WorldWideScience

Sample records for multi-centre interrupted time

  1. Algorithm Design of CPCI Backboard's Interrupts Management Based on VxWorks' Multi-Tasks

    Science.gov (United States)

    Cheng, Jingyuan; An, Qi; Yang, Junfeng

    2006-09-01

    This paper begins with a brief introduction of the embedded real-time operating system VxWorks and CompactPCI standard, then gives the programming interfaces of Peripheral Controller Interface (PCI) configuring, interrupts handling and multi-tasks programming interface under VxWorks, and then emphasis is placed on the software frameworks of CPCI interrupt management based on multi-tasks. This method is sound in design and easy to adapt, ensures that all possible interrupts are handled in time, which makes it suitable for data acquisition systems with multi-channels, a high data rate, and hard real-time high energy physics.

  2. Enhanced Interrupt Response Time in the nMPRA based on Embedded Real Time Microcontrollers

    Directory of Open Access Journals (Sweden)

    GAITAN, N. C.

    2017-08-01

    Full Text Available In any real-time operating system, task switching and scheduling, interrupts, synchronization and communication between processes, represent major problems. The implementation of these mechanisms through software generates significant delays for many applications. The nMPRA (Multi Pipeline Register Architecture architecture is designed for the implementation of real-time embedded microcontrollers. It supports the competitive execution of n tasks, enabling very fast switching between them, with a usual delay of one machine cycle and a maximum of 3 machine cycles, for the memory-related work instructions. This is because each task has its own PC (Program Counter, set of pipeline registers and a general registers file. The nMPRA is provided with an advanced distributed interrupt controller that implements the concept of "interrupts as threads". This allows the attachment of one or more interrupts to the same task. In this context, the original contribution of this article is to presents the solutions for improving the response time to interrupts when a task has attached a large number of interrupts. The proposed solutions enhance the original architecture for interrupts logic in order to transfer control, to the interrupt handler as soon as possible, and to create an interrupt prioritization at task level.

  3. Servicing a globally broadcast interrupt signal in a multi-threaded computer

    Science.gov (United States)

    Attinella, John E.; Davis, Kristan D.; Musselman, Roy G.; Satterfield, David L.

    2015-12-29

    Methods, apparatuses, and computer program products for servicing a globally broadcast interrupt signal in a multi-threaded computer comprising a plurality of processor threads. Embodiments include an interrupt controller indicating in a plurality of local interrupt status locations that a globally broadcast interrupt signal has been received by the interrupt controller. Embodiments also include a thread determining that a local interrupt status location corresponding to the thread indicates that the globally broadcast interrupt signal has been received by the interrupt controller. Embodiments also include the thread processing one or more entries in a global interrupt status bit queue based on whether global interrupt status bits associated with the globally broadcast interrupt signal are locked. Each entry in the global interrupt status bit queue corresponds to a queued global interrupt.

  4. Analysis of Smartphone Interruptions on Academic General Internal Medicine Wards. Frequent Interruptions may cause a 'Crisis Mode' Work Climate.

    Science.gov (United States)

    Vaisman, Alon; Wu, Robert C

    2017-01-04

    Hospital-based medical services are increasingly utilizing team-based pagers and smartphones to streamline communications. However, an unintended consequence may be higher volumes of interruptions potentially leading to medical error. There is likely a level at which interruptions are excessive and cause a 'crisis mode' climate. We retrospectively collected phone, text messaging, and email interruptions directed to hospital-assigned smartphones on eight General Internal Medicine (GIM) teams at two tertiary care centres in Toronto, Ontario from April 2013 to September 2014. We also calculated the number of times these interruptions exceeded a pre-specified threshold per hour, termed 'crisis mode', defined as at least five interruptions in 30 minutes. We analyzed the correlation between interruptions and date, site, and patient volumes. A total of 187,049 interruptions were collected over an 18-month period. Daily weekday interruptions rose sharply in the morning, peaking between 11 AM to 12 PM and measuring 4.8 and 3.7 mean interruptions/hour at each site, respectively. Mean daily interruptions per team totaled 46.2 ± 3.6 at Site 1 and 39.2 ± 4.2 at Site 2. The 'crisis mode' threshold was exceeded, on average, 2.3 times/day per GIM team during weekdays. In a multivariable linear regression analysis, site (β6.43 CI95% 5.44 - 7.42, ptime.

  5. The time-course of recovery from interruption during reading: eye movement evidence for the role of interruption lag and spatial memory.

    Science.gov (United States)

    Cane, James E; Cauchard, Fabrice; Weger, Ulrich W

    2012-01-01

    Two experiments examined how interruptions impact reading and how interruption lags and the reader's spatial memory affect the recovery from such interruptions. Participants read paragraphs of text and were interrupted unpredictably by a spoken news story while their eye movements were monitored. Time made available for consolidation prior to responding to the interruption did not aid reading resumption. However, providing readers with a visual cue that indicated the interruption location did aid task resumption substantially in Experiment 2. Taken together, the findings show that the recovery from interruptions during reading draws on spatial memory resources and can be aided by processes that support spatial memory. Practical implications are discussed.

  6. Thinking aloud in the presence of interruptions and time constraints

    DEFF Research Database (Denmark)

    Hertzum, Morten; Holmegaard, Kristin Due

    2013-01-01

    and time constraints, two frequent elements of real-world activities. We find that the presence of auditory, visual, audiovisual, or no interruptions interacts with thinking aloud for task solution rate, task completion time, and participants’ fixation rate. Thinking-aloud participants also spend longer......Thinking aloud is widely used for usability evaluation and its reactivity is therefore important to the quality of evaluation results. This study investigates whether thinking aloud (i.e., verbalization at levels 1 and 2) affects the behaviour of users who perform tasks that involve interruptions...... responding to interruptions than control participants. Conversely, the absence or presence of time constraints does not interact with thinking aloud, suggesting that time pressure is less likely to make thinking aloud reactive than previously assumed. Our results inform practitioners faced with the decision...

  7. Ethical dilemmas of a large national multi-centre study in Australia: time for some consistency.

    Science.gov (United States)

    Driscoll, Andrea; Currey, Judy; Worrall-Carter, Linda; Stewart, Simon

    2008-08-01

    To examine the impact and obstacles that individual Institutional Research Ethics Committee (IRECs) had on a large-scale national multi-centre clinical audit called the National Benchmarks and Evidence-based National Clinical guidelines for Heart failure management programmes Study. Multi-centre research is commonplace in the health care system. However, IRECs continue to fail to differentiate between research and quality audit projects. The National Benchmarks and Evidence-based National Clinical guidelines for Heart failure management programmes study used an investigator-developed questionnaire concerning a clinical audit for heart failure programmes throughout Australia. Ethical guidelines developed by the National governing body of health and medical research in Australia classified the National Benchmarks and Evidence-based National Clinical guidelines for Heart failure management programmes Study as a low risk clinical audit not requiring ethical approval by IREC. Fifteen of 27 IRECs stipulated that the research proposal undergo full ethical review. None of the IRECs acknowledged: national quality assurance guidelines and recommendations nor ethics approval from other IRECs. Twelve of the 15 IRECs used different ethics application forms. Variability in the type of amendments was prolific. Lack of uniformity in ethical review processes resulted in a six- to eight-month delay in commencing the national study. Development of a national ethics application form with full ethical review by the first IREC and compulsory expedited review by subsequent IRECs would resolve issues raised in this paper. IRECs must change their ethics approval processes to one that enhances facilitation of multi-centre research which is now normative process for health services. The findings of this study highlight inconsistent ethical requirements between different IRECs. Also highlighted are the obstacles and delays that IRECs create when undertaking multi-centre clinical audits

  8. Network interruptions

    CERN Multimedia

    2005-01-01

    On Sunday 12 June 2005, a site-wide security software upgrade will be performed on all CERN network equipment. This maintenance operation will cause at least 2 short network interruptions of 2 minutes on each equipment item. There are hundreds of such items across the CERN site (Meyrin, Prévessin and all SPS and LHC pits), and it will thus take the whole day to treat them all. All network users and services will be affected. Central batch computing services will be interrupted during this period, expected to last from 8 a.m. until late evening. Job submission will still be possible but no jobs will actually be run. It is hoped to complete the computer centre upgrades in the morning so that stable access can be restored to lxplus, afs and nice services as soon as possible; this cannot be guaranteed, however. The opportunity will be used to interrupt and perform upgrades on the CERN Document Servers.

  9. The effect of interruptions and prolonged treatment time in radiotherapy for nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Kwong, Dora L.W.; Sham, Jonathan S.T.; Chua, Daniel T.T.; Choy, Damon T.K.; Au, Gordon K.H.; Wu, P.M.

    1997-01-01

    Purpose: The effect of interruptions and prolonged overall treatment time in radiotherapy for nasopharyngeal carcinoma and the significance of timing of interruption was investigated. Methods and Materials: Treatment records of 229 patients treated with continuous course (CC) and 567 patients treated with split course (SC) radiotherapy for nonmetastatic NPC were reviewed. Overall treatment time without inclusion of time for boost was calculated. Treatment that extended 1 week beyond scheduled time was considered prolonged. Outcome in patients who completed treatment 'per schedule' were compared with those who had 'prolonged' treatment. Because of known patient selection bias between CC and SC, patients on the two schedules were analyzed separately. Multivariate analysis was performed for patients on SC. Total number of days of interruption, age, sex, T and N stage, and the use of boost were tested for the whole SC group. Analysis on the effect of timing of interruption was performed in a subgroup of 223 patients on SC who had a single unplanned interruption. Timing of interruption, either before or after the fourth week for the unplanned interruption, was tested in addition to the other variables in multivariate analysis for this subgroup of SC. Results: Twenty-seven (11.8%) patients on CC and 96 (16.9%) patients on SC had prolonged treatment. Patients on SC who had prolonged treatment had significantly poorer loco-regional control rate and disease free survival when compared with those who completed radiotherapy per schedule (p = 0.0063 and 0.001, respectively, with adjustment for stage). For CC, the effect of prolonged treatment on outcome was not significant. The small number of events for patients on CC probably account for the insignificant finding. The number of days of interruption was confirmed as prognostic factor, independent of T and N stages, for loco-regional control and disease-free survival in multivariate analysis for SC. The hazard rate for loco

  10. Building a Multi-centre Clinical Research Facilitation Network: The ARC Experience

    Directory of Open Access Journals (Sweden)

    Ian Nicholson

    2017-06-01

    Full Text Available Introduction: In order to practice evidence-based veterinary medicine, good quality clinical evidence needs to be produced, in order that it can be apprasied systematically by the EBVM network, and used by vets. There is very little good-quality veterinary evidence for most of the veterinary procedures carried out every day across the world. Very few, if any, individuals have all the necessary qualities (case-load, time, research expertise, financial support to be able to systematically produce good-quality, and relevant, clinical research on their own, in a timely manner. The Association for Veterinary Soft Tissue Surgery (AVSTS www.avsts.org.uk is an affiliate group with the British Small Animal Veterinary Association (BSAVA, and functions as a clinical network of like-minded individuals. In 2013 AVSTS sought to create a role for itself in facilitating the production (by its members of multi-centre clinical research of relevance to its members.Materials and methods: Members of AVSTS were asked to join the AVSTS Research Cooperative (ARC, with a veterinary epidemiologist and an experienced multi-centre veterinary clinical researcher (to help with study design and statistical planning, and the Animal Health Trust clinical research ethics committee. An email list was established, and a page was set up on the AVSTS website, to allow information to be disseminated. The AVSTS spring and autumn meetings were used as a regular forum by ARC, to discuss its direction, to generate interest, to create and promote specific studies (in order to widen participation amongst different centres, and to update members about previous studies.Results: Membership of ARC has grown to 224 people, although the epidemiologist left. One multi-centre study has been published, two have been presented and await publication, one has been accepted for presentation, two other studies are gathering data at present, and further studies are in the pipeline. There has been

  11. Power Supply Interruption Costs: Models and Methods Incorporating Time Dependent Patterns

    International Nuclear Information System (INIS)

    Kjoelle, G.H.

    1996-12-01

    This doctoral thesis develops models and methods for estimation of annual interruption costs for delivery points, emphasizing the handling of time dependent patterns and uncertainties in the variables determining the annual costs. It presents an analytical method for calculation of annual expected interruption costs for delivery points in radial systems, based on a radial reliability model, with time dependent variables. And a similar method for meshed systems, based on a list of outage events, assuming that these events are found in advance from load flow and contingency analyses. A Monte Carlo simulation model is given which handles both time variations and stochastic variations in the input variables and is based on the same list of outage events. This general procedure for radial and meshed systems provides expectation values and probability distributions for interruption costs from delivery points. There is also a procedure for handling uncertainties in input variables by a fuzzy description, giving annual interruption costs as a fuzzy membership function. The methods are developed for practical applications in radial and meshed systems, based on available data from failure statistics, load registrations and customer surveys. Traditional reliability indices such as annual interruption time, power- and energy not supplied, are calculated as by-products. The methods are presented as algorithms and/or procedures which are available as prototypes. 97 refs., 114 figs., 62 tabs

  12. Power Supply Interruption Costs: Models and Methods Incorporating Time Dependent Patterns

    Energy Technology Data Exchange (ETDEWEB)

    Kjoelle, G.H.

    1996-12-01

    This doctoral thesis develops models and methods for estimation of annual interruption costs for delivery points, emphasizing the handling of time dependent patterns and uncertainties in the variables determining the annual costs. It presents an analytical method for calculation of annual expected interruption costs for delivery points in radial systems, based on a radial reliability model, with time dependent variables. And a similar method for meshed systems, based on a list of outage events, assuming that these events are found in advance from load flow and contingency analyses. A Monte Carlo simulation model is given which handles both time variations and stochastic variations in the input variables and is based on the same list of outage events. This general procedure for radial and meshed systems provides expectation values and probability distributions for interruption costs from delivery points. There is also a procedure for handling uncertainties in input variables by a fuzzy description, giving annual interruption costs as a fuzzy membership function. The methods are developed for practical applications in radial and meshed systems, based on available data from failure statistics, load registrations and customer surveys. Traditional reliability indices such as annual interruption time, power- and energy not supplied, are calculated as by-products. The methods are presented as algorithms and/or procedures which are available as prototypes. 97 refs., 114 figs., 62 tabs.

