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  1. The Great Depression and the Great Recession: A Comparative Analysis of their Analogies

    Directory of Open Access Journals (Sweden)

    Cristina Peicuti

    2014-06-01

    Full Text Available The decades preceding the Great Depression and the U.S. subprime mortgage crisis have close similarities. Both decades were characterized by rapid growth without major contractions, by an increase in liquidity, a lack of inflation, and a generalized decrease in risk premiums. Additional similarities included significant changes in the financing of real estate by commercial banks along with a consolidation of the banking sector and high hopes that the efficiency of monetary policy would prevent financial crises. These decades were also characterized by the consolidation of the powers of young central banks (the Federal Reserve System in the 1920s and the European Central Bank in the 2000s, by unsuccessful attempts to control market speculation, by their international dimensions, and by the eruption of crises after the failure of a major American financial institution that could have been avoided. Understanding these analogies help us better identify the causes of the subprime mortgage crisis and prevent history from repeating itself to the extentof such large-scale devastating consequences.

  2. 100 ways to make good photos great tips & techniques for improving your digital photography

    CERN Document Server

    Cope, Peter

    2013-01-01

    A practical, accessible guide to turning your good photographs into great ones whether you are shooting on the latest digital SLR or a camera phone! Discover 100 simple and fun ways to improve your photographs both in-camera and through post-processing image manipulation. Every key photographic genre is covered, from perfect portraits and the great outdoors, to travel photos and shooting at night. Filled with inspirational examples of great photographs compared against the more average images, with easy to follow techniques for how you can achieve the same results.

  3. Breast and cervical screening by race/ethnicity: comparative analyses before and during the Great Recession.

    Science.gov (United States)

    King, Christopher J; Chen, Jie; Garza, Mary A; Thomas, Stephen B

    2014-04-01

    Traditionally, economic recessions have resulted in decreased utilization of preventive health services. To explore racial and ethnic differences in breast and cervical cancer screening rates before and during the Great Recession. The Medical Expenditure Panel was the source for identifying 10,894 women, ages 50-74 for breast screening and 19,957 women, ages 21-65 for cervical screening. Survey years included 2004-2005 and 2009-2010. Dependent variables were as follows: 1) receipt of mammogram within the past 2 years; and 2) receipt of a Pap smear within the past 3 years. The interaction of the recession and the likelihood of screening between whites and minorities was analyzed. Multivariate regressions were applied to estimate the likelihood of screening for the two time periods while controlling for a recession variable. Nationally, breast and cervical cancer screening rates dropped during the recession period; white women contributed most to the decline. However, there were significant improvements in timely screening for both cancers among Hispanics during the recession period. After controlling for the recession, African American women were more likely to have timely screenings compared to white women. Screening rates during the recession were lowest in the South, Midwest and West. There was a national reduction in the percentages of women who obtained timely breast and cervical screenings during the Great Recession. Outreach efforts are needed to ensure that women who were not screened during the recession are screened. Widespread education about the Affordable Care Act may be helpful. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  4. Modeling detection probability to improve marsh bird surveys in southern Canada and the Great Lakes states

    Directory of Open Access Journals (Sweden)

    Douglas C. Tozer

    2016-12-01

    Full Text Available Marsh birds are notoriously elusive, with variation in detection probability across species, regions, seasons, and different times of day and weather. Therefore, it is important to develop regional field survey protocols that maximize detections, but that also produce data for estimating and analytically adjusting for remaining differences in detections. We aimed to improve regional field survey protocols by estimating detection probability of eight elusive marsh bird species throughout two regions that have ongoing marsh bird monitoring programs: the southern Canadian Prairies (Prairie region and the southern portion of the Great Lakes basin and parts of southern Québec (Great Lakes-St. Lawrence region. We accomplished our goal using generalized binomial N-mixture models and data from ~22,300 marsh bird surveys conducted between 2008 and 2014 by Bird Studies Canada's Prairie, Great Lakes, and Québec Marsh Monitoring Programs. Across all species, on average, detection probability was highest in the Great Lakes-St. Lawrence region from the beginning of May until mid-June, and then fell throughout the remainder of the season until the end of June; was lowest in the Prairie region in mid-May and then increased throughout the remainder of the season until the end of June; was highest during darkness compared with light; and did not vary significantly according to temperature (range: 0-30°C, cloud cover (0%-100%, or wind (0-20 kph, or during morning versus evening. We used our results to formulate improved marsh bird survey protocols for each region. Our analysis and recommendations are useful and contribute to conservation of wetland birds at various scales from local single-species studies to the continental North American Marsh Bird Monitoring Program.

  5. Comparative habitat use of sympatric Mexican spotted and great horned owls

    Science.gov (United States)

    Joseph L. Ganey; William M. Block; Jeffrey S. Jenness; Randolph A. Wilson

    1997-01-01

    To provide information on comparative habitat use, we studied radiotagged Mexican spotted owls (Strix occidentalis lucida: n = 13) and great horned owls (Bubo virginianus: n = 4) in northern Arizona. Home-range size (95% adaptive kernel estimate) did not differ significantly between species during either the breeding or nonbreeding...

  6. 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.

  7. Comparative Study of Flexible Pavement Designs for New Road in Great Britain and Indonesia

    OpenAIRE

    Basri, Hanafi

    2009-01-01

    The objective of this article is to compare the design methods for flexible pavements for new roads and overlays between two countries, Great Britain and Indonesia.Pavement design procedures provide a structure that can be accepted in a specific environmental condition and able to satisfy the anticipated traffic loading. There are many factors influencing the thickness design of pavement, such as pavement materials, traffic load and climatic conditions, there is no doubt that the method of pa...

  8. COMPARATIVE LEGISLATIVE ANALYSIS OF ACTIVE BRIBERY IN THE UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND

    Directory of Open Access Journals (Sweden)

    Mijo Galiot

    2015-01-01

    Full Text Available Confronting socially unacceptable activities, especially corruptive criminal acts, including bribing, makes an important issue of every regulated legal system. The crucial part of such policies are the criminal polices. In this paper, the author deals with the criminal legislation of the United Kingdom of Great Britain and Northern Ireland, related to the matters of active bribing as one of the basic forms of corruptive behaviour. While comparing the way the penal system is regulated in the said country, the author comments basic similarities and differences of the passive bribing legal regulation in the United Kingdom and the Republic of Croatia.

  9. Comparative riverscape genetics reveals reservoirs of genetic diversity for conservation and restoration of Great Plains fishes.

    Science.gov (United States)

    Osborne, Megan J; Perkin, Joshuah S; Gido, Keith B; Turner, Thomas F

    2014-12-01

    We used comparative landscape genetics to examine the relative roles of historical events, intrinsic traits and landscape factors in determining the distribution of genetic diversity of river fishes across the North American Great Plains. Spatial patterns of diversity were overlaid on a patch-based graphical model and then compared within and among three species that co-occurred across five Great Plains watersheds. Species differing in reproductive strategy (benthic vs. pelagic-spawning) were hypothesized to have different patterns of genetic diversity, but the overriding factor shaping contemporary patterns of diversity was the signature of past climates and geological history. Allelic diversity was significantly higher at southern latitudes for Cyprinella lutrensis and Hybognathus placitus, consistent with northward expansion from southern Pleistocene refugia. Within the historical context, all species exhibited lowered occupancy and abundance in heavily fragmented and drier upstream reaches, particularly H. placitus; a pelagic-spawning species, suggesting rates of extirpation have outpaced losses of genetic diversity in this species. Within most tributary basins, genetically diverse populations of each species persisted. Hence, reconnecting genetically diverse populations with those characterized by reduced diversity (regardless of their position within the riverine network) would provide populations with greater genetic and demographic resilience. We discuss cases where cross-basin transfer may be appropriate to enhance genetic diversity and mitigate negative effects of climate change. Overall, striking similarities in genetic patterns and in response to fragmentation and dewatering suggest a common strategy for genetic resource management in this unique riverine fish assemblage. © 2014 John Wiley & Sons Ltd.

  10. Great improvement in pseudocapacitor properties of nickel hydroxide via simple gold deposition

    Science.gov (United States)

    Kim, Sun-I.; Thiyagarajan, Pradheep; Jang, Ji-Hyun

    2014-09-01

    In this letter, we report a facile approach to improve the capacitor properties of nickel hydroxide (Ni(OH)2) by simply coating gold nanoparticles (Au NPs) on the surface of Ni(OH)2. Au NP-deposited Ni(OH)2 (Au/Ni(OH)2) has been prepared by application of a conventional colloidal coating of Au NPs on the surface of 3D-Ni(OH)2 synthesized via a hydrothermal method. Compared with pristine Ni(OH)2, Au/Ni(OH)2 shows a 41% enhanced capacitance value, excellent rate capacitance behavior at high current density conditions, and greatly improved cycling stability for supercapacitor applications. The specific capacitance of Au/Ni(OH)2 reached 1927 F g-1 at 1 A g-1, which is close to the theoretical capacitance and retained 66% and 80% of the maximum value at a high current density of 20 A g-1 and 5000 cycles while that of pristine Ni(OH)2 was 1363 F g-1 and significantly decreased to 48% and 30%, respectively, under the same conditions. The outstanding performance of Au/Ni(OH)2 as a supercapacitor is attributed to the presence of metal Au NPs on the surface of semiconductor Ni(OH)2; this permits the creation of virtual 3D conducting networks via metal/semiconductor contact, which induces fast electron and ion transport by acting as a bridge between Ni(OH)2 nanostructures, thus eventually leading to significantly improved electrochemical capacitive behaviors, as confirmed by the EIS and I-V characteristic data.In this letter, we report a facile approach to improve the capacitor properties of nickel hydroxide (Ni(OH)2) by simply coating gold nanoparticles (Au NPs) on the surface of Ni(OH)2. Au NP-deposited Ni(OH)2 (Au/Ni(OH)2) has been prepared by application of a conventional colloidal coating of Au NPs on the surface of 3D-Ni(OH)2 synthesized via a hydrothermal method. Compared with pristine Ni(OH)2, Au/Ni(OH)2 shows a 41% enhanced capacitance value, excellent rate capacitance behavior at high current density conditions, and greatly improved cycling stability for

  11. Comparing electricity distribution network revenues and costs in New South Wales, Great Britain and Victoria

    International Nuclear Information System (INIS)

    Mountain, Bruce; Littlechild, Stephen

    2010-01-01

    A decade ago, electricity distribution network revenues per customer in New South Wales (NSW) were twice those in Great Britain (GB). Recent price controls imply that by 2014 they will be nearly four times as high. This paper examines possible reasons for this. The main reason does not seem to be geography, operating environment or industry structure. GB and Victoria have managed to accommodate increasing demand at broadly constant or even declining costs and revenues while delivering higher quality of service, while NSW has not. The regulatory framework and the practice of the regulatory body within that framework seem relevant. Australian regulators have not used benchmarking techniques as the GB regulator has. Perhaps the most important explanatory factor is private ownership in GB and Victoria compared to state ownership in NSW. This could also impact on the nature and effectiveness of regulation. (author)

  12. Leveraging Big Data to Improve Health Awareness Campaigns: A Novel Evaluation of the Great American Smokeout.

    Science.gov (United States)

    Ayers, John W; Westmaas, J Lee; Leas, Eric C; Benton, Adrian; Chen, Yunqi; Dredze, Mark; Althouse, Benjamin M

    2016-01-01

    Awareness campaigns are ubiquitous, but little is known about their potential effectiveness because traditional evaluations are often unfeasible. For 40 years, the "Great American Smokeout" (GASO) has encouraged media coverage and popular engagement with smoking cessation on the third Thursday of November as the nation's longest running awareness campaign. We proposed a novel evaluation framework for assessing awareness campaigns using the GASO as a case study by observing cessation-related news reports and Twitter postings, and cessation-related help seeking via Google, Wikipedia, and government-sponsored quitlines. Time trends (2009-2014) were analyzed using a quasi-experimental design to isolate spikes during the GASO by comparing observed outcomes on the GASO day with the simulated counterfactual had the GASO not occurred. Cessation-related news typically increased by 61% (95% CI 35-87) and tweets by 13% (95% CI -21 to 48) during the GASO compared with what was expected had the GASO not occurred. Cessation-related Google searches increased by 25% (95% CI 10-40), Wikipedia page visits by 22% (95% CI -26 to 67), and quitline calls by 42% (95% CI 19-64). Cessation-related news media positively coincided with cessation tweets, Internet searches, and Wikipedia visits; for example, a 50% increase in news for any year predicted a 28% (95% CI -2 to 59) increase in tweets for the same year. Increases on the day of the GASO rivaled about two-thirds of a typical New Year's Day-the day that is assumed to see the greatest increases in cessation-related activity. In practical terms, there were about 61,000 more instances of help seeking on Google, Wikipedia, or quitlines on GASO each year than would normally be expected. These findings provide actionable intelligence to improve the GASO and model how to rapidly, cost-effectively, and efficiently evaluate hundreds of awareness campaigns, nearly all for the first time.

  13. Prenatal Diagnosis of Transposition of the Great Arteries over a 20-Year Period: Improved but Imperfect

    Science.gov (United States)

    Escobar-Diaz, Maria C; Freud, Lindsay R; Bueno, Alejandra; Brown, David W; Friedman, Kevin; Schidlow, David; Emani, Sitaram; del Nido, Pedro; Tworetzky, Wayne

    2015-01-01

    Objective To evaluate temporal trends in prenatal diagnosis of transposition of the great arteries with intact ventricular septum (TGA/IVS) and its impact on neonatal morbidity and mortality. Methods Newborns with TGA/IVS referred for surgical management to our center over a 20-year period (1992 – 2011) were included. The study time was divided into 5 four-year periods, and the primary outcome was rate of prenatal diagnosis. Secondary outcomes included neonatal pre-operative status and perioperative survival. Results Of the 340 patients, 81 (24%) had a prenatal diagnosis. Prenatal diagnosis increased over the study period from 6% to 41% (p<0.001). Prenatally diagnosed patients underwent a balloon atrial septostomy (BAS) earlier than postnatally diagnosed patients (0 vs. 1 day, p<0.001) and fewer required mechanical ventilation (56% vs. 69%, p=0.03). There were no statistically significant differences in pre-operative acidosis (16% vs. 26%, p=0.1) and need for preoperative ECMO (2% vs. 3%, p=1.0). There was also no significant mortality difference (1 pre-operative and no post-operative deaths among prenatally diagnosed patients, as compared to 4 pre-operative and 6 post-operative deaths among postnatally diagnosed patients). Conclusion The prenatal detection rate of TGA/IVS has improved but still remains below 50%, suggesting the need for strategies to increase detection rates. The mortality rate was not statistically different between pre- and postnatally diagnosed patients; however, there were significant pre-operative differences with regard to earlier BAS and less mechanical ventilation. Ongoing study is required to elucidate whether prenatal diagnosis confers long-term benefit. PMID:25484180

  14. Comparative Analysis of the Representations of the Great Patriotic War: Generational Aspects (Russia, Ukraine, Belarus

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    Владимир Михайлович Филиппов

    2015-12-01

    Full Text Available Russian, Ukrainian and Belarusian peoples` (who has been considered fraternal for a long time representations of the modern world currently due to many factors are subjected to complex processes of transformation. So the importance of the historical period of the Great Patriotic War in the life of all three peoples, the memory of which has an important means of confrontation western propaganda, is certainly true. The article presents the results of the study of Russian, Ukrainian and Belarusian students’ and their parents’ representations of the Great Patriotic War. The study was being held in Peoples’ friendship University of Russia, immediately after the celebration of the 70th anniversary of the Great Victory.

  15. Optimizing hyaluronidase dose and plasmid DNA delivery greatly improves gene electrotransfer efficiency in rat skeletal muscle

    DEFF Research Database (Denmark)

    Åkerström, Thorbjörn; Vedel, Kenneth; Needham Andersen, Josefine

    2015-01-01

    Transfection of rat skeletal muscle in vivo is a widely used research model. However, gene electrotransfer protocols have been developed for mice and yield variable results in rats. We investigated whether changes in hyaluronidase pre-treatment and plasmid DNA delivery can improve transfection...... with a homogenous distribution. We also show that transfection was stable over five weeks of regular exercise or inactivity. Our findings show that species-specific plasmid DNA delivery and hyaluronidase pre-treatment greatly improves transfection efficiency in rat skeletal muscle....... efficiency in rat skeletal muscle. We found that pre-treating the muscle with a hyaluronidase dose suitable for rats (0.56. U/g b.w.) prior to plasmid DNA injection increased transfection efficiency by >200% whereas timing of the pre-treatment did not affect efficiency. Uniformly distributing plasmid DNA...

  16. Comparative Analysis of Tannins in the Rhizomes of Great Burnet (Sanguisorba officinalis L.)

    OpenAIRE

    Mukhametgaliev N.R.; Idrisova G.I.; Gilazieva G.Z.

    2015-01-01

    Quantitative analysis of the content of tannins in the rhizomes of great burnet (Sanguisorba officinalis L.) was performed using Leventhal’s permanganometric method, its Kursanov's modification, and spectrophotometry. Advantages and disadvantages of the methods used were discussed to determine the quantitative content of tannins in the active parts of different plants. New locations of S. officinalis populations in various regions of the Republic of Tatarstan were detected. The discovered pop...

  17. Humans and great apes share increased neocortical neuropeptide Y innervation compared to other haplorhine primates

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    Mary Ann eRaghanti

    2014-02-01

    Full Text Available Neuropeptide Y (NPY plays a role in a variety of basic physiological functions and has also been implicated in regulating cognition, including learning and memory. A decrease in neocortical NPY has been reported for Alzheimer’s disease, schizophrenia, bipolar disorder, and depression, potentially contributing to associated cognitive deficits. The goal of the present analysis was to examine variation in neocortical NPY-immunoreactive axon and varicosity density among haplorhine primates (monkeys, apes, and humans. Stereologic methods were used to measure the ratios of NPY-expressing axon length density to total neuron density (ALv/Nv and NPY-immunoreactive varicosity density to neuron density (Vv/Nv, as well as the mean varicosity spacing in neocortical areas 10, 24, 44, and 22 (Tpt of humans, African great apes, New World monkeys, and Old World monkeys. Humans and great apes showed increased cortical NPY innervation relative to monkey species for ALv/Nv and Vv/Nv. Furthermore, humans and great apes displayed a conserved pattern of varicosity spacing across cortical areas and layers, with no differences between cortical layers or among cortical areas. These phylogenetic differences may be related to shared life history variables and may reflect specific cognitive abilities.

  18. Guiding principles for the improved governance of port and shipping impacts in the Great Barrier Reef.

    Science.gov (United States)

    Grech, A; Bos, M; Brodie, J; Coles, R; Dale, A; Gilbert, R; Hamann, M; Marsh, H; Neil, K; Pressey, R L; Rasheed, M A; Sheaves, M; Smith, A

    2013-10-15

    The Great Barrier Reef (GBR) region of Queensland, Australia, encompasses a complex and diverse array of tropical marine ecosystems of global significance. The region is also a World Heritage Area and largely within one of the world's best managed marine protected areas. However, a recent World Heritage Committee report drew attention to serious governance problems associated with the management of ports and shipping. We review the impacts of ports and shipping on biodiversity in the GBR, and propose a series of guiding principles to improve the current governance arrangements. Implementing these principles will increase the capacity of decision makers to minimize the impacts of ports and shipping on biodiversity, and will provide certainty and clarity to port operators and developers. A 'business as usual' approach could lead to the GBR's inclusion on the List of World Heritage in Danger in 2014. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Femoral morphology and femoropelvic musculoskeletal anatomy of humans and great apes: a comparative virtopsy study.

    Science.gov (United States)

    Morimoto, Naoki; Ponce de León, Marcia S; Nishimura, Takeshi; Zollikofer, Christoph P E

    2011-09-01

    The proximal femoral morphology of fossil hominins is routinely interpreted in terms of muscular topography and associated locomotor modes. However, the detailed correspondence between hard and soft tissue structures in the proximal femoral region of extant great apes is relatively unknown, because dissection protocols typically do not comprise in-depth osteological descriptions. Here, we use computed tomography and virtopsy (virtual dissection) for non-invasive examination of the femoropelvic musculoskeletal anatomy in Pan troglodytes, P. paniscus, Gorilla gorilla, Pongo pygmaeus, and Homo sapiens. Specifically, we analyze the topographic relationship between muscle attachment sites and surface structures of the proximal femoral shaft such as the lateral spiral pilaster. Our results show that the origin of the vastus lateralis muscle is anterior to the insertion of gluteus maximus in all examined great ape specimens and humans. In gorillas and orangutans, the insertion of gluteus maximus is on the inferior (anterolateral) side of the lateral spiral pilaster. In chimpanzees, however, the maximus insertion is on its superior (posteromedial) side, similar to the situation in modern humans. These findings support the hypothesis that chimpanzees and humans exhibit a shared-derived musculoskeletal topography of the proximal femoral region, irrespective of their different locomotor modes, whereas gorillas and orangutans represent the primitive condition. Caution is thus warranted when inferring locomotor behavior from the surface topography of the proximal femur of fossil hominins, as the morphology of this region may contain a strong phyletic signal that tends to blur locomotor adaptation. Copyright © 2011 Wiley-Liss, Inc.

  20. Methodology of Comparative Analysis of Public School Teachers' Continuing Professional Development in Great Britain, Canada and the USA

    Science.gov (United States)

    Mukan, Nataliya; Kravets, Svitlana

    2015-01-01

    In the article the methodology of comparative analysis of public school teachers' continuing professional development (CPD) in Great Britain, Canada and the USA has been presented. The main objectives are defined as theoretical analysis of scientific and pedagogical literature, which highlights different aspects of the problem under research;…

  1. Sphingomyelin exhibits greatly enhanced protection compared with egg yolk phosphatidylcholine against detergent bile salts

    NARCIS (Netherlands)

    Moschetta, A.; vanBerge-Henegouwen, G. P.; Portincasa, P.; Palasciano, G.; Groen, A. K.; van Erpecum, K. J.

    2000-01-01

    Inclusion of phosphatidylcholine within bile salt micelles protects against bile salt-induced cytotoxicity. In addition to phosphatidylcholine, bile may contain significant amounts of sphingomyelin, particularly under cholestatic conditions. We compared protective effects of egg yolk

  2. An evaluation of The Great Escape: can an interactive computer game improve young children's fire safety knowledge and behaviors?

    Science.gov (United States)

    Morrongiello, Barbara A; Schwebel, David C; Bell, Melissa; Stewart, Julia; Davis, Aaron L

    2012-07-01

    Fire is a leading cause of unintentional injury and, although young children are at particularly increased risk, there are very few evidence-based resources available to teach them fire safety knowledge and behaviors. Using a pre-post randomized design, the current study evaluated the effectiveness of a computer game (The Great Escape) for teaching fire safety information to young children (3.5-6 years). Using behavioral enactment procedures, children's knowledge and behaviors related to fire safety were compared to a control group of children before and after receiving the intervention. The results indicated significant improvements in knowledge and fire safety behaviors in the intervention group but not the control. Using computer games can be an effective way to promote young children's understanding of safety and how to react in different hazardous situations.

  3. Comparing of the Financial Ratios: A case study on United States, Great Britain, Greece Due Financial Crisis

    Directory of Open Access Journals (Sweden)

    Dr. Stamatis Kontsas

    2013-07-01

    Full Text Available The aim of this paper is to present a comparative study of the countries through the financial ratios that were analysed. This study was carried out in order to find the characteristics of each economy in comparison to the others. It would be worthy to mention that the three economies that were put under comparative study, are not of the same dynamic. The United States of America and Great Britain show some common characteristics due to the positions of power that they possess in the allocation of the global economy. However, in the case of Greece the same dynamic with the other two countries doesn’t exist, a fact that is greatly imprinted in their in-between comparison.

  4. Comparing photo modeling methodologies and techniques: the instance of the Great Temple of Abu Simbel

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    Sergio Di Tondo

    2013-10-01

    Full Text Available After fifty years from the Salvage of the Abu Simbel Temples it has been possible to experiment the contemporary photo-modeling tools beginning from the original data of the photogrammetrical survey carried out in the 1950s. This produced a reflection on “Image Based” methods and modeling techniques, comparing strict 3d digital photogrammetry with the latest Structure From Motion (SFM systems. The topographic survey data, the original photogrammetric stereo couples, the points coordinates and their representation in contour lines, allowed to obtain a model of the monument in his configuration before the moving of the temples. The impossibility to carry out a direct survey led to touristic shots to create SFM models to use for geometric comparisons.

  5. Summary of Great East Japan Earthquake response at Onagawa Nuclear Power Station and further safety improvement measures

    International Nuclear Information System (INIS)

    Sato, Toru

    2013-01-01

    A large earthquake occurred on March 11, 2011 and tsunami was generated following it. The East Japan suffered serious damage by the earthquake and tsunami. This is called the Great East Japan Earthquake. Onagawa Nuclear Power Station (NPS) is located closest to the epicenter of Great East Japan Earthquake. We experienced intense shake by the earthquake and some flooding from the tsunami, however, we have succeeded safely cold shutdown of the reactors. In this paper, we introduce summary of Great East Japan Earthquake response a Onagawa NPS and safety improvement measures which are based on both experience of Onagawa NPS and lesson from Fukushima Daiichi NPS accident. (author)

  6. Cheatgrass percent cover change: Comparing recent estimates to climate change − Driven predictions in the Northern Great Basin

    Science.gov (United States)

    Boyte, Stephen P.; Wylie, Bruce K.; Major, Donald J.

    2016-01-01

    Cheatgrass (Bromus tectorum L.) is a highly invasive species in the Northern Great Basin that helps decrease fire return intervals. Fire fragments the shrub steppe and reduces its capacity to provide forage for livestock and wildlife and habitat critical to sagebrush obligates. Of particular interest is the greater sage grouse (Centrocercus urophasianus), an obligate whose populations have declined so severely due, in part, to increases in cheatgrass and fires that it was considered for inclusion as an endangered species. Remote sensing technologies and satellite archives help scientists monitor terrestrial vegetation globally, including cheatgrass in the Northern Great Basin. Along with geospatial analysis and advanced spatial modeling, these data and technologies can identify areas susceptible to increased cheatgrass cover and compare these with greater sage grouse priority areas for conservation (PAC). Future climate models forecast a warmer and wetter climate for the Northern Great Basin, which likely will force changing cheatgrass dynamics. Therefore, we examine potential climate-caused changes to cheatgrass. Our results indicate that future cheatgrass percent cover will remain stable over more than 80% of the study area when compared with recent estimates, and higher overall cheatgrass cover will occur with slightly more spatial variability. The land area projected to increase or decrease in cheatgrass cover equals 18% and 1%, respectively, making an increase in fire disturbances in greater sage grouse habitat likely. Relative susceptibility measures, created by integrating cheatgrass percent cover and temporal standard deviation datasets, show that potential increases in future cheatgrass cover match future projections. This discovery indicates that some greater sage grouse PACs for conservation could be at heightened risk of fire disturbance. Multiple factors will affect future cheatgrass cover including changes in precipitation timing and totals and

  7. PROPOSAL FOR IMPROVEMENT OF BUINESS CONTINUITY PLAN (BCP) BASED ON THE LESSONS OF THE GREAT EAST JAPAN EARTHQUAKE

    Science.gov (United States)

    Maruya, Hiroaki

    For most Japanese companies and organizations, the enormous damage of the Great East Japan Earthquake was more than expected. In addition to great tsunami and earthquake motion, the lack of electricity and fuel disturbed to business activities seriously, and they should be considered important constraint factors in future earthquakes. Furthermore, disruption of supply chains also led considerable decline of production in many industries across Japan and foreign countries. Therefore it becomes urgent need for Japanese government and industries to utilize the lessons of the Great Earthquake and execute effective countermeasures, considering great earthquakes such as Tonankai & Nankai earthquakes and Tokyo Inland Earthquakes. Obviously most basic step is improving earthquake-resistant ability of buildings and facilities. In addition the spread of BCP and BCM to enterprises and organizations is indispensable. Based on the lessons, the BCM should include the point of view of the supply chain management more clearly, and emphasize "substitute strategy" more explicitly because a company should survive even if it completely loses its present production base. The central and local governments are requested, in addition to develop their own BCP, to improve related systematic conditions for BCM of the private sectors.

  8. Improving cattle nutrition on the Great Plains with shrubs and fecal seeding of fourwing saltbush

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    Two in vitro trials were conducted for estimates of dietary percentage of fourwing saltbush (Atriplex canescens; FS) or winterfat (Krascheninnikovia lanata; WF) to improve diet digestibility when cattle graze mature cool-season grass. Three in vitro trials were conducted to estimate the percentage ...

  9. COMPARING SEA LEVEL RESPONSE AT MONTEREY, CALIFORNIA FROM THE 1989 LOMA PRIETA EARTHQUAKE AND THE 1964 GREAT ALASKAN EARTHQUAKE

    Directory of Open Access Journals (Sweden)

    L. C. Breaker

    2009-01-01

    Full Text Available Two of the largest earthquakes to affect water levels in Monterey Bay in recent years were the Loma Prieta Earthquake (LPE of 1989 with a moment magnitude of 6.9, and the Great Alaskan Earthquake (GAE of 1964 with a moment magnitude of 9.2. In this study, we compare the sea level response of these events with a primary focus on their frequency content and how the bay affected it, itself. Singular Spectrum Analysis (SSA was employed to extract the primary frequencies associated with each event. It is not clear how or exactly where the tsunami associated with the LPE was generated, but it occurred inside the bay and most likely began to take on the characteristics of a seiche by the time it reached the tide gauge in Monterey Harbor. Results of the SSA decomposition revealed two primary periods of oscillation, 9-10 minutes, and 31-32 minutes. The first oscillation is in agreement with the range of periods for the expected natural oscillations of Monterey Harbor, and the second oscillation is consistent with a bay-wide oscillation or seiche mode. SSA decomposition of the GAE revealed several sequences of oscillations all with a period of approximately 37 minutes, which corresponds to the predicted, and previously observed, transverse mode of oscillation for Monterey Bay. In this case, it appears that this tsunami produced quarter-wave resonance within the bay consistent with its seiche-like response. Overall, the sea level responses to the LPE and GAE differed greatly, not only because of the large difference in their magnitudes but also because the driving force in one case occurred inside the bay (LPE, and in the second, outside the bay (GAE. As a result, different modes of oscillation were excited.

  10. Fast egg collection method greatly improves randomness of egg sampling in Drosophila melanogaster

    DEFF Research Database (Denmark)

    Schou, Mads Fristrup

    2013-01-01

    When obtaining samples for population genetic studies, it is essential that the sampling is random. For Drosophila, one of the crucial steps in sampling experimental flies is the collection of eggs. Here an egg collection method is presented, which randomizes the eggs in a water column...... and diminishes environmental variance. This method was compared with a traditional egg collection method where eggs are collected directly from the medium. Within each method the observed and expected standard deviations of egg-to-adult viability were compared, whereby the difference in the randomness...... and to obtain a representative collection of genotypes, the method presented here is strongly recommended when collecting eggs from Drosophila....

  11. Comparing Kaolin and Pinolene to Improve Sustainable Grapevine Production during Drought

    OpenAIRE

    Brillante, Luca; Belfiore, Nicola; Gaiotti, Federica; Lovat, Lorenzo; Sansone, Luigi; Poni, Stefano; Tomasi, Diego

    2016-01-01

    Viticulture is widely practiced in dry regions, where the grapevine is greatly exposed to water stress. Optimizing plant water use efficiency (WUE) without affecting crop yield, grape and wine quality is crucial to limiting use of water for irrigation and to significantly improving viticulture sustainability. This study examines the use in vineyards of particle film technology (engineered kaolin) and compares it to a film-forming antitranspirant (pinolene), traditionally used to limit leaf wa...

  12. Assessing community values for reducing agricultural emissions to improve water quality and protect coral health in the Great Barrier Reef

    Science.gov (United States)

    Rolfe, John; Windle, Jill

    2011-12-01

    Policymakers wanting to increase protection of the Great Barrier Reef from pollutants generated by agriculture need to identify when measures to improve water quality generate benefits to society that outweigh the costs involved. The research reported in this paper makes a contribution in several ways. First, it uses the improved science understanding about the links between management changes and reef health to bring together the analysis of costs and benefits of marginal changes, helping to demonstrate the appropriate way of addressing policy questions relating to reef protection. Second, it uses the scientific relationships to frame a choice experiment to value the benefits of improved reef health, with the results of mixed logit (random parameter) models linking improvements explicitly to changes in "water quality units." Third, the research demonstrates how protection values are consistent across a broader population, with some limited evidence of distance effects. Fourth, the information on marginal costs and benefits that are reported provide policymakers with information to help improve management decisions. The results indicate that while there is potential for water quality improvements to generate net benefits, high cost water quality improvements are generally uneconomic. A major policy implication is that cost thresholds for key pollutants should be set to avoid more expensive water quality proposals being selected.

  13. Complete exon sequencing of all known Usher syndrome genes greatly improves molecular diagnosis.

    Science.gov (United States)

    Bonnet, Crystel; Grati, M'hamed; Marlin, Sandrine; Levilliers, Jacqueline; Hardelin, Jean-Pierre; Parodi, Marine; Niasme-Grare, Magali; Zelenika, Diana; Délépine, Marc; Feldmann, Delphine; Jonard, Laurence; El-Amraoui, Aziz; Weil, Dominique; Delobel, Bruno; Vincent, Christophe; Dollfus, Hélène; Eliot, Marie-Madeleine; David, Albert; Calais, Catherine; Vigneron, Jacqueline; Montaut-Verient, Bettina; Bonneau, Dominique; Dubin, Jacques; Thauvin, Christel; Duvillard, Alain; Francannet, Christine; Mom, Thierry; Lacombe, Didier; Duriez, Françoise; Drouin-Garraud, Valérie; Thuillier-Obstoy, Marie-Françoise; Sigaudy, Sabine; Frances, Anne-Marie; Collignon, Patrick; Challe, Georges; Couderc, Rémy; Lathrop, Mark; Sahel, José-Alain; Weissenbach, Jean; Petit, Christine; Denoyelle, Françoise

    2011-05-11

    Usher syndrome (USH) combines sensorineural deafness with blindness. It is inherited in an autosomal recessive mode. Early diagnosis is critical for adapted educational and patient management choices, and for genetic counseling. To date, nine causative genes have been identified for the three clinical subtypes (USH1, USH2 and USH3). Current diagnostic strategies make use of a genotyping microarray that is based on the previously reported mutations. The purpose of this study was to design a more accurate molecular diagnosis tool. We sequenced the 366 coding exons and flanking regions of the nine known USH genes, in 54 USH patients (27 USH1, 21 USH2 and 6 USH3). Biallelic mutations were detected in 39 patients (72%) and monoallelic mutations in an additional 10 patients (18.5%). In addition to biallelic mutations in one of the USH genes, presumably pathogenic mutations in another USH gene were detected in seven patients (13%), and another patient carried monoallelic mutations in three different USH genes. Notably, none of the USH3 patients carried detectable mutations in the only known USH3 gene, whereas they all carried mutations in USH2 genes. Most importantly, the currently used microarray would have detected only 30 of the 81 different mutations that we found, of which 39 (48%) were novel. Based on these results, complete exon sequencing of the currently known USH genes stands as a definite improvement for molecular diagnosis of this disease, which is of utmost importance in the perspective of gene therapy.

  14. Good to great: using 360-degree feedback to improve physician emotional intelligence.

    Science.gov (United States)

    Hammerly, Milton E; Harmon, Larry; Schwaitzberg, Steven D

    2014-01-01

    The past decade has seen intense interest and dramatic change in how hospitals and physician organizations review physician behaviors. The characteristics of successful physicians extend past their technical and cognitive skills. Two of the six core clinical competencies (professionalism and interpersonal/communication skills) endorsed by the Accreditation Council for Graduate Medical Education, the American Board of Medical Specialties, and The Joint Commission require physicians to succeed in measures associated with emotional intelligence (EI). Using 360-degree anonymous feedback surveys to screen for improvement opportunities in these two core competencies enables organizations to selectively offer education to further develop physician EI. Incorporating routine use of these tools and interventions into ongoing professional practice evaluation and focused professional practice evaluation processes may be a cost-effective strategy for preventing disruptive behaviors and increasing the likelihood of success when transitioning to an employed practice model. On the basis of a literature review, we determined that physician EI plays a key role in leadership; teamwork; and clinical, financial, and organizational outcomes. This finding has significant implications for healthcare executives seeking to enhance physician alignment and transition to a team-based delivery model.

  15. Complete exon sequencing of all known Usher syndrome genes greatly improves molecular diagnosis

    Directory of Open Access Journals (Sweden)

    Lacombe Didier

    2011-05-01

    Full Text Available Abstract Background Usher syndrome (USH combines sensorineural deafness with blindness. It is inherited in an autosomal recessive mode. Early diagnosis is critical for adapted educational and patient management choices, and for genetic counseling. To date, nine causative genes have been identified for the three clinical subtypes (USH1, USH2 and USH3. Current diagnostic strategies make use of a genotyping microarray that is based on the previously reported mutations. The purpose of this study was to design a more accurate molecular diagnosis tool. Methods We sequenced the 366 coding exons and flanking regions of the nine known USH genes, in 54 USH patients (27 USH1, 21 USH2 and 6 USH3. Results Biallelic mutations were detected in 39 patients (72% and monoallelic mutations in an additional 10 patients (18.5%. In addition to biallelic mutations in one of the USH genes, presumably pathogenic mutations in another USH gene were detected in seven patients (13%, and another patient carried monoallelic mutations in three different USH genes. Notably, none of the USH3 patients carried detectable mutations in the only known USH3 gene, whereas they all carried mutations in USH2 genes. Most importantly, the currently used microarray would have detected only 30 of the 81 different mutations that we found, of which 39 (48% were novel. Conclusions Based on these results, complete exon sequencing of the currently known USH genes stands as a definite improvement for molecular diagnosis of this disease, which is of utmost importance in the perspective of gene therapy.

  16. Improving comparability between microarray probe signals by thermodynamic intensity correction

    DEFF Research Database (Denmark)

    Bruun, G. M.; Wernersson, Rasmus; Juncker, Agnieszka

    2007-01-01

    different probes. It is therefore of great interest to correct for the variation between probes. Much of this variation is sequence dependent. We demonstrate that a thermodynamic model for hybridization of either DNA or RNA to a DNA microarray, which takes the sequence-dependent probe affinities...... determination of transcription start sites for a subset of yeast genes. In another application, we identify present/absent calls for probes hybridized to the sequenced Escherichia coli strain O157:H7 EDL933. The model improves the correct calls from 85 to 95% relative to raw intensity measures. The model thus...... makes applications which depend on comparisons between probes aimed at different sections of the same target more reliable....

  17. Big Ship Data: Using vessel measurements to improve estimates of temperature and wind speed on the Great Lakes

    Science.gov (United States)

    Fries, Kevin; Kerkez, Branko

    2017-05-01

    The sheer size of many water systems challenges the ability of in situ sensor networks to resolve spatiotemporal variability of hydrologic processes. New sources of vastly distributed and mobile measurements are, however, emerging to potentially fill these observational gaps. This paper poses the question: How can nontraditional measurements, such as those made by volunteer ship captains, be used to improve hydrometeorological estimates across large surface water systems? We answer this question through the analysis of one of the largest such data sets: an unprecedented collection of one million unique measurements made by ships on the North American Great Lakes from 2006 to 2014. We introduce a flexible probabilistic framework, which can be used to integrate ship measurements, or other sets of irregular point measurements, into contiguous data sets. The performance of this framework is validated through the development of a new ship-based spatial data product of water temperature, air temperature, and wind speed across the Great Lakes. An analysis of the final data product suggests that the availability of measurements across the Great Lakes will continue to play a large role in the confidence with which these large surface water systems can be studied and modeled. We discuss how this general and flexible approach can be applied to similar data sets, and how it will be of use to those seeking to merge large collections of measurements with other sources of data, such as physical models or remotely sensed products.

  18. The use of process models to inform and improve statistical models of nitrate occurrence, Great Miami River Basin, southwestern Ohio

    Science.gov (United States)

    Walter, Donald A.; Starn, J. Jeffrey

    2013-01-01

    local hydrologic settings, would inform and improve the development of statistical models can be implicitly estimated by evaluating the differences between explanatory variables estimated from the contributing recharge areas and the circular buffers used to develop existing statistical models. The larger the difference in estimated variables, the more likely that statistical models would be changed, and presumably improved, if explanatory variables estimated from contributing recharge areas were used in model development. Comparing model predictions from the two sets of estimated variables would further quantify—albeit implicitly—how an improved, physically based estimate of explanatory variables would be reflected in model predictions. Differences between the two sets of estimated explanatory variables and resultant model predictions vary spatially; greater differences are associated with areas of steep hydraulic gradients. A direct comparison, however, would require the development of a separate set of statistical models using explanatory variables from contributing recharge areas. Area-weighted means of three environmental variables—silt content, alfisol content, and depth to water from the U.S. Department of Agriculture State Soil Geographic (STATSGO) data—and one nitrogen-source variable (fertilizer-application rate from county data mapped to Enhanced National Land Cover Data 1992 (NLCDe 92) agricultural land use) can vary substantially between circular buffers and volume-equivalent contributing recharge areas and among contributing recharge areas for different sets of well variables. The differences in estimated explanatory variables are a function of the same factors affecting the contributing recharge areas as well as the spatial resolution and local distribution of the underlying spatial data. As a result, differences in estimated variables between circular buffers and contributing recharge areas are complex and site specific as evidenced by differences

  19. Comparing post-combustion CO2 capture operation at retrofitted coal-fired power plants in the Texas and Great Britain electric grids

    Science.gov (United States)

    Cohen, Stuart M.; Chalmers, Hannah L.; Webber, Michael E.; King, Carey W.

    2011-04-01

    This work analyses the carbon dioxide (CO2) capture system operation within the Electric Reliability Council of Texas (ERCOT) and Great Britain (GB) electric grids using a previously developed first-order hourly electricity dispatch and pricing model. The grids are compared in their 2006 configuration with the addition of coal-based CO2 capture retrofits and emissions penalties from 0 to 100 US dollars per metric ton of CO2 (USD/tCO2). CO2 capture flexibility is investigated by comparing inflexible CO2 capture systems to flexible ones that can choose between full- and zero-load CO2 capture depending on which operating mode has lower costs or higher profits. Comparing these two grids is interesting because they have similar installed capacity and peak demand, and both are isolated electricity systems with competitive wholesale electricity markets. However, differences in capacity mix, demand patterns, and fuel markets produce diverging behaviours of CO2 capture at coal-fired power plants. Coal-fired facilities are primarily base load in ERCOT for a large range of CO2 prices but are comparably later in the dispatch order in GB and consequently often supply intermediate load. As a result, the ability to capture CO2 is more important for ensuring dispatch of coal-fired facilities in GB than in ERCOT when CO2 prices are high. In GB, higher overall coal prices mean that CO2 prices must be slightly higher than in ERCOT before the emissions savings of CO2 capture offset capture energy costs. However, once CO2 capture is economical, operating CO2 capture on half the coal fleet in each grid achieves greater emissions reductions in GB because the total coal-based capacity is 6 GW greater than in ERCOT. The market characteristics studied suggest greater opportunity for flexible CO2 capture to improve operating profits in ERCOT, but profit improvements can be offset by a flexibility cost penalty.

  20. Comparing post-combustion CO2 capture operation at retrofitted coal-fired power plants in the Texas and Great Britain electric grids

    International Nuclear Information System (INIS)

    Cohen, Stuart M; Webber, Michael E; Chalmers, Hannah L; King, Carey W

    2011-01-01

    This work analyses the carbon dioxide (CO 2 ) capture system operation within the Electric Reliability Council of Texas (ERCOT) and Great Britain (GB) electric grids using a previously developed first-order hourly electricity dispatch and pricing model. The grids are compared in their 2006 configuration with the addition of coal-based CO 2 capture retrofits and emissions penalties from 0 to 100 US dollars per metric ton of CO 2 (USD/tCO 2 ). CO 2 capture flexibility is investigated by comparing inflexible CO 2 capture systems to flexible ones that can choose between full- and zero-load CO 2 capture depending on which operating mode has lower costs or higher profits. Comparing these two grids is interesting because they have similar installed capacity and peak demand, and both are isolated electricity systems with competitive wholesale electricity markets. However, differences in capacity mix, demand patterns, and fuel markets produce diverging behaviours of CO 2 capture at coal-fired power plants. Coal-fired facilities are primarily base load in ERCOT for a large range of CO 2 prices but are comparably later in the dispatch order in GB and consequently often supply intermediate load. As a result, the ability to capture CO 2 is more important for ensuring dispatch of coal-fired facilities in GB than in ERCOT when CO 2 prices are high. In GB, higher overall coal prices mean that CO 2 prices must be slightly higher than in ERCOT before the emissions savings of CO 2 capture offset capture energy costs. However, once CO 2 capture is economical, operating CO 2 capture on half the coal fleet in each grid achieves greater emissions reductions in GB because the total coal-based capacity is 6 GW greater than in ERCOT. The market characteristics studied suggest greater opportunity for flexible CO 2 capture to improve operating profits in ERCOT, but profit improvements can be offset by a flexibility cost penalty.

  1. Intensive precipitation observation greatly improves hydrological modelling of the poorly gauged high mountain Mabengnong catchment in the Tibetan Plateau

    Science.gov (United States)

    Wang, Li; Zhang, Fan; Zhang, Hongbo; Scott, Christopher A.; Zeng, Chen; Shi, Xiaonan

    2018-01-01

    Precipitation is one of the most critical inputs for models used to improve understanding of hydrological processes. In high mountain areas, it is challenging to generate a reliable precipitation data set capturing the spatial and temporal heterogeneity due to the harsh climate, extreme terrain and the lack of observations. This study conducts intensive observation of precipitation in the Mabengnong catchment in the southeast of the Tibetan Plateau during July to August 2013. Because precipitation is greatly influenced by altitude, the observed data are used to characterize the precipitation gradient (PG) and hourly distribution (HD), showing that the average PG is 0.10, 0.28 and 0.26 mm/d/100 m and the average duration is around 0.1, 0.8 and 5.2 h for trace, light and moderate rain, respectively. A distributed biosphere hydrological model based on water and energy budgets with improved physical process for snow (WEB-DHM-S) is applied to simulate the hydrological processes with gridded precipitation data derived from a lower altitude meteorological station and the PG and HD characterized for the study area. The observed runoff, MODIS/Terra snow cover area (SCA) data, and MODIS/Terra land surface temperature (LST) data are used for model calibration and validation. Runoff, SCA and LST simulations all show reasonable results. Sensitivity analyses illustrate that runoff is largely underestimated without considering PG, indicating that short-term intensive precipitation observation has the potential to greatly improve hydrological modelling of poorly gauged high mountain catchments.

  2. The development of a sub-daily gridded rainfall product to improve hydrological predictions in Great Britain

    Science.gov (United States)

    Quinn, Niall; Freer, Jim; Coxon, Gemma; O'Loughlin, Fiachra; Woods, Ross; Liguori, Sara

    2015-04-01

    In Great Britain and many other regions of the world, flooding resulting from short duration, high intensity rainfall events can lead to significant economic losses and fatalities. At present, such extreme events are often poorly evaluated using hydrological models due, in part, to their rarity and relatively short duration and a lack of appropriate data. Such storm characteristics are not well represented by daily rainfall records currently available using volumetric gauges and/or derived gridded products. This research aims to address this important data gap by developing a sub-daily gridded precipitation product for Great Britain. Our focus is to better understand these storm events and some of the challenges and uncertainties in quantifying such data across catchment scales. Our goal is to both improve such rainfall characterisation and derive an input to drive hydrological model simulations. Our methodology involves the collation, error checking, and spatial interpolation of approximately 2000 rain gauges located across Great Britain, provided by the Scottish Environment Protection Agency (SEPA) and the Environment Agency (EA). Error checking was conducted over the entirety of the TBR data available, utilising a two stage approach. First, rain gauge data at each site were examined independently, with data exceeding reasonable thresholds marked as suspect. Second, potentially erroneous data were marked using a neighbourhood analysis approach whereby measurements at a given gauge were deemed suspect if they did not fall within defined bounds of measurements at neighbouring gauges. A total of eight error checks were conducted. To provide the user with the greatest flexibility possible, the error markers associated with each check have been recorded at every site. This approach aims to enable the user to choose which checks they deem most suitable for a particular application. The quality assured TBR dataset was then spatially interpolated to produce a national

  3. Spatial distribution and trends of total mercury in waters of the Great Lakes and connecting channels using an improved sampling technique

    International Nuclear Information System (INIS)

    Dove, A.; Hill, B.; Klawunn, P.; Waltho, J.; Backus, S.; McCrea, R.C.

    2012-01-01

    Environment Canada recently developed a clean method suitable for sampling trace levels of metals in surface waters. The results of sampling for total mercury in the Laurentian Great Lakes between 2003 and 2009 give a unique basin-wide perspective of concentrations of this important contaminant and represent improved knowledge of mercury in the region. Results indicate that concentrations of total mercury in the offshore regions of the lakes were within a relatively narrow range from about 0.3 to 0.8 ng/L. The highest concentrations were observed in the western basin of Lake Erie and concentrations then declined towards the east. Compared to the offshore, higher levels were observed at some nearshore locations, particularly in lakes Erie and Ontario. The longer-term temporal record of mercury in Niagara River suspended sediments indicates an approximate 30% decrease in equivalent water concentrations since 1986. - Highlights: ► Basin-wide concentrations of total mercury in Great Lakes surface waters are provided for the first time. ► A clean sampling method is described, stressing isolation of the sample from extraneous sources of contamination. ► Sub-ng/L concentrations of total mercury are observed in most Great Lakes offshore areas. ► Concentrations in the western basin of Lake Erie are consistently the highest observed in the basin. ► The longer-term record of mercury in Niagara River suspended sediments indicates an approximate 30% decrease since 1986. - A new, clean sampling method for metals is described and basin-wide measurements of total mercury are provided for Great Lakes surface waters for the first time.

  4. High-Resolution Mid-IR Imaging of Jupiter's Great Red Spot: Comparing Cassini, VLT and Subaru Observations

    Science.gov (United States)

    Fletcher, Leigh N.; Orton, G. S.; Yanamandra-Fisher, P.; Irwin, P. G. J.; Baines, K. H.; Edkins, E.; Line, M. R.; Mousis, O.; Parrish, P. D.; Vanzi, L.; Fuse, T.; Fujoyoshi, T.

    2008-09-01

    In the eight years since the Cassini fly-by of Jupiter, the spatial resolution of ground-based observations of Jupiter's giant anticyclonic storm systems (the Great Red Spot, Oval BA and others) using 8m-class telescopes has surpassed the resolution of the Cassini/CIRS maps. We present a time-series of mid-IR imaging of the Great Red Spot (GRS) and its environs from the VISIR instrument on the Very Large Telescope (UT3/Melipal) and the COMICS instrument on the Subaru telescope (Hawaii). The NEMESIS optimal-estimation retrieval algorithm (Irwin et al., 2008) is used to analyse both the 7-25 micron filtered imaging from 2005-2008 and Cassini/CIRS 7-16 micron data from 2000. We demonstrate the ability to map temperatures in the 100-400 mbar range, NH3, aerosol opacity and the para-H2 fraction from the filtered imaging. Furthermore, the Cassini/CIRS spectra are used to map the PH3 mole fraction around the GRS. The thermal field, gaseous composition and aerosol distribution are used as diagnostics for the atmospheric motion associated with the GRS. Changes in the atmospheric state in response to close encounters with Oval BA and other vortices will be assessed. These results will be discussed in light of their implications for the planning of the Europa-Jupiter System Mission.

  5. The Great Recession was not so Great

    NARCIS (Netherlands)

    van Ours, J.C.

    2015-01-01

    The Great Recession is characterized by a GDP-decline that was unprecedented in the past decades. This paper discusses the implications of the Great Recession analyzing labor market data from 20 OECD countries. Comparing the Great Recession with the 1980s recession it is concluded that there is a

  6. Antibiotic Resistome: Improving Detection and Quantification Accuracy for Comparative Metagenomics.

    Science.gov (United States)

    Elbehery, Ali H A; Aziz, Ramy K; Siam, Rania

    2016-04-01

    The unprecedented rise of life-threatening antibiotic resistance (AR), combined with the unparalleled advances in DNA sequencing of genomes and metagenomes, has pushed the need for in silico detection of the resistance potential of clinical and environmental metagenomic samples through the quantification of AR genes (i.e., genes conferring antibiotic resistance). Therefore, determining an optimal methodology to quantitatively and accurately assess AR genes in a given environment is pivotal. Here, we optimized and improved existing AR detection methodologies from metagenomic datasets to properly consider AR-generating mutations in antibiotic target genes. Through comparative metagenomic analysis of previously published AR gene abundance in three publicly available metagenomes, we illustrate how mutation-generated resistance genes are either falsely assigned or neglected, which alters the detection and quantitation of the antibiotic resistome. In addition, we inspected factors influencing the outcome of AR gene quantification using metagenome simulation experiments, and identified that genome size, AR gene length, total number of metagenomics reads and selected sequencing platforms had pronounced effects on the level of detected AR. In conclusion, our proposed improvements in the current methodologies for accurate AR detection and resistome assessment show reliable results when tested on real and simulated metagenomic datasets.

  7. Multilevel Empirical Bayes Modeling for Improved Estimation of Toxicant Formulations to Suppress Parasitic Sea Lamprey in the Upper Great Lakes

    Science.gov (United States)

    Hatfield, L.A.; Gutreuter, S.; Boogaard, M.A.; Carlin, B.P.

    2011-01-01

    Estimation of extreme quantal-response statistics, such as the concentration required to kill 99.9% of test subjects (LC99.9), remains a challenge in the presence of multiple covariates and complex study designs. Accurate and precise estimates of the LC99.9 for mixtures of toxicants are critical to ongoing control of a parasitic invasive species, the sea lamprey, in the Laurentian Great Lakes of North America. The toxicity of those chemicals is affected by local and temporal variations in water chemistry, which must be incorporated into the modeling. We develop multilevel empirical Bayes models for data from multiple laboratory studies. Our approach yields more accurate and precise estimation of the LC99.9 compared to alternative models considered. This study demonstrates that properly incorporating hierarchical structure in laboratory data yields better estimates of LC99.9 stream treatment values that are critical to larvae control in the field. In addition, out-of-sample prediction of the results of in situ tests reveals the presence of a latent seasonal effect not manifest in the laboratory studies, suggesting avenues for future study and illustrating the importance of dual consideration of both experimental and observational data. ?? 2011, The International Biometric Society.

  8. Detailed comparative anatomy of the extrinsic cardiac nerve plexus and postnatal reorganization of the cardiac position and innervation in the great apes: orangutans, gorillas, and chimpanzees.

    Science.gov (United States)

    Kawashima, Tomokazu; Sato, Fumi

    2012-03-01

    To speculate how the extrinsic cardiac nerve plexus (ECNP) evolves phyletically and ontogenetically within the primate lineage, we conducted a comparative anatomical study of the ECNP, including an imaging examination in the great apes using 20 sides from 11 bodies from three species and a range of postnatal stages from newborns to mature adults. Although the position of the middle cervical ganglion (MG) in the great apes tended to be relatively lower than that in humans, the morphology of the ECNP in adult great apes was almost consistent with that in adult humans but essentially different from that in the lesser apes or gibbons. Therefore, the well-argued anatomical question of when did the MG acquire communicating branches with the spinal cervical nerves and appear constantly in all sympathetic cardiac nerves during primate evolution is clearly considered to be after the great apes and gibbons split. Moreover, a horizontal four-chambered heart and a lifted cardiac apex with a relatively large volume in newborn great apes rapidly changed its position downward, as seen in humans during postnatal growth and was associated with a reduction in the hepatic volume by imaging diagnosis and gross anatomy. In addition, our observation using a range of postnatal stages exhibits that two sympathetic ganglia, the middle cervical and cervicothoracic ganglia, differed between the early and later postnatal stages. Copyright © 2011 Wiley Periodicals, Inc.

  9. Surface BRDF estimation from an aircraft compared to MODIS and ground estimates at the Southern Great Plains site

    Energy Technology Data Exchange (ETDEWEB)

    Knobelspiesse, Kirk D.; Cairns, Brian; Schmid, Beat; Roman, Miguel O.; Schaaf, Crystal B.

    2008-10-21

    The surface spectral albedo is an important component of climate models since it determines the amount of incident solar radiation that is absorbed by the ground. The albedo can be highly heterogeneous, both in space and time, and thus adequate measurement and modeling is challenging. One source of measurements that constrain the surface albedo are satellite instruments that observe the Earth, such as the Moderate Resolution Imaging Spectroradiometer (MODIS). Satellites estimate the surface bidirectional reflectance distribution function (BRDF) by correcting top of the atmosphere (TOA) radiances for atmospheric effects and accumulating observations at a variety of viewing geometries. The BRDF can then be used to determine the albedo that is required in climate modeling. Other measurements that provide a more direct constraint on surface albedo are those made by upward and downward looking radiometers at the ground. One product in particular, the Best Estimate Radiation Flux (BEFLUX) value added product of the Department of Energy’s Atmospheric Radiation Measurement (ARM) Program at the Southern Great Plains Central Facility (SGP CF) in central Oklahoma, has been used to evaluate the quality of the albedo products derived from MODIS BRDF estimates. These comparisons have highlighted discrepancies between the energy absorbed at the surface that is calculated from the BEFLUX products and that is predicted from the MODIS BRDF product. This paper attempts to investigate these discrepancies by using data from an airborne scanning radiometer, the Research Scanning Polarimeter (RSP) that was flown at low altitude in the vicinity of the SGP CF site during the Aerosol Lidar Validation Experiment (ALIVE) in September of 2005. The RSP is a polarimeter that scans in the direction of the aircraft ground track, and can thus estimate the BRDF in a period of seconds, rather than the days required by MODIS to accumulate enough viewing angles. Atmospheric correction is aided by the

  10. Men who have sex with men in Great Britain: comparing methods and estimates from probability and convenience sample surveys

    OpenAIRE

    Prah, Philip; Hickson, Ford; Bonell, Chris; McDaid, Lisa M; Johnson, Anne M; Wayal, Sonali; Clifton, Soazig; Sonnenberg, Pam; Nardone, Anthony; Erens, Bob; Copas, Andrew J; Riddell, Julie; Weatherburn, Peter; Mercer, Catherine H

    2016-01-01

    Objective: To examine sociodemographic and behavioural differences between men whohave sex with men (MSM) participating in recent UK convenience surveys and a national probability sample survey.\\ud Methods: We compared 148 MSM aged 18–64 years interviewed for Britain's third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) undertaken in 2010–2012, with men inthe same age range participating in contemporaneous convenience surveys of MSM: 15 500 British resident men in the European...

  11. Men who have sex with men in Great Britain: comparing methods and estimates from probability and convenience sample surveys.

    Science.gov (United States)

    Prah, Philip; Hickson, Ford; Bonell, Chris; McDaid, Lisa M; Johnson, Anne M; Wayal, Sonali; Clifton, Soazig; Sonnenberg, Pam; Nardone, Anthony; Erens, Bob; Copas, Andrew J; Riddell, Julie; Weatherburn, Peter; Mercer, Catherine H

    2016-09-01

    To examine sociodemographic and behavioural differences between men who have sex with men (MSM) participating in recent UK convenience surveys and a national probability sample survey. We compared 148 MSM aged 18-64 years interviewed for Britain's third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) undertaken in 2010-2012, with men in the same age range participating in contemporaneous convenience surveys of MSM: 15 500 British resident men in the European MSM Internet Survey (EMIS); 797 in the London Gay Men's Sexual Health Survey; and 1234 in Scotland's Gay Men's Sexual Health Survey. Analyses compared men reporting at least one male sexual partner (past year) on similarly worded questions and multivariable analyses accounted for sociodemographic differences between the surveys. MSM in convenience surveys were younger and better educated than MSM in Natsal-3, and a larger proportion identified as gay (85%-95% vs 62%). Partner numbers were higher and same-sex anal sex more common in convenience surveys. Unprotected anal intercourse was more commonly reported in EMIS. Compared with Natsal-3, MSM in convenience surveys were more likely to report gonorrhoea diagnoses and HIV testing (both past year). Differences between the samples were reduced when restricting analysis to gay-identifying MSM. National probability surveys better reflect the population of MSM but are limited by their smaller samples of MSM. Convenience surveys recruit larger samples of MSM but tend to over-represent MSM identifying as gay and reporting more sexual risk behaviours. Because both sampling strategies have strengths and weaknesses, methods are needed to triangulate data from probability and convenience surveys. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. Men who have sex with men in Great Britain: comparing methods and estimates from probability and convenience sample surveys

    Science.gov (United States)

    Prah, Philip; Hickson, Ford; Bonell, Chris; McDaid, Lisa M; Johnson, Anne M; Wayal, Sonali; Clifton, Soazig; Sonnenberg, Pam; Nardone, Anthony; Erens, Bob; Copas, Andrew J; Riddell, Julie; Weatherburn, Peter; Mercer, Catherine H

    2016-01-01

    Objective To examine sociodemographic and behavioural differences between men who have sex with men (MSM) participating in recent UK convenience surveys and a national probability sample survey. Methods We compared 148 MSM aged 18–64 years interviewed for Britain's third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) undertaken in 2010–2012, with men in the same age range participating in contemporaneous convenience surveys of MSM: 15 500 British resident men in the European MSM Internet Survey (EMIS); 797 in the London Gay Men's Sexual Health Survey; and 1234 in Scotland's Gay Men's Sexual Health Survey. Analyses compared men reporting at least one male sexual partner (past year) on similarly worded questions and multivariable analyses accounted for sociodemographic differences between the surveys. Results MSM in convenience surveys were younger and better educated than MSM in Natsal-3, and a larger proportion identified as gay (85%–95% vs 62%). Partner numbers were higher and same-sex anal sex more common in convenience surveys. Unprotected anal intercourse was more commonly reported in EMIS. Compared with Natsal-3, MSM in convenience surveys were more likely to report gonorrhoea diagnoses and HIV testing (both past year). Differences between the samples were reduced when restricting analysis to gay-identifying MSM. Conclusions National probability surveys better reflect the population of MSM but are limited by their smaller samples of MSM. Convenience surveys recruit larger samples of MSM but tend to over-represent MSM identifying as gay and reporting more sexual risk behaviours. Because both sampling strategies have strengths and weaknesses, methods are needed to triangulate data from probability and convenience surveys. PMID:26965869

  13. Comparative analysis of metagenomes of Italian top soil improvers

    International Nuclear Information System (INIS)

    Gigliucci, Federica; Brambilla, Gianfranco; Tozzoli, Rosangela; Michelacci, Valeria; Morabito, Stefano

    2017-01-01

    Biosolids originating from Municipal Waste Water Treatment Plants are proposed as top soil improvers (TSI) for their beneficial input of organic carbon on agriculture lands. Their use to amend soil is controversial, as it may lead to the presence of emerging hazards of anthropogenic or animal origin in the environment devoted to food production. In this study, we used a shotgun metagenomics sequencing as a tool to perform a characterization of the hazards related with the TSIs. The samples showed the presence of many virulence genes associated to different diarrheagenic E. coli pathotypes as well as of different antimicrobial resistance-associated genes. The genes conferring resistance to Fluoroquinolones was the most relevant class of antimicrobial resistance genes observed in all the samples tested. To a lesser extent traits associated with the resistance to Methicillin in Staphylococci and genes conferring resistance to Streptothricin, Fosfomycin and Vancomycin were also identified. The most represented metal resistance genes were cobalt-zinc-cadmium related, accounting for 15–50% of the sequence reads in the different metagenomes out of the total number of those mapping on the class of resistance to compounds determinants. Moreover the taxonomic analysis performed by comparing compost-based samples and biosolids derived from municipal sewage-sludges treatments divided the samples into separate populations, based on the microbiota composition. The results confirm that the metagenomics is efficient to detect genomic traits associated with pathogens and antimicrobial resistance in complex matrices and this approach can be efficiently used for the traceability of TSI samples using the microorganisms’ profiles as indicators of their origin. - Highlights: • Sludge- and green- based biosolids analysed by metagenomics. • Biosolids may introduce microbial hazards in the food chain. • Metagenomics enables tracking biosolids’ sources.

  14. Comparative analysis of metagenomes of Italian top soil improvers

    Energy Technology Data Exchange (ETDEWEB)

    Gigliucci, Federica, E-mail: Federica.gigliucci@libero.it [Department of Veterinary Public Health and Food Safety, Istituto Superiore di Sanità, Viale Regina Elena, 299 00161 Rome (Italy); Department of Sciences, University Roma,Tre, Viale Marconi, 446, 00146 Rome (Italy); Brambilla, Gianfranco; Tozzoli, Rosangela; Michelacci, Valeria; Morabito, Stefano [Department of Veterinary Public Health and Food Safety, Istituto Superiore di Sanità, Viale Regina Elena, 299 00161 Rome (Italy)

    2017-05-15

    Biosolids originating from Municipal Waste Water Treatment Plants are proposed as top soil improvers (TSI) for their beneficial input of organic carbon on agriculture lands. Their use to amend soil is controversial, as it may lead to the presence of emerging hazards of anthropogenic or animal origin in the environment devoted to food production. In this study, we used a shotgun metagenomics sequencing as a tool to perform a characterization of the hazards related with the TSIs. The samples showed the presence of many virulence genes associated to different diarrheagenic E. coli pathotypes as well as of different antimicrobial resistance-associated genes. The genes conferring resistance to Fluoroquinolones was the most relevant class of antimicrobial resistance genes observed in all the samples tested. To a lesser extent traits associated with the resistance to Methicillin in Staphylococci and genes conferring resistance to Streptothricin, Fosfomycin and Vancomycin were also identified. The most represented metal resistance genes were cobalt-zinc-cadmium related, accounting for 15–50% of the sequence reads in the different metagenomes out of the total number of those mapping on the class of resistance to compounds determinants. Moreover the taxonomic analysis performed by comparing compost-based samples and biosolids derived from municipal sewage-sludges treatments divided the samples into separate populations, based on the microbiota composition. The results confirm that the metagenomics is efficient to detect genomic traits associated with pathogens and antimicrobial resistance in complex matrices and this approach can be efficiently used for the traceability of TSI samples using the microorganisms’ profiles as indicators of their origin. - Highlights: • Sludge- and green- based biosolids analysed by metagenomics. • Biosolids may introduce microbial hazards in the food chain. • Metagenomics enables tracking biosolids’ sources.

  15. Alternative Frameworks for Improving Government Organizational Performance: A Comparative Analysis

    National Research Council Canada - National Science Library

    Simon, Cary

    1997-01-01

    .... Six major frameworks emerging in the U.S. since 1980, applicable to the public sector, and designed to enhance organizational change toward improved performance are reviewed and analyzed: Total Quality; 'Excellence...

  16. Improvement of Water and Sanitation Services : a Comparative ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This grant will support a pilot water and sanitation project that engages both the local community and the local government. The project will be informed by the findings of a field survey in Irbid, Jordan, which has similar cultural and demographic characteristics, and where water and sanitation provision has improved in ...

  17. Evolutionary pattern of mutation in the factor IX genes of great apes: How does it compare to the pattern of recent germline mutation in patients with hemophilia B?

    Energy Technology Data Exchange (ETDEWEB)

    Grouse, L.H.; Ketterling, R.P.; Sommer, S.S. [Mayo Clinic/Foundation, Rochester, MN (United States)

    1994-09-01

    Most mutations causing hemophilia B have arisen within the past 150 years. By correcting for multiple biases, the underlying rates of spontaneous germline mutation have been estimated in the factor IX gene. From these rates, an underlying pattern of mutation has emerged. To determine if this pattern compares to a underlying pattern found in the great apes, sequence changes were determined in intronic regions of the factor IX gene. The following species were studied: Gorilla gorilla, Pan troglodytes (chimpanzee), Pongo pygmacus (orangutan) and Homo sapiens. Intronic sequences at least 200 bp from a splice junction were randomly chosen, amplified by cross-species PCR, and sequenced. These regions are expected to be subject to little if any selective pressure. Early diverged species of Old World monkeys were also studied to help determine the direction of mutational changes. A total of 62 sequence changes were observed. Initial data suggest that the average pattern since evolution of the great apes has a paucity of transitions at CpG dinucleotides and an excess of microinsertions to microdeletions when compared to the pattern observed in humans during the past 150 years (p<.05). A larger study is in progress to confirm these results.

  18. Great Apes

    Science.gov (United States)

    Sleeman, Jonathan M.; Cerveny, Shannon

    2014-01-01

    Anesthesia of great apes is often necessary to conduct diagnostic analysis, provide therapeutics, facilitate surgical procedures, and enable transport and translocation for conservation purposes. Due to the stress of remote delivery injection of anesthetic agents, recent studies have focused on oral delivery and/or transmucosal absorption of preanesthetic and anesthetic agents. Maintenance of the airway and provision of oxygen is an important aspect of anesthesia in great ape species. The provision of analgesia is an important aspect of the anesthesia protocol for any procedure involving painful stimuli. Opioids and nonsteroidal anti-inflammatory drugs (NSAIDs) are often administered alone, or in combination to provide multi-modal analgesia. There is increasing conservation management of in situ great ape populations, which has resulted in the development of field anesthesia techniques for free-living great apes for the purposes of translocation, reintroduction into the wild, and clinical interventions.

  19. Comparing in situ removal strategies for improving styrene bioproduction.

    Science.gov (United States)

    McKenna, Rebekah; Moya, Luis; McDaniel, Matthew; Nielsen, David R

    2015-01-01

    As an important conventional monomer compound, the biological production of styrene carries significant promise with respect to creating novel sustainable materials. Since end-product toxicity presently limits styrene production by previously engineered Escherichia coli, in situ product removal by both solvent extraction and gas stripping were explored as process-based strategies for circumventing its inhibitory effects. In solvent extraction, the addition of bis(2-ethylhexyl)phthalate offered the greatest productivity enhancement, allowing net volumetric production of 836 ± 64 mg/L to be reached, representing a 320 % improvement over single-phase cultures. Gas stripping rates, meanwhile, were controlled by rates of bioreactor agitation and, to a greater extent, aeration. A periodic gas stripping protocol ultimately enabled up to 561 ± 15 mg/L styrene to be attained. Lastly, by relieving the effects of styrene toxicity, new insight was gained regarding subsequent factors limiting its biosynthesis in E. coli and strategies for future strain improvement are discussed.

  20. Catheter-directed thrombolysis for acute iliofemoral deep vein thrombosis via the ipsilateral great saphenous vein approach: a comparative clinical study

    International Nuclear Information System (INIS)

    Su Haobo; Gu Jianping; Lou Wensheng; He Xu; Chen Liang; Chen Guoping; Song Jinhua; Wang Tao

    2011-01-01

    Objective: To investigate prospectively the feasibility and clinical value of catheterization via the ipsilateral great saphenous vein in catheter-directed thrombolysis (CDT) for acute iliofemoral deep vein thrombosis (IFVT) by a comparative study. Methods: The prospective study included 93 cases of IFVT proved by venography. All patients were divided into three groups randomly. In group A, 31 patients received CDT via the ipsilateral great saphenous vein. In group B, 27 patients received CDT via the ipsilateral popliteal vein. In group C, 35 patients received anterograde thrombolysis via an ipsilateral dorsalis pedis vein. Urokinase was adopted as the thrombolytic agent in all cases. The assessment of the curative effect include therapeutic effective rate, rate of edema reduction and venous patency which were observed according to the clinical symptoms and the follow-up venograms obtained 5 days after thrombolysis. The time and comfort scores of procedures was recorded and compared between group A and B using two independent samples t test. The rate of edema reduction and venous patency were assessed using analysis of variance (LSD method). Therapeutic effective rate and complication rate were assessed using Chi-square test. Results: The total effective rate of the three groups were 90.3% (28/31), 92.6% (25/27) and 68.6% (24/35) respectively. The limbs edema reduction rate were (83.5±21.1)%, (82.4±20.1)%, and (67.0±23.3)% respectively (F= 6.059, P=0.003). The venous patency rate after thrombolysis were (61.2±20.2)%, (55.7±20.5)%, and (44.2±23.6)% respectively. There was no significant difference between group A and B in therapeutic effective rate (χ 2 =0.09, P=0.759), rate of edema reduction (P=0.822) and venous patency (P=0.343) . There was a significant difference statistically in therapeutic effective rate (χ 2 =4.65, P=0.031), rate of edema reduction (P=0.002) and venous patency (P=0.002) between group A and C. Compared with group A and B, the

  1. Comparing Kaolin and Pinolene to Improve Sustainable Grapevine Production during Drought.

    Science.gov (United States)

    Brillante, Luca; Belfiore, Nicola; Gaiotti, Federica; Lovat, Lorenzo; Sansone, Luigi; Poni, Stefano; Tomasi, Diego

    2016-01-01

    Viticulture is widely practiced in dry regions, where the grapevine is greatly exposed to water stress. Optimizing plant water use efficiency (WUE) without affecting crop yield, grape and wine quality is crucial to limiting use of water for irrigation and to significantly improving viticulture sustainability. This study examines the use in vineyards of particle film technology (engineered kaolin) and compares it to a film-forming antitranspirant (pinolene), traditionally used to limit leaf water loss, and to an untreated control. The trial was carried out under field conditions over three growing seasons, during which moderate to very severe plant water stress (down to -1.9 MPa) was measured through stem water potential. Leaf stomatal conductance (gs) and photosynthesis rate (An) were measured during the seasons and used to compute intrinsic WUE (WUEi, defined as An/gs ratio). Leaf temperature was also recorded and compared between treatments. Bunch quantity, bunch and berry weight, sugar accumulation, anthocyanin and flavonoid contents were measured. Finally, microvinifications were performed and resultant wines subjected to sensory evaluation.Results showed that the use of kaolin increased grapevine intrinsic WUE (+18% on average as compared to unsprayed vines) without affecting berry and bunch weight and quantity, or sugar level. Anthocyanin content increased (+35%) in kaolin treatment, and the wine was judged more attractive (p-value wine was the least appreciated. This study demonstrates that particle film technology can improve vine WUEi and wine quality at the same time, while traditional antitranspirants were not as effective for these purposes. This positive effect can be used in interaction with other already-demonstrated uses of particle film technology, such as pest control and sunburn reduction, in order to achieve more sustainable vineyard management.

