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Sample records for instrumental delivery rates

  1. [French residents' training in instrumental deliveries: A national survey].

    Science.gov (United States)

    Saunier, C; Raimond, E; Dupont, A; Pelissier, A; Bonneau, S; Gabriel, R; Graesslin, O

    2016-11-01

    To evaluate French residents in Obstetrics and Gynaecology's training in instrumental deliveries in 2015. We conducted a national descriptive survey among 758 residents between December 2014 and January 2015. Respondents were invited by email to specify their University Hospital, their current university term, the number of instrumental deliveries performed by vacuum extractor, forceps or spatulas, and whether they made systematic ultrasound exams before performing the extraction. Response rate was 34.7 % (n=263). There were important differences between regions in terms of type of instruments used. Vacuum extractor was the most commonly used instrument for instrumental deliveries by French residents (56.9 %), more than forceps (25.2 %) and spatulas (17.9 %). At the end of the residency, all the residents had been trained in instrumental deliveries with at least two instruments. The training of difficult techniques as well as their perfect control is required for instrumental deliveries. Yet, we are forced to note that there are substantial differences in the French residents' training in instrumental deliveries depending on their region. So, teaching at least two techniques seems essential as well as improving the training capacities and standardizing practices. A greater systematization of the teaching of the mechanics and obstetric techniques might be a solution to be considered too. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  2. Risk factors for cesarean section and instrumental vaginal delivery after successful external cephalic version.

    Science.gov (United States)

    de Hundt, Marcella; Vlemmix, Floortje; Bais, Joke M J; de Groot, Christianne J; Mol, Ben Willem; Kok, Marjolein

    2016-01-01

    Aim of this article is to examine if we could identify factors that predict cesarean section and instrumental vaginal delivery in women who had a successful external cephalic version. We used data from a previous randomized trial among 25 hospitals and their referring midwife practices in the Netherlands. With the data of this trial, we performed a cohort study among women attempting vaginal delivery after successful ECV. We evaluated whether maternal age, gestational age, parity, time interval between ECV and delivery, birth weight, neonatal gender, and induction of labor were predictive for a vaginal delivery on one hand or a CS or instrumental vaginal delivery on the other hand. Unadjusted and adjusted odds ratios were calculated with univariate and multivariate logistic regression analysis. Among 301 women who attempted vaginal delivery after a successful external cephalic version attempt, the cesarean section rate was 13% and the instrumental vaginal delivery rate 6%, resulting in a combined instrumental delivery rate of 19%. Nulliparity increased the risk of cesarean section (OR 2.7 (95% CI 1.2-6.1)) and instrumental delivery (OR 4.2 (95% CI 2.1-8.6)). Maternal age, gestational age at delivery, time interval between external cephalic version and delivery, birth weight and neonatal gender did not contribute to the prediction of failed spontaneous vaginal delivery. In our cohort of 301 women with a successful external cephalic version, nulliparity was the only one of seven factors that predicted the risk for cesarean section and instrumental vaginal delivery.

  3. Instrumental vaginal delivery - an assessment of use in a tertiary ...

    African Journals Online (AJOL)

    O'SHEHU

    Results: The incidence of instrumental vaginal delivery was 1.06% of all deliveries ... and the most common maternal complication was post-partum ... that in modern obstetric practice, the goal is ... expulsive efforts due to fatigue or exhaustion.

  4. Instrumental delivery: clinical practice guidelines from the French College of Gynaecologists and Obstetricians.

    Science.gov (United States)

    Vayssière, Christophe; Beucher, Gael; Dupuis, Olivier; Feraud, Olivia; Simon-Toulza, Caroline; Sentilhes, Loïc; Meunier, Emmanuelle; Parant, Olivier; Schmitz, Thomas; Riethmuller, Didier; Baud, Olivier; Galley-Raulin, Fabienne; Diemunsch, Pierre; Pierre, Fabrice; Schaal, Jean-Patrick; Fournié, Alain; Oury, Jean François

    2011-11-01

    Routine use of a partograph is associated with a reduction in the use of forceps, but is not associated with a reduction in the use of vacuum extraction (Level A). Early artificial rupture of the membranes, associated with oxytocin perfusion, does not reduce the number of operative vaginal deliveries (Level A), but does increase the rate of fetal heart rate abnormalities (Level B). Early correction of lack of progress in dilatation by oxytocin perfusion can reduce the number of operative vaginal deliveries (Level B). The use of low-concentration epidural infusions of bupivacaine potentiated by morphinomimetics reduces the number of operative interventions compared with larger doses (Level A). Placement of an epidural before 3-cm dilatation does not increase the number of operative vaginal deliveries (Level A). Posterior positions of the fetus result in more operative vaginal deliveries (Level B). Manual rotation of the fetus from a posterior position to an anterior position may reduce the number of operative deliveries (Level C). Walking during labour is not associated with a reduction in the number of operative vaginal deliveries (Level A). Continuous support of the parturient by a midwife or partner/family member during labour reduces the number of operative vaginal deliveries (Level A). Under epidural analgesia, delayed pushing (2h after full dilatation) reduces the number of difficult operative vaginal deliveries (Level A). Ultrasound is recommended if there is any clinical doubt about the presentation of the fetus (Level B). The available scientific data are insufficient to contra-indicate attempted midoperative delivery (professional consensus). The duration of the operative intervention is slightly shorter with forceps than with a vacuum extractor (Level C). Nonetheless, the urgency of operative delivery is not a reason to choose one instrument over another (professional consensus). The cup-shaped vacuum extractor seems to be the instrument of choice for

  5. Instrumental vaginal delivery - an assessment of use in a tertiary ...

    African Journals Online (AJOL)

    Background: Majority of women in sub-Saharan Africa expect to achieve spontaneous vaginal delivery at the end of pregnancy. This is usually possible, but, a few women will receive one form of assistance or another (forceps or vacuum) to avert maternal or foetal morbidity or mortality. Training and research in instrumental ...

  6. Obstetric anal sphincter injury rates among primiparous women with different modes of vaginal delivery.

    Science.gov (United States)

    Ampt, Amanda J; Patterson, Jillian A; Roberts, Christine L; Ford, Jane B

    2015-12-01

    To determine whether rates of obstetric anal sphincter injuries (OASIS) are continuing to increase and whether risk of OASIS according to mode of delivery is constant over time. In a retrospective population-based study, data were obtained for vaginal singleton vertex deliveries at 37-41 weeks of pregnancy among primiparous women in New South Wales, Australia, between January 2001 and December 2011. Annual OASIS rates were determined among non-instrumental, forceps, and vacuum deliveries with and without episiotomy. Multivariable logistic regression was used to determine adjusted odds ratios for each delivery mode category by year. Trends in adjusted odds ratios over time for each delivery category were compared. OASIS occurred in 955 (4.1%) of 23 081 deliveries in 2001 and 1487 (5.9%) of 25 081 deliveries in 2011. After adjustment for known risk factors, the only delivery categories to show statistically significant increases in OASIS over the study period were non-instrumental deliveries without episiotomy (linear trend Pdeliveries with episiotomy (linear trend P=0.004). Overall, OASIS rates have continued to increase. Known risk factors do not fully explain the increase in OASIS rates in non-instrumental deliveries without an episiotomy and in forceps deliveries with an episiotomy. Crown Copyright © 2015. Published by Elsevier Ireland Ltd. All rights reserved.

  7. Effects of epidural analgesia on labor length, instrumental delivery, and neonatal short-term outcome.

    Science.gov (United States)

    Hasegawa, Junichi; Farina, Antonio; Turchi, Giovanni; Hasegawa, Yuko; Zanello, Margherita; Baroncini, Simonetta

    2013-02-01

    We aimed to clarify whether the short-term adverse neonatal outcomes associated with epidural analgesia are due to the epidural analgesia itself or to the instrumental delivery. A retrospective case-control study was conducted to evaluate the relationship between epidural analgesia, labor length, and perinatal outcomes. A total of 350 pregnant women at term who delivered under epidural analgesia (cases) were compared with 1400 patients without epidural analgesia (controls). Vacuum extraction (6.5 vs. 2.9 %) and cesarean section (19.9 vs. 11.1 %) were more frequently performed in the cases than controls (p neonatal variables stratified by mode of delivery were not different in cases and controls, except for a slightly lower umbilical arterial pH in spontaneous delivery for the cases group. However, the Apgar scores and umbilical arterial pH were significantly lower in the neonates delivered by vacuum extraction compared with those in the neonates delivered by spontaneous delivery or cesarean section, regardless of whether epidural analgesia was performed. A multivariable analysis showed that vacuum extraction much more consistently affected the arterial pH than the analgesia itself (the β coefficients were -0.036 for epidural analgesia vs. -0.050 for vacuum extraction). Epidural analgesia was associated with slowly progressing labor, thus resulting in an increased rate of instrumental delivery. This instrumental delivery appears to adversely affect the neonatal outcomes more strongly than the analgesia itself.

  8. A rating instrument for fear of hospitalisation.

    Science.gov (United States)

    Jankovic, Slobodan M; Antonijevic, Gordana V; Vasic, Ivana R; Zivkovic-Radojevic, Marija N; Mirkovic, Snjezana N; Nikolic, Bosko V; Opancina, Valentina D; Putnik, Srdjan S; Radoicic, Ljiljana R; Raspopovic, Katarina M; Stanojevic, Dragan R; Teofilov, Sladjana D; Tomasevic, Katarina V; Radonjic, Vesela

    2018-04-01

    To develop and validate a reliable instrument that can measure fear of hospitalisation experienced by outpatients. After having a diagnosis established, some patients experience sense of fear, unpleasantness and embarrassment due to the possibility to be admitted to a hospital. Currently, there is no available instrument for measuring fear of hospitalisation. Cross-sectional study for assessing reliability and validity of a questionnaire. The questionnaire with 17 items and answers according to the Likert scale was developed during two brainstorming sessions of the research team. Its reliability, validity and temporal stability were tested on the sample of 330 outpatients. The study was multicentric, involving patients from seven cities and three countries. Fear of hospitalisation scale showed satisfactory reliability, when rated both by the investigators (Cronbach's alpha .799) and by the patients themselves (Cronbach's alpha .760). It is temporally stable, and both divergent and convergent validity tests had good results. Factorial analysis revealed three domains: fear of being injured, trust to medical staff and fear of losing privacy or autonomy. This study developed new reliable and valid instrument for measuring fear of hospitalisation. Identification of patients with high level of fear of hospitalisation by this instrument should help clinicians to administer measures which may decrease fear and prevent avoidance of healthcare utilisation. © 2018 John Wiley & Sons Ltd.

  9. Study Protocol. IDUS -- Instrumental delivery & ultrasound. A multi-centre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery

    LENUS (Irish Health Repository)

    Murphy, Deirdre J

    2012-09-13

    AbstractBackgroundInstrumental deliveries are commonly performed in the United Kingdom and Ireland, with rates of 12 – 17% in most centres. Knowing the exact position of the fetal head is a pre-requisite for safe instrumental delivery. Traditionally, diagnosis of the fetal head position is made on transvaginal digital examination by delineating the suture lines of the fetal skull and the fontanelles. However, the accuracy of transvaginal digital examination can be unreliable and varies between 20% and 75%. Failure to identify the correct fetal head position increases the likelihood of failed instrumental delivery with the additional morbidity of sequential use of instruments or second stage caesarean section. The use of ultrasound in determining the position of the fetal head has been explored but is not part of routine clinical practice.Methods\\/DesignA multi-centre randomised controlled trial is proposed. The study will take place in two large maternity units in Ireland with a combined annual birth rate of 13,500 deliveries. It will involve 450 nulliparous women undergoing instrumental delivery after 37 weeks gestation. The main outcome measure will be incorrect diagnosis of the fetal head position. A study involving 450 women will have 80% power to detect a 10% difference in the incidence of inaccurate diagnosis of the fetal head position with two-sided 5% alpha.DiscussionIt is both important and timely to evaluate the use of ultrasound to diagnose the fetal head position prior to instrumental delivery before routine use can be advocated. The overall aim is to reduce the incidence of incorrect diagnosis of the fetal head position prior to instrumental delivery and improve the safety of instrumental deliveries.Trial registrationCurrent Controlled Trials ISRCTN72230496

  10. Study Protocol. IDUS – Instrumental delivery & ultrasound. A multi-centre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery

    Directory of Open Access Journals (Sweden)

    Murphy Deirdre J

    2012-09-01

    Full Text Available Abstract Background Instrumental deliveries are commonly performed in the United Kingdom and Ireland, with rates of 12 – 17% in most centres. Knowing the exact position of the fetal head is a pre-requisite for safe instrumental delivery. Traditionally, diagnosis of the fetal head position is made on transvaginal digital examination by delineating the suture lines of the fetal skull and the fontanelles. However, the accuracy of transvaginal digital examination can be unreliable and varies between 20% and 75%. Failure to identify the correct fetal head position increases the likelihood of failed instrumental delivery with the additional morbidity of sequential use of instruments or second stage caesarean section. The use of ultrasound in determining the position of the fetal head has been explored but is not part of routine clinical practice. Methods/Design A multi-centre randomised controlled trial is proposed. The study will take place in two large maternity units in Ireland with a combined annual birth rate of 13,500 deliveries. It will involve 450 nulliparous women undergoing instrumental delivery after 37 weeks gestation. The main outcome measure will be incorrect diagnosis of the fetal head position. A study involving 450 women will have 80% power to detect a 10% difference in the incidence of inaccurate diagnosis of the fetal head position with two-sided 5% alpha. Discussion It is both important and timely to evaluate the use of ultrasound to diagnose the fetal head position prior to instrumental delivery before routine use can be advocated. The overall aim is to reduce the incidence of incorrect diagnosis of the fetal head position prior to instrumental delivery and improve the safety of instrumental deliveries. Trial registration Current Controlled Trials ISRCTN72230496

  11. Study protocol. IDUS - Instrumental delivery & ultrasound: a multi-centre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery.

    LENUS (Irish Health Repository)

    Murphy, Deirdre J

    2012-01-01

    Instrumental deliveries are commonly performed in the United Kingdom and Ireland, with rates of 12 - 17% in most centres. Knowing the exact position of the fetal head is a pre-requisite for safe instrumental delivery. Traditionally, diagnosis of the fetal head position is made on transvaginal digital examination by delineating the suture lines of the fetal skull and the fontanelles. However, the accuracy of transvaginal digital examination can be unreliable and varies between 20% and 75%. Failure to identify the correct fetal head position increases the likelihood of failed instrumental delivery with the additional morbidity of sequential use of instruments or second stage caesarean section. The use of ultrasound in determining the position of the fetal head has been explored but is not part of routine clinical practice.

  12. National Rates of Uterine Rupture are not Associated with Rates of Previous Caesarean Delivery

    DEFF Research Database (Denmark)

    Colmorn, Lotte B.; Langhoff-Roos, Jens; Jakobsson, Maija

    2017-01-01

    % of all Nordic deliveries. Information on the comparison population was retrieved from the national medical birth registers. Incidence rate ratios by previous caesarean delivery and intended mode of delivery after caesarean were modelled using Poisson regression. RESULTS: The incidence of uterine rupture......BACKGROUND: Previous caesarean delivery and intended mode of delivery after caesarean are well-known individual risk factors for uterine rupture. We examined if different national rates of uterine rupture are associated with differences in national rates of previous caesarean delivery and intended...... was 7.8/10 000 in Finland and 4.6/10 000 in Denmark. Rates of caesarean (21.3%) and previous caesarean deliveries (11.5%) were highest in Denmark, while the rate of intended vaginal delivery after caesarean was highest in Finland (72%). National rates of uterine rupture were not associated...

  13. Instrumental vaginal delivery: a dying saving art; an experience at ...

    African Journals Online (AJOL)

    Of the 12 interviewed doctors only 4 (28.6%) had ever used vacuum for deliveries where out of 24 interviewed midwives, only 8 (33.3%) had ever used vacuum for delivery. All of them self reported to have a theoretical knowledge on the use of vacuum but only 5 (35.7%) of the interviewed doctors said they had a practical ...

  14. Evaluation of Instrumentation and Dynamic Thermal Ratings for Overhead Lines

    Energy Technology Data Exchange (ETDEWEB)

    Phillips, A. [New York Power Authority, White Plains, NY (United States)

    2013-01-31

    In 2010, a project was initiated through a partnership between the Department of Energy (DOE) and the New York Power Authority (NYPA) to evaluate EPRI's rating technology and instrumentation that can be used to monitor the thermal states of transmission lines and provide the required real-time data for real-time rating calculations. The project included the installation and maintenance of various instruments at three 230 kV line sites in northern New York. The instruments were monitored, and data collection and rating calculations were performed for about a three year period.

  15. Contributing Indications to the Rising Cesarean Delivery Rate

    Science.gov (United States)

    BARBER, Emma L.; LUNDSBERG, Lisbet; BELANGER, Kathleen; PETTKER, Christian M.; FUNAI, Edmund F.; ILLUZZI, Jessica L.

    2013-01-01

    OBJECTIVE To examine physician-documented indications for cesarean delivery in order to investigate the specific indications contributing to this increase. METHODS We analyzed rates of primary and repeat cesarean delivery, including indications for the procedure, among 32,443 live births at a major academic hospital between 2003–2009. Time trends for each indication were modeled to estimate the absolute and cumulative annualized relative risk of cesarean by indication over time and the relative contribution of each indication to the overall increase in primary cesarean delivery rate. RESULTS The cesarean delivery rate increased from 26% to 36.5% between 2003 and 2009; 50.0% of the increase was attributable to an increase in primary cesarean delivery. Among the documented indications, nonreassuring fetal status, arrest of dilation, multiple gestation, pre-eclampsia, suspected macrosomia, and maternal request increased over time, while arrest of descent, malpresentation, maternal-fetal indications, and other obstetric indications (eg, cord prolapse, placenta previa) did not increase. The relative contributions of each indication to the total increase in primary cesarean rate were: Non-reassuring fetal status (32%), labor arrest disorders (18%), multiple gestation (16%), suspected macrosomia (10%), pre-eclampsia (10%), maternal request (8%), maternal-fetal conditions (5%), and other obstetric conditions (1%). CONCLUSION Primary cesarean births accounted for 50% of the increasing cesarean rate. Among primary cesareans, more subjective indications (nonreassuring fetal status and arrest of dilation) contributed larger proportions than more objective indications (malpresentation, maternal-fetal, and obstetric conditions). PMID:21646928

  16. Instrument evaluation no. 9. Mini-instruments dose rate meter type 5 - 1OR

    International Nuclear Information System (INIS)

    Iles, W.J.; Burgess, P.H.; Callowhill, K.

    1977-04-01

    This instrument is a portable, battery powered dose rate meter covering the dose rate range from 0 to 200 mrad h -1 . The instrument is designed to measure X- and γ-radiation dose rates over the energy range from 45 keV to 3 MeV. The radiation detector of the instrument is a GM tube with a specially designed energy compensation sheath. This detector is incorporated in a probe connected to the rate meter by an extensible cable which may be either hand-held or clipped on to the top of the instrument case. All the measurements in this report have been taken with the long axis of the probe normal to the direction of the incident radiation, the orientation recommended by the manufacturer. The information is given under the following headings: facilities and controls; radiation characteristics; electrical characteristics; effect of ambient temperature; mechanical characteristics; summary of performance; conclusions. (U.K.)

  17. Labour dystocia--risk of recurrence and instrumental delivery in following labour--a population-based cohort study.

    Science.gov (United States)

    Sandström, A; Cnattingius, S; Wikström, A K; Stephansson, O

    2012-12-01

    To investigate risk of recurrence of labour dystocia and mode of delivery in second labour after taking first labour and fetal and maternal characteristics into account. A population-based cohort study. The Swedish Medical Birth Register from 1992 to 2006. A total of 239 953 women who gave birth to their first and second singleton infants in cephalic presentation at ≥ 37 weeks of gestation with spontaneous onset of labour. We used logistic regression analysis to estimate crude and adjusted odds ratios. Labour dystocia and mode of delivery in second labour. Overall labour dystocia affected only 12% of women with previous dystocia. Regardless of mode of first delivery, rates of dystocia in the second labour were higher in women with than without previous dystocia, but were more pronounced in women with previous caesarean section (34%). Analyses with risk score groups for dystocia (risk factors were long interpregnancy interval, maternal age ≥ 35 years, obesity, short maternal stature, not cohabiting and post-term pregnancy) showed that risk of instrumental delivery in second labour increased with previous dystocia and increasing risk score. Among women with trial of labour after caesarean section with previous dystocia and a risk score of 3 or more, 66% had a vaginal instrumental or caesarean delivery (17 and 49%, respectively). In women with trial of labour after caesarean section without previous dystocia and a risk score of 0, corresponding risk was 32% (14 and 18%, respectively). Previous labour dystocia increases the risk of dystocia in subsequent delivery. Taking first labour and fetal and maternal characteristics into account is important in the risk assessments for dystocia and instrumental delivery in second labour. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

  18. The U.S. Twin Delivery Volume and Association with Cesarean Delivery Rates: A Hospital-Level Analysis.

    Science.gov (United States)

    Easter, Sarah Rae; Robinson, Julian N; Carusi, Daniela; Little, Sarah E

    2018-03-01

     The objective of this study was to test whether hospitals experienced in twin delivery have lower rates of cesarean delivery for twins.  We divided obstetric hospitals in the 2011 National Inpatient Sample by quartile of annual twin deliveries and compared twin cesarean delivery rates between hospitals with weighted linear regression. We used Pearson's coefficients to correlate a hospital's twin cesarean delivery rate to its overall cesarean delivery and vaginal birth after cesarean (VBAC) rates.  Annual twin delivery volume ranged from 1 to 506 across the 547 analyzed hospitals with a median of 10 and mode of 3. Adjusted rates of cesarean delivery were independent of delivery volume with a rate of 75.5 versus 74.8% in the lowest and highest volume hospitals ( p  = 0.09 across quartiles). A hospital's cesarean delivery rate for twins moderately correlated with the overall cesarean rate ( r  = 0.52, p  < 0.01) and inversely correlated with VBAC rate ( r  =  - 0.42, p  < 0.01).  Most U.S. obstetrical units perform a low volume of twin deliveries with no decrease in cesarean delivery rates at higher volume hospitals. Twin cesarean delivery rates correlate with other obstetric parameters such as singleton cesarean delivery and VBAC rates suggesting twin cesarean delivery rate is more closely related to a hospital's general obstetric practice than its twin delivery volume. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  19. Frequency of instrumental vaginal delivery in patients with and without receiving epidural analgesia

    International Nuclear Information System (INIS)

    Phool, B.

    2013-01-01

    Aims and Objectives: Frequency of instrumental vaginal delivery in women receiving epidural analgesia and those who are not receiving.Study Design: It was a cohort study. Duration: 6th month. Results: Majority of the patients were found between 20 - 25 years of age in both A and B groups, in Group - A 46.11% (n = 83) and in Group - B 52.22% (n = 94), mean and standard deviation was calculated 26.21 +- 3.56 in Group - A and 27.34 +- 3.78 in Group - B, comparison of instrumental vaginal delivery reveals 10.55% (n = 19) in Group - A were with instrumental delivery while in Group - B only 2.78% (n = 5) cases were found delivered with instruments.Conclusion: Epidural analgesia is considered to be an effective method of pain relief during labor but due to the higher risk of increased duration of 2nd stage of labour it increases the possibility of instrumental delivery. (author)

  20. Risk factors for cesarean section and instrumental vaginal delivery after successful external cephalic version

    NARCIS (Netherlands)

    de Hundt, Marcella; Vlemmix, Floortje; Bais, Joke M. J.; de Groot, Christianne J.; Mol, Ben Willem; Kok, Marjolein

    2016-01-01

    Aim of this article is to examine if we could identify factors that predict cesarean section and instrumental vaginal delivery in women who had a successful external cephalic version. We used data from a previous randomized trial among 25 hospitals and their referring midwife practices in the

  1. Food intake rate and delivery strategy in aquaculture

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    In aquaculture, it is important to estimate in advance how much food cultured animals would take. The rate of food consumption by cultured animals to available food amount is defined as the food intake rate (FIR) in this paper. To some extents, FIR reflects the quality of food, the health of cultured animals and the delivery efficiency. In practice, it is difficult to estimate in advance the accurate quantity of food that cultured animal needs. Usually, food is provided more than the need by animals, causing excess food that may pollute water and environment. Our experiments in past years show that FIR at 80% is recommended.

  2. Technological Advancements and Error Rates in Radiation Therapy Delivery

    Energy Technology Data Exchange (ETDEWEB)

    Margalit, Danielle N., E-mail: dmargalit@partners.org [Harvard Radiation Oncology Program, Boston, MA (United States); Harvard Cancer Consortium and Brigham and Women' s Hospital/Dana Farber Cancer Institute, Boston, MA (United States); Chen, Yu-Hui; Catalano, Paul J.; Heckman, Kenneth; Vivenzio, Todd; Nissen, Kristopher; Wolfsberger, Luciant D.; Cormack, Robert A.; Mauch, Peter; Ng, Andrea K. [Harvard Cancer Consortium and Brigham and Women' s Hospital/Dana Farber Cancer Institute, Boston, MA (United States)

    2011-11-15

    Purpose: Technological advances in radiation therapy (RT) delivery have the potential to reduce errors via increased automation and built-in quality assurance (QA) safeguards, yet may also introduce new types of errors. Intensity-modulated RT (IMRT) is an increasingly used technology that is more technically complex than three-dimensional (3D)-conformal RT and conventional RT. We determined the rate of reported errors in RT delivery among IMRT and 3D/conventional RT treatments and characterized the errors associated with the respective techniques to improve existing QA processes. Methods and Materials: All errors in external beam RT delivery were prospectively recorded via a nonpunitive error-reporting system at Brigham and Women's Hospital/Dana Farber Cancer Institute. Errors are defined as any unplanned deviation from the intended RT treatment and are reviewed during monthly departmental quality improvement meetings. We analyzed all reported errors since the routine use of IMRT in our department, from January 2004 to July 2009. Fisher's exact test was used to determine the association between treatment technique (IMRT vs. 3D/conventional) and specific error types. Effect estimates were computed using logistic regression. Results: There were 155 errors in RT delivery among 241,546 fractions (0.06%), and none were clinically significant. IMRT was commonly associated with errors in machine parameters (nine of 19 errors) and data entry and interpretation (six of 19 errors). IMRT was associated with a lower rate of reported errors compared with 3D/conventional RT (0.03% vs. 0.07%, p = 0.001) and specifically fewer accessory errors (odds ratio, 0.11; 95% confidence interval, 0.01-0.78) and setup errors (odds ratio, 0.24; 95% confidence interval, 0.08-0.79). Conclusions: The rate of errors in RT delivery is low. The types of errors differ significantly between IMRT and 3D/conventional RT, suggesting that QA processes must be uniquely adapted for each technique

  3. Technological Advancements and Error Rates in Radiation Therapy Delivery

    International Nuclear Information System (INIS)

    Margalit, Danielle N.; Chen, Yu-Hui; Catalano, Paul J.; Heckman, Kenneth; Vivenzio, Todd; Nissen, Kristopher; Wolfsberger, Luciant D.; Cormack, Robert A.; Mauch, Peter; Ng, Andrea K.

    2011-01-01

    Purpose: Technological advances in radiation therapy (RT) delivery have the potential to reduce errors via increased automation and built-in quality assurance (QA) safeguards, yet may also introduce new types of errors. Intensity-modulated RT (IMRT) is an increasingly used technology that is more technically complex than three-dimensional (3D)–conformal RT and conventional RT. We determined the rate of reported errors in RT delivery among IMRT and 3D/conventional RT treatments and characterized the errors associated with the respective techniques to improve existing QA processes. Methods and Materials: All errors in external beam RT delivery were prospectively recorded via a nonpunitive error-reporting system at Brigham and Women’s Hospital/Dana Farber Cancer Institute. Errors are defined as any unplanned deviation from the intended RT treatment and are reviewed during monthly departmental quality improvement meetings. We analyzed all reported errors since the routine use of IMRT in our department, from January 2004 to July 2009. Fisher’s exact test was used to determine the association between treatment technique (IMRT vs. 3D/conventional) and specific error types. Effect estimates were computed using logistic regression. Results: There were 155 errors in RT delivery among 241,546 fractions (0.06%), and none were clinically significant. IMRT was commonly associated with errors in machine parameters (nine of 19 errors) and data entry and interpretation (six of 19 errors). IMRT was associated with a lower rate of reported errors compared with 3D/conventional RT (0.03% vs. 0.07%, p = 0.001) and specifically fewer accessory errors (odds ratio, 0.11; 95% confidence interval, 0.01–0.78) and setup errors (odds ratio, 0.24; 95% confidence interval, 0.08–0.79). Conclusions: The rate of errors in RT delivery is low. The types of errors differ significantly between IMRT and 3D/conventional RT, suggesting that QA processes must be uniquely adapted for each technique

  4. Delivery of Patient-Reported Outcome Instruments by Automated Mobile Phone Text Messaging.

    Science.gov (United States)

    Anthony, Christopher A; Lawler, Ericka A; Glass, Natalie A; McDonald, Katelyn; Shah, Apurva S

    2017-11-01

    Patient-reported outcome (PRO) instruments allow patients to interpret their health and are integral in evaluating orthopedic treatments and outcomes. The purpose of this study was to define: (1) correlation between PROs collected by automated delivery of text messages on mobile phones compared with paper delivery; and (2) patient use characteristics of a technology platform utilizing automated delivery of text messages on mobile phones. Paper versions of the 12-Item Short Form Health Survey (SF-12) and the short form of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) were completed by patients in orthopedic hand and upper extremity clinics. Over the next 48 hours, the same patients also completed the mobile phone portion of the study outside of the clinic which included text message delivery of the SF-12 and QuickDASH, assigned in a random order. Correlations between paper and text message delivery of the 2 PROs were assessed. Among 72 patients, the intraclass correlation coefficient (ICC) between the written and mobile phone delivery of QuickDASH was 0.91 (95% confidence interval [CI], 0.85-0.95). The ICC between the paper and mobile phone delivery of the SF-12 physical health composite score was 0.88 (95% CI, 0.79-0.93) and 0.86 (95% CI, 0.75-0.92) for the SF-12 mental health composite score. We find that text message delivery using mobile phones permits valid assessment of SF-12 and QuickDASH scores. The findings suggest that software-driven automated delivery of text communication to patients via mobile phones may be a valid method to obtain other PRO scores in orthopedic patients.

  5. Changes in vaginal breech delivery rates in a single large metropolitan area.

    LENUS (Irish Health Repository)

    Hehir, Mark P

    2012-06-01

    Vaginal breech delivery rates have been accepted widely to be in decline and the Term Breech Trial (TBT) has recommended delivery of a breech-presenting infant by elective cesarean section delivery. Our aim was to examine the rate of vaginal delivery of term breech pregnancies in the 8 years before and after the publication of the TBT.

  6. Cesarean delivery rates and obstetric culture - an Italian register-based study.

    Science.gov (United States)

    Plevani, Cristina; Incerti, Maddalena; Del Sorbo, Davide; Pintucci, Armando; Vergani, Patrizia; Merlino, Luca; Locatelli, Anna

    2017-03-01

    Cesarean delivery rates are rising due to multiple factors, including less use of operative vaginal delivery and vaginal birth after cesarean delivery, which often reflect local obstetric practices. Objectives of the study were to analyze the relations between cesarean delivery, these practices, and perinatal outcomes. We included all deliveries in the 72 hospitals of Lombardia, a region in northern Italy, during the year 2013. The delivery certificate was used as data source. Pearson's correlation coefficient and logistic regression were used for statistical analysis. We included 87 896 deliveries. The number of deliveries per hospital ranged from 140 to 6123. The rate of cesarean delivery was 28.3% (range 9.9-86.4%), operative vaginal delivery 4.7% (range 0.2-10.0%), and vaginal birth after cesarean 17.3% (range 0-79.2%). We found a significant inverse correlation between rates of overall cesarean delivery and operative vaginal delivery (r = -0.25, p = 0.04). The correlation between rate of overall cesarean delivery and vaginal birth after cesarean was also inverse and significant (r = -0.57, p cesarean delivery rate and the rates of Apgar score at 5 min cesarean delivery, could reduce the rising cesarean delivery rate. This will require a change in obstetric culture, continuing education of healthcare providers, and leadership. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

  7. Assessing the role of case mix in cesarean delivery rates.

    Science.gov (United States)

    Lieberman, E; Lang, J M; Heffner, L J; Cohen, A

    1998-07-01

    Implicit in comparisons of unadjusted cesarean rates for hospitals and providers is the assumption that differences result from management practices rather than differences in case mix. This study proposes a method for comparison of cesarean rates that takes the effect of case mix into account. All women delivered of infants at our institution from December 1, 1994, through July 31, 1995, were classified according to whether they received care from community-based practitioners (N=3913) or from the hospital-based practice that serves a higher-risk population (N=1556). Women were categorized according to both obstetric history (nulliparas, multiparas without a previous cesarean, multiparas with a previous cesarean) and the presence of obstetric conditions influencing the risk of cesarean delivery (multiple birth, breech presentation or transverse lie, preterm, no trial of labor for a medical indication). We determined the percent of women in each parity-obstetric condition subgroup and calculated a standardized cesarean rate for the hospital-based practice using the case mix of the community-based practitioners as the standard. The crude cesarean rate was higher for the hospital-based practice (24.4%) than for the community-based practitioners (21.5%), a rate difference of 2.9% (95% confidence interval=0.4%, 5.4%; P=.02). However, the proportion of women falling into categories conferring a high risk of cesarean delivery (multiple pregnancy, breech presentation or transverse lie, preterm, no trial of labor permitted) was twice as high for the hospital-based practice (24.4% hospital, 12.1% community). The standardization indicates that if the hospital-based practitioners had the same case mix as community-based practitioners, their overall cesarean rate would be 20.1%, similar to the 21.5% rate of community providers (rate difference=-1.4%, 95% confidence interval =-3.1%, 0.3%; P=.11). Standardization for case mix provides a mechanism for distinguishing differences

  8. A cohort study of maternal and neonatal morbidity in relation to use of sequential instruments at operative vaginal delivery.

    LENUS (Irish Health Repository)

    Murphy, Deirdre J

    2012-02-01

    OBJECTIVE: To evaluate the risk factors and maternal and neonatal morbidity associated with sequential use of instruments (vacuum and forceps) at operative vaginal delivery. STUDY DESIGN: A cohort study of 1360 nulliparous women delivered by a single instrument (vacuum or forceps) or by both instruments, within two university teaching hospitals in Scotland and England. Outcomes were compared for use of sequential instruments versus use of any single instrument. A sub-group analysis compared sequential instruments versus forceps alone. Outcomes of interest included anal sphincter tears, postpartum haemorrhage, urinary retention, urinary incontinence, prolonged hospital admission, neonatal trauma, low Apgar scores, abnormal cord bloods and admission to the neonatal intensive care unit (NICU). RESULTS: Use of sequential instruments at operative vaginal delivery was associated with fetal malpositions, Odds Ratio (OR) 1.8 (95% Confidence Interval (CI) 1.3-2.6), and large neonatal head circumference (>37 cm) (OR 5.0, 95% CI 2.6-9.7) but not with maternal obesity or grade of operator. Sequential use of instruments was associated with greater maternal and neonatal morbidity than single instrument use (anal sphincter tear 17.4% versus 8.4%, adjusted OR 2.1, 95% CI 1.2-3.3; umbilical artery pH <7.10, 13.8% versus 5.0%, adjusted OR 3.3, 95% CI 1.7-6.2). Sequential instrument use had greater morbidity than single instrument use with forceps alone (anal sphincter tear OR 1.8, 95% CI 1.1-2.9; umbilical artery pH <7.10 OR 3.0, 95% CI 1.7-5.5). CONCLUSIONS: The use of sequential instruments significantly increases maternal and neonatal morbidity. Obstetricians need training in the appropriate selection and use of instruments with the aim of completing delivery safely with one instrument.

  9. Dynamic Line Rating Oncor Electric Delivery Smart Grid Program

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Justin; Smith, Cale; Young, Mike; Donohoo, Ken; Owen, Ross; Clark, Eddit; Espejo, Raul; Aivaliotis, Sandy; Stelmak, Ron; Mohr, Ron; Barba, Cristian; Gonzalez, Guillermo; Malkin, Stuart; Dimitrova, Vessela; Ragsdale, Gary; Mitchem, Sean; Jeirath, Nakul; Loomis, Joe; Trevino, Gerardo; Syracuse, Steve; Hurst, Neil; Mereness, Matt; Johnson, Chad; Bivens, Carrie

    2013-05-04

    Electric transmission lines are the lifeline of the electric utility industry, delivering its product from source to consumer. This critical infrastructure is often constrained such that there is inadequate capacity on existing transmission lines to efficiently deliver the power to meet demand in certain areas or to transport energy from high-generation areas to high-consumption regions. When this happens, the cost of the energy rises; more costly sources of power are used to meet the demand or the system operates less reliably. These economic impacts are known as congestion, and they can amount to substantial dollars for any time frame of reference: hour, day or year. There are several solutions to the transmission constraint problem, including: construction of new generation, construction of new transmission facilities, rebuilding and reconductoring of existing transmission assets, and Dynamic Line Rating (DLR). All of these options except DLR are capital intensive, have long lead times and often experience strong public and regulatory opposition. The Smart Grid Demonstration Program (SGDP) project co-funded by the Department of Energy (DOE) and Oncor Electric Delivery Company developed and deployed the most extensive and advanced DLR installation to demonstrate that DLR technology is capable of resolving many transmission capacity constraint problems with a system that is reliable, safe and very cost competitive. The SGDP DLR deployment is the first application of DLR technology to feed transmission line real-time dynamic ratings directly into the system operation’s State Estimator and load dispatch program, which optimizes the matching of generation with load demand on a security, reliability and economic basis. The integrated Dynamic Line Rating (iDLR)1 collects transmission line parameters at remote locations on the lines, calculates the real-time line rating based on the equivalent conductor temperature, ambient temperature and influence of wind and solar

  10. 26 CFR 1.1275-5 - Variable rate debt instruments.

    Science.gov (United States)

    2010-04-01

    ... nonpublicly traded property. A debt instrument (other than a tax-exempt obligation) that would otherwise... variations in the cost of newly borrowed funds in the currency in which the debt instrument is denominated... on the yield of actively traded personal property (within the meaning of section 1092(d)(1)). (ii...

  11. Increasing low birth weight rates: deliveries in a tertiary hospital in istanbul.

    Science.gov (United States)

    Akin, Yasemin; Cömert, Serdar; Turan, Cem; Unal, Orhan; Piçak, Abdülkadir; Ger, Lale; Telatar, Berrin

    2010-09-01

    Prevalence of low birth weight deliveries may vary across different environments. The necessity of determination of regional data prompted this study. Information of all deliveries from January 2004 to December 2008 was obtained from delivery registry records retrospectively. Initial data including birth weight, vital status, sex, maternal age and mode of delivery were recorded using medical files. The frequency of low birth weight, very low birth weight, extremely low birth weight and stillbirth deliveries were determined. Among 19,533 total births, there were 450 (23.04 per 1000) stillbirths. Low birth weight rate was 10.61%. A significant increase in yearly distribution of low birth weight deliveries was observed (Pbirth weight and extremely low birth weight delivery rates were 3.14% and 1.58% respectively. Among 2073 low birth weight infants, 333 (16.06%) were stillbirths. The stillbirth delivery rate and the birth of a female infant among low birth weight deliveries were significantly higher than infants with birth weight ≥2500g (Pbirth weight and maternal age. The rate of cesarean section among low birth weight infants was 49.4%. High low birth weight and stillbirth rates, as well as the increase in low birth weight deliveries over the past five years in this study are striking. For reduction of increased low birth weight rates, appropriate intervention methods should be initiated.

  12. A multimodal instrument for real-time in situ study of ultrasound and cavitation mediated drug delivery.

    Science.gov (United States)

    Bian, Shuning; Seth, Anjali; Daly, Dan; Carlisle, Robert; Stride, Eleanor

    2017-03-01

    The development of a multimodal instrument capable of real-time in situ measurements of cavitation activity and effect in tissue mimicking phantoms during ultrasound and cavitation mediated drug delivery experiments is described here. The instrument features an acoustic arm that can expose phantoms to high-intensity focused-ultrasound while measuring cavitation activity and an optical arm that monitors cavitation effect using confocal microscopy. This combination of modalities allows real-time in situ characterisation of drug delivery in tissue and tissue mimicking phantoms during ultrasound and cavitation mediated drug delivery experiments. A representative result, obtained with a tissue mimicking phantom and acoustically activated droplets, is presented here as a demonstration of the instrument's capabilities and potential applications.

  13. Relationship among reaction rate, release rate and efficiency of nanomachine-based targeted drug delivery.

    Science.gov (United States)

    Zhao, Qingying; Li, Min; Luo, Jun

    2017-12-04

    In nanomachine applications towards targeted drug delivery, drug molecules released by nanomachines propagate and chemically react with tumor cells in aqueous environment. If the nanomachines release drug molecules faster than the tumor cells react, it will result in loss and waste of drug molecules. It is a potential issue associated with the relationship among reaction rate, release rate and efficiency. This paper aims to investigate the relationship among reaction rate, release rate and efficiency based on two drug reception models. We expect to pave a way for designing a control method of drug release. We adopted two analytical methods that one is drug reception process based on collision with tumors and another is based on Michaelis Menten enzymatic kinetics. To evaluate the analytical formulations, we used the well-known simulation framework N3Sim to establish simulations. The analytical results of the relationship among reaction rate, release rate and efficiency is obtained, which match well with the numerical simulation results in a 3-D environment. Based upon two drug reception models, the results of this paper would be beneficial for designing a control method of nanomahine-based drug release.

  14. Maternal obesity and rate of cesarean delivery in Djibouti.

    Science.gov (United States)

    Minsart, Anne-Frederique; N'guyen, Thai-Son; Dimtsu, Hirut; Ratsimanresy, Rachel; Dada, Fouad; Ali Hadji, Rachid

    2014-11-01

    To calculate the prevalence of maternal obesity and to determine the relation between obesity and cesarean delivery in an urban hospital in Djibouti. In an observational cohort study, all women who had a live birth or stillbirth between October 2012 and November 2013 were considered for inclusion. Body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) was calculated throughout pregnancy, and women with a BMI of at least 30.0 were deemed to be obese. Multivariate logistic regression analyses were used to evaluate the relation between cesarean and obesity. Overall, 100 (24.8%) of 404 women were obese before 14 weeks of pregnancy, as were 112 (25.2%) of 445 before 22 weeks, and 200 (43.2%) of 463 at delivery. Obesity before 22 weeks was associated with a 127% excess risk of cesarean delivery (adjusted odds ratio 2.27; 95% CI 1.07-4.82; P=0.032). Similar trends were found when the analyses were limited to the subgroup of women without a previous cesarean delivery or primiparae. Prevalence of maternal obesity is high in Djibouti City and is related to an excess risk of cesarean delivery, even after controlling for a range of medical and socioeconomic variables. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  15. A summary of the performance of exposure rate and dose rate instruments contained in instrument evaluation reports NRPB-IE1 to NRPB-IE13

    International Nuclear Information System (INIS)

    Burgess, P.H.; Iles, W.J.

    1979-06-01

    The various radiations encountered in radiological protection cover a wide range of energies and radiation measurements have to be carried out under an equally broad spectrum of environmental conditions. This report is one of a series intended to give information on the performance characteristics of radiological protection instruments, to assist in the selection of appropriate instruments for a given purpose, to interpret the results obtained with such instruments, and, in particular, to know the likely sources and magnitude of errors that might be associated with measurements in the field. The radiation, electrical and environmental characteristics of radiation protection instruments are considered together with those aspects of the construction which make an instrument convenient for routine use. To provide consistent criteria for instrument performance, the range of tests performed on any particular class of instrument, the test methods and the criteria of acceptable performance are based broadly on the appropriate Recommendations of the International Electrotechnical Commission. The radiations in the tests are, in general, selected from the range of reference radiations for instrument calibration being drawn up by the International Standards Organisation. Normally, each report deals with the capabilities and limitations of one model of instrument and no direct comparison with other instruments intended for similar purposes is made, since the significance of particular performance characteristics largely depends on the radiations and environmental conditions in which the instrument is to be used. The results quoted here have all been obtained from tests on instruments in routine production, with the appropriate measurements being made by the NRPB. This report provides a concise summary of measurements of the more important performance characteristics of radiation protection dose rate or exposure rate survey instruments which have been assessed by NRPB as part

  16. A multimodal instrument for real-time in situ study of ultrasound and cavitation mediated drug delivery

    OpenAIRE

    Bian, S; Seth, A; Daly, D; Carlisle, R; Stride, E

    2017-01-01

    The development of a multimodal instrument capable of real-time in situ measurements of cavitation activity and effect in tissue mimicking phantoms during ultrasound and cavitation mediated drug delivery experiments is described here. The instrument features an acoustic arm that can expose phantoms to high-intensity focused-ultrasound while measuring cavitation activity and an optical arm that monitors cavitation effect using confocal microscopy. This combination of modalities allows real-tim...

  17. Decreased rates of nosocomial endometritis and urinary tract infection after vaginal delivery in a French surveillance network, 1997-2003.

    Science.gov (United States)

    Ayzac, Louis; Caillat-Vallet, Emmanuelle; Girard, Raphaële; Chapuis, Catherine; Depaix, Florence; Dumas, Anne-Marie; Gignoux, Chantal; Haond, Catherine; Lafarge-Leboucher, Joëlle; Launay, Carine; Tissot-Guerraz, Françoise; Vincent, Agnès; Fabry, Jacques

    2008-06-01

    To identify independent risk factors for endometritis and urinary tract infection (UTI) after vaginal delivery, and to monitor changes in nosocomial infection rates and derive benchmarks for prevention. Prospective study. We analyzed routine surveillance data for all vaginal deliveries between January 1997 and December 2003 at 66 maternity units participating in the Mater Sud-Est surveillance network. Adjusted odds ratios for risk of endometritis or UTI were obtained using a logistic regression model. The overall incidence rates were 0.5% for endometritis and 0.3% for UTI. There was a significant decrease in the incidence and risk of endometritis but not of UTI during the 7-year period. Significant risk factors for endometritis were fever during labor, parity of 1, and instrumental delivery and/or manual removal of the placenta. Significant risk factors for UTI were urinary infection on admission, premature rupture of membranes (more than 12 hours before admission), blood loss of more than 800 mL, parity of 1, instrumental delivery, and receipt of more than 5 vaginal digital examinations. Each maternity unit received a poster showing graphs of the number of expected and observed cases of UTI and endometritis associated with vaginal deliveries, which enabled each maternity unit to determine their rank within the network and to initiate prevention programs. Although routine surveillance means additional work for maternity units, our results demonstrate the usefulness of regular targeted monitoring of risk factors and of the most common nosocomial infections in obstetrics. Most of the information needed for monitoring is already present in the patients' records.

  18. Protective interest rate as tax instrument of corporate capital protection

    Directory of Open Access Journals (Sweden)

    Vukašinović Jovan

    2015-01-01

    Full Text Available This paper deals with researching negative consequences of allocation of economic (virtual gains made as a result of conventional accounting concept by facing current income with historical expenses and necessity to promote additional stimulating instruments that are at disposal by the state in order to eliminate these negative consequences. one of them is certainly protective interest as a relatively new active fiscal instrument of capital protection and recognition of price of invested owner's equity in business ventures, i.e. a specific form of compensation by the state for invested capital bearing in mind, that no source is free, including ones own sources. We also showed mechanisms of protective interest which, together with other measures of macroeconomic policy, should contribute to the protection of real purchasing power of company equity and increase of net gain, left on company's disposal for new investments, new work places, more money in the budget, protection of actual assets against taxing in the conditions of inflation, etc.

  19. Rising rates of caesarean deliveries at full cervical dilatation: a concerning trend.

    LENUS (Irish Health Repository)

    Unterscheider, J

    2011-08-01

    To audit caesarean sections performed at full cervical dilatation over a three year period in a tertiary referral centre in Ireland. To evaluate (i) the rate of caesarean deliveries in the second stage of labour, (ii) the indication for delivery and (iii) the associated fetal and maternal morbidity in this cohort of women.

  20. Obstetrician perceptions of the causes of high cesarean delivery rates in Turkey.

    Science.gov (United States)

    Küçük, Mert

    2017-07-01

    To assess obstetricians' perceptions surrounding cesarean delivery rates in Turkey. The present cross-sectional descriptive study was performed between May 1 and June 30, 2016. Practicing obstetricians with contact details known by the researchers and those attending a conference in Turkey were asked to complete a self-administered questionnaire that collected demographic data and information on participants' opinions, beliefs, knowledge, attitudes, and practices related to cesarean delivery. There were 100 obstetricians who responded to the survey. Awareness of high cesarean delivery rates was reported by 96 (96%) participants and 95 (95%) respondents said they were supportive of efforts to reduce it. There were 60 (60%), 83 (83%), and 100 (100%) participants aware of associations between high cesarean delivery rates and increased maternal and infant mortality; increased risk of uterine rupture; and increased risk of placenta previa, placenta accreta, and emergency cesarean hysterectomy, respectively. The most commonly reported reason for high cesarean delivery rates was high compensation costs during medical litigation legal proceedings, reported by all 100 (100%) participants. Participants were generally aware of the risks associated with high cesarean delivery rates. The results suggest that the greatest concern among obstetricians who perform cesarean deliveries was malpractice litigation. © 2017 International Federation of Gynecology and Obstetrics.

  1. Delivery after external cephalic version, is there an increased rate of cesarian section?

    Science.gov (United States)

    Lago Leal, Victor; Pradillo Aramendi, Tamara; Nicolas Montero, Estefania; Ocaña Martínez, Vanesa; Del Barrio Fernández, Pablo; Martínez-Cortés, Luis

    2016-04-01

    The aim of this study was to compare the obstetric outcomes after successful external cephalic version (cases) with a group of pregnant women with a spontaneous cephalic fetal position at delivery (controls). Retrospective review of the cohort of study was performed at the University Hospital of Getafe (Madrid, Spain) between January 2012 and January 2013. 1516 patients (48 cases; 1468 controls). We compared the type of delivery in pregnant women after ECV performed successfully (cases) with spontaneous cephalic presentations (controls). Pregnancies with vaginal delivery contraindicated, elective cesarean section (CS) justified by maternal disease, multiple pregnancies, or pregnancies below 37 weeks were excluded. Maternal age, BMI, parity, gestational age at delivery, and onset of labor (spontaneous or induced) were controlled. Prevalence of CS and operative delivery in both groups. Women who underwent a successful ECV had a significantly higher CS rate compared with the women of the control group (12/48 [25%] vs. 202/1468 [13.76%]; P=0.028). There was no difference in the rate of operative delivery (6/48 [12.5%] vs. 177/1468 [12.05%] P=0.92). Deliveries following a successful ECV are associated with an increased CS rate compared with deliveries of fetuses with spontaneous cephalic presentations.

  2. Variation in Primary Cesarean Delivery Rates by Individual Physician within a Single Hospital Laborist Model

    Science.gov (United States)

    METZ, Torri D.; ALLSHOUSE, Amanda A.; GILBERT, Sara A Babcock; DOYLE, Reina; TONG, Angie; CAREY, J. Christopher

    2016-01-01

    Background Laborist practice models are associated with lower cesarean delivery rates than individual private practice models in several studies; however, this effect is not uniform. Further exploration of laborist models may help us better understand the observed reduction in cesarean delivery rates in some hospitals with implementation of a laborist model. Objective Our objective was to evaluate the degree of variation in primary cesarean delivery rates by individual laborists within a single institution employing a laborist model. In addition, we sought to evaluate whether differences in cesarean delivery rates resulted in different maternal or short-term neonatal outcomes. Study Design At this teaching institution, one laborist (either a generalist or maternal-fetal medicine attending physician) is directly responsible for labor and delivery management during each shift. No patients are followed in a private practice model nor are physicians incentivized to perform deliveries. We retrospectively identified all laborists who delivered nulliparous, term women with cephalic singletons at this institution from 2007-14. Overall and individual primary cesarean delivery rates were reported as percentages with exact Pearson 95% CI. Laborists were grouped by tertile as having low, medium or high cesarean delivery rates. Characteristics of the women delivered, indications for cesarean delivery, and short-term neonatal outcomes were compared between these groups. A binomial regression model of cesarean delivery was estimated, where the relative rates of each laborist compared to the lowest-unadjusted laborist rate were calculated; a second model was estimated to adjust for patient-level maternal characteristics. Results Twenty laborists delivered 2,224 nulliparous, term women with cephalic singletons. The overall cesarean delivery rate was 24.1% (95% CI 21.4-26.8). In an unadjusted binomial model, the overall effect of individual laborist was significant (pcesarean

  3. Optical instrument for measurement of vaginal coating thickness by drug delivery formulations

    International Nuclear Information System (INIS)

    Henderson, Marcus H.; Peters, Jennifer J.; Walmer, David K.; Couchman, Grace M.; Katz, David F.

    2005-01-01

    An optical device has been developed for imaging the human vaginal epithelial surfaces, and quantitatively measuring distributions of coating thickness of drug delivery formulations - such as gels - applied for prophylaxis, contraception or therapy. The device consists of a rigid endoscope contained within a 27-mm-diam hollow, polished-transparent polycarbonate tube (150 mm long) with a hemispherical cap. Illumination is from a xenon arc. The device is inserted into, and remains stationary within the vagina. A custom gearing mechanism moves the endoscope relative to the tube, so that it views epithelial surfaces immediately apposing its outer surface (i.e., 150 mm long by 360 deg. azimuthal angle). Thus, with the tube fixed relative to the vagina, the endoscope sites local regions at distinct and measurable locations that span the vaginal epithelium. The returning light path is split between a video camera and photomultiplier. Excitation and emission filters in the light path enable measurement of fluorescence of the sited region. Thus, the instrument captures video images simultaneously with photometric measurement of fluorescence of each video field [∼10 mm diameter; formulations are labeled with 0.1% w/w United States Pharmacoepia (USP) injectable sodium fluorescein]. Position, time and fluorescence measurements are continuously displayed (on video) and recorded (to a computer database). The photomultiplier output is digitized to quantify fluorescence of the endoscope field of view. Quantification of the thickness of formulation coating of a surface sited by the device is achieved due to the linear relationship between thickness and fluorescence intensity for biologically relevant thin layers (of the order of 0.5 mm). Summary measures of coating have been developed, focusing upon extent, location and uniformity. The device has begun to be applied in human studies of model formulations for prophylaxis against infection with HIV and other sexually transmitted

  4. Association between rising professional liability insurance premiums and primary cesarean delivery rates.

    Science.gov (United States)

    Murthy, Karna; Grobman, William A; Lee, Todd A; Holl, Jane L

    2007-12-01

    To estimate the association between changes in Illinois professional liability premiums for obstetrician-gynecologists and singleton primary cesarean delivery rates. Data from the National Center for Health Statistics were used to identify all singleton births between 37 weeks and 44 weeks of gestation occurring in Illinois from 1998 through 2003. Primary cesarean delivery rates for women delivered between 37 weeks and 44 weeks of gestation per 1,000 gravid women eligible to have a primary cesarean delivery were calculated for each Illinois county. The annual medical professional liability premium for each county in Illinois was represented by the reported professional liability insurance rate charges (adjusted to 2004 dollars) from the ISMIE Mutual Insurance Company. Separate analyses were conducted for nulliparous and multiparous women. The independent association between county-level primary cesarean delivery rates and the previous year's insurance premiums was evaluated using linear regression models. During the study period, 817,521 women were eligible for inclusion in the analysis. The county-level mean primary cesarean delivery rate increased from 126 to 163 per 1,000 (Pinsurance premiums also rose significantly (from $60,766 in 1997 to $83,167 in 2002, Pinsurance premium increase, the primary cesarean delivery rate increased by 15.7 per 1,000 for nulliparous women. This association also was evident for multiparous women, who had an increase in cesarean deliveries of 4.7 per 1,000 for every $10,000 increase. Higher rates of primary cesarean delivery are associated with increased medical professional liability premiums for obstetrician-gynecologists in Illinois. II.

  5. Effect of severity of illness on cesarean delivery rates in Washington State.

    Science.gov (United States)

    Hitti, Jane; Walker, Suzan; Benedetti, Thomas J

    2017-10-01

    Hospitals and providers are increasingly held accountable for their cesarean delivery rates. In the perinatal quality improvement arena, there is vigorous debate about whether all hospitals can be held to the same benchmark for an acceptable cesarean rate regardless of patient acuity. However, the causes of variation in hospital cesarean delivery rates are not well understood. We sought to evaluate the association and temporal trends between severity of illness at admission and the primary term singleton vertex cesarean delivery rate among hospitals in Washington State. We hypothesized that hospitals with higher patient acuity would have higher cesarean delivery rates and that this pattern would persist over time. In this cross-sectional analysis, we analyzed aggregate hospital-level data for all nonmilitary hospitals in Washington State with ≥100 deliveries/y during federal fiscal years 2010 through 2014 (287,031 deliveries). Data were obtained from the Washington State Comprehensive Hospital Abstract Reporting System, which includes inpatient demographic, diagnosis, procedure, and discharge information derived from hospital billing systems. Age, admission diagnoses and procedure codes were converted to patient-level admission severity-of-illness scores using the All Patient Refined Diagnosis Related Groups classification system. This system is widely used throughout the United States to adjust hospital data for severity of illness. Mean admission hospital-level severity-of-illness scores were calculated for each fiscal year among the term singleton vertex population with no history of cesarean delivery. We used linear regression to evaluate the association between hospital admission severity of illness and the primary term singleton vertex cesarean delivery rate, calculated Pearson correlation coefficients, and compared regression line slopes and 95% confidence intervals for each fiscal year. Hospitals were diverse with respect to delivery volume, level of care

  6. Instrumentation

    International Nuclear Information System (INIS)

    Prieur, G.; Nadi, M.; Hedjiedj, A.; Weber, S.

    1995-01-01

    This second chapter on instrumentation gives little general consideration on history and classification of instrumentation, and two specific states of the art. The first one concerns NMR (block diagram of instrumentation chain with details on the magnets, gradients, probes, reception unit). The first one concerns precision instrumentation (optical fiber gyro-meter and scanning electron microscope), and its data processing tools (programmability, VXI standard and its history). The chapter ends with future trends on smart sensors and Field Emission Displays. (D.L.). Refs., figs

  7. Instrument evaluation no. 1. Nuclear Enterprises dose rate meter type NE 2602

    International Nuclear Information System (INIS)

    White, D.F.

    1974-01-01

    The NE2602 is a portable, battery-operated instrument for the measurement of exposure rates from 0.1 mR/h to 200 mR/h. The detector is an internally mounted Geiger-Muller tube provided with a correcting filter to minimise the variation of response with radiation energy. The instrument was specifically designed for the measurement of exposure rates from packages intended for transport. The detector is therefore mounted very close to the front surface of the instrument. The information is given under the following headings: facilities and controls; radiation performance; electrical characteristics; summary of performance; calibration procedure; construction; conclusions. (U.K.)

  8. Instrumentation

    International Nuclear Information System (INIS)

    Decreton, M.

    2000-01-01

    SCK-CEN's research and development programme on instrumentation aims at evaluating the potentials of new instrumentation technologies under the severe constraints of a nuclear application. It focuses on the tolerance of sensors to high radiation doses, including optical fibre sensors, and on the related intelligent data processing needed to cope with the nuclear constraints. Main achievements in these domains in 1999 are summarised

  9. Instrumentation

    Energy Technology Data Exchange (ETDEWEB)

    Decreton, M

    2001-04-01

    SCK-CEN's research and development programme on instrumentation involves the assessment and the development of sensitive measurement systems used within a radiation environment. Particular emphasis is on the assessment of optical fibre components and their adaptability to radiation environments. The evaluation of ageing processes of instrumentation in fission plants, the development of specific data evaluation strategies to compensate for ageing induced degradation of sensors and cable performance form part of these activities. In 2000, particular emphasis was on in-core reactor instrumentation applied to fusion, accelerator driven and water-cooled fission reactors. This involved the development of high performance instrumentation for irradiation experiments in the BR2 reactor in support of new instrumentation needs for MYRRHA, and for diagnostic systems for the ITER reactor.

  10. Instrumentation

    International Nuclear Information System (INIS)

    Decreton, M.

    2001-01-01

    SCK-CEN's research and development programme on instrumentation involves the assessment and the development of sensitive measurement systems used within a radiation environment. Particular emphasis is on the assessment of optical fibre components and their adaptability to radiation environments. The evaluation of ageing processes of instrumentation in fission plants, the development of specific data evaluation strategies to compensate for ageing induced degradation of sensors and cable performance form part of these activities. In 2000, particular emphasis was on in-core reactor instrumentation applied to fusion, accelerator driven and water-cooled fission reactors. This involved the development of high performance instrumentation for irradiation experiments in the BR2 reactor in support of new instrumentation needs for MYRRHA, and for diagnostic systems for the ITER reactor

  11. Instrumentation

    International Nuclear Information System (INIS)

    Decreton, M.

    2002-01-01

    SCK-CEN's R and D programme on instrumentation involves the development of advanced instrumentation systems for nuclear applications as well as the assessment of the performance of these instruments in a radiation environment. Particular emphasis is on the use of optical fibres as umbilincal links of a remote handling unit for use during maintanance of a fusion reacor, studies on the radiation hardening of plasma diagnostic systems; investigations on new instrumentation for the future MYRRHA accelerator driven system; space applications related to radiation-hardened lenses; the development of new approaches for dose, temperature and strain measurements; the assessment of radiation-hardened sensors and motors for remote handling tasks and studies of dose measurement systems including the use of optical fibres. Progress and achievements in these areas for 2001 are described

  12. Instrumentation

    Energy Technology Data Exchange (ETDEWEB)

    Decreton, M

    2002-04-01

    SCK-CEN's R and D programme on instrumentation involves the development of advanced instrumentation systems for nuclear applications as well as the assessment of the performance of these instruments in a radiation environment. Particular emphasis is on the use of optical fibres as umbilincal links of a remote handling unit for use during maintanance of a fusion reacor, studies on the radiation hardening of plasma diagnostic systems; investigations on new instrumentation for the future MYRRHA accelerator driven system; space applications related to radiation-hardened lenses; the development of new approaches for dose, temperature and strain measurements; the assessment of radiation-hardened sensors and motors for remote handling tasks and studies of dose measurement systems including the use of optical fibres. Progress and achievements in these areas for 2001 are described.

  13. Instrumentation

    Energy Technology Data Exchange (ETDEWEB)

    Decreton, M

    2000-07-01

    SCK-CEN's research and development programme on instrumentation aims at evaluating the potentials of new instrumentation technologies under the severe constraints of a nuclear application. It focuses on the tolerance of sensors to high radiation doses, including optical fibre sensors, and on the related intelligent data processing needed to cope with the nuclear constraints. Main achievements in these domains in 1999 are summarised.

  14. Instrumentation

    International Nuclear Information System (INIS)

    Umminger, K.

