WorldWideScience

Sample records for intensive front-line immunochemotherapy

  1. Coping on the Front-line

    DEFF Research Database (Denmark)

    Sanden, Guro Refsum; Lønsmann, Dorte

    language boundaries in their everyday work. Despite official English language policies in the three companies, our findings show that employees face a number of different language boundaries, and that ad hoc and informal solutions in many cases are vital for successful cross-language communication. Drawing......This article investigates how front-line employees respond to English language policies implemented by the management of three multinational corporations (MNCs) headquartered in Scandinavia. Based on interview and document data the article examines the ways in which front-line employees cross...

  2. Discretionary Power on the Front-line

    DEFF Research Database (Denmark)

    Sanden, Guro Refsum; Lønsmann, Dorte

    This article investigates the communication practices used by front-line employees to cross language boundaries in the context of English language policies implemented by the management of three multinational corporations (MNCs) headquartered in Scandinavia. Based on an analysis of interview...... and document data, our findings show that employees face a number of different language boundaries in their everyday work, and that ad hoc and informal solutions in many cases are vital for successful cross-language communication. We introduce the concept of ‘discretionary power’ to explain how and why front...

  3. Discretionary power on the front-line

    DEFF Research Database (Denmark)

    Sanden, Guro Refsum; Lønsmann, Dorte

    2018-01-01

    This article investigates the communication practices used by front-line employees to cross language boundaries in the context of English language policies implemented by the management of three multinational corporations headquartered in Scandinavia. Based on an analysis of interview and document...... data, our findings show that employees face a number of different language boundaries in their everyday work, and that ad hoc and informal solutions in many cases are vital for successful cross-language communication. We introduce the concept of discretionary power to explain how and why front...

  4. Discretionary Power on the Front Line

    DEFF Research Database (Denmark)

    Sanden, Guro Refsum; Lønsmann, Dorte

    2018-01-01

    This paper investigates the communication practices used by front-line employees to cross language boundaries in the context of English language policies implemented by the management of three multinational corporations (MNCs) headquartered in Scandinavia. Based on an analysis of interview...... and document data, our findings show that employees face a number of different language boundaries in their everyday work, and that ad hoc and informal solutions in many cases are vital for successful cross-language communication. We introduce the concept of 'discretionary power' to explain how and why front...

  5. The Front Line of Genomic Translation

    International Nuclear Information System (INIS)

    O'Neill, C. S.; McBride, C. M.; Koehly, L. M.; Bryan, A. D.; Wideroff, L.

    2012-01-01

    Cancer prevention, detection, and treatment represent the front line of genomic translation. Increasingly, new genomic knowledge is being used to inform personalized cancer prevention recommendations and treatment [1-3]. Genomic applications proposed and realized span the full cancer continuum, from cancer prevention and early detection vis a vis genomic risk profiles to motivate behavioral risk reduction and adherence [4] to screening and prophylactic prevention recommendations for high-risk families [5-7], to enhancing cancer survivorship by using genomic tumor profiles to inform treatment decisions and targeted cancer therapies [8, 9]. Yet the utility for many of these applications is as yet unclear and will be influenced heavily by the public’s, patients’, and health care providers’ responses and in numerous other factors, such as health care delivery models [3]. The contributors to this special issue consider various target groups’ responses and contextual factors. To reflect the cancer continuum, the special issue is divided into three broad, overlapping themes-primary prevention, high risk families and family communication and clinical translation.

  6. Relvakogujad sõjaajalooklubist Front Line vahistati / Kadri Ratt

    Index Scriptorium Estoniae

    Ratt, Kadri

    2009-01-01

    Kaitsepolitsei võttis vahi alla 9 meest, keda kahtlustatakse suures koguses lõhkeainete, lõhkekehade ja tulirelvade ebaseaduslikus käitlemises. 6 meest neist kuuluvad sõjaajalooklubisse Front Line

  7. Your employees: the front line in cyber security

    OpenAIRE

    Ashenden, D

    2016-01-01

    First published in The Chemical Engineer and reproduced by Crest - Centre for Research and Evidence on Security Threats, 26/01/2016 (https://crestresearch.ac.uk/comment/employees-front-line-cyber-security/)

  8. Protecting front-line survey and rescue teams during emergencies

    International Nuclear Information System (INIS)

    Tresise, H.

    1980-01-01

    Means of protecting front-line survey and rescue teams during emergencies are described. The team composition, their apparatus, the selection of the incident control point, the use of guidelines and breathing apparatus and control point trolley and equipment are discussed. (H.K.)

  9. Virulence evolution at the front line of spreading epidemics.

    Science.gov (United States)

    Griette, Quentin; Raoul, Gaël; Gandon, Sylvain

    2015-11-01

    Understanding and predicting the spatial spread of emerging pathogens is a major challenge for the public health management of infectious diseases. Theoretical epidemiology shows that the speed of an epidemic is governed by the life-history characteristics of the pathogen and its ability to disperse. Rapid evolution of these traits during the invasion may thus affect the speed of epidemics. Here we study the influence of virulence evolution on the spatial spread of an epidemic. At the edge of the invasion front, we show that more virulent and transmissible genotypes are expected to win the competition with other pathogens. Behind the front line, however, more prudent exploitation strategies outcompete virulent pathogens. Crucially, even when the presence of the virulent mutant is limited to the edge of the front, the invasion speed can be dramatically altered by pathogen evolution. We support our analysis with individual-based simulations and we discuss the additional effects of demographic stochasticity taking place at the front line on virulence evolution. We confirm that an increase of virulence can occur at the front, but only if the carrying capacity of the invading pathogen is large enough. These results are discussed in the light of recent empirical studies examining virulence evolution at the edge of spreading epidemics. © 2015 The Author(s). Evolution © 2015 The Society for the Study of Evolution.

  10. Front-line ordering clinicians: matching workforce to workload.

    Science.gov (United States)

    Fieldston, Evan S; Zaoutis, Lisa B; Hicks, Patricia J; Kolb, Susan; Sladek, Erin; Geiger, Debra; Agosto, Paula M; Boswinkel, Jan P; Bell, Louis M

    2014-07-01

    Matching workforce to workload is particularly important in healthcare delivery, where an excess of workload for the available workforce may negatively impact processes and outcomes of patient care and resident learning. Hospitals currently lack a means to measure and match dynamic workload and workforce factors. This article describes our work to develop and obtain consensus for use of an objective tool to dynamically match the front-line ordering clinician (FLOC) workforce to clinical workload in a variety of inpatient settings. We undertook development of a tool to represent hospital workload and workforce based on literature reviews, discussions with clinical leadership, and repeated validation sessions. We met with physicians and nurses from every clinical care area of our large, urban children's hospital at least twice. We successfully created a tool in a matrix format that is objective and flexible and can be applied to a variety of settings. We presented the tool in 14 hospital divisions and received widespread acceptance among physician, nursing, and administrative leadership. The hospital uses the tool to identify gaps in FLOC coverage and guide staffing decisions. Hospitals can better match workload to workforce if they can define and measure these elements. The Care Model Matrix is a flexible, objective tool that quantifies the multidimensional aspects of workload and workforce. The tool, which uses multiple variables that are easily modifiable, can be adapted to a variety of settings. © 2014 Society of Hospital Medicine.

  11. Front-Line Physicians' Satisfaction with Information Systems in Hospitals.

    Science.gov (United States)

    Peltonen, Laura-Maria; Junttila, Kristiina; Salanterä, Sanna

    2018-01-01

    Day-to-day operations management in hospital units is difficult due to continuously varying situations, several actors involved and a vast number of information systems in use. The aim of this study was to describe front-line physicians' satisfaction with existing information systems needed to support the day-to-day operations management in hospitals. A cross-sectional survey was used and data chosen with stratified random sampling were collected in nine hospitals. Data were analyzed with descriptive and inferential statistical methods. The response rate was 65 % (n = 111). The physicians reported that information systems support their decision making to some extent, but they do not improve access to information nor are they tailored for physicians. The respondents also reported that they need to use several information systems to support decision making and that they would prefer one information system to access important information. Improved information access would better support physicians' decision making and has the potential to improve the quality of decisions and speed up the decision making process.

  12. Implementing an ambidextrous sales strategy at the front line: an internal marketing perspective

    NARCIS (Netherlands)

    van der Borgh, W.; de Jong, A.; Nijssen, E.J.; Ahearne, M.; Bigné, E.

    2014-01-01

    Ambidextrous sales strategies, wherein managers pursue the concurrent sale of new and existing products, often fail at the front line. A proposed internal marketing perspective accounts for the role of two vertical relational mechanisms (manager ambidexterity and salesperson organizational

  13. Factors influencing job satisfaction of front line nurse managers: a systematic review.

    Science.gov (United States)

    Lee, How; Cummings, Greta G

    2008-10-01

    The purpose of this study was to systematically review the research literature that examined the determinants of front line nurse managers' job satisfaction. Front line managers are the vital link between senior management and clinical nurses. They influence organizational culture and outcomes for patients and staff so their job satisfaction and ultimately retention is of importance. A review of research articles that examined the determinants of front line nurse managers' job satisfaction was conducted. These managers supervise staff nurses and have direct responsibility for the management of a nursing unit or team in any type of healthcare facility. Fourteen studies were included in the final analysis. Evidence of significant positive relationships were found between span of control, organizational support, empowerment and the job satisfaction of front line nurse managers. The review suggests that job satisfaction of front line managers may be improved by addressing span of control and workload, increasing organizational support from supervisors and empowering managers to participate in decision-making. Healthcare organizations may enhance the recruitment, retention and sustainability of future nursing leadership by addressing the factors that influence job satisfaction of front line managers.

  14. Impact of patient suicide on front-line staff in Ireland.

    LENUS (Irish Health Repository)

    Gaffney, Paul

    2009-08-01

    Research and anecdotal evidence suggests that coming to terms with the suicide of a patient can be extremely distressing for front-line professionals. Some research also suggests that exposure to such situations can undermine professionals\\' functioning and feelings of competence, cause them to question their professional standing and ultimately contribute to burnout. A survey of 447 front-line professionals\\' experiences of patient suicide was undertaken to further explore these issues. Thematic analysis of open-ended questionnaire items revealed that concerns for the bereaved family, feelings of responsibility for the death and having a close therapeutic relationship with the client are key factors that influence the adjustment and coping of a health professional in the aftermath of the death of a client by suicide. The results are discussed with a focus on the impact of suicide on front-line staff, the need for ongoing support and training and the development of specific post-suicide protocols.

  15. The effect of privatisation on front line employees in a service organisation

    Directory of Open Access Journals (Sweden)

    FW Struwig

    2004-07-01

    Full Text Available A government organisation in the water supply business was faced with the challenge of changing their traditional way of doing business to operate as a profit driven entity. This research focuses on how privatisation has affected front-line service employees. Both the front-line service employees and management were interviewed and included as cases to investigate changes that have occurred as a result of privatisation. These cases revealed that after privatisation front line service employees have received better training, appreciated a better system of communication, experienced a higher degree of empowerment and enjoyed an organisational culture that is more customer focused. The research, however, indicated lower levels of motivation, that employees do not appreciate an improvement in their reward system neither do they get feedback regarding their achievements and that they experience little job security.

  16. Poverty, Place and Pedagogy in Education: Research Stories from Front-Line Workers

    Science.gov (United States)

    Comber, Barbara

    2016-01-01

    This article considers what it means to teach and learn in places of poverty through the narratives of front-line workers--particularly students and teachers. What is the work of teaching and learning in places of poverty in current times? How has this changed? What can be learned from both the haunting and hopeful narratives of front-line…

  17. Sacrifice zones: the front lines of toxic chemical exposure in the United States

    National Research Council Canada - National Science Library

    Lerner, Steve

    2010-01-01

    ... States of America. Library of Congress Cataloging-in-Publication Data Lerner, Steve. Sacrifice zones: the front lines of toxic chemical exposure in the United States / Steve Lerner. p. cm. Includes bibliographical references and index. ISBN 978-0-262-01440-3 (hardcover : alk. paper) 1. Environmental toxicology- United States- Case studies. 2. Che...

  18. The establishment of the Croatian Dental Crops: the front-line experience of a dentist volunteer.

    Science.gov (United States)

    Jelaca-Bagić, S; Sipina, J; Visković, R; Cakarun, Z; Vlatković, I; Biloglav, D

    1997-01-01

    The establishment of the first dental office of the Croatian Dental Corps (CDC) in the city of Zadar represented at the same time the beginning of the CDC. This article describes the front-line experience of a dentist who volunteered to provide basic medical help, which eventually laid the groundwork for providing general dental care and establishing the first CDC dental office. The office was opened on December 16, 1991, and provided general dental care except prosthetics. Although faced with numerous problems and extremely difficult conditions, the office staff completed 1,913 initial and 1,157 control checkups and performed 4,002 services by treating 12 to 16 patients per day. The main causes for emergencies were caries (59%) and endodontic complications (28%). This variety of services in the proximity of the front line is considered extensive even for advanced medical corps of modern armies.

  19. Revisiting the Impact of Perceived Empowerment on Job Performance: Results from Front-Line Employees

    Directory of Open Access Journals (Sweden)

    Ozgur Devrim Yilmaz

    2015-01-01

    Full Text Available This study was conducted to examine the probable effect of perceived empowerment on job performance and the sample of research consisted of 230 participants working in tourism sector as front-line employees. The outcomes of this study indicated that psychological empowerment was positively correlated with employee job performance and employees’ job performance were mostly effected from self-determination and impact dimensions of empowerment. Moreover, tests were conducted to analyze the significant differences in participants’ perception of empowerment and job performance according to their demographic characteristics. There was a significant difference between perceived empowerment and gender, age and work experience where as there was no significant difference between empowerment and education levels. On the other hand, the relationship between job performance and work experience was supported however no relationship was found between job performance and gender, age and education level of the participants. Trying to find out what might possibly lead front-line employees to increased job performance, it can be claimed that psychological empowerment still turns out to be a central issue and therefore this research makes useful contributions to the current knowledge by entirely investigating the direct effect of perceived empowerment on employee job performance in hospitality industry where especially front-line employees spend most of their time directly with customers.

  20. The challenges of leading change in health-care delivery from the front-line.

    Science.gov (United States)

    Byers, Vivienne

    2017-09-01

    The public sector is facing turbulent times and this challenges nurses, who are expected to serve both patient interests and the efficiency drives of their organisations. In the context of implementing person-centred health policy, this paper explores the evolving role of front-line nurses as leaders and champions of change. Nurses can be seen to have some autonomy in health-care delivery. However, they are subject to systems of social control. In implementing person-centred policy, nurses can be seen to be doing the best they can within a constrained environment. A survey of nursing practice in person-centred health-policy implementation is presented. Despite much being written about managing health-professional resistance to policy implementation, there is a gap between what is being asked of nurses and the resources made available to them to deliver. In this milieu, nurses are utilising their discretion and leading from the front-line in championing change. Empowering nurses who seek to lead patient involvement could be the key to unlocking health-care improvement. Health services tend to be over-managed and under-led and there is a need to harness the potential of front-line nurses by facilitating leadership development through appropriate organisational support. © 2015 John Wiley & Sons Ltd.

  1. Genome-wide mutagenesis and multi-drug resistance in American trypanosomes induced by the front-line drug benznidazole

    KAUST Repository

    Campos, Mô nica C.; Phelan, Jody; Francisco, Amanda F.; Taylor, Martin C.; Lewis, Michael D.; Pain, Arnab; Clark, Taane G.; Kelly, John M.

    2017-01-01

    Chagas disease is caused by the protozoan parasite Trypanosoma cruzi and affects 5–8 million people in Latin America. Although the nitroheterocyclic compound benznidazole has been the front-line drug for several decades, treatment failures

  2. MYC-rearranged lymphomas other than Burkitt: Comparison between R-CHOP and Burkitt-type immunochemotherapy.

    Science.gov (United States)

    Baptista, Maria Joao; Tapia, Gustavo; Hernández-Rivas, José-Ángel; Martínez-Trillos, Alejandra; Mate, José-Luis; Navarro, José-Tomás

    2017-10-23

    MYC-rearranged (MYC-R) lymphomas other than Burkitt lymphoma (BL) are very aggressive, with poor prognosis when treated with standard regimens. We aimed to study the characteristics and outcome of a series of MYC-R lymphomas comparing the treatment results between R-CHOP based and a specific intensive regimen for BL (BURKIMAB). Retrospective study of patients diagnosed with MYC-R. Translocations of MYC, BCL2 and BCL6 were evaluated by fluorescent in situ hybridization. Patients were treated with either, R-CHOP based immunochemotherapy or the Burkitt type regimen, BURKIMAB. Thirty-four MYC-R lymphoma cases were studied: 21 treated with R-CHOP and 13 treated with BURKIMAB. There were no differences in CR rate; 45% (9/20) for R-CHOP and 42% (5/12) for BURKIMAB (P=.99). Although overall survival (OS) and progression free survival (PFS) of BURKIMAB-treated patients were better than those of R-CHOP-treated (3y-OS: 46 vs. 24%; 3y-PFS: 46 vs. 10%), the differences were not statistically significant. MYC-R lymphomas show poor outcomes even when treated with intensive immunochemotherapy for BL. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  3. An exploratory study of work-family conflicts and enrichment of front-line hotel employees in the Philippines

    OpenAIRE

    Nabong, Tristan Kirby Mansueto

    2012-01-01

    Master's thesis in International hotel and tourism management The study aims to explore and identify the front-line hotel employees’ issues and perceptions of work-life balance in the Philippine context. The respondents were front-line hotel personnel assigned to various departments of selected top luxury hotels in the Philippines. Self-administered questionnaires were used to collect the data. Factor analysis discovered five factors: (1) time-based conflict; (2) strain-based conflict; (3...

  4. Front-line managers as boundary spanners: effects of span and time on nurse supervision satisfaction.

    Science.gov (United States)

    Meyer, Raquel M; O'Brien-Pallas, Linda; Doran, Diane; Streiner, David; Ferguson-Paré, Mary; Duffield, Christine

    2011-07-01

    To examine the influence of nurse manager span (number of direct report staff), time in staff contact, transformational leadership practices and operational hours on nurse supervision satisfaction. Increasing role complexity has intensified the boundary spanning functions of managers. Because work demands and scope vary by management position, time in staff contact rather than span may better explain managers' capacity to support staff. A descriptive, correlational design was used to collect cross-sectional survey and prospective work log and administrative data from a convenience sample of 558 nurses in 51 clinical areas and 31 front-line nurse managers from four acute care hospitals in 2007-2008. Data were analysed using hierarchical linear modelling. Span, but not time in staff contact, interacted with leadership and operational hours to explain supervision satisfaction. With compressed operational hours, supervision satisfaction was lower with highly transformational leadership in combination with wider spans. With extended operational hours, supervision satisfaction was higher with highly transformational leadership, and this effect was more pronounced under wider spans. Operational hours, which influence the manager's daily span (average number of direct report staff working per weekday), should be factored into the design of front-line management positions. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

  5. Front-line ownership: generating a cure mindset for patient safety.

    Science.gov (United States)

    Zimmerman, Brenda; Reason, Paige; Rykert, Liz; Gitterman, Leah; Christian, Jennifer; Gardam, Michael

    2013-01-01

    Great advances have been made in standardization and human factors engineering that have reduced variability and increased reliability in healthcare. As important as these advances are, the authors believe there is another important but largely ignored layer to the safety story in healthcare that has prevented us from progressing. In the field of infection prevention and control (IPAC), despite great attempts over several decades to improve compliance with hand hygiene, surveillance, environmental cleaning, isolation protocols and other control measures, very significant challenges remain. We believe this failure is in part due to the power gradients, often dysfunctional relationships and lack of safety mindfulness that exist in hospitals and healthcare more generally. Furthermore, safety culture requires different approaches and considerable ongoing attentiveness. If this is the case, and the authors contend in this paper that it is, then the role of the front line is much more important than many of our healthcare safety and IPAC approaches suggest. Copyright © 2013 Longwoods Publishing.

  6. Desmoid-type fibromatosis: a front-line conservative approach to select patients for surgical treatment.

    Science.gov (United States)

    Fiore, Marco; Rimareix, Françoise; Mariani, Luigi; Domont, Julien; Collini, Paola; Le Péchoux, Cecile; Casali, Paolo G; Le Cesne, Axel; Gronchi, Alessandro; Bonvalot, Sylvie

    2009-09-01

    Surgery is still the standard treatment for desmoid-type fibromatosis (DF). Recently, the Institut Gustave Roussy (IGR), Villejuif, France, reported a series of patients treated with a front-line conservative approach (no surgery and no radiotherapy). The disease remained stable in more than half of patients. This study was designed to evaluate this approach on the natural history of the disease in a larger series of patients. A total of 142 patients presenting to the IGR or Istituto Nazionale Tumori (INT), Milan, Italy, were initially treated using a front-line deliberately conservative policy. Their progression-free survival (PFS) was observed and a multivariate analysis was performed for major clinical variables. Seventy-four patients presented with primary tumor, 68 with recurrence. Eighty-three patients received a "wait & see" policy (W&S), whereas 59 were initially offered medical therapy (MT), mainly hormonal therapy and chemotherapy. A family history of sporadic colorectal cancer was present in 8% of patients. The 5-year PFS was 49.9% for the W&S group and 58.6% for the medically treated patients (P = 0.3196). Similar results emerged for primary and recurrent DF. Multivariate analysis identified no clinical variables as independent predictors of PFS. In the event of progression, all patients were subsequently managed safely. A conservative policy could be a safe approach to primary and recurrent DF, which could avoid unnecessary morbidity from surgery and/or radiation therapy. Half of patients had medium-term stable disease after W&S or MT. A multidisciplinary, stepwise approach should be prospectively tested in DF.

  7. Moral Stress, Moral Practice, and Ethical Climate in Community-Based Drug-Use Research: Views From the Front Line.

    Science.gov (United States)

    Fisher, Celia B; True, Gala; Alexander, Leslie; Fried, Adam L

    2013-01-01

    The role of front-line researchers, those whose responsibilities include face-to-face contact with participants, is critical to ensuring the responsible conduct of community-based drug use research. To date, there has been little empirical examination of how front-line researchers perceive the effectiveness of ethical procedures in their real-world application and the moral stress they may experience when adherence to scientific procedures appears to conflict with participant protections. This study represents a first step in applying psychological science to examine the work-related attitudes, ethics climate, and moral dilemmas experienced by a national sample of 275 front-line staff members whose responsibilities include face-to-face interaction with participants in community-based drug-use research. Using an anonymous Web-based survey we psychometrically evaluated and examined relationships among six new scales tapping moral stress (frustration in response to perceived barriers to conducting research in a morally appropriate manner); organizational ethics climate; staff support; moral practice dilemmas (perceived conflicts between scientific integrity and participant welfare); research commitment; and research mistrust. As predicted, front-line researchers who evidence a strong commitment to their role in the research process and who perceive their organizations as committed to research ethics and staff support experienced lower levels of moral stress. Front-line researchers who were distrustful of the research enterprise and frequently grappled with moral practice dilemmas reported higher levels of moral stress. Applying psychometrically reliable scales to empirically examine research ethics challenges can illuminate specific threats to scientific integrity and human subjects protections encountered by front-line staff and suggest organizational strategies for reducing moral stress and enhancing the responsible conduct of research.

  8. Managing Contradictions from the Middle: A Cultural Historical Activity Theory Investigation of Front-Line Supervisors' Learning Lives

    Science.gov (United States)

    Lord, Ramo J.

    2009-01-01

    This study focused on front-line supervisors in a union shop, steel-production plant and how they learn to successfully negotiate their role with in the corporation's division of labor. Negotiating their role means continued practice in how issues of standpoint, agency, power, oppression, habits, knowledge, related business concerns, mediating…

  9. USDA Snack Policy Implementation: Best Practices From the Front Lines, United States, 2013-2014.

    Science.gov (United States)

    Asada, Yuka; Chriqui, Jamie; Chavez, Noel; Odoms-Young, Angela; Handler, Arden

    2016-06-16

    The Smart Snacks in Schools interim final rule was promulgated by the US Department of Agriculture (USDA) as authorized by the Healthy, Hunger-Free Kids Act of 2010 (PL 111-296) and implementation commenced beginning July 1, 2014; however, in the years leading up to this deadline, national studies suggested that most schools were far from meeting the USDA standards. Evidence to guide successful implementation of the standards is needed. This study examined snack policy implementation in exemplary high schools to learn best practices for implementation. Guided by a multiple case study approach, school professionals (n = 37) from 9 high schools across 8 states were recruited to be interviewed about perceptions of school snack implementation; schools were selected using criterion sampling on the basis of the HealthierUS Schools Challenge: Smarter Lunchrooms (HUSSC: SL) database. Interview transcripts and internal documents were organized and coded in ATLAS.Ti v7; 2 researchers coded and analyzed data using a constant comparative analysis method to identify best practice themes. Best practices for snack policy implementation included incorporating the HUSSC: SL award's comprehensive wellness approach; leveraging state laws or district policies to reinforce snack reform initiatives; creating strong internal and external partnerships; and crafting positive and strategic communications. Implementation of snack policies requires evidence of successful experiences from those on the front lines. As federal, state, and local technical assistance entities work to ensure implementation of the Smart Snacks standards, these best practices provide strategies to facilitate the process.

  10. Implementing a Lean Management System in Primary Care: Facilitators and Barriers From the Front Lines.

    Science.gov (United States)

    Hung, Dorothy; Martinez, Meghan; Yakir, Maayan; Gray, Caroline

    2015-01-01

    Although Lean management techniques are increasingly used in health care to improve quality and reduce costs, lessons about how to successfully implement this approach on the front lines of care delivery are not well documented. In this study, we highlight key facilitators and barriers to implementing Lean among frontline primary care providers. This case study took place at a large, ambulatory care delivery system serving nearly 1 million patients. In-depth interviews were conducted with primary care physicians, staff, and administrators to identify key factors impacting Lean redesigns in primary care. Overall, staff engagement and performance management, sensitivity to the professional values and culture of medicine, and perceived adequacy of organizational resources were critical when introducing Lean changes. Specific drivers of change included empowerment of staff at all levels, visual display of performance metrics, and a culture of innovation and collaboration. Barriers included physician resistance to standardized work, difficulty transferring management responsibilities to non-physician staff, and time and staffing required for participating in improvement efforts. Although Lean offers a new approach to delivering care, the implementation process itself is both complex and crucial to success. Understanding early facilitators and barriers can maximize Lean's, potential to improve health care delivery.

  11. Strategic variation in mobbing as a front line of defense against brood parasitism.

    Science.gov (United States)

    Welbergen, Justin A; Davies, Nicholas B

    2009-02-10

    Coevolutionary arms races, where adaptations in one party select for counter-adaptations in another and vice versa, are fundamental to interactions between organisms and their predators, pathogens, and parasites [1]. Avian brood parasites and their hosts have emerged as model systems for studying such reciprocal coevolutionary processes [2, 3]. For example, hosts have evolved changes in egg appearance and rejection of foreign eggs in response to brood parasitism from cuckoos, and cuckoos have evolved host-egg mimicry as a counter-response [4-6]. However, the host's front line of defense is protecting the nest from being parasitized in the first place [7-10], yet little is known about the effectiveness of nest defense as an antiparasite adaptation, and its coevolutionary significance remains poorly understood [10]. Here we show first that mobbing of common cuckoos Cuculus canorus by reed warblers Acrocephalus scirpaceus is an effective defense against parasitism. Second, mobbing of cuckoos is a phenotypically plastic trait that is modified strategically according to local parasitism risk. This supports the view that hosts use a "defense in-depth strategy," with successive flexible lines of defense that coevolve with corresponding offensive lines of the parasite. This highlights the need for more holistic research into the coevolutionary consequences when multiple adaptations and counter-adaptations evolve in concert [11].

  12. Families of Children With Medical Complexity: A View From the Front Lines.

    Science.gov (United States)

    Allshouse, Carolyn; Comeau, Meg; Rodgers, Rylin; Wells, Nora

    2018-03-01

    This article, written by a group of experienced parents of children with medical complexity (CMC), provides an overview of the demands of managing care from their unique perspective. The article articulates why attention to understanding the challenges that families of CMC face with a fragmented health care system, inadequate health insurance coverage, deficits in the delivery of medical care, and problems accessing other critical services (as well as lack of support for children and adolescents in developing and exercising self-management skills) are vital to efforts to improve the current system and positively impact the life course of vulnerable populations. The authors discuss the financial and intangible costs experienced by families of CMC and other stakeholders (including providers, payers, and others), as well as the benefits that can result when effective, flexible, comanaged team-based care coordination is provided within the environment that is the most natural locus of care for the family. The authors detail the role of policy strategies that provide protections for CMC and the importance of family-led advocacy and support organizations in helping families "on the front lines." Throughout the article, the case is made that families authentically involved at every level of health care systems are critical partners in designing policies and systems that will improve care for CMC. The experiences of families of CMC should inform and guide efforts to improve systems of care, thus positively impacting the life course of this vulnerable population. Copyright © 2018 by the American Academy of Pediatrics.

  13. Police on the Front Line of Community Geriatric Healthcare: Challenges and Opportunities

    Science.gov (United States)

    Brown, Rebecca T.; Ahalt, Cyrus; Steinman, Michael A.; Kruger, Kelly; Williams, Brie A.

    2015-01-01

    As the population ages, police increasingly serve as first responders to incidents involving older adults in which aging-related health plays a critical role. The goals of this study were to assess police officers’ knowledge of aging-related health; to identify challenges police experience in their encounters with older adults; and to describe their recommendations for how to address those challenges. This was a mixed methods study of 141 San Francisco police officers recruited from mandatory police trainings between 2011 and 2013. Descriptive statistics were used to analyze 141 self-administered questionnaires and principles of grounded theory were used to analyze open-ended questionnaire responses and 11 additional qualitative interviews. Nearly all officers (89%) reported interacting with older adults at least monthly. Although 84% of police reported prior training in working with older adults, only 32% rated themselves knowledgeable about aging-related health. Participants described themselves as first-responders to medical and social emergencies involving older adults and identified several challenges including identifying and responding to aging-related conditions and ensuring appropriate medical and social service hand-offs. To address these challenges, officers recommended developing trainings focused on recognizing and responding to aging-related conditions and improving police knowledge of community resources for older adults. They also called for enhanced communication and collaboration between police and clinicians. These findings suggest that despite playing a front-line role in responding to older adults with complex medical and social needs, many police may benefit from additional knowledge about aging-related health and community resources. Collaboration between police and healthcare providers presents an important opportunity to develop geriatrics training and interprofessional systems of care to support police work with a rapidly aging

  14. Revolving drug funds at front-line health facilities in Vientiane, Lao PDR.

    Science.gov (United States)

    Murakami, H; Phommasack, B; Oula, R; Sinxomphou, S

    2001-03-01

    Pharmaceutical cost recovery programmes, which have been mainly implemented in Africa, are gradually spreading to Southeast Asian countries that formerly belonged to the socialist bloc. This report describes the economic and operational realities of revolving drug funds (RDFs) at district hospitals and health centres in the capital of the Lao PDR by reviewing research conducted by the implementing department. People in the municipality spent an average of US$11 on drugs in 1996. The RDFs comprised only 3% of the total yearly drug sales in the municipality, whereas private pharmacies accounted for 75%. The RDFs were forced to operate in conjunction with the remaining government drug endowment and the thriving private pharmacies. This scheme has provided a stable supply of essential drugs. The assurance of drug availability at the front-line health facilities has resulted in increased utilization of the facilities despite the introduction of a drug fee. The cost recovery rate was 107% at health centres and 108% at district hospitals in two monitored districts during the 10 months from November 1997. Decentralized financial management was essential for cost recovery, allowing timely adjustment of selling prices as purchase prices rapidly inflated after the Asian economic crisis. The health staff observed that the people perceived drugs as everyday commodities that they should buy and take based on self-diagnosis and personal preference. Adaptation of the public health authorities to market-oriented thinking along with the establishment of pharmaceutical cost recovery occurred with few problems. However, both financial and operational management capacity at the municipal level pose a major challenge to policy clarification and scheme setting, especially in procurement, control of prescribing practices and the integration of drug dispensing with other components of quality clinical care.

  15. Patterns of relapse and outcome of elderly multiple myeloma patients treated as front-line therapy with novel agents combinations

    Directory of Open Access Journals (Sweden)

    Aurelio Lopez

    2015-01-01

    Full Text Available We report the characteristics of relapse, treatment response, and outcomes of 145 elderly patients with multiple myeloma in first relapse after front-line treatment with VMP or VTP. Reappearance of CRAB symptoms (113 patients and more aggressive forms of disease (32 patients were the most common patterns of relapse. After second-line therapy, 75 (51.7% patients achieved at partial response and 16 (11% complete response (CR. Overall survival was longer among patients receiving VMP as front-line induction (21.4 vs. 14.4 months, P=0.037, in patients achieving CR (28.3 vs. 14.8 months; P=0.04, and in patients without aggressive relapse (28.6 vs. 7.6 months; P=0.0007.

  16. Patterns of relapse and outcome of elderly multiple myeloma patients treated as front-line therapy with novel agents combinations☆

    Science.gov (United States)

    Lopez, Aurelio; Mateos, Maria-Victoria; Oriol, Albert; Valero, Marta; Martínez, Joaquín; Lorenzo, Jose Ignacio; Perez, Montserrat; Martinez, Rafael; de Paz, Raquel; Granell, Miguel; De Arriba, Felipe; Blanchard, M. Jesús; Peñalver, Francisco Javier; Bello, Jose Luis; Martin, Maria Luisa; Bargay, Joan; Blade, Joan; Lahuerta, Juan Jose; San Miguel, Jesús F.; de la Rubia, Javier

    2015-01-01

    We report the characteristics of relapse, treatment response, and outcomes of 145 elderly patients with multiple myeloma in first relapse after front-line treatment with VMP or VTP. Reappearance of CRAB symptoms (113 patients) and more aggressive forms of disease (32 patients) were the most common patterns of relapse. After second-line therapy, 75 (51.7%) patients achieved at partial response and 16 (11%) complete response (CR). Overall survival was longer among patients receiving VMP as front-line induction (21.4 vs. 14.4 months, P=0.037), in patients achieving CR (28.3 vs. 14.8 months; P=0.04), and in patients without aggressive relapse (28.6 vs. 7.6 months; P=0.0007). PMID:26500850

  17. Creating an Excellent Patient Experience Through Service Education: Content and Methods for Engaging and Motivating Front-Line Staff.

    Science.gov (United States)

    Kennedy, Denise M

    2017-12-01

    Service quality and patient satisfaction affect an organization's value-based payments. This new value paradigm calls for a new approach to service education and training for front-line staff. Thoughtfully conceived, department-specific content, infused with patient feedback, value creation, and science of service quality principles, was developed to give front-line staff a deeper understanding of the impact of their performance on patient experience, value creation, and value-based revenue. Feedback from nearly 1500 trainees in 60 educational sessions delivered over 7 years indicates good understanding of the content and appreciation of the targeted approach. On a 5-point scale ranging from 1 (least effective) to 5 (most effective), trainees' ratings of their understanding of service quality concepts and impact on value ranged from 4.7 to 4.9. Verbatim comments showed a positive impact on staff. Employee feedback suggests that value-based service education may be useful in motivating front-line staff, improving service quality, and creating value.

  18. Treatment of B-cells non-Hodgkin lymphomas with combined immunochemotherapy: ability to treatment optimization

    Directory of Open Access Journals (Sweden)

    N. V. Smirnova

    2015-01-01

    .7 % developed after 2–4 months of remission, were observed only in patients with Burkitt lymphoma/leukemia. In this cases 2nd line therapy and auto-HSCT is not allowed to achieve remission. All PMBCL and DLBCL patients were achieved remission, but in 50 % of cases only after second line, radio- and cell therapy.The authors conclude that a combined immunochemotherapy of B-NHL in children and adolescents, including the target drug (rituximab and 5-day courses of cytostatic therapy, highly effective, despite a reduce induction intensity. Therapy for the analyzed protocol requires qualitative dynamic efficacy monitoring and timely correction of therapy. In order to solve a refractory problem and further reduce the toxicity, necessary to continue research using fundamental discoveries in recent years.

  19. Rationing access to care to the medically uninsured: the role of bureaucratic front-line discretion at large healthcare institutions.

    Science.gov (United States)

    Weiner, Saul J; Laporte, Margaret; Abrams, Richard I; Moswin, Arthur; Warnecke, Richard

    2004-04-01

    Medically uninsured patients seeking nonemergency care are not guaranteed access to services at most healthcare institutions. They must first register with a clerk who could require a deposit and/or payment on an outstanding debt. This study examines the factors that influence whether nonmedical bureaucratic staff sign in or turn away uninsured patients who cannot meet prepayment requirements. The study was conducted at a for-profit, a not-for-profit, and a public healthcare institution in a metropolitan area. The authors explored the relevant policy environment through interviews with senior administrators and a review of documents pertaining to the management of self-pay patients. Then they examined how policies affecting access were implemented through in-depth, semistructured, audiotaped interviews with 55 front-line clerical personnel. At all 3 institutions, policies were ambiguous about what to do when uninsured patients cannot afford required prepayments. Seventy-one percent of staff reported they do not turn patients away; the remainder stated that on occasion they do. A variety of rationales were provided for how decisions are made. Those with the lowest-level positions were significantly more likely to be sympathetic to indigent patients and less likely to report turning patients away. Consistent with other studies of front-line bureaucracies indicating that low-level personnel who interface with clients make discretionary decisions, particularly when organizations pursue potentially conflicting priorities, this preliminary investigation found that nonmedical personnel play a significant role in decisions affecting access to care for medically indigent patients.

  20. A survey of front-line paramedics examining the professional relationship between paramedics and physician medical oversight.

    Science.gov (United States)

    Foerster, Christopher R; Tavares, Walter; Virkkunen, Ilkka; Kämäräinen, Antti

    2018-03-01

    Paramedicine is often dependent on physician medical directors and their associated programs for direction and oversight. A positive relationship between paramedics and their oversight physicians promotes safety and quality care while a strained or ineffective one may threaten these goals. The objective of this study was to explore and understand the professional relationship between paramedics and physician medical oversight as viewed by front-line paramedics. All active front-line paramedics from four municipal paramedic services involving three medical oversight groups in Ontario were invited to complete an online survey. Five hundred and four paramedics were invited to participate in the study, with 242 completing the survey (48% response rate); 66% male, 76% primary care paramedics with an average of 13 (SD=9) years of experience. Paramedics had neutral or positive perceptions regarding their autonomy, opportunities to interact with their medical director, and medical director understanding of the prehospital setting. Paramedics perceived medical directives as rigid and ambiguous. A significant amount of respondents reported a perception of having provided suboptimal patient care due to fear of legal or disciplinary consequences. Issues of a lack of support for critical thinking and a lack of trust between paramedics and medical oversight groups were often raised. Paramedic perceptions of physician medical oversight were mixed. Concerning areas identified were perceptions of ambiguous written directives and concerns related to the level of trust and support for critical thinking. These perceptions may have implications for the system of care and should be explored further.

  1. Molecular diagnosis of Legionella infections--Clinical utility of front-line screening as part of a pneumonia diagnostic algorithm.

    Science.gov (United States)

    Gadsby, Naomi J; Helgason, Kristjan O; Dickson, Elizabeth M; Mills, Jonathan M; Lindsay, Diane S J; Edwards, Giles F; Hanson, Mary F; Templeton, Kate E

    2016-02-01

    Urinary antigen testing for Legionella pneumophila serogroup 1 is the leading rapid diagnostic test for Legionnaires' Disease (LD); however other Legionella species and serogroups can also cause LD. The aim was to determine the utility of front-line L. pneumophila and Legionella species PCR in a severe respiratory infection algorithm. L. pneumophila and Legionella species duplex real-time PCR was carried out on 1944 specimens from hospitalised patients over a 4 year period in Edinburgh, UK. L. pneumophila was detected by PCR in 49 (2.7%) specimens from 36 patients. During a LD outbreak, combined L. pneumophila respiratory PCR and urinary antigen testing had optimal sensitivity and specificity (92.6% and 98.3% respectively) for the detection of confirmed cases. Legionella species was detected by PCR in 16 (0.9%) specimens from 10 patients. The 5 confirmed and 1 probable cases of Legionella longbeachae LD were both PCR and antibody positive. Front-line L. pneumophila and Legionella species PCR is a valuable addition to urinary antigen testing as part of a well-defined algorithm. Cases of LD due to L. longbeachae might be considered laboratory-confirmed when there is a positive Legionella species PCR result and detection of L. longbeachae specific antibody response. Copyright © 2015 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  2. [An intractable gastric cancer showing an extremely effective response to immunochemotherapy].

    Science.gov (United States)

    Takashima, S; Komaki, H; Yokota, H; Kiriyama, M; Kinami, Y

    1988-07-01

    Reported herein is the case of a terminal patient with advanced gastric cancer who was shown an extremely effective response to immunochemotherapy. The patient, a 62-year-old female, was determined as having a gastric cancer, Borr. type 2, originating in the pyloric antrum. The tumor was found to be H3P3S2N2 (stage IV), and its histology revealed a mucus-producing papillary adeno-carcinoma, ss gamma, n(+), ly2, and V1. Thus the patient underwent a distal gastrectomy, and was given an operative administration of MMC, followed by postoperative immunochemotherapy with FT 207 and OK 432. Consequently, no ascites were noticed throughout the recuperative course, and repeated CT scannings of the hepatic metastatic lesions, revealed a remarkable regression. Two years after this operation, she resumed normal daily life. Further, her preoperatively elevated tumor markers have returned to normal.

  3. Managing a front-line field hospital in Libya: Description of case mix and lessons learned for future humanitarian emergencies

    Directory of Open Access Journals (Sweden)

    Adam C. Levine

    2012-06-01

    Full Text Available Between June and August 2011, International Medical Corps deployed a field hospital near the front-line of the fighting between government troops and opposition fighters in Western Libya. The field hospital cared for over 1300 combatants and non-combatants from both sides of the conflict during that time period, the vast majority of them presenting with war-related injuries. Over 60% of battle-related injuries were due to shrapnel wounds and blast injuries from exploding small mortars, with smaller percentages due to battle-related motor vehicle accidents, gun shot wounds, burns, and other causes. The most pertinent lessons learned from our experience were the importance of dedicating significant resources to logistics and supply chain management, the rewards garnered from building strong ties with the local community early in the deployment of the field hospital, and the need to pay careful attention to basic principles of humanitarian ethics.

  4. Youth Delinquency or Everyday Racism? Front-line Professionals’ Perspectives on Preventing Racism and Intolerance in Sweden

    Directory of Open Access Journals (Sweden)

    Alida Skiple

    2018-03-01

    Full Text Available In this article, I ask which problematizations of racism and intolerance that substantiate a local implementation of a targeted educational program in Sweden, called the Tolerance Project. By participating in municipality-level meetings and conversations with front-line professionals concerning the recent implementation of the program in one specific region, I have found several motivations for the continuing work to reduce racism and intolerance at schools. To emphasize this point, I have divided the problematizations into four ideal types and applied a ‘what’s the problem represented to be’ analysis to each of them. The four problematizations can be described in the following terms: generational racism, growth of the Sweden Democrats, normalization of racist language, and general ‘at-risk’ youths. The first three problematizations are context dependent, in terms of both time (during the so-called refugee crisis and space (in a region with a long history of National Socialism. Problematizing generational racism, growth of the Sweden Democrats and normalization of racist language indicate that what is mainly to be prevented is anti-immigrant sentiments in the young as well as the adult population. This implies a limitation to the role of schools in prevention, as adults cannot be directly targeted by the school. The fourth ideal type, at-risk youth, emphasizes that there are certain risk factors that might cause young people to later radicalize or deviate in one way or another. This corresponds to the general discourse of radicalization, but, in line with other studies of front-line professionals’ perspectives, there is no clear distinction between preventing radicalization and fostering democratic citizens. Furthermore, the conglomeration of problematizations might decrease the stigmatizing effect that a targeted initiative can have, as opposed to initiatives that operate with one specific target group. The Tolerance Project might

  5. The front line of social capital creation--a natural experiment in symbolic interaction.

    Science.gov (United States)

    Patulny, Roger; Siminski, Peter; Mendolia, Silvia

    2015-01-01

    This paper offers theoretical and empirical contributions to understanding the micro-sociological processes behind the creation of social capital. Theoretically, we argue that the emotional and shared experience of participating in symbolic interaction rituals may affect social capital in four different ways, via: (i) a 'citizenship' effect, connecting participants symbolically to the broader, civic society; (ii) a 'supportive' effect, bonding participants with each other; (iii) an exclusive 'tribal' effect, which crowds-out connections with other groups and the wider society; and (iv) an 'atomising' effect, whereby intense experiences create mental health problems that damage social capital. We illustrate this with a case study of Australian veterans of the Vietnam War. The randomness of the National Service conscription lotteries of that era translates into a high-quality natural experiment. We formulate several hypotheses about which of the four effects dominates for veterans who participated in the 'symbolic interaction' of training and deployment. We test these hypotheses using data from the 2006 Australian Census of Population and Housing, and the NSW 45 & Up Study. We found that war service reduced 'bonding' social capital, but increased 'bridging' social capital, and this is not explained completely by mental health problems. This suggests that while the combined 'tribal' and 'atomizing' effects of service outweigh the 'supportive' effects, the 'citizenship' effect is surprisingly robust. Although they feel unsupported and isolated, veterans are committed to their community and country. These paradoxical findings suggest that social capital is formed through symbolic interaction. The emotional and symbolic qualities of interaction rituals may formulate non-strategic (perhaps irrational) connections with society regardless of the status of one's personal support networks. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Intentions to Participate in Counselling among Front-Line, At-Risk Irish Government Employees: An Application of the Theory of Planned Behaviour

    Science.gov (United States)

    Hyland, Philip E.; McLaughlin, Christopher G.; Boduszek, Daniel; Prentice, Garry R.

    2012-01-01

    The study set out to examine intentions to engage in counselling among at-risk Irish government employees and the differential utility of two alternative theory of planned behaviour (TPB) models of behaviour to explain intentions to participate in counselling. Individuals (N = 259) employed in a front-line, at-risk occupation for the Irish…

  7. Voices from the front lines. Four leaders on the cross-border challeng they've faced.

    Science.gov (United States)

    Minguet, Luc; Caride, Eduardo; Yamaguchi, Takeo; Tedjarati, Shane

    2014-09-01

    Executives on the front lines of managing across borders share their insights: Luc Minguet, of France's Michelin, talks about the importance of cultural training not just for managers taking on assignments abroad but also for local employees who work with colleagues from around the world. He describes how his own experience learning to communicate across cultures reflects the tire-maker's broader practices. Eduardo Caride, of Madrid-based Telefónica, explains how the relatively young multinational is investing in a diverse talent mix as it strives to become a truly global company. Whereas early on, leaders relied on exporting Spanish managers abroad, he notes, the street now runs both ways. Takeo Yamaguchi, of Japan's Hitachi, details his efforts to create standardized global HR systems and processes across the conglomerate's 948 separate companies. "Three years ago, we had no systematic way of tracking employees, evaluating performance, or identifying future leaders," Yamaguchi says. "Today we do." And Shane Tedjarati, from the United States' Honeywell, talks about how the industrial powerhouse is shifting its strategy toward new regions, such as China, India, vietnam, and Indonesia. "We call these markets 'high-growth regions' instead of emerging markets," says Tedjarati, "because they now account for more than half of Honeywell's total growth."

  8. Genome-wide mutagenesis and multi-drug resistance in American trypanosomes induced by the front-line drug benznidazole

    KAUST Repository

    Campos, Mônica C.

    2017-10-25

    Chagas disease is caused by the protozoan parasite Trypanosoma cruzi and affects 5–8 million people in Latin America. Although the nitroheterocyclic compound benznidazole has been the front-line drug for several decades, treatment failures are common. Benznidazole is a pro-drug and is bio-activated within the parasite by the mitochondrial nitroreductase TcNTR-1, leading to the generation of reactive metabolites that have trypanocidal activity. To better assess drug action and resistance, we sequenced the genomes of T. cruzi Y strain (35.5 Mb) and three benznidazole-resistant clones derived from a single drug-selected population. This revealed the genome-wide accumulation of mutations in the resistant parasites, in addition to variations in DNA copy-number. We observed mutations in DNA repair genes, linked with increased susceptibility to DNA alkylating and inter-strand cross-linking agents. Stop-codon-generating mutations in TcNTR-1 were associated with cross-resistance to other nitroheterocyclic drugs. Unexpectedly, the clones were also highly resistant to the ergosterol biosynthesis inhibitor posaconazole, a drug proposed for use against T. cruzi infections, in combination with benznidazole. Our findings therefore identify the highly mutagenic activity of benznidazole metabolites in T. cruzi, demonstrate that this can result in multi-drug resistance, and indicate that vigilance will be required if benznidazole is used in combination therapy.

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

    Science.gov (United States)

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

    1999-08-01

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

  10. Reversible Hypopituitarism Associated with Intravascular Large B-Cell Lymphoma: Case Report of Successful Immunochemotherapy.

    Science.gov (United States)

    Sawada, Yusuke; Ishii, Sumiyasu; Koga, Yasuhiko; Tomizawa, Taku; Matsui, Ayako; Tomaru, Takuya; Ozawa, Atsushi; Shibusawa, Nobuyuki; Satoh, Tetsurou; Shimizu, Hiroaki; Hirato, Junko; Yamada, Masanobu

    2016-03-01

    Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of diffuse large B-cell lymphoma. There have been only a limited number of reports regarding pituitary dysfunction associated with IVLBCL. We present a 71-year-old woman with hypopituitarism without any hypothalamic/pituitary abnormalities as assessed by magnetic resonance imaging. She presented with edema, abducens palsy, and elevated levels of lactate dehydrogenase and soluble interleukin-2 receptor. Provocative testing showed that the peaks of luteinizing hormone, follicle-stimulating hormone, thyroid-stimulating hormone and adrenocorticotropic hormone were evoked to normal levels by simultaneous administration of luteinizing hormone-releasing hormone, thyrotropin-releasing hormone and corticotropin-releasing hormone, but the responses of these four pituitary hormones showed a delayed pattern. She was diagnosed with IVLBCL with cerebrospinal invasion by pathological findings of the bone marrow, skin, and cerebrospinal fluid. She achieved hematological remission after immunochemotherapy. Pituitary function was also restored without hormonal replacement, and the improvement of the pituitary function was confirmed by dynamic testing. We reviewed the literature with respect to hypopituitarism associated with IVLBCL. There were less than 20 case reports and most of the patients died. Endocrinological course was described in only two cases, and both of them required hormonal supplementation. To our knowledge, this is the first case of hypopituitarism induced by IVLBCL that was successfully managed by immunochemotherapy alone. This case suggests that early diagnosis and treatment of IVLBCL might improve anterior pituitary function and enable patients to avoid hormone replacement therapy.

  11. Everyday resilience in district health systems: emerging insights from the front lines in Kenya and South Africa.

    Science.gov (United States)

    Gilson, Lucy; Barasa, Edwine; Nxumalo, Nonhlanhla; Cleary, Susan; Goudge, Jane; Molyneux, Sassy; Tsofa, Benjamin; Lehmann, Uta

    2017-01-01

    Recent global crises have brought into sharp relief the absolute necessity of resilient health systems that can recognise and react to societal crises. While such crises focus the global mind, the real work lies, however, in being resilient in the face of routine, multiple challenges. But what are these challenges and what is the work of nurturing everyday resilience in health systems? This paper considers these questions, drawing on long-term, primarily qualitative research conducted in three different district health system settings in Kenya and South Africa, and adopting principles from case study research methodology and meta-synthesis in its analytic approach. The paper presents evidence of the instability and daily disruptions managed at the front lines of the district health system. These include patient complaints, unpredictable staff, compliance demands, organisational instability linked to decentralisation processes and frequently changing, and sometimes unclear, policy imperatives. The paper also identifies managerial responses to these challenges and assesses whether or not they indicate everyday resilience, using two conceptual lenses. From this analysis, we suggest that such resilience seems to arise from the leadership offered by multiple managers, through a combination of strategies that become embedded in relationships and managerial routines, drawing on wider organisational capacities and resources. While stable governance structures and adequate resources do influence everyday resilience, they are not enough to sustain it. Instead, it appears important to nurture the power of leaders across every system to reframe challenges, strengthen their routine practices in ways that encourage mindful staff engagement, and develop social networks within and outside organisations. Further research can build on these insights to deepen understanding.

  12. Fludarabine plus alemtuzumab (FA) front-line treatment in young patients with chronic lymphocytic leukemia (CLL) and an adverse biologic profile.

    Science.gov (United States)

    Mauro, Francesca R; Molica, Stefano; Laurenti, Luca; Cortelezzi, Agostino; Carella, Angelo M; Zaja, Francesco; Chiarenza, Annalisa; Angrilli, Francesco; Nobile, Francesco; Marasca, Roberto; Musolino, Caterina; Brugiatelli, Maura; Piciocchi, Alfonso; Vignetti, Marco; Fazi, Paola; Gentile, Giuseppe; De Propris, Maria S; Della Starza, Irene; Marinelli, Marilisa; Chiaretti, Sabina; Del Giudice, Ilaria; Nanni, Mauro; Albano, Francesco; Cuneo, Antonio; Guarini, Anna; Foà, Robin

    2014-02-01

    In 45, ≤ 60 years old patients with CLL and an adverse biologic profile, a front-line treatment with Fludarabine and Campath (Alemtuzumab(®)) was given. The overall response rate was 75.5%, the complete response rate (CR) 24.4% with the lowest CR rates, 16.7% and 8.3%, in 11q and 17p deleted cases. The 3-year progression-free survival (PFS) and overall survival were 42.5% and 79.9%, respectively. PFS was significantly influenced by CLL duration, beta2-microglobulin, and improved by post-remissional stem cell transplantation. Front-line fludarabine and alemtuzumab showed a manageable safety profile and evidence of a benefit in a small series of CLL patients with adverse biologic features. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. The Role of Public Organizations of Kursk Province in Provision of Assistance to the Front Line in the First World War

    Directory of Open Access Journals (Sweden)

    Fedor A. Gavrikov

    2014-09-01

    Full Text Available The First World War caused great changes in the everyday life of the Russian province. It was forced to adapt to the wartime and the shortage of resources. The current situation promoted local authorities to establish and develop charity committees and public organizations, which rendered assistance to the Kursk Province in complex circumstances. The charitable work, organized by local authorities enabled to render material assistance to the front line and lift the spirit of the Russian soldiers.

  14. Conference Session I: Mitigating Risk at the Front Lines: The Copyright First Responders Program. Presented by Kyle Courtney, Copyright Advisor, the Office for Scholarly Communication, Harvard University.

    Directory of Open Access Journals (Sweden)

    Sara R. Benson

    2018-02-01

    Full Text Available This is a summary of Kyle Courtney's Invited Presentation at the 2017 Kraemer Copyright Conference titled "Mitigating Risk at the Front Lines:  The Copyright First Responders Program."  After reading this article you will better understand the method and purpose of the First Responders Program and, hopefully, like me, you will be ready to volunteer your institution to add to the growing list of libraries engaged in this hub-and-spoke model of copyright information system.

  15. Fixed-dose combinations at the front line of multimodal pain management: perspective of the nurse-prescriber

    Directory of Open Access Journals (Sweden)

    O'Brien J

    2013-02-01

    Full Text Available Joanne O’Brien,1 Joseph V Pergolizzi Jr,2 Mart van de Laar3, Hans-Ulrich Mellinghoff,4 Ignacio Morón Merchante,5 Srinivas Nalamachu,6 Serge Perrot,7 Robert B Raffa81Department of Pain Medicine, Beaumont Hospital, Beaumont, Dublin, Ireland; 2Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Association of Chronic Pain Patients, Houston, TX; Department of Pharmacology, Temple University School of Medicine, Philadelphia, PA, USA; 3Arthritis Center Twente, Enschede, The Netherlands; 4Department of Endocrinology, Diabetology and Osteology, Kantonsspital St Gallen, Switzerland; 5Centro de Salud Universitario Goya, Madrid, Spain; 6Kansas University Medical Center, Kansas City, and International Clinic Research, Leawood, KS, USA; 7Service de Médecine Interne et Consultation de la Douleur, Hôpital Hotel Dieu, Paris Descartes University, Paris, France; 8Department of Pharmaceutical Sciences, Temple University School of Pharmacy, Philadelphia PA, USAAbstract: Pain should be treated promptly and effectively to restore the patient to full function, avoid pain chronification, and preserve quality of life. A recent pain specialists' meeting discussed the use of different pharmacological treatment options, such as topical analgesics, nonopioid agents (such as paracetamol and nonsteroidal anti-inflammatory drugs, weak and strong opioids, and fixed-dose combination products in the management of moderate to severe pain from different etiologies. One of the topics discussed in, and subsequent to, this meeting was the role of fixed-dose combination products for nurse-prescribers who are in many ways at the front line of managing both acute and chronic pain syndromes. The panel agreed that proper product selection should take into account the patient's age, condition, type of pain, and comorbidities, as well as balance safety with effectiveness. Although nurse-prescribers need to be aware of cumulative paracetamol dosing, fixed

  16. Immunotherapy and immunochemotherapy in visceral leishmaniasis: promising treatments for this neglected disease

    Directory of Open Access Journals (Sweden)

    Bruno Mendes Roatt

    2014-06-01

    Full Text Available Leishmaniasis has several clinical forms: self-healing or chronic cutaneous leishmaniasis or post-kala-azar dermal leishmaniasis; mucosal leishmaniasis; and visceral leishmaniasis, which is fatal if left untreated. The epidemiology and clinical features of VL vary greatly due to the interaction of multiple factors including parasite strains, vectors, host genetics, and the environment. HIV infection, augments the severity of VL increasing the risk of developing active disease by 100 to 2320 times. An effective vaccine for humans is not yet available. Resistance to chemotherapy is a growing problem in many regions, and the costs associated with drug identification and development, make commercial production for leishmaniasis, unattractive. The toxicity of currently drugs, their long treatment course, and limited efficacy are significant concerns. For cutaneous disease, many studies have shown promising results with immunotherapy/immunochemotherapy, aimed to modulate and activate the immune response to obtain a therapeutic cure. Nowadays, the focus of many groups centers on treating canine VL by using vaccines and immunomodulators with or without chemotherapy. In human disease, the use of cytokines like Interferon-γ associated with pentavalent antimonials demonstrated promising results in patients that did not respond to conventional treatment. In mice, immunomodulation based on monoclonal antibodies to remove endogenous immunosuppressive cytokines (interleukin-10 or block their receptors, antigen-pulsed syngeneic dendritic cells, or biological products like Pam3Cys (TLR ligand has already been shown as a prospective treatment of the disease. This review addresses VL treatment, particularly immunotherapy and/or immunochemotherapy as an alternative to conventional drug treatment in experimental models, canine VL, and human disease.

  17. How front-line healthcare workers respond to stock-outs of essential medicines in the Eastern Cape Province of South Africa.

    Science.gov (United States)

    Hodes, R; Price, I; Bungane, N; Toska, E; Cluver, L

    2017-08-25

    Shortages of essential medicines are a daily occurrence in many of South Africa (SA)'s public health facilities. This study focuses on the responses of healthcare workers to stock-outs, investigating how actors at the 'front line' of public health delivery understand, experience and respond to shortages of essential medicines and equipment in their facilities. Findings are based on focus groups, observations and interviews with healthcare workers and patients at healthcare facilities in the Eastern Cape Province of SA, conducted as part of the Mzantsi Wakho study. The research revealed a discrepancy between 'informal' definitions of stock-outs and their reporting through formal stock-out management channels. Front-line healthcare workers had designed their own systems for classifying the severity of stock-outs, based on the product in question, and on their potential to access stocks from other facilities. Beyond formal systems of procurement and supply, healthcare workers had established vast networks of alternative communication and action, often using personal resources to procure medical supplies. Stock-outs were only reported when informal methods of stock-sharing did not secure top-up supplies. These findings have implications for understanding the frequency and severity of stock-outs, and for taking action to prevent and manage stock-outs effectively.

  18. A cross sectional study of knowledge and attitudes towards tuberculosis amongst front-line tuberculosis personnel in high burden areas of Lima, Peru.

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    Mark Minnery

    Full Text Available INTRODUCTION: Tuberculosis, reported as the second most common infectious cause of death worldwide, is a key mortality contributor in developing countries and globally. The disease is endemic in Peru and while relative success was achieved during the 1990s in its control, this slowed as new complications, such as multi drug resistant TB arose. Health centre workers participating in the national DOTS program, create the front-line TB work-force in Peru meaning their knowledge and attitudes about the disease are key in its control. METHODS: A Spanish language, multiple choice knowledge and attitudes survey was designed based on previous successful studies and the national Peruvian TB control guidelines. It was applied to two health networks in Lima, Peru amongst 301 health workers participating in the national TB control program from 66 different health centres. The study results were analysed to test mean knowledge scores amongst different groups, overall gaps in key areas of TB treatment and control knowledge, and attitudes towards the disease and the national TB control program. RESULTS: A mean knowledge score of 10.1 (+/- 1.7 out of 15 or 67.3% correct was shown. Demographics shown to have an effect on knowledge score were age and level of education. Major knowledge gaps were noted primarily in themes relating to treatment and diagnostics. Greater community involvement including better patient education about TB was seen as important in implementing the national TB control program. Participants were in disagreement about the current distribution of health resources throughout the study area. Discussion Serious knowledge gaps were identified from the survey; these reflect findings from a previous study in Lima and other studies from TB endemic areas throughout the world. Understanding these gaps and observations made by front-line TB workers in Lima may help to improve the national TB control program and other control efforts globally.

