Human mesenchymal stem cell osteoblast differentiation, ECM deposition, and biomineralization on PAH/PAA polyelectrolyte multilayers.

Science.gov (United States)

Pattabhi, Sudhakara Rao; Lehaf, Ali M; Schlenoff, Joseph B; Keller, Thomas C S

2015-05-01

Polyelectrolyte multilayer (PEMU) coatings built layer by layer with alternating pairs of polyelectrolytes can be tuned to improve cell interactions with surfaces and may be useful as biocompatible coatings to improve fixation between implants and tissues. Here, we show that human mesenchymal stromal cells (hMSCs) induced with bone differentiation medium (BDM) to become osteoblasts biomineralize crosslinked PEMUs built with the polycation poly(allylamine hydrochloride) (PAH) and the polyanion poly(acrylic acid) (PAA). Degrees of hMSC osteoblast differentiation and surface biomineralization on the smooth PAH-terminated PEMUs (PAH-PEMUs) and microstructured PAA-terminated PEMUs (PAA-PEMUs) reflect differences in cell-deposited extracellular matrix (ECM). BDM-induced hMSCs expressed higher levels of the early osteoblast differentiation marker alkaline phosphatase and collagen 1 (COL1) sooner on PAA-PEMUs than on PAH-PEMUs. Cells on both types of PEMUs proceeded to express the later stage osteoblast differentiation marker bone sialoprotein (BSP), but the BDM-induced cells organized a more amorphous Collagen I and denser BSP localization on PAA-PEMUs than on PAH-PEMUs. These ECM properties correlated with greater biomineralization on the PAA-PEMUs than on PAH-PEMUs. Together, these results confirm the suitability of PAH/PAA PEMUs as a substrate for hMSC osteogenesis and highlight the importance of substrate effects on ECM organization and BSP presentation on biomineralization. © 2014 Wiley Periodicals, Inc.

Primary aromatic amines (PAAs) in black nylon and other food-contact materials, 2004-2009

DEFF Research Database (Denmark)

Trier, Xenia Thorsager; Okholm, B.; Foverskov, Annie

2010-01-01

Primary aromatic amines (PAAs) were analysed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) in migrates from 234 samples of food-contact materials, including black nylon (polyamide) kitchen utensils (n = 136), coloured plastics (28), and clear/printed multilayer film/laminates (41......), from retailers, importers, and food producers. A further 29 utensils in use were obtained from colleagues. Very high PAA migration was found from black nylon kitchen utensils to the food simulant 3% acetic acid: the 'non-detectable' limit (20 mu g aniline equivalents kg-1 food) was exceeded by up...... migration test conditions influenced the final test results. Long-term release of PAAs was fitted by diffusion modelling experiments and long-term release was also seen as expected from used utensils. Toxicologists consider these migration levels of the suspected carcinogenic PAAs as a problem of major...

Enhanced corrosion protective PANI-PAA/PEI multilayer composite coatings for 316SS by spin coating technique

Energy Technology Data Exchange (ETDEWEB)

Syed, Junaid Ali; Lu, Hongbin; Tang, Shaochun; Meng, Xiangkang, E-mail: mengxk@nju.edu.cn

2015-01-15

Highlights: • PANI-PAA/PEI multilayers with controllable thickness were fabricated by spin assembly. • PAA matrix results in the homogeneous dispersion of PANI in the composite coatings. • Spin coating combined with heating assures the linear increase in thickness with n. • The corrosion protection property of PANI-PAA/PEI coatings were optimized at n = 20. • Enhanced protection owing to multilayer structure that lengthens the diffusion pathway of ions. - Abstract: In the present study, polyaniline-polyacrylic acid/polyethyleneimine (PANI-PAA/PEI) composite coatings with a multilayer structure for corrosion protection of 316 stainless steels (316SS) were prepared by an alternate deposition. Spin coating combined with heating assists removal of residual water that result in a linear increase in thickness with layer number (n). The combination of PANI-PAA composite with PEI and their multilayer structure provides a synergistic enhancement of corrosion resistance properties as determined by electrochemical measurements in 3.5% NaCl solution. Importantly, the PANI-PAA/PEI coating with an optimized layer number of n = 20 shows improved corrosion protection. The superior performance was attributed to the formation of an interfacial oxide layer as well as the multilayer structure that extend the diffusion pathway of corrosive ions.

Electrical conduction of polyimide films prepared from polyamic acid (PAA and pre-imidized polyimide (PI solution

Directory of Open Access Journals (Sweden)

2007-07-01

Full Text Available Electrical conduction characteristics in two different polyimide films prepared by the imidization of polyamic acid (PAA and pre-imidized polyimide (PI solution were investigated. It is found that the current density of the polyimide film from PAA was higher than that of the polyimide film from PI at the same electric field, even though the conduction mechanism in both polyimide films follows the ionic hopping model. The hopping distance was calculated to be 2.8 nm for PAA type and 3.2 nm for PI type polyimide film. It is also found that the decay rate of the residual electrostatic charges on the polyimide films becomes faster in the PAA type than in the PI type polyimide film.

Water and Wastewater Disinfection with Peracetic Acid and UV Radiation and Using Advanced Oxidative Process PAA/UV

Directory of Open Access Journals (Sweden)

Jeanette Beber de Souza

2015-01-01

Full Text Available The individual methods of disinfection peracetic acid (PAA and UV radiation and combined process PAA/UV in water (synthetic and sanitary wastewater were employed to verify the individual and combined action of these advanced oxidative processes on the effectiveness of inactivation of microorganisms indicators of fecal contamination E. coli, total coliforms (in the case of sanitary wastewater, and coliphages (such as virus indicators. Under the experimental conditions investigated, doses of 2, 3, and 4 mg/L of PAA and contact time of 10 minutes and 60 and 90 s exposure to UV radiation, the results indicated that the combined method PAA/UV provided superior efficacy when compared to individual methods of disinfection.

Hydrogels of polyvinylpyrrolidone (PVP) and poly(acrylic acid) (PAA) synthesized by radiation-induced crosslinking of homopolymers

Science.gov (United States)

Kadłubowski, Sławomir; Henke, Artur; Ulański, Piotr; Rosiak, Janusz M.

2010-03-01

pH-sensitive PVP-PAA hydrogels have been prepared by electron-beam-induced irradiation at pH close to pKa of carboxylic groups. Protonation of these groups promoted the formation of hydrogen bonds between the PAA and PVP segments within the crosslinked structure and caused interpolymer complex formation. To demonstrate possible future application of such gels, we tested them as simple chemical detectors. When loaded with glucose oxidase, the PAA-PVP gel's turbidity and shrinkage was triggered by the presence of glucose due to a drop in pH caused by the enzymatic reaction.

A new inorganic-organic composite coagulant, consisting of polyferric sulphate (PFS) and polyacrylamide (PAA).

Science.gov (United States)

Moussas, P A; Zouboulis, A I

2009-08-01

Currently, research is focused on the synthesis of new composite coagulants, which are constituted of both inorganic and organic materials. In this paper, the development of relevant reagents was investigated, by combining the inorganic pre-polymerised iron-based coagulant Polyferric Sulphate (PFS) with an organic, non-ionic polymer (Polyacrylamide, PAA) under different PAA/Fe (mg/l) and OH/Fe molar ratios. Moreover, the new reagents were characterised in terms of typical properties, stability and morphological analysis (XRD, FTIR, SEM). Their coagulation performance, when treating low or high turbid kaolin-humic acid suspensions, was also investigated, whereas the applied coagulation mechanisms were discussed by using the Photometric Dispersion Analysis (PDA) analysis. The results show that the new coagulation reagents present improved properties, including increased effective polymer species concentration, and they exhibit very good stability. The respective tests using PDA confirmed that the predominant coagulation mechanism of PFS-PAA is the bridge formation mechanism. Coagulation experiments in low or high turbid kaolin-humic acid suspensions reveal that the novel composite reagent PFS-PAA exhibits better coagulation performance, when compared with simple PFS, in terms of zeta-potential reduction, turbidity and organic matter removal and residual iron concentration.

Crystallization and preliminary X-ray characterization of a PaaX-like protein from Sulfolobus solfataricus P2

International Nuclear Information System (INIS)

Cao, Yi; Lou, Zhiyong; Sun, Yuna; Xue, Fei; Feng, Changzeng; Gong, Xiaocui; Yang, Dongmei; Bartlam, Mark; Meng, Zhaohui; Zhang, Keqin

2009-01-01

In this study, the PaaX-like protein from the hyperthermophilic archaeon Sulfolobus solfataricus P2 was successfully crystallized by the hanging-drop vapour-diffusion method using ammonium sulfate as a precipitant. PaaX is a global regulator of the phenylacetyl-coenzyme A catabolon that adjusts the expression of different operons to that of the paa-encoded central pathway. In this study, the PaaX-like protein from the hyperthermophilic archaeon Sulfolobus solfataricus P2 was successfully crystallized by the hanging-drop vapour-diffusion method using ammonium sulfate as a precipitant. Diffraction data were obtained to a resolution of 3.0 Å using synchrotron radiation at the Photon Factory. The crystal belonged to space group P321, with unit-cell parameters a = 86.4, b = 86.4, c = 105.5 Å

Analysis of primary aromatic amines (PAA) in black nylon kitchenware 2014

DEFF Research Database (Denmark)

Trier, Xenia; Granby, Kit

is 0,01 mg of substance per kg of food or food simulant. The detection limit applies to the sum of primary aromatic amines released’ Since July 1st 2011, an additional EU regulation has come into place, which states that each consignment of polyamide (nylon) kitchen utensils from China and Hong Kong......% acetic acid as food simulant at an exposure temperature of 100°C and time from ½-4 hours, depending on the foreseeable use of the utensil. The samples were collected by the Norwegian Food Safety Authority at importers and retail shops. Of the 20 PAAs analysed. four PAAs were detected, being aniline (ANL...

Description of development of an analytical method for measurement of PAA in tattoo ink and PMU

DEFF Research Database (Denmark)

Lassen, Pia

This review gives a background on azo pigments and primary aromatic amines (PAA) and describe how to develop a robust method for analyzing these in tattoo ink.......This review gives a background on azo pigments and primary aromatic amines (PAA) and describe how to develop a robust method for analyzing these in tattoo ink....

Synthesis and photoluminescence enhancement of nano-PAA-ZnCl_2 with controllable dimension and morphology

International Nuclear Information System (INIS)

Wu, Jianguo; Wang, Kaige; Zhou, Yukun; Wang, Shuang; Zhang, Chen; Wang, Guiren

2016-01-01

Highlights: • One kind of large area nano-PAA-ZnCl_2 composite film is fabricated, its dimension and morphology is controllable. The properties of nano-composite films have been heavily influenced by the concentration of initial ZnCl_2 solution, the depth of nano-PAAM substrate and the growth time of ZnCl_2 crystals. • At room temperature, the nano-PAA-ZnCl_2 film has the same excitation center (335 nm) and emission center (430 nm) as the nano-PAAM substrate, and the PL intensities can be doubly enhanced. • After annealing at 500 °C, the emission peak spectra of the nano-composite films stabilized at 385 nm, 402 nm, and 430 nm. - Abstract: One kind of ZnCl_2 nano-films with controllable dimension and morphology is successfully synthesized on the top surface of nano-porous anodic alumina membrane (nano-PAAM) by self-organized method. The nano-PAA-ZnCl_2 composite films are characterized by field emission scanning electron microscopy, energy dispersive spectrometer, and laser confocal Raman spectroscopy. The results indicate that the concentration of initial ZnCl_2 solution, the depth of nano-PAAM substrate and the growth time of ZnCl_2 crystals have important influences on the properties of nano-composite films. Furthermore, the characteristics of nano-composites such as the photoluminescence (PL) spectra are investigated. Compared with the nano-PAAM substrate, at room temperature, all of the nano-PAA-ZnCl_2 composite films have both the same excitation center (335 nm) and emission center (430 nm), no matter what the nano-composite morphologies being; and the PL intensity of nano-PAA-ZnCl_2 composite films are all enhanced and the maximum enhancement is two times; after annealing at 500 °C, the emission spectra of the nano-composite films stabilized at the 385 nm, 402 nm and 430 nm. The research provides a new, simple, economical and practical technology to fabricate nano-PAA composite films with higher luminousintensity.

Intestinal Targeting of Ganciclovir Release Employing a Novel HEC-PAA Blended Lyomatrix.

Science.gov (United States)

Mabrouk, Mostafa; Mulla, Jameel A S; Kumar, Pradeep; Chejara, Dharmesh R; Badhe, Ravindra V; Choonara, Yahya E; du Toit, Lisa C; Pillay, Viness

2016-10-01

A hydroxyethylcellulose-poly(acrylic acid) (HEC-PAA) lyomatrix was developed for ganciclovir (GCV) intestine targeting to overcome its undesirable degradation in the stomach. GCV was encapsulated within the HEC-PAA lyomatrix prepared by lyophilization. Conventional tablets were also prepared with identical GCV concentrations in order to compare the GCV release behavior from the lyomatrix and tablets. GCV incorporation (75.12%) was confirmed using FTIR, DSC, and TGA. The effect of GCV loading on the microstructure properties of the lyomatrix was evaluated by SEM, AFM, and BET surface area measurements. The in vitro drug release study showed steady and rapid release profiles from the GCV-loaded lyomatrix compared with the tablet formulation at identical pH values. Minimum GCV release was observed at acidic pH (≤40%) and maximum release occurred at intestinal pH values (≥90%) proving the intestinal targeting ability of the lyomatrix. Kinetic modeling revealed that the GCV-loaded lyomatrix exhibited zero-order release kinetics (n = 1), while the tablets were best described via the Peppas model. Textural analysis highlighted enhanced matrix resilience and rigidity gradient (12.5%, 20 Pa) for the GCV-loaded lyomatrix compared to the pure (7%, 9.5 Pa) HEC-PAA lyomatrix. Bench-top MRI imaging was used to confirm the mechanism of GCV release behavior by monitoring the swelling and erosion rates. The swelling and erosion rate of the tablets was not sufficient to achieve rapid zero-order GCV release as with the lyomatrix. These combined results suggest that the HEC-PAA lyomatrix may be suitable for GCV intestinal targeting after oral administration.

Preparation of chitosan/MCM-41-PAA nanocomposites and the adsorption behaviour of Hg(II) ions

Science.gov (United States)

Fu, Yong; Huang, Yue; Hu, Jianshe

2018-03-01

A novel functional hybrid mesoporous composite material (CMP) based on chitosan and MCM-41-PAA was reported and its application as an excellent adsorbent for Hg(II) ions was also investigated. Innovatively, MCM-41-PAA was prepared by using diatomite and polyacrylic acid (PAA) with integrated polymer-silica hybrid frameworks, and then CMP was fabricated by introducing MCM-41-PAA to chitosan using glutaraldehyde as a cross-linking agent. The structure and morphology of CMP were characterized by X-ray diffraction, Fourier transform infrared spectra, thermogravimetric analysis, scanning electron microscopy and Brunauer-Emmett-Teller measurements. The results showed that the CMP possessed multifunctional groups such as -OH, -COOH and -NH2 with large specific surface area. Adsorption behaviour of Hg(II) ions onto CMP was fitted better by the pseudo-second-order kinetic model and the Langmuir model when the initial Hg(II) concentration, pH, adsorption temperature and time were 200 mg l-1, 4, 298 K and 120 min, respectively, as the optimum conditions. The corresponding maximum adsorption capacity could reach 164 mg g-1. According to the thermodynamic parameters determined such as free energy, enthalpy and entropy, the adsorption process of Hg(II) ions was spontaneous endothermic adsorption.

Preparation of chitosan/MCM-41-PAA nanocomposites and the adsorption behaviour of Hg(II) ions

Science.gov (United States)

Fu, Yong; Huang, Yue; Hu, Jianshe

2018-01-01

A novel functional hybrid mesoporous composite material (CMP) based on chitosan and MCM-41-PAA was reported and its application as an excellent adsorbent for Hg(II) ions was also investigated. Innovatively, MCM-41-PAA was prepared by using diatomite and polyacrylic acid (PAA) with integrated polymer–silica hybrid frameworks, and then CMP was fabricated by introducing MCM-41-PAA to chitosan using glutaraldehyde as a cross-linking agent. The structure and morphology of CMP were characterized by X-ray diffraction, Fourier transform infrared spectra, thermogravimetric analysis, scanning electron microscopy and Brunauer–Emmett–Teller measurements. The results showed that the CMP possessed multifunctional groups such as –OH, –COOH and –NH2 with large specific surface area. Adsorption behaviour of Hg(II) ions onto CMP was fitted better by the pseudo-second-order kinetic model and the Langmuir model when the initial Hg(II) concentration, pH, adsorption temperature and time were 200 mg l−1, 4, 298 K and 120 min, respectively, as the optimum conditions. The corresponding maximum adsorption capacity could reach 164 mg g−1. According to the thermodynamic parameters determined such as free energy, enthalpy and entropy, the adsorption process of Hg(II) ions was spontaneous endothermic adsorption. PMID:29657793

3D Printed, PVA–PAA Hydrogel Loaded-Polycaprolactone Scaffold for the Delivery of Hydrophilic In-Situ Formed Sodium Indomethacin

Directory of Open Access Journals (Sweden)

Mershen Govender

2018-06-01

Full Text Available 3D printed polycaprolactone (PCL-blended scaffolds have been designed, prepared, and evaluated in vitro in this study prior to the incorporation of a polyvinyl alcohol–polyacrylic acid (PVA–PAA hydrogel for the delivery of in situ-formed sodium indomethacin. The prepared PCL–PVA–PAA scaffold is proposed as a potential structural support system for load-bearing tissue damage where inflammation is prevalent. Uniaxial strain testing of the PCL-blended scaffolds were undertaken to determine the scaffold’s resistance to strain in addition to its thermal, structural, and porosimetric properties. The viscoelastic properties of the incorporated PVA–PAA hydrogel has also been determined, as well as the drug release profile of the PCL–PVA–PAA scaffold. Results of these analyses noted the structural strength, thermal stability, and porosimetric properties of the scaffold, as well as the ability of the PCL–PVA–PAA scaffold to deliver sodium indomethacin in simulated physiological conditions of pH and temperature. The results of this study therefore highlight the successful design, fabrication, and in vitro evaluation of a 3D printed polymeric strain-resistant supportive platform for the delivery of sodium indomethacin.

Synthesis and photoluminescence enhancement of nano-PAA-ZnCl{sub 2} with controllable dimension and morphology

Energy Technology Data Exchange (ETDEWEB)

Wu, Jianguo [State Key Laboratory of Cultivation Base for Photoelectric Technology and Functional Materials, Laboratory of Optoelectronic Technology of Shaanxi Province, National Center for International Research of Photoelectric Technology & Nano-functional Materials and Application, Institute of Photonics and Photon-Technology, Northwest University, Xi’an 710069 (China); Physics Department, Northwest University, Xi’an 710069 (China); Wang, Kaige, E-mail: wangkg@nwu.edu.cn [State Key Laboratory of Cultivation Base for Photoelectric Technology and Functional Materials, Laboratory of Optoelectronic Technology of Shaanxi Province, National Center for International Research of Photoelectric Technology & Nano-functional Materials and Application, Institute of Photonics and Photon-Technology, Northwest University, Xi’an 710069 (China); Zhou, Yukun; Wang, Shuang; Zhang, Chen [State Key Laboratory of Cultivation Base for Photoelectric Technology and Functional Materials, Laboratory of Optoelectronic Technology of Shaanxi Province, National Center for International Research of Photoelectric Technology & Nano-functional Materials and Application, Institute of Photonics and Photon-Technology, Northwest University, Xi’an 710069 (China); Wang, Guiren [State Key Laboratory of Cultivation Base for Photoelectric Technology and Functional Materials, Laboratory of Optoelectronic Technology of Shaanxi Province, National Center for International Research of Photoelectric Technology & Nano-functional Materials and Application, Institute of Photonics and Photon-Technology, Northwest University, Xi’an 710069 (China); Mechanical Engineering Department & Biomedical Engineering Program, University of South Carolina, Columbia SC 29208 (United States); and others

2016-12-30

Highlights: • One kind of large area nano-PAA-ZnCl{sub 2} composite film is fabricated, its dimension and morphology is controllable. The properties of nano-composite films have been heavily influenced by the concentration of initial ZnCl{sub 2} solution, the depth of nano-PAAM substrate and the growth time of ZnCl{sub 2} crystals. • At room temperature, the nano-PAA-ZnCl{sub 2} film has the same excitation center (335 nm) and emission center (430 nm) as the nano-PAAM substrate, and the PL intensities can be doubly enhanced. • After annealing at 500 °C, the emission peak spectra of the nano-composite films stabilized at 385 nm, 402 nm, and 430 nm. - Abstract: One kind of ZnCl{sub 2} nano-films with controllable dimension and morphology is successfully synthesized on the top surface of nano-porous anodic alumina membrane (nano-PAAM) by self-organized method. The nano-PAA-ZnCl{sub 2} composite films are characterized by field emission scanning electron microscopy, energy dispersive spectrometer, and laser confocal Raman spectroscopy. The results indicate that the concentration of initial ZnCl{sub 2} solution, the depth of nano-PAAM substrate and the growth time of ZnCl{sub 2} crystals have important influences on the properties of nano-composite films. Furthermore, the characteristics of nano-composites such as the photoluminescence (PL) spectra are investigated. Compared with the nano-PAAM substrate, at room temperature, all of the nano-PAA-ZnCl{sub 2} composite films have both the same excitation center (335 nm) and emission center (430 nm), no matter what the nano-composite morphologies being; and the PL intensity of nano-PAA-ZnCl{sub 2} composite films are all enhanced and the maximum enhancement is two times; after annealing at 500 °C, the emission spectra of the nano-composite films stabilized at the 385 nm, 402 nm and 430 nm. The research provides a new, simple, economical and practical technology to fabricate nano-PAA composite films with higher

In vivo kinetic analysis of the penicillin biosynthesis pathway using PAA stimulus response experiments.

Science.gov (United States)

Deshmukh, Amit T; Verheijen, Peter J T; Maleki Seifar, Reza; Heijnen, Joseph J; van Gulik, Walter M

2015-11-01

In this study we combined experimentation with mathematical modeling to unravel the in vivo kinetic properties of the enzymes and transporters of the penicillin biosynthesis pathway in a high yielding Penicillium chrysogenum strain. The experiment consisted of a step response experiment with the side chain precursor phenyl acetic acid (PAA) in a glucose-limited chemostat. The metabolite data showed that in the absence of PAA all penicillin pathway enzymes were expressed, leading to the production of a significant amount of 6-aminopenicillanic acid (6APA) as end product. After the stepwise perturbation with PAA, the pathway produced PenG within seconds. From the extra- and intracellular metabolite measurements, hypotheses for the secretion mechanisms of penicillin pathway metabolites were derived. A dynamic model of the penicillin biosynthesis pathway was then constructed that included the formation and transport over the cytoplasmic membrane of pathway intermediates, PAA and the product penicillin-G (PenG). The model parameters and changes in the enzyme levels of the penicillin biosynthesis pathway under in vivo conditions were simultaneously estimated using experimental data obtained at three different timescales (seconds, minutes, hours). The model was applied to determine changes in the penicillin pathway enzymes in time, calculate fluxes and analyze the flux control of the pathway. This led to a reassessment of the in vivo behavior of the pathway enzymes and in particular Acyl-CoA:Isopenicillin N Acyltransferase (AT). Copyright © 2015 International Metabolic Engineering Society. Published by Elsevier Inc. All rights reserved.

Elevated phenylacetic acid levels do not correlate with adverse events in patients with urea cycle disorders or hepatic encephalopathy and can be predicted based on the plasma PAA to PAGN ratio.

Science.gov (United States)

Mokhtarani, M; Diaz, G A; Rhead, W; Berry, S A; Lichter-Konecki, U; Feigenbaum, A; Schulze, A; Longo, N; Bartley, J; Berquist, W; Gallagher, R; Smith, W; McCandless, S E; Harding, C; Rockey, D C; Vierling, J M; Mantry, P; Ghabril, M; Brown, R S; Dickinson, K; Moors, T; Norris, C; Coakley, D; Milikien, D A; Nagamani, S C; Lemons, C; Lee, B; Scharschmidt, B F

2013-12-01

Phenylacetic acid (PAA) is the active moiety in sodium phenylbutyrate (NaPBA) and glycerol phenylbutyrate (GPB, HPN-100). Both are approved for treatment of urea cycle disorders (UCDs) - rare genetic disorders characterized by hyperammonemia. PAA is conjugated with glutamine in the liver to form phenylacetyleglutamine (PAGN), which is excreted in urine. PAA plasma levels ≥ 500 μg/dL have been reported to be associated with reversible neurological adverse events (AEs) in cancer patients receiving PAA intravenously. Therefore, we have investigated the relationship between PAA levels and neurological AEs in patients treated with these PAA pro-drugs as well as approaches to identifying patients most likely to experience high PAA levels. The relationship between nervous system AEs, PAA levels and the ratio of plasma PAA to PAGN were examined in 4683 blood samples taken serially from: [1] healthy adults [2], UCD patients of ≥ 2 months of age, and [3] patients with cirrhosis and hepatic encephalopathy (HE). The plasma ratio of PAA to PAGN was analyzed with respect to its utility in identifying patients at risk of high PAA values. Only 0.2% (11) of 4683 samples exceeded 500 μg/ml. There was no relationship between neurological AEs and PAA levels in UCD or HE patients, but transient AEs including headache and nausea that correlated with PAA levels were observed in healthy adults. Irrespective of population, a curvilinear relationship was observed between PAA levels and the plasma PAA:PAGN ratio, and a ratio>2.5 (both in μg/mL) in a random blood draw identified patients at risk for PAA levels>500 μg/ml. The presence of a relationship between PAA levels and reversible AEs in healthy adults but not in UCD or HE patients may reflect intrinsic differences among the populations and/or metabolic adaptation with continued dosing. The plasma PAA:PAGN ratio is a functional measure of the rate of PAA metabolism and represents a useful dosing biomarker. © 2013.

Water and Wastewater Disinfection with Peracetic Acid and UV Radiation and Using Advanced Oxidative Process PAA/UV

OpenAIRE

Beber de Souza, Jeanette; Queiroz Valdez, Fernanda; Jeranoski, Rhuan Felipe; Vidal, Carlos Magno de Sousa; Cavallini, Grasiele Soares

2015-01-01

The individual methods of disinfection peracetic acid (PAA) and UV radiation and combined process PAA/UV in water (synthetic) and sanitary wastewater were employed to verify the individual and combined action of these advanced oxidative processes on the effectiveness of inactivation of microorganisms indicators of fecal contamination E. coli, total coliforms (in the case of sanitary wastewater), and coliphages (such as virus indicators). Under the experimental conditions investigated, doses o...

Natural gold composition studied by proton activation analysis (PAA)

International Nuclear Information System (INIS)

Cojocaru, V.; Badica, T.; Popescu, I.V.

2003-01-01

The minor and trace element concentration of natural gold is essential for provenance studies of gold archaeological artifacts. In this work proton activation analysis is used in order to find what elements can be put into evidence in natural gold. For that purpose some gold nuggets from Romania were used. It was found that PAA is a good supplemental method to neutron activation analysis. (authors)

Crystallization and preliminary X-ray analysis of PaaAC, the main component of the hydroxylase of the Escherichia coli phenylacetyl-coenzyme A oxygenase complex

International Nuclear Information System (INIS)

Grishin, Andrey M.; Ajamian, Eunice; Zhang, Linhua; Cygler, Miroslaw

2010-01-01

The expression, purification, crystallization and preliminary crystallographic analysis of the PaaAC complex is reported. This is the main component of the E. coliphenylacetyl-coenzyme A oxygenase complex. The Escherichia coli paa operon encodes enzymes of the phenylacetic acid-utilization pathway that metabolizes phenylacetate in the form of a coenzyme A (CoA) derivative. The phenylacetyl-coenzyme A oxygenase complex, which has been postulated to contain five components designated PaaABCDE, catalyzes ring hydroxylation of phenylacetyl-CoA. The PaaAC subcomplex shows low sequence similarity to other bacterial multicomponent monooxygenases (BMMs) and forms a separate branch on the phylogenetic tree. PaaAC, which catalyzes the hydroxylation reaction, was purified and crystallized in the absence of a bound ligand as well as in complexes with CoA, 3-hydroxybutyryl-CoA, benzoyl-CoA and the true substrate phenylacetyl-CoA. Crystals of the ligand-free enzyme belonged to space group P2 1 2 1 2 1 and diffracted to 2.65 Å resolution, whereas complexes with CoA and its derivatives crystallized in space group P4 1 2 1 2 and diffracted to ∼2.0 Å resolution. PaaAC represents the first crystallized BMM hydroxylase that utilizes a CoA-linked substrate

Results of a Pilot-Scale Disinfection Test using Peracetic Acid (PAA) at the Oak Ridge National Laboratory (ORNL) Sewage Treatment Plant (STP)

Energy Technology Data Exchange (ETDEWEB)

Taylor, Paul Allen [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

2017-03-01

The purpose of this report is to present the results of a small pilot-scale test using PAA to disinfect a side stream of the effluent from the ORNL STP. These results provide the basis for requesting approval for full-scale use of PAA at the ORNL STP.

A novel pAA virulence plasmid encoding toxins and two distinct variants of the fimbriae of enteroaggregative Escherichia coli

DEFF Research Database (Denmark)

Jønsson, Rie; Struve, Carsten; Boll, Erik J.

2017-01-01

phylogenetically distinct, strains harboring the major pilin subunits from both AAF/III and AAF/V. Whole-genome and plasmid sequencing revealed that in these six strains the agg3A and agg5A genes were located on a novel pAA plasmid variant. Moreover, the plasmid also encoded several other virulence genes including...... some not previously found on pAA plasmids. Thus, this plasmid endows the host strains with a remarkably high number of EAEC associated virulence genes hereby likely promoting strain pathogenicity....

Brazilian policies and strategies for rural territorial development in Mozambique: South-South cooperation and the case of ProSAVANA and PAA

OpenAIRE

Clements, Elizabeth Alice [UNESP

2015-01-01

This thesis analyzes Brazil's present role in South-South development cooperation in Africa, focusing on the implementation and impact of Brazilian policies for rural territorial development in Mozambique. Specifically, two different programs for agricultural development-ProSAVANA and PAA Africa-are examined. ProSAVANA is an ongoing trilateral program run by the governments of Brazil, Japan and Mozambique that aims to modernize agriculture in three provinces in Northern Mozambique. PAA Africa...

o PAA e o PNPB

Directory of Open Access Journals (Sweden)

Dinalva Donizete Ribeiro

2013-01-01

Full Text Available The public policy for Family Agriculture, as a strategy of capitalist development in Brazilian countryside promotes tensions and conflicts to the families that make use of them. This policy is based on programs, actions and strategies that aim to insert the families in the production process, making them suitable to the market system. At the same time it denies the peasant rationality, it hides structural issues of the field, such as the need for land reform, exploitation and expropriation of the wealth and conflicts (reexistents. In order to handle and analyze such issues, highlighting the conflicts surrounding the relation between public policy and peasant families, it was analyzed the processes of implementation of the Production and Use of Biodiesel National Program (PNPB and the Acquisition of Food from Familiar Agriculture Program (PAA, in rural settlements in Jataí and Perolândia, in the Southwest area of Goiás. The data presented and discussed make up a larger research bounded to the Graduation Program in Geography from Goiás Federal University, Campus Jataí, since 2010.

Madalam veohind jääb Eestis veel unistuseks / Kadri Paas

Index Scriptorium Estoniae

Paas, Kadri, 1982-

2008-01-01

Ilmunud ka: Delovõje Vedomosti 1. okt. lk. 22. Vedajad sõltuvad Eesti kütusemüüjate diktaadist, mistõttu kütusehinnad ei ole siin samas tempos vähenenud. Vt. samas: Nafta nõudlus kuivab kokku; Kadrin Kärner, Kadri Paas. Jaan Lepp: kütusehindade tõus on firmadele jätnud kustumatu jälje; Diagramm: Nafta ja bensiini hind jätkuvas languses. Küsimusele vastab Ilo Rannu

Co-existence of COPD and bronchiectasis: a risk factor for a high ratio of main pulmonary artery to aorta diameter (PA:A from computed tomography in COPD patients

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Dou S

2018-02-01

Full Text Available Shuang Dou,1 Chunyan Zheng,1 Xiuli Ji,2 Wei Wang,1 Mengshuang Xie,1 Liwei Cui,1 Wei Xiao1 1Department of Pulmonary Medicine, Qilu Hospital, Shandong University, Jinan, People’s Republic of China; 2Department of Pulmonary Disease, Jinan Traditional Chinese Medicine Hospital, Jinan, People’s Republic of China Background: Pulmonary vascular disease, especially pulmonary hypertension, is an important complication of COPD. Bronchiectasis is considered not only a comorbidity of COPD, but also a risk factor for vascular diseases. The main pulmonary artery to aorta diameter ratio (PA:A ratio has been found to be a reliable indicator of pulmonary vascular disease. It is hypothesized that the co-existence of COPD and bronchiectasis may be associated with relative pulmonary artery enlargement (PA:A ratio >1.Methods: This retrospective study enrolled COPD patients from 2012 through 2016. Demographic and clinical data were collected. Bhalla score was used to determine the severity of bronchiectasis. Patient characteristics were analyzed in two ways: the high (PA:A >1 and low (PA:A ≤1 ratio groups; and COPD with and without bronchiectasis groups. Logistic regression analysis was used to assess risk factors for high PA:A ratios.Results: In this study, 480 COPD patients were included, of whom 168 had radiographic bronchiectasis. Patients with pulmonary artery enlargement presented with poorer nutrition (albumin, 35.6±5.1 vs 38.3±4.9, P<0.001, lower oxygen partial pressure (74.4±34.5 vs 81.3±25.4, P<0.001, more severe airflow obstruction (FEV1.0, 0.9±0.5 vs 1.1±0.6, P=0.004, and a higher frequency of bronchiectasis (60% vs 28.8%, P<0.001 than patients in the low ratio group. Patients with both COPD and bronchiectasis had higher levels of systemic inflammation (erythrocyte sedimentation rate, P<0.001 and fibrinogen, P=0.006 and PA:A ratios (P<0.001. A higher PA:A ratio was significantly closely correlated with a higher Bhalla score (r=0.412, P<0

Peroxyacetyl nitrate (PAN and peroxyacetic acid (PAA measurements by iodide chemical ionisation mass spectrometry: first analysis of results in the boreal forest and implications for the measurement of PAN fluxes

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G. J. Phillips

2013-02-01

Full Text Available We describe measurements of peroxyacetyl nitrate (CH₃C(OO₂NO₂, PAN and peroxyacetic acid (CH₃C(OOOH, PAA in the Boreal forest using iodide chemical ionization mass spectrometry (ICIMS. The measurements were made during the Hyytiälä United Measurement of Photochemistry and Particles – Comprehensive Organic Particle and Environmental Chemistry (HUMPPA-COPEC-2010 measurement intensive. Mixing ratios of PAN and PAA were determined by measuring the acetate ion signal (CH₃C(OO⁻, m/z = 59 resulting from reaction of CH₃C(OO₂ (from the thermal dissociation of PAN or CH₃C(OOOH with iodide ions using alternatively heated and ambient temperature inlet lines. During some periods of high temperature (~ 30 °C and low NO_x (< 1 ppbv, PAA mixing ratios were similar to, or exceeded those of PAN and thus contributed a significant fraction of the total acetate signal. PAA is thus a potential interference for ICIMS measurements of PAN, and especially eddy covariance flux measurements in environments where the PAA flux is likely to be a significant proportion of the (short timescale acetate ion variability. Within the range of mixing ratios of NO_x measured during HUMPPA-COPEC, the modelled ratio of PAA-to-PAN was found to be sensitive to temperature (through the thermal decomposition rate of PAN and the HO₂ mixing ratio, thus providing some constraint to estimates of photochemical activity and oxidation rates in the Boreal environment.

The Influence of Lyophilized EmuGel Silica Microspheres on the Physicomechanical Properties, In Vitro Bioactivity and Biodegradation of a Novel Ciprofloxacin-Loaded PCL/PAA Scaffold

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Mostafa Mabrouk

2016-06-01

Full Text Available A new composite poly(caprolactone (PCL and poly(acrylic acid (PAA (PCL:PAA 1:5 scaffold was synthesized via dispersion of PCL particles into a PAA network. Silica microspheres (Si (2–12 μm were then prepared by a lyophilized micro-emulsion/sol-gel (Emugel system using varying weight ratios. The model drug ciprofloxacin (CFX was used for in situ incorporation into the scaffold. The physicochemical and thermal integrity, morphology and porosity of the system was analyzed by X-Ray Diffraction (XRD, Attenuated Total Refelctance Fourier Transform Infrared (ATR-FTIR, Differential Scanning Calorimetry (DSC, SEM, surface area analysis and liquid displacement, respectively. The mechanical properties of the scaffold were measured by textural analysis and in vitro bioactivity, biodegradation and pH variations were evaluated by XRD, FTIR and SEM after immersion in Simulated Body Fluid (SBF. The in vitro and in vivo studies of the prepared scaffold were considered as future aspects for this study. CFX release was determined in phosphate buffer saline (PBS (pH 7.4; 37 °C. The incorporation of the Si microspheres and CFX into the scaffold was confirmed by XRD, FTIR, DSC and SEM, and the scaffold microstructure was dependent on the concentration of Si microspheres and the presence of CFX. The system displayed enhanced mechanical properties (4.5–14.73 MPa, in vitro bioactivity, biodegradation and controlled CFX release. Therefore, the PCL/PAA scaffolds loaded with Si microspheres and CFX with a porosity of up to 87% may be promising for bone tissue engineering.

Toroidal cores of Mn{sub x}Co{sub 1−x}Fe{sub 2}O{sub 4}/PAA nanocomposites with potential applications in antennas

Energy Technology Data Exchange (ETDEWEB)

Alcalá, Olgi [Laboratorio de Física de la Materia Condensada, Centro de Física, Instituto Venezolano de Investigaciones Científicas (IVIC), Apartado 20632, Caracas, 1020-A (Venezuela, Bolivarian Republic of); Briceño, Sarah [Laboratorio de Materiales, Centro de Ingenieria de Materiales y Nanotecnología, Instituto Venezolano de Investigaciones Científicas (IVIC), Apartado 20632, Caracas, 1020-A (Venezuela, Bolivarian Republic of); Brämer-Escamilla, Werner [Laboratorio de Física de la Materia Condensada, Centro de Física, Instituto Venezolano de Investigaciones Científicas (IVIC), Apartado 20632, Caracas, 1020-A (Venezuela, Bolivarian Republic of); Silva, Pedro, E-mail: pejosi@gmail.com [Laboratorio de Física de la Materia Condensada, Centro de Física, Instituto Venezolano de Investigaciones Científicas (IVIC), Apartado 20632, Caracas, 1020-A (Venezuela, Bolivarian Republic of)

2017-05-01

In this work, we study the electrical response of toroidal coils with cores of mixed ferrites magnetic nanoparticles (MNPs) embedded in a polyacrylamide matrix (Mn{sub x}Co{sub 1−x}Fe{sub 2}O{sub 4}/PAA, 0 ≤ x ≤ 1). The MNPs were synthesized by thermal decomposition of molecular precursors and Mn{sub x}Co{sub 1−x}Fe{sub 2}O{sub 4}/PAA toroidal cores were constructed by using the method of copolymerization of MNPs with acrylamide and bis-acrylamide. X-Ray Diffraction (XRD) patterns of MNPs correspond to the cubic spinel phase. The MNPs average size obtained by using Transmission Electron Microscopy (TEM) ranges from 6 to 12 nm. In order to compare our results we measure the characteristics of a commercial toroidal coil and we found that the impedance curves show a resonance peak for each configuration (commercial and Laboratory-made coils) around 75 MHz; the signal intensity of the Laboratory-made coil increases by one order of magnitude with respect to the commercial coil. We found that both, magnetic and electrical measurements, are related to the manganese concentration. The advantage of the designed Mn{sub x}Co{sub 1−x}Fe{sub 2}O{sub 4}/PAA toroidal coils system lies in the fact that versatile combinations of Mn{sup 2+} and Co{sup 2+} components can bring facile tuning of the electrical and magnetic properties to optimize the impedance of the coils. - Highlights: • We prepare Mn{sub x}Co{sub 1−x}Fe{sub 2}O{sub 4} nanoparticles (MNPs) using a thermal decomposition method. • Mn{sub x}Co{sub 1−x}Fe{sub 2}O{sub 4}/PAA nanocomposite were prepared embedding the MNPs in a Polyacrylamide matrix. • Toroidal coils with cores of the Mn{sub x}Co{sub 1−x}Fe{sub 2}O{sub 4}/PAA nanocomposite were prepared. • We Compare Impedance measurements in our cores with that of a commercial core T50. • The intensity peak around 75 MHz was one order of magnitude greater in our cores.

Activity concentration and radiological impact assessment of 226Ra, 228Ra and 40K in drinking waters from (OML) 30, 58 and 61 oil fields and host communities in Niger Delta region of Nigeria

International Nuclear Information System (INIS)

Agbalagba, E.O.; Avwiri, G.O.; Ononugbo, C.P.

2013-01-01

This paper presents the concentrations of naturally occurring radionuclides ( 226 Ra, 228 Ra and 40 K) measured in hand dug wells, boreholes and river waters collected from three oil mineral leases (OML) 30, 58 and 61 oil and gas fields onshore of the Niger delta, using gamma spectroscopy. Fifty-four water samples from the three sources of drinking water supply were collected within the oil fields and host communities and three water samples from a control site. The results showed average activity concentrations of 226 Ra, 228 Ra and 40 K as 8.9 ± 1.0, 8.1 ± 0.9 and 39.8 ± 3.3 respectively for hand dug wells, 4.4 ± 0.8, 4.6 ± 0.5 and 28.5 ± 3.0 for borehole water and 8.2 ± 1.0, 6.7 ± 0.7 and 32.1 ± 3.5 for river water respectively. These 226 Ra, 228 Ra and 40 K average are well above the WHO permissible levels of 1.0, 0.1 and 10 BqL −1 respectively and also above the control values. Although the hazard indices calculated are still within their tolerable levels, the estimated committed effective dose due to intake of the sampled water for all the four age groups considered are far above the ICPR 0.1 mSvyr −1 maximum permissible limit. The result indicates some level of water pollution in the studied area. - Highlights: ► The concentration of natural radioactive series nuclides varies widely within oil fields and from one oil field to another in the OML30. ► The radionuclide activity concentrations in most water samples are higher than world average values. ► Calculated hazard indices and committed effective dose to assess the potential radiological health risk in samples are well above their permissible limit. ► The sources of water in these oil fields have been polluted and may cause some health hazard to the public users.

Amperometric biosensor based on direct electrochemistry of hemoglobin in poly-allylamine (PAA) film

International Nuclear Information System (INIS)

Kafi, A.K.M.; Lee, Dong-Yun; Park, Sang-Hyun; Kwon, Young-Soo

2007-01-01

Hemoglobin (Hb) was immobilized in poly-allylamine (PAA) film onto the gold electrode by layer by layer (LBL) method. The modified electrode exhibited a pair of well-defined peaks during cyclic voltammetry, which was attributed from the direct electron transfer of heme proteins. The immobilized Hb showed an excellent electrocatalytical response to the reduction of hydrogen peroxide. The sensor exhibited a fast response and high sensitivity. Through the use of optimized conditions, the linear range for H 2 O 2 detection was from 2.5 x 10 -6 M to 5 x 10 -4 M with detection limit of 0.2 μM. The proposed biosensor showed long-lasting stability and excellent reproducibility

Synthesis, surface modification/decoration of luminescent–magnetic core/shell nanomaterials, based on the lanthanide doped fluorides (Fe3O4/SiO2/NH2/PAA/LnF3)

International Nuclear Information System (INIS)

Runowski, Marcin; Lis, Stefan

2016-01-01

The synthesized magnetite nanoparticles (10–15 nm) were successfully coated with amine modified silica nanoshell, which led to the formation of core/shell type nanostructures (30–50 nm). The as-prepared nanoparticles were surface modified with polyacrylic acid (PAA) via electrostatic interactions of –NH 2 and –COOH groups. Afterwards, the surface PAA molecules acted as complexing agents of the introduced lanthanide (Ln 3+ ) ions. Subsequently, the as-prepared nanostructures were surface decorated with luminescent LnF 3 nanoparticles, forming Eu 3+ or Tb 3+ doped Fe 3 O 4 /SiO 2 /NH 2 /PAA/LnF 3 nanomaterials (50–100 nm). The obtained luminescent–magnetic products exhibited simultaneously bright red or green emission under UV lamp irradiation (λ ex =254 nm), and a response for the applied magnetic field (strong magnet attracts the colloidal particles, dispersed in aqueous medium). After the synthesis, properties of the nanomaterials were investigated by powder X-ray diffraction (XRD) technique, transmission electron microscopy (TEM), infrared spectroscopy (IR) and spectrofluorometry (analysis of excitation/emission spectra and luminescence decay curves). Such advanced nanomaterials can be potentially used in multimodal imaging, targeted therapies and as multifunctional contrast agents, novel luminescent–magnetic tracers, protection of documents, etc. - Highlights: • Luminescent–magnetic nanomaterials Fe 3 O 4 /SiO 2 /NH 2 /PAA/LnF 3 were synthesized. • Core/shell nanostructures were obtained by surface modification of nanoparticles. • Luminescent lanthanide fluoride nanoparticles doped with Eu 3+ and Tb 3+ ions. • Multifunctional core/shell nanostructures exhibited red or green emission. • Nanomaterials formed stable aqueous colloids.

Interpretation of the quasi-elastic neutron scattering on PAA by rotational diffusion models

International Nuclear Information System (INIS)

Bata, L.; Vizi, J.; Kugler, S.

1974-10-01

First the most important data determined by other methods for para azoxy anisolon (PAA) are collected. This molecule makes a rotational oscillational motion around the mean molecular direction. The details of this motion can be determined by inelastic neutron scattering. Quasielastic neutron scattering measurements were carried out without orienting magnetic field on a time-of-flight facility with neutron beam of 4.26 meV. For the interpretation of the results two models, the spherical rotation diffusion model and the circular random walk model are investigated. The comparison shows that the circular random walk model (with N=8 sites, d=4A diameter and K=10 10 s -1 rate constant) fits very well with the quasi-elastic neutron scattering, while the spherical rotational diffusion model seems to be incorrect. (Sz.N.Z.)

Colhendo os frutos : dificuldades e conquistas da modalidade do PAA compra-institucional em uma Universidade Pública

OpenAIRE

Paula, Natália Ferreira de

2016-01-01

Orientadora : Profª. Drª. Islandia Bezerra Coorientadora : Profª Dra. Mônica de Caldas Rosa dos Anjos Dissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação em Alimentação e Nutrição. Defesa: Curitiba, 27/07/2016 Inclui referências : f. 72-79;81-89 Resumo: O Programa de Aquisição de Alimentos da Agricultura Familiar (PAA) foi criado no Brasil em 2003, a partir de proposições da sociedade civil e adotado como uma estratégia de...

Oral mucosal lesions in a Chilean elderly population: A retrospective study with a systematic review from thirteen countries.

Science.gov (United States)

Rivera, César; Droguett, Daniel; Arenas-Márquez, María-Jesús

2017-02-01

The oral examination is an essential part of the multidisciplinary medical care in elderly people. Oral mucosal lesions and normal variations of oral anatomy (OMLs) are very common in this people, but few studies have examined the frequency and prevalence of these conditions worldwide and less in Chile. The aim of this research was to evaluate the frequency of OMLs in a Chilean elderly population. It was conducted a retrospective study (Talca, Chile). Two hundred seventy-seven OMLs were classified in groups and anatomical sites. In order to contextualize our numbers, we made a systematic review using Publish or Perish software, Google Scholar and InteractiVenn. The most prevalent OMLs groups were soft tissue tumors, epithelial pathology, facial pain and neuromuscular diseases, and dermatologic diseases. The most frequent OMLs included irritation fibroma (30 patients, 10.8%), hemangioma (20, 7.2%), burning mouth syndrome (20 cases, 7.2%), oral lichen planus (12, 4.3%) and epulis fissuratum (12, 4.3%). In the systematic review, 75 OMLs were relevant and the more studied pathologies were traumatic ulcerations (11 of 15 articles), oral lichen planus (10/15), irritation fibroma, melanotic pigmentations, and recurrent aphthous stomatitis (9/10, respectively). Considering all included articles, most frequent OMLs in elderly people included denture-related stomatitis (13.3%), irritation fibroma (8.7%) and fissured tongue (6.3%). The results reflect the frequency of OMLs diagnosed in a specialized service in south of Chile and many countries around the world. These numbers will allow the establishment of preventive politics and adequacy of the clinical services. Key words: Oral mucosal lesions, elderly people, Chilean population, frequency, systematic review.

Oral mucosal lesions in skin diseased patients attending a dermatologic clinic: a cross-sectional study in Sudan

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Salman Hussein

2011-09-01

Full Text Available Abstract Background So far there have been no studies focusing on the prevalence of a wide spectrum of oral mucosal lesions (OML in patients with dermatologic diseases. This is noteworthy as skin lesions are strongly associated with oral lesions and could easily be neglected by dentists. This study aimed to estimate the frequency and socio-behavioural correlates of OML in skin diseased patients attending outpatient's facility of Khartoum Teaching Hospital - Dermatology Clinic, Sudan. Methods A cross-sectional hospital-based study was conducted in Khartoum from October 2008 to January 2009. A total of 588 patients (mean age 37.2 ± 16 years, 50.3% females completed an oral examination and a personal interview of which 544 patients (mean age 37.1 ± 15.9 years, 50% females with confirmed skin disease diagnosis were included for further analyses. OML were recorded using the World Health Organization criteria (WHO. Biopsy and smear were used as adjuvant techniques for confirmation. Data were analysed using the Statistical Package for Social Science (Version 15.0.1. Cross tabulation and Chi-square with Fisher's exact test were used. Results A total of 438 OML were registered in 315 (57.9%, males: 54.6% versus females: 45.6%, p Tongue lesions were the most frequently diagnosed OML (23.3%, followed in descending order by white lesions (19.1%, red and blue lesions (11% and vesiculobullous diseases (6%. OML in various skin diseases were; vesiculobullous reaction pattern (72.2%, lichenoid reaction pattern (60.5%, infectious lesions (56.5%, psoriasiform reaction pattern (56.7%, and spongiotic reaction pattern (46.8%. Presence of OML in skin diseased patients was most frequent in older age groups (62.4% older versus 52.7% younger, p Conclusions OML were frequently diagnosed in skin diseased patients and varied systematically with age, gender, systemic condition and use of toombak. The high prevalence of OML emphasizes the importance of routine examination

Prevalence of oral mucosal lesions in dermatologically diseased patients: A cross-sectional study in Meerut

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Tanushree Keswani

2014-01-01

Full Text Available Introduction: It is a noted fact that dermatologic diseases have varied oral manifestations. By far, there have been inordinately few studies focusing on the prevalence of a wide spectrum of oral mucosal lesions (OML in patients with dermatologic diseases. This is significant as oral lesions may be the only or the primary feature of the skin disease, which could be neglected by dentists. This study aimed to estimate the frequency and sociobehavioral correlates of OML in skin disease patients attending outpatient′s facility of Subharti Hospital, Dermatology Clinic, Meerut, India. Materials and Methods: This was a cross-sectional hospital-based study conducted in Meerut during the period from August 2013 to October 2013. A total of 500 patients (mean age 37.2 ± 14.11 years, 41.4% females completed an oral examination and a personal interview. OML were recorded using the World Health Organization criteria. Data were analyzed using the Statistical Package for Social Science (version 15.0.1. Cross tabulation and Chi-square with Fisher′s exact test were used. Results: At least one kind of OML was registered in 11.8%, males (58.6%: 60.0% versus females (40.0%: 45.6%, P < 0.01 skin disease patients. Thus, a certain number of patients had more than one type of OML. Aphthae were the most frequently diagnosed OML (3.4%, followed in descending order by oral lichen planus (1.8% and geographic tongue (1.6%. Conclusion: OML were frequently diagnosed in skin disease patients (11.80% and varied systematically with the dermatologic disease, age, and gender. The substantial prevalence rates of OML emphasize the importance of routine examination of the oral mucosa in a dermatology clinic.

Guidelines for calculating impacts on the Swedish environmental objectives from altered energy use; Vaegledning foer att beraekna paaverkan fraan foeraendrad energianvaendning paa de svenska miljoemaalen

Energy Technology Data Exchange (ETDEWEB)

Engstroem, Rebecka; Gode, Jenny; Axelsson, Ulrik

2009-01-15

The guidelines in this report have been developed by IVL Swedish Environmental Research Institute, within a project financed by the Environmental Objectives Council, the Swedish Energy Agency and the Swedish Environmental Protection Agency. The idea originated from an earlier project for the Swedish Energy Agency and the Swedish Environmental Protection Agency, where the potential of a business model for energy efficiency (Energy Performance Contracting, EPC) to contribute to fulfil the national environmental objectives was studied. When environmental impacts from the studied EPC projects was to be calculated, it was evident how many difficult methodological choices one is faced with when trying to follow up the environmental impacts from projects changing the energy use. A second project was then performed to further analyse the issues involved. The result is this guideline report. The guidelines are on the first hand directed at companies and municipalities performing projects with effects on the energy use, that want to calculate impacts from these on the Swedish environmental objectives. The guidelines can also be useful for county administrations, central authorities and other actors with interest in the issues. A starting point for the recommendations is the Swedish environmental objectives, with focus on those of special interest in relation to energy use and airborne emissions. These are Reduced climate impact, Clean air, Natural acidification only, Zero eutrophication and A good built environment. The environmental objectives are mainly concentrated on what affects the Swedish environment. However, not only emissions in Sweden cause such effects, but also emissions in other countries can be transported by air and fall down and cause impacts in Sweden. Thus, the guidelines focus on Sweden, but include to a certain extent also emissions in other countries. Another starting point is that the guidelines are developed to follow up effects from individual

Orbital-motion-limited theory of dust charging and plasma response

International Nuclear Information System (INIS)

Tang, Xian-Zhu; Luca Delzanno, Gian

2014-01-01

The foundational theory for dusty plasmas is the dust charging theory that provides the dust potential and charge arising from the dust interaction with a plasma. The most widely used dust charging theory for negatively charged dust particles is the so-called orbital motion limited (OML) theory, which predicts the dust potential and heat collection accurately for a variety of applications, but was previously found to be incapable of evaluating the dust charge and plasma response in any situation. Here, we report a revised OML formulation that is able to predict the plasma response and hence the dust charge. Numerical solutions of the new OML model show that the widely used Whipple approximation of dust charge-potential relationship agrees with OML theory in the limit of small dust radius compared with plasma Debye length, but incurs large (order-unity) deviation from the OML prediction when the dust size becomes comparable with or larger than plasma Debye length. This latter case is expected for the important application of dust particles in a tokamak plasma

Synthesis, surface modification/decoration of luminescent–magnetic core/shell nanomaterials, based on the lanthanide doped fluorides (Fe{sub 3}O{sub 4}/SiO{sub 2}/NH{sub 2}/PAA/LnF{sub 3})

Energy Technology Data Exchange (ETDEWEB)

Runowski, Marcin; Lis, Stefan, E-mail: blis@amu.edu.pl

2016-02-15

The synthesized magnetite nanoparticles (10–15 nm) were successfully coated with amine modified silica nanoshell, which led to the formation of core/shell type nanostructures (30–50 nm). The as-prepared nanoparticles were surface modified with polyacrylic acid (PAA) via electrostatic interactions of –NH{sub 2} and –COOH groups. Afterwards, the surface PAA molecules acted as complexing agents of the introduced lanthanide (Ln{sup 3+}) ions. Subsequently, the as-prepared nanostructures were surface decorated with luminescent LnF{sub 3} nanoparticles, forming Eu{sup 3+} or Tb{sup 3+} doped Fe{sub 3}O{sub 4}/SiO{sub 2}/NH{sub 2}/PAA/LnF{sub 3} nanomaterials (50–100 nm). The obtained luminescent–magnetic products exhibited simultaneously bright red or green emission under UV lamp irradiation (λ{sub ex}=254 nm), and a response for the applied magnetic field (strong magnet attracts the colloidal particles, dispersed in aqueous medium). After the synthesis, properties of the nanomaterials were investigated by powder X-ray diffraction (XRD) technique, transmission electron microscopy (TEM), infrared spectroscopy (IR) and spectrofluorometry (analysis of excitation/emission spectra and luminescence decay curves). Such advanced nanomaterials can be potentially used in multimodal imaging, targeted therapies and as multifunctional contrast agents, novel luminescent–magnetic tracers, protection of documents, etc. - Highlights: • Luminescent–magnetic nanomaterials Fe{sub 3}O{sub 4}/SiO{sub 2}/NH{sub 2}/PAA/LnF{sub 3} were synthesized. • Core/shell nanostructures were obtained by surface modification of nanoparticles. • Luminescent lanthanide fluoride nanoparticles doped with Eu{sup 3+} and Tb{sup 3+} ions. • Multifunctional core/shell nanostructures exhibited red or green emission. • Nanomaterials formed stable aqueous colloids.