  13. Interrupted Time Series Versus Statistical Process Control in Quality Improvement Projects.

    Science.gov (United States)

    Andersson Hagiwara, Magnus; Andersson Gäre, Boel; Elg, Mattias

    2016-01-01

    To measure the effect of quality improvement interventions, it is appropriate to use analysis methods that measure data over time. Examples of such methods include statistical process control analysis and interrupted time series with segmented regression analysis. This article compares the use of statistical process control analysis and interrupted time series with segmented regression analysis for evaluating the longitudinal effects of quality improvement interventions, using an example study on an evaluation of a computerized decision support system.

  14. Interrupted time series analysis in drug utilization research is increasing: systematic review and recommendations.

    Science.gov (United States)

    Jandoc, Racquel; Burden, Andrea M; Mamdani, Muhammad; Lévesque, Linda E; Cadarette, Suzanne M

    2015-08-01

    To describe the use and reporting of interrupted time series methods in drug utilization research. We completed a systematic search of MEDLINE, Web of Science, and reference lists to identify English language articles through to December 2013 that used interrupted time series methods in drug utilization research. We tabulated the number of studies by publication year and summarized methodological detail. We identified 220 eligible empirical applications since 1984. Only 17 (8%) were published before 2000, and 90 (41%) were published since 2010. Segmented regression was the most commonly applied interrupted time series method (67%). Most studies assessed drug policy changes (51%, n = 112); 22% (n = 48) examined the impact of new evidence, 18% (n = 39) examined safety advisories, and 16% (n = 35) examined quality improvement interventions. Autocorrelation was considered in 66% of studies, 31% reported adjusting for seasonality, and 15% accounted for nonstationarity. Use of interrupted time series methods in drug utilization research has increased, particularly in recent years. Despite methodological recommendations, there is large variation in reporting of analytic methods. Developing methodological and reporting standards for interrupted time series analysis is important to improve its application in drug utilization research, and we provide recommendations for consideration. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  15. Real time interrupt handling using FORTRAN IV plus under RSX-11M

    International Nuclear Information System (INIS)

    Schultz, D.E.

    1981-01-01

    A real-time data acquisition application for a linear accelerator is described. The important programming features of this application are use of connect to interrupt, a shared library, map to I/O page, and a shared data area. How you can provide rapid interrupt handling using these tools from FORTRAN IV PLUS is explained

  16. Authorship issues in multi-centre clinical trials

    DEFF Research Database (Denmark)

    Rosenberg, Jacob; Burcharth, Jakob; Pommergaard, Hans-Christian

    2015-01-01

    Discussions about authorship often arise in multi-centre clinical trials. Such trials may involve up to hundreds of contributors of whom some will eventually co-author the final publication. It is, however, often impossible to involve all contributors in the manuscript process sufficiently for th...

  17. Authorship issues in multi-centre clinical trials

    DEFF Research Database (Denmark)

    Rosenberg, Jacob; Burcharth, Jakob; Pommergaard, Hans-Christian

    2015-01-01

    to qualify for authorship as defined by the International Committee of Medical Journal Editors. Therefore, rules for authorship in multi-centre trials are strongly recommended. We propose two contracts to prevent conflicts regarding authorship; both are freely available for use without pay but with reference...... to the original source....

  18. Effects of unstratified and centre-stratified randomization in multi-centre clinical trials.

    Science.gov (United States)

    Anisimov, Vladimir V

    2011-01-01

    This paper deals with the analysis of randomization effects in multi-centre clinical trials. The two randomization schemes most often used in clinical trials are considered: unstratified and centre-stratified block-permuted randomization. The prediction of the number of patients randomized to different treatment arms in different regions during the recruitment period accounting for the stochastic nature of the recruitment and effects of multiple centres is investigated. A new analytic approach using a Poisson-gamma patient recruitment model (patients arrive at different centres according to Poisson processes with rates sampled from a gamma distributed population) and its further extensions is proposed. Closed-form expressions for corresponding distributions of the predicted number of the patients randomized in different regions are derived. In the case of two treatments, the properties of the total imbalance in the number of patients on treatment arms caused by using centre-stratified randomization are investigated and for a large number of centres a normal approximation of imbalance is proved. The impact of imbalance on the power of the study is considered. It is shown that the loss of statistical power is practically negligible and can be compensated by a minor increase in sample size. The influence of patient dropout is also investigated. The impact of randomization on predicted drug supply overage is discussed. Copyright © 2010 John Wiley & Sons, Ltd.

  19. Interrupt Handlers in Java

    DEFF Research Database (Denmark)

    Korsholm, Stephan; Schoeberl, Martin; Ravn, Anders Peter

    2008-01-01

    An important part of implementing device drivers is to control the interrupt facilities of the hardware platform and to program interrupt handlers. Current methods for handling interrupts in Java use a server thread waiting for the VM to signal an interrupt occurrence. It means that the interrupt...... is handled at a later time, which has some disadvantages. We present constructs that allow interrupts to be handled directly and not at a later point decided by a scheduler. A desirable feature of our approach is that we do not require a native middleware layer but can handle interrupts entirely with Java...... code. We have implemented our approach using an interpreter and a Java processor, and give an example demonstrating its use....

  20. PERFORMANCE COMPARISON OF USART COMMUNICATION BETWEEN REAL TIME OPERATING SYSTEM (RTOS AND NATIVE INTERRUPT

    Directory of Open Access Journals (Sweden)

    Novian Habibie

    2016-02-01

    Full Text Available Comunication between microcontrollers is one of the crucial point in embedded sytems. On the other hand, embedded system must be able to run many parallel task simultaneously. To handle this, we need a reliabe system that can do a multitasking without decreasing every task’s performance. The most widely used methods for multitasking in embedded systems are using Interrupt Service Routine (ISR or using Real Time Operating System (RTOS. This research compared perfomance of USART communication on system with RTOS to a system that use interrupt. Experiments run on two identical development board XMega A3BU-Xplained which used intenal sensor (light and temperature and used servo as external component. Perfomance comparison done by counting ping time (elapsing time to transmit data and get a reply as a mark that data has been received and compare it. This experiments divided into two scenarios: (1 system loaded with many tasks, (2 system loaded with few tasks. Result of the experiments show that communication will be faster if system only loaded with few tasks. System with RTOS has won from interrupt in case (1, but lose to interrupt in case (2.

  1. BED-time charts and their application to the problems of interruptions in external beam radiotherapy treatments

    International Nuclear Information System (INIS)

    Sinclair, Judith A.; Oates, Jason P.; Dale, Roger G.

    1999-01-01

    Purpose: The use of radiobiological modelling to examine the likely consequences of interruptions to radiotherapy schedules and to assess various compensatory measures. Methods and Materials: An effect-time graphical display, the BED-time chart, has been developed using the linear-quadratic (LQ) model. This is used to examine the effects on tumour and normal tissues of treatment interruption scenarios representative of clinical situations. The mathematical criteria governing successful salvage have also been drafted and applied to typical situations. Results: The successful salvage of an interrupted treatment is dependent on a number of interacting factors and the method presented here can be used to examine the trade-offs that exist. Although the mathematics may be complex, it is shown that the dilemmas posed by an interrupted treatment may be more easily appreciated with reference to BED-time charts. These may therefore have a useful role as a teaching aid for portraying a wider variety of radiotherapy problems and also in the documentation of interruptions to treatment and the measures taken to compensate for them. Conclusions: Interruptions to radiotherapy regimes are undesirable and compensatory measures need to be initiated as soon as possible after the gap, with a view to completing the amended treatment within the originally prescribed treatment time. Adequate compensation is particularly difficult for long gaps and gaps which occur towards the end of the scheduled treatment. Modelling exercises can help establish guidelines on the available windows of opportunity

  2. The Impact of the Hotel Room Tax: An Interrupted Time Series Approach

    OpenAIRE

    Bonham, Carl; Fujii, Edwin; Im, Eric; Mak, James

    1992-01-01

    Employs interrupted time series analysis to estimate ex post the impact of a hotel room tax on real net hotel revenues by analyzing that time series before and after the imposition of the tax. Finds that the tax had a negligible effect on real hotel revenues.

  3. Dosimetry audit for a multi-centre IMRT head and neck trial

    International Nuclear Information System (INIS)

    Clark, Catharine H.; Hansen, Vibeke Nordmark; Chantler, Hannah; Edwards, Craig; James, Hayley V.; Webster, Gareth; Miles, Elizabeth A.; Guerrero Urbano, M. Teresa; Bhide, Shree A.; Bidmead, A. Margaret; Nutting, Christoper M.

    2009-01-01

    Background and purpose: PARSPORT was a multi-centre randomised trial in the UK which compared Intensity-Modulated Radiotherapy (IMRT) and conventional radiotherapy (CRT) for patients with head and neck cancer. The dosimetry audit goals were to verify the plan delivery in participating centres, ascertain what tolerances were suitable for head and neck IMRT trials and develop an IMRT credentialing program. Materials and methods: Centres enrolling patients underwent rigorous quality assurance before joining the trial. Following this each centre was visited for a dosimetry audit, which consisted of treatment planning system tests, fluence verification films, combined field films and dose point measurements. Results: Mean dose point measurements were made at six centres. For the primary planning target volume (PTV) the differences with the planned values for the IMRT and CRT arms were -0.6% (1.8% to -2.4%) and 0.7% (2.0% to -0.9%), respectively. Ninety-four percent of the IMRT fluence films for individual fields passed gamma criterion of 3%/3 mm and 75% of the films for combined fields passed gamma criterion 4%/3 mm (no significant difference between dynamic delivery and step and shoot delivery). Conclusions: This audit suggests that a 3% tolerance could be applied for PTV point doses. For dose distributions tolerances of 3%/3 mm on individual fields and 4%/3 mm for combined fields are proposed for multi-centre head and neck IMRT trials.

  4. Graphical Data Analysis on the Circle: Wrap-Around Time Series Plots for (Interrupted) Time Series Designs.

    Science.gov (United States)

    Rodgers, Joseph Lee; Beasley, William Howard; Schuelke, Matthew

    2014-01-01

    Many data structures, particularly time series data, are naturally seasonal, cyclical, or otherwise circular. Past graphical methods for time series have focused on linear plots. In this article, we move graphical analysis onto the circle. We focus on 2 particular methods, one old and one new. Rose diagrams are circular histograms and can be produced in several different forms using the RRose software system. In addition, we propose, develop, illustrate, and provide software support for a new circular graphical method, called Wrap-Around Time Series Plots (WATS Plots), which is a graphical method useful to support time series analyses in general but in particular in relation to interrupted time series designs. We illustrate the use of WATS Plots with an interrupted time series design evaluating the effect of the Oklahoma City bombing on birthrates in Oklahoma County during the 10 years surrounding the bombing of the Murrah Building in Oklahoma City. We compare WATS Plots with linear time series representations and overlay them with smoothing and error bands. Each method is shown to have advantages in relation to the other; in our example, the WATS Plots more clearly show the existence and effect size of the fertility differential.

  5. Efficacy of night-time compression for breast cancer related lymphedema (LYNC): protocol for a multi-centre, randomized controlled efficacy trial

    International Nuclear Information System (INIS)

    McNeely, Margaret L.; Campbell, Kristin L.; Webster, Marc; Kuusk, Urve; Tracey, Karen; Mackey, John

    2016-01-01

    Lymphedema is a prevalent long-term effect of breast cancer treatment that is associated with reduced quality of life. More recent observational data suggest that the addition of night-time compression to day-time use of a compression garment results in better long-term control of arm lymphedema. The primary objectives of the randomized controlled phase of the trial are to determine the efficacy of night-time compression on arm lymphedema volume maintenance and quality of life in breast cancer survivors who have completed intensive reduction treatment for their lymphedema. The study will be a parallel 3-arm, multi-centre randomized fast-track trial. A total of 120 women with breast cancer related lymphedema will be recruited from 3 centres in Canada and randomized to group 1: Day-time compression garment alone or Group 2: Day-time compression garment + night-time compression bandaging or Group 3: Day-time compression garment + use of a night-time compression system garment. The duration of the primary intervention period will be 12 weeks. The follow-up period after the intervention (weeks 13 to 24) will follow a longitudinal observational design. The primary outcome variables: differences from baseline to week 12 in arm volume and quality of life (Lymphoedema Functioning, Disability and Health Questionnaire: Lymph-ICF). Secondary outcomes include bioimpedance analysis, sleep disturbance and self-efficacy. All measurements are standardized and will be performed prior to randomization, and at weeks 6, 12, 18 and 24. The use of night-time compression as a self-management strategy for chronic breast cancer related lymphedema is seen as an innovative approach to improve long-term control over the condition. This trial aims to advance the knowledge on self-management strategies for lymphedema

  6. Multi-disciplinary facilities at the centre for nuclear sciences, U.W.I

    International Nuclear Information System (INIS)

    Lalor, G.C.; Robotham, H.

    1994-01-01

    The Centre for Nuclear Sciences was established in 1984 with the mandate to introduce Caribbean scientists to the application of nuclear technology in multi-disciplinary studies, and to carry out research in areas of national and regional importance. It describes the present facilities and the major programmes being carried out at the Centre. (author) 9 refs

  7. Distributed Scheduling to Support a Call Centre: a Co-operative Multi-Agent Approach

    NARCIS (Netherlands)

    Brazier, F.M.; Jonker, C.M.; Jungen, F.J.; Treur, J.; Nwana, H.S.