  19. Similar prognosis of transformed and de novo diffuse large B-cell lymphomas in patients treated with immunochemotherapy.

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    Sorigue, Marc; Garcia, Olga; Baptista, Maria Joao; Sancho, Juan-Manuel; Tapia, Gustavo; Mate, José Luis; Feliu, Evarist; Navarro, José-Tomás; Ribera, Josep-Maria

    2017-03-22

    The prognosis of diffuse large B-cell lymphomas (DLBCL) transformed from indolent lymphoma (TL) has been considered poorer than that of de novo DLBCL. However, it seems to have improved since the introduction of rituximab. We compared the characteristics (including the cell-of-origin), and the prognosis of 29 patients with TL and 101 with de novo DLBCL treated with immunochemotherapy. Patients with TL and de novo DLBCL had similar characteristics. All TL cases evolving from follicular lymphoma were germinal-center B-cell-like, while those TL from marginal zone lymphoma or chronic lymphocytic leukemia were non-germinal-center B-cell-like. The complete response rate was similar in TL and de novo DLBCL (62 vs. 66%, P=.825). The 5-year overall and progression-free survival probabilities (95% CI) were 59% (40-78) and 41% (22-60) for TL and 63% (53-73) and 60% (50-70) for de novo DLBCL, respectively (P=.732 for overall survival and P=.169 for progression-free survival). In this study, the prognosis of TL and de novo DLBCL treated with immunochemotherapy was similar. The role of intensification with stem cell transplantation in the management of TL may be questionable in the rituximab era. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  20. Azacitidine front-line in 339 patients with myelodysplastic syndromes and acute myeloid leukaemia: comparison of French-American-British and World Health Organization classifications

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    Lisa Pleyer

    2016-04-01

    Full Text Available Abstract Background The MDS-IWG and NCCN currently endorse both FAB and WHO classifications of MDS and AML, thus allowing patients with 20–30 % bone marrow blasts (AML20–30, formerly MDS-RAEB-t to be categorised and treated as either MDS or AML. In addition, an artificial distinction between AML20–30 and AML30+ was made by regulatory agencies by initially restricting approval of azacitidine to AML20–30. Thus, uncertainty prevails regarding the diagnosis, prognosis and optimal treatment timing and strategy for patients with AML20–30. Here, we aim to provide clarification for patients treated with azacitidine front-line. Methods The Austrian Azacitidine Registry is a multicentre database (ClinicalTrials.gov: NCT01595295. For this analysis, we selected 339 patients treated with azacitidine front-line. According to the WHO classification 53, 96 and 190 patients had MDS-RAEB-I, MDS-RAEB-II and AML (AML20–30: n = 79; AML30+: n = 111, respectively. According to the FAB classification, 131, 101 and 111 patients had MDS-RAEB, MDS-RAEB-t and AML, respectively. Results The median ages of patients with MDS and AML were 72 (range 37–87 and 77 (range 23–93 years, respectively. Overall, 80 % of classifiable patients (≤30 % bone marrow blasts had intermediate-2 or high-risk IPSS scores. Most other baseline, treatment and response characteristics were similar between patients diagnosed with MDS or AML. WHO-classified patients with AML20–30 had significantly worse OS than patients with MDS-RAEB-II (13.1 vs 18.9 months; p = 0.010, but similar OS to patients with AML30+ (10.9 vs 13.1 months; p = 0.238. AML patients that showed MDS-related features did not have worse outcomes compared with patients who did not (13.2 vs 8.9 months; p = 0.104. FAB-classified patients with MDS-RAEB-t had similar survival to patients with AML30+ (12.8 vs 10.9 months; p = 0.376, but significantly worse OS than patients with MDS-RAEB (10

  1. Is the Front Line Prepared for the Changing Faces of Patients? Predictors of Cross-Cultural Preparedness Among Clinical Nurses and Resident Physicians in Lausanne, Switzerland.

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    Casillas, Alejandra; Paroz, Sophie; Green, Alexander R; Wolff, Hans; Weber, Orest; Faucherre, Florence; Ninane, Françoise; Bodenmann, Patrick

    2015-01-01

    PHENOMENON: Assuring quality medical care for all persons requires that healthcare providers understand how sociocultural factors affect a patient's health beliefs/behaviors. Switzerland's changing demographics highlight the importance of provider cross-cultural preparedness for all patients-especially those at risk for social/health precarity. We evaluated healthcare provider cross-cultural preparedness for commonly encountered vulnerable patient profiles. A survey on cross-cultural care was mailed to Lausanne University hospital's "front-line healthcare providers": clinical nurses and resident physicians at our institution. Preparedness items asked "How prepared do you feel to care for … ?" (referring to example patient profiles) on an ascending 5-point Likert scale. We examined proportions of "4 - well/5 - very well prepared" and the mean composite score for preparedness. We used linear regression to examine the adjusted effect of demographics, work context, cultural-competence training, and cross-cultural care problem awareness, on preparedness. Of 885 questionnaires, 368 (41.2%) were returned: 124 (33.6%) physicians and 244 (66.4%) nurses. Mean preparedness composite was 3.30 (SD = 0.70), with the lowest proportion of healthcare providers feeling prepared for patients "whose religious beliefs affect treatment" (22%). After adjustment, working in a sensitized department (β = 0.21, p = .01), training on the history/culture of a specific group (β = 0.25, p = .03), and awareness regarding (a) a lack of practical experience caring for diverse populations (β = 0.25, p = .004) and (b) inadequate cross-cultural training (β = 0.18, p = .04) were associated with higher preparedness. Speaking French as a dominant language and physician role (vs. nurse) were negatively associated with preparedness (β = -0.26, p = .01; β = -0.22, p = .01). INSIGHTS: The state of cross-cultural care preparedness among Lausanne's front-line healthcare providers leaves room for

  2. Life on the front lines.

    Science.gov (United States)

    Hern, W M

    1993-01-01

    A physician who owns and operates an abortion clinic in Boulder, Colorado, in the US relates how he came to offer this procedure to women and how this choice has affected his life. The physician had worked as a medical student at a Schweitzer-inspired hospital in the Peruvian Amazon in 1964 and later as a Peace Corps physician in Brazil. He performed his first abortion in 1970, in Washington, D. C., for a 17-year-old high school student whose future plans would have been derailed by her pregnancy. At that time, the physician was working to change the federal government's restrictions on abortion funding and he began to correspond with abortion rights groups and heard the Supreme Court arguments in the landmark abortion cases. As part-time medical director of a family planning training program in the Rocky Mountain region, part of his job was to provide information about new abortion techniques. In 1973, he was asked to help start an abortion clinic in Boulder, and he accepted the position of medical director reporting to an executive director. He had to struggle to acquire privileges at Boulder Community Hospital in order to admit patients with complications. In addition, a "Fight the Abortion Clinic Committee" tried to have the clinic closed by the Colorado Board of Health. Further obstacles were placed by members of the Boulder County Medical Society who formed another committee with the intent of closing the clinic. After a tour of the clinic, the committee chairman declared that the clinic met the highest standards of medical care, so that effort was ended. In November 1973, antiabortion groups began to picket the clinic and the physician began to receive threatening phone calls at home. He purchased a rifle and kept it by his bed. In the summer of 1974, he participated in a debate on Denver television. He had to be secreted out a back door after a subsequent debate. The same summer, the Denver chapter of the National Organization for Women held a rally to honor those who advanced the cause of women's rights. They honored the physician who had to shout over hecklers to make his remarks heard. After a year of operation, the physician encountered differences with the Board of Directors of the clinic. Soon after that, he resigned and opened his own clinic with a bank loan of $7000. Within 4 years, his clinic had expanded, and he purchased its building. The harassment from antiabortion protesters continued, with broken windows, pickets, and, in February 1988, bullets fired through the front windows of the waiting room. This necessitated the installation of bullet-proof glass and a security system which cost $17,000. As of March 1, 1993, there had been 1285 acts of violence towards abortion clinics, which led to the destruction of more than 100. On March 10 of that year, a physician who performed abortions in Florida was gunned down by an anti-abortion protestor. People who provide abortions hope for legal protection and respect for their civil liberties, but they will continue to provide this service even if conditions do not improve.

  3. Diffuse Large B-Cell Lymphoma in the Elderly: Real World Outcomes of Immunochemotherapy in Asian Population.

    Science.gov (United States)

    Byun, Ja Min; Lee, Jeong-Ok; Kang, Beodeul; Kim, Ji-Won; Kim, Se Hyun; Kim, Jin Won; Kim, Yu Jung; Lee, Keun-Wook; Bang, Soo-Mee; Lee, Jong Seok

    2016-09-01

    We evaluated the real-life treatment outcomes of elderly patients with diffuse large B-cell lymphoma from a homogenous Asian population and defined the cutoff age for "elderly." The medical records of 192 DLBCL patients aged > 60 years who had received first-line immunochemotherapy were retrospectively evaluated. The treatment schedule, adverse events, and survival outcomes were analyzed overall and stratified by 4 age groups (> 60-64, 65-69, 70-74, and ≥ 75 years). Patient age of ≥ 75 years was associated with a significantly lower complete remission rate (86.5% vs. 81.4% vs. 82.0% vs. 51%; P population, 75 years seems to be a judicious cutoff for predicting treatment outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Front-line perspectives on 'joined-up' working relationships: a qualitative study of social prescribing in the west of Scotland.

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    White, Jane M; Cornish, Flora; Kerr, Susan

    2017-01-01

    Cross-sector collaboration has been promoted by government policies in the United Kingdom and many western welfare states for decades. Literature on joint working has focused predominantly on the strategic level, neglecting the role of individual practitioners in putting 'joined-up working' into practice. This paper takes the case of 'social prescribing' in the west of Scotland as an instance of joined-up working, in which primary healthcare professionals are encouraged to refer patients to non-medical sources of support in the third sector. This study draws on social capital theory to analyse the quality of the relationships between primary healthcare professionals and third sector practitioners. Eighteen health professionals and 15 representatives of third sector organisations participated in a qualitative interview study. Significant barriers to collaborative working were evident. The two stakeholder groups expressed different understandings of health, with few primary healthcare professionals considering non-medical sources of support to be useful or relevant. Health professionals were mistrustful of unknown third sector organisations, and concerned about their accountability for referrals that were not successful or positive for the patient. Third sector practitioners sought to build trust through face-to-face interactions with health professionals. However, primary healthcare professionals and third sector practitioners were not connected in effective networks. We highlight the ongoing imbalance of power between primary healthcare professionals and third sector organisations. Strategic collaborations should be complemented by efforts to build shared understandings, trust and connections between the diverse front-line workers whose mutual co-operation is necessary to achieve effective joined-up working. © 2015 John Wiley & Sons Ltd.

  5. Achieving deeper molecular response is associated with a better clinical outcome in chronic myeloid leukemia patients on imatinib front-line therapy

    Science.gov (United States)

    Etienne, Gabriel; Dulucq, Stéphanie; Nicolini, Franck-Emmanuel; Morisset, Stéphane; Fort, Marie-Pierre; Schmitt, Anna; Etienne, Madeleine; Hayette, Sandrine; Lippert, Eric; Bureau, Caroline; Tigaud, Isabelle; Adiko, Didier; Marit, Gérald; Reiffers, Josy; Mahon, François-Xavier

    2014-01-01

    Sustained imatinib treatment in chronic myeloid leukemia patients can result in complete molecular response allowing discontinuation without relapse. We set out to evaluate the frequency of complete molecular response in imatinib de novo chronic phase chronic myeloid leukemia patients, to identify base-line and under-treatment predictive factors of complete molecular response in patients achieving complete cytogenetic response, and to assess if complete molecular response is associated with a better outcome. A random selection of patients on front-line imatinib therapy (n=266) were considered for inclusion. Complete molecular response was confirmed and defined as MR 4.5 with undetectable BCR-ABL transcript levels. Median follow up was 4.43 years (range 0.79–10.8 years). Sixty-five patients (24%) achieved complete molecular response within a median time of 32.7 months. Absence of spleen enlargement at diagnosis, achieving complete cytogenetic response before 12 months of therapy, and major molecular response during the year following complete cytogenetic response was predictive of achieving further complete molecular response. Patients who achieved complete molecular response had better event-free and failure-free survivals than those with complete cytogenetic response irrespective of major molecular response status (95.2% vs. 64.7% vs. 27.7%, P=0.00124; 98.4% vs. 82.3% vs. 56%, P=0.0335), respectively. Overall survival was identical in the 3 groups. In addition to complete cytogenetic response and major molecular response, further deeper molecular response is associated with better event-free and failure-free survivals, and complete molecular response confers the best outcome. PMID:24362549

  6. Front-line Bevacizumab in combination with Oxaliplatin, Leucovorin and 5-Fluorouracil (FOLFOX in patients with metastatic colorectal cancer: a multicenter phase II study

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    Touroutoglou Nikolaos

    2007-05-01

    Full Text Available Abstract Purpose To evaluate the efficacy and the toxicity of front line FOLFOX4 combined with bevacizumab in patients with metastatsic CRC (mCRC. Patients and Methods Chemotherapy-naïve patients with mCRC, received bevacizumab (5 mg/kg every 2 weeks d1, oxaliplatin (85 mg/m2 on d1, leucovorin (200 mg/m2 on days 1 and 2 and 5-Fluorouracil (400 mg/m2 as i.v. bolus and 600 mg/m2 as 22 h i.v. continuous infusion on days 1 and 2 every 2 weeks. Results Fifty three patients (46 with a PS 0–1 were enrolled. Complete and partial response was achieved in eight (15.1% and 28 (52.8% patients, respectively (ORR: 67.9%; 95% C.I.: 53.8%–92%; 11 (20.7% patients had stable disease and six (11.3% progressive disease. With a median follow up period of 13.5 months, time to tumor progression was 11 months while the median survival has not yet been reached; the probability of 1-, 2- and 3- year survival was 79.8%, 63.8% and 58.3%, respectively; Two patients relapsed during the follow up period. Eight (15% patients underwent metastasectomy with R0 resections. Grade 3–4 neutropenia occurred in 15.1% of patients and one (1.9% of them presented febrile neutropenia. Non-hematologic toxicity included grade 3 diarrhea (7.6% and grade 2 and 3 neurotoxicity in 16.9 and 15.1% of patients, respectively. One (1.9% patient presented pulmonary embolism and one (1.9% cardiac ischaemia. There was one (1.9% sudden death after the first cycle. Conclusion The combination of FOLFOX4/bevacizumab appears to be highly effective, well tolerated and merits further evaluation in patients with mCRC.

  7. Protecting the public or setting the bar too high? Understanding the causes and consequences of regulatory actions of front-line regulators and specialized drug shop operators in Kenya.

    Science.gov (United States)

    Wafula, Francis; Molyneux, Catherine; Mackintosh, Maureen; Goodman, Catherine

    2013-11-01

    The problem of poor regulatory compliance has been widely reported across private health providers in developing countries. Less known are the underlying reasons for poor compliance, especially with regards to the roles played by front-line regulatory staff, and the regulatory institution as a whole. We designed a qualitative study to address this gap, with the study questions and tools drawing on a conceptual framework informed by theoretical literature on regulation. Data were collected from specialized drug shops (SDSs) in two rural districts in Western Kenya in 2011 through eight focus group discussions, and from regulatory staff from organizations governing the pharmaceutical sector through a total of 24 in-depth interviews. We found that relationships between front-line regulators and SDS operators were a strong influence on regulatory behaviour, often resulting in non-compliance and perverse outcomes such as corruption. It emerged that separate regulatory streams operated in urban and rural locations, based mainly on differing relationships between the front-line regulators and SDS operators, and on broader factors such as the competition environment and community expectations. Effective incentive structures for regulatory staff were either absent, or poorly linked to performance in regulatory organizations, resulting in divergences between the purposes of the regulatory organization and activities of front-line staff. Given the rural-urban differences in the practice environment, the introduction of lower retail practice requirements for rural SDSs could be considered. This would allow illegally operated shops to be brought within the regulatory framework, facilitating good quality provision of essential commodities to marginalized areas, without lowering the practice requirements for the better complying urban SDSs. In addition, regulatory organizations need to devise incentives that better link the level of effort to rewards such as professional

  8. Front-line window therapy with cisplatin in patients with primary disseminated Ewing sarcoma: A study by the Associazione Italiana di Ematologia ed Oncologia Pediatrica and Italian Sarcoma Group.

    Science.gov (United States)

    Luksch, Roberto; Grignani, Giovanni; D'Angelo, Paolo; Prete, Arcangelo; Puma, Nadia; Podda, Marta; Casanova, Michela; Ferrari, Andrea; Morosi, Carlo; Fagioli, Franca; Aglietta, Massimo; Ferrari, Stefano; Picci, Piero; Massimino, Maura

    2017-12-01

    The aim was to assess the activity of cisplatin (CDDP) in Ewing sarcoma (ES). The study consisted of front-line window therapy with CDDP 120 mg/sqm every 3 weeks for two courses in children and young adults with primary disseminated ES. Response was assessed using the Response Evaluation Criteria in Solid Tumours criteria, and Simon's two-stage design was applied. Twelve consecutive patients were enrolled in stage 1. Only one objective response was observed. Since the target response rate was not achieved, accrual was stopped and CDDP as a single agent in ES was judged unworthy of further assessment. © 2017 Wiley Periodicals, Inc.

  9. Prognostic significance of immunohistochemistry-based markers and algorithms in immunochemotherapy-treated diffuse large B cell lymphoma patients.

    Science.gov (United States)

    Culpin, Rachel E; Sieniawski, Michal; Angus, Brian; Menon, Geetha K; Proctor, Stephen J; Milne, Paul; McCabe, Kate; Mainou-Fowler, Tryfonia

    2013-12-01

    To reassess the prognostic validity of immunohistochemical markers and algorithms identified in the CHOP era in immunochemotherapy-treated diffuse large B cell lymphoma patients. The prognostic significance of immunohistochemical markers (CD10, Bcl-6, Bcl-2, MUM1, Ki-67, CD5, GCET1, FoxP1, LMO2) and algorithms (Hans, Hans*, Muris, Choi, Choi*, Nyman, Visco-Young, Tally) was assessed using clinical diagnostic blocks taken from an unselected, population-based cohort of 190 patients treated with R-CHOP. Dichotomizing expression, low CD10 (<10%), low LMO2 (<70%) or high Bcl-2 (≥80%) predicted shorter overall survival (OS; P = 0.033, P = 0.010 and P = 0.008, respectively). High Bcl-2 (≥80%), low Bcl-6 (<60%), low GCET1 (<20%) or low LMO2 (<70%) predicted shorter progression-free survival (PFS; P = 0.001, P = 0.048, P = 0.045 and P = 0.002, respectively). The Hans, Hans* and Muris classifiers predicted OS (P = 0.022, P = 0.037 and P = 0.011) and PFS (P = 0.021, P = 0.020 and P = 0.004). The Choi, Choi* and Tally were associated with PFS (P = 0.049, P = 0.009 and P = 0.023). In multivariate analysis, the International Prognostic Index (IPI) was the only independent predictor of outcome (OS; HR: 2.60, P < 0.001 and PFS; HR: 2.91, P < 0.001). Results highlight the controversy surrounding immunohistochemistry-based algorithms in the R-CHOP era. The need for more robust markers, applicable to the clinic, for incorporation into improved prognostic systems is emphasized. © 2013 John Wiley & Sons Ltd.

  10. Dose-intensive chemotherapy including rituximab is highly effective but toxic in human immunodeficiency virus-infected patients with Burkitt lymphoma/leukemia: parallel study of 81 patients.

    Science.gov (United States)

    Xicoy, Blanca; Ribera, Josep-Maria; Müller, Markus; García, Olga; Hoffmann, Christian; Oriol, Albert; Hentrich, Marcus; Grande, Carlos; Wasmuth, Jan-Christian; Esteve, Jordi; van Lunzen, Jan; Del Potro, Eloy; Knechten, Heribert; Brunet, Salut; Mayr, Christoph; Escoda, Lourdes; Schommers, Philipp; Alonso, Natalia; Vall-Llovera, Ferran; Pérez, Montserrat; Morgades, Mireia; González, José; Fernández, Angeles; Thoden, Jan; Gökbuget, Nicola; Hoelzer, Dieter; Fätkenheuer, Gerd; Wyen, Christoph

    2014-10-01

    The results of intensive immunochemotherapy were analyzed in human immunodeficiency virus (HIV)-related Burkitt lymphoma/leukemia (BLL) in two cohorts (Spain and Germany). Alternating cycles of chemotherapy were administered, with dose reductions for patients over 55 years. Eighty percent of patients achieved remission, 11% died during induction, 9% failed and 7% died in remission. Four-year overall survival (OS) and progression-free survival (PFS) probabilities were 72% (95% confidence interval [CI]: 62-82%) and 71% (95% CI: 61-81%). CD4 T-cell count 2 (odds ratio [OR] 11.9 [1.4-99.9]) with induction death. In HIV-related BLL, intensive immunochemotherapy was feasible and effective, but toxic. Prognostic factors were performance status, CD4 T-cell count and bone marrow involvement.

  11. Azacitidine for Front-Line Therapy of Patients with AML: Reproducible Efficacy Established by Direct Comparison of International Phase 3 Trial Data with Registry Data from the Austrian Azacitidine Registry of the AGMT Study Group

    Directory of Open Access Journals (Sweden)

    Lisa Pleyer

    2017-02-01

    Full Text Available We recently published a clinically-meaningful improvement in median overall survival (OS for patients with acute myeloid leukaemia (AML, >30% bone marrow (BM blasts and white blood cell (WBC count ≤15 G/L, treated with front-line azacitidine versus conventional care regimens within a phase 3 clinical trial (AZA-AML-001; NCT01074047; registered: February 2010. As results obtained in clinical trials are facing increased pressure to be confirmed by real-world data, we aimed to test whether data obtained in the AZA-AML-001 trial accurately represent observations made in routine clinical practice by analysing additional AML patients treated with azacitidine front-line within the Austrian Azacitidine Registry (AAR; NCT01595295; registered: May 2012 and directly comparing patient-level data of both cohorts. We assessed the efficacy of front-line azacitidine in a total of 407 patients with newly-diagnosed AML. Firstly, we compared data from AML patients with WBC ≤ 15 G/L and >30% BM blasts included within the AZA-AML-001 trial treated with azacitidine (“AML-001” cohort; n = 214 with AAR patients meeting the same inclusion criteria (“AAR (001-like” cohort; n = 95. The current analysis thus represents a new sub-analysis of the AML-001 trial, which is directly compared with a new sub-analysis of the AAR. Baseline characteristics, azacitidine application, response rates and OS were comparable between all patient cohorts within the trial or registry setting. Median OS was 9.9 versus 10.8 months (p = 0.616 for “AML-001” versus “AAR (001-like” cohorts, respectively. Secondly, we pooled data from both cohorts (n = 309 and assessed the outcome. Median OS of the pooled cohorts was 10.3 (95% confidence interval: 8.7, 12.6 months, and the one-year survival rate was 45.8%. Thirdly, we compared data from AAR patients meeting AZA-AML-001 trial inclusion criteria (n = 95 versus all AAR patients with World Health Organization (WHO-defined AML (

  12. Immunotherapy, immunochemotherapy and chemotherapy for American cutaneous leishmaniasis treatment Imunoterapia, imunoquimioterapia e quimioterapia no tratamento da leishmaniose tegumentar americana

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    Wilson Mayrink

    2006-02-01

    Full Text Available The first choice of treatment for American cutaneous leishmaniasis is the pentavalent antimonial drug. Although it has been shown that this treatment is mostly effective and indicated, some disadvantages should be taken into account such as side effects, long term treatment inconveniences and counter-indication for patients suffering from cardiopathy, nephropathy; yet, aging, pregnancy and other conditions. With the advent of the vaccine anti-American cutaneous leishmaniasis as a prophylactic measure, studies on therapy using the vaccine associated or not with other drugs have been performed by many investigators and it is currently among the alternative treatments and prevention measures for American cutaneous leishmaniasis. In conclusion, the association between antimony and vaccine (immunochemotherapy showed the same cure rate when compared with the standard treatment (100% and it was also able to reduce the salt volume in 17.9% and treatment length from 87 to 62 days, decreasing side effects.O tratamento de primeira escolha para leishmaniose tegumentar americana é o antimonial pentavalente. Embora este tratamento seja na maioria das vezes efetivo e indicado, devem ser consideradas as desvantagens tais como efeitos colaterais, longa duração do tratamento e contra-indicação para cardiopatas, nefropatas, idosos, grávidas e outras condições. Com o advento da vacina antileishmaniose tegumentar americana para fins profiláticos e terapêuticos, associando-a ou não a outros fármacos, muitas pesquisas têm sido desenvolvidas, sendo a vacina a principal entre os atuais recursos no tratamento e prevenção da leishmaniose tegumentar americana. Em conclusão, a associação do antimônio com a vacina (imunoquimioterapia apresentou o mesmo índice de cura em relação ao tratamento padrão (100%, e ainda reduziu o volume do sal em 17,9% e o tempo de cura significativamente, de 87 para 62 dias; conseqüentemente, reduzindo os efeitos colaterais.

  13. Multi-institutional randomized clinical study on the comparative effects of intracavital chemotherapy alone versus immunotherapy alone versus immunochemotherapy for malignant effusion

    Science.gov (United States)

    Nio, Y; Nagami, H; Tamura, K; Tsubono, M; Nio, M; Sato, M; Kawabata, K; Hayashi, H; Shiraishi, T; Imai, S; Tsuchitani, T; Mizuta, J; Nakagawa, M; Fukumoto, M

    1999-01-01

    The current prospective randomized study was designed to compare the effects of intracavitary (i.c.) chemotherapy vs immunotherapy vs immunochemotherapy for malignant effusion. Between 1992 and 1995, a total of 42 patients with malignant effusion were registered, and 41 patients were eligible for statistical analysis. The primary diseases of the eligible patients included 27 gastric, four colorectal, four pancreatic, three lung, two liver and one oesophageal cancers. The patients with malignant effusion were randomly assigned into one of three i.c. therapeutic regimens: chemotherapy alone with weekly injection of anticancer agents (ACAs: cisplatin, mitomycin-C, adriamycin, etc.) (Group A, n = 13); immunotherapy alone with weekly injection of streptococcal preparation OK-432 (Group B, n = 14); or immunochemotherapy with ACAs and OK-432 (Group C, n = 14). The response of the effusion, patient survival and the kinetics of cytokines in the effusion were compared. There were no differences in the patients' backgrounds. The side-effects of the regimens included pain, anorexia, fever, leucopenia and anaemia and there were no differences in their incidence among the three groups. One patient died after cisplatin (CDDP) administration in Group A. Cytologic examination revealed that tumour cells in the effusion disappeared in 23% of Group A cases, 36% of Group B cases and 36% of Group C cases. The malignant effusion did not disappear in any of the Group A cases; however, the effusion disappeared in 29% of Group B cases and 43% of Group C cases (P = 0.03, Group A vs Group C). Furthermore, the 50% survival period was 1.6 months for Group A, 2.4 months for Group B and 3.5 months for Group C. The 6-month survival rate was 7% for Group A, 6% for Group B and 34% for Group C, and the 1-year survival rate was 0%, 0% and 17% respectively (P = 0.048, Group A vs Group C by the log-rank test). The analysis of the cytokine kinetics revealed a prominent increase in the level of

  14. German Command’s Guidelines on Training of Wehrmacht’s Military Units at Soviet-German Front Based on the Front-line Experience in 1941-1942

    Directory of Open Access Journals (Sweden)

    Shendrikov Evgeniy Aleksandrovich

    2014-09-01

    Full Text Available he article analyzes the guidelines of the training division of the General Staff of German land forces on improving the fighting techniques of Wehrmacht’s military units on the basis of the front-line experience gained in armed hostilities with the Red Army in 1941-1942. The study of archives allowed the author to reveal drawbacks and shortcomings of Wehrmacht’s military units training in the period preceding the second major German advance in Summer of 1942. In particular, the following drawbacks were revealed: incatious movement through monitored terrains, insufficient camouflage security, lack of proper skills in overhead shooting, poor field engineering of the infantry, poor land navigation, defeat of tank attacks and finally, tank combating at close range. The article also contains the characteristics of profound and thorough training of German command for the summer campaign of 1942, which covered all major issues such as the actions of reconnaissance forces, the organization of officers and non-commissioned officers’ training, close combat instructions, training of infantry’s field engineering, night training, making reports etc. At the end of the article the author comes to the conclusion that despite the intensified training and correction of previous mistakes, German command failed to achieve radical turning point in the war, which ended in the total defeat of fascist Germany.

  15. Matched-pair analysis to compare the outcomes of a second salvage auto-SCT to systemic chemotherapy alone in patients with multiple myeloma who relapsed after front-line auto-SCT.

    Science.gov (United States)

    Yhim, H-Y; Kim, K; Kim, J S; Kang, H J; Kim, J-A; Min, C-K; Bae, S H; Park, E; Yang, D-H; Suh, C; Kim, M K; Mun, Y-C; Eom, H S; Shin, H J; Yoon, H-J; Kwon, J H; Lee, J H; Kim, Y S; Yoon, S-S; Kwak, J-Y

    2013-03-01

    The aims of this study were to investigate the outcomes of second salvage auto-SCT and to identify the impacts of a second auto-SCT compared with systemic chemotherapy alone on disease outcome. Data from 48 patients who underwent second auto-SCT were matched to 144 patients (1:3) who received systemic chemotherapy alone from the Korean Myeloma Registry. Groups were matched for nine potential prognostic factors and compared for treatment outcomes. The median age of matching-pairs at relapse was 55.5 years. A total of 156 patients (81%) received vincristine, doxorubicin and dexamethasone induction therapy before the first auto-SCT. Thirty-five patients (73%) in the second auto-SCT group received novel agent-based therapies before the second auto-SCT, and similar proportion in both groups received novel therapies after relapse of front-line auto-SCT. With a median follow-up of 55.3 months, patients who underwent a second auto-SCT had significantly better median OS (55.5 vs 25.4 months, P=0.035). In multivariate analysis for OS, SCT, International Staging System III and salvage chemotherapy alone were independent predictors for worse OS. The outcomes of second auto-SCT appear to be superior to those of systemic chemotherapy alone. A randomized trial comparing both treatment strategies is required.

  16. Outcome of patients older than 60 years with classical Hodgkin lymphoma treated with front line ABVD chemotherapy: frequent pulmonary events suggest limiting the use of bleomycin in the elderly.

    Science.gov (United States)

    Stamatoullas, Aspasia; Brice, Pauline; Bouabdallah, Reda; Mareschal, Sylvain; Camus, Vincent; Rahal, Ilhem; Franchi, Patricia; Lanic, Hélène; Tilly, Hervé

    2015-07-01

    There is no standard of care in elderly classical Hodgkin lymphoma (cHL) patients. ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine), the standard chemotherapy for younger patients, is also used in elderly patients but little is known about toxicity and efficacy. We retrospectively analysed 147 patients aged 60 years and over treated with ABVD in three French haematological centres. Treatment regimen modification was applied in 56 patients for toxicity or HL progression. Bleomycin was removed or reduced in 53 patients, mainly for pulmonary toxicity. Neither initial characteristics nor treatment characteristics were found to correlate with lung toxicity. One hundred and seventeen patients achieved a complete remission, 6 a partial remission, 16 had refractory disease and 8 were non-evaluable. Five-year overall survival was estimated at 67%. With a median follow-up of 58 months, 51 patients died and 14% of deaths were related to lung toxicity. Our study confirms the efficacy of ABVD in elderly patients even if results are inferior to those obtained in younger patients with the same regimen. ABVD can be proposed as front-line chemotherapy in selected elderly cHL patients. The frequency of pulmonary events leads us to propose to either reduce the dose of bleomycin or to remove it from the regimen. © 2015 John Wiley & Sons Ltd.

  17. The Front Line: Unlikely Fable, Fractured Dream.

    Science.gov (United States)

    Unks, Gerald

    1980-01-01

    The author argues that there is no profession in which the gulf between professional training and practical application is quite as wide as it is in teaching. He asserts that teacher educators and public schools are now--and always have been--engaged in ideological warfare. (Author/SJL)

  18. Philosophy and the front line of science.

    Science.gov (United States)

    Pernu, Tuomas K

    2008-03-01

    According to one traditional view, empirical science is necessarily preceded by philosophical analysis. Yet the relevance of philosophy is often doubted by those engaged in empirical sciences. I argue that these doubts can be substantiated by two theoretical problems that the traditional conception of philosophy is bound to face. First, there is a strong normative etiology to philosophical problems, theories, and notions that is dfficult to reconcile with descriptive empirical study. Second, conceptual analysis (a role that is typically assigned to philosophy) seems to lose its object of study if it is granted that terms do not have purely conceptual meanings detached from their actual use in empirical sciences. These problems are particularly acute to the current naturalistic philosophy of science. I suggest a more concrete integration of philosophy and the sciences as a possible way of making philosophy of science have more impact.

  19. The Front Line: Thou Shalt Not Think!

    Science.gov (United States)

    Unks, Gerald

    1979-01-01

    Teachers who desire the academic freedom to discuss all sides of an issue are often branded as disloyal, communistic, or evil. But it is those who propose thought control and oppose total access to knowledge, not teachers advocating their students' right to know, who are America's actual subversives. (Author/SJL)

  20. Radiation Detection Center on the Front Lines

    International Nuclear Information System (INIS)

    Hazi, A

    2005-01-01

    Many of today's radiation detection tools were developed in the 1960s. For years, the Laboratory's expertise in radiation detection resided mostly within its nuclear test program. When nuclear testing was halted in the 1990s, many of Livermore's radiation detection experts were dispersed to other parts of the Laboratory, including the directorates of Chemistry and Materials Science (CMS); Physics and Advanced Technologies (PAT); Defense and Nuclear Technologies (DNT); and Nonproliferation, Arms Control, and International Security (NAI). The RDC-- was formed to maximize the benefit of radiation detection technologies being developed in 15 to 20 research and development (R and D) programs. These efforts involve more than 200 Laboratory employees across eight directorates, in areas that range from electronics to computer simulations. The RDC's primary focus is the detection, identification, and analysis of nuclear materials and weapons. A newly formed outreach program within the RDC-- is responsible for conducting radiation detection workshops and seminars across the country and for coordinating university student internships. Simon Labov, director of the RDC, says, ''Virtually all of the Laboratory's programs use radiation detection devices in some way. For example, DNT uses radiation detection to create radiographs for their work in stockpile stewardship and in diagnosing explosives; CMS uses it to develop technology for advancing the detection, diagnosis, and treatment of cancer; and the Energy and Environment Directorate uses radiation detection in the Marshall Islands to monitor the aftermath of nuclear testing in the Pacific. In the future, the National Ignition Facility will use radiation detection to probe laser targets and study shock dynamics.''

  1. Single-Institution Experience in the Treatment of Primary Mediastinal B Cell Lymphoma Treated With Immunochemotherapy in the Setting of Response Assessment by 18Fluorodeoxyglucose Positron Emission Tomography

    International Nuclear Information System (INIS)

    Pinnix, Chelsea C.; Dabaja, Bouthaina; Ahmed, Mohamed Amin; Chuang, Hubert H.; Costelloe, Colleen; Wogan, Christine F.; Reed, Valerie; Romaguera, Jorge E.; Neelapu, Sattva; Oki, Yasuhiro; Rodriguez, M. Alma; Fayad, Luis; Hagemeister, Frederick B.; Nastoupil, Loretta; Turturro, Francesco; Fowler, Nathan; Fanale, Michelle A.; Nieto, Yago; Khouri, Issa F.; Ahmed, Sairah

    2015-01-01

    Purpose: Excellent outcomes obtained after infusional dose-adjusted etoposide, doxorubicin, cyclophosphamide, vincristine, prednisone, and rituximab (R-EPOCH) alone have led some to question the role of consolidative radiation therapy (RT) in the treatment of primary mediastinal B cell lymphoma (PMBL). We reviewed the outcomes in patients treated with 1 of 3 rituximab-containing regimens (cyclophosphamide, doxorubicin, vincristine, prednisone [R-CHOP]; hyperfractionated cyclophosphamide, vincristine, doxorubicin and dexamethasone [R-HCVAD], or R-EPOCH) with or without RT. We also evaluated the ability of positron emission tomography–computed tomography (PET-CT) to identify patients at risk of relapse. Methods and Materials: We retrospectively identified 97 patients with diagnoses of stage I/II PMBCL treated at our institution between 2001 and 2013. The clinical characteristics, treatment outcomes, and toxicity were assessed. We analyzed whether postchemotherapy PET-CT could identify patients at risk for progressive disease according to a 5 point scale (5PS) Deauville score assigned. Results: Among 97 patients (median follow-up time, 57 months), the 5-year overall survival rate was 99%. Of patients treated with R-CHOP, 99% received RT; R-HCVAD, 82%; and R-EPOCH, 36%. Of 68 patients with evaluable end-of-chemotherapy PET-CT scans, 62% had a positive scan (avidity above that of the mediastinal blood pool [Deauville 5PS = 3]), but only 9 patients experienced relapse (n=1) or progressive disease (n=8), all with a 5PS of 4 to 5. Of the 25 patients who received R-EPOCH, 4 experienced progression, all with 5PS of 4 to 5; salvage therapy (RT and autologous stem cell transplantation) was successful in all cases. Conclusion: Combined modality immunochemotherapy and RT is well tolerated and effective for treatment of PMBCL. A postchemotherapy 5PS of 4 to 5, rather than 3 to 5, can identify patients at high risk of progression who should be considered for therapy beyond

  2. Feasibility of abbreviated cycles of immunochemotherapy for completely resected limited-stage CD20+ diffuse large B-cell lymphoma (CISL 12-09).

    Science.gov (United States)

    Yoon, Dok Hyun; Sohn, Byeong Seok; Oh, Sung Yong; Lee, Won-Sik; Lee, Sang Min; Yang, Deok-Hwan; Huh, Jooryung; Suh, Cheolwon

    2017-02-21

    The appropriate number of chemotherapy cycles for limited stage diffuse large B-cell lymphoma (DLBCL) patients without gross residual lesions after complete resection, has not been specifically questioned. We performed a multicenter, single-arm, phase 2 study to investigate the feasibility of 3 cycles of abbreviated R-CHOP chemotherapy in low-risk patients with completely resected localized CD20+ DLBCL. Between December 2010 and May 2013, we recruited 23 patients. One was excluded due to ineligibility, and hence, 22 were included in the final analysis. The primary sites comprised the intestine (n = 15), cervical lymph nodes (n = 4), stomach (n = 1), tonsil (n = 1), and spleen (n = 1). All patients successfully completed the 3 cycles of planned R-CHOP chemotherapy. Over a median follow-up of 39.5 months (95% confidence interval, 29.9-47.1 months), both the estimated 2-year disease-free survival and overall survival rates was 95% confidence interval, 85.9-104.1%. Only one patient with an international prognostic index of 2 experienced relapse and died. The most common grade 3 or 4 toxicity condition included neutropenia (n = 8, 36.4%). Three patients experienced grade 3 febrile neutropenia, but no grade 3 or 4 non-hematologic toxicity was observed. DLBCL patients without residual lesions after resection were enrolled and R-CHOP chemotherapy was repeated at 3-week-intervals over 3 cycles. The primary endpoint was 2-year disease-free survival. Three cycles of abbreviated R-CHOP immunochemotherapy is feasible for completely resected low risk localized DLBCL.

  3. Positron Emission Tomography/Computed Tomography Assessment After Immunochemotherapy and Irradiation Using the Lugano Classification Criteria in the IELSG-26 Study of Primary Mediastinal B-Cell Lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Ceriani, Luca, E-mail: luca.ceriani@eoc.ch [Nuclear Medicine and PET-CT Center, Oncology Institute of Southern Switzerland, Bellinzona (Switzerland); Martelli, Maurizio [Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome (Italy); Gospodarowicz, Maria K. [Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Ricardi, Umberto [Department of Oncology, University of Torino, Torino (Italy); Ferreri, Andrés J.M. [Unit of Lymphoid Malignancies, Department of Onco-Hematology, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milano (Italy); Chiappella, Annalisa [Hematology, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Torino (Italy); Stelitano, Caterina [Hematology, Azienda Ospedaliera Bianchi-Melacrino-Morelli, Reggio Calabria (Italy); Balzarotti, Monica [Hematology, IRCCS Humanitas Cancer Center, Rozzano, Milan (Italy); Cabrera, Maria E. [Hematology, Hospital del Salvador, Universidad de Chile, Santiago (Chile); Cunningham, David [Department of Medicine, The Royal Marsden National Health Service Foundation Trust, London and Surrey (United Kingdom); Guarini, Attilio [Hematology Unit, Istituto Nazionale Tumori Giovanni Paolo II IRCCS, Bari (Italy); Zinzani, Pier Luigi [Institute of Hematology and Medical Oncology, Policlinico S.Orsola-Malpighi, Bologna (Italy); Giovanella, Luca [Nuclear Medicine and PET-CT Center, Oncology Institute of Southern Switzerland, Bellinzona (Switzerland); Johnson, Peter W.M. [Cancer Research UK Centre, University of Southampton, Southampton (United Kingdom); Zucca, Emanuele [Oncology Department, Oncology Institute of Southern Switzerland, Bellinzona (Switzerland)

    2017-01-01

    Purpose: To assess the predictive value of {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) for disease recurrence after immunochemotherapy (R-CHT) and mediastinal irradiation (RT), using the recently published criteria of the Lugano classification to predict outcomes for patients with primary mediastinal large B-cell lymphoma. Methods and Materials: Among 125 patients prospectively enrolled in the IELSG-26 study, 88 were eligible for central review of PET/CT scans after completion of RT. Responses were evaluated using the 5-point Deauville scale at the end of induction R-CHT and after consolidation RT. According to the Lugano classification, a complete metabolic response (CMR) was defined by a Deauville score (DS) ≤3. Results: The CMR (DS1, -2, or -3) rate increased from 74% (65 patients) after R-CHT to 89% (78 patients) after consolidation RT. Among the 10 patients (11%) with persistently positive scans, the residual uptake after RT was slightly higher than the liver uptake in 6 patients (DS4; 7%) and markedly higher in 4 patients (DS5; 4%): these patients had a significantly poorer 5-year progression-free survival and overall survival. At a median follow-up of 60 months (range, 35-107 months), no patients with a CMR after RT have relapsed. Among the 10 patients who did not reach a CMR, 3 of the 4 patients (positive predictive value, 75%) with DS5 after RT had subsequent disease progression (within the RT volume in all cases) and died. All patients with DS4 had good outcomes without recurrence. Conclusions: All the patients obtaining a CMR defined as DS ≤3 remained progression-free at 5 years, confirming the excellent negative predictive value of the Lugano classification criteria in primary mediastinal large B-cell lymphoma patients. The few patients with DS4 also had an excellent outcome, suggesting that they do not necessarily require additional therapy, because the residual {sup 18}F-fluorodeoxyglucose uptake may

  4. Th1/2 Immune Response Signature Predicts Outcome after Dose-Dense Immunochemotherapy in Patients with High Risk Diffuse Large B-Cell Lymphoma – Results from Nordic Lymphoma Group Trials

    DEFF Research Database (Denmark)

    M, Autio; Jørgensen, Judit Meszaros; SK, Leivonen

    treatment-specific roles in diffuse large B-cell lymphoma. For the high risk DLBCL patients treated with dose-dense immunochemotherapy, high expression of type 1/2 immune response signature genes predicts a poor outcome. A detailed characterization of immune cell composition in the tumor microenvironment......Introduction: Despite better therapeutic options and improved survival of diffuse large B-cell lymphoma (DLBCL), 30-40% of the patients still relapse and have dismal prognosis. Recently, the impact of genomic aberrations, allowing lymphoma cells to escape immune recognition on DLBCL pathogenesis...... has been recognized. However, whether immune related signatures could be used as determinants for treatment outcome has not been rigorously evaluated. Here, our aim was to elucidate the immunologic characteristics of the tumor microenvironment, and associate the findings with outcome in patients...

  5. FDG-PET/CT at the end of immuno-chemotherapy in follicular lymphoma: the prognostic role of the ratio between target lesion and liver SUVmax (rPET).

    Science.gov (United States)

    Annunziata, Salvatore; Cuccaro, Annarosa; Tisi, Maria Chiara; Hohaus, Stefan; Rufini, Vittoria

    2018-06-01

    To retrospectively investigate the prognostic role of the ratio between target lesion and liver SUV max (rPET) in patients with follicular lymphoma (FL) submitted to FDG-PET/CT at the end of immuno-chemotherapy (PI-PET), and to compare rPET with International Harmonization Project criteria (IHP), Deauville Score (5p-DS) and FL International Prognostic Index at diagnosis (FLIPI). Eighty-nine patients with FL undergoing PI-PET were evaluated. The receiver operating characteristic (ROC) approach was applied to identify the optimal cut-point of rPET with respect to 5-years progression free survival (PFS). The prognostic significance of rPET was compared with IHP, DS and FLIPI. Positive predictive value (PPV) and negative predictive value (NPV) were calculated using the presence of adverse events as gold standard. The ROC analysis for rPET as predictor of progression showed an optimal rPET cut-point of 0.98. Patients with positive values of IHP, DS and rPET had a PFS of 50, 30 and 31%. PPV were of 56, 80 and 80%, NPV of 83, 86 and 88%, respectively. DS and rPET differed only in two patients. FLIPI was not predictive of progression and relapse. rPET is a prognostic factor in patients with FL submitted to PI-PET. Although it has a similar prognostic power as DS, it can have methodological advantages over visual analysis. PI-PET with different evaluation systems has a stronger prognostic power than FLIPI at diagnosis, so it could be useful to identify patients with FL at risk for early relapse after immuno-chemotherapy.

  6. Culture of innovation and business competitiveness in knowledge intensive services.The mediating role of co-creative culture; Cultura innovadora y competitividad en las empresas de servicios intensivos en conocimiento. El papel mediador de la cultura co-creadora

    Energy Technology Data Exchange (ETDEWEB)

    Santos Vijande, M. L.; Gonzalez Mieres, C.; Lopez Sanchez, J. A.

    2012-07-01

    This research investigates the relationship between innovative culture and performance among knowledge-intensive business services (KIBS). Performance indicators include customer-related outcomes and market and financial results relative to competition. To provide insight into how inattentiveness contributes to sustaining a KIBS' competitiveness, the mediating role of the predisposition to involve customers and front-line employees in new service development is also considered. In accordance with the objectives of the research, and from an extensive review of the literature, the conceptual model proposed is tested on a sample of 154 Spanish KIBS using structural equation modelling. Results show that KIBS appraisal of customers and front-line employees participation in new service co-creation is strongly determined by the firm's innovative culture. (Author)

  7. France in the front line for geothermal energy

    International Nuclear Information System (INIS)

    Richard, Aude; Talpin, Juliette

    2016-01-01

    A set of articles illustrates that France is among the European leaders in heat networks fed by deep aquifers in sedimentary basins, and will soon possess new types of plants to valorise this hot water. A first article describes the operation principle and the distinction between the different geothermal energy levels (very low, low and medium, high). The still slow but actual development of geothermal energy is commented. It notably concerns local communities and industries, but not yet individuals. A brief focus is proposed on the case of the Aquitaine basin and of Bordeaux, and on the use of geothermal energy to cool the wine. The case of Ferney-Voltaire is then discussed: a whole district will be supplied with probe-based tempered water loops. The interest of the ADEME in geo-cooling is evoked. An article comments the development of a new model of deep geothermal energy developed by France and Germany: a dozen of plants are planned to be built by 2020, and the Ecogi plant in Rittershoffen is a showcase of a first application of fractured rock geothermal technology (the operation is described). A map indicates locations of geothermal search permits which have been awarded for 16 sites in France. An overview is given of various initiatives in Ile-de-France. The case of Geothermie Bouillante plant in Guadeloupe is evoked: it has been purchased by an American group and will multiply its electricity production by a factor 4 by 2025. The two last articles respectively address the need to boost the very low geothermal energy sector, and the use of geothermal energy in cities near Paris (Grigny and Viry-Chatillon) which aim at supplying energy at lower prices, and thus struggle against energy poverty

  8. Front-Line Advocacy: Fighting Off a Voucher Measure

    Science.gov (United States)

    Grimesey, Robert P., Jr.

    2012-01-01

    In September 2010, the U.S. Senate's Armed Services Committee approved an amendment to the proposed National Defense Authorization Act. The amendment, known as Section 583, authorized a Defense Department pilot voucher program to mitigate the cost of private school tuition for special-needs children of military parents. Sen. Jim Webb, a member of…

  9. AIDS education from a front line worker's perspective.

    Science.gov (United States)

    Waines, R

    1993-01-01

    The author is an AIDS educator working in Vancouver, Canada, who does not agree with current HIV prevention tactics which bombard audiences with information on HIV and its consequences and preventive approaches. It should be clear by now that inundating people with information while ignoring the emotions behind their choices does not work. Efforts must be made to close the gap between individual knowledge and action. The author has learned over his four-year tenure as youth educator that educational sessions should be small and interactive. The educator should stress that no question, topic, feeling, or prejudice is taboo and encourage open discussion of pertinent issues. No person should be allowed to dominate the discussion and only minimal time spent on topics such as whether mosquitoes can transmit HIV. The focus should be taken off of condoms, because people have heard enough already, and alternatives to unprotected anal, vaginal, and oral sex encouraged. Women should be encouraged to choose what kind of sex they want, participants should be encouraged to discuss and adhere to what they have learned after the session, and obstacles raise by conservative parents' groups must be fought. Further, the educator must prepare for the session and follow up on opinions afterwards. The author also critiques Catholic education as puritan and disrespectful of the rights of youth to information and free choice, and assails discrimination against people with AIDS and all people in general.

  10. Opinions from the front lines of cat colony management conflict.

    Directory of Open Access Journals (Sweden)

    M Nils Peterson

    Full Text Available Outdoor cats represent a global threat to terrestrial vertebrate conservation, but management has been rife with conflict due to differences in views of the problem and appropriate responses to it. To evaluate these differences we conducted a survey of opinions about outdoor cats and their management with two contrasting stakeholder groups, cat colony caretakers (CCCs and bird conservation professionals (BCPs across the United States. Group opinions were polarized, for both normative statements (CCCs supported treating feral cats as protected wildlife and using trap neuter and release [TNR] and BCPs supported treating feral cats as pests and using euthanasia and empirical statements. Opinions also were related to gender, age, and education, with females and older respondents being less likely than their counterparts to support treating feral cats as pests, and females being less likely than males to support euthanasia. Most CCCs held false beliefs about the impacts of feral cats on wildlife and the impacts of TNR (e.g., 9% believed feral cats harmed bird populations, 70% believed TNR eliminates cat colonies, and 18% disagreed with the statement that feral cats filled the role of native predators. Only 6% of CCCs believed feral cats carried diseases. To the extent the beliefs held by CCCs are rooted in lack of knowledge and mistrust, rather than denial of directly observable phenomenon, the conservation community can manage these conflicts more productively by bringing CCCs into the process of defining data collection methods, defining study/management locations, and identifying common goals related to caring for animals.

  11. Opinions from the Front Lines of Cat Colony Management Conflict

    Science.gov (United States)

    Peterson, M. Nils; Hartis, Brett; Rodriguez, Shari; Green, Matthew; Lepczyk, Christopher A.

    2012-01-01

    Outdoor cats represent a global threat to terrestrial vertebrate conservation, but management has been rife with conflict due to differences in views of the problem and appropriate responses to it. To evaluate these differences we conducted a survey of opinions about outdoor cats and their management with two contrasting stakeholder groups, cat colony caretakers (CCCs) and bird conservation professionals (BCPs) across the United States. Group opinions were polarized, for both normative statements (CCCs supported treating feral cats as protected wildlife and using trap neuter and release [TNR] and BCPs supported treating feral cats as pests and using euthanasia) and empirical statements. Opinions also were related to gender, age, and education, with females and older respondents being less likely than their counterparts to support treating feral cats as pests, and females being less likely than males to support euthanasia. Most CCCs held false beliefs about the impacts of feral cats on wildlife and the impacts of TNR (e.g., 9% believed feral cats harmed bird populations, 70% believed TNR eliminates cat colonies, and 18% disagreed with the statement that feral cats filled the role of native predators). Only 6% of CCCs believed feral cats carried diseases. To the extent the beliefs held by CCCs are rooted in lack of knowledge and mistrust, rather than denial of directly observable phenomenon, the conservation community can manage these conflicts more productively by bringing CCCs into the process of defining data collection methods, defining study/management locations, and identifying common goals related to caring for animals. PMID:22970269

  12. The front line health worker: selection, training, and performance.

    Science.gov (United States)

    Ronaghy, H A; Najarzadeh, E; Schwartz, T A; Russel, S S; Solter, S; Zeighami, B

    1976-03-01

    Iranian villagers with basic literacy were recruited, selected, trained, and deployed as Village Health Workers (VHWs) to rural areas of Iran. VHW clinical visit records and activities logs were analyzed to determine levels and nature of effort achieved in the field. Within six months of deployment, the number of patient visits to VHW treatment services constituted 53% of the target population. Within ten months of deployment, the number of family planning acceptors rose from 8% to 21% of the population at risk. Improvements to water supplies have been effected in 50% of target villages. Sanitary improvements have been made to 35% of the houses and 88% of toilets in those villages. Demographic characteristics, class rank, and place of residence of VHWs appear unassociated with village differences in levels of achievement. However, availability of material resources and actual time spent by VHWs on the job may be factors influencing the differences in outcome between villages.

  13. Opinions from the front lines of cat colony management conflict.

    Science.gov (United States)

    Peterson, M Nils; Hartis, Brett; Rodriguez, Shari; Green, Matthew; Lepczyk, Christopher A

    2012-01-01

    Outdoor cats represent a global threat to terrestrial vertebrate conservation, but management has been rife with conflict due to differences in views of the problem and appropriate responses to it. To evaluate these differences we conducted a survey of opinions about outdoor cats and their management with two contrasting stakeholder groups, cat colony caretakers (CCCs) and bird conservation professionals (BCPs) across the United States. Group opinions were polarized, for both normative statements (CCCs supported treating feral cats as protected wildlife and using trap neuter and release [TNR] and BCPs supported treating feral cats as pests and using euthanasia) and empirical statements. Opinions also were related to gender, age, and education, with females and older respondents being less likely than their counterparts to support treating feral cats as pests, and females being less likely than males to support euthanasia. Most CCCs held false beliefs about the impacts of feral cats on wildlife and the impacts of TNR (e.g., 9% believed feral cats harmed bird populations, 70% believed TNR eliminates cat colonies, and 18% disagreed with the statement that feral cats filled the role of native predators). Only 6% of CCCs believed feral cats carried diseases. To the extent the beliefs held by CCCs are rooted in lack of knowledge and mistrust, rather than denial of directly observable phenomenon, the conservation community can manage these conflicts more productively by bringing CCCs into the process of defining data collection methods, defining study/management locations, and identifying common goals related to caring for animals.

  14. Segmental front line dynamics of randomly pinned ferroelastic domain walls

    Science.gov (United States)

    Puchberger, S.; Soprunyuk, V.; Schranz, W.; Carpenter, M. A.

    2018-01-01

    Dynamic mechanical analysis (DMA) measurements as a function of temperature, frequency, and dynamic force amplitude are used to perform a detailed study of the domain wall motion in LaAlO3. In previous DMA measurements Harrison et al. [Phys. Rev. B 69, 144101 (2004), 10.1103/PhysRevB.69.144101] found evidence for dynamic phase transitions of ferroelastic domain walls in LaAlO3. In the present work we focus on the creep-to-relaxation region of domain wall motion using two complementary methods. We determine, in addition to dynamic susceptibility data, waiting time distributions of strain jerks during slowly increasing stress. These strain jerks, which result from self-similar avalanches close to the depinning threshold, follow a power-law behavior with an energy exponent ɛ =1.7 ±0.1 . Also, the distribution of waiting times between events follows a power law N (tw) ∝tw-(n +1 ) with an exponent n =0.9 , which transforms to a power law of susceptibility S (ω ) ∝ω-n . The present dynamic susceptibility data can be well fitted with a power law, with the same exponent (n =0.9 ) up to a characteristic frequency ω ≈ω* , where a crossover from stochastic DW motion to the pinned regime is well described using the scaling function of Fedorenko et al. [Phys. Rev. B 70, 224104 (2004), 10.1103/PhysRevB.70.224104].

  15. Front-Line Resilience Perspectives: The Electric Grid

    Energy Technology Data Exchange (ETDEWEB)

    Finster, M. [Argonne National Lab. (ANL), Argonne, IL (United States); Phillips, J. [Argonne National Lab. (ANL), Argonne, IL (United States); Wallace, K. [Argonne National Lab. (ANL), Argonne, IL (United States)

    2016-11-01

    This report seeks to summarize how states and local utility companies are approaching all-hazards resilience in planning, construction, operations, and maintenance of the electric system, as well as challenges faced when addressing all-hazards resilience.

  16. Single-Institution Experience in the Treatment of Primary Mediastinal B Cell Lymphoma Treated With Immunochemotherapy in the Setting of Response Assessment by {sup 18}Fluorodeoxyglucose Positron Emission Tomography

    Energy Technology Data Exchange (ETDEWEB)

    Pinnix, Chelsea C. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Dabaja, Bouthaina, E-mail: bdabaja@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Ahmed, Mohamed Amin [Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Chuang, Hubert H. [Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Costelloe, Colleen [Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Wogan, Christine F.; Reed, Valerie [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Romaguera, Jorge E.; Neelapu, Sattva; Oki, Yasuhiro [Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Rodriguez, M. Alma [Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Office of Medical Affairs, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Fayad, Luis; Hagemeister, Frederick B.; Nastoupil, Loretta; Turturro, Francesco; Fowler, Nathan; Fanale, Michelle A. [Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Nieto, Yago; Khouri, Issa F.; Ahmed, Sairah [Department of Stem Cell Transplantation, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); and others

    2015-05-01

    Purpose: Excellent outcomes obtained after infusional dose-adjusted etoposide, doxorubicin, cyclophosphamide, vincristine, prednisone, and rituximab (R-EPOCH) alone have led some to question the role of consolidative radiation therapy (RT) in the treatment of primary mediastinal B cell lymphoma (PMBL). We reviewed the outcomes in patients treated with 1 of 3 rituximab-containing regimens (cyclophosphamide, doxorubicin, vincristine, prednisone [R-CHOP]; hyperfractionated cyclophosphamide, vincristine, doxorubicin and dexamethasone [R-HCVAD], or R-EPOCH) with or without RT. We also evaluated the ability of positron emission tomography–computed tomography (PET-CT) to identify patients at risk of relapse. Methods and Materials: We retrospectively identified 97 patients with diagnoses of stage I/II PMBCL treated at our institution between 2001 and 2013. The clinical characteristics, treatment outcomes, and toxicity were assessed. We analyzed whether postchemotherapy PET-CT could identify patients at risk for progressive disease according to a 5 point scale (5PS) Deauville score assigned. Results: Among 97 patients (median follow-up time, 57 months), the 5-year overall survival rate was 99%. Of patients treated with R-CHOP, 99% received RT; R-HCVAD, 82%; and R-EPOCH, 36%. Of 68 patients with evaluable end-of-chemotherapy PET-CT scans, 62% had a positive scan (avidity above that of the mediastinal blood pool [Deauville 5PS = 3]), but only 9 patients experienced relapse (n=1) or progressive disease (n=8), all with a 5PS of 4 to 5. Of the 25 patients who received R-EPOCH, 4 experienced progression, all with 5PS of 4 to 5; salvage therapy (RT and autologous stem cell transplantation) was successful in all cases. Conclusion: Combined modality immunochemotherapy and RT is well tolerated and effective for treatment of PMBCL. A postchemotherapy 5PS of 4 to 5, rather than 3 to 5, can identify patients at high risk of progression who should be considered for therapy beyond

  17. Método para classificação de tipos de erros humanos: estudo de caso em acidentes em canteiros de obras An algorithm for classifying error types of front-line workers: a case study in accidents in construction sites

    Directory of Open Access Journals (Sweden)

    Tarcisio Abreu Saurin

    2012-04-01

    Full Text Available Este trabalho tem como objetivo principal desenvolver melhorias em um método de classificação de tipos de erros humanos de operadores de linha de frente. Tais melhorias foram desenvolvidas com base no teste do método em canteiros de obras, um ambiente no qual ele ainda não havia sido aplicado. Assim, foram investigados 19 acidentes de trabalho ocorridos em uma construtora de pequeno porte, sendo classificados os tipos de erros dos trabalhadores lesionados e de colegas de equipe que se encontravam no cenário do acidente. Os resultados indicaram que não houve nenhum erro em 70,5% das 34 vezes em que o método foi aplicado, evidenciando que as causas dos acidentes estavam fortemente associadas a fatores organizacionais. O estudo apresenta ainda recomendações para a interpretação das perguntas que constituem o método, bem como modificações em algumas dessas perguntas em comparação às versões anteriores.The objective of this study is to propose improvements in the algorithm for classifying error types of front-line workers. The improvements have been identified on the basis of testing the algorithm in construction sites, an environment where it had not been implemented it. To this end, 19 occupational accidents which occurred in a small construction company were investigated, and the error types of both injured workers and team members were classified. The results indicated that there was no error in 70.5% of the 34 times the algorithm was applied, providing evidence that the causes were strongly linked to organizational factors. Moreover, the study presents not only recommendations to facilitate the interpretation of the questions that constitute the algorithm, but also changes in some questions in comparison to the previous versions of the tool.

