, as well. In general endophytic bacteria occur at lower population densities than rhizospheric bacteria or bacterial pathogens. Endophytic populations, like rhizospheric populations, are conditioned by biotic and abiotic factors, but endophytic bacteria could be better protected from biotic and abiotic stresses than rhizospheric bacteria. It is clear that the interaction between plants and some endophytic bacteria is associated with beneficial effects such as plant growth promotion and biocontrol potential against plant pathogens. These types of bacteria are often capable of eliciting significant physiological changes that modulate the growth and development of the plant. Most of the time, these beneficial effects of endophytes are greater than those of many rhizosphere-colonizing bacteria. Endophytic bacteria affect bacterial growth by numerous mechanisms directly or indirectly. Some genus of bacteria such as Azosprillium, Enterobacter, Azotobacter and Pseudomonas produces plant growth regulators which lead to plant growth improvement. Microorganism profit from plants due to the enhanced availability of nutrients, whereas plants can receive benefits from bacterial associates by growth enhancement or stress reduction. Therefore, mutualistic interactions between host plants and associated

  14. Household trends in access to improved water sources and sanitation facilities in Vietnam and associated factors: findings from the Multiple Indicator Cluster Surveys, 2000–2011

    Science.gov (United States)

    Tuyet-Hanh, Tran Thi; Lee, Jong-Koo; Oh, Juhwan; Van Minh, Hoang; Ou Lee, Chul; Hoan, Le Thi; Nam, You-Seon; Long, Tran Khanh

    2016-01-01

    Background Despite progress made by the Millennium Development Goal (MDG) number 7.C, Vietnam still faces challenges with regard to the provision of access to safe drinking water and basic sanitation. Objective This paper describes household trends in access to improved water sources and sanitation facilities separately, and analyses factors associated with access to improved water sources and sanitation facilities in combination. Design Secondary data from the Vietnam Multiple Indicator Cluster Survey in 2000, 2006, and 2011 were analyzed. Descriptive statistics and tests of significance describe trends over time in access to water and sanitation by location, demographic and socio-economic factors. Binary logistic regressions (2000, 2006, and 2011) describe associations between access to water and sanitation, and geographic, demographic, and socio-economic factors. Results There have been some outstanding developments in access to improved water sources and sanitation facilities from 2000 to 2011. In 2011, the proportion of households with access to improved water sources and sanitation facilities reached 90% and 77%, respectively, meeting the 2015 MDG targets for safe drinking water and basic sanitation set at 88% and 75%, respectively. However, despite these achievements, in 2011, only 74% of households overall had access to combined improved drinking water and sanitation facilities. There were also stark differences between regions. In 2011, only 47% of households had access to both improved water and sanitation facilities in the Mekong River Delta compared with 94% in the Red River Delta. In 2011, households in urban compared to rural areas were more than twice as likely (odds ratio [OR]: 2.2; 95% confidence interval [CI]: 1.9–2.5) to have access to improved water and sanitation facilities in combination, and households in the highest compared with the lowest wealth quintile were over 40 times more likely (OR: 42.3; 95% CI: 29.8–60.0). Conclusions More

  15. Household trends in access to improved water sources and sanitation facilities in Vietnam and associated factors: findings from the Multiple Indicator Cluster Surveys, 2000–2011

    Directory of Open Access Journals (Sweden)

    Tran Thi Tuyet-Hanh

    2016-02-01

    Full Text Available Background: Despite progress made by the Millennium Development Goal (MDG number 7.C, Vietnam still faces challenges with regard to the provision of access to safe drinking water and basic sanitation. Objective: This paper describes household trends in access to improved water sources and sanitation facilities separately, and analyses factors associated with access to improved water sources and sanitation facilities in combination. Design: Secondary data from the Vietnam Multiple Indicator Cluster Survey in 2000, 2006, and 2011 were analyzed. Descriptive statistics and tests of significance describe trends over time in access to water and sanitation by location, demographic and socio-economic factors. Binary logistic regressions (2000, 2006, and 2011 describe associations between access to water and sanitation, and geographic, demographic, and socio-economic factors. Results: There have been some outstanding developments in access to improved water sources and sanitation facilities from 2000 to 2011. In 2011, the proportion of households with access to improved water sources and sanitation facilities reached 90% and 77%, respectively, meeting the 2015 MDG targets for safe drinking water and basic sanitation set at 88% and 75%, respectively. However, despite these achievements, in 2011, only 74% of households overall had access to combined improved drinking water and sanitation facilities. There were also stark differences between regions. In 2011, only 47% of households had access to both improved water and sanitation facilities in the Mekong River Delta compared with 94% in the Red River Delta. In 2011, households in urban compared to rural areas were more than twice as likely (odds ratio [OR]: 2.2; 95% confidence interval [CI]: 1.9–2.5 to have access to improved water and sanitation facilities in combination, and households in the highest compared with the lowest wealth quintile were over 40 times more likely (OR: 42.3; 95% CI: 29.8–60

  16. Household trends in access to improved water sources and sanitation facilities in Vietnam and associated factors: findings from the Multiple Indicator Cluster Surveys, 2000-2011.

    Science.gov (United States)

    Tuyet-Hanh, Tran Thi; Lee, Jong-Koo; Oh, Juhwan; Van Minh, Hoang; Ou Lee, Chul; Hoan, Le Thi; Nam, You-Seon; Long, Tran Khanh

    2016-01-01

    Despite progress made by the Millennium Development Goal (MDG) number 7.C, Vietnam still faces challenges with regard to the provision of access to safe drinking water and basic sanitation. This paper describes household trends in access to improved water sources and sanitation facilities separately, and analyses factors associated with access to improved water sources and sanitation facilities in combination. Secondary data from the Vietnam Multiple Indicator Cluster Survey in 2000, 2006, and 2011 were analyzed. Descriptive statistics and tests of significance describe trends over time in access to water and sanitation by location, demographic and socio-economic factors. Binary logistic regressions (2000, 2006, and 2011) describe associations between access to water and sanitation, and geographic, demographic, and socio-economic factors. There have been some outstanding developments in access to improved water sources and sanitation facilities from 2000 to 2011. In 2011, the proportion of households with access to improved water sources and sanitation facilities reached 90% and 77%, respectively, meeting the 2015 MDG targets for safe drinking water and basic sanitation set at 88% and 75%, respectively. However, despite these achievements, in 2011, only 74% of households overall had access to combined improved drinking water and sanitation facilities. There were also stark differences between regions. In 2011, only 47% of households had access to both improved water and sanitation facilities in the Mekong River Delta compared with 94% in the Red River Delta. In 2011, households in urban compared to rural areas were more than twice as likely (odds ratio [OR]: 2.2; 95% confidence interval [CI]: 1.9-2.5) to have access to improved water and sanitation facilities in combination, and households in the highest compared with the lowest wealth quintile were over 40 times more likely (OR: 42.3; 95% CI: 29.8-60.0). More efforts are required to increase household access to

  17. Interactive Cognitive-Motor Step Training Improves Cognitive Risk Factors of Falling in Older Adults - A Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Daniel Schoene

    Full Text Available Interactive cognitive-motor training (ICMT requires individuals to perform both gross motor movements and complex information processing. This study investigated the effectiveness of ICMT on cognitive functions associated with falls in older adults.A single-blinded randomized controlled trial was conducted in community-dwelling older adults (N = 90, mean age 81.5±7 without major cognitive impairment. Participants in the intervention group (IG played four stepping games that required them to divide attention, inhibit irrelevant stimuli, switch between tasks, rotate objects and make rapid decisions. The recommended minimum dose was three 20-minute sessions per week over a period of 16 weeks unsupervised at home. Participants in the control group (CG received an evidence-based brochure on fall prevention. Measures of processing speed, attention/executive function (EF, visuo-spatial ability, concerns about falling and depression were assessed before and after the intervention.Eighty-one participants (90% attended re-assessment. There were no improvements with respect to the Stroop Stepping Test (primary outcome in the intervention group. Compared to the CG, the IG improved significantly in measures of processing speed, visuo-spatial ability and concern about falling. Significant interactions were observed for measures of EF and divided attention, indicating group differences varied for different levels of the covariate with larger improvements in IG participants with poorer baseline performance. The interaction for depression showed no change for the IG but an increase in the CG for those with low depressive symptoms at baseline. Additionally, low and high-adherer groups differed in their baseline performance and responded differently to the intervention. Compared to high adherers, low adherers improved more in processing speed and visual scanning while high-adherers improved more in tasks related to EF.This study shows that unsupervised stepping

  18. Reversible dual inhibitor against G9a and DNMT1 improves human iPSC derivation enhancing MET and facilitating transcription factor engagement to the genome.

    Directory of Open Access Journals (Sweden)

    Juan Roberto Rodriguez-Madoz

    Full Text Available The combination of defined factors with small molecules targeting epigenetic factors is a strategy that has been shown to enhance optimal derivation of iPSCs and could be used for disease modelling, high throughput screenings and/or regenerative medicine applications. In this study, we showed that a new first-in-class reversible dual G9a/DNMT1 inhibitor compound (CM272 improves the efficiency of human cell reprogramming and iPSC generation from primary cells of healthy donors and patient samples, using both integrative and non-integrative methods. Moreover, CM272 facilitates the generation of human iPSC with only two factors allowing the removal of the most potent oncogenic factor cMYC. Furthermore, we demonstrated that mechanistically, treatment with CM272 induces heterochromatin relaxation, facilitates the engagement of OCT4 and SOX2 transcription factors to OSKM refractory binding regions that are required for iPSC establishment, and enhances mesenchymal to epithelial transition during the early phase of cell reprogramming. Thus, the use of this new G9a/DNMT reversible dual inhibitor compound may represent an interesting alternative for improving cell reprogramming and human iPSC derivation for many different applications while providing interesting insights into reprogramming mechanisms.

  19. Reversible dual inhibitor against G9a and DNMT1 improves human iPSC derivation enhancing MET and facilitating transcription factor engagement to the genome.

    Science.gov (United States)

    Rodriguez-Madoz, Juan Roberto; San Jose-Eneriz, Edurne; Rabal, Obdulia; Zapata-Linares, Natalia; Miranda, Estibaliz; Rodriguez, Saray; Porciuncula, Angelo; Vilas-Zornoza, Amaia; Garate, Leire; Segura, Victor; Guruceaga, Elizabeth; Agirre, Xabier; Oyarzabal, Julen; Prosper, Felipe

    2017-01-01

    The combination of defined factors with small molecules targeting epigenetic factors is a strategy that has been shown to enhance optimal derivation of iPSCs and could be used for disease modelling, high throughput screenings and/or regenerative medicine applications. In this study, we showed that a new first-in-class reversible dual G9a/DNMT1 inhibitor compound (CM272) improves the efficiency of human cell reprogramming and iPSC generation from primary cells of healthy donors and patient samples, using both integrative and non-integrative methods. Moreover, CM272 facilitates the generation of human iPSC with only two factors allowing the removal of the most potent oncogenic factor cMYC. Furthermore, we demonstrated that mechanistically, treatment with CM272 induces heterochromatin relaxation, facilitates the engagement of OCT4 and SOX2 transcription factors to OSKM refractory binding regions that are required for iPSC establishment, and enhances mesenchymal to epithelial transition during the early phase of cell reprogramming. Thus, the use of this new G9a/DNMT reversible dual inhibitor compound may represent an interesting alternative for improving cell reprogramming and human iPSC derivation for many different applications while providing interesting insights into reprogramming mechanisms.

  20. Work improvement factors for the amelioration of work ability, with a focus on individual capacity to deal with stress in an IT company.

    Science.gov (United States)

    Ohta, Masanori; Higuchi, Yoshiyuki; Kumashiro, Masaharu; Yamato, Hiroshi; Sugimura, Hisamichi

    2015-03-01

    The aim of this study was to explore factors that ameliorate work ability by focusing on workers' capacity to deal with stress.The subjects were 1,330 workers from the Japanese information technology (IT) sector. Each subject completed questionnaires in 2011 and 2012 that consisted of the work ability index (WAI), the three-item sense of coherence (SOC), and the Mental Health Improvement and Reinforcement Research of Recognition (MIRROR). The results of the WAI were also obtained in 2013. The median SOC score in 2011 was used to divide the subjects into two groups, the Low SOC group and the High SOC group, then we verified the factors that contributed to improved work ability in both of these groups over a two-year period. Results indicate that an improvement in work ability in the Low SOC group could be predicted by giving workers opportunities for education or training, by making efforts to reduce the stress of commuting, by clarifying their assignments, and by establishing support systems when troubles occur. For the High SOC group, such improvements could be predicted by giving workers job control, by giving education or training for the promotion of their abilities, and by establishing a system for assuming responsibility. In conclusion, improvements in the work environment can increase the work ability of Japanese IT workers in conformity with their capacity to deal with stress.

  1. Factors affecting implementation of accreditation programmes and the impact of the accreditation process on quality improvement in hospitals: a SWOT analysis.

    Science.gov (United States)

    Ng, G K B; Leung, G K K; Johnston, J M; Cowling, B J

    2013-10-01

    The objectives of this review were to identify factors that influence implementation of hospital accreditation programmes and to assess the impact of the accreditation process on quality improvement in public hospitals. Two electronic databases, Medline (OvidSP) and PubMed, were systematically searched. "Public hospital", "hospital accreditation", and "quality improvement" were used as the search terms. A total of 348 citations were initially identified. After critical appraisal and study selection, 26 articles were included in the review. The data were extracted and analysed using a SWOT (strengths, weaknesses, opportunities, threats) analysis. Increased staff engagement and communication, multidisciplinary team building, positive changes in organisational culture, and enhanced leadership and staff awareness of continuous quality improvement were identified as strengths. Weaknesses included organisational resistance to change, increased staff workload, lack of awareness about continuous quality improvement, insufficient staff training and support for continuous quality improvement, lack of applicable accreditation standards for local use, and lack of performance outcome measures. Opportunities included identification of improvement areas, enhanced patient safety, additional funding, public recognition, and market advantage. Threats included opportunistic behaviours, funding cuts, lack of incentives for participation, and a regulatory approach to mandatory participation. By relating the findings to the operational issues of accreditation, this review discussed the implications for successful implementation and how accreditation may drive quality improvement. These findings have implications for various stakeholders (government, the public, patients and health care providers), when it comes to embarking on accreditation exercises.

  2. The new albumin-free recombinant factor VIII concentrates for treatment of hemophilia: do they represent an actual incremental improvement?

    Science.gov (United States)

    Josephson, Cassandra D; Abshire, Thomas

    2004-07-01

    The goal of eliminating the low levels of infectious disease risk from hemophilia treatment has resulted in the development of multiple generations of recombinant factor VIII (rFVIII) products. The ideal product should be devoid of human and animal proteins, which may transmit infectious agents. These products should also maintain molecular integrity, hemostatic efficacy, similar immunogenicity, and acceptable side effect profiles as compared to plasma-derived factor VIII. Currently available first-, second-, and third-generation rFVIII products include Recombinate; Kogenate FS/Helixate FS and ReFacto; and Advate, respectively. During the evolution of rFVIII products, either full-length or B-domain-deleted factor VIII were transfected into immortalized cell lines. The B-domain-deleted product, ReFacto, has resulted in an additional method to monitor factor VIII levels. The third-generation products offer the theoretical advantage of being produced without human and/or animal proteins. Upon initial introduction into the marketplace, the newer products have a higher cost. However, when analyzing historical trends, the prices of these products are almost equivalent to first-generation products within 3 years of licensure. Thus, the initial cost of the product may be a minimal issue in the medical decision process when selecting rFVIII replacement therapy.

  3. High gellan gum concentration and secondary somatic embryogenesis: two key factors to improve somatic embryo development in Pseudotsuga menziesii [Mirb.

    Czech Academy of Sciences Publication Activity Database

    Lelu-Walter, M.A.; Gautier, J.; Eliášová, Kateřina; Sanchez, L.; Teyssier, C.; Lomenech, A. M.; Le Metté, C.; Hargreaves, R.; Trontin, J.F.; Reeves, G.

    2018-01-01

    Roč. 132, č. 1 (2018), s. 137-155 ISSN 0167-6857 Institutional support: RVO:61389030 Keywords : Cell density * Cleavage polyembryony * Douglas-fir * Embryogenic potential * Protein pattern * Vegetative propagation Subject RIV: EF - Botanics OBOR OECD: Plant sciences, botany Impact factor: 2.002, year: 2016

  4. Development of an optimization technique of CETOP-D inlet flow factor for reactor core thermal margin improvement

    International Nuclear Information System (INIS)

    Hong, Sung Duk; Im, Jong Sun; Yoo, Yun Jong; Kwon, Jung Taek; Park, Jong Ryool

    1995-01-01

    The recent ABB/CE(Asea Brown Boveri Combustion Engineering) type pressurized water reactors have the on-line monitoring system, i.e., the COLSS(core operating limit supervisory system), to prevent the specified acceptable fuel design limits from being violated during normal operation and anticipated operational occurrences. One of the main functions of COLSS is the on-line monitoring of the DNB(departure from nucleate boiling) overpower margin by calculating the MDNBR(minimum DNB ratio) for the measured operating condition at every second. The CETOP-D model, used in the MDNBR calculation of COLSS, is benchmarked conservatively against the TORC model using an inlet flow factor of hot assembly in CETOP-D as an adjustment factor for TORC. In this study, a technique to optimize the CETOP-D inlet flow factor has been developed by eliminating the excessive conservatism in the ABB/CE's. A correlation is introduced to account for the actual variation of the CETOP-D inlet flow factor within the core operating limits. This technique was applied to the core operating range of the Yonggwang Units 3 and 4 Cycle 1, which results in the increase of 2% in the DNB overpower margin at the normal operating condition, compared with that from the ABB/CE method. 7 figs., 2 tabs., 10 refs. (Author)

  5. Improving the robustness of Surface Enhanced Raman Spectroscopy based sensors by Bayesian Non-negative Matrix Factorization

    DEFF Research Database (Denmark)

    Alstrøm, Tommy Sonne; Frøhling, Kasper Bayer; Larsen, Jan

    2014-01-01

    a Bayesian Non-negative Matrix Factorization (NMF) approach to identify locations of target molecules. The proposed method is able to successfully analyze the spectra and extract the target spectrum. A visualization of the loadings of the basis vector is created and the results show a clear SNR enhancement...

  6. Stromal cell-derived factor-1 alpha (SDF-1 alpha) improves neural recovery after spinal cord contusion in rats

    NARCIS (Netherlands)

    Zendedel, A.; Nobakht, M.; Bakhtiyari, M.; Beyer, C.; Kipp, M.; Baazm, M.; Joghataie, M.T.

    2012-01-01

    Stromal cell-derived factor-1 alpha (SDF-1α) is an important cytokine, implicated in the control of stem cell trafficking and bone marrow-derived stem cell mobilization. Generally, SDF-1α regulates multiple physiological processes such as embryonic development and organ homeostasis. There is also

  7. Uncertainty evaluation of EnPIs in industrial applications as a key factor in setting improvement actions

    Science.gov (United States)

    D'Emilia, G.; Di Gasbarro, D.; Gaspari, A.; Natale, E.

    2015-11-01

    A methodology is proposed assuming high-level Energy Performance Indicators (EnPIs) uncertainty as quantitative indicator of the evolution of an Energy Management System (EMS). Motivations leading to the selection of the EnPIs, uncertainty evaluation techniques and criteria supporting decision-making are discussed, in order to plan and pursue reliable measures for energy performance improvement. In this paper, problems, priorities, operative possibilities and reachable improvement limits are examined, starting from the measurement uncertainty assessment. Two different industrial cases are analysed with reference to the following aspects: absence/presence of energy management policy and action plans; responsibility level for the energy issues; employees’ training and motivation in respect of the energy problems; absence/presence of adequate infrastructures for monitoring and sharing of energy information; level of standardization and integration of methods and procedures linked to the energy activities; economic and financial resources for the improvement of energy efficiency. A critic and comparative analysis of the obtained results is realized. The methodology, experimentally validated, allows developing useful considerations for effective, realistic and economically feasible improvement plans, depending on the specific situation. Recursive application of the methodology allows getting reliable and resolved assessment of the EMS status, also in dynamic industrial contexts.

  8. Identification of key factors in consumers' adoption behavior of intelligent medical terminals based on a hybrid modified MADM model for product improvement.

    Science.gov (United States)

    Liu, Yupeng; Chen, Yifei; Tzeng, Gwo-Hshiung

    2017-09-01

    As a new application technology of the Internet of Things (IoT), intelligent medical treatment has attracted the attention of both nations and industries through its promotion of medical informatisation, modernisation, and intelligentisation. Faced with a wide variety of intelligent medical terminals, consumers may be affected by various factors when making purchase decisions. To examine and evaluate the key influential factors (and their interrelationships) of consumer adoption behavior for improving and promoting intelligent medical terminals toward achieving set aspiration level in each dimension and criterion. A hybrid modified Multiple Attribute Decision-Making (MADM) model was used for this study, based on three components: (1) the Decision-Making Trial and Evaluation Laboratory (DEMATEL) technique, to build an influential network relationship map (INRM) at both 'dimensions' and 'criteria' levels; (2) the DEMATEL-based analytic network process (DANP) method, to determine the interrelationships and influential weights among the criteria and identify the source-influential factors; and (3) the modified Vlse Kriterijumska Optimizacija I Kompromisno Resenje (VIKOR) method, to evaluate and improve for reducing the performance gaps to meet the consumers' needs for continuous improvement and sustainable products-development. First, a consensus on the influential factors affecting consumers' adoption of intelligent medical terminals was collected from experts' opinion in practical experience. Next, the interrelationships and influential weights of DANP among dimensions/criteria based on the DEMATEL technique were determined. Finally, two intelligent medicine bottles (AdhereTech, A 1 alternative; and Audio/Visual Alerting Pillbox, A 2 alternative) were reviewed as the terminal devices to verify the accuracy of the MADM model and evaluate its performance on each criterion for improving the total certification gaps by systematics according to the modified VIKOR method

  9. Food Safety Instruction Improves Knowledge and Behavior Risk and Protection Factors for Foodborne Illnesses in Pregnant Populations.

    Science.gov (United States)

    Kendall, Patricia; Scharff, Robert; Baker, Susan; LeJeune, Jeffrey; Sofos, John; Medeiros, Lydia

    2017-08-01

    Objective This study compared knowledge and food-handling behavior after pathogen-specific (experimental treatment) versus basic food safety instruction (active control) presented during nutrition education classes for low-income English- and Spanish-language pregnant women. Methods Subjects (n = 550) were randomly assigned to treatment groups in two different locations in the United States. Food safety instruction was part of an 8-lesson curriculum. Food safety knowledge and behavior were measured pre/post intervention. Descriptive data were analyzed by Chi-Square or ANOVA; changes after intervention were analyzed by regression analysis. Results Knowledge improved after intervention in the pathogen-specific treatment group compared to active control, especially among Spanish-language women. Behavior change after intervention for the pathogen-specific treatment group improved for thermometer usage, refrigeration and consumption of foods at high risk for safety; however, all other improvements in behavior were accounted for by intervention regardless of treatment group. As expected, higher pre-instruction behavioral competency limited potential gain in behavior post-instruction due to a ceiling effect. This effect was more dominant among English-language women. Improvements were also linked to formal education completed, a partner at home, and other children in the home. Conclusions for Practice This study demonstrated that pathogen-specific food safety instruction leads to enhance knowledge and food handling behaviors that may improve the public health of pregnant women and their unborn children, especially among Spanish-language women. More importantly, food safety instruction, even at the most basic level, benefited pregnant women's food safety knowledge and food-handling behavior after intervention.

  10. The influence of contextual factors on healthcare quality improvement initiatives: what works, for whom and in what setting? Protocol for a realist review.

    Science.gov (United States)

    Coles, Emma; Wells, Mary; Maxwell, Margaret; Harris, Fiona M; Anderson, Julie; Gray, Nicola M; Milner, Gill; MacGillivray, Stephen

    2017-08-23

    Context shapes the effectiveness of knowledge implementation and influences health improvement. Successful healthcare quality improvement (QI) initiatives frequently fail to transfer to different settings, with local contextual factors often cited as the cause. Understanding and overcoming contextual barriers is therefore crucial to implementing effective improvement; yet context is still poorly understood. There is a paucity of information on the mechanisms underlying how and why QI projects succeed or fail in given settings. A realist review of empirical studies of healthcare QI initiatives will be undertaken to examine the influence and impact of contextual factors on quality improvement in healthcare settings and explore whether QI initiatives can work in all contexts. The review will explore which contextual factors are important, and how, why, when and for whom they are important, within varied settings. The dynamic nature of context and change over time will be explored by examining which aspects of context impact at key points in the improvement trajectory. The review will also consider the influence of context on improvement outcomes (provider- and patient-level), spread and sustainability. The review process will follow five iterative steps: (1) clarify scope, (2) search for evidence, (3) appraise primary studies and extract data, (4) synthesise evidence and draw conclusions and (5) disseminate findings. The reviewers will consult with experts and stakeholders in the early stages to focus the review and develop a programme theory consisting of explanatory 'context-mechanism-outcome' configurations. Searches for primary evidence will be conducted iteratively. Data will be extracted and tested against the programme theory. A review advisory group will oversee the review process. Review findings will follow RAMESES guidelines and will be disseminated via a report, presentations and peer-reviewed publications. The review will update and consolidate evidence

  11. The use of SIWI strategy to improve the performance of Grade 8 students in factoring polynomials by a common monomial

    Directory of Open Access Journals (Sweden)

    Shamile Josephine T. Arobo

    2017-12-01

    Full Text Available Teachers play an important role in honing students’ knowledge and skills. The strategy used in teaching greatly affects the final result of students learning. Hence, the teacher should properly plan and organize the strategy to be used. In this paper, we presented another teaching strategy in mathematics which is more fun and easier for students to understand mathematical concepts like factoring polynomials. We devised the so-called Substitute It With Icons or (SIWI as teaching strategy in factoring polynomials by common monomial. Results revealed that SIWI is more helpful among low achievers group compared to high achievers who still preferred the old variable number style. It is recommended to try out SIWI with other mathematics topic like Algebra.

  12. Transplantation of Rat Mesenchymal Stem Cells Overexpressing Hypoxia-Inducible FactorImproves Blood Perfusion and Arteriogenesis in a Rat Hindlimb Ischemia Model

    Directory of Open Access Journals (Sweden)

    Weifeng Lu

    2017-01-01

    Full Text Available Mesenchymal stem cells (MSCs have been increasingly tested in cell-based therapy to treat numerous diseases. Genetic modification to improve MSC behavior may enhance posttransplantation outcome. This study aims to test the potential therapeutic benefits of rat bone marrow MSCs overexpressing hypoxia-inducible factor 2α (rMSCsHIF-2α in a rat hindlimb ischemia model. PBS, rMSCs, or rMSCsHIF-2α were injected into rat ischemic hindlimb. Compared with the injection of PBS or rMSCs, transplantation of rMSCsHIF-2α significantly improved blood perfusion, increased the number of vessel branches in the muscle of the ischemic hindlimb, and improved the foot mobility of the ischemic hindlimb (all P<0.05. rMSCHIF-2α transplantation also markedly increased the expression of proangiogenic factors VEGF, bFGF, and SDF1 and Notch signaling proteins including DII4, NICD, Hey1, and Hes1, whereas it reduced the expression of proapoptotic factor Bax in the muscle of the ischemic hindlimb. Overexpression of HIF-2α did not affect rMSC stemness and proliferation under normoxia but significantly increased rMSC migration and tube formation in matrigel under hypoxia (all P<0.05. RMSCsHIF-2α stimulated endothelial cell invasion under hypoxia significantly (P<0.05. Genetic modification of rMSCs via overexpression of HIF-2α improves posttransplantation outcomes in a rat hindlimb ischemia model possibly by stimulating proangiogenic growth factors and cytokines.

  13. A group randomized trial of a complexity-based organizational intervention to improve risk factors for diabetes complications in primary care settings: study protocol

    OpenAIRE

    Noel Polly H; Culler Steven D; Pugh Jacqueline A; Parchman Michael L; Arar Nedal H; Romero Raquel L; Palmer Raymond F

    2008-01-01

    Abstract Background Most patients with type 2 diabetes have suboptimal control of their glucose, blood pressure (BP), and lipids – three risk factors for diabetes complications. Although the chronic care model (CCM) provides a roadmap for improving these outcomes, developing theoretically sound implementation strategies that will work across diverse primary care settings has been challenging. One explanation for this difficulty may be that most strategies do not account for the complex adapti...