    2008-01-01

    A proper measurement of the relevant single and two-phase flow parameters is the basis for the understanding of many complex thermal-hydraulic processes. Reliable instrumentation is therefore necessary for the interaction between analysis and experiment especially in the field of nuclear safety research where postulated accident scenarios have to be simulated in experimental facilities and predicted by complex computer code systems. The so-called conventional instrumentation for the measurement of e. g. pressures, temperatures, pressure differences and single phase flow velocities is still a solid basis for the investigation and interpretation of many phenomena and especially for the understanding of the overall system behavior. Measurement data from such instrumentation still serves in many cases as a database for thermal-hydraulic system codes. However some special instrumentation such as online concentration measurement for boric acid in the water phase or for non-condensibles in steam atmosphere as well as flow visualization techniques were further developed and successfully applied during the recent years. Concerning the modeling needs for advanced thermal-hydraulic codes, significant advances have been accomplished in the last few years in the local instrumentation technology for two-phase flow by the application of new sensor techniques, optical or beam methods and electronic technology. This paper will give insight into the current state of instrumentation technology for safety-related thermohydraulic experiments. Advantages and limitations of some measurement processes and systems will be indicated as well as trends and possibilities for further development. Aspects of instrumentation in operating reactors will also be mentioned.

  15. A Native American community with a 7% cesarean delivery rate: does case mix, ethnicity, or labor management explain the low rate?

    Science.gov (United States)

    Leeman, Lawrence; Leeman, Rebecca

    2003-01-01

    Cesarean delivery rates vary widely across populations. Studying communities with low rates of cesarean delivery may identify practices that can lower the cesarean rate. A population-based historical cohort study included all pregnant women (N = 1132) from 1992 through 1996 in a predominantly Native American region of northwestern New Mexico known to have a high prevalence of gestational diabetes and preeclampsia. The outcomes studied included delivery type (eg, cesarean, operative vaginal, spontaneous vaginal), indication for cesarean delivery, presence of obstetrical risk factors, and use of labor induction or augmentation. The cesarean delivery rate of the study group (7.3%) was only 35% of the 1996 US rate of 20.7%. Among study participants, the relative risk of a primary cesarean delivery for dystocia was 0.22 (95% CI, 0.14, 0.35). Trial of labor after cesarean delivery was attempted by 93% of study participants compared with 42% of women nationwide in 1994. The cesarean delivery rates for women with diabetes in pregnancy (11.5% versus 35.4%) and preeclampsia (14.8% versus 37.4%) were significantly lower than nationwide rates. Case-mix analysis comparison with a standardized population and comparison of standard (ie, term, singleton, vertex) primiparous women demonstrate that the low rate of cesarean delivery was not because of a lower prevalence of risk factors. The community's low rate of cesarean delivery is primarily the result of a decreased use of cesarean delivery for labor dystocia and an almost universal acceptance of trial of labor after cesarean delivery. Cultural attitudes toward childbirth, design of the perinatal system, and genetic factors also may explain the low rate of cesarean delivery.

  16. Hospital differences in rates of cesarean deliveries in the Sardinian region: An observational study

    Directory of Open Access Journals (Sweden)

    Massimo Cannas

    2014-11-01

    Full Text Available Background: The rates of cesarean deliveries have been increasing steadily in several European countries in recent decades, with Italy having the second-highest rate (38% in 2010, causing concern and debate about the appropriateness of many interventions. Moreover, some recent studies suggest that rates of common obstetric interventions are not homogeneous across hospitals, maybe not only because of patient case mix but also possibly because of different hospital practices and cultures. Thus, it is important to investigate whether the variation in rates of cesarean sections can be traced back to patient characteristics or whether it depends upon context variables at the hospital level. Objective and method: Using official hospital abstracts on deliveries that occurred in Sardinia over a two-year period, we implement multilevel logistic regression models in order to assess whether the observed differences in cesarean rates across hospitals can be justified by case-mix differences across hospitals. Results: The between-hospital variation in rates of cesarean delivery is estimated to be 0.388 in the model with only the intercept and 0.382 in the model controlling for the mother’s clinical and sociodemographic characteristics. Conclusions: The results show that taking into account the individual characteristics of delivered mothers is not enough to justify the observed variation across hospital rates, suggesting the important role of unobserved variables at the hospital level in determining cesarean section rates.

  17. State variation in rates of cesarean and VBAC delivery: 1989 and 1993.

    Science.gov (United States)

    Clarke, S C; Taffel, S M

    1996-01-01

    There is wide variation among states in rates of cesarean and vaginal births after cesarean (VBAC) deliveries. In general, states in the South have the highest cesarean rates, states in the West have the lowest, and states in the Northeast and Midwest are intermediate. Louisiana had the highest overall rate in 1993 (27.7 per 100 births) while Alaska had the lowest rate (15.2). The majority of states had declines in their cesarean rate between 1989 and 1993. Patterns in primary cesarean rates are similar to those of the overall rate-states in the South generally have the highest rates while states in the West have the lowest rates. Primary cesarean rates ranged between a high of 19.6 in Louisiana to a low of 10.6 in Wisconsin. In general, states with low cesarean rates have among the highest rates of VBAC delivery. Alaska had the highest VBAC rate (40.0), which was almost quadruple the rate of Louisiana (11.2), the state with the lowest rate. Most states had substantial increases in VBAC rates between 1989 and 1993. When examining cesarean rates by maternal age and birth order, states with the highest overall rates also have among the highest age/birth order-specific rates. Cesarean rates were lowest for mothers under 25 years of age having a second or higher order birth in Alaska, 10.4, and highest for mothers 35 years of age or over having a first birth in Mississippi, 51.3. Standardized cesarean rates which were adjusted for differences between states in maternal age and birth order distributions did not diminish the variation among areas.

  18. Intravenous fluid rate for reduction of cesarean delivery rate in nulliparous women: a systematic review and meta-analysis.

    Science.gov (United States)

    Ehsanipoor, Robert M; Saccone, Gabriele; Seligman, Neil S; Pierce-Williams, Rebecca A M; Ciardulli, Andrea; Berghella, Vincenzo

    2017-07-01

    The National Institute of Child Health and Human Development, American College of Obstetricians and Gynecologists, and Society for Maternal-Fetal Medicine have emphasized the need to promote vaginal delivery and have offered recommendations to safely prevent primary cesarean delivery. However, there has been limited discussion regarding management of intravenous fluids and other aspects of labor management that may influence mode of delivery. Therefore the aim of our study was to determine whether an intravenous fluid rate of 250 vs. 125 mL/h is associated with a difference in cesarean delivery rate. Searches were performed in MEDLINE, OVID, Scopus, ClinicalTrials.gov, the PROSPERO International Prospective Register of Systematic Reviews, Embase, Web of Science, and the Cochrane Library for randomized controlled trials. We included all randomized controlled trials comparing intravenous fluid rates of 250 vs. 125 mL/h in nulliparous women in spontaneous labor at term with singleton pregnancies at ≥36 weeks. Studies were included regardless of the type of intravenous fluids used and regardless of whether oral intake was restricted during labor. Studies including multiparous women or women whose labor was induced were excluded. The primary outcome was the incidence of cesarean delivery. We planned to assess a subgroup analysis according to type of fluids used and according to restriction of oral fluid intake. Seven trials including 1215 nulliparous women in spontaneous labor at term were analyzed; 593 (48.8%) in the 250 mL/h group, and 622 (51.2%) in the 125 mL/h group. Five studies used lactated Ringer's solution, one used normal saline in dextrose water, and in one study it was unclear which intravenous fluid was used. Women who received intravenous fluids at 250 mL/h had a significantly lower incidence of cesarean delivery for any indication (12.5 vs. 18.1%; RR 0.70, 95% CI 0.53-0.92; seven studies, 1215 participants; I 2 = 0%) and for dystocia (4.9 vs. 7.7%; RR

  19. Early and late preterm delivery rates - a comparison of differing tocolytic policies in a single urban population.

    LENUS (Irish Health Repository)

    Hehir, Mark P

    2012-11-01

    Preterm delivery results in neonatal morbidity and mortality. We set out to estimate the difference in rates of preterm delivery in two institutions, serving a single population, with differing policies regarding use of tocolytic drugs for the prevention of preterm delivery.

  20. Instrument evaluation no. 8. Nuclear Enterprises beta/gamma dose rate meter type 0500

    International Nuclear Information System (INIS)

    Iles, W.J.; Burgess, P.H.; Callowhill, K.

    1977-04-01

    This instrument is a portable, battery powered survey meter covering the dose rate range from 0 to 10,000 mrad h -1 and the dose range 0 to 1000 mrad. The instrument was designed to measure X and γ-radiation dose and dose rate over a wide energy range, and also β-radiation dose and dose rate. An unsealed ionisation chamber is used as the detector. The aluminised melinex thin end window of the chamber is provided with a detachable plastic end cap. The calibration plane of the chamber is indicated by a cross on the side of the instrument. The information is given under the following headings: facilities and controls; radiation characteristics; electrical characteristics; environmental characteristics; mechanical characteristics; summary of performance; conclusions. (U.K.)

  1. Instruments

    International Nuclear Information System (INIS)

    Buehrer, W.

    1996-01-01

    The present paper mediates a basic knowledge of the most commonly used experimental techniques. We discuss the principles and concepts necessary to understand what one is doing if one performs an experiment on a certain instrument. (author) 29 figs., 1 tab., refs

  2. Instrumentation

    International Nuclear Information System (INIS)

    Muehllehner, G.; Colsher, J.G.

    1982-01-01

    This chapter reviews the parameters which are important to positron-imaging instruments. It summarizes the options which various groups have explored in designing tomographs and the methods which have been developed to overcome some of the limitations inherent in the technique as well as in present instruments. The chapter is not presented as a defense of positron imaging versus single-photon or other imaging modality, neither does it contain a description of various existing instruments, but rather stresses their common properties and problems. Design parameters which are considered are resolution, sampling requirements, sensitivity, methods of eliminating scattered radiation, random coincidences and attenuation. The implementation of these parameters is considered, with special reference to sampling, choice of detector material, detector ring diameter and shielding and variations in point spread function. Quantitation problems discussed are normalization, and attenuation and random corrections. Present developments mentioned are noise reduction through time-of-flight-assisted tomography and signal to noise improvements through high intrinsic resolution. Extensive bibliography. (U.K.)

  3. Cesarean Delivery Rates Vary 10-Fold Among US Hospitals; Reducing Variation May Address Quality, Cost Issues

    Science.gov (United States)

    Kozhimannil, Katy Backes; Law, Michael R.; Virnig, Beth A.

    2013-01-01

    Cesarean delivery is the most commonly performed surgical procedure in the United States, and cesarean rates are increasing. Working with 2009 data from 593 US hospitals nationwide, we found that cesarean rates varied tenfold across hospitals, from 7.1 percent to 69.9 percent. Even for women with lower-risk pregnancies, in which more limited variation might be expected, cesarean rates varied fifteen-fold, from 2.4 percent to 36.5 percent. Thus, vast differences in practice patterns are likely to be driving the costly overuse of cesarean delivery in many US hospitals. Because Medicaid pays for nearly half of US births, government efforts to decrease variation are warranted. We focus on four promising directions for reducing these variations, including better coordination of maternity care, more data collection and measurement, tying Medicaid payment to quality improvement, and enhancing patient-centered decision making through public reporting. PMID:23459732

  4. Student Evaluation of Teaching: A Study Exploring Student Rating Instrument Free-Form Text Comments

    Science.gov (United States)

    Stupans, Ieva; McGuren, Therese; Babey, Anna Marie

    2016-01-01

    Student rating instruments are recognised to be valid indicators of effective instruction, providing a valuable tool to improve teaching. However, free-form text comments obtained from the open-ended question component of such surveys are only infrequently analysed comprehensively. We employed an innovative, systematic approach to the analysis of…

  5. Reliability of the Motor Learning Strategy Rating Instrument for Children and Youth with Acquired Brain Injury

    Science.gov (United States)

    Kamath, Trishna; Pfeifer, Megan; Banerjee-Guenette, Priyanka; Hunter, Theresa; Ito, Julia; Salbach, Nancy M.; Wright, Virginia; Levac, Danielle

    2012-01-01

    Purpose: To evaluate reliability and feasibility of the Motor Learning Strategy Rating Instrument (MLSRI) in children with acquired brain injury (ABI). The MLSRI quantifies the extent to which motor learning strategies (MLS) are used within physiotherapy (PT) interventions. Methods: PT sessions conducted by ABI team physiotherapists with a…

  6. Queueing theoretic analysis of labor and delivery : Understanding management styles and C-section rates.

    Science.gov (United States)

    Gombolay, Matthew; Golen, Toni; Shah, Neel; Shah, Julie

    2017-09-04

    Childbirth is a complex clinical service requiring the coordinated support of highly trained healthcare professionals as well as management of a finite set of critical resources (such as staff and beds) to provide safe care. The mode of delivery (vaginal delivery or cesarean section) has a significant effect on labor and delivery resource needs. Further, resource management decisions may impact the amount of time a physician or nurse is able to spend with any given patient. In this work, we employ queueing theory to model one year of transactional patient information at a tertiary care center in Boston, Massachusetts. First, we observe that the M/G/∞ model effectively predicts patient flow in an obstetrics department. This model captures the dynamics of labor and delivery where patients arrive randomly during the day, the duration of their stay is based on their individual acuity, and their labor progresses at some rate irrespective of whether they are given a bed. Second, using our queueing theoretic model, we show that reducing the rate of cesarean section - a current quality improvement goal in American obstetrics - may have important consequences with regard to the resource needs of a hospital. We also estimate the potential financial impact of these resource needs from the hospital perspective. Third, we report that application of our model to an analysis of potential patient coverage strategies supports the adoption of team-based care, in which attending physicians share responsibilities for patients.

  7. Test and Delivery of the Chemin Mineralogical Instrument for Mars Science Laboratory

    Science.gov (United States)

    Blake, D. F.; Vaniman, D.; Anderson, R.; Bish, D.; Chipera, S.; Chemtob, S.; Crisp, J.; DesMarais, D. J.; Downs, R.; Feldman, S.; hide

    2010-01-01

    The CheMin mineralogical instrument on MSL will return quantitative powder X-ray diffraction data (XRD) and qualitative X-ray fluorescence data (XRF; 14

  8. The use of quality control performance charts to analyze cesarean delivery rates nationally.

    LENUS (Irish Health Repository)

    Turner, Michael J

    2012-02-01

    OBJECTIVE: To examine the use of quality control performance charts to analyze cesarean rates nationally. METHODS: Information on cesarean rates was obtained for all 19 Irish maternity hospitals receiving state funding in 2009. All women who underwent cesarean delivery of a live or stillborn infant weighing 500 g or more between January 1 and December 31 were included. Deliveries were classified as elective or emergency. Individual hospitals were not identified in the analysis. RESULTS: The mean rates per hospital of elective and emergency cesarean were 12.9+\\/-2.6% (n=9337) and 13.8+\\/-3.0% (n=9989), respectively-giving an overall mean rate of 26.7+\\/-4.2% (n=19326) per hospital. Cesarean rates were normally distributed. Using a quality control performance chart with a cutoff 2 standard deviations from the mean, 1 hospital was above the normal range for both total and elective cesareans, indicating that its pre-labor obstetric practices warrant clinical review. Another hospital had a mean emergency cesarean rate above the normal range, indicating that its labor ward practices warrant review. CONCLUSION: Quality control performance charts can be used to analyze cesarean rates nationally and, thus, to identify hospitals at which obstetric practices should be reviewed.

  9. Impact of epidural analgesia on cesarean and operative vaginal delivery rates classified by the Ten Groups Classification System.

    Science.gov (United States)

    Lucovnik, M; Blajic, I; Verdenik, I; Mirkovic, T; Stopar Pintaric, T

    2018-05-01

    The Ten Group Classification System (TGCS) allows critical analysis according to the obstetric characteristics of women in labor: singleton or multiple pregnancy, nulliparous, multiparous, or multiparous with a previous cesarean delivery, cephalic, breech presentation or other malpresentation, spontaneous or induced labor, and term or preterm births. Labor outcomes associated with epidural analgesia may be different among the different labor classification groups. The aim of this study was to explore associations between epidural analgesia and cesarean delivery, and epidural analgesia and assisted vaginal delivery, in women classified using the TGCS. Slovenian National Perinatal Information System data for the period 2007-2014 were analyzed. All women after spontaneous onset or induction of labor were classified according to the TGCS, within which cesarean and vaginal assisted delivery rates were investigated (P cesarean delivery rates. Women in group 1 (nulliparous term women with singleton fetuses in cephalic presentation in spontaneous labor) with epidural analgesia had a higher cesarean delivery rate. In most TGCS groups women with epidural analgesia had higher assisted vaginal delivery rates. Epidural analgesia is associated with different effects on cesarean delivery and assisted vaginal delivery rates in different TGCS groups. Copyright © 2018. Published by Elsevier Ltd.

  10. Whole house particle removal and clean air delivery rates for in-duct and portable ventilation systems.

    Science.gov (United States)

    Macintosh, David L; Myatt, Theodore A; Ludwig, Jerry F; Baker, Brian J; Suh, Helen H; Spengler, John D

    2008-11-01

    A novel method for determining whole house particle removal and clean air delivery rates attributable to central and portable ventilation/air cleaning systems is described. The method is used to characterize total and air-cleaner-specific particle removal rates during operation of four in-duct air cleaners and two portable air-cleaning devices in a fully instrumented test home. Operation of in-duct and portable air cleaners typically increased particle removal rates over the baseline rates determined in the absence of operating a central fan or an indoor air cleaner. Removal rates of 0.3- to 0.5-microm particles ranged from 1.5 hr(-1) during operation of an in-duct, 5-in. pleated media filter to 7.2 hr(-1) for an in-duct electrostatic air cleaner in comparison to a baseline rate of 0 hr(-1) when the air handler was operating without a filter. Removal rates for total particulate matter less than 2.5 microm in aerodynamic diameter (PM2.5) mass concentrations were 0.5 hr(-1) under baseline conditions, 0.5 hr(-1) during operation of three portable ionic air cleaners, 1 hr(-1) for an in-duct 1-in. media filter, 2.4 hr(-1) for a single high-efficiency particle arrestance (HEPA) portable air cleaner, 4.6 hr(-1) for an in-duct 5-in. media filter, 4.7 hr(-1) during operation of five portable HEPA filters, 6.1 hr(-1) for a conventional in-duct electronic air cleaner, and 7.5 hr(-1) for a high efficiency in-duct electrostatic air cleaner. Corresponding whole house clean air delivery rates for PM2.5 attributable to the air cleaner independent of losses within the central ventilation system ranged from 2 m3/min for the conventional media filter to 32 m3/min for the high efficiency in-duct electrostatic device. Except for the portable ionic air cleaner, the devices considered here increased particle removal indoors over baseline deposition rates.

  11. Influence of Loading Rate on the Calibration of Instrumented Charpy Strikers

    Energy Technology Data Exchange (ETDEWEB)

    Lucon, E.; Scibetta, M.; McColskey, D.; McCowan, C.

    2009-01-15

    One of the key factors for obtaining reliable instrumented Charpy results is the calibration of the instrumented striker. The conventional approach for establishing an analytical relationship between strain gage output and force applied to the transducer is the static calibration, which is preferably performed with the striker installed in the pendulum assembly. However, the response of an instrumented striker under static force application may sometimes differ significantly from its dynamic performance during an actual Charpy test. This is typically reflected in a large difference between absorbed energy returned by the pendulum encoder (KV) and calculated under the instrumented force/displacement test record (Wt). Such difference can be either minimized by optimizing the striker design or analytically removed by adjusting forces and displacements until KV = Wt (the so-called 'Dynamic Force Adjustment'). This study investigates the influence of increasing force application rates on the force/voltage characteristics of two instrumented strikers, one at NIST in Boulder, CO and one at SCK-CEN in Mol, Belgium.

  12. Institutional setting and wealth gradients in cesarean delivery rates: Evidence from six developing countries.

    Science.gov (United States)

    Sepehri, Ardeshir

    2018-06-01

    The influence of the type of institutional setting on cesarean delivery is well documented. However, the traditional boundaries between public and private providers have become increasingly blurred with the commercialization of the state health sector that allows providers to tailor the quantity and quality of care according to patients' ability to pay. This study examined wealth-related variations in cesarean rates in six lower- and upper-middle income countries: the Dominican Republic, Egypt, Guatemala, Jordan, Pakistan, and the Philippines. Demographic and Health Survey data and a hierarchical regression model were used to assess wealth-related variations in cesarean rates in government and private hospitals while controlling for a wide range of women's socioeconomic and risk profiles. The odds of undergoing a cesarean delivery were greater in private facilities than government hospitals by 58% in Jordan, 129% in Guatemala, and 262% and 279% in the Dominican Republic and Egypt, respectively. Additional analysis involving interactions between the type of facility and wealth quintiles indicated that wealthier women were more likely to undergo a cesarean birth in government hospitals than poorer women in all countries but the Dominican Republic and Guatemala. Moreover, in both Egypt and Jordan, differences in cesarean rates between government and private hospitals were smaller for the wealthier strata than for the nonwealthy. Large wealth-related variations in the mode of delivery across government and private hospitals suggest the need for well-developed guidelines and standards to achieve a more appropriate selection of cases for cesarean delivery. © 2018 Wiley Periodicals, Inc.

  13. The retributive rates, economic instrument, effective for the water decontamination in the Oriente Antioqueno

    International Nuclear Information System (INIS)

    Castro Hernandez, Luis Fernando

    1999-01-01

    The article contains the antecedents of the collection of the recompensing rates in Colombia at the beginning of the decade of the eighty it not insinuates as a mechanism for the atmospheric contamination. Later on the law 99 of 1993 defines it as the most important mechanism to not achieve the contamination of sources of water in the country. It establishes this way it the ordinance 901 of April of 1997 by means of which the process of implementation of the recompensing rates begins in the Oriente Antioqueno where at the moment is carried out the collection in eight basins. The article also registers the results that leave the economic instrument in what refers at levels of non-contamination of basins and in money collected after having billed five semesters. Likewise it reports a series of benefits that leaves the instrument after two years of implementation in the Oriente Antioqueno

  14. Implementation of vaginal cleansing prior to cesarean delivery to decrease endometritis rates.

    Science.gov (United States)

    Felder, Laura; Paternostro, Amanda; Quist-Nelson, Johanna; Baxter, Jason; Berghella, Vincenzo

    2018-01-17

    Endometritis is a postpartum complication that is more common after cesarean delivery. It frequently requires intravenous antibiotic administration, prolonged hospital stays, and carries a risk of sepsis or abscess formation. Precesarean vaginal preparation has been shown to decrease the risk of endometritis in patients who have labored or have ruptured membranes. The objective of this study was to assess the practical implementation of a protocol for vaginal cleansing prior to cesarean delivery and the subsequent effect on endometritis rates in a clinical setting. This is a before-after retrospective cohort study evaluating the first 6 months of implementation of a vaginal cleansing protocol at a single institution. The primary outcome was the rate of implementation. Secondary outcomes included endometritis and other postoperative complications. The rate of implementation after 6 months was 68.3% (p < .001) and postoperative endometritis rates decreased from 14.0% before implementation to 11.7% after implementation (p .49, OR 0.77, CI 0.36-1.62). Postoperative fever decreased from 22.3% to 18.3% (p .256, OR 0.70, CI 0.37-1.30) and infectious wound complications were 4.5% and 5.8%, respectively (p .76, OR 1.07, CI 0.69-3.64). Implementation of a protocol for vaginal cleansing prior to cesarean delivery in women with ruptured membranes or in labor has high uptake, but in almost a third of eligible women it was not performed. The implementation, has led to a clinical, although not statistical, decrease in postoperative endometritis. Continued research is needed to explore how to improve uptake of this quality improvement measure.

  15. ''Iodine delivery rate'' with catheterangiography under pressure conditions of hand injection

    International Nuclear Information System (INIS)

    Busch, H.P.; Stocker, K.P.

    1998-01-01

    Purpose: The aim of this study was to record the flow-rate and to calculate the 'iodine delivery rate' (IDR) of contrast media of various viscosities when the contrast media are injected by hand. Methods: Five different catheters for coronary angiography were tested with the injection system Medral Mark V Plus. Injections were performed with pressures of 100, 200 and 400 PSI. The contrast media examined were Imeron 350, Imeron 400, Omnipaque 350 and Ultravist 370. The IDR was calculated on the basis of the measured flow rate and the Iodine content of the contrast medium. Results: As was expected, the IDR was higher as the pressure increased. In addition to the iodine content the viscosity of the contrast medium is a very important factor for the IDR. At both 100 PSI and 200 PSI the increase of the IDR was higher with Imeron 350 than with Imeron 400. The comparison of contrast media with identical iodine contents but differing viscosities (Imeron 350, Omnipaque 350) clearly showed that the IDR depended on viscosity. Conclusion: The 'iodine delivery rate' is a decisive factor in the opacification of arterial vessels. Both iodine content and viscosity of a contrast medium are important for the IDR. Because of the low pressure at manual injection, contrast media with low viscosities should be used. A further possibility to increase the IDR is warming-up the contrast medium to body temperature. (orig.) [de

  16. Development of an instrument for direct ozone production rate measurements: measurement reliability and current limitations

    Science.gov (United States)

    Sklaveniti, Sofia; Locoge, Nadine; Stevens, Philip S.; Wood, Ezra; Kundu, Shuvashish; Dusanter, Sébastien

    2018-02-01

    Ground-level ozone (O3) is an important pollutant that affects both global climate change and regional air quality, with the latter linked to detrimental effects on both human health and ecosystems. Ozone is not directly emitted in the atmosphere but is formed from chemical reactions involving volatile organic compounds (VOCs), nitrogen oxides (NOx = NO + NO2) and sunlight. The photochemical nature of ozone makes the implementation of reduction strategies challenging and a good understanding of its formation chemistry is fundamental in order to develop efficient strategies of ozone reduction from mitigation measures of primary VOCs and NOx emissions. An instrument for direct measurements of ozone production rates (OPRs) was developed and deployed in the field as part of the IRRONIC (Indiana Radical, Reactivity and Ozone Production Intercomparison) field campaign. The OPR instrument is based on the principle of the previously published MOPS instrument (Measurement of Ozone Production Sensor) but using a different sampling design made of quartz flow tubes and a different Ox (O3 and NO2) conversion-detection scheme composed of an O3-to-NO2 conversion unit and a cavity attenuated phase shift spectroscopy (CAPS) NO2 monitor. Tests performed in the laboratory and in the field, together with model simulations of the radical chemistry occurring inside the flow tubes, were used to assess (i) the reliability of the measurement principle and (ii) potential biases associated with OPR measurements. This publication reports the first field measurements made using this instrument to illustrate its performance. The results showed that a photo-enhanced loss of ozone inside the sampling flow tubes disturbs the measurements. This issue needs to be solved to be able to perform accurate ambient measurements of ozone production rates with the instrument described in this study. However, an attempt was made to investigate the OPR sensitivity to NOx by adding NO inside the instrument

  17. Increasing vaginal progesterone gel supplementation after frozen-thawed embryo transfer significantly increases the delivery rate

    DEFF Research Database (Denmark)

    Alsbjerg, Birgit; Polyzos, Nikolaos P; Elbaek, Helle Olesen

    2013-01-01

    The aim of this study was to evaluate the reproductive outcome in patients receiving frozen-thawed embryo transfer before and after doubling of the vaginal progesterone gel supplementation. The study was a retrospective study performed in The Fertility Clinic, Skive Regional Hospital, Denmark....... A total of 346 infertility patients with oligoamenorrhoea undergoing frozen-thawed embryo transfer after priming with oestradiol and vaginal progesterone gel were included. The vaginal progesterone dose was changed from 90mg (Crinone) once a day to twice a day and the reproductive outcome during the two...... rate (8.7% versus 20.5%, respectively; P=0.002). Doubling of the vaginal progesterone gel supplementation during frozen-thawed embryo transfer cycles decreased the early pregnancy loss rate, resulting in a significantly higher delivery rate. This study evaluated the reproductive outcome of 346 women...

  18. Development of a portable instrument to measure ozone production rates in the troposphere

    Science.gov (United States)

    Sklaveniti, Sofia; Locoge, Nadine; Stevens, Philip; Kumar, Vinod; Sinha, Vinayak; Dusanter, Sébastien

    2015-04-01

    Ground-level ozone is a key species related to air pollution, causing respiratory problems, damaging crops and forests, and affecting the climate. Our current understanding of the tropospheric ozone-forming chemistry indicates that net ozone production occurs via reactions of peroxy radicals (HO2 + RO2) with NO producing NO2, whose photolysis leads to O3 formation. Production rates of tropospheric ozone, P(O3), depend on concentrations of oxides of nitrogen (NOx = NO + NO2) and Volatile Organic Compounds (V OCs), but also on production rates of ROx radicals (OH + HO2 + RO2). The formation of ozone follows a complex nonlinear chemistry that makes strategies for reducing ozone difficult to implement. In this context, atmospheric chemistry models are used to develop emission regulations, but there are still uncertainties associated with the chemical mechanisms used in these models. Testing the ozone formation chemistry in atmospheric models is needed, in order to ensure the development of effective strategies for ozone reduction. We will present the development of an instrument for direct measurements of ozone production rates (OPR) in ambient air. The OPR instrument is made of three components: (i) two quartz flow tubes to sample ambient air, one exposed to solar radiation and one covered by a UV filter, (ii) a NO2-to-O3 conversion unit, and (iii) an ozone analyzer. The total amount of ozone exiting each flow tube is conserved in the form of Ox = NO2 + O3. Ozone production rates P(O3) are derived from the difference in Ox concentration between the two flow tubes, divided by the exposure time of air inside the flow tubes. We will present studies that were carried out in the laboratory to characterize each part of the instrument and we will discuss the performances of the OPR instrument based on experiments carried out using synthetic air mixtures of known composition (NOx and V OCs). Chemical modeling will also be presented to assess the reliability of ozone

  19. Collection of radiation resistant characteristics reports for instruments and materials in high dose rate environment

    International Nuclear Information System (INIS)

    Kusano, Joichi

    2008-03-01

    This document presents the collected official reports of radiation irradiation study for the candidate materials to be used in high dose rate environment as J-PARC facility. The effect of radiation damage by loss-beam or secondary particle beam of the accelerators influences the performance and the reliability of various instruments. The knowledge on the radiation resistivity of the materials is important to estimate the life of the equipments, the maintenance interval and dose evaluation for the personnel at the maintenance period. The radiation damage consists with mechanical property, electrical property and gas-evolution property. (author)

  20. Prospective longitudinal cohort study on cumulative 5-year delivery and adoption rates among 1338 couples initiating infertility treatment

    DEFF Research Database (Denmark)

    Pinborg, A; Hougaard, C O; Andersen, A Nyboe

    2009-01-01

    occurred for 5.9% (48/817) of the women. Positive prognostic factors for delivery were male infertility, female age infertility and less than three previous treatment cycles. CONCLUSIONS A crude delivery rate of 69.4% in the total population 5 years after referral to tertiary......BACKGROUND The objective was to assess crude 5-year delivery rates after assisted reproductive technology (ART) treatment, intrauterine inseminations (IUI), spontaneous conceptions (SC) and adoptions in a large infertile cohort. METHODS A prospective longitudinal survey comprised 1338 infertile...... couples starting public infertility programmes offering IUIs and three free ART cycles during 2000-2001. The cohort was cross-linked with the National Medical Birth Register to obtain delivery rates for all 1338 couples. More detailed data were available from 817 women responding to a 5-year follow...

  1. Development of strategies to reduce cesarean delivery rates in iran 2012-2014: A mixed methods study

    Directory of Open Access Journals (Sweden)

    Razieh Lotfi

    2014-01-01

    Full Text Available Background: With the change in population policy from birth control toward encouraging birth and population growth in Iran, repeated cesarean deliveries as a main reason of cesarean section are associated with more potential adverse consequences. The aim of this research was to explore effective strategies to reduce cesarean delivery rates in Iran. Methods: A mixed methodological study was designed and implemented. First, using a qualitative approach, concepts and influencing factors of increased cesarean delivery were explored. Based on the findings of this phase of the study, a questionnaire including the proposed strategies to reduce cesarean delivery was developed. Then in a quantitative phase, the questionnaire was assessed by key informants from across the country and evaluated to obtain more effective strategies to reduce cesarean delivery. Ten participants in the qualitative study included policy makers from the Ministry of Health, obstetricians, midwives and anthropologists. In the next step, 141 participants from private and public hospitals, insurance experts, Academic Associations of Midwifery, and policy makers in Maternity Health Affairs of Ministry of Health were invited to assess and provide feedback on the strategies that work to reduce cesarean deliveries. Results: Qualitative data analysis showed four concept related to increased cesarean delivery rates including; "standardization", "education", "amending regulations", and "performance supervision". Effective strategies extracted from qualitative data were rated by participants then, using ACCEPT derived from A as attainability, C as costing, C as complication, E as effectiveness, P as popularity, and T as timing table 19 strategies were detected as priorities. Conclusions: Although developing effective strategies to reduce cesarean delivery rates is complex process because of the multi-factorial nature of increased cesarean deliveries, in this study we have achieved

  2. Retrospective analysis of dose delivery in intra-operative high dose rate brachytherapy

    International Nuclear Information System (INIS)

    Oh, M.; Avadhani, J.S.; Malhotra, H.K.; Cunningham, B.; Tripp, P.; Jaggernauth, W.; Podgorsak, M.B.

    2007-01-01

    Background. This study was performed to quantify the inaccuracy in clinical dose delivery due to the incomplete scatter conditions inherent in intra-operative high dose rate (IOHDR) brachytherapy. Methods. Treatment plans of 10 patients previously treated in our facility, which had irregular shapes of treated areas, were used. Treatment geometries reflecting each clinical case were simulated using a phantom assembly with no added build-up on top of the applicator. The treatment planning geometry (full scatter surrounding the applicator) was subsequently simulated for each case by adding bolus on top of the applicator. Results. For geometries representing the clinical IOHDR incomplete scatter environment, measured doses at the 5 mm and 10 mm prescription depths were lower than the corresponding prescribed doses by about 7.7% and 11.1%, respectively. Also, for the two prescription methods, an analysis of the measured dose distributions and their corresponding treatment plans showed average decreases of 1.2 mm and 2.2 mm in depth of prescription dose, respectively. Conclusions. Dosimetric calculations with the assumption of an infinite scatter environment around the applicator and target volume have shown to result in dose delivery errors that significantly decrease the prescription depth for IOHDR treatment.(author)

  3. Initial ratings of different types of e-cigarettes and relationships between product appeal and nicotine delivery.

    Science.gov (United States)

    Hajek, Peter; Przulj, Dunja; Phillips-Waller, Anna; Anderson, Rebecca; McRobbie, Hayden

    2018-04-01

    Little is known about features of e-cigarettes (EC) that facilitate or hinder the switch from smoking to vaping. We tested eight brands of EC to determine how nicotine delivery and other product characteristics influence user's initial reactions. Fifteen vapers tested each product after overnight abstinence from both smoking and vaping. At each session, participant's vaped ad lib for 5 min. Blood samples were taken at baseline and at 2, 4, 6, 8, 10 and 30 min after starting vaping. Participants rated the products on a range of characteristics. The products tested included six 'cig-a-like' and two refillable products, one with variable voltage. We also tested participants' own EC. All products significantly reduced urges to smoke. Refillable products delivered more nicotine and received generally superior ratings in terms of craving relief, subjective nicotine delivery, throat hit and vapour production but in overall ratings, they were joined by a cig-a-like, Blu. Participants puffed more on low nicotine delivery products. Participants' estimates of nicotine delivery from different EC were closely linked to 'throat hit'. Nicotine delivery was less important in the initial product ratings than draw resistance, mouthpiece comfort and effects on reducing urge to smoke. All EC products reduced urges to smoke. Refillable products received generally more favourable ratings than 'cig-a-likes' with similar nicotine content. Perception of nicotine delivery was guided by throat sensations. Lower nicotine delivery was associated with more frequent puffing. The first impressions of EC products are guided less by nicotine delivery than by sensory signals.

  4. Delivery by Cesarean Section is not Associated With Decreased at-Birth Fracture Rates in Osteogenesis Imperfecta

    Science.gov (United States)

    Bellur, S; Jain, M; Cuthbertson, D; Krakow, D; Shapiro, JR; Steiner, RD; Smith, PA; Bober, MB; Hart, T; Krischer, J; Mullins, M; Byers, PH; Pepin, M; Durigova, M; Glorieux, FH; Rauch, F; Sutton, VR; Lee, B; Nagamani, SC

    2015-01-01

    Purpose Osteogenesis imperfecta (OI) predisposes to recurrent fractures. The moderate-to-severe forms of OI present with antenatal fractures and the mode of delivery that would be safest for the fetus is not known. Methods We conducted systematic analyses on the largest cohort of individuals (n=540) with OI enrolled to-date in the OI Linked Clinical Research Centers. Self-reported at-birth fracture rates were compared in individuals with OI types I, III, and IV. Multivariate analyses utilizing backward-elimination logistic regression model building were performed to assess the effect of multiple covariates including method of delivery on fracture-related outcomes. Results When accounting for other covariates, at-birth fracture rates did not differ based on whether delivery was by vaginal route or by cesarean section (CS). Increased birth weight conferred higher risk for fractures irrespective of the delivery method. In utero fracture, maternal history of OI, and breech presentation were strong predictors for choosing CS for delivery. Conclusion Our study, the largest to analyze the effect of various factors on at-birth fracture rates in OI shows that delivery by CS is not associated with decreased fracture rate. With the limitation that the fracture data were self-reported in this cohort, these results suggest that CS should be performed only for other maternal or fetal indications, but not for the sole purpose of fracture prevention in OI. PMID:26426884

  5. Increasing Low Birth Weight Rates: Deliveries in a Tertiary Hospital in Istanbul

    OpenAIRE

    Berrin Telatar; Orhan Ünal; Abdülkadir Piçak; Lale Ger; Serdar Cömert; Cem Turan; Yasemin Akin

    2010-01-01

    Objective:Prevalence of low birth weight deliveries may vary across different environments. The necessity of determination of regional data prompted this study. Methods:Information of all deliveries from January 2004 to December 2008 was obtained from delivery registry records retrospectively. Initial data including birth weight, vital status, sex, maternal age and mode of delivery were recorded using medical files. The frequency of low birth weight, very low birth weight, extremely low birth...

  6. Effect of milk sample delivery methods and arrival conditions on bacterial contamination rates.

    Science.gov (United States)

    Dinsmore, R P; English, P B; Matthews, J C; Sears, P M

    1990-07-01

    A cross sectional study was performed of factors believed to contribute to the contamination of bovine milk sample cultures submitted to the Ithaca Regional Laboratory of the Quality Milk Promotion Services/New York State Mastitis Control. Of 871 samples entered in the study, 137 (15.7%) were contaminated. There were interactions between the sample source (veterinarian vs dairyman), delivery method, and time between sample collection and arrival at the laboratory. If only those samples collected and hand delivered by the dairyman within 1 day of collection were compared to a like subset of samples collected and hand delivered by veterinarians, no statistically significant differences in milk sample contamination rate (MSCR) were found. Samples were delivered to the laboratory by hand, US Postal Service, United Parcel Service, via the New York State College of Veterinary Medicine Diagnostic Laboratory, or Northeast Dairy Herd Improvement Association Courier. The MSCR was only 7.6% for hand delivered samples, while 26% of Postal Service samples were contaminated. These rates differed significantly from other delivery methods (P less than 0.0001). The USPS samples arrived a longer time after sampling than did samples sent by other routes, and time had a significant effect on MSCR (0 to 1 day, 8.9%; greater than 1 day, 25.9%; P less than 0.01). Samples packaged with ice packs sent by routes other than the Postal Service had a lower MSCR than those not packaged with ice packs, but ice packs did not reduce the MSCR for samples sent by the Postal Service.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Planned home compared with planned hospital births: Mode of delivery and Perinatal mortality rates, an observational study

    NARCIS (Netherlands)

    Kooy, J. (Jacoba); E. Birnie (Erwin); S. Denktaş (Semiha); E.A.P. Steegers (Eric); G.J. Bonsel (Gouke)

    2017-01-01

    textabstractBackground: To compare the mode of delivery between planned home versus planned hospital births and to determine if differences in intervention rates could be interpreted as over- or undertreatment. Methods: Intervention and perinatal mortality rates were obtained for 679,952 low-risk

  8. Comparing variation in hospital rates of cesarean delivery among low-risk women using 3 different measures.

    Science.gov (United States)

    Armstrong, Joanne C; Kozhimannil, Katy B; McDermott, Patricia; Saade, George R; Srinivas, Sindhu K

    2016-02-01

    This report describes the development of a measure of low-risk cesarean delivery by the Society for Maternal-Fetal Medicine (SMFM). Safely lowering the cesarean delivery rate is a priority for maternity care clinicians and health care delivery systems. Therefore, hospital quality assurance programs are increasingly tracking cesarean delivery rates among low-risk pregnancies. Two commonly used definitions of "low risk" are available, the Joint Commission (JC) and the Agency for Healthcare Research and Quality (AHRQ) measures, but these measures are not clinically comprehensive. We sought to refine the definition of the low-risk cesarean delivery rate to enhance the validity of the metric for quality measurement. We created this refined definition-called the SMFM definition-and compared it to the JC and AHRQ measures using claims-based data from the 2011 Nationwide Inpatient Sample of >863,000 births in 612 hospitals. Using these definitions, we calculated means and interquartile ranges (25th-75th percentile range) for hospital low-risk cesarean delivery rates, stratified by hospital size, teaching status, urban/rural location, and payer mix. Across all hospitals, the mean low-risk cesarean delivery rate was lowest for the SMFM definition (12.65%), but not substantially different from the JC and AHRQ measures (13.12% and 13.29%, respectively). We empirically examined the SMFM definition to ensure its validity and utility. This refined definition performs similarly to existing measures and has the added advantage of clinical perspective, enhanced face validity, and ease of use. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Increased planned delivery contributes to declining rates of pregnancy hypertension in Australia: a population-based record linkage study.

    Science.gov (United States)

    Roberts, Christine L; Algert, Charles S; Morris, Jonathan M; Ford, Jane B

    2015-10-05

    Since the 1990s, pregnancy hypertension rates have declined in some countries, but not all. Increasing rates of early planned delivery (before the due date) have been hypothesised as the reason for the decline. The aim of this study was to explore whether early planned delivery can partly explain the declining pregnancy hypertension rates in Australia. Population-based record linkage study utilising linked birth and hospital records. A cohort of 1,076,122 deliveries in New South Wales, Australia, 2001-2012. Pregnancy hypertension (including gestational hypertension, pre-eclampsia and eclampsia) was the main outcome; pre-eclampsia was a secondary outcome. From 2001 to 2012, pregnancy hypertension rates declined by 22%, from 9.9% to 7.7%, and pre-eclampsia by 27%, from 3.3% to 2.4% (trend prate was predicted to increase to 10.5%. Examination of annual gestational age distributions showed that pregnancy hypertension rates actually declined from 38 weeks gestation and were steepest from 41 weeks; at least 36% of the decrease could be attributed to planned deliveries. The risk factors for pregnancy hypertension were also risk factors for planned delivery. It appears that an unanticipated consequence of increasing early planned deliveries is a decline in the incidence of pregnancy hypertension. Women with risk factors for hypertension were relatively more likely to be selected for early delivery. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Intravascular enhancement with identical iodine delivery rate using different iodine contrast media in a circulation phantom.

    Science.gov (United States)

    Mihl, Casper; Wildberger, Joachim E; Jurencak, Tomas; Yanniello, Michael J; Nijssen, Estelle C; Kalafut, John F; Nalbantov, Georgi; Mühlenbruch, Georg; Behrendt, Florian F; Das, Marco

    2013-11-01

    Both iodine delivery rate (IDR) and iodine concentration are decisive factors for vascular enhancement in computed tomographic angiography. It is unclear, however, whether the use of high-iodine concentration contrast media is beneficial to lower iodine concentrations when IDR is kept identical. This study evaluates the effect of using different iodine concentrations on intravascular attenuation in a circulation phantom while maintaining a constant IDR. A circulation phantom with a low-pressure venous compartment and a high-pressure arterial compartment simulating physiological circulation parameters was used (heart rate, 60 beats per minute; stroke volume, 60 mL; blood pressure, 120/80 mm Hg). Maintaining a constant IDR (2.0 g/s) and a constant total iodine load (20 g), prewarmed (37°C) contrast media with differing iodine concentrations (240-400 mg/mL) were injected into the phantom using a double-headed power injector. Serial computed tomographic scans at the level of the ascending aorta (AA), the descending aorta (DA), and the left main coronary artery (LM) were obtained. Total amount of contrast volume (milliliters), iodine delivery (grams of iodine), peak flow rate (milliliter per second), and intravascular pressure (pounds per square inch) were monitored using a dedicated data acquisition program. Attenuation values in the AA, the DA, and the LM were constantly measured (Hounsfield unit [HU]). In addition, time-enhancement curves, aortic peak enhancement, and time to peak were determined. All contrast injection protocols resulted in similar attenuation values: the AA (516 [11] to 531 [37] HU), the DA (514 [17] to 531 [32] HU), and the LM (490 [10] to 507 [17] HU). No significant differences were found between the AA, the DA, and the LM for either peak enhancement (all P > 0.05) or mean time to peak (AA, 19.4 [0.58] to 20.1 [1.05] seconds; DA, 21.1 [1.0] to 21.4 [1.15] seconds; LM, 19.8 [0.58] to 20.1 [1.05] seconds). This phantom study demonstrates that

  11. Mind the information gap: fertility rate and use of cesarean delivery and tocolytic hospitalizations in Taiwan.

    Science.gov (United States)

    Ma, Ke-Zong M; Norton, Edward C; Lee, Shoou-Yih D

    2011-12-12

    Physician-induced demand (PID) is an important theory to test given the longstanding controversy surrounding it. Empirical health economists have been challenged to find natural experiments to test the theory because PID is tantamount to strong income effects. The data requirements are both a strong exogenous change in income and two types of treatment that are substitutes but have different net revenues. The theory implies that an exogenous fall in income would lead physicians to recoup their income by substituting a more expensive treatment for a less expensive treatment. This study takes advantages of the dramatic decline in the Taiwanese fertility rate to examine whether an exogenous and negative income shock to obstetricians and gynecologists (ob/gyns) affected the use of c-sections, which has a higher reimbursement rate than vaginal delivery under Taiwan's National Health Insurance system during the study period, and tocolytic hospitalizations. The primary data were obtained from the 1996 to 2004 National Health Insurance Research Database in Taiwan. We hypothesized that a negative income shock to ob/gyns would cause them to provide more c-sections and tocolytic hospitalizations to less medically-informed pregnant women. Multinomial probit and probit models were estimated and the marginal effects of the interaction term were conducted to estimate the impacts of ob/gyn to birth ratio and the information gap. Our results showed that a decline in fertility did not lead ob/gyns to supply more c-sections to less medically-informed pregnant women, and that during fertility decline ob/gyns may supply more tocolytic hospitalizations to compensate their income loss, regardless of pregnant women's access to health information. The exogenous decline in the Taiwanese fertility rate and the use of detailed medical information and demographic attributes of pregnant women allowed us to avoid the endogeneity problem that threatened the validity of prior research. They also

  12. The role of nocturnal delivery and delivery during the holiday period in Finland on obstetric anal sphincter rupture rates- a population based observational study

    Directory of Open Access Journals (Sweden)

    Vehviläinen-Julkunen Katri

    2010-02-01

    Full Text Available Abstract Background Obstetric anal sphincter rupture (OASR is a serious complication of delivery, which frequently results in faecal incontinence despite primary repair and has serious implications for women's health. The objective of this study was to assess whether human factors, workload and staffing at night, at weekends and during holidays has an effect on the increasing OASR rates among all singleton vaginal deliveries (n = 514,741 having occurred between 1997 and 2007 in Finland. Women (n = 2,849 with OASR were compared in terms of possible risk factors to women without OASR using stepwise logistic regression analysis. Findings In Finland, the increase in OASR rate is striking, from 0.2% in 1997 to 0.9% in 2007. OASR rates varied from 0.49% to 0.58% (≤ 0.001 according to the time of day, and were lowest at night. After adjustment for patient-mix and the use of interventions, the risk of OASR was 11% lower (95% CI 3-18% at night and 15% lower (95% CI 3-26% in July - the main holiday month. Only 14% of the increased OASR risk during the day time (8-23.59 was attributable to vacuum assistance and birth weight, whereas the holiday period had no effect. Conclusions Decreased OASR rates at night and in July suggest that human factors such as decreased alertness due to fatigue or hospitals' administrative factors such as workload and staffing did not increase the rates of OASR.

  13. Risk-free assets: Are they truly risk-free? A comparative study of South African rates and instruments

    Directory of Open Access Journals (Sweden)

    Oosthuizen, A.V.

    2013-10-01

    Full Text Available Determining the price of a financial instrument is something that happens every day in the financial markets. Every price starts off with a spot price adjusted for interest until maturity of the particular instrument. The interest is usually described as risk-free interest. The price so determined is the most basic price that an investor is willing to pay if not risk is involved. Risk-free assets, then, are securities of which the future rates of return are known with certainty. An exceptional degree of confidence in the issuer of the security brings about this certainty. Risk-free assets are normally in the fixed income securities (capital markets investment category or in the liquid money market instruments such as treasury bills, category. This study attempts to determine whether the risk-free rates used by treasury managers and traders in South Africa to formulate their bond yield curves and which are used in valuation models, may be deemed risk-free. The study specifies certain criteria that an asset must satisfy in order to be used as a risk-free asset. Short term and long term South African instruments are compared to the US counterpart instruments, to gain an understanding of the South African instruments relative to the US ones. The behaviour of the risk-free instruments used in South Africa is also compared to the FTSE/JSE All Share Index and gold spot prices, which are perceived to be a risky asset classes. To gain some understanding of the behaviour of these instruments, analyses were done from different angles. The standard deviations of the daily percentage changes of the R157 were significantly lower than that of the ALSI and the gold spot price change. Compared to the ALSI and gold spot price, therefore, the R157 may be deemed a “low risk” instrument. The JIBAR was even less volatile that the R157. Interestingly, the US instruments were substantially more risky than the SA instruments over the analysis period. Also the JIBAR

  14. Decrease in delivery room intubation rates after use of nasal intermittent positive pressure ventilation in the delivery room for resuscitation of very low birth weight infants.

    Science.gov (United States)

    Biniwale, Manoj; Wertheimer, Fiona

    2017-07-01

    The literature supports minimizing duration of invasive ventilation to decrease lung injury in premature infants. Neonatal Resuscitation Program recommended use of non-invasive ventilation (NIV) in delivery room for infants requiring prolonged respiratory support. To evaluate the impact of implementation of non-invasive ventilation (NIV) using nasal intermittent positive pressure ventilation (NIPPV) for resuscitation in very low birth infants. Retrospective study was performed after NIPPV was introduced in the delivery room and compared with infants receiving face mask to provide positive pressure ventilation for resuscitation of very low birth weight infants prior to its use. Data collected from 119 infants resuscitated using NIPPV and 102 infants resuscitated with a face mask in a single institution. The primary outcome was the need for endotracheal intubation in the delivery room. Data was analyzed using IBM SPSS Statistics software version 24. A total of 31% of infants were intubated in the delivery room in the NIPPV group compared to 85% in the Face mask group (p=rates were 11% in the NIPPV group and 31% in the Face mask group (p<0.001). Epinephrine administration was also lower in NIPPV group (2% vs. 8%; P=0.03). Only 38% infants remained intubated at 24hours of age in the NIPPV group compared to 66% in the Face mask group (p<0.001). Median duration of invasive ventilation in the NIPPV group was shorter (2days) compared to the Face mask group (11days) (p=0.01). The incidence of air-leaks was not significant between the two groups. NIPPV was safely and effectively used in the delivery room settings to provide respiratory support for VLBW infants with less need for intubation, chest compressions, epinephrine administration and subsequent invasive ventilation. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Is the introduction of anonymous delivery associated with a reduction of high neonaticide rates in Austria? A retrospective study.

    Science.gov (United States)

    Klier, C M; Grylli, C; Amon, S; Fiala, C; Weizmann-Henelius, G; Pruitt, S L; Putkonen, H

    2013-03-01

    To assess rates of neonaticide after the implementation of a preventative 'anonymous delivery' law in mid-2001 in Austria. Women are allowed to access antenatal care and give birth in a hospital anonymously, without showing any ID and free of charge. Retrospective study. A complete census of police-reported neonaticides was obtained from the police statistics of Austria, Sweden and Finland. All neonaticides reported to the police, 1991-2009. Neonaticide rates before (1991-2001) and after (2002-2009) the introduction of anonymous delivery legislation per 100 000 births. The Mann-Whitney U-test for two independent samples was used to compare neonaticide rates in the period before the new law was introduced with the rates observed after the implementation of the new law for each country. On average the rate of police-reported neonaticides was 7.2 per 100 000 births (SD 3.5, median 7.1) in Austria prior to the new law being passed, and 3.1 per 100 000 births (SD 2.1, median 2.6) after the law was passed. A significant decrease in neonaticide was observed in Austria after the implementation of anonymous delivery (Mann-Whitney U-test P = 0.017). Whereas the Finnish and Swedish rates were lower than the Austrian rates before and after the implementation of the Austrian law, they remained unchanged over the study period. Our data demonstrate a significant decrease in the number of police-reported neonaticides in Austria after the implementation of anonymous delivery. Even though underlying factors associated with neonaticide are complex, the findings could indicate an effect of anonymous delivery in the prevention of this crime. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

  16. [C-section rate in low-risk women: a useful indicator to compare hospitals attending deliveries with different risks].

    Science.gov (United States)

    Librero, Julián; Peiró, Salvador; Belda, Ana; Calabuig, Julia

    2014-01-01

    the C-section rate has been criticized as a performance indicator for not considering that different hospitals manage deliveries with diverse risks. In this work we explore the characteristics of a new indicator restricted to low C-section risk deliveries. retrospective cohort of all births (n=214,611) in all public hospitals during 2005-2010 in the Valencia Region, Spain (source: minimum basic dataset). A low-risk subpopulation consisting of women under-35, no history of c-section, between 37 and 41 gestational weeks, and with a single fetus, with cephalic presentation and normal weight (2500-3999 g) was constructed. We analyzed variability in the new indicator, its correlation with the crude indicator and, using multilevel logistic regression models, the presence of residual risks. a total of 117 589 births (58.4% of the whole deliveries) were identified as low C-section risk. The c-section rate in these women was 11.9% (24.4% for all deliveries) ranging between hospitals from 7.0% to 28.9%. The c-section rate in low-risk and total deliveries correlated strongly (r=0.88). The remaining risks in the population of low risk did not alter the hospital effect on the c-section rate. the percentage of C-section in low risk women include a high volume of deliveries, correlated with the crude indicator and residual risks are not differentially influenced by hospitals, being a useful indicator for monitoring the quality of obstetric care in the National Health System.

  17. Reducing the cesarean delivery rates for breech presentations: administration of spinal anesthesia facilitates manipulation to cephalic presentation, but is it cost saving?

    Science.gov (United States)

    2014-01-01

    Background External cephalic version (ECV) is infrequently performed and 98% of breech presenting fetuses are delivered surgically. Neuraxial analgesia can increase the success rate of ECV significantly, potentially reducing cesarean delivery rates for breech presentation. The current study aims to determine whether the additional cost to the hospital of spinal anesthesia for ECV is offset by cost savings generated by reduced cesarean delivery. Methods In our tertiary hospital, three variables manpower, disposables, and fixed costs were calculated for ECV, ECV plus anesthetic doses of spinal block, vaginal delivery and cesarean delivery. Total procedure costs were compared for possible delivery pathways. Manpower data were obtained from management payroll, fixed costs by calculating cost/lifetime usage rate and disposables were micro-costed in 2008, expressed in 2013 NIS. Results Cesarean delivery is the most expensive option, 11670.54 NIS and vaginal delivery following successful ECV under spinal block costs 5497.2 NIS. ECV alone costs 960.21 NIS, ECV plus spinal anesthesia costs 1386.97 NIS. The highest individual cost items for vaginal, cesarean delivery and ECV were for manpower. Expensive fixed costs for cesarean delivery included operating room trays and postnatal hospitalization (minimum 3 days). ECV with spinal block is cheaper due to lower expected cesarean delivery rate and its lower associated costs. Conclusions The additional cost of the spinal anesthesia is offset by increased success rates for the ECV procedure resulting in reduction in the cesarean delivery rate. PMID:24564984

  18. The Children's Sleep Comic: Psychometrics of a Self-rating Instrument for Childhood Insomnia.

    Science.gov (United States)

    Schwerdtle, Barbara; Kanis, Julia; Kübler, Andrea; Schlarb, Angelika A

    2016-02-01

    The Children's Sleep Comic is a standardized self-report questionnaire for assessing insomnia in children ages 5-11 years. The goal of the present study is to introduce a revised version of this measure and to present psychometrics and a cut-off score. Therefore, the revised Children's Sleep Comic, the Sleep Self Report, the Children's Sleep Habits Questionnaire, and the Child Behavior Checklist were applied to a sample of 393 children and their parents. Of the parents who participated voluntarily, a subsample (n = 176) was interviewed on the phone to diagnose their children with sleep disorders according to the International Classification of Sleep Disorders, if applicable. The results indicated that the Children's Sleep Comic is a reliable self-rating instrument for diagnosing childhood insomnia. Internal consistency was α = 0.83; and convergent and divergent validity were adequate. The child-friendly format can foster a good therapeutic relationship, and thus establish the basis for successful intervention.

  19. Development of a Self-Rating instrument to Measure Team Situation Awareness

    NARCIS (Netherlands)

    Schraagen, J.M.C.; Koning, L. de; Hof, T.; Dongen, K. van

    2010-01-01

    The goal of this paper is to describe the development of an instrument to measure team situation awareness (TSA). Individual team member SA may or may not be shared through communication processes with other team members. Most existing instruments do not measure these processes but measure TSA as a

  20. Development and Reliability Evaluation of the Movement Rating Instrument for Virtual Reality Video Game Play.

    Science.gov (United States)

    Levac, Danielle; Nawrotek, Joanna; Deschenes, Emilie; Giguere, Tia; Serafin, Julie; Bilodeau, Martin; Sveistrup, Heidi

    2016-06-01

    Virtual reality active video games are increasingly popular physical therapy interventions for children with cerebral palsy. However, physical therapists require educational resources to support decision making about game selection to match individual patient goals. Quantifying the movements elicited during virtual reality active video game play can inform individualized game selection in pediatric rehabilitation. The objectives of this study were to develop and evaluate the feasibility and reliability of the Movement Rating Instrument for Virtual Reality Game Play (MRI-VRGP). Item generation occurred through an iterative process of literature review and sample videotape viewing. The MRI-VRGP includes 25 items quantifying upper extremity, lower extremity, and total body movements. A total of 176 videotaped 90-second game play sessions involving 7 typically developing children and 4 children with cerebral palsy were rated by 3 raters trained in MRI-VRGP use. Children played 8 games on 2 virtual reality and active video game systems. Intraclass correlation coefficients (ICCs) determined intra-rater and interrater reliability. Excellent intrarater reliability was evidenced by ICCs of >0.75 for 17 of the 25 items across the 3 raters. Interrater reliability estimates were less precise. Excellent interrater reliability was achieved for far reach upper extremity movements (ICC=0.92 [for right and ICC=0.90 for left) and for squat (ICC=0.80) and jump items (ICC=0.99), with 9 items achieving ICCs of >0.70, 12 items achieving ICCs of between 0.40 and 0.70, and 4 items achieving poor reliability (close-reach upper extremity-ICC=0.14 for right and ICC=0.07 for left) and single-leg stance (ICC=0.55 for right and ICC=0.27 for left). Poor video quality, differing item interpretations between raters, and difficulty quantifying the high-speed movements involved in game play affected reliability. With item definition clarification and further psychometric property evaluation, the MRI

  1. The Effect of Teaching Experience and Specialty (Vocal or Instrumental) on Vocal Health Ratings of Music Teachers

    Science.gov (United States)

    Hackworth, Rhonda S.

    2010-01-01

    The current study sought to determine the relationship among music teachers' length of teaching experience, specialty (vocal or instrumental), and ratings of behaviors and teaching activities related to vocal health. Participants (N = 379) were experienced (n = 208) and preservice (n = 171) music teachers, further categorized by specialty, either…

  2. Mode of delivery following successful external cephalic version: comparison with spontaneous cephalic presentations at delivery.

    Science.gov (United States)

    Kuppens, Simone M I; Hutton, Eileen K; Hasaart, Tom H M; Aichi, Nassira; Wijnen, Henrica A; Pop, Victor J M

    2013-10-01

    To compare the obstetric outcomes of pregnant women after successful external cephalic version (ECV) (cases) with a large group of pregnant women with a spontaneously occurring cephalic fetal position at delivery (controls). We conducted a retrospective matched cohort study in a teaching hospital in the Netherlands. Delivery outcomes of women with a successful ECV were compared with those of women with spontaneously occurring cephalic presentations, controlling for maternal age, parity, gestational age at delivery, and onset of labour (spontaneous or induced). Exclusion criteria were a history of Caesarean section, delivery at < 35 weeks, and elective Caesarean section. The primary outcome was the prevalence of Caesarean section and instrumental delivery in both groups; secondary outcomes were the characteristics of cases requiring intervention such as Caesarean section or instrumental delivery. Women who had a successful ECV had a significantly higher Caesarean section rate than the women in the control group (33/220 [15%] vs. 62/1030 [6.0 %]; P < 0.001). There was no difference in the incidence of instrumental delivery (20/220 [9.1%] vs. 103/1030 [10%]). Comparison of characteristics of women in the cases group showed that nulliparity, induction of labour, and occiput posterior presentation were associated with Caesarean section and instrumental deliveries. Compared with delivery of spontaneous cephalic presenta-tions, delivery of cephalic presenting babies following successful ECV is associated with an increased rate of Caesarean section, especially in nulliparous women and women whose labour is induced.

  3. Changes in Cesarean Delivery Rates by Gestational Age: United States, 1996-2011

    Science.gov (United States)

    ... delivered by cesarean per 100 multiple births. Gestational age categories Early preterm : Births prior to 34 completed weeks of ... delivery among multiple births compared with singletons. The primary measure used to determine gestational age is the interval between the first day of ...

  4. Rating counselor-client behavior in online counseling: development and preliminary psychometric properties of the Counseling Progress and Depth Rating Instrument.

    Science.gov (United States)

    Bagraith, Karl; Chardon, Lydia; King, Robert John

    2010-11-01

    Although there are widely accepted and utilized models and frameworks for nondirective counseling (NDC), there is little in the way of tools or instruments designed to assist in determining whether or not a specific episode of counseling is consistent with the stated model or framework. The Counseling Progress and Depth Rating Instrument (CPDRI) was developed to evaluate counselor integrity in the use of Egan's skilled helper model in online counseling. The instrument was found to have sound internal consistency, good interrater reliability, and good face and convergent validity. The CPDRI is, therefore, proposed as a useful tool to facilitate investigation of the degree to which counselors adhere to and apply a widely used approach to NDC.

  5. Dose rate mapping and quantitative analysis of radioactive deposition with simple monitoring instruments in Finland after the Chernobyl accident.

    Energy Technology Data Exchange (ETDEWEB)

    Koivukoski, J. [Ministry of the Interior, Rescue Dept., Helsinki (Finland); Paatero, J. [Finnish Meteorological Inst., Helsinki (Finland)], E-mail: janne.koivukoski@intermin.fi

    2013-03-01

    This article reviews the Finnish dose-rate mapping equipment and the system to process the obtained results, which were used immediately after the 1986 Chernobyl accident. We present the results of the external gamma-radiation monitoring carried out with simple civil-defence gamma monitoring instruments and compare them with the subsequent deposition mapping performed with research-grade instruments. The analysis shows that the quality of radiation mapping is good enough for decision makers to direct protective measures to the right areas. This review also demonstrates that a simple stationary external gamma radiation monitoring network can be effectively used for early warning in radiation emergency situations. (orig.)

