WorldWideScience

Sample records for major improvements include

  1. Impact of a pain protocol including hypnosis in major burns.

    Science.gov (United States)

    Berger, Mette M; Davadant, Maryse; Marin, Christian; Wasserfallen, Jean-Blaise; Pinget, Christophe; Maravic, Philippe; Koch, Nathalie; Raffoul, Wassim; Chiolero, René L

    2010-08-01

    Pain is a major issue after burns even when large doses of opioids are prescribed. The study focused on the impact of a pain protocol using hypnosis on pain intensity, anxiety, clinical course, and costs. All patients admitted to the ICU, aged >18 years, with an ICU stay >24h, accepting to try hypnosis, and treated according to standardized pain protocol were included. Pain was scaled on the Visual Analog Scale (VAS) (mean of daily multiple recordings), and basal and procedural opioid doses were recorded. Clinical outcome and economical data were retrieved from hospital charts and information system, respectively. Treated patients were matched with controls for sex, age, and the burned surface area. Forty patients were admitted from 2006 to 2007: 17 met exclusion criteria, leaving 23 patients, who were matched with 23 historical controls. Altogether patients were 36+/-14 years old and burned 27+/-15%BSA. The first hypnosis session was performed after a median of 9 days. The protocol resulted in the early delivery of higher opioid doses/24h (ppatient. A pain protocol including hypnosis reduced pain intensity, improved opioid efficiency, reduced anxiety, improved wound outcome while reducing costs. The protocol guided use of opioids improved patient care without side effects, while hypnosis had significant psychological benefits.

  2. Necessity of including medico-legal autopsy data in epidemiological surveys of individuals with major trauma.

    Science.gov (United States)

    Bagher, A; Wingren, C J; Ottosson, A; Andersson, L; Wangefjord, S; Acosta, S

    2015-08-01

    It is rare that epidemiological surveys of patients with major trauma include both those admitted to the emergency department and those sent for medico-legal autopsy. The main aim of the present population-based study of major trauma was to examine the importance of medico-legal autopsy data. A new injury severity score (NISS)>15 or lethal outcome was used as criteria for major trauma and to identify patients at the emergency, anaesthesiology and forensic departments and/or being within the jurisdiction of the Malmö police authority and subjected to a medico-legal autopsy between 2011 and 2013. According to Swedish legislation all trauma related deaths should be reported to the police who refer these cases for medico-legal autopsy. Among the 174 individuals included, 92 (53%) died and 81 (47%) underwent medico-legal autopsy. One hundred twenty-six patients were primarily admitted to hospital and 48 died before admission to hospital and were sent directly for medico-legal autopsy. Forty-four in-hospital deaths occurred, of whom 33 (75%) were sent to medico-legal autopsy. In those sent directly to the department of forensic medicine the proportion of accidents was lower (pautopsies among trauma-related deaths at hospital were high age (pautopsy according to legislation, but did not. The high proportion of positive toxicological findings among fatalities examined at medico-legal autopsy implies that toxicology screening should be routine in major trauma patients, in order to improve treatment and prevention. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Adjuvant occupational therapy for work-related major depression works: randomized trial including economic evaluation

    NARCIS (Netherlands)

    Schene, Aart H.; Koeter, Maarten W. J.; Kikkert, Martijn J.; Swinkels, Jan A.; McCrone, Paul

    2007-01-01

    BACKGROUND: Major depression has far-reaching consequences for work functioning and absenteeism. In most cases depression is treated by medication and clinical management. The addition of occupational therapy (OT) might improve outcome. We determined the cost-effectiveness of the addition of OT to

  4. Including Health in Environmental Assessments of Major Transport Infrastructure Projects: A Documentary Analysis.

    Science.gov (United States)

    Riley, Emily; Harris, Patrick; Kent, Jennifer; Sainsbury, Peter; Lane, Anna; Baum, Fran

    2018-05-10

    Transport policy and practice impacts health. Environmental Impact Assessments (EIAs) are regulated public policy mechanisms that can be used to consider the health impacts of major transport projects before they are approved. The way health is considered in these environmental assessments (EAs) is not well known. This research asked: How and to what extent was human health considered in EAs of four major transport projects in Australia. We developed a comprehensive coding framework to analyse the Environmental Impact Statements (EISs) of four transport infrastructure projects: three road and one light rail. The coding framework was designed to capture how health was directly and indirectly included. We found that health was partially considered in all four EISs. In the three New South Wales (NSW) projects, but not the one South Australian project, this was influenced by the requirements issued to proponents by the government which directed the content of the EIS. Health was assessed using human health risk assessment (HHRA). We found this to be narrow in focus and revealed a need for a broader social determinants of health approach, using multiple methods. The road assessments emphasised air quality and noise risks, concluding these were minimal or predicted to improve. The South Australian project was the only road project not to include health data explicitly. The light rail EIS considered the health benefits of the project whereas the others focused on risk. Only one project considered mental health, although in less detail than air quality or noise. Our findings suggest EIAs lag behind the known evidence linking transport infrastructure to health. If health is to be comprehensively included, a more complete model of health is required, as well as a shift away from health risk assessment as the main method used. This needs to be mandatory for all significant developments. We also found that considering health only at the EIA stage may be a significant

  5. Narrative therapy for adults with major depressive disorder: improved symptom and interpersonal outcomes.

    Science.gov (United States)

    Vromans, Lynette P; Schweitzer, Robert D

    2011-01-01

    This study investigated depressive symptom and interpersonal relatedness outcomes from eight sessions of manualized narrative therapy for 47 adults with major depressive disorder. Post-therapy, depressive symptom improvement (d=1.36) and proportions of clients achieving reliable improvement (74%), movement to the functional population (61%), and clinically significant improvement (53%) were comparable to benchmark research outcomes. Post-therapy interpersonal relatedness improvement (d=.62) was less substantial than for symptoms. Three-month follow-up found maintenance of symptom, but not interpersonal gains. Benchmarking and clinical significance analyses mitigated repeated measure design limitations, providing empirical evidence to support narrative therapy for adults with major depressive disorder.

  6. Improving Project Management of Complex or Major Systems

    Science.gov (United States)

    2016-05-05

    Major Automated Information Systems (MAIS) 3 1 Joint Program; Army-Led 2 Joint Program; USMC Led 3 Over 90% expended; non-reporting 4 Limited...funding available through vehicle Mod-lines --- shared across various motor transport programs PB-17 $M (including OCO) Program ACAT FYDP (FY17

  7. Exercise therapy improves aerobic capacity of inpatients with major depressive disorder.

    Science.gov (United States)

    Kerling, Arno; von Bohlen, Anne; Kück, Momme; Tegtbur, Uwe; Grams, Lena; Haufe, Sven; Gützlaff, Elke; Kahl, Kai G

    2016-06-01

    Unipolar depression is one of the most common diseases worldwide and is associated with a higher cardiovascular risk partly due to reduced aerobic capacity. Therefore, the aim of our study was to examine whether a structured aerobic training program can improve aerobic capacity in inpatients with MDD (major depressive disorder). Overall, 25 patients (13 women, 12 men) diagnosed with MDD were included in the study. Parameters of aerobic capacity, such as maximum performance, maximum oxygen consumption, and VAT (ventilatory anaerobic threshold), were assessed on a bicycle ergometer before and 6 weeks after a training period (three times per week for 45 min on two endurance machines). In addition, a constant load test was carried out at 50% of the maximum performance prior to and after the training period. The performance data were compared with 25 healthy controls matched for sex, age, and body mass index before and after the training period. Compared to controls, patients with MDD had significantly lower aerobic capacity. After training, there was a significant improvement in their performance data. A significant difference remained only for VAT between patients with MDD and healthy controls. With regard to the coincidence of MDD with cardiovascular and cardiometabolic disorders, a structured supervised exercise program carried out during hospitalization is a useful supplement for patients with MDD.

  8. Do Biology Majors Really Differ from Non–STEM Majors?

    Science.gov (United States)

    Cotner, Sehoya; Thompson, Seth; Wright, Robin

    2017-01-01

    Recent calls to action urge sweeping reform in science education, advocating for improved learning for all students—including those majoring in fields beyond the sciences. However, little work has been done to characterize the differences—if any exist—between students planning a career in science and those studying other disciplines. We describe an attempt to clarify, in broad terms, how non–STEM (science, technology, engineering, and mathematics) majors differ from life sciences majors, and how they are similar. Using survey responses and institutional data, we find that non–STEM majors are not unilaterally science averse; non–STEM majors are more likely than biology majors to hold misconceptions about the nature of science, yet they are not completely ignorant of how science works; non–STEM majors are less likely than biology majors to see science as personally relevant; and non–STEM majors populations are likely to be more diverse—with respect to incoming knowledge, perceptions, backgrounds, and skills—than a biology majors population. We encourage science educators to consider these characteristics when designing curricula for future scientists or simply for a well-informed citizenry. PMID:28798210

  9. Hopanoid-producing bacteria in the Red Sea include the major marine nitrite-oxidizers

    KAUST Repository

    Kharbush, Jenan J

    2018-04-10

    Hopanoids, including the extended side chain-containing bacteriohopanepolyols (BHPs), are bacterial lipids found abundantly in the geological record and across Earth\\'s surface environments. However, the physiological roles of this biomarker remain uncertain, limiting interpretation of their presence in current and past environments. Recent work investigating the diversity and distribution of hopanoid producers in the marine environment implicated low-oxygen regions as important loci of hopanoid production, and data from marine oxygen minimum zones (OMZs) suggested that the dominant hopanoid producers in these environments are nitrite-utilizing organisms, revealing a potential connection between hopanoid production and the marine nitrogen cycle. Here we use metagenomic data from the Red Sea to investigate the ecology of hopanoid producers in an environmental setting that is biogeochemically distinct from those investigated previously. The distributions of hopanoid production and nitrite oxidation genes in the Red Sea are closely correlated, and the majority of hopanoid producers are taxonomically affiliated with the major marine nitrite oxidizers, Nitrospinae and Nitrospirae. These results suggest that the relationship between hopanoid production and nitrite oxidation is conserved across varying biogeochemical conditions in dark ocean microbial ecosystems.

  10. Hopanoid-producing bacteria in the Red Sea include the major marine nitrite-oxidizers

    KAUST Repository

    Kharbush, Jenan J; Thompson, Luke R; Haroon, Mohamed; Knight, Rob; Aluwihare, Lihini I

    2018-01-01

    Hopanoids, including the extended side chain-containing bacteriohopanepolyols (BHPs), are bacterial lipids found abundantly in the geological record and across Earth's surface environments. However, the physiological roles of this biomarker remain uncertain, limiting interpretation of their presence in current and past environments. Recent work investigating the diversity and distribution of hopanoid producers in the marine environment implicated low-oxygen regions as important loci of hopanoid production, and data from marine oxygen minimum zones (OMZs) suggested that the dominant hopanoid producers in these environments are nitrite-utilizing organisms, revealing a potential connection between hopanoid production and the marine nitrogen cycle. Here we use metagenomic data from the Red Sea to investigate the ecology of hopanoid producers in an environmental setting that is biogeochemically distinct from those investigated previously. The distributions of hopanoid production and nitrite oxidation genes in the Red Sea are closely correlated, and the majority of hopanoid producers are taxonomically affiliated with the major marine nitrite oxidizers, Nitrospinae and Nitrospirae. These results suggest that the relationship between hopanoid production and nitrite oxidation is conserved across varying biogeochemical conditions in dark ocean microbial ecosystems.

  11. Improving core surgical training in a major trauma centre.

    Science.gov (United States)

    Morris, Daniel L J; Bryson, David J; Ollivere, Ben J; Forward, Daren P

    2016-06-01

    English Major Trauma Centres (MTCs) were established in April 2012. Increased case volume and complexity has influenced trauma and orthopaedic (T&O) core surgical training in these centres. To determine if T&O core surgical training in MTCs meets Joint Committee on Surgical Training (JCST) quality indicators including performance of T&O operative procedures and consultant supervised session attendance. An audit cycle assessing the impact of a weekly departmental core surgical trainee rota. The rota included allocated timetabled sessions that optimised clinical and surgical learning opportunities. Intercollegiate Surgical Curriculum Programme (ISCP) records for T&O core surgical trainees at a single MTC were analysed for 8 months pre and post rota introduction. Outcome measures were electronic surgical logbook evidence of leading T&O operative procedures and consultant validated work-based assessments (WBAs). Nine core surgical trainees completed a 4 month MTC placement pre and post introduction of the core surgical trainee rota. Introduction of core surgical trainee rota significantly increased the mean number of T&O operative procedures led by a core surgical trainee during a 4 month MTC placement from 20.2 to 34.0 (pcore surgical trainee during a 4 month MTC placement was significantly increased (0.3 vs 2.4 [p=0.04]). Those of dynamic hip screw fixation (2.3 vs 3.6) and ankle fracture fixation (0.7 vs 1.6) were not. Introduction of a core surgical trainee rota significantly increased the mean number of consultant validated WBAs completed by a core surgical trainee during a 4 month MTC placement from 1.7 to 6.6 (pcore surgical trainee rota utilising a 'problem-based' model can significantly improve T&O core surgical training in MTCs. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Maintained improvement in neurocognitive function in major depressive disorders 6 months after ECT

    Directory of Open Access Journals (Sweden)

    Christine Mohn

    2016-12-01

    Full Text Available Both impaired and improved cognitive function after electroconvulsive treatment (ECT in major depressive disorder (MDD patients may occur. We have previously found improved cognitive function 6 weeks after ECT in this group. The aim of this study was to report 6-month follow-up results from the same prospective project monitoring cognitive effects of ECT. Thirty-one patients with major depressive disorder were assessed with the MATRICS Consensus Cognitive Battery (MCCB, the Everyday Memory Questionnaire (EMQ, and the Montgomery-Åsberg Depression Rating Scale (MADRS prior to, 6 weeks, and 6 months after ECT.Compared to baseline, the Speed of Processing, Attention/Vigilance, and Reasoning/Problem Solving test results were significantly improved. The depression score was significantly reduced. There were no changes in subjective memory complaint. There were no significant relationship between the EMQ and the MCCB subtests, but a significant correlation between current depression level and the EMQ.Six months after ECT the cognitive improvement reported at 6 weeks follow-up was maintained and extended. The corresponding decrease in depressive symptoms and stability in subjectively reported memory complaints suggests that the antidepressant effects of ECT do not occur at the expense of cognitive function.

  13. Longitudinal assessment of neuropsychological function in major depression.

    Science.gov (United States)

    Douglas, Katie M; Porter, Richard J

    2009-12-01

    Neuropsychological impairment is a core component of major depression, yet its relationship to clinical state is unclear. The aims of the present review were to determine which neuropsychological domains and tasks were most sensitive to improvement in clinical state in major depression and to highlight the methodological issues in such research. Studies that included a baseline and at least one follow-up neuropsychological testing session in adults with major depression were identified using MEDLINE, Web of Science and ScienceDirect databases. Thirty studies were included in the review. Findings in younger adult populations suggested that improvement in mood was most strongly related to improved verbal memory and verbal fluency, while measures of executive functioning and attention tended to remain impaired across treatment. In late-life major depression, improved psychomotor speed was most closely related to treatment response, but there was much inconsistency between study findings, which may be due to methodological issues. In major depression, particular neuropsychological domains are more strongly related to clinical state than others. The findings from the present review suggest that the domains most sensitive to clinical state are verbal learning and memory, verbal fluency and psychomotor speed. In contrast, measures of attention and executive functioning perhaps represent more trait-like markers of major depression. With further methodologically sound research, the changes in neuropsychological function associated with treatment response may provide a means of evaluating different treatment strategies in major depression.

  14. Reframing conceptual physics: Improving relevance to elementary education and sonography majors

    Science.gov (United States)

    LaFazia, David Gregory

    This study outlines the steps taken to reframe the Waves and Periodicity unit within a conceptual physics course. Beyond this unit reframing process, this paper explores the activities that made up the reframed unit and how each was developed and revised. The unit was reframed to improve relevance of the activities to the Elementary Education and Diagnostic Medical Sonography majors who make up the bulk of the course roster. The unit was reframed around ten design principles that were built on best practices from the literature, survey responses, and focused interviews. These principles support the selection of a biology-integrated themed approach to teaching physics. This is done through active and highly kinesthetic learning across three realms of human experience: physical, social, and cognitive. The unit materials were designed around making connections to students' future careers while requiring students to take progressively more responsibility in activities and assessments. Several support strategies are employed across these activities and assessments, including an energy-first, guided-inquiry approach to concept scaffolding and accommodations for diverse learners. Survey responses were solicited from physics instructors experienced with this population, Elementary Education and Sonography program advisors, and curriculum design, learning strategies, and educational technology experts. The reframed unit was reviewed by doctoral-level science education experts and revised to further improve the depth and transparency with which the design principles reframe the unit activities. The reframed unit contains a full unit plan, lesson plans, and full unit materials. These include classroom and online activities, assessments, and templates for future unit and lesson planning. Additional supplemental materials are provided to support Elementary Education and Sonography students and program advisors and also further promote the reframed unit materials and design

  15. Recommended Resources for Planning to Evaluate Program Improvement Efforts (Including the SSIP)

    Science.gov (United States)

    National Center for Systemic Improvement at WestEd, 2015

    2015-01-01

    This document provides a list of recommended existing resources for state Part C and Part B 619 staff and technical assistance (TA) providers to utilize to support evaluation planning for program improvement efforts (including the State Systemic Improvement Plan, SSIP). There are many resources available related to evaluation and evaluation…

  16. Do Biology Majors Really Differ from Non-STEM Majors?

    Science.gov (United States)

    Cotner, Sehoya; Thompson, Seth; Wright, Robin

    2017-01-01

    Recent calls to action urge sweeping reform in science education, advocating for improved learning for all students-including those majoring in fields beyond the sciences. However, little work has been done to characterize the differences-if any exist-between students planning a career in science and those studying other disciplines. We describe an attempt to clarify, in broad terms, how non-STEM (science, technology, engineering, and mathematics) majors differ from life sciences majors, and how they are similar. Using survey responses and institutional data, we find that non-STEM majors are not unilaterally science averse; non-STEM majors are more likely than biology majors to hold misconceptions about the nature of science, yet they are not completely ignorant of how science works; non-STEM majors are less likely than biology majors to see science as personally relevant; and non-STEM majors populations are likely to be more diverse-with respect to incoming knowledge, perceptions, backgrounds, and skills-than a biology majors population. We encourage science educators to consider these characteristics when designing curricula for future scientists or simply for a well-informed citizenry. © 2017 S. Cotner et al. CBE—Life Sciences Education © 2017 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  17. Energy intensity developments in 40 major economies: Structural change or technology improvement?

    International Nuclear Information System (INIS)

    Voigt, Sebastian; De Cian, Enrica; Schymura, Michael; Verdolini, Elena

    2014-01-01

    This study analyzes energy intensity trends and drivers in 40 major economies using the WIOD database, a novel harmonized and consistent dataset of input–output table time series accompanied by environmental satellite data. We use logarithmic mean Divisia index decomposition to (1) attribute efficiency changes to either changes in technology or changes in the structure of the economy, (2) study trends in global energy intensity between 1995 and 2007, and (3) highlight sectoral and regional differences. For the country analysis we apply the traditional two factor index decomposition approach, while for the global analysis we use a three factor decomposition which includes the consideration of regional structural changes in the global economy. We first show that heterogeneity within each sector across countries is high. These general trends within sectors are dominated by large economies, first and foremost the United States. In most cases, heterogeneity is lower within each country across the different sectors. Regarding changes of energy intensity at the country level, improvements between 1995 and 2007 are largely attributable to technological change while structural change is less important in most countries. Notable exceptions are Japan, the United States, Australia, Taiwan, Mexico and Brazil where a change in the industry mix was the main driver behind the observed energy intensity reduction. At the global level we find that despite a shift of the global economy to more energy-intensive countries, aggregate energy efficiency improved mostly due to technological change

  18. Improving the strength of amalgams by including steel fibers

    Energy Technology Data Exchange (ETDEWEB)

    Cochran, Calvin T. [Hendrix College, Conway, AR 72032 (United States); Van Hoose, James R. [Siemens, Orlando, FL 32826 (United States); McGill, Preston B. [Marshall Space Flight Center, EM20, Huntsville, AL 35812 (United States); Grugel, Richard N., E-mail: richard.n.grugel@nasa.gov [Marshall Space Flight Center, EM30, Huntsville, AL 35812 (United States)

    2012-05-30

    Highlights: Black-Right-Pointing-Pointer A room temperature liquid Ga-In alloy was successfully substituted for mercury. Black-Right-Pointing-Pointer Physically sound amalgams with included steel fibers can be made. Black-Right-Pointing-Pointer A small volume fraction inclusion of fibers increased strength by {approx}20%. - Abstract: Mercury amalgams, due to their material properties, are widely and successfully used in dental practice. They are, however, also well recognized as having poor tensile strength. With the possibility of expanding amalgam applications it is demonstrated that tensile strength can be increased some 20% by including a small amount of steel fibers. Furthermore, it is shown that mercury can be replaced with a room temperature liquid gallium-indium alloy. Processing, microstructures, and mechanical test results of these novel amalgams are presented and discussed in view of means to further improve their properties.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  20. The improvement of rice varieties for major pest and diseases resistance

    International Nuclear Information System (INIS)

    Sahi, I.; Silitonga, T.S.

    1988-01-01

    Since 1971, the rice breeding program in Indonesia has developed on intensive program to improve varieties for yield potential, resistancy to major pests and diseases, early maturity good grain and eating quality. In recent years, the attacks of insects and diseases are very severe in rice cultivation in Asia. Much of the losses were due to acontinuous planting or certain varieties. Between 1966 and 1973 tungro occured in epidemic proportions on separate occasions in Indonesia, Thailand, Nort East India, Bangladesh, and Philippine. Since 1973, investation of brown planthopper and green leafhopper several damaged rice crop in most parts of Indonesia. Presently, rice improvement are directed to develop high yielding rice varieties that are resistant to brown planthopper, ragged stunt virus, blast, green leafhopper, and gallmidge. Screening for pests and diseases are conducted in the laboratory as well as in the field. The adoption of those improved varieties by farmers has contributed greatly in our efforts to attain self sufficiency in rice production in Indonesia. GH 147 -M-40 krad-Pn-89 (irradiated Barito) showed resistant to brown planthopper biotype 1 and 2 and moderately resistant to biotype 3. Napa 40 krad-St-12 has resistant reaction to blast. (authors). 4 refs, 8 tabs

  1. Restoring function in major depressive disorder: A systematic review.

    Science.gov (United States)

    Sheehan, David V; Nakagome, Kazuyuki; Asami, Yuko; Pappadopulos, Elizabeth A; Boucher, Matthieu

    2017-06-01

    Functional impairment contributes to significant disability and economic burden in major depressive disorder (MDD). Treatment response is measured by improvement in depressive symptoms, but functional improvement often lags behind symptomatic improvement. Residual deficits are associated with relapse of depressive symptoms. A literature search was conducted using the following terms: "major depressive disorder," "functional impairment," "functional outcomes," "recovery of function," "treatment outcome," "outcome assessment," "social functioning," "presenteeism," "absenteeism," "psychiatric status rating scales," and "quality of life." Search limits included publication date (January 1, 1995 to August 31, 2016), English language, and human clinical trials. Controlled, acute-phase, nonrecurrent MDD treatment studies in adults were included if a functional outcome was measured at baseline and endpoint. The qualitative analysis included 35 controlled studies. The Sheehan Disability Scale was the most commonly used functional assessment. Antidepressant treatments significantly improved functional outcomes. Early treatment response predicted functional improvement, while baseline disease severity did not. Clinical studies utilized various methodologies and assessments for functional impairment, and were not standardized or adequately powered. The lack of synchronicity between symptomatic and functional improvement highlights an unmet need for MDD. Treatment guided by routine monitoring of symptoms and functionality may minimize residual functional impairments. Copyright © 2017. Published by Elsevier B.V.

  2. Improved Iterative Hard- and Soft-Reliability Based Majority-Logic Decoding Algorithms for Non-Binary Low-Density Parity-Check Codes

    Science.gov (United States)

    Xiong, Chenrong; Yan, Zhiyuan

    2014-10-01

    Non-binary low-density parity-check (LDPC) codes have some advantages over their binary counterparts, but unfortunately their decoding complexity is a significant challenge. The iterative hard- and soft-reliability based majority-logic decoding algorithms are attractive for non-binary LDPC codes, since they involve only finite field additions and multiplications as well as integer operations and hence have significantly lower complexity than other algorithms. In this paper, we propose two improvements to the majority-logic decoding algorithms. Instead of the accumulation of reliability information in the existing majority-logic decoding algorithms, our first improvement is a new reliability information update. The new update not only results in better error performance and fewer iterations on average, but also further reduces computational complexity. Since existing majority-logic decoding algorithms tend to have a high error floor for codes whose parity check matrices have low column weights, our second improvement is a re-selection scheme, which leads to much lower error floors, at the expense of more finite field operations and integer operations, by identifying periodic points, re-selecting intermediate hard decisions, and changing reliability information.

  3. Relief of depression and pain improves daily functioning and quality of life in patients with major depressive disorder.

    Science.gov (United States)

    Lin, Ching-Hua; Yen, Yung-Chieh; Chen, Ming-Chao; Chen, Cheng-Chung

    2013-12-02

    The objective of this study was to investigate the effects of depression relief and pain relief on the improvement in daily functioning and quality of life (QOL) for depressed patients receiving a 6-week treatment of fluoxetine. A total of 131 acutely ill inpatients with major depressive disorder (MDD) were enrolled to receive 20mg of fluoxetine daily for 6 weeks. Depression severity, pain severity, daily functioning, and health-related QOL were assessed at baseline and again at week 6. Depression severity, pain severity, and daily functioning were assessed using the 17-item Hamilton Depression Rating Scale, the Short-Form 36 (SF-36) Body Pain Index, and the Work and Social Adjustment Scale. Health-related QOL was assessed by three primary domains of the SF-36, including social functioning, vitality, and general health perceptions. Pearson's correlation and structural equation modeling were used to examine relationships among the study variables. Five models were proposed. In model 1, depression relief alone improved daily functioning and QOL. In model 2, pain relief alone improved daily functioning and QOL. In model 3, depression relief, mediated by pain relief, improved daily functioning and QOL. In model 4, pain relief, mediated by depression relief, improved daily functioning and QOL. In model 5, both depression relief and pain relief improved daily functioning and QOL. One hundred and six patients completed all the measures at baseline and at week 6. Model 5 was the most fitted structural equation model (χ(2) = 8.62, df = 8, p = 0.376, GFI = 0.975, AGFI = 0.935, TLI = 0.992, CFI = 0.996, RMSEA = 0.027). Interventions which relieve depression and pain improve daily functioning and QOL among patients with MDD. The proposed model can provide quantitative estimates of improvement in treating patients with MDD. © 2013 Elsevier Inc. All rights reserved.

  4. Novel Augmentation Strategies in Major Depression

    DEFF Research Database (Denmark)

    Martiny, Klaus

    2017-01-01

    Hypothesis The hypotheses of all the four included studies share the common idea that it is possible to augment the effect of antidepressant drug treatment by applying different interventions and with each intervention attain a clinically meaningful better effect compared to a control condition......, and with minor side effects, thus improving the short- and medium-term outcome in major depression. Procedures Study design The basic study design has been the double blind randomised controlled trial (RCT). In the light therapy study, all patients were treated with sertraline for the whole of the study duration...... open psychiatric wards. Only a few patients were re-cruited through advertisements (in the PEMF and Chronos studies). Inclusion criteria Inclusion criteria were major depression according to the DSM-IV, including a depressive episode as part of a bipolar disorder. For the PEMF study, treatment...

  5. Incremental cost-effectiveness of trauma service improvements for road trauma casualties: experience of an Australian major trauma centre.

    Science.gov (United States)

    Dinh, Michael M; Bein, Kendall J; Hendrie, Delia; Gabbe, Belinda; Byrne, Christopher M; Ivers, Rebecca

    2016-09-01

    Objective The aim of the present study was to estimate the cost-effectiveness of trauma service funding enhancements at an inner city major trauma centre. Methods The present study was a cost-effectiveness analysis using retrospective trauma registry data of all major trauma patients (injury severity score >15) presenting after road trauma between 2001 and 2012. The primary outcome was cost per life year gained associated with the intervention period (2007-12) compared with the pre-intervention period (2001-06). Incremental costs were represented by all trauma-related funding enhancements undertaken between 2007 and 2010. Risk adjustment for years of life lost was conducted using zero-inflated negative binomial regression modelling. All costs were expressed in 2012 Australian dollar values. Results In all, 876 patients were identified during the study period. The incremental cost of trauma enhancements between 2007 and 2012 totalled $7.91million, of which $2.86million (36%) was attributable to road trauma patients. After adjustment for important covariates, the odds of in-hospital mortality reduced by around half (adjusted odds ratio (OR) 0.48; 95% confidence interval (CI) 0.27, 0.82; P=0.01). The incremental cost-effectiveness ratio was A$7600 per life year gained (95% CI A$5524, $19333). Conclusion Trauma service funding enhancements that enabled a quality improvement program at a single major trauma centre were found to be cost-effective based on current international and Australian standards. What is known about this topic? Trauma quality improvement programs have been implemented across most designated trauma hospitals in an effort to improve hospital care processes and outcomes for injured patients. These involve a combination of education and training, the use of audit and key performance indicators. What does this paper add? A trauma quality improvement program initiated at an Australian Major Trauma Centre was found to be cost-effective over 12 years with

  6. The Event Chain of Survival in the Context of Music Festivals: A Framework for Improving Outcomes at Major Planned Events.

    Science.gov (United States)

    Lund, Adam; Turris, Sheila

    2017-08-01

    Despite the best efforts of event producers and on-site medical teams, there are sometimes serious illnesses, life-threatening injuries, and fatalities related to music festival attendance. Producers, clinicians, and researchers are actively seeking ways to reduce the mortality and morbidity associated with these events. After analyzing the available literature on music festival health and safety, several major themes emerged. Principally, stakeholder groups planning in isolation from one another (ie, in silos) create fragmentation, gaps, and overlap in plans for major planned events (MPEs). The authors hypothesized that one approach to minimizing this fragmentation may be to create a framework to "connect the dots," or join together the many silos of professionals responsible for safety, security, health, and emergency planning at MPEs. Adapted from the well-established literature regarding the management of cardiac arrests, both in and out of hospital, the "chain of survival" concept is applied to the disparate groups providing services that support event safety in the context of music festivals. The authors propose this framework for describing, understanding, coordinating and planning around the integration of safety, security, health, and emergency service for events. The adapted Event Chain of Survival contains six interdependent links, including: (1) event producers; (2) police and security; (3) festival health; (4) on-site medical services; (5) ambulance services; and (6) off-site medical services. The authors argue that adapting and applying this framework in the context of MPEs in general, and music festivals specifically, has the potential to break down the current disconnected approach to event safety, security, health, and emergency planning. It offers a means of shifting the focus from a purely reactive stance to a more proactive, collaborative, and integrated approach. Improving health outcomes for music festival attendees, reducing gaps in planning

  7. Towards ligand docking including explicit interface water molecules.

    Directory of Open Access Journals (Sweden)

    Gordon Lemmon

    Full Text Available Small molecule docking predicts the interaction of a small molecule ligand with a protein at atomic-detail accuracy including position and conformation the ligand but also conformational changes of the protein upon ligand binding. While successful in the majority of cases, docking algorithms including RosettaLigand fail in some cases to predict the correct protein/ligand complex structure. In this study we show that simultaneous docking of explicit interface water molecules greatly improves Rosetta's ability to distinguish correct from incorrect ligand poses. This result holds true for both protein-centric water docking wherein waters are located relative to the protein binding site and ligand-centric water docking wherein waters move with the ligand during docking. Protein-centric docking is used to model 99 HIV-1 protease/protease inhibitor structures. We find protease inhibitor placement improving at a ratio of 9:1 when one critical interface water molecule is included in the docking simulation. Ligand-centric docking is applied to 341 structures from the CSAR benchmark of diverse protein/ligand complexes [1]. Across this diverse dataset we see up to 56% recovery of failed docking studies, when waters are included in the docking simulation.

  8. Interpersonal psychotherapy (IPT) in major depressive disorder.

    Science.gov (United States)

    Brakemeier, Eva-Lotta; Frase, Lukas

    2012-11-01

    In this article, we will introduce interpersonal psychotherapy as an effective short-term treatment strategy in major depression. In IPT, a reciprocal relationship between interpersonal problems and depressive symptoms is regarded as important in the onset and as a maintaining factor of depressive disorders. Therefore, interpersonal problems are the main therapeutic targets of this approach. Four interpersonal problem areas are defined, which include interpersonal role disputes, role transitions, complicated bereavement, and interpersonal deficits. Patients are helped to break the interactions between depressive symptoms and their individual interpersonal difficulties. The goals are to achieve a reduction in depressive symptoms and an improvement in interpersonal functioning through improved communication, expression of affect, and proactive engagement with the current interpersonal network. The efficacy of this focused and structured psychotherapy in the treatment of acute unipolar major depressive disorder is summarized. This article outlines the background of interpersonal psychotherapy, the process of therapy, efficacy, and the expansion of the evidence base to different subgroups of depressed patients.

  9. The Normal Position of Umbilicus in the Newborn: An Aid to Improve Cosmetic Result in Exomphalos Major

    Directory of Open Access Journals (Sweden)

    H Davari

    2004-02-01

    Full Text Available Background: Position of umbilicus is an important esthetic landmark and its absence or deformity may be associated with poor self-image. In abdominoplasty, the creation of a normal-looking, well shaped and sufficiently deep umbilicus on a normal position seems essential. The aim of this study was to determine the normal position of umbilicus and hence to improve the cosmetic result of exomphalos major repair. Methods: In a cross-sectional study the position of umbilicus was determined in a random sample of 200 healthy and normal neonates (107 boys and 93 girls who were born in Isfahan University hospitals from Oct. 2002 till Mar. 2003, with respect to the xiphisternum and pubis. Results: The normal umbilical position was 59.3 ± 5.2 percent of the way from the inferior border of xiphisternum to the superior border of the pubis in the midline and it was independent of gender and neonatal Conclusions: Recent years have witnessed major improvements in the survival of newborns with exomphalocele. The primary repair of the abdominal wall with umbilicoplasty is generally considered the treatment of choice, and the cosmetic appearance of the navel becomes increasingly important as children grow older. In repair of exomphalos major, the most esthetically pleasing result is obtained if the umbilicus is placed 59.3% of the way from the xiphisternum to the pubis. Keywords: Umbilicus, Exomphalos, Neonate, Umbilicoplasty, Isfahan

  10. Specific balance training included in an endurance-resistance exercise program improves postural balance in elderly patients undergoing haemodialysis.

    Science.gov (United States)

    Frih, Bechir; Mkacher, Wajdi; Jaafar, Hamdi; Frih, Ameur; Ben Salah, Zohra; El May, Mezry; Hammami, Mohamed

    2018-04-01

    The purpose of this study was to evaluate the effects of 6 months of specific balance training included in endurance-resistance program on postural balance in haemodialysis (HD) patients. Forty-nine male patients undergoing HD were randomly assigned to an intervention group (balance training included in an endurance-resistance training, n = 26) or a control group (resistance-endurance training only, n = 23). Postural control was assessed using six clinical tests; Timed Up and Go test, Tinetti Mobility Test, Berg Balance Scale, Unipodal Stance test, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scale. All balance measures increased significantly after the period of rehabilitation training in the intervention group. Only the Timed Up and Go, Berg Balance Scale, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scores were improved in the control group. The ranges of change in these tests were greater in the balance training group. In HD patients, specific balance training included in a usual endurance-resistance training program improves static and dynamic balance better than endurance-resistance training only. Implications for rehabilitation Rehabilitation using exercise in haemodialysis patients improved global mobility and functional abilities. Specific balance training included in usual endurance resistance training program could lead to improved static and dynamic balance.

  11. Low emotion-oriented coping and informal help-seeking behaviour as major predictive factors for improvement in major depression at 5-year follow-up in the adult community.

    Science.gov (United States)

    Rodgers, S; Vandeleur, C L; Strippoli, M-P F; Castelao, E; Tesic, A; Glaus, J; Lasserre, A M; Müller, M; Rössler, W; Ajdacic-Gross, V; Preisig, M

    2017-09-01

    Given the broad range of biopsychosocial difficulties resulting from major depressive disorder (MDD), reliable evidence for predictors of improved mental health is essential, particularly from unbiased prospective community samples. Consequently, a broad spectrum of potential clinical and non-clinical predictors of improved mental health, defined as an absence of current major depressive episode (MDE) at follow-up, were examined over a 5-year period in an adult community sample. The longitudinal population-based PsyCoLaus study from the city of Lausanne, Switzerland, was used. Subjects having a lifetime MDD with a current MDE at baseline assessment were selected, resulting in a subsample of 210 subjects. Logistic regressions were applied to the data. Coping styles were the most important predictive factors in the present study. More specifically, low emotion-oriented coping and informal help-seeking behaviour at baseline were associated with the absence of an MDD diagnosis at follow-up. Surprisingly, neither formal help-seeking behaviour, nor psychopharmacological treatment, nor childhood adversities, nor depression subtypes turned out to be relevant predictors in the current study. The paramount role of coping styles as predictors of improvement in depression found in the present study might be a valuable target for resource-oriented therapeutic models. On the one hand, the positive impact of low emotion-oriented coping highlights the utility of clinical interventions interrupting excessive mental ruminations during MDE. On the other hand, the importance of informal social networks raises questions regarding how to enlarge the personal network of affected subjects and on how to best support informal caregivers.

  12. Levels of major and trace elements, including rare earth elements, and ²³⁸U in Croatian tap waters.

    Science.gov (United States)

    Fiket, Željka; Rožmarić, Martina; Krmpotić, Matea; Benedik, Ljudmila

    2015-05-01

    Concentrations of 46 elements, including major, trace, and rare earth elements, and (238)U in Croatian tap waters were investigated. Selected sampling locations include tap waters from various hydrogeological regions, i.e., different types of aquifers, providing insight into the range of concentrations of studied elements and (238)U activity concentrations in Croatian tap waters. Obtained concentrations were compared with the Croatian maximum contaminant levels for trace elements in water intended for human consumption, as well as WHO and EPA drinking water standards. Concentrations in all analyzed tap waters were found in accordance with Croatian regulations, except tap water from Šibenik in which manganese in concentration above maximum permissible concentration (MPC) was measured. Furthermore, in tap water from Osijek, levels of arsenic exceeded the WHO guidelines and EPA regulations. In general, investigated tap waters were found to vary considerably in concentrations of studied elements, including (238)U activity concentrations. Causes of variability were further explored using statistical methods. Composition of studied tap waters was found to be predominately influenced by hydrogeological characteristics of the aquifer, at regional and local level, the existing redox conditions, and the household plumbing system. Rare earth element data, including abundances and fractionation patterns, complemented the characterization and facilitated the interpretation of factors affecting the composition of the analyzed tap waters.

  13. A major trauma course based on posters, audio-guides and simulation improves the management skills of medical students: Evaluation via medical simulator.

    Science.gov (United States)

    Cuisinier, Adrien; Schilte, Clotilde; Declety, Philippe; Picard, Julien; Berger, Karine; Bouzat, Pierre; Falcon, Dominique; Bosson, Jean Luc; Payen, Jean-François; Albaladejo, Pierre

    2015-12-01

    Medical competence requires the acquisition of theoretical knowledge and technical skills. Severe trauma management teaching is poorly developed during internship. Nevertheless, the basics of major trauma management should be acquired by every future physician. For this reason, the major trauma course (MTC), an educational course in major traumatology, has been developed for medical students. Our objective was to evaluate, via a high fidelity medical simulator, the impact of the MTC on medical student skills concerning major trauma management. The MTC contains 3 teaching modalities: posters with associated audio-guides, a procedural workshop on airway management and a teaching session using a medical simulator. Skills evaluation was performed 1 month before (step 1) and 1 month after (step 3) the MTC (step 2). Nineteen students were individually evaluated on 2 different major trauma scenarios. The primary endpoint was the difference between steps 1 and 3, in a combined score evaluating: admission, equipment, monitoring and safety (skill set 1) and systematic clinical examinations (skill set 2). After the course, the combined primary outcome score improved by 47% (P<0.01). Scenario choice or the order of use had no significant influence on the skill set evaluations. This study shows improvement in student skills for major trauma management, which we attribute mainly to the major trauma course developed in our institution. Copyright © 2015 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

  14. Improving weather predictability by including land-surface model parameter uncertainty

    Science.gov (United States)

    Orth, Rene; Dutra, Emanuel; Pappenberger, Florian

    2016-04-01

    The land surface forms an important component of Earth system models and interacts nonlinearly with other parts such as ocean and atmosphere. To capture the complex and heterogenous hydrology of the land surface, land surface models include a large number of parameters impacting the coupling to other components of the Earth system model. Focusing on ECMWF's land-surface model HTESSEL we present in this study a comprehensive parameter sensitivity evaluation using multiple observational datasets in Europe. We select 6 poorly constrained effective parameters (surface runoff effective depth, skin conductivity, minimum stomatal resistance, maximum interception, soil moisture stress function shape, total soil depth) and explore their sensitivity to model outputs such as soil moisture, evapotranspiration and runoff using uncoupled simulations and coupled seasonal forecasts. Additionally we investigate the possibility to construct ensembles from the multiple land surface parameters. In the uncoupled runs we find that minimum stomatal resistance and total soil depth have the most influence on model performance. Forecast skill scores are moreover sensitive to the same parameters as HTESSEL performance in the uncoupled analysis. We demonstrate the robustness of our findings by comparing multiple best performing parameter sets and multiple randomly chosen parameter sets. We find better temperature and precipitation forecast skill with the best-performing parameter perturbations demonstrating representativeness of model performance across uncoupled (and hence less computationally demanding) and coupled settings. Finally, we construct ensemble forecasts from ensemble members derived with different best-performing parameterizations of HTESSEL. This incorporation of parameter uncertainty in the ensemble generation yields an increase in forecast skill, even beyond the skill of the default system. Orth, R., E. Dutra, and F. Pappenberger, 2016: Improving weather predictability by

  15. Improving selenium nutritional value of major crops

    Science.gov (United States)

    Micronutrient efficiency and development of nutrient-dense crops continue to be one of the most important global challenges. Se is an essential micronutrient to humans and serves as a cancer preventative agent. In order to improve Se nutritional and health promoting values in food crops, a better un...

  16. Trends and prospects of international major commodity prices

    Directory of Open Access Journals (Sweden)

    Maria Cartas

    2013-04-01

    Full Text Available Trends and prospects of international major commodity prices. In 2012, the international commodity markets have seen declining prices, especially during the first half of the year, with some improvement mainly in the last quarter. On the whole, most of major commodity prices declined, following generally weaker demand and the uncertain global economic situation. The short term outlook shows broad declines of prices for all major commodity groups, including oil and excepting metal prices, which are expected to be sustained by the global economic recovery and increasing demand, mainly in China. This country represents a major player, with a great contribution to the movement of prices on most of international commodity markets, as she has a great role in the world consumption and trade of commodities, as well as in the world production of some of these goods, on the one hand, and enjoys huge financial resources, on the other.

  17. The impact of major trauma network triage systems on patients with major burns.

    Science.gov (United States)

    Nizamoglu, Metin; O'Connor, Edmund Fitzgerald; Bache, Sarah; Theodorakopoulou, Evgenia; Sen, Sankhya; Sherren, Peter; Barnes, David; Dziewulski, Peter

    2016-12-01

    Trauma is a leading cause of death and disability worldwide. Patients presenting with severe trauma and burns benefit from specifically trained multidisciplinary teams. Regional trauma systems have shown improved outcomes for trauma patients. The aim of this study is to determine whether the development of major trauma systems have improved the management of patients with major burns. A retrospective study was performed over a four-year period reviewing all major burns in adults and children received at a regional burns centre in the UK before and after the implementation of the regional trauma systems and major trauma centres (MTC). Comparisons were drawn between three areas: (1) Patients presenting before the introduction of MTC and after the introduction of MTC. (2) Patients referred from MTC and non-MTC within the region, following the introduction of MTC. (3) Patients referred using the urban trauma protocol and the rural trauma protocol. Following the introduction of regional trauma systems and major trauma centres (MTC), isolated burn patients seen at our regional burns centre did not show any significant improvement in transfer times, admission resuscitation parameters, organ dysfunction or survival when referred from a MTC compared to a non-MTC emergency department. There was also no significant difference in survival when comparing referrals from all hospitals pre and post establishment of the major trauma network. No significant outcome benefit was demonstrated for burns patients referred via MTCs compared to non-MTCs. We suggest further research is needed to ascertain whether burns patients benefit from prolonged transfer times to a MTC compared to those seen at their local hospitals prior to transfer to a regional burns unit for further specialist care. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  18. Health Impacts of Air Pollution around Major Industrial Areas

    Directory of Open Access Journals (Sweden)

    Mathilde Pascal

    2013-01-01

    Full Text Available We performed a literature review to investigate how epidemiological studies have been used to assess the health consequences of living in the vicinity of industries. 77 papers on the chronic effects of air pollution around major industrial areas were reviewed. Major health themes were cancers (27 studies, morbidity (25 studies, mortality (7 studies, and birth outcome (7 studies. Only 3 studies investigated mental health. While studies were available from many different countries, a majority of papers came from the United Kingdom, Italy, and Spain. Several studies were motivated by concerns from the population or by previous observations of an overincidence of cases. Geographical ecological designs were largely used for studying cancer and mortality, including statistical designs to quantify a relationship between health indicators and exposure. Morbidity was frequently investigated through cross-sectional surveys on the respiratory health of children. Few multicenter studies were performed. In a majority of papers, exposed areas were defined based on the distance to the industry and were located from 20 km from the plants. Improving the exposure assessment would be an asset to future studies. Criteria to include industries in multicenter studies should be defined.

  19. Levomilnacipran Extended-Release Treatment in Patients With Major Depressive Disorder: Improvements in Functional Impairment Categories

    Science.gov (United States)

    Gommoll, Carl P.; Chen, Changzheng; Greenberg, William M.; Ruth, Adam

    2015-01-01

    Objective: In this post hoc analysis, improvement in functional impairment in patients with major depressive disorder (MDD) treated with levomilnacipran extended release (ER) was evaluated by assessing shifts from more severe to less severe functional impairment categories on individual Sheehan Disability Scale (SDS) subscales. Method: SDS data were pooled from 5 phase II/III studies conducted between December 2006 and March 2012 of levomilnacipran ER versus placebo in adult patients with MDD (DSM-IV-TR criteria). Proportions of patients shifting from moderate-extreme baseline impairment (score ≥ 4) to mild-no impairment (score ≤ 3) at end of treatment were assessed for each SDS subscale. Proportions of patients shifting from marked-extreme (score ≥ 7) baseline impairment to moderate-no (score ≤ 6) or mild-no impairment (score ≤ 3) at end of treatment, and shifts in which patients worsened from moderate-no to marked-extreme impairment, were also evaluated. Results: A significantly higher proportion of patients treated with levomilnacipran ER than placebo-treated patients improved from more severe categories of functional impairment at baseline to less severe impairment categories across all SDS subscales: work/school, social life, and family life/home responsibilities (P impairment at baseline improved to mild or no impairment, compared with no more than 40% of placebo patients on any subscale. Almost half (42%–47%) of levomilnacipran ER–treated patients versus only about one-third (29%–34%) of placebo patients improved from marked-extreme to mild or no impairment across functional domains. Conclusions: These results suggest that functional improvement was observed across the SDS functional domains. To our knowledge, this is the first such categorical analysis of functional improvement, as measured by the SDS, for an antidepressant. Trial Registration: ClinicalTrials.gov identifiers: NCT00969709, NCT01377194, NCT00969150, and NCT01034462 and Eudra

  20. Major life events and development of major depression in Parkinson's disease patients

    DEFF Research Database (Denmark)

    Rod, Naja Hulvej; Bordelon, Y; Thompson, A

    2012-01-01

    BACKGROUND AND PURPOSE: Non-motor symptoms including depression are important features of Parkinson's disease (PD). We aim to address the relationship between major life events and depression amongst PD patients free of depressive symptoms at baseline. METHODS: New-onset PD patients from California...... were recruited in 2001-2007 and followed up for 3-4 years. The participants (n = 221) were examined by neurologists and responded to comprehensive interviews that included major life events, social support, and coping measures from validated scales. Major depression was assessed using the Structured...... Clinical Interview for the DSM-IV depression module (SCID). RESULTS: More than half of all patients had experienced major life events since diagnosed with PD, and 22 patients developed a major depression. The number of life events was associated with risk of depression in an exposure-dependent manner...

  1. International Charter "Space and Major Disasters": Typical Examples of Disaster Management Including Asian Tsunami

    Science.gov (United States)

    Cubero-Castan, Eliane; Bequignon, Jerome; Mahmood, Ahmed; Lauritson, Levin; Soma, P.; Platzeck, Gabriel; Chu, Ishida

    2005-03-01

    The International Charter 'Space and Major Disaster', now entering its 5th year of operation, has been activated nearly 80 times to provide space-based data and information in response to natural disasters. The disasters ranged from volcanic eruption in Columbia, floods in Europe, Argentina, Sudan to earthquakes in Iran, from landslides in Philippines to the tragic tsunami in Asia, all resulting in major loss of life and property. The Charter provided imagery and the related information were found to be useful in disaster relief and assessment. Since July 1st 2003, a framework cooperation agreement has been allowing United Nations organizations involved in disaster response to request activation of the Charter.The purpose of the Charter is to provide assistance in situations of emergencies caused by natural and technological disasters by pooling together the space and associated ground resources of the Charter participants, which are currently the European (ESA), French (CNES), Canadian (CSA), Indian (ISRO), American (NOAA), Argentinean (CONAE) and Japanese (JAXA) space organizations.This paper will point out some of the best cases of Charter activation for different disasters leading to change detection imagery and damage assessment products which could be used for disaster reduction in close co-ordination with the end users after the crisis period.

  2. Improving adherence with deferoxamine regimen in thalassemia major using education

    Directory of Open Access Journals (Sweden)

    Gholamreza Pouladfar

    2006-02-01

    Full Text Available Background: Subcutaneous deferoxamine is the first line for management of iron overload in thalassemia major. There is a wide deferoxamine adherence variation in patients with thalassemia major. In order to assess the effect of education on patients and their parents, a cognitive approach was used. Methods: In a randomized control trial, 78 consecutive patients with thalassemia major were randomly divided into educational (38 cases, 50% male and 50% female and control (40 cases, 65% male and 35% female groups. Oral and practical education sessions for deferoxamine injection were planned. Deferoxamine usage, pump function, side effects, knowledge levels of the patients and their parents, and ferritin serum levels were assessed before and after the trail. The knowledge was also evaluated promptly after educational sessions. Results: the mean age of experimental and control groups were 14.6 and 13.0 years, respectively. There was no significant difference in age, sex and weight (P>0.05 at the end of the study, there was no significant change in the level of knowledge in both groups however, the patients who used deferoxamine at least 5 times a week were increased in the experimental group (P0.001. Conclusion: A cognitive approach had relatively significant effect on deferoxamine adherence. However, educational sessions had not dramatic change in knowledge levels of the patients and their parents, but oral and practical education produced a significant change in decreasing local side effects of subcutaneous deferoxamine in thalassemia major.

  3. Plaque Structural Stress Estimations Improve Prediction of Future Major Adverse Cardiovascular Events After Intracoronary Imaging.

    Science.gov (United States)

    Brown, Adam J; Teng, Zhongzhao; Calvert, Patrick A; Rajani, Nikil K; Hennessy, Orla; Nerlekar, Nitesh; Obaid, Daniel R; Costopoulos, Charis; Huang, Yuan; Hoole, Stephen P; Goddard, Martin; West, Nick E J; Gillard, Jonathan H; Bennett, Martin R

    2016-06-01

    Although plaque rupture is responsible for most myocardial infarctions, few high-risk plaques identified by intracoronary imaging actually result in future major adverse cardiovascular events (MACE). Nonimaging markers of individual plaque behavior are therefore required. Rupture occurs when plaque structural stress (PSS) exceeds material strength. We therefore assessed whether PSS could predict future MACE in high-risk nonculprit lesions identified on virtual-histology intravascular ultrasound. Baseline nonculprit lesion features associated with MACE during long-term follow-up (median: 1115 days) were determined in 170 patients undergoing 3-vessel virtual-histology intravascular ultrasound. MACE was associated with plaque burden ≥70% (hazard ratio: 8.6; 95% confidence interval, 2.5-30.6; P<0.001) and minimal luminal area ≤4 mm(2) (hazard ratio: 6.6; 95% confidence interval, 2.1-20.1; P=0.036), although absolute event rates for high-risk lesions remained <10%. PSS derived from virtual-histology intravascular ultrasound was subsequently estimated in nonculprit lesions responsible for MACE (n=22) versus matched control lesions (n=22). PSS showed marked heterogeneity across and between similar lesions but was significantly increased in MACE lesions at high-risk regions, including plaque burden ≥70% (13.9±11.5 versus 10.2±4.7; P<0.001) and thin-cap fibroatheroma (14.0±8.9 versus 11.6±4.5; P=0.02). Furthermore, PSS improved the ability of virtual-histology intravascular ultrasound to predict MACE in plaques with plaque burden ≥70% (adjusted log-rank, P=0.003) and minimal luminal area ≤4 mm(2) (P=0.002). Plaques responsible for MACE had larger superficial calcium inclusions, which acted to increase PSS (P<0.05). Baseline PSS is increased in plaques responsible for MACE and improves the ability of intracoronary imaging to predict events. Biomechanical modeling may complement plaque imaging for risk stratification of coronary nonculprit lesions. © 2016

  4. Frequency of short stature in - thalassemia major patients

    International Nuclear Information System (INIS)

    Aslam, M.S.; Roshan, E.; Shahid, M.

    2013-01-01

    Objective: To determine the frequency of short stature in children with - thalassemia major receiving multiple transfusions at Military Hospital Rawalpindi. Study Design: Descriptive cross sectional study. Place and Duration of Study: Study was conducted at Military Hospital from 1st January 2010 to 30th June 2010. Subjects and Methods: Total 100 multi-transfused cases of - thalassemia major were included in the study. The height of every child was measured in centimeters using the same free-standing standard stadiometer, and the same technique by a single pediatrician. Results: Out of 100 patients of - thalassemia major 57.0% (n=57) were male while 43% (n=43) were female. Mean age was 9.94 years (SD +- 2.93) with range of 6 to 14 years. Mean height was 115.77 cm (SD +- 13.79) with range of 72.00 to 148.00 cm. 57.0% (n=57) were found to be short statured while 43.0% (n=43) were with normal height. Mean age of short statured patients was 11.61 +- 2.34 years and mean age of patients with normal height was 7.73 +- 2.05 years. Conclusion: The frequency of short stature in our patients with - thalassemia major receiving multiple transfusions is high. There is need to monitor the height of thalassemic children regularly and to improve the quality of care being provided to them so as to improve their quality of life. (author)

  5. An innovative nonpharmacological intervention combined with intravenous patient-controlled analgesia increased patient global improvement in pain and satisfaction after major surgery

    Directory of Open Access Journals (Sweden)

    Chuang CC

    2017-04-01

    Full Text Available Chia-Chun Chuang,1 Chien-Ching Lee,1,2 Li-Kai Wang,1 Bor-Shyh Lin,2 Wen-Ju Wu,1 Chung-Han Ho,3 Jen-Yin Chen1,4 1Department of Anesthesiology, Chi Mei Medical Center, 2Department of Imaging and Biomedical Photonics, National Chiao Tung University, 3Department of Medical Research, Chi Mei Medical Center, 4Department of the Senior Citizen Service Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan, Republic of China Purpose: This study aimed to evaluate whether a nonpharmacological approach through implementation of a communication improvement program (named CICARE for Connect, Introduce, Communicate, Ask, Respond and Exit into standard operating procedure (SOP in acute pain service (APS improved satisfaction in patients receiving intravenous patient-controlled analgesia (IV-PCA.Patients and methods: This was a nonrandomized before–after study. Adult patients (aged between 20 and 80 years who received IV-PCA after major surgery were included. Implementing CICARE into SOP was conducted in APS. Anonymous questionnaires were used to measure outcomes in this prospective two-part survey. The first part completed by APS nurses contained patients’ characteristics, morphine dosage, delivery/demand ratios, IV-PCA side effects and pain at rest measured with an 11-point numeric rating scale (NRS, 0–10. A score of NRS ≥4 was defined as inadequately treated pain. The ten-question second part was completed by patients voluntarily after IV-PCA was discontinued. Each question was assessed with a 5-point Likert scale (1: extremely poor; 5: excellent. Patients were separated into “before” and “after” CICARE groups. Primary outcomes were patient global impression of improvement in pain (PGI-Improvement and patient satisfaction. Secondary outcomes included quality of communication skills, instrument proficiency and accessibility/availability of IV-PCA.Results: The response rate was 55.3%, with 187 usable questionnaires. CICARE

  6. Upgrading and efficiency improvement in coal-fired power plants

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-08-01

    Improving the efficiencies of the large number of older coal-fired power plants operating around the world would give major savings in CO2 emissions together with significant other benefits. This report begins with a summary of the ways efficiency can become degraded and of the means available to combat the decrease in performance. These include improvements to operating and maintenance practices and more major techniques that are available, including boiler and turbine retrofits. There is also an update on fuel drying developments as a route to higher efficiency in plants firing high moisture lignites. The largest chapter of the report contains a number of descriptions of case study improvement projects, to illustrate measures that have been applied, benefits that have been achieved and identify best practices, which are summarised. Major national and international upgrading programmes are described.

  7. Improvement of radioisotope production technology

    International Nuclear Information System (INIS)

    Li Yongjian

    1987-01-01

    The widespreading and deepgoing applications of radioisotopes results the increasing demands on both quality and quantity. This in turn stimulating the production technology to be improved unceasingly to meet the different requirements on availability, variety, facility, purity, specific activity and specificity. The major approaches of achieving these improvements including: optimizing mode of production; enhancing irradiation conditions; amelioration target arrangement; adapting nuclear process and inventing chemical processing. (author)

  8. The Relationship between Symptom Relief and Psychosocial Functional Improvement during Acute Electroconvulsive Therapy for Patients with Major Depressive Disorder.

    Science.gov (United States)

    Lin, Ching-Hua; Yang, Wei-Cheng

    2017-07-01

    We aimed to compare the degree of symptom relief to psychosocial functional (abbreviated as "functional") improvement and explore the relationships between symptom relief and functional improvement during acute electroconvulsive therapy for patients with major depressive disorder. Major depressive disorder inpatients (n=130) requiring electroconvulsive therapy were recruited. Electroconvulsive therapy was generally performed for a maximum of 12 treatments. Symptom severity, using the 17-item Hamilton Depression Rating Scale, and psychosocial functioning (abbreviated as "functioning"), using the Modified Work and Social Adjustment Scale, were assessed before electroconvulsive therapy, after every 3 electroconvulsive therapy treatments, and after the final electroconvulsive therapy. Both 17-item Hamilton Depression Rating Scale and Modified Work and Social Adjustment Scale scores were converted to T-score units to compare the degrees of changes between depressive symptoms and functioning after electroconvulsive therapy. Structural equation modeling was used to test the relationships between 17-item Hamilton Depression Rating Scale and Modified Work and Social Adjustment Scale during acute electroconvulsive therapy. One hundred sixteen patients who completed at least the first 3 electroconvulsive therapy treatments entered the analysis. Reduction of 17-item Hamilton Depression Rating Scale T-scores was significantly greater than that of Modified Work and Social Adjustment Scale T-scores at assessments 2, 3, 4, and 5. The model analyzed by structural equation modeling satisfied all indices of goodness-of-fit (chi-square = 32.882, P =.107, TLI = 0.92, CFI = 0.984, RMSEA = 0.057). The 17-item Hamilton Depression Rating Scale change did not predict subsequent Modified Work and Social Adjustment Scale change. Functioning improved less than depressive symptoms during acute electroconvulsive therapy. Symptom reduction did not predict subsequent functional improvement

  9. Improvement of prediction ability for genomic selection of dairy cattle by including dominance effects.

    Directory of Open Access Journals (Sweden)

    Chuanyu Sun

    Full Text Available Dominance may be an important source of non-additive genetic variance for many traits of dairy cattle. However, nearly all prediction models for dairy cattle have included only additive effects because of the limited number of cows with both genotypes and phenotypes. The role of dominance in the Holstein and Jersey breeds was investigated for eight traits: milk, fat, and protein yields; productive life; daughter pregnancy rate; somatic cell score; fat percent and protein percent. Additive and dominance variance components were estimated and then used to estimate additive and dominance effects of single nucleotide polymorphisms (SNPs. The predictive abilities of three models with both additive and dominance effects and a model with additive effects only were assessed using ten-fold cross-validation. One procedure estimated dominance values, and another estimated dominance deviations; calculation of the dominance relationship matrix was different for the two methods. The third approach enlarged the dataset by including cows with genotype probabilities derived using genotyped ancestors. For yield traits, dominance variance accounted for 5 and 7% of total variance for Holsteins and Jerseys, respectively; using dominance deviations resulted in smaller dominance and larger additive variance estimates. For non-yield traits, dominance variances were very small for both breeds. For yield traits, including additive and dominance effects fit the data better than including only additive effects; average correlations between estimated genetic effects and phenotypes showed that prediction accuracy increased when both effects rather than just additive effects were included. No corresponding gains in prediction ability were found for non-yield traits. Including cows with derived genotype probabilities from genotyped ancestors did not improve prediction accuracy. The largest additive effects were located on chromosome 14 near DGAT1 for yield traits for both

  10. Improved application of the electrophoretic tissue clearing technology, CLARITY, to intact solid organs including brain, pancreas, liver, kidney, lung, and intestine.

    Science.gov (United States)

    Lee, Hyunsu; Park, Jae-Hyung; Seo, Incheol; Park, Sun-Hyun; Kim, Shin

    2014-12-21

    Mapping of tissue structure at the cellular, circuit, and organ-wide scale is important for understanding physiological and biological functions. A bio-electrochemical technique known as CLARITY used for three-dimensional anatomical and phenotypical mapping within transparent intact tissues has been recently developed. This method provided a major advance in understanding the structure-function relationships in circuits of the nervous system and organs by using whole-body clearing. Thus, in the present study, we aimed to improve the original CLARITY procedure and developed specific CLARITY protocols for various intact organs. We determined the optimal conditions for reducing bubble formation, discoloration, and depositing of black particles on the surface of tissue, which allowed production of clearer organ images. We also determined the appropriate replacement cycles of clearing solution for each type of organ, and convincingly demonstrated that 250-280 mA is the ideal range of electrical current for tissue clearing. We then acquired each type of cleared organs including brain, pancreas, liver, lung, kidney, and intestine. Additionally, we determined the images of axon fibers of hippocampal region, the Purkinje layer of cerebellum, and vessels and cellular nuclei of pancreas. CLARITY is an innovative biochemical technology for the structural and molecular analysis of various types of tissue. We developed improved CLARITY methods for clearing of the brain, pancreas, lung, intestine, liver, and kidney, and identified the appropriate experimental conditions for clearing of each specific tissue type. These optimized methods will be useful for the application of CLARITY to various types of organs.

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

    NARCIS (Netherlands)

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

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

  12. Brain activation predicts treatment improvement in patients with major depressive disorder.

    LENUS (Irish Health Repository)

    Samson, Andrea C

    2012-02-01

    Major depressive disorder (MDD) is associated with alterations in brain function that might be useful for therapy evaluation. The current study aimed to identify predictors for therapy improvement and to track functional brain changes during therapy. Twenty-one drug-free patients with MDD underwent functional MRI twice during performance of an emotional perception task: once before and once after 4 weeks of antidepressant treatment (mirtazapine or venlafaxine). Twelve healthy controls were investigated once with the same methods. A significant difference between groups was a relative greater activation of the right dorsolateral prefrontal cortex (dlPFC) in the patients vs. controls. Before treatment, patients responding better to pharmacological treatment showed greater activation in the dorsomedial PFC (dmPFC), posterior cingulate cortex (pCC) and superior frontal gyrus (SFG) when viewing of negative emotional pictures was compared with the resting condition. Activations in the caudate nucleus and insula contrasted for emotional compared to neutral stimuli were also associated with successful treatment. Responders had also significantly higher levels of activation, compared to non-responders, in a range of other brain regions. Brain activation related to treatment success might be related to altered self-referential processes and a differential response to external emotional stimuli, suggesting differences in the processing of emotionally salient stimuli between those who are likely to respond to pharmacological treatment and those who will not. The present investigation suggests the pCC, dmPFC, SFG, caudate nucleus and insula may have a key role as a biological marker for treatment response and predictor for therapeutic success.

  13. Pharmacological prevention of suicide in patients with major mood disorders.

    Science.gov (United States)

    Rihmer, Zoltan; Gonda, Xenia

    2013-12-01

    The risk of self-destructive behavior in mood disorders is an inherent phenomenon and suicidal behavior in patients with unipolar or bipolar major mood disorders strongly relates to the presence and severity of depressive episodes. Consequently, early recognition, and successful acute and long-term treatment of depressive disorders is essential for suicide prevention in such patients. Large-scale, retrospective and prospective naturalistic long-term clinical studies, including severely ill, frequently suicidal depressives show that appropriate pharmacotherapy markedly reduces suicide morbidity and mortality even in this high-risk population. Supplementary psycho-social interventions further improve the effect. The slightly elevated (but in absolute sense quite low) risk of suicidal behavior among patients taking antidepressants compared to those taking placebo in randomized controlled antidepressant trials on unipolar major depression might be the consequence of the depression-worsening potential of antidepressant monotherapy in subthreshold and mixed bipolar depressed patients included in these trials and falsely diagnosed as suffering from unipolar major depression. Concurrent depression-focused psychotherapies increase the effectiveness of pharmacotherapy and this way contribute to suicide prevention for patients with mood disorders. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Kalaeloa Energy System Redevelopment Options Including Advanced Microgrids.

    Energy Technology Data Exchange (ETDEWEB)

    Hightower, Marion Michael [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Baca, Michael J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); VanderMey, Carissa [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-03-01

    In June 2016, the Department of Energy's (DOE's) Office of Energy Efficiency and Renewable Energy (EERE) in collaboration with the Renewable Energy Branch for the Hawaii State Energy Office (HSEO), the Hawaii Community Development Authority (HCDA), the United States Navy (Navy), and Sandia National Laboratories (Sandia) established a project to 1) assess the current functionality of the energy infrastructure at the Kalaeloa Community Development District, and 2) evaluate options to use both existing and new distributed and renewable energy generation and storage resources within advanced microgrid frameworks to cost-effectively enhance energy security and reliability for critical stakeholder needs during both short-term and extended electric power outages. This report discusses the results of a stakeholder workshop and associated site visits conducted by Sandia in October 2016 to identify major Kalaeloa stakeholder and tenant energy issues, concerns, and priorities. The report also documents information on the performance and cost benefits of a range of possible energy system improvement options including traditional electric grid upgrade approaches, advanced microgrid upgrades, and combined grid/microgrid improvements. The costs and benefits of the different improvement options are presented, comparing options to see how well they address the energy system reliability, sustainability, and resiliency priorities identified by the Kalaeloa stakeholders.