  2. Comparing Kaolin and Pinolene to Improve Sustainable Grapevine Production during Drought.

    Directory of Open Access Journals (Sweden)

    Luca Brillante

    Full Text Available Viticulture is widely practiced in dry regions, where the grapevine is greatly exposed to water stress. Optimizing plant water use efficiency (WUE without affecting crop yield, grape and wine quality is crucial to limiting use of water for irrigation and to significantly improving viticulture sustainability. This study examines the use in vineyards of particle film technology (engineered kaolin and compares it to a film-forming antitranspirant (pinolene, traditionally used to limit leaf water loss, and to an untreated control. The trial was carried out under field conditions over three growing seasons, during which moderate to very severe plant water stress (down to -1.9 MPa was measured through stem water potential. Leaf stomatal conductance (gs and photosynthesis rate (An were measured during the seasons and used to compute intrinsic WUE (WUEi, defined as An/gs ratio. Leaf temperature was also recorded and compared between treatments. Bunch quantity, bunch and berry weight, sugar accumulation, anthocyanin and flavonoid contents were measured. Finally, microvinifications were performed and resultant wines subjected to sensory evaluation.Results showed that the use of kaolin increased grapevine intrinsic WUE (+18% on average as compared to unsprayed vines without affecting berry and bunch weight and quantity, or sugar level. Anthocyanin content increased (+35% in kaolin treatment, and the wine was judged more attractive (p-value <0.05 and slightly more appreciated (p-value < 0.1 than control. Pinolene did not increase WUEi, limiting An more than gs; grapes with this treatment contained lower sugar and anthocyanin content than control, and the obtained wine was the least appreciated. This study demonstrates that particle film technology can improve vine WUEi and wine quality at the same time, while traditional antitranspirants were not as effective for these purposes. This positive effect can be used in interaction with other already

  3. Improved extraction of ePTFE and medical adhesive modified defibrillation leads from the coronary sinus and great cardiac vein.

    Science.gov (United States)

    Wilkoff, Bruce L; Belott, Peter H; Love, Charles J; Scheiner, Avram; Westlund, Randy; Rippy, Marian; Krishnan, Mohan; Norlander, Barry E; Steinhaus, Bruce; Emmanuel, Janson; Zeller, Peter J

    2005-03-01

    Permanent leads with shocking coils for defibrillation therapy are sometimes implanted in the coronary sinus (CS) and great cardiac vein (GCV). These shocking coils, as documented by pathologic examination of animal investigations, often become tightly encapsulated by fibrosis and can be very difficult to remove. One of three configurations of the Guidant model 7109 Perimeter coronary sinus shocking lead was implanted into the distal portion of the GCV of 24 sheep for up to 14 months. Group 1 had unmodified coils (control), group 2 had coils backfilled with medical adhesive (MA), and Group 3 had coils coated with expanded polytetrafluoroethylene (ePTFE). Eighteen leads, three from each group at 6 and 14 months were transvenously extracted from the left jugular vein. The remaining six animals were not subject to extraction. All animals were euthanized for pathological and microscopic examination. All six of the control, three of the MA, and one of the ePTFE leads required the use of an electrosurgical dissection sheath (EDS) for extraction. Five control, two MA, and none of the ePTFE leads had significant fibrotic attachments to the shocking coils. Significant trauma was observed at necropsy for those leads requiring the use of the EDS for extraction. Tissue ingrowth is a major impediment to the removal of defibrillation leads implanted in the CS and GCV of sheep. Reduction of tissue ingrowth by coating the shocking coils with ePTFE or by backfilling with MA facilitates transvenous lead removal with reduced tissue trauma.

  4. Great Expectations

    NARCIS (Netherlands)

    Dickens, Charles

    2005-01-01

    One of Dickens's most renowned and enjoyable novels, Great Expectations tells the story of Pip, an orphan boy who wishes to transcend his humble origins and finds himself unexpectedly given the opportunity to live a life of wealth and respectability. Over the course of the tale, in which Pip

  5. Social support improves mental health among the victims relocated to temporary housing following the Great East Japan Earthquake and Tsunami.

    Science.gov (United States)

    Koyama, Shihoko; Aida, Jun; Kawachi, Ichiro; Kondo, Naoki; Subramanian, S V; Ito, Kanade; Kobashi, Gen; Masuno, Kanako; Kondo, Katsunori; Osaka, Ken

    2014-11-01

    The victims of the Great East Japan Earthquake and Tsunami have been forced to live in temporary housing, mainly by two different methods of resettlement: group allocation that preserved pre-existing local social ties and lottery allocation. We examined the effects of various factors, including the resettlement methods and social support, on mental health. From February to March 2012, we completed a cross-sectional survey of 281 refugees aged 40 years or older, who had lost their homes in the tsunami and were living in temporary housing in Iwanuma city. Psychological distress of the victims was assessed using the Kessler Psychological Distress Scale (K6) that consists of six self-reported items. Participants were also asked whether they had provided or received social support during this time. Participants were categorized as "providing social support" if they listened to someone else's concerns and complaints, or "receiving social support" if they have someone who listened to their concerns and complaints. After adjusting for age and sex, multiple log-binomial regression analysis showed that participants without social support had a higher risk of psychological distress. Group allocation victims were more likely to receive social support than those who underwent lottery allocation. However, the resettlement approach did not significantly correlate with distress. Other factors associated with a higher risk of psychological distress were a younger age (55 or younger), living with either 3 people or 6 or more people, and having a lower income. The present results suggest that social support promotes the mental health of disaster victims.

  6. Reconsidering great ape imitation and pantomime. Comment on "Towards a Computational Comparative Neuroprimatology: framing the language-ready brain" by Michael A. Arbib

    Science.gov (United States)

    Russon, Anne E.

    2016-03-01

    Like previous commentators, I see Arbib's reconstruction of the mirror neuron system's contribution to language evolution [1] as valuable but in need of revision [2,3]. My concerns focus on his proposed behavioral pathway to language - complex imitation to pantomime to protosign - as it concerns great apes. Arbib portrays these abilities as unique to the human lineage, despite evidence that great apes are capable of all three. I suggest great ape findings worth reconsidering.

  7. Great Lakes

    Science.gov (United States)

    Edsall, Thomas A.; Mac, Michael J.; Opler, Paul A.; Puckett Haecker, Catherine E.; Doran, Peter D.

    1998-01-01

    The Great Lakes region, as defined here, includes the Great Lakes and their drainage basins in Minnesota, Wisconsin, Illinois, Indiana, Ohio, Pennsylvania, and New York. The region also includes the portions of Minnesota, Wisconsin, and the 21 northernmost counties of Illinois that lie in the Mississippi River drainage basin, outside the floodplain of the river. The region spans about 9º of latitude and 20º of longitude and lies roughly halfway between the equator and the North Pole in a lowland corridor that extends from the Gulf of Mexico to the Arctic Ocean.The Great Lakes are the most prominent natural feature of the region (Fig. 1). They have a combined surface area of about 245,000 square kilometers and are among the largest, deepest lakes in the world. They are the largest single aggregation of fresh water on the planet (excluding the polar ice caps) and are the only glacial feature on Earth visible from the surface of the moon (The Nature Conservancy 1994a).The Great Lakes moderate the region’s climate, which presently ranges from subarctic in the north to humid continental warm in the south (Fig. 2), reflecting the movement of major weather masses from the north and south (U.S. Department of the Interior 1970; Eichenlaub 1979). The lakes act as heat sinks in summer and heat sources in winter and are major reservoirs that help humidify much of the region. They also create local precipitation belts in areas where air masses are pushed across the lakes by prevailing winds, pick up moisture from the lake surface, and then drop that moisture over land on the other side of the lake. The mean annual frost-free period—a general measure of the growing-season length for plants and some cold-blooded animals—varies from 60 days at higher elevations in the north to 160 days in lakeshore areas in the south. The climate influences the general distribution of wild plants and animals in the region and also influences the activities and distribution of the human

  8. Great Ellipse Route Planning Based on Space Vector

    Directory of Open Access Journals (Sweden)

    LIU Wenchao

    2015-07-01

    Full Text Available Aiming at the problem of navigation error caused by unified earth model in great circle route planning using sphere model and modern navigation equipment using ellipsoid mode, a method of great ellipse route planning based on space vector is studied. By using space vector algebra method, the vertex of great ellipse is solved directly, and description of great ellipse based on major-axis vector and minor-axis vector is presented. Then calculation formulas of great ellipse azimuth and distance are deduced using two basic vectors. Finally, algorithms of great ellipse route planning are studied, especially equal distance route planning algorithm based on Newton-Raphson(N-R method. Comparative examples show that the difference of route planning between great circle and great ellipse is significant, using algorithms of great ellipse route planning can eliminate the navigation error caused by the great circle route planning, and effectively improve the accuracy of navigation calculation.

  9. Comparing prey composition and prey size delivered to nestlings by great tits, Parus major, and blue tits, Cyanistes caeruleus, in a Mediterranean sclerophyllous mixed forest

    International Nuclear Information System (INIS)

    Navalpotro, H.; Pagani-Nuñez, E.; Hernandez-Gomez, S.; Senar, J.C.

    2016-01-01

    Resource partitioning is a central issue in ecology because it can establish to which point similar species can coexist in the same habitat. Great tits and blue tits have been classical model species in studies of trophic competence. However, most studies on the topic have been conducted at localities where caterpillars are by far the most relevant prey brought to the nestlings. In Mediterranean mixed forests, nevertheless, the abundance of caterpillars is relatively low and it is spiders that play a key role in the diet of great tits, at least for nestlings. The aim of this paper was to study nest food provisioning to establish the degree of diet overlap of these two tit species in a Mediterranean forest. Our results showed that blue tit feeding rates were higher than those of great tits, probably to compensate for the smaller prey delivered to nestlings by blue tits. Blue tits brought more spiders than great tits, while grey tits brought larger prey and more caterpillars. This may be because larger great tits can prey upon larger prey items than blue tits. As a main result, this study supports the view of resource partitioning by great and blue tits in sclerophyllous Mediterranean forest ecosystem. (Author)

  10. Comparing prey composition and prey size delivered to nestlings by great tits, Parus major, and blue tits, Cyanistes caeruleus, in a Mediterranean sclerophyllous mixed forest

    Directory of Open Access Journals (Sweden)

    Navalpotro, H.

    2016-04-01

    Full Text Available Resource partitioning is a central issue in ecology because it can establish to which point similar species can coexist in the same habitat. Great tits and blue tits have been classical model species in studies of trophic competence. However, most studies on the topic have been conducted at localities where caterpillars are by far the most relevant prey brought to the nestlings. In Mediterranean mixed forests, nevertheless, the abundance of caterpillars is relatively low and it is spiders that play a key role in the diet of great tits, at least for nestlings. The aim of this paper was to study nest food provisioning to establish the degree of diet overlap of these two tit species in a Mediterranean forest. Our results showed that blue tit feeding rates were higher than those of great tits, probably to compensate for the smaller prey delivered to nestlings by blue tits. Blue tits brought more spiders than great tits, while grey tits brought larger prey and more caterpillars. This may be because larger great tits can prey upon larger prey items than blue tits. As a main result, this study supports the view of resource partitioning by great and blue tits in sclerophyllous Mediterranean forest ecosystem.

  11. Comparing prey composition and prey size delivered to nestlings by great tits, Parus major, and blue tits, Cyanistes caeruleus, in a Mediterranean sclerophyllous mixed forest

    Energy Technology Data Exchange (ETDEWEB)

    Navalpotro, H.; Pagani-Nuñez, E.; Hernandez-Gomez, S.; Senar, J.C.

    2016-07-01

    Resource partitioning is a central issue in ecology because it can establish to which point similar species can coexist in the same habitat. Great tits and blue tits have been classical model species in studies of trophic competence. However, most studies on the topic have been conducted at localities where caterpillars are by far the most relevant prey brought to the nestlings. In Mediterranean mixed forests, nevertheless, the abundance of caterpillars is relatively low and it is spiders that play a key role in the diet of great tits, at least for nestlings. The aim of this paper was to study nest food provisioning to establish the degree of diet overlap of these two tit species in a Mediterranean forest. Our results showed that blue tit feeding rates were higher than those of great tits, probably to compensate for the smaller prey delivered to nestlings by blue tits. Blue tits brought more spiders than great tits, while grey tits brought larger prey and more caterpillars. This may be because larger great tits can prey upon larger prey items than blue tits. As a main result, this study supports the view of resource partitioning by great and blue tits in sclerophyllous Mediterranean forest ecosystem. (Author)

  12. Lifetime Costs and Outcomes of Repair of Tetralogy of Fallot Compared to Natural Progression of the Disease: Great Ormond Street Hospital Cohort

    Science.gov (United States)

    Hunter, Rachael Maree; Isaac, Mark; Frigiola, Alessandra; Blundell, David; Brown, Kate; Bull, Kate

    2013-01-01

    Background Tetralogy of Fallot is a congenital heart disease that requires surgical repair without which survival through childhood is extremely rare. The aim of this paper is to use data from the mandatory follow-up of patients with Tetralogy of Fallot to model the health-related costs and outcomes over the first 55-years of life. Method A decision analytical model was developed to establish costs and outcomes for patients up to 55 years after diagnosis and first repair of Tetralogy of Fallot compared to natural progression. Data from Adult Congenital Heart Disease (ACHD) centres that follow up Tetralogy of Fallot patients and Great Ormond Street Hospital (GOSH), London, United Kingdom (UK) medical records was used to establish the cost and effectiveness of current interventions. Data from a Czech cohort was used for the natural, no intervention condition. Results The average cost per patient of a repair for Tetralogy of Fallot was £26,938 (SE = £4,140). The full life time cost per patient, with no discount rate, was £65,310 (95% CI £64,981–£65,729); £56,559 discounted (95% CI £56,159–£56,960). Patients with a repair had an average of 35 Quality Adjusted Life Years (QALYs) per patient over 55 years undiscounted and 20.16 QALYs discounted. If the disorder was left to take its natural course, patients on average had a total of 3 QALYs per patient with no discount rate and 2.30 QALYs discounted. Conclusion A model has been developed that provides an estimate of the value for money of an expensive repair of a congenital heart disease. The model could be used to test the cost-effectiveness of making amendments to the care pathway. PMID:23533645

  13. Improved nuclear emergency management system reflecting lessons learned from the emergency response at Fukushima Daini Nuclear Power Station after the Great East Japan Earthquake

    International Nuclear Information System (INIS)

    Kawamura, Shinichi; Narabayashi, Tadashi

    2016-01-01

    Three nuclear reactors at Fukushima Daini Nuclear Power Station lost all their ultimate heat sinks owing to damage from the tsunami caused by the Great East Japan Earthquake on March 11, 2011. Water was injected into the reactors by alternate measures, damaged cooling systems were restored with promptly supplied substitute materials, and all the reactors were brought to a cold shutdown state within four days. Lessons learned from this experience were identified to improve emergency management, especially in the areas of strategic response planning, logistics, and functions supporting response activities continuing over a long period. It was found that continuous planning activities reflecting information from plant parameters and response action results were important, and that relevant functions in emergency response organizations should be integrated. Logistics were handled successfully but many difficulties were experienced. Therefore, their functions should be clearly established and improved by emergency response organizations. Supporting emergency responders in the aspects of their physical and mental conditions was important for sustaining continuous response. As a platform for improvement, the concept of the Incident Command System was applied for the first time to a nuclear emergency management system, with specific improvement ideas such as a phased approach in response planning and common operation pictures. (author)

  14. Price promotions on healthier compared with less healthy foods: a hierarchical regression analysis of the impact on sales and social patterning of responses to promotions in Great Britain.

    Science.gov (United States)

    Nakamura, Ryota; Suhrcke, Marc; Jebb, Susan A; Pechey, Rachel; Almiron-Roig, Eva; Marteau, Theresa M

    2015-04-01

    There is a growing concern, but limited evidence, that price promotions contribute to a poor diet and the social patterning of diet-related disease. We examined the following questions: 1) Are less-healthy foods more likely to be promoted than healthier foods? 2) Are consumers more responsive to promotions on less-healthy products? 3) Are there socioeconomic differences in food purchases in response to price promotions? With the use of hierarchical regression, we analyzed data on purchases of 11,323 products within 135 food and beverage categories from 26,986 households in Great Britain during 2010. Major supermarkets operated the same price promotions in all branches. The number of stores that offered price promotions on each product for each week was used to measure the frequency of price promotions. We assessed the healthiness of each product by using a nutrient profiling (NP) model. A total of 6788 products (60%) were in healthier categories and 4535 products (40%) were in less-healthy categories. There was no significant gap in the frequency of promotion by the healthiness of products neither within nor between categories. However, after we controlled for the reference price, price discount rate, and brand-specific effects, the sales uplift arising from price promotions was larger in less-healthy than in healthier categories; a 1-SD point increase in the category mean NP score, implying the category becomes less healthy, was associated with an additional 7.7-percentage point increase in sales (from 27.3% to 35.0%; P sales uplift from promotions was larger for higher-socioeconomic status (SES) groups than for lower ones (34.6% for the high-SES group, 28.1% for the middle-SES group, and 23.1% for the low-SES group). Finally, there was no significant SES gap in the absolute volume of purchases of less-healthy foods made on promotion. Attempts to limit promotions on less-healthy foods could improve the population diet but would be unlikely to reduce health

  15. Improved StrongARM latch comparator: Design, analysis and performance evaluation

    KAUST Repository

    Almansouri, Abdullah Saud Mohammed

    2017-07-13

    This paper presents an improved StrongARM latch comparator, designed and simulated in 90nm and 32nm CMOS technologies. The proposed design provides an improvement of 7% in energy efficiency, 14% in speed and an average reduction of 41% in the clock feedthrough, compared to the conventional design. The new architecture also minimizes the area by reducing the required transistors needed for the enhanced performance.

  16. A randomized prospective long-term (>1 year) clinical trial comparing the efficacy and safety of radiofrequency ablation to 980 nm laser ablation of the great saphenous vein.

    Science.gov (United States)

    Sydnor, Malcolm; Mavropoulos, John; Slobodnik, Natalia; Wolfe, Luke; Strife, Brian; Komorowski, Daniel

    2017-07-01

    Purpose To compare the short- and long-term (>1 year) efficacy and safety of radiofrequency ablation (ClosureFAST™) versus endovenous laser ablation (980 nm diode laser) for the treatment of superficial venous insufficiency of the great saphenous vein. Materials and methods Two hundred patients with superficial venous insufficiency of the great saphenous vein were randomized to receive either radiofrequency ablation or endovenous laser ablation (and simultaneous adjunctive therapies for surface varicosities when appropriate). Post-treatment sonographic and clinical assessment was conducted at one week, six weeks, and six months for closure, complications, and patient satisfaction. Clinical assessment of each patient was conducted at one year and then at yearly intervals for patient satisfaction. Results Post-procedure pain ( p radiofrequency ablation group. Improvements in venous clinical severity score were noted through six months in both groups (endovenous laser ablation 6.6 to 1; radiofrequency ablation 6.2 to 1) with no significant difference in venous clinical severity score ( p = 0.4066) or measured adverse effects; 89 endovenous laser ablation and 87 radiofrequency patients were interviewed at least 12 months out with a mean long-term follow-up of 44 and 42 months ( p = 0.1096), respectively. There were four treatment failures in each group, and every case was correctable with further treatment. Overall, there were no significant differences with regard to patient satisfaction between radiofrequency ablation and endovenous laser ablation ( p = 0.3009). There were no cases of deep venous thrombosis in either group at any time during this study. Conclusions Radiofrequency ablation and endovenous laser ablation are highly effective and safe from both anatomic and clinical standpoints over a multi-year period and neither modality achieved superiority over the other.

  17. Multilevel eEmpirical Bayes modeling for improved estimation of toxicant formulations tosuppress parasitic sea lamprey in the Upper Great Lakes

    Science.gov (United States)

    Hatfield, Laura A.; Gutreuter, Steve; Boogaard, Michael A.; Carlin, Bradley P.

    2011-01-01

    Estimation of extreme quantal-response statistics, such as the concentration required to kill 99.9% of test subjects (LC99.9), remains a challenge in the presence of multiple covariates and complex study designs. Accurate and precise estimates of the LC99.9 for mixtures of toxicants are critical to ongoing control of a parasitic invasive species, the sea lamprey, in the Laurentian Great Lakes of North America. The toxicity of those chemicals is affected by local and temporal variations in water chemistry, which must be incorporated into the modeling. We develop multilevel empirical Bayes models for data from multiple laboratory studies. Our approach yields more accurate and precise estimation of the LC99.9 compared to alternative models considered. This study demonstrates that properly incorporating hierarchical structure in laboratory data yields better estimates of LC99.9 stream treatment values that are critical to larvae control in the field. In addition, out-of-sample prediction of the results of in situ tests reveals the presence of a latent seasonal effect not manifest in the laboratory studies, suggesting avenues for future study and illustrating the importance of dual consideration of both experimental and observational data.

  18. Comparative mapping of DNA probes derived from the V{sub k} immunoglobulin gene regions on human and great ape chromosomes by fluorescence in situ hybridization

    Energy Technology Data Exchange (ETDEWEB)

    Arnold, N.; Wienberg, J.; Ermert, K. [Universitaet Muenchen (Germany)] [and others

    1995-03-01

    Fluorescence in situ hybridization (FISH) of cosmid clones of human V{sub K} gene regions to human and primate chromosomes contributed to the dating of chromosome reorganizations in evolution. A clone from the K locus at 2p11-p12 (cos 106) hybridized to the assumed homologous chromosome bands in the chimpanzees Pan troglodytes (PTR) and P. paniscus (PPA), the Gorilla gorilla (GGO), and the orangutan Pongo Pygmaeus (PPY). Human and both chimpanzees differed from gorilla and orangutan by the mapping of cos 170, a clone derived from chromosome 2cen-q11.2; the transposition of this orphon to the other side of the centromere can, therefore, be dated after the human/chimpanzee and gorilla divergence. Hybridization to homologous bands was also found with a cosmid clone containing a V{sub K}I orphon located on chromosome 1 (cos 115, main signal at 1q31-q32), although the probe is not fully unique. Also, a clone derived from the orphon V{sub K} region on chromosome 22q11 (cos 121) hybridized to the homologous bands in the great apes. This indicates that the orphons on human chromosomes 1 and 22 had been translocated early in primate evolution. 18 refs., 2 figs.

  19. Stress-inducible expression of AtDREB1A transcription factor greatly improves drought stress tolerance in transgenic indica rice.

    Science.gov (United States)

    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.

  20. Nuts Improve Diet Quality Compared to Other Energy-Dense Snacks While Maintaining Body Weight

    Directory of Open Access Journals (Sweden)

    Siew Ling Tey

    2011-01-01

    Full Text Available Previous studies have reported that regular nut consumption reduces cardiovascular disease (CVD risk and does not promote weight gain despite the fact that nuts are energy-dense. However, no studies have investigated the body composition of those regularly consuming nuts compared to similar intakes of other snacks of equal energy density. This parallel study (n = 118 examined the effects of providing daily portions (~1100 kJ/d of hazelnuts, chocolate, or potato crisps compared to a control group receiving no snacks for twelve weeks. Effects on body weight and composition, blood lipids and lipoproteins, resting metabolic rate (RMR, appetite indices, and dietary quality were compared. At week 12, there was no significant difference in any of the outcome measurements between the groups except for dietary quality, which improved significantly in the nut group. Nuts can be incorporated into the diet without adversely affecting body weight and can improve diet quality.

  1. A comparative study on methods of improving SCR for ship detection in SAR image

    Science.gov (United States)

    Lang, Haitao; Shi, Hongji; Tao, Yunhong; Ma, Li

    2017-10-01

    Knowledge about ship positions plays a critical role in a wide range of maritime applications. To improve the performance of ship detector in SAR image, an effective strategy is improving the signal-to-clutter ratio (SCR) before conducting detection. In this paper, we present a comparative study on methods of improving SCR, including power-law scaling (PLS), max-mean and max-median filter (MMF1 and MMF2), method of wavelet transform (TWT), traditional SPAN detector, reflection symmetric metric (RSM), scattering mechanism metric (SMM). The ability of SCR improvement to SAR image and ship detection performance associated with cell- averaging CFAR (CA-CFAR) of different methods are evaluated on two real SAR data.

  2. Comparative ozone responses of cutleaf coneflowers (Rudbeckia laciniata var. digitata, var. ampla) from Rocky Mountain and Great Smoky Mountains National Parks, USA.

    Science.gov (United States)

    Neufeld, Howard S; Johnson, Jennifer; Kohut, Robert

    2018-01-01

    Cutleaf coneflower (Rudbeckia laciniata L. var. digitata) is native to Great Smoky Mountains National Park (GRSM) and an ozone bioindicator species. Variety ampla, whose ozone sensitivity is less well known, is native to Rocky Mountain National Park (ROMO). In the early 2000s, researchers found putative ozone symptoms on var. ampla and rhizomes were sent to Appalachian State University to verify that the symptoms were the result of ozone exposure. In 2011, potted plants were exposed to ambient ozone from May to August. These same plants were grown in open-top chambers (OTCs) in 2012 and 2013, and exposed to charcoal-filtered (CF), non-filtered (NF), elevated ozone (EO), NF+50ppb in 2012 for 47days and NF+30/NF+50ppb ozone in 2013 for 36 and 36days, respectively. Ozone symptoms similar to those found in ROMO (blue-black adaxial stippling) were reproduced both in ambient air and in the OTCs. Both varieties exhibited foliar injury in the OTCs in an exposure-dependent manner, verifying that symptoms resulted from ozone exposure. In two of the three study years, var. digitata appeared more sensitive than var. ampla. Exposure to EO caused reductions in ambient photosynthetic rate (A) and stomatal conductance (g s ) for both varieties. Light response curves indicated that ozone reduced A, g s , and the apparent quantum yield while it increased the light compensation point. In CF air, var. ampla had higher light saturated A (18.2±1.04 vs 11.6±0.37μmolm -2 s -1 ), higher light saturation (1833±166.7 vs 1108±141.7μmolm -2 s -1 ), and lower Ci/Ca ratio (0.67±0.01 vs 0.77±0.01) than var. digitata. Coneflowers in both Parks are adversely affected by exposure to ambient ozone and if ozone concentrations increase in the Rocky Mountains, greater amounts of injury on var. ampla can be expected. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. 30-day mortality after coronary artery bypass grafting and valve surgery has greatly improved over the last decade, but the 1-year mortality remains constant

    Directory of Open Access Journals (Sweden)

    Laura Sommer Hansen

    2015-01-01

    Full Text Available Introduction: European system for cardiac operative risk evaluation (EuroSCORE is a valuable tool in control of the quality of cardiac surgery. However, the validity of the risk score for the individual patient may be questioned. The present study was carried out to investigate whether the continued fall in short-term mortality reflects an actual improvement in late mortality, and subsequently, to investigate EuroSCORE as predictor of 1-year mortality. Methods: A population-based cohort study of 25,602 patients from a 12-year period from three public university hospitals undergoing coronary artery bypass grafting (CABG or valve surgery. Analysis was carried out based on EuroSCORE, age and co-morbidity factors (residual EuroSCORE. Results: During the period the average age increased from 65.1 ± 10.0 years to 68.9 ± 10.7 years (P < 0.001, one-way ANOVA, and the number of females increased from 26.0% to 28.2% (P = 0.0012, Chi-square test. The total EuroSCORE increased from 4.67 to 5.68 while the residual EuroSCORE decreased from 2.64 to 1.83. Thirty-day mortality decreased from 4.07% in 1999-2000 to 2.44% in 2011-2012 (P = 0.0056; Chi-square test, while 1-year mortality was unchanged (6.50% in 1999-2000 vs. 6.25% in 2011-2012 [P = 0.8086; Chi-square test]. Discussion: The study demonstrates that both co-morbidity and age has a great impact on 30-day mortality. However, with time the impact of co-morbidity seems less. Thus, age is more important than co-morbidity in late mortality. The various developments in short and long-term mortality are not readily explained. Conclusion: Although 30-day mortality of CABG and valve surgery patients has decreased during the 12-year period, the 1-year mortality remains the same.

  4. CYberinfrastructure for COmparative effectiveness REsearch (CYCORE): improving data from cancer clinical trials

    OpenAIRE

    Patrick, Kevin; Wolszon, Laura; Basen-Engquist, Karen M; Demark-Wahnefried, Wendy; Prokhorov, Alex V; Barrera, Stephanie; Baru, Chaitan; Farcas, Emilia; Krueger, Ingolf; Palmer, Doug; Raab, Fred; Rios, Phil; Ziftci, Celal; Peterson, Susan

    2010-01-01

    ABSTRACT Improved approaches and methodologies are needed to conduct comparative effectiveness research (CER) in oncology. While cancer therapies continue to emerge at a rapid pace, the review, synthesis, and dissemination of evidence-based interventions across clinical trials lag in comparison. Rigorous and systematic testing of competing therapies has been clouded by age-old problems: poor patient adherence, inability to objectively measure the environmental influences on health, lack of kn...

  5. Great software debates

    CERN Document Server

    Davis, A

    2004-01-01

    The industry’s most outspoken and insightful critic explains how the software industry REALLY works. In Great Software Debates, Al Davis, shares what he has learned about the difference between the theory and the realities of business and encourages you to question and think about software engineering in ways that will help you succeed where others fail. In short, provocative essays, Davis fearlessly reveals the truth about process improvement, productivity, software quality, metrics, agile development, requirements documentation, modeling, software marketing and sales, empiricism, start-up financing, software research, requirements triage, software estimation, and entrepreneurship.

  6. Comparing safety climate in naval aviation and hospitals: implications for improving patient safety.

    Science.gov (United States)

    Singer, Sara J; Rosen, Amy; Zhao, Shibei; Ciavarelli, Anthony P; Gaba, David M

    2010-01-01

    Evidence of variation in safety climate suggests the need for improvement among at least some hospitals. However, comparisons only among hospitals may underestimate the improvement required. Comparison of hospitals with analogous industries may provide a broader perspective on the safety status of our nation's hospitals. The purpose of this study was to compare safety climate among hospital workers with personnel from naval aviation, an organization that operates with high reliability despite intrinsically hazardous conditions. We surveyed a random sample of health care workers in 67 U.S. hospitals and, for generalizability, 30 veterans affairs hospitals using questions comparable with those posed at approximately the same time (2007) to a census of personnel from 35 squadrons of U.S. naval aviators. We received 13,841 (41%) completed surveys in U.S. hospitals, 5,511 (50%) in veterans affairs hospitals, and 14,854 (82%) among naval aviators. We examined differences in respondents' perceptions of safety climate at their institution overall and for 16 individual items. Safety climate was three times better on average among naval aviators than among hospital personnel. Naval aviators perceived a safer climate (up to seven times safer) than hospital personnel with respect to each of the 16 survey items. Compared with hospital managers, naval commanders perceived climate more like frontline personnel did. When contrasting naval aviators with hospital personnel working in comparably hazardous areas, safety climate discrepancies increased rather than decreased. One individual hospital performed as well as naval aviation on average, and at least one hospital outperformed the Navy benchmark for all but three individual survey items. Results suggest that hospitals have not sufficiently created a uniform priority of safety. However, if each hospital performed as well as the top-performing hospital in each area measured, hospitals could achieve safety climate levels comparable

  7. Quality improvement strategies and tools: A comparative analysis between Italy and the United States.

    Science.gov (United States)

    Villa, Stefano; Restuccia, Joseph D; Anessi-Pessina, Eugenio; Rizzo, Marco Giovanni; Cohen, Alan B

    2018-01-01

    Italian and American hospitals, in two different periods, have been urged by external circumstances to extensively redesign their quality improvement strategies. This paper, through the use of a survey administered to chief quality officers in both countries, aims to identify commonalities and differences between the two systems and to understand which approaches are effective in improving quality of care. In both countries chief quality officers report quality improvement has become a strategic priority, clinical governance approaches, and tools-such as disease-specific quality improvement projects and clinical pathways-are commonly used, and there is widespread awareness that clinical decision making must be supported by protocols and guidelines. Furthermore, the study clearly outlines the critical importance of adopting a system-wide approach to quality improvement. To this extent Italy seems lagging behind compared to US in fact: (i) responsibilities for different dimensions of quality are spread across different organizational units; (ii) quality improvement strategies do not typically involve administrative staff; and (iii) quality performance measures are not disseminated widely within the organization but are reported primarily to top management. On the other hand, in Italy chief quality officers perceive that the typical hospital organizational structure, which is based on clinical directories, allows better coordination between clinical specialties than in the United States. In both countries, the results of the study show that it is not the single methodology/model that makes the difference but how the different quality improvement strategies and tools interact to each other and how they are coherently embedded with the overall organizational strategy.

  8. Comparing clinical efficacy of Symbicort versus Pulmicort in reducing asthma symptom and improving its control

    Directory of Open Access Journals (Sweden)

    Mohammad Emami

    2014-01-01

    Full Text Available Background: Recently, higher efficacy of the combination of long-acting beta2-adrenoceptor agonist and inhaled corticosteroids on controlling asthma symptoms has been hypothesized. This study aimed to examine the clinical effects of the combination of Budesonide with formoterol (Symbicort and Budesonide (Pulmicort alone in persistent asthma. Materials and Methods: In a randomized double-blinded clinical trial, 76 patients with definite diagnosis of moderate-to-severe asthma were randomized to receive Pulmicort 180 mcg/inhalation two puffs twice daily, or receive Symbicort 80/4.5 mg/inhalation two puffs twice daily, or receive Symbicort 160/4.5 mg/inhalation two puffs twice daily for 3 months. All participants were initially evaluated by spirometry for assessing respiratory parameters and also the level of asthma control was assessed by Asthma Control Test (ACT. Results: More significant improvement in spirometry parameters, including forced expiratory volume in 1 second (FEV1, forced vital capacity (FVC, FEV1/FVC ratio, as well as in peak expiratory flow (PEF in both groups of Symbicort with the regimens 80/4.5 mg/inhalation or 160/4.5 mg/inhalation 2 puffs twice daily compared with Pulmicort group, ACT score was significantly improved in Symbicort group with the regimens 160/4.5 mg/inhalation compared with both Symbicort groups with lower dosage and Pulmicort group . Response to treatment in PEF parameter and also in ACT level was significantly more in those who received Symbicort with the regimens 160/4.5 mg/inhalation compared with other two interventional groups adjusted for gender and age. Conclusion: Symbicort with the regimens 160/4.5 mg/inhalation has higher efficacy in reducing asthma symptom and improving its control compared with low doses of this drug and with Pulmicort.

  9. COMPAR

    International Nuclear Information System (INIS)

    Kuefner, K.

    1976-01-01

    COMPAR works on FORTRAN arrays with four indices: A = A(i,j,k,l) where, for each fixed k 0 ,l 0 , only the 'plane' [A(i,j,k 0 ,l 0 ), i = 1, isub(max), j = 1, jsub(max)] is held in fast memory. Given two arrays A, B of this type COMPAR has the capability to 1) re-norm A and B ind different ways; 2) calculate the deviations epsilon defined as epsilon(i,j,k,l): =[A(i,j,k,l) - B(i,j,k,l)] / GEW(i,j,k,l) where GEW (i,j,k,l) may be chosen in three different ways; 3) calculate mean, standard deviation and maximum in the array epsilon (by several intermediate stages); 4) determine traverses in the array epsilon; 5) plot these traverses by a printer; 6) simplify plots of these traverses by the PLOTEASY-system by creating input data blocks for this system. The main application of COMPAR is given (so far) by the comparison of two- and three-dimensional multigroup neutron flux-fields. (orig.) [de

  10. The Improved Sensitivity to Crossmodal Asynchrony Caused by Voluntary Action: Comparing Combinations of Sensory Modalities

    Directory of Open Access Journals (Sweden)

    Norimichi Kitagawa

    2011-10-01

    Full Text Available The brain has to assess the fine temporal relationship between voluntary actions and their sensory effects to achieve precise spatiotemporal control of body movement. Recently we found that voluntary action improved the subsequent perceptual temporal discrimination between somatosensory and auditory events. In voluntary condition, participants actively pressed a button and a noise burst was presented at various onset asynchronies relative to the button press. The participants made either ‘sound-first’ or ‘touch-first’ responses. We found that the temporal order judgment performance in the voluntary condition (as indexed by just noticeable difference was significantly better than that when their finger was passively stimulated (passive condition. Temporal attention and comparable involuntary movement did not explain the improvement caused by the voluntary action. The results suggest that predicting sensory consequences via a ‘forward’ model enhances perceptual temporal resolution for precise control of the body. The present study examined whether this improved temporal sensitivity caused by the voluntary action is also observed for the other combinations of sensory modalities. We compared the effects of voluntary action on the temporal sensitivity between auditory-somatosensory, visual-somatosensory, and somatosensory-somatosensory stimulus pairs.

  11. Great Lakes Science Center

    Data.gov (United States)

    Federal Laboratory Consortium — Since 1927, Great Lakes Science Center (GLSC) research has provided critical information for the sound management of Great Lakes fish populations and other important...

  12. Making Psychotherapy Great Again?

    Science.gov (United States)

    Plakun, Eric M

    2017-05-01

    Psychotherapy never stopped being as "great" as other treatments. This column explores the evidence base for both psychotherapy and medications, using depression as a specific example. The limitations are comparable for psychotherapy and medication, with much of the evidence based on small degrees of "statistically significant" rather than "clinically meaningful" change. Our field's biomedical emphasis leads to a false assumption that most patients present with single disorders, when comorbidity is the rule rather than the exception. This false assumption contributes to limitations in the evidence base and in our ability to treat patients optimally.

  13. Application of quality improvement analytic methodology in emergency medicine research: A comparative evaluation.

    Science.gov (United States)

    Harries, Bruce; Filiatrault, Lyne; Abu-Laban, Riyad B

    2018-05-30

    Quality improvement (QI) analytic methodology is rarely encountered in the emergency medicine literature. We sought to comparatively apply QI design and analysis techniques to an existing data set, and discuss these techniques as an alternative to standard research methodology for evaluating a change in a process of care. We used data from a previously published randomized controlled trial on triage-nurse initiated radiography using the Ottawa ankle rules (OAR). QI analytic tools were applied to the data set from this study and evaluated comparatively against the original standard research methodology. The original study concluded that triage nurse-initiated radiographs led to a statistically significant decrease in mean emergency department length of stay. Using QI analytic methodology, we applied control charts and interpreted the results using established methods that preserved the time sequence of the data. This analysis found a compelling signal of a positive treatment effect that would have been identified after the enrolment of 58% of the original study sample, and in the 6th month of this 11-month study. Our comparative analysis demonstrates some of the potential benefits of QI analytic methodology. We found that had this approach been used in the original study, insights regarding the benefits of nurse-initiated radiography using the OAR would have been achieved earlier, and thus potentially at a lower cost. In situations where the overarching aim is to accelerate implementation of practice improvement to benefit future patients, we believe that increased consideration should be given to the use of QI analytic methodology.

  14. Drug supply indicators: Pitfalls and possibilities for improvements to assist comparative analysis.

    Science.gov (United States)

    Singleton, Nicola; Cunningham, Andrew; Groshkova, Teodora; Royuela, Luis; Sedefov, Roumen

    2018-06-01

    Interventions to tackle the supply of drugs are seen as standard components of illicit drug policies. Therefore drug market-related administrative data, such as seizures, price, purity and drug-related offending, are used in most countries for policy monitoring and assessment of the drug situation. International agencies, such as the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and the UN Office of Drugs and Crime, also monitor and report on the drug situation cross-nationally and therefore seek to collect and make available key data in a uniform manner from the countries they cover. However, these data are not primarily collected for this purpose, which makes interpretation and comparative analysis difficult. Examples of limitations of these data sources include: the extent to which they reflect operational priorities rather than market changes; question marks over the robustness of and consistency in data collection methods, and issues around the timeliness of data availability. Such problems are compounded by cultural, social and contextual differences between countries. Making sense of such data is therefore challenging and extreme care needs to be taken using it. Nevertheless, these data provide an important window on a hidden area, so improving the quality of the data collected and expanding its scope should be a priority for those seeking to understand or monitor drug markets and supply reduction. In addition to highlighting some of the potential pitfalls in using supply indicators for comparative analysis, this paper presents a selection of options for improvements based on the current EMCDDA programme of work to improve their supply-related monitoring and analysis. The conceptual framework developed to steer this work may have wider application. Adopting this approach has the potential to provide a richer picture of drug markets, at both national and international levels, and make it easier to compare data between countries. Copyright

  15. Comparing and improving proper orthogonal decomposition (POD) to reduce the complexity of groundwater models

    Science.gov (United States)

    Gosses, Moritz; Nowak, Wolfgang; Wöhling, Thomas

    2017-04-01

    Physically-based modeling is a wide-spread tool in understanding and management of natural systems. With the high complexity of many such models and the huge amount of model runs necessary for parameter estimation and uncertainty analysis, overall run times can be prohibitively long even on modern computer systems. An encouraging strategy to tackle this problem are model reduction methods. In this contribution, we compare different proper orthogonal decomposition (POD, Siade et al. (2010)) methods and their potential applications to groundwater models. The POD method performs a singular value decomposition on system states as simulated by the complex (e.g., PDE-based) groundwater model taken at several time-steps, so-called snapshots. The singular vectors with the highest information content resulting from this decomposition are then used as a basis for projection of the system of model equations onto a subspace of much lower dimensionality than the original complex model, thereby greatly reducing complexity and accelerating run times. In its original form, this method is only applicable to linear problems. Many real-world groundwater models are non-linear, tough. These non-linearities are introduced either through model structure (unconfined aquifers) or boundary conditions (certain Cauchy boundaries, like rivers with variable connection to the groundwater table). To date, applications of POD focused on groundwater models simulating pumping tests in confined aquifers with constant head boundaries. In contrast, POD model reduction either greatly looses accuracy or does not significantly reduce model run time if the above-mentioned non-linearities are introduced. We have also found that variable Dirichlet boundaries are problematic for POD model reduction. An extension to the POD method, called POD-DEIM, has been developed for non-linear groundwater models by Stanko et al. (2016). This method uses spatial interpolation points to build the equation system in the

  16. Does patella lowering improve crouch gait in cerebral palsy? Comparative retrospective study.

    Science.gov (United States)

    Desailly, E; Thévenin-Lemoine, C; Khouri, N

    2017-09-01

    Patella lowering aims to improve quadriceps function as a means of correcting crouch gait in patients with cerebral palsy. Few studies have assessed the effects of patella lowering as a component of multilevel surgery. Including patella lowering into the components of multilevel surgery is beneficial in patients with crouch gait and patella alta. In 12 lower limbs with patella alta (Caton-Deschamps index>1.4) in 41 children with cerebral palsy, patella lowering was performed, without distal femoral extension osteotomy or hamstring release. Among limbs with similar surgical procedures (e.g., hamstring lengthening, rectus femoris transfer) except for patella lowering, controls were selected retrospectively by matching on a propensity score for patella lowering. The propensity score was computed based on preoperative knee flexion contracture, knee extension lag, and minimum knee flexion at mid-stance. Clinical and 3D kinematic data were compared between the two groups. The improvement in minimum knee flexion at mid-stance was significantly greater in the group with patellar lowering (-24°±12°vs. -12°±7°). The Gait Deviation Index improved similarly in the two groups. Knee flexion contracture improved only in the group with patellar lowering. Extension lag did not improve in either group. Peak knee flexion during the swing phase remained unchanged in both groups. Patellar lowering is effective in diminishing minimum knee flexion at mid-stance in patients with patella alta and crouch gait due to cerebral palsy. Patellar lowering has not adverse effects on gait. These findings cannot be assumed to apply to patients with normal patellar height. IV (retrospective study). Copyright © 2017. Published by Elsevier Masson SAS.

  17. Improved sugar yields from biomass sorghum feedstocks: comparing low-lignin mutants and pretreatment chemistries.

    Science.gov (United States)

    Godin, Bruno; Nagle, Nick; Sattler, Scott; Agneessens, Richard; Delcarte, Jérôme; Wolfrum, Edward

    2016-01-01

    For biofuel production processes to be economically efficient, it is essential to maximize the production of monomeric carbohydrates from the structural carbohydrates of feedstocks. One strategy for maximizing carbohydrate production is to identify less recalcitrant feedstock cultivars by performing some type of experimental screening on a large and diverse set of candidate materials, or by identifying genetic modifications (random or directed mutations or transgenic plants) that provide decreased recalcitrance. Economic efficiency can also be increased using additional pretreatment processes such as deacetylation, which uses dilute NaOH to remove the acetyl groups of hemicellulose prior to dilute acid pretreatment. In this work, we used a laboratory-scale screening tool that mimics relevant thermochemical pretreatment conditions to compare the total sugar yield of three near-isogenic brown midrib ( bmr ) mutant lines and the wild-type (WT) sorghum cultivar. We then compared results obtained from the laboratory-scale screening pretreatment assay to a large-scale pretreatment system. After pretreatment and enzymatic hydrolysis, the bmr mutants had higher total sugar yields than the WT sorghum cultivar. Increased pretreatment temperatures increased reactivity for all sorghum samples reducing the differences observed at lower reaction temperatures. Deacetylation prior to dilute acid pretreatment increased the total sugar yield for all four sorghum samples, and reduced the differences in total sugar yields among them, but solubilized a sizable fraction of the non-structural carbohydrates. The general trends of increased total sugar yield in the bmr mutant compared to the WT seen at the laboratory scale were observed at the large-scale system. However, in the larger reactor system, the measured total sugar yields were lower and the difference in total sugar yield between the WT and bmr sorghum was larger. Sorghum bmr mutants, which have a reduced lignin content showed

  18. Intensity-Modulated Radiotherapy for Sinonasal Cancer: Improved Outcome Compared to Conventional Radiotherapy

    International Nuclear Information System (INIS)

    Dirix, Piet; Vanstraelen, Bianca; Jorissen, Mark; Vander Poorten, Vincent; Nuyts, Sandra

    2010-01-01

    Purpose: To evaluate clinical outcome and toxicity of postoperative intensity-modulated radiotherapy (IMRT) for malignancies of the nasal cavity and paranasal sinuses. Methods and Materials: Between 2003 and 2008, 40 patients with cancer of the paranasal sinuses (n = 34) or nasal cavity (n = 6) received postoperative IMRT to a dose of 60 Gy (n = 21) or 66 Gy (n = 19). Treatment outcome and toxicity were retrospectively compared with that of a previous patient group (n = 41) who were also postoperatively treated to the same doses but with three-dimensional conformal radiotherapy without intensity modulation, from 1992 to 2002. Results: Median follow-up was 30 months (range, 4-74 months). Two-year local control, overall survival, and disease-free survival were 76%, 89%, and 72%, respectively. Compared to the three-dimensional conformal radiotherapy treatment, IMRT resulted in significantly improved disease-free survival (60% vs. 72%; p = 0.02). No grade 3 or 4 toxicity was reported in the IMRT group, either acute or chronic. The use of IMRT significantly reduced the incidence of acute as well as late side effects, especially regarding skin toxicity, mucositis, xerostomia, and dry-eye syndrome. Conclusions: Postoperative IMRT for sinonasal cancer significantly improves disease-free survival and reduces acute as well as late toxicity. Consequently, IMRT should be considered the standard treatment modality for malignancies of the nasal cavity and paranasal sinuses.

  19. Planning ability improves in a yogic education system compared to a modern.

    Science.gov (United States)

    Rangan, R; Nagendra, H R; Bhat, G Ramachandra

    2008-07-01

    Planning skills play a key role in higher developmental processes. The Tower of London test not only measures planning skills, but also the ability to execute plans. Yoga practices aim to bring about higher development. Can a Yoga-based education system be shown to meet this challenge? This study was aimed at comparing a Modern Education System (MES) with the ancient Yoga-based system of education, the Gurukula Education System (GES), in developing planning skills. Forty-nine boys with ages ranging from 11 to 13 years were selected from each of two residential schools, one MES and the other GES, providing similar ambience and daily routines. The boys were matched for age and socio-economic status. The GES educational program is based around integrated yoga modules while the MES provides a conventional modern education program. Planning and executive abilities were assessed using the Tower of London test at the start and the end of an academic year. Within groups, the pre-post test differences were significant for both groups. However, the between-groups results showed improvement in the GES group compared to the MES group at a P education improve planning and execution skills in school boys, GES is more effective of the two systems.

  20. Comparing and improving reconstruction methods for proxies based on compositional data

    Science.gov (United States)

    Nolan, C.; Tipton, J.; Booth, R.; Jackson, S. T.; Hooten, M.

    2017-12-01

    Many types of studies in paleoclimatology and paleoecology involve compositional data. Often, these studies aim to use compositional data to reconstruct an environmental variable of interest; the reconstruction is usually done via the development of a transfer function. Transfer functions have been developed using many different methods. Existing methods tend to relate the compositional data and the reconstruction target in very simple ways. Additionally, the results from different methods are rarely compared. Here we seek to address these two issues. First, we introduce a new hierarchical Bayesian multivariate gaussian process model; this model allows for the relationship between each species in the compositional dataset and the environmental variable to be modeled in a way that captures the underlying complexities. Then, we compare this new method to machine learning techniques and commonly used existing methods. The comparisons are based on reconstructing the water table depth history of Caribou Bog (an ombrotrophic Sphagnum peat bog in Old Town, Maine, USA) from a new 7500 year long record of testate amoebae assemblages. The resulting reconstructions from different methods diverge in both their resulting means and uncertainties. In particular, uncertainty tends to be drastically underestimated by some common methods. These results will help to improve inference of water table depth from testate amoebae. Furthermore, this approach can be applied to test and improve inferences of past environmental conditions from a broad array of paleo-proxies based on compositional data

  1. A Comparative Study of Effectiveness of Neurofeedback and Ritalin on Improving Conduct Problems and Hyperactivity

    Directory of Open Access Journals (Sweden)

    K. Khoushabi

    2012-01-01

    Full Text Available Introduction & Objective: There are varieties of interventions to treatment of ADHD, among which drug therapy, behavior therapy, parental management training and neurofeedback can be cited. The present study designed to investigate and compare the effectiveness of neurofeedback and Ritalin on improving conduct problems and hyperactivity. Materials & Methods: Quasi-experimental research method with pretest-post test design has been applied in the research. Statistical population of the study consisted of ADHD children of Tehran. The study samples of the study were patients referred to children psychiatric clinic. Based on the purpose of the study' 20 children were randomly selected and classified into 2 groups according to random assignment. CPRS-48 (parent form was administered by parents before and after the treatments as research tools. Recruited data was analyzed by SPSS-19 in two sections of descriptive and inferential statistics. ANCOVA revealed some differences in the groups. Results: The findings of the study showed that there was a significant difference between Ritalin and neurofeedback on improving conduct problems; in other words, Ritalin was more effective in alleviating the problems. Also there was no significant difference between the interventions on improving hyperactivity index. Conclusion: With respect to more efficiency of Ritalin than neurofeedback on certain continuum of signs/symptoms of ADHD, as a whole, preferences of interventions should be based on type, magnitude and severity of the syndrome(Sci J Hamadan Univ Med Sci 2012;18(4:53-59

  2. CYberinfrastructure for COmparative effectiveness REsearch (CYCORE): improving data from cancer clinical trials.

    Science.gov (United States)

    Patrick, Kevin; Wolszon, Laura; Basen-Engquist, Karen M; Demark-Wahnefried, Wendy; Prokhorov, Alex V; Barrera, Stephanie; Baru, Chaitan; Farcas, Emilia; Krueger, Ingolf; Palmer, Doug; Raab, Fred; Rios, Phil; Ziftci, Celal; Peterson, Susan

    2011-03-01

    Improved approaches and methodologies are needed to conduct comparative effectiveness research (CER) in oncology. While cancer therapies continue to emerge at a rapid pace, the review, synthesis, and dissemination of evidence-based interventions across clinical trials lag in comparison. Rigorous and systematic testing of competing therapies has been clouded by age-old problems: poor patient adherence, inability to objectively measure the environmental influences on health, lack of knowledge about patients' lifestyle behaviors that may affect cancer's progression and recurrence, and limited ability to compile and interpret the wide range of variables that must be considered in the cancer treatment. This lack of data integration limits the potential for patients and clinicians to engage in fully informed decision-making regarding cancer prevention, treatment, and survivorship care, and the translation of research results into mainstream medical care. Particularly important, as noted in a 2009 report on CER to the President and Congress, the limited focus on health behavior-change interventions was a major hindrance in this research landscape (DHHS 2009). This paper describes an initiative to improve CER for cancer by addressing several of these limitations. The Cyberinfrastructure for Comparative Effectiveness Research (CYCORE) project, informed by the National Science Foundation's 2007 report "Cyberinfrastructure Vision for 21(st) Century Discovery" has, as its central aim, the creation of a prototype for a user-friendly, open-source cyberinfrastructure (CI) that supports acquisition, storage, visualization, analysis, and sharing of data important for cancer-related CER. Although still under development, the process of gathering requirements for CYCORE has revealed new ways in which CI design can significantly improve the collection and analysis of a wide variety of data types, and has resulted in new and important partnerships among cancer researchers engaged in

  3. Hardystonite improves biocompatibility and strength of electrospun polycaprolactone nanofibers over hydroxyapatite: A comparative study

    Energy Technology Data Exchange (ETDEWEB)

    Jaiswal, Amit K. [Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai, 400076 (India); Chhabra, Hemlata; Kadam, Sachin S. [Department of Chemical Engineering, Indian Institute of Technology Bombay, Powai, Mumbai, 400076 (India); Londhe, Kishore; Soni, Vivek P. [Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai, 400076 (India); Bellare, Jayesh R., E-mail: jb@iitb.ac.in [Department of Chemical Engineering, Indian Institute of Technology Bombay, Powai, Mumbai, 400076 (India)

    2013-07-01

    The aim of this study was to compare physico-chemical and biological properties of hydroxyapatite (HA) and hardystonite (HS) based composite scaffolds. Hardystonite (Ca{sub 2}ZnSi{sub 2}O{sub 7}) powders were synthesized by a sol–gel method while polycaprolactone–hardystonite (PCL–HS) and polycaprolactone–hydroxyapatite (PCL–HA) were fabricated in nanofibrous form by electrospinning. The physico-chemical and biological properties such as tensile strength, cell proliferation, cell infiltration and alkaline phosphatase activity were determined on both kinds of scaffolds. We found that PCL–HS scaffolds had better mechanical strength compared to PCL–HA scaffolds. Addition of HA and HS particles to PCL did not show any inhibitory effect on blood biocompatibility of scaffolds when assessed by hemolysis assay. The in vitro cellular behavior was evaluated by growing murine adipose-tissue-derived stem cells (mE-ASCs) over the scaffolds. Enhanced cell proliferation and improved cellular infiltrations on PCL–HS scaffolds were observed when compared to HA containing scaffolds. PCL–HS scaffolds exhibited a significant increase in alkaline phosphatase (ALP) activity and better mineralization of the matrix in comparison to PCL–HA scaffolds. These results clearly demonstrate the stimulatory role of Zn and Si present in HS based composite scaffolds, suggesting their potential application for bone tissue engineering. - Highlights: • The osteogenic potential of PCL–HA and PCL–HS scaffolds was compared. • PCL–HS scaffolds showed better mechanical strength as compared to PCL–HA scaffolds. • Enhanced cell proliferation and infiltration were observed on PCL–HS scaffolds. • mE-ASCs showed better ALP activity and matrix mineralization on PCL–HS scaffolds.

  4. Persufflation Improves Pancreas Preservation When Compared With the Two-Layer Method

    Science.gov (United States)

    Scott, W.E.; O'Brien, T.D.; Ferrer-Fabrega, J.; Avgoustiniatos, E.S.; Weegman, B.P.; Anazawa, T.; Matsumoto, S.; Kirchner, V.A.; Rizzari, M.D.; Murtaugh, M.P.; Suszynski, T.M.; Aasheim, T.; Kidder, L.S.; Hammer, B.E.; Stone, S.G.; Tempelman, L.; Sutherland, D.E.R.; Hering, B.J.; Papas, K.K.

    2010-01-01

    Islet transplantation is emerging as a promising treatment for patients with type 1 diabetes. It is important to maximize viable islet yield for each organ due to scarcity of suitable human donor pancreata, high cost, and the high dose of islets required for insulin independence. However, organ transport for 8 hours using the two-layer method (TLM) frequently results in lower islet yields. Since efficient oxygenation of the core of larger organs (eg, pig, human) in TLM has recently come under question, we investigated oxygen persufflation as an alternative way to supply the pancreas with oxygen during preservation. Porcine pancreata were procured from non–heart-beating donors and preserved by either TLM or persufflation for 24 hours and fixed. Biopsies were collected from several regions of the pancreas, sectioned, stained with hematoxylin and eosin, and evaluated by a histologist. Persufflated tissues exhibited distended capillaries due to gas perfusion and significantly less autolysis/cell death than regions not exposed to persufflation or tissues exposed to TLM. The histology presented here suggests that after 24 hours of preservation, persufflation dramatically improves tissue health when compared with TLM. These results indicate the potential for persufflation to improve viable islet yields and extend the duration of preservation, allowing more donor organs to be utilized. PMID:20692396

  5. A Comparative Study on Controllers for Improving Transient Stability of DFIG Wind Turbines During Large Disturbances

    Directory of Open Access Journals (Sweden)

    Minh Quan Duong

    2018-02-01

    Full Text Available Under power system short-circuits, the Doubly-Fed Induction Generator (DFIG Wind Turbines (WT are required to be equipped with crowbar protections to preserve the lifetime of power electronics devices. When the crowbar is switched on, the rotor windings are short-circuited. In this case, the DFIG behaves like a squirrel-cage induction generator (SCIG and can adsorb reactive power, which can affect the power system. A DFIG based-fault-ride through (FRT scheme with crowbar, rotor-side and grid-side converters has recently been proposed for improving the transient stability: in particular, a hybrid cascade Fuzzy-PI-based controlling technique has been demonstrated to be able to control the Insulated Gate Bipolar Transistor (IGBT based frequency converter in order to enhance the transient stability. The performance of this hybrid control scheme is analyzed here and compared to other techniques, under a three-phase fault condition on a single machine connected to the grid. In particular, the transient operation of the system is investigated by comparing the performance of the hybrid system with conventional proportional-integral and fuzzy logic controller, respectively. The system validation is carried out in Simulink, confirming the effectiveness of the coordinated advanced fuzzy logic control.

  6. Heated humidification improves clinical outcomes, compared to a heat and moisture exchanger in children with tracheostomies.

    Science.gov (United States)

    McNamara, David G; Asher, M Innes; Rubin, Bruce K; Stewart, Alistair; Byrnes, Catherine A

    2014-01-01

    The upper airway humidifies and warms inspired gases before they reach the trachea, a process bypassed by the insertion of a tracheostomy, necessitating humidification of inspired gases. The optimal method of humidification is not known. We conducted a short-term 20-hour study and a long-term 10-week randomized crossover study comparing a heated humidifier (HH) to a heat and moisture exchanger (HME) in children with established tracheostomies. Subjects were assessed for clinical events, clinical examination findings, airway cytokine levels, and airway secretion viscoelasticity. For the short-term study, 15 children were recruited; for the long-term study, 14 children were recruited. Children using the HH had decreased respiratory examination score (P < .001) but no change in clinical events over the short term. There was a decrease in acute clinical events (P = .008) in the long-term study. No differences were found in airway secretion viscoelasticity results or cytokine levels in either study, but these sample numbers were limited. Over 20 hours use, HH, compared to HME, improved work of breathing. Over a longer 10 week treatment period HH resulted in decreased adverse clinical events.

  7. Combined platelet-rich plasma and lipofilling treatment provides great improvement in facial skin-induced lesion regeneration for scleroderma patients

    OpenAIRE

    Virzì, Francesco; Bianca, Paola; Giammona, Alessandro; Apuzzo, Tiziana; Di Franco, Simone; Mangiapane, Laura Rosa; Colorito, Maria Luisa; Catalano, Dario; Scavo, Emanuela; Nicotra, Annalisa; Benfante, Antonina; Pistone, Giuseppe; Caputo, Valentina; Dieli, Francesco; Pirrello, Roberto

    2017-01-01

    Background The use of stem cells, including mesenchymal stem cells (MSCs), for regenerative medicine is gaining interest for the clinical benefits so far obtained in patients. This study investigates the use of adipose autologous tissue in combination with platelet-rich plasma (PRP) to improve the clinical outcome of patients affected by systemic sclerosis (SSc). Methods Adipose-derived mesenchymal stem cells (AD-MSCs) and PRPs were purified from healthy donors and SSc patients. The multiline...

  8. Comparative effectiveness of different Rhizobium sp. for improving growth and yield of maize (Zea mays L.

    Directory of Open Access Journals (Sweden)

    Ijaz Mehboob, Zahir Ahmad Zahir, Muhammad Arshad, Muhammad Khalid

    2012-05-01

    Full Text Available During the last couple of decades, it has been demonstrated that rhizobia can associate with roots of non-legumes also without forming true nodules, and can promote their growth by using one or more of the direct or indirect mechanisms of actions. This work examines the growth and yield responses of maize to inoculation with different species of rhizobia, isolated from the root nodules of chickpea (Cicer arietinum L., lentil (Lens culinaris M. and mung bean (Vigna radiata L. in pots and fields. Twenty isolates of rhizobia were isolated from root nodules each of mung bean, lentil and chickpea and were screened under axenic conditions. On the basis of their promising performance under axenic conditions, nine most efficient isolates (three from each legume host were selected, characterized and further evaluated for their growth promoting activities by conducting pot and field experiments. Results of pot experiment revealed that maximum increase in grain yield, 1000 grain weight, N, P and K uptake (up to 47.89, 54.52, 73.46, 84.66 and 59.19% by CRI28, respectively, over un-inoculated control was produced by the isolate of Mesorhizobium ciceri. Whereas, maximum improvement in rest of the parameters was caused by the isolates of Rhizobium phaseoli (i.e. fresh biomass, straw yield and root length up to 36.30% by A18, 25.46% by S6 and 81.89% by A18, respectively over un-inoculated control. Rhizobium leguminosarum isolates came out to be the least effective among the species tested. Similarly, all the selected isolates improved the growth and yield attributing parameters in fields as well but with varying capacity compared with un-inoculated control. The selected isolates of Mesorhizobium ciceri and Rhizobium phaseoli again remained superior compared to the isolates of Rhizobium leguminosarum under field conditions. The results of this study imply that rhizobium species had potential to promote growth and yield of maize but this technology should be

  9. Regulations, policies and practices concerning work stress prevention and improving well-being at work in Sweden, Great-Britain, Germany, France and the Netherlands

    NARCIS (Netherlands)

    Gier, E. de; Kompier, M.; Draaisma, D.; Smulders, P.

    1994-01-01

    At the request of the Dutch Ministry of Social Affairs and Employment, the TNO Institute of Preventive Health Care (NIPG) carried out a comparative survey of regulations, policies and practices in the Netherlands, Sweden, the United Kingdom, Germany and France with regard to the prevention of work

  10. Improved Biofilm Antimicrobial Activity of Polyethylene Glycol Conjugated Tobramycin Compared to Tobramycin in Pseudomonas aeruginosa Biofilms.

    Science.gov (United States)

    Du, Ju; Bandara, H M H N; Du, Ping; Huang, Hui; Hoang, Khang; Nguyen, Dang; Mogarala, Sri Vasudha; Smyth, Hugh D C

    2015-05-04

    The objective of this study was to develop a functionally enhanced antibiotic that would improve the therapeutic activity against bacterial biofilms. Tobramycin was chemically conjugated with polyethylene glycol (PEG) via site-specific conjugation to form PEGylated-tobramycin (Tob-PEG). The antibacterial efficacy of Tob-PEG, as compared to tobramycin, was assessed on the planktonic phase and biofilms phase of Pseudomonas aeruginosa. The minimum inhibitory concentration (MIC80) of Tob-PEG was higher (13.9 μmol/L) than that of tobramycin (1.4 μmol/L) in the planktonic phases. In contrast, the Tob-PEG was approximately 3.2-fold more effective in eliminating bacterial biofilms than tobramycin. Specifically, Tob-PEG had a MIC80 lower than those exhibited by tobramycin (27.8 μmol/L vs 89.8 μmol/L). Both confocal laser scanning microscopy and scanning electron microscopy further confirmed these data. Thus, modification of antimicrobials by PEGylation appears to be a promising approach for overcoming the bacterial resistance in the established biofilms of Pseudomonas aeruginosa.

  11. Early warning of climate tipping points from critical slowing down: comparing methods to improve robustness

    Science.gov (United States)

    Lenton, T. M.; Livina, V. N.; Dakos, V.; Van Nes, E. H.; Scheffer, M.

    2012-01-01

    We address whether robust early warning signals can, in principle, be provided before a climate tipping point is reached, focusing on methods that seek to detect critical slowing down as a precursor of bifurcation. As a test bed, six previously analysed datasets are reconsidered, three palaeoclimate records approaching abrupt transitions at the end of the last ice age and three models of varying complexity forced through a collapse of the Atlantic thermohaline circulation. Approaches based on examining the lag-1 autocorrelation function or on detrended fluctuation analysis are applied together and compared. The effects of aggregating the data, detrending method, sliding window length and filtering bandwidth are examined. Robust indicators of critical slowing down are found prior to the abrupt warming event at the end of the Younger Dryas, but the indicators are less clear prior to the Bølling-Allerød warming, or glacial termination in Antarctica. Early warnings of thermohaline circulation collapse can be masked by inter-annual variability driven by atmospheric dynamics. However, rapidly decaying modes can be successfully filtered out by using a long bandwidth or by aggregating data. The two methods have complementary strengths and weaknesses and we recommend applying them together to improve the robustness of early warnings. PMID:22291229

  12. Improved growth of preterm infants receiving mother's own raw milk compared with pasteurized donor milk.

    Science.gov (United States)

    Montjaux-Régis, N; Cristini, C; Arnaud, C; Glorieux, I; Vanpee, M; Casper, C

    2011-12-01

    To determine whether growth, feeding tolerance and infectious events of preterm infants is related to the proportion of intake of mother's own raw milk (maternal milk) versus pooled pasteurized banked breast milk (donor milk). This is a prospective observational study of 55 premature infants born less than 32 weeks of gestational age admitted to the neonatal intensive care unit at the Children's Hospital of Toulouse during two 6-month periods from 2003 to 2005. Enrolled infants were exclusively on enteral feeds with maternal milk ± donor milk. Mean gestational age was 28.6 weeks (SD 1.5) and mean birth weight 1105 grams (SD 282). During the time of exclusively breast milk feeds, weight gain (g/kg/day) was correlated to the proportion of maternal milk consumed (p = 0.0048, r = 0.4). Necrotizing enterocolitis was inversely correlated to the amount of maternal milk. The amount of maternal milk did not impact on infectious events. Mother's own raw milk improves weight gain compared with donor milk in preterm infants. Lactation strategies should be sought that helps mothers to increase their milk production. © 2011 The Author(s)/Acta Paediatrica © 2011 Foundation Acta Paediatrica.

  13. Improving the transparency of health information found on the internet through the honcode: a comparative study.

    Science.gov (United States)

    Laversin, Sabine; Baujard, Vincent; Gaudinat, Arnaud; Simonet, Maria-Ana; Boyer, Célia

    2011-01-01

    This study aims to show that health websites not asking for HONcode certification (Control sample websites A) do not respect elementary ethical standards such as the HONcode. The HONcode quality and ethical standards and the certification process have been developed by the Health on the Net Foundation to improve the transparency of the health and medical information found on the Internet. We compared the compliance with the 8 HONcode principles, and respectively the respect of principles 1 (authority), 4 (assignment), 5 (justification) and 8 (honesty in advertising and editorial policy) by certified websites (A) and by health websites which have not requested the certification (B). The assessment of the HONcode compliance was performed by HON evaluators by the same standards for all type of sites. Results shows that 0.6% of health websites not asking for HONcode certification does respect the eight HONcode ethical standards vs. 89% of certified websites. Regarding the principles 1, 4, 5 and 8, 1.2% of B respect these principles vs. 92% for A. The certification process led health websites to respect the ethical and quality standards such as the HONcode, and disclosing the production process of the health website.

  14. Does cryotherapy improve skin circulation compared with compression and elevation in preventing venous leg ulcers?

    Science.gov (United States)

    Kelechi, Teresa J; Mueller, Martina; Madisetti, Mohan; Prentice, Margie A; Dooley, Mary J

    2017-08-01

    This trial compared skin blood flow, temperature and incidence of venous leg ulcers in patients with chronic venous disease using compression wraps and elevation pillows. Patients with CEAP C4 skin damage and C5 history of ulcers were randomly assigned to a cryotherapy intervention (n = 138) or placebo cuff control (n = 138) applied to the lower legs over 9 months. The time the ulcers healed prior to enrollment in the study for the cryotherapy group ranged from 1 to 2218 days (n = 8, median = 32 days); for the control group, the range was 24 to 489 days (n = 6, median = 390 days). There were no statistically significant blood flow changes measured in perfusion units with a laser Doppler flowmetre within or between the groups; mean difference between the groups was 0·62, P = 0·619. No differences were noted in skin temperature measured with an infrared thermometer within and between the groups; mean difference between the groups was -0·17°C, P = 0·540. Cryotherapy did not improve skin blood flow or temperature and did not show efficacy in preventing ulcers. However, at least 30% of intervention and 50% of control participants were anticipated to develop an ulcer during the study; only ∼7% occurred. These findings suggest that strict adherence to standard of care decreases the incidence of leg ulcers and remains a best practice for leg ulcer prevention. © 2016 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  15. Combined platelet-rich plasma and lipofilling treatment provides great improvement in facial skin-induced lesion regeneration for scleroderma patients.

    Science.gov (United States)

    Virzì, Francesco; Bianca, Paola; Giammona, Alessandro; Apuzzo, Tiziana; Di Franco, Simone; Mangiapane, Laura Rosa; Colorito, Maria Luisa; Catalano, Dario; Scavo, Emanuela; Nicotra, Annalisa; Benfante, Antonina; Pistone, Giuseppe; Caputo, Valentina; Dieli, Francesco; Pirrello, Roberto; Stassi, Giorgio

    2017-10-23

    The use of stem cells, including mesenchymal stem cells (MSCs), for regenerative medicine is gaining interest for the clinical benefits so far obtained in patients. This study investigates the use of adipose autologous tissue in combination with platelet-rich plasma (PRP) to improve the clinical outcome of patients affected by systemic sclerosis (SSc). Adipose-derived mesenchymal stem cells (AD-MSCs) and PRPs were purified from healthy donors and SSc patients. The multilineage differentiation potential of AD-MSCs and their genotypic-phenotypic features were investigated. A cytokine production profile was evaluated on AD-MSCs and PRPs from both healthy subjects and SSc patients. The adipose tissue-derived cell fraction, the so-called stromal vascular fraction (SVF), was coinjected with PRP in the perioral area of SSc patients. Histopathological and phenotypical analysis of adipose tissue from SSc patients revealed a disorganization of its distinct architecture coupled with an altered cell composition. Although AD-MSCs derived from SSc patients showed high multipotency, they failed to sustain a terminally differentiated progeny. Furthermore, SVFs derived from SSc patients differed from healthy donors in their MSC-like traits coupled with an aberrant cytokine production profile. Finally, the administration of PRP in combination with autologous SVF improved buccal's rhyme, skin elasticity and vascularization for all of the SSc patients enrolled in this study. This innovative regenerative therapy could be exploited for the treatment of chronic connective tissue diseases, including SSc.