  18. Recruiting intensity

    OpenAIRE

    R. Jason Faberman

    2014-01-01

    To hire new workers, employers use a variety of recruiting methods in addition to posting a vacancy announcement. The intensity with which employers use these alternative methods can vary widely with a firm’s performance and with the business cycle. In fact, persistently low recruiting intensity helps to explain the sluggish pace of US job growth following the Great Recession.

  19. Sound intensity

    DEFF Research Database (Denmark)

    Crocker, Malcolm J.; Jacobsen, Finn

    1998-01-01

    This chapter is an overview, intended for readers with no special knowledge about this particular topic. The chapter deals with all aspects of sound intensity and its measurement from the fundamental theoretical background to practical applications of the measurement technique.......This chapter is an overview, intended for readers with no special knowledge about this particular topic. The chapter deals with all aspects of sound intensity and its measurement from the fundamental theoretical background to practical applications of the measurement technique....

  20. Sound Intensity

    DEFF Research Database (Denmark)

    Crocker, M.J.; Jacobsen, Finn

    1997-01-01

    This chapter is an overview, intended for readers with no special knowledge about this particular topic. The chapter deals with all aspects of sound intensity and its measurement from the fundamental theoretical background to practical applications of the measurement technique.......This chapter is an overview, intended for readers with no special knowledge about this particular topic. The chapter deals with all aspects of sound intensity and its measurement from the fundamental theoretical background to practical applications of the measurement technique....

  1. Intensive mobilities

    DEFF Research Database (Denmark)

    Vannini, Phillip; Bissell, David; Jensen, Ole B.

    with fieldwork conducted in Canada, Denmark and Australia to develop our understanding of the experiential politics of long distance workers. Rather than focusing on the extensive dimensions of mobilities that are implicated in patterns and trends, our paper turns to the intensive dimensions of this experience......This paper explores the intensities of long distance commuting journeys as a way of exploring how bodily sensibilities are being changed by the mobilities that they undertake. The context of this paper is that many people are travelling further to work than ever before owing to a variety of factors...... which relate to transport, housing and employment. Yet we argue that the experiential dimensions of long distance mobilities have not received the attention that they deserve within geographical research on mobilities. This paper combines ideas from mobilities research and contemporary social theory...

  2. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... Compartir For more help with what counts as aerobic activity, watch this video: Windows Media Player, 4: ... ways to understand and measure the intensity of aerobic activity: relative intensity and absolute intensity. Relative Intensity ...

  3. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... 45 David, Age 65 Harold, Age 67 Data & Statistics Facts About Physical Activity Data, Trends and Maps ... relative intensity and absolute intensity. Relative Intensity The level of effort required by a person to do ...

  4. Tales from the front lines: the creative essay as a tool for teaching genetics.

    Science.gov (United States)

    Koehler, K E; Hawley, R S

    1999-07-01

    In contrast to the more typical mock grant proposals or literature reviews, we describe the use of the creative essay as a novel tool for teaching human genetics at the college level. This method has worked well for both nonmajor and advanced courses for biology majors. The 10- to 15-page essay is written in storylike form and represents a student's response to the choice of 6-8 scenarios describing human beings coping with various genetic dilemmas. We have found this tool to be invaluable both in developing students' ability to express genetic concepts in lay terms and in promoting student awareness of genetic issues outside of the classroom. Examples from student essays are presented to illustrate these points, and guidelines are suggested regarding instructor expectations of student creativity and scientific accuracy. Methods of grading this assignment are also discussed.

  5. Reports from the Front Line: English Headteachers' Work in an Era of Practice Centralization

    Science.gov (United States)

    Bottery, Michael

    2007-01-01

    This article investigates the perceptions of English headteachers to questions addressing the setting of goals and the effects of external pressure on headteachers. The research utilizes semi-structured interviews with headteachers from a variety of contexts. These interviews were used to write individual headteacher "portraits", which…

  6. Canada in the 21st Century - Triumph or Tragedy? The Front Line.

    Science.gov (United States)

    Kilgour, David

    1996-01-01

    Argues that new patterns of trade and production combined with an emphasis on a knowledge-based economy/society make it imperative that Canada upgrade its educational system. Specifically notes that several growing and dominant industries (microelectronics, biotechnology, telecommunications) require a high-tech skilled labor force. (MJP)

  7. The Management Development Needs of Front-Line Managers: Voices from the Field.

    Science.gov (United States)

    Longenecker, Clinton O.; Neubert, Mitchell

    2003-01-01

    A survey of 524 managers identified key practices to improve performance in a changing environment: clarifying roles, goals, and expectations; ongoing performance evaluation, feedback, and coaching; mentoring; challenging assignments; formal career planning; customer contact; cross-training; and 360-degree feedback. (Contains 31 references.) (SK)

  8. Greener plants, grayer skies? A report from the front lines of China's energy sector

    International Nuclear Information System (INIS)

    Steinfeld, Edward S.; Lester, Richard K.; Cunningham, Edward A.

    2009-01-01

    This article presents findings from the MIT China Energy Group's first-of-its-kind, independent nationwide survey of Chinese coal-fired power plants. It is well understood that developments in China's energy sector now have global environmental implications. It is also well understood that this sector has in recent years experienced rapidly rising fuel costs. The MIT survey, by delving into technology choice, pricing, fuel sourcing, and environmental cleanup at the firm level, provides insights into how the Chinese power sector as a whole responds, and what the environmental implications are. The findings suggest rapid uptake of advanced combustion technologies across the system, largely in response to rising fuel costs. Environmental cleanup systems, particularly for sulfur dioxide, have also spread rapidly, in large part due to regulatory enforcement. Yet, operationally, plants pollute substantially. Price hikes encourage them to source low-grade fuel and idle cleanup systems. On the whole, the Chinese system infrastructurally has a proven capacity for rapid technological upgrading in the face of new market and regulatory pressures. Operationally, however, in part due to exposure to market forces, and in part due to limited state capacity for monitoring operations, even the most advanced power plants remain major polluters.

  9. Political Challenges and Opportunities to Climate Change Mitigation: A View from the Front Lines

    Science.gov (United States)

    Weaver, A. J.

    2014-12-01

    Subsequent to the release of the 2007 Report of the Intergovernmental Panel on Climate Change, the Province of British Columbia in Canada became an international leader in the development and implementation of innovative climate change mitigation policies. These include, but are not limited to, the 2008 Greenhouse Gas Reductions Target Act, the 2008 Carbon Tax Act and the 2010 Clean Energy Act. British Columbia's Cleantech sector quickly responded to, and thrived as a result of, the signal sent by government to the market. But with a change in Premier in 2011 came a change in priorities. A number of the previous initiatives have either been weakened or no longer followed through with as the Province sets its vision of being a major exporter of Liquified Natural Gas. As a member of the British Columbia Climate Action Team set up by Premier Gordon Campbell in 2007 to provide advice to government on a variety of policy-related matters, I was fortunate to be able to watch first hand as the Province aggressively moved towards reducing its Greenhouse gas emissions. Rather than stand on the sidelines as the government lost its direction on the climate file I chose to run with the BC Green Party in the 2013 provincial election. I was subsequently elected as a Member of the Legislative Assembly representing the constituents of Oak Bay Gordon Head. While science can and should inform policy deliberations, in and of itself, science cannot and should not prescribe policy outcomes. Whether or not we deal with today's challenge of climate change boils down to a question of intergeneration equity. Does the present generation owe anything to future generations in terms of the quality of the environment that they inherit? Many of today's elected decision-makers are focused on short-term decision-making. Yet those who will be affected by the consequences of these decisions are not part of the decision making process — hence the political conundrum. In this presentation I detail some of the political opportunities and challenges associated with efforts to ensure political decision-makers consider the long term consequences of their climate and energy policy while balancing a myriad other immediately-pressing issues.

  10. INSIGHTS FROM THE FRONT LINES: A COLLECTION OF STORIES OF HTA IMPACT FROM INAHTA MEMBER AGENCIES.

    Science.gov (United States)

    Schuller, Tara; Söderholm Werkö, Sophie

    2017-01-01

    This mini-theme contains six stories of health technology assessment (HTA) impact from member agencies of The International Network of Agencies for Health Technology Assessment (INAHTA), which were originally shared at the 2015 and 2016 INAHTA Congresses. The INAHTA impact story sharing is an innovative network activity where member agency representatives share experiences of HTA impact in a loosely structured story format. Through this process, members gain insights from other agencies on new ways of thinking about and approaching HTA impact assessment. A guide is provided to members to prepare their story, and the best story receives the David Hailey Award for Best Impact Story. This mini-theme contains stories of HTA impact from six member agencies in different parts of the world: the Health Assessment Division of the Ministry of Public Health (Uruguay), the Institute of Quality and Efficiency in Health Care (Germany), the Health Information and Quality Authority (Ireland), the Finnish Office for Health Technology Assessment (Finland), the Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (Australia), and the Institut national d'excellence en santé et en services sociaux (Canada). Across the papers, common themes emerge about the importance of appropriate engagement of stakeholders and the broadening scope of HTA beyond reimbursement decision making.

  11. Taking stock of pay-for-performance: a candid assessment from the front lines.

    Science.gov (United States)

    Damberg, Cheryl L; Raube, Kristiana; Teleki, Stephanie S; Dela Cruz, Erin

    2009-01-01

    Pay-for-performance (P4P) has been widely adopted, but it remains unclear how providers are responding and whether results are meeting expectations. Physician organizations involved in the California Integrated Healthcare Association's (IHA) P4P program reported having increased physician-level performance feedback and accountability, speeded up information technology adoption, and sharpened their organizational focus and support for improvement in response to P4P; however, after three years of investment, these changes had not translated into breakthrough quality improvements. Continued monitoring is required to determine whether early investments made by physician organizations provide a basis for greater improvements in the future.

  12. Recruitment of ethnic minorities into cancer clinical trials: experience from the front lines.

    Science.gov (United States)

    Symonds, R P; Lord, K; Mitchell, A J; Raghavan, D

    2012-09-25

    Throughout the world there are problems recruiting ethnic minority patients into cancer clinical trials. A major barrier to trial entry may be distrust of research and the medical system. This may be compounded by the regulatory framework governing research with an emphasis on written consent, closed questions and consent documentation, as well as fiscal issues. The Leicester UK experience is that trial accrual is better if British South Asian patients are approached by a senior doctor rather than someone of perceived lesser hierarchical status and a greater partnership between the hospital and General Practitioner may increase trial participation of this particular ethnic minority. In Los Angeles, USA, trial recruitment was improved by a greater utilisation of Hispanic staff and a Spanish language-based education programme. Involvement of community leaders is essential. While adhering to national, legal and ethnical standards, information sheets and consent, it helps if forms can be tailored towards the local ethnic minority population. Written translations are often of limited value in the recruitment of patients with no or limited knowledge of English. In some cultural settings, tape-recorded verbal consent (following approval presentations) may be an acceptable substitute for written consent, and appropriate legislative changes should be considered to facilitate this option. Approaches should be tailored to specific minority populations, taking consideration of their unique characteristics and with input from their community leadership.

  13. Recruitment of multiple stakeholders to health services research: Lessons from the front lines

    Directory of Open Access Journals (Sweden)

    Brouwers Melissa C

    2010-05-01

    Full Text Available Abstract Background Self-administered surveys are an essential methodological tool for health services and knowledge translation research, and engaging end-users of the research is critical. However, few documented accounts of the efforts invested in recruitment of multiple different stakeholders to one health services research study exist. Here, we highlight the challenges of recruiting key stakeholders (policy-makers, clinicians, guideline developers to a Canadian Institutes of Health Research (CIHR funded health services research (HSR study aimed to develop an updated and refined version of a guideline appraisal tool, the AGREE. Methods Using evidence-based methods of recruitment, our goal was to recruit 192 individuals: 80 international guideline developers, 80 Canadian clinicians and 32 Canadian policy/decision-makers. We calculated the participation rate and the recruitment efficiency. Results We mailed 873 invitation letters. Of 838 approached, our participation rate was 29%(240 and recruitment efficiency, 19%(156. One policy-maker manager did not allow policy staff to participate in the study. Conclusions Based on the results from this study, we suggest that future studies aiming to engage similar stakeholders in HSR over sample by at least 5 times to achieve their target sample size and allow for participant withdrawals. We need continued efforts to communicate the value of research between researchers and end-users of research (policy-makers, clinicians, and other researchers, integration of participatory research strategies, and promotion of the value of end-user involvement in research. Future research to understand methods of improving recruitment efficiency and engaging key stakeholders in HSR is warranted.

  14. Recruitment of multiple stakeholders to health services research: lessons from the front lines.

    Science.gov (United States)

    Kho, Michelle E; Rawski, Ellen; Makarski, Julie; Brouwers, Melissa C

    2010-05-13

    Self-administered surveys are an essential methodological tool for health services and knowledge translation research, and engaging end-users of the research is critical. However, few documented accounts of the efforts invested in recruitment of multiple different stakeholders to one health services research study exist. Here, we highlight the challenges of recruiting key stakeholders (policy-makers, clinicians, guideline developers) to a Canadian Institutes of Health Research (CIHR) funded health services research (HSR) study aimed to develop an updated and refined version of a guideline appraisal tool, the AGREE. Using evidence-based methods of recruitment, our goal was to recruit 192 individuals: 80 international guideline developers, 80 Canadian clinicians and 32 Canadian policy/decision-makers. We calculated the participation rate and the recruitment efficiency. We mailed 873 invitation letters. Of 838 approached, our participation rate was 29%(240) and recruitment efficiency, 19%(156). One policy-maker manager did not allow policy staff to participate in the study. Based on the results from this study, we suggest that future studies aiming to engage similar stakeholders in HSR over sample by at least 5 times to achieve their target sample size and allow for participant withdrawals. We need continued efforts to communicate the value of research between researchers and end-users of research (policy-makers, clinicians, and other researchers), integration of participatory research strategies, and promotion of the value of end-user involvement in research. Future research to understand methods of improving recruitment efficiency and engaging key stakeholders in HSR is warranted.

  15. Academic health centers on the front lines: survival strategies in highly competitive markets.

    Science.gov (United States)

    Blumenthal, D; Weissman, J S; Griner, P F

    1999-09-01

    The authors describe approaches that five academic health centers (AHCs) have taken to reduce costs, enhance quality, or improve their market positions since the onset of price competition and managed care. The five AHCs, all on the West Coast, were selected for study because they (1) are located in markets that had been highly competitive for the longest time; (2) are committed to all the major missions of AHCs; and (3) own or substantially control their major clinical teaching facilities. The study findings reflect the status of the five AHCs during the fall of 1998. Although some findings may no longer be current (especially in light of ongoing implementation of the Balanced Budget Act of 1997), they still provide insights into the options and opportunities available to many AHCs in highly competitive markets. The authors report on the institutions' financial viability (positive), levels of government support (advantageous), and competition from other AHCs (modest). They outline the study AHCs' survival strategies in three broad areas: increasing revenues via exploiting market niches, reducing costs, and reorganizing to improve internal governance and decision making. They also report how marketplace competition and the strategies the AHCs used to confront it have affected the AHCs' missions. The authors summarize the outstanding lessons that all AHCs can learn from the experiences of the AHCs studied, although adding that AHCs in other parts of the country should use caution in looking to the West Coast AHCs for answers.

  16. Adolescents on the Front Line: Exposure to Shelling Via Television and the Parental Role.

    Science.gov (United States)

    Lavi, Tamar; Itzhaky, Liat; Menachem, Mazal; Solomon, Zahava

    2016-01-01

    Research suggests that exposure to traumatic content via television inadvertently increases posttraumatic stress symptoms (PTSS) as well as psychological distress, especially among adolescent viewers. The aim of the current study was to assess the effect of news consumption on PTSS and general distress among adolescents who live in a war area, as well as to examine the role of parents as intermediaries of news broadcasting. A total of 65 adolescents who live in a war zone filled out the Child Post Traumatic Stress Reaction Index, the Brief Symptoms Inventory, and a scale measuring the level of real-life exposure, news broadcast consumption, and parents as intermediaries of news broadcasting. A main effect for real-life exposure on both PTSS and general distress was revealed. Interestingly, a three-way interaction between real-life exposure, television exposure, and parents as intermediators was found for general distress. Only under low real-life exposure did parents as intermediaries buffer the effect of television exposure on general distress. Parental intermediation of news broadcasting of traumatic events, especially in situations of continuous, real-life exposure, is essential.

  17. Dressing down the front line: How political discussion of teachers affects their political and institutional trust

    DEFF Research Database (Denmark)

    Bech, Emily Cochran

    We know that government performance and the tone of political debate can affect citizens’ trust in state institutions and political leaders, which have long been known to underpin democratic sustainability. But how does political debate about public employees affect their confidence in political...

  18. Mobilization of peripheral blood stem cells in CLL patients after front-line fludarabine treatment.

    Science.gov (United States)

    Lysak, D; Koza, V; Steinerova, K; Jindra, P; Vozobulova, V; Schutzova, M

    2005-07-01

    Autologous peripheral blood stem cell transplantation is performed in an increasing number of chronic lymphocytic leukaemia (CLL) patients who are in the first remission following fludarabine treatment. There are contradictory data about the adverse impact of fludarabine on stem cell harvest. We analysed retrospectively mobilization results in 56 poor-risk CLL patients (median age: 56 years) who underwent first-line treatment with fludarabine and cyclophosphamide. The mobilization, consisting of cyclophosphamide 3 g/m(2) and granulocyte colony-stimulating factor (G-CSF) 10 microg/kg per day, was performed with a median of 77 days following the last fludarabine course. The target yield was >or=2.0x10(6) CD34+ cells/kg. The procedure was successful in 23 (41%) patients. A median of 3.3x10(6) CD34+ cells/kg was collected per patient. The successful mobilization was associated with a longer interval from the last chemotherapy (>2 months). The mobilization result was not influenced by the number of fludarabine cycles. No correlation was found in other parameters such as disease stage at diagnosis, disease status at stimulation or age. The poorly mobilized patients had significantly lower prestimulation blood counts (platelets, WBC and haemoglobin). Our data show that fludarabine does not generally prevent the stem cell mobilization; nevertheless, mechanisms related to the impact of fludarabine on stem cell harvest must be further investigated.

  19. Airpower Leadership on the Front Line: Lt Gen George H. Brett and Combat Command

    Science.gov (United States)

    2006-09-01

    was assigned the additional duty of unit photographer and historian, bequeathing a photo album depicting his adventures to his oldest daughter.10 Lt...his fellow residents with piano music when the men were off duty.21 At the close of the war Brett was a temporary major and listed among officers who

  20. Leaders on the Front Line--Managing Emotion for Ethical Decision Making

    Science.gov (United States)

    Tenuto, Penny L.; Gardiner, Mary E.; Yamamoto, Julie K.

    2016-01-01

    To build capacity for students in educational leadership programs, we developed a teaching case study focused on managing emotion for ethical decision making in supervision of personnel. The case offers troubling encounters between a secondary assistant principal and a novice teacher, a veteran teacher, and a veteran administrator. Scenarios…

  1. Testing a eustress–distress emotion regulation model in British and Spanish front-line employees

    OpenAIRE

    Quinones, C; Rodríguez-Carvajal, R; Griffiths, MD

    2017-01-01

    Studies suggest that suppressing emotions required by occupational roles (i.e., surface acting [SA]) can lead to employees’ emotional exhaustion. In contrast, trying to experience the emotions required by the role (i.e., deep acting [DA]) appears to be a less harmful strategy for the employee. However, problems with 1 of the mainstream measures of DA call for a reexamination of the construct’s operationalization and a clarification of its consequences. Furthermore, an integrated model explain...

  2. Exploring Stigma by Association among Front-Line Care Providers Serving Sex Workers

    OpenAIRE

    Phillips, Rachel; Benoit, Cecilia

    2013-01-01

    Stigma by association, also referred to as “courtesy stigma,” involves public disapproval evoked as a consequence of associating with stigmatized persons. While a small number of sociological studies have shown how stigma by association limits the social support and social opportunities available to family members, there is a paucity of research examining this phenomenon among the large network of persons who provide health and social services to stigmatized groups. This paper presents result...

  3. Exploring stigma by association among front-line care providers serving sex workers.

    Science.gov (United States)

    Phillips, Rachel; Benoit, Cecilia

    2013-10-01

    Stigma by association, also referred to as "courtesy stigma," involves public disapproval evoked as a consequence of associating with stigmatized persons. While a small number of sociological studies have shown how stigma by association limits the social support and social opportunities available to family members, there is a paucity of research examining this phenomenon among the large network of persons who provide health and social services to stigmatized groups. This paper presents results from a primarily qualitative study of the work-place experiences of a purposive sample of staff from an organization providing services to sex workers. The findings suggest that stigma by association has an impact on staff health because it shapes both the workplace environment as well as staff perceptions of others' support. At the same time, it is evident that some staff, owing to their more advantaged social location, are better able to manage courtesy stigma than others. Copyright © 2013 Longwoods Publishing.

  4. Courtesy stigma: a hidden health concern among front-line service providers to sex workers.

    Science.gov (United States)

    Phillips, Rachel; Benoit, Cecilia; Hallgrimsdottir, Helga; Vallance, Kate

    2012-06-01

    Courtesy stigma, also referred to as 'stigma by association', involves public disapproval evoked as a consequence of associating with a stigmatised individual or group. While a small number of sociological studies have shown how courtesy stigma limits the social support and social opportunities available to family members of stigmatised individuals, there is a paucity of research examining courtesy stigma among the large network of people who provide health and social services to stigmatised groups. This article presents results from a mixed methods study of the workplace experiences of a purposive sample of workers in a non-profit organisation providing services to sex workers in Canada. The findings demonstrate that courtesy stigma plays a role in workplace health as it shapes both the workplace environment, including the range of resources made available to staff to carry out their work activities, as well as staff perceptions of others' support. At the same time, it was evident that some workers were more vulnerable to courtesy stigma than others depending on their social location. We discuss these results in light of the existing literature on courtesy stigma and conclude that it is an under-studied determinant of workplace health among care providers serving socially denigrated groups. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  5. [On the front line: survey on shared responsibility. General practitioners and schizophrenia].

    Science.gov (United States)

    Stip, Emmanuel; Boyer, Richard; Sepehry, Amir Ali; Rodriguez, Jean Pierre; Umbricht, Daniel; Tempier, Adrien; Simon, Andor E

    2007-01-01

    General practitioners (GP) play a preponderant role in the treatment of patients suffering of schizophrenia. Discovering the number of patients with schizophrenia who are treated by GPs ; the needs and attitudes of GPs, their knowledge concerning diagnosis, and the treatment they provide. A postal survey was conducted with Quebec GPs who were randomly chosen. A total of 1003 GPs have participated in the survey. Among them, a small percentage have to treat an early onset schizophrenia and the GPs have expressed their wish to be more informed on the accessibility of specialized services. Results pertaining to questions on diagnoses and knowledge on treatments are inconsistent. The majority of GPs treat the first psychotic episodes with antipsychotic medication. Only a third of GPs surveyed propose maintaining the treatment after a first psychotic episode, in accordance with international recommendations and the recent Canadian guidelines on practices that recommends at least 6 to 12 months of treatment after a partial or complete clinical response. Time given by male GPs to a first contact varies between 10 and 20 minutes, while 80 % of female GPs spend at least 20 minutes. The adverse effects of antipsychotic medication that raise most concern is weight gain before neurological signs. some of this survey's data should be considered by various professional and governmental associations, in order to improve the place of GPs in a health plan destined to treat schizophrenia.

  6. An Explorative Note on Tourism Development along Former War Front Lines

    Directory of Open Access Journals (Sweden)

    Myriam Jansen-Verbeke

    2016-11-01

    Full Text Available Current research about the pro-active role of tourism in valorizing war memories and landscapes still is in an explorative stage; learning from case studies, all marked by their political context, in time and space, and mainly describing local and/or regional key issues. Obviously, creating landscapes of memories for contemporary uses and visitors’ experiences implies a trans-disciplinary understanding of the process of changing values (heritage landscapes and of the intrinsic dynamics of tourism development. Shifting values and creativity in linking histories of war sites and their narratives with places and people today, leads to branding ‘sites of memories’ in the mindset of residents and visitors.We briefly scan four very different examples of border areas with a war history, that became landmarks on the tourist’ maps today.  The challenge for tourism development in former war related sites is to identify the dynamics - in time and space - to assess the political and economic forces and to identify shifts in the process of remembrance and valorization of war heritage sites, in terms of interests in war memories, narratives and experiences. These are now strategically integrated in national, regional and local tourism development planning.Historical military front zones, political borders in past wars, presently marked as tourism destinations, are on the research agenda of ‘War and Tourism’.  The observations below on four different former  war border zones with their specific landmarks and memoryscapes, are inspiring for current tourism development. Four different war border zones were briefly  explored “The Great Wall in China” “The Roman Limes”, The “Wire of Death”  in the  First World War  and the ”Iron Curtain” in the Cold War. These observations can inspire future research on tourismification of war heritage.

  7. On the Front Lines of Rare Disease Research | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... a project focused on finding treatments for this lipid storage disease. Additional NCATS programs and initiatives that support rare diseases research include but are not limited to the following: ...

  8. Factors affecting job satisfaction of front-line extension workers in ...

    African Journals Online (AJOL)

    The study examined the factors affecting job satisfaction of field extension workers in Enugu State Agricultural Development Programme. Forty-two extension staff randomly selected across the three agricultural zones were used for the study. The field extension workers indicated low level of satisfaction with their job content, ...

  9. Victims of Domestic Violence and Front-Line Workers: A Helping Paradigm

    Science.gov (United States)

    Peters, Scott W.; Trepal, Heather C.; de Vries, Sabina M.; Day, Sally W.; Leeth, Christopher

    2009-01-01

    Victims of domestic violence present a challenge to law enforcement and emergency room personnel. The authors propose a helping approach to assist these professionals. This paradigm is composed of: active and empathetic listening, acceptance without judgment, identifying victims' strengths, honoring victims as experts, and the process of leaving…

  10. Light at the edge of the universe dispatches from the front lines of cosmology

    CERN Document Server

    Lemonick, Michael D

    2014-01-01

    Will the universe expand forever? Or will it collapse in a Big Crunch within the next few billion years? If the Big Bang theory is correct in presenting the origins of the universe as a smooth fireball, how did the universe come to contain structures as large as the recently discovered ""Great Wall"" of galaxies, which stretches hundreds of millions of light years? Such are the compelling questions that face cosmologists today, and it is the excitement and wonder of their research that Michael Lemonick shares in this lively tour of the current state of astrophysics and cosmology. Here we vis

  11. Health information exchange technology on the front lines of healthcare: workflow factors and patterns of use

    Science.gov (United States)

    Johnson, Kevin B; Lorenzi, Nancy M

    2011-01-01

    Objective The goal of this study was to develop an in-depth understanding of how a health information exchange (HIE) fits into clinical workflow at multiple clinical sites. Materials and Methods The ethnographic qualitative study was conducted over a 9-month period in six emergency departments (ED) and eight ambulatory clinics in Memphis, Tennessee, USA. Data were collected using direct observation, informal interviews during observation, and formal semi-structured interviews. The authors observed for over 180 h, during which providers used the exchange 130 times. Results HIE-related workflow was modeled for each ED site and ambulatory clinic group and substantial site-to-site workflow differences were identified. Common patterns in HIE-related workflow were also identified across all sites, leading to the development of two role-based workflow models: nurse based and physician based. The workflow elements framework was applied to the two role-based patterns. An in-depth description was developed of how providers integrated HIE into existing clinical workflow, including prompts for HIE use. Discussion Workflow differed substantially among sites, but two general role-based HIE usage models were identified. Although providers used HIE to improve continuity of patient care, patient–provider trust played a significant role. Types of information retrieved related to roles, with nurses seeking to retrieve recent hospitalization data and more open-ended usage by nurse practitioners and physicians. User and role-specific customization to accommodate differences in workflow and information needs may increase the adoption and use of HIE. Conclusion Understanding end users' perspectives towards HIE technology is crucial to the long-term success of HIE. By applying qualitative methods, an in-depth understanding of HIE usage was developed. PMID:22003156

  12. How front-line healthcare workers respond to stock-outs of essential ...

    African Journals Online (AJOL)

    care.[14-19]. While the National Department of Health is committed to ... 1 AIDS and Society Research Unit, Centre for Social Science Research, University of Cape Town, ... clinic manager laughed when asked if her facility had a pharmacist.

  13. News from the front lines of nuclear law; Aus der Werkstatt des Nuklearrechts

    Energy Technology Data Exchange (ETDEWEB)

    Raetzke, Christian; Feldmann, Ulrike; Frank, Akos (eds.)

    2016-07-01

    This volume contains the proceedings of the 14th Regional Conference of the German Branch of the International Nuclear Law Association (INLA) held in Nuremberg in September 2015. In five chapters, German and international experts, with contributions partly in German but predominantly in English, explain the most recent developments in nuclear law in Germany, in other countries and on the international level. The topics include: turnkey contracts in the nuclear industry; claims under EU environmental law and under ICSID arbitration; developments in legal requirements for final disposal of nuclear waste in various countries such as Germany and the US; topics of nuclear liability, such as the situation in India; and finally nuclear safety and regulation. For anyone who wants to keep up-to-date on important developments of nuclear law, this volume is an obvious choice.

  14. DoD CPB-ECMO Initiative - A Suspended Animation Front Lines Casualty Management System

    National Research Council Canada - National Science Library

    Casas, Fernando; Reeves, Andrew; Dudzinski, David; Weber, Stephen; Lorenz, Markus; Sinkewich, Martin; Foster, Robert; Smith, William A

    2004-01-01

    Cardiopulmonary bypass (CPB), the shunting of blood around the heart and lungs, is a well-established technique that permits difficult surgical procedures on the heart and its adjacent main blood vessels...

  15. Case Managers on the Front Lines of Ethical Dilemmas: Advocacy, Autonomy, and Preventing Case Manager Burnout.

    Science.gov (United States)

    Sortedahl, Charlotte; Mottern, Nina; Campagna, Vivian

    The purpose of this article is to examine how case managers are routinely confronted by ethical dilemmas within a fragmented health care system and given the reality of financial pressures that influence life-changing decisions. The Code of Professional Conduct for Case Managers (Code), published by the Commission for Case Manager Certification, acknowledges "case managers may often confront ethical dilemmas" (Code 1996, Rev. 2015). The Code and expectations that professional case managers, particularly those who are board certified, will uphold ethical and legal practice apply to case managers in every practice setting across the full continuum of health care. This discussion acknowledges the ethical dilemmas that case managers routinely confront, which empowers them to seek support, guidance, and resources to support ethical practice. In addition, the article seeks to raise awareness of the effects of burnout and moral distress on case managers and others with whom they work closely on interdisciplinary teams.

  16. Teacher Responses to Bullying: Self-Reports from the Front Line

    Science.gov (United States)

    Marshall, Megan L.; Varjas, Kris; Meyers, Joel; Graybill, Emily C.; Skoczylas, Rebecca B.

    2009-01-01

    School climate research emphasizes the critical role teachers play in providing safe and supportive environments for students to learn. Despite numerous negative physical and mental health consequences related to bullying in schools, research investigating teachers' responses to reduce bullying is scarce. Individual in-depth interviews were…

  17. Reporting From the Front Lines: Implementing Oregon's Alternative Payment Methodology in Federally Qualified Health Centers.

    Science.gov (United States)

    Cottrell, Erika K; Hall, Jennifer D; Kautz, Glenn; Angier, Heather; Likumahuwa-Ackman, Sonja; Sisulak, Laura; Keller, Sara; Cameron, David C; DeVoe, Jennifer E; Cohen, Deborah J

    Alternative payment models have been proposed as a way to facilitate patient-centered medical home model implementation, yet little is known about how payment reform translates into changes in care delivery. We conducted site visits, observed operations, and conducted interviews within 3 Federally Qualified Health Center organizations that were part of Oregon's Alternative Payment Methodology demonstration project. Data were analyzed using an immersion-crystallization approach. We identified several care delivery changes during the early stages of implementation, as well as challenges associated with this new model of payment. Future research is needed to further understand the implications of these changes.

  18. The effect of providing resuscitation training to front- line staff on ...

    African Journals Online (AJOL)

    assistants (three years training) or clinical officers (four years training). ... run sixteen times since 2005 and a total of 391 health care workers have ... lecture topics are described in Table 3, and the small group discussion topics ... There were also some specific .... were presented by way of case studies in the case of each.

  19. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... using relative intensity, people pay attention to how physical activity affects their heart rate and breathing. The talk test is a simple way to measure relative intensity. ...

  20. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... Older Adults Overcoming Barriers Measuring Physical Activity Intensity Target Heart Rate & Estimated Maximum Heart Rate Perceived Exertion ( ... a heavy backpack Other Methods of Measuring Intensity Target Heart Rate and Estimated Maximum Heart Rate Perceived ...

  1. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... Share Compartir For more help with what counts as aerobic activity, watch this video: Windows Media Player, ... The table below lists examples of activities classified as moderate-intensity or vigorous-intensity based upon the ...

  2. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... for a breath. Absolute Intensity The amount of energy used by the body per minute of activity. ... or vigorous-intensity based upon the amount of energy used by the body while doing the activity. ...

  3. Iowa Intensive Archaeological Survey

    Data.gov (United States)

    Iowa State University GIS Support and Research Facility — This shape file contains intensive level archaeological survey areas for the state of Iowa. All intensive Phase I surveys that are submitted to the State Historic...

  4. Rainfed intensive crop systems

    DEFF Research Database (Denmark)

    Olesen, Jørgen E

    2014-01-01

    This chapter focuses on the importance of intensive cropping systems in contributing to the world supply of food and feed. The impact of climate change on intensive crop production systems is also discussed.......This chapter focuses on the importance of intensive cropping systems in contributing to the world supply of food and feed. The impact of climate change on intensive crop production systems is also discussed....

  5. Stochastic conditional intensity processes

    DEFF Research Database (Denmark)

    Bauwens, Luc; Hautsch, Nikolaus

    2006-01-01

    model allows for a wide range of (cross-)autocorrelation structures in multivariate point processes. The model is estimated by simulated maximum likelihood (SML) using the efficient importance sampling (EIS) technique. By modeling price intensities based on NYSE trading, we provide significant evidence......In this article, we introduce the so-called stochastic conditional intensity (SCI) model by extending Russell’s (1999) autoregressive conditional intensity (ACI) model by a latent common dynamic factor that jointly drives the individual intensity components. We show by simulations that the proposed...... for a joint latent factor and show that its inclusion allows for an improved and more parsimonious specification of the multivariate intensity process...

  6. [Mantle cell lymphoma: Towards a personalized therapeutic strategy?].

    Science.gov (United States)

    Navarro Matilla, Belén; García-Marco, José A

    2015-06-22

    Mantle cell lymphoma (MCL) is a clinically heterogeneous non-Hodgkin lymphoma with an aggressive clinical behaviour and short survival in some cases and an indolent course in others. Advances in the biology and pathogenesis of MCL have unveiled several genes involved in deregulation of cell cycle checkpoints and the finding of subclonal populations with specific recurrent mutations (p53, ATM, NOTCH2) with an impact on disease progression and refractoriness to treatment. Prognostic stratification helps to distinguish between indolent and aggressive forms of MCL. Currently, younger fit patients benefit from more intensive front line chemotherapy regimens and consolidation with autologous transplantation, while older or frail patients are treated with less intensive regimens and rituximab maintenance. For relapsing disease, the introduction of bortezomib and lenalidomide containing regimens and B-cell receptor pathway inhibitors such as ibrutinib and idelalisib in combination with immunochemotherapy have emerged as therapeutic agents with promising clinical outcomes. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  7. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... Healthy Weight Breastfeeding Micronutrient Malnutrition State and Local Programs Measuring Physical Activity Intensity Recommend on Facebook Tweet Share Compartir For more help with what ...

  8. AGS intensity upgrades

    International Nuclear Information System (INIS)

    Roser, T.

    1995-01-01

    After the successful completion of the AGS Booster and several upgrades of the AGS, a new intensity record of 6.3 x 10 13 protons per pulse accelerated to 24 GeV was achieved. The high intensity slow-extracted beam program at the AGS typically serves about five production targets and about eight experiments including three rare Kaon decay experiments. Further intensity upgrades are being discussed that could increase the average delivered beam intensity by up to a factor of four

  9. PTK2 expression and immunochemotherapy outcome in chronic lymphocytic leukemia

    DEFF Research Database (Denmark)

    Weisser, Martin; Yeh, Ru-Fang; Duchateau-Nguyen, Guillemette

    2014-01-01

    with improved outcomes for CLL patients treated with R-FC vs FC. PTK2 expression may be a useful biomarker for patient selection in future trials. These trials were registered at www.clinicaltrials.gov as #NCT00090051 (REACH) and #NCT00281918 (CLL8)....... assessed genome-wide expression of 300 pretreatment specimens from a subset of 552 patients in REACH, a study of FC or R-FC in relapsed CLL. An independent test set was derived from 282 pretreatment specimens from CLL8, a study of FC or R-FC in treatment-naïve patients. Genes specific for benefit from R-FC...... were determined by assessing treatment-gene interactions in Cox proportional hazards models. REACH patients with higher pretreatment protein tyrosine kinase 2 (PTK2) messenger RNA levels derived greater benefit from R-FC, with significant improvements in progression-free survival, independent of known...

  10. Metabonomics and Intensive Care

    OpenAIRE

    Antcliffe, D; Gordon, AC

    2016-01-01

    This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency medicine 2016. Other selected articles can be found online at http://www.biomedcentral.com/collections/annualupdate2016. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901.

  11. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... miles per hour Tennis (doubles) Ballroom dancing General gardening Vigorous Intensity Race walking, jogging, or running Swimming ... miles per hour or faster Jumping rope Heavy gardening (continuous digging or hoeing) Hiking uphill or with ...

  12. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... The amount of energy used by the body per minute of activity. The table below lists examples ... of Page Moderate Intensity Walking briskly (3 miles per hour or faster, but not race-walking) Water ...

  13. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... For this reason, some items on this page will be unavailable. For more information about this message, ... If you're doing vigorous-intensity activity, you will not be able to say more than a ...

  14. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... level of effort required by a person to do an activity. When using relative intensity, people pay ... State and Local Programs File Formats Help: How do I view different file formats (PDF, DOC, PPT, ...

  15. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... an activity. When using relative intensity, people pay attention to how physical activity affects their heart rate ... Physical Activity Overweight & Obesity Healthy Weight Breastfeeding Micronutrient Malnutrition State and Local Programs File Formats Help: How ...

  16. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... Local Programs Measuring Physical Activity Intensity Recommend on Facebook Tweet Share Compartir For more help with what ... RSS ABOUT About CDC Jobs Funding LEGAL Policies Privacy FOIA No Fear Act OIG 1600 Clifton Road ...

  17. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... Intensity The amount of energy used by the body per minute of activity. The table below lists ... upon the amount of energy used by the body while doing the activity. Top of Page Moderate ...

  18. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... to Your Life Activities for Children Activities for Older Adults Overcoming Barriers ... required by a person to do an activity. When using relative intensity, people pay attention to how physical activity affects their ...

  19. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... Adults Need More Physical Activity MMWR Data Highlights State Indicator Report on Physical Activity, 2014 Recommendations & Guidelines ... Activity Overweight & Obesity Healthy Weight Breastfeeding Micronutrient Malnutrition State and Local Programs Measuring Physical Activity Intensity Recommend ...

  20. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... 10 miles per hour or faster Jumping rope Heavy gardening (continuous digging or hoeing) Hiking uphill or with a heavy backpack Other Methods of Measuring Intensity Target Heart ...

  1. Measuring Physical Activity Intensity

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    Full Text Available ... Adults Needs for Children What Counts Needs for Older Adults Needs for Pregnant or Postpartum Women Physical Activity & ... to Your Life Activities for Children Activities for Older Adults Overcoming Barriers Measuring Physical Activity Intensity Target Heart ...

  2. Measuring Physical Activity Intensity

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    Full Text Available ... Hiking uphill or with a heavy backpack Other Methods of Measuring Intensity Target Heart Rate and Estimated ... Help: How do I view different file formats (PDF, DOC, PPT, MPEG) on this site? Adobe PDF ...

  3. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... Hiking uphill or with a heavy backpack Other Methods of Measuring Intensity Target Heart Rate and Estimated ... YouTube Instagram Listen Watch RSS ABOUT About CDC Jobs Funding LEGAL Policies Privacy FOIA No Fear Act ...

  4. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... Measuring Intensity Target Heart Rate and Estimated Maximum Heart Rate Perceived Exertion (Borg Rating of Perceived Exertion Scale) Get Email Updates To receive email updates about this page, enter your email ... ...

  5. Measuring Physical Activity Intensity

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    Full Text Available ... be able to say more than a few words without pausing for a breath. Absolute Intensity The ... site? Adobe PDF file Microsoft PowerPoint file Microsoft Word file Microsoft Excel file Audio/Video file Apple ...

  6. [Intensive medicine in Spain].

    Science.gov (United States)

    2011-03-01

    Intensive care medicine is a medical specialty that was officially established in our country in 1978, with a 5-year training program including two years of common core training followed by three years of specific training in an intensive care unit accredited for training. During this 32-year period, intensive care medicine has carried out an intense and varied activity, which has allowed its positioning as an attractive and with future specialty in the hospital setting. This document summarizes the history of the specialty, its current situation, the key role played in the programs of organ donation and transplantation of the National Transplant Organization (after more than 20 years of mutual collaboration), its training activities with the development of the National Plan of Cardiopulmonary Resuscitation, with a trajectory of more than 25 years, its interest in providing care based on quality and safety programs for the severely ill patient. It also describes the development of reference registries due to the need for reliable data on the care process for the most prevalent diseases, such as ischemic heart disease or ICU-acquired infections, based on long-term experience (more than 15 years), which results in the availability of epidemiological information and characteristics of care that may affect the practical patient's care. Moreover, features of its scientific society (SEMICYUC) are reported, an organization that agglutinates the interests of more than 280 ICUs and more than 2700 intensivists, with reference to the journal Medicina Intensiva, the official journal of the society and the Panamerican and Iberian Federation of Critical Medicine and Intensive Care Societies. Medicina Intensiva is indexed in the Thompson Reuters products of Science Citation Index Expanded (Scisearch(®)) and Journal Citation Reports, Science Edition. The important contribution of the Spanish intensive care medicine to the scientific community is also analyzed, and in relation to

  7. Data-intensive science

    CERN Document Server

    Critchlow, Terence

    2013-01-01

    Data-intensive science has the potential to transform scientific research and quickly translate scientific progress into complete solutions, policies, and economic success. But this collaborative science is still lacking the effective access and exchange of knowledge among scientists, researchers, and policy makers across a range of disciplines. Bringing together leaders from multiple scientific disciplines, Data-Intensive Science shows how a comprehensive integration of various techniques and technological advances can effectively harness the vast amount of data being generated and significan

  8. Towards higher intensities

    CERN Multimedia

    CERN Bulletin

    2010-01-01

    Over the past 2 weeks, commissioning of the machine protection system has advanced significantly, opening up the possibility of higher intensity collisions at 3.5 TeV. The intensity has been increased from 2 bunches of 1010 protons to 6 bunches of 2x1010 protons. Luminosities of 6x1028 cm-2s-1 have been achieved at the start of fills, a factor of 60 higher than those provided for the first collisions on 30 March.   The recent increase in LHC luminosity as recorded by the experiments. (Graph courtesy of the experiments and M. Ferro-Luzzi) To increase the luminosity further, the commissioning crews are now trying to push up the intensity of the individual proton bunches. After the successful injection of nominal intensity bunches containing 1.1x1011 protons, collisions were subsequently achieved at 450 GeV with these intensities. However, half-way through the first ramping of these nominal intensity bunches to 3.5 TeV on 15 May, a beam instability was observed, leading to partial beam loss...

  9. Intensity Conserving Spectral Fitting

    Science.gov (United States)

    Klimchuk, J. A.; Patsourakos, S.; Tripathi, D.

    2015-01-01

    The detailed shapes of spectral line profiles provide valuable information about the emitting plasma, especially when the plasma contains an unresolved mixture of velocities, temperatures, and densities. As a result of finite spectral resolution, the intensity measured by a spectrometer is the average intensity across a wavelength bin of non-zero size. It is assigned to the wavelength position at the center of the bin. However, the actual intensity at that discrete position will be different if the profile is curved, as it invariably is. Standard fitting routines (spline, Gaussian, etc.) do not account for this difference, and this can result in significant errors when making sensitive measurements. Detection of asymmetries in solar coronal emission lines is one example. Removal of line blends is another. We have developed an iterative procedure that corrects for this effect. It can be used with any fitting function, but we employ a cubic spline in a new analysis routine called Intensity Conserving Spline Interpolation (ICSI). As the name implies, it conserves the observed intensity within each wavelength bin, which ordinary fits do not. Given the rapid convergence, speed of computation, and ease of use, we suggest that ICSI be made a standard component of the processing pipeline for spectroscopic data.

  10. The intense neutron generator

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, W B

    1966-07-01

    The presentation discusses both the economic and research contexts that would be served by producing neutrons in gram quantities at high intensities by electrical means without uranium-235. The revenue from producing radioisotopes is attractive. The array of techniques introduced by the multipurpose 65 megawatt Intense Neutron Generator project includes liquid metal cooling, superconducting magnets for beam bending and focussing, super-conductors for low-loss high-power radiofrequency systems, efficient devices for producing radiofrequency power, plasma physics developments for producing and accelerating hydrogen, ions at high intensity that are still far out from established practice, a multimegawatt high voltage D.C. generating machine that could have several applications. The research fields served relate principally to materials science through neutron-phonon and other quantum interactions as well as through neutron diffraction. Nuclear physics is served through {mu}-, {pi}- and K-meson production. Isotope production enters many fields of applied research. (author)

  11. The intense neutron generator

    International Nuclear Information System (INIS)

    Lewis, W.B.

    1966-01-01

    The presentation discusses both the economic and research contexts that would be served by producing neutrons in gram quantities at high intensities by electrical means without uranium-235. The revenue from producing radioisotopes is attractive. The array of techniques introduced by the multipurpose 65 megawatt Intense Neutron Generator project includes liquid metal cooling, superconducting magnets for beam bending and focussing, super-conductors for low-loss high-power radiofrequency systems, efficient devices for producing radiofrequency power, plasma physics developments for producing and accelerating hydrogen, ions at high intensity that are still far out from established practice, a multimegawatt high voltage D.C. generating machine that could have several applications. The research fields served relate principally to materials science through neutron-phonon and other quantum interactions as well as through neutron diffraction. Nuclear physics is served through μ-, π- and K-meson production. Isotope production enters many fields of applied research. (author)

  12. Strongly intensive quantities

    International Nuclear Information System (INIS)

    Gorenstein, M. I.; Gazdzicki, M.

    2011-01-01

    Analysis of fluctuations of hadron production properties in collisions of relativistic particles profits from use of measurable intensive quantities which are independent of system size variations. The first family of such quantities was proposed in 1992; another is introduced in this paper. Furthermore we present a proof of independence of volume fluctuations for quantities from both families within the framework of the grand canonical ensemble. These quantities are referred to as strongly intensive ones. Influence of conservation laws and resonance decays is also discussed.

  13. High intensity hadron accelerators

    International Nuclear Information System (INIS)

    Teng, L.C.

    1989-05-01

    This rapporteur report consists mainly of two parts. Part I is an abridged review of the status of all High Intensity Hadron Accelerator projects in the world in semi-tabulated form for quick reference and comparison. Part II is a brief discussion of the salient features of the different technologies involved. The discussion is based mainly on my personal experiences and opinions, tempered, I hope, by the discussions I participated in in the various parallel sessions of the workshop. In addition, appended at the end is my evaluation and expression of the merits of high intensity hadron accelerators as research facilities for nuclear and particle physics

  14. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... Updates To receive email updates about this page, enter your email address: Enter Email Address What's this? Submit What's this? Submit ... Intensity Walking briskly (3 miles per hour or faster, but not race-walking) Water aerobics Bicycling slower ...

  15. AGS intensity record

    International Nuclear Information System (INIS)

    Bleser, Ed

    1994-01-01

    As flashed in the September issue, this summer the Brookhaven Alternating Gradient Synchrotron (AGS) reached a proton beam intensity of 4.05 x 10 13 protons per puise, claimed as the highest intensity ever achieved in a proton synchrotron. It is, however, only two-thirds of the way to its final goal of 6 x 10 13 . The achievement is the resuit of many years of effort. The Report of the AGS II Task Force, issued in February 1984, laid out a comprehensive programme largely based on a careful analysis of the PS experience at CERN. The AGS plan had two essential components: the construction of a new booster, and major upgrades to the AGS itself.

  16. Intensities of Mobility

    DEFF Research Database (Denmark)

    Bissell, David; Vannini, Phillip; Jensen, Ole B.

    2017-01-01

    This paper explores the intensities of long-distance commuting journeys in order to understand how bodily sensibilities become attuned to the regular mobilities which they undertake. More people are travelling farther to and from work than ever before, owing to a variety of factors which relate...... to complex social and geographical dynamics of transport, housing, lifestyle, and employment. Yet, the experiential dimensions of long-distance commuting have not received the attention that they deserve within research on mobilities. Drawing from fieldwork conducted in Australia, Canada, and Denmark...... this paper aims to further develop our collective understanding of the experiential particulars of long-distance workers or ‘supercommuters’. Rather than focusing on the extensive dimensions of mobilities that are implicated in broad social patterns and trends, our paper turns to the intensive dimensions...

  17. Intensive culture”

    DEFF Research Database (Denmark)

    Michelsen, Anders Ib

    2012-01-01

    Scott Lash argumenterer i bogen Intensive Culture for en vending fra ”ekstensiv” til ”intensiv” i den nutidige globalisering. Bogens udgangspunkt er en stadig mere ekstensiv og gennemtrængende globalisering af kultur, forbrugs- og vareformer, ”comtemporary culture, today’s capitalism – our global......, samlivsmøstre etc.; ”the sheer pace of life in the streets of today’s mega-city would seem somehow to be intensive”....

  18. Intense ion beam generator

    International Nuclear Information System (INIS)

    Humphries, S. Jr.; Sudan, R.N.

    1977-01-01

    Methods and apparatus for producing intense megavolt ion beams are disclosed. In one embodiment, a reflex triode-type pulsed ion accelerator is described which produces ion pulses of more than 5 kiloamperes current with a peak energy of 3 MeV. In other embodiments, the device is constructed so as to focus the beam of ions for high concentration and ease of extraction, and magnetic insulation is provided to increase the efficiency of operation

  19. Intense fusion neutron sources

    International Nuclear Information System (INIS)

    Kuteev, B. V.; Goncharov, P. R.; Sergeev, V. Yu.; Khripunov, V. I.

    2010-01-01

    The review describes physical principles underlying efficient production of free neutrons, up-to-date possibilities and prospects of creating fission and fusion neutron sources with intensities of 10 15 -10 21 neutrons/s, and schemes of production and application of neutrons in fusion-fission hybrid systems. The physical processes and parameters of high-temperature plasmas are considered at which optimal conditions for producing the largest number of fusion neutrons in systems with magnetic and inertial plasma confinement are achieved. The proposed plasma methods for neutron production are compared with other methods based on fusion reactions in nonplasma media, fission reactions, spallation, and muon catalysis. At present, intense neutron fluxes are mainly used in nanotechnology, biotechnology, material science, and military and fundamental research. In the near future (10-20 years), it will be possible to apply high-power neutron sources in fusion-fission hybrid systems for producing hydrogen, electric power, and technological heat, as well as for manufacturing synthetic nuclear fuel and closing the nuclear fuel cycle. Neutron sources with intensities approaching 10 20 neutrons/s may radically change the structure of power industry and considerably influence the fundamental and applied science and innovation technologies. Along with utilizing the energy produced in fusion reactions, the achievement of such high neutron intensities may stimulate wide application of subcritical fast nuclear reactors controlled by neutron sources. Superpower neutron sources will allow one to solve many problems of neutron diagnostics, monitor nano-and biological objects, and carry out radiation testing and modification of volumetric properties of materials at the industrial level. Such sources will considerably (up to 100 times) improve the accuracy of neutron physics experiments and will provide a better understanding of the structure of matter, including that of the neutron itself.

  20. Intense fusion neutron sources

    Science.gov (United States)

    Kuteev, B. V.; Goncharov, P. R.; Sergeev, V. Yu.; Khripunov, V. I.

    2010-04-01

    The review describes physical principles underlying efficient production of free neutrons, up-to-date possibilities and prospects of creating fission and fusion neutron sources with intensities of 1015-1021 neutrons/s, and schemes of production and application of neutrons in fusion-fission hybrid systems. The physical processes and parameters of high-temperature plasmas are considered at which optimal conditions for producing the largest number of fusion neutrons in systems with magnetic and inertial plasma confinement are achieved. The proposed plasma methods for neutron production are compared with other methods based on fusion reactions in nonplasma media, fission reactions, spallation, and muon catalysis. At present, intense neutron fluxes are mainly used in nanotechnology, biotechnology, material science, and military and fundamental research. In the near future (10-20 years), it will be possible to apply high-power neutron sources in fusion-fission hybrid systems for producing hydrogen, electric power, and technological heat, as well as for manufacturing synthetic nuclear fuel and closing the nuclear fuel cycle. Neutron sources with intensities approaching 1020 neutrons/s may radically change the structure of power industry and considerably influence the fundamental and applied science and innovation technologies. Along with utilizing the energy produced in fusion reactions, the achievement of such high neutron intensities may stimulate wide application of subcritical fast nuclear reactors controlled by neutron sources. Superpower neutron sources will allow one to solve many problems of neutron diagnostics, monitor nano-and biological objects, and carry out radiation testing and modification of volumetric properties of materials at the industrial level. Such sources will considerably (up to 100 times) improve the accuracy of neutron physics experiments and will provide a better understanding of the structure of matter, including that of the neutron itself.

  1. Orchestrating intensities and rhythms

    DEFF Research Database (Denmark)

    Staunæs, Dorthe; Juelskjær, Malou

    2016-01-01

    environmentality and learning-centered governance standards has dramatic and performative effects for the production of (educational) subjectivities. This implies a shift from governing identities, categories and structures towards orchestrating affective intensities and rhythms. Finally, the article discusses...... and the making of subjects have held sway for many years; and it is also well known that schools have been some of the most regular purchasers of psychological methods, tests and classifications. Following but also elaborating upon governmentality studies, it is suggested that a current shift towards...

  2. French intensive truck garden

    Energy Technology Data Exchange (ETDEWEB)

    Edwards, T D

    1983-01-01

    The French Intensive approach to truck gardening has the potential to provide substantially higher yields and lower per acre costs than do conventional farming techniques. It was the intent of this grant to show that there is the potential to accomplish the gains that the French Intensive method has to offer. It is obvious that locally grown food can greatly reduce transportation energy costs but when there is the consideration of higher efficiencies there will also be energy cost reductions due to lower fertilizer and pesticide useage. As with any farming technique, there is a substantial time interval for complete soil recovery after there have been made substantial soil modifications. There were major crop improvements even though there was such a short time since the soil had been greatly disturbed. It was also the intent of this grant to accomplish two other major objectives: first, the garden was managed under organic techniques which meant that there were no chemical fertilizers or synthetic pesticides to be used. Second, the garden was constructed so that a handicapped person in a wheelchair could manage and have a higher degree of self sufficiency with the garden. As an overall result, I would say that the garden has taken the first step of success and each year should become better.

  3. Case management for high-intensity service users: towards a relational approach to care co-ordination.

    Science.gov (United States)

    McEvoy, Phil; Escott, Diane; Bee, Penny

    2011-01-01

    This study is based on a formative evaluation of a case management service for high-intensity service users in Northern England. The evaluation had three main purposes: (i) to assess the quality of the organisational infrastructure; (ii) to obtain a better understanding of the key influences that played a role in shaping the development of the service; and (iii) to identify potential changes in practice that may help to improve the quality of service provision. The evaluation was informed by Gittell's relational co-ordination theory, which focuses upon cross-boundary working practices that facilitate task integration. The Assessment of Chronic Illness Care Survey was used to assess the organisational infrastructure and qualitative interviews with front line staff were conducted to explore the key influences that shaped the development of the service. A high level of strategic commitment and political support for integrated working was identified. However, the quality of care co-ordination was variable. The most prominent operational factor that appeared to influence the scope and quality of care co-ordination was the pattern of interaction between the case managers and their co-workers. The co-ordination of patient care was much more effective in integrated co-ordination networks. Key features included clearly defined, task focussed, relational workspaces with interactive forums where case managers could engage with co-workers in discussions about the management of interdependent care activities. In dispersed co-ordination networks with fewer relational workspaces, the case managers struggled to work as effectively. The evaluation concluded that the creation of flexible and efficient task focused relational workspaces that are systemically managed and adequately resourced could help to improve the quality of care co-ordination, particularly in dispersed networks. © 2010 Blackwell Publishing Ltd.

  4. Building capacity and capabilty at the front line of care – North Zealand Hospital’s Leadership Program

    DEFF Research Database (Denmark)

    von Plessen, Christian; Ulriksen, Inge; Nielsen, Lisbeth

    24.Ulriksen I, Nielsen L, Plessen von C, . International Forum on Quality and Safety in Health Care, London April 2015......24.Ulriksen I, Nielsen L, Plessen von C, . International Forum on Quality and Safety in Health Care, London April 2015...

  5. School Nurses on the Front Lines of Medicine: Take a BREATH: The Approach to a Student With Respiratory Distress.

    Science.gov (United States)

    Loaec, Morgann; Olympia, Robert P

    2018-01-01

    Students presenting with varying degrees of respiratory symptoms and distress occur commonly in the school setting. It is important to develop a differential diagnosis for respiratory distress, to initiate stabilization of the student with life-threatening symptoms, and to triage these students to an appropriate level of care (back to the classroom, home with their guardian with follow up at their primary health care provider's office, or directly to the closest emergency department via Emergency Medical Services). This article describes the initial assessment and management of a student presenting with respiratory distress.

  6. On the front line of HIV virological monitoring: barriers and facilitators from a provider perspective in resource-limited settings.

    Science.gov (United States)

    Rutstein, S E; Golin, C E; Wheeler, S B; Kamwendo, D; Hosseinipour, M C; Weinberger, M; Miller, W C; Biddle, A K; Soko, A; Mkandawire, M; Mwenda, R; Sarr, A; Gupta, S; Mataya, R

    2016-01-01

    Scale-up of viral load (VL) monitoring for HIV-infected patients on antiretroviral therapy (ART) is a priority in many resource-limited settings, and ART providers are critical to effective program implementation. We explored provider-perceived barriers and facilitators of VL monitoring. We interviewed all providers (n = 17) engaged in a public health evaluation of dried blood spots for VL monitoring at five ART clinics in Malawi. All ART clinics were housed within district hospitals. We grouped themes at patient, provider, facility, system, and policy levels. Providers emphasized their desire for improved ART monitoring strategies, and frustration in response to restrictive policies for determining which patients were eligible to receive VL monitoring. Although many providers pled for expansion of monitoring to include all persons on ART, regardless of time on ART, the most salient provider-perceived barrier to VL monitoring implementation was the pressure of work associated with monitoring activities. The work burden was exacerbated by inefficient data management systems, highlighting a critical interaction between provider-, facility-, and system-level factors. Lack of integration between laboratory and clinical systems complicated the process for alerting providers when results were available, and these communication gaps were intensified by poor facility connectivity. Centralized second-line ART distribution was also noted as a barrier: providers reported that the time and expenses required for patients to collect second-line ART frequently obstructed referral. However, provider empowerment emerged as an unexpected facilitator of VL monitoring. For many providers, this was the first time they used an objective marker of ART response to guide clinical management. Providers' knowledge of a patient's virological status increased confidence in adherence counseling and clinical decision-making. Results from our study provide unique insight into provider perceptions of VL monitoring and indicate the importance of policies responsive to individual and environmental challenges of VL monitoring program implementation. Findings may inform scale-up by helping policy-makers identify strategies to improve feasibility and sustainability of VL monitoring.