  15. Weaving History through the Major

    Science.gov (United States)

    Mayfield, Betty

    2014-01-01

    The benefits of including the study of the history of mathematics in the education of mathematics majors have been discussed at length elsewhere. Many colleges and universities now offer a History of Mathematics course for mathematics majors, for mathematics education majors, or for general credit. At Hood College, we emphasize our commitment to…

  16. Adjunctive minocycline treatment for major depressive disorder: A proof of concept trial.

    Science.gov (United States)

    Dean, Olivia M; Kanchanatawan, Buranee; Ashton, Melanie; Mohebbi, Mohammadreza; Ng, Chee Hong; Maes, Michael; Berk, Lesley; Sughondhabirom, Atapol; Tangwongchai, Sookjaroen; Singh, Ajeet B; McKenzie, Helen; Smith, Deidre J; Malhi, Gin S; Dowling, Nathan; Berk, Michael

    2017-08-01

    Conventional antidepressant treatments result in symptom remission in 30% of those treated for major depressive disorder, raising the need for effective adjunctive therapies. Inflammation has an established role in the pathophysiology of major depressive disorder, and minocycline has been shown to modify the immune-inflammatory processes and also reduce oxidative stress and promote neuronal growth. This double-blind, randomised, placebo-controlled trial examined adjunctive minocycline (200 mg/day, in addition to treatment as usual) for major depressive disorder. This double-blind, randomised, placebo-controlled trial investigated 200 mg/day adjunctive minocycline (in addition to treatment as usual) for major depressive disorder. A total of 71 adults with major depressive disorder ( Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition) were randomised to this 12-week trial. Outcome measures included the Montgomery-Asberg Depression Rating Scale (primary outcome), Clinical Global Impression-Improvement and Clinical Global Impression-Severity, Hamilton Anxiety Rating Scale, Quality of Life Enjoyment and Satisfaction Questionnaire, Social and Occupational Functioning Scale and the Range of Impaired Functioning Tool. The study was registered on the Australian and New Zealand Clinical Trials Register: www.anzctr.org.au , #ACTRN12612000283875. Based on mixed-methods repeated measures analysis of variance at week 12, there was no significant difference in Montgomery-Asberg Depression Rating Scale scores between groups. However, there were significant differences, favouring the minocycline group at week 12 for Clinical Global Impression-Improvement score - effect size (95% confidence interval) = -0.62 [-1.8, -0.3], p = 0.02; Quality of Life Enjoyment and Satisfaction Questionnaire score - effect size (confidence interval) = -0.12 [0.0, 0.2], p minocycline may be a useful adjunct to improve global experience, functioning and quality of life in people with

  17. Enhancing Brassinosteroid Signaling via Overexpression of Tomato (Solanum lycopersicum SlBRI1 Improves Major Agronomic Traits

    Directory of Open Access Journals (Sweden)

    Shuming Nie

    2017-08-01

    Full Text Available Brassinosteroids (BRs play important roles in plant growth, development, and stress responses through the receptor, Brassinosteroid-insensitive 1 (BRI1, which perceives BRs and initiates BR signaling. There is considerable potential agricultural value in regulating BR signaling in crops. In this study, we investigated the effects of overexpressing the tomato (Solanum lycopersicum BRI1 gene, SlBRI1, on major agronomic traits, such as seed germination, vegetative growth, fruit ethylene production, carotenoid accumulation, yield, and quality attributes. SlBRI1 overexpression enhanced the endogenous BR signaling intensity thereby increasing the seed germination rate, lateral root number, hypocotyl length, CO2 assimilation, plant height, and flower size. The transgenic plants also showed an increase in fruit yield and fruit number per plant, although the mean weight of individual fruit was reduced, compared with wild type. SlBRI1 overexpression also promoted fruit ripening and ethylene production, and caused an increase in levels of carotenoids, ascorbic acid, soluble solids, and soluble sugars during fruit ripening. An increased BR signaling intensity mediated by SlBRI1 overexpression was therefore positively correlated with carotenoid accumulation and fruit nutritional quality. Our results indicate that enhancing BR signaling by overexpression of SlBRI1 in tomato has the potential to improve multiple major agronomic traits.

  18. An improved technique for breast cancer irradiation including the locoregional lymph nodes

    NARCIS (Netherlands)

    Hurkmans, C. W.; Saarnak, A. E.; Pieters, B. R.; Borger, J. H.; Bruinvis, I. A.

    2000-01-01

    PURPOSE: To find an irradiation technique for locoregional irradiation of breast cancer patients which, compared with a standard technique, improves the dose distribution to the internal mammary-medial supraclavicular (IM-MS) lymph nodes. The improved technique is intended to minimize the lung dose

  19. Are Improvements in Cognitive Content and Depressive Symptoms Correlates or Mediators during Acute-Phase Cognitive Therapy for Recurrent Major Depressive Disorder?

    Science.gov (United States)

    Vittengl, Jeffrey R; Clark, Lee Anna; Thase, Michael E; Jarrett, Robin B

    2014-01-09

    The cognitive model of depression posits that cognitive therapy's (CT) effect on depressive symptoms is mediated by changes in cognitive content (e.g., automatic negative thoughts dysfunctional attitudes, failure attributions). We tested improvement and normalization of cognitive content among outpatients ( N = 523) with recurrent major depressive disorder treated with acute-phase CT (Jarrett & Thase, 2010; Jarrett et al., 2013). We also tested whether improvement in cognitive content accounted for subsequent changes in depressive symptoms and vice versa. Five measures of content improved substantively from pre- to post-CT (median d = 0.96), and the proportions of patients scoring in "healthy" ranges increased (median 45% to 82%). Evidence for cognitive mediation of symptom reduction was limited (median r = .06), as was evidence for symptom mediation of cognitive content improvement (median r = .07). We discuss measurement and design issues relevant to detection of mediators and consider alternative theories of change.

  20. The utility of including pathology reports in improving the computational identification of patients

    Directory of Open Access Journals (Sweden)

    Wei Chen

    2016-01-01

    Full Text Available Background: Celiac disease (CD is a common autoimmune disorder. Efficient identification of patients may improve chronic management of the disease. Prior studies have shown searching International Classification of Diseases-9 (ICD-9 codes alone is inaccurate for identifying patients with CD. In this study, we developed automated classification algorithms leveraging pathology reports and other clinical data in Electronic Health Records (EHRs to refine the subset population preselected using ICD-9 code (579.0. Materials and Methods: EHRs were searched for established ICD-9 code (579.0 suggesting CD, based on which an initial identification of cases was obtained. In addition, laboratory results for tissue transglutaminse were extracted. Using natural language processing we analyzed pathology reports from upper endoscopy. Twelve machine learning classifiers using different combinations of variables related to ICD-9 CD status, laboratory result status, and pathology reports were experimented to find the best possible CD classifier. Ten-fold cross-validation was used to assess the results. Results: A total of 1498 patient records were used including 363 confirmed cases and 1135 false positive cases that served as controls. Logistic model based on both clinical and pathology report features produced the best results: Kappa of 0.78, F1 of 0.92, and area under the curve (AUC of 0.94, whereas in contrast using ICD-9 only generated poor results: Kappa of 0.28, F1 of 0.75, and AUC of 0.63. Conclusion: Our automated classification system presented an efficient and reliable way to improve the performance of CD patient identification.

  1. Co-suppression of synthesis of major x-kafirin sub-class together with y-kafirin-1 and y-kafirin-2 required for substantially improved protein digestibility in transgenic sorghum

    CSIR Research Space (South Africa)

    Grootboom, AW

    2014-01-01

    Full Text Available Co-suppressing major kafirin sub-classes is fundamental to improved protein digestibility and nutritional value of sorghum. The improvement is linked to an irregularly invaginated phenotype of protein bodies....

  2. Dynamics of Major Cereals Productivity in Nepal

    Directory of Open Access Journals (Sweden)

    Samaya Gairhe

    2018-05-01

    Full Text Available Cereal crops have played major roles in addressing food security issues in Nepal. In recent years there have been fluctuations in crop production and demands situations due to various reasons. Thus, the present study aims to analyze the dynamics of major cereals productivity in Nepal from 1995 to 2014. Focus group discussions were done in mid-hills and tarai of Nepal in 2015. Percentage change, compound growth rate, annual rate of change, coefficient of variation, instability index were calculated to analyze results. The result shows that the area, production and productivity of major cereals had an increasing trend over the study period. The major factors contributing on productivity increase in cereal crops were irrigation facilities, use of improved and hybrid seeds, chemical fertilizer and better technical knowhow among the farmers. For effective adoption of research outputs to improve the productivity emphasis should also be given on promotion of public private partnership (PPP in research and development.

  3. Status of Agricultural Production and Crop Variety Improvement in Thailand

    Institute of Scientific and Technical Information of China (English)

    JIAO Chun-hai; GUO Ying; YAO Ming-hua; WAN Zheng-huang

    2012-01-01

    We introduced basic conditions of agricultural production in Thailand, and variety improvement of major crops, including rice, cassava, rubber, and vegetable, in the hope of providing reference for agricultural production and crop variety improvement in Hubei Province and even in the whole country.

  4. Evaluation of a novel educational strategy, including inhaler-based reminder labels, to improve asthma inhaler technique.

    Science.gov (United States)

    Basheti, Iman A; Armour, Carol L; Bosnic-Anticevich, Sinthia Z; Reddel, Helen K

    2008-07-01

    To evaluate the feasibility, acceptability and effectiveness of a brief intervention about inhaler technique, delivered by community pharmacists to asthma patients. Thirty-one pharmacists received brief workshop education (Active: n=16, CONTROL: n=15). Active Group pharmacists were trained to assess and teach dry powder inhaler technique, using patient-centered educational tools including novel Inhaler Technique Labels. Interventions were delivered to patients at four visits over 6 months. At baseline, patients (Active: 53, CONTROL: 44) demonstrated poor inhaler technique (mean+/-S.D. score out of 9, 5.7+/-1.6). At 6 months, improvement in inhaler technique score was significantly greater in Active cf. CONTROL patients (2.8+/-1.6 cf. 0.9+/-1.4, p<0.001), and asthma severity was significantly improved (p=0.015). Qualitative responses from patients and pharmacists indicated a high level of satisfaction with the intervention and educational tools, both for their effectiveness and for their impact on the patient-pharmacist relationship. A simple feasible intervention in community pharmacies, incorporating daily reminders via Inhaler Technique Labels on inhalers, can lead to improvement in inhaler technique and asthma outcomes. Brief training modules and simple educational tools, such as Inhaler Technique Labels, can provide a low-cost and sustainable way of changing patient behavior in asthma, using community pharmacists as educators.

  5. Distortion product otoacoustic emissions in college music majors and nonmusic majors

    Directory of Open Access Journals (Sweden)

    Rebecca L. Warner Henning

    2016-01-01

    Full Text Available The presence and absence of distortion product otoacoustic emissions (DPOAEs as well as DPOAE amplitudes were compared between college music majors and a control group of nonmusic majors. Participants included 28 music majors and 35 nonmusic majors enrolled at a university with ages ranging from 18-25 years. DPOAEs and hearing thresholds were measured bilaterally on all the participants. DPOAE amplitudes were analyzed at the following f2 frequencies: 1,187 Hz, 1,500 Hz, 1,906 Hz, 2,531 Hz, 3,031 Hz, 3812 Hz, 4,812 Hz, and 6,031 Hz. Significantly more music majors (7/28 than nonmusic majors (0/35 exhibited absent DPOAEs for at least one frequency in at least one ear. Both groups of students reported similar histories of recreational and occupational noise exposures that were unrelated to studying music, and none of the students reported high levels of noise exposure within the previous 48 h. There were no differences in audiometric thresholds between the groups at any frequency. At DPOAE f2 frequencies from 3,031 Hz to 6,031 Hz, nonsignificantly lower amplitudes of 2-4 dB were seen in the right ears of music majors versus nonmajors, and in the right ears of music majors playing brass instruments compared to music majors playing nonbrass instruments. Given the greater prevalence of absent DPOAEs in university music majors compared to nonmusic majors, it appears that early stages of cochlear damage may be occurring in this population. Additional research, preferably longitudinal and across multiple colleges/universities, would be beneficial to more definitively determine when the music students begin to show signs of cochlear damage, and to identify whether any particular subgroups of music majors are at a greater risk of cochlear damage.

  6. Adjuvant occupational therapy improves long-term depression recovery and return-to-work in good health in sick-listed employees with major depression: results of a randomised controlled trial

    NARCIS (Netherlands)

    Hees, Hiske L.; de Vries, Gabe; Koeter, Maarten W. J.; Schene, Aart H.

    2013-01-01

    To evaluate whether adjuvant occupational therapy (OT) can improve the effectiveness of treatment-as-usual (TAU) in sick-listed employees with major depression. In total, 117 employees sick-listed for a median duration of 4.8 months (IQR=2.6 to 10.1 months) because of major depression were

  7. Predictors, moderators, and mediators (correlates) of treatment outcome in major depressive disorder.

    Science.gov (United States)

    Papakostas, George I; Fava, Maurizio

    2008-01-01

    Major Depressive Disorder (MDD) is a prevalent illness that is frequently associated with significant disability, morbidity and mortality Despite the development and availability of numerous treatment options for MDD, studies have shown that antidepressant monotherapy yields only modest rates of response and remission. Clearly, there is an urgent need to develop more effective treatment strategies for patients with MDD. One possible approach towards the development of novel pharmacotherapeutic strategies for MDD involves identifying subpopulations of depressed patients who are more likely to experience the benefits of a given (existing) treatment versus placebo, or versus a second treatment. Attempts have been made to identify such "subpopulations", specifically by testing whether a given biological or clinical marker also serves as a moderator, mediator (correlate), or predictor of clinical improvement following the treatment of MDD with standard, first-line antidepressants. In the following article, we will attempt to summarize the literature focusing on several major areas ("leads") where preliminary evidence exists regarding clinical and biologic moderators, mediators, and predictors of symptom improvement in MDD. Such clinical leads will include the presence of hopelessness, anxious symptoms, or medical comorbidity. Biologic leads will include gene polymorphisms, brain metabolism, quantitative electroencephalography, loudness dependence of auditory evoked potentials, and functional brain asymmetry.

  8. Major hazards onshore and offshore

    International Nuclear Information System (INIS)

    1992-01-01

    This symposium continues the tradition of bringing together papers on a topic of current interest and importance in terms of process safety - in this case, Major Hazards Onshore and Offshore. Lord Cullen in his report on the Piper Alpha disaster has, in effect, suggested that the experience gained in the control of major hazards onshore during the 1980s should be applied to improve safety offshore during the 1990s. This major three-day symposium reviews what has been learned so far with regard to major hazards and considers its present and future applications both onshore and offshore. The topics covered in the programme are wide ranging and deal with all aspects of legislation, the application of regulations, techniques for evaluating hazards and prescribing safety measures in design, construction and operation, the importance of the human factors, and recent technical developments in protective measures, relief venting and predicting the consequences of fires and explosions. (author)

  9. Modeling Major Adverse Outcomes of Pediatric and Adult Patients With Congenital Heart Disease Undergoing Cardiac Catheterization: Observations From the NCDR IMPACT Registry (National Cardiovascular Data Registry Improving Pediatric and Adult Congenital Treatment).

    Science.gov (United States)

    Jayaram, Natalie; Spertus, John A; Kennedy, Kevin F; Vincent, Robert; Martin, Gerard R; Curtis, Jeptha P; Nykanen, David; Moore, Phillip M; Bergersen, Lisa

    2017-11-21

    Risk standardization for adverse events after congenital cardiac catheterization is needed to equitably compare patient outcomes among different hospitals as a foundation for quality improvement. The goal of this project was to develop a risk-standardization methodology to adjust for patient characteristics when comparing major adverse outcomes in the NCDR's (National Cardiovascular Data Registry) IMPACT Registry (Improving Pediatric and Adult Congenital Treatment). Between January 2011 and March 2014, 39 725 consecutive patients within IMPACT undergoing cardiac catheterization were identified. Given the heterogeneity of interventional procedures for congenital heart disease, new procedure-type risk categories were derived with empirical data and expert opinion, as were markers of hemodynamic vulnerability. A multivariable hierarchical logistic regression model to identify patient and procedural characteristics predictive of a major adverse event or death after cardiac catheterization was derived in 70% of the cohort and validated in the remaining 30%. The rate of major adverse event or death was 7.1% and 7.2% in the derivation and validation cohorts, respectively. Six procedure-type risk categories and 6 independent indicators of hemodynamic vulnerability were identified. The final risk adjustment model included procedure-type risk category, number of hemodynamic vulnerability indicators, renal insufficiency, single-ventricle physiology, and coagulation disorder. The model had good discrimination, with a C-statistic of 0.76 and 0.75 in the derivation and validation cohorts, respectively. Model calibration in the validation cohort was excellent, with a slope of 0.97 (standard error, 0.04; P value [for difference from 1] =0.53) and an intercept of 0.007 (standard error, 0.12; P value [for difference from 0] =0.95). The creation of a validated risk-standardization model for adverse outcomes after congenital cardiac catheterization can support reporting of risk

  10. Plasma fluoxetine concentrations and clinical improvement in an adolescent sample diagnosed with major depressive disorder, obsessive-compulsive disorder, or generalized anxiety disorder.

    Science.gov (United States)

    Blázquez, Ana; Mas, Sergi; Plana, Maria Teresa; Gassó, Patricia; Méndez, Iria; Torra, Mercè; Arnaiz, Joan Albert; Lafuente, Amàlia; Lázaro, Luisa

    2014-06-01

    Fluoxetine (FLX) has been one of the most widely studied selective serotonin reuptake inhibitors in adolescents. Despite its efficacy, however, 30% to 40% of patients do not respond to treatment. The aim of this study was to evaluate whether clinical improvement or adverse events are related to the corrected dose of FLX at 8 and 12 weeks after starting treatment in a sample of adolescents diagnosed with major depressive disorder, obsessive-compulsive disorder, or generalized anxiety disorder. Seventy-four subjects aged between 10 and 17 years participated in the study. Clinical improvement was measured with the Clinical Global Impression-Improvement Scale, whereas the UKU (Udvalg for Klinske Undersogelser) scale was administered to assess adverse effects of treatment. Fluoxetine per kilograms of body weight was related to serum concentration of FLX, NORFLX (norfluoxetine), FLX + NORFLX, and FLX/NORFLX. No relationship was found between dose-corrected FLX levels and therapeutic or adverse effects. No differences in serum concentrations were found between responders and nonresponders to treatment. Sex differences were observed in relation to dose and FLX serum concentration. The analysis by diagnosis revealed differences in FLX dose between obsessive-compulsive disorder patients and both generalized anxiety disorder and major depressive disorder patients. Fluoxetine response seems to be influenced by factors such as sex, diagnosis, or certain genes that might be involved in the drug's pharmacokinetics and pharmacodynamics. Clinical and pharmacogenetic studies are needed to elucidate further the differences between treatment responders and nonresponders.

  11. Does Duloxetine Improve Cognitive Function Independently of Its Antidepressant Effect in Patients with Major Depressive Disorder and Subjective Reports of Cognitive Dysfunction?

    Directory of Open Access Journals (Sweden)

    Tracy L. Greer

    2014-01-01

    Full Text Available Introduction. Cognitive deficits are commonly reported by patients with major depressive disorder (MDD. Duloxetine, a dual serotonin/noradrenaline reuptake inhibitor, may improve cognitive deficits in MDD. It is unclear if cognitive improvements occur independently of antidepressant effects with standard antidepressant medications. Methods. Thirty participants with MDD who endorsed cognitive deficits at screening received 12-week duloxetine treatment. Twenty-one participants completed treatment and baseline and posttreatment cognitive testing. The Cambridge Neuropsychological Test Automated Battery was used to assess the following cognitive domains: attention, visual memory, executive function/set shifting and working memory, executive function/spatial planning, decision making and response control, and verbal learning and memory. Results. Completers showed significant cognitive improvements across several domains on tasks assessing psychomotor function and mental processing speed, with additional improvements in visual and verbal learning and memory, and affective decision making and response control. Overall significance tests for executive function tasks were also significant, although individual tasks were not, perhaps due to the small sample size. Most notably, cognitive improvements were observed independently of symptom reduction on all domains except verbal learning and memory. Conclusions. Patients reporting baseline cognitive deficits achieved cognitive improvements with duloxetine treatment, most of which were independent of symptomatic improvement. This trial is registered with NCT00933439.

  12. Comparison of views of the nature of science between natural science and nonscience majors.

    Science.gov (United States)

    Miller, Marie C Desaulniers; Montplaisir, Lisa M; Offerdahl, Erika G; Cheng, Fu-Chih; Ketterling, Gerald L

    2010-01-01

    Science educators have the common goal of helping students develop scientific literacy, including understanding of the nature of science (NOS). University faculties are challenged with the need to develop informed NOS views in several major student subpopulations, including science majors and nonscience majors. Research into NOS views of undergraduates, particularly science majors, has been limited. In this study, NOS views of undergraduates in introductory environmental science and upper-level animal behavior courses were measured using Likert items and open-ended prompts. Analysis revealed similarities in students' views between the two courses; both populations held a mix of naïve, transitional, and moderately informed views. Comparison of pre- and postcourse mean scores revealed significant changes in NOS views only in select aspects of NOS. Student scores on sections addressing six aspects of NOS were significantly different in most cases, showing notably uninformed views of the distinctions between scientific theories and laws. Evidence-based insight into student NOS views can aid in reforming undergraduate science courses and will add to faculty and researcher understanding of the impressions of science held by undergraduates, helping educators improve scientific literacy in future scientists and diverse college graduates.

  13. Major Peripheral Nerve Injuries After Elbow Arthroscopy.

    Science.gov (United States)

    Desai, Mihir J; Mithani, Suhail K; Lodha, Sameer J; Richard, Marc J; Leversedge, Fraser J; Ruch, David S

    2016-06-01

    To survey the American Society for Surgery of the Hand membership to determine the nature and distribution of nerve injuries treated after elbow arthroscopy. An online survey was sent to all members of the American Society for Surgery of the Hand under an institutional review board-approved protocol. Collected data included the number of nerve injuries observed over a 5-year period, the nature of treatment required for the injuries, and the outcomes observed after any intervention. Responses were anonymous, and results were securely compiled. We obtained 372 responses. A total of 222 nerve injuries were reported. The most injured nerves reported were ulnar, radial, and posterior interosseous (38%, 22%, and 19%, respectively). Nearly half of all patients with injuries required operative intervention, including nerve graft, tendon transfer, nerve repair, or nerve transfer. Of the patients who sustained major injuries, those requiring intervention, 77% had partial or no motor recovery. All minor injuries resolved completely. Our results suggest that major nerve injuries after elbow arthroscopy are not rare occurrences and the risk of these injuries is likely under-reported in the literature. Furthermore, patients should be counseled on this risk because most nerve injuries show only partial or no functional recovery. With the more widespread practice of elbow arthroscopy, understanding the nature and sequelae of significant complications is critically important in ensuring patient safety and improving outcomes. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  14. Improvement in genetic evaluation of female fertility in dairy cattle using multiple-trait models including milk production traits

    DEFF Research Database (Denmark)

    Sun, C; Madsen, P; Lund, M S

    2010-01-01

    This study investigated the improvement in genetic evaluation of fertility traits by using production traits as secondary traits (MILK = 305-d milk yield, FAT = 305-d fat yield, and PROT = 305-d protein yield). Data including 471,742 records from first lactations of Denmark Holstein cows, covering...... the years of inseminations during first lactations from 1995 to 2004, were analyzed. Six fertility traits (i.e., interval in days from calving to first insemination, calving interval, days open, interval in days from first to last insemination, numbers of inseminations per conception, and nonreturn rate...... stability and predictive ability than single-trait models for all the fertility traits, except for nonreturn rate within 56 d after first service. The stability and predictive ability for the model including MILK or PROT were similar to the model including all 3 milk production traits and better than...

  15. Benchmarking and performance improvement at Rocky Flats Technology Site

    International Nuclear Information System (INIS)

    Elliott, C.; Doyle, G.; Featherman, W.L.

    1997-03-01

    The Rocky Flats Environmental Technology Site has initiated a major work process improvement campaign using the tools of formalized benchmarking and streamlining. This paper provides insights into some of the process improvement activities performed at Rocky Flats from November 1995 through December 1996. It reviews the background, motivation, methodology, results, and lessons learned from this ongoing effort. The paper also presents important gains realized through process analysis and improvement including significant cost savings, productivity improvements, and an enhanced understanding of site work processes

  16. Improvement in Detection of Wrong-Patient Errors When Radiologists Include Patient Photographs in Their Interpretation of Portable Chest Radiographs.

    Science.gov (United States)

    Tridandapani, Srini; Olsen, Kevin; Bhatti, Pamela

    2015-12-01

    This study was conducted to determine whether facial photographs obtained simultaneously with radiographs improve radiologists' detection rate of wrong-patient errors, when they are explicitly asked to include the photographs in their evaluation. Radiograph-photograph combinations were obtained from 28 patients at the time of portable chest radiography imaging. From these, pairs of radiographs were generated. Each unique pair consisted of one new and one old (comparison) radiograph. Twelve pairs of mismatched radiographs (i.e., pairs containing radiographs of different patients) were also generated. In phase 1 of the study, 5 blinded radiologist observers were asked to interpret 20 pairs of radiographs without the photographs. In phase 2, each radiologist interpreted another 20 pairs of radiographs with the photographs. Radiologist observers were not instructed about the purpose of the photographs but were asked to include the photographs in their review. The detection rate of mismatched errors was recorded along with the interpretation time for each session for each observer. The two-tailed Fisher exact test was used to evaluate differences in mismatch detection rates between the two phases. A p value of error detection rates without (0/20 = 0%) and with (17/18 = 94.4%) photographs were different (p = 0.0001). The average interpretation times for the set of 20 radiographs were 26.45 (SD 8.69) and 20.55 (SD 3.40) min, for phase 1 and phase 2, respectively (two-tailed Student t test, p = 0.1911). When radiologists include simultaneously obtained photographs in their review of portable chest radiographs, there is a significant improvement in the detection of labeling errors. No statistically significant difference in interpretation time was observed. This may lead to improved patient safety without affecting radiologists' throughput.

  17. Outcome of patients with major depressive disorder after serious suicide attempt.

    Science.gov (United States)

    Suominen, Kirsi; Haukka, Jari; Valtonen, Hanna M; Lönnqvist, Jouko

    2009-10-01

    To investigate the outcome of subjects with major depressive disorder after serious suicide attempt and to examine the effect of psychotic symptoms on their outcome. The study population included all individuals aged 16 years or older in Finland who were hospitalized with ICD-10 diagnoses of major depressive disorder and attempted suicide from 1996 to 2003 (N = 1,820). The main outcome measures were completed suicides, overall mortality, and repeated suicide attempts during drug treatment versus no treatment. During the 4-year follow-up period, 13% of patients died, 6% completed suicide, and 31% made a repeat suicide attempt. Subjects with major depression with psychotic features completed suicide more often than subjects without psychotic features during the follow-up (hazard ratio [HR] 3.32; 95% CI, 1.95 - 5.67). Antidepressant treatment reduced all-cause mortality by 24% (HR 0.74; 95% CI, 0.56 - 0.97) but did not reduce suicide mortality (HR 1.06; 95% CI, 0.71 - 1.58). Psychotic symptoms during major depressive episode increase the risk of completed suicide after serious suicide attempt. The quality of treatment for major depression with psychotic features after attempted suicide should be improved to prevent suicide. Copyright 2009 Physicians Postgraduate Press, Inc.

  18. Improving Major Depressive Episode Assessment: A New Tool Developed by Formal Psychological Assessment.

    Science.gov (United States)

    Serra, Francesca; Spoto, Andrea; Ghisi, Marta; Vidotto, Giulio

    2017-01-01

    Aim: Major depressive episode (MDE) can manifest with different features. Discriminating between different types of MDEs is crucial for proper treatment. The aim of this study is to propose a new tool for MDE assessment in bipolar disorder (BD) or major depressive disorder (MDD) to overcome some limitations of current rating scales. The proposed tool investigates all of the clinical features of different MDEs and gives qualitative information, differentiating patients with the same score but different symptoms and psychopathology severity. To achieve this purpose authors used a new methodology called Formal Psychological Assessment (FPA). FPA allows creating relations between the items of an assessment tool, and the set of diagnostic criteria of a given clinical disorder. In the application at hand, given the capability to analyze all clinical features, FPA appears a useful way to highlight and differentiate between inhibited and agitated depressive symptoms. Method: The new tool contains 41 items constructed through 23 clinical criteria from the DSM-5 and literature symptoms. In line with FPA, starting from a set of items and a set of clinical criteria, a Boolean matrix was built assigning to each item its own set of clinical criteria. The participants include 265 in the control group and 38 patients with MDE (diagnosed with MDD or BD) who answered the QuEDS. After 1 month, 63 participants performed the test again and 113 took the Depression-Anxiety-Stress Scale to analyze convergent-divergent validity. Results: The scale showed adequate reliability and validity. A hierarchical confirmatory factor analysis highlighted the presence of three sub factors (affective, somatic, and cognitive) and one high-order factor (depression). Conclusions: The new tool is potentially able to inform clinicians about the patients' most likely diagnostic configuration. Indeed, the clinical state of a patient consists of the subset of items he/she answered affirmatively, along with his

  19. Improvement of Scratch and Wear Resistance of Polymers by Fillers Including Nanofillers

    Directory of Open Access Journals (Sweden)

    Witold Brostow

    2017-03-01

    Full Text Available Polymers have lower resistance to scratching and wear than metals. Liquid lubricants work well for metals but not for polymers nor for polymer-based composites (PBCs. We review approaches for improvement of tribological properties of polymers based on inclusion of fillers. The fillers can be metallic or ceramic—with obvious consequences for electrical resistivity of the composites. Distinctions between effectiveness of micro- versus nano-particles are analyzed. For example, aluminum nanoparticles as filler are more effective for property improvement than microparticles at the same overall volumetric concentration. Prevention of local agglomeration of filler particles is discussed along with a technique to verify the prevention.

  20. Experience and improved techniques in radiological environmental monitoring at major DOE low-level waste disposal sites

    International Nuclear Information System (INIS)

    1986-09-01

    A summary of routine radiological environmental surveillance programs conducted at major active US Department of Energy (DOE) solid low-level waste (LLW) disposal sites is provided. The DOE disposal sites at which monitoring programs were reviewed include those located at Hanford, Idaho National Engineering Laboratory (INEL), Nevada Test Site (NTS), Los Alamos National Laboratory (LANL), Oak Ridge National Laboratory (ORNL) and Savannah River Plant (SRP). The review is limited to activities conducted for the purpose of monitoring disposal site performance. Areas of environmental monitoring reviewed include air monitoring for particulates and gases, monitoring of surface water runoff, surface water bodies, ground water, monitoring of surface soils and the vadose zone, and monitoring of ambient penetrating radiation. Routine environmental surveillance is conducted at major LLW disposal sites at various levels of effort for specific environmental media. In summary, all sites implement a routine monitoring program for penetrating radiation. Four sites (INEL, NTS, LANL, and SRP) monitor particulates in air specifically at LLW disposal sites. Hanford monitors particulates at LLW sites in conjunction with monitoring of other site operations. Particulates are monitored on a reservationwide network at ORNL. Gases are monitored specifically at active LLW sites operated at NTS, LANL, and SRP. Ground water is monitored specifically at LLW sites at INEL, LANL, and SRP, in conjunction with other operations at Hanford, and as part of a reservationwide program at NTS and ORNL. Surface water is monitored at INEL, LANL, and SRP LLW sites. Surface soil is sampled and analyzed on a routine basis at INEL and LANL. Routine monitoring of the vadose zone is conducted at the INEL and SRP. Techniques and equipment in use are described and other aspects of environmental monitoring programs, such as quality assurance and data base management, are reviewed

  1. Majorization arrow in quantum-algorithm design

    International Nuclear Information System (INIS)

    Latorre, J.I.; Martin-Delgado, M.A.

    2002-01-01

    We apply majorization theory to study the quantum algorithms known so far and find that there is a majorization principle underlying the way they operate. Grover's algorithm is a neat instance of this principle where majorization works step by step until the optimal target state is found. Extensions of this situation are also found in algorithms based in quantum adiabatic evolution and the family of quantum phase-estimation algorithms, including Shor's algorithm. We state that in quantum algorithms the time arrow is a majorization arrow

  2. Promoting health and advancing development through improved housing in low-income settings

    NARCIS (Netherlands)

    Haines, A.; Bruce, N.; Cairncross, S.; Davies, M.; Greenland, K.; Hiscox, A.F.; Lindsay, S.; Lindsay, T.; Satterthwaite, D.; Wilkinson, P.

    2013-01-01

    There is major untapped potential to improve health in low-income communities through improved housing design, fittings, materials and construction. Adverse effects on health from inadequate housing can occur through a range of mechanisms, both direct and indirect, including as a result of extreme

  3. Endocrinopathies in thalassemia major patient

    Science.gov (United States)

    Lubis, D. A.; Yunir, E. M.

    2018-03-01

    Advanced in chelation therapy and regular blood transfusion have marked improvements in the life expectancy of patients with thalassemia major, however these patients still have to deal with several complications. We report a 19-year-old male, presented with multiple endocrine complication-related thalassemia; hypogonadism, short stature, osteoporosis with history of fracture, and subclinical hypothyroid.

  4. Major obstetric haemorrhage of 2000 ml or greater: a clinical audit.

    Science.gov (United States)

    O'Sullivan, J; Mansfield, R; Talbot, R; Cairns, A E

    2018-05-04

    Haemorrhage remains a leading cause of maternal death. We conducted an audit to identify strategies to improve the management at our local NHS Trust. A data collection form was based on our local guideline. A coded database search was conducted for all deliveries where the estimated blood loss was ≥2000 ml (from June 1 2015 to December 31 2015), returning 68 search results (13.7/1000 births). Fifty-six records were included. Poor compliance (<75%) was seen in some key areas including the major obstetric haemorrhage (MOH) call activation (52%), the presence of an anaesthetic consultant (63%) and tranexamic acid administration (46%). Thirty out of 56 cases (54%) were acutely transfused. Women, who were not transfused acutely, appeared to be more likely to need a secondary transfusion if no MOH call had been activated (9/27 (33%) versus 3/29 (10%), p = .052). A key area for improvement was the activation of MOH calls. Following this audit, we adjusted our guideline to make it more clinically useful and staff training sessions were held, including simulation training. Impact statement What is already known on this subject? A postpartum haemorrhage (PPH) is an obstetric emergency. A structured approach is important to optimise the care of the mothers during this dangerous time, and has been shown to reduce the transfusion requirements. However, clinical practice may not adhere to the guideline recommendations. What the results of this study add? With the objective evidence of increased rates of PPH ≥2000 ml at our institution, our work identifying the flaws in management was a critical component of the work to improve the outcomes. This study gives impetus to find innovative ways to improve adherence to guidelines, and inspired an update of our local guideline to improve the applicability and utility. This project suggests a new marker for the adequacy of an acute management (a requirement for secondary blood transfusion without having received an acute

  5. Improvement in Student Data Analysis Skills after Out-of-Class Assignments

    Directory of Open Access Journals (Sweden)

    Kristen Lee Williams Walton

    2016-12-01

    Full Text Available The ability to understand and interpret data is a critical aspect of scientific thinking.  However, although data analysis is often a focus in biology majors classes, many textbooks for allied health majors classes are primarily content-driven and do not include substantial amounts of experimental data in the form of graphs and figures.  In a lower-division allied health majors microbiology class, students were exposed to data from primary journal articles as take-home assignments and their data analysis skills were assessed in a pre-/posttest format.  Students were given 3 assignments that included data analysis questions.  Assignments ranged from case studies that included a figure from a journal article to reading a short journal article and answering questions about multiple figures or tables.  Data were represented as line or bar graphs, gel photographs, and flow charts.  The pre- and posttest was designed incorporating the same types of figures to assess whether the assignments resulted in any improvement in data analysis skills.  The mean class score showed a small but significant improvement from the pretest to the posttest across three semesters of testing.  Scores on individual questions testing accurate conclusions and predictions improved the most.  This supports the conclusion that a relatively small number of out-of-class assignments through the semester resulted in a significant improvement in data analysis abilities in this population of students.

  6. Major operations and activities

    Energy Technology Data Exchange (ETDEWEB)

    Black, D.G.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report summarizes the major operations and activities on the site. These operations and activities include site management, waste management, environmental restoration and corrective actions, and research and technology development.

  7. Major operations and activities

    International Nuclear Information System (INIS)

    Black, D.G.

    1995-01-01

    This section of the 1994 Hanford Site Environmental Report summarizes the major operations and activities on the site. These operations and activities include site management, waste management, environmental restoration and corrective actions, and research and technology development

  8. 24 Command Fire Improvement Action Program Plan

    International Nuclear Information System (INIS)

    GRIFFIN, G.B.

    2000-01-01

    Fluor Hanford (FH) is responsible for providing support to the Department of Energy Richland Operations Office (RL) in the implementation of the Hanford Emergency Preparedness (EP) program. During fiscal year 2000, a number of program improvements were identified from various sources including a major range fire (24 Command Fire). Evaluations of the emergency preparedness program have confirmed that it currently meets all requirements and that performance of personnel involved is good, however the desire to effect continuous improvement resulted in the development of this improvement program plan. This program plan defines the activities that will be performed in order to achieve the desired performance improvements

  9. Improving major amputation rates in the multicomplex diabetic foot patient: focus on the severity of peripheral arterial disease

    Science.gov (United States)

    Brechow, Andrej; Slesaczeck, Torsten; Münch, Dirk; Nanning, Thomas; Paetzold, Hartmut; Schwanebeck, Uta; Bornstein, Stefan

    2013-01-01

    Objective: Peripheral arterial disease (PAD), as well as diabetic neuropathy, is a risk factor for the development of diabetic foot ulcers. The aim of this study was to evaluate differences and predictors of outcome parameters in patients with diabetic foot by stratifying these subjects according to the severity of PAD. Research design and methods: In a prospective study, patients with new diabetic foot ulcers have been treated and investigated by structured healthcare. Subjects were recruited between 1 January 2000 and 31 December 2007. All study participants underwent a 2-year follow-up observation period. The patients underwent a standardized examination and classification of their foot ulcers according to a modification of the University of Texas Wound Classification System. The severity of PAD was estimated by measurement of the ankle brachial index (ABI) and the continuous wave Doppler flow curve into undisturbed perfusion (0.9 diabetic foot were consecutively included into the study (69% male, mean age 66.3 ± 11.0 years, mean diabetes duration 15.8 ± 10.2 years). Major amputations (above the ankle) were performed in 4.7% of the patients. 22.1% of these subjects had decompensated PAD. These subjects had delayed ulcer healing, higher risk for major amputation [odds ratio (OR) 7.7, 95% confidence interval (CI) 2.8–21.2, p diabetic foot ulcers regarding to wound healing, major amputation and mortality. PMID:23730502

  10. Benchmarking and Performance Improvement at Rocky Flats Environmental Technology Site

    Energy Technology Data Exchange (ETDEWEB)

    Elliott, C. [Kaiser-Hill Co., LLC, Golden, CO (United States)], Doyle, D. [USDOE Rocky Flats Office, Golden, CO (United States)], Featherman, W.D. [Project Performance Corp., Sterline, VA (United States)

    1997-12-31

    The Rocky Flats Environmental Technology Site (RFETS) has initiated a major work process improvement campaign using the tools of formalized benchmarking and streamlining. This paper provides insights into some of the process improvement activities performed at Rocky Flats from November 1995 through December 1996. It reviews the background, motivation, methodology, results, and lessons learned from this ongoing effort. The paper also presents important gains realized through process analysis and improvement including significant cost savings, productivity improvements, and an enhanced understanding of site work processes.

  11. Reconsidering English Grammar Teaching for Improving Non-English Majors' English Writing Ability

    Science.gov (United States)

    Shen, Yuru

    2012-01-01

    With the globalization of world economy, English learners' writing ability has been attached less and less importance. As a result, many college students in China, especially the non-English majors, cannot express themselves effectively in written English. They make various kinds of mistakes, mostly grammar mistakes, such as writing sentence…

  12. BROMOCEA Code: An Improved Grand Canonical Monte Carlo/Brownian Dynamics Algorithm Including Explicit Atoms.

    Science.gov (United States)

    Solano, Carlos J F; Pothula, Karunakar R; Prajapati, Jigneshkumar D; De Biase, Pablo M; Noskov, Sergei Yu; Kleinekathöfer, Ulrich

    2016-05-10

    All-atom molecular dynamics simulations have a long history of applications studying ion and substrate permeation across biological and artificial pores. While offering unprecedented insights into the underpinning transport processes, MD simulations are limited in time-scales and ability to simulate physiological membrane potentials or asymmetric salt solutions and require substantial computational power. While several approaches to circumvent all of these limitations were developed, Brownian dynamics simulations remain an attractive option to the field. The main limitation, however, is an apparent lack of protein flexibility important for the accurate description of permeation events. In the present contribution, we report an extension of the Brownian dynamics scheme which includes conformational dynamics. To achieve this goal, the dynamics of amino-acid residues was incorporated into the many-body potential of mean force and into the Langevin equations of motion. The developed software solution, called BROMOCEA, was applied to ion transport through OmpC as a test case. Compared to fully atomistic simulations, the results show a clear improvement in the ratio of permeating anions and cations. The present tests strongly indicate that pore flexibility can enhance permeation properties which will become even more important in future applications to substrate translocation.

  13. Trends of major disease outbreaks in the African region, 2003-2007.

    Science.gov (United States)

    Kebede, Senait; Duales, Sambe; Yokouide, Allarangar; Alemu, Wondimagegnehu

    2010-03-01

    Communicable disease outbreaks cause millions of deaths throughout Sub-Saharan Africa each year. Most of the diseases causing epidemics in the region have been nearly eradicated or brought under control in other parts of the world. In recent years, considerable effort has been directed toward public health initiatives and strategies with a potential for significant impact in the fight against infectious diseases. In 1998, the World Health Organization African Regional Office (WHO/AFRO) launched the Integrated Disease Surveillance and Response (IDSR) strategy aimed at mitigating the impact of communicable diseases, including epidemic-prone diseases, through improving surveillance, laboratory confirmation and appropriate and timely public health interventions. Over the past decade, WHO and its partners have been providing technical and financial resources to African countries to strengthen epidemic preparedness and response (EPR) activities. This review examined the major epidemics reported to WHO/AFRO from 2003 to 2007. we conduct a review of documents and reports obtained from WHO/AFRO, WHO inter-country team, and partners and held meeting and discussions with key stakeholders to elicit the experiences of local, regional and international efforts against these epidemics to evaluate the lessons learned and to stimulate discussion on the future course for enhancing EPR. The most commonly reported epidemic outbreaks in Africa include: cholera, dysentery, malaria and hemorrhagic fevers (e.g. Ebola, Rift Valley fever, Crimean-Congo fever and yellow fever). The cyclic meningococcal meningitis outbreak that affects countries along the "meningitis belt" (spanning Sub-Saharan Africa from Senegal and The Gambia to Kenya and Ethiopia) accounts for other major epidemics in the region. The reporting of disease outbreaks to WHO/AFRO has improved since the launch of the IDSR strategy in 1998. Although the epidemic trends for cholera showed a decline in case fatality rate (CFR

  14. Data Sets from Major NCI Initiaves

    Science.gov (United States)

    The NCI Data Catalog includes links to data collections produced by major NCI initiatives and other widely used data sets, including animal models, human tumor cell lines, epidemiology data sets, genomics data sets from TCGA, TARGET, COSMIC, GSK, NCI60.

  15. Improving the actinides recycling in closed fuel cycles, a major step towards nuclear energy sustainability

    International Nuclear Information System (INIS)

    Poinssot, C.; Grandjean, S.; Masson, M.; Bouillis, B.; Warin, D.

    2013-01-01

    Increasing the sustainability of nuclear energy is a longstanding road that requires a stepwise approach to successively tackle the following 3 objectives. First of all, optimize the consumption of natural resource to preserve them for future generations and hence guarantee the energetic independence of the countries (no uranium ore is needed anymore). The current twice-through cycle of Pu implemented by France, UK, Japan and soon China is a first step in this direction and already allows the development and optimization of the relevant industrial processes. It also allows a major improvement regarding the conditioning of the ultimate waste in a durable and robust nuclear glass. Secondly, the recycling of americium could be an interesting option for the future with the deployment of FR fleet to save the repository resource and optimize its use by allowing a denser disposal. It would limit the burden towards the future generations and the need for additional repositories before several centuries. Thirdly, the recycling of the whole minor actinides inventory could be an interesting option for the far-future for strongly decreasing the waste long-term toxicity, down to a few centuries. It would bring the waste issue back within the human history, which should promote its acceptance by the social opinion

  16. Food for thought: understanding the value, variety and usage of management algorithms for major depressive disorder.

    Science.gov (United States)

    Katzman, Martin A; Anand, Leena; Furtado, Melissa; Chokka, Pratap

    2014-12-01

    By 2020, depression is projected to be among the most important contributors to the global burden of disease. A plethora of data confirms that despite the availability of effective therapies, major depressive disorder continues to exact an enormous toll; this, in part, is due to difficulties reaching complete remission, as well as the specific associated costs of both the disorder's morbidity and mortality. The negative effects of depression include those on patients' occupational functioning, including absenteeism, presenteeism, and reduced opportunities for educational and work success. The use of management algorithms has been shown to improve treatment outcomes in major depressive disorder and may be less costly than "usual care" practices. Nevertheless, many patients with depression remain untreated. As well, even those who are treated often continue to experience suboptimal quality of life. As such, the treatment algorithms in this article may improve outcomes for patients suffering with depression. This paper introduces some of the principal reasons underlying these treatment gaps and examines measures or recommendations that might be changed or strengthened in future practice guidelines to bridge them. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Parent Involvement Activities in School Improvement Plans in the Northwest Region. Issues & Answers. REL 2008-No. 064

    Science.gov (United States)

    Speth, Timothy; Saifer, Steffen; Forehand, Gregory

    2008-01-01

    Although the No Child Left Behind Act of 2001 (NCLB) spells out parent involvement requirements for schools in need of improvement, the majority of the Northwest Region school improvement plans reviewed failed to include such provisions. Reported findings include: (1) Despite a wide range of parent involvement practices discussed in legislation…

  18. Strains of Sarcocystis neurona exhibit differences in their surface antigens, including the absence of the major surface antigen SnSAG1.

    Science.gov (United States)

    Howe, Daniel K; Gaji, Rajshekhar Y; Marsh, Antoinette E; Patil, Bhagyashree A; Saville, William J; Lindsay, David S; Dubey, J P; Granstrom, David E

    2008-05-01

    A gene family of surface antigens is expressed by merozoites of Sarcocystis neurona, the primary cause of equine protozoal myeloencephalitis (EPM). These surface proteins, designated SnSAGs, are immunodominant and therefore excellent candidates for development of EPM diagnostics or vaccines. Prior work had identified an EPM isolate lacking the major surface antigen SnSAG1, thus suggesting there may be some diversity in the SnSAGs expressed by different S. neurona isolates. Therefore, a bioinformatic, molecular and immunological study was conducted to assess conservation of the SnSAGs. Examination of an expressed sequence tag (EST) database revealed several notable SnSAG polymorphisms. In particular, the EST information implied that the EPM strain SN4 lacked the major surface antigen SnSAG1. The absence of this surface antigen from the SN4 strain was confirmed by both Western blot and Southern blot. To evaluate SnSAG polymorphisms in the S. neurona population, 14 strains were examined by Western blots using monospecific polyclonal antibodies against the four described SnSAGs. The results of these analyses demonstrated that SnSAG2, SnSAG3, and SnSAG4 are present in all 14 S. neurona strains tested, although some variance in SnSAG4 was observed. Importantly, SnSAG1 was not detected in seven of the strains, which included isolates from four cases of EPM and a case of fatal meningoencephalitis in a sea otter. Genetic analyses by PCR using gene-specific primers confirmed the absence of the SnSAG1 locus in six of these seven strains. Collectively, the data indicated that there is heterogeneity in the surface antigen composition of different S. neurona isolates, which is an important consideration for development of serological tests and prospective vaccines for EPM. Furthermore, the diversity reported herein likely extends to other phenotypes, such as strain virulence, and may have implications for the phylogeny of the various Sarcocystis spp. that undergo sexual stages

  19. Biomass Burning: Major Uncertainties, Advances, and Opportunities

    Science.gov (United States)

    Yokelson, R. J.; Stockwell, C.; Veres, P. R.; Hatch, L. E.; Barsanti, K. C.; Liu, X.; Huey, L. G.; Ryerson, T. B.; Dibb, J. E.; Wisthaler, A.; Müller, M.; Alvarado, M. J.; Kreidenweis, S. M.; Robinson, A. L.; Toon, O. B.; Peischl, J.; Pollack, I. B.

    2014-12-01

    Domestic and open biomass burning are poorly-understood, major influences on Earth's atmosphere composed of countless individual fires that (along with their products) are difficult to quantify spatially and temporally. Each fire is a minimally-controlled complex phenomenon producing a diverse suite of gases and aerosols that experience many different atmospheric processing scenarios. New lab, airborne, and space-based observations along with model and algorithm development are significantly improving our knowledge of biomass burning. Several campaigns provided new detailed emissions profiles for previously undersampled fire types; including wildfires, cooking fires, peat fires, and agricultural burning; which may increase in importance with climate change and rising population. Multiple campaigns have better characterized black and brown carbon and used new instruments such as high resolution PTR-TOF-MS and 2D-GC/TOF-MS to improve quantification of semi-volatile precursors to aerosol and ozone. The aerosol evolution and formation of PAN and ozone, within hours after emission, have now been measured extensively. The NASA DC-8 sampled smoke before and after cloud-processing in two campaigns. The DC-8 performed continuous intensive sampling of a wildfire plume from the source in California to Canada probing multi-day aerosol and trace gas aging. Night-time plume chemistry has now been measured in detail. Fire inventories are being compared and improved, as is modeling of mass transfer between phases and sub-grid photochemistry for global models.

  20. Reforming a large lecture modern physics course for engineering majors using a PER-based design

    Science.gov (United States)

    McKagan, S. B.; Perkins, K. K.; Wieman, C. E.

    2007-01-01

    We have reformed a large lecture modern physics course for engineering majors by radically changing both the content and the learning techniques implemented in lecture and homework. Traditionally this course has been taught in a manner similar to the equivalent course for physics majors, focusing on mathematical solutions of abstract problems. Based on interviews with physics and engineering professors, we developed a syllabus and learning goals focused on content that was more useful to our actual student population: engineering majors. The content of this course emphasized reasoning development, model building, and connections to real world applications. In addition we implemented a variety of PER-based learning techniques, including peer instruction, collaborative homework sessions, and interactive simulations. We have assessed the effectiveness of reforms in this course using pre/post surveys on both content and beliefs. We have found significant improvements in both content knowledge and beliefs compared with the same course before implementing these reforms and a corresponding course for physics majors.

  1. Improving Prevention, Early Recognition and Management of Acute Kidney Injury after Major Surgery: Results of a Planning Meeting with Multidisciplinary Stakeholders

    Directory of Open Access Journals (Sweden)

    Matthew T James

    2014-08-01

    Full Text Available Purpose of review: Acute kidney injury (AKI is common after major surgery, and is associated with morbidity, mortality, increased length of hospital stay, and high health care costs. Although recent guidelines for AKI provide recommendations for identification of patients at risk, monitoring, diagnosis, and management of AKI, there is lack of understanding to guide successful implementation of these recommendations into clinical practice. Sources of information: We held a planning meeting with multidisciplinary stakeholders to identify barriers, facilitators, and strategies to implement recommendations for prevention, early identification, and management of AKI after major surgery. Barriers and facilitators to knowledge use for peri-operative AKI prevention and care were discussed. Findings: Stakeholders identified barriers in knowledge (how to identify high-risk patients, what criteria to use for diagnosis of AKI, attitudes (self-efficacy in preventive care and management of AKI, and behaviors (common use of diuretics, non-steroidal anti-inflammatory drugs, withholding of intravenous fluids, and competing time demands in peri-operative care. Educational, informatics, and organizational interventions were identified by stakeholders as potentially useful elements for future interventions for peri-operative AKI. Limitation: Meeting participants were from a single centre. Implications: The information and recommendations obtained from this stakeholder's meeting will be useful to design interventions to improve prevention and early care for AKI after major surgery.

  2. Cost-effectiveness of collaborative care including PST and an antidepressant treatment algorithm for the treatment of major depressive disorder in primary care; a randomised clinical trial

    Directory of Open Access Journals (Sweden)

    Beekman Aartjan TF

    2007-03-01

    Full Text Available Abstract Background Depressive disorder is currently one of the most burdensome disorders worldwide. Evidence-based treatments for depressive disorder are already available, but these are used insufficiently, and with less positive results than possible. Earlier research in the USA has shown good results in the treatment of depressive disorder based on a collaborative care approach with Problem Solving Treatment and an antidepressant treatment algorithm, and research in the UK has also shown good results with Problem Solving Treatment. These treatment strategies may also work very well in the Netherlands too, even though health care systems differ between countries. Methods/design This study is a two-armed randomised clinical trial, with randomization on patient-level. The aim of the trial is to evaluate the treatment of depressive disorder in primary care in the Netherlands by means of an adapted collaborative care framework, including contracting and adherence-improving strategies, combined with Problem Solving Treatment and antidepressant medication according to a treatment algorithm. Forty general practices will be randomised to either the intervention group or the control group. Included will be patients who are diagnosed with moderate to severe depression, based on DSM-IV criteria, and stratified according to comorbid chronic physical illness. Patients in the intervention group will receive treatment based on the collaborative care approach, and patients in the control group will receive care as usual. Baseline measurements and follow up measures (3, 6, 9 and 12 months are assessed using questionnaires and an interview. The primary outcome measure is severity of depressive symptoms, according to the PHQ9. Secondary outcome measures are remission as measured with the PHQ9 and the IDS-SR, and cost-effectiveness measured with the TiC-P, the EQ-5D and the SF-36. Discussion In this study, an American model to enhance care for patients with a

  3. Manipulatives-Based Laboratory for Majors Biology – a Hands-On Approach to Understanding Respiration and Photosynthesis

    Directory of Open Access Journals (Sweden)

    Sarah M. Boomer

    2011-09-01

    Full Text Available The first course in our year-long introductory series for Biology majors encompasses four learning units: biological molecules and cells, metabolism, genetics, and evolution. Of these, the metabolism unit, which includes respiration and photosynthesis, has shown the lowest student exam scores, least interest, and lowest laboratory ratings. Consequently, we hypothesized that modeling metabolic processes in the laboratory would improve student content learning during this course unit. Specifically, we developed manipulatives-based laboratory exercises that combined paper cutouts, movable blocks, and large diagrams of the cell. In particular, our novel use of connecting LEGO blocks allowed students to move model electrons and phosphates between molecules and within defined spaces of the cell. We assessed student learning using both formal (content indicators and attitude surveys and informal (the identification of misconceptions or discussions with students approaches. On the metabolism unit content exam, student performance improved by 46% over pretest scores and by the end of the course, the majority of students rated metabolism as their most-improved (43% and favorite (33% subject as compared with other unit topics. The majority of students rated manipulatives-based labs as very helpful, as compared to non-manipulatives-based labs. In this report, we will demonstrate that students made learning gains across all content areas, but most notably in the unit that covered respiration and photosynthesis.

  4. Medical school accreditation in Australia: Issues involved in assessing major changes and new programs

    Directory of Open Access Journals (Sweden)

    Michael J. Field

    2011-06-01

    Full Text Available The Australian Medical Council (AMC is an independent company for quality assurance and quality improvement in medical education in Australia and New Zealand. Accreditation procedures for the 20 medical schools in these two countries are somewhat different for three different circumstances or stages of school development: existing medical schools, established courses undergoing major changes, and new schools. This paper will outline some issues involved in major changes to existing courses, and new medical school programs. Major changes have included change from a 6 year undergraduate course to a 5 year undergraduate course or 4 year graduate-entry course, introduction of a lateral graduate-entry stream, new domestic site of course delivery, offshore course delivery, joint program between two universities, and major change to curriculum. In the case of a major change assessment, accreditation of the new or revised course may be granted for a period up to two years after the full course has been implemented. In the assessment of proposals for introduction of new medical courses, six issues needing careful consideration have arisen: forward planning, academic staffing, adequate clinical experience, acceptable research program, adequacy of resources, postgraduate training program and employment.

  5. Differential diagnosis of bipolar disorder and major depressive disorder.

    Science.gov (United States)

    Hirschfeld, R M

    2014-12-01

    Patients with bipolar disorder spend approximately half of their lives symptomatic and the majority of that time suffering from symptoms of depression, which complicates the accurate diagnosis of bipolar disorder. Challenges in the differential diagnosis of bipolar disorder and major depressive disorder are reviewed, and the clinical utility of several screening instruments is evaluated. The estimated lifetime prevalence of major depressive disorder (i.e., unipolar depression) is over 3 and one-half times that of bipolar spectrum disorders. The clinical presentation of a major depressive episode in a bipolar disorder patient does not differ substantially from that of a patient with major depressive disorder (unipolar depression). Therefore, it is not surprising that without proper screening and comprehensive evaluation many patients with bipolar disorder may be misdiagnosed with major depressive disorder (unipolar depression). In general, antidepressants have demonstrated little or no efficacy for depressive episodes associated with bipolar disorder, and treatment guidelines recommend using antidepressants only as an adjunct to mood stabilizers for patients with bipolar disorder. Thus, correct identification of bipolar disorder among patients who present with depression is critical for providing appropriate treatment and improving patient outcomes. Clinical characteristics indicative of bipolar disorder versus major depressive disorder identified in this review are based on group differences and may not apply to each individual patient. The overview of demographic and clinical characteristics provided by this review may help medical professionals distinguish between major depressive disorder and bipolar disorder. Several validated, easily administered screening instruments are available and can greatly improve the recognition of bipolar disorder in patients with depression. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. Creating Quality Improvement Culture in Public Health Agencies

    Science.gov (United States)

    Mahanna, Elizabeth; Joly, Brenda; Zelek, Michael; Riley, William; Verma, Pooja; Fisher, Jessica Solomon

    2014-01-01

    Objectives. We conducted case studies of 10 agencies that participated in early quality improvement efforts. Methods. The agencies participated in a project conducted by the National Association of County and City Health Officials (2007–2008). Case study participants included health directors and quality improvement team leaders and members. We implemented multiple qualitative analysis processes, including cross-case analysis and logic modeling. We categorized agencies according to the extent to which they had developed a quality improvement culture. Results. Agencies were conducting informal quality improvement projects (n = 4), conducting formal quality improvement projects (n = 3), or creating a quality improvement culture (n = 4). Agencies conducting formal quality improvement and creating a quality improvement culture had leadership support for quality improvement, participated in national quality improvement initiatives, had a greater number of staff trained in quality improvement and quality improvement teams that met regularly with decision-making authority. Agencies conducting informal quality improvement were likely to report that accreditation is the major driver for quality improvement work. Agencies creating a quality improvement culture were more likely to have a history of evidence-based decision-making and use quality improvement to address emerging issues. Conclusions. Our findings support previous research and add the roles of national public health accreditation and emerging issues as factors in agencies’ ability to create and sustain a quality improvement culture. PMID:24228680

  7. Creating quality improvement culture in public health agencies.

    Science.gov (United States)

    Davis, Mary V; Mahanna, Elizabeth; Joly, Brenda; Zelek, Michael; Riley, William; Verma, Pooja; Fisher, Jessica Solomon

    2014-01-01

    We conducted case studies of 10 agencies that participated in early quality improvement efforts. The agencies participated in a project conducted by the National Association of County and City Health Officials (2007-2008). Case study participants included health directors and quality improvement team leaders and members. We implemented multiple qualitative analysis processes, including cross-case analysis and logic modeling. We categorized agencies according to the extent to which they had developed a quality improvement culture. Agencies were conducting informal quality improvement projects (n = 4), conducting formal quality improvement projects (n = 3), or creating a quality improvement culture (n = 4). Agencies conducting formal quality improvement and creating a quality improvement culture had leadership support for quality improvement, participated in national quality improvement initiatives, had a greater number of staff trained in quality improvement and quality improvement teams that met regularly with decision-making authority. Agencies conducting informal quality improvement were likely to report that accreditation is the major driver for quality improvement work. Agencies creating a quality improvement culture were more likely to have a history of evidence-based decision-making and use quality improvement to address emerging issues. Our findings support previous research and add the roles of national public health accreditation and emerging issues as factors in agencies' ability to create and sustain a quality improvement culture.

  8. Treatment with escitalopram improves the attentional bias toward negative facial expressions in patients with major depressive disorders.

    Science.gov (United States)

    Zhou, Zhenhe; Cao, Suxia; Li, Hengfen; Li, Youhui

    2015-10-01

    We hypothesized that treatment with escitalopram would improve cognitive bias and contribute to the recovery process for patients with major depressive disorder (MDD). Many previous studies have established that patients with MDD tend to pay selective attention to negative stimuli. The assessment of the level of cognitive bias is regarded as a crucial dimension of treatment outcomes for MDD. To our knowledge, no prior studies have been reported on the effects of treatment with escitalopram on attentional bias in MDD, employing a dot probe task of facial expression. We studied 25 patients with MDD and 25 controls, and used a dot probe task of facial expression to measure cognitive bias. The patients' psychopathologies were rated using the Hamilton Depression Scale (HAMD) at baseline and after 8 weeks of treatment with escitalopram. All participants performed the facial expression dot probe task. The results revealed that the 8 week escitalopram treatment decreased the HAMD scores. The patients with MDD at baseline exhibited an attentional bias towards negative faces, however, no significant bias toward either negative or happy faces were observed in the controls. After the 8 week escitalopram treatment, no significant bias toward negative faces was observed in the patient group. In conclusion, patients with MDD pay more attention to negative facial expressions, and treatment with escitalopram improves this attentional bias toward negative facial expressions. This is the first study, to our knowledge, on the effects of treatment with escitalopram on attentional bias in patients with MDD that has employed a dot probe task of facial expression. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. [Improving treatment adherence in kidney transplantation: a major challenge].

    Science.gov (United States)

    Kessler, Michèle

    2014-06-01

    The kidney transplant recipient is faced not only with the perspective of taking immunosuppressive drugs lifelong, but also the possibility of other long-term treatments prescribed for preexisting conditions, complications, or side effects. Proper management, and most importantly patient adherence, can become a complex challenge. Here we recall current definitions and describe methods for measuring treatment adherence, followed by a discussion on the prevalence of non-adherence in kidney transplant recipients, its effect on graft survival, and factors predictive of non-adherence. Ways of improving adherence are examined, leading to the conviction that helping patients take their medications regularly would probably have a greater impact on graft survival than marketing a new immunosuppressive agent. Copyright © 2014 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

  10. Energy-Efficiency Improvement Opportunities for the Textile Industry

    Energy Technology Data Exchange (ETDEWEB)

    China Energy Group; Hasanbeigi, Ali

    2010-09-29

    The textile industry is one of the most complicated manufacturing industries because it is a fragmented and heterogeneous sector dominated by small and medium enterprises (SMEs). Energy is one of the main cost factors in the textile industry. Especially in times of high energy price volatility, improving energy efficiency should be a primary concern for textile plants. There are various energy-efficiency opportunities that exist in every textile plant, many of which are cost-effective. However, even cost-effective options often are not implemented in textile plants mostly because of limited information on how to implement energy-efficiency measures, especially given the fact that a majority of textile plants are categorized as SMEs and hence they have limited resources to acquire this information. Know-how on energy-efficiency technologies and practices should, therefore, be prepared and disseminated to textile plants. This guidebook provides information on energy-efficiency technologies and measures applicable to the textile industry. The guidebook includes case studies from textile plants around the world and includes energy savings and cost information when available. First, the guidebook gives a brief overview of the textile industry around the world, with an explanation of major textile processes. An analysis of the type and the share of energy used in different textile processes is also included in the guidebook. Subsequently, energy-efficiency improvement opportunities available within some of the major textile sub-sectors are given with a brief explanation of each measure. The conclusion includes a short section dedicated to highlighting a few emerging technologies in the textile industry as well as the potential for the use of renewable energy in the textile industry.

  11. Performance profiles of major energy producers, 1991

    International Nuclear Information System (INIS)

    1992-01-01

    Performance Profiles of Major Energy Producers 1991 is the fifteenth annual report of the Energy Information Administration's (EIA) Financial Reporting System (FRS). The report examines financial and operating developments, with particular reference to the 23 major energy companies (the FRS companies) required to report annually on Form EIA-28. It also traces key developments affecting the financial performance of major energy companies in 1991, as well as reviews important trends. Financial information is reported by major lines of business including oil and gas production, petroleum refining and marketing, and other energy operations. Domestic and international operations are examined separately in this report

  12. Power extraction calculation improvement when local parameters are included

    Science.gov (United States)

    Flores-Mateos, L. M.; Hartnett, M.

    2016-02-01

    The improvement of the tidal resource assessment will be studied by comparing two approaches in a two-dimensional, finite difference, hydrodynamic model DIVAST-ADI; in a channel of non-varying cross-sectional area that connects two large basins. The first strategy, considers a constant trust coefficient; the second one, use the local field parameters around the turbine. These parameters are obtained after applying the open channel theory in the tidal stream and after considering the turbine as a linear momentum actuator disk. The parameters correspond to the upstream and downstream, with respect to the turbine, speeds and depths; also the blockage ratio, the wake velocity and the bypass coefficients and they have already been incorporated in the model. The figure (a) shows the numerical configuration at high tide developed with DIVAST-ADI. The experiment undertakes two open boundary conditions. The first one is a sinusoidal forcing introduced as a water level located at (I, J=1) and the second one, indicate that a zero velocity and a constant water depth were kept (I, J=362); when the turbine is introduced it is placed in the middle of the channel (I=161, J=181). The influence of the turbine in the velocity and elevation around the turbine region is evident; figure (b) and (c) shows that the turbine produces a discontinuity in the depth and velocity profile, when we plot a transect along the channel. Finally, the configuration implemented reproduced with satisfactory accuracy the quasi-steady flow condition, even without presenting shock-capturing capability. Also, the range of the parameters 0.01<α 4<0.55, $0

  13. Teleophthalmology: improving patient outcomes?

    Directory of Open Access Journals (Sweden)

    Sreelatha OK

    2016-02-01

    Full Text Available Omana Kesary Sreelatha,1 Sathyamangalam VenkataSubbu Ramesh2 1Ophthalmology Department, Sultan Qaboos University Hospital, Muscat, Oman; 2Department of Optometry, School of Allied Health Sciences, Manipal University, Manipal, India Abstract: Teleophthalmology is gaining importance as an effective eye care delivery modality worldwide. In many developing countries, teleophthalmology is being utilized to provide quality eye care to the underserved urban population and the unserved remote rural population. Over the years, technological innovations have led to improvement in evidence and teleophthalmology has evolved from a research tool to a clinical tool. The majority of the current teleophthalmology services concentrate on patient screening and appropriate referral to experts. Specialty care using teleophthalmology services for the pediatric group includes screening as well as providing timely care for retinopathy of prematurity (ROP. Among geriatric eye diseases, specialty teleophthalmology care is focused toward screening and referral for diabetic retinopathy (DR, glaucoma, age-related macular degeneration (ARMD, and other sight-threatening conditions. Comprehensive vision screening and refractive error services are generally covered as part of most of the teleophthalmology methods. Over the past decades, outcome assessment of health care system includes patients’ assessments on their health, care, and services they receive. Outcomes, by and large, remain the ultimate validators of the effectiveness and quality of medical care. Teleophthalmology produces the same desired clinical outcome as the traditional system. Remote portals allow specialists to provide care over a larger region, thereby improving health outcomes and increasing accessibility of specialty care to a larger population. A high satisfaction level and acceptance is reported in the majority of the studies because of increased accessibility and reduced traveling cost and time

  14. Environmental Safety of the Use of Major Surfactant Classes in North America

    DEFF Research Database (Denmark)

    Cowan-Ellsberry, Christina; Sanderson, Hans; Belanger, Scott

    2014-01-01

    to the aquatic or sediment environments. This paper also highlights the many years of research that the surfactant and cleaning products industry has supported, as part of their environmental sustainability commitment, to improve environmental tools, approaches, and develop innovative methods appropriate...... to address environmental properties of personal care and cleaning product chemicals, many of which have become approved international standard methods.......This paper brings together over 250 published and unpublished studies on the environmental properties, fate and toxicity of the four major, high volume surfactant classes and relevant feedstocks. The surfactants and feedstocks covered include alcohol sulfate (AS), alcohol ethoxysulfate (AES...

  15. Vortioxetine versus placebo in major depressive disorder comorbid with social anxiety disorder.

    Science.gov (United States)

    Liebowitz, Michael R; Careri, Jason; Blatt, Kyra; Draine, Ann; Morita, Junko; Moran, Melissa; Hanover, Rita

    2017-12-01

    Major Depressive Disorder (MDD) and Social Anxiety Disorder (SAD) are highly comorbid, yet the combined condition has not been subject to any placebo-controlled treatment trials. This study reports a trial of vortioxetine, an antidepressant that has also shown benefit in Generalized Anxiety Disorder (GAD), in patients meeting DSM-5 criteria for both MDD and SAD. The study was a 12-week double-blind, placebo-controlled comparison of vortioxetine 10-20 mg/day or placebo administered on a 1:1 ratio. The study was designed to include 40 male or female outpatients aged 18-70 years. The primary endpoint was the "composite" Clinical Global Impression of Improvement (CGI-I) responder rate, factoring in improvement in both MDD and SAD features. Major secondary outcome measures were changes on the Montgomery Asberg Depression Rating Scale (MADRS) and Liebowitz Social Anxiety Scale (LSAS). On the composite CGI-I, 10 of 20 (50%) vortioxetine and six of 20 (30%) placebo-treated patients were rated as responders, a non-significant difference. However, vortioxetine-treated patients did show significantly greater improvement than those on placebo on both the MADRS (effect size 0.672) and LSAS (effect size 0.714). Efficacy in depression was seen before improvement in SAD. Adverse effects were similar to those previously reported. In this preliminary trial vortioxetine appears safe and effective for patients with MDD comorbid with SAD, with robust effect sizes on dimensional measures of both depression and social anxiety, but failure to separate from placebo on the primary outcome measure of composite responder rate. More studies of patients with comorbid conditions are needed, as this mirrors what is often seen in clinical practice. © 2017 Wiley Periodicals, Inc.