  16. Combined platelet-rich plasma and lipofilling treatment provides great improvement in facial skin-induced lesion regeneration for scleroderma patients

    Directory of Open Access Journals (Sweden)

    Francesco Virzì

    2017-10-01

    Full Text Available Abstract Background The use of stem cells, including mesenchymal stem cells (MSCs, for regenerative medicine is gaining interest for the clinical benefits so far obtained in patients. This study investigates the use of adipose autologous tissue in combination with platelet-rich plasma (PRP to improve the clinical outcome of patients affected by systemic sclerosis (SSc. Methods Adipose-derived mesenchymal stem cells (AD-MSCs and PRPs were purified from healthy donors and SSc patients. The multilineage differentiation potential of AD-MSCs and their genotypic–phenotypic features were investigated. A cytokine production profile was evaluated on AD-MSCs and PRPs from both healthy subjects and SSc patients. The adipose tissue-derived cell fraction, the so-called stromal vascular fraction (SVF, was coinjected with PRP in the perioral area of SSc patients. Results Histopathological and phenotypical analysis of adipose tissue from SSc patients revealed a disorganization of its distinct architecture coupled with an altered cell composition. Although AD-MSCs derived from SSc patients showed high multipotency, they failed to sustain a terminally differentiated progeny. Furthermore, SVFs derived from SSc patients differed from healthy donors in their MSC-like traits coupled with an aberrant cytokine production profile. Finally, the administration of PRP in combination with autologous SVF improved buccal’s rhyme, skin elasticity and vascularization for all of the SSc patients enrolled in this study. Conclusions This innovative regenerative therapy could be exploited for the treatment of chronic connective tissue diseases, including SSc.

  17. CMAQv5.1 with new dust IMPROVE site compare files

    Data.gov (United States)

    U.S. Environmental Protection Agency — CMAQv5.1 with a new dust module IMPROVE sitex files containing 24-hr (every 3rd day) paired model/ob data for the IMPROVE network. This dataset is associated with...

  18. Revolutionary impact of PET and PET-CT on the day-to-day practice of medicine and its great potential for improving future health care

    International Nuclear Information System (INIS)

    Basu, S.; Alavi, A.

    2009-01-01

    In this communication, we present an overview of the impact and advantages of PET and PET-CT fusion imaging in the practice of medicine. We also discuss the evolution of this promising molecular imaging technique since its inception and the future prospects of the combined structure-function approach. Superior contrast resolution, accurate quantification and above all optimal image quality aid in improved diagnosis of many serious disorders including cancer. We speculate that this powerful imaging approach will almost completely replace most other conventional methods in the future. Currently, 18[F]-fluorodeoxyglucose (FDG) is the main radiopharmaceutical employed for PET studies around the globe. With the availability of high quality PET images on a routine basis in most centres around the world and the likelihood that several other useful PET tracers will be approved in the near future for routine clinical applications, this technique will likely become essential in almost any medical disorder. (authors)

  19. Human decellularized bone scaffolds from aged donors show improved osteoinductive capacity compared to young donor bone.

    Directory of Open Access Journals (Sweden)

    Christopher A Smith

    Full Text Available To improve the safe use of allograft bone, decellularization techniques may be utilized to produce acellular scaffolds. Such scaffolds should retain their innate biological and biomechanical capacity and support mesenchymal stem cell (MSC osteogenic differentiation. However, as allograft bone is derived from a wide age-range, this study aimed to determine whether donor age impacts on the ability an osteoinductive, acellular scaffold produced from human bone to promote the osteogenic differentiation of bone marrow MSCs (BM-MSC. BM-MSCs from young and old donors were seeded on acellular bone cubes from young and old donors undergoing osteoarthritis related hip surgery. All combinations resulted in increased osteogenic gene expression, and alkaline phosphatase (ALP enzyme activity, however BM-MSCs cultured on old donor bone displayed the largest increases. BM-MSCs cultured in old donor bone conditioned media also displayed higher osteogenic gene expression and ALP activity than those exposed to young donor bone conditioned media. ELISA and Luminex analysis of conditioned media demonstrated similar levels of bioactive factors between age groups; however, IGF binding protein 1 (IGFBP1 concentration was significantly higher in young donor samples. Additionally, structural analysis of old donor bone indicated an increased porosity compared to young donor bone. These results demonstrate the ability of a decellularized scaffold produced from young and old donors to support osteogenic differentiation of cells from young and old donors. Significantly, the older donor bone produced greater osteogenic differentiation which may be related to reduced IGFBP1 bioavailability and increased porosity, potentially explaining the excellent clinical results seen with the use of allograft from aged donors.

  20. Great Lakes Literacy Principles

    Science.gov (United States)

    Fortner, Rosanne W.; Manzo, Lyndsey

    2011-03-01

    Lakes Superior, Huron, Michigan, Ontario, and Erie together form North America's Great Lakes, a region that contains 20% of the world's fresh surface water and is home to roughly one quarter of the U.S. population (Figure 1). Supporting a $4 billion sport fishing industry, plus $16 billion annually in boating, 1.5 million U.S. jobs, and $62 billion in annual wages directly, the Great Lakes form the backbone of a regional economy that is vital to the United States as a whole (see http://www.miseagrant.umich.edu/downloads/economy/11-708-Great-Lakes-Jobs.pdf). Yet the grandeur and importance of this freshwater resource are little understood, not only by people in the rest of the country but also by many in the region itself. To help address this lack of knowledge, the Centers for Ocean Sciences Education Excellence (COSEE) Great Lakes, supported by the U.S. National Science Foundation and the National Oceanic and Atmospheric Administration, developed literacy principles for the Great Lakes to serve as a guide for education of students and the public. These “Great Lakes Literacy Principles” represent an understanding of the Great Lakes' influences on society and society's influences on the Great Lakes.

  1. The Next Great Generation?

    Science.gov (United States)

    Brownstein, Andrew

    2000-01-01

    Discusses ideas from a new book, "Millennials Rising: The Next Great Generation," (by Neil Howe and William Strauss) suggesting that youth culture is on the cusp of a radical shift with the generation beginning with this year's college freshmen who are typically team oriented, optimistic, and poised for greatness on a global scale. Includes a…

  2. Hydrological services and biodiversity conservation under forestation scenarios: comparing options to improve watershed management

    Science.gov (United States)

    Carvalho-Santos, Claudia; Nunes, João Pedro; Sousa-Silva, Rita; Gonçalves, João; Pradinho Honrado, João

    2015-04-01

    and biodiversity conservation value were assessed using the Spearman rank correlation. The current delivery of hydrological services in the Vez watershed is higher at the high and low mountain sub-basins, with lower provision in the valley. The overall performance for water quantity and timing is better under the shrubland and the oak scenarios, when compared to the eucalyptus/pine scenario, which performs better for flood regulation and erosion control, especially in the low mountain sub-basin. However, this scenario is the one with more spatial trade-offs with biodiversity conservation value, especially inside protected areas. Several strategies may be suggested for effective land use planning in the Vez watershed. Eucalyptus/pine is the scenario with the best results for flood regulation and soil erosion control, associated to the positive revenues from the pulp production industry. However, cautions should be taken regarding strategies for biodiversity conservation (preferably by favoring native oak species), as well as the potential increase in fire risk. This study highlights SWAT as an effective tool for modelling and mapping hydrological services generated at the watershed scale, therefore contributing to improve the options for land management.

  3. Information Operations Versus Civilian Marketing and Advertising: A Comparative Analysis to Improve IO Planning and Strategy

    National Research Council Canada - National Science Library

    Chilton, Dan

    2008-01-01

    .... must re-focus its efforts on Information Operations to achieve GWOT objectives. In an environment where rapidly advancing technology is drastically improving the individual's ability to conduct IO against the U.S...

  4. A Comparative Analysis of Transmission Control Protocol Improvement Techniques over Space-Based Transmission Media

    National Research Council Canada - National Science Library

    Lawson, Joseph M

    2006-01-01

    The purpose of this study was to assess the throughput improvement afforded by the various TCP optimization techniques, with respect to a simulated geosynchronous satellite system, to provide a cost...

  5. Great Indoors Awards 2007

    Index Scriptorium Estoniae

    2007-01-01

    Hollandis Maastrichtis jagati 17. XI esimest korda rahvusvahelist auhinda The Great Indoors Award. Aasta sisekujundusfirmaks valiti Masamichi Katayama asutatud Wonderwall. Auhinna said veel Zaha Hadid, Heatherwick Studio, Ryui Nakamura Architects ja Item Idem

  6. Great Lakes Bathymetry

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Bathymetry of Lakes Michigan, Erie, Saint Clair, Ontario and Huron has been compiled as a component of a NOAA project to rescue Great Lakes lake floor geological and...

  7. Comparability of the Social Skills Improvement System to the Social Skills Rating System: A Norwegian Study

    Science.gov (United States)

    Gamst-Klaussen, Thor; Rasmussen, Lene-Mari P.; Svartdal, Frode; Strømgren, Børge

    2016-01-01

    The Social Skills Improvement System-Rating Scales (SSIS-RS) is a multi-informant instrument assessing social skills and problem behavior in children and adolescents. It is a revised version of the Social Skills Rating System (SSRS). A Norwegian translation of the SSRS has been validated, but this has not yet been done for the Norwegian…

  8. Measuring and Comparing Descend in Elite Race Cycling with a Perspective on Real-Time Feedback for Improving Individual Performance

    OpenAIRE

    Reijne, M.M.; Bregman, D.J.J.; Schwab, A.L.; Espinosa, Hugo G.; Rowlands, David R.; Shepherd, Jonathan; Thiel, David V.

    2018-01-01

    Descend technique and performance vary among elite racing cyclists and it is not clear what slower riders should do to improve their performance. An observation study was performed of the descending technique of members of a World Tour cycling team and the technique of each member was compared with the fastest descender amongst them. The obtained data gives us guidelines for rider specific feedback in order to improve his performance. The bicycles were equipped with a system that could measur...

  9. Comparative evaluation of audio and audio - tactile methods to improve oral hygiene status of visually impaired school children

    OpenAIRE

    R Krishnakumar; Swarna Swathi Silla; Sugumaran K Durai; Mohan Govindarajan; Syed Shaheed Ahamed; Logeshwari Mathivanan

    2016-01-01

    Background: Visually impaired children are unable to maintain good oral hygiene, as their tactile abilities are often underdeveloped owing to their visual disturbances. Conventional brushing techniques are often poorly comprehended by these children and hence, it was decided to evaluate the effectiveness of audio and audio-tactile methods in improving the oral hygiene of these children. Objective: To evaluate and compare the effectiveness of audio and audio-tactile methods in improving oral h...

  10. Employees Motivation and Openness for Continuous Improvement: Comparative Study in Polish and Japanese Companies

    Directory of Open Access Journals (Sweden)

    Stadnicka Dorota

    2017-09-01

    Full Text Available Currently, companies must change and evolve to keep pace with the changing environment, customers’ requirements and to be better than their competitors. The changes result from the need to adapt the products to new customers’ requirements as well as to maintain competitive prices of their products. Therefore, companies should be flexible to guarantee short lead time and minimalize their costs to offer a good price for the customers. At the same time, companies should create good work environment for their employees in order to get them involved in improvement processes. In order to survive and develop companies should motivate and involve their employees into a continuous improvement process in different areas of the company. Unfortunately, as based on the companies’ practice and previous research, in many cases employees are not willing to engage in the company development. Continuous improvement is the basis of the philosophy of Quality Management and Lean Manufacturing, which come from Toyota Production System (TPS. The TPS eventually spread throughout the world, and it is held up as an example of the proper management of a production system. The assumptions of TPS system were used to build systems in other companies, but not always with the same success as it was in Toyota. For this reason, the authors of this paper seek to answer the question of whether there are differences in engagement in a continuous improvement process between employees in a Japanese company and a Polish company operating in the same industry and realizing the similar manufacturing. In order to verify this, the research was conducted in two manufacturing companies which operate in the automotive industry. The results of the study and their analysis are presented in the work.

  11. Improving the Comparability and Local Usefulness of International Assessments: A Look Back and a Way Forward

    Science.gov (United States)

    Rutkowski, Leslie; Rutkowski, David

    2018-01-01

    Over time international large-scale assessments have grown in terms of number of studies, cycles, and participating countries, many of which are a heterogeneous mix of economies, languages, cultures, and geography. This heterogeneity has meaningful consequences for comparably measuring both achievement and non-achievement constructs, such as…

  12. Improving staging accuracy in colon and rectal cancer by sentinel lymph node mapping: A comparative study

    NARCIS (Netherlands)

    van der Zaag, E. S.; Buskens, C. J.; Kooij, N.; Akol, H.; Peters, H. M.; Bouma, W. H.; Bemelman, W. A.

    2009-01-01

    Aim: To compare the predictive value of sentinel lymph node (SN) mapping between patients with colon and rectal cancer. Patients and methods: An ex vivo SN procedure was performed in 100 patients with colon and 32 patients with rectal cancer. If the sentinel node was negative, immunohistochemical

  13. An intervention to improve interprofessional collaboration and communications: a comparative qualitative study.

    Science.gov (United States)

    Rice, Kathleen; Zwarenstein, Merrick; Conn, Lesley Gotlib; Kenaszchuk, Chris; Russell, Ann; Reeves, Scott

    2010-07-01

    Interprofessional communication and collaboration are promoted by policymakers as fundamental building blocks for improving patient safety and meeting the demands of increasingly complex care. This paper reports qualitative findings of an interprofessional intervention designed to improve communication and collaboration between different professions in general internal medicine (GIM) hospital wards in Canada. The intervention promoted self-introduction by role and profession to a collaborating colleague in relation to the shared patient, a question or communication regarding the patient, to be followed by an explicit request for feedback from the partner professional. Implementation and uptake of the intervention were evaluated using qualitative methods, including 90 hours of ethnographic observations and interviews collected in both intervention and comparison wards. Documentary data were also collected and analysed. Fieldnotes and interviews were transcribed and analysed thematically. Our findings suggested that the intervention did not produce the anticipated changes in communication and collaboration between health professionals, and allowed us to identify barriers to the implementation of effective collaboration interventions. Despite initially offering verbal support, senior physicians, nurses, and allied health professionals minimally explained the intervention to their junior colleagues and rarely role-modelled or reiterated support for it. Professional resistances as well as the fast paced, interruptive environment reduced opportunities or incentive to enhance restrictive interprofessional relationships. In a healthcare setting where face-to-face spontaneous interprofessional communication is not hostile but is rare and impersonal, the perceived benefits of improvement are insufficient to implement simple and potentially beneficial communication changes, in the face of habit, and absence of continued senior clinician and management support.

  14. Projecting future expansion of invasive species: comparing and improving methodologies for species distribution modeling.

    Science.gov (United States)

    Mainali, Kumar P; Warren, Dan L; Dhileepan, Kunjithapatham; McConnachie, Andrew; Strathie, Lorraine; Hassan, Gul; Karki, Debendra; Shrestha, Bharat B; Parmesan, Camille

    2015-12-01

    Modeling the distributions of species, especially of invasive species in non-native ranges, involves multiple challenges. Here, we developed some novel approaches to species distribution modeling aimed at reducing the influences of such challenges and improving the realism of projections. We estimated species-environment relationships for Parthenium hysterophorus L. (Asteraceae) with four modeling methods run with multiple scenarios of (i) sources of occurrences and geographically isolated background ranges for absences, (ii) approaches to drawing background (absence) points, and (iii) alternate sets of predictor variables. We further tested various quantitative metrics of model evaluation against biological insight. Model projections were very sensitive to the choice of training dataset. Model accuracy was much improved using a global dataset for model training, rather than restricting data input to the species' native range. AUC score was a poor metric for model evaluation and, if used alone, was not a useful criterion for assessing model performance. Projections away from the sampled space (i.e., into areas of potential future invasion) were very different depending on the modeling methods used, raising questions about the reliability of ensemble projections. Generalized linear models gave very unrealistic projections far away from the training region. Models that efficiently fit the dominant pattern, but exclude highly local patterns in the dataset and capture interactions as they appear in data (e.g., boosted regression trees), improved generalization of the models. Biological knowledge of the species and its distribution was important in refining choices about the best set of projections. A post hoc test conducted on a new Parthenium dataset from Nepal validated excellent predictive performance of our 'best' model. We showed that vast stretches of currently uninvaded geographic areas on multiple continents harbor highly suitable habitats for parthenium

  15. The GREAT3 challenge

    International Nuclear Information System (INIS)

    Miyatake, H; Mandelbaum, R; Rowe, B

    2014-01-01

    The GRavitational lEnsing Accuracy Testing 3 (GREAT3) challenge is an image analysis competition that aims to test algorithms to measure weak gravitational lensing from astronomical images. The challenge started in October 2013 and ends 30 April 2014. The challenge focuses on testing the impact on weak lensing measurements of realistically complex galaxy morphologies, realistic point spread function, and combination of multiple different exposures. It includes simulated ground- and space-based data. The details of the challenge are described in [1], and the challenge website and its leader board can be found at http://great3challenge.info and http://great3.projects.phys.ucl.ac.uk/leaderboard/, respectively

  16. Improving persistence in red clover: Insights from QTL analysis and comparative phenotypic evaluation

    DEFF Research Database (Denmark)

    Herrmann, Dorris; Boller, Beat; Studer, Bruno

    2008-01-01

    , persistence is difficult to improve. The objectives of this study were to optimize the phenotypic evaluation of persistence, to identify quantitative trait loci (QTLs) for this important trait, and to investigate the association of persistence with other important traits. A weighted average of vigor scores...... assessed during two winters and three growing seasons was identified as the optimal method to phenotype persistence. For this index, one QTL explaining 12.2% of the total phenotypic variation was identified. While there was no negative correlation between persistence and seed yield, persistence...

  17. Nothing Great Is Easy

    OpenAIRE

    Stansbie, Lisa

    2014-01-01

    A solo exhibition of 13 pieces of art work.\\ud \\ud Nothing Great is Easy is an exhibition of sculpture, film, drawing and photography that proposes reconstructed narratives using the sport of swimming and in particular the collective interaction and identity of the channel swimmer. The work utilises the processes, rituals/rules, language and the apparatus of sport.\\ud \\ud “Nothing great is easy” are the words on the memorial to Captain Matthew Webb who was the first man to swim the English ch...

  18. A comparative study of breast cancer diagnosis based on neural network ensemble via improved training algorithms.

    Science.gov (United States)

    Azami, Hamed; Escudero, Javier

    2015-08-01

    Breast cancer is one of the most common types of cancer in women all over the world. Early diagnosis of this kind of cancer can significantly increase the chances of long-term survival. Since diagnosis of breast cancer is a complex problem, neural network (NN) approaches have been used as a promising solution. Considering the low speed of the back-propagation (BP) algorithm to train a feed-forward NN, we consider a number of improved NN trainings for the Wisconsin breast cancer dataset: BP with momentum, BP with adaptive learning rate, BP with adaptive learning rate and momentum, Polak-Ribikre conjugate gradient algorithm (CGA), Fletcher-Reeves CGA, Powell-Beale CGA, scaled CGA, resilient BP (RBP), one-step secant and quasi-Newton methods. An NN ensemble, which is a learning paradigm to combine a number of NN outputs, is used to improve the accuracy of the classification task. Results demonstrate that NN ensemble-based classification methods have better performance than NN-based algorithms. The highest overall average accuracy is 97.68% obtained by NN ensemble trained by RBP for 50%-50% training-test evaluation method.

  19. Multisensory stimuli improve relative localisation judgments compared to unisensory auditory or visual stimuli

    OpenAIRE

    Bizley, Jennifer; Wood, Katherine; Freeman, Laura

    2018-01-01

    Observers performed a relative localisation task in which they reported whether the second of two sequentially presented signals occurred to the left or right of the first. Stimuli were detectability-matched auditory, visual, or auditory-visual signals and the goal was to compare changes in performance with eccentricity across modalities. Visual performance was superior to auditory at the midline, but inferior in the periphery, while auditory-visual performance exceeded both at all locations....

  20. Great Books. What Works Clearinghouse Intervention Report

    Science.gov (United States)

    What Works Clearinghouse, 2011

    2011-01-01

    "Great Books" is a program that aims to improve the reading, writing, and critical thinking skills of students in kindergarten through high school. The program is implemented as a core or complementary curriculum and is based on the Shared Inquiry[TM] method of learning. The purpose of "Great Books" is to engage students in…

  1. Multi-Objective Optimization for Energy Performance Improvement of Residential Buildings: A Comparative Study

    Directory of Open Access Journals (Sweden)

    Kangji Li

    2017-02-01

    Full Text Available Numerous conflicting criteria exist in building design optimization, such as energy consumption, greenhouse gas emission and indoor thermal performance. Different simulation-based optimization strategies and various optimization algorithms have been developed. A few of them are analyzed and compared in solving building design problems. This paper presents an efficient optimization framework to facilitate optimization designs with the aid of commercial simulation software and MATLAB. The performances of three optimization strategies, including the proposed approach, GenOpt method and artificial neural network (ANN method, are investigated using a case study of a simple building energy model. Results show that the proposed optimization framework has competitive performances compared with the GenOpt method. Further, in another practical case, four popular multi-objective algorithms, e.g., the non-dominated sorting genetic algorithm (NSGA-II, multi-objective particle swarm optimization (MOPSO, the multi-objective genetic algorithm (MOGA and multi-objective differential evolution (MODE, are realized using the propose optimization framework and compared with three criteria. Results indicate that MODE achieves close-to-optimal solutions with the best diversity and execution time. An uncompetitive result is achieved by the MOPSO in this case study.

  2. Minimally invasive compared to conventional approach for coronary artery bypass grafting improves outcome

    Directory of Open Access Journals (Sweden)

    Jitumoni Baishya

    2017-01-01

    Full Text Available Introduction: Minimally invasive (MI cardiac surgery is a rapidly gaining popularity, globally as well as in India. We aimed to compare the outcome of MI to the conventional approach for coronary artery bypass graft (CABG surgery. Methods: This prospective, comparative study was conducted at a tertiary care cardiac surgical center. All patients who underwent CABG surgery via MI approach (MI group from July 2015 to December 2015 were enrolled and were compared against same number of EuroSCORE II matched patients undergoing CABG through conventional mid-sternotomy approach (CON group. Demographic, intra- and post-operative variables were collected. Results: In MI group, duration of the surgery was significantly longer (P = 0.029. Intraoperative blood loss lesser (P = 0.002, shorter duration of ventilation (P = 0.002, shorter Intensive Care Unit stay (P = 0.004, shorter hospital stay (P = 0.003, lesser postoperative analgesic requirements (P = 0.027, and lower visual analog scale scores on day of surgery (P = 0.032 and 1 st postoperative day (P = 0.025. No significant difference in postoperative blood loss, blood transfusion, or duration of inotrope requirement observed. There was no conversion to mid-sternotomy in any patients, 8% of patients had desaturation intraoperatively. There was no operative mortality. Conclusion: MI surgery is associated with lesser intraoperative blood loss, better analgesia, and faster recovery.

  3. Autologous Cartilage Chip Transplantation Improves Repair Tissue Composition Compared With Marrow Stimulation.

    Science.gov (United States)

    Christensen, Bjørn Borsøe; Olesen, Morten Lykke; Lind, Martin; Foldager, Casper Bindzus

    2017-06-01

    Repair of chondral injuries by use of cartilage chips has recently demonstrated clinical feasibility. To investigate in vivo cartilage repair outcome of autologous cartilage chips compared with marrow stimulation in full-thickness cartilage defects in a minipig model. Controlled laboratory study. Six Göttingen minipigs received two 6-mm chondral defects in the medial and lateral trochlea of each knee. The two treatment groups were (1) autologous cartilage chips embedded in fibrin glue (ACC) (n = 12) and (2) marrow stimulation (MST) (n = 12). The animals were euthanized after 6 months, and the composition of repair tissue was quantitatively determined using histomorphometry. Semiquantitative evaluation was performed by means of the International Cartilage Repair Society (ICRS) II score. Collagen type II staining was used to further evaluate the repair tissue composition. Significantly more hyaline cartilage was found in the ACC (17.1%) compared with MST (2.9%) group ( P cartilage repair tissue compared with MST at 6 months postoperatively. Further studies are needed to investigate ACC as a possible alternative first-line treatment for focal cartilage injuries in the knee.

  4. Measuring and Comparing Descend in Elite Race Cycling with a Perspective on Real-Time Feedback for Improving Individual Performance

    NARCIS (Netherlands)

    Reijne, M.M.; Bregman, D.J.J.; Schwab, A.L.; Espinosa, Hugo G.; Rowlands, David R.; Shepherd, Jonathan; Thiel, David V.

    2018-01-01

    Descend technique and performance vary among elite racing cyclists and it is not clear what slower riders should do to improve their performance. An observation study was performed of the descending technique of members of a World Tour cycling team and the technique of each member was compared with

  5. Comparing the Efficacy of Digital Flashcards versus Paper Flashcards to Improve Receptive and Productive L2 Vocabulary

    Science.gov (United States)

    Dizon, Gilbert; Tang, Daniel

    2017-01-01

    Several researchers have compared the efficacy of digital flashcards (DFs) versus paper flashcards (PFs) to improve L2 vocabulary and have concluded that using DFs is more effective (Azabdaftari & Mozaheb, 2012; Basoglu & Akdemir, 2010; Kiliçkaya & Krajka, 2010). However, these studies did not utilize vocabulary learning strategies…

  6. Geometric morphometrics as a tool for improving the comparative study of behavioural postures.

    Science.gov (United States)

    Fureix, Carole; Hausberger, Martine; Seneque, Emilie; Morisset, Stéphane; Baylac, Michel; Cornette, Raphaël; Biquand, Véronique; Deleporte, Pierre

    2011-07-01

    Describing postures has always been a central concern when studying behaviour. However, attempts to compare postures objectively at phylogenetical, populational, inter- or intra-individual levels generally either rely upon a few key elements or remain highly subjective. Here, we propose a novel approach, based on well-established geometric morphometrics, to describe and to analyse postures globally (i.e. considering the animal's body posture in its entirety rather than focusing only on a few salient elements, such as head or tail position). Geometric morphometrics is concerned with describing and comparing variation and changes in the form (size and shape) of organisms using the coordinates of a series of homologous landmarks (i.e. positioned in relation to skeletal or muscular cues that are the same for different species for every variety of form and function and that have derived from a common ancestor, i.e. they have a common evolutionary ancestry, e.g. neck, wings, flipper/hand). We applied this approach to horses, using global postures (1) to characterise behaviours that correspond to different arousal levels, (2) to test potential impact of environmental changes on postures. Our application of geometric morphometrics to horse postures showed that this method can be used to characterise behavioural categories, to evaluate the impact of environmental factors (here human actions) and to compare individuals and groups. Beyond its application to horses, this promising approach could be applied to all questions involving the analysis of postures (evolution of displays, expression of emotions, stress and welfare, behavioural repertoires…) and could lead to a whole new line of research.

  7. Comparing and Combining Remotely Sensed Land Surface Temperature Products for Improved Hydrological Applications

    Directory of Open Access Journals (Sweden)

    Robert M. Parinussa

    2016-02-01

    Full Text Available Land surface temperature (LST is an important variable that provides a valuable connection between the energy and water budget and is strongly linked to land surface hydrology. Space-borne remote sensing provides a consistent means for regularly observing LST using thermal infrared (TIR and passive microwave observations each with unique strengths and weaknesses. The spatial resolution of TIR based LST observations is around 1 km, a major advantage when compared to passive microwave observations (around 10 km. However, a major advantage of passive microwaves is their cloud penetrating capability making them all-weather sensors whereas TIR observations are routinely masked under the presence of clouds and aerosols. In this study, a relatively simple combination approach that benefits from the cloud penetrating capacity of passive microwave sensors was proposed. In the first step, TIR and passive microwave LST products were compared over Australia for both anomalies and raw timeseries. A very high agreement was shown over the vast majority of the country with R2 typically ranging from 0.50 to 0.75 for the anomalies and from 0.80 to 1.00 for the raw timeseries. Then, the scalability of the passive microwave based LST product was examined and a pixel based merging approach through linear scaling was proposed. The individual and merged LST products were further compared against independent LST from the re-analysis model outputs. This comparison revealed that the TIR based LST product agrees best with the re-analysis data (R2 0.26 for anomalies and R2 0.76 for raw data, followed by the passive microwave LST product (R2 0.16 for anomalies and R2 0.66 for raw data and the combined LST product (R2 0.18 for anomalies and R2 0.62 for raw data. It should be noted that the drop in performance comes with an increased revisit frequency of approximately 20% compared to the revised frequency of the TIR alone. Additionally, this comparison against re

  8. Improving skill development: an exploratory study comparing a philosophical and an applied ethical analysis technique

    Science.gov (United States)

    Al-Saggaf, Yeslam; Burmeister, Oliver K.

    2012-09-01

    This exploratory study compares and contrasts two types of critical thinking techniques; one is a philosophical and the other an applied ethical analysis technique. The two techniques analyse an ethically challenging situation involving ICT that a recent media article raised to demonstrate their ability to develop the ethical analysis skills of ICT students and professionals. In particular the skill development focused on includes: being able to recognise ethical challenges and formulate coherent responses; distancing oneself from subjective judgements; developing ethical literacy; identifying stakeholders; and communicating ethical decisions made, to name a few.

  9. The Great Mathematician Project

    Science.gov (United States)

    Goldberg, Sabrina R.

    2013-01-01

    The Great Mathematician Project (GMP) introduces both mathematically sophisticated and struggling students to the history of mathematics. The rationale for the GMP is twofold: first, mathematics is a uniquely people-centered discipline that is used to make sense of the world; and second, students often express curiosity about the history of…

  10. Price promotions on healthier compared with less healthy foods: a hierarchical regression analysis of the impact on sales and social patterning of responses to promotions in Great Britain12345

    Science.gov (United States)

    Nakamura, Ryota; Suhrcke, Marc; Jebb, Susan A; Pechey, Rachel; Almiron-Roig, Eva; Marteau, Theresa M

    2015-01-01

    Background: There is a growing concern, but limited evidence, that price promotions contribute to a poor diet and the social patterning of diet-related disease. Objective: We examined the following questions: 1) Are less-healthy foods more likely to be promoted than healthier foods? 2) Are consumers more responsive to promotions on less-healthy products? 3) Are there socioeconomic differences in food purchases in response to price promotions? Design: With the use of hierarchical regression, we analyzed data on purchases of 11,323 products within 135 food and beverage categories from 26,986 households in Great Britain during 2010. Major supermarkets operated the same price promotions in all branches. The number of stores that offered price promotions on each product for each week was used to measure the frequency of price promotions. We assessed the healthiness of each product by using a nutrient profiling (NP) model. Results: A total of 6788 products (60%) were in healthier categories and 4535 products (40%) were in less-healthy categories. There was no significant gap in the frequency of promotion by the healthiness of products neither within nor between categories. However, after we controlled for the reference price, price discount rate, and brand-specific effects, the sales uplift arising from price promotions was larger in less-healthy than in healthier categories; a 1-SD point increase in the category mean NP score, implying the category becomes less healthy, was associated with an additional 7.7–percentage point increase in sales (from 27.3% to 35.0%; P sales uplift from promotions was larger for higher–socioeconomic status (SES) groups than for lower ones (34.6% for the high-SES group, 28.1% for the middle-SES group, and 23.1% for the low-SES group). Finally, there was no significant SES gap in the absolute volume of purchases of less-healthy foods made on promotion. Conclusion: Attempts to limit promotions on less-healthy foods could improve the

  11. What great managers do.

    Science.gov (United States)

    Buckingham, Marcus

    2005-03-01

    Much has been written about the qualities that make a great manager, but most of the literature overlooks a fundamental question: What does a great manager actually do? While there are countless management styles, one thing underpins the behavior of all great managers. Above all, an exceptional manager comes to know and value the particular quirks and abilities of her employees. She figures out how to capitalize on her staffers' strengths and tweaks her environment to meet her larger goals. Such a specialized approach may seem like a lot of work. But in fact, capitalizing on each person's uniqueness can save time. Rather than encourage employees to conform to strict job descriptions that may include tasks they don't enjoy and aren't good at, a manager who develops positions for his staff members based on their unique abilities will be rewarded with behaviors that are far more efficient and effective than they would be otherwise. This focus on individuals also makes employees more accountable. Because staffers are evaluated on their particular strengths and weaknesses, they are challenged to take responsibility for their abilities and to hone them. Capitalizing on a person's uniqueness also builds a stronger sense of team. By taking the time to understand what makes each employee tick, a great manager shows that he sees his people for who they are. This personal investment not only motivates individuals but also galvanizes the entire team. Finally, this approach shakes up existing hierarchies, which leads to more creative thinking. To take great managing from theory to practice, the author says, you must know three things about a person: her strengths, the triggers that activate those strengths, and how she learns. By asking the right questions, squeezing the right triggers, and becoming aware of your employees' learning styles, you will discover what motivates each person to excel.

  12. Comparative sequence analysis of Sordaria macrospora and Neurospora crassa as a means to improve genome annotation.

    Science.gov (United States)

    Nowrousian, Minou; Würtz, Christian; Pöggeler, Stefanie; Kück, Ulrich

    2004-03-01

    One of the most challenging parts of large scale sequencing projects is the identification of functional elements encoded in a genome. Recently, studies of genomes of up to six different Saccharomyces species have demonstrated that a comparative analysis of genome sequences from closely related species is a powerful approach to identify open reading frames and other functional regions within genomes [Science 301 (2003) 71, Nature 423 (2003) 241]. Here, we present a comparison of selected sequences from Sordaria macrospora to their corresponding Neurospora crassa orthologous regions. Our analysis indicates that due to the high degree of sequence similarity and conservation of overall genomic organization, S. macrospora sequence information can be used to simplify the annotation of the N. crassa genome.

  13. A comparative study on the nanoparticles for improved drug delivery systems.

    Science.gov (United States)

    Mahmoodi, Nosrat O; Ghavidast, Atefeh; Amirmahani, Najmeh

    2016-09-01

    Nanoparticles have attracted considerable recent interest for diverse biomedical applications because of the unique properties of the nanomaterials. It is already known that one of the major advances in the relative application of nanoparticles is the recognition of the steric stabilization which can increase the particle stability in the biological environment and provide the opportunities of the application of nanoparticles in the development of drug delivery systems (DDSs) for achieving drug targeting and controlled drug release. To facilitate their use in such applications, the appropriate design of surface ligands on these nanoparticles is necessary. In view of these, functionalized nanoparticles through surface modification can be utilized to specifically interact with the target molecules on the cell membrane or intracellular ones. This review briefly presents self-assembled nanoparticles with molecules of therapeutic significance with two strategies. The first strategy attempts to improve the placement of the drugs using conjugating the appropriate ligands or adding targeting moieties to the DDS. The second strategy utilizes trigger-controlled drug-release, which restricts drug release at the targeted site to kill cancer cells by externally controlled mechanisms. Among external stimulations, conveniently light has attracted much interest because it, as an orthogonal external stimulus, gives spatiotemporal control of payload release. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Improved survival for rectal cancer compared to colon cancer: the four cohort study.

    Science.gov (United States)

    Buchwald, Pamela; Hall, Claire; Davidson, Callum; Dixon, Liane; Dobbs, Bruce; Robinson, Bridget; Frizelle, Frank

    2018-03-01

    Colorectal cancer (CRC) is the third most common cancer worldwide. This study was undertaken to evaluate survival outcomes and changes of disease outcomes of CRC patients over the last decades. A retrospective analysis of CRC patients in Christchurch was performed in four patient cohorts at 5 yearly intervals; 1993-94, 1998-99, 2004-05 and 2009. Data on cancer location, stage, surgical and oncological treatment and survival were collected. Univariate, multivariate and Kaplan-Meier survival analysis were performed. There were 1391 patients (355, 317, 419 and 300 per cohort), 1037 colon and 354 rectal cancers, respectively. For colon cancer, right-sided cancers appeared more common in later cohorts (P = 0.01). There was a significant decrease in the number of permanent stomas for colon cancer patients (P = 0.001). There was an analogous trend for rectal cancers (P = 0.075). More CRC patients with stage IV disease were treated surgically (P = 0.001) and colon cancer stages I and II tended to have increased survival if operated by a colorectal surgeon (P = 0.06). Oncology referrals have increased remarkably (P = 0.001). Overall 56% of patients were alive at 5 years however rectal cancer patients had significantly better 5-year survival than those with colon cancer (P rectal cancer patients have a better 5-year survival than colon cancer patients. The improved survival with early stage colon cancers operated on by specialist colorectal surgeons needs further exploration. © 2016 Royal Australasian College of Surgeons.

  15. Review of comparative LCAs of food waste management systems – Current status and potential improvements

    International Nuclear Information System (INIS)

    Bernstad, A.; Cour Jansen, J. la

    2012-01-01

    Highlights: ► GHG-emissions from different treatment alternatives vary largely in 25 reviewed comparative LCAs of bio-waste management. ► System-boundary settings often vary largely in reviewed studies. ► Existing LCA guidelines give varying recommendations in relation to several key issues. - Abstract: Twenty-five comparative cycle assessments (LCAs) addressing food waste treatment were reviewed, including the treatment alternatives landfill, thermal treatment, compost (small and large scale) and anaerobic digestion. The global warming potential related to these treatment alternatives varies largely amongst the studies. Large differences in relation to setting of system boundaries, methodological choices and variations in used input data were seen between the studies. Also, a number of internal contradictions were identified, many times resulting in biased comparisons between alternatives. Thus, noticed differences in global warming potential are not found to be a result of actual differences in the environmental impacts from studied systems, but rather to differences in the performance of the study. A number of key issues with high impact on the overall global warming potential from different treatment alternatives for food waste were identified through the use of one-way sensitivity analyses in relation to a previously performed LCA of food waste management. Assumptions related to characteristics in treated waste, losses and emissions of carbon, nutrients and other compounds during the collection, storage and pretreatment, potential energy recovery through combustion, emissions from composting, emissions from storage and land use of bio-fertilizers and chemical fertilizers and eco-profiles of substituted goods were all identified as highly relevant for the outcomes of this type of comparisons. As the use of LCA in this area is likely to increase in coming years, it is highly relevant to establish more detailed guidelines within this field in order to

  16. Review of comparative LCAs of food waste management systems - Current status and potential improvements

    Energy Technology Data Exchange (ETDEWEB)

    Bernstad, A., E-mail: anna.bernstad@chemeng.lth.se [Water and Environmental Engineering at the Department of Chemical Engineering, Lund University, Chemical Centre, 221 00 Lund (Sweden); Cour Jansen, J. la [Water and Environmental Engineering at the Department of Chemical Engineering, Lund University, Chemical Centre, 221 00 Lund (Sweden)

    2012-12-15

    Highlights: Black-Right-Pointing-Pointer GHG-emissions from different treatment alternatives vary largely in 25 reviewed comparative LCAs of bio-waste management. Black-Right-Pointing-Pointer System-boundary settings often vary largely in reviewed studies. Black-Right-Pointing-Pointer Existing LCA guidelines give varying recommendations in relation to several key issues. - Abstract: Twenty-five comparative cycle assessments (LCAs) addressing food waste treatment were reviewed, including the treatment alternatives landfill, thermal treatment, compost (small and large scale) and anaerobic digestion. The global warming potential related to these treatment alternatives varies largely amongst the studies. Large differences in relation to setting of system boundaries, methodological choices and variations in used input data were seen between the studies. Also, a number of internal contradictions were identified, many times resulting in biased comparisons between alternatives. Thus, noticed differences in global warming potential are not found to be a result of actual differences in the environmental impacts from studied systems, but rather to differences in the performance of the study. A number of key issues with high impact on the overall global warming potential from different treatment alternatives for food waste were identified through the use of one-way sensitivity analyses in relation to a previously performed LCA of food waste management. Assumptions related to characteristics in treated waste, losses and emissions of carbon, nutrients and other compounds during the collection, storage and pretreatment, potential energy recovery through combustion, emissions from composting, emissions from storage and land use of bio-fertilizers and chemical fertilizers and eco-profiles of substituted goods were all identified as highly relevant for the outcomes of this type of comparisons. As the use of LCA in this area is likely to increase in coming years, it is highly

  17. With Great Measurements Come Great Results

    Science.gov (United States)

    Williams, Carl

    Measurements are the foundation for science and modern life. Technologies we take for granted every day depend on them-cell phones, CAT scans, pharmaceuticals, even sports equipment. Metrology, or measurement science, determines what industry can make reliably and what they cannot. At the National Institute of Standards and Technology (NIST) we specialize in making world class measurements that an incredibly wide range of industries use to continually improve their products - computer chips with nanoscale components, atomic clocks that you can hold in your hand, lasers for both super-strong welds and delicate eye surgeries. Think of all the key technologies developed over the last 100 years and better measurements, standards, or analysis techniques played a role in making them possible. NIST works collaboratively with industry researchers on the advanced metrology for tomorrow's technologies. A new kilogram based on electromagnetic force, cars that weigh half as much but are just as strong, quantum computers, personalized medicine, single atom devices - it's all happening in our labs now. This talk will focus on how metrology creates the future.

  18. A Comparative Study of Improved Artificial Bee Colony Algorithms Applied to Multilevel Image Thresholding

    Directory of Open Access Journals (Sweden)

    Kanjana Charansiriphaisan

    2013-01-01

    Full Text Available Multilevel thresholding is a highly useful tool for the application of image segmentation. Otsu’s method, a common exhaustive search for finding optimal thresholds, involves a high computational cost. There has been a lot of recent research into various meta-heuristic searches in the area of optimization research. This paper analyses and discusses using a family of artificial bee colony algorithms, namely, the standard ABC, ABC/best/1, ABC/best/2, IABC/best/1, IABC/rand/1, and CABC, and some particle swarm optimization-based algorithms for searching multilevel thresholding. The strategy for an onlooker bee to select an employee bee was modified to serve our purposes. The metric measures, which are used to compare the algorithms, are the maximum number of function calls, successful rate, and successful performance. The ranking was performed by Friedman ranks. The experimental results showed that IABC/best/1 outperformed the other techniques when all of them were applied to multilevel image thresholding. Furthermore, the experiments confirmed that IABC/best/1 is a simple, general, and high performance algorithm.

  19. Improving everyday prospective memory performance in older adults: comparing cognitive process and strategy training.

    Science.gov (United States)

    Brom, Sarah Susanne; Kliegel, Matthias

    2014-09-01

    Considering the importance of prospective memory for independence in old age recently, research has started to examine interventions to reduce prospective memory errors. Two general approaches can be proposed: (a) process training of executive control associated with prospective memory functioning, and/or (b) strategy training to reduce executive task demands. The present study was the first to combine and compare both training methods in a sample of 62 community-dwelling older adults (60-86 years) and to explore their effects on an ecologically valid everyday life prospective memory task (here: regular blood pressure monitoring). Even though the training of executive control was successful in enhancing the trained ability, clear transfer effects on prospective memory performance could only be found for the strategy training. However, participants with low executive abilities benefited particularly from the implementation intention strategy. Conceptually, this supports models suggesting interactions between task demands and individual differences in executive control in explaining individual differences in prospective memory performance. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  20. Improved Murine Blastocyst Quality and Development in a Single Culture Medium Compared to Sequential Culture Media.

    Science.gov (United States)

    Hennings, Justin M; Zimmer, Randall L; Nabli, Henda; Davis, J Wade; Sutovsky, Peter; Sutovsky, Miriam; Sharpe-Timms, Kathy L

    2016-03-01

    Validate single versus sequential culture media for murine embryo development. Prospective laboratory experiment. Assisted Reproduction Laboratory. Murine embryos. Thawed murine zygotes cultured for 3 or 5 days (d3 or d5) in single or sequential embryo culture media developed for human in vitro fertilization. On d3, zygotes developing to the 8 cell (8C) stage or greater were quantified using 4',6-diamidino-2-phenylindole (DAPI), and quality was assessed by morphological analysis. On d5, the number of embryos reaching the blastocyst stage was counted. DAPI was used to quantify total nuclei and inner cell mass nuclei. Localization of ubiquitin C-terminal hydrolase L1 (UCHL1) and ubiquitin C-terminal hydrolase L3 (UCHL3) was reference points for evaluating cell quality. Comparing outcomes in single versus to sequential media, the odds of embryos developing to the 8C stage on d3 were 2.34 time greater (P = .06). On d5, more embryos reached the blastocyst stage (P = culture. Human embryo studies are needed. © The Author(s) 2015.

  1. Great magnetic storms

    International Nuclear Information System (INIS)

    Tsurutani, B.T.; Yen Te Lee; Tang, F.; Gonzalez, W.D.

    1992-01-01

    The five largest magnetic storms that occurred between 1971 and 1986 are studied to determine their solar and interplanetary causes. All of the events are found to be associated with high speed solar wind streams led by collisionless shocks. The high speed streams are clearly related to identifiable solar flares. It is found that (1) it is the extreme values of the southward interplanetary magnetic fields rather than solar wind speeds that are the primary causes of great magnetic storms, (2) shocked and draped sheath fields preceding the driver gas (magnetic cloud) are at least as effective in causing the onset of great magnetic storms (3 of 5 events ) as the strong fields within the driver gas itself, and (3) precursor southward fields ahead of the high speed streams allow the shock compression mechanism (item 2) to be particularly geoeffective

  2. SiteBinder: an improved approach for comparing multiple protein structural motifs.

    Science.gov (United States)

    Sehnal, David; Vařeková, Radka Svobodová; Huber, Heinrich J; Geidl, Stanislav; Ionescu, Crina-Maria; Wimmerová, Michaela; Koča, Jaroslav

    2012-02-27

    There is a paramount need to develop new techniques and tools that will extract as much information as possible from the ever growing repository of protein 3D structures. We report here on the development of a software tool for the multiple superimposition of large sets of protein structural motifs. Our superimposition methodology performs a systematic search for the atom pairing that provides the best fit. During this search, the RMSD values for all chemically relevant pairings are calculated by quaternion algebra. The number of evaluated pairings is markedly decreased by using PDB annotations for atoms. This approach guarantees that the best fit will be found and can be applied even when sequence similarity is low or does not exist at all. We have implemented this methodology in the Web application SiteBinder, which is able to process up to thousands of protein structural motifs in a very short time, and which provides an intuitive and user-friendly interface. Our benchmarking analysis has shown the robustness, efficiency, and versatility of our methodology and its implementation by the successful superimposition of 1000 experimentally determined structures for each of 32 eukaryotic linear motifs. We also demonstrate the applicability of SiteBinder using three case studies. We first compared the structures of 61 PA-IIL sugar binding sites containing nine different sugars, and we found that the sugar binding sites of PA-IIL and its mutants have a conserved structure despite their binding different sugars. We then superimposed over 300 zinc finger central motifs and revealed that the molecular structure in the vicinity of the Zn atom is highly conserved. Finally, we superimposed 12 BH3 domains from pro-apoptotic proteins. Our findings come to support the hypothesis that there is a structural basis for the functional segregation of BH3-only proteins into activators and enablers.

  3. Comparative analysis of different joining techniques to improve the passive fit of cobalt-chromium superstructures.

    Science.gov (United States)

    Barbi, Francisco C L; Camarini, Edevaldo T; Silva, Rafael S; Endo, Eliana H; Pereira, Jefferson R

    2012-12-01

    The influence of different joining techniques on passive fit at the interface structure/abutment of cobalt-chromium (Co-Cr) superstructures has not yet been clearly established. The purpose of this study was to compare 3 different techniques of joining Co-Cr superstructures by measuring the resulting marginal misfit in a simulated prosthetic assembly. A specially designed metal model was used for casting, sectioning, joining, and measuring marginal misfit. Forty-five cast bar-type superstructures were fabricated in a Co-Cr alloy and randomly assigned by drawing lots to 3 groups (n=15) according to the joining method used: conventional gas-torch brazing (G-TB), laser welding (LW), and tungsten inert gas welding (TIG). Joined specimens were assembled onto abutment analogs in the metal model with the 1-screw method. The resulting marginal misfit was measured with scanning electron microscopy (SEM) at 3 different points: distal (D), central (C), and mesial (M) along the buccal aspect of both abutments: A (tightened) and B (without screw). The Levene test was used to evaluate variance homogeneity and then the Welsch ANOVA for heteroscedastic data (α=.05). Significant differences were found on abutment A between groups G-TB and LW (P=.013) measured mesially and between groups G-TB and TIG (P=.037) measured centrally. On abutment B, significant differences were found between groups G-TB and LW (Plaser method. Copyright © 2012 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

  4. The great intimidators.

    Science.gov (United States)

    Kramer, Roderick M

    2006-02-01

    After Disney's Michael Eisner, Miramax's Harvey Weinstein, and Hewlett-Packard's Carly Fiorina fell from their heights of power, the business media quickly proclaimed thatthe reign of abrasive, intimidating leaders was over. However, it's premature to proclaim their extinction. Many great intimidators have done fine for a long time and continue to thrive. Their modus operandi runs counter to a lot of preconceptions about what it takes to be a good leader. They're rough, loud, and in your face. Their tactics include invading others' personal space, staging tantrums, keeping people guessing, and possessing an indisputable command of facts. But make no mistake--great intimidators are not your typical bullies. They're driven by vision, not by sheer ego or malice. Beneath their tough exteriors and sharp edges are some genuine, deep insights into human motivation and organizational behavior. Indeed, these leaders possess political intelligence, which can make the difference between paralysis and successful--if sometimes wrenching--organizational change. Like socially intelligent leaders, politically intelligent leaders are adept at sizing up others, but they notice different things. Those with social intelligence assess people's strengths and figure out how to leverage them; those with political intelligence exploit people's weaknesses and insecurities. Despite all the obvious drawbacks of working under them, great intimidators often attract the best and brightest. And their appeal goes beyond their ability to inspire high performance. Many accomplished professionals who gravitate toward these leaders want to cultivate a little "inner intimidator" of their own. In the author's research, quite a few individuals reported having positive relationships with intimidating leaders. In fact, some described these relationships as profoundly educational and even transformational. So before we throw out all the great intimidators, the author argues, we should stop to consider what

  5. Great Lakes Energy Institute

    Energy Technology Data Exchange (ETDEWEB)

    Alexander, J. Iwan [Case Western Reserve Univ., Cleveland, OH (United States)

    2012-11-18

    The vision of the Great Lakes Energy Institute is to enable the transition to advanced, sustainable energy generation, storage, distribution and utilization through coordinated research, development, and education. The Institute will place emphasis on translating leading edge research into next generation energy technology. The Institute’s research thrusts focus on coordinated research in decentralized power generation devices (e.g. fuel cells, wind turbines, solar photovoltaic devices), management of electrical power transmission and distribution, energy storage, and energy efficiency.

  6. Measuring and Comparing Descend in Elite Race Cycling with a Perspective on Real-Time Feedback for Improving Individual Performance

    Directory of Open Access Journals (Sweden)

    M. M. Reijne

    2018-02-01

    Full Text Available Descend technique and performance vary among elite racing cyclists and it is not clear what slower riders should do to improve their performance. An observation study was performed of the descending technique of members of a World Tour cycling team and the technique of each member was compared with the fastest descender amongst them. The obtained data gives us guidelines for rider specific feedback in order to improve his performance. The bicycles were equipped with a system that could measure: velocity, cadence, pedal power, position, steer angle, 3D orientation, rotational speeds and linear accelerations of the rear frame and brake force front and rear. From our observation study, the brake point and apex position turned out to be distinctive indicators of a fast cornering technique in a descent for a tight, hairpin corner. These two indicators can be used as feedback for a slower rider to improve his descend performance.

  7. Comparative Effectiveness of Different Phase Change Materials to Improve Cooling Performance of Heat Sinks for Electronic Devices

    Directory of Open Access Journals (Sweden)

    Ahmad Hasan

    2016-08-01

    Full Text Available This paper thermo-physically characterizes salt hydrate, paraffin wax and milk fat as phase change materials (PCMs. The three PCMs are compared in terms of improving heat sink (HS performance for cooling electronic packaging. An experimental study is carried out on commercially available finned HS with and without PCM under natural ventilation (NV and forced ventilation (FV at different heat loads (4 W to 10 W. The results indicate that integration of all of the PCMs into the HS improves its cooling performance; however, milk fat lags behind the other two PCMs in terms of cooling produced. A three-dimensional pressure-based conjugate heat transfer model has been developed and validated with experimental results. The model predicts the parametric influence of PCM melting range, thermal conductivity and density on HS thermal management performance. The HS cooling performance improves with increased density and conductivity while it deteriorates with the wider melting range of the PCMs.

  8. Improved shielding of the gonads of infants during comparative X-ray examination of the hip joints

    International Nuclear Information System (INIS)

    Petrik, R.; Reumuth, H.J.

    1979-01-01

    Improved shielding of the gonads of infants during comparative X-ray examination of the hip joints. The presented gonad shielding device for male and female infants aged 3 to 12 months has two small windows for the incident X-ray beam and allows to keep the gonad dose very low. The regions of the skeleton concerned are adequately displayed. The shield can be applied in routine examinations and does not require personnel to hold the patient. (author)

  9. The balanced scorecard as a potential instrument for supporting planning and improvement in accounting education: Comparative survey findings

    Directory of Open Access Journals (Sweden)

    CJ Cronje

    2004-04-01

    Full Text Available This paper is firstly a comparison of the components of a potential balanced scorecard for accounting departments of universities in South Africa and Australia. Secondly, the various suggested measurement criteria of the balanced scorecard components are also compared. The findings of the research paper indicate no significant differences. The conclusion is that the balanced scorecard constitutes a potential instrument for supporting the planning and improvement of the accounting education environment.

  10. Comparative effects of building envelope improvements and occupant behavioural changes on the exergy consumption for heating and cooling

    International Nuclear Information System (INIS)

    Schweiker, Marcel; Shukuya, Masanori

    2010-01-01

    Much focus is put on measures to improve the building envelope system performance to reduce the impact of the building sector on the global environmental degradation. This paper compares the potential of building envelope improvements to those of a change in the occupant's behavioural pattern. Three cases of improvements together with a base case were analysed using exergy analysis, because the exergy concept is useful to understand the underlying processes and the necessary adjustments to the calculation of the heat-pump system. The assumptions for the occupant behaviour were set up based on our field measurements conducted in a dormitory building and the calculation was for steady-state conditions. It was found that the potential of occupant behavioural changes for the reduction in exergy consumption is more affected by the outdoor temperature compared to building envelope improvements. The influence of occupant behaviour was highly significant (more than 90% decrease of exergy consumption) when the temperature difference between indoors and outdoors is small, which is the case for long periods in regions with moderate temperatures during summer and/or winter. Nevertheless, both measures combined lead to a reduction from 76% up to 95% depending on the outside conditions and should be the final goal.

  11. Idiopathic great saphenous phlebosclerosis.

    Directory of Open Access Journals (Sweden)

    Ahmadreza Jodati

    2013-06-01

    Full Text Available Arterial sclerosis has been extensively described but reports on venous sclerosis are very sparse. Phlebosclerosis refers to the thickening and hardening of the venous wall. Despite its morphological similarities with arteriosclerosis and potential morbid consequences, phlebosclerosis has gained only little attention. We report a 72 year old male with paralysis and atrophy of the right leg due to childhood poliomyelitis who was referred for coronary artery bypass surgery. The great saphenous vein, harvested from the left leg, showed a hardened cord-like obliterated vein. Surprisingly, harvested veins from the atrophic limb were normal and successfully used for grafting.

  12. What killed Alexander the Great?

    Science.gov (United States)

    Battersby, Cameron

    2007-01-01

    The cause of the death of the Macedonian King, Alexander the Great, at Babylon in 323 BC has excited interest and conjecture throughout the ages. The information available in the surviving ancient sources, none of which is contemporaneous, has been reviewed and compared with modern knowledge as set out in several well-known recent surgical texts. The ancient sources record epic drinking by the Macedonian nobility since at least the time of Phillip II, Alexander's father. Alexander's sudden illness and death is likely to have resulted from a surgical complication of acute alcoholic excess.

  13. Great Britain at CERN

    CERN Multimedia

    2006-01-01

    From 14 to 16 November 2006 Administration Building, Bldg. 60/61 - ground and 1st floor 09.30 - 17.30 Fifteen companies will present their latest technologies at the 'Great Britain at CERN' exhibition. British industry will exhibit products and technologies related to the field of particle physics. The main fields represented will be computing technologies, electrical engineering, electronics, mechanical engineering, vacuum & low temperature technologies and particle detectors. The exhibition is organised by BEAMA Exhibitions (the British Electrotechnical and Allied Manufacturers Association). Below you will find: a list of the exhibitors. A detailed programme will be available in due course: from your Departmental secretariat, from the Reception information desk, Building 33, at the exhibition itself. A detailed list of the companies is available at the following FI link: http://fi-dep.web.cern.ch/fi-dep/structure/memberstates/exhibitions_visits.htm LIST OF EXHIBITORS 3D Metrics Almat...

  14. Great Britain at CERN

    CERN Multimedia

    2006-01-01

    From 14 to 16 November 2006 Administration Building, Bldg. 60/61 - ground and 1st floor 09.30 - 17.30 Fifteen companies will present their latest technologies at the 'Great Britain at CERN' exhibition. British industry will exhibit products and technologies related to the field of particle physics. The main fields represented will be computing technologies, electrical engineering, electronics, mechanical engineering, vacuum & low temperature technologies and particle detectors. The exhibition is organised by BEAMA Exhibitions (the British Electrotechnical and Allied Manufacturers Association). Below you will find: a list of the exhibitors. A detailed programme will be available in due course: from your Departmental secretariat, from the Reception information desk, Building 33, at the exhibition itself. A detailed list of the companies is available at the following FI link: http://fi-dep.web.cern.ch/fi-dep/structure/memberstates/exhibitions_visits.htm LIST OF EXHIBITORS 3D Metrics Alma...

  15. The AL 333-160 fourth metatarsal from Hadar compared to that of humans, great apes, baboons and proboscis monkeys: non-conclusive evidence for pedal arches or obligate bipedality in Hadar hominins.

    Science.gov (United States)

    Mitchell, P J; Sarmiento, E E; Meldrum, D J

    2012-10-01

    Based on comparisons to non-statistically representative samples of humans and two great ape species (i.e. common chimpanzees Pan troglodytes and lowland gorillas Gorilla gorilla), Ward et al. (2011) concluded that a complete hominin fourth metatarsal (4th MT) from Hadar, AL 333-160, belonged to a committed terrestrial biped with fixed transverse and longitudinal pedal arches, which was no longer under selection favoring substantial arboreal behaviors. According to Ward et al., the Hadar 4th MT had (1) a torsion value indicating a transverse arch, (2) sagittal plane angles between the diaphyseal long axis and the planes of the articular surfaces indicating a longitudinal arch, and (3) a narrow mediolateral to dorsoplantar base ratio, an ectocuneiform facet, and tarsal articular surface contours all indicating a rigid foot without an ape-like mid-tarsal break. Comparisons of the Hadar 4th MT characters to those of statistically representative samples of humans, all five great ape species, baboons and proboscis monkeys show that none of the correlations Ward et al. make to localized foot function were supported by this analysis. The Hadar 4th MT characters are common to catarrhines that have a midtarsal break and lack fixed transverse or longitudinal arches. Further comparison of the AL 333-160 4th MT length, and base, midshaft and head circumferences to those of catarrhines with field collected body weights show that this bone is uniquely short with a large base. Its length suggests the AL 333-160 individual was a poor leaper with limited arboreal behaviors and lacked a longitudinal arch, i.e. its 4th MT long axis was usually held perpendicular to gravity. Its large base implies cuboid-4th MT joint mobility. A relatively short 4th MT head circumference indicates AL 333-160 had small proximal phalanges with a restricted range of mobility. Overall, AL 333-160 is most similar to the 4th MT of eastern gorillas, a slow moving quadruped that sacrifices arboreal behaviors

  16. The Time Scale of Recombination Rate Evolution in Great Apes

    Science.gov (United States)

    Stevison, Laurie S.; Woerner, August E.; Kidd, Jeffrey M.; Kelley, Joanna L.; Veeramah, Krishna R.; McManus, Kimberly F.; Bustamante, Carlos D.; Hammer, Michael F.; Wall, Jeffrey D.

    2016-01-01

    Abstract We present three linkage-disequilibrium (LD)-based recombination maps generated using whole-genome sequence data from 10 Nigerian chimpanzees, 13 bonobos, and 15 western gorillas, collected as part of the Great Ape Genome Project (Prado-Martinez J, et al. 2013. Great ape genetic diversity and population history. Nature 499:471–475). We also identified species-specific recombination hotspots in each group using a modified LDhot framework, which greatly improves statistical power to detect hotspots at varying strengths. We show that fewer hotspots are shared among chimpanzee subspecies than within human populations, further narrowing the time scale of complete hotspot turnover. Further, using species-specific PRDM9 sequences to predict potential binding sites (PBS), we show higher predicted PRDM9 binding in recombination hotspots as compared to matched cold spot regions in multiple great ape species, including at least one chimpanzee subspecies. We found that correlations between broad-scale recombination rates decline more rapidly than nucleotide divergence between species. We also compared the skew of recombination rates at centromeres and telomeres between species and show a skew from chromosome means extending as far as 10–15 Mb from chromosome ends. Further, we examined broad-scale recombination rate changes near a translocation in gorillas and found minimal differences as compared to other great ape species perhaps because the coordinates relative to the chromosome ends were unaffected. Finally, on the basis of multiple linear regression analysis, we found that various correlates of recombination rate persist throughout the African great apes including repeats, diversity, and divergence. Our study is the first to analyze within- and between-species genome-wide recombination rate variation in several close relatives. PMID:26671457

  17. Using poisson regression to compare rates of unsatisfactory pap smears among gynecologists and to evaluate a performance improvement plan.

    Science.gov (United States)

    Wachtel, Mitchell S; Hatley, Warren G; de Riese, Cornelia

    2009-01-01

    To evaluate impact of a performance improvement (PI) plan implemented after initial analysis, comparing 7 gynecologists working in 2 clinics. From January to October 2005, unsatisfactory rates for gynecologists and clinics were calculated. A PI plan was instituted at the end of the first quarter of 2006. Unsatisfactory rates for each quarter of 2006 and the first quarter of 2007 were calculated. Poisson regression analyzed results. A total of 100 ThinPrep Pap smears initially deemed unsatisfactory underwent reprocessing and revaluation. The study's first part evaluated 2890 smears. Clinic unsatisfactory rates, 2.7% and 2.6%, were similar (p > 0.05). Gynecologists' unsatisfactory rates were 4.8-0.6%; differences between each of the highest 2 and lowest rates were significant (p improvement. Reprocessing ThinPrep smears is an important means of reducing unsatisfactory rates but should not be a substitute for attention to quality in sampling.

  18. Silymarin improves the behavioural, biochemical and histoarchitecture alterations in focal ischemic rats: a comparative evaluation with piracetam and protocatachuic acid.

    Science.gov (United States)

    Muley, Milind M; Thakare, Vishnu N; Patil, Rajesh R; Kshirsagar, Ajay D; Naik, Suresh R

    2012-08-01

    Comparative neuroprotective potential of silymarin, piracetam and protocatechuic acid ethyl ester (PCA) was evaluated in focal ischemic rats. Various pharmacological, biochemical (lipid peroxidation, reduced glutathione, catalase, nitrite content, brain water content) and behavioural (memory impairment, motor control, neurological score) including infarct size and histopathological alterations were evaluated. Silymarin (200mg/kg) and PCA treatment significantly improved behavioural, biochemical and histopathological changes, and reduced water content and infarct size. However, piracetam only improved behavioural and histopathological changes, reduced water content and infarct size. The findings indicate that silymarin exhibits neuroprotective activity better than PCA and piracetam in focal ischemia/reperfusion reflected by its better restoration of behavioural and antioxidant profile. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. Improved Bone Safety of Tenofovir Alafenamide Compared to Tenofovir Disoproxil Fumarate Over 2 Years in Patients With Chronic HBV Infection.

    Science.gov (United States)

    Seto, Wai-Kay; Asahina, Yasuhiro; Brown, Todd T; Peng, Cheng-Yuan; Stanciu, Carol; Abdurakhmanov, Dzhamal; Tabak, Fehmi; Nguyen, Tuan T; Chuang, Wan-Long; Inokuma, Tetsuro; Ikeda, Fusao; Santantonio, Teresa Antonia; Habersetzer, François; Ramji, Alnoor; Lau, Audrey H; Suri, Vithika; Flaherty, John F; Wang, Hongyuan; Gaggar, Anuj; Subramanian, G Mani; Mukewar, Shrikant; Brunetto, Maurizia R; Fung, Scott; Chan, Henry Lik-Yuen

    2018-06-19

    Long-term use of tenofovir disoproxil fumarate (TDF) reduces bone mineral density (BMD). Tenofovir alafenamide (TAF), a new prodrug of tenofovir, has shown non-inferior efficacy to TDF in patients with chronic hepatitis B virus (HBV) infection, with improved bone effects at 48 weeks. We performed a randomized trial to evaluate the bone safety of TAF compared with TDF over 2 years, assessing baseline risk factors for bone loss, were evaluated after 2 years of treatment. In a double-blind study, hepatitis B e antigen (HBeAg)-positive patients (n=873) and HBeAg-negative patients (n=425) were randomly assigned (2:1) to groups given TAF (25 mg, n=866) or TDF (300 mg, n=432) once daily. We assessed bone safety, including hip and spine BMD, using dual-energy X-ray absorptiometry and measured changes in serum markers of bone turnover over 96 weeks. At baseline, treatment groups were well matched. At week 96, patients receiving TAF had significantly smaller decreases in hip BMD (mean reduction of 0.33%) than patients receiving TDF (mean reduction of 2.51%) (PTAF vs reduction of 2.57% in patients receiving TDF) (PTAF and TDF groups increased at week 96 compared to week 48 (PTAF group had minimal changes in markers of bone turnover by 12 weeks of treatment, but the TDF group had significant changes, compared to baseline. Risk factors for bone loss had fewer effects in patients receiving TAF than TDF at week 96. In double-blind randomized trials, we found that after 2 years of treatment, patients receiving TAF had continued improvements in bone safety compared with patients receiving TDF. Clinicaltrial.gov no: NCT01940471 and NCT01940341. Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.

  20. COMPARATIVE EFFECT OF STATIC AND DYNAMIC STRETCHING EXERCISE TO IMPROVE FLEXIBILITY OF HAMSTRING MUSCLES AMONG NON ATHLETES

    Directory of Open Access Journals (Sweden)

    Jibi Paul

    2014-10-01

    Full Text Available Background: Stretching exercises have been routinely used in persons with hamstring tightness and athletes to increase flexibility of muscle and to reduce joint injuries. Many studies have reported effect of static and dynamic stretching on flexibility of this muscle. Finding the best method to improve flexibility of hamstring muscle is important for athletes and individuals to reduce their injuries. Objective of the study was to find out the effect of static stretching exercise and dynamic stretching exercise on flexibility of hamstring muscle and also to compare the effect of static and dynamic stretching exercise on flexibility of hamstring muscle. Methods: This was a comparative experimental study with seventy four female healthy subjects from physiotherapy department of KPJ Healthcare University College, Malaysia. Convenient sampling method used to select the samples. The subjects were selected by inclusion criteria and randomly divided equally in to two with 37 subjects in each group. Static stretching exercise and dynamic stretching exercise were given as intervention program for four weeks respectively for experimental and control group. Pre and post data of restricted range of movement for knee extension was measured using goniometry and documented separately for both group. Result: In experimental and control group, pre-post statistical analysis found significant effect in increase of hamstring flexibility with P<0.0001, for right and left side. Comparative study between experimental and control group found that static stretching exercise have significant effect in increase of hamstring flexibility for right and left side with P<0.04. Conclusion: This study concluded that static stretching exercise is more effective to improve hamstring flexibility compared to dynamic stretching exercise.

  1. The improved biological response of shark tooth bioapatites in a comparative in vitro study with synthetic and bovine bone grafts.

    Science.gov (United States)

    López-Álvarez, M; Pérez-Davila, S; Rodríguez-Valencia, C; González, P; Serra, J

    2016-06-07

    Autologous bone is considered to be the gold standard for bone tissue regeneration, providing more highly efficient functional responses compared to synthetic materials, and avoiding the rejection risks of allogenic grafts. However, it presents limitations for certain types of surgery due to its high resorption levels and donor site morbidity. Different biphasic synthetic composites, based onnon-apatitic calcium phosphates enriched with apatitic phases-such as hydroxyapatite, and bioderived bone grafts of bovine and porcine origin-are proposed as lower resorption materials due to their higher crystalline structure. The present work proposes two new sources of bioapatites for bone filler applications obtained from the dentine and enameloid of shark teeth, respectively. These bioapatites each present a characteristic apatite-based composition and additional enrichments of specific trace elements, such as magnesium and fluorine, with proven roles in bone metabolism. Their processing and physicochemical characterization (SEM, FT-Raman and XRD) is presented, together with an in vitro evaluation of osteogenic activity compared to a commercial bovine mineralized matrix and synthetic HA/β TCP grafts. The results proved the globular morphology (0.5-1.5 μm) and porosity (~50 μm and ~0.5-1 μm) of shark dentine bioapatites with biphasic composition: apatitic (hydroxyapatite and apatite-(CaF)), non-apatitic (whitlockite), and an apatitic phase (fluorapatite), organized in oriented crystals in enameloid bioapatites. An evaluation of the pre-osteoblast MC3T3-E1 morphology revealed the colonization of pores in dentine bioapatites and an aligned cell growth in the oriented enameloid crystals. A higher proliferation (p  <  0.01) was detected at up to 21 d in both the shark bioapatites and synthetic biphasic graft with respect to the bovine mineralized matrix. Finally, the great potential of porous biphasic dentine bioapatites enriched with Mg and the aligned

  2. Comparative metabolomics profiling of engineered Saccharomyces cerevisiae lead to a strategy that improving β-carotene production by acetate supplementation.

    Directory of Open Access Journals (Sweden)

    Xiao Bu

    Full Text Available A comparative metabolomic analysis was conducted on recombinant Saccharomyces cerevisiae strain producing β-carotene and the parent strain cultivated with glucose as carbon source using gas chromatography-mass spectrometry (GC-MS, high performance liquid chromatography-mass spectrometry (HPLC-MS and ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS based approach. The results showed that most of the central intermediates associated with amino acids, carbohydrates, glycolysis and TCA cycle intermediates (acetic acid, glycerol, citric acid, pyruvic acid and succinic acid, fatty acids, ergosterol and energy metabolites were produced in a lower amount in recombinant strain, as compared to the parent strain. To increase β-carotene production in recombinant strain, a strategy that exogenous addition of acetate (10 g/l in exponential phase was developed, which could enhance most intracellular metabolites levels and result in 39.3% and 14.2% improvement of β-carotene concentration and production, respectively, which was accompanied by the enhancement of acetyl-CoA, fatty acids, ergosterol and ATP contents in cells. These results indicated that the amounts of intracellular metabolites in engineered strain are largely consumed by carotenoid formation. Therefore, maintaining intracellular metabolites pool at normal levels is essential for carotenoid biosynthesis. To relieve this limitation, rational supplementation of acetate could be a potential way because it can partially restore the levels of intracellular metabolites and improve the production of carotenoid compounds in recombinant S. cerevisiae.

  3. A novel stent inflation protocol improves long-term outcomes compared with rapid inflation/deflation deployment method.

    Science.gov (United States)

    Vallurupalli, Srikanth; Kasula, Srikanth; Kumar Agarwal, Shiv; Pothineni, Naga Venkata K; Abualsuod, Amjad; Hakeem, Abdul; Ahmed, Zubair; Uretsky, Barry F

    2017-08-01

    High-pressure inflation for coronary stent deployment is universally performed. However, the duration of inflation is variable and does not take into account differences in lesion compliance. We developed a standardized "pressure optimization protocol" (POP) using inflation pressure stability rather than an arbitrary inflation time or angiographic balloon appearance for stent deployment. Whether this approach improves long-term outcomes is unknown. 792 patients who underwent PCI using either rapid inflation/deflation (n = 376) or POP (n = 416) between January 2009 and March 2014 were included. Exclusion criteria included PCI for acute myocardial infarction, in-stent restenosis, chronic total occlusion, left main, and saphenous vein graft lesions. Primary endpoint was target vessel failure [TVF = combined end point of target vessel revascularization (TVR), myocardial infarction, and cardiac death]. Outcomes were analyzed in the entire cohort and in a propensity analysis. Stent implantation using POP with a median follow-up of 1317 days was associated with lower TVF compared with rapid inflation/deflation (10.1 vs. 17.8%, P inflation/deflation (10 vs. 18%, P < 0.0001). Stent deployment using POP led to reduced TVF compared to rapid I/D. These results recommend this method to improve long-term outcomes. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  4. Grooming Great Urban Teachers

    Science.gov (United States)

    Foster, Michele; Lewis, Jeffrey; Onafowora, Laura

    2005-01-01

    Master teachers working in real urban classrooms have shared their exemplary teaching practices in an After-School Pedagogical Laboratory (L-TAPL), a program for elementary students that aims to improve the achievement of urban students and the competence of their teachers. The L-TAPL enrichment program curriculum includes language arts, math,…

  5. Addressing Flooding and SuDS when Improving Drainage and Sewerage Systems—A Comparative Study of Selected Scandinavian Cities

    Directory of Open Access Journals (Sweden)

    Geir Torgersen

    2014-04-01

    Full Text Available Pluvial flooding already challenges the capacity of drainage and sewerage system in urban areas in Scandinavia. For system owners this requires a stricter prioritization when improving the systems. Experts seem to agree that a regime shift from improving old combined sewers by piped solutions to more sustainable drainage systems (SuDS, must take place. In this paper results from an investigation amongst the largest cities in Norway, Denmark and Sweden concerning drivers and preferred methods for improving the old system are presented. The results indicate that Norway ranks flood prevention lower than the other Scandinavian countries. During the last decades, Norwegian authorities have had a strong focus on pollution from wastewater treatment plants (WWTP. The attention to drainage and sewerage system regarding flooding, water leaks, infiltration or pollution has been neglected. Renewal or rate of investment in relation to existing drainage and sewerage system is easy to register, and provides a measure of the activity. In order to optimize flood prevention, and may be promoting the use of SuDS, the cities should be required to measure the efficiency, either by monitoring or modeling the impact of stormwater to the system. Lack of such requirements from Norwegian authorities seem to be a plausible explanation to why Norwegian cities are less focused on flood prevention compared to Swedish and Danish cities.