  7. Developing the public health role of a front line clinical service: integrating stop smoking advice into routine podiatry services.

    Science.gov (United States)

    Gray, Jackie; Eden, Gary; Williams, Maria

    2007-06-01

    Although smoking is a major public health problem, many clinicians do not routinely provide evidence-based health improvement advice to smokers to help them to quit. Plan, Do, Study, Act (PDSA) cycle methodology was used to design and implement a service development so that health improvement advice for smokers featured in all podiatry consultations provided by a Primary Care Trust in North East England. IT systems were developed to record the number and proportion of patients for whom smoking status was assessed, and the number and proportion of smokers who were given advice to quit and referred for specialist support. A questionnaire to staff explored their perceptions of the development on their clinics and consultations. During a 6-month period, smoking status was recorded for all 8831 (100%) patients attending podiatry clinics; 83% of smokers were given brief advice to quit; 7% of smokers were given help to access specialist stop smoking support services. Improvements were introduced within existing budgets and did not prolong clinics. It is straightforward and inexpensive to develop clinical services so that public health guidance is routinely implemented. More widespread implementation of similar service developments could lead to national improvements in public health.

  8. On the front line of primary health care: the profile of community health workers in rural Quechua communities in Peru.

    Science.gov (United States)

    Brown, Angela; Malca, Rosa; Zumaran, Adriana; Miranda, J Jaime

    2006-05-17

    To describe the profile of community health workers--health promoters, traditional birth attendants and traditional healers--in rural Quechua communities from Ayacucho, Peru. Basic quantitative and qualitative information was gathered as part of a community health project implemented between 1997 and 2002 in 40 Andean communities with information from questionnaires, personal interviews and group discussions. The majority of current community health workers are men with limited education who are primarily Quechua speakers undertaking their work on a voluntary basis. Health promoters are mostly young, male, high school graduates. There exists a high drop-out rate among these workers. In contrast, traditional healers and traditional birth attendants possess an almost diametrically opposite profile in terms of age, education and drop-out rates, though males still predominate. At the community level the health promoters are the most visible community health workers. It is very important to consider and to be aware of the profile of community health workers in order to provide appropriate alternatives when working with these groups as well as with the indigenous population, particularly in terms of culture, language and gender issues.

  9. On the front line of primary health care: the profile of community health workers in rural Quechua communities in Peru

    Directory of Open Access Journals (Sweden)

    Zumaran Adriana

    2006-05-01

    Full Text Available Abstract Objective To describe the profile of community health workers – health promoters, traditional birth attendants and traditional healers – in rural Quechua communities from Ayacucho, Peru. Methods Basic quantitative and qualitative information was gathered as part of a community health project implemented between 1997 and 2002 in 40 Andean communities with information from questionnaires, personal interviews and group discussions. Results The majority of current community health workers are men with limited education who are primarily Quechua speakers undertaking their work on a voluntary basis. Health promoters are mostly young, male, high school graduates. There exists a high drop-out rate among these workers. In contrast, traditional healers and traditional birth attendants possess an almost diametrically opposite profile in terms of age, education and drop-out rates, though males still predominate. At the community level the health promoters are the most visible community health workers. Conclusion It is very important to consider and to be aware of the profile of community health workers in order to provide appropriate alternatives when working with these groups as well as with the indigenous population, particularly in terms of culture, language and gender issues.

  10. On the Front Lines of Schools: Perspectives of Teachers and Principals on the High School Dropout Problem

    Science.gov (United States)

    Bridgeland, John M.; Dilulio, John J., Jr.; Balfanz, Robert

    2009-01-01

    Teachers and administrators in public high schools recognize there is a dropout problem, know they are confronted with daunting challenges in classrooms and in schools, and express strong support for reforms to address high dropout rates. Yet, less than one-third of teachers believe that schools should expect all students to meet high academic…

  11. Nuclear physics research front line by K computer. Elucidation of inter-hadron interactions by lattice QCD simulation

    International Nuclear Information System (INIS)

    Doi, Takumi

    2013-01-01

    Research of nuclear forces by lattice QCD including inter-hadron interactions is presented. Determination of nuclear forces based on the first principle of QCD means to give underpinning of nuclear physics from the elementary particle standard model. Determining the unknown interactions such as hyperon forces or three-body ones gives large impacts not only to the nuclear physics but also to the universe or astrophysics. In this paper, the most up-to-date achievements as well as the scientific visions of future by using K computer is introduced. The nuclear potential is shown to be determined by the first principle simulation based on the purely fundamental theory without using any input from experiments. When this research is completed, nuclear physics is consolidated in the frame of standard model of elementary particles. The formulation of nuclear potentials was though very problematic but solved by using HAL method. The way to use Nambu-Bethe-Salpeter wave functions to go to the QCD is explained. The results of the lattice QCD simulation are shown about the nuclear force potential of 1 S 0 channel and the scattering phase differences. About the hyperon forces, computer results from the limit of flavor SU(3) where the masses of u, d and s quarks are equal are introduced here. Further studies using different quark masses are necessary and calculation taking the SU(3) breaking into consideration is in progress. The calculation result of triple proton channel is shown as an example of three-body forth, which is another important nuclear force. To let the lattice QCD exert the predicting ability further steps are left. Calculations on real quark masses are considered especially important as the future problem. Confronting the large problem of hadron many-body systems, K computer is the biggest challenging force as well as the new formalism of HAL QCD and Unified Contraction Algorithm (UCA). (S. Funahashi)

  12. Conceptualizing the Science-Practice Interface: Lessons from a Collaborative Network on the Front-Line of Climate Change

    Directory of Open Access Journals (Sweden)

    Nathan P. Kettle

    2017-06-01

    Full Text Available The gap between science and practice is widely recognized as a major concern in the production and application of decision-relevant science. This research analyzed the roles and network connections of scientists, service providers, and decision makers engaged in climate science and adaptation practice in Alaska, where rapid climate change is already apparent. Our findings identify key actors as well as significant differences in the level of bonding ties between network members who perceive similarity in their social identities, bridging ties between network members across different social groups, and control of information across roles—all of which inform recommendations for adaptive capacity and the co-production of usable knowledge. We also find that some individuals engage in multiple roles in the network suggesting that conceptualizing science policy interactions with the traditional categories of science producers and consumers oversimplifies how experts engage with climate science, services, and decision making. Our research reinforces the notion that the development and application of knowledge is a networked phenomenon and highlights the importance of centralized individuals capable of playing multiple roles in their networks for effective translation of knowledge into action.

  13. Social Capital in Scottish and Danish Neighbourhoods: Paradoxes of a Police-Community Nexus at the Front Line

    DEFF Research Database (Denmark)

    Deuchar, Ross; Søgaard, Thomas Friis; Holligan, Chris

    2018-01-01

    Community-oriented social capital strategies and punitive-oriented policing approaches conflict. Establishing local networking initiatives with community-oriented policing at the centre lends itself to an assets-based policing approach, based on honouring, mobilizing and extending the assets...... of community members. Scholars argue about the need for comparative research on convergences and divergencies across subcultures on the streets and communities. Based on qualitative data gathered from working class communities in Scotland and Denmark in 2014, the article draws inspiration from community......-generated theory of social capital to explore the microsociology of experiences and understandings about community–police integration policy initiatives. We use this perspective to argue that the building of positive inter-generational and police–community relationships is the result of social exchanges...

  14. Compton scattering at high intensities

    Energy Technology Data Exchange (ETDEWEB)

    Heinzl, Thomas, E-mail: thomas.heinzl@plymouth.ac.u [University of Plymouth, School of Mathematics and Statistics, Drake Circus, Plymouth PL4 8AA (United Kingdom)

    2009-12-01

    High-intensity Compton scattering takes place when an electron beam is brought into collision with a high power laser. We briefly review the main intensity signatures using the formalism of strong-field quantum electrodynamics.

  15. Turbulence Intensity Scaling: A Fugue

    OpenAIRE

    Basse, Nils T.

    2018-01-01

    We study streamwise turbulence intensity definitions using smooth- and rough-wall pipe flow measurements made in the Princeton Superpipe. Scaling of turbulence intensity with the bulk (and friction) Reynolds number is provided for the definitions. The turbulence intensity is proportional to the square root of the friction factor with the same proportionality constant for smooth- and rough-wall pipe flow. Turbulence intensity definitions providing the best description of the measurements are i...

  16. High intensity circular proton accelerators

    International Nuclear Information System (INIS)

    Craddock, M.K.

    1987-12-01

    Circular machines suitable for the acceleration of high intensity proton beams include cyclotrons, FFAG accelerators, and strong-focusing synchrotrons. This paper discusses considerations affecting the design of such machines for high intensity, especially space charge effects and the role of beam brightness in multistage accelerators. Current plans for building a new generation of high intensity 'kaon factories' are reviewed. 47 refs

  17. Intensity modulated conformal radiotherapy

    International Nuclear Information System (INIS)

    Noel, Georges; Moty-Monnereau, Celine; Meyer, Aurelia; David, Pauline; Pages, Frederique; Muller, Felix; Lee-Robin, Sun Hae; David, Denis Jean

    2006-12-01

    This publication reports the assessment of intensity-modulated conformal radiotherapy (IMCR). This assessment is based on a literature survey which focussed on indications, efficiency and safety on the short term, on the risk of radio-induced cancer on the long term, on the role in the therapeutic strategy, on the conditions of execution, on the impact on morbidity-mortality and life quality, on the impact on the health system and on public health policies and program. This assessment is also based on the opinion of a group of experts regarding the technical benefit of IMCR, its indications depending on the cancer type, safety in terms of radio-induced cancers, and conditions of execution. Before this assessment, the report thus indicates indications for which the use of IMCR can be considered as sufficient or not determined. It also proposes a technical description of IMCR and helical tomo-therapy, discusses the use of this technique for various pathologies or tumours, analyses the present situation of care in France, and comments the identification of this technique in foreign classifications

  18. Intensive Care Unit Delirium

    Directory of Open Access Journals (Sweden)

    Yongsuk Kim

    2015-05-01

    Full Text Available Delirium is described as a manifestation of acute brain injury and recognized as one of the most common complications in intensive care unit (ICU patients. Although the causes of delirium vary widely among patients, delirium increases the risk of longer ICU and hospital length of stay, death, cost of care, and post-ICU cognitive impairment. Prevention and early detection are therefore crucial. However, the clinical approach toward delirium is not sufficiently aggressive, despite the condition’s high incidence and prevalence in the ICU setting. While the underlying pathophysiology of delirium is not fully understood, many risk factors have been suggested. As a way to improve delirium-related clinical outcome, high-risk patients can be identified. A valid and reliable bedside screening tool is also needed to detect the symptoms of delirium early. Delirium is commonly treated with medications, and haloperidol and atypical antipsychotics are commonly used as standard treatment options for ICU patients although their efficacy and safety have not been established. The approaches for the treatment of delirium should focus on identifying the underlying causes and reducing modifiable risk factors to promote early mobilization.

  19. MRI intensity inhomogeneity correction by combining intensity and spatial information

    International Nuclear Information System (INIS)

    Vovk, Uros; Pernus, Franjo; Likar, Bostjan

    2004-01-01

    We propose a novel fully automated method for retrospective correction of intensity inhomogeneity, which is an undesired phenomenon in many automatic image analysis tasks, especially if quantitative analysis is the final goal. Besides most commonly used intensity features, additional spatial image features are incorporated to improve inhomogeneity correction and to make it more dynamic, so that local intensity variations can be corrected more efficiently. The proposed method is a four-step iterative procedure in which a non-parametric inhomogeneity correction is conducted. First, the probability distribution of image intensities and corresponding second derivatives is obtained. Second, intensity correction forces, condensing the probability distribution along the intensity feature, are computed for each voxel. Third, the inhomogeneity correction field is estimated by regularization of all voxel forces, and fourth, the corresponding partial inhomogeneity correction is performed. The degree of inhomogeneity correction dynamics is determined by the size of regularization kernel. The method was qualitatively and quantitatively evaluated on simulated and real MR brain images. The obtained results show that the proposed method does not corrupt inhomogeneity-free images and successfully corrects intensity inhomogeneity artefacts even if these are more dynamic

  20. Intense electron and ion beams

    CERN Document Server

    Molokovsky, Sergey Ivanovich

    2005-01-01

    Intense Ion and Electron Beams treats intense charged-particle beams used in vacuum tubes, particle beam technology and experimental installations such as free electron lasers and accelerators. It addresses, among other things, the physics and basic theory of intense charged-particle beams; computation and design of charged-particle guns and focusing systems; multiple-beam charged-particle systems; and experimental methods for investigating intense particle beams. The coverage is carefully balanced between the physics of intense charged-particle beams and the design of optical systems for their formation and focusing. It can be recommended to all scientists studying or applying vacuum electronics and charged-particle beam technology, including students, engineers and researchers.

  1. Macroseismic intensity attenuation in Iran

    Science.gov (United States)

    Yaghmaei-Sabegh, Saman

    2018-01-01

    Macroseismic intensity data plays an important role in the process of seismic hazard analysis as well in developing of reliable earthquake loss models. This paper presents a physical-based model to predict macroseismic intensity attenuation based on 560 intensity data obtained in Iran in the time period 1975-2013. The geometric spreading and energy absorption of seismic waves have been considered in the proposed model. The proposed easy to implement relation describes the intensity simply as a function of moment magnitude, source to site distance and focal depth. The prediction capability of the proposed model is assessed by means of residuals analysis. Prediction results have been compared with those of other intensity prediction models for Italy, Turkey, Iran and central Asia. The results indicate the higher attenuation rate for the study area in distances less than 70km.

  2. Intense low energy positron beams

    International Nuclear Information System (INIS)

    Lynn, K.G.; Jacobsen, F.M.

    1993-01-01

    Intense positron beams are under development or being considered at several laboratories. Already today a few accelerator based high intensity, low brightness e + beams exist producing of the order of 10 8 - 10 9 e + /sec. Several laboratories are aiming at high intensity, high brightness e + beams with intensities greater than 10 9 e + /sec and current densities of the order of 10 13 - 10 14 e + sec - 1 cm -2 . Intense e + beams can be realized in two ways (or in a combination thereof) either through a development of more efficient B + moderators or by increasing the available activity of B + particles. In this review we shall mainly concentrate on the latter approach. In atomic physics the main trust for these developments is to be able to measure differential and high energy cross-sections in e + collisions with atoms and molecules. Within solid state physics high intensity, high brightness e + beams are in demand in areas such as the re-emission e + microscope, two dimensional angular correlation of annihilation radiation, low energy e + diffraction and other fields. Intense e + beams are also important for the development of positronium beams, as well as exotic experiments such as Bose condensation and Ps liquid studies

  3. Energy intensity: a new look

    International Nuclear Information System (INIS)

    Khatib, H.

    1995-01-01

    Energy intensity is compared among different countries by dividing their energy use by their gross domestic product (GDP) in dollar terms. GDP (US$), being a varying monetary value, will have different meaning in different countries because of the varying means of converting it into dollars. Therefore distorted results of energy intensity are obtained. The newly devised concept of presenting GDP in terms of purchasing power parity in dollars (US PPP) goes a long way to solving this distortion. It also allows the energy intensity of developing countries to be presented in a more favourable way. (author)

  4. The Danish Intensive Care Database

    DEFF Research Database (Denmark)

    Christiansen, Christian Fynbo; Møller, Morten Hylander; Nielsen, Henrik

    2016-01-01

    AIM OF DATABASE: The aim of this database is to improve the quality of care in Danish intensive care units (ICUs) by monitoring key domains of intensive care and to compare these with predefined standards. STUDY POPULATION: The Danish Intensive Care Database (DID) was established in 2007...... and standardized mortality ratios for death within 30 days after admission using case-mix adjustment (initially using age, sex, and comorbidity level, and, since 2013, using SAPS II) for all patients and for patients with septic shock. DESCRIPTIVE DATA: The DID currently includes 335,564 ICU admissions during 2005...

  5. Transport of intense ion beams

    International Nuclear Information System (INIS)

    Lambertson, G.; Laslett, L.J.; Smith, L.

    1977-01-01

    The possibility of using intense bursts of heavy ions to initiate an inertially confined fusion reaction has stimulated interest in the transport of intense unneutralized heavy ion beams by quadrupole or solenoid systems. This problem was examined in some detail, using numerical integration of the coupled envelope equations for the quadrupole case. The general relations which emerge are used to develop examples of high energy transport systems and as a basis for discussing the limitations imposed by a transport system on achievable intensities for initial acceleration

  6. Intensive variable and its application

    CERN Document Server

    Zheng, Xinqi; Yuan, Zhiyuan

    2014-01-01

    Opening with intensive variables theory, using a combination of static and dynamic GIS and integrating numerical calculation and spatial optimization, this book creates a framework and methodology for evaluating land use effect, among other concepts.

  7. Vacuum in intensive gauge fields

    International Nuclear Information System (INIS)

    Matinian, S.G.

    1977-12-01

    The behaviour of vacuum in a covariantly constant Yang-Mills field is considered. The expressions for the effective Lagrangian in an intensive field representing the asymptotic freedom of the theory are found

  8. Sustained reduction of central line-associated bloodstream infections outside the intensive care unit with a multimodal intervention focusing on central line maintenance.

    Science.gov (United States)

    Dumyati, Ghinwa; Concannon, Cathleen; van Wijngaarden, Edwin; Love, Tanzy M T; Graman, Paul; Pettis, Ann Marie; Greene, Linda; El-Daher, Nayef; Farnsworth, Donna; Quinlan, Gail; Karr, Gloria; Ward, Lynnette; Knab, Robin; Shelly, Mark

    2014-07-01

    Central venous catheter use is common outside the intensive care units (ICUs), but prevention in this setting is not well studied. We initiated surveillance for central line-associated bloodstream infections (CLABSIs) outside the ICU setting and studied the impact of a multimodal intervention on the incidence of CLABSIs across multiple hospitals. This project was constructed as a prospective preintervention-postintervention design. The project comprised 3 phases (preintervention [baseline], intervention, and postintervention) over a 4.5-year period (2008-2012) and was implemented through a collaborative of 37 adult non-ICU wards at 6 hospitals in the Rochester, NY area. The intervention focused on engagement of nursing staff and leadership, nursing education on line care maintenance, competence evaluation, audits of line care, and regular feedback on CLABSI rates. Quarterly rates were compared over time in relation to intervention implementation. The overall CLABSI rate for all participating units decreased from 2.6/1000 line-days preintervention to 2.1/1,000 line-days during the intervention and to 1.3/1,000 line-days postintervention, a 50% reduction (95% confidence interval, .40-.59) compared with the preintervention period (P .0179). A multipronged approach blending both the adaptive and technical aspects of care including front line engagement, education, execution of best practices, and evaluation of both process and outcome measures may provide an effective strategy for reducing CLABSI rates outside the ICU. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  9. Scenarios of future energy intensities

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    In this chapter, the authors present scenarios of potential change in energy intensities in the OECD countries and in the Soviet Union. These scenarios are meant to illustrate how intensities might evolve over the next 20 years given different conditions with respect to energy prices, energy-efficiency policies, and other key factors. Changes in intensity will also be affected by the rates of growth and stock turnover in each sector. They have not tried to forecast how activity levels and structure will evolve. However, the OECD scenarios assume a world in which GDP averages growth in the 2-3%/year range, with some differences among countries. For the Soviet Union, the degree and pace of intensity decline will be highly dependent on the success of the transition to a market economy; each scenario explicitly envisions a different degree of success. They have not constructed comparable scenarios for the developing countries. The scenarios presented in this chapter do not predict what will happen in the future. They believe, however, that they illustrate a plausible set of outcomes if energy prices, policies, programs, and other factors evolve as described in each case. With higher energy prices and vigorous policies and programs, intensities in the OECD countries in 2010 could be nearly 50% less on average than the level where trends seem to be point. In the former Soviet Union, a combination of rapid, successful economic reform and extra effort to improve energy efficiency might result in average intensity being nearly 40% less than in a slow reform case. And in the LDCs, a mixture of sound policies, programs, and energy pricing reform could also lead to intensities being far lower than they would be otherwise. 8 refs., 10 figs., 1 tab

  10. Energy intensities: Prospects and potential

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    In the previous chapter, the author described how rising activity levels and structural change are pushing toward higher energy use in many sectors and regions, especially in the developing countries. The extent to which more activity leads to greater energy use will depend on the energy intensity of end-use activities. In this chapter, the author presents an overview of the potential for intensity reductions in each sector over the next 10-20 years. It is not the author's intent to describe in detail the various technologies that could be employed to improve energy efficiency, which has been done by others (see, for example, Lovins ampersand Lovins, 1991; Goldembert et al., 1987). Rather, he discusses the key factors that will shape future energy intensities in different parts of the world, and gives a sense for the changes that could be attained if greater attention were given to accelerate efficiency improvement. The prospects for energy intensities, and the potential for reduction, vary among sectors and parts of the world. In the majority of cases, intensities are tending to decline as new equipment and facilities come into use and improvements are made on existing stocks. The effect of stock turnover will be especially strong in the developing countries, where stocks are growing at a rapid pace, and the Former East Bloc, where much of the existing industrial plant will eventually be retired and replaced with more modern facilities. While reductions in energy intensity are likely in most areas, there is a large divergence between the technical and economic potential for reducing energy intensities and the direction in which present trends are moving. In the next chapter, the author presents scenarios that illustrate where trends are pointing, and what could be achieved if improving energy efficiency were a focus of public policies. 53 refs., 4 figs., 2 tabs

  11. High-intensity laser physics

    International Nuclear Information System (INIS)

    Mohideen, U.

    1993-01-01

    This thesis is a study of the effect of high intensity lasers on atoms, free electrons and the generation of X-rays from solid density plasmas. The laser produced 50 milli Joule 180 femto sec pulses at 5 Hz. This translates to a maximum intensity of 5 x 10 18 W/cm 2 . At such high fields the AC stark shifts of atoms placed at the focus is much greater than the ionization energy. The characteristics of multiphoton ionization of atoms in intense laser fields was studied by angle resolved photoelectron spectroscopy. Free electrons placed in high intensity laser fields lead to harmonic generation. This phenomenon of Nonlinear Compton Scattering was theoretically investigated. Also, when these high intensity pulses are focused on solids a hot plasma is created. This plasma is a bright source of a short X-ray pulse. The pulse-width of X-rays from these solid density plasmas was measured by time-resolved X-ray spectroscopy

  12. Raman spectroscopy an intensity approach

    CERN Document Server

    Guozhen, Wu

    2017-01-01

    This book summarizes the highlights of our work on the bond polarizability approach to the intensity analysis. The topics covered include surface enhanced Raman scattering, Raman excited virtual states and Raman optical activity (ROA). The first chapter briefly introduces the Raman effect in a succinct but clear way. Chapter 2 deals with the normal mode analysis. This is a basic tool for our work. Chapter 3 introduces our proposed algorithm for the Raman intensity analysis. Chapter 4 heavily introduces the physical picture of Raman virtual states. Chapter 5 offers details so that the readers can have a comprehensive idea of Raman virtual states. Chapter 6 demonstrates how this bond polarizability algorithm is extended to ROA intensity analysis. Chapters 7 and 8 offer details on ROA, showing many findings on ROA mechanism that were not known or neglected before. Chapter 9 introduces our proposed classical treatment on ROA which, as combined with the results from the bond polarizability analysis, leads to a com...

  13. The Danish Intensive Care Database

    Directory of Open Access Journals (Sweden)

    Christiansen CF

    2016-10-01

    Full Text Available Christian Fynbo Christiansen,1 Morten Hylander Møller,2 Henrik Nielsen,1 Steffen Christensen3 1Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, 2Department of Intensive Care 4131, Copenhagen University Hospital Rigshospitalet, Copenhagen, 3Department of Intensive Care, Aarhus University Hospital, Aarhus, Denmark Aim of database: The aim of this database is to improve the quality of care in Danish intensive care units (ICUs by monitoring key domains of intensive care and to compare these with predefined standards. Study population: The Danish Intensive Care Database (DID was established in 2007 and includes virtually all ICU admissions in Denmark since 2005. The DID obtains data from the Danish National Registry of Patients, with complete follow-up through the Danish Civil Registration System. Main variables: For each ICU admission, the DID includes data on the date and time of ICU admission, type of admission, organ supportive treatments, date and time of discharge, status at discharge, and mortality up to 90 days after admission. Descriptive variables include age, sex, Charlson comorbidity index score, and, since 2010, the Simplified Acute Physiology Score (SAPS II. The variables are recorded with 90%–100% completeness in the recent years, except for SAPS II score, which is 73%–76% complete. The DID currently includes five quality indicators. Process indicators include out-of-hour discharge and transfer to other ICUs for capacity reasons. Outcome indicators include ICU readmission within 48 hours and standardized mortality ratios for death within 30 days after admission using case-mix adjustment (initially using age, sex, and comorbidity level, and, since 2013, using SAPS II for all patients and for patients with septic shock. Descriptive data: The DID currently includes 335,564 ICU admissions during 2005–2015 (average 31,958 ICU admissions per year. Conclusion: The DID provides a

  14. Intense beams of light ions

    International Nuclear Information System (INIS)

    Camarcat, Noel

    1985-01-01

    Results of experiments performed in order to accelerate intense beams of light and heavier ions are presented. The accelerating diodes are driven by existing pulsed power generators. Optimization of the generator structure is described in chapter I. Nuclear diagnostics of the accelerated light ion beams are presented in chapter II. Chapter III deals with the physics of intense charged particle beams. The models developed are applied to the calculation of the performances of the ion diodes described in the previous chapters. Chapter IV reports preliminary results on a multiply ionized carbon source driven by a 0.1 TW pulsed power generator. (author) [fr

  15. Low intensity transcranial electric stimulation

    DEFF Research Database (Denmark)

    Antal, Andrea; Alekseichuk, I; Bikson, M

    2017-01-01

    Low intensity transcranial electrical stimulation (TES) in humans, encompassing transcranial direct current (tDCS), transcutaneous spinal Direct Current Stimulation (tsDCS), transcranial alternating current (tACS), and transcranial random noise (tRNS) stimulation or their combinations, appears...

  16. Sound intensity and its measurement

    DEFF Research Database (Denmark)

    Jacobsen, Finn

    1997-01-01

    The paper summarises the basic theory of sound intensity and its measurement and gives an overview of the state of the art with particular emphasis on recent developments in the field. Eighty references are given, most of which to literature published in the past two years. The paper describes...

  17. Industrial Penetration and Internet Intensity

    NARCIS (Netherlands)

    C-L. Chang (Chia-Lin); M.J. McAleer (Michael); Y-C. Wu (Yu-Chieh)

    2016-01-01

    textabstractThis paper investigates the effect of industrial penetration and internet intensity for Taiwan manufacturing firms, and analyses whether the relationships are substitutes or complements. The sample observations are based on 153,081 manufacturing plants, and covers 26 two-digit industry

  18. Spatiotemporal control of laser intensity

    Science.gov (United States)

    Froula, Dustin H.; Turnbull, David; Davies, Andrew S.; Kessler, Terrance J.; Haberberger, Dan; Palastro, John P.; Bahk, Seung-Whan; Begishev, Ildar A.; Boni, Robert; Bucht, Sara; Katz, Joseph; Shaw, Jessica L.

    2018-05-01

    The controlled coupling of a laser to plasma has the potential to address grand scientific challenges1-6, but many applications have limited flexibility and poor control over the laser focal volume. Here, we present an advanced focusing scheme called a `flying focus', where a chromatic focusing system combined with chirped laser pulses enables a small-diameter laser focus to propagate nearly 100 times its Rayleigh length. Furthermore, the speed at which the focus moves (and hence the peak intensity) is decoupled from the group velocity of the laser. It can co- or counter-propagate along the laser axis at any velocity. Experiments validating the concept measured subluminal (-0.09c) to superluminal (39c) focal-spot velocities, generating a nearly constant peak intensity over 4.5 mm. Among possible applications, the flying focus could be applied to a photon accelerator7 to mitigate dephasing, facilitating the production of tunable XUV sources.

  19. The intense neutron generator study

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, W B

    1966-07-01

    The study has confirmed that a beam of 65 mA of protons at 1000 MeV, striking a molten lead-bismuth target surrounded by heavy water moderator, would give the desired flux of 10{sup 16} thermal neutrons per cm{sup 2} per second to provide intense beams of neutrons and also to produce radioisotopes. The proton beam passing through a thin auxiliary target would also produce beams of mesons. The design and construction of the ion source, injector, accelerator, target and auxiliaries present challenging technical problems. Moreover, continued development for improved life and economy promises to be rewarding. The high neutron intensity is sought for research in solid and liquid state physics and also for nuclear physics. Participation by universities and industry, both in development and use, is expected to be extensive. (author)

  20. How is intensive care reimbursed?

    DEFF Research Database (Denmark)

    Bittner, Martin-Immanuel; Donnelly, Maria; van Zanten, Arthur Rh

    2013-01-01

    Reimbursement schemes in intensive care are more complex than in other areas of healthcare, due to special procedures and high care needs. Knowledge regarding the principles of functioning in other countries can lead to increased understanding and awareness of potential for improvement. This can...... be achieved through mutual exchange of solutions found in other countries. In this review, experts from eight European countries explain their respective intensive care unit reimbursement schemes. Important conclusions include the apparent differences in the countries' reimbursement schemes---despite all...... of them originating from a DRG system, the high degree of complexity found, and the difficulties faced in several countries when collecting the data for this collaborative work. This review has been designed to help the intensivist clinician and researcher to understanding neighbouring countries...

  1. The intense neutron generator study

    International Nuclear Information System (INIS)

    Lewis, W.B.

    1966-01-01

    The study has confirmed that a beam of 65 mA of protons at 1000 MeV, striking a molten lead-bismuth target surrounded by heavy water moderator, would give the desired flux of 10 16 thermal neutrons per cm 2 per second to provide intense beams of neutrons and also to produce radioisotopes. The proton beam passing through a thin auxiliary target would also produce beams of mesons. The design and construction of the ion source, injector, accelerator, target and auxiliaries present challenging technical problems. Moreover, continued development for improved life and economy promises to be rewarding. The high neutron intensity is sought for research in solid and liquid state physics and also for nuclear physics. Participation by universities and industry, both in development and use, is expected to be extensive. (author)

  2. Box-particle intensity filter

    OpenAIRE

    Schikora, Marek; Gning, Amadou; Mihaylova, Lyudmila; Cremers, Daniel; Koch, Wofgang; Streit, Roy

    2012-01-01

    This paper develops a novel approach for multi-target tracking, called box-particle intensity filter (box-iFilter). The approach is able to cope with unknown clutter, false alarms and estimates the unknown number of targets. Furthermore, it is capable of dealing with three sources of uncertainty: stochastic, set-theoretic and data association uncertainty. The box-iFilter reduces the number of particles significantly, which improves the runtime considerably. The low particle number enables thi...

  3. Intensity-modulated radiation therapy.

    Science.gov (United States)

    Goffman, Thomas E; Glatstein, Eli

    2002-07-01

    Intensity-modulated radiation therapy (IMRT) is an increasingly popular technical means of tightly focusing the radiation dose around a cancer. As with stereotactic radiotherapy, IMRT uses multiple fields and angles to converge on the target. The potential for total dose escalation and for escalation of daily fraction size to the gross cancer is exciting. The excitement, however, has greatly overshadowed a range of radiobiological and clinical concerns.

  4. LHC Report: reaching high intensity

    CERN Multimedia

    Jan Uythoven

    2015-01-01

    After both beams having been ramped to their full energy of 6.5 TeV, the last two weeks saw the beam commissioning process advancing on many fronts. An important milestone was achieved when operators succeeded in circulating a nominal-intensity bunch. During the operation, some sudden beam losses resulted in beam dumps at top energy, a problem that needed to be understood and resolved.   In 2015 the LHC will be circulating around 2800 bunches in each beam and each bunch will contain just over 1 x 1011 protons. Until a few days ago commissioning was taking place with single bunches of 5 x 109 protons. The first nominal bunch with an intensity of 1 x 1011 protons was injected on Tuesday, 21 April. In order to circulate such a high-intensity bunch safely, the whole protection system must be working correctly: collimators, which protect the aperture, are set at preliminary values known as coarse settings; all kicker magnets for injecting and extracting the beams are commissioned with beam an...

  5. Absolute intensities of supersonic beams

    International Nuclear Information System (INIS)

    Beijerinck, H.C.W.; Habets, A.H.M.; Verster, N.F.

    1977-01-01

    In a molecular beam experiment the center-line intensity I(0) (particles s -1 sterad -1 ) and the flow rate dN/dt (particles s -1 ) of a beam source are important features. To compare the performance of different types of beam sources the peaking factor, kappa, is defined as the ratio kappa=π(I(0)/dN/dt). The factor π is added to normalize to kappa=1 for an effusive source. The ideal peaking factor for the supersonic flow from a nozzle follows from continuum theory. Numerical values of kappa are available. Experimental values of kappa for an argon expansion are presented in this paper, confirming these calculations. The actual center-line intensity of a supersonic beam source with a skimmer is reduced in comparison to this ideal intensity if the skimmer shields part of the virtual source from the detector. Experimental data on the virtual source radius are given enabling one to predict this shielding quantitatively. (Auth.)

  6. High Intensity Source Laboratory (HISL)

    International Nuclear Information System (INIS)

    1992-01-01

    The High Intensity Source Laboratory (HISL) is a laboratory facility operated for the US Department of Energy (DOE) by EG ampersand G, Energy Measurements (EG ampersand G/EM). This document is intended as an overview -- primarily for external users -- of the general purposes and capabilities of HISL; numerous technical details are beyond its scope. Moreover, systems at HISL are added, deleted, and modified to suit current needs, and upgraded with continuing development. Consequently, interested parties are invited to contact the HISL manager for detailed, current, technical, and administrative information. The HISL develops and operates pulsed radiation sources with energies, intensities, and pulse widths appropriate for several applications. Principal among these are development, characterization, and calibration of various high-bandwidth radiation detectors and diagnostic systems. Hardness/vulnerability of electronic or other sensitive components to radiation is also tested. In this connection, source development generally focuses on attending (1) the highest possible intensities with (2) reasonably short pulse widths and (3) comprehensive output characterization

  7. Intensive treatment of leg lymphedema

    Directory of Open Access Journals (Sweden)

    Pereira de Godoy Jose

    2010-01-01

    Full Text Available Background: Despite of all the problems caused by lymphedema, this disease continues to affect millions of people worldwide. Thus, the identification of the most efficacious forms of treatment is necessary. Aim: The aim of this study was to evaluate a novel intensive outpatient treatment for leg lymphedema. Methods: Twenty-three legs of 19 patients were evaluated in a prospective randomized study. The inclusion criteria were patients with Grade II and III lymphedema, where the difference, measured by volumetry, between the affected limb below the knee and the healthy limb was greater than 1.5 kg. Intensive treatment was carried out for 6- to 8-h sessions in the outpatient clinic. Analysis of variance was utilized for statistical analysis with an alpha error of 5% (P-value < 0.05 being considered significant. Results: All limbs had significant reductions in size with the final mean loss being 81.1% of the volume of edema. The greatest losses occurred in the first week (P-value < 0.001. Losses of more than 90% of the lymphedema occurred in 9 (39.13% patients; losses of more than 80% in 13 (56.52%, losses of more than 70% in 17 (73.91% and losses of more than 50% were recorded for 95.65% of the patients; only 1 patient lost less than 50% (37.9% of the edema. Conclusion: The intensive treatment of lymphedema in the outpatient clinic can produce significant reductions in the volume of edema over a short period of time and can be recommended for any grade of lymphedema, in particular the more advanced degrees.

  8. Lean production of intensive cities

    DEFF Research Database (Denmark)

    Ratner, Helene Gad; Bojesen, Anders; Bramming, Pia

    2014-01-01

    turnover. This is analysed in terms of Italo Calvino's Invisible cities. It is argued that Calvino's themes and prose help us understand change as a multiplicity of temporal intensities producing ambivalence and affect. We describe this use of literary abstractions as a ‘hyperbolic social epistemology......’. Through the depiction of four intensifications of Lean Production, the metaphors of Calvino's cities show how reality and illusion; hope and poverty; dreams and death and utopia and dystopia are intricately mingled and produce temporary and equally ambivalent affects of alienation, hypocrisy, self...

  9. Light intensity modulation in phototherapy

    Science.gov (United States)

    Lukyanovich, P. A.; Zon, B. A.; Kunin, A. A.; Pankova, S. N.

    2015-04-01

    A hypothesis that blocking ATP synthesis is one of the main causes of the stimulating effect is considered based on analysis of the primary photostimulation mechanisms. The light radiation intensity modulation is substantiated and the estimates of such modulation parameters are made. An explanation is offered to the stimulation efficiency decrease phenomenon at the increase of the radiation dose during the therapy. The results of clinical research of the medical treatment in preventive dentistry are presented depending on the spectrum and parameters of the light flux modulation.

  10. INTENSITY DEPENDENT EFFECTS IN RHIC

    International Nuclear Information System (INIS)

    WEI, J.

    1999-01-01

    The Relativistic Heavy Ion Collider (RHIC) is currently under commissioning after a seven-year construction cycle. Unlike conventional hadron colliders, this machine accelerates, stores, and collides heavy ion beams of various combinations of species. The dominant intensity dependent effects are intra-beam scattering at both injection and storage, and complications caused by crossing transition at a slow ramp rate. In this paper, the authors present theoretical formalisms that have been used for the study, and discuss mechanisms, impacts, and compensation methods including beam cooling and transition jump schemes. Effects of space charge, beam-beam, and ring impedances are also summarized

  11. Plasmas and intense laser light

    International Nuclear Information System (INIS)

    Kennedy, E.T.

    1984-01-01

    The present article begins with a description of the laser technology required to reach the high irradiances of interest and provides a brief outline of the more important diagnostic techniques used in investigating the plasmas. An introduction to plasma waves is given and the linear and nonlinear excitation of waves is discussed. The remainder of the article describes some of the experimental evidence supporting the interpretation of the plasma behaviour at high laser-light intensities in terms of the excitation of plasma waves and the subsequent heating of plasma by these waves. (author)

  12. Intensive and critical care medicine

    International Nuclear Information System (INIS)

    Aochi, Osamu; Amaha, Keisuke; Takeshita, Hiroshi

    1990-01-01

    Eight papers in this volume are in INIS scope, respectively dealing with the scientific use of the chest radiograph in intensive care unit, xenon computed tomography cerebral blood flow in diagnosis and management of symptomatic vasospasm and severe head injury, therapeutic relevance of MRI in acute head trauma, computerized tomography in the diagnosis of cerebral air embolism, thallium 201 myocardial perfusion during weaning from mechanical ventilation, thoracic computed tomography for ICU patients, and the effect of xenon inhalation upon internal carotid artery blood flow in awake monkeys. (H.W.). refs.; figs.; tabs

  13. The intense proton accelerator program

    International Nuclear Information System (INIS)

    Kaneko, Yoshihiko

    1990-01-01

    The Science and Technology Agency of Japan has formulated the OMEGA project, in which incineration of nuclear wastes by use of accelerators is defined as one of the important tasks. Japan Atomic Energy Research Institute (JAERI) has been engaged for several years in basic studies in incineration technology with use of an intense proton linear accelerator. The intense proton accelerator program intends to provide a large scale proton linear accelerator called Engineering Test Accelerator. The principal purpose of the accelerator is to develop nuclear waste incineration technology. The accelerator will also be used for other industrial applications and applied science studies. The present report further outlines the concept of incineration of radio-activities of nuclear wastes, focusing on nuclear reactions and a concept of incineration plant. Features of Engineering Test Accelerator are described focusing on the development of the accelerator, and research and development of incineration technology. Applications of science and technology other than nuclear waste incineration are also discussed. (N.K.)

  14. Intensive outpatient treatment of elephantiasis.

    Science.gov (United States)

    Pereira De Godoy, J M; Amador Franco Brigidio, P; Buzato, E; Fátima Guerreiro De Godoy, M

    2012-10-01

    The aim of this paper was to report on a novel approach to the intensive outpatient treatment of elephantiasis of an underprivileged population. Prospective, random study, the diagnosis of lymphedema was clinical and the inclusion of patients was by order of arrival in the treatment center where all were invited to participate in the study. Intensive outpatient therapy was performed for 6 to 8 hours daily over a period of four weeks. Eleven legs with grade III elephantiasis of 8 patients were evaluated in a random prospective study. Three patients were men and five were women with ages ranging between 28 and 66 years old. Treatment included mechanical lymph drainage using the RAGodoy® apparatus for a period of 6 to 8 hours daily and the Godoy & Godoy cervical stimulation technique for 20 minutes per day, both associated to the use of a home-made medical compression stocking using a low-stretch cotton-polyester material. Additionally, manual lymph drainage using the Godoy & Godoy technique was performed for one hour. Perimetry was used to compare measurements made before and after treatment, of the three points of the limb with the largest circumferences. The paired t-test was utilized for statistical analysis with an alpha error greater than 5% (P-value elephantiasis.

  15. Beam intensity increases at the intense pulsed neutron source accelerator

    International Nuclear Information System (INIS)

    Potts, C.; Brumwell, F.; Norem, J.; Rauchas, A.; Stipp, V.; Volk, G.

    1985-01-01

    The Intense Pulsed Neutron Source (IPNS) accelerator system has managed a 40% increase in time average beam current over the last two years. Currents of up to 15.6μA (3.25 x 10 12 protons at 30 Hz) have been successfully accelerated and cleanly extracted. Our high current operation demands low loss beam handling to permit hands-on maintenance. Synchrotron beam handling efficiencies of 90% are routine. A new H - ion source which was installed in March of 1983 offered the opportunity to get above 8 μA but an instability caused unacceptable losses when attempting to operate at 10 μA and above. Simple techniques to control the instabilities were introduced and have worked well. These techniques are discussed below. Other improvements in the regulation of various power supplies have provided greatly improved low energy orbit stability and contributed substantially to the increased beam current

  16. Time variations in geomagnetic intensity

    Science.gov (United States)

    Valet, Jean-Pierre

    2003-03-01

    After many years spent by paleomagnetists studying the directional behavior of the Earth's magnetic field at all possible timescales, detailed measurements of field intensity are now needed to document the variations of the entire vector and to analyze the time evolution of the field components. A significant step has been achieved by combining intensity records derived from archeological materials and from lava flows in order to extract the global field changes over the past 12 kyr. A second significant step was due to the emergence of coherent records of relative paleointensity using the remanent magnetization of sediments to retrace the evolution of the dipole field. A third step was the juxtaposition of these signals with those derived from cosmogenic isotopes. Contemporaneous with the acquisition of records, new techniques have been developed to constrain the geomagnetic origin of the signals. Much activity has also been devoted to improving the quality of determinations of absolute paleointensity from volcanic rocks with new materials, proper selection of samples, and investigations of complex changes in magnetization during laboratory experiments. Altogether these developments brought us from a situation where the field changes were restricted to the past 40 kyr to the emergence of a coherent picture of the changes in the geomagnetic dipole moment for at least the past 1 Myr. On longer timescales the field variability and its average behavior is relatively well documented for the past 400 Myr. Section 3 gives a summary of most methods and techniques that are presently used to track the field intensity changes in the past. In each case, current limits and potential promises are discussed. The section 4 describes the field variations measured so far over various timescales covered by the archeomagnetic and the paleomagnetic records. Preference has always been given to composite records and databases in order to extract and discuss major and global geomagnetic

  17. Intensive Care for Eclampic Coma

    Directory of Open Access Journals (Sweden)

    V. V. Moroz

    2010-01-01

    Full Text Available Objective: to enhance the efficiency of treatment of puerperas with eclampic coma, by substantiating, developing, and introducing new algorithms for correction of systemic hemodynamic, metabolic disturbances, and perfusion-metabolic changes in brain tissues. Subjects and methods. Studies were conducted in 18 puerperas with eclampic coma (Group 2 in whom the authors used a new treatment algorithm aimed at maintaining baseline cerebral perfusion pressure (CPP, restoring volemic levels at the expense of interstitial fluid. A control group (Group 1 included 30 patients who received conventional standard therapy. Regional cerebral circulation was measured by a non-invasive (inhalation radioisotopic method, by applying the tracer 131Xe, as described by V. D. Obrist et al., on a modified КПРДИ-1 apparatus (USSR. The rate of brain oxygen uptake was determined from the oxygen content between the artery and the internal jugular vein. Central hemodynamic parameters were studied by the direct method of right heart catheterization using a flow-directed Swan-Ganz catheter. The volumes of total and extracellular fluids were estimated using 20% urea and mannitol solutions, respectively, at 0.2 g/kg weight by the procedure of V. M. Mogen. Circulating blood volume (CBV was determined by a radioisotopic method using 131iodine albumin on an УPI-7 apparatus (USSR. Cerebral spinal fluid pressure was measured by an ИиНД apparatus. Studies were made in four steps: 1 on admission; 2 on days 2—3; 3 during emergence from coma; 4 before transition. Results. The use of the new algorithm for intensive care for eclampic coma, which is aimed at improving the perfusion metabolic provision of brain structures, with a reduction in mean blood pressure by 10—15% of the baseline level, by administering magnesium sulfate and nimodipine, and at compensating for CBV by high-molecular-weight hydroxyethylated starch (stabizol, ensured early emergence from a comatose state

  18. Sleep in intensive care unit

    DEFF Research Database (Denmark)

    Boyko, Yuliya; Jennum, Poul; Nikolic, Miki

    2017-01-01

    PURPOSE: To determine if improving intensive care unit (ICU) environment would enhance sleep quality, assessed by polysomnography (PSG), in critically ill mechanically ventilated patients. MATERIALS AND METHODS: Randomized controlled trial, crossover design. The night intervention "quiet routine...... Medicine) sleep scoring criteria were insufficient for the assessment of polysomnograms. Modified classification for sleep scoring in critically ill patients, suggested by Watson et al. (Crit Care Med 2013;41:1958-1967), was used. RESULTS: Sound level analysis showed insignificant effect...... patients. We were not able to further reduce the already existing low noise levels in the ICU and did not find any association between the environmental intervention and the presence of normal sleep characteristics in the PSG....

  19. Jet target intense neutron source

    International Nuclear Information System (INIS)

    Meier, K.L.

    1977-01-01

    A jet target Intense Neutron Source (INS) is being built by the Los Alamos Scientific Laboratory with DOE/MFE funding in order to perform radiation damage experiments on materials to be used in fusion power reactors. The jet target can be either a supersonic or a subsonic jet. Each type has its particular advantages and disadvantages, and either of the jets can be placed inside the spherical blanket converter which will be used to simulate a fusion reactor neutron environment. Preliminary mock-up experiments with a 16-mA, 115 keV, H + ion beam on a nitrogen gas supersonic jet show no serious problems in the beam formation, transport, or jet interaction

  20. Human Influence on Tropical Cyclone Intensity

    Science.gov (United States)

    Sobel, Adam H.; Camargo, Suzana J.; Hall, Timothy M.; Lee, Chia-Ying; Tippett, Michael K.; Wing, Allison A.

    2016-01-01

    Recent assessments agree that tropical cyclone intensity should increase as the climate warms. Less agreement exists on the detection of recent historical trends in tropical cyclone intensity.We interpret future and recent historical trends by using the theory of potential intensity, which predicts the maximum intensity achievable by a tropical cyclone in a given local environment. Although greenhouse gas-driven warming increases potential intensity, climate model simulations suggest that aerosol cooling has largely canceled that effect over the historical record. Large natural variability complicates analysis of trends, as do poleward shifts in the latitude of maximum intensity. In the absence of strong reductions in greenhouse gas emissions, future greenhouse gas forcing of potential intensity will increasingly dominate over aerosol forcing, leading to substantially larger increases in tropical cyclone intensities.

  1. Global intensity correction in dynamic scenes

    NARCIS (Netherlands)

    Withagen, P.J.; Schutte, K.; Groen, F.C.A.

    2007-01-01

    Changing image intensities causes problems for many computer vision applications operating in unconstrained environments. We propose generally applicable algorithms to correct for global differences in intensity between images recorded with a static or slowly moving camera, regardless of the cause

  2. The patient experience of intensive care

    DEFF Research Database (Denmark)

    Egerod, Ingrid; Bergbom, Ingegerd; Lindahl, Berit

    2015-01-01

    : Nordic intensive care units. PARTICIPANTS: Patients in Nordic intensive care units. METHODS: We performed a literature search of qualitative studies of the patient experience of intensive care based on Nordic publications in 2000-2013. We searched the following databases: PubMed, CINAHL, Scopus, and Psyc...

  3. Treatment Intensity and Childhood Apraxia of Speech

    Science.gov (United States)

    Namasivayam, Aravind K.; Pukonen, Margit; Goshulak, Debra; Hard, Jennifer; Rudzicz, Frank; Rietveld, Toni; Maassen, Ben; Kroll, Robert; van Lieshout, Pascal

    2015-01-01

    Background: Intensive treatment has been repeatedly recommended for the treatment of speech deficits in childhood apraxia of speech (CAS). However, differences in treatment outcomes as a function of treatment intensity have not been systematically studied in this population. Aim: To investigate the effects of treatment intensity on outcome…

  4. Subjective intensity and pleasantness in taste

    NARCIS (Netherlands)

    Veldhuizen, M.G.

    2006-01-01

    This thesis contains studies on intensity and pleasantness in taste perception. There is a formal relationship between intensity and hedonic value of stimuli, which can be expressed in an inverted U. The fact that pleasantness depends partially on stimulus intensity poses a problem when one wants to

  5. Analytical theory of intensity fluctuations in SASE

    Energy Technology Data Exchange (ETDEWEB)

    Yu, L.H.; Krinsky, S. [Brookhaven National Lab., Upton, NY (United States). National Synchrotron Light Source

    1997-07-01

    Recent advances in SASE experiments stimulate interest in quantitative comparison of measurements with theory. Extending the previous analysis of the SASE intensity in guided modes, the authors provide an analytical description of the intensity fluctuations by calculating intensity correlation functions in the frequency domain. Comparison of the results with experiment yields new insight into the SASE process.

  6. The combined use of radiotherapy and immunochemotherapy with Krestin for intra-oral cancer

    International Nuclear Information System (INIS)

    Komatsu, Yukihisa; Kuroda, Manabu

    1981-01-01

    Interstitial irradiation with needles 226 Ra was performed on 3 patients with intra-oral cancer. Krestin, an immunotherapeutic agent, was administered three times a day. All patients were also given 600 mg of FT-207/day as adjuvant chemotherapy. Moreover, one of them was also given 0.75 mg/day of eskinon every day. As parameters of immunological competence, PPD and PHA intracutaneous responses and the lymphocyte count in peripheral blood were used. Ulcers of intra-oral cancer were completely heated and there was no lymph node enargement. Though there were changes in PPD intracutaneous responses among three patients, positive responses were maintained. Absolute values of the lymphocyte count in peripheral blood were almost above 1,000/mm 3 in patients treated with both krestin and FT-207, but those in a patient treated with additional eskinon decreased gradually to 450/mm 3 . (Tsunoda, M.)

  7. [Copy number alterations in adult patients with mature B acute lymphoblastic leukemia treated with specific immunochemotherapy].

    Science.gov (United States)

    Ribera, Jordi; Zamora, Lurdes; García, Olga; Hernández-Rivas, Jesús-María; Genescà, Eulàlia; Ribera, Josep-Maria

    2016-12-02

    Unlike Burkitt lymphoma, molecular abnormalities other than C-MYC rearrangements have scarcely been studied in patients with mature B acute lymphoblastic leukemia (B-ALL). The aim of this study was to analyze the frequency and prognostic significance of copy number alterations (CNA) in genes involved in lymphoid differentiation, cell cycle and tumor suppression in adult patients with B-ALL. We have analyzed by multiplex ligation-dependent probe amplification the genetic material from bone marrow at diagnosis from 25 adult B-ALL patients treated with rituximab and specific chemotherapy. The most frequent CNA were alterations in the 14q32.33 region (11 cases, 44%) followed by alterations in the cell cycle regulator genes CDKN2A/B and RB1 (16%). No correlation between the presence of specific CNA and the clinical-biologic features or the response to therapy was found. The high frequency of CNA in the 14q32.33 region, CDKN2A/B and RB1 found in our study could contribute to the aggressiveness and invasiveness of mature B-ALL. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  8. Enhanced Tumor Retention Effect by Click Chemistry for Improved Cancer Immunochemotherapy.

    Science.gov (United States)

    Mei, Ling; Liu, Yayuan; Rao, Jingdong; Tang, Xian; Li, Man; Zhang, Zhirong; He, Qin

    2018-05-30

    Because of the limited drug concentration in tumor tissues and inappropriate treatment strategies, tumor recurrence and metastasis are critical challenges for effectively treating malignancies. A key challenge for effective delivery of nanoparticles is to reduce uptake by reticuloendothelial system and to enhance the permeability and retention effect. Herein, we demonstrated Cu(I)-catalyzed click chemistry triggered the aggregation of azide/alkyne-modified micelles, enhancing micelles accumulation in tumor tissues. In addition, combined doxorubicin with the adjuvant monophosphoryl lipid A, an agonist of toll-like receptor4, generated immunogenic cell death, which further promoted maturity of dendritic cells, antigen presentation and induced strong effector T cells in vivo. Following combined with anti-PD-L1 therapy, substantial antitumor and metastasis inhibitory effects were achieved because of the reduced PD-L1 expression and regulatory T cells. In addition, effective long-term immunity from memory T cell responses protected mice from tumor recurrence.

  9. The Canadian intense neutron generator

    Energy Technology Data Exchange (ETDEWEB)

    Tunnicliffe, P R

    1967-07-01

    Atomic Energy of Canada Ltd. has proposed construction of an Intense Neutron-Generator. The generator would produce uniquely-intense beams of thermal neutrons for solid-state and low-energy nuclear studies and would yield significant quantities of radioisotopes of both research and commercial value; it would also produce copious sources of mesons and energetic nucleons for use in intermediate-energy nuclear physics and in nuclear-structure studies. The primary neutron source of 10{sup 19}/sec would be generated by bombarding a heavy-element target with a continuous beam of 65 mA of 1 GeV protons. The target of circulating and cooled Pb-Bi eutectic would be surrounded by a tank of heavy water moderator yielding a maximum useful flux of 10{sup 16} thermal neutrons/cm{sup 2}/sec in the region where neutron beams can be extracted. This high-energy spallation process for producing neutrons is nearly four times more efficient in producing neutrons per unit of thermal energy released in the neutron source compared with a fission reactor. Nevertheless, if energy costs for producing the 65 MW proton beam are to be within reason, the machine producing the beam must be efficient. A D.C. machine is in principle ideal but practical achievement of 1 GV is not likely within the time desired. An accelerator where the protons gain energy from radio-frequency fields is the most likely prospect. We have selected a linear accelerator as our reference design and detailed theoretical and experimental studies are in progress. The machine is based on the Los Alamos Meson Physics Facility design reoptimized for continuous rather than pulsed operation. It is approximately one mile long and is expected to achieve nearly 50 percent overall efficiency. There are two major portions, an 'Alvarez' Section operating at 200 MHz accelerating the beam to about 150 MeV, followed by a 'Waveguide' section operating at 800 MHz. Protons are initially injected by an 0.75 MV D.C. accelerator. The Alvarez

  10. Analysis of energy intensity in Japan

    International Nuclear Information System (INIS)

    Okajima, Shigeharu; Okajima, Hiroko

    2013-01-01

    This study discusses the causes of the increase in Japan's energy intensity, defined as energy consumption divided by GDP, since the early 1990s. The significant reduction in Japan's energy intensity ceased in the early 1980s and has even slightly increased since the early 1990s, indicating that Japan seemingly stopped taking aggressive action to improve energy use. However, further analysis at prefecture level and sector level provides additional insight on energy intensity trends. To analyze the causes of the increase in Japan's energy intensity, energy intensity is decomposed into energy efficiency (improvements in energy efficiency) and energy activity (structural changes from the secondary sector to the tertiary sector of the economy). Our result indicates that the non-uniform energy intensity trends between prefectures are attributed to a high variability in energy efficiency. At sector level, we estimate the income elasticity of energy consumption in each sector and find that a structural change in energy consumption behaviors occurred in all sectors at different time points. The industrial sector and commercial sector became less energy efficient after 1981 and 1988, respectively, which is presumably responsible for the deterioration of Japan's energy intensity since the early 1990s. - Highlights: • We examine why the reduction in Japan's energy intensity increased in the early 1990s. • There is a high variability in energy intensity trends between regions. • The structural changes in energy consumption behaviors occurred in sector level. • These changes may be responsible for the deterioration of Japan's energy intensity

  11. Low-intensity conflict in multinational corporations

    DEFF Research Database (Denmark)

    Lauring, Jakob; Andersen, Poul Houman; Storgaard, Marianne

    2017-01-01

    in four Danish MNCs. Findings: They describe consequences of low-intensity conflict and identify three types of actions by headquarters’ representatives that could lead to the development of low-intensity conflicts, namely, ignoring, bypassing and educating. Originality/value: Very few studies have dealt......Purpose: This paper aims to identify antecedents for, and consequences of, low-intensity inter-unit conflict in multinational corporations (MNCs). Inter-unit conflict in MNCs is an important and well-researched theme. However, while most studies have focused on open conflict acknowledged by both...... parties, much less research has dealt with low-intensity conflicts. Still, low-intensity conflicts can be highly damaging – not least because they are rarely resolved. Design/methodology/approach: The authors used a qualitative approach to understanding low-intensity conflict relying on 170 interviews...

  12. School Nurses on the Front Lines of Medicine: The Approach to a Student After a Syncopal Event: Don't "PASS OUT".

    Science.gov (United States)

    Hackett, Gretchen; Brady, Jodi; Olympia, Robert P

    2018-03-01

    Students presenting with syncope and/or seizure occur occasionally in the school setting. Several studies have shown that seizures as well as respiratory distress are the most common medical emergencies that prompt school nurses and staff to contact emergency medical services (EMS) to transport students to the closest emergency department (Knight 1999, Olympia 2005). It is important to develop a differential diagnosis for syncope, to initiate stabilization of the student with life-threatening symptoms, and to triage these students to an appropriate level of care (back to the classroom, home with their guardian with follow-up at their primary health care provider's office, or directly to the closest emergency department via EMS). This article describes the initial assessment and management of two students presenting after syncopal events.

  13. Stories from the Front Lines of Student Success: The Implementation and Progress of Near Peer Mentoring Programs in Alaska and Idaho. Western Policy Exchanges

    Science.gov (United States)

    Krueger, Carl

    2016-01-01

    This brief provides an overview of the implementation and impact of near peer mentoring programs in Alaska and Idaho from the standpoint of both existing research and the near peers themselves. While progress is being monitored as part of state College Access Challenge Grant (CACG) program implementation and activity, only limited data on the…

  14. What are the beliefs, attitudes and practices of front-line staff in long-term care (LTC facilities related to osteoporosis awareness, management and fracture prevention?

    Directory of Open Access Journals (Sweden)

    Adachi Jonathan D

    2010-10-01

    Full Text Available Abstract Background Compared to the general elderly population, those institutionalized in LTC facilities have the highest prevalence of osteoporosis and subsequently have higher incidences of vertebral and hip fractures. The goal of this study is to determine how well nurses at LTC facilities are educated to properly administer bisphosphonates. A secondary question assessed was the nurse's and PSW's attitudes and beliefs regarding the role and benefits of vitamin D for LTC patients. Methods Eight LTC facilities in Hamilton were surveyed, and all nurses were offered a survey. A total 57 registered nurses were surveyed. A 21 item questionnaire was developed to assess existing management practices and specific osteoporosis knowledge areas. Results The questionnaire assessed the nurse's and personal support worker's (PSWs education on how to properly administer bisphosphonates by having them select all applicable responses from a list of options. These options included administering the drug before, after or with meals, given with or separate from other medications, given with juice, given with or without water, given with the patient sitting up, or finally given with the patient supine. Only 52% of the nurses and 8.7% of PSWs administered the drug properly, where they selected the options: (given before meals, given with water, given separate from all other medications, and given in a sitting up position. If at least one incorrect option was selected, then it was scored as an inappropriate administration. Bisphosphonates were given before meals by 85% of nurses, given with water by 90%, given separately from other medication by 71%, and was administered in an upright position by 79%. Only 52% of the nurses and 8.7% of PSWs surveyed were administering the drug properly. Regarding the secondary question, of the 57 nurses surveyed, 68% strongly felt their patients should be prescribed vitamin D supplements. Of the 124 PSWs who completed the survey, 44.4% strongly felt their patients should be prescribed vitamin D supplementation. Conclusion Bisphosphonates are quite effective in increasing the bone mineral density of LTC patients, and may reduce fracture rates, but it is only effective if properly administered. In our study, proper administration of bisphosphonate therapy was less than optimal. In summary, although the education of health providers has improved since the mid-1990's, this area still requires further attention and the subject of future quality assurance research.