    1998-01-01

    This paper describes a multi-agent system architecture to increase the value of 24 hour a day call centre service. This system supports call centres in making appointments with clients on the basis of knowledge of employees and their schedules. Relevant activities of employees are scheduled for

  8. Coronary CT angiography using 64 detector rows: methods and design of the multi-centre trial CORE-64

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Julie M.; Vavere, Andrea L.; Arbab-Zadeh, Armin; Bush, David E.; Lardo, Albert C.; Texter, John; Brinker, Jeffery; Lima, Joao A.C. [Johns Hopkins Hospital, Johns Hopkins University, Department of Medicine, Division of Cardiology, Baltimore, MD (United States); Dewey, Marc [Charite - Universitaetsmedizin Berlin, Medical School, Humboldt-Universitaet und Freie Universitaet zu Berlin, Department of Radiology, Berlin, PO Box 10098 (Germany); Rochitte, Carlos E.; Lemos, Pedro A. [University of Sao Paulo Medical School, Heart Institute (InCor), Sao Paulo (Brazil); Niinuma, Hiroyuki [Iwate Medical University, Department of Cardiology, Morioka (Japan); Paul, Narinder [Toronto General Hospital, Department of Medical Imaging, Toronto (Canada); Hoe, John [Medi-Rad Associates Ltd, CT Centre, Mt Elizabeth Hospital, Singapore (Singapore); Roos, Albert de [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Yoshioka, Kunihiro [Iwate Medical University, Department of Radiology, Morioka (Japan); Cox, Christopher [Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD (United States); Clouse, Melvin E. [Harvard University, Department of Radiology, Beth Israel Deaconess, Boston, MA (United States)

    2009-04-15

    Multislice computed tomography (MSCT) for the noninvasive detection of coronary artery stenoses is a promising candidate for widespread clinical application because of its non-invasive nature and high sensitivity and negative predictive value as found in several previous studies using 16 to 64 simultaneous detector rows. A multi-centre study of CT coronary angiography using 16 simultaneous detector rows has shown that 16-slice CT is limited by a high number of nondiagnostic cases and a high false-positive rate. A recent meta-analysis indicated a significant interaction between the size of the study sample and the diagnostic odds ratios suggestive of small study bias, highlighting the importance of evaluating MSCT using 64 simultaneous detector rows in a multi-centre approach with a larger sample size. In this manuscript we detail the objectives and methods of the prospective ''CORE-64'' trial (''Coronary Evaluation Using Multidetector Spiral Computed Tomography Angiography using 64 Detectors''). This multi-centre trial was unique in that it assessed the diagnostic performance of 64-slice CT coronary angiography in nine centres worldwide in comparison to conventional coronary angiography. In conclusion, the multi-centre, multi-institutional and multi-continental trial CORE-64 has great potential to ultimately assess the per-patient diagnostic performance of coronary CT angiography using 64 simultaneous detector rows. (orig.)

  9. Assessment of data quality in an international multi-centre randomised trial of coronary artery surgery

    Directory of Open Access Journals (Sweden)

    Bochenek Andrzej

    2011-09-01

    Full Text Available Abstract Background ART is a multi-centre randomised trial of cardiac surgery which provided a unique opportunity to evaluate the data from a large number of centres from a variety of countries. We attempted to assess data quality, including recruitment rates, timeliness and completeness of the data obtained from the centres in different socio-economic strata. Methods The analysis was based on the 2-page CRF completed at the 6 week follow-up. CRF pages were categorised into "clean" (no edit query and "dirty" (any incomplete, inconsistent or illegible data. The timelines were assessed on the basis of the time interval from the visit and receipt of complete CRF. Data quality was defined as the number of data queries (in percent and time delay (in days between visit and receipt of correct data. Analyses were stratified according to the World Bank definitions into: "Developing" countries (Poland, Brazil and India and "Developed" (Italy, UK, Austria and Australia. Results There were 18 centres in the "Developed" and 10 centres in the "Developing" countries. The rate of enrolment did not differ significantly by economic level ("Developing":4.1 persons/month, "Developed":3.7 persons/month. The time interval for the receipt of data was longer for "Developing" countries (median:37 days compared to "Developed" ones (median:11 days (p Conclusions In this study we showed that data quality was comparable between centres from "Developed" and "Developing" countries. Data was received in a less timely fashion from Developing countries and appropriate systems should be instigated to minimize any delays. Close attention should be paid to the training of centres and to the central management of data quality. Trial registration ISRCTN46552265

  10. Health Facility Utilisation Changes during the Introduction of Community Case Management of Malaria in South Western Uganda: An Interrupted Time Series Approach.

    Directory of Open Access Journals (Sweden)

    Sham Lal

    Full Text Available Malaria endemic countries have scaled-up community health worker (CHW interventions, to diagnose and treat malaria in communities with limited access to public health systems. The evaluations of these programmes have centred on CHW's compliance to guidelines, but the broader changes at public health centres including utilisation and diagnoses made, has received limited attention.This analysis was conducted during a CHW-intervention for malaria in Rukungiri District, Western Uganda. Outpatient department (OPD visit data were collected for children under-5 attending three health centres one year before the CHW-intervention started (pre-intervention period and for 20 months during the intervention (intervention-period. An interrupted time series analysis with segmented regression models was used to compare the trends in malaria, non-malaria and overall OPD visits during the pre-intervention and intervention-period.The introduction of a CHW-intervention suggested the frequency of diagnoses of diarrhoeal diseases, pneumonia and helminths increased, whilst the frequency of malaria diagnoses declined at health centres. In May 2010 when the intervention began, overall health centre utilisation decreased by 63% compared to the pre-intervention period and the health centres saw 32 fewer overall visits per month compared to the pre-intervention period (p<0.001. Malaria visits also declined shortly after the intervention began and there were 27 fewer visits per month during the intervention-period compared with the pre-intervention period (p<0.05. The declines in overall and malaria visits were sustained for the entire intervention-period. In contrast, there were no observable changes in trends of non-malarial visits between the pre-intervention and intervention-period.This analysis suggests introducing a CHW-intervention can reduce the number of child malaria visits and change the profile of cases presenting at health centres. The reduction in workload of

  11. Effects of Interruptibility-Aware Robot Behavior

    OpenAIRE

    Banerjee, Siddhartha; Silva, Andrew; Feigh, Karen; Chernova, Sonia

    2018-01-01

    As robots become increasingly prevalent in human environments, there will inevitably be times when a robot needs to interrupt a human to initiate an interaction. Our work introduces the first interruptibility-aware mobile robot system, and evaluates the effects of interruptibility-awareness on human task performance, robot task performance, and on human interpretation of the robot's social aptitude. Our results show that our robot is effective at predicting interruptibility at high accuracy, ...

  12. Causes of unplanned interruption of radiotherapy

    International Nuclear Information System (INIS)

    Diegues, Sylvia Suelotto; Ciconelli, Rozana Mesquita; Segreto, Roberto Araujo

    2008-01-01

    Objective: To evaluate the occurrence and causes of unplanned interruption of radiotherapy. Materials and methods: Retrospective study developed in the Division of Radiotherapy of Hospital Alemao Oswaldo Cruz in Sao Paulo, SP, Brazil, with data collected from 560 dossiers of patients submitted to radiotherapy in the period between January 1, 2005 and December 31, 2005. Chi-squared and Student t tests were utilized in the data analysis, and p < 0.05 was considered as statistically significant. Results: Interruption of treatment was identified in 350 cases, corresponding to 62.5% of the patients. The reasons for treatment interruption were the following: preventive device maintenance (55%), patient's own private reasons (13%), adverse reactions to the treatment or to combined radiotherapy/chemotherapy (6%), clinical worsening (3%), two or more combined reasons (23%). The interruption time interval ranged between 1 and 24 days (mean 1.4 day). One-day interruption was mostly due to preventive device maintenance (84.4%); two-five-day interruption was due to combined reasons (48.28%). Conclusion: The most frequent cause of interruption was preventive device maintenance, with maximum two-day time interval. (author)

  13. Understanding Emergency Medicine Physicians Multitasking Behaviors Around Interruptions.

    Science.gov (United States)

    Fong, Allan; Ratwani, Raj M

    2018-06-11

    Interruptions can adversely impact human performance, particularly in fast-paced and high-risk environments such as the emergency department (ED). Understanding physician behaviors before, during, and after interruptions is important to the design and promotion of safe and effective workflow solutions. However, traditional human factors based interruption models do not accurately reflect the complexities of real-world environments like the ED and may not capture multiple interruptions and multitasking. We present a more comprehensive framework for understanding interruptions that is composed of three phases, each with multiple levels: Interruption Start Transition, Interruption Engagement, and Interruption End Transition. This three-phase framework is not constrained to discrete task transitions, providing a robust method to categorize multitasking behaviors around interruptions. We apply this framework in categorizing 457 interruption episodes. 457 interruption episodes were captured during 36 hours of observation. The interrupted task was immediately suspended 348 (76.1%) times. Participants engaged in new self-initiated tasks during the interrupting task 164 (35.9%) times and did not directly resume the interrupted task in 284 (62.1%) interruption episodes. Using this framework provides a more detailed description of the types of physician behaviors in complex environments. Understanding the different types of interruption and resumption patterns, which may have a different impact on performance, can support the design of interruption mitigation strategies. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  14. Real-Time Predictions of Reservoir Size and Rebound Time during Antiretroviral Therapy Interruption Trials for HIV.

    Directory of Open Access Journals (Sweden)

    Alison L Hill

    2016-04-01

    Full Text Available Monitoring the efficacy of novel reservoir-reducing treatments for HIV is challenging. The limited ability to sample and quantify latent infection means that supervised antiretroviral therapy (ART interruption studies are generally required. Here we introduce a set of mathematical and statistical modeling tools to aid in the design and interpretation of ART-interruption trials. We show how the likely size of the remaining reservoir can be updated in real-time as patients continue off treatment, by combining the output of laboratory assays with insights from models of reservoir dynamics and rebound. We design an optimal schedule for viral load sampling during interruption, whereby the frequency of follow-up can be decreased as patients continue off ART without rebound. While this scheme can minimize costs when the chance of rebound between visits is low, we find that the reservoir will be almost completely reseeded before rebound is detected unless sampling occurs at least every two weeks and the most sensitive viral load assays are used. We use simulated data to predict the clinical trial size needed to estimate treatment effects in the face of highly variable patient outcomes and imperfect reservoir assays. Our findings suggest that large numbers of patients-between 40 and 150-will be necessary to reliably estimate the reservoir-reducing potential of a new therapy and to compare this across interventions. As an example, we apply these methods to the two "Boston patients", recipients of allogeneic hematopoietic stem cell transplants who experienced large reductions in latent infection and underwent ART-interruption. We argue that the timing of viral rebound was not particularly surprising given the information available before treatment cessation. Additionally, we show how other clinical data can be used to estimate the relative contribution that remaining HIV+ cells in the recipient versus newly infected cells from the donor made to the

  15. Authorship issues in multi-centre clinical trials: the importance of making an authorship contract.

    Science.gov (United States)

    Rosenberg, Jacob; Burcharth, Jakob; Pommergaard, Hans-Christian; Vinther, Siri

    2015-02-01

    Discussions about authorship often arise in multi-centre clinical trials. Such trials may involve up to hundreds of contributors of whom some will eventually co-author the final publication. It is, however, often impossible to involve all contributors in the manuscript process sufficiently for them to qualify for authorship as defined by the International Committee of Medical Journal Editors. Therefore, rules for authorship in multi-centre trials are strongly recommended. We propose two contracts to prevent conflicts regarding authorship; both are freely available for use without pay but with reference to the original source.

  16. Using machine learning to identify structural breaks in single-group interrupted time series designs.

    Science.gov (United States)

    Linden, Ariel; Yarnold, Paul R

    2016-12-01

    Single-group interrupted time series analysis (ITSA) is a popular evaluation methodology in which a single unit of observation is being studied, the outcome variable is serially ordered as a time series and the intervention is expected to 'interrupt' the level and/or trend of the time series, subsequent to its introduction. Given that the internal validity of the design rests on the premise that the interruption in the time series is associated with the introduction of the treatment, treatment effects may seem less plausible if a parallel trend already exists in the time series prior to the actual intervention. Thus, sensitivity analyses should focus on detecting structural breaks in the time series before the intervention. In this paper, we introduce a machine-learning algorithm called optimal discriminant analysis (ODA) as an approach to determine if structural breaks can be identified in years prior to the initiation of the intervention, using data from California's 1988 voter-initiated Proposition 99 to reduce smoking rates. The ODA analysis indicates that numerous structural breaks occurred prior to the actual initiation of Proposition 99 in 1989, including perfect structural breaks in 1983 and 1985, thereby casting doubt on the validity of treatment effects estimated for the actual intervention when using a single-group ITSA design. Given the widespread use of ITSA for evaluating observational data and the increasing use of machine-learning techniques in traditional research, we recommend that structural break sensitivity analysis is routinely incorporated in all research using the single-group ITSA design. © 2016 John Wiley & Sons, Ltd.

  17. Surgical timing after chemoradiotherapy for rectal cancer, analysis of technique (STARRCAT): results of a feasibility multi-centre randomized controlled trial.

    Science.gov (United States)

    Foster, J D; Ewings, P; Falk, S; Cooper, E J; Roach, H; West, N P; Williams-Yesson, B A; Hanna, G B; Francis, N K

    2016-10-01

    The optimal time of rectal resection after long-course chemoradiotherapy (CRT) remains unclear. A feasibility study was undertaken for a multi-centre randomized controlled trial evaluating the impact of the interval after chemoradiotherapy on the technical complexity of surgery. Patients with rectal cancer were randomized to either a 6- or 12-week interval between CRT and surgery between June 2012 and May 2014 (ISRCTN registration number: 88843062). For blinded technical complexity assessment, the Observational Clinical Human Reliability Analysis technique was used to quantify technical errors enacted within video recordings of operations. Other measured outcomes included resection completeness, specimen quality, radiological down-staging, tumour cell density down-staging and surgeon-reported technical complexity. Thirty-one patients were enrolled: 15 were randomized to 6 and 16-12 weeks across 7 centres. Fewer eligible patients were identified than had been predicted. Of 23 patients who underwent resection, mean 12.3 errors were observed per case at 6 weeks vs. 10.7 at 12 weeks (p = 0.401). Other measured outcomes were similar between groups. The feasibility of measurement of operative performance of rectal cancer surgery as an endpoint was confirmed in this exploratory study. Recruitment of sufficient numbers of patients represented a challenge, and a proportion of patients did not proceed to resection surgery. These results suggest that interval after CRT may not substantially impact upon surgical technical performance.

  18. The Future of Leisure Time Centres in Decin

    OpenAIRE

    Hochwalderová, Světluše

    2014-01-01

    This Bachelor thesis deals with the issue of extracurricular education in Decin. The goal of the thesis is to find out whether the conditions for providing extracurricular education in leisure time centres and basic schools can influence the future of leisure time centres. Another goal of the thesis is to map and analyse the offer ot extracurricular activities in leisrue time centres and basic schools. The theoretical part is based on literature, laws, regulations and available resources. The...