  6. Optimal Chest Compression Rate and Compression to Ventilation Ratio in Delivery Room Resuscitation: Evidence from Newborn Piglets and Neonatal Manikins

    OpenAIRE

    Solev?g, Anne Lee; Schm?lzer, Georg M.

    2017-01-01

    Cardiopulmonary resuscitation (CPR) duration until return of spontaneous circulation (ROSC) influences survival and neurologic outcomes after delivery room (DR) CPR. High quality chest compressions (CC) improve cerebral and myocardial perfusion. Improved myocardial perfusion increases the likelihood of a faster ROSC. Thus, optimizing CC quality may improve outcomes both by preserving cerebral blood flow during CPR and by reducing the recovery time. CC quality is determined by rate, CC to vent...

  7. Maternal infection rates after cesarean delivery by Pfannenstiel or Joel-Cohen incision: a multicenter surveillance study.

    Science.gov (United States)

    Dumas, Anne Marie; Girard, Raphaële; Ayzac, Louis; Caillat-Vallet, Emmanuelle; Tissot-Guerraz, Françoise; Vincent-Bouletreau, Agnès; Berland, Michel

    2009-12-01

    Our purpose was to evaluate maternal nosocomial infection rates according to the incision technique used for caesarean delivery, in a routine surveillance study. This was a prospective study of 5123 cesarean deliveries (43.2% Joel-Cohen, 56.8% Pfannenstiel incisions) in 35 maternity units (Mater Sud Est network). Data on routine surveillance variables, operative duration, and three additional variables (manual removal of the placenta, uterine exteriorization, and/or cleaning of the parieto-colic gutter) were collected. Multiple logistic regression analysis was used to identify independent risk factors for infection. The overall nosocomial infection and endometritis rates were higher for the Joel-Cohen than Pfannenstiel incision (4.5% vs. 3.3%, 0.8% vs. 0.3%, respectively). The higher rate of nosocomial infections with the Joel-Cohen incision was due to a greater proportion of patients presenting risk factors (i.e., emergency delivery, primary cesarean, blood loss > or =800 mL, no manual removal of the placenta and no uterine exteriorization). However, the Joel-Cohen technique was an independent risk factor for endometritis. The Joel-Cohen technique is faster than the Pfannenstiel technique but is associated with a higher incidence of endometritis.

  8. Developing a Teacher Evaluation Instrument to Provide Formative Feedback Using Student Ratings of Teaching Acts

    Science.gov (United States)

    van der Lans, Rikkert M.; van de Grift, Wim J. C. M.; van Veen, Klaas

    2015-01-01

    This study reports on the development of a teacher evaluation instrument, based on students' observations, which exhibits cumulative ordering in terms of the complexity of teaching acts. The study integrates theory on teacher development with theory on teacher effectiveness and applies a cross-validation procedure to verify whether teaching acts…

  9. Planned home compared with planned hospital births: mode of delivery and Perinatal mortality rates, an observational study.

    Science.gov (United States)

    van der Kooy, Jacoba; Birnie, Erwin; Denktas, Semiha; Steegers, Eric A P; Bonsel, Gouke J

    2017-06-08

    To compare the mode of delivery between planned home versus planned hospital births and to determine if differences in intervention rates could be interpreted as over- or undertreatment. Intervention and perinatal mortality rates were obtained for 679,952 low-risk women from the Dutch Perinatal Registry (2000-2007). Intervention was defined as operative vaginal delivery and/or caesarean section. Perinatal mortality was defined as the intrapartum and early neonatal mortality rate up to 7 days postpartum. Besides adjustment for maternal and care factors, we included for additional casemix adjustment: presence of congenital abnormality, small for gestational age, preterm birth, or low Apgar score. The techniques used were nested multiple stepwise logistic regression, and stratified analysis for separate risk groups. An intention-to-treat like analysis was performed. The intervention rate was lower in planned home compared to planned hospital births (10.9% 95% CI 10.8-11.0 vs. 13.8% 95% CI 13.6-13.9). Intended place of birth had significant impact on the likelihood to intervene after adjustment (planned homebirth (OR 0.77 95% CI. 0.75-0.78)). The mortality rate was lower in planned home births (0.15% vs. 0.18%). After adjustment, the interaction term home- intervention was significant (OR1.51 95% CI 1.25-1.84). In risk groups, a higher perinatal mortality rate was observed in planned home births. The potential presence of over- or under treatment as expressed by adjusted perinatal mortality differs per risk group. In planned home births especially multiparous women showed universally lower intervention rates. However, the benefit of substantially fewer interventions in the planned home group seems to be counterbalanced by substantially increased mortality if intervention occurs.

  10. The Comparative Ratings and Indices as the Instruments of Measurement of Political Stability

    Directory of Open Access Journals (Sweden)

    Анна Олеговна Ярославцева

    2012-06-01

    Full Text Available In the given article the main comparative ratings and indices of measurement of political stability in different countries are analyzed. The author proves that despite the broad acknowledgement and heuristic value of these ratings they often lack objectivity when depict situation in Russia.

  11. A hyaluronic acid membrane delivery system for cultured keratinocytes: clinical "take" rates in the porcine kerato-dermal model.

    Science.gov (United States)

    Myers, S R; Grady, J; Soranzo, C; Sanders, R; Green, C; Leigh, I M; Navsaria, H A

    1997-01-01

    The clinical take rates of cultured keratinocyte autografts are poor on a full-thickness wound unless a dermal bed is provided. Even under these circumstances two important problems are the time delay in growing autografts and the fragility of the grafts. A laser-perforated hyaluronic acid membrane delivery system allows grafting at early confluence without requiring dispase digestion to release grafts from their culture dishes. We designed this study to investigate the influence of this membrane on clinical take rates in an established porcine kerato-dermal grafting model. The study demonstrated a significant reduction in take as a result of halving the keratinocyte seeding density onto the membrane. The take rates, however, of grafts grown on the membrane at half or full conventional seeding density and transplanted to a dermal wound bed were comparable, if not better, than those of keratinocyte sheet grafts.

  12. Design and testing of a phantom and instrumented gynecological applicator based on GaN dosimeter for use in high dose rate brachytherapy quality assurance

    Energy Technology Data Exchange (ETDEWEB)

    Guiral, P.; Ribouton, J.; Jalade, P. [Service de Physique Médicale et Radioprotection, Centre Hospitalier Lyon Sud, Pierre-Bénite F-69495 (France); Wang, R.; Galvan, J.-M.; Lu, G.-N.; Pittet, P., E-mail: patrick.pittet@univ-lyon1.fr [Institut des Nanotechnologies de Lyon, University Lyon, Université Claude Bernard Lyon 1, CNRS, INL UMR5270, F-69622 Villeurbanne (France); Rivoire, A.; Gindraux, L. [DOSILAB, 66 Boulevard Niels Bohr, Villeurbanne F-69100 (France)

    2016-09-15

    Purpose: High dose rate brachytherapy (HDR-BT) is widely used to treat gynecologic, anal, prostate, head, neck, and breast cancers. These treatments are typically administered in large dose per fraction (>5 Gy) and with high-gradient-dose-distributions, with serious consequences in case of a treatment delivery error (e.g., on dwell position and dwell time). Thus, quality assurance (QA) or quality control (QC) should be systematically and independently implemented. This paper describes the design and testing of a phantom and an instrumented gynecological applicator for pretreatment QA and in vivo QC, respectively. Methods: The authors have designed a HDR-BT phantom equipped with four GaN-based dosimeters. The authors have also instrumented a commercial multichannel HDR-BT gynecological applicator by rigid incorporation of four GaN-based dosimeters in four channels. Specific methods based on the four GaN dosimeter responses are proposed for accurate determination of dwell time and dwell position inside phantom or applicator. The phantom and the applicator have been tested for HDR-BT QA in routine over two different periods: 29 and 15 days, respectively. Measurements in dwell position and time are compared to the treatment plan. A modified position–time gamma index is used to monitor the quality of treatment delivery. Results: The HDR-BT phantom and the instrumented applicator have been used to determine more than 900 dwell positions over the different testing periods. The errors between the planned and measured dwell positions are 0.11 ± 0.70 mm (1σ) and 0.01 ± 0.42 mm (1σ), with the phantom and the applicator, respectively. The dwell time errors for these positions do not exhibit significant bias, with a standard deviation of less than 100 ms for both systems. The modified position–time gamma index sets a threshold, determining whether the treatment run passes or fails. The error detectability of their systems has been evaluated through tests on

  13. The utilization rate of the regional health information exchange: how it impacts on health care delivery outcomes.

    Science.gov (United States)

    Mäenpää, Tiina; Asikainen, Paula; Gissler, Mika; Siponen, Kimmo; Maass, Marianne; Saranto, Kaija; Suominen, Tarja

    2012-01-01

    Interest in improving quality and effectiveness is the primary driver for health information exchange efforts across a health care system to improve the provision of public health care services. The aim here was to describe and identify the impact of a regional health information exchange (HIE) using quantitative statistics for 2004-2008 in one hospital district in Finland. We conducted a comparative, longitudinal 5-year follow-up study to evaluate the utilization rates of HIE, and the impact on health care delivery outcomes. The selected outcomes were total laboratory tests, radiology examinations, appointments, emergency visits, and referrals. The HIE utilization rates increased annually in all 10 federations of municipalities, and the viewing of reference information increased steadily in each professional group over the 5-year study period. In these federations, a significant connection was found to the number of laboratory tests and radiology examinations, with a statistically significant increase in the number of viewed references and use of HIE. The higher the numbers of emergency visits and appointments, the higher the numbers of emergency referrals to specialized care, viewed references, and HIE usage among the groups of different health care professionals. There is increasing interest in HIE usage through regional health information system among health professionals to improve health care delivery regionally and bring information on the patient directly to care delivery. It will be important to study which changes in working methods in the service system are explained by RHIS. Also, the experiences of the change that has taken place should be studied among the different stakeholders, administrative representatives, and patients.

  14. Estimation of glucose rate of appearance from cgs and subcutaneous insulin delivery in type 1 diabetes

    KAUST Repository

    Laleg-Kirati, Taous-Meriem

    2017-08-31

    Method and System for providing estimates of Glucose Rate of Appearance from the intestine (GRA) using continuous glucose sensor measurements (CGS) taken from the subcutaneous of a diabetes patient and the amount of insulin administered to the patient.

  15. Estimation of glucose rate of appearance from cgs and subcutaneous insulin delivery in type 1 diabetes

    KAUST Repository

    Laleg-Kirati, Taous-Meriem; Al-Matouq, Ali Ahmed

    2017-01-01

    Method and System for providing estimates of Glucose Rate of Appearance from the intestine (GRA) using continuous glucose sensor measurements (CGS) taken from the subcutaneous of a diabetes patient and the amount of insulin administered

  16. An extended EPQ-based problem with a discontinuous delivery policy, scrap rate, and random breakdown.

    Science.gov (United States)

    Chiu, Singa Wang; Lin, Hong-Dar; Song, Ming-Syuan; Chen, Hsin-Mei; Chiu, Yuan-Shyi P

    2015-01-01

    In real supply chain environments, the discontinuous multidelivery policy is often used when finished products need to be transported to retailers or customers outside the production units. To address this real-life production-shipment situation, this study extends recent work using an economic production quantity- (EPQ-) based inventory model with a continuous inventory issuing policy, defective items, and machine breakdown by incorporating a multiple delivery policy into the model to replace the continuous policy and investigates the effect on the optimal run time decision for this specific EPQ model. Next, we further expand the scope of the problem to combine the retailer's stock holding cost into our study. This enhanced EPQ-based model can be used to reflect the situation found in contemporary manufacturing firms in which finished products are delivered to the producer's own retail stores and stocked there for sale. A second model is developed and studied. With the help of mathematical modeling and optimization techniques, the optimal run times that minimize the expected total system costs comprising costs incurred in production units, transportation, and retail stores are derived, for both models. Numerical examples are provided to demonstrate the applicability of our research results.

  17. An Extended EPQ-Based Problem with a Discontinuous Delivery Policy, Scrap Rate, and Random Breakdown

    Directory of Open Access Journals (Sweden)

    Singa Wang Chiu

    2015-01-01

    Full Text Available In real supply chain environments, the discontinuous multidelivery policy is often used when finished products need to be transported to retailers or customers outside the production units. To address this real-life production-shipment situation, this study extends recent work using an economic production quantity- (EPQ- based inventory model with a continuous inventory issuing policy, defective items, and machine breakdown by incorporating a multiple delivery policy into the model to replace the continuous policy and investigates the effect on the optimal run time decision for this specific EPQ model. Next, we further expand the scope of the problem to combine the retailer’s stock holding cost into our study. This enhanced EPQ-based model can be used to reflect the situation found in contemporary manufacturing firms in which finished products are delivered to the producer’s own retail stores and stocked there for sale. A second model is developed and studied. With the help of mathematical modeling and optimization techniques, the optimal run times that minimize the expected total system costs comprising costs incurred in production units, transportation, and retail stores are derived, for both models. Numerical examples are provided to demonstrate the applicability of our research results.

  18. Mode of delivery affected questionnaire response rates in a birth cohort study

    OpenAIRE

    Bray, I.; Noble, S.; Robinson, R.; Molloy, L.; Tilling, K.

    2017-01-01

    Objectives Cohort studies must collect data from their participants as economically as possible, while maintaining response rates. This randomized controlled trial investigated whether offering a choice of online or paper questionnaires resulted in improved response rates compared with offering online first. Study Design and Setting Eligible participants were young people in the Avon Longitudinal Study of Parents and Children (ALSPAC) study (born April 1, 1991, to December 31, 1992, in the Av...

  19. The Effects of Performance Quality Ratings on Perceptions of Instrumental Music Lessons

    Science.gov (United States)

    Henninger, Jacqueline C.

    2008-01-01

    This study examines the extent to which the perceptions of observers instructed to rate the quality of students' performances within ensemble rehearsals and applied lessons differ from those not so instructed. Music education majors (N = 52) wrote statements of observation during their viewing of a stimulus tape. All participants were informed of…

  20. Global environmental ratings as an instrument of environmental policies: what factors determine the rank of Russia?

    Science.gov (United States)

    Alekseeva, Nina; Arshinova, Marina; Milanova, Elena

    2017-04-01

    Systems of global environmental rankings have emerged as a result of the escalating need for revealing the trends of ecological development for the world and for certain countries and regions. Both the environmental indicators and indexes and the ratings made on their basis are important for the assessment and forecast of the ecological situation in order to tackle the global and regional problems of sustainable development and help to translate the research findings into policy developments. Data sources for the global environmental ratings are most often the statistical information accumulated in databases of the international organizations (World Bank, World Resources Institute, FAO, WHO, etc.) These data are highly reliable and well-comparable that makes the ratings very objective. There are also good examples of using data of sociological polls, information from social networks, etc. The global environmental ratings are produced by the international organizations (World Bank, World Resources Institute, the UN Environment Program), non-governmental associations (WWF, Climate Action Network Europe (CAN-E), Germanwatch Nord-Süd-Initiative, Friends of the Earth, World Development Movement), research structures (scientific centers of the Yale and Colombian universities, the Oak-Ridge National Laboratory, the New Economic Foundation), and also individual experts, news agencies, etc. Thematic (sectoral) ratings cover various spheres from availability of resources and anthropogenic impact on environment components to nature protection policies and perception of environmental problems. The environmental indicators cover all parameters important for understanding the current ecological situation and the trajectories of its development (the DPSIR model, i.e. drivers, pressures, state, impact and response). Complex (integral) ratings are based on environmental indexes which are combined measurement tools using a complex of aggregated indicators based on a wide range of

  1. Women's preferences for obstetric care in rural Ethiopia: a population-based discrete choice experiment in a region with low rates of facility delivery.

    Science.gov (United States)

    Kruk, M E; Paczkowski, M M; Tegegn, A; Tessema, F; Hadley, C; Asefa, M; Galea, S

    2010-11-01

    Delivery attended by skilled professionals is essential to reducing maternal mortality. Although the facility delivery rate in Ethiopia's rural areas is extremely low, little is known about which health system characteristics most influence women's preferences for delivery services. In this study, women's preferences for attributes of health facilities for delivery in rural Ethiopia were investigated. A population-based discrete choice experiment (DCE) was fielded in Gilgel Gibe, in southwest Ethiopia, among women with a delivery in the past 5 years. Women were asked to select a hypothetical health facility for future delivery from two facilities on a picture card. A hierarchical Bayesian procedure was used to estimate utilities associated with facility attributes: distance, type of provider, provider attitude, drugs and medical equipment, transport and cost. 1006 women completed 8045 DCE choice tasks. Among them, 93.8% had delivered their last child at home. The attributes with the greatest influence on the overall utility of a health facility for delivery were availability of drugs and equipment (mean β=3.9, pdelivery nonetheless value health facility attributes that indicate high technical quality: availability of drugs and equipment and physician providers. Well-designed policy experiments that measure the contribution of quality improvements to facility delivery rates in Ethiopia and other countries with low health service utilisation and high maternal mortality may inform national efforts to reduce maternal mortality.

  2. Rates, indications, and outcomes of caesarean section deliveries: A comparison of tribal and non-tribal women in Gujarat, India.

    Directory of Open Access Journals (Sweden)

    Gayatri Desai

    Full Text Available Even though the caesarean section is an essential component of comprehensive obstetric and newborn care for reducing maternal and neonatal mortality, there is a lack of data regarding caesarean section rates, its determinants and health outcomes among tribal communities in India.The aim of this study is to estimate and compare rates, determinants, indications and outcomes of caesarean section. The article provides an assessment on how the inequitable utilization can be addressed in a community-based hospital in tribal areas of Gujarat, India.Prospectively collected data of deliveries (N = 19923 from April 2010 to March 2016 in Kasturba Maternity Hospital was used. The odds ratio of caesarean section was estimated for tribal and non-tribal women. Decomposition analysis was done to decompose the differences in the caesarean section rates between tribal and non-tribal women.The caesarean section rate was significantly lower among tribal compared to the non-tribal women (9.4% vs 15.6%, p-value < 0.01 respectively. The 60% of the differences in the rates of caesarean section between tribal and non-tribal women were unexplained. Within the explained variation, the previous caesarean accounted for 96% (p-value < 0.01 of the variation. Age of the mother, parity, previous caesarean and distance from the hospital were some of the important determinants of caesarean section rates. The most common indications of caesarean section were foetal distress (31.2%, previous caesarean section (23.9%, breech (16% and prolonged labour (11.2%. There was no difference in case fatality rate (1.3% vs 1.4%, p-value = 0.90 and incidence of birth asphyxia (0.3% vs 0.6%, p-value = 0.26 comparing the tribal and non-tribal women.Similar to the prior evidences, we found higher caesarean rates among non-tribal compare to tribal women. However, the adverse outcomes were similar between tribal and non-tribal women for caesarean section deliveries.

  3. Avoidance of Timeout from Response-Independent Food: Effects of Delivery Rate and Quality

    Science.gov (United States)

    Richardson, Joseph V.; Baron, Alan

    2008-01-01

    In three experiments, a rat's lever presses could postpone timeouts from food pellets delivered on response-independent schedules. In Experiment 1, the pellets were delivered at variable-time (VT) rates ranging from VT 0.5 to VT 8 min. Experiment 2 replicated the VT 1 min and VT 8 min conditions of Experiment 1 with new subjects. Finally, subjects…

  4. Heart Rate Variability in Obstetricians Working 14-Hour Call Compared to 24-Hour Call in Labour and Delivery.

    Science.gov (United States)

    Thurman, Robin H; Yoon, Eugene; Murphy, Kellie E; Windrim, Rory; Farrugia, M Michéle

    2017-12-01

    Obstetricians have stressful and demanding jobs that may impact their health. A physiological measurement of cardiac function which varies with stress is heart rate variability (HRV). By measuring the cyclic variations in R-R intervals, or beat-to-beat differences, HRV reflects the continuous interplay of the controlling forces in the autonomic nervous system. Studies have shown HRV to be reduced during periods of work-induced stress, including 24-hour shifts. Our study aimed to determine if there was a correlation between length of shift worked and HRV. We hypothesised that working for a full 24-hour period is more stressful than a shorter, nighttime-only period, and HRV analyses were used to measure this objectively. Obstetricians wore an HRV monitor for 24 hours during both a regular day followed by a 14-hour night shift and a continuous 24-hour shift in labour and delivery. The 24-hour samples were analysed using standard HRV measurements. HRV measurements obtained from each physician were then compared according to shift type, with each physician acting as his or her own comparator. There were no statistically significant differences in the most important measures of HRV between 24-hour periods which included either a 14-hour overnight shift or a continuous 24-hour shift on labour and delivery. We found no significant differences in key HRV measures in obstetricians working 14 hours versus 24 hours in labour and delivery. An anecdotal increase in physician awareness of his/her own health related to working conditions was noted during the study. Future studies should attempt to control for the hours prior to a night shift, assess associated endocrine variations, and focus upon HRV in the post-shift period. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  5. A dual-energy medical instrument for measurement of x-ray source voltage and dose rate

    Science.gov (United States)

    Ryzhikov, V. D.; Naydenov, S. V.; Volkov, V. G.; Opolonin, O. D.; Makhota, S.; Pochet, T.; Smith, C. F.

    2016-03-01

    An original dual-energy detector and medical instrument have been developed to measure the output voltages and dose rates of X-ray sources. Theoretical and experimental studies were carried out to characterize the parameters of a new scintillator-photodiode sandwich-detector based on specially-prepared zinc selenide crystals in which the low-energy detector (LED) works both as the detector of the low-energy radiation and as an absorption filter allowing the highenergy fraction of the radiation to pass through to the high-energy detector (HED). The use of the LED as a low-energy filter in combination with a separate HED opens broad possibilities for such sandwich structures. In particular, it becomes possible to analyze and process the sum, difference and ratio of signals coming from these detectors, ensuring a broad (up to 106) measurement range of X-ray intensity from the source and a leveling of the energy dependence. We have chosen an optimum design of the detector and the geometry of the component LED and HED parts that allow energy-dependence leveling to within specified limits. The deviation in energy dependence of the detector does not exceed about 5% in the energy range from 30 to 120 keV. The developed detector and instrument allow contactless measurement of the anode voltage of an X-ray emitter from 40 to 140 kV with an error no greater than 3%. The dose rate measurement range is from 1 to 200 R/min. An original medical instrument has passed clinical testing and was recommended for use in medical institutions for X-ray diagnostics.

  6. Mode of delivery affected questionnaire response rates in a birth cohort study.

    Science.gov (United States)

    Bray, Isabelle; Noble, Sian; Robinson, Ross; Molloy, Lynn; Tilling, Kate

    2017-01-01

    Cohort studies must collect data from their participants as economically as possible, while maintaining response rates. This randomized controlled trial investigated whether offering a choice of online or paper questionnaires resulted in improved response rates compared with offering online first. Eligible participants were young people in the Avon Longitudinal Study of Parents and Children (ALSPAC) study (born April 1, 1991, to December 31, 1992, in the Avon area). After exclusions, 8,795 participants were randomized. The "online first" group were invited to complete the questionnaire online. The "choice" group were also sent a paper questionnaire and offered a choice of completion method. The trial was embedded within routine data collection. The main outcome measure was the number of questionnaires returned. Data on costs were also collected. Those in the "online first" arm of the trial were less likely to return a questionnaire [adjusted odds ratio: 0.90; 95% confidence interval (CI): 0.82, 0.99]. The "choice" arm was more expensive (mean difference per participant £0.71; 95% CI: £0.65, £0.76). It cost an extra £47 to have one extra person to complete the questionnaire in the "choice" arm. Offering a choice of completion methods (paper or online) for questionnaires in ALSPAC increased response rates but was more expensive than offering online first. Copyright © 2016 The Author(s). Published by Elsevier Inc. All rights reserved.

  7. A constant velocity Moessbauer spectrometer free of long-term instrumental drifts in the count rate

    International Nuclear Information System (INIS)

    Sarma, P.R.; Sharma, A.K.; Tripathi, K.C.

    1979-01-01

    Two new control circuits to be used with a constant velocity Moessbauer spectrometer with a loud-speaker drive have been described. The wave-forms generated in the circuits are of the stair-case type instead of the usual square wave-form, so that in each oscillation of the source it remains stationary for a fraction of the time-period. The gamma-rays counted during this period are monitored along with the positive and negative velocity counts and are used to correct any fluctuation in the count rate by feeding these pulses into the timer. The associated logic circuits have been described and the statistical errors involved in the circuits have been computed. (auth.)

  8. Impact of concentration and rate of intraluminal drug delivery on absorption and gut wall metabolism of verapamil in humans.

    Science.gov (United States)

    Glaeser, Hartmut; Drescher, Siegfried; Hofmann, Ute; Heinkele, Georg; Somogyi, Andrew A; Eichelbaum, Michel; Fromm, Martin F

    2004-09-01

    In humans gut wall metabolism can be quantitatively as important as hepatic drug metabolism in limiting the systemic exposure to drugs after oral administration. However, it has been proposed that the role of gut wall metabolism might be overemphasized, because high luminal drug concentrations would lead to a saturation of gut wall metabolism. Therefore we investigated the impact of concentration and rate of intraluminal drug delivery on absorption (F(abs)) and gastrointestinal extraction (E(GI)) of a luminally administered cytochrome P450 (CYP) 3A4 substrate (verapamil) using a multilumen perfusion catheter in combination with a stable isotope technique. Two 20-cm-long, adjacent jejunal segments were isolated with the multilumen perfusion catheter in 7 subjects. In this study 80 mg of unlabeled verapamil (d0-verapamil 15 min) was infused into one segment over a 15-minute period, 80 mg of 3-fold deuterated verapamil (d3-verapamil 240 min) was administered over a 240-minute period into the other segment, and simultaneously, 5 mg of 7-fold deuterated verapamil (d7-verapamil) was injected intravenously over a 15-minute period. The rate of intraluminal drug delivery had only a modest effect on bioavailability of the verapamil isotopes (after correction for F abs ) (F/F abs d3-verapamil 240 min versus d0-verapamil 15 min, 0.24 +/- 0.10 versus 0.20 +/- 0.09; P d3-verapamil 240 min was 0.50 +/- 0.18 compared with 0.59 +/- 0.14 for d0 -verapamil 15 min ( P d0-verapamil 15 min ) correlated strongly with E GI (d3-verapamil 240 min ) (r = 0.94, P d0-verapamil 15 min /d3-verapamil 240 min (r = 0.62, P =.03). Substantial gut wall metabolism of verapamil occurs in humans and can be predicted from ex vivo data by use of shed enterocytes. The different intraluminal concentrations and rates of intraluminal drug delivery did not lead to a pronounced saturation of intestinal drug metabolism.

  9. Detecting The Expected Rate of Return Volatility of Financing Instruments of Indonesian Islamic Banking through GARCH Modeling (Generalized Autoregressive Conditional Heteroscedasticity

    Directory of Open Access Journals (Sweden)

    Nurul Huda

    2015-04-01

    Full Text Available Objective - Islamic banks are banks which its activities, both fund raising and funds distribution are on the basis of Islamic principles, namely buying and selling and profit sharing. Islamic banking is aimed at supporting the implementation of national development in order to improve justice, togetherness, and equitable distribution of welfare. In pursuit of supporting the implementation of national development, Islamic banking often faced stability problems of financing instruments being operated. In this case, it is measured by the gap between the actual rate of return and the expected rate of return. The individual actual RoR of this instrument will generate an expected rate of return. This raises the gap or difference between the actual rate of return and the expected rate of return of individual instruments, which in this case is called the abnormal rate of return. The stability of abnormal rate of return of individual instruments is certainly influenced by the stability of the expected rate of return. Expected rate of return has a volatility or fluctuation levels for each financing instrument. It is also a key element or material basis for the establishment of a variance of individual instruments. Variance in this case indicates the level of uncertainty of the rate of return. Individual variance is the origin of the instrument base for variance in the portfolio finance that further a portfolio analysis. So, this paper is going to analyze the level of expected RoR volatility as an initial step to see and predict the stability of the fluctuations in the rate of return of Indonesian Islamic financing instruments.Methods – Probability of Occurence, Expected Rate of Return (RoR and GARCH (Generalized Autoregressive Conditional Heteroscedasticity.Results - The expected RoR volatility of the murabaha and istishna financing instruments tend to be more volatile than expected RoR volatility of musharaka and qardh financing instruments

  10. Determination of relationship between sensory viscosity rating and instrumental flow behaviour of soluble dietary fibers.

    Science.gov (United States)

    Arora, Simran Kaur; Patel, A A; Kumar, Naveen; Chauhan, O P

    2016-04-01

    The shear-thinning low, medium and high-viscosity fiber preparations (0.15-1.05 % psyllium husk, 0.07-0.6 % guar gum, 0.15-1.20 % gum tragacanth, 0.1-0.8 % gum karaya, 0.15-1.05 % high-viscosity Carboxy Methyl Cellulose and 0.1-0.7 % xanthan gum) showed that the consistency coefficient (k) was a function of concentration, the relationship being exponential (R(2), 0.87-0.96; P flow behaviour index (n) (except for gum karaya and CMC) was exponentially related to concentration (R(2), 0.61-0.98). The relationship between k and sensory viscosity rating (SVR) was essentially linear in nearly all cases. The SVR could be predicted from the consistency coefficient using the regression equations developed. Also, the relationship of k with fiber concentration would make it possible to identify the concentration of a particular gum required to have desired consistency in terms of SVR.

  11. [Impact of the external cephalic version on the obstetrical prognosis in a team with a high success rate of vaginal delivery in breech presentation].

    Science.gov (United States)

    Coppola, C; Mottet, N; Mariet, A S; Baeza, C; Poitrey, E; Bourtembourg, A; Ramanah, R; Riethmuller, D

    2016-10-01

    To analyse the impact of external cephalic version (ECV) on caesarean section rate in a team with a high success rate of vaginal delivery in breech presentation. Retrospective monocentric study including 298 patients with a breech presentations between 33 and 35weeks of amenorrhea followed at our university hospital and delivered after 35weeks, between 1st January 2011 and 31st December 2013. Patients were divided into 2 groups: planned ECV (n=216 patients) versus no planned ECV (n=57 patients). Our rate of successful vaginal breech delivery over the period of the study was 61.1%. We performed 165 ECV, with a 21.8% success rate. The average term of the attempt of ECV was 36.7weeks of amenorrhea. The caesarean section rate was not significantly different in the planned ECV group, even after adjustment on age, parity and previous caesarean delivery (adjusted OR=1.67 [0.77-3.61]). Attempt of ECV did not reduce the number of breech presentation at delivery (61.1% versus 61.4% [P=0.55]). Planned ECV in our center with a high level of breech vaginal delivery did not significantly impact our cesarean section rate. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  12. Classification of caesarean section and normal vaginal deliveries using foetal heart rate signals and advanced machine learning algorithms.

    Science.gov (United States)

    Fergus, Paul; Hussain, Abir; Al-Jumeily, Dhiya; Huang, De-Shuang; Bouguila, Nizar

    2017-07-06

    Visual inspection of cardiotocography traces by obstetricians and midwives is the gold standard for monitoring the wellbeing of the foetus during antenatal care. However, inter- and intra-observer variability is high with only a 30% positive predictive value for the classification of pathological outcomes. This has a significant negative impact on the perinatal foetus and often results in cardio-pulmonary arrest, brain and vital organ damage, cerebral palsy, hearing, visual and cognitive defects and in severe cases, death. This paper shows that using machine learning and foetal heart rate signals provides direct information about the foetal state and helps to filter the subjective opinions of medical practitioners when used as a decision support tool. The primary aim is to provide a proof-of-concept that demonstrates how machine learning can be used to objectively determine when medical intervention, such as caesarean section, is required and help avoid preventable perinatal deaths. This is evidenced using an open dataset that comprises 506 controls (normal virginal deliveries) and 46 cases (caesarean due to pH ≤ 7.20-acidosis, n = 18; pH > 7.20 and pH machine-learning algorithms are trained, and validated, using binary classifier performance measures. The findings show that deep learning classification achieves sensitivity = 94%, specificity = 91%, Area under the curve = 99%, F-score = 100%, and mean square error = 1%. The results demonstrate that machine learning significantly improves the efficiency for the detection of caesarean section and normal vaginal deliveries using foetal heart rate signals compared with obstetrician and midwife predictions and systems reported in previous studies.

  13. How does pattern of feeding and rate of nutrient delivery influence conditioned food preferences?

    Science.gov (United States)

    Duncan, A J; Elwert, C; Villalba, J J; Yearsley, J; Pouloupoulou, I; Gordon, I J

    2007-09-01

    Ruminant herbivores have been shown to learn about food properties by associating food flavours with the food's post-ingestive consequences. Previous experimentation supporting the conditioned food aversion/preference hypothesis has generally employed very simple diet learning tasks which do not effectively represent the wide range of foods selected within single bouts typical of wild, free-ranging ruminant herbivores. We tested the ability of a ruminant herbivore to associate a food with artificially administered nutrient rewards in a designed experiment where we altered the temporal pattern of encounter with the food as well as the nature (fast or slow reward) of the post-ingestive outcome. Twenty-four goats were offered branches of Sitka spruce (SS) and Norway spruce (NS) for 4 h per day on two days per week for five weeks. The pattern of feeding varied with treatment such that the species on offer changed every hour (short) or every 2 h (long). The energy treatment altered the reward delivered during Sitka consumption so that animals were dosed either with predominantly sugar (rapidly fermented), predominantly starch (slower fermentation rate), or with water (placebo). Preference was measured on the day following each learning day. We expected that goats would find it easier to associate SS with post-ingestive rewards when the duration of encounter was longest, and that associations would be stronger with the most rapidly digested post-ingestive reward. In the event, goats did not alter their consumption of SS in response to the treatments. Our results suggest that at the scale of temporal resolution of encounters with different plant species (1-2 h), and at the different rates of experiencing post-ingestive consequences tested in this experiment, ruminants do not appear to discriminate the nutritive properties of foods predominantly through a post-ingestive feedback mechanism. They must, instead, use a range of cues-including post-ingestive consequences

  14. Comparison of readmission rates between groups with early versus late discharge after vaginal or cesarean delivery: a retrospective analyzes of 14,460 cases.

    Science.gov (United States)

    Bostanci Ergen, Evrim; Ozkaya, Enis; Eser, Ahmet; Abide Yayla, Cigdem; Kilicci, Cetin; Yenidede, Ilter; Eser, Semra Kayatas; Karateke, Ates

    2018-05-01

    The aim of this retrospective analysis was to show the readmission rate of cases with and without early discharge following vaginal or cesarean delivery. After exclusion of cases with pregnancy, delivery and neonatal complications, a total of 14,460 cases who delivered at Zeynep Kamil Women and Children's Health Training and Research Hospital were retrospectively screened from hospital database. Subjects were divided into two groups as Group 1: early discharge (n = 6802) and Group 2: late discharge (n = 7658). Groups were compared in terms of readmission rates and indications for readmission. There were 6802 cases with early discharge whereas the remaining women were discharged after 24 h for vaginal delivery and 48 h following cesarean delivery on regular bases. Among cases with early discharge, 205 (3%) cases readmitted to emergency service with variable indications, while there were 216 (2.8%) readmitted women who were discharged on regular bases. Most common indication for readmission was wound infection in both groups. Neonatal sex distributions were similar between groups (p > .05), where as there was a higher rate of cesarean deliveries in Group 2 (p discharge (p discharges following vaginal or cesarean delivery without any mortality or permanent morbidity and cost analyses revealed 68 Turkish liras lower cost with early discharge.

  15. Optimal Chest Compression Rate and Compression to Ventilation Ratio in Delivery Room Resuscitation: Evidence from Newborn Piglets and Neonatal Manikins

    Science.gov (United States)

    Solevåg, Anne Lee; Schmölzer, Georg M.

    2017-01-01

    Cardiopulmonary resuscitation (CPR) duration until return of spontaneous circulation (ROSC) influences survival and neurologic outcomes after delivery room (DR) CPR. High quality chest compressions (CC) improve cerebral and myocardial perfusion. Improved myocardial perfusion increases the likelihood of a faster ROSC. Thus, optimizing CC quality may improve outcomes both by preserving cerebral blood flow during CPR and by reducing the recovery time. CC quality is determined by rate, CC to ventilation (C:V) ratio, and applied force, which are influenced by the CC provider. Thus, provider performance should be taken into account. Neonatal resuscitation guidelines recommend a 3:1 C:V ratio. CCs should be delivered at a rate of 90/min synchronized with ventilations at a rate of 30/min to achieve a total of 120 events/min. Despite a lack of scientific evidence supporting this, the investigation of alternative CC interventions in human neonates is ethically challenging. Also, the infrequent occurrence of extensive CPR measures in the DR make randomized controlled trials difficult to perform. Thus, many biomechanical aspects of CC have been investigated in animal and manikin models. Despite mathematical and physiological rationales that higher rates and uninterrupted CC improve CPR hemodynamics, studies indicate that provider fatigue is more pronounced when CC are performed continuously compared to when a pause is inserted after every third CC as currently recommended. A higher rate (e.g., 120/min) is also more fatiguing, which affects CC quality. In post-transitional piglets with asphyxia-induced cardiac arrest, there was no benefit of performing continuous CC at a rate of 90/min. Not only rate but duty cycle, i.e., the duration of CC/total cycle time, is a known determinant of CC effectiveness. However, duty cycle cannot be controlled with manual CC. Mechanical/automated CC in neonatal CPR has not been explored, and feedback systems are under-investigated in this

  16. Review of techniques and detectors used in instruments for field measurement of beta doses and dose rates

    International Nuclear Information System (INIS)

    Jones, A.R.

    1983-01-01

    Generally, field measurements are required to assess the hazard from #betta#-rays before personnel are allowed to occupy a working space or perform a task. Occasionally, the measurements are required for an assessment after a #betta#-ray exposure is suspected to have occurred. Until recently the dose or dose rate have been the quantities of interest but there is now felt to be a need to characterize the energies and directions of the #betta#-rays as well. The purpose of #betta#-dosimetry is the assessment of hazard to superficial tissues (within approx. 10 mm of the surface) and that these tissues may also be exposed simultaneously to other ionizing radiations. The #betta#-dosimetry technique must take account of this. With these uses of field instruments in mind the following detectors, and associated techniques will be discussed in terms of the measurement principles, advantages and limitations: thin-walled ion chambers (sometimes in combination with thick-walled ones or with covers thick enough to prevent penetration of #betta#-particles); thin scintillators, nearly tissue equivalent, to provide a detector analogous to skin; scintillators, thick enough to absorb all the energy of the #betta#-particles (circuitry is required to count pulses according to size to permit calculation of dose or dose rate); silicon diodes with thin detection layers operated as photocurrent generators; silicon diodes, reversed biassed, with pulses counted according to size; and simple pulse counters (e.g., GM counters or silicon diodes with thin windows)

  17. Interstitial high-dose-rate brachytherapy boost: The feasibility and cosmetic outcome of a fractionated outpatient delivery scheme

    International Nuclear Information System (INIS)

    Manning, Matthew A.; Arthur, Douglas W.; Schmidt-Ullrich, Rupert K.; Arnfield, Mark R.; Amir, Cyrus; Zwicker, Robert D.

    2000-01-01

    Purpose: To evaluate the feasibility, potential toxicity, and cosmetic outcome of fractionated interstitial high dose rate (HDR) brachytherapy boost for the management of patients with breast cancer at increased risk for local recurrence. Methods and Materials: From 1994 to 1996, 18 women with early stage breast cancer underwent conventionally fractionated whole breast radiotherapy (50-50.4 Gy) followed by interstitial HDR brachytherapy boost. All were considered to be at high risk for local failure. Seventeen had pathologically confirmed final surgical margins of less than 2 mm or focally positive. Brachytherapy catheter placement and treatment delivery were conducted on an outpatient basis. Preplanning was used to determine optimal catheter positions to enhance dose homogeneity of dose delivery. The total HDR boost dose was 15 Gy delivered in 6 fractions of 2.5 Gy over 3 days. Local control, survival, late toxicities (LENT-SOMA), and cosmetic outcome were recorded in follow-up. In addition, factors potentially influencing cosmesis were analyzed by logistic regression analysis. Results: The minimum follow-up is 40 months with a median 50 months. Sixteen patients were alive without disease at last follow-up. There have been no in-breast failures observed. One patient died with brain metastases, and another died of unrelated causes without evidence of disease. Grade 1-2 late toxicities included 39% with hyperpigmentation, 56% with detectable fibrosis, 28% with occasional discomfort, and 11% with visible telangiectasias. Grade 3 toxicity was reported in one patient as persistent discomfort. Sixty-seven percent of patients were considered to have experienced good/excellent cosmetic outcomes. Factors with a direct relationship to adverse cosmetic outcome were extent of surgical defect (p = 0.00001), primary excision volume (p = 0.017), and total excision volume (p = 0.015). Conclusions: For high risk patients who may benefit from increased doses, interstitial HDR

  18. Gamma-scintigraphy as a novel method to study the distribution and clearance rate of different muco adhesive nasal delivery systems

    International Nuclear Information System (INIS)

    Tofaghodi, M.; Zakavi, R.; Sajadi Tabasi, A.; Jaafari, M.R.

    2002-01-01

    Nasal route has a high potential for drug delivery. One important limiting factor for nasal drug delivery is the rapid clearance of drugs from the nasal cavity. Several nasal drug delivery systems including different kinds of microspheres and liposomes have been tried for encapsulation of drugs and increasing the residence time in nasal cavity. In this study clearance rate of three kinds of microspheres (Alginate, PLGA and Dextran) and four kinds of liposomes (neutral, cationic, fusogenic and cationic-fusogenic) was determined. Lactose powder was used as negative control. Technetium pertechnetate labeling and gamma scintigraphy was used for precise and quantitative measurement of clearance rate of these delivery system. 99 mTc labeled microspheres and liposomes were prepared using technetium pertechnetate in the presence of a potent reducing agent, st annus chloride. The labeling procedure was set in a manner that each 150 micro litter of liposome suspensions and each 3-5 mg of microspheres contained 2 MBq of radioactivity. Labeling efficiency was calculated by paper chromatography using acetone as mobile phase. Each delivery system containing 2 MBq of activity was sprayed into right nostril of four healthy volunteers and immediately after spraying, anterior view of nasal cavity was measured by a large field gamma camera equipped with a low-energy high resolution parallel collimator. One minute static views were repeated each half hour until 4 hours. Clearance rates were compared using two ROI; the initial site of deposition of sprays, and all of nasal cavity to nasopharynx. Clearance rate of each one of microspheres and liposomes was calculated after applying the physical decay corrections. The labeling efficiency for liposomes and microspheres calculated as 41.2% and 60.7% respectively. The cleared percent of delivery systems after 4 hours was determined as follows: neutral liposomes 18.7±3.9% cationic liposomes 43.7±2.1%; fusogenic liposomes 32.8±2

  19. Review of techniques and detectors used in instruments for field measurement of β doses and dose rates

    International Nuclear Information System (INIS)

    Jones, A.R.

    1984-01-01

    Generally, field measurements are required to assess the hazard from β-rays before personnel are allowed to occupy a working space or perform a task. Occasionally, the measurements are required for an assessment after a β-ray exposure is suspected to have occurred. With these uses of field instruments in mind, the following detectors and associated techniques will be discussed in terms of the measurement principles, advantages, and limitations: 1) thin-walled ion chambers (sometimes in combination with thick-walled ones or with covers thick enough to prevent penetration of β-particles); 2) thin scintillators, nearly tissue equivalent, to provide a detector analogous to skin; 3) scintillators, thick enough to absorb all the energy of the β-particles. Circuitry is required to count pulses according to size to permit calculation of dose or dose rate; 4) silicon diodes with thin detection layers operated as photocurrent generators; 5) silicon diodes, reversed biassed, with pulses counted according to size; 6) simple pulse counters (e.g., GM counters or silicon diodes with thin windows)

  20. Assessing variable rate nitrogen fertilizer strategies within an extensively instrument field site using the MicroBasin model

    Science.gov (United States)

    Ward, N. K.; Maureira, F.; Yourek, M. A.; Brooks, E. S.; Stockle, C. O.

    2014-12-01

    The current use of synthetic nitrogen fertilizers in agriculture has many negative environmental and economic costs, necessitating improved nitrogen management. In the highly heterogeneous landscape of the Palouse region in eastern Washington and northern Idaho, crop nitrogen needs vary widely within a field. Site-specific nitrogen management is a promising strategy to reduce excess nitrogen lost to the environment while maintaining current yields by matching crop needs with inputs. This study used in-situ hydrologic, nutrient, and crop yield data from a heavily instrumented field site in the high precipitation zone of the wheat-producing Palouse region to assess the performance of the MicroBasin model. MicroBasin is a high-resolution watershed-scale ecohydrologic model with nutrient cycling and cropping algorithms based on the CropSyst model. Detailed soil mapping conducted at the site was used to parameterize the model and the model outputs were evaluated with observed measurements. The calibrated MicroBasin model was then used to evaluate the impact of various nitrogen management strategies on crop yield and nitrate losses. The strategies include uniform application as well as delineating the field into multiple zones of varying nitrogen fertilizer rates to optimize nitrogen use efficiency. We present how coupled modeling and in-situ data sets can inform agricultural management and policy to encourage improved nitrogen management.

  1. Medical costs, Cesarean delivery rates, and length of stay in specialty hospitals vs. non-specialty hospitals in South Korea.

    Directory of Open Access Journals (Sweden)

    Seung Ju Kim

    Full Text Available Since 2011, specialty hospitals in South Korea have been known for providing high- quality care in specific clinical areas. Much research related to specialty hospitals and their performance in many such areas has been performed, but investigations about their performance in obstetrics and gynecology are lacking. Thus, we aimed to compare specialty vs. non-specialty hospitals with respect to mode of obstetric delivery, especially the costs and length of stay related to Cesarean section (CS procedures, and to provide evidence to policy-makers for evaluating the success of hospitals that specialize in obstetric and gynecological (OBGYN care.We obtained National Health Insurance claim data from 2012 to 2014, which included information from 418,141 OBGYN cases at 214 hospitals. We used a generalized estimating equation model to identify a potential association between the likelihood of CS at specialty hospitals compared with other hospitals. We also evaluated medical costs and length of stay in specialty hospitals according to type of delivery.We found that 150,256 (35.9% total deliveries were performed by CS. The odds ratio of CS was significantly lower in specialty hospitals (OR: 0.95, 95% CI: 0.93-0.96compared to other hospitals Medical costs (0.74% and length of stay (1% in CS cases increased in specialty hospitals, although length of stay following vaginal delivery was lower (0.57% in specialty hospitals compared with other hospitals.We determined that specialty hospitals are significantly associated with a lower likelihood of CS delivery and shorter length of stay after vaginal delivery. Although they are also associated with higher costs for delivery, the increased cost could be due to the high level of intensive care provided, which leads to improve quality of care. Policy-makers should consider incentive programs to maintain performance of specialty hospitals and promote efficiency that could reduce medical costs accrued by patients.

  2. Impact of alternative reimbursement strategies in the new cooperative medical scheme on caesarean delivery rates: a mixed-method study in rural China

    Directory of Open Access Journals (Sweden)

    Huang Kun

    2012-07-01

    Full Text Available Abstract Background The rate of caesarean delivery (CD in rural China has been rapidly increasing in recent decades. Due to the exorbitant costs associated with CD, paying for this expensive procedure is often a great challenge for the majority of rural families. Since 2003, the Chinese government has re-established the New Cooperative Medical Scheme (NCMS, aimed to improve the access of essential healthcare to rural residents and reduce financial burden owing to high out of pocket payments. This paper seeks to test the hypothesis that NCMS may provide service users and providers with financial incentives to select CD. It also assesses the effect of different health insurance reimbursement strategies of NCMS on CD rates in rural China. Methods Mixed quantitative and qualitative methods were adopted for data collection. Two cross-sectional household surveys were conducted with women having babies delivered in 2006 and 2009; 2326 and 1515 women, respectively, from the study sites were interviewed using structured questionnaires, to collect demographic and socio-economic data, maternal and child care characteristics and health-related expenditures. Focus group discussions (FGDs and in-depth key informant interviews (KIIs were undertaken with policy makers, health managers, providers and mothers to understand their perceptions of the influence of NCMS on the choices of delivery mode. Results The CD rates in the two study counties were 46.0 percent and 64.7 percent in 2006, increasing to 63.6 percent and 82.1 percent, respectively, in 2009. The study found that decisions on the selection of CD largely came from the pregnant women. Logistic regression analysis, after adjusting for socio-economic, maternal and fetal characteristics, did not indicate a significant effect of either proportional reimbursement or fixed amount reimbursement on the choice of CD for both study years. Interviews with stakeholders reflected that different reimbursable rates for

  3. Comparison of Obstetric Outcome in Terms of the Risk of Low Birth Weight, Preterm Delivery, Cesarean Section Rate and Anemia in Primigravid Adolescents and Older Primigravida

    International Nuclear Information System (INIS)

    Naz, U.

    2014-01-01

    Objective: To compare the obstetric outcome in terms of risk of low birth weight, preterm delivery, cesarean section rate and anemia in primigravid adolescents and older primigravida. Study Design: Cohort study. Place and Duration of Study: Department of Obstetrics and Gynaecology, Sir Ganga Ram Hospital, Lahore, from July to December 2012. Methodology: Three hundred primigravid women presenting to department of obstetrics and gynecology of Sir Ganga Ram Hospital, Lahore, having live singleton pregnancy, including 150 adolescents (A/sup 2/ 19 years) and 150 adults (A/sup 3/ 20 years) were studied. Obstetric outcome in terms of gestational age at delivery, infant's birth weight, presence of anemia and cesarean section rate was compared between two groups. Results were analyzed using Statistical Package for Social Sciences (SPSS) version 16. Chi-square test was applied with 0.05 as level of significance. Results: The mean age of adolescent subjects was 17.3 + 1.5 years and of adults 25.6 + 3.4 years. Mean gestational age at delivery was similar in two groups (39.2 weeks and 39.4 weeks, p = 0.37). Adolescents were more likely to have a preterm delivery (11.2% vs. 4.9%, p = 0.04) and low birth weight infants (19.3% vs. 8.2%, p = 0.005) than adults. Adolescents were more likely to be anemic (46% vs. 32%, p = 0.01) than adults. However, cesarean section rate was not statistically different between two groups. Conclusion: This study showed that primiparous adolescents have significantly higher risk of adverse pregnancy outcomes such as preterm delivery, low birth weight infants and anemia as compared to adult primiparas. (author)

  4. Identifying developmental coordination disorder : MOQ-T validity as a fast screening instrument based on teachers' ratings and its relationship with praxic and visuospatial working memory deficits

    NARCIS (Netherlands)

    Giofre, David; Cornoldi, Cesare; Schoemaker, Marina M.

    2014-01-01

    The present study was devoted to test the validity, of the Italian adaptation of the Motor Observation Questionnaire for Teachers (MOQ-T, Schoemaker, Flapper, Reinders-Messelink, & De Kloet, 2008) as a fast screening instrument, based on teachers' ratings, for detecting developmental coordination

  5. Impact of the Atlantic Multidecadal Oscillation (AMO) on deriving anthropogenic warming rates from the instrumental temperature record

    NARCIS (Netherlands)

    van der Werf, G.R.; Dolman, A.J.

    2014-01-01

    The instrumental surface air temperature record has been used in several statistical studies to assess the relative role of natural and anthropogenic drivers of climate change. The results of those studies varied considerably, with anthropogenic temperature trends over the past 25-30 years suggested

  6. Code of practice for in-core instrumentation for neutron fluence rate (flux) measurements in power reactors

    International Nuclear Information System (INIS)

    Anon.

    1982-01-01

    This standard applies to in-core (on-line) neutron detectors and instrumentation which is designed for safety, information or control purposes. It also applies to components in so far as these components are contained within the primary envelope of the reactor. The detector types usually used are dc ionization chambers and self-powered neutron detectors

  7. Present status of ambient dose equivalent rate and radioactive substance concentration measurements in working environment. (3) Measuring instruments for ionizing radiation in working environments

    International Nuclear Information System (INIS)

    Matsubara, Shohei

    2006-01-01

    In order to measure the airborne radioactive substance concentration in working environments, some kinds of sampler such as dust sampler and iodine sampler, measuring instruments (alpha and beta spectrometer, and liquid scintillation counter), monitor (dust-, iodine- and gas-monitor), survey meter for measuring gamma ray dose rate are stated. The measurement method of α, β and γ-ray nuclides and ambient dose-equivalent at 10 mm was explained. Some examples of the list of dust sampler, filter, tritium sampler, dust monitor, iodine monitor, gas monitor, and survey meter on the market are shown. There are so many kinds of measuring instruments for ionizing radiation in working environment that the best instrument for measurement should be selected. The environment conditions such as sample form, temperature and humidity have to be considered in order to evaluate the measurement values. (S.Y.)

  8. [The "Mini-ICF-Rating for Mental Disorders (Mini-ICF-P)". A short instrument for the assessment of disabilities in mental disorders].

    Science.gov (United States)

    Linden, M; Baron, S

    2005-06-01

    Supplementary to the description of diseases at symptom level, the International Classification of Functioning, Disability and Health (ICF), edited by the WHO, for the first time enables a systematic description also at the level of disabilities and impairments. The Mini-ICF-Rating for Mental Disorders (Mini-ICF-P) is a short observer rating instrument for the assessment of disabilities, especially with regard to occupational functioning. The Mini-ICF-P was first evaluated empirically in 125 patients of a Department of Behavioural Medicine and Psychosomatics. Parallel-test reliability was r = 0.59. Correlates were found with cognitive and motivational variables and duration of sick leave from work. In summary, the Mini-ICF-P is a quick and practicable instrument.

  9. Cotrel-dubousset instrumentation for the correction of adolescent idiopathic scoliosis. Long-term results with an unexpected high revision rate

    Directory of Open Access Journals (Sweden)

    Mueller Franz J

    2012-06-01

    pain (LOSP. The average time until removal of instrumentation was 62.7 months (range 18 to 146 months post surgery; and one patient received partial device removal for prominent instrumentation 11 months post surgery. Altogether, only 22 out of 40 CD instrumentations (55% were still in situ. After an average period of 14.3 years post surgery, it was possible to follow-up 14 out of 40 patients (35% using the SRS-24 questionnaire. The average score was 93 points, without showing significant differences between patients with or without their instrumentation in situ. Conclusions Retrospectively, we documented for the first time a very high revisions rate in patients with AIS and treated by CD instrumentation. Nearly half of the instrumentation had to be removed due to late infection and LOSP. The reasons for the high rate of late infections with or without fistulae and for LOSP were analysed and discussed in detail.

  10. Transdermal drug delivery

    Science.gov (United States)

    Prausnitz, Mark R.; Langer, Robert

    2009-01-01

    Transdermal drug delivery has made an important contribution to medical practice, but has yet to fully achieve its potential as an alternative to oral delivery and hypodermic injections. First-generation transdermal delivery systems have continued their steady increase in clinical use for delivery of small, lipophilic, low-dose drugs. Second-generation delivery systems using chemical enhancers, non-cavitational ultrasound and iontophoresis have also resulted in clinical products; the ability of iontophoresis to control delivery rates in real time provides added functionality. Third-generation delivery systems target their effects to skin’s barrier layer of stratum corneum using microneedles, thermal ablation, microdermabrasion, electroporation and cavitational ultrasound. Microneedles and thermal ablation are currently progressing through clinical trials for delivery of macromolecules and vaccines, such as insulin, parathyroid hormone and influenza vaccine. Using these novel second- and third-generation enhancement strategies, transdermal delivery is poised to significantly increase impact on medicine. PMID:18997767

  11. An Integrated Instrumentation System for Velocity, Concentration and Mass Flow Rate Measurement of Solid Particles Based on Electrostatic and Capacitance Sensors

    Directory of Open Access Journals (Sweden)

    Jian Li

    2015-12-01

    Full Text Available The online and continuous measurement of velocity, concentration and mass flow rate of pneumatically conveyed solid particles for the high-efficiency utilization of energy and raw materials has become increasingly significant. In this paper, an integrated instrumentation system for the velocity, concentration and mass flow rate measurement of dense phase pneumatically conveyed solid particles based on electrostatic and capacitance sensorsis developed. The electrostatic sensors are used for particle mean velocity measurement in combination with the cross-correlation technique, while the capacitance sensor with helical surface-plate electrodes, which has relatively homogeneous sensitivity distribution, is employed for the measurement of particle concentration and its capacitance is measured by an electrostatic-immune AC-based circuit. The solid mass flow rate can be further calculated from the measured velocity and concentration. The developed instrumentation system for velocity and concentration measurement is verified and calibrated on a pulley rig and through static experiments, respectively. Finally the system is evaluated with glass beads on a gravity-fed rig. The experimental results demonstrate that the system is capable of the accurate solid mass flow rate measurement, and the relative error is within −3%–8% for glass bead mass flow rates ranging from 0.13 kg/s to 0.9 kg/s.

  12. Ninety-five orthotopic transplantations in 74 women of ovarian tissue after cytotoxic treatment in a fertility preservation network: tissue activity, pregnancy and delivery rates.

    Science.gov (United States)

    Van der Ven, H; Liebenthron, J; Beckmann, M; Toth, B; Korell, M; Krüssel, J; Frambach, T; Kupka, M; Hohl, M K; Winkler-Crepaz, K; Seitz, S; Dogan, A; Griesinger, G; Häberlin, F; Henes, M; Schwab, R; Sütterlin, M; von Wolff, M; Dittrich, R

    2016-09-01

    What is the success rate in terms of ovarian activity (menstrual cycles) as well as pregnancy and delivery rates 1 year after orthotopic ovarian transplantations conducted in a three-country network? In 49 women with a follow-up >1 year after transplantation, the ovaries were active in 67% of cases and the pregnancy and delivery rates were 33 and 25%, respectively. Cryopreservation of ovarian tissue in advance of cytotoxic therapies and later transplantation of the tissue is being performed increasingly often, and the total success rates in terms of pregnancy and delivery have been described in case series. However, published case series have not allowed either a more detailed analysis of patients with premature ovarian insufficiency (POI) or calculation of success rates based on the parameter 'tissue activity'. Retrospective analysis of 95 orthotopic transplantations in 74 patients who had been treated for cancer, performed in the FertiPROTEKT network from 2008 to June 2015. Of those 95 transplantations, a first subgroup (Subgroup 1) was defined for further analysis, including 49 women with a follow-up period >1 year after transplantation. Of those 49 women, a second subgroup (Subgroup 5) was further analysed, including 40 women who were transplanted for the first time and who were diagnosed with POI before transplantation. Transplantation was performed in 16 centres and data were transferred to the FertiPROTEKT registry. The transplantations were carried out after oncological treatment had been completed and after a remission period of at least 2 years. Tissue was transplanted orthotopically, either into or onto the residual ovaries or into a pelvic peritoneal pocket. The success rates were defined as tissue activity (menstrual cycles) after 1 year (primary outcome) and as pregnancies and deliveries achieved. The average age of all transplanted 74 women was 31 ± 5.9 years at the time of cryopreservation and 35 ± 5.2 at the time of transplantation. Twenty

  13. Induction of labor before 40 weeks is associated with lower rate of cesarean delivery in women with gestational diabetes mellitus.

    Science.gov (United States)

    Melamed, Nir; Ray, Joel G; Geary, Michael; Bedard, Daniel; Yang, Cathy; Sprague, Ann; Murray-Davis, Beth; Barrett, Jon; Berger, Howard

    2016-03-01

    In women with gestational diabetes mellitus, it is not clear whether routine induction of labor at gestation is beneficial to mother and newborn infant. The purpose of this study was to compare outcomes among women with gestational diabetes mellitus who had induction of labor at either 38 or 39 weeks with those whose pregnancy was managed expectantly. We included all women in Ontario, Canada, with diagnosed gestational diabetes mellitus who had a singleton hospital birth at ≥38 + 0 weeks of gestation between April 2012 and March 2014. Data were obtained from the Better Outcomes Registry & Network Ontario, which is a province-wide registry of all births in Ontario, Canada. Women who underwent induction of labor at 38 + 0 to 38 + 6 weeks of gestation (38-IOL; n = 1188) were compared with those who remained undelivered until 39 + 0 weeks of gestation (38-Expectant; n = 5229). Separately, those women who underwent induction of labor at 39 + 0 to 39 + 6 weeks of gestation (39-IOL; n = 1036) were compared with women who remained undelivered until 40 + 0 weeks of gestation (39-Expectant; n = 2162). Odds ratios and 95% confidence intervals were adjusted for maternal age, parity, insulin treatment, and prepregnancy body mass index. Of 281,480 women who gave birth during the study period, 14,600 women (5.2%) had gestational diabetes mellitus; of these, 8392 women (57.5%) met all inclusion criteria. Compared with the 38-Expectant group, those women in the 38-IOL group had lower odds for cesarean delivery (adjusted odds ratio, 0.73; 95% confidence interval, 0.52-0.90), higher odds for neonatal intensive care unit admission (adjusted odds ratio, 1.36; 95% confidence interval, 1.09-1.69), and no difference in other maternal-newborn infant outcomes. Compared with the 39-Expectant group, women in the 39-IOL group likewise had lower odds for cesarean delivery (adjusted odds ratio, 0.73; 95% confidence interval, 0.58-0.93) but no difference in neonatal intensive care unit

  14. Conditioned instrumental behaviour in the rat: Effects of prenatal irradiation with various low dose-rate doses

    International Nuclear Information System (INIS)

    Klug, H.

    1986-01-01

    4 groups of rats of the Wistar-strain were subjected to γ-irradiation on the 16th day of gestation. 5 rats received 0,6 Gy low dose rate irradiation, 5 animals received 0,9 Gy low dose and 6 high dose irradiation, 3 females were shamirradiated. The male offspring of these 3 irradiation groups and 1 control group were tested for locomotor coordination on parallel bars and in a water maze. The female offspring were used in an operant conditioning test. The locomotor test showed slight impairment of locomotor coordination in those animals irradiated with 0,9 Gy high dose rate. Swimming ability was significantly impaired by irradiation with 0,9 Gy high dose rate. Performance in the operant conditioning task was improved by irradiation with 0,9 Gy both low and high dose rate. The 0,9 Gy high dose rate group learned faster than all the other groups. For the dose of 0,9 Gy a significant dose rate effect could be observed. For the dose of 0,6 Gy a similar tendency was observed, differences between 0,6 Gy high and low dose rate and controls not being significant. (orig./MG) [de

  15. Final Report: Part 1. In-Place Filter Testing Instrument for Nuclear Material Containers. Part 2. Canister Filter Test Standards for Aerosol Capture Rates.

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Austin Douglas [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Runnels, Joel T. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Moore, Murray E. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Reeves, Kirk Patrick [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2014-11-02

    ) fouling of o-rings, (B) leakage through simulated cracks in o-rings, and (C) air leakage due to inadequately tightened canister lids. The Los Alamos POC instrument determined pertinent air flow and pressure quantities, and this knowledge was used to specify a customized Isaac® (Z axis, Salt Lake City, UT) leak test module. The final Los Alamos IPFT (incorporating the Isaac® leak test module) was used to repeat the tests in the Instrument Development Plan (with simulated filter clogging tests and canister leak pathway tests). The Los Alamos IPFT instrument is capable of determining filter clogging and leak rate conditions, without requiring removal of the container lid. The IPFT measures pressure decay rate from 1.7E-03 in WC/sec to 1.7E-01 in WC/sec. On the same unit scale, helium leak testing of canisters has a range from 5.7E-07 in WC/sec to 1.9E-03 in WC/sec. For a 5-quart storage canister, the IPFT measures equivalent leak flow rates from 0.03 to 3.0 cc/sec. The IPFT does not provide the same sensitivity as helium leak testing, but is able to gauge the assembled condition of as-found and in-situ canisters.