  15. From the front lines to the home front: a history of the development of psychiatric nursing in the U.S. during the World War II era.

    Science.gov (United States)

    Silverstein, Christine M

    2008-07-01

    During World War II, psychiatric nurses learned valuable lessons on how to deal with the traumas of war. Using psychohistorical inquiry, this historian examined primary and secondary sources, beyond the facts and dates associated with historical events, to understand why and how psychiatric nurse pioneers developed therapeutic techniques to address the psychosocial and physical needs of combatants. Not only is the story told about the hardships endured as nurses ministered to soldiers, but their attitudes, beliefs, and emotions, that is, how they felt and what they thought about their circumstances, are explored. In this study the lived experiences of two psychiatric nurses, Votta and Peplau, are contrasted to explicate how knowledge development improved care and how this knowledge had an impact on the home front in nursing practice and education, as well as in mental institutions and society, long after the war was won.

  16. How State-Funded Home Care Programs Respond to Changes in Medicare Home Health Care: Resource Allocation Decisions on the Front Line

    Science.gov (United States)

    Corazzini, Kirsten

    2003-01-01

    Objective To examine how case managers in a state-funded home care program allocate home care services in response to information about a client's Medicare home health care status, with particular attention to the influence of work environment. Data Sources/Study Setting Primary data collected on 355 case managers and 26 agency directors employed in June 1999 by 26 of the 27 regional agencies administering the Massachusetts Home Care Program for low-income elders. Study Design Data were collected in a cross-sectional survey study design. A case manager survey included measures of work environment, demographics, and factorial survey vignette clients (N=2,054), for which case managers assessed service eligibility levels. An agency director survey included measures of management practices. Data Collection/Extraction Methods Hierarchical linear models estimated the effects of work environment on the relationship between client receipt of Medicare home health care and care plan levels while controlling for case-mix differences in agencies' clients. Principal Findings Case managers did not supplement extant Medicare home health services, but did allocate more generous service plans to clients who have had Medicare home health care services recently terminated. This finding persisted when controlling for case mix and did not vary by work environment. Work environment affected overall care plan levels. Conclusions Study findings indicate systematic patterns of frontline resource allocation shaping the relationships among community-based long-term care payment sources. Further, results illustrate how nonuniform implementation of upper-level initiatives may be partially attributed to work environment characteristics. PMID:14596390

  17. Front line of cement technolgy and control. Part 5. ; Baking process and chemical reactions. Cement saisentan sono gijutsu to kanri 5. ; Shosei katei to kagaku hanno

    Energy Technology Data Exchange (ETDEWEB)

    Hirai, M. (Ube Industries, Ltd., Yamaguchi (Japan))

    1990-06-01

    The baking process in cement production means the process that the raw materials which were mixed and pulverized in the raw material preparation process are charged into a reaction furnace which is called kiln, and clinders (intermediate product of cement) are generated. It is the process which affects quality as well as production cost of cement more significantly than anything else. In this article, an outline of the above baking facilities, how the raw materials change and clinkers are generated therein, and how they are controlled are introduced. Clinkers are composed of such products as alite, belite, aluminate and ferrite, etc. which were generated after decomposition reactions of such raw materials as lime stone, clay, silica rock and iron oxide in the above kiln. The essential ponts of the process control which makes the generation reactions of clinker compounds efficiently are such two points as well balanced raw materials to be charged into the baking facilities and stable operation of such facilities. The quality of cement which is required as finished goods is achieved by the quality control at each intermediate process and the quality tests of cement. 5 refs., 10 figs., 2 tabs.

  18. The weather-stains of care: interpreting the meaning of bad weather for front-line health care workers in rural long-term care.

    Science.gov (United States)

    Joseph, Gillian M; Skinner, Mark W; Yantzi, Nicole M

    2013-08-01

    This paper addresses the gap in health services and policy research about the implications of everyday weather for health care work. Building on previous research on the weather-related challenges of caregiving in homes and communities, it examines the experiences of 'seasonal bad weather' for health care workers in long-term care institutions. It features a hermeneutic phenomenology analysis of six transcripts from interviews with nurses and personal support workers from a qualitative study of institutional long-term care work in rural Canada. Focussing on van Manen's existential themes of lived experience (body, relations, space, time), the analysis reveals important contradictions between the lived experiences of health care workers coping with bad weather and long-term care policies and practices that mitigate weather-related risk and vulnerability. The findings contribute to the growing concern for rural health issues particularly the neglected experiences of rural health providers and, in doing so, offer insight into the recent call for greater attention to the geographies of health care work. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. How Should We Estimate the Performance Effect of Management? : Comparing Impacts of Public Managers' and Front-line Employees' Perceptions of Management

    DEFF Research Database (Denmark)

    Favero, Nathan; Andersen, Simon Calmar; Meier, Kenneth J.

    2016-01-01

    Many areas of public management research are dominated by a top-focused perspective in which emphasis is placed on the notion that managers themselves are usually the best sources of information about managerial behavior. Outside of the leadership literature, managers are also the typical survey...... respondents in public management studies. An alternative perspective on management can be provided by subordinates’ perceptions of what management is doing. Surveys of subordinates and of managers each pose potential advantages and potential disadvantages when it comes to measuring management, and each...... approach is likely to prove more fruitful for measuring certain management functions. Using a unique data set of parallel surveys on management with managers and their subordinates as respondents, we examine the differences and relationships between Danish school managers’ and teachers’ perceptions...

  20. Front-line management, staffing and nurse-doctor relationships as predictors of nurse and patient outcomes. a survey of Icelandic hospital nurses.

    Science.gov (United States)

    Gunnarsdóttir, Sigrún; Clarke, Sean P; Rafferty, Anne Marie; Nutbeam, Don

    2009-07-01

    To investigate aspects of nurses' work environments linked with job outcomes and assessments of quality of care in an Icelandic hospital. Prior research suggests that poor working environments in hospitals significantly hinder retention of nurses and high quality patient care. On the other hand, hospitals with high retention rates (such as Magnet hospitals) show supportive management, professional autonomy, good inter-professional relations and nurse job satisfaction, reduced nurse burnout and improved quality of patient care. Cross-sectional survey of 695 nurses at Landspitali University Hospital, Reykjavík. Nurses' work environments were measured using the nursing work index-revised (NWI-R) and examined as predictors of job satisfaction, the Maslach burnout inventory (MBI) and nurse-assessed quality of patient care using linear and logistic regression approaches. An Icelandic adaptation of the NWI-R showed a five-factor structure similar to that of Lake (2002). After controlling for nurses' personal characteristics, job satisfaction, emotional exhaustion and nurse rated quality of care were found to be independently associated with perceptions of support from unit-level managers, staffing adequacy, and nurse-doctor relations. The NWI-R measures elements of hospital nurses' work environments that predict job outcomes and nurses' ratings of the quality of patient care in Iceland. Efforts to improve and maintain nurses' relations with nurse managers and doctors, as well as their perceptions of staffing adequacy, will likely improve nurse job satisfaction and employee retention, and may improve the quality of patient care.

  1. Knowledge, Attitudes, and Practices Regarding Epidemiology and Management of Travelers' Diarrhea: A Survey of Front-Line Providers in Iraq and Afghanistan

    National Research Council Canada - National Science Library

    Sanders, John W

    2005-01-01

    To evaluate the relationship between medical knowledge and clinical practice, a survey on travelers' diarrhea was administered to military health care providers attending a professional development...

  2. CHLORAMBUCIL PLUS RITUXIMAB AS FRONT-LINE THERAPY IN ELDERLY/UNFIT PATIENTS AFFECTED BY B-CELL CHRONIC LYMPHOCYTIC LEUKEMIA: RESULTS OF A SINGLE-CENTRE EXPERIENCE.

    Directory of Open Access Journals (Sweden)

    Luca Laurenti

    2013-05-01

    Full Text Available Currently standard first line therapy for fit patients with B-CLL/SLL are fludarabine-based regimens. Elderly patients or patients with comorbidities poorly tolerate purine analogue-based chemotherapy and they are often treated with Chlorambucil (Chl. However, complete response (CR and overall response (OR rates with Chl are relatively low. We now investigated whether the addition of Rituximab to Chl will improve the efficacy without impairing the tolerability in elderly and unfit patients. We included in our study 27 elderly or unfit patients that had not received prior therapy. All patients were treated with Chl (1mg/Kg per 28-day cycle for 8 cycles plus Rituximab (375 mg/m2 for the first course and 500 mg/m2 for subsequent cycles until the 6th cycle. We obtained an OR rate of 74%. The most frequent adverse effect was grade 3-4 neutropenia, which occurred in 18.5% of the patients. Infections or grade 3-4 extra-hematological side effects were not recorded. None of the patients required reduction of dose, delay of therapy or hospitalization. Overall, these data suggest that Chl-R is an effective and well tolerated regimen in elderly/unfit patients with CLL.

  3. Front line defenders of the ecological niche! Screening the structural diversity of peptaibiotics from saprotrophic and fungicolous Trichoderma/Hypocrea species

    DEFF Research Database (Denmark)

    Röhrich, Christian René; Jaklitsch, Walter Michael; Voglmayr, Hermann

    2014-01-01

    Approximately 950 individual sequences of nonribosomally biosynthesised peptides are produced by the genus Trichoderma/Hypocreathat belong to a perpetually growing class of mostly linear antibiotic oligopeptides, which are rich in the non-proteinogenic α-aminoisobutyric acid (Aib). Thus, they are......Approximately 950 individual sequences of nonribosomally biosynthesised peptides are produced by the genus Trichoderma/Hypocreathat belong to a perpetually growing class of mostly linear antibiotic oligopeptides, which are rich in the non-proteinogenic α-aminoisobutyric acid (Aib). Thus...

  4. Ellipsoid clustering machine: a front line to aid in disease diagnosis - DOI: 10.3395/reciis.v1i2.Sup.101en

    Directory of Open Access Journals (Sweden)

    Paulo Costa Carvalho

    2007-12-01

    Full Text Available This study presents a new machine learning strategy to address the disease diagnosis classification problem that comprises an unknown number of disease classes. This is exemplified by a software called Ellipsoid Clustering Machine (ECM that identifies conserved regions in mass spectrometry proteomic profiles obtained from control subjects and uses these to estimate classification boundaries based on sample variance. The software can also be used for visual inspection of data reproducibility. ECM was evaluated using mass spectrometry protein profiles obtained from serum of Hodgkin’s disease patients (HD and control subjects. According to the leave-one-out cross validation, ECM completely separated both groups based only on the information derived from four selected mass spectral peaks. Classification details and a 3D graphical model showing the separation between the control subject cluster and HD patients is also presented. The software is available on the project website together with online interactive models of the dataset and an animation demonstrating the method.

  5. Propensity Score–Matched Analysis of Comprehensive Local Therapy for Oligometastatic Non-Small Cell Lung Cancer That Did Not Progress After Front-Line Chemotherapy

    International Nuclear Information System (INIS)

    Sheu, Tommy; Heymach, John V.; Swisher, Stephen G.; Rao, Ganesh; Weinberg, Jeffrey S.; Mehran, Reza; McAleer, Mary Frances; Liao, Zhongxing; Aloia, Thomas A.; Gomez, Daniel R.

    2014-01-01

    Purpose: To retrospectively analyze factors influencing survival in patients with non-small cell lung cancer presenting with ≤3 synchronous metastatic lesions. Methods and Materials: We identified 90 patients presenting between 1998 and 2012 with non-small cell lung cancer and ≤3 metastatic lesions who had received at least 2 cycles of chemotherapy followed by surgery or radiation therapy before disease progression. The median number of chemotherapy cycles before comprehensive local therapy (CLT) (including concurrent chemoradiation as first-line therapy) was 6. Factors potentially affecting overall (OS) or progression-free survival (PFS) were evaluated with Cox proportional hazards regression. Propensity score matching was used to assess the efficacy of CLT. Results: Median follow-up time was 46.6 months. Benefits in OS (27.1 vs 13.1 months) and PFS (11.3 months vs 8.0 months) were found with CLT, and the differences were statistically significant when propensity score matching was used (P ≤ .01). On adjusted analysis, CLT had a statistically significant benefit in terms of OS (hazard ratio, 0.37; 95% confidence interval, 0.20-0.70; P ≤ .01) but not PFS (P=.10). In an adjusted subgroup analysis of patients receiving CLT, favorable performance status (hazard ratio, 0.43; 95% confidence interval, 0.22-0.84; P=.01) was found to predict improved OS. Conclusions: Comprehensive local therapy was associated with improved OS in an adjusted analysis and seemed to favorably influence OS and PFS when factors such as N status, number of metastatic lesions, and disease sites were controlled for with propensity score–matched analysis. Patients with favorable performance status had improved outcomes with CLT. Ultimately, prospective, randomized trials are needed to provide definitive evidence as to the optimal treatment approach for this patient population

  6. Propensity Score–Matched Analysis of Comprehensive Local Therapy for Oligometastatic Non-Small Cell Lung Cancer That Did Not Progress After Front-Line Chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Sheu, Tommy [University of Texas School of Public Health, Houston, Texas (United States); Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Heymach, John V. [Department of Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Swisher, Stephen G. [Department of Thoracic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Rao, Ganesh; Weinberg, Jeffrey S. [Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Mehran, Reza [Department of Thoracic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); McAleer, Mary Frances; Liao, Zhongxing [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Aloia, Thomas A. [Department of Gastrointestinal Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Gomez, Daniel R., E-mail: dgomez@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2014-11-15

    Purpose: To retrospectively analyze factors influencing survival in patients with non-small cell lung cancer presenting with ≤3 synchronous metastatic lesions. Methods and Materials: We identified 90 patients presenting between 1998 and 2012 with non-small cell lung cancer and ≤3 metastatic lesions who had received at least 2 cycles of chemotherapy followed by surgery or radiation therapy before disease progression. The median number of chemotherapy cycles before comprehensive local therapy (CLT) (including concurrent chemoradiation as first-line therapy) was 6. Factors potentially affecting overall (OS) or progression-free survival (PFS) were evaluated with Cox proportional hazards regression. Propensity score matching was used to assess the efficacy of CLT. Results: Median follow-up time was 46.6 months. Benefits in OS (27.1 vs 13.1 months) and PFS (11.3 months vs 8.0 months) were found with CLT, and the differences were statistically significant when propensity score matching was used (P ≤ .01). On adjusted analysis, CLT had a statistically significant benefit in terms of OS (hazard ratio, 0.37; 95% confidence interval, 0.20-0.70; P ≤ .01) but not PFS (P=.10). In an adjusted subgroup analysis of patients receiving CLT, favorable performance status (hazard ratio, 0.43; 95% confidence interval, 0.22-0.84; P=.01) was found to predict improved OS. Conclusions: Comprehensive local therapy was associated with improved OS in an adjusted analysis and seemed to favorably influence OS and PFS when factors such as N status, number of metastatic lesions, and disease sites were controlled for with propensity score–matched analysis. Patients with favorable performance status had improved outcomes with CLT. Ultimately, prospective, randomized trials are needed to provide definitive evidence as to the optimal treatment approach for this patient population.

  7. Clinical Effectiveness and Cost of a Hospital-Based Fall Prevention Intervention: The Importance of Time Nurses Spend on the Front Line of Implementation.

    Science.gov (United States)

    Nuckols, Teryl K; Needleman, Jack; Grogan, Tristan R; Liang, Li-Jung; Worobel-Luk, Pamela; Anderson, Laura; Czypinski, Linda; Coles, Courtney; Walsh, Catherine M

    2017-11-01

    The aim of this study is to evaluate the clinical effectiveness and incremental net cost of a fall prevention intervention that involved hourly rounding by RNs at 2 hospitals. Minimizing in-hospital falls is a priority, but little is known about the value of fall prevention interventions. We used an uncontrolled before-after design to evaluate changes in fall rates and time use by RNs. Using decision-analytical models, we estimated incremental net costs per hospital per year. Falls declined at 1 hospital (incidence rate ratio [IRR], 0.47; 95% confidence interval [CI], 0.26-0.87; P = .016), but not the other (IRR, 0.83; 95% CI, 0.59-1.17; P = .28). Cost analyses projected a 67.9% to 72.2% probability of net savings at both hospitals due to unexpected declines in the time that RNs spent in fall-related activities. Incorporating fall prevention into hourly rounds might improve value. Time that RNs invest in implementing quality improvement interventions can equate to sizable opportunity costs or savings.

  8. Front-line intraperitoneal versus intravenous chemotherapy in stage III-IV epithelial ovarian, tubal, and peritoneal cancer with minimal residual disease: a competing risk analysis.

    Science.gov (United States)

    Chang, Yen-Hou; Li, Wai-Hou; Chang, Yi; Peng, Chia-Wen; Cheng, Ching-Hsuan; Chang, Wei-Pin; Chuang, Chi-Mu

    2016-03-17

    In the analysis of survival data for cancer patients, the problem of competing risks is often ignored. Competing risks have been recognized as a special case of time-to-event analysis. The conventional techniques for time-to-event analysis applied in the presence of competing risks often give biased or uninterpretable results. Using a prospectively collected administrative health care database in a single institution, we identified patients diagnosed with stage III or IV primary epithelial ovarian, tubal, and peritoneal cancers with minimal residual disease after primary cytoreductive surgery between 1995 and 2012. Here, we sought to evaluate whether intraperitoneal chemotherapy outperforms intravenous chemotherapy in the presence of competing risks. Unadjusted and multivariable subdistribution hazards models were applied to this database with two types of competing risks (cancer-specific mortality and other-cause mortality) coded to measure the relative effects of intraperitoneal chemotherapy. A total of 1263 patients were recruited as the initial cohort. After propensity score matching, 381 patients in each arm entered into final competing risk analysis. Cumulative incidence estimates for cancer-specific mortality were statistically significantly lower (p = 0.017, Gray test) in patients receiving intraperitoneal chemotherapy (5-year estimates, 34.5%; 95% confidence interval [CI], 29.5-39.6%, and 10-year estimates, 60.7%; 95% CI, 52.2-68.0%) versus intravenous chemotherapy (5-year estimates, 41.3%; 95% CI, 36.2-46.3%, and 10-year estimates, 67.5%, 95% CI, 61.6-72.7%). In subdistribution hazards analysis, for cancer-specific mortality, intraperitoneal chemotherapy outperforms intravenous chemotherapy (Subdistribution hazard ratio, 0.82; 95% CI, 0.70-0.96) after correcting other covariates. In conclusion, results from this comparative effectiveness study provide supportive evidence for previous published randomized trials that intraperitoneal chemotherapy outperforms intravenous chemotherapy even eliminating the confounding of competing risks. We suggest that implementation of competing risk analysis should be highly considered for the investigation of cancer patients who have medium to long-term follow-up period.

  9. Lenalidomide-induced myelosuppression is associated with renal dysfunction: adverse events evaluation of treatment-naïve patients undergoing front-line lenalidomide and dexamethasone therapy.

    Science.gov (United States)

    Niesvizky, Ruben; Naib, Tara; Christos, Paul J; Jayabalan, David; Furst, Jessica R; Jalbrzikowski, Jessica; Zafar, Faiza; Mark, Tomer; Lent, Richard; Pearse, Roger N; Ely, Scott; Leonard, John P; Mazumdar, Madhu; Chen-Kiang, Selina; Coleman, Morton

    2007-09-01

    Data on 72 patients receiving lenalidomide/dexamethasone for multiple myeloma (MM) was used to determine the factors that are associated with lenalidomide-induced myelosuppression. Eight of 14 patients with grade > or =3 myelosuppression had baseline creatinine clearance (CrCl) < or =0.67 ml/s. Kaplan-Meier analysis by log-rank test demonstrated a significant association (P < 0.0001) between renal insufficiency and time to myelosuppression (hazard ratio = 8.4; 95% confidence interval 2.9-24.7, P = 0.0001). Therefore, CrCl is inversely associated with significant myelosuppression. Caution should be exercised when lenalidomide therapy is commenced and CrCl should be incorporated as a determinant of the initial dosing of lenalidomide in MM patients.

  10. A Large-Scale Internet/Computer-Based, Training Module: Dissemination of Evidence-Based Management of Postpartum Hemorrhage to Front-Line Health Care Workers

    Science.gov (United States)

    Abawi, Karim; Gertiser, Lynn; Idris, Raqibat; Villar, José; Langer, Ana; Chatfield, Alison; Campana, Aldo

    2017-01-01

    Postpartum hemorrhage (PPH) is the leading cause of maternal mortality in most developing and low-income countries and the cause of one-quarter of maternal deaths worldwide. With appropriate and prompt care, these deaths can be prevented. With the current and rapidly developing research and worldwide access to information, a lack of knowledge of…

  11. Sulphur mountain: Cosmic ray intensity records

    International Nuclear Information System (INIS)

    Venkatesan, D.; Mathews, T.

    1985-01-01

    This book deals with the comic ray intensity registrations at the Sulphur Mountain Cosmic Ray Laboratory. The time series of intensity form a valuable data-set, for studying cosmic ray intensity variations and their dependence on solar activity. The IGY neutron monitor started operating from July 1, 1957 and continued through 1963. Daily mean values are tabulated for the period and these are also represented in plots. This monitor was set up by the National Research Council of Canada

  12. Latitudinal variation of the solar photospheric intensity

    OpenAIRE

    Rast, Mark P.; Ortiz, Ada; Meisner, Randle W.

    2007-01-01

    We have examined images from the Precision Solar Photometric Telescope (PSPT) at the Mauna Loa Solar Observatory (MLSO) in search of latitudinal variation in the solar photospheric intensity. Along with the expected brightening of the solar activity belts, we have found a weak enhancement of the mean continuum intensity at polar latitudes (continuum intensity enhancement $\\sim0.1 - 0.2%$ corresponding to a brightness temperature enhancement of $\\sim2.5{\\rm K}$). This appears to be thermal in ...

  13. Energy Intensity of the Electric Vehicle

    Directory of Open Access Journals (Sweden)

    Mieczysław Dziubiński

    2017-12-01

    Full Text Available Continuous energy intensity is a dependency between continuous energy intensity and energy intensity of movement. In the paper it is proposed analyze energy intensity of the movement, as the size specifying the power demand to the wheel drive and presented the balance of power of an electric car moving in the urban cycle. The object of the test was the hybrid vehicle with an internal combustion engine and electric motor. The measurements were carried out for 4 speeds and 2 driving profiles.

  14. Hurricane feedback research may improve intensity forecasts

    Science.gov (United States)

    Schultz, Colin

    2012-06-01

    Forecasts of a hurricane's intensity are generally much less accurate than forecasts of its most likely path. Large-scale atmospheric patterns dictate where a hurricane will go and how quickly it will get there. The storm's intensity, however, depends on small-scale shifts in atmospheric stratification, upwelling rates, and other transient dynamics that are difficult to predict. Properly understanding the risk posed by an impending storm depends on having a firm grasp of all three properties: translational speed, intensity, and path. Drawing on 40 years of hurricane records representing 3090 different storms, Mei et al. propose that a hurricane's translational speed and intensity may be closely linked.

  15. Fundamental Physics at the Intensity Frontier

    CERN Document Server

    Hewett, J.L.; Brock, R.; Butler, J.N.; Casey, B.C.K.; Collar, J.; de Gouvea, A.; Essig, R.; Grossman, Y.; Haxton, W.; Jaros, J.A.; Jung, C.K.; Lu, Z.T.; Pitts, K.; Ligeti, Z.; Patterson, J.R.; Ramsey-Musolf, M.; Ritchie, J.L.; Roodman, A.; Scholberg, K.; Wagner, C.E.M.; Zeller, G.P.; Aefsky, S.; Afanasev, A.; Agashe, K.; Albright, C.; Alonso, J.; Ankenbrandt, C.; Aoki, M.; Arguelles, C.A.; Arkani-Hamed, N.; Armendariz, J.R.; Armendariz-Picon, C.; Arrieta Diaz, E.; Asaadi, J.; Asner, D.M.; Babu, K.S.; Bailey, K.; Baker, O.; Balantekin, B.; Baller, B.; Bass, M.; Batell, B.; Beacham, J.; Behr, J.; Berger, N.; Bergevin, M.; Berman, E.; Bernstein, R.; Bevan, A.J.; Bishai, M.; Blanke, M.; Blessing, S.; Blondel, A.; Blum, T.; Bock, G.; Bodek, A.; Bonvicini, G.; Bossi, F.; Boyce, J.; Breedon, R.; Breidenbach, M.; Brice, S.J.; Briere, R.A.; Brodsky, S.; Bromberg, C.; Bross, A.; Browder, T.E.; Bryman, D.A.; Buckley, M.; Burnstein, R.; Caden, E.; Campana, P.; Carlini, R.; Carosi, G.; Castromonte, C.; Cenci, R.; Chakaberia, I.; Chen, Mu-Chun; Cheng, C.H.; Choudhary, B.; Christ, N.H.; Christensen, E.; Christy, M.E.; Chupp, T.E.; Church, E.; Cline, D.B.; Coan, T.E.; Coloma, P.; Comfort, J.; Coney, L.; Cooper, J.; Cooper, R.J.; Cowan, R.; Cowen, D.F.; Cronin-Hennessy, D.; Datta, A.; Davies, G.S.; Demarteau, M.; DeMille, D.P.; Denig, A.; Dermisek, R.; Deshpande, A.; Dewey, M.S.; Dharmapalan, R.; Dhooghe, J.; Dietrich, M.R.; Diwan, M.; Djurcic, Z.; Dobbs, S.; Duraisamy, M.; Dutta, Bhaskar; Duyang, H.; Dwyer, D.A.; Eads, M.; Echenard, B.; Elliott, S.R.; Escobar, C.; Fajans, J.; Farooq, S.; Faroughy, C.; Fast, J.E.; Feinberg, B.; Felde, J.; Feldman, G.; Fierlinger, P.; Fileviez Perez, P.; Filippone, B.; Fisher, P.; Flemming, B.T.; Flood, K.T.; Forty, R.; Frank, M.J.; Freyberger, A.; Friedland, A.; Gandhi, R.; Ganezer, K.S.; Garcia, A.; Garcia, F.G.; Gardner, S.; Garrison, L.; Gasparian, A.; Geer, S.; Gehman, V.M.; Gershon, T.; Gilchriese, M.; Ginsberg, C.; Gogoladze, I.; Gonderinger, M.; Goodman, M.; Gould, H.; Graham, M.; Graham, P.W.; Gran, R.; Grange, J.; Gratta, G.; Green, J.P.; Greenlee, H.; Group, R.C.; Guardincerri, E.; Gudkov, V.; Guenette, R.; Haas, A.; Hahn, A.; Han, T.; Handler, T.; Hardy, J.C.; Harnik, R.; Harris, D.A.; Harris, F.A.; Harris, P.G.; Hartnett, J.; He, B.; Heckel, B.R.; Heeger, K.M.; Henderson, S.; Hertzog, D.; Hill, R.; Hinds, E.A.; Hitlin, D.G.; Holt, R.J.; Holtkamp, N.; Horton-Smith, G.; Huber, P.; Huelsnitz, W.; Imber, J.; Irastorza, I.; Jaeckel, J.; Jaegle, I.; James, C.; Jawahery, A.; Jensen, D.; Jessop, C.P.; Jones, B.; Jostlein, H.; Junk, T.; Kagan, A.L.; Kalita, M.; Kamyshkov, Y.; Kaplan, D.M.; Karagiorgi, G.; Karle, A.; Katori, T.; Kayser, B.; Kephart, R.; Kettell, S.; Kim, Y.K.; Kirby, M.; Kirch, K.; Klein, J.; Kneller, J.; Kobach, A.; Kohl, M.; Kopp, J.; Kordosky, M.; Korsch, W.; Kourbanis, I.; Krisch, A.D.; Krizan, P.; Kronfeld, A.S.; Kulkarni, S.; Kumar, K.S.; Kuno, Y.; Kutter, T.; Lachenmaier, T.; Lamm, M.; Lancaster, J.; Lancaster, M.; Lane, C.; Lang, K.; Langacker, P.; Lazarevic, S.; Le, T.; Lee, K.; Lesko, K.T.; Li, Y.; Lindgren, M.; Lindner, A.; Link, J.; Lissauer, D.; Littenberg, L.S.; Littlejohn, B.; Liu, C.Y.; Loinaz, W.; Lorenzon, W.; Louis, W.C.; Lozier, J.; Ludovici, L.; Lueking, L.; Lunardini, C.; MacFarlane, D.B.; Machado, P.A.N.; Mackenzie, P.B.; Maloney, J.; Marciano, W.J.; Marsh, W.; Marshak, M.; Martin, J.W.; Mauger, C.; McFarland, K.S.; McGrew, C.; McLaughlin, G.; McKeen, D.; McKeown, R.; Meadows, B.T.; Mehdiyev, R.; Melconian, D.; Merkel, H.; Messier, M.; Miller, J.P.; Mills, G.; Minamisono, U.K.; Mishra, S.R.; Mocioiu, I.; Sher, S.Moed; Mohapatra, R.N.; Monreal, B.; Moore, C.D.; Morfin, J.G.; Mousseau, J.; Moustakas, L.A.; Mueller, G.; Mueller, P.; Muether, M.; Mumm, H.P.; Munger, C.; Murayama, H.; Nath, P.; Naviliat-Cuncin, O.; Nelson, J.K.; Neuffer, D.; Nico, J.S.; Norman, A.; Nygren, D.; Obayashi, Y.; O'Connor, T.P.; Okada, Y.; Olsen, J.; Orozco, L.; Orrell, J.L.; Osta, J.; Pahlka, B.; Paley, J.; Papadimitriou, V.; Papucci, M.; Parke, S.; Parker, R.H.; Parsa, Z.; Partyka, K.; Patch, A.; Pati, J.C.; Patterson, R.B.; Pavlovic, Z.; Paz, Gil; Perdue, G.N.; Perevalov, D.; Perez, G.; Petti, R.; Pettus, W.; Piepke, A.; Pivovaroff, M.; Plunkett, R.; Polly, C.C.; Pospelov, M.; Povey, R.; Prakesh, A.; Purohit, M.V.; Raby, S.; Raaf, J.L.; Rajendran, R.; Rajendran, S.; Rameika, G.; Ramsey, R.; Rashed, A.; Ratcliff, B.N.; Rebel, B.; Redondo, J.; Reimer, P.; Reitzner, D.; Ringer, F.; Ringwald, A.; Riordan, S.; Roberts, B.L.; Roberts, D.A.; Robertson, R.; Robicheaux, F.; Rominsky, M.; Roser, R.; Rosner, J.L.; Rott, C.; Rubin, P.; Saito, N.; Sanchez, M.; Sarkar, S.; Schellman, H.; Schmidt, B.; Schmitt, M.; Schmitz, D.W.; Schneps, J.; Schopper, A.; Schuster, P.; Schwartz, A.J.; Schwarz, M.; Seeman, J.; Semertzidis, Y.K.; Seth, K.K.; Shafi, Q.; Shanahan, P.; Sharma, R.; Sharpe, S.R.; Shiozawa, M.; Shiltsev, V.; Sigurdson, K.; Sikivie, P.; Singh, J.; Sivers, D.; Skwarnicki, T.; Smith, N.; Sobczyk, J.; Sobel, H.; Soderberg, M.; Song, Y.H.; Soni, A.; Souder, P.; Sousa, A.; Spitz, J.; Stancari, M.; Stavenga, G.C.; Steffen, J.H.; Stepanyan, S.; Stoeckinger, D.; Stone, S.; Strait, J.; Strassler, M.; Sulai, I.A.; Sundrum, R.; Svoboda, R.; Szczerbinska, B.; Szelc, A.; Takeuchi, T.; Tanedo, P.; Taneja, S.; Tang, J.; Tanner, D.B.; Tayloe, R.; Taylor, I.; Thomas, J.; Thorn, C.; Tian, X.; Tice, B.G.; Tobar, M.; Tolich, N.; Toro, N.; Towner, I.S.; Tsai, Y.; Tschirhart, R.; Tunnell, C.D.; Tzanov, M.; Upadhye, A.; Urheim, J.; Vahsen, S.; Vainshtein, A.; Valencia, E.; Van de Water, R.G.; Van de Water, R.S.; Velasco, M.; Vogel, J.; Vogel, P.; Vogelsang, W.; Wah, Y.W.; Walker, D.; Weiner, N.; Weltman, A.; Wendell, R.; Wester, W.; Wetstein, M.; White, C.; Whitehead, L.; Whitmore, J.; Widmann, E.; Wiedemann, G.; Wilkerson, J.; Wilkinson, G.; Wilson, P.; Wilson, R.J.; Winter, W.; Wise, M.B.; Wodin, J.; Wojcicki, S.; Wojtsekhowski, B.; Wongjirad, T.; Worcester, E.; Wurtele, J.; Xin, T.; Xu, J.; Yamanaka, T.; Yamazaki, Y.; Yavin, I.; Yeck, J.; Yeh, M.; Yokoyama, M.; Yoo, J.; Young, A.; Zimmerman, E.; Zioutas, K.; Zisman, M.; Zupan, J.; Zwaska, R.; Intensity Frontier Workshop

    2012-01-01

    The Proceedings of the 2011 workshop on Fundamental Physics at the Intensity Frontier. Science opportunities at the intensity frontier are identified and described in the areas of heavy quarks, charged leptons, neutrinos, proton decay, new light weakly-coupled particles, and nucleons, nuclei, and atoms.

  16. Intense, ultrashort light and dense, hot matter

    Indian Academy of Sciences (India)

    This article presents an overview of the physics and applications of the interaction of high intensity laser light with matter. It traces the crucial advances that have occurred over the past few decades in laser technology and nonlinear optics and then discusses physical phenomena that occur in intense laser fields and their ...

  17. African Journal of Anaesthesia and Intensive Care

    African Journals Online (AJOL)

    The purpose of the African Journal of Anaesthesia and Intensive Care is to provide a medium for the dissemination of original works in Africa and other parts of the world about anaesthesia and intensive care including the application of basic sciences ...

  18. Development and comparison of different intensity duration ...

    African Journals Online (AJOL)

    Nigerian Journal of Technology ... Microsoft Excel software was used to develop exponential, logarithmic and power intensity-duration-frequency models for return period (T) of duration-frequency models for return period (T) of between 2 years and 100 years using rainfall intensity data for durations of 2, 5, 10, 15, 30, 60, ...

  19. Treatment intensity and childhood apraxia of speech

    NARCIS (Netherlands)

    Namasivayam, Aravind K.; Pukonen, Margit; Goshulak, Debra; Hard, Jennifer; Rudzicz, Frank; Rietveld, Toni; Maassen, Ben; Kroll, Robert; van Lieshout, Pascal

    BackgroundIntensive treatment has been repeatedly recommended for the treatment of speech deficits in childhood apraxia of speech (CAS). However, differences in treatment outcomes as a function of treatment intensity have not been systematically studied in this population. AimTo investigate the

  20. Government expenditure and energy intensity in China

    International Nuclear Information System (INIS)

    Yuxiang, Karl; Chen, Zhongchang

    2010-01-01

    The recent economic stimulus package of China has raised growing concern about its potential impact on energy demand and efficiency. To what extent does such expansion of government expenditure influence energy intensity? This question has not been well answered by the previous research. Using provincial panel data, this paper provides some evidence of a link between government expenditure and energy intensity in China. The empirical results demonstrate that the expansion of government expenditure since Asian financial crisis has exerted a significant influence on energy intensity. An increase in government expenditure in China leads to an increase in energy intensity. Further analysis compares such relationships in different economic situations. The comparison shows that such positive effect of government expenditure remains significant after the alteration in economic situation. Therefore, the results suggest introducing some measures to consolidate China's existing gains in energy efficiency. The analysis also explains why the downward trend in energy intensity is reversed in China since 2002. (author)

  1. [Quality management in intensive care medicine].

    Science.gov (United States)

    Martin, J; Braun, J-P

    2013-09-01

    Treatment of critical ill patients in the intensive care unit is tantamount to well-designed risk or quality management. Several tools of quality management and quality assurance have been developed in intensive care medicine. In addition to extern quality assurance by benchmarking with regard to the intensive care medicine, peer review procedures have been established for external quality assurance in recent years. In the process of peer review of an intensive care unit (ICU), external physicians and nurses visit the ICU, evaluate on-site proceedings, and discuss with the managing team of the ICU possibilities for optimization. Furthermore, internal quality management in the ICU is possible based on the 10 quality indicators of the German Interdisciplinary Society for Intensive Care Medicine (DIVI, "Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin"). Thereby every ICU has numerous possibilities to improve their quality management system.

  2. High Intensity Exercise in Multiple Sclerosis

    DEFF Research Database (Denmark)

    Wens, Inez; Dalgas, Ulrik; Vandenabeele, Frank

    2015-01-01

    Introduction Low-to-moderate intensity exercise improves muscle contractile properties and endurance capacity in multiple sclerosis (MS). The impact of high intensity exercise remains unknown. Methods Thirty-four MS patients were randomized into a sedentary control group (SED, n = 11) and 2...... exercise groups that performed 12 weeks of a high intensity interval (HITR, n = 12) or high intensity continuous cardiovascular training (HCTR, n = 11), both in combination with resistance training. M.vastus lateralis fiber cross sectional area (CSA) and proportion, knee-flexor/extensor strength, body...... composition, maximal endurance capacity and self-reported physical activity levels were assessed before and after 12 weeks. Results Compared to SED, 12 weeks of high intensity exercise increased mean fiber CSA (HITR: +21±7%, HCTR: +23±5%). Furthermore, fiber type I CSA increased in HCTR (+29±6%), whereas type...

  3. Evaluation of gamma-ray intensities

    International Nuclear Information System (INIS)

    Yoshizawa, Yasukazu; Inoue, Hikaru; Hoshi, Masaharu; Shizuma, Kiyoshi; Iwata, Yosei.

    1980-04-01

    Relative intensities and intensities per decay of gamma rays were evaluated for 16 nuclides, 22 Na, 24 Na, 46 Sc, 54 Mn, 60 Co, 85 Sr, 88 Y, 95 Nb, sup(108m)Ag, 134 Cs, 133 Ba, 139 Ce, sup(180m)Hf, 198 Au, 203 Hg and 207 Bi. For most of these nuclides disintegration rates can be determined by means of β-γ or X-γ coincidence method. Since decay schemes of these nuclides are established, intensities per decay of strong gamma rays were accurately evaluated by using weak beta-ray branching ratios, relative gamma-ray intensities and internal conversion coefficients. Half-lives of the nuclides were also evaluated. Use of the nuclides, therefore, are recommended for precision intensity calibration of the detectors. (author)

  4. [Quality assurance concepts in intensive care medicine].

    Science.gov (United States)

    Brinkmann, A; Braun, J P; Riessen, R; Dubb, R; Kaltwasser, A; Bingold, T M

    2015-11-01

    Intensive care medicine (ICM) is characterized by a high degree of complexity and requires intense communication and collaboration on interdisciplinary and multiprofessional levels. In order to achieve good quality of care in this environment and to prevent errors, a proactive quality and error management as well as a structured quality assurance system are essential. Since the early 1990s, German intensive care societies have developed concepts for quality management and assurance in ICM. In 2006, intensive care networks were founded in different states to support the implementation of evidence-based knowledge into clinical routine and to improve medical outcome, efficacy, and efficiency in ICM. Current instruments and concepts of quality assurance in German ICM include core intensive care data from the data registry DIVI REVERSI, quality indicators, peer review in intensive care, IQM peer review, and various certification processes. The first version of German ICM quality indicators was published in 2010 by an interdisciplinary and interprofessional expert commission. Key figures, indicators, and national benchmarks are intended to describe the quality of structures, processes, and outcomes in intensive care. Many of the quality assurance tools have proved to be useful in clinical practice, but nationwide implementation still can be improved.

  5. Dynamic jump intensities and risk premiums

    DEFF Research Database (Denmark)

    Christoffersen, Peter; Ornthanalai, Chayawat; Jacobs, Kris

    2012-01-01

    We build a new class of discrete-time models that are relatively easy to estimate using returns and/or options. The distribution of returns is driven by two factors: dynamic volatility and dynamic jump intensity. Each factor has its own risk premium. The models significantly outperform standard...... models without jumps when estimated on S&P500 returns. We find very strong support for time-varying jump intensities. Compared to the risk premium on dynamic volatility, the risk premium on the dynamic jump intensity has a much larger impact on option prices. We confirm these findings using joint...

  6. Innovation system and knowledge-intensive entrepreneurship

    DEFF Research Database (Denmark)

    Timmermans, Bram

    2011-01-01

    The goal of this deliverable is to investigate the properties and the nature of knowledge-intensive entrepreneurship as a largely distributed phenomenon at firm, sector and national levels in Denmark. Following the guidelines previously developed in the Deliverable 2.2.1 “Innovation systems...... and knowledge-intensive entrepreneurship: Analytical framework and guidelines for case study research” I will investigate the interplay between national innovation systems and knowledge- intensive entrepreneurship by focusing on two main sectors: machine tools, and computer and related activities....

  7. Neutron intensity of fast reactor spent fuel

    Energy Technology Data Exchange (ETDEWEB)

    Takamatsu, Misao; Aoyama, Takafumi [Power Reactor and Nuclear Fuel Development Corp., Oarai, Ibaraki (Japan). Oarai Engineering Center

    1998-03-01

    Neutron intensity of spent fuel of the JOYO Mk-II core with a burnup of 62,500 MWd/t and cooling time of 5.2 years was measured at the spent fuel storage pond. The measured data were compared with the calculated values based on the JOYO core management code system `MAGI`, and the average C/E approximately 1.2 was obtained. It was found that the axial neutron intensity didn`t simply follow the burnup distribution, and the neutron intensity was locally increased at the bottom end of the fuel region due to an accumulation of {sup 244}Cm. (author)

  8. Intense Ion Pulses for Radiation Effects Research

    Science.gov (United States)

    2017-04-01

    induction linear accelerator that has been developed to deliver intense, up to 50 nC/pulse/mm2, sub-ns pulses of light ions with kinetic energy up to 1.2...II induction linear accelerator for intense ion beam pulses at Berkeley Lab. Figure 3. Helium current and integrated charge versus time at the...under contracts DE-AC02-205CH11231 and DE-AC52-07NA27344. JOURNAL OF RADIATION EFFECTS, Research and Engineering Vol. 35, No. 1, April 2017 158 INTENSE

  9. Generation of intensity duration frequency curves and intensity temporal variability pattern of intense rainfall for Lages/SC

    Directory of Open Access Journals (Sweden)

    Célio Orli Cardoso

    2014-04-01

    Full Text Available The objective of this work was to analyze the frequency distribution and intensity temporal variability of intense rainfall for Lages/SC from diary pluviograph data. Data on annual series of maximum rainfalls from rain gauges of the CAV-UDESC Weather Station in Lages/SC were used from 2000 to 2009. Gumbel statistic distribution was applied in order to obtain the rainfall height and intensity in the following return periods: 2, 5, 10, 15 and 20 years. Results showed intensity-duration-frequency curves (I-D-F for those return periods, as well as I-D-F equations: i=2050.Tr0,20.(t+30-0,89, where i was the intensity, Tr was the rainfall return periods and t was the rainfall duration. For the intensity of temporal variability pattern along of the rainfall duration time, the convective, or advanced pattern was the predominant, with larger precipitate rainfalls in the first half of the duration. The same pattern presented larger occurrences in the spring and summer stations.

  10. Intensive educational course in allergy and immunology.

    Science.gov (United States)

    Elizalde, A; Perez, E E; Sriaroon, P; Nguyen, D; Lockey, R F; Dorsey, M J

    2012-09-01

    A one-day intensive educational course on allergy and immunology theory and diagnostic procedure significantly increased the competency of allergy and immunology fellows-in-training. © 2012 John Wiley & Sons A/S.

  11. Data Intensive Systems (DIS) Benchmark Performance Summary

    National Research Council Canada - National Science Library

    Musmanno, Joseph

    2003-01-01

    .... However, elements such as larger caches, prefetching, and multithreading do not address the needs of data-intensive DoD applications, which consequently operate at rates far below the peak processor- capacity...

  12. Intensive care patient diaries in Scandinavia

    DEFF Research Database (Denmark)

    Egerod, Ingrid; Storli, Sissel Lisa; Åkerman, Eva

    2011-01-01

    Critical illness and intensive care therapy are often followed by psychological problems such as nightmares, hallucinations, delusions, anxiety, depression, and symptoms of posttraumatic stress. Intensive care patient diaries have been kept by nurses and the patients' family since the early 1990s...... in the Scandinavian countries to help critically ill patients come to terms with their illness after hospital discharge. The aim of the study was to describe and compare the emergence and evolution of intensive care patient diaries in Denmark, Norway, and Sweden. The study had a comparative international design using...... secondary analysis of qualitative data generated by key-informant telephone interviews with intensive care nurses (n=114). The study showed that diaries were introduced concurrently in the three Scandinavian countries as a grass-roots initiative by mutual cross-national inspiration. The concept has evolved...

  13. Intelligent agents in data-intensive computing

    CERN Document Server

    Correia, Luís; Molina, José

    2016-01-01

    This book presents new approaches that advance research in all aspects of agent-based models, technologies, simulations and implementations for data intensive applications. The nine chapters contain a review of recent cross-disciplinary approaches in cloud environments and multi-agent systems, and important formulations of data intensive problems in distributed computational environments together with the presentation of new agent-based tools to handle those problems and Big Data in general. This volume can serve as a reference for students, researchers and industry practitioners working in or interested in joining interdisciplinary work in the areas of data intensive computing and Big Data systems using emergent large-scale distributed computing paradigms. It will also allow newcomers to grasp key concepts and potential solutions on advanced topics of theory, models, technologies, system architectures and implementation of applications in Multi-Agent systems and data intensive computing. .

  14. Intensive Care Management of Patients with Cirrhosis.

    Science.gov (United States)

    Olson, Jody C

    2018-06-01

    Cirrhosis is a major worldwide health problem which results in a high level of morbidity and mortality. Patients with cirrhosis who require intensive care support have high mortality rates of near 50%. The goal of this review is to address the management of common complications of cirrhosis in the ICU. Recent epidemiological studies have shown an increase in hospitalizations due to advanced liver disease with an associated increase in intensive care utilization. Given an increasing burden on the healthcare system, it is imperative that we strive to improve our management cirrhotic patients in the intensive care unit. Large studies evaluating the management of patients in the intensive care setting are lacking. To date, most recommendations are based on extrapolation of data from studies in cirrhosis outside of the ICU or by applying general critical care principles which may or may not be appropriate for the critically ill cirrhotic patient. Future research is required to answer important management questions.

  15. Physiotherapy patients in intensive care unit

    Directory of Open Access Journals (Sweden)

    Agnieszka Miszewska

    2017-01-01

    Full Text Available Regulation of the Minister of Health dated 20/12/2012 on medical standards of conduct in the field of Anaesthesiology and intensive therapy, for carrying out the activities of healing in section § 2.2 intense therapy defines as: "any proceedings to maintain vital functions, and treatment of patients in life-threatening States, caused by potentially reversible renal failure one or more basic body systems, in particular the respiration, cardiovascular, central nervous system". However, in point § 12.1. We read that "Treatment of patients under intensive care in the hospital is an interdisciplinary". Annex 1 to this regulation refers to the work of physiotherapist in the ICU (INTENSIVE CARE UNITS and reads as follows: "the equivalent of at least 0.5 FTE-physical therapist-up to a range of benefits to be performed (the third reference level". [6

  16. Evaluation of gamma-ray intensities

    International Nuclear Information System (INIS)

    Yoshizawa, Yasukazu; Inoue, Hikaru; Hoshi, Masaharu; Shizuma, Kiyoshi; Iwata, Yosei.

    1978-03-01

    Results of literature survey and evaluation of relative intensities and intensities per decay of gamma rays are presented. Evaluations were made for 22 Na, 24 Na, 46 Sc, 48 Sc, 48 V, 54 Mn, 57 Co, 60 Co, 85 Sr, 88 Y, 95 Nb, 95 Zr, sup(108m)Ag, 134 Cs, 137 Cs, 144 Ce, 144 Pr, 203 Hg, and 207 Bi. For eight of the nuclides, the half-lives were also evaluated. (auth.)

  17. Solar flares and the cosmic ray intensity

    International Nuclear Information System (INIS)

    Hatton, C.J.

    1980-01-01

    The relationship between the cosmic ray intensity and solar activity during solar cycle 20 is discussed. A model is developed whereby it is possible to simulate the observed cosmic ray intensity from the observed number of solar flares of importance >= 1. This model leads to a radius for the modulation region of 60-70 AU. It is suggested that high speed solar streams also made a small contribution to the modulation of cosmic rays during solar cycle 20. (orig.)

  18. Developing data-intensive applications on Facebook

    OpenAIRE

    Hribar, Rok

    2011-01-01

    Facebook applications are becoming an important asset to companies in marketing and promotion of their services or products. For easier and more efficient marketing for companies there are many different data-intensive Facebook applications that businesses can use. Data-intensive applications require large amounts of data, the greater part of the implementation is used primarily for searching and transfering data from database. In my graduation thesis I focused on the development, transfe...

  19. Early stages of technology intensive companies

    OpenAIRE

    Muhos, M. (Matti)

    2011-01-01

    Abstract This study aims to clarify the early development stages of technology intensive companies. The current literature does not offer an extensive review of stage perspectives for company growth – the overall picture of the field is somewhat vague. The evolution of this field remains unclear as well as the current state. Further, recent empirical stage models focusing on technology intensive companies have not been delineated. As companies move through their early stages, they face ev...

  20. Intensity of plant collecting in southern Africa

    Directory of Open Access Journals (Sweden)

    G. E. Gibbs Russell

    1984-12-01

    Full Text Available The intensity of plant collecting in southern Africa is mapped using records from the Pretoria National Herbarium Computerized Information System (PRECIS, For the entire area, over 85% of the quarter degree grid squares have fewer than 100 specimens recorded. Collecting intensities are compared for different countries, biomes and climatic zones. Future field work from the National Herbarium will be concentrated in areas most seriously under-collected.

  1. Proton energy dependence of slow neutron intensity

    International Nuclear Information System (INIS)

    Teshigawara, Makoto; Harada, Masahide; Watanabe, Noboru; Kai, Tetsuya; Sakata, Hideaki; Ikeda, Yujiro

    2001-01-01

    The choice of the proton energy is an important issue for the design of an intense-pulsed-spallation source. The optimal proton beam energy is rather unique from a viewpoint of the leakage neutron intensity but no yet clear from the slow-neutron intensity view point. It also depends on an accelerator type. Since it is also important to know the proton energy dependence of slow-neutrons from the moderators in a realistic target-moderator-reflector assembly (TMRA). We studied on the TMRA proposed for Japan Spallation Neutron Source. The slow-neutron intensities from the moderators per unit proton beam power (MW) exhibit the maximum at about 1-2 GeV. At higher proton energies the intensity per MW goes down; at 3 and 50 GeV about 0.91 and 0.47 times as low as that at 1 GeV. The proton energy dependence of slow-neutron intensities was found to be almost the same as that of total neutron yield (leakage neutrons) from the same bare target. It was also found that proton energy dependence was almost the same for the coupled and decoupled moderators, regardless the different moderator type, geometry and coupling scheme. (author)

  2. Tornado intensity estimated from damage path dimensions.

    Directory of Open Access Journals (Sweden)

    James B Elsner

    Full Text Available The Newcastle/Moore and El Reno tornadoes of May 2013 are recent reminders of the destructive power of tornadoes. A direct estimate of a tornado's power is difficult and dangerous to get. An indirect estimate on a categorical scale is available from a post-storm survery of the damage. Wind speed bounds are attached to the scale, but the scale is not adequate for analyzing trends in tornado intensity separate from trends in tornado frequency. Here tornado intensity on a continuum is estimated from damage path length and width, which are measured on continuous scales and correlated to the EF rating. The wind speeds on the EF scale are treated as interval censored data and regressed onto the path dimensions and fatalities. The regression model indicates a 25% increase in expected intensity over a threshold intensity of 29 m s(-1 for a 100 km increase in path length and a 17% increase in expected intensity for a one km increase in path width. The model shows a 43% increase in the expected intensity when fatalities are observed controlling for path dimensions. The estimated wind speeds correlate at a level of .77 (.34, .93 [95% confidence interval] with a small sample of wind speeds estimated independently from a doppler radar calibration. The estimated wind speeds allow analyses to be done on the tornado database that are not possible with the categorical scale. The modeled intensities can be used in climatology and in environmental and engineering applications. Research is needed to understand the upward trends in path length and width.

  3. Tornado intensity estimated from damage path dimensions.

    Science.gov (United States)

    Elsner, James B; Jagger, Thomas H; Elsner, Ian J

    2014-01-01

    The Newcastle/Moore and El Reno tornadoes of May 2013 are recent reminders of the destructive power of tornadoes. A direct estimate of a tornado's power is difficult and dangerous to get. An indirect estimate on a categorical scale is available from a post-storm survery of the damage. Wind speed bounds are attached to the scale, but the scale is not adequate for analyzing trends in tornado intensity separate from trends in tornado frequency. Here tornado intensity on a continuum is estimated from damage path length and width, which are measured on continuous scales and correlated to the EF rating. The wind speeds on the EF scale are treated as interval censored data and regressed onto the path dimensions and fatalities. The regression model indicates a 25% increase in expected intensity over a threshold intensity of 29 m s(-1) for a 100 km increase in path length and a 17% increase in expected intensity for a one km increase in path width. The model shows a 43% increase in the expected intensity when fatalities are observed controlling for path dimensions. The estimated wind speeds correlate at a level of .77 (.34, .93) [95% confidence interval] with a small sample of wind speeds estimated independently from a doppler radar calibration. The estimated wind speeds allow analyses to be done on the tornado database that are not possible with the categorical scale. The modeled intensities can be used in climatology and in environmental and engineering applications. Research is needed to understand the upward trends in path length and width.

  4. ON COMPUTING UPPER LIMITS TO SOURCE INTENSITIES

    International Nuclear Information System (INIS)

    Kashyap, Vinay L.; Siemiginowska, Aneta; Van Dyk, David A.; Xu Jin; Connors, Alanna; Freeman, Peter E.; Zezas, Andreas

    2010-01-01

    A common problem in astrophysics is determining how bright a source could be and still not be detected in an observation. Despite the simplicity with which the problem can be stated, the solution involves complicated statistical issues that require careful analysis. In contrast to the more familiar confidence bound, this concept has never been formally analyzed, leading to a great variety of often ad hoc solutions. Here we formulate and describe the problem in a self-consistent manner. Detection significance is usually defined by the acceptable proportion of false positives (background fluctuations that are claimed as detections, or Type I error), and we invoke the complementary concept of false negatives (real sources that go undetected, or Type II error), based on the statistical power of a test, to compute an upper limit to the detectable source intensity. To determine the minimum intensity that a source must have for it to be detected, we first define a detection threshold and then compute the probabilities of detecting sources of various intensities at the given threshold. The intensity that corresponds to the specified Type II error probability defines that minimum intensity and is identified as the upper limit. Thus, an upper limit is a characteristic of the detection procedure rather than the strength of any particular source. It should not be confused with confidence intervals or other estimates of source intensity. This is particularly important given the large number of catalogs that are being generated from increasingly sensitive surveys. We discuss, with examples, the differences between these upper limits and confidence bounds. Both measures are useful quantities that should be reported in order to extract the most science from catalogs, though they answer different statistical questions: an upper bound describes an inference range on the source intensity, while an upper limit calibrates the detection process. We provide a recipe for computing upper

  5. A savanna response to precipitation intensity.

    Directory of Open Access Journals (Sweden)

    Ryan S Berry

    Full Text Available As the atmosphere warms, precipitation events are becoming less frequent but more intense. A three-year experiment in Kruger National Park, South Africa, found that fewer, more intense precipitation events encouraged woody plant encroachment. To test whether or not these treatment responses persisted over time, here, we report results from all five years of that experiment. Grass growth, woody plant growth, total fine root number and area and hydrologic tracer uptake by grasses and woody plants were measured in six treated plots (8 m by 8 m and six control plots. Treatment effects on soil moisture were measured continuously in one treated and one control plot. During the fourth year, increased precipitation intensity treatments continued to decrease water flux in surface soils (0-10 cm, increase water flux in deeper soils (20+ cm, decrease grass growth and increase woody plant growth. Greater root numbers at 20-40 cm and greater woody plant uptake of a hydrological tracer from 45-60 cm suggested that woody plants increased growth by increasing root number and activity (but not root area in deeper soils. During the fifth year, natural precipitation events were large and intense so treatments had little effect on precipitation intensity or plant available water. Consistent with this effective treatment removal, there was no difference in grass or woody growth rates between control and treated plots, although woody plant biomass remained higher in treated than control plots due to treatment effects in the previous four years. Across the five years of this experiment, we found that 1 small increases in precipitation intensity can result in large increases in deep (20-130 cm soil water availability, 2 plant growth responses to precipitation intensity are rapid and disappear quickly, and 3 because woody plants accumulate biomass, occasional increases in precipitation intensity can result in long-term increases in woody plant biomass (i.e., shrub

  6. FOREIGN DIRECT INVESTMENT INTENSITY EFFECTS ON TFP INTENSITY OF ASEAN 5 PLUS 2

    OpenAIRE

    Elsadig Musa Ahmed

    2008-01-01

    This study aims to investigate the role of foreign direct investment (FDI) intensity through decomposition of labour productivity growth into contributions of capital deepening, increased usage of foreign direct investment (FDI) intensity, and the simultaneous contribution of the quality of these factors. This has expressed as the contribution of total factor productivity (TFP) intensity growth in achieving productivity driven growth in ASEAN 5 (Malaysia, Indonesia, Philippines, Singapore and...

  7. Numerical evaluation of the intensity transport equation for well-known wavefronts and intensity distributions

    Science.gov (United States)

    Campos-García, Manuel; Granados-Agustín, Fermín.; Cornejo-Rodríguez, Alejandro; Estrada-Molina, Amilcar; Avendaño-Alejo, Maximino; Moreno-Oliva, Víctor Iván.

    2013-11-01

    In order to obtain a clearer interpretation of the Intensity Transport Equation (ITE), in this work, we propose an algorithm to solve it for some particular wavefronts and its corresponding intensity distributions. By simulating intensity distributions in some planes, the ITE is turns into a Poisson equation with Neumann boundary conditions. The Poisson equation is solved by means of the iterative algorithm SOR (Simultaneous Over-Relaxation).

  8. Gait Recognition and Walking Exercise Intensity Estimation

    Directory of Open Access Journals (Sweden)

    Bor-Shing Lin

    2014-04-01

    Full Text Available Cardiovascular patients consult doctors for advice regarding regular exercise, whereas obese patients must self-manage their weight. Because a system for permanently monitoring and tracking patients’ exercise intensities and workouts is necessary, a system for recognizing gait and estimating walking exercise intensity was proposed. For gait recognition analysis, αβ filters were used to improve the recognition of athletic attitude. Furthermore, empirical mode decomposition (EMD was used to filter the noise of patients’ attitude to acquire the Fourier transform energy spectrum. Linear discriminant analysis was then applied to this energy spectrum for training and recognition. When the gait or motion was recognized, the walking exercise intensity was estimated. In addition, this study addressed the correlation between inertia and exercise intensity by using the residual function of the EMD and quadratic approximation to filter the effect of the baseline drift integral of the acceleration sensor. The increase in the determination coefficient of the regression equation from 0.55 to 0.81 proved that the accuracy of the method for estimating walking exercise intensity proposed by Kurihara was improved in this study.

  9. Steganography based on pixel intensity value decomposition

    Science.gov (United States)

    Abdulla, Alan Anwar; Sellahewa, Harin; Jassim, Sabah A.

    2014-05-01

    This paper focuses on steganography based on pixel intensity value decomposition. A number of existing schemes such as binary, Fibonacci, Prime, Natural, Lucas, and Catalan-Fibonacci (CF) are evaluated in terms of payload capacity and stego quality. A new technique based on a specific representation is proposed to decompose pixel intensity values into 16 (virtual) bit-planes suitable for embedding purposes. The proposed decomposition has a desirable property whereby the sum of all bit-planes does not exceed the maximum pixel intensity value, i.e. 255. Experimental results demonstrate that the proposed technique offers an effective compromise between payload capacity and stego quality of existing embedding techniques based on pixel intensity value decomposition. Its capacity is equal to that of binary and Lucas, while it offers a higher capacity than Fibonacci, Prime, Natural, and CF when the secret bits are embedded in 1st Least Significant Bit (LSB). When the secret bits are embedded in higher bit-planes, i.e., 2nd LSB to 8th Most Significant Bit (MSB), the proposed scheme has more capacity than Natural numbers based embedding. However, from the 6th bit-plane onwards, the proposed scheme offers better stego quality. In general, the proposed decomposition scheme has less effect in terms of quality on pixel value when compared to most existing pixel intensity value decomposition techniques when embedding messages in higher bit-planes.