  19. Identifying biological pathway interrupting toxins using multi-tree ensembles

    Directory of Open Access Journals (Sweden)

    Gergo Barta

    2016-08-01

    Full Text Available The pharmaceutical industry constantly seeks new ways to improve current methods that scientists use to evaluate environmental chemicals and develop new medicines. Various automated steps are involved in the process as testing hundreds of thousands of chemicals manually would be infeasible. Our research effort and the Toxicology in the 21st Century Data Challenge focused on cost-effective automation of toxicological testing, a chemical substance screening process looking for possible toxic effects caused by interrupting biological pathways. The computational models we propose in this paper successfully combine various publicly available substance fingerprinting tools with advanced machine learning techniques. In our paper, we explore the significance and utility of assorted feature selection methods as the structural analyzers generate a plethora of features for each substance. Machine learning models were carefully selected and evaluated based on their capability to cope with the high-dimensional high-variety data with multi-tree ensemble methods coming out on top. Techniques like Random forests and Extra trees combine numerous simple tree models and proved to produce reliable predictions on toxic activity while being nearly non-parametric and insensitive to dimensionality extremes. The Tox21 Data Challenge contest offered a great platform to compare a wide range of solutions in a controlled and orderly manner. The results clearly demonstrate that the generic approach presented in this paper is comparable to advanced deep learning and domain-specific solutions. Even surpassing the competition in some nuclear receptor signaling and stress pathway assays and achieving an accuracy of up to 94 percent.

  20. Proposal for the standardisation of multi-centre trials in nuclear medicine imaging

    DEFF Research Database (Denmark)

    Dickson, John Caddell; Tossici-Bolt, Livia; Sera, Terez

    2012-01-01

    Multi-centre trials are an important part of proving the efficacy of procedures, drugs and interventions. Imaging components in such trials are becoming increasingly common; however, without sufficient control measures the usefulness of these data can be compromised. This paper describes a framew...

  1. Vacuum interrupters used for the interruption of high dc currents

    International Nuclear Information System (INIS)

    Warren, R.W.

    1977-01-01

    Conventional ac vacuum interrupters are being used to interrupt currents in pulsed energy storage systems. They have been tested with dc currents of up to 37 kA. The limit to the current which can be successfully interrupted has been measured as a function of various parameters. Among these are (1) the size of the interrupter, (2) the magnitude of the counterpulse current, (3) the nature and flux rating of the saturable reactor used, and (4) the kind of ''snubber'' circuit used. Fragmentary data have also been collected on electrode erosion rates and on mechanical failure of the bellows. A description is given of the circuits used in these tests and of the results found for a representative selection of the commercially available domestic interrupters. More recently efforts have been made to increase the values found for the maximum interruptible current. The techniques used have included connecting interrupters in parallel and operating them in an impressed axial magnetic field. The results of this work are discussed

  2. Static Checking of Interrupt-driven Software

    DEFF Research Database (Denmark)

    Brylow, Dennis; Damgaard, Niels; Palsberg, Jens

    2001-01-01

    at the assembly level. In this paper we present the design and implementation of a static checker for interrupt-driven Z86-based software with hard real-time requirements. For six commercial microcontrollers, our checker has produced upper bounds on interrupt latencies and stack sizes, as well as verified...

  3. Multi-centre audit of VMAT planning and pre-treatment verification.

    Science.gov (United States)

    Jurado-Bruggeman, Diego; Hernández, Victor; Sáez, Jordi; Navarro, David; Pino, Francisco; Martínez, Tatiana; Alayrach, Maria-Elena; Ailleres, Norbert; Melero, Alejandro; Jornet, Núria

    2017-08-01

    We performed a multi-centre intercomparison of VMAT dose planning and pre-treatment verification. The aims were to analyse the dose plans in terms of dosimetric quality and deliverability, and to validate whether in-house pre-treatment verification results agreed with those of an external audit. The nine participating centres encompassed different machines, equipment, and methodologies. Two mock cases (prostate and head and neck) were planned using one and two arcs. A plan quality index was defined to compare the plans and different complexity indices were calculated to check their deliverability. We compared gamma index pass rates using the centre's equipment and methodology to those of an external audit (global 3D gamma, absolute dose differences, 10% of maximum dose threshold). Log-file analysis was performed to look for delivery errors. All centres fulfilled the dosimetric goals but plan quality and delivery complexity were heterogeneous and uncorrelated, depending on the manufacturer and the planner's methodology. Pre-treatment verifications results were within tolerance in all cases for gamma 3%-3mm evaluation. Nevertheless, differences between the external audit and in-house measurements arose due to different equipment or methodology, especially for 2%-2mm criteria with differences up to 20%. No correlation was found between complexity indices and verification results amongst centres. All plans fulfilled dosimetric constraints, but plan quality and complexity did not correlate and were strongly dependent on the planner and the vendor. In-house measurements cannot completely replace external audits for credentialing. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Low sodium diet and pregnancy-induced hypertension: a multi-centre randomised controlled trial

    NARCIS (Netherlands)

    Knuist, M.; Bonsel, G. J.; Zondervan, H. A.; Treffers, P. E.

    1998-01-01

    To examine the effectiveness of the standard policy in the Netherlands to prescribe a sodium restricted diet to prevent or to treat mild pregnancy-induced hypertension. Multi-centre randomised controlled trial between April 1992 and April 1994. Seven practices of independent midwives and one

  5. A high-throughput, multi-channel photon-counting detector with picosecond timing

    CERN Document Server

    Lapington, J S; Miller, G M; Ashton, T J R; Jarron, P; Despeisse, M; Powolny, F; Howorth, J; Milnes, J

    2009-01-01

    High-throughput photon counting with high time resolution is a niche application area where vacuum tubes can still outperform solid-state devices. Applications in the life sciences utilizing time-resolved spectroscopies, particularly in the growing field of proteomics, will benefit greatly from performance enhancements in event timing and detector throughput. The HiContent project is a collaboration between the University of Leicester Space Research Centre, the Microelectronics Group at CERN, Photek Ltd., and end-users at the Gray Cancer Institute and the University of Manchester. The goal is to develop a detector system specifically designed for optical proteomics, capable of high content (multi-parametric) analysis at high throughput. The HiContent detector system is being developed to exploit this niche market. It combines multi-channel, high time resolution photon counting in a single miniaturized detector system with integrated electronics. The combination of enabling technologies; small pore microchanne...

  6. Comparison Groups in Short Interrupted Time-Series: An Illustration Evaluating No Child Left Behind

    Science.gov (United States)

    Wong, Manyee; Cook, Thomas D.; Steiner, Peter M.

    2009-01-01

    Interrupted time-series (ITS) are often used to assess the causal effect of a planned or even unplanned shock introduced into an on-going process. The pre-intervention slope is supposed to index the causal counterfactual, and deviations from it in mean, slope or variance are used to indicate an effect. However, a secure causal inference is only…

  7. Evaluation of the preliminary auditory profile test battery in an international multi-centre study

    NARCIS (Netherlands)

    van Esch, T.E.M.; Kollmeier, B.; Vormann, M.; Lijzenga, J.; Houtgast, T.; Hallgren, M.; Larsby, B.; Athalye, S.P.; Lutman, M.E.; Dreschler, W.A.

    2013-01-01

    Objective: This paper describes the composition and international multi-centre evaluation of a battery of tests termed the preliminary auditory profile. It includes measures of loudness perception, listening effort, speech perception, spectral and temporal resolution, spatial hearing, self-reported

  8. The Effects of Interruptions on Oncologists' Patient Assessment and Medication Ordering Practices

    Directory of Open Access Journals (Sweden)

    Patricia L. Trbovich

    2013-01-01

    Full Text Available Interruptions are causal factors in medication errors. Although researchers have assessed the nature and frequency of interruptions during medication administration, there has been little focus on understanding their effects during medication ordering. The goal of this research was to examine the nature, frequency, and impact of interruptions on oncologists' ordering practices. Direct observations were conducted at a Canadian cancer treatment facility to (1 document the nature, frequency, and timing of interruptions during medication ordering, and (2 quantify the use of coping mechanisms by oncologists. On average, oncologists were interrupted 17 % of their time, and were frequently interrupted during safety-critical stages of medication ordering. When confronted with interruptions, oncologists engaged/multitasked more often than resorting to deferring/blocking. While some interruptions are necessary forms of communication, efforts must be made to reduce unnecessary interruptions during safety-critical tasks, and to develop interventions that increase oncologists' resiliency to inevitable interruptions.

  9. Prevention of brachial plexus injury-12 years of shoulder dystocia training: an interrupted time-series study.

    Science.gov (United States)

    Crofts, J F; Lenguerrand, E; Bentham, G L; Tawfik, S; Claireaux, H A; Odd, D; Fox, R; Draycott, T J

    2016-01-01

    To investigate management and outcomes of incidences of shoulder dystocia in the 12 years following the introduction of an obstetric emergencies training programme. Interrupted time-series study comparing management and neonatal outcome of births complicated by shoulder dystocia over three 4-year periods: (i) Pre-training (1996-99), (ii) Early training (2001-04), and (iii) Late training (2009-12). Southmead Hospital, Bristol, UK, with approximately 6000 births per annum. Infants and their mothers who experienced shoulder dystocia. A bi-monthly multi-professional 1-day intrapartum emergencies training course, that included a 30-minute practical session on shoulder dystocia management, commenced in 2000. Neonatal morbidity (brachial plexus injury, humeral fracture, clavicular fracture, 5-minute Apgar score dystocia (resolution manoeuvres performed, traction applied, head-to-body delivery interval). Compliance with national guidance improved with continued training. At least one recognised resolution manoeuvre was used in 99.8% (561/562) of cases of shoulder dystocia in the late training period, demonstrating a continued improvement from 46.3% (150/324, P dystocia. © 2015 Royal College of Obstetricians and Gynaecologists.

  10. Opioid interruptions, pain, and withdrawal symptoms in nursing home residents.

    Science.gov (United States)

    Redding, Sarah E; Liu, Sophia; Hung, William W; Boockvar, Kenneth S

    2014-11-01

    Interruptions in opioid use have the potential to cause pain relapse and withdrawal symptoms. The objectives of this study were to observe patterns of opioid interruption during acute illness in nursing home residents and examine associations between interruptions and pain and withdrawal symptoms. Patients from 3 nursing homes in a metropolitan area who were prescribed opioids were assessed for symptoms of pain and withdrawal by researchers blinded to opioid dosage received, using the Brief Pain Inventory Scale and the Clinical Opioid Withdrawal Scale, respectively, during prespecified time periods. The prespecified time periods were 2 weeks after onset of acute illness (eg, urinary tract infection), and 2 weeks after hospital admission and nursing home readmission, if they occurred. Opioid dosing was recorded and a significant interruption was defined as a complete discontinuation or a reduction in dose of >50% for ≥1 day. The covariates age, sex, race, comorbid conditions, initial opioid dose, and initial pain level were recorded. Symptoms pre- and post-opioid interruptions were compared and contrasted with those in a group without opioid interruptions. Sixty-six patients receiving opioids were followed for a mean of 10.9 months and experienced a total of 104 acute illnesses. During 64 (62%) illnesses, patients experienced any reduction in opioid dosing, with a mean (SD) dose reduction of 63.9% (29.9%). During 39 (38%) illnesses, patients experienced a significant opioid interruption. In a multivariable model, residence at 1 of the 3 nursing homes was associated with a lower risk of interruption (odds ratio = 0.073; 95% CI, 0.009 to 0.597; P pain score (difference -0.50 [2.66]; 95% CI, -3.16 to 2.16) and withdrawal score (difference -0.91 [3.12]; 95% CI, -4.03 to 2.21) after the interruption as compared with before interruption. However, when compared with patients without interruptions, patients with interruptions experienced larger increases in pain scores

  11. Researches on Nutritional Behaviour in Romanian Black and White Primiparous Cows. Interruptions Number and their Duration in the Ration Consumption Time

    Directory of Open Access Journals (Sweden)

    Silvia Erina

    2012-10-01

    Full Text Available The study was carried out on 9 Romanian Black and White primiparous cows. The aim of this study was todetermine some aspect of nutritional behaviour of the cows. During the experiments, the following behaviour aspectswere determined: interruption number and their duration in the feed consumption time. Results showed that theadministration order of forages had an influence on the interruptions number, which was 0.74 less for hay in fibroussucculentorder (O1. For silage, the interruption number was 0.42 higher in fibrous-succulent order (O1. Betweenportion 1 (P1 and portion 3 (P3, the significant difference (p<0.05 was for interruptions duration, duringconsumption silage, in favour portion P1. Distinct significant differences (p<0.01 was observed for the interruptionnumber during consumption silage (0.95 sec. higher in P1 than in P3, for interruption duration (5.96 sec. higher inP1 than in P3. Between P2 and P3, significant difference (p<0.05 was observed for interruptions number duringconsumption silage and for average interruptions duration during consumption beet in favour to portion P2.Regarding the number of feedings per portion, always the differences were higher in the second feeding F1 than inthe first feeding F2.

  12. Individual Differences in Working-Memory Capacity and Task Resumption Following Interruptions

    Science.gov (United States)

    Foroughi, Cyrus K.; Werner, Nicole E.; McKendrick, Ryan; Cades, David M.; Boehm-Davis, Deborah A.

    2016-01-01

    Previous research has shown that there is a time cost (i.e., a resumption lag) associated with resuming a task following an interruption and that the longer the duration of the interruption, the greater the time cost (i.e., resumption lag increases as interruption duration increases). The memory-for-goals model (Altmann & Trafton, 2002)…

  13. Interrupting the Interruption: Neoliberalism and the Challenges of an Antiracist School

    Science.gov (United States)

    Meshulam, Assaf; Apple, Michael W.

    2014-01-01

    The article examines a US public elementary bilingual, multicultural school that attempts to interrupt the reproduction of existing relations of dominance and subordination across a variety of differences. The school's experiences illuminate the complex reality of schools as a site of struggle and compromise between at times contradictory…

  14. Experiments with vacuum interrupters used for large dc-current interruption

    International Nuclear Information System (INIS)

    Warren, R.W.

    1977-10-01

    Vacuum interrupters have been tested in circuits similar to those used in theta-pinch and Tokamak fusion devices. The effects on performance of auxiliary circuit components and axial magnetic fields have been determined, and limits to lifetime caused by mechanical and electrical wear have been measured. Results show that the upper reliable limit of interruption is independent of the auxiliary components but quite dependent on interrupter size and on the axial field

  15. The Validity and Precision of the Comparative Interrupted Time-Series Design: Three Within-Study Comparisons

    Science.gov (United States)

    St. Clair, Travis; Hallberg, Kelly; Cook, Thomas D.