  16. Effects of Recruiting Midwives into a Family Physician Program on Women's Awareness and Preference for Mode of Delivery and Caesarean Section Rates in Rural Areas of Kurdistan.

    Science.gov (United States)

    Hajizadeh, Shayesteh; Tehrani, Fahimeh Ramezani; Simbar, Masoumeh; Farzadfar, Farshad

    2016-01-01

    The accepted rate rate of caesarean section is 15%. It is expected that an increase in the density of midwives in the family physician program lead to a decrease in this indicator. This study aimed to compare the rates of caesarean section and women's awareness and preference for mode of delivery before and after the implementation of the family physician program in health centres with and without an increase in midwives density. In this cross-sectional study, using multistage cluster sampling method a total of 668 mothers with two-month-old children were selected from among all mothers with two-month-old children who were living in rural areas of Kurdistan province. Using the difference-in-differences model and Matchit statistical model, the factors associated with caesarean section rates and women's awareness and preference for mode of delivery were compared in centres with and without an increase in midwives density after the implementation of the family physician program. To compare the changes before and after the program, we used the data collected from the same number of women in 2005 as the baseline. After adjusting for baseline data collected in 2005, the resutls showed no significant change in caesarean section rates and women's awareness and preference for mode of delivery in the centres with and without an increase in midwives density after the implementation of the family physician program. The Matchit model showed a significant mean increase 14%(0.03-0.25) in women's awareness of the benefits of natural childbirth between 2005 and 2013 in health centres where the density of midwives increased compared with health centres where it did not. The difference-in-differences model showed that the odds ratio of women's preference for caesarean section decreased by 41% among participants who were aware of the benefits of natural childbirth, (OR = 0.59, 95% CI: (0.22-0.85); P>0.001). The results of this study showed that an increase in the density of midwives

  17. A High-Rate Virtual Instrument of Marine Vehicle Motions for Underwater Navigation and Ocean Remote Sensing

    CERN Document Server

    Gelin, Chrystel

    2013-01-01

    Dead-Reckoning aided with Doppler velocity measurement has been the most common method for underwater navigation for small vehicles. Unfortunately DR requires frequent position recalibrations and underwater vehicle navigation systems are limited to periodic position update when they surface. Finally standard Global Positioning System (GPS) receivers are unable to provide the rate or precision required when used on a small vessel. To overcome this, a low cost high rate motion measurement system for an Unmanned Surface Vehicle (USV) with underwater and oceanographic purposes is proposed. The proposed onboard system for the USV consists of an Inertial Measurement Unit (IMU) with accelerometers and rate gyros, a GPS receiver, a flux-gate compass, a roll and tilt sensor and an ADCP. Interfacing all the sensors proved rather challenging because of their different characteristics. The proposed data fusion technique integrates the sensors and develops an embeddable software package, using real time data fusion method...

  18. Major, trace and rate earth elements in sediments of the Julian Adame-Alatorre dam by instrumental neutron activation analysis

    Energy Technology Data Exchange (ETDEWEB)

    Mireles, F.; Pinedo, J. L.; Davila, J. I.; Oliva, J. E. [Universidad Autonoma de Zacatecas, Calle Cipres No. 10, Fracc. La Penuela, 98068 Zacatecas (Mexico); Speakman, R. J. [Museum Conservation Institute, Smithsonian Institution, Suitland, MD 20746 (United States); Glascock, M. D., E-mail: fmireles@uaz.edu.m [Research Reactor Center, University of Missouri, Columbia, MO 65211 (United States)

    2010-10-15

    The rapid industrial development in regions of Mexico during recent years has had the side effect of introducing toxic metals, fertilizers, and pesticides into the ecosystem. Sediment cores were collected from eight locations around the Julian Adame-Alatorre dam located in Municipality of Villanueva in the Zacatecas State, Mexico. The cores were analyzed for 32 major, trace, and rare earth elements (As, La, Lu, Nd, Sm, U, Yb, Ce, Co, Cr, Cs, Eu, Fe, Hf, Rb, Sb, Sc, Sr, Ta, Tb, Th, Zn, Zr, Al, Ba, Ca, Dy, K, Mn, Na, Ti, V) in order to estimate the health risk. The samples were analyzed by instrument neutron activation analysis using thermal neutron fluxes of 8 x 10{sup 13} and 5 x 10{sup 13} n cm{sup -2} s{sup -1} for short and long irradiations, respectively. The results of the contamination levels for elements such as As, Ba, Cr, Fe, Mn, Ta, V, and Zn were compared with the Mexican regulations and the guidelines of US EPA. (Author)

  19. Major, trace and rate earth elements in sediments of the Julian Adame-Alatorre dam by instrumental neutron activation analysis

    International Nuclear Information System (INIS)

    Mireles, F.; Pinedo, J. L.; Davila, J. I.; Oliva, J. E.; Speakman, R. J.; Glascock, M. D.

    2010-10-01

    The rapid industrial development in regions of Mexico during recent years has had the side effect of introducing toxic metals, fertilizers, and pesticides into the ecosystem. Sediment cores were collected from eight locations around the Julian Adame-Alatorre dam located in Municipality of Villanueva in the Zacatecas State, Mexico. The cores were analyzed for 32 major, trace, and rare earth elements (As, La, Lu, Nd, Sm, U, Yb, Ce, Co, Cr, Cs, Eu, Fe, Hf, Rb, Sb, Sc, Sr, Ta, Tb, Th, Zn, Zr, Al, Ba, Ca, Dy, K, Mn, Na, Ti, V) in order to estimate the health risk. The samples were analyzed by instrument neutron activation analysis using thermal neutron fluxes of 8 x 10 13 and 5 x 10 13 n cm -2 s -1 for short and long irradiations, respectively. The results of the contamination levels for elements such as As, Ba, Cr, Fe, Mn, Ta, V, and Zn were compared with the Mexican regulations and the guidelines of US EPA. (Author)

  20. Influence of inspiratory flow rate, particle size, and airway caliber on aerosolized drug delivery to the lung.

    Science.gov (United States)

    Dolovich, M A

    2000-06-01

    A number of studies in the literature support the use of fine aerosols of drug, inhaled at low IFRs to target peripheral airways, with the objective of improving clinical responses to inhaled therapy (Fig. 8). Attempts have been made to separate response due to changes in total administered dose or the surface concentration of the dose from response due to changes in site of deposition--both are affected by the particle size of the aerosol, with IFR additionally influencing the latter. The tools for measuring dose and distribution have improved over the last 10-15 years, and thus we should expect greater accuracy in these measurements for assessing drug delivery to the lung. There are still issues, though, in producing radiolabeled (99m)technetium aerosols that are precise markers for the pharmaceutical product being tested and in quantitating absolute doses deposited in the lung. PET isotopes may provide the means for directly labelling a drug and perhaps can offer an alternative for making these measurements in the future, but deposition measurements should not be used in isolation; protocols should incorporate clinical tests to provide parallel therapeutic data in response to inhalation of the drug by the various patient populations being studied.

  1. Interrater Reliability of the ENERGY Photo-Rating Instrument for School Environments Related to Physical Activity and Eating

    NARCIS (Netherlands)

    Altenburg, T.; te Velde, S.; Chiu, K.-J.; Moschonis, G.; Manios, Y.; De Bourdeaudhuij, I.; Vik, F.N.; Lien, N.; Brug, J.; Chinapaw, M.

    Background: The school environment can play an important role in the prevention of childhood overweight and obesity. Photos of the school environment may contribute to more adequate measurement of the school environment, as photos can be rated by different assessors. We aimed to examine the

  2. Virtual Instrument for Determining Rate Constant of Second-Order Reaction by pX Based on LabVIEW 8.0.

    Science.gov (United States)

    Meng, Hu; Li, Jiang-Yuan; Tang, Yong-Huai

    2009-01-01

    The virtual instrument system based on LabVIEW 8.0 for ion analyzer which can measure and analyze ion concentrations in solution is developed and comprises homemade conditioning circuit, data acquiring board, and computer. It can calibrate slope, temperature, and positioning automatically. When applied to determine the reaction rate constant by pX, it achieved live acquiring, real-time displaying, automatical processing of testing data, generating the report of results; and other functions. This method simplifies the experimental operation greatly, avoids complicated procedures of manual processing data and personal error, and improves veracity and repeatability of the experiment results.

  3. APPLICATION OF THE SPECTROMETRIC METHOD FOR CALCULATING THE DOSE RATE FOR CREATING CALIBRATION HIGHLY SENSITIVE INSTRUMENTS BASED ON SCINTILLATION DETECTION UNITS

    Directory of Open Access Journals (Sweden)

    R. V. Lukashevich

    2017-01-01

    Full Text Available Devices based on scintillation detector are highly sensitive to photon radiation and are widely used to measure the environment dose rate. Modernization of the measuring path to minimize the error in measuring the response of the detector to gamma radiation has already reached its technological ceiling and does not give the proper effect. More promising for this purpose are new methods of processing the obtained spectrometric information. The purpose of this work is the development of highly sensitive instruments based on scintillation detection units using a spectrometric method for calculating dose rate.In this paper we consider the spectrometric method of dosimetry of gamma radiation based on the transformation of the measured instrumental spectrum. Using predetermined or measured functions of the detector response to the action of gamma radiation of a given energy and flux density, a certain function of the energy G(E is determined. Using this function as the core of the integral transformation from the field to dose characteristic, it is possible to obtain the dose value directly from the current instrumentation spectrum. Applying the function G(E to the energy distribution of the fluence of photon radiation in the environment, the total dose rate can be determined without information on the distribution of radioisotopes in the environment.To determine G(E by Monte-Carlo method instrumental response function of the scintillator detector to monoenergetic photon radiation sources as well as other characteristics are calculated. Then the whole full-scale energy range is divided into energy ranges for which the function G(E is calculated using a linear interpolation.Spectrometric method for dose calculation using the function G(E, which allows the use of scintillation detection units for a wide range of dosimetry applications is considered in the article. As well as describes the method of calculating this function by using Monte-Carlo methods

  4. The 30-second rule: the effects of prolonged intubation attempts on oxygen saturation and heart rate in preterm infants in the delivery room.

    Science.gov (United States)

    Wozniak, Madeline; Arnell, Kathy; Brown, Melissa; Gonzales, Sarah; Lazarus, Danielle; Rich, Wade; Katheria, Anup

    2018-04-01

    A duration of 30 seconds has been shown to improve the success rate of intubation attempts without any decompensation. There is limited data regarding the detrimental effects of prolonged intubation attempts in preterm infants. The aim was to determine the effect of prolonged intubation attempts on heart rate and oxygen saturation in preterm infants. We retrospectively reviewed videos and physiologic data collected during delivery room (DR) resuscitations. Infants who had a functioning pulse oximeter at the time of intubation in the delivery room were analyzed using video and analog recordings. The duration of the intubation attempt was defined as the time the laryngoscope blade was in the infant's mouth. Prolonged intubations were defined as intubations over 30 seconds. Baseline heart rate and saturations were defined as the heart rate and saturation immediately prior to the intubation attempt. Video recording was used to determine time laryngoscope was in the mouth, what other procedures were performed, and whether there was recovery between attempts. Analog data including heart rate, airway pressure and saturation was also recorded. There were 52 intubation attempts in 28 infants. The median (IQR) birth weight and gestational age were 795 (705, 972) grams and 25 (25, 27) weeks. The duration of an intubation attempt was 35 (27, 46) seconds with number of attempts 2 (1, 2). There were 34 intubation attempts greater than 30 seconds (prolonged group) and 18 attempts less than or equal to 30 seconds (short group). Longer attempts did not affect intubation success (successful 34 [25,37] seconds vs. unsuccessful 41[29, 53] seconds; P=0.05). Infants in the prolonged group had a greater decrease in oxygen saturation percentage from baseline (5±8 percent, short intubation group and 13±27 prolonged intubation group; P=0.004). There was also a significant decrease in heart rate beats per minute between the two groups (6±9 in the short intubation group and 23±29

  5. SWE-based Observation Data Delivery from the Instrument to the User - Sensor Web Technology in the NeXOS Project

    Science.gov (United States)

    Jirka, Simon; del Rio, Joaquin; Toma, Daniel; Martinez, Enoc; Delory, Eric; Pearlman, Jay; Rieke, Matthes; Stasch, Christoph

    2017-04-01

    The rapidly evolving technology for building Web-based (spatial) information infrastructures and Sensor Webs, there are new opportunities to improve the process how ocean data is collected and managed. A central element in this development is the suite of Sensor Web Enablement (SWE) standards specified by the Open Geospatial Consortium (OGC). This framework of standards comprises on the one hand data models as well as formats for measurement data (ISO/OGC Observations and Measurement, O&M) and metadata describing measurement processes and sensors (OGC Sensor Model Language, SensorML). On the other hand the SWE standards comprise (Web service) interface specifications for pull-based access to observation data (OGC Sensor Observation Service, SOS) and for controlling or configuring sensors (OGC Sensor Planning Service, SPS). Also within the European INSPIRE framework the SWE standards play an important role as the SOS is the recommended download service interface for O&M-encoded observation data sets. In the context of the EU-funded Oceans of Tomorrow initiative the NeXOS (Next generation, Cost-effective, Compact, Multifunctional Web Enabled Ocean Sensor Systems Empowering Marine, Maritime and Fisheries Management) project is developing a new generation of in-situ sensors that make use of the SWE standards to facilitate the data publication process and the integration into Web based information infrastructures. This includes the development of a dedicated firmware for instruments and sensor platforms (SEISI, Smart Electronic Interface for Sensors and Instruments) maintained by the Universitat Politècnica de Catalunya (UPC). Among other features, SEISI makes use of OGC SWE standards such OGC-PUCK, to enable a plug-and-play mechanism for sensors based on SensorML encoded metadata. Thus, if a new instrument is attached to a SEISI-based platform, it automatically configures the connection to these instruments, automatically generated data files compliant with the ISO

  6. Sonographic large fetal head circumference and risk of cesarean delivery.

    Science.gov (United States)

    Lipschuetz, Michal; Cohen, Sarah M; Israel, Ariel; Baron, Joel; Porat, Shay; Valsky, Dan V; Yagel, Oren; Amsalem, Hagai; Kabiri, Doron; Gilboa, Yinon; Sivan, Eyal; Unger, Ron; Schiff, Eyal; Hershkovitz, Reli; Yagel, Simcha

    2018-03-01

    Persistently high rates of cesarean deliveries are cause for concern for physicians, patients, and health systems. Prelabor assessment might be refined by identifying factors that help predict an individual patient's risk of cesarean delivery. Such factors may contribute to patient safety and satisfaction as well as health system planning and resource allocation. In an earlier study, neonatal head circumference was shown to be more strongly associated with delivery mode and other outcome measures than neonatal birthweight. In the present study we aimed to evaluate the association of sonographically measured fetal head circumference measured within 1 week of delivery with delivery mode. This was a multicenter electronic medical record-based study of birth outcomes of primiparous women with term (37-42 weeks) singleton fetuses presenting for ultrasound with fetal biometry within 1 week of delivery. Fetal head circumference and estimated fetal weight were correlated with maternal background, obstetric, and neonatal outcome parameters. Elective cesarean deliveries were excluded. Multinomial regression analysis provided adjusted odds ratios for instrumental delivery and unplanned cesarean delivery when the fetal head circumference was ≥35 cm or estimated fetal weight ≥3900 g, while controlling for possible confounders. In all, 11,500 cases were collected; 906 elective cesarean deliveries were excluded. A fetal head circumference ≥35 cm increased the risk for unplanned cesarean delivery: 174 fetuses with fetal head circumference ≥35 cm (32%) were delivered by cesarean, vs 1712 (17%) when fetal head circumference cesarean delivery by an adjusted odds ratio of 1.75 (95% confidence interval, 1.4-2.18) controlling for gestational age, fetal gender, and epidural anesthesia. The rate of prolonged second stage of labor was significantly increased when either the fetal head circumference was ≥35 cm or the estimated fetal weight ≥3900 g, from 22.7% in the total

  7. Fine-scale environmental effects on Cape hake survey catch rates in the Northern Benguela, using data from a trawl-mounted instrument package

    DEFF Research Database (Denmark)

    Kainge, Paulus Inekela; Wieland, Kai

    2017-01-01

    We investigated fine-scale effects of environmental variables associated with habitat distribution for 4 size groups of Cape hakes, Merluccius capensis and M. paradoxus, using generalized additive models (GAMs) with a negative binominal error distribution. This study took place during the Namibian...... hake trawl survey of 2016, and was made possible for the first time in Namibia by collecting oceanographic information with a trawl-mounted instrument package concurrently with the catch data. Depth, geographical position, bottom oxygen and bottom temperature had the most pronounced effect on the catch...... rates of both hake species, whereas solar zenith angle representing diel effects and surface layer chlorophyll appeared to be less important. The explained deviance for the best models ranged from 71.4% for M. capensis to 92.7% for M. paradoxus between 43 and 57 cm in length. Differences in catch rates...

  8. Quality assurance regime for the fabrication and calibration of ambient dose rate measuring instruments with proportional counters

    International Nuclear Information System (INIS)

    Schloesser, H.

    1997-01-01

    The proportional detectors FHZ 600A and FHZ 601A serve as examples to illustrate the quality assurance regime applied in fabrication and operation of the detector. Calibration is done by a licensed establishment connected to the standard 137 Cs calibration source at PTB. In addition to the basic calibration, the intrinsic selfdosing effect of the device and its response to cosmic radiation are known and can be taken into account in interpretations of measured results. The individual calibration of the intelligent probes of type FHZ 601A achieves a yet better measuring accuracy at higher dose rates, as compared to the basic calibration and performance of the FHZ 600A probes, as was shown by a type approval test. The paper also shows that control measurements and ''intelligent'' measuring systems with integrated checking routines improve the measuring reliability. (orig./CB) [de

  9. Taking the Test Taker's Perspective: Response Process and Test Motivation in Multidimensional Forced-Choice Versus Rating Scale Instruments.

    Science.gov (United States)

    Sass, Rachelle; Frick, Susanne; Reips, Ulf-Dietrich; Wetzel, Eunike

    2018-03-01

    The multidimensional forced-choice (MFC) format has been proposed as an alternative to the rating scale (RS) response format. However, it is unclear how changing the response format may affect the response process and test motivation of participants. In Study 1, we investigated the MFC response process using the think-aloud technique. In Study 2, we compared test motivation between the RS format and different versions of the MFC format (presenting 2, 3, 4, and 5 items simultaneously). The response process to MFC item blocks was similar to the RS response process but involved an additional step of weighing the items within a block against each other. The RS and MFC response format groups did not differ in their test motivation. Thus, from the test taker's perspective, the MFC format is somewhat more demanding to respond to, but this does not appear to decrease test motivation.

  10. Validation of cross-cultural child mental health and psychosocial research instruments: adapting the Depression Self-Rating Scale and Child PTSD Symptom Scale in Nepal

    Science.gov (United States)

    2011-01-01

    Background The lack of culturally adapted and validated instruments for child mental health and psychosocial support in low and middle-income countries is a barrier to assessing prevalence of mental health problems, evaluating interventions, and determining program cost-effectiveness. Alternative procedures are needed to validate instruments in these settings. Methods Six criteria are proposed to evaluate cross-cultural validity of child mental health instruments: (i) purpose of instrument, (ii) construct measured, (iii) contents of construct, (iv) local idioms employed, (v) structure of response sets, and (vi) comparison with other measurable phenomena. These criteria are applied to transcultural translation and alternative validation for the Depression Self-Rating Scale (DSRS) and Child PTSD Symptom Scale (CPSS) in Nepal, which recently suffered a decade of war including conscription of child soldiers and widespread displacement of youth. Transcultural translation was conducted with Nepali mental health professionals and six focus groups with children (n = 64) aged 11-15 years old. Because of the lack of child mental health professionals in Nepal, a psychosocial counselor performed an alternative validation procedure using psychosocial functioning as a criterion for intervention. The validation sample was 162 children (11-14 years old). The Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS) and Global Assessment of Psychosocial Disability (GAPD) were used to derive indication for treatment as the external criterion. Results The instruments displayed moderate to good psychometric properties: DSRS (area under the curve (AUC) = 0.82, sensitivity = 0.71, specificity = 0.81, cutoff score ≥ 14); CPSS (AUC = 0.77, sensitivity = 0.68, specificity = 0.73, cutoff score ≥ 20). The DSRS items with significant discriminant validity were "having energy to complete daily activities" (DSRS.7), "feeling that life is not worth living" (DSRS.10), and "feeling

  11. Validation of cross-cultural child mental health and psychosocial research instruments: adapting the Depression Self-Rating Scale and Child PTSD Symptom Scale in Nepal

    Directory of Open Access Journals (Sweden)

    Tol Wietse A

    2011-08-01

    Full Text Available Abstract Background The lack of culturally adapted and validated instruments for child mental health and psychosocial support in low and middle-income countries is a barrier to assessing prevalence of mental health problems, evaluating interventions, and determining program cost-effectiveness. Alternative procedures are needed to validate instruments in these settings. Methods Six criteria are proposed to evaluate cross-cultural validity of child mental health instruments: (i purpose of instrument, (ii construct measured, (iii contents of construct, (iv local idioms employed, (v structure of response sets, and (vi comparison with other measurable phenomena. These criteria are applied to transcultural translation and alternative validation for the Depression Self-Rating Scale (DSRS and Child PTSD Symptom Scale (CPSS in Nepal, which recently suffered a decade of war including conscription of child soldiers and widespread displacement of youth. Transcultural translation was conducted with Nepali mental health professionals and six focus groups with children (n = 64 aged 11-15 years old. Because of the lack of child mental health professionals in Nepal, a psychosocial counselor performed an alternative validation procedure using psychosocial functioning as a criterion for intervention. The validation sample was 162 children (11-14 years old. The Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS and Global Assessment of Psychosocial Disability (GAPD were used to derive indication for treatment as the external criterion. Results The instruments displayed moderate to good psychometric properties: DSRS (area under the curve (AUC = 0.82, sensitivity = 0.71, specificity = 0.81, cutoff score ≥ 14; CPSS (AUC = 0.77, sensitivity = 0.68, specificity = 0.73, cutoff score ≥ 20. The DSRS items with significant discriminant validity were "having energy to complete daily activities" (DSRS.7, "feeling that life is not worth living" (DSRS.10, and

  12. Delivery presentations

    Science.gov (United States)

    Pregnancy - delivery presentation; Labor - delivery presentation; Occiput posterior; Occiput anterior; Brow presentation ... The mother can walk, rock, and try different delivery positions during labor to help encourage the baby ...

  13. Determination of the Clean Air Delivery Rate (CADR of Photocatalytic Oxidation (PCO Purifiers for Indoor Air Pollutants Using a Closed-Loop Reactor. Part I: Theoretical Considerations

    Directory of Open Access Journals (Sweden)

    Éric Dumont

    2017-03-01

    Full Text Available This study demonstrated that a laboratory-scale recirculation closed-loop reactor can be an efficient technique for the determination of the Clean Air Delivery Rate (CADR of PhotoCatalytic Oxidation (PCO air purification devices. The recirculation closed-loop reactor was modeled by associating equations related to two ideal reactors: one is a perfectly mixed reservoir and the other is a plug flow system corresponding to the PCO device itself. Based on the assumption that the ratio between the residence time in the PCO device and the residence time in the reservoir τP/τR tends to 0, the model highlights that a lab closed-loop reactor can be a suitable technique for the determination of the efficiency of PCO devices. Moreover, if the single-pass removal efficiency is lower than 5% of the treated flow rate, the decrease in the pollutant concentration over time can be characterized by a first-order decay model in which the time constant is proportional to the CADR. The limits of the model are examined and reported in terms of operating conditions (experiment duration, ratio of residence times, and flow rate ranges.

  14. Depression and anxiety in patients with coronary artery disease, measured by means of self-report measures and clinician-rated instrument.

    Science.gov (United States)

    Moryś, Joanna M; Bellwon, Jerzy; Adamczyk, Katarzyna; Gruchała, Marcin

    2016-01-01

    The presence of depression symptomatology significantly deteriorates the prognosis for the patient. There are many instruments developed to measure depression and anxiety in clinical trials; however, the suitability of the specific scale for screening these disorders in cardiovascular patients is debatable. The aim of current study is to verify which of the major assessment instruments is the most relevant for the screening evaluation of depression and anxiety in patients with cardiovascular system diseases. The sample studied consisted of 120 patients with stable coronary artery disease (CAD). They did not display serious psychiatric or somatic disorders. To assess depressive and anxiety symptoms we used self-reporting measures (BDI-II, HADS, SSAI/STAI, and PHQ), the results of which were compared to results obtained on the basis of a clinician-rating instrument (HRSD). We found that depressive symptoms assessed on the basis of HRSD, BDI-II, and PHQ-9 were equivalent in results, while the results obtained in HADS-D were significantly lower. Anxiety symptoms were found at approximate levels in HADS, SSAI, and GAD-7. The assessment of somatic symptoms in patients with CAD indicates that 87.5% of the subjects reported somatic symptoms of various intensity. Screening assessment of depression in patients with CAD gives different results depending on the tool used. We found that HADS significantly underestimates the percentage of patients with symptoms of depression in patients with CAD. Assessing anxiety symptoms with the aid of HADS gave outcomes close to the results gained by use of other tools.

  15. Assessment of the rates and characteristics of the short-term supply of medication (Tider from an integrated healthcare delivery system in the United States

    Directory of Open Access Journals (Sweden)

    Delate T

    2017-06-01

    Full Text Available Objectives: The purpose of this study was to describe the rate of medication short-term supply dispensings (tider, patient and medication characteristics associated with a tider, and costs for tider dispensings in an integrated healthcare delivery system in Colorado, United States. Methods: This was a retrospective study conducted in an integrated healthcare delivery system’s outpatient clinics. All patients who had a prescription dispensed for a study medication at any of the system’s 28 outpatient pharmacies during the first quarter of 2016 were included. A tider was identified as a 3-day supply of a prescription medication that was dispensed at no charge to a patient. The quarterly tider rate and the per member per month (PMPM cost of tiders were estimated. Patient and medication characteristics associated with a tider were assessed. Results: A total of 444,225 study medications were dispensed for 135,907 patients during the study period. There were 3,430 (0.77%, 95%CI 0.75%:0.80% medications dispensed as a tider. The PMPM cost of tider medications and their dispensing fees was USD 0.03. There were 1,092 (0.8% and 134,815 (99.2% patients who did and did not, respectively, have at least one tider dispensed during the study period. Patient characteristics strongly associated with having had a tider dispensed included being older, male, and a Medicare beneficiary. Cardiovascular and neuromuscular medications had the highest rates of tider dispensing. Conclusions: The rate of tider dispensing was relatively low; however, approximately one out of 125 patients had at least one tider. Patients who had a tider were more likely to be older, female, a Medicare beneficiary, and having had a previous tider dispensing and a higher burden of chronic disease. The tider medication was more likely to be a cardiovascular or neuromuscular medication class and more likely to be dispensed on a weekend. The total cost of dispensing a tider appears reasonable

  16. Latex paint as a delivery vehicle for diethylphthalate and di-n-butylphthalate: predictable boundary layer concentrations and emission rates.

    Science.gov (United States)

    Schripp, Tobias; Salthammer, Tunga; Fauck, Christian; Bekö, Gabriel; Weschler, Charles J

    2014-10-01

    The description of emission processes of volatile and semi-volatile organic compounds (VOCs and SVOCs) from building products requires a detailed understanding of the material and the air flow conditions at the surface boundary. The mass flux between the surface of the material and air depends on the mass transfer coefficient (hm) through the boundary layer, the gas phase concentration of the target compound immediately adjacent to the material (y0), and the gas-phase concentration in bulk air (y(t)). In the present study emission experiments were performed in two chambers of quite different sizes (0.25 m(3) and 55 m(3)), and, in the larger chamber, at two different temperatures (23°C and 30°C). The emitting material was latex wall paint that had been doped with two plasticizers, diethylphthalate (DEP) and di-n-butylphthalate (DnBP). The phthalate content in the paint was varied in the small chamber experiment to evaluate the impact of the initial concentration in the bulk material (C0) on the emission rate. Boundary layer theory was applied to calculate hm for the specific phthalates from the Sherwood number (Sh) and the diffusion coefficient (Dair). Then y0 was determined based on the bulk gas-phase concentration at steady state (y¯). For both, DEP and DnBP, the y0 obtained was lower than the respective saturation vapor pressure (Ps). Furthermore, for both phthalates in latex paint, the material/air partition coefficient (C0/y0) was close in value to the octanol/air partition coefficient (KOA). This study provides a basis for designing phthalate emitting reference materials that mimic the emission behavior of common building materials. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Mode of delivery after successful external cephalic version: a systematic review and meta-analysis.

    Science.gov (United States)

    de Hundt, Marcella; Velzel, Joost; de Groot, Christianne J; Mol, Ben W; Kok, Marjolein

    2014-06-01

    To assess the mode of delivery in women after a successful external cephalic version by performing a systematic review and meta-analysis. We searched MEDLINE, Embase, ClinicalTrials.gov, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library for studies reporting on the mode of delivery in women after successful external cephalic version at term and women with a spontaneous cephalic-presenting fetus. Two reviewers independently selected studies, extracted data, and assessed study quality. The association between mode of delivery and successful external cephalic version was expressed as a common odds ratio with a 95% confidence interval (CI). We identified three cohort studies and eight case-control studies, reporting on 46,641 women. The average cesarean delivery rate for women with a successful external cephalic version was 21%. Women after successful external cephalic version were at increased risk for cesarean delivery for dystocia (odds ratio [OR] 2.2, 95% CI 1.6-3.0), cesarean delivery for fetal distress (OR 2.2, 95% CI 1.6-2.9), and instrumental vaginal delivery (OR 1.4, 95% CI 1.1-1.7). Women who have had a successful external cephalic version for breech presentation are at increased risk for cesarean delivery and instrumental vaginal delivery as compared with women with a spontaneous cephalic presentation. Nevertheless, with a number needed to treat of three, external cephalic version still remains a very efficient procedure to prevent a cesarean delivery.

  18. Nuclear reactor instrumentation

    International Nuclear Information System (INIS)

    Duncombe, E.; McGonigal, G.

    1975-01-01

    A liquid metal cooled nuclear reactor is described which has an equal number of fuel sub-assemblies and sensing instruments. Each instrument senses temperature and rate of coolant flow of a coolant derived from a group of three sub-assemblies so that an abnormal value for one sub-assembly will be indicated on three instruments thereby providing for redundancy of up to two of the three instruments. The abnormal value may be a precurser to unstable boiling of coolant

  19. Risk of recurrence and subsequent delivery after obstetric anal sphincter injuries.

    Science.gov (United States)

    Baghestan, E; Irgens, L M; Børdahl, P E; Rasmussen, S

    2012-01-01

    To investigate the recurrence risk, the likelihood of having further deliveries and mode of delivery after third to fourth degree obstetric anal sphincter injuries (OASIS). Population-based cohort study. The Medical Birth Registry of Norway. A cohort of 828,864 mothers with singleton, vertex-presenting infants, weighing 500 g or more, during the period 1967-2004. Comparison of women with and without a history of OASIS with respect to the occurrence of OASIS, subsequent delivery rate and planned caesarean rate. OASIS in second and third deliveries, subsequent delivery rate and mode of delivery. Adjusted odds ratios of the recurrence of OASIS in women with a history of OASIS in the first, and in both the first and second deliveries, were 4.2 (95% CI 3.9-4.5; 5.6%) and 10.6 (95% CI 6.2-18.1; 9.5%), respectively, relative to women without a history of OASIS. Instrumental deliveries, in particular forceps deliveries, birthweights of 3500 g or more and large maternity units were associated with a recurrence of OASIS. Instrumental delivery did not further increase the excess recurrence risk associated with high birthweight. A man who fathered a child whose delivery was complicated by OASIS was more likely to father another child whose delivery was complicated by OASIS in another woman who gave birth in the same maternity unit (adjusted OR 2.1; 95% CI 1.2-3.7; 5.6%). However, if the deliveries took place in different maternity units, the recurrence risk was not significantly increased (OR 1.3; 95% CI 0.8-2.1; 4.4%). The subsequent delivery rate was not different in women with and without previous OASIS, whereas women with a previous OASIS were more often scheduled to caesarean delivery. Recurrence risks in second and third deliveries were high. A history of OASIS had little or no impact on the rates of subsequent deliveries. Women with previous OASIS were delivered more frequently by planned caesarean delivery. © 2011 The Authors BJOG An International Journal of

  20. Exploring the relationships among performance-based functional ability, self-rated disability, perceived instrumental support, and depression: a structural equation model analysis.

    Science.gov (United States)

    Weil, Joyce; Hutchinson, Susan R; Traxler, Karen

    2014-11-01

    Data from the Women's Health and Aging Study were used to test a model of factors explaining depressive symptomology. The primary purpose of the study was to explore the association between performance-based measures of functional ability and depression and to examine the role of self-rated physical difficulties and perceived instrumental support in mediating the relationship between performance-based functioning and depression. The inclusion of performance-based measures allows for the testing of functional ability as a clinical precursor to disability and depression: a critical, but rarely examined, association in the disablement process. Structural equation modeling supported the overall fit of the model and found an indirect relationship between performance-based functioning and depression, with perceived physical difficulties serving as a significant mediator. Our results highlight the complementary nature of performance-based and self-rated measures and the importance of including perception of self-rated physical difficulties when examining depression in older persons. © The Author(s) 2014.

  1. Examining the evidence for a recent acceleration in the rate of sea-level rise using combined instrumental and proxy data, North Carolina, USA

    Science.gov (United States)

    Kemp, A.; Horton, B. P.

    2007-12-01

    Whilst accelerated rates of relative sea-level (RSL) rise are potentially one of the most devastating impacts of future climate change, our understanding of decadal scale changes in sea-level is poor. This paper seeks to address this knowledge gap by combining tide gauge and high-precision geological reconstructions of relative sea-level of sufficient resolution and duration to detect any recent acceleration in the rate of sea-level rise. We offer a high resolution relative sea-level history for the last ~2000 years from the Albemarle - Pamlico Estuarine System in North Carolina. Contemporary foraminifera were collected from five back barrier marshes to create a regional scale modern training set. The use of multiple marshes from a region increases the ecological and environmental diversity included within the training set and reduces the probability of a no modern analogue outcome. To merge the five spatially distinct sites and to relate each to local tide levels we used the VDatum transformation tool. This method relates all samples to a common orthometric datum (NAVD88) and reduces error. We developed an accurate and precise transfer function to reconstruct former sea levels based upon the modern observable relationship between foraminifera and elevation with respect to the tidal frame. We applied the transfer function to salt-marsh core(s) from Sand Point (Roanoke Island), North Carolina to produce a late Holocene RSL record. An age-depth model was produced from composite chronologies of 210Pb, 14C and pollen chrono-horizons. We validated our approach by comparing geological based reconstructions and instrumental tide gauge records. Our records show that in the last ~2000 years sea level has risen at a background rate of ~1.1mm/yr. There is evidence for two recent accelerations in the rate of sea-level rise during the late 19th and 20th centuries to a current rate of ~4mm/yr.

  2. Determination of the Clean Air Delivery Rate (CADR of Photocatalytic Oxidation (PCO Purifiers for Indoor Air Pollutants Using a Closed-Loop Reactor. Part II: Experimental Results

    Directory of Open Access Journals (Sweden)

    Valérie Héquet

    2017-03-01

    Full Text Available The performances of a laboratory PhotoCatalytic Oxidation (PCO device were determined using a recirculation closed-loop pilot reactor. The closed-loop system was modeled by associating equations related to two ideal reactors: a perfectly mixed reservoir with a volume of VR = 0.42 m3 and a plug flow system corresponding to the PCO device with a volume of VP = 5.6 × 10−3 m3. The PCO device was composed of a pleated photocatalytic filter (1100 cm2 and two 18-W UVA fluorescent tubes. The Clean Air Delivery Rate (CADR of the apparatus was measured under different operating conditions. The influence of three operating parameters was investigated: (i light irradiance I from 0.10 to 2.0 mW·cm−2; (ii air velocity v from 0.2 to 1.9 m·s−1; and (iii initial toluene concentration C0 (200, 600, 1000 and 4700 ppbv. The results showed that the conditions needed to apply a first-order decay model to the experimental data (described in Part I were fulfilled. The CADR values, ranging from 0.35 to 3.95 m3·h−1, were mainly dependent on the light irradiance intensity. A square root influence of the light irradiance was observed. Although the CADR of the PCO device inserted in the closed-loop reactor did not theoretically depend on the flow rate (see Part I, the experimental results did not enable the confirmation of this prediction. The initial concentration was also a parameter influencing the CADR, as well as the toluene degradation rate. The maximum degradation rate rmax ranged from 342 to 4894 ppbv/h. Finally, this study evidenced that a recirculation closed-loop pilot could be used to develop a reliable standard test method to assess the effectiveness of PCO devices.

  3. The rate of second electron transfer to QB(-) in bacterial reaction center of impaired proton delivery shows hydrogen-isotope effect.

    Science.gov (United States)

    Maróti, Ágnes; Wraight, Colin A; Maróti, Péter

    2015-02-01

    The 2nd electron transfer in reaction center of photosynthetic bacterium Rhodobacter sphaeroides is a two step process in which protonation of QB(-) precedes interquinone electron transfer. The thermal activation and pH dependence of the overall rate constants of different RC variants were measured and compared in solvents of water (H2O) and heavy water (D2O). The electron transfer variants where the electron transfer is rate limiting (wild type and M17DN, L210DN and H173EQ mutants) do not show solvent isotope effect and the significant decrease of the rate constant of the second electron transfer in these mutants is due to lowering the operational pKa of QB(-)/QBH: 4.5 (native), 3.9 (L210DN), 3.7 (M17DN) and 3.1 (H173EQ) at pH7. On the other hand, the proton transfer variants where the proton transfer is rate limiting demonstrate solvent isotope effect of pH-independent moderate magnitude (2.11±0.26 (WT+Ni(2+)), 2.16±0.35 (WT+Cd(2+)) and 2.34±0.44 (L210DN/M17DN)) or pH-dependent large magnitude (5.7 at pH4 (L213DN)). Upon deuteration, the free energy and the enthalpy of activation increase in all proton transfer variants by about 1 kcal/mol and the entropy of activation becomes negligible in L210DN/M17DN mutant. The results are interpreted as manifestation of equilibrium and kinetic solvent isotope effects and the structural, energetic and kinetic possibility of alternate proton delivery pathways are discussed. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. MDCT angiography of the pulmonary arteries: intravascular contrast enhancement does not depend on iodine concentration when injecting equal amounts of iodine at standardized iodine delivery rates

    International Nuclear Information System (INIS)

    Keil, S.; Plumhans, C.; Behrendt, F.F.; Das, M.; Muehlenbruch, G.; Mahnken, A.H.; Guenther, R.W.; Stanzel, S.; Seidensticker, P.; Knackstedt, C.; Wildberger, J.E.

    2008-01-01

    To compare the impact of iodine concentration using two different contrast materials (CM) at standardized iodine delivery rate (IDR) and overall iodine load in 16-multidetector-row-CT-angiography (MDCTA) of the pulmonary arteries of 192 patients with known or suspected pulmonary embolism. One hundred three patients (group A) received 148 ml of a CM containing 300 mg iodine/ml (Ultravist 300 trademark, BayerScheringPharma) at a flow rate of 4.9 ml/s. Eighty-nine patients (group B) received 120 ml of a CM with a concentration of 370 mg iodine/ml (Ultravist370 trademark) at a flow rate of 4.0 ml/s, resulting in a standardized IDR (∝1.5 gI/s) and the same overall amount of iodine (44.4 g). Both CM injections were followed by a saline chaser. Mean density values were determined in the pulmonary trunk, the ascending and the descending aorta, respectively. Applying repeated-measures ANOVA, no statistically significant differences between both MDCTA protocols were found (p=0.5790): the mean density in the pulmonary trunk was 355±116 Hounsfield Units (group A) and 358±115 (group B). The corresponding values for the ascending and descending aorta were 295±79 (group A) and 284±65 (group B) as well as 272±71 and 262±70. In conclusion, the use of standardized IDR and overall iodine load provides comparable intravascular CM density in pulmonary 16-MDCTA for delivering contrast materials with different iodine concentrations. (orig.)

  5. Selective attention and the auditory vertex potential. I - Effects of stimulus delivery rate. II - Effects of signal intensity and masking noise

    Science.gov (United States)

    Schwent, V. L.; Hillyard, S. A.; Galambos, R.

    1976-01-01

    The effects of varying the rate of delivery of dichotic tone pip stimuli on selective attention measured by evoked-potential amplitudes and signal detectability scores were studied. The subjects attended to one channel (ear) of tones, ignored the other, and pressed a button whenever occasional targets - tones of a slightly higher pitch were detected in the attended ear. Under separate conditions, randomized interstimulus intervals were short, medium, and long. Another study compared the effects of attention on the N1 component of the auditory evoked potential for tone pips presented alone and when white noise was added to make the tones barely above detectability threshold in a three-channel listening task. Major conclusions are that (1) N1 is enlarged to stimuli in an attended channel only in the short interstimulus interval condition (averaging 350 msec), (2) N1 and P3 are related to different modes of selective attention, and (3) attention selectivity in multichannel listening task is greater when tones are faint and/or difficult to detect.

  6. On-Site Determination and Monitoring of Real-Time Fluence Delivery for an Operating UV Reactor Based on a True Fluence Rate Detector.

    Science.gov (United States)

    Li, Mengkai; Li, Wentao; Qiang, Zhimin; Blatchley, Ernest R

    2017-07-18

    At present, on-site fluence (distribution) determination and monitoring of an operating UV system represent a considerable challenge. The recently developed microfluorescent silica detector (MFSD) is able to measure the approximate true fluence rate (FR) at a fixed position in a UV reactor that can be compared with a FR model directly. Hence it has provided a connection between model calculation and real-time fluence determination. In this study, an on-site determination and monitoring method of fluence delivery for an operating UV reactor was developed. True FR detectors, a UV transmittance (UVT) meter, and a flow rate meter were used for fundamental measurements. The fluence distribution, as well as reduction equivalent fluence (REF), 10th percentile dose in the UV fluence distribution (F 10 ), minimum fluence (F min ), and mean fluence (F mean ) of a test reactor, was calculated in advance by the combined use of computational fluid dynamics and FR field modeling. A field test was carried out on the test reactor for disinfection of a secondary water supply. The estimated real-time REF, F 10 , F min , and F mean decreased 73.6%, 71.4%, 69.6%, and 72.9%, respectively, during a 6-month period, which was attributable to lamp output attenuation and sleeve fouling. The results were analyzed with synchronous data from a previously developed triparameter UV monitoring system and water temperature sensor. This study allowed demonstration of an accurate method for on-site, real-time fluence determination which could be used to enhance the security and public confidence of UV-based water treatment processes.

  7. Radioisotope instruments

    CERN Document Server

    Cameron, J F; Silverleaf, D J

    1971-01-01

    International Series of Monographs in Nuclear Energy, Volume 107: Radioisotope Instruments, Part 1 focuses on the design and applications of instruments based on the radiation released by radioactive substances. The book first offers information on the physical basis of radioisotope instruments; technical and economic advantages of radioisotope instruments; and radiation hazard. The manuscript then discusses commercial radioisotope instruments, including radiation sources and detectors, computing and control units, and measuring heads. The text describes the applications of radioisotop

  8. Identifying developmental coordination disorder: MOQ-T validity as a fast screening instrument based on teachers' ratings and its relationship with praxic and visuospatial working memory deficits.

    Science.gov (United States)

    Giofrè, David; Cornoldi, Cesare; Schoemaker, Marina M

    2014-12-01

    The present study was devoted to test the validity of the Italian adaptation of the Motor Observation Questionnaire for Teachers (MOQ-T, Schoemaker, Flapper, Reinders-Messelink, & De Kloet, 2008) as a fast screening instrument, based on teachers' ratings, for detecting developmental coordination disorders symptoms and to study its relationship with praxic and visuospatial working memory deficits. In a first study on a large sample of children, we assessed the reliability and structure of the Italian adaptation of the MOQ-T. Results showed a good reliability of the questionnaire and a hierarchical structure with two first-order factors (reflecting motor and handwriting skills), which are influenced by a second-order factor (general motor function) at the top. In a second study, we looked at the external validity of the MOQ-T and found that children with symptoms of Developmental Coordination Disorder (children with high scores on the MOQ-T) also had difficulty reproducing gestures, either imitating others or in response to verbal prompts. Our results also showed that children with high MOQ-T scores had visuospatial WM impairments. The theoretical and clinical implications of these findings are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Relationship between fetal heart rate patterns and a time course for evaluation of fetal well-being: “the 30 minutes rule” for decision of mechanical delivery

    Directory of Open Access Journals (Sweden)

    Shintaro Makino

    2017-12-01

    Conclusions: We confirmed the time indices for predicting and preventing acidosis in fetuses showing decelerations. To prevent fetal acidosis, the decision related to proper timing for performing assisted delivery by considering the time course is important.

  10. Instrumental interaction

    OpenAIRE

    Luciani , Annie

    2007-01-01

    International audience; The expression instrumental interaction as been introduced by Claude Cadoz to identify a human-object interaction during which a human manipulates a physical object - an instrument - in order to perform a manual task. Classical examples of instrumental interaction are all the professional manual tasks: playing violin, cutting fabrics by hand, moulding a paste, etc.... Instrumental interaction differs from other types of interaction (called symbolic or iconic interactio...

  11. Improved design model for the multi-bed system in the storage and delivery system at ITER: Effects of decay of hydriding and dehydriding rate of a getter bed

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae-Uk [Department of Chemical Engineering, Pohang University of Science and Technology, San 31, Hyoja-Dong, Pohang 790-784 (Korea, Republic of); Chang, Min Ho; Yun, Sei-Hun [National Fusion Research Institute, 169-148-gil Kwahak-ro, Yusong-gu, Daejon 34133 (Korea, Republic of); Lee, Euy Soo, E-mail: eslee@dongguk.edu [Department of Chemical & Biochemical Engineering, Dongguk University, Seoul 100-715 (Korea, Republic of); Lee, In-Beum [Department of Chemical Engineering, Pohang University of Science and Technology, San 31, Hyoja-Dong, Pohang 790-784 (Korea, Republic of)

    2016-12-15

    This paper proposes an improved design model for the multi-bed system in the Storage and Delivery System considering that the hydriding and dehydriding rates of a getter bed decay over time. More specifically, the hydriding and dehydriding rates are influenced by the amount of remaining inventory in the getter bed and time simultaneously. Therefore, we formulate the rate decays mathematically to consider these features in the design model. The optimization problem is formulated as a mixed integer nonlinear program (MINLP) model with nonlinear constraints. Inductive operation scenario is presented to illustrate the applicability of the proposed model.

  12. Improved design model for the multi-bed system in the storage and delivery system at ITER: Effects of decay of hydriding and dehydriding rate of a getter bed

    International Nuclear Information System (INIS)

    Lee, Jae-Uk; Chang, Min Ho; Yun, Sei-Hun; Lee, Euy Soo; Lee, In-Beum

    2016-01-01

    This paper proposes an improved design model for the multi-bed system in the Storage and Delivery System considering that the hydriding and dehydriding rates of a getter bed decay over time. More specifically, the hydriding and dehydriding rates are influenced by the amount of remaining inventory in the getter bed and time simultaneously. Therefore, we formulate the rate decays mathematically to consider these features in the design model. The optimization problem is formulated as a mixed integer nonlinear program (MINLP) model with nonlinear constraints. Inductive operation scenario is presented to illustrate the applicability of the proposed model.

  13. Instrumentation Facility

    Data.gov (United States)

    Federal Laboratory Consortium — Provides instrumentation support for flight tests of prototype weapons systems using a vast array of airborne sensors, transducers, signal conditioning and encoding...

  14. Instruments to assess integrated care

    DEFF Research Database (Denmark)

    Lyngsø, Anne Marie; Godtfredsen, Nina Skavlan; Høst, Dorte

    2014-01-01

    INTRODUCTION: Although several measurement instruments have been developed to measure the level of integrated health care delivery, no standardised, validated instrument exists covering all aspects of integrated care. The purpose of this review is to identify the instruments concerning how to mea...... was prevalent. It is uncertain whether development of a single 'all-inclusive' model for assessing integrated care is desirable. We emphasise the continuing need for validated instruments embedded in theoretical contexts.......INTRODUCTION: Although several measurement instruments have been developed to measure the level of integrated health care delivery, no standardised, validated instrument exists covering all aspects of integrated care. The purpose of this review is to identify the instruments concerning how...... to measure the level of integration across health-care sectors and to assess and evaluate the organisational elements within the instruments identified. METHODS: An extensive, systematic literature review in PubMed, CINAHL, PsycINFO, Cochrane Library, Web of Science for the years 1980-2011. Selected...

  15. Relationship between low tube voltage (70 kV and the iodine delivery rate (IDR in CT angiography: An experimental in-vivo study.

    Directory of Open Access Journals (Sweden)

    Michael M Lell

    Full Text Available Very short acquisition times and the use of low-kV protocols in CTA demand modifications in the contrast media (CM injection regimen. The aim of this study was to optimize the use of CM delivery parameters in thoraco-abdominal CTA in a porcine model.Six pigs (55-68 kg were examined with a dynamic CTA protocol (454 mm scan length, 2.5 s temporal resolution, 70 s total acquisition time. Four CM injection protocols were applied in a randomized order. 120 kV CTA protocol: (A 300 mg iodine/kg bodyweight (bw, IDR = 1.5 g/s (flow = 5 mL/s, injection time (ti 12 s (60 kg bw. 70 kV CTA protocols: 150 mg iodine/kg bw: (B IDR = 0.75 g/s (flow = 2.5 mL/s, ti = 12 s (60 kg bw; (C IDR = 1.5 g/s (flow = 5 mL/s, ti = 12 s (60 kg bw; (D IDR = 3.0 g/s (flow = 10 mL/s, ti = 3 s (60 kg bw. The complete CM bolus shape was monitored by creating time attenuation curves (TAC in different vascular territories. Based on the TAC, the time to peak (TTP and the peak enhancement were determined. The diagnostic window (relative enhancement > 300 HU, was calculated and compared to visual inspection of the corresponding CTA data sets.The average relative arterial peak enhancements after baseline correction were 358.6 HU (A, 356.6 HU (B, 464.0 HU (C, and 477.6 HU (D. The TTP decreased with increasing IDR and decreasing ti, protocols A and B did not differ significantly (systemic arteries, p = 0.843; pulmonary arteries, p = 0.183. The delay time for bolus tracking (trigger level 100 HU; target enhancement 300 HU for single-phase CTA was comparable for protocol A and B (3.9, 4.3 s and C and D (2.4, 2.0 s. The scan window time frame was comparable for the different protocols by visual inspection of the different CTA data sets and by analyzing the TAC.All protocols provided sufficient arterial enhancement. The use of a 70 kV CTA protocol is recommended because of a 50% reduction of total CM volume and a 50% reduced flow rate while maintaining the bolus profile. In contrast to

  16. After Delivery

    Science.gov (United States)

    ... Rights Employment Discrimination Health Care Professionals Law Enforcement Driver's License For Lawyers Food & Fitness Home Food MyFoodAdvisor ... A Listen En Español After Delivery After your baby arrives, your body begins to recover from the ...

  17. Instrumentation development

    International Nuclear Information System (INIS)

    Ubbes, W.F.; Yow, J.L. Jr.

    1988-01-01

    Instrumentation is developed for the Civilian Radioactive Waste Management Program to meet several different (and sometimes conflicting) objectives. This paper addresses instrumentation development for data needs that are related either directly or indirectly to a repository site, but does not touch on instrumentation for work with waste forms or other materials. Consequently, this implies a relatively large scale for the measurements, and an in situ setting for instrument performance. In this context, instruments are needed for site characterization to define phenomena, develop models, and obtain parameter values, and for later design and performance confirmation testing in the constructed repository. The former set of applications is more immediate, and is driven by the needs of program design and performance assessment activities. A host of general technical and nontechnical issues have arisen to challenge instrumentation development. Instruments can be classed into geomechanical, geohydrologic, or other specialty categories, but these issues cut across artificial classifications. These issues are outlined. Despite this imposing list of issues, several case histories are cited to evaluate progress in the area

  18. Instrumented Pipeline Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Thomas Piro; Michael Ream

    2010-07-31

    This report summarizes technical progress achieved during the cooperative agreement between Concurrent Technologies Corporation (CTC) and U.S. Department of Energy to address the need for a for low-cost monitoring and inspection sensor system as identified in the Department of Energy (DOE) National Gas Infrastructure Research & Development (R&D) Delivery Reliability Program Roadmap.. The Instrumented Pipeline Initiative (IPI) achieved the objective by researching technologies for the monitoring of pipeline delivery integrity, through a ubiquitous network of sensors and controllers to detect and diagnose incipient defects, leaks, and failures. This report is organized by tasks as detailed in the Statement of Project Objectives (SOPO). The sections all state the objective and approach before detailing results of work.

  19. Instrumental analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Jae; Seo, Seong Gyu

    1995-03-15

    This textbook deals with instrumental analysis, which consists of nine chapters. It has Introduction of analysis chemistry, the process of analysis and types and form of the analysis, Electrochemistry on basic theory, potentiometry and conductometry, electromagnetic radiant rays and optical components on introduction and application, Ultraviolet rays and Visible spectrophotometry, Atomic absorption spectrophotometry on introduction, flame emission spectrometry and plasma emission spectrometry. The others like infrared spectrophotometry, X-rays spectrophotometry and mass spectrometry, chromatography and the other instrumental analysis like radiochemistry.

  20. Instrumental analysis

    International Nuclear Information System (INIS)

    Kim, Seung Jae; Seo, Seong Gyu

    1995-03-01

    This textbook deals with instrumental analysis, which consists of nine chapters. It has Introduction of analysis chemistry, the process of analysis and types and form of the analysis, Electrochemistry on basic theory, potentiometry and conductometry, electromagnetic radiant rays and optical components on introduction and application, Ultraviolet rays and Visible spectrophotometry, Atomic absorption spectrophotometry on introduction, flame emission spectrometry and plasma emission spectrometry. The others like infrared spectrophotometry, X-rays spectrophotometry and mass spectrometry, chromatography and the other instrumental analysis like radiochemistry.

  1. LOFT instrumentation

    International Nuclear Information System (INIS)

    Bixby, W.W.

    1979-01-01

    A description of instrumentation used in the Loss-of-Fluid Test (LOFT) large break Loss-of-Coolant Experiments is presented. Emphasis is placed on hydraulic and thermal measurements in the primary system piping and components, reactor vessel, and pressure suppression system. In addition, instrumentation which is being considered for measurement of phenomena during future small break testing is discussed. (orig.) 891 HP/orig. 892 BRE [de

  2. After vaginal delivery - in the hospital

    Science.gov (United States)

    After vaginal birth; Pregnancy - after vaginal delivery; Postpartum care - after vaginal delivery ... blood pressure, heart rate, and the amount of vaginal bleeding Check to make sure your uterus is ...

  3. Instrumental Capital

    Directory of Open Access Journals (Sweden)

    Gabriel Valerio

    2007-07-01

    Full Text Available During the history of human kind, since our first ancestors, tools have represented a mean to reach objectives which might otherwise seemed impossibles. In the called New Economy, where tangibles assets appear to be losing the role as the core element to produce value versus knowledge, tools have kept aside man in his dairy work. In this article, the author's objective is to describe, in a simple manner, the importance of managing the organization's group of tools or instruments (Instrumental Capital. The characteristic conditions of this New Economy, the way Knowledge Management deals with these new conditions and the sub-processes that provide support to the management of Instrumental Capital are described.

  4. SU-E-T-375: Evaluation of a MapCHECK2(tm) Planar 2-D Diode Array for High-Dose-Rate Brachytherapy Treatment Delivery Verifications

    Energy Technology Data Exchange (ETDEWEB)

    Macey, N; Siebert, M; Shvydka, D; Parsai, E [University of Toledo Medical Center, Toledo, OH (United States)

    2015-06-15

    Purpose: Despite improvements of HDR brachytherapy delivery systems, verification of source position is still typically based on the length of the wire reeled out relative to the parked position. Yet, the majority of errors leading to medical events in HDR treatments continue to be classified as missed targets or wrong treatment sites. We investigate the feasibility of using dose maps acquired with a two-dimensional diode array to independently verify the source locations, dwell times, and dose during an HDR treatment. Methods: Custom correction factors were integrated into frame-by-frame raw counts recorded for a Varian VariSource™ HDR afterloader Ir-192 source located at various distances in air and in solid water from a MapCHECK2™ diode array. The resultant corrected counts were analyzed to determine the dwell position locations and doses delivered. The local maxima of polynomial equations fitted to the extracted dwell dose profiles provided the X and Y coordinates while the distance to the source was determined from evaluation of the full width at half maximum (FWHM). To verify the approach, the experiment was repeated as the source was moved through dwell positions at various distances along an inclined plane, mimicking a vaginal cylinder treatment. Results: Dose map analysis was utilized to provide the coordinates of the source and dose delivered over each dwell position. The accuracy in determining source dwell positions was found to be +/−1.0 mm of the preset values, and doses within +/−3% of those calculated by the BrachyVision™ treatment planning system for all measured distances. Conclusion: Frame-by-frame data furnished by a 2 -D diode array can be used to verify the dwell positions and doses delivered by the HDR source over the course of treatment. Our studies have verified that measurements provided by the MapCHECK2™ can be used as a routine QA tool for HDR treatment delivery verification.

  5. SMS text pre-notification and delivery of reminder e-mails to increase response rates to postal questionnaires in the SUSPEND trial: a factorial design, randomised controlled trial.

    Science.gov (United States)

    Starr, Kathryn; McPherson, Gladys; Forrest, Mark; Cotton, Seonaidh C

    2015-07-08

    Patient-reported outcomes are vital in informing randomised controlled trials (RCTs) and health-care interventions and policies from the patient's perspective. However, participant non-response may introduce bias and can affect the generalisability of the trial. This study evaluates two interventions aimed at increasing response rates to postal questionnaires within a large, UK-wide RCT: pre-notification via short messenger service (SMS) text prior to sending the initial mailing of trial questionnaires versus no pre-notification; for non-responders to the initial mailing of the questionnaires, an e-mail reminder (containing a hyperlink to complete the questionnaire online) versus a postal reminder. This study is a 2 × 2 partial factorial design RCT nested within an RCT of medical expulsive therapy for ureteric stone disease. Participants who supplied a mobile telephone number were randomly assigned to receive an SMS text pre-notification of questionnaire delivery or no pre-notification. Those who supplied an e-mail address were randomly assigned to receive a questionnaire reminder by e-mail or post. Participants could be randomly assigned to the pre-notification comparison or the reminder comparison or both. The primary outcome measure was response rate at each questionnaire time point. Four hundred eighteen participants were randomly assigned to the SMS pre-notification comparison (80% were male, and the mean age was 41 years with a standard deviation (SD) of 11.1). The intervention had no effect on response rate at either questionnaire time point. In subgroup analyses, SMS pre-notification increased response rates in women but only at the first questionnaire time point. One hundred nineteen participants were randomly assigned to the reminder comparison (80% were male, and the mean age was 42 years with an SD of 12.1). There was no difference in response rate in those who received an e-mail reminder compared with those who received a postal reminder. SMS text pre

  6. Innovative instrumentation

    International Nuclear Information System (INIS)

    Anon.

    1983-01-01

    At this year's particle physics conference at Brighton, a parallel session was given over to instrumentation and detector development. While this work is vital to the health of research and its continued progress, its share of prime international conference time is limited. Instrumentation can be innovative three times — first when a new idea is outlined, secondly when it is shown to be feasible, and finally when it becomes productive in a real experiment, amassing useful data rather than operational experience. Hyams' examples showed that it can take a long time for a new idea to filter through these successive stages, if it ever makes it at all

  7. Innovative instrumentation

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1983-11-15

    At this year's particle physics conference at Brighton, a parallel session was given over to instrumentation and detector development. While this work is vital to the health of research and its continued progress, its share of prime international conference time is limited. Instrumentation can be innovative three times — first when a new idea is outlined, secondly when it is shown to be feasible, and finally when it becomes productive in a real experiment, amassing useful data rather than operational experience. Hyams' examples showed that it can take a long time for a new idea to filter through these successive stages, if it ever makes it at all.

  8. Instrumental aspects

    Directory of Open Access Journals (Sweden)

    Qureshi Navid

    2017-01-01

    Full Text Available Every neutron scattering experiment requires the choice of a suited neutron diffractometer (or spectrometer in the case of inelastic scattering with its optimal configuration in order to accomplish the experimental tasks in the most successful way. Most generally, the compromise between the incident neutron flux and the instrumental resolution has to be considered, which is depending on a number of optical devices which are positioned in the neutron beam path. In this chapter the basic instrumental principles of neutron diffraction will be explained. Examples of different types of experiments and their respective expectable results will be shown. Furthermore, the production and use of polarized neutrons will be stressed.

  9. Nuclear instrument technician training

    International Nuclear Information System (INIS)

    Wollesen, E.S.

    1991-01-01

    This paper reports on Nuclear Instrument Technician (NIT) training that has developed at an accelerated rate over the past three decades. During the 1960's commercial nuclear power plants were in their infancy. For that reason, there is little wonder that NIT training had little structure and little creditability. NIT training, in many early plants, was little more than On-The Job Training (OJT). The seventies brought changes in Instrumentation and Controls as well as emphasis on the requirements for more in depth training and documentation. As in the seventies, the eighties saw not only changes in technologies but tighter requirements, standardized training and the development of accredited Nuclear Instrument Training; thus the conclusion: Nuclear Instrument Training Isn't What It Used To Be

  10. Question order sensitivity of subjective well-being measures: focus on life satisfaction, self-rated health, and subjective life expectancy in survey instruments.

    Science.gov (United States)

    Lee, Sunghee; McClain, Colleen; Webster, Noah; Han, Saram

    2016-10-01

    This study examines the effect of question context created by order in questionnaires on three subjective well-being measures: life satisfaction, self-rated health, and subjective life expectancy. We conducted two Web survey experiments. The first experiment (n = 648) altered the order of life satisfaction and self-rated health: (1) life satisfaction asked immediately after self-rated health; (2) self-rated health immediately after life satisfaction; and (3) two items placed apart. We examined their correlation coefficient by experimental condition and further examined its interaction with objective health. The second experiment (n = 479) asked life expectancy before and after parental mortality questions. Responses to life expectancy were compared by order using ANOVA, and we examined interaction with parental mortality status using ANCOVA. Additionally, response time and probes were examined. Correlation coefficients between self-rated health and life satisfaction differed significantly by order: 0.313 (life satisfaction first), 0.508 (apart), and 0.643 (self-rated health first). Differences were larger among respondents with chronic conditions. Response times were the shortest when self-rated health was asked first. When life expectancy asked after parental mortality questions, respondents reported considering parents more for answering life expectancy; and respondents with deceased parents reported significantly lower expectancy, but not those whose parents were alive. Question context effects exist. Findings suggest placing life satisfaction and self-rated health apart to avoid artificial attenuation or inflation in their association. Asking about parental mortality prior to life expectancy appears advantageous as this leads respondents to consider parental longevity more, an important factor for true longevity.