  6. Comparing the efficacy of digital flashcards versus paper flashcards to improve receptive and productive L2 vocabulary

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    Gilbert Dizon

    2017-06-01

    Full Text Available Several researchers have compared the efficacy of digital flashcards (DFs versus paper flashcards (PFs to improve L2 vocabulary and have concluded that using DFs is more effective (Azabdaftari & Mozaheb, 2012; Başoğlu & Akdemir, 2010; Kiliçkaya & Krajka, 2010. However, these studies did not utilize vocabulary learning strategies (VLSs as a way to support the vocabulary development of those using PFs. This is significant because DFs often offer a range of features to promote vocabulary development, whereas PFs are much more basic; thus, learners who study via paper materials are at a disadvantage compared with those who use DFs. Given the success that VLSs have had in fostering L2 vocabulary enhancement (e.g., Mizumoto & Takeuchi, 2009, their incorporation could have influenced the previous studies. Therefore, one of the primary aims of this study was to find if there were significant differences in receptive and productive L2 vocabulary improvements between students who used PFs in conjunction with 3 VLSs – dropping, association, and oral rehearsal – and those who used the DF tools Quizlet and Cram. Additionally, the researchers examined the learners’ opinions to see if there was a preference for either study method. A total of 52 EFL students at two Japanese universities participated in the 12-week study. Pre- and post-tests were administered to measure the vocabulary gains in the PF group (n = 26 and the DF group (n = 26. Results from a paired t-test revealed that both groups made significant improvements in receptive and productive vocabulary. However, the difference between the gains was not significant, which contrasts with past comparison studies of DFs and PFs and highlights the importance of VLSs. A 10-item survey with closed and Likert-scale questions was also administered to determine the participants’ opinions towards the study methods. Higher levels of agreement were found in the experimental group, indicating that the

  7. Review: The Great Gatsby

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    Antonia de Jesus Sales

    2016-08-01

    Full Text Available A presente resenha busca discutir a tradução de The Great Gatsby para o contexto brasileiro. Diversas traduções foram feitas, em diversas épocas e com repercussão positiva no contexto brasileiro. Para o presente estudo, foi observada a tradução de Vanessa Bárbara, de 2011. Nesse sentido, o aspecto biográficos do autor e a forma como se apresentam os personagens na obra são fatores de cotejamento na obra original e na tradução brasileira. Francis Scott Key Fitzgerald (1896 – 1940 é famoso por ter em suas obras traços biográficos, algo que certamente influencia o leitor que adentra a sua obra. Quanto à recepção de O Grande Gatsby no contexto brasileiro, há que se considerar que O Grande Gatsby teve diversas traduções no Brasil. Depois dessa tradução de Vanessa Bárbara, em 2011, outras três vieram em 2013, juntamente com o filme. Há que considerar os aspectos comerciais embutidos nessas traduções e que muito corroboram para o resultado final. Prova disso são as capas, que são sempre diferenciadas em cada edição lançada. O tradutor nem sempre pode opinar sobre questões como estas. A tradução, a meu ver, é uma obra de qualidade, visto que a tradutora buscou ser fiel, sem dificultar a interpretação da obra para o leitor.

  8. Review: The Great Gatsby

    Directory of Open Access Journals (Sweden)

    Antonia de Jesus Sales

    2016-05-01

    Full Text Available A presente resenha busca discutir a tradução de The Great Gatsby para o contexto brasileiro. Diversas traduções foram feitas, em diversas épocas e com repercussão positiva no contexto brasileiro. Para o presente estudo, foi observada a tradução de Vanessa Bárbara, de 2011. Nesse sentido, o aspecto biográficos do autor e a forma como se apresentam os personagens na obra são fatores de cotejamento na obra original e na tradução brasileira. Francis Scott Key Fitzgerald (1896 – 1940 é famoso por ter em suas obras traços biográficos, algo que certamente influencia o leitor que adentra a sua obra. Quanto à recepção de O Grande Gatsby no contexto brasileiro, há que se considerar que O Grande Gatsby teve diversas traduções no Brasil. Depois dessa tradução de Vanessa Bárbara, em 2011, outras três vieram em 2013, juntamente com o filme. Há que considerar os aspectos comerciais embutidos nessas traduções e que muito corroboram para o resultado final. Prova disso são as capas, que são sempre diferenciadas em cada edição lançada. O tradutor nem sempre pode opinar sobre questões como estas. A tradução, a meu ver, é uma obra de qualidade, visto que a tradutora buscou ser fiel, sem dificultar a interpretação da obra para o leitor.

  9. Great Lakes Environmental Database (GLENDA)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Great Lakes Environmental Database (GLENDA) houses environmental data on a wide variety of constituents in water, biota, sediment, and air in the Great Lakes area.

  10. Soon we will almost all use IFRS when preparing accounting information – but does that improve financial statements’ comparability?

    DEFF Research Database (Denmark)

    Schøler, Finn

    2013-01-01

    “version” of IFRS is at stake here? For our comparisons and analyses we carefully chose ROIC since this financial ratio is not biased by differences in the capital structure or size of the companies but serves as a well-defined and commonly used accounting operational profitability measure. RESULTS...... to prescribe some accounting practice such as references to the process or input part of producing accounting information when the alleged aim is to improve the comparability of the accounting information provided by the companies, i.e. the financial statements or the output part? DATA & METHODS From...... the global ORBIS-database, we selected all listed non-financial and non-insurance companies with a turnover in the last available financial year larger than 100 million USD, which left us with more than 18 thousand public accounts (companies) from 124 different countries from all over the world. Based...

  11. Interpreting the improved outcome of patients with central nervous system metastases managed in clinical trials compared with standard hospital practice

    International Nuclear Information System (INIS)

    Tang, J.I; Back, M.; Shakespeare, T.; Lu, J.J.; Mukherjee, R.; Wynne, C.

    2005-01-01

    The aims were to determine the median survival and prognostic factors of patients with central nervous system (CNS) metastases managed with whole-brain radiation therapy (WBRT), and to explore selection criteria in recently published clinical trials using aggressive interventions in CNS metastases. A retrospective audit was performed on patients managed with WBRT for CNS metastases. Potential prognostic factors were recorded and analysed for their association with survival duration. The proportion of patients with these factors was also compared with those of patients managed under three recently reported studies investigating aggressive interventions, such as radiosurgery and chemotherapy for CNS metastases. Seventy-three patients were treated with WBRT for cerebral metastases over a 12-month period. The median survival of the population was 3.4 months (95% confidence interval: 2.7-4.1), with 6- and 12-month survival rates of 30 and 18%, respectively. Significant prognostic factors for prolonged median survival were Eastern Cooperative Oncology Group status 0-2 (P = 0.015), Medical Research Council neurological functional status 0-1 (P = 0.006), and Recursive Partitioning Analysis Class 2 versus Class 3 (P = 0.020). On multivariate analysis, younger patient age (P = 0.02) and better performance status (P<0.01) were associated with improved outcome. When comparing these characteristics with selected published studies, our study cohort demonstrated a higher proportion of patients with poor performance status, a greater number of metastases per patient and a higher incidence of extracranial disease. This reflects the selected nature of patients in these published studies. Central nervous system metastases confer a poor prognosis and, for the majority of patients, aggressive interventions are unlikely to improve survival. The use of potentially toxic and expensive treatments should be reserved for those few in whom these studies have shown a potential benefit

  12. Different surgical strategies for chronic pancreatitis significantly improve long-term outcome: a comparative single center study

    Directory of Open Access Journals (Sweden)

    Hildebrand P

    2010-08-01

    Full Text Available Abstract Objective In general, chronic pancreatitis (CP primarily requires conservative treatment. The chronic pain syndrome and complications make patients seek surgical advice, frequently after years of progression. In the past, surgical procedures involving drainage as well as resection have been employed successfully. The present study compared the different surgical strategies. Patients and Methods From March 2000 until April 2005, a total of 51 patients underwent surgical treatment for CP at the Department of surgery, University of Schleswig-Holstein, Campus Lübeck. Out of those 51 patients, 39 (76.5% were operated according to the Frey procedure, and in 12 cases (23.5% the Whipple procedure was performed. Patient data were documented prospectively throughout the duration of the hospital stay. The evaluation of the postoperative pain score was carried out retrospectively with a validated questionnaire. Results Average operating time was 240 minutes for the Frey group and 411 minutes for the Whipple group. The medium number of blood transfusions was 1 in the Frey group and 4.5 in the Whipple group. Overall morbidity was 21% in the Frey group and 42% in the Whipple group. 30-day mortality was zero for all patients. During the median follow-up period of 50 months, an improvement in pain score was observed in 93% of the patients of the Frey group and 67% of the patients treated according to the Whipple procedure. Conclusion The results show that both the Frey procedure as well as partial pancreaticoduodenectomy are capable of improving chronic pain symptoms in CP. As far as later endocrine and exocrine pancreatic insufficiency is concerned, however, the extended drainage operation according to Frey proves to be advantageous compared to the traditional resection procedure by Whipple. Accordingly, the Frey procedure provides us with an organ-preserving surgical procedure which treats the complications of CP sufficiently, thus being an

  13. A COMPARATIVE STUDY ON EFFECTIVENESS OF OPEN VERSUS CLOSED KINETIC CHAIN EXERCISES TO IMPROVE GAIT IN SPASTIC DIPLEGIC CEREBRAL PALSY

    Directory of Open Access Journals (Sweden)

    Trishna Saikia Baruah

    2016-04-01

    Full Text Available Background: Cerebral Palsy (CP describes a non- progressive but not unchanging disorder of movement and posture due to an insult to or anomaly of the developing brain. People with spastic diplegia typically walk slowly and have difficulties in performing activities such as walking running or jumping. Children with spastic diplegic cerebral palsy are relied more on cadence to increase speed. Hence, the purpose of this study is to compare the effectiveness of open and closed kinetic chain (OKC and CKC exercises in improving gait in spastic diplegic cerebral palsy. Methods: 30 children with spastic diplegic cerebral palsy of both genders with age 4-12 years was taken. Cadence and distance covered in 1Minute Walk Test was calculated before and after the test. The intervention for group A was CKC exercises and group B was OKC exercises for 3 days a week for 6 weeks and each session lasted for 30-45 minutes was given for both the groups. Results: Paired t-test was performed to find effectiveness of CKC and OKC improving gait in spastic diplegic CP to see the difference of means of 1minute walk, t = 10.789 which is significant (p = 0.000 and for cadence, t = 3.37 which is highly significant (p = 0.00 implying that cadence and distance covered in1minute walk was more with CKC exercises. Conclusion: Based on the result it is concluded that CKC exercises are effective in improving gait than OKC exercises in spastic diplegic cerebral palsy.

  14. Efficacy, safety, and improved tolerability of travoprost BAK-free ophthalmic solution compared with prior prostaglandin therapy

    Directory of Open Access Journals (Sweden)

    J Charles Henry

    2008-10-01

    Full Text Available J Charles Henry1, James H Peace2, Jeanette A Stewart3,4, William C Stewart3,41Little Rock Eye Clinic, Little Rock, AR, USA; 2Diabetic Eye Medical Clinic, Inglewood, CA, USA; 3PRN Pharmaceutical Research Network, LLC, Dallas,TX, USA; 4Carolina Eye Institute, University of South Carolina, School of Medicine, Columbia, SC, USAPurpose: To evaluate the efficacy, safety and tolerability of changing to travoprost BAK-free from prior prostaglandin therapy in patients with primary open-angle glaucoma or ocular hypertension.Design: Prospective, multi-center, historical control study.Methods: Patients treated with latanoprost or bimatoprost who needed alternative therapy due to tolerability issues were enrolled. Patients were surveyed using the Ocular Surface Disease Index (OSDI to evaluate OSD symptoms prior to changing to travoprost BAK-free dosed once every evening. Patients were re-evaluated 3 months later.Results: In 691 patients, travoprost BAK-free demonstrated improved mean OSDI scores compared to either latanoprost or bimatoprost (p < 0.0001. Patients having any baseline OSD symptoms (n = 235 demonstrated significant improvement after switching to travoprost BAK-free (p < 0.0001. In 70.2% of these patients, symptoms were reduced in severity by at least 1 level. After changing medications to travoprost BAK-free, mean intraocular pressure (IOP was significantly decreased (p < 0.0001. Overall, 72.4% preferred travoprost BAK-free (p < 0.0001, travoprost BAK-free vs prior therapy. Travoprost BAK-free demonstrated less conjunctival hyperemia than either prior therapy (p < 0.0001.Conclusions: Patients previously treated with a BAK-preserved prostaglandin analog who are changed to travoprost BAK-free have clinically and statistically significant improvement in their OSD symptoms, decreased hyperemia, and equal or better IOP control.Keywords: glaucoma, prostaglandin analog, travoprost, latanoprost, bimatoprost, preservative, benzalkonium chloride

  15. Timely disclosure of progress in long-term cancer survival: the boomerang method substantially improved estimates in a comparative study.

    Science.gov (United States)

    Brenner, Hermann; Jansen, Lina

    2016-02-01

    Monitoring cancer survival is a key task of cancer registries, but timely disclosure of progress in long-term survival remains a challenge. We introduce and evaluate a novel method, denoted "boomerang method," for deriving more up-to-date estimates of long-term survival. We applied three established methods (cohort, complete, and period analysis) and the boomerang method to derive up-to-date 10-year relative survival of patients diagnosed with common solid cancers and hematological malignancies in the United States. Using the Surveillance, Epidemiology and End Results 9 database, we compared the most up-to-date age-specific estimates that might have been obtained with the database including patients diagnosed up to 2001 with 10-year survival later observed for patients diagnosed in 1997-2001. For cancers with little or no increase in survival over time, the various estimates of 10-year relative survival potentially available by the end of 2001 were generally rather similar. For malignancies with strongly increasing survival over time, including breast and prostate cancer and all hematological malignancies, the boomerang method provided estimates that were closest to later observed 10-year relative survival in 23 of the 34 groups assessed. The boomerang method can substantially improve up-to-dateness of long-term cancer survival estimates in times of ongoing improvement in prognosis. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Comparative research on tillable properties of diatomite-improved soils in the Yangtze River Delta region, China.

    Science.gov (United States)

    Qu, Ji-Li; Zhao, Dong-Xue

    2016-10-15

    To improve soil texture and structure, techniques associated with physical, biological or chemical aspects are generally adopted, among which diatomite is an important soil conditioner. However, few studies have been conducted to investigate the physical, hydraulic and tillage performance of diatomite-improved soils. Consistency limits and compaction properties were investigated in this study, and several performance indicators were compared, such as the liquid limit, plastic limit and compactability, of silt, silt loam and silty-clay loam soils to which diatomite was added at volumetric ratios of 0%, 10%, 20%, and 30%. The results showed that diatomite significantly (pdiatomite lowered the maximum dry bulk density (MBD) of the classified soils, the optimum moisture content (OMC) was increased overall. The trend was consistent with the proportion of diatomite, and MBD decreased by 8.7%, 10.3%, and 13.2% in the silt, silt loam and silty-clay loam soils when 30% diatomite was mixed, whereas OMC increased by 28.7%, 22.4%, and 25.3%, respectively. Additionally, aggregate stability was negatively correlated with MBD but positively correlated with OMC. Diatomite exerts positive effects on soil mechanical strength, suggesting that soils from sludge farms are more tillable with a larger stabilized and workable matrix. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. A randomized trial comparing in person and electronic interventions for improving adherence to oral medications in schizophrenia.

    Science.gov (United States)

    Velligan, Dawn; Mintz, Jim; Maples, Natalie; Xueying, Li; Gajewski, Stephanie; Carr, Heather; Sierra, Cynthia

    2013-09-01

    Poor adherence to medication leads to symptom exacerbation and interferes with the recovery process for patients with schizophrenia. Following baseline assessment, 142 patients in medication maintenance at a community mental health center were randomized to one of 3 treatments for 9 months: (1) PharmCAT, supports including pill containers, signs, alarms, checklists and the organization of belongings established in weekly home visits from a PharmCAT therapist; (2) Med-eMonitor (MM), an electronic medication monitor that prompts use of medication, cues the taking of medication, warns patients when they are taking the wrong medication or taking it at the wrong time, record complaints, and, through modem hookup, alerts treatment staff of failures to take medication as prescribed; (3) Treatment as Usual (TAU). All patients received the Med-eMonitor device to record medication adherence. The device was programmed for intervention only in the MM group. Data on symptoms, global functioning, and contact with emergency services and police were obtained every 3 months. Repeated measures analyses of variance for mixed models indicated that adherence to medication was significantly better in both active conditions than in TAU (both p<0.0001). Adherence in active treatments ranged from 90-92% compared to 73% in TAU based on electronic monitoring. In-person and electronic interventions significantly improved adherence to medication, but that did not translate to improved clinical outcomes. Implications for treatment and health care costs are discussed.

  18. Hemodiafiltration Improves Plasma 25-Hepcidin Levels: A Prospective, Randomized, Blinded, Cross-Over Study Comparing Hemodialysis and Hemodiafiltration

    Directory of Open Access Journals (Sweden)

    Bergur V. Stefánsson

    2012-03-01

    Full Text Available Background/Aims: Data from studies comparing the effect of hemodiafiltration (HDF and conventional hemodialysis (HD on clinically important outcomes are insufficient to support superiority of HDF. None of these studies has been participant-blinded. Methods: We performed a prospective, randomized, and patient-blinded cross-over study. Twenty patients on chronic HD received either HD for 2 months followed by post-dilution HDF for 2 months or in opposite order. A range of clinical parameters, as well as markers of inflammation, oxidative stress and iron metabolism was measured. Results: The two treatments were similar with respect to dialysis-related complications, quality of life, and the biomarkers of oxidative stress and inflammation. Compared to HD, 25-hepcidin and β2-microglobulin were 38 and 32%, respectively, lower after 60 days of HDF (p Conclusion: In short term, HDF is not superior to HD regarding dialysis-related complications. The higher ESA consumption observed with HDF can be explained by blood clotting in tubing and dialyzers, as more anticoagulation was needed with post-dilution HDF. In a longer perspective, lowering serum hepcidin levels may improve pathological iron homeostasis.

  19. The great transition.

    Science.gov (United States)

    Lieberthal, Kenneth; Lieberthal, Geoffrey

    2003-10-01

    As China's economy grows and opens further, the opportunity it presents to multinationals is changing. Foreign companies are moving to country development and new strategic choices. Now, foreign firms can actually go after the Chinese domestic market, and it's worth going after. Improvements in China's infrastructure, workforce, and regulatory environment are making it possible for companies to lower their costs to reap new competitive advantages. Multifaceted and often-shifting risks accompany this shifting opportunity. The reforms required for admission into the WTO will be politically difficult for China to implement, and its progress will be slowed by the scarcity of resources for the country's shaky banking system, the inadequacy of the social safety net, environmental problems, and local governments' cash shortage. China's breathtaking 9% average annual GDP growth rests on an unsteady foundation of overcapitalized state-owned enterprises, which have oversupplied many markets, and fiercely protectionist regional government officials pursuing growth-at-almost-all-costs policies. Frequent changes in regulations, bureaucracies, and reporting relationships will continue to make planning difficult, and, as the SARS epidemic demonstrated, there is always the potential for serious disruptions. But for at least the next ten years, multinationals should be the biggest winners in China. To reap the benefits, a multinational must properly nest its effort into its overall organization, show "one face to China" at the national level but also tailor local strategies, be wary of joint ventures, and mitigate risk, in particular the theft of intellectual property. China is a major opportunity for companies that forthrightly face its complexities. It will remain largely inscrutable--and unprofitable--for the rest.

  20. A comparative study of art therapy in cancer patients receiving chemotherapy and improvement in quality of life by watercolor painting.

    Science.gov (United States)

    Bozcuk, H; Ozcan, K; Erdogan, C; Mutlu, H; Demir, M; Coskun, S

    2017-02-01

    There is limited data on the role of art therapy used in cancer patients. We wanted to test the effect of painting art therapy provided by a dedicated professional painting artist on quality of life and anxiety and depression levels in patients having chemotherapy. Cancer patients having chemotherapy in the day unit of a medical oncology department of a university hospital were offered to take part in a painting art therapy program (PATP). This program consisted of a professional painting artist facilitating and helping patients to perform painting during their chemotherapy sessions while they were in the day unit, as well as supplying them painting material for home practice. The changes in quality of life domains of EORTC-QLQ-C30 questionnaire and in Hospital Anxiety and Depression Scores (HADS) were assessed before and after the PATP. These results were contrasted with a reference group of cancer patients on chemotherapy but not taking part in the PATP. In order to adjust for multiple comparisons of quality of life parameters between patient groups, we utilized the Bonferroni correction. A total of 48 patients, of which 26 patients did and 22 did not have prior exposure to PATP, were enrolled in the PATP. A control group of 24 patients who did not have any PATP activity during the study period also took part in the study. With PATP, there was significant improvement in global quality of life (F=7.87, P=0.001), and depression scores (F=7.80, P=0.001). To our knowledge, this is the largest comparative PATP experience in cancer patients on chemotherapy and show that PATP is feasible in the clinics. Our results confirm that art therapy in the form of painting improves quality of life and depression in cancer patients having chemotherapy. This effect was more pronounced in patients without any previous experience of PATP. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Comparing the Effectiveness of Paroxetine, Attention Modification Program and Combination of both on Improving Social Anxiety Symptoms

    Directory of Open Access Journals (Sweden)

    Hosein Khedmatgozar

    2012-08-01

    Full Text Available Introduction: Although the effectiveness of paroxetine and Attention Modification Program has been studied separately in treating social anxiety disorder, there has been no research comparing them according to the literature. The aim of this study was to compare the effectiveness of paroxetine, Attention Modification Program (AMP and combination of both on improving the Social Anxiety Symptoms. Methods: 33 patients meeting DSM-IV-TR criteria for social anxiety disorder were randomly assigned in 3 groups: 11 in paroxetine group, 11 in AMP group and 11 in combined group. Treatment intervention was done during 8 weeks period. Social Phobia Inventory (SPIN, Beck Depression Inventory (BDI-II and Sheehan Disability Scale (SDS were administered before and after treatment intervention. One-way Analysis of Covariance (ANCOVA was used to determine the differences and efficacy of treatment interventions between groups. Data analysis was done by SPSS-16 software. Results: 28 participants completed the treatment period. One-way ANCOVA results showed statistically significant differences in post-treatment scores of social phobia (p=0/007, depressive symptoms (p=0.007 and daily life functioning (p=0.011 between three groups. Bonferroni correction showed that combined treatment is significantly more effective than AMP in reducing social phobia symptoms (p=0.007, depressive symptoms (p=0.022 and enhancing daily life functioning (0.019. Yet, there were no significant differences between Paroxetine and combined treatment in all post-treatment scores (p=0.890, p=1.000, p=1.000 for social phobia, depressive symptoms and daily life functioning respectively. Paroxetine showed more significant improvement of depressive symptoms (p=0.016 and enhancing daily life functioning (p=0.045 than AMP. Also, there were no significant differences between paroxetine and AMP in reducing social anxiety symptoms. Discussion: It seems that paroxetine has wider effect in reducing social

  2. Comparing the Effectiveness of Paroxetine, Attention Modification Program and Combination of both on Improving Social Anxiety Symptoms

    Directory of Open Access Journals (Sweden)

    Aliasghar Asgharnejad Farid

    2012-09-01

    Full Text Available Introduction: Although the effectiveness of paroxetine and Attention Modification Program has been studied separately in treating social anxiety disorder, there has been no research comparing them according to the literature. The aim of this study was to compare the effectiveness of paroxetine, Attention Modification Program (AMP and combination of both on improving the Social Anxiety Symptoms.Methods:33 patients meeting DSM-IV-TR criteria for social anxiety disorder were randomly assigned in 3 groups: 11 in paroxetine group, 11 in AMP group and 11 in combined group. Treatment intervention was done during 8 weeks period. Social Phobia Inventory (SPIN, Beck Depression Inventory (BDI-II and Sheehan Disability Scale (SDS were administered before and after treatment intervention. One-way Analysis of Covariance (ANCOVA was used to determine the differences and efficacy of treatment interventions between groups. Data analysis was done by SPSS-16 software.Results:28 participants completed the treatment period. One-way ANCOVA results showed statistically significant differences in post-treatment scores of social phobia (p=0/007, depressive symptoms (p=0.007 and daily life functioning (p=0.011 between three groups. Bonferroni correction showed that combined treatment is significantly more effective than AMP in reducing social phobia symptoms (p=0.007, depressive symptoms (p=0.022 and enhancing daily life functioning (0.019. Yet, there were no significant differences between Paroxetine and combined treatment in all post-treatment scores (p=0.890, p=1.000, p=1.000 for social phobia, depressive symptoms and daily life functioning respectively. Paroxetine showed more significant improvement of depressive symptoms (p=0.016 and enhancing daily life functioning (p=0.045 than AMP. Also, there were no significant differences between paroxetine and AMP in reducing social anxiety symptoms.Discussion:It seems that paroxetine has wider effect in reducing social

  3. Climate variability and Great Plains agriculture

    International Nuclear Information System (INIS)

    Rosenberg, N.J.; Katz, L.A.

    1991-01-01

    The ways in which inhabitants of the Great Plains, including Indians, early settlers, and 20th century farmers, have adapted to climate changes on the Great Plains are explored. The climate of the Great Plains, because of its variability and extremes, can be very stressful to plants, animals and people. It is suggested that agriculture and society on the Great Plains have, during the last century, become less vulnerable to the stresses imposed by climate. Opinions as to the sustainability of agriculture on the Great Plains vary substantially. Lockeretz (1981) suggests that large scale, high cost technologies have stressed farmers by creating surpluses and by requiring large investments. Opie (1989) sees irrigation as a climate substitute, however he stresses that the Ogallala aquifer must inevitably become depleted. Deborah and Frank Popper (1987) believe that farming on the Plains is unsustainable, and destruction of shelterbelts, out-migration of the rural population and environmental problems will lead to total collapse. With global warming, water in the Great Plains is expected to become scarcer, and although improvements in irrigation efficiency may slow depletion of the Ogallala aquifer, ultimately the acreage under irrigation must decrease to levels that can be sustained by natural recharge and reliable surface flows. 23 refs., 2 figs

  4. Conformal treatment of prostate cancer with improved targeting: superior prostate-specific antigen response compared to standard treatment

    Energy Technology Data Exchange (ETDEWEB)

    Corn, Benjamin W; Hanks, Gerald E; Schultheiss, Timothy E; Hunt, Margie A; Lee, W Robert; Coia, Lawrence R

    1995-05-15

    Purpose: Conformal radiation therapy (CRT) decreases the morbidity of prostate cancer treatment, but no published data attest to the improved ability of CRT to control disease. Therefore, we compared Prostate-Specific Antigen (PSA) response at 1 year among similarly staged patients treated by conformal techniques to those treated with conventional approaches, looking for an early indicator of tumor response. Method and Materials: Patients with locally advanced disease were treated by pelvic fields followed by prostate field conedowns; those with early stage/low grade disease received only prostate field irradiation. Between October, 1987 and November, 1991, conventional treatments used rectangular beams with or without corner blocks. Neither urethrography nor immobilization casts were used for conventionally treated patients. Between April, 1989 and December, 1992, conformal treatments have used rigid immobilization and Computed Tomography-based, beams-eye-view field design. As such, our conformal approach allowed improved targeting. Median prescribed doses (minimal doses to the Planning Target Volume) were 70 Gy (66-73 Gy) and 70.2 Gy (64.8-75 Gy) for conventionally and conformally treated patients, respectively. Median daily fraction size was 1.8 Gy for conventional treatment and 2.0 Gy for conformal therapy. Baseline PSA data were available on 170 consecutive patients treated conformally and 90 consecutive patients treated conventionally. Results: Among those receiving only prostatic field irradiation, 12-month PSA values returned to normal in 96% and 85% of conformally and conventionally treated patients, respectively, when normalization was defined as {<=} 4 ng/ml (p < 0.03) and in 76% vs. 55% of patients when PSA normalization was defined as {<=} 1.5 ng/ml (p < 0.02). Among those receiving pelvic irradiation prior to prostatic conedown, PSA normalization ({<=} 4 ng/ml) occurred in 82% and 61% (p < 0.01) of conformally and conventionally treated patients

  5. Comparative Effectiveness of Usual Source of Care Approaches to Improve End-of-Life Outcomes for Children With Intellectual Disability.

    Science.gov (United States)

    Lindley, Lisa C; Cozad, Melanie J

    2017-09-01

    Children with intellectual disability (ID) are at risk for adverse end-of-life outcomes including high emergency room utilization and hospital readmissions, along with low hospice enrollment. The objective of this study was to compare the effectiveness of usual source of care approaches to improve end-of-life outcomes for children with ID. We used longitudinal California Medicaid claims data. Children were included who were 21 years with fee-for-service Medicaid claims, died between January 1, 2007, and December 31, 2010, and had a moderate-to-profound ID diagnosis. End-of-life outcomes (i.e., hospice enrollment, emergency room utilization, hospital readmissions) were measured via claims data. Our treatments were usual source of care (USC) only vs. usual source of care plus targeted case management (USC plus TCM). Using instrumental variable analysis, we compared the effectiveness of treatments on end-of-life outcomes. Ten percent of children with ID enrolled in hospice, 73% used the emergency room, and 20% had three or more hospital admissions in their last year of life. USC plus TCM relative to USC only had no effect on hospice enrollment; however, it significantly reduced the probability of emergency room utilization (B = -1.29, P life outcomes for children with ID. Further study of the extent of UCS and TCM involvement in reducing emergency room utilization and hospital readmissions at end of life is needed. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  6. Comparing different maize supplementation strategies to improve resilience and resistance against gastrointestinal nematode infections in browsing goats.

    Science.gov (United States)

    Gárate-Gallardo, Leslie; Torres-Acosta, Juan Felipe de Jesús; Aguilar-Caballero, Armando Jacinto; Sandoval-Castro, Carlos Alfredo; Cámara-Sarmiento, Ramón; Canul-Ku, Hilda Lorena

    2015-01-01

    The effect of maize grain supplementation on the resilience and resistance of browsing Criollo goat kids against gastrointestinal nematodes was evaluated. Five-month-old kids (n = 42), raised worm-free, were allocated to five groups: infected + not supplemented (I-NS; n = 10), infected + maize supplement at 108 g/d (I-S108; n = 8), maize supplement at 1% of body weight (BW) (I-S1%; n = 8), maize supplement at 1.5% BW (I-S1.5%; n = 8), or infected + supplemented (maize supplement 1.5% BW) + moxidectin (0.2 mg/kg BW subcutaneously every 28 d) (T-S1.5%; n = 8). Kids browsed daily (7 h) in a tropical forest for 112 days during the rainy season. Kids were weighed weekly to adjust supplementary feeding. Hematocrit (Ht), hemoglobin (Hb), and eggs per gram of feces were determined fortnightly. On day 112, five goat kids were slaughtered per group to determine worm burdens. Kids of the I-S1.5% group showed similar body-weight change, Ht and Hb, compared to kids without gastrointestinal nematodes (T-S1.5%), as well as lower eggs per gram of feces and Trichostrongylus colubriformis worm burden compared to the I-NS group (P > 0.05). Thus, among the supplement levels tested, increasing maize supplementation at 1.5% BW of kids was the best strategy to improve their resilience and resistance against natural gastrointestinal nematode infections under the conditions of forage from the tropical forest. © L. Gárate-Gallardo et al., published by EDP Sciences, 2015.

  7. Comparative study of protoporphyrin IX fluorescence image enhancement methods to improve an optical imaging system for oral cancer detection

    Science.gov (United States)

    Jiang, Ching-Fen; Wang, Chih-Yu; Chiang, Chun-Ping

    2011-07-01

    Optoelectronics techniques to induce protoporphyrin IX fluorescence with topically applied 5-aminolevulinic acid on the oral mucosa have been developed to noninvasively detect oral cancer. Fluorescence imaging enables wide-area screening for oral premalignancy, but the lack of an adequate fluorescence enhancement method restricts the clinical imaging application of these techniques. This study aimed to develop a reliable fluorescence enhancement method to improve PpIX fluorescence imaging systems for oral cancer detection. Three contrast features, red-green-blue reflectance difference, R/B ratio, and R/G ratio, were developed first based on the optical properties of the fluorescence images. A comparative study was then carried out with one negative control and four biopsy confirmed clinical cases to validate the optimal image processing method for the detection of the distribution of malignancy. The results showed the superiority of the R/G ratio in terms of yielding a better contrast between normal and neoplastic tissue, and this method was less prone to errors in detection. Quantitative comparison with the clinical diagnoses in the four neoplastic cases showed that the regions of premalignancy obtained using the proposed method accorded with the expert's determination, suggesting the potential clinical application of this method for the detection of oral cancer.

  8. Comparative effectiveness of quality improvement interventions for pressure ulcer prevention in academic medical centers in the United States.

    Science.gov (United States)

    Padula, William V; Makic, Mary Beth F; Mishra, Manish K; Campbell, Jonathan D; Nair, Kavita V; Wald, Heidi L; Valuck, Robert J

    2015-06-01

    Prevention of pressure ulcers, one of the hospital-acquired conditions (HACs) targeted by the 2008 nonpayment policy of the Centers for Medicare & Medicaid Services (CMS), is a critical issue. This study was conducted to determine the comparative effectiveness of quality improvement (QI) interventions associated with reduced hospital-acquired pressure ulcer (HAPU) rates. In an quasi-experimental design, interrupted time series analyses were conducted to determine the correlation between HAPU incidence rates and adoption of QI interventions. Among University HealthSystem Consortium hospitals, 55 academic medical centers were surveyed from September 2007 through February 2012 for adoption patterns of QI interventions for pressure ulcer prevention, and hospital-level data for 5,208 pressure ulcer cases were analyzed. Between- and within-hospital reduction significance was tested with t-tests post-CMS policy intervention. Fifty-three (96%) of the 55 hospitals used QI interventions for pressure ulcer prevention. The effect size analysis identified five effective interventions that each reduced pressure ulcer rates by greater than 1 case per 1,000 patient discharges per quarter: leadership initiatives, visual tools, pressure ulcer staging, skin care, and patient nutrition. The greatest reductions in rates occurred earlier in the adoption process (pprevention protocol for pressure ulcers. Hospitals can not only use these findings from this study as part of a QI bundle for preventing HAPUs.

  9. Long-term mortality rates (>8-year) improve as compared to the general and obese population following bariatric surgery.

    Science.gov (United States)

    Telem, Dana A; Talamini, Mark; Shroyer, A Laurie; Yang, Jie; Altieri, Maria; Zhang, Qiao; Gracia, Gerald; Pryor, Aurora D

    2015-03-01

    Sparse data are available on long-term patient mortality following bariatric surgery as compared to the general population. The purpose of this study was to assess long-term mortality rates and identify risk factors for all-cause mortality following bariatric surgery. New York State (NYS) Planning and Research Cooperative System (SPARCS) longitudinal administrative data were used to identify 7,862 adult patients who underwent a primary laparoscopic bariatric surgery from 1999 to 2005. The Social Security Death Index database identified >30-day mortalities. Risk factors for mortality were screened using a univariate Cox proportional hazard (PH) model and analyzed using a multiple PH model. Based on age, gender, and race/ethnicity, actuarial projections for NYS mortality rates obtained from Centers of Disease Control were compared to the actual post-bariatric surgery mortality rates observed. The mean bariatric mortality rate was 2.5 % with 8-14 years of follow-up. Mean time to death ranged from 4 to 6 year and did not differ by operation (p = 0.073). From 1999 to 2010, the actuarial mortality rate predicted for the general NYS population was 2.1 % versus the observed 1.5 % for the bariatric surgery population (p = 0.005). Extrapolating to 2013, demonstrated the actuarial mortality predictions at 3.1 % versus the bariatric surgery patients' observed morality rate of 2.5 % (p = 0.01). Risk factors associated with an earlier time to death included: age, male gender, Medicare/Medicaid insurance, congestive heart failure, rheumatoid arthritis, pulmonary circulation disorders, and diabetes. No procedure-specific or perioperative complication impact for time-to-death was found. Long-term mortality rate of patients undergoing bariatric surgery significantly improves as compared to the general population regardless of bariatric operation performed. Additionally, perioperative complications do not increase long-term mortality risk. This study did identify specific patient

  10. [The great virus comeback].

    Science.gov (United States)

    Forterre, Patrick

    2013-01-01

    Viruses have been considered for a long time as by-products of biological evolution. This view is changing now as a result of several recent discoveries. Viral ecologists have shown that viral particles are the most abundant biological entities on our planet, whereas metagenomic analyses have revealed an unexpected abundance and diversity of viral genes in the biosphere. Comparative genomics have highlighted the uniqueness of viral sequences, in contradiction with the traditional view of viruses as pickpockets of cellular genes. On the contrary, cellular genomes, especially eukaryotic ones, turned out to be full of genes derived from viruses or related elements (plasmids, transposons, retroelements and so on). The discovery of unusual viruses infecting archaea has shown that the viral world is much more diverse than previously thought, ruining the traditional dichotomy between bacteriophages and viruses. Finally, the discovery of giant viruses has blurred the traditional image of viruses as small entities. Furthermore, essential clues on virus history have been obtained in the last ten years. In particular, structural analyses of capsid proteins have uncovered deeply rooted homologies between viruses infecting different cellular domains, suggesting that viruses originated before the last universal common ancestor (LUCA). These studies have shown that several lineages of viruses originated independently, i.e., viruses are polyphyletic. From the time of LUCA, viruses have coevolved with their hosts, and viral lineages can be viewed as lianas wrapping around the trunk, branches and leaves of the tree of life. Although viruses are very diverse, with genomes encoding from one to more than one thousand proteins, they can all be simply defined as organisms producing virions. Virions themselves can be defined as infectious particles made of at least one protein associated with the viral nucleic acid, endowed with the capability to protect the viral genome and ensure its

  11. A Call for Consensus on Methodology and Terminology to Improve Comparability in the Study of Preventable Prehospital Trauma Deaths: A Systematic Literature Review.

    Science.gov (United States)

    Oliver, Govind J; Walter, Darren P

    2016-04-01

    The study of preventable deaths is essential to trauma research for measuring service quality and highlighting avenues for improving care and as a performance indicator. However, variations in the terminology and methodology of studies on preventable prehospital trauma death limit the comparability and wider application of data. The objective of this study was to describe the heterogeneity in terminology and methodology. We performed a systematic literature review and report this using the PRISMA guidelines. Searches were conducted using PubMed (including Medline), Ovid, and Embase databases. Studies, with a full text available in English published between 1990 and 2015, meeting the following inclusion criteria were included: analysis of 1) deaths from trauma, 2) occurring in the prehospital phase of care, and 3) application of criteria to ascertain whether deaths were preventable. One author screened database results for relevance by title and abstract. The full text of identified papers was reviewed for inclusion. The reference list of included papers was screened for studies not identified by the database search. Data were extracted on predefined core elements relating to preventability reporting and definitions using a standardized form. Twenty-seven studies meeting the inclusion criteria were identified: 12 studies used two categories to assess the preventability of death while 15 used three categories. Fifteen variations in the terminology of these categories and combination with death descriptors were found. Eleven different approaches were used in defining what constituted a preventable death. Twenty-one included survivability of injuries as a criterion. Methods used to determine survivability differed and eight variations in parameters for categorization of deaths were used. Nineteen used panel review in determining preventability with six implementing panel blinding. Panel composition varied greatly by expertise of personnel. Separation of prehospital

  12. What Caused the Great Depression?

    Science.gov (United States)

    Caldwell, Jean; O'Driscoll, Timothy G.

    2007-01-01

    Economists and historians have struggled for almost 80 years to account for the American Great Depression, which began in 1929 and lasted until the early years of World War II. In this article, the authors discuss three major schools of thought on the causes of the Great Depression and the long failure of the American economy to return to full…

  13. Improvdent: Improving dentures for patient benefit. A crossover randomised clinical trial comparing impression materials for complete dentures

    Directory of Open Access Journals (Sweden)

    Gray Janine C

    2012-08-01

    Full Text Available Abstract Background According to the UK Adult Dental Health Survey (2009 15% of adults aged 65–74, 30% aged 75–84 and 47% aged >85 years are edentulous and require complete dentures. Patients’ quality of life and nutrition status are affected by poor dentures. The quality of the dental impression is the most important issue for improving the fit and comfort of new dentures. There is paucity of RCT evidence for which impression material is best for complete dentures construction. This study aims to compare two impression materials for effectiveness and cost effectiveness. Methods/Design IMPROVDENT is a double-blind crossover trial comparing the use of alginate and silicone, two commonly used denture impression materials, in terms of patient preference and cost-effectiveness. Eighty five edentulous patients will be recruited and provided with two sets of dentures, similar in all aspects except for the impression material used (alginate or silicone. Patients will try both sets of dentures for a two-week period, unadjusted, to become accustomed to the feel of the new dentures (habituation period. Patients will then wear each set of dentures for a period of 8 weeks (in random order during which time the dentures will be adjusted for optimum comfort. Finally, patients will be given both sets of dentures for a further two weeks to wear whichever denture they prefer (confirmation period. Patients will be asked about quality of life and to rate dentures on function and comfort at the end of each trial period and asked which set they prefer at the end of the habituation period (unadjusted denture preference and confirmation period (adjusted denture preference. A health economic evaluation will estimate incremental cost-effectiveness ratios of producing dentures from the two materials. A qualitative study will investigate the impact of dentures on behaviour and quality of life. Funding: IMPROVDENT is funded by NIHR RfPB (PB-PG-0408-16300. Discussion

  14. Text mining effectively scores and ranks the literature for improving chemical-gene-disease curation at the comparative toxicogenomics database.

    Directory of Open Access Journals (Sweden)

    Allan Peter Davis

    Full Text Available The Comparative Toxicogenomics Database (CTD; http://ctdbase.org/ is a public resource that curates interactions between environmental chemicals and gene products, and their relationships to diseases, as a means of understanding the effects of environmental chemicals on human health. CTD provides a triad of core information in the form of chemical-gene, chemical-disease, and gene-disease interactions that are manually curated from scientific articles. To increase the efficiency, productivity, and data coverage of manual curation, we have leveraged text mining to help rank and prioritize the triaged literature. Here, we describe our text-mining process that computes and assigns each article a document relevancy score (DRS, wherein a high DRS suggests that an article is more likely to be relevant for curation at CTD. We evaluated our process by first text mining a corpus of 14,904 articles triaged for seven heavy metals (cadmium, cobalt, copper, lead, manganese, mercury, and nickel. Based upon initial analysis, a representative subset corpus of 3,583 articles was then selected from the 14,094 articles and sent to five CTD biocurators for review. The resulting curation of these 3,583 articles was analyzed for a variety of parameters, including article relevancy, novel data content, interaction yield rate, mean average precision, and biological and toxicological interpretability. We show that for all measured parameters, the DRS is an effective indicator for scoring and improving the ranking of literature for the curation of chemical-gene-disease information at CTD. Here, we demonstrate how fully incorporating text mining-based DRS scoring into our curation pipeline enhances manual curation by prioritizing more relevant articles, thereby increasing data content, productivity, and efficiency.

  15. Text Mining Effectively Scores and Ranks the Literature for Improving Chemical-Gene-Disease Curation at the Comparative Toxicogenomics Database

    Science.gov (United States)

    Johnson, Robin J.; Lay, Jean M.; Lennon-Hopkins, Kelley; Saraceni-Richards, Cynthia; Sciaky, Daniela; Murphy, Cynthia Grondin; Mattingly, Carolyn J.

    2013-01-01

    The Comparative Toxicogenomics Database (CTD; http://ctdbase.org/) is a public resource that curates interactions between environmental chemicals and gene products, and their relationships to diseases, as a means of understanding the effects of environmental chemicals on human health. CTD provides a triad of core information in the form of chemical-gene, chemical-disease, and gene-disease interactions that are manually curated from scientific articles. To increase the efficiency, productivity, and data coverage of manual curation, we have leveraged text mining to help rank and prioritize the triaged literature. Here, we describe our text-mining process that computes and assigns each article a document relevancy score (DRS), wherein a high DRS suggests that an article is more likely to be relevant for curation at CTD. We evaluated our process by first text mining a corpus of 14,904 articles triaged for seven heavy metals (cadmium, cobalt, copper, lead, manganese, mercury, and nickel). Based upon initial analysis, a representative subset corpus of 3,583 articles was then selected from the 14,094 articles and sent to five CTD biocurators for review. The resulting curation of these 3,583 articles was analyzed for a variety of parameters, including article relevancy, novel data content, interaction yield rate, mean average precision, and biological and toxicological interpretability. We show that for all measured parameters, the DRS is an effective indicator for scoring and improving the ranking of literature for the curation of chemical-gene-disease information at CTD. Here, we demonstrate how fully incorporating text mining-based DRS scoring into our curation pipeline enhances manual curation by prioritizing more relevant articles, thereby increasing data content, productivity, and efficiency. PMID:23613709

  16. Improving education under work-hour restrictions: comparing learning and teaching preferences of faculty, residents, and students.

    Science.gov (United States)

    Jack, Megan C; Kenkare, Sonya B; Saville, Benjamin R; Beidler, Stephanie K; Saba, Sam C; West, Alisha N; Hanemann, Michael S; van Aalst, John A

    2010-01-01

    Faced with work-hour restrictions, educators are mandated to improve the efficiency of resident and medical student education. Few studies have assessed learning styles in medicine; none have compared teaching and learning preferences. Validated tools exist to study these deficiencies. Kolb describes 4 learning styles: converging (practical), diverging (imaginative), assimilating (inductive), and accommodating (active). Grasha Teaching Styles are categorized into "clusters": 1 (teacher-centered, knowledge acquisition), 2 (teacher-centered, role modeling), 3 (student-centered, problem-solving), and 4 (student-centered, facilitative). Kolb's Learning Style Inventory (HayGroup, Philadelphia, Pennsylvania) and Grasha-Riechmann's TSS were administered to surgical faculty (n = 61), residents (n = 96), and medical students (n = 183) at a tertiary academic medical center, after informed consent was obtained (IRB # 06-0612). Statistical analysis was performed using χ(2) and Fisher exact tests. Surgical residents preferred active learning (p = 0.053), whereas faculty preferred reflective learning (p style more often than surgical faculty (p = 0.01). Medical students preferred converging learning (42%) and cluster 4 teaching (35%). Statistical significance was unchanged when corrected for gender, resident training level, and subspecialization. Significant differences exist between faculty and residents in both learning and teaching preferences; this finding suggests inefficiency in resident education, as previous research suggests that learning styles parallel teaching styles. Absence of a predominant teaching style in residents suggests these individuals are learning to be teachers. The adaptation of faculty teaching methods to account for variations in resident learning styles may promote a better learning environment and more efficient faculty-resident interaction. Additional, multi-institutional studies using these tools are needed to elucidate these findings fully

  17. Ballistic strength training compared with usual care for improving mobility following traumatic brain injury: protocol for a randomised, controlled trial.

    Science.gov (United States)

    Williams, Gavin; Ada, Louise; Hassett, Leanne; Morris, Meg E; Clark, Ross; Bryant, Adam L; Olver, John

    2016-07-01

    Traumatic brain injury is the leading cause of disability in young adults aged 15 to 45 years. Mobility limitations are prevalent, and range in severity from interfering with basic day-to-day tasks to restricting participation in higher level social, leisure, employment and sporting activities. Despite the prevalence and severity of physical impairments, such as poor balance and spasticity, the main contributor to mobility limitations following traumatic brain injury is low muscle power generation. Strengthening exercises that are performed quickly are termed 'ballistic' as they are aimed at improving the rate of force production and, hence, muscle power. This is compared with conventional strength training, which is performed slowly and aims to improve maximum force production, yet has limited impact on mobility. In people recovering from traumatic brain injury: (1) is a 12-week ballistic strength-training program targeting the three muscle groups critical for walking more effective than usual care at improving mobility, strength and balance; and (2) does improved mobility translate to better health-related quality of life? A prospective, multi-centre, randomised, single-blind trial with concealed allocation will be conducted. Participants will be patients with a neurologically based movement disorder affecting mobility as a result of traumatic brain injury. Patients will be recruited during the acute phase of rehabilitation (n=166), from brain injury units in large metropolitan hospitals in Melbourne and Sydney, Australia. For 12 weeks, participants in the experimental group will have three 60-minute sessions of usual physiotherapy intervention replaced by three 60-minute sessions of strength training (ballistic strength, gait). The three key muscle groups responsible for forward propulsion will be targeted: ankle plantarflexors, hip flexors and the hip extensors. Initial loads will be low, to facilitate high contraction velocities. Progression to higher loads

  18. Building unique surface structure on aramid fibers through a green layer-by-layer self-assembly technique to develop new high performance fibers with greatly improved surface activity, thermal resistance, mechanical properties and UV resistance

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Lifang; Yuan, Li; Guan, Qingbao; Gu, Aijuan, E-mail: ajgu@suda.edu.cn; Liang, Guozheng, E-mail: lgzheng@suda.edu.cn

    2017-07-31

    Highlights: • A green technology is setup to build unique surface structure on aramid fiber (AF). • The method is layer-by-layer self-assembling SiO{sub 2} and layered double hydroxide. • The surface of AF is adjustable by controlling the self-assembly cycle number. • New AF has excellent surface activity, anti-UV, thermal and mechanical properties. • The origin behind attractive performances of new AFs was intensively studied. - Abstract: Combining green preparation and high performance is becoming the direction of sustainable development of materials. How to simultaneously overcome the two bottlenecks (poor surface activity and UV resistance) of aramid fibers (AFs) while improving thermal and mechanical properties through a green process is still an interesting issue with big challenge. Herein, new AFs (BL-AFs) were prepared by alternately self-assembling SiO{sub 2} and MgAlFe layered double hydroxide (LDH) on surfaces of AFs, successively, through a green layer-by-layer (LBL) self-assembly technique without using high temperature and organic solvent. The structures and properties of BL-AFs were systematically studied, which are controllable by adjusting the number of self-assembly cycle. The new fibers with three or more self-assembly cycles have remarkably improved surface activity, thermal resistance, mechanical properties and UV resistance compared with AFs. Typically, with three self-assembly cycles, the initial degradation temperature and char yield of the new fiber (3BL-AF) are as high as 552.9 °C and 81.2%, about 92 °C and 25.2% higher than those of AF, respectively; after 168 h-UV irradiation, the retention of tensile performances of 3BL-AF fiber is as high as 91–95%, about 29–14% higher than that of AF, showing the best overall performances among all modified AFs prepared using a green technique reported so far. The origin behind the attractive performances of BL-AFs is revealed through correlating with structures of original and

  19. Transposition of the great arteries

    Directory of Open Access Journals (Sweden)

    Castela Eduardo

    2008-10-01

    Full Text Available Abstract Transposition of the great arteries (TGA, also referred to as complete transposition, is a congenital cardiac malformation characterised by atrioventricular concordance and ventriculoarterial (VA discordance. The incidence is estimated at 1 in 3,500–5,000 live births, with a male-to-female ratio 1.5 to 3.2:1. In 50% of cases, the VA discordance is an isolated finding. In 10% of cases, TGA is associated with noncardiac malformations. The association with other cardiac malformations such as ventricular septal defect (VSD and left ventricular outflow tract obstruction is frequent and dictates timing and clinical presentation, which consists of cyanosis with or without congestive heart failure. The onset and severity depend on anatomical and functional variants that influence the degree of mixing between the two circulations. If no obstructive lesions are present and there is a large VSD, cyanosis may go undetected and only be perceived during episodes of crying or agitation. In these cases, signs of congestive heart failure prevail. The exact aetiology remains unknown. Some associated risk factors (gestational diabetes mellitus, maternal exposure to rodenticides and herbicides, maternal use of antiepileptic drugs have been postulated. Mutations in growth differentiation factor-1 gene, the thyroid hormone receptor-associated protein-2 gene and the gene encoding the cryptic protein have been shown implicated in discordant VA connections, but they explain only a small minority of TGA cases. The diagnosis is confirmed by echocardiography, which also provides the morphological details required for future surgical management. Prenatal diagnosis by foetal echocardiography is possible and desirable, as it may improve the early neonatal management and reduce morbidity and mortality. Differential diagnosis includes other causes of central neonatal cyanosis. Palliative treatment with prostaglandin E1 and balloon atrial septostomy are usually

  20. Great Lakes Environmental Research Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — NOAA-GLERL and its partners conduct innovative research on the dynamic environments and ecosystems of the Great Lakes and coastal regions to provide information for...

  1. What Caused the Great Recession?

    OpenAIRE

    Homburg, Stefan

    2014-01-01

    This paper examines five possible explanations for the Great Recession of 2008 and 2009, using data for the United States and the eurozone. Of these five hypotheses, four are not supported by the data, while the fifth appears reasonable.

  2. Arthroscopy of the great toe

    NARCIS (Netherlands)

    Frey, C.; van Dijk, C. N.

    1999-01-01

    The few available reports of arthroscopic treatment of the first MTP joint in the literature indicate favorable outcome. However, arthroscopy of the great toe is an advanced technique and should only be undertaken by experienced surgeons

  3. The Sixth Great Mass Extinction

    Science.gov (United States)

    Wagler, Ron

    2012-01-01

    Five past great mass extinctions have occurred during Earth's history. Humanity is currently in the midst of a sixth, human-induced great mass extinction of plant and animal life (e.g., Alroy 2008; Jackson 2008; Lewis 2006; McDaniel and Borton 2002; Rockstrom et al. 2009; Rohr et al. 2008; Steffen, Crutzen, and McNeill 2007; Thomas et al. 2004;…

  4. Study on the production and quality improvement of soft unripened cheese made from buffalo milk as compared with camel milk

    Directory of Open Access Journals (Sweden)

    A.A. Farooq

    2010-02-01

    Full Text Available The study was carried out to produce and improve the quality of soft unripened cheese made from buffalo milk as compared to cheese made from camel milk using conventional cheese-making technique. Before making cheese all the milk samples were skimmed and analyzed for their physico-chemical composition. Mean values for pH, acidity, specific gravity, total solids, SNF, fat percentages of raw and skimmed camel milk samples, respectively were 6.87±0.03 and 6.87±0.04, 0.17±0.01 and 0.18±0.01, 1.015±0.001 and 1.023±0.001, 11.69±0.33 and 7.93±0.27, 7.59±0.26 and 7.64±0.26, 4.09±0.36 and 0.29±0.08, and total protein, casein, lactose, ash and chlorides percentages of raw and skimmed milk samples respectively were 3.16±0.20 and 3.56±0.41, 2.21 ±0.23 and 1.67±0.11, 3.48±0.27 and 3.14±0.29, 0.94±0.03 and 0.93±0.07, and 0.26±0.01 and 0.25±0.01, whereas the mean values of buffalo raw milk were 6.53, 0.17%, 1.032, 15.78%, 9.23%, 6.55%, 5.35%, 4.01%, 3.24%, 0.64%, 0.07%, and skimmed milk were 6.55, 0.18%,1.035, 10.27%, 10.12%,0.15%, 4.80%, 3.38%, 4.74%, 0.49% and 0.078% respectively. The cheese samples were analyzed for their physico-chemical properties. The mean values for pH was (5.23± 0.13, acidity in terms of lactic acid (1.01± 0.23%, total solids (29.54±0.39%, solids not fat (28.66± 0.33%, fat (0.88±0.19%, total proteins(23.14±0.42%, casein(17.57±0.68%, ash(2.15±0.14% and chloride contents(0.67± 0.08% whereas the values of physico-chemical quality of soft unripened cheese made from buffalo milk for pH, acidity, total solids, SNF, fat, total protein, casein, ash and chlorides percentages were respectively 5.47, 0.45, 30.79, 30.49, 0.3, 23.44, 17.41, 1.65,0.355. Trial 1 yielded the highest percentage (7.68 of cheese followed by Trial 2 (7.38, Trial 3 (7.22 and Trial 5 (5.68. While Trial 4 yielded the lowest percentage (5.49. Whereas cheese yielded from buffalo milk was 12.22 %. Samples from each trial were presented to the

  5. Head CT: Image quality improvement of posterior fossa and radiation dose reduction with ASiR - comparative studies of CT head examinations

    International Nuclear Information System (INIS)

    Guzinski, Maciej; Waszczuk, Lukasz; Sasiadek, Marek J.

    2016-01-01

    To evaluate head CT protocol developed to improve visibility of the brainstem and cerebellum, lower bone-related artefacts in the posterior fossa and maintain patient radioprotection. A paired comparison of head CT performed without Adaptive Statistical Iterative Reconstruction (ASiR) and a clinically indicated follow-up with 40 % ASiR was acquired in one group of 55 patients. Patients were scanned in the axial mode with different scanner settings for the brain and the posterior fossa. Objective image quality analysis was performed with signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Subjective image quality analysis was based on brain structure visibility and evaluation of the artefacts. We achieved 19 % reduction of total DLP and significantly better image quality of posterior fossa structures. SNR for white and grey matter in the cerebellum were 34 % to 36 % higher, respectively, CNR was improved by 142 % and subjective analyses were better for images with ASiR. When imaging parameters are set independently for the brain and the posterior fossa imaging, ASiR has a great potential to improve CT performance: image quality of the brainstem and cerebellum is improved, and radiation dose for the brain as well as total radiation dose are reduced. (orig.)

  6. Head CT: Image quality improvement of posterior fossa and radiation dose reduction with ASiR - comparative studies of CT head examinations

    Energy Technology Data Exchange (ETDEWEB)

    Guzinski, Maciej; Waszczuk, Lukasz; Sasiadek, Marek J. [Wroclaw Medical University, Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw (Poland)

    2016-10-15

    To evaluate head CT protocol developed to improve visibility of the brainstem and cerebellum, lower bone-related artefacts in the posterior fossa and maintain patient radioprotection. A paired comparison of head CT performed without Adaptive Statistical Iterative Reconstruction (ASiR) and a clinically indicated follow-up with 40 % ASiR was acquired in one group of 55 patients. Patients were scanned in the axial mode with different scanner settings for the brain and the posterior fossa. Objective image quality analysis was performed with signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Subjective image quality analysis was based on brain structure visibility and evaluation of the artefacts. We achieved 19 % reduction of total DLP and significantly better image quality of posterior fossa structures. SNR for white and grey matter in the cerebellum were 34 % to 36 % higher, respectively, CNR was improved by 142 % and subjective analyses were better for images with ASiR. When imaging parameters are set independently for the brain and the posterior fossa imaging, ASiR has a great potential to improve CT performance: image quality of the brainstem and cerebellum is improved, and radiation dose for the brain as well as total radiation dose are reduced. (orig.)

  7. State Government Revenue Recovery from the Great Recession

    OpenAIRE

    James Alm; David L. Sjoquist

    2014-01-01

    The "Great Recession" lasted from December 2007 to June 2009, and it wreaked havoc on the revenues of state (and local) governments. While the U.S. economy has improved since the end of the Great Recession, state government revenues have in most cases still not completely recovered. We use various indicators to measure how different states have -- or have not -- recovered in the aftermath of the Great Recession, and we also attempt to explain why these different patterns of recovery have emer...

  8. Great Basin Factsheet Series 2016 - Information and tools to restore and conserve Great Basin ecosystems

    Science.gov (United States)

    Jeanne C. Chambers

    2016-01-01

    Land managers are responsible for developing effective strategies for conserving and restoring Great Basin ecosystems in the face of invasive species, conifer expansion, and altered fire regimes. A warming climate is magnifying the effects of these threats and adding urgency to implementation of management practices that will maintain or improve ecosystem...

  9. What Principals Do to Improve Teaching and Learning: Comparing the Use of Informal Classroom Observations in Two School Districts

    Science.gov (United States)

    Ing, Marsha

    2013-01-01

    Informally observing classrooms is one way that principals can help improve teaching and learning. This study describes the variability of principals' classroom observations across schools and identifies the conditions under which observations relate to the instructional climate in some schools and not others. Data for this study come from…

  10. Comparing methods for measuring consumer willingness to pay for a basic and an improved ready made soup product

    DEFF Research Database (Denmark)

    Grunert, Klaus G.; Juhl, Hans Jørn; Esbjerg, Lars

    2009-01-01

    Willingness to pay (WTP) for a basic chilled soup product and for an improved, self-heating version was measured by methods experimentally varied according to a 2 x 3 design, varying the basic measurement approach (contingent valuation, experimental auction, conjoint analysis) and the use of real...

  11. Diversifying Schools and Leveraging School Improvement: A Comparative Analysis of the English Radical, and Singapore Conservative, Specialist Schools' Policies

    Science.gov (United States)

    Dimmock, Clive

    2011-01-01

    Within the context of fierce global economic competition, school diversification and specialist schools have been seen by governments as cornerstones of education policy to engineer school improvement in both England and Singapore for more than a decade. In both systems, the policy has manifested in different school types, school names and…

  12. Comparing welfare estimates across stated preference and uncertainty elicitation formats for air quality improvements in Nairobi, Kenya

    NARCIS (Netherlands)

    Ndambiri, H.; Brouwer, R.; Mungatana, E.

    2016-01-01

    The effect of preference uncertainty on estimated willingness to pay (WTP) is examined using identical payment cards and alternative uncertainty elicitation procedures in three split samples, focusing on air quality improvement in Nairobi. The effect of the stochastic payment card (SPC) and

  13. Head CT: Image quality improvement of posterior fossa and radiation dose reduction with ASiR - comparative studies of CT head examinations.

    Science.gov (United States)

    Guziński, Maciej; Waszczuk, Łukasz; Sąsiadek, Marek J

    2016-10-01

    To evaluate head CT protocol developed to improve visibility of the brainstem and cerebellum, lower bone-related artefacts in the posterior fossa and maintain patient radioprotection. A paired comparison of head CT performed without Adaptive Statistical Iterative Reconstruction (ASiR) and a clinically indicated follow-up with 40 % ASiR was acquired in one group of 55 patients. Patients were scanned in the axial mode with different scanner settings for the brain and the posterior fossa. Objective image quality analysis was performed with signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Subjective image quality analysis was based on brain structure visibility and evaluation of the artefacts. We achieved 19 % reduction of total DLP and significantly better image quality of posterior fossa structures. SNR for white and grey matter in the cerebellum were 34 % to 36 % higher, respectively, CNR was improved by 142 % and subjective analyses were better for images with ASiR. When imaging parameters are set independently for the brain and the posterior fossa imaging, ASiR has a great potential to improve CT performance: image quality of the brainstem and cerebellum is improved, and radiation dose for the brain as well as total radiation dose are reduced. •With ASiR it is possible to lower radiation dose or improve image quality •Sequentional imaging allows setting scan parameters for brain and posterior-fossa independently •We improved visibility of brainstem structures and decreased radiation dose •Total radiation dose (DLP) was decreased by 19.

  14. Improvement of visual debugging tool. Shortening the elapsed time for getting data and adding new functions to compare/combine a set of visualized data

    International Nuclear Information System (INIS)

    Matsuda, Katsuyuki; Takemiya, Hiroshi

    2001-03-01

    The visual debugging tool 'vdebug' has been improved, which was designed for the debugging of programs for scientific computing. Improved were the following two points; (1) shortening the elapsed time required for getting appropriate data to visualize; (2) adding new functions which enable to compare and/or combine a set of visualized data originated from two or more different programs. As for shortening elapsed time for getting data, with the improved version of 'vdebug', we could achieve the following results; over hundred times shortening the elapsed time with dbx, pdbx of SX-4 and over ten times with ndb of SR2201. As for the new functions to compare/combine visualized data, it was confirmed that we could easily checked the consistency between the computational results obtained in each calculational steps on two different computers: SP and ONYX. In this report, we illustrate how the tool 'vdebug' has been improved with an example. (author)

  15. Electrofishing survey of the Great Miami River

    International Nuclear Information System (INIS)

    Stocker, L.E.; Miller, M.C.; Engman, J.; Evans, R.L.; Koch, R.W.; Brence, W.A.

    1994-01-01

    Fish sampling by electroshocking in the Great Miami River above and below the Fernald sit was designed to determine changes in the health of the fish community compared to the previous nine years and to collect samples for uranium analysis in fish filets. This document contains information describing the findings of this program. Topics discussed include: physical and chemical parameters, species richness, species diversity, and water analysis

  16. Employment services in Great Britain and Turkey

    OpenAIRE

    ÖZKANLI, Özlem

    2001-01-01

    This artiele criticaUy compares the institutions and procedures for the employment services of Great Britain (GB) and Turkey. The similarities and differences of two employment organisations, the Department for Education and Employment in GB and the Turkish Employment Organisation, are examined. Data is collected in field study from these organisations, based in London and Ankara, through interviews and observation techniques. Field study in London is financed by the World Bank. After briefly...

  17. Famous puzzles of great mathematicians

    CERN Document Server

    Petković, Miodrag S

    2009-01-01

    This entertaining book presents a collection of 180 famous mathematical puzzles and intriguing elementary problems that great mathematicians have posed, discussed, and/or solved. The selected problems do not require advanced mathematics, making this book accessible to a variety of readers. Mathematical recreations offer a rich playground for both amateur and professional mathematicians. Believing that creative stimuli and aesthetic considerations are closely related, great mathematicians from ancient times to the present have always taken an interest in puzzles and diversions. The goal of this

  18. Vacuum structure revealed by over-improved stout-link smearing compared with the overlap analysis for quenched QCD

    International Nuclear Information System (INIS)

    Ilgenfritz, E.M.; Leinweber, D.; Moran, P.; Koller, K.; Weinberg, V.; Freie Univ. Berlin

    2008-01-01

    A detailed comparison is made between the topological structure of quenched QCD as revealed by the recently proposed over-improved stout-link smearing in conjunction with an improved gluonic definition of the topological density on one hand and a similar analysis made possible by the overlap-fermionic topological charge density both with and without variable ultraviolet cutoff λ cut . The matching is twofold, provided by fitting the density-density two-point functions on one hand and by a point-by-point fitting of the topological densities according to the two methods. We point out the similar cluster structure of the topological density for moderate smearing and 200 MeV cut <600 MeV, respectively. We demonstrate the relation of the gluonic topological density for extensive smearing to the location of the overlap zero modes and the lowest overlap non-zero mode as found for the unsmeared configurations. (orig.)

  19. Vacuum structure revealed by over-improved stout-link smearing compared with the overlap analysis for quenched QCD

    Energy Technology Data Exchange (ETDEWEB)

    Ilgenfritz, E.M.; Leinweber, D.; Moran, P. [Adelaide Univ., SA (AU). Special Research Centre for the Subatomic Structure of Matter (CSSM); Koller, K. [Muenchen Univ. (Germany). Sektion Physik; Schierholz, G. [Deutsches Elektronen-Synchrotron (DESY), Zeuthen (Germany). John von Neumann-Inst. fuer Computing NIC; Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Weinberg, V. [Deutsches Elektronen-Synchrotron (DESY), Zeuthen (Germany). John von Neumann-Inst. fuer Computing NIC; Freie Univ. Berlin (Germany). Inst. fuer Theoretische Physik

    2008-01-11

    A detailed comparison is made between the topological structure of quenched QCD as revealed by the recently proposed over-improved stout-link smearing in conjunction with an improved gluonic definition of the topological density on one hand and a similar analysis made possible by the overlap-fermionic topological charge density both with and without variable ultraviolet cutoff {lambda}{sub cut}. The matching is twofold, provided by fitting the density-density two-point functions on one hand and by a point-by-point fitting of the topological densities according to the two methods. We point out the similar cluster structure of the topological density for moderate smearing and 200 MeV<{lambda}{sub cut}<600 MeV, respectively. We demonstrate the relation of the gluonic topological density for extensive smearing to the location of the overlap zero modes and the lowest overlap non-zero mode as found for the unsmeared configurations. (orig.)

  20. MANUFACTURING AND CONTINUOUS IMPROVEMENT PERFORMANCE LEVEL IN PLANTS OF MEXICO; A COMPARATIVE ANALYSIS AMONG LARGE AND MEDIUM SIZE PLANTS

    OpenAIRE

    Carlos Monge; Jesús Cruz

    2015-01-01

    A random and statistically significant sample of 40 medium (12) and large (28) manufacturing plants of Apodaca, Mexico were surveyed using a structured and validated questionnaire to investigate the level of implementation of lean manufacturing, sustainable manufacturing, continuous improvement and operational efficiency and environmental responsibility in them, it is important to mention it was found that performance in the mentioned philosophies, on the two categories of plants is low, howe...

  1. Improved Titanium Billet Inspection Sensitivity through Optimized Phased Array Design, Part II: Experimental Validation and Comparative Study with Multizone

    International Nuclear Information System (INIS)

    Hassan, W.; Vensel, F.; Knowles, B.; Lupien, V.

    2006-01-01

    The inspection of critical rotating components of aircraft engines has made important advances over the last decade. The development of Phased Array (PA) inspection capability for billet and forging materials used in the manufacturing of critical engine rotating components has been a priority for Honeywell Aerospace. The demonstration of improved PA inspection system sensitivity over what is currently used at the inspection houses is a critical step in the development of this technology and its introduction to the supply base as a production inspection. As described in Part I (in these proceedings), a new phased array transducer was designed and manufactured for optimal inspection of eight inch diameter Ti-6Al-4V billets. After confirming that the transducer was manufactured in accordance with the design specifications a validation study was conducted to assess the sensitivity improvement of the PAI over the current capability of Multi-zone (MZ) inspection. The results of this study confirm the significant (≅ 6 dB in FBH number sign sensitivity) improvement of the PAI sensitivity over that of MZI

  2. Improving Comparability Of Survey Results Through Ex-Post Harmonisation A Case Study With Twelve European National Travel Surveys

    DEFF Research Database (Denmark)

    Christensen, Linda; Hubert, Jean-Paul; Järvi, Tuuli

    An essential prerequisite for research, decision making and effective policies in the field of sustainable transport are reliable data on travel behaviour. In particular comparative analyses over space or time allow for a better understanding of transport systems and their impact on travel...... behaviour. Further, there is an increasing need for comparable transport indicators at the international level. All along, National Travel Surveys (NTS) have been used to perform such analyses and to generate respective indicators. Despite their similar intention to elicit basic information on travel...

  3. Social Connectedness and Life Satisfaction: Comparing Mean Levels for 2 Undergraduate Samples and Testing for Improvement Based on Brief Counseling

    Science.gov (United States)

    Blau, Gary; DiMino, John; DeMaria, Peter A.; Beverly, Clyde; Chessler, Marcy; Drennan, Rob

    2016-01-01

    Objectives: Comparing the mean levels of social connectedness and life satisfaction, and analyzing their relationship for 2 undergraduate samples, and testing for an increase in their means for a brief counseling sample. Participants: Between October 2013 and May 2015, 3 samples were collected: not-in-counseling (NIC; n = 941), initial counseling…

  4. Improved Survival After the Ross Procedure Compared With Mechanical Aortic Valve Replacement.

    Science.gov (United States)

    Buratto, Edward; Shi, William Y; Wynne, Rochelle; Poh, Chin L; Larobina, Marco; O'Keefe, Michael; Goldblatt, John; Tatoulis, James; Skillington, Peter D

    2018-03-27

    It is unclear whether the Ross procedure offers superior survival compared with mechanical aortic valve replacement (AVR). This study evaluated experience and compared long-term survival between the Ross procedure and mechanical AVR. Between 1992 and 2016, a total of 392 Ross procedures were performed. These were compared with 1,928 isolated mechanical AVRs performed during the same time period as identified using the University of Melbourne and Australia and New Zealand Society of Cardiac and Thoracic Surgeons' Cardiac Surgery Databases. Only patients between 18 and 65 years of age were included. Propensity-score matching was performed for risk adjustment. Ross procedure patients were younger, and had fewer cardiovascular risk factors. The Ross procedure was associated with longer cardiopulmonary bypass and aortic cross-clamp times. Thirty-day mortality was similar (Ross, 0.3%; mechanical, 0.8%; p = 0.5). Ross procedure patients experienced superior unadjusted long-term survival at 20 years (Ross, 95%; mechanical, 68%; p mechanical, 84%; p = 0.018). In this Australian, propensity-score matched study, the Ross procedure was associated with better long-term survival compared with mechanical AVR. In younger patients, with a long life expectancy, the Ross procedure should be considered in centers with sufficient expertise. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

  5. Choice-Based Evaluation for the Improvement of Upper-Extremity Function Compared With Other Impairments in Tetraplegia

    NARCIS (Netherlands)

    Snoek, Govert J.; IJzerman, Maarten Joost; Post, Marcel W.; Stiggelbout, Anne M.; Roach, Mary J.; Zilvold, Gerrit

    2005-01-01

    Objectives To assess preference of reconstructive treatment of upper extremities in subjects with tetraplegia compared with preference of treatment of 3 other impairments and to determine the effect of subjects’ characteristics on preference of upper-extremity reconstruction. Design Survey. Setting

  6. Improved physical fitness of cancer survivors : A randomised controlled trial comparing physical training with physical and cognitive-behavioural training

    NARCIS (Netherlands)

    May, Anne M.; Van Weert, Ellen; Korstjens, Irene; Hoekstra-Weebers, Josette E. H. M.; Van Der Schans, Cees P.; Zonderland, Maria L.; Mesters, Ilse; Van Den Borne, Bart; Ros, Wynand J. G.