  14. Analyzing Factors to Improve Service Quality of Local Specialties Restaurants: A Comparison with Fast Food Restaurants in Southern Vietnam

    OpenAIRE

    Lai Wang Wang; Thanh Tuyen Tran

    2014-01-01

    The top fast food restaurant brands like KFC and MacDonald?s have gone global and demonstrated their successful business strategies through providing quick-service and convenience for customers. Meanwhile, local specialty food has recently emerged as a phenomenon attracting customers? attention on traditional value of ethnic food culture. The purpose of this study is to conduct a regional survey in Vietnamese restaurant companies to identify some key factors that make customers interested in ...

  15. On the effects of hydrogenation of thin film polycrystalline silicon: A key factor to improve heterojunction solar cells

    Czech Academy of Sciences Publication Activity Database

    Qiu, Y.; Kunz, O.; Fejfar, Antonín; Ledinský, Martin; Teik Chan, B.; Gordon, I.; Van Gestel, D.; Venkatachalm, S.; Egan, R.

    2014-01-01

    Roč. 122, MAR (2014), s. 31-39 ISSN 0927-0248 R&D Projects: GA MŠk 7E10061; GA MŠk(CZ) LM2011026 EU Projects: European Commission(XE) 240826 - PolySiMode Institutional support: RVO:68378271 Keywords : silicon * thin films * polycrystalline * hydrogenation * Raman spectroscopy Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 5.337, year: 2014 http://www.sciencedirect.com/science/article/pii/S0927024813006016

  16. Factors associated with sustainability of 2 quality improvement programs after achieving early implementation success. A qualitative case study.

    Science.gov (United States)

    Ament, Stephanie M C; Gillissen, Freek; Moser, Albine; Maessen, José M C; Dirksen, Carmen D; von Meyenfeldt, Maarten F; van der Weijden, Trudy

    2017-12-01

    Sustainability of innovations is a relatively new concept in health care research and has become an issue of growing interest. The current study explored factors related to the sustainability of 2 multidisciplinary hospital-based programs 3 to 6 years after achieving early implementation success. An exploratory qualitative study was conducted into 2 implementation cases, an Enhanced Recovery After Surgery program for colorectal surgery and a short-stay program for breast cancer surgery. Semistructured interviews were held with key persons involved in the care process in 14 hospitals from both cases minimally 3 years after the implementation, between March 2012 and May 2013. The Consolidated Framework for Implementation Research was used to direct the development of the interview guide, during data collection and during analysis. A directed content analysis was performed. A total of 21 interviews with 26 individuals were held, 18 regarding the Enhanced Recovery After Surgery case and 8 regarding the short-stay program case. Respondents mentioned the following factors associated with sustainability of the programs: modification and adaptability of the program, cost-effectiveness, institutionalization into existing systems, short communication lines within the multidisciplinary team, an innovative culture, benefits for patients, cosmopolitanism, the existence of external policies and incentives, trust and belief in the program, and spread of the program to other settings. Two factors are not covered by the Consolidated Framework for Implementation Research, ie, modification of the program over the years and spread of the program to other contexts. The factors associated with sustainability put forward in both cases were largely the same. Leadership and the implementation project were not mentioned as having influenced the long-term sustainability of the benefits achieved. Sustainability of the innovations is influenced by determinants stemming from all ecological

  17. SEIPS 2.0: A human factors framework for studying and improving the work of healthcare professionals and patients

    Science.gov (United States)

    Holden, Richard J.; Carayon, Pascale; Gurses, Ayse P.; Hoonakker, Peter; Hundt, Ann Schoofs; Ozok, A. Ant; Rivera-Rodriguez, A. Joy

    2013-01-01

    Healthcare practitioners, patient safety leaders, educators, and researchers increasingly recognize the value of human factors/ergonomics and make use of the discipline’s person-centered models of sociotechnical systems. This paper first reviews one of the most widely used healthcare human factors systems models, the Systems Engineering Initiative for Patient Safety (SEIPS) model, and then introduces an extended model, “SEIPS 2.0.” SEIPS 2.0 incorporates three novel concepts into the original model: configuration, engagement, and adaptation. The concept of configuration highlights the dynamic, hierarchical, and interactive properties of sociotechnical systems, making it possible to depict how health-related performance is shaped at “a moment in time.” Engagement conveys that various individuals and teams can perform health-related activities separately and collaboratively. Engaged individuals often include patients, family caregivers, and other non-professionals. Adaptation is introduced as a feedback mechanism that explains how dynamic systems evolve in planned and unplanned ways. Key implications and future directions for human factors research in healthcare are discussed. PMID:24088063

  18. The South Asian heart lifestyle intervention (SAHELI) study to improve cardiovascular risk factors in a community setting: Design and methods

    OpenAIRE

    Kandula, Namratha R.; Patel, Yasin; Dave, Swapna; Seguil, Paola; Kumar, Santosh; Baker, David W.; Spring, Bonnie; Siddique, Juned

    2013-01-01

    Disseminating and implementing evidence-based, cardiovascular disease (CVD) prevention lifestyle interventions in community settings and in ethnic minority populations is a challenge. We describe the design and methods for the South Asian heart lifestyle intervention (SAHELI) study, a pilot study designed to determine the feasibility and initial efficacy of a culturally-targeted, community-based lifestyle intervention to improve physical activity and diet behaviors among medically underserved...

  19. Factors affecting improvement of children and adolescents who were treated in the child and adolescent psychiatry inpatient unit.

    Science.gov (United States)

    Serim Demirgoren, Burcu; Ozbek, Aylin; Gencer, Ozlem

    2017-08-01

    Objective This study aimed to assess the correlates and predictors of improvement in general functioning of children and adolescents who are treated in the child and adolescent psychiatry (CAMHS) inpatient unit. Methods Hospital records of 308 children and adolescents who were treated for at least 1 month in the CAMHS inpatient unit from 2005-2016 were included. Associations with individual, familial, and clinical variables and the difference in Children's Global Assessment Scale (ΔCGAS) scores at admission and discharge were evaluated. Results Positive predictors of ΔCGAS were older age and lower CGAS scores at admission, whereas high familial risk scores at admission and diagnosis of early-onset schizophrenia negatively predicted ΔCGAS (B = 0.698, p = 0002; B = -0.620, p < 0.001; B = -0.842, p = 0.002; B =-9.184, p = 0.000, respectively). Familial risk scores were significantly and negatively correlated with ΔCGAS (p = 0.004, Spearman's rho = -0.2). Conclusions This study indicates that improvement in general functioning during inpatient treatment in CAMHS is better at an older age and with lower general functioning at admission. However, high familial risks and diagnosis of early-onset schizophrenia weakens this improvement.

  20. Work System Assessment to Facilitate the Dissemination of a Quality Improvement Program for Optimizing Blood Culture Use: A Case Study Using a Human Factors Engineering Approach.

    Science.gov (United States)

    Xie, Anping; Woods-Hill, Charlotte Z; King, Anne F; Enos-Graves, Heather; Ascenzi, Judy; Gurses, Ayse P; Klaus, Sybil A; Fackler, James C; Milstone, Aaron M

    2017-11-20

    Work system assessments can facilitate successful implementation of quality improvement programs. Using a human factors engineering approach, we conducted a work system assessment to facilitate the dissemination of a quality improvement program for optimizing blood culture use in pediatric intensive care units at 2 hospitals. Semistructured face-to-face interviews were conducted with clinicians from Johns Hopkins All Children's Hospital and University of Virginia Medical Center. Interview data were analyzed using qualitative content analysis. Blood culture-ordering practices are influenced by various work system factors, including people, tasks, tools and technologies, the physical environment, organizational conditions, and the external environment. A clinical decision-support tool could facilitate implementation by (1) standardizing blood culture-ordering practices, (2) ensuring that prescribing clinicians review the patient's condition before ordering a blood culture, (3) facilitating critical thinking, and (4) empowering nurses to communicate with physicians and advocate for adherence to blood culture-ordering guidelines. The success of interventions for optimizing blood culture use relies heavily on the local context. A work system analysis using a human factors engineering approach can identify key areas to be addressed for the successful dissemination of quality improvement interventions. © The Author 2017. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. Improved Rice Residue Burning Emissions Estimates: Accounting for Practice-Specific Emission Factors in Air Pollution Assessments of Vietnam

    Science.gov (United States)

    Lasko, Kristofer; Vadrevu, Krishna

    2018-01-01

    In Southeast Asia and Vietnam, rice residues are routinely burned after the harvest to prepare fields for the next season. Specific to Vietnam, the two prevalent burning practices include: a). piling the residues after hand harvesting; b). burning the residues without piling, after machine harvesting. In this study, we synthesized field and laboratory studies from the literature on rice residue burning emission factors for Particulate Matter less than 2.5 microns (PM2.5). We found significant differences in the resulting burning-practice specific emission factors, with 16.9 grams per square kilogram (plus or minus 6.9) for pile burning and 8.8 grams per square kilogram (plus or minus 3.5) for non-pile burning. We calculated burning practice specific emissions based on rice area data, region-specific fuel-loading factors, combined emission factors, and estimates of burning from the literature. Our results for year 2015 estimate 180 gigagrams of PM2.5 result from the pile burning method and 130 gigagrams result from non-pile burning method, with the most-likely current emission scenario of 150 gigagrams PM2.5 emissions for Vietnam. For comparison purposes, we calculated emissions using generalized agricultural emission factors employed in global biomass burning studies. These results estimate 80 gigagrams PM2.5, which is only 44 percent of the pile burning-based estimates, suggesting underestimation in previous studies. We compare our emissions to an existing all-combustion sources inventory, results show emissions account for 14-18 percent of Vietnam's total PM2.5 depending on burning practice. Within the highly-urbanized and cloud-covered Hanoi Capital region (HCR), we use rice area from Sentinel-1A to derive spatially-explicit emissions and indirectly estimate residue burning dates. Results from HYSPLIT (Hybrid Single-Particle Lagrangian Integrated Trajectory) back-trajectory analysis stratified by season show autumn has most emission trajectories originating in

  2. Improving and disaggregating N{sub 2}O emission factors for ruminant excreta on temperate pasture soils

    Energy Technology Data Exchange (ETDEWEB)

    Krol, D.J., E-mail: kroldj@tcd.ie [Teagasc, Crops, Land Use and Environment Programme, Johnstown Castle, Co., Wexford (Ireland); Carolan, R. [Agri-Food and Biosciences Institute (AFBI), Belfast BT9 5PX (Ireland); Minet, E. [Teagasc, Crops, Land Use and Environment Programme, Johnstown Castle, Co., Wexford (Ireland); McGeough, K.L.; Watson, C.J. [Agri-Food and Biosciences Institute (AFBI), Belfast BT9 5PX (Ireland); Forrestal, P.J. [Teagasc, Crops, Land Use and Environment Programme, Johnstown Castle, Co., Wexford (Ireland); Lanigan, G.J., E-mail: gary.lanigan@teagasc.ie [Teagasc, Crops, Land Use and Environment Programme, Johnstown Castle, Co., Wexford (Ireland); Richards, K.G. [Teagasc, Crops, Land Use and Environment Programme, Johnstown Castle, Co., Wexford (Ireland)

    2016-10-15

    Cattle excreta deposited on grazed grasslands are a major source of the greenhouse gas (GHG) nitrous oxide (N{sub 2}O). Currently, many countries use the IPCC default emission factor (EF) of 2% to estimate excreta-derived N{sub 2}O emissions. However, emissions can vary greatly depending on the type of excreta (dung or urine), soil type and timing of application. Therefore three experiments were conducted to quantify excreta-derived N{sub 2}O emissions and their associated EFs, and to assess the effect of soil type, season of application and type of excreta on the magnitude of losses. Cattle dung, urine and artificial urine treatments were applied in spring, summer and autumn to three temperate grassland sites with varying soil and weather conditions. Nitrous oxide emissions were measured from the three experiments over 12 months to generate annual N{sub 2}O emission factors. The EFs from urine treated soil was greater (0.30–4.81% for real urine and 0.13–3.82% for synthetic urine) when compared with dung (− 0.02–1.48%) treatments. Nitrous oxide emissions were driven by environmental conditions and could be predicted by rainfall and temperature before, and soil moisture deficit after application; highlighting the potential for a decision support tool to reduce N{sub 2}O emissions by modifying grazing management based on these parameters. Emission factors varied seasonally with the highest EFs in autumn and were also dependent on soil type, with the lowest EFs observed from well-drained and the highest from imperfectly drained soil. The EFs averaged 0.31 and 1.18% for cattle dung and urine, respectively, both of which were considerably lower than the IPCC default value of 2%. These results support both lowering and disaggregating EFs by excreta type. - Highlights: • N{sub 2}O emissions were measured from cattle excreta applied to pasture. • N{sub 2}O was universally higher from urine compared with dung. • N{sub 2}O was driven by rainfall, temperature

  3. Plant nuclear factor Y (NF-Y) B subunits confer drought tolerance and lead to improved corn yields on water-limited acres.

    Science.gov (United States)

    Nelson, Donald E; Repetti, Peter P; Adams, Tom R; Creelman, Robert A; Wu, Jingrui; Warner, David C; Anstrom, Don C; Bensen, Robert J; Castiglioni, Paolo P; Donnarummo, Meghan G; Hinchey, Brendan S; Kumimoto, Roderick W; Maszle, Don R; Canales, Roger D; Krolikowski, Katherine A; Dotson, Stanton B; Gutterson, Neal; Ratcliffe, Oliver J; Heard, Jacqueline E

    2007-10-16

    Commercially improved crop performance under drought conditions has been challenging because of the complexity of the trait and the multitude of factors that influence yield. Here we report the results of a functional genomics approach that identified a transcription factor from the nuclear factor Y (NF-Y) family, AtNF-YB1, which acts through a previously undescribed mechanism to confer improved performance in Arabidopsis under drought conditions. An orthologous maize transcription factor, ZmNF-YB2, is shown to have an equivalent activity. Under water-limited conditions, transgenic maize plants with increased ZmNF-YB2 expression show tolerance to drought based on the responses of a number of stress-related parameters, including chlorophyll content, stomatal conductance, leaf temperature, reduced wilting, and maintenance of photosynthesis. These stress adaptations contribute to a grain yield advantage to maize under water-limited environments. The application of this technology has the potential to significantly impact maize production systems that experience drought.

  4. Factors affecting domestic water consumption in rural households upon access to improved water supply: insights from the Wei River Basin, China.

    Science.gov (United States)

    Fan, Liangxin; Liu, Guobin; Wang, Fei; Geissen, Violette; Ritsema, Coen J

    2013-01-01

    Comprehensively understanding water consumption behavior is necessary to design efficient and effective water use strategies. Despite global efforts to identify the factors that affect domestic water consumption, those related to domestic water use in rural regions have not been sufficiently studied, particularly in villages that have gained access to improved water supply. To address this gap, we investigated 247 households in eight villages in the Wei River Basin where three types of improved water supply systems are implemented. Results show that domestic water consumption in liters per capita per day was significantly correlated with water supply pattern and vegetable garden area, and significantly negatively correlated with family size and age of household head. Traditional hygiene habits, use of water appliances, and preference for vegetable gardening remain dominant behaviors in the villages with access to improved water supply. Future studies on rural domestic water consumption should pay more attention to user lifestyles (water appliance usage habits, outdoor water use) and cultural backgrounds (age, education).

  5. Improving substance information in USEtox® , part 1: Discussion on data and approaches for estimating freshwater ecotoxicity effect factors.

    Science.gov (United States)

    Saouter, Erwan; Aschberger, Karin; Fantke, Peter; Hauschild, Michael Z; Bopp, Stephanie K; Kienzler, Aude; Paini, Alicia; Pant, Rana; Secchi, Michela; Sala, Serenella

    2017-12-01

    The scientific consensus model USEtox ® is recommended by the European Commission as the reference model to characterize life cycle chemical emissions in terms of their potential human toxicity and freshwater aquatic ecotoxicity impacts in the context of the International Reference Life Cycle Data System Handbook and the Environmental Footprint pilot phase looking at products (PEF) and organizations (OEF). Consequently, this model has been systematically used within the PEF/OEF pilot phase by 25 European Union industry sectors, which manufacture a wide variety of consumer products. This testing phase has raised some questions regarding the derivation of and the data used for the chemical-specific freshwater ecotoxicity effect factor in USEtox. For calculating the potential freshwater aquatic ecotoxicity impacts, USEtox bases the effect factor on the chronic hazard concentration (HC50) value for a chemical calculated as the arithmetic mean of all logarithmized geometric means of species-specific chronic median lethal (or effect) concentrations (L[E]C50). We investigated the dependency of the USEtox effect factor on the selection of ecotoxicological data source and toxicological endpoints, and we found that both influence the ecotoxicity ranking of chemicals and may hence influence the conclusions of a PEF/OEF study. We furthermore compared the average measure (HC50) with other types of ecotoxicity effect indicators, such as the lowest species EC50 or no-observable-effect concentration, frequently used in regulatory risk assessment, and demonstrated how they may also influence the ecotoxicity ranking of chemicals. We acknowledge that these indicators represent different aspects of a chemical's ecotoxicity potential and discuss their pros and cons for a comparative chemical assessment as performed in life cycle assessment and in particular within the PEF/OEF context. Environ Toxicol Chem 2017;36:3450-3462. © 2017 The Authors. Environmental Toxicology and Chemistry

  6. Increasing the industrial potential of a region as a factor of improving the region’s competitiveness

    Directory of Open Access Journals (Sweden)

    Lidiya Viktorovna Shamray

    2015-09-01

    Full Text Available Objective to determine the factors of increasing the region competitiveness by defining the industrial potential of its enterprises. Methods in the research the systemic structural functional situational economic analysis was widely used as well as modelling of the economic entities functioning. The main modeling method used in this work is the model of breakeven point widely known and tested in many enterprises. The dependence proposed by the author is of analytical character. Results the article considers different approaches to the definition of competitiveness the effect of the factors is described. The industrial potential of the enterprises is presented as one of the factors of regional competitiveness. The difference is described between the competitive advantage in commercial and production activities. The author suggests a methodology allowing to evaluate the competitiveness of industrial enterprises through the performance of production capacity the possibility of making managerial decisions based on the results of its application the results of the model testing are present. The possibility of applying the model at the regional level is shown. Scientific novelty the article presents the authorrsquos method allowing to calculate the potential growth of the enterprises competitiveness using the output capacities as the difference between the maximum and actual values of capacity. Practical significance the use of models in the practice of the company allows to evaluate the enterprise competitiveness identifying the marginal productivity of the equipment. Once it has been reached the questions arise how long the company will remain competitive in achieving 100 capacity utilization selection of areas of extensive growth due to the fact that the limits of intensive growth have been achieved. Testing of the model was carried out at the Volgograd baking enterprises it showed a high accuracy of the calculation the deviation of calculated

  7. Human recombinant factor VIIa may improve heat intolerance in mice by attenuating hypothalamic neuronal apoptosis and damage.

    Science.gov (United States)

    Hsu, Chuan-Chih; Chen, Sheng-Hsien; Lin, Cheng-Hsien; Yung, Ming-Chi

    2014-10-01

    Intolerance to heat exposure is believed to be associated with hypothalamo-pituitary-adrenocortical (HPA) axis impairment [reflected by decreases in blood concentrations of both adrenocorticotrophic-hormone (ACTH) and corticosterone]. The purpose of this study was to determine the effect of human recombinant factor VIIa (rfVIIa) on heat intolerance, HPA axis impairment, and hypothalamic inflammation, ischemic and oxidative damage, and apoptosis in mice under heat stress. Immediately after heat stress (41.2 °C for 1 h), mice were treated with vehicle (1 mL/kg of body weight) or rfVIIa (65-270 µg/kg of body weight) and then returned to room temperature (26 °C). Mice still alive on day 4 of heat exposure were considered survivors. Cellular ischemia markers (e.g., glutamate, lactate-to-pyruvate ratio), oxidative damage markers (e.g., nitric oxide metabolite, hydroxyl radials), and pro-inflammatory cytokines (e.g., interleukin-6, interleukin-1β, tumor necrosis factor-α) in hypothalamus were determined. In addition, blood concentrations of both ACTH and corticosterone were measured. Hypothalamic cell damage was assessed by determing the neuronal damage scores, whereas the hypothalamic cell apoptosis was determined by assessing the numbers of cells stained with terminal deoxynucleotidyl transferase-mediated αUTP nick-end labeling, caspase-3-positive cells, and platelet endothelial cell adhesion molecula-1-positive cells in hypothalamus. Compared with vehicle-treated heated mice, rfVIIa-treated heated mice had significantly higher fractional survival (8/10 vs 1/10), lesser thermoregulatory deficit (34.1 vs 24.8 °C), lesser extents of ischemic, oxidative, and inflammatory markers in hypothalamus, lesser neuronal damage scores and apoptosis in hypothalamus, and lesser HPA axis impairment. Human recombinant factor VIIa appears to exert a protective effect against heatstroke by attenuating hypothalamic cell apoptosis (due to ischemic, inflammatory, and oxidative damage

  8. Sources of pain in laparoendoscopic gynecological surgeons: An analysis of ergonomic factors and proposal of an aid to improve comfort.

    Science.gov (United States)

    Lee, Sa Ra; Shim, Sunah; Yu, Taeri; Jeong, Kyungah; Chung, Hye Won

    2017-01-01

    Minimally invasive surgery (MIS) offers cosmetic benefits to patients; however, surgeons often experience pain during MIS. We administered an ergonomic questionnaire to 176 Korean laparoscopic gynecological surgeons to determine potential sources of pain during surgery. Logistic regression analysis was used to identify factors that had a significant impact on gynecological surgeons' pain. Operating table height at the beginning of surgery and during the operation were significantly associated with neck and shoulder discomfort (P ergonomic solutions to reduce gynecological laparoscopic surgeons' pain. Based on our results, we propose the use of an ergonomic surgical step stool to reduce physical pain related to performing laparoscopic operations.

  9. Schistosomiasis mansoni incidence data in Rwanda can improve prevalence assessments, by providing high-resolution hotspot and risk factors identification.

    Science.gov (United States)

    Nyandwi, E; Veldkamp, A; Amer, S; Karema, C; Umulisa, I

    2017-10-25

    Schistosomiasis mansoni constitutes a significant public health problem in Rwanda. The nationwide prevalence mapping conducted in 2007-2008 revealed that prevalence per district ranges from 0 to 69.5% among school children. In response, mass drug administration campaigns were initiated. However, a few years later some additional small-scale studies revealed the existence of areas of high transmission in districts formerly classified as low endemic suggesting the need for a more accurate methodology for identification of hotspots. This study investigated if confirmed cases of schistosomiasis recorded at health facility level can be used to, next to existing prevalence data, detect geographically more accurate hotspots of the disease and its associated risk factors. A GIS-based spatial and statistical analysis was carried out. Confirmed cases, recorded at primary health facilities level, were combined with demographic data to calculate incidence rates for each of 367 health facility service area. Empirical Bayesian smoothing was used to deal with rate instability. Incidence rates were compared with prevalence data to identify their level of agreement. Spatial autocorrelation of the incidence rates was analyzed using Moran's Index, to check if spatial clustering occurs. Finally, the spatial relationship between schistosomiasis distribution and potential risk factors was assessed using multiple regression. Incidence rates for 2007-2008 were highly correlated with prevalence values (R 2  = 0.79), indicating that in the case of Rwanda incidence data can be used as a proxy for prevalence data. We observed a focal distribution of schistosomiasis with a significant spatial autocorrelation (Moran's I > 0: 0,05-0.20 and p ≤ 0,05), indicating the occurrence of hotspots. Regarding risk factors, it was identified that the spatial pattern of schistosomiasis is significantly associated with wetland conditions and rice cultivation. In Rwanda the high density of health

  10. The Improvement of HR-management as a Factor of Increasing of Companies’ Competitiveness in the Labour Market

    Directory of Open Access Journals (Sweden)

    Buyar Kateryna

    2015-09-01

    Full Text Available In my article were researched market economy mechanisms for increasing the competitiveness of companies in the labour market. The paper target was to prove the need to use economic and administrative mechanisms to improve a level of competitiveness of the company in the labour market. Such researches become more important today, because after my empirical analyse of literature I can only conclude that not a lot of researchers studied in this field of science and the most theories suggest that only employees must be competitive on the labour market. But as a result of my research I can deny this one-sided view and can confirm that nowadays not just employees, but also employers compete with each other in the labour market. So, successful organizations must pay big attention to the processes of HR-management, which must be improved. But not enough attention is paid to the system of management and its impact on workers. It is important to form close links between existing system management with inherent for company effective economic management mechanisms in the companies with the level of competitiveness of the company in the labour market. So the results of my research showed that companies must develop economic and administrative mechanisms to improve their competitiveness in the labour market. These mechanisms are a set of applied styles and methods of management that have a direct impact on the loyalty of workers and consequently, enhance its competitiveness both inside the company and in external labour markets. So I can conclude that the paper target was achieved.

  11. Phenotype analysis of early risk factors from electronic medical records improves image-derived diagnostic classifiers for optic nerve pathology

    Science.gov (United States)

    Chaganti, Shikha; Nabar, Kunal P.; Nelson, Katrina M.; Mawn, Louise A.; Landman, Bennett A.

    2017-03-01

    We examine imaging and electronic medical records (EMR) of 588 subjects over five major disease groups that affect optic nerve function. An objective evaluation of the role of imaging and EMR data in diagnosis of these conditions would improve understanding of these diseases and help in early intervention. We developed an automated image processing pipeline that identifies the orbital structures within the human eyes from computed tomography (CT) scans, calculates structural size, and performs volume measurements. We customized the EMR-based phenome-wide association study (PheWAS) to derive diagnostic EMR phenotypes that occur at least two years prior to the onset of the conditions of interest from a separate cohort of 28,411 ophthalmology patients. We used random forest classifiers to evaluate the predictive power of image-derived markers, EMR phenotypes, and clinical visual assessments in identifying disease cohorts from a control group of 763 patients without optic nerve disease. Image-derived markers showed more predictive power than clinical visual assessments or EMR phenotypes. However, the addition of EMR phenotypes to the imaging markers improves the classification accuracy against controls: the AUC improved from 0.67 to 0.88 for glaucoma, 0.73 to 0.78 for intrinsic optic nerve disease, 0.72 to 0.76 for optic nerve edema, 0.72 to 0.77 for orbital inflammation, and 0.81 to 0.85 for thyroid eye disease. This study illustrates the importance of diagnostic context for interpretation of image-derived markers and the proposed PheWAS technique provides a flexible approach for learning salient features of patient history and incorporating these data into traditional machine learning analyses.

  12. Spanning maternal, newborn and child health (MNCH) and health systems research boundaries: conducive and limiting health systems factors to improving MNCH outcomes in West Africa.