  11. Surgical Instrument

    NARCIS (Netherlands)

    Dankelman, J.; Horeman, T.

    2009-01-01

    The present invention relates to a surgical instrument for minimall-invasive surgery, comprising a handle, a shaft and an actuating part, characterised by a gastight cover surrounding the shaft, wherein the cover is provided with a coupler that has a feed- through opening with a loskable seal,

  12. Weather Instruments.

    Science.gov (United States)

    Brantley, L. Reed, Sr.; Demanche, Edna L.; Klemm, E. Barbara; Kyselka, Will; Phillips, Edwin A.; Pottenger, Francis M.; Yamamoto, Karen N.; Young, Donald B.

    This booklet presents some activities to measure various weather phenomena. Directions for constructing a weather station are included. Instruments including rain gauges, thermometers, wind vanes, wind speed devices, humidity devices, barometers, atmospheric observations, a dustfall jar, sticky-tape can, detection of gases in the air, and pH of…

  13. Aethalometer™ Instrument Handbook

    Energy Technology Data Exchange (ETDEWEB)

    Sedlacek, Arthur J. [Brookhaven National Lab. (BNL), Upton, NY (United States)

    2016-04-01

    The Aethalometer is an instrument that provides a real-time readout of the concentration of “Black” or “Elemental” carbon aerosol particles (BC or E) in an air stream (see Figure 1 and Figure 2). It is a self-contained instrument that measures the rate of change of optical transmission through a spot on a filter where aerosol is being continuously collected and uses the information to calculate the concentration of optically absorbing material in the sampled air stream. The instrument measures the transmitted light intensities through the “sensing” portion of the filter, on which the aerosol spot is being collected, and a “reference” portion of the filter as a check on the stability of the optical source. A mass flowmeter monitors the sample air flow rate. The data from these three measurements is used to determine the mean BC content of the air stream.

  14. Non-technical skills evaluation in the critical care air ambulance environment: introduction of an adapted rating instrument--an observational study.

    Science.gov (United States)

    Myers, Julia A; Powell, David M C; Psirides, Alex; Hathaway, Karyn; Aldington, Sarah; Haney, Michael F

    2016-03-08

    In the isolated and dynamic health-care setting of critical care air ambulance transport, the quality of clinical care is strongly influenced by non-technical skills such as anticipating, recognising and understanding, decision making, and teamwork. However there are no published reports identifying or applying a non-technical skills framework specific to an intensive care air ambulance setting. The objective of this study was to adapt and evaluate a non-technical skills rating framework for the air ambulance clinical environment. In the first phase of the project the anaesthetists' non-technical skills (ANTS) framework was adapted to the air ambulance setting, using data collected directly from clinician groups, published literature, and field observation. In the second phase experienced and inexperienced inter-hospital transport clinicians completed a simulated critical care air transport scenario, and their non-technical skills performance was independently rated by two blinded assessors. Observed and self-rated general clinical performance ratings were also collected. Rank-based statistical tests were used to examine differences in the performance of experienced and inexperienced clinicians, and relationships between different assessment approaches and assessors. The framework developed during phase one was referred to as an aeromedical non-technical skills framework, or AeroNOTS. During phase two 16 physicians from speciality training programmes in intensive care, emergency medicine and anaesthesia took part in the clinical simulation study. Clinicians with inter-hospital transport experience performed more highly than those without experience, according to both AeroNOTS non-technical skills ratings (p = 0.001) and general performance ratings (p = 0.003). Self-ratings did not distinguish experienced from inexperienced transport clinicians (p = 0.32) and were not strongly associated with either observed general performance (r(s) = 0.4, p = 0

  15. The influence of torque and manual glide path on the defect or separation rate of NiTi rotary instruments in root canal therapy

    Directory of Open Access Journals (Sweden)

    Zarrabi M

    2010-01-01

    Full Text Available Introduction: One of the effecting factors in prognosis of root canal therapy is accidental procedure as broken files that may be unpreventable. Many manufacturers have designed and marketed various electromotors that can control rotational speed and torque. On the other hand, some studies have recommended applying a manual glide path to diminish contact area between the file and canal walls. The purpose of this study was evaluation of the effect of torque and a manual glide path on defects as separation of Nickel-titanium (NiTi rotary files. Materials and Methods: This ex vivo randomized controlled trial study was carried out on 160 canals of human′s matured molars with mild curvature (15-338. After initial preparation of samples and checking for inclusion criteria, in first group, preparation was carried out with air-driven handpiece, and in group two, Endo IT was used as electromotor. In both groups, Mtwo files with simultaneous technique were used for preparation. Then all data were collected and analyzed with Mann Whitny, Mantel Cox, and t-test. Results: No significant differences between two groups (P < 0.05 were observed. Based on survival analysis, safety probability of files after preparation of nine canals is 64% in group one and 69.9% in group two. There was no significant differences between this safety probability in two groups (P = 0.272. Conclusion: Usage of torque control handpiece is not an important factor, comparing instrumentation technique.

  16. Development of a Suitable Survey Instrument To Identify Causes Behind High Turnover Rates within the 0301 Series in the Communications Electronics Command

    Science.gov (United States)

    2017-09-01

    CAUSES BEHIND HIGH TURNOVER RATES WITHIN THE 0301 SERIES IN THE COMMUNICATIONS- ELECTRONICS COMMAND September 2017 By: Antonia U. Orjih...THE COMMUNICATIONS- ELECTRONICS COMMAND 5. FUNDING NUMBERS 6. AUTHOR(S) Antonia U. Orjih and Shamika M. Fleuranges 7. PERFORMING ORGANIZATION...AGENCY NAME(S) AND ADDRESS(ES) Communications- Electronics Command (CECOM) Aberdeen Proving Ground (APG), Maryland 10. SPONSORING / MONITORING

  17. Instruments for assessing the burden of informal caregiving for stroke patients in clinical practice: a comparison of CSI, CRA, SCQ and self-rated burden

    NARCIS (Netherlands)

    van Exel, N. Job A.; Scholte op Reimer, Wilma J. M.; Brouwer, Werner B. F.; van den Berg, Bernard; Koopmanschap, Marc A.; van den Bos, Geertrudis A. M.

    2004-01-01

    Objective: To compare the feasibility, convergent and clinical validity of three commonly used burden scales: Caregiver Strain Index (CSI), Caregiver Reaction Assessment (CRA) and Sense of Competence Questionnaire (SCQ), with a self-developed single question on self-rated burden (SRB). Subjects:

  18. Nuclear instrumentation

    International Nuclear Information System (INIS)

    Weill, Jacky; Fabre, Rene.

    1981-01-01

    This article sums up the Research and Development effort at present being carried out in the five following fields of applications: Health physics and Radioprospection, Control of nuclear reactors, Plant control (preparation and reprocessing of the fuel, testing of nuclear substances, etc.), Research laboratory instrumentation, Detectors. It also sets the place of French industrial activities by means of an estimate of the French market, production and flow of trading with other countries [fr

  19. Divided Instruments

    Science.gov (United States)

    Chapman, A.; Murdin, P.

    2000-11-01

    Although the division of the zodiac into 360° probably derives from Egypt or Assyria around 2000 BC, there is no surviving evidence of Mesopotamian cultures embodying this division into a mathematical instrument. Almost certainly, however, it was from Babylonia that the Greek geometers learned of the 360° circle, and by c. 80 BC they had incorporated it into that remarkably elaborate device gener...

  20. Instrumentation development

    International Nuclear Information System (INIS)

    Anon.

    1976-01-01

    Areas being investigated for instrumentation improvement during low-level pollution monitoring include laser opto-acoustic spectroscopy, x-ray fluorescence spectroscopy, optical fluorescence spectroscopy, liquid crystal gas detectors, advanced forms of atomic absorption spectroscopy, electro-analytical chemistry, and mass spectroscopy. Emphasis is also directed toward development of physical methods, as opposed to conventional chemical analysis techniques for monitoring these trace amounts of pollution related to energy development and utilization

  1. Instrumentation maintenance

    International Nuclear Information System (INIS)

    Mack, D.A.

    1976-09-01

    It is essential to any research activity that accurate and efficient measurements be made for the experimental parameters under consideration for each individual experiment or test. Satisfactory measurements in turn depend upon having the necessary instruments and the capability of ensuring that they are performing within their intended specifications. This latter requirement can only be achieved by providing an adequate maintenance facility, staffed with personnel competent to understand the problems associated with instrument adjustment and repair. The Instrument Repair Shop at the Lawrence Berkeley Laboratory is designed to achieve this end. The organization, staffing and operation of this system is discussed. Maintenance policy should be based on studies of (1) preventive vs. catastrophic maintenance, (2) records indicating when equipment should be replaced rather than repaired and (3) priorities established to indicate the order in which equipment should be repaired. Upon establishing a workable maintenance policy, the staff should be instructed so that they may provide appropriate scheduled preventive maintenance, calibration and corrective procedures, and emergency repairs. The education, training and experience of the maintenance staff is discussed along with the organization for an efficient operation. The layout of the various repair shops is described in the light of laboratory space and financial constraints

  2. Estimating background denudation rates and delivery of landslide sediment from a time series of 10Be concentrations in landslide dominated basins in the southern Central Range of Taiwan

    Science.gov (United States)

    Chen, C. Y.; Willett, S.; West, A. J.; Dadson, S. J.; Hovius, N.; Christl, M.; Shyu, J. B. H.

    2017-12-01

    The southern Central Range of Taiwan is located at a tectonic transition zone between an oceanic subduction zone and the arc-continent collision forming the Taiwan orogen. The rapidly evolving tectonic setting, tropical climate and frequent typhoons result in a complex uplift pattern, transient landscapes and extensive landslides. For this study, we obtained a series of 10Be concentrations over the last decade for 13 major drainage basins in the southern Central Range, bracketing the occurrence of a major typhoon, Morakot, which hit Taiwan in 2009 and triggered thousands of landslides. This time series allows us to simultaneously estimate the background erosion rate and assess the impact of Morakot-triggered landslides on 10Be concentrations. The time series of 10Be concentrations shows temporally lower concentrations of 10Be indicating dilution following the Morakot event in most basins. The diluted 10Be concentrations imply erosion rates up to three times higher than the lowest measured rates in the same basins. We constructed a simple sediment-mixing model parameterized by a sudden input of sediment supplied from landslides superimposed on a background denudation rate. This model was calibrated to measured landslide inventories and the series of 10Be data. We obtain a range of permissible background erosion rate and fraction of landslide sediments over time for each basin. The inferred background erosion rate reveals a northward increasing trend, reflecting the initial stage of the mountain building and indicating tectonic forcing is the main driver of the landscape evolution in the southern Central Range. The temporal changes in fraction of landslide sediments show that the available landslide material generated by the Morakot event is decreasing over time with a timescale of several years.

  3. Technological considerations in emergency instrument preparedness

    International Nuclear Information System (INIS)

    Selby, J.M.

    1975-01-01

    The types of emergency instrumentation systems necessary to characterize the severity and extent of radiation accidents and to aid in the protection of operating personnel and personnel living near the plant are discussed. These include instruments for direct measurement of the airborne radioactive material within the facility, fixed instrumentation for ambient dose rate monitoring or area monitoring, and portable instruments for environmental monitoring

  4. Assisted Vaginal Delivery

    Science.gov (United States)

    ... Education & Events Advocacy For Patients About ACOG Assisted Vaginal Delivery Home For Patients Search FAQs Assisted Vaginal ... Vaginal Delivery FAQ192, February 2016 PDF Format Assisted Vaginal Delivery Labor, Delivery, and Postpartum Care What is ...

  5. Births in two different delivery units in the same clinic – A prospective study of healthy primiparous women

    Directory of Open Access Journals (Sweden)

    Nilsen Anne

    2009-06-01

    Full Text Available Abstract Background Earlier studies indicate that midwife-led birth settings are associated with modest benefits, including reduced medical interventions and increased maternal satisfaction. The generalizability of these studies to birth settings with low intervention rates, like those generally found in Norway, is not obvious. The aim of the present study was to compare intervention rates associated with labour in low-risk women who begin their labour in a midwife-led unit and a conventional care unit. Methods Eligible participants were low-risk primiparas who met the criteria for delivery in the midwife-led ward regardless of which cohort they were allocated to. The two wards are localised at the same floor. Women in both cohorts received the same standardized public antenatal care by general medical practitioners and midwifes who were not involved in the delivery. After admission of a woman to the midwife-led ward, the next woman who met the inclusion criteria, but preferred delivery at the conventional delivery ward, was allocated to the conventional delivery ward cohort. Among the 252 women in the midwife-led ward cohort, 74 (29% women were transferred to the conventional delivery ward during labour. Results Emergency caesarean and instrumental delivery rates in women who were admitted to the midwife-led and conventional birth wards were statistically non-different, but more women admitted to the conventional birth ward had episiotomy. More women in the conventional delivery ward received epidural analgesia, pudental nerve block and nitrous oxide, while more women in the midwife-led ward received opiates and non-pharmacological pain relief. Conclusion We did not find evidence that starting delivery in the midwife-led setting offers the advantage of lower operative delivery rates. However, epidural analgesia, pudental nerve block and episiotomies were less often while non-pharmacological pain relief was often used in the midwife-led ward.

  6. Premature delivery

    Directory of Open Access Journals (Sweden)

    Bernardita Donoso Bernales

    2012-09-01

    Full Text Available Preterm delivery is the single most important cause of perinatal morbidity and mortality. In Chile, preterm births have increased in the past decade, although neonatal morbidity and mortality attributable to it shows a downward trend, thanks to improvements in neonatal care of premature babies, rather than the success of obstetric preventive and therapeutic strategies. This article describes clinical entities, disease processes and conditions that constitute predisposing factors of preterm birth, as well as an outline for the prevention and clinical management of women at risk of preterm birth.

  7. Redefining continuing education delivery.

    Science.gov (United States)

    Carlton, K H

    1997-01-01

    Just as technology is transforming the delivery of education, the Internet and advanced telecommunication applications are changing the "face" of CE and the connotation of "lifelong learning." As late as the mid-1980s, a discussion of computer applications in nursing CE focused on the "timely" transition to microcomputers as tools for the enhancement of managerial tasks for increased productivity. Even as recently as 1990, there seemed to be "time" for those providers who were "slower to adopt innovation" to "catch up." Now, the CE provider who does not integrate the microcomputer and advanced telecommunications as an integral component of their delivery modalities may be outsourced rapidly by an educational or commercial competitive unit that is able to utilize the communication medium, mergers and partnerships, enterprise, and individual lifestyle and learning patterns that will epitomize the CE unit of the 21st century. As with the "re-engineering" of nursing education, the "re-engineered" delivery modalities of evolving CE entity might now best be conceptualized on a continuum from the traditional mode that time and place dependent to a mode of synchronous and asynchronous data and advanced telecommunication. Delivery methods will need to be selected according to the target populations, content, and situation. The health-care educational provider may discover, as in other industries, that a combination of distance and residential offerings will be the most successful medium for the delivery of CE to the progressively more "information and technologically savvy" lifelong learner of the 21st century. In addressing the dramatic effects of the information technology era on the refocused multimedia/interactive delivery method for student education, educators amply quoted Bob Dylan's phrase of the 1960s, "The times, they are a-changing." And so, we see that the times are also changing at an astronomical rate for the health-care educational provider as well as the

  8. Combined spinal-epidural analgesia in labour: its effects on delivery outcome

    Directory of Open Access Journals (Sweden)

    Suneet Kaur Sra Charanjit Singh

    2016-06-01

    Full Text Available ABSTRACT BACKGROUND AND OBJECTIVES: Combined spinal-epidural (CSE has become an increasingly popular alternative to traditional labour epidural due to its rapid onset and reliable analgesia provided. This was a prospective, convenient sampling study to determine the effects of CSE analgesia on labour outcome. METHODS: One hundred and ten healthy primigravida parturients with a singleton pregnancy of ≥37 weeks gestation and in the active phase of labour were studied. They were enrolled to the CSE (n = 55 or Non-CSE (n = 55 group based on whether they consented to CSE analgesia. Non-CSE parturients were offered other methods of labour analgesia. The duration of the first and second stage of labour, rate of instrumental vaginal delivery and emergency cesarean section, and Apgar scores were compared. RESULTS: The mean duration of the first and second stage of labour was not significantly different between both groups. Instrumental delivery rates between the groups were not significantly different (CSE group, 11% versus Non-CSE group, 16%. The slightly higher incidence of cesarean section in the CSE group (16% versus 15% in the Non-CSE group was not statistically significant. Neonatal outcome in terms of Apgar score of less than 7 at 1 and 5 min was similar in both groups. CONCLUSION: There were no significant differences in the duration of labour, rate of instrumental vaginal delivery and emergency cesarean section, and neonatal outcome in parturients who received compared to those who did not receive CSE for labour analgesia.

  9. Effectiveness of Educational Program Based on the Theory of Reasoned Action to Decrease the Rate of Cesarean Delivery Among Pregnant Women in Fasa, Southern Iran

    Directory of Open Access Journals (Sweden)

    Ali Khan-Jeihooni

    2014-06-01

    Full Text Available Introduction: Cesarean section is considered as a major surgery accompanied by several complications. The present study aimed to determine the effect of educational intervention based on the theory of reasoned action to reduce the rate of cesarean section among pregnant women in Fasa, Southern Iran. Materials and Methods: This quasi-experimental study was performed on 100 (50 participants in each of the control and intervention groups primiparous women in the third trimester of pregnancy admitted to health centers of Fasa city, Fars province, Iran. The data-gathering tool was a multipart questionnaire containing demographic variables and the theory of reasoned action structures. After the pretest, the intervention group underwent exclusive training based on the theory of reasoned action. Then, after 3 months, both groups took part in the posttest. Data was analyzed by paired T-test, independent T-test and chi-square using SPSS-18 software. Results: A significant difference was found between the two groups regarding knowledge, evaluations behavioral outcomes, Behavioral beliefs and intention (P<0.001. Chi-square analysis showed a significant difference between the two groups regarding their performance (P<0.001. Conclusion: The present intervention was effective in increasing the pregnant women’s knowledge, evaluation of outcomes, attitude and strengthening their intention as well as performance. Therefore, it is suggested to use this model and other systematic straining for pregnant women to decrease the rate of cesarean section.

  10. Uncovering high rates of unsafe injection equipment reuse in rural Cameroon: validation of a survey instrument that probes for specific misconceptions

    Directory of Open Access Journals (Sweden)

    Reid Savanna R

    2011-02-01

    Full Text Available Abstract Background Unsafe reuse of injection equipment in hospitals is an on-going threat to patient safety in many parts of Africa. The extent of this problem is difficult to measure. Standard WHO injection safety assessment protocols used in the 2003 national injection safety assessment in Cameroon are problematic because health workers often behave differently under the observation of visitors. The main objective of this study is to assess the extent of unsafe injection equipment reuse and potential for blood-borne virus transmission in Cameroon. This can be done by probing for misconceptions about injection safety that explain reuse without sterilization. These misconceptions concern useless precautions against cross-contamination, i.e. "indirect reuse" of injection equipment. To investigate whether a shortage of supply explains unsafe reuse, we compared our survey data against records of purchases. Methods All health workers at public hospitals in two health districts in the Northwest Province of Cameroon were interviewed about their own injection practices. Injection equipment supply purchase records documented for January to December 2009 were compared with self-reported rates of syringe reuse. The number of HIV, HBV and HCV infections that result from unsafe medical injections in these health districts is estimated from the frequency of unsafe reuse, the number of injections performed, the probability that reused injection equipment had just been used on an infected patient, the size of the susceptible population, and the transmission efficiency of each virus in an injection. Results Injection equipment reuse occurs commonly in the Northwest Province of Cameroon, practiced by 44% of health workers at public hospitals. Self-reported rates of syringe reuse only partly explained by records on injection equipment supplied to these hospitals, showing a shortage of syringes where syringes are reused. Injection safety interventions could

  11. Turbulent energy dissipation rates observed by Doppler MST Radar and by rocket-borne instruments during the MIDAS/MaCWAVE campaign 2002

    Directory of Open Access Journals (Sweden)

    N. Engler

    2005-06-01

    Full Text Available During the MIDAS/MaCWAVE campaign in summer 2002 we have observed turbulence using Doppler beam steering measurements obtained from the ALWIN VHF radar at Andøya/Northern Norway. This radar was operated in the Doppler beam steering mode for turbulence investigations during the campaign, as well as in spaced antenna mode, for continuously measuring the background wind field. The real-time data analysis of the Doppler radar backscattering provided the launch conditions for the sounding rockets. The spectral width data observed during the occurrence of PMSE were corrected for beam and shear broadening caused by the background wind field to obtain the turbulent part of the spectral width. The turbulent energy dissipation rates determined from the turbulent spectral width vary between 5 and 100mW kg-1 in the altitude range of 80-92km and increase with altitude. These estimations agree well with the in-situ measurements using the CONE sensor which was launched on 3 sounding rockets during the campaign.

  12. Instruments for assessing the burden of informal caregiving for stroke patients in clinical practice: a comparison of CSI, CRA, SCQ and self-rated burden.

    Science.gov (United States)

    van Exel, N Job A; Scholte op Reimer, Wilma J M; Brouwer, Werner B F; van den Berg, Bernard; Koopmanschap, Marc A; van den Bos, Geertrudis A M

    2004-03-01

    To compare the feasibility, convergent and clinical validity of three commonly used burden scales: Caregiver Strain Index (CSI), Caregiver Reaction Assessment (CRA) and Sense of Competence Questionnaire (SCQ), with a self-developed single question on self-rated burden (SRB). Stroke patients receiving support from an informal caregiver (n = 148) and their caregivers were followed up to six months after stroke. Feasibility was assessed with several measures of missing values. Convergent validity was assessed on the basis of the correlation patterns between the burden scales, and clinical validity through evaluation of expected associations between levels of burden and explanatory patients' and caregivers' characteristics. Missing values were less often observed on CSI and SRB than SCQ and CRA. Significant correlation coefficients (p CRA. Evidence for clinical validity was strongest for CSI and SRB, based on associations between higher burden scores and patients' disability, and patients' and caregivers' poor level of health-related quality of life (all p CRA. SRB could be used for quick screening of caregivers at risk. CSI is indicated for further diagnosis of the burden of informal caregivers.

  13. Ceramic drug-delivery devices.

    Science.gov (United States)

    Lasserre, A; Bajpai, P K

    1998-01-01

    A variety of ceramics and delivery systems have been used to deliver chemicals, biologicals, and drugs at various rates for desired periods of time from different sites of implantation. In vitro and in vivo studies have shown that ceramics can successfully be used as drug-delivery devices. Matrices, inserts, reservoirs, cements, and particles have been used to deliver a large variety of therapeutic agents such as antibiotics, anticancer drugs, anticoagulants, analgesics, growth factors, hormones, steroids, and vaccines. In this article, the advantages and disadvantages of conventional drug-delivery systems and the different approaches used to deliver chemical and biological agents by means of ceramic systems will be reviewed.

  14. Oral and intravenous l-[1-13 C]phenylalanine delivery measure similar rates of elimination when gastric emptying and splanchnic extraction are accounted for in adult mixed hounds.

    Science.gov (United States)

    Gooding, M A; Cant, J P; Pencharz, P B; Davenport, G M; Atkinson, J L; Shoveller, A K

    2013-02-01

    There are few reported estimates of amino acid (AA) kinetics in adult mammals and none exist in adult dogs. The study objectives were to evaluate the use of oral isotope delivery in contrast to the more commonly used intravenous (IV) delivery to estimate AA kinetics in adult dogs and to estimate splanchnic extraction and gastric emptying using a commonly accepted mathematical model. Dogs received 25 × 1/2-hourly meals (13 g/kg BW/day) and either an oral or IV bolus of l-[1-(13) C]Phe (12 mg/kg BW). Blood samples were taken immediately before each feeding. Concentrations of plasma Phe were measured using liquid chromatography-tandem mass spectrometry. There were no differences in baseline plasma Phe concentrations (34 μm ± 0.61), Phe distribution volume, Phe pool size and rate constants between dogs when the tracer was administered IV or orally (p > 0.25). Decay curve for plasma l-[1-(13) C]Phe differed between IV and oral dosing protocols with IV dosing fit best using a two-compartment model. Phe disappeared from plasma at a mean rate of 2.8%/min. Estimates of gastric emptying and splanchnic extraction did not differ based on oral or IV tracer dosing when the decay curves were fit with the two-compartment model (p > 0.40). The half-life for gastric emptying was 18 min, and first-pass Phe extraction by the splanchnic bed was 24% of the dietary Phe. These results suggest that oral isotope dosing can be used as an alternative to IV isotope dosing in studies that utilize a primed, constant dosing approach to measure protein and amino acid kinetics. © 2011 Blackwell Verlag GmbH.

  15. Manual rotation to decrease operative delivery in posterior or transverse positions.

    Science.gov (United States)

    Le Ray, Camille; Deneux-Tharaux, Catherine; Khireddine, Imane; Dreyfus, Michel; Vardon, Delphine; Goffinet, François

    2013-09-01

    To assess the effect of a policy of manual rotation on the mode of delivery of fetuses in posterior or transverse positions at full dilatation. This was a prospective study to compare two policies of management for posterior and transverse positions in two different hospitals (Hospital 1: no manual rotation and Hospital 2: manual rotation). We used univariable and multivariable analyses to study the association between the management policy for posterior and transverse positions at full dilatation in these hospitals and maternal and neonatal outcomes. The principal end point was operative delivery (ie, cesarean or instrumental vaginal delivery). All factors associated with the risk of operative delivery in the univariable analysis (Pmanual rotation was independently associated with a reduction in operative deliveries. The rate of posterior or transverse positions at full dilatation was 15.9% (n=111) in Hospital 1 and 15.3% (n=220) in Hospital 2 (P=.75). Of the 172 attempts of manual rotation in Hospital 2, 155 (90.1%) were successful. The rate of operative delivery was significantly lower in Hospital 2, which performed manual rotations (23.2% compared with 38.7% in Hospital 1, adjusted odds ratio [OR] 0.52, 95% confidence interval [CI] 0.28-0.95). After multivariable analysis, manual rotation remained significantly associated with a reduction in the risk of operative delivery (adjusted OR 0.45, 95% CI 0.25-0.85). Five-minute Apgar score and arterial pH at birth were similar in the two hospitals. For fetuses in posterior or transverse positions at full dilatation, a strategy of manual rotation is associated with a reduction in the rate of operative delivery. III.

  16. The WERCAP Screen and the WERC Stress Screen: psychometrics of self-rated instruments for assessing bipolar and psychotic disorder risk and perceived stress burden.

    Science.gov (United States)

    Mamah, Daniel; Owoso, Akinkunle; Sheffield, Julia M; Bayer, Chelsea

    2014-10-01

    Identification of individuals in the prodromal phase of bipolar disorder and schizophrenia facilitates early intervention and promises an improved prognosis. There are no current assessment tools for clinical risk symptoms of bipolar disorder, and psychosis-risk assessment generally involves semi-structured interviews, which are time consuming and rater dependent. We present psychometric data on two novel quantitative questionnaires: the Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen for assessing bipolar and psychotic disorder risk traits, and the accompanying WERC Stress Screen for assessing individual and total psychosocial stressor severities. Prevalence rates of the WERCAP Screen were evaluated among 171 community youth (aged 13-24 years); internal consistency was assessed and k-means cluster analysis was used to identify symptom groups. In 33 participants, test-retest reliability coefficients were assessed, and ROC curve analysis was used to determine the validity of the psychosis section of the WERCAP Screen (pWERCAP) against the Structured Interview of Psychosis-Risk Symptoms (SIPS). Correlations of the pWERCAP, the affectivity section of the WERCAP Screen (aWERCAP) and the WERC Stress Screen were examined to determine the relatedness of scores with cognition and clinical measures. Cluster analysis identified three groups of participants: a normative (47%), a psychosis-affectivity (18%) and an affectivity only (35%) group. Internal consistency of the aWERCAP and pWERCAP resulted in alphas of 0.87 and 0.92, and test-retest reliabilities resulted in intraclass correlation coefficients of 0.76 and 0.86 respectively. ROC curve analysis showed the optimal cut-point on the pWERCAP as a score of >30 (sensitivity: 0.89; specificity: 1.0). There was a significant negative correlation between aWERCAP scores and total cognition (R=-0.42), and between pWERCAP scores and sensorimotor processing speed. Total stress scores correlated

  17. China’s Conversion of Cropland to Forest Program for Household Delivery of Ecosystem Services: How Important is a Local Implementation Regime to Survival Rate Outcomes?

    Directory of Open Access Journals (Sweden)

    Michael T. Bennett

    2014-09-01

    Full Text Available China’s Conversion of Cropland to Forests Program (CCFP is the world’s largest afforestation-based Payments for Ecosystem Services (PES program, having retired and afforested over 24 million ha involving 32 million rural households. Prior research has primarily focused on the CCFP’s rural welfare impacts, with few studies on program-induced environmental improvements, particularly at the household level. In this study, data from a 2010 survey covering 2808 rural households from across China was analyzed using an interval regression model to explain household-reported survival rates of trees planted on program-enrolled cropland. In addition to household-level factors, we explore the influence of local conditions and institutional configurations by exploiting the wide diversity of contexts covered by the data set. We find that households with more available labor and more forestry experience manage trees better, but that higher opportunity costs for both land and labor have the opposite effect. We also find that the local implementation regime- e.g., the degree of prior consultation with participants and regular monitoring - has a strong positive effect on reported survivorship. We suggest that the level of subsidy support to participating households will be key to survivorship of trees in planted CCFP forests for some time to come.

  18. Mucoadhesive drug delivery systems

    Directory of Open Access Journals (Sweden)

    Rahamatullah Shaikh

    2011-01-01

    Full Text Available Mucoadhesion is commonly defined as the adhesion between two materials, at least one of which is a mucosal surface. Over the past few decades, mucosal drug delivery has received a great deal of attention. Mucoadhesive dosage forms may be designed to enable prolonged retention at the site of application, providing a controlled rate of drug release for improved therapeutic outcome. Application of dosage forms to mucosal surfaces may be of benefit to drug molecules not amenable to the oral route, such as those that undergo acid degradation or extensive first-pass metabolism. The mucoadhesive ability of a dosage form is dependent upon a variety of factors, including the nature of the mucosal tissue and the physicochemical properties of the polymeric formulation. This review article aims to provide an overview of the various aspects of mucoadhesion, mucoadhesive materials, factors affecting mucoadhesion, evaluating methods, and finally various mucoadhesive drug delivery systems (buccal, nasal, ocular, gastro, vaginal, and rectal.

  19. Vacuum Delivery in Jos University Teaching Hospital, Jos, Nigeria ...

    African Journals Online (AJOL)

    Obstetric practice continues to change, particularly assisted vaginal delivery. Vacuum delivery is a mode of delivery technique in Jos University Teaching Hospital (JUTH) in the maternity unit. The objective of the study was to determine the rate of ventouse delivery, its indications, and maternal and fetal morbidity in our ...

  20. [Operative vaginal deliveries training].

    Science.gov (United States)

    Dupuis, O

    2008-12-01

    The appropriate use of forceps, vacuums or spatulas facilitates the rapid delivery of foetuses faced with life-threatening situations. It also makes possible the relief of certain cases of prolonged second-stage labor. In France, operative vaginal delivery (OVD) accounts for approximately 10% of all births. OVD training aims to optimize maternal, as well as neonatal safety. It should enable trainees to indicate or contraindicate an OVD safely, as well as to choose the appropriate instrument, use it correctly, and master quality control principles. Traditional OVD training is confronted with both spatial and time-related limitations. Spatial constraints involve both the teacher and trainee who only have limited visual access to the pelvic canal, and the head of the foetus; the time constraint occurs whenever the OVD occurs in an emergency setting. These limitations have been further aggravated by new constraints: decreasing time dedicated to training (European safety rules prohibit work the day after night duty), increasing litigation, and constraints imposed by society. Training by means of simulation removes such limitations making it possible to both avoid exposing pregnant women to the hazards of traditional training, and adapt the training to the skills of each trainee. OVD training should include forceps, vacuums and the use of spatulas. The OVD skills of obstetricians should be audited regularly on both a personal and a confidential level. Such audits could be based on a method using a simulator. Prospective studies comparing traditional and simulation-based training should be encouraged.

  1. Seismic instrumentation

    International Nuclear Information System (INIS)

    1984-06-01

    RFS or Regles Fondamentales de Surete (Basic Safety Rules) applicable to certain types of nuclear facilities lay down requirements with which compliance, for the type of facilities and within the scope of application covered by the RFS, is considered to be equivalent to compliance with technical French regulatory practice. The object of the RFS is to take advantage of standardization in the field of safety, while allowing for technical progress in that field. They are designed to enable the operating utility and contractors to know the rules pertaining to various subjects which are considered to be acceptable by the Service Central de Surete des Installations Nucleaires, or the SCSIN (Central Department for the Safety of Nuclear Facilities). These RFS should make safety analysis easier and lead to better understanding between experts and individuals concerned with the problems of nuclear safety. The SCSIN reserves the right to modify, when considered necessary, any RFS and specify, if need be, the terms under which a modification is deemed retroactive. The aim of this RFS is to define the type, location and operating conditions for seismic instrumentation needed to determine promptly the seismic response of nuclear power plants features important to safety to permit comparison of such response with that used as the design basis

  2. Meteorological instrumentation

    International Nuclear Information System (INIS)

    1982-06-01

    RFS or ''Regles Fondamentales de Surete'' (Basic Safety Rules) applicable to certain types of nuclear facilities lay down requirements with which compliance, for the type of facilities and within the scope of application covered by the RFS, is considered to be equivalent to compliance with technical French regulatory practice. The object of the RFS is to take advantage of standardization in the field of safety , while allowing for technical progress in that field. They are designed to enable the operating utility and contractors to know the rules pertaining to various subjects which are considered to be acceptable by the ''Service Central de Surete des Installations Nucleaires'' or the SCSIN (Central Department for the Safety of Nuclear Facilities). These RFS should make safety analysis easier and lead to better understanding between experts and individuals concerned with the problems of nuclear safety. The SCSIN reserves the right to modify, when considered necessary any RFS and specify, if need be, the terms under which a modification is deemed retroactive. The purpose of this RFS is to specify the meteorological instrumentation required at the site of each nuclear power plant equipped with at least one pressurized water reactor

  3. [Delivery of the IUGR fetus].

    Science.gov (United States)

    Perrotin, F; Simon, E G; Potin, J; Laffon, M

    2013-12-01

    The purpose of this paper is to review available data regarding the management of delivery in intra uterine growth retarded fetuses and try to get recommendations for clinical obstetrical practice. Bibliographic research performed by consulting PubMed database and recommendations from scientific societies with the following words: small for gestational age, intra-uterine growth restriction, fetal growth restriction, very low birth weight infants, as well as mode of delivery, induction of labor, cesarean section and operative delivery. The diagnosis of severe IUGR justifies the orientation of the patient to a referral centre with all necessary resources for very low birth weight or premature infants Administration of corticosteroids for fetal maturation (before 34 WG) and a possible neuroprotective treatment by with magnesium sulphate (before 32-33 WG) should be discussed. Although elective caesarean section is common, there is no current evidence supporting the use of systematic cesarean section, especially when the woman is in labor. Induction of labor, even with unfavorable cervix is possible under continuous FHR monitoring, in favorable obstetric situations and in the absence of severe fetal hemodynamic disturbances. Instrumental delivery and routine episiotomy are not recommended. For caesarean section under spinal anesthesia, an adequate anesthetic management must ensure the maintenance of basal blood pressure. Compared with appropriate for gestational age fetus, IUGR fetus is at increased risk of metabolic acidosis or perinatal asphyxia during delivery. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  4. Radiological instrument

    International Nuclear Information System (INIS)

    Kronenberg, S.; McLaughlin, W.L.; Seibentritt, C.R. Jr.

    1986-01-01

    An instrument is described for measuring radiation, particularly nuclear radiation, comprising: a radiation sensitive structure pivoted toward one end and including a pair of elongated solid members contiguously joined together along their length dimensions and having a common planar interface therebetween. One of the pairs of members is comprised of radiochromic material whose index of refraction changes due to anomolous dispersion as a result of being exposed to nuclear radiation. The pair of members further has mutually different indices of refraction with the member having the larger index of refraction further being transparent for the passage of light and of energy therethrough; means located toward the other end of the structure for varying the angle of longitudinal elevation of the pair of members; means for generating and projecting a beam of light into one end of the member having the larger index of refraction. The beam of light is projected toward the planar interface where it is reflected out of the other end of the same member as a first output beam; means projecting a portion of the beam of light into one end of the member having the larger index of refraction where it traverses therethrough without reflection and out of the other end of the same member as a second output beam; and means adjacent the structure for receiving the first and second output beams, whereby a calibrated change in the angle of elevation of the structure between positions of equal intensity of the first and second output beams prior to and following exposure provides a measure of the radiation sensed due to a change of refraction of the radiochromic material

  5. Instrumented home energy rating and commissioning

    Energy Technology Data Exchange (ETDEWEB)

    Wray, Craig P.; Walker, Iain S.; Sherman, Max H.

    2003-05-01

    Currently, houses do not perform optimally or even as many codes and forecasts predict, largely because they are field assembled and there is no consistent process to identify deficiencies or to correct them. Solving this problem requires field performance evaluations using appropriate and agreed upon procedures in the form of a new process called residential commissioning. The purpose of this project is to develop and document these procedures and to demonstrate the value that applying them could provide in both new and existing California houses. This project has four specific objectives: to develop metrics and diagnostics for assessing house performance, to provide information on the potential benefits of commissioning using a whole-house approach, to develop programmatic guidelines for commissioning, and to conduct outreach efforts to transfer project results to industry stakeholders. The primary outcomes from this project are the development of residential commissioning guidelines and the analytical confirmation that there are significant potential benefits associated with commissioning California houses, particularly existing ones. In addition, we have made substantial advances in understanding the accuracy and usability of diagnostics for commissioning houses. In some cases, we have been able to work with equipment manufacturers to improve these aspects of their diagnostic tools. These outcomes provide a solid foundation on which to build a residential commissioning program in California. We expect that a concerted effort will be necessary to integrate such a program with existing building industry efforts and to demonstrate its use in the field.

  6. Assisted delivery with forceps

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000509.htm Assisted delivery with forceps To use the sharing features on ... called vacuum assisted delivery . When is a Forceps Delivery Needed? Even after your cervix is fully dilated ( ...

  7. Nuclear reactor instrumentation

    International Nuclear Information System (INIS)

    Duncombe, E.; McGonigal, G.

    1976-01-01

    Reference is made to the instrumentation of liquid metal cooled fast reactors. In order to ensure the safe operation of such reactors it is necessary to constantly monitor the coolant flowing through the fuel assemblies for temperature and rate of flow, requiring a large number of sensors. An improved and simplified arrangement is claimed in which the fuel assemblies feed a fraction of coolant to three instrument units arranged to sense the temperature and rate of flow of samples of coolant. Each instrument unit comprises a sleeve housing a sensing unit and has a number of inlet ducts arranged for receiving coolant from a fuel assembly together with a single outlet. The sensing unit has three thermocouple hot junctions connected in series, the hot junctions and inlet ducts being arranged in pairs. Electromagnetic windings around an inductive core are arranged to sense variation in flow of liquid metal by flux distortion. Fission product sensing means may also be provided. Full constructional details are given. (U.K.)

  8. Radiation measuring instrument

    International Nuclear Information System (INIS)

    Genrich, V.

    1985-01-01

    A highly sensitive and compactly structured radiation measuring instrument for detecting ionizing radiation, in particular for measuring dose rates and contamination. The laminar structure of the associated counter tube, using only a few, simple plastic parts and a highly elastic counter wire, makes it possible to use the simplest manufacturing techniques. The service life of the counter tube construction, which is completely and permanently sealed and filled with gas, is expected to be more than 12 years. The described counter tube can be adapted in optimal fashion to the available space in a pocket instrument if it is used in combination with a specialized high-voltage generator which is low in interference voltage and with a pulse evaluation circuit having a means of compensating for interference voltage

  9. Risk factors for cesarean delivery and adverse neonatal outcome in twin pregnancies attempting vaginal delivery.

    Science.gov (United States)

    Schachter-Safrai, Natali; Karavani, Gilad; Haj-Yahya, Rani; Ofek Shlomai, Noa; Porat, Shay

    2018-02-24

    Twin vaginal delivery presents a unique clinical challenge for obstetricians. The Twin Birth Study demonstrated the safety of planned vaginal delivery regarding neonatal outcomes. However, that study lacked a description of the risk factors associated with and the outcome of unplanned cesarean section. The aim of this study is to identify potential risk factors for cesarean section and delivery related neonatal morbidity and mortality in women with twin pregnancy attempting vaginal delivery. A retrospective cohort study including 1070 women with twin pregnancy that underwent a trial of labor between 2003 and 2015. The study population was divided according to the mode of delivery: vaginal delivery, combined vaginal-cesarean and intrapartum cesarean delivery of both twins. Several risk factors and neonatal outcomes were examined by both univariate analysis and multinomial logistic regression analysis. The rate of vaginal delivery of both twins was 88.3%, whereas the rates of combined vaginal cesarean and unplanned cesarean delivery were 4.6% and 7.1%, respectively. Nulliparity and nonvertex presentation of twin B were found to be independently associated with cesarean delivery for both twins. Additionally, nonvertex presentation of twin B was independently associated with combined vaginal-cesarean delivery. The proportion of neonates with Apgar score cesarean group compared with those delivered by the vaginal route alone. Nulliparity and nonvertex presentation of twin B were found to be associated with intrapartum cesarean delivery in twin pregnancies. © 2018 Nordic Federation of Societies of Obstetrics and Gynecology.

  10. Quantification of human epidermal growth factor receptor 2 immunohistochemistry using the Ventana Image Analysis System: correlation with gene amplification by fluorescence in situ hybridization: the importance of instrument validation for achieving high (>95%) concordance rate.

    Science.gov (United States)

    Dennis, Jake; Parsa, Rezvaneh; Chau, Donnie; Koduru, Prasad; Peng, Yan; Fang, Yisheng; Sarode, Venetia Rumnong

    2015-05-01

    The use of computer-based image analysis for scoring human epidermal growth factor receptor 2 (HER2) immunohistochemistry (IHC) has gained a lot of interest recently. We investigated the performance of the Ventana Image Analysis System (VIAS) in HER2 quantification by IHC and its correlation with fluorescence in situ hybridization (FISH). We specifically compared the 3+ IHC results using the manufacturer's machine score cutoffs versus laboratory-defined cutoffs with the FISH assay. Using the manufacturer's 3+ cutoff (VIAS score; 2.51 to 3.5), 181/536 (33.7%) were scored 3+, and FISH was positive in 147/181 (81.2%), 2 (1.1%) were equivocal, and 32 (17.6%) were FISH (-). Using the laboratory-defined 3+ cutoff (VIAS score 3.5), 52 (28.7%) cases were downgraded to 2+, of which 29 (55.7%) were FISH (-), and 23 (44.2%) were FISH (+). With the revised cutoff, there were improvements in the concordance rate from 89.1% to 97.0% and in the positive predictive value from 82.1% to 97.6%. The false-positive rate for 3+ decreased from 9.0% to 0.8%. Six of 175 (3.4%) IHC (-) cases were FISH (+). Three cases with a VIAS score 3.5 showed polysomy of chromosome 17. In conclusion, the VIAS may be a valuable tool for assisting pathologists in HER2 scoring; however, the positive cutoff defined by the manufacturer is associated with a high false-positive rate. This study highlights the importance of instrument validation/calibration to reduce false-positive results.

  11. A new Loan-Stock Financial Instrument

    OpenAIRE

    Morozovsky, Alexander; Narasimhan, Rajan; Kholodenko, Yuri

    2000-01-01

    A new financial instrument (a new kind of a loan) is introduced. The loan-stock instrument (LSI) combines fixed rate instruments (loans, etc.) with other financial instruments that have higher volatilities and returns (stocks, mutual funds, currencies, derivatives, options, etc.). This new loan depends on the value of underlying security (for example, stock) in such a way that when underlying security increases, the value of loan decreases and backwards. The procedure to create a risk free po...

  12. blood transfusion requirement during caesarean delivery: risk factors

    African Journals Online (AJOL)

    PLWAs are getting pregnant and may require operative delivery on account of Preventing ... abnormalities such as bone marrow depression, anaemia9 and ... operative clinical status up to 48 hours post-delivery or death. Transfusion rate was.

  13. Transdermal drug delivery

    OpenAIRE

    Prausnitz, Mark R.; Langer, Robert

    2008-01-01

    Transdermal drug delivery has made an important contribution to medical practice, but has yet to fully achieve its potential as an alternative to oral delivery and hypodermic injections. First-generation transdermal delivery systems have continued their steady increase in clinical use for delivery of small, lipophilic, low-dose drugs. Second-generation delivery systems using chemical enhancers, non-cavitational ultrasound and iontophoresis have also resulted in clinical products; the ability ...

  14. Software Build and Delivery Systems

    Energy Technology Data Exchange (ETDEWEB)

    Robey, Robert W. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-07-10

    This presentation deals with the hierarchy of software build and delivery systems. One of the goals is to maximize the success rate of new users and developers when first trying your software. First impressions are important. Early successes are important. This also reduces critical documentation costs. This is a presentation focused on computer science and goes into detail about code documentation.

  15. Future of Automated Insulin Delivery Systems

    NARCIS (Netherlands)

    Castle, Jessica R.; DeVries, J. Hans; Kovatchev, Boris

    2017-01-01

    Advances in continuous glucose monitoring (CGM) have brought on a paradigm shift in the management of type 1 diabetes. These advances have enabled the automation of insulin delivery, where an algorithm determines the insulin delivery rate in response to the CGM values. There are multiple automated

  16. Evaluating musical instruments

    International Nuclear Information System (INIS)

    Campbell, D. Murray

    2014-01-01

    Scientific measurements of sound generation and radiation by musical instruments are surprisingly hard to correlate with the subtle and complex judgments of instrumental quality made by expert musicians

  17. Influence of osmolarity of contrast medium and saline flush on computed tomography angiography: Comparison of monomeric and dimeric iodinated contrast media with different iodine concentrations at an identical iodine delivery rate

    International Nuclear Information System (INIS)

    Kishimoto, Miori; Doi, Shoko; Shimizu, Junichiro; Lee, Ki-Ja; Iwasaki, Toshiroh; Miyake, Yoh-Ichi; Yamada, Kazutaka

    2010-01-01

    Purpose: To evaluate the influence of osmolarity of iodinated contrast media and saline flush on the contrast effect in thoracic computed tomography angiography (CTA) at an identical iodine delivery rate (IDR). Materials and methods: Seven beagles were used in a cross-over experiment. The contrast media used were iohexol 350 mgI/ml (IOH350; osmolarity 844 mmol/kg) and iodixanol 320 mgI/ml (IDX320; osmolarity 290 mmol/kg). Each contrast medium was administered to groups with and without saline flush at 40.0 mgI/kg/s for all experiments. Dynamic CT scanning was performed at the ninth thoracic vertebra level. The peak value, area under the curve (AUC), and time to peak (TTP) were calculated from the time attenuation curves of the pulmonary artery and aorta. Results: There was no significant difference between IOH350 and IDX320 with or without saline flush in the peak values for the pulmonary artery and aorta. AUC was significantly higher in groups with saline flush for both contrast media and arteries (p < 0.05) with no significant difference between contrast media. TTP was significantly longer in groups with saline flush than without saline flush for both contrast media and arteries (p < 0.05), with no significant difference between contrast media. Conclusions: There were no significant differences in the contrast effects of monomeric IOH350 and dimeric IDX320 in thoracic CTA when used at an identical IDR. Moreover, saline flush prolonged the peak duration at 600 mgI/kg.

  18. Defining the Most Appropriate Delivery Mode in Women with Inflammatory Bowel Disease: A Systematic Review.

    Science.gov (United States)

    Foulon, Arthur; Dupas, Jean-Louis; Sabbagh, Charles; Chevreau, Julien; Rebibo, Lionel; Brazier, Franck; Bouguen, Guillaume; Gondry, Jean; Fumery, Mathurin

    2017-05-01

    High cesarean section (CS) rates are observed in patients with inflammatory bowel disease (IBD), but limited data are available to support this decision. We conducted a comprehensive review to evaluate the most appropriate mode of delivery in women with IBD according to disease phenotype and activity, as well as surgical history. We searched MEDLINE (source PubMed) and international conference abstracts, and included all studies that evaluated digestive outcome after delivery in patients with IBD. A total of 41 articles or abstracts were screened, and 18 studies were considered in this review, with sample sizes ranging from 4 to 229 patients and follow-up ranging from 2 months to 7.7 years. Pooled CS rates in patients without Perianal Crohn's disease (PCD), healed PCD or active PCD, were 27%, 43%, and 46%, respectively. Regarding the median rate of new PCD (3.0% [IQR, 1.5-11.5] versus 6.5% [0-19.7]) or PCD recurrence (13.5% [3.2-32.7] versus 45% [0-58]), no increase was observed in patients with vaginal delivery compared to CS, but for patients with an active disease, worsening of symptoms was noted in two-thirds of cases. Episiotomy, perianal tears, and instrumental delivery did not influence the incidence of PCD. In patients with ileal pouch anal anastomosis, uncomplicated vaginal delivery seemed to moderately influence pouch function, with no significant difference in terms of overall continence, daytime, or night-time stool frequency, or incontinence. However, these parameters seemed negatively impacted by a complicated vaginal delivery. New long-term data from well-designed studies are needed, but our review suggests that systematic CS in patients suffering from IBD should probably be limited to women at risk of perineal tears and obstetric injuries, with an active PCD, or with ileal pouch anal anastomosis.

  19. A GC Instrument Simulator

    Science.gov (United States)

    Armitage, D. Bruce

    1999-02-01

    the difference between the boiling point of the component and the temperature of the column. The polarity difference between the column packing and the component is also used to modify the retention time. The retention time decreases as the difference between the boiling point of the component and the temperature of the column increases, and retention time increases as the polarity of the component approaches the polarity of the column. If the temperature of the column is too low, a warning message is given and the chromatogram does not show that component. There is no "carry-over" to the next chromatogram, as might be the case for an actual instrument. Carrier-gas flow rate is fixed and is not part of the retention-time calculation. Because of this latter condition and the method used to determine retention time, this simulator is not useful for gas chromatography method development and is not intended for such use. The purpose of the simulator is to give a beginning student experience in what happens as column temperature is varied, why one might need temperature programming, why an autosampler might be useful, and the pitfalls of "smart" integrators. When students make mistakes in instrument setup with the simulator the consequences are not damaging to the simulator but might cause serious problems with a real instrument. Hardware and Software Requirements Hardware and software requirements for A GC Instrument Simulator are shown in Table 1. right> right> Shown (right to left) are the main instrument control window and the manual injection window from A GC Instrument Simulator.

  20. Improved overall delivery documentation following implementation of a standardized shoulder dystocia delivery form

    Science.gov (United States)

    Moragianni, Vasiliki A.; Hacker, Michele R.; Craparo, Frank J.

    2013-01-01

    Objective Our objective was to evaluate whether using a standardized shoulder dystocia delivery form improved documentation. A standardized delivery form was added to our institution’s obstetrical record in August 2003. Methods A retrospective cohort study was conducted comparing 100 vaginal deliveries complicated by shoulder dystocia before, and 81 after implementation of the standardized delivery form. The two groups were compared in terms of obstetric characteristics, neonatal outcomes and documentation components. Results Charts that included the standardized delivery form were more likely to contain documentation of estimated fetal weight (82.7% vs. 39.0% without the form, Pdystocia, and second stage duration. Conclusions Inclusion of a standardized form in the delivery record improves the rate of documentation of both shoulder dystocia-specific and general delivery components. PMID:22017330

  1. FastStats: Births -- Method of Delivery

    Science.gov (United States)

    ... 1990–2013 [PDF – 423 KB] Primary Cesarean Delivery Rates, by State: Results From the Revised Birth Certificate, 2006–2012 [PDF – 274 KB] Related Links Vital Statistics downloadable public use data files American College of ...

  2. eDelivery

    Data.gov (United States)

    US Agency for International Development — eDelivery provides the electronic packaging and delivery of closed and complete OPM investigation files to government agencies, including USAID, in a secure manner....

  3. Vacuum-assisted delivery

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000514.htm Vacuum-assisted delivery To use the sharing features on this page, ... through the birth canal. When is Vacuum-assisted Delivery Needed? Even after your cervix is fully dilated ( ...

  4. IOT Overview: IR Instruments

    Science.gov (United States)

    Mason, E.

    In this instrument review chapter the calibration plans of ESO IR instruments are presented and briefly reviewed focusing, in particular, on the case of ISAAC, which has been the first IR instrument at VLT and whose calibration plan served as prototype for the coming instruments.

  5. Health physics instrument manual

    International Nuclear Information System (INIS)

    Gupton, E.D.

    1978-08-01

    The purpose of this manual is to provide apprentice health physics surveyors and other operating groups not directly concerned with radiation detection instruments a working knowledge of the radiation detection and measuring instruments in use at the Laboratory. The characteristics and applications of the instruments are given. Portable instruments, stationary instruments, personnel monitoring instruments, sample counters, and miscellaneous instruments are described. Also, information sheets on calibration sources, procedures, and devices are included. Gamma sources, beta sources, alpha sources, neutron sources, special sources, a gamma calibration device for badge dosimeters, and a calibration device for ionization chambers are described

  6. Astronomical Instruments in India

    Science.gov (United States)

    Sarma, Sreeramula Rajeswara

    The earliest astronomical instruments used in India were the gnomon and the water clock. In the early seventh century, Brahmagupta described ten types of instruments, which were adopted by all subsequent writers with minor modifications. Contact with Islamic astronomy in the second millennium AD led to a radical change. Sanskrit texts began to lay emphasis on the importance of observational instruments. Exclusive texts on instruments were composed. Islamic instruments like the astrolabe were adopted and some new types of instruments were developed. Production and use of these traditional instruments continued, along with the cultivation of traditional astronomy, up to the end of the nineteenth century.

  7. Articulating feedstock delivery device

    Science.gov (United States)

    Jordan, Kevin

    2013-11-05

    A fully articulable feedstock delivery device that is designed to operate at pressure and temperature extremes. The device incorporates an articulating ball assembly which allows for more accurate delivery of the feedstock to a target location. The device is suitable for a variety of applications including, but not limited to, delivery of feedstock to a high-pressure reaction chamber or process zone.

  8. Biomedical Instruments for Fetal and Neonatal Surveillance

    International Nuclear Information System (INIS)

    Rolfe, P; Scopesi, F; Serra, G

    2006-01-01

    Specialised instruments have been developed to aid the care of the fetus and the newborn baby. Miniature sensors using optical, electrical, chemical, mechanical and magnetic principles have been produced for capturing key measurands. These include temperature, pressure, flow and dimension, as well as several specific molecules such as glucose, oxygen and carbon dioxide. During pregnancy ultrasound imaging and blood flow techniques provide valuable information concerning fetal abnormalities, fetal growth, fetal breathing and fetal heart rate. Signal processing and pattern recognition can be useful for deriving indicators of fetal distress and clinical status, based on biopotentials as well as ultrasound signals. Fetal pH measurement is a critical requirement during labour and delivery. The intensive care of ill preterm babies involves provision of an optimal thermal environment and respiratory support. Monitoring of blood gas and acid-base status is essential, and this involves both blood sampling for in vitro analysis as well as the use of invasive or non-invasive sensors. For the future it will be vital that the technologies used are subjected to controlled trials to establish benefit or otherwise

  9. Troubleshooting in nuclear instruments

    International Nuclear Information System (INIS)

    1987-06-01

    This report on troubleshooting of nuclear instruments is the product of several scientists and engineers, who are closely associated with nuclear instrumentation and with the IAEA activities in the field. The text covers the following topics: Preamplifiers, amplifiers, scalers, timers, ratemeters, multichannel analyzers, dedicated instruments, tools, instruments, accessories, components, skills, interfaces, power supplies, preventive maintenance, troubleshooting in systems, radiation detectors. The troubleshooting and repair of instruments is illustrated by some real examples

  10. Quality of prenatal care questionnaire: instrument development and testing

    Science.gov (United States)

    2014-01-01

    Background Utilization indices exist to measure quantity of prenatal care, but currently there is no published instrument to assess quality of prenatal care. The purpose of this study was to develop and test a new instrument, the Quality of Prenatal Care Questionnaire (QPCQ). Methods Data for this instrument development study were collected in five Canadian cities. Items for the QPCQ were generated through interviews with 40 pregnant women and 40 health care providers and a review of prenatal care guidelines, followed by assessment of content validity and rating of importance of items. The preliminary 100-item QPCQ was administered to 422 postpartum women to conduct item reduction using exploratory factor analysis. The final 46-item version of the QPCQ was then administered to another 422 postpartum women to establish its construct validity, and internal consistency and test-retest reliability. Results Exploratory factor analysis reduced the QPCQ to 46 items, factored into 6 subscales, which subsequently were validated by confirmatory factor analysis. Construct validity was also demonstrated using a hypothesis testing approach; there was a significant positive association between women’s ratings of the quality of prenatal care and their satisfaction with care (r = 0.81). Convergent validity was demonstrated by a significant positive correlation (r = 0.63) between the “Support and Respect” subscale of the QPCQ and the “Respectfulness/Emotional Support” subscale of the Prenatal Interpersonal Processes of Care instrument. The overall QPCQ had acceptable internal consistency reliability (Cronbach’s alpha = 0.96), as did each of the subscales. The test-retest reliability result (Intra-class correlation coefficient = 0.88) indicated stability of the instrument on repeat administration approximately one week later. Temporal stability testing confirmed that women’s ratings of their quality of prenatal care did not change as a result of giving

  11. Quality of prenatal care questionnaire: instrument development and testing.

    Science.gov (United States)

    Heaman, Maureen I; Sword, Wendy A; Akhtar-Danesh, Noori; Bradford, Amanda; Tough, Suzanne; Janssen, Patricia A; Young, David C; Kingston, Dawn A; Hutton, Eileen K; Helewa, Michael E

    2014-06-03

    Utilization indices exist to measure quantity of prenatal care, but currently there is no published instrument to assess quality of prenatal care. The purpose of this study was to develop and test a new instrument, the Quality of Prenatal Care Questionnaire (QPCQ). Data for this instrument development study were collected in five Canadian cities. Items for the QPCQ were generated through interviews with 40 pregnant women and 40 health care providers and a review of prenatal care guidelines, followed by assessment of content validity and rating of importance of items. The preliminary 100-item QPCQ was administered to 422 postpartum women to conduct item reduction using exploratory factor analysis. The final 46-item version of the QPCQ was then administered to another 422 postpartum women to establish its construct validity, and internal consistency and test-retest reliability. Exploratory factor analysis reduced the QPCQ to 46 items, factored into 6 subscales, which subsequently were validated by confirmatory factor analysis. Construct validity was also demonstrated using a hypothesis testing approach; there was a significant positive association between women's ratings of the quality of prenatal care and their satisfaction with care (r = 0.81). Convergent validity was demonstrated by a significant positive correlation (r = 0.63) between the "Support and Respect" subscale of the QPCQ and the "Respectfulness/Emotional Support" subscale of the Prenatal Interpersonal Processes of Care instrument. The overall QPCQ had acceptable internal consistency reliability (Cronbach's alpha = 0.96), as did each of the subscales. The test-retest reliability result (Intra-class correlation coefficient = 0.88) indicated stability of the instrument on repeat administration approximately one week later. Temporal stability testing confirmed that women's ratings of their quality of prenatal care did not change as a result of giving birth or between the early postpartum

  12. Laser light scattering instrument advanced technology development

    Science.gov (United States)

    Wallace, J. F.

    1993-01-01

    The objective of this advanced technology development (ATD) project has been to provide sturdy, miniaturized laser light scattering (LLS) instrumentation for use in microgravity experiments. To do this, we assessed user requirements, explored the capabilities of existing and prospective laser light scattering hardware, and both coordinated and participated in the hardware and software advances needed for a flight hardware instrument. We have successfully breadboarded and evaluated an engineering version of a single-angle glove-box instrument which uses solid state detectors and lasers, along with fiber optics, for beam delivery and detection. Additionally, we have provided the specifications and written verification procedures necessary for procuring a miniature multi-angle LLS instrument which will be used by the flight hardware project which resulted from this work and from this project's interaction with the laser light scattering community.

  13. Performing the Super Instrument

    DEFF Research Database (Denmark)

    Kallionpaa, Maria

    2016-01-01

    can empower performers by producing super instrument works that allow the concert instrument to become an ensemble controlled by a single player. The existing instrumental skills of the performer can be multiplied and the qualities of regular acoustic instruments extended or modified. Such a situation......The genre of contemporary classical music has seen significant innovation and research related to new super, hyper, and hybrid instruments, which opens up a vast palette of expressive potential. An increasing number of composers, performers, instrument designers, engineers, and computer programmers...... have become interested in different ways of “supersizing” acoustic instruments in order to open up previously-unheard instrumental sounds. Super instruments vary a great deal but each has a transformative effect on the identity and performance practice of the performing musician. Furthermore, composers...

  14. UAV Delivery Monitoring System

    Directory of Open Access Journals (Sweden)

    San Khin Thida

    2018-01-01

    Full Text Available UAV-based delivery systems are increasingly being used in the logistics field, particularly to achieve faster last-mile delivery. This study develops a UAV delivery system that manages delivery order assignments, autonomous flight operation, real time control for UAV flights, and delivery status tracking. To manage the delivery item assignments, we apply the concurrent scheduler approach with a genetic algorithm. The present paper describes real time flight data based on a micro air vehicle communication protocol (MAVLink. It also presents the detailed hardware components used for the field tests. Finally, we provide UAV component analysis to choose the suitable components for delivery in terms of battery capacity, flight time, payload weight and motor thrust ratio.

  15. Breastfeeding: guidance received in prenatal care, delivery and postpartum care

    Directory of Open Access Journals (Sweden)

    Mayara Caroline Barbieri

    2014-07-01

    Full Text Available The aim of the study was to analyze the guidelines considering breastfeeding given by health professionals to women during prenatal care, delivery and postpartum care. Quantitative and descriptive work developed at Regional Pinheiros, Maringá-PR, from the registry in SisPreNatal, from May to August 2009. Data were collected through interviews conducted with parents at home, using a structured instrument. Participants were 36 mothers, most of whom received counseling for breastfeeding during prenatal (58.3%, maternity (87.6% and in nursing visits to newborn (84.6%. The prevalence of exclusive breastfeeding was 37.5%, even with the end of maternity leave. The rate is still below the recommended by the World Health Organization for exclusive breastfeeding. The present results may contribute to the monitoring of health actions and development of new strategies in the maintenance of exclusive breastfeeding.

  16. Industrial measurement instruments that use radioisotopes

    International Nuclear Information System (INIS)

    Monno, Asao

    2004-01-01

    An example of a large-scale system for controlling hot rolling, and recent developments for a gamma-ray thickness gauge for the inner-mill housing of a plate and a thickness gauge for a hot seamless tube mill are introduced. The dramatically higher speed response, versatile intelligent elements, larger data capacity and formation of a database are advantages of these instruments over conventional devices. Moreover, Fuji Electric's industrial measuring instruments that use radioisotopes are manufactured and marketed to be compatible with those of Hitachi, and we have already compiled a track record of many deliveries. (author)

  17. Instrument design and automation

    International Nuclear Information System (INIS)

    Wernlund, R.F.