    2008-01-01

    We compared the effect of a group-based 12-week supervised exercise programme, i.e. aerobic and resistance exercise, and group sports, with that of the same programme combined with cognitive-behavioural training on physical fitness and activity of cancer survivors. One hundred and forty seven cancer

  7. Making a Great First Impression

    Science.gov (United States)

    Evenson, Renee

    2007-01-01

    Managers and business owners often base hiring decisions on first impressions. That is why it is so important to teach students to make a great first impression--before they go on that first job interview. Managers do not have unrealistic expectations, they just want to hire people who they believe can develop into valuable employees. A nice…

  8. Great Basin paleoenvironmental studies project

    International Nuclear Information System (INIS)

    1993-01-01

    Project goals, project tasks, progress on tasks, and problems encountered are described and discussed for each of the studies that make up the Great Basin Paleoenvironmental Studies Project for Yucca Mountain. These studies are: Paleobotany, Paleofauna, Geomorphology, and Transportation. Budget summaries are also given for each of the studies and for the overall project

  9. The Great Books and Economics.

    Science.gov (United States)

    Hartley, James E.

    2001-01-01

    Describes an introductory economics course in which all of the reading material is drawn from the Great Books of Western Civilization. Explains the rationale and mechanics of the course. Includes an annotated course syllabus that details how the reading material relates to the lecture material. (RLH)

  10. Great tit hatchling sex ratios

    NARCIS (Netherlands)

    Lessells, C.M.; Mateman, A.C.; Visser, J.

    1996-01-01

    The sex of Great Tit Parus major nestlings was determined using PCR RAPDs. Because this technique requires minute amounts of DNA, chicks could be sampled soon (0-2d) after hatching, before any nestling mortality occurred. The proportion of males among 752 chicks hatching in 102 broods (98.9% of

  11. The Great Gatsby. [Lesson Plan].

    Science.gov (United States)

    Zelasko, Ken

    Based on F. Scott Fitzgerald's novel "The Great Gatsby," this lesson plan presents activities designed to help students understand that adapting part of a novel into a dramatic reading makes students more intimate with the author's intentions and craft; and that a part of a novel may lend itself to various oral interpretations. The main activity…

  12. Great Basin wildlife disease concerns

    Science.gov (United States)

    Russ Mason

    2008-01-01

    In the Great Basin, wildlife diseases have always represented a significant challenge to wildlife managers, agricultural production, and human health and safety. One of the first priorities of the U.S. Department of Agriculture, Division of Fish and Wildlife Services was Congressionally directed action to eradicate vectors for zoonotic disease, particularly rabies, in...

  13. Economic Load Dispatch - A Comparative Study on Heuristic Optimization Techniques With an Improved Coordinated Aggregation-Based PSO

    DEFF Research Database (Denmark)

    Vlachogiannis, Ioannis (John); Lee, KY

    2009-01-01

    In this paper an improved coordinated aggregation-based particle swarm optimization (ICA-PSO) algorithm is introduced for solving the optimal economic load dispatch (ELD) problem in power systems. In the ICA-PSO algorithm each particle in the swarm retains a memory of its best position ever...... encountered, and is attracted only by other particles with better achievements than its own with the exception of the particle with the best achievement, which moves randomly. Moreover, the population size is increased adaptively, the number of search intervals for the particles is selected adaptively...

  14. Precipitation Dynamical Downscaling Over the Great Plains

    Science.gov (United States)

    Hu, Xiao-Ming; Xue, Ming; McPherson, Renee A.; Martin, Elinor; Rosendahl, Derek H.; Qiao, Lei

    2018-02-01

    Detailed, regional climate projections, particularly for precipitation, are critical for many applications. Accurate precipitation downscaling in the United States Great Plains remains a great challenge for most Regional Climate Models, particularly for warm months. Most previous dynamic downscaling simulations significantly underestimate warm-season precipitation in the region. This study aims to achieve a better precipitation downscaling in the Great Plains with the Weather Research and Forecast (WRF) model. To this end, WRF simulations with different physics schemes and nudging strategies are first conducted for a representative warm season. Results show that different cumulus schemes lead to more pronounced difference in simulated precipitation than other tested physics schemes. Simply choosing different physics schemes is not enough to alleviate the dry bias over the southern Great Plains, which is related to an anticyclonic circulation anomaly over the central and western parts of continental U.S. in the simulations. Spectral nudging emerges as an effective solution for alleviating the precipitation bias. Spectral nudging ensures that large and synoptic-scale circulations are faithfully reproduced while still allowing WRF to develop small-scale dynamics, thus effectively suppressing the large-scale circulation anomaly in the downscaling. As a result, a better precipitation downscaling is achieved. With the carefully validated configurations, WRF downscaling is conducted for 1980-2015. The downscaling captures well the spatial distribution of monthly climatology precipitation and the monthly/yearly variability, showing improvement over at least two previously published precipitation downscaling studies. With the improved precipitation downscaling, a better hydrological simulation over the trans-state Oologah watershed is also achieved.

  15. Increasing synthetic serum substitute (SSS) concentrations in P1 glucose/phosphate-free medium improves implantation rate: a comparative study.

    Science.gov (United States)

    Ben-Yosef, D; Yovel, I; Schwartz, T; Azem, F; Lessing, J B; Amit, A

    2001-11-01

    To assess the comparative efficacy of IVF medium (MediCult, with 5.2 mM glucose) and a glucose/phosphate-free medium, P1 (Irvine Scientific), and to investigate the influence of increasing the serum supplementation (synthetic serum substitute; SSS; Irvine Scientific) to P1 on embryo development and implantation. Patients were randomly assigned to IVF medium (Group 1, cycles n = 172) or P1 supplemented with 10% SSS (Group 2, cycles n = 229) according to the medium scheduled for use on the day of oocyte retrieval. Another 555 IVF consequent cycles (Group 3) were performed using increased SSS concentrations (20%) in P1 medium. In this large series of IVF cycles, we herein demonstrate that significantly higher pregnancy and implantation rates were found when embryos were cultured in glucose/phosphate-free medium P1 supplemented with 20% SSS compared to supplementation with the lower SSS concentration and with IVF medium.

  16. To compare the effects of multiple sessions of Hyperbaric Oxygen Therapy in neurological improvement in head injury patients: A prospective randomized trial

    Directory of Open Access Journals (Sweden)

    Amlendu Yadav

    2015-01-01

    Full Text Available Introduction: Hyperbaric oxygen therapy (HBOT is used to improve functional outcome following brain injuries. Different number of sessions of HBOT have been reported but the frequency of HBOT sessions in head injured patients has not been standardized. We planned this prospective randomized study with an aim to compare the neurological effects of 10, 20 and 30 sessions of HBOT in the head injured patients. Materials and Methods: After review board approval, this study was conducted in 60 head injury patients with Glasgow Coma Scale (GCS score ≤ 9. All patients were resuscitated, stabilized and received neurological care according to institutional protocol. Patients were randomly allotted to-Group H10 (n-20-which received 10 sittings of HBOT, Group H20 (n-20-which received 20 sittings of HBOT, Group H30 (n-30-which received 30 sittings of HBOT. GCS score was recorded after every 10 sittings and at 30 days from initiation of HBOT. Improvement Global rating and Glasgow outcome scale (GOS were recorded after 30 days. Results: The maximum improvement in GCS scores was seen in group H30. The difference in the average improvement global rating scale was significant between group H10 and group H20, between group H10 and group H30 but was comparable between groups H20 and H30. The GOS was better after 30 sessions as compared to 10 sessions. Patients of all groups showed improvement in spasticity but group H30 showed a maximum improvement. Conclusion: A minimum of 30 HBOT sessions should be considered in head injury patients to show improvement with HBOT. Progressive improvement in GCS scores, GOS, spasticity, mood swings was better seen with increased number of HBOT sessions.

  17. A randomized clinical trial comparing pelvic floor muscle training to a Pilates exercise program for improving pelvic muscle strength.

    Science.gov (United States)

    Culligan, Patrick J; Scherer, Janet; Dyer, Keisha; Priestley, Jennifer L; Guingon-White, Geri; Delvecchio, Donna; Vangeli, Margi

    2010-04-01

    The purpose of this study is to determine whether a Pilates exercise program and a pelvic floor muscle-training (PFMT) program could provide similar improvements in pelvic muscle strength. Sixty-two women with little or no pelvic floor dysfunction were randomized to Pilates or PFMT. Each group had 24 biweekly 1-h sessions with either a physical therapist or Pilates instructor. Strength was measured via perineometry (cmH(2)O). Two questionnaires--pelvic floor distress inventory (PFDI-20) and pelvic floor impact questionnaire (PFIQ-7)--were also collected. At baseline, the Pilates and PFMT groups measured 14.9 +/- 12.5 and 12.5 +/- 10.4 cmH(2)O, respectively (p = 0.41). Both the Pilates and PFMT groups got stronger (6.2 +/- 7.5 cmH(2)O, p = 0.0002 and 6.6 +/- 7.4 cmH(2)O, p = 0.0002, respectively), with no difference between groups p = 0.85. PFIQ and PFDI scores improved from baseline but not between groups. Further study is required to determine if Pilates can actually treat pelvic floor dysfunction.

  18. Comparative investigation of novel hetero gate dielectric and drain engineered charge plasma TFET for improved DC and RF performance

    Science.gov (United States)

    Yadav, Dharmendra Singh; Verma, Abhishek; Sharma, Dheeraj; Tirkey, Sukeshni; Raad, Bhagwan Ram

    2017-11-01

    Tunnel-field-effect-transistor (TFET) has emerged as one of the most prominent devices to replace conventional MOSFET due to its ability to provide sub-threshold slope below 60 mV/decade (SS ≤ 60 mV/decade) and low leakage current. Despite this, TFETs suffer from ambipolar behavior, lower ON-state current, and poor RF performance. To address these issues, we have introduced drain and gate work function engineering with hetero gate dielectric for the first time in charge plasma based doping-less TFET (DL TFET). In this, the usage of dual work functionality over the drain region significantly reduces the ambipolar behavior of the device by varying the energy barrier at drain/channel interface. Whereas, the presence of dual work function at the gate terminal increases the ON-state current (ION). The combined effect of dual work function at the gate and drain electrode results in the increment of ON-state current (ION) and decrement of ambipolar conduction (Iambi) respectively. Furthermore, the incorporation of hetero gate dielectric along with dual work functionality at the drain and gate electrode provides an overall improvement in the performance of the device in terms of reduction in ambipolarity, threshold voltage and sub-threshold slope along with improved ON-state current and high frequency figures of merit.

  19. Comparing Tablets and PCs in teaching Mathematics: An attempt to improve Mathematics Competence in Early Childhood Education

    OpenAIRE

    Papadakis, Stamatis; Kalogiannakis, Michail; Zaranis, Nicholas

    2016-01-01

    The present study investigates and compares the influence of using computers and tablets, in the development of mathematical competence in early childhood education. For the implementation of the survey, we conducted a 14 weeks intervention, which included one experimental and one control group. Children in both groups were taught Mathematics according to Greek curriculum for early childhood education in conjunction with the use either of the same educational software, which depending on the ...

  20. Three-dimensional velocity map imaging: Setup and resolution improvement compared to three-dimensional ion imaging

    International Nuclear Information System (INIS)

    Kauczok, S.; Goedecke, N.; Veckenstedt, M.; Maul, C.; Gericke, K.-H.; Chichinin, A. I.

    2009-01-01

    For many years the three-dimensional (3D) ion imaging technique has not benefited from the introduction of ion optics into the field of imaging in molecular dynamics. Thus, a lower resolution of kinetic energy as in comparable techniques making use of inhomogeneous electric fields was inevitable. This was basically due to the fact that a homogeneous electric field was needed in order to obtain the velocity component in the direction of the time of flight spectrometer axis. In our approach we superimpose an Einzel lens field with the homogeneous field. We use a simulation based technique to account for the distortion of the ion cloud caused by the inhomogeneous field. In order to demonstrate the gain in kinetic energy resolution compared to conventional 3D Ion Imaging, we use the spatial distribution of H + ions emerging from the photodissociation of HCl following the two photon excitation to the V 1 Σ + state. So far a figure of merit of approximately four has been achieved, which means in absolute numbers Δv/v=0.022 compared to 0.086 at v≅17 000 m/s. However, this is not a theoretical limit of the technique, but due to our rather short TOF spectrometer (15 cm). The photodissociation of HBr near 243 nm has been used to recognize and eliminate systematic deviations between the simulation and the experimentally observed distribution. The technique has also proven to be essential for the precise measurement of translationally cold distributions.

  1. Spray-dried powders improve the controlled release of antifungal tioconazole-loaded polymeric nanocapsules compared to with lyophilized products

    International Nuclear Information System (INIS)

    Ribeiro, Roseane Fagundes; Motta, Mariana Heldt; Härter, Andréia Pisching Garcia; Flores, Fernanda Cramer; Beck, Ruy Carlos Ruver; Schaffazick, Scheila Rezende

    2016-01-01

    This work aimed to obtain solid formulations from polymeric nanocapsules and nanoemulsions containing tioconazole, a broad spectrum antifungal drug. Two dehydration methods were used: spray-drying and freeze-drying, using lactose as adjuvant (10%, w/v). The liquid formulations had a mean particle size around 206 nm and 182 nm for nanocapsules and nanoemulsions, respectively, and an adequate polydispersity index. Tioconazole content was close to the theoretical amount (1.0 mg/mL). After drying, the content ranged between 98 and 102% with a mean nanometric size of the dried products after redispersion. Scanning electron microscopy showed that the particles are rounded, sphere-shaped for the dried products obtained by spray-drying, and shapeless and irregular shapes for those obtained by freeze-drying. In the microbiological evaluation, all dried products remained active against the yeast Candida albicans when compared to the original systems. The dried products obtained by spray-drying from nanocapsules presented better control of the tioconazole release when compared to the freeze-drying products. - Highlights: • Polymeric nanocapsule suspensions containing tioconazole were submitted to spray-drying and freeze-drying. • Dried products from nanocapsule suspensions were stable for 30 days. • Release studies showed that the dried products presented greater control of drug release compared to the original suspension.

  2. Spray-dried powders improve the controlled release of antifungal tioconazole-loaded polymeric nanocapsules compared to with lyophilized products

    Energy Technology Data Exchange (ETDEWEB)

    Ribeiro, Roseane Fagundes [Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal de Santa Maria, Av. Roraima, 1000, Santa Maria, RS, 97105-900 (Brazil); Motta, Mariana Heldt [Curso de Farmácia, Centro de Ciências da Saúde, Universidade Federal de Santa Maria, Av. Roraima, 1000, Santa Maria, RS, 97105-900 (Brazil); Härter, Andréia Pisching Garcia; Flores, Fernanda Cramer [Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal de Santa Maria, Av. Roraima, 1000, Santa Maria, RS, 97105-900 (Brazil); Beck, Ruy Carlos Ruver [Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Av. Ipiranga, 2752, Porto Alegre, RS, 90610-000 (Brazil); Schaffazick, Scheila Rezende [Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal de Santa Maria, Av. Roraima, 1000, Santa Maria, RS, 97105-900 (Brazil); and others

    2016-02-01

    This work aimed to obtain solid formulations from polymeric nanocapsules and nanoemulsions containing tioconazole, a broad spectrum antifungal drug. Two dehydration methods were used: spray-drying and freeze-drying, using lactose as adjuvant (10%, w/v). The liquid formulations had a mean particle size around 206 nm and 182 nm for nanocapsules and nanoemulsions, respectively, and an adequate polydispersity index. Tioconazole content was close to the theoretical amount (1.0 mg/mL). After drying, the content ranged between 98 and 102% with a mean nanometric size of the dried products after redispersion. Scanning electron microscopy showed that the particles are rounded, sphere-shaped for the dried products obtained by spray-drying, and shapeless and irregular shapes for those obtained by freeze-drying. In the microbiological evaluation, all dried products remained active against the yeast Candida albicans when compared to the original systems. The dried products obtained by spray-drying from nanocapsules presented better control of the tioconazole release when compared to the freeze-drying products. - Highlights: • Polymeric nanocapsule suspensions containing tioconazole were submitted to spray-drying and freeze-drying. • Dried products from nanocapsule suspensions were stable for 30 days. • Release studies showed that the dried products presented greater control of drug release compared to the original suspension.

  3. Assessment and improvement of statistical tools for comparative proteomics analysis of sparse data sets with few experimental replicates

    DEFF Research Database (Denmark)

    Schwämmle, Veit; León, Ileana R.; Jensen, Ole Nørregaard

    2013-01-01

    Large-scale quantitative analyses of biological systems are often performed with few replicate experiments, leading to multiple nonidentical data sets due to missing values. For example, mass spectrometry driven proteomics experiments are frequently performed with few biological or technical...... replicates due to sample-scarcity or due to duty-cycle or sensitivity constraints, or limited capacity of the available instrumentation, leading to incomplete results where detection of significant feature changes becomes a challenge. This problem is further exacerbated for the detection of significant...... as a novel and optimal way to detect significantly changing features in these data sets. This approach is suitable for large quantitative data sets from stable isotope labeling and mass spectrometry experiments and should be applicable to large data sets of any type. An R script that implements the improved...

  4. Comparative potentials of native arbuscular mycorrhizal fungi to improve nutrient uptake and biomass of Sorghum bicolor Linn

    Directory of Open Access Journals (Sweden)

    Pattarawadee Sumthong Nakmee

    2016-05-01

    Full Text Available Sorghum (Sorghum bicolor Linn. seedlings were grown in pots using Pakchong soil from Nakhon Ratchasima province. Ten species of native Arbuscular mycorrhizal (AM fungi: Glomus sp. 1, Glomus sp. 2, Glomus sp. 3, Glomus aggregatum, Glomus fasciculatum, Acaulospora longula, Glomus occultum, Acaulospora scrobiculata, Acaulospora spinosa and Scutellospora sp., were used to inoculate sorghum seedlings. The sorghum growth and uptake of several major nutrients were evaluated at the harvesting stage. The results revealed that sorghum inoculated with A. scrobiculata produced the greatest biomass, grain dry weight and total nitrogen uptake in shoots. The highest phosphorus uptake in shoots was found in A. spinosa-inoculated plants, followed by Glomus sp. and A. scrobiculata, whereas Scutellospora sp.-inoculated plants showed the highest potassium uptake in shoots followed by A. scrobiculata. Overall, the most efficient AM fungi for improvement of nutrient uptake, biomass and grain dry weight in sorghum were A. scrobiculata.

  5. Improved sensitivity and specificity for resting state and task fMRI with multiband multi-echo EPI compared to multi-echo EPI at 7T.

    NARCIS (Netherlands)

    Boyacioglu, R.; Schulz, J.; Koopmans, P.J.; Barth, M.; Norris, David Gordon

    2015-01-01

    A multiband multi-echo (MBME) sequence is implemented and compared to a matched standard multi-echo (ME) protocol to investigate the potential improvement in sensitivity and spatial specificity at 7 T for resting state and task fMRI. ME acquisition is attractive because BOLD sensitivity is less

  6. Analyses adjusting for selective crossover show improved overall survival with adjuvant letrozole compared with tamoxifen in the BIG 1-98 study

    DEFF Research Database (Denmark)

    Colleoni, Marco; Giobbie-Hurder, Anita; Regan, Meredith M

    2011-01-01

    Among postmenopausal women with endocrine-responsive breast cancer, the aromatase inhibitor letrozole, when compared with tamoxifen, has been shown to significantly improve disease-free survival (DFS) and time to distant recurrence (TDR). We investigated whether letrozole monotherapy prolonged ov...

  7. Improvement in 5-year mortality in incident rheumatoid arthritis compared with the general population-closing the mortality gap.

    Science.gov (United States)

    Lacaille, Diane; Avina-Zubieta, J Antonio; Sayre, Eric C; Abrahamowicz, Michal

    2017-06-01

    Excess mortality in rheumatoid arthritis (RA) is expected to have improved over time, due to improved treatment. Our objective was to evaluate secular 5-year mortality trends in RA relative to general population controls in incident RA cohorts diagnosed in 1996-2000 vs 2001-2006. We conducted a population-based cohort study, using administrative health data, of all incident RA cases in British Columbia who first met RA criteria between January 1996 and December 2006, with general population controls matched 1:1 on gender, birth and index years. Cohorts were divided into earlier (RA onset 1996-2000) and later (2001-2006) cohorts. Physician visits and vital statistics data were obtained until December 2010. Follow-up was censored at 5 years to ensure equal follow-up in both cohorts. Mortality rates, mortality rate ratios and HRs for mortality (RA vs controls) using proportional hazard models adjusting for age, were calculated. Differences in mortality in RA versus controls between earlier and later incident cohorts were tested via interaction between RA status (case/control) and cohort (earlier/later). 24 914 RA cases and controls experienced 2747 and 2332 deaths, respectively. Mortality risk in RA versus controls differed across incident cohorts for all-cause, cardiovascular diseases (CVD) and cancer mortality (interactions pyears was observed in people with RA onset before, but not after, 2000. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  8. Improvements in health-related quality of life with liraglutide 3.0 mg compared with placebo in weight management.

    Science.gov (United States)

    Kolotkin, R L; Fujioka, K; Wolden, M L; Brett, J H; Bjorner, J B

    2016-08-01

    Obesity has a negative impact on health-related quality of life (HRQoL). The SCALE Obesity and Prediabetes study investigated the effect of liraglutide 3.0 mg, as adjunct to diet and exercise, on HRQoL in patients with obesity [body mass index (BMI) ≥ 30 kg m(-2) ] or overweight (BMI ≥ 27 kg m(-2) ) with comorbidity. Participants were advised on a 500 kcal d(-1) deficit diet and a 150-min week(-1) exercise programme and were randomised 2:1 to once-daily subcutaneous liraglutide 3.0 mg or placebo. HRQoL was assessed using the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) and Short-Form 36 (SF-36) v2 health questionnaires. Individuals on liraglutide 3.0 mg (n = 2046) had significantly greater improvements in IWQOL-Lite total score (10.6 ± 13.3) vs. placebo (n = 1020) (7.7 ± 12.8) and SF-36 physical (PCS) and mental (MCS) component summary scores (PCS, 3.6 ± 6.8; MCS, 0.2 ± 8.1) vs. placebo (PCS, 2.2 ± 7.7; MCS, -0.9 ± 9.1). The estimated treatment differences were IWQOL-Lite total score 3.1 (95% CI: 2.2; 4.0), P 3.0 mg vs. placebo. More patients on liraglutide 3.0 mg experienced meaningful improvement on the IWQOL-Lite total (P < 0.0001) and the SF-36 PCS (P < 0.0001) scores. © 2016 The Authors. Clinical Obesity published by John Wiley & Sons Ltd on behalf of International Association for the Study of Obesity (IASO).

  9. Robotic technique improves entry point alignment for intramedullary nailing of femur fractures compared to the conventional technique: a cadaveric study.

    Science.gov (United States)

    Suero, Eduardo M; Westphal, Ralf; Citak, Musa; Hawi, Nael; Liodakis, Emmanouil; Krettek, Christian; Stuebig, Timo

    2017-08-11

    We aimed to test whether a robotic technique would offer more accurate access to the proximal femoral medullary cavity for insertion of an intramedullary nail compared to the conventional manual technique. The medullary cavity of ten femur specimens was accessed in a conventional fashion using fluoroscopic control. In ten additional femur specimens, ISO-C 3D scans were obtained and a computer program calculated the ideal location of the cavity opening based on the trajectory of the medullary canal. In both techniques, the surgeon opened the cavity using a drill and inserted a radiopaque tube that matched the diameter of the cavity. The mean difference in angle between the proximal opening and the medullary canal in the shaft of the femur was calculated for both groups. Robotic cavity opening was more accurate than the manual technique, with a mean difference in trajectory between the proximal opening and the shaft canal of 2.0° (95% CI 0.6°-3.5°) compared to a mean difference of 4.3° (95% CI 2.11°-6.48°) using the manual technique (P = 0.0218). The robotic technique was more accurate than the manual procedure for identifying the optimal location for opening the medullary canal for insertion of an intramedullary nail. Additional advantages may include a reduction in total radiation exposure, as only one ISO-C 3D scan is needed, as opposed to multiple radiographs when using the manual technique.

  10. Early small-bowel ischemia: dual-energy CT improves conspicuity compared with conventional CT in a swine model.

    Science.gov (United States)

    Potretzke, Theodora A; Brace, Christopher L; Lubner, Meghan G; Sampson, Lisa A; Willey, Bridgett J; Lee, Fred T

    2015-04-01

    To compare dual-energy computed tomography (CT) with conventional CT for the detection of small-bowel ischemia in an experimental animal model. The study was approved by the animal care and use committee and was performed in accordance with the Guide for Care and Use of Laboratory Animals issued by the National Research Council. Ischemic bowel segments (n = 8) were created in swine (n = 4) by means of surgical occlusion of distal mesenteric arteries and veins. Contrast material-enhanced dual-energy CT and conventional single-energy CT (120 kVp) sequences were performed during the portal venous phase with a single-source fast-switching dual-energy CT scanner. Attenuation values and contrast-to-noise ratios of ischemic and perfused segments on iodine material-density, monospectral dual-energy CT (51 keV, 65 keV, and 70 keV), and conventional 120-kVp CT images were compared. Linear mixed-effects models were used for comparisons. The attenuation difference between ischemic and perfused segments was significantly greater on dual-energy 51-keV CT images than on conventional 120-kVp CT images (mean difference, 91.7 HU vs 47.6 HU; P conventional CT by increasing attenuation differences between ischemic and perfused segments on low-kiloelectron volt and iodine material density images. © RSNA, 2014.

  11. Sliding Mode Controller and Lyapunov Redesign Controller to Improve Microgrid Stability: A Comparative Analysis with CPL Power Variation

    Directory of Open Access Journals (Sweden)

    Eklas Hossain

    2017-11-01

    Full Text Available To mitigate the microgrid instability despite the presence of dense Constant Power Load (CPL loads in the system, a number of compensation techniques have already been gone through extensive research, proposed, and implemented around the world. In this paper, a storage based load side compensation technique is used to enhance stability of microgrids. Besides adopting this technique here, Sliding Mode Controller (SMC and Lyapunov Redesign Controller (LRC, two of the most prominent nonlinear control techniques, are individually implemented to control microgrid system stability with desired robustness. CPL power is then varied to compare robustness of these two control techniques. This investigation revealed the better performance of the LRC system compared to SMC to retain stability in microgrid with dense CPL load. All the necessary results are simulated in Matlab/Simulink platform for authentic verification. Reasons behind inferior SMC performance and ways to mitigate that are also discussed. Finally, the effectiveness of SMC and LRC systems to attain stability in real microgrids is verified by numerical analysis.

  12. Initial paclitaxel improves outcome compared with CMFP combination chemotherapy as front-line therapy in untreated metastatic breast cancer.

    Science.gov (United States)

    Bishop, J F; Dewar, J; Toner, G C; Smith, J; Tattersall, M H; Olver, I N; Ackland, S; Kennedy, I; Goldstein, D; Gurney, H; Walpole, E; Levi, J; Stephenson, J; Canetta, R

    1999-08-01

    To determine the place of single-agent paclitaxel compared with nonanthracycline combination chemotherapy as front-line therapy in metastatic breast cancer. Patients with previously untreated metastatic breast cancer were randomized to receive either paclitaxel 200 mg/m(2) intravenously (IV) over 3 hours for eight cycles (24 weeks) or standard cyclophosphamide 100 mg/m(2)/d orally on days 1 to 14, methotrexate 40 mg/m(2) IV on days 1 and 8, fluorouracil 600 mg/m(2) IV on days 1 and 8, and prednisone 40 mg/m(2)/d orally on days 1 to 14 (CMFP) for six cycles (24 weeks) with epirubicin recommended as second-line therapy. A total of 209 eligible patients were randomized with a median survival duration of 17.3 months for paclitaxel and 13.9 months for CMFP. Multivariate analysis showed that patients who received paclitaxel survived significantly longer than those who received CMFP (P =.025). Paclitaxel produced significantly less severe leukopenia, thrombocytopenia, mucositis, documented infections (all P = .07). Initial paclitaxel was associated with significantly less myelosuppression and fewer infections, with longer survival and similar quality of life and control of metastatic breast cancer compared with CMFP.

  13. Why greatness cannot be planned the myth of the objective

    CERN Document Server

    Stanley, Kenneth O

    2015-01-01

    Why does modern life revolve around objectives? From how science is funded, to improving how children are educated -- and nearly everything in-between -- our society has become obsessed with a seductive illusion: that greatness results from doggedly measuring improvement in the relentless pursuit of an ambitious goal. In Why Greatness Cannot Be Planned, Stanley and Lehman begin with a surprising scientific discovery in artificial intelligence that leads ultimately to the conclusion that the objective obsession has gone too far. They make the case that great achievement can't be bottled up int

  14. Hospital Capital Investment During the Great Recession.

    Science.gov (United States)

    Choi, Sung

    2017-01-01

    Hospital capital investment is important for acquiring and maintaining technology and equipment needed to provide health care. Reduction in capital investment by a hospital has negative implications for patient outcomes. Most hospitals rely on debt and internal cash flow to fund capital investment. The great recession may have made it difficult for hospitals to borrow, thus reducing their capital investment. I investigated the impact of the great recession on capital investment made by California hospitals. Modeling how hospital capital investment may have been liquidity constrained during the recession is a novel contribution to the literature. I estimated the model with California Office of Statewide Health Planning and Development data and system generalized method of moments. Findings suggest that not-for-profit and public hospitals were liquidity constrained during the recession. Comparing the changes in hospital capital investment between 2006 and 2009 showed that hospitals used cash flow to increase capital investment by $2.45 million, other things equal.

  15. Hospital Capital Investment During the Great Recession

    Science.gov (United States)

    Choi, Sung

    2017-01-01

    Hospital capital investment is important for acquiring and maintaining technology and equipment needed to provide health care. Reduction in capital investment by a hospital has negative implications for patient outcomes. Most hospitals rely on debt and internal cash flow to fund capital investment. The great recession may have made it difficult for hospitals to borrow, thus reducing their capital investment. I investigated the impact of the great recession on capital investment made by California hospitals. Modeling how hospital capital investment may have been liquidity constrained during the recession is a novel contribution to the literature. I estimated the model with California Office of Statewide Health Planning and Development data and system generalized method of moments. Findings suggest that not-for-profit and public hospitals were liquidity constrained during the recession. Comparing the changes in hospital capital investment between 2006 and 2009 showed that hospitals used cash flow to increase capital investment by $2.45 million, other things equal. PMID:28617202

  16. Proximal splenic angioembolization does not improve outcomes in treating blunt splenic injuries compared with splenectomy: a cohort analysis.

    Science.gov (United States)

    Duchesne, Juan C; Simmons, Jon D; Schmieg, Robert E; McSwain, Norman E; Bellows, Charles F

    2008-12-01

    Although splenic angioembolization (SAE) has been introduced and adopted in many trauma centers, the appropriate selection for and utility of SAE in trauma patients remains under debate. This study examined the outcomes of proximal SAE as part of a management algorithm for adult traumatic splenic injury compared with splenectomy. A retrospective cohort analysis was performed on all hemodynamically stable (HDS) blunt trauma patients with isolated splenic injury and computed tomographic (CT) evidence of active contrast extravasation that presented to a level 1 Trauma Center over a period of 5 years. The cohorts were defined by two separate 30 month periods and included 78 patients seen before (group I) and 76 patients seen after (group II) the introduction of an institutional SAE protocol. Demographics, splenic injury grade, and outcomes of the two groups were compared using Student's t test, or chi2 test. Analysis was by intention-to-treat. Six hundred eighty-two patients with blunt splenic injury were identified; 154 patients (29%) were HDS with CT evidence of active contrast extravasation. Group I (n = 78) was treated with splenectomy and group II (n = 76) was treated with proximal SAE. There was no difference in age (33 +/- 14 vs. 37 +/- 17 years), Injury Severity Score (31 +/- 13 vs. 29 +/- 11), or mortality (18% vs. 15%) between the two groups. However, the incidence of Adult Respiratory Distress Syndrome (ARDS) was 4-fold higher in those patients that underwent proximal SAE compared with those that underwent splenectomy (22% vs. 5%, p = 0.002). Twenty two patients failed nonoperative management (NOM) after SAE. This failure appeared to be directly related to the grade of splenic organ injury (grade I and II: 0%; grade III: 24%; grade IV: 53%; and grade V: 100%). Introduction of proximal SAE in NOM of HDS splenic trauma patients with active extravasation did not alter mortality rates at a Level 1 Trauma Center. Increased incidence of ARDS and association of

  17. Southern Great Plains Safety Orientation

    Energy Technology Data Exchange (ETDEWEB)

    Schatz, John

    2014-05-01

    Welcome to the Atmospheric Radiation Measurement (ARM) Climate Research Facility (ARM) Southern Great Plains (SGP) site. This U.S. Department of Energy (DOE) site is managed by Argonne National Laboratory (ANL). It is very important that all visitors comply with all DOE and ANL safety requirements, as well as those of the Occupational Safety and Health Administration (OSHA), the National Fire Protection Association, and the U.S. Environmental Protection Agency, and with other requirements as applicable.

  18. A Proteomic Workflow Using High-Throughput De Novo Sequencing Towards Complementation of Genome Information for Improved Comparative Crop Science.

    Science.gov (United States)

    Turetschek, Reinhard; Lyon, David; Desalegn, Getinet; Kaul, Hans-Peter; Wienkoop, Stefanie

    2016-01-01

    The proteomic study of non-model organisms, such as many crop plants, is challenging due to the lack of comprehensive genome information. Changing environmental conditions require the study and selection of adapted cultivars. Mutations, inherent to cultivars, hamper protein identification and thus considerably complicate the qualitative and quantitative comparison in large-scale systems biology approaches. With this workflow, cultivar-specific mutations are detected from high-throughput comparative MS analyses, by extracting sequence polymorphisms with de novo sequencing. Stringent criteria are suggested to filter for confidential mutations. Subsequently, these polymorphisms complement the initially used database, which is ready to use with any preferred database search algorithm. In our example, we thereby identified 26 specific mutations in two cultivars of Pisum sativum and achieved an increased number (17 %) of peptide spectrum matches.

  19. Comparing two enhancing methods for improving kitchen waste anaerobic digestion: bentonite addition and autoclaved de-oiling pretreatment

    DEFF Research Database (Denmark)

    Zhang, Duojiao; Duan, Na; Tian, Hailin

    2018-01-01

    The effects of different enhancement methods, including adding bentonite (1.25%, w/w, wet substrate) and autoclaved de-oiling pretreatment (121 °C, 30 minutes), on the anaerobic digestion of kitchen waste (KW) were comparably studied. Mesophilic continuous stirred tank reactors were used under...... different organic loading rates (OLRs) of 1.11 to 1.84 gVS (volatile solid)L−1d−1 and two different hydraulic retention times (HRTs) (20 d and 25 d). In this study, two enhancement methods and extending HRT could prevent volatile fatty acids (VFA) accumulation and obtain a high methane production at low OLR...... design and process evaluation of a CSTR biogas plant treating with KW based on the laboratory experiment was stated....

  20. Improvements in health-related quality of life with liraglutide 3.0 mg compared with placebo in weight management

    DEFF Research Database (Denmark)

    Kolotkin, R. L.; Fujioka, K.; Wolden, M. L.

    2016-01-01

    Obesity has a negative impact on health-related quality of life (HRQoL). The SCALE Obesity and Prediabetes study investigated the effect of liraglutide 3.0 mg, as adjunct to diet and exercise, on HRQoL in patients with obesity [body mass index (BMI) ≥ 30 kg m−2] or overweight (BMI ≥ 27 kg m−2......) with comorbidity. Participants were advised on a 500 kcal d−1 deficit diet and a 150-min week−1 exercise programme and were randomised 2:1 to once-daily subcutaneous liraglutide 3.0 mg or placebo. HRQoL was assessed using the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) and Short-Form 36 (SF-36) v2 health...... questionnaires. Individuals on liraglutide 3.0 mg (n = 2046) had significantly greater improvements in IWQOL-Lite total score (10.6 ± 13.3) vs. placebo (n = 1020) (7.7 ± 12.8) and SF-36 physical (PCS) and mental (MCS) component summary scores (PCS, 3.6 ± 6.8; MCS, 0.2 ± 8.1) vs. placebo (PCS, 2.2 ± 7.7; MCS, −0...

  1. Strain elastography of abnormal axillary nodes in breast cancer patients does not improve diagnostic accuracy compared with conventional ultrasound alone.

    Science.gov (United States)

    Park, Young Mi; Fornage, Bruno D; Benveniste, Ana Paula; Fox, Patricia S; Bassett, Roland L; Yang, Wei Tse

    2014-12-01

    The purpose of this study was to determine the diagnostic value of strain elastography (SE) alone and in combination with gray-scale ultrasound in the diagnosis of benign versus metastatic disease for abnormal axillary lymph nodes in breast cancer patients. Patients with breast cancer and axillary lymph nodes suspicious for metastatic disease on conventional ultrasound who underwent SE of the suspicious node before ultrasound-guided fine-needle aspiration biopsy (FNAB) were included in this study. On conventional ultrasound, the long- and short-axis diameters, long-axis-to-short-axis ratio, cortical echogenicity, thickness, and evenness were documented. The nodal vascularity was assessed on power Doppler imaging. Elastograms were evaluated for the percentage of black (hard) areas in the lymph node, and the SE-ultrasound size ratio was calculated. Two readers assessed the images independently and then in consensus in cases of disagreement. ROC AUCs were calculated for conventional ultrasound, SE, and both methods combined. Interreader reliability was assessed using kappa statistics. A total of 101 patients with 104 nodes were examined; 35 nodes were benign, and 69 had metastases. SE alone showed a significantly lower AUC (62%) than did conventional ultrasound (92%) (pultrasound and the AUC of the combination of conventional ultrasound and SE (93%) (p=0.16). Interreader reliability was moderate for all variables (κ≥0.60) except the SE-ultrasound size ratio (κ=0.35). Added SE does not improve the diagnostic ability of conventional ultrasound when evaluating abnormal axillary lymph nodes.

  2. Portal Vein Embolization before Right Hepatectomy: Improved Results Using n-Butyl-Cyanoacrylate Compared to Microparticles Plus Coils

    Energy Technology Data Exchange (ETDEWEB)

    Guiu, Boris, E-mail: boris.guiu@chu-dijon.fr; Bize, Pierre; Gunthern, Daniel [Centre Hospitalo-Univeristaire Vaudois, Digestive and Oncologic Imaging and Interventional Radiology Unit, Department of Radiology and Interventional Radiology (Switzerland); Demartines, Nicolas; Halkic, Nermin [Centre Hospitalo-Univeristaire Vaudois, Department of Visceral Surgery (Switzerland); Denys, Alban [Centre Hospitalo-Univeristaire Vaudois, Digestive and Oncologic Imaging and Interventional Radiology Unit, Department of Radiology and Interventional Radiology (Switzerland)

    2013-10-15

    Background: There is currently no consensus in the literature on which embolic agent induces the greatest degree of liver hypertrophy after portal vein embolization (PVE). Only experimental results in a pig model have demonstrated an advantage of n-butyl-cyanoacrylate (NBCA) over 3 other embolic materials (hydrophilic gel, small and large polyvinyl alcohol particles) for PVE. Therefore, the aim of this human study was to retrospectively compare the results of PVE using NBCA with those using spherical microparticles plus coils. Methods: A total of 34 patients underwent PVE using either NBCA (n = 20), or spherical microparticles plus coils (n = 14). PVE was decided according to preoperative volumetry on the basis of contrast-enhanced CT. Groups were compared for age, sex, volume of the left lobe before PVE and future remnant liver ratio (FRL) (volume of the left lobe/total liver volume - tumor volume). The primary end point was the increase in left lobe volume 1 month after PVE. Secondary end points were procedure complications and biological tolerance. Results: Both groups were similar in terms of age, sex ratio, left lobe volume, and FRL before PVE. NBCA induced a greater increase in volume after PVE than did microparticles plus coils (respectively, +74 {+-} 69 % and +23 {+-} 14 %, p < 0.05). The amount of contrast medium used for the procedure was significantly larger when microparticles and coils rather than NBCA were used (respectively, 264 {+-} 43 ml and 162 {+-} 34 ml, p < 0.01). The rate of PVE complications as well as the biological tolerance was similar in both groups. Conclusion: NBCA seems more effective than spherical microparticles plus coils to induce left-lobe hypertrophy.

  3. Incorporating High-Frequency Physiologic Data Using Computational Dictionary Learning Improves Prediction of Delayed Cerebral Ischemia Compared to Existing Methods.

    Science.gov (United States)

    Megjhani, Murad; Terilli, Kalijah; Frey, Hans-Peter; Velazquez, Angela G; Doyle, Kevin William; Connolly, Edward Sander; Roh, David Jinou; Agarwal, Sachin; Claassen, Jan; Elhadad, Noemie; Park, Soojin

    2018-01-01

    Accurate prediction of delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) can be critical for planning interventions to prevent poor neurological outcome. This paper presents a model using convolution dictionary learning to extract features from physiological data available from bedside monitors. We develop and validate a prediction model for DCI after SAH, demonstrating improved precision over standard methods alone. 488 consecutive SAH admissions from 2006 to 2014 to a tertiary care hospital were included. Models were trained on 80%, while 20% were set aside for validation testing. Modified Fisher Scale was considered the standard grading scale in clinical use; baseline features also analyzed included age, sex, Hunt-Hess, and Glasgow Coma Scales. An unsupervised approach using convolution dictionary learning was used to extract features from physiological time series (systolic blood pressure and diastolic blood pressure, heart rate, respiratory rate, and oxygen saturation). Classifiers (partial least squares and linear and kernel support vector machines) were trained on feature subsets of the derivation dataset. Models were applied to the validation dataset. The performances of the best classifiers on the validation dataset are reported by feature subset. Standard grading scale (mFS): AUC 0.54. Combined demographics and grading scales (baseline features): AUC 0.63. Kernel derived physiologic features: AUC 0.66. Combined baseline and physiologic features with redundant feature reduction: AUC 0.71 on derivation dataset and 0.78 on validation dataset. Current DCI prediction tools rely on admission imaging and are advantageously simple to employ. However, using an agnostic and computationally inexpensive learning approach for high-frequency physiologic time series data, we demonstrated that we could incorporate individual physiologic data to achieve higher classification accuracy.

  4. Incorporating High-Frequency Physiologic Data Using Computational Dictionary Learning Improves Prediction of Delayed Cerebral Ischemia Compared to Existing Methods

    Directory of Open Access Journals (Sweden)

    Murad Megjhani

    2018-03-01

    Full Text Available PurposeAccurate prediction of delayed cerebral ischemia (DCI after subarachnoid hemorrhage (SAH can be critical for planning interventions to prevent poor neurological outcome. This paper presents a model using convolution dictionary learning to extract features from physiological data available from bedside monitors. We develop and validate a prediction model for DCI after SAH, demonstrating improved precision over standard methods alone.Methods488 consecutive SAH admissions from 2006 to 2014 to a tertiary care hospital were included. Models were trained on 80%, while 20% were set aside for validation testing. Modified Fisher Scale was considered the standard grading scale in clinical use; baseline features also analyzed included age, sex, Hunt–Hess, and Glasgow Coma Scales. An unsupervised approach using convolution dictionary learning was used to extract features from physiological time series (systolic blood pressure and diastolic blood pressure, heart rate, respiratory rate, and oxygen saturation. Classifiers (partial least squares and linear and kernel support vector machines were trained on feature subsets of the derivation dataset. Models were applied to the validation dataset.ResultsThe performances of the best classifiers on the validation dataset are reported by feature subset. Standard grading scale (mFS: AUC 0.54. Combined demographics and grading scales (baseline features: AUC 0.63. Kernel derived physiologic features: AUC 0.66. Combined baseline and physiologic features with redundant feature reduction: AUC 0.71 on derivation dataset and 0.78 on validation dataset.ConclusionCurrent DCI prediction tools rely on admission imaging and are advantageously simple to employ. However, using an agnostic and computationally inexpensive learning approach for high-frequency physiologic time series data, we demonstrated that we could incorporate individual physiologic data to achieve higher classification accuracy.

  5. PillCam ESO in esophageal studies: improved diagnostic yield of 14 frames per second (fps) compared with 4 fps.

    Science.gov (United States)

    Koslowsky, B; Jacob, H; Eliakim, R; Adler, S N

    2006-01-01

    Capsule endoscopy, using the PillCam ESO and sending images at a rate of 4 frames per second (fps), has a high sensitivity and specificity in diagnosing gastroesophageal reflux disease (GERD) lesions. We tested a new device which produces images at a rate of 14 fps. The diagnostic performance and esophageal visualization of these two devices were compared. 42 patients with GERD symptoms and eight patients with a history of Barrett's esophagus had an esophagogastroduodenoscopy (EGD). All patients underwent capsule endoscopy of the esophagus within 1 hour prior to EGD. The first 25 patients had a capsule endoscopy examination with the 4-fps device. The following 25 patients underwent capsule endoscopy under identical conditions but using the 14-fps device. The reader of the capsule endoscopy study was blinded to the EGD findings. A diagnosis of GERD or Barrett's esophagus was established with EGD. The findings at capsule endoscopy were compared with the EGD findings. We also examined how frequently the esophagus in its entirety was visualized by these two devices. The 4-fps device diagnosed 16/19 cases of esophageal erosions or ulcers (sensitivity 84 %) and 6/8 cases of Barrett's esophagus (sensitivity 75 %). The 14-fps capsule diagnosed 16/16 cases of esophageal ulcers or erosions and 7/7 cases of Barrett's esophagus (sensitivity 100 %). The total diagnostic miss rate in the 4-fps group was 5/27 (18 %) whereas the diagnostic miss rate in the 14-fps group was 0/23 (0 %) P fps group and in 20/25 patients (80 %) in the 14-fps group ( P fps device and in 19/25 (76 %) by the 14-fps device ( P fps PillCam ESO capsule is consistent with the data obtained from fluoroscopic studies of swallowed PillCam capsules, showing that capsule speed may reach 20 cm/s. For the 14-fps PillCam this means one image transmitted per 3-cm segment at maximal capsule speed, therefore still allowing for full visualization of the entire esophagus. Capsule endoscopy using the 14-fps PillCam ESO

  6. Can the localization of primary colonic tumors be improved by staging CT without specific bowel preparation compared to optical colonoscopy?

    International Nuclear Information System (INIS)

    Feuerlein, Sebastian; Grimm, Lars J.; Davenport, Matthew S.; Haystead, Clare M.; Miller, Chad M.; Neville, Amy M.; Jaffe, Tracy A.

    2012-01-01

    Objectives: To investigate the ability of staging computed tomography (CT) without bowel preparation to accurately localize colonic tumors compared to optical colonoscopy. Methods: The local institutional review board approved this retrospective and HIPAA-compliant study. Forty-six patients with colonic adenocarcinoma, preoperative colonoscopy, and staging CT within 60 days of resection were included. Patients underwent contrast enhanced CT imaging without bowel preparation or oral contrast. The colon was divided into four segments with the operative reports used as the standard. Rectal and cecal cancers were excluded. CT scans were reviewed by 5 readers in a segmental binary fashion using a 5-point confidence scale in two sessions blinded and unblinded to the colonoscopy report. Results: At surgery 49 tumors were found in 46 patients. Readers detected 86.1%, 74.3%, and 66.9% of lesions with 92.0%, 94.1%, and 95.4% accuracy for confidence scores of ≥3, ≥4, and 5. CT interobserver agreement was good (κ = 0.82) for the unblinded and moderate (κ = 0.60) for the blinded read. Colonoscopic localization was only 78.7% accurate with 2 tumors undiscovered. Colonoscopic accuracy was low in the descending colon (57.1%) and the transverse colon (55.6%). Conclusions: Preoperative staging CT is more accurate than colonoscopy in the localization of colonic tumors

  7. A comparative study between an improved novel air-cushion sensor and a wheeled probe for minimally invasive surgery.

    Science.gov (United States)

    Zbyszewski, Dinusha; Challacombe, Benjamin; Li, Jichun; Seneviratne, Lakmal; Althoefer, Kaspar; Dasgupta, Prokar; Murphy, Declan

    2010-07-01

    We describe a comparative study between an enhanced air-cushion tactile sensor and a wheeled indentation probe. These laparoscopic tools are designed to rapidly locate soft-tissue abnormalities during minimally invasive surgery (MIS). The air-cushion tactile sensor consists of an optically based sensor with a 7.8 mm sphere "floating" on a cushion of air at the tip of a shaft. The wheeled indentation probe is a 10 mm wide and 5 mm in diameter wheel mounted to a force/torque sensor. A continuous rolling indentation technique is used to pass the sensors over the soft-tissue surfaces. The variations in stiffness of the viscoelastic materials that are detected during the rolling indentations are illustrated by stiffness maps that can be used for tissue diagnosis. The probes were tested by having to detect four embedded nodules in a silicone phantom. Each probe was attached to a robotic manipulator and rolled over the silicone phantom in parallel paths. The readings of each probe collected during the process of rolling indentation were used to achieve the final results. The results show that both sensors reliably detected the areas of variable stiffness by accurately identifying the location of each nodule. These are illustrated in the form of two three-dimensional spatiomechanical maps. These probes have the potential to be used in MIS because they could provide surgeons with information on the mechanical properties of soft tissue, consequently enhancing the reduction in haptic feedback.

  8. Comparative Study of Electric Energy Storages and Thermal Energy Auxiliaries for Improving Wind Power Integration in the Cogeneration System

    Directory of Open Access Journals (Sweden)

    Yanjuan Yu

    2018-01-01

    Full Text Available In regards to the cogeneration system in Northern China, mainly supported by combined heat and power (CHP plants, it usually offers limited operation flexibility due to the joint production of electric and thermal power. For that large-scale wind farms included in the cogeneration system, a large amount of wind energy may have to be wasted. To solve this issue, the utilization of the electric energy storages and the thermal energy auxiliaries are recommended, including pumped hydro storage (PHS, compressed air energy storage (CAES, hydrogen-based energy storage (HES, heat storage (HS, electric boilers (EB, and heat pumps (HP. This paper proposes a general evaluation method to compare the performance of these six different approaches for promoting wind power integration. In consideration of saving coal consumption, reducing CO2 emissions, and increasing investment cost, the comprehensive benefit is defined as the evaluation index. Specifically, a wind-thermal conflicting expression (WTCE is put forward to simplify the formulation of the comprehensive benefit. Further, according to the cogeneration system of the West Inner Mongolia (WIM power grid, a test system is modelled to perform the comparison of the six different approaches. The results show that introducing the electric energy storages and the thermal energy auxiliaries can both contribute to facilitating wind power integration, and the HP can provide the best comprehensive benefit.

  9. Comparing the Selection and Placement of Best Management Practices in Improving Water Quality Using a Multiobjective Optimization and Targeting Method

    Directory of Open Access Journals (Sweden)

    Li-Chi Chiang

    2014-03-01

    Full Text Available Suites of Best Management Practices (BMPs are usually selected to be economically and environmentally efficient in reducing nonpoint source (NPS pollutants from agricultural areas in a watershed. The objective of this research was to compare the selection and placement of BMPs in a pasture-dominated watershed using multiobjective optimization and targeting methods. Two objective functions were used in the optimization process, which minimize pollutant losses and the BMP placement areas. The optimization tool was an integration of a multi-objective genetic algorithm (GA and a watershed model (Soil and Water Assessment Tool—SWAT. For the targeting method, an optimum BMP option was implemented in critical areas in the watershed that contribute the greatest pollutant losses. A total of 171 BMP combinations, which consist of grazing management, vegetated filter strips (VFS, and poultry litter applications were considered. The results showed that the optimization is less effective when vegetated filter strips (VFS are not considered, and it requires much longer computation times than the targeting method to search for optimum BMPs. Although the targeting method is effective in selecting and placing an optimum BMP, larger areas are needed for BMP implementation to achieve the same pollutant reductions as the optimization method.

  10. Network Interactions in the Great Altai Region

    Directory of Open Access Journals (Sweden)

    Lev Aleksandrovich Korshunov

    2017-12-01

    Full Text Available To improve the efficiency and competitiveness of the regional economy, an effective interaction between educational institutions in the Great Altai region is needed. The innovation growth can enhancing this interaction. The article explores the state of network structures in the economy and higher education in the border territories of the countries of Great Altai. The authors propose an updated approach to the three-level classification of network interaction. We analyze growing influence of the countries with emerging economies. We define the factors that impede the more stable and multifaceted regional development of these countries. Further, the authors determine indicators of the higher education systems and cooperation systems at the university level between the Shanghai Cooperation Organization countries (SCO and BRICS countries, showing the international rankings of the universities in these countries. The teaching language is important to overcome the obstacles in the interregional cooperation. The authors specify the problems of the development of the universities of the SCO and BRICS countries as global educational networks. The research applies basic scientific logical methods of analysis and synthesis, induction and deduction, as well as the SWOT analysis method. We have indentified and analyzed the existing economic and educational relations. To promote the economic innovation development of the border territories of the Great Altai, we propose a model of regional network university. Modern universities function in a new economic environment. Thus, in a great extent, they form the technological and social aspects of this environment. Innovative network structures contribute to the formation of a new network institutional environment of the regional economy, which impacts the macro- and microeconomic performance of the region as a whole. The results of the research can help to optimize the regional economies of the border

  11. Comparative analysis of CDPK family in maize, Arabidopsis, rice and sorghum revealed potential targets for drought tolerance improvement

    Science.gov (United States)

    Mittal, Shikha; Mallikarjuna, Mallana Gowdra; Rao, Atmakuri R.; Jain, Prashant A.; Dash, Prasanta K.; Thirunavukkarasu, Nepolean

    2017-12-01

    genes could be targeted in development of drought tolerant cultivars in maize, rice and sorghum through appropriate breeding approaches. Our comparative experiments of CDPK genes could also be extended in the drought stress breeding programmes of the related species.

  12. Stage-specific adhesion of Leishmania promastigotes to sand fly midguts assessed using an improved comparative binding assay.

    Directory of Open Access Journals (Sweden)

    Raymond Wilson

    2010-09-01

    Full Text Available The binding of Leishmania promastigotes to the midgut epithelium is regarded as an essential part of the life-cycle in the sand fly vector, enabling the parasites to persist beyond the initial blood meal phase and establish the infection. However, the precise nature of the promastigote stage(s that mediate binding is not fully understood.To address this issue we have developed an in vitro gut binding assay in which two promastigote populations are labelled with different fluorescent dyes and compete for binding to dissected sand fly midguts. Binding of procyclic, nectomonad, leptomonad and metacyclic promastigotes of Leishmania infantum and L. mexicana to the midguts of blood-fed, female Lutzomyia longipalpis was investigated. The results show that procyclic and metacyclic promastigotes do not bind to the midgut epithelium in significant numbers, whereas nectomonad and leptomonad promastigotes both bind strongly and in similar numbers. The assay was then used to compare the binding of a range of different parasite species (L. infantum, L. mexicana, L. braziliensis, L. major, L. tropica to guts dissected from various sand flies (Lu. longipalpis, Phlebotomus papatasi, P. sergenti. The results of these comparisons were in many cases in line with expectations, the natural parasite binding most effectively to its natural vector, and no examples were found where a parasite was unable to bind to its natural vector. However, there were interesting exceptions: L. major and L. tropica being able to bind to Lu. longipalpis better than L. infantum; L. braziliensis was able to bind to P. papatasi as well as L. major; and significant binding of L. major to P. sergenti and L. tropica to P. papatasi was observed.The results demonstrate that Leishmania gut binding is strictly stage-dependent, is a property of those forms found in the middle phase of development (nectomonad and leptomonad forms, but is absent in the early blood meal and final stages (procyclic

  13. Rumen-protected methionine compared with rumen-protected choline improves immunometabolic status in dairy cows during the peripartal period.

    Science.gov (United States)

    Zhou, Z; Bulgari, O; Vailati-Riboni, M; Trevisi, E; Ballou, M A; Cardoso, F C; Luchini, D N; Loor, J J

    2016-11-01

    The immunometabolic status of peripartal cows is altered due to changes in liver function, inflammation, and oxidative stress. Nutritional management during this physiological state can affect the biological components of immunometabolism. The objectives of this study were to measure concentrations of biomarkers in plasma, liver tissue, and milk, and also polymorphonuclear leukocyte function to assess the immunometabolic status of cows supplemented with rumen-protected methionine (Met) or choline (CHOL). Forty-eight multiparous Holstein cows were used in a randomized complete block design with 2×2 factorial arrangement of Met (Smartamine M, Adisseo NA, Alpharetta, GA) and CHOL (ReaShure, Balchem Inc., New Hampton, NY) level (with or without). Treatments (12 cows each) were control (CON), no Met or CHOL; CON and Met (SMA); CON and CHOL (REA); and CON and Met and CHOL (MIX). From -50 to -21d before expected calving, all cows received the same diet [1.40Mcal of net energy for lactation (NE L )/kg of DM] with no Met or CHOL. From -21d to calving, cows received the same close-up diet (1.52Mcal of NE L /kg of DM) and were assigned randomly to each treatment. From calving to 30d, cows were on the same postpartal diet (1.71Mcal of NE L /kg of DM) and continued to receive the same treatments until 30d. The Met supplementation was adjusted daily at 0.08% DM of diet, and CHOL was supplemented at 60g/cow per day. Liver (-10, 7, 21, and 30d) and blood (-10, 4, 8, 20, and 30d) samples were harvested for biomarker analyses. Neutrophil and monocyte phagocytosis and oxidative burst were assessed at d 1, 4, 14, and 28d. The Met-supplemented cows tended to have greater plasma paraoxonase. Greater plasma albumin and IL-6 as well as a tendency for lower haptoglobin were detected in Met- but not CHOL-supplemented cows. Similarly, cows fed Met compared with CHOL had greater concentrations of total and reduced glutathione (a potent intracellular antioxidant) in liver tissue. Upon a

  14. Comparative Analysis of CDPK Family in Maize, Arabidopsis, Rice, and Sorghum Revealed Potential Targets for Drought Tolerance Improvement

    Directory of Open Access Journals (Sweden)

    Shikha Mittal

    2017-12-01

    through different ABA and MAPK signaling cascades. These selected candidate genes could be targeted in development of drought tolerant genotypes in maize, rice, and sorghum through appropriate breeding approaches. Our comparative experiments of CDPK genes could also be extended in the drought stress breeding programmes of the related species.

  15. Learning and the Great Moderation

    OpenAIRE

    Bullard, James B.; Singh, Aarti

    2009-01-01

    We study a stylized theory of the volatility reduction in the U.S. after 1984 - the Great Moderation - which attributes part of the stabilization to less volatile shocks and another part to more difficult inference on the part of Bayesian households attempting to learn the latent state of the economy. We use a standard equilibrium business cycle model with technology following an unobserved regime-switching process. After 1984, according to Kim and Nelson (1999a), the variance of U.S. macroec...

  16. Pricing regulations in Great Britain

    International Nuclear Information System (INIS)

    Cicoletti, G.

    1993-01-01

    This paper briefly describes the structure and functions of Great Britain's essential electric power regulatory authority institutionalized by the 1989 British Electricity Act, i.e., the Office of Electricity Regulation, OFFER, and the responsibilities and tasks of the head of OFFER -the Director General of Electricity Supply (DGES). In particular, with regard to the latter, the paper describes how the DGES works together with regional electricity commissions to ensure the respect, by the various utilities, of consumer price caps and compliance with overall quality of service standards, as well as, to oversee 'pooling' activities by producers and distributors

  17. Pricing regulations in Great Britain

    International Nuclear Information System (INIS)

    Cicoletti, G.

    1993-01-01

    This paper briefly describes the structure and functions of Great Britain's essential electric power regulatory authority institutionalized by the 1989 British Electricity Act, i.e., the Office of Electricity Regulation, OFFER, and the responsibilities and tasks of the head of OFFER - the Director General of Electricity Supply (DGES). In particular, with regard to the latter, the paper describes how the DGES works together with regional electricity commissions to ensure the respect, by the various utilities, of consumer price caps and compliance with overall quality of service standards, as well as, to oversee 'pooling' activities by producers and distributors

  18. Commanders of the Great Victory

    Directory of Open Access Journals (Sweden)

    Anatoly Dmitriyevich Borshchov

    2015-01-01

    Full Text Available The honorary title of «commander» as well as the «admiral» is granted to a military or naval figure on the basis of public recognition of his personal contribution to the success of actions. Generals are usually individuals with creative thinking, the ability to foresee the development of military events. Generals usually have such personality traits as a strong will and determination, rich combat experience, credibility and high organizational skills. In an article dedicated to the 70th anniversary of the Soviet victory in the Great War examines the experience of formation and practice of the most talent-ed Soviet military leaders.

  19. GREAT: a web portal for Genome Regulatory Architecture Tools.

    Science.gov (United States)

    Bouyioukos, Costas; Bucchini, François; Elati, Mohamed; Képès, François

    2016-07-08

    GREAT (Genome REgulatory Architecture Tools) is a novel web portal for tools designed to generate user-friendly and biologically useful analysis of genome architecture and regulation. The online tools of GREAT are freely accessible and compatible with essentially any operating system which runs a modern browser. GREAT is based on the analysis of genome layout -defined as the respective positioning of co-functional genes- and its relation with chromosome architecture and gene expression. GREAT tools allow users to systematically detect regular patterns along co-functional genomic features in an automatic way consisting of three individual steps and respective interactive visualizations. In addition to the complete analysis of regularities, GREAT tools enable the use of periodicity and position information for improving the prediction of transcription factor binding sites using a multi-view machine learning approach. The outcome of this integrative approach features a multivariate analysis of the interplay between the location of a gene and its regulatory sequence. GREAT results are plotted in web interactive graphs and are available for download either as individual plots, self-contained interactive pages or as machine readable tables for downstream analysis. The GREAT portal can be reached at the following URL https://absynth.issb.genopole.fr/GREAT and each individual GREAT tool is available for downloading. © The Author(s) 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.

  20. Estimating Spring Condensation on the Great Lakes

    Science.gov (United States)

    Meyer, A.; Welp, L.

    2017-12-01

    The Laurentian Great Lakes region provides opportunities for shipping, recreation, and consumptive water use to a large part of the United States and Canada. Water levels in the lakes fluctuate yearly, but attempts to model the system are inadequate because the water and energy budgets are still not fully understood. For example, water levels in the Great Lakes experienced a 15-year low period ending in 2013, the recovery of which has been attributed partially to decreased evaporation and increased precipitation and runoff. Unlike precipitation, the exchange of water vapor between the lake and the atmosphere through evaporation or condensation is difficult to measure directly. However, estimates have been constructed using off-shore eddy covariance direct measurements of latent heat fluxes, remote sensing observations, and a small network of monitoring buoys. When the lake surface temperature is colder than air temperature as it is in spring, condensation is larger than evaporation. This is a relatively small component of the net annual water budget of the lakes, but the total amount of condensation may be important for seasonal energy fluxes and atmospheric deposition of pollutants and nutrients to the lakes. Seasonal energy fluxes determine, and are influenced by, ice cover, water and air temperatures, and evaporation in the Great Lakes. We aim to quantify the amount of spring condensation on the Great Lakes using the National Center for Atmospheric Prediction North American Regional Reanalysis (NCEP NARR) Data for Winter 2013 to Spring 2017 and compare the condensation values of spring seasons following high volume, high duration and low volume, low duration ice cover.

  1. Comparably improved health-related quality of life after total arterial revascularization versus conventional coronary surgery--Copenhagen arterial revascularization randomized patency and outcome trial

    DEFF Research Database (Denmark)

    Damgaard, Sune; Lund, Jens T; Lilleør, Nikolaj B

    2011-01-01

    OBJECTIVE: We compared health-related quality of life up to 11 months after coronary artery bypass grafting using total arterial revascularization versus conventional coronary surgery. METHODS: In this randomized single-center trial, 161 patients underwent total arterial revascularization using.......01). For total arterial revascularization, there were also not statistically significant improvements for 'physical component summary' (P=0.09), 'bodily pain' (P=0.07) and 'vitality' (P=0.08). CONCLUSION: Health-related quality of life up to 1 year after total arterial revascularization is equal or slightly...... of the general Danish population. On all scales of the SF-36, there was statistically significant improvement at 3 and 11 months in both groups. For 'social functioning', the improvement following total arterial revascularization was significantly higher than following conventional revascularization (P=0...

  2. Great apes prefer cooked food.

    Science.gov (United States)

    Wobber, Victoria; Hare, Brian; Wrangham, Richard

    2008-08-01

    The cooking hypothesis proposes that a diet of cooked food was responsible for diverse morphological and behavioral changes in human evolution. However, it does not predict whether a preference for cooked food evolved before or after the control of fire. This question is important because the greater the preference shown by a raw-food-eating hominid for the properties present in cooked food, the more easily cooking should have been adopted following the control of fire. Here we use great apes to model food preferences by Paleolithic hominids. We conducted preference tests with various plant and animal foods to determine whether great apes prefer food items raw or cooked. We found that several populations of captive apes tended to prefer their food cooked, though with important exceptions. These results suggest that Paleolithic hominids would likewise have spontaneously preferred cooked food to raw, exapting a pre-existing preference for high-quality, easily chewed foods onto these cooked items. The results, therefore, challenge the hypothesis that the control of fire preceded cooking by a significant period.

  3. Studying The Great Russian Revolution

    Directory of Open Access Journals (Sweden)

    A. V. Torkunov

    2017-01-01

    Full Text Available The article revises an established view of Russian Revolution as two separate events - February Revolution and October Revolution. The author supports the concept of the «Great Russian Revolution», which unites these two events in a single process of revolutionary development. The author draws attention to the following advantages of the concept under consideration. First, it conceptualizes the revolution as a process contingent of a local and global historical context. In this sense, the revolution is presented as the transition of society to the modern stage of development, meaning the transition to modernity. Second, revolutionary events in Russia are considered from the point of view of the evolution of the spatial and socioeconomic distribution and rearrangement of key social groups: peasantry, elites, national and ethnic minorities. Third, it takes into account the personal factor in the revolutionary events, the influence of individual personalities on escalation or the reduction of socio-political tensions. Fourth, it draws attention to the fact that revolutions imply the use of various forms of political violence. Each revolution is characterized by a unique correlation of forms and intensity of political violence. Finally, it gives a normative assessment of the Revolution, encouraging a national discussion on the results and consequences of this great event.

  4. Chimney stoves modestly improved indoor air quality measurements compared with traditional open fire stoves: results from a small-scale intervention study in rural Peru.

    Science.gov (United States)

    Hartinger, S M; Commodore, A A; Hattendorf, J; Lanata, C F; Gil, A I; Verastegui, H; Aguilar-Villalobos, M; Mäusezahl, D; Naeher, L P

    2013-08-01

    Nearly half of the world's population depends on biomass fuels to meet domestic energy needs, producing high levels of pollutants responsible for substantial morbidity and mortality. We compare carbon monoxide (CO) and particulate matter (PM2.5) exposures and kitchen concentrations in households with study-promoted intervention (OPTIMA-improved stoves and control stoves) in San Marcos Province, Cajamarca Region, Peru. We determined 48-h indoor air concentration levels of CO and PM2.5 in 93 kitchen environments and personal exposure, after OPTIMA-improved stoves had been installed for an average of 7 months. PM2.5 and CO measurements did not differ significantly between OPTIMA-improved stoves and control stoves. Although not statistically significant, a post hoc stratification of OPTIMA-improved stoves by level of performance revealed mean PM2.5 and CO levels of fully functional OPTIMA-improved stoves were 28% lower (n = 20, PM2.5, 136 μg/m(3) 95% CI 54-217) and 45% lower (n = 25, CO, 3.2 ppm, 95% CI 1.5-4.9) in the kitchen environment compared with the control stoves (n = 34, PM2.5, 189 μg/m(3), 95% CI 116-261; n = 44, CO, 5.8 ppm, 95% CI 3.3-8.2). Likewise, although not statistically significant, personal exposures for OPTIMA-improved stoves were 43% and 17% lower for PM2.5 (n = 23) and CO (n = 25), respectively. Stove maintenance and functionality level are factors worthy of consideration for future evaluations of stove interventions. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Air pollution and environmental justice in the Great Lakes region

    Science.gov (United States)

    Comer, Bryan

    While it is true that air quality has steadily improved in the Great Lakes region, air pollution remains at unhealthy concentrations in many areas. Research suggests that vulnerable and susceptible groups in society -- e.g., minorities, the poor, children, and poorly educated -- are often disproportionately impacted by exposure to environmental hazards, including air pollution. This dissertation explores the relationship between exposure to ambient air pollution (interpolated concentrations of fine particulate matter, PM2.5) and sociodemographic factors (race, housing value, housing status, education, age, and population density) at the Census block-group level in the Great Lakes region of the United States. A relatively novel approach to quantitative environmental justice analysis, geographically weighted regression (GWR), is compared with a simplified approach: ordinary least squares (OLS) regression. While OLS creates one global model to describe the relationship between air pollution exposure and sociodemographic factors, GWR creates many local models (one at each Census block group) that account for local variations in this relationship by allowing the value of regression coefficients to vary over space, overcoming OLS's assumption of homogeneity and spatial independence. Results suggest that GWR can elucidate patterns of potential environmental injustices that OLS models may miss. In fact, GWR results show that the relationship between exposure to ambient air pollution and sociodemographic characteristics is non-stationary and can vary geographically and temporally throughout the Great Lakes region. This suggests that regulators may need to address environmental justice issues at the neighborhood level, while understanding that the severity of environmental injustices can change throughout the year.

  6. The Great Hedge of India

    International Nuclear Information System (INIS)

    Moxham, Roy

    2015-01-01

    The 'Great Hedge of India', a 3 700 kilometre-long hedge installed by the British customs to safeguard the colonial salt tax system and avoid salt smuggling totally faded from both memory and records (e.g. maps) in less than a century. Roy Moxham found traces of the hedge in a book footnote and searched it for several years until he found its meagre remains. The speaker wrote a book about this quest. He said that this story reveals how things disappear when they are no longer useful and, especially, when they are linked to parts of history that are not deemed particularly positive (the hedge was a means of colonial power)

  7. Gypsum karst in Great Britain

    Directory of Open Access Journals (Sweden)

    Cooper A.H.

    1996-01-01

    Full Text Available In Great Britain the most spectacular gypsum karst development is in the Zechstein gypsum (late Permian mainly in north-eastern England. The Midlands of England also has some karst developed in the Triassic gypsum in the vicinity of Nottingham. Along the north-east coast, south of Sunderland, well-developed palaeokarst, with magnificent breccia pipes, was produced by dissolution of Permian gypsum. In north-west England a small gypsum cave system of phreatic origin has been surveyed and recorded. A large actively evolving phreatic gypsum cave system has been postulated beneath the Ripon area on the basis of studies of subsidence and boreholes. The rate of gypsum dissolution here, and the associated collapse lead to difficult civil engineering and construction conditions, which can also be aggravated by water abstraction.

  8. Great-Britain at CERN

    CERN Multimedia

    C. Laignel

    2004-01-01

    From 23 to 25 November 2004 Administration Building Bldg 60/61 - ground and 1st floor 09.30 - 17.30 Twenty five companies will present their latest technology at the "Great-Britain at CERN" exhibition. British industry will exhibit products and technologies which are related to the field of particle physics. The main subjects are: electrical engineering, electronics, mechanical engineering, vacuum & low temperatures technologies, particles detectors and telecommunications. The exhibition is organised by BEAMA Exhibitions, The British Electrotechnical and Allied Manufacturer's Association There follows : the list of exhibitors. A detailed programme will be available in due course at : your Departemental secretariat, the reception information desk, Building 33, the exhibition. A detailed list of firms is available under the following FI link: http://fi-dep.web.cern.ch/fi-dep/structure/memberstates/exhibitions_visits.htm 1 Accles & Pollock 2 A S Scientific Products Ltd 3 C...