  16. Description of an oral Chagas disease outbreak in Venezuela, including a vertically transmitted case.

    Science.gov (United States)

    Noya, Belkisyolé Alarcón de; Pérez-Chacón, Gladymar; Díaz-Bello, Zoraida; Dickson, Sonia; Muñoz-Calderón, Arturo; Hernández, Carlos; Pérez, Yadira; Mauriello, Luciano; Moronta, Eyleen

    2017-08-01

    We describe the eleventh major outbreak of foodborne Trypanosoma cruzi transmission in urban Venezuela, including evidence for vertical transmission from the index case to her fetus. After confirming fetal death at 24 weeks of gestation, pregnancy interruption was performed. On direct examination of the amniotic fluid, trypomastigotes were detected. T. cruzi specific-polymerase chain reaction (PCR) also proved positive when examining autopsied fetal organs. Finally, microscopic fetal heart examination revealed amastigote nests. Acute orally transmitted Chagas disease can be life threatening or even fatal for pregnant women and unborn fetuses owing to vertical transmission. There is therefore an urgent need to improve national epidemiologic control measures.

  17. Survey of Programs Designed to Improve Employee Morale in Seven Major American Shipyards

    National Research Council Canada - National Science Library

    1992-01-01

    ... and therefore his productivity. This study is purposely limited to those employee morale improvement programs which were designed to improve productivity and which in the opinion of management did, in fact, cause an increase in productivity whether or not that increase in productivity is quantifiable.

  18. Examining the Impact of Patient-Reported Hope for Improvement and Patient Satisfaction with Clinician/Treatment on the Outcome of Major Depressive Disorder Treatment.

    Science.gov (United States)

    IsHak, Waguih William; Vilhauer, Jennice; Kwock, Richard; Wu, Fan; Gohar, Sherif; Collison, Katherine; Thomas, Shannon Nicole; Naghdechi, Lancer; Elashoff, David

    This analysis aims at examining if patient-reported variables such as hope for improvement and patient satisfaction with clinician/treatment could influence the outcome major depressive disorder (MDD) treatment, namely depression remission, in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial. Retrospective cohort study. The STAR*D study was conducted at 18 primary care and 23 psychiatric care settings in the United States from 2001-2007 and was funded by the National Institute of Mental health (NIMH). The analysis contained in this manuscript was conceptualized at the Cedars-Sinai Department of Psychiatry and Behavioral Neurosciences and performed at the UCLA School of Public Health. Using data from STAR*D, the current study used logistic regression and survival analyses to examine the relationship between depressive symptoms remission and two sets of self-reported factors: Hope for improvement and, Patient satisfaction with treatment/clinician. First, more than 90% of STAR*D patients reported having high hope for improvement (agree or strongly agree) and more than 66% endorsed high satisfaction with clinicians and more than 50% expressed high satisfaction with treatments (very or mostly satisfied). Second, hope for improvement was predictive of depression remission (pdepression remission in contrast to satisfaction with clinician/treatment. Future studies should prospectively incorporate patients' subjective attitudes regarding hope for improvement and satisfaction with clinicians and treatments as mediators and moderators of MDD treatment success.

  19. Major workplace related accidents in Singapore: A major trauma centre's experience.

    Science.gov (United States)

    Ng, Zhi Xu; Teo, Li Tserng; Go, Karen T S; Yeo, Yen Teng; Chiu, Ming Terk

    2010-12-01

    Major workplace related accidents pose a significant healthcare resource challenge in Singapore. Our study looks at the epidemiology of patients who were admitted for workplace related accidents, in a single institution, with an Injury Severity Score of >9. There were 196 cases of major workplace related accidents admitted between January 2006 and December 2007. The median age of patients admitted was 37 years with a large percentage being males (95.4%) and non-residents (57.1%). The most common ethnic group was Chinese (53.1%) followed by Indians (23.5%). The most common mechanism of injury was fall from height (66.3%) followed by injuries as a result of falling objects at work (21.9%). The percentage of patients who required surgical intervention was 69.9%. Patients admitted for major workplace related accidents had a median length of stay of 5 days in the hospital, a median length of 24 days of medical leave (ML), certifying them unfit for duty and the average cost of stay for each patient was S$11,000. We have a better understanding of the epidemiology and socio-economic impact of workplace related accidents through this study. Workplace related accidents result in significant number of man-days lost from work and monetary cost to employers, medical insurance and the hospital. With an improved understanding, we propose methods to prevent and reduce such accidents in future. A direct consequence of which will be the possible reduction of hospitalisation costs and better allocation of healthcare resources in the future.

  20. Project Seahorse evolves into major marine protector | IDRC ...

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

    2012-10-29

    Oct 29, 2012 ... Project Seahorse evolves into major marine protector ... local people, have greatly improved the prospects of survival for threatened species. ... “We tackle issues on any political level or geographical scale, according to what ...

  1. Citizen Science: The Small World Initiative Improved Lecture Grades and California Critical Thinking Skills Test Scores of Nonscience Major Students at Florida Atlantic University.

    Science.gov (United States)

    Caruso, Joseph P; Israel, Natalie; Rowland, Kimberly; Lovelace, Matthew J; Saunders, Mary Jane

    2016-03-01

    Course-based undergraduate research is known to improve science, technology, engineering, and mathematics student achievement. We tested "The Small World Initiative, a Citizen-Science Project to Crowdsource Novel Antibiotic Discovery" to see if it also improved student performance and the critical thinking of non-science majors in Introductory Biology at Florida Atlantic University (a large, public, minority-dominant institution) in academic year 2014-15. California Critical Thinking Skills Test pre- and posttests were offered to both Small World Initiative (SWI) and control lab students for formative amounts of extra credit. SWI lab students earned significantly higher lecture grades than control lab students, had significantly fewer lecture grades of D+ or lower, and had significantly higher critical thinking posttest total scores than control students. Lastly, more SWI students were engaged while taking critical thinking tests. These results support the hypothesis that utilizing independent course-based undergraduate science research improves student achievement even in nonscience students.

  2. Including α s1 casein gene information in genomic evaluations of French dairy goats.

    Science.gov (United States)

    Carillier-Jacquin, Céline; Larroque, Hélène; Robert-Granié, Christèle

    2016-08-04

    Genomic best linear unbiased prediction methods assume that all markers explain the same fraction of the genetic variance and do not account effectively for genes with major effects such as the α s1 casein polymorphism in dairy goats. In this study, we investigated methods to include the available α s1 casein genotype effect in genomic evaluations of French dairy goats. First, the α s1 casein genotype was included as a fixed effect in genomic evaluation models based only on bucks that were genotyped at the α s1 casein locus. Less than 1 % of the females with phenotypes were genotyped at the α s1 casein gene. Thus, to incorporate these female phenotypes in the genomic evaluation, two methods that allowed for this large number of missing α s1 casein genotypes were investigated. Probabilities for each possible α s1 casein genotype were first estimated for each female of unknown genotype based on iterative peeling equations. The second method is based on a multiallelic gene content approach. For each model tested, we used three datasets each divided into a training and a validation set: (1) two-breed population (Alpine + Saanen), (2) Alpine population, and (3) Saanen population. The α s1 casein genotype had a significant effect on milk yield, fat content and protein content. Including an α s1 casein effect in genetic and genomic evaluations based only on male known α s1 casein genotypes improved accuracies (from 6 to 27 %). In genomic evaluations based on all female phenotypes, the gene content approach performed better than the other tested methods but the improvement in accuracy was only slightly better (from 1 to 14 %) than that of a genomic model without the α s1 casein effect. Including the α s1 casein effect in a genomic evaluation model for French dairy goats is possible and useful to improve accuracy. Difficulties in predicting the genotypes for ungenotyped animals limited the improvement in accuracy of the obtained estimated breeding values.

  3. Student Motivation in Science Subjects in Tanzania, Including Students' Voices

    Science.gov (United States)

    Mkimbili, Selina Thomas; Ødegaard, Marianne

    2017-12-01

    Fostering and maintaining students' interest in science is an important aspect of improving science learning. The focus of this paper is to listen to and reflect on students' voices regarding the sources of motivation for science subjects among students in community secondary schools with contextual challenges in Tanzania. We conducted a group-interview study of 46 Form 3 and Form 4 Tanzanian secondary school students. The study findings reveal that the major contextual challenges to student motivation for science in the studied schools are limited resources and students' insufficient competence in the language of instruction. Our results also reveal ways to enhance student motivation for science in schools with contextual challenges; these techniques include the use of questioning techniques and discourse, students' investigations and practical work using locally available materials, study tours, more integration of classroom science into students' daily lives and the use of real-life examples in science teaching. Also we noted that students' contemporary life, culture and familiar language can be utilised as a useful resource in facilitating meaningful learning in science in the school. Students suggested that, to make science interesting to a majority of students in a Tanzanian context, science education needs to be inclusive of students' experiences, culture and contemporary daily lives. Also, science teaching and learning in the classroom need to involve learners' voices.

  4. Iron chelation therapy in thalassemia major: a systematic review with meta-analyses of 1520 patients included on randomized clinical trials

    DEFF Research Database (Denmark)

    Maggio, Aurelio; Filosa, Aldo; Vitrano, Angela

    2011-01-01

    The effectiveness of deferoxamine (DFO), deferiprone (DFP), or deferasirox (DFX) in thalassemia major was assessed. Outcomes were reported as means±SD, mean differences with 95% CI, or standardized mean differences. Statistical heterogeneity was tested using χ2 (Q) and I2. Sources of bias...

  5. Performance profiles of major energy producers 1989

    Energy Technology Data Exchange (ETDEWEB)

    1991-01-23

    Performance Profiles of Major Energy Producers 1989 is the thirteenth annual report of the Energy Information Administration's (EIA) Financial Reporting System (FRS). The report examines financial and operating developments, with particular reference to the 23 major energy companies (the FRS companies'') required to report annually on Form EIA-28. Financial information is reported by major lines of business including oil and gas production, petroleum refining and marketing, and other energy operations. Domestic and international operations are examined separately in this report. It also traces key developments affecting the financial performance of major energy companies in 1989, as well as review of important trends.

  6. A qualitative exploration of the major challenges facing pharmacovigilance in Saudi Arabia.

    Science.gov (United States)

    Aljadhey, Hisham; Mahmoud, Mansour A; Alshammari, Thamir M; Al-Dhaeefi, Mohammed; Le Louet, Herve; Perez-Gutthann, Susana; Pitts, Peter J

    2015-09-01

    To explore the challenges facing pharmacovigilance in Saudi Arabia and formulate recommendations to improve it from the perspective of healthcare professionals in Saudi Arabia. This was a qualitative study of 4 focus group discussions with pharmacists, physicians, and academicians held under the auspices of the King Saud University School of Pharmacy and the Center for Medicine in the Public Interest, Riyadh, Saudi Arabia. A total of 29 eligible healthcare professionals were invited to participate in the discussion. The predefined themes of the study were the current practice and major challenges facing pharmacovigilance in regulatory bodies, hospitals, the community, and academia, as well as recommendations to improve pharmacovigilance practice.  Of the 29 participants invited, 27 attended the discussion. Challenges facing regulatory bodies included complicated adverse drug reactions (ADR) reporting forms, lack of feedback on ADRs submitted to the Saudi Food and Drug Authority, lack of decisions from the local authority to withdraw medications, and lack of data on pharmacovigilance. The challenges to pharmacovigilance in hospitals included the lack of knowledge of the significance of ADR reporting, workload, blaming culture, and lack of collaboration between regulatory bodies and hospitals. However, challenges facing pharmaceutical industries included the lack of drug manufacturers in Saudi Arabia and lack of interest in pharmacovigilance. Recommendations to improve pharmacovigilance included the need for communication, stronger regulatory requirements, the need for research, the need for unified ADRs reporting, and continuous education and training.  The study has identified the challenges facing pharmacovigilance in Saudi Arabia and made certain recommendations to overcome them. These recommendations might be helpful for regulatory bodies to enhance spontaneous reporting and promote pharmacovigilance.

  7. Improving the Practical Education of Chemical and Pharmaceutical Engineering Majors in Chinese Universities

    Science.gov (United States)

    Zhao, Feng-qing; Yu, Yi-feng; Ren, Shao-feng; Liu, Shao-jie; Rong, Xin-yu

    2014-01-01

    Practical education in chemical engineering has drawn increasing attention in recent years. This paper discusses two approaches to teaching and learning about experiments among upper-level chemical and pharmaceutical engineering majors in China. On the basis of years of experience in teaching chemical and pharmaceutical engineering, we propose the…

  8. Development of the major trauma case review tool.

    Science.gov (United States)

    Curtis, Kate; Mitchell, Rebecca; McCarthy, Amy; Wilson, Kellie; Van, Connie; Kennedy, Belinda; Tall, Gary; Holland, Andrew; Foster, Kim; Dickinson, Stuart; Stelfox, Henry T

    2017-02-28

    As many as half of all patients with major traumatic injuries do not receive the recommended care, with variance in preventable mortality reported across the globe. This variance highlights the need for a comprehensive process for monitoring and reviewing patient care, central to which is a consistent peer-review process that includes trauma system safety and human factors. There is no published, evidence-informed standardised tool that considers these factors for use in adult or paediatric trauma case peer-review. The aim of this research was to develop and validate a trauma case review tool to facilitate clinical review of paediatric trauma patient care in extracting information to facilitate monitoring, inform change and enable loop closure. Development of the trauma case review tool was multi-faceted, beginning with a review of the trauma audit tool literature. Data were extracted from the literature to inform iterative tool development using a consensus approach. Inter-rater agreement was assessed for both the pilot and finalised versions of the tool. The final trauma case review tool contained ten sections, including patient factors (such as pre-existing conditions), presenting problem, a timeline of events, factors contributing to the care delivery problem (including equipment, work environment, staff action, organizational factors), positive aspects of care and the outcome of panel discussion. After refinement, the inter-rater reliability of the human factors and outcome components of the tool improved with an average 86% agreement between raters. This research developed an evidence-informed tool for use in paediatric trauma case review that considers both system safety and human factors to facilitate clinical review of trauma patient care. This tool can be used to identify opportunities for improvement in trauma care and guide quality assurance activities. Validation is required in the adult population.

  9. Information Technology: Opportunities for Improving Acquisitions and Operations

    Science.gov (United States)

    2017-04-01

    1GAO, Federal Chief Information Officers : Opportunities Exist to Improve Role in Information Technology Management, GAO-11-634...approach and a collaborative relationship among agency executives (e.g., Chief Financial Officer and agency component leadership) had stopped 45...executives, including Chief Financial Officers and executives of major bureaus and component agencies for whom the technology is serving, to ensure that

  10. An improved computer controlled triple-axis neutron spectrometer

    International Nuclear Information System (INIS)

    Cooper, M.J.; Hall, J.W.; Hutchings, M.T.

    1975-07-01

    A description is given of the computer-controlled triple-axis neutron spectrometer installed at the PLUTO reactor at Harwell. The reasons for an nature of recent major improvements are discussed. Following a general description of the spectrometer, details are then given of the new computerised control system, including the functions of the various programs which are now available to the user. (author)

  11. Karyotype characterization of Mugil incilis Hancock, 1830 (Mugiliformes: Mugilidae, including a description of an unusual co-localization of major and minor ribosomal genes in the family

    Directory of Open Access Journals (Sweden)

    Anne Kathrin Hett

    Full Text Available This study reports the description of the karyotype of Mugil incilis from Venezuela. The chromosome complement is composed of 48 acrocentric chromosomes, which uniformly decrease in size. Therefore, the homologues can not be clearly identified, with the exception of one of the largest chromosome pairs, classified as number 1, whose homologues may show a subcentromeric secondary constriction, and of chromosome pair number 24, which is considerably smaller than the others. C-banding showed heterochromatic blocks at the centromeric/pericentromeric regions of all chromosomes, which were more conspicuous on chromosomes 1, given the C-positive signals include the secondary constrictions. AgNO3 and fluorescent in situ hybridization (FISH with 45S rDNA demonstrated that the nucleolus organizer regions are indeed located on the secondary constrictions of chromosome pair number 1. FISH with 5S rDNA revealed that the minor ribosomal genes are located on this same chromosome pair, near the NORs, though signals are closer to the centromeres and of smaller size, compared to those of the major ribosomal gene clusters. This is the first description of co-localization of major and minor ribosomal genes in the family. Data are discussed from a cytotaxonomic and phylogenetic perspective.

  12. Improved Riccati Transfer Matrix Method for Free Vibration of Non-Cylindrical Helical Springs Including Warping

    Directory of Open Access Journals (Sweden)

    A.M. Yu

    2012-01-01

    Full Text Available Free vibration equations for non-cylindrical (conical, barrel, and hyperboloidal types helical springs with noncircular cross-sections, which consist of 14 first-order ordinary differential equations with variable coefficients, are theoretically derived using spatially curved beam theory. In the formulation, the warping effect upon natural frequencies and vibrating mode shapes is first studied in addition to including the rotary inertia, the shear and axial deformation influences. The natural frequencies of the springs are determined by the use of improved Riccati transfer matrix method. The element transfer matrix used in the solution is calculated using the Scaling and Squaring method and Pad'e approximations. Three examples are presented for three types of springs with different cross-sectional shapes under clamped-clamped boundary condition. The accuracy of the proposed method has been compared with the FEM results using three-dimensional solid elements (Solid 45 in ANSYS code. Numerical results reveal that the warping effect is more pronounced in the case of non-cylindrical helical springs than that of cylindrical helical springs, which should be taken into consideration in the free vibration analysis of such springs.

  13. White paper of radiotherapy in France. Twelve objectives to improve one of the major cancer treatments -2013

    International Nuclear Information System (INIS)

    Chauvet, Bruno; Mazeron, Jean-Jacques; Mahe, Marc-Andre; Maingon, Philippe; Mornex, Francoise; Azria, David; Barillot, Isabelle; Chauvet, Bruno; Denis, Fabrice; Lartigau, Eric; Lipinski, Francis; Maingon, Philippe; Mornex, Francoise; Ardiet, Jean-Michel; Bibault, Jean-Emmanuel; Caudrelier, Valerie; Diaz, Olivia; Crevoisier, Renaud de; Martel, Catherine de; Dubray, Bernard; Estivalet, Stephane; Faivre, Jean-Christophe; Fenoglietto, Pascal; Ferlay, Jacques; Fumagalli, Ingrid; Giraud, Philippe; Hennequin, Christophe; Henoch, Herve; Khodri, Mustapha; Lagrange, Jean-Leon; Llacer, Carmen; Lorchel, Fabrice; Mahe, Marc-Andre; Meyrieux, Charlotte; Noel, Georges; Oozeer, Rashid; Peiffert, Didier; Pourel, Nicolas; Pradier, Olivier; Rocher, Francois; Thureau, Sebastien; Eschwege, Francois; Martin, Philippe; Parmentier Gerard; Eschwege, Francois

    2013-01-01

    This white paper aims at presenting the status and perspectives of radiotherapy in France, at proposing solutions for the improvement of treatment quality and safety. Along with surgery and chemotherapy, radiotherapy is one of the major techniques of cancer treatment and the first part gives an overview of increased needs due to population ageing, of the fast technical advances (better definition of target volumes and doses, better taking into account of anatomy variations and movements), of the impact of these advances on treatment results for various types of cancer, and of the current status of equipment (a slow evolution is noticed) and future needs. The second part addresses the various professions and their demography. The third part examines how to correct the unequal access to care with respect to geography, to equipment and treatment quality, or to delay before treatment. It also evokes collaborations between centres, the diffusion of good practices, specialisation, and makes some proposals for an equal access to care. The fourth part highlights quality and security improvements due to quality control practices, recommendations, prevention actions and risk management. The next part addresses the financial aspect and makes some proposals to reduce inequalities and archaisms. It also compares costs in France and in Europe. The report then gives an overview of the administrative and professional environment and of the different involved bodies, and outlines the need of a better coordination. Patient information is discussed (patients are better informed) as well as support cares. The last parts address activities of research and development and the organisation and possibilities offered by education and training

  14. Hazards of nuclear reactors and other major industrial complexes

    International Nuclear Information System (INIS)

    Farmer, F.R.

    1982-01-01

    Some of the problems of quantified risk analysis of the hazards of nuclear reactors and other major industrial complexes are raised particularly as seen by the proponents and opponents of atomic energy. These are exemplified by discussing the chemical accidents at Flixborough and Canvey Island and the Light Water Reactor Studies. The role of risk analysis in improving knowledge of the systems studies, improving methods of analysis, identifying weaknesses in systems and in improving engineering/maintenance/operation is also stressed. (U.K.)

  15. Conservation biology in Asia: the major policy challenges.

    Science.gov (United States)

    McNeely, Jeffrey A; Kapoor-Vijay, Promila; Zhi, Lu; Olsvig-Whittaker, Linda; Sheikh, Kashif M; Smith, Andrew T

    2009-08-01

    With about half the world's human population and booming economies, Asia faces numerous challenges to its biodiversity. The Asia Section of the Society for Conservation Biology has identified some key policy issues in which significant progress can be made. These include developing new sources of funding for forest conservation; identifying potential impacts of energy alternatives on the conservation of biodiversity; curbing the trade in endangered species of plants and animals; a special focus on the conservation of mountain biodiversity; enhancing relevant research; ensuring that conservation biology contributes to major international conventions and funding mechanisms; using conservation biology to build a better understanding of zoonotic diseases; more effectively addressing human-animal conflicts; enhancing community-based conservation; and using conservation biology to help address the pervasive water-deficit problems in much of Asia. These challenges can be met through improved regional cooperation among the relevant stakeholders.

  16. Securing Major Events

    International Nuclear Information System (INIS)

    Loeoef, Susanna

    2013-01-01

    When asked why the IAEA should provide nuclear security support to countries that organize large public events, Nuclear Security Officer Sophia Miaw answers quickly and without hesitation. ''Imagine any major public event such as the Olympics, a football championship, or an Expo. If a dirty bomb were to be exploded at a site where tens of thousands of people congregate, the radioactive contamination would worsen the effects of the bomb, increase the number of casualties, impede a rapid emergency response, and cause long term disruption in the vicinity,'' she said. Avoiding such nightmarish scenarios is the driving purpose behind the assistance the IAEA offers States that host major sporting or other public events. The support can range from a single training course to a comprehensive programme that includes threat assessment, training, loaned equipment and exercises. The type and scope of assistance depends on the host country's needs. ''We incorporate nuclear security measures into their security plan. We don't create anything new,'' Miaw said

  17. Proposed NOAA Budget Includes Hefty Increase for Satellites

    Science.gov (United States)

    Showstack, Randy

    2010-03-01

    The Obama administration's proposed fiscal year (FY) 2011 budget for the U.S. National Oceanic and Atmospheric Administration (NOAA) would provide the agency with $5.55 billion, which represents a total increase of $806.1 million, or 17% above the FY 2010 budget enacted by Congress. At a February briefing about the budget, NOAA administrator Jane Lubchenco said the budget is a very good package for the agency and that it reflects the administration's commitment to the environment, science, public safety, and job creation. Noting that the agency's budget remained essentially flat between FY 2005 and FY 2008 during the George W. Bush administration, Lubchenco said, “the increasing demand for NOAA's services, coupled with a static budget, created a major challenge for NOAA in delivering on expectations.” She said the funding picture for the agency improved with the FY 2009 and FY 2010 enacted budgets. Lubchenco noted that the proposed budget would include $949 million for research and development, an $82 million increase, adding, “Our 2011 request for each line office [within NOAA] is higher than it was in 2010, and we are better aligned with congressional funding levels than in previous budgets.”

  18. Cognitive Effects of Electroconvulsive Therapy in Patients with Major Depressive, Bipolar and Schizophrenia Disorders

    Directory of Open Access Journals (Sweden)

    N Fouladi

    2011-10-01

    Full Text Available Background & Aim: Electroconvulsive therapy (ECT is a highly effective treatment for affective and schizophrenic disorders. The main objective of this study was to examine the cognitive effects of ECT in patients with major depressive, bipolar and schizophrenia disorders. Methods: In this study we administered a battery of cognitive tasks on 90 patients with major depressive, bipolar and schizophrenia disorders, one day before and after the termination of ECT. The effects were measured by a set of computerized cognitive tests including: auditory reaction time, visual reaction time, verbal memory, Benton visual memory, Wisconsin card sort and motor function. The collected data were analyzed using One-way ANOVA and dependent t-test. Results: The results showed that depressive patients had poorer verbal memory and motor function after the termination of ECT compared to pretest, but their executive function was improved (p<0.05. After the termination of ECT the verbal and visual memory and executive function was significantly improved in patients with bipolar and schizophrenia disorders but their motor function was significantly reduced (p<0.05. Conclusion: Results of this study showed improvement for most cognitive functions in patients after electroconvulsive therapy. Findings of this study may help patients and their families to overcome their fear of electroconvulsive therapy. The results also can aware patients regarding the cognitive effects of electroconvulsive therapy.

  19. Establishing Maximal Medical Improvement After Arthroscopic Rotator Cuff Repair.

    Science.gov (United States)

    Zuke, William A; Leroux, Timothy S; Gregory, Bonnie P; Black, Austin; Forsythe, Brian; Romeo, Anthony A; Verma, Nikhil N

    2018-03-01

    As health care transitions from a pay-for-service to a pay-for-performance infrastructure, the value of orthopaedic care must be defined accurately. Significant efforts have been made in defining quality and cost in arthroplasty; however, there remains a lag in ambulatory orthopaedic care. Two-year follow-up has been a general requirement for reporting outcomes after rotator cuff repair. However, this time requirement has not been established scientifically and is of increasing importance in the era of value-based health care. Given that arthroscopic rotator cuff repair is a common ambulatory orthopaedic procedure, the purpose of this study was to establish a time frame for maximal medical improvement (the state when improvement has stabilized) after arthroscopic rotator cuff repair. Systematic review. A systematic review of the literature was conducted, identifying studies reporting sequential patient-reported outcomes up to a minimum of 2 years after arthroscopic rotator cuff repair. The primary clinical outcome was patient-reported outcomes at 3-month, 6-month, 1-year, and 2-year follow-up. Secondary clinical outcomes included range of motion, strength, retears, and complications. Clinically significant improvement was determined between various time intervals by use of the minimal clinically important difference. The review included 19 studies including 1370 patients who underwent rotator cuff repair. Clinically significant improvement in patient-reported outcomes was seen up to 1 year after rotator cuff repair, but no clinical significance was noted from 1 year to 2 years. The majority of improvement in strength and range of motion was seen up to 6 months, but no clinically meaningful improvement was seen thereafter. All reported complications and the majority of retears occurred within 6 months after rotator cuff repair. After rotator cuff repair, a clinically significant improvement in patient-reported outcomes, range of motion, and strength was seen up to 1

  20. Major histocompatibility complex harbors widespread genotypic variability of non-additive risk of rheumatoid arthritis including epistasis.

    Science.gov (United States)

    Wei, Wen-Hua; Bowes, John; Plant, Darren; Viatte, Sebastien; Yarwood, Annie; Massey, Jonathan; Worthington, Jane; Eyre, Stephen

    2016-04-25

    Genotypic variability based genome-wide association studies (vGWASs) can identify potentially interacting loci without prior knowledge of the interacting factors. We report a two-stage approach to make vGWAS applicable to diseases: firstly using a mixed model approach to partition dichotomous phenotypes into additive risk and non-additive environmental residuals on the liability scale and secondly using the Levene's (Brown-Forsythe) test to assess equality of the residual variances across genotype groups per marker. We found widespread significant (P 5e-05) vGWAS signals within the major histocompatibility complex (MHC) across all three study cohorts of rheumatoid arthritis. We further identified 10 epistatic interactions between the vGWAS signals independent of the MHC additive effects, each with a weak effect but jointly explained 1.9% of phenotypic variance. PTPN22 was also identified in the discovery cohort but replicated in only one independent cohort. Combining the three cohorts boosted power of vGWAS and additionally identified TYK2 and ANKRD55. Both PTPN22 and TYK2 had evidence of interactions reported elsewhere. We conclude that vGWAS can help discover interacting loci for complex diseases but require large samples to find additional signals.

  1. A review of a radioactive material shipping container including design, testing, upgrading compliance program and shipping logistics

    International Nuclear Information System (INIS)

    Celovsky, A.; Lesco, R.; Gale, B.; Sypes, J.

    2003-01-01

    Ten years ago Atomic Energy of Canada developed a Type B(U)-85 shipping container for the global transport of highly radioactive materials. This paper reviews the development of the container, including a summary of the design requirements, a review of the selected materials and key design elements, and the results of the major qualification tests (drop testing, fire test, leak tightness testing, and shielding integrity tests). As a result of the testing, improvements to the structural, thermal and containment design were made. Such improvements, and reasons thereof, are noted. Also provided is a summary of the additional analysis work required to upgrade the package from a Type B(U) to a Type B(F), i.e. essentially upgrading the container to include fissile radioisotopes to the authorized radioactive contents list. Having a certified shipping container is only one aspect governing the global shipments of radioactive material. By necessity the shipment of radioactive material is a highly regulated environment. This paper also explores the experiences with other key aspects of radioactive shipments, including the service procedures used to maintain the container certification, the associated compliance program for radioactive material shipments, and the shipping logistics involved in the transport. (author)

  2. Functional impairment in patients with major depressive disorder: the 2-year PERFORM study.

    Science.gov (United States)

    Hammer-Helmich, Lene; Haro, Josep Maria; Jönsson, Bengt; Tanguy Melac, Audrey; Di Nicola, Sylvie; Chollet, Julien; Milea, Dominique; Rive, Benoît; Saragoussi, Delphine

    2018-01-01

    The Prospective Epidemiological Research on Functioning Outcomes Related to Major depressive disorder (PERFORM) study describes the course of depressive symptoms, perceived cognitive symptoms, and functional impairment over 2 years in outpatients with major depressive disorder (MDD) and investigates the patient-related factors associated with functional impairment. This was a 2-year observational study in 1,159 outpatients with MDD aged 18-65 years who were either initiating antidepressant monotherapy or undergoing their first switch of antidepressant. Functional impairment was assessed by the Sheehan Disability Scale and the Work Productivity and Activity Impairment questionnaire. Patients assessed depression severity using the nine-item Patient Health Questionnaire and severity of perceived cognitive symptoms using the five-item Perceived Deficit Questionnaire. To investigate which patient-related factors were associated with functional impairment, univariate analyses of variance were performed to identify relevant factors that were then included in multivariate analyses of covariance at baseline, month 2, months 6 and 12 combined, and months 18 and 24 combined. The greatest improvement in depressive symptoms, perceived cognitive symptoms, and functional impairment was seen immediately (within 2 months) following initiation or switch of antidepressant therapy, followed by more gradual improvement and long-term stabilization. Improvement in perceived cognitive symptoms was less marked than improvement in depressive symptoms during the acute treatment phase. Functional impairment in patients with MDD was not only associated with severity of depressive symptoms but also independently associated with severity of perceived cognitive symptoms when adjusted for depression severity throughout the 2 years of follow-up. These findings highlight the burden of functional impairment in MDD and the importance of recognizing and managing cognitive symptoms in daily practice.

  3. Traffic safety in the U.S.: re-examining major opportunities.

    Science.gov (United States)

    Sivak, Michael; Luoma, Juha; Flannagan, Michael J; Bingham, C Raymond; Eby, David W; Shope, Jean T

    2007-01-01

    This article examines five major road-safety risk factors: exceeding posted speed limits, not using safety belts, driving while intoxicated, nighttime driving, and young drivers. The importance of each of these factors is documented, known effective countermeasures (both policy and technology based) are discussed, and impediments to the implementation of these countermeasures in the United States are examined. Based on current understanding of the five major risk factors, and of the available countermeasures, there appear to be a variety of opportunities to make substantial gains in road safety using existing knowledge. The limited implementation of a variety of known countermeasures therefore appears to be inconsistent with high-level, strategic goals to improve road safety. Consequently, a recommendation is made to comprehensively re-examine the balance between the countermeasures discussed in this article and economic, mobility, and privacy concerns. IMPACT ON PUBLIC SAFETY: Such a re-examination is likely to result in broad support for these countermeasures, with a consequent major improvement in road safety.

  4. Barriers to efficiency improvement and fuel switching in Karnataka, India

    International Nuclear Information System (INIS)

    Reddy, A.

    1991-01-01

    Implementing energy efficiency changes requires a wide range measures. Improvements, therefore, require actions at the lowest level of the consumer, through the highest level of the global agencies. Due to the multiplicity of participants, however, barriers to achieving these improvements can arise at every level. The major barriers to improving energy efficiency in developing countries are defined and paths to overcome these challenges are identified. Topics of discussion include: energy consumers; end-use equipment manufacturers; end-use equipment providers; energy carrier producers and distributors; actual/potential cogenerators; financial institutions; government; and international, multilateral and industrialized country funding/aid agencies

  5. Does surgery for deep infiltrating bowel endometriosis improve fertility? A systematic review.

    Science.gov (United States)

    Iversen, Maja L; Seyer-Hansen, Mikkel; Forman, Axel

    2017-06-01

    Reduced fertility is a major concern in women with endometriosis. The influence of surgery of deep infiltrating endometriosis (DIE) affecting the bowel wall on fertility is controversial and the literature on this field is heterogeneous. In this review we addressed whether surgery for bowel DIE improves the spontaneous pregnancy rate, and the results of in vitro fertilization (IVF), and the potential risk of such surgery. We conducted a literature search including the terms "deep", "deep infiltrating", "bowel", rectovaginal", "endometriosis", "fertility", "infertility" and "IVF" in PubMed. No randomized controlled studies were found. Other publications of relevance included four retrospective and three prospective observational studies. Moreover, one retrospective study compared results of IVF treatment with or without previous surgery for bowel DIE. All studies reported detailed data on surgical complications. The poor data quality precluded firm conclusions. The results indicate, however, the possibility that surgery for bowel DIE may improve the spontaneous pregnancy rate, and positive effects on IVF outcome cannot be excluded. Such surgery will be associated with risk of major complications. The lack of proper data precludes conclusions on the potential role for bowel DIE surgery to improve the spontaneous pregnancy rate and results of IVF treatment. Positive effects cannot be excluded, but the definite risk of major complications must be taken into account. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  6. Energy upgrading measures improve also indoor climate

    DEFF Research Database (Denmark)

    Foldbjerg, Peter; Knudsen, Henrik Nellemose

    2014-01-01

    A new survey shows that the economy is what motivates Danish owners of single-family houses the most to start energy upgrading, and that improved indoor climate is also an important factor. After the upgrading, homeowners experience both improved economy and indoor climate. In a strategy...... to increase the number of homeowners who venture into a major energy upgrading of their house, the demonstrated positive side effects, more than energy savings, should be included in the communication to motivate homeowners. The barriers should be reduced by “taking the homeowners by the hand” and helping...... them to choose relevant energy-saving solutions as well as clarifying the financial consequences and opportunities....

  7. A review of the epidemiological methods used to investigate the health impacts of air pollution around major industrial areas.

    Science.gov (United States)

    Pascal, Mathilde; Pascal, Laurence; Bidondo, Marie-Laure; Cochet, Amandine; Sarter, Hélène; Stempfelet, Morgane; Wagner, Vérène

    2013-01-01

    We performed a literature review to investigate how epidemiological studies have been used to assess the health consequences of living in the vicinity of industries. 77 papers on the chronic effects of air pollution around major industrial areas were reviewed. Major health themes were cancers (27 studies), morbidity (25 studies), mortality (7 studies), and birth outcome (7 studies). Only 3 studies investigated mental health. While studies were available from many different countries, a majority of papers came from the United Kingdom, Italy, and Spain. Several studies were motivated by concerns from the population or by previous observations of an overincidence of cases. Geographical ecological designs were largely used for studying cancer and mortality, including statistical designs to quantify a relationship between health indicators and exposure. Morbidity was frequently investigated through cross-sectional surveys on the respiratory health of children. Few multicenter studies were performed. In a majority of papers, exposed areas were defined based on the distance to the industry and were located from 20 km from the plants. Improving the exposure assessment would be an asset to future studies. Criteria to include industries in multicenter studies should be defined.

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

    Science.gov (United States)

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

    2018-02-01

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

  9. Engineering, maintenance, and initiatives to improve LAMPF beam availability and system reliability

    International Nuclear Information System (INIS)

    Harris, H.W.; DeHaven, R.A.; Hart, V.E.; Parsons, W.M.; Sturrock, J.C.

    1992-01-01

    Two different requirements are driving engineering studies and hardware development to improve LAMPF. The first is concerned with component and system improvements to increase beam availability during the LAMPF production cycle. Hardware changes in RF, power supplies, and magnets are being implemented to increase mean time between failure and reduce time to replace or repair failed units. A joint LAMPF-Industry project is on-going to improve reliability of RF components. A component test stand is being refurbished to include significant development capability. The second approach includes several changes that will increase the duty factor of the existing accelerator. Major changes are being evaluated for replacing the front end of the accelerator. Other changes improving the high brightness capability could result in a new performance plateau for LAMPF. 2 refs., 2 figs

  10. Applying the model of Goal-Directed Behavior, including descriptive norms, to physical activity intentions: A contribution to improving the Theory of Planned Behavior

    Science.gov (United States)

    The theory of planned behavior (TPB) has received its fair share of criticism lately, including calls for it to retire. We contributed to improving the theory by testing extensions such as the model of goal-directed behavior (MGDB, which adds desire and anticipated positive and negative emotions) ap...

  11. Engineering, maintenance, and new initiatives to improve LAMPF beam availability and system reliability

    International Nuclear Information System (INIS)

    Harris, H.W.; DeHaven, R.A.; Hart, V.E.; Parsons, W.M.; Sturrock, J.C.

    1992-01-01

    Two different requirements are driving engineering studies and hardware development to improve LAMPF. The first is concerned with component and system improvements to increase beam availability during the LAMPF production cycle. Hardware changes in RF, power supplies, and magnets are being implemented to increase mean time between failure and reduce time to replace or repair failed units. A joint LAMPF-Industry project is on-going to improve reliability of RF components. A component test stand is being refurbished to include significant development capability. The second approach includes several changes that will increase the duty factor of the existing accelerator. Major changes are being evaluated for replacing the front end of the accelerator. Other changes improving high brightness capability could result in a new performance plateau for LAMPF

  12. Major multinational food and beverage companies and informal sector contributions to global food consumption: implications for nutrition policy

    OpenAIRE

    Yach Derek; Alexander Eleanore; Mensah George A

    2011-01-01

    Abstract Background In recent years, 10 major multinational food and beverage companies have worked together within the International Food and Beverage Alliance (IFBA) to increase their commitments to public health. Current IFBA commitments include initiatives to improve the nutrition quality of products and how these products are advertised to children. The impact and magnitude of IFBA member contributions to the total market share of packaged foods and beverages consumed remain incompletely...

  13. Improvement of basic food crops in Africa through plant breeding, including the use of induced mutations. Proceedings of a final research co-ordination meeting

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-07-01

    The Co-ordinated Research Programme (CRP) on Improvement of Basic Food Crops in Africa Through Plant Breeding, Including the Use of Induced Mutations, funded by the Italian Government, was initiated in 1989 in the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture. The primary objective of this CRP was to breed improved varieties of stable food crops of Africa with the main emphasis on the indigenous species and their local cultivars. The fourth and final Research Co-ordination meeting under the CRP was held in Naples, Italy from 30 October - 3 November 1995. This publication includes the reports, conclusions and recommendations made by the participants. We hope that it will be of value to researchers, students and policy makers alike in their endeavour to promote plant breeding and increase food productions in Africa. Refs, figs, tabs.

  14. Improvement of basic food crops in Africa through plant breeding, including the use of induced mutations. Proceedings of a final research co-ordination meeting

    International Nuclear Information System (INIS)

    1997-07-01

    The Co-ordinated Research Programme (CRP) on Improvement of Basic Food Crops in Africa Through Plant Breeding, Including the Use of Induced Mutations, funded by the Italian Government, was initiated in 1989 in the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture. The primary objective of this CRP was to breed improved varieties of stable food crops of Africa with the main emphasis on the indigenous species and their local cultivars. The fourth and final Research Co-ordination meeting under the CRP was held in Naples, Italy from 30 October - 3 November 1995. This publication includes the reports, conclusions and recommendations made by the participants. We hope that it will be of value to researchers, students and policy makers alike in their endeavour to promote plant breeding and increase food productions in Africa. Refs, figs, tabs

  15. Starting an Actuarial Science Major at a Liberal Arts College

    Science.gov (United States)

    Mills, Mark A.

    2014-01-01

    The article provides details of the process of starting an actuarial science major at a small, liberal arts college. Some critique of the major is included, as well as some challenges that may be faced by others wanting to start such a major at their institution.

  16. Main modelling features of the ASTEC V2.1 major version

    International Nuclear Information System (INIS)

    Chatelard, P.; Belon, S.; Bosland, L.; Carénini, L.; Coindreau, O.; Cousin, F.; Marchetto, C.; Nowack, H.; Piar, L.; Chailan, L.

    2016-01-01

    Highlights: • Recent modelling improvements of the ASTEC European severe accident code are outlined. • Key new physical models now available in the ASTEC V2.1 major version are described. • ASTEC progress towards a multi-design reactor code is illustrated for BWR and PHWR. • ASTEC strong link with the on-going EC CESAM FP7 project is emphasized. • Main remaining modelling issues (on which IRSN efforts are now directing) are given. - Abstract: A new major version of the European severe accident integral code ASTEC, developed by IRSN with some GRS support, was delivered in November 2015 to the ASTEC worldwide community. Main modelling features of this V2.1 version are summarised in this paper. In particular, the in-vessel coupling technique between the reactor coolant system thermal-hydraulics module and the core degradation module has been strongly re-engineered to remove some well-known weaknesses of the former V2.0 series. The V2.1 version also includes new core degradation models specifically addressing BWR and PHWR reactor types, as well as several other physical modelling improvements, notably on reflooding of severely damaged cores, Zircaloy oxidation under air atmosphere, corium coolability during corium concrete interaction and source term evaluation. Moreover, this V2.1 version constitutes the back-bone of the CESAM FP7 project, which final objective is to further improve ASTEC for use in Severe Accident Management analysis of the Gen.II–III nuclear power plants presently under operation or foreseen in near future in Europe. As part of this European project, IRSN efforts to continuously improve both code numerical robustness and computing performances at plant scale as well as users’ tools are being intensified. Besides, ASTEC will continue capitalising the whole knowledge on severe accidents phenomenology by progressively keeping physical models at the state of the art through a regular feed-back from the interpretation of the current and

  17. Improved self-exclusion program: preliminary results.

    Science.gov (United States)

    Tremblay, Nicole; Boutin, Claude; Ladouceur, Robert

    2008-12-01

    The gambling industry has offered self-exclusion programs for quite a long time. Such measures are designed to limit access to gaming opportunities and provide problem gamblers with the help they need to cease or limit their gambling behaviour. However, few studies have empirically evaluated these programs. This study has three objectives: (1) to observe the participation in an improved self-exclusion program that includes an initial voluntary evaluation, phone support, and a mandatory meeting, (2) to evaluate satisfaction and usefulness of this service as perceived by self-excluders, (3) to measure the preliminary impact of this improved program. One hundred sixteen self-excluders completed a questionnaire about their satisfaction and their perception of the usefulness during the mandatory meeting. Among those participants, 39 attended an initial meeting. Comparisons between data collected at the initial meeting and data taken at the final meeting were made for those 39 participants. Data showed that gamblers chose the improved self-exclusion program 75% of the time; 25% preferred to sign a regular self-exclusion contract. Among those who chose the improved service, 40% wanted an initial voluntary evaluation and 37% of these individuals actually attended that meeting. Seventy percent of gamblers came to the mandatory meeting, which was a required condition to end their self-exclusion. The majority of participants were satisfied with the improved self-exclusion service and perceived it as useful. Major improvements were observed between the final and the initial evaluation on time and money spent, consequences of gambling, DSM-IV score, and psychological distress. The applicability of an improved self-exclusion program is discussed and, as shown in our study, the inclusion of a final mandatory meeting might not be so repulsive for self-excluders. Future research directives are also proposed.

  18. Accredited Health Department Partnerships to Improve Health: An Analysis of Community Health Assessments and Improvement Plans.

    Science.gov (United States)

    Kronstadt, Jessica; Chime, Chinecherem; Bhattacharya, Bulbul; Pettenati, Nicole

    The Public Health Accreditation Board (PHAB) Standards & Measures require the development and updating of collaborative community health assessments (CHAs) and community health improvement plans (CHIPs). The goal of this study was to analyze the CHAs and CHIPs of PHAB-accredited health departments to identify the types of partners engaged, as well as the objectives selected to measure progress toward improving community health. The study team extracted and coded data from documents from 158 CHA/CHIP processes submitted as part of the accreditation process. Extracted data included population size, health department type, data sources, and types of partner organizations. Health outcome objectives were categorized by Healthy People 2020 Leading Health Indicator (LHI), as well as by the 7 broad areas in the PHAB reaccreditation framework for population health outcomes reporting. Participants included health departments accredited between 2013 and 2016 that submitted CHAs and CHIPs to PHAB, including 138 CHAs/CHIPs from local health departments and 20 from state health departments. All the CHAs/CHIPs documented collaboration with a broad array of partners, with hospitals and health care cited most frequently (99.0%). Other common partners included nonprofit service organizations, education, business, and faith-based organizations. Small health departments more frequently listed many partner types, including law enforcement and education, compared with large health departments. The majority of documents (88.6%) explicitly reference Healthy People 2020 goals, with most addressing the LHIs nutrition/obesity/physical activity and access to health services. The most common broad areas from PHAB's reaccreditation framework were preventive health care and individual behavior. This study demonstrates the range of partners accredited health departments engage with to collaborate on improving their communities' health as well as the objectives used to measure community health

  19. Major KEEP Findings, 1971 - 1975.

    Science.gov (United States)

    Kamehameha Schools, Honolulu, HI. Kamehameha Early Education Project.

    This report lists the 34 major research findings from the Kamehameha Early Education Program (KEEP) for the years 1971-1975. Each finding is accompanied by a listing of KEEP technical reports and working papers which contain information relevant to that finding. Included among areas covered in the findings are: (1) student motivation, (2) teacher…

  20. Major plant retrofits at Monticello nuclear generating plant

    International Nuclear Information System (INIS)

    Larsen, D.E.; Hogg, C.B.

    1986-01-01

    For the past several years, Northern States Power (NSP) has been making major plant retrofits to Monticello Nuclear generating Station in order to improve plant availability and upgrade the plant components for the potential extension of the operating license (life extension). This paper discusses in detail three major retrofits that have been completed or in the process of completion; recirculation loop piping replacement, reactor pressure vessel (RPV) water level-instrumentation modification, core spray piping replacement, the authors will address the scope of work, design and installation concerns, and life extension considerations during the design and procurement process for these three projects

  1. Assessing Microplastic Loads in the Mississippi River and Its Major Tributaries

    Science.gov (United States)

    Hasenmueller, E. A.; Martin, K. M.; Conkle, J. L.; White, J. R.

    2017-12-01

    Plastic debris is ubiquitous in marine environments and can cause significant harm to aquatic life when organisms become entangled in the plastic or mistake it for food. Macroplastic debris (plastic >5 mm in diameter) has received significant attention from the public, government agencies, and the scientific community. However, the majority of plastics in aquatic environments are microplastics (plastic Administration (NOAA) Marine Debris Program, has quantified and characterized microplastics (i.e., size, shape, and resin type) at the surface and at depth along the mainstem of the Mississippi River, including near major cities such as St. Louis and New Orleans, as well as in some of the Mississippi River's major tributaries (i.e., the Missouri River, Ohio River, and Illinois River). Sampling is ongoing, but our datasets will allow us to characterize: 1) total microplastic concentrations and loads, 2) spatial and temporal trends in microplastic abundances, and 3) land-use effects on microplastic levels across the Mississippi River watershed. Our data will also provide estimates of the total discharge of microplastics from the Mississippi River to the Gulf of Mexico. These efforts will provide a baseline for future research relating to the fate and effects of microplastics in aquatic environments and can guide federal and local policy makers in creating and assessing mitigation strategies to improve water quality.

  2. Drug delivery device including electrolytic pump

    KAUST Repository

    Foulds, Ian G.; Buttner, Ulrich; Yi, Ying

    2016-01-01

    Systems and methods are provided for a drug delivery device and use of the device for drug delivery. In various aspects, the drug delivery device combines a “solid drug in reservoir” (SDR) system with an electrolytic pump. In various aspects an improved electrolytic pump is provided including, in particular, an improved electrolytic pump for use with a drug delivery device, for example an implantable drug delivery device. A catalytic reformer can be incorporated in a periodically pulsed electrolytic pump to provide stable pumping performance and reduced actuation cycle.

  3. Drug delivery device including electrolytic pump

    KAUST Repository

    Foulds, Ian G.

    2016-03-31

    Systems and methods are provided for a drug delivery device and use of the device for drug delivery. In various aspects, the drug delivery device combines a “solid drug in reservoir” (SDR) system with an electrolytic pump. In various aspects an improved electrolytic pump is provided including, in particular, an improved electrolytic pump for use with a drug delivery device, for example an implantable drug delivery device. A catalytic reformer can be incorporated in a periodically pulsed electrolytic pump to provide stable pumping performance and reduced actuation cycle.

  4. On improvement in ejection fraction with iron chelation in thalassemia major and the risk of future heart failure

    Directory of Open Access Journals (Sweden)

    Carpenter JP

    2011-09-01

    Full Text Available Abstract Background Trials of iron chelator regimens have increased the treatment options for cardiac siderosis in beta-thalassemia major (TM patients. Treatment effects with improved left ventricular (LV ejection fraction (EF have been observed in patients without overt heart failure, but it is unclear whether these changes are clinically meaningful. Methods This retrospective study of a UK database of TM patients modelled the change in EF between serial scans measured by cardiovascular magnetic resonance (CMR to the relative risk (RR of future development of heart failure over 1 year. Patients were divided into 2 strata by baseline LVEF of 56-62% (below normal for TM and 63-70% (lower half of the normal range for TM. Results A total of 315 patients with 754 CMR scans were analyzed. A 1% absolute increase in EF from baseline was associated with a statistically significant reduction in the risk of future development of heart failure for both the lower EF stratum (EF 56-62%, RR 0.818, p Conclusion These data show that during treatment with iron chelators for cardiac siderosis, small increases in LVEF in TM patients are associated with a significantly reduced risk of the development of heart failure. Thus the iron chelator induced improvements in LVEF of 2.6% to 3.1% that have been observed in randomized controlled trials, are associated with risk reductions of 25.5% to 46.4% for the development of heart failure over 12 months, which is clinically meaningful. In cardiac iron overload, heart mitochondrial dysfunction and its relief by iron chelation may underlie the changes in LV function.

  5. Performance profiles of major energy producers 1994

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-02-01

    Performance Profiles of Major Energy Producers 1994 is the eighteenth annual report of the Energy Information Administration`s (EIA) Financial Reporting System (FRS). The report examines financial and operating developments in energy markets, with particular reference to the 24 major U.S. energy companies required to report annually on Form EIA-28. Financial information is reported by major lines of business, including oil and gas production, petroleum refining and marketing, other energy operations, and nonenergy businesses. Financial and operating results are presented in the context of energy market developments with a view toward identifying changing corporate strategies and measuring the performance of ongoing operations both in the United States and abroad.

  6. Improved Sleep in Military Personnel is Associated with Changes in the Expression of Inflammatory Genes and Improvement in Depression Symptoms

    Directory of Open Access Journals (Sweden)

    Whitney S. Livingston

    2015-04-01

    Full Text Available Study Objectives: Sleep disturbances are common in military personnel and are associated with increased risk for psychiatric morbidity, including posttraumatic stress disorder and depression, as well as inflammation. Improved sleep quality is linked to reductions in inflammatory bio-markers; however, the underlying mechanisms remain elusive. Methods: In this study we examine whole genome expression changes related to improved sleep in 68 military personnel diagnosed with insomnia. Subjects were classified into the following groups and then compared: improved sleep (n=46, or non-improved sleep (n=22 following three months of standard of care treatment for insomnia. Within subject differential expression was determined from microarray data using the Partek Genomics Suite analysis program and the interactive pathway analysis was used to determine key regulators of observed expression changes. Changes in symptoms of depression and posttraumatic stress disorder were also compared. Results: At baseline both groups were similar in demographics, clinical characteristics, and gene-expression profiles. The microarray data revealed that 217 coding genes were differentially expressed at the follow-up-period compared to baseline in the participants with improved sleep. Expression of inflammatory cytokines were reduced including IL-1β, IL-6, IL-8 and IL-13, with fold changes ranging from -3.19 to -2.1, and there were increases in the expression of inflammatory regulatory genes including toll-like receptors 1, 4, 7, and 8 in the improved sleep group. Interactive pathway analysis revealed 6 gene networks, including ubiquitin which was a major regulator in these gene-expression changes. The improved sleep group also had a significant reduction in the severity of depressive symptoms.Conclusions: Interventions that restore sleep likely reduce the expression of inflammatory genes, which relate to ubiquitin genes and relate to reductions in depressive symptoms.

  7. Still making progress to improve the hospital workplace environment? Results from the 2008 National Survey of Registered Nurses.

    Science.gov (United States)

    Buerhaus, Peter I; DesRoches, Catherine; Donelan, Karen; Hess, Robert

    2009-01-01

    Despite the majority of RNs perceiving a shortage of nurses, findings from the 2008 National Survey of RNs indicate the hospital workplace improved in several areas compared to a 2006 survey. Improvements included the time RNs spend with patients, quality of nursing care, and a decreasing impact of the shortage on delaying nurses' responses to pages or calls, staff communication, patients' wait time for surgery, and timeliness and efficiency of care. Areas the environment was perceived to have worsened included overtime hours, sexual harassment/hostile, and physical violence. RNs hold mixed views about the consequences of reporting errors and mistakes with a majority agreeing that reporting them had led to positive changes to prevent future errors, but that mistakes were held against them. Overall, results suggest that hospital managers can be reassured that their efforts to improve the workplace environment are having their intended effect but, at the same time, important areas for improvement remain.

  8. Increased transmission potential of Leishmania major/Leishmania infantum hybrids

    OpenAIRE

    Volf, Petr; Benkova, Ivana; Myskova, Jitka; Sadlova, Jovana; Campino, Lenea; Ravel, Christophe

    2007-01-01

    Development of Leishmania infantum/Leishmania major hybrids was studied in two sand fly species. In Phlebotomus papatasi, which supported development of L. major but not L. infantum, the hybrids produced heavy late-stage infections with high numbers of metacyclic promastigotes. In the permissive vector Lutzomyia longipalpis, all Leishmania strains included in this study developed well. Hybrids were found to express L. major lipophosphoglycan, apparently enabling them to survive in P. papatasi...

  9. The petroleum industry improving the bottom line

    International Nuclear Information System (INIS)

    Benner, R.I.

    1992-01-01

    The oil and gas exploration and production business environment has presented many challenges over the last decade, notably price volatility and rising costs. Managing the margin and changing a company's cost structure to improve the bottom line is a major issue with company executives. The experiences of Oryx Energy Company since its spinoff from Sun Company in 1988 are used as an example of a company makeover. A generalized exploration and production income statement is employed to present industry cost/portfolio relationships and strategies for improving the bottom line. At Oryx, three major strategies were set in place to enhance shareholder value: an increased emphasis on applied technology, including horizontal drilling, advanced 3-dimensional seismic prospecting, and intensive use of interactive computer workstations; international expansion; and an emphasis on the U.S. Gulf of Mexico, deemphasizing the onshore U.S. and the gas processing business. Specific strategies are outlined in the areas of increasing revenues, reducing production cost and exploration expense, and controlling general and administrative expenses. 8 refs., 18 figs., 2 tabs

  10. Improving trauma imaging in Wales through Kotter's theory of change

    International Nuclear Information System (INIS)

    Maclean, D.F.W.; Vannet, N.

    2016-01-01

    Aim: To improve the practice of trauma computed tomography (CT) within Wales using recognised leadership techniques for change. Materials and methods: Royal College of Radiologists' (RCR) guidance, in addition to other key recent evidence, were used to form an aspirational standard. All centres across Wales with a major emergency department were included. Kotter's theory of change was utilised to facilitate an improvement in practice across the region, with larger units prioritised initially. Results: Of the 13 major emergency units in Wales, eight centres had no formal trauma CT protocol. Only one centre utilised the Bastion protocol (in comparison to 75% of major trauma centres). After the campaign to improve trauma imaging, seven centres now offer the Bastion protocol, with currently only three peripheral centres still without a procedure for whole-body CT. The two largest centres have implemented an emergency department pro forma. Conclusion: Trauma CT within Wales has significantly improved as a result of this project. Kotter's theory is demonstrated as an effective tool for facilitating a change in practice on a regional/national scale. - Highlights: • The practice of Trauma CT in Wales initially did not meet RCR guidance. • Kotter's theory of change was utilised to improve standards. • A superior quality of trauma imaging is now available across Wales.

  11. THE COMPATIBILITY STUDENT CHOICE OF UNIVERSITY MAJORING; A PRELIMINARY STUDIES

    Directory of Open Access Journals (Sweden)

    Daharnis Daharnis

    2016-06-01

    Full Text Available The continuous improvements in order to optimize the basic education to higher education are still running. Based on that purpose, there are many factors to supporting the students' learning activities success; one of the factors is suitability with majors in university. The purpose of this study is to reveal the condition of the compatibility of students majoring with their interest, then to describe the information when the student choose their majoring. Samples in this study were 122 peoples, taken by random sampling from the Padang State University. Data obtained by distributing questionnaires. The results showed that there are students that their major do not match with their interest (22.13%, only 3.28% of students who feel compatible with their major. This result should be a major concern, particularly for counselor in schools for design counseling services to solve these problems. The result of this study used as a grand tour or a preliminary study for further research.

  12. Improved methods for irrigation and planting of major crops in waterlogged areas

    International Nuclear Information System (INIS)

    Kahlown, M.A.; Iqbal, M.; Raoof, A.

    2002-01-01

    The improved irrigation methods for wheat and cotton were evaluated in the fordwah Eastern Sadigia (South) Irrigation and Drainage Project area, during 1996-97 and 1997-98 cropping seasons, under three water table depths. Irrigation methods for wheat included 70, 95 and 120 cm Beds, with Flat Basin, as a check for comparative evaluation. Cotton had Ridge-planting on the top and side, Bed and Furrow, and Flat Basin as control. These irrigation methods were compared at water table depths of < 1 m, 1-2 and 2-3 m. The wheat variety inqalab-91, and cotton cultivar, CIM-109, were planted during the 3rd week of November and May every year. All the inputs and management practices, such as seed-rate, fertilizer, seeding method, weed control, plant-protection measures, etc. were kept common. The results on cotton indicated maximum water-use efficiency with the Bed and Furrow Method of irrigation Followed by ridge planting. The traditional Flat-planting had the lowest yield and the highest water-consumption, resulting in the minimum water-use efficiency. In harmony with cotton, the Flat Method of planting had maximum water-consumption. For wheat crop, the water-use efficiency was in descending order, with 120, 95 and 70 cm for Bed and Flat Methods. Bed planting of 95 cm had a fairly high water-use efficiency and yields were more were more comparable than Flat planting. This method had a high level of adaptabilities, especially when the groundwater was close to the root-zone and higher possibilities, especially when the groundwater was close to the root-zone and higher possibility of crop-submergence are existent during rainy spells. The results of the investigation strongly favoured the Bed and furrow methods to irrigate cotton and wheat. However, under well-drained soil conditions, Bed planting of wheat is not recommended. (author)

  13. Successful implementation of inquiry-based physiology laboratories in undergraduate major and nonmajor courses.

    Science.gov (United States)

    Casotti, G; Rieser-Danner, L; Knabb, M T

    2008-12-01

    Recent evidence has demonstrated that inquiry-based physiology laboratories improve students' critical- and analytical-thinking skills. We implemented inquiry-based learning into three physiology courses: Comparative Vertebrate Physiology (majors), Human Physiology (majors), and Human Anatomy and Physiology (nonmajors). The aims of our curricular modifications were to improve the teaching of physiological concepts, teach students the scientific approach, and promote creative and critical thinking. We assessed our modifications using formative (laboratory exams, oral presentations, and laboratory reports) and summative evaluations (surveys, laboratory notebook, and an end of semester project). Students appreciated the freedom offered by the new curriculum and the opportunity to engage in the inquiry process. Results from both forms of evaluation showed a marked improvement due to the curricular revisions. Our analyses indicate an increased confidence in students' ability to formulate questions and hypotheses, design experiments, collect and analyze data, and make conclusions. Thus, we have successfully incorporated inquiry-based laboratories in both major and nonmajor courses.

  14. Surgical management of giant sphenoid wing meningiomas encasing major cerebral arteries.

    Science.gov (United States)

    Champagne, Pierre-Olivier; Lemoine, Emile; Bojanowski, Michel W

    2018-04-01

    OBJECTIVE Sphenoid wing meningiomas are a heterogeneous group of tumors with variable surgical risks and prognosis. Those that have grown to a very large size, encasing the major cerebral arteries, are associated with a high risk of stroke. In reviewing the authors' series of giant sphenoid wing meningiomas, the goal was to evaluate how the extent of the tumor's invasion of surrounding structures affected the ability to safely remove the tumor and restore function. METHODS The authors conducted a retrospective study of a series of giant sphenoid wing meningiomas operated on between 1996 and 2016. Inclusion criteria were meningiomas with a globoid component ≥ 6 cm, encasing at least 1 major intradural cerebral artery. Extent of resection was measured according to Simpson grade. RESULTS This series included 12 patients, with a mean age of 59 years. Visual symptoms were the most common clinical presentation. There was complete or partial encasement of all 3 major cerebral arteries except for 3 cases in which only the anterior cerebral artery was not involved. The lateral wall of the cavernous sinus was invaded in 8 cases (67%) and the optic canal in 6 (50%). Complete resection was achieved in 2 cases (Simpson grades 2 and 3). In the remaining 10 cases of partial resection (Simpson grade 4), radical removal (> 90%) was achieved in 7 cases (70%). In the immediate postoperative period, there were no deaths. Four of 9 patients with visual deficits improved, while the 5 others remained unchanged. Two patients experienced transient neurological deficits. Other than an asymptomatic lacuna of the internal capsule, there were no ischemic lesions following surgery. Tumor recurrence occurred in 5 patients, between 24 and 168 months (mean 61 months) following surgery. CONCLUSIONS Although these giant lesions encasing major cerebral arteries are particularly treacherous for surgery, this series demonstrates that it is possible to safely achieve radical removal and at times even

  15. Sharing reference data and including cows in the reference population improve genomic predictions in Danish Jersey.

    Science.gov (United States)

    Su, G; Ma, P; Nielsen, U S; Aamand, G P; Wiggans, G; Guldbrandtsen, B; Lund, M S

    2016-06-01

    Small reference populations limit the accuracy of genomic prediction in numerically small breeds, such like Danish Jersey. The objective of this study was to investigate two approaches to improve genomic prediction by increasing size of reference population in Danish Jersey. The first approach was to include North American Jersey bulls in Danish Jersey reference population. The second was to genotype cows and use them as reference animals. The validation of genomic prediction was carried out on bulls and cows, respectively. In validation on bulls, about 300 Danish bulls (depending on traits) born in 2005 and later were used as validation data, and the reference populations were: (1) about 1050 Danish bulls, (2) about 1050 Danish bulls and about 1150 US bulls. In validation on cows, about 3000 Danish cows from 87 young half-sib families were used as validation data, and the reference populations were: (1) about 1250 Danish bulls, (2) about 1250 Danish bulls and about 1150 US bulls, (3) about 1250 Danish bulls and about 4800 cows, (4) about 1250 Danish bulls, 1150 US bulls and 4800 Danish cows. Genomic best linear unbiased prediction model was used to predict breeding values. De-regressed proofs were used as response variables. In the validation on bulls for eight traits, the joint DK-US bull reference population led to higher reliability of genomic prediction than the DK bull reference population for six traits, but not for fertility and longevity. Averaged over the eight traits, the gain was 3 percentage points. In the validation on cows for six traits (fertility and longevity were not available), the gain from inclusion of US bull in reference population was 6.6 percentage points in average over the six traits, and the gain from inclusion of cows was 8.2 percentage points. However, the gains from cows and US bulls were not accumulative. The total gain of including both US bulls and Danish cows was 10.5 percentage points. The results indicate that sharing reference

  16. Thalassaemia major and the heart

    Directory of Open Access Journals (Sweden)

    J. Malcolm Walker

    2013-03-01

    Full Text Available Disorders of haemoglobin synthesis are the commonest monogenetic disorders worldwide. When first described, thalassaemia was universally fatal in childhood, but after the adoption of regular blood transfusion survival until early teenage and adulthood was to be expected. At that stage in the life of these affected individuals organ failure followed, due to accumulated iron, for which the human has no excretory capacity. Principal amongst the tissues affected by iron overload is the heart and even to the present day, heart disease accounts for the overwhelming majority of premature deaths in this population. Managing transfusion derived iron overload was the next hurdle for clinicians and the families of the patients. For nearly four decades the only available treatment was the demanding regime of parenteral chelation therapy, required on a daily basis, to achieve growth, development and survival with limited or no organ damage. Despite the adoption of these treatment strategies the outlook for thalassaemia patients remained poor, with a 30% to 40% mortality occurring between late teenage and 30 years of age, even in well organised health care systems, such as in the UK, where regular transfusion and desferioxamine treatment were readily available. This dreadful early mortality, largely as a consequence of myocardial iron overload, (1,2 is now improving so that in the UK and other developed nations, heart failure in thalassaemic patients has become uncommon and premature death a much rarer tragedy. This editorial reviews, from a personal viewpoint of a cardiologist involved in the care of these patients for the last 20 years, the progress in the management of the cardiovascular complications of thalassaemia major (TM, which has followed better techniques of identifying those thalassaemic individuals at greatest risk, improved chelation strategies making best use of the three chelating agents that are now available and improved co

  17. Continuous improvement of the BNFL transport integrated management system

    International Nuclear Information System (INIS)

    Hale, J.A.

    1998-01-01

    The integrated Management System of BNFL Transport and Pacific Nuclear Transport Limited (PNTL) is subject to continuous improvement by the application of established improvement techniques adopted by BNFL. The technique currently being used is the application of a Total Quality Management (TQM) philosophy, involving the identification of key processes, benchmarking against existing measures, initiating various improvement projects and applying process changes within the Company. The measurement technique being used is based upon the European Foundation for Quality Management Model (EFQM). A major initiative was started in 1996 to include the requirements of the Environmental Management Systems standard ISO 14001 within the existing integrated management system. This resulted in additional activities added to the system, modification to some existing activities and additional training for personnel. The system was audited by a third party certification organisation, Lloyds Register Quality Assurance (LRQA), during 1997. This paper describes the arrangements to review and update the integrated management system of BNFL Transport and PNTL to include the requirements of the environmental standard ISO 14001 and it also discusses the continuous improvement process adopted by BNFL Transport. (authors)

  18. Proximal major limb amputations – a retrospective analysis of 45 oncological cases

    Directory of Open Access Journals (Sweden)

    Goertz Ole

    2009-02-01

    Full Text Available Abstract Background Proximal major limb amputations due to malignant tumors have become rare but are still a valuable treatment option in palliation and in some cases can even cure. The aim of this retrospective study was to analyse outcome in those patients, including the postoperative course, survival, pain, quality of life, and prosthesis usage. Methods Data of 45 consecutive patients was acquired from patient's charts and contact to patients, and general practitioners. Patients with interscapulothoracic amputation (n = 14, shoulder disarticulation (n = 13, hemipelvectomy (n = 3 or hip disarticulation (n = 15 were included. Results The rate of proximal major limb amputations in patients treated for sarcoma was 2.3% (37 out of 1597. Survival for all patients was 42.9% after one year and 12.7% after five years. Survival was significantly better in patients with complete tumor resections. Postoperative chemotherapy and radiation did not prolong survival. Eighteen percent of the patients with malignant disease developed local recurrence. In 44%, postoperative complications were observed. Different modalities of postoperative pain management and the site of the amputation had no significant influence on long-term pain assessment and quality of life. Eighty-seven percent suffered from phantom pain, 15.6% considered their quality of life worse than before the operation. Thirty-two percent of the patients who received a prosthesis used it regularly. Conclusion Proximal major limb amputations severely interfere with patients' body function and are the last, albeit valuable, option within the treatment concept of extremity malignancies or severe infections. Besides short survival, high complication rates, and postoperative pain, patients' quality of life can be improved for the time they have remaining.

  19. Applications of process improvement techniques to improve workflow in abdominal imaging.

    Science.gov (United States)

    Tamm, Eric Peter

    2016-03-01

    Major changes in the management and funding of healthcare are underway that will markedly change the way radiology studies will be reimbursed. The result will be the need to deliver radiology services in a highly efficient manner while maintaining quality. The science of process improvement provides a practical approach to improve the processes utilized in radiology. This article will address in a step-by-step manner how to implement process improvement techniques to improve workflow in abdominal imaging.