    1984-01-01

    The ion mobility spectrometer-mass spectrometer (IMS-MS) is described and consists of two separate instruments coupled in tandem: an ion mobility spectrometer coupled to a quadrupole mass spectrometer. The two insturments operate at different pressures in a synergistic manner, supplying both drift time and mass information about ions which are formed at atmospheric pressure in the ion mobility spectrometer tube. Two types of ion intensity signals are presented to the data processor. The IMS produces an analog voltage with major components from dc to 5 KHz. The mass spectrometer signal output resides in the pulse count rate derived from a series of TTL level pulses where each pulse represents the arrival of a single ion. The hardware, software, interfacing capabilities and basic data acquisition program are described in detail

  18. FMIT diagnostic instrumentation

    International Nuclear Information System (INIS)

    Gilpatrick, J.D.; Chamberlin, D.D.

    1985-01-01

    The Fusion Materials Irradiation Test facility (FMIT) cw prototype accelerator has noninterceptive beamline instrumentation to measure beam parameters. The transverse emittances and beam profiles are measured with an array of photodiode sensors viewing light emitted from the beam region. Tomographic reconstructions of both spatial-density distributions and of transverse-emittance distributions are performed throughout a quadrupole focusing section. Beam bunches passing through capacitive probes produce bipolar waveforms whose zero crossing corresponds to the bunch's longitudinal centroid. By measuring the time required for a bunch to travel the known distance between two probes, velocity and energy are determined. A toroidal transformer measures the average ac beam current. Beam spill is measured by a set of movable jaws that intercept the beam edges. Each jaw contains a water flow channel whose flow rate and differential temperature are measured to derive a transverse power distribution. Beam centroid position is measured by a four-lobe, magnetic-loop pickup. 5 refs., 6 figs

  19. Route of delivery following successful external cephalic version.

    Science.gov (United States)

    Policiano, Catarina; Costa, Ana; Valentim-Lourenço, Alexandre; Clode, Nuno; Graça, Luís M

    2014-09-01

    To evaluate the delivery route and the indications for cesarean delivery after successful external cephalic version (ECV). A retrospective matched case-control study was conducted at a hospital in Lisbon, Portugal, between 2002 and 2012. Each woman who underwent successful ECV (n = 44) was compared with the previous and next women who presented for labor management and who had the same parity and a singleton vertex pregnancy at term (n = 88). The outcome measures were route of delivery, indications for cesarean delivery, and incidence of nonreassuring fetal status. Attempts at ECV were successful in 62 (46%) of 134 women, and 44 women whose fetuses remained in a cephalic presentation until delivery were included in the study. The rates of intrapartum cesarean delivery and operative vaginal delivery did not differ significantly between cases and controls (intrapartum cesarean delivery, 9 [20%] vs 16 [18%], P = 0.75; operative vaginal delivery, 14 [32%] vs 19 [22%], P = 0.20). The indications for cesarean delivery after successful ECV did not differ; in both groups, cesarean delivery was mainly performed for labor arrest disorders (cases, 6 [67%] vs controls, 13 [81%]; P = 0.63). Successful ECV was not associated with increased rates of intrapartum cesarean delivery or operative vaginal delivery. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  20. Personal birth preferences and actual mode of delivery outcomes of obstetricians and gynaecologists in South West England; with comparison to regional and national birth statistics.

    Science.gov (United States)

    Lightly, Katie; Shaw, Elisabeth; Dailami, Narges; Bisson, Dina

    2014-10-01

    To determine personal birth preferences of obstetricians in various clinical scenarios, in particular elective caesarean section for maternal request. To determine actual rates of modes of deliveries amongst the same group. To compare the obstetrician's mode of delivery rates, to the general population. Following ethical approval, a piloted online survey link was sent via email to 242 current obstetricians and gynaecologists, (consultants and trainees) in South West England. Mode of delivery results were compared to regional and national population data, using Hospital Episode Statistics and subjected to statistical analysis. The response rate was 68%. 90% would hypothetically plan a vaginal delivery, 10% would consider a caesarean section in an otherwise uncomplicated primiparous pregnancy. Of the 94/165 (60%) respondents with children (201 children), mode of delivery for the first born child; normal vaginal delivery 48%, caesarean section 26.5% (elective 8.5%, emergency 18%), instrumental 24.5% and vaginal breech 1%. Only one chose an elective caesarean for maternal request. During 2006-2011 obstetricians have the same overall actual modes of birth as the population (p=0.9). Ten percent of obstetricians report they would consider requesting caesarean section for themselves/their partner, which is the lowest rate reported within UK studies. However only 1% actually had a caesarean solely for maternal choice. When compared to regional/national statistics obstetricians currently have modes of delivery that are not significantly different than the population and suggests that they choose non interventional delivery if possible. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. Instrument Modeling and Synthesis

    Science.gov (United States)

    Horner, Andrew B.; Beauchamp, James W.

    During the 1970s and 1980s, before synthesizers based on direct sampling of musical sounds became popular, replicating musical instruments using frequency modulation (FM) or wavetable synthesis was one of the “holy grails” of music synthesis. Synthesizers such as the Yamaha DX7 allowed users great flexibility in mixing and matching sounds, but were notoriously difficult to coerce into producing sounds like those of a given instrument. Instrument design wizards practiced the mysteries of FM instrument design.

  2. Aeroacoustics of Musical Instruments

    NARCIS (Netherlands)

    Fabre, B.; Gilbert, J.; Hirschberg, Abraham; Pelorson, X.

    2012-01-01

    We are interested in the quality of sound produced by musical instruments and their playability. In wind instruments, a hydrodynamic source of sound is coupled to an acoustic resonator. Linear acoustics can predict the pitch of an instrument. This can significantly reduce the trial-and-error process

  3. [Low urinary tract symptoms after Thierry's spatula delivery at first pregnancy].

    Science.gov (United States)

    Provansal, M; Bretelle, F; Bannier, M; Gamerre, M; Mazouni, C

    2007-11-01

    This study was undertaken to evaluate prevalence of low urinary tract symptoms (LUTS) after Thierry's spatula delivery at first pregnancy. A retrospective study of 236 primiparous with instrumental delivery or spontaneous delivery who had delivered from January 2001 to December 2002. Low urinary tract symptoms (LUTS) were evaluated one year after delivery with a questionnaire. Incidence of LUTS was compared depending on mode of delivery. Of the 236 patients included, 88.1% replied to the questionnaire, 106 who delivered spontaneously and 102 who underwent Thierry's spatula delivery. The incidence of urinary incontinence was similar after instrumental deliveries and after spontaneous vaginal deliveries (34.9 versus 24.5%, p=0.10). In univariate analysis, symptoms of urinary urgency and urinary frequency were higher after instrumental delivery than after spontaneous delivery, respectively, 34.9 versus 22.5%, p=0.049 and 19.8 versus 8.8%, p=0.03. After controlling for confounding factors, no difference in LUTS was observed between the two groups; the respective adjusted odds-ratios (95% IC) were 1,5 (0.8-3) for urinary incontinence, 1.7 (0.9-3.5) for urgency and 2.5 (0.9-6.3) for urinary frequency. One year after delivery, one third of patients will present urinary incontinence and more than 50% will complain of bladder instability symptoms. Compared to spontaneous vaginal delivery, the use of Thierry's spatulas at first pregnancy does not induce higher risk of LUTS.

  4. Project delivery system (PDS)

    CERN Document Server

    2001-01-01

    As business environments become increasingly competitive, companies seek more comprehensive solutions to the delivery of their projects. "Project Delivery System: Fourth Edition" describes the process-driven project delivery systems which incorporates the best practices from Total Quality and is aligned with the Project Management Institute and ISO Quality Standards is the means by which projects are consistently and efficiently planned, executed and completed to the satisfaction of clients and customers.

  5. Mode of delivery and Pelvic floor disorder

    International Nuclear Information System (INIS)

    Noor, R.; Neelam, H.; Bashir, M.S.

    2017-01-01

    Objective: To compare pelvic floor dysfunction in non pregnant women who had delivered vaginally versus those with cesarean delivery. Methodology: The prevalence of pelvic floor disorders among non pregnant women was assesses by using a standardized tool pelvic floor distress inventory short form (PFDI-20). Data was collected from Jinnah Hospital Lahore, Pakistan. Results: Total numbers of participants were 278. 47.12% subjects had moderate, 36.69% miner and 16.19% had severe pelvic floor dysfunction. The symptoms of pelvic organ prolapse were more prevalent (mean value is 59.1876) than Urinary Distress (mean value is 40.5426), while the Colorectal-Anal Distress (mean value is 35.9150) were least prevalent. Conclusion: Pelvic floor disorders are very common among females and are strongly associated with mode of delivery. Although spontaneous vaginal birth was extensively associated with pelvic floor disorders the instrumental delivery affects most. (author)

  6. Ketobemidone prodrugs for buccal delivery

    DEFF Research Database (Denmark)

    Hansen, L.B.; Christrup, Lona Louring; Bundgaard, H.

    1992-01-01

    As part of studies aiming at developing a ketobemidone prodrug suitable for buccal or sublingual administration, the potential impact of saliva enzyme-catalyzed hydrolysis of various ester prodrugs was assessed. The hydrolysis of three ketobemidone esters in human whole saliva, obtained under con...... in the mouth and their rate of disintegration were shown to have some influence on the rate of saliva secretion and hence on saliva esterase activity but not to an extent compromising the efficient buccal or sublingual delivery of the ketobemidone prodrugs....

  7. Status of safeguards instrumentation

    International Nuclear Information System (INIS)

    Higinbotham, W.A.

    The International Atomic Energy Agency is performing safeguards at some nuclear power reactors, 50 bulk processing facilities, and 170 research facilities. Its verification activities require the use of instruments to measure nuclear materials and of surveillance instruments to maintain continuity of knowledge of the locations of nuclear materials. Instruments that are in use and under development to measure weight, volume, concentration, and isotopic composition of nuclear materials, and the major surveillance instruments, are described in connection with their uses at representative nuclear facilities. The current status of safeguards instrumentation and the needs for future development are discussed

  8. Early modern mathematical instruments.

    Science.gov (United States)

    Bennett, Jim

    2011-12-01

    In considering the appropriate use of the terms "science" and "scientific instrument," tracing the history of "mathematical instruments" in the early modern period is offered as an illuminating alternative to the historian's natural instinct to follow the guiding lights of originality and innovation, even if the trail transgresses contemporary boundaries. The mathematical instrument was a well-defined category, shared across the academic, artisanal, and commercial aspects of instrumentation, and its narrative from the sixteenth to the eighteenth century was largely independent from other classes of device, in a period when a "scientific" instrument was unheard of.

  9. Medical instruments and devices principles and practices

    CERN Document Server

    Schreiner, Steven; Peterson, Donald R

    2015-01-01

    Medical Instruments and Devices: Principles and Practices originates from the medical instruments and devices section of The Biomedical Engineering Handbook, Fourth Edition. Top experts in the field provide material that spans this wide field. The text examines how biopotential amplifiers help regulate the quality and content of measured signals. It includes instruments and devices that span a range of physiological systems and the physiological scale: molecular, cellular, organ, and system. The book chronicles the evolution of pacemakers and their system operation and discusses oscillometry, cardiac output measurement, and the direct and indirect methods of measuring cardiac output. The authors also expound on the mechanics and safety of defibrillators and cover implantable stimulators, respiration, and the structure and function of mechanical ventilators. In addition, this text covers in depth: Anesthesia Delivery Electrosurgical Units and Devices Biomedical Lasers Measuring Cellular Traction Forces Blood G...

  10. Delivery systems for antimicrobial peptides

    DEFF Research Database (Denmark)

    Nordström, Randi; Malmsten, Martin

    2017-01-01

    Due to rapidly increasing resistance development against conventional antibiotics, finding novel approaches for the treatment of infections has emerged as a key health issue. Antimicrobial peptides (AMPs) have attracted interest in this context, and there is by now a considerable literature...... on the identification such peptides, as well as on their optimization to reach potent antimicrobial and anti-inflammatory effects at simultaneously low toxicity against human cells. In comparison, delivery systems for antimicrobial peptides have attracted considerably less interest. However, such delivery systems...... are likely to play a key role in the development of potent and safe AMP-based therapeutics, e.g., through reducing chemical or biological degradation of AMPs either in the formulation or after administration, by reducing adverse side-effects, by controlling AMP release rate, by promoting biofilm penetration...

  11. Timing of administration of epidural analgesia and risk of operative delivery in nulliparous women: A case–control randomised study

    Directory of Open Access Journals (Sweden)

    Ipsita Chattopadhyay

    2018-01-01

    Full Text Available >Background and Aim: Epidural analgesia (EA offers an effective form of labour analgesia. The time of administration of EA and its relationship with the mode of delivery is controversial. Our study tried to assess whether early initiation of epidural analgesia influences the obstetric outcome in nulliparous women.Materials and Methods: This was a case control, randomised study which included 60 parturients in spontaneous labour divided into two equal groups, the cases and controls. Cases received EA with 10 mL of 0.125% injection bupivacaine, whereas the control group received a systemic opioid (injection pethidine 100 mg intramuscularly for pain relief. Cases were further divided into parturients receiving EA at a cervical dilatation of 3 cm or less classified as the early epidural group and those receiving EA at 4 cm or more classified as the late epidural group. The modes of delivery for the study population were recorded. Data analysis was done using Wilcoxon two-sample test. P < 0.05 was considered statistically significant.Results: The rate of instrumental vaginal delivery between the early epidural group [95% confidence interval (CI 0.358–10.821; P = 0.43] and late epidural group (95% CI 0.150–6.055; P = 0.96 was not significantly different. The cesarean-delivery rate was also not significantly different between those receiving early EA (P = 0.95 and late EA (P = 0.58 when compared with control group.Conclusion: This study showed no significant difference in the incidence of caesarean or instrumental delivery for women receiving early epidural analgesia when compared with late epidurals or no EA.

  12. 6. Home deliveries

    African Journals Online (AJOL)

    Sitwala

    determine factors associated with home deliveries. Main outcome ... deliver at home than a health facility compared to those who .... regression analysis, women who had four years of schooling or .... by report bias, the burden of home deliveries is a real challenge .... Journal of Econometrics 1987; 36: 185-204. 14. Michelo ...

  13. Global Delivery Models

    DEFF Research Database (Denmark)

    Manning, Stephan; Larsen, Marcus M.; Bharati, Pratyush

    2013-01-01

    This article examines antecedents and performance implications of global delivery models (GDMs) in global business services. GDMs require geographically distributed operations to exploit both proximity to clients and time-zone spread for efficient service delivery. We propose and empirically show...

  14. Health care delivery systems.

    NARCIS (Netherlands)

    Stevens, F.; Zee, J. van der

    2007-01-01

    A health care delivery system is the organized response of a society to the health problems of its inhabitants. Societies choose from alternative health care delivery models and, in doing so, they organize and set goals and priorities in such a way that the actions of different actors are effective,

  15. Global Delivery Models

    DEFF Research Database (Denmark)

    Manning, Stephan; Møller Larsen, Marcus; Bharati, Pratyush

    -zone spread allowing for 24/7 service delivery and access to resources. Based on comprehensive data we show that providers are likely to establish GDM configurations when clients value access to globally distributed talent pools and speed of service delivery, and in particular when services are highly...

  16. The N2N instrument to evaluate healthy work environments: an Italian validation.

    Science.gov (United States)

    Palese, Alvisa; Dante, Angelo; Tonzar, Laura; Balboni, Bernardo

    2014-02-01

    The aims of the study were to (a) validate N2N Healthy Work Environment tool, (b) assess the healthiness of work environments as perceived by nurses themselves and (c) identify the factors associated with Italian nurses' perception of work environment healthiness. The linguistic and cultural adaptation of USA-N2N Healthy Work Environments was achieved through a process of forward/backward translation. Content validity was assessed by three expert nurses. The stability of the instrument was checked with a test/retest evaluation. The instrument psychometric properties, the confirmatory factor analysis as well the healthiness of the work environment and its determinant factors were evaluated with a sample of 294 nurses. The content and face validity of the N2N Healthy Work Environment instrument was confirmed. The instrument demonstrated good internal consistency (α of 0.82), excellent stability values (ρ > 0.70) and high levels of acceptability (response rate: 96.4 %). The confirmatory factor analysis has corroborated the existence of two factors as documented in the original instrument (Mays et al. in J Nurs Manag 19:18-26, 2011). Eighty-seven (29.6 %) nurses perceived the work environment where they work as "healthy". Working under a functional model of care delivery (χ(2) 24.856, p 0.000) and being responsible for one project or more (χ(2) 5.256, p 0.021) were associated with healthy environments. The instrument--valid and reliable, short in the number of items, easy to understand and based on international standards--allows a systematic assessment of the healthiness of the environment and might provide not only the opportunity to evaluate the effects of new organizational models and interventions, but also the possibility to activate a process of self-analysis and a process of ongoing review. The instrument can be used to systematically check the healthiness of Italian working environments, allowing for organizational diagnosis, targeted interventions and

  17. Instrumentation a reader

    CERN Document Server

    Pope, P

    1990-01-01

    This book contains a selection of papers and articles in instrumentation previously pub­ lished in technical periodicals and journals of learned societies. Our selection has been made to illustrate aspects of current practice and applications of instrumentation. The book does not attempt to be encyclopaedic in its coverage of the subject, but to provide some examples of general transduction techniques, of the sensing of particular measurands, of components of instrumentation systems and of instrumentation practice in two very different environments, the food industry and the nuclear power industry. We have made the selection particularly to provide papers appropriate to the study of the Open University course T292 Instrumentation. The papers have been chosen so that the book covers a wide spectrum of instrumentation techniques. Because of this, the book should be of value not only to students of instrumen­ tation, but also to practising engineers and scientists wishing to glean ideas from areas of instrumen...

  18. Instrumentation for Nuclear Applications

    International Nuclear Information System (INIS)

    1998-01-01

    The objective of this project was to develop and coordinate nuclear instrumentation standards with resulting economies for the nuclear and radiation fields. There was particular emphasis on coordination and management of the Nuclear Instrument Module (NIM) System, U.S. activity involving the CAMAC international standard dataway system, the FASTBUS modular high-speed data acquisition and control system and processing and management of national nuclear instrumentation and detector standards, as well as a modest amount of assistance and consultation services to the Pollutant Characterization and Safety Research Division of the Office of Health and Environmental Research. The principal accomplishments were the development and maintenance of the NIM instrumentation system that is the predominant instrumentation system in the nuclear and radiation fields worldwide, the CAMAC digital interface system in coordination with the ESONE Committee of European Laboratories, the FASTBUS high-speed system and numerous national and international nuclear instrumentation standards

  19. VIRUS instrument enclosures

    Science.gov (United States)

    Prochaska, T.; Allen, R.; Mondrik, N.; Rheault, J. P.; Sauseda, M.; Boster, E.; James, M.; Rodriguez-Patino, M.; Torres, G.; Ham, J.; Cook, E.; Baker, D.; DePoy, Darren L.; Marshall, Jennifer L.; Hill, G. J.; Perry, D.; Savage, R. D.; Good, J. M.; Vattiat, Brian L.

    2014-08-01

    The Visible Integral-Field Replicable Unit Spectrograph (VIRUS) instrument will be installed at the Hobby-Eberly Telescope† in the near future. The instrument will be housed in two enclosures that are mounted adjacent to the telescope, via the VIRUS Support Structure (VSS). We have designed the enclosures to support and protect the instrument, to enable servicing of the instrument, and to cool the instrument appropriately while not adversely affecting the dome environment. The system uses simple HVAC air handling techniques in conjunction with thermoelectric and standard glycol heat exchangers to provide efficient heat removal. The enclosures also provide power and data transfer to and from each VIRUS unit, liquid nitrogen cooling to the detectors, and environmental monitoring of the instrument and dome environments. In this paper, we describe the design and fabrication of the VIRUS enclosures and their subsystems.

  20. Radiation protection instrument 1993

    International Nuclear Information System (INIS)

    1993-04-01

    The Radiation Protection Instrument, 1993 (Legislative Instrument 1559) prescribes the powers and functions of the Radiation Protection Board established under the Ghana Atomic Energy Commission by the Atomic Energy Commission (Amendment) Law, 1993 (P.N.D.C. Law 308). Also included in the Legislative Instrument are schedules on control and use of ionising radiation and radiation sources as well as procedures for notification, licensing and inspection of ionising radiation facilities. (EAA)

  1. Permeation enhancer strategies in transdermal drug delivery.

    Science.gov (United States)

    Marwah, Harneet; Garg, Tarun; Goyal, Amit K; Rath, Goutam

    2016-01-01

    Today, ∼74% of drugs are taken orally and are not found to be as effective as desired. To improve such characteristics, transdermal drug delivery was brought to existence. This delivery system is capable of transporting the drug or macromolecules painlessly through skin into the blood circulation at fixed rate. Topical administration of therapeutic agents offers many advantages over conventional oral and invasive techniques of drug delivery. Several important advantages of transdermal drug delivery are prevention from hepatic first pass metabolism, enhancement of therapeutic efficiency and maintenance of steady plasma level of the drug. Human skin surface, as a site of drug application for both local and systemic effects, is the most eligible candidate available. New controlled transdermal drug delivery systems (TDDS) technologies (electrically-based, structure-based and velocity-based) have been developed and commercialized for the transdermal delivery of troublesome drugs. This review article covers most of the new active transport technologies involved in enhancing the transdermal permeation via effective drug delivery system.

  2. Networked Instrumentation Element

    Data.gov (United States)

    National Aeronautics and Space Administration — Armstrong researchers have developed a networked instrumentation system that connects modern experimental payloads to existing analog and digital communications...

  3. Instrument validation project

    International Nuclear Information System (INIS)

    Reynolds, B.A.; Daymo, E.A.; Geeting, J.G.H.; Zhang, J.

    1996-06-01

    Westinghouse Hanford Company Project W-211 is responsible for providing the system capabilities to remove radioactive waste from ten double-shell tanks used to store radioactive wastes on the Hanford Site in Richland, Washington. The project is also responsible for measuring tank waste slurry properties prior to injection into pipeline systems, including the Replacement of Cross-Site Transfer System. This report summarizes studies of the appropriateness of the instrumentation specified for use in Project W-211. The instruments were evaluated in a test loop with simulated slurries that covered the range of properties specified in the functional design criteria. The results of the study indicate that the compact nature of the baseline Project W-211 loop does not result in reduced instrumental accuracy resulting from poor flow profile development. Of the baseline instrumentation, the Micromotion densimeter, the Moore Industries thermocouple, the Fischer and Porter magnetic flow meter, and the Red Valve Pressure transducer meet the desired instrumental accuracy. An alternate magnetic flow meter (Yokagawa) gave nearly identical results as the baseline fischer and Porter. The Micromotion flow meter did not meet the desired instrument accuracy but could potentially be calibrated so that it would meet the criteria. The Nametre on-line viscometer did not meet the desired instrumental accuracy and is not recommended as a quantitative instrument although it does provide qualitative information. The recommended minimum set of instrumentation necessary to ensure the slurry meets the Project W-058 acceptance criteria is the Micromotion mass flow meter and delta pressure cells

  4. Instrument performance evaluation

    International Nuclear Information System (INIS)

    Swinth, K.L.

    1993-03-01

    Deficiencies exist in both the performance and the quality of health physics instruments. Recognizing the implications of such deficiencies for the protection of workers and the public, in the early 1980s the DOE and the NRC encouraged the development of a performance standard and established a program to test a series of instruments against criteria in the standard. The purpose of the testing was to establish the practicality of the criteria in the standard, to determine the performance of a cross section of available instruments, and to establish a testing capability. Over 100 instruments were tested, resulting in a practical standard and an understanding of the deficiencies in available instruments. In parallel with the instrument testing, a value-impact study clearly established the benefits of implementing a formal testing program. An ad hoc committee also met several times to establish recommendations for the voluntary implementation of a testing program based on the studies and the performance standard. For several reasons, a formal program did not materialize. Ongoing tests and studies have supported the development of specific instruments and have helped specific clients understand the performance of their instruments. The purpose of this presentation is to trace the history of instrument testing to date and suggest the benefits of a centralized formal program

  5. [Controlling instruments in radiology].

    Science.gov (United States)

    Maurer, M

    2013-10-01

    Due to the rising costs and competitive pressures radiological clinics and practices are now facing, controlling instruments are gaining importance in the optimization of structures and processes of the various diagnostic examinations and interventional procedures. It will be shown how the use of selected controlling instruments can secure and improve the performance of radiological facilities. A definition of the concept of controlling will be provided. It will be shown which controlling instruments can be applied in radiological departments and practices. As an example, two of the controlling instruments, material cost analysis and benchmarking, will be illustrated.

  6. Ocean Optics Instrumentation Systems

    Data.gov (United States)

    Federal Laboratory Consortium — FUNCTION: Provides instrumentation suites for a wide variety of measurements to characterize the ocean’s optical environment. These packages have been developed to...

  7. Sustained subconjunctival protein delivery using a thermosetting gel delivery system.

    Science.gov (United States)

    Rieke, Erin R; Amaral, Juan; Becerra, S Patricia; Lutz, Robert J

    2010-02-01

    An effective treatment modality for posterior eye diseases would provide prolonged delivery of therapeutic agents, including macromolecules, to eye tissues using a safe and minimally invasive method. The goal of this study was to assess the ability of a thermosetting gel to deliver a fluorescently labeled protein, Alexa 647 ovalbumin, to the choroid and retina of rats following a single subconjunctival injection of the gel. Additional experiments were performed to compare in vitro to in vivo ovalbumin release rates from the gel. The ovalbumin content of the eye tissues was monitored by spectrophotometric assays of tissue extracts of Alexa 647 ovalbumin from dissected sclera, choroid, and retina at time points ranging from 2 h to 14 days. At the same time points, fluorescence microscopy images of tissue samples were also obtained. Measurement of intact ovalbumin was verified by LDS-PAGE analysis of the tissue extract solutions. In vitro release of Alexa 488 ovalbumin into 37 degrees C PBS solutions from ovalbumin-loaded gel pellets was also monitored over time by spectrophotometric assay. In vivo ovalbumin release rates were determined by measurement of residual ovalbumin extracted from gel pellets removed from rat eyes at various time intervals. Our results indicate that ovalbumin concentrations can be maintained at measurable levels in the sclera, choroid, and retina of rats for up to 14 days using the thermosetting gel delivery system. The concentration of ovalbumin exhibited a gradient that decreased from sclera to choroid and to retina. The in vitro release rate profiles were similar to the in vivo release profiles. Our findings suggest that the thermosetting gel system may be a feasible method for safe and convenient sustained delivery of proteins to choroidal and retinal tissue in the posterior segments of the eye.

  8. What Is a Cesarean Delivery?

    Science.gov (United States)

    ... Twitter Pinterest Email Print What is a cesarean delivery? A cesarean delivery is a surgical procedure in which a fetus ... 32.2% of U.S. births were by cesarean delivery. 2 The CDC also found that the number ...

  9. Future of Automated Insulin Delivery Systems.

    Science.gov (United States)

    Castle, Jessica R; DeVries, J Hans; Kovatchev, Boris

    2017-06-01

    Advances in continuous glucose monitoring (CGM) have brought on a paradigm shift in the management of type 1 diabetes. These advances have enabled the automation of insulin delivery, where an algorithm determines the insulin delivery rate in response to the CGM values. There are multiple automated insulin delivery (AID) systems in development. A system that automates basal insulin delivery has already received Food and Drug Administration approval, and more systems are likely to follow. As the field of AID matures, future systems may incorporate additional hormones and/or multiple inputs, such as activity level. All AID systems are impacted by CGM accuracy and future CGM devices must be shown to be sufficiently accurate to be safely incorporated into AID. In this article, we summarize recent achievements in AID development, with a special emphasis on CGM sensor performance, and discuss the future of AID systems from the point of view of their input-output characteristics, form factor, and adaptability.

  10. Biodegradable polymeric nanocarriers for pulmonary drug delivery.

    Science.gov (United States)

    Rytting, Erik; Nguyen, Juliane; Wang, Xiaoying; Kissel, Thomas

    2008-06-01

    Pulmonary drug delivery is attractive for both local and systemic drug delivery as a non-invasive route that provides a large surface area, thin epithelial barrier, high blood flow and the avoidance of first-pass metabolism. Nanoparticles can be designed to have several advantages for controlled and targeted drug delivery, including controlled deposition, sustained release, reduced dosing frequency, as well as an appropriate size for avoiding alveolar macrophage clearance or promoting transepithelial transport. This review focuses on the development and application of biodegradable polymers to nanocarrier-based strategies for the delivery of drugs, peptides, proteins, genes, siRNA and vaccines by the pulmonary route. The selection of natural or synthetic materials is important in designing particles or nanoparticle clusters with the desired characteristics, such as biocompatibility, size, charge, drug release and polymer degradation rate.

  11. TRANSDERMAL DRUG DELIVERY SYSTEM: REVIEW

    OpenAIRE

    Vishvakarama Prabhakar; Agarwal Shivendra; Sharma Ritika; Saurabh Sharma

    2012-01-01

    Various new technologies have been developed for the transdermal delivery of some important drugs. Today about 74% of drugs are taken orally and are found not to be as effective as desired. To improve such characters transdermal drug delivery system was emerged. Drug delivery through the skin to achieve a systemic effect of a drug is commonly known as transdermal drug delivery and differs from traditional topical drug delivery. Transdermal drug delivery systems (TDDS) are dosage forms involve...

  12. Ultrasound mediated nanoparticle drug delivery

    Science.gov (United States)

    Mullin, Lee B.

    . Ultrasound parameters are optimized to achieve maximum cell internalization of molecules and increased nanoparticle delivery to a cell layer on a coverslip. In-vivo studies demonstrate the possibility of using a lower dose of paclitaxel to slow tumor growth rates, increase doxorubicin concentration in tumor tissue, and enhance tumor delivery of fluorescent molecules through treatments that combine nanoparticles with ultrasound and microbubbles.

  13. Direct concurrent comparison of multiple pediatric acute asthma scoring instruments.

    Science.gov (United States)

    Johnson, Michael D; Nkoy, Flory L; Sheng, Xiaoming; Greene, Tom; Stone, Bryan L; Garvin, Jennifer

    2017-09-01

    Appropriate delivery of Emergency Department (ED) treatment to children with acute asthma requires clinician assessment of acute asthma severity. Various clinical scoring instruments exist to standardize assessment of acute asthma severity in the ED, but their selection remains arbitrary due to few published direct comparisons of their properties. Our objective was to test the feasibility of directly comparing properties of multiple scoring instruments in a pediatric ED. Using a novel approach supported by a composite data collection form, clinicians categorized elements of five scoring instruments before and after initial treatment for 48 patients 2-18 years of age with acute asthma seen at the ED of a tertiary care pediatric hospital ED from August to December 2014. Scoring instruments were compared for inter-rater reliability between clinician types and their ability to predict hospitalization. Inter-rater reliability between clinician types was not different between instruments at any point and was lower (weighted kappa range 0.21-0.55) than values reported elsewhere. Predictive ability of most instruments for hospitalization was higher after treatment than before treatment (p < 0.05) and may vary between instruments after treatment (p = 0.054). We demonstrate the feasibility of comparing multiple clinical scoring instruments simultaneously in ED clinical practice. Scoring instruments had higher predictive ability for hospitalization after treatment than before treatment and may differ in their predictive ability after initial treatment. Definitive conclusions about the best instrument or meaningful comparison between instruments will require a study with a larger sample size.

  14. Overview of LOFT instrumentation

    International Nuclear Information System (INIS)

    Bixby, W.W.

    1979-01-01

    A description of instrumentation used in the Loss-of-Fluid Test (LOFT) large break Loss-of-Coolant Experiments is presented. Emphasis is placed on hydraulic and thermal measurements in the primary system piping and components, reactor vessel, and pressure suppression system. In addition, instrumentation which is being considered for measurement of phenomena during future small break testing is discussed

  15. Corticotomy-facilitated orthodontics using piezosurgery versus rotary instruments: an experimental study.

    Science.gov (United States)

    Farid, Karim A; Mostafa, Yehya A; Kaddah, Mohammed A; El-Sharaby, Fouad Aly

    2014-10-01

    The aim of this study was to evaluate corticotomy-facilitated orthodontics (CFO) using piezosurgery versus conventional rotary instruments. Ten healthy adult male mongrel dogs of comparable age with a complete set of permanent dentition with average weights between 13-17 kilograms were used. CFO using conventional rotary instruments versus piezosurgery was performed on each dog in a split mouth design. For every dog, mandibular 2nd premolar retraction on each side was attempted after extracting 3rd premolars followed by corticotomy-facilitated orthodontics using conventional rotary surgical burs on the left side and an ultrasonic piezosurgery system on the right side of the same animal. Intraoral measurements of the rate of tooth movement were taken with a sliding caliper. Measurements were performed by the same operator at the time of surgery (appliance delivery) and every month for six months. The dogs were sacrificed after six months from initiation of tooth movement to evaluate the amount of tooth movement for both conventional rotary and piezosurgery corticotomy techniques. A statistically significantly higher mean amount of tooth movement for conventional rotary instrument versus the piezosurgery corticotomy technique was observed at all time intervals. Tooth movement was 1.6 times faster when CFO was done using conventional rotary instruments as compared to a piezosurgery device.

  16. Predicting Agency Rating Migrations with Spread Implied Ratings

    OpenAIRE

    Jianming Kou; Dr Simone Varotto

    2005-01-01

    Investors traditionally rely on credit ratings to price debt instruments. However, rating agencies are known to be prudent in their approach to rating revisions, which results in delayed ratings adjustments to mutating credit conditions. For a large set of eurobonds we derive credit spread implied ratings and compare them with the ratings issued by rating agencies. Our results indicate that spread implied ratings often anticipate future movement of agency ratings and hence could help track cr...

  17. The impact of treatment complexity and computer-control delivery technology on treatment delivery errors

    International Nuclear Information System (INIS)

    Fraass, Benedick A.; Lash, Kathy L.; Matrone, Gwynne M.; Volkman, Susan K.; McShan, Daniel L.; Kessler, Marc L.; Lichter, Allen S.

    1998-01-01

    machines. Results: The overall reported error rate (all treatments, machines) was 0.13% per segment, or 0.44% per treatment session. The rate (per machine) depended on automation and plan complexity. The error rates per segment for machines M1 through M4 were 0.16%, 0.27%, 0.12%, 0.05%, respectively, while plan complexity increased from M1 up to machine M4. Machine M4 (the most complex plans and automation) had the lowest error rate. The error rate decreased with increasing automation in spite of increasing plan complexity, while for the manual machines, the error rate increased with complexity. Note that the real error rates on the two manual machines are likely to be higher than shown here (due to unnoticed and/or unreported errors), while (particularly on M4) virtually all random treatment delivery errors were noted by the CCRS system and related QA checks (including routine checks of machine and table readouts for each treatment). Treatment delivery times averaged from 14 min to 23 min per plan, and depended on the number of segments/plan, although this analysis is complicated by other factors. Conclusion: Use of a sophisticated computer-controlled delivery system for routine patient treatments with complex 3D conformal plans has led to a decrease in treatment delivery errors, while at the same time allowing delivery of increasingly complex and sophisticated conformal plans with little increase in treatment time. With renewed vigilance for the possibility of systematic problems, it is clear that use of complete and integrated computer-controlled delivery systems can provide improvements in treatment delivery, since more complex plans can be delivered with fewer errors, and without increasing treatment time

  18. Vaginal delivery - discharge

    Science.gov (United States)

    Pregnancy - discharge after vaginal delivery ... You may have bleeding from your vagina for up to 6 weeks. Early on, you may pass some small clots when you first get up. Bleeding will slowly become ...

  19. Bribes for Faster Delivery

    OpenAIRE

    Sanyal, Amal

    2000-01-01

    The paper models the practice of charging bribes for faster delivery of essential services in third world countries. It then examines the possibility of curbing corruption by supervision, and secondly, by introducing competition among delivery agents. It is argued that a supervisory solution eludes the problem because no hard evidence of the reduction of corruption can be established for this type of offenses. It is also shown that using more than one supplier cannot eliminate the practice, a...

  20. A pulsed mode electrolytic drug delivery device

    International Nuclear Information System (INIS)

    Yi, Ying; Foulds, Ian G; Buttner, Ulrich; Carreno, Armando A A; Conchouso, David

    2015-01-01

    This paper reports the design of a proof-of-concept drug delivery device that is actuated using the bubbles formed during electrolysis. The device uses a platinum (Pt) coated nickel (Ni) metal foam and a solid drug in reservoir (SDR) approach to improve the device’s performance. This electrochemically-driven pump has many features that are unlike conventional drug delivery devices: it is capable of pumping periodically and being refilled automatically; it features drug release control; and it enables targeted delivery. Pt-coated metal foam is used as a catalytic reforming element, which reduces the period of each delivery cycle. Two methods were used for fabricating the Pt-coated metal: sputtering and electroplating. Of these two methods, the sputtered Pt-coated metal foam has a higher pumping rate; it also has a comparable recombination rate when compared to the electroplated Pt-coated metal foam. The only drawback of this catalytic reformer is that it consumes nickel scaffold. Considering long-term applications, the electroplated Pt metal foam was selected for drug delivery, where a controlled drug release rate of 2.2 μg  ±  0.3 μg per actuation pulse was achieved using 4 mW of power. (paper)

  1. A pulsed mode electrolytic drug delivery device

    KAUST Repository

    Yi, Ying

    2015-09-14

    This paper reports the design of a proof-of-concept drug delivery device that is actuated using the bubbles formed during electrolysis. The device uses a platinum (Pt) coated nickel (Ni) metal foam and a solid drug in reservoir (SDR) approach to improve the device\\'s performance. This electrochemically-driven pump has many features that are unlike conventional drug delivery devices: it is capable of pumping periodically and being refilled automatically; it features drug release control; and it enables targeted delivery. Pt-coated metal foam is used as a catalytic reforming element, which reduces the period of each delivery cycle. Two methods were used for fabricating the Pt-coated metal: sputtering and electroplating. Of these two methods, the sputtered Pt-coated metal foam has a higher pumping rate; it also has a comparable recombination rate when compared to the electroplated Pt-coated metal foam. The only drawback of this catalytic reformer is that it consumes nickel scaffold. Considering long-term applications, the electroplated Pt metal foam was selected for drug delivery, where a controlled drug release rate of 2.2 μg ± 0.3 μg per actuation pulse was achieved using 4 mW of power.

  2. The Delivery of Developmental Mathematics: Course Redesign and Implementation at a Community College

    Science.gov (United States)

    Westerfield, Mary Ann K.

    2013-01-01

    This research was undertaken to determine if the redesigned modular delivery method for developmental mathematics produced a higher sequence completion rate within a year as compared to the traditional lecture style delivery. Re-enrollment rates from fall to spring for the modularized delivery system were compared to the traditional delivery…

  3. Conditioned instrumental behaviour in the rat: Effects of prenatal irradiation with various low dose-rate doses. Instrumentelle Verhaltensuntersuchungen an der Ratte: Ueber die Wirkung verschiedener Dosen einer praenatalen Bestrahlung niedriger Dosisleistung

    Energy Technology Data Exchange (ETDEWEB)

    Klug, H.

    1986-01-01

    4 groups of rats of the Wistar-strain were subjected to ..gamma..-irradiation on the 16th day of gestation. 5 rats received 0,6 Gy low dose rate irradiation, 5 animals received 0,9 Gy low dose and 6 high dose irradiation, 3 females were shamirradiated. The male offspring of these 3 irradiation groups and 1 control group were tested for locomotor coordination on parallel bars and in a water maze. The female offspring were used in an operant conditioning test. The locomotor test showed slight impairment of locomotor coordination in those animals irradiated with 0,9 Gy high dose rate. Swimming ability was significantly impaired by irradiation with 0,9 Gy high dose rate. Performance in the operant conditioning task was improved by irradiation with 0,9 Gy both low and high dose rate. The 0,9 Gy high dose rate group learned faster than all the other groups. For the dose of 0,9 Gy a significant dose rate effect could be observed. For the dose of 0,6 Gy a similar tendency was observed, differences between 0,6 Gy high and low dose rate and controls not being significant.

  4. [Delivery management for the prevention of shoulder dystocia in case of identified risk factors].

    Science.gov (United States)

    Schmitz, T

    2015-12-01

    To determine the impact of (i) computed tomographic (CT) pelvimetry for the choice of the mode of delivery, (ii) cesarean, (iii) induction of labor, and of (iv) various delivery managements on the risk of shoulder dystocia in case of fetal macrosomia, with or without maternal diabetes, and in women with previous history of shoulder dystocia. The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. In case of clinically suspected macrosomia, a sonography should be performed to increase diagnostic performances and to assist in decision-making (Professional consensus). Because CT pelvimetry is associated with high false positive rates and increases cesarean deliveries, its use is not recommended to prevent shoulder dystocia in case of fetal macrosomia (Professional consensus). To avoid the neonatal complications of shoulder dystocia, mainly permanent brachial plexus palsy, cesarean delivery is recommended in case of estimated fetal weight (EFW) greater than 4500 g if associated with maternal diabetes (grade C), and greater than 5000 g in the absence of maternal diabetes (grade C). The published data do not provide definitive evidences to recommend systematic labor induction in case of impending fetal macrosomia (Professional consensus). In case of favourable cervix and gestational age greater than 39 weeks of gestation, labor induction should be promoted (Professional consensus). Prophylactic McRoberts maneuver is not recommended to prevent shoulder dystocia in case of fetal macrosomia (grade C). Because data are lacking, no recommendation is possible regarding the use of episiotomy. In case of fetal macrosomia and failure to progress in the second stage of labor, midpelvic and higher instrumental deliveries are not recommended and a cesarean delivery should be preferred (grade C), if the fetal head is at or lower than a +2 station, cesarean delivery is not recommended and an

  5. A review on target drug delivery: magnetic microspheres

    OpenAIRE

    Amit Chandna; Deepa Batra; Satinder Kakar; Ramandeep Singh

    2013-01-01

    Novel drug delivery system aims to deliver the drug at a rate directed by the needs of the body during the period of treatment, and target the active entity to the site of action. A number of novel drug delivery systems have emerged encompassing various routes of administration, to achieve controlled and targeted drug delivery, magnetic micro carriers being one of them. Magnetic microsphere is newer approach in pharmaceutical field. Magnetic microspheres as an alternative to traditional ra...

  6. 76 FR 39234 - Federal Acquisition Regulation; Unique Procurement Instrument Identifier

    Science.gov (United States)

    2011-07-05

    ..., therefore, was not subject to review under section 6(b) of E.O. 12866, Regulatory Planning and Review, dated... for procurement actions, such as delivery and task orders or basic ordering agreements, the order or... Instrument Identifier (PIID). Agencies shall have in place a process that ensures that each PIID reported to...

  7. Instrumentation reference book

    CERN Document Server

    Boyes, Walt

    2002-01-01

    Instrumentation is not a clearly defined subject, having a 'fuzzy' boundary with a number of other disciplines. Often categorized as either 'techniques' or 'applications' this book addresses the various applications that may be needed with reference to the practical techniques that are available for the instrumentation or measurement of a specific physical quantity or quality. This makes it of direct interest to anyone working in the process, control and instrumentation fields where these measurements are essential.* Comprehensive and authoritative collection of technical information* Writte

  8. The latest radiation instrument

    International Nuclear Information System (INIS)

    Kang, Se Sik; Gwon, Dal Gwan; Kim, Gyeong Geum

    2008-08-01

    This book deals with the latest radiation instrument, which is comprised of eight chapters. It explains X rays instrument for medial treatment, X-ray tube instrument and permissible burden with its history, structure and characteristic high voltage apparatus with high voltage rectifier circuit, X-ray control apparatus for medical treatment, X-ray image equipment X-ray television apparatus and CCD 205, X-ray apparatus of install and types, Digital X-ray apparatus with CR 261 and DR 269, performance management on X-ray for medical treatment with its history, necessity and management in the radiation field.

  9. Soil monitoring instrumentation

    International Nuclear Information System (INIS)

    Umbarger, C.J.

    1980-01-01

    The Los Alamos Scientific Laboratory (LASL) has an extensive program for the development of nondestructive assay instrumentation for the quantitative analysis of transuranic (TRU) materials found in bulk solid wastes generated by Department of Energy facilities and by the commercial nuclear power industry. Included are wastes generated in decontamination and decommissioning of outdated nuclear facilities as well as wastes from old waste burial ground exhumation programs. The assay instrumentation is designed to have detection limits below 10 nCi/g wherever practicable. Because of the topic of this workshop, only the assay instrumentation applied specifically to soil monitoring will be discussed here. Four types of soil monitors are described

  10. Soil monitoring instrumentation

    International Nuclear Information System (INIS)

    Umbarger, C.J.

    1981-01-01

    The Los Alamos Scientific Laboratory (LASL) has an extensive program for the development of nondestructive assay instrumentation for the quantitative analysis of transuranic (TRU) materials found in bulk solid wastes generated by Department of Energy facilities and by the commercial nuclear power industry. Included are wastes generated in decontamination and decommissioning of outdated nuclear facilities, as well as from old waste-burial-ground exhumation programs. The assay instrumentation is designed to have detection limits below 10 nCi/g wherever practicable. The assay instrumentation that is applied specifically to soil monitoring is discussed

  11. Jones' instrument technology

    CERN Document Server

    Jones, Ernest Beachcroft; Kingham, Edward G; Radnai, Rudolf

    1985-01-01

    Jones' Instrument Technology, Volume 5: Automatic Instruments and Measuring Systems deals with general trends in automatic instruments and measuring systems. Specific examples are provided to illustrate the principles of such devices. A brief review of a considerable number of standards is undertaken, with emphasis on the IEC625 Interface System. Other relevant standards are reviewed, including the interface and backplane bus standards. This volume is comprised of seven chapters and begins with a short introduction to the principles of automatic measurements, classification of measuring system

  12. Medical instruments in museums

    DEFF Research Database (Denmark)

    Söderqvist, Thomas; Arnold, Ken

    2011-01-01

    This essay proposes that our understanding of medical instruments might benefit from adding a more forthright concern with their immediate presence to the current historical focus on simply decoding their meanings and context. This approach is applied to the intriguingly tricky question of what...... actually is meant by a "medical instrument." It is suggested that a pragmatic part of the answer might lie simply in reconsidering the holdings of medical museums, where the significance of the physical actuality of instruments comes readily to hand....

  13. CHANGING TRENDS IN CAESAREAN DELIVERY - A CLINICAL STUDY

    Directory of Open Access Journals (Sweden)

    Annappa Shetty

    2016-10-01

    Full Text Available BACKGROUND Today, there is a concern over the rising caesarean delivery both in the developed and developing countries across the world. It has been observed that both primary and repeat caesarean deliveries have been increasing at an alarming rate. Indications for caesarean deliveries also shows changing trends in the present scenario. The main aim of this study is to compare the caesarean delivery rates over the last one decade. The objective behind the study is to understand the contributing factors for the new trends. MATERIALS AND METHODS For this study, the data was collected in a retrospective manner from all the deliveries that occurred between July 1, 2005, to June 30, 2006, and July 2015 to June 30, 2016, in the Department of Obstetrics and Gynaecology, Karwar Institute of Medical Science, Karwar. A cohort of 2752 delivered women were studied. Among the caesarean births, the indications for both the primary and repeat caesarean sections were studied. After analysing the caesarean births from total live births, the rate for both primary and repeat caesarean were calculated. RESULTS The caesarean delivery rate is increased from 167 to 263 for 1000 live births with increase in primary caesarean delivery rate from 101 (10.1% to 187 (18.7% per 1000 live births in last one decade. Foetal distress, cephalopelvic disproportion, arrest of descent, multiple gestations, breech presentation contributed to this increase. CONCLUSION There is an increase in the total caesarean rate with significant rise in the primary caesarean rate in the last one decade.

  14. [Development of an Instrument to Assess the Quality of Childbirth Care from the Mother's Perspective].

    Science.gov (United States)

    Jeong, Geum Hee; Kim, Hyun Kyoung; Kim, Young Hee; Kim, Sun Hee; Lee, Sun Hee; Kim, Kyung Won

    2018-02-01

    This study aimed to develop an instrument to assess the quality of childbirth care from the perspective of a mother after delivery. The instrument was developed from a literature review, interviews, and item validation. Thirty-eight items were compiled for the instrument. The data for validity and reliability testing were collected using a questionnaire survey conducted on 270 women who had undergone normal vaginal delivery in Korea and analyzed with descriptive statistics, exploratory factor analysis, and reliability coefficients. The exploratory factor analysis reduced the number of items in the instrument to 28 items that were factored into four subscales: family-centered care, personal care, emotional empowerment, and information provision. With respect to convergence validation, there was positive correlation between this instrument and birth satisfaction scale (r=.34, pinstrument could be used as a measure of the quality of nursing care for women who have a normal vaginal delivery. © 2018 Korean Society of Nursing Science.

  15. Environment for the instruments

    International Nuclear Information System (INIS)

    Ambro, P.

    1992-01-01

    A properly conditioned AC power supply is necessary for reliable functioning of instruments. Electric mains power is produced primarily for industry, workshops, lighting and household uses. Its quality is adjusted to these uses. In areas sand countries with a fast growing demand for electric power, these requirements are far from being met. Electronic instruments and computers, especially in these countries, need protection against disturbances of the mains supply. A clean and dry environment is needed for reliable functioning and long life of instruments. High humidity, specially at higher temperatures, changes the characteristics of electronic components. Moreover, under these conditions fungal growth causes leakage of currents and corrosion causes poor contacts. The presence of dust enhances these effects. They give rise to malfunction of instruments, particularly of high voltage equipment

  16. CCAT Heterodyne Instrument Development

    Data.gov (United States)

    National Aeronautics and Space Administration — This work will extend and proof-out the design concept for a high pixel count (128 pixels in 2 bands) submillimeter-wave heterodyne receiver array instrument for the...

  17. Environment for the instruments

    Energy Technology Data Exchange (ETDEWEB)

    Ambro, P

    1993-12-31

    A properly conditioned AC power supply is necessary for reliable functioning of instruments. Electric mains power is produced primarily for industry, workshops, lighting and household uses. Its quality is adjusted to these uses. In areas sand countries with a fast growing demand for electric power, these requirements are far from being met. Electronic instruments and computers, especially in these countries, need protection against disturbances of the mains supply. A clean and dry environment is needed for reliable functioning and long life of instruments. High humidity, specially at higher temperatures, changes the characteristics of electronic components. Moreover, under these conditions fungal growth causes leakage of currents and corrosion causes poor contacts. The presence of dust enhances these effects. They give rise to malfunction of instruments, particularly of high voltage equipment

  18. Fiber Optics Instrumentation Development

    Science.gov (United States)

    Chan, Patrick Hon Man; Parker, Allen R., Jr.; Richards, W. Lance

    2010-01-01

    This is a general presentation of fiber optics instrumentation development work being conducted at NASA Dryden for the past 10 years and recent achievements in the field of fiber optics strain sensors.

  19. Carbon Footprint Reduction Instruments

    Science.gov (United States)

    This page outlines the major differences between Renewable Energy Certificates (REC) and Project Offsets and what types of claims each instrument allows the organization to make in regards to environmental emissions claims.

  20. Instrument care: everyone's responsibility

    Directory of Open Access Journals (Sweden)

    Renée du Toit

    2011-12-01

    Full Text Available Everyone working in an ophthalmic operating theatre must be competent in the care, handling, storage, and maintenance of instruments. This will help to improve surgical outcomes, maintain an economic and affordable service for patients, and provide a safe environment for the wellbeing of patients and staff.Including instrument care in theatre courses and in-service training is one way of ensuring staff competence.

  1. Instrument uncertainty predictions

    International Nuclear Information System (INIS)

    Coutts, D.A.

    1991-07-01

    The accuracy of measurements and correlations should normally be provided for most experimental activities. The uncertainty is a measure of the accuracy of a stated value or equation. The uncertainty term reflects a combination of instrument errors, modeling limitations, and phenomena understanding deficiencies. This report provides several methodologies to estimate an instrument's uncertainty when used in experimental work. Methods are shown to predict both the pretest and post-test uncertainty

  2. Experimenting with woodwind instruments

    Science.gov (United States)

    Lo Presto, Michael C.

    2007-05-01

    Simple experiments involving musical instruments of the woodwind family can be used to demonstrate the basic physics of vibrating air columns in resonance tubes using nothing more than straightforward measurements and data collection hardware and software. More involved experimentation with the same equipment can provide insight into the effects of holes in the tubing and other factors that make simple tubes useful as musical instruments.

  3. Maintenance of scientific instruments

    International Nuclear Information System (INIS)

    Lucero, E.

    1986-01-01

    During the last years Colombia has increased the use of nuclear techniques, instruments and equipment in ambitious health programs, as well as in research centers, industry and education; this has resulted in numerous maintenance problems. As an alternative solution IAN has established a Central Maintenance Laboratory for nuclear instruments within an International Atomic Energy Agency program for eight Latin American and nine Asian Countries. Established strategies and some results are detailed in this writing

  4. Microprocessor Based Temperature Control of Liquid Delivery with Flow Disturbances.

    Science.gov (United States)

    Kaya, Azmi

    1982-01-01

    Discusses analytical design and experimental verification of a PID control value for a temperature controlled liquid delivery system, demonstrating that the analytical design techniques can be experimentally verified by using digital controls as a tool. Digital control instrumentation and implementation are also demonstrated and documented for…

  5. Audit of the influence of body mass index on the performance of epidural analgesia in labour and the subsequent mode of delivery.

    Science.gov (United States)

    Dresner, M; Brocklesby, J; Bamber, J

    2006-10-01

    To assess the influence of body mass index (BMI) on the performance of epidural analgesia in labour and the subsequent mode of delivery. A retrospective audit of prospectively collected quality assurance data. The delivery suite of Leeds General Infirmary, Leeds, UK. This is a 4500-delivery teaching hospital unit. All women receiving epidural analgesia during labour in our unit between April 1997 and December 2005. Epidural recipients were divided into BMI groups according to World Health Organization (WHO) categories and compared for indices of epidural performance and mode of delivery. Midwife and patient satisfaction scores with epidural analgesia, epidural resite rates, and mode of delivery. Data from 13 299 epidural recipients were analysed. Using WHO definitions, 22.8% were of normal body mass, 41.9% were overweight, 31.9% obese, and 3.4% morbidly obese. Epidurals were more likely to fail as BMI increased, as judged by midwife satisfaction scores (P < 0.001) and epidural resite rates (P < 0.01). This trend was not seen for maternal satisfaction scores using the WHO BMI categories. However, if women with BMI below 30 kg/m2 were grouped together, a significant trend was found (P < 0.01). BMI had no influence on vaginal instrumental deliveries, but caesarean section rates rose from 11.5% in women of normal BMI to 29.2% in the morbidly obese women (P < 0.001). Obesity increases the incidence of analgesic failure and the need for resite of epidurals. The caesarean section rate among epidural recipients increases dramatically as BMI rises.

  6. Microfabrication for Drug Delivery

    Science.gov (United States)

    Koch, Brendan; Rubino, Ilaria; Quan, Fu-Shi; Yoo, Bongyoung; Choi, Hyo-Jick

    2016-01-01

    This review is devoted to discussing the application of microfabrication technologies to target challenges encountered in life processes by the development of drug delivery systems. Recently, microfabrication has been largely applied to solve health and pharmaceutical science issues. In particular, fabrication methods along with compatible materials have been successfully designed to produce multifunctional, highly effective drug delivery systems. Microfabrication offers unique tools that can tackle problems in this field, such as ease of mass production with high quality control and low cost, complexity of architecture design and a broad range of materials. Presented is an overview of silicon- and polymer-based fabrication methods that are key in the production of microfabricated drug delivery systems. Moreover, the efforts focused on studying the biocompatibility of materials used in microfabrication are analyzed. Finally, this review discusses representative ways microfabrication has been employed to develop systems delivering drugs through the transdermal and oral route, and to improve drug eluting implants. Additionally, microfabricated vaccine delivery systems are presented due to the great impact they can have in obtaining a cold chain-free vaccine, with long-term stability. Microfabrication will continue to offer new, alternative solutions for the development of smart, advanced drug delivery systems. PMID:28773770

  7. Advanced SLARette delivery machine

    International Nuclear Information System (INIS)

    Bodner, R.R.

    1995-01-01

    SLARette 1 equipment, comprising of a SLARette Delivery Machine, SLAR Tools, SLAR power supplies and SLAR Inspection Systems was designed, developed and manufactured to service fuel channels of CANDU 6 stations during the regular yearly station outages. The Mark 2 SLARette Delivery Machine uses a Push Tube system to provide the axial and rotary movements of the SLAR Tool. The Push Tubes are operated remotely but must be attached and removed manually. Since this operation is performed at the Reactor face, there is radiation dose involved for the workers. An Advanced SLARette Delivery Machine which incorporates a computer controlled telescoping Ram in the place of the Push Tubes has been recently designed and manufactured. Utilization of the Advanced SLARette Delivery Machine significantly reduces the amount of radiation dose picked up by the workers because the need to have workers at the face of the Reactor during the SLARette operation is greatly reduced. This paper describes the design, development and manufacturing process utilized to produce the Advanced SLARette Delivery Machine and the experience gained during the Gentilly-2 NGS Spring outage. (author)

  8. Advanced optical instruments technology

    Science.gov (United States)

    Shao, Mike; Chrisp, Michael; Cheng, Li-Jen; Eng, Sverre; Glavich, Thomas; Goad, Larry; Jones, Bill; Kaarat, Philip; Nein, Max; Robinson, William

    1992-08-01

    The science objectives for proposed NASA missions for the next decades push the state of the art in sensitivity and spatial resolution over a wide range of wavelengths, including the x-ray to the submillimeter. While some of the proposed missions are larger and more sensitive versions of familiar concepts, such as the next generation space telescope, others use concepts, common on the Earth, but new to space, such as optical interferometry, in order to provide spatial resolutions impossible with other concepts. However, despite their architecture, the performance of all of the proposed missions depends critically on the back-end instruments that process the collected energy to produce scientifically interesting outputs. The Advanced Optical Instruments Technology panel was chartered with defining technology development plans that would best improve optical instrument performance for future astrophysics missions. At this workshop the optical instrument was defined as the set of optical components that reimage the light from the telescope onto the detectors to provide information about the spatial, spectral, and polarization properties of the light. This definition was used to distinguish the optical instrument technology issues from those associated with the telescope, which were covered by a separate panel. The panel identified several areas for optical component technology development: diffraction gratings; tunable filters; interferometric beam combiners; optical materials; and fiber optics. The panel also determined that stray light suppression instruments, such as coronagraphs and nulling interferometers, were in need of general development to support future astrophysics needs.

  9. Problems with radiological surveillance instrumentation

    International Nuclear Information System (INIS)

    Swinth, K.L.; Tanner, J.E.; Fleming, D.M.

    1984-09-01

    Many radiological surveillance instruments are in use at DOE facilities throughout the country. These instruments are an essential part of all health physics programs, and poor instrument performance can increase program costs or compromise program effectiveness. Generic data from simple tests on newly purchased instruments shows that many instruments will not meet requirements due to manufacturing defects. In other cases, lack of consideration of instrument use has resulted in poor acceptance of instruments and poor reliability. The performance of instruments is highly variable for electronic and mechanical performance, radiation response, susceptibility to interferences and response to environmental factors. Poor instrument performance in these areas can lead to errors or poor accuracy in measurements

  10. Problems with radiological surveillance instrumentation

    International Nuclear Information System (INIS)

    Swinth, K.L.; Tanner, J.E.; Fleming, D.M.

    1985-01-01

    Many radiological surveillance instruments are in use at DOE facilities throughout the country. These instruments are an essential part of all health physics programs, and poor instrument performance can increase program costs or compromise program effectiveness. Generic data from simple tests on newly purchased instruments shows that many instruments will not meet requirements due to manufacturing defects. In other cases, lack of consideration of instrument use has resulted in poor acceptance of instruments and poor reliability. The performance of instruments is highly variable for electronic and mechanical performance, radiation response, susceptibility to interferences and response to environmental factors. Poor instrument performance in these areas can lead to errors or poor accuracy in measurements

  11. Collagen macromolecular drug delivery systems

    International Nuclear Information System (INIS)

    Gilbert, D.L.

    1988-01-01

    The objective of this study was to examine collagen for use as a macromolecular drug delivery system by determining the mechanism of release through a matrix. Collagen membranes varying in porosity, crosslinking density, structure and crosslinker were fabricated. Collagen characterized by infrared spectroscopy and solution viscosity was determined to be pure and native. The collagen membranes were determined to possess native vs. non-native quaternary structure and porous vs. dense aggregate membranes by electron microscopy. Collagen monolithic devices containing a model macromolecule (inulin) were fabricated. In vitro release rates were found to be linear with respect to t 1/2 and were affected by crosslinking density, crosslinker and structure. The biodegradation of the collagen matrix was also examined. In vivo biocompatibility, degradation and 14 C-inulin release rates were evaluated subcutaneously in rats

  12. MRI in ocular drug delivery

    OpenAIRE

    Li, S. Kevin; Lizak, Martin J.; Jeong, Eun-Kee

    2008-01-01

    Conventional pharmacokinetic methods for studying ocular drug delivery are invasive and cannot be conveniently applied to humans. The advancement of MRI technology has provided new opportunities in ocular drug-delivery research. MRI provides a means to non-invasively and continuously monitor ocular drug-delivery systems with a contrast agent or compound labeled with a contrast agent. It is a useful technique in pharmacokinetic studies, evaluation of drug-delivery methods, and drug-delivery de...

  13. Elective cesarean delivery for term breech

    DEFF Research Database (Denmark)

    Krebs, Lone; Langhoff-Roos, Jens

    2003-01-01

    and anemia (RR 0.91; 95% CI 0.84, 0.97), and operations for wound infection (RR 0.69; 95% CI 0.57, 0.83) than emergency cesarean delivery. There was a higher rate of puerperal fever and pelvic infection (RR 1.20; 95% CI 1.11, 1.25) than for vaginal delivery. Thromboembolic disease occurred in 0.1% of women......OBJECTIVE: To compare the maternal complications of elective cesarean delivery for breech at term with those after vaginal or emergency cesarean delivery. METHODS: We conducted a population-based, retrospective cohort study of 15441 primiparas who delivered singleton breech at term. Information...... was obtained from the Danish Medical Birth Register, the Register of Death Causes, and the Denmark Patient Register. RESULTS: Elective cesarean delivery was associated with lower rates of puerperal fever and pelvic infection (relative risk [RR] 0.81; 95% confidence interval [CI] 0.70, 0.92), hemorrhage...