    Science.gov (United States)

    Agyepong, Irene Akua; Kwamie, Aku; Frimpong, Edith; Defor, Selina; Ibrahim, Abdallah; Aryeetey, Genevieve C; Lokossou, Virgil; Sombie, Issiaka

    2017-07-12

    Despite improvements over time, West Africa lags behind global as well as sub-Saharan averages in its maternal, newborn and child health (MNCH) outcomes. This is despite the availability of an increasing body of knowledge on interventions that improve such outcomes. Beyond our knowledge of what interventions work, insights are needed on others factors that facilitate or inhibit MNCH outcome improvement. This study aimed to explore health system factors conducive or limiting to MNCH policy and programme implementation and outcomes in West Africa, and how and why they work in context. We conducted a mixed methods multi-country case study focusing predominantly, but not exclusively, on the six West African countries (Burkina Faso, Benin, Mali, Senegal, Nigeria and Ghana) of the Innovating for Maternal and Child Health in Africa initiative. Data collection involved non-exhaustive review of grey and published literature, and 48 key informant interviews. We validated our findings and conclusions at two separate multi-stakeholder meetings organised by the West African Health Organization. To guide our data collection and analysis, we developed a unique theoretical framework of the link between health systems and MNCH, in which we conceptualised health systems as the foundations, pillars and roofing of a shelter for MNCH, and context as the ground on which the foundation is laid. A multitude of MNCH policies and interventions were being piloted, researched or implemented at scale in the sub-region, most of which faced multiple interacting conducive and limiting health system factors to effective implementation, as well as contextual challenges. Context acted through its effect on health system factors as well as on the social determinants of health. To accelerate and sustain improvements in MNCH outcomes in West Africa, an integrated approach to research and practice of simultaneously addressing health systems and contextual factors alongside MNCH service delivery

  13. Health locus of control as a psychological factor in improving treatment results in adolescents with primary hypertension and diabetes

    Directory of Open Access Journals (Sweden)

    Marta Anna Biernacka

    2016-10-01

    Full Text Available Background The belief that an individual can influence and control the course of events is a factor which enables a person to overcome difficulties. Some studies, however, have questioned the universality of this statement. This study aims to investigate and explore the relationship between the self-health locus of control and the effectiveness of cooperation in the treatment process in adolescents with chronic diseases. Participants and procedure One hundred and sixty-four adolescent patients suffering from chronic diseases (61 girls and 103 boys ranging from 11 to 17 years old participated in the study. Eighty-seven had primary hypertension and 77 had type 1 diabetes. To investigate their sense of health control we used the Health Locus of Control Scale (HLC. Cooperation in the treatment process was assessed using a 4-item scale completed by a doctor. Results Better results in the treatment were positively correlated with a better internal health locus of control. A negative correlation between the chance health locus of control and results in the treatment was found. Differences in the health locus of control proved to be dependent on gender, age and different clinical groups. Conclusions Health locus of control in patients with chronic diseases seems to be a crucial factor in determining the results of the treatment process in such patients.

  14. Advancing national greenhouse gas inventories for agriculture in developing countries: improving activity data, emission factors and software technology

    International Nuclear Information System (INIS)

    Ogle, Stephen M; Hartman, Melannie; Spencer, Shannon; Buendia, Leandro; Butterbach-Bahl, Klaus; Breidt, F Jay; Yagi, Kazuyuki; Nayamuth, Rasack; Wirth, Tom; Smith, Pete

    2013-01-01

    Developing countries face many challenges when constructing national inventories of greenhouse gas (GHG) emissions, such as lack of activity data, insufficient measurements for deriving country-specific emission factors, and a limited basis for assessing GHG mitigation options. Emissions from agricultural production are often significant sources in developing countries, particularly soil nitrous oxide, and livestock enteric and manure methane, in addition to wetland rice methane. Consequently, estimating GHG emissions from agriculture is an important part of constructing developing country inventories. While the challenges may seem insurmountable, there are ways forward such as: (a) efficiently using resources to compile activity data by combining censuses and surveys; (b) using a tiered approach to measure emissions at appropriately selected sites, coupled with modeling to derive country-specific emission factors; and (c) using advanced software systems to guide compilers through the inventory process. With a concerted effort by compilers and assistance through capacity-building efforts, developing country compilers could produce transparent, accurate, complete, consistent and comparable inventories, as recommended by the IPCC (Intergovernmental Panel on Climate Change). In turn, the resulting inventories would provide the foundation for robust GHG mitigation analyses and allow for the development of nationally appropriate mitigation actions and low emission development strategies. (letter)

  15. Critical Success Factors to Improve Perception of Information Technology Careers: A Specific Case in a Mexican Higher Education Institution

    Directory of Open Access Journals (Sweden)

    Alejandra Aldrette-Malacara

    2013-06-01

    Full Text Available It is a fact that fashion plays an important role to select a career, new options of careers from engineering are preferred by students instead of traditional options; for example, Mechatronics, Aeronautics, Automotive specializations, Bionics, Biomedical and others are so popular. Every day, new necessities are required in the world and it is necessary to find the way to solve them, for that reason these new majors are good options to students, however traditional areas are important too. Information Technology is not the exception because every enterprise, school, association and organization needs computers with systems that help to solve specific situations or to manage resources. In Mexico, Information Technology careers are been affected for low enrollment of students, of course private universities have suffered more this situation than public schools [1]. In this research work are shown the most important factors that have a real incidence to choose an Information Technology career. The methodology consisted in the design of a survey using seven points Likert´s scale where potential students could express more about their expectative, preferences and required abilities to study these majors. The mentioned survey had three versions and each one was validated through Cronbach’s Alpha. Data collected were analyzed using statistical software SPSS to obtain the critical success factors.

  16. Growth factor-enriched autologous plasma improves wound healing after surgical debridement in odontogenic necrotizing fasciitis: a case report

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    Martinez-Fong Daniel

    2011-03-01

    Full Text Available Abstract Background Odontogenic necrotizing fasciitis of the neck is a fulminant infection of odontogenic origin that quickly spreads along the fascial planes and results in necrosis of the affected tissues. It is usually polymicrobial, occurs frequently in immunocompromised patients, and has a high mortality rate. Case presentation A 69-year old Mexican male had a pain in the maxillar right-canine region and a swelling of the submental and submandibular regions. Our examination revealed local pain, tachycardia, hyperthermia (39°C, and the swelling of bilateral submental and submandibular regions, which also were erythematous, hyperthermic, crepitant, and with a positive Godet sign. Mobility and third-degree caries were seen in the right mandibular canine. Bacteriological cultures isolated streptococcus pyogenes and staphylococcus aureus. The histopathological diagnosis was odontogenic necrotizing fasciitis of the submental and submandibular regions. The initial treatment was surgical debridement and the administration of antibiotics. After cultures were negative, the surgical wound was treated with a growth factor-enriched autologous plasma eight times every third day until complete healing occurred. Conclusions The treatment with a growth factor-enriched autologous plasma caused a rapid healing of an extensive surgical wound in a patient with odontogenic necrotizing fasciitis. The benefits were rapid tissue regeneration, an aesthetic and a functional scar, and the avoidance of further surgery and possible complications.

  17. Platelet growth factors from allogeneic platelet-rich plasma for clinical improvement in split-thickness skin graft.

    Science.gov (United States)

    Sonker, Atul; Dubey, Anju; Bhatnagar, Ankur; Chaudhary, Rajendra

    2015-01-01

    Platelets are a source of numerous growth factors which facilitate repair and healing. Thus platelet rich plasma has been increasingly used as a treatment modality in the field of reconstructive surgeries for wound healing. This preliminary study was carried out to explore whether platelet growth factors from platelet rich plasma could be used for enhancement of split thickness skin graft survival. Twenty patients (13 males and 7 females) requiring split thickness skin graft for various clinical reasons were enrolled in the study. Platelet rich plasma was collected by apheresis and frozen at -80° C. It was thawed at room temperature immediately before its intended application. PRP was applied only on one half of the wound, while another half served as control. Patient was followed for 6 weeks. The effect was assessed at first dressing in terms of graft uptake and subsequently as time taken for complete healing. There was 100% uptake of the graft in the area where platelet rich plasma was applied. In the control area, there was complete graft loss in 4 cases, partial loss in 7 cases and complete uptake in 9 cases. This study demonstrated promising results on application of PRP to split thickness skin grafts. Further randomized studies with greater sample size may be undertaken to establish platelet rich plasma as a validated treatment modality.

  18. Sources of pain in laparoendoscopic gynecological surgeons: An analysis of ergonomic factors and proposal of an aid to improve comfort.

    Directory of Open Access Journals (Sweden)

    Sa Ra Lee

    Full Text Available Minimally invasive surgery (MIS offers cosmetic benefits to patients; however, surgeons often experience pain during MIS. We administered an ergonomic questionnaire to 176 Korean laparoscopic gynecological surgeons to determine potential sources of pain during surgery. Logistic regression analysis was used to identify factors that had a significant impact on gynecological surgeons' pain. Operating table height at the beginning of surgery and during the operation were significantly associated with neck and shoulder discomfort (P <0.001. The ability to control the operating table height was the single factor most significantly associated with neck (P <0.001 and shoulder discomfort (P <0.001. Discomfort of the hand/digits was significantly associated with the trocar site (P = 0.035. The type of electrocautery activation switch and foot pedal were significantly related to surgeons' foot and leg discomfort (P <0.001. In evaluating the co-occurrence of pain in 4 different sites (neck, shoulder, back, hand/digits, the neck and shoulder were determined to have the highest co-occurrence of pain (Spearman's ρ = 0.64, P <0.001. These results provide guidance for identifying ergonomic solutions to reduce gynecological laparoscopic surgeons' pain. Based on our results, we propose the use of an ergonomic surgical step stool to reduce physical pain related to performing laparoscopic operations.

  19. The prediction of resting energy expenditure in type 2 diabetes mellitus is improved by factoring for glycemia.

    Science.gov (United States)

    Gougeon, R; Lamarche, M; Yale, J-F; Venuta, T

    2002-12-01

    Predictive equations have been reported to overestimate resting energy expenditure (REE) for obese persons. The presence of hyperglycemia results in elevated REE in obese persons with type 2 diabetes, and its effect on the validity of these equations is unknown. We tested whether (1) indicators of diabetes control were independent associates of REE in type 2 diabetes and (2) their inclusion would improve predictive equations. A cross-sectional study of 65 (25 men, 40 women) obese type 2 diabetic subjects. Variables measured were: REE by ventilated-hood indirect calorimetry, body composition by bioimpedance analysis, body circumferences, fasting plasma glucose (FPG) and hemoglobin A(1c). Data were analyzed using stepwise multiple linear regression. REE, corrected for weight, fat-free mass, age and gender, was significantly greater with FPG>10 mmol/l (P=0.017) and correlated with FPG (P=0.013) and hemoglobin A(1c) as percentage upper limit of normal (P=0.02). Weight was the main determinant of REE. Together with hip circumference and FPG, it explained 81% of the variation. FPG improved the predictability of the equation by >3%. With poor glycemic control, it can represent an increase in REE of up to 8%. Our data indicate that in a population of obese subjects with type 2 diabetes mellitus, REE is better predicted when fasting plasma glucose is included as a variable.

  20. Immunogenicity of anti-tumor necrosis factor antibodies-toward improved methods of anti-antibody measurement.

    Science.gov (United States)

    Aarden, Lucien; Ruuls, Sigrid R; Wolbink, Gertjan

    2008-08-01

    To date, millions of people have been treated with therapeutic monoclonal antibodies (TmAbs) for various indications. It is becoming increasingly clear that TmAbs can be immunogenic, which may reduce efficacy or induce adverse effects. Over the years, the importance of antibody formation has been questioned and sometimes minimized, as few antibody responses to TmAbs (HACA or HAHA) were reported. However, the methods to detect and quantify such antibodies used in the past have been problematic. Only recently, methods have been developed that have adequate sensitivity and are not seriously disturbed by false-positive reactions caused by rheumatoid factors, natural antibodies to Fab or F(ab')2 fragments, or Fc interactions of IgG4. The large number of treated patients, in combination with these new assays, presents a unique opportunity to study the anti-antibody immune response in man, possibly allowing us to manipulate immunogenicity in the future.

  1. Application of bias factor method using random sampling technique for prediction accuracy improvement of critical eigenvalue of BWR

    International Nuclear Information System (INIS)

    Ito, Motohiro; Endo, Tomohiro; Yamamoto, Akio; Kuroda, Yusuke; Yoshii, Takashi

    2017-01-01

    The bias factor method based on the random sampling technique is applied to the benchmark problem of Peach Bottom Unit 2. Validity and availability of the present method, i.e. correction of calculation results and reduction of uncertainty, are confirmed in addition to features and performance of the present method. In the present study, core characteristics in cycle 3 are corrected with the proposed method using predicted and 'measured' critical eigenvalues in cycles 1 and 2. As the source of uncertainty, variance-covariance of cross sections is considered. The calculation results indicate that bias between predicted and measured results, and uncertainty owing to cross section can be reduced. Extension to other uncertainties such as thermal hydraulics properties will be a future task. (author)

  2. Overexpression of a New Zinc Finger Protein Transcription Factor OsCTZFP8 Improves Cold Tolerance in Rice

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    Yong-Mei Jin

    2018-01-01

    Full Text Available Cold stress is one of the most important abiotic stresses in rice. C2H2 zinc finger proteins play important roles in response to abiotic stresses in plants. In the present study, we isolated and functionally characterized a new C2H2 zinc finger protein transcription factor OsCTZFP8 in rice. OsCTZFP8 encodes a C2H2 zinc finger protein, which contains a typical zinc finger motif, as well as a potential nuclear localization signal (NLS and a leucine-rich region (L-box. Expression of OsCTZFP8 was differentially induced by several abiotic stresses and was strongly induced by cold stress. Subcellular localization assay and yeast one-hybrid analysis revealed that OsCTZFP8 was a nuclear protein and has transactivation activity. To characterize the function of OsCTZFP8 in rice, the full-length cDNA of OsCTZFP8 was isolated and transgenic rice with overexpression of OsCTZFP8 driven by the maize ubiquitin promoter was generated using Agrobacterium-mediated transformation. Among 46 independent transgenic lines, 6 single-copy homozygous overexpressing lines were selected by Southern blot analysis and Basta resistance segregation assay in both T1 and T2 generations. Transgenic rice overexpressing OsCTZFP8 exhibited cold tolerant phenotypes with significantly higher pollen fertilities and seed setting rates than nontransgenic control plants. In addition, yield per plant of OsCTZFP8-expressing lines was significantly (p<0.01 higher than that of nontransgenic control plants under cold treatments. These results demonstrate that OsCTZFP8 was a C2H2 zinc finger transcription factor that plays an important role in cold tolerance in rice.

  3. The Improvement of the Accommodation Offer in Vojvodina (Serbia as a Factor of its Competitiveness on the Market

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    Svetlana Vukosav

    2009-06-01

    Full Text Available The accommodation offer, particularly hotel industry in Vojvodina is experiencing significant changes today both in quality and in quantity compared to the period 10 years ago. These positive changes and the improvement of the receptive base are a direct consequence of the transition process, ownership transformation and investment in accommodation facilities, which is reflected through the constant increase of foreign tourists, foreign exchange input, as well as market share and competitiveness of certain types of accommodation. Investments in the accommodation offer in Vojvodina are one of the priorities in the Strategy of Tourism Development of Serbia, where a significant increase in the number of accommodation units in the Province is expected.

  4. MODERN INFORMATIONAL AND EDUCATIONAL ENVIRONMENT AS A FACTOR OF IMPROVEMENT OF FUTURE UNIVERSITY TEACHER’S PROFESSIONAL TRAINING

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    Наталія Гунька

    2014-10-01

    Full Text Available The article presents the analysis of the notion of “informational and educational environment”. The difference between the “informational environment” and the “informational and educational environment” has been shown. The main functions of the informational and educational environment and its facilities to enhance the quality of education have been revealed. There have been defined major components of the informational and educational environment. A connection has been detected between the informational and educational environment and the formation of the foundations of pedagogical skills. The research also presents a description of the electronic system “Socrates” of Vinnytsia State Agrarian University, and shows possible ways of its use in the educational process with an aim of the formation and improvement of higher educational institution teacher’s professional skills.

  5. Improving care by understanding the way we work: human factors and behavioural science in the context of intensive care

    Science.gov (United States)

    Sevdalis, Nick; Brett, Stephen J

    2009-01-01

    Effectiveness and efficiency of care of the critically ill patient are subject to a number of systemic influences, including skills of individual physicians/nurses (technical and non-technical), team-working in the intensive care unit (ICU), and the ICU environment. We first discuss the paper of Fackler and colleagues as a contribution to the systems approach to clinical performance in the context of intensive care. We then highlight features of care delivery that are unique to intensive care and discuss the need for better understanding of human and non-human elements of the system of care of the critically ill patient as a driver for improvement of care delivery. PMID:19439048

  6. Short-term exposure of umbilical cord blood CD34+ cells to granulocyte-macrophage colony-stimulating factor early in culture improves ex vivo expansion of neutrophils.

    Science.gov (United States)

    Marturana, Flavia; Timmins, Nicholas E; Nielsen, Lars K

    2011-03-01

    Despite the availability of modern antibiotics/antimycotics and cytokine support, neutropenic infection accounts for the majority of chemotherapy-associated deaths. While transfusion support with donor neutrophils is possible, cost and complicated logistics make such an option unrealistic on a routine basis. A manufactured neutrophil product could enable routine prophylactic administration of neutrophils, preventing the onset of neutropenia and substantially reducing the risk of infection. We examined the use of pre-culture strategies and various cytokine/modulator combinations to improve neutrophil expansion from umbilical cord blood (UCB) hematopoietic stem and progenitor cells (HPC). Enriched UCB HPC were cultured using either two-phase pre-culture strategies or a single phase using various cytokine/modulator combinations. Outcome was assessed with respect to numerical expansion, cell morphology, granulation and respiratory burst activity. Pre-culture in the absence of strong differentiation signals (e.g. granulocyte colony-stimulating factor; G-CSF) failed to provide any improvement to final neutrophil yields. Similarly, removal of differentiating cells during pre-culture failed to improve neutrophil yields to an appreciable extent. Of the cytokine/modulator combinations, the addition of granulocyte-macrophage (GM)-colony-stimulating factor (CSF) alone gave the greatest increase. In order to avoid production of monocytes, it was necessary to remove GM-CSF on day 5. Using this strategy, neutrophil expansion improved 2.7-fold. Although all cytokines and culture strategies employed have been reported previously to enhance HPC expansion, we found that the addition of GM-CSF alone was sufficient to improve total cell yields maximally. The need to remove GM-CSF on day 5 to avoid monocyte differentiation highlights the context and time-dependent complexity of exogenous signaling in hematopoietic cell differentiation and growth.

  7. Plasma rich in growth factors (PRGF-Endoret) stimulates tendon and synovial fibroblasts migration and improves the biological properties of hyaluronic acid.

    Science.gov (United States)

    Anitua, E; Sanchez, M; De la Fuente, M; Zalduendo, M M; Orive, G

    2012-09-01

    Cell migration plays an essential role in development, wound healing, and tissue regeneration. Plasma rich in growth factors (PRGF-Endoret) technology offers a potential source of growth factors involved in tissue regeneration. Here, we evaluate the potential of PRGF-Endoret over tendon cells and synovial fibroblasts migration and study whether the combination of this autologous technology with hyaluronic acid (HA) improves the effect and potential of the biomaterials over the motility of both types of fibroblasts. Migration of primary tendon cells and synovial fibroblasts after culturing with either PRGF or PPGF (plasma poor in growth factors) at different doses was evaluated. Furthermore, the migratory capacity induced by the combination of PPGF and PRGF with HA was tested. PPGF stimulated migration of both types of cells but this effect was significantly higher when PRGF was used. Tendon cells showed an increase of 212% in migratory ability when HA was combined with PPGF and of 335% in the case of HA + PRGF treatment compared with HA alone. PRGF-Endoret stimulates migration of tendon cells and synovial fibroblasts and improves the biological properties of HA.

  8. Local myocardial insulin-like growth factor 1 (IGF-1) delivery with biotinylated peptide nanofibers improves cell therapy for myocardial infarction

    Science.gov (United States)

    Davis, Michael E.; Hsieh, Patrick C. H.; Takahashi, Tomosaburo; Song, Qing; Zhang, Shuguang; Kamm, Roger D.; Grodzinsky, Alan J.; Anversa, Piero; Lee, Richard T.

    2006-05-01

    Strategies for cardiac repair include injection of cells, but these approaches have been hampered by poor cell engraftment, survival, and differentiation. To address these shortcomings for the purpose of improving cardiac function after injury, we designed self-assembling peptide nanofibers for prolonged delivery of insulin-like growth factor 1 (IGF-1), a cardiomyocyte growth and differentiation factor, to the myocardium, using a "biotin sandwich" approach. Biotinylated IGF-1 was complexed with tetravalent streptavidin and then bound to biotinylated self-assembling peptides. This biotin sandwich strategy allowed binding of IGF-1 but did not prevent self-assembly of the peptides into nanofibers within the myocardium. IGF-1 that was bound to peptide nanofibers activated Akt, decreased activation of caspase-3, and increased expression of cardiac troponin I in cardiomyocytes. After injection into rat myocardium, biotinylated nanofibers provided sustained IGF-1 delivery for 28 days, and targeted delivery of IGF-1 in vivo increased activation of Akt in the myocardium. When combined with transplanted cardiomyocytes, IGF-1 delivery by biotinylated nanofibers decreased caspase-3 cleavage by 28% and increased the myocyte cross-sectional area by 25% compared with cells embedded within nanofibers alone or with untethered IGF-1. Finally, cell therapy with IGF-1 delivery by biotinylated nanofibers improved systolic function after experimental myocardial infarction, demonstrating how engineering the local cellular microenvironment can improve cell therapy. engineering | maturation | scaffold

  9. Studies on improving ostrich egg hatch ability and its relation with some factors affecting embryonic development during artificial incubation

    International Nuclear Information System (INIS)

    Amer, N.S.I.

    2012-01-01

    The present study was carried out in co-operation between the Ostrich Production Farm, Nuclear Research Center, Atomic Energy Authority, Cairo, Egypt and the Faculty of Agriculture, AL-Azhar University, Nasr City, Cairo, Egypt. Ostrich eggs were obtained from Resk Company for Ostrich Production and set for incubation at ElShfie Farm, Belbas, Sharkia, Egypt. The objectives are:1- To follow up changes in some vital physiological parameters and blood components associated with ostrich embryonic development during incubation and to provide reference blood biochemical baseline values for future studies of avian species and to document novel information on some normal changes associated with growth of the developing ostrich embryo during the incubation, as no similar and complete data could be found on this aspect in the literature. 2- In an effort to improve the hatch ability and hatching performance of ostrich eggs by testing the effect of in ovo injection of several nutrients. Two trials were carried out: 1-First trial To follow up changes in some vital physiological parameters and blood components associated with ostrich embryonic development during incubation. A total number of 60 ostrich eggs weighed between 1300 and 1500 g were obtained from from Resk Company for Ostrich Production. Eggs were collected weekly in patches of 25 eggs and Egg incubation was performed in ElShfie Farm, Belbas, Egypt. Egg weight and egg weight loss during incubation were determined on each eggs.2- Second Trial In vivo injection In an effort to improve the hatch ability and hatching performance of ostrich eggs by testing the effect of in ovo injection of several nutrients. A total of 100 fertile ostrich eggs weighed between 1300 and 1500 g were obtained from from Resk Company for Ostrich Production. Eggs were collected weekly in patches of 25 eggs and egg incubation was performed in ElShfie Farm, Belbas, Egypt. Eggs were injected at the 7 th day of incubation to deposit test material in

  10. Long-Term Improvements in Knowledge and Psychosocial Factors of a Teen Pregnancy Prevention Intervention Implemented in Group Homes.

    Science.gov (United States)

    Green, Jennifer; Oman, Roy F; Lu, Minggen; Clements-Nolle, Kristen D

    2017-06-01

    Youth in out-of-home care have higher rates of sexual risk behaviors and pregnancy than youth nationally. This study aimed to determine if Power Through Choices (PTC), a teen pregnancy prevention program developed for youth in out-of-home care, significantly improves knowledge and psychosocial outcomes regarding HIV and sexually transmitted infections (STIs), sexual activity and contraception methods, long term. A cluster randomized controlled trial was conducted with 1,036 ethnically diverse youths (aged 13-18 years) recruited from 44 residential group homes in three states. Intervention participants received the 10-session PTC intervention; control participants received usual care. Participants were administered self-report surveys at baseline, after intervention, 6 and 12 months after the intervention. Survey items assessed knowledge, attitudes, self-efficacy, and behavioral intentions regarding HIV and STIs, sexual activity and contraception methods. Random intercept logistic regression analyses were used to assess differences between the intervention and control groups. Compared with youth in the control group, youth in the PTC intervention demonstrated significant improvements in knowledge about anatomy and fertility (adjusted odds ratio [AOR] = 1.07, 95% confidence interval [CI] = 1.03-1.11), HIV and STIs (AOR = 1.03, 95% CI = 1.002-1.07), and methods of protection (AOR = 1.06, 95% CI = 1.03-1.09), as well as self-efficacy regarding self-efficacy to communicate with a partner (AOR = 1.14, 95% CI = 1.04-1.26), plan for protected sex and avoid unprotected sex (AOR = 1.16, 95% CI = 1.04-1.28), and where to get methods of birth control (AOR = 1.13, 95% CI = 1.01-1.26) 12 months after the intervention. Findings suggest that the PTC intervention can have positive long-term knowledge and psychosocial effects regarding contraception methods on youth in out-of-home care. Copyright © 2017 Society for Adolescent Health and Medicine. Published by

  11. Optimization of environmental factors for improved production of rhamnolipid biosurfactant by Pseudomonas aeruginosa RS29 on glycerol.

    Science.gov (United States)

    Saikia, Rashmi Rekha; Deka, Suresh; Deka, Manab; Sarma, Hemen

    2012-08-01

    A biosurfactant producing Pseudomonas aeruginosa RS29 (identified on the basis of 16S rDNA analysis) with good foaming and emulsification properties has been isolated from crude oil contaminated sites. Optimization of different environmental factors was carried out with an objective to achieve maximum production of biosurfactant. Production of biosurfactant was estimated in terms of surface tension reduction and emulsification (E24) index. It was recorded that the isolated strain produced highest biosurfactant after 48 h of incubation at 37.5 °C, with a pH range of 7-8 and at salinity biosurfactant (Surface tension, 26.3 and 26.4 mN/m and E24 index, 80 and 79% respectively). The CMC of the biosurfactant was 90 mg/l. Maximum biomass (6.30 g/l) and biosurfactant production (0.80 g/l) were recorded at an optimal C/N ratio of 12.5. Biochemical analysis and FTIR spectra confirmed that the biosurfactant was rhamnolipid in nature. GC-MS analysis revealed the presence of C(8) and C(10) fatty acid components in the purified biosurfactant. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  12. Suppression of a NAC-Like Transcription Factor Gene Improves Boron-Toxicity Tolerance in Rice1

    Science.gov (United States)

    Ochiai, Kumiko; Shimizu, Akifumi; Okumoto, Yutaka; Fujiwara, Toru; Matoh, Toru

    2011-01-01

    We identified a gene responsible for tolerance to boron (B) toxicity in rice (Oryza sativa), named BORON EXCESS TOLERANT1. Using recombinant inbred lines derived from the B-toxicity-sensitive indica-ecotype cultivar IR36 and the tolerant japonica-ecotype cultivar Nekken 1, the region responsible for tolerance to B toxicity was narrowed to 49 kb on chromosome 4. Eight genes are annotated in this region. The DNA sequence in this region was compared between the B-toxicity-sensitive japonica cultivar Wataribune and the B-toxicity-tolerant japonica cultivar Nipponbare by eco-TILLING analysis and revealed a one-base insertion mutation in the open reading frame sequence of the gene Os04g0477300. The gene encodes a NAC (NAM, ATAF, and CUC)-like transcription factor and the function of the transcript is abolished in B-toxicity-tolerant cultivars. Transgenic plants in which the expression of Os04g0477300 is abolished by RNA interference gain tolerance to B toxicity. PMID:21543724

  13. Allogeneic lymphocyte-licensed DCs expand T cells with improved antitumor activity and resistance to oxidative stress and immunosuppressive factors

    Directory of Open Access Journals (Sweden)

    Chuan Jin

    2014-01-01

    Full Text Available Adoptive T-cell therapy of cancer is a treatment strategy where T cells are isolated, activated, in some cases engineered, and expanded ex vivo before being reinfused to the patient. The most commonly used T-cell expansion methods are either anti-CD3/CD28 antibody beads or the “rapid expansion protocol” (REP, which utilizes OKT-3, interleukin (IL-2, and irradiated allogeneic feeder cells. However, REP-expanded or bead-expanded T cells are sensitive to the harsh tumor microenvironment and often short-lived after reinfusion. Here, we demonstrate that when irradiated and preactivated allosensitized allogeneic lymphocytes (ASALs are used as helper cells to license OKT3-armed allogeneic mature dendritic cells (DCs, together they expand target T cells of high quality. The ASAL/DC combination yields an enriched Th1-polarizing cytokine environment (interferon (IFN-γ, IL-12, IL-2 and optimal costimulatory signals for T-cell stimulation. When genetically engineered antitumor T cells were expanded by this coculture system, they showed better survival and cytotoxic efficacy under oxidative stress and immunosuppressive environment, as well as superior proliferative response during tumor cell killing compared to the REP protocol. Our result suggests a robust ex vivo method to expand T cells with improved quality for adoptive cancer immunotherapy.