    2016-01-01

    We explore the conditions under which short, comparative interrupted time-series (CITS) designs represent valid alternatives to randomized experiments in educational evaluations. To do so, we conduct three within-study comparisons, each of which uses a unique data set to test the validity of the CITS design by comparing its causal estimates to…

  16. Consent: an event or a memory in lumbar spinal surgery? A multi-centre, multi-specialty prospective study of documentation and patient recall of consent content.

    Science.gov (United States)

    Lo, William B; McAuley, Ciaran P; Gillies, Martin J; Grover, Patrick J; Pereira, Erlick A C

    2017-11-01

    Prospective, multi-centre, multi-specialty medical notes review and patient interview. The consenting process is an important communication tool which also carries medico-legal implications. While written consent is a pre-requisite before spinal surgery in the UK, the standard and effectiveness of the process have not been assessed previously. This study assesses standard of written consent for elective lumbar decompressive surgery for degenerative disc disease across different regions and specialties in the UK; level of patient recall of the consent content; and identifies factors which affect patient recall. Consent forms of 153 in-patients from 4 centres a, b, c, d were reviewed. Written documentation of intended benefits, alternative treatments and operative risks was assessed. Of them, 108 patients were interviewed within 24 h before or after surgeries to assess recall. The written documentation rates of the operative risks showed significant inter-centre variations in haemorrhage and sphincter disturbance (P = 0.000), but not for others. Analysis of pooled data showed variations in written documentation of risks (P recall of these risks, there was no inter-centre variation. Patients' recall of paralysis as a risk was highest (50.9%) and that of recurrence was lowest (6.5%). Patients recalled risks better than those ≥65, significantly so for infection (29.9 vs 9.7%, P = 0.027). Patients consented >14 days compared to recall for paralysis (65.2 vs 43.7%) and recurrence (17.4 vs 2.8%). Patient recall was independent of consenter grade. Overall, the standard of written consent for elective lumbar spinal decompressive surgery was sub-optimal, which was partly reflected in the poor patient recall. While consenter seniority did not affect patient recall, younger age and longer consent-to-surgery time improved it.

  17. Simulation-Based Testing of Pager Interruptions During Laparoscopic Cholecystectomy.

    Science.gov (United States)

    Sujka, Joseph A; Safcsak, Karen; Bhullar, Indermeet S; Havron, William S

    2018-01-30

    To determine if pager interruptions affect operative time, safety, or complications and management of pager issues during a simulated laparoscopic cholecystectomy. Twelve surgery resident volunteers were tested on a Simbionix Lap Mentor II simulator. Each resident performed 6 randomized simulated laparoscopic cholecystectomies; 3 with pager interruptions (INT) and 3 without pager interruptions (NO-INT). The pager interruptions were sent in the form of standardized patient vignettes and timed to distract the resident during dissection of the critical view of safety and clipping of the cystic duct. The residents were graded on a pass/fail scale for eliciting appropriate patient history and management of the pager issue. Data was extracted from the simulator for the following endpoints: operative time, safety metrics, and incidence of operative complications. The Mann-Whitney U test and contingency table analysis were used to compare the 2 groups (INT vs. NO-INT). Level I trauma center; Simulation laboratory. Twelve general surgery residents. There was no significant difference between the 2 groups in any of the operative endpoints as measured by the simulator. However, in the INT group, only 25% of the time did the surgery residents both adequately address the issue and provide effective patient management in response to the pager interruption. Pager interruptions did not affect operative time, safety, or complications during the simulated procedure. However, there were significant failures in the appropriate evaluations and management of pager issues. Consideration for diversion of patient care issues to fellow residents not operating to improve quality and safety of patient care outside the operating room requires further study. Copyright © 2018. Published by Elsevier Inc.

  18. The Effects of Interruption Task Complexity and Interruptions on Student Multitasking

    OpenAIRE

    Tan, Jiun Yi

    2013-01-01

    Students commonly multitask while studying. The ubiquitous use of laptops and computers has facilitated this phenomenon and even changed the nature of multitasking in studying environments. Interruptions have an undeniable presence in these everyday studying environments and there are growing concerns about their potential to disrupt both performance and the learning process. Since interruptions are unavoidable, it is useful to identify the features that make some interruptions more disruptiv...

  19. Interrupted time-series analysis: studying trends in neurosurgery.

    Science.gov (United States)

    Wong, Ricky H; Smieliauskas, Fabrice; Pan, I-Wen; Lam, Sandi K

    2015-12-01

    OBJECT Neurosurgery studies traditionally have evaluated the effects of interventions on health care outcomes by studying overall changes in measured outcomes over time. Yet, this type of linear analysis is limited due to lack of consideration of the trend's effects both pre- and postintervention and the potential for confounding influences. The aim of this study was to illustrate interrupted time-series analysis (ITSA) as applied to an example in the neurosurgical literature and highlight ITSA's potential for future applications. METHODS The methods used in previous neurosurgical studies were analyzed and then compared with the methodology of ITSA. RESULTS The ITSA method was identified in the neurosurgical literature as an important technique for isolating the effect of an intervention (such as a policy change or a quality and safety initiative) on a health outcome independent of other factors driving trends in the outcome. The authors determined that ITSA allows for analysis of the intervention's immediate impact on outcome level and on subsequent trends and enables a more careful measure of the causal effects of interventions on health care outcomes. CONCLUSIONS ITSA represents a significant improvement over traditional observational study designs in quantifying the impact of an intervention. ITSA is a useful statistical procedure to understand, consider, and implement as the field of neurosurgery evolves in sophistication in big-data analytics, economics, and health services research.

  20. A Unified Framework for Estimating Minimum Detectable Effects for Comparative Short Interrupted Time Series Designs

    Science.gov (United States)

    Price, Cristofer; Unlu, Fatih

    2014-01-01

    The Comparative Short Interrupted Time Series (C-SITS) design is a frequently employed quasi-experimental method, in which the pre- and post-intervention changes observed in the outcome levels of a treatment group is compared with those of a comparison group where the difference between the former and the latter is attributed to the treatment. The…

  1. Current interruption transients calculation

    CERN Document Server

    Peelo, David F

    2014-01-01

    Provides an original, detailed and practical description of current interruption transients, origins, and the circuits involved, and how they can be calculated Current Interruption Transients Calculationis a comprehensive resource for the understanding, calculation and analysis of the transient recovery voltages (TRVs) and related re-ignition or re-striking transients associated with fault current interruption and the switching of inductive and capacitive load currents in circuits. This book provides an original, detailed and practical description of current interruption transients, origins,

  2. Assessment of treatment interruption among pulmonary tuberculosis patients: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Satya Bhgath Gorityala

    2015-01-01

    Full Text Available Background: Multi-drug resistant tuberculosis (TB is a rising peril of the TB control in India caused mostly by incomplete treatment. Aim: The aim was to assess the treatment interruption among pulmonary TB (PTB patients. Materials and Methods: A cross-sectional study was carried out for a period of 9 months among PTB patients. Patients admitted with active pulmonary Koch′s and history of anti-TB treatment (ATT for 1-month or more from any source and who returns to treatment after not taking ATT consecutively for 2 months or more were included in the study. The data were collected from the patients or their caretakers to obtain the source of treatment given previously before default, number of treatment interruptions, phase and reasons for treatment interruption treatment. Results: A total of 107 defaulters were identified during the study period. In the present study, 62.6% of the patients interrupted treatment only once, 55.34% of the patient′s early continuation (3-4 months treatment, and 47.66% of the patient′s only one reason for the treatment interruptions during the course of the treatment. The most common reason for the treatment interruptions were felt well with TB treatment (29.53% followed by side effects (16.06%, lack of money (8.29%, and other reasons. Conclusion: The study revealed that most of the defaulters were in the age group between 35 and 60 years, male gender, illiterates, daily wage labor, and married. The treatment interruptions were minimized by putting the efforts to improve direct supervision; pretreatment counseling and retrieve treatment interrupters were recommended.

  3. SLA-based optimisation of virtualised resource for multi-tier web applications in cloud data centres

    Science.gov (United States)

    Bi, Jing; Yuan, Haitao; Tie, Ming; Tan, Wei

    2015-10-01

    Dynamic virtualised resource allocation is the key to quality of service assurance for multi-tier web application services in cloud data centre. In this paper, we develop a self-management architecture of cloud data centres with virtualisation mechanism for multi-tier web application services. Based on this architecture, we establish a flexible hybrid queueing model to determine the amount of virtual machines for each tier of virtualised application service environments. Besides, we propose a non-linear constrained optimisation problem with restrictions defined in service level agreement. Furthermore, we develop a heuristic mixed optimisation algorithm to maximise the profit of cloud infrastructure providers, and to meet performance requirements from different clients as well. Finally, we compare the effectiveness of our dynamic allocation strategy with two other allocation strategies. The simulation results show that the proposed resource allocation method is efficient in improving the overall performance and reducing the resource energy cost.

  4. A high-throughput, multi-channel photon-counting detector with picosecond timing

    Science.gov (United States)

    Lapington, J. S.; Fraser, G. W.; Miller, G. M.; Ashton, T. J. R.; Jarron, P.; Despeisse, M.; Powolny, F.; Howorth, J.; Milnes, J.

    2009-06-01

    High-throughput photon counting with high time resolution is a niche application area where vacuum tubes can still outperform solid-state devices. Applications in the life sciences utilizing time-resolved spectroscopies, particularly in the growing field of proteomics, will benefit greatly from performance enhancements in event timing and detector throughput. The HiContent project is a collaboration between the University of Leicester Space Research Centre, the Microelectronics Group at CERN, Photek Ltd., and end-users at the Gray Cancer Institute and the University of Manchester. The goal is to develop a detector system specifically designed for optical proteomics, capable of high content (multi-parametric) analysis at high throughput. The HiContent detector system is being developed to exploit this niche market. It combines multi-channel, high time resolution photon counting in a single miniaturized detector system with integrated electronics. The combination of enabling technologies; small pore microchannel plate devices with very high time resolution, and high-speed multi-channel ASIC electronics developed for the LHC at CERN, provides the necessary building blocks for a high-throughput detector system with up to 1024 parallel counting channels and 20 ps time resolution. We describe the detector and electronic design, discuss the current status of the HiContent project and present the results from a 64-channel prototype system. In the absence of an operational detector, we present measurements of the electronics performance using a pulse generator to simulate detector events. Event timing results from the NINO high-speed front-end ASIC captured using a fast digital oscilloscope are compared with data taken with the proposed electronic configuration which uses the multi-channel HPTDC timing ASIC.

  5. A high-throughput, multi-channel photon-counting detector with picosecond timing

    International Nuclear Information System (INIS)

    Lapington, J.S.; Fraser, G.W.; Miller, G.M.; Ashton, T.J.R.; Jarron, P.; Despeisse, M.; Powolny, F.; Howorth, J.; Milnes, J.

    2009-01-01

    High-throughput photon counting with high time resolution is a niche application area where vacuum tubes can still outperform solid-state devices. Applications in the life sciences utilizing time-resolved spectroscopies, particularly in the growing field of proteomics, will benefit greatly from performance enhancements in event timing and detector throughput. The HiContent project is a collaboration between the University of Leicester Space Research Centre, the Microelectronics Group at CERN, Photek Ltd., and end-users at the Gray Cancer Institute and the University of Manchester. The goal is to develop a detector system specifically designed for optical proteomics, capable of high content (multi-parametric) analysis at high throughput. The HiContent detector system is being developed to exploit this niche market. It combines multi-channel, high time resolution photon counting in a single miniaturized detector system with integrated electronics. The combination of enabling technologies; small pore microchannel plate devices with very high time resolution, and high-speed multi-channel ASIC electronics developed for the LHC at CERN, provides the necessary building blocks for a high-throughput detector system with up to 1024 parallel counting channels and 20 ps time resolution. We describe the detector and electronic design, discuss the current status of the HiContent project and present the results from a 64-channel prototype system. In the absence of an operational detector, we present measurements of the electronics performance using a pulse generator to simulate detector events. Event timing results from the NINO high-speed front-end ASIC captured using a fast digital oscilloscope are compared with data taken with the proposed electronic configuration which uses the multi-channel HPTDC timing ASIC.

  6. Basic interrupt and command structures and applications

    International Nuclear Information System (INIS)

    Davies, R.C.

    1974-01-01

    Interrupt and command structures of a real-time system are described through specific examples. References to applications of a real-time system and programing development references are supplied. (auth)

  7. Interruptions in emergency medicine: things are not always what they seem.

    Science.gov (United States)

    Walter, Scott R

    2018-06-20

    We have all felt the cognitive disjuncture of being interrupted during an important task. Most ED physicians will readily proffer the high frequency and/or burden of interruptions during their work, and of the many observational studies of interruptions in healthcare EDs do indeed have high interruption rates[2]. In experimental psychology, where many of these ideas originated, there is plenty of evidence that interruptions negatively affect performance. Interruptions have been associated with reduced performance on complex tasks[3,4], increased sequence errors[5], increased task completion time and augmented annoyance and anxiety[6]. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  8. Multi-criteria correlation of tephra deposits to source centres applied in the Auckland Volcanic Field, New Zealand

    Science.gov (United States)

    Hopkins, Jenni L.; Wilson, Colin J. N.; Millet, Marc-Alban; Leonard, Graham S.; Timm, Christian; McGee, Lucy E.; Smith, Ian E. M.; Smith, Euan G. C.