  20. Interventions to improve water quality for preventing diarrhoea

    OpenAIRE

    Clasen, Thomas F; Alexander, Kelly T; Sinclair, David; Boisson, Sophie; Peletz, Rachel; Chang, Howard H; Majorin, Fiona; Cairncross, Sandy

    2015-01-01

    Background Diarrhoea is a major cause of death and disease, especially among young children in low-income countries. In these settings, many infectious agents associated with diarrhoea are spread through water contaminated with faeces. In remote and low-income settings, source-based water quality improvement includes providing protected groundwater (springs, wells, and bore holes), or harvested rainwater as an alternative to surface sources (rivers and lakes). Point-of-use water quality impro...

  1. Differential effects of atomic bomb irradiation in inducing major leukemia types

    International Nuclear Information System (INIS)

    Tomonaga, Masao; Matsuo, Tatsuki; Carter, R.L.

    1993-05-01

    In this report we utilize data from the additional 517 cases from the leukemia registry together with the Life Span Study (LSS) cohort data to study the effects of atomic bomb irradiation on major leukemia types. The French-American-British classification and other improved diagnostic methods were used to reclassify cases into 21 categories, including new disease entities such as adult T-cell leukemia (ATL). These categories were then grouped into four major types for analysis: (1) acute lymphocytic leukemia (ALL), (2) acute myeloid leukemia (AML) including myelodysplastic syndromes (MDS), (3) chronic myeloid leukemia (CML), and (4) OTHER types including ATL. Analyses of radiation effects were based on the updated Dosimetry System 1986(DS86). Incidence rates of all four leukemia types increased with increasing exposure level. The effects of radiation were significantly greater on the incidence of ALL and CML than on that of AML and OTHER. In the two lowest dose categories (1-49 and 50-499 mGy), estimated incidence either remained constant or increased slightly as the population of survivors aged. In the two highest dose categories (500-1,499 and ≥ 1,500 mGy). Among unexposed persons, the estimated risk of CML in Nagasaki relative to Hiroshima was significantly less than that of AML, whereas that of OTHER types was significantly greater. The time to onset of ALL, AML, and CML declined with increasing dose. The rate of decline, however, was greater for ALL and CML than for AML. The resulting differences at high doses reflect shorter incubation times for atomic-bomb-induced ALL and CML than for AML. (J.P.N.)

  2. Ten years of major equestrian injury: are we addressing functional outcomes?

    Science.gov (United States)

    Ball, Jill E; Ball, Chad G; Mulloy, Robert H; Datta, Indraneel; Kirkpatrick, Andrew W

    2009-02-19

    Horseback riding is considered more dangerous than motorcycle riding, skiing, automobile racing, football and rugby. The integral role of rehabilitation therapy in the recovery of patients who have sustained a major horse-related injury is previously not described. The goals of this paper were to (1) define the incidence and pattern of severe equestrian trauma, (2) identify the current level of in-patient rehabilitation services, (3) describe functional outcomes for patients, and (4) discuss methods for increasing rehabilitation therapy in this unique population. A retrospective review of the trauma registry at a level 1 center (1995-2005) was completed in conjunction with a patient survey outlining formal in-hospital therapy. Forty-nine percent of patients underwent in-patient rehabilitation therapy. Injuries predictive of receiving therapy included musculoskeletal and spinal cord trauma. Previous injury while horseback riding was predictive of not receiving therapy. The majority (55%) of respondents had chronic physical difficulties following their accident. Rehabilitation therapy is significantly underutilized following severe equestrian trauma. Increased therapy services should target patients with brain, neck and skull injuries. Improvements in the initial provision, and follow-up of rehabilitation therapy could enhance functional outcomes in the treatment resistant Western equestrian population.

  3. Performance profiles of major energy producers 1992

    Energy Technology Data Exchange (ETDEWEB)

    1994-01-13

    Performance Profiles of Major Energy Producers 1992 is the sixteenth annual report of the Energy Information Administration`s (EIA) Financial Reporting System (FRS). The report examines financial and operating developments, with particular reference to the 25 major energy companies (the FRS companies) required to report annually on Form EIA-28. Financial information is reported by major lines of business, including oil and gas production, petroleum refining and marketing, and other energy operations. Domestic and international operations are examined separately in this report. The data are presented in the context of key energy market developments with a view toward identifying changing strategies of corporate development and measuring the apparent success of current ongoing operations.

  4. Performance profiles of major energy producers 1992

    International Nuclear Information System (INIS)

    1994-01-01

    Performance Profiles of Major Energy Producers 1992 is the sixteenth annual report of the Energy Information Administration's (EIA) Financial Reporting System (FRS). The report examines financial and operating developments, with particular reference to the 25 major energy companies (the FRS companies) required to report annually on Form EIA-28. Financial information is reported by major lines of business, including oil and gas production, petroleum refining and marketing, and other energy operations. Domestic and international operations are examined separately in this report. The data are presented in the context of key energy market developments with a view toward identifying changing strategies of corporate development and measuring the apparent success of current ongoing operations

  5. Major advances in applied dairy cattle nutrition.

    Science.gov (United States)

    Eastridge, M L

    2006-04-01

    Milk yield per cow continues to increase with a slower rate of increase in dry matter intake; thus, efficiency of ruminal fermentation and digestibility of the dietary components are key factors in improving the efficiency of feed use. Over the past 25 yr, at least 2,567 articles relating to ruminant or dairy nutrition have been published in the Journal of Dairy Science. These studies have provided important advancements in improving feed efficiency and animal health by improving quality of feeds, increasing feedstuff and overall diet digestibility, better defining interactions among feedstuffs in diets, identifying alternative feed ingredients, better defining nutrient requirements, and improving efficiency of ruminal fermentation. The publications are vital in continuing to make advancements in providing adequate nutrition to dairy cattle and for facilitating exchange of knowledge among scientists. Forages have been studied more extensively than any other type of feed. Cereal grains continue to be the primary contributors of starch to diets, and thus are very important in meeting the energy needs of dairy cattle. Processing of cereal grains has improved their use. Feeding by-products contributes valuable nutrients to diets and allows feedstuffs to be used that would otherwise be handled as wastes in landfills. Many of these by-products provide a considerable amount of protein, nonforage fiber, fat, and minerals (sometimes a detriment as in the case of P) to diets. The primary feeding system today is the total mixed ration, with still considerable use of the pasture system. Major improvements have occurred in the use of protein, carbohydrates, and fats in diets. Although advancements have been made in feeding practices to minimize the risk of metabolic diseases, the periparturient period continues to present some of the greatest challenges in animal health. Computers are a must today for diet formulation and evaluation, but fewer software programs are developed by

  6. Recruitment Strategies for Geoscience Majors: Conceptual Framework and Practical Suggestions

    Science.gov (United States)

    Richardson, R. M.; Eyles, C.; Ormand, C. J.

    2009-12-01

    One characteristic of strong geoscience departments is that they recruit and retain quality students. In a survey to over 900 geoscience departments in the US and Canada several years ago nearly 90% of respondents indicated that recruiting and retaining students was important. Two years ago we offered a pre-GSA workshop on recruiting and retaining students that attracted over 30 participants from over 20 different institutions, from liberal arts colleges to state universities to research intensive universities. Since then we have sought additional feedback from a presentation to the AGU Heads & Chairs at a Fall AGU meeting, and most recently from a workshop on strengthening geoscience programs in June 2009. In all of these settings, a number of themes and concrete strategies have emerged. Key themes included strategies internal to the department/institution; strategies that reach beyond the department/institution; determining how scalable/transferable strategies that work in one setting are to your own setting; identifying measures of success; and developing or improving on an existing action plan specific to your departmental/institutional setting. The full results of all of these efforts to distill best practices in recruiting students will be shared at the Fall AGU meeting, but some of the best practices for strategies local to the department/institution include: 1) focusing on introductory classes (having the faculty who are most successful in that setting teach them, having one faculty member make a common presentation to all classes about what one can do with a geoscience major, offering topical seminars, etc.); 2) informing students of career opportunities (inviting alumni back to talk to students, using AGI resources, etc.,); 3) creating common space for students to work, study, and be a community; 4) inviting all students earning an ‘A’ (or ‘B’) in introductory classes to a departmental event just for them; and 5) creating a field trip for incoming

  7. Improving patient safety in radiology: a work in progress

    International Nuclear Information System (INIS)

    Sze, Raymond W.

    2008-01-01

    The purpose of this paper is to share the experiences, including successes and failures, as well as the ongoing process of developing and implementing a safety program in a large pediatric radiology department. Building a multidisciplinary pediatric radiology safety team requires successful recruitment of team members, selection of a team leader, and proper and ongoing training and tools, and protected time. Challenges, including thorough examples, are presented on improving pediatric radiology safety intradepartmentally, interdepartmentally, and institutionally. Finally, some major challenges to improving safety in pediatric radiology, and healthcare in general, are presented along with strategies to overcome these challenges. Our safety program is a work in progress; this article is a personal account and the reader is asked for tolerance of its occasional subjective tone and contents. (orig.)

  8. The Choice of Comprehensive Reform Path of Business Administration Majors

    Directory of Open Access Journals (Sweden)

    Chen Yijun

    2015-01-01

    Full Text Available Looking back on the development history of business administration majors in colleges of China, the author conducts an analysis on the distribution of colleges offering business administration majors and market demands for these graduates, according to the results of market survey. It finds that there is a large gap between market’s requirements on business administration graduates and their real abilities. Based on the principle of system dynamics, it is necessary to construct a path choosing model of comprehensive reform of busness administration majors, emphasize normal and scientific research and prediction on employers’ requirements, explore advantages and characteristics of colleges, find the orientation professionally and accurately, define the objective of cultivating undergraduates of business administration majors, reform and optimize the talent training system of business administration majors, improve the structure of teachers team, integrate experimental and training resources in colleges, and cultivate students’ abilities in practice and employment.

  9. A Randomized Control Study on Psycho-Education Group on Improving Health-Related Quality of Life of Chinese Persons with Major Neurocognitive Disorder.

    Science.gov (United States)

    Young, Kim-Wan

    2016-01-01

    People with a major neurocognitive disorder (PwND) are found to have a lower health related quality of life (HRQoL) than those without neurocognitive disorder. This research study aims to evaluate the effectiveness of a psycho-education group in improving the HRQoL of Chinese PwND. By adopting randomized control trial (RCT), Chinese PwND were randomly assigned to either a 10-session psycho-education group or the control group. Family caregivers of treatment group were encouraged to take part in two sessions focusing on the caring and communication skills. Control group and their family caregivers received standardized educational materials on basic information on neurocognitive disorder for them to read at home. Standardized assessment was conducted both with PwND and their caregivers independently to give the self-rated and caregiver-rated HRQoL of PwND in the pre- and post- treatment periods by a research assistant who was blind to the group assignment of the participants. Moreover, qualitative interviews were also conducted for ten participants and five family caregivers of the treatment group to identify those group elements relating to its effectiveness. 2 × 2 repeated measures ANCOVA demonstrated that the treatment group (n = 32) was significantly more effective than the control group (n = 32) in improving the caregiver-rated HRQoL (F[1, 61] = 4.35, p = .04 psycho-education group significantly improves caregiver-rated HRQoL of PwND, supporting the feasibility and effectiveness of the psycho-education group.

  10. Design and practice of a comprehensively functional integrated management information system for major construction

    Science.gov (United States)

    Liu, Yuling; Wang, Xiaoping; Zhu, Yuhui; Fei, Lanlan

    2017-08-01

    This paper introduces a Comprehensively Functional Integrated Management Information System designed for the Optical Engineering Major by the College of Optical Science and Engineering, Zhejiang University, which combines the functions of teaching, students learning, educational assessment and management. The system consists of 5 modules, major overview, online curriculum, experiment teaching management, graduation project management and teaching quality feedback. The major overview module introduces the development history, training program, curriculums and experiment syllabus and teaching achievements of optical engineering major in Zhejiang University. The Management Information System is convenient for students to learn in a mobile and personalized way. The online curriculum module makes it very easy for teachers to setup a website for new curriculums. On the website, teachers can help students on their problems about the curriculums in time and collect their homework online. The experiment teaching management module and the graduation project management module enables the students to fulfill their experiment process and graduation thesis under the help of their supervisors. Before students take an experiment in the lab, they must pass the pre-experiment quiz on the corresponding module. After the experiment, students need to submit the experiment report to the web server. Moreover, the module contains experiment process video recordings, which are very helpful to improve the effect of the experiment education. The management of the entire process of a student's graduation program, including the project selection, mid-term inspection, progress report of every two weeks, final thesis, et al, is completed by the graduation project management module. The teaching quality feedback module is not only helpful for teachers to know whether the education effect of curriculum is good or not, but also helpful for the administrators of the college to know whether the

  11. Preoperative oral nutritional interventions in surgery, including arginine- and glutamine-enhanced supplements

    NARCIS (Netherlands)

    Brinkmann, S.J.H.; Buijs, N.; Luttikhold, J.; Mahdavian Delavary, B.; Niessen, F.B.; van Leeuwen, P.A.M.

    2013-01-01

    The patients' condition prior to surgery is of major importance for clinical outcome. It is believed nowadays that artificial nutrition in the form of a preoperative drink may improve postoperative outcome. Until now, a clear overview concerning the effects of preoperative supplementation on

  12. A Module-Based Environmental Science Course for Teaching Ecology to Non-Majors

    Science.gov (United States)

    Smith, Geoffrey R.

    2010-01-01

    Using module-based courses has been suggested to improve undergraduate science courses. A course based around a series of modules focused on major environmental issues might be an effective way to teach non-science majors about ecology and ecology's role in helping to solve environmental problems. I have used such a module-based environmental…

  13. Impact sound insulation improvement of wooden floors on concrete slabs

    DEFF Research Database (Denmark)

    Rasmussen, Birgit; Hoffmeyer, Dan; Hansen, Rói

    2014-01-01

    renovating housing. In Denmark, there are about 1 million dwellings in multi-storey housing. About half of the dwellings are built with timber floors, and the other half with wooden floors on concrete slabs, either in-situ cast or prefabricated hollow-core elements. In a project including mapping of sound......Improvement of impact sound insulation is one of the major challenges, when renovating housing. In Denmark, building regulations for impact sound in new-build were strengthened 5 dB in 2008, implying a main requirement L’n,w ≤ 53 dB between dwellings. The same value should also be a goal, when...... insulation in the Danish housing stock and investigation of improvement possibilities, a pilot laboratory study of wooden floors on concrete was carried out. The laboratory study included impact sound improvement measurements of full-scale samples (10 m2) fulfilling the conditions in EN ISO 10140...

  14. An improved multiple linear regression and data analysis computer program package

    Science.gov (United States)

    Sidik, S. M.

    1972-01-01

    NEWRAP, an improved version of a previous multiple linear regression program called RAPIER, CREDUC, and CRSPLT, allows for a complete regression analysis including cross plots of the independent and dependent variables, correlation coefficients, regression coefficients, analysis of variance tables, t-statistics and their probability levels, rejection of independent variables, plots of residuals against the independent and dependent variables, and a canonical reduction of quadratic response functions useful in optimum seeking experimentation. A major improvement over RAPIER is that all regression calculations are done in double precision arithmetic.

  15. Neuroimaging Mechanisms of Therapeutic Transcranial Magnetic Stimulation for Major Depressive Disorder.

    Science.gov (United States)

    Philip, Noah S; Barredo, Jennifer; Aiken, Emily; Carpenter, Linda L

    2018-03-01

    Research into therapeutic transcranial magnetic stimulation (TMS) for major depression has dramatically increased in the last decade. Understanding the mechanism of action of TMS is crucial to improve efficacy and develop the next generation of therapeutic stimulation. Early imaging research provided initial data supportive of widely held assumptions about hypothesized inhibitory or excitatory consequences of stimulation. Early work also indicated that while TMS modulated brain activity under the stimulation site, effects at deeper regions, in particular, the subgenual anterior cingulate cortex, were associated with clinical improvement. Concordant with earlier findings, functional connectivity studies also demonstrated that clinical improvements were related to changes distal, rather than proximal, to the site of stimulation. Moreover, recent work suggests that TMS modulates and potentially normalizes functional relationships between neural networks. An important observation that emerged from this review is that similar patterns of connectivity changes are observed across studies regardless of TMS parameters. Though promising, we stress that these imaging findings must be evaluated cautiously given the widespread reliance on modest sample sizes and little implementation of statistical validation. Additional limitations included use of imaging before and after a course of TMS, which provided little insight into changes that might occur during the weeks of stimulation. Furthermore, as studies to date have focused on depression, it is unclear whether our observations were related to mechanisms of action of TMS for depression or represented broader patterns of functional brain changes associated with clinical improvement. Published by Elsevier Inc.

  16. Importance of including small-scale tile drain discharge in the calibration of a coupled groundwater-surface water catchment model

    DEFF Research Database (Denmark)

    Hansen, Anne Lausten; Refsgaard, Jens Christian; Christensen, Britt Stenhøj Baun

    2013-01-01

    the catchment. In this study, a coupled groundwater-surface water model based on the MIKE SHE code was developed for the 4.7 km2 Lillebæk catchment in Denmark, where tile drain flow is a major contributor to the stream discharge. The catchment model was calibrated in several steps by incrementally including...... the observation data into the calibration to see the effect on model performance of including diverse data types, especially tile drain discharge. For the Lillebæk catchment, measurements of hydraulic head, daily stream discharge, and daily tile drain discharge from five small (1–4 ha) drainage areas exist....... The results showed that including tile drain data in the calibration of the catchment model improved its general performance for hydraulic heads and stream discharges. However, the model failed to correctly describe the local-scale dynamics of the tile drain discharges, and, furthermore, including the drain...

  17. The benefits of improved technologies in agricultural aviation. [economic impact and aircraft configurations

    Science.gov (United States)

    1978-01-01

    The economic benefits attributable to a variety of potential technological improvements in agricultural aviation are discussed. Topics covered include: the ag-air industry, the data base used to estimate the potential benefits and a summary of the potential benefits from technological improvements; ag-air activities in the United States; foreign ag-air activities; major ag-air aircraft is use and manufacturers' sales and distribution networks; and estimates of the benefits to the United States of proposed technological improvements to the aircraft and dispersal equipment. A bibliography of references is appended.

  18. Risk prediction of major complications in individuals with diabetes: the Atherosclerosis Risk in Communities Study.

    Science.gov (United States)

    Parrinello, C M; Matsushita, K; Woodward, M; Wagenknecht, L E; Coresh, J; Selvin, E

    2016-09-01

    To develop a prediction equation for 10-year risk of a combined endpoint (incident coronary heart disease, stroke, heart failure, chronic kidney disease, lower extremity hospitalizations) in people with diabetes, using demographic and clinical information, and a panel of traditional and non-traditional biomarkers. We included in the study 654 participants in the Atherosclerosis Risk in Communities (ARIC) study, a prospective cohort study, with diagnosed diabetes (visit 2; 1990-1992). Models included self-reported variables (Model 1), clinical measurements (Model 2), and glycated haemoglobin (Model 3). Model 4 tested the addition of 12 blood-based biomarkers. We compared models using prediction and discrimination statistics. Successive stages of model development improved risk prediction. The C-statistics (95% confidence intervals) of models 1, 2, and 3 were 0.667 (0.64, 0.70), 0.683 (0.65, 0.71), and 0.694 (0.66, 0.72), respectively (p < 0.05 for differences). The addition of three traditional and non-traditional biomarkers [β-2 microglobulin, creatinine-based estimated glomerular filtration rate (eGFR), and cystatin C-based eGFR] to Model 3 significantly improved discrimination (C-statistic = 0.716; p = 0.003) and accuracy of 10-year risk prediction for major complications in people with diabetes (midpoint percentiles of lowest and highest deciles of predicted risk changed from 18-68% to 12-87%). These biomarkers, particularly those of kidney filtration, may help distinguish between people at low versus high risk of long-term major complications. © 2016 John Wiley & Sons Ltd.

  19. The Gains from Improved Market Efficiency

    DEFF Research Database (Denmark)

    Persson, Karl Gunnar; Ejrnæs, Mette

    faster, violations of the law of one price become smaller and hence less persistent. There were also significant gains from improved market efficiency but that improvement took place after the information ‘regime’ shifted from pre-telegraphic communication to a regime with swift transmission...... of information in an era which developed a sophisticated commercial press and telegraphic communication. Improved market efficiency probably stimulated trade more than falling transport costs......This paper looks at the gains from improved market efficiency in long-distance grain trade in the second half of the 19th century when violations of the law of one price were reduced due to improved information transmission. Two markets, a major export centre, Chicago, and a major importer...

  20. Long-term odor recognition memory in unipolar major depression and Alzheimer׳s disease.

    Science.gov (United States)

    Naudin, Marine; Mondon, Karl; El-Hage, Wissam; Desmidt, Thomas; Jaafari, Nematollah; Belzung, Catherine; Gaillard, Philippe; Hommet, Caroline; Atanasova, Boriana

    2014-12-30

    Major depression and Alzheimer׳s disease (AD) are often observed in the elderly. The identification of specific markers for these diseases could improve their screening. The aim of this study was to investigate long-term odor recognition memory in depressed and AD patients, with a view to identifying olfactory markers of these diseases. We included 20 patients with unipolar major depressive episodes (MDE), 20 patients with mild to moderate AD and 24 healthy subjects. We investigated the cognitive profile and olfactory memory capacities (ability to recognize familiar and unfamiliar odors) of these subjects. Olfactory memory test results showed that AD and depressed patients were characterized by significantly less correct responses and more wrong responses than healthy controls. Detection index did not differ significantly between patients with major depression and those with AD when the results were analyzed for all odors. However, MDE patients displayed an impairment of olfactory memory for both familiar and unfamiliar odors, whereas AD subjects were impaired only in the recognition of unfamiliar odors, with respect to healthy subjects. If preservation of olfactory memory for familiar stimuli in patients with mild to moderate AD is confirmed, this test could be used in clinical practice as a complementary tool for diagnosis. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. Major depressive disorder: insight into candidate cerebrospinal fluid protein biomarkers from proteomics studies.

    Science.gov (United States)

    Al Shweiki, Mhd Rami; Oeckl, Patrick; Steinacker, Petra; Hengerer, Bastian; Schönfeldt-Lecuona, Carlos; Otto, Markus

    2017-06-01

    Major Depressive Disorder (MDD) is the leading cause of global disability, and an increasing body of literature suggests different cerebrospinal fluid (CSF) proteins as biomarkers of MDD. The aim of this review is to summarize the suggested CSF biomarkers and to analyze the MDD proteomics studies of CSF and brain tissues for promising biomarker candidates. Areas covered: The review includes the human studies found by a PubMed search using the following terms: 'depression cerebrospinal fluid biomarker', 'major depression biomarker CSF', 'depression CSF biomarker', 'proteomics depression', 'proteomics biomarkers in depression', 'proteomics CSF biomarker in depression', and 'major depressive disorder CSF'. The literature analysis highlights promising biomarker candidates and demonstrates conflicting results on others. It reveals 42 differentially regulated proteins in MDD that were identified in more than one proteomics study. It discusses the diagnostic potential of the biomarker candidates and their association with the suggested pathologies. Expert commentary: One ultimate goal of finding biomarkers for MDD is to improve the diagnostic accuracy to achieve better treatment outcomes; due to the heterogeneous nature of MDD, using bio-signatures could be a good strategy to differentiate MDD from other neuropsychiatric disorders. Notably, further validation studies of the suggested biomarkers are still needed.

  2. RELAP5/MOD2 implementation on various mainframes including the IBM and SX-2 supercomputer

    International Nuclear Information System (INIS)

    DeForest, D.L.; Hassan, Y.A.

    1987-01-01

    The RELAP5/MOD2 (cycle 36.04) code is a one-dimensional, two-fluid, nonequilibrium, nonhomogeneous transient analysis code designed to simulate operational and accident scenarios in pressurized water reactors (PWRs). System models are solved using a semi-implicit finite difference method. The code was developed at EG and G in Idaho Falls under sponsorship of the US Nuclear Regulatory Commission (NRC). The major enhancement from RELAP5/MOD1 is the use of a six-equation, two-fluid nonequilibrium and nonhomogeneous model. Other improvements include the addition of a noncondensible gas component and the revision and addition of drag formulation, wall friction, and wall heat transfer. Several test cases were run to benchmark the IBM and SX-2 installations against the CDC computer and the CRAY-2 and CRAY/XMP. These included the Edward's pipe blow-down and two separate reflood cases developed to simulate the FLECHT-SEASET reflood test 31504 and a postcritical heat flux (CHF) test performed at Lehigh University

  3. Steam generator replacement: a story of continuous improvement

    International Nuclear Information System (INIS)

    Sills, M.S.; Wilkerson, R.

    2009-01-01

    This paper provides a review of the history of steam generator replacement in the US focusing on the last five years. From the early replacements in the 1980s, there have been major technology improvements resulting in dramatically shorter outages and reduced radiological exposure for workers. Even though the changes for the last five years have been less dramatic, the improvement trend continues. No two steam generator replacement (SGR) projects are the same and there are some major differences including; the access path for the components to containment (is a construction opening in containment required), type of containment, number of steam generators, one piece or two piece replacement, plant type (Westinghouse, CE or B and W) and plant layout. These differences along with other variables such as delays due to plant operations and other activities not related to the steam generator replacement make analysis of performance data difficult. However, trends in outage performance and owner expectations can be identified. How far this trend will go is also discussed. Along with the trend of improved performance, there is also a significant variation in performance. Some of the contributors to this variation are identified. This paper addresses what is required for a successful outage, meeting the increasing expectations and setting new records. The authors will discuss various factors that contribute to the success of a steam generator replacement. These factors include technical issues and, equally important, organizational interface and the role the customer plays. Recommendations are provided for planning a successful steam generator replacement outage. (author)

  4. Short-Term Psychiatric Rehabilitation in Major Depressive and Bipolar Disorders: Neuropsychological-Psychosocial Outcomes.

    Science.gov (United States)

    Perna, Giampaolo; Daccò, Silvia; Sacco, Ferdinando; Micieli, Wilma; Cavedini, Paolo; Caldirola, Daniela

    2017-01-01

    Our pilot study aims to investigate the efficacy of a Short-Term (4 weeks) Psychiatric Rehabilitation Program (S-T PsyRP), without specific cognitive remediation trainings, on the neuropsychological performance and psychosocial functioning of inpatients with Major Depressive Disorder (MDD) or Bipolar Disorder (BD). Published studies with similar aims are lacking. Fifty-three inpatients with MDD and 27 with BD (type I/II) were included. The S-T PsyRP was usually performed as clinical practice at Villa San Benedetto Menni Hospital and included a variety of activities aimed at promoting personal autonomies, interpersonal/social skills, and self-care. At the beginning and the end of the hospitalization we evaluated: neuropsychological performance (cognitive tests on verbal/visual working memory, attention, visual-constructive ability, language fluency, and comprehension); psychosocial functioning by the Rehabilitation Areas Form (RAF, handbook VADO); illness severity by the Brief Psychiatric Rating Scale (BPRS). Repeated-measure ANOVA and Pearson's linear correlation were used. We found significant improvement (pneuropsychological tests except for one, in 4 out of 6 RAF psychosocial areas ("involvement in ward activities", "autonomies", "self-care", and "self-management of health") and in clinical symptoms severity. No associations were found between the amelioration of clinical symptoms and neuropsychological or psychosocial improvement. A S-T PsyRP without specific cognitive remediation trainings may improve several cognitive/functional domains in MDD or BD inpatients, probably by offering opportunities to engage in demanding problem-solving conditions and cognitively stimulating activities.

  5. Improving Peptide Applications Using Nanotechnology.

    Science.gov (United States)

    Narayanaswamy, Radhika; Wang, Tao; Torchilin, Vladimir P

    2016-01-01

    Peptides are being successfully used in various fields including therapy and drug delivery. With advancement in nanotechnology and targeted delivery carrier systems, suitable modification of peptides has enabled achievement of many desirable goals over-riding some of the major disadvantages associated with the delivery of peptides in vivo. Conjugation or physical encapsulation of peptides to various nanocarriers, such as liposomes, micelles and solid-lipid nanoparticles, has improved their in vivo performance multi-fold. The amenability of peptides to modification in chemistry and functionalization with suitable nanocarriers are very relevant aspects in their use and have led to the use of 'smart' nanoparticles with suitable linker chemistries that favor peptide targeting or release at the desired sites, minimizing off-target effects. This review focuses on how nanotechnology has been used to improve the number of peptide applications. The paper also focuses on the chemistry behind peptide conjugation to nanocarriers, the commonly employed linker chemistries and the several improvements that have already been achieved in the areas of peptide use with the help of nanotechnology.

  6. Including RNA secondary structures improves accuracy and robustness in reconstruction of phylogenetic trees.

    Science.gov (United States)

    Keller, Alexander; Förster, Frank; Müller, Tobias; Dandekar, Thomas; Schultz, Jörg; Wolf, Matthias

    2010-01-15

    In several studies, secondary structures of ribosomal genes have been used to improve the quality of phylogenetic reconstructions. An extensive evaluation of the benefits of secondary structure, however, is lacking. This is the first study to counter this deficiency. We inspected the accuracy and robustness of phylogenetics with individual secondary structures by simulation experiments for artificial tree topologies with up to 18 taxa and for divergency levels in the range of typical phylogenetic studies. We chose the internal transcribed spacer 2 of the ribosomal cistron as an exemplary marker region. Simulation integrated the coevolution process of sequences with secondary structures. Additionally, the phylogenetic power of marker size duplication was investigated and compared with sequence and sequence-structure reconstruction methods. The results clearly show that accuracy and robustness of Neighbor Joining trees are largely improved by structural information in contrast to sequence only data, whereas a doubled marker size only accounts for robustness. Individual secondary structures of ribosomal RNA sequences provide a valuable gain of information content that is useful for phylogenetics. Thus, the usage of ITS2 sequence together with secondary structure for taxonomic inferences is recommended. Other reconstruction methods as maximum likelihood, bayesian inference or maximum parsimony may equally profit from secondary structure inclusion. This article was reviewed by Shamil Sunyaev, Andrea Tanzer (nominated by Frank Eisenhaber) and Eugene V. Koonin. Reviewed by Shamil Sunyaev, Andrea Tanzer (nominated by Frank Eisenhaber) and Eugene V. Koonin. For the full reviews, please go to the Reviewers' comments section.

  7. Performance profiles of major energy producers 1993

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-01-01

    Performance Profiles of Major Energy Producers 1993 is the seventeenth annual report of the Energy Information Administration`s (EIA) Financial Reporting System (FRS). The report examines financial and operating developments in energy markets, with particular reference to the 25 major US energy companies required to report annually on Form EIA-28. Financial information is reported by major liens of business, including oil and gas production, petroleum refining and marketing, other energy operations, and nonenergy businesses. Financial and operating results are presented in the context of energy market developments with a view toward identifying changing corporate strategies and measuring the performance of ongoing operations both in the US and abroad. This year`s report analyzes financial and operating developments for 1993 (Part 1: Developments in 1993) and also reviews key developments during the 20 years following the Arab Oil Embargo of 1973--1974 (Part 2: Major Energy Company Strategies Since the Arab Oil Embargo). 49 figs., 104 tabs.

  8. Major depression

    Science.gov (United States)

    Depression - major; Depression - clinical; Clinical depression; Unipolar depression; Major depressive disorder ... providers do not know the exact causes of depression. It is believed that chemical changes in the ...

  9. MAJOR OIL PLAYS IN UTAH AND VICINITY

    International Nuclear Information System (INIS)

    Chidsey, Thomas C.; Morgan, Craig D.; McClure, Kevin; Willis, Grant C.

    2003-01-01

    Utah oil fields have produced over 1.2 billion barrels (191 million m 3 ). However, the 13.7 million barrels (2.2 million m 3 ) of production in 2002 was the lowest level in over 40 years and continued the steady decline that began in the mid-1980s. The Utah Geological Survey believes this trend can be reversed by providing play portfolios for the major oil-producing provinces (Paradox Basin, Uinta Basin, and thrust belt) in Utah and adjacent areas in Colorado and Wyoming. Oil plays are geographic areas with petroleum potential caused by favorable combinations of source rock, migration paths, reservoir rock characteristics, and other factors. The play portfolios will include: descriptions and maps of the major oil plays by reservoir; production and reservoir data; case-study field evaluations; summaries of the state-of-the-art drilling, completion, and secondary/tertiary techniques for each play; locations of major oil pipelines; descriptions of reservoir outcrop analogs; and identification and discussion of land use constraints. All play maps, reports, databases, and so forth, produced for the project will be published in interactive, menu-driven digital (web-based and compact disc) and hard-copy formats. This report covers research activities for the fourth quarter of the first project year (April 1 through June 30, 2003). This work included describing outcrop analogs to the Jurassic Nugget Sandstone and Pennsylvanian Paradox Formation, the major oil producers in the thrust belt and Paradox Basin, respectively. Production-scale outcrop analogs provide an excellent view, often in three dimensions, of reservoir-facies characteristics and boundaries contributing to the overall heterogeneity of reservoir rocks. They can be used as a ''template'' for evaluation of data from conventional core, geophysical and petrophysical logs, and seismic surveys. The Nugget Sandstone was deposited in an extensive dune field that extended from Wyoming to Arizona. Outcrop analogs are

  10. Improvements to ATLAS track reconstruction for Run II

    Energy Technology Data Exchange (ETDEWEB)

    Cairo, Valentina Maria Martina, E-mail: valentina.maria.cairo@cern.ch [University of Calabria, Arcavacata di Rende (Italy); CERN, Meyrin (Switzerland)

    2016-07-11

    Run II of the LHC will provide new challenges to track and vertex reconstruction with higher energies, denser jets and higher rates. A major change to the Inner Detector layout during the shutdown period has been the installation of the Insertable B-Layer, a fourth pixel layer located at a radius of 33 mm. This contribution discusses improvements to track reconstruction developed during the two year shutdown of the LHC. These include novel techniques developed to improve the performance in the dense cores of jets, optimisation for the expected conditions, and a big software campaign which lead to more than a factor of three decrease in the CPU time needed to process each recorded event.

  11. Britain's Nuclear Electric pursues a major programme to enhance safety

    International Nuclear Information System (INIS)

    Anon.

    1991-01-01

    The UK state-owned nuclear utility, Nuclear Electric, is actively pursuing a major initiative inherited from its predecessor the Central Electricity Generating Board, known as the Station Enhancement Programme. The Enhancement Programme is a multi-million pound project and covers all Nuclear Electric's stations (including relevant aspects of the de-commissioning site at Berkeley). Its fundamental objective is to enhance the arrangements, practices and attitudes on the power stations to create an overall environment likely to promote ever safer and more reliable operation, and to take full account of the best international practices. The four year programme started in the spring of 1989, and is expected to be completed in 1993. Key elements of the programme include quality assurance based management systems; improvements to site and plant material conditions; a more formal approach to training; additional resources and controls to aid the management of maintenance defects; higher profile for the feedback of operational experience; management targets; a station evaluation programme; and formal feedback of lessons learned from the IAEA operational and safety review team visit to the Oldbury-on-Severn station in 1989. (author)

  12. Intending to stay: Positive images, attitudes, and classroom experiences as influences on students' intentions to persist in science and engineering majors

    Science.gov (United States)

    Wyer, Mary Beth

    2000-10-01

    Contemporary research on persistence in undergraduate education in science and engineering has focused primarily on identifying the structural, social, and psychological barriers to participation by students in underrepresented groups. As a result, there is a wealth of data to document why students leave their majors, but there is little direct empirical data to support prevailing presumptions about why students stay. Moreover, researchers have used widely differing definitions and measures of persistence, and they have seldom explored field differences. This study compared three ways of measuring persistence. These constituted three criterion variables: commitment to major, degree aspirations, and commitment to a science/engineering career. The study emphasized social factors that encourage students to persist, including four predictor variables---(1) positive images of scientists/engineers, (2) positive attitudes toward gender and racial equality, (3) positive classroom experiences, and (4) high levels of social integration. In addition, because researchers have repeatedly documented the degree to which women are more likely than men to drop out of science and engineering majors, the study examined the potential impact of gender in relation to these predictor variables. A survey was administered in the classroom to a total of 285 students enrolled in a required course for either a biological sciences and or an engineering major. Predictor variables were developed from standard scales, including the Images of Science/Scientists Scale, the Attitudes toward Women Scale, the Women in Science Scale, and the Perceptions of Prejudice Scale. Based on logistic regression models, results indicate that positive images of scientists and engineers was significantly related to improving the odds of students having a high commitment to major, high degree aspirations, and high commitment to career. There was also evidence that positive attitudes toward gender and racial equality

  13. beta-thalassaemia major hos børn og unge i Danmark

    DEFF Research Database (Denmark)

    Jung, Anne; Main, Katharina Maria; Scheibel, Elma

    2002-01-01

    INTRODUCTION: Beta-thalassemia major occurs with increasing frequency among Danish children as a result of immigration. The aim of the study was to estimate the occurrence of beta-thalassemia major in Denmark, analyse the treatment and organ functions, and identify areas for an improved treatment...... strategy. MATERIAL AND METHODS: During 1998-99 all Danish pediatric departments were contacted for identification of children aged 0-18 years with beta-thalassemia major. Blood transfusions and chelation therapy were registered, and for Eastern Denmark clinical, endocrine, cardiac, and serologic parameters...... were performed. RESULTS: Twenty-six children had beta-thalassemia major. Out of these, 20 received blood transfusions, and 17 patients were chelated. Eight patients were not chelated owing to previous bone marrow transplantation, treatment with hydroxyurea or ferritin

  14. Beta-thalassaemia major hos børn og unge i Danmark

    DEFF Research Database (Denmark)

    Jung, A.; Main, K.M.; Scheibel, E.

    2002-01-01

    INTRODUCTION: Beta-thalassemia major occurs with increasing frequency among Danish children as a result of immigration. The aim of the study was to estimate the occurrence of beta-thalassemia major in Denmark, analyse the treatment and organ functions, and identify areas for an improved treatment...... strategy. MATERIAL AND METHODS: During 1998-99 all Danish pediatric departments were contacted for identification of children aged 0-18 years with beta-thalassemia major. Blood transfusions and chelation therapy were registered, and for Eastern Denmark clinical, endocrine, cardiac, and serologic parameters...... were performed. RESULTS: Twenty-six children had beta-thalassemia major. Out of these, 20 received blood transfusions, and 17 patients were chelated. Eight patients were not chelated owing to previous bone marrow transplantation, treatment with hydroxyurea or ferritin

  15. A major advance in the quality of the training aimed at improving results

    International Nuclear Information System (INIS)

    Delgado, J. L.; Gonzalez Anez, F.

    2013-01-01

    Tecnatom has made in the last years several initiatives focused on improving quality and standards of training services with respect to processes,methodology and instructor qualification. Main areas of actuation are described in this article. (Author)

  16. Including RNA secondary structures improves accuracy and robustness in reconstruction of phylogenetic trees

    Directory of Open Access Journals (Sweden)

    Dandekar Thomas

    2010-01-01

    Full Text Available Abstract Background In several studies, secondary structures of ribosomal genes have been used to improve the quality of phylogenetic reconstructions. An extensive evaluation of the benefits of secondary structure, however, is lacking. Results This is the first study to counter this deficiency. We inspected the accuracy and robustness of phylogenetics with individual secondary structures by simulation experiments for artificial tree topologies with up to 18 taxa and for divergency levels in the range of typical phylogenetic studies. We chose the internal transcribed spacer 2 of the ribosomal cistron as an exemplary marker region. Simulation integrated the coevolution process of sequences with secondary structures. Additionally, the phylogenetic power of marker size duplication was investigated and compared with sequence and sequence-structure reconstruction methods. The results clearly show that accuracy and robustness of Neighbor Joining trees are largely improved by structural information in contrast to sequence only data, whereas a doubled marker size only accounts for robustness. Conclusions Individual secondary structures of ribosomal RNA sequences provide a valuable gain of information content that is useful for phylogenetics. Thus, the usage of ITS2 sequence together with secondary structure for taxonomic inferences is recommended. Other reconstruction methods as maximum likelihood, bayesian inference or maximum parsimony may equally profit from secondary structure inclusion. Reviewers This article was reviewed by Shamil Sunyaev, Andrea Tanzer (nominated by Frank Eisenhaber and Eugene V. Koonin. Open peer review Reviewed by Shamil Sunyaev, Andrea Tanzer (nominated by Frank Eisenhaber and Eugene V. Koonin. For the full reviews, please go to the Reviewers' comments section.

  17. Aging management of major light water reactor components

    International Nuclear Information System (INIS)

    Shah, V.N.; Sinha, U.P.; Ware, A.G.

    1992-01-01

    Review of technical literature and field experience has identified stress corrosion cracking as one of the major degradation mechanisms for the major light water reactor components. Three of the stress corrosion cracking mechanisms of current concern are (a) primary water stress corrosion cracking (PWSCC) in pressurized water reactors, and (b) intergranular stress corrosion cracking (IGSCC) and (c) irradiation-assisted stress corrosion cracking (IASCC) in boiling water reactors. Effective aging management of stress corrosion cracking mechanisms includes evaluation of interactions between design, materials, stressors, and environment; identification and ranking of susceptible sites; reliable inspection of any damage; assessment of damage rate; mitigation of damage; and repair and replacement using corrosion-resistant materials. Management of PWSCC includes use of lower operating temperatures, reduction in residual tensile stresses, development of reliable inspection techniques, and use of Alloy 690 as replacement material. Management of IGSCC of nozzle and attachment welds includes use of Alloy 82 as weld material, and potential use of hydrogen water chemistry. Management of IASCC also includes potential use of hydrogen water chemistry

  18. Recent Major Improvements to the ALS Sector 5 Macromolecular Crystallography Beamlines

    International Nuclear Information System (INIS)

    Morton, Simon A.; Glossinger, James; Smith-Baumann, Alexis; McKean, John P.; Trame, Christine; Dickert, Jeff; Rozales, Anthony; Dauz, Azer; Taylor, John; Zwart, Petrus; Duarte, Robert; Padmore, Howard; McDermott, Gerry; Adams, Paul

    2007-01-01

    crystals, and on more rapidly screening larger numbers of candidate crystals; all of these requirements translate directly into a pressing need for increased flux, a tighter beam focus and faster detectors. With these growing demands in mind a major program of beamline and detector upgrades was initiated in 2004 with the goal of dramatically enhancing all aspects of beamline performance. Approximately $3 million in funding from diverse sources including NIH, LBL, the ALS, and the industrial and academic members of the beamline Participating Research Team (PRT), has been employed to develop and install new high performance beamline optics and to purchase the latest generation of CCD detectors. This project, which reached fruition in early 2007, has now fulfilled all of its original goals--boosting the flux on all three beamlines by up to 20-fold--with a commensurate reduction in exposure and data acquisition times for users. The performance of the Sector 5.0 beamlines is now comparable to that of the latest generation ALS superbend beamlines and, in the case of beamline 5.0.2, even surpasses it by a considerable margin. Indeed, the present performance of this beamline is now, once again, comparable to that envisioned for many MX beamlines planned or under construction on newer or higher energy machines

  19. Review of major plutonium pyrochemical technology

    International Nuclear Information System (INIS)

    Moser, W.S.; Navratil, J.D.

    1983-01-01

    The past twenty years have seen significant growth in the development and application of pyrochemical technology for processing of plutonium. For particular feedstocks and specific applications, non-aqueous high-temperature processes offer key advantages over conventional hydrometallurgical systems. Major processes in use today include: (1) direct oxide reduction for conversion of PuO 2 to metal, (2) molten salt extraction for americium removal from plutonium, (3) molten salt electrorefining for Pu purification, and (4) hydriding to remove plutonium from host substrates. This paper reviews current major pyrochemical processes from the classical calcination-hydrofluorination-bomb reduction sequence through new techniques under development. Each process is presented and brief descriptions of production equipment are given. 47 references, 5 figures

  20. Semuloparin for prevention of venous thromboembolism after major orthopedic surgery

    DEFF Research Database (Denmark)

    Lassen, M R; Fisher, W; Mouret, P

    2012-01-01

    BACKGROUND: Semuloparin is a novel ultra-low-molecular-weight heparin under development for venous thromboembolism (VTE) prevention in patients at increased risk, such as surgical and cancer patients. OBJECTIVES: Three Phase III studies compared semuloparin and enoxaparin after major orthopedic...... was to be performed between days 7 and 11. The primary efficacy endpoint was a composite of any deep vein thrombosis, non-fatal pulmonary embolism or all-cause death. Safety outcomes included major bleeding, clinically relevant non-major (CRNM) bleeding, and any clinically relevant bleeding (major bleeding plus CRNM...

  1. Enhanced Recovery After Surgery Protocols in Major Urologic Surgery

    Directory of Open Access Journals (Sweden)

    Natalija Vukovic

    2018-04-01

    Full Text Available The purpose of the reviewThe analysis of the components of enhanced recovery after surgery (ERAS protocols in urologic surgery.Recent findingsERAS protocols has been studied for over 20 years in different surgical procedures, mostly in colorectal surgery. The concept of improving patient care and reducing postoperative complications was also applied to major urologic surgery and especially procedure of radical cystectomy. This procedure is technically challenging, due to a major surgical resection and high postoperative complication rate that may reach 65%. Several clinical pathways were introduced to improve perioperative course and reduce the length of hospital stay. These protocols differ from ERAS modalities in other surgeries. The reasons for this are longer operative time, increased risk of perioperative transfusion and infection, and urinary diversion achieved using transposed intestinal segments. Previous studies in this area analyzed the need for mechanical bowel preparation, postoperative nasogastric tube decompression, as well as the duration of urinary drainage. Furthermore, the attention has also been drawn to perioperative fluid optimization, pain management, and bowel function.SummaryNotwithstanding partial resemblance between the pathways in major urologic surgery and other pelvic surgeries, there are still scarce guidelines for ERAS protocols in urology, which is why further studies should assess the importance of preoperative medical optimization, implementation of thoracic epidural anesthesia and analgesia, and perioperative nutritional management.

  2. Congressional hearing reviews NSF major research and facilities projects

    Science.gov (United States)

    Showstack, Randy

    2012-03-01

    An 8 March congressional hearing about the U.S. National Science Foundation's Major Research Equipment and Facilities Construction (NSF MREFC) account focused on fiscal management and accountability of projects in that account and reviewed concerns raised by NSF's Office of Inspector General (OIG). NSF established the MREFC account in 1995 to better plan and manage investments in major equipment and facilities projects, which can cost from tens of millions to hundreds of millions of dollars, and the foundation has funded 17 MREFC projects since then. The Obama administration's proposed fiscal year (FY) 2013 budget includes funding for four MREFC projects: Advanced Laser Gravitational-Wave Observatory (AdvLIGO), Advanced Technology Solar Telescope (ATST), National Ecological Observatory (NEON), and Ocean Observatories Initiative (OOI). The hearing, held by a subcommittee of the House of Representatives' Committee on Science, Space, and Technology, reviewed management oversight throughout the life cycles of MREFC projects and concerns raised in recent OIG reports about the use of budget contingency funds. NSF's February 2012 manual called "Risk management guide for large facilities" states that cost contingency is "that portion of the project budget required to cover `known unknowns,'" such as planning and estimating errors and omissions, minor labor or material price fluctuations, and design developments and changes within the project scope. Committee members acknowledged measures that NSF has made to improve the MREFC oversight process, but they also urged the agency to continue to take steps to ensure better project management.

  3. Increasing persistence in undergraduate science majors: a model for institutional support of underrepresented students.

    Science.gov (United States)

    Toven-Lindsey, Brit; Levis-Fitzgerald, Marc; Barber, Paul H; Hasson, Tama

    2015-01-01

    The 6-yr degree-completion rate of undergraduate science, technology, engineering, and mathematics (STEM) majors at U.S. colleges and universities is less than 40%. Persistence among women and underrepresented minorities (URMs), including African-American, Latino/a, Native American, and Pacific Islander students, is even more troubling, as these students leave STEM majors at significantly higher rates than their non-URM peers. This study utilizes a matched comparison group design to examine the academic achievement and persistence of students enrolled in the Program for Excellence in Education and Research in the Sciences (PEERS), an academic support program at the University of California, Los Angeles, for first- and second-year science majors from underrepresented backgrounds. Results indicate that PEERS students, on average, earned higher grades in most "gatekeeper" chemistry and math courses, had a higher cumulative grade point average, completed more science courses, and persisted in a science major at significantly higher rates than the comparison group. With its holistic approach focused on academics, counseling, creating a supportive community, and exposure to research, the PEERS program serves as an excellent model for universities interested in and committed to improving persistence of underrepresented science majors and closing the achievement gap. © 2015 B. Toven-Lindsey et al. CBE—Life Sciences Education © 2015 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  4. Mirtazapine, a sedating antidepressant, and improved driving safety in patients with major depressive disorder: a prospective, randomized trial of 28 patients.

    Science.gov (United States)

    Shen, Jianhua; Moller, Henry J; Wang, Xuehua; Chung, Sharon A; Shapiro, Gilla K; Li, Xiuying; Shapiro, Colin M

    2009-03-01

    The objectives of the study were to investigate the effects of mirtazapine, a sedating antidepressant, on driving safety in major depressive disorder (MDD) patients and to observe the effect of mirtazapine on daytime alertness. Twenty-eight patients who met the DSM-IV criteria for MDD completed the study in a university teaching hospital. Half of these patients took mirtazapine 30 mg at bedtime for 30 days. A computerized driving simulator test (DST) and the Maintenance of Wakefulness Test (MWT) were conducted at baseline and on days 2, 9, 16, and 30 after commencement of antidepressant use. Fourteen untreated depressed patients performed a DST and MWT at baseline and on days 2 and 9 to evaluate the possibility of a learning effect. Data collection was from June 2005 through January 2006. There were significant linear effects of the treatment on road position at All Trials (p = .018) and on the morning sessions at 10:00 a.m. (p < .001) and 12:00 p.m. (p = .022) and on the number of crashes at All Trials (p = .034) and the 4:00 p.m. session (p = .050) for the group on active treatment. Compared with the values at baseline, those of road position at 10:00 a.m. significantly improved on days 2 (p < .05), 9 (p < .01), 16 (p < .01) and 30 (p < .01) and road position at 12:00 p.m. significantly improved on days 16 (p < .05) and 30 (p < .05). The number of crashes significantly decreased on day 30 (p < .05). The untreated patients showed no improvement in performance in any of the measures, suggesting that the results are not due to a learning effect. A sedating antidepressant can increase driving safety in MDD patients. clinicaltrials.gov Identifier: NCT00385437. ©Copyright 2009 Physicians Postgraduate Press, Inc.

  5. The majority of genes in the pathogenic Neisseria species are present in non-pathogenic Neisseria lactamica, including those designated as 'virulence genes'

    Directory of Open Access Journals (Sweden)

    Saunders Nigel J

    2006-05-01

    Full Text Available Abstract Background Neisseria meningitidis causes the life-threatening diseases meningococcal meningitis and meningococcal septicemia. Neisseria gonorrhoeae is closely related to the meningococcus, but is the cause of the very different infection, gonorrhea. A number of genes have been implicated in the virulence of these related yet distinct pathogens, but the genes that define and differentiate the species and their behaviours have not been established. Further, a related species, Neisseria lactamica is not associated with either type of infection in normally healthy people, and lives as a harmless commensal. We have determined which of the genes so far identified in the genome sequences of the pathogens are also present in this non-pathogenic related species. Results Thirteen unrelated strains of N. lactamica were investigated using comparative genome hybridization to the pan-Neisseria microarray-v2, which contains 2845 unique gene probes. The presence of 127 'virulence genes' was specifically addressed; of these 85 are present in N. lactamica. Of the remaining 42 'virulence genes' only 11 are present in all four of the sequenced pathogenic Neisseria. Conclusion Assessment of the complete dataset revealed that the vast majority of genes present in the pathogens are also present in N. lactamica. Of the 1,473 probes to genes shared by all four pathogenic genome sequences, 1,373 hybridize to N. lactamica. These shared genes cannot include genes that are necessary and sufficient for the virulence of the pathogens, since N. lactamica does not share this behaviour. This provides an essential context for the interpretation of gene complement studies of the pathogens.

  6. Strategic planning among the oil and gas major

    International Nuclear Information System (INIS)

    Grant, R.M.

    1998-01-01

    The increased focus on profitability and shareholder return, the impossibility of forecasting and the increased need for flexibility have made the strategic planning processes of the oil majors to change considerably in the past decade. While shifting from control to co-ordination, strategic planning has been acting less as a guidance and more as a mechanism for improving the quality of strategic decision-making [it

  7. Teaching Biotechnology through Case Studies--Can We Improve Higher Order Thinking Skills of Nonscience Majors?

    Science.gov (United States)

    Dori, Yehudit J.; Tal, Revital T.; Tsaushu, Masha

    2003-01-01

    Teaching nonscience majors topics in biotechnology through case studies is the focus of this research. Our "Biotechnology, Environment, and Related Issues" module, developed within the "Science for All" framework, is aimed at elevating the level of students' scientific and technological literacy and their higher order thinking…

  8. Improving Value for Patients with Eczema.

    Science.gov (United States)

    Block, Julie

    2018-04-01

    Chronic diseases now represent a cost majority in the United States health care system. Contributing factors to rising costs include expensive novel and emerging therapies, under-treatment of disease, under-management of comorbidities, and patient dissatisfaction with care results. Critical to identifying replicable improvement methods is a reliable model to measure value. If we understand value within healthcare consumerism to be equal to a patient's health outcome improvement over costs associated with care (Value=Outcomes/Costs), we can use this equation to measure the improvement of value. Research and literature show that patient activation-the skills and confidence that equip patients to become actively engaged in their health care-impact health outcomes, costs, and patient experience. Reaching patient activation through engagement methods including shared decision-making (SDM) lead to improved value of care received. The National Eczema Association (NEA) Shared Decision-Making Resource Center can be a transformative strategy to measure and evaluate value of health care interventions for eczema patients to advance a value-driven health care system in the United States. Through this Resource Center, NEA will measure patient value through their own perceptions using validated PRO instruments and other patient-generated health data. Assessment of this data will reveal findings that can assist researchers in evaluating the impact this care framework on patient-perceived value across other chronic diseases. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  9. The construct validity of the Major Depression Inventory

    DEFF Research Database (Denmark)

    Nielsen, Marie Germund; Ørnbøl, Eva; Vestergaard, Mogens

    2017-01-01

    Objective We aimed to assess the measurement properties of the ten-item Major Depression Inventory when used on clinical suspicion in general practice by performing a Rasch analysis. Methods General practitioners asked consecutive persons to respond to the web-based Major Depression Inventory...... on clinical suspicion of depression. We included 22 practices and 245 persons. Rasch analysis was performed using RUMM2030 software. The Rasch model fit suggests that all items contribute to a single underlying trait (defined as internal construct validity). Mokken analysis was used to test dimensionality...... for gender, age, work status and education. The Rasch and Mokken analyses revealed two dimensions, but the Major Depression Inventory showed fit to one scale if items 9 and 10 were excluded. Conclusion Our study indicated scalability problems in the current version of the Major Depression Inventory...

  10. Major multinational food and beverage companies and informal sector contributions to global food consumption: implications for nutrition policy

    Directory of Open Access Journals (Sweden)

    Yach Derek

    2011-08-01

    Full Text Available Abstract Background In recent years, 10 major multinational food and beverage companies have worked together within the International Food and Beverage Alliance (IFBA to increase their commitments to public health. Current IFBA commitments include initiatives to improve the nutrition quality of products and how these products are advertised to children. The impact and magnitude of IFBA member contributions to the total market share of packaged foods and beverages consumed remain incompletely understood, however. Methods In order to evaluate this impact, we examined packaged food and soft drink company shares provided by Euromonitor, an international independent market analysis company. Packaged foods include baby food, bakery, canned/preserved food, chilled/processed food, confectionery, dairy, dried processed food, frozen processed food, ice cream, meal replacement, noodles, oils and fats, pasta, ready meals, sauces, dressings and condiments, snack bars, soup, spreads, and sweet and savoury snacks. Soft drinks include carbonates, packaged fruit/vegetable juice, bottled water, functional drinks, concentrates, ready-to-drink tea, ready-to-drink coffee and Asian specialty drinks. We calculated the market shares for IFBA companies, globally and within nine countries--the US, China, India, Egypt, South Africa, Brazil, Mexico, Turkey and the UK. Results Worldwide, the top ten packaged food companies account for 15.2% of sales, with each individual company contributing less than 3.3%. The top ten soft drink companies account for 52.3% of sales worldwide; Coca-Cola and PepsiCo lead with 25.9% and 11.5% of sales, respectively. Conclusions Although the top ten soft drink companies account for half of global sales, the top ten packaged food companies account for only a small proportion of market share with most individual companies contributing less than 3.3% each. Major multinational companies need to be joined by the myriad of small- and medium

  11. Major multinational food and beverage companies and informal sector contributions to global food consumption: implications for nutrition policy

    Science.gov (United States)

    2011-01-01

    Background In recent years, 10 major multinational food and beverage companies have worked together within the International Food and Beverage Alliance (IFBA) to increase their commitments to public health. Current IFBA commitments include initiatives to improve the nutrition quality of products and how these products are advertised to children. The impact and magnitude of IFBA member contributions to the total market share of packaged foods and beverages consumed remain incompletely understood, however. Methods In order to evaluate this impact, we examined packaged food and soft drink company shares provided by Euromonitor, an international independent market analysis company. Packaged foods include baby food, bakery, canned/preserved food, chilled/processed food, confectionery, dairy, dried processed food, frozen processed food, ice cream, meal replacement, noodles, oils and fats, pasta, ready meals, sauces, dressings and condiments, snack bars, soup, spreads, and sweet and savoury snacks. Soft drinks include carbonates, packaged fruit/vegetable juice, bottled water, functional drinks, concentrates, ready-to-drink tea, ready-to-drink coffee and Asian specialty drinks. We calculated the market shares for IFBA companies, globally and within nine countries--the US, China, India, Egypt, South Africa, Brazil, Mexico, Turkey and the UK. Results Worldwide, the top ten packaged food companies account for 15.2% of sales, with each individual company contributing less than 3.3%. The top ten soft drink companies account for 52.3% of sales worldwide; Coca-Cola and PepsiCo lead with 25.9% and 11.5% of sales, respectively. Conclusions Although the top ten soft drink companies account for half of global sales, the top ten packaged food companies account for only a small proportion of market share with most individual companies contributing less than 3.3% each. Major multinational companies need to be joined by the myriad of small- and medium-sized enterprises in developing and

  12. Major multinational food and beverage companies and informal sector contributions to global food consumption: implications for nutrition policy.

    Science.gov (United States)

    Alexander, Eleanore; Yach, Derek; Mensah, George A

    2011-08-01

    In recent years, 10 major multinational food and beverage companies have worked together within the International Food and Beverage Alliance (IFBA) to increase their commitments to public health. Current IFBA commitments include initiatives to improve the nutrition quality of products and how these products are advertised to children. The impact and magnitude of IFBA member contributions to the total market share of packaged foods and beverages consumed remain incompletely understood, however. In order to evaluate this impact, we examined packaged food and soft drink company shares provided by Euromonitor, an international independent market analysis company. Packaged foods include baby food, bakery, canned/preserved food, chilled/processed food, confectionery, dairy, dried processed food, frozen processed food, ice cream, meal replacement, noodles, oils and fats, pasta, ready meals, sauces, dressings and condiments, snack bars, soup, spreads, and sweet and savoury snacks. Soft drinks include carbonates, packaged fruit/vegetable juice, bottled water, functional drinks, concentrates, ready-to-drink tea, ready-to-drink coffee and Asian specialty drinks. We calculated the market shares for IFBA companies, globally and within nine countries--the US, China, India, Egypt, South Africa, Brazil, Mexico, Turkey and the UK. Worldwide, the top ten packaged food companies account for 15.2% of sales, with each individual company contributing less than 3.3%. The top ten soft drink companies account for 52.3% of sales worldwide; Coca-Cola and PepsiCo lead with 25.9% and 11.5% of sales, respectively. Although the top ten soft drink companies account for half of global sales, the top ten packaged food companies account for only a small proportion of market share with most individual companies contributing less than 3.3% each. Major multinational companies need to be joined by the myriad of small- and medium-sized enterprises in developing and implementing programs to improve the

  13. Concurrent Improvement in Both Binge Eating and Depressive Symptoms with Naltrexone/Bupropion Therapy in Overweight or Obese Subjects with Major Depressive Disorder in an Open-Label, Uncontrolled Study.

    Science.gov (United States)

    Guerdjikova, Anna I; Walsh, Brandon; Shan, Kevin; Halseth, Amy E; Dunayevich, Eduardo; McElroy, Susan L

    2017-10-01

    Binge eating disorder (BED) is associated with obesity and major depressive disorder (MDD). Naltrexone extended-release (ER)/bupropion ER (NB) is approved as an adjunct to diet and physical activity for chronic weight management. In a prospectively designed 24-week open-label, single-arm, single-site trial of 25 women with MDD and overweight/obesity, NB reduced weight and depressive symptoms. This post hoc analysis investigated the relationship between change in self-reported binge eating behavior (evaluated with the Binge Eating Scale [BES]) and changes in weight, control of eating, and depressive symptoms. At baseline, 91% of subjects had moderate or severe BES scores, suggesting BED. BES scores were significantly improved from week 4, and by week 24, 83% reported "little or no problem." Improvement in BES scores correlated with improvement in depressive symptoms and control of eating. NB may be effective in reducing binge eating symptoms associated with MDD and overweight/obesity. Evaluation of NB in BED appears warranted. Orexigen Therapeutics, Inc.

  14. Plantago major in Traditional Persian Medicine and modern phytotherapy: a narrative review

    Science.gov (United States)

    Najafian, Younes; Hamedi, Shokouh Sadat; Farshchi, Masoumeh Kaboli

    2018-01-01

    Plantago major has been used widely since ancient times, to manage a wide range of diseases including constipation, coughs and wounds. The aim of this study is to review the traditional application, botanical characterization, pharmacological activities, phytochemistry effects and toxicity of Plantago major. In this review study, medicinal properties of Plantago major are collected from credible pharmacopeias, textbooks of traditional Persian medicine (TPM) belonging to the 10–18th century AD, such as “The Canon of Medicine”, “Makhzan-Al- Advia” and so on. Moreover, electronic databases including Scopus, Medline and Web of science were explored for this purpose. Plantago major has been prescribed in various forms such as roasted seeds, decoction, syrup, liniment, gargle, rectal enema, vaginal suppository, eye and nasal drop for each illness by TPM scholars. Some of its traditional properties including wound healing, antipyretic, antitussive, anti-infective, anti-hemorrhagic, anti-inflammatory, diuretic, laxative, astringent and hemostatic have been confirmed in recent researches. Phytochemical investigations showed that Plantago major contains volatile compounds, triterpenoids, phenolic acids and flavonoids. Modern pharmacological studies have proven some of the traditional applications of Plantago major. Nevertheless, more investigations are required on this plant, because it has the potential to be used to produce various natural medications. PMID:29629064

  15. Major Oil Plays in Utah and Vicinity

    Energy Technology Data Exchange (ETDEWEB)

    Thomas C. Chidsey; Craig D. Morgan; Kevin McClure; Douglas A. Sprinkel; Roger L. Bon; Hellmut H. Doelling

    2003-12-31

    Utah oil fields have produced over 1.2 billion barrels (191 million m{sup 3}). However, the 13.7 million barrels (2.2 million m{sup 3}) of production in 2002 was the lowest level in over 40 years and continued the steady decline that began in the mid-1980s. The Utah Geological Survey believes this trend can be reversed by providing play portfolios for the major oil-producing provinces (Paradox Basin, Uinta Basin, and thrust belt) in Utah and adjacent areas in Colorado and Wyoming. Oil plays are geographic areas with petroleum potential caused by favorable combinations of source rock, migration paths, reservoir rock characteristics, and other factors. The play portfolios will include: descriptions and maps of the major oil plays by reservoir; production and reservoir data; case-study field evaluations; locations of major oil pipelines; identification and discussion of land-use constraints; descriptions of reservoir outcrop analogs; and summaries of the state-of-the-art drilling, completion, and secondary/tertiary techniques for each play. This report covers research activities for the sixth quarter of the project (October 1 through December 31, 2003). This work included describing outcrop analogs for the Jurassic Twin Creek Limestone and Mississippian Leadville Limestone, major oil producers in the thrust belt and Paradox Basin, respectively, and analyzing best practices used in the southern Green River Formation play of the Uinta Basin. Production-scale outcrop analogs provide an excellent view of reservoir petrophysics, facies characteristics, and boundaries contributing to the overall heterogeneity of reservoir rocks. They can be used as a ''template'' for evaluation of data from conventional core, geophysical and petrophysical logs, and seismic surveys. In the Utah/Wyoming thrust belt province, the Jurassic Twin Creek Limestone produces from subsidiary closures along major ramp anticlines where the low-porosity limestone beds are extensively

  16. Gas storage materials, including hydrogen storage materials

    Science.gov (United States)

    Mohtadi, Rana F; Wicks, George G; Heung, Leung K; Nakamura, Kenji

    2013-02-19

    A material for the storage and release of gases comprises a plurality of hollow elements, each hollow element comprising a porous wall enclosing an interior cavity, the interior cavity including structures of a solid-state storage material. In particular examples, the storage material is a hydrogen storage material such as a solid state hydride. An improved method for forming such materials includes the solution diffusion of a storage material solution through a porous wall of a hollow element into an interior cavity.

  17. Rediscovering the wound hematoma as a site of hemostasis during major arterial hemorrhage.

    Science.gov (United States)

    White, N J; Mehic, E; Wang, X; Chien, D; Lim, E; St John, A E; Stern, S A; Mourad, P D; Rieger, M; Fries, D; Martinowitz, U

    2015-12-01

    Treatments for major internal bleeding after injury include permissive hypotension to decrease the rate of blood loss, intravenous infusion of plasma or clotting factors to improve clot formation, and rapid surgical hemostasis or arterial embolization to control bleeding vessels. Yet, little is known regarding major internal arterial hemostasis, or how these commonly used treatments might influence hemostasis. (i) To use a swine model of femoral artery bleeding to understand the perivascular hemostatic response to contained arterial hemorrhage. (ii) To directly confirm the association between hemodynamics and bleeding velocity. (iii) To observe the feasibility of delivering an activated clotting factor directly to internal sites of bleeding using a simplified angiographic approach. Ultrasound was used to measure bleeding velocity and in vivo clot formation by elastography in a swine model of contained femoral artery bleeding with fluid resuscitation. A swine model of internal pelvic and axillary artery hemorrhage was also used to demonstrate the feasibility of local delivery of an activated clotting factor. In this model, clots formed slowly within the peri-wound hematoma, but eventually contained the bleeding. Central hemodynamics correlated positively with bleeding velocity. Infusion of recombinant human activated factor VII into the injured artery near the site of major internal hemorrhage in the pelvis and axillae was feasible. We rediscovered that clot formation within the peri-wound hematoma is an integral component of hemostasis and a feasible target for the treatment of major internal bleeding using activated clotting factors delivered using a simplified angiographic approach. © 2015 International Society on Thrombosis and Haemostasis.

  18. Acoustics for Music Majors-- A Laboratory Course

    Science.gov (United States)

    McDonald, Perry F.

    1972-01-01

    Brief descriptions of several of the laboratory experiments which have been incorporated into an acoustics course for music majors. Includes vibratory motion and sound generation, nature, speed, and pitch of sound, spectrum analysis and electronic synthesis of musical sound and some conventional sound experiments. (Author/TS)

  19. The Prevalence, Measurement, and Treatment of the Cognitive Dimension/Domain in Major Depressive Disorder

    DEFF Research Database (Denmark)

    McIntyre, Roger S; Xiao, Holly X; Syeda, Kahlood

    2015-01-01

    Insufficient outcomes amongst adults with major depressive disorder (MDD) provide the impetus to identify and refine therapeutic targets that are most critical to outcome from patient, provider, and societal perspectives. Towards this aim, a pivotal shift towards the transnosological domain...... depressive disorder, depression, unipolar depression, cognition, cognitive dysfunction, cognitive deficit, and cognitive function. The search was supplemented with a manual review of relevant references. The selection of articles for inclusion in this review was based on overall methodological quality...... are currently under investigation for possible benefit in mitigating cognitive deficits and improving cognitive performance (e.g., intranasal insulin, erythropoietin, anti-inflammatory agents). Non-pharmacological approaches including, but not limited to, cognitive remediation (CR), aerobic exercise...

  20. Predictive Value of C-Reactive Protein for Major Complications after Major Abdominal Surgery: A Systematic Review and Pooled-Analysis.