  14. Improved fill factor in inverted planar perovskite solar cells with zirconium acetate as the hole-and-ion-blocking layer.

    Science.gov (United States)

    Zhang, Xuewen; Liang, Chunjun; Sun, Mengjie; Zhang, Huimin; Ji, Chao; Guo, Zebang; Xu, Yajun; Sun, Fulin; Song, Qi; He, Zhiqun

    2018-03-14

    Planar perovskite solar cells (PSCs) have gained great interest due to their low-temperature solution preparation and simple process. In inverted planar PSCs, an additional buffer layer is usually needed on the top of the PCBM electron-transport layer (ETL) to enhance the device performance. In this work, we used a new buffer layer, zirconium acetate (Zr(Ac) 4 ). The inclusion of the Zr(Ac) 4 buffer layer leads to the increase of FF from ∼68% to ∼79% and PCE from ∼14% to ∼17% in the planar PSCs. The UPS measurement indicates that the Zr(Ac) 4 layer has a low HOMO level of -8.2 eV, indicating that the buffer layer can act as a hole-blocking layer. Surface morphology and surface chemistry investigations reveal that the elements I, MA and Pb can diffuse across the PCBM ETL, damaging the device performance. The covering Zr(Ac) 4 molecules fill in the pinholes of the PCBM layer and effectively block the ions/molecules of the perovskite from diffusion across the ETL. The resulting more robust PCBM/Zr(Ac) 4 ETL leads to weaker ionic charge accumulation and lower diode leakage current. The double role of hole-and-ion blocking of the Zr(Ac) 4 layer explains the improved FF and PCE in the PSCs.

  15. Brain-derived neurotrophic factor improves proliferation of endometrial epithelial cells by inhibition of endoplasmic reticulum stress during early pregnancy.

    Science.gov (United States)

    Lim, Whasun; Bae, Hyocheol; Bazer, Fuller W; Song, Gwonhwa

    2017-12-01

    Brain-derived neurotrophic factor (BDNF) is a member of the neurotrophin family binds to two transmembrane receptors; neurotrophic receptor tyrosine kinase 2 (NTRK2) with high affinity and p75 with low affinity. Although BDNF-NTRK2 signaling in the central nervous system is known, signaling in the female reproductive system is unknown. Therefore, we determined effects of BDNF on porcine endometrial luminal epithelial (pLE) cells isolated from Day 12 of pregnancy, as well as expression of BDNF and NTRK2 in endometria of cyclic and pregnant pigs. BDNF-NTRK2 genes were expressed in uterine glandular (GE) and luminal (LE) epithelia during early pregnancy. In addition, their expression in uterine GE and LE decreased with increasing parity of sows. Recombinant BDNF increased proliferation in pLE cells in a dose-dependent, as well as expression of PCNA and Cyclin D1 in nuclei of pLE cells. BDNF also activated phosphorylation of AKT, P70S6K, S6, ERK1/2, JNK, P38 proteins in pLE cells. In addition, cell death resulting from tunicamycin-induced ER stress was prevented when pLE cells were treated with the combination of tunicamycin and BDNF which also decreased cells in the Sub-G 1 phase of the cell cycle. Furthermore, tunicamycin-induced unfolded protein response genes were mostly down-regulated to the basal levels as compared to non-treated pLE cells. Our finding suggests that BDNF acts via NTRK2 to induce development of pLE cells for maintenance of implantation and pregnancy by activating cell signaling via the PI3K and MAPK pathways and by inhibiting ER stress. © 2017 Wiley Periodicals, Inc.

  16. Improved wound healing in pressure-induced decubitus ulcer with controlled release of basic fibroblast growth factor

    International Nuclear Information System (INIS)

    Jiang Wei; Wang Hailun; Jin Faguang; Yu Chunyan; Chu Dongling; Wang Lin; Lu Xian

    2008-01-01

    The purpose was to evaluate the efficacy of the wound dressing containing basic fibroblast growth factor (bFGF)-loaded microspheres on promoting healing in pressure-induced decubitus ulcer. In this study, the pressure-induced ulcer in swine was used as a model to demonstrate the hypothesis that controlled release of bFGF has the potential to provide optimal healing milieu for chronic wounds in the repair process. Average size of the microspheres was 14.36 ± 3.56 μm and the network gelatin sponges were characterized with an average pore size of 80-160 μm. Both the in vitro release efficiency and the protein bioactivity revealed that bFGF was released from the microspheres in a controlled manner and it was biologically active as assessed by its ability to induce the proliferation of fibroblasts. Pressure-induced ulcer was created at 500 g/cm 2 pressure loaded on swine dorsal skin 12 h daily for 2 consecutive days. After removal of the pressure load, the gelatin sponge containing bFGF gelatin microspheres or bFGF in solution was implanted into the wound. Swine were sacrificed at 7, 14, and 21 days after implantation, and a full-thickness biopsy was taken and stained for histological analysis. It was observed that controlled release of bFGF provided an accelerated recovery in the wound areas. Histological investigations showed that the dressings were biocompatible and had capability of proliferating fibroblasts and inducing neovascularisation. The present study implied the clinical potential of gelatin sponge with bFGF microspheres to promote the healing in pressure-induced decubitus ulcer

  17. Transient B cell depletion or improved transgene expression by codon optimization promote tolerance to factor VIII in gene therapy.

    Directory of Open Access Journals (Sweden)

    Brandon K Sack

    Full Text Available The major complication in the treatment of hemophilia A is the development of neutralizing antibodies (inhibitors against factor VIII (FVIII. The current method for eradicating inhibitors, termed immune tolerance induction (ITI, is costly and protracted. Clinical protocols that prevent rather than treat inhibitors are not yet established. Liver-directed gene therapy hopes to achieve long-term correction of the disease while also inducing immune tolerance. We sought to investigate the use of adeno-associated viral (serotype 8 gene transfer to induce tolerance to human B domain deleted FVIII in hemophilia A mice. We administered an AAV8 vector with either human B domain deleted FVIII or a codon-optimized transgene, both under a liver-specific promoter to two strains of hemophilia A mice. Protein therapy or gene therapy was given either alone or in conjunction with anti-CD20 antibody-mediated B cell depletion. Gene therapy with a low-expressing vector resulted in sustained near-therapeutic expression. However, supplementary protein therapy revealed that gene transfer had sensitized mice to hFVIII in a high-responder strain but not in mice of a low-responding strain. This heightened response was ameliorated when gene therapy was delivered with anti-murine CD20 treatment. Transient B cell depletion prevented inhibitor formation in protein therapy, but failed to achieve a sustained hypo-responsiveness. Importantly, use of a codon-optimized hFVIII transgene resulted in sustained therapeutic expression and tolerance without a need for B cell depletion. Therefore, anti-CD20 may be beneficial in preventing vector-induced immune priming to FVIII, but higher levels of liver-restricted expression are preferred for tolerance.

  18. Improved wound healing in pressure-induced decubitus ulcer with controlled release of basic fibroblast growth factor

    Energy Technology Data Exchange (ETDEWEB)

    Jiang Wei [Department of Respiratory Diseases, Tangdu Hospital, Fourth Military Medical University, Xi' an 710038 (China); Wang Hailun [Department of Dermatology, Tangdu Hospital, Fourth Military Medical University, Xi' an 710038 (China); Jin Faguang [Department of Respiratory Diseases, Tangdu Hospital, Fourth Military Medical University, Xi' an 710038 (China)], E-mail: nidewenzhang@163.com; Yu Chunyan [Department of Dermatology, Tangdu Hospital, Fourth Military Medical University, Xi' an 710038 (China); Chu Dongling [Department of Respiratory Diseases, Tangdu Hospital, Fourth Military Medical University, Xi' an 710038 (China); Wang Lin [Department of Internal Medicine, 316 Hospital of PLA, Beijing 100093 (China); Lu Xian [93942 Unit Hospital of PLA, Xianyang 710012 (China)

    2008-07-14

    The purpose was to evaluate the efficacy of the wound dressing containing basic fibroblast growth factor (bFGF)-loaded microspheres on promoting healing in pressure-induced decubitus ulcer. In this study, the pressure-induced ulcer in swine was used as a model to demonstrate the hypothesis that controlled release of bFGF has the potential to provide optimal healing milieu for chronic wounds in the repair process. Average size of the microspheres was 14.36 {+-} 3.56 {mu}m and the network gelatin sponges were characterized with an average pore size of 80-160 {mu}m. Both the in vitro release efficiency and the protein bioactivity revealed that bFGF was released from the microspheres in a controlled manner and it was biologically active as assessed by its ability to induce the proliferation of fibroblasts. Pressure-induced ulcer was created at 500 g/cm{sup 2} pressure loaded on swine dorsal skin 12 h daily for 2 consecutive days. After removal of the pressure load, the gelatin sponge containing bFGF gelatin microspheres or bFGF in solution was implanted into the wound. Swine were sacrificed at 7, 14, and 21 days after implantation, and a full-thickness biopsy was taken and stained for histological analysis. It was observed that controlled release of bFGF provided an accelerated recovery in the wound areas. Histological investigations showed that the dressings were biocompatible and had capability of proliferating fibroblasts and inducing neovascularisation. The present study implied the clinical potential of gelatin sponge with bFGF microspheres to promote the healing in pressure-induced decubitus ulcer.

  19. Factors affecting perception of beneficiaries of National Programme on Improved Cookstoves regarding cost-benefit of adoption of Mamta Stove

    Energy Technology Data Exchange (ETDEWEB)

    George, R.; Yadla, V.L. [M.S. Univ. of Baroda, Vadodara (India). Home Management Dept.

    1995-10-01

    Perceived levels of cost-benefit of adoption of Mamta Stove (MS) was investigated on a sample of 390 beneficiaries of National Programme on Improved Cookstoves (NPIC) drawn through multistage random sampling technique from 3 villages in Gujarat State, viz., Kanjari, Vadadla, and Sindhrot. A standardized cost-benefit scale that exhibited a reliability coefficient of 0.92 was used in the study. The main cooks revealed a mean age of 36 years. Regarding perception on available sources of cooking fuel and accessibility to those, a wide disparity was observed, not only with reference to commercial sources and fuel forms but also with reference to free fuels gathered from forest land and waste land. MSs were installed in rural kitchens with the active involvement of about 50% of the main cooks. Majority of the cooks in Sindhrot village attended user education camps. The mean perceived cost-benefit ratio (PCBR) was computed to be 0.14. However, PCBR of the cooks from Sindhrot village was 0.51 while those of Vadadla and Kanjari were 0.09 and {minus}0.19 respectively. The correlation coefficient computed between PCBR and selected variables revealed that there existed a significant positive correlation between PCBR of the cook and their participation in NPIC and quality of installation of MS. The observation of the highest PCBR in Sindhrot village, a model smokeless village developed by TBU Baroda, could be attributed to the implementation of NPIC in a systematic manner adopting participatory model. The paper discusses at length the implications of the study and outlines the strategies for achieving widespread adoption of MS by beneficiaries of NPIC.

  20. Analysis of the factors that prevent adherence to treatment in patients with diabetes mellitus and the strategies that contribute to the improvement in adherence

    Directory of Open Access Journals (Sweden)

    Natalia V. Likhodey

    2018-03-01

    Full Text Available This review examined the current problem of low adherence to treatment in patients with chronic diseases, particularly type 2 diabetes mellitus. According to the definition of the World Health Organization, ‘adherence to treatment’ is the degree to which a patient’s behaviour corresponds to the doctor’s recommendations with respect to medications and implementation of dietary advice and/or lifestyle changes. The current medical literature includes a large number of scientific publications devoted to the study of various factors that lead to low adherence to treatment. The term ‘barriers’ is most often used to designate these factors. The first part of this work contains an analysis of the main factors that impede compliance to the doctor’s recommendations, such as socioeconomic and psychological (personal barriers related to the disease itself, the peculiarities of its treatment and the organisation of medical care (the health care system. The second part of this review examines the different theoretical models of patient behaviour and strategies that improve adherence to treatment. Most researchers believe that there is an unsatisfactory (low adherence to treatment and that none of the existing intervention strategies can improve adherence to treatment among all patients. The cornerstone of the entire diabetes management system is the training of patients within the framework of developed structured programmes. Conversely,, success depends on the individual approach, the course of the disease and the mandatory consideration of the individual psychological characteristics of each person. Establishment of a partnership built on trust between a doctor and a patient contributes to greater patient satisfaction with treatment and improved adherence, and this relationship ultimately affects the treatment efficacy and clinical outcomes.

  1. Improved technical efficiency and exogenous factors in transportation demand for energy: An application of structural time series analysis to South Korean data

    International Nuclear Information System (INIS)

    Sa'ad, Suleiman

    2010-01-01

    This paper stresses the importance of incorporating the effects of improved technical efficiency and exogenous factors when estimating energy demand functions. Using annual time series data for the period 1973-2007 in the STSM (structural time series model) developed by Harvey et al. the paper estimates price and income elasticities of demand for energy as well as the annual growth of the stochastic trend at the end of the estimation period. The results of the study reveal a long-run income elasticity of 1.37 and a price elasticity of -0.19. In addition, the underlying trend is generally stochastic and negatively sloping during the greater part of the estimation period. Finally, the estimated result from the structural time series is compared with the results from the Johansen Cointegration. These results suggest that income is the dominant factor in energy consumption. In addition, the coefficient of linear trend is negative, supporting the results from the STSM.

  2. Improved technical efficiency and exogenous factors in transportation demand for energy: An application of structural time series analysis to South Korean data

    Energy Technology Data Exchange (ETDEWEB)

    Sa' ad, Suleiman [Surrey Centre for Energy Economics (SEEC), University of Surrey, Guildford (United Kingdom)

    2010-07-15

    This paper stresses the importance of incorporating the effects of improved technical efficiency and exogenous factors when estimating energy demand functions. Using annual time series data for the period 1973-2007 in the STSM (structural time series model) developed by Harvey et al. the paper estimates price and income elasticities of demand for energy as well as the annual growth of the stochastic trend at the end of the estimation period. The results of the study reveal a long-run income elasticity of 1.37 and a price elasticity of -0.19. In addition, the underlying trend is generally stochastic and negatively sloping during the greater part of the estimation period. Finally, the estimated result from the structural time series is compared with the results from the Johansen Cointegration. These results suggest that income is the dominant factor in energy consumption. In addition, the coefficient of linear trend is negative, supporting the results from the STSM. (author)

  3. Efficacy of an Exercise Game Based on Kinect in Improving Physical Performances of Fall Risk Factors in Community-Dwelling Older Adults.

    Science.gov (United States)

    Kayama, Hiroki; Okamoto, Kazuya; Nishiguchi, Shu; Yukutake, Taiki; Tanigawa, Takanori; Nagai, Koutatsu; Yamada, Minoru; Aoyama, Tomoki

    2013-08-01

    The purpose of this study was to demonstrate whether a 12-week program of training with dual-task Tai Chi (DTTC), which is a new concept game we developed using Kinect (Microsoft, Redmond, WA), would be effective in improving physical functions of fall risk factors. This study examined balance, muscle strength, locomotive ability, and dual-task ability in community-dwelling older adults (75.4±6.3 years) before and after 12 weeks of DTTC training (training group [TG]; n=32) or standardized training (control group [CG]; n=41). Primary end points were based on the difference in physical functions between the TG and the CG. Significant differences were observed between the two groups with significant group×time interaction for the following physical function measures: timed up-and-go (TUG) (Pone-leg standing (OLS) (Pstand (5-CS) (Prisk factors for falls.

  4. Factors that enable or limit the sustained use of improved firewood cookstoves: Qualitative findings eight years after an intervention in rural Mexico.

    Science.gov (United States)

    Catalán-Vázquez, Minerva; Fernández-Plata, Rosario; Martínez-Briseño, David; Pelcastre-Villafuerte, Blanca; Riojas-Rodríguez, Horacio; Suárez-González, Laura; Pérez-Padilla, Rogelio; Schilmann, Astrid

    2018-01-01

    The aim of this study was to analyze the factors enabling/limiting the use of improved cookstoves among rural fuel wood users from one mestizo and two indigenous communities eight years after an intervention in the state of Michoacan, in Mexico. A qualitative study with an ethnographic perspective was conducted in 2013/2014 based on 62 interviews with women who had participated in an improved firewood cookstove program in 2005. Thematic qualitative content analysis was performed. Very few women from the indigenous communities were using the improved cookstove at the time of the study; the majority had dismantled or had ceased using it; whereas most of those from the mestizo community were using it for all of their cooking activities. In the indigenous communities, characterized by extended families, uptake of new technology was limited by traditional routine practices, rearrangement of rooms in the house, attachment to the traditional stove, a low- or non-risk perception of woodsmoke; gender relations, insufficient training, non-compliance with program recommendations and design-related aspects. Conversely, in the mestizo community, the uptake of the improved cookstove was favored by routine cooking practices in a nuclear family, a previous use of a raised cookstove and social representations on the health-disease-death effects of woodsmoke vs. the health benefits of cooking with improved stoves. The sociocultural dimension of communities and the cookstove design are aspects that either favor or limit the use of improved cookstoves in indigenous and mestizo populations. Effective cookstove programs must take these elements into account from their early planning stages, and blend them into implementation and follow-up. Project communication, training and differentiated follow-up activities ensuring the operation and maintenance of the cookstove, should be designed according to the specific needs and traditions of each community; they should be based on the

  5. Vascular endothelial growth factor gene therapy improves nerve regeneration in a model of obstetric brachial plexus palsy.

    Science.gov (United States)

    Hillenbrand, Matthias; Holzbach, Thomas; Matiasek, Kaspar; Schlegel, Jürgen; Giunta, Riccardo E

    2015-03-01

    The treatment of obstetric brachial plexus palsy has been limited to conservative therapies and surgical reconstruction of peripheral nerves. In addition to the damage of the brachial plexus itself, it also leads to a loss of the corresponding motoneurons in the spinal cord, which raises the need for supportive strategies that take the participation of the central nervous system into account. Based on the protective and regenerative effects of VEGF on neural tissue, our aim was to analyse the effect on nerve regeneration by adenoviral gene transfer of vascular endothelial growth factor (VEGF) in postpartum nerve injury of the brachial plexus in rats. In the present study, we induced a selective crush injury to the left spinal roots C5 and C6 in 18 rats within 24 hours after birth and examined the effect of VEGF-gene therapy on nerve regeneration. For gene transduction an adenoviral vector encoding for VEGF165 (AdCMV.VEGF165) was used. In a period of 11 weeks, starting 3 weeks post-operatively, functional regeneration was assessed weekly by behavioural analysis and force measurement of the upper limb. Morphometric evaluation was carried out 8 months post-operatively and consisted of a histological examination of the deltoid muscle and the brachial plexus according to defined criteria of degeneration. In addition, atrophy of the deltoid muscle was evaluated by weight determination comparing the left with the right side. VEGF expression in the brachial plexus was quantified by an enzyme-linked immunosorbent assay (ELISA). Furthermore the motoneurons of the spinal cord segment C5 were counted comparing the left with the right side. On the functional level, VEGF-treated animals showed faster nerve regeneration. It was found less degeneration and smaller mass reduction of the deltoid muscle in VEGF-treated animals. We observed significantly less degeneration of the brachial plexus and a greater number of surviving motoneurons (P reason for these effects. The clinical use

  6. A community-based, environmental chronic disease prevention intervention to improve healthy eating psychosocial factors and behaviors in indigenous populations in the Canadian Arctic.

    Science.gov (United States)

    Mead, Erin L; Gittelsohn, Joel; Roache, Cindy; Corriveau, André; Sharma, Sangita

    2013-10-01

    Diet-related chronic diseases are highly prevalent among indigenous populations in the Canadian Arctic. A community-based, multi-institutional nutritional and lifestyle intervention-Healthy Foods North-was implemented to improve food-related psychosocial factors and behaviors among Inuit and Inuvialuit in four intervention communities (with two comparison communities) in Nunavut and the Northwest Territories, Canada, in 2008. The 12-month program was developed from theory (social cognitive theory and social ecological models), formative research, and a community participatory process. It included an environmental component to increase healthy food availability in local stores and activities consisting of community-wide and point-of-purchase interactive educational taste tests and cooking demonstrations, media (e.g., radio ads, posters, shelf labels), and events held in multiple venues, including recreation centers and schools. The intervention was evaluated using pre- and postassessments with 246 adults from intervention and 133 from comparison communities (311 women, 68 men; mean age 42.4 years; 78.3% retention rate). Outcomes included psychosocial constructs (healthy eating knowledge, self-efficacy, and behavioral intentions), frequency of healthy and unhealthy food acquisition, healthiness of commonly used food preparation methods, and body mass index (kg/m(2)). After adjustment for demographic, socioeconomic status, and body mass index variables, respondents living in intervention communities showed significant improvements in food-related self-efficacy (β = 0.15, p = .003) and intentions (β = 0.16, p = .001) compared with comparison communities. More improvements from the intervention were seen in overweight, obese, and high socioeconomic status respondents. A community-based, multilevel intervention is an effective strategy to improve psychosocial factors for healthy nutritional behavior change to reduce chronic disease in indigenous Arctic populations.

  7. 一种改进的证据冲突衡量因子%An Improved Measure Factor of Evidence Conflict

    Institute of Scientific and Technical Information of China (English)

    邢晓辰; 蔡远文; 李岩; 姚静波

    2015-01-01

    为解决证据融合时证据间冲突衡量不准确问题,提出了一种新的证据冲突衡量方法。对当前冲突衡量方法国内外研究现状进行总结,结合典型算例分析,指出了当前方法存在的主要问题。基于前人研究成果,提出了一种改进冲突因子用于衡量证据间冲突,主要基于修正证据距离与合取冲突,对两者采用加性组合。通过一般类型算例与特殊类型算例对所提方法进行验证,结果表明改进的冲突衡量因子能够准确衡量证据间冲突,并具有普适性。%The evidence conflict measure in Dempster-Shafer( D-S) evidence theory sometimes may be not accurate. In order to solve this problem,a new evidence conflict measure method is proposed. Research on evidence conflict measure methods at home and abroad is summarized and analyzed,and the problems of those methods are analyzed. Based on the foregoing research on evidence conflict measure, an improved conflict factor of evidence conflict is put forward,which is mainly built up by modified evidence distance and combination conflict factor. The improved conflict factor combines modified evidence distance and combination conflict factor based on the sum way. General types and special types of cases are used to ver-ify the correctness of the proposed method,and the result shows that the improved conflict factor can meas-ure the evidence conflict correctly and has universal applicability.

  8. Collaborative Improvement

    DEFF Research Database (Denmark)

    Kaltoft, Rasmus

    -organisational continuous improvement of their performance, relative to that of other EMEs. Developing a collaborative improvement relationship between companies is a protracted and complex process and, according to some surveys, the failure rate is as low as one to three. This failure rate is affected by a whole range...... of factors. The research presented in this thesis was aimed at identifying these factors and investigating their interplay and influence on the progress and success of the development of the collaborative improvement. This thesis presents our findings regarding the factors found, their interplay...

  9. Monocyte Locomotion Inhibitory Factor Produced by E. histolytica Improves Motor Recovery and Develops Neuroprotection after Traumatic Injury to the Spinal Cord

    Science.gov (United States)

    Bermeo, Gabriela; García, Elisa; Flores-Romero, Adrian; Rico-Rosillo, Guadalupe; Marroquín, Rubén; Flores, Carmina; Blanco-Favela, Francisco; Silva-García, Raúl

    2013-01-01

    Monocyte locomotion inhibitory factor (MLIF) is a pentapeptide produced by Entamoeba histolytica that has a potent anti-inflammatory effect. Either MLIF or phosphate buffered saline (PBS) was administered directly onto the spinal cord (SC) immediately after injury. Motor recovery was evaluated. We also analyzed neuroprotection by quantifying the number of surviving ventral horn motor neurons and the persistence of rubrospinal tract neurons. To evaluate the mechanism through which MLIF improved the outcome of SC injury, we quantified the expression of inducible nitric oxide synthase (iNOS), interleukin-10 (IL-10), and transforming growth factor-β (TGF-β) genes at the site of injury. Finally, the levels of nitric oxide and of lipid peroxidation were also determined in peripheral blood. Results showed that MLIF improved the rate of motor recovery and this correlated with an increased survival of ventral horn and rubrospinal neurons. These beneficial effects were in turn associated with a reduction in iNOS gene products and a significant upregulation of IL-10 and TGF-β expression. In the same way, MLIF reduced the concentration of nitric oxide and the levels of lipid peroxidation in systemic circulation. The present results demonstrate for the first time the neuroprotective effects endowed by MLIF after SC injury. PMID:24294606

  10. Improvement of gamma-ray Sn transport calculations including coherent and incoherent scatterings and secondary sources of bremsstrahlung and fluorescence: Determination of gamma-ray buildup factors

    International Nuclear Information System (INIS)

    Kitsos, S.; Diop, C.M.; Assad, A.; Nimal, J.C.; Ridoux, P.

    1996-01-01

    Improvements of gamma-ray transport calculations in S n codes aim at taking into account the bound-electron effect of Compton scattering (incoherent), coherent scattering (Rayleigh), and secondary sources of bremsstrahlung and fluorescence. A computation scheme was developed to take into account these phenomena by modifying the angular and energy transfer matrices, and no modification in the transport code has been made. The incoherent and coherent scatterings as well as the fluorescence sources can be strictly treated by the transfer matrix change. For bremsstrahlung sources, this is possible if one can neglect the charged particles path as they pass through the matter (electrons and positrons) and is applicable for the energy range of interest for us (below 10 MeV). These improvements have been reported on the kernel attenuation codes by the calculation of new buildup factors. The gamma-ray buildup factors have been carried out for 25 natural elements up to 30 mean free paths in the energy range between 15 keV and 10 MeV

  11. A group randomized trial of a complexity-based organizational intervention to improve risk factors for diabetes complications in primary care settings: study protocol

    Directory of Open Access Journals (Sweden)

    Noel Polly H

    2008-03-01

    Full Text Available Abstract Background Most patients with type 2 diabetes have suboptimal control of their glucose, blood pressure (BP, and lipids – three risk factors for diabetes complications. Although the chronic care model (CCM provides a roadmap for improving these outcomes, developing theoretically sound implementation strategies that will work across diverse primary care settings has been challenging. One explanation for this difficulty may be that most strategies do not account for the complex adaptive system (CAS characteristics of the primary care setting. A CAS is comprised of individuals who can learn, interconnect, self-organize, and interact with their environment in a way that demonstrates non-linear dynamic behavior. One implementation strategy that may be used to leverage these properties is practice facilitation (PF. PF creates time for learning and reflection by members of the team in each clinic, improves their communication, and promotes an individualized approach to implement a strategy to improve patient outcomes. Specific objectives The specific objectives of this protocol are to: evaluate the effectiveness and sustainability of PF to improve risk factor control in patients with type 2 diabetes across a variety of primary care settings; assess the implementation of the CCM in response to the intervention; examine the relationship between communication within the practice team and the implementation of the CCM; and determine the cost of the intervention both from the perspective of the organization conducting the PF intervention and from the perspective of the primary care practice. Intervention The study will be a group randomized trial conducted in 40 primary care clinics. Data will be collected on all clinics, with 60 patients in each clinic, using a multi-method assessment process at baseline, 12, and 24 months. The intervention, PF, will consist of a series of practice improvement team meetings led by trained facilitators over 12

  12. Improved Variable Selection Algorithm Using a LASSO-Type Penalty, with an Application to Assessing Hepatitis B Infection Relevant Factors in Community Residents

    Science.gov (United States)

    Guo, Pi; Zeng, Fangfang; Hu, Xiaomin; Zhang, Dingmei; Zhu, Shuming; Deng, Yu; Hao, Yuantao

    2015-01-01

    Objectives In epidemiological studies, it is important to identify independent associations between collective exposures and a health outcome. The current stepwise selection technique ignores stochastic errors and suffers from a lack of stability. The alternative LASSO-penalized regression model can be applied to detect significant predictors from a pool of candidate variables. However, this technique is prone to false positives and tends to create excessive biases. It remains challenging to develop robust variable selection methods and enhance predictability. Material and methods Two improved algorithms denoted the two-stage hybrid and bootstrap ranking procedures, both using a LASSO-type penalty, were developed for epidemiological association analysis. The performance of the proposed procedures and other methods including conventional LASSO, Bolasso, stepwise and stability selection models were evaluated using intensive simulation. In addition, methods were compared by using an empirical analysis based on large-scale survey data of hepatitis B infection-relevant factors among Guangdong residents. Results The proposed procedures produced comparable or less biased selection results when compared to conventional variable selection models. In total, the two newly proposed procedures were stable with respect to various scenarios of simulation, demonstrating a higher power and a lower false positive rate during variable selection than the compared methods. In empirical analysis, the proposed procedures yielding a sparse set of hepatitis B infection-relevant factors gave the best predictive performance and showed that the procedures were able to select a more stringent set of factors. The individual history of hepatitis B vaccination, family and individual history of hepatitis B infection were associated with hepatitis B infection in the studied residents according to the proposed procedures. Conclusions The newly proposed procedures improve the identification of

  13. TJC: HCOs need to be on alert for HIT problems related to sociotechnical factors, take steps to improve safety culture, process, and leadership.