    2017-07-01

    Linking tephras back to their source centre(s) in volcanic fields is crucial not only to reconstruct the eruptive history of the volcanic field but also to understand tephra dispersal patterns and thus the potential hazards posed by a future eruption. Here we present a multi-disciplinary approach to correlate distal basaltic tephra deposits from the Auckland Volcanic Field (AVF) to their source centres using proximal whole-rock geochemical signatures. In order to achieve these correlations, major and trace element tephra-derived glass compositions are compared with published and newly obtained whole-rock geochemical data for the entire field. The results show that incompatible trace element ratios (e.g. (Gd/Yb)N, (La/Yb)N, (Zr/Yb)N) vary widely across the AVF (e.g. (La/Yb)N = 5 to 40) but show a more restricted range within samples from a single volcanic centre (e.g. (La/Yb)N = 5 to 10). These ratios are also the least affected by fractional crystallisation and are therefore the most appropriate geochemical tools for correlation between tephra and whole-rock samples. However, findings for the AVF suggest that each volcanic centre does not have a unique geochemical signature in the field as a whole, thus preventing unambiguous correlation of tephras to source centre using geochemistry alone. A number of additional criteria are therefore combined to further constrain the source centres of the distal tephras including age, eruption scale, and location (of centres, and sites where tephra were sampled). The combination of tephrostratigraphy, 40Ar/39Ar dating and morphostratigraphic constraints allow, for the first time, the relative and absolute ordering of 48 of 53 volcanic centres of the Auckland Volcanic Field to be resolved. Eruption frequencies are shown to vary between 0.13 and 1.5 eruptions/kyr and repose periods between individual eruptions vary from <0.1 to 13 kyr, with 23 of the 48 centres shown to have pre-eruptive repose periods of <1000 years. No spatial

  9. The impact of study design and diagnostic approach in a large multi-centre ADHD study. Part 1: ADHD symptom patterns

    Directory of Open Access Journals (Sweden)

    Roeyers Herbert

    2011-04-01

    Full Text Available Abstract Background The International Multi-centre ADHD Genetics (IMAGE project with 11 participating centres from 7 European countries and Israel has collected a large behavioural and genetic database for present and future research. Behavioural data were collected from 1068 probands with the combined type of attention deficit/hyperactivity disorder (ADHD-CT and 1446 'unselected' siblings. The aim was to analyse the IMAGE sample with respect to demographic features (gender, age, family status, and recruiting centres and psychopathological characteristics (diagnostic subtype, symptom frequencies, age at symptom detection, and comorbidities. A particular focus was on the effects of the study design and the diagnostic procedure on the homogeneity of the sample in terms of symptom-based behavioural data, and potential consequences for further analyses based on these data. Methods Diagnosis was based on the Parental Account of Childhood Symptoms (PACS interview and the DSM-IV items of the Conners' teacher questionnaire. Demographics of the full sample and the homogeneity of a subsample (all probands were analysed by using robust statistical procedures which were adjusted for unequal sample sizes and skewed distributions. These procedures included multi-way analyses based on trimmed means and winsorised variances as well as bootstrapping. Results Age and proband/sibling ratios differed between participating centres. There was no significant difference in the distribution of gender between centres. There was a significant interaction between age and centre for number of inattentive, but not number of hyperactive symptoms. Higher ADHD symptom frequencies were reported by parents than teachers. The diagnostic symptoms differed from each other in their frequencies. The face-to-face interview was more sensitive than the questionnaire. The differentiation between ADHD-CT probands and unaffected siblings was mainly due to differences in hyperactive

  10. The impact of study design and diagnostic approach in a large multi-centre ADHD study. Part 1: ADHD symptom patterns.

    LENUS (Irish Health Repository)

    Muller, Ueli C

    2011-04-07

    Abstract Background The International Multi-centre ADHD Genetics (IMAGE) project with 11 participating centres from 7 European countries and Israel has collected a large behavioural and genetic database for present and future research. Behavioural data were collected from 1068 probands with the combined type of attention deficit\\/hyperactivity disorder (ADHD-CT) and 1446 \\'unselected\\' siblings. The aim was to analyse the IMAGE sample with respect to demographic features (gender, age, family status, and recruiting centres) and psychopathological characteristics (diagnostic subtype, symptom frequencies, age at symptom detection, and comorbidities). A particular focus was on the effects of the study design and the diagnostic procedure on the homogeneity of the sample in terms of symptom-based behavioural data, and potential consequences for further analyses based on these data. Methods Diagnosis was based on the Parental Account of Childhood Symptoms (PACS) interview and the DSM-IV items of the Conners\\' teacher questionnaire. Demographics of the full sample and the homogeneity of a subsample (all probands) were analysed by using robust statistical procedures which were adjusted for unequal sample sizes and skewed distributions. These procedures included multi-way analyses based on trimmed means and winsorised variances as well as bootstrapping. Results Age and proband\\/sibling ratios differed between participating centres. There was no significant difference in the distribution of gender between centres. There was a significant interaction between age and centre for number of inattentive, but not number of hyperactive symptoms. Higher ADHD symptom frequencies were reported by parents than teachers. The diagnostic symptoms differed from each other in their frequencies. The face-to-face interview was more sensitive than the questionnaire. The differentiation between ADHD-CT probands and unaffected siblings was mainly due to differences in hyperactive

  11. Multi-centre experience of implementing image-guided intensity-modulated radiotherapy using the TomoTherapy platform

    International Nuclear Information System (INIS)

    Dean, J.C.; Tudor, G.S.J.; Mott, J.H.; Dunlop, P.R.; Morris, S.L.; Harron, E.C.; Christian, J.A.; Sanghera, P.; Elsworthy, M.; Burnet, N.G.

    2013-01-01

    Use of image guided (IG) intensity modulated radiotherapy (IMRT) is increasing, and helical tomotherapy provides an effective, integrated solution. Practical experience of implementation, shared at a recent UK TomoTherapy Users' meeting, may help centres introducing these techniques using TomoTherapy or other platforms. Seven centres participated, with data shared from 6, varying from 2500 - 4800 new patients per year. Case selection of patients “most likely” to benefit from IG-IMRT was managed in all centres by multi-professional groups comprising clinical oncologists, physicists, treatment planners and radiographers. Radical treatments ranged from 94% to 100%. The proportions of tumour types varied substantially: head and neck: range 0%–100% (mean of centres 50%), prostate: 3%–96% (mean of centres 28%). Head and neck cases were considered most likely to benefit from IMRT, prostate cases from IGRT, or IG-IMRT if pelvic nodes were being treated. IMRT was also selected for complex target volumes, to avoid field junctions, for technical treatment difficulties, and retreatments. Across the centres, every patient was imaged every day, with positional correction before treatment. In one centre, for prostate patients including pelvic treatment, the pelvis was also imaged weekly. All centres had designed a ‘ramp up’ of patient numbers, which was similar in 5. One centre, treating 96% prostate patients, started with 3 and increased to 36 patients per day within 3 months. The variation in case mix implies wide applicability of IG-IMRT. Daily on-line IGRT with IMRT can be routinely implemented into busy departments

  12. Coping with interruptions in clinical nursing - a qualitative study

    DEFF Research Database (Denmark)

    Laustsen, Sussie; Brahe, Liselotte

    2018-01-01

    phenomenological approach. METHODS: Observations were performed combined with semi-structured qualitative interviews. RESULTS: Managing interruptions depend on level of competence, working environment, dialogue and matching of expectations, collegial roles and implicit rules. Working procedures impact on how......AIMS AND OBJECTIVES: To gain knowledge on how nurses' cope with interruptions in clinical practice. BACKGROUND: Interruptions may delay work routines and result in wasted time, disorganised planning and ineffective working procedures, affecting nurses' focus and overview in different ways. Research......: Culture work and matching of expectations are important to reflect on and discuss personal- and group behaviour caused by interruptions. We need to focus on the role of each nurse in the professional team, types of personality and unspoken rules. Professional competencies for example prioritising, keeping...

  13. Water supply interruptions and suspected cholera incidence: a time-series regression in the Democratic Republic of the Congo.

    Science.gov (United States)

    Jeandron, Aurélie; Saidi, Jaime Mufitini; Kapama, Alois; Burhole, Manu; Birembano, Freddy; Vandevelde, Thierry; Gasparrini, Antonio; Armstrong, Ben; Cairncross, Sandy; Ensink, Jeroen H J

    2015-10-01

    The eastern provinces of the Democratic Republic of the Congo have been identified as endemic areas for cholera transmission, and despite continuous control efforts, they continue to experience regular cholera outbreaks that occasionally spread to the rest of the country. In a region where access to improved water sources is particularly poor, the question of which improvements in water access should be prioritized to address cholera transmission remains unresolved. This study aimed at investigating the temporal association between water supply interruptions and Cholera Treatment Centre (CTC) admissions in a medium-sized town. Time-series patterns of daily incidence of suspected cholera cases admitted to the Cholera Treatment Centre in Uvira in South Kivu Province between 2009 and 2014 were examined in relation to the daily variations in volume of water supplied by the town water treatment plant. Quasi-poisson regression and distributed lag nonlinear models up to 12 d were used, adjusting for daily precipitation rates, day of the week, and seasonal variations. A total of 5,745 patients over 5 y of age with acute watery diarrhoea symptoms were admitted to the CTC over the study period of 1,946 d. Following a day without tap water supply, the suspected cholera incidence rate increased on average by 155% over the next 12 d, corresponding to a rate ratio of 2.55 (95% CI: 1.54-4.24), compared to the incidence experienced after a day with optimal production (defined as the 95th percentile-4,794 m3). Suspected cholera cases attributable to a suboptimal tap water supply reached 23.2% of total admissions (95% CI 11.4%-33.2%). Although generally reporting less admissions to the CTC, neighbourhoods with a higher consumption of tap water were more affected by water supply interruptions, with a rate ratio of 3.71 (95% CI: 1.91-7.20) and an attributable fraction of cases of 31.4% (95% CI: 17.3%-42.5%). The analysis did not suggest any association between levels of residual

  14. Person-centred web-based support--development through a Swedish multi-case study.

    Science.gov (United States)

    Josefsson, Ulrika; Berg, Marie; Koinberg, Ingalill; Hellström, Anna-Lena; Nolbris, Margaretha Jenholt; Ranerup, Agneta; Lundin, Carina Sparud; Skärsäter, Ingela

    2013-10-19

    Departing from the widespread use of the internet in modern society and the emerging use of web applications in healthcare this project captures persons' needs and expectations in order to develop highly usable web recourses. The purpose of this paper is to outline a multi-case research project focused on the development and evaluation of person-centred web-based support for people with long-term illness. To support the underlying idea to move beyond the illness, we approach the development of web support from the perspective of the emergent area of person-centred care. The project aims to contribute to the ongoing development of web-based supports in health care and to the emerging field of person-centred care. The research design uses a meta-analytical approach through its focus on synthesizing experiences from four Swedish regional and national cases of design and use of web-based support in long-term illness. The cases include children (bladder dysfunction and urogenital malformation), young adults (living close to persons with mental illness), and two different cases of adults (women with breast cancer and childbearing women with type 1 diabetes). All of the cases are ongoing, though in different stages of design, implementation, and analysis. This, we argue, will lead to a synthesis of results on a meta-level not yet described. To allow valid comparisons between the four cases we explore and problematize them in relation to four main aspects: 1) The use of people's experiences and needs; 2) The role of use of theories in the design of person-centred web-based supports; 3) The evaluation of the effects of health outcomes for the informants involved and 4) The development of a generic person-centred model for learning and social support for people with long-term illness and their significant others. Person-centred web-based support is a new area and few studies focus on how web-based interventions can contribute to the development of person-centred care. In

  15. Before-and-After Study of Interruptions in a Pharmacy Department.

    Science.gov (United States)

    Guérin, Aurélie; Caron, Elaine; Lebel, Denis; Bussières, Jean-François

    2013-01-01

    Few data exist on interruptions in the drug-use process in hospital pharmacies and their effects on patient care. The primary objective was to compare the hourly number of stimuli received and emitted (i.e., generated) by pharmacists and pharmacy technicians before and after implementation of measures intended to reduce interruptions. The secondary objective was to evaluate the impact of the corrective measures on 4 specific stimuli. This before-and-after cross-sectional observational study was conducted in the main dispensing area of the pharmacy department of a Canadian university hospital centre. Stimuli received and emitted by pharmacists and pharmacy technicians were counted before (2010) and after (2012) implementation of corrective measures designed to limit interruptions. The effect of corrective measures on targeted stimuli was measured with a t test. Data were collected during a total of 93 randomly scheduled 30-min observation periods: 62 periods in 2010 (n = 2663 stimuli) and 31 periods in 2012 (n = 1217 stimuli). The average hourly stimulus rate (± standard deviation) was unchanged after implementation of corrective measures: 85.9 ± 22.2 in 2010 and 78.5 ± 20.1 in 2012 (p = 0.06). However, a significant decline was observed for many individual stimuli, including the number of face-to-face nonprofessional conversations among pharmacists (4.4 ± 4.2 in 2010 versus 1.2 ± 1.8 in 2012, p = 0.003). Despite the implementation of corrective measures, there was no statistically significant change in the hourly stimulus rates from 2010 to 2012. Other studies are needed to better characterize the nature and repercussions of stimuli, distractions, and interruptions.

  16. Photolytic interruptions of the bacteriorhodopsin photocycle examined by time-resolved resonance raman spectroscopy.

    Science.gov (United States)

    Grieger, I; Atkinson, G H

    1985-09-24

    An investigation of the photolytic conditions used to initiate and spectroscopically monitor the bacteriorhodopsin (BR) photocycle utilizing time-resolved resonance Raman (TR3) spectroscopy has revealed and characterized two photoinduced reactions that interrupt the thermal pathway. One reaction involves the photolytic interconversion of M-412 and M', and the other involves the direct photolytic conversion of the BR-570/K-590 photostationary mixture either to M-412 and M' or to M-like intermediates within 10 ns. The photolytic threshold conditions describing both reactions have been quantitatively measured and are discussed in terms of experimental parameters.

  17. Timing system for multi-bunch/multi-train operation at ATF

    International Nuclear Information System (INIS)

    Naito, T.; Hayano, H.; Urakawa, J.; Imai, T.