  14. Monitoring and evaluation pilots Energy Box and Energy vouchers. Measuring the success rate of two instruments for energy saving in households; Monitoring en evaluatie pilots Energiebox en Energiebon. Succesmeting van twee instrumenten voor energiebesparing bij huishoudens

    Energy Technology Data Exchange (ETDEWEB)

    Groot, M.I.; Koot, M.C.M.; Schepers, B.L.; Wielders, L.M.L. [CE, Delft (Netherlands); Jungblut, P. [Blauw Research, Rotterdam (Netherlands)

    2007-06-15

    The Dutch government wants to incite energy saving behavior in households and increase the use of energy saving products. By means of the pilot projects of the Energy Box and the Energy Voucher the Dutch Ministry of Housing, Spatial Planning and the Environment wants to examine if these instruments can contribute to changing behavior and the corresponding CO2 reduction. This final report describes the results of the monitoring and evaluation study of the pilots with the aim of establishing how the actions are values in real life, which products are actually used and what the direct and indirect effects are of these actions on energy saving, CO2 reduction and changing behavior [mk]. [Dutch] De overheid wil Nederlandse huishoudens aanzetten tot energiebesparend gedrag en gebruik van energiebesparende producten. Met de uitgevoerde pilotprojecten van de Energiebox en de Energiebon wil het Ministerie van VROM onderzoeken of met deze instrumenten een bijdrage kan worden geleverd aan gedragsverandering en de daarmee samenhangende CO2-reductie. In deze eindrapportage worden de resultaten van de monitoring en evaluatiestudie van de pilots beschreven met als doel: Bepalen hoe de acties in de praktijk gewaardeerd worden, welke producten daadwerkelijk worden gebruikt en welk directe en indirecte effecten de acties hebben op energiebesparing, CO2-reductie en gedragsverandering.

  15. In-pile Instrumentation Development

    International Nuclear Information System (INIS)

    Vermeeren, L.

    2005-01-01

    Advanced irradiations in research reactors require the on-line monitoring of crucial parameters like neutron fluxes, gamma dose rates, central fuel rod temperatures, fission gas release pressures and small geometry changes. Our activities in this field aim at a detailed understanding of the sensor behaviour in the irradiation conditions in order to extract reliable real-time information. The objectives of work performed by SCK-CEN are to study of the on-line in-pile measurement of gamma and neutron fluxes in real time and to investigate parasitic radiation-induced signals in instrumentation cables

  16. Revisiting the mode of delivery and outcome of singleton breech ...

    African Journals Online (AJOL)

    There was an increased rate of special care baby unit admission in the group that had assisted vaginal breech delivery than in those that had elective caesarean section. There was no difference in terms of birth injury, neonatal death and maternal morbidities between those that had assisted vaginal breech delivery and ...

  17. Twin Delivery: Comparison of Incidence and Foetal Outcome in two ...

    African Journals Online (AJOL)

    Background: The incidence of twin delivery in Nigeria may have changed, in view of the worldwide increase in the rates of twinning attributed to increasing maternal age and use of fertility therapies. Objective: To determine the current incidence of twin delivery in Benin City and document the foetal outcome in twins.

  18. Varying gestational age patterns in cesarean delivery: An international comparison

    NARCIS (Netherlands)

    Delnord, M.; Blondel, B.; Drewniak, N.; Klungsøyr, K.; Bolumar, F.; Mohangoo, A.; Gissler, M.; Szamotulska, K.; Lack, N.; Nijhuis, J.; Velebil, P.; Sakkeus, L.; Chalmers, J.; Zeitlin, J.; Haidinger, G.; XMartens, G.; Misselwitz, B.; Wenzlaff, P.; Bonham, S.; Jaselioniene, J.; Gatt, M.; Klungsøyr, K.; Barros, H.; Novak, Z.; Gottvall, K.

    2014-01-01

    Background: While international variations in overall cesarean delivery rates are well documented, less information is available for clinical sub-groups. Cesarean data presented by subgroups can be used to evaluate uptake of cesarean reduction policies or to monitor delivery practices for high and

  19. 76 FR 59592 - Government Securities Act Regulations; Replacement of References to Credit Ratings and Technical...

    Science.gov (United States)

    2011-09-27

    ... creditworthiness of a security or money market instrument; and (2) any references to or requirements in such... or gross short position in money market instruments qualifying as Treasury market risk instruments...), that mature in 45 days or more, settled on a cash or delivery basis. Money market instruments...

  20. Human pavlovian-instrumental transfer.

    Science.gov (United States)

    Talmi, Deborah; Seymour, Ben; Dayan, Peter; Dolan, Raymond J

    2008-01-09

    The vigor with which a participant performs actions that produce valuable outcomes is subject to a complex set of motivational influences. Many of these are believed to involve the amygdala and the nucleus accumbens, which act as an interface between limbic and motor systems. One prominent class of influences is called pavlovian-instrumental transfer (PIT), in which the motivational characteristics of a predictor influence the vigor of an action with respect to which it is formally completely independent. We provide a demonstration of behavioral PIT in humans, with an audiovisual predictor of the noncontingent delivery of money inducing participants to perform more avidly an action involving squeezing a handgrip to earn money. Furthermore, using functional magnetic resonance imaging, we show that this enhanced motivation was associated with a trial-by-trial correlation with the blood oxygenation level-dependent (BOLD) signal in the nucleus accumbens and a subject-by-subject correlation with the BOLD signal in the amygdala. Our data dovetails well with the animal literature and sheds light on the neural control of vigor.

  1. Human Pavlovian–Instrumental Transfer

    Science.gov (United States)

    Talmi, Deborah; Seymour, Ben; Dayan, Peter; Dolan, Raymond J.

    2009-01-01

    The vigor with which a participant performs actions that produce valuable outcomes is subject to a complex set of motivational influences. Many of these are believed to involve the amygdala and the nucleus accumbens, which act as an interface between limbic and motor systems. One prominent class of influences is called pavlovian–instrumental transfer (PIT), in which the motivational characteristics of a predictor influence the vigor of an action with respect to which it is formally completely independent. We provide a demonstration of behavioral PIT in humans, with an audiovisual predictor of the noncontingent delivery of money inducing participants to perform more avidly an action involving squeezing a handgrip to earn money. Furthermore, using functional magnetic resonance imaging, we show that this enhanced motivation was associated with a trial-by-trial correlation with the blood oxygenation level-dependent (BOLD) signal in the nucleus accumbens and a subject-by-subject correlation with the BOLD signal in the amygdala. Our data dovetails well with the animal literature and sheds light on the neural control of vigor. PMID:18184778

  2. [Methods of pushing at vaginal delivery and pelvi-perineal consequences. Review].

    Science.gov (United States)

    Ratier, N; Balenbois, E; Letouzey, V; Marès, P; de Tayrac, R

    2015-03-01

    The main objective of that review was to evaluate the pelvi-perineal consequences of the different methods of pushing at vaginal delivery. A review on PubMed, the Cochrane Library and EM-Premium was performed from 1984 to 2014. Among 29 manuscripts analysed, only nine randomised controlled trials (including one meta-analysis of three trials) comparing Valsalva and spontaneous pushing were selected. A 10 th study, secondary analysis of a randomized controlled trial comparing different methods of perineal protection (warm compresses, massage and manual protection), was also selected. Two trials have shown that spontaneous pushing reduces the risk of perineal tears, but studies were heterogeneous and discordant results do not allowed definitive conclusions. Results on the duration of the second stage of labour are conflicting. The method of pushing does not seem to affect the rate of episiotomy, instrumental delivery and cesarean section. Maternal satisfaction seems to be better after spontaneous pushing. It seems that there is no negative effect of spontaneous pushing on neonate well-being, and one study has shown a significant improvement of prenatal fetal parameters during the expulsive phase. According to current knowledge, both techniques of pushing during the expulsive phase at delivery seem comparable in terms of duration, risk of perineal tears and neonatal outcome. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  3. Some emergency instrumentation

    Energy Technology Data Exchange (ETDEWEB)

    Burgess, P H

    1986-10-01

    The widespread release of activity and the resultant spread of contamination after the Chernobyl accident resulted in requests to NRPB to provide instruments for, and expertise in, the measurement of radiation. The most common request was for advice on the usefulness of existing instruments, but Board staff were also involved in their adaptation or in the development of new instruments specially to meet the circumstances of the accident. The accident occurred on 26 April. On 1 May, NRPB was involved at Heathrow Airport in the monitoring of the British students who had returned from Kiev and Minsk. The main purpose was to reassure the students by checking that their persons and belongings did not have significant surface contamination. Additional measurements were also made of iodine activity in thyroid using hand-held detectors or a mobile body monitor. This operation was arranged with the Foreign and Commonwealth Office, which had also received numerous requests for instruments from embassies and consulates in countries close to the scene of the accident. There was concern for the well-being of staff and other United Kingdom nationals who resided in or intended to visit the most affected countries. The board supplied suitable instruments, and the FCO distributed them to embassies. The frequency of environmental monitoring was increased from 29 April in anticipation of contamination and appropriate Board instrumentation was deployed. After the Chernobyl cloud arrived in the UK on 2 May, there were numerous requests from local government, public authorities, private companies and members of the public for information and advice on monitoring equipment and procedures. Some of these requirements could be met with existing equipment but members of the public were usually advised not to proceed. At a later stage, the contamination of foodstuffs and livestock required the development of an instrument capable of detecting low levels of {sup 137}Cs and {sup 134}Cs in food

  4. Reduction of treatment delivery variances with a computer-controlled treatment delivery system

    International Nuclear Information System (INIS)

    Fraass, B.A.; Lash, K.L.; Matrone, G.M.; Lichter, A.S.

    1997-01-01

    does not depend on fixed therapist staff on particular machines. Results: The overall reported variance rate (all treatments, machines) was < 0.1 % per port or 0.33 % per treatment session. The rate (per machine) depended on automation and plan complexity (see table). Machine M4 (most complex plans and most automation) had the lowest variance rate. The variance rate decreased with increasing automation in spite of increasing plan complexity, while for the manual machines the variance rate increased with complexity. Note that the real variance rates on the two manual machines must be higher than shown here, while (particularly on M4) virtually all random treatment delivery errors were noted by the CCRS system and its QA checks. Treatment delivery times averaged from 14 to 23 minutes per plan, and depended on ports/plan, although this analysis is complicated by other factors. Conclusion: Use of a sophisticated computer-controlled delivery system for routine patient treatments with complex 3-D conformal plans has led to a significant decrease in treatment delivery variances, while at the same time allowing delivery of increasingly complex and sophisticated conformal plans without a significant increase in treatment time. With renewed vigilance for the possibility of systematic problems, it is clear that use of complete and integrated computer-controlled delivery systems can provide significant improvements in treatment delivery, since better plans can be delivered with significantly fewer errors, and without significantly increasing treatment time

  5. Reactor instrumentation and control

    International Nuclear Information System (INIS)

    Wach, D.; Beraha, D.

    1980-01-01

    The methods for measuring radiation are shortly reviewed. The instrumentation for neutron flux measurement is classified into out-of-core and in-core instrumentation. The out-of-core instrumentation monitors the operational range from the subcritical reactor to full power. This large range is covered by several measurement channels which derive their signals from counter tubes and ionization chambers. The in-core instrumentation provides more detailed information on the power distribution in the core. The self-powered neutron detectors and the aeroball system in PWR reactors are discussed. Temperature and pressure measurement devices are briefly discussed. The different methods for leak detection are described. In concluding the plant instrumentation part some new monitoring systems and analysis methods are presented: early failure detection methods by noise analysis, acoustic monitoring and vibration monitoring. The presentation of the control starts from an qualitative assessment of the reactor dynamics. The chosen control strategy leads to the definition of the part-load diagram, which provides the set-points for the different control systems. The tasks and the functions of these control systems are described. In additiion to the control, a number of limiting systems is employed to keep the reactor in a safe operating region. Finally, an outlook is given on future developments in control, concerning mainly the increased application of process computers. (orig./RW)

  6. Instrumental analysis, second edition

    International Nuclear Information System (INIS)

    Christian, G.D.; O'Reilly, J.E.

    1988-01-01

    The second edition of Instrumental Analysis is a survey of the major instrument-based methods of chemical analysis. It appears to be aimed at undergraduates but would be equally useful in a graduate course. The volume explores all of the classical quantitative methods and contains sections on techniques that usually are not included in a semester course in instrumentation (such as electron spectroscopy and the kinetic methods). Adequate coverage of all of the methods contained in this book would require several semesters of focused study. The 25 chapters were written by different authors, yet the style throughout the book is more uniform than in the earlier edition. With the exception of a two-chapter course in analog and digital circuits, the book purports to de-emphasize instrumentation, focusing more on the theory behind the methods and the application of the methods to analytical problems. However, a detailed analysis of the instruments used in each method is by no means absent. The book has the favor of a user's guide to analysis

  7. Ethical issues in cesarean delivery.

    Science.gov (United States)

    Chervenak, Frank A; McCullough, Laurence B

    2017-08-01

    Cesarean delivery is the most common and important surgical intervention in obstetric practice. Ethics provides essential guidance to obstetricians for offering, recommending, recommending against, and performing cesarean delivery. This chapter provides an ethical framework based on the professional responsibility model of obstetric ethics. This framework is then used to address two especially ethically challenging clinical topics in cesarean delivery: patient-choice cesarean delivery and trial of labor after cesarean delivery. This chapter emphasizes a preventive ethics approach, designed to prevent ethical conflict in clinical practice. To achieve this goal, a preventive ethics approach uses the informed consent process to offer cesarean delivery as a medically reasonable alternative to vaginal delivery, to recommend cesarean delivery, and to recommend against cesarean delivery. The limited role of shared decision making is also described. The professional responsibility model of obstetric ethics guides this multi-faceted preventive ethics approach. Copyright © 2017. Published by Elsevier Ltd.

  8. Use of the theory of recognition of patterns in developing methane metering equipment for blow-out-dangerous mines. [Instrument recognizes rate of change of methane concentration and, if dangerous, shuts off electrical equipment

    Energy Technology Data Exchange (ETDEWEB)

    Medvedev, V N

    1978-01-01

    In the most general form, the existing methane-metering equipment which issues command signals when the maximum permissible value of methane concentration has been reached can be viewed as a recognition system. The algorithm for operation on the principle of evaluating the degree of blow-out danger of the ore atmosphere stipulates the recognition of two situations: 1) ''not dangerous ''(methane concentration below maximum permissible value); 2) ''dangerous'' (disorders in technological process; methane concentration above maximum permissible value). This approach for constructing means for gas protection is optimal only for mines working beds which are not dangerous for sudden blow-outs. However, if we ''train'' the apparatus to recognize what was the reason for increase in methane concentration, ways are afforded for solving the problem of creating an effective methane-metering equipment for mines with sudden blow-outs. Gas-dynamic processes with sudden blow-outs can be distinguished from standard technological, in particular, according to the rate in increase in methane concentration. On this basis, functional plan is proposed for constructing the automatic gas protection for explosiondangerous mines which includes a primary measurement of methane concentration, block of concentration control, block of process recognition, block of command signals, block of information delay, block of measuring the rate of methane concentration, threshold device for the rate of increase in concentration.

  9. House of Commons No 2027. Proposal of law aiming at applying the reduced AVT rate to the selling and delivery of electricity, gas and fuel oil for domestic space heating use

    International Nuclear Information System (INIS)

    Nicolin, Y.

    2005-01-01

    The aim of this proposal is to apply the same 5.5% reduced added value tax to all energy sources when used for domestic space heating. This reduce tax rate is today only applied to wood wastes and products. (J.S.)

  10. [Postpartum urinary and fecal incontinence in gemelar pregnancy according to route and mode of delivery].

    Science.gov (United States)

    Cuerva González, Marcos Javier; López Carpintero, Nayara; de la Calle Fernández, Miranda María; Usandizaga, Ramón; González, Antonio

    2011-09-01

    The incidence of multiple pregnancies increased in the last two decades. Several studies seeking the incidence of pelvic floor pathology, particularly urinary incontinence and its risk factors, conclude that a previous cesarean and vaginal delivery even more, carry an increased risk for developing urinary and fecal incontinence, compared with patients nulligravida. To determine the different risk factors for urinary incontinence after a twin pregnancy. 331 women from 20 to 50 years of age without symptoms prior to pregnancy were interviewed, attending antenatal care of twin pregnancy in the Hospital La Paz, Madrid. The interview included the ICIQ-SF (International Consultation on Incontinence Questionnaire-Short Form). We recorded maternal age, gestational age, parity, episiotomy, weights of both newborns, the need for urinary protectors and fecal or gas incontinence. The prevalence of urinary incontinence postpartum according ICIQ-SF >0 was 23%; 20.4% in the caesarean group, 25.3% in the eutocic delivery group and 35.5% in the instrumental delivery group (p = 0.033). The prevalence of moderate to severe incontinence (ICIQ-SF >6) was 14.8%; 12.3% in caesarean group, 14.5% in the eutocic delivery group and 32.3% in the instrumental delivery group (p = 0.005). The prevalence of fecal incontinence was 3.4%; 4.8% in eutocic delivery group, 1.9% in the caesarean group and 9.7% in the instrumental delivery group (p = 0.058). The risk of urinary incontinence after a twin pregnancy was higher among patients who had an instrumental delivery when compared with patients with eutocic delivery or cesarean section. The total fetal weight and maternal age did not appear as risk factors in our study. Any woman who had an instrumental delivery for twins should be followed up by a pelvic floor specialist.

  11. Development of an EDV-supported decision instrument for site pre-selection of nuclear power plants. EDV-supported instrument for calculation of the space distribution of the collective dose rate and area contamination. Vol. 1. Radiation exposure through air- and water paths under authorized operating conditions and during incidents

    Energy Technology Data Exchange (ETDEWEB)

    Bruessermann, K; Eschhaus, M; Kreymborg, A; Muenster, M; Schommer, N

    1980-01-01

    The collective dose rate and the area contamination form a basis for site criteria going beyond the individual considerations of distribution of the population, hydrology, meteorology etc. The possibilities of radio-ecological models on the radiation exposure through air- and water paths during operation and incidents are described by example of Biblis, Muelheim-Kaerlich and Esensham. Comparative evaluations were effected for Fessenheim.

  12. Biochemistry Instrumentation Core Technology Center

    Data.gov (United States)

    Federal Laboratory Consortium — The UCLA-DOE Biochemistry Instrumentation Core Facility provides the UCLA biochemistry community with easy access to sophisticated instrumentation for a wide variety...

  13. Heat Flux Instrumentation Laboratory (HFIL)

    Data.gov (United States)

    Federal Laboratory Consortium — Description: The Heat Flux Instrumentation Laboratory is used to develop advanced, flexible, thin film gauge instrumentation for the Air Force Research Laboratory....

  14. Health Care Delivery.

    Science.gov (United States)

    Starfield, Barbara

    1987-01-01

    The article reviews emerging health care delivery options for handicapped children. Cost structures, quality of care, and future prospects are considered for Health Maintenance Organizations, Preferred Provider Organizations, Tax Supported Direct Service Programs, Hospital-Based Services, and Ambulatory Care Organizations. (Author/DB)

  15. Drug delivery and formulations.

    Science.gov (United States)

    Breitkreutz, Jörg; Boos, Joachim

    2011-01-01

    Paediatric drug delivery is a major challenge in drug development. Because of the heterogeneous nature of the patient group, ranging from newborns to adolescents, there is a need to use appropriate excipients, drug dosage forms and delivery devices for different age groups. So far, there is a lack of suitable and safe drug formulations for children, especially for the very young and seriously ill patients. The new EU legislation will enforce paediatric clinical trials and drug development. Current advances in paediatric drug delivery include interesting new concepts such as fast-dissolving drug formulations, including orodispersible tablets and oral thin strips (buccal wafers), and multiparticulate dosage forms based on mini-tabletting or pelletization technologies. Parenteral administration is likely to remain the first choice for children in the neonatal period and for emergency cases. Alternative routes of administration include transdermal, pulmonary and nasal drug delivery systems. A few products are already available on the market, but others still need further investigations and clinical proof of concept.

  16. Drug delivery through microneedles

    NARCIS (Netherlands)

    Luttge, R.; Dietzel, A.

    2016-01-01

    Drug delivery through microneedles is a new form of a pharmaceutical dosage system. While single microneedles have been clinically applied already, the out-of-plane integration of a multitude of microneedles in a pharmaceutical patch is a disruptive technology. To take advantage of micro- and

  17. A Medical Delivery Device

    DEFF Research Database (Denmark)

    2010-01-01

    The present invention relates to a medical delivery device comprising at least two membrane electrode assembly units each of which comprises three layers: an upper and a lower electrode and a selective ionic conductive membrane provided there-between. At least one of the three layers are shared...

  18. Global Delivery Models

    DEFF Research Database (Denmark)

    Manning, Stephan; Møller Larsen, Marcus; Bharati, Pratyush M.

    2015-01-01

    antecedents and contingencies of setting up GDM structures. Based on comprehensive data we show that providers are likely to establish GDM location configurations when clients value access to globally distributed talent and speed of service delivery, in particular when services are highly commoditized...

  19. Characteristics of protective instrumentation

    International Nuclear Information System (INIS)

    Reichart, G.

    1982-01-01

    Protective Instrumentation (PI) for Nuclear Power Plants (NPP) is a general term for an highly reliable instrumentation, which provides information for keeping the system within safe limits, for initation of countermeasures in the case of an incident or for mitigation of consequences of an accident. In German NPPs one can find a hierarchical structure of protective instrumentation, wherein the Reactor Protection System (RPS) has the highest priority. To meet the reliability requirements different design principles are used, like - redundancy - diversity - fail safe - decoupling. The presentation gives an overview about the different design principles and characterizes their reliability aspects. As an example for the technical realization the RPS of a German NPP is discussed in some detail. Furthermore some information about other type of PI is given and reliability aspects of the interaction of operating personell with these systems are mentioned. (orig.)

  20. The IKARUS instrument

    International Nuclear Information System (INIS)

    Gerster, H.J.; Stein, G.

    1994-01-01

    When the Federal Government decided on a 25% reduction of CO 2 emissions till 2005 in 1990 the necessity resulted that an instrument has to be developed for the analysis and assessment of the ecological, economic and energetic impact of different reduction strategies. The development task was awarded by the BMFT to the Research Centre Juelich in cooperation with well-known institutions of energy system research. The total instrument is scheduled to be finished by the end of 1994. For the decentral use of the instrument by a wide specialist public the developed models and data banks which are equipped with a user-friendly surface are suited for larger PCs (486, 16 MB RAM/500-1000 MB ROM). (orig.) [de

  1. ISSUERS OF FINANCIAL INSTRUMENTS

    Directory of Open Access Journals (Sweden)

    Cristian GHEORGHE

    2016-05-01

    Full Text Available The rules laid down by Romanian Capital Market Law and the regulations put in force for its implementation apply to issuers of financial instruments admitted to trading on the regulated market established in Romania. But the issuers remain companies incorporated under Company Law of 1990. Such dual regulations need increased attention in order to observe the legal status of the issuers/companies and financial instruments/shares. Romanian legislator has chosen to implement in Capital Market Law special rules regarding the administration of the issuers of financial instruments, not only rules regarding admitting and maintaining to a regulated market. Thus issuers are, in Romanian Law perspective, special company that should comply special rule regarding board of administration and general shareholders meeting.

  2. Virtual Sensor Test Instrumentation

    Science.gov (United States)

    Wang, Roy

    2011-01-01

    Virtual Sensor Test Instrumentation is based on the concept of smart sensor technology for testing with intelligence needed to perform sell-diagnosis of health, and to participate in a hierarchy of health determination at sensor, process, and system levels. A virtual sensor test instrumentation consists of five elements: (1) a common sensor interface, (2) microprocessor, (3) wireless interface, (4) signal conditioning and ADC/DAC (analog-to-digital conversion/ digital-to-analog conversion), and (5) onboard EEPROM (electrically erasable programmable read-only memory) for metadata storage and executable software to create powerful, scalable, reconfigurable, and reliable embedded and distributed test instruments. In order to maximize the efficient data conversion through the smart sensor node, plug-and-play functionality is required to interface with traditional sensors to enhance their identity and capabilities for data processing and communications. Virtual sensor test instrumentation can be accessible wirelessly via a Network Capable Application Processor (NCAP) or a Smart Transducer Interlace Module (STIM) that may be managed under real-time rule engines for mission-critical applications. The transducer senses the physical quantity being measured and converts it into an electrical signal. The signal is fed to an A/D converter, and is ready for use by the processor to execute functional transformation based on the sensor characteristics stored in a Transducer Electronic Data Sheet (TEDS). Virtual sensor test instrumentation is built upon an open-system architecture with standardized protocol modules/stacks to interface with industry standards and commonly used software. One major benefit for deploying the virtual sensor test instrumentation is the ability, through a plug-and-play common interface, to convert raw sensor data in either analog or digital form, to an IEEE 1451 standard-based smart sensor, which has instructions to program sensors for a wide variety of

  3. Monetary Policy Instruments and Bank Risks in China

    OpenAIRE

    Zhongyuan Geng; Xue Zhai

    2013-01-01

    The authors use a panel data regression model to examine the effects of main monetary policy instruments on commercial bank risks in China from 1998 to 2011. The interest rate has a positive effect on bank risk while the interest rate margin, the reserve requirement ratio and open market operation have a negative effect. Among the three monetary policy instruments, the reserve requirement ratio has the greatest effect on bank risk, the interest rate (the interest rate margin) the second large...

  4. ICFA: Instrumentation school

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1987-10-15

    74 students, including 45 from developing countries, ten lecturers and nine laboratory instructors participated in the novel instrumentation school held in June at the International Centre for Theoretical Physics (ICTP), Trieste, Italy, sponsored by ICTP and arranged through the Instrumentation Panel of the International Committee for Future Accelerators (ICF). During the two weeks of the course, students had the chance to construct and test a proportional chamber, measure the lifetime of cosmic ray muons, operate and analyse the performance of an 8-wire imaging drift chamber, or study noise and signal processing using a silicon photodiode.

  5. Interfacing to accelerator instrumentation

    International Nuclear Information System (INIS)

    Shea, T.J.

    1995-01-01

    As the sensory system for an accelerator, the beam instrumentation provides a tremendous amount of diagnostic information. Access to this information can vary from periodic spot checks by operators to high bandwidth data acquisition during studies. In this paper, example applications will illustrate the requirements on interfaces between the control system and the instrumentation hardware. A survey of the major accelerator facilities will identify the most popular interface standards. The impact of developments such as isochronous protocols and embedded digital signal processing will also be discussed

  6. Spectroelectrochemical Instrument Measures TOC

    Science.gov (United States)

    Kounaves, Sam

    2011-01-01

    A spectroelectrochemical instrument has been developed for measuring the total organic carbon (TOC) content of an aqueous solution. Measurements of TOC are frequently performed in environmental, clinical, and industrial settings. Until now, techniques for performing such measurements have included, various ly, the use of hazardous reagents, ultraviolet light, or ovens, to promote reactions in which the carbon contents are oxidized. The instrument now being developed is intended to be a safer, more economical means of oxidizing organic carbon and determining the TOC levels of aqueous solutions and for providing a low power/mass unit for use in planetary missions.

  7. Neutron multiplication measurement instrument

    International Nuclear Information System (INIS)

    Nixon, K.V.; Dowdy, E.J.; France, S.W.; Millegan, D.R.; Robba, A.A.

    1983-01-01

    The Advanced Nuclear Technology Group of the Los Alamos National Laboratory is now using intelligent data-acquisition and analysis instrumentation for determining the multiplication of nuclear material. Earlier instrumentation, such as the large NIM-crate systems, depended on house power and required additional computation to determine multiplication or to estimate error. The portable, battery-powered multiplication measurement unit, with advanced computational power, acquires data, calculates multiplication, and completes error analysis automatically. Thus, the multiplication is determined easily and an available error estimate enables the user to judge the significance of results

  8. Standard NIM instrumentation system

    International Nuclear Information System (INIS)

    1990-05-01

    NIM is a standard modular instrumentation system that is in wide use throughout the world. As the NIM system developed and accommodations were made to a dynamic instrumentation field and a rapidly advancing technology, additions, revisions and clarifications were made. These were incorporated into the standard in the form of addenda and errata. This standard is a revision of the NIM document, AEC Report TID-20893 (Rev. 4) dated July 1974. It includes all the addenda and errata items that were previously issued as well as numerous additional items to make the standard current with modern technology and manufacturing practice

  9. Virtual Reality Musical Instruments

    DEFF Research Database (Denmark)

    Serafin, Stefania; Erkut, Cumhur; Kojs, Juraj

    2016-01-01

    The rapid development and availability of low-cost technologies have created a wide interest in virtual reality. In the field of computer music, the term “virtual musical instruments” has been used for a long time to describe software simulations, extensions of existing musical instruments......, and ways to control them with new interfaces for musical expression. Virtual reality musical instruments (VRMIs) that include a simulated visual component delivered via a head-mounted display or other forms of immersive visualization have not yet received much attention. In this article, we present a field...

  10. ICFA: Instrumentation school

    International Nuclear Information System (INIS)

    Anon.

    1987-01-01

    74 students, including 45 from developing countries, ten lecturers and nine laboratory instructors participated in the novel instrumentation school held in June at the International Centre for Theoretical Physics (ICTP), Trieste, Italy, sponsored by ICTP and arranged through the Instrumentation Panel of the International Committee for Future Accelerators (ICF). During the two weeks of the course, students had the chance to construct and test a proportional chamber, measure the lifetime of cosmic ray muons, operate and analyse the performance of an 8-wire imaging drift chamber, or study noise and signal processing using a silicon photodiode

  11. Instrumentation Cables Test Plan

    Energy Technology Data Exchange (ETDEWEB)

    Muna, Alice Baca [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); LaFleur, Chris Bensdotter [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2016-10-01

    A fire at a nuclear power plant (NPP) has the potential to damage structures, systems, and components important to safety, if not promptly detected and suppressed. At Browns Ferry Nuclear Power Plant on March 22, 1975, a fire in the reactor building damaged electrical power and control systems. Damage to instrumentation cables impeded the function of both normal and standby reactor coolant systems, and degraded the operators’ plant monitoring capability. This event resulted in additional NRC involvement with utilities to ensure that NPPs are properly protected from fire as intended by the NRC principle design criteria (i.e., general design criteria 3, Fire Protection). Current guidance and methods for both deterministic and performance based approaches typically make conservative (bounding) assumptions regarding the fire-induced failure modes of instrumentation cables and those failure modes effects on component and system response. Numerous fire testing programs have been conducted in the past to evaluate the failure modes and effects of electrical cables exposed to severe thermal conditions. However, that testing has primarily focused on control circuits with only a limited number of tests performed on instrumentation circuits. In 2001, the Nuclear Energy Institute (NEI) and the Electric Power Research Institute (EPRI) conducted a series of cable fire tests designed to address specific aspects of the cable failure and circuit fault issues of concern1. The NRC was invited to observe and participate in that program. The NRC sponsored Sandia National Laboratories to support this participation, whom among other things, added a 4-20 mA instrumentation circuit and instrumentation cabling to six of the tests. Although limited, one insight drawn from those instrumentation circuits tests was that the failure characteristics appeared to depend on the cable insulation material. The results showed that for thermoset insulated cables, the instrument reading tended to drift

  12. Celadon Figurines Play Instruments

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    This group of figurines, each 0.15m tall, were unearthed from a Tang Dynasty tomb in Changsha in 1977. Music was very developed in the Tang Dynasty. Colorful musical instruments and dances were popular both among the people and in the palace. These vivid-looking figurines wear pleated skirts with small sleeves and open chest, a style influenced by the non-Han nationalities living in the north and west of China. Some of the musical instruments were brought from the Western Regions. The figurines are playing the xiao (a vertical bamboo flute), the konghou (an

  13. Inspector-instrument interface in portable NDA instrumentation

    International Nuclear Information System (INIS)

    Halbig, J.K.; Klosterbuer, S.F.

    1981-01-01

    Recent electronics technology advances make it possible to design sophisticated instruments in small packages for convenient field implementation. An inspector-instrument interface design that allows communication of procedures, responses, and results between the instrument and user is presented. This capability has been incorporated into new spent-fuel instrumentation and a battery-powered multichannel analyzer

  14. Inspector-instrument interface in portable NDA instrumentation

    International Nuclear Information System (INIS)

    Halbig, J.K.; Klosterbuer, S.F.

    1981-01-01

    Recent electronics technology advances make it possible to design sophisticated instruments in small packages for convenient field implementation. This report describes an inspector-instrument interface design which allows communication of procedures, responses, and results between the instrument and user. The interface has been incorporated into new spent-fuel instrumentation and a battery-powered multichannel analyzer

  15. Factors associated with institutional delivery in Dangila district, North ...

    African Journals Online (AJOL)

    Introduction: Childbirth in a health institution has been shown to be associated with lower rates of maternal and neonatal mortality. However ..... seling services on the benefit of institutional delivery ... housewives, due to their outdoor exposure.

  16. Self-nanoemulsifying drug delivery systems for oral insulin delivery

    DEFF Research Database (Denmark)

    Li, Ping; Tan, Angel; Prestidge, Clive A

    2014-01-01

    This study aims at evaluating the combination of self-nanoemulsifying drug delivery systems (SNEDDS) and enteric-coated capsules as a potential delivery strategy for oral delivery of insulin. The SNEDDS preconcentrates, loaded with insulin-phospholipid complex at different levels (0, 2.5 and 10% w...

  17. Power station instrumentation

    International Nuclear Information System (INIS)

    Jervis, M.W.

    1993-01-01

    Power stations are characterized by a wide variety of mechanical and electrical plant operating with structures, liquids and gases working at high pressures and temperatures and with large mass flows. The voltages and currents are also the highest that occur in most industries. In order to achieve maximum economy, the plant is operated with relatively small margins from conditions that can cause rapid plant damage, safety implications, and very high financial penalties. In common with other process industries, power stations depend heavily on control and instrumentation. These systems have become particularly significant, in the cost-conscious privatized environment, for providing the means to implement the automation implicit in maintaining safety standards, improving generation efficiency and reducing operating manpower costs. This book is for professional instrumentation engineers who need to known about their use in power stations and power station engineers requiring information about the principles and choice of instrumentation available. There are 8 chapters; chapter 4 on instrumentation for nuclear steam supply systems is indexed separately. (Author)

  18. University Reactor Instrumentation Program

    International Nuclear Information System (INIS)

    Vernetson, W.G.

    1992-11-01

    Recognizing that the University Reactor Instrumentation Program was developed in response to widespread needs in the academic community for modernization and improvement of research and training reactors at institutions such as the University of Florida, the items proposed to be supported by this grant over its two year period have been selected as those most likely to reduce foreed outages, to meet regulatory concerns that had been expressed in recent years by Nuclear Regulatory Commission inspectors or to correct other facility problems and limitations. Department of Energy Grant Number DE-FG07-90ER129969 was provided to the University of Florida Training Reactor(UFTR) facility through the US Department of Energy's University Reactor Instrumentation Program. The original proposal submitted in February, 1990 requested support for UFTR facility instrumentation and equipment upgrades for seven items in the amount of $107,530 with $13,800 of this amount to be the subject of cost sharing by the University of Florida and $93,730 requested as support from the Department of Energy. A breakdown of the items requested and total cost for the proposed UFTR facility instrumentation and equipment improvements is presented

  19. Neutron instrumentation for biology

    Energy Technology Data Exchange (ETDEWEB)

    Mason, S.A. [Institut Laue-Langevin, Grenoble (France)

    1994-12-31

    In the October 1994 round of proposals at the ILL, the external biology review sub- committee was asked to allocate neutron beam time to a wide range of experiments, on almost half the total number of scheduled neutron instruments: on 3 diffractometers, on 3 small angle scattering instruments, and on some 6 inelastic scattering spectrometers. In the 3.5 years since the temporary reactor shutdown, the ILL`s management structure has been optimized, budgets and staff have been trimmed, the ILL reactor has been re-built, and many of the instruments up-graded, many powerful (mainly Unix) workstations have been introduced, and the neighboring European Synchrotron Radiation Facility has established itself as the leading synchrotron radiation source and has started its official user program. The ILL reactor remains the world`s most intense dedicated neutron source. In this challenging context, it is of interest to review briefly the park of ILL instruments used to study the structure and energetics of small and large biological systems. A brief summary will be made of each class of experiments actually proposed in the latest ILL proposal round.

  20. The ozone monitoring instrument

    NARCIS (Netherlands)

    Levelt, P.F.; Oord, G.H.J. van den; Dobber, M.R.; Mälkki, A.; Visser, H.; Vries, J. de; Stammes, P.; Lundell, J.O.V.; Saari, H.

    2006-01-01

    The Ozone Monitoring Instrument (OMI) flies on the National Aeronautics and Space Adminsitration's Earth Observing System Aura satellite launched in July 2004. OMI is a ultraviolet/visible (UV/VIS) nadir solar backscatter spectrometer, which provides nearly global coverage in one day with a spatial

  1. Economic Policy Instruments

    DEFF Research Database (Denmark)

    Klemmensen, Børge

    2007-01-01

    Økonomiske instrumenter begrundes med behovet for politiske indgreb, der muliggør internaliseringen af omkostningerne ved de miljøpåvirkninger, produktion and levevis afstedkommer, således at hensyntagen til miljøet bliver en del af virksomheders og husholdningers omkostninger og dermed en tilsky...

  2. Radiometric well logging instruments

    International Nuclear Information System (INIS)

    Davydov, A.V.

    1975-01-01

    The technical properties of well instruments for radioactive logging used in the radiometric logging complexes PKS-1000-1 (''Sond-1'') and PRKS-2 (''Vitok-2'') are described. The main features of the electric circuit of the measuring channels are given

  3. Advanced instrumentation and teleoperation

    International Nuclear Information System (INIS)

    Decreton, M.

    1998-01-01

    SCK-CEN's advanced instrumentation and teleoperation project aims at evaluating the potential of a telerobotic approach in a nuclear environment and, in particular, the use of remote-perception systems. Main achievements in 1997 in the areas of R and D on radiation tolerance for remote sensing, optical fibres and optical-fibre sensors, and computer-aided teleoperation are reported

  4. Health physics instrumentation needs

    International Nuclear Information System (INIS)

    Selby, J.M.; Swinth, K.L.; Kenoyer, J.L.

    1984-10-01

    Deficiencies and desirable improvements can be identified in every technical area in which health physics instruments are employed. The needed improvements cover the full spectrum including long-term reliability, human factors, accuracy, ruggedness, ease of calibration, improved radiation response, and improved mixed field response. Some specific areas of deficiency noted along with needed improvements. 17 references

  5. Virtual reality musical instruments

    DEFF Research Database (Denmark)

    Serafin, Stefania; Erkut, Cumhur; Kojs, Juraj

    2016-01-01

    The rapid development and availability of low cost technologies has created a wide interest in virtual reality (VR), but how to design and evaluate multisensory interactions in VR remains as a challenge. In this paper, we focus on virtual reality musical instruments, present an overview of our...

  6. Creating a Super Instrument

    DEFF Research Database (Denmark)

    Kallionpää, Maria; Gasselseder, Hans-Peter

    2015-01-01

    Thanks to the development of new technology, musical instruments are no more tied to their existing acoustic or technical limitations as almost all parameters can be augmented or modified in real time. An increasing number of composers, performers, and computer programmers have thus become intere...

  7. CMO Site: Ocean Instrumentation

    Science.gov (United States)

    1997-02-01

    Precipitation , Lightning, Visibility 0150 A InterOcea Hawser Strain 1.. systems, inc. and more... n 1946 3540 aero court san diego ca 92123-1799 usa phone: (619...AGU’s Microgal culture Association, P.O. Box 1004, April 8-10, 1997-Underwater Gravimetry : Instruments, Observa- Niland, CA 92257; (619) 359-3474

  8. Instrumentation in thermoluminescence dosimetry

    International Nuclear Information System (INIS)

    Julius, H.W.

    1986-01-01

    In the performance of a thermoluminescence dosimetry (TLD) system the equipment plays an important role. Crucial parameters of instrumentation in TLD are discussed in some detail. A review is given of equipment available on the market today - with some emphasis on automation - which is partly based on information from industry and others involved in research and development. (author)

  9. Ion chamber instrument

    International Nuclear Information System (INIS)

    Stephan, D.H.

    1975-01-01

    An electrical ionization chamber is described having a self-supporting wall of cellular material which is of uniform areal density and formed of material, such as foamed polystyrene, having an average effective atomic number between about 4 and about 9, and easily replaceable when on the instrument. (auth)

  10. Integrating Nephelometer Instrument Handbook

    Energy Technology Data Exchange (ETDEWEB)

    Uin, J. [Brookhaven National Lab. (BNL), Upton, NY (United States)

    2016-03-01

    The Integrating Nephelometer (Figure 1) is an instrument that measures aerosol light scattering. It measures aerosol optical scattering properties by detecting (with a wide angular integration – from 7 to 170°) the light scattered by the aerosol and subtracting the light scattered by the carrier gas, the instrument walls and the background noise in the detector (zeroing). Zeroing is typically performed for 5 minutes every day at midnight UTC. The scattered light is split into red (700 nm), green (550 nm), and blue (450 nm) wavelengths and captured by three photomultiplier tubes. The instrument can measure total scatter as well as backscatter only (from 90 to 170°) (Heintzenberg and Charlson 1996; Anderson et al. 1996; Anderson and Ogren 1998; TSI 3563 2015) At ARM (Atmospheric Radiation Measurement), two identical Nephelometers are usually run in series with a sample relative humidity (RH) conditioner between them. This is possible because Nephelometer sampling is non-destructive and the sample can be passed on to another instrument. The sample RH conditioner scans through multiple RH values in cycles, treating the sample. This kind of setup allows to study how aerosol particles’ light scattering properties are affected by humidification (Anderson et al. 1996). For historical reasons, the two Nephelometers in this setup are labeled “wet” and “dry”, with the “dry” Nephelometer usually being the one before the conditioner and sampling ambient air (the names are switched for the MAOS measurement site due to the high RH of the ambient air).

  11. Measurement and Instrumentation

    Energy Technology Data Exchange (ETDEWEB)

    Kirkham, Harold

    2018-01-02

    This is a chapter for a book called the Standard Handbook for Electrical Engineering. Though it is not obvious from the title, the book deals mainly with power engineering. The first chapter (not mine) is about the fundamental quantities used in measurement. This chapter is about the process and the instrumentation.

  12. Analytical chemistry instrumentation

    International Nuclear Information System (INIS)

    Laing, W.R.

    1986-01-01

    In nine sections, 48 chapters cover 1) analytical chemistry and the environment 2) environmental radiochemistry 3) automated instrumentation 4) advances in analytical mass spectrometry 5) fourier transform spectroscopy 6) analytical chemistry of plutonium 7) nuclear analytical chemistry 8) chemometrics and 9) nuclear fuel technology

  13. CRISP instrument manual

    International Nuclear Information System (INIS)

    Bucknall, D.G.; Langridge, Sean

    1997-05-01

    This document is a user manual for CRISP, one of the two neutron reflectomers at ISIS. CRISP is highly automated allowing precision reproducible measurements. The manual provides detailed instructions for the setting-up and running of the instrument and advice on data analysis. (UK)

  14. The Science of String Instruments

    CERN Document Server

    Rossing, Thomas D

    2010-01-01

    Many performing musicians, as well as instrument builders, are coming to realize the importance of understanding the science of musical instruments. This book explains how string instruments produce sound. It presents basic ideas in simple language, and it also translates some more sophisticated ideas in non-technical language. It should be of interest to performers, researchers, and instrument makers alike.

  15. Supplier Cooperation in Drone Delivery

    OpenAIRE

    Sawadsitang, Suttinee; Niyato, Dusit; Siew, Tan Puay; Wang, Ping

    2018-01-01

    Recently, unmanned aerial vehicles (UAVs), also known as drones, has emerged as an efficient and cost-effective solution for package delivery. Especially, drones are expected to incur lower cost, and achieve fast and environment friendly delivery. While most of existing drone research concentrates on surveillance applications, few works studied the drone package delivery planning problem. Even so, the previous works only focus on the drone delivery planning of a single supplier. In this paper...

  16. Floating Microparticulate Oral Diltiazem Hydrochloride Delivery ...

    African Journals Online (AJOL)

    Delivery System for Improved Delivery to Heart ... Conclusion: Microparticulate floating (gastroretentive) oral drug delivery system of diltiazem prepared ..... treatment of cardiac disease. ... hydrochloride-loaded mucoadhesive microspheres.

  17. Supersaturating drug delivery systems

    DEFF Research Database (Denmark)

    Laitinen, Riikka; Löbmann, Korbinian; Grohganz, Holger

    2017-01-01

    of the bioavailability of poorly water-soluble drugs by increasing the driving force for drug absorption. However, ASDs often require a high weight percentage of carrier (usually a hydrophilic polymer) to ensure molecular mixing of the drug in the carrier and stabilization of the supersaturated state, often leading......Amorphous solid dispersions (ASDs) are probably the most common and important supersaturating drug delivery systems for the formulation of poorly water-soluble compounds. These delivery systems are able to achieve and maintain a sustained drug supersaturation which enables improvement...... strategy for poorly-soluble drugs. While the current research on co-amorphous formulations is focused on preparation and characterization of these systems, more detailed research on their supersaturation and precipitation behavior and the effect of co-formers on nucleation and crystal growth inhibition...

  18. Pyomyositis after vaginal delivery.

    LENUS (Irish Health Repository)

    Gaughan, Eve

    2011-01-01

    Pyomyositis is a purulent infection of skeletal muscle that arises from haematogenous spread, usually with abscess formation. It can develop after a transient bacteraemia of any cause. This type of infection has never been reported before in the literature after vaginal delivery. A 34-year-old woman had progressive severe pain in the left buttock and thigh and weakness in the left lower limb day 1 post spontaneous vaginal delivery. MRI showed severe oedema of the left gluteus, iliacus, piriformis and adductor muscles of the left thigh and a small fluid collection at the left hip joint. She was diagnosed with pyomyositis. She had fever of 37.9°C immediately postpartum and her risk factors for bacteraemia were a mild IV cannula-associated cellulitis and labour itself. She required prolonged treatment with antibiotics before significant clinical improvement was noted.

  19. Social video content delivery

    CERN Document Server

    Wang, Zhi; Zhu, Wenwu

    2016-01-01

    This brief presents new architecture and strategies for distribution of social video content. A primary framework for socially-aware video delivery and a thorough overview of the possible approaches is provided. The book identifies the unique characteristics of socially-aware video access and social content propagation, revealing the design and integration of individual modules that are aimed at enhancing user experience in the social network context. The change in video content generation, propagation, and consumption for online social networks, has significantly challenged the traditional video delivery paradigm. Given the massive amount of user-generated content shared in online social networks, users are now engaged as active participants in the social ecosystem rather than as passive receivers of media content. This revolution is being driven further by the deep penetration of 3G/4G wireless networks and smart mobile devices that are seamlessly integrated with online social networking and media-sharing s...

  20. A cyclically actuated electrolytic drug delivery device

    KAUST Repository

    Yi, Ying

    2015-01-01

    This work, focusing on an implantable drug delivery system, presents the first prototype electrolytic pump that combines a catalytic reformer and a cyclically actuated mode. These features improve the release performance and extend the lifetime of the device. Using our platinum (Pt)-coated carbon fiber mesh that acts as a catalytic reforming element, the cyclical mode is improved because the faster recombination rate allows for a shorter cycling time for drug delivery. Another feature of our device is that it uses a solid-drug-in-reservoir (SDR) approach, which allows small amounts of a solid drug to be dissolved in human fluid, forming a reproducible drug solution for long-term therapies. We have conducted proof-of-principle drug delivery studies using such an electrolytic pump and solvent blue 38 as the drug substitute. These tests demonstrate power-controlled and pulsatile release profiles of the chemical substance, as well as the feasibility of this device. A drug delivery rate of 11.44 ± 0.56 μg min-1 was achieved by using an input power of 4 mW for multiple pulses, which indicates the stability of our system. © The Royal Society of Chemistry 2015.

  1. Peptide and protein delivery using new drug delivery systems.

    Science.gov (United States)

    Jain, Ashish; Jain, Aviral; Gulbake, Arvind; Shilpi, Satish; Hurkat, Pooja; Jain, Sanjay K

    2013-01-01

    Pharmaceutical and biotechnological research sorts protein drug delivery systems by importance based on their various therapeutic applications. The effective and potent action of the proteins/peptides makes them the drugs of choice for the treatment of numerous diseases. Major research issues in protein delivery include the stabilization of proteins in delivery devices and the design of appropriate target-specific protein carriers. Many efforts have been made for effective delivery of proteins/peptidal drugs through various routes of administrations for successful therapeutic effects. Nanoparticles made of biodegradable polymers such as poly lactic acid, polycaprolactone, poly(lactic-co-glycolic acid), the poly(fumaric-co-sebacic) anhydride chitosan, and modified chitosan, as well as solid lipids, have shown great potential in the delivery of proteins/peptidal drugs. Moreover, scientists also have used liposomes, PEGylated liposomes, niosomes, and aquasomes, among others, for peptidal drug delivery. They also have developed hydrogels and transdermal drug delivery systems for peptidal drug delivery. A receptor-mediated delivery system is another attractive strategy to overcome the limitation in drug absorption that enables the transcytosis of the protein across the epithelial barrier. Modification such as PEGnology is applied to various proteins and peptides of the desired protein and peptides also increases the circulating life, solubility and stability, pharmacokinetic properties, and antigenicity of protein. This review focuses on various approaches for effective protein/peptidal drug delivery, with special emphasis on insulin delivery.

  2. netherland hydrological modeling instrument

    Science.gov (United States)

    Hoogewoud, J. C.; de Lange, W. J.; Veldhuizen, A.; Prinsen, G.

    2012-04-01

    Netherlands Hydrological Modeling Instrument A decision support system for water basin management. J.C. Hoogewoud , W.J. de Lange ,A. Veldhuizen , G. Prinsen , The Netherlands Hydrological modeling Instrument (NHI) is the center point of a framework of models, to coherently model the hydrological system and the multitude of functions it supports. Dutch hydrological institutes Deltares, Alterra, Netherlands Environmental Assessment Agency, RWS Waterdienst, STOWA and Vewin are cooperating in enhancing the NHI for adequate decision support. The instrument is used by three different ministries involved in national water policy matters, for instance the WFD, drought management, manure policy and climate change issues. The basis of the modeling instrument is a state-of-the-art on-line coupling of the groundwater system (MODFLOW), the unsaturated zone (metaSWAP) and the surface water system (MOZART-DM). It brings together hydro(geo)logical processes from the column to the basin scale, ranging from 250x250m plots to the river Rhine and includes salt water flow. The NHI is validated with an eight year run (1998-2006) with dry and wet periods. For this run different parts of the hydrology have been compared with measurements. For instance, water demands in dry periods (e.g. for irrigation), discharges at outlets, groundwater levels and evaporation. A validation alone is not enough to get support from stakeholders. Involvement from stakeholders in the modeling process is needed. There fore to gain sufficient support and trust in the instrument on different (policy) levels a couple of actions have been taken: 1. a transparent evaluation of modeling-results has been set up 2. an extensive program is running to cooperate with regional waterboards and suppliers of drinking water in improving the NHI 3. sharing (hydrological) data via newly setup Modeling Database for local and national models 4. Enhancing the NHI with "local" information. The NHI is and has been used for many

  3. Developments in analytical instrumentation

    Science.gov (United States)

    Petrie, G.

    The situation regarding photogrammetric instrumentation has changed quite dramatically over the last 2 or 3 years with the withdrawal of most analogue stereo-plotting machines from the market place and their replacement by analytically based instrumentation. While there have been few new developments in the field of comparators, there has been an explosive development in the area of small, relatively inexpensive analytical stereo-plotters based on the use of microcomputers. In particular, a number of new instruments have been introduced by manufacturers who mostly have not been associated previously with photogrammetry. Several innovative concepts have been introduced in these small but capable instruments, many of which are aimed at specialised applications, e.g. in close-range photogrammetry (using small-format cameras); for thematic mapping (by organisations engaged in environmental monitoring or resources exploitation); for map revision, etc. Another innovative and possibly significant development has been the production of conversion kits to convert suitable analogue stereo-plotting machines such as the Topocart, PG-2 and B-8 into fully fledged analytical plotters. The larger and more sophisticated analytical stereo-plotters are mostly being produced by the traditional mainstream photogrammetric systems suppliers with several new instruments and developments being introduced at the top end of the market. These include the use of enlarged photo stages to handle images up to 25 × 50 cm format; the complete integration of graphics workstations into the analytical plotter design; the introduction of graphics superimposition and stereo-superimposition; the addition of correlators for the automatic measurement of height, etc. The software associated with this new analytical instrumentation is now undergoing extensive re-development with the need to supply photogrammetric data as input to the more sophisticated G.I.S. systems now being installed by clients, instead

  4. Intraperiodontal pocket: An ideal route for local antimicrobial drug delivery

    Directory of Open Access Journals (Sweden)

    Sreeja C Nair

    2012-01-01

    Full Text Available Periodontal pockets act as a natural reservoir filled with gingival crevicular fluid for the controlled release delivery of antimicrobials directly. This article reflects the present status of nonsurgical controlled local intrapocket delivery of antimicrobials in the treatment of periodontitis. These sites have specialty in terms of anatomy, permeability, and their ability to retain a delivery system for a desired length of time. A number of antimicrobial products and the composition of the delivery systems, its use, clinical results, and their release are summarized. The goal in using an intrapocket device for the delivery of an antimicrobial agent is the achievement and maintenance of therapeutic drug concentration for the desired period of time. Novel controlled drug delivery system are capable of improving patient compliance as well as therapeutic efficacy with precise control of the rate by which a particular drug dosage is released from a delivery system without the need for frequent administration. These are considered superior drug delivery system because of low cost, greater stability, non-toxicity, biocompatibility, non-immunogenicity, and are biodegradable in nature. This review also focus on the importance and ideal features of periodontal pockets as a drug delivery platform for designing a suitable dosage form along with its potential advantage and limitations. The microbes in the periodontal pocket could destroy periodontal tissues, and a complete knowledge of these as well as an ideal treatment strategy could be helpful in treating this disease.

  5. Nanocarriers in ocular drug delivery: an update review.

    Science.gov (United States)

    Wadhwa, Sheetu; Paliwal, Rishi; Paliwal, Shivani Rai; Vyas, S P

    2009-01-01

    Controlled drug delivery to eye is one of the most challenging fields of pharmaceutical research. Low drug-contact time and poor ocular bioavailability due to drainage of solution, tear turnover and its dilution or lacrimation are the problems associated with conventional systems. In addition, anatomical barriers and physiological conditions of eye are also important parameters which control designing of drug delivery systems. Nanosized carriers like micro/nano-suspensions, liposome, niosome, dendrimer, nanoparticles, ocular inserts, implants, hydrogels and prodrug approaches have been developed for this purpose. These novel systems offer manifold advantages over conventional systems as they increase the efficiency of drug delivery by improving the release profile and also reduce drug toxicity. Conventional delivery systems get diluted with tear, washed away through the lacrimal gland and usually require administering at regular time intervals whereas nanocarriers release drug at constant rate for a prolonged period of time and thus enhance its absorption and site specific delivery. This review presents an overview of the various aspects of the ocular drug delivery, with special emphasis on nanocarrier based strategies, including structure of eye, its barriers, delivery routes and the challenges/limitations associated with development of novel nanocarriers. The recent progresses in therapy of ocular disease like gene therapy have also been included so that future options should also be considered from the delivery point of view. Recent progress in the delivery of proteins and peptides via ocular route has also been incorporated for reader benefit.

  6. Obstetricians' perspective towards cesarean section delivery based on professional level: experience from Egypt.

    Science.gov (United States)

    Shaaban, Mohamed M; Sayed Ahmed, Waleed Ali; Ahmed, Waleed S; Khadr, Zeinab; El-Sayed, Hesham F

    2012-08-01

    (1) To investigate Egyptian obstetricians' views towards cesarean delivery on maternal request, (2) to investigate Egyptian obstetricians' views towards some of the "potentially neglected" or controversial obstetrical skills or maneuvers as external cephalic version (ECV), fetal scalp pH measurement or tubal ligation during CS and (3) to examine the effect of professional level on the above factors. This is a descriptive study performed at the 8th annual Obstetrics and Gynecology conference of Suez Canal University held at Ismailia city in Egypt in June 2011 via a structured self administered questionnaire. Questionnaire was distributed to 223 conference attendants from the three professional levels (consultants, specialists and registrars) working at the two major institutions in Egypt: University and Ministry of Health. The structured questionnaire was based on informed opinion and professional guidelines. In total, 167 (75%) completed the questionnaire. Cesarean delivery on maternal request was accepted by 66% of the studied group and acceptance was significantly higher among consultants. There was no difference in all physicians' practices of cesarean section in both private and public settings. Limited access to medical equipment such as cardiotocogram (CTG) was shown in consultant group reflecting improper private sector preparations. The study revealed that 59% of obstetricians accepted vaginal breech delivery, and only 14% would consider ECV. Fetal scalp pH taking in cases of abnormal CTG was accepted by only 16.3% and 49% rejected the practice of instrumental delivery. There were significant differences among the three professional and the two institutional groups regarding these attitudes. There were different views regarding tubal sterilization during CS. Lack of knowledge, the need to improve some clinical skills and some professional attitudes may shed light on rising CS rates in Egypt.

  7. Cyclic delivery scheduling to customers with different priorities

    Directory of Open Access Journals (Sweden)

    Katarzyna Zofia Gdowska

    2013-12-01

    Full Text Available Background: In this paper a cyclic delivery scheduling problem for customers with different priorities is presented. Shops, which are provided with deliveries, are occasionally located in places which are crucial for the proper flow of traffic. In such places coordination of deliveries is crucial; therefore it allows to completely eliminate the phenomenon of the simultaneous arrivals of suppliers. Methods: In this paper the cyclic delivery scheduling problem for customers with different priorities was presented. To this theoretical problem a mix integer programming model was developed. Specific approach to the cyclic delivery scheduling problem is inspired by timetabling problem for urban public transport. Results: Mixed integer programming model was employed for solving four cases of cyclic delivery scheduling problem for customers with different priorities. When the value of the synchronization priority assigned to a single customer raised then the total number of synchronizations in the whole network decreased. In order to compare solutions a synchronization rate was utilized. A simple factor was utilized - the proportion of number of synchronizations of deliveries to a given customer to the total number of synchronizations obtained for the whole network. When the value of synchronization priority raised then the value of synchronization rate of this customer improved significantly. Conclusions: The mixed integer programming model for the cyclic delivery scheduling problem for customers with different priorities presented in this paper can be utilized for generating schedules of serving customers located in places where only one delivery can be received and unloaded at one go and where there is no space for other suppliers to wait in a queue. Such a schedule can be very useful for organizing deliveries to small shops united in a franchising network, since they operate in a way that is very similar to the network presented in this paper

  8. Prenatal care and socioeconomic status: effect on cesarean delivery.

    Science.gov (United States)

    Milcent, Carine; Zbiri, Saad

    2018-03-10

    Cesarean deliveries are widely used in many high- and middle-income countries. This overuse both increases costs and lowers quality of care and is thus a major concern in the healthcare industry. The study first examines the impact of prenatal care utilization on cesarean delivery rates. It then determines whether socioeconomic status affects the use of prenatal care and thereby influences the cesarean delivery decision. Using exclusive French delivery data over the 2008-2014 period, with multilevel logit models, and controlling for relevant patient and hospital characteristics, we show that women who do not participate in prenatal education have an increased probability of a cesarean delivery compared to those who do. The study further indicates that attendance at prenatal education varies according to socioeconomic status. Low socioeconomic women are more likely to have cesarean deliveries and less likely to participate in prenatal education. This result emphasizes the importance of focusing on pregnancy health education, particularly for low-income women, as a potential way to limit unnecessary cesarean deliveries. Future studies would ideally investigate the effect of interventions promoting such as care participation on cesarean delivery rates.

  9. Tax system competition – instruments and beneficiaries

    OpenAIRE

    Krzysztof Biernacki

    2014-01-01

    Tax competition among states and jurisdictions has already been examined many times in the economic literature. However, the main scope of the research was focused on a tax rates competition in income taxes and its consequences in bringing direct investments. This scripture/commentary tries to analyze various instruments and beneficiaries of the tax system competition and provide a general overview on this subject.

  10. Predictors of Instrumental Music Teacher Job Satisfaction

    Science.gov (United States)

    Bryant, Robert Louis, III

    2012-01-01

    Previous research studies related to teacher quality have found that teacher attrition rates are at an all-time high. Although much research has been conducted in the area of job satisfaction within the general teaching population, few studies of job satisfaction exist for instrumental music teachers. The purpose of this correlational study was to…

  11. Advanced Instrumentation for Positron Emission Tomography [PET

    Science.gov (United States)

    Derenzo, S. E.; Budinger, T. F.

    1985-04-01

    This paper summarizes the physical processes and medical science goals that underlay modern instrumentation design for Positron Emission Tomography. The paper discusses design factors such as detector material, crystalphototube coupling, shielding geometry, sampling motion, electronics design, time-of-flight, and the interrelationships with quantitative accuracy, spatial resolution, temporal resolution, maximum data rates, and cost.

  12. Data acquisition instruments: Psychopharmacology

    Energy Technology Data Exchange (ETDEWEB)

    Hartley, D.S. III

    1998-01-01

    This report contains the results of a Direct Assistance Project performed by Lockheed Martin Energy Systems, Inc., for Dr. K. O. Jobson. The purpose of the project was to perform preliminary analysis of the data acquisition instruments used in the field of psychiatry, with the goal of identifying commonalities of data and strategies for handling and using the data in the most advantageous fashion. Data acquisition instruments from 12 sources were provided by Dr. Jobson. Several commonalities were identified and a potentially useful data strategy is reported here. Analysis of the information collected for utility in performing diagnoses is recommended. In addition, further work is recommended to refine the commonalities into a directly useful computer systems structure.

  13. Social Responsibility Instruments

    Directory of Open Access Journals (Sweden)

    Katarzyna Mizera

    2008-09-01

    Full Text Available Responsible business notion is more and more present in Polish economy, however the results of the research carried out in Polish business still shows a low level of CRS idea knowledge, especially in small and medium companies. Although responsible business notion is generally known, its details, ways of preparing strategy, instruments and what is more its benefits are still narrowly spread. Many business people face the lack of knowledge and information, which on one hand make it easier to spread and deepen wrong stereotypes connected with this notion and on the other hand make business people unwilling to implement CRS in their companies. The subjects of this article are examples of instruments which are responsible for realization of social responsibility strategy.

  14. Techniques for assisting difficult delivery at caesarean section.

    Science.gov (United States)

    Waterfall, Heather; Grivell, Rosalie M; Dodd, Jodie M

    2016-01-31

    Caesarean section involves making an incision in the woman's abdomen and cutting through the uterine muscle. The baby is then delivered through that incision. Difficult caesarean birth may result in injury for the infant or complications for the mother. Methods to assist with delivery include vacuum or forceps extraction or manual delivery utilising fundal pressure. Medication that relaxes the uterus (tocolytic medication) may facilitate the birth of the baby at caesarean section. Delivery of the impacted head after prolonged obstructed labour can be associated with significant maternal and neonatal complication; to facilitate delivery of the head the surgeon may utilise either reverse breech extraction or head pushing. To compare the use of tocolysis (routine or selective use) with no use of tocolysis or placebo and to compare different extraction methods at the time of caesarean section for outcomes of infant birth trauma, maternal complications (particularly postpartum haemorrhage requiring blood transfusion), and long-term measures of infant and childhood morbidity. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2015) and reference lists of retrieved studies. All published, unpublished, and ongoing randomised controlled trials comparing the use of tocolytic agents (routine or selective) at caesarean section versus no use of tocolytic or placebo at caesarean section to facilitate the birth of the baby. Use of instrument versus manual delivery to facilitate birth of the baby. Reverse breech extraction versus head pushing to facilitate delivery of the deeply impacted fetal head. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. Seven randomised controlled trials, involving 582 women undergoing caesarean section were included in this review. The risk of bias of included trials was variable, with some trials not adequately describing allocation or

  15. [Do online ratings reflect structural differences in healthcare? The example of German physician-rating websites].