Oral mucosal lesions in denture wearers.

Science.gov (United States)

Jainkittivong, Aree; Aneksuk, Vilaiwan; Langlais, Robert P

2010-03-01

To determine the prevalence of oral mucosal lesions (OMLs) and denture-related mucosal lesions (DMLs) in denture wearers and to co-relate the prevalence with age, gender, type of denture and any systemic conditions. Dental records of 380 denture wearers were retrospectively reviewed for OMLs and DMLs. We found 45% of the denture wearers had DMLs and 60.8% had OMLs not related to denture wearing. Although the prevalence of DMLs was higher in complete denture wearers than in partial denture wearers (49% vs. 42.2%), this difference was not significant. The most common DMLs were traumatic ulcer (19.5%) and denture-induced stomatitis (18.1%). When analysed by type, traumatic ulcer, denture hyperplasia, frictional keratosis and candidiasis were more common in complete denture wearers, whereas denture-induced stomatitis was more common in partial denture wearers. Frictional keratosis was more common in men than in women. The prevalence of OMLs not related to denture wearing was higher in complete denture wearers than in partial denture wearers, and the most common OML was fissured tongue (27.6%). No association between DMLs and systemic conditions or xerostomic drugs was noted. No differences in the prevalence of DMLs in association with denture type were found. The prevalence of OMLs not related to denture wearing was higher in complete denture wearers than in partial denture wearers. This difference was affected by age, and the data were similar to the findings observed in the elderly.

Adherence of physical therapy with clinical practice guidelines for the rehabilitation of stroke in an active inpatient setting.

Science.gov (United States)

M S, Ajimsha; Kooven, Smithesh; Al-Mudahka, Noora

2018-03-09

Clinical guidelines are systematically developed statements designed to help practitioners and patients to make decisions about appropriate health care. Clinical practice guideline adherence analysis is the best way to fine tune the best practices in a health care industry with international benchmarks. To assess the physical therapist's adherence to structured stroke clinical practice guidelines in an active inpatient rehabilitation center in Qatar. Department of Physical therapy in the stroke rehabilitation tertiary referral hospital in Qatar. A retrospective chart audit was performed on the clinical records of 216 stroke patients discharged from the active inpatient stroke rehabilitation unit with a diagnosis of stroke in 2016. The audit check list was structured to record the adherence of the assessment, goal settings and the management domains as per the "Physical Therapy After Acute Stroke" (PAAS) guideline. Of the 216 case files identified during the initial search, 127 files were ultimately included in the audit. Overall adherence to the clinical practice guideline was 71%, a comparable rate with the studies analyzing the same in various international health care facilities. Domains which were shared by interdisciplinary teams than managed by physical therapy alone and treatments utilizing sophisticated technology had lower adherence with the guideline. A detailed strength and weakness breakdown were then conducted. This audit provides an initial picture of the current adherence of physical therapy assessment and management with the stroke physical therapy guideline at a tertiary rehabilitation hospital in the state of Qatar. An evaluation of the guideline adherence and practice variations helps to fine tune the physical therapy care to a highest possible standard of practice. Implications for Rehabilitation  • An evaluation of the guideline adherence and practice variations helps to fine tune the rehabilitation care to the highest possible standard

Pre/post-strike atmospheric assessment system (PAAS)

International Nuclear Information System (INIS)

Peglow, S. G.; Molitoris, J. D.

1997-01-01

The Pre/Post-Strike Atmospheric Assessment System was proposed to show the importance of local meteorological conditions in the vicinity of a site suspected of storing or producing toxic agents and demonstrate a technology to measure these conditions, specifically wind fields. The ability to predict the collateral effects resulting from an attack on a facility containing hazardous materials is crucial to conducting effective military operations. Our study approach utilized a combination of field measurements with dispersion modeling to better understand which variables in terrain and weather were most important to collateral damage predictions. To develop the PAAS wind-sensing technology, we utilized a combination of emergent and available technology from micro-Doppler and highly coherent laser systems. The method used for wind sensing is to probe the atmosphere with a highly coherent laser beam. As the beam probes, light is back-scattered from particles entrained in the air to the lidar transceiver and detected by the instrument. Any motion of the aerosols with a component along the beam axis leads to a Doppler shift of the received light. Scanning in a conical fashion about the zenith results in a more accurate and two-dimensional measurement of the wind velocity. The major milestones in the benchtop system development were to verify the design by demonstrating the technique in the laboratory, then scale the design down to a size consistent with a demonstrator unit which could be built to take data in the field. The micro-Doppler heterodyne system we developed determines absolute motion by optically mixing a reference beam with the return signal and has shown motion sensitivity to better than 1 cm/s. This report describes the rationale, technical approach and laboratory testing undertaken to demonstrate the feasibility and utility of a system to provide local meteorological data and predict atmospheric particulate motion. The work described herein was funded by

OMI/Aura Level 1B VIS Zoom-in Geolocated Earthshine Radiances 1-orbit L2 Swath 13x12 km V003

Data.gov (United States)

National Aeronautics and Space Administration — The Level-1B (L1B) Radiance Product OML1BRVZ (Version-3) from the Aura-OMI is now available (http://disc.gsfc.nasa.gov/Aura/OMI/oml1brvz_v003.shtml) to public from...

OMI/Aura Level 1B UV Global Geolocated Earthshine Radiances 1-orbit L2 Swath 13x24 km V003

Data.gov (United States)

National Aeronautics and Space Administration — The Level-1B (L1B) Radiance Product OML1BRUG (Version-3) from the Aura-OMI is now available to public (http://disc.gsfc.nasa.gov/Aura/OMI/oml1brug_v003.shtml) from...

OMI/Aura Level 1B UV Zoom-in Geolocated Earthshine Radiances 1-orbit L2 Swath 13x12 km V003

Data.gov (United States)

National Aeronautics and Space Administration — The Level-1B (L1B) Radiance Product OML1BRUZ (Version-3) from the Aura-OMI is now available (http://disc.gsfc.nasa.gov/Aura/OMI/oml1bruz_v003.shtml) to public from...

A Silvicultural Revolution. The Dissolution of Traditional Agro-Forestry in Denmark. AD 1730 - 1820

DEFF Research Database (Denmark)

Fritzbøger, Bo

1998-01-01

Skovbruget undergik i 1700-tallet akkurat lige som landbruget en gennemgribende omlægning af såvel værdisæt og målsætninger som teknologiske virkemidler og social organisering. Det er denne omlægning, der er artiklens genstand....

Spectroscopic study; Estudio espectroscopico del PAA con iones de Eu{sup 3+} como material luminescente

Energy Technology Data Exchange (ETDEWEB)

Flores, M.; Rodriguez, R. [Departamento de Fisica, Universidad Autonoma Metropolitana Iztapalapa, Mexico D.F. (Mexico); Arroyo, R. [Departamento de Quimica, Universidad Autonoma Metropolitana Iztapalapa, A.P. 55-534, 09340 Mexico D.F. (Mexico)

1999-07-01

This work is focused about the spectroscopic properties of a polymer material which consists of Polyacrylic acid (Paa) doped at different concentrations of Europium ions (Eu{sup 3+}). They show that to stay chemically joined with the polymer by a study of Nuclear Magnetic Resonance (NMR) of {sup 1} H, {sup 13} C and Fourier Transform Infrared Spectroscopy (Ft-IR) they present changes in the intensity of signals, just as too when this material is irradiated at {lambda} = 394 nm. In according with the results obtained experimentally in this type of materials it can say that is possible to unify chemically the polymer with this type of cations, as well as, varying the concentration of them, since that these are distributed homogeneously inside the matrix maintaining its optical properties. These materials can be obtained more quickly and easy in solid or liquid phase and they have the best conditions for to make a quantitative analysis. (Author)

Distribution of Euphausia mucronata at the upwelling area of Peninsula Mejillones, northern Chile: The influence of the oxygen minimum layer

Directory of Open Access Journals (Sweden)

R. Escribano

2000-03-01

Full Text Available Analysis of zooplankton samples from 53 stations obtained around Peninsula Mejillones (Northern Chile, from two strata: 0-50 m and 150-200 m, during active upwelling in December 1996, allowed the study of horizontal and vertical distribution of Euphausia mucronata, endemic Krill of the Humboldt Current. Information from CTDO and a fluorometer was used to analyze the influence of oceanographic variables on distribution of E. mucronata. E. mucronata was found distributed all around the Peninsula, although with greater aggregations in the southern area, especially in the deeper layer. Stepwise multiple regression showed that none of the variables (temperature, salinity and chlorophyll was significantly correlated to numerical abundance of the species. However there was a significant effect of depth of the oxygen minimum layer (OML, defined as 0.5 ml O2 l-1, on integrated abundance of the species, such that individuals are more likely to be found in areas where the OML is deeper. A vertical distribution parameter suggested a diurnal migrational pattern. This parameter was also correlated with distance to shoreline. The OML rises abrutply in nearshore areas because of active upwelling, but there are still nearshore zones where the OML remains deep. Therefore E. mucronata appears to aggregate around the upwelling lenses and filaments, where phytoplankton is more concentrated, but at the same time avoiding places where the OML is too shallow.

A Tutorial on Optical Feeding of Millimeter-Wave Phased Array Antennas for Communication Applications

Directory of Open Access Journals (Sweden)

Ivan Aldaya

2015-01-01

Full Text Available Given the interference avoidance capacity, high gain, and dynamical reconfigurability, phased array antennas (PAAs have emerged as a key enabling technology for future broadband mobile applications. This is especially important at millimeter-wave (mm-wave frequencies, where the high power consumption and significant path loss impose serious range constraints. However, at mm-wave frequencies the phase and amplitude control of the feeding currents of the PAA elements is not a trivial issue because electrical beamforming requires bulky devices and exhibits relatively narrow bandwidth. In order to overcome these limitations, different optical beamforming architectures have been presented. In this paper we review the basic principles of phased arrays and identify the main challenges, that is, integration of high-speed photodetectors with antenna elements and the efficient optical control of both amplitude and phase of the feeding current. After presenting the most important solutions found in the literature, we analyze the impact of the different noise sources on the PAA performance, giving some guidelines for the design of optically fed PAAs.

Computerization of guidelines: towards a "guideline markup language".

Science.gov (United States)

Dart, T; Xu, Y; Chatellier, G; Degoulet, P

2001-01-01

Medical decision making is one of the most difficult daily tasks for physicians. Guidelines have been designed to reduce variance between physicians in daily practice, to improve patient outcomes and to control costs. In fact, few physicians use guidelines in daily practice. A way to ease the use of guidelines is to implement computerised guidelines (computer reminders). We present in this paper a method of computerising guidelines. Our objectives were: 1) to propose a generic model that can be instantiated for any specific guidelines; 2) to use eXtensible Markup Language (XML) as a guideline representation language to instantiate the generic model for a specific guideline. Our model is an object representation of a clinical algorithm, it has been validated by running two different guidelines issued by a French official Agency. In spite of some limitations, we found that this model is expressive enough to represent complex guidelines devoted to diabetes and hypertension management. We conclude that XML can be used as a description format to structure guidelines and as an interface between paper-based guidelines and computer applications.

Reply to the Comment by A. Wyttenbach and L. Tobler and correction for errata on 'Minor and trace element determination of food spices and pulses of different origins by NAA and PAA'

International Nuclear Information System (INIS)

Miyamoto, Y.; Kajikawa, A.; Zaidi, J.H.; Nakanishi, T.; Sakamoto, K.; Kanazawa Univ.

2001-01-01

Reply is given to the comment by A. Wyttenbach and L. Tobler in J. Radioanal. Nucl. Chem., 247 (2001) 457 on the article by Y. Miyamoto et. al. published in J. Radioanal. Nucl. Chem. 243 (2000) 747 on 'Minor and trace element determination of food spices and pulses of different origins by NAA and PAA'. (N.T.)

Update on the Systemic Risks of Superpotent Topical Steroids.

Science.gov (United States)

Nakamura, Mio; Abrouk, Michael; Zhu, Henry; Farahnik, Benjamin; Koo, John; Bhutani, Tina

2017-07-01

INTRODUCTION: The potential for systemic effects due to percutaneous absorption of superpotent topical steroids has been a longstanding concern. The Food and Drug Administration currently recommends limiting the use of superpotent topical steroids to 50g per week for 2 or 4 consecutive weeks depending on the formulation, which is mostly based on the exact duration with which phase 3 clinical trials were allowed to be conducted per the FDA. This article reviews all published clinical incidence of adrenal adverse effects in the medical literature, specifically Cushing's syndrome (CS) and pathologic adrenal suppression (PAAS), to try to ascertain a more realistic limit for the safe use of superpotent topical steroids as it pertains to its potential systemic effects. METHODS: Literature search was conducted using PubMed. Only cases of CS and PAAS secondary to the use of Class I superpotent topical steroids were included. Pediatric cases and full articles unavailable in English were excluded. RESULTS: There were a total of 14 cases of CS and 5 cases of subsequent PAAS found in the current literature. DISCUSSION: From our review of these cases, if the amount used per week is within FDA guidelines, it appears that patients needed to use superpotent topical steroids for far greater than 2 or 4 weeks to develop CS or PAAS. CS did not necessarily predict occurrence of PAAS, but in all cases CS appeared to be a prerequisite for developing PAAS. All cases of CS and all but one case of PAAS were reversible. If excessive amount of greater than 50g per week is avoided, it appears that superpotent topical steroids may be safe to use consecutively for months, perhaps even years, without causing systemic effects. J Drugs Dermatol. 2017;16(7):643-648..

Histological changes and antioxidant enzyme activity in signal crayfish (Pacifastacus leniusculus) associated with sub-acute peracetic acid exposure.

Science.gov (United States)

Chupani, Latifeh; Zuskova, Eliska; Stara, Alzbeta; Velisek, Josef; Kouba, Antonin

2016-01-01

Peracetic acid (PAA) is a powerful disinfectant recently adopted as a therapeutic agent in aquaculture. A concentration of 10 mg L(-1) PAA effectively suppresses zoospores of Aphanomyces astaci, the agent of crayfish plague. To aid in establishing safe therapeutic guideline, the effects of PAA on treated crayfish were investigated through assessment of histological changes and oxidative damage. Adult female signal crayfish Pacifastacus leniusculus (n = 135) were exposed to 2 mg L(-1) and 10 mg L(-1) of PAA for 7 days followed by a 7 day recovery period in clean water. Superoxide dismutase activity was significantly lower in gill and hepatopancreas after three days exposure to 10 mg L(1) PAA than in the group treated with 2 mg L(-1) PAA and a control in only clean water. Catalase activity in gill and hepatopancreas remained unaffected by both exposures. Glutathione reductase was significantly decreased in gill of 10 mg L(-1) PAA treated crayfish and increased in group exposed to 2 mg L(-1) compared to control after 7 days exposure. Antioxidant enzyme activity in exposed groups returned to control values after recovery period. Gill, hepatopancreas, and antennal gland showed slight damage in crayfish treated with 2 mg L(-1) of PAA compared to the control group. The extent and frequency of histological alterations were more pronounced in animals exposed to 10 mg L(-1). The gill was the most affected organ, infiltrated by granular hemocytes and displaying malformations of lamella tips and disorganization of epithelial cells. After a 7 day recovery period, the infiltrating cells in affected tissues of the exposed crayfish began to return to normal levels. Results suggested that the given concentrations could be applied to signal crayfish against crayfish plague agent in aquaculture; however, further studies are required for safe use. Copyright © 2015 Elsevier Ltd. All rights reserved.

Guidelines for methodological choices when calculating impacts on the Swedish environmental objectives from changing the energy use; Vaegledning till metodval vid beraekning av paaverkan fraan foeraendrad energianvaendning paa de svenska miljoemaalen

Energy Technology Data Exchange (ETDEWEB)

Engstroem, Rebecka; Gode, Jenny; Axelsson, Ulrik

2009-01-15

The guidelines in this report have been developed by IVL Swedish Environmental Research Institute, within a project financed by the Environmental Objectives Council, the Swedish Energy Agency and the Swedish Environmental Protection Agency. The idea originated from an earlier project for the Swedish Energy Agency and the Swedish Environmental Protection Agency, where the potential of a business model for energy efficiency (Energy Performance Contracting, EPC) to contribute to fulfil the national environmental objectives was studied. When environmental impacts from the studied EPC projects was to be calculated, it was evident how many difficult methodological choices one is faced with when trying to follow up the environmental impacts from projects changing the energy use. A second project was then performed to further analyse the issues involved. The result is this guideline report. The guidelines are on the first hand directed at companies and municipalities performing projects with effects on the energy use, that want to calculate impacts from these on the Swedish environmental objectives. The guidelines can also be useful for county administrations, central authorities and other actors with interest in the issues. A starting point for the recommendations is the Swedish environmental objectives, with focus on those of special interest in relation to energy use and airborne emissions. These are Reduced climate impact, Clean air, Natural acidification only, Zero eutrophication and A good built environment. The environmental objectives are mainly concentrated on what affects the Swedish environment. However, not only emissions in Sweden cause such effects, but also emissions in other countries can be transported by air and fall down and cause impacts in Sweden. Thus, the guidelines focus on Sweden, but include to a certain extent also emissions in other countries. Another starting point is that the guidelines are developed to follow up effects from individual

Oral mucosal lesions' impact on oral health-related quality of life in preschool children.

Science.gov (United States)

de Oliveira, Luísa Jardim Corrêa; Torriani, Dione Dias; Correa, Marcos Britto; Peres, Marco Aurélio; Peres, Karen Glazer; Matijasevich, Alicia; Dos Santos, Iná da Silva; Barros, Aluisio J D; Demarco, Flávio Fernando; Tarquinio, Sandra Beatriz Chaves

2015-12-01

The aim of this study was to assess the prevalence of oral mucosal lesions and their impact on oral health-related quality of life (OHRQoL) in children aged 5 years. A sample of 1118 children from Pelotas' birth cohort, born in 2004 (response rate of 85.8%), were selected to participate in the study. Data were collected using a questionnaire applied to mothers and from the oral examinations of the children. OML were identified by type, site, and size. Early Childhood Oral Health Impact Scale (ECOHIS) was used to assess caregivers' perception on children's OHRQoL. Descriptive, bivariate, and multivariate Poisson regression analyses were carried out, considering the impact on OHRQoL (total ECOHIS score) as the outcome. The prevalence of the OML was 30.1% (95% CI 27.5-32.9). Ulcers were the more prevalent type of lesion (29.4%), and the most affected site was the gums (31.0%). In bivariate analysis, there was a positive association between the presence of OML and OHRQoL impact measured by the following: mean overall score of ECOHIS (P children with OML presented higher impact on OHRQoL [rate ratio (RR) 1.38 95% CI 1.11; 1.72] comparing with their counterparts. Analyzing specific domains, children with OML also presented higher impact on children symptoms (RR 1.46 95% CI 1.20; 1.66) and family functional (RR 3.14 95% CI 1.59; 6.22) domains. Almost one-third of children presented with oral mucosal lesions, and these lesions impaired children's oral health-related quality of life. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Improving thermal stability and efficacy of BCNU in treating glioma cells using PAA-functionalized graphene oxide

Directory of Open Access Journals (Sweden)

Lu YJ

2012-03-01

Full Text Available Yu-Jen Lu1,2,#, Hung-Wei Yang1,#, Sheng-Che Hung3, Chiung-Yin Huang2, Shin-Ming Li4, Chen-Chi M Ma4, Pin-Yuan Chen2, Hong-Chieh Tsai2, Kuo-Chen Wei2, Jyh-Ping Chen1 1Department of Chemical and Materials Engineering, Chang Gung University, Kwei-San, Taoyuan, Taiwan; 2Department of Neurosurgery, Chang Gung Memorial Hospital, Kwei-San, Taoyuan, Taiwan; 3Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan; 4Department of Chemical Engineering, National Tsing Hua University, Hsinchu, Taiwan#These authors contributed equally to this workBackground: 1,3-bis(2-chloroethyl-1-nitrosourea (BCNU, a commercial chemotherapeutic drug for treating malignant brain tumors, has poor thermal stability and a short half-life. Immobilization of BCNU on a nanocarrier might increase the thermal stability of BCNU and extend its half-life.Methods: Nanosized graphene oxide (GO could be modified by polyacrylic acid (PAA to improve the aqueous solubility and increase the cell penetration efficacy of the nanocarrier. PAA–GO intended as a drug carrier for BCNU was prepared and characterized in this study. The size and thickness of PAA–GO was investigated by transmission electron microscopy and atomic force microscopy, and the presence of PAA functional groups was confirmed by electron spectroscopy for chemical analysis and thermogravimetric analysis. BCNU was conjugated to PAA–GO by covalent binding for specific killing of cancer cells, which could also enhance the thermal stability of the drug.Results: Single layer PAA–GO (about 1.9 nm with a lateral width as small as 36 nm was successfully prepared. The optimum drug immobilization condition was by reacting 0.5 mg PAA–GO with 0.4 mg BCNU, and the drug-loading capacity and residual drug activity were 198 µg BCNU/mg PAA–GO and 70%, respectively. This nanocarrier significantly prolonged the half-life of bound BCNU from 19 to 43 hours compared with free drug and showed efficient intracellular

Developing clinical practice guidelines: target audiences, identifying topics for guidelines, guideline group composition and functioning and conflicts of interest.

Science.gov (United States)

Eccles, Martin P; Grimshaw, Jeremy M; Shekelle, Paul; Schünemann, Holger J; Woolf, Steven

2012-07-04

Clinical practice guidelines are one of the foundations of efforts to improve health care. In 1999, we authored a paper about methods to develop guidelines. Since it was published, the methods of guideline development have progressed both in terms of methods and necessary procedures and the context for guideline development has changed with the emergence of guideline clearing houses and large scale guideline production organisations (such as the UK National Institute for Health and Clinical Excellence). It therefore seems timely to, in a series of three articles, update and extend our earlier paper. In this first paper we discuss: the target audience(s) for guidelines and their use of guidelines; identifying topics for guidelines; guideline group composition (including consumer involvement) and the processes by which guideline groups function and the important procedural issue of managing conflicts of interest in guideline development.

Guideline of guidelines: asymptomatic microscopic haematuria.

Science.gov (United States)

Linder, Brian J; Bass, Edward J; Mostafid, Hugh; Boorjian, Stephen A

2018-02-01

The aim of the present study was to review major organizational guidelines on the evaluation and management of asymptomatic microscopic haematuria (AMH). We reviewed the haematuria guidelines from: the American Urological Association; the consensus statement by the Canadian Urological Association, Canadian Urologic Oncology Group and Bladder Cancer Canada; the American College of Physicians; the Joint Consensus Statement of the Renal Association and British Association of Urological Surgeons; and the National Institute for Health and Care Excellence. All guidelines reviewed recommend evaluation for AMH in the absence of potential benign aetiologies, with the evaluation including cystoscopy and upper urinary tract imaging. Existing guidelines vary in their definition of AMH (role of urine dipstick vs urine microscopy), the age threshold for recommending evaluation, and the optimal imaging method (computed tomography vs ultrasonography). Of the reviewed guidelines, none recommended the use of urine cytology or urine markers during the initial AMH evaluation. Patients should have ongoing follow-up after a negative initial AMH evaluation. Significant variation exists among current guidelines for AMH with respect to who should be evaluated and in what manner. Given the patient and health system implications of balancing appropriately focused and effective diagnostic evaluation, AMH represents a valuable future research opportunity. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

Guidelines for Guidelines: Are They Up to the Task? A Comparative Assessment of Clinical Practice Guideline Development Handbooks

Science.gov (United States)

Ansari, Shabnam; Rashidian, Arash

2012-01-01

Objectives We conducted a comparative review of clinical practice guideline development handbooks. We aimed to identify the main guideline development tasks, assign weights to the importance of each task using expert opinions and identify the handbooks that provided a comprehensive coverage of the tasks. Methods We systematically searched and included handbooks published (in English language) by national, international or professional bodies responsible for evidenced-based guideline development. We reviewed the handbooks to identify the main guideline development tasks and scored each handbook for each task from 0 (the handbook did not mention the task) to 2 (the task suitably addressed and explained), and calculated a weighted score for each handbook. The tasks included in over 75% of the handbooks were considered as ‘necessary’ tasks. Result Nineteen guideline development handbooks and twenty seven main tasks were identified. The guideline handbooks’ weighted scores ranged from 100 to 220. Four handbooks scored over 80% of the maximum possible score, developed by the National Institute for Health and Clinical Excellence, Swiss Centre for International Health, Scottish Intercollegiate Guidelines Network and World Health Organization. Necessary tasks were: selecting the guideline topic, determining the guideline scope, identifying relevant existing guidelines, involving the consumers, forming guideline development group,, developing clinical questions, systematic search for evidence, selecting relevant evidence, appraising identifies research evidence, making group decision, grading available evidence, creating recommendations, final stakeholder consultation, guideline implementation strategies, updating recommendations and correcting potential errors. Discussion Adequate details for evidence based development of guidelines were still lacking from many handbooks. The tasks relevant to ethical issues and piloting were missing in most handbooks. The findings

Charging and heat collection by a positively charged dust grain in a plasma.

Science.gov (United States)

Delzanno, Gian Luca; Tang, Xian-Zhu

2014-07-18

Dust particulates immersed in a quasineutral plasma can emit electrons in several important applications. Once electron emission becomes strong enough, the dust enters the positively charged regime where the conventional orbital-motion-limited (OML) theory can break down due to potential-well effects on trapped electrons. A minimal modification of the trapped-passing boundary approximation in the so-called OML(+) approach is shown to accurately predict the dust charge and heat collection flux for a wide range of dust size and temperature.

Omlæg operationen i Afghanistan

DEFF Research Database (Denmark)

Veicherts, Nicolas Teodors

2008-01-01

Ingen er længere i tvivl om, at tidens krige i f.eks. Afghanistan ikke alene kan vindes med militære midler. Sejr i Afghanistan i form af et nyt stabilt politisk system kan kun ske gennem en kombination af militær og civil indsats. Særligt når det gælder bekæmpelsen af væbnede og aggressive...

Advanced control room design review guidelines: Integration of the NUREG-0700 guidelines and development of new human-system interface guidelines

Energy Technology Data Exchange (ETDEWEB)

Carter, R.J.

1997-07-01

This report documents the work conducted in four tasks of the Nuclear Regulatory Commission (NRC) project entitled Review Criteria for Human Factors Aspects of Advanced Controls and Instrumentation. The purpose of the first task was to integrate the applicable sections of NUREG-0700 into the advanced control room design review (ACRDR) guidelines to ensure that all applicable guidelines are together in one document and conveniently accessible to users. The primary objective of the second task was to formulate a strategy for the development of new ACRDR guidelines that have not otherwise been identified. The main focus of the third task was to modify the individual ACRDR guidelines generated to date to ensure that they are suitable for the intended nuclear power plant (NPP) control station system application. The goal of the fourth task was to develop human factors guidelines for two human-system interface categories that are missing from the current ACRDR guidelines document. During the first task those areas in NUREG-0700 that are not addressed by the ACRDR guidelines document were identified, the areas were subsequently reviewed against six recent industry human factors engineering review guidelines, and the NUREG-0700 guidelines were updated as necessary. In the second task 13 general categories of human-system interface guidelines that are either missing from or not adequately addressed by the ACRDR document were discovered. An approach was derived for the development of new ACRDR guidelines, a preliminary assessment of the available sources that may be useful in the creation of new guidelines and their applicability to the identified human-system interface categories was performed, and an estimate was made of the amount of time and level of effort required to complete the development of needed new ACRDR guidelines. During the third task those NPP control station systems to which the NUREG-0700 and ACRDR guidelines apply were identified, matrices of such

Advanced control room design review guidelines: Integration of the NUREG-0700 guidelines and development of new human-system interface guidelines

International Nuclear Information System (INIS)

Carter, R.J.

1997-07-01

This report documents the work conducted in four tasks of the Nuclear Regulatory Commission (NRC) project entitled Review Criteria for Human Factors Aspects of Advanced Controls and Instrumentation. The purpose of the first task was to integrate the applicable sections of NUREG-0700 into the advanced control room design review (ACRDR) guidelines to ensure that all applicable guidelines are together in one document and conveniently accessible to users. The primary objective of the second task was to formulate a strategy for the development of new ACRDR guidelines that have not otherwise been identified. The main focus of the third task was to modify the individual ACRDR guidelines generated to date to ensure that they are suitable for the intended nuclear power plant (NPP) control station system application. The goal of the fourth task was to develop human factors guidelines for two human-system interface categories that are missing from the current ACRDR guidelines document. During the first task those areas in NUREG-0700 that are not addressed by the ACRDR guidelines document were identified, the areas were subsequently reviewed against six recent industry human factors engineering review guidelines, and the NUREG-0700 guidelines were updated as necessary. In the second task 13 general categories of human-system interface guidelines that are either missing from or not adequately addressed by the ACRDR document were discovered. An approach was derived for the development of new ACRDR guidelines, a preliminary assessment of the available sources that may be useful in the creation of new guidelines and their applicability to the identified human-system interface categories was performed, and an estimate was made of the amount of time and level of effort required to complete the development of needed new ACRDR guidelines. During the third task those NPP control station systems to which the NUREG-0700 and ACRDR guidelines apply were identified, matrices of such

[Guidelines for management of epilepsy--commentary on Scottish ("SIGN") guidelines].

Science.gov (United States)

Planjar-Prvan, Miljenka; Granić, Davorka

2005-01-01

The choice of AED (antiepileptic drug), worldwide and in Croatia, is been still based on the physician's subjective decision, personal experience, knowledge and marketing pressure made by big pharmaceutical industries. Therefore, according to some opinions, there is a need of treatment guidelines for epilepsy that would provide relevant information based on scientific evidence on the efficacy, tolerability and safety of AEDs. The guidelines, published by a competent source, should be designed as to allow for easy access to the information on the best practice in specific cases. An extensive background literature review was made to identify such a type of guidelines for the management of epilepsy. The literature review revealed a number of references with the recommendations for treating epilepsy in different groups of patients and from various, specific aspects of epilepsy treatment. However, only one comprehensive set of guidelines for the diagnosis and treatment of epilepsy treatment was found, i.e. the evidence-based guidelines published by the Scottish Intercollegiate Guidelines Network (SIGN). The development of this set of guidelines is quite extensively described in order to illustrate how rigorous and long-lasting the process was, including a great number of health professionals at the national level. Such a type of well designed guidelines facilitates access to highest educational standards for all professionals involved in the primary and secondary care of people with epilepsy. However, it is clear that guidelines can fully replace the standards of clinical practice based on critical evaluation and integration of all clinical data of each individual patient. No guidelines can replace the physician's obligation to keep informed of the novel achievements in the epileptology either.

The development of oncology treatment guidelines: an analysis of the National Guidelines Clearinghouse.

Science.gov (United States)

Palta, Manisha; Lee, W Robert

2011-01-01

In the last 2 decades, guidelines have been developed to improve quality of patient care. A recent editorial of guideline development procedures suggested the process has significant limitations that affect their scientific validity.(1) This prompted us to review oncology treatment guidelines to determine if such limitations are widespread. We performed a review of oncology treatment guidelines registered at the National Guidelines Clearinghouse (www.guideline.gov). Each guideline was independently reviewed by 2 authors and the following criteria were assessed: coordinating organization, guideline panel composition, reporting conflict of interest, peer review, dissent, expiration date, PubMed citation, and evidence-based scoring and grading of recommendations. Disagreements were resolved by consensus in subsequent discussions. Sixty-four guidelines were reviewed (39 [61%] were developed by a medical specialty society and 25 [39%] were developed by government agencies). Fifty (78%) guideline panels were multidisciplinary and 44 (69%) included individuals with epidemiologic and health services research expertise. Potential conflicts of interest were disclosed in 43 (67%) guidelines. Sixty (94%) guidelines underwent peer review, with external review in 31 (48%). Seventeen (27%) guidelines are indexed by PubMed. Fifty-one (80%) guidelines included evidence-based methodologies and 46 (72%) used evidence-based scoring of recommendations. Significant differences were observed according to coordinating organization (eg, disclosure of conflict of interest in 46% of guidelines developed by medical specialty societies versus 100% authored by government agencies [P <.0001]). The majority of oncology-related treatment guidelines registered at the National Guidelines Clearinghouse satisfy most of the criteria for sound guideline development. Significant differences in these criteria were observed according to the coordinating organization that developed the guideline. Copyright

Suppressor mutations identify amino acids in PAA-1/PR65 that facilitate regulatory RSA-1/B″ subunit targeting of PP2A to centrosomes in C. elegans.

Science.gov (United States)

Lange, Karen I; Heinrichs, Jeffrey; Cheung, Karen; Srayko, Martin

2013-01-15

Protein phosphorylation and dephosphorylation is a key mechanism for the spatial and temporal regulation of many essential developmental processes and is especially prominent during mitosis. The multi-subunit protein phosphatase 2A (PP2A) enzyme plays an important, yet poorly characterized role in dephosphorylating proteins during mitosis. PP2As are heterotrimeric complexes comprising a catalytic, structural, and regulatory subunit. Regulatory subunits are mutually exclusive and determine subcellular localization and substrate specificity of PP2A. At least 3 different classes of regulatory subunits exist (termed B, B', B″) but there is no obvious similarity in primary sequence between these classes. Therefore, it is not known how these diverse regulatory subunits interact with the same holoenzyme to facilitate specific PP2A functions in vivo. The B″ family of regulatory subunits is the least understood because these proteins lack conserved structural domains. RSA-1 (regulator of spindle assembly) is a regulatory B″ subunit required for mitotic spindle assembly in Caenorhabditis elegans. In order to address how B″ subunits interact with the PP2A core enzyme, we focused on a conditional allele, rsa-1(or598ts), and determined that this mutation specifically disrupts the protein interaction between RSA-1 and the PP2A structural subunit, PAA-1. Through genetic screening, we identified a putative interface on the PAA-1 structural subunit that interacts with a defined region of RSA-1/B″. In the context of previously published results, these data propose a mechanism of how different PP2A B-regulatory subunit families can bind the same holoenzyme in a mutually exclusive manner, to perform specific tasks in vivo.

Suppressor mutations identify amino acids in PAA-1/PR65 that facilitate regulatory RSA-1/B″ subunit targeting of PP2A to centrosomes in C. elegans

Directory of Open Access Journals (Sweden)

Karen I. Lange

2012-11-01

Protein phosphorylation and dephosphorylation is a key mechanism for the spatial and temporal regulation of many essential developmental processes and is especially prominent during mitosis. The multi-subunit protein phosphatase 2A (PP2A enzyme plays an important, yet poorly characterized role in dephosphorylating proteins during mitosis. PP2As are heterotrimeric complexes comprising a catalytic, structural, and regulatory subunit. Regulatory subunits are mutually exclusive and determine subcellular localization and substrate specificity of PP2A. At least 3 different classes of regulatory subunits exist (termed B, B′, B″ but there is no obvious similarity in primary sequence between these classes. Therefore, it is not known how these diverse regulatory subunits interact with the same holoenzyme to facilitate specific PP2A functions in vivo. The B″ family of regulatory subunits is the least understood because these proteins lack conserved structural domains. RSA-1 (regulator of spindle assembly is a regulatory B″ subunit required for mitotic spindle assembly in Caenorhabditis elegans. In order to address how B″ subunits interact with the PP2A core enzyme, we focused on a conditional allele, rsa-1(or598ts, and determined that this mutation specifically disrupts the protein interaction between RSA-1 and the PP2A structural subunit, PAA-1. Through genetic screening, we identified a putative interface on the PAA-1 structural subunit that interacts with a defined region of RSA-1/B″. In the context of previously published results, these data propose a mechanism of how different PP2A B-regulatory subunit families can bind the same holoenzyme in a mutually exclusive manner, to perform specific tasks in vivo.

Guidelines for Description

NARCIS (Netherlands)

Links, P.; Horsman, Peter; Kühnel, Karsten; Priddy, M.; Reijnhoudt, Linda; Merenmies, Mark

2013-01-01

The Guidelines follow the conceptual metadata model (deliverable 17.2). They include guidelines for description of collection-holding institutions, document collections, organisations, personalities, events, camps and ghettos. As much as possible the guidelines comply with the descriptive standards

Prevalence of oral mucosal lesions in a brazilian military police population.

Science.gov (United States)

Araújo, Viviani-Silva; Godinho, Eliane-Lopes; Farias, Lucyana-Conceição; Marques-Silva, Luciano; Santos, Sérgio-Henrique-Sousa; Rodrigues-Neto, João-Felício; Ferreira, Raquel-Conceição; De-Paula, Alfredo-Maurício-Batista; Martins, Andréa-Maria-Eleutério-de Barros-Lima; Sena-Guimarães, André-Luiz

2015-04-01

Data obtained from oral health surveys are very important for identifying disease-susceptible groups and for developing dental care and prevention programs. So, the purpose of the current article was to investigate the prevalence of oral mucosa lesions (OMLs) in a population of Brazilian police. Interviews and oral cavity examinations were performed on a sample of 395 police officers who were randomly selected by the calibrated researcher. The number of individuals was obtained by a sample calculation using the finite population correction. The diagnostic criteria were based on the WHO (1997) criteria and adapted to Brazilian surveys. In total, 8.61% of the population presented some OML. Traumatic injuries and benign migratory glossitis (BMG) were the most prevalent lesions. The prevalence of potentially malignant disorders was lower than among the Brazilian population.The most prevalent lesion among the police officers was related to trauma. Patients dissatisfied with oral health had a higher risk of presenting OMLs. Key words:Mouth disease, mouth mucosa, military personnel, public health, oral pathology, oral leukoplakia.

Primary care guidelines

DEFF Research Database (Denmark)

Ijäs, Jarja; Alanen, Seija; Kaila, Minna

2009-01-01

OBJECTIVE: To describe the adoption of the national Hypertension Guideline in primary care and to evaluate the consistency of the views of the health centre senior executives on the guideline's impact on clinical practices in the treatment of hypertension in their health centres. DESIGN: A cross...... Guideline. RESULTS: Data were available from 143 health centres in Finland (49%). The views of head physicians and senior nursing officers on the adoption of the Hypertension Guideline were not consistent. Head physicians more often than senior nursing officers (44% vs. 29%, p ...: Hypertension Guideline recommendations that require joint agreements between professionals are less often adopted than simple, precise recommendations. More emphasis on effective multidisciplinary collaboration is needed....

Radiological risk comparison guidelines

International Nuclear Information System (INIS)

Hallinan, E.J.; Muhlestein, L.D.; Brown, L.F.; Yoder, R.E.

1992-01-01

An important aspect of DOE safety analyses is estimating potential accident risk. The estimates are used to: determine if additional controls are needed, identify Safety Class Items, and demonstrate adequate risk reduction. Thus, guidelines are needed to measure comparative risks. The Westinghouse M ampersand O Nuclear Facility Safety Committee and the Safety Envelope Working Group have developed radiological risk guidelines for comparing the risks from individual accident analyses. These guidelines were prepared under contract with the US Department of Energy. These guidelines are based on historical DOE guidelines and current requirements, and satisfy DOE and technical community proposals. for goals that demonstrate acceptable risk. The guidelines consist of a frequency versus consequence curve for credible accidents. Offsite and onsite guidelines are presented. The offsite risk acceptance guidelines are presented in Figure 1. The guidelines are nearly isorisk for anticipated events where impacts are chronic, and provide additional reduction for unlikely events where impacts may be acute and risk uncertainties may be significant. The guidelines are applied to individual release accident scenarios where a discrete frequency and consequence has been estimated. The guideline curves are not to be used for total risk assessments. Common cause events are taken into consideration only for an individual facility. Frequencies outside the guideline range are considered to be local site option (analyst judgement) as far as assessments of risk acceptance are concerned. If the curve is exceeded, then options include either a more detailed analysis or imposing additional preventive or mitigative features. Another presentation discusses implementation in detail. Additional work is needed to provide risk comparison guidelines for releases from multiple facilities and for toxic releases

Quality Guidelines

Science.gov (United States)

... this page: https://medlineplus.gov/criteria.html MedlinePlus Quality Guidelines To use the sharing features on this ... materials must also meet our existing quality guidelines. Quality, authority and accuracy of health content The organization's ...

Which points deserve special attention in the new guidelines on X-ray use (testing guidelines for experts and quality assurance guidelines)?

International Nuclear Information System (INIS)

Ewen, K.; Lauber, I.

2004-01-01

Two important guidelines for the application of X-rays in medicine became effective on 1 October 2003 and 1 December 2003. These are testing guidelines for experts and quality assurance guidelines. Both guidelines are very extensive and not always easy to interpret. In the present paper the authors try to explain in detail some chapters important for radiology and to make the necessary technical background transparent. Both authors took an essential part in forming the guidelines. (orig.) [de

Guidelines 2.0: systematic development of a comprehensive checklist for a successful guideline enterprise

Science.gov (United States)

Schünemann, Holger J.; Wiercioch, Wojtek; Etxeandia, Itziar; Falavigna, Maicon; Santesso, Nancy; Mustafa, Reem; Ventresca, Matthew; Brignardello-Petersen, Romina; Laisaar, Kaja-Triin; Kowalski, Sérgio; Baldeh, Tejan; Zhang, Yuan; Raid, Ulla; Neumann, Ignacio; Norris, Susan L.; Thornton, Judith; Harbour, Robin; Treweek, Shaun; Guyatt, Gordon; Alonso-Coello, Pablo; Reinap, Marge; Brožek, Jan; Oxman, Andrew; Akl, Elie A.

2014-01-01

Background: Although several tools to evaluate the credibility of health care guidelines exist, guidance on practical steps for developing guidelines is lacking. We systematically compiled a comprehensive checklist of items linked to relevant resources and tools that guideline developers could consider, without the expectation that every guideline would address each item. Methods: We searched data sources, including manuals of international guideline developers, literature on guidelines for guidelines (with a focus on methodology reports from international and national agencies, and professional societies) and recent articles providing systematic guidance. We reviewed these sources in duplicate, extracted items for the checklist using a sensitive approach and developed overarching topics relevant to guidelines. In an iterative process, we reviewed items for duplication and omissions and involved experts in guideline development for revisions and suggestions for items to be added. Results: We developed a checklist with 18 topics and 146 items and a webpage to facilitate its use by guideline developers. The topics and included items cover all stages of the guideline enterprise, from the planning and formulation of guidelines, to their implementation and evaluation. The final checklist includes links to training materials as well as resources with suggested methodology for applying the items. Interpretation: The checklist will serve as a resource for guideline developers. Consideration of items on the checklist will support the development, implementation and evaluation of guidelines. We will use crowdsourcing to revise the checklist and keep it up to date. PMID:24344144

[Implementation of Study Results in Guidelines and Adherence to Guidelines in Clinical Practice].

Science.gov (United States)

Waldfahrer, F

2016-04-01

Guidelines were introduced in hospital and practice-based otorhinolaryngology in the 1990s, and have been undergoing further development ever since. There are currently 20 guidelines on file at the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. The Society has cooperated in a further 34 guidelines. The quality of the guidelines has been continually improved by concrete specifications put forward by the Association of the Scientific Medical Societies in Germany [Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V.]. Since increasing digitalisation has made access to scientific publications quicker and more simple, relevant study results can be incorporated in guidelines more easily today than in the analogue world. S2e and S3 guidelines must be based on a formal literature search with subsequent evaluation of the evidence. The consensus procedure for S2k guidelines is also regulated. However, the implementation of guidelines in routine medical practice must still be considered inadequate, and there is still a considerable need for improvement in adherence to these guidelines. © Georg Thieme Verlag KG Stuttgart · New York.

IMAGE Programming Guidelines

Energy Technology Data Exchange (ETDEWEB)

Stehfest, E; De Waal, L.

2010-09-15

This document describes the requirements and guidelines for the software of the IMAGE system. The motivation for this report was a substantial restructuring of the source code for IMAGE version 2.5. The requirements and guidelines relate to design considerations as well as to aspects of maintainability and portability. The design considerations determine guidelines about subjects, such as program structure, model hierarchy, the use of data modules, and the error message system. Maintainability and portability aspects determine the guidelines on, for example, the Fortran 90 standard, naming conventions, code lay-out, and internal documentation.

Adsorption Properties of PVA/PAA/clay Composite Hydrogel Synthesized by Gamma Radiation and its Application in Removal of Crystal Violet Dye from Its Aqueous Solution

International Nuclear Information System (INIS)

Kamal, H.; El-Sayed, A. Hegazy; Mohamed, M.M.; Sabaa, M.W.; El-Dessouky, M.M.

2014-01-01

Copolymer hydrogels composed of Poly vinyl alcohol (PVA) and Poly acrylic acid (PAA) were prepared by γ-irradiation in the presence of N,N’ methylene bis acrylamide (MBAM) as crosslinking agent or bentonite clay. The copolymers were characterized by FTIR and SEM. The dye adsorption experiments for Crystal Violet dye (CV) were carried out by using bath procedure. UV-visible absorption spectroscopy was used to determine the adsorption behavior. The effect of different copolymer composition, clay concentration, ph, contact time, adsorbent dose, initial dye concentration, and adsorption temperature were investigated to obtain the best experimental conditions. The adsorption equilibrium was attained after about 24h. of contact time. It was found that the adsorption process was correlated with Freundlich isotherm equation. Kinetic and thermodynamic studies of CV dye onto the prepared hydrogels were also evaluated

The new hypertension guidelines.

Science.gov (United States)

Stern, Ralph H

2013-10-01

The Canadian Hypertension Education Program (CHEP) has published guidelines annually since 2000. The CHEP guidelines are a model of concise, comprehensive, up-to-date, evidence-rated guidelines for physicians who diagnose and treat hypertension. The guidelines address measurement of blood pressure and the definition of hypertension, secondary hypertension evaluation and treatment, and blood pressure targets and medication choices in patients with and without compelling indications. This review describes CHEP's process for developing guidelines and provides an overview of the 2013 recommendations. ©2013 Wiley Periodicals, Inc.

Index-TB Guidelines: Guidelines on extrapulmonary tuberculosis for India

Science.gov (United States)

Sharma, Surendra K.; Ryan, H.; Khaparde, Sunil; Sachdeva, K. S.; Singh, Achintya D.; Mohan, Alladi; Sarin, Rohit; Paramasivan, C N; Kumar, Prahlad; Nischal, Neeraj; Khatiwada, Saurav; Garner, Paul; Tharyan, Prathap

2017-01-01

Extrapulmonary tuberculosis (EPTB) is frequently a diagnostic and therapeutic challenge. It is a common opportunistic infection in people living with HIV/AIDS and other immunocompromised states such as diabetes mellitus and malnutrition. There is a paucity of data from clinical trials in EPTB and most of the information regarding diagnosis and management is extrapolated from pulmonary TB. Further, there are no formal national or international guidelines on EPTB. To address these concerns, Indian EPTB guidelines were developed under the auspices of Central TB Division and Directorate of Health Services, Ministry of Health and Family Welfare, Government of India. The objective was to provide guidance on uniform, evidence-informed practices for suspecting, diagnosing and managing EPTB at all levels of healthcare delivery. The guidelines describe agreed principles relevant to 10 key areas of EPTB which are complementary to the existing country standards of TB care and technical operational guidelines for pulmonary TB. These guidelines provide recommendations on three priority areas for EPTB: (i) use of Xpert MTB/RIF in diagnosis, (ii) use of adjunct corticosteroids in treatment, and (iii) duration of treatment. The guidelines were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, which were evidence based, and due consideration was given to various healthcare settings across India. Further, for those forms of EPTB in which evidence regarding best practice was lacking, clinical practice points were developed by consensus on accumulated knowledge and experience of specialists who participated in the working groups. This would also reflect the needs of healthcare providers and develop a platform for future research. PMID:28862176

Public informations guidelines

International Nuclear Information System (INIS)

1986-06-01

The purpose of these Public Information Guidelines is to provide principles for the implementation of the NWPA mandate and the Mission Plan requirements for the provision of public information. These Guidelines set forth the public information policy to be followed by all Office of Civilian Radioactive Waste Management (OCRWM) performance components. The OCRWM offices should observe these Guidelines in shaping and conducting public information activities

Public informations guidelines

Energy Technology Data Exchange (ETDEWEB)

None

1986-06-01

The purpose of these Public Information Guidelines is to provide principles for the implementation of the NWPA mandate and the Mission Plan requirements for the provision of public information. These Guidelines set forth the public information policy to be followed by all Office of Civilian Radioactive Waste Management (OCRWM) performance components. The OCRWM offices should observe these Guidelines in shaping and conducting public information activities.

The CARE guidelines: consensus-based clinical case report guideline development.

Science.gov (United States)

Gagnier, Joel J; Kienle, Gunver; Altman, Douglas G; Moher, David; Sox, Harold; Riley, David

2014-01-01

A case report is a narrative that describes, for medical, scientific, or educational purposes, a medical problem experienced by one or more patients. Case reports written without guidance from reporting standards are insufficiently rigorous to guide clinical practice or to inform clinical study design. Develop, disseminate, and implement systematic reporting guidelines for case reports. We used a three-phase consensus process consisting of (1) pre-meeting literature review and interviews to generate items for the reporting guidelines, (2) a face-to-face consensus meeting to draft the reporting guidelines, and (3) post-meeting feedback, review, and pilot testing, followed by finalization of the case report guidelines. This consensus process involved 27 participants and resulted in a 13-item checklist-a reporting guideline for case reports. The primary items of the checklist are title, key words, abstract, introduction, patient information, clinical findings, timeline, diagnostic assessment, therapeutic interventions, follow-up and outcomes, discussion, patient perspective, and informed consent. We believe the implementation of the CARE (CAse REport) guidelines by medical journals will improve the completeness and transparency of published case reports and that the systematic aggregation of information from case reports will inform clinical study design, provide early signals of effectiveness and harms, and improve healthcare delivery. Copyright © 2014 Reproduced with permission of Global Advances in Health and Medicine. Published by Elsevier Inc. All rights reserved.

Summary guidelines

Energy Technology Data Exchange (ETDEWEB)

Halsnaes, K.; Painuly, J.P.; Turkson, J.; Meyer, H.J.; Markandya, A.

1999-09-01

This document is a summary version of the methodological guidelines for climate change mitigation assessment developed as part of the Global Environment Facility (GEF) project Economics of Greenhouse Gas Limitations; Methodological Guidelines. The objectives of this project have been to develop a methodology, an implementing framework and a reporting system which countries can use in the construction of national climate change mitigation policies and in meeting their future reporting obligations under the FCCC. The methodological framework developed in the Methodological Guidelines covers key economic concepts, scenario building, modelling tools and common assumptions. It was used by several country studies included in the project. (au) 13 refs.

A Comparison of Interactive Multimedia Instruction Designs Addressing Soldiers Learning Needs

Science.gov (United States)

2016-03-01

animations, and if learners need such cues to support their learning (de Koning et al., 2009). If cues are overused, learners’ attention can be divided...J. P., Paas, F. (2009). Towards a framework for attention cueing in instructional animations: Guidelines for research and design. Educational...information (i.e., contextual content) than familiarization. This design strategy was selected on the basis of discussion with MCoE DOTD, who expressed a

Derivation and Osmotolerance Characterization of Three Immortalized Tilapia (Oreochromis mossambicus) Cell Lines

Science.gov (United States)

Gardell, Alison M.; Qin, Qin; Rice, Robert H.; Li, Johnathan; Kültz, Dietmar

2014-01-01

Fish cell cultures are becoming more widely used models for investigating molecular mechanisms of physiological response to environmental challenge. In this study, we derived two immortalized Mozambique tilapia (Oreochromis mossambicus) cell lines from brain (OmB) and lip epithelium (OmL), and compared them to a previously immortalized bulbus arteriosus (TmB) cell line. The OmB and OmL cell lines were generated without or with Rho-associated kinase (ROCK) inhibitor/3T3 feeder layer supplementation. Although both approaches were successful, ROCK inhibitor/feeder layer supplementation was found to offer the advantages of selecting for epithelial-like cell type and decreasing time to immortalization. After immortalization (≥ passage 5), we characterized the proteomes of the newly derived cell lines (OmB and OmL) using LCMS and identified several unique cell markers for each line. Subsequently, osmotolerance for each of the three cell lines following acute exposure to elevated sodium chloride was evaluated. The acute maximum osmotolerance of these tilapia cell lines (>700 mOsm/kg) was markedly higher than that of any other known vertebrate cell line, but was significantly higher in the epithelial-like OmL cell line. To validate the physiological relevance of these tilapia cell lines, we quantified the effects of acute hyperosmotic challenge (450 mOsm/kg and 700 mOsm/kg) on the transcriptional regulation of two enzymes involved in biosynthesis of the compatible organic osmolyte, myo-inositol. Both enzymes were found to be robustly upregulated in all three tilapia cell lines. Therefore, the newly established tilapia cells lines represent valuable tools for studying molecular mechanisms involved in the osmotic stress response of euryhaline fish. PMID:24797371

Index-TB guidelines: Guidelines on extrapulmonary tuberculosis for India

Directory of Open Access Journals (Sweden)

Surendra K Sharma

2017-01-01

Full Text Available Extrapulmonary tuberculosis (EPTB is frequently a diagnostic and therapeutic challenge. It is a common opportunistic infection in people living with HIV/AIDS and other immunocompromised states such as diabetes mellitus and malnutrition. There is a paucity of data from clinical trials in EPTB and most of the information regarding diagnosis and management is extrapolated from pulmonary TB. Further, there are no formal national or international guidelines on EPTB. To address these concerns, Indian EPTB guidelines were developed under the auspices of Central TB Division and Directorate of Health Services, Ministry of Health and Family Welfare, Government of India. The objective was to provide guidance on uniform, evidence-informed practices for suspecting, diagnosing and managing EPTB at all levels of healthcare delivery. The guidelines describe agreed principles relevant to 10 key areas of EPTB which are complementary to the existing country standards of TB care and technical operational guidelines for pulmonary TB. These guidelines provide recommendations on three priority areas for EPTB: (i use of Xpert MTB/RIF in diagnosis, (ii use of adjunct corticosteroids in treatment, and (iii duration of treatment. The guidelines were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE criteria, which were evidence based, and due consideration was given to various healthcare settings across India. Further, for those forms of EPTB in which evidence regarding best practice was lacking, clinical practice points were developed by consensus on accumulated knowledge and experience of specialists who participated in the working groups. This would also reflect the needs of healthcare providers and develop a platform for future research.