    Science.gov (United States)

    2015-06-01

    Noting that too many errors related to health information technology (HIT) are resulting in adverse consequences, The Joint Commission (TJC) has issued a Sentinel Event Alert, urging health care providers to take steps to improve their safety culture, approach to process improvement, and leadership in this area. In this latest alert, the accrediting agency is taking particular aim at risks posed by sociotechnical factors--or the ways in which HIT is implemented and used. Experts say that many of these risks are, in fact, exemplified at a higher level in the emergency setting, where providers are under constant pressure to see more patients and move them though the system faster. In an analysis of 3,375 sentinel events that resulted in permanent patient harm or death between January 1, 2010, and June 20, 2013, The Joint Commission (TJC) found that 120 events included HIT-related contributing factors. Many of the problems cited by TJC relate to orders or medicines being prescribed for the wrong patients. These can result from toggling errors or pop-up screens where providers are asked to click on the appropriate patient or medicine, and they mistakenly click on the wrong selection. In the ED, experts recommend the creation of a multidisciplinary performance improvement group to continuously monitor the ED information system (EDIS), recognize problems, and work with the vendor to resolve them. Also important is a quick and easy way for providers to report HIT-related problems. Experts add that emergency providers need to be fully engaged in the process of selecting HIT that they will be using, and that health care organizations should arrange for usability assessments before purchasing HIT.

  14. Improvement of 2D ERT measurements conducted along a small earth-filled dyke using 3D topographic data and 3D computation of geometric factors

    Science.gov (United States)

    Bièvre, Grégory; Oxarango, Laurent; Günther, Thomas; Goutaland, David; Massardi, Michael

    2018-06-01

    In the framework of earth-filled dykes characterization and monitoring, Electrical Resistivity Tomography (ERT) turns out to be a commonly used method. 2D sections are generally acquired along the dyke crest thus putting forward the question of 3D artefacts in the inversion process. This paper proposes a methodology based on 3D direct numerical simulations of the ERT acquisition using a realistic topography of the study site. It allows computing ad hoc geometrical factors which can be used for the inversion of experimental ERT data. The method is first evaluated on a set of synthetic dyke configurations. Then, it is applied to experimental static and time-lapse ERT data set acquired before and after repair works carried out on a leaking zone of an earth-filled canal dyke in the centre of France. The computed geometric factors are lower than the analytic geometric factors in a range between -8% and - 18% for measurements conducted on the crest of the dyke. They exhibit a maximum under-estimation for intermediate electrode spacings in the Wenner and Schlumberger configurations. In the same way, for measurements conducted on the mid-slope of the dyke, the computed geometric factors are higher for short electrode spacings (+18%) and lower for lower for large electrode spacings (-8%). The 2D inversion of the synthetic data with these computed geometric factors provides a significant improvement of the agreement with the original resistivity. Two experimental profiles conducted on the same portion of the dyke but at different elevations also reveal a better agreement using this methodology. The comparison with apparent resistivity from EM31 profiling along the stretch of the dyke also supports this evidence. In the same way, some spurious effects which affected the time-lapse data were removed and improved the global readability of the time-lapse resistivity sections. The benefit on the structural interpretation of ERT images remains moderate but allows a better

  15. Factors affecting domestic water consumption in rural households upon access to improved water supply: insights from the Wei River Basin, China.

    Directory of Open Access Journals (Sweden)

    Liangxin Fan

    Full Text Available Comprehensively understanding water consumption behavior is necessary to design efficient and effective water use strategies. Despite global efforts to identify the factors that affect domestic water consumption, those related to domestic water use in rural regions have not been sufficiently studied, particularly in villages that have gained access to improved water supply. To address this gap, we investigated 247 households in eight villages in the Wei River Basin where three types of improved water supply systems are implemented. Results show that domestic water consumption in liters per capita per day was significantly correlated with water supply pattern and vegetable garden area, and significantly negatively correlated with family size and age of household head. Traditional hygiene habits, use of water appliances, and preference for vegetable gardening remain dominant behaviors in the villages with access to improved water supply. Future studies on rural domestic water consumption should pay more attention to user lifestyles (water appliance usage habits, outdoor water use and cultural backgrounds (age, education.

  16. Predictive factors of overall functioning improvement in patients with chronic schizophrenia and schizoaffective disorder treated with paliperidone palmitate and aripiprazole monohydrate.

    Science.gov (United States)

    Girardi, Paolo; Del Casale, Antonio; Rapinesi, Chiara; Kotzalidis, Georgios D; Splendori, Francesca; Verzura, Claudio; Trovini, Giada; Sorice, Serena; Carrus, Dario; Mancinelli, Iginia; Comparelli, Anna; De Filippis, Sergio; Francomano, Antonio; Ballerini, Andrea; Marcellusi, Andrea; Mennini, Francesco S; Ducci, Giuseppe; Sani, Gabriele; Pompili, Maurizio; Brugnoli, Roberto

    2018-05-01

    Long-acting injectable (LAI) antipsychotics can improve medication adherence and reduce hospitalisation rates compared with oral treatments. Paliperidone palmitate (PAL) and aripiprazole monohydrate (ARI) LAI treatments were associated with improvements in global functioning in patients with schizophrenia. The objective of this study was to assess the predictive factors of better overall functioning in patients with chronic schizophrenia and schizoaffective disorder treated with PAL and ARI. Enrolled were 143 (97 males, 46 females, mean age 38.24 years, SD = 12.65) patients with a diagnosis of schizophrenia or schizoaffective disorder, whom we allocated in two groups (PAL and ARI treatments). We assessed global functioning, amount of oral medications, adherence to oral treatment, and number of hospitalisations before LAI introduction and at assessment time point. Longer treatment time with LAIs (p schizoaffective disorder. Better improvement in functioning could be achieved with ARI in young individuals with recent illness onset and PAL in patients at risk for recurrent hospitalisations. Copyright © 2018 John Wiley & Sons, Ltd.

  17. Pretransplant mobilization with granulocyte colony-stimulating factor improves B-cell reconstitution by lentiviral vector gene therapy in SCID-X1 mice.

    Science.gov (United States)

    Huston, Marshall W; Riegman, Adriaan R A; Yadak, Rana; van Helsdingen, Yvette; de Boer, Helen; van Til, Niek P; Wagemaker, Gerard

    2014-10-01

    Hematopoietic stem cell (HSC) gene therapy is a demonstrated effective treatment for X-linked severe combined immunodeficiency (SCID-X1), but B-cell reconstitution and function has been deficient in many of the gene therapy treated patients. Cytoreductive preconditioning is known to improve HSC engraftment, but in general it is not considered for SCID-X1 since the poor health of most of these patients at diagnosis and the risk of toxicity preclude the conditioning used in standard bone marrow stem cell transplantation. We hypothesized that mobilization of HSC by granulocyte colony-stimulating factor (G-CSF) should create temporary space in bone marrow niches to improve engraftment and thereby B-cell reconstitution. In the present pilot study supplementing our earlier preclinical evaluation (Huston et al., 2011), Il2rg(-/-) mice pretreated with G-CSF were transplanted with wild-type lineage negative (Lin(-)) cells or Il2rg(-/-) Lin(-) cells transduced with therapeutic IL2RG lentiviral vectors. Mice were monitored for reconstitution of lymphocyte populations, level of donor cell chimerism, and antibody responses as compared to 2 Gy total body irradiation (TBI), previously found effective in promoting B-cell reconstitution. The results demonstrate that G-CSF promotes B-cell reconstitution similar to low-dose TBI and provides proof of principle for an alternative approach to improve efficacy of gene therapy in SCID patients without adverse effects associated with cytoreductive conditioning.

  18. Prevalence of self-reported diagnosis of diabetes mellitus and associated risk factors in a national survey in the US population: SHIELD (Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes).

    Science.gov (United States)

    Bays, Harold E; Bazata, Debbra D; Clark, Nathaniel G; Gavin, James R; Green, Andrew J; Lewis, Sandra J; Reed, Michael L; Stewart, Walter; Chapman, Richard H; Fox, Kathleen M; Grandy, Susan

    2007-10-03

    Studies derived from continuous national surveys have shown that the prevalence of diagnosed diabetes mellitus in the US is increasing. This study estimated the prevalence in 2004 of self-reported diagnosis of diabetes and other conditions in a community-based population, using data from the Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD). The initial screening questionnaire was mailed in 2004 to a stratified random sample of 200,000 households in the US, to identify individuals, age > or = 18 years of age, with diabetes or risk factors associated with diabetes. Follow-up disease impact questionnaires were then mailed to a representative, stratified random sample of individuals (n = 22,001) in each subgroup of interest (those with diabetes or different numbers of risk factors for diabetes). Estimated national prevalence of diabetes and other conditions was calculated, and compared to prevalence estimates from the National Health and Nutrition Examination Survey (NHANES) 1999-2002. Response rates were 63.7% for the screening, and 71.8% for the follow-up baseline survey. The SHIELD screening survey found overall prevalence of self-reported diagnosis of diabetes (either type 1 or type 2) was 8.2%, with increased prevalence with increasing age and decreasing income. In logistic regression modeling, individuals were more likely to be diagnosed with type 2 diabetes if they had abdominal obesity (odds ratio [OR] = 3.50; p or =28 kg/m2 (OR = 4.04; p self-report only) to those from NHANES 1999-2002 (self-report, clinical and laboratory evaluations), the prevalence of diabetes was similar. SHIELD allows the identification of respondents with and without a current diagnosis of the illness of interest, and potential longitudinal evaluation of risk factors for future diagnosis of that illness.

  19. Historical flood data series of Eastern Spanish Coast (14th-20th centuries). Improving identification of climatic patterns and human factors of flood events from primary documentary sources

    Science.gov (United States)

    Alberola, Armando; Barriendos, Mariano; Gil-Guirado, Salvador; Pérez-Morales, Alfredo; Balasch, Carles; Castelltort, Xavier; Mazón, Jordi; Pino, David; Lluís Ruiz-Bellet, Josep; Tuset, Jordi

    2016-04-01

    Historical flood data series of Eastern Spanish Coast (14th-20th centuries). Improving identification of climatic patterns and human factors of flood events from primary documentary sources Armando Alberola, Barriendos, M., Gil-Guirado, S., Pérez Morales, A., Balasch, C., Castelltort, X., Mazón, J., Pino, D., Ruiz-Bellet, J.L., Tuset, J. Historical flood events in eastern spanish coast have been studied by different research groups and projects. Complexity of flood processes, involving atmospheric, surface and human factors, is not easily understandable when long time series are required. Present analysis from PREDIFLOOD Project Consortium defines a new step of flood event databases: Improved access to primary (documentary) and secondary (bibliographical) sources, data collection for all possible locations where floods are detected, and improved system of classification (Barriendos et al., 2014). A first analysis is applied to 8 selected flood series. Long chronologies from PREDIFLOOD Project for Catalonia region (Girona, Barcelona, Tarragona, Lleida, Tortosa). In addition, to cover all sector of spanish mediterranean coast, we introduce Valencia city in Turia River basin. South Eastern sector is cover with Murcia and Caravaca cities, Segura River basin. Extension of area under study required contributions of research teams experienced in work of documentary primary sources (Alberola, 2006; Gil-Guirado, 2013). Flood frequency analysis for long scale periods show natural climatic oscillations into so-called Little Ice Age. There are general patterns, affecting most of basins, but also some local anomalies or singularities. To explain these differences and analogies it is not enough to use purely climatic factors. In this way, we analyze human factors that have been able to influence the variability of floods along last 6 centuries (demography, hydraulic infrastructures, urban development...). This approach improves strongly understanding of mechanisms producing

  20. Does modifying the timing of meal intake improve cardiovascular risk factors? Protocol of an Australian pilot intervention in night shift workers with abdominal obesity.

    Science.gov (United States)

    Bonham, Maxine P; Leung, Gloria K W; Davis, Rochelle; Sletten, Tracey L; Murgia, Chiara; Young, Morag J; Eikelis, Nina; Lambert, Elisabeth A; Huggins, Catherine E

    2018-03-14

    Shift work is an independent risk factor for cardiovascular disease (CVD). Shift workers who are awake overnight and sleep during the day are misaligned with their body's endogenous circadian rhythm. Eating at night contributes to this increased risk of CVD by forcing the body to actively break down and process nutrients at night. This pilot study aims to determine whether altering meal timing overnight, in a shift working population, will impact favourably on modifiable risk factors for CVD (postprandial bplasma lipids and glucose concentration). A randomised cross-over study with two 4-week test periods, separated by a minimum of a 2-week washout will be undertaken. The effectiveness of redistributing energy intake overnight versus ad libitum eating patterns on CVD risk factors will be examined in night shift workers (n=20), using a standard acute test meal challenge protocol. Primary outcomes (postprandial lipids and glucose) will be compared between the two conditions: post-intervention and post-control period using analysis of variance. Potential effect size estimates to inform sample size calculations for a main trial will also be generated. Ethics approval has been granted by the Monash University Human Research Ethics Committee (2017-8619-10329). Outcomes from this study will determine whether eliminating food intake for a defined period at night (1-6 am) impacts favourably on metabolic risk factors for CVD in night shift workers. Collective results from this novel trial will be disseminated through peer-reviewed journals, and national and international presentations. The results are essential to inform health promotion policies and guidelines for shift workers, especially those who aim to improve their metabolic health. ACTRN12617000791336; Pre-results. © 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.

  1. Desalted deep-sea water improves cognitive function in mice by increasing the production of insulin-like growth factor-I in the hippocampus.

    Science.gov (United States)

    Harada, Naoaki; Zhao, Juan; Kurihara, Hiroki; Nakagata, Naomi; Okajima, Kenji

    2011-08-01

    The stimulation of sensory neurons in the gastrointestinal (GI) tract improves cognitive function by increasing the hippocampal production of insulin-like growth factor-I (IGF-I) in mice. In the current study, we examined whether oral administration of desalted deep-sea water (DSW) increases the hippocampal production of IGF-I by stimulating sensory neurons in the GI tract, thereby improving cognitive function in mice. Desalted DSW increased calcitonin gene-related peptide (CGRP) release from dorsal root ganglion (DRG) neurons isolated from wild-type (WT) mice by activating transient receptor potential vanilloid 1. The plasma levels of IGF-I and tissue levels of CGRP, IGF-I, and IGF-I mRNA in the hippocampus were increased by oral administration of desalted DSW in WT mice. In these animals, nociceptive information originating from the GI tract was transmitted to the hippocampus via the spinothalamic pathway. Improvement of spatial learning was observed in WT mice after administration of desalted DSW. Distilled DSW showed results similar to those of desalted DSW in vitro and in vivo. None of the effects of desalted DSW in WT mice were observed after the administration of desalted DSW in CGRP-knockout (CGRP-/-) mice. No volatile compounds were detected in distilled DSW on GC-MS analysis. These observations suggest that desalted DSW may increase the hippocampal IGF-I production via sensory neuron stimulation in the Gl tract, thereby improving cognitive function in mice. Such effects of desalted DSW might not be dependent on the minerals but are dependent on the function of the water molecule itself. Copyright © 2011 Mosby, Inc. All rights reserved.

  2. Supported exercise improves controlled eating and weight through its effects on psychosocial factors: extending a systematic research program toward treatment development.

    Science.gov (United States)

    Annesi, James J

    2012-01-01

    Behavioral weight-loss treatments have been overwhelmingly unsuccessful. Many inadequately address both behavioral theory and extant research--especially in regard to the lack of viability of simply educating individuals on improved eating and exercise behaviors. The aim was to synthesize research on associations of changes in exercise behaviors, psychosocial factors, eating behaviors, and weight; and then conduct further direct testing to inform the development of an improved treatment approach. A systematic program of health behavior-change research based on social cognitive theory, and extensions of that theory applied to exercise and weight loss, was first reviewed. Then, to extend this research toward treatment development and application, a field-based study of obese adults was conducted. Treatments incorporated a consistent component of cognitive-behaviorally supported exercise during 26 weeks that was paired with either standard nutrition education (n = 183) or cognitive-behavioral methods for controlled eating that emphasized self-regulatory methods such as goal setting and caloric tracking, cognitive restructuring, and eating cue awareness (n = 247). Both treatment conditions were associated with improved self-efficacy, self-regulation, mood, exercise, fruit and vegetable consumption, weight, and waist circumference; with improvements in self-regulation for eating, fruit and vegetable consumption, weight, and waist circumference significantly greater in the cognitive-behavioral nutrition condition. Changes in exercise- and eating-related self-efficacy and self-regulation were associated with changes in exercise and eating (R(2) = 0.40 and 0.17, respectively), with mood change increasing the explanatory power to R(2) = 0.43 and 0.20. Improved self-efficacy and self-regulation for exercise carried over to self-efficacy and self-regulation for controlled eating (β= 0.53 and 0.68, respectively). Development and longitudinal testing of a new and different

  3. Factors Affecting the Improvement of the Initial Peak Urinary Flow Rate after Transurethral Resection of the Prostate or Photoselective Vaporization of the Prostate for Treating Benign Prostatic Hyperplasia

    Directory of Open Access Journals (Sweden)

    Hwa Sub Choi

    2011-03-01

    Full Text Available Purpose We evaluated the factors that affect the improvement of the initial peak flow rate after transurethral resection of the prostate (TURP or photoselective vaporization of the prostate (PVP for benign prostatic hyperplasia (BPH patients by using noninvasive tools. Methods One hundred and twenty seven BPH patients who had undergone TURP or PVP between January 2005 and May 2009 were evaluated. They were divided into 2 groups: the postoperative initial peak urinary flow rate (Qmax was less than 10 mL/sec (Group 1; n=37, TURP=11, PVP=26 and more than 10 mL/sec (Group 2; n=90, TURP=41, PVP=49. We confirmed the patients' preoperative check lists. The check list were the international prostate symptom score (IPSS, the quality of life score, a past history of acute urinary retention (AUR, body mass index and/or pyuria, the serum prostate-specific antigen (PSA level and the prostate volume, the prostate transitional zone volume and prostatic calcification. The initial Qmax was measured at the outpatient clinic one week after discharge. Results The improvement rate was not significant difference between the TURP group (78.8% and the PVP group (65.3%. The efficacy parameters were the IPSS-storage symptom score, the prostate volume, the PSA level and a past history of AUR. The IPSS-storage symptom scores of Group 1 (12.3±3.3 was higher than those of Group 2 (10.5±1.7. The prostate volume of Group 2 (42.3±16.6 g was bigger than that of Group 1 (36.6±7.8 g. The PSA level of Group 2 (3.8±2.6 ng/mL was higher than that of Group 1 (2.6±2.6 ng/mL. A past history of AUR in Group 1 (35.1% was more prevalent than that of Group 2 (15.6%. Conclusions The non-invasive factors affecting the initial Qmax after TURP or PVP were the IPSS-storage symptom score, the prostate volume and a past history of AUR. Accordingly, in patients who have a higher IPSS-storage symptom score, a smaller prostate volume and a history of AUR, there might be a detrimental effect on

  4. Disclosure of Personalized Rheumatoid Arthritis Risk Using Genetics, Biomarkers, and Lifestyle Factors to Motivate Health Behavior Improvements: A Randomized Controlled Trial.

    Science.gov (United States)

    Sparks, Jeffrey A; Iversen, Maura D; Yu, Zhi; Triedman, Nellie A; Prado, Maria G; Miller Kroouze, Rachel; Kalia, Sarah S; Atkinson, Michael L; Mody, Elinor A; Helfgott, Simon M; Todd, Derrick J; Dellaripa, Paul F; Bermas, Bonnie L; Costenbader, Karen H; Deane, Kevin D; Lu, Bing; Green, Robert C; Karlson, Elizabeth W

    2017-10-12

    To determine the effect of disclosure of rheumatoid arthritis (RA) risk personalized with genetics, biomarkers, and lifestyle factors on health behavior intentions. We performed a randomized controlled trial among first-degree relatives without RA. Subjects assigned to the Personalized Risk Estimator for Rheumatoid Arthritis (PRE-RA) group received the web-based PRE-RA tool for RA risk factor education and disclosure of personalized RA risk estimates, including genotype/autoantibody results and behaviors (n = 158). Subjects assigned to the comparison arm received standard RA education (n = 80). The primary outcome was readiness for change based on the trans-theoretical model, using validated contemplation ladder scales. Increased motivation to improve RA risk-related behaviors (smoking, diet, exercise, or dental hygiene) was defined as an increase in any ladder score compared to baseline, assessed immediately, 6 weeks, and 6 months post-intervention. Subjects reported behavior change at each visit. We performed intent-to-treat analyses using generalized estimating equations for the binary outcome. Subjects randomized to PRE-RA were more likely to increase ladder scores over post-intervention assessments (relative risk 1.23, 95% confidence interval [95% CI] 1.01, 1.51) than those randomized to nonpersonalized education. At 6 months, 63.9% of PRE-RA subjects and 50.0% of comparison subjects increased motivation to improve behaviors (age-adjusted difference 15.8%; 95% CI 2.8%, 28.8%). Compared to nonpersonalized education, more PRE-RA subjects increased fish intake (45.0% versus 22.1%; P = 0.005), brushed more frequently (40.7% versus 22.9%; P = 0.01), flossed more frequently (55.7% versus 34.8%; P = 0.004), and quit smoking (62.5% versus 0.0% among 11 smokers; P = 0.18). Disclosure of RA risk personalized with genotype/biomarker results and behaviors increased motivation to improve RA risk-related behaviors. Personalized medicine approaches may motivate health

  5. Improvements in glucose metabolism early after gastric bypass surgery are not explained by increases in total bile acids and fibroblast growth factor 19 concentrations

    DEFF Research Database (Denmark)

    Jørgensen, Nils B; Dirksen, Carsten; Bojsen-Møller, Kirstine N

    2015-01-01

    Context: Bile acids and fibroblast growth factor 19 (FGF19) have been suggested as key mediators of the improvements in glucose metabolism after Roux-en-Y gastric bypass (RYGB). Objective: To describe fasting and postprandial state total bile acid (TBA) and FGF19 concentrations before and after...... (T2D) patients and 12 normal glucose tolerant (NGT) subjects participated in the study. Intervention: A 4-hour liquid meal test was performed before and 1 week, 3 months, and 1 year after RYGB. Main Outcome Measures: We measured fasting and postprandial TBA and FGF19 concentrations. Results: Fasting...... TBA concentrations decreased in NGT subjects (P TBA was decreased in NGT subjects 1 week after RYGB (before surgery, 567...

  6. Key factors for a high-quality peritoneal dialysis program--the role of the PD team and continuous quality improvement.

    Science.gov (United States)

    Fang, Wei; Ni, Zhaohui; Qian, Jiaqi

    2014-06-01

    The proportion of end-stage renal disease (ESRD) patients on peritoneal dialysis (PD) has increased very fast in China over the last decade. Renji Hospital, affiliated with Shanghai Jiaotong University School of Medicine, is a recognized high-quality PD unit with a high PD utilization rate, excellent patient and technique survival (1-year and 5-year patient survival rate of 93% and 71%, and 1-year and 5-year technique survival of 96% and 82%, respectively), low peritonitis rate and a well-documented good quality of life of the treated patients. We believe that a dedicated and experienced PD team, a structured patient training program, continuous patient support, establishing and utilizing standardized protocols, starting PD with low dialysis dose, monitoring key performance indicators (KPIs), and continuous quality improvement (CQI) are the key factors underlying this successful PD program. Copyright © 2014 International Society for Peritoneal Dialysis.

  7. Improvement of the calculation of the stress intensity factors for underclad and through-clad defects in a reactor pressure vessel subjected to a pressurised thermal shock

    International Nuclear Information System (INIS)

    Marie, S.; Chapuliot, S.

    2008-01-01

    The analysis of the stability of a defect in a cladded reactor pressure vessel (RPV) of a nuclear pressure water reactor (PWR) subjected to pressurised thermal shock (PTS) is one main elements of the general safety demonstration. Recently, CEA proposed several improved analytical tools for the analysis of the PTS. First, an analytical solution for the vessel through-thickness temperature variation has been developed to deal with any fluid temperature, taking into account the possible presence of a cladding, in the case of an internal PTS. The associated thermal stress expression has been simplified and a complete linearised solution is given for the thermal loading and also for internal pressure, depending on the main vessel material and on the cladding properties. Finally, a complete compendium is also given for the elastic stresses intensity factor calculation. This paper proposes several improvements of the proposed analytical method to deal with a PTS in a PWR cladded vessel. A variable heat transfer coefficient is now taken into account based on an equivalent fluid temperature variation determination, associated with a constant heat transfer coefficient, to keep the same thermal exchange between the fluid and the inner skin of the vessel obtained with the initial data. A more accurate expression for the linearised stresses due to the internal pressure is given, and a possible effect of residual stresses due to the difference between the operating temperature and the stress-free temperature is also taken into account. Finally, an extension of the domain of definition of the influence functions for the elastic stress intensity factor calculation is given

  8. Prognostic Markers in Core-Binding Factor AML and Improved Survival with Multiple Consolidation Cycles of Intermediate/High-dose Cytarabine.

    Science.gov (United States)

    Prabahran, Ashvind; Tacey, Mark; Fleming, Shaun; Wei, Andrew; Tate, Courtney; Marlton, Paula; Wight, Joel; Grigg, Andrew; Tuckfield, Annabel; Szer, Jeff; Ritchie, David; Chee, Lynette

    2018-05-02

    Core-binding factor acute myeloid leukaemia (CBF AML) defined by t(8;21)(q22;q22) or inv(16)(p13q22)/t(16;16)(p13;q22) has a favourable prognosis, however 30-40% of patients still relapse after chemotherapy. We sought to evaluate risk factors for relapse in a de novo CBF AML cohort. A retrospective review of patients from 4 Australian tertiary centres from 2001-2012, comprising 40 t(8;21) and 30 inv(16) AMLs. Multivariate analysis identified age (p=0.032) and WCC>40 (p=0.025) as significant predictors for inferior OS and relapse respectively. Relapse risk was higher in the inv(16) group vs the t(8;21) group (57% vs 18%, HR 4.31, 95% CI: 1.78-10.42, p=0.001). Induction therapy had no bearing on OS or relapse free survival (RFS) however, consolidation treatment with >3 cycles of intermediate/high dose cytarabine improved OS (p=0.035) and relapse-free survival (RFS) (p=0.063). 5 patients demonstrated post-treatment stable q PCR positivity without relapse. (1)>3 consolidation cycles of intermediate/ high-dose cytarabine improves patient outcomes. (2)Age and inv(16) CBF AML subtype are predictors of inferior OS and RFS respectively. (3)Stable low-level MRD by qPCR does not predict relapse. (4)Similar OS in the inv(16) cohort compared to the t(8;21) cohort, despite a higher relapse rate, confirms salvageability of relapsed disease. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  9. Local administration of platelet-derived growth factor B (PDGFB) improves follicular development and ovarian angiogenesis in a rat model of Polycystic Ovary Syndrome.

    Science.gov (United States)

    Di Pietro, Mariana; Scotti, Leopoldina; Irusta, Griselda; Tesone, Marta; Parborell, Fernanda; Abramovich, Dalhia

    2016-09-15

    Alterations in ovarian angiogenesis are common features in Polycystic Ovary Syndrome (PCOS) patients; the most studied of these alterations is the increase in vascular endothelial growth factor (VEGF) production by ovarian cells. Platelet-derived growth factor B (PDGFB) and D (PDGFD) are decreased in follicular fluid of PCOS patients and in the ovaries of a rat model of PCOS. In the present study, we aimed to analyze the effects of local administration of PDGFB on ovarian angiogenesis, follicular development and ovulation in a DHEA-induced PCOS rat model. Ovarian PDGFB administration to PCOS rats partially restored follicular development, decreased the percentage of cysts, increased the percentage of corpora lutea, and decreased the production of anti-Müllerian hormone. In addition, PDGFB administration improved ovarian angiogenesis by reversing the increase in periendothelial cell area and restoring VEGF levels. Our results shed light into the mechanisms that lead to altered ovarian function in PCOS and provide new data for potential therapeutic strategies. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Maintenance of membrane organization in the aging mouse brain as the determining factor for preventing receptor dysfunction and for improving response to anti-Alzheimer treatments.