  9. Great Basin Experimental Range: Annotated bibliography

    Science.gov (United States)

    E. Durant McArthur; Bryce A. Richardson; Stanley G. Kitchen

    2013-01-01

    This annotated bibliography documents the research that has been conducted on the Great Basin Experimental Range (GBER, also known as the Utah Experiment Station, Great Basin Station, the Great Basin Branch Experiment Station, Great Basin Experimental Center, and other similar name variants) over the 102 years of its existence. Entries were drawn from the original...

  10. The origin of 'Great Walls'

    International Nuclear Information System (INIS)

    Shandarin, Sergei F.

    2009-01-01

    A new semi-analytical model that explains the formation and sizes of the 'great walls' - the largest structures observed in the universe is suggested. Although the basis of the model is the Zel'dovich approximation it has been used in a new way very different from the previous studies. Instead of traditional approach that evaluates the nonlinear density field it has been utilized for identification of the regions in Lagrangian space that after the mapping to real or redshift space (depending on the kind of structure is studied) end up in the regions where shell-crossing occurs. The set of these regions in Lagrangian space form the progenitor of the structure and after the mapping it determines the pattern of the structure in real or redshift space. The particle trajectories have crossed in such regions and the mapping is no longer unique there. The progenitor after mapping makes only one stream in the multi-stream flow regions therefore it does not comprise all the mass. Nevertheless, it approximately retains the shape of the structure. The progenitor of the structure in real space is determined by the linear density field along with two non-Gaussian fields derived from the initial potential. Its shape in Eulerian space is also affected by the displacement field. The progenitor of the structure in redshift space also depends on these fields but in addition it is strongly affected by two anisotropic fields that determine the pattern of great walls as well as their huge sizes. All the fields used in the mappings are derived from the linear potential smoothed at the current scale of nonlinearity which is R nl = 2.7 h −1 Mpc for the adopted parameters of the ΛCDM universe normalized to σ 8 = 0.8. The model predicts the existence of walls with sizes significantly greater than 500 h −1 Mpc that may be found in sufficiently large redshift surveys

  11. The Great Warming Brian Fagan

    Science.gov (United States)

    Fagan, B. M.

    2010-12-01

    The Great Warming is a journey back to the world of a thousand years ago, to the Medieval Warm Period. Five centuries of irregular warming from 800 to 1250 had beneficial effects in Europe and the North Atlantic, but brought prolonged droughts to much of the Americas and lands affected by the South Asian monsoon. The book describes these impacts of warming on medieval European societies, as well as the Norse and the Inuit of the far north, then analyzes the impact of harsh, lengthy droughts on hunting societies in western North America and the Ancestral Pueblo farmers of Chaco Canyon, New Mexico. These peoples reacted to drought by relocating entire communities. The Maya civilization was much more vulnerable that small-scale hunter-gatherer societies and subsistence farmers in North America. Maya rulers created huge water storage facilities, but their civilization partially collapsed under the stress of repeated multiyear droughts, while the Chimu lords of coastal Peru adapted with sophisticated irrigation works. The climatic villain was prolonged, cool La Niñalike conditions in the Pacific, which caused droughts from Venezuela to East Asia, and as far west as East Africa. The Great Warming argues that the warm centuries brought savage drought to much of humanity, from China to Peru. It also argues that drought is one of the most dangerous elements in today’s humanly created global warming, often ignored by preoccupied commentators, but with the potential to cause over a billion people to starve. Finally, I use the book to discuss the issues and problems of communicating multidisciplinary science to the general public.

  12. Fibrin Gels Exhibit Improved Biological, Structural, and Mechanical Properties Compared with Collagen Gels in Cell-Based Tendon Tissue-Engineered Constructs

    Science.gov (United States)

    Dyment, Nathaniel A.; Lu, Yinhui; Rao, Marepalli; Shearn, Jason T.; Rowe, David W.; Kadler, Karl E.; Butler, David L.

    2015-01-01

    The prevalence of tendon and ligament injuries and inadequacies of current treatments is driving the need for alternative strategies such as tissue engineering. Fibrin and collagen biopolymers have been popular materials for creating tissue-engineered constructs (TECs), as they exhibit advantages of biocompatibility and flexibility in construct design. Unfortunately, a few studies have directly compared these materials for tendon and ligament applications. Therefore, this study aims at determining how collagen versus fibrin hydrogels affect the biological, structural, and mechanical properties of TECs during formation in vitro. Our findings show that tendon and ligament progenitor cells seeded in fibrin constructs exhibit improved tenogenic gene expression patterns compared with their collagen-based counterparts for approximately 14 days in culture. Fibrin-based constructs also exhibit improved cell-derived collagen alignment, increased linear modulus (2.2-fold greater) compared with collagen-based constructs. Cyclic tensile loading, which promotes the maturation of tendon constructs in a previous work, exhibits a material-dependent effect in this study. Fibrin constructs show trending reductions in mechanical, biological, and structural properties, whereas collagen constructs only show improved tenogenic expression in the presence of mechanical stimulation. These findings highlight that components of the mechanical stimulus (e.g., strain amplitude or time of initiation) need to be tailored to the material and cell type. Given the improvements in tenogenic expression, extracellular matrix organization, and material properties during static culture, in vitro findings presented here suggest that fibrin-based constructs may be a more suitable alternative to collagen-based constructs for tissue-engineered tendon/ligament repair. PMID:25266738

  13. Early morning fledging improves recruitment in great tits Parus major

    NARCIS (Netherlands)

    Radersma, Reinder; Komdeur, Jan; Tinbergen, Joost M.

    A potential key event linking the nestling phase to first-year survival is fledging (nest leaving) because this process is characterized by a major change of environments and therefore a sudden shift in selective forces. Here we assessed whether different facets of fledging predicted subsequent

  14. Boosted classification trees result in minor to modest improvement in the accuracy in classifying cardiovascular outcomes compared to conventional classification trees

    Science.gov (United States)

    Austin, Peter C; Lee, Douglas S

    2011-01-01

    Purpose: Classification trees are increasingly being used to classifying patients according to the presence or absence of a disease or health outcome. A limitation of classification trees is their limited predictive accuracy. In the data-mining and machine learning literature, boosting has been developed to improve classification. Boosting with classification trees iteratively grows classification trees in a sequence of reweighted datasets. In a given iteration, subjects that were misclassified in the previous iteration are weighted more highly than subjects that were correctly classified. Classifications from each of the classification trees in the sequence are combined through a weighted majority vote to produce a final classification. The authors' objective was to examine whether boosting improved the accuracy of classification trees for predicting outcomes in cardiovascular patients. Methods: We examined the utility of boosting classification trees for classifying 30-day mortality outcomes in patients hospitalized with either acute myocardial infarction or congestive heart failure. Results: Improvements in the misclassification rate using boosted classification trees were at best minor compared to when conventional classification trees were used. Minor to modest improvements to sensitivity were observed, with only a negligible reduction in specificity. For predicting cardiovascular mortality, boosted classification trees had high specificity, but low sensitivity. Conclusions: Gains in predictive accuracy for predicting cardiovascular outcomes were less impressive than gains in performance observed in the data mining literature. PMID:22254181

  15. Different mechanisms of risperidone result in improved interpersonal trust, social engagement and cooperative behavior in patients with schizophrenia compared to trifluoperazine.

    Science.gov (United States)

    Tse, Wai Shing; Wong, Ann Siu Wah; Chan, Fu; Pang, Alfred Hin Tat; Bond, Alyson Jane; Chan, Chau Kiu Raymond

    2016-05-01

    Atypical antipsychotic treatment (e.g. risperidone) has been found to improve social functioning more than standard antipsychotic treatment. However, it is unclear which specific social behaviors are implicated in this improvement. The current study employed an interactive puzzle game to examine how social behaviors contribute to the improvement of social functioning by comparing patients receiving risperidone with those receiving trifluoperazine. Scores on the Positive and Negative Syndrome Scale, executive functioning, and social functioning were obtained from 24 patients with schizophrenia receiving either risperidone (n = 12) or trifluoperazine (n = 12), before their social behavior was measured in the interactive Tangrams Game. Immediately after the Tangrams Game, participants filled in two questionnaires measuring their interpersonal trust and rejection toward their game partner. Patients receiving risperidone showed more social engagement, cooperative behavior and interpersonal trust toward their game partners than those receiving trifluoperazine. Additional multivariate analysis of variance revealed that lower affiliative behavior was a function of positive symptoms; interpersonal trust had an impact on social engagement but executive functioning did not explain lower interpersonal trust or social disengagement. Improvement of social competence by risperidone might be related to the enhancement of both social behaviors and interpersonal trust as well as better symptom resolution. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

  16. The heart and great vessels

    International Nuclear Information System (INIS)

    Condon, V.

    1985-01-01

    Heart disease is the fifth most common cause of death in infants and children (preceded by anoxic and hypoxic conditions, gross congenital malformations, accidental death, and immaturity). Of all the cardiac lesions, congenital heart disease (CHD) makes up the gross majority, accounting for approximately 90% of all cardiac deaths. Approximately two-thirds of all infants who die from CHD do so within the first year of life; of these, approximately one-third die within the first month. The most common cause of death in the first month is hypoplastic left heart syndrome and lesions associated with it, i.e., aortic atresia/critical aortic stenosis and mitral atresia/critical mitral stenosis. Severe coarctation of the aorta (coarctation syndrome) and transposition of the great arteries are the other most important causes of death in this age group. CHD occurs as a familial condition in approximately 1-4% of cases; ventricular septal defects, patent ductus arteriosus, and atrial septal defect are particularly common forms. Parental age plays an important role, with a significantly increased risk of CHD in infants of mothers over 39 years of age. Patent ductus arteriosus is more prevalent in firstborn children, particularly those born prematurely to young mothers. Environmental factors, such as exposure to teratogenic agents, have also been shown to increase the incidence of CHD. Children with various syndromes also have increased incidence of CHD. Down syndrome is a classic example, as are other trisomies

  17. Tipping Points, Great and Small

    Science.gov (United States)

    Morrison, Foster

    2010-12-01

    The Forum by Jordan et al. [2010] addressed environmental problems of various scales in great detail, but getting the critical message through to the formulators of public policies requires going back to basics, namely, that exponential growth (of a population, an economy, or most anything else) is not sustainable. When have you heard any politician or economist from anywhere across the ideological spectrum say anything other than that more growth is essential? There is no need for computer models to demonstrate “limits to growth,” as was done in the 1960s. Of course, as one seeks more details, the complexity of modeling will rapidly outstrip the capabilities of both observation and computing. This is common with nonlinear systems, even simple ones. Thus, identifying all possible “tipping points,” as suggested by Jordan et al. [2010], and then stopping just short of them, is impractical if not impossible. The main thing needed to avoid environmental disasters is a bit of common sense.

  18. Data requirements of GREAT-ER: Modelling and validation using LAS in four UK catchments

    International Nuclear Information System (INIS)

    Price, Oliver R.; Munday, Dawn K.; Whelan, Mick J.; Holt, Martin S.; Fox, Katharine K.; Morris, Gerard; Young, Andrew R.

    2009-01-01

    Higher-tier environmental risk assessments on 'down-the-drain' chemicals in river networks can be conducted using models such as GREAT-ER (Geography-referenced Regional Exposure Assessment Tool for European Rivers). It is important these models are evaluated and their sensitivities to input variables understood. This study had two primary objectives: evaluate GREAT-ER model performance, comparing simulated modelled predictions for LAS (linear alkylbenzene sulphonate) with measured concentrations, for four rivers in the UK, and investigate model sensitivity to input variables. We demonstrate that the GREAT-ER model is very sensitive to variability in river discharges. However it is insensitive to the form of distributions used to describe chemical usage and removal rate in sewage treatment plants (STPs). It is concluded that more effort should be directed towards improving empirical estimates of effluent load and reducing uncertainty associated with usage and removal rates in STPs. Simulations could be improved by incorporating the effect of river depth on dissipation rates. - Validation of GREAT-ER.

  19. Data requirements of GREAT-ER: Modelling and validation using LAS in four UK catchments

    Energy Technology Data Exchange (ETDEWEB)

    Price, Oliver R., E-mail: oliver.price@unilever.co [Safety and Environmental Assurance Centre, Unilever, Colworth Science Park, Sharnbrook, Bedfordshire MK44 1LQ (United Kingdom); Munday, Dawn K. [Safety and Environmental Assurance Centre, Unilever, Colworth Science Park, Sharnbrook, Bedfordshire MK44 1LQ (United Kingdom); Whelan, Mick J. [Department of Natural Resources, School of Applied Sciences, Cranfield University, College Road, Cranfield, Bedfordshire MK43 0AL (United Kingdom); Holt, Martin S. [ECETOC, Ave van Nieuwenhuyse 4, Box 6, B-1160 Brussels (Belgium); Fox, Katharine K. [85 Park Road West, Birkenhead, Merseyside CH43 8SQ (United Kingdom); Morris, Gerard [Environment Agency, Phoenix House, Global Avenue, Leeds LS11 8PG (United Kingdom); Young, Andrew R. [Wallingford HydroSolutions Ltd, Maclean building, Crowmarsh Gifford, Wallingford, Oxon OX10 8BB (United Kingdom)

    2009-10-15

    Higher-tier environmental risk assessments on 'down-the-drain' chemicals in river networks can be conducted using models such as GREAT-ER (Geography-referenced Regional Exposure Assessment Tool for European Rivers). It is important these models are evaluated and their sensitivities to input variables understood. This study had two primary objectives: evaluate GREAT-ER model performance, comparing simulated modelled predictions for LAS (linear alkylbenzene sulphonate) with measured concentrations, for four rivers in the UK, and investigate model sensitivity to input variables. We demonstrate that the GREAT-ER model is very sensitive to variability in river discharges. However it is insensitive to the form of distributions used to describe chemical usage and removal rate in sewage treatment plants (STPs). It is concluded that more effort should be directed towards improving empirical estimates of effluent load and reducing uncertainty associated with usage and removal rates in STPs. Simulations could be improved by incorporating the effect of river depth on dissipation rates. - Validation of GREAT-ER.

  20. Design and synthesis of dimethylaminomethyl-substituted curcumin derivatives/analogues: potent antitumor and antioxidant activity, improved stability and aqueous solubility compared with curcumin.

    Science.gov (United States)

    Fang, Xubin; Fang, Lei; Gou, Shaohua; Cheng, Lin

    2013-03-01

    A series of dimethylaminomethyl-substituted curcumin derivatives/analogues were designed and synthesized. All compounds effectively inhibited HepG2, SGC-7901, A549 and HCT-116 tumor cell lines proliferation in MTT assay. Particularly, compounds 2a and 3d showed much better activity than curcumin against all of the four tumor cell lines. Antioxidant test revealed that these compounds had higher free radical scavenging activity than curcumin towards both DPPH and galvinoxyl radicals. Furthermore, the aqueous solubility and stability of the target compounds were also significantly improved compared with curcumin. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Osteochondral Biopsy Analysis Demonstrates That BST-CarGel Treatment Improves Structural and Cellular Characteristics of Cartilage Repair Tissue Compared With Microfracture

    Science.gov (United States)

    Méthot, Stéphane; Changoor, Adele; Tran-Khanh, Nicolas; Hoemann, Caroline D.; Stanish, William D.; Restrepo, Alberto; Shive, Matthew S.; Buschmann, Michael D.

    2016-01-01

    Objective The efficacy and safety of BST-CarGel, a chitosan-based medical device for cartilage repair, was compared with microfracture alone at 1 year during a multicenter randomized controlled trial (RCT) in the knee. The quality of repair tissue of osteochondral biopsies collected from a subset of patients was compared using blinded histological assessments. Methods The international RCT evaluated repair tissue quantity and quality by 3-dimensional quantitative magnetic resonance imaging as co-primary endpoints at 12 months. At an average of 13 months posttreatment, 21/41 BST-CarGel and 17/39 microfracture patients underwent elective second look arthroscopies as a tertiary endpoint, during which ICRS (International Cartilage Repair Society) macroscopic scoring was carried out, and osteochondral biopsies were collected. Stained histological sections were evaluated by blinded readers using ICRS I and II histological scoring systems. Collagen organization was evaluated using a polarized light microscopy score. Results BST-CarGel treatment resulted in significantly better ICRS macroscopic scores (P = 0.0002) compared with microfracture alone, indicating better filling, integration, and tissue appearance. Histologically, BST-CarGel resulted in a significant improvement of structural parameters—Surface Architecture (P = 0.007) and Surface/Superficial Assessment (P = 0.042)—as well as cellular parameters—Cell Viability (P = 0.006) and Cell Distribution (P = 0.032). No histological parameters were significantly better for the microfracture group. BST-CarGel treatment also resulted in a more organized repair tissue with collagen stratification more similar to native hyaline cartilage, as measured by polarized light microscopy scoring (P = 0.0003). Conclusion Multiple and independent analyses in this biopsy substudy demonstrated that BST-CarGel treatment results in improved structural and cellular characteristics of repair tissue at 1 year posttreatment compared with

  2. Behind every great ant, there is a great gut

    DEFF Research Database (Denmark)

    Poulsen, Michael; Sapountzis, Panagiotis

    2012-01-01

    on the potential contribution of the ants’ gut symbionts. This issue of Molecular Ecology contains a study by Anderson et al. (2012), who take a comparative approach to explore the link between trophic levels and ant microbiomes, specifically, to address three main questions: (i) Do closely related herbivorous...... conserved gut microbiomes, suggesting symbiont functions that directly relate to dietary preference of the ant host. These findings suggest an ecological role of gut symbionts in ants, for example, in metabolism and/or protection, and the comparative approach taken supports a model of co-evolution between...... ant species and specific core symbiont microbiomes. This study, thereby, highlights the omnipresence and importance of gut symbioses—also in the Hymenoptera—and suggests that these hitherto overlooked microbes likely have contributed to the ecological success of the ants....

  3. Estradiol and Antagonist Pretreatment Prior to Microdose Leuprolide in in Vitro Fertilization. Does It Improve IVF Outcomes in Poor Responders as Compared to Oral Contraceptive Pill?

    Science.gov (United States)

    Elassar, Alyaa; Nulsen, John; Engmann, Lawrence; Benadiva, Claudio

    2015-01-01

    To compare in vitro fertilization (IVF) outcomes in low responders stimulated with microdose leuprolide protocol (ML) following pretreatment with either oral contraceptive pill (OCP) or luteal estradiol (E2) + GnRH antagonist (E2 + antag) for follicular synchronization prior to controlled ovarian hyperstimulation (COH). This was a retrospective study of 130 women, who were poor responders, undergoing IVF with either OCP/ML or E2+ antag/ML protocols. The main outcome measures were ongoing pregnancy rates, number of oocytes retrieved, and cancellation rate. Both groups were similar in baseline characteristics. There were no significant differences in gonadotropin requirement, cancellation rate, and number of embryos transferred. Ongoing pregnancy rates (40% vs. 15%) were significantly higher in the OCP/ML group. Trends toward greater number of oocytes retrieved (7.7 ± 3.4 vs. 5.9 ± 4.2) and improved implantation rates (20% vs. 12%) were also noted, but these did not reach statistical significance. E2+antag pretreatment does not appear to improve IVF outcomes in ML protocol when compared to the standard OCP in poor responders. Randomized trials with adequate power to study the optimal method of steroid pretreatments appear justified.

  4. Does prolonged β-lactam infusions improve clinical outcomes compared to intermittent infusions? A meta-analysis and systematic review of randomized, controlled trials

    Directory of Open Access Journals (Sweden)

    Van Arendonk Kyle J

    2011-06-01

    Full Text Available Abstract Background The emergence of multi-drug resistant Gram-negatives (MDRGNs coupled with an alarming scarcity of new antibiotics has forced the optimization of the therapeutic potential of available antibiotics. To exploit the time above the minimum inhibitory concentration mechanism of β-lactams, prolonging their infusion may improve outcomes. The primary objective of this meta-analysis was to determine if prolonged β-lactam infusion resulted in decreased mortality and improved clinical cure compared to intermittent β-lactam infusion. Methods Relevant studies were identified from searches of MEDLINE, EMBASE, and CENTRAL. Heterogeneity was assessed qualitatively, in addition to I2 and Chi-square statistics. Pooled relative risks (RR and 95% confidence intervals (CI were calculated using Mantel-Haenszel random-effects models. Results Fourteen randomized controlled trials (RCTs were included. Prolonged infusion β-lactams were not associated with decreased mortality (n= 982; RR 0.92; 95% CI:0.61-1.37 or clinical cure (n = 1380; RR 1.00 95% CI:0.94-1.06 compared to intermittent infusions. Subgroup analysis for β-lactam subclasses and equivalent total daily β-lactam doses yielded similar results. Most studies had notable methodological flaws. Conclusions No clinical advantage was observed for prolonged infusion β-lactams. The limited number of studies with MDRGNs precluded evaluation of prolonged infusion of β-lactams for this subgroup. A large, multicenter RCT with critically ill patients infected with MDRGNs is needed.

  5. A New Keynesian Perspective on the Great Recession

    OpenAIRE

    Peter N. Ireland

    2010-01-01

    With an estimated New Keynesian model, this paper compares the "Great Recession" of 2007-09 to its two immediate predecessors in 1990-91 and 2001. The model attributes all three downturns to a similar mix of aggregate demand and supply disturbances. The most recent series of adverse shocks lasted longer and became more severe, however, prolonging and deepening the Great Recession. In addition, the zero lower bound on the nominal interest rate prevented monetary policy from stabilizing the US ...

  6. Simulation-based inter-professional education to improve attitudes towards collaborative practice: a prospective comparative pilot study in a Chinese medical centre.

    Science.gov (United States)

    Yang, Ling-Yu; Yang, Ying-Ying; Huang, Chia-Chang; Liang, Jen-Feng; Lee, Fa-Yauh; Cheng, Hao-Min; Huang, Chin-Chou; Kao, Shou-Yen

    2017-11-08

    Inter-professional education (IPE) builds inter-professional collaboration (IPC) attitude/skills of health professionals. This interventional IPE programme evaluates whether benchmarking sharing can successfully cultivate seed instructors responsible for improving their team members' IPC attitudes. Prospective, pre-post comparative cross-sectional pilot study. Thirty four physicians, 30 nurses and 24 pharmacists, who volunteered to be trained as seed instructors participated in 3.5-hour preparation and 3.5-hour simulation courses. Then, participants (n=88) drew lots to decide 44 presenters, half of each profession, who needed to prepare IPC benchmarking and formed Group 1. The remaining participants formed Group 2 (regular). Facilitators rated the Group 1 participants' degree of appropriate transfer and sustainable practice of the learnt IPC skills in the workplace according to successful IPC examples in their benchmarking sharing. For the three professions, improvement in IPC attitude was identified by sequential increase in the post-course (second month, T 2 ) and end-of-study (third month, T 3 ) Interdisciplinary Education Perception Scale (IEPS) and Attitudes Towards Healthcare Teams Scale (ATHCTS) scores, compared with pre-course (first month, T 1 ) scores. By IEPS and ATHCTS-based assessment, the degree of sequential improvements in IPC attitude was found to be higher among nurses and pharmacists than in physicians. In benchmarking sharing, the facilitators' agreement about the degree of participants'appropriate transfer and sustainable practice learnt 'communication and teamwork' skills in the workplace were significantly higher among pharmacists and nurses than among physicians. The post-intervention random sampling survey (sixth month, T post ) found that the IPC attitude of the three professions improved after on-site IPC skill promotion by new programme-trained seed instructors within teams. Addition of benchmark sharing to a diamond-based IPE simulation

  7. Beryllium, a material of great promise

    International Nuclear Information System (INIS)

    Le Fauconnier, J.P.; Nomine, A.M.

    1992-01-01

    Beryllium is one of the lightest metals. It also owns an outstanding combination of physical, mechanical and nuclear properties which gives it a favorable position, compared to more usual materials, in various fields of applications. Constant technological advancements in the elaboration and working up have induced a significant improvement of its ductility and a reduction of the production costs. (Author). 12 refs., 7 figs

  8. Hummingbirds have a greatly enlarged hippocampal formation.

    Science.gov (United States)

    Ward, Brian J; Day, Lainy B; Wilkening, Steven R; Wylie, Douglas R; Saucier, Deborah M; Iwaniuk, Andrew N

    2012-08-23

    Both field and laboratory studies demonstrate that hummingbirds (Apodiformes, Trochilidae) have exceptional spatial memory. The complexity of spatial-temporal information that hummingbirds must retain and use daily is probably subserved by the hippocampal formation (HF), and therefore, hummingbirds should have a greatly expanded HF. Here, we compare the relative size of the HF in several hummingbird species with that of other birds. Our analyses reveal that the HF in hummingbirds is significantly larger, relative to telencephalic volume, than any bird examined to date. When expressed as a percentage of telencephalic volume, the hummingbird HF is two to five times larger than that of caching and non-caching songbirds, seabirds and woodpeckers. This HF expansion in hummingbirds probably underlies their ability to remember the location, distribution and nectar content of flowers, but more detailed analyses are required to determine the extent to which this arises from an expansion of HF or a decrease in size of other brain regions.

  9. Impact of policy support on uptake of evidence-based continuous quality improvement activities and the quality of care for Indigenous Australians: a comparative case study.

    Science.gov (United States)

    Bailie, Ross; Matthews, Veronica; Larkins, Sarah; Thompson, Sandra; Burgess, Paul; Weeramanthri, Tarun; Bailie, Jodie; Cunningham, Frances; Kwedza, Ru; Clark, Louise

    2017-10-05

    To examine the impact of state/territory policy support on (1) uptake of evidence-based continuous quality improvement (CQI) activities and (2) quality of care for Indigenous Australians. Mixed-method comparative case study methodology, drawing on quality-of-care audit data, documentary evidence of policies and strategies and the experience and insights of stakeholders involved in relevant CQI programmes. We use multilevel linear regression to analyse jurisdictional differences in quality of care. Indigenous primary healthcare services across five states/territories of Australia. 175 Indigenous primary healthcare services. A range of national and state/territory policy and infrastructure initiatives to support CQI, including support for applied research. PRIMARY AND SECONDARY OUTCOME MEASURES: (i) Trends in the consistent uptake of evidence-based CQI tools available through a research-based CQI initiative (the Audit and Best Practice in Chronic Disease programme) and (ii) quality of care (as reflected in adherence to best practice guidelines). Progressive uptake of evidence-based CQI activities and steady improvements or maintenance of high-quality care occurred where there was long-term policy and infrastructure support for CQI. Where support was provided but not sustained there was a rapid rise and subsequent fall in relevant CQI activities. Health authorities should ensure consistent and sustained policy and infrastructure support for CQI to enable wide-scale and ongoing improvement in quality of care and, subsequently, health outcomes. It is not sufficient for improvement initiatives to rely on local service managers and clinicians, as their efforts are strongly mediated by higher system-level influences. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Chest Compressions during Sustained Inflations Improve Recovery When Compared to a 3:1 Compression:Ventilation Ratio during Cardiopulmonary Resuscitation in a Neonatal Porcine Model of Asphyxia.

    Science.gov (United States)

    Li, Elliott S; Görens, Immanuel; Cheung, Po-Yin; Lee, Tze-Fun; Lu, Min; O'Reilly, Megan; Schmölzer, Georg M

    2017-01-01

    Recently, sustained inflations (SI) during chest compression (CC) (CC+SI) have been suggested as an alternative to the current approach during neonatal resuscitation. No previous study compared CC+SI using CC rates of 90/min to the current 3:1 compression:ventilation ratio (C:V). To determine whether CC+SI versus a 3:1 C:V reduces the time to the return of spontaneous circulation (ROSC) and improves hemodynamic recovery in newborn piglets with asphyxia-induced bradycardia. Term newborn piglets were anesthetized, intubated, instrumented, and exposed to 45-min normocapnic hypoxia followed by asphyxia. Cardiopulmonary resuscitation (CPR) was initiated when the heart rate decreased to 25% of baseline. Piglets were randomized into 3 groups: CC during SI at a rate of 90 CC/min (SI+CC 90, n = 8), a 3:1 C:V using 90 CC and 30 inflations (3:1, n = 8), or a sham group (n = 6). Cardiac function, carotid blood flow, cerebral oxygenation, and respiratory parameters were continuously recorded throughout the experiment. CC+SI significantly reduced the median (IQR) time of ROSC, i.e., 34 s (28-156 s) versus 210 s (72-300 s) in the 3:1 group (p = 0.048). CC+SI also significantly reduced the requirement for 100% oxygen, improved respiratory parameters, and resulted in a similar hemodynamic recovery. CC+SI during CPR significantly improved ROSC in a porcine model of neonatal resuscitation. This is of considerable clinical relevance because improved respiratory and hemodynamic parameters potentially minimize morbidity and mortality in newborn infants. © 2017 S. Karger AG, Basel.

  11. Cosmic Reason of Great Glaciation

    Science.gov (United States)

    Bagrov, Alexander; Murtazov, Andrey

    The origin of long-time and global glaciations in the past of our planet, which have been named «great», is still not clear. Both the advance of glaciers and their subsequent melting must be connected with some energy consuming processes. There is a powerful energy source permanently functioning throughout the Earth’s history - the solar radiation. The equality of the incoming shortwave solar energy and the transformed long-wave energy emitted by the Earth provides for the whole ecosphere’s sustainable evolution. Great glaciations might be caused by space body falls into the world oceans. If the body is large enough, it can stir waters down to the bottom. The world waters are part of the global heat transfer from the planet’s equator to its poles (nowadays, mostly to the North Pole). The mixing of the bottom and surface waters breaks the circulation of flows and they stop. The termination of heat transfer to the poles will result in an icecap at high latitudes which in its turn will decrease the total solar heat inflow to the planet and shift the pole ice boarder to the equator. This positive feedback may last long and result in long-time glaciations. The oceanic currents will remain only near the equator. The factor obstructing the global cooling is the greenhouse effect. Volcanic eruptions supply a lot of carbon dioxide into the atmosphere. When due to the increased albedo the planet receives less solar heat, plants bind less carbon oxide into biomass and more of it retains in the atmosphere. Therefore, the outflow of heat from the planet decreases and glaciations does not involve the whole planet. The balance established between the heat inflow and heat losses is unstable. Any imbalance acts as a positive feed-back factor. If the volcanic activity grows, the inflow of the carbon dioxide into the atmosphere will cause its heating-up (plants will fail to reproduce themselves quickly enough to utilize the carbonic acid). The temperature growth will lead to

  12. Improvement in blood pressure after short-term inorganic nitrate supplementation is attenuated in cigarette smokers compared to non-smoking controls.

    Science.gov (United States)

    Bailey, Stephen J; Blackwell, Jamie R; Wylie, Lee J; Holland, Terezia; Winyard, Paul G; Jones, Andrew M

    2016-12-30

    Dietary supplementation with inorganic nitrate (NO 3 - ) has been reported to improve cardiovascular health indices in healthy adults. Cigarette smoking increases circulating thiocyanate (SCN - ), which has been suggested to competitively inhibit salivary nitrate (NO 3 - ) uptake, a rate-limiting step in dietary NO 3 - metabolism. Therefore, this study tested the hypothesis that dietary NO 3 - supplementation would be less effective at increasing the circulating plasma nitrite concentration ([NO 2 - ]) and lowering blood pressure in smokers (S) compared to non-smokers (NS). Nine healthy smokers and eight healthy non-smoking controls reported to the laboratory at baseline (CON) and following six day supplementation periods with 140 mL day -1 NO 3 - -rich (8.4 mmol NO 3 -  day -1 ; NIT) and NO 3 - -depleted (0.08 mmol NO 3 -  day -1 ; PLA) beetroot juice in a cross-over experiment. Plasma and salivary [SCN - ] were elevated in smokers compared to non-smokers in all experimental conditions (P smokers and non-smokers (P vs. NS: 7.5 ± 4.4 mM), plasma [NO 3 - ] (S: 484 ± 198 vs. NS: 802 ± 199 μM) and plasma [NO 2 - ] (S: 218 ± 128 vs. NS: 559 ± 419 nM) between the CON and NIT conditions was lower in the smokers compared to the non-smokers (P smokers and non-smokers (P > 0.05). Systolic blood pressure was lowered compared to PLA with NIT in non-smokers (P smokers (P > 0.05). These findings suggest that dietary NO 3 - metabolism is compromised in smokers leading to an attenuated blood pressure reduction compared to non-smokers after NO 3 - supplementation. These observations may provide novel insights into the cardiovascular risks associated with cigarette smoking and suggest that this population may be less likely to benefit from improved cardiovascular health if they increase dietary NO 3 - intake. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Great Lakes Regional Biomass Energy Program

    International Nuclear Information System (INIS)

    Kuzel, F.

    1993-01-01

    The Great Lakes Regional Biomass Energy Program (GLRBEP) was initiated September, 1983, with a grant from the Office of Energy Efficiency and Renewable Energy of the US Department of Energy (DOE). The program provides resources to public and private organizations in the Great Lakes region to increase the utilization and production of biomass fuels. The objectives of the GLRBEP are to: (1) improve the capabilities and effectiveness of biomass energy programs in the state energy offices; (2) assess the availability of biomass resources for energy in light of other competing needs and uses; (3) encourage private sector investments in biomass energy technologies; (4) transfer the results of government-sponsored biomass research and development to the private sector; (5) eliminate or reduce barriers to private sector use of biomass fuels and technology; (6) prevent or substantially mitigate adverse environmental impacts of biomass energy use. The Program Director is responsible for the day-to-day activities of the GLRBEP and for implementing program mandates. A 40 member Technical Advisory Committee (TAC) sets priorities and recommends projects. The governor of each state in the region appoints a member to the Steering Council, which acts on recommendations of the TAC and sets basic program guidelines. The GLRBEP is divided into three separate operational elements. The State Grants component provides funds and direction to the seven state energy offices in the region to increase their capabilities in biomass energy. State-specific activities and interagency programs are emphasized. The Subcontractor component involves the issuance of solicitations to undertake projects that address regional needs, identified by the Technical Advisory Committee. The Technology Transfer component includes the development of nontechnical biomass energy publications and reports by Council staff and contractors, and the dissemination of information at conferences, workshops and other events

  14. Predicting Great Lakes fish yields: tools and constraints

    Science.gov (United States)

    Lewis, C.A.; Schupp, D.H.; Taylor, W.W.; Collins, J.J.; Hatch, Richard W.

    1987-01-01

    Prediction of yield is a critical component of fisheries management. The development of sound yield prediction methodology and the application of the results of yield prediction are central to the evolution of strategies to achieve stated goals for Great Lakes fisheries and to the measurement of progress toward those goals. Despite general availability of species yield models, yield prediction for many Great Lakes fisheries has been poor due to the instability of the fish communities and the inadequacy of available data. A host of biological, institutional, and societal factors constrain both the development of sound predictions and their application to management. Improved predictive capability requires increased stability of Great Lakes fisheries through rehabilitation of well-integrated communities, improvement of data collection, data standardization and information-sharing mechanisms, and further development of the methodology for yield prediction. Most important is the creation of a better-informed public that will in turn establish the political will to do what is required.

  15. Protein supplements after weight loss do not improve weight maintenance compared with recommended dietary protein intake despite beneficial effects on appetite sensation and energy expenditure

    DEFF Research Database (Denmark)

    Kjølbæk, Louise; Sørensen, Lone Brinkmann; Søndertoft, Nadja Buus

    2017-01-01

    Background: High-protein diets increase weight loss (WL) during energy restriction; therefore, it has been suggested that additional protein intake may improve weight maintenance (WM) after WL.Objective: We investigated the effect of protein supplements from either whey with or without calcium...... were performed to investigate diet-induced-thermogenesis (DIT) and appetite sensation. Compliance was tested by 24-h urinary nitrogen excretion.Results: A total of 151 participants completed the WM period. The control and 3 protein supplements did not result in different mean ± SD weight regains (whey.......58 ± 1.4 kg; and control: 1.74 ± 1.4 kg; P = 0.50) during WM. Changes in blood pressure and blood biochemistry were not different between groups. Compared with the control, protein supplementation resulted in higher DIT (∼30 kJ/2.5 h) and resting energy expenditure (243 kJ/d) and an anorexigenic appetite...

  16. Parametric Simulations of the Great Dark Spots of Neptune

    Science.gov (United States)

    Deng, Xiaolong; Le Beau, R.

    2006-09-01

    Observations by Voyager II and the Hubble Space Telescope of the Great Dark Spots (GDS) of Neptune suggest that large vortices with lifespans of years are not uncommon occurrences in the atmosphere of Neptune. The variability of these features over time, in particular the complex motions of GDS-89, make them challenging candidates to simulate in atmospheric models. Previously, using the Explicit Planetary Isentropic-Coordinate (EPIC) General Circulation Model, LeBeau and Dowling (1998) simulated the GDS-like vortex features. Qualitatively, the drift, oscillation, and tail-like features of GDS-89 were recreated, although precise numerical matches were only achieved for the meridional drift rate. In 2001, Stratman et al. applied EPIC to simulate the formation of bright companion clouds to the Great Dark Spots. In 2006, Dowling et al. presented a new version of EPIC, which includes hybrid vertical coordinate, cloud physics, advanced chemistry, and new turbulence models. With the new version of EPIC, more observation results, and more powerful computers, it is the time to revisit CFD simulations of the Neptune's atmosphere and do more detailed work on GDS-like vortices. In this presentation, we apply the new version of EPIC to simulate GDS-89. We test the influences of different parameters in the EPIC model: potential vorticity gradient, wind profile, initial latitude, vortex shape, and vertical structure. The observed motions, especially the latitudinal drift and oscillations in orientation angle and aspect ratio, are used as diagnostics of these unobserved atmospheric conditions. Increased computing power allows for more refined and longer simulations and greater coverage of the parameter space than previous efforts. Improved quantitative results have been achieved, including voritices with near eight-day oscillations and comparable variations in shape to GDS-89. This research has been supported by Kentucky NASA EPSCoR.

  17. Central nervous system tumours among adolescents and young adults (15-39 years) in Southern and Eastern Europe: Registration improvements reveal higher incidence rates compared to the US.

    Science.gov (United States)

    Georgakis, Marios K; Panagopoulou, Paraskevi; Papathoma, Paraskevi; Tragiannidis, Athanasios; Ryzhov, Anton; Zivkovic-Perisic, Snezana; Eser, Sultan; Taraszkiewicz, Łukasz; Sekerija, Mario; Žagar, Tina; Antunes, Luis; Zborovskaya, Anna; Bastos, Joana; Florea, Margareta; Coza, Daniela; Demetriou, Anna; Agius, Domenic; Strahinja, Rajko M; Sfakianos, Georgios; Nikas, Ioannis; Kosmidis, Sofia; Razis, Evangelia; Pourtsidis, Apostolos; Kantzanou, Maria; Dessypris, Nick; Petridou, Eleni Th

    2017-11-01

    To present incidence of central nervous system (CNS) tumours among adolescents and young adults (AYAs; 15-39 years) derived from registries of Southern and Eastern Europe (SEE) in comparison to the Surveillance, Epidemiology and End Results (SEER), US and explore changes due to etiological parameters or registration improvement via evaluating time trends. Diagnoses of 11,438 incident malignant CNS tumours in AYAs (1990-2014) were retrieved from 14 collaborating SEE cancer registries and 13,573 from the publicly available SEER database (1990-2012). Age-adjusted incidence rates (AIRs) were calculated; Poisson and joinpoint regression analyses were performed for temporal trends. The overall AIR of malignant CNS tumours among AYAs was higher in SEE (28.1/million) compared to SEER (24.7/million). Astrocytomas comprised almost half of the cases in both regions, albeit the higher proportion of unspecified cases in SEE registries (30% versus 2.5% in SEER). Similar were the age and gender distributions across SEE and SEER with a male-to-female ratio of 1.3 and an overall increase of incidence by age. Increasing temporal trends in incidence were documented in four SEE registries (Greater Poland, Portugal North, Turkey-Izmir and Ukraine) versus an annual decrease in Croatia (-2.5%) and a rather stable rate in SEER (-0.3%). This first report on descriptive epidemiology of AYAs malignant CNS tumours in the SEE area shows higher incidence rates as compared to the United States of America and variable temporal trends that may be linked to registration improvements. Hence, it emphasises the need for optimisation of cancer registration processes, as to enable the in-depth evaluation of the observed patterns by disease subtype. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Paliperidone palmitate once-monthly maintains improvement in functioning domains of the Personal and Social Performance scale compared with placebo in subjects with schizoaffective disorder.

    Science.gov (United States)

    Fu, Dong-Jing; Turkoz, Ibrahim; Walling, David; Lindenmayer, Jean-Pierre; Schooler, Nina R; Alphs, Larry

    2018-02-01

    Evaluate the effect of paliperidone palmitate once-monthly (PP1M) injectable on the specific functioning domains of the Personal and Social Performance (PSP) scale in patients with schizoaffective disorder (SCA) participating in a long-term study. This study (NCT01193153) included both in- and outpatient subjects with SCA experiencing an acute exacerbation of psychotic and mood symptoms. Subjects were treated with PP1M either as monotherapy or in combination with antidepressants or mood stabilizers during a 25-week open-label (OL) phase. Stabilized subjects were randomly assigned 1:1 (PP1M or placebo) into a 15-month double-blind (DB) relapse-prevention period. Functioning of the randomized subjects during OL and DB phases was evaluated using the PSP scale (four domains: socially useful activities, personal/social relationships, self-care, and disturbing/aggressive behaviors). Three statistical approaches were utilized to analyze PSP scores to assess robustness and consistency of findings. No adjustments were made for multiplicity. 334 of 667 enrolled subjects were stabilized with PP1M, randomly assigned to PP1M (n=164) or placebo (n=170) in the DB phase, and included in this analysis. Improvements in all PSP domain scores were observed during the OL phase and were maintained during the DB phase with PP1M, but decreased with placebo. Differences compared to placebo were significant in all four PSP domains during the DB phase (P≤0.008). The analysis in this study showed that PP1M improves functioning, as measured by the four PSP domain scores, in symptomatic subjects with SCA. Functioning was maintained compared with placebo. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  19. Comparative effectiveness of audit-feedback versus additional physician communication training to improve cancer screening for patients with limited health literacy.

    Science.gov (United States)

    Price-Haywood, Eboni G; Harden-Barrios, Jewel; Cooper, Lisa A

    2014-08-01

    We designed a continuing medical education (CME) program to teach primary care physicians (PCP) how to engage in cancer risk communication and shared decision making with patients who have limited health literacy (HL). We evaluated whether training PCPs, in addition to audit-feedback, improves their communication behaviors and increases cancer screening among patients with limited HL to a greater extent than only providing clinical performance feedback. Four-year cluster randomized controlled trial. Eighteen PCPs and 168 patients with limited HL who were overdue for colorectal/breast/cervical cancer screening. Communication intervention PCPs received skills training that included standardized patient (SP) feedback on counseling behaviors. All PCPs underwent chart audits of patients' screening status semiannually up to 24 months and received two annual performance feedback reports. PCPs experienced three unannounced SP encounters during which SPs rated PCP communication behaviors. We examined between-group differences in changes in SP ratings and patient knowledge of cancer screening guidelines over 12 months; and changes in patient cancer screening rates over 24 months. There were no group differences in SP ratings of physician communication at baseline. At follow-up, communication intervention PCPs were rated higher in general communication about cancer risks and shared decision making related to colorectal cancer screening compared to PCPs who only received performance feedback. Screening rates increased among patients of PCPs in both groups; however, there were no between-group differences in screening rates except for mammography. The communication intervention did not improve patient cancer screening knowledge. Compared to audit and feedback alone, including PCP communication training increases PCP patient-centered counseling behaviors, but not cancer screening among patients with limited HL. Larger studies must be conducted to determine whether lack of

  20. Dreissenid mussels from the Great Lakes contain elevated thiaminase activity

    Science.gov (United States)

    Tillitt, D.E.; Riley, S.C.; Evans, A.N.; Nichols, S.J.; Zajicek, J.L.; Rinchard, J.; Richter, C.A.; Krueger, C.C.

    2009-01-01

    We examined thiaminase activity in dreissenid mussels collected at different depths and seasons, and from various locations in Lakes Michigan, Ontario, and Huron. Here we present evidence that two dreissenid mussel species (Dreissena bugensis and D. polymorpha) contain thiaminase activity that is 5-100 fold greater than observed in Great Lakes fishes. Thiaminase activity in zebra mussels ranged from 10,600 to 47,900??pmol g- 1??min- 1 and activities in quagga mussels ranged from 19,500 to 223,800??pmol g- 1??min- 1. Activity in the mussels was greatest in spring, less in summer, and least in fall. Additionally, we observed greater thiaminase activity in dreissenid mussels collected at shallow depths compared to mussels collected at deeper depths. Dreissenids constitute a significant and previously unknown pool of thiaminase in the Great Lakes food web compared to other known sources of this thiamine (vitamin B1)-degrading enzyme. Thiaminase in forage fish of the Great Lakes has been causally linked to thiamine deficiency in salmonines. We currently do not know whether linkages exist between thiaminase activities observed in dreissenids and the thiaminase activities in higher trophic levels of the Great Lakes food web. However, the extreme thiaminase activities observed in dreissenids from the Great Lakes may represent a serious unanticipated negative effect of these exotic species on Great Lakes ecosystems.

  1. Aural stimulation with capsaicin ointment improved swallowing function in elderly patients with dysphagia: a randomized, placebo-controlled, double-blind, comparative study.

    Science.gov (United States)

    Kondo, Eiji; Jinnouchi, Osamu; Nakano, Seiichi; Ohnishi, Hiroki; Kawata, Ikuji; Okamoto, Hidehiko; Takeda, Noriaki

    2017-01-01

    The aim of this study was to assess whether aural stimulation with ointment containing capsaicin improves swallowing function in elderly patients with dysphagia. A randomized, placebo-controlled, double-blind, comparative study. Secondary hospital. Twenty elderly dysphagic patients with a history of cerebrovascular disorder or Parkinson's disease were randomly divided into two groups: 10 receiving aural stimulation with 0.025% capsaicin ointment and 10 stimulated with placebo. The ointments were applied to the external auditory canal with a cotton swab. Then, swallowing of a bolus of blue-dyed water was recorded using transnasal videoendoscopy, and the swallowing function was evaluated according to both endoscopic swallowing scoring and Sensory-Motor-Reflex-Clearance (SMRC) scale. The sum of endoscopic swallowing scores was significantly decreased 30 and 60 min after a single administration in patients treated with capsaicin, but not with placebo. Reflex score, but not Sensory, Motion and Clearance scores, of the SMRC scale was significantly increased 5, 30 and 60 min after single administration in patients treated with capsaicin, but not with placebo. No patient showed signs of adverse effects. As capsaicin is an agonist of the transient receptor potential vanilloid 1 (TRPV1), these findings suggest that improvement of the swallowing function, especially glottal closure and cough reflexes, in elderly dysphagic patients was due to TRPV1-mediated aural stimulation of vagal Arnold's nerve with capsaicin, but not with a nonspecific mechanical stimulation with a cotton swab.

  2. Lowering Interleukin-12 Activity Improves Myocardial and Vascular Function Compared With Tumor Necrosis Factor-a Antagonism or Cyclosporine in Psoriasis.

    Science.gov (United States)

    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.

  3. The effectiveness of virtual reality interventions in improving balance in adults with impaired balance compared with standard or no treatment: a systematic review and meta-analysis.

    Science.gov (United States)

    Booth, Vicky; Masud, Tahir; Connell, Louise; Bath-Hextall, Fiona

    2014-05-01

    To evaluate whether virtual reality interventions, including interactive gaming systems, are effective at improving balance in adults with impaired balance. Systematic review and meta-analysis of randomized control trials. Studies were identified from electronic databases (CENTRAL, MEDLINE, EMBASE, AMED, CINAHL, PyschINFO, PyschBITE, OTseeker, Ei Compendex, and Inspec) searched to November 2011, and repeated in November 2012. Two reviewers selected studies meeting inclusion criteria and quality of included studies assessed using a Joanna Briggs Institute appraisal tool. Data was pooled and a meta-analysis completed. The systematic review was reported following guidance of the PRISMA statement. A total of 251 articles were screened. Eight randomized control trials were included. These studies presented the results of 239 participants, with various aetiologies, and used a variety of virtual reality systems. The number of falls was documented in only one included study. Meta-analysis was completed on data from the Berg Balance Scale, walking speed, 30 second sit-to-stand test, and Timed Up and Go Test, and favoured standard therapy when compared with standard plus virtual reality interventions. There was a notable inconsistency in the outcome measures, experimental, and control interventions used within the included studies. The pooled results of the studies showed no significant difference. Therefore this review cannot support nor refute the use of virtual reality interventions, rather than conventional physiotherapy, to improve balance in adults with impaired balance.

  4. Does Combination Therapy with Tamsulosin and Tolterodine Improve Ureteral Stent Discomfort Compared with Tamsulosin Alone? A Double-Blind, Randomized, Controlled Trial.

    Science.gov (United States)

    Sivalingam, Sri; Streeper, Necole M; Sehgal, Priyanka D; Sninsky, Brian C; Best, Sara L; Nakada, Stephen Y

    2016-02-01

    Ureteral stent discomfort is a significant postoperative problem for many patients. Despite the use of narcotics and α-blockers patients often experience bothersome lower urinary tract symptoms and pain, which impair daily activities. We compared combination therapy with an α-blocker and an anticholinergic to monotherapy with an α-blocker. A double-blind, randomized, controlled trial was performed from December 2012 to April 2014. A total of 80 patients were randomized, including 44 to the combination group (tamsulosin 0.4 mg and tolterodine early release 4 mg) and 36 to the monotherapy group (tamsulosin 0.4 mg and placebo). Patients with preexisting ureteral stent placement or current anticholinergic therapy were excluded from study. Patients completed USSQ (Urinary Stent Symptom Questionnaire) before stent placement on the day of surgery, the day after stent placement, the morning of stent removal and the day after stent removal. The questionnaire included questions regarding urinary symptoms, general health, body pain, and work and sexual history. A total of 80 patients (40 males and 40 females) were studied. Mean age was 51.5 vs 51.3 years (p = 0.95) and mean body mass index was 33.6 vs 31.9 kg/m(2) (p = 0.44) in monotherapy group 1 vs combination therapy group 2. Between the 2 groups there was no significant difference in urinary symptoms, body pain and activities of daily living from baseline to just before stent removal (p = 0.95, 0.40 and 0.95, respectively). Although there was no difference between the groups, both showed improvement in urinary symptoms from the time of initial stent insertion to just prior to stent removal (difference -0.50 for combination therapy and -0.40 for monotherapy). The mean stent indwelling time of 9.6 and 8.7 days in the combination and monotherapy groups, respectively, did not differ (p = 0.67). On ANOVA it had no significant impact on results (p = 0.64). Combination therapy with tamsulosin and tolterodine does not

  5. An Optimization Study on Listening Experiments to Improve the Comparability of Annoyance Ratings of Noise Samples from Different Experimental Sample Sets.

    Science.gov (United States)

    Di, Guoqing; Lu, Kuanguang; Shi, Xiaofan

    2018-03-08

    Annoyance ratings obtained from listening experiments are widely used in studies on health effect of environmental noise. In listening experiments, participants usually give the annoyance rating of each noise sample according to its relative annoyance degree among all samples in the experimental sample set if there are no reference sound samples, which leads to poor comparability between experimental results obtained from different experimental sample sets. To solve this problem, this study proposed to add several pink noise samples with certain loudness levels into experimental sample sets as reference sound samples. On this basis, the standard curve between logarithmic mean annoyance and loudness level of pink noise was used to calibrate the experimental results and the calibration procedures were described in detail. Furthermore, as a case study, six different types of noise sample sets were selected to conduct listening experiments using this method to examine the applicability of it. Results showed that the differences in the annoyance ratings of each identical noise sample from different experimental sample sets were markedly decreased after calibration. The determination coefficient ( R ²) of linear fitting functions between psychoacoustic annoyance (PA) and mean annoyance (MA) of noise samples from different experimental sample sets increased obviously after calibration. The case study indicated that the method above is applicable to calibrating annoyance ratings obtained from different types of noise sample sets. After calibration, the comparability of annoyance ratings of noise samples from different experimental sample sets can be distinctly improved.

  6. Physiologically-based, predictive analytics using the heart-rate-to-Systolic-Ratio significantly improves the timeliness and accuracy of sepsis prediction compared to SIRS.

    Science.gov (United States)

    Danner, Omar K; Hendren, Sandra; Santiago, Ethel; Nye, Brittany; Abraham, Prasad

    2017-04-01

    Enhancing the efficiency of diagnosis and treatment of severe sepsis by using physiologically-based, predictive analytical strategies has not been fully explored. We hypothesize assessment of heart-rate-to-systolic-ratio significantly increases the timeliness and accuracy of sepsis prediction after emergency department (ED) presentation. We evaluated the records of 53,313 ED patients from a large, urban teaching hospital between January and June 2015. The HR-to-systolic ratio was compared to SIRS criteria for sepsis prediction. There were 884 patients with discharge diagnoses of sepsis, severe sepsis, and/or septic shock. Variations in three presenting variables, heart rate, systolic BP and temperature were determined to be primary early predictors of sepsis with a 74% (654/884) accuracy compared to 34% (304/884) using SIRS criteria (p < 0.0001)in confirmed septic patients. Physiologically-based predictive analytics improved the accuracy and expediency of sepsis identification via detection of variations in HR-to-systolic ratio. This approach may lead to earlier sepsis workup and life-saving interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Underwater hearing in the great cormorant (Phalacrocorax carbo sinensis)

    DEFF Research Database (Denmark)

    Hansen, Kirstin Anderson; Larsen, Ole Næsbye; Wahlberg, Magnus

    2016-01-01

    The underwater hearing threshold of a great cormorant (Phalacrocroax carbo sinensis) was measured at 2 kHz using psychophysical methods. Previous in-air and underwater testing suggests that cormorants have rather poor in-air hearing compared to other birds of similar size (Johansen, 2016). Prelim......The underwater hearing threshold of a great cormorant (Phalacrocroax carbo sinensis) was measured at 2 kHz using psychophysical methods. Previous in-air and underwater testing suggests that cormorants have rather poor in-air hearing compared to other birds of similar size (Johansen, 2016...

  8. Potential for Improved Intelligence Quotient Using Volumetric Modulated Arc Therapy Compared With Conventional 3-Dimensional Conformal Radiation for Whole-Ventricular Radiation in Children

    International Nuclear Information System (INIS)

    Qi, X. Sharon; Stinauer, Michelle; Rogers, Brion; Madden, Jennifer R.; Wilkening, Greta N.; Liu, Arthur K.

    2012-01-01

    Purpose: To compare volumetric modulated arc therapy (VMAT) with 3-dimensional conformal radiation therapy (3D-CRT) in the treatment of localized intracranial germinoma. We modeled the effect of the dosimetric differences on intelligence quotient (IQ). Method and Materials: Ten children with intracranial germinomas were used for planning. The prescription doses were 23.4 Gy to the ventricles followed by 21.6 Gy to the tumor located in the pineal region. For each child, a 3D-CRT and full arc VMAT was generated. Coverage of the target was assessed by computing a conformity index and heterogeneity index. We also generated VMAT plans with explicit temporal lobe sparing and with smaller ventricular margin expansions. Mean dose to the temporal lobe was used to estimate IQ 5 years after completion of radiation, using a patient age of 10 years. Results: Compared with the 3D-CRT plan, VMAT improved conformality (conformity index 1.10 vs 1.85), with slightly higher heterogeneity (heterogeneity index 1.09 vs 1.06). The averaged mean doses for left and right temporal lobes were 31.3 and 31.7 Gy, respectively, for VMAT plans and 37.7 and 37.6 Gy for 3D-CRT plans. This difference in mean temporal lobe dose resulted in an estimated IQ difference of 3.1 points at 5 years after radiation therapy. When the temporal lobes were explicitly included in the VMAT optimization, the mean temporal lobe dose was reduced 5.6-5.7 Gy, resulting in an estimated IQ difference of an additional 3 points. Reducing the ventricular margin from 1.5 cm to 0.5 cm decreased mean temporal lobe dose 11.4-13.1 Gy, corresponding to an estimated increase in IQ of 7 points. Conclusion: For treatment of children with intracranial pure germinomas, VMAT compared with 3D-CRT provides increased conformality and reduces doses to normal tissue. This may result in improvements in IQ in these children.

  9. Brachytherapy Improves Biochemical Failure–Free Survival in Low- and Intermediate-Risk Prostate Cancer Compared With Conventionally Fractionated External Beam Radiation Therapy: A Propensity Score Matched Analysis

    International Nuclear Information System (INIS)

    Smith, Graham D.; Pickles, Tom; Crook, Juanita; Martin, Andre-Guy; Vigneault, Eric; Cury, Fabio L.; Morris, Jim; Catton, Charles; Lukka, Himu; Warner, Andrew; Yang, Ying; Rodrigues, George

    2015-01-01

    Purpose: To compare, in a retrospective study, biochemical failure-free survival (bFFS) and overall survival (OS) in low-risk and intermediate-risk prostate cancer patients who received brachytherapy (BT) (either low-dose-rate brachytherapy [LDR-BT] or high-dose-rate brachytherapy with external beam radiation therapy [HDR-BT+EBRT]) versus external beam radiation therapy (EBRT) alone. Methods and Materials: Patient data were obtained from the ProCaRS database, which contains 7974 prostate cancer patients treated with primary radiation therapy at four Canadian cancer institutions from 1994 to 2010. Propensity score matching was used to obtain the following 3 matched cohorts with balanced baseline prognostic factors: (1) low-risk LDR-BT versus EBRT; (2) intermediate-risk LDR-BT versus EBRT; and (3) intermediate-risk HDR-BT+EBRT versus EBRT. Kaplan-Meier survival analysis was performed to compare differences in bFFS (primary endpoint) and OS in the 3 matched groups. Results: Propensity score matching created acceptable balance in the baseline prognostic factors in all matches. Final matches included 2 1:1 matches in the intermediate-risk cohorts, LDR-BT versus EBRT (total n=254) and HDR-BT+EBRT versus EBRT (total n=388), and one 4:1 match in the low-risk cohort (LDR-BT:EBRT, total n=400). Median follow-up ranged from 2.7 to 7.3 years for the 3 matched cohorts. Kaplan-Meier survival analysis showed that all BT treatment options were associated with statistically significant improvements in bFFS when compared with EBRT in all cohorts (intermediate-risk EBRT vs LDR-BT hazard ratio [HR] 4.58, P=.001; intermediate-risk EBRT vs HDR-BT+EBRT HR 2.08, P=.007; low-risk EBRT vs LDR-BT HR 2.90, P=.004). No significant difference in OS was found in all comparisons (intermediate-risk EBRT vs LDR-BT HR 1.27, P=.687; intermediate-risk EBRT vs HDR-BT+EBRT HR 1.55, P=.470; low-risk LDR-BT vs EBRT HR 1.41, P=.500). Conclusions: Propensity score matched analysis showed that BT options led

  10. The QICKD study protocol: a cluster randomised trial to compare quality improvement interventions to lower systolic BP in chronic kidney disease (CKD in primary care

    Directory of Open Access Journals (Sweden)

    du Bois Elizabeth

    2009-07-01

    Full Text Available Abstract Background Chronic kidney disease (CKD is a relatively newly recognised but common long-term condition affecting 5 to 10% of the population. Effective management of CKD, with emphasis on strict blood pressure (BP control, reduces cardiovascular risk and slows the progression of CKD. There is currently an unprecedented rise in referral to specialist renal services, which are often located in tertiary centres, inconvenient for patients, and wasteful of resources. National and international CKD guidelines include quality targets for primary care. However, there have been no rigorous evaluations of strategies to implement these guidelines. This study aims to test whether quality improvement interventions improve primary care management of elevated BP in CKD, reduce cardiovascular risk, and slow renal disease progression Design Cluster randomised controlled trial (CRT Methods This three-armed CRT compares two well-established quality improvement interventions with usual practice. The two interventions comprise: provision of clinical practice guidelines with prompts and audit-based education. The study population will be all individuals with CKD from general practices in eight localities across England. Randomisation will take place at the level of the general practices. The intended sample (three arms of 25 practices powers the study to detect a 3 mmHg difference in systolic BP between the different quality improvement interventions. An additional 10 practices per arm will receive a questionnaire to measure any change in confidence in managing CKD. Follow up will take place over two years. Outcomes will be measured using anonymised routinely collected data extracted from practice computer systems. Our primary outcome measure will be reduction of systolic BP in people with CKD and hypertension at two years. Secondary outcomes will include biomedical outcomes and markers of quality, including practitioner confidence in managing CKD. A small

  11. Book review: Diane Ravitch "The death and life of the great American school system". New York: Basic Books , 2010

    Directory of Open Access Journals (Sweden)

    Beals K.

    2015-09-01

    Full Text Available The current paper is a translation of Katharine Beals' review of the book "The death and life of the great American school system" by Diane Ravich. The article analyses the views on the causes of the inefficiency of the American school system expressed by Ravich, as well as the ways of its improvement suggested by her. A change of stance compared to her previous works is also noted. Translator: Vinogradova K.N.

  12. 'Great Power Style' in China's Economic Policy

    DEFF Research Database (Denmark)

    Jiang, Yang

    2011-01-01

    China’s ascendance attracts concern, even though Beijing claims to be a responsible great power and tries to demonstrate its ‘great power style’ in economic diplomacy. This article therefore discusses the following questions: to what extent does the current notion and practice of Chinese ‘great...... power style’ in economic diplomacy comply with, or differ from, the criteria of benign hegemony; and what are the major constraining factors? Conceptually, China’s ‘great power style’ is rooted in ancient Chinese political philosophy and institution, but it highly resembles the Western notion of benign...

  13. Can a Drill Guide Improve the Coracoid Graft Placement During the Latarjet Procedure? A Prospective Comparative Study With the Freehand Technique.

    Science.gov (United States)

    Barth, Johannes; Boutsiadis, Achilleas; Neyton, Lionel; Lafosse, Laurent; Walch, Gilles

    2017-10-01

    One of the factors that can affect the success of the Latarjet procedure is accurate coracoid graft (CG) placement. The use of a guide can improve placement of the CG and screw positioning in the sagittal and axial planes as compared with the classic open ("freehand") technique. Cohort study; Level of evidence, 2. A total of 49 patients who underwent a Latarjet procedure for the treatment of recurrent anterior shoulder instability were prospectively included; the procedure was performed with the freehand technique in 22 patients (group 1) and with use of a parallel drill guide during screw placement in 27 patients (group 2). All patients underwent a postoperative computed tomography scan with the same established protocol. The scans were used to evaluate and compare the position of the CG in the sagittal and axial planes, the direction of the screws (α angle), and overall contact of the graft with the anterior surface of the glenoid after the 2 surgical techniques. The CG was placed >60% below the native glenoid equator in 23 patients (85.2%) in group 2, compared with 14 patients (63.6%) in group 1 ( P = .004). In the axial plane, the position of the CG in group 2 patients was more accurate (85.2% and 88.9% flush) at the inferior and middle quartiles of the glenoid surface ( P = .012 and .009), respectively. Moreover, with the freehand technique (group 1), the graft was in a more lateral position in the inferior and middle quartiles ( P = .012 and .009, respectively). No differences were found between groups 1 and 2 regarding the mean α angle of the superior (9° ± 4.14° vs 11° ± 6.3°, P = .232) and inferior (9.5° ± 6° vs 10° ± 7.5°, P = .629) screws. However, the mean contact angle (angle between the posterior coracoid and the anterior glenoid surface) with the freehand technique (3.8° ± 6.8°) was better than that of the guide (8.55° ± 8°) ( P = .05). Compared with the classic freehand operative technique, the parallel drill guide can ensure

  14. Children with speech sound disorder: Comparing a non-linguistic auditory approach with a phonological intervention approach to improve phonological skills

    Directory of Open Access Journals (Sweden)

    Cristina eMurphy

    2015-02-01

    Full Text Available This study aimed to compare the effects of a non-linguistic auditory intervention approach with a phonological intervention approach on the phonological skills of children with speech sound disorder. A total of 17 children, aged 7-12 years, with speech sound disorder were randomly allocated to either the non-linguistic auditory temporal intervention group (n = 10, average age 7.7 ± 1.2 or phonological intervention group (n = 7, average age 8.6 ± 1.2. The intervention outcomes included auditory-sensory measures (auditory temporal processing skills and cognitive measures (attention, short-term memory, speech production and phonological awareness skills. The auditory approach focused on non-linguistic auditory training (eg. backward masking and frequency discrimination, whereas the phonological approach focused on speech sound training (eg. phonological organisation and awareness. Both interventions consisted of twelve 45-minute sessions delivered twice per week, for a total of nine hours. Intra-group analysis demonstrated that the auditory intervention group showed significant gains in both auditory and cognitive measures, whereas no significant gain was observed in the phonological intervention group. No significant improvement on phonological skills was observed in any of the groups. Inter-group analysis demonstrated significant differences between the improvement following training for both groups, with a more pronounced gain for the non-linguistic auditory temporal intervention in one of the visual attention measures and both auditory measures. Therefore, both analyses suggest that although the non-linguistic auditory intervention approach appeared to be the most effective intervention approach, it was not sufficient to promote the enhancement of phonological skills.

  15. Reduced intensity haplo plus single cord transplant compared to double cord transplant: improved engraftment and graft-versus-host disease-free, relapse-free survival

    Science.gov (United States)

    van Besien, Koen; Hari, Parameswaran; Zhang, Mei-Jie; Liu, Hong-Tao; Stock, Wendy; Godley, Lucy; Odenike, Olatoyosi; Larson, Richard; Bishop, Michael; Wickrema, Amittha; Gergis, Usama; Mayer, Sebastian; Shore, Tsiporah; Tsai, Stephanie; Rhodes, Joanna; Cushing, Melissa M.; Korman, Sandra; Artz, Andrew

    2016-01-01

    Umbilical cord blood stem cell transplants are commonly used in adults lacking HLA-identical donors. Delays in hematopoietic recovery contribute to mortality and morbidity. To hasten recovery, we used co-infusion of progenitor cells from a partially matched related donor and from an umbilical cord blood graft (haplo-cord transplant). Here we compared the outcomes of haplo-cord and double-cord transplants. A total of 97 adults underwent reduced intensity conditioning followed by haplo-cord transplant and 193 patients received reduced intensity conditioning followed by double umbilical cord blood transplantation. Patients in the haplo-cord group were more often from minority groups and had more advanced malignancy. Haplo-cord recipients received fludarabine-melphalan-anti-thymocyte globulin. Double umbilical cord blood recipients received fludarabine-cyclophosphamide and low-dose total body irradiation. In a multivariate analysis, haplo-cord had faster neutrophil (HR=1.42, P=0.007) and platelet (HR=2.54, Pdisease (HR=0.26, Pdisease (HR=0.06, Pdisease-free, relapse-free survival was superior with haplo-cord (HR 0.63, P=0.002) but not overall survival (HR=0.97, P=0.85). Haplo-cord transplantation using fludarabine-melphalan-thymoglobulin conditioning hastens hematopoietic recovery with a lower risk of relapse relative to double umbilical cord blood transplantation using the commonly used fludarabine-cyclophosphamide-low-dose total body irradiation conditioning. Graft-versus-host disease-free and relapse-free survival is significantly improved. Haplo-cord is a readily available graft source that improves outcomes and access to transplant for those lacking HLA-matched donors. Trials registered at clinicaltrials.gov identifiers 00943800 and 01810588. PMID:26869630

  16. A randomized, clinical trial of education or motivational-interviewing-based coaching compared to usual care to improve cancer pain management.

    Science.gov (United States)

    Thomas, Mary Laudon; Elliott, Janette E; Rao, Stephen M; Fahey, Kathleen F; Paul, Steven M; Miaskowski, Christine

    2012-01-01

    To test the effectiveness of two interventions compared to usual care in decreasing attitudinal barriers to cancer pain management, decreasing pain intensity, and improving functional status and quality of life (QOL). Randomized clinical trial. Six outpatient oncology clinics (three Veterans Affairs [VA] facilities, one county hospital, and one community-based practice in California, and one VA clinic in New Jersey)Sample: 318 adults with various types of cancer-related pain. Patients were randomly assigned to one of three groups: control, standardized education, or coaching. Patients in the education and coaching groups viewed a video and received a pamphlet on managing cancer pain. In addition, patients in the coaching group participated in four telephone sessions with an advanced practice nurse interventionist using motivational interviewing techniques to decrease attitudinal barriers to cancer pain management. Questionnaires were completed at baseline and six weeks after the final telephone calls. Analysis of covariance was used to evaluate for differences in study outcomes among the three groups. Pain intensity, pain relief, pain interference, attitudinal barriers, functional status, and QOL. Attitudinal barrier scores did not change over time among groups. Patients randomized to the coaching group reported significant improvement in their ratings of pain-related interference with function, as well as general health, vitality, and mental health. Although additional evaluation is needed, coaching may be a useful strategy to help patients decrease attitudinal barriers toward cancer pain management and to better manage their cancer pain. By using motivational interviewing techniques, advanced practice oncology nurses can help patients develop an appropriate plan of care to decrease pain and other symptoms.

  17. The David V Valve-Sparing Root Replacement Provides Improved Survival Compared With Mechanical Valve-conduits in the Treatment of Young Patients With Aortic Root Pathology.

    Science.gov (United States)

    Esaki, Jiro; Leshnower, Bradley G; Binongo, Jose N; Lasanajak, Yi; McPherson, LaRonica; Halkos, Michael E; Guyton, Robert A; Chen, Edward P

    2016-11-01

    Valve-sparing root replacement (VSRR) is an attractive therapy for aortic root aneurysms; however, there is a paucity of data comparing VSRR with conventional root replacement using a mechanical valve-conduit (MECH). This study evaluates and compares outcomes of VSRR and MECH. A retrospective review from 2002 to 2015 at a US academic center identified 444 patients who underwent VSRR (282 patients) or MECH (162 patients). Propensity score matching was performed, based on 22 preoperative and intraoperative characteristics, and 87 matched pairs were identified. There was no difference in mean age between the groups (VSRR 45.0 years, MECH 44.2 years, p = 0.59). The incidence of Marfan syndrome (VSRR 10.3%, MECH 12.6%, p = 0.63), type A acute aortic dissection (VSRR 25.3%, MECH 27.6%, p = 0.73), reoperation (VSRR 23.0%, MECH 21.8%, p = 0.86), and arch replacement (VSRR 54.0%, MECH 52.9%, p = 0.88) were similar in both groups. Ejection fraction was similar (VSRR 52.8% ± 10.9%, MECH 52.4% ± 11.7%, p = 0.83). Operative mortality was 2.3% with VSRR and 8.0% with MECH (p = 0.10). There were no significant differences in renal failure requiring dialysis (VSRR 1.1%, MECH 4.6%, p = 0.24), permanent neurologic dysfunction (VSRR 2.3%, MECH 6.9%, p = 0.16), and pacemaker implantation (VSRR 1.1%, MECH 1.1%, p = 0.99) between the groups. Survival at 7 years was significantly improved in patients who underwent VSSR (VSRR 85.5%, MECH 73.6%, p = 0.03). In comparison with patients undergoing MECH, there is improved midterm survival among patients undergoing VSRR, with similar operative mortality and morbidity. For appropriately selected patients, VSRR provides an attractive and potentially superior alternative to MECH. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  18. Does double-row rotator cuff repair improve functional outcome of patients compared with single-row technique? A systematic review.

    Science.gov (United States)

    DeHaan, Alexander M; Axelrad, Thomas W; Kaye, Elizabeth; Silvestri, Lorenzo; Puskas, Brian; Foster, Timothy E

    2012-05-01

    The advantage of single-row versus double-row arthroscopic rotator cuff repair techniques has been a controversial issue in sports medicine and shoulder surgery. There is biomechanical evidence that double-row techniques are superior to single-row techniques; however, there is no clinical evidence that the double-row technique provides an improved functional outcome. When compared with single-row rotator cuff repair, double-row fixation, although biomechanically superior, has no clinical benefit with respect to retear rate or improved functional outcome. Systematic review. The authors reviewed prospective studies of level I or II clinical evidence that compared the efficacy of single- and double-row rotator cuff repairs. Functional outcome scores included the American Shoulder and Elbow Surgeons (ASES) shoulder scale, the Constant shoulder score, and the University of California, Los Angeles (UCLA) shoulder rating scale. Radiographic failures and complications were also analyzed. A test of heterogeneity for patient demographics was also performed to determine if there were differences in the patient profiles across the included studies. Seven studies fulfilled our inclusion criteria. The test of heterogeneity across these studies showed no differences. The functional ASES, Constant, and UCLA outcome scores revealed no difference between single- and double-row rotator cuff repairs. The total retear rate, which included both complete and partial retears, was 43.1% for the single-row repair and 27.2% for the double-row repair (P = .057), representing a trend toward higher failures in the single-row group. Through a comprehensive literature search and meta-analysis of current arthroscopic rotator cuff repairs, we found that the single-row repairs did not differ from the double-row repairs in functional outcome scores. The double-row repairs revealed a trend toward a lower radiographic proven retear rate, although the data did not reach statistical significance. There

  19. A Randomized Controlled Trial to Compare e-Feedback Versus "Standard" Face-to-Face Verbal Feedback to Improve the Acquisition of Procedural Skill.