    2000-01-01

    A timing system has been constructed for multi-bunch/multi-train operation at KEK-ATF. The linac accelerates 20 bunches of multi-bunch with 2.8 ns spacing. The Damping Ring stores up to 5 trains of multi-bunch. The timing system is required to provide flexible operation mode and bucket selection. A personal computer is used for manipulating the timing. The performance of kicker magnets at the injection/extruction is key issue for multi-train operation. The hardware and the test results are presented. (author)

  18. The impact of study design and diagnostic approach in a large multi-centre ADHD study: Part 2: Dimensional measures of psychopathology and intelligence

    Directory of Open Access Journals (Sweden)

    Roeyers Herbert

    2011-04-01

    Full Text Available Abstract Background The International Multi-centre ADHD Genetics (IMAGE project with 11 participating centres from 7 European countries and Israel has collected a large behavioural and genetic database for present and future research. Behavioural data were collected from 1068 probands with ADHD and 1446 unselected siblings. The aim was to describe and analyse questionnaire data and IQ measures from all probands and siblings. In particular, to investigate the influence of age, gender, family status (proband vs. sibling, informant, and centres on sample homogeneity in psychopathological measures. Methods Conners' Questionnaires, Strengths and Difficulties Questionnaires, and Wechsler Intelligence Scores were used to describe the phenotype of the sample. Data were analysed by use of robust statistical multi-way procedures. Results Besides main effects of age, gender, informant, and centre, there were considerable interaction effects on questionnaire data. The larger differences between probands and siblings at home than at school may reflect contrast effects in the parents. Furthermore, there were marked gender by status effects on the ADHD symptom ratings with girls scoring one standard deviation higher than boys in the proband sample but lower than boys in the siblings sample. The multi-centre design is another important source of heterogeneity, particularly in the interaction with the family status. To a large extent the centres differed from each other with regard to differences between proband and sibling scores. Conclusions When ADHD probands are diagnosed by use of fixed symptom counts, the severity of the disorder in the proband sample may markedly differ between boys and girls and across age, particularly in samples with a large age range. A multi-centre design carries the risk of considerable phenotypic differences between centres and, consequently, of additional heterogeneity of the sample even if standardized diagnostic procedures are

  19. The impact of study design and diagnostic approach in a large multi-centre ADHD study: Part 2: Dimensional measures of psychopathology and intelligence.

    LENUS (Irish Health Repository)

    Muller, Ueli C

    2011-04-07

    Abstract Background The International Multi-centre ADHD Genetics (IMAGE) project with 11 participating centres from 7 European countries and Israel has collected a large behavioural and genetic database for present and future research. Behavioural data were collected from 1068 probands with ADHD and 1446 unselected siblings. The aim was to describe and analyse questionnaire data and IQ measures from all probands and siblings. In particular, to investigate the influence of age, gender, family status (proband vs. sibling), informant, and centres on sample homogeneity in psychopathological measures. Methods Conners\\' Questionnaires, Strengths and Difficulties Questionnaires, and Wechsler Intelligence Scores were used to describe the phenotype of the sample. Data were analysed by use of robust statistical multi-way procedures. Results Besides main effects of age, gender, informant, and centre, there were considerable interaction effects on questionnaire data. The larger differences between probands and siblings at home than at school may reflect contrast effects in the parents. Furthermore, there were marked gender by status effects on the ADHD symptom ratings with girls scoring one standard deviation higher than boys in the proband sample but lower than boys in the siblings sample. The multi-centre design is another important source of heterogeneity, particularly in the interaction with the family status. To a large extent the centres differed from each other with regard to differences between proband and sibling scores. Conclusions When ADHD probands are diagnosed by use of fixed symptom counts, the severity of the disorder in the proband sample may markedly differ between boys and girls and across age, particularly in samples with a large age range. A multi-centre design carries the risk of considerable phenotypic differences between centres and, consequently, of additional heterogeneity of the sample even if standardized diagnostic procedures are used. These

  20. Randomized trial of time-limited interruptions of protease inhibitor-based antiretroviral therapy (ART vs. continuous therapy for HIV-1 infection.

    Directory of Open Access Journals (Sweden)

    Cynthia Firnhaber

    Full Text Available The clinical outcomes of short interruptions of PI-based ART regimens remains undefined.A 2-arm non-inferiority trial was conducted on 53 HIV-1 infected South African participants with viral load 450 cells/µl on stavudine (or zidovudine, lamivudine and lopinavir/ritonavir. Subjects were randomized to a sequential 2, 4 and 8-week ART interruptions or b continuous ART (cART. Primary analysis was based on the proportion of CD4 count >350 cells(c/ml over 72 weeks. Adherence, HIV-1 drug resistance, and CD4 count rise over time were analyzed as secondary endpoints.The proportions of CD4 counts >350 cells/µl were 82.12% for the intermittent arm and 93.73 for the cART arm; the difference of 11.95% was above the defined 10% threshold for non-inferiority (upper limit of 97.5% CI, 24.1%; 2-sided CI: -0.16, 23.1. No clinically significant differences in opportunistic infections, adverse events, adherence or viral resistance were noted; after randomization, long-term CD4 rise was observed only in the cART arm.We are unable to conclude that short PI-based ART interruptions are non-inferior to cART in retention of immune reconstitution; however, short interruptions did not lead to a greater rate of resistance mutations or adverse events than cART suggesting that this regimen may be more forgiving than NNRTIs if interruptions in therapy occur.ClinicalTrials.gov NCT00100646.

  1. A knowledge translation tool improved osteoporosis disease management in primary care: an interrupted time series analysis.

    Science.gov (United States)

    Kastner, Monika; Sawka, Anna M; Hamid, Jemila; Chen, Maggie; Thorpe, Kevin; Chignell, Mark; Ewusie, Joycelyne; Marquez, Christine; Newton, David; Straus, Sharon E

    2014-09-25

    Osteoporosis affects over 200 million people worldwide at a high cost to healthcare systems, yet gaps in management still exist. In response, we developed a multi-component osteoporosis knowledge translation (Op-KT) tool involving a patient-initiated risk assessment questionnaire (RAQ), which generates individualized best practice recommendations for physicians and customized education for patients at the point of care. The objective of this study was to evaluate the effectiveness of the Op-KT tool for appropriate disease management by physicians. The Op-KT tool was evaluated using an interrupted time series design. This involved multiple assessments of the outcomes 12 months before (baseline) and 12 months after tool implementation (52 data points in total). Inclusion criteria were family physicians and their patients at risk for osteoporosis (women aged ≥ 50 years, men aged ≥ 65 years). Primary outcomes were the initiation of appropriate osteoporosis screening and treatment. Analyses included segmented linear regression modeling and analysis of variance. The Op-KT tool was implemented in three family practices in Ontario, Canada representing 5 family physicians with 2840 age eligible patients (mean age 67 years; 76% women). Time series regression models showed an overall increase from baseline in the initiation of screening (3.4%; P management addressed by their physician. Study limitations included the inherent susceptibility of our design compared with a randomized trial. The multicomponent Op-KT tool significantly increased osteoporosis investigations in three family practices, and highlights its potential to facilitate patient self-management. Next steps include wider implementation and evaluation of the tool in primary care.

  2. A multi-centre dosimetry audit on advanced radiotherapy in lung as part of the Isotoxic IMRT study

    Directory of Open Access Journals (Sweden)

    Yat Tsang

    2017-10-01

    Conclusion: This multi-centre dosimetry audit of complex IMRT/VMAT delivery provides confidence in the accuracy of modern planning and delivery systems in inhomogeneous tissues. The findings from this study can be used as a reference for future dosimetry audits.

  3. Driven to distraction: The nature and apparent purpose of interruptions in critical care and implications for HIT.

    Science.gov (United States)

    Mamykina, Lena; Carter, Eileen J; Sheehan, Barbara; Stanley Hum, R; Twohig, Bridget C; Kaufman, David R

    2017-05-01

    To examine the apparent purpose of interruptions in a Pediatric Intensive Care Unit and opportunities to reduce their burden with informatics solutions. In this prospective observational study, researchers shadowed clinicians in the unit for one hour at a time, recording all interruptions participating clinicians experienced or initiated, their starting time, duration, and a short description that could help to infer their apparent purpose. All captured interruptions were classified inductively on their source and apparent purpose and on the optimal representational media for fulfilling their apparent purpose. The researchers observed thirty-four one-hour sessions with clinicians in the unit, including 21 nurses and 13 residents and house physicians. The physicians were interrupted on average 11.9 times per hour and interrupted others 8.8 times per hour. Nurses were interrupted 8.6 times per hour and interrupted others 5.1 times per hour. The apparent purpose of interruptions included Information Seeking and Sharing (n=259, 46.3%), Directives and Requests (n=70, 12%), Shared Decision-Making (n=49, 8.8%), Direct Patient Care (n=36, 6.4%), Social (n=71, 12.7%), Device Alarms (n=28, 5%), and Non-Clinical (n=10, 1.8%); 6.6% were not classified due to insufficient description. Of all captured interruptions, 29.5% were classified as being better served with informational displays or computer-mediated communication. Deeper understanding of the purpose of interruptions in critical care can help to distinguish between interruptions that require face-to-face conversation and those that can be eliminated with informatics solutions. The proposed taxonomy of interruptions and representational analysis can be used to further advance the science of interruptions in clinical care. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Impact of Frequent Interruption on Nurses' Patient-Controlled Analgesia Programming Performance.

    Science.gov (United States)

    Campoe, Kristi R; Giuliano, Karen K

    2017-12-01

    The purpose was to add to the body of knowledge regarding the impact of interruption on acute care nurses' cognitive workload, total task completion times, nurse frustration, and medication administration error while programming a patient-controlled analgesia (PCA) pump. Data support that the severity of medication administration error increases with the number of interruptions, which is especially critical during the administration of high-risk medications. Bar code technology, interruption-free zones, and medication safety vests have been shown to decrease administration-related errors. However, there are few published data regarding the impact of number of interruptions on nurses' clinical performance during PCA programming. Nine acute care nurses completed three PCA pump programming tasks in a simulation laboratory. Programming tasks were completed under three conditions where the number of interruptions varied between two, four, and six. Outcome measures included cognitive workload (six NASA Task Load Index [NASA-TLX] subscales), total task completion time (seconds), nurse frustration (NASA-TLX Subscale 6), and PCA medication administration error (incorrect final programming). Increases in the number of interruptions were associated with significant increases in total task completion time ( p = .003). We also found increases in nurses' cognitive workload, nurse frustration, and PCA pump programming errors, but these increases were not statistically significant. Complex technology use permeates the acute care nursing practice environment. These results add new knowledge on nurses' clinical performance during PCA pump programming and high-risk medication administration.

  5. Workflow interruptions, social stressors from supervisor(s) and attention failure in surgery personnel.

    Science.gov (United States)

    Pereira, Diana; Müller, Patrick; Elfering, Achim

    2015-01-01

    Workflow interruptions and social stressors among surgery personnel may cause attention failure at work that may increase rumination about work issues during leisure time. The test of these assumptions should contribute to the understanding of exhaustion in surgery personnel and patient safety. Workflow interruptions and supervisor-related social stressors were tested to predict attention failure that predicts work-related rumination during leisure time. One hundred ninety-four theatre nurses, anaesthetists and surgeons from a Swiss University hospital participated in a cross-sectional survey. The participation rate was 58%. Structural equation modelling confirmed both indirect paths from workflow interruptions and social stressors via attention failure on rumination (both pworkflow interruptions and social stressors on rumination-could not be empirically supported. Workflow interruptions and social stressors at work are likely to trigger attention failure in surgery personnel. Work redesign and team intervention could help surgery personnel to maintain a high level of quality and patient safety and detach from work related issues to recover during leisure time.

  6. A multi-centre evaluation of oral cancer in Southern and Western Nigeria: an African oral pathology research consortium initiative.

    Science.gov (United States)

    Omitola, Olufemi Gbenga; Soyele, Olujide Oladele; Sigbeku, Opeyemi; Okoh, Dickson; Akinshipo, Abdulwarith Olaitan; Butali, Azeez; Adeola, Henry Ademola

    2017-01-01

    Oral cancer is a leading cause of cancer deaths among African populations. Lack of standard cancer registries and under-reporting has inaccurately depicted its magnitude in Nigeria. Development of multi-centre collaborative oral pathology networks such as the African Oral Pathology Research Consortium (AOPRC) facilitates skill and expertise exchange and fosters a robust and systematic investigation of oral diseases across Africa. In this descriptive cross-sectional study, we have leveraged the auspices of the AOPRC to examine the burden of oral cancer in Nigeria, using a multi-centre approach. Data from 4 major tertiary health institutions in Western and Southern Nigeria was generated using a standardized data extraction format and analysed using the SPSS data analysis software (version 20.0; SPSS Inc. Chicago, IL). Of the 162 cases examined across the 4 centres, we observed that oral squamous cell carcinomas (OSCC) occurred mostly in the 6 th and 7 th decades of life and maxillary were more frequent than mandibular OSCC lesions. Regional variations were observed both for location, age group and gender distribution. Significant regional differences was found between poorly, moderately and well differentiated OSCC (p value = 0.0071). A multi-centre collaborative oral pathology research approach is an effective way to achieve better insight into the patterns and distribution of various oral diseases in men of African descent. The wider outlook for AOPRC is to employ similar approaches to drive intensive oral pathology research targeted at addressing the current morbidity and mortality of various oral diseases across Africa.

  7. Markets and pricing for interruptible electric power

    International Nuclear Information System (INIS)

    Gedra, T.W.; Varaiya, P.P.

    1993-01-01

    The authors propose a market for interruptible, or callable, forward contracts for electric power, in which the consumer grants the power supplier the right to interrupt a given unit of load in return for a price discount. The callable forward contracts are traded continuously until the time of use. This allows recourse for those customers with uncertain demand, while risk-averse consumers can minimize their price risk by purchasing early. Callable forward contracts are simple in form, and can be directly incorporated into the utility's economic dispatch procedure

  8. Computerized detection of breast lesions in multi-centre and multi-instrument DCE-MR data using 3D principal component maps and template matching

    Science.gov (United States)

    Ertas, Gokhan; Doran, Simon; Leach, Martin O.

    2011-12-01

    In this study, we introduce a novel, robust and accurate computerized algorithm based on volumetric principal component maps and template matching that facilitates lesion detection on dynamic contrast-enhanced MR. The study dataset comprises 24 204 contrast-enhanced breast MR images corresponding to 4034 axial slices from 47 women in the UK multi-centre study of MRI screening for breast cancer and categorized as high risk. The scans analysed here were performed on six different models of scanner from three commercial vendors, sited in 13 clinics around the UK. 1952 slices from this dataset, containing 15 benign and 13 malignant lesions, were used for training. The remaining 2082 slices, with 14 benign and 12 malignant lesions, were used for test purposes. To prevent false positives being detected from other tissues and regions of the body, breast volumes are segmented from pre-contrast images using a fast semi-automated algorithm. Principal component analysis is applied to the centred intensity vectors formed from the dynamic contrast-enhanced T1-weighted images of the segmented breasts, followed by automatic thresholding to eliminate fatty tissues and slowly enhancing normal parenchyma and a convolution and filtering process to minimize artefacts from moderately enhanced normal parenchyma and blood vessels. Finally, suspicious lesions are identified through a volumetric sixfold neighbourhood connectivity search and calculation of two morphological features: volume and volumetric eccentricity, to exclude highly enhanced blood vessels, nipples and normal parenchyma and to localize lesions. This provides satisfactory lesion localization. For a detection sensitivity of 100%, the overall false-positive detection rate of the system is 1.02/lesion, 1.17/case and 0.08/slice, comparing favourably with previous studies. This approach may facilitate detection of lesions in multi-centre and multi-instrument dynamic contrast-enhanced breast MR data.