    Science.gov (United States)

    Colin, Julie; Thomas, Mélanie H; Gregory-Pauron, Lynn; Pinçon, Anthony; Lanhers, Marie-Claire; Corbier, Catherine; Claudepierre, Thomas; Yen, Frances T; Oster, Thierry; Malaplate-Armand, Catherine

    2017-06-01

    Although a major risk factor for Alzheimer's disease (AD), the "aging" parameter is not systematically considered in preclinical validation of anti-AD drugs. To explore how aging affects neuronal reactivity to anti-AD agents, the ciliary neurotrophic factor (CNTF)-associated pathway was chosen as a model. Comparison of the neuroprotective properties of CNTF in 6- and 18-month old mice revealed that CNTF resistance in the older animals is associated with the exclusion of the CNTF-receptor subunits from rafts and their subsequent dispersion to non-raft cortical membrane domains. This age-dependent membrane remodeling prevented both the formation of active CNTF-receptor complexes and the activation of prosurvival STAT3 and ERK1/2 pathways, demonstrating that age-altered membranes impaired the reactivity of potential therapeutic targets. CNTF-receptor distribution and CNTF signaling responses were improved in older mice receiving dietary docosahexaenoic acid, with CNTF-receptor functionality being similar to those of younger mice, pointing toward dietary intervention as a promising adjuvant strategy to maintain functional neuronal membranes, thus allowing the associated receptors to respond appropriately to anti-AD agents. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Plasma rich in growth factors (PRGF-Endoret) reduces neuropathologic hallmarks and improves cognitive functions in an Alzheimer's disease mouse model.

    Science.gov (United States)

    Anitua, Eduardo; Pascual, Consuelo; Antequera, Desiree; Bolos, Marta; Padilla, Sabino; Orive, Gorka; Carro, Eva

    2014-07-01

    Impaired growth factor function is thought to drive many of the alterations observed in Alzheimer's disease (AD) patients. Endogenous regenerative technology, PRGF (plasma rich in growth factor)-Endoret, is designed for the delivery of a complex pool of patient's own active morphogens that may stimulate tissue regeneration. We obtained and characterized PRGF-Endoret preparations from human blood. We used, as experimental approach in vivo, APP/PS1 mice, characterized by age-dependent brain amyloid-β (Aβ) accumulation. Intranasal administration of PRGF-Endoret to APP/PS1 mice resulted in an important decrease in brain Aβ deposition and tau phosphorylation. PRGF-Endoret-treated APP/PS1 mice also showed decreased astrocyte reactivity, and prevented protein synaptic loss. In vitro approaches demonstrated that PRGF-Endoret treatment modulated astrocyte activation, reducing inflammatory responses, and promoted Aβ degradation. Furthermore, PRGF-Endoret stimulated global improvements in anxiety, learning, and memory behaviors. Our findings show that PRGF-Endoret exerts multifunctional and complementary effects that result in the reversal of the broad range of cognitive deficits in AD, suggesting that PRGF-Endoret may hold promise as an innovative therapy in AD. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Combined intranasal nerve growth factor and ventricle neural stem cell grafts prolong survival and improve disease outcome in amyotrophic lateral sclerosis transgenic mice.

    Science.gov (United States)

    Zhong, Shi-Jiang; Gong, Yan-Hua; Lin, Yan-Chen

    2017-08-24

    Amyotrophic lateral sclerosis (ALS) is a fatal disease that selectively involves motor neurons. Neurotrophic factor supplementation and neural stem cell (NSC) alternative therapy have been used to treat ALS. The two approaches can affect each other in their pathways of action, and there is a possibility for synergism. However, to date, there have been no studies demonstrating the effects of combined therapy in the treatment of ALS. In this study, for the first time, we adopted a method involving the intranasal administration of nerve growth factor combined with lateral ventricle NSC transplantation using G93A-SOD1 transgenic mice as experimental subjects to explore the treatment effect of this combined therapy in ALS. We discover that the combined therapy increase the quantity of TrkA receptors, broaden the migration of exogenous NSCs, further promote active proliferation in neurogenic regions of the brain and enhance the preservation of motor neurons in the spinal cord. Regarding physical activity, the combined therapy improved motor functions, further postponed ALS onset and extended the survival time of the mice. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Overexpression of the TaSHN1 transcription factor in bread wheat leads to leaf surface modifications, improved drought tolerance and no yield penalty under controlled growth conditions.

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    Bi, Huihui; Shi, Jianxin; Kovalchuk, Natalia; Luang, Sukanya; Bazanova, Natalia; Chirkova, Larissa; Zhang, Dabing; Shavrukov, Yuri; Stepanenko, Anton; Tricker, Penny; Langridge, Peter; Hrmova, Maria; Lopato, Sergiy; Borisjuk, Nikolai

    2018-05-14

    Transcription factors regulate multiple networks, mediating the responses of organisms to stresses, including drought. Here we investigated the role of the wheat transcription factor TaSHN1 in crop growth and drought tolerance. TaSHN1, isolated from bread wheat, was characterised for molecular interactions and functionality. The overexpression of TaSHN1 in wheat was followed by the evaluation of T 2 and T 3 transgenic lines for drought tolerance, growth and yield components. Leaf surface changes were analysed by light microscopy, SEM, TEM and GC-MS/GC-FID. TaSHN1 behaves as a transcriptional activator in a yeast transactivation assay and binds stress-related DNA cis-elements, determinants of which were revealed using 3D molecular modelling. The overexpression of TaSHN1 in transgenic wheat did not result in a yield penalty under the controlled plant growth conditions of a glasshouse. Transgenic lines had significantly lower stomatal density and leaf water loss, and exhibited improved recovery after severe drought, compared to control plants. The comparative analysis of cuticular waxes revealed an increased accumulation of alkanes in leaves of transgenic lines. Our data demonstrate that TaSHN1 may operate as a positive modulator of drought stress tolerance. Positive attributes could be mediated through an enhanced accumulation of alkanes and reduced stomatal density. This article is protected by copyright. All rights reserved.

  14. Development of a health promotion programme to improve awareness of factors that affect fertility, and evaluation of its reach in the first 5 years

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    Karin Hammarberg

    2017-06-01

    Full Text Available Awareness among people of reproductive age about the factors that influence fertility and reproductive outcomes, including medically assisted reproduction outcomes, is generally low. To improve awareness about the potentially modifiable factors that affect fertility and reproductive outcomes, ‘Your Fertility’, a fertility health promotion programme funded by the Australian Government, was established in 2011. This paper describes the development and evaluation of the reach of the Your Fertility programme from its inception in 2011 to June 2016. Systematically recorded outcomes for the programme’s key focus areas and Google Analytics data were collated. Key achievements include developing and maintaining an internationally renowned website that experiences high growth and demand for fertility-related information; by 2016, over 5 million users had viewed more than 10 million webpages, and over 96,000 users had engaged in programme messages across social media. Programme messages have reached more than 4 million Australian social media users, and a potential audience of 150 million through media coverage across more than 320 media features. More than 4200 education and health professionals have completed online learning modules, and external partnerships have been established with 14 separate organizations. Data collected over 5 years indicate that the Your Fertility programme meets a need for targeted, evidence-based, accessible fertility-related information.

  15. Lowering Interleukin-12 Activity Improves Myocardial and Vascular Function Compared With Tumor Necrosis Factor-a Antagonism or Cyclosporine in Psoriasis.

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    Ikonomidis, Ignatios; Papadavid, Evangelia; Makavos, George; Andreadou, Ioanna; Varoudi, Maria; Gravanis, Kostas; Theodoropoulos, Kostas; Pavlidis, George; Triantafyllidi, Helen; Moutsatsou, Paraskevi; Panagiotou, Christina; Parissis, John; Iliodromitis, Efstathios; Lekakis, John; Rigopoulos, Dimitrios

    2017-09-01

    Interleukin (IL)-12 activity is involved in the pathogenesis of psoriasis and acute coronary syndromes. We investigated the effects of IL-12 inhibition on vascular and left ventricular (LV) function in psoriasis. One hundred fifty psoriasis patients were randomized to receive an anti-IL-12/23 (ustekinumab, n=50), anti-tumor necrosis factor-a (TNF-α; etanercept, n=50), or cyclosporine treatment (n=50). At baseline and 4 months post-treatment, we measured (1) LV global longitudinal strain, twisting, and percent difference between peak twisting and untwisting at mitral valve opening (%untwMVO) using speckle-tracking echocardiography, (2) coronary flow reserve, (3) pulse wave velocity and augmentation index, (4) circulating NT-proBNP (N-terminal pro-B-type natriuretic peptide), TNF-α, IL-6, IL-12, IL-17, malondialdehyde, and fetuin-a. Compared with baseline, all patients had improved global longitudinal strain (median values: -17.7% versus -19.5%), LV twisting (12.4° versus 14°), %untwMVO (27.8% versus 35%), and coronary flow reserve (2.8 versus 3.1) and reduced circulating NT-proBNP, IL-17, TNF-α, and IL-6 post-treatment ( P psoriasis, IL-12/23 inhibition results in a greater improvement of coronary, arterial, and myocardial function than TNF-α inhibition or cyclosporine treatment. URL: http://www.clinicaltrials.gov. Unique identifier: NCT02144857. © 2017 American Heart Association, Inc.

  16. Stress-inducible expression of AtDREB1A transcription factor greatly improves drought stress tolerance in transgenic indica rice.

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    Ravikumar, G; Manimaran, P; Voleti, S R; Subrahmanyam, D; Sundaram, R M; Bansal, K C; Viraktamath, B C; Balachandran, S M

    2014-06-01

    The cultivation of rice (Oryza sativa L.), a major food crop, requires ample water (30 % of the fresh water available worldwide), and its productivity is greatly affected by drought, the most significant environmental factor. Much research has focussed on identifying quantitative trait loci, stress-regulated genes and transcription factors that will contribute towards the development of climate-resilient/tolerant crop plants in general and rice in particular. The transcription factor DREB1A, identified from the model plant Arabidopsis thaliana, has been reported to enhance stress tolerance against drought stress. We developed transgenic rice plants with AtDREB1A in the background of indica rice cultivar Samba Mahsuri through Agrobacterium-mediated transformation. The AtDREB1A gene was stably inherited and expressed in T1 and T2 plants and in subsequent generations, as indicated by the results of PCR, Southern blot and RT-PCR analyses. Expression of AtDREB1A was induced by drought stress in transgenic rice lines, which were highly tolerant to severe water deficit stress in both the vegetative and reproductive stages without affecting their morphological or agronomic traits. The physiological studies revealed that the expression of AtDREB1A was associated with an increased accumulation of the osmotic substance proline, maintenance of chlorophyll, increased relative water content and decreased ion leakage under drought stress. Most of the homozygous lines were highly tolerant to drought stress and showed significantly a higher grain yield and spikelet fertility relative to the nontransgenic control plants under both stressed and unstressed conditions. The improvement in drought stress tolerance in combination with agronomic traits is very essential in high premium indica rice cultivars, such as Samba Mahsuri, so that farmers can benefit in times of seasonal droughts and water scarcity.

  17. Therapy with granulocyte colony-stimulating factor in the chronic stage, but not in the acute stage, improves experimental autoimmune myocarditis in rats via nitric oxide.

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    Shimada, Kana; Okabe, Taka-aki; Mikami, Yu; Hattori, Miki; Fujita, Masatoshi; Kishimoto, Chiharu

    2010-09-01

    We systematically investigated serial efficacy of granulocyte colony-stimulating factor (G-CSF) therapy upon experimental autoimmune myocarditis (EAM) in rats treated with and without the inhibition of nitric oxide (NO) with the analyses of tissue regeneration. G-CSF could mobilize multipotent progenitor cells of bone marrow into the peripheral blood and may improve ventricular function. A rat model of porcine myosin-induced EAM was used. After the immunization of myosin, G-CSF (10 microg/kg/day) or saline was injected intraperitoneally on days 0-21 in experiment 1 and on days 21-42 in experiment 2. Additional myosin-immunized rats were orally given 25 mg/kg/day of N(G)-nitro-L-arginine methylester (L-NAME), an inhibitor of nitric oxide synthase (NOS), in each experiment (each group; n=8-21). Serum cytokines and peripheral blood cell counts were measured in each group. In experiment 1, G-CSF treatment aggravated cardiac pathology associated with increased macrophage inflammatory protein-2 (MIP-2) and interleukin-6 (IL-6) levels and enhanced superoxide production. In experiment 2, G-CSF treatment reduced the severity of myocarditis with increased capillary density and improved left ventricular ejection fraction. In the rats with EAM treated with G-CSF associated with oral L-NAME treatment in experiment 2, the severity of myocarditis was not reduced. Myocardial c-kit(+) cells were demonstrated only in G-CSF-treated group in experiment 2 but not in other groups. G-CSF has differential effects on EAM in rats associated with the modulation of cytokine network. The overwhelming superoxide production by G-CSF administration in the acute stage may worsen the disease. G-CSF therapy improved cardiac function via NO system in a rat model of myocarditis in the chronic stage, but not in the acute stage, possibly through the myocardial regeneration and acceleration of healing process. Copyright 2010 Elsevier Ltd. All rights reserved.

  18. A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes.

    Science.gov (United States)

    Barnard, Neal D; Cohen, Joshua; Jenkins, David J A; Turner-McGrievy, Gabrielle; Gloede, Lise; Jaster, Brent; Seidl, Kim; Green, Amber A; Talpers, Stanley

    2006-08-01

    We sought to investigate whether a low-fat vegan diet improves glycemic control and cardiovascular risk factors in individuals with type 2 diabetes. Individuals with type 2 diabetes (n = 99) were randomly assigned to a low-fat vegan diet (n = 49) or a diet following the American Diabetes Association (ADA) guidelines (n = 50). Participants were evaluated at baseline and 22 weeks. Forty-three percent (21 of 49) of the vegan group and 26% (13 of 50) of the ADA group participants reduced diabetes medications. Including all participants, HbA(1c) (A1C) decreased 0.96 percentage points in the vegan group and 0.56 points in the ADA group (P = 0.089). Excluding those who changed medications, A1C fell 1.23 points in the vegan group compared with 0.38 points in the ADA group (P = 0.01). Body weight decreased 6.5 kg in the vegan group and 3.1 kg in the ADA group (P vegan group and 10.7% in the ADA group (P = 0.02). After adjustment for baseline values, urinary albumin reductions were greater in the vegan group (15.9 mg/24 h) than in the ADA group (10.9 mg/24 h) (P = 0.013). Both a low-fat vegan diet and a diet based on ADA guidelines improved glycemic and lipid control in type 2 diabetic patients. These improvements were greater with a low-fat vegan diet.

  19. Is exercise a therapeutic tool for improvement of cardiovascular risk factors in adolescents with type 1 diabetes mellitus? A randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Salem Mona A

    2010-07-01

    Full Text Available Abstract Background Type 1 diabetes mellitus (T1DM is associated with a high risk for early atherosclerotic complications especially risk of coronary heart disease. Objective To evaluate the impact of six months exercise prgram on glycemic control, plasma lipids values, blood pressure, severity and frequency of hypoglycemia, anthropometric measurements and insulin dose in a sample of adolescents with T1DM. Research design and methods A total of 196 type 1 diabetic patients participated in the study. They were classified into three groups: Group (A did not join the exercise program(n = 48, group (B attended the exercise sessions once/week (n = 75, group (C attended the exercise sessions three times/week (n = 73. Studied parameters were evaluated before and six months after exercise programe. Results Exercise improved glycemic control by reducing HbA1c values in exercise groups (P = 0.03, P = 0.01 respectively and no change in those who were not physically active (P = 0.2. Higher levels of HbA1c were associated with higher levels of cholesterol, LDL-c, and triglycerides (P = 0.000 each. In both groups, B and C, frequent exercise improved dyslipidemia and reduced insulin requirements significantly (P = 0.00 both, as well as a reduction in BMI (P = 0.05, P = 0.00 respectively and waist circumference(P = 0.02, P = 0.00 respectively. The frequency of hypoglycemic attacks were not statistically different between the control group and both intervention groups (4.7 ± 3.56 and 4.82 ± 4.23, P = 0.888 respectively. Reduction of blood pressure was statistically insignificant apart from the diastolic blood presure in group C (P = 0.04. Conclusion Exercise is an indispensable component in the medical treatment of patients with T1DM as it improves glycemic control and decreases cardiovascular risk factors among them.

  20. Workplace Digital Health Is Associated with Improved Cardiovascular Risk Factors in a Frequency-Dependent Fashion: A Large Prospective Observational Cohort Study.

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    R Jay Widmer

    Full Text Available Cardiovascular disease (CVD is the leading cause of morbidity and mortality in the US. Emerging employer-sponsored work health programs (WHP and Digital Health Intervention (DHI provide monitoring and guidance based on participants' health risk assessments, but with uncertain success. DHI--mobile technology including online and smartphone interventions--has previously been found to be beneficial in reducing CVD outcomes and risk factors, however its use and efficacy in a large, multisite, primary prevention cohort has not been described to date. We analyzed usage of DHI and change in intermediate markers of CVD over the course of one year in 30,974 participants of a WHP across 81 organizations in 42 states between 2011 and 2014, stratified by participation log-ins categorized as no (n = 14,173, very low (<12/yr, n = 12,260, monthly (n = 3,360, weekly (n = 651, or semi-weekly (at least twice per week. We assessed changes in weight, waist circumference, body mass index (BMI, blood pressure, lipids, and glucose at one year, as a function of participation level. We utilized a Poisson regression model to analyze variables associated with increased participation. Those with the highest level of participation were slightly, but significantly (p<0.0001, older (48.3±11.2 yrs than non-participants (47.7±12.2 yr and more likely to be females (63.7% vs 37.3% p<0.0001. Significant improvements in weight loss were demonstrated with every increasing level of DHI usage with the largest being in the semi-weekly group (-3.39±1.06 lbs; p = 0.0013 for difference from weekly. Regression analyses demonstrated that greater participation in the DHI (measured by log-ins was significantly associated with older age (p<0.001, female sex (p<0.001, and Hispanic ethnicity (p<0.001. The current study demonstrates the success of DHI in a large, community cohort to modestly reduce CVD risk factors in individuals with high participation rate. Furthermore, participants

  1. An improved ChIP-seq peak detection system for simultaneously identifying post-translational modified transcription factors by combinatorial fusion, using SUMOylation as an example.

    Science.gov (United States)

    Cheng, Chia-Yang; Chu, Chia-Han; Hsu, Hung-Wei; Hsu, Fang-Rong; Tang, Chung Yi; Wang, Wen-Ching; Kung, Hsing-Jien; Chang, Pei-Ching

    2014-01-01

    Post-translational modification (PTM) of transcriptional factors and chromatin remodelling proteins is recognized as a major mechanism by which transcriptional regulation occurs. Chromatin immunoprecipitation (ChIP) in combination with high-throughput sequencing (ChIP-seq) is being applied as a gold standard when studying the genome-wide binding sites of transcription factor (TFs). This has greatly improved our understanding of protein-DNA interactions on a genomic-wide scale. However, current ChIP-seq peak calling tools are not sufficiently sensitive and are unable to simultaneously identify post-translational modified TFs based on ChIP-seq analysis; this is largely due to the wide-spread presence of multiple modified TFs. Using SUMO-1 modification as an example; we describe here an improved approach that allows the simultaneous identification of the particular genomic binding regions of all TFs with SUMO-1 modification. Traditional peak calling methods are inadequate when identifying multiple TF binding sites that involve long genomic regions and therefore we designed a ChIP-seq processing pipeline for the detection of peaks via a combinatorial fusion method. Then, we annotate the peaks with known transcription factor binding sites (TFBS) using the Transfac Matrix Database (v7.0), which predicts potential SUMOylated TFs. Next, the peak calling result was further analyzed based on the promoter proximity, TFBS annotation, a literature review, and was validated by ChIP-real-time quantitative PCR (qPCR) and ChIP-reChIP real-time qPCR. The results show clearly that SUMOylated TFs are able to be pinpointed using our pipeline. A methodology is presented that analyzes SUMO-1 ChIP-seq patterns and predicts related TFs. Our analysis uses three peak calling tools. The fusion of these different tools increases the precision of the peak calling results. TFBS annotation method is able to predict potential SUMOylated TFs. Here, we offer a new approach that enhances Ch

  2. Fatores críticos para a melhoria contínua em indústrias brasileiras Critical factors for the continuous improvement in brazilian manufacturing companies

    Directory of Open Access Journals (Sweden)

    Pedro Carlos Oprime

    2011-03-01

    Full Text Available O objetivo deste artigo é identificar e analisar fatores críticos no desenvolvimento de atividades de melhoria contínua (MC em empresas industriais brasileiras. Um modelo conceitual de relacionamento entre práticas e resultados foi testado por meio de um survey utilizando uma amostra de 46 empresas industriais. Fatores como: treinamento em ferramentas de solução de problemas, o incentivo a sugestões, a comunicação face a face, visitas ao chão de fábrica e adoção de sistemas de incentivos, se mostraram críticos para alcance de sucesso em atividades de MC. Identificaram pela análise fatorial dois constructos críticos relacionados ao processo de melhoria contínua: 1 a promoção das atividades de melhoria contínua por meio de políticas de incentivos; e 2 o suporte e liderança da alta administração e ativa participação da gerência. Observou-se que há relação estatisticamente significativa entre o uso de técnicas de solução de problemas e mecanismos de incentivos com o desempenho das empresas.The aim of this paper is to identify and analyze critical factors in the development of continuous improvement (CI activities in Brazilian manufacturing companies. A conceptual model of relationship between practices and results was tested through a survey conducted in 46 manufacturing companies. Factors such as: problems solving tools training, suggestion incentives, face-to-face communication, visits to the shop floor and adoption of incentive systems, have proved to be critical at reaching success in CI activities. Through factorial analysis, two critical constructs concerning continuous improvement process were identified: 1 promotion of continuous improvement through incentive mechanisms; and 2 High level management support and leadership and management active involvement. It was observed that there is a statistically meaningful relationship between the use of problem solving techniques and the incentive mechanisms in face of

  3. Four-factor prothrombin complex concentrate improves thrombin generation and prothrombin time in patients with bleeding complications related to rivaroxaban: a single-center pilot trial.

    Science.gov (United States)

    Schenk, Bettina; Goerke, Stephanie; Beer, Ronny; Helbok, Raimund; Fries, Dietmar; Bachler, Mirjam

    2018-01-01

    Direct oral anticoagulants (DOACs) pose a great challenge for physicians in life-threatening bleeding events. The aim of this study was to test the efficacy of reversing the DOAC rivaroxaban using four-factor PCC (prothrombin complex concentrate), a non-specific reversing agent. Patients with life-threatening bleeding events during rivaroxaban treatment were included and administered 25 U kg -1 of PCC. Blood samples were collected immediately prior to as well as after PCC treatment at predefined time intervals. The primary endpoint was defined as the difference in thrombin generation (TG) parameters ETP (endogenous thrombin potential) and C max (peak thrombin generation) prior to and ten minutes subsequent to PCC treatment. Thirteen patients, of whom the majority suffered from intra-cranial haemorrhage (ICH) or subdural haemorrhage (SDH), were included and administered PCC. The results show that the ETP (TG) significantly ( p  = 0.001) improved by 68% and C max (TG) by 54% (p = 0.001) during PCC treatment. In addition, the Quick value (prothrombin time: Quick PT ) significantly improved by 28% and the activated partial thromboplastin time (aPTT) was decreased by 7% ten minutes after PCC administration. C max was reduced at baseline, but not ETP, aPTT or Quick PT . Lag time until initiation (TG, t lag ), thromboelastometry clotting time (CT EXTEM ) and time to peak (TG, t max ) correlated best with measured rivaroxaban levels and were out of normal ranges at baseline, but did not improve after PCC administration. In 77% of the patients bleeding (ICH/SDH-progression) ceased following PCC administration. During the study three participants passed away due to other complications not related to PCC treatment. The possibility of thrombosis formation was also evaluated seven days after administering PCC and no thromboses were found. This study shows that use of PCC improved ETP, C max, Quick PT and aPTT. However, of these parameters, only C max was reduced at the

  4. Lipid Replacement Therapy Functional Food Formulation with NT Factor for Reducing Weight, Girth, Body Mass, Appetite and Fatigue While Improving Blood Lipid Profiles

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    Rita R. Ellithorpe

    2012-01-01

    Full Text Available Background: Lipid Replacement Therapy using NT Factor® plus kidney bean alpha-amylase inhibitor (Healthy Curb® was used in a two month weight loss clinical trial to reduce weight and improve fatigue without changing easting or exercise patterns and without use of drugs, stimulants or herbs. Objectives: To determine the effects of an all-natural functional food, NT Factor® plus alpha-amylase inhibitor (Healthy Curb®, on weight loss, body girth, body mass and index, basal metabolic rate, appetite, carvings for sweets and fatigue as well as blood lipid profiles during a 2-month open label clinical trial without food restrictions or increases in physical activity.Methods: Thirty subjects (Mean Age = 56.8 ± 1.8; 24 females and 6 males used the functional food containing NT Factor® (500 mg and alpha-amylase inhibitor (500 mg 30 min before each meal in tablet form. Participants were told to eat and exercise normally. Weight, waist and hip measurements were taken weekly. Appetite and sweet cravings were assessed weekly by standard methods. Fatigue was determined using the Piper Fatigue Scale. Blood samples were taken prior to and at the end of the trial for lipid and chemical analyses. Results: Sixty-three percent of the participants lost an average of 6.11 ± 0.28 pounds (2.77 ± 0.12 Kg (p<0.001 along with average reductions of 2.51 ± 0.05 inches (6.4 ± 0.13 cm (p<0.0001 and 1.5 ± 0.04 inches (3.8 ± 0.10 cm (p<0.0001 from waist and hip circumferences, respectively. The entire Functional Foods in Health and Disease 2012, 2(1:11-24 group lost an average of 3.63 ± 0.13 pounds (1.65 ± 0.11 Kg (p<0.001 with average reductions of 1.59 ± 0.03 inches (4.04 ± 0.06 cm (p<0.0001 and 1.13 ± 0.02 inch (2.87 ± 0.05 cm (p<0.0001 from waist and hip circumferences, respectively. Weight loss and body measurement decreases were gradual, consistent and significant, along with reductions in body mass index (BMI and basal metabolic rate (BMR measurements

  5. Myeloid-Epithelial-Reproductive Receptor Tyrosine Kinase and Milk Fat Globule Epidermal Growth Factor 8 Coordinately Improve Remodeling After Myocardial Infarction via Local Delivery of Vascular Endothelial Growth Factor.