  10. Affect intensity and processing fluency of deterrents.

    Science.gov (United States)

    Holman, Andrei

    2013-01-01

    The theory of emotional intensity (Brehm, 1999) suggests that the intensity of affective states depends on the magnitude of their current deterrents. Our study investigated the role that fluency--the subjective experience of ease of information processing--plays in the emotional intensity modulations as reactions to deterrents. Following an induction phase of good mood, we manipulated both the magnitude of deterrents (using sets of photographs with pre-tested potential to instigate an emotion incompatible with the pre-existent affective state--pity) and their processing fluency (normal vs. enhanced through subliminal priming). Current affective state and perception of deterrents were then measured. In the normal processing conditions, the results revealed the cubic effect predicted by the emotional intensity theory, with the initial affective state being replaced by the one appropriate to the deterrent only in participants exposed to the high magnitude deterrence. In the enhanced fluency conditions the emotional intensity pattern was drastically altered; also, the replacement of the initial affective state occurred at a lower level of deterrence magnitude (moderate instead of high), suggesting the strengthening of deterrence emotional impact by enhanced fluency.

  11. Analgesia, sedation, and memory of intensive care.

    Science.gov (United States)

    Capuzzo, M; Pinamonti, A; Cingolani, E; Grassi, L; Bianconi, M; Contu, P; Gritti, G; Alvisi, R

    2001-09-01

    The purpose of this article was to investigate the relationship between analgesia, sedation, and memory of intensive care. One hundred fifty-two adult, cooperative intensive care unit (ICU) patients were interviewed 6 months after hospital discharge about their memory of intensive care. The patient was considered to be cooperative when he/she was aware of self and environment at the interview. The patients were grouped as follows: A (45 patients) substantially no sedation, B (85) morphine, and C (22) morphine and other sedatives. The patients having no memory of intensive care were 38%, 34%, and 23% respectively, in the three groups. They were less ill, according to SAPS II (P memories was not different among the three groups. Females reported at least one emotional memory more frequently than males (odds ratio 4.17; 95% CI 10.97-1.59). The patients receiving sedatives in the ICU are not comparable with those receiving only opiates or nothing, due to the different clinical condition. The lack of memory of intensive care is present in one third of patients and is influenced more by length of stay in ICU than by the sedation received. Sedation does not influence the incidence of factual, sensation, and emotional memories of ICU admitted patients. Females have higher incidences of emotional memories than males. Copyright 2001 by W.B. Saunders Company

  12. Stimulated Raman backscattering at high laser intensities

    Energy Technology Data Exchange (ETDEWEB)

    Skoric, M M [Vinca Inst. of Nuclear Sciences, Belgrade (Yugoslavia); Tajima, Toshiki; Sasaki, Akira; Maluckov, A; Jovanovic, M

    1998-03-01

    Signatures of Stimulated Raman backscattering of a short-pulse high-intensity laser interacting with an underdense plasma are discussed. We introduce a nonlinear three-wave interaction model that accounts for laser pump depletion and relativistic detuning. A mechanism is revealed based on a generic route to chaos, that predicts a progressive increase of the backscatter complexity with a growing laser intensity. Importance of kinetic effects is outlined and demonstrated in fluid-hybrid and particle simulations. As an application, we show that spectral anomalies of the backscatter, predicted by the above model, are consistent with recent sub-picosecond, high-intensity laser gas-target measurements at Livermore and elsewhere. Finally, a recently proposed scheme for generation of ultra-short, low-prepulse laser pulses by Raman backscattering in a thin foil target, is shown. (author)

  13. Infrared line intensities of chlorine monoxide

    Science.gov (United States)

    Kostiuk, T.; Faris, J. L.; Mumma, M. J.; Deming, D.; Hillman, J. J.

    1986-01-01

    Absolute infrared line intensities of several ClO lines in the rotational-vibrational (1-0) band were measured using infrared heterodyne spectroscopy near 12 microns. A measurement technique using combined ultraviolet absorption and infrared line measurements near 9.5 microns and 12 microns permitted an accurate determination of the column densities of O3 and ClO in the absorption cell and thus improved ClO line intensities. Results indicate ClO line and band intensities approximately 2.4 times lower than previous experimental results. Effects of possible failure of local thermodynamic equilibrium conditions in the absorption cell and the implication of the results for stratospheric ClO measurements in the infrared are discussed.

  14. Changing land use intensity in Europe

    DEFF Research Database (Denmark)

    van der Sluis, Theo; Pedroli, Bas; Kristensen, Søren Bech Pilgaard

    2016-01-01

    In recent decades the intensification of agricultural production in many European countries has been one of the key components of land-use change. The impact of agricultural intensification varies according to national and local contexts and a greater understanding of the drivers of intensification...... will help to mitigate against its negative impacts and harness potential benefits. This paper analyses changes in land use intensity in six case studies in Europe. A total of 437 landowners were interviewed and their responses were analysed in relation to changes in land use intensity and agricultural...... use intensity) versus those in the Netherlands, Denmark and Greece (decreasing). In the Mediterranean cases we observe a process where agriculture is becoming increasingly marginalised, at the same time as changes in function with regard to urbanisation and recreational land uses have taken place...

  15. Intense pulsed ion beams for fusion applications

    International Nuclear Information System (INIS)

    Humphries, S. Jr.

    1980-04-01

    The subject of this review paper is the field of intense pulsed ion beam generation and the potential application of the beams to fusion research. Considerable progress has been made over the past six years. The ion injectors discussed utilize the introduction of electrons into vacuum acceleration gaps in conjunction with high voltage pulsed power technology to achieve high output current. Power levels from injectors exceeding 1000 MW/cm 2 have been obtained for pulse lengths on the order of 10 -7 sec. The first part of the paper treats the physics and technology of intense ion beams. The second part is devoted to applications of intense ion beams in fusion research. A number of potential uses in magnetic confinement systems have been proposed

  16. Making thermodynamic functions of nanosystems intensive

    International Nuclear Information System (INIS)

    Nassimi, A M; Parsafar, G A

    2007-01-01

    The potential energy of interaction among particles in many systems is proportional to r -α . In systems for which α< d, we encounter nonextensive (nonintensive) thermodynamic functions, where d is the space dimension. A scaling parameter, N-tilde, has been introduced to make the nonextensive (nonintensive) thermodynamic functions of such systems extensive (intensive). Our simulation results show that this parameter is not capable of making the thermodynamic functions of a nanosystem extensive (intensive). Here we have presented a theoretical justification for N-tilde. Then we have generalized this scaling parameter to be capable of making the nonextensive (nonintensive) thermodynamic functions of nanosystems extensive (intensive). This generalized parameter is proportional to the potential energy per particle at zero temperature

  17. Spin and radiation in intense laser fields

    International Nuclear Information System (INIS)

    Walser, M.W.; Urbach, D.J.; Hatsagortsyan, K.Z.; Hu, S.X.; Keitel, C.H.

    2002-01-01

    The spin dynamics and its reaction on the particle motion are investigated for free and bound electrons in intense linearly polarized laser fields. Employing both classical and quantum treatments we analytically evaluate the spin oscillation of free electrons in intense laser fields and indicate the effect of spin-orbit coupling on the motion of the electron. In Mott scattering an estimation for the spin oscillation is derived. In intense laser ion dynamics spin signatures are studied in detail with emphasis on high-order harmonic generation in the tunneling regime. First- and second-order calculations in the ratio of electron velocity and the speed of light show spin signatures in the radiation spectrum and spin-orbit effects in the electron polarization

  18. Intensity and directionality of bat echolocation signals

    DEFF Research Database (Denmark)

    Jakobsen, Lasse; Brinkløv, Signe; Surlykke, Annemarie

    2013-01-01

    will increase signal directionality in the field along with intensity thus increasing sonar range. During the last phase of prey pursuit, vespertilionid bats broaden their echolocation beam considerably, probably to counter evasive maneuvers of eared prey. We highlight how multiple call parameters (frequency......The paper reviews current knowledge of intensity and directionality of bat echolocation signals. Recent studies have revealed that echolocating bats can be much louder than previously believed. Bats previously dubbed "whispering" can emit calls with source levels up to 110 dB SPL at 10 cm......, duration, intensity, and directionality of echolocation signals) in unison define the search volume probed by bats and in turn how bats perceive their surroundings. Small changes to individual parameters can, in combination, drastically change the bat's perception, facilitating successful navigation...

  19. Workload modelling for data-intensive systems

    CERN Document Server

    Lassnig, Mario

    This thesis presents a comprehensive study built upon the requirements of a global data-intensive system, built for the ATLAS Experiment at CERN's Large Hadron Collider. First, a scalable method is described to capture distributed data management operations in a non-intrusive way. These operations are collected into a globally synchronised sequence of events, the workload. A comparative analysis of this new data-intensive workload against existing computational workloads is conducted, leading to the discovery of the importance of descriptive attributes in the operations. Existing computational workload models only consider the arrival rates of operations, however, in data-intensive systems the correlations between attributes play a central role. Furthermore, the detrimental effect of rapid correlated arrivals, so called bursts, is assessed. A model is proposed that can learn burst behaviour from captured workload, and in turn forecast potential future bursts. To help with the creation of a full representative...

  20. Intensive agriculture reduces soil biodiversity across Europe.

    Science.gov (United States)

    Tsiafouli, Maria A; Thébault, Elisa; Sgardelis, Stefanos P; de Ruiter, Peter C; van der Putten, Wim H; Birkhofer, Klaus; Hemerik, Lia; de Vries, Franciska T; Bardgett, Richard D; Brady, Mark Vincent; Bjornlund, Lisa; Jørgensen, Helene Bracht; Christensen, Sören; Hertefeldt, Tina D'; Hotes, Stefan; Gera Hol, W H; Frouz, Jan; Liiri, Mira; Mortimer, Simon R; Setälä, Heikki; Tzanopoulos, Joseph; Uteseny, Karoline; Pižl, Václav; Stary, Josef; Wolters, Volkmar; Hedlund, Katarina

    2015-02-01

    Soil biodiversity plays a key role in regulating the processes that underpin the delivery of ecosystem goods and services in terrestrial ecosystems. Agricultural intensification is known to change the diversity of individual groups of soil biota, but less is known about how intensification affects biodiversity of the soil food web as a whole, and whether or not these effects may be generalized across regions. We examined biodiversity in soil food webs from grasslands, extensive, and intensive rotations in four agricultural regions across Europe: in Sweden, the UK, the Czech Republic and Greece. Effects of land-use intensity were quantified based on structure and diversity among functional groups in the soil food web, as well as on community-weighted mean body mass of soil fauna. We also elucidate land-use intensity effects on diversity of taxonomic units within taxonomic groups of soil fauna. We found that between regions soil food web diversity measures were variable, but that increasing land-use intensity caused highly consistent responses. In particular, land-use intensification reduced the complexity in the soil food webs, as well as the community-weighted mean body mass of soil fauna. In all regions across Europe, species richness of earthworms, Collembolans, and oribatid mites was negatively affected by increased land-use intensity. The taxonomic distinctness, which is a measure of taxonomic relatedness of species in a community that is independent of species richness, was also reduced by land-use intensification. We conclude that intensive agriculture reduces soil biodiversity, making soil food webs less diverse and composed of smaller bodied organisms. Land-use intensification results in fewer functional groups of soil biota with fewer and taxonomically more closely related species. We discuss how these changes in soil biodiversity due to land-use intensification may threaten the functioning of soil in agricultural production systems. © 2014 John Wiley

  1. The future of intensive care medicine.

    Science.gov (United States)

    Blanch, L; Annane, D; Antonelli, M; Chiche, J D; Cuñat, J; Girard, T D; Jiménez, E J; Quintel, M; Ugarte, S; Mancebo, J

    2013-03-01

    Intensive care medical training, whether as a primary specialty or as secondary add-on training, should include key competences to ensure a uniform standard of care, and the number of intensive care physicians needs to increase to keep pace with the growing and anticipated need. The organisation of intensive care in multiple specialty or central units is heterogeneous and evolving, but appropriate early treatment and access to a trained intensivist should be assured at all times, and intensivists should play a pivotal role in ensuring communication and high-quality care across hospital departments. Structures now exist to support clinical research in intensive care medicine, which should become part of routine patient management. However, more translational research is urgently needed to identify areas that show clinical promise and to apply research principles to the real-life clinical setting. Likewise, electronic networks can be used to share expertise and support research. Individuals, physicians and policy makers need to allow for individual choices and priorities in the management of critically ill patients while remaining within the limits of economic reality. Professional scientific societies play a pivotal role in supporting the establishment of a defined minimum level of intensive health care and in ensuring standardised levels of training and patient care by promoting interaction between physicians and policy makers. The perception of intensive care medicine among the general public could be improved by concerted efforts to increase awareness of the services provided and of the successes achieved. Copyright © 2012 Elsevier España, S.L. and SEMICYUC. All rights reserved.

  2. Locating irregularly shaped clusters of infection intensity

    DEFF Research Database (Denmark)

    Yiannakoulias, Niko; Wilson, Shona; Kariuki, H. Curtis

    2010-01-01

    of infection intensity identifies two small areas within the study region in which infection intensity is elevated, possibly due to local features of the physical or social environment. Collectively, our results show that the "greedy growth scan" is a suitable method for exploratory geographical analysis...... for cluster detection. Real data are based on samples of hookworm and S. mansoni from Kitengei, Makueni district, Kenya. Our analysis of simulated data shows how methods able to find irregular shapes are more likely to identify clusters along rivers than methods constrained to fixed geometries. Our analysis...

  3. Solar cycle variations in IMF intensity

    International Nuclear Information System (INIS)

    King, J.H.

    1979-01-01

    Annual averages of logarithms of hourly interplanetary magnetic field (IMF) intensities, obtained from geocentric spacecraft between November 1963 and December 1977, reveal the following solar cycle variation. For 2--3 years at each solar minimum period, the IMF intensity is depressed by 10--15% relative to its mean value realized during a broad 9-year period contered at solar maximum. No systematic variations occur during this 9-year period. The solar minimum decrease, although small in relation to variations in some other solar wind parameters, is both statistically and physically significant

  4. Cryogenic semiconductor high-intensity radiation monitors

    International Nuclear Information System (INIS)

    Palmieri, V.G.; Bell, W.H.; Borer, K.; Casagrande, L.; Da Via, C.; Devine, S.R.H.; Dezillie, B.; Esposito, A.; Granata, V.; Hauler, F.; Jungermann, L.; Li, Z.; Lourenco, C.; Niinikoski, T.O.; Shea, V. O'; Ruggiero, G.; Sonderegger, P.

    2003-01-01

    This paper describes a novel technique to monitor high-intensity particle beams by means of a semiconductor detector. It consists of cooling a semiconductor detector down to cryogenic temperature to suppress the thermally generated leakage current and to precisely measure the integrated ionization signal. It will be shown that such a device provides very good linearity and a dynamic range wider than is possible with existing techniques. Moreover, thanks to the Lazarus effect, extreme radiation hardness can be achieved providing in turn absolute intensity measurements against precise calibration of the device at low beam flux

  5. Data-Intensive Science and Research Integrity.

    Science.gov (United States)

    Resnik, David B; Elliott, Kevin C; Soranno, Patricia A; Smith, Elise M

    2017-01-01

    In this commentary, we consider questions related to research integrity in data-intensive science and argue that there is no need to create a distinct category of misconduct that applies to deception related to processing, analyzing, or interpreting data. The best way to promote integrity in data-intensive science is to maintain a firm commitment to epistemological and ethical values, such as honesty, openness, transparency, and objectivity, which apply to all types of research, and to promote education, policy development, and scholarly debate concerning appropriate uses of statistics.

  6. Beam monitoring system for intense neutron source

    International Nuclear Information System (INIS)

    Tron, A.M.

    2001-01-01

    Monitoring system realizing novel principle of operation and allowing to register a two-dimensional beam current distribution within entire aperture (100...200 mm) of ion pipe for a time in nanosecond range has been designed and accomplished for beam control of the INR intense neutron source, for preventing thermo-mechanical damage of its first wall. Key unit of the system is monitor of two-dimensional beam current distribution, elements of which are high resistant to heating by the beam and to radiation off the source. The description of the system and monitor are presented. Implementation of the system for the future sources with more high intensities are discussed. (author)

  7. Intense positron beams and possible experiments

    International Nuclear Information System (INIS)

    Lynn, K.G.; Frieze, W.E.

    1983-07-01

    In this paper, we survey some of the ideas that have been proposed regarding the production of intense beams of low energy positrons. Various facilities to produce beams of this type are already under design or construction and other methods beyond those in use have been previously discussed. Moreover, a variety of potential experiments utilizing intense positron beams have been suggested. It is to be hoped that this paper can serve as a useful summary of some of the current ideas, as well as a stimulation for new ideas to be forthcoming at the workshop. 31 references

  8. Intense particle beam and multiple applications

    International Nuclear Information System (INIS)

    Ueda, M.; Machida, M.

    1988-01-01

    The Multiple Application Intense Particle Beam project is an experiment in which an injector of high energy neutral or ionized particles will be used to diagnose high density and high temperature plasmas. The acceleration of the particles will be carried out feeding a diode with a high voltage pulse produced by a Marx generator. Other apllications of intense particle beam generated by this injector that could be explored in the future include: heating and stabilization of compact toroids, treatment of metallic surfaces and ion implantation. (author) [pt

  9. Beam-intensity limitations in linear accelerators

    International Nuclear Information System (INIS)

    Jameson, R.A.

    1981-01-01

    Recent demand for high-intensity beams of various particles has renewed interest in the investigation of beam current and beam quality limits in linear RF and induction accelerators and beam-transport channels. Previous theoretical work is reviewed, and new work on beam matching and stability is outlined. There is a real need for extending the theory to handle the time evolution of beam emittance; some present work toward this goal is described. The role of physical constraints in channel intensity limitation is emphasized. Work on optimizing channel performance, particularly at low particle velocities, has resulted in major technological advances. The opportunities for combining such channels into arrays are discussed. 50 references

  10. Does intensity of physical activity moderate interrelationships among ...

    African Journals Online (AJOL)

    Abstract. The aim of this study was to determine whether perceived intensity of training ... intensity of training and functional capacity with various measures of health. Perceived intensity of training had marginally moderating effects on physical ...

  11. Locating irregularly shaped clusters of infection intensity

    Directory of Open Access Journals (Sweden)

    Niko Yiannakoulias

    2010-05-01

    Full Text Available Patterns of disease may take on irregular geographic shapes, especially when features of the physical environment influence risk. Identifying these patterns can be important for planning, and also identifying new environmental or social factors associated with high or low risk of illness. Until recently, cluster detection methods were limited in their ability to detect irregular spatial patterns, and limited to finding clusters that were roughly circular in shape. This approach has less power to detect irregularly-shaped, yet important spatial anomalies, particularly at high spatial resolutions. We employ a new method of finding irregularly-shaped spatial clusters at micro-geographical scales using both simulated and real data on Schistosoma mansoni and hookworm infection intensities. This method, which we refer to as the “greedy growth scan”, is a modification of the spatial scan method for cluster detection. Real data are based on samples of hookworm and S. mansoni from Kitengei, Makueni district, Kenya. Our analysis of simulated data shows how methods able to find irregular shapes are more likely to identify clusters along rivers than methods constrained to fixed geometries. Our analysis of infection intensity identifies two small areas within the study region in which infection intensity is elevated, possibly due to local features of the physical or social environment. Collectively, our results show that the “greedy growth scan” is a suitable method for exploratory geographical analysis of infection intensity data when irregular shapes are suspected, especially at micro-geographical scales.

  12. Low-intensity pulsed ultrasound: Nonunions

    Directory of Open Access Journals (Sweden)

    Dijkman Bernadette

    2009-01-01

    Full Text Available Nonunions occur in 5-10% of fractures and are characterized by the failure to heal without further intervention. Low intensity pulsed ultrasound therapy has been developed as an alternative to surgery in the treatment of nonunions. We describe a systematic review on trials of low-intensity pulsed ultrasound therapy for healing of nonunions. We searched the electronic databases Medline and the Cochrane library for articles on ultrasound and healing of nonunions published up to 2008. Trials selected for the review met the following criteria: treatment of at least one intervention group with low intensity pulsed ultrasound; inclusion of patients (humans with one or more nonunions (defined as "established" or as a failure to heal for a minimum of eight months after initial injury; and assessment of healing and time to healing, as determined radiographically. The following data were abstracted from the included studies: sample size, ultrasound treatment characteristics, nonunion location, healing rate, time to fracture healing, fracture age, and demographic information. We found 79 potentially eligible publications, of which 14 met our inclusion criteria. Of these, eight studies were used for data abstraction. Healing rates averaged 87%, (range 65.6%-100% among eight trials. Mean time to healing was 146.5 days, (range 56-219 days. There is evidence from trials that low-intensity pulsed ultrasound may be an effective treatment for healing of nonunions. More homogeneous and larger controlled series are needed to further investigate its efficacy.

  13. Particle theory and intense hadron facilities

    International Nuclear Information System (INIS)

    Ng, J.N.

    1989-05-01

    A brief overview of particle physics that can be done at an intense hadron facility (IHF) is given. The emphasis is placed on testing the standard model, light Higgs boson searches and CP violation, which are areas an IHF can do especially well

  14. Managing the overflow of intensive care patients

    NARCIS (Netherlands)

    van Rijsbergen, M.; Boucherie, Richardus J.; van Houdenhoven, M.; Litvak, Nelli

    2005-01-01

    Many hospitals in the Netherlands are confronted with capacity problems at their Intensive Care Units (ICUs) resulting in cancelling operations, overloading the staff with extra patients, or rejecting emergency patients. In practice, the last option is a common choice because juridically, as well as

  15. Patients' experiences of intensive care diaries

    DEFF Research Database (Denmark)

    Egerod, Ingrid; Bagger, Christine

    2010-01-01

    The aim of the study was to explore patients' experiences and perceptions of receiving intensive care diaries. A focus group and intensive care diaries for four former ICU patients were analysed to understand what works and what needs further development for patients who receive a diary. The stud......-ICU patients to gradually construct or reconstruct their own illness narrative, which is pieced together by their fragmented memory, the diary, the pictures, the hospital chart and the accounts from family and friends.......The aim of the study was to explore patients' experiences and perceptions of receiving intensive care diaries. A focus group and intensive care diaries for four former ICU patients were analysed to understand what works and what needs further development for patients who receive a diary. The study...... that the diary alone provided incomplete information and reading the diary did not necessarily bring back memories, but helped complete their story. The patients needed to know what they had gone through in ICU and wished to share their story with their family. We conclude that diaries might help post...

  16. Application of superconductivity to intense proton linacs

    International Nuclear Information System (INIS)

    Heinrichs, H.

    1996-01-01

    Three examples of proposed superconducting linacs for intense particle beams are presented, and in two cases compared to normal conducting counterparts. Advantages and disadvantages of both types are discussed. Suggestions for future developments are presented. Finally a comparison of estimated operational costs of the normal and the superconducting linac for the ESS is given. (R.P.)

  17. Engineering Education in Research-Intensive Universities

    Science.gov (United States)

    Alpay, E.; Jones, M. E.

    2012-01-01

    The strengths and weaknesses of engineering education in research-intensive institutions are reported and key areas for developmental focus identified. The work is based on a questionnaire and session summaries used during a two-day international conference held at Imperial College London. The findings highlight several common concerns, such as…

  18. Spectral intensity distribution of trapped fermions

    Indian Academy of Sciences (India)

    Trapped fermions; local density approximation; spectral intensity distribution function. ... Thus, cold atomic systems allow us to study interesting ... In fermions, synthetic non-Abelian gauge ... energy eigenstates of the isotropic harmonic oscillator [26–28]. ... d i=1. (ni + 1. 2. )ω0. In calculating the SIDF exactly these eigenfunc-.

  19. Early intensive rehabilitation after oral cancer treatment.

    Science.gov (United States)

    Bschorer, Maximilian; Schneider, Daniel; Hennig, Matthias; Frank, Bernd; Schön, Gerhard; Heiland, Max; Bschorer, Reinhard

    2018-06-01

    The treatment of oral cancer requires an effective rehabilitation strategy such as an early intensive rehabilitation (EIR) program. The medical records and data of 41 patients who participated in an EIR program and 20 control group patients were analyzed. These patients all underwent surgical resection of the primary tumor followed by microsurgical reconstruction using free flaps. The length of stay (LOS) at the acute care hospital was compared between the two groups. Four indexes were used to evaluate the effectiveness of the EIR program. EIR patients stayed an average of 11.6 fewer days at the acute care hospital. All indexes showed significant improvements (p < 0.001). The Barthel Index (BI) and the Early Intensive Rehabilitation Barthel Index (EIR-BI) improved by 36.0 and 103.6 points, respectively. At discharge, the Bogenhausener Dysphagia Score (BODS) had improved to a score of 11.0 compared to the 13.9 at admission. EIR patients had a Work Ability Index (WAI) score of 25.7. Length of stay at the acute care hospital can be reduced using early intensive rehabilitation if patients are transferred to an intensive rehabilitation clinic early. Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  20. The determinants of subjective emotional intensity.

    NARCIS (Netherlands)

    Frijda, N.H.; Sonnemans, J.

    1995-01-01

    Tested the hypothesis that emotional intensity is determined jointly by variables from the following 4 classes: concerns (strength and relevance), appraisal, regulation, and individual response propensities. For 6 wks, 37 college students reported an emotion every week and answered questions on a

  1. Moderately acurate oscillator strengths from NBS intensities

    International Nuclear Information System (INIS)

    Cowley, C.R.

    1983-01-01

    An earlier paper explored the calibration of NBS Monograph 145 intensity measurements for the purpose of obtaining useful oscillator strengths. In the present work we investigate the question of a single 'temperature' for the copper arc light sources. Statistical arguments support rejection of the null hypothesis of a single temperature. Evidence is found for a mild correction to the intensity scale, but there is no indication that the intensities drift with wave length. We reinforce earlier findings that very useful gf-values can be derived from Monograph 145 intensities for any spectrum in which there are enough accurate measurements for a calibration. For the present, it seems that such calibrations must be made individually for each spectrum, and the predictions should not be extrapolated beyond the calibration domains. A table lists interpolation coefficients for Fe I, Co I, Ni I, Ti I, Zr II, Y II, Nd II and U II. An improved formula is given to transform the Corliss-Tech Fe I oscillator strengths to the Oxford system. (author)

  2. An intensive tree-ring experience

    NARCIS (Netherlands)

    Sánchez-Salguero, Raúl; Hevia, Andrea; Camarero, J.J.; Treydte, Kerstin; Frank, Dave; Crivellaro, Alan; Domínguez-Delmás, Marta; Hellman, Lena; Kaczka, Ryszard J.; Kaye, Margot; Akhmetzyanov, Linar; Ashiq, Muhammad Waseem; Bhuyan, Upasana; Bondarenko, Olesia; Camisón, Álvaro; Camps, Sien; García, Vicenta Constante; Vaz, Filipe Costa; Gavrila, Ionela G.; Gulbranson, Erik; Huhtamaa, Heli; Janecka, Karolina; Jeffers, Darren; Jochner, Matthias; Koutecký, Tomáš; Lamrani-Alaoui, Mostafa; Lebreton-Anberrée, Julie; Seijo, María Martín; Matulewski, Pawel; Metslaid, Sandra; Miron, Sergiu; Morrisey, Robert; Opdebeeck, Jorgen; Ovchinnikov, Svyatoslav; Peters, Richard; Petritan, Any M.; Popkova, Margarita; Rehorkova, Stepanka; Ariza, María O.R.; Sánchez-Miranda, Ángela; Linden, Van der Marjolein; Vannoppen, Astrid; Volařík, Daniel

    2017-01-01

    The European Dendroecologial Fieldweek (EDF) provides an intensive learning experience in tree-ring research that challenges any participant to explore new multidisciplinary dendro-sciences approaches within the context of field and laboratory settings. Here we present the 25th EDF, held in

  3. Intrinsic intensity fluctuations in random lasers

    International Nuclear Information System (INIS)

    Molen, Karen L. van der; Mosk, Allard P.; Lagendijk, Ad

    2006-01-01

    We present a quantitative experimental and theoretical study of intensity fluctuations in the emitted light of a random laser that has different realizations of disorder for every pump pulse. A model that clarifies these intrinsic fluctuations is developed. We describe the output versus input power graphs of the random laser with an effective spontaneous emission factor (β factor)

  4. Performance and burnout in intensive care units

    NARCIS (Netherlands)

    Keijsers, GJ; Schaufeli, WB; LeBlanc, P; Zwerts, C; Miranda, DR

    1995-01-01

    The relationship between three different performance measures and burnout was explored in 20 Dutch Intensive Care Units (ICUs). Burnout (i.e. emotional exhaustion and depersonalization) proved to be significantly related to nurses' perceptions of performance as well as to objectively assessed unit

  5. Heating of underdense plasmas by intense lasers

    International Nuclear Information System (INIS)

    Kruer, W.L.

    1972-08-01

    In this note we show that two intense driving fields with frequency much greater than the electron plasma frequency (ω/sub pe/), but with a frequency separation of nearly ω/sub pe/, will couple electron and ion plasma waves and drive them unstable. 6 refs

  6. Knowledge Sharing in Knowledge-Intensive Firms

    DEFF Research Database (Denmark)

    Gupta, Akshey; Michailova, Snejina

    2004-01-01

    This paper is a study of the knowledge-sharing difficulties experienced by three departments in a knowledge-intensive firm. The case organization is a global consulting firm that has been on the forefront of knowledge management and has won several knowledge management related international accla...

  7. [Medication errors in Spanish intensive care units].

    Science.gov (United States)

    Merino, P; Martín, M C; Alonso, A; Gutiérrez, I; Alvarez, J; Becerril, F

    2013-01-01

    To estimate the incidence of medication errors in Spanish intensive care units. Post hoc study of the SYREC trial. A longitudinal observational study carried out during 24 hours in patients admitted to the ICU. Spanish intensive care units. Patients admitted to the intensive care unit participating in the SYREC during the period of study. Risk, individual risk, and rate of medication errors. The final study sample consisted of 1017 patients from 79 intensive care units; 591 (58%) were affected by one or more incidents. Of these, 253 (43%) had at least one medication-related incident. The total number of incidents reported was 1424, of which 350 (25%) were medication errors. The risk of suffering at least one incident was 22% (IQR: 8-50%) while the individual risk was 21% (IQR: 8-42%). The medication error rate was 1.13 medication errors per 100 patient-days of stay. Most incidents occurred in the prescription (34%) and administration (28%) phases, 16% resulted in patient harm, and 82% were considered "totally avoidable". Medication errors are among the most frequent types of incidents in critically ill patients, and are more common in the prescription and administration stages. Although most such incidents have no clinical consequences, a significant percentage prove harmful for the patient, and a large proportion are avoidable. Copyright © 2012 Elsevier España, S.L. and SEMICYUC. All rights reserved.

  8. Serum release boosts sweetness intensity in gels

    NARCIS (Netherlands)

    Sala, G.; Stieger, M.A.; Velde, van de F.

    2010-01-01

    This paper describes the effect of serum release on sweetness intensity in mixed whey protein isolate/gellan gum gels. The impact of gellan gum and sugar concentration on microstructure, permeability, serum release and large deformation properties of the gels was determined. With increasing gellan

  9. Alexithymia and Affect Intensity of Fine Artists

    Science.gov (United States)

    Botella, Marion; Zenasni, Franck; Lubart, Todd

    2015-01-01

    Research on creative artists has examined mainly their personality traits or cognitive abilities. However, it seems important to explore also their emotional traits to complete the profile. This study examines two emotional characteristics: alexithymia and affect intensity. Even if most research suggests that artists are less alexithymic and…

  10. State of the Profession: Intensive English Programs

    Science.gov (United States)

    Szasz, Patricia

    2010-01-01

    This article focuses on the current state of the ESL profession for teachers in Intensive English Programs (IEPs). Because the IEP context may be unfamiliar to some readers, the author first gives an overview of the characteristics and goals of these types of programs. Second, an examination of how administrators and programs are striving to…

  11. Message Control Intensity: Rationale and Preliminary Findings.

    Science.gov (United States)

    Rogers, L. Edna; And Others

    The discussions of four family-related topics by 85 married couples were recorded and analyzed to test the validity of an expanded version of the relational communication coding system developed by L. Edna Rogers and Richard V. Farace. The expanded version of the system is based on the implicit intensity continuum that underlies the communication…

  12. Material properties under intensive dynamic loading

    CERN Document Server

    Cherne, Frank J; Zhernokletov, Mikhail V; Glushak, B L; Zocher, Marvin A

    2007-01-01

    Understanding the physical and thermomechanical response of materials subjected to intensive dynamic loading is a challenge of great significance in engineering today. This volume assumes the task of gathering both experimental and diagnostic methods in one place, since not much information has been previously disseminated in the scientific literature.

  13. On calculating intensity from XPS spectra

    International Nuclear Information System (INIS)

    Vegh, Janos

    2006-01-01

    The intensity calculation is the basis for all quantitative applications of electron spectroscopy. Unfortunately, some misinterpreted terms are used and correctly interpreted terms are misused in the overwhelming majority of publications in XPS, including most textbooks as well as accepted and proposed standards. Due to this mistake the number of the detected electrons is given as having dimension of energy (?) and also the formulas for calculating the peak area and its standard deviation are wrong. Since in all other spectroscopic fields the number of the detected particles is dimensionless, continuing this practice leads to isolating XPS from both other measurement sciences and theory, because the measured total intensity in XPS is simply not comparable to the ones derived with other spectroscopic methods or theoretically. Therefore, the basic measuring processes and terms are critically reviewed and their physically correct interpretation is given. This interpretation reveals that the error is hidden in the incorrect interpretation of both the measurement process and the measured quantity. It is shown that through using the correct interpretation both the dimensions of the intensity calculated from electron spectroscopic measurements as well as the formulas related to the intensity and its standard deviation will agree with all other spectroscopic fields

  14. Teamwork in the Neonatal Intensive Care Unit

    Science.gov (United States)

    Barbosa, Vanessa Maziero

    2013-01-01

    Medical and technological advances in neonatology have prompted the initiation and expansion of developmentally supportive services for newborns and have incorporated rehabilitation professionals into the neonatal intensive care unit (NICU) multidisciplinary team. Availability of therapists specialized in the care of neonates, the roles of…

  15. Photonuclear physics with low intensity photon beams

    International Nuclear Information System (INIS)

    Mecking, B.A.

    1985-01-01

    Experiments in photonuclear physics are discussed that require a low intensity photon beam and large acceptance detectors. This combination is especially suitable for the investigation of photoprocesses on nucleons and light nuclei. A specific experimental setup for the electron stretcher ring ELSA is presented. (orig.)

  16. Cofactors Influencing Prevalence and Intensity of Schistosoma ...

    African Journals Online (AJOL)

    Urine samples were collected from 657 individuals and analyzed by centrifugation, and the number of ova was determined by microscopy. ... Cattle rearing (OR=9.01; CI=4.00-20.75; P=0.00) and farming (OR=3.14; CI=1.82-5.43; P=0.00) showed significant association with the prevalence and intensity of the disease.

  17. Power curve report - with turbulence intensity normalization

    DEFF Research Database (Denmark)

    Gómez Arranz, Paula; Wagner, Rozenn; Vesth, Allan

    , additional shear and turbulence intensitity filters are applied on the measured data. Secondly, the method for normalization to a given reference turbulence intensity level (as described in Annex M of the draft of IEC 61400-12-1 Ed.2 [3]) is applied. The measurements have been performed using DTU...

  18. Radiologic protection in intensive therapy units

    International Nuclear Information System (INIS)

    Andrea, H.; Juliana, C.; Gerusa, R.; Laurete, M.B.; Suelen, S.; Derech, Rodrigo D.A.

    2013-01-01

    The discovery of X-ray was a great achievement for humanity, especially for the medical community. In Intensive Care Units (ICUs), the RX tests, performed with mobile devices, add immense value to the diagnosis of inpatients who do not have the option to carry them out of bed. Following the technology and its improvements, fatalities arose from misuse of ionizing radiation, which mostly gave up for lack of knowledge of the biological effects caused by them, which leads to fear among professionals and often prevents a quick job and effectively by professionals of radiological techniques. The research it is a systematic review of the literature and justified by the scarcity of materials that reflect on the radiological protection in ICUs. For this study we found the Virtual Health Library (VHL) and Pubmed were indexed terms radiological protection and intensive care units, the search in Portuguese and English terms were used radiological protection and intensive care unit. The study aims to inform professionals of ICUs on the main aspects that refer to X-rays in hospital beds, the standards of radiological protection and personal protective equipment, thus avoiding possible damage to the biological health of workers, addressing subjects in rules and laws about the X radiation, emphasizing the protection of professionals in intensive care. It is clear, finally, that little research is conducted in the context of radiological protection of workers ICU's and this is a place that receives daily RX equipment, deserving more attention to protect the worker. (author)

  19. Performances of BNL high-intensity synchrotrons

    International Nuclear Information System (INIS)

    Weng, W.T.

    1998-03-01

    The AGS proton synchrotron was completed in 1960 with initial intensity in the 10 to the 10th power proton per pulse (ppp) range. Over the years, through many upgrades and improvements, the AGS now reached an intensity record of 6.3 x 10 13 ppp, the highest world intensity record for a proton synchrotron on a single pulse basis. At the same time, the Booster reached 2.2 x 10 13 ppp surpassing the design goal of 1.5 x 10 13 ppp due to the introduction of second harmonic cavity during injection. The intensity limitation caused by space charge tune spread and its relationship to injection energy at 50 MeV, 200 MeV, and 1,500 MeV will be presented as well as many critical accelerator manipulations. BNL currently participates in the design of an accumulator ring for the SNS project at Oak Ridge. The status on the issues of halo formation, beam losses and collimation are also presented

  20. Fan beam intensity modulated proton therapy

    Science.gov (United States)

    Hill, Patrick M.

    A fan beam proton therapy is developed which delivers intensity modulated proton therapy using distal edge tracking. The system may be retrofit onto existing proton therapy gantries without alterations to infrastructure in order to improve treatments through intensity modulation. A novel range and intensity modulation system is designed using acrylic leaves that are inserted or retracted from subsections of the fan beam. Leaf thicknesses are chosen in a base-2 system and motivated in a binary manner. Dose spots from individual beam channels range between 1 and 5 cm. Integrated collimators attempting to limit crosstalk among beam channels are investigated, but found to be inferior to uncollimated beam channel modulators. A treatment planning system performing data manipulation in MATLAB and dose calculation in MCNPX is developed. Beamlet dose is calculated on patient CT data and a fan beam source is manually defined to produce accurate results. An energy deposition tally follows the CT grid, allowing straightforward registration of dose and image data. Simulations of beam channels assume that a beam channel either delivers dose to a distal edge spot or is intensity modulated. A final calculation is performed separately to determine the deliverable dose accounting for all sources of scatter. Treatment plans investigate the effects that varying system parameters have on dose distributions. Beam channel apertures may be as large as 20 mm because the sharp distal falloff characteristic of proton dose provides sufficient intensity modulation to meet dose objectives, even in the presence of coarse lateral resolution. Dose conformity suffers only when treatments are delivered from less than 10 angles. Jaw widths of 1--2 cm produce comparable dose distributions, but a jaw width of 4 cm produces unacceptable target coverage when maintaining critical structure avoidance. Treatment time for a prostate delivery is estimated to be on the order of 10 minutes. Neutron production

  1. Intensity attenuation for active crustal regions

    Science.gov (United States)

    Allen, Trevor I.; Wald, David J.; Worden, C. Bruce

    2012-07-01

    We develop globally applicable macroseismic intensity prediction equations (IPEs) for earthquakes of moment magnitude M W 5.0-7.9 and intensities of degree II and greater for distances less than 300 km for active crustal regions. The IPEs are developed for two distance metrics: closest distance to rupture ( R rup) and hypocentral distance ( R hyp). The key objective for developing the model based on hypocentral distance—in addition to more rigorous and standard measure R rup—is to provide an IPE which can be used in near real-time earthquake response systems for earthquakes anywhere in the world, where information regarding the rupture dimensions of a fault may not be known in the immediate aftermath of the event. We observe that our models, particularly the model for the R rup distance metric, generally have low median residuals with magnitude and distance. In particular, we address whether the direct use of IPEs leads to a reduction in overall uncertainties when compared with methods which use a combination of ground-motion prediction equations and ground motion to intensity conversion equations. Finally, using topographic gradient as a proxy and median model predictions, we derive intensity-based site amplification factors. These factors lead to a small reduction of residuals at shallow gradients at strong shaking levels. However, the overall effect on total median residuals is relatively small. This is in part due to the observation that the median site condition for intensity observations used to develop these IPEs is approximately near the National Earthquake Hazard Reduction Program CD site-class boundary.

  2. Collimator setting optimization in intensity modulated radiotherapy

    International Nuclear Information System (INIS)

    Williams, M.; Hoban, P.

    2001-01-01

    Full text: The aim of this study was to investigate the role of collimator angle and bixel size settings in IMRT when using the step and shoot method of delivery. Of particular interest is minimisation of the total monitor units delivered. Beam intensity maps with bixel size 10 x 10 mm were segmented into MLC leaf sequences and the collimator angle optimised to minimise the total number of MU's. The monitor units were estimated from the maximum sum of positive-gradient intensity changes along the direction of leaf motion. To investigate the use of low resolution maps at optimum collimator angles, several high resolution maps with bixel size 5 x 5 mm were generated. These were resampled into bixel sizes, 5 x 10 mm and 10 x 10 mm and the collimator angle optimised to minimise the RMS error between the original and resampled map. Finally, a clinical IMRT case was investigated with the collimator angle optimised. Both the dose distribution and dose-volume histograms were compared between the standard IMRT plan and the optimised plan. For the 10 x 10 mm bixel maps there was a variation of 5% - 40% in monitor units at the different collimator angles. The maps with a high degree of radial symmetry showed little variation. For the resampled 5 x 5 mm maps, a small RMS error was achievable with a 5 x 10 mm bixel size at particular collimator positions. This was most noticeable for maps with an elongated intensity distribution. A comparison between the 5 x 5 mm bixel plan and the 5 x 10 mm showed no significant difference in dose distribution. The monitor units required to deliver an intensity modulated field can be reduced by rotating the collimator and aligning the direction of leaf motion with the axis of the fluence map that has the least intensity. Copyright (2001) Australasian College of Physical Scientists and Engineers in Medicine

  3. Intensive meditation for refractory pain and symptoms.

    Science.gov (United States)

    Goyal, Madhav; Haythornthwaite, Jennifer; Levine, David; Becker, Diane; Vaidya, Dhananjay; Hill-Briggs, Felicia; Ford, Daniel

    2010-06-01

    The objective of this study was to assess patient interest in intensive meditation training for chronic symptoms. This was a cross-sectional anonymous survey among six chronic disease clinics in Baltimore including Chronic Kidney Disease, Crohn's Disease, Headache, Renal Transplant Recipients, General Rheumatology, and lupus clinic. Subjects were 1119 consecutive patients registering for their appointments at these clinics. Outcome measures were 6-month pain, global symptomatology, four-item perceived stress scale, use of complementary and alternative medicine (CAM) therapies, and attitudes toward use of meditation for managing symptoms. We then gave a scripted description of an intensive, 10-day meditation training retreat. Patient interest in attending such a retreat was assessed. Seventy-seven percent (77%) of patients approached completed the survey. Fifty-three percent (53%) of patients reported moderate to severe pain over the past 6 months. Eighty percent (80%) reported use of some CAM therapy in the past. Thirty-five percent (35%) thought that learning meditation would improve their health, and 49% thought it would reduce stress. Overall, 39% reported interest in attending the intensive 10-day meditation retreat. Among those reporting moderate to severe pain or stress, the percentages were higher (48% and 59%). In a univariate analysis, higher education, nonworking/disabled status, female gender, higher stress, higher pain, higher symptomatology, and any CAM use were all associated with a greater odds of being moderately to very interested in an intensive 10-day meditation retreat. A multivariate model that included prior use of CAM therapies as predictors of interest in the program fit the data significantly better than a model not including CAM therapies (p = 0.0013). Over 50% of patients followed in chronic disease clinics complain of moderate to severe pain. Patients with persistent pain or stress are more likely to be interested in intensive meditation.

  4. [Intensive care medicine-survival and prospect of life].

    Science.gov (United States)

    Valentin, A

    2017-10-01

    Intensive care medicine has achieved a significant increase in survival rates from critical illness. In addition to short-term outcomes like intensive care unit or hospital mortality, long-term prognosis and prospect of life of intensive care patients have recently become increasingly important. Pure survival is no longer a sole goal of intensive care medicine. The prediction of an intensive care patient's individual course should include the period after intensive care. A relevant proportion of all intensive care patients is affected by physical, psychological, cognitive, and social limitations after discharge from the intensive care unit. The prognosis of the status of the patient after discharge from the intensive care unit is an important part of the decision-making process with respect to the implementation or discontinuation of intensive care measures. The heavy burden of intensive care treatment should not solely be argued by pure survival but an anticipated sound prospect of life.

  5. Exercise intensity of cycle-touring events.

    Science.gov (United States)

    Neumayr, G; Pfister, R; Mitterbauer, G; Gaenzer, H; Sturm, W; Eibl, G; Hoertnagl, H

    2002-10-01

    The aim of the study was to analyze the exercise intensity of recreational cyclists participating in a cycling-touring event. In 14 male healthy recreational cyclists heart rate (HR) monitoring was performed during the Otztal Radmarathon 1999 (distance: 230 km; altitude difference: 5500 m) in order to evaluate the HR response and to estimate the cardiopulmonary strains for the less-trained athlete confronted with such a marathon. Four different exercise intensities were defined as percentages of maximal HR (HR(max)) as follows: recovery HR (HR(re)) 90 %. All athletes finished the competition successfully. The mean racing time was 10 h 14 min, the average speed 22.5 km/h. The mean HR(max) was 188 bpm, the average value of the measured HRs (HR(average)) was 145 bpm resulting in a mean HR(average)/HR(max) ratio of 0.77. Athletes spent 18.5 % (1 h 54 min) of total race time within HR(re), 28 % (2 h 52 min) within HR(ma), 39.5 % (4 h 02 min) within HR(ia), and 14 % (1 h 26 min) within HR(an). The vast majority of exercise was done under "aerobic conditions" (HR(re) + HR(ma) + HR(ia) = 86 % or 8 h 48 min) - confirming the knowledge that the aerobic energy supply is crucial for the performance of long-term exercise. The large amount of high exercise intensities (HR(ia) + HR(an) = 53.5 % or 5 h 30 min), however, features the intense cardiopulmonary strains evoked by such competitions. The HR response was related to the course profile with HRs significantly declining in all subjects to an extent of 10 % during the course of race. Our findings show that the exercise intensity borne by recreational cyclists during a cycle-touring event is high and very similar to that of professionals. With respect to the high cardiovascular strains a thorough medical screening is advisable for any participant of such an event combining both high volume and high intensity loads.

  6. SALIVARY CORTISOL RESPONSES AND PERCEIVED EXERTION DURING HIGH INTENSITY AND LOW INTENSITY BOUTS OF RESISTANCE EXERCISE

    Directory of Open Access Journals (Sweden)

    Alison D. Egan

    2004-03-01

    Full Text Available The purpose of this study was to measure the salivary cortisol response to different intensities of resistance exercise. In addition, we wanted to determine the reliability of the session rating of perceived exertion (RPE scale to monitor resistance exercise intensity. Subjects (8 men, 9 women completed 2 trials of acute resistance training bouts in a counterbalanced design. The high intensity resistance exercise protocol consisted of six, ten-repetition sets using 75% of one repetition maximum (RM on a Smith machine squat and bench press exercise (12 sets total. The low intensity resistance exercise protocol consisted of three, ten-repetition sets at 30% of 1RM of the same exercises as the high intensity protocol. Both exercise bouts were performed with 2 minutes of rest between each exercise and sessions were repeated to test reliability of the measures. The order of the exercise bouts was randomized with least 72 hours between each session. Saliva samples were obtained immediately before, immediately after and 30 mins following each resistance exercise bout. RPE measures were obtained using Borg's CR-10 scale following each set. Also, the session RPE for the entire exercise session was obtained 30 minutes following completion of the session. There was a significant 97% increase in the level of salivary cortisol immediately following the high intensity exercise session (P<0.05. There was also a significant difference in salivary cortisol of 145% between the low intensity and high intensity exercise session immediately post-exercise (P<0.05. The low intensity exercise did not result in any significant changes in cortisol levels. There was also a significant difference between the session RPE values for the different intensity levels (high intensity 7.1 vs. low intensity 1.9 (P<0.05. The intraclass correlation coefficient for the session RPE measure was 0.95. It was concluded that the session RPE method is a valid and reliable method of

  7. Progress in ultrafast intense laser science XIII

    CERN Document Server

    III, Wendell; Paulus, Gerhard

    2017-01-01

    This thirteenth volume covers a broad range of topics from this interdisciplinary research field, focusing on atoms, molecules, and clusters interacting in intense laser field and high-order harmonics generation and their applications. The PUILS series delivers up-to-date reviews of progress in Ultrafast Intense Laser Science, the interdisciplinary research field spanning atomic and molecular physics, molecular science, and optical science, which has been stimulated by the recent developments in ultrafast laser technologies. Each volume compiles peer-reviewed articles authored by researchers at the forefront of each their own subfields of UILS. Every chapter opens with an overview of the topics to be discussed, so that researchers unfamiliar to the subfield, as well as graduate students, can grasp the importance and attractions of the research topic at hand; these are followed by reports of cutting-edge discoveries.   .

  8. Symmetry tests with intense hadron beams

    International Nuclear Information System (INIS)

    Vogt, E.W.

    1994-08-01

    The Government of Canada has pulled the plug on funding of the KAON facility in Canada. But the science opportunities for symmetry tests with the kinds of beams that KAON would have provided remain. For example, the full intensity of kaons, which KAON would have provided, is needed to find the magnitude and phase of V td and therefore to describe direct CP violation. The combination of K + → π + ν ν - and K L o → π o ν ν - serve this purpose. A variety of other symmetry tests are possible with the kind of intense beams of kaons, antinucleons, other hadrons and neutrinos which KAON would have provided. A perspective will be given for such experiments and their future prospects, now that KAON will not be built. (author). 10 refs., 1 tab., 2 figs

  9. The Tianlai 21cm intensity mapping experiment

    Science.gov (United States)

    Chen, Xuelei

    2015-08-01

    The Tianlai 21cm intensity mapping experiment is aimed at surveying the northern sky 21cm intensity at mid-redshifts, thus map out the neutral hydrogen distribution. The experiment is named "Tianlai" which means "heavenly sound" in classic Chinese, because its ultimate goal is to use the baryon acoustic oscillation (BAO) feature in the correlation function or power spectrum of large scale structure to constrain the cosmic expansion rate, and determine the nature of dark energy.The pathfinder experiment consists three cylinder reflectors of 15m wide x 40m long, and 16 dishes of 6 meter aperture, for testing the basic principle and key technologies. A radio-quiet site in Hongliuxia, Xinjiang of north-west China is selected, currently the facilities are under construction, and the prototype is expected to start commissioning later this year. The experiment is run by NAOC, with members from France, USA and Canada.

  10. Plasma mirrors for ultrahigh-intensity optics

    International Nuclear Information System (INIS)

    Thaury, C.; Quere, F.; Levy, A.; Ceccotti, T.; Monot, P.; Bougeard, M.; Reau, F.; D'Oliveira, P.; Martin, PH.; Geindre, J.P.; Audebert, P.; Marjoribanks, R.; Marjoribanks, R.

    2007-01-01

    Specular reflection is one of the most fundamental processes of optics. At moderate light intensities generated by conventional light sources this process is well understood. But at those capable of being produced by modern ultrahigh-intensity lasers, many new and potentially useful phenomena arise. When a pulse from such a laser hits an optically polished surface, it generates a dense plasma that itself acts as a mirror, known as a plasma mirror (PM). PMs do not just reflect the remainder of the incident beam, but can act as active optical elements. Using a set of three consecutive PMs in different regimes, we significantly improve the temporal contrast of femtosecond pulses, and demonstrate that high-order harmonics of the laser frequency can be generated through two distinct mechanisms. A better understanding of these processes should aid the development of laser-driven atto-second sources for use in fields from materials science to molecular biology. (authors)

  11. Storage-Intensive Supercomputing Benchmark Study

    Energy Technology Data Exchange (ETDEWEB)

    Cohen, J; Dossa, D; Gokhale, M; Hysom, D; May, J; Pearce, R; Yoo, A

    2007-10-30

    Critical data science applications requiring frequent access to storage perform poorly on today's computing architectures. This project addresses efficient computation of data-intensive problems in national security and basic science by exploring, advancing, and applying a new form of computing called storage-intensive supercomputing (SISC). Our goal is to enable applications that simply cannot run on current systems, and, for a broad range of data-intensive problems, to deliver an order of magnitude improvement in price/performance over today's data-intensive architectures. This technical report documents much of the work done under LDRD 07-ERD-063 Storage Intensive Supercomputing during the period 05/07-09/07. The following chapters describe: (1) a new file I/O monitoring tool iotrace developed to capture the dynamic I/O profiles of Linux processes; (2) an out-of-core graph benchmark for level-set expansion of scale-free graphs; (3) an entity extraction benchmark consisting of a pipeline of eight components; and (4) an image resampling benchmark drawn from the SWarp program in the LSST data processing pipeline. The performance of the graph and entity extraction benchmarks was measured in three different scenarios: data sets residing on the NFS file server and accessed over the network; data sets stored on local disk; and data sets stored on the Fusion I/O parallel NAND Flash array. The image resampling benchmark compared performance of software-only to GPU-accelerated. In addition to the work reported here, an additional text processing application was developed that used an FPGA to accelerate n-gram profiling for language classification. The n-gram application will be presented at SC07 at the High Performance Reconfigurable Computing Technologies and Applications Workshop. The graph and entity extraction benchmarks were run on a Supermicro server housing the NAND Flash 40GB parallel disk array, the Fusion-io. The Fusion system specs are as follows

  12. Plasma mirrors for ultrahigh-intensity optics

    Energy Technology Data Exchange (ETDEWEB)

    Thaury, C; Quere, F; Levy, A; Ceccotti, T; Monot, P; Bougeard, M; Reau, F; D' Oliveira, P; Martin, PH [CEA, DSM, DRECAM, Serv Photons Atomes and Mol, F-91191 Gif Sur Yvette, (France); Geindre, J P; Audebert, P [Ecole Polytech, CNRS, Lab Utilisat Lasers Inst, F-91128 Palaiseau, (France); Marjoribanks, R [Univ Toronto, Dept Phys, Toronto, ON M5S 1A7, (Canada); Marjoribanks, R [Univ Toronto, Inst Opt Sci, Toronto, ON M5S 1A7, (Canada)

    2007-07-01

    Specular reflection is one of the most fundamental processes of optics. At moderate light intensities generated by conventional light sources this process is well understood. But at those capable of being produced by modern ultrahigh-intensity lasers, many new and potentially useful phenomena arise. When a pulse from such a laser hits an optically polished surface, it generates a dense plasma that itself acts as a mirror, known as a plasma mirror (PM). PMs do not just reflect the remainder of the incident beam, but can act as active optical elements. Using a set of three consecutive PMs in different regimes, we significantly improve the temporal contrast of femtosecond pulses, and demonstrate that high-order harmonics of the laser frequency can be generated through two distinct mechanisms. A better understanding of these processes should aid the development of laser-driven atto-second sources for use in fields from materials science to molecular biology. (authors)

  13. Progress in Ultrafast Intense Laser Science

    CERN Document Server

    Yamanouchi, Kaoru; Li, Ruxin; Chin, See Leang

    2009-01-01

    The PUILS series presents Progress in Ultrafast Intense Laser Science, a newly emerging interdisciplinary research field spanning atomic and molecular physics, molecular science, and optical science. PUILS has been stimulated by the recent development of ultrafast laser technologies. Each volume contains approximately 15 chapters, authored by researchers at the forefront. Each chapter opens with an overview of the topics to be discussed, so that researchers, who are not experts in the specific topics, as well as graduate students can grasp the importance and attractions of this sub-field of research, and these are followed by reports of cutting-edge discoveries. This fourth volume covers a broad range of topics from this interdisciplinary research field, focusing on strong field ionization of atoms; excitation, ionization and fragmentation of molecules; nonlinear intense optical phenomena and attosecond pulses; and laser - solid interactions and photoemission.

  14. ELISE, a code for intensity dependent effects

    International Nuclear Information System (INIS)

    Barton, M.Q.

    1991-01-01

    The Electron ring Limits on Intensity, Stability, and Emittance (ELISE) code described in this paper computes many of the intensity dependent effects of interest to the builder of a small electron storage ring. ELISE is a program, developed largely for the author's own use, which duplicates many of the functions provided by the more general program ZAP developed by the Berkeley group. The motivation for the code was to provide an interactive system for quick answers that could be used during accelerator commissioning. A lattice program, IDA, developed earlier by the author while at Brookhaven National Laboratory, provides a good model of the type of user friendly interaction that would be desirable in such a code

  15. Progress in Ultrafast Intense Laser Science III

    CERN Document Server

    Yamanouchi, Kaoru; Agostini, Pierre; Ferrante, Gaetano

    2008-01-01

    The PUILS series presents Progress in Ultrafast Intense Laser Science, a newly emerging interdisciplinary research field spanning atomic and molecular physics, molecular science, and optical science. PUILS has been stimulated by the recent development of ultrafast laser technologies. Each volume contains approximately 15 chapters, authored by researchers at the forefront. Each chapter opens with an overview of the topics to be discussed, so that researchers, who are not experts in the specific topics, as well as graduate students can grasp the importance and attractions of this sub-field of research, and these are followed by reports of cutting-edge discoveries. This third volume covers a diverse range of disciplines, focusing on such topics as strong field ionization of atoms, ionization and fragmentation of molecules and clusters, generation of high-order harmonics and attosecond pulses, filamentation and laser plasma interaction, and the development of ultrashort and ultrahigh-intensity light sources.

  16. Beam halo in high-intensity beams

    International Nuclear Information System (INIS)

    Wangler, T.P.

    1993-01-01

    In space-charge dominated beams the nonlinear space-charge forces produce a filamentation pattern, which in projection to the 2-D phase spaces results in a 2-component beam consisting of an inner core and a diffuse outer halo. The beam-halo is of concern for a next generation of cw, high-power proton linacs that could be applied to intense neutron generators for nuclear materials processing. The author describes what has been learned about beam halo and the evolution of space-charge dominated beams using numerical simulations of initial laminar beams in uniform linear focusing channels. Initial results are presented from a study of beam entropy for an intense space-charge dominated beam

  17. Energetic particle pressure in intense ESP events

    Science.gov (United States)

    Lario, D.; Decker, R. B.; Roelof, E. C.; Viñas, A.-F.

    2015-09-01

    We study three intense energetic storm particle (ESP) events in which the energetic particle pressure PEP exceeded both the pressure of the background thermal plasma Pth and the pressure of the magnetic field PB. The region upstream of the interplanetary shocks associated with these events was characterized by a depression of the magnetic field strength coincident with the increase of the energetic particle intensities and, when plasma measurements were available, a depleted solar wind density. The general feature of cosmic-ray mediated shocks such as the deceleration of the upstream background medium into which the shock propagates is generally observed. However, for those shocks where plasma parameters are available, pressure balance is not maintained either upstream of or across the shock, which may result from the fact that PEP is not included in the calculation of the shock parameters.

  18. Radiation control through licensing and intensive training

    International Nuclear Information System (INIS)

    Cheng, C.-H.; Yang, Y.-C.; Wu, T.-Y.; Weng, P.-S.

    1982-01-01

    Various types of intensive training courses to suit radiation workers in different fields were sponsored by both the Atomic Energy Council of Executive Yuan and the National Health Administration of Executive Yuan, Republic of China during the past seven years. During the years 1974-79, the number of radiation workers attending each training course, their age, sex and educational background are presented in detail. The typical course contents for both medical and non-medical radiation workers are given. A summary of the percentage of passes and failures of the final examination given at the end of each training course is also given. The present status of licensing for radiation facilities and workers is described, and its results are indicated. The successful control of ionizing radiation through this kind of intensive training and licensing is evidenced in the film badge records given by a centralized service laboratory located at the National Tsing Hua University. (author)

  19. Intensive integrated therapy of type 2 diabetes

    DEFF Research Database (Denmark)

    Gaede, Peter; Pedersen, Oluf

    2004-01-01

    The macro- and microvascular burden of type 2 diabetes is well established. A number of recent single risk factor intervention trials targeting hyperglycemia, dyslipidemia, hypertension, procoagulation, microalbumuria, and existing cardiovascular disorders have, however, shown major beneficial...... effects on long-term outcome. The results from these studies are anticipated to change the future management of type 2 diabetes, and most of the updated national guidelines for the treatment of type 2 diabetes recommend a multipronged approach driven by ambitious treatment targets. The outcome...... of this intensive integrated therapy has, however, only been investigated in a few studies of patients with type 2 diabetes. One of these trials, the Steno-2 Study, showed that intensive intervention for an average of 7.8 years cuts cardiovascular events as well as nephropathy, retinopathy, and autonomic neuropathy...