    Science.gov (United States)

    Meszmer, Nina; Jaegers, Lena; Schöffski, Oliver; Emmert, Martin

    2018-04-01

    Previous surveys have shown that patient satisfaction varies with the regional supply of physicians. Online ratings on physician-rating websites represent a relatively new instrument to display patient satisfaction results. The aim of this study was (1) to assess the current state of online ratings for two medical disciplines (dermatologists and ear, nose and throat (ENT) specialists), and (2) to analyze online derived patient satisfaction results according to the physician density in Germany. We collected online ratings for 420 dermatologists and 450 ear, nose, and throat (ENT) specialists on twelve German physician-rating websites. We analyzed the online ratings according to the physician density (low, medium, high physician density). For this purpose, we collected secondary data from both physician-rating websites and the regional associations of statutory health insurance physicians. Data analysis was performed using Median tests and Chi-square tests. In total, 10,239 online ratings for dermatologists and 8,168 online ratings for ENT specialists were analyzed. Almost all dermatologists (99.3 %) and ENT specialists (98.9 %) were listed on one of the physician-rating websites. A total of 93.5 % of all listed dermatologists and 96.9 % of ENT-specialists were rated on at least one of the physician-rating websites. Significant differences were found in the distribution (i.e., percentage of listed or rated physicians) of the ratings according to the regional physician density on only one physician-rating website (pexample, dermatologist ratings were better in regions with a higher physician density compared to regions with a lower number of physicians (average rating: 2.16 vs. 2.67; p<0.001). Online ratings of dermatologists and ENT specialists hardly differ in terms of regional physician density. Physician-rating websites thus do not appear to be appropriate to mirror differences in the health service delivery structure. Our findings thus do not confirm the

  16. Radon-Instrumentation

    International Nuclear Information System (INIS)

    Moreno y Moreno, A.

    2003-01-01

    The presentation of the active and passive methods for radon, their identification and measure, instrumentation and characteristics are the objectives of this work. Active detectors: Active Alpha Cam Continuous Air Monitor, Model 758 of Victoreen, Model CMR-510 Continuous Radon Monitor of the Signature Femto-Tech. Passive detectors: SSNTD track detectors in solids Measurement Using Charcoal Canisters, disk of activated coal deposited in a metallic box Electrets Methodology. (Author)

  17. Testing Aircraft Instruments.

    Science.gov (United States)

    1981-02-11

    1. Have test data been collected, recorded, and presented in accordance with this TOP? Yes No Comment : 2. Were the facilities, test equipment...instrumentation, and support accommodations adequate to accomplish the test objectives? Yes No Comment : 3. Have all data collected been reviewed for...correctness and completeness? Yes No Comment : 4. Were the test results compromised in any way due to insufficient test planning? Yes No Comment : 5. Were the

  18. Transgressive or Instrumental?

    DEFF Research Database (Denmark)

    Chemi, Tatiana

    2018-01-01

    Contemporary practices that connect the arts with learning are widespread at all level of educational systems and in organisations, but they include very diverse approaches, multiple methods and background values. Regardless of explicit learning benefits, the arts/learning partnerships bring about...... creativity and the other on practices of arts-integration. My final point rests on the belief that the opposition of transgression and instrumentality is a deceiving perspective on the arts, against the background of the aesthetic plurality and hybridity....

  19. Development on experimental VHTR instrumentation

    International Nuclear Information System (INIS)

    Wakayama, N.; Ara, K.; Terada, H.; Yamagishi, H.; Tomoda, T.

    1982-06-01

    This paper describes developmental works on the instrumentation of the Experimental VHTR. In the area of the nuclear instrumentation for the reactor control, high temperature fission counter-chambers have been developed. These withstood the accelerated irradiation life tests at 600 deg. C, the long term in-reactor operating test at 600 deg. C and the 800 deg. C-operating tests for several hundred hours in a simulated accident condition. Platinum-Molybdenum alloy thermocouples have been studied as a neutron-irradiation-resistant high-temperature thermocouple for the in-core temperature distribution monitoring of the VHTR in the temperature range between 1000 deg. C and 1350 deg. C. The instability problems of the Pt-5% Mo/Pt-0.1% Mo thermocouple seem to be overcome by introducing a double sheath structure and adopting a better material to the inner sheath. A local failure and abnormality monitoring method for the HTR fuel is also studied using a gas-sweeping irradiation rig for the CPF compacts. This study aims mainly at the development of a method to compensate for the dependency of the FP-release rate on the fuel temperature, the neutron flux density, the burn-up and others, in order to increase the detection sensitivity of fuel failures. (author)

  20. EPRTM Reactor neutron instrumentation

    International Nuclear Information System (INIS)

    Pfeiffer, Maxime; SALA, Stephanie

    2013-06-01

    The core safety during operation is linked, in particular, to the respect of criteria related to the heat generated in fuel rods and to the heat exchange between the rods and the coolant. This local power information is linked to the power distribution in the core. In order to evaluate the core power distribution, the EPR TM reactor relies on several types of neutron detectors: - ionization chambers located outside the vessel and used for protection and monitoring - a fixed in-core instrumentation based on Cobalt Self Powered Neutron Detectors used for protection and monitoring - a mobile reference in-core instrumentation based on Vanadium aero-balls This document provides a description of this instrumentation and its use in core protection, limitation, monitoring and control functions. In particular, a description of the detectors and the principles of their signal generation is supplied as well as the description of the treatments related to these detectors in the EPR TM reactor I and C systems (including periodical calibration). (authors)

  1. Mandolin Family Instruments

    Science.gov (United States)

    Cohen, David J.; Rossing, Thomas D.

    The mandolin family of instruments consists of plucked chordophones, each having eight strings in four double courses. With the exception of the mandobass, the courses are tuned in intervals of fifths, as are the strings in violin family instruments. The soprano member of the family is the mandolin, tuned G3-D4-A4-E5. The alto member of the family is the mandola, tuned C3-G3-D4-A4. The mandola is usually referred to simply as the mandola in the USA, but is called the tenor mandola in Europe. The tenor member of the family is the octave mandolin, tuned G2-D3-A3-E4. It is referred to as the octave mandolin in the USA, and as the octave mandola in Europe. The baritone member of the family is the mandocello, or mandoloncello, tuned C2-G2-D3-A3. A variant of the mandocello not common in the USA is the five-course liuto moderno, or simply liuto, designed for solo repertoire. Its courses are tuned C2-G2-D3-A3-E4. A mandobass was also made by more than one manufacturer during the early twentieth century, though none are manufactured today. They were fretted instruments with single string courses tuned E1-A1-D2-G2. There are currently a few luthiers making piccolo mandolins, tuned C4-G4-D5-A5.

  2. Cardiopulmonary function and oxygen delivery during total liquid ventilation.

    Science.gov (United States)

    Tsagogiorgas, Charalambos; Alb, Markus; Herrmann, Peter; Quintel, Michael; Meinhardt, Juergen P

    2011-10-01

    Total liquid ventilation (TLV) with perfluorocarbons has shown to improve cardiopulmonary function in the injured and immature lung; however there remains controversy over the normal lung. Hemodynamic effects of TLV in the normal lung currently remain undetermined. This study compared changes in cardiopulmonary and circulatory function caused by either liquid or gas tidal volume ventilation. In a prospective, controlled study, 12 non-injured anesthetized, adult New Zealand rabbits were primarily conventionally gas-ventilated (CGV). After instrumentation for continuous recording of arterial (AP), central venous (CVP), left artrial (LAP), pulmonary arterial pressures (PAP), and cardiac output (CO) animals were randomized into (1) CGV group and (2) TLV group. In the TLV group partial liquid ventilation was initiated with instillation of perfluoroctylbromide (12 ml/kg). After 15 min, TLV was established for 3 hr applying a volume-controlled, pressure-limited, time-cycled ventilation mode using a double-piston configured TLV. Controls (CGV) remained gas-ventilated throughout the experiment. During TLV, heart rate, CO, PAP, MAP, CVP, and LAP as well as derived hemodynamic variables, arterial and mixed venous blood gases, oxygen delivery, PVR, and SVR did not differ significantly compared to CGV. Liquid tidal volumes suitable for long-term TLV in non-injured rabbits do not significantly impair CO, blood pressure, and oxygen dynamics when compared to CGV. Copyright © 2011 Wiley-Liss, Inc.

  3. Stuttering Intervention in Three Service Delivery Models (Direct, Hybrid, and Telepractice: Two Case Studies

    Directory of Open Access Journals (Sweden)

    Daniel T. Valentine

    2015-01-01

    Full Text Available This study assessed outcomes in stuttering intervention across three service delivery models: direct, hybrid, and telepractice for two 11-year old children who stutter. The goal of the study was to investigate whether short-term goals were maintained through the telepractice sessions. The Stuttering Severity Instrument, Fourth Edition (SSI-4 was administered to each child before and after each intervention period and weekly fluency samples (percentage of stuttered syllables in a monologue were obtained in each of the 10-week intervention periods. In addition, the Communication Attitudes Test-Revised was used to assess the children’s attitudes toward speaking. Following the telepractice period, parents and children completed a questionnaire concerning the therapy experience via telepractice. Both children continued to improve fluency as measured by the weekly fluency samples. SSI-4 severity ratings improved for one child and remained consistent for the other. These outcomes appear to demonstrate that telepractice is viable for improving and maintaining fluency.

  4. Lentiviral Delivery of Proteins for Genome Engineering.

    Science.gov (United States)

    Cai, Yujia; Mikkelsen, Jacob Giehm

    2016-01-01

    Viruses have evolved to traverse cellular barriers and travel to the nucleus by mechanisms that involve active transport through the cytoplasm and viral quirks to resist cellular restriction factors and innate immune responses. Virus-derived vector systems exploit the capacity of viruses to ferry genetic information into cells, and now - more than three decades after the discovery of HIV - lentiviral vectors based on HIV-1 have become instrumental in biomedical research and gene therapies that require genomic insertion of transgenes. By now, the efficacy of lentiviral gene delivery to stem cells, cells of the immune system including T cells, hepatic cells, and many other therapeutically relevant cell types is well established. Along with nucleic acids, HIV-1 virions carry the enzymatic tools that are essential for early steps of infection. Such capacity to package enzymes, even proteins of nonviral origin, has unveiled new ways of exploiting cellular intrusion of HIV-1. Based on early findings demonstrating the packaging of heterologous proteins into virus particles as part of the Gag and GagPol polypeptides, we have established lentiviral protein transduction for delivery of DNA transposases and designer nucleases. This strategy for delivering genome-engineering proteins facilitates high enzymatic activity within a short time frame and may potentially improve the safety of genome editing. Exploiting the full potential of lentiviral vectors, incorporation of foreign protein can be combined with the delivery of DNA transposons or a donor sequence for homology-directed repair in so-called 'all-in-one' lentiviral vectors. Here, we briefly describe intracellular restrictions that may affect lentiviral gene and protein delivery and review the current status of lentiviral particles as carriers of tool kits for genome engineering.

  5. CARMENES instrument overview

    Science.gov (United States)

    Quirrenbach, A.; Amado, P. J.; Caballero, J. A.; Mundt, R.; Reiners, A.; Ribas, I.; Seifert, W.; Abril, M.; Aceituno, J.; Alonso-Floriano, F. J.; Ammler-von Eiff, M.; Antona Jiménez, R.; Anwand-Heerwart, H.; Azzaro, M.; Bauer, F.; Barrado, D.; Becerril, S.; Béjar, V. J. S.; Benítez, D.; Berdiñas, Z. M.; Cárdenas, M. C.; Casal, E.; Claret, A.; Colomé, J.; Cortés-Contreras, M.; Czesla, S.; Doellinger, M.; Dreizler, S.; Feiz, C.; Fernández, M.; Galadí, D.; Gálvez-Ortiz, M. C.; García-Piquer, A.; García-Vargas, M. L.; Garrido, R.; Gesa, L.; Gómez Galera, V.; González Álvarez, E.; González Hernández, J. I.; Grözinger, U.; Guàrdia, J.; Guenther, E. W.; de Guindos, E.; Gutiérrez-Soto, J.; Hagen, H.-J.; Hatzes, A. P.; Hauschildt, P. H.; Helmling, J.; Henning, T.; Hermann, D.; Hernández Castaño, L.; Herrero, E.; Hidalgo, D.; Holgado, G.; Huber, A.; Huber, K. F.; Jeffers, S.; Joergens, V.; de Juan, E.; Kehr, M.; Klein, R.; Kürster, M.; Lamert, A.; Lalitha, S.; Laun, W.; Lemke, U.; Lenzen, R.; López del Fresno, Mauro; López Martí, B.; López-Santiago, J.; Mall, U.; Mandel, H.; Martín, E. L.; Martín-Ruiz, S.; Martínez-Rodríguez, H.; Marvin, C. J.; Mathar, R. J.; Mirabet, E.; Montes, D.; Morales Muñoz, R.; Moya, A.; Naranjo, V.; Ofir, A.; Oreiro, R.; Pallé, E.; Panduro, J.; Passegger, V.-M.; Pérez-Calpena, A.; Pérez Medialdea, D.; Perger, M.; Pluto, M.; Ramón, A.; Rebolo, R.; Redondo, P.; Reffert, S.; Reinhardt, S.; Rhode, P.; Rix, H.-W.; Rodler, F.; Rodríguez, E.; Rodríguez-López, C.; Rodríguez-Pérez, E.; Rohloff, R.-R.; Rosich, A.; Sánchez-Blanco, E.; Sánchez Carrasco, M. A.; Sanz-Forcada, J.; Sarmiento, L. F.; Schäfer, S.; Schiller, J.; Schmidt, C.; Schmitt, J. H. M. M.; Solano, E.; Stahl, O.; Storz, C.; Stürmer, J.; Suárez, J. C.; Ulbrich, R. G.; Veredas, G.; Wagner, K.; Winkler, J.; Zapatero Osorio, M. R.; Zechmeister, M.; Abellán de Paco, F. J.; Anglada-Escudé, G.; del Burgo, C.; Klutsch, A.; Lizon, J. L.; López-Morales, M.; Morales, J. C.; Perryman, M. A. C.; Tulloch, S. M.; Xu, W.

    2014-07-01

    This paper gives an overview of the CARMENES instrument and of the survey that will be carried out with it during the first years of operation. CARMENES (Calar Alto high-Resolution search for M dwarfs with Exoearths with Near-infrared and optical Echelle Spectrographs) is a next-generation radial-velocity instrument under construction for the 3.5m telescope at the Calar Alto Observatory by a consortium of eleven Spanish and German institutions. The scientific goal of the project is conducting a 600-night exoplanet survey targeting ~ 300 M dwarfs with the completed instrument. The CARMENES instrument consists of two separate echelle spectrographs covering the wavelength range from 0.55 to 1.7 μm at a spectral resolution of R = 82,000, fed by fibers from the Cassegrain focus of the telescope. The spectrographs are housed in vacuum tanks providing the temperature-stabilized environments necessary to enable a 1 m/s radial velocity precision employing a simultaneous calibration with an emission-line lamp or with a Fabry-Perot etalon. For mid-M to late-M spectral types, the wavelength range around 1.0 μm (Y band) is the most important wavelength region for radial velocity work. Therefore, the efficiency of CARMENES has been optimized in this range. The CARMENES instrument consists of two spectrographs, one equipped with a 4k x 4k pixel CCD for the range 0.55 - 1.05 μm, and one with two 2k x 2k pixel HgCdTe detectors for the range from 0.95 - 1.7μm. Each spectrograph will be coupled to the 3.5m telescope with two optical fibers, one for the target, and one for calibration light. The front end contains a dichroic beam splitter and an atmospheric dispersion corrector, to feed the light into the fibers leading to the spectrographs. Guiding is performed with a separate camera; on-axis as well as off-axis guiding modes are implemented. Fibers with octagonal cross-section are employed to ensure good stability of the output in the presence of residual guiding errors. The

  6. The frequent shift to intermediate flora in preterm delivery cases after abnormal vaginal flora screening

    Science.gov (United States)

    Honda, Hiroshi; Yokoyama, Takanori; Akimoto, Yumiko; Tanimoto, Hirotoshi; Teramoto, Mitsue; Teramoto, Hideki

    2014-01-01

    The effect of screening and treatment for abnormal vaginal flora on the reduction of preterm deliveries remains controversial. We evaluated whether this screening and treatment reduces the preterm delivery rate for general-population pregnant women. Pregnant women of the Intervention group (n = 574) underwent the screening test and the treatment of vaginal metronidazole during the early second trimester, and those of the Control group (n = 1,161) did not. We compared the preterm delivery rate between these two groups. We also compared the profiles of vaginal flora of the preterm delivery cases with those of the pregnant women with a normal course. There was no significant difference in the preterm delivery rate between these two groups. However, in the preterm delivery cases, a frequent shift to intermediate flora was observed not before but after the screening in the Intervention group. This shift may explain why most of the previous studies failed in regard to the prevention of preterm deliveries. PMID:24762852

  7. Sustained Release Drug Delivery Applications of Polyurethanes

    Directory of Open Access Journals (Sweden)

    Michael B. Lowinger

    2018-05-01

    Full Text Available Since their introduction over 50 years ago, polyurethanes have been applied to nearly every industry. This review describes applications of polyurethanes to the development of modified release drug delivery. Although drug delivery research leveraging polyurethanes has been ongoing for decades, there has been renewed and substantial interest in the field in recent years. The chemistry of polyurethanes and the mechanisms of drug release from sustained release dosage forms are briefly reviewed. Studies to assess the impact of intrinsic drug properties on release from polyurethane-based formulations are considered. The impact of hydrophilic water swelling polyurethanes on drug diffusivity and release rate is discussed. The role of pore formers in modulating drug release rate is examined. Finally, the value of assessing mechanical properties of the dosage form and approaches taken in the literature are described.

  8. Forward instrumentation for ILC detectors

    International Nuclear Information System (INIS)

    Abramowicz, Halina; Abusleme, Angel; Afanaciev, Konstantin

    2010-09-01

    Two special calorimeters are foreseen for the instrumentation of the very forward region of the ILC detector, a luminometer designed to measure the rate of low angle Bhabha scattering events with a precision better than 10 -3 and a low polar angle calorimeter, adjacent to the beam-pipe. The latter will be hit by a large amount of beamstrahlung remnants. The amount and shape of these depositions will allow a fast luminosity estimate and the determination of beam parameters. The sensors of this calorimeter must be radiation hard. Both devices will improve the hermeticity of the detector in the search for new particles. Finely segmented and very compact calorimeters will match the requirements. Due to the high occupancy fast front-end electronics is needed. The design of the calorimeters developed and optimised with Monte Carlo simulations is presented. Sensors and readout electronics ASICs have been designed and prototypes are available. Results on the performance of these major components are summarised. (orig.)

  9. Forward Instrumentation for ILC Detectors

    CERN Document Server

    Abramowicz, Halina; Afanaciev, Konstantin; Aguilar, Jonathan; Ambalathankandy, Prasoon; Bambade, Philip; Bergholz, Matthias; Bozovic-Jelisavcic, Ivanka; Castro, Elena; Chelkov, Georgy; Coca, Cornelia; Daniluk, Witold; Dragone, Angelo; Dumitru, Laurentiu; Elsener, Konrad; Emeliantchik, Igor; Fiutowski, Tomasz; Gostkin, Mikhail; Grah, Christian; Grzelak, Grzegorz; Haller, Gunter; Henschel, Hans; Ignatenko, Alexandr; Idzik, Marek; Ito, Kazutoshi; Jovin, Tatjana; Kielar, Eryk; Kotula, Jerzy; Krumstein, Zinovi; Kulis, Szymon; Lange, Wolfgang; Lohmann, Wolfgang; Levy, Aharon; Moszczynski, Arkadiusz; Nauenberg, Uriel; Novgorodova, Olga; Ohlerich, Marin; Orlandea, Marius; Oleinik, Gleb; Oliwa, Krzysztof; Olshevski, Alexander; Pandurovic, Mila; Pawlik, Bogdan; Przyborowski, Dominik; Sato, Yutaro; Sadeh, Iftach; Sailer, Andre; Schmidt, Ringo; Schumm, Bruce; Schuwalow, Sergey; Smiljanic, Ivan; Swientek, Krzysztof; Takubo, Yosuke; Teodorescu, Eliza; Wierba, Wojciech; Yamamoto, Hitoshi; Zawiejski, Leszek; Zhang, Jinlong

    2010-01-01

    Two special calorimeters are foreseen for the instrumentation of the very forward region of the ILC detector, a luminometer designed to measure the rate of low angle Bhabha scattering events with a precision better than 10-3 and a low polar angle calorimeter, adjacent to the beam-pipe. The latter will be hit by a large amount of beamstrahlung remnants. The amount and shape of these depositions will allow a fast luminosity estimate and the determination of beam parameters. The sensors of this calorimeter must be radiation hard. Both devices will improve the hermeticity of the detector in the search for new particles. Finely segmented and very compact calorimeters will match the requirements. Due to the high occupancy fast front-end electronics is needed. The design of the calorimeters developed and optimised with Monte Carlo simulations is presented. Sensors and readout electronics ASICs have been designed and prototypes are available. Results on the performance of these major components are summarised.

  10. Instrumentation for environmental monitoring: biomedical

    International Nuclear Information System (INIS)

    1979-05-01

    An update is presented to Volume four of the six-volume series devoted to a survey of instruments useful for measurements in biomedicine related to environmental research and monitoring. Results of the survey are given as descriptions of the physical and operating characteristics of available instruments, critical comparisons among instrumentation methods, and recommendations of promising methodology and development of new instrumentation. Methods of detection and analysis of gaseous organic pollutants and metals, including Ni and As are presented. Instrument techniques and notes are included on atomic spectrometry and uv and visible absorption instrumentation

  11. High-Level Disinfection of Otorhinolaryngology Clinical Instruments: An Evaluation of the Efficacy and Cost-effectiveness of Instrument Storage.

    Science.gov (United States)

    Yalamanchi, Pratyusha; Yu, Jason; Chandler, Laura; Mirza, Natasha

    2018-01-01

    Objectives Despite increasing interest in individual instrument storage, risk of bacterial cross-contamination of otorhinolaryngology clinic instruments has not been assessed. This study is the first to determine the clinical efficacy and cost-effectiveness of standard high-level disinfection and clinic instrument storage. Methods To assess for cross-contamination, surveillance cultures of otorhinolaryngology clinic instruments subject to standard high-level disinfection and storage were obtained at the start and end of the outpatient clinical workday. Rate of microorganism recovery was compared with cultures of instruments stored in individual peel packs and control cultures of contaminated instruments. Based on historical clinic data, the direct allocation method of cost accounting was used to determine aggregate raw material cost and additional labor hours required to process and restock peel-packed instruments. Results Among 150 cultures of standard high-level disinfected and co-located clinic instruments, 3 positive bacterial cultures occurred; 100% of control cultures were positive for bacterial species ( P cost of individual semicritical instrument storage at $97,852.50 per year. Discussion With in vitro inoculation of >200 otorhinolaryngology clinic instruments, this study demonstrates that standard high-level disinfection and storage are equally efficacious to more time-consuming and expensive individual instrument storage protocols, such as peel packing, with regard to bacterial contamination. Implications for Practice Standard high-level disinfection and storage are equally effective to labor-intensive and costly individual instrument storage protocols.

  12. Waste Feed Delivery Transfer System Analysis

    Energy Technology Data Exchange (ETDEWEB)

    JULYK, L.J.

    2000-05-05

    This document provides a documented basis for the required design pressure rating and pump pressure capacity of the Hanford Site waste-transfer system in support of the waste feed delivery to the privatization contractor for vitrification. The scope of the analysis includes the 200 East Area double-shell tank waste transfer pipeline system and the associated transfer system pumps for a11 Phase 1B and Phase 2 waste transfers from AN, AP, AW, AY, and A2 Tank Farms.

  13. Waste Feed Delivery Transfer System Analysis

    International Nuclear Information System (INIS)

    JULYK, L.J.

    2000-01-01

    This document provides a documented basis for the required design pressure rating and pump pressure capacity of the Hanford Site waste-transfer system in support of the waste feed delivery to the privatization contractor for vitrification. The scope of the analysis includes the 200 East Area double-shell tank waste transfer pipeline system and the associated transfer system pumps for a11 Phase 1B and Phase 2 waste transfers from AN, AP, AW, AY, and A2 Tank Farms

  14. Asymmetrical Polymer Vesicles for Drug delivery and Other Applications

    Directory of Open Access Journals (Sweden)

    Yi Zhao

    2017-06-01

    Full Text Available Scientists have been attracted by polymersomes as versatile drug delivery systems since the last two decades. Polymersomes have the potential to be versatile drug delivery systems because of their tunable membrane formulations, stabilities in vivo, various physicochemical properties, controlled release mechanisms, targeting abilities, and capacities to encapsulate a wide range of drugs and other molecules. Asymmetrical polymersomes are nano- to micro-sized polymeric capsules with asymmetrical membranes, which means, they have different outer and inner coronas so that they can exhibit better endocytosis rate and endosomal escape ability than other polymeric systems with symmetrical membranes. Hence, asymmetrical polymersomes are highly promising as self-assembled nano-delivery systems in the future for in vivo therapeutics delivery and diagnostic imaging applications. In this review, we prepared a summary about recent research progresses of asymmetrical polymersomes in the following aspects: synthesis, preparation, applications in drug delivery and others.

  15. Home delivery and neonatal mortality in North Carolina.

    Science.gov (United States)

    Burnett, C A; Jones, J A; Rooks, J; Chen, C H; Tyler, C W; Miller, C A

    1980-12-19

    Neonatal mortality examined by place and circumstances of delivery in North Carolina during 1974 through 1976 with attention given to home delivery. Planned home deliveries by lay-midwives resulted in three neonatal deaths per 1,000 live births; planned home deliveries without a lay-midwife, 30 neonatal deaths per 1,000 live births; and unplanned home deliveries, 120 neonatal deaths per 1,000 live births. The women babies were delivered by lay-midwives were screened in county health departments and found to be medically at low risk of complication, despite having demographic characteristics associated with high-risk of neonatal mortality. Conversely, the women delivered at home without known prenatal screening or a trained attendant had low-risk demographic characteristics but experienced a high rate of neonatal mortality. Planning, prenatal screening, and attendant-training were important in differentiating the risk of neonatal mortality in this uncontrolled, observational study.

  16. Microcontainers - an oral drug delivery system for poorly soluble drugs

    DEFF Research Database (Denmark)

    Nielsen, Line Hagner; Petersen, Ritika Singh; Marizza, Paolo

    In oral delivery, it can sometimes be necessary to employ drug delivery systems to achieve targeted delivery to the intestine. Microcontainers are polymeric, cylindrical devices in the micrometer size range (Figure 1), and are suggested as a promising oral drug delivery system [1],[2]. The purpose...... of these studies was to fabricate microcontainers in either SU-8 or biodegradable poly-L-lactic acid (PLLA), and fill the microcontainers with poorly soluble drugs. Furthermore, the application of the microcontainers as an oral drug delivery system was investigated in terms of release, in situ intestinal perfusion...... medium at pH 6.5 was observed. In situ intestinal perfusions were performed in rats of the Eudragit-coated ASSF-filled microcontainers and compared to a furosemide solution. At the end of the study, the small intestine was harvested from the rat and imaged under a light microscope. The absorption rate...

  17. Monte Carlo simulation of neutron scattering instruments

    International Nuclear Information System (INIS)

    Seeger, P.A.

    1995-01-01

    A library of Monte Carlo subroutines has been developed for the purpose of design of neutron scattering instruments. Using small-angle scattering as an example, the philosophy and structure of the library are described and the programs are used to compare instruments at continuous wave (CW) and long-pulse spallation source (LPSS) neutron facilities. The Monte Carlo results give a count-rate gain of a factor between 2 and 4 using time-of-flight analysis. This is comparable to scaling arguments based on the ratio of wavelength bandwidth to resolution width

  18. Rates of Very Preterm Birth in Europe and Neonatal Mortality Rates

    DEFF Research Database (Denmark)

    Field, David John; Draper, Elizabeth S; Fenton, Alan

    2008-01-01

    OBJECTIVE: To estimate the influence of variation in the rate of very preterm delivery on the reported rate of neonatal death in ten European regions. DESIGN: Comparison of 10 separate geographically defined European populations, from nine European countries, over a one year period (seven months......) a standardised rate of very preterm delivery and b) the existing death rate for babies born at this gestation in the individual region. This produced much greater homogeneity in terms of neonatal mortality. CONCLUSIONS: Variation in the rate of very preterm delivery has a major influence on reported neonatal...

  19. New labor management guidelines and changes in cesarean delivery patterns.

    Science.gov (United States)

    Rosenbloom, Joshua I; Stout, Molly J; Tuuli, Methodius G; Woolfolk, Candice L; López, Julia D; Macones, George A; Cahill, Alison G

    2017-12-01

    In 2010 the Consortium on Safe Labor published labor curves. It was proposed that the rate of cesarean delivery could be lowered by avoiding the diagnosis of arrest of dilation before 6 cm. However, there is little information on the uptake of the guidelines and on changes in cesarean delivery rates that may have occurred. The objective of the study was to test the following hypotheses: (1) among patients laboring at term, rates of arrest of dilation disorders have decreased, leading to a decrease in the rate of cesarean delivery; (2) in the second stage, pushing duration prior to diagnosis of arrest of descent has increased, also leading to a reduction in the rate of cesarean delivery for this indication. As a secondary aim, we investigated changes in maternal and neonatal morbidity. This was a secondary analysis of a prospective cohort study of all patients presenting at ≥37 weeks' gestation from 2010 through 2014 with a nonanomalous vertex singleton and no prior history of cesarean delivery. Rates of cesarean delivery, arrest of dilation, and changes in rates of maternal and neonatal morbidity were calculated in crude and adjusted models. Cervical dilation at diagnosis of the arrest of dilation, time spent at the maximal dilation prior to diagnosis of arrest of dilation, and time in the second stage prior to the diagnosis of arrest of descent were compared over the study period. There were 7845 eligible patients. The cesarean delivery rate in 2010 was 15.8% and, in 2014, 17.7% (P trend = .51). In patients undergoing cesarean delivery for the arrest of dilation, the median cervical dilation at the time of cesarean delivery was at 5.5 cm in 2010 and 6.0 cm in 2014 (P trend = .94). In these patients, there was an increase in the time spent at last dilation: 3.8 hours in 2010 to 5.2 hours in 2014 (P trend = .02). There was no change in the frequency of patients diagnosed with the arrest of dilation at labor management that have occurred over the initial years

  20. Multifunctional Nanoparticles for Drug Delivery Applications Imaging, Targeting, and Delivery

    CERN Document Server

    Prud'homme, Robert

    2012-01-01

    This book clearly demonstrates the progression of nanoparticle therapeutics from basic research to applications. Unlike other books covering nanoparticles used in medical applications, Multifunctional Nanoparticles for Drug Delivery Applications presents the medical challenges that can be reduced or even overcome by recent advances in nanoscale drug delivery. Each chapter highlights recent progress in the design and engineering of select multifunctional nanoparticles with topics covering targeting, imaging, delivery, diagnostics, and therapy.

  1. Analysis Brazilian preference shares: financial liabilities or equity instruments?

    OpenAIRE

    Diana Lucia de Almeida; Patricia de Souza Costa; Eliseu Martins

    2016-01-01

    The Brazilian preference shares, in general, except when they present specific features, such as mandatory redemption and cumulative dividends, meet the accounting definition of equity instruments. However, the scientific literature believes that those shares that do not have discretion to avoid the delivery of cash must be classified as financial liabilities. In a context in which remain differences of understanding of their proper accounting treatment, the following question arises: pre...

  2. Instruments for measuring mental health recovery: a systematic review.

    Science.gov (United States)

    Sklar, Marisa; Groessl, Erik J; O'Connell, Maria; Davidson, Larry; Aarons, Gregory A

    2013-12-01

    Persons in recovery, providers, and policymakers alike are advocating for recovery-oriented mental health care, with the promotion of recovery becoming a prominent feature of mental health policy in the United States and internationally. One step toward creating a recovery-oriented system of care is to use recovery-oriented outcome measures. Numerous instruments have been developed to assess progress towards mental health recovery. This review identifies instruments of mental health recovery and evaluates the appropriateness of their use including their psychometric properties, ease of administration, and service-user involvement in their development. A literature search using the Medline and Psych-INFO databases was conducted, identifying 21 instruments for potential inclusion in this review, of which thirteen met inclusion criteria. Results suggest only three instruments (25%) have had their psychometric properties assessed in three or more unique samples of participants. Ease of administration varied between instruments, and for the majority of instruments, development included service user involvement. This review updates and expands previous reviews of instruments to assess mental health recovery. As mental health care continues to transform to a recovery-oriented model of service delivery, this review may facilitate selection of appropriate assessments of mental health recovery for systems to use in evaluating and improving the care they provide. © 2013.

  3. Payment Instrument Characteristics

    DEFF Research Database (Denmark)

    Holst, Jacques; Kjeldsen, Martin; Hedman, Jonas

    2015-01-01

    Over the last decade, we have witnessed payment innovations that fundamentally have changed the ways we pay. Payment innovations, such as mobile payments and on-line banking, include characteristics or features that are essential to understand if we want to know how and why payers choose among...... payment innovations. Using the Repertory Grid technique to explore 15 payers’ perception of six payment instruments, including coins, banknotes, debit cards, credit cards, mobile payments, and on-line banking, we identify 16 payment characteristics. The characteristics aggregate seventy-six unique...

  4. Operational Test Instrumentation Guide.

    Science.gov (United States)

    1981-11-01

    System. A topographic, transit-level measuring system, instrumented with altimeter, clinometers, compasses , and an alidade, plane table, and stadia rod...dual hangar 250 x 135 feet with two door openings, 80 feet each. There is no compass swing base, no electronic landing aids, ro aircraft wash or...month) of SDG &E) Haybarn Canyon 15,000 6,183,870 Lan Pulgas 1,500 433,890 Las Pulgas Well #41621 100 4,258 Las Pulgas Well #41611 150 7,548 Las Flores

  5. Beam Instrumentation and Diagnostics

    CERN Document Server

    Strehl, Peter

    2006-01-01

    This treatise covers all aspects of the design and the daily operations of a beam diagnostic system for a large particle accelerator. A very interdisciplinary field, it involves contributions from physicists, electrical and mechanical engineers and computer experts alike so as to satisfy the ever-increasing demands for beam parameter variability for a vast range of operation modi and particles. The author draws upon 40 years of research and work, most of them spent as the head of the beam diagnostics group at GSI. He has illustrated the more theoretical aspects with many real-life examples that will provide beam instrumentation designers with ideas and tools for their work.

  6. Instrumentation for tomograph positioning

    International Nuclear Information System (INIS)

    Frenkel, A.D.B.; Castello Branco, L.M.; Reznik, D.S.; Santos, C.A.C.; Borges, J.C.

    1986-01-01

    The COPPE's Nuclear Instrumentation Lab. has been developing researches directed towards the implementation of a Computer-Based Tomography System. Basically, the system reported in this paper can be divided into three major parts: the mechanical part, responsible for the physical movement (Stepper-Motors, table, etc.); the electronic part, which controls the mechanical part and handles the data-acquisition process (microcomputer, interfaces, etc.); and finally, the support of a software-oriented system, including control programs and information processing routines. (Author) [pt

  7. Easy instrumental analysis

    International Nuclear Information System (INIS)

    Ko, Myeong Su; Kim, Tae Hwa; Park, Gyu Hyeon; Yang, Jong Beom; Oh, Chang Hwan; Lee, Kyoung Hye

    2010-04-01

    This textbook describes instrument analysis in easy way with twelve chapters. The contents of the book are pH measurement on principle, pH meter, pH measurement, examples of the experiments, centrifugation, Absorptiometry, Fluorescent method, Atomic absorption analysis, Gas-chromatography, Gas chromatography-mass spectrometry, High performance liquid chromatography liquid chromatograph-mass spectrometry, Electrophoresis on practical case and analysis of the result and examples, PCR on principle, device, application and examples and Enzyme-linked immunosorbent assay with indirect ELISA, sandwich ELISA and ELISA reader.

  8. Maintenance of nuclear instruments

    International Nuclear Information System (INIS)

    Oliveira Rebelo, A.M. de; Santos, C.J.F. dos; Jesus, E.F.O. de; Silva, L.E.M.C.; Borges, J.C.

    1988-01-01

    A program to design and repairing of nuclear instruments for teaching and research was founded in the UFRJ to find solutions for technical support problem - The GEMD-RADIACOES. This group has assisted to several groups of the University in recuperation and conservation of devices like: Linear scanner, Cromatograph and system of radiation detection in general. Recuperation of these devices had required a study of theirs operations modes, to make it possible the setting up of a similar system. Recuperation also involves operation tests, calibration and technical for users, orienting them to get the best performance. (Author) [pt

  9. Easy instrumental analysis

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Myeong Su; Kim, Tae Hwa; Park, Gyu Hyeon; Yang, Jong Beom; Oh, Chang Hwan; Lee, Kyoung Hye

    2010-04-15

    This textbook describes instrument analysis in easy way with twelve chapters. The contents of the book are pH measurement on principle, pH meter, pH measurement, examples of the experiments, centrifugation, Absorptiometry, Fluorescent method, Atomic absorption analysis, Gas-chromatography, Gas chromatography-mass spectrometry, High performance liquid chromatography liquid chromatograph-mass spectrometry, Electrophoresis on practical case and analysis of the result and examples, PCR on principle, device, application and examples and Enzyme-linked immunosorbent assay with indirect ELISA, sandwich ELISA and ELISA reader.

  10. Instruments of Transformative Governance

    DEFF Research Database (Denmark)

    Borrás, Susana

    production and distribution channels. PDPs aim at overcoming current market and government failures by pooling resources in the attempt to solve this global social challenge. Thus, PDPs are a case of instruments of transformative research and innovation, operating in a transnational governance context....... They exhibit three novelties: they address strategic long-term problems in a holistic manner, set substantive output-oriented goals, and are implemented through new organizational structures. After characterizing the different types of current PDPs and the context in which they emerged, the paper examines...

  11. Diamonds for beam instrumentation

    International Nuclear Information System (INIS)

    Griesmayer, Erich

    2013-01-01

    Diamond is perhaps the most versatile, efficient and radiation tolerant material available for use in beam detectors with a correspondingly wide range of applications in beam instrumentation. Numerous practical applications have demonstrated and exploited the sensitivity of diamond to charged particles, photons and neutrons. In this paper, a brief description of a generic diamond detector is given and the interaction of the CVD diamond detector material with protons, electrons, photons and neutrons is presented. Latest results of the interaction of sCVD diamond with 14 MeV mono-energetic neutrons are shown.

  12. Pesticide reducing instruments

    DEFF Research Database (Denmark)

    Jacobsen, Lars-Bo; Jensen, Jørgen Dejgård; Andersen, Martin

    2005-01-01

    -mentioned models and tools. All three scenarios are constructed such that they result in the same welfare implication (measured by national consumption in the CGE model). The scenarios are: 1) pesticide taxes resulting in a 25 percent overall reduction; 2) use of unsprayed field margins, resulting in the same...... for improving bio-diversity and securing drinking water. That is, combining economic modeling with physical biological modeling and geological evaluation allows us to select unsprayed field margins as the most effective instrument. Sensitivity analysis conducted on bio-diversity suggest that this result...

  13. Money market rates and implied CCAPM rates: some international evidence

    OpenAIRE

    Yamin Ahmad

    2004-01-01

    New Neoclassical Synthesis models equate the instrument of monetary policy to the implied CCAPM rate arising from an Euler equation. This paper identifies monetary policy shocks within six of the G7 countries and examines the movement of money market and implied CCAPM rates. The key result is that an increase in the nominal interest rate leads to a fall in the implied CCAPM rate. Incorporating habit still yields the same result. The findings suggest that the movement of these two rates implie...

  14. Calibration of radiation monitoring instruments

    International Nuclear Information System (INIS)

    1973-01-01

    Radiation protection is dependent on good radiation monitoring, and properly calibrated instruments are essential for this work. Simple procedures for periodically checking and recalibrating different kinds of radiation monitoring instruments are shown in this training film

  15. Calibration of "Babyline" RP instruments

    CERN Multimedia

    2015-01-01

      If you have old RP instrumentation of the “Babyline” type, as shown in the photo, please contact the Radiation Protection Group (Joffrey Germa, 73171) to have the instrument checked and calibrated. Thank you. Radiation Protection Group

  16. Calibration of radiation monitoring instruments

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1974-12-31

    Radiation protection is dependent on good radiation monitoring, and properly calibrated instruments are essential for this work. Simple procedures for periodically checking and recalibrating different kinds of radiation monitoring instruments are shown in this training film

  17. Instruments for Water Quality Monitoring

    Science.gov (United States)

    Ballinger, Dwight G.

    1972-01-01

    Presents information regarding available instruments for industries and agencies who must monitor numerous aquatic parameters. Charts denote examples of parameters sampled, testing methods, range and accuracy of test methods, cost analysis, and reliability of instruments. (BL)

  18. 26 CFR 1.1274-4 - Test rate.

    Science.gov (United States)

    2010-04-01

    ... applicable Federal rate for the debt instrument is a foreign currency rate of interest that is analogous to... test rate of interest—(1) In general—(i) Test rate is the 3-month rate. Except as provided in paragraph (a)(2) of this section, the test rate of interest for a debt instrument issued in consideration for...

  19. Dendrimers for Drug Delivery

    Directory of Open Access Journals (Sweden)

    Abhay Singh Chauhan

    2018-04-01

    Full Text Available Dendrimers have come a long way in the last 25 years since their inception. Originally created as a wonder molecule of chemistry, dendrimer is now in the fourth class of polymers. Dr. Donald Tomalia first published his seminal work on Poly(amidoamine (PAMAM dendrimers in 1985. Application of dendrimers as a drug delivery system started in late 1990s. Dendrimers for drug delivery are employed using two approaches: (i formulation and (ii nanoconstruct. In the formulation approach, drugs are physically entrapped in a dendrimer using non-covalent interactions, whereas drugs are covalently coupled on dendrimers in the nanoconstruct approach. We have demonstrated the utility of PAMAM dendrimers for enhancing solubility, stability and oral bioavailability of various drugs. Drug entrapment and drug release from dendrimers can be controlled by modifying dendrimer surfaces and generations. PAMAM dendrimers are also shown to increase transdermal permeation and specific drug targeting. Dendrimer platforms can be engineered to attach targeting ligands and imaging molecules to create a nanodevice. Dendrimer nanotechnology, due to its multifunctional ability, has the potential to create next generation nanodevices.

  20. A wireless actuating drug delivery system

    International Nuclear Information System (INIS)

    Jo, Won-Jun; Baek, Seung-Ki; Park, Jung-Hwan

    2015-01-01

    A wireless actuating drug delivery system was devised. The system is based on induction heating for drug delivery. In this study, thermally generated nitrogen gas produced by induction heating of azobisisobutyronitrile (AIBN) was utilized for pressure-driven release of the drug. The delivery device consists of an actuator chamber, a drug reservoir, and a microchannel. A semicircular copper disc (5 and 6 mm in diameter and 100 µm thick), and thermal conductive tape were integrated as the heating element in the actuator chamber. The final device was 2.7 mm thick. 28 µl of drug solution were placed in the reservoir and the device released the drug quickly at the rate of 6 µl s −1 by induction heating at 160 µT of magnetic intensity. The entire drug solution was released and dispersed after subcutaneous implantation under identical experimental condition. This study demonstrates that the device was simply prepared and drug delivery could be achieved by wireless actuation of a thin, pressure-driven actuator. (paper)

  1. Genetically engineered nanocarriers for drug delivery

    Directory of Open Access Journals (Sweden)

    Shi P

    2014-03-01

    Full Text Available Pu Shi, Joshua A Gustafson, J Andrew MacKayDepartment of Pharmacology and Pharmaceutical Sciences, University of Southern California, Los Angeles, CA, USAAbstract: Cytotoxicity, low water solubility, rapid clearance from circulation, and off-target side-effects are common drawbacks of conventional small-molecule drugs. To overcome these shortcomings, many multifunctional nanocarriers have been proposed to enhance drug delivery. In concept, multifunctional nanoparticles might carry multiple agents, control release rate, biodegrade, and utilize target-mediated drug delivery; however, the design of these particles presents many challenges at the stage of pharmaceutical development. An emerging solution to improve control over these particles is to turn to genetic engineering. Genetically engineered nanocarriers are precisely controlled in size and structure and can provide specific control over sites for chemical attachment of drugs. Genetically engineered drug carriers that assemble nanostructures including nanoparticles and nanofibers can be polymeric or non-polymeric. This review summarizes the recent development of applications in drug and gene delivery utilizing nanostructures of polymeric genetically engineered drug carriers such as elastin-like polypeptides, silk-like polypeptides, and silk-elastin-like protein polymers, and non-polymeric genetically engineered drug carriers such as vault proteins and viral proteins.Keywords: polymeric drug carrier, non-polymeric drug carrier, gene delivery, GE drug carriers

  2. Nuclear instrumentation for research reactors

    International Nuclear Information System (INIS)

    Hofer, Carlos G.; Pita, Antonio; Verrastro, Claudio A.; Maino, Eduardo J.

    1997-01-01

    The nuclear instrumentation for research reactors in Argentina was developed in 70'. A gradual modernization of all the nuclear instrumentation is planned. It includes start-up and power range instrumentation, as well as field monitors, clamp, scram and rod movement control logic. The new instrumentation is linked to a computer network, based on real time operating system for data acquisition, display and logging. This paper describes the modules and whole system aspects. (author). 2 refs

  3. Maternal morbidity and mortality associated with delivery after intrauterine death

    International Nuclear Information System (INIS)

    Ifnan, F.; Jameel, M.B.

    2006-01-01

    To determine the maternal morbidity and mortality associated with delivery after intrauterine fetal death (IUFD) and to find out the place of fetal destructive procedures and cesarean section. All women were included in the present study who presented before the onset of labour pains, after intrauterine fetal death at 26 weeks or onward with singleton pregnancy. Assessment of maternal demographic characteristics, gestational age at fetal demise, delivery-IUFD interval, mode of delivery; vaginal with or without fetal destructive procedures/cesarean section and maternal complications were the main outcome measures. There were 1834 live birth and 63 deliveries with intrauterine fetal death. Mode of delivery was vaginal in 87.4% and cesarean section in 12.6% of the cases. Twelve (21%) of the vaginal deliveries were complicated by lower urogenital tract injuries in certain cases, whereas 75% (6/8) of patients delivered by cesarean section developed major postoperative complications like postpartum haemorrhage, shock, endometritis, peritonitis and wound dehiscence. No maternal death was identified. Rate of delivery with intrauterine fetal death was 34.3/1000 live-birth deliveries. (author)

  4. The QUIET Instrument

    Energy Technology Data Exchange (ETDEWEB)

    Bischoff, C.; et al.

    2012-07-01

    The Q/U Imaging ExperimenT (QUIET) is designed to measure polarization in the Cosmic Microwave Background, targeting the imprint of inflationary gravitational waves at large angular scales ({approx}1{sup o}). Between 2008 October and 2010 December, two independent receiver arrays were deployed sequentially on a 1.4m side-fed Dragonian telescope. The polarimeters which form the focal planes use a highly compact design based on High Electron Mobility Transistors (HEMTs) that provides simultaneous measurements of the Stokes parameters Q, U, and I in a single module. The 17-element Q-band polarimeter array, with a central frequency of 43.1 GHz, has the best sensitivity (69 {mu}Ks{sup 1/2}) and the lowest instrumental systematic errors ever achieved in this band, contributing to the tensor-to-scalar ratio at r < 0:1. The 84-element W-band polarimeter array has a sensitivity of 87 {mu}Ks{sup 1/2} at a central frequency of 94.5 GHz. It has the lowest systematic errors to date, contributing at r < 0:01. The two arrays together cover multipoles in the range {ell} {approx} 25 -- 975. These are the largest HEMT-based arrays deployed to date. This article describes the design, calibration, performance of, and sources of systematic error for the instrument.

  5. Nuclear electronic instrumentation

    International Nuclear Information System (INIS)

    Ramirez J, F. J.

    2010-01-01

    The activities carried out in the Instituto Nacional de Investigaciones Nucleares (ININ) in the field of the nuclear electronic instrumentation included those activities corresponding to the design and production of nuclear instruments in a first stage, as well as the internal activities of design, repair and maintenance that have supported to other projects of the institution during many years. It is mentioned of the presence and constant collaboration of the ININ with the IAEA in different projects and programs. Also, it is mentioned on the establishment of the Radiation Detectors Laboratory, which for their characteristics and repair capacities of radiation detectors of cooled semiconductor, it is only in their specialty. It is emphasized the investigation and the development in the field of new radiation detectors and applications, as well as the important contribution in this field, in institutions like: Mexican Petroleum, National Commission of Nuclear Safety and Safeguards and Federal Commission of Electricity. Finally a position of the future of these activities is made, considering the speed of the advances of the electronic and nuclear technology. (Author)

  6. Neutron instrumentation system

    International Nuclear Information System (INIS)

    Akiyama, Takao; Arita, Setsuo; Yuchi, Hiroyuki

    1989-01-01

    The neutron instrumentation system of this invention can greatly reduce the possibility that the shutdown flux is increased greater than a predetermiend value to cause scram due to vibrations caused by earthquakes or shocks in the neutron instrumentation system without injuring the reactor safety. That is, a sensor having a zero sensitivity to a neutron flux which is an object to be detected by the sensor (dummy sensor) is used together with a conventional sensor (a sensor having predetermined sensitivity to a neutron flux as an object to be measured ----- true sensor). Further, identical signal transmission cables, connector and the signal processing circuits are used for both of true sensor and the dummy sensor. The signal from the dummy sensor is subtracted from the signal from the true sensor at the output of the signal processing circuit. Since the output of the dummy sensor is zero during normal operation, the subtracted value is the same as the value from the true sensor. If the true sensor causes an output with the reason other than the neutron flux, this is outputted also from the dummy sensor but does not appear in the subtracted value. (I.S.)

  7. Incore instrument device

    International Nuclear Information System (INIS)

    Sakima, Naoki

    1996-01-01

    An incore instrument device has an integrally disposed touch panel having a function of displaying an operation indication method such as for setting of conditions for incore measurement and information processing and results of the incore measurement and a function capable of conducting operation indication such as for setting conditions and information processing for incore measurement relative to a control section upon touching an information position on a displayed information. In addition, an information processing section comprising a man-machine function program formed so as to recognize the content of the operation indication for the incore measurement by touching and let the control section to conduct it is disposed to the outside by way of a communication interface. In addition, a programming device is disposed for forming and rewriting the program of the man-machine function relative to the information processing section. Then, when various indication operations are conducted upon performing incore measurement, a view point can be concentrated to one predetermined point thereby enabling to improve the operationability without danger. In addition, the programming of the man-machine function does not apply unnecessary load to the control section in the incore instrumentation device. (N.H.)

  8. Balances instruments, manufacturers, history

    CERN Document Server

    Robens, Erich; Kiefer, Susanne

    2014-01-01

    The book deals mainly with direct mass determination by means of a conventional balances. It covers the history of the balance from the beginnings in Egypt earlier than 3000 BC to recent developments. All balance types are described with emphasis on scientific balances. Methods of indirect mass determination, which are applied to very light objects like molecules and the basic particles of matter and celestial bodies, are included.  As additional guidance, today’s manufacturers are listed and the profile of important companies is reviewed. Several hundred photographs, reproductions and drawings show instruments and their uses. This book includes commercial weighing instruments for merchandise and raw materials in workshops as well as symbolic weighing in the ancient Egyptian’s ceremony of ‘Weighing of the Heart’, the Greek fate balance, the Roman  Justitia, Juno Moneta and Middle Ages scenes of the Last Judgement with Jesus or St. Michael and of modern balances. The photographs are selected from the...

  9. Flight Test Guide (Part 61 Revised): Instrument Pilot: Helicopter.

    Science.gov (United States)

    Federal Aviation Administration (DOT), Washington, DC. Flight Standards Service.

    The guide provides an outline of the skills required to pass the flight test for an Instrument Pilot Helicopter Rating under Part 61 (revised) of Federal Aviation Regulations. General procedures for flight tests are described and the following pilot operations outlined: maneuvering by reference to instruments, IFR navigation, instrument…

  10. The rise in caesarean birth rate in Sagamu, Nigeria: reflection of changes in obstetric practice.

    Science.gov (United States)

    Oladapo, O T; Sotunsa, J O; Sule-Odu, A O

    2004-06-01

    A retrospective and comparative study of women delivered by caesarean section over two different 3-year periods was conducted at Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. The caesarean section rate (CSR) increased from 10.3% in 1989-1991 to 23.1% in 2000-2003. The most frequent indication in both periods was different: prolonged/obstructed labour (20.0%) in 1989-1991 and antepartum haemorrhage (14.9%) in 2000-2003. Malpresentation, antepartum haemorrhage and pre-eclampsia/eclampsia were responsible for 51.7% of the difference in the CSR recorded between both periods. The CSR rose from 13.3% to 25.0% while the instrumental vaginal delivery (IVD) rate decreased significantly by 11.4% among the nulliparous women between the periods. Increase in CSR can be attributed mainly to reduction in IVD rate and alteration in the management of labour complications and induction policy. Strategies to reduce the CSR should cut across all indications and focus on encouraging instrumental vaginal deliveries, especially among nulliparous women.

  11. Advancements in Actuated Musical Instruments

    DEFF Research Database (Denmark)

    Overholt, Daniel; Berdahl, Edgar; Hamilton, Robert

    2011-01-01

    are physical instruments that have been endowed with virtual qualities controlled by a computer in real-time but which are nevertheless tangible. These instruments provide intuitive and engaging new forms of interaction. They are different from traditional (acoustic) and fully automated (robotic) instruments...

  12. Rio de Janeiro: Instrumentation school

    International Nuclear Information System (INIS)

    Anon.

    1990-01-01

    Students from Latin America were able to get hands-on experience in state-of-the-art physics instrumentation in this year's School on Instrumentation for High Energy Physics organized by the active Instrumentation Panel of ICFA (the International Committee for Future Accelerators) at the Centro Brasileiro de Pesquicas Fisicas (CBPF), Rio de Janeiro, in July

  13. Instrument Remote Control via the Astronomical Instrument Markup Language

    Science.gov (United States)

    Sall, Ken; Ames, Troy; Warsaw, Craig; Koons, Lisa; Shafer, Richard

    1998-01-01

    The Instrument Remote Control (IRC) project ongoing at NASA's Goddard Space Flight Center's (GSFC) Information Systems Center (ISC) supports NASA's mission by defining an adaptive intranet-based framework that provides robust interactive and distributed control and monitoring of remote instruments. An astronomical IRC architecture that combines the platform-independent processing capabilities of Java with the power of Extensible Markup Language (XML) to express hierarchical data in an equally platform-independent, as well as human readable manner, has been developed. This architecture is implemented using a variety of XML support tools and Application Programming Interfaces (API) written in Java. IRC will enable trusted astronomers from around the world to easily access infrared instruments (e.g., telescopes, cameras, and spectrometers) located in remote, inhospitable environments, such as the South Pole, a high Chilean mountaintop, or an airborne observatory aboard a Boeing 747. Using IRC's frameworks, an astronomer or other scientist can easily define the type of onboard instrument, control the instrument remotely, and return monitoring data all through the intranet. The Astronomical Instrument Markup Language (AIML) is the first implementation of the more general Instrument Markup Language (IML). The key aspects of our approach to instrument description and control applies to many domains, from medical instruments to machine assembly lines. The concepts behind AIML apply equally well to the description and control of instruments in general. IRC enables us to apply our techniques to several instruments, preferably from different observatories.

  14. Management of persistent occiput posterior position: a substantial role of instrumental rotation in the setting of failed manual rotation.

    Science.gov (United States)

    Guerby, Paul; Allouche, Mickael; Simon-Toulza, Caroline; Vayssiere, Christophe; Parant, Olivier; Vidal, Fabien

    2018-01-01

    To compare the maternal and neonatal outcomes associated with Instrumental Rotation (IR) to operative vaginal delivery in occiput posterior (OP) position with Thierry's spatulas (TS), in the setting of failed manual rotation (MR). We led a prospective observational cohort study in a tertiary referral hospital in Toulouse, France. All women presenting in labor with persistent OP position at full cervical dilatation and who delivered vaginally after failed MR and with IR or OP assisted delivery were included from January 2014 to December 2015. The main outcomes measured were maternal morbidity parameters including episiotomy rate, incidence and severity of perineal lacerations, perineal hematomas and postpartum hemorrhage. Severe perineal tears corresponded to third and fourth degree lacerations. Fetal morbidity outcomes comprised neonatal Apgar scores, acidemia, fetal injuries, birth trauma and neonatal intensive care unit admissions. Among 9762 women, 910 (9.3%) presented with persistent OP position at full cervical dilatation and 222 deliveries were enrolled. Of 111 attempted IR, 97 were successful (87.4%). The incidence of anal sphincter injuries was significantly reduced after IR attempt (1.8% vs. 12.6%; p manual rotation.

  15. The Preschool Rating Instrument for Science and Mathematics (PRISM)

    Science.gov (United States)

    Brenneman, Kimberly; Stevenson-Garcia, Judi; Jung, Kwanghee; Frede, Ellen

    2011-01-01

    Until recently, few valid and reliable assessments were available to measure young children's mathematics and science learning in a "comprehensive" way. Now, a number of mathematics assessments have been developed and subjected to testing (Klein, Starkey, & Wakeley, 2000; Ginsburg, 2008; Clements & Sarama, 2008), and progress has…

  16. Microencapsulation: A promising technique for controlled drug delivery.

    Science.gov (United States)

    Singh, M N; Hemant, K S Y; Ram, M; Shivakumar, H G

    2010-07-01

    MICROPARTICLES OFFER VARIOUS SIGNIFICANT ADVANTAGES AS DRUG DELIVERY SYSTEMS, INCLUDING: (i) an effective protection of the encapsulated active agent against (e.g. enzymatic) degradation, (ii) the possibility to accurately control the release rate of the incorporated drug over periods of hours to months, (iii) an easy administration (compared to alternative parenteral controlled release dosage forms, such as macro-sized implants), and (iv) Desired, pre-programmed drug release profiles can be provided which match the therapeutic needs of the patient. This article gives an overview on the general aspects and recent advances in drug-loaded microparticles to improve the efficiency of various medical treatments. An appropriately designed controlled release drug delivery system can be a foot ahead towards solving problems concerning to the targeting of drug to a specific organ or tissue, and controlling the rate of drug delivery to the target site. The development of oral controlled release systems has been a challenge to formulation scientist due to their inability to restrain and localize the system at targeted areas of gastrointestinal tract. Microparticulate drug delivery systems are an interesting and promising option when developing an oral controlled release system. The objective of this paper is to take a closer look at microparticles as drug delivery devices for increasing efficiency of drug delivery, improving the release profile and drug targeting. In order to appreciate the application possibilities of microcapsules in drug delivery, some fundamental aspects are briefly reviewed.

  17. A new electrospray method for targeted gene delivery.

    Science.gov (United States)

    Boehringer, Stephan; Ruzgys, Paulius; Tamò, Luca; Šatkauskas, Saulius; Geiser, Thomas; Gazdhar, Amiq; Hradetzky, David

    2018-03-05

    A challenge for gene therapy is absence of safe and efficient local delivery of therapeutic genetic material. An efficient and reproducible physical method of electrospray for localized and targeted gene delivery is presented. Electrospray works on the principle of coulombs repulsion, under influence of electric field the liquid carrying genetic material is dispersed into micro droplets and is accelerated towards the targeted tissue, acting as a counter electrode. The accelerated droplets penetrate the targeted cells thus facilitating the transfer of genetic material into the cell. The work described here presents the principle of electrospray for gene delivery, the basic instrument design, and the various optimized parameters to enhance gene transfer in vitro. We estimate a transfection efficiency of up to 60% was achieved. We describe an efficient gene transfer method and a potential electrospray-mediated gene transfer mechanism.

  18. Secondary fuel delivery system

    Science.gov (United States)

    Parker, David M.; Cai, Weidong; Garan, Daniel W.; Harris, Arthur J.

    2010-02-23

    A secondary fuel delivery system for delivering a secondary stream of fuel and/or diluent to a secondary combustion zone located in the transition piece of a combustion engine, downstream of the engine primary combustion region is disclosed. The system includes a manifold formed integral to, and surrounding a portion of, the transition piece, a manifold inlet port, and a collection of injection nozzles. A flowsleeve augments fuel/diluent flow velocity and improves the system cooling effectiveness. Passive cooling elements, including effusion cooling holes located within the transition boundary and thermal-stress-dissipating gaps that resist thermal stress accumulation, provide supplemental heat dissipation in key areas. The system delivers a secondary fuel/diluent mixture to a secondary combustion zone located along the length of the transition piece, while reducing the impact of elevated vibration levels found within the transition piece and avoiding the heat dissipation difficulties often associated with traditional vibration reduction methods.

  19. Focus on Delivery

    DEFF Research Database (Denmark)

    Hasman, Kirsten; Barfoed, Anne

    Background: Compared to other Nordic countries, Denmark has a high incidence of anal sphincter injury. Recent studies indicate that a strict focus on prevention of severe perineal trauma has decreased the incidence (1). This has resulted in changed clinical procedures in several Danish labour wards...... (2). It is, however, not clarified which of the multifaceted aspects of preventing perineal injury that might explain the decrease (3). Aims: We hypothesized that the use of structured reflection on a clinical practice by midwives and midwifery students would increase both parts’ knowledge on how...... attended the delivery, facilitated the midwife’s and the student’s structured reflection. Further, the project midwife held daily simulation workshops with midwives and students. Two focus group interviews with students and midwives were conducted and analyzed using content analysis. Results and conclusion...

  20. Effects of Cesarean Delivery on Breastfeeding Practices and Duration: A Prospective Cohort Study.

    Science.gov (United States)

    Chen, Cheng; Yan, Yan; Gao, Xiao; Xiang, Shiting; He, Qiong; Zeng, Guangyu; Liu, Shiping; Sha, Tingting; Li, Ling

    2018-01-01

    Mothers are encouraged to exclusively breastfeed for the first 6 months. However, cesarean delivery rates have increased worldwide, which may affect breastfeeding. Research aim: This study aimed to determine the potential effects of cesarean delivery on breastfeeding practices and breastfeeding duration. This was a 6-month cohort study extracted from a 24-month prospective cohort study of mother-infant pairs in three communities in Hunan, China. Data about participants' characteristics, delivery methods, breastfeeding initiation, use of formula in the hospital, exclusive breastfeeding, and any breastfeeding were collected at 1, 3, and 6 months following each infant's birth. The chi-square test, logistic regression model, and Cox proportional hazard regression model were used to examine the relationship between breastfeeding practices and cesarean delivery. The number of women who had a cesarean delivery was 387 (40.6%), and 567 (59.4%) women had a vaginal delivery. The exclusive breastfeeding rates at 1, 3, and 6 months were 80.2%, 67.4%, and 21.5%, respectively. Women who had a cesarean delivery showed a lower rate of exclusive breastfeeding and any breastfeeding than those who had a vaginal delivery ( p cesarean delivery was related with using formula in the hospital and delayed breastfeeding initiation. Cesarean delivery also shortened the breastfeeding duration (hazard ratio = 1.40, 95% confidence interval [1.06, 1.84]). Healthcare professionals should provide more breastfeeding skills to women who have a cesarean delivery and warn mothers about the dangers of elective cesarean section for breastfeeding practices.