Global Imaging referral guidelines

International Nuclear Information System (INIS)

Kawooya, M.; Perez, M.; Lau, L.; Reeed, M.

2010-01-01

The medical imaging specialists called for global referral guidelines which would be made available to referring doctors. These referral guidelines should be:- Applicable in different health care settings, including resource-poor settings; Inclusive in terms of the range of clinical conditions; User-friendly and accessible (format/media); Acceptable to stakeholders, in particular to the referrers as the main target audience. To conceive evidence-based medicine as an integration of best research evidence with clinical expertise and patient values. The Direct recipients of the Referral Guidelines would be:- Referrers: general practitioners / family doctors; paediatricians; emergency department doctors; other specialists and health workers. Providers (medical imaging practitioners): radiologists; nuclear medicine physicians; radiographers; other appropriately qualified practitioners providing diagnostic imaging services. For the Referral Guidelines to be effective there need to be: Credibility evidence-based Practicality end user involvement Context local resources, disease profiles Endorsement, opinion leaders Implementation- policy, education, CPOE - Monitoring of the use clinical audit, report feedback. The aim of the Referral Guidelines Project was to: Produce global referral guidelines that are evidence-based, cost effective and appropriate for the local setting, and include consideration of available equipment and expertise (RGWG; SIGs); Include supporting information about radiation doses, potential risks, protection of children and pregnant women (introductory chapter); Facilitate the implementation of the guidelines through guidance and tools (e.g. implementation guides, checklists, capacity building tools, guides on stakeholders engagement, audit support criteria); Conduct pilot testing in different clinical settings from each of the six WHO regions; Promote the inclusion of the referral guidelines in the curricula of medical schools; Develop and implement

Low work-function thermionic emission and orbital-motion-limited ion collection at bare-tether cathodic contact

Energy Technology Data Exchange (ETDEWEB)

Chen, Xin, E-mail: xin.chen@upm.es; Sanmartín, J. R., E-mail: juanr.sanmartin@upm.es [Departamento de Física Aplicada, Escuela Técnica Superior de Ingeniería Aeronáutica y del Espacio, Universidad Politécnica de Madrid, Plaza Cardenal Cisneros, 3, 28040 Madrid (Spain)

2015-05-15

With a thin coating of low-work-function material, thermionic emission in the cathodic segment of bare tethers might be much greater than orbital-motion-limited (OML) ion collection current. The space charge of the emitted electrons decreases the electric field that accelerates them outwards, and could even reverse it for high enough emission, producing a potential hollow. In this work, at the conditions of high bias and relatively low emission that make the potential monotonic, an asymptotic analysis is carried out, extending the OML ion-collection analysis to investigate the probe response due to electrons emitted by the negatively biased cylindrical probe. At given emission, the space charge effect from emitted electrons increases with decreasing magnitude of negative probe bias. Although emitted electrons present negligible space charge far away from the probe, their effect cannot be neglected in the global analysis for the sheath structure and two thin layers in between sheath and the quasineutral region. The space-charge-limited condition is located. It is found that thermionic emission increases the range of probe radius for OML validity and is greatly more effective than ion collection for cathodic contact of tethers.

Validating experimental and theoretical Langmuir probe analyses

Science.gov (United States)

Pilling, L. S.; Carnegie, D. A.

2007-08-01

Analysis of Langmuir probe characteristics contains a paradox in that it is unknown a priori which theory is applicable before it is applied. Often theories are assumed to be correct when certain criteria are met although they may not validate the approach used. We have analysed the Langmuir probe data from cylindrical double and single probes acquired from a dc discharge plasma over a wide variety of conditions. This discharge contains a dual-temperature distribution and hence fitting a theoretically generated curve is impractical. To determine the densities, an examination of the current theories was necessary. For the conditions where the probe radius is the same order of magnitude as the Debye length, the gradient expected for orbital-motion limited (OML) is approximately the same as the radial-motion gradients. An analysis of the 'gradients' from the radial-motion theory was able to resolve the differences from the OML gradient value of two. The method was also able to determine whether radial or OML theories applied without knowledge of the electron temperature, or separation of the ion and electron contributions. Only the value of the space potential is necessary to determine the applicable theory.

Algal toxicity of the alternative disinfectants performic acid (PFA), peracetic acid (PAA), chlorine dioxide (ClO2) and their by-products hydrogen peroxide (H2O2) and chlorite (ClO2-)

DEFF Research Database (Denmark)

Chhetri, Ravi Kumar; Baun, Anders; Andersen, Henrik Rasmus

2017-01-01

Environmental effect evaluation of disinfection of combined sewer overflow events with alternative chemical disinfectants requires that the environmental toxicity of the disinfectants and the main by-products of their use are known. Many disinfectants degrade quickly in water which should......: performic acid (PFA), peracetic acid (PAA) and chlorine dioxide (ClO2) as well as two by-products of their use: hydrogen peroxide (H2O2) and chlorite. All of the five chemicals investigated showed clear toxicity to the algae with well-defined dose response curves. The EC50 values ranged from 0.16 to 2.9 mg...

Bitcoins

DEFF Research Database (Denmark)

Kühn Pedersen, Mogens

2018-01-01

Bitcoins udtænkt i 2008 og bragt i omløb de følgende 10 år fungerer nu i en anden politisk-økonomisk ramme end ved lanceringen. Disse rammer afslører nu betydelige svagheder ved de oprindelige forestillinger on et nyt pengesystem med en ny global pengeenhed.......Bitcoins udtænkt i 2008 og bragt i omløb de følgende 10 år fungerer nu i en anden politisk-økonomisk ramme end ved lanceringen. Disse rammer afslører nu betydelige svagheder ved de oprindelige forestillinger on et nyt pengesystem med en ny global pengeenhed....

Organic food conversion in Danish public kitchens

DEFF Research Database (Denmark)

Sørensen, Nina Nørgaard

Økologifremmeordningen under Økologiplan Danmark gav tilsagn til økologiomlægnings-projekter for første gang i efteråret 2012 samt foråret 2013. Denne ph.d. afhandling undersøger effekten af disse økologiomlægningsprojekter på økologiprocenten samt arbejdstrivslen blandt køkkenmedarbejdere i de d...... tværtimod, at de som følge af omlægningen har fået større glæde og motivation ved arbejdet. Kun bør der være opmærksomhed på, om omlægningerne giver anledning til større fysisk nedslidning....

Design patterns for modelling guidelines

NARCIS (Netherlands)

Serban, Radu; Ten Teije, Annette; Marcos, Mar; Polo-Conde, Cristina; Rosenbrand, Kitty C J G M; Wittenberg, Jolanda; van Croonenborg, Joyce

2005-01-01

It is by now widely accepted that medical guidelines can help to significantly improve the quality of medical care. Unfortunately, constructing the required medical guidelines is a very labour intensive and costly process. The cost of guideline construction would decrease if guidelines could be

7 CFR 622.5 - Guidelines.

Science.gov (United States)

2010-01-01

... 7 Agriculture 6 2010-01-01 2010-01-01 false Guidelines. 622.5 Section 622.5 Agriculture... AGRICULTURE WATER RESOURCES WATERSHED PROJECTS General § 622.5 Guidelines. Guidelines for carrying out... Environmental Principles and Guidelines for Water and Related Land Resources Implementation Studies issued by...

Thiolated polymers: evaluation of the influence of the amount of covalently attached L-cysteine to poly(acrylic acid).

Science.gov (United States)

Palmberger, Thomas F; Albrecht, Karin; Loretz, Brigitta; Bernkop-Schnürch, Andreas

2007-06-01

It was the aim of this study to investigate the influence of the amount of thiol groups being covalently attached to poly(acrylic acid) 450 kDa on its properties. Five different PAA(450)-L-cysteine conjugates (PAA(450)-Cys) were synthesized bearing 53.0 (PAA I), 113.4 (PAA II), 288.8 (PAA III), 549.1 (PAA IV) and 767.0 (PAA V) micromol immobilized thiol groups per gram polymer. Mucoadhesion studies utilizing the rotating cylinder method, tensile studies and disintegration studies were performed. Self-crosslinking properties were measured by the increase in viscosity. Permeation studies were performed on rat small intestine and Caco-2 monolayers using sodium fluorescein as model drug. Following residence times on the rotating cylinder could be identified: PAA I 3.1; PAA II 5.2; PAA III 22.0; PAA IV 33.8; PAA V 53.7; control 1.3 [h]. The disintegration time of all PAA(450)-Cys tablets was strongly dependent on the degree of thiolation of the polymer. Self-crosslinking studies showed that the different PAA(450)-Cys conjugates (3% m/v) in phosphate buffer, pH 6.8, formed intramolecular disulfide bonds. In case of Caco-2 monolayer transport studies following P(app)-values could be identified: PAA I 9.8; PAA II 10.1; PAA III 11.1; PAA IV 8.9; PAA V 8.2; control 6.4 [P(app)x10(-6), cms(-1)]. Mucoadhesive and self-crosslinking properties are strongly dependent on the degree of thiolation of the polymer and with respect to transport studies, an optimum amount of covalently attached L-cysteine could be identified.

Development of cancer treatment guidelines

African Journals Online (AJOL)

Krystyna Kiel

2011-05-26

May 26, 2011 ... KEYWORDS. Cancer;. Therapy;. Guidelines. Contents. 1. Why develop guidelines? ... Widely available guideline resources in cancer care. ... The use of guidelines in medicine has a long history. Many .... She has a negative family history. ... The patient has 1 cm grade 3 infiltrating ductal carcinoma.

28 CFR 42.306 - Guidelines.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Guidelines. 42.306 Section 42.306... PROCEDURES Equal Employment Opportunity Program Guidelines § 42.306 Guidelines. (a) Recipient agencies are... guidelines under their equal employment opportunity program which will correct, in a timely manner, any...

28 CFR 42.404 - Guidelines.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Guidelines. 42.404 Section 42.404... Guidelines. (a) Federal agencies shall publish title VI guidelines for each type of program to which they extend financial assistance, where such guidelines would be appropriate to provide detailed information...

Visitor's Computer Guidelines | CTIO

Science.gov (United States)

Visitor's Computer Guidelines Network Connection Request Instruments Instruments by Telescope IR Instruments Guidelines Library Facilities Outreach NOAO-S EPO Program team Art of Darkness Image Gallery EPO/CADIAS ‹› You are here CTIO Home » Astronomers » Visitor's Computer Guidelines Visitor's Computer

Nurses' experiences of guideline implementation

DEFF Research Database (Denmark)

Alanen, Seija; Välimäki, Marita; Kaila, Minna

2009-01-01

AIMS: The aim of the study was to address the following questions: What kind of experiences do primary care nurses have of guideline implementation? What do nurses think are the most important factors affecting the adoption of guidelines? BACKGROUND: The implementation of clinical guidelines seems...... to be dependent on multiple context-specific factors. This study sets out to explore the experiences of primary care nurses concerning guideline implementation. DESIGN: Qualitative interview. METHODS: Data were generated by four focus group interviews involving nurses working in out-patient services in primary...... to nurses, (iii) factors related to the anticipated consequences and (iv) factors related to the patient group. Nurses' awareness and acceptance of guidelines and the anticipated positive consequences facilitate the implementation of guidelines. Organisational support, especially the adapting of guidelines...

76 FR 60017 - Technical Conference on Penalty Guidelines; Notice of Technical Conference on Penalty Guidelines

Science.gov (United States)

2011-09-28

... Conference on Penalty Guidelines; Notice of Technical Conference on Penalty Guidelines The staff of the... the Penalty Guidelines, which the Commission issued on September 17, 2010.\\1\\ The conference will be... impact of the Penalty Guidelines on compliance and enforcement matters. More information on the topics to...

Physical Activity Guidelines

Science.gov (United States)

... use this site. health.gov Physical Activity Guidelines Physical Activity Physical activity is key to improving the health of the Nation. Based on the latest science, the Physical Activity Guidelines for Americans is an essential resource for ...

An exploration of how guideline developer capacity and guideline implementability influence implementation and adoption: study protocol

Directory of Open Access Journals (Sweden)

Lemieux-Charles Louise

2009-07-01

Full Text Available Abstract Background Practice guidelines can improve health care delivery and outcomes but several issues challenge guideline adoption, including their intrinsic attributes, and whether and how they are implemented. It appears that guideline format may influence accessibility and ease of use, which may overcome attitudinal barriers of guideline adoption, and appear to be important to all stakeholders. Guideline content may facilitate various forms of decision making about guideline adoption relevant to different stakeholders. Knowledge and attitudes about, and incentives and capacity for implementation on the part of guideline sponsors may influence whether and how they develop guidelines containing these features, and undertake implementation. Examination of these issues may yield opportunities to improve guideline adoption. Methods The attributes hypothesized to facilitate adoption will be expanded by thematic analysis, and quantitative and qualitative summary of the content of international guidelines for two primary care (diabetes, hypertension and institutional care (chronic ulcer, chronic heart failure topics. Factors that influence whether and how guidelines are implemented will be explored by qualitative analysis of interviews with individuals affiliated with guideline sponsoring agencies. Discussion Previous research examined guideline implementation by measuring rates of compliance with recommendations or associated outcomes, but this produced little insight on how the products themselves, or their implementation, could be improved. This research will establish a theoretical basis upon which to conduct experimental studies to compare the cost-effectiveness of interventions that enhance guideline development and implementation capacity. Such studies could first examine short-term outcomes predictive of guideline utilization, such as recall, attitude toward, confidence in, and adoption intention. If successful, then long-term objective

Testing post-editing guidelines

DEFF Research Database (Denmark)

Flanagan, Marian; Christensen, Tina Paulsen

2014-01-01

guidelines to use in translator training programmes. Recently, the first set of publicly available industry-focused PE guidelines (for ‘good enough’ and ‘publishable’ quality) were developed by Translation Automation User Society (TAUS) in partnership with the Centre for Global Intelligent Content (CNGL......), which can be used as a basis on which to instruct post-editors in professional environments. This paper reports on a qualitative study that investigates how trainee translators on an MA course, which is aimed at preparing the trainees for the translation industry, interpret these PE guidelines...... for publishable quality. The findings suggest trainees have difficulties interpreting the guidelines, primarily due to trainee competency gaps, but also due to the wording of the guidelines. Based on our findings we propose training measures to address these competency gaps. Furthermore, we provide post...

Appraising and comparing pressure ulcer guidelines.

Science.gov (United States)

Wimpenny, Peter; van Zelm, Ruben

2007-01-01

Whilst considerable activity has been related to guideline development for nurses regarding pressure ulcer prevention and management, no attempt has been made to comparatively evaluate these guidelines against some form of quality indicators. To compare and contrast four national pressure ulcer guidelines, and identify similarities and differences in their quality and content. An international comparative appraisal method, using the AGREE (Appraisal of Guidelines Research and Evaluation) instrument, was undertaken to appraise four published pressure ulcer guidelines. Two further domains were added to the AGREE instrument to assess comparability of the guidelines and their perceived contribution to practice. An international group undertook the comparative appraisal. The domain scores for each guideline show some but not total agreement among reviewers. One particular set of guidelines was identified as scoring highest in a majority of AGREE domains. Overall, evidence of variability exists between pressure ulcer guidelines and common areas of development to consider for all guidelines. The results raise many questions concerning the "best" pressure ulcer guideline to use, particularly related to the AGREE scoring. Some notable shortcomings exist in all the pressure ulcer guidelines reviewed and these shortcomings need to be addressed from a quality perspective. However, other issues such as style of reporting and potential contribution to practice might more fully affect choice by practitioners as opposed to guideline developers. Notable differences exist among the four guidelines that are possibly explained by different approaches to development and also because of different cultural factors and intentions for use. Whilst the AGREE tool identifies the quality of the guideline development process it still requires local engagement with practitioners to determine which guideline should be implemented.

Study of the influence of the codopant over the photoluminescent properties of PAA doped with Eu3+, Gd3+, and Tb3+

International Nuclear Information System (INIS)

Flores, M.; Arroyo, R.

2003-01-01

The results are presented obtained about the synthesis of acrylic poly acid characterization (PAA) doped with Eu 3+ , Gd 3+ and Tb 3+ . They got ready materials with even of these ions and it was studied the influence of the co dopant in the processes of emission of Eu 3+ (λ em = 618 nm), Gd 3+ (λ em = 624 nm) and Tb 3+ (λ em = 546 nm), as well as their effect in the phosphorescence (λ em = 450 nm) of the polymeric matrix. It was found that the intensity of the emission of Eu 3+ diminishes substantially due to the presence of the ions Gd 3+ , contrary to what happens when the co dopant is Tb 3+ , which causes an increase. In the one case of the emission of Tb 3+ , this it increases with the presence of Gd 3+ but it diminishes when Eu 3+ is present. These results are consequence of the homogeneous distribution of those dopants and of the phenomena of energy transfer that happen in the materials synthesized. (Author)

The Closing Digital Divide: Delivery Modality and Family Attendance in the Pathways for African American Success (PAAS) Program.

Science.gov (United States)

Murry, Velma McBride; Berkel, Cady; Liu, Na

2018-01-22

Although family-focused, evidence-based programs (EBPs) have the potential to reduce disparities in health and behavioral outcomes for youth, access to such programs is severely limited in the most affected areas, including African American communities in the rural South. As expanding the reach of EBPs is the primary goal of translational research, interest is growing in the potential of technology as a viable platform to disseminate services to areas with limited resources. To test whether African American families in the rural South would be willing to engage in a technology-based family-focused EBP to prevent adolescent risk behavior, we examined attendance using data from two arms of a three-arm community-based trial of the Pathways for African American Success (PAAS) program. In the overall study, sixth graders (N = 412) and their primary caregivers were randomly assigned to the following conditions: (a) in-person, small group sessions led by facilitators; (b) self-directed, technology-based sessions; or (c) a literature control with home-mailed educational materials. Results indicated that attendance was higher in the technology condition than in the small group condition. Parental age, education, and socioeconomic status did not limit attendance in the technology condition. We conclude from these results that the use of technology can be an acceptable strategy for disseminating parenting EBPs to African American families in the rural South.

Japanese Guideline for Atopic Dermatitis

Directory of Open Access Journals (Sweden)

Ichiro Katayama

2011-01-01

The basics of treatment discussed in this guideline are based on the “Guidelines for the Treatment of Atopic Dermatitis 2008” prepared by the Health and Labour Sciences Research and the “Guidelines for the Management of Atopic Dermatitis 2009 (ADGL2009” prepared by the Atopic Dermatitis Guidelines Advisory Committee, Japanese Society of Allergology in principle.

Integrating guideline development and implementation: analysis of guideline development manual instructions for generating implementation advice

Directory of Open Access Journals (Sweden)

Gagliardi Anna R

2012-07-01

Full Text Available Abstract Background Guidelines are important tools that inform healthcare delivery based on best available research evidence. Guideline use is in part based on quality of the guidelines, which includes advice for implementation and has been shown to vary. Others hypothesized this is due to limited instructions in guideline development manuals. The purpose of this study was to examine manual instructions for implementation advice. Methods We used a directed and summative content analysis approach based on an established framework of guideline implementability. Six manuals identified by another research group were examined to enumerate implementability domains and elements. Results Manuals were similar in content but lacked sufficient detail in particular domains. Most frequently this was Accomodation, which includes information that would help guideline users anticipate and/or overcome organizational and system level barriers. In more than one manual, information was also lacking for Communicability, information that would educate patients or facilitate their involvement in shared decision making, and Applicability, or clinical parameters to help clinicians tailor recommendations for individual patients. Discussion Most manuals that direct guideline development lack complete information about incorporating implementation advice. These findings can be used by those who developed the manuals to consider expanding their content in these domains. It can also be used by guideline developers as they plan the content and implementation of their guidelines so that the two are integrated. New approaches for guideline development and implementation may need to be developed. Use of guidelines might be improved if they included implementation advice, but this must be evaluated through ongoing research.

10 CFR 960.3 - Implementation guidelines.

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Implementation guidelines. 960.3 Section 960.3 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3 Implementation guidelines. The guidelines of this subpart...

[The German Program for Disease Management Guidelines: COPD Guideline 2006. Short review].

Science.gov (United States)

Ollenschläger, Günter; Kopp, Ina; Lelgemann, Monika

2007-01-15

In Germany, the first national consensus on evidence-based recommendations for COPD prevention and disease management was reached in spring 2006. After a development period of 9 months, the National Disease Management Guideline COPD was finalized by nominal group process under the authorship of the scientific societies for pneumology (DGP and Atemwegsliga), general internal medicine (DGIM), family medicine (DEGAM), and the Drug Commission of the German Medical Association (AKDAE). The recommendations' main sources are the NICE COPD Guideline 2004, the GOLD Recommendations as well as existing German guidelines and reviews of recent scientific evidence. The article gives an overview on authors, sources, and key recommendations of the German National Disease Management Guideline COPD 2006 (www.copd.versorgungsleitlinien.de).

Maintenance Trades Guidelines

Science.gov (United States)

Weidner, Theodore J.

2008-01-01

In 2002, APPA published "Maintenance Staffing Guidelines for Educational Facilities," the first building maintenance trades staffing guideline designed to assist educational facilities professionals with their staffing needs. addresses how facilities professionals can determine the appropriate size and mix of their organization. Contents…

10 CFR 960.5 - Preclosure guidelines.

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Preclosure guidelines. 960.5 Section 960.5 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Preclosure Guidelines § 960.5 Preclosure guidelines. The guidelines in this subpart specify the...

10 CFR 960.4 - Postclosure guidelines.

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Postclosure guidelines. 960.4 Section 960.4 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Postclosure Guidelines § 960.4 Postclosure guidelines. The guidelines in this subpart specify the...

Implementation of an evidence-based guideline on fluid resuscitation: lessons learnt for future guidelines

NARCIS (Netherlands)

Tabbers, M.M.; Boluyt, N.; Offringa, M.

2010-01-01

There is little experience with the nationwide implementation of an evidence-based pediatric guideline on first-choice fluid for resuscitation in hypovolemia. We investigated fluid prescribing behavior at (1) guideline development, (2) after guideline development, and (3) after active implementation

RSK-guidelines for PWR reactors

International Nuclear Information System (INIS)

1979-01-01

The RSK guidelines for PWA reactors of April 24, 1974, have been revised and amended in this edition. The RSK presents a summary of safety requirements to be observed in the design, construction, and operation of PWR reactors in the form of guidelines. From January 1979 onwards these guidelines will be the basis of siting and safety considerations for new PWR reactors, and newly built nuclear power plants will have to form these guidelines. They are not binding for existing nuclear power plants under construction or in operation. It will be a matter of individual discussion whether or not the guidelines will be applied in these plants. The main purpose of the guidelines is to facilitate discussion among RSK members and to give early information on necessary safety requirements. If the guidelines are observed by producers and operators, the RSK will make statements on individual projects at short notice. (orig./HP) [de

A review of clinical guidelines.

LENUS (Irish Health Repository)

Andrews, E J

2012-02-03

BACKGROUND: Clinical guidelines are increasingly used in patient management but few clinicians are familiar with their origin or appropriate application. METHODS: A Medline search using the terms \\'clinical guidelines\\' and \\'practice guidelines\\' was conducted. Additional references were sourced by manual searching from the bibliographies of articles located. RESULTS AND CONCLUSION: Clinical guidelines originated in the USA in the early 1980s, initially as a cost containment exercise. Significant improvements in the process and outcomes of care have been demonstrated following their introduction, although the extent of improvement varies considerably. The principles for the development of guidelines are well established but many published guidelines fall short of these basic quality criteria. Guidelines are only one aspect of improving quality and should be used within a wider framework of promoting clinical effectiveness. Understanding their limitations as well as their potential benefits should enable clinicians to have a clearer view of their place in everyday practice.

Oral precancerous lesions: Problems of early detection and oral cancer prevention

Science.gov (United States)

Gileva, Olga S.; Libik, Tatiana V.; Danilov, Konstantin V.

2016-08-01

The study presents the results of the research in the structure, local and systemic risk factors, peculiarities of the clinical manifestation, and quality of primary diagnosis of precancerous oral mucosa lesions (OMLs). In the study a wide range of OMLs and high (25.4%) proportion of oral precancerous lesions (OPLs) in their structure was indicated. The high percentage of different diagnostic errors and the lack of oncological awareness of dental practitioners, as well as the sharp necessity of inclusion of precancer/cancer early detection techniques into their daily practice were noted. The effectiveness of chemilumenescence system of early OPLs and oral cancer detection was demonstrated, the prospects of infrared thermography as a diagnostic tool were also discussed.

From Clinical Practice Guidelines to Computer-interpretable Guidelines. A Literature Overview

NARCIS (Netherlands)

Latoszek-Berendsen, A.; Tange, H.; van den Herik, H. J.; Hasman, A.

2010-01-01

Background: Guidelines are among us for over 30 years. Initially they were used as algorithmic protocols by nurses and other ancillary personnel. Many physicians regarded the use of guidelines as cookbook medicine. However, quality and patient safety issues have changed the attitude towards

Guidelines for radiological interventions

International Nuclear Information System (INIS)

Kauffmann, G.W.

1998-01-01

The German Radiological Society, in cooperation with other German professional bodies, set up draft Guidelines for Radiological Interventions and submitted them to the professional community for discussion. The Guidelines are meant to assess the potential of radiological interventions as treatment alternatives to surgery or aggressive therapy such as chemotherapy. In fact, technical practicability on its own is insufficient to warrant intervention. The Guidelines are systematically compiled notions and recommendations whose aim it is to provide support to physicians and patients in choosing suitable medical care provisions (prevention, diagnosis, therapy, aftertreatment) in specific circumstances. A complete Czech translation of the Guidelines is given. (P.A.)

Peracetic acid degradation in freshwater aquaculture systems and possible practical implications

DEFF Research Database (Denmark)

Pedersen, Lars-Flemming; Meinelt, Thomas; Straus, David L.

2013-01-01

, and it decays rapidly when applied to freshwater in aquaculture systems. The rapid decay is beneficial in an environmental context but a challenge to aquaculturists. To assess the impact of organic matter content and temperature on PAA decay, twenty-four batch experiments were set up using PAA doses ranging...... from 0 to 2.0 mg/l. The results revealed that increasing organic matter content significantly facilitated PAA decay, and positive temperature-decay correlations were found. Instantaneous PAA consumption above 0.2 mg/l was observed, and PAA half-lives were found to be in the order of a few minutes....... The relative PAA recovery, calculated as measured PAA concentration over time compared to the PAA concentration applied, decreased with declining dose. Measurements of PAA residuals during water treatment scenarios at three different freshwater fish farms revealed moderate to substantial PAA consumption...

Japanese Guideline for Atopic Dermatitis 2014

Directory of Open Access Journals (Sweden)

Ichiro Katayama

2014-01-01

The basics of treatment discussed in this guideline are based on the "Guidelines for the Treatment of Atopic Dermatitis 2008" prepared by the Health and Labour Sciences Research and the "Guidelines for the Management of Atopic Dermatitis 2012 (ADGL2012" prepared by the Atopic Dermatitis Guidelines Advisory Committee, Japanese Society of Allergology in principle. The guidelines for the treatment of atopic dermatitis are summarized in the "Japanese Guideline for the Diagnosis and Treatment of Allergic Disease 2013" together with those for other allergic diseases.

Incorporating a gender perspective into the development of clinical guidelines: a training course for guideline developers

Directory of Open Access Journals (Sweden)

Burgers Jako S

2007-11-01

Full Text Available Abstract Background Dutch guideline-developing organizations do not focus systematically on differences between men and women when developing guidelines, even though there is increasing evidence that being male or female may have an effect on health and health outcomes. In collaboration with two prominent Dutch guideline-developing organizations, we designed a training course to encourage systematic attention to sex differences in guideline development procedures. Methods The course is targeted towards guideline developers. Its aims are to improve awareness concerning the relevance of considering sex differences in the guideline development process, as well as the competence and skills necessary for putting this into practice. The design and teaching methods of the course are based on adult learning styles and principles of changing provider behaviour. It was adjusted to the working methods of guideline organizations. The course was taught to, and evaluated by, a group of staff members from two guideline organizations in the Netherlands. Results The course consists of five modules, each of which corresponds to a key step in the guideline development process. The participants rated the training course positively on content, programme, and trainers. Their written comments suggest that the course met its objectives. Conclusion The training course is the first to address sex differences in guideline development. Results from the pilot test suggest that the course achieved its objectives. Because its modules and teaching methods of the course are widely transferable, the course could be useful for many organizations that are involved in developing guidelines. Follow-up studies are needed to assess the long-term effect of the course on the actions of guideline developers and its utility in other settings.

[The German Program for Disease Management Guidelines: CHD Guideline 2006. Short review].

Science.gov (United States)

Ollenschläger, Günter; Lelgemann, Monika; Kopp, Ina

2006-12-15

In Germany, the first national consensus on evidence-based recommendations for disease management in patients with chronic coronary heart disease was reached in summer 2006. After a development period of 4 years, the National Disease Management Guideline Chronic Coronary Heart Disease was finalized by nominal group process under the authorship of the scientific associations for cardiac rehabilitation (DGPR), cardiac surgery (DGTHG), cardiology (DGK), general internal medicine (DGIM), family medicine (DEGAM), and the Drug Commission of the German Medical Association (AKDAE). The recommendations' main sources are the ACC/AHA guidelines 2002 updates as well as existing German guidelines and reviews of recent scientific evidence. The article gives an overview on authors, sources, and key recommendations of the German National Disease Management Guideline Chronic Coronary Heart Disease 2006 (www.khk.versorgungsleitlinie.de).

Japanese guidelines for atopic dermatitis 2017

Directory of Open Access Journals (Sweden)

Ichiro Katayama

2017-04-01

The basics of treatment discussed in this guideline are based on the “Guidelines for the Treatment of Atopic Dermatitis 2008” prepared by the Health and Labour Sciences Research and the “Guidelines for the Management of Atopic Dermatitis 2015 (ADGL2015” prepared by the Atopic Dermatitis Guidelines Advisory Committee, Japanese Society of Allergology in principle. The guidelines for the treatment of atopic dermatitis are summarized in the “Japanese Guideline for the Diagnosis and Treatment of Allergic Disease 2016” together with those for other allergic diseases.

OSART guidelines

International Nuclear Information System (INIS)

1988-02-01

The IAEA Operational Safety Review Team (OSART) programme provides advice and assistance to Member States to enhance the operational safety of nuclear power plants. These OSART Guidelines provide overall guidance for the experts to ensure the consistency and comprehensiveness of the operational safety review. Specific guidelines are provided as guide for the systematic review in the following areas important to operational safety: management, organization and administration, training and qualification, operations, maintenance, technical support, radiation protection, chemistry, emergency planning and preparedness

An investigation of human activity and vegetation change around Mkuze Game Reserve, South Africa

OpenAIRE

2014-01-01

M.A. (Geography) In the last century, the establishment of protected areas has become an important part of managing South Africa’s wilderness and wildlife. The notion of untouched protected areas is becoming contested in a time when developing nations are seeking to improve quality of life for their citizens. With the promulgation of the NEM: PAA of 2003, resource sharing with local rural communities has become an important policy guideline for protected area management authorities. An exa...

36 CFR 1191.1 - Accessibility guidelines.

Science.gov (United States)

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Accessibility guidelines... COMPLIANCE BOARD AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY GUIDELINES FOR BUILDINGS AND FACILITIES; ARCHITECTURAL BARRIERS ACT (ABA) ACCESSIBILITY GUIDELINES § 1191.1 Accessibility guidelines. (a) The...

A critical appraisal of guidelines for the management of knee osteoarthritis using Appraisal of Guidelines Research and Evaluation criteria

Science.gov (United States)

Poitras, Stéphane; Avouac, Jérôme; Rossignol, Michel; Avouac, Bernard; Cedraschi, Christine; Nordin, Margareta; Rousseaux, Chantal; Rozenberg, Sylvie; Savarieau, Bernard; Thoumie, Philippe; Valat, Jean-Pierre; Vignon, Éric; Hilliquin, Pascal

2007-01-01

Clinical practice guidelines have been elaborated to summarize evidence related to the management of knee osteoarthritis and to facilitate uptake of evidence-based knowledge by clinicians. The objectives of the present review were summarizing the recommendations of existing guidelines on knee osteoarthritis, and assessing the quality of the guidelines using a standardized and validated instrument – the Appraisal of Guidelines Research and Evaluation (AGREE) tool. Internet medical literature databases from 2001 to 2006 were searched for guidelines, with six guidelines being identified. Thirteen clinician researchers participated in the review. Each reviewer was trained in the AGREE instrument. The guidelines were distributed to four groups of three or four reviewers, each group reviewing one guideline with the exception of one group that reviewed two guidelines. One independent evaluator reviewed all guidelines. All guidelines effectively addressed only a minority of AGREE domains. Clarity/presentation was effectively addressed in three out of six guidelines, scope/purpose and rigour of development in two guidelines, editorial independence in one guideline, and stakeholder involvement and applicability in none. The clinical management recommendation tended to be similar among guidelines, although interventions addressed varied. Acetaminophen was recommended for initial pain treatment, combined with exercise and education. Nonsteroidal anti-inflammatory drugs were recommended if acetaminophen failed to control pain, but cautiously because of gastrointestinal risks. Surgery was recommended in the presence of persistent pain and disability. Education and activity management interventions were superficially addressed in most guidelines. Guideline creators should use the AGREE criteria when developing guidelines. Innovative and effective methods of knowledge translation to health professionals are needed. PMID:18062805

Guidelines on Building Regulations 2008

DEFF Research Database (Denmark)

Thse guidelines clarify and intepret the provisions of the Building Regulations of 2008 (BR08). The Guidelines, which match BR08 in terms of organisation into Parts, are accompanied by the full text of the regulations and the explanatory notes issued by the Danish Enterprise and Construction...... Authority. The Guidelines refer the reader to sources such as relevant standards, instructions and other background material which provides more detailed information. The Guidelines cover the same ground as BR08, including building control regulations, layout, fitting out, structures, fire safety, indoor...... climate, energy consumotion and services. The Guidelines are aimed at all professionals involved in building projects, particularly building design consultants, contractors and municipal application officers....

Managing challenging interactions with family caregivers in the cancer setting: Guidelines for clinicians (TRIO Guidelines-2).

Science.gov (United States)

Laidsaar-Powell, Rebekah; Butow, Phyllis; Boyle, Frances; Juraskova, Ilona

2018-06-01

Family caregivers can, at times, add complexity to clinical encounters. Difficult family caregivers and dynamics may: derail consultation communication, reduce patient autonomy, and compromise effective clinical care. A paucity of practical strategies guiding effective clinician-family communication exists. This study aimed to develop and evaluate the first comprehensive, evidence-based guidelines (the TRIO guidelines) for oncology physicians and nurses to better manage several complex/challenging situations involving family members. TRIO Guidelines were based on a comprehensive review of literature, relevant guidelines, and feedback from an expert advisory group (n = 10). Draft guidelines underwent two rounds of evaluation via an online Delphi consensus process involving international experts (n = 35). Guidelines incorporate topic areas, strategies, and sub-strategies on managing challenging family involvement (7 topics). Example wording, behaviours and level of evidence are provided. Challenging triadic interactions require skillful navigation, and the TRIO Guidelines provide clear, specific, and evidence-based strategies for clinicians to utilise in these potentially stressful encounters. Training based on these guidelines may improve both patient care and clinician confidence. Implementation of these guidelines into medical/nursing curricula and as a component of continuing professional development programs will likely be highly beneficial. Copyright © 2018 Elsevier B.V. All rights reserved.

Evidence-based guidelines

DEFF Research Database (Denmark)

Rovira, Àlex; Wattjes, Mike P; Tintoré, Mar

2015-01-01

diagnosis in patients with MS. The aim of this article is to provide guidelines for the implementation of MRI of the brain and spinal cord in the diagnosis of patients who are suspected of having MS. These guidelines are based on an extensive review of the recent literature, as well as on the personal...

Adopting preoperative fasting guidelines.

Science.gov (United States)

Anderson, Megan; Comrie, Rhonda

2009-07-01

In 1999, the American Society of Anesthesiologists adopted preoperative fasting guidelines to enhance the quality and efficiency of patient care. Guidelines suggest that healthy, non-pregnant patients should fast six hours from solids and two hours from liquids. Although these guidelines are in place, studies suggest that providers are still using the blanket statement "NPO after midnight" without regard to patient characteristics, the procedure, or the time of the procedure. Using theory to help change provider's beliefs may help make change more successful. Rogers' Theory of Diffusion of Innovations can assist in changing long-time practice by laying the groundwork for an analysis of the benefits and disadvantages of proposed changes, such as changes to fasting orders, while helping initiate local protocols instead of additional national guidelines.

Study of the influence of the codopant over the photoluminescent properties of PAA doped with Eu{sup 3+}, Gd{sup 3+}, and Tb{sup 3+}; Estudio de la influencia del codopante sobre las propiedades fotoluminiscentes de PAA dopado con Eu{sup 3+}, Gd{sup 3+} y Tb{sup 3+}

Energy Technology Data Exchange (ETDEWEB)

Flores, M.; Arroyo, R. [Departamento de Fisica, UAM-I, A.P. 55-534, 09820 Mexico D.F. (Mexico)

2003-07-01

The results are presented obtained about the synthesis of acrylic poly acid characterization (PAA) doped with Eu{sup 3+}, Gd{sup 3+} and Tb{sup 3+}. They got ready materials with even of these ions and it was studied the influence of the co dopant in the processes of emission of Eu{sup 3+} ({lambda}{sub em} = 618 nm), Gd{sup 3+} ({lambda}{sub em} = 624 nm) and Tb{sup 3+} ({lambda}{sub em} = 546 nm), as well as their effect in the phosphorescence ({lambda}{sub em} = 450 nm) of the polymeric matrix. It was found that the intensity of the emission of Eu{sup 3+} diminishes substantially due to the presence of the ions Gd{sup 3+}, contrary to what happens when the co dopant is Tb{sup 3+} , which causes an increase. In the one case of the emission of Tb{sup 3+}, this it increases with the presence of Gd{sup 3+} but it diminishes when Eu{sup 3+} is present. These results are consequence of the homogeneous distribution of those dopants and of the phenomena of energy transfer that happen in the materials synthesized. (Author)

32 CFR 231.11 - Guidelines.

Science.gov (United States)

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Guidelines. 231.11 Section 231.11 National... PROCEDURES GOVERNING BANKS, CREDIT UNIONS AND OTHER FINANCIAL INSTITUTIONS ON DOD INSTALLATIONS Guidelines for Application of the Privacy Act to Financial Institution Operations § 231.11 Guidelines. (a) The...

Methodological quality of guidelines in gastroenterology.

Science.gov (United States)

Malheiro, Rui; de Monteiro-Soares, Matilde; Hassan, Cesare; Dinis-Ribeiro, Mário

2014-06-01

Clinical guidelines are a common feature in modern endoscopy practice and they are being produced faster than ever. However, their methodological quality is rarely assessed. This study evaluated the methodological quality of current clinical guidelines in the field of gastroenterology, with an emphasis on endoscopy. Practice guidelines published by the American College of Gastroenterology (ACG), American Gastroenterological Association (AGA), American Society for Gastrointestinal Endoscopy (ASGE), European Society of Gastrointestinal Endoscopy (ESGE), British Society of Gastroenterology (BSG), National Institute for Health and Care Excellence (NICE), and the Scottish Intercollegiate Guidelines Network (SIGN) were searched between September and October 2012 and evaluated using the AGREE II (Appraisal of Guidelines for Research and Evaluation) instrument (23 items, scores 1 - 7 for each item; higher scores mean better quality). A total of 100 guidelines were assessed. The mean number of items scoring 6 or 7 per guideline was 9.2 (out of 23 items). Overall, 99 % of guidelines failed to include the target population in the development process, and 96 % did not report facilitators and barriers to guideline application. In addition, 86 % did not include advice or tools, and 94 % did not present monitoring or auditing criteria. The global methodological quality of clinical guidelines in the field of gastroenterology is poor, particularly regarding involvement of the target population in the development of guidelines and in the provision of clear suggestions to practitioners. © Georg Thieme Verlag KG Stuttgart · New York.

BWR emergency procedure guidelines

International Nuclear Information System (INIS)

Post, J.S.; Karner, E.F.; Stratman, R.A.

1984-01-01

This chapter describes plans for dealing with reactor accidents developed by the Boiling Water Reactor (BWR) Owners' Group in response to post-Three Mile Island US NRC requirements. The devised Emergency Procedure Guidelines (EPGs), applicable to all BWRs, are symptom-based rather than event-based. According to the EPGs, the operator does not need to identify what event is occurring in the plant in order to decide what action to take, but need only observe the symptoms (values and trends of key control parameters) which exist and take appropriate action to control these symptoms. The original objective was to provide reactor operator guidance in responding to a small break loss-of-coolant accident (LOCA), but subsequent revisions have included other types of reactor accidents. Topics considered include the reactor pressure vessel (RPV) control guideline, the primary containment control guideline, the secondary containment control guideline, the radioactivity release control guideline, multiple failures vs. the design basis, safe limits vs. technical specifications, the technical status, licensing, and implementation. The EPGs are based upon maintaining both adequate core cooling and primary containment integrity

Are BTS guidelines followed?

Science.gov (United States)

2002-03-01

In 1993, the British Thoracic Society (BTS) issued guidelines for the management of spontaneous pneumothorax. The study's aim was to determine the level of adherence to these guidelines at a London teaching hospital. A retrospective case note audit of 59 episodes was performed. In patients undergoing intervention, the initial procedure was simple aspiration in 32 (73 per cent) and chest tube insertion in 12 (27 per cent) cases, contrasting with the BTS recommendation that aspiration should be attempted first in all such patients. Simple aspiration was successful on 34 per cent of occasions. Successful aspiration was associated with a significantly shorter hospital stay (median 3, range 1-11 days) than either failed aspiration (7, 3-66 days) or chest tube insertion without aspiration (9, 3-16 days). Other areas where practice differed from the BTS guidelines were clamping of chest tubes and use of a pursestring suture for wound closure. A follow up questionnaire suggested a lack of familiarity with the guidelines. These findings indicate that current management of spontaneous pneumothorax deviates from the BTS guidelines in potentially important respects.

36 CFR 910.67 - Square guidelines.

Science.gov (United States)

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Square guidelines. 910.67... GUIDELINES AND UNIFORM STANDARDS FOR URBAN PLANNING AND DESIGN OF DEVELOPMENT WITHIN THE PENNSYLVANIA AVENUE DEVELOPMENT AREA Glossary of Terms § 910.67 Square guidelines. Square Guidelines establish the Corporation's...

28 CFR 2.36 - Rescission guidelines.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Rescission guidelines. 2.36 Section 2.36... guidelines. (a) The following guidelines shall apply to the sanctioning of disciplinary infractions or new... such period of confinement has resulted from initial parole to a detainer). These guidelines specify...

23 CFR 650.211 - Guidelines.

Science.gov (United States)

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Guidelines. 650.211 Section 650.211 Highways FEDERAL..., STRUCTURES, AND HYDRAULICS Erosion and Sediment Control on Highway Construction Projects § 650.211 Guidelines. (a) The FHWA adopts the AASHTO Highway Drainage Guidelines, Volume III, “Erosion and Sediment Control...

15 CFR 1170.4 - Guidelines.

Science.gov (United States)

2010-01-01

... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Guidelines. 1170.4 Section 1170.4... ADMINISTRATION, DEPARTMENT OF COMMERCE METRIC CONVERSION POLICY FOR FEDERAL AGENCIES § 1170.4 Guidelines. Each... agency actions, activities or programs undertaken in compliance with these guidelines or other laws or...

ESUR prostate MR guidelines 2012

DEFF Research Database (Denmark)

Barentsz, Jelle O; Richenberg, Jonathan; Clements, Richard

2012-01-01

The aim was to develop clinical guidelines for multi-parametric MRI of the prostate by a group of prostate MRI experts from the European Society of Urogenital Radiology (ESUR), based on literature evidence and consensus expert opinion. True evidence-based guidelines could not be formulated......, but a compromise, reflected by "minimal" and "optimal" requirements has been made. The scope of these ESUR guidelines is to promulgate high quality MRI in acquisition and evaluation with the correct indications for prostate cancer across the whole of Europe and eventually outside Europe. The guidelines...... provides guidelines for magnetic resonance imaging (MRI) in prostate cancer. Clinical indications, and minimal and optimal imaging acquisition protocols are provided. A structured reporting system (PI-RADS) is described....

Guidelines for District Heating Substations

Energy Technology Data Exchange (ETDEWEB)

2009-07-15

The present guidelines contain a set of recommendations focusing on planning, installation, use and maintenance of district heating (DH) substations within district heating systems throughout Europe. The recommendations were developed in order to enable readers to develop well-functioning substations and an effective heat and domestic warm water delivery. These guidelines are intended to give the most effective overall solutions for various parts of the customer installation. The guidelines are not meant to specify the different components of the substation such as meters or heat exchangers. The guidelines deal with a wide variety of issues concerning both present systems of today and district heating systems of the future. Specific handling and maintenance recommendations are mainly focused on present modern systems but are also intended to cover the future situation as much as is feasible. For this reason, certain existing systems are not dealt with in these guidelines. For instance, these guidelines do not cover steam systems, systems with temperatures exceeding 110 deg C and pressure levels above 1.6 MPa. The guidelines include a chapter on the heat meter, as the meter and especially the meter installation is always installed simultaneously with the rest of the substation. These guidelines aim to provide best-practice and easy-to-handle recommendations for: - those who are responsible for relations between district heating utilities and customers; - those who own or maintain a building connected to the district heating network; - those who manufacture, plan, purchase, test and install substations. These guidelines do not deal with investment or cost aspects, but in general, Euroheat and Power recommends looking at the lifetime cost of all components of the substation, instead of investment costs alone. An example of this is provided in Chapter 7.8. The Guidelines were developed based on the most optimal operating principles of substations and meters

32 CFR 143.8 - Guidelines.

Science.gov (United States)

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Guidelines. 143.8 Section 143.8 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN DOD POLICY ON... BARGAINING § 143.8 Guidelines. The guidelines for making certain factual determinations are as follows: (a...

Transparent Guideline Methodology Needed

DEFF Research Database (Denmark)

Lidal, Ingeborg; Norén, Camilla; Mäkelä, Marjukka

2013-01-01

As part of learning at the Nordic Workshop of Evidence-based Medicine, we have read with interest the practice guidelines for central venous access, published in your Journal in 2012.1 We appraised the quality of this guideline using the checklist developed by The Evidence-Based Medicine Working ...... are based on best currently available evidence. Our concerns are in two main categories: the rigor of development, including methodology of searching, evaluating, and combining the evidence; and editorial independence, including funding and possible conflicts of interest....... Group.2 Similar criteria for guideline quality have been suggested elsewhere.3 Our conclusion was that this much needed guideline is currently unclear about several aspects of the methodology used in developing the recommendations. This means potential users cannot be certain that the recommendations...

Addressing implementation challenges during guideline development - a case study of Swedish national guidelines for methods of preventing disease.

Science.gov (United States)

Richter-Sundberg, Linda; Kardakis, Therese; Weinehall, Lars; Garvare, Rickard; Nyström, Monica E

2015-01-22

Many of the world's life threatening diseases (e.g. cancer, heart disease, stroke) could be prevented by eliminating life-style habits such as tobacco use, unhealthy diet, physical inactivity and excessive alcohol use. Incorporating evidence-based research on methods to change unhealthy lifestyle habits in clinical practice would be equally valuable. However gaps between guideline development and implementation are well documented, with implications for health care quality, safety and effectiveness. The development phase of guidelines has been shown to be important both for the quality in guideline content and for the success of implementation. There are, however, indications that guidelines related to general disease prevention methods encounter specific barriers compared to guidelines that are diagnosis-specific. In 2011 the Swedish National board for Health and Welfare launched guidelines with a preventive scope. The aim of this study was to investigate how implementation challenges were addressed during the development process of these disease preventive guidelines. Seven semi-structured interviews were conducted with members of the guideline development management group. Archival data detailing the guideline development process were also collected and used in the analysis. Qualitative data were analysed using content analysis as the analytical framework. The study identified several strategies and approaches that were used to address implementation challenges during guideline development. Four themes emerged from the analysis: broad agreements and consensus about scope and purpose; a formalized and structured development procedure; systematic and active involvement of stakeholders; and openness and transparency in the specific guideline development procedure. Additional factors concerning the scope of prevention and the work environment of guideline developers were perceived to influence the possibilities to address implementation issues. This case study

Regulatory odour model development: Survey of modelling tools and datasets with focus on building effects

DEFF Research Database (Denmark)

Olesen, H. R.; Løfstrøm, P.; Berkowicz, R.

dispersion models for estimating local concentration levels in general. However, the report focuses on some particular issues, which are relevant for subsequent work on odour due to animal production. An issue of primary concern is the effect that buildings (stables) have on flow and dispersion. The handling...... of building effects is a complicated problem, and a major part of the report is devoted to the treatment of building effects in dispersion models......A project within the framework of a larger research programme, Action Plan for the Aquatic Environment III (VMP III) aims towards improving an atmospheric dispersion model (OML). The OML model is used for regulatory applications in Denmark, and it is the candidate model to be used also in future...

Current Guidelines Have Limited Applicability to Patients with Comorbid Conditions: A Systematic Analysis of Evidence-Based Guidelines

Science.gov (United States)

Lugtenberg, Marjolein; Burgers, Jako S.; Clancy, Carolyn; Westert, Gert P.; Schneider, Eric C.

2011-01-01

Background Guidelines traditionally focus on the diagnosis and treatment of single diseases. As almost half of the patients with a chronic disease have more than one disease, the applicability of guidelines may be limited. The aim of this study was to assess the extent that guidelines address comorbidity and to assess the supporting evidence of recommendations related to comorbidity. Methodology/Principal Findings We conducted a systematic analysis of evidence-based guidelines focusing on four highly prevalent chronic conditions with a high impact on quality of life: chronic obstructive pulmonary disease, depressive disorder, diabetes mellitus type 2, and osteoarthritis. Data were abstracted from each guideline on the extent that comorbidity was addressed (general comments, specific recommendations), the type of comorbidity discussed (concordant, discordant), and the supporting evidence of the comorbidity-related recommendations (level of evidence, translation of evidence). Of the 20 guidelines, 17 (85%) addressed the issue of comorbidity and 14 (70%) provided specific recommendations on comorbidity. In general, the guidelines included few recommendations on patients with comorbidity (mean 3 recommendations per guideline, range 0 to 26). Of the 59 comorbidity-related recommendations provided, 46 (78%) addressed concordant comorbidities, 8 (14%) discordant comorbidities, and for 5 (8%) the type of comorbidity was not specified. The strength of the supporting evidence was moderate for 25% (15/59) and low for 37% (22/59) of the recommendations. In addition, for 73% (43/59) of the recommendations the evidence was not adequately translated into the guidelines. Conclusions/Significance Our study showed that the applicability of current evidence-based guidelines to patients with comorbid conditions is limited. Most guidelines do not provide explicit guidance on treatment of patients with comorbidity, particularly for discordant combinations. Guidelines should be more

Ecologo guidelines spark disagreement

International Nuclear Information System (INIS)

Anon.

1999-01-01

Defining what renewable means has been a challenge, but the authors of a new set of guidelines for the Ecologo certification of renewable low-impact electrcity expect after some delay to have the new rules on the street by March 2000.. There was contention in developing the guideline, according to Terra Choice Environmental Services, the company that created and applied criteria for Ecologo certification under the federal government's Environmetal Choice Program. Interim guidleines were developed and have been in place for renewable power since 1996, and have since been used to certify wood-waste biomass, landfill gas, small hydro and wind power plants, in addition to three green power marketing programs. The first draft of the revised guidelines was issued in March. It was one of the harder guidelines to have been worked on because Canadian power producers did not readily agree on what should qualify as renewable, particularly around the whole area of hydro. While small run-of-river hydro plants will continue to fit within the Ecologo guidelines, larger projects will not. Wind power producers are relatively happy with the latest version of TerraChoice's draft guidelines, released at the end of November. A significant revision of the original rules is a limit on the amount of older generation green power marketers who want to promote the green power Ecologo electricity can sell. At least 50% of their capacity must originate from plants installed after January 1, 1991

Web Accessibility and Guidelines

Science.gov (United States)

Harper, Simon; Yesilada, Yeliz

Access to, and movement around, complex online environments, of which the World Wide Web (Web) is the most popular example, has long been considered an important and major issue in the Web design and usability field. The commonly used slang phrase ‘surfing the Web’ implies rapid and free access, pointing to its importance among designers and users alike. It has also been long established that this potentially complex and difficult access is further complicated, and becomes neither rapid nor free, if the user is disabled. There are millions of people who have disabilities that affect their use of the Web. Web accessibility aims to help these people to perceive, understand, navigate, and interact with, as well as contribute to, the Web, and thereby the society in general. This accessibility is, in part, facilitated by the Web Content Accessibility Guidelines (WCAG) currently moving from version one to two. These guidelines are intended to encourage designers to make sure their sites conform to specifications, and in that conformance enable the assistive technologies of disabled users to better interact with the page content. In this way, it was hoped that accessibility could be supported. While this is in part true, guidelines do not solve all problems and the new WCAG version two guidelines are surrounded by controversy and intrigue. This chapter aims to establish the published literature related to Web accessibility and Web accessibility guidelines, and discuss limitations of the current guidelines and future directions.

10 CFR 960.4-2 - Technical guidelines.

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Technical guidelines. 960.4-2 Section 960.4-2 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Postclosure Guidelines § 960.4-2 Technical guidelines. The technical guidelines in this subpart...

International Variation in Asthma and Bronchiolitis Guidelines.