  20. Progress in Ultrafast Intense Laser Science VIII

    CERN Document Server

    Nisoli, Mauro; Hill, Wendell; III, III

    2012-01-01

    The PUILS series delivers up-to-date reviews of progress in Ultrafast Intense Laser Science, a newly emerging interdisciplinary research field spanning atomic and molecular physics, molecular science and optical science which has been stimulated by the recent developments in ultrafast laser technologies. Each volume compiles peer-reviewed articles authored by researchers at the forefront of each their own subfields of UILS. Every chapter opens with an overview of the topics to be discussed, so that researchers unfamiliar to the subfield as well as graduate students can grasp the importance and attractions of the research topic at hand. These are followed by reports of cutting-edge discoveries. This eighth volume covers a broad range of topics from this interdisciplinary research field, focusing on molecules interacting with ultrashort and intense laser fields, advanced technologies for the characterization of ultrashort laser pulses and their applications, laser plasma formation and laser acceleration.

  1. Resolving Tropical Cyclone Intensity in Models

    Science.gov (United States)

    Davis, C. A.

    2018-02-01

    In recent years, global weather forecast models and global climate models have begun to depict intense tropical cyclones, even up to category 5 on the Saffir-Simpson scale. In light of the limitation of horizontal resolution in such models, the author performs calculations, using the extended Best Track data for Atlantic tropical cyclones, to estimate the ability of models with differing grid spacing to represent Atlantic tropical cyclone intensity statistically. Results indicate that, under optimistic assumptions, models with horizontal grid spacing of one fourth degree or coarser should not produce a realistic number of category 4 and 5 storms unless there are errors in spatial attributes of the wind field. Furthermore, the case of Irma (2017) is used to demonstrate the importance of a realistic depiction of angular momentum and to motivate the use of angular momentum in model evaluation.

  2. Very high intensity reaction chamber design

    International Nuclear Information System (INIS)

    Devaney, J.J.

    1975-09-01

    The problem of achieving very high intensity irradiation by light in minimal regions was studied. Three types of irradiation chamber are suggested: the common laser-reaction chamber, the folded concentric or near-concentric resonator, and the asymmetric confocal resonator. In all designs the ratio of high-intensity illuminated volume to other volume is highly dependent (to the 3 / 2 power) on the power and fluence tolerances of optical elements, primarily mirrors. Optimization of energy coupling is discussed for the common cavity. For the concentric cavities, optimization for both coherent and incoherent beams is treated. Formulae and numerical examples give the size of chambers, aspect ratios, maximum pass number, image sizes, fluences, and the like. Similarly for the asymmetric confocal chamber, formulae and numerical examples for fluences, dimensions, losses, and totally contained pass numbers are given

  3. Development of high intensity proton accelerator

    International Nuclear Information System (INIS)

    Mizumoto, M.; Kusano, J.; Hasegawa, K.; Ouchi, N.; Oguri, H.; Kinsho, M.; Touchi, Y.; Honda, Y.; Mukugi, K.; Ino, H.; Noda, F.; Akaoka, N.; Kaneko, H.; Chishiro, E.; Fechner, B.

    1997-01-01

    The high-intensity proton linear accelerator with an energy of 1.5 GeV and an average current of 5.33mA has been proposed for the Neutron Science Project (NSP) at JAERI. the NSP is aiming at exploring nuclear technologies for nuclear waste transmutation based on a proton induced spallation neutrons. The proposed accelerators facilities will be also used in the various basic research fields such as condensed matter physics in combination with a high intensity proton storage ring. The R and D work has been carried out for the components of the front-end of the proton accelerator. For the high energy portion above 100 MeV, superconducting (SC) accelerator linac has been designed and developed as a major option. (Author) 7 refs

  4. Reducing nosocomial infections in neonatal intensive care.

    Science.gov (United States)

    Rogers, Eileen; Alderdice, Fiona; McCall, Emma; Jenkins, John; Craig, Stanley

    2010-09-01

    Nosocomial infection is a common problem in neonatal intensive care. A pilot quality improvement initiative focussing on hand hygiene and aimed at reducing nosocomial infection in very low birth weight (VLBW) infants was introduced in five Neonatal Intensive Care Units. Line associated laboratory confirmed bloodstream infection (LCBSI) and ventilator associated pneumonia (VAP) were chosen as main outcome measures. In VLBW infants, the rate of line associated LCBSI per 1000 central venous catheter days fell by 24%. The rate of VAP per 1000 ventilator days in VLBW infants fell by 38%. Pre- and post-intervention questionnaires showed a statistically significant increase in use of alcohol-based gels and increased knowledge of hand hygiene.

  5. Intense EM filamentation in relativistic hot plasmas

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Qiang-Lin [Department of Physics, Jinggangshan University, Ji' an, Jiangxi 343009 (China); Chen, Zhong-Ping [Department of Physics and Institute for Fusion Studies, The University of Texas at Austin, Austin, TX 78712 (United States); Mahajan, Swadesh M., E-mail: mahajan@mail.utexas.edu [Department of Physics and Institute for Fusion Studies, The University of Texas at Austin, Austin, TX 78712 (United States); Department of Physics, School of Natural Sciences, Shiv Nadar University, Uttar Pradesh 201314 (India)

    2017-03-03

    Highlights: • Breaking up of an intense EM pulse into filaments is a spectacular demonstration of the nonlinear wave-plasma interaction. • Filaments are spectacularly sharper, highly extended and longer lived at relativistic temperatures. • EM energy concentration can trigger new nonlinear phenomena with absolute consequences for high energy density matter. - Abstract: Through 2D particle-in-cell (PIC) simulations, we demonstrate that the nature of filamentation of a high intensity electromagnetic (EM) pulse propagating in an underdense plasma, is profoundly affected at relativistically high temperatures. The “relativistic” filaments are sharper, are dramatically extended (along the direction of propagation), and live much longer than their lower temperature counterparts. The thermally boosted electron inertia is invoked to understand this very interesting and powerful phenomenon.

  6. Progress in Ultrafast Intense Laser Science VI

    CERN Document Server

    Yamanouchi, Kaoru; Bandrauk, André D

    2010-01-01

    The PUILS series delivers up-to-date reviews of progress in Ultrafast Intense Laser Science, a newly emerging interdisciplinary research field spanning atomic and molecular physics, molecular science, and optical science, which has been stimulated by the recent developments in ultrafast laser technologies. Each volume compiles peer-reviewed articles authored by researchers at the forefront of each their own subfields of UILS. Every chapter opens with an overview of the topics to be discussed, so that researchers unfamiliar to the subfield, as well as graduate students, can grasp the importance and attractions of the research topic at hand; these are followed by reports of cutting-edge discoveries. This sixth volume covers a broad range of topics from this interdisciplinary research field, focusing on responses of molecules to ultrashort intense laser pulses, generation and characterization of attosecond pulses and high-order harmonics, and filamentation and laser-plasma interaction.

  7. Computed radiography in neonatal intensive care

    International Nuclear Information System (INIS)

    Merlo, L.; Bighi, S.; Cervi, P.M.; Lupi, L.

    1991-01-01

    The Authors report their experience in the employment of a computerized digital radiographic system in Neonatal Intensive Care. The analog screen-film system is replaced by photosensitive imaging plates, scanned after X-ray exposure by a laser that releases the digital image, which can then be manipulated on computer work-stations. In a period of twelve months about 200 chest-abdomen X-ray examinations in Neonatal Intensive Care have been performed using this method with good technical and diagnostic results. The use of digital radiography in the neonatal area is of high interest: this system produces good quality images, there is a reduction in radiation dose and 'retakes', the system allows selective enhancement of different structures and their magnification. (orig.)

  8. Progress in ultrafast intense laser science XII

    CERN Document Server

    Roso, Luis; Li, Ruxin; Mathur, Deepak; Normand, Didier

    2015-01-01

    This  volume covers a broad range of topics focusing on atoms, molecules, and clusters interacting in intense laser field, laser induced filamentation, and laser plasma interaction and application. The PUILS series delivers up-to-date reviews of progress in Ultrafast Intense Laser Science, a newly emerging interdisciplinary research field spanning atomic and molecular physics, molecular science, and optical science, which has been stimulated by the recent developments in ultrafast laser technologies. Each volume compiles peer-reviewed articles authored by researchers at the forefront of each their own subfields of UILS. Every chapter opens with an overview of the topics to be discussed, so that researchers unfamiliar to the subfield, as well as graduate students, can grasp the importance and attractions of the research topic at hand; these are followed by reports of cutting-edge discoveries. .

  9. Energy intensity, target level of energy intensity, and room for improvement in energy intensity: An application to the study of regions in the EU

    International Nuclear Information System (INIS)

    Chang, Ming-Chung

    2014-01-01

    While the previous literature shows that a decline in energy intensity represents an improvement in energy use efficiency, it does not provide a target level of energy intensity, nor what room for improvement in terms of energy intensity could entail. This study establishes an indicator of such room for improvement in terms of energy intensity by measuring the difference between the target level of energy intensity and the actual energy intensity and thereby monitors energy use efficiency. The traditional indicator of energy intensity, defined as energy use over GDP, mainly estimates energy use efficiency, but is a partial effect between the energy input and GDP output. However, our proposed indicator of the room for improvement in terms of energy intensity is the total-factor effects based on the multiple-inputs model. By taking the 27 EU members to investigate their energy use efficiency using the indicator of the room for improvement in terms of energy intensity, this study concludes that an improvement in energy intensity does not fully depend on a decline in energy intensity, and we instead need to confirm whether the room for improvement in terms of energy intensity decreases. This finding is particularly relevant for energy policy-makers. - Highlights: • This paper establishes an indicator for the room for improvement in terms of energy intensity. • This study takes the 27 EU members to investigate their energy use efficiency. • A different result appears by using our proposed indicator

  10. An intense transmission spectrometer for ISIS

    International Nuclear Information System (INIS)

    Newport, R.J.; Howells, W.S.

    1986-07-01

    The report seeks to outline a design for an intense transmission spectrometer (ITS) suitable for installation on the pulsed neutron source ISIS. The performance of the instrument is evaluated and several examples of the areas of science made accessible are discussed. It is shown that the proposed design will represent a scientifically valuable and cost-effective addition to the present suite of ISIS instruments. (author)

  11. Intensive Care Nursing And Time Management

    OpenAIRE

    ÖZCANLI, Derya; İLGÜN, Seda

    2008-01-01

    Time is not like other resources, because it can not be bought, sold, stolen, borrowed, stored, saved, multiplied or changed. All it can be done is spent. Time management means the effective use of resources, including time, in such a way that indi- viduals are effective in achieving important personal goals. With the increasing emphasis on efficiency in health care, how a nurse manages her time is an important consideration. Since intensive care nurs- ing is focused on the care and tr...

  12. Theory of atomic spectral emission intensity

    International Nuclear Information System (INIS)

    Yngstroem, S.

    1989-02-01

    The theoretical derivation of a new spectral line intensity formula for atomic radiative emission is presented. The theory is based on first principles of quantum physics and statistical physics. It is argued that the formulation of the theory provides a very good example of the manner in which quantum logic transforms into common sense logic. The theory is strongly supported by experimental evidence. (author) (16 refs.)

  13. Making thermodynamic functions of nanosystems intensive

    OpenAIRE

    Nassimi, Ali Mohammad; Parsafar, Gholamabbas

    2006-01-01

    The interaction potential energy among particles in many systems is of the form of r^-(alpha), at least at long distances. It has been argued that, in systems for which (alpha) < d (d is the space dimension) we encounter with nonextensive (nonintensive) thermodynamic functions. A scaling parameter N~ has been introduced to make nonextensive (nonintensive) thermodynamic functions of such systems extensive (intensive) functions. Our simulation results show that this parameter is not capable of ...

  14. Frontiers of particle beams: Intensity limitations

    International Nuclear Information System (INIS)

    Dienes, M.; Month, M.; Turner, S.

    1992-01-01

    The present volume is the proceedings of the latest of these joint schools, held on Hilton Head Island, South Carolina, in 1990. This course dealt with intensity limitations and was centered on a series of lectures which could be divided into the following main categories: Self and environmental fields, Coherent instabilities and their simulation, Beam-beam interaction, Other multiparticle effects, Beam source limitations, Engineering limitations. (orig.)

  15. Unconventional Use of Intense Pulsed Light

    OpenAIRE

    Piccolo, D.; Di Marcantonio, D.; Crisman, G.; Cannarozzo, G.; Sannino, M.; Chiricozzi, A.; Chimenti, S.

    2014-01-01

    According to the literature, intense pulsed light (IPL) represents a versatile tool in the treatment of some dermatological conditions (i.e., pigmentation disorders, hair removal, and acne), due to its wide range of wavelengths. The authors herein report on 58 unconventional but effective uses of IPL in several cutaneous diseases, such as rosacea (10 cases), port-wine stain (PWS) (10 cases), disseminated porokeratosis (10 cases), pilonidal cyst (3 cases), seborrheic keratosis (10 cases), hype...

  16. Burnout Among Anesthetists and Intensive Care Physicians.

    Science.gov (United States)

    Mikalauskas, Audrius; Benetis, Rimantas; Širvinskas, Edmundas; Andrejaitienė, Judita; Kinduris, Šarūnas; Macas, Andrius; Padaiga, Žilvinas

    2018-01-01

    Burnout is a syndrome of depersonalization, emotional exhaustion, and low personal accomplishment. Little is known about burnout in physicians. Our objective was to determine the prevalence of burnout among anesthetists and intensive care physicians, and associations between burnout and personal, as well as professional, characteristics. In total, 220 anesthetists and intensive care physicians were contacted by email, asking them to participate in the study. For depression screening the PHQ-2 questionnaire, for problem drinking, CAGE items were used. Burnout was measured by the Maslach Burnout Inventory. Overall, 34% anesthetists and intensive care physicians indicated high levels of emotional exhaustion, 25% indicated high levels of depersonalization, and 38% showed low personal accomplishment. Burnout was found more frequent among subjects with problem drinking (OR 3.2, 95% CI 1.5-6.8), depressiveness (OR 10.2, 95% CI 4.6-22.6), cardiovascular disorders (OR 3.4, 95% CI 1.7-7.1), and digestive disorders (OR 2.2, 95% CI 1.2-4.0). Some favorite after-work activities positively correlated with burnout, such as sedative medications abuse (OR 4.8, 95% CI 1.8-12.5), alcohol abuse (OR 2.4, 95% CI 1.3-4.5), eating more than usual (OR 1.9, 95% CI 1.1-3.5), and transferring the accumulated stress to relatives (OR 2.8, 95% CI 1.4-5.5). In contrast, reading of non-medical literature seemed to have a protective effect (OR 0.5, 95% CI 0.2-0.9). Burnout was highly prevalent among anesthetists and intensive care physicians with two fifths of them meeting diagnostic criteria. It was strongly correlated with problem drinking, depressiveness, cardiovascular and digestive disorders, use of sedatives and overeating.

  17. Trade Exposure of Energy Intensive Sectors

    International Nuclear Information System (INIS)

    Korteland, M.H.; Nelissen, D.; De Bruyn, S.M.

    2010-04-01

    In this report we analysed the origin and destinations of trade flows between EU and non-EU countries with respect to eight industrial sectors. In addition we looked at the political pledges made during the Copenhagen negotiations last December. If we combine these two types of insights, we get an idea of the risk of carbon leakage due to EU climate policies. Our analysis shows that the EU often trades with countries that have climate policy in place. As these major trading partners of the EU can be expected to adopt similar stringent climate policies, CO2 might get a price in these markets as well and the risk of carbon leakage is reduced/absent. Trade intensities should be corrected for that. In case the EU will adopt a -30% emission reduction target, trade with Australia, New Zealand, Japan, Switzerland, Brazil and Mexico, need to be excluded from the calculation of trade intensities since those countries will adopt comparable climate policies. The average downward correction on trade intensities is 3%. If the EU eventually decides to adopt a -20% reduction scenario, trade flows with Russia, Canada and the USA should also be excluded. Those countries will then have policies of similar stringency. The average correction on trade intensities is then -8,5%. These findings have direct consequences on the allocation mechanism for some sectors, which will no longer receive free emission rights as they do not qualify as 'exposed' to international competition anymore. These sectors are listed in Table 4 (-30% scenario) and Table 5 (-20% scenario) on page 31. Yet, those sectors that are expected to face large cost increases (>5%) due to EU ETS, will still receive free allocation.

  18. Circular Intensity Differential Scattering of chiral molecules

    Energy Technology Data Exchange (ETDEWEB)

    Bustamante, C.J.

    1980-12-01

    In this thesis a theory of the Circular Intensity Differential Scattering (CIDS) of chiral molecules as modelled by a helix oriented with respect to the direction of incidence of light is presented. It is shown that a necessary condition for the existence of CIDS is the presence of an asymmetric polarizability in the scatterer. The polarizability of the scatterer is assumed generally complex, so that both refractive and absorptive phenomena are taken into account.

  19. Statistics of spatially integrated speckle intensity difference

    DEFF Research Database (Denmark)

    Hanson, Steen Grüner; Yura, Harold

    2009-01-01

    We consider the statistics of the spatially integrated speckle intensity difference obtained from two separated finite collecting apertures. For fully developed speckle, closed-form analytic solutions for both the probability density function and the cumulative distribution function are derived...... here for both arbitrary values of the mean number of speckles contained within an aperture and the degree of coherence of the optical field. Additionally, closed-form expressions are obtained for the corresponding nth statistical moments....

  20. Intensive Variables & Nanostructuring in Magnetostructural Materials

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, Laura

    2014-08-13

    Over the course of this project, fundamental inquiry was carried out to investigate, understand and predict the effects of intensive variables, including the structural scale, on magnetostructural phase transitions in the model system of equiatomic FeRh. These transitions comprise simultaneous magnetic and structural phase changes that have their origins in very strong orbital-lattice coupling and thus may be driven by a plurality of effects.

  1. Health, Work Intensity, and Technological Innovations

    OpenAIRE

    Raouf Boucekkine; Natali Hritonenko; Yuri Yatsenko

    2013-01-01

    Work significantly affects human life and health. Overworking may decrease the quality of life and cause direct economic losses. Technological innovations encourage modernization of firms' capital and improve labor productivity in the workplace. The paper investigates the optimal individual choice of work intensity under improving technology embodied in new equipment leading to shorter lifetime of capital goods (obsolescence). The balanced growth trajectories are analyzed in this context to f...

  2. Knowledge-intensive entrepreneurship and financial capital

    DEFF Research Database (Denmark)

    Bøllingtoft, Anne; Neergaard, Helle; Ulhøi, John Parm

    2001-01-01

    This paper addresses various financial issues of relevance in the context of knowledge-intensive entrepreneurship. The study can be seen as an empirical test of parts of a theoretical framework previously developed which aims at identifying and explaining some of the key factors affecting...... investigated (IT and life sciences). In closing, the paper briefly touches upon implications for policy makers, investors and business managers and for research....

  3. Intensity-modulated arc therapy simplified

    International Nuclear Information System (INIS)

    Wong, Eugene; Chen, Jeff Z.; Greenland, Jonathan

    2002-01-01

    Purpose: We present a treatment planning strategy for intensity-modulated radiation therapy using gantry arcs with dynamic multileaf collimator, previously termed intensity-modulated arc therapy (IMAT). Methods and Materials: The planning strategy is an extension of the photon bar arc and asymmetric arc techniques and is classified into three levels of complexity, with increasing number of gantry arcs. This principle allows us to generalize the analysis of the number of arcs required for intensity modulation for a given treatment site. Using a phantom, we illustrate how the current technique is more flexible than the photon bar arc technique. We then compare plans from our strategy with conventional three-dimensional conformal treatment plans for three sites: prostate (prostate plus seminal vesicles), posterior pharyngeal wall, and chest wall. Results: Our strategy generates superior IMAT treatment plans compared to conventional three-dimensional conformal plans. The IMAT plans spare critical organs well, and the trade-off for simplicity is that the dose uniformity in the target volume may not rival that of true inverse treatment plans. Conclusions: The analyses presented in this paper give a better understanding of IMAT plans. Our strategy is easier to understand and more efficient in generating plans than inverse planning systems; our plans are also simpler to modify, and quality assurance is more intuitive

  4. Carbohydrate Dependence During Prolonged, Intense Endurance Exercise.

    Science.gov (United States)

    Hawley, John A; Leckey, Jill J

    2015-11-01

    A major goal of training to improve the performance of prolonged, continuous, endurance events lasting up to 3 h is to promote a range of physiological and metabolic adaptations that permit an athlete to work at both higher absolute and relative power outputs/speeds and delay the onset of fatigue (i.e., a decline in exercise intensity). To meet these goals, competitive endurance athletes undertake a prodigious volume of training, with a large proportion performed at intensities that are close to or faster than race pace and highly dependent on carbohydrate (CHO)-based fuels to sustain rates of muscle energy production [i.e., match rates of adenosine triphosphate (ATP) hydrolysis with rates of resynthesis]. Consequently, to sustain muscle energy reserves and meet the daily demands of training sessions, competitive athletes freely select CHO-rich diets. Despite renewed interest in high-fat, low-CHO diets for endurance sport, fat-rich diets do not improve training capacity or performance, but directly impair rates of muscle glycogenolysis and energy flux, limiting high-intensity ATP production. When highly trained athletes compete in endurance events lasting up to 3 h, CHO-, not fat-based fuels are the predominant fuel for the working muscles and CHO, not fat, availability becomes rate limiting for performance.

  5. LHC Report: Intensity ramp-up

    CERN Multimedia

    Mike Lamont for the LHC Team

    2012-01-01

    The first stable beams at 4 TeV were declared on Thursday, 5 April with 3 bunches per beam. This marked the start of the intensity ramp-up, which aims to get back up to 1380 bunches per beam as quickly as is safely possible.   The next couple of days saw fills with 47, 84 and 264 bunches per beam and on Sunday, 8 April the move was made to 624 bunches. With the squeeze to 60 cm in place, 624 bunches with reasonably high bunch intensities of around 1.3 to 1.4 x1011 protons per bunch have already yielded respectable peak luminosities of up to 2.5 x1033 cm-2s-1. Following a lot of hard work during the Christmas technical stop, machine availability is very good at the moment. The ramp-up in the number of bunches is accompanied by a series of checks aimed to make sure the machine protection systems and operational procedures are in a good enough shape to safely deal with the beam intensity. 624 bunches at 4 TeV already represents an energy over 50 MJ and serious damage potential. The next few days sh...

  6. Intense ion beams for inertial confinement fusion

    International Nuclear Information System (INIS)

    Mehlhorn, T.A.

    1997-01-01

    Intense beams of light of heavy ions are being studied as inertial confinement fusion (ICF) drivers for high yield and energy. Heavy and light ions have common interests in beam transport, targets, and alternative accelerators. Self-pinched transport is being jointly studied. This article reviews the development of intense ion beams for ICF. Light-ion drivers are highlighted because they are compact, modular, efficient and low cost. Issues facing light ions are: (1) decreasing beam divergence; (2) increasing beam brightness; and (3) demonstrating self-pinched transport. Applied-B ion diodes are favored because of efficiency, beam brightness, perceived scalability, achievable focal intensity, and multistage capability. A light-ion concept addressing these issues uses: (1) an injector divergence of ≤ 24 mrad at 9 MeV; (2) two-stage acceleration to reduce divergence to ≤ 12 mrad at 35 MeV; and (3) self-pinched transport accepting divergences up to 12 mrad. Substantial progress in ion-driven target physics and repetitive ion diode technology is also presented. Z-pinch drivers are being pursued as the shortest pulsed power path to target physics experiments and high-yield fusion. However, light ions remain the pulsed power ICF driver of choice for high-yield fusion energy applications that require driver standoff and repetitive operation. 100 refs

  7. High intensity hadron facility, AGS II

    International Nuclear Information System (INIS)

    Lee, Y.Y.; Lowenstein, D.I.

    1989-01-01

    There is a large and growing community of particle and nuclear physicists around the world who are actively lobbying for the construction of an accelerator that could provide 1-2 orders of magnitude increase in proton intensity above that of the present AGS. There have been a series of proposals from Canada, Europe, Japan, and the USA. They can all be characterized as machines varying in energy from 12-60 GeV and intensities of 30-100 μA. The community of physicists using the AGS are in a unique position however. The AGS is the only machine available that can provide the beams to execute the physics program that this large international community is interested in. The BNL approach to the communities interests involves a stepwise intensity upgrade program. At present the AGS slow extracted beam current is 1 μA. With the completion of the Booster in 1990 and the associated AGS modifications, the current will rise to 4-5 μA. With the subsequent addition of the Stretcher which is under design, the current will rise to 8-10 μA and approximately 100% duty factor. The possibility of a further enhancement to a current level of 40-50 μA CW is now being examined. 2 figures, 6 tables

  8. Multicharged and intense heavy ion beam sources

    International Nuclear Information System (INIS)

    Kutner, V.B.

    1981-01-01

    The cyclotron plasma-are source (PIG), duoplasmatron (DP), laser source (LS), electron beam ion source (EBIS) and electron cyclotron resonance source (ECRS) from the viewpoint of generating intense and high charge state beams are considered. It is pointed out that for the last years three types of multicharged ion sources-EBIS, ECR and LS have been essentially developed. In the EBIS source the Xe 48+ ions are produced. The present day level of the development of the electron-beam ionization technique shows that by means of this technique intensive uranium nuclei beams production becomes a reality. On the ECR source Xe 26+ approximately 4x10 10 h/s, Asub(r)sup(12+) approximately 10 12 h/s intensive ion beams are produced. In the laser source a full number of C 6+ ions during one laser pulse constitutes not less than 10 10 from the 5x10mm 2 emission slit. At the present time important results are obtained pointing to the possibility to separate the ion component of laser plasma in the cyclotron central region. On the PIG source the Xe 15+ ion current up to 10μA per pulse is produced. In the duoplasmatron the 11-charge state of xenon ion beams is reached [ru

  9. Intensity dependence of focused ultrasound lesion position

    Science.gov (United States)

    Meaney, Paul M.; Cahill, Mark D.; ter Haar, Gail R.

    1998-04-01

    Knowledge of the spatial distribution of intensity loss from an ultrasonic beam is critical to predicting lesion formation in focused ultrasound surgery. To date most models have used linear propagation models to predict the intensity profiles needed to compute the temporally varying temperature distributions. These can be used to compute thermal dose contours that can in turn be used to predict the extent of thermal damage. However, these simulations fail to adequately describe the abnormal lesion formation behavior observed for in vitro experiments in cases where the transducer drive levels are varied over a wide range. For these experiments, the extent of thermal damage has been observed to move significantly closer to the transducer with increasing transducer drive levels than would be predicted using linear propagation models. The simulations described herein, utilize the KZK (Khokhlov-Zabolotskaya-Kuznetsov) nonlinear propagation model with the parabolic approximation for highly focused ultrasound waves, to demonstrate that the positions of the peak intensity and the lesion do indeed move closer to the transducer. This illustrates that for accurate modeling of heating during FUS, nonlinear effects must be considered.

  10. A Methodological Approach to Quantifying Plyometric Intensity.

    Science.gov (United States)

    Jarvis, Mark M; Graham-Smith, Phil; Comfort, Paul

    2016-09-01

    Jarvis, MM, Graham-Smith, P, and Comfort, P. A Methodological approach to quantifying plyometric intensity. J Strength Cond Res 30(9): 2522-2532, 2016-In contrast to other methods of training, the quantification of plyometric exercise intensity is poorly defined. The purpose of this study was to evaluate the suitability of a range of neuromuscular and mechanical variables to describe the intensity of plyometric exercises. Seven male recreationally active subjects performed a series of 7 plyometric exercises. Neuromuscular activity was measured using surface electromyography (SEMG) at vastus lateralis (VL) and biceps femoris (BF). Surface electromyography data were divided into concentric (CON) and eccentric (ECC) phases of movement. Mechanical output was measured by ground reaction forces and processed to provide peak impact ground reaction force (PF), peak eccentric power (PEP), and impulse (IMP). Statistical analysis was conducted to assess the reliability intraclass correlation coefficient and sensitivity smallest detectable difference of all variables. Mean values of SEMG demonstrate high reliability (r ≥ 0.82), excluding ECC VL during a 40-cm drop jump (r = 0.74). PF, PEP, and IMP demonstrated high reliability (r ≥ 0.85). Statistical power for force variables was excellent (power = 1.0), and good for SEMG (power ≥0.86) excluding CON BF (power = 0.57). There was no significant difference (p > 0.05) in CON SEMG between exercises. Eccentric phase SEMG only distinguished between exercises involving a landing and those that did not (percentage of maximal voluntary isometric contraction [%MVIC] = no landing -65 ± 5, landing -140 ± 8). Peak eccentric power, PF, and IMP all distinguished between exercises. In conclusion, CON neuromuscular activity does not appear to vary when intent is maximal, whereas ECC activity is dependent on the presence of a landing. Force characteristics provide a reliable and sensitive measure enabling precise description of intensity

  11. River flooding due to intense precipitation

    International Nuclear Information System (INIS)

    Lin, James C.

    2014-01-01

    River stage can rise and cause site flooding due to local intense precipitation (LIP), dam failures, snow melt in conjunction with precipitation or dam failures, etc. As part of the re-evaluation of the design basis as well as the PRA analysis of other external events, the likelihood and consequence of river flooding leading to the site flooding need to be examined more rigorously. To evaluate the effects of intense precipitation on site structures, the site watershed hydrology and pond storage are calculated. To determine if river flooding can cause damage to risk-significant systems, structures, and components (SSC), water surface elevations are analyzed. Typically, the amount and rate of the input water is determined first. For intense precipitation, the fraction of the rainfall in the watershed drainage area not infiltrated into the ground is collected in the river and contributes to the rise of river water elevation. For design basis analysis, the Probable Maximum Flood (PMF) is evaluated using the Probable Maximum Precipitation (PMP) based on the site topography/configuration. The peak runoff flow rate and water surface elevations resulting from the precipitation induced flooding can then be estimated. The runoff flow hydrograph and peak discharge flows can be developed using the synthetic hydrograph method. The standard step method can then be used to determine the water surface elevations along the river channel. Thus, the flood water from the local intense precipitation storm and excess runoff from the nearby river can be evaluated to calculate the water surface elevations, which can be compared with the station grade floor elevation to determine the effects of site flooding on risk-significant SSCs. The analysis needs to consider any possible diversion flow and the effects of changes to the site configurations. Typically, the analysis is performed based on conservative peak rainfall intensity and the assumptions of failure of the site drainage facilities

  12. Provincial energy intensity in China: The role of urbanization

    International Nuclear Information System (INIS)

    Yan, Huijie

    2015-01-01

    Chinese policymakers have attached great importance to energy intensity reduction. However, the unprecedented urbanization process exercises additional pressure on the realization of energy intensity reduction targets. A better understanding of the impacts of urbanization is necessary for designing effective policies aimed at reaching the next energy intensity reduction targets. This paper empirically investigates the impacts of urbanization on China's aggregate and disaggregated energy intensities using a balanced panel dataset of 30 provinces covering the period from 2000 to 2012 and panel estimation techniques. The results show that urbanization significantly increases aggregate energy intensity, electricity intensity and coal intensity. - Highlights: • This paper investigates the determinants of China's energy intensity. • Urbanization is responsible for the increase in China's energy intensity. • The fluctuation in China's energy intensity is also affected by other key factors.

  13. Linac design for intense hadron beams

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Chuan

    2009-12-14

    Based on the RFQ and H-type DTL structures, this dissertation is dedicated to study the beam dynamics in the presence of significantly strong space-charge effects while accelerating intense hadron beams in the low- and medium-{beta} region. Besides the 5 mA/30 mA, 17 MeV proton injector (RFQ+DTL) and the 125 mA, 40 MeV deuteron DTL of the EUROTRANS and IFMIF facilities, a 200 mA, 700 keV proton RFQ has been also intensively studied for a small-scale but ultra-intense neutron source FRANZ planned at Frankfurt University. The most remarkable properties of the FRANZ RFQ and the IFMIF DTL are the design beam intensities, 200 mA and 125 mA. A new design approach, which can provide a balanced and accelerated beam bunching at low energy, has been developed for intense beams. To design the IFMIF DTL and the injector DTL part of the EUROTRANS driver linac, which have been foreseen as the first real applications of the novel superconducting CH-DTL structure, intensive attempts have been made to fulfill the design goals under the new conditions. For the IFMIF DTL, the preliminary IAP design has been considerably improved with respect to the linac layout as well as the beam dynamics. By reserving sufficient drift spaces for the cryosystem, diagnostic devices, tuner and steerer, introducing SC solenoid lenses and adjusting the accelerating gradients and accordingly other configurations of the cavities, a more realistic, reliable and efficient linac system has been designed. On the other hand, the specifications and positions of the transverse focusing elements as well as the phase- and energy-differences between the bunch-center particle and the synchronous particle at the beginning of the {phi}{sub s}=0 sections have been totally redesigned. For the EUROTRANS injector DTL, in addition to the above-mentioned procedures, extra optimization concepts to coordinate the beam dynamics between two intensities have been applied. In the beam transport simulations for both DTL designs

  14. Fan-beam intensity modulated proton therapy.

    Science.gov (United States)

    Hill, Patrick; Westerly, David; Mackie, Thomas

    2013-11-01

    This paper presents a concept for a proton therapy system capable of delivering intensity modulated proton therapy using a fan beam of protons. This system would allow present and future gantry-based facilities to deliver state-of-the-art proton therapy with the greater normal tissue sparing made possible by intensity modulation techniques. A method for producing a divergent fan beam of protons using a pair of electromagnetic quadrupoles is described and particle transport through the quadrupole doublet is simulated using a commercially available software package. To manipulate the fan beam of protons, a modulation device is developed. This modulator inserts or retracts acrylic leaves of varying thickness from subsections of the fan beam. Each subsection, or beam channel, creates what effectively becomes a beam spot within the fan area. Each channel is able to provide 0-255 mm of range shift for its associated beam spot, or stop the beam and act as an intensity modulator. Results of particle transport simulations through the quadrupole system are incorporated into the MCNPX Monte Carlo transport code along with a model of the range and intensity modulation device. Several design parameters were investigated and optimized, culminating in the ability to create topotherapy treatment plans using distal-edge tracking on both phantom and patient datasets. Beam transport calculations show that a pair of electromagnetic quadrupoles can be used to create a divergent fan beam of 200 MeV protons over a distance of 2.1 m. The quadrupole lengths were 30 and 48 cm, respectively, with transverse field gradients less than 20 T/m, which is within the range of water-cooled magnets for the quadrupole radii used. MCNPX simulations of topotherapy treatment plans suggest that, when using the distal edge tracking delivery method, many delivery angles are more important than insisting on narrow beam channel widths in order to obtain conformal target coverage. Overall, the sharp distal

  15. Linac design for intense hadron beams

    International Nuclear Information System (INIS)

    Zhang, Chuan

    2009-01-01

    Based on the RFQ and H-type DTL structures, this dissertation is dedicated to study the beam dynamics in the presence of significantly strong space-charge effects while accelerating intense hadron beams in the low- and medium-β region. Besides the 5 mA/30 mA, 17 MeV proton injector (RFQ+DTL) and the 125 mA, 40 MeV deuteron DTL of the EUROTRANS and IFMIF facilities, a 200 mA, 700 keV proton RFQ has been also intensively studied for a small-scale but ultra-intense neutron source FRANZ planned at Frankfurt University. The most remarkable properties of the FRANZ RFQ and the IFMIF DTL are the design beam intensities, 200 mA and 125 mA. A new design approach, which can provide a balanced and accelerated beam bunching at low energy, has been developed for intense beams. To design the IFMIF DTL and the injector DTL part of the EUROTRANS driver linac, which have been foreseen as the first real applications of the novel superconducting CH-DTL structure, intensive attempts have been made to fulfill the design goals under the new conditions. For the IFMIF DTL, the preliminary IAP design has been considerably improved with respect to the linac layout as well as the beam dynamics. By reserving sufficient drift spaces for the cryosystem, diagnostic devices, tuner and steerer, introducing SC solenoid lenses and adjusting the accelerating gradients and accordingly other configurations of the cavities, a more realistic, reliable and efficient linac system has been designed. On the other hand, the specifications and positions of the transverse focusing elements as well as the phase- and energy-differences between the bunch-center particle and the synchronous particle at the beginning of the φ s =0 sections have been totally redesigned. For the EUROTRANS injector DTL, in addition to the above-mentioned procedures, extra optimization concepts to coordinate the beam dynamics between two intensities have been applied. In the beam transport simulations for both DTL designs, no beam

  16. Intense harmonic generation from various ablation media

    International Nuclear Information System (INIS)

    Ozaki, T.; Elouga, L.; Suzuki, M.; Kuroda, H.; Ganeev, R.A.

    2006-01-01

    Complete test of publication follows. High-order harmonic generation (HHG) is a unique source of coherent extreme ultraviolet (XUV) radiation, which can produce soft x-rays within the spectral 'water-window' (between 2.3 and 4.4 nm), and ultimately short pulses with attosecond duration. However, the intensity of present-day harmonics is still low, and serious applications will need an increase of the conversion efficiency. Instead of using gas media, one can also use ablation material, produced on solid targets using a low-intensity prepulse, as the nonlinear medium to generate high-order harmonics. Recently, we have successfully demonstrated the generation of up to the 63 rd harmonic (λ = 12.6 nm) of a Ti:sapphire laser radiation using boron ablation, and a strong enhancement in the intensity of the 13 th harmonic from indium ablation. These harmonics were generated with a modest laser (10 mJ, 150 fs) and with the pre-pulse to main pulse energy ratio constant. In this paper, we perform systematic investigations of ablation harmonics, using the 200 mJ, 30 fs Ti:sapphire beam line of the Canadian Advanced Laser Light Source (ALLS) facility. ALLS allows studying ablation harmonics over wider experimental parameters, and with independent control over the pre-pulse and main pulse energies. The 10 Hz, 200 mJ Ti:sapphire beam line of ALLS is divided into two beams. Each beam has its own energy control system, which allows independent control over the energy of each beam. One of the beams is used as a pre-pulse for creating ablation, which is focused onto the solid target without pulse compression, with pulse duration of 200 ps. The second beam is used as the main pulse for harmonic generation. The main pulse is delayed in time relative to the pre-pulse by propagating through an optical delay line, and then sent through a pulse compressor. The compressed pulse duration have typical pulse duration of 30 fs FWHM, which is then focused onto the ablation medium using MgF 2

  17. Active Provenance in Data-intensive Research

    Science.gov (United States)

    Spinuso, Alessandro; Mihajlovski, Andrej; Filgueira, Rosa; Atkinson, Malcolm

    2017-04-01

    Scientific communities are building platforms where the usage of data-intensive workflows is crucial to conduct their research campaigns. However managing and effectively support the understanding of the 'live' processes, fostering computational steering, sharing and re-use of data and methods, present several bottlenecks. These are often caused by the poor level of documentation on the methods and the data and how users interact with it. This work wants to explore how in such systems, flexibility in the management of the provenance and its adaptation to the different users and application contexts can lead to new opportunities for its exploitation, improving productivity. In particular, this work illustrates a conceptual and technical framework enabling tunable and actionable provenance in data-intensive workflow systems in support of reproducible science. It introduces the concept of Agile data-intensive systems to define the characteristic of our target platform. It shows a novel approach to the integration of provenance mechanisms, offering flexibility in the scale and in the precision of the provenance data collected, ensuring its relevance to the domain of the data-intensive task, fostering its rapid exploitation. The contributions address aspects of the scale of the provenance records, their usability and active role in the research life-cycle. We will discuss the use of dynamically generated provenance types as the approach for the integration of provenance mechanisms into a data-intensive workflow system. Enabling provenance can be transparent to the workflow user and developer, as well as fully controllable and customisable, depending from their expertise and the application's reproducibility, monitoring and validation requirements. The API that allows the realisation and adoption of a provenance type is presented, especially for what concerns the support of provenance profiling, contextualisation and precision. An actionable approach to provenance

  18. Nitrification inhibitors mitigated reactive gaseous nitrogen intensity in intensive vegetable soils from China.

    Science.gov (United States)

    Fan, Changhua; Li, Bo; Xiong, Zhengqin

    2018-01-15

    Nitrification inhibitors, a promising tool for reducing nitrous oxide (N 2 O) losses and promoting nitrogen use efficiency by slowing nitrification, have gained extensive attention worldwide. However, there have been few attempts to explore the broad responses of multiple reactive gaseous nitrogen emissions of N 2 O, nitric oxide (NO) and ammonia (NH 3 ) and vegetable yield to nitrification inhibitor applications across intensive vegetable soils in China. A greenhouse pot experiment with five consecutive vegetable crops was performed to assess the efficacies of two nitrification inhibitors, namely, nitrapyrin and dicyandiamide on reactive gaseous nitrogen emissions, vegetable yield and reactive gaseous nitrogen intensity in four typical vegetable soils representing the intensive vegetable cropping systems across mainland China: an Acrisol from Hunan Province, an Anthrosol from Shanxi Province, a Cambisol from Shandong Province and a Phaeozem from Heilongjiang Province. The results showed soil type had significant influences on reactive gaseous nitrogen intensity, with reactive gaseous nitrogen emissions and yield mainly driven by soil factors: pH, nitrate, C:N ratio, cation exchange capacity and microbial biomass carbon. The highest reactive gaseous nitrogen emissions and reactive gaseous nitrogen intensity were in Acrisol while the highest vegetable yield occurred in Phaeozem. Nitrification inhibitor applications decreased N 2 O and NO emissions by 1.8-61.0% and 0.8-79.5%, respectively, but promoted NH 3 volatilization by 3.2-44.6% across all soils. Furthermore, significant positive correlations were observed between inhibited N 2 O+NO and stimulated NH 3 emissions with nitrification inhibitor additions across all soils, indicating that reduced nitrification posed the threat of NH 3 losses. Additionally, reactive gaseous nitrogen intensity was significantly reduced in the Anthrosol and Cambisol due to the reduced reactive gaseous nitrogen emissions and increased

  19. Kinetic Analysis of Horizontal Plyometric Exercise Intensity.

    Science.gov (United States)

    Kossow, Andrew J; Ebben, William P

    2018-05-01

    Kossow, AJ, DeChiara, TG, Neahous, SM, and Ebben, WP. Kinetic analysis of horizontal plyometric exercise intensity. J Strength Cond Res 32(5): 1222-1229, 2018-Plyometric exercises are frequently performed as part of a strength and conditioning program. Most studies assessed the kinetics of plyometric exercises primarily performed in the vertical plane. The purpose of this study was to evaluate the multiplanar kinetic characteristics of a variety of plyometric exercises, which have a significant horizontal component. This study also sought to assess sex differences in the intensity progression of these exercises. Ten men and 10 women served as subjects. The subjects performed a variety of plyometric exercises including the double-leg hop, standing long jump, single-leg standing long jump, bounding, skipping, power skipping, cone hops, and 45.72-cm hurdle hops. Subjects also performed the countermovement jump for comparison. All plyometric exercises were evaluated using a force platform. Dependent variables included the landing rate of force development and landing ground reaction forces for each exercise in the vertical, frontal, and sagittal planes. A 2-way mixed analysis of variance with repeated-measures for plyometric exercise type demonstrated main effects for exercise type for all dependent variables (p ≤ 0.001). There was no significant interaction between plyometric exercise type and sex for any of the variable assessed. Bonferroni-adjusted pairwise comparisons identified a number of differences between the plyometric exercises for the dependent variables assessed (p ≤ 0.05). These findings should be used to guide practitioners in the progression of plyometric exercise intensity, and thus program design, for those who require significant horizontal power in their sport.

  20. Kinetic quantification of plyometric exercise intensity.

    Science.gov (United States)

    Ebben, William P; Fauth, McKenzie L; Garceau, Luke R; Petushek, Erich J

    2011-12-01

    Ebben, WP, Fauth, ML, Garceau, LR, and Petushek, EJ. Kinetic quantification of plyometric exercise intensity. J Strength Cond Res 25(12): 3288-3298, 2011-Quantification of plyometric exercise intensity is necessary to understand the characteristics of these exercises and the proper progression of this mode of exercise. The purpose of this study was to assess the kinetic characteristics of a variety of plyometric exercises. This study also sought to assess gender differences in these variables. Twenty-six men and 23 women with previous experience in performing plyometric training served as subjects. The subjects performed a variety of plyometric exercises including line hops, 15.24-cm cone hops, squat jumps, tuck jumps, countermovement jumps (CMJs), loaded CMJs equal to 30% of 1 repetition maximum squat, depth jumps normalized to the subject's jump height (JH), and single leg jumps. All plyometric exercises were assessed with a force platform. Outcome variables associated with the takeoff, airborne, and landing phase of each plyometric exercise were evaluated. These variables included the peak vertical ground reaction force (GRF) during takeoff, the time to takeoff, flight time, JH, peak power, landing rate of force development, and peak vertical GRF during landing. A 2-way mixed analysis of variance with repeated measures for plyometric exercise type demonstrated main effects for exercise type and all outcome variables (p ≤ 0.05) and for the interaction between gender and peak vertical GRF during takeoff (p ≤ 0.05). Bonferroni-adjusted pairwise comparisons identified a number of differences between the plyometric exercises for the outcome variables assessed (p ≤ 0.05). These findings can be used to guide the progression of plyometric training by incorporating exercises of increasing intensity over the course of a program.

  1. Development of a high intensity proton accelerator

    International Nuclear Information System (INIS)

    Mizumoto, Motoharu; Kusano, Joichi; Hasegawa, Kazuo; Ito, Nobuo; Oguri, Hidetomo; Touchi, Yutaka; Mukugi, Ken; Ino, Hiroshi

    1997-01-01

    The high-intensity proton linear accelerator with a beam power of 15 MW has been proposed for various engineering tests for the nuclear waste transmutation system as one of the research plans in the Neutron Science Research Program (NSRP) in JAERI. High intensity proton beam and secondary particle beams such as neutron, pion, muon and unstable radio isotope (RI) beam generated from the proton spallation reaction will be utilized at these facilities in each research field. The R and D work has been carried out for the components of the front-end part of the proton accelerator; ion source, RFQ, DTL and RF source. In the beam test, the current of 70 mA with a duty factor of 7% has been accelerated from the RFQ at the energy of 2 MeV. A hot test model of the DTL for the high power and high duty operation was fabricated and tested. For the high energy portion above 100 MeV, superconducting accelerating cavity is studied as a main option. The superconducting linac is expected to have several favourable characteristics for high intensity accelerator such as short accelerator length, large bore radius resulting in low beam losses and cost effectiveness for construction and operation. A test stand with equipment of cryogenics system, vacuum system, RF system and cavity processing and cleaning is prepared to test the physics issues and fabrication process. The proposed plan for accelerator design and construction will compose of two consecutive stages. The first stage will be completed in about 7 years with the beam power of 1.5 MW. As the second stage gradual upgrading of the beam power will be made up to 15 MW. 7 refs., 3 figs., 4 tabs

  2. Capital effectiveness in a capital intensive project

    Energy Technology Data Exchange (ETDEWEB)

    Yarossi, M.E. (IPA Institute, The Hague (Netherlands))

    2009-07-01

    The technical difficulty of incorporating new technology in capital intensive projects has been underestimated. Bio-refineries projects are no exemption. These projects in many occasions have assigned inadequate project resources, such as lean project teams and overly optimistic contingencies. Furthermore, project developers have set unrealistic expectations; for example: aggressive schedule duration, low cost targets and optimistic operability targets. These project drivers set before project's authorization compromise the project's outcome. In many cases, this translates into lower return on investment, higher costs, and lower operability. In order to counteract these outcomes, it is critical for capital intensive projects, like bio-refineries, to have a well define project which will enable to increase its chance of success. IPA's research has shown that bio-refineries projects have poor project performance due to poor project practices, lack of owner project controls and inadequate change management. An adequate risk analysis during definition is a critical component of a project's success, especially when there is new technology, like biomass conversion. It is of outmost importance to asses this technology and set realistic expectations. parallel to this, there is a need to have a well established execution strategy, which should be maintained throughout the execution of the project. In conclusion, IPA's research has indicated that bio-refineries, as any other capital intensive project, need to assign adequate resources at an early state of project development, by making sure there is and adequate team in place, reasonable schedule, technical difficulties evaluation, and keeping control during execution. Although these elements might be seen as common practices that should be taken into account when developing a project, many projects being their execution without having a proper foundation, and thus affecting the project

  3. Origin of transient cosmic ray intensity variations

    International Nuclear Information System (INIS)

    Duggal, S.P.; Pomerantz, M.A.

    1977-01-01

    A new approach to determining the solar progenitor of transient cosmic ray intensity variations has revealed that in a statistical sense, solar flares, heretofore regarded as the predominant source of the modulation, actually do not precede the reduction in flux observed at earth. Superposed epoch analysis of the cosmic ray data with respect to the time of occurrence of all 379 solar flares of importance (Imp) < or =2 observed during solar cycle 20 (1964-1974 inclusive) shows that the onset of a decrease in the composite nucleonic intensity at polar stations occurs prior to the zero day (i.e., time of the flare) well before the arrival in the vicinity of earth of the associated solar plasma. The statistical significance of this result is confirmed by comparing the pooled variance determined from Chree analysis of an equal number of random epochs with that of the curve representing the flare epochs. Subdivision of the latter into three groups according to the heliographic longitude of the flares shows that whereas eastern flares might be associated with cosmic ray decreases, central (30degree to -30degree) and western flares cannot be thus related. A similar analysis of all flares of Imp< or =2 that occurred in a selected set of 24 extraordinary flare-rich active centers during 1964--1974 confirms these results and shows that the observed cosmic ray intensity decrease is, in fact, associated with the central meridian passage ( +- 1 day) of the active regions. Thus earlier conclusions concerning relationships between the heliolongitude of flares and their apparent effectiveness in producing Forbush decreases require reevaluation. The specific feature associated with solar active centers that is actually the principal source of transient modulations remanins to be identified

  4. Hand hygiene in the intensive care unit.

    Science.gov (United States)

    Tschudin-Sutter, Sarah; Pargger, Hans; Widmer, Andreas F

    2010-08-01

    Healthcare-associated infections affect 1.4 million patients at any time worldwide, as estimated by the World Health Organization. In intensive care units, the burden of healthcare-associated infections is greatly increased, causing additional morbidity and mortality. Multidrug-resistant pathogens are commonly involved in such infections and render effective treatment challenging. Proper hand hygiene is the single most important, simplest, and least expensive means of preventing healthcare-associated infections. In addition, it is equally important to stop transmission of multidrug-resistant pathogens. According to the Centers for Disease Control and Prevention and World Health Organization guidelines on hand hygiene in health care, alcohol-based handrub should be used as the preferred means for routine hand antisepsis. Alcohols have excellent in vitro activity against Gram-positive and Gram-negative bacteria, including multidrug-resistant pathogens, such as methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci, Mycobacterium tuberculosis, a variety of fungi, and most viruses. Some pathogens, however, such as Clostridium difficile, Bacillus anthracis, and noroviruses, may require special hand hygiene measures. Failure to provide user friendliness of hand hygiene equipment and shortage of staff are predictors for noncompliance, especially in the intensive care unit setting. Therefore, practical approaches to promote hand hygiene in the intensive care unit include provision of a minimal number of handrub dispensers per bed, monitoring of compliance, and choice of the most attractive product. Lack of knowledge of guidelines for hand hygiene, lack of recognition of hand hygiene opportunities during patient care, and lack of awareness of the risk of cross-transmission of pathogens are barriers to good hand hygiene practices. Multidisciplinary programs to promote increased use of alcoholic handrub lead to an increased compliance of healthcare

  5. Method of enhancing cyclotron beam intensity

    Science.gov (United States)

    Hudson, Ed D.; Mallory, Merrit L.

    1977-01-01

    When an easily ionized support gas such as xenon is added to the cold cathode in sources of the Oak Ridge Isochronous Cyclotron, large beam enhancements are produced. For example, .sup.20 Ne.sup.7+ is increased from 0.05 enA to 27 enA, and .sup.16 O.sup.5+ intensities in excess of 35 e.mu.A have been extracted for periods up to 30 minutes. Approximately 0.15 cc/min of the easily ionized support gas is supplied to the ion source through a separate gas feed line and the primary gas flow is reduced by about 30%.

  6. Moderate and high intensity pulsed electric fields

    OpenAIRE

    Timmermans, Rian Adriana Hendrika

    2018-01-01

    Pulsed Electric Field (PEF) processing has gained a lot of interest the last decades as mild processing technology as alternative to thermal pasteurisation, and is suitable for preservation of liquid food products such as fruit juices. PEF conditions typically applied at industrial scale for pasteurisation are high intensity pulsed electric fields aiming for minimal heat load, with an electric field strength (E) in the range of 15 − 20 kV/cm and pulse width (τ) between 2 − 20 μs. Alternativel...

  7. Status of the intense pulsed neutron source

    International Nuclear Information System (INIS)

    Brown, B.S.; Carpenter, J.M.; Crawford, R.K.; Rauchas, A.V.; Schulke, A.W.; Worlton, T.G.

    1989-01-01

    Since 1981 the average proton currents at IPNS has increased substantially. The reliability has averaged 91%. The moderator has changed from a room temperature polyethylene to cryogenic methane. This report details progress made at IPNS (Intense Pulsed Neutron Source) during the last two years. The topics discussed are the operating status of the accelerator systems, other accelerator activities (such as, IPNS participation in SDI), instrumentation operating at IPNS, chopper development at IPNS, data acquisition, Booster target, moderators and examples of recent scientific results. The ever increasing instrument capability, the Booster target and the very active involvement with the scientific user community guarantees a productive scientific future at IPNS. 9 figs., 3 tabs

  8. Progress in Ultrafast Intense Laser Science II

    CERN Document Server

    Yamanouchi, Kaoru; Agostini, Pierre; Ferrante, Gaetano

    2007-01-01

    This book series addresses a newly emerging interdisciplinary research field, Ultrafast Intense Laser Science, spanning atomic and molecular physics, molecular science, and optical science. Its progress is being stimulated by the recent development of ultrafast laser technologies. Highlights of this second volume include Coulomb explosion and fragmentation of molecules, control of chemical dynamics, high-order harmonic generation, propagation and filamentation, and laser-plasma interaction. All chapters are authored by foremost experts in their fields and the texts are written at a level accessible to newcomers and graduate students, each chapter beginning with an introductory overview.

  9. Cloud computing for data-intensive applications

    CERN Document Server

    Li, Xiaolin

    2014-01-01

    This book presents a range of cloud computing platforms for data-intensive scientific applications. It covers systems that deliver infrastructure as a service, including: HPC as a service; virtual networks as a service; scalable and reliable storage; algorithms that manage vast cloud resources and applications runtime; and programming models that enable pragmatic programming and implementation toolkits for eScience applications. Many scientific applications in clouds are also introduced, such as bioinformatics, biology, weather forecasting and social networks. Most chapters include case studie

  10. Interaction of Intense Lasers with Plasmas

    Science.gov (United States)

    Shvets, Gennady

    1995-01-01

    This thesis addresses two important topics in nonlinear laser plasma physics: the interaction of intense lasers with a non thermal homogeneous plasma, the excitation of laser wakefields in hollow plasma channels, and the stability of channel guided propagation of laser pulses. In the first half of this thesis a new theoretical approach to the nonlinear interaction of intense laser pulses with underdense plasmas is developed. Unlike previous treatments, this theory is three-dimensional, relativistically covariant, and does not assume that astudied. An experimental check of this calculation is suggested, based on the predicted non-linear polarization rotation (the second harmonic is emitted polarized perpendicularly to polarization of the incident signal). The concept of renormalization is applied to the plasma and electromagnetic radiation (photons and plasmons). To the lowest order, this corresponds to relativistically correcting the electron mass for its oscillation in an intense EM field and to replacing the vacuum dispersion relation by the usual relativistic plasma dispersion relation. This renormalization procedure is then carried to higher order in epsilon=omega_sp{p} {2}a^2/[(1+a^2/2)^ {3/2}omega^2]. This yields the nonlinear modification of the index of refraction of a strong electromagnetic wave and the dispersion of a weak probe in the presence of the wave. In the second part of this thesis the stability of short laser pulses propagating through parabolic channels and the wake excitation of hollow plasma channels are studied. The stability of a channel guided short laser pulse propagation is analyzed for the first time. Perturbations to the laser pulse are shown to modify the ponderomotive pressure, which distorts the dielectric properties of the plasma channel. The channel perturbation then further distorts the laser pulse. A set of coupled mode equations is derived, and a matrix dispersion relation is obtained analytically. The ponderomotive excitation

  11. Progress in ultrafast intense laser science XI

    CERN Document Server

    Yamanouchi, Kaoru; Martin, Philippe

    2014-01-01

    The PUILS series delivers up-to-date reviews of progress in Ultrafast Intense Laser Science, a newly emerging interdisciplinary research field spanning atomic and molecular physics, molecular science and optical science, which has been stimulated by the recent developments in ultrafast laser technologies. Each volume compiles peer-reviewed articles authored by researchers at the forefront of each their own subfields of UILS. Every chapter opens with an overview of the topics to be discussed, so that researchers unfamiliar to the subfield, as well as graduate students, can grasp the importance

  12. Particle physics in intense electromagnetic fields

    International Nuclear Information System (INIS)

    Kurilin, A.V.

    1999-01-01

    The quantum field theory in the presence of classical background electromagnetic field is reviewed giving a pedagogical introduction to the Feynman-Furry method of describing non-perturbative interactions with very strong electromagnetic fields. A particular emphasis is given to the case of the plane-wave electromagnetic field for which the charged particles' wave functions and propagators are presented. Some general features of quantum processes proceeding in the intense electromagnetic background are argued. The possibilities of searching new physics through the investigations of quantum phenomena induced by a strong electromagnetic environment are also discussed

  13. FBCT fast intensity measurement using TRIC cards

    CERN Document Server

    Allica, J C; Belohrad, D; Jensen, L; Lenardon, F; SØby, L

    2015-01-01

    At the CERN PS complex, precise fast intensity measurements are very important in order to optimize the transfer efficiencies between the different accelerators. Over the last two years a complete renovation has been ongoing, where the old electronics, based on analogue integrators, have been replaced by a fully digital system enclosed in a single VME based card. This new system called TRIC (Transformer Integration Card) is based on a 12 bit, 212 MS/s ADC and an FPGA for the signal processing. Also located on the same board one finds a 250 V/1.5 W DCDC converter used to generate precise calibration pulses.

  14. Progress in ultrafast intense laser science

    CERN Document Server

    Yamanouchi, Kaoru; Mathur, Deepak

    2014-01-01

    The PUILS series delivers up-to-date reviews of progress in Ultrafast Intense Laser Science, a newly emerging interdisciplinary research field spanning atomic and molecular physics, molecular science, and optical science, which has been stimulated by the recent developments in ultrafast laser technologies. Each volume compiles peer-reviewed articles authored by researchers at the forefront of each their own subfields of UILS. Every chapter opens with an overview of the topics to be discussed, so that researchers unfamiliar to the subfield, as well as graduate students, can grasp the importance

  15. Exploring high-intensity QED at ELI

    Energy Technology Data Exchange (ETDEWEB)

    Heinzl, T. [Plymouth Univ., School of Mathematics and Statistics, Drake Circus, PL4 8AA (United Kingdom); Ilderton, A. [School of Mathematics, Hamilton Building, Trinity College, Dublin (Ireland)

    2009-11-15

    We give a non-technical overview of quantum electrodynamics (QED) effects arising in the presence of ultra-strong electromagnetic fields highlighting the new prospects provided by a realisation of the ELI laser facility. Vacuum polarization is a genuine QED process describing the probability amplitude of a propagating photon fluctuating into a virtual electron-positron pair. It has measurable effects such as the Lamb shift and charge screening at short distances. Nonlinear Compton scattering that consists of processes of the type: e + ngamma{sub L} -> e' + gamma (where n counting the number of laser photons involved) is an intensity dependent effect that is accessible to experimental observation

  16. The utilization of high-intensity lasers

    International Nuclear Information System (INIS)

    Fabre, E.

    1988-01-01

    The 1988 progress report of the laboratory for the Utilization of High-Intensity Lasers (Polytechnic School, France), is presented. The research program is focused on the laser-plasma physics, on the generation of high pressures by means of laser shock heating, on the laser spectroscopy and on the laser implosions. Numerical simulation codes are developed. Concerning the atomic physics, the investigations on dense plasmas and the x-laser research developments are carried out. The research activities of the laboratory teams, the published papers, the national and international cooperations, are given [fr

  17. Computed tomography for neurological intensive care patients

    International Nuclear Information System (INIS)

    Rodiek, S.; Neu, I.