    Science.gov (United States)

    Al-Jundi, Wissam; Elsharif, Mohamed; Anderson, Melanie; Chan, Phillip; Beard, Jonathan; Nawaz, Shah

    Constructive feedback plays an important role in learning during surgical training. Standard feedback is usually given verbally following direct observation of the procedure by a trained assessor. However, such feedback requires the physical presence of expert faculty members who are usually busy and time-constrained by clinical commitments. We aim to evaluate electronic feedback (e-feedback) after video observation of surgical suturing in comparison with standard face-to-face verbal feedback. A prospective, blinded, randomized controlled trial comparing e-feedback with standard verbal feedback was carried out in February 2015 using a validated pro formas for assessment. The study participants were 38 undergraduate medical students from the University of Sheffield, UK. They were recorded on video performing the procedural skill, completed a self-evaluation form, and received e-feedback on the same day (group 1); observed directly by an assessor, invited to provide verbal self-reflection, and then received standard verbal feedback (group 2). In both groups, the feedback was provided after performing the procedure. The participants returned 2 days later and performed the same skill again. Poststudy questionnaire was used to assess the acceptability of each feedback among the participants. Overall, 19 students in group 1 and 18 students in group 2 completed the study. Although there was a significant improvement in the overall mean score on the second performance of the task for all participants (first performance mean 11.59, second performance mean 15.95; p ≤ 0.0001), there was no difference in the overall mean improvement score between group 1 and group 2 (4.74 and 3.94, respectively; p = 0.49). The mean overall scores for the e-feedback group at baseline recorded by 2 independent investigators showed good agreement (mean overall scores of 12.84 and 11.89; Cronbach α = 0.86). Poststudy questionnaire demonstrated that both e-feedback and standard verbal feedback

  20. Effects of Improving Primary Health Care Workers' Knowledge About Public Health Services in Rural China: A Comparative Study of Blended Learning and Pure E-Learning.

    Science.gov (United States)

    Zhan, Xingxin; Zhang, Zhixia; Sun, Fang; Liu, Qian; Peng, Weijun; Zhang, Heng; Yan, Weirong

    2017-05-01

    rural China, a blended-learning approach to BPHS training could result in a higher knowledge achievement and satisfaction level compared with a pure e-learning approach. The findings of the study will contribute knowledge to improve the competency of PHCWs in similar settings. ©Xingxin Zhan, Zhixia Zhang, Fang Sun, Qian Liu, Weijun Peng, Heng Zhang, Weirong Yan. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 01.05.2017.

  1. Effects of Improving Primary Health Care Workers’ Knowledge About Public Health Services in Rural China: A Comparative Study of Blended Learning and Pure E-Learning

    Science.gov (United States)

    Zhan, Xingxin; Zhang, Zhixia; Sun, Fang; Liu, Qian; Peng, Weijun; Zhang, Heng

    2017-01-01

    .63 (95% CI 1.08-2.48; P=.02). Conclusions Among PHCWs in rural China, a blended-learning approach to BPHS training could result in a higher knowledge achievement and satisfaction level compared with a pure e-learning approach. The findings of the study will contribute knowledge to improve the competency of PHCWs in similar settings. PMID:28461286

  2. Empirical study of peak-load pricing and investment policies for the domestic market of gas in Great Britain

    Energy Technology Data Exchange (ETDEWEB)

    Tzoannos, J

    1977-06-01

    This paper reports the main results of a study aimed at determining empirically an optimal structure of seasonal tariffs for the domestic sector of gas in Great Britain. The study first involves the development of a peak-load pricing model which maximizes social welfare. The model is then quantified with cost and demand functions which have been statistically estimated for Great Britian using data for town gas. The procedure of estimating these functions is based on an error components model. The seasonal pricing and investment policy resulting from the solution to the above model is then compared with the existing policy for the domestic sector of gas in Great Britain. It is shown that the former is superior to the latter in terms of improvements in social welfare and capacity utilization. 22 references.

  3. Health Improvements Have Been More Rapid and Widespread in China than in India: A Comparative Analysis of Health and Socioeconomic Trends from 1960 to 2011

    Directory of Open Access Journals (Sweden)

    Gopal K. Singh, PhD

    2012-11-01

    Full Text Available ObjectivesWe examined differences between China and India in key health and socioeconomic indicators, including life expectancy, infant and child mortality, non-communicable disease mortality from cancer, cardiovascular diseases (CVD, and diabetes, Human Development Index, Gender Inequality Index, material living conditions, and health expenditure.MethodsData on health and social indicators came from various World Health Organization and United Nations databases on global health and development statistics, including the GLOBOCAN cancer database. Mortality trends were modeled by log-linear regression, and differences in rates and relative risks were tested for statistical significance.ResultsAlthough both countries have made marked improvements, India lags behind China on several key health indicators. Differential rates of mortality decline during 1960-2009 have led to a widening health gap between China and India. In 2009 the infant mortality rate in India was 50 deaths per 1,000 live births, 3 times greater than the rate for China. Sixty-six out of 1,000 Indian children died before reaching their 5th birthday, compared with 19 children in China. China’s life expectancy is 9 years longer than India’s. Life expectancy at birth in India increased from 42 years in 1960 to 65 years in 2009, while life expectancy in China increased from 47 years in 1960 to 74 years in 2009. Major health concerns for China include high rates of stomach, liver, and lung cancer, CVD, and smoking prevalence. Globally, India ranked 90th and China 102nd in life satisfaction.Conclusions and Public Health Implications:India’s less favorable health profile compared to China is largely attributable to its higher rates of mortality from communicable diseases and maternal and perinatal conditions. Further health gains can be achieved by reducing social inequality, greater investments in human development and health services, and by prevention and control of chronic

  4. What Is the Best Way to Measure Surgical Quality? Comparing the American College of Surgeons National Surgical Quality Improvement Program versus Traditional Morbidity and Mortality Conferences.

    Science.gov (United States)

    Zhang, Jacques X; Song, Diana; Bedford, Julie; Bucevska, Marija; Courtemanche, Douglas J; Arneja, Jugpal S

    2016-04-01

    Morbidity and mortality conferences have played a traditional role in tracking complications. Recently, the American College of Surgeons National Surgical Quality Improvement Program Pediatrics (ACS NSQIP-P) has gained popularity as a risk-adjusted means of addressing quality assurance. The purpose of this article is to report an analysis of the two methodologies used within pediatric plastic surgery to determine the best way to manage quality. ACS NSQIP-P and morbidity and mortality data were extracted for 2012 and 2013 at a quaternary care institution. Overall complication rates were compared statistically, segregated by type and severity, followed by a subset comparison of ACS NSQIP-P-eligible cases only. Concordance and discordance rates between the two methodologies were determined. One thousand two hundred sixty-one operations were performed in the study period. Only 51.4 percent of cases were ACS NSQIP-P eligible. The overall complication rates of ACS NSQIP-P (6.62 percent) and morbidity and mortality conferences (6.11 percent) were similar (p = 0.662). Comparing for only ACS NSQIP-P-eligible cases also yielded a similar rate (6.62 percent versus 5.71 percent; p = 0.503). Although different complications are tracked, the concordance rate for morbidity and mortality and ACS NSQIP-P was 35.1 percent and 32.5 percent, respectively. The ACS NSQIP-P database is able to accurately track complication rates similarly to morbidity and mortality conferences, although it samples only half of all procedures. Although both systems offer value, limitations exist, such as differences in definitions and purpose. Because of the rigor of the ACS NSQIP-P, we recommend that it be expanded to include currently excluded cases and an extension of the study interval.

  5. Comparing Mobile Health Strategies to Improve Medication Adherence for Veterans With Coronary Heart Disease (Mobile4Meds): Protocol for a Mixed-Methods Study.

    Science.gov (United States)

    Park, Linda G; Collins, Eileen G; Shim, Janet K; Whooley, Mary A

    2017-07-18

    Adherence to antiplatelet medications is critical to prevent life threatening complications (ie, stent thrombosis) after percutaneous coronary interventions (PCIs), yet rates of nonadherence range from 21-57% by 12 months. Mobile interventions delivered via text messaging or mobile apps represent a practical and inexpensive strategy to promote behavior change and enhance medication adherence. The Mobile4Meds study seeks to determine whether text messaging or a mobile app, compared with an educational website control provided to all Veterans, can improve adherence to antiplatelet therapy among patients following acute coronary syndrome (ACS) or PCI. The three aims of the study are to: (1) determine preferences for content and frequency of text messaging to promote medication adherence through focus groups; (2) identify the most patient-centered app that promotes adherence, through a content analysis of all commercially available apps for medication adherence and focus groups centered on usability; and (3) compare adherence to antiplatelet medications in Veterans after ACS/PCI via a randomized clinical trial (RCT). We will utilize a mixed-methods design that uses focus groups to achieve the first and second aims (N=32). Patients will be followed for 12 months after being randomly assigned to one of three arms: (1) customized text messaging, (2) mobile app, or (3) website-control groups (N=225). Medication adherence will be measured with electronic monitoring devices, pharmacy records, and self-reports. Enrollment for the focus groups is currently in progress. We expect to enroll patients for the RCT in the beginning of 2018. Determining the efficacy of mobile technology using a Veteran-designed protocol to promote medication adherence will have a significant impact on Veteran health and public health, particularly for individuals with chronic diseases that require strict medication adherence. ClinicalTrials.gov NCT03022669. ©Linda G Park, Eileen G Collins, Janet K

  6. The Stockholm-3 (STHLM3) Model can Improve Prostate Cancer Diagnostics in Men Aged 50-69 yr Compared with Current Prostate Cancer Testing.

    Science.gov (United States)

    Eklund, Martin; Nordström, Tobias; Aly, Markus; Adolfsson, Jan; Wiklund, Peter; Brandberg, Yvonne; Thompson, James; Wiklund, Fredrik; Lindberg, Johan; Presti, Joseph C; StLezin, Mark; Clements, Mark; Egevad, Lars; Grönberg, Henrik

    2016-11-23

    Prostate cancer screening is associated with low specificity, unnecessary biopsies, and overdiagnosis. We have previously shown that the Stockholm-3 model (S3M) can reduce biopsies compared with using prostate-specific antigen (PSA) ≥3ng/ml as an indication for biopsy. Urologists in today's current prostate cancer testing (CPT) have access to numerous variables in addition to PSA (eg, age, ethnicity, family history, free PSA, PSA velocity, digital rectal examination, and prostate volume) to support biopsy decisions. We estimated the number of prostate cancers diagnosed and prostate biopsies performed if S3M replaced CPT in Stockholm, Sweden, by comparing biopsy results in 56 282 men who underwent PSA testing according to CPT in Stockholm in 2011 with the 47 688 men enrolled in the STHLM3 validation cohort 2012-2015. With the same sensitivity as CPT to diagnose Gleason score ≥7 prostate cancer, S3M was estimated to reduce the number of men biopsied by 53% (95% confidence interval [CI]: 41-65%), avoid 76% (95% CI: 67-81%) of negative biopsies, and reduce Gleason score 6 cancers by 23% (95% CI: 6-40%). S3M has the potential to improve prostate cancer diagnostics by better selecting men with high risk of GS ≥7 prostate cancer. We modeled the effect the Stockholm-3 model would have on prostate cancer diagnostics if it replaced current clinical practice. We found that Stockholm-3 model may substantially reduce the number of biopsies, while maintaining the same sensitivity to diagnose clinically significant prostate cancer. Copyright © 2016. Published by Elsevier B.V.

  7. The Great Recession: a comparison of recession magnitudes in Europe, USA and Japan

    OpenAIRE

    Mazurek, Jiří

    2013-01-01

    In this article recession magnitudes in Europe, the USA and Japan during the Great Recession are compared. The strongest recessions (of severe category) occurred in Latvia, Lithuania and Estonia, while recessions in Japan and the USA were significantly weaker. Even the strongest recession (in Latvia) was found smaller in its magnitude than the Great Depression 1929-1933 in the USA. Hence, comparisons of the Great Recession to the Great Depression in the literature are somewhat exaggerated.

  8. Improved end-stage high-intensity performance but similar glycemic responses after waxy barley starch ingestion compared to dextrose in type 1 diabetes.

    Science.gov (United States)

    Gray, Benjamin J; Page, Rhydian; Turner, Daniel; West, Daniel J; Campbell, Matthew D; Kilduff, Liam P; Stephens, Jeffrey W; Bain, Stephen C; Bracken, Richard M

    2016-11-01

    Pre-exercise carbohydrate (CHO) ingestion is an effective strategy for reducing the occurrence of hypoglycemia during or after exercise in individuals with type 1 diabetes (T1DM). The metabolic effects of ingestion of different CHOs for glycemic or performance gains have been under-researched. This study compared metabolic responses and fuel use during sub-maximal and high-intensity performance running following pre-exercise ingestion of waxy barley starch (WBS) or dextrose (DEX) in T1DM. Seven participants attended the laboratory on two separate occasions following preliminary testing. On each visit participants consumed either 0.6 g/kg body mass of DEX or WBS 2 hours before a 26-minute discontinuous incremental treadmill protocol (4-minute running: 1.5-min rest) finishing at 80±4% V̇O2peak followed by a 10-min performance run on a non-motorized treadmill. Capillary blood samples were taken at rest, during and following exercise and analyzed for glucose (BG) and acid-base variables. Data (mean ± SEM) were analyzed using repeated measures ANOVA (P0.05). In the final quartile of the performance run, a greater distance was completed under WBS (WBS 323±21 vs. DEX 301±20 m, P=0.02). Consumption of WBS demonstrated similar hyperglycemic responses to dextrose ingestion but a greater rate of CHO use at rest. Interestingly, T1DM individuals displayed an improved performance at the latter stages of a high-intensity run test.

  9. Syllogisms delivered in an angry voice lead to improved performance and engagement of a different neural system compared to neutral voice

    Directory of Open Access Journals (Sweden)

    Kathleen Walton Smith

    2015-05-01

    Full Text Available Despite the fact that most real-world reasoning occurs in some emotional context, very little is known about the underlying behavioral and neural implications of such context. To further understand the role of emotional context in logical reasoning we scanned 15 participants with fMRI while they engaged in logical reasoning about neutral syllogisms presented through the auditory channel in a sad, angry, or neutral tone of voice. Exposure to angry voice led to improved reasoning performance compared to exposure to sad and neutral voice. A likely explanation for this effect is that exposure to expressions of anger increases selective attention toward the relevant features of target stimuli, in this case the reasoning task. Supporting this interpretation, reasoning in the context of angry voice was accompanied by activation in the superior frontal gyrus—a region known to be associated with selective attention. Our findings contribute to a greater understanding of the neural processes that underlie reasoning in an emotional context by demonstrating that two emotional contexts, despite being of the same (negative valence, have different effects on reasoning.

  10. Improving the Wear Resistance of Moulds for the Injection of Glass Fibre–Reinforced Plastics Using PVD Coatings: A Comparative Study

    Directory of Open Access Journals (Sweden)

    Francisco Silva

    2017-02-01

    Full Text Available It is well known that injection of glass fibre–reinforced plastics (GFRP causes abrasive wear in moulds’ cavities and runners. Physical vapour deposition (PVD coatings are intensively used to improve the wear resistance of different tools, also being one of the most promising ways to increase the moulds’ lifespan, mainly when used with plastics strongly reinforced with glass fibres. This work compares four different thin, hard coatings obtained using the PVD magnetron sputtering process: TiAlN, TiAlSiN, CrN/TiAlCrSiN and CrN/CrCN/DLC. The first two are monolayer coatings while the last ones are nanostructured and consist of multilayer systems. In order to carry out the corresponding tribological characterization, two different approaches were selected: A laboratorial method, using micro-abrasion wear tests based on a ball-cratering configuration, and an industrial mode, analysing the wear resistance of the coated samples when inserted in a plastic injection mould. As expected, the wear phenomena are not equivalent and the results between micro-abrasion and industrial tests are not similar due to the different means used to promote the abrasion. The best wear resistance performance in the laboratorial wear tests was attained by the TiAlN monolayer coating while the best performance in the industrial wear tests was obtained by the CrN/TiAlCrSiN nanostructured multilayer coating.

  11. Blastocyst transfer does not improve cycle outcome as compared to D3 transfer in antagonist cycles with an elevated progesterone level on the day of hCG.

    Science.gov (United States)

    Demirel, Cem; Aydoğdu, Serkan; Özdemir, Arzu İlknur; Keskin, Gülşah; Baştu, Ercan; Buyru, Faruk

    2017-09-01

    To evaluate the association between progesterone elevation on the day of human chorionic gonadotropin (hCG) administration and clinical pregnancy rates of gonadotropin-releasing hormone (GnRH) antagonist in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles with the transfer of embryos at different developmental stages (day-3 versus day-5 ETs). This is a retrospective analysis of fresh IVF/ICSI; 194 cycles out of 2676 conducted in a single center. A total of 2676 cycles were analyzed, of which 386 had no progesterone measurements available. Two hundred eighteen cycles had progesterone elevation (p>1.5 ng/mL) giving an overall incidence of 9.5%. Twenty-four cycles were excluded from further analysis. Of the remaining 194 cycles, 151 had day-3 transfers and 43 had blastocyst transfers. There was no statistically significant difference in pregnancy and clinical pregnancy rates per transfer between the D3-ET and D5-ET groups (46% vs. 49%, and 39% vs. 35%, respectively). The results of this study suggest that blastocyst transfer does not improve cycle outcomes compared with D3 transfer in GnRH antagonist cycles with an elevated progesterone level on the day of hCG.

  12. An innovative brioche enriched in protein and energy improves the nutritional status of malnourished nursing home residents compared to oral nutritional supplement and usual breakfast: FARINE+ project.

    Science.gov (United States)

    Van Wymelbeke, Virginie; Brondel, Laurent; Bon, Francis; Martin-Pfitzenmeyer, Isabelle; Manckoundia, Patrick

    2016-10-01

    To compare the effects of a 12-week nutritional intervention, in which an innovative protein-and-energy-enriched brioche, an oral nutritional supplement or a usual breakfast were eaten, on food intake and nutritional status in nursing home residents. Three-armed, multicentre, controlled trial. Eight nursing homes in Burgundy, France. Sixty-eight malnourished participants aged between 70 and 99 years old. Participants were randomly assigned to one of three groups according to the breakfast provided: brioche group, one portion of 65 g brioche enriched in protein and energy (12.8 g and 180 kcal) added to usual breakfast; supplement group, 200-ml of a ready-to-use, energy-dense liquid (14 g protein and 200 kcal) added to usual breakfast or control group, a usual breakfast only. Total energy intakes were assessed for three days at different periods of the study (day 0, day 30 and day 90); blood parameters, nutritional status (mini nutritional assessment, weight) and functional capacities (grip strength and activity level) were measured at the beginning and at the end of the nutritional intervention study (day 0 and day 90). The participants of the brioche group had higher total energy intakes at day 30 (p value 0.004) and at day 90 (p value 0.018) compared with the supplement group and the control group. At the end of the interventional study, 72% of the participants in the brioche group had reached the recommended minimum level of protein of 0.8 g/kg/day, compared with 53% in the supplement group and 36% in the control group (p value 0.036). In addition, between day 0 and day 90 in the brioche group, blood levels of vitamins B 9 , B 2 , D (all p value <0.001), B 6 (p value 0.026) and B 12 (p value 0.036) had increased and plasma homocysteine had decreased (p value 0.024). The protein-and-energy-enriched brioche effectively increased energy and protein intakes and improved the nutritional status of elderly people living in nursing homes. It could be a good

  13. Great Expectations for Middle School Counselors

    Science.gov (United States)

    Wright, Robert J.

    2012-01-01

    During the Great Recession, 2008 to 2010, school systems scrambled to balance budgets, and the ratio of counselors to students became even larger. To make matters worse, the Great Recession had a major impact on cuts in educational funding. Budget cutbacks tend to occur where the public will be least likely to notice. The loss of teachers and the…

  14. Great ape genetic diversity and population history

    DEFF Research Database (Denmark)

    Prado-Martinez, Javier; Sudmant, Peter H; Kidd, Jeffrey M

    2013-01-01

    Most great ape genetic variation remains uncharacterized; however, its study is critical for understanding population history, recombination, selection and susceptibility to disease. Here we sequence to high coverage a total of 79 wild- and captive-born individuals representing all six great ape...

  15. Libraries Achieving Greatness: Technology at the Helm

    Science.gov (United States)

    Muir, Scott P.

    2009-01-01

    Libraries have been around for thousands of years. Many of them are considered great because of their magnificent architecture or because of the size of their collections. This paper offers ten case studies of libraries that have used technology to achieve greatness. Because almost any library can implement technology, a library does not have to…

  16. Recensie "The Great Reset" : Richard Florida

    NARCIS (Netherlands)

    Roy van Dalm

    2010-01-01

    Like the Great Depression and the Long Depression before it, experts have viewed prolonged economic downturns as crises. In The Great Reset , bestselling author Richard Florida argues that we should instead see the recent recession as an opportunity to create entirely new ways of working and living

  17. Testing auditory sensitivity in the great cormorant (Phalacrocorax carbo sinensis)

    DEFF Research Database (Denmark)

    Maxwell, Alyssa; Hansen, Kirstin Anderson; Larsen, Ole Næsbye

    2016-01-01

    Psychoacoustic and electrophysiological methods were used to measure the in-air hearing sensitivity of the great cormorant (Phalacrocorax carbo sinensis). One individual was used to determine the behavioral thresholds, which was then compared to previously collected data on the auditory brainstem...

  18. Improvement of primary care for patients with chronic heart failure: a study protocol for a cluster randomised trial comparing two strategies.

    Science.gov (United States)

    van Lieshout, Jan; Steenkamer, Betty; Knippenberg, Marjan; Wensing, Michel

    2011-03-25

    Many patients with chronic heart failure (CHF), a common condition with high morbidity and mortality rates, receive treatment in primary care. To improve the management of CHF in primary care, we developed an implementation programme comprised of educational and organisational components, with support by a practice visitor and focus both on drug treatment and lifestyle advice, and on organisation of care within the practice and collaboration with other healthcare providers. Tailoring has been shown to improve the success of implementation programmes, but little is known about what would be best methods for tailoring, specifically with respect to CHF in primary care. We describe the study protocol of a cluster randomised controlled trial to examine the effectiveness of tailoring a CHF implementation programme to general practices compared to a standardised way of delivering a programme. The study population will consist of 60 general practitioners (GPs) and the CHF patients they include. GPs are randomised in blocks of four, stratified according to practice size. With a tailored implementation programme GPs prioritise the issues that will form the bases of the support for the practice visits. These may comprise several issues, both educational and organizational.The primary outcome measures are patient's experience of receiving structured primary care for CHF (PACIC, a questionnaire related to the Chronic Care Model), patients' health-related utilities (EQ-5D), and drugs prescriptions using the guideline adherence index. Patients being clustered in practices, multilevel regression analyses will be used to explore the effect of practice size and type of intervention programme. In addition we will examine both changes within groups and differences at follow-up between groups with respect to drug dosages and advice on lifestyle issues. Furthermore, in interviews the feasibility of the programme and goal attainment, organisational changes in CHF care, and formalised

  19. Improvement of primary care for patients with chronic heart failure: A study protocol for a cluster randomised trial comparing two strategies

    Directory of Open Access Journals (Sweden)

    Wensing Michel

    2011-03-01

    Full Text Available Abstract Background Many patients with chronic heart failure (CHF, a common condition with high morbidity and mortality rates, receive treatment in primary care. To improve the management of CHF in primary care, we developed an implementation programme comprised of educational and organisational components, with support by a practice visitor and focus both on drug treatment and lifestyle advice, and on organisation of care within the practice and collaboration with other healthcare providers. Tailoring has been shown to improve the success of implementation programmes, but little is known about what would be best methods for tailoring, specifically with respect to CHF in primary care. Methods/design We describe the study protocol of a cluster randomised controlled trial to examine the effectiveness of tailoring a CHF implementation programme to general practices compared to a standardised way of delivering a programme. The study population will consist of 60 general practitioners (GPs and the CHF patients they include. GPs are randomised in blocks of four, stratified according to practice size. With a tailored implementation programme GPs prioritise the issues that will form the bases of the support for the practice visits. These may comprise several issues, both educational and organizational. The primary outcome measures are patient's experience of receiving structured primary care for CHF (PACIC, a questionnaire related to the Chronic Care Model, patients' health-related utilities (EQ-5D, and drugs prescriptions using the guideline adherence index. Patients being clustered in practices, multilevel regression analyses will be used to explore the effect of practice size and type of intervention programme. In addition we will examine both changes within groups and differences at follow-up between groups with respect to drug dosages and advice on lifestyle issues. Furthermore, in interviews the feasibility of the programme and goal attainment

  20. Bi-level CPAP does not improve gas exchange when compared with conventional CPAP for the treatment of neonates recovering from respiratory distress syndrome.

    Science.gov (United States)

    Lampland, Andrea L; Plumm, Brenda; Worwa, Cathy; Meyers, Patricia; Mammel, Mark C

    2015-01-01

    We hypothesised that short-term application of bi-level nasal continuous positive airway pressure CPAP (SiPAP) compared with conventional nasal CPAP (nCPAP) at the same mean airway pressure in infants with persistent oxygen need recovering from respiratory distress syndrome would improve CO2 removal with no change in oxygen requirement. Non-blinded, randomised, observational four-period crossover study. Level III NICU; low-birthweight infants requiring CPAP and oxygen while recovering from respiratory distress syndrome. Infants requiring nasal CPAP for >24 h prior to study enrolment, and fraction of inspired oxygen requirement (FiO2) of 0.25-0.5, were randomised to either nCPAP or SiPAP. A crossover design with four 1 h treatment periods was used such that each infant received both treatments twice. Oxygen saturations (SaO2), transcutaneous CO2 (tcCO2) and vital signs were monitored continuously. Polysomnographic recordings were analysed for apnoea, bradycardia and oxygen desaturation. Twenty low-birthweight infants receiving 0.3±0.04% supplemental oxygen on CPAP of 6 cm H2O were studied at an average of 33 days of age (±23 days, SD). There were no differences in tcCO2 or other physiological parameters except mean blood pressure, which was lower during nCPAP (52.3±8.3 vs 54.4±9.1 mm Hg; ±SD; p<0.01). No differences in short or prolonged apnoea, bradycardia or significant desaturation events were observed. At similar mean airway pressures, SiPAP does not improve CO2 removal, oxygenation or other studied physiological parameters with the exception of mean blood pressure, which was not clinically significant. NCT01053455. 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.

  1. INFLUENCE OF GREAT HYDRAULIC WORKS UPON NATURE AND MANKIND

    Directory of Open Access Journals (Sweden)

    Mircea O. POPOVICIU

    2011-11-01

    Full Text Available The great hydraulic works represent heavy environmental modifications and influence both humans (during the construction and the utilization and nature. The present paper compares these influences for two such works the Suez Canal and the Panama Canal. Both are relatively recent, have the same purpose (the increase of the East-West trade and were initiated by Ferdinand de Lesseps. The possibility of realization was analyzed long time before the beginning of the work. Both works are sources of huge incomes and created endless disputes between the great powers. The forecast level increase of the planetary ocean will affect differently these works.

  2. Artificial reefs and reef restoration in the Laurentian Great Lakes

    Science.gov (United States)

    McLean, Matthew W.; Roseman, Edward; Pritt, Jeremy J.; Kennedy, Gregory W.; Manny, Bruce A.

    2015-01-01

    We reviewed the published literature to provide an inventory of Laurentian Great Lakes artificial reef projects and their purposes. We also sought to characterize physical and biological monitoring for artificial reef projects in the Great Lakes and determine the success of artificial reefs in meeting project objectives. We found records of 6 artificial reefs in Lake Erie, 8 in Lake Michigan, 3 in Lakes Huron and Ontario, and 2 in Lake Superior. We found 9 reefs in Great Lakes connecting channels and 6 reefs in Great Lakes tributaries. Objectives of artificial reef creation have included reducing impacts of currents and waves, providing safe harbors, improving sport-fishing opportunities, and enhancing/restoring fish spawning habitats. Most reefs in the lakes themselves were incidental (not created purposely for fish habitat) or built to improve local sport fishing, whereas reefs in tributaries and connecting channels were more frequently built to benefit fish spawning. Levels of assessment of reef performance varied; but long-term monitoring was uncommon as was assessment of physical attributes. Artificial reefs were often successful at attracting recreational species and spawning fish; however, population-level benefits of artificial reefs are unclear. Stressors such as sedimentation and bio-fouling can limit the effectiveness of artificial reefs as spawning enhancement tools. Our investigation underscores the need to develop standard protocols for monitoring the biological and physical attributes of artificial structures. Further, long-term monitoring is needed to assess the benefits of artificial reefs to fish populations and inform future artificial reef projects.

  3. Pacific salmonines in the Great Lakes Basin

    Science.gov (United States)

    Claramunt, Randall M.; Madenjian, Charles P.; Clapp, David; Taylor, William W.; Lynch, Abigail J.; Léonard, Nancy J.

    2012-01-01

    Pacific salmon (genus Oncorhynchus) are a valuable resource, both within their native range in the North Pacific rim and in the Great Lakes basin. Understanding their value from a biological and economic perspective in the Great Lakes, however, requires an understanding of changes in the ecosystem and of management actions that have been taken to promote system stability, integrity, and sustainable fisheries. Pacific salmonine introductions to the Great Lakes are comprised mainly of Chinook salmon, coho salmon, and steelhead and have accounted for 421, 177, and 247 million fish, respectively, stocked during 1966-2007. Stocking of Pacific salmonines has been effective in substantially reducing exotic prey fish abundances in several of the Great Lakes (e.g., lakes Michigan, Huron, and Ontario). The goal of our evaluation was to highlight differences in management strategies and perspectives across the basin, and to evaluate policies for Pacific salmonine management in the Great Lakes. Currently, a potential conflict exists between Pacific salmonine management and native fish rehabilitation goals because of the desire to sustain recreational fisheries and to develop self-sustaining populations of stocked Pacific salmonines in the Great Lakes. We provide evidence that suggests Pacific salmonines have not only become naturalized to the food webs of the Great Lakes, but that their populations (specifically Chinook salmon) may be fluctuating in concert with specific prey (i.e., alewives) whose populations are changing relative to environmental conditions and ecosystem disturbances. Remaining questions, however, are whether or not “natural” fluctuations in predator and prey provide enough “stability” in the Great Lakes food webs, and even more importantly, would a choice by managers to attempt to reduce the severity of predator-prey oscillations be antagonistic to native fish restoration efforts. We argue that, on each of the Great Lakes, managers are pursuing

  4. Improving access to geriatric mental health services: a randomized trial comparing treatment engagement with integrated versus enhanced referral care for depression, anxiety, and at-risk alcohol use.

    Science.gov (United States)

    Bartels, Stephen J; Coakley, Eugenie H; Zubritsky, Cynthia; Ware, James H; Miles, Keith M; Areán, Patricia A; Chen, Hongtu; Oslin, David W; Llorente, Maria D; Costantino, Giuseppe; Quijano, Louise; McIntyre, Jack S; Linkins, Karen W; Oxman, Thomas E; Maxwell, James; Levkoff, Sue E

    2004-08-01

    The authors sought to determine whether integrated mental health services or enhanced referral to specialty mental health clinics results in greater engagement in mental health/substance abuse services by older primary care patients. This multisite randomized trial included 10 sites consisting of primary care and specialty mental health/substance abuse clinics. Primary care patients 65 years old or older (N=24,930) were screened. The final study group consisted of 2,022 patients (mean age=73.5 years; 26% female; 48% ethnic minority) with depression (N=1,390), anxiety (N=70), at-risk alcohol use (N=414), or dual diagnosis (N=148) who were randomly assigned to integrated care (mental health and substance abuse providers co-located in primary care; N=999) or enhanced referral to specialty mental health/substance abuse clinics (i.e., facilitated scheduling, transportation, payment; N=1,023). Seventy-one percent of patients engaged in treatment in the integrated model compared with 49% in the enhanced referral model. Integrated care was associated with more mental health and substance abuse visits per patient (mean=3.04) relative to enhanced referral (mean=1.91). Overall, greater engagement was predicted by integrated care and higher mental distress. For depression, greater engagement was predicted by integrated care and more severe depression. For at-risk alcohol users, greater engagement was predicted by integrated care and more severe problem drinking. For all conditions, greater engagement was associated with closer proximity of mental health/substance abuse services to primary care. Older primary care patients are more likely to accept collaborative mental health treatment within primary care than in mental health/substance abuse clinics. These results suggest that integrated service arrangements improve access to mental health and substance abuse services for older adults who underuse these services.

  5. Body composition is improved during 12 months' treatment with metformin alone or combined with oral contraceptives compared with treatment with oral contraceptives in polycystic ovary syndrome.

    Science.gov (United States)

    Glintborg, Dorte; Altinok, Magda Lambaa; Mumm, Hanne; Hermann, Anne Pernille; Ravn, Pernille; Andersen, Marianne

    2014-07-01

    Central obesity in polycystic ovary syndrome (PCOS) is associated with increased inflammatory markers and increased risk for type 2 diabetes. The objective of the study was to evaluate whether treatment with metformin (M) or M combined with oral contraceptive pills (OCPs) resulted in a more advantageous body composition than treatment with OCP alone. The study was conducted at an outpatient clinic. This was a randomized, controlled clinical trial. Ninety patients with PCOS were randomized to 12 months' treatment with M (2 g/d), M + OCP (150 mg desogestrel+30 μg ethinylestradiol), or OCP. Whole-body dual-energy x-ray absorptiometry scans and clinical and hormonal evaluations were performed before and after the intervention period. A total of 65 of 90 patients completed the study. Changes in weight at 6 and 12 months and changes in regional fat mass estimates at 12 months were measured. Dropout rates between intervention groups were not significantly different. Treatment with M and M+OCP were superior to OCP regarding weight and regional fat mass. The median (quartiles) weight changes during 12 months of M, M+OCP, and OCP treatment were -3.0 (-10.3; 0.6), -1.9 (-4.9; 0.1), and 1.2 (-0.8; 3.0) kg, respectively, P weight loss and improved body composition compared with OCP, whereas free T levels decreased during M+OCP or OCP. Combined treatment with M+OCP should be considered as an alternative to treatment with OCP alone to avoid weight gain in PCOS.

  6. Great Lakes Restoration Initiative Great Lakes Mussel Watch(2009-2014)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Following the inception of the Great Lakes Restoration Initiative (GLRI) to address the significant environmental issues plaguing the Great Lakes region, the...

  7. Credit spread variability in U.S. business cycles: the Great Moderation versus the Great Recession

    OpenAIRE

    Hylton Hollander; Guangling Liu

    2014-01-01

    This paper establishes the prevailing financial factors that influence credit spread variability, and its impact on the U.S. business cycle over the Great Moderation and Great Recession periods. To do so, we develop a dynamic general equilibrium framework with a central role of financial intermediation and equity assets. Over the Great Moderation and Great Recession periods, we find an important role for bank market power (sticky rate adjustments and loan rate markups) on credit spread variab...

  8. Credit spread variability in U.S. business cycles: The Great Moderation versus the Great Recession

    OpenAIRE

    Hylton Hollander and Guangling Liu

    2014-01-01

    This paper establishes the prevailing financial factors that influence credit spread variability, and its impact on the U.S. business cycle over the Great Moderation and Great Recession periods. To do so, we develop a dynamic general equilibrium framework with a central role of financial intermediation and equity assets. Over the Great Moderation and Great Recession periods, we find an important role for bank market power (sticky rate adjustments and loan rate markups) on credit spread variab...

  9. 75 FR 6354 - NOAA Great Lakes Habitat Restoration Program Project Grants under the Great Lakes Restoration...

    Science.gov (United States)

    2010-02-09

    ...-04] RIN 0648-ZC10 NOAA Great Lakes Habitat Restoration Program Project Grants under the Great Lakes... Atmospheric Administration (NOAA), Department of Commerce. ACTION: Notice of funding availability; Date... on January 19, 2010. That notice announced the NOAA Great Lakes Habitat Restoration Program Project...

  10. Does Sympathy Motivate Prosocial Behaviour in Great Apes?

    Science.gov (United States)

    Liebal, Katja; Vaish, Amrisha; Haun, Daniel; Tomasello, Michael

    2014-01-01

    Prosocial behaviours such as helping, comforting, or sharing are central to human social life. Because they emerge early in ontogeny, it has been proposed that humans are prosocial by nature and that from early on empathy and sympathy motivate such behaviours. The emerging question is whether humans share these abilities to feel with and for someone with our closest relatives, the great apes. Although several studies demonstrated that great apes help others, little is known about their underlying motivations. This study addresses this issue and investigates whether four species of great apes (Pongo pygmaeus, Gorilla gorilla, Pan troglodytes, Pan paniscus) help a conspecific more after observing the conspecific being harmed (a human experimenter steals the conspecific’s food) compared to a condition where no harming occurred. Results showed that in regard to the occurrence of prosocial behaviours, only orangutans, but not the African great apes, help others when help is needed, contrasting prior findings on chimpanzees. However, with the exception of one population of orangutans that helped significantly more after a conspecific was harmed than when no harm occurred, prosocial behaviour in great apes was not motivated by concern for others. PMID:24416212

  11. The Slogan Great Wall from the SDSS Data Release 4

    International Nuclear Information System (INIS)

    Deng Xin-Fa; He Ji-Zhou; Luo Cheng-Hong; Wu Ping; Tang Xiao-Xun; He Cong-Gen

    2007-01-01

    Using the MAIN galaxy data from the SDSS Data Release 4 (SDSS4), we further study the Sloan Great Wall by three-dimensional cluster analysis. Because the basic properties of Main galaxies change with redshift, we select 50942 Main galaxies having the same redshift region (0.07 ≤ z ≤ 0.09) as the Sloan Great Wall from the Main galaxy sample, and construct our SubMain sample. From the SubMain sample, 2013 isolated galaxies are identified at dimensionless radius r = 1.4. We perform the comparative studies of galaxy properties among the Sloan Great Wall, isolated galaxies and the SubMain sample in different redshift bins. It turns out that the statistical properties of luminosities and sizes of galaxies for the Sloan Great Wall, isolated galaxies and the SubMain sample are almost the same, the proportion of early-type isolated galaxies is relatively low. We also d that mean color of member galaxies of the Sloan Great Wall is redder than that of isolated galaxies. These results indicate that some properties of galaxies may be closely correlated with the environment or clustering. (author)

  12. The Great Recession and confidence in homeownership

    OpenAIRE

    Anat Bracha; Julian Jamison

    2013-01-01

    Confidence in homeownership shifts for those who personally experienced real estate loss during the Great Recession. Older Americans are confident in the value of homeownership. Younger Americans are less confident.

  13. Great Lakes CoastWatch Node

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — CoastWatch is a nationwide National Oceanic and Atmospheric Administration (NOAA) program within which the Great Lakes Environmental Research Laboratory (GLERL)...

  14. The Making of a Great Captain

    National Research Council Canada - National Science Library

    Weibel, Theodore G

    2006-01-01

    ... judgement. This paper examines the hypothesis that Great Captains are a product of their families, are highly educated from an early age, possess the qualities of a genius, encounter grand life experiences...

  15. Thirty years of great ape gestures.

    Science.gov (United States)

    Tomasello, Michael; Call, Josep

    2018-02-21

    We and our colleagues have been doing studies of great ape gestural communication for more than 30 years. Here we attempt to spell out what we have learned. Some aspects of the process have been reliably established by multiple researchers, for example, its intentional structure and its sensitivity to the attentional state of the recipient. Other aspects are more controversial. We argue here that it is a mistake to assimilate great ape gestures to the species-typical displays of other mammals by claiming that they are fixed action patterns, as there are many differences, including the use of attention-getters. It is also a mistake, we argue, to assimilate great ape gestures to human gestures by claiming that they are used referentially and declaratively in a human-like manner, as apes' "pointing" gesture has many limitations and they do not gesture iconically. Great ape gestures constitute a unique form of primate communication with their own unique qualities.

  16. Southern Great Plains Atmospheric Radiation Measurement Site

    Data.gov (United States)

    Federal Laboratory Consortium — The Southern Great Plains Atmospheric Radiation Measurement Site (SGP-ARM) is the oldest and largest of DOE's Arm sites. It was established in 1992. It consists of...

  17. Theodosius Dohzhansky: A Great Inspirer 1

    Indian Academy of Sciences (India)

    the direct personal influence of some of these great scientists on their peers and successors is re~atively small. A very small number of scientists ... studying the evolutionary genetics of speciation in Drosophila. --------~--------43. RESONANCE I ...

  18. Great Lakes rivermouths: a primer for managers

    Science.gov (United States)

    Pebbles, Victoria; Larson, James; Seelbach, Paul; Pebbles, Victoria; Larson, James; Seelbach, Paul

    2013-01-01

    Between the North American Great Lakes and their tributaries are the places where the confluence of river and lake waters creates a distinct ecosystem: the rivermouth ecosystem. Human development has often centered around these rivermouths, in part, because they provide a rich array of ecosystem services. Not surprisingly, centuries of intense human activity have led to substantial pressures on, and alterations to, these ecosystems, often diminishing or degrading their ecological functions and associated ecological services. Many Great Lakes rivermouths are the focus of intense restoration efforts. For example, 36 of the active Great Lakes Areas of Concern (AOCs) are rivermouths or areas that include one or more rivermouths. Historically, research of rivermouth ecosystems has been piecemeal, focused on the Great Lakes proper or on the upper reaches of tributaries, with little direct study of the rivermouth itself. Researchers have been divided among disciplines, agencies and institutions; and they often work independently and use disparate venues to communicate their work. Management has also been fragmented with a focus on smaller, localized, sub-habitat units and socio-political or economic elements, rather than system-level consideration. This Primer presents the case for a more holistic approach to rivermouth science and management that can enable restoration of ecosystem services with multiple benefits to humans and the Great Lakes ecosystem. A conceptual model is presented with supporting text that describes the structures and processes common to all rivermouths, substantiating the case for treating these ecosystems as an identifiable class.1 Ecological services provided by rivermouths and changes in how humans value those services over time are illustrated through case studies of two Great Lakes rivermouths—the St. Louis River and the Maumee River. Specific ecosystem services are identified in italics throughout this Primer and follow definitions described

  19. Understanding Great Earthquakes in Japan's Kanto Region

    Science.gov (United States)

    Kobayashi, Reiji; Curewitz, Daniel

    2008-10-01

    Third International Workshop on the Kanto Asperity Project; Chiba, Japan, 16-19 February 2008; The 1703 (Genroku) and 1923 (Taisho) earthquakes in Japan's Kanto region (M 8.2 and M 7.9, respectively) caused severe damage in the Tokyo metropolitan area. These great earthquakes occurred along the Sagami Trough, where the Philippine Sea slab is subducting beneath Japan. Historical records, paleoseismological research, and geophysical/geodetic monitoring in the region indicate that such great earthquakes will repeat in the future.

  20. The diverse impacts of the great recession

    OpenAIRE

    Makoto Nakajima

    2013-01-01

    The Great Recession had a large negative impact on the U.S. economy. Asset prices, most notably stock and house prices, declined substantially, resulting in a loss in wealth for many American households. In this article, Makoto Nakajima documents how diverse households were affected in a variety of dimensions during the Great Recession, in particular between 2007 and 2009, using newly available data from the 2007-2009 Survey of Consumer Finances. He discusses why it is important to look at th...

  1. The Great War and German Memory

    DEFF Research Database (Denmark)

    Leese, Peter

    2012-01-01

    Review essay on Jason Crouthamel, The Great War and German Memory. Society, Politics and Psychological Trauma, 1914-18 (2009) and Anton Kaes, Shell Shock Cinema: Weimar Culture and the Wounds of War (2009)......Review essay on Jason Crouthamel, The Great War and German Memory. Society, Politics and Psychological Trauma, 1914-18 (2009) and Anton Kaes, Shell Shock Cinema: Weimar Culture and the Wounds of War (2009)...

  2. TO STUDY THE EFFECT OF AGILITY AND PERTURBATION EXERCISES VERSUS DYNAMIC RESISTANCE EXERCISES TO IMPROVE KNEE FUNCTION IN KNEE OSTEOARTHRITIS A COMPARATIVE STUDY

    Directory of Open Access Journals (Sweden)

    Jeutishree Roy

    2015-10-01

    Full Text Available Background: Primary osteoarthritis is more commonly found in post menopausal women; Secondary osteoarthritis had an underlying cause such as trauma, obesity or inflammatory arthritis. It is characterized by a progressive degeneration of the articular cartilage with subsequent remodeling and hypertrophy of the bone at the joint margins. Muscle weakness is associated with increased functional limitation, disability. Muscle strengthening through resistance exercises increases physical function; decreases pain due to osteoarthritis and reduces self reported disability. Agility is the ability to change direction and maintain stability and is more often important in changing direction and speed; In order to train muscle to react quickly neuromuscular training is essential; Perturbation enhances the ability of the proprioceptor signals to the muscle and prevent injuries and enhances performance. The aim of this study is to compare the effectiveness of agility training and dynamic resistance training in patients with primary osteoarthritis. Methods: 50 subjects were assigned in two groups 25 each group and subjects were selected by convenient sampling method. Group A with agility training and Group B with dynamic resistance training. The treatment session was performed 3 days a week for 3 weeks lasting for 45minutes. Day 0 is the starting day of the session and Day-21 last day of the session. Each subject performed all the measurement with knee function assessed by Timed up and Go test (TUG and Lower extremity function Scale (LEFS. Both outcomes were tested at starting day and at the end of 21st day. Results: All the analysis was carried out in PASW version 21.0. An alpha level of 0.05 was used to determine statistical significance. The between group analysis of agility training and dynamic strengthening for LEFS and TUG in evaluation of knee function was done using independent ‘t’ test showed statistically very significant (P=0.000. Conclusions

  3. Ordered nanoporous silica as carriers for improved delivery of water insoluble drugs: a comparative study between three dimensional and two dimensional macroporous silica

    Directory of Open Access Journals (Sweden)

    Wang Y

    2013-10-01

    Full Text Available Ying Wang, Qinfu Zhao, Yanchen Hu, Lizhang Sun, Ling Bai, Tongying Jiang, Siling WangDepartment of Pharmaceutics, Shenyang Pharmaceutical University, Liaoning Province, People’s Republic of ChinaAbstract: The goal of the present study was to compare the drug release properties and stability of the nanoporous silica with different pore architectures as a matrix for improved delivery of poorly soluble drugs. For this purpose, three dimensional ordered macroporous (3DOM silica with 3D continuous and interconnected macropores of different sizes (200 nm and 500 nm and classic mesoporous silica (ie, Mobil Composition of Matter [MCM]-41 and Santa Barbara Amorphous [SBA]-15 with well-ordered two dimensional (2D cylindrical mesopores were successfully fabricated and then loaded with the model drug indomethacin (IMC via the solvent deposition method. Scanning electron microscopy (SEM, N2 adsorption, differential scanning calorimetry (DSC, and X-ray diffraction (XRD were applied to systematically characterize all IMC-loaded nanoporous silica formulations, evidencing the successful inclusion of IMC into nanopores, the reduced crystallinity, and finally accelerated dissolution of IMC. It was worth mentioning that, in comparison to 2D mesoporous silica, 3DOM silica displayed a more rapid release profile, which may be ascribed to the 3D interconnected pore networks and the highly accessible surface areas. The results obtained from the stability test indicated that the amorphous state of IMC entrapped in the 2D mesoporous silica (SBA-15 and MCM-41 has a better physical stability than in that of 3DOM silica. Moreover, the dissolution rate and stability of IMC loaded in 3DOM silica was closely related to the pore size of macroporous silica. The colorimetric 3-(4,5-Dimethylthiazol-2-yl-2,5-diphenyltetrazolium bromide (MTT and Cell Counting Kit (CCK-8 assays in combination with direct morphology observations demonstrated the good biocompatibility of nanoporous

  4. Energy and water in the Great Lakes.

    Energy Technology Data Exchange (ETDEWEB)

    Tidwell, Vincent Carroll

    2011-11-01

    The nexus between thermoelectric power production and water use is not uniform across the U.S., but rather differs according to regional physiography, demography, power plant fleet composition, and the transmission network. That is, in some regions water demand for thermoelectric production is relatively small while in other regions it represents the dominate use. The later is the case for the Great Lakes region, which has important implications for the water resources and aquatic ecology of the Great Lakes watershed. This is today, but what about the future? Projected demographic trends, shifting lifestyles, and economic growth coupled with the threat of global climate change and mounting pressure for greater U.S. energy security could have profound effects on the region's energy future. Planning for such an uncertain future is further complicated by the fact that energy and environmental planning and regulatory decisionmaking is largely bifurcated in the region, with environmental and water resource concerns generally taken into account after new energy facilities and technologies have been proposed, or practices are already in place. Based on these confounding needs, the objective of this effort is to develop Great Lakes-specific methods and tools to integrate energy and water resource planning and thereby support the dual goals of smarter energy planning and development, and protection of Great Lakes water resources. Guiding policies for this planning are the Great Lakes and St. Lawrence River Basin Water Resources Compact and the Great Lakes Water Quality Agreement. The desired outcome of integrated energy-water-aquatic resource planning is a more sustainable regional energy mix for the Great Lakes basin ecosystem.

  5. The Great London Smog of 1952.

    Science.gov (United States)

    Polivka, Barbara J

    2018-04-01

    : The Great London Smog of December 1952 lasted five days and killed up to 12,000 people. The smog developed primarily because of extensive burning of high-sulfur coal. The health effects were both immediate and long lasting, with a recent study revealing an increased likelihood of childhood asthma development in those exposed to the Great Smog while in utero or during their first year of life. Subsequent pollution legislation-including the U.S. Clean Air Act and its amendments-have demonstrably reduced air pollution and positively impacted health outcomes. With poor air quality events like the Great Smog continuing to occur today, nurses need to be aware of the impact such environmental disasters can have on human health.

  6. ["Great jobs"-also in psychiatry?].

    Science.gov (United States)

    Spiessl, H; Hübner-Liebermann, B

    2003-09-01

    Against the background of a beginning shortage of psychiatrists, results from interviews with 112 employees of an automotive company with the topic "Great Job" are presented to discuss their relevance to psychiatry. The interviews were analysed by means of a qualitative content analysis. Most employees assigned importance to great pay, constructive collaboration with colleagues, and work appealing to personal interests. Further statements particularly relevant to psychiatry were: successful career, flexible working hours, manageable job, work-life balance, well-founded training, no bureaucracy within the company, and personal status in society. The well-known economic restrictions in health care and the still negative attitude towards psychiatry currently reduce the attraction of psychiatry as a profession. From the viewpoint of personnel management, the attractors of a great job revealed in this study are proposed as important clues for the recruitment of medical students for psychiatry and the development of psychiatric staff.

  7. Great Basin geologic framework and uranium favorability

    International Nuclear Information System (INIS)

    Larson, L.T.; Beal, L.H.

    1978-01-01

    Work on this report has been done by a team of seven investigators assisted over the project span by twenty-three undergraduate and graduate students from May 18, 1976 to August 19, 1977. The report is presented in one volume of text, one volume or Folio of Maps, and two volumes of bibliography. The bibliography contains approximately 5300 references on geologic subjects pertinent to the search for uranium in the Great Basin. Volume I of the bibliography lists articles by author alphabetically and Volume II cross-indexes these articles by location and key word. Chapters I through IV of the Text volume and accompanying Folio Map Sets 1, 2, 3, 4, and 5, discuss the relationship of uranium to rock and structural environments which dominate the Great Basin. Chapter 5 and Map Sets 6 and 7 provide a geochemical association/metallogenic grouping of mineral occurrences in the Great Basin along with information on rock types hosting uranium. Chapter VI summarizes the results of a court house claim record search for 'new' claiming areas for uranium, and Chapter VII along with Folio Map Set 8 gives all published geochronological data available through April 1, 1977 on rocks of the Great Basin. Chapter VIII provides an introduction to a computer analysis of characteristics of certain major uranium deposits in crystalline rocks (worldwide) and is offered as a suggestion of what might be done with uranium in all geologic environments. We believe such analysis will assist materially in constructing exploration models. Chapter IX summarizes criteria used and conclusions reached as to the favorability of uranium environments which we believe to exist in the Great Basin and concludes with recommendations for both exploration and future research. A general summary conclusion is that there are several geologic environments within the Great Basin which have considerable potential and that few, if any, have been sufficiently tested

  8. Great Lakes Research Review, 1982. Appendices.

    Science.gov (United States)

    1982-11-01

    7D-i53 28 GREAT LAKES RESEARCH REVIEW 1982 PPENDICES (U) / PETROLEUM REFINERY PO INT SOURCE TASK FORCE WINDSOR (ONTARIO) NOV 82UNCLASSIFIED F/G 8...C7 U. 3 X 7 45 1 2 0. ODm C of. C.’ WC.’ L. LI 7 R-Ri53 62B GREAT LKES RESEARCH REVIEW 1982 PPENDICES (U) 2/3 PETROLEUM REFINERY POINT SOURCE TASK...NUMBER ORGANIZATION* TITLE OF PROJECT 001 A** 0300 ERL-D Acute and Early Life Stage Toxicity Testing of Priority Pollutant Chemicals 002 A 0302 ERL-D

  9. Great Importance Attached to Intangible Cultural Heritage

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    @@ Intangible Cultural Heritage on Verge of Extinction? With the acceleration of globalization and modernization, dramatic changes have taken place in China's cultural ecology: intangible cultural heritage is confronted with great challenges and a lot of orally and behaviorally transmitted cultural heritage disappear one after another; a great deal of traditional craftsmanship is on the verge of extinction; a large number of precious objects and materials of historical and cultural values are destroyed,deserted or lost in foreign countries; arbitrary misuse and excessive exploitation of intangible cultural heritage occur from time to time. Therefore, the protection of intangible cultural heritage brooks no delay.

  10. Spontaneous improvement in randomised clinical trials: meta-analysis of three-armed trials comparing no treatment, placebo and active intervention

    DEFF Research Database (Denmark)

    Krogsbøll, Lasse Theis; Hróbjartsson, Asbjørn; Gøtzsche, Peter C

    2009-01-01

    were psychological in 17 trials, physical in 15 trials, and pharmacological in 5 trials. Overall, across all conditions and interventions, there was a statistically significant change from baseline in all three arms. The standardized mean difference (SMD) for change from baseline was -0.24 (95...... uncertainty, as indicated by the confidence intervals for the three SMDs. The conditions that had the most pronounced spontaneous improvement were nausea (45%), smoking (40%), depression (35%), phobia (34%) and acute pain (25%). CONCLUSION: Spontaneous improvement and effect of placebo contributed importantly...

  11. Native plant development and restoration program for the Great Basin, USA

    Science.gov (United States)

    N. L. Shaw; M. Pellant; P. Olweli; S. L. Jensen; E. D. McArthur

    2008-01-01

    The Great Basin Native Plant Selection and Increase Project, organized by the USDA Bureau of Land Management, Great Basin Restoration Initiative and the USDA Forest Service, Rocky Mountain Research Station in 2000 as a multi-agency collaborative program (http://www.fs.fed.us/rm/boise/research/shrub/greatbasin.shtml), has the objective of improving the availability of...

  12. A Comparative Case Study Analysis of Administrators Perceptions on the Adaptation of Quality and Continuous Improvement Tools to Community Colleges in the State of Michigan

    Science.gov (United States)

    Mattis, Ted B.

    2011-01-01

    The purpose of this study was to determine whether community college administrators in the state of Michigan believe that commonly known quality and continuous improvement tools, prevalent in a manufacturing environment, can be adapted to a community college model. The tools, specifically Six Sigma, benchmarking and process mapping have played a…

  13. Montana Advanced Biofuels Great Falls Approval

    Science.gov (United States)

    This November 20, 2015 letter from EPA approves the petition from Montana Advanced Biofuels, LLC, Great Falls facility, regarding ethanol produced through a dry mill process, qualifying under the Clean Air Act for advanced biofuel (D-code 5) and renewable

  14. Alfanet Worked Example: What is Greatness?

    NARCIS (Netherlands)

    dr. Pierre Gorissen

    2004-01-01

    This document consists of an example of a Learning Design based on the What is Greatness example originally created by James Dalziel from WebMCQ using LAMS. Note: The example has been created in parallel with the actual development of the Alfanet system. So no claims can be made that the example

  15. Nevada, the Great Recession, and Education

    Science.gov (United States)

    Verstegen, Deborah A.

    2013-01-01

    The impact of the Great Recession and its aftermath has been devastating in Nevada, especially for public education. This article discusses the budget shortfalls and the impact of the economic crisis in Nevada using case study methodology. It provides a review of documents, including Governor Gibbon's proposals for the public K-12 education system…

  16. Professor Witold Nowicki - a greatly spirited pathologist.

    Science.gov (United States)

    Wincewicz, A; Szepietowska, A; Sulkowski, S

    2016-06-01

    This paper presents a complete overview of the scientific, professional and social activity of a great Polish pathologist, Witold Nowicki (1878-1941), from mainly Polish-written, original sources with a major impact on mostly his own publications. The biographical commemoration of this eminent professor is not only due to the fact that he provided a profound microscopic characterization of pneumatosis cystoides in 1909 and 1924. Nowicki greatly influenced the development of anatomical pathology in Poland, having authored over 82 publications, with special reference to tuberculosis, lung cancer, sarcomatous carcinomas, scleroma and others. However, the first of all his merits for the readership of Polish pathologists was his textbook titled Anatomical Pathology, which was a basic pathology manual in pre-war Poland. Witold Nowicki - as the head of the academic pathological anatomy department and former dean of the medical faculty - was shot with other professors by Nazi Germans in the Wuleckie hills in Lvov during World War Two. Professor Nowicki was described as being "small in size but great in spirit" by one of his associates, and remains an outstanding example of a meticulous pathologist, a patient tutor and a great social activist to follow.

  17. 76 FR 32857 - Great Outdoors Month, 2011

    Science.gov (United States)

    2011-06-07

    ... protecting an iconic vast public land, or by creating a community garden or an urban park. Last year, I was... leaders, students, and community groups led to a report unveiled in February, America's Great Outdoors: A Promise to Future Generations, which lays the foundation for smarter, more community-driven action to...

  18. Dramatic Change in Jupiter's Great Red Spot

    Science.gov (United States)

    Simon, A. A.; Wong, M. H.; Rogers, J. H.; Orton, G. S.; de Pater, I.; Asay-Davis, X.; Carlson, R. W.; Marcus, P. S.

    2015-01-01

    Jupiter's Great Red Spot (GRS) is one of its most distinct and enduring features, having been continuously observed since the 1800's. It currently spans the smallest latitude and longitude size ever recorded. Here we show analyses of 2014 Hubble spectral imaging data to study the color, structure and internal dynamics of this long-live storm.

  19. Financial fragility in the Great Moderation

    NARCIS (Netherlands)

    Bezemer, Dirk; Grydaki, Maria

    2014-01-01

    A nascent literature explores the measurement of financial fragility. This paper considers evidence for rising financial fragility during the 1984-2007 Great Moderation in the U.S. The literature suggests that macroeconomic stability combined with strong growth of credit to asset markets, in asset

  20. The Great Work of the New Millennium

    Science.gov (United States)

    Berry, Thomas

    2013-01-01

    Thomas Berry explores the meaning of work from the standpoint of human civilization responding to the call of the universe, replacing use and exploitation of nature with the wonder, rapport, and intimacy so important to the psychic balance of the developing human and natural harmony of life on Earth. The Great Work is defined as the work of…

  1. Teaching Group Work with "The Great Debaters"

    Science.gov (United States)

    Moe, Jeffry; Autry, Linda; Olson, Joann S.; Johnson, Kaprea F.

    2014-01-01

    An experiential learning activity, based on the film "The Great Debaters" (Washington, D., 2007), was used during a group work class. Description and preliminary evaluation of the activity is provided, including analysis of participant scores on the group leader self-efficacy instrument at multiple points. Implications and future…

  2. A great potential for market power

    International Nuclear Information System (INIS)

    Trong, Maj Dang

    2003-01-01

    In a report the competition authorities of Norway, Sweden and Denmark conclude that there is a great potential for exerting market power in the Nordic countries. Bottlenecks in the transmission grid divide the Nordic market in shifting constellations of geographic markets and the market concentration in each market may therefore become very high

  3. The great neurosis of Dr. Joseph Gerard.

    Science.gov (United States)

    Lefrère, Jean-Jacques; Rouillon, Frédéric

    2013-01-01

    The Great Neurosis, of Dr. Joseph Gerard, was published in 1889 in Paris. The book, intended for the general public, shows the different varieties of neuroses through picturesque and instructive examples. Its scientific and medical value is poor, but provides us with the various meanings of the word 'neurosis' in the late nineteenth century. Copyright © 2013 S. Karger AG, Basel.

  4. The Technological Diegesis in "The Great Gatsby"

    Science.gov (United States)

    Zhang, Mingquan

    2008-01-01

    This paper explores the technological diegesis in "The Great Gatsby." In the novel, Fitzgerald cleverly integrates the technological forces into his writing. He particularly relies on the two main props of automobile and telephone to arrange his fragmented plots into a whole. By the deliberate juxtaposition of men and women and machines…

  5. The Classical Plotline of "The Great Gatsby"

    Science.gov (United States)

    Slattery, Dennis P.

    1975-01-01

    Argues that an understanding of the craft of fiction is furthered by a return to the original creation, concluding that "The Great Gatsby" is one of the best examples of Aristotle's description of tragedy as set forth in "The Poetics." (RB)

  6. History of Great Ideas: An Honors Seminar.

    Science.gov (United States)

    Terrill, Marty; And Others

    The History of Great Ideas is an interdisciplinary seminar course for sophomore honor students at North Arkansas Community Technical College that teaches the intellectual history of western civilization. Each semester, students study 14 ideas from science, philosophy, history, religion, sociology, and economics to discover how philosophical…

  7. 77 FR 33597 - Great Outdoors Month, 2012

    Science.gov (United States)

    2012-06-07

    ... Outdoors Month, 2012 By the President of the United States of America A Proclamation America's natural... launch the America's Great Outdoors Initiative. Building on input from tens of thousands of people across... engine of growth. As part of our National Travel and Tourism Strategy, my Administration is working to...

  8. GreatSchools.org Finds Its Niche

    Science.gov (United States)

    Samuels, Christina A.

    2012-01-01

    GreatSchools.org neatly ranks more than 136,000 traditional public, private, and charter schools nationwide on a scale of 1 to 10, based on state test scores. But what often draws readers are the gossipy insider comments posted by parents, students, and teachers, and the star ratings those commenters contribute. The growth of online school rating…

  9. Great plains regional climate assessment technical report

    Science.gov (United States)

    The Great Plains region (GP) plays important role in providing food and energy to the economy of the United States. Multiple climatic and non-climatic stressors put multiple sectors, livelihoods and communities at risk, including agriculture, water, ecosystems and rural and tribal communities. The G...

  10. The Last Great American Picture Show

    NARCIS (Netherlands)

    Elsaesser, Thomas; King, Noel; Horwath, Alexander

    2004-01-01

    The Last Great American Picture Show brings together essays by scholars and writers who chart the changing evaluations of the American cinema of the 1970s, sometimes referred to as the decade of the lost generation, but now more and more recognized as the first New Hollywood, without which the

  11. How To Become a Great Public Space.

    Science.gov (United States)

    Block, Marylaine

    2003-01-01

    Presents interviews with Fred Kent, founder of the Project for Public Spaces (PPS) and Phil Myrick, PPS's assistant vice president, about transforming libraries into desirable public spaces. Discusses qualities people value in public spaces; great library buildings and what they are doing right; the first thing library directors should do when…

  12. Chapter 17. Information needs: Great gray owls

    Science.gov (United States)

    Gregory D. Hayward

    1994-01-01

    Current understanding of great gray owl biology and ecology is based on studies of less than five populations. In an ideal world, a strong conservation strategy would require significant new information. However, current knowledge suggests that conservation of this forest owl should involve fewer conflicts than either the boreal or flammulated owl. The mix of forest...

  13. Great Depression a Timely Class Topic

    Science.gov (United States)

    Zehr, Mary Ann

    2009-01-01

    This article reports that a number of history and social studies teachers have found that because of the parallels they're able to draw between the current economic crisis and the Great Depression, their students are seeing that history is relevant. They're engaging more deeply in history lessons than they have in previous years. The teachers say…

  14. Ecosystem services in the Great Lakes

    Science.gov (United States)

    A comprehensive inventory of ecosystem services across the entire Great Lakes basin is currently lacking and is needed to make informed management decisions. A greater appreciation and understanding of ecosystem services, including both use and non-use services, may have avoided ...

  15. Syllogisms delivered in an angry voice lead to improved performance and engagement of a different neural system compared to neutral voice

    OpenAIRE

    Kathleen Walton Smith; Laura-Lee eBalkwill; Oshin eVartanian; Vinod eGoel; Vinod eGoel

    2015-01-01

    Despite the fact that most real-world reasoning occurs in some emotional context, very little is known about the underlying behavioral and neural implications of such context. To further understand the role of emotional context in logical reasoning we scanned 15 participants with fMRI while they engaged in logical reasoning about neutral syllogisms presented through the auditory channel in a sad, angry, or neutral tone of voice. Exposure to angry voice led to improved reasoning performance co...

  16. The survival of patients with Stage III Colon Cancer is improved in HNPCC compared with sporadic cases. A Danish registry based study

    DEFF Research Database (Denmark)

    Brixen, Line Merrild; Bernstein, Inge Thomsen; Bülow, Steffen

    2013-01-01

    AIM: Patients with hereditary non-polyposis colorectal cancer (HNPCC) seem to have a better prognosis than those with sporadic colon cancer (CC)s. The aim was to compare survival after stage III CC in patients with HNPCC with those having sporadic CC. METHOD: 230 patients with hereditary cancer...... from The Danish HNPCC-Register and 3557 patients with sporadic CC from The Danish Colorectal Cancer Database, diagnosed during May 2001-December 2008 were included. HNPCC patients were classified according to Mismatch Repair mutation status and family pedigree. Sporadic cases had no known family...... history of cancer. Patient characteristics, geographic differences and survival data were analyzed. RESULTS: The overall survival (OS) was better in HNPCC patients compared to sporadic CC after stratification for sex and age (p=0.02; CI 1.04-1.7). The 5-year survival was 70% in HNPCC patients compared...

  17. A 13-Weeks Mindfulness Based Pain Management Program Improves Psychological Distress in Patients with Chronic Pain Compared with Waiting List Controls

    DEFF Research Database (Denmark)

    Andersen, Tonny Elmose; Vægter, Henrik Bjarke

    2016-01-01

    BACKGROUND: Eradication of pain is seldom an option in chronic pain management. Hence, mindfulness meditation has become popular in pain management. OBJECTIVE: This pilot study compared the effect of a 13-weeks cognitive behavioural therapy program with integrated mindfulness meditation (CBTm......) in patients with chronic non-malignant pain with a control condition. It was hypothesised that the CBTm program would reduce pain intensity and psychological distress compared to the control condition and that level of mindfulness and acceptance both would be associated with the reduction in pain intensity...... and psychological distress were performed in both groups at baseline and after 13 weeks. RESULTS: The CBTm program reduced depression, anxiety and pain-catastrophizing compared with the control group. Increased level of mindfulness and acceptance were associated with change in psychological distress...

  18. Using a relational database to improve mortality and length of stay for a department of surgery: a comparative review of 5200 patients.

    Science.gov (United States)

    Ang, Darwin N; Behrns, Kevin E

    2013-07-01

    The emphasis on high-quality care has spawned the development of quality programs, most of which focus on broad outcome measures across a diverse group of providers. Our aim was to investigate the clinical outcomes for a department of surgery with multiple service lines of patient care using a relational database. Mortality, length of stay (LOS), patient safety indicators (PSIs), and hospital-acquired conditions were examined for each service line. Expected values for mortality and LOS were derived from University HealthSystem Consortium regression models, whereas expected values for PSIs were derived from Agency for Healthcare Research and Quality regression models. Overall, 5200 patients were evaluated from the months of January through May of both 2011 (n = 2550) and 2012 (n = 2650). The overall observed-to-expected (O/E) ratio of mortality improved from 1.03 to 0.92. The overall O/E ratio for LOS improved from 0.92 to 0.89. PSIs that predicted mortality included postoperative sepsis (O/E:1.89), postoperative respiratory failure (O/E:1.83), postoperative metabolic derangement (O/E:1.81), and postoperative deep vein thrombosis or pulmonary embolus (O/E:1.8). Mortality and LOS can be improved by using a relational database with outcomes reported to specific service lines. Service line quality can be influenced by distribution of frequent reports, group meetings, and service line-directed interventions.

  19. Keeping the ‘Great’ in the Great Barrier Reef: large-scale governance of the Great Barrier Reef Marine Park

    Directory of Open Access Journals (Sweden)

    Louisa S. Evans

    2014-08-01

    Full Text Available As part of an international collaboration to compare large-scale commons, we used the Social-Ecological Systems Meta-Analysis Database (SESMAD to systematically map out attributes of and changes in the Great Barrier Reef Marine Park (GBRMP in Australia. We focus on eight design principles from common-pool resource (CPR theory and other key social-ecological systems governance variables, and explore to what extent they help explain the social and ecological outcomes of park management through time. Our analysis showed that commercial fisheries management and the re-zoning of the GBRMP in 2004 led to improvements in ecological condition of the reef, particularly fisheries. These boundary and rights changes were supported by effective monitoring, sanctioning and conflict resolution. Moderate biophysical connectivity was also important for improved outcomes. However, our analysis also highlighted that continued challenges to improved ecological health in terms of coral cover and biodiversity can be explained by fuzzy boundaries between land and sea, and the significance of external drivers to even large-scale social-ecological systems (SES. While ecological and institutional fit in the marine SES was high, this was not the case when considering the coastal SES. Nested governance arrangements become even more important at this larger scale. To our knowledge, our paper provides the first analysis linking the re-zoning of the GBRMP to CPR and SES theory. We discuss important challenges to coding large-scale systems for meta-analysis.

  20. A Dynamical Downscaling study over the Great Lakes Region Using WRF-Lake: Historical Simulation

    Science.gov (United States)

    Xiao, C.; Lofgren, B. M.

    2014-12-01

    As the largest group of fresh water bodies on Earth, the Laurentian Great Lakes have significant influence on local and regional weather and climate through their unique physical features compared with the surrounding land. Due to the limited spatial resolution and computational efficiency of general circulation models (GCMs), the Great Lakes are geometrically ignored or idealized into several grid cells in GCMs. Thus, the nested regional climate modeling (RCM) technique, known as dynamical downscaling, serves as a feasible solution to fill the gap. The latest Weather Research and Forecasting model (WRF) is employed to dynamically downscale the historical simulation produced by the Geophysical Fluid Dynamics Laboratory-Coupled Model (GFDL-CM3) from 1970-2005. An updated lake scheme originated from the Community Land Model is implemented in the latest WRF version 3.6. It is a one-dimensional mass and energy balance scheme with 20-25 model layers, including up to 5 snow layers on the lake ice, 10 water layers, and 10 soil layers on the lake bottom. The lake scheme is used with actual lake points and lake depth. The preliminary results show that WRF-Lake model, with a fine horizontal resolution and realistic lake representation, provides significantly improved hydroclimates, in terms of lake surface temperature, annual cycle of precipitation, ice content, and lake-effect snowfall. Those improvements suggest that better resolution of the lakes and the mesoscale process of lake-atmosphere interaction are crucial to understanding the climate and climate change in the Great Lakes region.

  1. What Makes a Great Journal Great in Economics? The Singer Not the Song.

    NARCIS (Netherlands)

    C-L. Chang (Chia-Lin); M.J. McAleer (Michael); L. Oxley (Les)

    2010-01-01

    textabstractThe paper is concerned with analysing what makes a great journal great in economics, based on quantifiable measures. Alternative Research Assessment Measures (RAM) are discussed, with an emphasis on the Thomson Reuters ISI Web of Science database (hereafter ISI). The various ISI RAM that

  2. Ernst Chain: a great man of science.

    Science.gov (United States)

    Kardos, Nelson; Demain, Arnold L

    2013-08-01

    resources were scarce in postwar Britain, the British government declined the project. Chain then took a post in 1948 at Rome's Instituto Superiore di Sanitá, establishing a new biochemistry department with a pilot plant. During that period, his department developed important new antibiotics (including the first semisynthetic antibiotics) as well as improved technological processes to produce a wide variety of important microbial metabolites that are still in wide use today. Chain was also responsible for helping several countries to start up a modern penicillin industry following World War II, including the Soviet Union and the People's Republic of China. In 1964, Chain returned to England to establish a new biochemistry department and industrial scale fermentation pilot plant at Imperial College in London. Imperial College became the preeminent biochemical department in Europe. Chain was also a pioneer in changing the relationship between government, private universities, and private industry for collaboration and funding to support medical research. Ernst Chain has left a lasting impact as a great scientist and internationalist.