Science.gov (United States)

Bakel, Leigh Anne; Hamid, Jemila; Ewusie, Joycelyne; Liu, Kai; Mussa, Joseph; Straus, Sharon; Parkin, Patricia; Cohen, Eyal

2017-11-01

Guideline recommendations for the same clinical condition may vary. The purpose of this study was to determine the degree of agreement among comparable asthma and bronchiolitis treatment recommendations from guidelines. National and international guidelines were searched by using guideline databases (eg, National Guidelines Clearinghouse: December 16-17, 2014, and January 9, 2015). Guideline recommendations were categorized as (1) recommend, (2) optionally recommend, (3) abstain from recommending, (4) recommend against a treatment, and (5) not addressed by the guideline. The degree of agreement between recommendations was evaluated by using an unweighted and weighted κ score. Pairwise comparisons of the guidelines were evaluated similarly. There were 7 guidelines for asthma and 4 guidelines for bronchiolitis. For asthma, there were 166 recommendation topics, with 69 recommendation topics given in ≥2 guidelines. For bronchiolitis, there were 46 recommendation topics, with 21 recommendation topics provided in ≥2 guidelines. The overall κ for asthma was 0.03, both unweighted (95% confidence interval [CI]: -0.01 to 0.07) and weighted (95% CI: -0.01 to 0.10); for bronchiolitis, it was 0.32 unweighted (95% CI: 0.16 to 0.52) and 0.15 weighted (95% CI: -0.01 to 0.5). Less agreement was found in national and international guidelines for asthma than for bronchiolitis. Additional studies are needed to determine if differences are based on patient preferences and values and economic considerations or if other recommendation-level, guideline-level, and condition-level factors are driving these differences. Copyright © 2017 by the American Academy of Pediatrics.

Surfing the best practice guidelines: national clinical guideline clearinghouse in development.

Science.gov (United States)

1997-08-01

The growth in development and usage of clinical guidelines during the last five years has been remarkable. Not only are health care practitioners reaching for what's deemed to be the best in protocols and practice, consumers, too, are looking toward standards and guidelines as they become more educated about the quality and quantity of health care services they should be receiving.

10 CFR 960.5-2 - Technical guidelines.

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Technical guidelines. 960.5-2 Section 960.5-2 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Preclosure Guidelines § 960.5-2 Technical guidelines. The technical guidelines in this subpart set...

Metric Guidelines Inservice and/or Preservice

Science.gov (United States)

Granito, Dolores

1978-01-01

Guidelines are given for designing teacher training for going metric. The guidelines were developed from existing guidelines, journal articles, a survey of colleges, and the detailed reactions of a panel. (MN)

Elucidating the role of the phenylacetic acid metabolic complex in the pathogenic activity of Rhizoctonia solani anastomosis group 3.

Science.gov (United States)

Bartz, Faith E; Glassbrook, Norman J; Danehower, David A; Cubeta, Marc A

2012-01-01

The soil fungus Rhizoctonia solani produces phytotoxic phenylacetic acid (PAA) and hydroxy (OH-) and methoxy (MeO-) derivatives of PAA. However, limited information is available on the specific role that these compounds play in the development of Rhizoctonia disease symptoms and concentration(s) required to induce a host response. Reports that PAA inhibits the growth of R. solani conflict with the established ability of the fungus to produce and metabolize PAA. Experiments were conducted to clarify the role of the PAA metabolic complex in Rhizoctonia disease. In this study the concentration of PAA and derivatives required to induce tomato root necrosis and stem canker, in the absence of the fungus, and the concentration that inhibits mycelial growth of R. solani were determined. The effect of exogenous PAA and derivatives of PAA on tomato seedling growth also was investigated. Growth of tomato seedlings in medium containing 0.1-7.5 mM PAA and derivatives induced necrosis of up to 85% of root system. Canker development resulted from injection of tomato seedling stems with 7.5 mM PAA, 3-OH-PAA, or 3-MeO-PAA. PAA in the growth medium reduced R. solani biomass, with 50% reduction observed at 7.5 mM. PAA, and derivatives were quantified from the culture medium of 14 isolates of R. solani belonging to three distinct anastomosis groups by GC-MS. The quantities ranged from below the limit of detection to 678 nM, below the concentrations experimentally determined to be phytotoxic. Correlation analyses revealed that isolates of R. solani that produced high PAA and derivatives in vitro also caused high mortality on tomato seedlings. The results of this investigation add to the body of evidence that the PAA metabolic complex is involved in Rhizoctonia disease development but do not indicate that production of these compounds is the primary or the only determinant of pathogenicity.

13C based proteinogenic amino acid (PAA) and metabolic flux ratio analysis of Lactococcus lactis reveals changes in pentose phosphate (PP) pathway in response to agitation and temperature related stresses.

Science.gov (United States)

Azizan, Kamalrul Azlan; Ressom, Habtom W; Mendoza, Eduardo R; Baharum, Syarul Nataqain

2017-01-01

Lactococcus lactis subsp. cremoris MG1363 is an important starter culture for dairy fermentation. During industrial fermentations, L. lactis is constantly exposed to stresses that affect the growth and performance of the bacterium. Although the response of L. lactis to several stresses has been described, the adaptation mechanisms at the level of in vivo fluxes have seldom been described. To gain insights into cellular metabolism, 13 C metabolic flux analysis and gas chromatography mass spectrometry (GC-MS) were used to measure the flux ratios of active pathways in the central metabolism of L. lactis when subjected to three conditions varying in temperature (30°C, 37°C) and agitation (with and without agitation at 150 rpm). Collectively, the concentrations of proteinogenic amino acids (PAAs) and free fatty acids (FAAs) were compared, and Pearson correlation analysis ( r ) was calculated to measure the pairwise relationship between PAAs. Branched chain and aromatic amino acids, threonine, serine, lysine and histidine were correlated strongly, suggesting changes in flux regulation in glycolysis, the pentose phosphate (PP) pathway, malic enzyme and anaplerotic reaction catalysed by pyruvate carboxylase (pycA). Flux ratio analysis revealed that glucose was mainly converted by glycolysis, highlighting the stability of L. lactis' central carbon metabolism despite different conditions. Higher flux ratios through oxaloacetate (OAA) from pyruvate (PYR) reaction in all conditions suggested the activation of pyruvate carboxylate (pycA) in L. lactis , in response to acid stress during exponential phase. Subsequently, more significant flux ratio differences were seen through the oxidative and non-oxidative pentose phosphate (PP) pathways, malic enzyme, and serine and C1 metabolism, suggesting NADPH requirements in response to environmental stimuli. These reactions could play an important role in optimization strategies for metabolic engineering in L. lactis . Overall, the

13C based proteinogenic amino acid (PAA and metabolic flux ratio analysis of Lactococcus lactis reveals changes in pentose phosphate (PP pathway in response to agitation and temperature related stresses

Directory of Open Access Journals (Sweden)

Kamalrul Azlan Azizan

2017-07-01

Full Text Available Lactococcus lactis subsp. cremoris MG1363 is an important starter culture for dairy fermentation. During industrial fermentations, L. lactis is constantly exposed to stresses that affect the growth and performance of the bacterium. Although the response of L. lactis to several stresses has been described, the adaptation mechanisms at the level of in vivo fluxes have seldom been described. To gain insights into cellular metabolism, 13C metabolic flux analysis and gas chromatography mass spectrometry (GC-MS were used to measure the flux ratios of active pathways in the central metabolism of L. lactis when subjected to three conditions varying in temperature (30°C, 37°C and agitation (with and without agitation at 150 rpm. Collectively, the concentrations of proteinogenic amino acids (PAAs and free fatty acids (FAAs were compared, and Pearson correlation analysis (r was calculated to measure the pairwise relationship between PAAs. Branched chain and aromatic amino acids, threonine, serine, lysine and histidine were correlated strongly, suggesting changes in flux regulation in glycolysis, the pentose phosphate (PP pathway, malic enzyme and anaplerotic reaction catalysed by pyruvate carboxylase (pycA. Flux ratio analysis revealed that glucose was mainly converted by glycolysis, highlighting the stability of L. lactis’ central carbon metabolism despite different conditions. Higher flux ratios through oxaloacetate (OAA from pyruvate (PYR reaction in all conditions suggested the activation of pyruvate carboxylate (pycA in L. lactis, in response to acid stress during exponential phase. Subsequently, more significant flux ratio differences were seen through the oxidative and non-oxidative pentose phosphate (PP pathways, malic enzyme, and serine and C1 metabolism, suggesting NADPH requirements in response to environmental stimuli. These reactions could play an important role in optimization strategies for metabolic engineering in L. lactis. Overall

13C based proteinogenic amino acid (PAA) and metabolic flux ratio analysis of Lactococcus lactis reveals changes in pentose phosphate (PP) pathway in response to agitation and temperature related stresses

Science.gov (United States)

2017-01-01

Lactococcus lactis subsp. cremoris MG1363 is an important starter culture for dairy fermentation. During industrial fermentations, L. lactis is constantly exposed to stresses that affect the growth and performance of the bacterium. Although the response of L. lactis to several stresses has been described, the adaptation mechanisms at the level of in vivo fluxes have seldom been described. To gain insights into cellular metabolism, 13C metabolic flux analysis and gas chromatography mass spectrometry (GC-MS) were used to measure the flux ratios of active pathways in the central metabolism of L. lactis when subjected to three conditions varying in temperature (30°C, 37°C) and agitation (with and without agitation at 150 rpm). Collectively, the concentrations of proteinogenic amino acids (PAAs) and free fatty acids (FAAs) were compared, and Pearson correlation analysis (r) was calculated to measure the pairwise relationship between PAAs. Branched chain and aromatic amino acids, threonine, serine, lysine and histidine were correlated strongly, suggesting changes in flux regulation in glycolysis, the pentose phosphate (PP) pathway, malic enzyme and anaplerotic reaction catalysed by pyruvate carboxylase (pycA). Flux ratio analysis revealed that glucose was mainly converted by glycolysis, highlighting the stability of L. lactis’ central carbon metabolism despite different conditions. Higher flux ratios through oxaloacetate (OAA) from pyruvate (PYR) reaction in all conditions suggested the activation of pyruvate carboxylate (pycA) in L. lactis, in response to acid stress during exponential phase. Subsequently, more significant flux ratio differences were seen through the oxidative and non-oxidative pentose phosphate (PP) pathways, malic enzyme, and serine and C1 metabolism, suggesting NADPH requirements in response to environmental stimuli. These reactions could play an important role in optimization strategies for metabolic engineering in L. lactis. Overall, the

The appraisal of clinical guidelines in dentistry.

Science.gov (United States)

Glenny, Anne-Marie; Worthington, Helen V; Clarkson, Jan E; Esposito, Marco

2009-01-01

To appraise the reported processes involved in the development of published dental guidelines. Electronic databases were searched to identify guidelines making recommendations for any health professional within dentistry. All included guidelines were appraised using the Appraisal of Guidelines Research and Evaluation (AGREE) instrument. A total of 105 guidelines met the inclusion criteria. The appraised guidelines showed lack of rigour in their development (median score 14.3%; range 0% to 100%). Only 10 (9.5%) were coded as 'strongly recommend' by at least two assessors. If recommendations within clinical guidelines are to be relied upon, the methods used in their development must be explicit and free from bias. When using the AGREE checklist to make decisions on whether or not to implement individual sets of guidelines, the findings of the present assessment reinforce the need for more than two assessors to be included in the appraisal of each set of guidelines.

Comparison of international guideline programs to evaluate and update the Dutch program for clinical guideline development in physical therapy.

Science.gov (United States)

Van der Wees, Philip J; Hendriks, Erik J M; Custers, Jan W H; Burgers, Jako S; Dekker, Joost; de Bie, Rob A

2007-11-23

Clinical guidelines are considered important instruments to improve quality in health care. Since 1998 the Royal Dutch Society for Physical Therapy (KNGF) produced evidence-based clinical guidelines, based on a standardized program. New developments in the field of guideline research raised the need to evaluate and update the KNGF guideline program. Purpose of this study is to compare different guideline development programs and review the KNGF guideline program for physical therapy in the Netherlands, in order to update the program. Six international guideline development programs were selected, and the 23 criteria of the AGREE Instrument were used to evaluate the guideline programs. Information about the programs was retrieved from published handbooks of the organizations. Also, the Dutch program for guideline development in physical therapy was evaluated using the AGREE criteria. Further comparison the six guideline programs was carried out using the following elements of the guideline development processes: Structure and organization; Preparation and initiation; Development; Validation; Dissemination and implementation; Evaluation and update. Compliance with the AGREE criteria of the guideline programs was high. Four programs addressed 22 AGREE criteria, and two programs addressed 20 AGREE criteria. The previous Dutch program for guideline development in physical therapy lacked in compliance with the AGREE criteria, meeting only 13 criteria. Further comparison showed that all guideline programs perform systematic literature searches to identify the available evidence. Recommendations are formulated and graded, based on evidence and other relevant factors. It is not clear how decisions in the development process are made. In particular, the process of translating evidence into practice recommendations can be improved. As a result of international developments and consensus, the described processes for developing clinical practice guidelines have much in common

Glaucoma-service provision in Scotland: introduction and need for Scottish Intercollegiate Guidelines Network guidelines.

Science.gov (United States)

Syrogiannis, Andreas; Rotchford, Alan P; Agarwal, Pankaj Kumar; Kumarasamy, Manjula; Montgomery, Donald; Burr, Jennifer; Sanders, Roshini

2015-01-01

To describe the pattern of glaucoma-service delivery in Scotland and identify areas for improvement, taking into account Scottish General Ophthalmic Services (GOS) arrangements and the Eye Care Integration project, and to design Scottish Intercollegiate Guidelines Network (SIGN) guidelines to refine the primary and secondary interface of glaucoma care. A glaucoma-survey questionnaire was sent to all consultant glaucomatologists in Scotland. The design of SIGN guidelines was based on the results of the questionnaire using SIGN methodology. Over 90% of Scottish glaucoma care is triaged and delivered within hospital services. Despite GOS referral, information is variable. There are no consistent discharge practices to the community. These results led to defined research questions that were answered, thus formulating the content of the SIGN guidelines. The guideline covers the assessment of patients in primary care, referral criteria to hospital, discharge criteria from hospital to community, and monitoring of patients at risk of glaucoma. With increasing age and limitations to hospital resources, refining glaucoma pathways between primary and secondary care has become a necessity. Scotland has unique eye care arrangements with both the GOS and Eye Care Integration project. It is hoped that implementation of SIGN guidelines will identify glaucoma at the earliest opportunity and reduce the rate of false-positive referrals to hospital.

Wastewater disinfection by peracetic acid: assessment of models for tracking residual measurements and inactivation.

Science.gov (United States)

Santoro, Domenico; Gehr, Ronald; Bartrand, Timothy A; Liberti, Lorenzo; Notarnicola, Michele; Dell'Erba, Adele; Falsanisi, Dario; Haas, Charles N

2007-07-01

With its potential for low (if any) disinfection byproduct formation and easy retrofit for chlorine contactors, peracetic acid (PAA) or use of PAA in combination with other disinfectant technologies may be an attractive alternative to chlorine-based disinfection. Examples of systems that might benefit from use of PAA are water reuse schemes or plants discharging to sensitive receiving water bodies. Though PAA is in use in numerous wastewater treatment plants in Europe, its chemical kinetics, microbial inactivation rates, and mode of action against microorganisms are not thoroughly understood. This paper presents results from experimental studies of PAA demand, PAA decay, and microbial inactivation, with a complementary modeling analysis. Model results are used to evaluate techniques for measurement of PAA concentration and to develop hypotheses regarding the mode of action of PAA in bacterial inactivation. Kinetic and microbial inactivation rate data were collected for typical wastewaters and may be useful for engineers in evaluating whether to convert from chlorine to PAA disinfection.

Adherence to cancer treatment guidelines: influence of general and cancer-specific guideline characteristics.

NARCIS (Netherlands)

Heins, M.J.; Jong, J.D. de; Spronk, I.; Ho, V.K.; Brink, M.; Korevaar, J.C.

2017-01-01

Background: Guideline adherence remains a challenge in clinical practice, despite guidelines’ ascribed potential to improve patient outcomes. We studied the level of adherence to recommendations from Dutch national cancer treatment guidelines, and the influence of general and

D 59 Design Guidelines

DEFF Research Database (Denmark)

Burcharth, Hans F.; Lamberti, Alberto

The present guidelines are specifically dedicated to Low Crested Structures on attempt to provide methodological tools both for the engineering design of structures and for prediction of performance and environmental impacts. It is anticipated that the guidelines will provide valuable inputs to c...

Discursos y prácticas de la cooperación Sur-Sur brasileña en materia agrícola en el África Subsahariana: el caso del ProSavana y del PAA África

OpenAIRE

de Andrade e Sousa, Maria Eduarda

2016-01-01

Este artículo aborda la Cooperación Sur-Sur (CSS) brasileña en el África Subsahariana, con el objetivo de investigar en qué medida las iniciativas en materia agrícola pueden contribuir a la seguridad alimentaria de la región. Para ello, dos proyectos, el ProSavana y el PAA África, han sido estudiados en detalle a fin de valorar sus potencialidades desde el punto de vista de la seguridad alimentaria y analizar hasta qué punto están en línea con los principios de la cooperación técnica brasileñ...

Public safety around dams guidelines

Energy Technology Data Exchange (ETDEWEB)

Bennett, T [Canadian Dam Association, Edmonton, AB (Canada)

2010-07-01

This presentation discussed Canadian and international initiatives for improving dam safety and described some of the drivers for the development of new Canadian Dam Association (CDA) public safety guidelines for dams. The CDA guidelines were divided into the following 3 principal sections: (1) managed system elements, (2) risk assessment and management, and (3) technical bulletins. Public and media responses to the drownings have called for improved safety guidelines. While the public remains unaware of the hazards of dams, public interaction with dams is increasing as a result of interest in extreme sports and perceived rights of access. Guidelines are needed for dam owners in order to provide due diligence. Various organizations in Canada are preparing technical and public safety dam guidelines. CDA guidelines have also been prepared for signage, booms and buoys, and audible and visual alerts bulletins. Working groups are also discussing recommended practices for spill procedures, spillways and the role of professional engineers in ensuring public safety. Methods of assessing risk were also reviewed. Managed system elements for risk assessment and public interactions were also discussed, and stepped control measures were presented. tabs., figs.

Experimental multiphysical characterization of an SMA driven, camber morphing owl wing section

Science.gov (United States)

Stroud, Hannah R.; Leal, Pedro B. C.; Hartl, Darren J.

2018-03-01

In the context of aerospace engineering, morphing structures are useful in their ability to change the outer mold line (OML) while improving or maintaining certain aerodynamic performance metrics. Skin-based morphing is of particular interest in that it minimizes installation volume. Shape memory alloys (SMAs) have a high force to volume ratio that makes them a suitable choice for skin-based morphing. Because the thermomechanical properties of SMAs are coupled, strain can be generated via a temperature variation; this phenomenon is used as the actuation method. Therefore, it is necessary to determine the interaction of the system not only with aerodynamic loads, but with thermal loads as well. This paper describes the wind tunnel testing and in situ thermomechanical analysis of an SMA actuated, avian inspired morphing wing. The morphing wing is embedded with two SMA composite actuators and consists of a foam core enveloped in a fiberglass-epoxy composite. As the SMA wire is heated, the actuator contracts, morphing the wing from the original owl OML to a highly cambered, high lift OML. Configuration characteristics are analyzed in situ using simultaneous three dimensional digital image correlation (DIC) and infrared thermography, thereby coupling strain and thermal measurements. This method of testing allows for the nonintrusive, multiphysical data acquisition of each actuator separately and the system as a whole.

The Infectious Diseases Society of America Lyme guidelines: a cautionary tale about the development of clinical practice guidelines

Directory of Open Access Journals (Sweden)

Johnson Lorraine

2010-06-01

Full Text Available Abstract Flawed clinical practice guidelines may compromise patient care. Commercial conflicts of interest on panels that write treatment guidelines are particularly problematic, because panelists may have conflicting agendas that influence guideline recommendations. Historically, there has been no legal remedy for conflicts of interest on guidelines panels. However, in May 2008, the Attorney General of Connecticut concluded a ground-breaking antitrust investigation into the development of Lyme disease treatment guidelines by one of the largest medical societies in the United States, the Infectious Diseases Society of America (IDSA. Although the investigation found significant flaws in the IDSA guidelines development process, the subsequent review of the guidelines mandated by the settlement was compromised by a lack of impartiality at various stages of the IDSA review process. This article will examine the interplay between the recent calls for guidelines reform, the ethical canons of medicine, and due process considerations under antitrust laws as they apply to the formulation of the IDSA Lyme disease treatment guidelines. The article will also discuss pitfalls in the implementation of the IDSA antitrust settlement that should be avoided in the future.

Etnobotánica del "coro" (Nicotiana paa, Solanaceae: Un tabaco silvestre poco conocido del extremo sur de Sudamérica

Directory of Open Access Journals (Sweden)

Gustavo F. Scarpa

2011-07-01

Full Text Available El "coro" es un tabaco silvestre de Argentina y Chile cuyas raíces son empleadas como fumatorio y mascatorio desde tiempos inmemoriales por grupos indígenas. Si bien existen noticias sobre su empleo desde la época colonial, en la actualidad no hay consenso sobre su identidad botánica a la par que sus modalidades de obtención, procesado y consumo han sido escasamente descriptas. Se efectuaron campañas etnobotánicas al sudoeste de la provincia del Chaco donde se colectaron ejemplares que responden a dicho nombre vernáculo en compañía de indígenas y se analizaron fuentes bibliográficas históricas disponibles. Se comprobó in situ que los mocovíes actualmente fuman sus raíces mezcladas con tabaco tanto en contextos ceremoniales como extra-ceremoniales. Como resultado del análisis bibliográfico se infiere que también lo emplearon en el pasado de manera homóloga indígenas vilelas, qom (tobas; wichi y abipones. Se descarta la correspondencia del "coro" con especies de Trichocline por la inexistencia de registros etnobotánicos al respecto. Se confirma que este fumatorio corresponde a Nicotiana paa Mart. rov. y se presentan y discuten nuevos datos sobre su obtención, procesamiento y consumo.

Comparison of international guideline programs to evaluate and update the Dutch program for clinical guideline development in physical therapy

Directory of Open Access Journals (Sweden)

Burgers Jako S

2007-11-01

Full Text Available Abstract Background Clinical guidelines are considered important instruments to improve quality in health care. Since 1998 the Royal Dutch Society for Physical Therapy (KNGF produced evidence-based clinical guidelines, based on a standardized program. New developments in the field of guideline research raised the need to evaluate and update the KNGF guideline program. Purpose of this study is to compare different guideline development programs and review the KNGF guideline program for physical therapy in the Netherlands, in order to update the program. Method Six international guideline development programs were selected, and the 23 criteria of the AGREE Instrument were used to evaluate the guideline programs. Information about the programs was retrieved from published handbooks of the organizations. Also, the Dutch program for guideline development in physical therapy was evaluated using the AGREE criteria. Further comparison the six guideline programs was carried out using the following elements of the guideline development processes: Structure and organization; Preparation and initiation; Development; Validation; Dissemination and implementation; Evaluation and update. Results Compliance with the AGREE criteria of the guideline programs was high. Four programs addressed 22 AGREE criteria, and two programs addressed 20 AGREE criteria. The previous Dutch program for guideline development in physical therapy lacked in compliance with the AGREE criteria, meeting only 13 criteria. Further comparison showed that all guideline programs perform systematic literature searches to identify the available evidence. Recommendations are formulated and graded, based on evidence and other relevant factors. It is not clear how decisions in the development process are made. In particular, the process of translating evidence into practice recommendations can be improved. Conclusion As a result of international developments and consensus, the described processes

Evidence-based guidelines for the wise use of computers by children: physical development guidelines.

Science.gov (United States)

Straker, L; Maslen, B; Burgess-Limerick, R; Johnson, P; Dennerlein, J

2010-04-01

Computer use by children is common and there is concern over the potential impact of this exposure on child physical development. Recently principles for child-specific evidence-based guidelines for wise use of computers have been published and these included one concerning the facilitation of appropriate physical development. This paper reviews the evidence and presents detailed guidelines for this principle. The guidelines include encouraging a mix of sedentary and whole body movement tasks, encouraging reasonable postures during computing tasks through workstation, chair, desk, display and input device selection and adjustment and special issues regarding notebook computer use and carriage, computing skills and responding to discomfort. The evidence limitations highlight opportunities for future research. The guidelines themselves can inform parents and teachers, equipment designers and suppliers and form the basis of content for teaching children the wise use of computers. STATEMENT OF RELEVANCE: Many children use computers and computer-use habits formed in childhood may track into adulthood. Therefore child-computer interaction needs to be carefully managed. These guidelines inform those responsible for children to assist in the wise use of computers.

AIDS guidelines.

Science.gov (United States)

Berger, R

1986-04-30

The Sun article, "Employers finding that AIDS in the workplace is a managerial nightmare" (April 3), did not accurately portray the status of AIDS in the workplace. The AIDS virus, HTLV III, is transmitted by body fluids, primarily semen and blood, and there is no known risk of transmitting the virus by casual contact in the workplace. The Center for Disease Control (CDC) released guidelines for child care workers last August. Guidelines on preventing transmission of AIDS in the workplace were issued by CDC in November 1985. These guidelines specifically discussed health care, personal service, and food service workers. The recommendations were against routine screening. Furthermore, employment should not be restricted on the basis of a positive HTLV III antibody test. A person with HTLV III infection should be exempt from the workplace only if there are circumstances interfering with job performance. In Maryland, the Governor's Task Force on AIDS has gone on record as endorsing CDC guidelines related to employment. Furthermore, the task force condemns discrimination based on the disease AIDS, AIDS Related Complex (ARC), or HTLV III infection. Increasingly AIDS patients are being considered legally disabled and therefore are protected by federal and state laws prohibiting discrimination on the basis of a handicap. Marylanders who are subjected to mandatory HTLV III screening in the workplace, or if discriminated against on the basis of HTLV III inefction, should contact the Maryland Commission on Human Relations, the Maryland Department of Health and Mental Hygiene, or the Health Education Resource Organization (HERO). All 3 of these resources guarantee confidentiality. It is only by employees reporting incidents that a nightmare in the workplace can be avoided in Maryland. full text

Guidelines for nuclear reactor equipments safety-analysis

International Nuclear Information System (INIS)

1978-01-01

The safety analysis in approving the applications for nuclear reactor constructions (or alterations) is performed by the Committee on Examination of Reactor Safety in accordance with various guidelines prescribed by the Atomic Energy Commission. In addition, the above Committee set forth its own regulations for the safety analysis on common problems among various types of nuclear reactors. This book has collected and edited those guidelines and regulations. It has two parts: Part I includes the guidelines issued to date by the Atomic Energy Commission: and Part II - regulations of the Committee. Part I has collected 8 categories of guidelines which relate to following matters: nuclear reactor sites analysis guidelines and standards for their applications; standard exposure dose of plutonium; nuclear ship operation guidelines; safety design analysis guidelines for light-water type, electricity generating nuclear reactor equipments; safety evaluation guidelines for emergency reactor core cooling system of light-water type power reactors; guidelines for exposure dose target values around light-water type electricity generating nuclear reactor equipments, and guidelines for evaluation of above target values; and meteorological guidelines for the safety analysis of electricity generating nuclear reactor equipments. Part II includes regulations of the Committee concerning - the fuel assembly used in boiling-water type and in pressurized-water type reactors; techniques of reactor core heat designs, etc. in boiling-water reactors; and others

Incremental guideline formalization with tool support

NARCIS (Netherlands)

Serban, Radu; Puig-Centelles, Anna; ten Teije, Annette

2006-01-01

Guideline formalization is recognized as an important component in improving computerized guidelines, which in turn leads to better informedness, lower inter-practician variability and, ultimately, to higher quality healthcare. By means of a modeling exercise, we investigate the role of guideline

Quality of evidence-based pediatric guidelines

NARCIS (Netherlands)

Boluyt, Nicole; Lincke, Carsten R.; Offringa, Martin

2005-01-01

Objective. To identify evidence-based pediatric guidelines and to assess their quality. Methods. We searched Medline, Embase, and relevant Web sites of guideline development programs and national pediatric societies to identify evidence-based pediatric guidelines. A list with titles of identified

Building Chronic Kidney Disease Clinical Practice Guidelines Using the openEHR Guideline Definition Language.

Science.gov (United States)

Lin, Ching-Heng; Lo, Ying-Chih; Hung, Pei-Yuan; Liou, Der-Ming

2016-12-07

As a result of the disease's high prevalence, chronic kidney disease (CKD) has become a global public health problem. A clinical decision support system that integrates with computer-interpretable guidelines (CIGs) should improve clinical outcomes and help to ensure patient safety. The openEHR guideline definition language (GDL) is a formal language used to represent CIGs. This study explores the feasibility of using a GDL approach for CKD; it also attempts to identify any potential gaps between the ideal concept and reality. Using the Kidney Disease Improving Global Outcomes (KDIGO) anemia guideline as material, we designed a development workflow in order to establish a series of GDL guidelines. Focus group discussions were conducted in order to identify important issues related to GDL implementation. Ten GDL guidelines and 37 archetypes were established using the KDIGO guideline document. For the focus group discussions, 16 clinicians and 22 IT experts were recruited and their perceptions, opinions and attitudes towards the GDL approach were explored. Both groups provided positive feedback regarding the GDL approach, but raised various concerns about GDL implementation. Based on the findings of this study, we identified some potential gaps that might exist during implementation between the GDL concept and reality. Three directions remain to be investigated in the future. Two of them are related to the openEHR GDL approach. Firstly, there is a need for the editing tool to be made more sophisticated. Secondly, there needs to be integration of the present approach into non openEHR-based hospital information systems. The last direction focuses on the applicability of guidelines and involves developing a method to resolve any conflicts that occur with insurance payment regulations.

Whitebark pine planting guidelines

Science.gov (United States)

Ward McCaughey; Glenda L. Scott; Kay L. Izlar

2009-01-01

This article incorporates new information into previous whitebark pine guidelines for planting prescriptions. Earlier 2006 guidelines were developed based on review of general literature, research studies, field observations, and standard US Forest Service survival surveys of high-elevation whitebark pine plantations. A recent study of biotic and abiotic factors...

Measure Guideline: Ventilation Cooling

Energy Technology Data Exchange (ETDEWEB)

Springer, D. [Alliance for Residential Building Innovation (ARBI), David, CA (United States); Dakin, B. [Alliance for Residential Building Innovation (ARBI), David, CA (United States); German, A. [Alliance for Residential Building Innovation (ARBI), David, CA (United States)

2012-04-01

The purpose of this measure guideline is to provide information on a cost-effective solution for reducing cooling system energy and demand in homes located in hot-dry and cold-dry climates. This guideline provides a prescriptive approach that outlines qualification criteria, selection considerations, and design and installation procedures.

Standards and Guidelines in Telemedicine and Telehealth

Science.gov (United States)

Krupinski, Elizabeth A.; Bernard, Jordana

2014-01-01

The development of guidelines and standards for telemedicine is an important and valuable process to help insure effective and safe delivery of quality healthcare. Some organizations, such as the American Telemedicine Association (ATA), have made the development of standards and guidelines a priority. The practice guidelines developed so far have been well received by the telemedicine community and are being adopted in numerous practices, as well as being used in research to support the practice and growth of telemedicine. Studies that utilize published guidelines not only help bring them into greater public awareness, but they also provide evidence needed to validate existing guidelines and guide the revision of future versions. Telemedicine will continue to grow and be adopted by more healthcare practitioners and patients in a wide variety of forms not just in the traditional clinical environments, and practice guidelines will be a key factor in fostering this growth. Creation of guidelines is important to payers and regulators as well as increasingly they are adopting and integrating them into regulations and policies. This paper will review some of the recent ATA efforts in developing telemedicine practice guidelines, review the role of research in guidelines development, review data regarding their use, and discuss some of areas where guidelines are still needed. PMID:27429261

Raising the Bar with Trades Staffing Guidelines.

Science.gov (United States)

Weidner, Theodore J.

2000-01-01

Examines the APPA's Trades Staffing Guidelines Task Force for college campus building maintenance and presents descriptions of the proposed guideline levels and a matrix of indicators for the Trades Staffing Guidelines. The levels and matrix are intended to mimic features of the custodial staffing guidelines. (GR)

78 FR 38102 - Passenger Vessels Accessibility Guidelines

Science.gov (United States)

2013-06-25

... Costs and Benefits The primary estimates of the costs and benefits of the proposed guidelines are shown... quantify the benefits of the proposed guidelines due to the nature of the benefits. The proposed guidelines..., transportation, public accommodation, and leisure. The proposed guidelines would enable these individuals to...

Green synthesis of antimicrobial and antitumor N,N,N-trimethyl chitosan chloride/poly (acrylic acid)/silver nanocomposites.

Science.gov (United States)

Abu Elella, Mahmoud H; Mohamed, Riham R; Abdel-Aziz, Marwa M; Sabaa, Magdy W

2018-05-01

The present study is imported to solve two critical problems we face in our daily life which are microbial pollution and colon cancer. One pot green synthesis of a water soluble polyelectrolyte complex (PEC) between cationic polysaccharide as N,N,N-trimethyl chitosan chloride (TMC) and anionic polymer as poly (acrylic acid) (PAA) in presence of silver nanoparticles to yield (TMC/PAA/Ag) nanocomposites with different Ag weight ratios. Structure of TMC, PAA and TMC/PAA (PEC) were proved via different analysis tools. TMC/PAA and its Ag nanocomposites are used as antimicrobial agents against different pathogenic bacteria and fungi to solve microbial pollution. TMC/PAA-Silver nanocomposites had the highest antimicrobial activity which increases with increasing Ag %. Cytotoxicity data confirmed also that TMC/PAA/Ag (3%) had the most cytotoxic effect (the less cell viability %) towards colon cancer. TMC/PAA (PEC) was formed through electrostatic interactions between N-quaternized (-N + R 3 ) groups in TMC and carboxylate (-COO - ) groups in PAA. Copyright © 2018 Elsevier B.V. All rights reserved.

Growth inhibition of Aeromonas salmonicida and Yersinia ruckeri by disinfectants containing peracetic acid.

Science.gov (United States)

Meinelt, Thomas; Phan, Thy-My; Behrens, Sascha; Wienke, Andreas; Pedersen, Lars-Flemming; Liu, Dibo; Straus, David L

2015-04-08

Peracetic acid (PAA) is a therapeutic agent used for disinfection in aquaculture, but it must be investigated thoroughly in order to mitigate diseases without harming the fish. Successful disinfectants (like PAA) should not leave dangerous residues in the environment in order to successfully contribute to sustainable aquaculture. The aim of our study was to compare the effectiveness of 6 commercial PAA products with different molecular PAA:H2O2 ratios to reduce bacterial growth of Aeromonas salmonicida and Yersinia ruckeri and to determine effective concentrations and exposure times. All products reduced colony-forming units (CFUs) of A. salmonicida and Y. ruckeri. Products with higher molecular PAA:H2O2 ratios inhibited growth better than products with lower molecular PAA:H2O2 ratios at the same PAA concentration; this indicates that H2O2 is not the driving force in the reduction of A. salmonicida and Y. ruckeri growth by PAA in vitro. The practical application of the products with high molecular PAA:H2O2 ratios should be prioritized if these pathogens are diagnosed.

What makes lithium substituted polyacrylic acid a better binder than polyacrylic acid for silicon-graphite composite anodes?

Science.gov (United States)

Hays, Kevin A.; Ruther, Rose E.; Kukay, Alexander J.; Cao, Pengfei; Saito, Tomonori; Wood, David L.; Li, Jianlin

2018-04-01

Lithium substituted polyacrylic acid (LiPAA) has previously been demonstrated as a superior binder over polyacrylic acid (PAA) for Si anodes, but from where does this enhanced performance arise? In this study, full cells are assembled with PAA and LiPAA based Si-graphite composite anodes that dried at temperatures from 100 °C to 200 °C. The performance of full cells containing PAA based Si-graphite anodes largely depend on the secondary drying temperature, as decomposition of the binder is correlated to increased electrode moisture and a rise in cell impedance. Full cells containing LiPAA based Si-graphite composite electrodes display better Coulombic efficiency than those with PAA, because of the electrochemical reduction of the PAA binder. This is identified by attenuated total reflectance Fourier transform infrared spectrometry and observed gassing during the electrochemical reaction. Coulombic losses from the PAA and Si SEI, along with depletion of the Si capacity in the anode results in progressive underutilization of the cathode and full cell capacity loss.

28 CFR 23.30 - Funding guidelines.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Funding guidelines. 23.30 Section 23.30 Judicial Administration DEPARTMENT OF JUSTICE CRIMINAL INTELLIGENCE SYSTEMS OPERATING POLICIES § 23.30 Funding guidelines. The following funding guidelines shall apply to all Crime Control Act funded...

5 CFR 724.403 - Advisory guidelines.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Advisory guidelines. 724.403 Section 724.403 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS... RETALIATION ACT OF 2002 Best Practices § 724.403 Advisory guidelines. OPM will issue advisory guidelines to...

Electrical safety guidelines

Energy Technology Data Exchange (ETDEWEB)

1993-09-01

The Electrical Safety Guidelines prescribes the DOE safety standards for DOE field offices or facilities involved in the use of electrical energy. It has been prepared to provide a uniform set of electrical safety standards and guidance for DOE installations in order to affect a reduction or elimination of risks associated with the use of electrical energy. The objectives of these guidelines are to enhance electrical safety awareness and mitigate electrical hazards to employees, the public, and the environment.

Preparing strategic information management plans for hospitals: a practical guideline SIM plans for hospitals: a guideline.

Science.gov (United States)

Brigl, B; Ammenwerth, E; Dujat, C; Gräber, S; Grosse, A; Häber, A; Jostes, C; Winter, A

2005-01-01

Systematic information management in hospitals demands for a strategic information management plan (SIM plan). As preparing a SIM plan is a considerable challenge we provide a practical guideline that is directly applicable when a SIM plan is going to be prepared. The guideline recommends a detailed structure of a SIM plan and gives advice about its content and the preparation process. It may be used as template, which can be adapted to the individual demands of any hospital. The guideline was used in several hospitals preparing a SIM plan. Experiences showed that the SIM plans could be prepared very efficiently and timely using the guideline, that the proposed SIM plan structure suited well, that the guideline offers enough flexibility to meet the requirements of the individual hospitals and that the specific recommendations of the guideline were very helpful. Nevertheless, we must strive for a more comprehensive theory of strategic information management planning which -- in the sense of enterprise architecture planning -- represents the intrinsic correlations of the different parts of a SIM plan to a greater extent.

Inspector qualification guidelines

International Nuclear Information System (INIS)

Batty, A.C.; Van Binnebeek, J.J.; Ericsson, P.O.; Fisher, J.C.; Geiger, P.; Grandame, M.; Grimes, B.K.; Joode, A. de; Kaufer, B.; Kinoshita, M.; Klonk, H.; Koizumi, H.; Maeda, N.; Maqua, M.; Perez del Moral, C.; Roselli, F.; Warren, T.; Zimmerman, R.

1994-07-01

The OECD Nuclear Energy Agency Committee on Nuclear Regulatory Activities (CNRA) has a Working Group on Inspection Practices (WGIP). The WGIP provides a forum for the exchange of Information and experience on the safety Inspection practices of regulatory authorities In the CNRA member countries. A consistent qualification process and well defined level of training for all Inspectors who participate In the safety Inspections are needed to provide consistent Inspections and reliable Inspection results. The WGIP organized in 1992 a workshop on the conduct of inspections, inspector qualification and training, and shutdown inspections at the Technical Training Center of the US NRC in Chattanooga, Tennessee. In the connection of workshop the WGIP identified a need to develop guidance for inspector qualification which could be used as a model by those who are developing their qualification practices. The inspector qualification journals of US NRC provided a good basis for the work. The following inspector qualification guideline has been developed for guidance of qualification of a new inspector recruited to the regulatory body. This guideline has been developed for helping the supervisors and training officers to give the initial training and familiarization to the duties of a new inspector in a controlled manner. US NRC inspector qualification journals have been used to define the areas of attention. This guideline provides large flexibility for application in different type organizations. Large organizations can develop separate qualification journals for each inspector positions. Small regulatory bodies can develop individual training programmes by defining the necessary training topics on case by case basis. E.g. the guideline can be used to define the qualifications of contracted inspectors used in some countries. The appropriate part would apply. Annex 1 gives two examples how this guideline could be applied

Inspector qualification guidelines

Energy Technology Data Exchange (ETDEWEB)

Batty, A. C.; Van Binnebeek, J. J.; Ericsson, P. O.; Fisher, J. C.; Geiger, P.; Grandame, M.; Grimes, B. K.; Joode, A. de; Kaufer, B.; Kinoshita, M.; Klonk, H.; Koizumi, H.; Maeda, N.; Maqua, M.; Perez del Moral, C.; Roselli, F.; Warren, T.; Zimmerman, R.

1994-07-15

The OECD Nuclear Energy Agency Committee on Nuclear Regulatory Activities (CNRA) has a Working Group on Inspection Practices (WGIP). The WGIP provides a forum for the exchange of Information and experience on the safety Inspection practices of regulatory authorities In the CNRA member countries. A consistent qualification process and well defined level of training for all Inspectors who participate In the safety Inspections are needed to provide consistent Inspections and reliable Inspection results. The WGIP organized in 1992 a workshop on the conduct of inspections, inspector qualification and training, and shutdown inspections at the Technical Training Center of the US NRC in Chattanooga, Tennessee. In the connection of workshop the WGIP identified a need to develop guidance for inspector qualification which could be used as a model by those who are developing their qualification practices. The inspector qualification journals of US NRC provided a good basis for the work. The following inspector qualification guideline has been developed for guidance of qualification of a new inspector recruited to the regulatory body. This guideline has been developed for helping the supervisors and training officers to give the initial training and familiarization to the duties of a new inspector in a controlled manner. US NRC inspector qualification journals have been used to define the areas of attention. This guideline provides large flexibility for application in different type organizations. Large organizations can develop separate qualification journals for each inspector positions. Small regulatory bodies can develop individual training programmes by defining the necessary training topics on case by case basis. E.g. the guideline can be used to define the qualifications of contracted inspectors used in some countries. The appropriate part would apply. Annex 1 gives two examples how this guideline could be applied.

Guidelines for Posting Soil Contamination Areas

Energy Technology Data Exchange (ETDEWEB)

Mcnaughton, Michael [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Eisele, William [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2016-02-01

All soil guidelines were determined using RESRAD, version 6.1. All offsite guidelines are based on 15 mrem/year. This dose rate is sufficiently low to protect human health and is in accordance with DOE guidance and the proposed EPA 40-CFR-196 regulations for members of the public (never promulgated). For those onsite areas where general employees (non-radiological workers) could have routine access, soil concentrations should be based on a dose rate of 30 mrem/year (approximately one-third of the onsite LANL non-radiological worker dose of 100 mrem/year). In this case, soil concentration guidelines may be obtained by doubling the 15 mrem/year guidelines. Several scenarios were developed to provide maximum flexibility for application of the guidelines. The offsite guidelines were developed using: residential scenarios for both adults and children; a construction worker scenario; a resource user (e.g., a hunter) scenario; a child playing within canyon reaches scenario, a trail using jogger within canyon reaches scenario, and a trail using hiker within canyon reaches scenario. The residential guidelines represent the lowest values from both the adult residential scenario and the child residential scenario.

40 CFR 766.12 - Testing guidelines.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Testing guidelines. 766.12 Section 766... DIBENZO-PARA-DIOXINS/DIBENZOFURANS General Provisions § 766.12 Testing guidelines. Analytical test methods must be developed using methods equivalent to those described or reviewed in Guidelines for the...

5 CFR 720.206 - Selection guidelines.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Selection guidelines. 720.206 Section 720... guidelines. This subpart sets forth requirements for a recruitment program, not a selection program... procedures and criteria must be consistent with the Uniform Guidelines on Employee Selection Procedures (43...

76 FR 63565 - Event Reporting Guidelines

Science.gov (United States)

2011-10-13

...-2011-0237] Event Reporting Guidelines AGENCY: Nuclear Regulatory Commission. ACTION: Draft NUREG... comments on Draft NUREG-1022, Revision 3, ``Event Reporting Guidelines: 10 CFR 50.72 and 50.73''. The NUREG-1022 contains guidelines that the NRC staff considers acceptable for use in meeting the event reporting...

Reporting of financial conflicts of interest in clinical practice guidelines: a case study analysis of guidelines from the Canadian Medical Association Infobase.

Science.gov (United States)

Shnier, Adrienne; Lexchin, Joel; Romero, Mirna; Brown, Kevin

2016-08-15

Clinical practice guidelines are widely distributed by medical associations and relied upon by physicians for the best available clinical evidence. International findings report that financial conflicts of interest (FCOI) with drug companies may influence drug recommendations and are common among guideline authors. There is no comparable study on exclusively Canadian guidelines; therefore, we provide a case study of authors' FCOI declarations in guidelines from the Canadian Medical Association (CMA) Infobase. We also assess the financial relationships between guideline-affiliated organizations and drug companies. Using a population approach, we extracted first-line drug recommendations and authors' FCOI disclosures in guidelines from the CMA Infobase. We contacted the corresponding authors on guidelines when FCOI disclosures were missing for some or all authors. We also extracted guideline-affiliated organizations and searched each of their websites to determine if they had financial relationships with drug companies. We analyzed 350 authors from 28 guidelines. Authors were named on one, two, or three guidelines, yielding 400 FCOI statements. In 75.0 % of guidelines at least one author, and in 21.4 % of guidelines all authors, disclosed FCOI with drug companies. In 54.0 % of guidelines at least one author, and in 28.6 % of guidelines over half of the authors, disclosed FCOI with manufacturers of drugs that they recommended. Twenty of 48 authors on multiple guidelines reported different FCOI in their disclosures. Eight guidelines identified affiliated organizations with financial relationships with manufacturers of drugs recommended in those guidelines. This is the first study to systematically describe FCOI disclosures by authors of Canadian guidelines and financial relationships between guideline-affiliated organizations and pharmaceutical companies. These financial relationships are common. Because authoritative value is assigned to guidelines distributed by

Guidelines for identifying suspect/counterfeit material

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-09-01

These guidelines are intended to assist users of products in identifying: substandard, misrepresented, or fraudulently marked items. The guidelines provide information about such topics as: precautions, inspection and testing, dispositioning identified items, installed inspection and reporting suspect/counterfeit materials. These guidelines apply to users who are developing procurement documents, product acceptance/verification methods, company procedures, work instructions, etc. The intent of these SM guidelines in relation to the Quality Assurance Program Description (QAPD) and implementing company Management Control Procedures is not to substitute or replace existing requirements, as defined in either the QAPD or company implementing instructions (Management Control Procedures). Instead, the guidelines are intended to provide a consolidated source of information addressing the issue of Suspect/Counterfeit materials. These guidelines provide an extensive suspect component listing and suspect indications listing. Users can quickly check their suspect items against the list of manufacturers products (i.e., type, LD. number, and nameplate information) by consulting either of these listings.

Strengthening the Enforcement of CSR Guidelines

DEFF Research Database (Denmark)

Olsen, Birgitte Egelund; Sørensen, Karsten Engsig

2014-01-01

the extensive right to refer complaints to them, the broad scope of the recommendations in the Guidelines and especially the use of naming and shaming in cases of breaches of the Guidelines, has changed the original character of the Guidelines as a purely soft law instrument. Furthermore, it is shown...... that the use of very broad and vague terminology in the Guidelines makes it very difficult for enterprises to comply with them. This is further complicated by the fact that many of the terms, which lay down when the NCPs have jurisdiction, are not clearly defined or explained. The three NCPs examined have...... implemented the Guidelines very differently. In particular the Danish NCP stands out. It has a jurisdiction which in many respects goes far beyond that envisioned in the Guidelines. This may put in question the legitimacy and effectiveness of the Danish NCP, but at the same time it can also be viewed...

10 CFR 960.5-1 - System guidelines.

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false System guidelines. 960.5-1 Section 960.5-1 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Preclosure Guidelines § 960.5-1 System guidelines. (a) Qualifying conditions—(1) Preclosure...

32 CFR 310.36 - OMB training guidelines.

Science.gov (United States)

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false OMB training guidelines. 310.36 Section 310.36... PROGRAM DOD PRIVACY PROGRAM Training Requirements § 310.36 OMB training guidelines. The OMB guidelines (OMB Privacy Guidelines, 40 FR 28948 (July 9, 1975) require all agencies additionally to: (a) Instruct...

[Preoperative fasting guidelines: an update].

Science.gov (United States)

López Muñoz, A C; Busto Aguirreurreta, N; Tomás Braulio, J

2015-03-01

Anesthesiology societies have issued various guidelines on preoperative fasting since 1990, not only to decrease the incidence of lung aspiration and anesthetic morbidity, but also to increase patient comfort prior to anesthesia. Some of these societies have been updating their guidelines, as such that, since 2010, we now have 2 evidence-based preoperative fasting guidelines available. In this article, an attempt is made to review these updated guidelines, as well as the current instructions for more controversial patients such as infants, the obese, and a particular type of ophthalmic surgery. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

[Graphic synopsis of implementation of German guideline clearing reports in national disease management guidelines].

Science.gov (United States)

Thole, Henning

2011-01-01

While methods for the production of guidelines (evidence analysis, assessment, adaptation) have been continually refined throughout the past years, there is a lack of instruments for the production of easily understandable synopses. Definition of a methodological approach to encompass synopses by Spidernet diagrams. Tables of synopses can be generated with distinct information to bring down the main results in one Spidernet diagram. This is possible for both the entire synopsis and parts of it. Guideline comparisons require detailed analyses on the one hand and easily understandable presentations of their results on the other. Guideline synopses can be substantially supported by graphic presentation of the results of synopsis. Graphic synopsis is also helpful in other cases; it may be used, for example, to summarise HTA reports, systematic reviews or guidelines. Copyright © 2011. Published by Elsevier GmbH.

Water chemistry guidelines for BWRs

International Nuclear Information System (INIS)

Bilanin, W.J.; Jones, R.L.; Welty, C.S.

1984-01-01

Guidelines for BWR water chemistry control have been prepared by a committee of experienced utility industry personnel sponsored by the BWR Owners Group on IGSCC Research and coordinated by the Electric Power Research Institute. The guidelines are based on extensive plant operational experience and laboratory research data. The purpose of the guidelines is to provide guidance to the electric utility industry on water chemistry control to help reduce corrosion, especially stress corrosion cracking, in boiling water reactors

Olympic emblem guidelines: London 2012

OpenAIRE

2013-01-01

These guidelines issued by the London Organising Committee of the Olympic Games and Paralympic Games Ltd (“LOCOG”) provide standards, requirements and guidelines for use of the London 2012 Olympic Games Emblem (the “Emblem”) by LOCOG and the International Olympic Committee (IOC) creative, marketing and communications personnel, agencies and consultants only who are authorised to use the London 2012 marks. The purpose of these guidelines is to preserve and enhance the value of the Emblem for t...

5 CFR 1310.1 - Policy guidelines.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Policy guidelines. 1310.1 Section 1310.1 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET OMB DIRECTIVES OMB CIRCULARS § 1310.1 Policy guidelines. In carrying out its responsibilities, the Office of Management and Budget issues policy guidelines to...

In vitro free radical scavenging activity of platinum nanoparticles

Energy Technology Data Exchange (ETDEWEB)

Watanabe, Aki; Kajita, Masashi; Kim, Juewon; Kanayama, Atsuhiro; Miyamoto, Yusei [Department of Integrated Biosciences, Graduate School of Frontier Sciences, University of Tokyo, Bioscience Building 402, 5-1-5 Kashiwanoha, Kashiwa, Chiba 277-8562 (Japan); Takahashi, Kyoko; Mashino, Tadahiko, E-mail: yusei74@k.u-tokyo.ac.j [Department of Pharmaceutical Sciences, Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato, Tokyo 105-8512 (Japan)

2009-11-11

A polyacrylic acid (PAA)-protected platinum nanoparticle species (PAA-Pt) was prepared by alcohol reduction of hexachloroplatinate. The PAA-Pt nanoparticles were well dispersed and homogeneous in size with an average diameter of 2.0 {+-} 0.4 nm (n = 200). We used electron spin resonance to quantify the residual peroxyl radical AOO. generated from 2,2-azobis (2-aminopropane) dihydrochloride (AAPH) by thermal decomposition in the presence of O{sub 2} and a spectrophotometric method to quantify the residual 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical. PAA-Pt scavenged these two radicals in a dose-dependent manner. Platinum was the functional component. PAA-Pt reduced the rate of oxygen consumption required for linoleic acid peroxidation initiated by AOO. generated from AAPH, indicating inhibition of the propagation of linolate peroxidation. A thiobarbituric acid test also revealed dose-dependent inhibition of the linolate peroxidation by PAA-Pt. Fifty micromolar platinum, as PAA-Pt, completely quenched 250 {mu}M DPPH radical for 5 min. Even when twice diluted in half, the PAA-Pt still quenched 100% of the 250 {mu}M DPPH radical. The scavenging activity of PAA-Pt is durable. These observations suggest that PAA-Pt is an efficient scavenger of free radicals.

Design Guidelines for Low Crested Structures

DEFF Research Database (Denmark)

Burcharth, H. F.; Lamberti, Alberto

2004-01-01

1998-2002. The Guidelines comprise engineering aspects related to morphological impact and structure stability, biological aspects related to ecological impact, and socio-economical aspects related to the implementation of LCS-schemes. The guidelines are limited to submerged and regularly overtopped......The paper presents an overview of the design guidelines for low crested structures (LCS's) to be applied in coastal protection schemes. The design guidelines are formulated as a part of the research project: Environmental Design of Low Crested Coastal Defence Structures (DELOS) within the EC 5FP...

Methodological Quality of Consensus Guidelines in Implant Dentistry.

Science.gov (United States)

Faggion, Clovis Mariano; Apaza, Karol; Ariza-Fritas, Tania; Málaga, Lilian; Giannakopoulos, Nikolaos Nikitas; Alarcón, Marco Antonio

2017-01-01

Consensus guidelines are useful to improve clinical decision making. Therefore, the methodological evaluation of these guidelines is of paramount importance. Low quality information may guide to inadequate or harmful clinical decisions. To evaluate the methodological quality of consensus guidelines published in implant dentistry using a validated methodological instrument. The six implant dentistry journals with impact factors were scrutinised for consensus guidelines related to implant dentistry. Two assessors independently selected consensus guidelines, and four assessors independently evaluated their methodological quality using the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument. Disagreements in the selection and evaluation of guidelines were resolved by consensus. First, the consensus guidelines were analysed alone. Then, systematic reviews conducted to support the guidelines were included in the analysis. Non-parametric statistics for dependent variables (Wilcoxon signed rank test) was used to compare both groups. Of 258 initially retrieved articles, 27 consensus guidelines were selected. Median scores in four domains (applicability, rigour of development, stakeholder involvement, and editorial independence), expressed as percentages of maximum possible domain scores, were below 50% (median, 26%, 30.70%, 41.70%, and 41.70%, respectively). The consensus guidelines and consensus guidelines + systematic reviews data sets could be compared for 19 guidelines, and the results showed significant improvements in all domain scores (p dentistry journals is needed. The findings of the present study may help researchers to better develop consensus guidelines in implant dentistry, which will improve the quality and trust of information needed to make proper clinical decisions.