    Directory of Open Access Journals (Sweden)

    Jennifer Straatman

    Full Text Available Early diagnosis and treatment of complications after major abdominal surgery can decrease associated morbidity and mortality. Postoperative CRP levels have shown a strong correlation with complications. Aim of this systematic review and pooled-analysis was to assess postoperative values of CRP as a marker for major complications and construct a prediction model.A systematic review was performed for CRP levels as a predictor for complications after major abdominal surgery (MAS. Raw data was obtained from seven studies, including 1427 patients. A logit regression model assessed the probability of major complications as a function of CRP levels on the third postoperative day. Two practical cut-offs are proposed: an optimal cut-off for safe discharge in a fast track protocol and another for early identification of patients with increased risk for major complications.A prediction model was calculated for major complications as a function of CRP levels on the third postoperative day. Based on the model several cut-offs for CRP are proposed. For instance, a two cut-off system may be applied, consisting of a safe discharge criterion with CRP levels below 75 mg/L, with a negative predictive value of 97.2%. A second cut-off is set at 215 mg/L (probability 20% and serves as a predictor of complications, indicating additional CT-scan imaging.The present study provides insight in the interpretation of CRP levels after major abdominal surgery, proposing a prediction model for major complications as a function of CRP on postoperative day 3. Cut-offs for CRP may be implemented for safe early-discharge in a fast-track protocol and, secondly as a threshold for additional examinations, such as CT-scan imaging, even in absence of clinical signs, to confirm or exclude major complications. The prediction model allows for setting a cut-off at the discretion of individual surgeons or surgical departments.

  1. Big Five personality group differences across academic majors

    DEFF Research Database (Denmark)

    Vedel, Anna

    characterisations are more than humoristic elements in TV shows; are there real, measurable personality differences among groups of academics? One way to study this is to look at students in different academic majors and examine whether they differ on the group level in broad personality traits. During the past...... decades, studies have regularly explored associations between enrolment in specific academic majors and scores on the Big Five personality traits; Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness. The present review examines this research systematically, summarises group...... group differences in the Big Five personality traits were generally found in the included studies. None of the included studies reported effect sizes, though, so the magnitude of the obtained differences was not estimated. Consequently, effect sizes were calculated using means and standard deviations...

  2. Evidence for phase-based psychotherapy as a treatment for dissociative identity disorder comorbid with major depressive disorder and alcohol dependence.

    Science.gov (United States)

    Pollock, Brianna E; Macfie, Jenny; Elledge, L Christian

    2017-01-01

    We report on the treatment and successful outcome of a 58-year-old Native American male with a history of complex trauma presenting with dissociative identity disorder (DID) and major depressive disorder. The treatment included a trauma-informed phase-based psychotherapy as recommended by the International Society for the Study of Trauma and Dissociation for treating DID. We assessed symptoms at baseline and at three additional time points over the course of 14 months. We utilized the Reliable Change Index to examine statistically significant change in symptoms over the course of treatment. Significant symptom improvements were realized posttreatment across all measured domains of functioning, including dissociative symptoms, alcohol abuse, depression, anxiety, and emotion regulation skills. Moreover, the client no longer met criteria for DID, major depressive disorder, or alcohol abuse. Results are discussed in terms of the effectiveness of trauma-focused, phase-based treatment for DID for cases of complex trauma with comorbid disorders.

  3. Genetics of mechanisms controlling responses to two major pathogens in broiler and layer chickens

    DEFF Research Database (Denmark)

    Hamzic, Edin

    The objective of this thesis was to improve the understanding of molecular mechanisms controlling the response to two major pathogens, Eimeria maxima (coccidiosis) and infectious bronchitis virus (IBV), in broiler and layer chickens, respectively. Breeding for the improved response to the two...

  4. Triiodothyronine addition to paroxetine in the treatment of major depressive disorder

    NARCIS (Netherlands)

    Appelhof, Bente C.; Brouwer, Jantien P.; van Dyck, Richard; Fliers, Eric; Hoogendijk, Witte J. G.; Huyser, Jochanan; Schene, Aart H.; Tijssen, Jan G. P.; Wiersinga, Wilmar M.

    2004-01-01

    There is evidence that thyroid hormone T-3 increases serotonergic neurotransmission. Therefore, T-3 addition to antidepressants may improve treatment response in major depression. In nonrefractory depression, T-3 addition to tricyclic antidepressants indeed accelerates treatment response. Current

  5. Improvement of operational safety: The self-assessment at the Russian NPPs

    International Nuclear Information System (INIS)

    Kolotov, Aleksander

    2002-01-01

    The operating organization has scheduled for the forthcoming year to elaborate the NPP safety self-assessment standards and to settle precise criterion for its performance. Toward this end it was decided to form a Working Team including of NPP and VNIIAES representatives to elaborate major tasks on the self-assessment improvement, development and implementation of new documentation and training the personnel in new methodology. Actions developed by R osenergoatom , one of its items is the participation of 'Rosenergoatom' and VNIIAES representatives in the workshop, contains the sequence of Russian NPP safety self-assessment improvement at the first stage

  6. The transcriptional regulatory network in the drought response and its crosstalk in abiotic stress responses including drought, cold and heat

    Directory of Open Access Journals (Sweden)

    Kazuo eNakashima

    2014-05-01

    Full Text Available Drought negatively impacts plant growth and the productivity of crops around the world. Understanding the molecular mechanisms in the drought response is important for improvement of drought tolerance using molecular techniques. In plants, abscisic acid (ABA is accumulated under osmotic stress conditions caused by drought, and has a key role in stress responses and tolerance. Comprehensive molecular analyses have shown that ABA regulates the expression of many genes under osmotic stress conditions, and the ABA-responsive element (ABRE is the major cis-element for ABA-responsive gene expression. Transcription factors (TFs are master regulators of gene expression. ABRE-binding protein (AREB and ABRE-binding factor (ABF TFs control gene expression in an ABA-dependent manner. SNF1-related protein kinases 2, group A 2C-type protein phosphatases, and ABA receptors were shown to control the ABA signaling pathway. ABA-independent signaling pathways such as dehydration-responsive element-binding protein (DREB TFs and NAC TFs are also involved in stress responses including drought, heat and cold. Recent studies have suggested that there are interactions between the major ABA signaling pathway and other signaling factors in stress responses. The important roles of these transcription factors in crosstalk among abiotic stress responses will be discussed. Control of ABA or stress signaling factor expression can improve tolerance to environmental stresses. Recent studies using crops have shown that stress-specific overexpression of TFs improves drought tolerance and grain yield compared with controls in the field.

  7. The transcriptional regulatory network in the drought response and its crosstalk in abiotic stress responses including drought, cold, and heat.

    Science.gov (United States)

    Nakashima, Kazuo; Yamaguchi-Shinozaki, Kazuko; Shinozaki, Kazuo

    2014-01-01

    Drought negatively impacts plant growth and the productivity of crops around the world. Understanding the molecular mechanisms in the drought response is important for improvement of drought tolerance using molecular techniques. In plants, abscisic acid (ABA) is accumulated under osmotic stress conditions caused by drought, and has a key role in stress responses and tolerance. Comprehensive molecular analyses have shown that ABA regulates the expression of many genes under osmotic stress conditions, and the ABA-responsive element (ABRE) is the major cis-element for ABA-responsive gene expression. Transcription factors (TFs) are master regulators of gene expression. ABRE-binding protein and ABRE-binding factor TFs control gene expression in an ABA-dependent manner. SNF1-related protein kinases 2, group A 2C-type protein phosphatases, and ABA receptors were shown to control the ABA signaling pathway. ABA-independent signaling pathways such as dehydration-responsive element-binding protein TFs and NAC TFs are also involved in stress responses including drought, heat, and cold. Recent studies have suggested that there are interactions between the major ABA signaling pathway and other signaling factors in stress responses. The important roles of these TFs in crosstalk among abiotic stress responses will be discussed. Control of ABA or stress signaling factor expression can improve tolerance to environmental stresses. Recent studies using crops have shown that stress-specific overexpression of TFs improves drought tolerance and grain yield compared with controls in the field.

  8. Development of improved methods for the LWR lattice physics code EPRI-CELL

    International Nuclear Information System (INIS)

    Williams, M.L.; Wright, R.Q.; Barhen, J.

    1982-07-01

    A number of improvements have been made by ORNL to the lattice physics code EPRI-CELL (E-C) which is widely used by utilities for analysis of power reactors. The code modifications were made mainly in the thermal and epithermal routines and resulted in improved reactor physics approximations and more efficient running times. The improvements in the thermal flux calculation included implementation of a group-dependent rebalance procedure to accelerate the iterative process and a more rigorous calculation of interval-to-interval collision probabilities. The epithermal resonance shielding methods used in the code have been extensively studied to determine its major approximations and to examine the sensitivity of computed results to these approximations. The study has resulted in several improvements in the original methodology

  9. Nitric Oxide-Related Biological Pathways in Patients with Major Depression.

    Directory of Open Access Journals (Sweden)

    Andreas Baranyi

    Full Text Available Major depression is a well-known risk factor for cardiovascular diseases and increased mortality following myocardial infarction. However, biomarkers of depression and increased cardiovascular risk are still missing. The aim of this prospective study was to evaluate, whether nitric-oxide (NO related factors for endothelial dysfunction, such as global arginine bioavailability, arginase activity, L-arginine/ADMA ratio and the arginine metabolites asymmetric dimethylarginine (ADMA and symmetric dimethylarginine (SDMA might be biomarkers for depression-induced cardiovascular risk.In 71 in-patients with major depression and 48 healthy controls the Global Arginine Bioavailability Ratio (GABR, arginase activity (arginine/ornithine ratio, the L-arginine/ADMA ratio, ADMA, and SDMA were determined by high-pressure liquid chromatography. Psychiatric and laboratory assessments were obtained at baseline at the time of in-patient admittance and at the time of hospital discharge.The ADMA concentrations in patients with major depression were significantly elevated and the SDMA concentrations were significantly decreased in comparison with the healthy controls. Even after a first improvement of depression, ADMA and SDMA levels remained nearly unchanged. In addition, after a first improvement of depression at the time of hospital discharge, a significant decrease in arginase activity, an increased L-arginine/ADMA ratio and a trend for increased global arginine bioavailability were observed.Our study results are evidence that in patients with major depression ADMA and SDMA might be biomarkers to indicate an increased cardiovascular threat due to depression-triggered NO reduction. GABR, the L-arginine/ADMA ratio and arginase activity might be indicators of therapy success and increased NO production after remission.

  10. The T Cell Response to Major Grass Allergens Is Regulated and Includes IL-10 Production in Atopic but Not in Non-Atopic Subjects

    DEFF Research Database (Denmark)

    Domdey, A.; Liu, A.; Millner, A.

    2010-01-01

    in allergen-specific responses. The aim was to determine whether major grass allergens induce production of suppressive cytokines in allergic and healthy subjects and to examine the inhibitory effect of these cytokines on allergic responses. Methods: Peripheral blood mononuclear cells (PBMCs) were isolated...... from healthy and grass-allergic donors and stimulated with the major grass allergens Phl p 1 or Phl p 5. The effects of endogenous IL-10 and/or TGF-beta on proliferation and cytokine production were determined by use of blocking antibodies. In addition, the number of CD4(+)CD25(+) T cells...... in PBMCs in the two groups, but fewer cells from atopic donors were CD4(+)CD25(+)CCR4(+) and more cells were CD4(+)CD25(+)CLA(+) compared to healthy donors. Conclusion: Allergen-specific responses of grass allergic patients but not in non-atopic subjects are influenced by regulatory cytokines produced...

  11. Meeting the milestones. Strategies for including high-value care education in pulmonary and critical care fellowship training.

    Science.gov (United States)

    Courtright, Katherine R; Weinberger, Steven E; Wagner, Jason

    2015-04-01

    Physician decision making is partially responsible for the roughly 30% of U.S. healthcare expenditures that are wasted annually on low-value care. In response to both the widespread public demand for higher-quality care and the cost crisis, payers are transitioning toward value-based payment models whereby physicians are rewarded for high-value, cost-conscious care. Furthermore, to target physicians in training to practice with cost awareness, the Accreditation Council for Graduate Medical Education has created both individual objective milestones and institutional requirements to incorporate quality improvement and cost awareness into fellowship training. Subsequently, some professional medical societies have initiated high-value care educational campaigns, but the overwhelming majority target either medical students or residents in training. Currently, there are few resources available to help guide subspecialty fellowship programs to successfully design durable high-value care curricula. The resource-intensive nature of pulmonary and critical care medicine offers unique opportunities for the specialty to lead in modeling and teaching high-value care. To ensure that fellows graduate with the capability to practice high-value care, we recommend that fellowship programs focus on four major educational domains. These include fostering a value-based culture, providing a robust didactic experience, engaging trainees in process improvement projects, and encouraging scholarship. In doing so, pulmonary and critical care educators can strive to train future physicians who are prepared to provide care that is both high quality and informed by cost awareness.

  12. Major intrinsic proteins (MIPs) in plants: a complex gene family with major impacts on plant phenotype.

    Science.gov (United States)

    Forrest, Kerrie L; Bhave, Mrinal

    2007-10-01

    The ubiquitous cell membrane proteins called aquaporins are now firmly established as channel proteins that control the specific transport of water molecules across cell membranes in all living organisms. The aquaporins are thus likely to be of fundamental significance to all facets of plant growth and development affected by plant-water relations. A majority of plant aquaporins have been found to share essential structural features with the human aquaporin and exhibit water-transporting ability in various functional assays, and some have been shown experimentally to be of critical importance to plant survival. Furthermore, substantial evidence is now available from a number of plant species that shows differential gene expression of aquaporins in response to abiotic stresses such as salinity, drought, or cold and clearly establishes the aquaporins as major players in the response of plants to conditions that affect water availability. This review summarizes the function and regulation of these genes to develop a greater understanding of the response of plants to water insufficiency, and particularly, to identify tolerant genotypes of major crop species including wheat and rice and plants that are important in agroforestry.

  13. Silencing of omega-5 gliadins in transgenic wheat eliminates a major source of environmental variability and improves dough mixing properties of flour.

    Science.gov (United States)

    Altenbach, Susan B; Tanaka, Charlene K; Seabourn, Bradford W

    2014-12-24

    The end-use quality of wheat flour varies as a result of the growth conditions of the plant. Among the wheat gluten proteins, the omega-5 gliadins have been identified as a major source of environmental variability, increasing in proportion in grain from plants that receive fertilizer or are subjected to high temperatures during grain development. The omega-5 gliadins also have been associated with the food allergy wheat-dependent exercise-induced anaphylaxis (WDEIA). Recently, transgenic lines with reduced levels of omega-5 gliadins were developed using RNA interference (RNAi). These lines make it possible to determine whether changes in the levels of omega-5 gliadins in response to environmental conditions and agronomic inputs may be responsible for changes in flour end-use quality. Two transgenic wheat lines and a non-transgenic control were grown under a controlled temperature regimen with or without post-anthesis fertilizer and the protein composition of the resulting flour was analyzed by quantitative two-dimensional gel electrophoresis (2-DE). In one transgenic line, all 2-DE spots identified as omega-5 gliadins were substantially reduced without effects on other proteins. In the other transgenic line, the omega-5 gliadins were absent and there was a partial reduction in the levels of the omega-1,2 gliadins and the omega-1,2 chain-terminating gliadins as well as small changes in several other proteins. With the exception of the omega gliadins, the non-transgenic control and the transgenic plants showed similar responses to the fertilizer treatment. Protein contents of flour were determined by the fertilizer regimen and were similar in control and transgenic samples produced under each regimen while both mixing time and mixing tolerance were improved in flour from transgenic lines when plants received post-anthesis fertilizer. The data indicate that omega-5 gliadins have a negative effect on flour quality and suggest that changes in quality with the growth

  14. Neurobiology of Major Depressive Disorder

    Directory of Open Access Journals (Sweden)

    Rosa Villanueva

    2013-01-01

    Full Text Available We survey studies which relate abnormal neurogenesis to major depressive disorder. Clinically, descriptive gene and protein expression analysis and genetic and functional studies revised here show that individual alterations of a complex signaling network, which includes the hypothalamic-pituitary-adrenal axis; the production of neurotrophins and growth factors; the expression of miRNAs; the production of proinflammatory cytokines; and, even, the abnormal delivery of gastrointestinal signaling peptides, are able to induce major mood alterations. Furthermore, all of these factors modulate neurogenesis in brain regions involved in MDD, and are functionally interconnected in such a fashion that initial alteration in one of them results in abnormalities in the others. We highlight data of potential diagnostic significance and the relevance of this information to develop new therapeutic approaches. Controversial issues, such as whether neurogenesis is the basis of the disease or whether it is a response induced by antidepressant treatments, are also discussed.

  15. A summary of deliberations on strategic planning for continuous quality improvement in laboratory medicine.

    Science.gov (United States)

    Grzybicki, Dana Marie; Shahangian, Shahram; Pollock, Anne M; Raab, Stephen S

    2009-03-01

    On September 24-26, 2007, the Centers for Disease Control and Prevention convened the 2007 Institute on Critical Issues in Health Laboratory Practice: Managing for Better Health to develop an action plan for change for the immediate and long-term future. A wide variety of stakeholders, including pathologists, pathologist extenders, clinicians, and researchers, examined means to improve laboratory service communication, quality parameters, and potential future laboratory contributions to health care. In this summary document, we present the identified gaps, barriers, and proposed action plans for improvement for laboratory medicine in the 6 quality domains identified by the Institute of Medicine: safety, effectiveness, patient centeredness, timeliness, efficiency, and equity. Five major recommendations emerged from concluding discussions and included focusing on preanalytic and postanalytic processes as areas of potential quality improvement and recruiting a multidisciplinary group of nonlaboratory stakeholders to work with laboratory personnel to achieve improvement goals.

  16. Nuclear reactor shield including magnesium oxide

    International Nuclear Information System (INIS)

    Rouse, C.A.; Simnad, M.T.

    1981-01-01

    An improvement is described for nuclear reactor shielding of a type used in reactor applications involving significant amounts of fast neutron flux. The reactor shielding includes means providing structural support, neutron moderator material, neutron absorber material and other components, wherein at least a portion of the neutron moderator material is magnesium in the form of magnesium oxide either alone or in combination with other moderator materials such as graphite and iron

  17. Interventions to improve patient hand hygiene: a systematic review.

    Science.gov (United States)

    Srigley, J A; Furness, C D; Gardam, M

    2016-09-01

    Nosocomial pathogens may be acquired by patients via their own unclean hands, but there has been relatively little emphasis on patient hand hygiene as a tool for preventing healthcare-associated infections (HCAIs). The aim of this systematic review was to determine the efficacy of patient hand hygiene interventions in reducing HCAIs and improving patient hand hygiene rates compared to usual care. Electronic databases and grey literature were searched to August 2014. Experimental and quasi-experimental studies were included if they evaluated a patient hand hygiene intervention conducted in an acute or chronic healthcare facility and included HCAI incidence and/or patient hand hygiene rates as an outcome. All steps were performed independently by two investigators. Ten studies were included, most of which were uncontrolled before-after studies (N=8). The majority of interventions (N=7) were multi-modal, with components similar to healthcare worker hand hygiene programmes, including education, reminders, audit and feedback, and provision of hand hygiene products. Six studies reported HCAI outcomes and four studies assessed patient hand hygiene rates; all demonstrated improvements but were at moderate to high risk of bias. In conclusion, interventions to improve patient hand hygiene may reduce the incidence of HCAIs and improve hand hygiene rates, but the quality of evidence is low. Future studies should use stronger designs and be more selective in their choice of outcomes. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  18. Major Environmental Policy in 2000

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hong Jin [Ministry Of Environment, Kwachon (Korea)

    2000-04-01

    As a new millennium has started, there are active movements developing a basic paradigm of vision and policy over a nation-wide to prepare changes actively. For the environmental sector, it is possible to live in a pleasant environment if everyone prepare and work together like dealing with Y2K problem. With a goal of being an environmentally advanced country in the early new millennium, it is planned to improve a basic life environment such as water and air and to promote an advanced environmental management policy for showing results of its reform in 2000. Therefore, it examines environmental management circumstances and a direction of environmental policy first and it discusses more about major environmental policy related to petroleum industry. 7 tabs.

  19. Assessment of major nuclear technologies with decision and risk analysis

    International Nuclear Information System (INIS)

    Winterfeldt, D. von

    1995-01-01

    Selecting technologies for major nuclear programs involves several complexities, including multiple stakeholders, multiple conflicting objectives, uncertainties, and risk. In addition, the programmatic risks related to the schedule, cost, and performance of these technologies often become major issues in the selection process. This paper describes a decision analysis approach for addressing these complexities in a logical manner

  20. Upward appraisal as a means for improving supervisory performance and promoting process improvement, with long-term implications for organizational change

    Science.gov (United States)

    Siegfeldt, Denise V.

    1994-01-01

    This study represents the implementation phase of an organizational development project which was initiated last year in the Management Support Division (MSD) at Langley Research Center to diagnose organizational functioning. As a result of MSD survey data from last year's effort, a Quality Action Team was created to address the responses compiled from the MSD Organizational Assessment Questionnaire and Follow-Up Questionnaire. The team was officially named the MSD Employee Relations Improvement Team (MERIT). MERIT's goal was to analyze major concerns generated by the questionnaires and to present feasible solutions to management which would improve supervisory performance, promote process improvement; and ultimately, lead to a better organization. The team met weekly and was very disciplined in following guidelines needed to ensure a fully functioning team. Several TQM tools were used during the team process, including brainstorming and the cause and effect diagram. One of the products produced by MERIT was a 'report card', more formally known as an upward appraisal system, to evaluate supervisory performance in the division office, its three branches, and in teams. Major areas of emphasis on the 47 item report card were those identified by employees through the previously administered questionnaires as needing to be improved; specifically, training, recognition, teamwork, supervision and leadership, and communication. MERIT created an enlarged and modified version of the report card which enabled scores for each individual supervisor to be recorded on a separate form, along with summary results and employee comments. Report card results have been compiled and fed back to the Division Chief and Assistant Division Chief. These individuals will in turn, feed the results back to the remaining supervisors and the team leaders. Although results differ among supervisors, some similarities exist. Communication generally appears to be adequate, which represents an

  1. NCCDS configuration management process improvement

    Science.gov (United States)

    Shay, Kathy

    1993-01-01

    By concentrating on defining and improving specific Configuration Management (CM) functions, processes, procedures, personnel selection/development, and tools, internal and external customers received improved CM services. Job performance within the section increased in both satisfaction and output. Participation in achieving major improvements has led to the delivery of consistent quality CM products as well as significant decreases in every measured CM metrics category.

  2. Setting priorities for EU healthcare workforce IT skills competence improvement.

    Science.gov (United States)

    Li, Sisi; Bamidis, Panagiotis D; Konstantinidis, Stathis Th; Traver, Vicente; Car, Josip; Zary, Nabil

    2017-04-01

    A major challenge for healthcare quality improvement is the lack of IT skills and knowledge of healthcare workforce, as well as their ambivalent attitudes toward IT. This article identifies and prioritizes actions needed to improve the IT skills of healthcare workforce across the EU. A total of 46 experts, representing different fields of expertise in healthcare and geolocations, systematically listed and scored actions that would improve IT skills among healthcare workforce. The Child Health and Nutrition Research Initiative methodology was used for research priority-setting. The participants evaluated the actions using the following criteria: feasibility, effectiveness, deliverability, and maximum impact on IT skills improvement. The leading priority actions were related to appropriate training, integrating eHealth in curricula, involving healthcare workforce in the eHealth solution development, improving awareness of eHealth, and learning arrangement. As the different professionals' needs are prioritized, healthcare workforce should be actively and continuously included in the development of eHealth solutions.

  3. IMPROVING CO2 EFFICIENCY FOR RECOVERING OIL IN HETEROGENEOUS RESERVOIRS

    International Nuclear Information System (INIS)

    Grigg, Reid B.

    2002-01-01

    A three-year contract, DOE Contract No. DE-FG26-01BC15364 ''Improving CO 2 Efficiency for Recovering Oil in Heterogeneous Reservoirs,'' was started on September 28, 2001. This project examines three major areas in which CO 2 flooding can be improved: fluid and matrix interactions, conformance control/sweep efficiency, and reservoir simulation for improved oil recovery. This report discusses the activity during the six-month period covering January 1, 2002 through June 30, 2002 that covers the second and third fiscal quarters of the project's first year. Paper SPE 75178, ''Cost Reduction and Injectivity Improvements for CO 2 Foams for Mobility Control,'' has been presented and included in the proceedings of the SPE/DOE Thirteenth Symposium on Improved Oil Recovery, Tulsa, OK, April 13-17, 2002. During these two quarters of the project we have been working in several areas: reservoir fluid/rock interactions and their relationships to changing injectivity, producer survey on injectivity, and surfactant adsorption on quarried and reservoir core

  4. Gene cloning: exploring cotton functional genomics and genetic improvement

    Institute of Scientific and Technical Information of China (English)

    Diqiu LIU; Xianlong ZHANG

    2008-01-01

    Cotton is the most important natural fiber plant in the world. The genetic improvement of the quality of the cotton fiber and agricultural productivity is imperative under the situation of increasing consumption and rapid development of textile technology. Recently, the study of cotton molecular biology has progressed greatly. A lot of specifically or preferentially expressed cotton fiber genes were cloned and analyzed. On the other hand, identification of stress response genes expressed in cotton was performed by other research groups. The major stress factors were studied including the wilt pathogens Verticillium dahliae, Fusarium oxy-sporum f. sp. vasinfectum, bacterial blight, root-knot nematode, drought, and salt stress. What is more, a few genes related to the biosynthesis of gossypol, other sesquiterpene phytoalexins and the major seed oil fatty acids were isolated from cotton. In the present review, we focused on the major advances in cotton gene cloning and expression profiling in the recent years.

  5. Improving outcomes in lung cancer: the value of the multidisciplinary health care team

    Directory of Open Access Journals (Sweden)

    Denton E

    2016-03-01

    Full Text Available Eve Denton,1 Matthew Conron2 1Allergy, Immunology and Respiratory Department, Alfred Hospital, 2Department of Respiratory and Sleep Medicine, St Vincent's Hospital, Melbourne, VIC, Australia Abstract: Lung cancer is a major worldwide health burden, with high disease-related morbidity and mortality. Unlike other major cancers, there has been little improvement in lung cancer outcomes over the past few decades, and survival remains disturbingly low. Multidisciplinary care is the cornerstone of lung cancer treatment in the developed world, despite a relative lack of evidence that this model of care improves outcomes. In this article, the available literature concerning the impact of multidisciplinary care on key measures of lung cancer outcomes is reviewed. This includes the limited observational data supporting improved survival with multidisciplinary care. The impact of multidisciplinary care on other benchmark measures of quality lung cancer treatment is also examined, including staging accuracy, access to diagnostic investigations, improvements in clinical decision making, better utilization of radiotherapy and palliative care services, and improved quality of life for patients. Health service research suggests that multidisciplinary care improves care coordination, leading to a better patient experience, and reduces variation in care, a problem in lung cancer management that has been identified worldwide. Furthermore, evidence suggests that the multidisciplinary model of care overcomes barriers to treatment, promotes standardized treatment through adherence to guidelines, and allows audit of clinical services and for these reasons is more likely to provide quality care for lung cancer patients. While there is strengthening evidence suggesting that the multidisciplinary model of care contributes to improvements in lung cancer outcomes, more quality studies are needed. Keywords: lung cancer, multidisciplinary care, mortality, tumor board

  6. Interdisciplinary Project Experiences: Collaboration between Majors and Non-Majors

    Science.gov (United States)

    Smarkusky, Debra L.; Toman, Sharon A.

    2014-01-01

    Students in computer science and information technology should be engaged in solving real-world problems received from government and industry as well as those that expose them to various areas of application. In this paper, we discuss interdisciplinary project experiences between majors and non-majors that offered a creative and innovative…

  7. Minerals in thalassaemia major patients: An overview.

    Science.gov (United States)

    Ozturk, Zeynep; Genc, Gizem Esra; Gumuslu, Saadet

    2017-05-01

    Thalassaemia major (TM) is a hereditary blood disease characterised by reduced or absent production of beta globin chains. Erythrocyte transfusions are given to raise the haemoglobin level in patients with thalassaemia major. However, transfusions have been related to increased risk of iron overload and tissue damage related to excess iron. Both elevated oxidative stress due to iron overload and increased hemolysis lead to over utilisation of minerals required for antioxidant enzymes activities. Iron chelators have been used to prevent iron overload in thalassaemia major patients, but these chelators have the possibility of removing minerals from the body. Thalassaemia patients are more at risk for mineral deficiency because of increased oxidative stress and iron chelation therapies. Growth and maturational delay, cardiomyopathy, endocrinopathies and osteoporosis are the complications of thalassaemia. Minerals may play a particular role to prevent these complications. In the current review, we provide an overview of minerals including zinc (Zn), copper (Cu), selenium (Se), magnesium (Mg) and calcium (Ca) in thalassaemia major patients. We, also, underline that some complications of thalassaemia can be caused by an increased need for minerals or lack of the minerals. Copyright © 2017 Elsevier GmbH. All rights reserved.

  8. The power of the National Surgical Quality Improvement Program--achieving a zero pneumonia rate in general surgery patients.

    Science.gov (United States)

    Fuchshuber, Pascal R; Greif, William; Tidwell, Chantal R; Klemm, Michael S; Frydel, Cheryl; Wali, Abdul; Rosas, Efren; Clopp, Molly P

    2012-01-01

    The National Surgical Quality Improvement Program (NSQIP) of the American College of Surgeons provides risk-adjusted surgical outcome measures for participating hospitals that can be used for performance improvement of surgical mortality and morbidity. A surgical clinical nurse reviewer collects 135 clinical variables including preoperative risk factors, intraoperative variables, and 30-day postoperative mortality and morbidity outcomes for patients undergoing major surgical procedures. A report on mortality and complications is prepared twice a year. This article summarizes briefly the history of NSQIP and how its report on surgical outcomes can be used for performance improvement within a hospital system. In particular, it describes how to drive performance improvement with NSQIP data using the example of postoperative respiratory complications--a major factor of postoperative mortality. In addition, this article explains the benefit of a collaborative of several participating NSQIP hospitals and describes how to develop a "playbook" on the basis of an outcome improvement project.

  9. Diabetes mellitus in β-thalassemia major patients

    Directory of Open Access Journals (Sweden)

    Riadi Wirawan

    2003-06-01

    Full Text Available β-thalassemia major is a disease caused by β polypeptide chain synthesis disorder which is inherited as an autosomal recessive from both parents which is marked by little or no β globin chain synthesis. Medication for β thalassemia major patients is by repeated blood transfusions, which causes hemochromatosis. Hemochromatosis can occur in various organs including the pancreas. The aim of the study was to assess the alteration of plasma glucose concentration and the hemochromatosis prevalence. Fasting plasma glucose concentration and serum ferritin examination were measured in 115 β thalassemia major patients with ages between 10-23 years who were out-patients in the Thalassemia Centre, Department of Child Health, Medical School, University of Indonesia / Dr. Cipto Mangunkusumo General Hospital, Jakarta. The plasma glucose concentration examination was conducted by the GDH enzymatic method, with American Diabetes Association (ADA criteria in the evaluation, while the serum ferritin examination was conducted with the microparticle enzyme immuno assay (MEIA method. All patients had hemochromatosis, 14.8% of the patients had impaired fasting glucose level and 2.6% of the patients showed indications of diabetes mellitus. β thalassemia major patients who receive frequent transfusions will develop hemochromatosis that will in turn impair the pancreatic function. (Med J Indones 2003; 12: 87-93 Keywords : β thalassemia major, hemochromatosis, diabetes mellitus

  10. Science Café Course: An Innovative Means of Improving Communication Skills of Undergraduate Biology Majors

    Directory of Open Access Journals (Sweden)

    Anna Goldina

    2013-12-01

    Full Text Available To help bridge the increasing gap between scientists and the public, we developed an innovative two-semester course, called Science Café. In this course undergraduate biology majors learn to develop communication skills to be better able to explain science concepts and current developments in science to non-scientists. Students develop and host outreach events on various topics relevant to the community, thereby increasing interactions between budding scientists and the public. Such a Science Cafe course emphasizes development of science communication skills early, at the undergraduate level and empowers students to use their science knowledge in every day interactions with the public to increase science literacy, get involved in the local community and engage the public in a dialogue on various pressing science issues. We believe that undergraduate science majors can be great ambassadors for science and are often overlooked since many aspire to go on to medical/veterinary/pharmacy schools. However, science communication skills are especially important for these types of students because when they become healthcare professionals, they will interact with the public as part of their everyday jobs and can thus be great representatives for the field.

  11. Societal risk and major disasters

    International Nuclear Information System (INIS)

    Clement, C.F.

    1989-01-01

    A disaster can be defined as an event, or a series of events, in which a large number of people is adversely affected by a single cause. This definition includes man-made accidents, like that at Chernobyl, as well as the natural disasters that insurance companies are sometimes pleased to describe as Acts of God. In 1986 alone, 12,000 people died and 2.2 million were made homeless by 215 major accidents or disasters. The nature of risk is examined in this paper. (author)

  12. African-American students' perceptions of their majors, future professions, and the dietetics major and profession: a qualitative analysis.

    Science.gov (United States)

    Felton, Teena M; Nickols-Richardson, Sharon M; Serrano, Elena; Hosig, Kathy W

    2008-07-01

    African-American professionals are underrepresented in the profession of dietetics. This preliminary qualitative study identified African-American students' perceptions of their majors, future professions, and the dietetics major/profession to understand why they did or did not enter dietetics. It was hypothesized that dietetics students chose dietetics primarily for altruistic reasons, whereas students in other fields of study did not choose dietetics due to lack of awareness of dietetics. To learn students' views, African-American college students engaged in elicitation interviews or focus group discussions. Twenty-eight women and 12 men participated. Phenomenologic analysis identified common themes and meanings: African-American students selected their majors for a variety of reasons, including desire to help people, interest in the field, recommendation from an adult, and family influence. African-American students in fields of study other than dietetics believed that the dietetics major was not selected due to lack of awareness about dietetics. Both dietetics students and students in other fields of study perceived versatility, ability to work with/help people, and to have an influence as positive qualities about their future professions. Advanced degree and training requirements, lack of diversity, and low salary were identified as negative qualities about future professions. African-American students in fields of study other than dietetics had not been exposed to the dietetics major, careers, and profession. Recruitment efforts should begin early to increase the number of African-American students in dietetics.

  13. Conceptualizing a Dynamic Fall Risk Model Including Intrinsic Risks and Exposures.

    Science.gov (United States)

    Klenk, Jochen; Becker, Clemens; Palumbo, Pierpaolo; Schwickert, Lars; Rapp, Kilan; Helbostad, Jorunn L; Todd, Chris; Lord, Stephen R; Kerse, Ngaire

    2017-11-01

    Falls are a major cause of injury and disability in older people, leading to serious health and social consequences including fractures, poor quality of life, loss of independence, and institutionalization. To design and provide adequate prevention measures, accurate understanding and identification of person's individual fall risk is important. However, to date, the performance of fall risk models is weak compared with models estimating, for example, cardiovascular risk. This deficiency may result from 2 factors. First, current models consider risk factors to be stable for each person and not change over time, an assumption that does not reflect real-life experience. Second, current models do not consider the interplay of individual exposure including type of activity (eg, walking, undertaking transfers) and environmental risks (eg, lighting, floor conditions) in which activity is performed. Therefore, we posit a dynamic fall risk model consisting of intrinsic risk factors that vary over time and exposure (activity in context). eHealth sensor technology (eg, smartphones) begins to enable the continuous measurement of both the above factors. We illustrate our model with examples of real-world falls from the FARSEEING database. This dynamic framework for fall risk adds important aspects that may improve understanding of fall mechanisms, fall risk models, and the development of fall prevention interventions. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  14. Effectiveness of Interventions for Caregivers of People With Alzheimer's Disease and Related Major Neurocognitive Disorders: A Systematic Review.

    Science.gov (United States)

    Piersol, Catherine Verrier; Canton, Kerry; Connor, Susan E; Giller, Ilana; Lipman, Stacy; Sager, Suzanne

    The goal of the evidence review was to evaluate the effectiveness of interventions for caregivers of people with Alzheimer's disease and related major neurocognitive disorders that facilitate the ability to maintain participation in the caregiver role. Scientific literature published in English between January 2006 and April 2014 was reviewed. Databases included MEDLINE, PsycINFO, CINAHL, OTseeker, and the Cochrane Database of Systematic Reviews. Of 2,476 records screened, 43 studies met inclusion criteria. Strong evidence shows that multicomponent psychoeducational interventions improve caregiver quality of life (QOL), confidence, and self-efficacy and reduce burden; cognitive reframing reduces caregiver anxiety, depression, and stress; communication skills training improves caregiver skill and QOL in persons with dementia; mindfulness-based training improves caregiver mental health and reduces stress and burden; and professionally led support groups enhance caregiver QOL. Strong evidence exists for a spectrum of caregiver interventions. Translation of effective interventions into practice and evaluation of sustainability is necessary. Copyright © 2017 by the American Occupational Therapy Association, Inc.

  15. A water-based training program that include perturbation exercises to improve stepping responses in older adults: study protocol for a randomized controlled cross-over trial

    Directory of Open Access Journals (Sweden)

    Tsedek Irit

    2008-08-01

    Full Text Available Abstract Background Gait and balance impairments may increase the risk of falls, the leading cause of accidental death in the elderly population. Fall-related injuries constitute a serious public health problem associated with high costs for society as well as human suffering. A rapid step is the most important protective postural strategy, acting to recover equilibrium and prevent a fall from initiating. It can arise from large perturbations, but also frequently as a consequence of volitional movements. We propose to use a novel water-based training program which includes specific perturbation exercises that will target the stepping responses that could potentially have a profound effect in reducing risk of falling. We describe the water-based balance training program and a study protocol to evaluate its efficacy (Trial registration number #NCT00708136. Methods/Design The proposed water-based training program involves use of unpredictable, multi-directional perturbations in a group setting to evoke compensatory and volitional stepping responses. Perturbations are made by pushing slightly the subjects and by water turbulence, in 24 training sessions conducted over 12 weeks. Concurrent cognitive tasks during movement tasks are included. Principles of physical training and exercise including awareness, continuity, motivation, overload, periodicity, progression and specificity were used in the development of this novel program. Specific goals are to increase the speed of stepping responses and improve the postural control mechanism and physical functioning. A prospective, randomized, cross-over trial with concealed allocation, assessor blinding and intention-to-treat analysis will be performed to evaluate the efficacy of the water-based training program. A total of 36 community-dwelling adults (age 65–88 with no recent history of instability or falling will be assigned to either the perturbation-based training or a control group (no training

  16. Identifying and characterizing major emission point sources as a basis for geospatial distribution of mercury emissions inventories

    Science.gov (United States)

    Steenhuisen, Frits; Wilson, Simon J.

    2015-07-01

    Mercury is a global pollutant that poses threats to ecosystem and human health. Due to its global transport, mercury contamination is found in regions of the Earth that are remote from major emissions areas, including the Polar regions. Global anthropogenic emission inventories identify important sectors and industries responsible for emissions at a national level; however, to be useful for air transport modelling, more precise information on the locations of emission is required. This paper describes the methodology applied, and the results of work that was conducted to assign anthropogenic mercury emissions to point sources as part of geospatial mapping of the 2010 global anthropogenic mercury emissions inventory prepared by AMAP/UNEP. Major point-source emission sectors addressed in this work account for about 850 tonnes of the emissions included in the 2010 inventory. This work allocated more than 90% of these emissions to some 4600 identified point source locations, including significantly more point source locations in Africa, Asia, Australia and South America than had been identified during previous work to geospatially-distribute the 2005 global inventory. The results demonstrate the utility and the limitations of using existing, mainly public domain resources to accomplish this work. Assumptions necessary to make use of selected online resources are discussed, as are artefacts that can arise when these assumptions are applied to assign (national-sector) emissions estimates to point sources in various countries and regions. Notwithstanding the limitations of the available information, the value of this procedure over alternative methods commonly used to geo-spatially distribute emissions, such as use of 'proxy' datasets to represent emissions patterns, is illustrated. Improvements in information that would facilitate greater use of these methods in future work to assign emissions to point-sources are discussed. These include improvements to both national

  17. Effect of physical inactivity on major non-communicable diseases worldwide

    DEFF Research Database (Denmark)

    Lee, I-Min; Shiroma, Eric J; Lobelo, Felipe

    2012-01-01

    Strong evidence shows that physical inactivity increases the risk of many adverse health conditions, including major non-communicable diseases such as coronary heart disease, type 2 diabetes, and breast and colon cancers, and shortens life expectancy. Because much of the world's population...... is inactive, this link presents a major public health issue. We aimed to quantify the eff ect of physical inactivity on these major non-communicable diseases by estimating how much disease could be averted if inactive people were to become active and to estimate gain in life expectancy at the population level....

  18. 38 CFR 41.520 - Major program determination.

    Science.gov (United States)

    2010-07-01

    ... major programs. This risk-based approach shall include consideration of: Current and prior audit... of prior audit findings under § 41.510(a)(7) do not preclude the Type A program from being low-risk... this section), except this paragraph (e)(2)(i)(A) does not require the auditor to audit more high-risk...

  19. 78 FR 54949 - Major Project Financial Plan Guidance

    Science.gov (United States)

    2013-09-06

    ...'' (GA-090-751). That report recommended that Financial Plans include the cost of financing the project... Project Financial Plan Guidance AGENCY: Federal Highway Administration (FHWA), DOT. ACTION: Notice; Request for comments. SUMMARY: This notice requests comments on draft Major Project Financial Plan...

  20. Evaluation of major polluting accidents in China-Results and perspectives

    International Nuclear Information System (INIS)

    Hou Yu; Zhang Tianzhu

    2009-01-01

    Lessons learnt from accidents are essential sources for updating state-of-the-art requirements in pollution accident prevention. To improve this input in the People's Republic of China in a systematic way, a database for collecting and evaluating major pollution accidents is being established. This is being done in co-operation with Chinese Society for Environment Sciences and other national Institutions. At the time of writing over 80 major events from 2002-2006 have been collected. In this paper, a summary evaluation on the major polluting events in China from 2002 to 2006 is presented and some basic lessons drawn shown. There is no a systematic pollution accident notification system currently in China. The results from root cause analysis underline the importance of emergency measures, maintenance, human factor issues and the role of safety organization. Chronic pollution, especially water pollution and air pollution should be paid the same attention as the sudden pollution. It is important to keep in mind that collecting information from major accidents represents a small percentage of the actual number of events taking place.

  1. Regional cerebral blood flow (rCBF) changes in major depression

    International Nuclear Information System (INIS)

    Ohtaki, Junichi

    1992-01-01

    Regional cerebral blood flow (rCBF) in patients with major depression and in normal controls was measured by single photon emission computed tomography (SPECT) using N-isopropyl-p [ 123 I]-iodoamphetamine (IMP). The subjects were 22 patients with major depression and 14 normal controls. The rCBF was calculated by the ratio of activity per pixel in the cortical regions to activity per pixel in the cerebellum. IMP-SPECT was conducted in patients with major depression under the depressive and remitted states. rCBF values in the frontal, parietal, temporal, basal ganglia and the occipital regions, and the mean rCBF values were significantly lower in depressive patients than in the controls. Increased rCBF values were observed, and the mean rCBF became normal in the state of remittence. There was no significant difference in mean rCBF between depressive patients and the controls. Therefore, because the lower rCBF was normalized following improvement in expressive symptoms, the rCBF values could be useful as 'state dependent markers' in patients with major depression. (author)

  2. The Relationships among Learning Behaviors, Major Satisfaction, and Study Skills of First-Year Medical Students.

    Science.gov (United States)

    Park, Minjung

    2011-06-01

    This study aims at increasing our understanding of first-year medical students' learning behaviors, major satisfaction, and study skills. We investigate different features of freshmen's behavior in relation to learning and explore the extent to which freshmen were satisfied with their major and perceived their study skills. A total of 106 freshmen participated in this study. At midyear, first-year medical students were asked to complete a questionnaire that included the learning behaviors, major satisfaction, and study skills. The data collected from the survey were analyzed using t-test, ANOVA, chi-square test, correlation analysis, and multiple regression analysis. The study reported that most of freshmen had a lot of difficulties in studying at medical school by lack of prior learning. Despite first-year students, they were studying hard their major. Freshmen spent studying an average of 1 hour or less than 2 hours every day. The study also indicated that of major satisfaction, the overall satisfaction of the department was the highest and the satisfaction in learning environment was the lowest. There were significant differences among the freshmen on the major satisfaction due to admission process, academic performance, and housing type. Of 11 study skills, while freshman highly perceived their teamwork, stress management, and reading skills, their weak study skills identified in this study were writing, note taking, time management, and test taking skills. There were significant differences among the freshmen on the study skills due to gender and academic performance. Finally, freshmen's learning behaviors and major satisfaction were significantly associated with some of study skills. This study may have implications for the academic adjustment and learning processes in the first year. We need to consider variables such as learning behaviors, major satisfaction, and study skills, when discussing about how to maximize the learning potential of medical students

  3. Theory-based practice in a major medical centre.

    Science.gov (United States)

    Alligood, Martha Raile

    2011-11-01

    This project was designed to improve care quality and nursing staff satisfaction. Nursing theory structures thought and action as demonstrated by evidence of improvement in complex health-care settings. Nursing administrators selected Modelling and Role-Modelling (MRM) for the theory-based practice goal in their strategic plan. An action research approach structured implementation of MRM in a 1-year consultation project in 2001-2002. Quality of health care improved according to national quality assessment ratings, as well as patient satisfaction and nurse satisfaction. Modelling and Role-Modelling demonstrated capacity to structure nursing thought and action in patient care in a major medical centre. Uniformity of patient care language was valued by nurses as well as by allied health providers who wished to learn the holistic MRM style of practice. The processes of MRM and action research contributed to project success. A positive health-care change project was carried out in a large medical centre with action research. Introducing MRM theory-based practice was a beneficial decision by nursing administration that improved care and nurse satisfaction. Attention to nursing practice stimulated career development among the nurses to pursue bachelors, masters, and doctoral degrees. © 2011 Blackwell Publishing Ltd.

  4. Unsupervised classification of major depression using functional connectivity MRI.

    Science.gov (United States)

    Zeng, Ling-Li; Shen, Hui; Liu, Li; Hu, Dewen

    2014-04-01

    The current diagnosis of psychiatric disorders including major depressive disorder based largely on self-reported symptoms and clinical signs may be prone to patients' behaviors and psychiatrists' bias. This study aims at developing an unsupervised machine learning approach for the accurate identification of major depression based on single resting-state functional magnetic resonance imaging scans in the absence of clinical information. Twenty-four medication-naive patients with major depression and 29 demographically similar healthy individuals underwent resting-state functional magnetic resonance imaging. We first clustered the voxels within the perigenual cingulate cortex into two subregions, a subgenual region and a pregenual region, according to their distinct resting-state functional connectivity patterns and showed that a maximum margin clustering-based unsupervised machine learning approach extracted sufficient information from the subgenual cingulate functional connectivity map to differentiate depressed patients from healthy controls with a group-level clustering consistency of 92.5% and an individual-level classification consistency of 92.5%. It was also revealed that the subgenual cingulate functional connectivity network with the highest discriminative power primarily included the ventrolateral and ventromedial prefrontal cortex, superior temporal gyri and limbic areas, indicating that these connections may play critical roles in the pathophysiology of major depression. The current study suggests that subgenual cingulate functional connectivity network signatures may provide promising objective biomarkers for the diagnosis of major depression and that maximum margin clustering-based unsupervised machine learning approaches may have the potential to inform clinical practice and aid in research on psychiatric disorders. Copyright © 2013 Wiley Periodicals, Inc.

  5. Approaches for improving thermostability characteristics in cellulases.

    Science.gov (United States)

    Anbar, Michael; Bayer, Edward A

    2012-01-01

    Many efforts have been invested to reduce the cost of biofuel production to substitute renewable sources of energy for fossil-based fuels. At the forefront of these efforts are the initiatives to convert plant-derived cellulosic material to biofuels. Although significant improvements have been achieved recently in cellulase engineering in both efficiency and cost reduction, complete degradation of lignocellulosic material still requires very long periods of time and high enzyme loads. Thermostable cellulases offer many advantages in the bioconversion process, which include increase in specific activity, higher levels of stability, inhibition of microbial growth, increase in mass transfer rate due to lower fluid viscosity, and greater flexibility in the bioprocess. Besides rational design methods, which require deep understanding of protein structure-function relationship, two of the major methods for improvement in specific cellulase properties are directed evolution and knowledge-based library design based on multiple sequence alignments. In this chapter, we provide protocols for constructing and screening of improved thermostable cellulases. Modifications of these protocols may also be used for screening for other improved properties of cellulases such as pH tolerance, high salt, and more. Copyright © 2012 Elsevier Inc. All rights reserved.

  6. Strategies for improving memory: a randomized trial of memory groups for older people, including those with mild cognitive impairment.

    Science.gov (United States)

    Kinsella, Glynda J; Ames, David; Storey, Elsdon; Ong, Ben; Pike, Kerryn E; Saling, Michael M; Clare, Linda; Mullaly, Elizabeth; Rand, Elizabeth

    2016-01-01

    Governments are promoting the importance of maintaining cognitive health into older age to minimize risk of cognitive decline and dementia. Older people with amnestic mild cognitive impairment (aMCI) are particularly vulnerable to memory challenges in daily activities and are seeking ways to maintain independent living. To evaluate the effectiveness of memory groups for improving memory strategies and memory ability of older people, especially those with aMCI. 113 healthy older adults (HOA) and 106 adults with aMCI were randomized to a six-week memory group or a waitlist control condition. Outcome was evaluated through knowledge and use of memory strategies, memory ability (self-report and neuropsychological tests), and wellbeing. Assessments included a six-month follow-up. Using intention to treat analyses, there were intervention effects for HOA and aMCI groups in strategy knowledge (HOA: η2= 0.20; aMCI: η2= 0.06), strategy use (HOA: η2= 0.18; aMCI: η2= 0.08), and wellbeing (HOA: η2= 0.11; aMCI: η2= 0.05). There were also intervention effects in the HOA group, but not the aMCI group, in self-reported memory ability (η2= 0.06) and prospective memory tests (η2= 0.02). By six-month follow-up, gains were found on most HOA outcomes. In the aMCI group gains were found in strategy use, and by this stage, gains in prospective memory were also found. Memory groups can engage older people in techniques for maintaining cognitive health and improve memory performance, but more modest benefits are seen for older adults with aMCI.

  7. Charting the internal landscape: Affect associated with thoughts about major life domains explains life satisfaction

    Directory of Open Access Journals (Sweden)

    Talya Miron-Shatz

    2013-09-01

    Full Text Available Studies of happiness have examined the impact of demographics, personality and emotions accompanying daily activities on life satisfaction. We suggest that how people feel while contemplating aspects of their lives, including their weight, children and future prospects, is a promising yet uncharted territory within the internal landscape of life satisfaction. In a sample of 811 American women, we assessed women's feelings when thinking about major life domains and frequency of thoughts about each domain. Regression and dominance analyses showed that emotional valence of thoughts about major life domains was an important predictor of current and prior life satisfaction, surpassing, in descending order, demographics, participants' feelings during recent activities, and their neuroticism and extraversion scores. Domains thought about more frequently were often associated with greater emotional valence. These results suggest that life satisfaction may be improved by modifying emotional valence and frequency of thoughts about life domains. Moreover, these thoughts appear to be an important and relatively stable component of well-being worthy of further study.

  8. Evidence or eminence in abdominal surgery: Recent improvements in perioperative care

    OpenAIRE

    Segelman, Josefin; Nygren, Jonas

    2014-01-01

    Repeated surveys from Europe, the United States, Australia, and New Zealand have shown that adherence to an evidence-based perioperative care protocol, such as Enhanced Recovery After Surgery (ERAS), has been generally low. It is of great importance to support the implementation of the ERAS protocol as it has been shown to improve outcomes after a number of surgical procedures, including major abdominal surgery. However, despite an increasing awareness of the importance of structured perioper...

  9. Idaho Chemical Processing Plant Process Efficiency improvements

    International Nuclear Information System (INIS)

    Griebenow, B.

    1996-03-01

    In response to decreasing funding levels available to support activities at the Idaho Chemical Processing Plant (ICPP) and a desire to be cost competitive, the Department of Energy Idaho Operations Office (DOE-ID) and Lockheed Idaho Technologies Company have increased their emphasis on cost-saving measures. The ICPP Effectiveness Improvement Initiative involves many activities to improve cost effectiveness and competitiveness. This report documents the methodology and results of one of those cost cutting measures, the Process Efficiency Improvement Activity. The Process Efficiency Improvement Activity performed a systematic review of major work processes at the ICPP to increase productivity and to identify nonvalue-added requirements. A two-phase approach was selected for the activity to allow for near-term implementation of relatively easy process modifications in the first phase while obtaining long-term continuous improvement in the second phase and beyond. Phase I of the initiative included a concentrated review of processes that had a high potential for cost savings with the intent of realizing savings in Fiscal Year 1996 (FY-96.) Phase II consists of implementing long-term strategies too complex for Phase I implementation and evaluation of processes not targeted for Phase I review. The Phase II effort is targeted for realizing cost savings in FY-97 and beyond

  10. Adoption of improved oil palm processing technology in Umuahia ...

    African Journals Online (AJOL)

    It was found that a large percentage of the respondents were aware of the 5 improved oil palm processing technologies with friends and relatives as major source of information. Adoption was significant for 3 out of 5 technologies under study. The major constraints to improved oil palm processing technologies were high ...

  11. Suggestions of Policy Direction to Improve the Housing Quality in South Korea

    Directory of Open Access Journals (Sweden)

    Miyeon Park

    2016-05-01

    Full Text Available Following the recent global climate changes, many countries, including developed nations, are announcing greenhouse gas (GHG reduction targets and are actively participating in reducing GHG. Therefore, the role of the building sector on reducing GHG is being emphasized, and the establishment of policy structures for both making environmentally friendly capacity compulsory and improving the housing quality is being demanded. South Korea is also developing a policy for improving housing quality, but in order to achieve more competitive growth, this must be preceded by an analysis of current policy status within various countries on improving housing quality. This study aims to suggest direction about policies that will improve the housing quality in South Korea. For this, the policies of major countries were able to categorize and compare according to three major categories (performance, function, and aesthetics, and seven factors (safety, durability, cost and maintenance, response to residents’ needs, habitability, energy saving, and building design regarding housing quality. As a result, from the performance aspect, policy directions were suggested for safe housing, the urban environment, regeneration of quality stock, and the usage of existing stock; from the functional aspect, policies for improving housing quality that responds to the aging population and energy saving housing were suggested; from the aesthetic aspect, housing designs that consider the urban environment were suggested.

  12. Major advances in fresh milk and milk products: fluid milk products and frozen desserts.

    Science.gov (United States)

    Goff, H D; Griffiths, M W

    2006-04-01

    Major technological advances in the fluid milk processing industry in the last 25 yr include significant improvements in all the unit operations of separation, standardization, pasteurization, homogenization, and packaging. Many advancements have been directed toward production capacity, automation, and hygienic operation. Extended shelf-life milks are produced by high heat treatment, sometimes coupled with microfiltration or centrifugation. Other nonthermal methods have also been investigated. Flavored milk beverages have increased in popularity, as have milk beverages packaged in single-service, closeable plastic containers. Likewise, the frozen dairy processing industry has seen the development of large-capacity, automated processing equipment for a wide range of products designed to gain market share. Significant advancements in product quality have been made, many of these arising from improved knowledge of the functional properties of ingredients and their impact on structure and texture. Incidents of foodborne disease associated with dairy products continue to occur, necessitating even greater diligence in the control of pathogen transmission. Analytical techniques for the rapid detection of specific types of microorganisms have been developed and greatly improved during this time. Despite tremendous technological advancements for processors and a greater diversity of products for consumers, per capita consumption of fluid milk has declined and consumption of frozen dairy desserts has been steady during this 25-yr period.

  13. MAJOR: AN ASPECT WEAVER WITH FULL COVERAGE SUPPORT

    Directory of Open Access Journals (Sweden)

    Alex Villazón

    2011-01-01

    In this article we present MAJOR, an aspect weaver with full coverage support. That is, MAJOR ensures that aspects are woven into all classes loaded in a Java Virtual Machine, including those in the standard Java class library. We describe the intricacies of instrumentation of the Java class library and present an extended instrumentation approach allowing the user to choose between a pure Java weaving solution based on a two-phases instrumentation scheme, or a single-phase one requiring a tiny native code layer. The single-phase approach allows to better isolate the weaving process from the execution of the woven code.

  14. Genetic evaluation with major genes and polygenic inheritance when some animals are not genotyped using gene content multiple-trait BLUP.

    Science.gov (United States)

    Legarra, Andrés; Vitezica, Zulma G

    2015-11-17

    In pedigreed populations with a major gene segregating for a quantitative trait, it is not clear how to use pedigree, genotype and phenotype information when some individuals are not genotyped. We propose to consider gene content at the major gene as a second trait correlated to the quantitative trait, in a gene content multiple-trait best linear unbiased prediction (GCMTBLUP) method. The genetic covariance between the trait and gene content at the major gene is a function of the substitution effect of the gene. This genetic covariance can be written in a multiple-trait form that accommodates any pattern of missing values for either genotype or phenotype data. Effects of major gene alleles and the genetic covariance between genotype at the major gene and the phenotype can be estimated using standard EM-REML or Gibbs sampling. Prediction of breeding values with genotypes at the major gene can use multiple-trait BLUP software. Major genes with more than two alleles can be considered by including negative covariances between gene contents at each different allele. We simulated two scenarios: a selected and an unselected trait with heritabilities of 0.05 and 0.5, respectively. In both cases, the major gene explained half the genetic variation. Competing methods used imputed gene contents derived by the method of Gengler et al. or by iterative peeling. Imputed gene contents, in contrast to GCMTBLUP, do not consider information on the quantitative trait for genotype prediction. GCMTBLUP gave unbiased estimates of the gene effect, in contrast to the other methods, with less bias and better or equal accuracy of prediction. GCMTBLUP improved estimation of genotypes in non-genotyped individuals, in particular if these individuals had own phenotype records and the trait had a high heritability. Ignoring the major gene in genetic evaluation led to serious biases and decreased prediction accuracy. CGMTBLUP is the best linear predictor of additive genetic merit including

  15. What makes British general practitioners take part in a quality improvement scheme?

    Science.gov (United States)

    Spooner, A; Chapple, A; Roland, M

    2001-07-01

    To understand the reasons for the apparent success of a quality improvement scheme designed to produce widespread changes in chronic disease management in primary care. Purposeful sample of 36 primary care staff, managers and specialists. Qualitative analysis of 27 interviews in East Kent Health Authority area, where, over a three-year period, more than three-quarters of general practitioners (GPs) and enrolled in a quality improvement programme which required them to meet challenging chronic disease management targets (PRImary Care Clinical Effectiveness--PRICCE). Major changes in clinical practice appeared to have taken place as a result of participation in PRICCE. The scheme was significantly dependent on leadership from the health authority and on local professional support. Factors that motivated GPs to take part in the project included: a desire to improve patient care; financial incentives; maintenance of professional autonomy in how to reach the targets; maintenance of professional pride; and peer pressure. Good teamworking was essential to successful completion of the project and often improved as a result of taking part. The scheme included a combination of interventions known to be effective in producing professional behavioural change. When managerial vision is aligned to professional values, and combined with a range of interventions known to influence professional behaviour including financial incentives, substantial changes in clinical practice can result. Lessons are drawn for future quality improvement programmes in the National Health Service.

  16. Analisys of pectoralis major tendon in weightlifting athletes using ultrasonography and elastography

    OpenAIRE

    Pochini, Alberto de Castro; Ferretti, Mario; Kawakami, Eduardo Felipe Kin Ito; Fernandes, Artur da Rocha Corr?a; Yamada, Andre Fukunishi; de Oliveira, Gabriela Clemente; Cohen, Mois?s; Andreoli, Carlos Vicente; Ejnisman, Benno

    2015-01-01

    ABSTRACT Objective To evaluate tendinopathy of the pectoralis major muscle in weightlifting athletes using ultrasound and elastography. Methods This study included 20 patients, 10 with rupture of the pectoralis major muscle and 10 control patients. We evaluated pectoralis major muscle contralateral tendon with ultrasonographic and elastography examinations. The ultrasonographic examinations were performed using a high-resolution B mode ultrasound device. The elastography evaluation was cl...

  17. Paracetamol, Ibuprofen, and Recurrent Major Cardiovascular and Major Bleeding Events in 19 120 Patients With Recent Ischemic Stroke.

    Science.gov (United States)

    Gonzalez-Valcarcel, Jaime; Sissani, Leila; Labreuche, Julien; Bousser, Marie-Germaine; Chamorro, Angel; Fisher, Marc; Ford, Ian; Fox, Kim M; Hennerici, Michael G; Mattle, Heinrich P; Rothwell, Peter M; Steg, Philippe Gabriel; Vicaut, Eric; Amarenco, Pierre

    2016-04-01

    The presumed safety of paracetamol in high-cardiovascular risk patients has been questioned. We determined whether paracetamol or ibuprofen use is associated with major cardiovascular events (MACE) or major bleeding in 19 120 patients with recent ischemic stroke or transient ischemic attack of mainly atherothrombotic origin included in the Prevention of cerebrovascular and cardiovascular events of ischemic origin with terutroban in patients with a history of ischemic stroke or transient ischemic attack (PERFORM) trial. We performed 2 nested case-control analysis (2153 cases with MACE during trial follow-up and 4306 controls matched on Essen stroke risk score; 809 cases with major bleeding matched with 1616 controls) and a separate time-varying analysis. 12.3% were prescribed paracetamol and 2.5% ibuprofen. Median duration of treatment was 14 (interquartile range 5-145) days for paracetamol and 9 (5-30) days for ibuprofen. Paracetamol, but not ibuprofen, was associated with increased risk of MACE (odds ratio 1.21, 95% confidence interval [CI] 1.04-1.42) or a major bleeding (odds ratio 1.60, 95% CI 1.26-2.03), with no impact of daily dose and duration of paracetamol treatment. Time-varying analysis found an increased risk of MACE with both paracetamol (hazard ratio 1.22, 95% CI 1.05-1.43) and ibuprofen (hazard ratio 1.47, 95% CI 1.06-2.03) and of major bleeding with paracetamol (hazard ratio 1.95, 95% CI 1.45-2.62). There was a weak and inconsistent signal for association between paracetamol or ibuprofen and MACE or major bleeding, which may be related to either a genuine but modest effect of these drugs or to residual confounding. http://www.isrctn.com. Unique identifier: ISRCTN66157730. © 2016 American Heart Association, Inc.

  18. ASSOCIATION OF HFE GENE MUTATION IN THALASSEMIA MAJOR PATIENTS

    Directory of Open Access Journals (Sweden)

    Amit Kumar Tiwari

    2016-11-01

    Full Text Available BACKGROUND Thalassemia major patients are dependent on frequent blood transfusion and consequently develop iron overload. HFE gene mutations (C282Y, H63D and S65C in hereditary haemochromatosis has been shown to be associated with iron overload. The study aims at finding the association of HFE gene mutations in β-thalassemia major patients. MATERIALS AND METHODS A descriptive observational pilot study was conducted including fifty diagnosed -thalassemia major cases. DNA analysis by PCR-RFLP method for HFE gene mutations was performed. RESULTS Only H63D mutation (out of three HFE gene mutations was detected in 8 out of 50 cases. Observed frequency of H63D mutation was 16%. While frequency of C282Y and S65C were 0% each. CONCLUSION The frequency of HFE mutation in -thalassemia major is not very common.

  19. Major Sport Venues

    Data.gov (United States)

    Department of Homeland Security — The Major Public Venues dataset is composed of facilities that host events for the National Association for Stock Car Auto Racing, Indy Racing League, Major League...

  20. Improved survival of colorectal cancer in Denmark during 2001-2012

    DEFF Research Database (Denmark)

    Iversen, Lene Hjerrild; Green, Anders; Ingeholm, Peter

    2016-01-01

    cancer and 15 213 patients with rectal cancer were included. The stage distribution was almost stable over time. The mortality rate per 100 patient year within one year decreased from 32 to 26 in colon cancer and from 26 to 19 in rectal cancer with associated improvements in absolute survival from 73......% to 78% in colon cancer and from 78% to 83% in rectal cancer. The five-year relative survival of colon cancer improved from 58% to 63% and in rectal cancer from 59% to 65%. Comorbidity had major negative impact on outcome. Irrespective of tumor location, outcome improved relatively more in patients...... with stage III and IV disease. The proportion of patients who were spared surgery increased from 8% to 15% in colon cancer and from 13% to 19% in rectal cancer, and these changes were associated with improved outcome for rectal cancer patients, whereas outcome worsened for colon cancer patients. Conclusion...

  1. [Sickness absence associated with major life events].

    Science.gov (United States)

    Markussen, Simen; Røgeberg, Ole

    2012-05-29

    Sickness absence in the Norwegian workplace doubled in the period 1993-2003. However, the extent to which the driving factors were medical or non-medical remains unclear, as does the extent to which the cause may be found in the composition of the workforce. A differences-in-differences regression model was used to estimate the added sickness absence associated with major life events such as separation, death of spouse and pregnancy in the period 1993-2005. The data were obtained from administrative registers covering the entire Norwegian population, and include all absence periods of 16 days' duration or more reported by a doctor's medical certificate. The primary outcome measures were incidence (the proportion of absentees in a given time window) and absence (the proportion of sick days in a given time window). The level of absence among employees exposed to the specified life events was compared to control groups matched for gender, age, education and income. In 1993, people in each of the three groups exposed to major life events had more frequent and longer periods of absence than people in the control groups. This added sickness absence increased between 1993 and 2005. The changes in added sickness absence were at times significant, particularly for pregnant women. While sickness absence among pregnant women in 1993 was 15.4 percentage points higher than in the control group, the difference had increased to 24.8 percentage points in 2005. We find it improbable for the increase in added sickness absence to be caused by changes in the medical impact of life events or alterations in the workforce composition. We believe the increase is caused by changing attitudes among the working population and in the medical profession towards sickness absence on grounds that are not strictly medical, combined with improved social acceptance and diagnosis of mental health issues, and/or a medicalisation of natural health variations (pregnancy) and emotional distress (grief).

  2. The improvement program of radwaste treatment at Chinshan nuclear power station

    International Nuclear Information System (INIS)

    Lin, M.M.H.; Huang, C.Y.

    1986-01-01

    Chinshan-1 and 2, the twin 636-megawatt boiling water reactors with independent radwaste treatment facilities, located at northern Taiwan, started power generation in 1977 and 1978, respectively. Initial years of operation of CSNPS indicated a need for improvement of the radwaste scheme originally provided. The major betterment programs for radwaste system include: (1) addition of auxiliary demineralization system and addition resin storage tank/demineralizer, (2) addition of dry laundry and miscellant drain system, (3) addition of off-gas charcoal delay system, (4) tie connection of the liquid waste system of unit 1 and 2, (5) solid waste system retrofit study, (6) volume reduction study. The administration and water quality controls have also been much improved and the discharge of radioactivity is considerably lower after the improvement has been implemented

  3. Survival Analysis and its Associated Factors of Beta Thalassemia Major in Hamadan Province

    Directory of Open Access Journals (Sweden)

    Reza Zamani

    2015-05-01

    Full Text Available Background: There currently is a lack of knowledge about the long-term survival of patients with beta thalassemia (BT, particularly in regions with low incidence of the disease. The aim of the present study was to determine the survival rate of the patients with BT major and the factors associated with the survival time. Methods: This retrospective cohort study was performed in Hamadan province, located in the west of Iran. The study included patients that referred to the provincial hospitals during 16 year period from 1997 to 2013. The follow up of each subject was calculated from the date of birth to the date of death. Demographic and clinical data were extracted from patients’ medical records using a checklist. Statistical analysis included the Kaplan-Meier method to analyze survivals, log-rank to compare curves between groups, and Cox regression for multivariate prognostic analysis. Results: A total of 133 patients with BT major were enrolled, 54.9% of whom were male and 66.2% were urban. The 10-, 20- and 30-year survival rate for all patients were 98.3%, 88.4% and 80.5%, respectively. Based on hazard ratio (HR, we found that accompanied diseases (P=0.01, blood type (P=0.03 and residency status (P=0.01 were significant predictors for the survival time of patients. Conclusion: The survival rate of BT patients has improved. Future researches such as prospective designs are required for the estimation of survival rate and to find other prognostic factors, which have reliable sources of data.

  4. Public relations work for major railway projects; Oeffentlichkeitsarbeit fuer grosse Bahnprojekte

    Energy Technology Data Exchange (ETDEWEB)

    Guertner, R. [Tram Zuerich West, Verkehrsbetriebe Zuerich (Switzerland); Braun, D.; Steiner, R. [Basler und Hofmann Ingenieure und Planer AG, Zuerich (Switzerland)

    2005-07-01

    Major railway construction projects attract a lot of public attention. They involve heavy investment, and cause local residents a good deal of inconvenience. This tends to obscure the fact that new railway lines and new railway tunnels bring significant improvements for the majority of citizens: better connections, more comfortable travel and frequently also less local noise. Furthermore, only a few people in the know are aware of how much technical and human effort lies behind the new structures. All the more reason therefore to make a serious public relations effort - on the part of the clients as well as the contractors involved. (orig.)