    1977-01-01

    The first 100 computed tomographic (CT) examinations of the patients on the neurological intensive care ward are discussed and reported on the basis of selected typical findings. Characteristic patterns of the CT findings in determined cerebral diseases are explained. The possibility and necessity of CT observations of the development of inflammatory and cerebrovascular processes in particular are emphasized. A comparison of our experience with CT and other neuroradiological methods, is made. The clinical diagnoses, including the respective number of cases and the pertinent CT findings, are presented in a Table. (orig.) [de

  18. Antibiotic Policies in the Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Nese Saltoglu

    2003-08-01

    Full Text Available The antimicrobial management of patients in the Intensive Care Units are complex. Antimicrobial resistance is an increasing problem. Effective strategies for the prevention of antimicrobial resistance in ICUs have focused on limiting the unnecessary use of antibiotics and increasing compliance with infection control practices. Antibiotic policies have been implemented to modify antibiotic use, including national or regional formulary manipulations, antibiotic restriction forms, care plans, antibiotic cycling and computer assigned antimicrobial therapy. Moreover, infectious diseases consultation is a simple way to limit antibiotic use in ICU units. To improve rational antimicrobial using a multidisiplinary approach is suggested. [Archives Medical Review Journal 2003; 12(4.000: 299-309

  19. [Intensity of depression in pedagogy students].

    Science.gov (United States)

    Pietras, Tadeusz; Witusik, Andrzej; Panek, Michał; Zielińska-Wyderkiewicz, Ewa; Kuna, Piotr; Górski, Paweł

    2012-03-01

    The teacher's profession is regarded to be susceptible to professional burnout. Its early markers include high neuroticism and tendency to depressive reactions. The aim of the study was to assess the depression intensity and the occurrence of mood disorders in the population of full-time and extramural course students of pedagogy aged 19-30, as well as the difference in intensity of the measured constructs between men and women. The study was carried out on the group of 223 women and 162 men aged 19-30 studying pedagogy at Piotrków Trybunalski Division of Jan Kochanowski Memorial University in Kielce in the years 2008-2011. The control group consisted of 76 women and 88 men studying economics. Students of full-time and extramural courses were included. All the participants were assessed with Beck Depression Inventory. Depression as a syndrome was diagnosed if the score of 10 of more was obtained. Among female students of pedagogy, 21 out of 223 obtained Beck Depression Inventory scores equal to, or above 10; whereas among female students of economics 1 out of 76 obtained such a result. The relative risk of developing depression (understood as Beck Depression Inventory result of 10 or more) was found to be significantly higher among female pedagogues (OR 7.797; CI 1.0306 to 58.9856) than among female economists. Among male pedagogy students, 2 out of 162 obtained 10 points, or more. It means that the risk of depression in female pedagogues was as much as over eight-fold higher than in male pedagogues (OR 8.3168; CI 1.9215 - 35.9979). The risk of depression in men studying pedagogy was not higher than in men studying economics, who obtained the Beck Depression Inventory scores of 10 or more in 1 case out of 88 (OR 1.1; CI 0.0983 to 12.3032). Considering all pedagogues irrespectively of gender versus all economists, the risk of depression in the group of pedagogues is over five-fold higher than among economists (OR 5.1464; CI 1.1991 to 22.0885). In the whole group of

  20. Raman band intensities of tellurite glasses.

    Science.gov (United States)

    Plotnichenko, V G; Sokolov, V O; Koltashev, V V; Dianov, E M; Grishin, I A; Churbanov, M F

    2005-05-15

    Raman spectra of TeO2-based glasses doped with WO3, ZnO, GeO2, TiO2, MoO3, and Sb2O3 are measured. The intensity of bands in the Raman spectra of MoO3-TeO2 and MoO3-WO3-TeO2 glasses is shown to be 80-95 times higher than that for silica glass. It is shown that these glasses can be considered as one of the most promising materials for Raman fiber amplifiers.

  1. Raman overtone intensities measured for H2

    International Nuclear Information System (INIS)

    Shelton, D.P.

    1990-01-01

    The Raman spectra of the vibrational fundamental, first overtone and second overtone transitions of the H 2 molecule were recorded using visible and ultraviolet argon--ion laser excitation. The ratios of transition polarizability matrix elements, α 01,21 /α 01,11 and α 01,31 /α 01,11 , were determined from the measured intensities of the Q(1) Raman lines v,J=0,1→v',1 for v'=1,2,3. The experimentally determined value of the Raman first overtone matrix element is in good agreement with the value from the best ab initio calculation

  2. Wind Turbine Power Curves Incorporating Turbulence Intensity

    DEFF Research Database (Denmark)

    Sørensen, Emil Hedevang Lohse

    2014-01-01

    . The model and method are parsimonious in the sense that only a single function (the zero-turbulence power curve) and a single auxiliary parameter (the equivalent turbulence factor) are needed to predict the mean power at any desired turbulence intensity. The method requires only ten minute statistics......The performance of a wind turbine in terms of power production (the power curve) is important to the wind energy industry. The current IEC-61400-12-1 standard for power curve evaluation recognizes only the mean wind speed at hub height and the air density as relevant to the power production...

  3. Aligning molecules with intense nonresonant laser fields

    DEFF Research Database (Denmark)

    Larsen, J.J.; Safvan, C.P.; Sakai, H.

    1999-01-01

    Molecules in a seeded supersonic beam are aligned by the interaction between an intense nonresonant linearly polarized laser field and the molecular polarizability. We demonstrate the general applicability of the scheme by aligning I2, ICl, CS2, CH3I, and C6H5I molecules. The alignment is probed...... by mass selective two dimensional imaging of the photofragment ions produced by femtosecond laser pulses. Calculations on the degree of alignment of I2 are in good agreement with the experiments. We discuss some future applications of laser aligned molecules....

  4. High-intensity-laser-electron scattering

    International Nuclear Information System (INIS)

    Meyerhofer, D.D.

    1997-01-01

    In the field of an intense laser, photon-electron scattering becomes nonlinear when the oscillatory energy of the electron approaches its rest mass. The electron wave function is dressed by the field with a concomitant increase in the effective electron mass. When the photon energy in the electron rest frame is comparable to the electron rest mass, multiphoton Compton scattering occurs. When the photon energy is significantly lower than the electron rest mass, the electron acquires momentum from the photon field and emits harmonics. This paper reviews nonlinear photon-electron scattering processes and results from two recent experiments where they have been observed

  5. Quality of intensive care chest imaging

    International Nuclear Information System (INIS)

    Adam, G.; Wein, B.; Keulers, P.; Stargardt, A.; Guenther, R.W.

    1989-01-01

    The authors have evaluated the image quality of a stimulable phosphorous plate system in intensive care chest radiography. Four radiologists examined 308 chest radiographs (200 conventional, 108 digital) according to the following criteria: visibility of catheters, tubes (artificial objects), bronchi, central and peripheral vessels, diaphragm, trachea, and retrocardial lung parenchyma. Detectability of these structures was classified as good, poor, or impossible to see. In addition, optical density was measured in the region of liver, heart, and lung. Results were evaluated by Student and υ test

  6. Unsteady thermal blooming of intense laser beams

    Science.gov (United States)

    Ulrich, J. T.; Ulrich, P. B.

    1980-01-01

    A four dimensional (three space plus time) computer program has been written to compute the nonlinear heating of a gas by an intense laser beam. Unsteady, transient cases are capable of solution and no assumption of a steady state need be made. The transient results are shown to asymptotically approach the steady-state results calculated by the standard three dimensional thermal blooming computer codes. The report discusses the physics of the laser-absorber interaction, the numerical approximation used, and comparisons with experimental data. A flowchart is supplied in the appendix to the report.

  7. Intensity of interprofessional collaboration among intensive care nurses at a tertiary hospital.

    Science.gov (United States)

    Serrano-Gemes, G; Rich-Ruiz, M

    To measure the intensity of interprofessional collaboration (IPC) in nurses of an intensive care unit (ICU) at a tertiary hospital, to check differences between the dimensions of the Intensity of Interprofessional Collaboration Questionnaire, and to identify the influence of personal variables. A cross-sectional descriptive study was conducted with 63 intensive care nurses selected by simple random sampling. Explanatory variables: age, sex, years of experience in nursing, years of experience in critical care, workday type and work shift type; variable of outcome: IPC. The IPC was measured by: Intensity of Interprofessional Collaboration Questionnaire. Descriptive and bivariate statistical analysis (IPC and its dimensions with explanatory variables). 73.8% were women, with a mean age of 46.54 (±6.076) years. The average years experience in nursing and critical care was 23.03 (±6.24) and 14.25 (±8.532), respectively. 77% had a full time and 95.1% had a rotating shift. 62.3% obtained average IPC values. Statistically significant differences were found (P<.05) between IPC (overall score) and overall assessment with years of experience in critical care. This study shows average levels of IPC; the nurses with less experience in critical care obtained higher IPC and overall assessment scores. Copyright © 2016 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  8. High-intensity interval training evokes larger serum BDNF levels compared with intense continuous exercise.

    Science.gov (United States)

    Saucedo Marquez, Cinthia Maria; Vanaudenaerde, Bart; Troosters, Thierry; Wenderoth, Nicole

    2015-12-15

    Exercise can have a positive effect on the brain by activating brain-derived neurotrophic factor (BDNF)-related processes. In healthy humans there appears to be a linear relationship between exercise intensity and the positive short-term effect of acute exercise on BDNF levels (i.e., the highest BDNF levels are reported after high-intensity exercise protocols). Here we performed two experiments to test the effectiveness of two high-intensity exercise protocols, both known to improve cardiovascular health, to determine whether they have a similar efficacy in affecting BDNF levels. Participants performed a continuous exercise (CON) protocol at 70% of maximal work rate and a high-intensity interval-training (HIT) protocol at 90% of maximal work rate for periods of 1 min alternating with 1 min of rest (both protocols lasted 20 min). We observed similar BDNF kinetics in both protocols, with maximal BDNF concentrations being reached toward the end of training (experiment 1). We then showed that both exercise protocols significantly increase BDNF levels compared with a rest condition (CON P = 0.04; HIT P exercise are slightly more effective than continuous high-intensity exercise for elevating serum BDNF. Additionally, 73% of the participants preferred the HIT protocol (P = 0.02). Therefore, we suggest that the HIT protocol might represent an effective and preferred intervention for elevating BDNF levels and potentially promoting brain health. Copyright © 2015 the American Physiological Society.

  9. Nuclear energy = more jobs. [Capital-intensive vs labor-intensive systems

    Energy Technology Data Exchange (ETDEWEB)

    Brookes, L G

    1979-07-01

    In the April 1979 issue of Energy Manager, Dr. David Elliott of Open University says capital-intensive systems employ less labor per unit of output, concluding that nuclear energy represented a poor bargain in terms of money invested per job created. Responding to this earlier article, Dr. Brookes argues that capital-intensive systems may employ less labor per unit of output, but they also produce more output and income per worker. Dr. Brookes uses a simple analysis to illustrate how progress results by increasing capital investment and disagrees strongly with Elliotts conclusions - says output must become more capital-intensive to provide more employment opportunities. Further, he feels that Elliott and other antinuclear and environmentalist writers have fallen into the trap of the fallacy of composition - assuming that what is true for a small number of constituent parts taken singly is true also for the total system taken as a whole. Examples can be found in economics of microeconomic elements which do not add up to the expected macroeconomic composition, which explains why some capital-intensive strategies are good and others are not. The excess income produced by capital-intensive energy strategies supports the service and public administration sectors. 3 figures, 1 table. (DCK)

  10. Light-intensity and high-intensity interval training improve cardiometabolic health in rats.

    Science.gov (United States)

    Batacan, Romeo B; Duncan, Mitch J; Dalbo, Vincent J; Connolly, Kylie J; Fenning, Andrew S

    2016-09-01

    Physical activity has the potential to reduce cardiometabolic risk factors but evaluation of different intensities of physical activity and the mechanisms behind their health effects still need to be fully established. This study examined the effects of sedentary behaviour, light-intensity training, and high-intensity interval training on biometric indices, glucose and lipid metabolism, inflammatory and oxidative stress markers, and vascular and cardiac function in adult rats. Rats (12 weeks old) were randomly assigned to 1 of 4 groups: control (CTL; no exercise), sedentary (SED; no exercise and housed in small cages to reduce activity), light-intensity trained (LIT; four 30-min exercise bouts/day at 8 m/min separated by 2-h rest period, 5 days/week), and high-intensity interval trained (HIIT, four 2.5-min work bouts/day at 50 m/min separated by 3-min rest periods, 5 days/week). After 12 weeks of intervention, SED had greater visceral fat accumulation (p HIIT demonstrated beneficial changes in body weight, visceral and epididymal fat weight, glucose regulation, low-density lipoprotein cholesterol, total cholesterol, and mesenteric vessel contractile response compared with the CTL group (p HIIT had significant improvements in systolic blood pressure and endothelium-independent vasodilation to aorta and mesenteric artery compared with the CTL group (p HIIT induce health benefits by improving traditional cardiometabolic risk factors. LIT improves cardiac health while HIIT promotes improvements in vascular health.

  11. Data privacy considerations in Intensive Care Grids.

    Science.gov (United States)

    Luna, Jesus; Dikaiakos, Marios D; Kyprianou, Theodoros; Bilas, Angelos; Marazakis, Manolis

    2008-01-01

    Novel eHealth systems are being designed to provide a citizen-centered health system, however the even demanding need for computing and data resources has required the adoption of Grid technologies. In most of the cases, this novel Health Grid requires not only conveying patient's personal data through public networks, but also storing it into shared resources out of the hospital premises. These features introduce new security concerns, in particular related with privacy. In this paper we survey current legal and technological approaches that have been taken to protect a patient's personal data into eHealth systems, with a particular focus in Intensive Care Grids. However, thanks to a security analysis applied over the Intensive Care Grid system (ICGrid) we show that these security mechanisms are not enough to provide a comprehensive solution, mainly because the data-at-rest is still vulnerable to attacks coming from untrusted Storage Elements where an attacker may directly access them. To cope with these issues, we propose a new privacy-oriented protocol which uses a combination of encryption and fragmentation to improve data's assurance while keeping compatibility with current legislations and Health Grid security mechanisms.

  12. Film Dosimetry for Intensity Modulated Radiation Therapy

    International Nuclear Information System (INIS)

    Benites-Rengifo, J.; Martinez-Davalos, A.; Celis, M.; Larraga, J.

    2004-01-01

    Intensity Modulated Radiation Therapy (IMRT) is an oncology treatment technique that employs non-uniform beam intensities to deliver highly conformal radiation to the targets while minimizing doses to normal tissues and critical organs. A key element for a successful clinical implementation of IMRT is establishing a dosimetric verification process that can ensure that delivered doses are consistent with calculated ones for each patient. To this end we are developing a fast quality control procedure, based on film dosimetry techniques, to be applied to the 6 MV Novalis linear accelerator for IMRT of the Instituto Nacional de Neurologia y Neurocirugia (INNN) in Mexico City. The procedure includes measurements of individual fluence maps for a limited number of fields and dose distributions in 3D using extended dose-range radiographic film. However, the film response to radiation might depend on depth, energy and field size, and therefore compromise the accuracy of measurements. In this work we present a study of the dependence of Kodak EDR2 film's response on the depth, field size and energy, compared with those of Kodak XV2 film. The first aim is to devise a fast and accurate method to determine the calibration curve of film (optical density vs. doses) commonly called a sensitometric curve. This was accomplished by using three types of irradiation techniques: Step-and-shoot, dynamic and static fields

  13. Intense diagnostic neutral beam development for ITER

    International Nuclear Information System (INIS)

    Rej, D.J.; Henins, I.; Fonck, R.J.; Kim, Y.J.

    1992-01-01

    For the next-generation, burning tokamak plasmas such as ITER, diagnostic neutral beams and beam spectroscopy will continue to be used to determine a variety of plasma parameters such as ion temperature, rotation, fluctuations, impurity content, current density profile, and confined alpha particle density and energy distribution. Present-day low-current, long-pulse beam technology will be unable to provide the required signal intensities because of higher beam attenuation and background bremsstrahlung radiation in these larger, higher-density plasmas. To address this problem, we are developing a short-pulse, intense diagnostic neutral beam. Protons or deuterons are accelerated using magnetic-insulated ion-diode technology, and neutralized in a transient gas cell. A prototype 25-kA, 100-kV, 1-μs accelerator is under construction at Los Alamos. Initial experiments will focus on ITER-related issues of beam energy distribution, current density, pulse length, divergence, propagation, impurity content, reproducibility, and maintenance

  14. Nutritional Care in Iranian Intensive Care Units

    Science.gov (United States)

    2018-01-01

    Intensive care units (ICUs) provides intensive treatment medicine to avoid complications such as malnutrition, infection and even death. As very little is currently known about the nutritional practices in Iranian ICUs, this study attempted to assess the various aspects of current nutrition support practices in Iranian ICUs. We conducted a cross-sectional study on 150 critically ill patients at 18 ICUs in 12 hospitals located in 2 provinces of Iran from February 2015 to March 2016. Data were collected through interview with supervisors of ICUs, medical record reviews and direct observation of patients during feeding. Our study showed that hospital-prepared enteral tube feeding formulas are the main formulas used in Iranian hospitals. None of the dietitians worked exclusively an ICU and only 30% of patients received diet counselling. Regular monitoring of nutritional status, daily energy and protein intake were not recorded in any of the participating ICUs. Patients were not monitored for anthropometric measurements such as mid-arm circumference (MAC) and electrolyte status. The nasogastric tube was not switched to percutaneous endoscopic gastrostomy or jejunostomy (PEG/PEGJ) in approximately 85% of patients receiving long-term enteral nutrition (EN) support. Our findings demonstrated that the quality of nutritional care was inappropriate in Iranian ICUs and improvement of nutritional care services within Iranian ICUs is necessary. PMID:29713622

  15. Physics of high intensity nanosecond electron source

    International Nuclear Information System (INIS)

    Herrera-Gomez, A.; Spicer, W.E.

    1993-08-01

    A new high-intensity, short-time electron source is now being used at the Stanford Linear Accelerator Center (SLAC). Using a GaAs negative affinity semiconductor in the construction of the cathode, it is possible to fulfill operation requirements such as peak currents of tens of amperes, peak widths of the order of nanoseconds, hundreds of hours of operation stability, and electron spin polarization. The cathode is illuminated with high intensity laser pulses, and photoemitted electrons constitute the yield. Because of the high currents, some nonlinear effects are present. Very noticeable is the so-called Charge Limit (CL) effect, which consists of a limit on the total charge in each pulse-that is, the total bunch charge stops increasing as the light pulse total energy increases. In this paper, we explain the mechanism of the CL and how it is caused by the photovoltaic effect. Our treatment is based on the Three-Step model of photoemission. We relate the CL to the characteristics of the surface and bulk of the semiconductor, such as doping, band bending, surface vacuum level, and density of surface states. We also discuss possible ways to prevent the Char's Level effect

  16. Intense microwave pulses II. SPIE Volume 2154

    International Nuclear Information System (INIS)

    Brandt, H.E.

    1994-01-01

    The primary purpose of this conference was to present and critically evaluate new and ongoing research on the generation and transmission of intense microwave pulses. Significant progress was reported on high-power, high-current relativistic klystron amplifier research and design. Other work presented at the conference, include research on a high-power relativistic magnetron driven by a high-current linear induction accelerator, derivation of a Pierce-type dispersion relation describing the interaction of an intense relativistic electron beam with a corrugated cylindrical slow-wave structure, experiments on an X-band backward-wave cyclotron maser oscillator, and observation of frequency chirping in a free electron laser amplifier. Other presentations included work on multiwave Cerenkov generator experiments, analysis of resonance characteristics of slow-wave structures in high-power Cerenkov devices, linear analysis and numerical simulation of Doppler-shifted cyclotron harmonics in a cyclotron autoresonance klystron, high-power virtual cathode oscillator theory and experiments, design of a sixth-harmonic gyrofrequency multiplier as a millimeter-wave source, and experiments on dielectric-loaded and multiwave slotted gyro-TWT amplifiers. A review was presented on innovative concepts which employ high-power microwaves in propulsion of space vehicles. Separate abstracts were prepared for 34 papers of this conference

  17. Diagnostic imaging in intensive care patients

    International Nuclear Information System (INIS)

    Afione, Cristina; Binda, Maria del C.

    2004-01-01

    Purpose: To determine the role of imaging diagnostic methods in the location of infection causes of unknown origin in the critical care patient. Material and methods: A comprehensive medical literature search has been done. Recommendations for the diagnostic imaging of septic focus in intensive care patients are presented for each case, with analysis based on evidence. The degree of evidence utilized has been that of Oxford Center for Evidence-based Medicine. Results: Nosocomial infection is the most frequent complication in the intensive care unit (25 to 33%) with high sepsis incidence rate. In order to locate the infection focus, imaging methods play an important role, as a diagnostic tool and to guide therapeutic procedures. The most frequent causes of infection are: ventilation associated pneumonia, sinusitis, intra-abdominal infections and an acute acalculous cholecystitis. This paper analyses the diagnostic imaging of hospital infection, with the evaluation of choice methods for each one and proposes an algorithm to assess the septic patient. Conclusion: There are evidences, with different degrees of recommendation, for the use of diagnostic imaging methods for infectious focuses in critical care patients. The studies have been selected based on their diagnostic precision, on the capacity of the medical team and on the availability of resources, considering the risk-benefit balance for the best safety of the patient. (author)

  18. Intense video gaming is not essentially problematic.

    Science.gov (United States)

    Király, Orsolya; Tóth, Dénes; Urbán, Róbert; Demetrovics, Zsolt; Maraz, Aniko

    2017-11-01

    Video games are more popular than ever and the general public, including parents, educators, and the media, tends to consider intense video gaming fundamentally problematic. To test this hypothesis, participants were recruited via gaming-related websites resulting in a sample of N = 5,222 online video gamers (mean age: 22.2 years, SD = 6.4). Besides assessing gaming time, we administered the Ten-Item Internet Gaming Disorder Test, the Brief Symptom Inventory, and the Motives for Online Gaming Questionnaire. Two structural regression models were estimated with both gaming time and problematic gaming as outcome variables. Predictors were psychiatric symptoms in the first, and gaming motives in the second model. Both models yielded adequate fit indices. Psychiatric symptoms had a moderate positive effect on problematic use (β = .46, p gaming time was practically zero (β = -.01, p = .84). In the second model, Escape was the most prominent motive and was moderately to-strongly associated (β = .58, p gaming time was substantially weaker (β = .21, p gaming time and problematic use was weak-to-moderate in both models (r = .26, p gaming time is weakly associated with negative psychological factors such as psychiatric symptoms and Escape motive, which were found to be consistently related to problematic use. Therefore, the amount of gaming time alone appears to be an unreliable predictor of problematic use, which questions the aforementioned idea that intense gaming is essentially problematic. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  19. Hydrogen atom in intense magnetic field.

    Science.gov (United States)

    Canuto, V.; Kelly, D. C.

    1972-01-01

    The structure of a hydrogen atom situated in an intense magnetic field is investigaged. Three approaches are employed. An elementary Bohr picture establishes a crucial magnetic field strength, H sub a approximately equal to 5 x 10 to the 9th G. Fields in excess of H sub a are intense in that they are able to modify the characteristic atomic scales of length and binding energy. A second approach solves the Schrodinger equation by a combination of variational methods and perturbation theory. It yields analytic expressions for the wave functions and energy eigenvalues. A third approach determines the energy eigenvalues by reducing the Schrodinger equation to a one-dimensional wave equation, which is then solved numerically. Energy eigenvalues are tabulated for field strengths of 2 x 10 to the 10th G and 2 x 10 to the 12th G. It is found that at 2 x 10 to the 12th G the lowest energy eigenvalue is changed from -13.6 to about -180 eV in agreement with previous variational computations.

  20. High intensity discharge device containing oxytrihalides

    Science.gov (United States)

    Lapatovich, W.P.; Keeffe, W.M.; Liebermann, R.W.; Maya, J.

    1987-06-09

    A fill composition for a high intensity discharge device including mercury, niobium oxytrihalide, and a molecular stabilization agent is provided. The molar ratio of niobium oxytrihalide to the molecular stabilization agent in the fill is in the range of from about 5:1 to about 7.5:1. Niobium oxytrihalide is present in the fill in sufficient amount to produce, by dissociation in the discharge, atomic niobium, niobium oxide, NbO, and niobium dioxide, NbO[sub 2], with the molar ratio of niobium-containing vapor species to mercury in the fill being in the range of from about 0.01:1 to about 0.50:1; and mercury pressure of about 1 to about 50 atmospheres at lamp operating temperature. There is also provided a high intensity discharge device comprising a sealed light-transmissive arc tube; the arc tube including the above-described fill; and an energizing means for producing an electric discharge within the arc tube. 7 figs.

  1. A Statistical Model for Energy Intensity

    Directory of Open Access Journals (Sweden)

    Marjaneh Issapour

    2012-12-01

    Full Text Available A promising approach to improve scientific literacy in regards to global warming and climate change is using a simulation as part of a science education course. The simulation needs to employ scientific analysis of actual data from internationally accepted and reputable databases to demonstrate the reality of the current climate change situation. One of the most important criteria for using a simulation in a science education course is the fidelity of the model. The realism of the events and consequences modeled in the simulation is significant as well. Therefore, all underlying equations and algorithms used in the simulation must have real-world scientific basis. The "Energy Choices" simulation is one such simulation. The focus of this paper is the development of a mathematical model for "Energy Intensity" as a part of the overall system dynamics in "Energy Choices" simulation. This model will define the "Energy Intensity" as a function of other independent variables that can be manipulated by users of the simulation. The relationship discovered by this research will be applied to an algorithm in the "Energy Choices" simulation.

  2. [The intensity of shame in mental disorders].

    Science.gov (United States)

    Kämmerer, Annette

    2010-07-01

    Shame is a self-conscious emotion and mostly experienced in the context of moral and/or normative transgression. Feelings of shame about one's own body and its intimacy must be seen as different from those, which are experienced as a result of negative social evaluations. Feelings of shame have been discussed as being important in the emotional experience of mentally ill persons, although systematic research is missing. A scenario-based self-report questionnaire has been constructed, the "Heidelberger Fragebogen zu Schamgefühlen". It consists of two scales, one measuring shame in situations of bodily experiences and the other one in situations of social competence and achievement. Data have been collected with n=320 patients with various mental disorders and been compared to a control group (cross-sectional study). Additionally correlations between feelings of shame and personality styles have been measured. Feelings of shame in situations connected with bodily experiences are more important than those raising as a result of negative social achievement. Patients with affective and anxiety disorders show the most intensive feelings of shame - with the exception of social phobia. Intensive feelings of shame can be seen as a result of low self-esteem, fear of failure and of punishment. Georg Thieme Verlag KG Stuttgart-New York.

  3. Intense ion beam research at Los Alamos

    International Nuclear Information System (INIS)

    Rej, D.J.; Bartsch, R.R.; Davis, H.A.; Faehl, R.J.; Gautier, D.C.; Greenly, J.B.; Henins, I.; Linton, T.W.; Muenchausen, R.E.; Waganaar, W.J.

    1992-01-01

    Two new interdisciplinary programs are underway at Los Alamos involving the physics and technology of intense light ion beams. In contrast to high-power ICF applications, the LANL effort concentrates on the development of relatively low-voltage (50 to 800 kV) and long-pulsewidth (0.1 to 1 μs) beams. The first program involves the 1.2 MV, 300-kJ Anaconda generator which has been fitted with an extraction ion diode. Long pulsewidth ion beams have been accelerated, propagated, and extracted for a variety of magnetic field conditions. The primary application of this beam is the synthesis of novel materials. Initial experiments on the congruent evaporative deposition of metallic and ceramic thin films are reported. The second program involves the development of a 120-keV, 50-kA, 1-μs proton beam for the magnetic fusion program as an ion source for an intense diagnostic neutral beam. Ultra-bright, pulsed neutral beams will be required to successfully measure ion temperatures and thermalized alpha particle energy distributions in large, dense, ignited tokamaks such as ITER

  4. Intensity modulated radiotherapy (IMRT) with compensators

    International Nuclear Information System (INIS)

    Salz, H.; Wiezorek, T.; Scheithauer, M.; Kleen, W.; Schwedas, M.; Wendt, T.G.

    2002-01-01

    The irradiation with intensity-modulated fields is possible with static as well as dynamic methods. In our university hospital, the intensity-modulated radiotherapy (IMRT) with compensators was prepared and used for the first time for patient irradiation in July 2001. The compensators consist of a mixture of tin granulate and wax, which is filled in a milled negative mould. The treatment planning is performed with Helax-TMS (MDS Nordion). An additional software is used for editing the modulation matrix ('Modifix'). Before irradiation of the first patient, extensive measurements have been carried out in terms of quality assurance of treatment planning and production of compensators. The results of the verification measurements have shown that IMRT with compensators possesses high spatial and dosimetric exactness. The calculated dose distributions are applied correctly. The accuracy of the calculated monitor units is normally better than 3%; in small volumes, further dosimetric inaccuracies between calculated and measured dose distributions are mostly less than 3%. Therefore, the compensators contribute to the achievement of high-level IMRT even when apparatuses without MLC are used. This paper describes the use of the IMRT with compensators, presents the limits of this technology, and discusses the first practical experiences. (orig.) [de

  5. High-intensity deuteron linear accelerator (FMIT)

    International Nuclear Information System (INIS)

    Jameson, R.A.

    1979-01-01

    For fusion reactors to become operational, one of the many problems to be solved is to find materials able to withstand the intense bombardment of 14-MeV neutrons released by the fusion process. The development of alloys less likely to become damaged by this neutron bombardment will require years of work, making it desirable to begin studies in parallel with other aspects of fusion power generators. The Fusion Materials Irradiation Test (FMIT) Facility, to be built at the Hanford Engineering Development Laboratory (HEDL), Richland, Washington, will provide a high neutron flux and a neutron energy spectrum representative of fusion reactor conditions in volumes adequate to screen and qualify samples of candidate fusion reactor materials. FMIT's design goal is to provide an irradiation test volume of 10 cm 3 at a neutron flux of 10 15 n/cm 2 -s, and 500 cm 3 at a flux of 10 14 n/cm 2 -s. This will not allow testing of actual components, but samples in the most intense flux region can be subjected to accelerated life testing, accumulating in one year the total number of neutrons seen by a fusion reactor in 10 to 20 years of operation

  6. Localizing New Pulsars with Intensity Mapping

    Science.gov (United States)

    Swiggum, Joe; Gentile, Peter

    2018-01-01

    Although low-frequency, single dish pulsar surveys provide an efficient means of searching large regions of sky quickly, the localization of new discoveries is poor. For example, discoveries from 350 MHz surveys using the Green Bank Telescope (GBT) have position uncertainties up to the FWHM of the telescope's "beam" on the sky, over half a degree! Before finding a coherent timing solution (requires 8-12 months of dedicated timing observations) a "gridding" method is usually employed to improve localization of new pulsars, whereby a grid of higher frequency beam positions is used to tile the initial error region. This method often requires over an hour of observing time to achieve arcminute-precision localization (provided the pulsar is detectable at higher frequencies).Here, we describe another method that uses the same observing frequency as the discovery observation and scans over Right Ascension and Declination directions around the nominal position. A Gaussian beam model is fit to folded pulse profile intensities as a function of time/position to provide improved localization. Using five test cases, we show that intensity mapping localization at 350 MHz with the GBT yields pulsar positions to 1 arcminute precision, facilitating high-frequency follow-up and higher significance detections for future pulsar timing. This method is also well suited to be directly implemented in future low-frequency drift scan pulsar surveys (e.g. with the Five hundred meter Aperture Spherical Telescope; FAST).

  7. Intense pulsed neutron source accelerator status

    International Nuclear Information System (INIS)

    Potts, C.W.; Brumwell, F.R.; Stipp, V.F.

    1983-01-01

    The Intense Pulsed Neutron Source (IPNS) facility has been in operation since November 1, 1981. From that date through August 1, 1983, the accelerator system was scheduled for 7191 hours of operation. During this period, 627 million pulses totaling about 1.1 x 10 21 protons were delivered to the spallation target. The accelerator has exceeded goals set in 1981 by averaging 8.65 μA over this two year period. This average beam current, while modest by the standards of proposed machines, makes the IPNS synchrotron (Rapid Cycling Synchrotron [RCS]) the highest intensity proton synchrotron in the world today. Detailed data on accelerator operation are presented. Weekly average currents of 12 μA have been achieved along with peaks of 13.9 μA. A great deal has been learned about the required operating constraints during high beam current operation. It should be possible to increase the average beam current during this next year to 12 μA while observing these restraints. Improvement plans have been formulated to increase the beam current to 16 μA over the next three years

  8. Intense ion beam research at Los Alamos

    International Nuclear Information System (INIS)

    Rej, D.J.; Bartsch, R.R.; Davis, H.A.; Faehl, R.J.; Gautier, D.C.; Greenly, J.B.; Henins, I.; Linton, T.W.; Muenchausen, R.E.; Waganaar, W.J.

    1993-01-01

    Two new interdisciplinary programs are underway at Los Alamos involving the physics and technology of intense light ion beams. In contrast to high-power ICF applications, the LANL effort concentrates on the development of relatively low-voltage (50 to 800 kV) and long pulsewidth (0.1 to 1 μs) beams. The first program involves the 1.2 MV, 300-kJ Anaconda generator which has been fitted with an extraction ion diode. Long pulsewidth ion beams have been accelerated, propagated, and extracted for a variety of magnetic field conditions. The primary application of this beam is the synthesis of novel materials. Initial experiments on the congruent evaporative deposition of metallic and ceramic thin films are reported. The second program involves the development of a 120-keV, 50-kA, 1-μs proton beam for the magnetic fusion program as an ion source for an intense diagnostic neutral beam. Ultra-bright, pulsed neutral beams will be required to successfully measure ion temperatures and thermalized alpha particle distributions in large, dense, ignited tokamaks such as ITER

  9. Spaceborne intensity interferometry via spacecraft formation flight

    Science.gov (United States)

    Ribak, Erez N.; Gurfil, Pini; Moreno, Coral

    2012-07-01

    Interferometry in space has marked advantages: long integration times and observation in spectral bands where the atmosphere is opaque. When installed on separate spacecraft, it also has extended and flexible baselines for better filling of the uv plane. Intensity interferometry has an additional advantage, being insensitive to telescope and path errors, but is unfortunately much less light-sensitive. In planning towards such a mission, we are experimenting with some fundamental research issues. Towards this end, we constructed a system of three vehicles floating on an air table in formation flight, with an autonomous orbit control. Each such device holds its own light collector, detector, and transmitter, to broadcast its intensity signal towards a central receiving station. At this station we implement parallel radio receivers, analogue to digital converters, and a digital three-way correlator. Current technology limits us to ~1GHz transmission frequency, which corresponds to a comfortable 0.3m accuracy in light-bucket shape and in its relative position. Naïve calculations place our limiting magnitude at ~7 in the blue and ultraviolet, where amplitude interferometers are limited. The correlation signal rides on top of this huge signal with its own Poisson noise, requiring a very large dynamic range, which needs to be transmitted in full. We are looking at open questions such as deployable optical collectors and radio antennae of similar size of a few meters, and how they might influence our data transmission and thus set our flux limit.

  10. Pain progression, intensity and outcomes following tonsillectomy.

    Science.gov (United States)

    Warnock, F F; Lander, J

    1998-03-01

    The objective of this study was to assess outcomes of pediatric day surgery tonsillectomy. A total of 129 children, aged 5-16 years, and their parents were recruited from three urban hospitals which provided pediatric day surgery. Children reported pain on a visual analogue scale (VAS) in day surgery and then daily at home for 7 days. Parents reported outcomes of surgery, including fluid intake, nausea, vomiting and sleep disturbances. They also recorded analgesic administration. Three main results related to extent and duration of pain, quality of management of pain, and effect of pain on utilization of health services. Tonsillectomy caused considerable pain which lasted more than 7 days. Pain followed a trajectory of intense or moderately intense pain for the first 3 days followed by a gradual decline over the next 4 days. In general, post-tonsillectomy pain was poorly managed by health professionals and parents. An unexpected observation was that children who had a bupivacaine infiltration of the tonsil fossa during surgery had significantly more pain in the evening of surgery than children who did not have an infiltration. The increase in postoperative pain experienced by those who had the infiltration was attributed to quality of pain management. Children with persistent pain (those who did not follow the typical trajectory) were likely to be taken to a medical practitioner. One-third of the sample made unscheduled visits to practitioners with most occurring from Day 4 to Day 7 of the follow-up.

  11. Challenges and opportunities in mapping land use intensity globally

    DEFF Research Database (Denmark)

    Kuemmerle, Tobias; Erb, Karlheinz; Meyfroidt, Patrick

    2013-01-01

    Future increases in land-based production will need to focus more on sustainably intensifying existing production systems. Unfortunately, our understanding of the global patterns of land use intensity is weak, partly because land use intensity is a complex, multidimensional term, and partly becau...... challenges and opportunities for mapping land use intensity for cropland, grazing, and forestry systems, and identify key issues for future research....... we lack appropriate datasets to assess land use intensity across broad geographic extents. Here, we review the state of the art regarding approaches for mapping land use intensity and provide a comprehensive overview of available global-scale datasets on land use intensity. We also outline major...

  12. Estimation of historical earthquake intensities and intensity-PGA relationship for wooden house damages

    International Nuclear Information System (INIS)

    Choi, In-Kil; Seo, Jeong-Moon

    2002-01-01

    A series of tests and dynamic analyses on Korean traditional wooden houses was performed for the intensity estimation of the typical large historical earthquake records. Static and cyclic lateral load tests on the wooden frames were performed to assess the lateral load capacity of wooden frames. The shaking table tests on two 1:4 scaled models of a Korean ancient commoner's house made of fresh pine lumber were performed. Typical earthquake time histories recorded on soil and rock sites were used as input for the tests. The prototypical wooden house was analyzed for multiple time histories which match Ohsaki's ground response spectra. Seismic analyses comprise the aging of lumber and different soil condition. The relationship between the earthquake intensity and the peak ground acceleration (PGA) is proposed for the wooden house damages based on the results of this study. The intensity of major Korean historical earthquake records related with house collapses was quantitatively estimated to be MM VIII

  13. Exercise Intensity Modulation of Hepatic Lipid Metabolism

    Directory of Open Access Journals (Sweden)

    Fábio S. Lira

    2012-01-01

    Full Text Available Lipid metabolism in the liver is complex and involves the synthesis and secretion of very low density lipoproteins (VLDL, ketone bodies, and high rates of fatty acid oxidation, synthesis, and esterification. Exercise training induces several changes in lipid metabolism in the liver and affects VLDL secretion and fatty acid oxidation. These alterations are even more conspicuous in disease, as in obesity, and cancer cachexia. Our understanding of the mechanisms leading to metabolic adaptations in the liver as induced by exercise training has advanced considerably in the recent years, but much remains to be addressed. More recently, the adoption of high intensity exercise training has been put forward as a means of modulating hepatic metabolism. The purpose of the present paper is to summarise and discuss the merit of such new knowledge.

  14. Intense fluorescence of Au 20

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Chongqi; Harbich, Wolfgang; Sementa, Luca; Ghiringhelli, Luca; Apra, Edoardo; Stener, Mauro; Fortunelli, Alessandro; Brune, Harald

    2017-08-21

    Ligand-protected Au clusters are non-bleaching fluorescence markers in bio- and medical applications. We show that their fluorescence is an intrinsic property of the Au cluster itself. We find a very intense and sharp fluorescence peak located at λ =739.2 nm (1.68 eV) for Au20 clusters in a Ne matrix held at 6 K. The fluorescence reflects the HOMO-LUMO diabatic bandgap of the cluster. The cluster shows a very rich absorption fine structure reminiscent of well defined molecule-like quantum levels. These levels are resolved since Au20 has only one stable isomer (tetrahedral), therefore our sample is mono-disperse in cluster size and conformation. Density-functional theory (DFT) and time-dependent DFT calculations clarify the nature of optical absorptionand predict both main absorption peaks and intrinsic fluorescence in good agreement with experiment.

  15. THE CENTER FOR DATA INTENSIVE COMPUTING

    Energy Technology Data Exchange (ETDEWEB)

    GLIMM,J.

    2002-11-01

    CDIC will provide state-of-the-art computational and computer science for the Laboratory and for the broader DOE and scientific community. We achieve this goal by performing advanced scientific computing research in the Laboratory's mission areas of High Energy and Nuclear Physics, Biological and Environmental Research, and Basic Energy Sciences. We also assist other groups at the Laboratory to reach new levels of achievement in computing. We are ''data intensive'' because the production and manipulation of large quantities of data are hallmarks of scientific research in the 21st century and are intrinsic features of major programs at Brookhaven. An integral part of our activity to accomplish this mission will be a close collaboration with the University at Stony Brook.

  16. Theory of atomic spectral emission intensity

    Science.gov (United States)

    Yngström, Sten

    1994-07-01

    The theoretical derivation of a new spectral line intensity formula for atomic radiative emission is presented. The theory is based on first principles of quantum physics, electrodynamics, and statistical physics. Quantum rules lead to revision of the conventional principle of local thermal equilibrium of matter and radiation. Study of electrodynamics suggests absence of spectral emission from fractions of the numbers of atoms and ions in a plasma due to radiative inhibition caused by electromagnetic force fields. Statistical probability methods are extended by the statement: A macroscopic physical system develops in the most probable of all conceivable ways consistent with the constraining conditions for the system. The crucial role of statistical physics in transforming quantum logic into common sense logic is stressed. The theory is strongly supported by experimental evidence.

  17. Data intensive ATLAS workflows in the Cloud

    CERN Document Server

    Rzehorz, Gerhard Ferdinand; The ATLAS collaboration

    2016-01-01

    This contribution reports on the feasibility of executing data intensive workflows on Cloud infrastructures. In order to assess this, the metric ETC = Events/Time/Cost is formed, which quantifies the different workflow and infrastructure configurations that are tested against each other. In these tests ATLAS reconstruction Jobs are run, examining the effects of overcommitting (more parallel processes running than CPU cores available), scheduling (staggered execution) and scaling (number of cores). The desirability of commissioning storage in the cloud is evaluated, in conjunction with a simple analytical model of the system, and correlated with questions about the network bandwidth, caches and what kind of storage to utilise. In the end a cost/benefit evaluation of different infrastructure configurations and workflows is undertaken, with the goal to find the maximum of the ETC value

  18. Data intensive ATLAS workflows in the Cloud

    CERN Document Server

    AUTHOR|(INSPIRE)INSPIRE-00396985; The ATLAS collaboration; Keeble, Oliver; Quadt, Arnulf; Kawamura, Gen

    2017-01-01

    This contribution reports on the feasibility of executing data intensive workflows on Cloud infrastructures. In order to assess this, the metric ETC = Events/Time/Cost is formed, which quantifies the different workflow and infrastructure configurations that are tested against each other. In these tests ATLAS reconstruction Jobs are run, examining the effects of overcommitting (more parallel processes running than CPU cores available), scheduling (staggered execution) and scaling (number of cores). The desirability of commissioning storage in the Cloud is evaluated, in conjunction with a simple analytical model of the system, and correlated with questions about the network bandwidth, caches and what kind of storage to utilise. In the end a cost/benefit evaluation of different infrastructure configurations and workflows is undertaken, with the goal to find the maximum of the ETC value.

  19. RUTHERFORD/APPELTON: ISIS intensity record

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    The Rutherford Appleton Laboratory in the UK is home to the world's most intense pulsed neutron source. The heart of ISIS is a 50 Hz proton synchrotron accelerating two bunches of protons from 70 to 800 MeV. After extraction the protons, occupying a total pulse length of less than 0.5 microseconds, strike a heavy metal target: the neutrons generated are moderated and directed through channels in the shielding to any of 14 instruments for condensed matter studies. As neutrinos and muons are copious byproducts, major investments have also been made for investigations in these fields. Efficient charge exchange injection into the synchrotron at 70 MeV is achieved using negative hydrogen ions and an aluminium oxide stripping foil. Some particles are lost during trapping and the early acceleration period, but they are captured by graphite-covered beam collectors to reduce machine activation. Later acceleration and fast-extraction are virtually without loss

  20. Pulsed neutron source very intense, Booster

    International Nuclear Information System (INIS)

    Abbate, J.M.

    1978-09-01

    A compact Accelerator-Booster (fast, pulsed and modulate reactivity research reactor) is a new and appropriate conception to use as a very intense thermal neutrons source. Its definition and feasibility have been already described in several studies showing its relative advantages in comparison with others kinds of facilities. This work, wich is part of one of those studies, contains a general analysis on the meis facility parameters and core and shielding theoretical calculations. The following results were obtained: Selection and test of a calculation system suitable to use in compact fast reactors; Development a method to perform estimations in some safety and shielding problems and obtainment of adequate theoretical predictions on the general performance. Moreover, final results for importent parameters of the feasibility study and predesign (critical mass and volume, lifetime, etc.) and others related to the use of plutonium oxide as fuel are given and then evaluations of different basic functions are showed. (author) [es

  1. High-frequency, high-intensity photoionization

    Science.gov (United States)

    Reiss, H. R.

    1996-02-01

    Two analytical methods for computing ionization by high-frequency fields are compared. Predicted ionization rates compare well, but energy predictions for the onset of ionization differ radically. The difference is shown to arise from the use of a transformation in one of the methods that alters the zero from which energy is measured. This alteration leads to an apparent energy threshold for ionization that can, especially in the stabilization regime, differ strongly from the laboratory measurement. It is concluded that channel closings in intense-field ionization can occur at high as well as low frequencies. It is also found that the stabilization phenomenon at high frequencies, very prominent for hydrogen, is absent in a short-range potential.

  2. Intensity modulated radiotherapy for breast cancer

    International Nuclear Information System (INIS)

    Riou, O.; Fenoglietto, P.; Lemanski, C.; Azria, D.

    2012-01-01

    Intensity modulated radiotherapy (IMRT) is a technique allowing dose escalation and normal tissue sparing for various cancer types. For breast cancer, the main goals when using IMRT were to improve dose homogeneity within the breast and to enhance coverage of complex target volumes. Nonetheless, better heart and lung protections are achievable with IMRT as compared to standard irradiation for difficult cases. Three prospective randomized controlled trials of IMRT versus standard treatment showed that a better breast homogeneity can translate into better overall cosmetic results. Dosimetric and clinical studies seem to indicate a benefit of IMRT for lymph nodes irradiation, bilateral treatment, left breast and chest wall radiotherapy, or accelerated partial breast irradiation. The multiple technical IMRT solutions available tend to indicate a widespread use for breast irradiation. Nevertheless, indications for breast IMRT should be personalized and selected according to the expected benefit for each individual. (authors)

  3. Granger Causality Testing with Intensive Longitudinal Data.

    Science.gov (United States)

    Molenaar, Peter C M

    2018-06-01

    The availability of intensive longitudinal data obtained by means of ambulatory assessment opens up new prospects for prevention research in that it allows the derivation of subject-specific dynamic networks of interacting variables by means of vector autoregressive (VAR) modeling. The dynamic networks thus obtained can be subjected to Granger causality testing in order to identify causal relations among the observed time-dependent variables. VARs have two equivalent representations: standard and structural. Results obtained with Granger causality testing depend upon which representation is chosen, yet no criteria exist on which this important choice can be based. A new equivalent representation is introduced called hybrid VARs with which the best representation can be chosen in a data-driven way. Partial directed coherence, a frequency-domain statistic for Granger causality testing, is shown to perform optimally when based on hybrid VARs. An application to real data is provided.

  4. Orienting Paramecium with intense static magnetic fields

    Science.gov (United States)

    Valles, James M., Jr.; Guevorkian, Karine; Quindel, Carl

    2004-03-01

    Recent experiments on cell division suggest the application of intense static magnetic fields as a novel tool for the manipulation of biological systems [1]. The magnetic field appears to couple to the intrinsic anisotropies in the diamagnetic components of the cells. Here, we present measurements of the intrinsic average diamagnetic anisotropy of the whole single celled ciliate, Paramecium Caudatum. Magnetic fields, 2.5 T Paramecium Caudatum that were suspended in a density matched medium. The organisms align with their long axis parallel to the applied magnetic field. Their intrinsic diamagnetic anisotropy is 3x10-11 in cgs units. We will discuss the implications of these results for employing magnetic fields to probe the behavior of swimming Paramecium. [1] J. M. Valles, Jr. et al., Expt. Cell Res.274, 112-118 (2002).

  5. The Los Alamos Intense Neutron Source

    International Nuclear Information System (INIS)

    Nebel, R.A.; Barnes, D.C.; Bollman, R.; Eden, G.; Morrison, L.; Pickrell, M.M.; Reass, W.

    1997-01-01

    The Intense Neutron Source (INS) is an Inertial Electrostatic Confinement (IEC) fusion device presently under construction at Los Alamos National Laboratory. It is designed to produce 10 11 neutrons per second steady-state using D-T fuel. Phase 1 operation of this device will be as a standard three grid IEC ion focus device. Expected performance has been predicted by scaling from a previous IEC device. Phase 2 operation of this device will utilize a new operating scheme, the Periodically Oscillating Plasma Sphere (POPS). This scheme is related to both the Spherical Reflect Diode and the Oscillating Penning Trap. With this type of operation the authors hope to improve plasma neutron production to about 10 13 neutrons/second

  6. Production of high intensity radioactive beams

    International Nuclear Information System (INIS)

    Nitschke, J.M.

    1990-04-01

    The production of radioactive nuclear beams world-wide is reviewed. The projectile fragmentation and the ISOL approaches are discussed in detail, and the luminosity parameter is used throughout to compare different production methods. In the ISOL approach a thin and a thick target option are distinguished. The role of storage rings in radioactive beam research is evaluated. It is concluded that radioactive beams produced by the projectile fragmentation and the ISOL methods have complementary characteristics and can serve to answer different scientific questions. The decision which kind of facility to build has to depend on the significance and breadth of these questions. Finally a facility for producing a high intensity radioactive beams near the Coulomb barrier is proposed, with an expected luminosity of ∼10 39 cm -2 s -1 , which would yield radioactive beams in excess of 10 11 s -1 . 9 refs., 3 figs., 7 tabs

  7. Intense muon beams and neutrino factories

    International Nuclear Information System (INIS)

    Parsa, Z.

    2000-01-01

    High intensity muon sources are needed in exploring neutrino factories, lepton flavor violating muon processes, and lower energy experiments as the stepping phase towards building higher energy μ + μ - colliders. We present a brief overview, sketch of a neutrino source, and an example of a muon storage ring at BNL with detector(s) at Fermilab, Sudan, etc. Physics with low energy neutrino beams based on muon storage rings (μSR) and conventional Horn Facilities are described and compared. CP violation Asymmetries and a new Statistical Figure of Merit to be used for comparison is given. Improvements in the sensitivity of low energy experiments to study Flavor changing neutral currents are also included

  8. A High Intensity Hadron Facility, AGS II

    International Nuclear Information System (INIS)

    Lee, Y.Y.; Lowenstein, D.I.

    1988-01-01

    We have present one of several possibilities for the evolution of the AGS complex into a high intensity hadron facility. One could consider other alternatives, such as using the AGS as the Collector and constructing a new 9-30 GeV machine. We believe the most responsible scenario must minimize the cost and downtime to the ongoing physics program. With a stepwise approach, starting with the Booster, the physics program can evolve without a single major commitment in funds. At each step an evaluation of the funds versus physics merit can be made. As a final aside, each upgrade at the AGS and Booster is presently being implemented to support an interleaved operation of both protons and ions. 1 fig., 6 tabs

  9. Delirium in the intensive care unit

    Directory of Open Access Journals (Sweden)

    Suresh Arumugam

    2017-01-01

    Full Text Available Delirium is characterized by impaired cognition with nonspecific manifestations. In critically ill patients, it may develop secondary to multiple precipitating or predisposing causes. Although it can be a transient and reversible syndrome, its occurrence in Intensive Care Unit (ICU patients may be associated with long-term cognitive dysfunction. This condition is often under-recognized by treating physicians, leading to inappropriate management. For appropriate management of delirium, early identification and risk factor assessment are key factors. Multidisciplinary collaboration and standardized care can enhance the recognition of delirium. Interdisciplinary team working, together with updated guideline implementation, demonstrates proven success in minimizing delirium in the ICU. Moreover, should the use of physical restraint be necessary to prevent harm among mechanically ventilated patients, ethical clinical practice methodology must be employed. This traditional narrative review aims to address the presentation, risk factors, management, and ethical considerations in the management of delirium in ICU settings.

  10. Research possibilities with an intense neutron generator

    International Nuclear Information System (INIS)

    Bartholomew, G.A.

    1966-01-01

    As the title suggests this paper will depart somewhat from the general topic of this session and will be concerned more with applications of accelerators than with accelerators them elves. The particular application of interest at our laboratory concerns the use of a high current intermediate energy proton accelerator as the basis for a versatile intense neutron source. Chalk River's entry into the intermediate energy accelerator field with neutron production as the primary motivation is somewhat unusual. Although neutron production is also being explored by other laboratories interested in intermediate energy accelerators, e.g., Oak Ridge National Laboratory and Los Alamos Scientific Laboratory, it has not been the major motivation. Our initial motivation was in fact the production of thermal neutrons and this interest has remained foremost in our ING program. We are currently writing a proposal for this project. Our target is to have a proton beam in 1973. (author)

  11. Intensity modulated radiotherapy (IMRT) in bilateral retinoblastoma

    International Nuclear Information System (INIS)

    Atalar, Banu; Ozyar, Enis; Gunduz, Kaan; Gungor, Gorkem

    2010-01-01

    External beam radiotherapy (EBRT) for retinoblastoma has traditionally been done with conventional radiotherapy techniques which resulted high doses to the surrounding normal tissues. A 20 month-old girl with group D bilateral retinoblastoma underwent intensity modulated radiotherapy (IMRT) to both eyes after failing chemoreduction and focal therapies including cryotherapy and transpupillary thermotherapy. In this report, we discuss the use of IMRT as a method for reducing doses to adjacent normal tissues while delivering therapeutic doses to the tumour tissues compared with 3-dimensional conformal radiotherapy (3DCRT). At one year follow-up, the patient remained free of any obvious radiation complications. Image guided IMRT provides better dose distribution than 3DCRT in retinoblastoma eyes, delivering the therapeutic dose to the tumours and minimizing adjacent tissue damage

  12. THE CENTER FOR DATA INTENSIVE COMPUTING

    International Nuclear Information System (INIS)

    GLIMM, J.

    2001-01-01

    CDIC will provide state-of-the-art computational and computer science for the Laboratory and for the broader DOE and scientific community. We achieve this goal by performing advanced scientific computing research in the Laboratory's mission areas of High Energy and Nuclear Physics, Biological and Environmental Research, and Basic Energy Sciences. We also assist other groups at the Laboratory to reach new levels of achievement in computing. We are ''data intensive'' because the production and manipulation of large quantities of data are hallmarks of scientific research in the 21st century and are intrinsic features of major programs at Brookhaven. An integral part of our activity to accomplish this mission will be a close collaboration with the University at Stony Brook

  13. Intense Terahertz Sources for 2D Spectroscopy

    DEFF Research Database (Denmark)

    Pedersen, Pernille Klarskov

    in a molecular dynamics (MD) simulation. With this THz induced nonlinear responses and mode couplings in CsI and sucrose are investigated for increasing field strengths, and it is found that these occur for sucrose when the field strength is in the MV/cm range. THz sources based on LiNbO3, DAST, DSTMS and 2...... observed having a Gaussian beam profile. In addition to the intense THz pulses focused in free-space in order to achieve the highest possible field strength, it is shown that resonant microslit arrays can be used to enhance the THz field, and with the possibility of mounting crystalline samples inside...... the metallic slits, this is proposed as a combined spectroscopy system for investigating high-field phenomena. With a carefully optimized design, the slit resonance can be coupled to the lattice modes of the array structure to achieve a field enhancement of more than 35 times, which is approximately 60 % more...

  14. Generation of intense transient magnetic fields

    International Nuclear Information System (INIS)

    Benjamin, R.F.

    1983-01-01

    In a laser system, the return current of a laser generated plasma is conducted near a target to subject that target to a magnetic field. The target may be either a small non-fusion object for testing under the magnetic field or a laser-fusion pellet. In the laser-fusion embodiment, the laser-fusion pellet is irradiated during the return current flow and the intense transient magnetic field is used to control the hot electrons thereof to hinder them from striking and heating the core of the irradiated laser-fusion pellet. An emitter, e.g. a microballoon of glass, metal or plastics, is subjected to a laser pulse to generate the plasma from which the return current flows into a wire cage or a coil and then to earth. (author)

  15. THE CENTER FOR DATA INTENSIVE COMPUTING

    Energy Technology Data Exchange (ETDEWEB)

    GLIMM,J.

    2001-11-01

    CDIC will provide state-of-the-art computational and computer science for the Laboratory and for the broader DOE and scientific community. We achieve this goal by performing advanced scientific computing research in the Laboratory's mission areas of High Energy and Nuclear Physics, Biological and Environmental Research, and Basic Energy Sciences. We also assist other groups at the Laboratory to reach new levels of achievement in computing. We are ''data intensive'' because the production and manipulation of large quantities of data are hallmarks of scientific research in the 21st century and are intrinsic features of major programs at Brookhaven. An integral part of our activity to accomplish this mission will be a close collaboration with the University at Stony Brook.

  16. THE CENTER FOR DATA INTENSIVE COMPUTING

    Energy Technology Data Exchange (ETDEWEB)

    GLIMM,J.

    2003-11-01

    CDIC will provide state-of-the-art computational and computer science for the Laboratory and for the broader DOE and scientific community. We achieve this goal by performing advanced scientific computing research in the Laboratory's mission areas of High Energy and Nuclear Physics, Biological and Environmental Research, and Basic Energy Sciences. We also assist other groups at the Laboratory to reach new levels of achievement in computing. We are ''data intensive'' because the production and manipulation of large quantities of data are hallmarks of scientific research in the 21st century and are intrinsic features of major programs at Brookhaven. An integral part of our activity to accomplish this mission will be a close collaboration with the University at Stony Brook.

  17. Stress intensities in flawed pressure vessels

    International Nuclear Information System (INIS)

    Smith, C.W.; Jolles, M.; Peters, W.H.

    1977-01-01

    A technique for determining the stess intensity factor (SIF) near pressure vessel flaws or cracks experimentally from photoelastic data for use in two-dimensional problems was developed in the 1950's. This technique was modified and extended to a variety of two-dimensional problems. The technique has been refined further and what has evolved may be regarded as a hybrid technique which affects a marriage between ''frozen stress'' photoelastic results and a simple least-squares digital computer program for estimating SIF values in three-dimensional problems. This technique, in its original modified form, has been shown to be applicable to a study of surface flaws and the applicability of the method to complex crack body geometries of current technological importance are discussed. The analytical foundations of the method are reviewed

  18. Low-Intensity Repetitive Exercise Induced Rhabdomyolysis

    Directory of Open Access Journals (Sweden)

    Mina Tran

    2015-01-01

    Full Text Available Rhabdomyolysis is a rare condition caused by the proteins of damaged muscle cells entering the bloodstream and damaging the kidneys. Common symptoms of rhabdomyolysis are muscle pain and fatigue in conjunction with dark urine; kidney damage is a common symptom among these patients. We present a case of a 23-year-old woman who displayed myalgia in the upper extremities caused by low-intensity and high-repetition exercise. She was successfully diagnosed and treated for exertional rhabdomyolysis. This patient had no significant medical history that would induce this condition. We urge the emergency medical community to observe and monitor patients that complain of myalgia to ensure they are not suffering from rhabdomyolysis even in atypical cases.

  19. Research possibilities with an intense neutron generator

    Energy Technology Data Exchange (ETDEWEB)

    Bartholomew, G A

    1966-07-01

    As the title suggests this paper will depart somewhat from the general topic of this session and will be concerned more with applications of accelerators than with accelerators them elves. The particular application of interest at our laboratory concerns the use of a high current intermediate energy proton accelerator as the basis for a versatile intense neutron source. Chalk River's entry into the intermediate energy accelerator field with neutron production as the primary motivation is somewhat unusual. Although neutron production is also being explored by other laboratories interested in intermediate energy accelerators, e.g., Oak Ridge National Laboratory and Los Alamos Scientific Laboratory, it has not been the major motivation. Our initial motivation was in fact the production of thermal neutrons and this interest has remained foremost in our ING program. We are currently writing a proposal for this project. Our target is to have a proton beam in 1973. (author)

  20. Extreme metabolic alkalosis in intensive care.

    Science.gov (United States)

    Tripathy, Swagata

    2009-10-01

    Metabolic alkalosis is a commonly seen imbalance in the intensive care unit (ICU). Extreme metabolic alkalemia, however, is less common. A pH greater than 7.65 may carry a high risk of mortality (up to 80%). We discuss the entity of life threatening metabolic alkalemia by means of two illustrative cases - both with a pH greater than 7.65 on presentation. The cause, modalities of managing and complications of this condition is discussed from the point of view of both the traditional method of Henderson and Hasselbalch and the mathematical model based on physiochemical model described by Stewart. Special mention to the pitfalls in managing patients of metabolic alkalosis with concomitant renal compromise is made.