Clinical practice guidelines in breast cancer

Science.gov (United States)

Tyagi, N. Kumar; Dhesy-Thind, S.

2018-01-01

Background A number of clinical practice guidelines (cpgs) concerning breast cancer (bca) screening and management are available. Here, we review the strengths and weaknesses of cpgs from various professional organizations and consensus groups with respect to their methodologic quality, recommendations, and implementability. Methods Guidelines from four groups were reviewed with respect to two clinical scenarios: adjuvant ovarian function suppression (ofs) in premenopausal women with early-stage estrogen receptor–positive bca, and use of sentinel lymph node biopsy (slnb) after neoadjuvant chemotherapy (nac) for locally advanced bca. Guidelines from the American Society of Clinical Oncology (asco); Cancer Care Ontario’s Program in Evidence Based Care (cco’s pebc); the U.S. National Comprehensive Cancer Network (nccn); and the St. Gallen International Breast Cancer Consensus Conference were reviewed by two independent assessors. Guideline methodology and applicability were evaluated using the agree ii tool. Results The quality of the cpgs was greatest for the guidelines developed by asco and cco’s pebc. The nccn and St. Gallen guidelines were found to have lower scores for methodologic rigour. All guidelines scored poorly for applicability. The recommendations for ofs were similar in three guidelines. Recommendations by the various organizations for the use of slnb after nac were contradictory. Conclusions Our review demonstrated that cpgs can be heterogeneous in methodologic quality. Low-quality cpg implementation strategies contribute to low uptake of, and adherence to, bca cpgs. Further research examining the barriers to recommendations—such as intrinsic guideline characteristics and the needs of end users—is required. The use of bca cpgs can improve the knowledge-to-practice gap and patient outcomes.

Assessing Clinical Microbiology Practice Guidelines: American Society for Microbiology Ad Hoc Committee on Evidence-Based Laboratory Medicine Practice Guidelines Assessment.

Science.gov (United States)

Nachamkin, Irving; Kirn, Thomas J; Westblade, Lars F; Humphries, Romney

2017-11-01

As part of the American Society for Microbiology (ASM) Evidence-Based Laboratory Medicine Practice Guidelines Committee of the Professional Practice Committee, an ad hoc committee was formed in 2014 to assess guidelines published by the committee using an assessment tool, Appraisal of Guidelines for Research Evaluation II (AGREE II). The AGREE II assessment helps reviewers determine whether published guidelines are robust, transparent, and clear in presenting practice recommendations in a standardized manner. Identifying strengths and weaknesses of practice guidelines by ad hoc assessments helps with improving future guidelines through the participation of key stakeholders. This minireview describes the development of the ad hoc committee and results from their review of several ASM best practices guidelines and a non-ASM practice guideline from the Emergency Nurses Association. Copyright © 2017 American Society for Microbiology.

Data Qualification guidelines

International Nuclear Information System (INIS)

Edwards, T.B.; Shine, E.P.

1992-01-01

Data Qualification (DQ) is a formal, technical process whose objective is to affirm that experimental data are suitable for their intended use. Although it is not possible to develop a fixed recipe for the DQ process to cover all test situations, these general guidelines have been developed for the Nuclear Engineering Section to establish a framework for qualifying data from steady-state processing. These guidelines outline the role of the DQ team providing insight into the planning and conducting of the DQ process

Guidelines for Learning Stations.

Science.gov (United States)

Fehrle, Carl C.; Schulz, Jolene

Guidelines for designing and planning learning stations for pupils at the elementary grade level include suggestions on how to develop a station that will be successful in meeting the learners' needs. Instructions for the use of tapes at a station and matching pupils with stations are given, as are guidelines on classroom arrangement and record…

42 CFR 438.236 - Practice guidelines.

Science.gov (United States)

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Practice guidelines. 438.236 Section 438.236 Public... Improvement Standards § 438.236 Practice guidelines. (a) Basic rule: The State must ensure, through its...) Adoption of practice guidelines. Each MCO and, when applicable, each PIHP and PAHP adopts practice...

22 CFR 214.42 - Uniform pay guidelines.

Science.gov (United States)

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Uniform pay guidelines. 214.42 Section 214.42... Advisory Committees § 214.42 Uniform pay guidelines. (a) A.I.D. follows OMB/CSC guidelines in section 11 of... experts, their compensation shall be fixed in accordance with CSC guidelines and regulations, and the...

EFFECT OF DEXTRAN-graft-POLYACRYLAMIDE INTERNAL STRUCTURE ON FLOCCULATION PROCESS PARAMETERS

International Nuclear Information System (INIS)

Bezugla, T.; Kutsevol, N.; Shyichuk, A.; Ziolkowska, D.

2008-01-01

Dextran-graft-Polyacrylamide copolymers (D-g-PAA) of brush-like architecture were tested as flocculation aids in the model kaolin suspensions. Due to expanded conformation the D-g-PAA copolymers are more effective flocculants than individual PAA with close molecular mass. The internal structure of D-g-PAA copolymers which is determined by number and length of grafted PAA chains, the distance between grafts, etc., has the significant influence on flocculation behavior of such polymers

Mexican Asthma Guidelines: GUIMA 2017

Directory of Open Access Journals (Sweden)

Désirée Larenas-Linnemann

2017-04-01

Full Text Available Background: The need for a national guideline, with a broad basis among specialists and primary care physicians was felt in Mexico, to try unifying asthma management. As several high-quality asthma guidelines exist worldwide, it was decided to select the best three for transculturation. Methods: Following the internationally recommended methodology for guideline transculturation, ADAPTE, a literature search for asthma guidelines, published 1-1-2007 through 31-12-2015 was conducted. AGREE-II evaluations yielded 3/40 most suitable for transculturation. Their compound evidence was fused with local reality, patient preference, cost and safety considerations to draft the guideline document. Subsequently, this was adjusted by physicians from 12 national medical societies in several rounds of a Delphi process and 3 face-to-face meetings to reach the final version. Results: Evidence was fused from British Thoracic Society Asthma Guideline 2014, Global Initiative on Asthma 2015, and Guía Española del Manejo del Asma 2015 (2016 updates included. After 3 Delphi-rounds we developed an evidence-based document taking into account patient characteristics, including age, treatment costs and safety and best locally available medication. Conclusion: In cooperation pulmonologists, allergists, ENT physicians, paediatricians and GPs were able to develop an evidence-based document for the prevention, diagnosis and treatment of asthma and its exacerbations in Mexico.

Bioactivity and cytocompatibility of dicalcium phosphate/poly (amino acid) biocomposite with degradability

Energy Technology Data Exchange (ETDEWEB)

Zhang Yunfei [College of Chemistry, Sichuan University, Chengdu 610064 (China); Shan Wenpeng; Li Xiangde [Key Laboratory for Ultrafine Materials of Ministry of Education, East China University of Science and Technology, Shanghai 200237 (China); Wei Jie, E-mail: biomater2006@yahoo.com.cn [Key Laboratory for Ultrafine Materials of Ministry of Education, East China University of Science and Technology, Shanghai 200237 (China); Li Hong [College of Physical Science and Technology, Sichuan University, Chengdu 610064 (China); Ma Jian [Hospital of Stomatology, Tongji University, Shanghai 200072 (China); Yan Yonggang, E-mail: yan_yonggang@vip.163.com [College of Physical Science and Technology, Sichuan University, Chengdu 610064 (China)

2012-01-15

A bioactive composite of dicalcium phosphate (DCP) and poly (amino acid) (PAA) was fabricated, and the in vitro bioactivity, degradability, and cellular responses to the DCP/PAA composite (DPC) were investigated as compared to PAA. Apatite formation on DPC surfaces occurred after immersion into simulated body fluid (SBF) for 7 days, but not on the surface of PAA. The weight loss ratio of DPC could reach 18.6 {+-} 0.3 wt% after soaking into phosphate buffered saline (PBS) for 2 months, which was higher than PAA (11.0 {+-} 0.2 wt%). Cell attachment and proliferation of MG-63 cells on DPC was obviously higher than on PAA. Moreover, the cells spread and formed confluent layer on the DPC surfaces. The alkaline phosphatase activity (ALP) of the cells on DPC was significantly greater than PAA at day 5 and day 7. The results suggested that introducing DCP into PAA makes the composite bioactive and more degradable, and meanwhile enhances osteoblast-like cells attach, proliferation and osteogenic differentiation.

TGF-β Signaling Is Necessary and Sufficient for Pharyngeal Arch Artery Angioblast Formation

Directory of Open Access Journals (Sweden)

Maryline Abrial

2017-07-01

Full Text Available The pharyngeal arch arteries (PAAs are transient embryonic blood vessels that mature into critical segments of the aortic arch and its branches. Although defects in PAA development cause life-threating congenital cardiovascular defects, the molecular mechanisms that orchestrate PAA morphogenesis remain unclear. Through small-molecule screening in zebrafish, we identified TGF-β signaling as indispensable for PAA development. Specifically, chemical inhibition of the TGF-β type I receptor ALK5 impairs PAA development because nkx2.5+ PAA progenitor cells fail to differentiate into tie1+ angioblasts. Consistent with this observation, we documented a burst of ALK5-mediated Smad3 phosphorylation within PAA progenitors that foreshadows angioblast emergence. Remarkably, premature induction of TGF-β receptor activity stimulates precocious angioblast differentiation, thereby demonstrating the sufficiency of this pathway for initiating the PAA progenitor to angioblast transition. More broadly, these data uncover TGF-β as a rare signaling pathway that is necessary and sufficient for angioblast lineage commitment.

Clinical practice guidelines in patient management

Directory of Open Access Journals (Sweden)

Santosh Kumar

2001-01-01

Full Text Available Efforts have always been made to evolve certain prin-ciples to reduce the variability in the management of patients and make medical care more appropriate. These efforts have become almost a movement since 1980s as evidenced in the development of clinical practice guide-lines in all medical disciplines. This article describes the need for clinical practice guidelines and their de-velopment methods and qualities. Advantages and limi-tations of clinical practice guidelines are enumerated. The salient features of various available clinical prac-tice guidelines in urology are also described.

Guidelines in lower-middle income countries.

Science.gov (United States)

Olayemi, Edeghonghon; Asare, Eugenia V; Benneh-Akwasi Kuma, Amma A

2017-06-01

Guidelines include recommendations intended to optimize patient care; used appropriately, they make healthcare consistent and efficient. In most lower-middle income countries (LMICs), there is a paucity of well-designed guidelines; as a result, healthcare workers depend on guidelines developed in Higher Income Countries (HICs). However, local guidelines are more likely to be implemented because they are applicable to the specific environment; and consider factors such as availability of resources, specialized skills and local culture. If guidelines developed in HICs are to be implemented in LMICs, developers need to incorporate local experts in their development. Involvement of local stakeholders may improve the rates of implementation by identifying and removing barriers to implementation in LMICs. Another option is to encourage local experts to adapt them for use in LMICs; these guidelines may recommend strategies different from those used in HICs, but will be aimed at achieving the best practicable standard of care. Infrastructural deficits in LMICs could be improved by learning from and building on the successful response to the human immunodeficiency virus/acquired immunodeficiency syndrome pandemic through interactions between HICs and LMICs. Similarly, collaborations between postgraduate medical colleges in both HICs and LMICs may help specialist doctors training in LMICs develop skills required for guideline development and implementation. © 2017 John Wiley & Sons Ltd.

BWR water chemistry guidelines and PWR primary water chemistry guidelines in Japan – Purpose and technical background

Energy Technology Data Exchange (ETDEWEB)

Kawamura, Hirotaka, E-mail: kawamuh@criepi.denken.or.jp [Central Research Institute of Electric Power Industry (Japan); Hirano, Hideo [Central Research Institute of Electric Power Industry (Japan); Katsumura, Yousuke [University of Tokyo (Japan); Uchida, Shunsuke [Tohoku University (Japan); Mizuno, Takayuki [Mie University (Japan); Kitajima, Hideaki; Tsuzuki, Yasuo [Japan Nuclear Safety Institute (Japan); Terachi, Takumi [Institute of Nuclear Safety System, Inc. (Japan); Nagase, Makoto; Usui, Naoshi [Hitachi-GE Nuclear Energy, Ltd. (Japan); Takagi, Junichi; Urata, Hidehiro [Toshiba Corporation (Japan); Shoda, Yasuhiko; Nishimura, Takao [Mitsubishi Heavy Industry, Ltd. (Japan)

2016-12-01

Highlights: • Framework of BWR/PWR water chemistry Guidelines in Japan are presented. • Guideline necessity, definitions, philosophy and technical background are mentioned. • Some guideline settings for control parameters and recommendations are explaines. • Chemistry strategy is also mentioned. - Abstract: After 40 years of light water reactor (LWR) operations in Japan, the sustainable development of water chemistry technologies has aimed to ensure the highest coolant system component integrity and fuel reliability performance for maintaining LWRs in the world; additionally, it aimed to achieve an excellent dose rate reduction. Although reasonable control and diagnostic parameters are utilized by each boiling water reactor (BWR) and pressurized water reactor (PWR) owner, it is recognized that specific values are not shared among everyone involved. To ensure the reliability of BWR and PWR operation and maintenance, relevant members of the Atomic Energy Society of Japan (AESJ) decided to establish guidelines for water chemistry. The Japanese BWR and PWR water chemistry guidelines provide strategies to improve material and fuel reliability performance as well as to reduce dosing rates. The guidelines also provide reasonable “control values”, “diagnostic values” and “action levels” for multiple parameters, and they stipulate responses when these levels are exceeded. Specifically, “conditioning parameters” are adopted in the Japanese PWR primary water chemistry guidelines. Good practices for operational conditions are also discussed with reference to long-term experience. This paper presents the purpose, technical background and framework of the preliminary water chemistry guidelines for Japanese BWRs and PWRs. It is expected that the guidelines will be helpful as an introduction to achieve safety and reliability during operations.

Guidelines for Better Heart Health

Science.gov (United States)

Skip Navigation Bar Home Current Issue Past Issues Guidelines for Better Heart Health Past Issues / Winter 2007 ... women either had or did not have CVD. Guidelines at a Glance: Prevention should be tailored to ...

2012 Guidelines for Water Reuse

Science.gov (United States)

This manual is a revision of the "2004 Water Reuse Guidelines." This document is a summary of reuse guidelines, with supporting information, for the benefit of utilities of utilities and regulatory agencies, particularly EPA.

Inside guidelines: comparative analysis of recommendations and evidence in diabetes guidelines from 13 countries

NARCIS (Netherlands)

Burgers, Jako S.; Bailey, Julia V.; Klazinga, Niek S.; van der Bij, Akke K.; Grol, Richard; Feder, Gene

2002-01-01

OBJECTIVE: To compare guidelines on diabetes from different countries in order to examine whether differences in recommendations could be explained by use of different research evidence. RESEARCH DESIGN AND METHODS: We analyzed 15 clinical guidelines on type 2 diabetes from 13 countries using

Structure of the oceanic mixed layer in western Bay of Bengal during MONEX

Digital Repository Service at National Institute of Oceanography (India)

Anto, A.F.; Somayajulu, Y.K.

layer conditions of the overlying atmosphere. Structure of OML, as delineated with respect to the diurnal variation of temperature with depth, revealed three sub-layers: wave mixed, diurnal thermocline and transition layer. The first two sub...

ASSET guidelines. Revised 1991 Edition

International Nuclear Information System (INIS)

1991-12-01

The present publication is an updated version of the IAEA Assessment of Safety Significant Events Team (ASSET) Guidelines, IAEA-TECDOC-573, published in 1990. Sections 5 and 6 include revised definitions and investigation guidelines for identification of both direct and root causes. These revisions were recommended by a Consultants Meeting held in Vienna on 3-7 December 1990. This guidance is not intended to infringe an expert's prerogative to investigate additional items. Its main purpose is to provide a basic structure and ensure consistency in the assessments. Use of the ASSET guidelines should also facilitate comparison between the observations made in different nuclear power plants and harmonize the reporting of generic ASSET results. The guidelines should always be used with a critical attitude and a view to possible improvements

Total quality management implementation guidelines

Energy Technology Data Exchange (ETDEWEB)

1993-12-01

These Guidelines were designed by the Energy Quality Council to help managers and supervisors in the Department of Energy Complex bring Total Quality Management to their organizations. Because the Department is composed of a rich mixture of diverse organizations, each with its own distinctive culture and quality history, these Guidelines are intended to be adapted by users to meet the particular needs of their organizations. For example, for organizations that are well along on their quality journeys and may already have achieved quality results, these Guidelines will provide a consistent methodology and terminology reference to foster their alignment with the overall Energy quality initiative. For organizations that are just beginning their quality journeys, these Guidelines will serve as a startup manual on quality principles applied in the Energy context.

A Critical Review of Low Back Pain Guidelines.

Science.gov (United States)

Chetty, Laran

2017-09-01

Low back pain (LBP) remains one of the most common and challenging musculoskeletal conditions encountered by health care professionals and is a leading cause of absenteeism. Clinical guidelines are often considered best evidence in health care. The aim of this critical review was to assess the quality and recommendations of LBP guidelines using the Appraisal of Guidelines Research and Evaluation (AGREE) instrument. Electronic databases were used to identify LBP guidelines published between 2000 and 2015. Nine guidelines were selected for review from a total of 17. Only five guidelines effectively addressed the AGREE scoring. On the basis of the appraisal and domain scores, only four guidelines were strongly recommended. Improved translation of research evidence from guidelines to clinical practice is needed.

Librarian contributions to clinical practice guidelines.

Science.gov (United States)

Cruse, Peggy; Protzko, Shandra

2014-01-01

Librarians have become more involved in developing high quality systematic reviews. Evidence-based practice guidelines are an extension of systematic reviews and offer another significant area for librarian involvement. This column highlights opportunities and challenges for the librarian working on guideline panels and provides practical considerations for meaningful contributions to the guideline creation process.

AVALIAÇÃO DO PROGRAMA DE AQUISIÇÃO DE ALIMENTOS (PAA E DO PROGRAMA NACIONAL DE ALIMENTAÇÃO ESCOLAR (PNAE EM CASTILHO-SP E EM ANDRADINA-SP

Directory of Open Access Journals (Sweden)

Dóri Edson Lopes

2012-08-01

Full Text Available Em meio a debates e reivindicações sobre a necessidade de uma maior intervenção do Estado na questão da segurança e soberania alimentar, é criado em 2003 – pelo governo federal – o Programa de Aquisição de Alimentos (PAA. O programa tem como um de seus objetivos cooperar na luta contra a fome no Brasil, além de atender, pelo menos em parte, as reivindicações de movimentos sociais de luta pela terra que buscam um maior reconhecimento e apoio para a produção da agricultura familiar camponesa, que mesmo sendo deixada em segundo plano pelas políticas agrícolas do Estado brasileiro, é responsável por importante contribuição para a soberania e segurança alimentar do país.

Effect of peracetic acid on biofilms formed by Listeria monocytogenes strains isolated from a Brazilian cheese processing plant

Directory of Open Access Journals (Sweden)

Sarah Hwa In Lee

2017-10-01

Full Text Available ABSTRACT This study aimed to investigate the effect of peracetic acid (PAA, 0.5% on adherent cells of three strains of Listeria monocytogenes strains belonging to serotypes 4b and 1/2b that had been previously isolated from the environment of a Brazilian cheese plant. The assays were conducted using polystyrene microplates and stainless steel coupons and the adhered cells were treated with PAA for 60, 120 and 180 s. On stainless steel, biofilms were partially inactivated by PAA after 60 s and almost 100% of the cells were damaged within 180 s using epifluorescence microscopy with LIVE/DEAD® staining. On polystyrene microplates, PAA decreased (P<0.05 biofilm biomass produced by the three L. monocytogenes isolates at 60 s, when compared with controls (no PAA treatment. However, PAA did not completely eliminate L. monocytogenes cells on polystyrene microplates (decreasing 1.8-2.5 log cycles after treatment with PAA for 180 s. The correct concentration and contact time of PAA is critical for eliminating biofilms formed by L. monocytogenes on stainless steel surfaces, although further studies are needed for defining efficient PAA treatments to remove adherent cells of this pathogen on plastic polymers.

Comparison between Different Extraction Methods for Determination of Primary Aromatic Amines in Food Simulant

Directory of Open Access Journals (Sweden)

Morteza Shahrestani

2018-01-01

Full Text Available The primary aromatic amines (PAAs are food contaminants which may exist in packaged food. Polyurethane (PU adhesives which are used in flexible packaging are the main source of PAAs. It is the unreacted diisocyanates which in fact migrate to foodstuff and then hydrolyze to PAAs. These PAAs include toluenediamines (TDAs and methylenedianilines (MDAs, and the selected PAAs were 2,4-TDA, 2,6-TDA, 4,4′-MDA, 2,4′-MDA, and 2,2′-MDA. PAAs have genotoxic, carcinogenic, and allergenic effects. In this study, extraction methods were applied on a 3% acetic acid as food simulant which was spiked with the PAAs under study. Extraction methods were liquid-liquid extraction (LLE, dispersive liquid-liquid microextraction (DLLME, and solid-phase extraction (SPE with C18 ec (octadecyl, HR-P (styrene/divinylbenzene, and SCX (strong cationic exchange cartridges. Extracted samples were detected and analyzed by HPLC-UV. In comparison between methods, recovery rate of SCX cartridge showed the best adsorption, up to 91% for polar PAAs (TDAs and MDAs. The interested PAAs are polar and relatively soluble in water, so a cartridge with cationic exchange properties has the best absorption and consequently the best recoveries.

Main-coolant-pump shaft-seal guidelines. Volume 2. Operational guidelines. Final report

International Nuclear Information System (INIS)

Fair, C.E.; Greer, A.O.

1983-03-01

This report presents a set of guidelines and criteria for improving main coolant pump shaft seal operational reliability. The noted guidelines are developed from EPRI sponsored nuclear power plant seal operating experience studies. Usage procedures/practices and operational environment influence on seal life and reliability from the most recent such survey are summarized. The shaft seal and its auxiliary supporting systems are discussed both from technical and operational related viewpoints

Singapore Paediatric Resuscitation Guidelines 2016.

Science.gov (United States)

Ong, Gene Yong Kwang; Chan, Irene Lai Yeen; Ng, Agnes Suah Bwee; Chew, Su Yah; Mok, Yee Hui; Chan, Yoke Hwee; Ong, Jacqueline Soo May; Ganapathy, Sashikumar; Ng, Kee Chong

2017-07-01

We present the revised 2016 Singapore paediatric resuscitation guidelines. The International Liaison Committee on Resuscitation's Pediatric Taskforce Consensus Statements on Science and Treatment Recommendations, as well as the updated resuscitation guidelines from the American Heart Association and European Resuscitation Council released in October 2015, were debated and discussed by the workgroup. The final recommendations for the Singapore Paediatric Resuscitation Guidelines 2016 were derived after carefully reviewing the current available evidence in the literature and balancing it with local clinical practice. Copyright: © Singapore Medical Association.

Pulse versus continuous peracetic acid applications: effects on Rainbow trout performance, biofilm formation and water quality

Science.gov (United States)

Peracetic acid (PAA) products are being introduced to aquaculture as sustainable disinfectants. Two strategies are used to apply PAA: short term high dose (1-2 mg L-1 PAA) periodic pulse applications or continuous low dose (< 0.2 mg L-1 PAA) applications. In the present study, these strategies and a...

State Emergency Department Opioid Guidelines: Current Status.

Science.gov (United States)

Broida, Robert I; Gronowski, Tanner; Kalnow, Andrew F; Little, Andrew G; Lloyd, Christopher M

2017-04-01

The purpose of this study was to evaluate and categorize current state-sponsored opioid guidelines for the practice of emergency medicine (EM). We conducted a comprehensive search of EM-specific opioid prescribing guidelines and/or policies in each state to determine current state involvement in EM opioid prescribing, as well as to evaluate some of the specifics of each guideline or policy. The search was conducted using an online query and a follow-up email request to each state chapter of ACEP. We found that 17 states had emergency department-specific guidelines. We further organized the guidelines into four categories: limiting prescriptions for opioids with 67 total recommendations; preventing/diverting abuse with 56 total recommendations; addiction-related guidelines with 29 total recommendations; and a community resources section with 24 total recommendations. Our results showed that current state guidelines focus on providers limiting opioid pain prescriptions and vetting patients for possible abuse/diversion. This study highlights the 17 states that have addressed opioid prescribing guidelines and categorizes their efforts to date. It is hoped that this study will provide the basis for similar efforts in other states.

The complete European guidelines on phenylketonuria

DEFF Research Database (Denmark)

van Wegberg, A M J; MacDonald, A; Ahring, K

2017-01-01

severe intellectual disability, epilepsy and behavioural problems. PKU management differs widely across Europe and therefore these guidelines have been developed aiming to optimize and standardize PKU care. Professionals from 10 different European countries developed the guidelines according to the AGREE...... (Appraisal of Guidelines for Research and Evaluation) method. Literature search, critical appraisal and evidence grading were conducted according to the SIGN (Scottish Intercollegiate Guidelines Network) method. The Delphi-method was used when there was no or little evidence available. External consultants....... In addition, knowledge gaps are identified which require further research in order to direct better care for the future....

Misguided guidelines for managing labor.

Science.gov (United States)

Cohen, Wayne R; Friedman, Emanuel A

2015-06-01

In a recent review we expressed concerns about new guidelines for the assessment and management of labor recommended jointly by the American Congress of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM). These guidelines are based heavily on a new concept of how cervical dilatation and fetal descent progress, derived from the work of Zhang et al. In their Viewpoint article they have addressed, but not allayed, the concerns we described in our review. We assert that the dilatation curve promulgated by Zhang et al cannot be reconciled with direct clinical observation. Even if they were correct, however, it still does not follow that the ACOG/SMFM guidelines should recommend replacing the coherent system of identifying and managing labor aberrations described by Friedman. That system is grounded in well-established clinical principles based on decades of use and the objectively documented association of some labor abnormalities with poor fetal and maternal outcomes. Recommendations for new clinical management protocols should require the demonstration of superior outcomes through extensive, preferably prospective, assessment. Using untested guidelines for the management of labor may adversely affect women and children. Even if those guidelines were to reduce the currently excessive cesarean delivery rate, the price of that benefit is likely to be a trade-off in harm to parturients and their offspring. The nature and degree of that harm needs to be documented before considering adoption of the guidelines. Copyright © 2015 Elsevier Inc. All rights reserved.

Paralympic emblem guidelines: London 2012

OpenAIRE

2015-01-01

The purpose of these guidelines is to preserve and enhance the value of the Emblem for the benefit of all authorised users. These guidelines apply to LOCOG and IPC creative, marketing and communications personnel, agencies and consultants only.

Reporting guidelines and journal quality in otolaryngology.

Science.gov (United States)

Henderson, A H; Upile, T; Pilavakis, Y; Patel, N N

2016-10-01

Journals increasingly use reporting guidelines to standardise research papers, partly to improve quality. Although defining journal quality is difficult, various calculated metrics are used. This study investigates guideline adoption by otolaryngology journals and whether a relationship exists between this and journal quality. Retrospective MEDLINE database review for English language, Index Medicus, journals of interest to otolaryngologists (October 2013). The resulting journals were examined for the number of guidelines endorsed and then tabulated against surrogate measures of journal quality (Impact factor, Eigenfactor, SCImago, Source-Normalised rank). The primary outcome measure was the number of recognised reporting guidelines endorsed per journal. This was then correlated against journal quality scores. For comparison, a further small sample correlation was performed with 6 randomly selected and 6 high-profile clinical non-otolaryngology journals. 37 otolaryngology journals were identified. Number of guidelines used and quality scores were not normally distributed. Mean guideline usage was 1.0 for otolaryngology journals, 1.5 for randomly selected, and 5.5 for the high-profile journals. Only 18/37 (49%) otolaryngology journals endorsed any guidelines, compared with 11/12 non-otolaryngology journals. Within otolaryngology, Eigenfactor positively correlated with guideline use (r = 0.4, n = 44, p otolaryngology journals is low. Although it might be expected that use of reporting guidelines improved quality, this is not reflected in the derived quality scores in otolaryngology. This may reflect low levels of use/enforcement, that quality indicators are inherently flawed, or that generalised guidelines are not always appropriate or valued by editors. © 2015 John Wiley & Sons Ltd.

The 2015 Dutch food-based dietary guidelines.

Science.gov (United States)

Kromhout, D; Spaaij, C J K; de Goede, J; Weggemans, R M

2016-08-01

The objective of this study was to derive food-based dietary guidelines for the Dutch population. The dietary guidelines are based on 29 systematic reviews of English language meta-analyses in PubMed summarizing randomized controlled trials and prospective cohort studies on nutrients, foods and food patterns and the risk of 10 major chronic diseases: coronary heart disease, stroke, heart failure, diabetes, breast cancer, colorectal cancer, lung cancer, chronic obstructive pulmonary disease, dementia and depression. The committee also selected three causal risk factors for cardiovascular diseases or diabetes: systolic blood pressure, low-density lipoprotein cholesterol and body weight. Findings were categorized as strong or weak evidence, inconsistent effects, too little evidence or effect unlikely for experimental and observational data separately. Next, the committee selected only findings with a strong level of evidence for deriving the guidelines. Convincing evidence was based on strong evidence from the experimental data either or not in combination with strong evidence from prospective cohort studies. Plausible evidence was based on strong evidence from prospective cohort studies only. A general guideline to eat a more plant food-based dietary pattern and limit consumption of animal-based food and 15 specific guidelines have been formulated. There are 10 new guidelines on legumes, nuts, meat, dairy produce, cereal products, fats and oils, tea, coffee and sugar-containing beverages. Three guidelines on vegetables, fruits, fish and alcoholic beverages have been sharpened, and the 2006 guideline on salt stayed the same. A separate guideline has been formulated on nutrient supplements. Completely food-based dietary guidelines can be derived in a systematic and transparent way.

How do SAGES members rate its guidelines?

Science.gov (United States)

Hope, William W; Richardson, William; Fanelli, Robert; Stefanidis, Dimitrios

2014-04-01

The development of practice guidelines should take into consideration the opinions of end users. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has implemented several changes in its guideline development and dissemination process based on previous end-user input. An anonymous electronic survey was conducted via e-mail solicitation in September 2011. Respondents were asked to submit their feedback on the 26 guidelines produced by our society using a 32-item questionnaire and to suggest topics for new guideline development and areas of improvement. Responses from the survey were received by 494 people, of whom 474 (96 %) were clinicians; 373 (75 %) were general, laparoscopic, or bariatric surgeons; and 324 (65 %) held leadership roles within their institution. Most respondents were 35-44 years old (36 %), male (83 %), and had been in practice for over 10 years (54 %). A total of 383 (81 %) had used our guidelines, and, of those, 96 % agreed with their content. Guideline quality was rated 4.34; value 4.27; and ease of access 3.97 on a five-point Likert scale. The most commonly referenced guideline in the survey regarded surgical treatment of reflux (67 %), followed by laparoscopy during pregnancy (51 %). The three most common reasons guidelines were accessed were to update knowledge (68 %), to maximize patient care through evidence-based treatment (51 %), and to obtain a critical literature review. The majority of respondents indicated they greatly value and agree with our guidelines. These results indicate that recent efforts to improve our guidelines have succeeded.

In vivo evaluation of thiolated poly(acrylic acid) as a drug absorption modulator for MRP2 efflux pump substrates.

Science.gov (United States)

Greindl, Melanie; Föger, Florian; Hombach, Juliane; Bernkop-Schnürch, Andreas

2009-08-01

Recently, several polymers have been reported to modulate drug absorption by inhibition of intestinal efflux pumps such as multidrug resistance proteins (MRPs) and P-glycoprotein (P-gp). The aim of the present study was to evaluate the efficiency of thiolated poly(acrylic acid) (PAA-Cys) to act as a drug absorption modulator for MRP2 efflux pump substrates in vivo, using sulforhodamine 101 as representative MRP2 substrate. In vitro, the permeation-enhancing effect of unmodified PAA and PAA(250)-Cys(,) displaying 580 micromol free thiol groups per gram polymer, was evaluated by using freshly excised rat intestinal mucosa mounted in Ussing-type chambers. In comparison to that of the buffer control, the sulforhodamine 101 transport in the presence of 0.5% unmodified PAA(250) and 0.5% (w/v) PAA(250)-Cys was 1.3- and 4.0-fold improved, respectively. In vivo, sulforhodamine 101 solutions containing 4% (w/v) unmodified PAA(250) or 4% (w/v) thiolated PAA(250) were orally given to rats. The PAA(250)-Cys solution increased the area under the plasma concentration-time curve (AUC(0-12)) of sulforhodamine 101 3.8-fold in comparison to control and 2.2-fold in comparison to unmodified PAA(250). This in vivo study revealed that PAA(250)-Cys significantly increased the oral bioavailability of MRP2 substrate sulforhodamine 101.

Interconnection Guidelines

Science.gov (United States)

The Interconnection Guidelines provide general guidance on the steps involved with connecting biogas recovery systems to the utility electrical power grid. Interconnection best practices including time and cost estimates are discussed.

NCCN Guidelines® Insights Bladder Cancer, Version 2.2016 Featured Updates to the NCCN Guidelines

Science.gov (United States)

Clark, Peter E.; Spiess, Philippe E.; Agarwal, Neeraj; Bangs, Rick; Boorjian, Stephen A.; Buyyounouski, Mark K.; Efstathiou, Jason A.; Flaig, Thomas W.; Friedlander, Terence; Greenberg, Richard E.; Guru, Khurshid A.; Hahn, Noah; Herr, Harry W.; Hoimes, Christopher; Inman, Brant A.; Kader, A. Karim; Kibel, Adam S.; Kuzel, Timothy M.; Lele, Subodh M.; Meeks, Joshua J.; Michalski, Jeff; Montgomery, Jeffrey S.; Pagliaro, Lance C.; Pal, Sumanta K.; Patterson, Anthony; Petrylak, Daniel; Plimack, Elizabeth R.; Pohar, Kamal S.; Porter, Michael P.; Sexton, Wade J.; Siefker-Radtke, Arlene O.; Sonpavde, Guru; Tward, Jonathan; Wile, Geoffrey; Dwyer, Mary A.; Smith, Courtney

2017-01-01

These NCCN Guidelines Insights discuss the major recent updates to the NCCN Guidelines for Bladder Cancer based on the review of the evidence in conjunction with the expert opinion of the panel. Recent updates include (1) refining the recommendation of intravesical bacillus Calmette-Guérin, (2) strengthening the recommendations for perioperative systemic chemotherapy, and (3) incorporating immunotherapy into second-line therapy for locally advanced or metastatic disease. These NCCN Guidelines Insights further discuss factors that affect integration of these recommendations into clinical practice. PMID:27697976

Architecturally Significant Requirements Identification, Classification and Change Management for Multi-tenant Cloud-Based Systems

DEFF Research Database (Denmark)

Chauhan, Muhammad Aufeef; Probst, Christian W.

2017-01-01

presented a framework for requirements classification and change management focusing on distributed Platform as a Service (PaaS) and Software as a Service (SaaS) systems as well as complex software ecosystems that are built using PaaS and SaaS, such as Tools as a Service (TaaS). We have demonstrated...

Main-coolant-pump shaft-seal guidelines. Volume 3. Specification guidelines. Final report

International Nuclear Information System (INIS)

Fair, C.E.; Greer, A.O.

1983-03-01

This report presents a set of guidelines and criteria to aid in the generation of procurement specifications for Main Coolant Pump Shaft Seals. The noted guidelines are developed from EPRI sponsored nuclear power plant seal operating experience studies, a review of pump and shaft seal literature and discussions with pump and seal designers. This report is preliminary in nature and could be expanded and finalized subsequent to completion of further design, test and evaluation efforts

Effluent Guidelines

Science.gov (United States)

Effluent guidelines are national standards for wastewater discharges to surface waters and municipal sewage treatment plants. We issue the regulations for industrial categories based on the performance of treatment and control technologies.

Growth inhibition of Aeromonas salmonicida and Yersinia ruckeri by disinfectants containing peracetic acid

DEFF Research Database (Denmark)

Meinelt, Thomas; Phan, T.; Behrens, S.

2015-01-01

contribute to sustainable aquaculture. The aim of our study was to compare the effectiveness of 6 commercial PAA products with different molecular PAA:H2O2 ratios to reduce bacterial growth of Aeromonas salmonicida and Yersinia ruckeri and to determine effective concentrations and exposure times. All...... products reduced colony-forming units (CFUs) of A. salmonicida and Y. ruckeri. Products with higher molecular PAA:H2O2 ratios inhibited growth better than products with lower molecular PAA:H2O2 ratios at the same PAA concentration; this indicates that H2O2 is not the driving force in the reduction of A....... salmonicida and Y. ruckeri growth by PAA in vitro. The practical application of the products with high molecular PAA:H2O2 ratios should be prioritized if these pathogens are diagnosed...

Comparing peracetic acid and hypochlorite for disinfection of combined sewer overflows: Effects of suspended-solids and pH.

Science.gov (United States)

McFadden, M; Loconsole, J; Schockling, A J; Nerenberg, R; Pavissich, J P

2017-12-01

Peracetic acid (PAA) is an alternative disinfectant that may be effective for combined sewer overflow (CSO) disinfection, but little is known about the effect of particle size on PAA disinfection efficiency. In this work, PAA and hypochlorite were compared as disinfectants, with a focus on the effect of wastewater particles. Inactivation experiments were conducted on suspended cultures of Escherichia coli and wastewater suspended solids. Tested size fractions included particle diameters disinfection efficiency decreased with increasing solids size. However, solids size had little effect on PAA disinfection. The PAA disinfection efficiency decreased at pH values above 7.5. Live/dead staining revealed that PAA disinfection leaves most cells in a viable but non-culturable condition. Fourier transform infrared spectroscopy (FTIR) analyses suggests that PAA and hypochlorite may inactivate E. coli bacteria by similar mechanisms. Copyright © 2017 Elsevier B.V. All rights reserved.

IT governance guidelines for directors

CERN Document Server

Calder, Alan

2005-01-01

This important new book – 'IT Governance: Guidelines for Directors' provides directors, executives, managers and professional advisers with clear, pragmatic guidelines for ensuring that IT and the business work together for the same strategic objectives. 

Exploiting thesauri knowledge in medical guideline formalization

OpenAIRE

Serban, R.C.; ten Teije, A.C.M.

2009-01-01

Objectives: As in software product lifecycle, the effort spent in maintaining medical knowl edge in guidelines can be reduced, if modularization, formalization and tracking of domain knowledge are employed across the guideline development phases. Methods: We propose to exploit and combine knowledge templates with medical background knowledge from existing thesauri in order to produce reusable building blocks used in guideline development. These tem- plates enable easier guideline formalizatio...

A study on projection angles for an optimal image of PNS water's view on children

International Nuclear Information System (INIS)

Son, Sang Hyuk; Song, Young Geun; Kim, Sung Kyu; Hong, Sang Woo; Kim, Je Bong

2007-01-01

This study is to calculate the proper angle for the optimal image of PNS Water's view on children, comparing and analyzing the PNS Water's projection angles between children and adults at every age. This study randomly selected 50 patients who visited the Medical Center from January to May in 2005, and examined the incidence path of central ray, taking a PNS Water's and skull trans-Lat. view in Water's filming position while attaching a lead ball mark on the Orbit, EAM, and acanthion of the patient's skull. And then, we calculated the incidence angles (angle A) of the line connected from OML and the petrous ridge to the inferior margin of maxilla on general (random) patient's skull image, following the incidence path of central ray. Finally, we analyzed two pieces of the graphs at ages, developing out the patient's ideal images at PNS Water's filming position taken by a digital camera, and calculating the angle (angle B) between OML and IP(Image Plate). The angle between OML and IP is about 43 .deg. in 4-years-old children, which is higher than 37 .deg. as age increases the angle decreases, it goes to 37 .deg. around 30 years of age. That is similar result to maxillary growth period. We can get better quality of Water's image for children when taking the PNS Water's view if we change the projection angles, considering maxillary growth for patients in every age stage

[leksikon-artikler :  151 stk. cf. abstract

DEFF Research Database (Denmark)

Holm, Bent

2007-01-01

, Den; Monolog; Montaigu, Marie; Montaigu, René Magnon de; Moralitet; Mysteriespil; Nar; Nationalteater; Nattescene; Omløberspil; Oversættelse; Pantomime; Pantomimeteatret; Paris; Periakt; Piccolo Teatro; Pickelhering; Pietisme; Pjerrot; Poetik; Poulsen, Olaf; Price, familien; Påskespil; Quoten, Samuel...

Manual for implementing residual radioactivity guidelines

International Nuclear Information System (INIS)

Gilbert, T.L.; Eckerman, K.F.; Hansen, W.R.; Healy, J.W.; Kennedy, W.E.; Napier, B.A.; Solday, J.K.

1986-01-01

The US Department of Energy (DOE) has recently issued guidelines for residual radioactivity at Formerly Utilized Sites Remedial Action Program (FUSRAP) and remote Surplus Facilities Management Program (SFMP) sites. A manual for implementing these guidelines has been prepared jointly by four DOE laboratories (ANL, LANL, ORNL, and PNL) and is being issued as a supplement to the guidelines. The manual presents procedures and tables for deriving site-specific guidelines for levels of residual radionuclide concentrations in soil that must not be exceeded if a site is to be released for unrestricted use. Guidance for implementing DOE ALARA policy for remedial actions is also included. The concentration factor method is used in the pathway analysis for deriving soil guidelines. The analysis has been structured in a manner that explicitly identifies all of the factors involved. Tables are provided for dose-conversion factors and pathway factors from which environmental transport factors for each radionuclide and pathway may be calculated. The scenarios used for deriving the environmental transport factors and dose conversion factors, and the manner in which the information provided in the manual is used to derive site-specific soil guidelines will be presented

[Guideline 'Organ donation following euthanasia"

NARCIS (Netherlands)

Mulder, H.; Olthuis, G.J.; Siebelink, M.; Gerritsen, R; Heurn, E. van

2017-01-01

- The multidisciplinary guideline 'Organ donation following euthanasia' was published in March 2017 at request of the Minister of Health, Welfare and Sport.- This guideline provides recommendations for the organisation and implementation of a request to donate organs expressed by a patient who asks

Medical Malpractice Implications of Clinical Practice Guidelines.

Science.gov (United States)

Ruhl, Douglas S; Siegal, Gil

2017-08-01

Clinical practice guidelines aim to improve medical care by clarifying and making useful recommendations to providers. Although providers should account for patients' unique characteristics when determining a treatment plan, it is generally perceived as good practice to follow guidelines when applicable. This is of interest in malpractice litigation, where it is essential to establish a standard of care to evaluate the performances of providers. Although the opinions of expert witnesses are used to determine standards of care, guidelines are expected to play a leading role. Guidelines alone should not establish a legal standard but may help inform this discussion in the courtroom. Therefore, it is incumbent that excellent, practical, and timely guidelines are continually created and updated in a transparent way. These guidelines must be very clear and underscore the various strengths of recommendation based on the quality of available evidence.

Interaction between Al3+ and acrylic acid and polyacrylic acid in acidic aqueous solution: a model experiment for the behavior of Al3+ in acidified soil solution.

Science.gov (United States)

Etou, Mayumi; Masaki, Yuka; Tsuji, Yutaka; Saito, Tomoyuki; Bai, Shuqin; Nishida, Ikuko; Okaue, Yoshihiro; Yokoyama, Takushi

2011-01-01

From the viewpoint of the phytotoxicity and mobility of Al(3+) released from soil minerals due to soil acidification, the interaction between Al(3+) and acrylic acid (AA) and polyacrylic acid (PAA) as a model compound of fulvic acid was investigated. The interaction was examined at pH 3 so as to avoid the hydrolysis of Al(3+). The interaction between Al(3+) and AA was weak. However, the interaction between Al(3+) and PAA was strong and depended on the initial (COOH in PAA)/Al molar ratio (R(P)) of the solution. For the range of 1/R(P), the interaction between Al(3+) and PAA can be divided into three categories: (1) 1:1 Al-PAA-complex (an Al(3+) combines to a carboxyl group), (2) intermolecular Al-PAA-complex (an Al(3+) combines to more than 2 carboxyl groups of other Al-PAA-complexes) in addition to the 1:1 Al-PAA-complex and (3) precipitation of intermolecular complexes. In conclusion, R(P) is an important factor affecting the behavior of Al(3+) in acidic soil solution.

Fluorescence ON–OFF switching using micelle of stimuli-responsive double hydrophilic block copolymers: Nile Red fluorescence in micelles of poly(acrylic acid-b-N-isopropylacrylamide)

Energy Technology Data Exchange (ETDEWEB)

Yee, Min Min; Tsubone, Miyabi; Morita, Takuya [Department of Chemistry, Graduate School of Science & Engineering, Saga University, 1 Honjo, Saga 840-8502 (Japan); Yusa, Shin-ichi [Department of Materials Science and Chemistry, University of Hyogo, 2167 Shosha, Himeji 671-2280 (Japan); Nakashima, Kenichi, E-mail: nakashik@cc.saga-u.ac.jp [Department of Chemistry, Graduate School of Science & Engineering, Saga University, 1 Honjo, Saga 840-8502 (Japan)

2016-08-15

The dual-mode fluorescence ON–OFF switching of Nile Red (NR) by using stimuli-responsive polymeric micelle of poly(acrylic acid-b-N-isopropylacrylamide) (PAA-b-PNIPAM) has been studied. PAA-b-PNIPAM, one of double hydrophilic block copolymers, is known to form PNIPAM-core/PAA-corona micelles in aqueous solutions when the temperature of the solution is elevated up to the lower critical solution temperature (LCST) of PNIPAM block. It also forms PAA-core/PNIPAM-corona micelles when the anionic PAA block is charge-neutralized with cationic cetyltrimethylammonium ion. Fluorescence properties of NR in the micelles are elucidated by observing various fluorescence parameters such as intensity, polarization, and quantum yield. It is found that the fluorescence intensity is negligibly low (OFF-state) when PAA-b-PNIPAM exists as a form of unimer, whereas it is remarkably enhanced (ON-state) when the PNIPAM-core or PAA-core micelles are formed. These results demonstrate that a novel fluorescence ON–OFF switching system can be constructed by using PAA-b-PNIPAM micelles and NR.

Lupus nephritis management guidelines compared.

Science.gov (United States)

Wilhelmus, Suzanne; Bajema, Ingeborg M; Bertsias, George K; Boumpas, Dimitrios T; Gordon, Caroline; Lightstone, Liz; Tesar, Vladimir; Jayne, David R

2016-06-01

In the past years, many (randomized) trials have been performed comparing the treatment strategies for lupus nephritis. In 2012, these data were incorporated in six different guidelines for treating lupus nephritis. These guidelines are European, American and internationally based, with one separate guideline for children. They offer information on different aspects of the management of lupus nephritis including induction and maintenance treatment of the different histological classes, adjunctive treatment, monitoring of the patient, definitions of response and relapse, indications for (repeat) renal biopsy, and additional challenges such as the presence of vascular complications, the pregnant SLE patient, treatment in children and adolescents and considerations about end-stage renal disease and transplantation. In this review, we summarize the guidelines, determine the common ground between them, highlight the differences and discuss recent literature. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Characteristics of effective clinical guidelines for general practice.

NARCIS (Netherlands)

Burgers, J.S.; Grol, R.P.T.M.; Zaat, J.O.M.; Spies, T.H.; Bij, A.K. van der; Mokkink, H.G.A.

2003-01-01

BACKGROUND: The use of clinical guidelines in general practice is often limited. Research on barriers to guideline adherence usually focuses on attitudinal factors. Factors linked to the guideline itself are much less studied. AIM: To identify characteristics of effective clinical guidelines for

Air quality along motorways. Measuring and modelling calculations; Luftkvalitet langs motorveje. Maelekampagne og modelberegninger

Energy Technology Data Exchange (ETDEWEB)

Solvang Jensen, S.; Loefstroem, P.; Berkowich, R.; Roerdam Olsen, H.; Frydendall, J. [DMU, Afd. for Atmosfaerisk Miljoe, Roskilde (DK); Fuglsang, K. [FORCE Technology, Broendby (Denmark); Hummelshoej, P. [MetSupport, Roskilde (Denmark)

2004-12-01

This report describes the air quality along Koege Bugt motorway, one of the most trafficked sections in Denmark. A number of measurements have been carried out along Koege Bugt motorway at Greve for a three-month period in the autumn of 2003. For the first time in Denmark, NO{sub x} were measured with high time dissolution from different distances of the motorway. Furthermore, a number of meteorological parameters were measured in order to map local meteorological conditions. An air quality model describing dispersal and conversion has been made on the basis of the OML model. The OML model is modified in order to take traffic-made turbulence into consideration. The model has been evaluated through comparisons between measurements and simulated calculations. Furthermore, simulated calculations for the year 2003 has been made for comparison with extreme values. (BA)

Resistance to and killing by the sporicidal microbicide peracetic acid.

Science.gov (United States)

Leggett, Mark J; Schwarz, J Spencer; Burke, Peter A; Mcdonnell, Gerald; Denyer, Stephen P; Maillard, Jean-Yves

2015-03-01

To elucidate the mechanisms of spore resistance to and killing by the oxidizing microbicide peracetic acid (PAA). Mutants of Bacillus subtilis lacking specific spore structures were used to identify resistance properties in spores and to understand the mechanism of action of PAA. We also assessed the effect of PAA treatment on a number of spore properties including heat tolerance, membrane integrity and germination. The spore coat is essential for spore PAA resistance as spores with defective coats were greatly sensitized to PAA treatment. Small acid-soluble spore proteins apparently provide no protection against PAA. Defects in spore germination, specifically in germination via the GerB and GerK but not the GerA germination receptors, as well as leakage of internal components suggest that PAA is active at the spore inner membrane. It is therefore likely that the inner membrane is the major site of PAA's sporicidal activity. PAA treatment targets the spore membrane, with some of its activity directed specifically against the GerB and GerK germination receptors. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Guidelines for Reporting Medical Research

DEFF Research Database (Denmark)

Johansen, Mathilde; Thomsen, Simon Francis

2016-01-01

As a response to a low quality of reporting of medical research, guidelines for several different types of study design have been developed to secure accurate reporting and transparency for reviewers and readers from the scientific community. Herein, we review and discuss the six most widely...... accepted and used guidelines: PRISMA, CONSORT, STROBE, MOOSE, STARD, and SPIRIT. It is concluded that the implementation of these guidelines has led to only a moderate improvement in the quality of the reporting of medical research. There is still much work to be done to achieve accurate and transparent...... reporting of medical research findings....

Implementation guidelines for seismic PSA

International Nuclear Information System (INIS)

Coman, Ovidiu; Samaddar, Sujit; Hibino, Kenta; )

2014-01-01

The presentation was devoted to development of guidelines for implementation of a seismic PSA. If successful, these guidelines can close an important gap. ASME/ANS PRA standards and the related IAEA Safety Guide (IAEA NS-G-2.13) describe capability requirements for seismic PSA in order to support risk-informed applications. However, practical guidance on how to meet these requirements is limited. Such guidelines could significantly contribute to improving risk-informed safety demonstration, safety management and decision making. Extensions of this effort to further PSA areas, particularly to PSA for other external hazards, can enhance risk-informed applications

Maintaining formal models of living guidelines efficiently

NARCIS (Netherlands)

Seyfang, Andreas; Martínez-Salvador, Begoña; Serban, Radu; Wittenberg, Jolanda; Miksch, Silvia; Marcos, Mar; Ten Teije, Annette; Rosenbrand, Kitty C J G M

2007-01-01

Translating clinical guidelines into formal models is beneficial in many ways, but expensive. The progress in medical knowledge requires clinical guidelines to be updated at relatively short intervals, leading to the term living guideline. This causes potentially expensive, frequent updates of the

Compliance with practice guidelines: clinical autonomy revisited

NARCIS (Netherlands)

Klazinga, N.

1994-01-01

The development of practice guidelines is gaining popularity in both North America and Europe. This review article explores the different reasons behind guideline development, the methodologies used and the effects assessed so far. Experience since 1982 with a guideline development programme at CBO

Mechanical properties of polyelectrolyte multilayer self-assembled films

International Nuclear Information System (INIS)

Dai Xinhua; Zhang Yongjun; Guan Ying; Yang Shuguang; Xu Jian

2005-01-01

The mechanical properties of electrostatic self-assembled multilayer films from polyacrylic acid (PAA) and C 60 -ethylenediamine adduct (C 60 -EDA) or poly(allylamine hydrochloride) (PAH) were evaluated by atomic force microscopy (AFM) wear experiments. Because of the higher molecular weight of PAH, the wear resistance of the (PAH/PAA) 10 film is higher than that of the (PAH/PAA) 2 (C 60 -EDA/PAA) 8 film; that is, the former is mechanically more stable than the latter. The mechanical stability of both films can be improved significantly by heat treatment, which changes the nature of the linkage from ionic to covalent. The AFM measurement also reveals that the (PAH/PAA) 2 (C 60 -EDA/PAA) 8 film is softer than the (PAH/PAA) 10 film. The friction properties of the heated films were measured. These films can be developed as potential lubrication coatings for microelectromechanical systems

European guidelines for workplace drug testing in urine.

Science.gov (United States)

Taskinen, Sanna; Beck, Olof; Bosch, Tessa; Brcak, Michaela; Carmichael, Duncan; Fucci, Nadia; George, Claire; Piper, Mark; Salomone, Alberto; Schielen, Wim; Steinmeyer, Stefan; Weinmann, Wolfgang

2017-06-01

These European Guidelines for Workplace Drug Testing in Urine have been prepared and updated by the European Workplace Drug Testing Society (EWDTS). The first version of these urine guidelines was published in 2002. Since then, the guidelines have been followed by many laboratories in different European countries and their role has been essential particularly in countries lacking legislation for workplace drug testing. In 2014, the EWDTS started a guidelines updating project and published a new version of the urine guidelines in 2015. Here we represent this updated version of the urine guidelines. The European Guidelines are designed to establish best practice procedures whilst allowing individual countries to operate within the requirements of national customs and legislation. The EWDTS recommends that all European laboratories that undertake legally defensible workplace drug testing should use these guidelines as a template for accreditation. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

[Elaboration and critical evaluation of clinical guidelines].