  5. Major salt beds of the Palo Duro and Dalhart Basins, Texas

    International Nuclear Information System (INIS)

    1983-12-01

    Major salt beds are defined as salt intervals at least 75 feet thick that contain no interbeds greater than 10 feet thick and include no more than 15 percent non-salt interbeds. Maps based on the interpretation of geophysical logs from hundreds of oil and gas exploration wells reveal seven major salt beds in the Palo Duro Basin and one major salt bed in the Dalhart Basin. The most extensive major salt beds are in the central and northern Palo Duro Basin, in the Upper San Andres Formation and the Lower San Andres Formation Units 4 and 5. Of these, the major salt bed within the Lower San Andres Formation Unit 4 is the most widespread and generally the thickest. 7 references, 15 figures, 2 tables

  6. Quality planning for major plant design modifications

    International Nuclear Information System (INIS)

    Dulee, R.J.

    1988-01-01

    This paper reviews the approach and activities undertaken by Public Service Electric and Gas Company's (PSE and G's) nuclear quality assurance (QA) department to support major plant design modifications conducted during refueling outages at Salem Generating Station. It includes the planning and implementation of quality plans developed to provide both QA and quality control (QC) coverage of modification performed by contracted service organizations

  7. Teaching information literacy skills to sophomore-level biology majors.

    Science.gov (United States)

    Thompson, Leigh; Blankinship, Lisa Ann

    2015-05-01

    Many undergraduate students lack a sound understanding of information literacy. The skills that comprise information literacy are particularly important when combined with scientific writing for biology majors as they are the foundation skills necessary to complete upper-division biology course assignments, better train students for research projects, and prepare students for graduate and professional education. To help undergraduate biology students develop and practice information literacy and scientific writing skills, a series of three one-hour hands-on library sessions, discussions, and homework assignments were developed for Biological Literature, a one-credit, one-hour-per-week, required sophomore-level course. The embedded course librarian developed a learning exercise that reviewed how to conduct database and web searches, the difference between primary and secondary sources, source credibility, and how to access articles through the university's databases. Students used the skills gained in the library training sessions for later writing assignments including a formal lab report and annotated bibliography. By focusing on improving information literacy skills as well as providing practice in scientific writing, Biological Literature students are better able to meet the rigors of upper-division biology courses and communicate research findings in a more professional manner.

  8. Improving utility conservation programs: outcomes, interventions, and evaluations

    Energy Technology Data Exchange (ETDEWEB)

    Condelli, L; Archer, D; Aronson, E; Curbow, B; McLeod, B; Pettigrew, T F; White, L T; Yates, S

    1984-06-01

    Four major California utility companies have active energy conservation programs mandated by the State's Public Utilities Commission (CPUC). These companies evaluate their programs and send reports of the evaluations to the CPUC. A review of 213 of these reports revealed a marketing research approach toward promoting conservation. Advertising and informational campaigns characterize most programs, and attitudes and self-reported behavior were the major outcome measures. This approach is shown to be ineffective. Suggestions for improvement include: (1) the use of actual energy consumption as the primary outcome measure in evaluating conservation programs; (2) the abandonment of conventional advertising, and the use of it only for the promotion of ''hard'' interventions; (3) increased use of social diffusion methods to disseminate information; (4) the design of more effective educational material by incorporating cognitive social psychological principles; and (5) the utilization of ''hard'' interventions that have a direct, verifiable link to conservation.

  9. Efficacy and tolerability of vilazodone for major depressive disorder: evidence from phase III/IV randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Shi LG

    2016-11-01

    Full Text Available Ligen Shi,1,2 Jingyi Wang,1 Shenbin Xu,2 Yunrong Lu1 1Department of Psychiatry, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, 2Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China Abstract: Vilazodone is a new molecule approved for major depressive disorder (MDD. This report focuses on the efficacy and tolerability of vilazodone for MDD. MEDLINE, EMBASE, and Cochrane Library were searched. A total of 1,930 patients from four trials were included. A significant improvement in the Montgomery–Asberg Depression Rating Scale (MADRS total score was seen as early as week 2 (P<0.01 in vilazodone-treated patients. The results showed a higher rate of MADRS response with vilazodone compared with placebo (P<0.001. There were also greater improvements in the Hamilton Rating Scale for Anxiety as well as the Clinical Global Impressions (severity of illness and improvement of illness scores from baseline in vilazodone-treated patients compared to placebo patients (P<0.001. Discontinuation rates due to adverse events were higher with vilazodone than placebo (P=0.0002. The most common adverse events of vilazodone were vomiting, nausea, diarrhea, insomnia, somnolence, dizziness, and dry mouth (P<0.05. Treatment-related effects on sexual function were mild compared to placebo in men (P=0.03. In conclusion, 40 mg/day of vilazodone had a rapid onset of response and showed good improvement in anxiety symptoms as well as good tolerability during short-term treatment (8–10 weeks for MDD. Further studies should focus on the efficacy and tolerability of vilazodone over a longer duration and should utilize active comparators. Keywords: vilazodone, major depressive disorder, sexual dysfunction, anxiety

  10. Improving the teaching of econometrics

    Directory of Open Access Journals (Sweden)

    David F. Hendry

    2016-12-01

    Full Text Available We recommend a major shift in the Econometrics curriculum for both graduate and undergraduate teaching. It is essential to include a range of topics that are still rarely addressed in such teaching, but are now vital for understanding and conducting empirical macroeconomic research. We focus on a new approach to macro-econometrics teaching, since even undergraduate econometrics courses must include analytical methods for time series that exhibit both evolution from stochastic trends and abrupt changes from location shifts, and so confront the “non-stationarity revolution”. The complexity and size of the resulting equation specifications, formulated to include all theory-based variables, their lags and possibly non-linear functional forms, as well as potential breaks and rival candidate variables, places model selection for models of changing economic data at the centre of teaching. To illustrate our proposed new curriculum, we draw on a large UK macroeconomics database over 1860–2011. We discuss how we reached our present approach, and how the teaching of macro-econometrics, and econometrics in general, can be improved by nesting so-called “theory-driven” and “data-driven” approaches. In our methodology, the theory-model’s parameter estimates are unaffected by selection when the theory is complete and correct, so nothing is lost, whereas when the theory is incomplete or incorrect, improved empirical models can be discovered from the data. Recent software like Autometrics facilitates both the teaching and the implementation of econometrics, supported by simulation tools to examine operational performance, designed to be feasibly presented live in the classroom.

  11. Gas de France, a major player in Europe

    International Nuclear Information System (INIS)

    Mandil, C.

    1999-01-01

    Present in approximately 20 countries, the Gaz de France group has, for several years now, committed itself to a major program for international development. This trend should speed up as the European gas market opens. Nowadays, GdF has nearly twelve million customers, including two million outside France. (author)

  12. The surgery of peripheral nerves (including tumors)

    DEFF Research Database (Denmark)

    Fugleholm, Kåre

    2013-01-01

    Surgical pathology of the peripheral nervous system includes traumatic injury, entrapment syndromes, and tumors. The recent significant advances in the understanding of the pathophysiology and cellular biology of peripheral nerve degeneration and regeneration has yet to be translated into improved...... surgical techniques and better outcome after peripheral nerve injury. Decision making in peripheral nerve surgery continues to be a complex challenge, where the mechanism of injury, repeated clinical evaluation, neuroradiological and neurophysiological examination, and detailed knowledge of the peripheral...... nervous system response to injury are prerequisite to obtain the best possible outcome. Surgery continues to be the primary treatment modality for peripheral nerve tumors and advances in adjuvant oncological treatment has improved outcome after malignant peripheral nerve tumors. The present chapter...

  13. [Errors in medicine. Causes, impact and improvement measures to improve patient safety].

    Science.gov (United States)

    Waeschle, R M; Bauer, M; Schmidt, C E

    2015-09-01

    The guarantee of quality of care and patient safety is of major importance in hospitals even though increased economic pressure and work intensification are ubiquitously present. Nevertheless, adverse events still occur in 3-4 % of hospital stays and of these 25-50 % are estimated to be avoidable. The identification of possible causes of error and the development of measures for the prevention of medical errors are essential for patient safety. The implementation and continuous development of a constructive culture of error tolerance are fundamental.The origins of errors can be differentiated into systemic latent and individual active causes and components of both categories are typically involved when an error occurs. Systemic causes are, for example out of date structural environments, lack of clinical standards and low personnel density. These causes arise far away from the patient, e.g. management decisions and can remain unrecognized for a long time. Individual causes involve, e.g. confirmation bias, error of fixation and prospective memory failure. These causes have a direct impact on patient care and can result in immediate injury to patients. Stress, unclear information, complex systems and a lack of professional experience can promote individual causes. Awareness of possible causes of error is a fundamental precondition to establishing appropriate countermeasures.Error prevention should include actions directly affecting the causes of error and includes checklists and standard operating procedures (SOP) to avoid fixation and prospective memory failure and team resource management to improve communication and the generation of collective mental models. Critical incident reporting systems (CIRS) provide the opportunity to learn from previous incidents without resulting in injury to patients. Information technology (IT) support systems, such as the computerized physician order entry system, assist in the prevention of medication errors by providing

  14. Theoretical Frameworks to Guide School Improvement

    Science.gov (United States)

    Evans, Lisa; Thornton, Bill; Usinger, Janet

    2012-01-01

    A firm grounding in change theory can provide educational leaders with an opportunity to orchestrate meaningful organizational improvements. This article provides an opportunity for practicing leaders to review four major theories of organizational change--continuous improvement, two approaches to organizational learning, and appreciative inquiry.…

  15. Psychotherapy for Major Depressive Disorder and Generalized Anxiety Disorder: A Health Technology Assessment.

    Science.gov (United States)

    2017-01-01

    Major depressive disorder and generalized anxiety disorder are among the most commonly diagnosed mental illnesses in Canada; both are associated with a high societal and economic burden. Treatment for major depressive disorder and generalized anxiety disorder consists of pharmacological and psychological interventions. Three commonly used psychological interventions are cognitive behavioural therapy (CBT), interpersonal therapy, and supportive therapy. The objectives of this report were to assess the effectiveness and safety of these types of therapy for the treatment of adults with major depressive disorder and/or generalized anxiety disorder, to assess the cost-effectiveness of structured psychotherapy (CBT or interpersonal therapy), to calculate the budget impact of publicly funding structured psychotherapy, and to gain a greater understanding of the experiences of people with major depressive disorder and/or generalized anxiety disorder. We performed a literature search on October 27, 2016, for systematic reviews that compared CBT, interpersonal therapy, or supportive therapy with usual care, waitlist control, or pharmacotherapy in adult outpatients with major depressive disorder and/or generalized anxiety disorder. We developed an individual-level state-transition probabilistic model for a cohort of adult outpatients aged 18 to 75 years with a primary diagnosis of major depressive disorder to determine the cost-effectiveness of individual or group CBT (as a representative form of structured psychotherapy) versus usual care. We also estimated the 5-year budget impact of publicly funding structured psychotherapy in Ontario. Finally, we interviewed people with major depressive disorder and/or generalized anxiety disorder to better understand the impact of their condition on their daily lives and their experience with different treatment options, including psychotherapy. Interpersonal therapy compared with usual care reduced posttreatment major depressive disorder

  16. Evidence of a major gene from Bayesian segregation analyses of liability to osteochondral diseases in pigs.

    Science.gov (United States)

    Kadarmideen, Haja N; Janss, Luc L G

    2005-11-01

    Bayesian segregation analyses were used to investigate the mode of inheritance of osteochondral lesions (osteochondrosis, OC) in pigs. Data consisted of 1163 animals with OC and their pedigrees included 2891 animals. Mixed-inheritance threshold models (MITM) and several variants of MITM, in conjunction with Markov chain Monte Carlo methods, were developed for the analysis of these (categorical) data. Results showed major genes with significant and substantially higher variances (range 1.384-37.81), compared to the polygenic variance (sigmau2). Consequently, heritabilities for a mixed inheritance (range 0.65-0.90) were much higher than the heritabilities from the polygenes. Disease allele frequencies range was 0.38-0.88. Additional analyses estimating the transmission probabilities of the major gene showed clear evidence for Mendelian segregation of a major gene affecting osteochondrosis. The variants, MITM with informative prior on sigmau2, showed significant improvement in marginal distributions and accuracy of parameters. MITM with a "reduced polygenic model" for parameterization of polygenic effects avoided convergence problems and poor mixing encountered in an "individual polygenic model." In all cases, "shrinkage estimators" for fixed effects avoided unidentifiability for these parameters. The mixed-inheritance linear model (MILM) was also applied to all OC lesions and compared with the MITM. This is the first study to report evidence of major genes for osteochondral lesions in pigs; these results may also form a basis for underpinning the genetic inheritance of this disease in other animals as well as in humans.

  17. Artificial Neural Network forecasting of storm surge water levels at major estuarine ports to supplement national tide-surge models and improve port resilience planning

    Science.gov (United States)

    French, Jon; Mawdsley, Robert; Fujiyama, Taku; Achuthan, Kamal

    2017-04-01

    Effective prediction of tidal storm surge is of considerable importance for operators of major ports, since much of their infrastructure is necessarily located close to sea level. Storm surge inundation can damage critical elements of this infrastructure and significantly disrupt port operations and downstream supply chains. The risk of surge inundation is typically approached using extreme value analysis, while short-term forecasting generally relies on coastal shelf-scale tide and surge models. However, extreme value analysis does not provide information on the duration of a surge event and can be sensitive to the assumptions made and the historic data available. Also, whilst regional tide and surge models perform well along open coasts, their fairly coarse spatial resolution means that they do not always provide accurate predictions for estuarine ports. As part of a NERC Environmental Risks to Infrastructure Innovation Programme project, we have developed a tool that is specifically designed to forecast the North Sea storm surges on major ports along the east coast of the UK. Of particular interest is the Port of Immingham, Humber estuary, which handles the largest volume of bulk cargo in the UK including major flows of coal and biomass for power generation. A tidal surge in December 2013, with an estimated return period of 760 years, partly flooded the port, damaged infrastructure and disrupted operations for several weeks. This and other recent surge events highlight the need for additional tools to supplement the national UK Storm Tide Warning Service. Port operators are also keen to have access to less computationally expensive forecasting tools for scenario planning and to improve their resilience to actual events. In this paper, we demonstrate the potential of machine learning methods based on Artificial Neural Networks (ANNs) to generate accurate short-term forecasts of extreme water levels at estuarine North Sea ports such as Immingham. An ANN is

  18. Vanpooling: the three major approaches

    Energy Technology Data Exchange (ETDEWEB)

    Sears, P.M.

    1979-08-01

    The manual provides technical assistance to existing or prospective vanpool sponsors. It is designed to help them promote vanpooling in its three major approaches: employer sponsored, third party sponsored, and driver owned and operated. The first chapter is an overview of vanpooling and a second chapter, on vanpool marketing, is addressed to ridesharing coordinators and others whose responsibilities include the promotion of vanpooling. Some fact sheets on the three approaches provide convenient summaries of the needs and opportunities of each approach and suggest solutions to practical problems likely to be encountered in starting new vanpool programs.

  19. An Action Research on Improving Non-English Majors' English Writing by "Basic Sentence Pattern Translation Drills"

    Science.gov (United States)

    He, Xiaoyu

    2016-01-01

    English writing plays an indispensible part in EFL (English as a Foreign Language) learning for Chinese students, which accounts for a high score in an English test in China. And it is also a comprehensive reflection of students' abilities in L2 application. However, most non-English majors in vocational and technical colleges have great trouble…

  20. Improved technical specifications and related improvements to safety in commercial Nuclear power plants

    International Nuclear Information System (INIS)

    Hoffman, D.R.; Demitrack, T.; Schiele, R.; Jones, J.C.

    2004-01-01

    Many of the commercial nuclear power plants in the United States (US) have been converting a portion of the plant operating license known as the Technical Specifications (TS) in accordance with a document published by the US Nuclear Regulatory Commission (NRC). The TS prescribe commercial nuclear power plant operating requirements. There are several types of nuclear power plants in the US, based on the technology of different vendors, and there is an NRC document that supports each of the five different vendor designs. The NRC documents are known as the Improved Standard Technical Specifications (ISTS) and are contained in a separate document (NUREG series) for each one of the designs. EXCEL Services Corporation (hereinafter EXCEL) has played a major role in the development of the ISTS and in the development, licensing, and implementation of the plant specific Improved Technical Specifications (ITS) (which is based on the ISTS) for the commercial nuclear power plants in the US that have elected to make this conversion. There are currently 103 operating commercial nuclear power plants in the US and 68 of them have successfully completed the conversion to the ITS and are now operating in accordance with their plant specific ITS. The ISTS is focused mainly on safety by ensuring the commercial nuclear reactors can safely shut down and mitigate the consequences of any postulated transient and accident. It accomplishes this function by including requirements directly associated with safety in a document structured systematically and taking into account some key human factors and technical initiatives. This paper discusses the ISTS including its format, content, and detail, the history of the ISTS, the ITS development, licensing, and implementation process, the safety improvements resulting from a plant conversion to ITS, and the importance of the ITS Project to the industry. (Author)

  1. Improved technical specifications and related improvements to safety in commercial Nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Hoffman, D.R.; Demitrack, T.; Schiele, R.; Jones, J.C. [EXCEL Services Corporation, 11921 Rockville Pike, Suite 100, Rockville, MD 20852 (United States)]. e-mail: donaldh@excelservices.com

    2004-07-01

    Many of the commercial nuclear power plants in the United States (US) have been converting a portion of the plant operating license known as the Technical Specifications (TS) in accordance with a document published by the US Nuclear Regulatory Commission (NRC). The TS prescribe commercial nuclear power plant operating requirements. There are several types of nuclear power plants in the US, based on the technology of different vendors, and there is an NRC document that supports each of the five different vendor designs. The NRC documents are known as the Improved Standard Technical Specifications (ISTS) and are contained in a separate document (NUREG series) for each one of the designs. EXCEL Services Corporation (hereinafter EXCEL) has played a major role in the development of the ISTS and in the development, licensing, and implementation of the plant specific Improved Technical Specifications (ITS) (which is based on the ISTS) for the commercial nuclear power plants in the US that have elected to make this conversion. There are currently 103 operating commercial nuclear power plants in the US and 68 of them have successfully completed the conversion to the ITS and are now operating in accordance with their plant specific ITS. The ISTS is focused mainly on safety by ensuring the commercial nuclear reactors can safely shut down and mitigate the consequences of any postulated transient and accident. It accomplishes this function by including requirements directly associated with safety in a document structured systematically and taking into account some key human factors and technical initiatives. This paper discusses the ISTS including its format, content, and detail, the history of the ISTS, the ITS development, licensing, and implementation process, the safety improvements resulting from a plant conversion to ITS, and the importance of the ITS Project to the industry. (Author)

  2. Effect of Nitrogen Fertilizer on Herbivores and Its Stimulation to Major Insect Pests in Rice

    Directory of Open Access Journals (Sweden)

    Zhong-xian LU

    2007-03-01

    Full Text Available Nitrogen is one of the most important factors in development of herbivore populations. The application of nitrogen fertilizer in plants can normally increase herbivore feeding preference, food consumption, survival, growth, reproduction, and population density, except few examples that nitrogen fertilizer reduces the herbivore performances. In most of the rice growing areas in Asia, the great increases in populations of major insect pests of rice, including planthoppers (Nilaparvata lugens and Sogatella furcifera, leaffolder (Cnaphalocrocis medinalis, and stem borers (Scirpophaga incertulas, Chilo suppressalis, S. innotata, C. polychrysus and Sesamia inferens were closely related to the long-term excessive application of nitrogen fertilizers. The optimal regime of nitrogen fertilizer in irrigated paddy fields is proposed to improve the fertilizer-nitrogen use efficiency and reduce the environmental pollution.

  3. Precision Measurement and Improvement of e+, e- Storage Rings

    International Nuclear Information System (INIS)

    Yan, Y.T.; Cai, Y.; Colocho, W.; Decker, F-J.; Seeman, J.; Sullivan, M.; Turner, J.; Wienands, U.; Woodley, M.; Yocky, G.

    2006-01-01

    Through horizontal and vertical excitations, we have been able to make a precision measurement of linear geometric optics parameters with a Model-Independent Analysis (MIA). We have also been able to build up a computer model that matches the real accelerator in linear geometric optics with an SVD-enhanced Least-square fitting process. Recently, with the addition of longitudinal excitation, we are able to build up a computer virtual machine that matches the real accelerators in linear optics including dispersion without additional fitting variables. With this optics-matched virtual machine, we are able to find solutions that make changes of selected normal and skew quadrupoles for machine optics improvement. It has made major contributions to improve PEP-II optics and luminosity. Examples from application to PEP-II machines will be presented

  4. Collaborative Management of Complex Major Construction Projects: AnyLogic-Based Simulation Modelling

    Directory of Open Access Journals (Sweden)

    Na Zhao

    2016-01-01

    Full Text Available Complex supply chain system collaborative management of major construction projects effectively integrates the different participants in the construction project. This paper establishes a simulation model based on AnyLogic to reveal the collaborative elements in the complex supply chain management system and the modes of action as well as the transmission problems of the intent information. Thus it is promoting the participants to become an organism with coordinated development and coevolution. This study can help improve the efficiency and management of the complex system of major construction projects.

  5. Proposed IMS infrastructure improvement project, Seward, Alaska. Final environmental impact statement

    Energy Technology Data Exchange (ETDEWEB)

    1994-09-01

    This Environmental Impact Statement (EIS) examines a proposal for improvements at the existing University of Alaska, Fairbanks, Institute of Marine Science (IMS), Seward Marine Center. The Exxon Valdez Oil Spill (EVOS) Trustee Council is proposing to improve the existing research infrastructure to enhance the EVOS Trustee Council`s capabilities to study and rehabilitate marine mammals, marine birds, and the ecosystem injured by the Exxon Valdez oil spill. The analysis in this document focuses on the effects associated with construction and operation of the proposed project and its proposed alternatives. The EIS gives a detailed description of all major elements of the proposed project and its alternatives; identifies resources of major concern that were raised during the scoping process; describes the environmental background conditions of those resources; defines and analyzes the potential effects of the proposed project and its alternatives on these conditions; and identifies mitigating measures that are part of the project design as well as those proposed to minimize or reduce the adverse effects. Included in the EIS are written and oral comments received during the public comment period.

  6. Proposed IMS infrastructure improvement project, Seward, Alaska. Final environmental impact statement

    International Nuclear Information System (INIS)

    1994-09-01

    This Environmental Impact Statement (EIS) examines a proposal for improvements at the existing University of Alaska, Fairbanks, Institute of Marine Science (IMS), Seward Marine Center. The Exxon Valdez Oil Spill (EVOS) Trustee Council is proposing to improve the existing research infrastructure to enhance the EVOS Trustee Council's capabilities to study and rehabilitate marine mammals, marine birds, and the ecosystem injured by the Exxon Valdez oil spill. The analysis in this document focuses on the effects associated with construction and operation of the proposed project and its proposed alternatives. The EIS gives a detailed description of all major elements of the proposed project and its alternatives; identifies resources of major concern that were raised during the scoping process; describes the environmental background conditions of those resources; defines and analyzes the potential effects of the proposed project and its alternatives on these conditions; and identifies mitigating measures that are part of the project design as well as those proposed to minimize or reduce the adverse effects. Included in the EIS are written and oral comments received during the public comment period

  7. R2 & NE: NAVTEQ 2011 Q3 Major Road Network for the United States, including Puerto Rico and the US Virgin Islands in SDC Format

    Data.gov (United States)

    U.S. Environmental Protection Agency — The MROADS layer contains the Major Roads network using NAVTEQ Functional Class=1,2,3,4, where 4 represents routes connecting minor towns or villages and collecting...

  8. Improving Earth/Prediction Models to Improve Network Processing

    Science.gov (United States)

    Wagner, G. S.

    2017-12-01

    The United States Atomic Energy Detection System (USAEDS) primaryseismic network consists of a relatively small number of arrays andthree-component stations. The relatively small number of stationsin the USAEDS primary network make it both necessary and feasibleto optimize both station and network processing.Station processing improvements include detector tuning effortsthat use Receiver Operator Characteristic (ROC) curves to helpjudiciously set acceptable Type 1 (false) vs. Type 2 (miss) errorrates. Other station processing improvements include the use ofempirical/historical observations and continuous background noisemeasurements to compute time-varying, maximum likelihood probabilityof detection thresholds.The USAEDS network processing software makes extensive use of theazimuth and slowness information provided by frequency-wavenumberanalysis at array sites, and polarization analysis at three-componentsites. Most of the improvements in USAEDS network processing aredue to improvements in the models used to predict azimuth, slowness,and probability of detection. Kriged travel-time, azimuth andslowness corrections-and associated uncertainties-are computedusing a ground truth database. Improvements in station processingand the use of improved models for azimuth, slowness, and probabilityof detection have led to significant improvements in USADES networkprocessing.

  9. Cognitive remission: a novel objective for the treatment of major depression?

    Science.gov (United States)

    Bortolato, Beatrice; Miskowiak, Kamilla W; Köhler, Cristiano A; Maes, Michael; Fernandes, Brisa S; Berk, Michael; Carvalho, André F

    2016-01-22

    Cognitive dysfunction in major depressive disorder (MDD) encompasses several domains, including but not limited to executive function, verbal memory, and attention. Furthermore, cognitive dysfunction is a frequent residual manifestation in depression and may persist during the remitted phase. Cognitive deficits may also impede functional recovery, including workforce performance, in patients with MDD. The overarching aims of this opinion article are to critically evaluate the effects of available antidepressants as well as novel therapeutic targets on neurocognitive dysfunction in MDD. Conventional antidepressant drugs mitigate cognitive dysfunction in some people with MDD. However, a significant proportion of MDD patients continue to experience significant cognitive impairment. Two multicenter randomized controlled trials (RCTs) reported that vortioxetine, a multimodal antidepressant, has significant precognitive effects in MDD unrelated to mood improvement. Lisdexamfetamine dimesylate was shown to alleviate executive dysfunction in an RCT of adults after full or partial remission of MDD. Preliminary evidence also indicates that erythropoietin may alleviate cognitive dysfunction in MDD. Several other novel agents may be repurposed as cognitive enhancers for MDD treatment, including minocycline, insulin, antidiabetic agents, angiotensin-converting enzyme inhibitors, S-adenosyl methionine, acetyl-L-carnitine, alpha lipoic acid, omega-3 fatty acids, melatonin, modafinil, galantamine, scopolamine, N-acetylcysteine, curcumin, statins, and coenzyme Q10. The management of cognitive dysfunction remains an unmet need in the treatment of MDD. However, it is hoped that the development of novel therapeutic targets will contribute to 'cognitive remission', which may aid functional recovery in MDD.

  10. Splenectomy for people with thalassaemia major or intermedia.

    Science.gov (United States)

    Easow Mathew, Manu; Sharma, Akshay; Aravindakshan, Rajeev

    2016-06-14

    Thalassaemia is a genetic disease of the haemoglobin protein in red blood cells. It is classified into thalassaemia minor, intermedia and major, depending on the severity of the disease and the genetic defect. Thalassaemia major and intermedia require frequent blood transfusions to compensate for the lack of well-functioning red blood cells, although this need is significantly less in thalassaemia intermedia.Damaged or defective red blood cells are normally eliminated in the spleen. In people with thalassaemia there is a large quantity of defective red blood cells which results in an enlarged hyperfunctioning spleen (splenomegaly). Removal of the spleen may thus prolong red blood cell survival by reducing the amount of red blood cells removed from circulation and may ultimately result in the reduced need for blood transfusions. To assess the efficacy and safety of splenectomy in people with beta-thalassaemia major or intermedia. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Review Group's Haemoglobinopathies Trials Register, compiled from searches of electronic databases and the handsearching of journals and conference abstract books. We also searched the reference lists of relevant articles and reviews.Date of the most recent search: 25 April 2016. We included randomised controlled studies and quasi-randomised controlled studies of people of any age with thalassaemia major or intermedia, evaluating splenectomy in comparison to conservative treatment (transfusion therapy and iron chelation) or other forms of splenectomy compared to each other (laparoscopic, open, radio-frequency). Two authors independently selected and extracted data from the single included study using a customised data extraction form and assessed the risk of bias. One study, including 28 participants was included in the review; the results were described, primarily, in a narrative manner. The study assessed the feasibility of splenectomy using laparoscopy in comparison to open

  11. Personalized Education Approaches for Chemical Engineering and Relevant Majors

    Directory of Open Access Journals (Sweden)

    Zhao Feng-qing

    2016-01-01

    Full Text Available Personalized education has drawn increasing attention in universities these years. With the purpose of improving the studentss’ comprehensive ability and developing teaching strategies to ensure students’ education is tailored to their needs, we proposed Three-Stage Approach (TSA to enhance personalized education for chemical engineering and relevant majors: professional tutorial system--equipping with professional guidance teachers for freshman students to guide their learning activities and provide professional guidance; open experimental project--setting up open experimental projects for sophomore and junior students to choose freely; individualized education module--setting up 10 different individualized education modules for senior students to select. After years of practice, the personalized education model is improved day by day and proved effective and fruitful.

  12. The economic valuation on atmospheric improvement benefit by nuclear power generation

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, S. J.; Yoo, S. H.; Han, S. Y.; Do, G. W.; Lee, J. S. [Korea Univ., Seoul (Korea)

    2000-12-01

    The major contents are as follows : To begin with, major air pollutants' emissions and emission reduction facilities in industrial sectors including a power generation were investigated and the future prospect was suggested. Environmental effects by attributes of air pollutions were summarized through a extensive literature survey. And the concept of benefit-cost based upon social costs and economic values of generation was established to estimate atmospheric improvement benefits by using a nuclear power. As a result of investigating many valuation methodologies that can estimate economic values of environmental improvement, we adopted MAUA(multi-attribute utility assessment) as a research method and estimated environmental costs by air pollutant and by power generating source. Also, we presented foreign case studies related to social costs in power generating sector and horizontally compared study's results home and abroad. Then, we set up four scenarios based on total generation that the 5th long-term power resources planning forecasted and calculated economic values of atmospheric improvement benefits among scenarios. Further, we suggested the results incorporating uncertainty of estimation parameters. Finally, we suggested a rational ground to move toward environment-friendly energy consumption and proposed a plan for the national energy policy against the green age in the 21th century. 147 refs., 45 figs., 103 tabs. (Author)

  13. The economic valuation on atmospheric improvement benefit by nuclear power generation

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, S J; Yoo, S H; Han, S Y; Do, G W; Lee, J S [Korea Univ., Seoul (Korea)

    2000-12-01

    The major contents are as follows : To begin with, major air pollutants' emissions and emission reduction facilities in industrial sectors including a power generation were investigated and the future prospect was suggested. Environmental effects by attributes of air pollutions were summarized through a extensive literature survey. And the concept of benefit-cost based upon social costs and economic values of generation was established to estimate atmospheric improvement benefits by using a nuclear power. As a result of investigating many valuation methodologies that can estimate economic values of environmental improvement, we adopted MAUA(multi-attribute utility assessment) as a research method and estimated environmental costs by air pollutant and by power generating source. Also, we presented foreign case studies related to social costs in power generating sector and horizontally compared study's results home and abroad. Then, we set up four scenarios based on total generation that the 5th long-term power resources planning forecasted and calculated economic values of atmospheric improvement benefits among scenarios. Further, we suggested the results incorporating uncertainty of estimation parameters. Finally, we suggested a rational ground to move toward environment-friendly energy consumption and proposed a plan for the national energy policy against the green age in the 21th century. 147 refs., 45 figs., 103 tabs. (Author)

  14. The Occupational Aspirations and Expectations of College Students Majoring in Jazz Studies

    Science.gov (United States)

    Devroop, Karendra

    2012-01-01

    This study was designed to investigate the occupational aspirations and occupational expectations of college students majoring in jazz studies in the United States. Participants included the population of jazz studies majors (N = 211) at a large mid-southern university known for its prestigious and internationally recognized jazz program. A…

  15. The potential of transcranial photobiomodulation therapy for treatment of major depressive disorder.

    Science.gov (United States)

    Salehpour, Farzad; Rasta, Seyed Hossein

    2017-05-24

    Major depressive disorder is a common debilitating mood disorder that affects quality of life. Prefrontal cortex abnormalities, an imbalance in neurotransmitters, neuroinflammation, and mitochondrial dysfunction are the major factors in the etiology of major depressive disorder. Despite the efficacy of pharmacotherapy in the treatment of major depressive disorder, 30%-40% of patients do not respond to antidepressants. Given this, exploring the alternative therapies for treatment or prevention of major depressive disorder has aroused interest among scientists. Transcranial photobiomodulation therapy is the use of low-power lasers and light-emitting diodes in the far-red to near-infrared optical region for stimulation of neuronal activities. This non-invasive modality improves the metabolic capacity of neurons due to more oxygen consumption and ATP production. Beneficial effects of transcranial photobiomodulation therapy in the wide range of neurological and psychological disorders have been already shown. In this review, we focus on some issue relating to the application of photobiomodulation therapy for major depressive disorder. There is some evidence that transcranial photobiomodulation therapy using near-infrared light on 10-Hz pulsed mode appears to be a hopeful technique for treatment of major depressive disorder. However, further studies are necessary to find the safety of this method and to determine its effective treatment protocol.

  16. Optimistic Selection Rule Better Than Majority Voting System

    Science.gov (United States)

    Sugiyama, Takuya; Obata, Takuya; Hoki, Kunihito; Ito, Takeshi

    A recently proposed ensemble approach to game-tree search has attracted a great deal of attention. The ensemble system consists of M computer players, where each player uses a different series of pseudo-random numbers. A combination of multiple players under the majority voting system would improve the performance of a Shogi-playing computer. We present a new strategy of move selection based on the search values of a number of players. The move decision is made by selecting one player from all M players. Each move is selected by referring to the evaluation value of the tree search of each player. The performance and mechanism of the strategy are examined. We show that the optimistic selection rule, which selects the player that yields the highest evaluation value, outperforms the majority voting system. By grouping 16 or more computer players straightforwardly, the winning rates of the strongest Shogi programs increase from 50 to 60% or even higher.

  17. Physical and genetic map of the major nif gene cluster from Azotobacter vinelandii.

    OpenAIRE

    Jacobson, M R; Brigle, K E; Bennett, L T; Setterquist, R A; Wilson, M S; Cash, V L; Beynon, J; Newton, W E; Dean, D R

    1989-01-01

    Determination of a 28,793-base-pair DNA sequence of a region from the Azotobacter vinelandii genome that includes and flanks the nitrogenase structural gene region was completed. This information was used to revise the previously proposed organization of the major nif cluster. The major nif cluster from A. vinelandii encodes 15 nif-specific genes whose products bear significant structural identity to the corresponding nif-specific gene products from Klebsiella pneumoniae. These genes include ...

  18. Measuring and improving the quality of postoperative epidural analgesia for major abdominal surgery using statistical process control charts.

    Science.gov (United States)

    Duncan, Fiona; Haigh, Carol

    2013-10-01

    To explore and improve the quality of continuous epidural analgesia for pain relief using Statistical Process Control tools. Measuring the quality of pain management interventions is complex. Intermittent audits do not accurately capture the results of quality improvement initiatives. The failure rate for one intervention, epidural analgesia, is approximately 30% in everyday practice, so it is an important area for improvement. Continuous measurement and analysis are required to understand the multiple factors involved in providing effective pain relief. Process control and quality improvement Routine prospectively acquired data collection started in 2006. Patients were asked about their pain and side effects of treatment. Statistical Process Control methods were applied for continuous data analysis. A multidisciplinary group worked together to identify reasons for variation in the data and instigated ideas for improvement. The key measure for improvement was a reduction in the percentage of patients with an epidural in severe pain. The baseline control charts illustrated the recorded variation in the rate of several processes and outcomes for 293 surgical patients. The mean visual analogue pain score (VNRS) was four. There was no special cause variation when data were stratified by surgeons, clinical area or patients who had experienced pain before surgery. Fifty-seven per cent of patients were hypotensive on the first day after surgery. We were able to demonstrate a significant improvement in the failure rate of epidurals as the project continued with quality improvement interventions. Statistical Process Control is a useful tool for measuring and improving the quality of pain management. The applications of Statistical Process Control methods offer the potential to learn more about the process of change and outcomes in an Acute Pain Service both locally and nationally. We have been able to develop measures for improvement and benchmarking in routine care that

  19. Healthy and unhealthy dependence: implications for major depression.

    Science.gov (United States)

    Schulte, Fiona S; Mongrain, Myriam; Flora, David B

    2008-09-01

    To examine the contribution of varying levels of dependency to Axis I and Axis II disorders, and to the recurrence of major depression in a graduate student sample diagnosed with a history of the disorder. At Time 1, participants were interviewed to confirm a current or past episode of major depression along with the presence of Axis II and other current or past Axis I disorders. Various measures of dependency were administered including the Depressive Experiences Questionnaire (DEQ; Blatt, D'Afflitti, & Quinlan, 1976), the 3-Vector Dependency Inventory (3VDI; Pincus & Gurtman, 1995), and the Personal Style Inventory (PSI; Robins et al., 1994). Participants were interviewed 20 months later to determine the recurrence of a depressive episode. A factor analysis conducted on scale scores for each dependency measure resulted in three factors labelled 'unhealthy', 'intermediate', and 'healthy' dependence. Controlling for history of major depression, structural equation modelling found 'unhealthy' dependence to be the only predictor of recurrences of major depression and Axis II disorders, while 'healthy' dependence was related to fewer depressive symptoms. These results have important implications for the conceptualization of the dependency construct.

  20. Strategic Curricular Decisions in Butler University's Actuarial Science Major

    Science.gov (United States)

    Wilson, Christopher James

    2014-01-01

    We describe specific curricular decisions employed at Butler University that have resulted in student achievement in the actuarial science major. The paper includes a discussion of how these decisions might be applied in the context of a new actuarial program.

  1. The role of beta-endorphin in the pathophysiology of major depression.

    Science.gov (United States)

    Hegadoren, K M; O'Donnell, T; Lanius, R; Coupland, N J; Lacaze-Masmonteil, N

    2009-10-01

    A role for beta-endorphin (beta-END) in the pathophysiology of major depressive disorder (MDD) is suggested by both animal research and studies examining clinical populations. The major etiological theories of depression include brain regions and neural systems that interact with opioid systems and beta-END. Recent preclinical data have demonstrated multiple roles for beta-END in the regulation of complex homeostatic and behavioural processes that are affected during a depressive episode. Additionally, beta-END inputs to regulatory pathways involving feeding behaviours, motivation, and specific types of motor activity have important implications in defining the biological foundations for specific depressive symptoms. Early research linking beta-END to MDD did so in the context of the hypothalamic-pituitary-adrenal (HPA) axis activity, where it was suggested that HPA axis dysregulation may account for depressive symptoms in some individuals. The primary aims of this paper are to use both preclinical and clinical research (a) to critically review data that explores potential roles for beta-END in the pathophysiology of MDD and (b) to highlight gaps in the literature that limit further development of etiological theories of depression and testable hypotheses. In addition to examining methodological and theoretical challenges of past clinical studies, we summarize studies that have investigated basal beta-END levels in MDD and that have used challenge tests to examine beta-END responses to a variety of experimental paradigms. A brief description of the synthesis, location in the CNS and behavioural pharmacology of this neuropeptide is also provided to frame this discussion. Given the lack of clinical improvement observed with currently available antidepressants in a significant proportion of depressed individuals, it is imperative that novel mechanisms be investigated for antidepressant potential. We conclude that the renewed interest in elucidating the role of beta

  2. The Effects of Group Play Therapy on Self-Concept Among 7 to 11 Year-Old Children Suffering From Thalassemia Major.

    Science.gov (United States)

    Tomaj, Ome Kolsoum; Estebsari, Fatemeh; Taghavi, Taraneh; Borim Nejad, Leili; Dastoorpoor, Maryam; Ghasemi, Afsaneh

    2016-04-01

    Children suffering from thalassemia have higher levels of depression and lower levels of self-concept. The aim of this study was to determine if group play therapy could significantly increase self-concept among children with thalassemia major ages 7 to 11 years old in teaching hospitals of Golestan province, Iran, in 2012. In this randomized, controlled clinical trial, 60 children with thalassemia major were randomly assigned to intervention (30 children) and control (30 children) groups. The intervention included eight 45 to 60 minute sessions during four weeks, during which the intervention group received group play therapy. The control group received no interventions. Self-concept was measured three times using the Piers-Harris children's self-concept scale: before, immediately after, and a month after the intervention. For the intervention group, results showed that the mean self-concept score was significantly higher at the second point in time compared to the baseline (P 0.05). The results showed that group play therapy improves self-concept in children suffering from thalassemia major.

  3. Improving radiation worker safety at the Chernobyl Shelter

    International Nuclear Information System (INIS)

    Vargo, G.J.; Korneev, A.A.

    2000-01-01

    The Shelter (i.e. 'sarcophagus') enclosing the remains of the Chernobyl Nuclear Power Plant Unit 4 that was destroyed in the April 1986 accident presents a unique radiological and nuclear safety challenge. The Chomobyl Shelter holds over 190 tons of irradiated nuclear fuel in the form of lava fuel containing masses and dust. Hazards include very high radiation, surface contamination and transient airborne radioactivity concentrations. A state-of-the-art radiation protection program is needed to support international efforts stabilize the Chornobyl Shelter, reduce the potential for major structural failure, minimize the consequences of a such an event, and develop a long-term strategy and study for its conversion into an environmentally safe site. This project consists of the first phase of efforts to transfer health physics technology necessary to support stabilization of the Chornobyl Shelter. Technical specifications for each major system and component were jointly developed by staff from the U.S. Department of Energy's Pacific Northwest National Laboratory and the Chornobyl Shelter. Major elements of this technology transfer include equipment for external dose control (electronic dosimeters, thermoluminescent dosimeter (TLD) system, portable radiation survey instruments, and area radiation monitors), internal dose control (whole body counter, bioassay system design and technical support), health physics training, and other radiological technical support. A work planning system that includes the capability to collect data such as radiological surveys, photographs, video clips, and other data, was developed from a system demonstrated at the U.S. Department of Energy's Hanford Site. An access control system similar to one used at several commercial nuclear facilities in the U.S. was converted for bilingual support (Russian and English). Technology for improving contamination control includes HEPA-ventilation and vacuum cleaner systems, semi-permanent and portable

  4. Major Vascular Neurocognitive Disorder: A Reappraisal to Vascular Dementia

    Directory of Open Access Journals (Sweden)

    Emre Kumral

    2017-03-01

    Full Text Available Major vascular neurocognitive disorder (NCD is the second leading form of dementia after Alzheimer’s disease, accounting for 17-20% of all dementias. Vascular NCD is a progressive disease caused by reduced cerebral blood flow related to multiple large volume or lacunar infarcts that induce a sudden onset and stepwise decline in cognitive abilities. Despite its prevalence and clinical importance, there is still controversy in the terminology of vascular NCD. Only after the release of Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5 (2013 did the American Psychiatric Association define vascular dementia as “major vascular NCD”. This review includes an overview of risk factors, pathophysiology, types, diagnostic and clinical features of major vascular NCD, and current treatment options of vascular NCD regarding to DSM-5 criteria

  5. Photoactive devices including porphyrinoids with coordinating additives

    Science.gov (United States)

    Forrest, Stephen R; Zimmerman, Jeramy; Yu, Eric K; Thompson, Mark E; Trinh, Cong; Whited, Matthew; Diev, Vlacheslav

    2015-05-12

    Coordinating additives are included in porphyrinoid-based materials to promote intermolecular organization and improve one or more photoelectric characteristics of the materials. The coordinating additives are selected from fullerene compounds and organic compounds having free electron pairs. Combinations of different coordinating additives can be used to tailor the characteristic properties of such porphyrinoid-based materials, including porphyrin oligomers. Bidentate ligands are one type of coordinating additive that can form coordination bonds with a central metal ion of two different porphyrinoid compounds to promote porphyrinoid alignment and/or pi-stacking. The coordinating additives can shift the absorption spectrum of a photoactive material toward higher wavelengths, increase the external quantum efficiency of the material, or both.

  6. Aesthetic Surgical Procedures in Men: Major Complications and Associated Risk Factors.

    Science.gov (United States)

    Kaoutzanis, Christodoulos; Winocour, Julian; Yeslev, Max; Gupta, Varun; Asokan, Ishan; Roostaeian, Jason; Grotting, James C; Higdon, K Kye

    2018-03-14

    The number of men undergoing cosmetic surgery is increasing in North America. To determine the incidence and risk factors of major complications in males undergoing cosmetic surgery, compare the complication profiles between men and women, and identify specific procedures that are associated with higher risk of complications in males. A prospective cohort of patients undergoing cosmetic surgery between 2008 and 2013 was identified from the CosmetAssure database. Gender specific procedures were excluded. Primary outcome was occurrence of a major complication in males requiring emergency room visit, hospital admission, or reoperation within 30 days of the index operation. Univariate and multivariate analysis evaluated potential risk factors for major complications including age, body mass index (BMI), smoking, diabetes, type of surgical facility, type of procedure, and combined procedures. Of the 129,007 patients, 54,927 underwent gender nonspecific procedures, of which 5801 (10.6%) were males. Women showed a higher mean age (46.4 ± 14.1 vs 45.2 ± 16.7 years, P procedures (RR 3.47), and combined procedures (RR 2.56). Aesthetic surgery in men is safe with low major complication rates. Modifiable predictors of complications included BMI and combined procedures.

  7. Pectoralis major tears: anatomy, classification, and diagnosis with ultrasound and MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Chiavaras, Mary M. [McMaster University, Department of Radiology, Hamilton, ON (Canada); Jacobson, Jon A. [University of Michigan, Department of Radiology, Ann Arbor, MI (United States); Smith, Jay [Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN (United States); Department of Radiology, Mayo Clinic, Rochester, MN (United States); Department of Anatomy, Mayo Clinic, Rochester, MN (United States); Dahm, Diane L. [Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN (United States)

    2014-09-09

    Accurate characterization of pectoralis major tears is important to guide management. Imaging evaluation with ultrasound and MR imaging can be difficult given the complex regional anatomy. In addition, recent literature has redefined the anatomy of the distal pectoralis major. The purpose of this study is to review pectoralis major injuries taking into account new anatomic descriptions using ultrasound and MR imaging, including cadaveric dissection, surgically produced pectoralis tears, and clinical pectoralis tendon tear with surgical correlation. (orig.)

  8. Pectoralis major tears: anatomy, classification, and diagnosis with ultrasound and MR imaging

    International Nuclear Information System (INIS)

    Chiavaras, Mary M.; Jacobson, Jon A.; Smith, Jay; Dahm, Diane L.

    2015-01-01

    Accurate characterization of pectoralis major tears is important to guide management. Imaging evaluation with ultrasound and MR imaging can be difficult given the complex regional anatomy. In addition, recent literature has redefined the anatomy of the distal pectoralis major. The purpose of this study is to review pectoralis major injuries taking into account new anatomic descriptions using ultrasound and MR imaging, including cadaveric dissection, surgically produced pectoralis tears, and clinical pectoralis tendon tear with surgical correlation. (orig.)

  9. Altered cerebellar functional connectivity with intrinsic connectivity networks in adults with major depressive disorder.

    Directory of Open Access Journals (Sweden)

    Li Liu

    Full Text Available BACKGROUND: Numerous studies have demonstrated the higher-order functions of the cerebellum, including emotion regulation and cognitive processing, and have indicated that the cerebellum should therefore be included in the pathophysiological models of major depressive disorder. The aim of this study was to compare the resting-state functional connectivity of the cerebellum in adults with major depression and healthy controls. METHODS: Twenty adults with major depression and 20 gender-, age-, and education-matched controls were investigated using seed-based resting-state functional connectivity magnetic resonance imaging. RESULTS: Compared with the controls, depressed patients showed significantly increased functional connectivity between the cerebellum and the temporal poles. However, significantly reduced cerebellar functional connectivity was observed in the patient group in relation to both the default-mode network, mainly including the ventromedial prefrontal cortex and the posterior cingulate cortex/precuneus, and the executive control network, mainly including the superior frontal cortex and orbitofrontal cortex. Moreover, the Hamilton Depression Rating Scale score was negatively correlated with the functional connectivity between the bilateral Lobule VIIb and the right superior frontal gyrus in depressed patients. CONCLUSIONS: This study demonstrated increased cerebellar coupling with the temporal poles and reduced coupling with the regions in the default-mode and executive control networks in adults with major depression. These differences between patients and controls could be associated with the emotional disturbances and cognitive control function deficits that accompany major depression. Aberrant cerebellar connectivity during major depression may also imply a substantial role for the cerebellum in the pathophysiological models of depression.

  10. International Science Education: A Study of UNESCO Science Education Improvement Projects in Selected Anglophone Countries of Africa: Project Problems.

    Science.gov (United States)

    Nichter, Richard

    1984-01-01

    Discusses some of the problems faced by technical advisors implementing projects for the improvement of science education in Africa and reasons for these problems. Problem areas considered include underdevelopment, underestimating the process, finances, personality conflict and motivation, and opposition from key groups. (A list of major UNESCO…

  11. Shared governance: a way to improve the care in an inpatient rehabilitation facility.

    Science.gov (United States)

    Torres, Audrey; Kunishige, Nalani; Morimoto, Denise; Hanzawa, Tracie; Ebesu, Mike; Fernandez, John; Nohara, Lynne; SanAgustin, Eliseo; Borg, Stephanie

    2015-01-01

    Rehabilitation care is specialized and individualized requiring effective and efficient communication to achieve optimal patient outcomes. To examine how effective implementation of shared governance could improve care delivery, promote patient-centered care, and improve patient outcomes. The shared governance approach included all members of the rehabilitation team (i.e., physical therapist, occupational therapist, speech therapist, registered nurse and nurse aide) and was implemented over 6 months. The major end products of this shared governance effort were improved staff communication, problem solving, patient outcomes, and staff satisfaction on our stroke and brain injury unit. When effectively implemented and sustained, shared governance between all rehabilitation team stakeholders can increase the effectiveness of communication along with more positive patient and staff outcomes. © 2014 Association of Rehabilitation Nurses.

  12. A systematic review of religious beliefs about major end-of-life issues in the five major world religions.

    Science.gov (United States)

    Chakraborty, Rajshekhar; El-Jawahri, Areej R; Litzow, Mark R; Syrjala, Karen L; Parnes, Aric D; Hashmi, Shahrukh K

    2017-10-01

    The objective of this study was to examine the religious/spiritual beliefs of followers of the five major world religions about frequently encountered medical situations at the end of life (EoL). This was a systematic review of observational studies on the religious aspects of commonly encountered EoL situations. The databases used for retrieving studies were: Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus. Observational studies, including surveys from healthcare providers or the general population, and case studies were included for review. Articles written from a purely theoretical or philosophical perspective were excluded. Our search strategy generated 968 references, 40 of which were included for review, while 5 studies were added from reference lists. Whenever possible, we organized the results into five categories that would be clinically meaningful for palliative care practices at the EoL: advanced directives, euthanasia and physician-assisted suicide, physical requirements (artificial nutrition, hydration, and pain management), autopsy practices, and other EoL religious considerations. A wide degree of heterogeneity was observed within religions, depending on the country of origin, level of education, and degree of intrinsic religiosity. Our review describes the religious practices pertaining to major EoL issues and explains the variations in EoL decision making by clinicians and patients based on their religious teachings and beliefs. Prospective studies with validated tools for religiosity should be performed in the future to assess the impact of religion on EoL care.

  13. Psychosocial functioning in prepubertal major depressive disorders. II. Interpersonal relationships after sustained recovery from affective episode.

    Science.gov (United States)

    Puig-Antich, J; Lukens, E; Davies, M; Goetz, D; Brennan-Quattrock, J; Todak, G

    1985-05-01

    Psychosocial relationships with parents, peers, and siblings, as well as school functioning, were measured at two points in time by parental interview in 21 prepubertal children: during an episode of major depression and after they had sustained an affective recovery from the index episode for at least four months. School functioning was completely normalized, but deficits in the child's intrafamilial and extra-familial relationships had improved only partially. The pattern of improvement was merely quantitative. Moderate deficits during the depressive episode reached, after affective recovery, the level of the normal control group. In contrast, severe deficits only improved to a moderate level of severity. It is suggested that treating the affective disorder is not sufficient in many children with major depression and that efficacy studies of psychotherapeutic interventions in affectively recovered children are needed.

  14. Enhanced Recovery Implementation in Major Gynecologic Surgeries: Effect of Care Standardization.

    Science.gov (United States)

    Modesitt, Susan C; Sarosiek, Bethany M; Trowbridge, Elisa R; Redick, Dana L; Shah, Puja M; Thiele, Robert H; Tiouririne, Mohamed; Hedrick, Traci L

    2016-09-01

    To examine implementing an enhanced recovery after surgery (ERAS) protocol for women undergoing major gynecologic surgery at an academic institution and compare surgical outcomes before and after implementation. Two ERAS protocols were developed: a full pathway using regional anesthesia for open procedures and a light pathway without regional anesthesia for vaginal and minimally invasive procedures. Enhanced recovery after surgery pathways included extensive preoperative counseling, carbohydrate loading and oral fluids before surgery, multimodal analgesia with avoidance of intravenous opioids, intraoperative goal-directed fluid resuscitation, and immediate postoperative feeding and ambulation. A before-and-after study design was used to compare clinical outcomes, costs, and patient satisfaction. Complications and risk-adjusted length of stay were drawn from the American College of Surgeons' National Surgical Quality Improvement Program database. On the ERAS full protocol, 136 patients were compared with 211 historical controls and the median length of stay was reduced (2.0 compared with 3.0 days; P=.007) despite an increase in National Surgical Quality Improvement Program-predicted length of stay (2.5 compared with 2.0 days; P=.009). Reductions were seen in median intraoperative morphine equivalents (0.3 compared with 12.7 mg; Pcontrols and demonstrated decreased intraoperative and postoperative morphine equivalents (0.0 compared with 13.0 mg; Pcontrol, nurses keeping patients informed, and staff teamwork; 30-day total hospital costs were significantly decreased in both ERAS groups. Implementation of ERAS protocols in gynecologic surgery was associated with a substantial decrease in intravenous fluids and morphine administration coupled with reduction in length of stay for open procedures combined with improved patient satisfaction and decreased hospital costs.

  15. Selective Neurocognitive Impairments in Adolescents with Major Depressive Disorder

    Science.gov (United States)

    Han, Georges; Klimes-Dougan, Bonnie; Jepsen, Susie; Ballard, Kristin; Nelson, Megan; Houri, Alaa; Kumra, Sanjiv; Cullen, Kathryn

    2012-01-01

    This study investigated whether major depression in adolescence is characterized by neurocognitive deficits in attention, affective decision making, and cognitive control of emotion processing. Neuropsychological tests including the Wechsler Abbreviated Scale of Intelligence, the Continuous Performance Test-Identical Pairs, the Attention Network…

  16. Improving SFR Economics through Innovations from Thermal Design and Analysis Aspects

    Energy Technology Data Exchange (ETDEWEB)

    Haihua Zhao; Hongbin Zhang; Vincent Mousseau; Per F. Peterson

    2008-06-01

    Achieving economic competitiveness as compared to LWRs and other Generation IV (Gen-IV) reactors is one of the major requirements for large-scale investment in commercial sodium cooled fast reactor (SFR) power plants. Advances in R&D for advanced SFR fuel and structural materials provide key long-term opportunities to improve SFR economics. In addition, other new opportunities are emerging to further improve SFR economics. This paper provides an overview on potential ideas from the perspective of thermal hydraulics to improve SFR economics. These include a new hybrid loop-pool reactor design to further optimize economics, safety, and reliability of SFRs with more flexibility, a multiple reheat and intercooling helium Brayton cycle to improve plant thermal efficiency and reduce safety related overnight and operation costs, and modern multi-physics thermal analysis methods to reduce analysis uncertainties and associated requirements for over-conservatism in reactor design. This paper reviews advances in all three of these areas and their potential beneficial impacts on SFR economics.

  17. The soybean and mungbean improvement programs at AVRDC

    International Nuclear Information System (INIS)

    Shanmugasundaram, S.; Ahn, G.S.

    1983-01-01

    At the Asian Vegetable Research and Development Center (AVRDC) Soybean, Glycine max (L.) Merr. and mungbean, Vigna radiata (L.) Wilczek are included in the Legume Program for improvement. Germplasm collection in soybean and mungbean are 9,524 and 5,108 respectively. Developing improved selections with early, uniform maturity, high yield, wide adaptability and resistance to diseases and insects are the major breeding objectives for the tropics and subtropics. Genetic diversity and genetic resources are available in the germplasm for most of the desired traits both in soybean as well as mungbean. However, for traits such as soybean rust resistance in soybean and resistance to insects in mungbean are rare. Limited amount of radiation breeding is being employed in cooperation with Korean Atomic Energy Agency to obtain desirable genes in both species. A number of AVRDC identified accessions and breeding lines are being used by the national programs to develop improved cultivars. AVRDC developed breeding selections have been released as new cultivars in Costa Rica, Fiji, Korea, India, Indonesia, Malaysia and Taiwan. (author)

  18. Major knowledge gaps and system barriers to guideline implementation among European physicians treating patients with atrial fibrillation: a European Society of Cardiology international educational needs assessment.

    Science.gov (United States)

    Heidbuchel, Hein; Dagres, Nikolaos; Antz, Matthias; Kuck, Karl-Heinz; Lazure, Patrice; Murray, Suzanne; Carrera, Céline; Hindricks, Gerhard; Vahanian, Alec

    2018-03-12

    Guideline-adherent treatment is associated with improved prognosis in atrial fibrillation (AF) patients but is insufficiently implemented in clinical practice. The European Society of Cardiology (ESC) performed a multinational educational needs assessment study among cardiologists, general practitioners/family physicians (GPs/FPs), and neurologists in order to evaluate knowledge and skills of physicians and system factors related to AF care delivery. A total of 561 physicians (294 cardiologists, 131 neurologists, and 136 GPs/FPs) from six European countries participated. This mixed-methods study included exploratory semi-structured qualitative interviews (n = 30) and a quantitative survey that included two clinical cases (n = 531). We identified eight key knowledge gaps and system barriers across all domains of AF care. A majority across all specialties reported skills needing improvement to classify AF pathophysiologically, rather than based on duration of episodes, and reported lack of availability of long-term electrocardiogram recording. Skills interpreting the CHA2DS2-VASc and the HAS-BLED scores were reported as needing improvement by the majority of neurologists (52% and 60%, respectively) and GPs/FPs (65% and 74%). Cardiologists calculated the CHA2DS2-VASc and HAS-BLED scores in 94%/70% in a presented case patient, but only 60%/49% of neurologists and 58%/42% of GPs/FPs did. There was much uncertainty on how to deal with anticoagulant therapy in complex patients. There was also a high disparity in using rate or rhythm control strategies, and indications for ablation. Information delivery to patients and communication between different specialties was often considered suboptimal, while national regulations and restrictions often hamper international guideline implementation. We identified major gaps in physicians' knowledge and skills across all domains of AF care, as well as system factors hampering guideline-compliant care implementation and

  19. Beyond Astro 101: A First Report on Applying Interactive Education Techniques to an Astronphysics Class for Majors

    Science.gov (United States)

    Perrin, Marshall D.; Ghez, A. M.

    2009-05-01

    Learner-centered interactive instruction methods now have a proven track record in improving learning in "Astro 101" courses for non-majors, but have rarely been applied to higher-level astronomy courses. Can we hope for similar gains in classes aimed at astrophysics majors, or is the subject matter too fundamentally different for those techniques to apply? We present here an initial report on an updated calculus-based Introduction to Astrophysics class at UCLA that suggests such techniques can indeed result in increased learning for major students. We augmented the traditional blackboard-derivation lectures and challenging weekly problem sets by adding online questions on pre-reading assignments (''just-in-time teaching'') and frequent multiple-choice questions in class ("Think-Pair-Share''). We describe our approach, and present examples of the new Think-Pair-Share questions developed for this more sophisticated material. Our informal observations after one term are that with this approach, students are more engaged and alert, and score higher on exams than typical in previous years. This is anecdotal evidence, not hard data yet, and there is clearly a vast amount of work to be done in this area. But our first impressions strongly encourage us that interactive methods should be able improve the astrophysics major just as they have improved Astro 101.

  20. 14 CFR Appendix B to Part 43 - Recording of Major Repairs and Major Alterations

    Science.gov (United States)

    2010-01-01

    ... inspected. (d) For extended-range fuel tanks installed within the passenger compartment or a baggage... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Recording of Major Repairs and Major... to Part 43—Recording of Major Repairs and Major Alterations (a) Except as provided in paragraphs (b...

  1. Performance profiles of major energy producers, 1997

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-01-01

    The energy industry generally and petroleum and natural gas operations in particular are frequently reacting to a variety of unsettling forces. Falling oil prices, economic upswings, currency devaluations, increasingly rigorous environmental quality standards, deregulation of electricity markets, and continued advances in exploration and production technology were among the challenges and opportunities to the industry in 1997. To analyze the extent to which these and other developments have affected energy industry financial and operating performance, strategies, and industry structure, the Energy Information Administration (EIA) maintains the Financial Reporting Systems (FRS). Through Form EIA-28, major US energy companies annually report to the FRS. Financial and operating information is reported by major lines of business, including oil and gas production (upstream), petroleum refining and marketing (downstream), other energy operations, and nonenergy business. Performance Profiles of Major Producers 1997 examines the interplays of energy markets, companies` strategies, and government policies (in 1997 and in historical context) that gave rise to the results given here. The report also analyzes other key aspects of energy company financial performance as seen through the multifaceted lens provided by the FRS data and complementary data for industry overall. 41 figs., 77 tabs.

  2. Increased situation awareness in major incidents-radio frequency identification (RFID) technique: a promising tool.

    Science.gov (United States)

    Jokela, Jorma; Rådestad, Monica; Gryth, Dan; Nilsson, Helené; Rüter, Anders; Svensson, Leif; Harkke, Ville; Luoto, Markku; Castrén, Maaret

    2012-02-01

    In mass-casualty situations, communications and information management to improve situational awareness is a major challenge for responders. In this study, the feasibility of a prototype system that utilizes commercially available, low-cost components, including Radio Frequency Identification (RFID) and mobile phone technology, was tested in two simulated mass-casualty incidents. The feasibility and the direct benefits of the system were evaluated in two simulated mass-casualty situations: one in Finland involving a passenger ship accident resulting in multiple drowning/hypothermia patients, and another at a major airport in Sweden using an aircraft crash scenario. Both simulations involved multiple agencies and functioned as test settings for comparing the disaster management's situational awareness with and without using the RFID-based system. Triage documentation was done using both an RFID-based system, which automatically sent the data to the Medical Command, and a traditional method using paper triage tags. The situational awareness was measured by comparing the availability of up-to date information at different points in the care chain using both systems. Information regarding the numbers and status or triage classification of the casualties was available approximately one hour earlier using the RFID system compared to the data obtained using the traditional method. The tested prototype system was quick, stable, and easy to use, and proved to work seamlessly even in harsh field conditions. It surpassed the paper-based system in all respects except simplicity of use. It also improved the general view of the mass-casualty situations, and enhanced medical emergency readiness in a multi-organizational medical setting. The tested technology is feasible in a mass-casualty incident; further development and testing should take place.

  3. Benefit-risk trade-offs in retrospect: how major stakeholders perceive the decision-making process in the Barents Sea oil field development

    DEFF Research Database (Denmark)

    Renn, Ortwin; Grieger, Khara Deanne; Øien, Knut

    2013-01-01

    review of the decision-making process seen through the lenses of the major stakeholders involved in this process. The research design used qualitative methods of empirical research including stakeholder interviews during a five-day period in 2011 in Northern Norway. Results showed that the siting process...... additional benefits to the communities which would then be fairly distributed among the beneficiaries have been disappointed. We review the reasons behind these results as well as formulate recommendations regarding potential improvements to the risk-benefit communication process in addition to future siting...

  4. The Guyana Diabetes and Foot Care Project: Improved Diabetic Foot Evaluation Reduces Amputation Rates by Two-Thirds in a Lower Middle Income Country

    Science.gov (United States)

    Sibbald, R. Gary; Martin, Carlos

    2015-01-01

    Background. Type 2 diabetes is the fourth leading cause of death in Guyana, South America. A complex, interprofessional, quality improvement intervention to improve foot and diabetes care was rolled out in two phases. Methods & Findings. Phase 1: Establishment of an Interprofessional Diabetic Foot Center (DFC) of Excellence to improve foot care and reduce diabetes-related amputations at the national referral hospital. Phase 2: Regionalization to cover 90% of the Guyanese population and expansion to include improved management of diabetes and hypertension. Fourteen key opinion leaders were educated and 340 health care professionals from 97 facilities trained. Eight centers for the evaluation and treatment of foot ulcers were established and 7567 people with diabetes evaluated. 3452 participants had foot screening and 48% were deemed high risk; 10% of these had undocumented foot ulcers. There was a 68% reduction in rate of major amputations (P diabetes with women (F/M = 2.09) and increased risk of major amputation in men [odds ratio 2.16 (95% CI 1.83, 2.56)] were documented. Conclusions. This intervention improved foot care with reduction in major amputations sustained over 5 years. PMID:26089901

  5. Turnover among Filipino nurses in Ministry of Health hospitals in Saudi Arabia: causes and recommendations for improvement.

    Science.gov (United States)

    Aljohani, Khalid Abdullah; Alomari, Omar

    2018-01-01

    Nurse turnover is a critical challenge for healthcare organizations as it results in a decreasing nurse/patient ratio and increasing costs. Identify factors influencing the termination of Filipino nurses in Ministry of Health (MOH) hospitals and record nurse recommendations to improve retention. Cross-sectional. Data was gathered from a convenience sample of Filipino nurses with previous experience in MOH hospitals in Saudi Arabia who attended recruitment interviews at the Saudi employment office in Manila. The sample included 124 nurses. Major turnover factors included low salary (18.3%), low nurse/patient ratio (15%), end of contract (14.5%), discrimination (13.5%), and bad accommodations (9%). Suggested areas of improvement included financial motivations (34%), administration support (25%), quality of life (25%), and work environment (16%). Managing nurse turnover can be implemented on the organizational as well as at MOH levels. The recommendations given by the participants provide direct targets to improve retention. With convenience sampling, the sample is probably not representative of the Filipino nursing population. None.

  6. Qualitative Characteristics of Coherence, Substitution, and Reference by Non-English Major Chinese Students

    Science.gov (United States)

    Shen, Ying

    2010-01-01

    This study addresses the interrelation among coherence, substitution, and reference by non-English major Chinese students. The author collected data through student questionnaires. Participants included 30 non-English major Chinese undergraduate students. The findings of this study suggested that the similarities and differences were confirmed…

  7. Simple suggestions for including vertical physics in oil spill models

    International Nuclear Information System (INIS)

    D'Asaro, Eric; University of Washington, Seatle, WA

    2001-01-01

    Current models of oil spills include no vertical physics. They neglect the effect of vertical water motions on the transport and concentration of floating oil. Some simple ways to introduce vertical physics are suggested here. The major suggestion is to routinely measure the density stratification of the upper ocean during oil spills in order to develop a database on the effect of stratification. (Author)

  8. Commitment to COT verification improves patient outcomes and financial performance.

    Science.gov (United States)

    Maggio, Paul M; Brundage, Susan I; Hernandez-Boussard, Tina; Spain, David A

    2009-07-01

    After an unsuccessful American College of Surgery Committee on Trauma visit, our level I trauma center initiated an improvement program that included (1) hiring new personnel (trauma director and surgeons, nurse coordinator, orthopedic trauma surgeon, and registry staff), (2) correcting deficiencies in trauma quality assurance and process improvement programs, and (3) development of an outreach program. Subsequently, our trauma center had two successful verifications. We examined the longitudinal effects of these efforts on volume, patient outcomes and finances. The Trauma Registry was used to derive data for all trauma patients evaluated in the emergency department from 2001 to 2007. Clinical data analyzed included number of admissions, interfacility transfers, injury severity scores (ISS), length of stay, and mortality for 2001 to 2007. Financial performance was assessed for fiscal years 2001 to 2007. Data were divided into patients discharged from the emergency department and those admitted to the hospital. Admissions increased 30%, representing a 7.6% annual increase (p = 0.004), mostly due to a nearly fivefold increase in interfacility transfers. Severe trauma patients (ISS >24) increased 106% and mortality rate for ISS >24 decreased by 47% to almost half the average of the National Trauma Database. There was a 78% increase in revenue and a sustained increase in hospital profitability. A major hospital commitment to Committee on Trauma verification had several salient outcomes; increased admissions, interfacility transfers, and acuity. Despite more seriously injured patients, there has been a major, sustained reduction in mortality and a trend toward decreased intensive care unit length of stay. This resulted in a substantial increase in contribution to margin (CTM), net profit, and revenues. With a high level of commitment and favorable payer mix, trauma center verification improves outcomes for both patients and the hospital.