    Science.gov (United States)

    Howangyin, Kiave-Yune; Zlatanova, Ivana; Pinto, Cristina; Ngkelo, Anta; Cochain, Clément; Rouanet, Marie; Vilar, José; Lemitre, Mathilde; Stockmann, Christian; Fleischmann, Bernd K; Mallat, Ziad; Silvestre, Jean-Sébastien

    2016-03-01

    In infarcted heart, improper clearance of dying cells by activated neighboring phagocytes may precipitate the transition to heart failure. We analyzed the coordinated role of 2 major mediators of efferocytosis, the myeloid-epithelial-reproductive protein tyrosine kinase (Mertk) and the milk fat globule epidermal growth factor (Mfge8), in directing cardiac remodeling by skewing the inflammatory response after myocardial infarction. We generated double-deficient mice for Mertk and Mfge8 (Mertk(-/-)/Mfge8(-/-)) and challenged them with acute coronary ligature. Compared with wild-type, Mertk-deficient (Mertk(-/-)), or Mfge8-deficient (Mfge8(-/-)) animals, Mertk(-/-)/Mfge8(-/-) mice displayed greater alteration in cardiac function and remodeling. Mertk and Mfge8 were expressed mainly by cardiac Ly6C(High and Low) monocytes and macrophages. In parallel, Mertk(-/-)/Mfge8(-/-) bone marrow chimeras manifested increased accumulation of apoptotic cells, enhanced fibrotic area, and larger infarct size, as well as reduced angiogenesis. We found that the abrogation of efferocytosis affected neither the ability of circulating monocytes to infiltrate cardiac tissue nor the number of resident Ly6C(High) and Ly6C(How) monocytes/macrophages populating the infarcted milieu. In contrast, combined Mertk and Mfge8 deficiency in Ly6C(High)/Ly6C(Low) monocytes/macrophages either obtained from in vitro differentiation of bone marrow cells or isolated from infarcted hearts altered their capacity of efferocytosis and subsequently blunted vascular endothelial growth factor A (VEGFA) release. Using LysMCre(+)/VEGFA(fl/fl) mice, we further identified an important role for myeloid-derived VEGFA in improving cardiac function and angiogenesis. After myocardial infarction, Mertk- and Mfge8-expressing monocyte/macrophages synergistically engage the clearance of injured cardiomyocytes, favoring the secretion of VEGFA to locally repair the dysfunctional heart. © 2016 The Authors.

  6. Antimicrobial drug use and risk factors associated with treatment incidence and mortality in Swiss veal calves reared under improved welfare conditions.

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    Lava, M; Schüpbach-Regula, G; Steiner, A; Meylan, M

    2016-04-01

    Ninety-one Swiss veal farms producing under a label with improved welfare standards were visited between August and December 2014 to investigate risk factors related to antimicrobial drug use and mortality. All herds consisted of own and purchased calves, with a median of 77.4% of purchased calves. The calves' mean age was 29±15days at purchasing and the fattening period lasted at average 120±28 days. The mean carcass weight was 125±12kg. A mean of 58±33 calves were fattened per farm and year, and purchased calves were bought from a mean of 20±17 farms of origin. Antimicrobial drug treatment incidence was calculated with the defined daily dose methodology. The mean treatment incidence (TIADD) was 21±15 daily doses per calf and year. The mean mortality risk was 4.1%, calves died at a mean age of 94±50 days, and the main causes of death were bovine respiratory disease (BRD, 50%) and gastro-intestinal disease (33%). Two multivariable models were constructed, for antimicrobial drug treatment incidence (53 farms) and mortality (91 farms). No quarantine, shared air space for several groups of calves, and no clinical examination upon arrival at the farm were associated with increased antimicrobial treatment incidence. Maximum group size and weight differences >100kg within a group were associated with increased mortality risk, while vaccination and beef breed were associated with decreased mortality risk. The majority of antimicrobial treatments (84.6%) were given as group treatments with oral powder fed through an automatic milk feeding system. Combination products containing chlortetracycline with tylosin and sulfadimidine or with spiramycin were used for 54.9%, and amoxicillin for 43.7% of the oral group treatments. The main indication for individual treatment was BRD (73%). The mean age at the time of treatment was 51 days, corresponding to an estimated weight of 80-100kg. Individual treatments were mainly applied through injections (88.5%), and included

  7. Realizing improved patient care through human-centered operating room design: a human factors methodology for observing flow disruptions in the cardiothoracic operating room.

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    Palmer, Gary; Abernathy, James H; Swinton, Greg; Allison, David; Greenstein, Joel; Shappell, Scott; Juang, Kevin; Reeves, Scott T

    2013-11-01

    Human factors engineering has allowed a systematic approach to the evaluation of adverse events in a multitude of high-stake industries. This study sought to develop an initial methodology for identifying and classifying flow disruptions in the cardiac operating room (OR). Two industrial engineers with expertise in human factors workflow disruptions observed 10 cardiac operations from the moment the patient entered the OR to the time they left for the intensive care unit. Each disruption was fully documented on an architectural layout of the OR suite and time-stamped during each phase of surgery (preoperative [before incision], operative [incision to skin closure], and postoperative [skin closure until the patient leaves the OR]) to synchronize flow disruptions between the two observers. These disruptions were then categorized. The two observers made a total of 1,158 observations. After the elimination of duplicate observations, a total of 1,080 observations remained to be analyzed. These disruptions were distributed into six categories such as communication, usability, physical layout, environmental hazards, general interruptions, and equipment failures. They were further organized into 33 subcategories. The most common disruptions were related to OR layout and design (33%). By using the detailed architectural diagrams, the authors were able to clearly demonstrate for the first time the unique role that OR design and equipment layout has on the generation of physical layout flow disruptions. Most importantly, the authors have developed a robust taxonomy to describe the flow disruptions encountered in a cardiac OR, which can be used for future research and patient safety improvements.

  8. Arm crank ergometry improves cardiovascular disease risk factors and community mobility independent of body composition in high motor complete spinal cord injury.

    Science.gov (United States)

    Bresnahan, James J; Farkas, Gary J; Clasey, Jody L; Yates, James W; Gater, David R

    2018-01-15

    Evaluate the effect of aerobic exercise using arm crank ergometry (ACE) in high motor complete (ISNCSCI A/B) spinal cord injury (SCI) as primarily related to cardiovascular disease (CVD) risk factors and functional mobility and secondarily to body composition and metabolic profiles. Longitudinal interventional study at an academic medical center. Ten previously untrained participants (M8/F2, Age 36.7 y ± 10.1, BMI 24.5 ± 6.0) with high motor complete SCI (C7-T5) underwent ACE exercise training 30 minutes/day × 3 days/week for 10 weeks at 70% VO 2Peak . Primary outcome measures were pre- and post-intervention changes in markers of cardiovascular fitness (graded exercise testing (GXT): VO 2 , VO 2Peak , respiratory quotient [RQ], GXT time, peak power, and energy expenditure [EE]) and community mobility (time to traverse a 100ft-5° ramp, and 12-minute WC propulsion test). Secondary outcome measures were changes in body composition and metabolic profiles (fasting and area under the curve for glucose and insulin, homeostasis model assessment [HOMA] for %β-cell activity [%β], %insulin sensitivity [%S], and insulin resistance [IR], and Matsuda Index [ISI Matsuda ]). Resting VO 2 , relative VO 2Peak , absolute VO 2Peak , peak power, RQ, 12-minute WC propulsion, fasting insulin, fasting G:I ratio, HOMA-%S, and HOMA-IR all significantly improved following intervention (P 0.05). Ten weeks of ACE at 70% VO 2Peak in high motor complete SCI improves aerobic capacity, community mobility, and metabolic profiles independent of changes in body composition.

  9. Dietary supplementation of soy germ phytoestrogens or estradiol improves spatial memory performance and increases gene expression of BDNF, TrkB receptor and synaptic factors in ovariectomized rats

    Directory of Open Access Journals (Sweden)

    Li Zhuoneng

    2010-09-01

    Full Text Available Abstract Background Estrogen or phytoestrogens treatment has been suggested to improve cognitive function of the brain in postmenopausal women. However, there is lack of information on the mechanism of such treatment on the central nervous system. The present study aimed to determine the effects of estradiol and soy germ phytoestrogens on spatial memory performance in ovariectomized rats and to explore the underlying mechanisms affecting the central nervous system. Methods Ovariectomized Sprague-Dawley rats were fed a basic diet supplemented with soy germ phytoestrogens (0.4 g/kg or 1.6 g/kg or 17β-estradiol (0.15 g/kg for 12 weeks. At the end of the experiment, animals were evaluated for their spatial learning and memory performance by the Morris Water Maze task. The expressions of brain-derived neurotrophic factor (BDNF and synaptic formation proteins in the hippocampal tissue were estimated using RT-PCR and ELISA. Results It was found that rats supplemented with soy germ phytoestrogens or estradiol performed significantly better in spatial memory acquisition and retention when compared to the rats fed on the control diet. Estradiol or the high dose of phytoestrogens treatment significantly increased BDNF concentration and the mRNA levels for BDNF and its TrkB receptors as well as the synaptic formation proteins, synaptophysin, spinophilin, synapsin 1 and PSD-95, in the hippocampal tissue of the experimental animals. It was also found that phytoestrogens, in contrast to estradiol, did not show any significant effect on the vaginal and uteri. Conclusion Soy germ phytoestrogens, which may be a substitute of estradiol, improved spatial memory performance in ovariectomized rats without significant side-effects on the vaginal and uteri. The memory enhancement effect may relate to the increase in BDNF and the synaptic formation proteins expression in the hippocampus of the brain.

  10. Adenovirus-mediated transfer of hepatocyte growth factor gene to human dental pulp stem cells under good manufacturing practice improves their potential for periodontal regeneration in swine.

    Science.gov (United States)

    Cao, Yu; Liu, Zhenhai; Xie, Yilin; Hu, Jingchao; Wang, Hua; Fan, Zhipeng; Zhang, Chunmei; Wang, Jingsong; Wu, Chu-Tse; Wang, Songlin

    2015-12-15

    Periodontitis is one of the most widespread infectious diseases in humans. We previously promoted significant periodontal tissue regeneration in swine models with the transplantation of autologous periodontal ligament stem cells (PDLSCs) and PDLSC sheet. We also promoted periodontal tissue regeneration in a rat model with a local injection of allogeneic bone marrow mesenchymal stem cells. The purpose of the present study is to investigate the roles of the hepatocyte growth factor (HGF) and human dental pulp stem cells (DPSCs) in periodontal tissue regeneration in swine. In the present study, we transferred an adenovirus that carried HGF gene into human DPSCs (HGF-hDPSCs) under good manufacturing practice (GMP) conditions. These cells were then transplanted into a swine model for periodontal regeneration. Twenty miniature pigs were used to generate periodontitis with bone defect of 5 mm in width, 7 mm in length, and 3 mm in depth. After 12 weeks, clinical, radiological, quantitative and histological assessment of regenerated periodontal tissues was performed to compare periodontal regeneration in swine treated with cell implantation. Our study showed that injecting HGF-hDPSCs into this large animal model could significantly improve periodontal bone regeneration and soft tissue healing. A hDPSC or HGF-hDPSC sheet showed superior periodontal tissue regeneration compared to the injection of dissociated cells. However, the sheets required surgical placement; thus, they were suitable for surgically-managed periodontitis treatments. The adenovirus-mediated transfer of the HGF gene markedly decreased hDPSC apoptosis in a hypoxic environment or in serum-free medium, and it increased blood vessel regeneration. This study indicated that HGF-hDPSCs produced under GMP conditions significantly improved periodontal bone regeneration in swine; thus, this method represents a potential clinical application for periodontal regeneration.

  11. Factors influencing mother's participation in Posyandu for improving nutritional status of children under-five in Aceh Utara district, Aceh province, Indonesia.

    Science.gov (United States)

    Nazri, Cut; Yamazaki, Chiho; Kameo, Satomi; Herawati, Dewi M D; Sekarwana, Nanan; Raksanagara, Ardini; Koyama, Hiroshi

    2016-01-22

    Posyandu, or pos pelayanan terpadu (integrated service post), is a community-based activity for health services in Indonesia. According to the Indonesian Basic Health Survey, the prevalence of children under five in Indonesia who suffered from being underweight was 19.6 %. The wasting was 12.1 % and the stunting was 37.2 % in 2013, and these values have not changed greatly from 2007; much greater than the WHO targets of, less than 10 % underweight, 5 % wasting, and 20 % stunting. In Aceh were 26.6, 16.8, and 43.3 %, respectively. Also, the participation percentages of mothers to Posyandu was about 45 %, far below the national target of 100 %. In Aceh Province, the percentage was even lower (34 % in 2013). This study aimed to investigate the factors influencing participation of mothers in Posyandu. This research used a cross-sectional design with sample of mothers who had children under five. They were chosen by multistage random sampling. Sample size was determined by the WHO formula. Face-to-face interviews were carried out using a questionnaire. The questionnaire consisted of items about socio-demographic characteristics, satisfaction with Posyandu services, attitude towards Posyandu benefits, and intention to attend Posyandu. The collected data were analyzed by using EZR (version 1.21). Fisher's exact test was performed to examine the associations between the socio-demographic factors, attitude, satisfaction, and intention covariates with participation. Logistic regression was used to describe the strength of the relationship between the predictor variables and participation. There were no significant differences in age, marital status, education level, occupation, family size, and distance to Posyandu between low participation group except for the monthly household income. Among the socio-demographic factors, only monthly household income had a significant association with the frequency of mothers' participation. Satisfaction, attitude, and intention were

  12. Low-energy extracorporeal shock wave therapy promotes vascular endothelial growth factor expression and improves locomotor recovery after spinal cord injury.

    Science.gov (United States)

    Yamaya, Seiji; Ozawa, Hiroshi; Kanno, Haruo; Kishimoto, Koshi N; Sekiguchi, Akira; Tateda, Satoshi; Yahata, Kenichiro; Ito, Kenta; Shimokawa, Hiroaki; Itoi, Eiji

    2014-12-01

    Extracorporeal shock wave therapy (ESWT) is widely used for the clinical treatment of various human diseases. Recent studies have demonstrated that low-energy ESWT upregulates the expression of vascular endothelial growth factor (VEGF) and promotes angiogenesis and functional recovery in myocardial infarction and peripheral artery disease. Many previous reports suggested that VEGF produces a neuroprotective effect to reduce secondary neural tissue damage after spinal cord injury (SCI). The purpose of the present study was to investigate whether low-energy ESWT promotes VEGF expression and neuroprotection and improves locomotor recovery after SCI. Sixty adult female Sprague-Dawley rats were randomly divided into 4 groups: sham group (laminectomy only), sham-SW group (low-energy ESWT applied after laminectomy), SCI group (SCI only), and SCI-SW group (low-energy ESWT applied after SCI). Thoracic spinal cord contusion injury was inflicted using an impactor. Low-energy ESWT was applied to the injured spinal cord 3 times a week for 3 weeks. Locomotor function was evaluated using the Basso, Beattie, and Bresnahan (BBB) Scale (open field locomotor score) at different time points over 42 days after SCI. Hematoxylin and eosin staining was performed to assess neural tissue damage in the spinal cord. Neuronal loss was investigated by immunostaining for NeuN. The mRNA expressions of VEGF and its receptor, Flt-1, in the spinal cord were assessed using real-time polymerase chain reaction. Immunostaining for VEGF was performed to evaluate VEGF protein expression in the spinal cord. In both the sham and sham-SW groups, no animals showed locomotor impairment on BBB scoring. Histological analysis of H & E and NeuN stainings in the sham-SW group confirmed that no neural tissue damage was induced by the low-energy ESWT. Importantly, animals in the SCI-SW group demonstrated significantly better locomotor improvement than those in the SCI group at 7, 35, and 42 days after injury (p

  13. Correlation between the signal-to-noise ratio improvement factor (KSNR) and clinical image quality for chest imaging with a computed radiography system

    International Nuclear Information System (INIS)

    Moore, C S; Wood, T J; Saunderson, J R; Beavis, A W

    2015-01-01

    This work assessed the appropriateness of the signal-to-noise ratio improvement factor (K SNR ) as a metric for the optimisation of computed radiography (CR) of the chest. The results of a previous study in which four experienced image evaluators graded computer simulated chest images using a visual grading analysis scoring (VGAS) scheme to quantify the benefit of using an anti-scatter grid were used for the clinical image quality measurement (number of simulated patients  =  80). The K SNR was used to calculate the improvement in physical image quality measured in a physical chest phantom. K SNR correlation with VGAS was assessed as a function of chest region (lung, spine and diaphragm/retrodiaphragm), and as a function of x-ray tube voltage in a given chest region. The correlation of the latter was determined by the Pearson correlation coefficient. VGAS and K SNR image quality metrics demonstrated no correlation in the lung region but did show correlation in the spine and diaphragm/retrodiaphragmatic regions. However, there was no correlation as a function of tube voltage in any region; a Pearson correlation coefficient (R) of  −0.93 (p  =  0.015) was found for lung, a coefficient (R) of  −0.95 (p  =  0.46) was found for spine, and a coefficient (R) of  −0.85 (p  =  0.015) was found for diaphragm. All demonstrate strong negative correlations indicating conflicting results, i.e. K SNR increases with tube voltage but VGAS decreases. Medical physicists should use the K SNR metric with caution when assessing any potential improvement in clinical chest image quality when introducing an anti-scatter grid for CR imaging, especially in the lung region. This metric may also be a limited descriptor of clinical chest image quality as a function of tube voltage when a grid is used routinely. (paper)

  14. Using a combination of weighting factor method and imperialist competitive algorithm to improve speed and enhance process of reloading pattern optimization of VVER-1000 reactors in transient cycles

    Energy Technology Data Exchange (ETDEWEB)

    Rahmani, Yashar, E-mail: yashar.rahmani@gmail.com [Department of Physics, Faculty of Engineering, Islamic Azad University, Sari Branch, Sari (Iran, Islamic Republic of); Shahvari, Yaser [Department of Computer Engineering, Payame Noor University (PNU), P.O. Box 19395-3697, Tehran (Iran, Islamic Republic of); Kia, Faezeh [Golestan Institute of Higher Education, Gorgan 49139-83635 (Iran, Islamic Republic of)

    2017-03-15

    Highlights: • This article was an attempt to optimize reloading pattern of Bushehr VVER-1000 reactor. • A combination of weighting factor method and the imperialist competitive algorithm was used. • The speed of optimization and desirability of the proposed pattern increased considerably. • To evaluate arrangements, a coupling of WIMSD5-B, CITATION-LDI2 and WERL codes was used. • Results reflected the considerable superiority of the proposed method over direct optimization. - Abstract: In this research, an innovative solution is described which can be used with a combination of the new imperialist competitive algorithm and the weighting factor method to improve speed and increase globality of search in reloading pattern optimization of VVER-1000 reactors in transient cycles and even obtain more desirable results than conventional direct method. In this regard, to reduce the scope of the assumed searchable arrangements, first using the weighting factor method and based on values of these coefficients in each of the 16 types of loadable fuel assemblies in the second cycle, the fuel assemblies were classified in more limited groups. In consequence, the types of fuel assemblies were reduced from 16 to 6 and consequently the number of possible arrangements was reduced considerably. Afterwards, in the first phase of optimization the imperialist competitive algorithm was used to propose an optimum reloading pattern with 6 groups. In the second phase, the algorithm was reused for finding desirable placement of the subset assemblies of each group in the optimum arrangement obtained from the previous phase, and thus the retransformation of the optimum arrangement takes place from the virtual 6-group mode to the real mode with 16 fuel types. In this research, the optimization process was conducted in two states. In the first state, it was tried to obtain an arrangement with the maximum effective multiplication factor and the smallest maximum power peaking factor. In

  15. Transgenic tobacco plants with improved cyanobacterial Rubisco expression but no extra assembly factors grow at near wild-type rates if provided with elevated CO2.

    Science.gov (United States)

    Occhialini, Alessandro; Lin, Myat T; Andralojc, P John; Hanson, Maureen R; Parry, Martin A J

    2016-01-01

    Introducing a carbon-concentrating mechanism and a faster Rubisco enzyme from cyanobacteria into higher plant chloroplasts may improve photosynthetic performance by increasing the rate of CO2 fixation while decreasing losses caused by photorespiration. We previously demonstrated that tobacco plants grow photoautotrophically using Rubisco from Synechococcus elongatus, although the plants exhibited considerably slower growth than wild-type and required supplementary CO2 . Because of concerns that vascular plant assembly factors may not be adequate for assembly of a cyanobacterial Rubisco, prior transgenic plants included the cyanobacterial chaperone RbcX or the carboxysomal protein CcmM35. Here we show that neither RbcX nor CcmM35 is needed for assembly of active cyanobacterial Rubisco. Furthermore, by altering the gene regulatory sequences on the Rubisco transgenes, cyanobacterial Rubisco expression was enhanced and the transgenic plants grew at near wild-type growth rates, although still requiring elevated CO2 . We performed detailed kinetic characterization of the enzymes produced with and without the RbcX and CcmM35 cyanobacterial proteins. These transgenic plants exhibit photosynthetic characteristics that confirm the predicted benefits of introduction of non-native forms of Rubisco with higher carboxylation rate constants in vascular plants and the potential nitrogen-use efficiency that may be achieved provided that adequate CO2 is available near the enzyme. © 2015 The Authors The Plant Journal © 2015 John Wiley & Sons Ltd.

  16. Interventions Targeting Glucocorticoid-Krüppel-like Factor 15-Branched-Chain Amino Acid Signaling Improve Disease Phenotypes in Spinal Muscular Atrophy Mice

    Directory of Open Access Journals (Sweden)

    Lisa M. Walter

    2018-05-01

    Full Text Available The circadian glucocorticoid-Krüppel-like factor 15-branched-chain amino acid (GC-KLF15-BCAA signaling pathway is a key regulatory axis in muscle, whose imbalance has wide-reaching effects on metabolic homeostasis. Spinal muscular atrophy (SMA is a neuromuscular disorder also characterized by intrinsic muscle pathologies, metabolic abnormalities and disrupted sleep patterns, which can influence or be influenced by circadian regulatory networks that control behavioral and metabolic rhythms. We therefore set out to investigate the contribution of the GC-KLF15-BCAA pathway in SMA pathophysiology of Taiwanese Smn−/−;SMN2 and Smn2B/− mouse models. We thus uncover substantial dysregulation of GC-KLF15-BCAA diurnal rhythmicity in serum, skeletal muscle and metabolic tissues of SMA mice. Importantly, modulating the components of the GC-KLF15-BCAA pathway via pharmacological (prednisolone, genetic (muscle-specific Klf15 overexpression and dietary (BCAA supplementation interventions significantly improves disease phenotypes in SMA mice. Our study highlights the GC-KLF15-BCAA pathway as a contributor to SMA pathogenesis and provides several treatment avenues to alleviate peripheral manifestations of the disease. The therapeutic potential of targeting metabolic perturbations by diet and commercially available drugs could have a broader implementation across other neuromuscular and metabolic disorders characterized by altered GC-KLF15-BCAA signaling. Keywords: Spinal muscular atrophy, KLF15, Glucocorticoids, Branched-chain amino acids, Metabolism, Therapy

  17. Uncaria rhynchophylla and rhynchophylline improved kainic acid-induced epileptic seizures via IL-1β and brain-derived neurotrophic factor.

    Science.gov (United States)

    Ho, Tin-Yun; Tang, Nou-Ying; Hsiang, Chien-Yun; Hsieh, Ching-Liang

    2014-05-15

    Uncaria rhynchophylla (UR) has been used for the treatment of convulsions and epilepsy in traditional Chinese medicine. This study reported the major anti-convulsive signaling pathways and effective targets of UR and rhynchophylline (RP) using genomic and immunohistochemical studies. Epileptic seizure model was established by intraperitoneal injection of kainic acid (KA) in rats. Electroencephalogram and electromyogram recordings indicated that UR and RP improved KA-induced epileptic seizures. Toll-like receptor (TLR) and neurotrophin signaling pathways were regulated by UR in both cortex and hippocampus of KA-treated rats. KA upregulated the expression levels of interleukin-1β (IL-1β) and brain-derived neurotrophin factor (BDNF), which were involved in TLR and neurotrophin signaling pathways, respectively. However, UR and RP downregulated the KA-induced IL-1β and BDNF gene expressions. Our findings suggested that UR and RP exhibited anti-convulsive effects in KA-induced rats via the regulation of TLR and neurotrophin signaling pathways, and the subsequent inhibition of IL-1β and BDNF gene expressions. Copyright © 2014 Elsevier GmbH. All rights reserved.

  18. Down-regulation of fibroblast growth factor 2 and its co-receptors heparan sulfate proteoglycans by resveratrol underlies the improvement of cardiac dysfunction in experimental diabetes.

    Science.gov (United States)

    Strunz, Célia Maria Cássaro; Roggerio, Alessandra; Cruz, Paula Lázara; Pacanaro, Ana Paula; Salemi, Vera Maria Cury; Benvenuti, Luiz Alberto; Mansur, Antonio de Pádua; Irigoyen, Maria Cláudia

    2017-02-01

    Cardiac remodeling in diabetes involves cardiac hypertrophy and fibrosis, and fibroblast growth factor 2 (FGF2) is an important mediator of this process. Resveratrol, a polyphenolic antioxidant, reportedly promotes the improvement of cardiac dysfunction in diabetic rats. However, little information exists linking the amelioration of the cardiac function promoted by resveratrol and the expression of FGF2 and its co-receptors, heparan sulfate proteoglycans (HSPGs: Glypican-1 and Syndecan-4), in cardiac muscle of Type 2 diabetic rats. Diabetes was induced experimentally by the injection of streptozotocin and nicotinamide, and the rats were treated with resveratrol for 6 weeks. According to our results, there is an up-regulation of the expression of genes and/or proteins of Glypican-1, Syndecan-4, FGF2, peroxisome proliferator-activated receptor gamma and AMP-activated protein kinase in diabetic rats. On the other hand, resveratrol treatment promoted the attenuation of left ventricular diastolic dysfunction and the down-regulation of the expression of all proteins under study. The trigger for the changes in gene expression and protein synthesis promoted by resveratrol was the presence of diabetes. The negative modulation conducted by resveratrol on FGF2 and HSPGs expression, which are involved in cardiac remodeling, underlies the amelioration of cardiac function. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  19. A Tailored Web-Based Intervention to Improve Parenting Risk and Protective Factors for Adolescent Depression and Anxiety Problems: Postintervention Findings From a Randomized Controlled Trial.

    Science.gov (United States)

    Yap, Marie Bee Hui; Mahtani, Shireen; Rapee, Ronald M; Nicolas, Claire; Lawrence, Katherine A; Mackinnon, Andrew; Jorm, Anthony F

    2018-01-19

    Depression and anxiety disorders in young people are a global health concern. Parents have an important role in reducing the risk of these disorders, but cost-effective, evidence-based interventions for parents that can be widely disseminated are lacking. This study aimed to examine the postintervention effects of the Partners in Parenting (PiP) program on parenting risk and protective factors for adolescent depression and anxiety, and on adolescent depression and anxiety symptoms. A two-arm randomized controlled trial was conducted with 359 parent-adolescent dyads, recruited primarily through schools across Australia. Parents and adolescents were assessed at baseline and 3 months later (postintervention). Parents in the intervention condition received PiP, a tailored Web-based parenting intervention designed following Persuasive Systems Design (PSD) principles to target parenting factors associated with adolescents' risk for depression and anxiety problems. PiP comprises a tailored feedback report highlighting each parent's strengths and areas for improvement, followed by a set of interactive modules (up to nine) that is specifically recommended for the parent based on individually identified areas for improvement. Parents in the active-control condition received a standardized package of five Web-based factsheets about adolescent development and well-being. Parents in both conditions received a 5-min weekly call to encourage progress through their allocated program to completion. Both programs were delivered weekly via the trial website. The primary outcome measure at postintervention was parent-reported changes in parenting risk and protective factors, which were measured using the Parenting to Reduce Adolescent Depression and Anxiety Scale (PRADAS). Secondary outcome measures were the adolescent-report PRADAS, the parent- and child-report Short Mood and Feelings Questionnaire (depressive symptoms), and parent- and child-report Spence Children's Anxiety Scale

  20. Improving Patient Safety: Improving Communication.

    Science.gov (United States)

    Bittner-Fagan, Heather; Davis, Joshua; Savoy, Margot

    2017-12-01

    Communication among physicians, staff, and patients is a critical element in patient safety. Effective communication skills can be taught and improved through training and awareness. The practice of family medicine allows for long-term relationships with patients, which affords opportunities for ongoing, high-quality communication. There are many barriers to effective communication, including patient factors, clinician factors, and system factors, but tools and strategies exist to address these barriers, improve communication, and engage patients in their care. Use of universal precautions for health literacy, appropriate medical interpreters, and shared decision-making are evidence-based tools that improve communication and increase patient safety. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

  1. Organizational factors

    International Nuclear Information System (INIS)

    Holy, J.

    1999-12-01

    The following organizational factors are considered with respect to the human factor and operating safety of nuclear power plants: external influences; objectives and strategy; positions and ways of management; allocation of resources; working with human resources; operators' training; coordination of work; knowledge of organization and management; proceduralization of the topic; labour organizing culture; self-improvement system; and communication. (P.A.)

  2. Improvement of heart function in postinfarct heart failure swine models after hepatocyte growth factor gene transfer: comparison of low-, medium- and high-dose groups.