Science.gov (United States)

García Villar, C

2015-11-01

Clinical guidelines are documents to help professionals and patients select the best diagnostic or therapeutic option. Elaborating guidelines requires an efficient literature search and a critical evaluation of the articles found to select the most appropriate ones. After that, the recommendations are formulated and then must be externally evaluated before they can be disseminated. Even when the guidelines are very thorough and rigorous, it is important to know whether they fulfill all the methodological requisites before applying them. With this aim, various scales have been developed to critically appraise guidelines. Of these, the AGREE II instrument is currently the most widely used. This article explains the main steps in elaborating clinical guidelines and the main aspects that should be analyzed to know whether the guidelines are well written. Copyright © 2015 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

Closed cooling water chemistry guidelines revision

International Nuclear Information System (INIS)

McElrath, Joel; Breckenridge, Richard

2014-01-01

This second revision of the Closed Cooling Water Chemistry Guideline addresses the use of chemicals and monitoring methods to mitigate corrosion, fouling, and microbiological growth in the closed cooling-water (CCW) systems of nuclear and fossil-fueled power plants. This revision has been endorsed by the utility chemistry community and represents another step in developing a more proactive chemistry program to limit or control closed cooling system degradation with increased consideration of corporate resources and plant-specific design and operating concerns. These guidelines were developed using laboratory data, operating experience, and input from organizations and utilities within and outside of the United States of America. It is the intent of the Revision Committee that these guidelines are applicable to all nuclear and fossil-fueled generating stations around the world. A committee of industry experts—including utility specialists, Institute of Nuclear Power Operations representatives, water-treatment service-company representatives, consultants, a primary contractor, and EPRI staff—collaborated in reviewing available data on closed cooling-water system corrosion and microbiological issues. Recognizing that each plant owner has a unique set of design, operating, and corporate concerns, the Guidelines Committee developed a methodology for plant-specific optimization. The guideline provides the technical basis for a reasonable but conservative set of chemical treatment and monitoring programs. The use of operating ranges for the various treatment chemicals discussed in this guideline will allow a power plant to limit corrosion, fouling, and microbiological growth in CCW systems to acceptable levels. The guideline now includes closed cooling chemistry regimes proven successful in use in the international community. The guideline provides chemistry constraints for the use of phosphates control, as well as pure water with pH control. (author)

Guidelines for rating Global Assessment of Functioning (GAF

Directory of Open Access Journals (Sweden)

Aas IH Monrad

2011-01-01

Full Text Available Abstract Background Global Assessment of Functioning (GAF is a scoring system for the severity of illness in psychiatry. It is used clinically in many countries, as well as in research, but studies have shown several problems with GAF, for example concerning its validity and reliability. Guidelines for rating are important. The present study aimed to identify the current status of guidelines for rating GAF, and relevant factors and gaps in knowledge for the development of improved guidelines. Methods A thorough literature search was conducted. Results Few studies of existing guidelines have been conducted; existing guidelines are short; and rating has a subjective element. Seven main categories were identified as being important in relation to further development of guidelines: (1 general points about guidelines for rating GAF; (2 introduction to guidelines, with ground rules; (3 starting scoring at the top, middle or bottom level of the scale; (4 scoring for different time periods and of different values (highest, lowest or average; (5 the finer grading of the scale; (6 different guidelines for different conditions; and (7 different languages and cultures. Little information is available about how rules for rating are understood by different raters: the final score may be affected by whether the rater starts at the top, middle or bottom of the scale; there is little data on which value/combination of GAF values to record; guidelines for scoring within 10-point intervals are limited; there is little empirical information concerning the suitability of existing guidelines for different conditions and patient characteristics; and little is known about the effects of translation into different languages or of different cultural understanding. Conclusions Few studies have dealt specifically with guidelines for rating GAF. Current guidelines for rating GAF are not comprehensive, and relevant points for new guidelines are presented. Theoretical and

World Health Organization guideline development: an evaluation.

Directory of Open Access Journals (Sweden)

David Sinclair

Full Text Available BACKGROUND: Research in 2007 showed that World Health Organization (WHO recommendations were largely based on expert opinion, rarely used systematic evidence-based methods, and did not follow the organization's own "Guidelines for Guidelines". In response, the WHO established a "Guidelines Review Committee" (GRC to implement and oversee internationally recognized standards. We examined the impact of these changes on WHO guideline documents and explored senior staff's perceptions of the new procedures. METHODS AND FINDINGS: We used the AGREE II guideline appraisal tool to appraise ten GRC-approved guidelines from nine WHO departments, and ten pre-GRC guidelines matched by department and topic. We interviewed 20 senior staff across 16 departments and analyzed the transcripts using the framework approach. Average AGREE II scores for GRC-approved guidelines were higher across all six AGREE domains compared with pre-GRC guidelines. The biggest changes were noted for "Rigour of Development" (up 37.6%, from 30.7% to 68.3% and "Editorial Independence" (up 52.7%, from 20.9% to 73.6%. Four main themes emerged from the interviews: (1 high standards were widely recognized as essential for WHO credibility, particularly with regard to conflicts of interest; (2 views were mixed on whether WHO needed a single quality assurance mechanism, with some departments purposefully bypassing the procedures; (3 staff expressed some uncertainties in applying the GRADE approach, with departmental staff concentrating on technicalities while the GRC remained concerned the underlying principles were not fully institutionalized; (4 the capacity to implement the new standards varied widely, with many departments looking to an overstretched GRC for technical support. CONCLUSIONS: Since 2007, WHO guideline development methods have become more systematic and transparent. However, some departments are bypassing the procedures, and as yet neither the GRC, nor the quality assurance

PIAAC Technical Standards and Guidelines

Science.gov (United States)

OECD Publishing, 2014

2014-01-01

The Programme for International Assessment of Adult Competencies (PIAAC) will establish technical standards and guidelines to ensure that the survey design and implementation processes of PIAAC yield high-quality and internationally comparable data. This document provides a revised version of the technical standards and guidelines originally…

Specialty Guidelines for Forensic Psychology

Science.gov (United States)

American Psychologist, 2013

2013-01-01

In the past 50 years forensic psychological practice has expanded dramatically. Because the practice of forensic psychology differs in important ways from more traditional practice areas (Monahan, 1980) the "Specialty Guidelines for Forensic Psychologists" were developed and published in 1991 (Committee on Ethical Guidelines for Forensic…

ESUR prostate MR guidelines 2012

Energy Technology Data Exchange (ETDEWEB)

Barentsz, Jelle O.; Fuetterer, Jurgen J. [Radboud University Nijmegen Medical Center, Department of Radiology, Nijmegen (Netherlands); Richenberg, Jonathan [Brighton and Sussex University Hospital Trust, Brighton (United Kingdom); Clements, Richard [Royal Gwent Hospital, Department of Clinical Radiology, Newport, South Wales (United Kingdom); Choyke, Peter [National Cancer Institute, Molecular Imaging Program, Bethesda, MD (United States); Verma, Sadhna [University Of Cincinnati Medical Center, Cincinnati, OH (United States); Villeirs, Geert [Ghent University Hospital, Division of Genitourinary Radiology, Ghent (Belgium); Rouviere, Olivier [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Urinary and Vascular Imaging, Lyon (France); Universite de Lyon, Lyon (France); Universite Lyon 1, Faculte de Medecine Lyon Est, Lyon (France); Logager, Vibeke [Copenhagen University, Hospital Herlev, Herlev (Denmark)

2012-04-15

The aim was to develop clinical guidelines for multi-parametric MRI of the prostate by a group of prostate MRI experts from the European Society of Urogenital Radiology (ESUR), based on literature evidence and consensus expert opinion. True evidence-based guidelines could not be formulated, but a compromise, reflected by ''minimal'' and ''optimal'' requirements has been made. The scope of these ESUR guidelines is to promulgate high quality MRI in acquisition and evaluation with the correct indications for prostate cancer across the whole of Europe and eventually outside Europe. The guidelines for the optimal technique and three protocols for ''detection'', ''staging'' and ''node and bone'' are presented. The use of endorectal coil vs. pelvic phased array coil and 1.5 vs. 3 T is discussed. Clinical indications and a PI-RADS classification for structured reporting are presented. (orig.)

41 CFR 109-39.301 - Utilization guidelines.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Utilization guidelines... Management System Vehicles § 109-39.301 Utilization guidelines. DOE activities utilizing GSA IFMS motor... meeting DOE utilization guidelines or established local use objectives, as appropriate. Those vehicles not...

28 CFR 2.21 - Reparole consideration guidelines.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Reparole consideration guidelines. 2.21....21 Reparole consideration guidelines. (a)(1) If revocation is based upon administrative violation(s... analogy with listed federal offense behaviors. (b) The guidelines for parole consideration specified at 28...

Dutch physiotherapy guidelines for low back pain

NARCIS (Netherlands)

Bekkering, Geertruida E; Hendriks, H.J.M.; Koes, Bart W; Oostendorp, R. A B; Ostelo, R. W J G; Thomassen, J. M C; van Tulder, M. W.

2003-01-01

Many guidelines for the management of low back pain in primary care have been published during recent years, but guidelines for physiotherapy do not yet exist. Therefore, physiotherapy guidelines have been developed, reflecting the consequences of the current state of knowledge of effective and

Interactions between poly(acrylic acid) and sodium dodecyl sulfate: isothermal titration calorimetric and surfactant ion-selective electrode studies.

Science.gov (United States)

Wang, C; Tam, K C

2005-03-24

Interaction between a monodispersed poly(acrylic acid) (PAA) (M(W) = 5670 g/mol, M(w)/M(n) = 1.02) with sodium dodecyl sulfate (SDS) was investigated using isothermal titration calorimetry (ITC), ion-selective electrode (ISE), and dynamic light scattering measurements. Contrary to previous studies, we report for the first time evidence of interaction between SDS and PAA when the degree of neutralization (alpha) of PAA is lower than 0.2. Hydrocarbon chains of SDS cooperatively bind to apolar segments of PAA driven by hydrophobic interaction. The interaction is both enthalpy and entropy favored (deltaH is negative but deltaS is positive). In 0.05 wt % PAA solution, the SDS concentration corresponding to the onset of binding (i.e., CAC) is approximately 2.4 mM and the saturation concentration (i.e., C(S)) is approximately 13.3 mM when alpha = 0. When PAA was neutralized and ionized, the binding was hindered by the enhanced electrostatic repulsion between negatively charged SDS and PAA chains and improved solubility of the polymer. With increasing alpha to 0.2, CAC increases to approximately 6.2 mM, C(S) drops to 8.6 mM, and the interaction is significantly weakened where the amount of bound SDS on PAA is reduced considerably. The values of CAC and C(S) derived from different techniques are in good agreement. The binding results in the formation of mixed micelles on apolar PAA coils, which then expands and dissociates into single PAA chains. The majority of unneutralized PAA molecules exist as single polymer chains stabilized by bound SDS micelles in solution after the saturation concentration.

Mechanism of Bacillus subtilis spore inactivation by and resistance to supercritical CO2 plus peracetic acid.

Science.gov (United States)

Setlow, B; Korza, G; Blatt, K M S; Fey, J P; Setlow, P

2016-01-01

Determine how supercritical CO2 (scCO2 ) plus peracetic acid (PAA) inactivates Bacillus subtilis spores, factors important in spore resistance to scCO2 -PAA, and if spores inactivated by scCO2 -PAA are truly dead. Spores of wild-type B. subtilis and isogenic mutants lacking spore protective proteins were treated with scCO2 -PAA in liquid or dry at 35°C. Wild-type wet spores (aqueous suspension) were more susceptible than dry spores. Treated spores were examined for viability (and were truly dead), dipicolinic acid (DPA), mutations, permeability to nucleic acid stains, germination under different conditions, energy metabolism and outgrowth. ScCO2 -PAA-inactivated spores retained DPA, and survivors had no notable DNA damage. However, DPA was released from inactivated spores at a normally innocuous temperature (85°C), and colony formation from treated spores was salt sensitive. The inactivated spores germinated but did not outgrow, and these germinated spores had altered plasma membrane permeability and defective energy metabolism. Wet or dry coat-defective spores had increased scCO2 -PAA sensitivity, and dry spores but not wet spores lacking DNA protective proteins were more scCO2 -PAA sensitive. These findings suggest that scCO2 -PAA inactivates spores by damaging spores' inner membrane. The spore coat provided scCO2 -PAA resistance for both wet and dry spores. DNA protective proteins provided scCO2 -PAA resistance only for dry spores. These results provide information on mechanisms of spore inactivation of and resistance to scCO2 -PAA, an agent with increasing use in sterilization applications. © 2015 The Society for Applied Microbiology.

Application of polyacrylic acid-poly-N,N-dimethyldiallylammonium chloride polyelectrolyte complexes for structuring of polluted soil of Semipalatinsk nuclear test site

International Nuclear Information System (INIS)

Sabantseva, T.; Bashenova, A.; Orazzhanova, L.K.; Yashkarova, M.G.; Bimendina, L.A.

2002-01-01

The present communication is devoted to investigation of structuring efficiency of polyacrylic acid-poly-N,N-dimethyldiallylammonium chloride (PAA-PDMDAACI) polyelectrolyte complexes. The granulometric analysis of selected soil samples before and after the treatment of aqueous solution of PAA, PDMDAACI and PAA-PDMDAACI complexes at different molar ratio of polymer components and polymer concentrations was carried out. Analysis shows that nonstoichiometric polyelectrolyte complex [PAA]:[PDMDAACI]=3:1 possesses the best structuring effect. But this result is worse than in the case using of [PAA]:[polyethylene glycol]=1:1 inter-polymer complex

Application and analytical verification of peracetic acid use in different types of freshwater aquaculture systems

DEFF Research Database (Denmark)

Pedersen, Lars-Flemming

2011-01-01

of water sanitation with PAA application were used to analytically verify actual PAA concentration under real conditions at different kinds of aquaculture systems. A characteristic instant disinfection demand was found to be significantly positively related to water COD content, and PAA half-lives were...... found to be in the order of a few minutes. The study revealed that PAA degrades so rapidly that insufficient disinfection is a likely outcome. The observations have applications for optimizing water treatment strategies with PAA. The investigations also indicated that the rapid degradation and hence...

40 CFR 799.11 - Availability of test guidelines.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Availability of test guidelines. 799.11... General Provisions § 799.11 Availability of test guidelines. (a) The TSCA and FIFRA guidelines for the...-487-4650). (b) The OECD guidelines for the various study plans are available from the following...

The nuclear codes and guidelines

International Nuclear Information System (INIS)

Sonter, M.

1984-01-01

This paper considers problems faced by the mining industry when implementing the nuclear codes of practice. Errors of interpretation are likely. A major criticism is that the guidelines to the codes must be seen as recommendations only. They are not regulations. Specific clauses in the guidelines are criticised

Bioassay guideline 2: guidelines for tritium bioassay

International Nuclear Information System (INIS)

1983-01-01

This guideline is one of a series under preparation by the Federal-Provincial Working Group on Bioassay and In Vivo Monitoring Criteria. In this report tritium compounds have been grouped into four categories for the purpose of calculating Annual Limits on Intake and Investigation Levels: tritium gas, tritiated water, tritium-labelled compounds and nucleic acid precursors

5 CFR 1312.10 - Systematic review guidelines.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Systematic review guidelines. 1312.10... Declassification of National Security Information § 1312.10 Systematic review guidelines. The EOP Security Officer will prepare and keep current such guidelines as are required by Executive Order 12958 for the...

50 CFR 253.18 - Program operating guidelines.

Science.gov (United States)

2010-10-01

... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Program operating guidelines. 253.18 Section 253.18 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL OCEANIC AND ATMOSPHERIC... Guarantee Program § 253.18 Program operating guidelines. The Division may issue Program operating guidelines...

Osteoarthritis guidelines: Barriers to implementation and solutions.

Science.gov (United States)

Ferreira de Meneses, Sarah; Rannou, Francois; Hunter, David J

2016-06-01

Osteoarthritis (OA) is a leading cause of disability worldwide. Clinical practice guidelines (CPGs) have been developed to facilitate improved OA management. Scientific communities worldwide have proposed CPGs for OA treatment. Despite the number of highly prominent guidelines available and their remarkable consistency, their uptake has been suboptimal. Possibly because of the multitude of barriers related to the implementation of CPGs. For example, different guidelines show contradictions, some lack evidence, and they lack a hierarchy or tools to facilitate their translation and application. Also, the guidelines do not acknowledge the effect of comorbidities on choosing the treatments. Finally, poor integration of multidisciplinary services within and across healthcare settings is a major barrier to the effective implementation of management guidelines. Here we describe the main problems related to the OA guidelines and some solutions so as to offer some guidance on the elaboration of future CPGs and their implementation in primary care. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

National guidelines for the use of antibiotics in hospitalised adult patients: the SWAB guidelines revisited

NARCIS (Netherlands)

Prins, J. M.; Kullberg, B. J.; Gyssens, I. C.

2005-01-01

Since 1996, the Dutch Working Party on Antibiotic Policy (Stichting Werkgroep AntibioticaBeleid, SWAB) has been developing national guidelines for the use of antibiotics in hospitalised adult patients. As a result of both an inventory of the wishes of the users of these guidelines and the recently

Methodological guidelines

Energy Technology Data Exchange (ETDEWEB)

Halsnaes, K.; Callaway, J.M.; Meyer, H.J.

1999-04-01

The guideline document establishes a general overview of the main components of climate change mitigation assessment. This includes an outline of key economic concepts, scenario structure, common assumptions, modelling tools and country study assumptions. The guidelines are supported by Handbook Reports that contain more detailed specifications of calculation standards, input assumptions and available tools. The major objectives of the project have been provided a methodology, an implementing framework and a reporting system which countries can follow in meeting their future reporting obligations under the FCCC and for GEF enabling activities. The project builds upon the methodology development and application in the UNEP National Abatement Coasting Studies (UNEP, 1994a). The various elements provide countries with a road map for conducting climate change mitigation studies and submitting national reports as required by the FCCC. (au) 121 refs.

Methodological guidelines

International Nuclear Information System (INIS)

Halsnaes, K.; Callaway, J.M.; Meyer, H.J.

1999-01-01

The guideline document establishes a general overview of the main components of climate change mitigation assessment. This includes an outline of key economic concepts, scenario structure, common assumptions, modelling tools and country study assumptions. The guidelines are supported by Handbook Reports that contain more detailed specifications of calculation standards, input assumptions and available tools. The major objectives of the project have been provided a methodology, an implementing framework and a reporting system which countries can follow in meeting their future reporting obligations under the FCCC and for GEF enabling activities. The project builds upon the methodology development and application in the UNEP National Abatement Coasting Studies (UNEP, 1994a). The various elements provide countries with a road map for conducting climate change mitigation studies and submitting national reports as required by the FCCC. (au) 121 refs

Contemporaneous International Asthma Guidelines Present Differing Recommendations: An Analysis

Directory of Open Access Journals (Sweden)

Samir Gupta

2016-01-01

Full Text Available Background. Several international groups develop asthma guidelines. Conflicting recommendations across guidelines have been described in several disease areas and may contribute to practice variability. Accordingly, we compared the latest Canadian Thoracic Society (CTS asthma guideline with contemporaneous international asthma guidelines to evaluate conflicting recommendations and their causes. Methods. We identified the latest CTS asthma guideline update (2012 and the following societies which also updated their guidelines in 2012: the British Thoracic Society and Scottish Intercollegiate Guidelines Network and the Global Initiative for Asthma. We compared these three guidelines on (1 key methodological factors and (2 adult pharmacotherapy recommendations. Results. Methods used and documentation provided for literature search strategy and dates, evidence synthesis, outcomes considered, evidence appraisal, and recommendation formulation varied between guidelines. Criteria used to define suboptimal asthma control varied widely between guidelines. Inhaled corticosteroid dosing recommendations diverged, as did recommendations surrounding use of budesonide/formoterol as a reliever and controller and recommendations in the subsequent step. Conclusions. There are important differences between recommendations provided in contemporaneous asthma guidelines. Causes include differences in methods used for interpreting evidence and formulating recommendations. Adopting a common set of valid and explicit methods across international societies could harmonize recommendations and facilitate guideline implementation.

40 CFR 60.31d - Emissions guidelines.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Emissions guidelines. 60.31d Section 60...) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Sulfuric Acid Production Units § 60.31d Emissions guidelines. Sulfuric acid production units. The emission...

40 CFR 60.36e - Inspection guidelines.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Inspection guidelines. 60.36e Section...) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Hospital/Medical/Infectious Waste Incinerators § 60.36e Inspection guidelines. (a) For approval, a State plan shall...

41 CFR 101-39.301 - Utilization guidelines.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Utilization guidelines... § 101-39.301 Utilization guidelines. An agency must be able to justify a full-time vehicle assignment. The following guidelines may be employed by an agency requesting GSA Interagency Fleet Management...

76 FR 22342 - National Standard 10 Guidelines

Science.gov (United States)

2011-04-21

.... 110218147-1199-01] RIN 0648-BA74 National Standard 10 Guidelines AGENCY: National Marine Fisheries Service... comment on potential adjustments to the National Standard 10 Guidelines. DATES: Written comments regarding... advisory guidelines (which shall not have the force and effect of law), based on the national standards to...

41 CFR 101-27.102-2 - Guidelines.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Guidelines. 101-27.102-2 Section 101-27.102-2 Public Contracts and Property Management Federal Property Management Regulations... Replenishment § 101-27.102-2 Guidelines. Guidelines for implementing the EOQ principle of stock replenishment...

Journal of Wildlife Management guidelines

Science.gov (United States)

William M. Block; Frank R. Thompson; Dawn Hanseder; Allison Cox; Anna Knipps

2011-01-01

These Guidelines apply to all Journal of Wildlife Management (JWM, The Journal) submissions. Publishing a professional manuscript proceeds most smoothly if authors understand the policy, procedures, format, and style of the outlet to which they are submitting a manuscript. These instructions supersede all previous guidelines. Manuscripts that clearly deviate from this...

A simple method for decomposition of peracetic acid in a microalgal cultivation system.

Science.gov (United States)

Sung, Min-Gyu; Lee, Hansol; Nam, Kibok; Rexroth, Sascha; Rögner, Matthias; Kwon, Jong-Hee; Yang, Ji-Won

2015-03-01

A cost-efficient process devoid of several washing steps was developed, which is related to direct cultivation following the decomposition of the sterilizer. Peracetic acid (PAA) is known to be an efficient antimicrobial agent due to its high oxidizing potential. Sterilization by 2 mM PAA demands at least 1 h incubation time for an effective disinfection. Direct degradation of PAA was demonstrated by utilizing components in conventional algal medium. Consequently, ferric ion and pH buffer (HEPES) showed a synergetic effect for the decomposition of PAA within 6 h. On the contrary, NaNO3, one of the main components in algal media, inhibits the decomposition of PAA. The improved growth of Chlorella vulgaris and Synechocystis PCC6803 was observed in the prepared BG11 by decomposition of PAA. This process involving sterilization and decomposition of PAA should help cost-efficient management of photobioreactors in a large scale for the production of value-added products and biofuels from microalgal biomass.

Guidelines for bone scintigraphy in children

International Nuclear Information System (INIS)

Hahn, K.; Fischer, S.; Gordon, I.; Mann, M.; Piepsz, A.; Olivier, P.; Sixt, R.; Velzen, J. van

2000-01-01

The guidelines are intended to help nuclear medical teams in their daily routine. The guidelines give information relating to indications, performance of examinations, analysis and interpretation of the diagnostic results. The guidelines should be applied in the context of adopted basic quality criteria in nuclear medicine, requirements of the German radiation protection ordinance, as well as the regulatory codes for radiation protection in the medical field. The guidelines express the opinions of the Paediatric Committee of the EANM and hence focus on compliance with the relevant European standards in nuclear medicine. In order to enhance the specificity of results obtained with a bone scintigraphy, the interpretation of the results should be based on combined analysis with information drawn from X-rays. (orig./CB) [de

Guidelines for Developing Competency-Based Curriculum.

Science.gov (United States)

Goodson, Ludy

1979-01-01

Presents guidelines for the development of competency-based curriculum formulated as a result of an automotive mechanics curriculum workshop. Listed are specific guidelines for content development, writing style, and illustration. (LRA)

40 CFR 60.33e - Emissions guidelines.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Emissions guidelines. 60.33e Section 60...) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Hospital/Medical/Infectious Waste Incinerators § 60.33e Emissions guidelines. (a) For approval, a State plan shall...

Systematic review of recent dementia practice guidelines.

Science.gov (United States)

Ngo, Jennifer; Holroyd-Leduc, Jayna M

2015-01-01

dementia is a highly prevalent acquired cognitive disorder that interferes with activities of daily living, relationships and quality of life. Recognition and effective management strategies are necessary to provide comprehensive care for these patients and their families. High-quality clinical practice guidelines can improve the quality and consistency of care in all aspects of dementia diagnosis and management by clarifying interventions supported by sound evidence and by alerting clinicians to interventions without proven benefit. we aimed to offer a synthesis of existing practice recommendations for the diagnosis and management of dementia, based upon moderate-to-high quality dementia guidelines. we performed a systematic search in EMBASE and MEDLINE as well as the grey literature for guidelines produced between 2008 and 2013. thirty-nine retrieved practice guidelines were included for quality appraisal by the Appraisal of Guidelines Research and Evaluation II (AGREE-II) tool, performed by two independent reviewers. From the 12 moderate-to-high quality guidelines included, specific practice recommendations for the diagnosis and/or management of any aspect of dementia were extracted for comparison based upon the level of evidence and strength of recommendation. there was a general agreement between guidelines for many practice recommendations. However, direct comparisons between guidelines were challenging due to variations in grading schemes. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Main-coolant-pump shaft-seal guidelines. Volume 1. Maintenance-manual guidelines. Final report

International Nuclear Information System (INIS)

Fair, C.E.; Greer, A.O.

1983-03-01

This report presents a set of guidelines and a listing of information and data which should be included in maintenance manuals and procedures for Main Coolant Pump Shaft Seals. The noted guidelines and data listing are developed from EPRI sponsored nuclear plant seal operating experience studies. The maintenance oriented results of the most recent such study is summarized. The shaft seal and its auxiliary supporting systems are discussed from both technical and maintenance related viewpoints

Guideline for primary care management of headache in adults

Science.gov (United States)

Becker, Werner J.; Findlay, Ted; Moga, Carmen; Scott, N. Ann; Harstall, Christa; Taenzer, Paul

2015-01-01

Abstract Objective To increase the use of evidence-informed approaches to diagnosis, investigation, and treatment of headache for patients in primary care. Quality of evidence A comprehensive search was conducted for relevant guidelines and systematic reviews published between January 2000 and May 2011. The guidelines were critically appraised using the AGREE (Appraisal of Guidelines for Research and Evaluation) tool, and the 6 highest-quality guidelines were used as seed guidelines for the guideline adaptation process. Main message A multidisciplinary guideline development group of primary care providers and other specialists crafted 91 specific recommendations using a consensus process. The recommendations cover diagnosis, investigation, and management of migraine, tension-type, medication-overuse, and cluster headache. Conclusion A clinical practice guideline for the Canadian health care context was created using a guideline adaptation process to assist multidisciplinary primary care practitioners in providing evidence-informed care for patients with headache. PMID:26273080

National and international guidelines for rectal cancer

DEFF Research Database (Denmark)

Nielsen, Liv Bjerre Juul; Wille-Jørgensen, P

2014-01-01

, this might not be the case between guidelines. No formal evaluation of the contrasting guidance has been reported. METHOD: A systematic search for national and international guidelines on rectal cancer was performed. Eleven guidelines were identified for further analysis. RESULTS: There was no consensus...... concerning the definition of rectal cancer. Ten of the 11 guidelines use the TNM staging system and there was general agreement regarding the recommendation of MRI and CT in rectal cancer. There was consensus concerning a multidisciplinary approach, preoperative chemoradiotherapy (CRT) and total mesorectal...

78 FR 9743 - Event Reporting Guidelines

Science.gov (United States)

2013-02-11

... NUCLEAR REGULATORY COMMISSION [NRC-2011-0237] Event Reporting Guidelines AGENCY: Nuclear... Regulatory Commission (NRC) has issued NUREG- 1022, Revision 3, ``Event Reporting Guidelines: 10 CFR 50.72 and 50.73.'' [[Page 9744

Peracetic acid oxidation of saline waters in the absence and presence of H ₂O ₂: secondary oxidant and disinfection byproduct formation.

Science.gov (United States)

Shah, Amisha D; Liu, Zheng-Qian; Salhi, Elisabeth; Höfer, Thomas; von Gunten, Urs

2015-02-03

Peracetic acid (PAA) is a disinfectant considered for use in ballast water treatment, but its chemical behavior in such systems (i.e., saline waters) is largely unknown. In this study, the reactivity of PAA with halide ions (chloride and bromide) to form secondary oxidants (HOCl, HOBr) was investigated. For the PAA-chloride and PAA-bromide reactions, second-order rate constants of (1.47 ± 0.58) × 10(-5) and 0.24 ± 0.02 M(-1) s(-1) were determined for the formation of HOCl or HOBr, respectively. Hydrogen peroxide (H2O2), which is always present in PAA solutions, reduced HOCl or HOBr to chloride or bromide, respectively. As a consequence, in PAA-treated solutions with [H2O2] > [PAA], the HOBr (HOCl) steady-state concentrations were low with a limited formation of brominated (chlorinated) disinfection byproducts (DBPs). HOI (formed from the PAA-iodide reaction) affected this process because it can react with H2O2 back to iodide. H2O2 is thus consumed in a catalytic cycle and leads to less efficient HOBr scavenging at even low iodide concentrations (acid (MBAA), dibromoacetic acid (DBAA), and tribromoacetic acid (TBAA) formed at up to 260, 106, 230, and 89 μg/L, respectively for doses of 2 mM (ca. 150 mg/L) PAA and [H2O2] acid concentrations.

Comparative Study for Efficacy and Safety of Adenoidectomy according to the Surgical Method: A Prospective Multicenter Study.

Directory of Open Access Journals (Sweden)

Jeong-Whun Kim

Full Text Available There have been several operative techniques for adenoidectomy and their efficacy and morbidity are different according to the technique. This prospective multicenter study was aimed to compare the efficacy and morbidity of coblation adenoidectomy (CA with those of power-assisted adenoidectomy.Prospective multi-institutional study.Children who underwent CA, power-assisted adenoidectomy with cauterization (PAA+C or without cauterization (PAA-C due to adenoid hypertrophy were enrolled from 13 hospitals between July 2013 and June 2014. Mean operation time, degree of intraoperative bleeding and postoperative bleeding rate were evaluated.A total of 388 children (mean age ± standard deviation = 6.6 ± 2.5 years; 245 males and 143 females were included. According to the adenoidectomy technique, the children were classified into 3 groups: (1 CA (n = 116; (2 PAA+C (n = 153; and (3 PAA-C (n = 119. Significant differences were not found in age and sex among three groups. In the CA group, mean operation time was significantly shorter (P < 0.001 and degree of intraoperative bleeding was significantly less (P < 0.001 compared to PAA+C or PAA-C group. Delayed postoperative bleeding rate of PAA-C group was significantly higher than that of CA or PAA+C group (P = 0.016.This prospective multicenter study showed that CA was superior to PAA in terms of mean operation time and degree of intraoperative bleeding.

Belgian guidelines for economic evaluations: second edition.

Science.gov (United States)

Thiry, Nancy; Neyt, Mattias; Van De Sande, Stefaan; Cleemput, Irina

2014-12-01

The aim of this study was to present the updated methodological guidelines for economic evaluations of healthcare interventions (drugs, medical devices, and other interventions) in Belgium. The update of the guidelines was performed by three Belgian health economists following feedback from users of the former guidelines and personal experience. The updated guidelines were discussed with a multidisciplinary team consisting of other health economists, assessors of reimbursement request files, representatives of Belgian databases and representatives of the drugs and medical devices industry. The final document was validated by three external validators that were not involved in the previous discussions. The guidelines give methodological guidance for the following components of an economic evaluation: literature review, perspective of the evaluation, definition of the target population, choice of the comparator, analytic technique and study design, calculation of costs, valuation of outcomes, definition of the time horizon, modeling, handling uncertainty and discounting. We present a reference case that can be considered as the minimal requirement for Belgian economic evaluations of health interventions. These guidelines will improve the methodological quality, transparency and uniformity of the economic evaluations performed in Belgium. The guidelines will also provide support to the researchers and assessors performing or evaluating economic evaluations.

Clinical algorithms to aid osteoarthritis guideline dissemination.

Science.gov (United States)

Meneses, S R F; Goode, A P; Nelson, A E; Lin, J; Jordan, J M; Allen, K D; Bennell, K L; Lohmander, L S; Fernandes, L; Hochberg, M C; Underwood, M; Conaghan, P G; Liu, S; McAlindon, T E; Golightly, Y M; Hunter, D J

2016-09-01

Numerous scientific organisations have developed evidence-based recommendations aiming to optimise the management of osteoarthritis (OA). Uptake, however, has been suboptimal. The purpose of this exercise was to harmonize the recent recommendations and develop a user-friendly treatment algorithm to facilitate translation of evidence into practice. We updated a previous systematic review on clinical practice guidelines (CPGs) for OA management. The guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation for quality and the standards for developing trustworthy CPGs as established by the National Academy of Medicine (NAM). Four case scenarios and algorithms were developed by consensus of a multidisciplinary panel. Sixteen guidelines were included in the systematic review. Most recommendations were directed toward physicians and allied health professionals, and most had multi-disciplinary input. Analysis for trustworthiness suggests that many guidelines still present a lack of transparency. A treatment algorithm was developed for each case scenario advised by recommendations from guidelines and based on panel consensus. Strategies to facilitate the implementation of guidelines in clinical practice are necessary. The algorithms proposed are examples of how to apply recommendations in the clinical context, helping the clinician to visualise the patient flow and timing of different treatment modalities. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

50 CFR 510.9 - Uniform pay guidelines.

Science.gov (United States)

2010-10-01

... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Uniform pay guidelines. 510.9 Section 510... ACT § 510.9 Uniform pay guidelines. (a) Compensation of members and staff of, and consultants to the... accordance with guidelines established by the Director of the Office of Management and Budget pursuant to...

Physicians' preferences for asthma guidelines implementation.

Science.gov (United States)

Kang, Min-Koo; Kim, Byung-Keun; Kim, Tae-Wan; Kim, Sae-Hoon; Kang, Hye-Ryun; Park, Heung-Woo; Chang, Yoon-Seok; Kim, Sun-Sin; Min, Kyung-Up; Kim, You-Young; Cho, Sang-Heon

2010-10-01

Patient care based on asthma guidelines is cost-effective and leads to improved treatment outcomes. However, ineffective implementation strategies interfere with the use of these recommendations in clinical practice. This study investigated physicians' preferences for asthma guidelines, including content, supporting evidence, learning strategies, format, and placement in the clinical workplace. We obtained information through a questionnaire survey. The questionnaire was distributed to physicians attending continuing medical education courses and sent to other physicians by airmail, e-mail, and facsimile. A total of 183 physicians responded (male to female ratio, 2.3:1; mean age, 40.4±9.9 years); 89.9% of respondents were internists or pediatricians, and 51.7% were primary care physicians. Physicians preferred information that described asthma medications, classified the disease according to severity and level of control, and provided methods of evaluation/treatment/monitoring and management of acute exacerbation. The most effective strategies for encouraging the use of the guidelines were through continuing medical education and discussions with colleagues. Physicians required supporting evidence in the form of randomized controlled trials and expert consensus. They preferred that the guidelines be presented as algorithms or flow charts/flow diagrams on plastic sheets, pocket cards, or in electronic medical records. This study identified the items of the asthma guidelines preferred by physicians in Korea. Asthma guidelines with physicians' preferences would encourage their implementation in clinical practice.

Assessment of a colorimetric method for the measurement of low concentrations of peracetic acid and hydrogen peroxide in water.

Science.gov (United States)

Domínguez-Henao, Laura; Turolla, Andrea; Monticelli, Damiano; Antonelli, Manuela

2018-06-01

The recent growing interest in peracetic acid (PAA) as disinfectant for wastewater treatment demands reliable and readily-available methods for its measurement. In detail, the monitoring of PAA in wastewater treatment plants requires a simple, accurate, rapid and inexpensive measurement procedure. In the present work, a method for analyzing low concentrations of PAA, adapted from the US EPA colorimetric method for total chlorine, is assessed. This method employs N,N-diethyl-p-phenylelnediamine (DPD) in the presence of an excess of iodide in a phosphate buffer system. Pink colored species are produced proportionally to the concentration of PAA in the sample. Considering that PAA is available commercially as an equilibrium solution of PAA and hydrogen peroxide (H 2 O 2 ), a measurement method for H 2 O 2 is also investigated. This method, as the one for the determination of PAA, is also based on the oxidation of iodide to iodine, with the difference that ammonium molybdate Mo(VI) is added to catalyze the oxidation reaction between H 2 O 2 and iodide, quantifying the total peroxides (PAA+ H 2 O 2 ). The two methods are suitable for concentration ranges from about 0.1-1.65 mg L -1 and from about 0.3-3.3 mg L -1 , respectively for PAA and H 2 O 2 . Moreover, the work elucidates some relevant aspects related to the operational conditions, kinetics and the possible interference of H 2 O 2 on PAA measurement. Copyright © 2018 Elsevier B.V. All rights reserved.

The OH-initiated oxidation of atmospheric peroxyacetic acid: Experimental and model studies

Science.gov (United States)

Wu, Huihui; Wang, Yin; Li, Huan; Huang, Liubin; Huang, Dao; Shen, Hengqing; Xing, Yanan; Chen, Zhongming

2017-09-01

Peroxyacetic acid (PAA, CH3C(O)OOH) plays an important role in atmospheric chemistry, serving as reactive oxidant and affecting radical recycling. However, previous studies revealed an obvious gap between modelled and observed concentrations of atmospheric PAA, which may be partly ascribed to the uncertainty in the kinetics and mechanism of OH-oxidation. In this study, we measured the rate constant of OH radical reaction with PAA (kPAA+OH) and investigated the products in order to develop a more robust atmospheric PAA chemistry. Using the relative rates technique and employing toluene and meta-xylene as reference compounds, the kPAA+OH was determined to be (9.4-11.9) × 10-12 cm3 molecule-1 s-1 at 298 K and 1 atm, which is about (2.5-3.2) times larger than that parameter used in Master Chemical Mechanism v3.3.1 (MCM v3.3.1) (3.70 × 10-12 cm3 molecule-1 s-1). Incorporation of a box model and MCM v3.3.1 with revised PAA chemistry represented a better simulation of atmospheric PAA observed during Wangdu Campaign 2014, a rural site in North China Plain. It is found that OH-oxidation is an important sink of atmospheric PAA in this rural area, accounting for ∼30% of the total loss. Moreover, the major terminal products of PAA-OH reaction were identified as formaldehyde (HCHO) and formic acid (HC(O)OH). The modelled results show that both primary and secondary chemistry play an important role in the large HCHO and HC(O)OH formation under experimental conditions. There should exist the channel of methyl H-abstraction for PAA-OH reaction, which may also provide routes to HCHO and HC(O)OH formation.

Vessel based delineation guidelines for the elective lymph node regions in breast cancer radiation therapy – PROCAB guidelines

International Nuclear Information System (INIS)

Verhoeven, Karolien; Weltens, Caroline; Remouchamps, Vincent; Mahjoubi, Khalil; Veldeman, Liv; Lengele, Benoit; Hortobagyi, Eszter; Kirkove, Carine

2015-01-01

Objective: A national project to improve the quality of breast radiation therapy was started, named PROCAB (PROject on CAncer of the Breast). One of the objectives was to reach a national consensus guideline for the delineation of the regional lymph node areas in breast radiation therapy. Methods: The realization of the new guidelines was a step by step process that started with multiple expert meetings where the existing guidelines were analyzed and the delineations of the lymph node regions were performed together with a surgeon, specialized in the anatomy of the drainage of the breast. Results: The delineation guidelines are vessel-based. Since the occurrence of pathological lymph nodes is typically around the veins, the cranial and caudal borders of all different nodal regions are based on a 5 mm margin around the veins, except for the parasternal lymph node area. Compared to the existing guidelines there are some major changes. Conclusion: With this project a national as well as a European (ESTRO) consensus guideline for the delineation of the regional lymph node areas in breast RT is reached. The new delineation atlas is vessel-based and no longer field-based

American Clinical Neurophysiology Society Guideline 2: Guidelines for Standard Electrode Position Nomenclature.

Science.gov (United States)

Acharya, Jayant N; Hani, Abeer; Cheek, Janna; Thirumala, Partha; Tsuchida, Tammy N

2016-08-01

This revision to the EEG Guidelines is an update incorporating current electroencephalography technology and practice and was previously published as Guideline 5. While the 10-10 system of electrode position nomenclature has been accepted internationally for almost two decades, it has not been used universally. The reasons for this and clinical scenarios when the 10-10 system provides additional localizing information are discussed in this revision. In addition, situations in which AF1/2, AF5/6, PO1/2 and PO5/6 electrode positions may be utilized for EEG recording are discussed.

[The German program for disease management guidelines: type 2 diabetes--diabetic retinopathy/maculopathy guideline 2006. Short review].

Science.gov (United States)

Ollenschläger, Günter; Kopp, Ina; Thole, Henning; Lelgemann, Monika

2007-02-15

In Germany, the first national consensus between six medical scientific associations on evidence-based recommendations for prevention and therapy of retinopathy/maculopathy in type 2 diabetes was reached in fall 2006. The recommendations' main sources are the NICE Retinopathy Guideline 2002, and existing German guidelines and reviews of recent scientific evidence. The article gives an overview on authors, sources, and key recommendations of the German National Disease Management Guideline Type 2 Diabetes-Retinopathy/Maculopathy 2006 (www.diabetes.versorgungsleitlinien.de).

Vehicle recovery and towing guideline

Energy Technology Data Exchange (ETDEWEB)

NONE

2010-01-15

This guideline was developed to provide light and medium duty vehicles operators in the oil and gas industry with a set of best practices for avoiding injury and damage during the recovery of stuck vehicles. The aim of the guideline was to increase awareness of safety issues and promote the safe usage of the vehicles by personnel throughout the petroleum industry and to establish minimum standards of practice for vehicle recovery. The guideline included a step-by-step guide for pulling out a vehicle with a recovery strap as well as vehicle-mounted winch procedures. Pre-job checklists for both procedures were provided. Issues related to the strength rating of vehicle tow hooks and hitch receivers were discussed, as well as some of the hazards associated with steep terrains and heavy mud. The guideline also included recommendations for a vehicle recovery kit with instructions on vehicle recovery, a recovery strap, a recovery hitch and shackle, a collapsible shovel, traffic cones and reflector flares, and a heavy blanket and gloves. 7 refs., 2 tabs., 13 figs.

Implementing Practice Guidelines: A Workshop on Guidelines Dissemination and Implementation with a Focus on Asthma and COPD

Directory of Open Access Journals (Sweden)

Louis-Philippe Boulet

2006-01-01

Full Text Available The present supplement summarizes the proceedings of the symposium “Implementing practice guidelines: A workshop on guidelines dissemination and implementation with a focus on asthma and COPD”, which took place in Quebec City, Quebec, from April 14 to 16, 2005. This international symposium was a joint initiative of the Laval University Office of Continuing Medical Education (Bureau de la Formation Médicale Continue, the Canadian Thoracic Society and the Canadian Network for Asthma Care, and was supported by many other organizations and by industrial partners. The objectives of this meeting were to examine the optimal implementation of practice guidelines, review current initiatives for the implementation of asthma and chronic obstructive pulmonary disease (COPD guidelines in Canada and in the rest of the world, and develop an optimal strategy for future guideline implementation. An impressive group of scientists, physicians and other health care providers, as well as policy makers and representatives of patients’ associations, the pharmaceutical industry, research and health networks, and communications specialists, conveyed their perspectives on how to achieve these goals.

Demarcating Mobile Phone Interface Design Guidelines to Expedite Selection

Directory of Open Access Journals (Sweden)

Karen Vera Renaud

2017-12-01

Full Text Available Guidelines are recommended as a tool for informing user interface design. Despite a proliferation of guidelines in the research literature, there is little evidence of their use in industry, nor their influence in academic literature. In this paper, we explore the research literature related to mobile phone design guidelines to find out why this should be so. We commenced by carrying out a scoping literature review of the mobile phone design guideline literature to gain insight into the maturity of the field. The question we wanted to explore was: “Are researchers building on each others’ guidelines, or is the research field still in the foundational stage?” We discovered a poorly structured field, with many researchers proposing new guidelines, but little incremental refinement of extant guidelines. It also became clear that the current reporting of guidelines did not explicitly communicate their multi-dimensionality or deployment context. This leaves designers without a clear way of discriminating between guidelines, and could contribute to the lack of deployment we observed. We conducted a thematic analysis of papers identified by means of a systematic literature review to identify a set of dimensions of mobile phone interface design guidelines. The final dimensions provide a mechanism for differentiating guidelines and expediting choice.

Overview of guidelines on breast screening

DEFF Research Database (Denmark)

Juhl Jørgensen, Karsten; Kalager, Mette; Barratt, Alexandra

2017-01-01

Updated guidelines on breast cancer screening have been published by several major organisations over the past five years. Recommendations vary regarding both age range, screening interval, and even on whether breast screening should be offered at all. The variation between recommendations reflects....... The estimates vary according to the methodology of the randomised trials, and the design of the observational studies. Guideline recommendations reflect the choice of evidence informing them. While there are well-developed tools to deal with randomised trials in guideline work, these are not always used......, or they may not be followed as recommended. Further, results of trials performed decades ago may no longer be applicable. For observational studies, the framework for inclusion in guidelines is not similarly well-developed and there are methodological concerns specific to screening interventions...

Japanese guidelines for allergic rhinitis 2017

Directory of Open Access Journals (Sweden)

Kimihiro Okubo

2017-04-01

To incorporate evidence based medicine (EBM introduced from abroad, the most recent collection of evidence/literature was supplemented to the Practical Guideline for the Management of Allergic Rhinitis in Japan 2016. The revised guideline includes assessment of diagnosis/treatment and prescriptions for children and pregnant women, for broad clinical applications. An evidence-based step-by-step strategy for treatment is also described. In addition, the QOL concept and cost benefit analyses are also addressed. Along with Allergic Rhinitis and its Impact of Asthma (ARIA, this guideline is widely used for various clinical purposes, such as measures for patients with sinusitis, childhood allergic rhinitis, oral allergy syndrome, and anaphylaxis and for pregnant women. A Q&A section regarding allergic rhinitis in Japan was added to the end of this guideline.

Treatment Guidelines of Atrial Fibrillation (AFib or AF)

Science.gov (United States)

... Artery Disease Venous Thromboembolism Aortic Aneurysm More Treatment Guidelines of Atrial Fibrillation (AFib or AF) Updated:Jun 28,2017 What are the treatment guidelines for atrial fibrillation? Medical guidelines are written by ...

Comparing consensus guidelines on thromboprophylaxis in orthopedic surgery.

Science.gov (United States)

Struijk-Mulder, M C; Ettema, H B; Verheyen, C C; Büller, H R

2010-04-01

Different guidelines exist regarding the prevention of venous thromboembolism (VTE) in orthopedic surgery. We aimed to compare (inter)national guidelines and analyse differences. MEDLINE, the Cochrane Library and the internet were searched for guidelines on the prevention of VTE in orthopedic surgery. From these, we constructed a table comparing the different antithrombotic regimens during different orthopedic surgical and plaster cast treatments. Eleven guidelines from nine different countries and one international guideline were included. Few guidelines advise on thrombosis prophylaxis after plaster cast immobilization, (prolonged) arthroscopic surgery and isolated lower extremity trauma. Different opinions exist on the sole use of aspirin and mechanical prophylaxis and on the use of vitamin K antagonists after major hip and knee surgery. Based on the same available literature, different guidelines recommend different thromboprophylactic regimens. Ideally, the grade of recommendation should be based on the same level of evidence world-wide. Whilst there is no agreement on the relevance of different endpoints (e.g. asymptomatic DVT), it is very difficult to reach a consensus. Thromboprophylaxis guidelines should be reviewed and updated on a regular basis, because the evidence is evolving rapidly.

Reporting emissions on EMEP grid. Methods and principles; Rapportering af luftemissioner paa grid. Metoder og principper

Energy Technology Data Exchange (ETDEWEB)

Tranekjaer Jensen, M.; Nielsen, Ole-Kenneth; Hjorth Mikkelsen, M.; Winther, M.; Gyldenkaerne, S.; Viuf OErby, P.; Boll Illerup, J.

2008-03-15

country to deliver high quality and consistent data. At the moment the guidelines for reporting emission data under UNECE LRTAP are undergoing an extensive revision. The updated guidelines will be published in: Guidelines for Estimating and Reporting Emission Data under the Convention on Long-range Transboundary Air Pollution. As something quite new a special section concerning spatial mapping is included in the revised guidelines. The content describes methods and available spatial data for spatially distribution of emission data at different levels. (au)

Resonant infrared pulsed laser deposition of a polyimide precursor

Energy Technology Data Exchange (ETDEWEB)

Dygert, N L; Schriver, K E; Jr, R F Haglund [Department of Physics and Astronomy and W M Keck Foundation Free-Electron Laser Centre, Vanderbilt University, Nashville TN 37235 (United States)

2007-04-15

Poly(amic acid) (PAA), a precursor to polyimide, was successfully deposited on substrates without reaching curing temperature, by resonant infrared pulsed laser ablation. The PAA was prepared by dissolving pyromellitic dianhydride and 4, 4' oxidianiline in the polar solvent Nmethyl pyrrolidinone (NMP). The PAA was deposited in droplet-like morphologies when ablation occurred in air, and in string-like moieties in the case of ablation in vacuum. In the as-deposited condition, the PAA was easily removed by washing with NMP; however, once cured thermally for thirty minutes, the PAA hardened, indicating the expected thermosetting property. Plume shadowgraphy showed very clear contrasts in the ablation mechanism between ablation of the solvent alone and the ablation of the PAA, even at low concentrations. A Wavelength dependence in plume velocity was also observed.

Micelle-assisted signaling of peracetic acid by the oxidation of pyreneboronic acid via monomer-excimer switching.

Science.gov (United States)

Choi, Jiyoung; Lee, Hyo Jin; Cho, Min Jeoung; Chang, Suk-Kyu

2015-08-15

A simple fluorescent probe for the industrial oxidant peracetic acid (PAA) was investigated. PAA-assisted oxidative conversion of pyrene-1-boronic acid into 1-hydroxypyrene was used as the signaling tool. Pyreneboronic acid was found to display selective signaling behavior, being more responsive to PAA than to other commonly used practical oxidants such as H2O2 and HOCl. The changes in pyrene monomer fluorescence to excimer were used in the quantitative analysis of PAA. When using the surfactant hexadecyltrimethylammonium bromide as a micellar additive, the signaling of PAA was markedly enhanced. Selective fluorescence signaling of PAA by pyrene-1-boronic acid with a detection limit of 1.5×10(-6)M in aqueous environment was successfully achieved. Copyright © 2015 Elsevier B.V. All rights reserved.

From a Beautiful Swan to an Ugly Duckling

DEFF Research Database (Denmark)

Jørgensen, Henning

2009-01-01

Artiklen analyserer ændringer i dansk aktiveringspolitik siden 2003, hvor typer af institutionelle forandringer relateres til omlægninger på proces- og indholdssiden. Konklusionen er, at der har været tale om en systemtransformation af aktiveringspolitikken i Danmark. Udgivelsesdato: 2010/2009...

Time to detoxify medical literature from guideline overdose

Institute of Scientific and Technical Information of China (English)

Dinesh Vyas; Arpita K Vyas

2012-01-01

The current financial turmoil in the United States has been attributed to multiple reasons including healthcare expenditure.Health care spending has increased from 5.7 percent of the gross domestic product (GDP)in 1965 to 16 percent of the GDP in 2004.Healthcare is driven with a goal to provide best possible care available at that period of time.Guidelines are generally assumed to have the high level of certainty and security as conclusions generated by the conventional scientific method leading many clinicians to use guidelines as the final arbiters of care.To provide the standard of care,physicians follow guidelines,proposed by either groups of physicians or various medical societies or government organizations like National Comprehensive Cancer Network.This has lead to multiple tests for the patient and has not survived the test of time.This independence leads to lacunae in the standardization of guidelines,hence flooding of literature with multiple guidelines and confusion to patients and physicians and eventually overtreatment,inefficiency,and patient inconvenience.There is an urgent need to restrict articles with Guidelines and develop some strategy like have an intermediate stage of pre-guidelines and after 5-10 years of trials,a systematic launch of the Guidelines.There can be better ways than this for putting together guidelines as has been suggested by multiple authors and researchers.

OSART guidelines. 1992 edition

International Nuclear Information System (INIS)

1992-01-01

The IAEA Operational Safety Review Team (OSART) Guidelines provide overall guidance for the experts to ensure the consistency and comprehensiveness of the operational safety review. Specific guidelines are provided as a guide for the systematic review in the following areas important to operational safety: management, organization and administration, training and qualification, operations, maintenance, technical support, radiation protection, chemistry, emergency planning and preparedness. Additional guidance and reference material has been prepared by the IAEA to complement the expertise of the OSART members

12 CFR 708a.13 - Voting guidelines.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Voting guidelines. 708a.13 Section 708a.13... INSURED CREDIT UNIONS TO MUTUAL SAVINGS BANKS § 708a.13 Voting guidelines. A converting credit union must conduct its member vote on conversion in a fair and legal manner. NCUA provides the following guidelines...

Oak Regeneration Guidelines for the Central Appalachians

Science.gov (United States)

Kim C. Steiner; James C. Finley; Peter J. Gould; Songlin Fei; Marc McDill

2008-01-01

This article presents the first explicit guidelines for regenerating oaks in the central Appalachians. The objectives of this paper are (1) to describe the research foundation on which the guidelines are based and (2) to provide users with the instructions, data collection forms, supplementary tables, and decision charts needed to apply the guidelines in the field. The...

No. 354-Canadian HIV Pregnancy Planning Guidelines.

Science.gov (United States)

Loutfy, Mona; Kennedy, V Logan; Poliquin, Vanessa; Dzineku, Frederick; Dean, Nicola L; Margolese, Shari; Symington, Alison; Money, Deborah M; Hamilton, Scot; Conway, Tracey; Khan, Sarah; Yudin, Mark H

2018-01-01

The objective of the Canadian HIV Pregnancy Planning Guidelines is to provide clinical information and recommendations for health care providers to assist Canadians affected by HIV with their fertility, preconception, and pregnancy planning decisions. These guidelines are evidence- and community-based and flexible and take into account diverse and intersecting local/population needs based on the social determinants of health. EVIDENCE: Literature searches were conducted by a librarian using the Medline, Cochrane Central Register of Controlled Trials (CENTRAL), and Embase databases for published articles in English and French related to HIV and pregnancy and HIV and pregnancy planning for each section of the guidelines. The full search strategy is available upon request. The evidence obtained was reviewed and evaluated by the Infectious Diseases Committee of the SOGC under the leadership of the principal authors, and recommendations were made according to the guidelines developed by the Canadian Task Force on Preventive Health Care and through use of the Appraisal of Guidelines Research and Evaluation instrument for the development of clinical guidelines. Guideline implementation should assist the practitioner in developing an evidence-based approach for the prevention of unplanned pregnancy, preconception, fertility, and pregnancy planning counselling in the context of HIV infection. These guidelines have been reviewed and approved by the Infectious Disease Committee and the Executive and Council of the SOGC. Canadian Institutes of Health Research Grant Planning and Dissemination grant (Funding Reference # 137186), which funded a Development Team meeting in 2016. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

Hypertension guidelines and their effects on the health system

Directory of Open Access Journals (Sweden)

Konta, Brigitte

2005-12-01

Full Text Available Introduction: Hypertension guidelines, which have existed for many years and primarily used in the USA, Canada and Great Britain, are now becoming an issue in Germany. Strong efforts are presently underway for a German version comparable to the guidelines developed for the mentioned countries. The development of guidelines is a part of the implementation system of guidelines in Germany. It covers the mode of operation of the AWMF (work community of the scientific medical subject companies with the clearinghouse for guidelines (CLA and the cooperation with the centre for medical quality (ÄZQ. In the HTA report the real use of the hypertension guidelines shall be investigated for Germany from the development trends and further possibilities of use according to a medical applicability. Economic issues and an optimisation of use are also discussed. Question: The following questions shall be answered in particular: 1. How much are the guidelines used concerning hypertension? 2. Can effects (or their influence be established on the medical procedures? 3. Are there statements available about costs and cost effectiveness? 4. Are there recommendations for further use? Methodology: To answer these questions, a comprehensive literature search was done. No empirical investigation was carried out. From this enquiry 206 articles were checked in detail but not all of them were available in full text. Only those publications which directly dealt with high blood pressure guidelines or articles with a direct reference to the topic have been considered in the HTA report. Publications concerning screening or methods of prevention, medical studies of the hypertension syndrome without a direct reference to guidelines and publications concerned with putting guidelines into action were excluded. Results: After an analysis of the selected literature addressing the topic of hypertension guidelines, it was evident that the use of these guidelines cannot be gathered from

Cancer related fatigue: implementing guidelines for optimal management.