  9. HIV-related knowledge and perceptions by academic major: Implications for university interventions

    Directory of Open Access Journals (Sweden)

    Matthew Lee Smith

    2014-03-01

    Full Text Available Most universities offer human sexuality courses, although they are not required for graduation. While students in health-related majors may receive sexuality education in formal settings, majority of college students never receive formal sexual health or HIV/AIDS-related education, which may lead to elevated engagement in high-risk sexual behaviors. This study examines perceived knowledge about HIV/AIDS, perceived risk, and perceived consequences among college students by two distinct classifications of academic majors. Data were collected from 510 college students. Binary and multinomial logistic regressions were performed to compare HIV-related covariates by academic major category. Limited differences were observed by Science, Technology, Engineering, and Mathematics (STEM categorization. Relative to health and kinesiology (HK majors, those who self-reported being completely knowledgeable about HIV were less likely to be physical sciences, math, engineering, business (PMEB [OR=0.41, P=0.047] or education, humanities, and social sciences (EHS majors [OR=0.25, P=0.004]. PMEB majors were less likely to report behavioral factors as a risk for contracting HIV [OR=0.86, P=0.004] and perceived acquiring HIV would be more detrimental to their quality of life [OR=2.14, P=0.012], but less detrimental to their mental wellbeing [OR=0.58, P=0.042]. Findings can inform college-wide campaigns and interventions to raise HIV/AIDS awareness and improve college health.

  10. KLEPTOMANIA PRESENTING WITH MAJOR DEPRESSIVE DISORDER : A CASE REPORT

    OpenAIRE

    Sharma, R.C.

    1996-01-01

    A 35 year old, married, educated woman of well to do economic condition who was referred by court for psychiatric opinion was found to suffer from “Kleptomania” with “recurrent major depressive disorder.” The patient had been stealing and hoarding (at times giving away when caught) defective and useless objects for the past 3 years .mostly during periods of depression and had been arrested twice for stealing. Her kleplomanic symptoms improved moderately when her depression lifted with antidep...

  11. 2015 Status Report on Major Defence Equipment Procurements

    Directory of Open Access Journals (Sweden)

    David Perry

    2015-12-01

    Full Text Available Federal elections may be good for democracy, but the campaigns — particularly the lengthy one recently held in Canada — can be crippling for plans to better arm our military. Just before the election was called, there were public signs of important progress being made in what has long been a frustratingly slow and bureaucratically complex procurement process. But then the campaign left the Department of National Defence and other federal departments unable to secure approvals from either a defence minister or the Treasury Board, until the election ended and the new prime minister appointed the current cabinet. There had already been upheaval prior to that: In the first seven months of 2015, the three senior leaders at the Canadian Forces and the Defence Department (including the minister had been replaced, along with many other people critical to the procurement process. In addition, there had been changes in the Public Works Department and the Defence Procurement Strategy Secretariat. Frustrating and disappointing delays have long been a matter of course in Canada’s defence procurement process. In 2014/15, the number of ministerial or Treasury Board approvals to allow projects to proceed was half of that in 2009/10. Yet the demand for approvals has not abated. In addition to the turnover of key figures involved in the procurement and approval process, delays have come from a number of major steps added to the process, making an already lengthy and complex system even more so. To be sure, these steps were added in the pursuit of improved financial management and project management, with the aim of addressing longstanding problems. But it will take years to see if those objectives have been realized. An irony here is that the budget for military procurement has increased. Between 2004 and 2009, the Defence Department’s procurement budget nearly doubled. But the funding was never matched by the capacity to manage it. In 2003, the Material

  12. Reducing symptoms of major depressive disorder through a systematic training of general emotion regulation skills: protocol of a randomized controlled trial.

    Science.gov (United States)

    Ehret, Anna M; Kowalsky, Judith; Rief, Winfried; Hiller, Wolfgang; Berking, Matthias

    2014-01-27

    Major Depressive Disorder is one of the most challenging mental health problems of our time. Although effective psychotherapeutic treatments are available, many patients fail to demonstrate clinically significant improvements. Difficulties in emotion regulation have been identified as putative risk and maintaining factors for Major Depressive Disorder. Systematically enhancing adaptive emotion regulation skills should thus help reduce depressive symptom severity. However, at this point, no study has systematically evaluated effects of increasing adaptive emotion regulation skills application on symptoms of Major Depressive Disorder. In the intended study, we aim to evaluate stand-alone effects of a group-based training explicitly and exclusively targeting general emotion regulation skills on depressive symptom severity and assess whether this training augments the outcome of subsequent individual cognitive behavioral therapy for depression. In the evaluation of the Affect Regulation Training, we will conduct a prospective randomized-controlled trial. Effects of the Affect Regulation Training on depressive symptom severity and outcomes of subsequent individual therapy for depression will be compared with an active, common factor based treatment and a waitlist control condition. The study sample will include 120 outpatients meeting criteria for Major Depressive Disorder. Depressive symptom severity as assessed by the Hamilton Rating Scale will serve as our primary study outcome. Secondary outcomes will include further indicators of mental health and changes in adaptive emotion regulation skills application. All outcomes will be assessed at intake and at 10 points in time over the course of the 15-month study period. Measures will include self-reports, observer ratings, momentary ecological assessments, and will be complemented in subsamples by experimental investigations and the analysis of hair steroids. If findings should support the hypothesis that enhancing

  13. Psychotherapy for Major Depressive Disorder and Generalized Anxiety Disorder: A Health Technology Assessment

    Science.gov (United States)

    McMartin, Kristen; Gajic-Veljanoski, Olga; Wells, David; Higgins, Caroline; Walter, Melissa

    2017-01-01

    Background Major depressive disorder and generalized anxiety disorder are among the most commonly diagnosed mental illnesses in Canada; both are associated with a high societal and economic burden. Treatment for major depressive disorder and generalized anxiety disorder consists of pharmacological and psychological interventions. Three commonly used psychological interventions are cognitive behavioural therapy (CBT), interpersonal therapy, and supportive therapy. The objectives of this report were to assess the effectiveness and safety of these types of therapy for the treatment of adults with major depressive disorder and/or generalized anxiety disorder, to assess the cost-effectiveness of structured psychotherapy (CBT or interpersonal therapy), to calculate the budget impact of publicly funding structured psychotherapy, and to gain a greater understanding of the experiences of people with major depressive disorder and/or generalized anxiety disorder. Methods We performed a literature search on October 27, 2016, for systematic reviews that compared CBT, interpersonal therapy, or supportive therapy with usual care, waitlist control, or pharmacotherapy in adult outpatients with major depressive disorder and/or generalized anxiety disorder. We developed an individual-level state-transition probabilistic model for a cohort of adult outpatients aged 18 to 75 years with a primary diagnosis of major depressive disorder to determine the cost-effectiveness of individual or group CBT (as a representative form of structured psychotherapy) versus usual care. We also estimated the 5-year budget impact of publicly funding structured psychotherapy in Ontario. Finally, we interviewed people with major depressive disorder and/or generalized anxiety disorder to better understand the impact of their condition on their daily lives and their experience with different treatment options, including psychotherapy. Results Interpersonal therapy compared with usual care reduced

  14. The effects of social concern goals on the value of learning and on the intentions of medical students to change their majors.

    Science.gov (United States)

    Park, Soowon; Cho, Seunghee; Lee, Jun-Young

    2017-01-01

    In the process of developing a professional medical expertise, goals can become a psychological impetus and act as a source of retaining an individual's persistency. Therefore, the goals of medical students should be considered when designing a curriculum for health professions. The purpose of this study was to examine relative effects of goal categories on the value of learning and intention to change one's major. Data were obtained from the Korea Education Longitudinal Study, which included 1938 representative Korean college freshmen majoring in medicine, engineering, natural science and humanities. They answered a survey questionnaire about goal categories (i.e., social concern, affiliation, self-growth, leisure, wealth, and fame), the value of learning, and intention to change one's major. For medical students, social concern goals were positively related to the value of learning and negatively related to the intention to change one's major. Social concern goals decreased the intention to change one's major directly, and also indirectly through increased value of learning. Providing context for enhancing medical students' social concern goals is necessary in a medical training curriculum, not only for the students' professional development but also for improving society. GCT: Goal contents theory GPA: Grade point average KELS: Korea education longitudinal study SDLA: Self-directed learning abilities SDT: Self-determination theory.

  15. A Case for Including Transactions in OpenMP

    Energy Technology Data Exchange (ETDEWEB)

    Wong, M; Bihari, B L; de Supinski, B R; Wu, P; Michael, M; Liu, Y; Chen, W

    2010-01-25

    Transactional Memory (TM) has received significant attention recently as a mechanism to reduce the complexity of shared memory programming. We explore the potential of TM to improve OpenMP applications. We combine a software TM (STM) system to support transactions with an OpenMP implementation to start thread teams and provide task and loop-level parallelization. We apply this system to two application scenarios that reflect realistic TM use cases. Our results with this system demonstrate that even with the relatively high overheads of STM, transactions can outperform OpenMP critical sections by 10%. Overall, our study demonstrates that extending OpenMP to include transactions would ease programming effort while allowing improved performance.

  16. Frequent flyer business travelers: major exposure hazards.

    Science.gov (United States)

    Tompkins, Olga S; Randolph, Susan A; Ostendorf, Judith S

    2005-02-01

    Bagshaw (2004) notes "the modern commercial aircraft cabin is maintained with adequate environmental control for the comfort of most healthy individuals" (p. 417). Occupational health nurses frequently deal with a population that may include unhealthy individuals or those with pre-existing conditions. It is critical for occupational health nurses to stay current with major hazards faced by frequent flyer business travelers to assist in identifying and preventing adverse health effects associated with these exposures.

  17. Associations in the longitudinal course of body dysmorphic disorder with major depression, obsessive-compulsive disorder, and social phobia.

    Science.gov (United States)

    Phillips, Katharine A; Stout, Robert L

    2006-06-01

    Body dysmorphic disorder (BDD) is an impairing and relatively common disorder that has high comorbidity with certain Axis I disorders. However, the longitudinal associations between BDD and comorbid disorders have not previously been examined. Such information may shed light on the nature of BDD's relationship to putative "near-neighbor" disorders, such as major depression, obsessive-compulsive disorder (OCD), and social phobia. This study examined time-varying associations between BDD and these comorbid disorders in 161 participants over 1-3 years of follow-up in the first prospective longitudinal study of the course of BDD. We found that BDD had significant longitudinal associations with major depression--that is, change in the status of BDD and major depression was closely linked in time, with improvement in major depression predicting BDD remission, and, conversely, improvement in BDD predicting depression remission. We also found that improvement in OCD predicted BDD remission, but that BDD improvement did not predict OCD remission. No significant longitudinal associations were found for BDD and social phobia (although the results for analyses of OCD and social phobia were less numerically stable). These findings suggest (but do not prove) that BDD may be etiologically linked to major depression and OCD, i.e., that BDD may be a member of both the putative OCD spectrum and the affective spectrum. However, BDD does not appear to simply be a symptom of these comorbid disorders, as BDD symptoms persisted in a sizable proportion of subjects who remitted from these comorbid disorders. Additional studies are needed to elucidate the nature of BDD's relationship to commonly co-occurring disorders, as this issue has important theoretical and clinical implications.

  18. Synthetic sea water - An improved stress corrosion test medium for aluminum alloys

    Science.gov (United States)

    Humphries, T. S.; Nelson, E. E.

    1973-01-01

    A major problem in evaluating the stress corrosion cracking resistance of aluminum alloys by alternate immersion in 3.5 percent salt (NaCl) water is excessive pitting corrosion. Several methods were examined to eliminate this problem and to find an improved accelerated test medium. These included the addition of chromate inhibitors, surface treatment of specimens, and immersion in synthetic sea water. The results indicate that alternate immersion in synthetic sea water is a very promising stress corrosion test medium. Neither chromate inhibitors nor surface treatment (anodize and alodine) of the aluminum specimens improved the performance of alternate immersion in 3.5 percent salt water sufficiently to be classified as an effective stress corrosion test method.

  19. BetaShape: A new code for improved analytical calculations of beta spectra

    Directory of Open Access Journals (Sweden)

    Mougeot Xavier

    2017-01-01

    Full Text Available The new code BetaShape has been developed in order to improve the nuclear data related to beta decays. An analytical model was considered, except for the relativistic electron wave functions, for ensuring fast calculations. Output quantities are mean energies, log ft values and beta and neutrino spectra for single and multiple transitions. The uncertainties from the input parameters, read from an ENSDF file, are propagated. A database of experimental shape factors is included. A comparison over the entire ENSDF database with the standard code currently used in nuclear data evaluations shows consistent results for the vast majority of the transitions and highlights the improvements that can be expected with the use of BetaShape.

  20. Persistence among Minority STEM Majors: A Phenomenological Study

    Science.gov (United States)

    Williams-Watson, Stacey

    The United States needs to increase the number of science, technology, engineering, and math (STEM) graduates to remain competitive in the global market and maintain national security. Minority students, specifically African-American and Hispanic, are underrepresented in STEM fields. As the minority population continues to grow it is essential that higher education institutions improve minority students' persistence in STEM education. This study examined the problem of minority students' lack of persistence in STEM programs. The purpose of this qualitative transcendental phenomenological study was to describe the lived experiences that minority students perceived as contributing to their persistence in STEM. The central research question was: What are the lived experiences of minority STEM students that have contributed to their persistence in a STEM program? The sub-questions were: a) What led participants to majors in STEM?; b) What contributed to students' success and persistence in STEM?; and c) What advice do students have to offer? The researcher interviewed 12 minority STEM students and uncovered 10 themes that described the lived experiences of minority students' persistence in STEM programs. The themes were 1) Childhood experiences and interests; 2) Positive educational experiences in secondary school; 3) Self- motivation; 4) Positive experiences with professors; 5) Family encouragement and values; 6) Lack of minorities; 7) Lack of educational preparation; 8) The need for financial assistance; 9) Clubs and organizations; and 10) Friends within the major. The significance of these findings is the potential to produce changes in curricula, programs, and retention methods that may improve the persistence of minority students in STEM programs.

  1. Improving the Efficiency of Free Energy Calculations in the Amber Molecular Dynamics Package.

    Science.gov (United States)

    Kaus, Joseph W; Pierce, Levi T; Walker, Ross C; McCammont, J Andrew

    2013-09-10

    Alchemical transformations are widely used methods to calculate free energies. Amber has traditionally included support for alchemical transformations as part of the sander molecular dynamics (MD) engine. Here we describe the implementation of a more efficient approach to alchemical transformations in the Amber MD package. Specifically we have implemented this new approach within the more computational efficient and scalable pmemd MD engine that is included with the Amber MD package. The majority of the gain in efficiency comes from the improved design of the calculation, which includes better parallel scaling and reduction in the calculation of redundant terms. This new implementation is able to reproduce results from equivalent simulations run with the existing functionality, but at 2.5 times greater computational efficiency. This new implementation is also able to run softcore simulations at the λ end states making direct calculation of free energies more accurate, compared to the extrapolation required in the existing implementation. The updated alchemical transformation functionality will be included in the next major release of Amber (scheduled for release in Q1 2014) and will be available at http://ambermd.org, under the Amber license.

  2. Early cryoprecipitate for major haemorrhage in trauma: a randomised controlled feasibility trial.

    Science.gov (United States)

    Curry, N; Rourke, C; Davenport, R; Beer, S; Pankhurst, L; Deary, A; Thomas, H; Llewelyn, C; Green, L; Doughty, H; Nordmann, G; Brohi, K; Stanworth, S

    2015-07-01

    Low fibrinogen (Fg) concentrations in trauma haemorrhage are associated with poorer outcomes. Cryoprecipitate is the standard source for Fg administration in the UK and USA and is often given in the later stages of transfusion therapy. It is not known whether early cryoprecipitate therapy improves clinical outcomes. The primary aim of this feasibility study was to determine whether it was possible to administer cryoprecipitate, within 90 min of admission to hospital. Secondary aims were to evaluate laboratory measures of Fg and clinical outcomes including thrombotic events, organ failure, length of hospital stay and mortality. This was an unblinded RCT, conducted at two civilian UK major trauma centres of adult trauma patients (age ≥16 yrs), with active bleeding and requiring activation of the major haemorrhage protocol. Participants were randomised to standard major haemorrhage therapy (STANDARD) (n=22), or to standard haemorrhage therapy plus two early pools of cryoprecipitate (CRYO) (n=21). 85% (95% CI: 69-100%) CRYO participants received cryoprecipitate within 90 min, median time 60 min (IQR: 57-76) compared with 108 min (67-147), CRYO and STANDARD arms respectively (P=0.002). Fg concentrations were higher in the CRYO arm and were maintained above 1.8 g litre(-1) at all time-points during active haemorrhage. All-cause mortality at 28 days was not significantly different (P=0.14). Early Fg supplementation using cryoprecipitate is feasible in trauma patients. This study supports the need for a definitive RCT to determine the effect of early Fg supplementation on mortality and other clinical outcomes. ISRCTN55509212. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. An improved UHPLC-UV method for separation and quantification of carotenoids in vegetable crops.

    Science.gov (United States)

    Maurer, Megan M; Mein, Jonathan R; Chaudhuri, Swapan K; Constant, Howard L

    2014-12-15

    Carotenoid identification and quantitation is critical for the development of improved nutrition plant varieties. Industrial analysis of carotenoids is typically carried out on multiple crops with potentially thousands of samples per crop, placing critical needs on speed and broad utility of the analytical methods. Current chromatographic methods for carotenoid analysis have had limited industrial application due to their low throughput, requiring up to 60 min for complete separation of all compounds. We have developed an improved UHPLC-UV method that resolves all major carotenoids found in broccoli (Brassica oleracea L. var. italica), carrot (Daucus carota), corn (Zea mays), and tomato (Solanum lycopersicum). The chromatographic method is completed in 13.5 min allowing for the resolution of the 11 carotenoids of interest, including the structural isomers lutein/zeaxanthin and α-/β-carotene. Additional minor carotenoids have also been separated and identified with this method, demonstrating the utility of this method across major commercial food crops. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. The clinical nurse specialist: leadership in quality improvement.

    Science.gov (United States)

    Finkelman, Anita

    2013-01-01

    Healthcare delivery is in a crisis, requiring improvement. How to improve and who should assume more leadership are not clear. At the same time, the nursing profession struggles with a weak education system, graduating students who require major support for an extended time. There is also confusion related to nursing roles, particularly with nurses who have a graduate degree. The Institute of Medicine has published a series of reports about the healthcare system and need for improvement and describes a structure for improvement. The clinical nurse specialist is particularly suited to assume a major role in nursing leadership to guide staff and the healthcare system to better ensure improved care. There is great need to communicate that the clinical nurse specialist can and should assume this role. This will require a review and development of more quality improvement content and experiences in clinical nurse specialist educational programs, but much of the content is already in programs. The clinical nurse specialist works in systems, impacts systems, works with staff, and can thus reach more patients with improvement approaches.

  5. Discovery of the Collaborative Nature of Science with Undergraduate Science Majors and Non-Science Majors through the Identification of Microorganisms Enriched in Winogradsky Columns

    Directory of Open Access Journals (Sweden)

    Jasmine Ramirez

    2015-08-01

    Full Text Available Today’s science classrooms are addressing the need for non-scientists to become scientifically literate. A key aspect includes the recognition of science as a process for discovery. This process relies upon interdisciplinary collaboration. We designed a semester-long collaborative exercise that allows science majors taking a general microbiology course and non-science majors taking an introductory environmental science course to experience collaboration in science by combining their differing skill sets to identify microorganisms enriched in Winogradsky columns. These columns are self-sufficient ecosystems that allow researchers to study bacterial populations under specified environmental conditions. Non-science majors identified phototrophic bacteria enriched in the column by analyzing the signature chlorophyll absorption spectra whereas science majors used 16S rRNA gene sequencing to identify the general bacterial diversity. Students then compiled their results and worked together to generate lab reports with their final conclusions identifying the microorganisms present in their column. Surveys and lab reports were utilized to evaluate the learning objectives of this activity. In pre-surveys, nonmajors’ and majors’ answers diverged considerably, with majors providing responses that were more accurate and more in line with the working definition of collaboration. In post-surveys, the answers between majors and nonmajors converged, with both groups providing accurate responses. Lab reports showed that students were able to successfully identify bacteria present in the columns. These results demonstrate that laboratory exercises designed to group students across disciplinary lines can be an important tool in promoting science education across disciplines. Editor's Note:The ASM advocates that students must successfully demonstrate the ability to explain and practice safe laboratory techniques. For more information, read the laboratory

  6. Trickle-down evolution: an approach to getting major evolutionary adaptive changes into textbooks and curricula.

    Science.gov (United States)

    Padian, Kevin

    2008-08-01

    Although contemporary high school and college textbooks of biology generally cover the principles and data of microevolution (genetic and populational change) and speciation rather well, coverage of what is known of the major changes in evolution (macroevolution), and how the evidence is understood is generally poor to nonexistent. It is critical to improve this because acceptance of evolution by the American public rests on the understanding of how we know what we know about the emergence of major new taxonomic groups, and about their adaptations, behaviors, and ecologies in geologic time. An efficient approach to this problem is to improve the illustrations in college textbooks to show the consilience of different lines of fossil, morphological, and molecular evidence mapped on phylogenies. Such "evograms" will markedly improve traditional illustrations of phylogenies, "menageries," and "companatomies." If "evograms" are installed at the college level, the basic principles and evidence of macroevolution will be more likely taught in K-12, thus providing an essential missing piece in biological education.

  7. The gain from improved market efficiency

    DEFF Research Database (Denmark)

    Ejrnæs, Mette; Persson, Karl Gunnar

    2010-01-01

    demand as well as excess supply, which triggered off the tâtonnement process. Over time, adjustments to equilibrium, as measured by the half-life of a shock, became faster and violations of the law of one price become smaller. There were significant gains from improved market efficiency, which took place......This article looks at the gains from improved market efficiency in long-distance grain trade in the second half of the nineteenth century, when violations of the law of one price were reduced due to improved information transmission. Two markets, a major export centre, Chicago, and a major importer......, Liverpool, are analysed. We show that the law of one price equilibrium was an ‘attractor equilibrium'. The implication is that prices converged to that equilibrium in a tâtonnement process. Because of asymmetrically timed information between markets separated by long distances there were periods of excess...

  8. Effects of Icariside II on Corpus Cavernosum and Major Pelvic Ganglion Neuropathy in Streptozotocin-Induced Diabetic Rats

    Directory of Open Access Journals (Sweden)

    Guang-Yi Bai

    2014-12-01

    Full Text Available Diabetic erectile dysfunction is associated with penile dorsal nerve bundle neuropathy in the corpus cavernosum and the mechanism is not well understood. We investigated the neuropathy changes in the corpus cavernosum of rats with streptozotocin-induced diabetes and the effects of Icariside II (ICA II on improving neuropathy. Thirty-six 8-week-old Sprague-Dawley rats were randomly distributed into normal control group, diabetic group and ICA-II treated group. Diabetes was induced by a one-time intraperitoneal injection of streptozotocin (60 mg/kg. Three days later, the diabetic rats were randomly divided into 2 groups including a saline treated placebo group and an ICA II-treated group (5 mg/kg/day, by intragastric administration daily. Twelve weeks later, erectile function was measured by cavernous nerve electrostimulation with real time intracorporal pressure assessment. The penis was harvested for the histological examination (immunofluorescence and immunohistochemical staining and transmission electron microscopy detecting. Diabetic animals exhibited a decreased density of dorsal nerve bundle in penis. The neurofilament of the dorsal nerve bundle was fragmented in the diabetic rats. There was a decreased expression of nNOS and NGF in the diabetic group. The ICA II group had higher density of dorsal nerve bundle, higher expression of NGF and nNOS in the penis. The pathological change of major pelvic nerve ganglion (including the microstructure by transmission electron microscope and the neurite outgrowth length of major pelvic nerve ganglion tissue cultured in vitro was greatly attenuated in the ICA II-treated group (p < 0.01. ICA II treatment attenuates the diabetes-related impairment of corpus cavernosum and major pelvic ganglion neuropathy in rats with Streptozotocin-Induced Diabetes.

  9. Major gene mutations in fruit tree domestication

    International Nuclear Information System (INIS)

    Spiegel-Roy, P.

    1989-01-01

    Though fruit gathering from the wild began long before domestication, fruit tree domestication started only after the establishment of grain agriculture. Banana, fig, date, grape and olive were among the first fruit trees domesticated. Most fruit trees are outbreeders, highly heterozygous and vegetatively propagated. Knowledge of genetics and economic traits controlled by major genes is limited. Ease of vegetative propagation has played a prominent part in domestication; advances in propagation technology will play a role in domestication of new crops. Changes toward domestication affected by major genes include self-fertility in peach, apricot and sour cherry, while the emergence of self-fertile almond populations is more recent and due probably to introgression from Amygdalus webbii. Self-compatibility in the sweet cherry has been attained only by pollen irradiation. A single gene controls sex in Vitis. Wild grapes are dioecious, with most domesticated cultivars hermaphrodite, and only a few females. In the papaya changes from dioecism to hermaphroditism have also occurred. Self-compatible systems have also been selected during domestication in Rubus. Changes towards parthenocarpy and seedlessness during domestication occurred in the banana, citrus, grape, fig and pineapple. In the banana, parthenocarpy is due to three complementary dominant genes; stenospermocarpy in the grape depends on two complementary recessive genes; parthenocarpy and sterility in citrus seems more complicated; however, it can be induced in genetic material of suitable background with ease by irradiation. Presence of persistent syconia in the fig is controlled by a mutant allele P dominant to wild +. Thornlessness in blackberry is recessive, while in the pineapple spineless forms are dominant. Changes affecting fruit composition owing to major genes include the disappearance of amygdalin present in bitter almonds (bitter kernel recessive to sweet), shell hardness in almond, and a recessive

  10. Psychosocial implications of Thalassemia Major.

    Science.gov (United States)

    Aydinok, Yesim; Erermis, Serpil; Bukusoglu, Nagihan; Yilmaz, Deniz; Solak, Ufuk

    2005-02-01

    Many causes including the chronicity of disease, burden of treatment modalities, morbidities, and the expectation of early death resulting from the disease complications, may lead to psychosocial burden in Thalassemia Major (TM) patients. A total of 38 patients with TM and their mothers were recruited to evaluate the psychosocial burden as well as to disclose whether the psychological status of the patients contribute to the compliance with the therapy or to the contrary. Demographic and disease variables were obtained. Child Behavior Check-list (CBCL) was completed by the mothers of the patients. A detailed psychiatric interview based on the 4th edition of the Diagnostic and Statistical Manual diagnostic criteria was performed for each patient. Symptom Distress Checklist 90 (SCL-90) scale was given to all mothers for evaluating their psychopathology. Although CBCL scores remained between the normal ranges, desferrioxamine mesylate (DFO)-compliant patients and the patients with lower ferritin values had significantly higher scores. A total of 24% of the patients had a psychiatric diagnosis including major depression, anxiety disorder, tic disorder, and enuresis nocturnal. The psychiatric diagnosis was significantly higher in the patients who were compliant with desferrioxamine compared with the non-compliant group (P = 0.007). The SCL-90 scores indicated that the mothers who had a child with good adherence to DFO had higher scale scores than the mothers with a poor adherent child. The increase risk of psychosocial and behavioral problems in thalassemics and their parents indicated the importance of a lifelong psychosocial support for the prevention of mental health issues. The patients and their parents, who were more conscious of the illness, were more worried but more compliant with the therapy and need stronger psychiatric support.

  11. Improving Quality of Seal Leak Test Product using Six Sigma

    Science.gov (United States)

    Luthfi Malik, Abdullah; Akbar, Muhammad; Irianto, Dradjad

    2016-02-01

    Seal leak test part is a polyurethane material-based product. Based on past data, defect level of this product was 8%, higher than the target of 5%. Quality improvement effort was done using six sigma method that included phases of define, measure, analyse, improve, and control. In the design phase, a Delphi method was used to identify factors that were critical to quality. In the measure phase, stability and process capability was measured. Fault tree analysis (FTA) and failure mode and effect analysis (FMEA) were used in the next phase to analize the root cause and to determine the priority issues. Improve phase was done by compiling, selecting, and designing alternative repair. Some improvement efforts were identified, i.e. (i) making a checklist for maintenance schedules, (ii) making written reminder form, (iii) modifying the SOP more detail, and (iv) performing a major service to the vacuum machine. To ensure the continuity of improvement efforts, some control activities were executed, i.e. (i) controlling, monitoring, documenting, and setting target frequently, (ii) implementing reward and punishment system, (iii) adding cleaning tool, and (iv) building six sigma organizational structure.

  12. Improving Quality of Seal Leak Test Product using Six Sigma

    International Nuclear Information System (INIS)

    Malik, Abdullah Luthfi; Akbar, Muhammad; Irianto, Dradjad

    2016-01-01

    Seal leak test part is a polyurethane material-based product. Based on past data, defect level of this product was 8%, higher than the target of 5%. Quality improvement effort was done using six sigma method that included phases of define, measure, analyse, improve, and control. In the design phase, a Delphi method was used to identify factors that were critical to quality. In the measure phase, stability and process capability was measured. Fault tree analysis (FTA) and failure mode and effect analysis (FMEA) were used in the next phase to analize the root cause and to determine the priority issues. Improve phase was done by compiling, selecting, and designing alternative repair. Some improvement efforts were identified, i.e. (i) making a checklist for maintenance schedules, (ii) making written reminder form, (iii) modifying the SOP more detail, and (iv) performing a major service to the vacuum machine. To ensure the continuity of improvement efforts, some control activities were executed, i.e. (i) controlling, monitoring, documenting, and setting target frequently, (ii) implementing reward and punishment system, (iii) adding cleaning tool, and (iv) building six sigma organizational structure. (paper)

  13. An analysis on the satisfaction of radiology students with their major

    International Nuclear Information System (INIS)

    Kim, Jung Hoon; Kang, Se Sik; Kim, Chang Soo

    2016-01-01

    This study was conducted with a goal to identify the factors that determine radiology students' satisfaction with their major and to provide the basic data for efficient education and career guidance. The result indicated that the students' satisfaction with the professors' roles was high. However, overall, the level of satisfaction with the curriculum was found to be low. In addition, it was analyzed that there was a large gap between recognition and practice of self-directed learning. In the correlation analysis, the professors' roles were also found to be a very important factor. Based on the result, the professors' roles of center(teaching or state examination, students with questions etc.,), it was concluded that improvement of the radiology students' satisfaction with their major would help the students adapt themselves to the major and school successfully and develop a positive character to perform as professionals in the future

  14. An analysis on the satisfaction of radiology students with their major

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Hoon; Kang, Se Sik; Kim, Chang Soo [Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan, Busan (Korea, Republic of)

    2016-06-15

    This study was conducted with a goal to identify the factors that determine radiology students' satisfaction with their major and to provide the basic data for efficient education and career guidance. The result indicated that the students' satisfaction with the professors' roles was high. However, overall, the level of satisfaction with the curriculum was found to be low. In addition, it was analyzed that there was a large gap between recognition and practice of self-directed learning. In the correlation analysis, the professors' roles were also found to be a very important factor. Based on the result, the professors' roles of center(teaching or state examination, students with questions etc.,), it was concluded that improvement of the radiology students' satisfaction with their major would help the students adapt themselves to the major and school successfully and develop a positive character to perform as professionals in the future.

  15. Suicidal risk factors of recurrent major depression in Han Chinese women.

    Directory of Open Access Journals (Sweden)

    Yuzhang Zhu

    Full Text Available The relationship between suicidality and major depression is complex. Socio- demography, clinical features, comorbidity, clinical symptoms, and stressful life events are important factors influencing suicide in major depression, but these are not well defined. Thus, the aim of the present study was to assess the associations between the above-mentioned factors and suicide ideation, suicide plan, and suicide attempt in 6008 Han Chinese women with recurrent major depression (MD. Patients with any suicidality had significantly more MD symptoms, a significantly greater number of stressful life events, a positive family history of MD, a greater number of episodes, a significant experience of melancholia, and earlier age of onset. Comorbidity with dysthymia, generalized anxiety disorder (GAD, social phobia, and animal phobia was seen in suicidal patients. The present findings indicate that specific factors act to increase the likelihood of suicide in MD. Our results may help improve the clinical assessment of suicide risk in depressed patients, especially for women.

  16. Hydroxyurea appears beneficial in patients with beta-thalassaemia major and intermedia

    Directory of Open Access Journals (Sweden)

    S. F.S.A. Abdul Wahid

    2007-06-01

    Full Text Available Patients with severe inherited β-globin chain disorders may have milder illness if they produce high levels of fetal hemoglobin (HbF. Hydroxyurea (HU has been shown to enhance HbF levels in patients with sickle cell disease and may be useful in β-thalassemias. We administered HU to 13 patients with β-thalassemia intermedia or major, including 6 splenectomized patients. The patients received escalating doses (10 to 25 mg/kg/d of HU for around 2 years (median: 21 months, range: 8 - 55 months. Eleven patients responded with an increase in the pre-transfusion HbF levels, from a base line median of 8.0% (2.5 - 61.3% to 28.0% (6.6 - 49.2% and 40.7% (4.8 - 72.3% at 3 months and 18 months post-HU, respectively. A concomitant increment in median hemoglobin levels was noted at 1, 3 and 18 months of HU therapy. Six of 7 transfusion-dependent patients who had an increment of HbF (one with β-thalassemia major also had reduced transfusion requirement over the 2-year period of HU therapy. Response to HU was also shown by a reduction in spleen size. Apart from oral ulcers that resolved upon dose reduction of HU, no significant toxicity was noted. We conclude that increased HbF production in β-thalassemia patients, with an improvement in erythropoiesis, can be achieved using HU with minimal toxicity. (Med J Indones 2007; 16:78-83 Keywords: fetal hemoglobin (HbF, erythropoiesis, toxicity

  17. Pharmacogenetics-based warfarin dosing algorithm decreases time to stable anticoagulation and the risk of major hemorrhage: an updated meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Wang, Zhi-Quan; Zhang, Rui; Zhang, Peng-Pai; Liu, Xiao-Hong; Sun, Jian; Wang, Jun; Feng, Xiang-Fei; Lu, Qiu-Fen; Li, Yi-Gang

    2015-04-01

    Warfarin is yet the most widely used oral anticoagulant for thromboembolic diseases, despite the recently emerged novel anticoagulants. However, difficulty in maintaining stable dose within the therapeutic range and subsequent serious adverse effects markedly limited its use in clinical practice. Pharmacogenetics-based warfarin dosing algorithm is a recently emerged strategy to predict the initial and maintaining dose of warfarin. However, whether this algorithm is superior over conventional clinically guided dosing algorithm remains controversial. We made a comparison of pharmacogenetics-based versus clinically guided dosing algorithm by an updated meta-analysis. We searched OVID MEDLINE, EMBASE, and the Cochrane Library for relevant citations. The primary outcome was the percentage of time in therapeutic range. The secondary outcomes were time to stable therapeutic dose and the risks of adverse events including all-cause mortality, thromboembolic events, total bleedings, and major bleedings. Eleven randomized controlled trials with 2639 participants were included. Our pooled estimates indicated that pharmacogenetics-based dosing algorithm did not improve percentage of time in therapeutic range [weighted mean difference, 4.26; 95% confidence interval (CI), -0.50 to 9.01; P = 0.08], but it significantly shortened the time to stable therapeutic dose (weighted mean difference, -8.67; 95% CI, -11.86 to -5.49; P pharmacogenetics-based algorithm significantly reduced the risk of major bleedings (odds ratio, 0.48; 95% CI, 0.23 to 0.98; P = 0.04), but it did not reduce the risks of all-cause mortality, total bleedings, or thromboembolic events. Our results suggest that pharmacogenetics-based warfarin dosing algorithm significantly improves the efficiency of International Normalized Ratio correction and reduces the risk of major hemorrhage.

  18. Longitudinal social-interpersonal functioning among higher-risk responders to acute-phase cognitive therapy for recurrent major depressive disorder.

    Science.gov (United States)

    Vittengl, Jeffrey R; Clark, Lee Anna; Thase, Michael E; Jarrett, Robin B

    2016-07-15

    Social-interpersonal dysfunction increases disability in major depressive disorder (MDD). Here we clarified the durability of improvements in social-interpersonal functioning made during acute-phase cognitive therapy (CT), whether continuation CT (C-CT) or fluoxetine (FLX) further improved functioning, and relations of functioning with depressive symptoms and relapse/recurrence. Adult outpatients (N=241) with recurrent MDD who responded to acute-phase CT with higher risk of relapse (due to unstable or partial remission) were randomized to 8 months of C-CT, FLX, or pill placebo plus clinical management (PBO) and followed 24 additional months. We analyzed repeated measures of patients' social adjustment, interpersonal problems, dyadic adjustment, depressive symptoms, and major depressive relapse/recurrence. Large improvements in social-interpersonal functioning occurring during acute-phase CT (median d=1.4) were maintained, with many patients (median=66%) scoring in normal ranges for 32 months. Social-interpersonal functioning did not differ significantly among C-CT, FLX, and PBO arms. Beyond concurrently measured residual symptoms, deterioration in social-interpersonal functioning preceded and predicted upticks in depressive symptoms and major depressive relapse/recurrence. Results may not generalize to other patient populations, treatment protocols, or measures of social-interpersonal functioning. Mechanisms of risk connecting poorer social-interpersonal functioning with depression were not studied. Average improvements in social-interpersonal functioning among higher-risk responders to acute phase CT are durable for 32 months. After acute-phase CT, C-CT or FLX may not further improve social-interpersonal functioning. Among acute-phase CT responders, deteriorating social-interpersonal functioning provides a clear, measurable signal of risk for impending major depressive relapse/recurrence and opportunity for preemptive intervention. Copyright © 2016 Elsevier B

  19. Improvement in fatigue during Natalizumab treatment is linked to improvement in depression and day-time sleepiness

    Directory of Open Access Journals (Sweden)

    Iris-Katharina ePenner

    2015-02-01

    Full Text Available Background: Fatigue is a frequent symptom in multiple sclerosis (MS and often interrelated with depression and sleep disorders making symptomatic treatment decisions difficult. In the single-arm, observational phase IV TYNERGY study, relapsing-remitting MS patients showed a clinically meaningful decrease in fatigue over one year of treatment with natalizumab. Objective: To evaluate whether fatigue improvement might be directly linked to improved depression and daytime sleepiness. Methods: Patients were assessed regarding fatigue, depression, and daytime sleepiness. The relation between changes of the two latter symptoms and changes in fatigue was analysed. Results: After one year of natalizumab treatment, the majority of patients (>92% remained stable or improved in total, motor and cognitive fatigue. Proportion of patients without depression increased by 17% while proportions of mildly depressed patients or patients with potential major depression decreased by 5% and 12%, respectively. Proportion of patients classified as not being sleepy increased by 13% while proportions of sleepy and very sleepy patients decreased by 11% and 2%, respectively. Most importantly, improved depression and sleepiness were significantly related to improved fatigue. Conclusion: Our findings highlight the importance of patient-reported outcomes in identifying potential benefits of drug treatment beyond its well-established effects on disease activity and disability progression.

  20. Progression of major depression during pregnancy and postpartum: a preliminary study.

    Science.gov (United States)

    Shivakumar, Geetha; Johnson, Neysa L; McIntire, Donald D; Leveno, Kenneth

    2014-04-01

    The purpose of this pilot study was to investigate major depressive symptoms among a high-risk group of pregnant women managed at a tertiary care setting. The study prospectively evaluated pregnant women who met DSM-IV criteria for a major depressive episode (MDE). Psychiatric measures for depression, anxiety and social impairment were administered at monthly intervals during pregnancy and immediate postpartum period. Twenty-four women provided longitudinal data from mid pregnancy to 2 months of postpartum period. 86% of women were clinically symptomatic at the beginning of study during pregnancy and only 32% remained clinically symptomatic at 2 months following delivery reaching. This difference reached a statistical significance level p depression, comorbid anxiety disorder, histories of domestic violence, and those with uninvolved spouse or partners were more at-risk to be clinically symptomatic in the immediate postpartum period. In a group consisting of largely Latina women at a tertiary care setting, progression of major depression when treated with antidepressant medication(s) is that of an improvement from pregnancy to immediate postpartum period. Further longitudinal studies are needed to assess impact of clinical characteristics and treatment on major depression in larger diverse obstetric group.

  1. Sex similarities and differences in risk factors for recurrence of major depression.

    Science.gov (United States)

    van Loo, Hanna M; Aggen, Steven H; Gardner, Charles O; Kendler, Kenneth S

    2017-11-27

    Major depression (MD) occurs about twice as often in women as in men, but it is unclear whether sex differences subsist after disease onset. This study aims to elucidate potential sex differences in rates and risk factors for MD recurrence, in order to improve prediction of course of illness and understanding of its underlying mechanisms. We used prospective data from a general population sample (n = 653) that experienced a recent episode of MD. A diverse set of potential risk factors for recurrence of MD was analyzed using Cox models subject to elastic net regularization for males and females separately. Accuracy of the prediction models was tested in same-sex and opposite-sex test data. Additionally, interactions between sex and each of the risk factors were investigated to identify potential sex differences. Recurrence rates and the impact of most risk factors were similar for men and women. For both sexes, prediction models were highly multifactorial including risk factors such as comorbid anxiety, early traumas, and family history. Some subtle sex differences were detected: for men, prediction models included more risk factors concerning characteristics of the depressive episode and family history of MD and generalized anxiety, whereas for women, models included more risk factors concerning early and recent adverse life events and socioeconomic problems. No prominent sex differences in risk factors for recurrence of MD were found, potentially indicating similar disease maintaining mechanisms for both sexes. Course of MD is a multifactorial phenomenon for both males and females.

  2. Using community-based interventions to improve disease ...

    African Journals Online (AJOL)

    management, improved health systems support, and improved family and community practices, also known as Community-. IMCI (C-IMCI). Since families have the major responsibility of caring for their children, success in reducing childhood mortality and in promoting optimal growth and development of children requires a ...

  3. Japan's refiner/marketers headed for major shakeout

    International Nuclear Information System (INIS)

    Anon.

    1996-01-01

    Japan's downstream oil industry is in a state of crisis and headed for a major shakeout. The major catalyst for this was a dramatic deregulation step during April 1996 that allowed refined petroleum product imports by non-refiners. The move, together with a sharp drop in refining margins, falling retail gasoline prices, and a service station sector on the brink of collapse, are all leading to massive changes in the way the country's refiners and marketers do business. This paper reviews the collapse of corporate profits during this period of deregulation; the development of a new price system geared toward bringing the prices of gasoline, fuel oil, and kerosene into line with each other to offset the fall in gasoline prices; and industry restructuring including mergers, acquisitions, and marketing consolidation. The paper then makes predictions on the outcome of these changes on the Japanese oil industry

  4. Discovery of the Collaborative Nature of Science with Undergraduate Science Majors and Non-Science Majors through the Identification of Microorganisms Enriched in Winogradsky Columns.

    Science.gov (United States)

    Ramirez, Jasmine; Pinedo, Catalina Arango; Forster, Brian M

    2015-12-01

    Today's science classrooms are addressing the need for non-scientists to become scientifically literate. A key aspect includes the recognition of science as a process for discovery. This process relies upon interdisciplinary collaboration. We designed a semester-long collaborative exercise that allows science majors taking a general microbiology course and non-science majors taking an introductory environmental science course to experience collaboration in science by combining their differing skill sets to identify microorganisms enriched in Winogradsky columns. These columns are self-sufficient ecosystems that allow researchers to study bacterial populations under specified environmental conditions. Non-science majors identified phototrophic bacteria enriched in the column by analyzing the signature chlorophyll absorption spectra whereas science majors used 16S rRNA gene sequencing to identify the general bacterial diversity. Students then compiled their results and worked together to generate lab reports with their final conclusions identifying the microorganisms present in their column. Surveys and lab reports were utilized to evaluate the learning objectives of this activity. In pre-surveys, nonmajors' and majors' answers diverged considerably, with majors providing responses that were more accurate and more in line with the working definition of collaboration. In post-surveys, the answers between majors and nonmajors converged, with both groups providing accurate responses. Lab reports showed that students were able to successfully identify bacteria present in the columns. These results demonstrate that laboratory exercises designed to group students across disciplinary lines can be an important tool in promoting science education across disciplines.

  5. Improvement in cognitive function after surgery for low-grade glioma.

    Science.gov (United States)

    Barzilai, Ori; Ben Moshe, Shlomit; Sitt, Razi; Sela, Gal; Shofty, Ben; Ram, Zvi

    2018-03-23

    OBJECTIVE Cognition is a key component in health-related quality of life (HRQoL) and is currently incorporated as a major parameter of outcome assessment in patients treated for brain tumors. The effect of surgery on cognition and HRQoL remains debatable. The authors investigated the impact of resection of low-grade gliomas (LGGs) on cognition and the correlation with various histopathological markers. METHODS A retrospective analysis of patients with LGG who underwent craniotomy for tumor resection at a single institution between 2010 and 2014 was conducted. Of 192 who underwent resective surgery for LGG during this period, 49 had complete pre- and postoperative neurocognitive evaluations and were included in the analysis. These patients completed a full battery of neurocognitive tests (memory, language, attention and working memory, visuomotor organization, and executive functions) pre- and postoperatively. Tumor and surgical characteristics were analyzed, including volumetric measurements and histopathological markers (IDH, p53, GFAP). RESULTS Postoperatively, significant improvement was found in memory and executive functions. A subgroup analysis of patients with dominant-side tumors, most of whom underwent intraoperative awake mapping, revealed significant improvement in the same domains. Patients whose tumors were on the nondominant side displayed significant improvement only in memory functions. Positive staining for p53 testing was associated with improved language function and greater extent of resection in dominant-side tumors. GFAP positivity was associated with improved memory in patients whose tumors were on the nondominant side. No correlation was found between cognitive outcome and preoperative tumor volume, residual volume, extent of resection, or IDH1 status. CONCLUSIONS Resection of LGG significantly improves memory and executive function and thus is likely to improve functional outcome in addition to providing oncological benefit. GFAP and pP53

  6. Inequalities for majorizing analytic functions and their applications to rational trigonometric functions and polynomials

    International Nuclear Information System (INIS)

    Olesov, A V

    2014-01-01

    New inequalities are established for analytic functions satisfying Meiman's majorization conditions. Estimates for values of and differential inequalities involving rational trigonometric functions with an integer majorant on an interval of length less than the period and with prescribed poles which are symmetrically positioned relative to the real axis, as well as differential inequalities for trigonometric polynomials in some classes, are given as applications. These results improve several theorems due to Meiman, Genchev, Smirnov and Rusak. Bibliography: 27 titles

  7. Perceptions of an educational programme for registered nurses who work at non-major trauma services in Victoria, Australia: The Nursing Emergency eXternal Trauma Programme.

    Science.gov (United States)

    Ireland, Sharyn; Cross, Rachel; Decker, Kelly; Mitra, Biswadev

    2017-08-01

    Emergency nurses working in non-Major Trauma Service (non-MTS) facilities face the challenge of providing immediate care to seriously injured patients, despite infrequent presentations at their workplace. A one-day education programme endorsed by the Australian College of Nursing was developed to provide contemporary trauma education for nurses. The aim of this study was to report participants' perceptions of their experience of this programme. Peer reviewed lesson plans were developed to guide educational activities. Of 32 participants, 24 consented to and completed pre and post-programme surveys. Thematic analysis and descriptive statistics were used to report study findings. Most participants were nurses with greater than two years' experience in Emergency Nursing (92%). Trauma patient transfers each year from a non-MTS to a Major Trauma Service occurred infrequently; eight nurses (33.3%) reported greater than10 trauma transfers per year. Participant expectations of the programme included personal growth, knowledge acquisition, increased confidence and a focus on technical skills. Participants reported the day to be worthwhile and valuable; improved confidence, increased knowledge, and the opportunity to discuss current evidence based practice were highly regarded. Recommendations for future programmes included extending to two days and include burns and more complex pathophysiology. With centralisation of trauma care to major trauma services, frequent and continuing education of nurses is essential. Nurses from non-Major Trauma Service facilities in Victoria found this programme worthwhile as they gained knowledge and skills and increased confidence to care for trauma patients. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  8. Evidence from Scientific Literature about Improved Academic Performance

    Science.gov (United States)

    Studies that measure school conditions using an index of several variables consistently show improved scores on standardized tests as school conditions improve. On the other hand, schools with major unmet repair needs and fewer custodial workers per square

  9. What You Can Do to Improve Academic Performance

    Science.gov (United States)

    Studies that measure school conditions using an index of several variables consistently show improved scores on standardized tests as school conditions improve. On the other hand, schools with major unmet repair needs and fewer custodial workers per square

  10. Diet-induced obesity, gut microbiota and bone, including alveolar bone loss.

    Science.gov (United States)

    Eaimworawuthikul, Sathima; Thiennimitr, Parameth; Chattipakorn, Nipon; Chattipakorn, Siriporn C

    2017-06-01

    Obesity is a major risk factor for several pathologies, including jaw bone resorption. The underlying mechanisms involved in pathological conditions resulting from obesity include chronic systemic inflammation and the development of insulin resistance. Although numerous studies have indicated the importance of the role of gut microbiota in the pathogenesis of inflammation and insulin resistance in obesity, only a few studies have established a relationship between obesity, gut microbiota and status of the jaw bone. This review aims to summarize current findings relating to these issues, focusing on the role of obesity and gut microbiota on jaw bone health, including possible mechanisms which can explain this link. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Improving Accuracy of Processing Through Active Control

    Directory of Open Access Journals (Sweden)

    N. N. Barbashov

    2016-01-01

    Full Text Available An important task of modern mathematical statistics with its methods based on the theory of probability is a scientific estimate of measurement results. There are certain costs under control, and under ineffective control when a customer has got defective products these costs are significantly higher because of parts recall.When machining the parts, under the influence of errors a range scatter of part dimensions is offset towards the tolerance limit. To improve a processing accuracy and avoid defective products involves reducing components of error in machining, i.e. to improve the accuracy of machine and tool, tool life, rigidity of the system, accuracy of the adjustment. In a given time it is also necessary to adapt machine.To improve an accuracy and a machining rate there, currently  become extensively popular various the in-process gaging devices and controlled machining that uses adaptive control systems for the process monitoring. Improving the accuracy in this case is compensation of a majority of technological errors. The in-cycle measuring sensors (sensors of active control allow processing accuracy improvement by one or two quality and provide a capability for simultaneous operation of several machines.Efficient use of in-cycle measuring sensors requires development of methods to control the accuracy through providing the appropriate adjustments. Methods based on the moving average, appear to be the most promising for accuracy control since they include data on the change in some last measured values of the parameter under control.

  12. Family psychoeducation for major depressive disorder - study protocol for a randomized controlled trial

    DEFF Research Database (Denmark)

    Timmerby, Nina; Austin, Stephen F; Ussing, Kristian

    2016-01-01

    BACKGROUND: Major depressive disorder has been shown to affect many domains of family life including family functioning. Conversely, the influence of the family on the course of the depression, including the risk of relapse, is one reason for targeting the family in interventions. The few studies...... will investigate the effect of family psychoeducation compared to social support on the course of the illness in patients with major depressive disorder. METHOD/DESIGN: The study is designed as a dual center, two-armed, observer-blinded, randomized controlled trial. Relatives are randomized to participate in one...

  13. Treatment of Comorbid Obesity and Major Depressive Disorder: A Prospective Pilot Study for their Combined Treatment

    Directory of Open Access Journals (Sweden)

    Lucy F. Faulconbridge

    2011-01-01

    Full Text Available Background. Obese individuals who suffer from major depressive disorder are routinely screened out of weight loss trials. Treatments targeting obesity and depression concurrently have not been tested. Purpose. To test the short-term efficacy of a treatment that combined behavioral weight management and cognitive behavioral therapy (CBT for obese adults with depression. Methods. Twelve obese females diagnosed with major depressive disorder received weekly group behavioral weight management, combined with CBT for depression, for 16 weeks. Weight, symptoms of depression, and cardiovascular disease (CVD risk factors were measured at baseline and week 16. Results. Participants lost 11.4% of initial weight and achieved significant improvements in symptoms of depression and CVD risk factors. Conclusions. Obese individuals suffering from major depressive disorder can lose weight and achieve improvements in symptoms of depression and CVD risk factors with 16 weeks of combined treatment. A larger randomized controlled trial is needed to establish the efficacy of this treatment.

  14. Improved molecular tools for sugar cane biotechnology.

    Science.gov (United States)

    Kinkema, Mark; Geijskes, Jason; Delucca, Paulo; Palupe, Anthony; Shand, Kylie; Coleman, Heather D; Brinin, Anthony; Williams, Brett; Sainz, Manuel; Dale, James L

    2014-03-01

    Sugar cane is a major source of food and fuel worldwide. Biotechnology has the potential to improve economically-important traits in sugar cane as well as diversify sugar cane beyond traditional applications such as sucrose production. High levels of transgene expression are key to the success of improving crops through biotechnology. Here we describe new molecular tools that both expand and improve gene expression capabilities in sugar cane. We have identified promoters that can be used to drive high levels of gene expression in the leaf and stem of transgenic sugar cane. One of these promoters, derived from the Cestrum yellow leaf curling virus, drives levels of constitutive transgene expression that are significantly higher than those achieved by the historical benchmark maize polyubiquitin-1 (Zm-Ubi1) promoter. A second promoter, the maize phosphonenolpyruvate carboxylate promoter, was found to be a strong, leaf-preferred promoter that enables levels of expression comparable to Zm-Ubi1 in this organ. Transgene expression was increased approximately 50-fold by gene modification, which included optimising the codon usage of the coding sequence to better suit sugar cane. We also describe a novel dual transcriptional enhancer that increased gene expression from different promoters, boosting expression from Zm-Ubi1 over eightfold. These molecular tools will be extremely valuable for the improvement of sugar cane through biotechnology.

  15. An Effective Model for Improving Global Health Nursing Competence.

    Science.gov (United States)

    Kang, Sun-Joo

    2016-01-01

    This paper proposed an effective model for improving global health nursing competence among undergraduate students. A descriptive case study was conducted by evaluation of four implemented programs by the author. All programs were conducted with students majoring in nursing and healthcare, where the researcher was a program director, professor, or facilitator. These programs were analyzed in terms of students' needs assessment, program design, and implementation and evaluation factors. The concept and composition of global nursing competence, identified within previous studies, were deemed appropriate in all of our programs. Program composition varied from curricular to extracurricular domains. During the implementation phase, some of the programs included non-Korean students to improve cultural diversity and overcome language barriers. Qualitative and quantitative surveys were conducted to assess program efficacy. Data triangulation from students' reflective journals was examined. Additionally, students' awareness regarding changes within global health nursing, improved critical thinking, cultural understanding, and global leadership skills were investigated pre- and post-program implementation. The importance of identifying students' needs regarding global nursing competence when developing appropriate curricula is discussed.

  16. An Effective Model for Improving Global Health Nursing Competence

    Directory of Open Access Journals (Sweden)

    Sunjoo Kang

    2016-09-01

    Full Text Available This paper developed an effective model for improving global health nursing competence among undergraduate students. A descriptive case study was conducted by implementing four programs. All programs were conducted with students majoring nursing and healthcare, where the researcher was a program director, professor, or facilitator. These programs were analyzed in terms of students’ needs assessment, program design, and implementation and evaluation factors. The concept and composition of global nursing competence, identified within previous studies, were deemed appropriate in all of our programs. Program composition varied from curricular to extracurricular domains. During the implementation phase, most of the programs included non-Korean students to improve cultural diversity and overcome language barriers. Qualitative and quantitative surveys were conducted to assess program efficacy. Data triangulation from students’ reflective journals was examined. Additionally, students’ awareness regarding changes within global health nursing, improved critical thinking, cultural understanding, and global leadership skills were investigated pre and post-program implementation. We discuss how identifying students’ needs regarding global nursing competence when developing appropriate curricula.

  17. Improving the accuracy of self-assessment of practical clinical skills using video feedback--the importance of including benchmarks.

    Science.gov (United States)

    Hawkins, S C; Osborne, A; Schofield, S J; Pournaras, D J; Chester, J F

    2012-01-01

    Isolated video recording has not been demonstrated to improve self-assessment accuracy. This study examines if the inclusion of a defined standard benchmark performance in association with video feedback of a student's own performance improves the accuracy of student self-assessment of clinical skills. Final year medical students were video recorded performing a standardised suturing task in a simulated environment. After the exercise, the students self-assessed their performance using global rating scales (GRSs). An identical self-assessment process was repeated following video review of their performance. Students were then shown a video-recorded 'benchmark performance', which was specifically developed for the study. This demonstrated the competency levels required to score full marks (30 points). A further self-assessment task was then completed. Students' scores were correlated against expert assessor scores. A total of 31 final year medical students participated. Student self-assessment scores before video feedback demonstrated moderate positive correlation with expert assessor scores (r = 0.48, p benchmark performance demonstration, self-assessment scores demonstrated a very strong positive correlation with expert scores (r = 0.83, p benchmark performance in combination with video feedback may significantly improve the accuracy of students' self-assessments.

  18. Electrochromic Windows: Process and Fabrication Improvements for Lower Total Costs

    Energy Technology Data Exchange (ETDEWEB)

    Mark Burdis; Neil Sbar

    2007-03-31

    The overall goal with respect to the U.S. Department of Energy (DOE) is to achieve significant national energy savings through maximized penetration of EC windows into existing markets so that the largest cumulative energy reduction can be realized. The speed with which EC windows can be introduced and replace current IGU's (and current glazings) is clearly a strong function of cost. Therefore, the aim of this project was to investigate possible improvements to the SageGlass{reg_sign} EC glazing products to facilitate both process and fabrication improvements resulting in lower overall costs. The project was split into four major areas dealing with improvements to the electrochromic layer, the capping layer, defect elimination and general product improvements. Significant advancements have been made in each of the four areas. These can be summarized as follows: (1) Plasma assisted deposition for the electrochromic layer was pursued, and several improvements made to the technology for producing a plasma beam were made. Functional EC devices were produced using the new technology, but there are still questions to be answered regarding the intrinsic properties of the electrochromic films produced by this method. (2) The capping layer work was successfully implemented into the existing SageGlass{reg_sign} product, thereby providing a higher level of transparency and somewhat lower reflectivity than the 'standard' product. (3) Defect elimination is an ongoing effort, but this project spurred some major defect reduction programs, which led to significant improvements in yield, with all the implicit benefits afforded. In particular, major advances were made in the development of a new bus bar application process aimed at reducing the numbers of 'shorts' developed in the finished product, as well as making dramatic improvements in the methods used for tempering the glass, which had previously been seen to produce a defect which appeared as a

  19. Nurses' knowledge and attitudes regarding major immobility complications among bedridden patients: A prospective multicentre study.

    Science.gov (United States)

    Li, Zhen; Zhou, Xinmei; Cao, Jing; Li, Zheng; Wan, Xia; Li, Jiaqian; Jiao, Jing; Liu, Ge; Liu, Ying; Li, Fangfang; Song, Baoyun; Jin, Jingfen; Liu, Yilan; Wen, Xianxiu; Cheng, Shouzhen; Wu, Xinjuan

    2018-05-01

    To gain insight into nurses' knowledge and attitudes regarding major immobility complications (pressure ulcers, pneumonia, deep vein thrombosis and urinary tract infections) and explore the correlation of nurses' knowledge and attitudes with the incidence of these complications. Immobility complications have adverse consequences, and effective management requires appropriate knowledge, attitudes and skills. Evidence about nurses' knowledge and attitudes regarding immobility complications is lacking. Cross-sectional study. A total of 3,903 nurses and 21,333 bedridden patients from 25 hospitals in China were surveyed. Nurses' knowledge and attitudes regarding major immobility complications were assessed using researcher-developed questionnaires. The content validity, reliability and internal consistency of the questionnaires were validated through expert review and a pilot study. The incidence of major immobility complications among bedridden patients from selected wards was surveyed by trained investigators. Correlations between knowledge, attitudes and the incidence of major immobility complications were evaluated with multilevel regression models. Mean knowledge scores were 64.07% for pressure ulcers, 72.92% for deep vein thrombosis, 76.54% for pneumonia and 83.30% for urinary tract infections. Mean attitude scores for these complications were 86.25%, 84.31%, 85.00% and 84.53%, respectively. Knowledge and attitude scores were significantly higher among nurses with older age, longer employment duration, higher education level, previous training experience and those working in tertiary hospitals or critical care units. Nurses' knowledge about pressure ulcers was negatively related to the incidence of pressure ulcers, and attitude towards pneumonia was negatively correlated with the incidence of pneumonia. Clinical nurses have relatively positive attitudes but inadequate knowledge regarding major immobility complications. Improved knowledge and attitudes regarding

  20. A Major in Science? Initial Beliefs and Final Outcomes for College Major and Dropout

    OpenAIRE

    Ralph Stinebrickner; Todd R. Stinebrickner

    2014-01-01

    Taking advantage of unique longitudinal data, we provide the first characterization of what college students believe at the time of entrance about their final major, relate these beliefs to actual major outcomes, and provide an understanding of why students hold the initial beliefs about majors that they do. The data collection and analysis are based directly on a conceptual model in which a student's final major is best viewed as the end result of a learning process. We find that students en...

  1. Major gas projects in Latin America. Issues and perspectives

    International Nuclear Information System (INIS)

    Khelil, C.

    1997-01-01

    The Latin American energy demand will reach 677 MTOE by 2010, a 50% increase over 1995. There will be a major shift towards use of natural gas in power generation. US 503 10 9 Dollars will be required over 1995-2010 to discover and develop hydrocarbon reserves, build the pipeline system as well as generate and distribute electricity. US 19 10 9 Dollars will be required for gas pipelines and LNG projects in the region. Improvements in the policy, legal and regulatory framework are required in many countries to attract the needed investments. Several major gas projects are being implemented or planned in the region: Colombia Enron-built pipeline, Peru Camisea project, Chile Nova gas pipeline from Argentina, the Bolivia-Brazil pipeline and others. The World Bank group has been assisting countries in developing a competitive business environment and can provide, when needed, comfort to lenders in project financing through a guarantee scheme in several large complex cross border projects. (au)

  2. Impact of improved technologies on small-scale soybean production: empirical evidence from benue state, nigeria

    International Nuclear Information System (INIS)

    Adisa, R.S.; Balogun, K.S.

    2013-01-01

    The study examined the impact of improved technologies on the lives of small-scale soybean farmers in Benue State, Nigeria. A total of 160 respondents were selected using simple random sampling technique. Data were analyzed using descriptive statistics, Tobit model and the Kruskal-Wallis test. Findings revealed that 35.6% of the respondents were between 31 and 40 years old, 40.6% had household size of between 6 and 10 members. Majority of the respondents were male, married, and had secondary school education. Tobit analysis revealed that farmers socioeconomic characteristics which include gender, educational status and farming experience; and farmers knowledge on soybean innovations were significant factors determining the adoption of improved soybean production technologies. These factors were statistically significant at p=0.05. The adoption of improved soybean technologies has had a clear positive impact on farmers belief on soybean innovations. The major problems facing farmers in the adoption of improved soybean production technologies according to Kruskal-Wallis ranking were high cost of inputs, problem of labour availability and lack of credit/loan. The results of this study provide a strong case for the promotion of soybean as a solution for malnutrition and a means of poverty alleviation for poor people. (author)

  3. Study of immune function in children with thalassanemia major after partial splenic embolization

    International Nuclear Information System (INIS)

    Mei Quelin; Liu Pengcheng; Chen Yong; Li Yanhao

    2006-01-01

    Objective: To evaluate the changes of immunologic function in children with thalassanemia major after partial splenic embolization (PSE). Methods: Immunoglobulins, T cell subsets were detected by immunologic turbidimetry and APAAP with monoclonal antibody respectively in 40 children with thalassanemia major and also in 20 healthy persons before and after PSE. These immunologic indexes were compared before and after PSE. Results: The levels of IgG in serum were significantly lower one week after PSE than that before PSE. It turned to normal three weeks after PSE. The IgM, IgA levels remained unchanged during PSE. The levels of CD 3 , CD 4 ,CD 4 /CD 8 ratio in children with thalassanemia major were decreased (P<0.01) significantly in comparision with the normal controls. But , all of them were significantly increased after PSE than those before PSE (P<0.01), and returned to normal levels at the 3rd week. Conclusions: PSE is helpful for improving immunologic function of children with thalassanemia major. (authors)

  4. Surface expression, single-channel analysis and membrane topology of recombinant Chlamydia trachomatis Major Outer Membrane Protein

    Directory of Open Access Journals (Sweden)

    McClafferty Heather

    2005-01-01

    Full Text Available Abstract Background Chlamydial bacteria are obligate intracellular pathogens containing a cysteine-rich porin (Major Outer Membrane Protein, MOMP with important structural and, in many species, immunity-related roles. MOMP forms extensive disulphide bonds with other chlamydial proteins, and is difficult to purify. Leaderless, recombinant MOMPs expressed in E. coli have yet to be refolded from inclusion bodies, and although leadered MOMP can be expressed in E. coli cells, it often misfolds and aggregates. We aimed to improve the surface expression of correctly folded MOMP to investigate the membrane topology of the protein, and provide a system to display native and modified MOMP epitopes. Results C. trachomatis MOMP was expressed on the surface of E. coli cells (including "porin knockout" cells after optimizing leader sequence, temperature and medium composition, and the protein was functionally reconstituted at the single-channel level to confirm it was folded correctly. Recombinant MOMP formed oligomers even in the absence of its 9 cysteine residues, and the unmodified protein also formed inter- and intra-subunit disulphide bonds. Its topology was modeled as a (16-stranded β-barrel, and specific structural predictions were tested by removing each of the four putative surface-exposed loops corresponding to highly immunogenic variable sequence (VS domains, and one or two of the putative transmembrane strands. The deletion of predicted external loops did not prevent folding and incorporation of MOMP into the E. coli outer membrane, in contrast to the removal of predicted transmembrane strands. Conclusions C. trachomatis MOMP was functionally expressed on the surface of E. coli cells under newly optimized conditions. Tests of its predicted membrane topology were consistent with β-barrel oligomers in which major immunogenic regions are displayed on surface-exposed loops. Functional surface expression, coupled with improved understanding of MOMP

  5. Teleneonatology: a major tool for the future.

    Science.gov (United States)

    Minton, Stephen; Allan, Mark; Valdes, Wesley

    2014-02-01

    Hospitals have, for centuries, maintained a central position in the health care system, providing care for critically ill patients. Despite being a cornerstone of health care delivery, we are witnessing the beginning of a major transformation in their function. There are several forces driving this transformation, including health care costs, shortage of health care professionals, volume of people with chronic diseases, consumerism, health care reform, and hospital errors. The neonatal intensive care unit (NICU) at Utah Valley Regional Medical Center in Provo, Utah, began an aggressive redesign/quality improvement effort in 1990. It became obvious that our care processes were designed for health care deliverers and not for the families. An ongoing revamp of our care delivery processes was undertaken using significant input from a parent focus meeting, parental interviews, and development of a parent-to-parent support group. As a result of this work, it became obvious we needed a new model to truly empower parents. The idea of "NICU is Home" was born. We elected to make a mind shift, not to focus on what families think, but rather on how they think. Web cams and other video apparatus have been used in a number of NICUs across the country. We decided our equipment requirements would need to include high-resolution cameras, full high-definition video recording, autofocus, audio microphones, automatic noise reduction, and automatic low-light correction. Our conferencing software needed to accommodate multiple users and have multiple-picture capabilities, low band width, and inexpensive technology. It was recognized that a single video camera feed was insufficient to adequately capture the desired amount of information. Verbal communication between parents and their babies' principal care providers is critical. Parents loved the idea of expanding the remote NICU web cam of their baby to a two-way physician-parent communication bedside monitor. Doctors at Utah Valley

  6. Strategic issues for the oil majors - 1992

    Energy Technology Data Exchange (ETDEWEB)

    Oppenheimer, P M [Oxford Univ. (United Kingdom)

    1992-01-01

    Strategic issues facing major oil producers in the 1990s are very diffuse - in contrast with both the 1970s (when strategy meant the response to high oil prices) and the 1980s (when it meant anticipating and exploiting a drop in prices). Mainly upstream issues include the future of price management by OPEC or a successor, the speed of development of new markets for natural gas in power generation and the role of Russia in world energy markets. Other issues include the impact of environmental regulations and taxes on the product mix and on marketing. Human-resource management will continue to face the task of reconciling career opportunities with static or declining manpower requirements; and corporate cash mountains may periodically recur. (Author).

  7. Strategic issues for the oil majors - 1992

    International Nuclear Information System (INIS)

    Oppenheimer, P.M.