  3. Reduced lung dose and improved inspiration level reproducibility in visually guided DIBH compared to audio coached EIG radiotherapy for breast cancer patients

    DEFF Research Database (Denmark)

    Damkjær, Sidsel Marie Skov; Aznar, Marianne Camille; Pedersen, Anders Navrsted

    2013-01-01

    Patients with left-sided breast cancer with lymph node involvement have routinely been treated with enhanced inspiration gating (EIG) for a decade at our institution. In a transition from EIG to deep inspiration breath hold (DIBH) we compared the two techniques with focus on target coverage, dose...... to organs at risk and reproducibility of the inspiration level (IL)....

  4. Endeavour zotarolimus-eluting stent reduces stent thrombosis and improves clinical outcomes compared with cypher sirolimus-eluting stent : 4-year results of the PROTECT randomized trial

    NARCIS (Netherlands)

    Wijns, William; Steg, Ph. Gabriel; Mauri, Laura; Kurowski, Volkhard; Parikh, Keyur; Gao, Runlin; Bode, Christoph; Greenwood, John P.; Lipsic, Erik; Alamgir, Farqad; Rademaker-Havinga, Tessa; Boersma, Eric; Radke, Peter; van Leeuwen, Frank; Camenzind, Edoardo

    2014-01-01

    Aims To compare the long-term clinical safety between two drug-eluting stents with different healing characteristics in the Patient Related Outcomes with Endeavour (E-ZES) vs. Cypher (C-SES) Stenting Trial (PROTECT). At 3 years, there was no difference in the primary outcome of definite or probable

  5. Novel surveillance of psychological distress during the great recession.

    Science.gov (United States)

    Ayers, John W; Althouse, Benjamin M; Allem, Jon-Patrick; Childers, Matthew A; Zafar, Waleed; Latkin, Carl; Ribisl, Kurt M; Brownstein, John S

    2012-12-15

    Economic stressors have been retrospectively associated with net population increases in nonspecific psychological distress (PD). However, no sentinels exist to evaluate contemporaneous associations. Aggregate Internet search query surveillance was used to monitor population changes in PD around the United States' Great Recession. Monthly PD query trends were compared with unemployment, underemployment, homes in delinquency and foreclosure, median home value or sale prices, and S&P 500 trends for 2004-2010. Time series analyses, where economic indicators predicted PD one to seven months into the future, were performed in 2011. PD queries surpassed 1,000,000 per month, of which 300,000 may be attributable to the Great Recession. A one percentage point increase in mortgage delinquencies and foreclosures was associated with a 16% (95%CI, 9-24) increase in PD queries one-month, and 11% (95%CI, 3-18) four months later, in reference to a pre-Great Recession mean. Unemployment and underemployment had similar associations half and one-quarter the intensity. "Anxiety disorder", "what is depression", "signs of depression", "depression symptoms", and "symptoms of depression" were the queries exhibiting the strongest associations with mortgage delinquencies and foreclosures, unemployment or underemployment. Housing prices and S&P 500 trends were not associated with PD queries. A non-traditional measure of PD was used. It is unclear if actual clinically significant depression or anxiety increased during the Great Recession. Alternative explanations for strong associations between the Great Recession and PD queries, such as media, were explored and rejected. Because the economy is constantly changing, this work not only provides a snapshot of recent associations between the economy and PD queries but also a framework and toolkit for real-time surveillance going forward. Health resources, clinician screening patterns, and policy debate may be informed by changes in PD query

  6. TO STUDY THE EFFECT OF PLAY THERAPY AND CHILD FRIENDLY CONSTRAINT INDUCED MOMEMENT THERAPY TO IMPROVE HAND FUNCTION IN SPASTIC HEMIPLEGIC CEREBRAL PALSY CHILDREN: A COMPARATIVE STUDY

    Directory of Open Access Journals (Sweden)

    Anjuman Nahar

    2015-12-01

    Full Text Available Background: Cerebral Palsy (CP is a neurodevelopmental disorder caused by nonprogressive lesion in the developing brain. The early central nervous system (CNS damage results in chronic physical disabilities and often includes sensory impairments. In addition CP is often associated with epilepsy and abnormalities of speech, vision, and intellect; it is the selective vulnerability of the brains motor systems that defines the disorder. Child friendly CIMT involves intensive targeted practice with the involved extremity coordination above and beyond their unilateral impairments. Ply Therapy is designed for active involvement of child in performing various tasks. The aim of the study is to evaluate the effectiveness of constraint induced movement therapy and play therapy to improve hand function in spastic hemiplegic cerebral palsy children. Methods: A sample of 30 patients was divided in two groups, each group having 15 children. Convenient sampling was done on the basis of base line assessment and diagnosis of their condition. Duration of the study was 3 months and data collection started at day 0 and at the end of 90 days. Children in group A wore a bivalve plaster cast on the non-involved upper extremity from shoulder to finger tips for the entire time during the session lasting for 2 hours and the plaster cast was removed at the end of the session. B group consists of 15 subjects who received play therapy. The treatment program was conducted individually and adjusted to current needs and abilities of each of the patients. Outcomes: Box and Block test, QOM scale and AOU scale. Results: It was found that there is an improvement in the hand function on application of child friendly CIMT in the patients with spastic hemiplegic cerebral palsy which was found significant using the Mann-Whitney U test (p≤0.005. Conclusion: In this study it has been found that the use of Child friendly CIMT and PLAY THERAPY produces significant improvement in hand

  7. Do expanded seven-day NHS services improve clinical outcomes? Analysis of comparative institutional performance from the ?NHS Services, Seven Days a Week? project 2013?2016

    OpenAIRE

    Gan, Hoong-Wei; Wong, Danny Jon Nian; Dean, Benjamin John Floyd; Hall, Alistair Scott

    2017-01-01

    Background The cause of adverse weekend clinical outcomes remains unknown. In 2013, the ?NHS Services, Seven Days a Week? project was initiated to improve access to services across the seven-day week. Three years on, we sought to analyse the impact of such changes across the English NHS. Methods Aggregated trust-level data on crude mortality rates, Summary Hospital-Level Mortality Indicator (SHMI), mean length of stay (LOS), A&E admission and four-hour breach rates were obtained from national...

  8. Do expanded seven-day NHS services improve clinical outcomes? Analysis of comparative institutional performance from the "NHS Services, Seven Days a Week" project 2013-2016

    OpenAIRE

    Gan, H-W; Wong, D. J. N.; Dean, B. J. F.; Hall, A. S.

    2017-01-01

    Background: The cause of adverse weekend clinical outcomes remains unknown. In 2013, the “NHS Services, Seven Days a Week” project was initiated to improve access to services across the seven-day week. Three years on, we sought to analyse the impact of such changes across the English NHS. Methods: Aggregated trust-level data on crude mortality rates, Summary Hospital-Level Mortality Indicator (SHMI), mean length of stay (LOS), A&E admission and four-hour breach rates were obtained f...

  9. Great red spot dependence on solar activity

    International Nuclear Information System (INIS)

    Schatten, K.H.

    1979-01-01

    A new inquiry has been made into the question of whether Jupiter's Great Red Spot shows a solar activity dependence. From 1892 to 1947 a clear correlation was present. A dearth of sightings in the seventeenth century, along with the Maunder Minimum, further supports the relation. An anticorrelation, however, from l948 to l967 removed support for such an effect. The old observations have reexamined and recent observations have also been studied. The author reexamines this difficult question and suggests a possible physical mechanism for a Sun-Jovian weather relation. Prinn and Lewis' conversion reaction of Phosphine gas to triclinic red phosphorous crystals is a reaction dependent upon solar radiation. It may explain the dependence found, as well as the striking appearance of the Great Red Spot in the UV

  10. CT of the heart and great vessels

    International Nuclear Information System (INIS)

    Masuda, Yoshiaki; Inagaki, Yoshiaki

    1982-01-01

    Diseases of the heart and great vessels were diagnosed by CT through comparison of the pictures with that of control. Indications for CT included pericardiac diseases such as pericardial effusion, pericardiac cyst, pericardiac defect, pericardiac fat pad, and dilated or hypertrophic ventriculus. Of coronary artery diseases, myocardial infarction is the best indication for CT; and coronary artery calcification and coronary artery bypass graft for checking up the patency were also indications for this method. CT was useful for diagnosis of valvular diseases, especially mitral valve diseases, congenital heart diseases with structural abnormalities, abnormalities of the aorta and great veins, and of the pulmonary arteries and veins, and for follow-up of pulmonary congestion. (Ueda, J.)

  11. The power mix in Great-Britain

    International Nuclear Information System (INIS)

    Trebuchet, Charlotte

    2012-11-01

    This study addresses a new reform of the electric power sector in Great Britain: RIIO (Revenue = Incentives + Innovations + Outputs). The author discusses aspects related to market organisation and aspects related to the grid. First, she gives an overview of the situation of the electricity sector in Great-Britain by describing its evolution from the start of the liberalisation policy until our days, and by presenting the regulation of the electric power transport network. In a second part, she analyses which changes will be introduced by RIIO. She comments the general principles of this reform and discusses its implications for the sector. Appendices describe the LCN Fund (Low carbon network Fund) mechanism which is a specific bidding and selection process, and briefly indicate the projects selected by this fund in 2010 and 2011

  12. Why are there no great women chefs?

    Science.gov (United States)

    Druckman, Charlotte

    2010-01-01

    This article applies the rhetorical and deliberately provocative approach of the watershed essay art historian Linda Nochlin wrote in 1971—“Why Have there Been No Great Women Artists?”—to today's culinary industry. Nochlin used the question her title posed as a theoretical trap that would draw attention not only to the inherent sexism or prejudice that pervades the way the public perceives art, but also to those same issues' existence within and impact on academia and the other cultural institutions responsible for posing these sorts of questions. Nochlin bypassed the obvious and irrelevant debate over women's being less or differently talented and, in so doing, exposed that debate for being a distraction from the heart of the matter: how, sociologically (media) or institutionally (museums, foundations, etc.), people define a “great artist.” Although it's 40 years later, the polemic is as effective when used to understand the gender divide in the food world.

  13. Alexander the Great's relationship with alcohol.

    Science.gov (United States)

    Liappas, J A; Lascaratos, J; Fafouti, S; Christodoulou, G N

    2003-05-01

    This study sought to clarify if Alexander the Great indulged pathologically in alcohol and whether it contributed to his death. The texts of the historians Diodorus of Sicily, Plutarch, Arrian, Curtius Rufus, Athenaeus, Aelian and Justin were studied, with their information concerning wine consumption by Macedonians, and especially Alexander, and were evaluated. The surviving historical texts, all later than Alexander's epoch, are based on a series of contemporary histories and especially on the 'Royal Journals', an official diary written in the imperial court. Alexander consumed large quantities of undiluted wine periodically, reaching pathological intoxication. However, the existing data do not provide convincing evidence that Alexander the Great manifested abuse of or dependence on alcohol according to DSM-IV or ICD-10 criteria and it seems unlikely that alcohol was involved in his untimely death.

  14. Ultrasound assessment of great saphenous vein insufficiency

    Directory of Open Access Journals (Sweden)

    Chander RK

    2015-06-01

    Full Text Available Rajiv K Chander,1 Thomas S Monahan1,2 1Section of Vascular Surgery, Department of Surgery, University of Maryland School of Medicine, 2Department of Surgery, Baltimore Veterans Affairs Medical Center, Baltimore, MD, USA Abstract: Duplex ultrasonography is the ideal modality to assess great saphenous vein insufficiency. Duplex ultrasonography incorporates both gray scale images to delineate anatomy and color-Doppler imaging that visualizes the flow of blood in a structure. Assessment of great saphenous vein requires definition of the anatomy, augmentation of flow, evaluation for both superficial and deep vein thrombosis, and determining the presence of reflux. Currently, evolution in the treatment of reflux also relies on ultrasound for the treatment of the disease. Understanding the utilization of the ultrasound for the diagnosis and treatment of greater saphenous vein reflux is important for practitioners treating reflux disease. Keywords: duplex ultrasonography, small saphenous vein 

  15. Geoarchaeology of water management at Great Zimbabwe

    DEFF Research Database (Denmark)

    Sulas, Federica; Pikirayi, Innocent; Sagiya, Munyaradzi Elton

    In Africa, research on water management in urban contexts has often focussed rainfall, and the occurrence floods and droughts, whereas small-scale catchment systems and soil moisture regimes have received far less attention. This paper sets out to re-address the issue by examining the occurrence......, distribution and use of multiple water resources at the ancient urban landscape of Great Zimbabwe. Here, the rise and demise of the urban site have been linked to changing rainfall in the 1st mill. AD. Accordingly, rainfall shortages and consequent droughts eventually leading to the decline and abandonment...... of Great Zimbabwe at around 1550 AD. However, new research findings suggest a different scenario. Combining geoarchaeolological investigations, soil micromorphology and geochemistry with the study of historical sources and ethnographic records, new datasets indicate prolonged availability and diversified...

  16. A fenbendazole oral drench in addition to an ivermectin pour-on reduces parasite burden and improves feedlot and carcass performance of finishing heifers compared with endectocides alone.

    Science.gov (United States)

    Reinhardt, C D; Hutcheson, J P; Nichols, W T

    2006-08-01

    Two studies utilizing 1,862 yearling heifers were conducted to determine the effects of a fenbendazole oral drench in addition to an ivermectin pour-on (SG+IVPO), compared with an ivermectin pour-on (IVPO) or a doramectin injectable (DMX) alone, on parasite burden, feedlot performance, and carcass merit of feedlot cattle. In the first study, heifers receiving the SG+IVPO had fewer (P = 0.02) cattle retreated for disease and 73% fewer (P = 0.06) worm eggs per fecal sample 98 d after treatment than heifers treated with IVPO. Heifers treated with SG+IVPO consumed more DM, had greater ADG, were heavier at slaughter, and had heavier carcasses than IVPO-treated heifers (P fenbendazole oral drench and an ivermectin pour-on reduced parasite burden and increased feed intake, ADG, and carcass weight in feedlot heifers compared with treatment with an endectocide alone.

  17. Protocol: Adaptive Implementation of Effective Programs Trial (ADEPT): cluster randomized SMART trial comparing a standard versus enhanced implementation strategy to improve outcomes of a mood disorders program.

    Science.gov (United States)

    Kilbourne, Amy M; Almirall, Daniel; Eisenberg, Daniel; Waxmonsky, Jeanette; Goodrich, David E; Fortney, John C; Kirchner, JoAnn E; Solberg, Leif I; Main, Deborah; Bauer, Mark S; Kyle, Julia; Murphy, Susan A; Nord, Kristina M; Thomas, Marshall R

    2014-09-30

    Despite the availability of psychosocial evidence-based practices (EBPs), treatment and outcomes for persons with mental disorders remain suboptimal. Replicating Effective Programs (REP), an effective implementation strategy, still resulted in less than half of sites using an EBP. The primary aim of this cluster randomized trial is to determine, among sites not initially responding to REP, the effect of adaptive implementation strategies that begin with an External Facilitator (EF) or with an External Facilitator plus an Internal Facilitator (IF) on improved EBP use and patient outcomes in 12 months. This study employs a sequential multiple assignment randomized trial (SMART) design to build an adaptive implementation strategy. The EBP to be implemented is life goals (LG) for patients with mood disorders across 80 community-based outpatient clinics (N = 1,600 patients) from different U.S. regions. Sites not initially responding to REP (defined as implementation costs, and organizational change. This study design will determine whether an off-site EF alone versus the addition of an on-site IF improves EBP uptake and patient outcomes among sites that do not respond initially to REP. It will also examine the value of delaying the provision of EF/IF for sites that continue to not respond despite EF. ClinicalTrials.gov identifier: NCT02151331.

  18. A comparative study of zinc protoporphyrin IX-forming properties of animal by-products as sources for improving the color of meat products.

    Science.gov (United States)

    Wakamatsu, Jun-ichi; Murakami, Naoko; Nishimura, Takanori

    2015-05-01

    The objective of this study was to obtain fundamental data for improving the color of meat products by using animal by-products. We investigated zinc protoporphyrin IX (ZnPP)-forming properties of various internal organs from pigs and chickens. ZnPP was formed in the liver, heart and kidney, whereas the porcine spleen and bile, which are involved in the metabolism of heme, did not have ZnPP-forming properties. The optimum pH values were different among the internal organs and the ZnPP-forming properties of porcine organs were better than those of chicken organs. The porcine liver showed the greatest ZnPP-forming properties among all of the internal organs investigated in this study. The optimum pH value for ZnPP formation in the liver was lower than that of skeletal muscle. Oxygen did not inhibit the formation of ZnPP in the liver, unlike in skeletal muscle. Animal by-products such as the liver have good ability for the formation of ZnPP and might be useful for improving the color of meat products. © 2014 Japanese Society of Animal Science.

  19. A comparative evaluation of the in vitro penetration performance of the improved Crest Complete toothbrush versus the Colgate Total toothbrush and the Oral-B Advantage toothbrush.

    Science.gov (United States)

    Volpenhein, D W; Hartman, W L

    1996-01-01

    Removal of plaque and debris from interproximal surfaces during toothbrushing has generally been difficult to achieve, in large part because traditional flat-bristled toothbrushes do not offer good interproximal penetration. As a result, a number of varying bristle designs have been developed, with the rippled-design brush shown to be particularly effective at removing interproximal plaque. Recently, an existing rippled brush, the original Crest Complete, was modified to offer longer rippled outer tufts to clean along the gumline more effectively. Therefore, this study evaluated the overall and gumline interproximal penetration of three bristle designs: rippled, raised pattern (Improved Crest Complete); and two multi-level patterns (Colgate Total and Oral-B Advantage). The study used a previously reported in vitro model for determining interproximal penetration of manual toothbrushes (J Clin Dent 5:27-33, 1994). In order to effectively mimic the in-use characteristics of toothbrushing, this model is based on analysis of videotaped consumer brushing habits, tooth morphology, and in vivo plaque tenacity characteristics, and uses the three most predominantly used brushing techniques (circular, up-and-down, and back-and-forth with the brush held at both 45 degrees and 90 degrees to the tooth surface). In addition, the model's brush stroke length, brush force, and brush speed are likewise based on an analysis of consumer brushing patterns. The results of this study indicate that the Improved Crest Complete with longer rippled outer bristles provided significantly superior (p Colgate Total and Oral-B Advantage brushes.

  20. COMPARATIVE ANALYSIS BETWEEN THE INDUSTRIAL AND SERVICE SECTORS: A LITERATURE REVIEW OF THE IMPROVEMENTS OBTAINED THROUGH THE APPLICATION OF LEAN SIX SIGMA

    Directory of Open Access Journals (Sweden)

    Ana Carolina Martins Rosa

    2018-03-01

    Full Text Available The present work is a review of literature, to identify the improvements acquired from the application of the Lean Six Sigma methodology in the industrial and service sectors in different countries. The PRISMA methodology was used to select relevant articles to the topic of work, and the bibliographic databases used for the research were the Google Scholar, SciELO, ScienceDirect, Taylor & Francis and Web of Science. The study counted on 27 articles to better exemplify these points, being 11 focused on the industrial sector and 16 on the services sector. It was evident that in both sectors the variability of the process and its waste were reduced, by eliminating non-value-added activities, improving process quality, productivity, efficiency, the service provided, increasing customer satisfaction, reducing costs and generating savings. It has been found that Lean Six Sigma is a versatile tool that can be adapted and applied in any segment, allowing potential opportunities for new research and applications.

  1. COMPARATIVE ANALYSIS OF MEDICAL EQUIPMENT USED IN DIAGNOSTIC IMAGING IN BULGARIA AND COUNTRIES WORLDWIDE AND OPTIMIZATION AIMED AT IMPROVING THE HEALTH CARE SYSTEM MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Svetoslav Garov

    2016-07-01

    Full Text Available Purpose: to reveal the current condition of medical equipment in Bulgaria related to those major groups of socially significant diseases and to make an attempt to define guidelines for its optimization in view of improving the functioning and management of the healthcare system in this field. Material and methods: The following research methods have been applied: 1. Document review method – research, processing and analysis of medical statistical information taken from data from WHO and annual reports of NRA. The study includes data from 2009 - 2015. 2. Graphical method – summarizing data in relevant tables and diagram presentations. Results: The article analyzes the condition of medical equipment in the field of oncologic and cardiologic medical aid in Bulgaria based on data taken from WHO (World Health Organization and annual reports of NRA (Nuclear Regulatory Agency. Six types of diagnostic imaging and radiation therapy devices have been studied: Magnetic Resonance Imaging units (MRI; Computed Tomography Scanners (CT, Positron Emission Tomography Scanners, Mammographs, Linear accelerators and Telecobalt units (Cobalt-60. The condition of medical equipment since 2009 has been analyzed, results have been reported and trends - studied. Conclusion: The oncologic and cardiologic medical equipment in Bulgaria has been gradually improving in the last seven years, but quantitative indicators regarding the devices studied are still far away from the figures recommended by WHO with one single exception, i.e. Computed Tomography Scanners.

  2. Free acid gel form of β-hydroxy-β-methylbutyrate (HMB) improves HMB clearance from plasma in human subjects compared with the calcium HMB salt.

    Science.gov (United States)

    Fuller, John C; Sharp, Rick L; Angus, Hector F; Baier, Shawn M; Rathmacher, John A

    2011-02-01

    The leucine metabolite, β-hydroxy-β-methylbutyrate (HMB), is a nutritional supplement that increases lean muscle and strength with exercise and in disease states. HMB is presently available as the Ca salt (CaHMB). The present study was designed to examine whether HMB in free acid gel form will improve HMB availability to tissues. Two studies were conducted and in each study four males and four females were given three treatments in a randomised, cross-over design. Treatments were CaHMB (gelatin capsule, 1 g), equivalent HMB free acid gel swallowed (FASW) and free acid gel held sublingual for 15 s then swallowed (FASL). Plasma HMB was measured for 3 h following treatment in study 1 and 24 h with urine collection in study 2. In both the studies, the times to peak plasma HMB were 128 (sem 11), 38 (sem 4) and 38 (sem 1) min (P HMB excretion was not significantly increased resulting in more HMB retained (P HMB from plasma. In conclusion, HMB free acid gel could improve HMB availability and efficacy to tissues in health and disease.

  3. Comparative effectiveness of different carriers to improve the efficacy of bacterial consortium for enhancing wheat production under salt affected field conditions

    International Nuclear Information System (INIS)

    Shahzad, S.; Zahir, Z. A.; Asghar, H. N.; Chaudhry, U. K.

    2017-01-01

    Salinity is one of the most crucial problems for sustainable agriculture which is severely affecting crop growth and decreasing the food production. On another hand, burgeoning population in the world demands to produce more food. So, there is a need of hours to increase agricultural production particularly cereals from salt affected soils by adopting cost effective and environment friendly approaches. Use of bio-inoculants with salt tolerant plant growth promoting rhizobacteria (PGPR) could be a promising option to enhance the production of cereals in salt affected soils. Therefore, a field experiment was conducted to evaluate different carriers compost, peat, biogas slurry and press mud along with PGPR to enhance wheat production under salinity stress. Consortium containing equal proportion of three PGPR strains (Bacillus cereus strain Y5, Bacillus sp. Y14 and Bacillus subtilis strain Y16) was used with different carriers for seed coating. Finely ground and sterilized carriers were mixed in broth and coated on the surface of wheat seeds with different carriers. Coated seeds were sown in saline field with salinity range of 10-13 dS m/sup -1/. Results revealed that multi-strain bacterial inoculation improved the gas exchange, ionic, biochemical, growth and yield attributes of wheat crop under salinity stress. However, use of different carriers further improved the efficacy of multi-strain inoculation and significantly increased growth, yield and physiological parameters of wheat. The results of compost, peat and biogas slurry as carrier for bio-inoculants were statistically similar. (author)

  4. Improving China’s Environmental Performance through Adaptive Implementation—A Comparative Case Study of Cleaner Production in Hangzhou and Guiyang

    Directory of Open Access Journals (Sweden)

    Ting Guan

    2014-12-01

    Full Text Available This paper examines local policy implementation of Cleaner Production (CP in China. As the major policy implementer, China’s local government plays a crucial role in promoting CP. A better understanding of the factors affecting local government’s incentives regarding CP and different strategies available to the local government can help policy makers and implementers improve CP practices and other environmental policy outcomes. This paper uses the cases of Hangzhou and Guiyang to demonstrate that local conditions of policy implementation have a direct impact on the success of CP promotion. Based on 35 in-depth interviews, statistical data and internal government reports, we find that the location-based incentives of local government strongly influence their implementation strategies; and that the choices of different strategies can bring out various policy results. From this study, the identified location-based incentives are affected by energy resource endowment, economic development stage and technological competence. The successful implementation strategies involve using different policy instruments synthetically, regulating CP service organizations by controlling their qualifications, differentiating CP subsidizations, and improving transparency of project progress and outcomes.

  5. A Mediterranean diet improves HbA1c but not fasting blood glucose compared to alternative dietary strategies: a network meta-analysis.

    Science.gov (United States)

    Carter, P; Achana, F; Troughton, J; Gray, L J; Khunti, K; Davies, M J

    2014-06-01

    Overweight or obese individuals with type 2 diabetes are encouraged to lose weight for optimal glucose management, yet many find this difficult. Determining whether alterations in dietary patterns irrespective of weight loss can aid glucose control has not been fully investigated. We conducted a systematic review and meta-analysis aiming to determine the effects of a Mediterranean diet compared to other dietary interventions on glycaemic control irrespective of weight loss. Electronic databases were searched for controlled trials that included a Mediterranean diet intervention. The interventions included all major components of the Mediterranean diet and were carried out in free-living individuals at high risk or diagnosed with type 2 diabetes. Network meta-analysis compared all interventions with one another at the same time as maintaining randomisation. Analyses were conducted within a Bayesian framework. Eight studies met the inclusion criteria, seven examined fasting blood glucose (n = 972), six examined fasting insulin (n = 1330) and three examined HbA1c (n = 487). None of the interventions were significantly better than the others in lowering glucose parameters. The Mediterranean diet reduced HbA1c significantly compared to usual care but not compared to the Palaeolithic diet. The effect of alterations in dietary practice irrespective of weight loss on glycaemic control cannot be concluded from the present review. The need for further research in this area is apparent because no firm conclusions about relative effectiveness of interventions could be drawn as a result of the paucity of the evidence. © 2013 The British Dietetic Association Ltd.

  6. Improved ROS defense in the swimbladder of a facultative air-breathing erythrinid fish, jeju, compared to a non-air-breathing close relative, traira.

    Science.gov (United States)

    Pelster, Bernd; Giacomin, Marina; Wood, Chris M; Val, Adalberto L

    2016-07-01

    The jeju Hoplerythrinus unitaeniatus and the traira Hoplias malabaricus are two closely related erythrinid fish, both possessing a two-chambered physostomous swimbladder. In the jeju the anterior section of the posterior bladder is highly vascularized and the swimbladder is used for aerial respiration; the traira, in turn, is a water-breather that uses the swimbladder as a buoyancy organ and not for aerial oxygen uptake. Observation of the breathing behavior under different levels of water oxygenation revealed that the traira started aquatic surface respiration only under severe hypoxic conditions and did not breathe air. In the jeju air-breathing behavior was observed under normoxic conditions, and the frequency of air-breathing was significantly increased under hypoxic conditions. Unexpectedly, even under hyperoxic conditions (30 mg O2 L(-1)) the jeju continued to take air breaths, and compared with normoxic conditions the frequency was not reduced. Because the frequently air-exposed swimbladder tissue faces higher oxygen partial pressures than normally experienced by other fish tissues, it was hypothesized that in the facultative air-breathing jeju, swimbladder tissue would have a higher antioxidative capacity than the swimbladder tissue of the water breathing traira. Measurement of total glutathione (GSSG/GSH) concentration in anterior and posterior swimbladder tissue revealed a higher concentration of this antioxidant in swimbladder tissue as compared to muscle tissue in the jeju. Furthermore, the GSSG/GSH concentration in jeju tissues was significantly higher than in traira tissues. Similarly, activities of enzymes involved in the breakdown of reactive oxygen species were significantly higher in the jeju swimbladder as compared to the traira swimbladder. The results show that the jeju, using the swimbladder as an additional breathing organ, has an enhanced antioxidative capacity in the swimbladder as compared to the traira, using the swimbladder only as a

  7. The Rule of Saint Basil the Great

    Directory of Open Access Journals (Sweden)

    Piotr Pietrow

    2014-11-01

    Full Text Available The rules of monasticism were collected and published in a single work entitled Asketikon by Saint Basil the Great. It is arranged in the form of questions and answers to create one coherent work. It has two different publications.The first publication named The Small Asketikon dates to 370-370. It is the fruit of the Saint’s work among Pontic communities and consists of 203 questions and answers. The orignial Greek manuscript has not survived and it is available only in two translations: the Latin Rufin and fragments in Syrian language. The second publication named The Great Asketikon appeard in about 377 and presents the most mature step of cenobitic monasticismin Basil’s elaboration. The Great Asketikon was created by adding new questions to The Small Asketikon and consists of two parts called the The Longer Rules and The Shorter Rules. The Longer Rules are primarily a set of questions and answers. It includes a wide range of rules and norms of the overall life in community. It refers to the fundamental rules of spirituality, such as love, sacrifice, obedience and rudimental problems connected withcommunity organization, cenobitic monasticism and the role of the superior, work and prayer. The second part of The Great Asketikon consists of shorter rules. Two publications are known: the first one originated in Pont andincludes 286 questions and answers and second arose in Cezarei and includes 318 questions and answers. In this work, the Hierarch explains in detail issues regarding community life and solves difficult problems connected with conscience. He writes about behavior towards brothers and explains the significance of weaknesses and virtues.

  8. Academic Performance and the Great Recession

    OpenAIRE

    Adamopoulou, Effrosyni; Tanzi, Giulia M.

    2014-01-01

    In this paper we study how the Great Recession affected university students in terms of performance, with a special focus on the dropout probability. To do so, we use individual-level data on a representative sample of university students in Italy in 2007 and 2011. We measure the severity of the recession in terms of increases in adult and youth unemployment rate and we exploit geographical variation to achieve identification. On the one hand, an increase in adult male unemployment rate deter...

  9. Introduction: Mobilizing Shakespeare During the Great War

    OpenAIRE

    Smialkowska, Monika

    2014-01-01

    This introduction situates this special issue in the context of ongoing debates surrounding the “cultural mobilization” of Shakespeare during the Great War. The key areas of these debates include the degree to which Shakespeare could successfully be appropriated during the war for totalizing – nationalist and imperialist – purposes; the challenges to such appropriations (for instance, from the colonized nations); ideological fractures produced by seeing Shakespeare, simultaneously, as “univer...

  10. Determining Wind Erosion in the Great Plains

    OpenAIRE

    Elwin G. Smith; Burton C. English

    1982-01-01

    Wind erosion is defined as the movement of soil particles resulting from strong turbulent winds. The movement of soil particles can be categorized as suspension, saltation, or surface creep. Fine soil particles can be suspended in the atmosphere and carried for great distances. Particles too large to be suspended move in a jumping action along the soil surface, known as saltation. Heavier particles have a rolling movement along the surface and this type of erosion is surface creep.

  11. Corrected transposition of the great arteries

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Young Hi; Park, Jae Hyung; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1981-12-15

    The corrected transposition of the great arteries is an usual congenital cardiac malformation, which consists of transposition of great arteries and ventricular inversion, and which is caused by abnormal development of conotruncus and ventricular looping. High frequency of associated cardiac malformations makes it difficult to get accurate morphologic diagnosis. A total of 18 cases of corrected transposition of the great arteries is presented, in which cardiac catheterization and angiocardiography were done at the Department of Radiology, Seoul National University Hospital between September 1976 and June 1981. The clinical, radiographic, and operative findings with the emphasis on the angiocardiographic findings were analyzed. The results are as follows: 1. Among 18 cases, 13 cases have normal cardiac position, 2 cases have dextrocardia with situs solitus, 2 cases have dextrocardia with situs inversus and 1 case has levocardia with situs inversus. 2. Segmental sets are (S, L, L) in 15 cases, and (I, D,D) in 3 cases and there is no exception to loop rule. 3. Side by side interrelationships of both ventricles and both semilunar valves are noticed in 10 and 12 cases respectively. 4. Subaortic type conus is noted in all 18 cases. 5. Associated cardic malformations are VSD in 14 cases, PS in 11, PDA in 3, PFO in 3, ASD in 2, right aortic arch in 2, tricuspid insufficiency, mitral prolapse, persistent left SVC and persistent right SVC in 1 case respectively. 6. For accurate diagnosis of corrected TGA, selective biventriculography using biplane cineradiography is an essential procedure.

  12. Corrected transposition of the great arteries

    International Nuclear Information System (INIS)

    Choi, Young Hi; Park, Jae Hyung; Han, Man Chung

    1981-01-01

    The corrected transposition of the great arteries is an usual congenital cardiac malformation, which consists of transposition of great arteries and ventricular inversion, and which is caused by abnormal development of conotruncus and ventricular looping. High frequency of associated cardiac malformations makes it difficult to get accurate morphologic diagnosis. A total of 18 cases of corrected transposition of the great arteries is presented, in which cardiac catheterization and angiocardiography were done at the Department of Radiology, Seoul National University Hospital between September 1976 and June 1981. The clinical, radiographic, and operative findings with the emphasis on the angiocardiographic findings were analyzed. The results are as follows: 1. Among 18 cases, 13 cases have normal cardiac position, 2 cases have dextrocardia with situs solitus, 2 cases have dextrocardia with situs inversus and 1 case has levocardia with situs inversus. 2. Segmental sets are (S, L, L) in 15 cases, and (I, D,D) in 3 cases and there is no exception to loop rule. 3. Side by side interrelationships of both ventricles and both semilunar valves are noticed in 10 and 12 cases respectively. 4. Subaortic type conus is noted in all 18 cases. 5. Associated cardic malformations are VSD in 14 cases, PS in 11, PDA in 3, PFO in 3, ASD in 2, right aortic arch in 2, tricuspid insufficiency, mitral prolapse, persistent left SVC and persistent right SVC in 1 case respectively. 6. For accurate diagnosis of corrected TGA, selective biventriculography using biplane cineradiography is an essential procedure

  13. OF THE GREAT TEMPLE OF BEL

    Directory of Open Access Journals (Sweden)

    A. Denker

    2017-02-01

    Full Text Available The Great Temple of Bel in Palmyra was a unique edifice which had blended the well established lines of Greco-Roman architecture with the art and taste of the Orient. With the gilded bronze capitals of its 41 Corinthian columns it was the product of enormous effort and budget. It was the gem of a remarkable epoch of wealthy Palmyra and mighty Roma. With its splendidly decorated adyta ceilings it became a source of inspiration and imagination for Western architecture and decorative arts. While continuing to captivate the World, it was leveled and vanished as a grim result of conflict based vandalism. The aim of this work is to piece together this, the most eloquent and stupendous monument of the Roman East, from its ruins and reconstruct it as it was once extant. Its loss is irreplacable, but its photo-realistic reconstruction can offer some solace by waking the memories of the great temple as in the past. The lost reality of the Great Temple of Bel is revived here by digitally constructing its “ghost images".

  14. Great auricular neuropraxia with beach chair position

    Directory of Open Access Journals (Sweden)

    Joshi M

    2017-07-01

    Full Text Available Minal Joshi,1 Ruth Cheng,2 Hattiyangadi Kamath,1 Joel Yarmush1 1Department of Anesthesiology, New York Methodist Hospital, New York, NY, USA; 2School of Medicine, St. George’s University, Grenada, West Indies Abstract: Shoulder arthroscopy has been shown to be the procedure of choice for many diagnostic and therapeutic interventions. Neuropraxia of the great auricular nerve (GAN is an uncommon complication of shoulder surgery, with the patient in the beach chair position. We report a case of great auricular neuropraxia associated with direct compression by a horseshoe headrest, used in routine positioning for uncomplicated shoulder surgery. In this case, an arthroscopic approach was taken, under regional anesthesia with sedation in the beach chair position. The GAN, a superficial branch of the cervical plexus, is vulnerable to neuropraxia due to its superficial anatomical location. We recommend that for the procedures of the beach chair position, the auricle be protected and covered with cotton and gauze to avoid direct compression and the position of the head and neck be checked and corrected frequently. Keywords: neuropraxia, anesthesia, arthroscopy, great auricular nerve

  15. Moral reasoning about great apes in research

    Science.gov (United States)

    Okamoto, Carol Midori

    2006-04-01

    This study explored how individuals (biomedical scientists, Great Ape Project activists, lay adults, undergraduate biology and environmental studies students, and Grade 12 and 9 biology students) morally judge and reason about using great apes in biomedical and language research. How these groups perceived great apes' mental capacities (e.g., pain, logical thinking) and how these perceptions related to their judgments were investigated through two scenarios. In addition, the kinds of informational statements (e.g., biology, economics) that may affect individuals' scenario judgments were investigated. A negative correlation was found between mental attributions and scenario judgments while no clear pattern occurred for the informational statements. For the biomedical scenario, all groups significantly differed in mean judgment ratings except for the biomedical scientists, GAP activists and Grade 9 students. For the language scenario, all groups differed except for the GAP activists, and undergraduate environmental studies and Grade 9 students. An in-depth qualitative analysis showed that although the biomedical scientists, GAP activists and Grade 9 students had similar judgments, they produced different mean percentages of justifications under four moral frameworks (virtue, utilitarianism, deontology, and welfare). The GAP activists used more virtue reasoning while the biomedical scientists and Grade 9 students used more utilitarian and welfare reasoning, respectively. The results are discussed in terms of developing environmental/humane education curricula.

  16. The Great Recession, genetic sensitivity, and maternal harsh parenting.

    Science.gov (United States)

    Lee, Dohoon; Brooks-Gunn, Jeanne; McLanahan, Sara S; Notterman, Daniel; Garfinkel, Irwin

    2013-08-20

    Using data from the Fragile Families and Child Wellbeing Study, this study examined the effects of the Great Recession on maternal harsh parenting. We found that changes in macroeconomic conditions, rather than current conditions, affected harsh parenting, that declines in macroeconomic conditions had a stronger impact on harsh parenting than improvements in conditions, and that mothers' responses to adverse economic conditions were moderated by the DRD2 Taq1A genotype. We found no evidence of a moderating effect for two other, less well-studied SNPs from the DRD4 and DAT1 genes.

  17. A comparative evaluation of the regulation of GM crops or products containing dsRNA and suggested improvements to risk assessments.

    Science.gov (United States)

    Heinemann, Jack A; Agapito-Tenfen, Sarah Zanon; Carman, Judy A

    2013-05-01

    Changing the nature, kind and quantity of particular regulatory-RNA molecules through genetic engineering can create biosafety risks. While some genetically modified organisms (GMOs) are intended to produce new regulatory-RNA molecules, these may also arise in other GMOs not intended to express them. To characterise, assess and then mitigate the potential adverse effects arising from changes to RNA requires changing current approaches to food or environmental risk assessments of GMOs. We document risk assessment advice offered to government regulators in Australia, New Zealand and Brazil during official risk evaluations of GM plants for use as human food or for release into the environment (whether for field trials or commercial release), how the regulator considered those risks, and what that experience teaches us about the GMO risk assessment framework. We also suggest improvements to the process. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Comparing performance of mothers using simplified mid-upper arm circumference (MUAC) classification devices with an improved MUAC insertion tape in Isiolo County, Kenya

    DEFF Research Database (Denmark)

    Grant, Angeline; Njiru, James; Okoth, Edgar

    2018-01-01

    to a "gold standard" classification (the mean of three measurements taken by a research assistant using the MUAC insertion tape).  Results: The sensitivity of mother/caregiver classifications was high for all devices (>93% for severe acute malnutrition (SAM), defined by MUAC 90% for global...... acute malnutrition (GAM), defined by MUAC classification was higher using the MUAC insertion tape (100% sensitivity for SAM and 99% sensitivity for GAM) than using "Click-MUAC" devices. Younden's J for SAM classification, and sensitivity for GAM......Background: A novel approach for improving community case-detection of acute malnutrition involves mothers/caregivers screening their children for acute malnutrition using a mid-upper arm circumference (MUAC) insertion tape. The objective of this study was to test three simple MUAC classification...

  19. Intratendon Delivery of Leukocyte-Poor Platelet-Rich Plasma Improves Healing Compared With Leukocyte-Rich Platelet-Rich Plasma in a Rabbit Achilles Tendinopathy Model.

    Science.gov (United States)

    Yan, Ruijian; Gu, Yanjia; Ran, Jisheng; Hu, Yejun; Zheng, Zefeng; Zeng, Mengfeng; Heng, Boon Chin; Chen, Xiao; Yin, Zi; Chen, Weishan; Shen, Weiliang; Ouyang, Hongwei

    2017-07-01

    Chronic tendinopathy is a commonly occurring clinical problem that affects both athletes and inactive middle-aged patients. Although some studies have shown that different platelet-rich plasma (PRP) preparations could exert various therapeutic effects in vitro, the role of leukocytes in PRP has not yet been defined under tendinopathy conditions in vivo. This study compared the effects of the intratendon delivery of leukocyte-poor PRP (Lp-PRP) versus leukocyte-rich PRP (Lr-PRP) in a rabbit chronic tendinopathy model in vivo. Controlled laboratory study. Four weeks after a local injection of collagenase in the Achilles tendon, the following treatments were randomly administered on the lesions: injections of (1) 200 μL of Lp-PRP (n = 8), (2) 200 μL of Lr-PRP (n = 8), or (3) 200 μL of saline (n = 8). Healing outcomes were assessed at 4 weeks after therapy with magnetic resonance imaging (MRI), cytokine quantification, real-time polymerase chain reaction analysis of gene expression, histology, and transmission electron microscopy (TEM). MRI revealed that the Lr-PRP and saline groups displayed higher signal intensities compared with the Lp-PRP group with T2 mapping. Histologically, the Lp-PRP group displayed significantly better general scores compared with the Lr-PRP ( P = .001) and saline ( P tendon healing and is a preferable option for the clinical treatment of tendinopathy. PRP is widely used in the clinical management of chronic tendinopathy. However, the clinical results are ambiguous. It is imperative to understand the influence of leukocytes on PRP-mediated tissue healing in vivo, which could facilitate the better clinical management of chronic tendinopathy. Further studies are needed to translate our findings to the clinical setting.

  20. Does hydrotherapy improve strength and physical function in patients with osteoarthritis—a randomised controlled trial comparing a gym based and a hydrotherapy based strengthening programme

    Science.gov (United States)

    Foley, A; Halbert, J; Hewitt, T; Crotty, M

    2003-01-01

    Objective: To compare the effects of a hydrotherapy resistance exercise programme with a gym based resistance exercise programme on strength and function in the treatment of osteoarthritis (OA). Design: Single blind, three arm, randomised controlled trial. Subjects: 105 community living participants aged 50 years and over with clinical OA of the hip or knee. Methods: Participants were randomised into one of three groups: hydrotherapy (n = 35), gym (n = 35), or control (n = 35). The two exercising groups had three exercise sessions a week for six weeks. At six weeks an independent physiotherapist unaware of the treatment allocation performed all outcome assessments (muscle strength dynamometry, six minute walk test, WOMAC OA Index, total drugs, SF-12 quality of life, Adelaide Activities Profile, and the Arthritis Self-Efficacy Scale). Results: In the gym group both left and right quadriceps significantly increased in strength compared with the control group, and right quadriceps strength was also significantly better than in the hydrotherapy group. The hydrotherapy group increased left quadriceps strength only at follow up, and this was significantly different from the control group. The hydrotherapy group was significantly different from the control group for distance walked and the physical component of the SF-12. The gym group was significantly different from the control group for walk speed and self efficacy satisfaction. Compliance rates were similar for both exercise groups, with 84% of hydrotherapy and 75% of gym sessions attended. There were no differences in drug use between groups over the study period. Conclusion: Functional gains were achieved with both exercise programmes compared with the control group. PMID:14644853

  1. Does hydrotherapy improve strength and physical function in patients with osteoarthritis--a randomised controlled trial comparing a gym based and a hydrotherapy based strengthening programme.

    Science.gov (United States)

    Foley, A; Halbert, J; Hewitt, T; Crotty, M

    2003-12-01

    To compare the effects of a hydrotherapy resistance exercise programme with a gym based resistance exercise programme on strength and function in the treatment of osteoarthritis (OA). Single blind, three arm, randomised controlled trial. 105 community living participants aged 50 years and over with clinical OA of the hip or knee. Participants were randomised into one of three groups: hydrotherapy (n = 35), gym (n = 35), or control (n = 35). The two exercising groups had three exercise sessions a week for six weeks. At six weeks an independent physiotherapist unaware of the treatment allocation performed all outcome assessments (muscle strength dynamometry, six minute walk test, WOMAC OA Index, total drugs, SF-12 quality of life, Adelaide Activities Profile, and the Arthritis Self-Efficacy Scale). In the gym group both left and right quadriceps significantly increased in strength compared with the control group, and right quadriceps strength was also significantly better than in the hydrotherapy group. The hydrotherapy group increased left quadriceps strength only at follow up, and this was significantly different from the control group. The hydrotherapy group was significantly different from the control group for distance walked and the physical component of the SF-12. The gym group was significantly different from the control group for walk speed and self efficacy satisfaction. Compliance rates were similar for both exercise groups, with 84% of hydrotherapy and 75% of gym sessions attended. There were no differences in drug use between groups over the study period. Functional gains were achieved with both exercise programmes compared with the control group.

  2. BLADE acquisition method improves T2-weighted MR images of the female pelvis compared with a standard fast spin-echo sequence

    International Nuclear Information System (INIS)

    Fujimoto, Koji; Koyama, Takashi; Tamai, Ken; Morisawa, Nobuko; Okada, Tomohisa; Togashi, Kaori

    2011-01-01

    Purpose: To investigate feasibility of the periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER or BLADE) T2-weighted imaging (T2WI) of the female pelvis by comparing it with standard fast spin-echo T2WI (STD-T2WI). Materials and methods: Sagittal STD-T2WI and BLADE-T2WI of the female pelvis were performed with (36 patients) or without (15 patients) administration of butylscopolamine on a 1.5 T MR unit. Two radiologists independently rated depiction of the uterus, ovary, intestines, bladder, gynecological lesions, overall quality, and artifacts using a four-point scale. Results were compared between STD-T2WI vs. BLADE-T2WI either with (B+) or without (B−) administration of butylscopolamine, BLADE-T2WI (B−) vs. BLADE-T2WI (B+), and STD-T2WI (B+) vs. BLADE-T2WI (B−). Results: When butylscopolamine was administrated, depiction of the uterus, ovary, intestines, gynecological lesions, and overall image quality was rated higher and artifacts were rated fewer for BLADE-T2WI with significance compared with STD-T2WI. When the drug was not administrated, significant difference was observed in depiction of the lesion, overall quality, and artifacts. Depiction of the uterus, gynecological lesion, and overall quality was rated significantly higher and artifacts were fewer in BLADE-T2WI (B+) than in BLADE-T2WI (B−). Conclusion: BLADE method was feasible for female pelvic MRI, with best image quality in BLADE-T2WI (B+).

  3. An increased flip angle in late phase Gd-EOB-DTPA MRI shows improved performance in bile duct visualization compared to T2w-MRCP

    Energy Technology Data Exchange (ETDEWEB)

    Stelter, Lars, E-mail: lars.stelter@charite.de [Klinik für Radiologie, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin (Germany); Freyhardt, Patrick, E-mail: patrick.freyhardt@charite.de [Klinik für Radiologie, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin (Germany); Grieser, Christian, E-mail: christian.grieser@charite.de [Klinik für Radiologie, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin (Germany); Walter, Thula, E-mail: thula.walter@charite.de [Klinik für Radiologie, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin (Germany); Geisel, Dominik, E-mail: dominik.geisel@charite.de [Klinik für Radiologie, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin (Germany); Baur, Alexander, E-mail: alexander.baur@charite.de [Klinik für Radiologie, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin (Germany); and others

    2014-10-15

    Highlights: • EOB-MRC acquired with a flip angle of 35° revealed a better diagnostic performance compared to T2w-MRCP. • EOB-MRC increased the readers’ confidence in identifying anatomic variations of the biliary tree. • As EOB-MRC comprises functional information it is a valuable adjunct to T2w-MRCP. - Abstract: Objectives: To estimate the additional value of an increased flip angle of 35° in late phase Gd-EOB-DTPA-enhanced magnetic resonance cholangiography, as compared to T2w-MRCP. Methods: 40 adult patients underwent Gd-EOB-DTPA enhanced MRI of the liver including a T2-weighted 3D TSE MRCP (T2w-MRCP) as well as a late phase T1-weighted THRIVE sequences applying a flip angle of 35° (fa35). Two experienced observers evaluated the images regarding the delineation of the different biliary regions using a three-point grading system. A five-point scale was applied to determine the readers’ confidence in identifying anatomical variations of the biliary tree. ROI analysis was performed to compare the signal-to-noise (SNR) and contrast-to-noise (CNR) ratios. Results: The quality for visualizing the biliary tree differed between T2w-MRCP and fa35 (p = <0.001). Late phase EOB-MRC was rated as good for delineating the entire biliary system, whereas T2w-MRCP received an overall poor rating. Especially the depiction of the intrahepatic bile ducts was estimated as problematic in T2w-MRCP. T2w-MRCP and fa35 revealed a discordant assessment of anatomical variations in 12.5% of the cases, comprising a generally higher confidence level for fa35 (4.0 ± 1.1 vs. 2.2 ± 1.2, p = <0.001). SNR proofed to be significantly higher in fa35 (p = <0.001), whereas T2w-MRCP revealed a significantly higher CNR (<0.001). Conclusions: Gd-EOB-DTPA enhanced magnetic resonance cholangiography acquired with a flip angle of 35° revealed a better diagnostic performance compared to T2w-MRCP and might be a valuable adjunct in assessing functional bile duct abnormalities.

  4. Do infants fed directly from the breast have improved appetite regulation and slower growth during early childhood compared with infants fed from a bottle?

    Directory of Open Access Journals (Sweden)

    Fisher Jennifer O

    2011-08-01

    Full Text Available Abstract Background Behavioral mechanisms that contribute to the association between breastfeeding and reduced obesity risk are poorly understood. The purpose of this study was to evaluate the hypothesis that feeding human milk from the breast (direct breastfeeding has a more optimal association with subsequent child appetite regulation behaviors and growth, when compared to bottle-feeding. Methods Children (n = 109 aged 3- to 6- years were retrospectively classified as directly breastfed (fed exclusively at the breast, bottle-fed human milk, or bottle-fed formula in the first three months of life. Young children's appetite regulation was examined by measuring three constructs (satiety response, food responsiveness, enjoyment of food associated with obesity risk, using the Child Eating Behavior Questionnaire. Multinomial logistic regression analyses were used to test whether children bottle-fed either human milk or formula had reduced odds of high satiety and increased odds of high food responsiveness and high enjoyment of food compared to children fed directly from the breast. Current child weight status and growth trends from 6-36 months were also examined for their relation to direct breastfeeding and appetite regulation behaviors in early childhood. Results Children fed human milk in a bottle were 67% less likely to have high satiety responsiveness compared to directly breastfed children, after controlling for child age, child weight status, maternal race/ethnicity, and maternal education. There was no association of bottle-feeding (either human milk or formula with young children's food responsiveness and enjoyment of food. There was neither an association of direct breastfeeding with current child weight status, nor was there a clear difference between directly breastfed and bottle-fed children in growth trajectories from 6- to 36-months. More rapid infant changes in weight-for-age score were associated with lower satiety responsiveness

  5. Effectiveness of supervised toothbrushing and oral health education in improving oral hygiene status and practices of urban and rural school children: A comparative study.

    Science.gov (United States)

    Damle, Satyawan G; Patil, Anil; Jain, Saru; Damle, Dhanashree; Chopal, Nilika

    2014-09-01

    To evaluate and compare the oral health status and the impact of supervised toothbrushing and oral health education among school children of urban and rural areas of Maharashtra, India. A total of 200 school children in the age group 12-15 years were selected by stratified random sampling technique from two schools and were further divided into two groups: Group A (urban school) and Group B (rural school). Both the groups were again subdivided into control group and study group. Supervised toothbrushing was recommended for both the groups. The toothbrushing teaching program included session on oral health education, individual toothbrushing instructions, and supervised toothbrushing. Dental caries increment, plaque scores, and gingival status were assessed as per the World Health Organization (WHO) criteria (1997), Turesky-Gilmore-Glickman modification of the Quigley Hein Plaque Index, and Loe-Silness Gingival Index (1963), respectively. Cronbach's alpha, Chi-square test, paired t-test, and unpaired t-test were utilized for data analysis. The mean plaque and gingival score reduction was significantly higher in the study groups as compared to the control groups. An increase in the mean of Decayed, missing, filled teeth (DMFT) and Decayed, missing, filled teeth and surfaces (DMFS) scores throughout the study period was seen in children who participated in study. Oral health education was effective in establishing good oral health habits among school children and also in enhancing the knowledge of their parents about good oral health.

  6. Reproductive behavior of the great hornbill (Buceros bicornis).

    Science.gov (United States)

    Kozlowski, Corinne P; Bauman, Karen L; Asa, Cheryl S

    2015-01-01

    Great hornbills (Buceros bicornis) are a long-lived, monogamous species that forms strong pair-bonds, and mate compatibility is thought to be important for successful reproduction. Within AZA, great hornbills are listed as a red SSP. The population consists of a limited number of individuals that do not breed reliably, and improving reproduction is a top priority for the Coraciiformes TAG. To better understand mating behavior and evaluate mate compatibility, this study documented the behavior of pairs of great hornbills during and immediately after courtship. Using live observations, the study followed one female, an experienced and successful breeder, as she was paired with four successive males over 11 breeding seasons. Initially, males frequently vocalized, investigated the nest, and approached the female. As the female spent more time in the nest, these behaviors were replaced by regurgitation and food offering. The female was most often observed plastering and vocalizing. Behavioral differences between successful and unsuccessful pairs, possibly indicative of pair compatibility, included rates of approaching, billing, and biting. Numerous behaviors occurred more frequently during years that a chick hatched, including pseudoregurgitation, regurgitation, offering food items, and nest investigation. Males also spent more time in proximity to both the female and the nest during years that a chick hatched. Together, these results suggest that the amount of time pairs spend in proximity, the amount of time a male spends near the nest, and the frequency of certain behaviors may help evaluate compatibility and the likelihood of successful reproduction for pairs of great hornbills. © 2015 Wiley Periodicals, Inc.

  7. Enriching Great Britain's National Landslide Database by searching newspaper archives

    Science.gov (United States)

    Taylor, Faith E.; Malamud, Bruce D.; Freeborough, Katy; Demeritt, David

    2015-11-01

    Our understanding of where landslide hazard and impact will be greatest is largely based on our knowledge of past events. Here, we present a method to supplement existing records of landslides in Great Britain by searching an electronic archive of regional newspapers. In Great Britain, the British Geological Survey (BGS) is responsible for updating and maintaining records of landslide events and their impacts in the National Landslide Database (NLD). The NLD contains records of more than 16,500 landslide events in Great Britain. Data sources for the NLD include field surveys, academic articles, grey literature, news, public reports and, since 2012, social media. We aim to supplement the richness of the NLD by (i) identifying additional landslide events, (ii) acting as an additional source of confirmation of events existing in the NLD and (iii) adding more detail to existing database entries. This is done by systematically searching the Nexis UK digital archive of 568 regional newspapers published in the UK. In this paper, we construct a robust Boolean search criterion by experimenting with landslide terminology for four training periods. We then apply this search to all articles published in 2006 and 2012. This resulted in the addition of 111 records of landslide events to the NLD over the 2 years investigated (2006 and 2012). We also find that we were able to obtain information about landslide impact for 60-90% of landslide events identified from newspaper articles. Spatial and temporal patterns of additional landslides identified from newspaper articles are broadly in line with those existing in the NLD, confirming that the NLD is a representative sample of landsliding in Great Britain. This method could now be applied to more time periods and/or other hazards to add richness to databases and thus improve our ability to forecast future events based on records of past events.

  8. Effectively Improved Field Emission Properties of Multiwalled Carbon Nanotubes/Graphenes Composite Field Emitter by Covering on the Si Pyramidal Structure

    DEFF Research Database (Denmark)

    Chen, Leifeng; Yu, Hua; Zhong, Jiasong

    2015-01-01

    The composite nanostructure emitter of multiwalled carbon nanotubes and graphenes was deposited on pyramidal silicon substrate by the simple larger scale electrophoretic deposition process. The field emission (FE) properties of the composite/pyramidal Si device were greatly improved compared...

  9. The importance of coastal altimetry retracking and detiding: A case study around the Great Barrier Reef, Australia

    DEFF Research Database (Denmark)

    Idris, Nurul H.; Deng, Xiaoli; Andersen, Ole Baltazar

    2014-01-01

    , fuzzy-retracked SLAs become available within 5 km of the coast; meanwhile it becomes more important to use pointwise tide modelling rather than state-of-the-art global tidal models, as the latter leave residual ocean tide signals in retracked SLAs. These improvements are demonstrated for Jason-2...... waveforms in the area of the Great Barrier Reef, Australia. Comparing the retrieved SLAs with in situ tide gauge data from Townsville and Bundaberg stations showed that the SLAs from this study generally outperform those from conventional methods, demonstrating that adequate waveform retracking and detiding...

  10. Improvement in toxicity in high risk prostate cancer patients treated with image-guided intensity-modulated radiotherapy compared to 3D conformal radiotherapy without daily image guidance

    International Nuclear Information System (INIS)

    Sveistrup, Joen; Rosenschöld, Per Munck af; Deasy, Joseph O; Oh, Jung Hun; Pommer, Tobias; Petersen, Peter Meidahl; Engelholm, Svend Aage

    2014-01-01

    Image-guided radiotherapy (IGRT) facilitates the delivery of a very precise radiation dose. In this study we compare the toxicity and biochemical progression-free survival between patients treated with daily image-guided intensity-modulated radiotherapy (IG-IMRT) and 3D conformal radiotherapy (3DCRT) without daily image guidance for high risk prostate cancer (PCa). A total of 503 high risk PCa patients treated with radiotherapy (RT) and endocrine treatment between 2000 and 2010 were retrospectively reviewed. 115 patients were treated with 3DCRT, and 388 patients were treated with IG-IMRT. 3DCRT patients were treated to 76 Gy and without daily image guidance and with 1–2 cm PTV margins. IG-IMRT patients were treated to 78 Gy based on daily image guidance of fiducial markers, and the PTV margins were 5–7 mm. Furthermore, the dose-volume constraints to both the rectum and bladder were changed with the introduction of IG-IMRT. The 2-year actuarial likelihood of developing grade > = 2 GI toxicity following RT was 57.3% in 3DCRT patients and 5.8% in IG-IMRT patients (p < 0.001). For GU toxicity the numbers were 41.8% and 29.7%, respectively (p = 0.011). On multivariate analysis, 3DCRT was associated with a significantly increased risk of developing grade > = 2 GI toxicity compared to IG-IMRT (p < 0.001, HR = 11.59 [CI: 6.67-20.14]). 3DCRT was also associated with an increased risk of developing GU toxicity compared to IG-IMRT. The 3-year actuarial biochemical progression-free survival probability was 86.0% for 3DCRT and 90.3% for IG-IMRT (p = 0.386). On multivariate analysis there was no difference in biochemical progression-free survival between 3DCRT and IG-IMRT. The difference in toxicity can be attributed to the combination of the IMRT technique with reduced dose to organs-at-risk, daily image guidance and margin reduction

  11. The Great Firewall of China: A Critical Analysis

    National Research Council Canada - National Science Library

    Whiting, Michael D

    2008-01-01

    Censorship has a great impact on society as we enter the cyber environment. The Chinese "Great Firewall", as it is commonly called, brings great attention to China as they enter into the global economy...

  12. Contribution of nonneutralizing vaccine-elicited antibody activities to improved protective efficacy in rhesus macaques immunized with Tat/Env compared with multigenic vaccines.

    Science.gov (United States)

    Florese, Ruth H; Demberg, Thorsten; Xiao, Peng; Kuller, LaRene; Larsen, Kay; Summers, L Ebonita; Venzon, David; Cafaro, Aurelio; Ensoli, Barbara; Robert-Guroff, Marjorie

    2009-03-15

    Previously, chronic-phase protection against SHIV(89.6P) challenge was significantly greater in macaques primed with replicating adenovirus type 5 host range mutant (Ad5hr) recombinants encoding HIVtat and env and boosted with Tat and Env protein compared with macaques primed with multigenic adenovirus recombinants (HIVtat, HIVenv, SIVgag, SIVnef) and boosted with Tat, Env, and Nef proteins. The greater protection was correlated with Tat- and Env-binding Abs. Because the macaques lacked SHIV(89.6P)-neutralizing activity prechallenge, we investigated whether Ab-dependent cellular cytotoxicity (ADCC) and Ab-dependent cell-mediated viral inhibition (ADCVI) might exert a protective effect. We clearly show that Tat can serve as an ADCC target, although the Tat-specific activity elicited did not correlate with better protection. However, Env-specific ADCC activity was consistently higher in the Tat/Env group, with sustained cell killing postchallenge exhibited at higher levels (p vaccine regimens.

  13. Improving activities of daily living in danish centenarians--but only in women: A comparative study of two birth cohorts born in 1895 and 1905

    DEFF Research Database (Denmark)

    Engberg, Henriette; Christensen, Kaare; Andersen-Ranberg, Karen

    2008-01-01

    ) and Physical Activities of Daily Living (PADLs) were assessed in both cohorts. RESULTS: The 1905 cohort displayed better self-reported ADLs than the 1895 cohort did. Stratified by gender, this apparent cohort advantage was due to women in the 1905 cohort performing significantly better than their female......BACKGROUND: The number of centenarians has increased rapidly since the 1950s. In Denmark, 42% more of the 1905 birth cohort made it to 100 years of age compared to the 1895 cohort. We tested whether this increased survival proportion has resulted in an increased disability level in the more recent...... included all individuals born in Denmark in 1905. At baseline in 1998, a total of 2262 persons participated in the intake survey (63%). In total, 225 of 364 persons (62%) who reached their 100th birthday in the cohort participated in the most recent 2005 wave. Basic Activities of Daily Living (BADLs...

  14. A translation table for patient-centered comparative effectiveness research: guidance to improve the value of research for clinical and health policy decision-making.

    Science.gov (United States)

    Tunis, Sean R; Messner, Donna A; Mohr, Penny; Gliklich, Richard E; Dubois, Robert W

    2012-05-01

    This article provides background and context for a series of papers stemming from a collaborative effort by Outcome Sciences, Inc., the National Pharmaceutical Council and the Center for Medical Technology Policy to use a stakeholder-driven process to develop a decision tool to select appropriate methods for comparative effectiveness research. The perceived need and origins of the 'translation table' concept for method selection are described and the legislative history and role of the Patient-Centered Outcomes Research Institute are reviewed. The article concludes by stressing the significance of this effort for future health services and clinical research, and the importance of consulting end-users--patients, providers, payers and policy-makers--in the process of defining research questions and approaches to them.

  15. Comparative physiological, metabolomic, and transcriptomic analyses reveal mechanisms of improved abiotic stress resistance in bermudagrass [Cynodon dactylon (L). Pers.] by exogenous melatonin

    Science.gov (United States)

    Shi, Haitao; Jiang, Chuan; Ye, Tiantian; Tan, Dun-xian; Reiter, Russel J.; Zhang, Heng; Liu, Renyi; Chan, Zhulong

    2015-01-01

    Melatonin (N-acetyl-5-methoxytryptamine), a well-known animal hormone, is also involved in plant development and abiotic stress responses. In this study, it is shown that exogenous application of melatonin conferred improved salt, drought, and cold stress resistances in bermudagrass. Moreover, exogenous melatonin treatment alleviated reactive oxygen species (ROS) burst and cell damage induced by abiotic stress; this involved activation of several antioxidants. Additionally, melatonin-pre-treated plants exhibited higher concentrations of 54 metabolites, including amino acids, organic acids, sugars, and sugar alcohols, than non-treated plants under abiotic stress conditions. Genome-wide transcriptomic profiling identified 3933 transcripts (2361 up-regulated and 1572 down-regulated) that were differentially expressed in melatonin-treated plants versus controls. Pathway and gene ontology (GO) term enrichment analyses revealed that genes involved in nitrogen metabolism, major carbohydrate metabolism, tricarboxylic acid (TCA)/org transformation, transport, hormone metabolism, metal handling, redox, and secondary metabolism were over-represented after melatonin pre-treatment. Taken together, this study provides the first evidence of the protective roles of exogenous melatonin in the bermudagrass response to abiotic stresses, partially via activation of antioxidants and modulation of metabolic homeostasis. Notably, metabolic and transcriptomic analyses showed that the underlying mechanisms of melatonin could involve major reorientation of photorespiratory and carbohydrate and nitrogen metabolism. PMID:25225478

  16. Quality improvement of services in rural tourism - Comparative analysis regarding the satisfaction level of tourists accommodated in Neamţ County

    Directory of Open Access Journals (Sweden)

    Lucian TANASĂ

    2013-09-01

    Full Text Available Regarding the hospitality industry, it is very important that clients’ wishes are recognized in order to permanently ensure the quality of the tourism services. The questionnaire, as a statistic tool, is frequently used especially at the level of important hotel chains, but it also has an applicability to small-dimensioned accommodation structures. In the current paper such a questionnaire is applied in Neamţ County to “Buhalniţa Chalet” (Hangu commune, “Eden Boarding House” (Agapia commune and “Mariko Inn” Hotel (Cordun commune, representative for the three different types of tourism practiced in each area (Izvorul Muntelui Lake touristic sub-zone - ecotourism, Târgu-Neamţ touristic zone - cultural-religious tourism and also Roman touristic sub-zone - transit tourism. The case study analyzes the satisfaction level of tourists who benefited from services offered by the tourist structures mentioned above, thus offering important information regarding the clients’ profile (from a social, ethnic, professional and financial perspective and also on other relevant elements necessary in the process of improving the marketing strategy practiced by those accommodation structures.

  17. Detecting adverse events in surgery: comparing events detected by the Veterans Health Administration Surgical Quality Improvement Program and the Patient Safety Indicators.

    Science.gov (United States)

    Mull, Hillary J; Borzecki, Ann M; Loveland, Susan; Hickson, Kathleen; Chen, Qi; MacDonald, Sally; Shin, Marlena H; Cevasco, Marisa; Itani, Kamal M F; Rosen, Amy K

    2014-04-01

    The Patient Safety Indicators (PSIs) use administrative data to screen for select adverse events (AEs). In this study, VA Surgical Quality Improvement Program (VASQIP) chart review data were used as the gold standard to measure the criterion validity of 5 surgical PSIs. Independent chart review was also used to determine reasons for PSI errors. The sensitivity, specificity, and positive predictive value of PSI software version 4.1a were calculated among Veterans Health Administration hospitalizations (2003-2007) reviewed by VASQIP (n = 268,771). Nurses re-reviewed a sample of hospitalizations for which PSI and VASQIP AE detection disagreed. Sensitivities ranged from 31% to 68%, specificities from 99.1% to 99.8%, and positive predictive values from 31% to 72%. Reviewers found that coding errors accounted for some PSI-VASQIP disagreement; some disagreement was also the result of differences in AE definitions. These results suggest that the PSIs have moderate criterion validity; however, some surgical PSIs detect different AEs than VASQIP. Future research should explore using both methods to evaluate surgical quality. Published by Elsevier Inc.

  18. Comparative physiological, metabolomic, and transcriptomic analyses reveal mechanisms of improved abiotic stress resistance in bermudagrass [Cynodon dactylon (L). Pers.] by exogenous melatonin.

    Science.gov (United States)

    Shi, Haitao; Jiang, Chuan; Ye, Tiantian; Tan, Dun-Xian; Reiter, Russel J; Zhang, Heng; Liu, Renyi; Chan, Zhulong

    2015-02-01

    Melatonin (N-acetyl-5-methoxytryptamine), a well-known animal hormone, is also involved in plant development and abiotic stress responses. In this study, it is shown that exogenous application of melatonin conferred improved salt, drought, and cold stress resistances in bermudagrass. Moreover, exogenous melatonin treatment alleviated reactive oxygen species (ROS) burst and cell damage induced by abiotic stress; this involved activation of several antioxidants. Additionally, melatonin-pre-treated plants exhibited higher concentrations of 54 metabolites, including amino acids, organic acids, sugars, and sugar alcohols, than non-treated plants under abiotic stress conditions. Genome-wide transcriptomic profiling identified 3933 transcripts (2361 up-regulated and 1572 down-regulated) that were differentially expressed in melatonin-treated plants versus controls. Pathway and gene ontology (GO) term enrichment analyses revealed that genes involved in nitrogen metabolism, major carbohydrate metabolism, tricarboxylic acid (TCA)/org transformation, transport, hormone metabolism, metal handling, redox, and secondary metabolism were over-represented after melatonin pre-treatment. Taken together, this study provides the first evidence of the protective roles of exogenous melatonin in the bermudagrass response to abiotic stresses, partially via activation of antioxidants and modulation of metabolic homeostasis. Notably, metabolic and transcriptomic analyses showed that the underlying mechanisms of melatonin could involve major reorientation of photorespiratory and carbohydrate and nitrogen metabolism. © The Author 2014. Published by Oxford University Press on behalf of the Society for Experimental Biology.

  19. Patients with Revision Modern Megaprostheses of the Distal Femur Have Improved Disease-Specific and Health-Related Outcomes Compared to Those with Primary Replacements.

    Science.gov (United States)

    Heyberger, Clémence; Auberger, Guillaume; Babinet, Antoine; Anract, Philippe; Biau, David J

    2017-12-21

    We asked whether there would be any difference between primary and revision modern cemented fixed hinge megaprosthesis of the distal femur in function and activity-related outcomes following treatment of a bone tumor. An identical custom-made fixed hinge cemented megaprosthesis with a hydroxyapatite collar was used in all cases. The main outcomes were joint-specific function, disease-specific activity, and health-related quality of life. Implant survival was also evaluated. Patients in the revision group performed slightly better than patients in the primary group on disease-specific (Toronto Extremity Salvage Score, p  = 0.033; Musculoskeletal Tumor Society, p  = 0.072) and health-related outcomes (Short Form 36 [SF-36] physical component, p  = 0.085; SF-36 mental component, p  = 0.069) but not on joint-specific outcomes (Knee Society Score, p  = 0.94). The cumulative probabilities of revision for any reason were 14.5% (7-25%) at 5 years with no statistically significant difference between primary and revision procedures ( p  = 0.77). In conclusion, patients undergoing a revision have similar joint-specific functional outcome but improved disease-specific and health-related outcomes. Implant survival are similar between groups. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  20. Carbapenem therapy is associated with improved survival compared with piperacillin-tazobactam for patients with extended-spectrum β-lactamase bacteremia.

    Science.gov (United States)

    Tamma, Pranita D; Han, Jennifer H; Rock, Clare; Harris, Anthony D; Lautenbach, Ebbing; Hsu, Alice J; Avdic, Edina; Cosgrove, Sara E

    2015-05-01

    The effectiveness of piperacillin-tazobactam (PTZ) for the treatment of extended-spectrum β-lactamase (ESBL) bacteremia is controversial. We compared 14-day mortality of PTZ vs carbapenems as empiric therapy in a cohort of patients with ESBL bacteremia who all received definitive therapy with a carbapenem. Patients hospitalized between January 2007 and April 2014 with monomicrobial ESBL bacteremia were included. A decrease of >3 doubling dilutions in the minimum inhibitory concentration for third-generation cephalosporins tested in combination with 4 µg/mL of clavulanic acid was used to confirm ESBL status. The primary exposure was empiric therapy, defined as antibiotic therapy administered to a patient before ESBL status was known. Patients were excluded if they did not receive a carbapenem after ESBL production was identified. The primary outcome was time to death from the first day of bacteremia. Propensity scores using inverse probability of exposure weighting (IPW) were used to estimate the probability that a patient would receive PTZ vs carbapenems empirically. We calculated overall hazard ratios for mortality censored at 14 days using Cox proportional hazards models on an IPW-adjusted cohort. A total of 331 unique patients with ESBL bacteremia were identified. One hundred three (48%) patients received PTZ empirically and 110 (52%) received carbapenems empirically. The adjusted risk of death was 1.92 times higher for patients receiving empiric PTZ compared with empiric carbapenem therapy (95% confidence interval, 1.07-3.45). PTZ appears inferior to carbapenems for the treatment of ESBL bacteremia. For patients at high risk of invasive ESBL infections, early carbapenem therapy should be considered. Our findings should not be extended to β-lactam/β-lactamase inhibitor combinations in development, as limited clinical data are available for these agents. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of