Science.gov (United States)

Pearson, Elizabeth J M; Morris, Meg E; McKinstry, Carol E

2017-07-18

Cancer-related fatigue (CRF) is a key concern for people living with cancer and can impair physical functioning and activities of daily living. Evidence-based guidelines for CRF are available, yet inconsistently implemented globally. This study aimed to identify barriers and enablers to applying a cancer fatigue guideline and to derive implementation strategies. A mixed-method study explored the feasibility of implementing the CRF guideline developed by the Canadian Association for Psychosocial Oncology (CAPO). Health professionals, managers and consumers from different practice settings participated in a modified Delphi study with two survey rounds. A reference group informed the design of the study including the surveys. The first round focused on guideline characteristics, compatibility with current practice and experience, and behaviour change. The second survey built upon and triangulated the first round. Forty-five health practitioners and managers, and 68 cancer survivors completed the surveys. More than 75% of participants endorsed the CAPO cancer related fatigue guidelines. Some respondents perceived a lack of resources for accessible and expert fatigue management services. Further barriers to guideline implementation included complexity, limited practical details for some elements, and lack of clinical tools such as assessment tools or patient education materials. Recommendations to enhance guideline applicability centred around four main themes: (1) balancing the level of detail in the CAPO guideline with ease of use, (2) defining roles of different professional disciplines in CRF management, (3) how best to integrate CRF management into policy and practice, (4) how best to ensure a consumer-focused approach to CRF management. Translating current knowledge on optimal management of CRF into clinical practice can be enhanced by the adoption of valid guidelines. This study indicates that it is feasible to adopt the CAPO guidelines. Clinical application may

A survey of psychiatrists' attitudes toward treatment guidelines.

Science.gov (United States)

Healy, Daniel J; Goldman, Mona; Florence, Timothy; Milner, Karen K

2004-04-01

We developed a survey to look at psychiatrists' attitudes toward psychotropic prescribing guidelines, specifically the Texas Medication Algorithm Project (TMAP) algorithms. The 22-page survey was distributed to 24 psychiatrists working in 4 CMHC's; 13 completed the survey. 90% agreed that guidelines should be general and flexible. The majority also agreed that guidelines should define how to measure response to a specific agent; fewer agreed guidelines should specify dosage, side effect management, or augmentation strategies. Psychiatrists were familiar with TMAP; none referred to it in their practice. In spite of this, psychiatrists' medication preferences were similar to those suggested by guidelines.

Guideline Implementation: Hand Hygiene.

Science.gov (United States)

Goldberg, Judith L

2017-02-01

Performing proper hand hygiene and surgical hand antisepsis is essential to reducing the rates of health care-associated infections, including surgical site infections. The updated AORN "Guideline for hand hygiene" provides guidance on hand hygiene and surgical hand antisepsis, the wearing of fingernail polish and artificial nails, proper skin care to prevent dermatitis, the wearing of jewelry, hand hygiene product selection, and quality assurance and performance improvement considerations. This article focuses on key points of the guideline to help perioperative personnel make informed decisions about hand hygiene and surgical hand antisepsis. The key points address the necessity of keeping fingernails and skin healthy, not wearing jewelry on the hands or wrists in the perioperative area, properly performing hand hygiene and surgical hand antisepsis, and involving patients and visitors in hand hygiene initiatives. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Medicare depreciation; useful life guidelines--HCFA. Proposed rule.

Science.gov (United States)

1982-09-30

We are proposing to amend Medicare regulations to clarify which useful life guidelines providers of health care services may use to determine the useful life of a depreciable asset for Medicare reimbursement purposes. Current regulations state that providers must utilize HHS useful life guidelines or, if none have been published by HHS, the American Hospital Association (AHA) useful life guidelines of 1973 or IRS guidelines. We are proposing to eliminate the reference to IRS guidelines because those previously acceptable for Medicare purposes are outdated and have been made obsolete by the IRS or by statutory change. We would also delete the specific reference to the 1973 AHA guidelines. In addition, we intend this amendment to clarify that certain tax legislation on accelerated depreciation, recently passed by Congress, does not apply to the Medicare program.

Revised dietary guidelines for Koreans.

Science.gov (United States)

Jang, Young Ai; Lee, Haeng Shin; Kim, Bok Hee; Lee, Yoonna; Lee, Hae Jeung; Moon, Jae Jin; Kim, Cho-il

2008-01-01

With rapidly changing dietary environment, dietary guidelines for Koreans were revised and relevant action guides were developed. First, the Dietary Guidelines Advisory Committee was established with experts and government officials from the fields of nutrition, preventive medicine, health promotion, agriculture, education and environment. The Committee set dietary goals for Koreans aiming for a better nutrition state of all after a thorough review and analysis of recent information related to nutritional status and/or problems of Korean population, changes in food production/supply, disease pattern, health policy and agricultural policy. Then, the revised dietary guidelines were proposed to accomplish these goals in addition to 6 different sets of dietary action guides to accommodate specific nutrition and health problems of respective age groups. Subsequently, these guidelines and guides were subjected to the focus group review, consumer perception surveys, and a public hearing for general and professional comments. Lastly, the language was clarified in terms of public understanding and phraseology. The revised Dietary guidelines for Koreans are as follows: eat a variety of grains, vegetables, fruits, fish, meat, poultry and dairy products; choose salt-preserved foods less, and use less salt when you prepare foods; increase physical activity for a healthy weight, and balance what you eat with your activity; enjoy every meal, and do not skip breakfast; if you drink alcoholic beverages, do so in moderation; prepare foods properly, and order sensible amounts; enjoy our rice-based diet.

Effect of water hardness on peracetic acid toxicity to zebrafish, Danio rerio, embryos

DEFF Research Database (Denmark)

Marchand, Pierre_André; Strauss, David L.; Wienke, Andreas

2013-01-01

The use of peracetic acid (PAA) in aquaculture has been suggested as an alternative therapeutic agent. Few data are available concerning fish toxicity by PAA or factors that modify this toxicity. The aim of this study was to investigate the influence of water hardness on the acute toxicity of PAA...... acidic in low hardness. In conclusion, aquaculturists using PAA should pay attention to water hardness to avoid acidosis...

Managing Ulcerative Colitis – The Guidelines and Beyond

Directory of Open Access Journals (Sweden)

Mitchell RKL Lie

2013-11-01

Full Text Available Management guidelines offer clinicians clear, evidence-based and often succinct treatment advice. For ulcerative colitis these guidelines describe the use of 5-ASA, corticosteroids, thiopurines, cyclosporine, and anti-TNFα therapies. However, guidelines do have some drawbacks, mainly a lack of concrete advice concerning patients resistant to these aforementioned therapies. This review gives a short overview of current guidelines and addresses treatment alternatives for conventional therapies.

Cancer screening guidelines.

Science.gov (United States)

Zoorob, R; Anderson, R; Cefalu, C; Sidani, M

2001-03-15

Numerous medical organizations have developed cancer screening guidelines. Faced with the broad, and sometimes conflicting, range of recommendations for cancer screening, family physicians must determine the most reasonable and up-to-date method of screening. Major medical organizations have generally achieved consensus on screening guidelines for breast, cervical and colorectal cancer. For breast cancer screening in women ages 50 to 70, clinical breast examination and mammography are generally recommended every one or two years, depending on the medical organization. For cervical cancer screening, most organizations recommend a Papanicolaou test and pelvic examination at least every three years in patients between 20 and 65 years of age. Annual fecal occult blood testing along with flexible sigmoidoscopy at five-year to 10-year intervals is the standard recommendation for colorectal cancer screening in patients older than 50 years. Screening for prostate cancer remains a matter of debate. Some organizations recommend digital rectal examination and a serum prostate-specific antigen test for men older than 50 years, while others do not. In the absence of compelling evidence to indicate a high risk of endometrial cancer, lung cancer, oral cancer and ovarian cancer, almost no medical organizations have developed cancer screening guidelines for these types of cancer.

Oral lesions and dental status among institutionalized orphans in Yemen: A matched case-control study

Directory of Open Access Journals (Sweden)

Sadeq Ali Al-Maweri

2014-01-01

Full Text Available Objectives: The aim of this study was to assess the prevalence of oral mucosal lesions (OMLs and dental caries and to evaluate oral health practices among institutionalized orphan-children in Sana′a city, Yemen. Subjects and Methods: A sample of 202 institutionalized male-orphan-children in the main orphanage in Sana′a city, were matched to 202 non-orphan schoolchildren. Clinical examination included assessment of OMLs based on standard international diagnostic criteria and evaluation of dental status using the Decayed/decayed, Missed/missed and Filled/filled (DMFT/dmft index according to World Health Organization recommendations. Demographic data and oral hygiene practices were obtained by interviewing each subject using special questionnaire form. Results: Majority of children were in the 12-15 year age group. Nine types of lesions were reported among orphans; the most common lesions were fissured tongue (24.3%, herpes labialis (7.9% and traumatic ulcers (2.5%. The occurrence of herpes labialis was found to be significantly higher in orphans than in controls (P < 0.01. The prevalence of dental caries was insignificantly lower among the orphans (84.7% compared with the non-orphans (89.61%; P = 0.136. The mean dmft score was significantly lower in orphans than in controls (2.28 vs. 3.82; P = 0.001. Conclusions: The institutionalized children in this orphanage had a high prevalence of OMLs but low prevalence of dental caries, though they revealed poor oral hygiene practices. Effective oral health promotion strategies need to be implemented to improve the oral health and oral health practices of children living in orphanages.

Periodontics and the new CDC guidelines.

Science.gov (United States)

Basquill, Linda C; Basquill, Patrick J

2004-07-01

On December 19, 2003, the Centers for Disease Control and Prevention released the Guidelines for Infection Control in Dental Health-Care Settings--2003. The publication was the first comprehensive dental infection control update since 1993. Although the guidelines are not directed toward a particular dental specialty, some recommendations may have a significant impact on the practice of periodontics because of the nature of the procedures that are considered routine to the specialty. This article deals with some of the issues addressed in the guidelines, highlighting topics of special interest to periodontists.

Empirical influence of the multicultural guidelines: A brief report.

Science.gov (United States)

Fouad, Nadya A; Santana, Mercedes; Ghosh, Arpita

2017-10-01

In 2002, the American Psychological Association (APA) Council of Representatives approved the "Guidelines for Multicultural Education, Training, Research, Practice and Organizational Change for Psychologists." The Guidelines have been downloaded 64,153 times from the APA website from 2007 to 2013, and have been cited nearly 900 times. This suggests that the Guidelines have influenced education, training, research, and practice in psychology. However, it is unclear how the Guidelines have influenced these domains. We conducted a comprehensive literature review to examine how the Guidelines have influenced the field. Articles were coded for several criteria, including whether the Guidelines were cited, the type of research that was conducted, study findings, limitations, and future directions of research. The data for this study consisted of 895 empirical articles published since the 2003 publication of the Guidelines. A literature review using the keywords APA and multicultural guidelines were searched in PsycINFO and ERIC databases. Articles were then coded by the research team. Findings from the literature review suggested that although there were a total of 895 articles and books that cited the Guidelines, only 34 met our coding criteria. Our findings suggest that most of the articles that cited the Guidelines used the citation as a way to document that culture is important to consider. In some cases, other professions cited the Guidelines to argue that their discipline should also attend to culture. However, very few articles focused on framing an investigation around a specific guideline. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Heat exchanger performance monitoring guidelines

International Nuclear Information System (INIS)

Stambaugh, N.; Closser, W. Jr.; Mollerus, F.J.

1991-12-01

Fouling can occur in many heat exchanger applications in a way that impedes heat transfer and fluid flow and reduces the heat transfer or performance capability of the heat exchanger. Fouling may be significant for heat exchanger surfaces and flow paths in contact with plant service water. This report presents guidelines for performance monitoring of heat exchangers subject to fouling. Guidelines include selection of heat exchangers to monitor based on system function, safety function and system configuration. Five monitoring methods are discussed: the heat transfer, temperature monitoring, temperature effectiveness, delta P and periodic maintenance methods. Guidelines are included for selecting the appropriate monitoring methods and for implementing the selected methods. The report also includes a bibliography, example calculations, and technical notes applicable to the heat transfer method

Guidelines for the Pharmacotherapy of Schizophrenia in Adults.

Science.gov (United States)

Remington, Gary; Addington, Donald; Honer, William; Ismail, Zahinoor; Raedler, Thomas; Teehan, Michael

2017-09-01

The present guidelines address the pharmacotherapy of schizophrenia in adults across different stages, phases, and symptom domains. Guidelines were developed using the ADAPTE process, which takes advantage of existing guidelines. Six guidelines were identified for adaptation, with recommendations extracted from each. For those specific to the pharmacotherapy of schizophrenia in adults, a working group selected between guidelines and recommendations to create an adapted guideline. Recommendations can be categorized into 6 areas that include 1) first-episode schizophrenia, 2) acute exacerbation, 3) relapse prevention and maintenance treatment, 4) treatment-resistant schizophrenia, 5) clozapine-resistant schizophrenia, and 6) specific symptom domains. For each category, recommendations are made based on the available evidence, which is discussed and linked to other established guidelines. In most cases, evidence-based recommendations are made that can be used to guide current clinical treatment and decision making. Notably, however, there is a paucity of established evidence to guide treatment decision making in the case of clozapine-resistant schizophrenia, a subsample that represents a sizable proportion of those with schizophrenia.

77 FR 13585 - Electricity Subsector Cybersecurity Risk Management Process Guideline

Science.gov (United States)

2012-03-07

... DEPARTMENT OF ENERGY Electricity Subsector Cybersecurity Risk Management Process Guideline AGENCY... Electricity Subsector Cybersecurity Risk Management Process guideline. The guideline describes a risk... Cybersecurity Risk Management Process Guideline. The primary goal of this guideline is to describe a risk...

Condensate polishing guidelines for PWR and BWR plants

International Nuclear Information System (INIS)

Robbins, P.; Crinigan, P.; Graham, B.; Kohlmann, R.; Crosby, C.; Seager, J.; Bosold, R.; Gillen, J.; Kristensen, J.; McKeen, A.; Jones, V.; Sawochka, S.; Siegwarth, D.; Keeling, D.; Polidoroff, T.; Morgan, D.; Rickertsen, D.; Dyson, A.; Mills, W.; Coleman, L.

1993-03-01

Under EPRI sponsorship, an industry committee, similar in form and operation to other guideline committees, was created to develop Condensate Polishing Guidelines for both PWR and BWR systems. The committee reviewed the available utility and water treatment industry experience on system design and performance and incorporated operational and state-of-the-art information into document. These guidelines help utilities to optimize present condensate polisher designs as well as be a resource for retrofits or new construction. These guidelines present information that has not previously been presented in any consensus industry document. The committee generated guidelines that cover both deep bed and powdered resin systems as an integral part of the chemistry of PWR and BWR plants. The guidelines are separated into sections that deal with the basis for condensate polishing, system design, resin design and application, data management and performance and management responsibilities

Poly(acrylic acid) conjugated hollow mesoporous carbon as a dual-stimuli triggered drug delivery system for chemo-photothermal synergistic therapy

Energy Technology Data Exchange (ETDEWEB)

Li, Xian; Liu, Chang; Wang, Shengyu; Jiao, Jian; Di, Donghua; Jiang, Tongying; Zhao, Qinfu, E-mail: zqf021110505@163.com; Wang, Siling, E-mail: silingwang@syphu.edu.cn

2017-02-01

In this work, we described the development of the redox and pH dual stimuli-responsive drug delivery system and combination of the chemotherapy and photothermal therapy for cancer treatment. The poly(acrylic acid) (PAA) was conjugated on the outlets of hollow mesoporous carbon (HMC) via disulfide bonds. PAA was used as a capping to block drug within the mesopores of HMC for its lots of favorable advantages, such as good biocompatibility, appropriate molecular weight to block the mesopores of HMC, extension of the blood circulation, and the improvement of the dispersity of the nano-carriers in physiological environment. The DOX loaded DOX/HMC-SS-PAA had a high drug loading amount up to 51.9%. The in vitro drug release results illustrated that DOX/HMC-SS-PAA showed redox and pH dual-responsive drug release, and the release rate could be further improved by the near infrared (NIR) irradiation. Cell viability experiment indicated that DOX/HMC-SS-PAA had a synergistic therapeutic effect by combination of chemotherapy and photothermal therapy. This work suggested that HMC-SS-PAA exhibited dual-responsive drug release property and could be used as a NIR-adsorbing drug delivery system for chemo-photothermal synergistic therapy. - Highlights: • Poly(acrylic acid) was grafted on hollow mesoporous carbon (HMC) via disulfide bonds. • The grafted PAA could increase the biocompatibility and stability of HMC. • The DOX-loaded DOX/HMC-SS-PAA had a high drug loading efficiency up to 51.9%. • DOX/HMC-SS-PAA showed redox/pH dual-responsive and NIR-triggered drug release. • DOX/HMC-SS-PAA showed a chemo/photothermal synergistic therapy effect.

Description and evaluation of a peracetic acid air sampling and analysis method.

Science.gov (United States)

Nordling, John; Kinsky, Owen R; Osorio, Magdalena; Pechacek, Nathan

2017-12-01

Peracetic acid (PAA) is a corrosive chemical with a pungent odor, which is extensively used in occupational settings and causes various health hazards in exposed workers. Currently, there is no US government agency recommended method that could be applied universally for the sampling and analysis of PAA. Legacy methods for determining airborne PAA vapor levels frequently suffered from cross-reactivity with other chemicals, particularly hydrogen peroxide (H 2 O 2 ). Therefore, to remove the confounding factor of cross-reactivity, a new viable, sensitive method was developed for assessment of PAA exposure levels, based on the differential reaction kinetics of PAA with methyl p-tolylsulfide (MTS), relative to H 2 O 2 , to preferentially derive methyl p-tolysulfoxide (MTSO). By quantifying MTSO concentration produced in the liquid capture solution from an air sampler, using an internal standard, and utilizing the reaction stoichiometry of PAA and MTS, the original airborne concentration of PAA is determined. After refining this liquid trap high-performance liquid chromatography (HPLC) method in the laboratory, it was tested in five workplace settings where PAA products were used. PAA levels ranged from the detection limit of 0.013 parts per million (ppm) to 0.4 ppm. The results indicate a viable and potentially dependable method to assess the concentrations of PAA vapors under occupational exposure scenarios, though only a small number of field measurements were taken while field testing this method. However, the low limit of detection and precision offered by this method makes it a strong candidate for further testing and validation to expand the uses of this liquid trap HPLC method.

Poly(acrylic acid) conjugated hollow mesoporous carbon as a dual-stimuli triggered drug delivery system for chemo-photothermal synergistic therapy

International Nuclear Information System (INIS)

Li, Xian; Liu, Chang; Wang, Shengyu; Jiao, Jian; Di, Donghua; Jiang, Tongying; Zhao, Qinfu; Wang, Siling

2017-01-01

In this work, we described the development of the redox and pH dual stimuli-responsive drug delivery system and combination of the chemotherapy and photothermal therapy for cancer treatment. The poly(acrylic acid) (PAA) was conjugated on the outlets of hollow mesoporous carbon (HMC) via disulfide bonds. PAA was used as a capping to block drug within the mesopores of HMC for its lots of favorable advantages, such as good biocompatibility, appropriate molecular weight to block the mesopores of HMC, extension of the blood circulation, and the improvement of the dispersity of the nano-carriers in physiological environment. The DOX loaded DOX/HMC-SS-PAA had a high drug loading amount up to 51.9%. The in vitro drug release results illustrated that DOX/HMC-SS-PAA showed redox and pH dual-responsive drug release, and the release rate could be further improved by the near infrared (NIR) irradiation. Cell viability experiment indicated that DOX/HMC-SS-PAA had a synergistic therapeutic effect by combination of chemotherapy and photothermal therapy. This work suggested that HMC-SS-PAA exhibited dual-responsive drug release property and could be used as a NIR-adsorbing drug delivery system for chemo-photothermal synergistic therapy. - Highlights: • Poly(acrylic acid) was grafted on hollow mesoporous carbon (HMC) via disulfide bonds. • The grafted PAA could increase the biocompatibility and stability of HMC. • The DOX-loaded DOX/HMC-SS-PAA had a high drug loading efficiency up to 51.9%. • DOX/HMC-SS-PAA showed redox/pH dual-responsive and NIR-triggered drug release. • DOX/HMC-SS-PAA showed a chemo/photothermal synergistic therapy effect.

Enhanced apatite-forming ability and antibacterial activity of porous anodic alumina embedded with CaO-SiO2-Ag2O bioactive materials.

Science.gov (United States)

Ni, Siyu; Li, Xiaohong; Yang, Pengan; Ni, Shirong; Hong, Feng; Webster, Thomas J

2016-01-01

In this study, to provide porous anodic alumina (PAA) with bioactivity and anti-bacterial properties, sol-gel derived bioactive CaO-SiO2-Ag2O materials were loaded onto and into PAA nano-pores (termed CaO-SiO2-Ag2O/PAA) by a sol-dipping method and subsequent calcination of the gel-glasses. The in vitro apatite-forming ability of the CaO-SiO2-Ag2O/PAA specimens was evaluated by soaking them in simulated body fluid (SBF). The surface microstructure and chemical property before and after soaking in SBF were characterized. Release of ions into the SBF was also measured. In addition, the antibacterial properties of the samples were tested against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus). The results showed that CaO-SiO2-Ag2O bioactive materials were successfully decorated onto and into PAA nano-pores. In vitro SBF experiments revealed that the CaO-SiO2-Ag2O/PAA specimens dramatically enhanced the apatite-forming ability of PAA in SBF and Ca, Si and Ag ions were released from the samples in a sustained and slow manner. Importantly, E. coli and S. aureus were both killed on the CaO-SiO2-Ag2O/PAA (by 100%) samples compared to PAA controls after 3 days of culture. In summary, this study demonstrated that the CaO-SiO2-Ag2O/PAA samples possess good apatite-forming ability and high antibacterial activity causing it to be a promising bioactive coating candidate for implant materials for orthopedic applications. Copyright © 2015 Elsevier B.V. All rights reserved.

75 FR 48934 - Coral Reef Conservation Program Implementation Guidelines

Science.gov (United States)

2010-08-12

...-01] RIN 0648-ZC19 Coral Reef Conservation Program Implementation Guidelines AGENCY: National Oceanic... Guidelines (Guidelines) for the Coral Reef Conservation Program (CRCP or Program) under the Coral Reef... assistance for coral reef conservation projects under the Act. NOAA revised the Implementation Guidelines for...

Colorectal Cancer Screening: A Guide to the Guidelines

Directory of Open Access Journals (Sweden)

Douglas K Rex

1999-01-01

Full Text Available The two most recent guidelines for colorectal cancer screening are those of the Agency for Healthcare Policy and Research, and the American Cancer Society. The guidelines are similar in many regards and reflect current literature, consensus opinion and compromise between members of multidisciplinary panels. The emphasis of both guidelines is to increase the options available for colorectal cancer screening. Increasing choice should expand the attractiveness of colorectal cancer screening to more patients and physicians, and the development of guidelines should help compel payers to provide reimbursement for colorectal cancer screening. These guidelines are summarized and evaluated as they pertain to colorectal cancer screening.

Oxidation of β-lactam antibiotics by peracetic acid: Reaction kinetics, product and pathway evaluation.

Science.gov (United States)

Zhang, Kejia; Zhou, Xinyan; Du, Penghui; Zhang, Tuqiao; Cai, Meiquan; Sun, Peizhe; Huang, Ching-Hua

2017-10-15

Peracetic acid (PAA) is a disinfection oxidant used in many industries including wastewater treatment. β-Lactams, a group of widely prescribed antibiotics, are frequently detected in wastewater effluents and surface waters. The reaction kinetics and transformation of seven β-lactams (cefalexin (CFX), cefadroxil (CFR), cefapirin (CFP), cephalothin (CFT), ampicillin (AMP), amoxicillin (AMX) and penicillin G (PG)) toward PAA were investigated to elucidate the behavior of β-lactams during PAA oxidation processes. The reaction follows second-order kinetics and is much faster at pH 5 and 7 than at pH 9 due to speciation of PAA. Reactivity to PAA follows the order of CFR ∼ CFX > AMP ∼ AMX > CFT ∼ CFP ∼ PG and is related to β-lactam's nucleophilicity. The thioether sulfur of β-lactams is attacked by PAA to generate sulfoxide products. Presence of the phenylglycinyl amino group on β-lactams can significantly influence electron distribution and the highest occupied molecular orbital (HOMO) location and energy in ways that enhance the reactivity to PAA. Reaction rate constants obtained in clean water matrix can be used to accurately model the decay of β-lactams by PAA in surface water matrix and only slightly overestimate the decay in wastewater matrix. Results of this study indicate that the oxidative transformation of β-lactams by PAA can be expected under appropriate wastewater treatment conditions. Copyright © 2017. Published by Elsevier Ltd.

Development of human factors design review guidelines

International Nuclear Information System (INIS)

Lee, Jung Woon; Oh, In Suk; Suh, Sang Moon; Lee, Hyun Chul

1997-10-01

The Objective of this study is to develop human factors engineering program review guidelines and alarm system review guidelines in order to resolve the two major technical issues: '25, Human factors engineering program review model' and '26, Review criteria for human actors aspects of advanced controls and instrumentation', which are related to the development of human factors safety regulation guides be ing performed by KINS. For the development of human factors program review guidelines, we made a Korean version of NUREG-0711 and added our comments by considering Korean regulatory situation and reviewing the reference documents of NUREG-0711. We also computerized the Korean version of NUREG-0711, additional comments, and selected portion of the reference documents for the developer of safety regulation guides in KINS to see the contents comparatively at a glance and use them easily. For the development of alarm system review guidelines, we made a Korean version of NUREG/CR-6105, which was published by NRC in 1994 as a guideline document for the human factors review of alarm systems. Then we well update the guidelines by reviewing the literature related to alarm design published after 1994

Development of human factors design review guidelines

Energy Technology Data Exchange (ETDEWEB)

Lee, Jung Woon; Oh, In Suk; Suh, Sang Moon; Lee, Hyun Chul [Korea Atomic Energy Research Institute, Taejon (Korea)

1997-10-01

The objective of this study is to develop human factors engineering program review guidelines and alarm system review guidelines in order to resolve the two major technical issues: 25. Human Factors Engineering Program Review Model and 26. Review Criteria for Human Factors Aspects of Advanced Controls and Instrumentation, which are related to the development of human factors safety regulation guides being performed by KINS. For the development of human factors program review guidelines, we made a Korean version of NUREG-0711 and added our comments by considering Korean regulatory situation and reviewing the reference documents of NUREG-0711. We also computerized the Korean version of NUREG-0711, additional comments, and selected portion of the reference documents for the developer of safety regulation guides in KINS to see the contents comparatively at a glance and use them easily. For the development of alarm system review guidelines, we made a Korean version of NUREG/CR-6105, which was published by NRC in 1994 as a guideline document for the human factors review of alarm systems. Then we will update the guidelines by reviewing the literature related to alarm design published after 1994. (author). 12 refs., 5 figs., 2 tabs.

Comparing consensus guidelines on thromboprophylaxis in orthopedic surgery

NARCIS (Netherlands)

Struijk-Mulder, M. C.; Ettema, H. B.; Verheyen, C. C.; Büller, H. R.

2010-01-01

BACKGROUND: Different guidelines exist regarding the prevention of venous thromboembolism (VTE) in orthopedic surgery. OBJECTIVES: We aimed to compare (inter)national guidelines and analyse differences. Methods: MEDLINE, the Cochrane Library and the internet were searched for guidelines on the

Synthesis of poly acrylic acid modified silver nanoparticles and their antimicrobial activities

Energy Technology Data Exchange (ETDEWEB)

Ni, Zhihui [Key Laboratory for Special Functional Materials of Ministry of Education, Henan University, Kaifeng 475004 (China); Wang, Zhihua [Institute of Environmental and Analytical Sciences, College of Chemistry and Chemical Engineering, Henan University, Kaifeng 475004 (China); Sun, Lei, E-mail: sunlei@henu.edu.cn [Key Laboratory for Special Functional Materials of Ministry of Education, Henan University, Kaifeng 475004 (China); Li, Binjie [Key Laboratory of Cellular and Molecular Immunology, Henan University, Kaifeng 475004 (China); Zhao, Yanbao [Key Laboratory for Special Functional Materials of Ministry of Education, Henan University, Kaifeng 475004 (China)

2014-08-01

Poly acrylic acid modified silver (Ag/PAA) nanoparticles (NPs) have been successfully synthesized in the aqueous solution by using tannic acid as a reductant. The structure, morphology and composition of Ag/PAA NPs were characterized by various techniques such as X-ray powder diffraction (XRD), transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FTIR), ultraviolet–visible absorption spectroscopy (UV–vis) and thermogravimetry analysis (TGA). The results show that PAA/Ag NPs have a quasi-ball shape with an average diameter of 10 nm and exhibit well crystalline, and the reaction conditions have some effect on products morphology and size distribution. In addition, the as-synthesized Ag/PAA NPs antimicrobial activities against Escherichia coli (E. coli), Pseudomonas aeruginosa (P. aeruginosa) and Staphylococcus aureus (S. aureus) were evaluated by the methods of broth dilution, cup diffusion, optical density (OD600) and electron microscopy observation. The as-synthesized Ag/PAA NPs exhibit excellent antibacterial activity. The antimicrobial mechanism may be attributed to the damaging of bacterial cell membrane and causing leakage of cytoplasm. - Highlights: • Dispersed Ag/PAA NPs with small size were synthesized. • Ag/PAA NPs exhibited excellent antimicrobial properties. • Interaction mechanism between Ag/PAA NPs and bacteria was verified.

Self-assembled nanocomplexes of anionic pullulan and polyallylamine for DNA and pH-sensitive intracellular drug delivery

International Nuclear Information System (INIS)

Vora, Lalit; Tyagi, Monica; Patel, Ketan; Gupta, Sanjay; Vavia, Pradeep

2014-01-01

The amalgamation of chemotherapy and gene therapy is promising treatment option for cancer. In this study, novel biocompatible self-assembled nanocomplexes (NCs) between carboxylmethylated pullulan t335 (CMP) with polyallylamine (CMP–PAA NCs) were developed for plasmid DNA (pDNA) and pH-sensitive doxorubicin (DOX) delivery. DOX was conjugated to CMP (DOX–CMP) via hydrazone and confirmed by FTIR and 1 H-NMR. In vitro release studies of pH-sensitive DOX–CMP conjugate showed 23 and 85 % release after 48 h at pH 7.4 (physiological pH) and pH 5 (intracellular/tumoral pH), respectively. The CMP–PAA NCs or DOX–CMP–PAA NCs self-assembled into a nanosized (<250 nm) spherical shape as confirmed by DLS and TEM. The hemolysis and cytotoxicity study indicated that the CMP–PAA NCs did not show cytotoxicity in comparison with plain polyallylamine. Gel retardation assay showed complete binding of pDNA with CMP–PAA NCs at 1:2 weight ratio. CMP–PAA NCs/pDNA showed significantly higher transfection in HEK293 cells compared to PAA/pDNA complexes. Confocal imaging demonstrated successful cellular uptake of DOX–CMP–PAA NCs in HEK293 cells. Thus, NCs hold great potential for targeted pDNA and pH-sensitive intratumoral drug delivery

Synthesis of poly acrylic acid modified silver nanoparticles and their antimicrobial activities

International Nuclear Information System (INIS)

Ni, Zhihui; Wang, Zhihua; Sun, Lei; Li, Binjie; Zhao, Yanbao

2014-01-01

Poly acrylic acid modified silver (Ag/PAA) nanoparticles (NPs) have been successfully synthesized in the aqueous solution by using tannic acid as a reductant. The structure, morphology and composition of Ag/PAA NPs were characterized by various techniques such as X-ray powder diffraction (XRD), transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FTIR), ultraviolet–visible absorption spectroscopy (UV–vis) and thermogravimetry analysis (TGA). The results show that PAA/Ag NPs have a quasi-ball shape with an average diameter of 10 nm and exhibit well crystalline, and the reaction conditions have some effect on products morphology and size distribution. In addition, the as-synthesized Ag/PAA NPs antimicrobial activities against Escherichia coli (E. coli), Pseudomonas aeruginosa (P. aeruginosa) and Staphylococcus aureus (S. aureus) were evaluated by the methods of broth dilution, cup diffusion, optical density (OD600) and electron microscopy observation. The as-synthesized Ag/PAA NPs exhibit excellent antibacterial activity. The antimicrobial mechanism may be attributed to the damaging of bacterial cell membrane and causing leakage of cytoplasm. - Highlights: • Dispersed Ag/PAA NPs with small size were synthesized. • Ag/PAA NPs exhibited excellent antimicrobial properties. • Interaction mechanism between Ag/PAA NPs and bacteria was verified

Elaboration, characterization and application of polysulfone and polyacrylic acid blends as ultrafiltration membranes for removal of some heavy metals from water.

Science.gov (United States)

Mbareck, Chamekh; Nguyen, Quang Trong; Alaoui, Ouafa Tahiri; Barillier, Daniel

2009-11-15

Polysulfone (PSf)/polyacrylic acid ultrafiltration (PSf/PAA) membranes were prepared from a polymer blend in dimethylformamide by coagulation in water according to the wet phase inversion method. Immobilization of water-soluble PAA within the non-soluble PSf matrix was proven by the increase of ion exchange capacity and the intensity of the carboxyl groups' peak with the increase of PAA content as shown by Fourier transform infrared spectra. These results lead to consider that PSf and PAA form a semi-interpenetrating polymer networks. The obtained membranes showed a decrease of mean surface-pore sizes, the overall porosity and the hydraulic permeability with the increase in PAA content. Such results were imputed to the morphologic modifications of PSf film with the immobilization of increasing PAA amount. PSf/PAA membranes showed high lead, cadmium and chromium rejection which reaches 100% at pH superior to 5.7 and a low rejection at low pH. Moreover, the heavy metal rejection decreases with feed solution concentration and applied pressure increases. These behaviors were attributed to the role of carboxylic groups in ion exchange or complexation. As a matter of fact, the strong lead ion-PAA interactions were revealed by the scanning electron microscopy with energy dispersive X-rays (SEM-EDX).

Test methods for estimating the efficacy of the fast-acting disinfectant peracetic acid on surfaces of personal protective equipment.

Science.gov (United States)

Lemmer, K; Howaldt, S; Heinrich, R; Roder, A; Pauli, G; Dorner, B G; Pauly, D; Mielke, M; Schwebke, I; Grunow, R

2017-11-01

The work aimed at developing and evaluating practically relevant methods for testing of disinfectants on contaminated personal protective equipment (PPE). Carriers were prepared from PPE fabrics and contaminated with Bacillus subtilis spores. Peracetic acid (PAA) was applied as a suitable disinfectant. In method 1, the contaminated carrier was submerged in PAA solution; in method 2, the contaminated area was covered with PAA; and in method 3, PAA, preferentially combined with a surfactant, was dispersed as a thin layer. In each method, 0·5-1% PAA reduced the viability of spores by a factor of ≥6 log 10 within 3 min. The technique of the most realistic method 3 proved to be effective at low temperatures and also with a high organic load. Vaccinia virus and Adenovirus were inactivated with 0·05-0·1% PAA by up to ≥6 log 10 within 1 min. The cytotoxicity of ricin was considerably reduced by 2% PAA within 15 min of exposure. PAA/detergent mixture enabled to cover hydrophobic PPE surfaces with a thin and yet effective disinfectant layer. The test methods are objective tools for estimating the biocidal efficacy of disinfectants on hydrophobic flexible surfaces. © 2017 The Society for Applied Microbiology.

48 CFR 1603.7002 - Additional guidelines.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Additional guidelines. 1603.7002 Section 1603.7002 Federal Acquisition Regulations System OFFICE OF PERSONNEL MANAGEMENT FEDERAL... OF INTEREST Misleading, Deceptive, or Unfair Advertising 1603.7002 Additional guidelines. Any...

Soft tissue sarcoma - Compliance with guidelines

NARCIS (Netherlands)

Nijhuis, PHA; Schaapveld, M; Otter, R; Hoekstra, HJ

2001-01-01

BACKGROUND. Because soft tissue sarcomas (STS) are rare, guidelines for the diagnosis and treatment of patients with STS were developed. Because the diagnostic management is essential for definitive treatment, adherence to these guidelines is important. METHODS. Primary STS registered by the

Actinic Keratosis Clinical Practice Guidelines: An Appraisal of Quality

Directory of Open Access Journals (Sweden)

Joslyn S. Kirby

2015-01-01

Full Text Available Actinic keratosis (AK is a common precancerous skin lesion and many AK management guidelines exist, but there has been limited investigation into the quality of these documents. The objective of this study was to assess the strengths and weaknesses of guidelines that address AK management. A systematic search for guidelines with recommendations for AK was performed. The Appraisal of Guidelines for Research and Evaluation (AGREE II was used to appraise the quality of guidelines. Multiple raters independently reviewed each of the guidelines and applied the AGREE II tool and scores were calculated. Overall, 2,307 citations were identified and 7 fulfilled the study criteria. The Cancer Council of Australia/Australian Cancer Network guideline had the highest mean scores and was the only guideline to include a systematic review, include an evidence rating for recommendations, and report conflicts of interest and funding sources. High-quality, effective guidelines are evidence-based with recommendations that are concise and organized, so practical application is facilitated. Features such as concise tables, pictorial diagrams, and explicit links to evidence are helpful. However, the rigor and validity of some guidelines were weak. So, it is important for providers to be aware of the features that contribute to a high-quality, practical document.

The siting guidelines, 10 CFR Part 960

International Nuclear Information System (INIS)

Hanlon, C.L.

1991-01-01

The Siting Guidelines, 10 CFR Part 960, have played a major role in the U.S. Department of Energy's (the Department) Office of Civilian Radioactive Waste Management siting program since their development and implementation in response to the Nuclear Waste Policy Act of 1982. According to the Act, the Siting Guidelines were applicable to the selection of sites for characterization. The Nuclear Waste Policy Amendments Act of 1987 (the Amendments Act) has selected the Yucca Mountain, Nevada, site for characterization from among those nominated according to the Siting Guidelines. Thus, the Amendments Act has taken the repository program beyond the phase of Siting Guidelines applicability, making the U.S. Nuclear Regulatory Commission's 10 CFR Part 60 the applicable regulation. However, the Department has chosen to make use of aspects of the Siting Guidelines in the Site Characterization Plan for the Yucca Mountain Site. (author) 4 figs., 11 refs

Cellulose nanocrystal-filled poly(acrylic acid) nanocomposite fibrous membranes

International Nuclear Information System (INIS)

Lu Ping; Hsieh, You-Lo

2009-01-01

Nanocomposite fibrous membranes have been fabricated by electrospinning cellulose nanocrystal (CNC)-loaded poly(acrylic acid) (PAA) ethanol mixtures. Incorporating CNC in PAA significantly reduced fiber diameters and improved fiber uniformity. The average diameters of the as-spun nanocomposite fibers were significantly reduced from 349 nm to 162 nm, 141 nm, 90 nm and 69 nm at 5%, 10%, 15% and 20% CNC loading (by weight of a constant 4% PAA solution), respectively. CNC was well dispersed in the fibers as isolated rods oriented along the fiber axis and as spheres in the PAA matrix. The Young modulus and stress of the PAA/CNC nanocomposite fibers were significantly improved with increasing CNC loadings by up to 35-fold and 16-fold, respectively. Heat-induced esterification between the CNC surface hydroxyls and PAA carboxyl groups produced covalent crosslinks at the CNC-PAA interfaces, rendering the nanocomposite fibrous membranes insoluble in water, more thermally stable and far more superior in tensile strength. With 20% CNC, the crosslinked nanocomposite fibrous membrane exhibited a very impressive 77-fold increase in modulus and 58-fold increase in stress.

Guidelines for prevention in psychology.

Science.gov (United States)

2014-04-01

The effectiveness of prevention to enhance human functioning and reduce psychological distress has been demonstrated. From infancy through adulthood, access to preventive services and interventions is important to improve the quality of life and human functioning and reduce illness and premature death. The importance of prevention is consistent with the Patient Protection and Affordable Care Act of 2010. Even with the increased focus on prevention, psychology training programs rarely require specific courses on prevention. In particular, conceptualizations about best practices in prevention, particularly at the environmental level, are lacking. Therefore, psychologists engaged in prevention can benefit from a set of guidelines that address and inform prevention practices. Accordingly, the Guidelines for Prevention in Psychology are intended to "inform psychologists, the public, and other interested parties regarding desirable professional practices" in prevention. The Prevention Guidelines are recommended based on their potential benefits to the public and the professional practice of psychology. They support prevention as an important area of practice, research, and training for psychologists. The Guidelines give increased attention to prevention within APA, encouraging psychologists to become involved with preventive activities relevant to their area of practice. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

The European Society of Human Reproduction and Embryology guideline for the diagnosis and treatment of endometriosis : an electronic guideline implementability appraisal

NARCIS (Netherlands)

van Dijk, Lotte J. E. W.; Nelen, Willianne L. D. M.; D'Hooghe, Thomas M.; Dunselman, Gerard A. J.; Hermens, Rosella P. M. G.; Bergh, Christina; Nygren, Karl G.; Simons, Arnold H. M.; de Sutter, Petra; Marshall, Catherine; Burgers, Jako S.; Kremer, Jan A. M.

2011-01-01

Background: Clinical guidelines are intended to improve healthcare. However, even if guidelines are excellent, their implementation is not assured. In subfertility care, the European Society of Human Reproduction and Embryology (ESHRE) guidelines have been inventoried, and their methodological

For bestemmelse af drivhusgasudledning ved udtagning/Ekstensivering af landbrugsjorder på kulstofrige lavbundsjorder

DEFF Research Database (Denmark)

Gyldenkærne, Steen; Greve, Mogens Humlekrog

Sammenfatning: Rapporten beskriver hvordan man kan beregne ændringen i drivhusgasemissionen ved omlægning af landbrugsjord til naturarealer. Rapporten er primært rettet mod tilskudsordningen vedr. udtagning af organiske lavbundsjorde, men kan også anvendes i andre sammenhænge. Rapporten anvender de...

Strategy Guideline: Demonstration Home

Energy Technology Data Exchange (ETDEWEB)

Savage, C.; Hunt, A.

2012-12-01

This guideline will provide a general overview of the different kinds of demonstration home projects, a basic understanding of the different roles and responsibilities involved in the successful completion of a demonstration home, and an introduction into some of the lessons learned from actual demonstration home projects. Also, this guideline will specifically look at the communication methods employed during demonstration home projects. And lastly, we will focus on how to best create a communication plan for including an energy efficient message in a demonstration home project and carry that message to successful completion.

Strategy Guideline. Demonstration Home

Energy Technology Data Exchange (ETDEWEB)

Hunt, A.; Savage, C.

2012-12-01

This guideline will provide a general overview of the different kinds of demonstration home projects, a basic understanding of the different roles and responsibilities involved in the successful completion of a demonstration home, and an introduction into some of the lessons learned from actual demonstration home projects. Also, this guideline will specifically look at the communication methods employed during demonstration home projects. And lastly, we will focus on how to best create a communication plan for including an energy efficient message in a demonstration home project and carry that message to successful completion.

Department of Defense Use of Commercial Cloud Computing Capabilities and Services

Science.gov (United States)

2015-11-01

models (Infrastructure as a Service (IaaS), Platform as a Service (PaaS), and Software as a Service ( SaaS )), and four deployment models (Public...NIST defines three main models for cloud computing: IaaS, PaaS, and SaaS . These models help differentiate the implementation responsibilities that fall...and SaaS . 3. Public, Private, Community, and Hybrid Clouds Cloud services come in different forms, depending on the customer’s specific needs

48 CFR 13.202 - Purchase guidelines.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Purchase guidelines. 13.202 Section 13.202 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING... Threshold 13.202 Purchase guidelines. (a) Solicitation, evaluation of quotations, and award. (1) To the...

Do guidelines on first impression make sense? Implementation of a chest pain guideline in primary care: a systematic evaluation of acceptance and feasibility

Directory of Open Access Journals (Sweden)

Kramer Lena

2011-11-01

Full Text Available Abstract Background Most guidelines concentrate on investigations, treatment, and monitoring instead of patient history and clinical examination. We developed a guideline that dealt with the different aetiologies of chest pain by emphasizing the patient's history and physical signs. The objective of this study was to evaluate the guideline's acceptance and feasibility in the context of a practice test. Methods The evaluation study was nested in a diagnostic cross-sectional study with 56 General Practitioners (GPs and 862 consecutively recruited patients with chest pain. The evaluation of the guideline was conducted in a mixed method design on a sub-sample of 17 GPs and 282 patients. Physicians' evaluation of the guideline was assessed via standardized questionnaires and case record forms. Additionally, practice nursing staff and selected patients were asked for their evaluation of specific guideline modules. Quantitative data was analyzed descriptively for frequencies, means, and standard deviations. In addition, two focus groups with a total of 10 GPs were held to gain further insights in the guideline implementation process. The data analysis and interpretation followed the standards of the qualitative content analysis. Results The overall evaluation of the GPs participating in the evaluation study regarding the recommendations made in the chest pain guideline was positive. A total of 14 GPs were convinced that there was a need for this kind of guideline and perceived the guideline recommendations as useful. While the long version was partially criticized for a perceived lack of clarity, the short version of the chest pain guideline and the heart score were especially appreciated by the GPs. However, change of clinical behaviour as consequence of the guideline was inconsistent. While on a concrete patient related level, GPs indicated to have behaved as the guideline recommended, the feedback on a more general level was heterogeneous. Several

76 FR 17064 - Shared Use Path Accessibility Guidelines

Science.gov (United States)

2011-03-28

...] RIN 3014-AA41 Shared Use Path Accessibility Guidelines AGENCY: Architectural and Transportation... (ANPRM) to develop accessibility guidelines for shared use paths. Shared use paths are designed for both... users. The guidelines will include technical provisions for making newly constructed and altered shared...

Sustainable design guidelines to support the Washington State ferries terminal design manual : design guideline application and refinement.

Science.gov (United States)

2013-08-01

The Sustainable Design Guidelines were developed in Phase I of this research program (WA-RD : 816.1). Here we are reporting on the Phase II effort that beta-tested the Phase I Guidelines on : example ferry terminal designs and refinements made ...

Guideline implementation strategies for specialist mental healthcare.

Science.gov (United States)

Girlanda, Francesca; Fiedler, Ines; Ay, Esra; Barbui, Corrado; Koesters, Markus

2013-07-01

Clinical practice guidelines in mental healthcare are viewed as an essential asset if appropriately developed and implemented. The purpose of this article was to review the existing literature on how guidelines should be implemented to optimize their impact on provider performance and patient outcomes in specialist mental healthcare settings. Findings from recent studies suggest a trend toward an improvement in process and patient outcomes following guideline implementation. However, studies are heterogeneous in terms of design, implementation strategies and outcome measures, making it very difficult to draw firm conclusions about which implementation strategy is effective in different healthcare contexts. Current knowledge about how guidelines should be implemented is still sparse and inconclusive in mental healthcare. Future studies should attempt to employ more rigorous designs, including random allocation of patients or clusters of patients, to shed further light on this compelling issue. Research on guideline implementation strategies should additionally take into account potential barriers to knowledge translation, which can heavily influence the implementability of treatment recommendations.

Introducing guidelines into clinical practice.

Science.gov (United States)

Fowkes, F G; Roberts, C J

1984-04-01

The impetus for guidelines of practice has been accelerated by a worldwide trend towards insurance based systems of health care. In the past it has been the tradition for the clinician to order all the diagnostic procedures that conceivably might help to clarify what is wrong with a patient, or what course of treatment should be followed. This traditional view ignores the stubborn economic reality that resources are finite and that it is no longer possible to be both endlessly generous and continually fair. Making judgements about the need for, and value of, services now forms an important part of coping with this problem. Clinical practice has to strive to be as safe as possible and to produce a given benefit at a socially acceptable cost. Guidelines are recommendations, preferably developed by clinicians themselves, which describe how and when individual clinical activities should be offered in order to achieve these objectives. Utilisation review of current practice is a valuable source of information for the development of guidelines. In the United Kingdom the Royal College of Radiologists attempted to do this in connection with the use of pre-operative chest X-rays. In 1979 they published the findings of a multicentre review of 10,619 consecutive cases of elective non-cardiopulmonary surgery undertaken in 8 centres throughout the United Kingdom. Substantial variations were found in national practice. Use of pre-operative chest X-rays varied from 11.5% of patients in one centre to 54.2% of patients in another centre. The study also found that the chest X-ray report did not seem to have much influence on the decision to operate nor on the decision to use inhalation anaesthesia. The College study failed to find "any evidence at all for the effectiveness of pre-operative chest X-ray when used routinely" and it was estimated that even if the procedure was 10% effective the costs of avoiding one death would be approximately 1 million pounds. These findings provided

Risk management guidelines for petroleum storage tank sites

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-10-01

These guidelines provide a site management process designed particularly for soil and groundwater pollution originating from existing or former petroleum storage tank (PST) facilities and provide uniform standards for the remediation of polluted PST sites in Alberta. The numerical criteria, risk management objectives and technical information described in this document were compiled from four documents including Remediation Guidelines for Petroleum Storage Tank Sites 1994, the Canada-Wide Standards for Petroleum Hydrocarbons in Soil, Alberta Soil and Water Quality Guidelines for Hydrocarbons at Upstream Oil and Gas Facilities, and Guidelines for Managing Risks at Contaminated Sites in Alberta. The changes in these updated guidelines reflect new remediation criteria and provide a process for determining alternate site-specific management objectives for more petroleum storage tank sites. The guidelines were developed using a risk-based approach that ensures the protection of human health, safety and the environment. The guidelines apply to aboveground and underground storage tank facilities that contain gasoline, diesel, heating oil, and aviation fuel. The guidelines specify requirements by Alberta Environment and the Alberta Fire Code. The chapter on risk management process included information on site investigation, determination of soil type, pollution source removal, land use assessment, selection of exposure pathways, depth of remediation, human inhalation and groundwater protection pathways, and verification of remediation. figs, 4 tabs., 2 appendices.

EPRI PWR primary water chemistry guidelines revision

International Nuclear Information System (INIS)

McElrath, Joel; Fruzzetti, Keith

2014-01-01

EPRI periodically updates the PWR Primary Water Chemistry Guidelines as new information becomes available and as required by NEI 97-06 (Steam Generator Program Guidelines) and NEI 03-08 (Guideline for the Management of Materials Issues). The last revision of the PWR water chemistry guidelines identified an optimum primary water chemistry program based on then-current understanding of research and field information. This new revision provides further details with regard to primary water stress corrosion cracking (PWSCC), fuel integrity, and shutdown dose rates. A committee of industry experts, including utility specialists, nuclear steam supply system (NSSS) and fuel vendor representatives, Institute of Nuclear Power Operations (INPO) representatives, consultants, and EPRI staff collaborated in reviewing the available data on primary water chemistry, reactor water coolant system materials issues, fuel integrity and performance issues, and radiation dose rate issues. From the data, the committee updated the water chemistry guidelines that all PWR nuclear plants should adopt. The committee revised guidance with regard to optimization to reflect industry experience gained since the publication of Revision 6. Among the changes, the technical information regarding the impact of zinc injection on PWSCC initiation and dose rate reduction has been updated to reflect the current level of knowledge within the industry. Similarly, industry experience with elevated lithium concentrations with regard to fuel performance and radiation dose rates has been updated to reflect data collected to date. Recognizing that each nuclear plant owner has a unique set of design, operating, and corporate concerns, the guidelines committee has retained a method for plant-specific optimization. Revision 7 of the Pressurized Water Reactor Primary Water Chemistry Guidelines provides guidance for PWR primary systems of all manufacture and design. The guidelines continue to emphasize plant

41 CFR 109-38.502 - Guidelines.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Guidelines. 109-38.502 Section 109-38.502 Public Contracts and Property Management Federal Property Management Regulations System... 38-MOTOR EQUIPMENT MANAGEMENT 38.5-Scheduled Maintenance § 109-38.502 Guidelines. ...

48 CFR 813.202 - Purchase guidelines.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Purchase guidelines. 813.202 Section 813.202 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS CONTRACTING... Threshold 813.202 Purchase guidelines. Open market micro-purchases shall be equitably distributed among all...

Development application guidelines : Newfoundland offshore area

Energy Technology Data Exchange (ETDEWEB)

NONE

1988-12-01

The Canada-Newfoundland Offshore Petroleum Board has created a set of guidelines which describe the information needed by the Board to process a development application by a proponent of an offshore hydrocarbon development project. The guidelines also describe the review process that will be followed in considering a proponent`s application. Proponents must also refer to the Canada-Newfoundland Atlantic Accord Implementation Act and the Canada-Newfoundland Atlantic Accord Implementation (Newfoundland) Act. These guidelines also describe the requirements for the Canada-Newfoundland benefits plan, the environmental impact statement, the socio-economic impact statement, the safety plan, and the environmental protection plan.