    1992-01-01

    Strategic issues facing major oil producers in the 1990s are very diffuse - in contrast with both the 1970s (when strategy meant the response to high oil prices) and the 1980s (when it meant anticipating and exploiting a drop in prices). Mainly upstream issues include the future of price management by OPEC or a successor, the speed of development of new markets for natural gas in power generation and the role of Russia in world energy markets. Other issues include the impact of environmental regulations and taxes on the product mix and on marketing. Human-resource management will continue to face the task of reconciling career opportunities with static or declining manpower requirements; and corporate cash mountains may periodically recur. (Author)

  8. Ethnic disparities in traumatic brain injury care referral in a Hispanic-majority population.

    Science.gov (United States)

    Budnick, Hailey C; Tyroch, Alan H; Milan, Stacey A

    2017-07-01

    Functional outcomes after traumatic brain injury (TBI) can be significantly improved by discharge to posthospitalization care facilities. Many variables influence the discharge disposition of the TBI patient, including insurance status, patient condition, and patient prognosis. The literature has demonstrated an ethnic disparity in posthospitalization care referral, with Hispanics being discharged to rehabilitation and nursing facilities less often than non-Hispanics. However, this relationship has not been studied in a Hispanic-majority population, and thus, this study seeks to determine if differences in neurorehabilitation referrals exist among ethnic groups in a predominately Hispanic region. This study is a retrospective cohort that includes 1128 TBI patients who presented to University Medical Center El Paso, Texas, between the years 2005 and 2015. The patients' age, sex, race, residence, admission Glasgow Coma Scale (GCS), GCS motor, Injury Severity Score (ISS), hospital and intensive care unit length of stay (LOS), mechanism of injury, and discharge disposition were analyzed in univariate and multivariate models. Our study population had an insurance rate of 55.5%. Insurance status and markers of injury severity (hospital LOS, intensive care unit LOS, ISS, GCS, and GCS motor) were predictive of discharge disposition to rehabilitation facilities. The study population was 70% Hispanic, yet Hispanics were discharged to rehabilitation facilities (relative risk: 0.56, P: 0.001) and to long-term acute care/nursing facilities (relative risk: 0.35, P < 0.0001) less than non-Hispanics even after LOS, ISS, ethnicity, insurance status, and residence were adjusted for in multivariate analysis. This study suggests that patients of different ethnicities but comparable traumatic severity and insurance status receive different discharge dispositions post-TBI even in regions in which Hispanics are the demographic majority. Copyright © 2017 Elsevier Inc. All rights

  9. Major reduction in 30-day mortality after elective colorectal cancer surgery

    DEFF Research Database (Denmark)

    Iversen, Lene Hjerrild; Ingeholm, Peter; Gögenur, Ismail

    2014-01-01

    BACKGROUND: For years, the outcome of colorectal cancer (CRC) surgery has been inferior in Denmark compared to its neighbouring countries. Several strategies have been initiated in Denmark to improve CRC prognosis. We studied whether there has been any effect on postoperative mortality based...... on the information from a national database. METHODS: Patients who underwent elective major surgery for CRC in the period 2001-2011 were identified in the national Danish Colorectal Cancer Group database. Thirty-day mortality rates were calculated and factors with impact on mortality were identified using logistic...... the study period. CONCLUSION: The 30-day mortality rate after elective major surgery for CRC has decreased significantly in Denmark in the past decade. Laparoscopic surgical approach was associated with a reduction in mortality in colon cancer....

  10. Leishmania major infection in a dog with cutaneous manifestations.

    Science.gov (United States)

    Baneth, Gad; Nachum-Biala, Yaarit; Shabat Simon, Maytal; Brenner, Ori; Gaier, Sarit; Rojas, Alicia; Yasur-Landau, Daniel

    2016-05-10

    Leishmania major is a main cause of cutaneous leishmaniasis in humans in an area that stretches from India through Central Asia, the Middle East, to North and West Africa. In Israel, it is a common infection of humans with rodents as the reservoir hosts and Phlebotomus papatasi as its sand fly vector. A 6 months old spayed female mixed breed dog was referred to the Hebrew University Veterinary Teaching Hospital with a large ulcerative dermal lesion on the muzzle, and lesions in the foot pads and left hind leg. Histopathology of a skin biopsy found chronic lymphohistiocytic dermatitis with the presence of Leishmania spp. amastigotes in the muzzle. Physical examination indicated that the dog was overall in a good clinical condition and the main findings were the skin lesions and enlarged prescapular lymph nodes. Complete blood count and serum biochemistry profile were within reference ranges. Serology by ELISA was positive for Leishmania spp. and PCR of the prescapular lymph node was positive by an ITS1 region PCR-high resolution melt analysis. However, the melt curve and subsequent DNA sequencing indicated that infection was caused by L. major and not L. infantum, which is the main causative agent of canine leishmaniosis in the Mediterranean region. DNA was extracted from the paraffin embedded muzzle biopsy and PCR with sequencing also indicated L. major. The dog's young age and the absence of hyperglobulinemia and anemia were not typical of L. infantum infection. The dog was treated with allopurinol and the skin lesions improved and later disappeared when the dog was re-evaluated. This is the first molecularly-confirmed case of L. major infection in a dog. Two previous reports of L. major in dogs originated from Saudi-Arabia and Egypt in 1985 and 1987 were confirmed by enzymatic biochemical techniques. Serology for L. infantum was positive probably due to the well documented serological cross-reactivity between Leishmania spp. Although dogs and wild carnivores are

  11. Recent Improvements in the ATLAS PanDA Pilot

    International Nuclear Information System (INIS)

    Nilsson, P; De, K; Bejar, J Caballero; Maeno, T; Potekhin, M; Wenaus, T; Compostella, G; Contreras, C; Dos Santos, T

    2012-01-01

    The Production and Distributed Analysis system (PanDA) in the ATLAS experiment uses pilots to execute submitted jobs on the worker nodes. The pilots are designed to deal with different runtime conditions and failure scenarios, and support many storage systems. This talk will give a brief overview of the PanDA pilot system and will present major features and recent improvements including CernVM File System integration, the job retry mechanism, advanced job monitoring including JEM technology, and validation of new pilot code using the HammerCloud stress-testing system. PanDA is used for all ATLAS distributed production and is the primary system for distributed analysis. It is currently used at over 130 sites worldwide. We analyze the performance of the pilot system in processing LHC data on the OSG, EGI and Nordugrid infrastructures used by ATLAS, and describe plans for its further evolution.

  12. Major Roads

    Data.gov (United States)

    Minnesota Department of Natural Resources — This data set contains roadway centerlines for major roads (interstates and trunk highways) found on the USGS 1:24,000 mapping series. These roadways are current...

  13. A student's guide to Einstein's major papers

    CERN Document Server

    Kennedy, Robert E

    2012-01-01

    Our understanding of the physical universe underwent a revolution in the early twentieth century - evolving from the classical physics of Newton, Galileo, and Maxwell to the modern physics of relativity and quantum mechanics. The dominant figure in this revolutionary change was Albert Einstein. In a single year, 1905, Einstein produced breakthrough works in three areas of physics: on the size and the effects of atoms; on the quantization of the electromagnetic field; and on the special theory of relativity. In 1916 he produced a fourth breakthrough work, the general theory of relativity. A Student's Guide to Einstein's Major Papers focuses on Einstein's contributions, setting his major works into their historical context, and then takes the reader through the details of each paper, including the mathematics. This book helps the reader appreciate the simplicity and insightfulness of Einstein's ideas and how revolutionary his work was, and locate it in the evolution of scientific thought begun by the ancient...

  14. Improved image quality in pinhole SPECT by accurate modeling of the point spread function in low magnification systems

    International Nuclear Information System (INIS)

    Pino, Francisco; Roé, Nuria; Aguiar, Pablo; Falcon, Carles; Ros, Domènec; Pavía, Javier

    2015-01-01

    Purpose: Single photon emission computed tomography (SPECT) has become an important noninvasive imaging technique in small-animal research. Due to the high resolution required in small-animal SPECT systems, the spatially variant system response needs to be included in the reconstruction algorithm. Accurate modeling of the system response should result in a major improvement in the quality of reconstructed images. The aim of this study was to quantitatively assess the impact that an accurate modeling of spatially variant collimator/detector response has on image-quality parameters, using a low magnification SPECT system equipped with a pinhole collimator and a small gamma camera. Methods: Three methods were used to model the point spread function (PSF). For the first, only the geometrical pinhole aperture was included in the PSF. For the second, the septal penetration through the pinhole collimator was added. In the third method, the measured intrinsic detector response was incorporated. Tomographic spatial resolution was evaluated and contrast, recovery coefficients, contrast-to-noise ratio, and noise were quantified using a custom-built NEMA NU 4–2008 image-quality phantom. Results: A high correlation was found between the experimental data corresponding to intrinsic detector response and the fitted values obtained by means of an asymmetric Gaussian distribution. For all PSF models, resolution improved as the distance from the point source to the center of the field of view increased and when the acquisition radius diminished. An improvement of resolution was observed after a minimum of five iterations when the PSF modeling included more corrections. Contrast, recovery coefficients, and contrast-to-noise ratio were better for the same level of noise in the image when more accurate models were included. Ring-type artifacts were observed when the number of iterations exceeded 12. Conclusions: Accurate modeling of the PSF improves resolution, contrast, and recovery

  15. Improved image quality in pinhole SPECT by accurate modeling of the point spread function in low magnification systems

    Energy Technology Data Exchange (ETDEWEB)

    Pino, Francisco [Unitat de Biofísica, Facultat de Medicina, Universitat de Barcelona, Barcelona 08036, Spain and Servei de Física Mèdica i Protecció Radiològica, Institut Català d’Oncologia, L’Hospitalet de Llobregat 08907 (Spain); Roé, Nuria [Unitat de Biofísica, Facultat de Medicina, Universitat de Barcelona, Barcelona 08036 (Spain); Aguiar, Pablo, E-mail: pablo.aguiar.fernandez@sergas.es [Fundación Ramón Domínguez, Complexo Hospitalario Universitario de Santiago de Compostela 15706, Spain and Grupo de Imagen Molecular, Instituto de Investigacións Sanitarias de Santiago de Compostela (IDIS), Galicia 15782 (Spain); Falcon, Carles; Ros, Domènec [Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona 08036, Spain and CIBER en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona 08036 (Spain); Pavía, Javier [Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona 080836 (Spain); CIBER en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona 08036 (Spain); and Servei de Medicina Nuclear, Hospital Clínic, Barcelona 08036 (Spain)

    2015-02-15

    Purpose: Single photon emission computed tomography (SPECT) has become an important noninvasive imaging technique in small-animal research. Due to the high resolution required in small-animal SPECT systems, the spatially variant system response needs to be included in the reconstruction algorithm. Accurate modeling of the system response should result in a major improvement in the quality of reconstructed images. The aim of this study was to quantitatively assess the impact that an accurate modeling of spatially variant collimator/detector response has on image-quality parameters, using a low magnification SPECT system equipped with a pinhole collimator and a small gamma camera. Methods: Three methods were used to model the point spread function (PSF). For the first, only the geometrical pinhole aperture was included in the PSF. For the second, the septal penetration through the pinhole collimator was added. In the third method, the measured intrinsic detector response was incorporated. Tomographic spatial resolution was evaluated and contrast, recovery coefficients, contrast-to-noise ratio, and noise were quantified using a custom-built NEMA NU 4–2008 image-quality phantom. Results: A high correlation was found between the experimental data corresponding to intrinsic detector response and the fitted values obtained by means of an asymmetric Gaussian distribution. For all PSF models, resolution improved as the distance from the point source to the center of the field of view increased and when the acquisition radius diminished. An improvement of resolution was observed after a minimum of five iterations when the PSF modeling included more corrections. Contrast, recovery coefficients, and contrast-to-noise ratio were better for the same level of noise in the image when more accurate models were included. Ring-type artifacts were observed when the number of iterations exceeded 12. Conclusions: Accurate modeling of the PSF improves resolution, contrast, and recovery

  16. Analysis of National Major Work Safety Accidents in China, 2003-2012.

    Science.gov (United States)

    Ye, Yunfeng; Zhang, Siheng; Rao, Jiaming; Wang, Haiqing; Li, Yang; Wang, Shengyong; Dong, Xiaomei

    2016-01-01

    This study provides a national profile of major work safety accidents in China, which cause more than 10 fatalities per accident, intended to provide scientific basis for prevention measures and strategies to reduce major work safety accidents and deaths. Data from 2003-2012 Census of major work safety accidents were collected from State Administration of Work Safety System (SAWS). Published literature and statistical yearbook were also included to implement information. We analyzed the frequency of accidents and deaths, trend, geographic distribution and injury types. Additionally, we discussed the severity and urgency of emergency rescue by types of accidents. A total of 877 major work safety accidents were reported, resulting in 16,795 deaths and 9,183 injuries. The numbers of accidents and deaths, mortality rate and incidence of major accidents have declined in recent years. The mortality rate and incidence was 0.71 and 1.20 per 10(6) populations in 2012, respectively. Transportation and mining contributed to the highest number of major accidents and deaths. Major aviation and railway accidents caused more casualties per incident, while collapse, machinery, electrical shock accidents and tailing dam accidents were the most severe situation that resulted in bigger proportion of death. Ten years' major work safety accident data indicate that the frequency of accidents and number of eaths was declined and several safety concerns persist in some segments.

  17. Student Perceptions of the First Course in Accounting: Majors versus Non-Majors

    Science.gov (United States)

    Tickell, Geoffrey; Lim, Tiong Kiong; Balachandran, Balasinghan

    2012-01-01

    This paper contributes to the continuing debate regarding the curriculum for the first undergraduate course in accounting by examining student perceptions from studying such a course. Participants are divided into two cohorts--Accounting & Finance Majors (AFM) and Other Business Majors (OBM). Results reported in this paper indicate that…

  18. Rosa damascena oil improves SSRI-induced sexual dysfunction in male patients suffering from major depressive disorders: results from a double-blind, randomized, and placebo-controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Farnia V

    2015-03-01

    Full Text Available Vahid Farnia,1 Mehdi Shirzadifar,2 Jalal Shakeri,1 Mansour Rezaei,3 Hafez Bajoghli,4,5 Edith Holsboer-Trachsler,6 Serge Brand6,7 1Substance Abuse Prevention Research Center, Psychiatry Department, Kermanshah University of Medical Sciences, Kermanshah, Iran; 2Student Research Center, Psychiatry Department, Kermanshah University of Medical Sciences, Kermanshah, Iran; 3Department of Statistics and Epidemiology, Kermanshah University of Medical Sciences, Kermanshah, Iran; 4Iranian National Center for Addiction Studies, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran; 5ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand; 6Psychiatric Clinics of the Center for Affective, Stress and Sleep Disorders, Psychiatric Hospital of the University of Basel, Basel, Switzerland; 7Sport Science Section, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland Background: A substantial disadvantage of psychopharmacological treatment of major depressive disorder (MDD with selective serotonin-reuptake inhibitors (SSRIs is the impact on sexual dysfunction. The aim of the present study was to investigate whether the oil of Rosa damascena can have a positive influence on SSRI-induced sexual dysfunction (SSRI-I SD of male patients who are suffering from MDD and are being treated with SSRIs.Method: In a double-blind, randomized, and placebo-controlled clinical trial, a total of 60 male patients treated with an SSRI and suffering from MDD (mean age =32 years and SSRI-I SD were randomly assigned to take either verum (R. damascena oil or a placebo. Patients completed self-ratings of depression and sexual function at baseline, at 4 weeks later, and at the end of the study, 8 weeks after it started.Results: Over time, sexual dysfunction improved more in the verum group than in the control group. Improvements were observed in the verum group from week 4 to week

  19. Major Depression Among Adults

    Science.gov (United States)

    ... Depressive Episode Among Adolescents Data Sources Share Major Depression Definitions Major depression is one of the most ... Bethesda, MD 20892-9663 Follow Us Facebook Twitter YouTube Google Plus NIMH Newsletter NIMH RSS Feed NIMH ...

  20. Study on Major Factors Influencing University Students’ Behavior of Consumption on Online Tourism in Shijiazhuang

    OpenAIRE

    Xiao-Feng Xu

    2015-01-01

    In this study, we have a study of the major factors influencing university students’ behavior of consumption on online tourism in Shijiazhuang. The major factors influencing university students’ behavior of consumption on online tourism in Shijiazhuang include personal motivation, attitude, sense of security and satisfaction. The external factors include price, brand and reputation of the online tourism and tourism websites. Some suggestions for network marketing can be drawn from the feature...

  1. Psychology Degree Beliefs and Stereotypes: Differences in the Perceptions of Majors and Non-Majors

    Science.gov (United States)

    Brinthaupt, Thomas M.; Hurst, Jennifer R.; Johnson, Quinn R.

    2016-01-01

    Very little research examines the beliefs and stereotypes students have about the discipline and major of psychology. Previous research has found that psychology majors report hearing a variety of such beliefs and stereotypes more often from their fellow students than from their family members. In the current study, psychology majors/minors and…

  2. [Public health in major socio-economic crisis].

    Science.gov (United States)

    Cosmacini, G

    2014-01-01

    The term "crisis" in different cultures (such as ancient Greece or China) can have a positive meaning, since it indicates a time of growth, change and opportunity. Over the centuries there have been times of severe economic and social crisis that led to the implementation of major reforms and improved population health. Nowadays, despite the new economic crisis which has also affected health care for its rising costs, health economics does not hesitate to affirm the importance of key objectives such as prevention and medical assistance. Prevention is not prediction. Prevention means "going upstream" and fixing a problem at the source; the goal is to reduce diseases' effects, causes and risk factors, thereby reducing the prevalence of costly medical conditions.

  3. Financial planning for major initiatives: a framework for success.

    Science.gov (United States)

    Harris, John M

    2007-11-01

    A solid framework for assessing a major strategic initiative consists of four broad steps: Initial considerations, including level of analysis required and resources that will be brought to bear. Preliminary financial estimates for board approval to further assess the initiative. Assessment of potential partners' interest in the project. Feasibility analysis for board green light.

  4. "Rheum to Improve": Quality Improvement in Outpatient Rheumatology.

    Science.gov (United States)

    Chow, Shirley L; Shojania, Kaveh G

    2017-09-01

    The commitment to improve care processes and patient outcomes is a professional mandate for clinicians and is also seen as an operational priority for institutions. Quality improvement now figures in the accreditation of training programs, specialty examinations, and hospital scorecards. Rheumatologists have traditionally focused primarily on quality problems such as guideline adherence; however, improvement goals should also include other aspects of care that are helpful to patients and are professionally rewarding for practitioners. This review makes use of improvement projects in outlining tangible tools rheumatologists can use to resolve quality concerns in their practices.

  5. Age at Menarche and Choice of College Major: Implications for STEM Majors

    Science.gov (United States)

    Brenner-Shuman, Anna; Waren, Warren

    2013-01-01

    Even though boys and girls in childhood perform similarly in math and spatial thinking, after puberty fewer young women pursue majors that emphasize abilities such as science, technology, engineering, and math (STEM) in college. If postpubertal feminization contributes to a lower likelihood of choosing STEM majors, then young women who enter…

  6. Major issues in the training of security personnel

    International Nuclear Information System (INIS)

    Knauf, W.M.; Robertson, L.P.

    1982-01-01

    The effectiveness of the response component of a physical protection system depends greatly upon the training received by the security personnel. The issues and problems in the area of training which were of greatest concern to the attendees of the 1980 and 1981 INMM sponsored Technical Workshops on Guard Training are discussed. The attendees were training supervisors of managers of security personnel and represented a variety of organizations and companies including DOE facilities, NRC licensees, the military, private security contractors, and governmental agencies. Major categories of concern include: professionalism in security, legal constraints and obligations, physical and psychological testing and standards, governmental requirements, morale and motivation, and tactical training techniques

  7. Improving patient access to an interventional US clinic.

    Science.gov (United States)

    Steele, Joseph R; Clarke, Ryan K; Terrell, John A; Brightmon, Tonya R

    2014-01-01

    A continuous quality improvement project was conducted to increase patient access to a neurointerventional ultrasonography (US) clinic. The clinic was experiencing major scheduling delays because of an increasing patient volume. A multidisciplinary team was formed that included schedulers, medical assistants, nurses, technologists, and physicians. The team created an Ishikawa diagram of the possible causes of the long wait time to the next available appointment and developed a flowchart of the steps involved in scheduling and completing a diagnostic US examination and biopsy. The team then implemented a staged intervention that included adjustments to staffing and room use (stage 1); new procedures for scheduling same-day add-on appointments (stage 2); and a lead technician rotation to optimize patient flow, staffing, and workflow (stage 3). Six months after initiation of the intervention, the mean time to the next available appointment had decreased from 25 days at baseline to 1 day, and the number of available daily appointments had increased from 38 to 55. These improvements resulted from a coordinated provider effort and had a net present value of more than $275,000. This project demonstrates that structural changes in staffing, workflow, and room use can substantially reduce scheduling delays for critical imaging procedures. © RSNA, 2014.

  8. What are the benefits of hosting a major league sports franchise?

    OpenAIRE

    Jordan Rappaport; Chad R. Wilkerson

    2001-01-01

    Over the last few decades the number of U.S. metropolitan areas large enough to host a franchise from one of the four major professional sports leagues has soared. Even as major league baseball, football, basketball and hockey have expanded to include more franchises, demand by metro areas continues to exceed supply. Metro areas have thus been forced to compete with each other to retain and attract franchises. ; The resulting large public spending on new sports facilities has been quite contr...

  9. Major outage trends in light water reactors. Interim report

    International Nuclear Information System (INIS)

    Burns, E.T.

    1978-04-01

    The report is a summary of the major outages which occurred in light water reactor plants during the period January 1971 through June 1977. Only those outages greater than 100 hours duration (exclusive of refueling outages) are included in the report. The trends in outages related to various reactor systems and components are presented as a function of plant age, and alternatively, calendar year. The principal contributors to major outages are ranked by their effect on the overall outage time for PWRs and BWRs. In addition, the outage history of each operating nuclear plant greater than 150 MWe is presented, along with a brief summary of those outages greater than two months duration

  10. Prenatal dysthymia versus major depression effects on the neonate.

    Science.gov (United States)

    Field, Tiffany; Diego, Miguel; Hernandez-Reif, Maria

    2008-04-01

    Depressed pregnant women were classified as dysthymic or major depression disorder based on the Structured Clinical Interview for Depression and followed to the newborn period. The newborns of dysthymic versus major depression disorder mothers had a significantly shorter gestational age, a lower birthweight, shorter birth length and less optimal obstetric complications scores. The neonates of dysthymic mothers also had lower orientation and motor scores and more depressive symptoms on the Brazelton Neonatal Behavioral Assessment Scale. These findings were not surprising given the elevated cortisol levels and the inferior fetal measures including lower fetal weight, fetal length, femur length and abdominal circumference noted in our earlier study on fetuses of dysthymic pregnant women.

  11. An improved combustion apparatus for the determination of organically bound tritium in environmental samples

    International Nuclear Information System (INIS)

    Du, Lin; Shan, Jian; Ma, Yu-Hua; Wang, Ling; Qin, Lai-Lai; Pi, Li; Zeng, You-Shi; Xia, Zheng-Hai; Wang, Guang-Hua; Liu, Wei

    2016-01-01

    This paper reports an improved combustion apparatus for the determination of organically bound tritium in environmental samples. The performance of this apparatus including the recovery rate and reproducibility was investigated by combusting lettuce and pork samples. To determine the factors for the different recovery rates of lettuce and pork and investigate whether the samples were completely oxidized, the ashes and exhaust gases produced by the combustion were analyzed. The results indicate that the apparatus showed an excellent performance in the combustion of environmental samples. Thus, the improvements conducted in this study were effective. - Highlights: • Three major improvements were made to develop the combustion apparatus for OBT. • The recovery is higher and more stable than that of current equipment. • Little hydrogen was present in the ashes and exhaust after combustion.

  12. Cost analysis of paroxetine versus imipramine in major depression.

    Science.gov (United States)

    Bentkover, J D; Feighner, J P

    1995-09-01

    A simulation decision analytical model was used to compare the annual direct medical costs of treating patients with major depression using the selective serotonin reuptake inhibitor (SSRI) paroxetine or the tricyclic antidepressant (TCA) imipramine. Medical treatment patterns were determined from focus groups of general and family practitioners and psychiatrists in Boston, Dallas and Chicago, US. Direct medical costs included the wholesale drug acquisition costs (based on a 6-month course of drug therapy), psychiatrist and/or general practitioner visits, hospital outpatient visits, hospitalisation and electroconvulsive therapy. Acute phase treatment failure rates were derived from an intention-to-treat analysis of a previously published trial of paroxetine, imipramine and placebo in patients with major depression. Maintenance phase relapse rates were obtained from a 12-month trial of paroxetine, supplemented from the medical literature. The relapse rates for the final 6 months of the year were obtained from medical literature and expert opinion. Direct medical costs were estimated from a health insurance claims database. The estimated total direct medical cost per patient was slightly lower using paroxetine ($US2348) than generic imipramine ($US2448) as first-line therapy. This result was sensitive to short term dropout rates but robust to changes in other major parameters, including hospitalisation costs and relapse rates. The financial benefit of paroxetine, despite its 15-fold higher acquisition cost compared with imipramine, is attributable to a higher rate of completion of the initial course of therapy and consequent reduced hospitalisation rates.

  13. 75 FR 81908 - Defense Federal Acquisition Regulation Supplement; Organizational Conflicts of Interest in Major...

    Science.gov (United States)

    2010-12-29

    ... strategy, the apparently successful offeror will be able to provide objective and unbiased advice. Refining the definition of ``major subcontractor'' to include upper and lower limits on application of the... pricing data threshold would not be considered a major subcontract; and [cir] A subcontract equal to or...

  14. The importance of fungi and mycology for addressing major global challenges*

    OpenAIRE

    Lange, Lene

    2014-01-01

    In the new bioeconomy, fungi play a very important role in addressing major global challenges, being instrumental for improved resource efficiency, making renewable substitutes for products from fossil resources, upgrading waste streams to valuable food and feed ingredients, counteracting life-style diseases and antibiotic resistance through strengthening the gut biota, making crop plants more robust to survive climate change conditions, and functioning as host organisms for production of new...

  15. The Evolution of the Cup-Cage Technique for Major Acetabular Defects: Full and Half Cup-Cage Reconstruction.

    Science.gov (United States)

    Sculco, Peter K; Ledford, Cameron K; Hanssen, Arlen D; Abdel, Matthew P; Lewallen, David G

    2017-07-05

    Complex acetabular reconstruction for major bone loss can require advanced methods such as the use of a cup-cage construct. The purpose of this study was to review outcomes after the initial development of the cup-cage technique and the subsequent evolution to the use of a half cup-cage construct. We performed a retrospective, single-center review of 57 patients treated with cup-cage reconstruction for major acetabular bone loss. All patients had major acetabular defects graded as Paprosky Type 2B through 3B, with 34 (60%) having an associated pelvic discontinuity. Thirty patients received a full cup-cage construct and 27, a half cup-cage construct. The mean follow-up was 5 years. Both the full and half cup-cage cohorts demonstrated significantly improved Harris hip score (HHS) values, from 36 to 72 at a minimum of 2 years of follow-up (p cup-cage constructs and 6 (22%) of the half cup-cage constructs. One patient with a full cup-cage construct underwent re-revision of the acetabular component for progressive migration and aseptic loosening. Short-term survivorship free from re-revision for any cause or reoperation was 89% (83% and 96% for full and half cup-cage cohorts, respectively). Both full and half cup-cage constructs demonstrated successful clinical outcomes and survivorship in the treatment of major acetabular defects and pelvic discontinuity. Each method is utilized on the basis of individual intraoperative findings, including the extent and pattern of bone loss, the quality and location of host bone remaining after preparation, and the presence of pelvic discontinuity. Longer-term follow-up is required to understand the durability of these constructs in treating major acetabular defects and pelvic discontinuity. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

  16. Indirect Nitrous Oxide Emissions from Major Rivers in the World: Integration of a Process-based Model with Observational Data

    Science.gov (United States)

    Zhang, B.; Yao, Y.; Xu, R.; Yang, J.; WANG, Z.; Pan, S.; Tian, H.

    2016-12-01

    The atmospheric concentration of nitrous oxide (N2O), one of major greenhouse gases, has increased over 121% compared with the preindustrial level, and most of the increase arises from anthropogenic activities. Previous studies suggested that indirect emissions from global rivers remains a large source of uncertainty among all the N2O sources and restricted the assessment of N2O budget at both regional and global scales. Here, we have integrated a coupled biogeochemical model (DLEM) with observational data to quantify the magnitude and spatio-temporal variation of riverine N2O emission and attribute the environmental controls of indirect N2O emission from major rivers in the world. Our preliminary results indicate that the magnitude of indirect N2O emission from rivers is closely associated with the stream orders. To include N2O emissions from headwater streams is essential for reducing uncertainty in the estimation of indirect N2O emission. By implementing a set of factorial simulations, we have further quantified the relative contributions of climate, nitrogen deposition, nitrogen fertilizer use, and manure application to riverine N2O emission. Finally, this study has identified major knowledge gaps and uncertainties associated with model structure, parameters and input data that need to be improved in future research.

  17. Improving occupational safety in Kuzbass mines

    Energy Technology Data Exchange (ETDEWEB)

    Evseev, V S

    1986-08-01

    Some achievements of VostNII are listed in improving occupational safety in Kuzbass mines. Methane is a major problem: 90.6% of mines is in category III or supercategory; over 21% has an absolute methane emission of 30 m/sup 3//min or more. Another problem is spontaneous fires, which cost 2 million t of coal per year. One method of preventing these is injection of antipyrogens (urea and diammonium phosphate); another is the creation of gel (water glass, ammonium chloride and water) barriers in goaf areas. High pressure water jets are also used. Various methods of improving ventilation systems to match increased coal output are proposed, including drilling large diameter ventilation boreholes from the surface. In Leninskugol' mines the useful air is only 55.8% of the total delivered. More attention should be given to degassing (currently producing 130 million m/sup 3//y of methane). Dust levels are increasing due to the advent of narrow web cutter loaders (100% of coal cutter loaders in Kuzbass mines in 1984). Water injection and spraying are partially effective at dust suppression. Some electrical safety devices developed by VostNII are described.

  18. Major Links.

    Science.gov (United States)

    Henderson, Tona

    1995-01-01

    Provides electronic mail addresses for resources and discussion groups related to the following academic majors: art, biology, business, chemistry, computer science, economics, health sciences, history, literature, math, music, philosophy, political science, psychology, sociology, and theater. (AEF)

  19. Gulf digs in to tap a major uranium orebody

    International Nuclear Information System (INIS)

    Jackson, D.

    1977-01-01

    The progress and future plans of Gulf Mineral Resources Co. for tapping and developing a major uranium orebody via two concrete-lined shafts in the Grants uranium mineral belt in New Mexico are discussed. The mineralogy of the Grants belt is discussed as it relates to the Gulf development project. Numerous pictures of the operation are included

  20. MOS modeling hierarchy including radiation effects

    International Nuclear Information System (INIS)

    Alexander, D.R.; Turfler, R.M.

    1975-01-01

    A hierarchy of modeling procedures has been developed for MOS transistors, circuit blocks, and integrated circuits which include the effects of total dose radiation and photocurrent response. The models were developed for use with the SCEPTRE circuit analysis program, but the techniques are suitable for other modern computer aided analysis programs. The modeling hierarchy permits the designer or analyst to select the level of modeling complexity consistent with circuit size, parametric information, and accuracy requirements. Improvements have been made in the implementation of important second order effects in the transistor MOS model, in the definition of MOS building block models, and in the development of composite terminal models for MOS integrated circuits

  1. Positron emission tomography quantification of serotonin transporter in suicide attempters with major depressive disorder.

    Science.gov (United States)

    Miller, Jeffrey M; Hesselgrave, Natalie; Ogden, R Todd; Sullivan, Gregory M; Oquendo, Maria A; Mann, J John; Parsey, Ramin V

    2013-08-15

    Several lines of evidence implicate abnormal serotonergic function in suicidal behavior and completed suicide, including low serotonin transporter binding in postmortem studies of completed suicide. We have also reported low in vivo serotonin transporter binding in major depressive disorder (MDD) during a major depressive episode using positron emission tomography (PET) with [(11)C]McN5652. We quantified regional brain serotonin transporter binding in vivo in depressed suicide attempters, depressed nonattempters, and healthy controls using PET and a superior radiotracer, [(11)C]DASB. Fifty-one subjects with DSM-IV current MDD, 15 of whom were past suicide attempters, and 32 healthy control subjects underwent PET scanning with [(11)C]DASB to quantify in vivo regional brain serotonin transporter binding. Metabolite-corrected arterial input functions and plasma free-fraction were acquired to improve quantification. Depressed suicide attempters had lower serotonin transporter binding in midbrain compared with depressed nonattempters (p = .031) and control subjects (p = .0093). There was no difference in serotonin transporter binding comparing all depressed subjects with healthy control subjects considering six a priori regions of interest simultaneously (p = .41). Low midbrain serotonin transporter binding appears to be related to the pathophysiology of suicidal behavior rather than of major depressive disorder. This is consistent with postmortem work showing low midbrain serotonin transporter binding capacity in depressed suicides and may partially explain discrepant in vivo findings quantifying serotonin transporter in depression. Future studies should investigate midbrain serotonin transporter binding as a predictor of suicidal behavior in MDD and determine the cause of low binding. Copyright © 2013 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  2. Errors in translation made by English major students: A study on types and causes

    Directory of Open Access Journals (Sweden)

    Pattanapong Wongranu

    2017-05-01

    Full Text Available Many Thai English major students have problems when they translate Thai texts into English, as numerous errors can be found. Therefore, a study of translation errors is needed to find solutions to these problems. The objectives of this research were: 1 to examine types of translation errors in translation from Thai into English, 2 to determine the types of translation errors that are most common, and 3 to find possible explanations for the causes of errors. The results of this study will be used to improve translation teaching and the course “Translation from Thai into English”. The participants were 26 third-year, English major students at Kasetsart University. The data were collected from the students' exercises and examinations. Interviews and stimulated recall were also used to determine translation problems and causes of errors. The data were analyzed by considering the frequency and percentage, and by content analysis. The results shows that the most frequent translation errors were syntactic errors (65%, followed by semantic errors (26.5% and miscellaneous errors (8.5%, respectively. The causes of errors found in this study included translation procedures, carelessness, low self-confidence, and anxiety. It is recommended that more class time be spent to address the problematic points. In addition, more authentic translation and group work should be implemented to increase self-confidence and decrease anxiety.

  3. Atypical major depressive episode as initial presentation of intracranial germinoma in a male adolescent

    Directory of Open Access Journals (Sweden)

    Chen YT

    2016-12-01

    Full Text Available Yi-Ting Chen,1,3,4 Kuan-Pin Su,2–5 Jane Pei-Chen Chang2–5 1Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan; 2Graduate Institute of Neural and Cognitive Sciences, China Medical University, Taichung, Taiwan; 3School of Medicine, China Medical University, Taichung, Taiwan; 4Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan; 5Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK Abstract: A 17-year-old adolescent boy presented with atypical major depressive episode (MDE without specific focal neurological signs for 6 months. He had a diagnosis of intra­cranial germinoma, and the atypical MDE symptoms subsided after the operation. However, he had a relapse of atypical MDE 7 months after the first surgery. His mood and binge eating symptoms subsided, but intractable body weight gain only partially improved after treatment. When encountering manifestations of depression with atypical features, especially with binge eating symptoms in male children and adolescents, with early onset age, no family history, and prolonged depressive episodes, clinicians should consider not only mood disorders including bipolar spectrum disorders but also organic brain lesions such as intracranial germinoma. Keywords: intracranial germinoma, atypical major depressive episode, binge eating behavior, body weight gain

  4. CDBG Public Improvements Activity

    Data.gov (United States)

    Department of Housing and Urban Development — CDBG activity related to public improvements, including senior centers, youth centers, parks, street improvements, water/sewer improvements, child care centers, fire...

  5. Expectant management of PPROM and major complications before planned delivery

    DEFF Research Database (Denmark)

    Bendix, J M; Hegaard, H K; Bergholt, T

    2015-01-01

    Women with pre-term pre-labour rupture of membranes (PPROM) 22-33 weeks' gestation were included in a retrospective cohort study with a structured audit to identify risk factors of major complications following PPROM and to assess whether these complications are predictable. Of the 234 women...

  6. Improvement in rheumatic fever and rheumatic heart disease management and prevention using a health centre-based continuous quality improvement approach.

    Science.gov (United States)

    Ralph, Anna P; Fittock, Marea; Schultz, Rosalie; Thompson, Dale; Dowden, Michelle; Clemens, Tom; Parnaby, Matthew G; Clark, Michele; McDonald, Malcolm I; Edwards, Keith N; Carapetis, Jonathan R; Bailie, Ross S

    2013-12-18

    Rheumatic heart disease (RHD) remains a major health concern for Aboriginal Australians. A key component of RHD control is prevention of recurrent acute rheumatic fever (ARF) using long-term secondary prophylaxis with intramuscular benzathine penicillin (BPG). This is the most important and cost-effective step in RHD control. However, there are significant challenges to effective implementation of secondary prophylaxis programs. This project aimed to increase understanding and improve quality of RHD care through development and implementation of a continuous quality improvement (CQI) strategy. We used a CQI strategy to promote implementation of national best-practice ARF/RHD management guidelines at primary health care level in Indigenous communities of the Northern Territory (NT), Australia, 2008-2010. Participatory action research methods were employed to identify system barriers to delivery of high quality care. This entailed facilitated discussion with primary care staff aided by a system assessment tool (SAT). Participants were encouraged to develop and implement strategies to overcome identified barriers, including better record-keeping, triage systems and strategies for patient follow-up. To assess performance, clinical records were audited at baseline, then annually for two years. Key performance indicators included proportion of people receiving adequate secondary prophylaxis (≥80% of scheduled 4-weekly penicillin injections) and quality of documentation. Six health centres participated, servicing approximately 154 people with ARF/RHD. Improvements occurred in indicators of service delivery including proportion of people receiving ≥40% of their scheduled BPG (increasing from 81/116 [70%] at baseline to 84/103 [82%] in year three, p = 0.04), proportion of people reviewed by a doctor within the past two years (112/154 [73%] and 134/156 [86%], p = 0.003), and proportion of people who received influenza vaccination (57/154 [37%] to 86/156 [55%], p

  7. Forecasting space weather: Can new econometric methods improve accuracy?

    Science.gov (United States)

    Reikard, Gordon

    2011-06-01

    Space weather forecasts are currently used in areas ranging from navigation and communication to electric power system operations. The relevant forecast horizons can range from as little as 24 h to several days. This paper analyzes the predictability of two major space weather measures using new time series methods, many of them derived from econometrics. The data sets are the A p geomagnetic index and the solar radio flux at 10.7 cm. The methods tested include nonlinear regressions, neural networks, frequency domain algorithms, GARCH models (which utilize the residual variance), state transition models, and models that combine elements of several techniques. While combined models are complex, they can be programmed using modern statistical software. The data frequency is daily, and forecasting experiments are run over horizons ranging from 1 to 7 days. Two major conclusions stand out. First, the frequency domain method forecasts the A p index more accurately than any time domain model, including both regressions and neural networks. This finding is very robust, and holds for all forecast horizons. Combining the frequency domain method with other techniques yields a further small improvement in accuracy. Second, the neural network forecasts the solar flux more accurately than any other method, although at short horizons (2 days or less) the regression and net yield similar results. The neural net does best when it includes measures of the long-term component in the data.

  8. [Benefits of epidural analgesia in major neonatal surgery].

    Science.gov (United States)

    Gómez-Chacón, J; Encarnación, J; Couselo, M; Mangas, L; Domenech, A; Gutiérrez, C; García Sala, C

    2012-07-01

    The aim of this paper is to describe and evaluate the benefits of epidural anesthesia in major surgery neonatal. We have performed a matched case-control (2:1) study of patients undergoing neonatal major surgery (NMSs) who received intra-and postoperative epidural anesthesia (EA) and controls with conventional general anesthesia. The matching criteria were age, weight and baseline pathology. EA was administered by caudal puncture and epidural catheter placed with ultrasound support. Levobupivacaine was selected as anesthetic drug. The time to extubation, intestinal transit time, type of analgesia and complications were studied. This study is based on 11 cases (2 esophageal atresia, 2 diaphragmatic hernias, 1 necrotizing enterocolitis, 3 intestinal atresia, 2 anorectal malformation and 1 bladder exstrophy) and 22 controls. We observed statistically significant differences in time to extubation (95% CI OR 12 1.99 to 72.35; Chi2 p = 0.004, Mann U Whytney p = 0.013) and intestinal transit time (Mann Whitney U p analgesia. Therefore we believe that the intra-and postoperative EA helps improve postoperative management in neonates and should be preferred in centers where this technique is available.

  9. Does thromboprophylaxis prevent venous thromboembolism after major orthopedic surgery?

    Directory of Open Access Journals (Sweden)

    Evrim Eylem Akpinar

    2013-06-01

    Full Text Available OBJECTIVE: Pulmonary embolism (PE is an important complication of major orthopedic surgery. The aim of this study was to evaluate the incidence of venous thromboembolism (VTE and factors influencing the development of VTE in patients undergoing major orthopedic surgery in a university hospital. METHODS: Patients who underwent major orthopedic surgery (hip arthroplasty, knee arthroplasty, or femur fracture repair between February of 2006 and June of 2012 were retrospectively included in the study. The incidences of PE and deep vein thrombosis (DVT were evaluated, as were the factors influencing their development, such as type of operation, age, and comorbidities. RESULTS: We reviewed the medical records of 1,306 patients. The proportions of knee arthroplasty, hip arthroplasty, and femur fracture repair were 63.4%, 29.9%, and 6.7%, respectively. The cumulative incidence of PE and DVT in patients undergoing major orthopedic surgery was 1.99% and 2.22%, respectively. Most of the patients presented with PE and DVT (61.5% and 72.4%, respectively within the first 72 h after surgery. Patients undergoing femur fracture repair, those aged ≥ 65 years, and bedridden patients were at a higher risk for developing VTE. CONCLUSIONS: Our results show that VTE was a significant complication of major orthopedic surgery, despite the use of thromboprophylaxis. Clinicians should be aware of VTE, especially during the perioperative period and in bedridden, elderly patients (≥ 65 years of age.

  10. Improving energy efficiency in handheld biometric applications

    Science.gov (United States)

    Hoyle, David C.; Gale, John W.; Schultz, Robert C.; Rakvic, Ryan N.; Ives, Robert W.

    2012-06-01

    With improved smartphone and tablet technology, it is becoming increasingly feasible to implement powerful biometric recognition algorithms on portable devices. Typical iris recognition algorithms, such as Ridge Energy Direction (RED), utilize two-dimensional convolution in their implementation. This paper explores the energy consumption implications of 12 different methods of implementing two-dimensional convolution on a portable device. Typically, convolution is implemented using floating point operations. If a given algorithm implemented integer convolution vice floating point convolution, it could drastically reduce the energy consumed by the processor. The 12 methods compared include 4 major categories: Integer C, Integer Java, Floating Point C, and Floating Point Java. Each major category is further divided into 3 implementations: variable size looped convolution, static size looped convolution, and unrolled looped convolution. All testing was performed using the HTC Thunderbolt with energy measured directly using a Tektronix TDS5104B Digital Phosphor oscilloscope. Results indicate that energy savings as high as 75% are possible by using Integer C versus Floating Point C. Considering the relative proportion of processing time that convolution is responsible for in a typical algorithm, the savings in energy would likely result in significantly greater time between battery charges.

  11. Kaizen method for esophagectomy patients: improved quality control, outcomes, and decreased costs.

    Science.gov (United States)

    Iannettoni, Mark D; Lynch, William R; Parekh, Kalpaj R; McLaughlin, Kelley A

    2011-04-01

    The majority of costs associated with esophagectomy are related to the initial 3 days of hospital stay requiring intensive care unit stays, ventilator support, and intraoperative time. Additional costs arise from hospital-based services. The major cost increases are related to complications associated with the procedure. We attempted to define these costs and identify expense management by streamlining care through strict adherence to patient care maps, operative standardization, and rapid discharge planning to reduce variability. Utilizing methods of Kaizen philosophy we evaluated all processes related to the entire experience of esophageal resection. This process has taken over 5 years to achieve, with quality and cost being tracked over this time period. Cost analysis included expenses related to intensive care unit, anesthesia, disposables, and hospital services. Quality improvement measures were related to intraoperative complications, in-hospital complications, and postoperative outcomes. The Institutional Review Board approved the use of anonymous data from standard clinical practice because no additional treatment was planned (observational study). Utilizing a continuous process improvement methodology, a 43% reduction in cost per case has been achieved with a significant increase in contribution margin for esophagectomy. The length of stay has been reduced from 14 days to 5. With intraoperative and postoperative standardization the leak rate has dropped from 12% to less than 3% to no leaks in our current Kaizen modification of care in our last 64 patients. Utilizing lean manufacturing techniques and continuous process evaluation we have attempted to eliminate variability, standardized the phases of care resulting in improved outcomes, decreased length of stay, and improved contribution margins. These Kaizen improvements require continuous interventions, strict adherence to care maps, and input from all levels for quality improvements. Copyright © 2011 The

  12. Nationwide time trends and risk factors for in-hospital falls-related major injuries

    DEFF Research Database (Denmark)

    Jorgensen, T. S. H.; Hansen, A. H.; Sahlberg, M.

    2015-01-01

    BackgroundAccidental falls during hospitalisation have a range of complications and more information is needed to improve prevention. We investigated patterns of in-hospital fall-related major injuries in the period 2000-2012 and the association between chronic conditions and in-hospital fall......-related major injuries. MethodsUsing administrative databases, patients aged 65+ years with in-hospital falls causing fractures or head injuries with need for surgery or intensive observation were identified as cases and were individually matched with five controls. Joinpoint regression was used to examine time...... trends and conditional logistic regression was used to analyse odds ratio (OR) for in-hospital falls-related major injuries according to a range of comorbidities. ResultsFour thousand seven hundred and fifty-four cases were identified from 2000 to 2012 and the most common injury was femur fracture (61...

  13. New insight into benign tumours of major salivary glands by proteomic approach.

    Directory of Open Access Journals (Sweden)

    Elena Donadio

    Full Text Available Major salivary gland tumours are uncommon neoplasms of the head and neck. The increase of precise pre-operative diagnosis is crucial for their correct management and the identification of molecular markers would surely improve the required accuracy. In this study we performed a comparative proteomic analysis of fine needle aspiration fluids of the most frequent benign neoplasms of major salivary glands, namely pleomorphic adenoma and Warthin's tumour, in order to draw their proteomic profiles and to point out their significant features. Thirty-five patients submitted to parotidectomy were included in the study, 22 were identified to have pleomorphic adenoma and 14 Warthin's tumour. Fine needle aspiration samples were processed using a two-dimensional electrophoresis/mass spectrometry-based approach. A total of 26 differentially expressed proteins were identified. Ingenuity software was used to search the biological processes to which these proteins belong and to construct potential networks. Intriguingly, all Warthin's tumour up-regulated proteins such as Ig gamma-1 chain C region, Ig kappa chain C region and Ig alpha-1 chain C region and S100A9 were correlated to immunological and inflammatory diseases, while pleomorphic adenomas such as annexin A1, annexin A4, macrophage-capping protein, apolipoprotein E and alpha crystalline B chain were associated with cell death, apoptosis and tumorigenesis, showing different features of two benign tumours. Overall, our results shed new light on the potential usefulness of a proteomic approach to study parotid tumours and in particular up regulated proteins are able to discriminate two types of benign parotid lesions.

  14. Prospects after Major Trauma

    NARCIS (Netherlands)

    Holtslag, H.R.

    2007-01-01

    Introduction. After patients survived major trauma, their prospects, in terms of the consequences for functioning, are uncertain, which may impact severely on patient, family and society. The studies in this thesis describes the long-term outcomes of severe injured patients after major trauma. In

  15. The surgical care improvement project and prevention of post-operative infection, including surgical site infection.

    Science.gov (United States)

    Rosenberger, Laura H; Politano, Amani D; Sawyer, Robert G

    2011-06-01

    In response to inconsistent compliance with infection prevention measures, the Centers for Medicare & Medicaid Services collaborated with the U.S. Centers for Disease Control and Prevention on the Surgical Infection Prevention (SIP) project, introduced in 2002. Quality improvement measures were developed to standardize processes to increase compliance. In 2006, the Surgical Care Improvement Project (SCIP) developed out of the SIP project and its process measures. These initiatives, published in the Specifications Manual for National Inpatient Quality Measures, outline process and outcome measures. This continually evolving manual is intended to provide standard quality measures to unify documentation and track standards of care. Seven of the SCIP initiatives apply to the peri-operative period: Prophylactic antibiotics should be received within 1 h prior to surgical incision (1), be selected for activity against the most probable antimicrobial contaminants (2), and be discontinued within 24 h after the surgery end-time (3); (4) euglycemia should be maintained, with well-controlled morning blood glucose concentrations on the first two post-operative days, especially in cardiac surgery patients; (6) hair at the surgical site should be removed with clippers or by depilatory methods, not with a blade; (9) urinary catheters are to be removed within the first two post-operative days; and (10) normothermia should be maintained peri-operatively. There is strong evidence that implementation of protocols that standardize practices reduce the risk of surgical infection. The SCIP initiative targets complications that account for a significant portion of preventable morbidity as well as cost. One of the goals of the SCIP guidelines was a 25% reduction in the incidence of surgical site infections from implementation through 2010. Process measures are becoming routine, and as we practice more evidence-based medicine, it falls to us, the surgeons and scientists, to be active

  16. Access to major overseas research facilities

    International Nuclear Information System (INIS)

    Bolderman, J. W.

    1997-01-01

    This paper will describe four schemes which have been established to permit Australian researchers access to some of the most advanced overseas research facilities. These include, access to Major Research Facilities Program, the Australian National Beamline Facility at the Photon Factory, the Australian Synchrotron Research Program and the ISIS Agreement. The details of each of these programs is discussed and the statistics on the scientific output provided. All programs are managed on behalf of the Department of Industry, Science and Tourism by the Australian Nuclear Science and Technology Organisation. One hundred and thirteen senior scientists plus forty, one postgraduate, students were supported through these schemes during the 1996-1997 financial year

  17. The effects of cognitive therapy versus 'no intervention' for major depressive disorder

    DEFF Research Database (Denmark)

    Jakobsen, Janus Christian; Hansen, Jane Lindschou; Storebø, Ole Jakob

    2011-01-01

    BACKGROUND: Major depressive disorder afflicts an estimated 17% of individuals during their lifetimes at tremendous suffering and costs. Cognitive therapy may be an effective treatment option for major depressive disorder, but the effects have only had limited assessment in systematic reviews....... METHODS/PRINCIPAL FINDINGS: We used The Cochrane systematic review methodology with meta-analyses and trial sequential analyses of randomized trials comparing the effects of cognitive therapy versus 'no intervention' for major depressive disorder. Participants had to be older than 17 years with a primary...... diagnosis of major depressive disorder to be eligible. Altogether, we included 12 trials randomizing a total of 669 participants. All 12 trials had high risk of bias. Meta-analysis on the Hamilton Rating Scale for Depression showed that cognitive therapy significantly reduced depressive symptoms (four...

  18. Rupture of the pectoralis major: a case report and review.

    Science.gov (United States)

    Hasegawa, Kohei; Schofer, Joel M

    2010-02-01

    Rupture of the pectoralis major muscle is a rare clinical entity that is becoming more common due to the increasing popularity of weightlifting and recreational sports. Due to the rarity of this condition, it may be missed at initial presentation and inappropriately treated, potentially leading to increased disability. This case highlights the mechanism of injury, clinical features, diagnosis, and treatment of rupture of the pectoralis major. The patient was a 31-year-old male bodybuilder who presented to the Emergency Department with acute pain and swelling in the left axilla after performing a bench press with a 400-pound barbell. The diagnosis of pectoralis major rupture was suspected and confirmed by magnetic resonance imaging, and early surgical repair was performed. The most common mechanism of injury is excessive tension on a maximally contracted pectoralis major muscle. Weightlifting, specifically bench pressing, is a common cause. The diagnosis can usually be made based on a patient's history and physical examination, but shortly after injury, the diagnosis may be obscured by severe pain and swelling. Magnetic resonance imaging is the imaging modality of choice when the diagnosis remains unclear, and can avoid surgical delays. Early diagnosis and treatment within 3 to 8 weeks after the injury has the advantage of avoiding adhesions and muscle atrophy, and can prevent a delayed return to normal activities. Given the trend toward improved results with early surgical repair of complete rupture, it is important to raise awareness about pectoralis major muscle injury among Emergency Physicians to prevent missed or delayed diagnosis and repair. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  19. Detection systems for carbapenemase gene identification should include the SME serine carbapenemase.

    Science.gov (United States)

    Bush, Karen; Pannell, Megan; Lock, John L; Queenan, Anne Marie; Jorgensen, James H; Lee, Ryan M; Lewis, James S; Jarrett, Deidre

    2013-01-01

    Carbapenemase detection has become a major problem in hospitals that encounter outbreaks of infections caused by carbapenem-resistant Gram-negative bacteria. Rapid detection systems have been reported using multiplex PCR analyses and DNA microarray assays. Major carbapenemases that are detected by these systems include the KPC and OXA serine carbapenemases, and the IMP, VIM and NDM families of metallo-β-lactamases. However, increasing numbers of the SME serine carbapenemase are being reported from Serratia marcescens, especially from North and South America. These organisms differ from many of the other carbapenemase-producing pathogens in that they are generally susceptible to the expanded-spectrum cephalosporins ceftazidime and cefepime while retaining resistance to almost all other β-lactam antibiotics. Thus, multiplex PCR assays or DNA microarray testing of carbapenem-resistant S. marcescens isolates should include analyses for production of the SME carbapenemase. Confirmation of the presence of this enzyme may provide reassurance that oxyimino-cephalosporins can be considered for treatment of infections caused by these carbapenem-resistant pathogens. Copyright © 2012 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  20. 49 CFR 350.213 - What must a State CVSP include?

    Science.gov (United States)

    2010-10-01

    ... include education, enforcement, legislation, use of technology and improvements to safety infrastructure... activities affecting the transportation of controlled substances by CMV drivers and training on appropriate... regulations with the FMCSRs and HMRs. (m) A copy of any new law or regulation affecting CMV safety enforcement...

  1. 76 FR 24339 - Streamlining Service Delivery and Improving Customer Service

    Science.gov (United States)

    2011-05-02

    ... accessed by the Internet or mobile phone and improved processes that deliver services faster and more... ``Conversations with America'' to Further Improve Customer Service). However, with advances in technology and... major initiative (signature initiative) that will use technology to improve the customer experience; (b...

  2. Introduction to the Major Contribution: Counseling Psychology and Online Counseling

    Science.gov (United States)

    Mallen, Michael J.; Vogel, David L.

    2005-01-01

    This article introduces the Major Contribution, which focuses on online counseling. Several acronyms and terms are presented to familiarize the reader with distance-communication technology, including a definition of online counseling. The authors show how counseling psychology provides a framework for specific questions related to the theory,…

  3. Enhancing the Accounting Major with Online Learning

    Directory of Open Access Journals (Sweden)

    Hershey Friedman Ph.D

    2013-07-01

    Full Text Available Accounting majors who wish to be successful in life must learn to acquire knowledge using all kinds of platforms. The belief that the only way people can learn is by classroom instruction is not supported by research. The authors show how online learning is an important tool for achieving the various goals of accounting education that should include creativity, collaboration, communication, critical thinking and problem solving. The authors conclude that the optimal method to teach accounting is by combining face-to-face learning with on-line learning.

  4. "Metabolic staging" after major trauma - a guide for clinical decision making?

    Directory of Open Access Journals (Sweden)

    Moore Ernest E

    2010-06-01

    Full Text Available Abstract Metabolic changes after major trauma have a complex underlying pathophysiology. The early posttraumatic stress response is associated with a state of hyperinflammation, with increased oxygen consumption and energy expenditure. This hypercatabolic state must be recognized early and mandates an early nutritional management strategy. A proactive concept of early enteral "immunonutrition" in severely injured patients, is aimed at counterbalancing the negative aspects of hyperinflammation and hypercatabolism in order to reduce the risk of late complications, including infections and posttraumatic organ failure. Recently, the concept of "metabolic staging" has been advocated, which takes into account the distinct inflammatory phases and metabolic phenotypes after major trauma, including the "ischemia/reperfusion phenotype", the "leukocytic phenotype", and the "angiogenic phenotype". The potential clinical impact of metabolic staging, and of an appropriately adapted "metabolic control" and nutritional support, remains to be determined.

  5. 40 CFR 720.45 - Information that must be included in the notice form.

    Science.gov (United States)

    2010-07-01

    ... manufactured, processed, or used. (2) A process description of each manufacture, processing, and use operation which includes a diagram of the major unit operations and chemical conversions, the identity and entry... composition that can be represented by a specific, complete chemical structure diagram (a Class 1 substance...

  6. Pharmacological Treatment of Major Depressive Disorder in Adolescents

    Directory of Open Access Journals (Sweden)

    Rachel L. Farley

    2005-01-01

    Full Text Available Major depressive disorder (MDD affects a significant number of adolescents today. Its consequences (including social isolation, failure to achieve crucial developmental milestones, and suicide mandate close attention in clinical practice. While tricyclics and monoamine oxidase inhibitors (MAOIs have been used infrequently and with questionable efficacy, selective serotonin reuptake inhibitors (SSRIs, particularly fluoxetine, consistently have been shown to be of benefit in treating outpatient adolescents with MDD. Despite some success with other drugs in its class, fluoxetine remains the only SSRI that is FDA approved for treatment of children and adolescents with depression. A review of recent studies is presented, including the controversy regarding the relationship of antidepressants and suicidal behavior in this patient population.

  7. Wide operating window spin-torque majority gate towards large-scale integration of logic circuits

    Science.gov (United States)

    Vaysset, Adrien; Zografos, Odysseas; Manfrini, Mauricio; Mocuta, Dan; Radu, Iuliana P.

    2018-05-01

    Spin Torque Majority Gate (STMG) is a logic concept that inherits the non-volatility and the compact size of MRAM devices. In the original STMG design, the operating range was restricted to very small size and anisotropy, due to the exchange-driven character of domain expansion. Here, we propose an improved STMG concept where the domain wall is driven with current. Thus, input switching and domain wall propagation are decoupled, leading to higher energy efficiency and allowing greater technological optimization. To ensure majority operation, pinning sites are introduced. We observe through micromagnetic simulations that the new structure works for all input combinations, regardless of the initial state. Contrary to the original concept, the working condition is only given by threshold and depinning currents. Moreover, cascading is now possible over long distances and fan-out is demonstrated. Therefore, this improved STMG concept is ready to build complete Boolean circuits in absence of external magnetic fields.

  8. Loops formed by tidal tails as fossil records of a major merger

    Science.gov (United States)

    Wang, J.; Hammer, F.; Athanassoula, E.; Puech, M.; Yang, Y.; Flores, H.

    2012-02-01

    Context. Many haloes of nearby disc galaxies contain faint and extended features, including loops, which are often interpreted as relics of satellite infall in the main galaxy's potential well. In most cases, however, the residual nucleus of the satellite is not seen, although it is predicted by numerical simulations. Aims: We test whether such faint and extended features can be associated to gas-rich, major mergers, which may also lead to disc rebuilding and thus be a corner stone for the formation of spiral galaxies. Our goal is to test whether the major merger scenario can provide a good model for a particularly difficult case, that of NGC 5907, and to compare to the scenario of a satellite infall. Methods: Using the TreeSPH code GADGET-2, we model the formation of an almost bulge-less galaxy similar to NGC 5907 (B/T ≲ 0.2) after a gas-rich major merger. First, we trace tidal tail particles captured by the galaxy gravitational potential to verify whether they can form loops similar to those discovered in the galactic haloes. Results: We indeed find that 3:1 major mergers can form features similar to the loops found in many galactic haloes, including in NGC 5907, and can reproduce an extended thin disc, a bulge, as well as the pronounced warp of the gaseous disc. Relatively small bulge fractions can be reproduced by a large gas fraction in the progenitors, as well as appropriate orbital parameters. Conclusions: Even though it remains difficult to fully cover the large volume of free parameters, the present modelling of the loops in NGC 5907 proves that they could well be the result of a major merger. It has many advantages over the satellite infall scenario; e.g., it solves the problem of the visibility of the satellite remnant, and it may explain some additional features in the NGC 5907 halo, as well as some gas properties of this system. For orbital parameters derived from cosmological simulations, the loops in NGC 5907 can be reproduced by major mergers (3

  9. Difficult to predict early failure after major lower-extremity amputations

    DEFF Research Database (Denmark)

    Kristensen, Morten Tange; Holm, Gitte; Gebuhr, Peter

    2015-01-01

    INTRODUCTION: The successful outcome of a major amputation depends on several factors, including stump wound healing. The purpose of this study was to examine the criteria upon which the index amputation was based and to identify factors associated with early amputation failure after major non......-traumatic lower-extremity amputation. METHODS: We studied a consecutive one-year series of 36 men and 34 women with a median (25-75% quartiles) age of 72 (63-83) years who were treated in an acute orthopaedic ward; 44 below-knee and 26 above-knee amputees of whom 47 had an American Society of Anesthesiologists...... rating above two. Patient characteristics and other factors potentially influencing early amputation failure within 30 days were evaluated. RESULTS: Eleven patients died (16%) and 11 (16%) had a re-amputation at a higher level, whereas four (6%) had a major revision at the same level within 30 days...

  10. Should CAM and CAM Training Programs Be Included in the Curriculum of Schools That Provide Health Education?

    Directory of Open Access Journals (Sweden)

    2016-12-01

    Full Text Available Objectives: This study aimed to determine the knowledge levels and attitudes of School of Health and Vocational School of Health students toward complementary and alternative medicine (CAM. Methods: Three hundred thirty-three (333 students studying at the Mehmet Akif Ersoy University School of Health and the Golhisar Vocational School of Health in Burdur, Turkey, were included in the study. Research data were collected by using a survey method based on the expressed opinions of the participants. Results: Of the participants, 69.7% were female and 97% were single (unmarried. Of cigarette users and those with chronic illnesses, 46.8% and 47.8%, respectively, used CAM. Those using CAM were statistically more likely to be female (P < 0.021, to have higher grades (P < 0.007, to be single (P < 0.005, to be vocational school of health graduates (P < 0.008, and to have fathers at work (P < 0.021. While 9.6% of the students thought CAM to be nonsense, 10.8% thought that the methods of CAM should be tried before consulting a doctor. Conclusion: A majority of the students in the study population were found to use complementary and alternative medicine, but that they lacked information about its methods. As a way to address this, CAM should be included in the curriculum of schools that provide health education, and CAM training programs should be given to healthcare professionals to improve their knowledge of CAM. In Turkey, many more studies should be performed to determine nurses’ and doctors’ knowledge of and attitudes about CAM methods so that they can give correct guidance to society and take more active responsibility in improving patient safety.

  11. MYR1-Dependent Effectors Are the Major Drivers of a Host Cell's Early Response to Toxoplasma, Including Counteracting MYR1-Independent Effects.

    Science.gov (United States)

    Naor, Adit; Panas, Michael W; Marino, Nicole; Coffey, Michael J; Tonkin, Christopher J; Boothroyd, John C

    2018-04-03

    The obligate intracellular parasite Toxoplasma gondii controls its host cell from within the parasitophorous vacuole (PV) by using a number of diverse effector proteins, a subset of which require the aspartyl protease 5 enzyme (ASP5) and/or the recently discovered MYR1 protein to cross the PV membrane. To examine the impact these effectors have in the context of the entirety of the host response to Toxoplasma , we used RNA-Seq to analyze the transcriptome expression profiles of human foreskin fibroblasts infected with wild-type RH (RH-WT), RHΔ myr1 , and RHΔ asp5 tachyzoites. Interestingly, the majority of the differentially regulated genes responding to Toxoplasma infection are MYR1 dependent. A subset of MYR1 responses were ASP5 independent, and MYR1 function did not require ASP5 cleavage, suggesting the export of some effectors requires only MYR1. Gene set enrichment analysis of MYR1-dependent host responses suggests an upregulation of E2F transcription factors and the cell cycle and a downregulation related to interferon signaling, among numerous others. Most surprisingly, "hidden" responses arising in RHΔ myr1 - but not RH-WT-infected host cells indicate counterbalancing actions of MYR1-dependent and -independent activities. The host genes and gene sets revealed here to be MYR1 dependent provide new insight into the parasite's ability to co-opt host cell functions. IMPORTANCE Toxoplasma gondii is unique in its ability to successfully invade and replicate in a broad range of host species and cells within those hosts. The complex interplay of effector proteins exported by Toxoplasma is key to its success in co-opting the host cell to create a favorable replicative niche. Here we show that a majority of the transcriptomic effects in tachyzoite-infected cells depend on the activity of a novel translocation system involving MYR1 and that the effectors delivered by this system are part of an intricate interplay of activators and suppressors. Removal of all MYR1

  12. Decomposition of SO2, NOx and CO2 emissions from energy use of major economic sectors in Taiwan

    International Nuclear Information System (INIS)

    Sue J. Lin; Tzu C. Chang

    1996-01-01

    In this paper we use the Divisia index approach to decompose emission changes of SO 2 , NO, and CO 2 from major economic sectors in Taiwan during 1980 to 1992. The study highlights the interrelationships between energy use and environmental quality, and provides insights for policy making. The emission changes are decomposed into five components-pollution coefficient, fuel mix, energy intensity, economic growth and industrial structure. Of all components analyzed, economic growth had the largest positive effect on emission changes for Taiwan's major economic sectors. Emissions of SO 2 in industry and other sectors showed a decreasing trend due to fuel quality improvements antipollution control. However, NO, and CO 2 emissions increased sharply in all sectors. Comparisons were also made with Germany, Japan and USA. This study has shown that improvement in energy efficiency, pollution control and fuel substitution are major options to reduce SO 2 , NO, and CO 2 emissions

  13. Sequential change of hemodynamic reserve in patients with major cerebral artery occlusion of severe stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Hasegawa, Y.; Yamaguchi, T.; Tsuchiya, T. (National Cardiovascular Center, Osaka (Japan). Cerebrovascular Div.); Minematsu, K. (National Cardiovascular Center, Osaka (Japan). Research Inst.); Nishimura, T. (National Cardiovascular Inst., Osaka (Japan). Dept. of Diagnostic Radiology)

    1992-02-01

    To identify regional vasodilatory capacity and its sequential change, we evaluated prospectively a total of 78 acetazolamide tests in 51 patients with occlusion or greater than 75% stenosis of the carotid or middle cerebral arteries. The relative distribution of cerebral blood flow was determined by single photon emission computed tomography using N-isopropyl-p-({sup 123}I)-iodoamphetamine before and after intravenous injection of acetazolamide. Reduced vasodilatory capacity was demonstrated in 20 patients (38%), including 5 patients with hemodynamic transient ischemic attacks or infarction. Follow-up acetazolamide tests revealed asymptomatic progression of the arterial lesion (from stenosis to occlusion) in 1 patient and almost complete improvement of vasodilatory capacity in 5 patients, including 3 without surgical intervention. During an average follow-up period of 18.5 months, 4 patients died from cardiac causes or neoplasm; no neurovascular events occurred. Much larger numbers of patients with longer observation periods will be necessary to clarify the contribution of chronic hemodynamic failure to subsequent stroke. However, the present data indicate that the acetazolamide test is useful for assessing the course of high grade stenosis or occlusion of major cerebral arteries. (orig.).

  14. A Network Meta-Analysis Comparing Effects of Various Antidepressant Classes on the Digit Symbol Substitution Test (DSST) as a Measure of Cognitive Dysfunction in Patients with Major Depressive Disorder.

    Science.gov (United States)

    Baune, Bernhard T; Brignone, Mélanie; Larsen, Klaus Groes

    2018-02-01

    Major depressive disorder is a common condition that often includes cognitive dysfunction. A systematic literature review of studies and a network meta-analysis were carried out to assess the relative effect of antidepressants on cognitive dysfunction in major depressive disorder. MEDLINE, Embase, Cochrane, CDSR, and PsychINFO databases; clinical trial registries; and relevant conference abstracts were searched for randomized controlled trials assessing the effects of antidepressants/placebo on cognition. A network meta-analysis comparing antidepressants was conducted using a random effects model. The database search retrieved 11337 citations, of which 72 randomized controlled trials from 103 publications met the inclusion criteria. The review identified 86 cognitive tests assessing the effect of antidepressants on cognitive functioning. However, the Digit Symbol Substitution Test, which targets multiple domains of cognition and is recognized as being sensitive to change, was the only test that was used across 12 of the included randomized controlled trials and that allowed the construction of a stable network suitable for the network meta-analysis. The interventions asses