    Science.gov (United States)

    Yang, Zhi-jian; Chen, Bo; Sheng, Zhang; Zhang, Ding-guo; Jia, En-zhi; Wang, Wei; Ma, Dong-chao; Zhu, Tie-bing; Wang, Lian-sheng; Li, Chun-jian; Wang, Hui; Cao, Ke-jiang; Ma, Wen-zhu

    2010-04-01

    Despite advances in surgical and reperfusion therapy, there is no effective therapy currently exists to prevent the progressive decline in cardiac function following myocardial infarction. Hepatocyte growth factor has potent angiogenic and anti-apoptotic activities. The aim of this study was to investigate the therapeutic effect and dose-effect relationship on postinfarction heart failure with different doses of adenovirus-mediated human hepatocyte growth factor (Ad(5)-HGF) transference in swine models. Totally twenty swine were randomly divided into four groups: (a) control group (null- Ad(5), 1 ml); (b) low-dose group (1 x 10(9) Pfu/ml Ad(5)-HGF, 1 ml); (c) medium-dose group (5 x 10(9) Pfu/ml Ad(5)-HGF, 1 ml); (d) high-dose group (1 x 10(10) Pfu/ml Ad(5)-HGF, 1 ml). Four weeks after left anterior descending coronary artery (LAD) ligation, different doses of Ad(5)-HGF were transferred in three therapeutic groups via right coronary artery. Four and seven weeks after LAD ligation, gate cardiac perfusion imaging was performed to evaluate cardiac perfusion and left ventricular ejection fraction (LVEF). Seven weeks after surgery, the apoptotic index of cardiocyte was observed by TUNEL, the expression of Bcl-2, Bax, alpha-SMA and Factor VIII in the border zones were evaluated by immunohistochemistry, respectively. Four weeks after myocardial infarction, no significant difference was observed among four groups. Three weeks after Ad(5)-HGF transfer, the improvement of cardiac perfusion and LVEF was obviously observed, especially after 1 x 10(10) Pfu Ad(5)-HGF transfer. TUNEL assay showed that 5 x 10(9) Pfu and 1 x 10(10) Pfu Ad(5)-HGF treatment had a obvious reduction in the apoptotic index compared with the null-Ad(5) group, especially after 1 x 10(10) Pfu Ad(5)-HGF treatment. The expression of Bcl-2 protein was increased and the expression of Bax protein was inhibited in the 5 x 10(9) Pfu and 1 x 10(10) Pfu Ad(5)-HGF groups compared with the null-Ad(5) group. The vessel

  3. Predictive Factors of Patients' and Their Partners' Sexual Function Improvement After Collagenase Clostridium Histolyticum Injection for Peyronie's Disease: Results From a Multi-Center Single-Arm Study.

    Science.gov (United States)

    Cocci, Andrea; Russo, Giorgio Ivan; Salonia, Andrea; Cito, Gianmartin; Regis, Federica; Polloni, Gaia; Giubilei, Gianluca; Cacciamani, Giovanni; Capece, Marco; Falcone, Marco; Greco, Isabella; Timpano, Massimiliano; Minervini, Andrea; Gacci, Mauro; Cai, Tommaso; Garaffa, Giulio; Giammusso, Bruno; Arcaniolo, Davide; Mirone, Vincenzo; Mondaini, Nicola

    2018-05-01

    FSFI score. Furthermore, median change of PC was significantly associated with median change of FSFI (r = 0.25; 95% CI 0.02-0.11; P = .004). Global satisfaction after treatment was 89.6% (121/135). This modified CCH treatment protocol could improve both patients' and partner's sexual function. This was an open-label, single-arm clinical study, without placebo. where only heterosexual couples in stable relationships were included. Furthermore, no real assessment of female sexual distress was carried out and long-term sexual function in both patients and female partners were not taken into account. The modified treatment schedule with CCH injections for stable PD has a positive impact on both patients' and partners' sexual function in heterosexual couples with a stable sexual relationship. Cocci A, Russo GI, Salonia A, et al. Predictive Factors of Patients' and Their Partners' Sexual Function Improvement After Collagenase Clostridium Histolyticum Injection for Peyronie's Disease: Results From a Multi-Center Single-Arm Study. J Sex Med 2018;15:716-721. Copyright © 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  4. Low-energy extracorporeal shock wave therapy for promotion of vascular endothelial growth factor expression and angiogenesis and improvement of locomotor and sensory functions after spinal cord injury.

    Science.gov (United States)

    Yahata, Kenichiro; Kanno, Haruo; Ozawa, Hiroshi; Yamaya, Seiji; Tateda, Satoshi; Ito, Kenta; Shimokawa, Hiroaki; Itoi, Eiji

    2016-12-01

    OBJECTIVE Extracorporeal shock wave therapy (ESWT) is widely used to treat various human diseases. Low-energy ESWT increases expression of vascular endothelial growth factor (VEGF) in cultured endothelial cells. The VEGF stimulates not only endothelial cells to promote angiogenesis but also neural cells to induce neuroprotective effects. A previous study by these authors demonstrated that low-energy ESWT promoted expression of VEGF in damaged neural tissue and improved locomotor function after spinal cord injury (SCI). However, the neuroprotective mechanisms in the injured spinal cord produced by low-energy ESWT are still unknown. In the present study, the authors investigated the cell specificity of VEGF expression in injured spinal cords and angiogenesis induced by low-energy ESWT. They also examined the neuroprotective effects of low-energy ESWT on cell death, axonal damage, and white matter sparing as well as the therapeutic effect for improvement of sensory function following SCI. METHODS Adult female Sprague-Dawley rats were divided into the SCI group (SCI only) and SCI-SW group (low-energy ESWT applied after SCI). Thoracic SCI was produced using a New York University Impactor. Low-energy ESWT was applied to the injured spinal cord 3 times a week for 3 weeks after SCI. Locomotor function was evaluated using the Basso, Beattie, and Bresnahan open-field locomotor score for 42 days after SCI. Mechanical and thermal allodynia in the hindpaw were evaluated for 42 days. Double staining for VEGF and various cell-type markers (NeuN, GFAP, and Olig2) was performed at Day 7; TUNEL staining was also performed at Day 7. Immunohistochemical staining for CD31, α-SMA, and 5-HT was performed on spinal cord sections taken 42 days after SCI. Luxol fast blue staining was performed at Day 42. RESULTS Low-energy ESWT significantly improved not only locomotion but also mechanical and thermal allodynia following SCI. In the double staining, expression of VEGF was observed in Neu

  5. Risk factors for unplanned readmission within 30 days after pediatric neurosurgery: a nationwide analysis of 9799 procedures from the American College of Surgeons National Surgical Quality Improvement Program

    Science.gov (United States)

    Sherrod, Brandon A.; Johnston, James M.; Rocque, Brandon G.

    2017-01-01

    Objective Readmission rate is increasingly used as a quality outcome measure after surgery. The purpose of this study was to establish, using a national database, the baseline readmission rates and risk factors for readmission after pediatric neurosurgical procedures. Methods The American College of Surgeons National Surgical Quality Improvement Program–Pediatric database was queried for pediatric patients treated by a neurosurgeon from 2012 to 2013. Procedures were categorized by current procedural terminology code. Patient demographics, comorbidities, preoperative laboratory values, operative variables, and postoperative complications were analyzed via univariate and multivariate techniques to find associations with unplanned readmission within 30 days of the primary procedure. Results A total of 9799 cases met the inclusion criteria, 1098 (11.2%) of which had an unplanned readmission within 30 days. Readmission occurred 14.0 ± 7.7 days postoperatively (mean ± standard deviation). The 4 procedures with the highest unplanned readmission rates were CSF shunt revision (17.3%), repair of myelomeningocele > 5 cm in diameter (15.4%), CSF shunt creation (14.1%), and craniectomy for infratentorial tumor excision (13.9%). Spine (6.5%), craniotomy for craniosynostosis (2.1%), and skin lesion (1.0%) procedures had the lowest unplanned readmission rates. On multivariate regression analysis, the odds of readmission were greatest in patients experiencing postoperative surgical site infection (SSI; deep, organ/space, superficial SSI and wound disruption: OR > 12 and p readmission risk. Independent patient risk factors for unplanned readmission included Native American race (OR 2.363, p = 0.019), steroid use > 10 days (OR 1.411, p = 0.010), oxygen supplementation (OR 1.645, p = 0.010), nutritional support (OR 1.403, p = 0.009), seizure disorder (OR 1.250, p = 0.021), and longer operative time (per hour increase, OR 1.059, p = 0.014). Conclusions This study may aid in

  6. A novel technique for determination of two dimensional signal-to-noise ratio improvement factor of an antiscatter grid in digital radiography

    Science.gov (United States)

    Nøtthellen, Jacob; Konst, Bente; Abildgaard, Andreas

    2014-08-01

    Purpose: to present a new and simplified method for pixel-wise determination of the signal-to-noise ratio improvement factor KSNR of an antiscatter grid, when used with a digital imaging system. The method was based on approximations of published formulas. The simplified estimate of K2SNR may be used as a decision tool for whether or not to use an antiscatter grid. Methods: the primary transmission of the grid Tp was determined with and without a phantom present using a pattern of beam stops. The Bucky factor B was measured with and without a phantom present. Hence K2SNR maps were created based on Tp and B. A formula was developed to calculate K2SNR from the measured Bs without using the measured Tp. The formula was applied on two exposures of anthropomorphic phantoms, adult legs and baby chest, and on two homogeneous poly[methyl methacrylate] (PMMA) phantoms, 5 cm and 10 cm thick. The results from anthropomorphic phantoms were compared to those based on the beam stop method. The results for the PMMA-phantoms were compared to a study that used a contrast-detail phantom. Results: 2D maps of K2SNR over the entire adult legs and baby chest phantoms were created. The maps indicate that it is advantageous to use the antiscatter grid for imaging of the adult legs. For baby chest imaging the antiscatter grid is not recommended if only the lung regions are of interest. The K2SNR maps based on the new method correspond to those from the beam stop method, and the K2SNR from the homogenous phantoms arising from two different approaches also agreed well with each other. Conclusion: a method to measure 2D K2SNR associated with grid use in digital radiography system was developed and validated. The proposed method requires four exposures and use of a simple formula. It is fast and provides adequate estimates for K2SNR.

  7. Resveratrol improves urinary dysfunction in rats with chronic prostatitis and suppresses the activity of the stem cell factor/c-Kit signaling pathway.

    Science.gov (United States)

    Yu, Yang; Jiang, Jiang; He, Yi; Wang, Wei; Shen, Chen; Yang, Bo

    2017-08-01

    Chronic prostatitis (CP) is a common urological disorder, with bladder voiding dysfunction being the primary clinical manifestation. Resveratrol is polyphenolic compound isolated from numerous plants, with widely‑reported anti-inflammatory properties. The present study aimed to investigate whether resveratrol may improve overactive bladder in rats with CP and to investigate the underlying molecular mechanisms. Furthermore, the potential pharmacological synergy between resveratrol and solifenacin was also investigated as a potential treatment for CP. Following the successful establishment of a rat model of CP by subcutaneously injecting DPT vaccine, rats were treated with resveratrol or a combination of resveratrol + solifenacin. Bladder pressure and volume tests were performed to investigate the effect of resveratrol and solifenacin on urinary dysfunction in rats with chronic prostatitis. Western blot analysis and immunohistochemical staining were used to examine the expression of c‑Kit receptor, stem cell factor (SCF), AKT and phosphorylated‑AKT (p‑AKT) in the bladder tissue. The results of the bladder pressure and volume test indicated that the maximum capacity of the bladder, residual urine volume and maximum voiding pressure in the control group were 0.57 ml, 0.17 ml and 29.62 cm H2O, respectively. These values were increased by 71, 27 and 206% in rats in the CP group compared with the control group. Following treatment with resveratrol, the results in the resveratrol group were reduced by 25.77, 44.23 and 13.32% compared with the CP group. The results of western blot analysis, immunohistochemical staining and immunofluorescence labeling demonstrate that the protein expression of SCF, c‑Kit and p‑AKT in the bladder of rats in the CP group was 4.32, 6.13 and 6.31 times higher compared with the control group, respectively. Following treatment with resveratrol, protein expression was significantly reduced. However, no significant differences

  8. The L-arginine/asymmetric dimethylarginine ratio is improved by anti-tumor necrosis factor-α therapy in inflammatory arthropathies. Associations with aortic stiffness.

    Science.gov (United States)

    Angel, Kristin; Provan, Sella Aarrestad; Mowinckel, Petter; Seljeflot, Ingebjørg; Kvien, Tore Kristian; Atar, Dan

    2012-11-01

    Anti-Tumor Necrosis Factor (TNF)-α therapy improves vascular pathology in inflammatory arthropathies such as rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis. The l-arginine/ADMA ratio is important for modulation of the nitric oxide synthase activity. We examined the effect of TNF-α antagonists on ADMA and l-arginine/ADMA, and associations between ADMA, L-arginine/ADMA, aortic stiffness and carotid intima media thickness (CIMT) in patients with inflammatory arthropathies. Forty-eight patients who started with anti-TNF-α therapy were compared with a non-treated group of 32 patients. Plasma ADMA and L-arginine were assessed at baseline, 3 and 12 months. In a subgroup of 55 patients, aortic pulse wave velocity (aPWV) was measured at baseline, 3 and 12 moths, and CIMT was examined at baseline and 12 months. Anti-TNF-α therapy increased the L-arginine/ADMA ratio (mean [SD]) in the treatment group compared to the control group after 3 months (12 [29] vs. -13 [20], P < 0.001) and 12 months (7 [27] vs. -8 [19], P = 0.008), but did not affect ADMA (3 months: 0.00 [0.09] μmol/L vs. 0.02 [0.07] μmol/L, P = 0.42, 12 months: 0.01 [0.08] μmol/L vs. 0.01 [0.09] μmol/L, P = 0.88). Baseline aPWV was associated with ADMA (P = 0.02) and L-arginine/ADMA (P = 0.02) in multiple regression analyses, and the L-arginine/ADMA ratio was continuously associated with aPWV after initiation of anti-TNF-α therapy (P = 0.03). ADMA and L-arginine/ADMA were not correlated with CIMT. Anti-TNF-α therapy improved the L-arginine/ADMA ratio in patients with inflammatory arthropathies. ADMA and the L-arginine/ADMA ratio were associated with aPWV, and might have a mechanistic role in the aortic stiffening observed in these patients. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  9. Role of Purified Anthocyanins in Improving Cardiometabolic Risk Factors in Chinese Men and Women with Prediabetes or Early Untreated Diabetes-A Randomized Controlled Trial.

    Science.gov (United States)

    Yang, Liping; Ling, Wenhua; Yang, Yan; Chen, Yuming; Tian, Zezhong; Du, Zhicheng; Chen, Jianying; Xie, Yuanling; Liu, Zhaomin; Yang, Lili

    2017-10-10

    Objective: In vitro and animal studies suggest that purified anthocyanins have favorable effects on metabolic profiles, but clinical trials have reported inconsistent findings. Furthermore, no study has been specifically conducted among individuals with prediabetes. The aim of this study was to investigate whether purified anthocyanins could improve cardiometabolic risk factors in Chinese adults with early untreated hyperglycemia. Research Design and Methods: This was a 12-week randomized, double-blind, placebo-controlled trial. A total of 160 participants aged 40-75 years with prediabetes or early untreated diabetes were randomly allocated to receive either purified anthocyanins (320 mg/day, n = 80) or placebo ( n = 80) of identical appearance. A three-hour oral glucose tolerance test (OGTT) was performed, and cardiometabolic biomarkers (glycated hemoglobin A1c (HbA1c), fasting and postprandial glucose, insulin, C-peptide, and lipids) were measured at baseline and at the end of the trial. Results: A total of 138 subjects completed the protocol. Compared with placebo, purified anthocyanins moderately reduced HbA1c (-0.14%, 95% CI: -0.23~-0.04%; p = 0.005), low-density lipoprotein-c (LDL-c) (-0.2 mmol/L, 95% CI: -0.38~-0.01, p = 0.04), apolipoprotein A-1 (apo A1) (0.09 g/L, 95% CI: 0.02~0.17; p = 0.02), and apolipoprotein B (apo B) (-0.07 g/L, 95% CI: -0.13~-0.01; p = 0.01) according to intention-to-treat analysis. Subgroup analyses suggested that purified anthocyanins were more effective at improving glycemic control, insulin sensitivity, and lipids among patients with elevated metabolic markers. Conclusions: The 12-week randomized controlled trials (RCT) in Chinese adults with prediabetes or early untreated diabetes indicated that purified anthocyanins favorably affected glycemic control and lipid profile. Future studies of a longer duration that explore the dose-response relationship among patients with cardiometabolic disorders are needed to confirm our findings.

  10. Supplementation of Blackcurrant Anthocyanins Increased Cyclic Glycine-Proline in the Cerebrospinal Fluid of Parkinson Patients: Potential Treatment to Improve Insulin-Like Growth Factor-1 Function

    Directory of Open Access Journals (Sweden)

    Dawei Fan

    2018-06-01

    Full Text Available Background: Insulin-like growth factor-1 (IGF-1 function is impaired in Parkinson disease. Cyclic glycine-proline (cGP, a metabolite of IGF-1, is neuroprotective through improving IGF-1 function. Parkinson disease patients score lower on Hospital-associated Anxiety and Depression Scale after supplementing blackcurrant anthocyanins (BCA, which may be associated with IGF-1 function. We evaluated the changes of cGP and IGF-1 before and after the supplementation. Methods: Plasma and cerebrospinal fluid (CSF were collected from 11 male patients before and after 28 day supplementation of BCA. The concentrations of IGF-1, IGF binding protein (IGFBP-3, and cGP were measured using ELISA and HPLC-MS assays. The presence of cGP in the BCA was evaluated. Results: cGP presented in the BCA. BCA supplementation increased the concentration of cGP (p < 0.01, but not IGF-1 and IGFBP-3 in the CSF. CSF concentration of cGP was correlated with plasma concentration of cGP (R = 0.68, p = 0.01 and cGP/IGF-1 molar ratio (R = 0.66, p = 0.01. The CSF/plasma ratio was high in cGP and low in IGF-1 and IGFBP-3. Conclusion: cGP is a natural nutrient to the BCA. The increased CSF cGP in Parkinson disease patients may result from the central uptake of plasma cGP. Given neurotrophic function, oral availability, and effective central uptake of cGP, the BCA has the potential to be developed to treat neurological conditions with IGF-1 deficiency.

  11. Fibroblast growth factor 21 improves insulin sensitivity and synergizes with insulin in human adipose stem cell-derived (hASC adipocytes.

    Directory of Open Access Journals (Sweden)

    Darwin V Lee

    Full Text Available Fibroblast growth factor 21 (FGF21 has evolved as a major metabolic regulator, the pharmacological administration of which causes weight loss, insulin sensitivity and glucose control in rodents and humans. To understand the molecular mechanisms by which FGF21 exerts its metabolic effects, we developed a human in vitro model of adipocytes to examine crosstalk between FGF21 and insulin signaling. Human adipose stem cell-derived (hASC adipocytes were acutely treated with FGF21 alone, insulin alone, or in combination. Insulin signaling under these conditions was assessed by measuring tyrosine phosphorylation of insulin receptor (InsR, insulin receptor substrate-1 (IRS-1, and serine 473 phosphorylation of Akt, followed by a functional assay using 14C-2-deoxyglucose [14C]-2DG to measure glucose uptake in these cells. FGF21 alone caused a modest increase of glucose uptake, but treatment with FGF21 in combination with insulin had a synergistic effect on glucose uptake in these cells. The presence of FGF21 also effectively lowered the insulin concentration required to achieve the same level of glucose uptake compared to the absence of FGF21 by 10-fold. This acute effect of FGF21 on insulin signaling was not due to IR, IGF-1R, or IRS-1 activation. Moreover, we observed a substantial increase in basal S473-Akt phosphorylation by FGF21 alone, in contrast to the minimal shift in basal glucose uptake. Taken together, our data demonstrate that acute co-treatment of hASC-adipocytes with FGF21 and insulin can result in a synergistic improvement in glucose uptake. These effects were shown to occur at or downstream of Akt, or separate from the canonical insulin signaling pathway.

  12. A 12-week sports-based exercise programme for inactive Indigenous Australian men improved clinical risk factors associated with type 2 diabetes mellitus.

    Science.gov (United States)

    Mendham, Amy E; Duffield, Rob; Marino, Frank; Coutts, Aaron J

    2015-07-01

    This study assessed the effect of a 12-week sports-based exercise intervention on glucose regulation, anthropometry and inflammatory markers associated with the prevalence of type 2 diabetes mellitus (T2DM) in Indigenous Australian men. Twenty-six inactive Indigenous Australian men (48.6±6.6 years) were randomized into exercise (n=16) or control (n=10)conditions. Training included ∼2-3 days/week for 12 weeks of sports and gym exercises in a group environment, whilst control participants maintained normal activity and dietary patterns. Pre- and post-intervention testing included: anthropometry, peak aerobic capacity, fasting blood chemistry of inflammatory cytokines, adiponectin, leptin, cholesterol, glucose, insulin and C-peptide. An oral glucose tolerance test measured glucose, insulin and C-peptide 30, 60, 90 and 120min post 75g glucose ingestion. The exercise condition decreased insulin area under the curve (25±22%), increased estimated insulin sensitivity (35±62%) and decreased insulin resistance (9±35%; p0.05). The exercise condition decreased in body mass index, waist circumference and waist to hip ratio (p0.05). Leptin decreased in the exercise group, with no changes for adiponectin (p>0.05) or inflammatory markers (p>0.05) in either condition. Aerobic fitness variables showed significant increases in peak oxygen consumption for the exercise condition compared to no change in control (p>0.05). Findings indicate positive clinical outcomes in metabolic, anthropometric and aerobic fitness variables. This study provides evidence for sport and group-based activities leading to improved clinical risk factors associated with T2DM development in clinically obese Indigenous Australian men. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  13. STUDY OF FACTORS INFLUENCING EARLY SYMPTOMATIC IMPROVEMENT, RETURN TO NORMOXIA AND RADIOLOGICAL RESOLUTION IN SWINE FLU PATIENTS WITH RESPIRATORY FAILURE IN RICU

    Directory of Open Access Journals (Sweden)

    Vamsidhar Reddy Manne

    2017-05-01

    Full Text Available BACKGROUND Since 2009, swine influenza outbreaks have been recorded virtually every year, although their extent and severity have varied widely. Localised outbreaks are taking place at variable intervals, usually every 1-3 years. The most recent outbreak has been from December 2016 through April 2017. We still are in the midst of one. This study of factors influencing early clinical and radiological improvement and reversion to normoxia in swine flu patients with respiratory failure helps in saving precious lives. MATERIALS AND METHODS This is a cross-sectional study conducted at RICU, Department of Pulmonary Medicine, S.V.R.R. Government General Hospital/S.V. Medical College, Tirupathi, Andhra Pradesh, between January 2017 and April 2017. Study sample was the total number of swine flu patients admitted to the RICU of the Department of Pulmonary Medicine with respiratory failure. RESULTS Out of 42 patients who tested positive for swine flu, 37 had respiratory failure and were immediately admitted in RICU. Oxygen support, oseltamivir and higher antibiotics were immediately started, injectable steroids given where necessary. Comorbidities were meticulously managed. 19 were males and 18 were females. 21 patients (>50% were above 50 years. Cough and breathlessness were present in all patients (100%. At admission, all 37 showed SpO2 <85% and at discharge all of them were normoxic. 18 patients had either multilobar pneumonia or ARDS on CXR, which had resolved by the time of discharge. The shortest duration of stay was 7 days and the longest duration of stay was 11 days. 35 patients were discharged and 2 patients died. CONCLUSION Good oxygenation, starting of oseltamivir on day 1 of admission prevents further complications and hastens recovery. Swine flu patients with normal chest x-ray and no comorbidities can still end up with respiratory failure. Steroids decrease cough and breathlessness, but have no role in hastening recovery. No residual symptoms

  14. Insulin-Like growth factor-II (IGF-II) prevents proinflammatory cytokine-induced apoptosis and significantly improves islet survival after transplantation.

    Science.gov (United States)

    Hughes, Amy; Mohanasundaram, Daisy; Kireta, Svjetlana; Jessup, Claire F; Drogemuller, Chris J; Coates, P Toby H

    2013-03-15

    The early loss of functional islet mass (50-70%) due to apoptosis after clinical transplantation contributes to islet allograft failure. Insulin-like growth factor (IGF)-II is an antiapoptotic protein that is highly expressed in β-cells during development but rapidly decreases in postnatal life. We used an adenoviral (Ad) vector to overexpress IGF-II in isolated rat islets and investigated its antiapoptotic action against exogenous cytokines interleukin-1β- and interferon-γ-induced islet cell death in vitro. Using an immunocompromised marginal mass islet transplant model, the ability of Ad-IGF-II-transduced rat islets to restore euglycemia in nonobese diabetic/severe combined immunodeficient diabetic recipients was assessed. Ad-IGF-II transduction did not affect islet viability or function. Ad-IGF-II cytokine-treated islets exhibited decreased cell death (40% ± 2.8%) versus Ad-GFP and untransduced control islets (63.2% ± 2.5% and 53.6% ± 2.3%, respectively). Ad-IGF-II overexpression during cytokine treatment resulted in a marked reduction in terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling-positive apoptotic cells (8.3% ± 1.4%) versus Ad-GFP control (41% ± 4.2%) and untransduced control islets (46.5% ± 6.2%). Western blot analysis confirmed that IGF-II inhibits apoptosis via activation of the phosphatidylinositol 3-kinase/Akt signaling pathway. Transplantation of IGF-II overexpressing islets under the kidney capsule of diabetic mice restored euglycemia in 77.8% of recipients compared with 18.2% and 47.5% of Ad-GFP and untransduced control islet recipients, respectively (Pislet transplant outcomes in vivo. Antiapoptotic gene transfer is a potentially powerful tool to improve islet survival after transplantation.

  15. Stem cell mobilization induced by subcutaneous granulocyte-colony stimulating factor to improve cardiac regeneration after acute ST-elevation myocardial infarction: result of the double-blind, randomized, placebo-controlled stem cells in myocardial infarction (STEMMI) trial

    DEFF Research Database (Denmark)

    Ripa, RS; Jorgensen, E; Wang, Y

    2006-01-01

    BACKGROUND: Phase 1 clinical trials of granulocyte-colony stimulating factor (G-CSF) treatment after myocardial infarction have indicated that G-CSF treatment is safe and may improve left ventricular function. This randomized, double-blind, placebo-controlled trial aimed to assess the efficacy of......: Bone marrow stem cell mobilization with subcutaneous G-CSF is safe but did not lead to further improvement in ventricular function after acute myocardial infarction compared with the recovery observed in the placebo group...

  16. Analysis of context factors in compulsory and incentive strategies for improving attraction and retention of health workers in rural and remote areas: a systematic review.

    Science.gov (United States)

    Liu, Xiaoyun; Dou, Lixia; Zhang, Huan; Sun, Yang; Yuan, Beibei

    2015-07-21

    Current literature systematically reports that interventions to attract and retain health workers in underserved areas need to be context specific but rarely defines what that means. In this systematic review, we try to summarize and analyse context factors influencing the implementation of interventions to attract and retain rural health workers. We searched online databases, relevant websites and reference lists of selected literature to identify studies on compulsory rural service programmes and financial incentives. Forty studies were selected. Information regarding context factors at macro, meso and micro levels was extracted and synthesized. Macro-level context factors include political, economic and social factors. Meso-level factors include health system factors such as maldistribution of health workers, growing private sector, decentralization and health financing. Micro-level factors refer to the policy implementation process including funding sources, administrative agency, legislation process, monitoring and evaluation. Macro-, meso- and micro-level context factors can play different roles in agenda setting, policy formulation and implementation of health interventions to attract and retain rural health workers. These factors should be systematically considered in the different stages of policy process and evaluation.

  17. Risk factors for unplanned readmission within 30 days after pediatric neurosurgery: a nationwide analysis of 9799 procedures from the American College of Surgeons National Surgical Quality Improvement Program.

    Science.gov (United States)

    Sherrod, Brandon A; Johnston, James M; Rocque, Brandon G

    2016-09-01

    OBJECTIVE Hospital readmission rate is increasingly used as a quality outcome measure after surgery. The purpose of this study was to establish, using a national database, the baseline readmission rates and r