Fabrication of CdSe nanocrystals using porous anodic alumina and their optical properties

Energy Technology Data Exchange (ETDEWEB)

Laatar, Fakher, E-mail: fakher8laatar@gmail.com [Laboratory of Semiconductors, Nanostructures and Advanced Technology (LSNTA), Center for Research and Technology Energy, Tourist Route Soliman, BP 95, 2050 Hammam-Lif (Tunisia); Science faculty of Bizerte–Carthage University (Tunisia); Hassen, Mohamed [Laboratory of Semiconductors, Nanostructures and Advanced Technology (LSNTA), Center for Research and Technology Energy, Tourist Route Soliman, BP 95, 2050 Hammam-Lif (Tunisia); Higher Institute of Applied Science and Technology of Sousse, City Taffala (Ibn Khaldun), 4003 Sousse (Tunisia); Amri, Chohdi [Laboratory of Semiconductors, Nanostructures and Advanced Technology (LSNTA), Center for Research and Technology Energy, Tourist Route Soliman, BP 95, 2050 Hammam-Lif (Tunisia); Laatar, Fekri [Laboratory of Physical Chemistry of Minerals and Materials Applications, National Research Center for Materials Science, Technopole Borj Cedria (Tunisia); Smida, Alia; Ezzaouia, Hatem [Laboratory of Semiconductors, Nanostructures and Advanced Technology (LSNTA), Center for Research and Technology Energy, Tourist Route Soliman, BP 95, 2050 Hammam-Lif (Tunisia)

2016-10-15

In this paper, Porous anodic alumina (PAA) template with highly ordered nanopores structure was synthesized on aluminum foils by two step anodization process. PAA template has hexagonal pores with average size between 30 and 180 nm. L-cysteine (L-Cys) functionalized cadmium selenide nanocrystals (CdSe NCs) were successfully embedded inside PAA layers by simple immersion in aqueous solution. The effect of pore diameter enlargement on the microstructure of CdSe NCs/PAA films was systematically studied by FE-SEM, XRD, EDX, Raman, UV–VIS absorbance and PL analysis. FE-SEM microscopy was used to investigate the surface morphology of PAA templates before and after CdSe NCs deposition. XRD investigation demonstrates that CdSe NCs into PAA templates were cubic in nature with zinc-blende structure. Raman measurements exhibit the characteristic modes of CdSe on the PAA layers as well as the films crystallinity as function of widening pores diameter. Optical properties of deposited CdSe NCs on PAA templates have been investigated using optical absorption and PL techniques. Photoluminescence spectroscopy has been used to determine the bandgap energy and the average size of CdSe NCs deposited on PAA layer. This method involves fitting the experimental spectra, using a model based on quantum confinement of electrons in CdSe nanocrystals having spherical and cylindrical forms (Quantum Dots (QDs) and Quantum Wires (QWs)). This model allows correlation between the PL spectra and the microstructure of the CdSe/PAA. Both photoluminescence and optical absorption show that the PL peak energy and the optical absorption edge of CdSe NCs/PAA exhibit similar behavior with changes in nanostructure size. The spectral behaviors of optical absorption and PL are consistent with a quantum confinement model throughout the sizes and shapes of the CdSe nanocrystals of the luminescent films. The effective bandgap energies determined from the PL peaks position are in good agreement with those

Fabrication of CdSe nanocrystals using porous anodic alumina and their optical properties

International Nuclear Information System (INIS)

Laatar, Fakher; Hassen, Mohamed; Amri, Chohdi; Laatar, Fekri; Smida, Alia; Ezzaouia, Hatem

2016-01-01

In this paper, Porous anodic alumina (PAA) template with highly ordered nanopores structure was synthesized on aluminum foils by two step anodization process. PAA template has hexagonal pores with average size between 30 and 180 nm. L-cysteine (L-Cys) functionalized cadmium selenide nanocrystals (CdSe NCs) were successfully embedded inside PAA layers by simple immersion in aqueous solution. The effect of pore diameter enlargement on the microstructure of CdSe NCs/PAA films was systematically studied by FE-SEM, XRD, EDX, Raman, UV–VIS absorbance and PL analysis. FE-SEM microscopy was used to investigate the surface morphology of PAA templates before and after CdSe NCs deposition. XRD investigation demonstrates that CdSe NCs into PAA templates were cubic in nature with zinc-blende structure. Raman measurements exhibit the characteristic modes of CdSe on the PAA layers as well as the films crystallinity as function of widening pores diameter. Optical properties of deposited CdSe NCs on PAA templates have been investigated using optical absorption and PL techniques. Photoluminescence spectroscopy has been used to determine the bandgap energy and the average size of CdSe NCs deposited on PAA layer. This method involves fitting the experimental spectra, using a model based on quantum confinement of electrons in CdSe nanocrystals having spherical and cylindrical forms (Quantum Dots (QDs) and Quantum Wires (QWs)). This model allows correlation between the PL spectra and the microstructure of the CdSe/PAA. Both photoluminescence and optical absorption show that the PL peak energy and the optical absorption edge of CdSe NCs/PAA exhibit similar behavior with changes in nanostructure size. The spectral behaviors of optical absorption and PL are consistent with a quantum confinement model throughout the sizes and shapes of the CdSe nanocrystals of the luminescent films. The effective bandgap energies determined from the PL peaks position are in good agreement with those

Structuring and capturing of radioactive strontium-90 from the polluted soil of Semipalatinsk nuclear test site by inter-polymer complexes

International Nuclear Information System (INIS)

Bimendina, L.A.; Kudaibergenov, S.E.; Orazzhanova, L.K.; Yashkarova, M.G.; Kaliaskarova, B.

2002-01-01

The model and experiments on application of polymer-polymer complexes stabilized by hydrogen and ionic bonds for structuring of Semipalatinsk nuclear test site soils in order to prevent the wind and water erosion of radionuclides from contaminated soil are considered. It is expected that the treatment by inter-polymer complexes (IPC) would cause the structuring of soil particle. Besides IPSs are able to form thin films on the soil particles surface, aggregate and considerably protect the migration of radionuclides. Both the water soluble polymer-polyacrylic acid (PAA), polyethylene glycol (PEG), poly-N,N,-dimethyldiallylammonium chloride (PDMDAACI) and the PAA-PEG, PAA-PDMDAACI inter-polymer complexes were used as structuring agents. The treatment of soil particles was carried out by two methods: the first method is uniform splash of polymer solution and mixing with soil; the second one is pouring of soil surface by polymer solution. The obtained results are summarized as follows: - Optimal concentration of polymer solutions are arranged between 10 -4 -10 -2 mol·l -1 . The best results corresponds to concentration 10 -2 mol·l -1 ; - Pouring of soil surface is most preferential in comparison with splash of polymer solution and mixing with soil; - Both the individual polymers (PAA, PEG and PDMDAACI) and the PAA-PEG, PAA-PDMDAACI inter-polymer complexes show the structuring effect. However the best results were observed for IPC solution. The best structuring effect has been obtained for equimolar [PAA]:[PEG]=1:1 complex solution with 10 -2 mol·l -1 and at p H=3.0 when the IPC solution is poured through the soil surface. The similar results were obtained for [PAA]:[PDMDAACI]=1:1 system. The capillary moisture capacity and water stability at optimal soil treatment conditions of soil is given. Since PAA, PEG and PAA-PEG complexes form polymer-metal complexes with Sr 2+ ions the possibility of capture of soil radionuclides by means of binding into the complex particles

Japanese guidelines for childhood asthma 2017.

Science.gov (United States)

Arakawa, Hirokazu; Hamasaki, Yuhei; Kohno, Yoichi; Ebisawa, Motohiro; Kondo, Naomi; Nishima, Sankei; Nishimuta, Toshiyuki; Morikawa, Akihiro

2017-04-01

The Japanese Guideline for the Diagnosis and Treatment of Allergic Diseases 2017 (JAGL 2017) includes a minor revision of the Japanese Pediatric Guideline for the Treatment and Management of Asthma 2012 (JPGL 2012) by the Japanese Society of Pediatric Allergy and Clinical Immunology. The section on child asthma in JAGL 2017 provides information on how to diagnose asthma between infancy and adolescence (0-15 years of age). It makes recommendations for best practices in the management of childhood asthma, including management of acute exacerbations and non-pharmacological and pharmacological management. This guideline will be of interest to non-specialist physicians involved in the care of children with asthma. JAGL differs from the Global Initiative for Asthma Guideline in that JAGL emphasizes diagnosis and early intervention of children with asthma at asthma control levels, is easy to understand; thus, this guideline is suitable for the routine medical care of children with asthma. JAGL also recommends using a control test in children, so that the physician aims for complete control by avoiding exacerbating factors and appropriately using anti-inflammatory drugs (for example, inhaled corticosteroids and leukotriene receptor antagonists). Copyright © 2016 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

The development of evidence-based guidelines in dentistry.

Science.gov (United States)

Faggion, C M

2013-02-01

Use of guidelines is an important means of reducing the gap between research and clinical practice. Sound and unbiased information should be available to enable dental professionals to provide better clinical treatment for their patients. The development of clinical guidelines in dentistry should follow standard and transparent methodology. The purpose of this article is to propose important steps for developing evidence-based clinical recommendations in dentistry. Initially, dental guidelines should be extensively sought and assessed to answer focused clinical questions. If there is a paucity of guidelines or if existing guidelines are not of good methodological quality, systematic reviews should be searched or conducted to serve as a basis for the development of evidence-based guidelines. When systematic reviews are produced, they should be rigorous in order to provide the best evidence possible. In the last phase of the process, the overall quality of evidence should be scrutinized and assessed, together with other factors (balance between treatment effects and side effects, patients' values, and cost-effectiveness of therapy) to determine the strength of recommendations. It is expected this approach will result in the development of sound clinical guidelines and consequent improvement of dental treatment.

ACC/AHA guidelines superior to ESC/EAS guidelines for primary prevention with statins in non-diabetic Europeans

DEFF Research Database (Denmark)

Mortensen, Martin Bødtker; Nordestgaard, Børge G; Afzal, Shoaib

2017-01-01

Aim We compared the 2013 American College of Cardiology/American Heart Association (ACC/AHA) and the 2016 European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) guidelines on prevention of atherosclerotic cardiovascular disease (ASCVD) using different risk prediction models [US......-calibrated around decision thresholds for statin therapy. For a Class I recommendation, 42% of individuals qualified for statins using the ACC/AHA guidelines vs. 6% with the ESC/EAS guidelines. Using ACC/AHA- vs. ESC/EAS-defined statin eligibility led to a substantial gain in sensitivity (+62% for any ASCVD and+76......% for fatal ASCVD) with a smaller loss in specificity (-35% for any ASCVD and -36% for fatal ASCVD). Similar differences between the ACC/AHA and ESC/EAS guidelines were found for men and women separately, and for Class IIa recommendations. The sensitivity and specificity of a US-PCE risk of 5% were similar...

K-Basins design guidelines

International Nuclear Information System (INIS)

Roe, N.R.; Mills, W.C.

1995-06-01

The purpose of the design guidelines is to enable SNF and K Basin personnel to complete fuel and sludge removal, and basin water mitigation by providing engineering guidance for equipment design for the fuel basin, facility modifications (upgrades), remote tools, and new processes. It is not intended to be a purchase order reference for vendors. The document identifies materials, methods, and components that work at K Basins; it also Provides design input and a technical review process to facilitate project interfaces with operations in K Basins. This document is intended to compliment other engineering documentation used at K Basins and throughout the Spent Nuclear Fuel Project. Significant provisions, which are incorporated, include portions of the following: General Design Criteria (DOE 1989), Standard Engineering Practices (WHC-CM-6-1), Engineering Practices Guidelines (WHC 1994b), Hanford Plant Standards (DOE-RL 1989), Safety Analysis Manual (WHC-CM-4-46), and Radiological Design Guide (WHC 1994f). Documents (requirements) essential to the engineering design projects at K Basins are referenced in the guidelines

Aligning guidelines and medical practice: Literature review on pediatric palliative care guidelines.

Science.gov (United States)

De Clercq, Eva; Rost, Michael; Pacurari, Nadia; Elger, Bernice S; Wangmo, Tenzin

2017-08-01

Palliative care for children is becoming an important subspecialty of healthcare. Although concurrent administration of curative and palliative care is recommended, timely referral to pediatric palliative care (PPC) services remains problematic. This literature review aims to identify barriers and recommendations for proper implementation of palliative care for children through the looking glass of PPC guidelines. To identify studies on PPC guidelines, five databases were searched systematically between 1960 and 2015: Scopus, PubMed, PsycINFO, the Web of Science, and CINAHL. No restrictions were placed on the type of methodology employed in the studies. Concerning barriers, most of the papers focused on gaps within medical practice and the lack of evidence-based research. Common recommendations therefore included: training and education of healthcare staff, formation of a multidisciplinary PPC team, research on the benefits of PPC, and raising awareness about PPC. A small number of publications reported on the absence of clear guidance in PPC documents regarding bereavement care, as well as on the difficulties and challenges involved in multidisciplinary care teams. Our results indicate that a critical assessment of both the research guidelines and medical practice is required in order to promote timely implementation of PPC for pediatric patients.

Preparation of CaO-SiO2-CuO bioactive glasses-embedded anodic alumina with improved biological activities

Directory of Open Access Journals (Sweden)

Ni Siyu

2017-10-01

Full Text Available To improve bone cell cytocompatibility properties of porous anodic alumina (PAA and implement anti-bacterial properties, amorphous CaO-SiO2-CuO materials were loaded into PAA nano-pores (termed CaO-SiO2- CuO/PAA by a facile ultrasonic-assisted sol-dipping strategy. The surface features and chemistry of the obtained CaO-SiO2-CuO/PAA were investigated by a field emission scanning microscope (FESEM, an energy-dispersive Xray spectrometer (EDS and an X-ray photoelectron spectroscopy (XPS. The ability of the CaO-SiO2-CuO/PAA specimens to form apatite via a bio-mineralization processwas evaluated by soaking them in simulated body fluid (SBF in vitro. The surface microstructure and chemical properties after soaking in SBFwere characterized. The release of ions into the SBF was also measured. In addition, rat osteoblasts and two types of bacterial were cultured on the samples to determine their cytocompatibility and antibacterial properties. The results showed that the amorphous CaO-SiO2-CuO materials were successfully decorated into PAA nano-pores and at the same time maintained their nano-featured surfaces. The CaO-SiO2-CuO/PAA samples induced apatite-mineralization in SBF. Meanwhile, the CaO-SiO2-CuO/PAA samples demonstrated great potential for promoting the proliferation of osteoblasts and inhibiting Escherichia coli (E. coli as well as Staphylococcus. aureus (S. aureus growth. Specifically, there was an 86.5±4.1% reduction in E. coli, an 88.0 ± 2.2% reduction in S. aureus for the CaO-SiO2-CuO/PAA surfaces compared to PAA controls. The capability to promote osteoblast proliferation and better antibacterial activity of CaO-SiO2- CuO/PAA may be attributed to the fact that Cu ions can be slowly and constantly released from the samples. Importantly, this was achieved without the use of antibiotics or any pharmaceutical agent. Ultimately, these results suggest that the CaO-SiO2-CuO/PAA substrates possessed improved bone cell cytocompatibility and high

Comparative Study of Molecular Basket Sorbents Consisting of Polyallylamine and Polyethylenimine Functionalized SBA-15 for CO2 Capture from Flue Gas.

Science.gov (United States)

Wang, Dongxiang; Wang, Xiaoxing; Song, Chunshan

2017-11-17

Polyallylamine (PAA)-based molecular basket sorbents (MBS) have been studied for CO 2 capture in comparison with polyethylenimine (PEI)-based MBS. The characterizations including N 2 physisorption, diffuse reflectance infrared Fourier transform spectroscopy (DRIFTS), and thermogravimetric analysis (TGA) showed that PAA (M n =15 000) is more rigid and has more steric hindrance inside SBA-15 pores than PEI owing mainly to its different polymer structure. The effects of temperature and PAA loading on the CO 2 sorption capacity of PAA-based MBS have been examined by TGA by using 100 % CO 2 gas stream and compared with PEI/SBA-15. It was found that the capacity of the PAA/SBA-15 sorbent increased with increasing temperature. The optimum capacity of 88 mg CO2  g sorb -1 was obtained at 140 °C for PAA(50)/SBA-15 whereas the optimum sorption temperature was 75 and 90 °C for PEI-I(50)/SBA-15 (PEI-I, M n =423) and PEI-II(50)/SBA-15 (PEI-II, M n =25 000), respectively. The capacity initially increased with the increase of PAA loading and then dropped at high amine contents, owing to the increased diffusion barrier. The highest CO 2 capacity of 109 mg CO2  g sorb -1 was obtained at a PAA loading of 65 wt %, whereas the PAA(50)/SBA-15 sorbent gave the best amine efficiency of 0.23 mol CO2  mol N -1 . The effect of moisture was examined in a fixed-bed flow system with simulated flue gas containing 15 % CO 2 and 4.5 % O 2 in N 2 . It was found that the presence of moisture significantly enhanced CO 2 sorption over PAA(50)/SBA-15 and greatly improved its cyclic stability and regenerability. Compared with PEI/SBA-15, PAA/SBA-15 possesses a better thermal stability and higher resistance to oxidative degradation. However, the CO 2 sorption rate over the PAA(50)/SBA-15 sorbent was much slower. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Mexican Guidelines on the Diagnosis and Treatment of Urticaria

Directory of Open Access Journals (Sweden)

Désirée Larenas-Linnemann

2014-11-01

Full Text Available Background: Urticaria is a disease that a fth of the population shall suffer once in a lifetime. Recent clinical guidelines have proposed some fundamental changes in the diagnosis and treatment of urticaria, making the development of a national, multidisciplinary guideline, with wide acceptability among different professional groups –both specialists and primary health care workers–, necessary in Mexico. Material and method: Internationally recognized tools for guideline- development were used. An interdisciplinary group of clinical experts (some of them knowledgeable in methodology of guideline develop- ment determined the objectives and scope of the Evidence Based Clinical Practice Guideline with SCOPE. It was decided to adapt and transculturize international guidelines on the diagnosis and treatment of urticaria. With AGREE-II three high-quality guidelines (Zuberbier 2014, Sánchez-Borges 2012, Powell 2007 were selected to function as basic guidelines (BG. A set of Clinical Questions was formulated that lead to recommendations/suggestions, based on these BG, taking into account the cultural and economic background of Mexico, according to GRADE recommendation development. Results: By a formal process of discussion and voting during several working-sessions, experts and rst level healthcare physicians deter- mined the wording of the nal guideline, taking particularly care of developing a document, adjusted to the reality, values and preferences of the Mexican patients. The use of oral second generation, non-sedating antihistamines as rst line treatment is emphasized. Conclusion: This document is an Evidence Based Clinical Practice Guideline for the diagnosis and treatment of acute and chronic urticaria, based on three, high quality, international guidelines. It was developed by a multidisciplinary group. Tables and algorithms make the guideline user-friendly for both, rst line health care physicians and specialists

Appraisal tools for clinical practice guidelines: a systematic review.

Directory of Open Access Journals (Sweden)

Ulrich Siering

Full Text Available Clinical practice guidelines can improve healthcare processes and patient outcomes, but are often of low quality. Guideline appraisal tools aim to help potential guideline users in assessing guideline quality. We conducted a systematic review of publications describing guideline appraisal tools in order to identify and compare existing tools.Among others we searched MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews from 1995 to May 2011 for relevant primary and secondary publications. We also handsearched the reference lists of relevant publications. On the basis of the available literature we firstly generated 34 items to be used in the comparison of appraisal tools and grouped them into thirteen quality dimensions. We then extracted formal characteristics as well as questions and statements of the appraisal tools and assigned them to the items.We identified 40 different appraisal tools. They covered between three and thirteen of the thirteen possible quality dimensions and between three and 29 of the possible 34 items. The main focus of the appraisal tools were the quality dimensions "evaluation of evidence" (mentioned in 35 tools; 88%, "presentation of guideline content" (34 tools; 85%, "transferability" (33 tools; 83%, "independence" (32 tools; 80%, "scope" (30 tools; 75%, and "information retrieval" (29 tools; 73%. The quality dimensions "consideration of different perspectives" and "dissemination, implementation and evaluation of the guideline" were covered by only twenty (50% and eighteen tools (45% respectively.Most guideline appraisal tools assess whether the literature search and the evaluation, synthesis and presentation of the evidence in guidelines follow the principles of evidence-based medicine. Although conflicts of interest and norms and values of guideline developers, as well as patient involvement, affect the trustworthiness of guidelines, they are currently insufficiently considered. Greater focus should be

Developing the Botswana Primary Care Guideline: an integrated, symptom-based primary care guideline for the adult patient in a resource-limited setting

Directory of Open Access Journals (Sweden)

Tsima BM

2016-08-01

Full Text Available Billy M Tsima,1 Vincent Setlhare,1 Oathokwa Nkomazana2 1Department of Family Medicine and Public Health, 2Department of Surgery, Faculty of Medicine, University of Botswana, Gaborone, Botswana Background: Botswana’s health care system is based on a primary care model. Various national guidelines exist for specific diseases. However, most of the guidelines address management at a tertiary level and often appear nonapplicable for the limited resources in primary care facilities. An integrated symptom-based guideline was developed so as to translate the Botswana national guidelines to those applicable in primary care. The Botswana Primary Care Guideline (BPCG integrates the care of communicable diseases, including HIV/AIDS and noncommunicable diseases, by frontline primary health care workers.Methods: The Department of Family Medicine, Faculty of Medicine, University of Botswana, together with guideline developers from the Knowledge Translation Unit (University of Cape Town collaborated with the Ministry of Health to develop the guideline. Stakeholder groups were set up to review specific content of the guideline to ensure compliance with Botswana government policy and the essential drug list.Results: Participants included clinicians, academics, patient advocacy groups, and policymakers from different disciplines, both private and public. Drug-related issues were identified as necessary for implementing recommendations of the guideline. There was consensus by working groups for updating the essential drug list for primary care and expansion of prescribing rights of trained nurse prescribers in primary care within their scope of practice. An integrated guideline incorporating common symptoms of diseases seen in the Botswana primary care setting was developed.Conclusion: The development of the BPCG took a broad consultative approach with buy in from relevant stakeholders. It is anticipated that implementation of the BPCG will translate into better

10 CFR 1023.9 - General guidelines.

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false General guidelines. 1023.9 Section 1023.9 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) CONTRACT APPEALS Overview: Organization, Functions and Authorities § 1023.9 General guidelines. (a) The principles of this Overview shall apply to all Board functions...

32 CFR 705.17 - Participation guidelines.

Science.gov (United States)

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Participation guidelines. 705.17 Section 705.17 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS PUBLIC AFFAIRS REGULATIONS § 705.17 Participation guidelines. (a) The provisions...

32 CFR 644.136 - Leasing guidelines.

Science.gov (United States)

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Leasing guidelines. 644.136 Section 644.136 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL PROPERTY REAL ESTATE HANDBOOK Acquisition Acquisition by Leasing § 644.136 Leasing guidelines. Division and District...

Clinical Practice Guidelines and Helicobacter pylori Infection in Children

Directory of Open Access Journals (Sweden)

Colin Macarthur

1999-01-01

Full Text Available The objective of this paper is to review the principles, methods and issues behind the development of clinical practice guidelines. Practice guidelines have been defined as “systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances”. The ultimate goal of guidelines is to improve patient outcomes; however, they may also be used as tools to decrease health care costs, improve medical education and enhance quality assurance. Evidence-based guidelines use explicit methods to link recommendations to the quality of the underlying research. Following development of the guideline, implementation and evaluation are key steps. The ultimate aim of guideline development is to influence physician knowledge, attitudes and behaviour.

Evaluation of thirteen haloacetic acids and ten trihalomethanes formation by peracetic acid and chlorine drinking water disinfection.

Science.gov (United States)

Xue, Runmiao; Shi, Honglan; Ma, Yinfa; Yang, John; Hua, Bin; Inniss, Enos C; Adams, Craig D; Eichholz, Todd

2017-12-01

Free chlorine is a commonly used disinfectant in drinking water treatment. However, disinfection by-products (DBPs) are formed during water disinfection. Haloacetic acids (HAAs) and trihalomethanes (THMs) are two major groups of DBPs. Iodo-HAAs and iodo-THMs (I-HAAs and I-THMs) are formed during the disinfection of the water containing high levels of iodide and are much more toxic than their chlorinated and brominated analogs. Peracetic acid (PAA) is a strong antimicrobial disinfectant that is expected to reduce the formation of HAAs and THMs during disinfection. In this study, the formations of thirteen HAAs and ten THMs, including the iodinated forms, have been investigated during PAA disinfection and chlorination as the comparison. The DBP formations under different iodide concentrations, pHs, and contact times were systematically investigated. Two types of commercial PAAs containing different concentrations of PAA and hydrogen peroxide (H 2 O 2 ) were studied. A solid-phase microextraction gas chromatography-mass spectrometry method was upgraded for THM analysis including I-THMs. HAAs were analyzed by following a recently developed high performance ion chromatography-tandem mass spectrometry method. Results show that the ratio of PAA and H 2 O 2 concentration significantly affect the formation of I-THMs and I-HAAs. During PAA disinfection with lower PAA than H 2 O 2 , no detectable levels of THMs and HAAs were observed. During PAA disinfection with higher PAA than H 2 O 2 , low levels of monoiodoacetic acid, diiodoacetic acid, and iodoform were formed, and these levels were enhanced with the increase of iodide concentration. No significant quantities of chloro- or bromo-THMs and HAAs were formed during PAA disinfection treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

7 CFR 611.10 - Standards, guidelines, and plans.

Science.gov (United States)

2010-01-01

... 7 Agriculture 6 2010-01-01 2010-01-01 false Standards, guidelines, and plans. 611.10 Section 611... § 611.10 Standards, guidelines, and plans. (a) NRCS conducts soil surveys under national standards and guidelines for naming, classifying, and interpreting soils and for disseminating soil survey information. (b...

49 CFR 350.339 - What are tolerance guidelines?

Science.gov (United States)

2010-10-01

... 49 Transportation 5 2010-10-01 2010-10-01 false What are tolerance guidelines? 350.339 Section 350... MOTOR CARRIER SAFETY ASSISTANCE PROGRAM Funding § 350.339 What are tolerance guidelines? Tolerance guidelines set forth the limited deviations from the FMCSRs allowed in your State's laws and regulations...

36 CFR 292.42 - Management standards and guidelines.

Science.gov (United States)

2010-07-01

... guidelines. 292.42 Section 292.42 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF... standards and guidelines. (a) In addition to existing statutory and regulatory authority governing administration of National Forest System lands and resources, the standards and guidelines in §§ 292.43 to 292.48...

40 CFR 60.35e - Waste management guidelines.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Waste management guidelines. 60.35e... (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Hospital/Medical/Infectious Waste Incinerators § 60.35e Waste management guidelines. For approval, a State...

Evaluation of Combined Peracetic acid and UV treatment for ...

Science.gov (United States)

The current study evaluates the effectiveness of the combined application of Peracetic acid and ultraviolet radiation as alternative disinfectant agents to the traditional chlorination of wastewater effluents. Various pathogens (E. coli, enterococci and fecal coliforms) were evaluated in the study. Four experiments were conducted using low to high PAA levels and UV dosages. E. coli and enterococci were resistant to low to moderate PAA dosage (0.5- 1 mg/L). These microbes can be removed effectively at high PAA dosage (2.5 mg/L) with 30 min contact time. Fecal coliforms were completely inactivated even at a low PAA dose of 0.7 mg/L. E. coli was more susceptible to UV disinfection than enterococci at low UV dosages. Enterococci required at least 40 mJ/cm2 for 2.5 log inactivation. In combined PAA + UV treatment, low UV intensities between 7 – 40 mJ/cm2 showed poor disinfection performance at a low PAA concentration of 1.5 mg/L. High UV intensities of 120 and 60 mJ/cm2 inactivated all the pathogens to below detection levels even at low to moderate PAA (0.7 mg/L and 1 mg/L) pretreatment concentration. Combined PAA + UV treatment at 1 mg/L (for 15 and 30 min contact time) + 120 and 60 mJ/cm2 did not show any regrowth of microbes, whereas PAA only disinfection with 15 min contact time showed regrowth of enterococci and fecal coliforms. UV only disinfection showed E. coli regrowth. • This pilot scale study was designed for providing necessary parameter optimization

12 CFR 618.8015 - Policy guidelines.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Policy guidelines. 618.8015 Section 618.8015 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM GENERAL PROVISIONS Related Services § 618.8015 Policy guidelines. (a) The board of directors of each System bank or association providing...

C2 Product-Centric Approach to Transforming Current C4ISR Information Architectures

Science.gov (United States)

2004-06-01

SAML) Privacy (P3P) Digital Rights Management (XrML) Content Mngmnt (DASL) (WebDAV) Content Syndicat’n (ICE) (RSS) Ontology (OML) (OWL) Resource...RNIF Registry/ Repository BPSS eCommerce XML/EDI Universal Business Language (UBL) Internet & Computing Human Resources (HR-XML) Semantic C2RM

Anbefalinger til organisering af uddannelserne

DEFF Research Database (Denmark)

Andersen, Lars; Andersen, Lars Døvling; Hornemann, Birte C.

2009-01-01

Notatet sammenfatter de diskussioner, som det af fakulteterne nedsatte udvalg vedrørende nye undervisnings- og eksamensformer har haft, og de anbefalinger til en omlægning af vores uddannelsessystem, som udvalget har valgt at give. Notatet er samtidig en begyndelse på en erfaringsudveksling om ny...

OSART guidelines. 1994 edition

International Nuclear Information System (INIS)

1994-05-01

These guidelines have been prepared to provide a basic structure and common reference both across the various areas covered by an OSART mission and across all the missions in the programme. As such, they are addressed, principally, to the team members of OSART missions but they will also provide guidance to a host nuclear plant preparing to receive a mission. The guidelines are intended to help each expert to formulate his review in the light of this own experience. They are not all inclusive and should not limit the expert's investigations, but are better considered as illustrating the adequate requirements for his review

Standard operating procedures for ESPEN guidelines and consensus papers.

Science.gov (United States)

Bischoff, Stephan C; Singer, Pierre; Koller, Michael; Barazzoni, Rocco; Cederholm, Tommy; van Gossum, André

2015-12-01

The ESPEN Guideline standard operating procedures (SOP) is based on the methodology provided by the Association of Scientific Medical Societies of Germany (AWMF), the Scottish Intercollegiate Guidelines Network (SIGN), and the Centre for Evidence-based Medicine at the University of Oxford. The SOP is valid and obligatory for all future ESPEN-sponsored guideline projects aiming to generate high-quality guidelines on a regular basis. The SOP aims to facilitate the preparation of guideline projects, to streamline the consensus process, to ensure quality and transparency, and to facilitate the dissemination and publication of ESPEN guidelines. To achieve this goal, the ESPEN Guidelines Editorial board (GEB) has been established headed by two chairmen. The GEB will support and supervise the guideline processes and is responsible for the strategic planning of ESPEN guideline activities. Key elements of the SOP are the generation of well-built clinical questions according to the PICO system, a systemic literature search, a classification of the selected literature according to the SIGN evidence levels providing an evidence table, and a clear and straight-forward consensus procedure consisting of online voting's and a consensus conference. Only experts who meet the obligation to disclosure any potential conflict of interests and who are not employed by the Industry can participate in the guideline process. All recommendations will be graded according to the SIGN grading and novel outcome models besides biomedical endpoints. This approach will further extent the leadership of ESPEN in creating up-to-date and suitable for implementation guidelines and in sharing knowledge on malnutrition and clinical nutrition. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Dually cross-linked single network poly(acrylic acid) hydrogels with superior mechanical properties and water absorbency.

Science.gov (United States)

Zhong, Ming; Liu, Yi-Tao; Liu, Xiao-Ying; Shi, Fu-Kuan; Zhang, Li-Qin; Zhu, Mei-Fang; Xie, Xu-Ming

2016-06-28

Poly(acrylic acid) (PAA) hydrogels with superior mechanical properties, based on a single network structure with dual cross-linking, are prepared by one-pot free radical polymerization. The network structure of the PAA hydrogels is composed of dual cross-linking: a dynamic and reversible ionic cross-linking among the PAA chains enabled by Fe(3+) ions, and a sparse covalent cross-linking enabled by a covalent cross-linker (Bis). Under deformation, the covalently cross-linked PAA chains remain intact to maintain their original configuration, while the Fe(3+)-enabled ionic cross-linking among the PAA chains is broken to dissipate energy and then recombined. It is found that the mechanical properties of the PAA hydrogels are significantly influenced by the contents of covalent cross-linkers, Fe(3+) ions and water, which can be adjusted within a substantial range and thus broaden the applications of the hydrogels. Meanwhile, the PAA hydrogels have excellent recoverability based on the dynamic and reversible ionic cross-linking enabled by Fe(3+) ions. Moreover, the swelling capacity of the PAA hydrogels is as high as 1800 times in deionized water due to the synergistic effects of ionic and covalent cross-linkings. The combination of balanced mechanical properties, efficient recoverability, high swelling capacity and facile preparation provides a new method to obtain high-performance hydrogels.

Defence strategies and antibiotic resistance gene abundance in enterococci under stress by exposure to low doses of peracetic acid.

Science.gov (United States)

Turolla, Andrea; Sabatino, Raffaella; Fontaneto, Diego; Eckert, Ester M; Colinas, Noemi; Corno, Gianluca; Citterio, Barbara; Biavasco, Francesca; Antonelli, Manuela; Mauro, Alessandro; Mangiaterra, Gianmarco; Di Cesare, Andrea

2017-10-01

Peracetic acid (PAA) is an organic compound used efficiently as disinfectant in wastewater treatments. Yet, at low doses it may cause selection; thus, the effect of low doses of PAA on Enterococcus faecium as a proxy of human-related microbial waste was evaluated. Bacteria were treated with increasing doses of PAA (from 0 to 25 mg L -1 min) and incubated in regrowth experiments under non-growing, limiting conditions and under growing, favorable conditions. The changes in bacterial abundance, in bacterial phenotype (number and composition of small cell clusters), and in the abundance of an antibiotic resistance gene (ARG) was evaluated. The experiment demonstrated that the selected doses of PAA efficiently removed enterococci, and induced a long-lasting effect after PAA inactivation. The relative abundance of small clusters increased during the experiment when compared with that of the inoculum. Moreover, under growing favorable conditions the relative abundance of small clusters decreased and the number of cells per cluster increased with increasing PAA doses. A strong stability of the measured ARG was found, not showing any effect during the whole experiment. The results demonstrated the feasibility of low doses of PAA to inactivate bacteria. However, the stress induced by PAA disinfection promoted a bacterial adaptation, even if potentially without affecting the abundance of the ARG. Copyright © 2017 Elsevier Ltd. All rights reserved.

In-Use Evaluation of Peracetic Acid for High-Level Disinfection of Endoscopes.

Science.gov (United States)

Chenjiao, Wu; Hongyan, Zhang; Qing, Gu; Xiaoqi, Zhong; Liying, Gu; Ying, Fang

2016-01-01

Many high-level disinfectants have been used for disinfection of endoscopes such as 2% glutaraldehyde (GA), 0.55% ortho-phthalaldehyde (OPA), and peracetic acid (PAA). Both GA and OPA are widely used in disinfection of endoscopes and have been previously discussed, but there is little research on the practical use of PAA as an endoscope disinfectant. An experimental model of a flexible gastrointestinal endoscope being contaminated with 9 strains of microorganism was designed. After the cleaning and disinfecting procedure was completed, we evaluated the biocidal activity (850 ppm PAA, 2% GA, and 0.55% OPA) on our flexible gastrointestinal endoscope model. We also evaluated sterilization effectiveness of PAA on other bacteria, including some antibiotic-resistant bacteria (methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and Clostridium difficile). The residual bacterial colony count number of the PAA-disinfected endoscope was significantly lower than that of the GA- and OPA-disinfected endoscopes. The biocidal effect and efficiency of the endoscope disinfection by PAA appeared to be better than either the GA- or OPA-disinfected endoscope. PAA has demonstrated a good sterilization effect on other bacterial species; of particular note are common antibiotic-resistant bacteria such as methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and Clostridium difficile. The results of this study demonstrate that PAA is a fast and effective high-level disinfectant for use in the reprocessing of flexible endoscopes.

Clinical algorithms to aid osteoarthritis guideline dissemination

DEFF Research Database (Denmark)

Meneses, S. R. F.; Goode, A. P.; Nelson, A. E

2016-01-01

Background: Numerous scientific organisations have developed evidence-based recommendations aiming to optimise the management of osteoarthritis (OA). Uptake, however, has been suboptimal. The purpose of this exercise was to harmonize the recent recommendations and develop a user-friendly treatment...... algorithm to facilitate translation of evidence into practice. Methods: We updated a previous systematic review on clinical practice guidelines (CPGs) for OA management. The guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation for quality and the standards for developing...... to facilitate the implementation of guidelines in clinical practice are necessary. The algorithms proposed are examples of how to apply recommendations in the clinical context, helping the clinician to visualise the patient flow and timing of different treatment modalities. (C) 2016 Osteoarthritis Research...

Radiooncological guidelines. Radiotherapy of breast cancer. 2005 version

International Nuclear Information System (INIS)

Sauer, R.

2006-01-01

This is an updated and revised version of the DEGRO guideline of October 1999. The DEGRO guideline was updated with the focus on specific radiooncology aspects. It is based on the interdisciplinary guideline of Deutsche Krebsgesellschaft (DKG) and the contributing medical associations. This guideline, 'Diagnostik, Therapie und Nachsorge des Mammakarzinoms der Frau', was published by Informationszentrum fuer Standards in der Onkologie (ISTO) of Deutsche Krebsgesellschaft. The June 2004 version was also published as a book by AWMF and is available on the web under the register number 032/045 (www.leitlinien.net). (orig.)

A comparative review of pharmacoeconomic guidelines.

Science.gov (United States)

Jacobs, P; Bachynsky, J; Baladi, J F

1995-09-01

We have reviewed 4 international sets of guidelines for the economic evaluation of pharmaceutical products-those of the Australian Pharmaceutical Benefits Advisory Committee, the Canadian Coordinating Office for Health Technology Assessment, the Ontario Ministry of Health, and the England and Wales Department of Health. Comparison of these guidelines reveals that there are a number of differences between them, including disparities in outcome selection, costs and perspectives. These observations were attributed to differences in study purpose, conceptual approach, measurement techniques and value judgements. Uniformity can be achieved only in conceptual approach and measurement technique. Guidelines should be flexible to accommodate differences in the study purposes and value judgements of the analysts.

Conflict of Interest Policies and Industry Relationships of Guideline Development Group Members: A Cross-Sectional Study of Clinical Practice Guidelines for Depression.

Science.gov (United States)

Cosgrove, Lisa; Krimsky, Sheldon; Wheeler, Emily E; Peters, Shannon M; Brodt, Madeline; Shaughnessy, Allen F

2017-01-01

Because of increased attention to the issue of trustworthiness of clinical practice guidelines, it may be that both transparency and management of industry associations of guideline development groups (GDGs) have improved. The purpose of the present study was to assess a) the disclosure requirements of GDGs in a cross-section of guidelines for major depression; and, b) the extent and type of conflicts of panel members. Treatment guidelines for major depression were identified and searched for conflict of interest policies and disclosure statements. Multi-modal screens for undeclared conflicts were also conducted. Fourteen guidelines with a total of 172 panel members were included in the analysis. Eleven of the 14 guidelines (78%) had a stated conflict of interest policy or disclosure statement, although the policies varied widely. Most (57%) of the guidelines were developed by panels that had members with industry financial ties to drug companies that manufacture antidepressant medication. However, only a minority of total panel members (18%) had such conflicts of interest. Drug company speakers bureau participation was the most common type of conflict. Although some progress has been made, organizations that develop guidelines should continue to work toward greater transparency and minimization of financial conflicts of interest.

Use of Standard Guidelines for Department of Medicine Summary Letters.

Science.gov (United States)

Fitz, Matthew; La Rochelle, Jeffrey; Lang, Valerie; DeWaay, Deborah; Adams, William; Nasraty, Farah

2018-04-12

Phenomenon: Fourth-year medical students obtain Department of Medicine (DOM) letters ("Chair" letters) to support their residency applications. Writing and interpreting DOM letters are challenging. There is heterogeneity in the letters that makes it difficult to both write and read these letters. The purpose of this study is to determine the value of new guidelines developed by a task force of clerkship directors and program directors in internal medicine and assess the implementation of these guidelines. The Clerkship Directors in Internal Medicine performed a cross-sectional survey of internal medicine clerkship directors at U.S. and Canadian medical schools in 2014. In addition, the primary author's institution reviewed 1,347 DOM letters between 2012 and 2014 to assess the implementation of these guidelines. The survey response rate was 78%. DOM letter writers reported the guidelines were better, easier to implement, and more compatible with the purpose of DOM letters than previously. Most letter readers reported that letters using the guidelines were more credible. Writers of DOM letters in lower academic ranks rated the letters with guidelines higher in several domains than those in higher academic ranks. Readers of DOM letters in higher academic ranks rated the letters with guidelines higher in several domains than those in lower academic ranks. In the DOM letters examined, the odds of meeting each guideline increased with each additional year. However, for 3 guidelines there was an initial decline in adherence from 2012 to 2013 before increasing again in 2014-the recommended length, clerkship description, and detailed narrative guidelines. Letters solely written by a chair were less likely to incorporate the guidelines. Insights: Clerkship directors often write the DOM letters and identify with the purpose of the guidelines. As writers, lower ranking academic faculty value the guidelines more than higher ranking academic faculty. As readers of DOM letters

EMI Messaging Guidelines

CERN Document Server

Cons, L.

2011-01-01

Guidelines for potential users of messaging within EMI. The goal is to provide enough practical information so that EMI product teams can start investigating whether using messaging in their products can be beneficial or not.

25 CFR 163.81 - Assessment guidelines.

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Assessment guidelines. 163.81 Section 163.81 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER GENERAL FORESTRY REGULATIONS Program Assessment § 163.81 Assessment guidelines. Assessments shall be national in scope and shall include: (a) An...

Adult Asthma Consensus Guidelines Update 2003

Directory of Open Access Journals (Sweden)

Catherine Lemière

2004-01-01

Full Text Available BACKGROUND: Several sets of Canadian guidelines for the diagnosis and management of asthma have been published over the past 15 years. Since the last revision of the 1999 Canadian Asthma Consensus Report, important new studies have highlighted the need to incorporate new information into the asthma guidelines.

Guidelines Gas Act. Information and Consultation Document 2001

International Nuclear Information System (INIS)

De Groene, P.; Teljeur, E.; Verdonkschot, I.R.

2001-06-01

This Information and Consultation Document has been drawn up for the consultation period that will be held prior to the approval of the new Guidelines, in accordance with sections 13 and 18 of the Dutch Gas Act. In determining the topics for discussion in the consultation document, DTe has based its decision on the scope and aim of these Guidelines. In doing so, DTe's objective is to achieve these aims in a responsible manner, with limited interventions in the market. The Guidelines focus firstly on gas transport companies, in so far as they transport gas to supply eligible customers. In the year 2002, customers with an annual off-take of 1 million m 3 or more will be eligible. Secondly, the Guidelines focus on gas storage companies that have a dominant position or are deemed to have a dominant position, in accordance with section 18(2) of the Gas Act. In determining the Guidelines, in accordance with section 13(1) of the Gas Act, the Director of DTe has to take into account the promotion of trade and the promotion of the efficient operation of gas transport companies and users of the gas network. In addition, it appears from the Parliamentary Proceedings that the Guidelines also have the aim of preventing abuse of a dominant position. This document indicates the way DTe intends to achieve the statutory aims referred to above. Partly on the basis of experience in other countries, DTe assumes that realising these aims and creating a 'level playing field' on the Dutch gas market is a gradual process that may take several years. It will not be possible to realise all the conditions for achieving the above-mentioned objectives, as outlined by DTe in the Information and Consultation Document, in 2002. DTe therefore intends to limit the Guidelines for the year 2002 to the conditions that have priority. The aim of the consultation process and the responses of the various markets players is partly to determine the conditions that have priority. For the purposes of

Highly Sensitive and Selective In-Situ SERS Detection of Pb(2+), Hg(2+), and Cd(2+) Using Nanoporous Membrane Functionalized with CNTs.

Science.gov (United States)

Shaban, Mohamed; Galaly, A R

2016-05-04

Porous Anodic Alumina (PAA) membrane was functionalized with CoFe2O4 nanoparticles and used as a substrate for the growing of very long helical-structured Carbon Nanotubes (CNTs) with a diameter less than 20 nm. The structures and morphologies of the fabricated nanostructures were characterized by field emission- scanning electron microscopy (FE-SEM), energy dispersive X-ray (EDX), and Raman spectroscopy. By uploading the CNTs on PAA, the characteristic Raman peaks of CNTs and PAA showed 4 and 3 times enhancement, respectively, which leads to more sensitive Surface-Enhanced Raman Spectroscopy (SERS) substrates. For comparison, PAA and CNTs/PAA arrays were used as SERS substrates for the detection of Hg(2+), Cd(2+), and Pb(2+). The proposed sensor demonstrated high sensitivity and selectivity between these heavy metal ions. CNTs/PAA sensor showed excellent selectivity toward Pb(2+) over other metal ions, where the enhancement factor is decreased from ~17 for Pb(2+) to ~12 for Hg(2+) and to ~4 for Cd(2+). Therefore, the proposed CNTs/PAA sensor can be used as a powerful tool for the determination of heavy metal ions in aqueous solutions.

Highly Sensitive and Selective In-Situ SERS Detection of Pb2+, Hg2+, and Cd2+ Using Nanoporous Membrane Functionalized with CNTs

Science.gov (United States)

Shaban, Mohamed; Galaly, A. R.

2016-01-01

Porous Anodic Alumina (PAA) membrane was functionalized with CoFe2O4 nanoparticles and used as a substrate for the growing of very long helical-structured Carbon Nanotubes (CNTs) with a diameter less than 20 nm. The structures and morphologies of the fabricated nanostructures were characterized by field emission- scanning electron microscopy (FE-SEM), energy dispersive X-ray (EDX), and Raman spectroscopy. By uploading the CNTs on PAA, the characteristic Raman peaks of CNTs and PAA showed 4 and 3 times enhancement, respectively, which leads to more sensitive Surface-Enhanced Raman Spectroscopy (SERS) substrates. For comparison, PAA and CNTs/PAA arrays were used as SERS substrates for the detection of Hg2+, Cd2+, and Pb2+. The proposed sensor demonstrated high sensitivity and selectivity between these heavy metal ions. CNTs/PAA sensor showed excellent selectivity toward Pb2+ over other metal ions, where the enhancement factor is decreased from ~17 for Pb2+ to ~12 for Hg2+ and to ~4 for Cd2+. Therefore, the proposed CNTs/PAA sensor can be used as a powerful tool for the determination of heavy metal ions in aqueous solutions. PMID:27143512

Adherence to management guidelines for childhood asthma in Australia.

Science.gov (United States)

Bereznicki, Bonnie J; Beggs, Sean; Duff, Caitlin; Bereznicki, Luke

2015-12-01

Little is known about doctors' treatment preferences for childhood asthma. The aim of this study was to investigate adherence to management guidelines for childhood asthma. One thousand general practitioners (GPs) and paediatric specialists in Australia were invited to take part in a survey, which collected demographic details and explored their familiarity with and adherence to childhood asthma management guidelines. Two hundred doctors (20% response rate) responded and were eligible for inclusion in the survey. Approximately half (54.5%) of the respondents were very familiar with at least one of the childhood asthma management guidelines. The majority of respondents (86.8%) followed guideline recommendations when prescribing initial maintenance therapy for childhood asthma, while 89.2% and 68.0% followed guideline recommendations regarding step-up and step-down therapy respectively. Overall familiarity with childhood asthma management guidelines could be improved. There is scope for improvement in the adherence to these guidelines when prescribing medication in childhood asthma, particularly for step-down therapy.

Identifying target audiences: who are the guidelines for? : article 1 in Integrating and coordinating efforts in COPD guideline development. An official ATS/ERS workshop report.

Science.gov (United States)

Yawn, Barbara P; Akl, Elie A; Qaseem, Amir; Black, Peter; Campos-Outcalt, Doug

2012-12-01

Professional societies, like many other organizations around the world, have recognized the need to use rigorous processes to ensure that health care recommendations are informed by the best available research evidence. Different clinical practice guidelines addressing the management of the same disease may vary widely in the evidence used and the format of the recommendations, with the result that not all are appropriate for all audiences. This is the first of a series of 14 articles that clinicians, methodologists, and researchers from around the world prepared to advise those developing guidelines in respiratory and other diseases about the potential impact of identifying the target audiences for their clinical practice guidelines. In this review we address the following questions. (1) Which audiences are interested in a chronic obstructive pulmonary disease (COPD) guideline? (2) How many audiences can be addressed in a single COPD guideline? (3) What is the purpose of the guidelines? (4) Who should be included on the guideline panel? We collected information by searching PubMed and reviewing information from groups that are currently making and using respiratory disease guidelines, as well as from workshop discussions. Our conclusions are based on available evidence, consideration of what guideline developers are doing, and the opinions of those who attended the workshop. Clinicians desire COPD and other guidelines that are concise, use evidence from practices similar to theirs, and whose authors have expertise in providing care in similar settings and with similar patients. In the case of COPD, barriers to generalists' use of guidelines include lack of awareness of the guidelines, failure to embrace the diagnostic methods as capable of providing definitive confirmation of COPD, and, most importantly, failure of previous guidelines to address the treatment of COPD in the context of the broad range of multiple morbidities that affect most people with COPD. COPD

Review on Factors Influencing Physician Guideline Adherence in Cardiology.

Science.gov (United States)

Hoorn, C J G M; Crijns, H J G M; Dierick-van Daele, A T M; Dekker, L R C

2018-04-09

Cardiovascular disease is the most common cause of death in Western countries. Physician adherence to guidelines is often suboptimal, resulting in impaired patient outcome and prognosis. Multiple studies have been conducted to evaluate patterns and the influencing factors of patient adherence, but little is known about factors influencing physician guideline adherence. This review aims to identify factors influencing physician guideline adherence relevant to cardiology and to provide insights and suggestions for future improvement. Physician adherence was measured as adherence to standard local medical practice and applicable guidelines. Female gender and older age had a negative effect on physician guideline adherence. In addition, independent of the type of heart disease, physicians without cardiologic specialization were linked to physician noncompliance. Also, guideline adherence in primary care centers was at a lower level compared to secondary or tertiary care centers. The importance of guideline adherence increases as patients age, and complex diseases and comorbidity arise. Appropriate resources and interventions, taking important factors for nonadherence in account, are necessary to improve guideline adoption and adherence in every level of the chain. This in turn should improve patient outcome.

Guidelines for reporting evaluations based on observational methodology.

Science.gov (United States)

Portell, Mariona; Anguera, M Teresa; Chacón-Moscoso, Salvador; Sanduvete-Chaves, Susana

2015-01-01

Observational methodology is one of the most suitable research designs for evaluating fidelity of implementation, especially in complex interventions. However, the conduct and reporting of observational studies is hampered by the absence of specific guidelines, such as those that exist for other evaluation designs. This lack of specific guidance poses a threat to the quality and transparency of these studies and also constitutes a considerable publication hurdle. The aim of this study thus was to draw up a set of proposed guidelines for reporting evaluations based on observational methodology. The guidelines were developed by triangulating three sources of information: observational studies performed in different fields by experts in observational methodology, reporting guidelines for general studies and studies with similar designs to observational studies, and proposals from experts in observational methodology at scientific meetings. We produced a list of guidelines grouped into three domains: intervention and expected outcomes, methods, and results. The result is a useful, carefully crafted set of simple guidelines for conducting and reporting observational studies in the field of program evaluation.

Toward improved guideline quality: using the COGS statement with GEM.

Science.gov (United States)

Shiffman, Richard N; Michel, Georges

2004-01-01

The Conference on Guideline Standardization (COGS) was convened to create a standardized documentation checklist for clinical practice guidelines in an effort to promote guideline quality and facilitate implementation. The statement was created by a multidisciplinary panel using a rigorous consensus development methodology. The Guideline Elements Model (GEM) provides a standardized approach to representing guideline documents using XML. In this work, we demonstrate the sufficiency of GEM for describing COGS components. Using the mapping between COGS and GEM elements we built an XSLT application to examine a guideline's adherence (or non-adherence) to the COGS checklist. Once a guideline has been marked up according to the GEM hierarchy, its knowledge content can be reused in multiple ways.

Inconsistencies in clinical guidelines for obstetric anaesthesia for Caesarean section

DEFF Research Database (Denmark)

Winther, Lars; Mitchell, A U; Møller, Ann

2013-01-01

Anaesthetists need evidence-based clinical guidelines, also in obstetric anaesthesia. We compared the Danish, English, American, and German national guidelines for anaesthesia for Caesarean section. We focused on assessing the quality of guideline development and evaluation of the guidelines...

Peracetic acid is a suitable disinfectant for recirculating fish-microalgae integrated multi-trophic aquaculture systems

DEFF Research Database (Denmark)

Liu, Dibo; Behrens, Sascha; Pedersen, Lars-Flemming

2016-01-01

culture of a marine microalgae Tetraselmis chuii once per day for four days to four PAA productswith differing hydrogen peroxide (H2O2)/PAA proportions at two concentrations (1 and 2 mg L−1PAA).The H2O2solutions at equivalent total peroxide (H2O2+ PAA) concentrations were tested in parallel. Theresults...... show that the growth and photosynthesis of T. chuii were not affected by three of the PAA prod-ucts (Wofasteril®E400, Wofasteril®E250 and Applichem®150) and equivalent H2O2solutions at bothconcentrations. In contrast, Wofasteril®Lspez and an equivalent H2O2solution at both concentrationscaused...... which are effective against these threats, but safe to fish and microalgae. For this purpose,peracetic acid (PAA) is a valid option because it is highly effective against fish pathogens and bacteria atlow concentrations and degrades spontaneously to harmless residues. In the present study, we exposedthe...

Self-Assembly Assisted Fabrication of Dextran-Based Nanohydrogels with Reduction-Cleavable Junctions for Applications as Efficient Drug Delivery Systems

Science.gov (United States)

Wang, Hao; Dai, Tingting; Zhou, Shuyan; Huang, Xiaoxiao; Li, Songying; Sun, Kang; Zhou, Guangdong; Dou, Hongjing

2017-01-01

In order to overcome the key challenge in improving both fabrication efficiency and their drug delivery capability of anti-cancer drug delivery systems (ACDDS), here polyacrylic acid (PAA) grafted dextran (Dex) nanohydrogels (NGs) with covalent crosslinked structure bearing redox sensitive disulfide crosslinking junctions (Dex-SS-PAA) were synthesized efficiently through a one-step self-assembly assisted methodology (SAA). The Dex-SS-PAA were subsequently conjugated with doxorubicin through an acid-labile hydrazone bond (Dex-SS-PAA-DOX). The in vitro drug release behavior, anti-cancer effects in vivo, and biosafety of the as-prepared acid- and redox-dual responsive biodegradable NGs were systematically investigated. The results revealed that the Dex-SS-PAA-DOX exhibited pH- and redox-controlled drug release, greatly reduced the toxicity of free DOX, while exhibiting a strong ability to inhibit the growth of MDA-MB-231 tumors. Our study demonstrated that the Dex-SS-PAA-DOX NGs are very promising candidates as ACDDS for anti-cancer therapeutics.

Overview and status of Department of Energy siting guidelines

International Nuclear Information System (INIS)

Hanlon, C.

1984-01-01

One of the initial requirements of the Nuclear Waste Policy Act of 1982 was the development of siting guidelines for use in the selection of repository sites. The key issues raised during the consultation process are summarized as follows: the use of NRC and EPA regulations; the application of the guidelines in the siting process; the structure and specificity of the guidelines; the relationship between system and technical guidelines; the use of the systems approach in evaluating the overall performance of the repository system; the relative importance of individual guidelines; the degree of reliance placed on engineered barriers; impacts on the local population; impacts on the environment; protection of ground-water resources; and transportation. All of these issues were considered in revising the guidelines, and the responses to them are summarized in general terms