  9. A work observation study of nuclear medicine technologists: interruptions, resilience and implications for patient safety.

    Science.gov (United States)

    Larcos, George; Prgomet, Mirela; Georgiou, Andrew; Westbrook, Johanna

    2017-06-01

    Errors by nuclear medicine technologists during the preparation of radiopharmaceuticals or at other times can cause patient harm and may reflect the impact of interruptions, busy work environments and deficient systems or processes. We aimed to: (a) characterise the rate and nature of interruptions technologists experience and (b) identify strategies that support safety. We performed 100 hours of observation of 11 technologists at a major public hospital and measured the proportions of time spent in eight categories of work tasks, location of task, interruption rate and type and multitasking (tasks conducted in parallel). We catalogued specific safety-oriented strategies used by technologists. Technologists completed 5227 tasks and experienced 569 interruptions (mean, 4.5 times per hour; 95% CI 4.1 to 4.9). The highest interruption rate occurred when technologists were in transit between rooms (10.3 per hour (95% CI 8.3 to 12.5)). Interruptions during radiopharmaceutical preparation occurred a mean of 4.4 times per hour (95% CI 3.3 to 5.6). Most (n=426) tasks were interrupted once only and all tasks were resumed after interruption. Multitasking occurred 16.6% of the time. At least some interruptions were initiated by other technologists to convey important information and/or to render assistance. Technologists employed a variety of verbal and non-verbal strategies in all work areas (notably in the hot-lab) to minimise the impact of interruptions and optimise the safe conduct of procedures. Although most were due to individual choices, some strategies reflected overt or subliminal departmental policy. Some interruptions appear beneficial. Technologists' self-initiated strategies to support safe work practices appear to be an important element in supporting a resilient work environment in nuclear medicine. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. Sound, memory and interruption

    DEFF Research Database (Denmark)

    Pinder, David

    2016-01-01

    This chapter considers how art can interrupt the times and spaces of urban development so they might be imagined, experienced and understood differently. It focuses on the construction of the M11 Link Road through north-east London during the 1990s that demolished hundreds of homes and displaced...... around a thousand people. The highway was strongly resisted and it became the site of one of the country’s longest and largest anti-road struggles. The chapter addresses specifically Graeme Miller’s sound walk LINKED (2003), which for more than a decade has been broadcasting memories and stories...... of people who were violently displaced by the road as well as those who actively sought to halt it. Attention is given to the walk’s interruption of senses of the given and inevitable in two main ways. The first is in relation to the pace of the work and its deployment of slowness and arrest in a context...

  11. Water Supply Interruptions and Suspected Cholera Incidence: A Time-Series Regression in the Democratic Republic of the Congo

    Science.gov (United States)

    Jeandron, Aurélie; Saidi, Jaime Mufitini; Kapama, Alois; Burhole, Manu; Birembano, Freddy; Vandevelde, Thierry; Gasparrini, Antonio; Armstrong, Ben; Cairncross, Sandy; Ensink, Jeroen H. J.

    2015-01-01

    Background The eastern provinces of the Democratic Republic of the Congo have been identified as endemic areas for cholera transmission, and despite continuous control efforts, they continue to experience regular cholera outbreaks that occasionally spread to the rest of the country. In a region where access to improved water sources is particularly poor, the question of which improvements in water access should be prioritized to address cholera transmission remains unresolved. This study aimed at investigating the temporal association between water supply interruptions and Cholera Treatment Centre (CTC) admissions in a medium-sized town. Methods and Findings Time-series patterns of daily incidence of suspected cholera cases admitted to the Cholera Treatment Centre in Uvira in South Kivu Province between 2009 and 2014 were examined in relation to the daily variations in volume of water supplied by the town water treatment plant. Quasi-poisson regression and distributed lag nonlinear models up to 12 d were used, adjusting for daily precipitation rates, day of the week, and seasonal variations. A total of 5,745 patients over 5 y of age with acute watery diarrhoea symptoms were admitted to the CTC over the study period of 1,946 d. Following a day without tap water supply, the suspected cholera incidence rate increased on average by 155% over the next 12 d, corresponding to a rate ratio of 2.55 (95% CI: 1.54–4.24), compared to the incidence experienced after a day with optimal production (defined as the 95th percentile—4,794 m3). Suspected cholera cases attributable to a suboptimal tap water supply reached 23.2% of total admissions (95% CI 11.4%–33.2%). Although generally reporting less admissions to the CTC, neighbourhoods with a higher consumption of tap water were more affected by water supply interruptions, with a rate ratio of 3.71 (95% CI: 1.91–7.20) and an attributable fraction of cases of 31.4% (95% CI: 17.3%–42.5%). The analysis did not suggest any

  12. The mythology of anticoagulation therapy interruption for dental surgery.

    Science.gov (United States)

    Wahl, Michael J

    2018-01-01

    Continuous anticoagulation therapy is used to prevent heart attacks, strokes, and other embolic complications. When patients receiving anticoagulation therapy undergo dental surgery, a decision must be made about whether to continue anticoagulation therapy and risk bleeding complications or briefly interrupt anticoagulation therapy and increase the risk of developing embolic complications. Results from decades of studies of thousands of dental patients receiving anticoagulation therapy reveal that bleeding complications requiring more than local measures for hemostasis have been rare and never fatal. However, embolic complications (some of which were fatal and others possibly permanently debilitating) sometimes have occurred in patients whose anticoagulation therapy was interrupted for dental procedures. Although there is now virtually universal consensus among national medical and dental groups and other experts that anticoagulation therapy should not be interrupted for most dental surgery, there are still some arguments made supporting anticoagulation therapy interruption. An analysis of these arguments shows them to be based on a collection of myths and half-truths rather than on logical scientific conclusions. The time has come to stop anticoagulation therapy interruption for dental procedures. Copyright © 2018 American Dental Association. Published by Elsevier Inc. All rights reserved.

  13. ZOOM or Non-ZOOM? Assessing Spinal Cord Diffusion Tensor Imaging Protocols for Multi-Centre Studies.

    Directory of Open Access Journals (Sweden)

    Rebecca S Samson

    Full Text Available The purpose of this study was to develop and evaluate two spinal cord (SC diffusion tensor imaging (DTI protocols, implemented at multiple sites (using scanners from two different manufacturers, one available on any clinical scanner, and one using more advanced options currently available in the research setting, and to use an automated processing method for unbiased quantification. DTI parameters are sensitive to changes in the diseased SC. However, imaging the cord can be technically challenging due to various factors including its small size, patient-related and physiological motion, and field inhomogeneities. Rapid acquisition sequences such as Echo Planar Imaging (EPI are desirable but may suffer from image distortions. We present a multi-centre comparison of two acquisition protocols implemented on scanners from two different vendors (Siemens and Philips, one using a reduced field-of-view (rFOV EPI sequence, and one only using options available on standard clinical scanners such as outer volume suppression (OVS. Automatic analysis was performed with the Spinal Cord Toolbox for unbiased and reproducible quantification of DTI metrics in the white matter. Images acquired using the rFOV sequence appear less distorted than those acquired using OVS alone. SC DTI parameter values obtained using both sequences at all sites were consistent with previous measurements made at 3T. For the same scanner manufacturer, DTI parameter inter-site SDs were smaller for the rFOV sequence compared to the OVS sequence. The higher inter-site reproducibility (for the same manufacturer and acquisition details, i.e. ZOOM data acquired at the two Philips sites of rFOV compared to the OVS sequence supports the idea that making research options such as rFOV more widely available would improve accuracy of measurements obtained in multi-centre clinical trials. Future multi-centre studies should also aim to match the rFOV technique and signal-to-noise ratios in all

  14. Stress Outcomes of Four Types of Perceived Interruptions.

    Science.gov (United States)

    Fletcher, Keaton A; Potter, Sean M; Telford, Britany N

    2018-03-01

    Objective We sought to define and measure four types of perceived interruptions and to examine their relationships with stress outcomes. Background Interruptions have been defined and measured in a variety of inconsistent ways. No study has simultaneously examined the subjective experience of all types of interruptions. Method First, we provide a synthesized definition and model of interruptions that aligns interruptions along two qualities: origin and degree of multitasking. Second, we create and validate a self-report measure of these four types of perceived interruptions within two samples (working undergraduate students and working engineers). Last, we correlate this measure with self-reported psychological and physical stress outcomes. Results Our results support the four-factor model of interruptions. Results further support the link between each of the four types of interruptions (intrusions, breaks, distractions, and a specific type of ruminations, discrepancies) and stress outcomes. Specifically, results suggest that distractions explain a unique portion of variance in stress outcomes above and beyond the shared variance explained by intrusions, breaks, and discrepancies. Conclusion The synthesized four-factor model of interruptions is an adequate representation of the overall construct of interruptions. Further, perceived interruptions can be measured and are significantly related to stress outcomes. Application Measuring interruptions by observation can be intrusive and resource intensive. Additionally, some types of interruptions may be internal and therefore unobservable. Our survey measure offers a practical alternative method for practitioners and researchers interested in the outcomes of interruptions, especially stress outcomes.

  15. Control instrumentation and data handling of heavy current inductive load interrupter

    International Nuclear Information System (INIS)

    Calpin, J.E.

    1983-01-01

    The heavy duty DC interrupter is a switching system with the ability to interrupt very high inductive currents with precise timing, work in concert with an additional number of similar systems, and withstand fast recovery voltages (30 kV) after interruption. Further, it is required to be self-protecting and the high current busses isolated to 50 kV DC and subjected to 95 kV BIL test voltages. Interruption is accomplished by the separation of vacuum interrupter contacts, which prior to counterpulse arc for milliseconds, generating horrendous noise signals of frequencies from DC to ultraviolet. Neutralization of such signals on the computer interface was effected by unique BALUN filters on 25 control and status lines. The noise abatement circuitry rationale will be discussed along with triple shielding, Hall effect current level sensing and light pipe communication between high level busses and interface HTL cards. Triggering of the isolated counterpulse circuitry will be outlined. The self-protective aspects of the system employ current sensors to reclose the interrupter if current persists for two milliseconds after counterpulse

  16. Executing application function calls in response to an interrupt

    Science.gov (United States)

    Almasi, Gheorghe; Archer, Charles J.; Giampapa, Mark E.; Gooding, Thomas M.; Heidelberger, Philip; Parker, Jeffrey J.

    2010-05-11

    Executing application function calls in response to an interrupt including creating a thread; receiving an interrupt having an interrupt type; determining whether a value of a semaphore represents that interrupts are disabled; if the value of the semaphore represents that interrupts are not disabled: calling, by the thread, one or more preconfigured functions in dependence upon the interrupt type of the interrupt; yielding the thread; and if the value of the semaphore represents that interrupts are disabled: setting the value of the semaphore to represent to a kernel that interrupts are hard-disabled; and hard-disabling interrupts at the kernel.

  17. Using forecast modelling to evaluate treatment effects in single-group interrupted time series analysis.

    Science.gov (United States)

    Linden, Ariel

    2018-05-11

    Interrupted time series analysis (ITSA) is an evaluation methodology in which a single treatment unit's outcome is studied serially over time and the intervention is expected to "interrupt" the level and/or trend of that outcome. ITSA is commonly evaluated using methods which may produce biased results if model assumptions are violated. In this paper, treatment effects are alternatively assessed by using forecasting methods to closely fit the preintervention observations and then forecast the post-intervention trend. A treatment effect may be inferred if the actual post-intervention observations diverge from the forecasts by some specified amount. The forecasting approach is demonstrated using the effect of California's Proposition 99 for reducing cigarette sales. Three forecast models are fit to the preintervention series-linear regression (REG), Holt-Winters (HW) non-seasonal smoothing, and autoregressive moving average (ARIMA)-and forecasts are generated into the post-intervention period. The actual observations are then compared with the forecasts to assess intervention effects. The preintervention data were fit best by HW, followed closely by ARIMA. REG fit the data poorly. The actual post-intervention observations were above the forecasts in HW and ARIMA, suggesting no intervention effect, but below the forecasts in the REG (suggesting a treatment effect), thereby raising doubts about any definitive conclusion of a treatment effect. In a single-group ITSA, treatment effects are likely to be biased if the model is misspecified. Therefore, evaluators should consider using forecast models to accurately fit the preintervention data and generate plausible counterfactual forecasts, thereby improving causal inference of treatment effects in single-group ITSA studies. © 2018 John Wiley & Sons, Ltd.

  18. Results of antiretroviral treatment interruption and intensification in advanced multi-drug resistant HIV infection from the OPTIMA trial.

    Directory of Open Access Journals (Sweden)

    Mark Holodniy

    2011-03-01

    Full Text Available Guidance is needed on best medical management for advanced HIV disease with multidrug resistance (MDR and limited retreatment options. We assessed two novel antiretroviral (ARV treatment approaches in this setting.We conducted a 2×2 factorial randomized open label controlled trial in patients with a CD4 count≤300 cells/µl who had ARV treatment (ART failure requiring retreatment, to two options (a re-treatment with either standard (≤4 ARVs or intensive (≥5 ARVs ART and b either treatment starting immediately or after a 12-week monitored ART interruption. Primary outcome was time to developing a first AIDS-defining event (ADE or death from any cause. Analysis was by intention to treat. From 2001 to 2006, 368 patients were randomized. At baseline, mean age was 48 years, 2% were women, median CD4 count was 106/µl, mean viral load was 4.74 log(10 copies/ml, and 59% had a prior AIDS diagnosis. Median follow-up was 4.0 years in 1249 person-years of observation. There were no statistically significant differences in the primary composite outcome of ADE or death between re-treatment options of standard versus intensive ART (hazard ratio 1.17; CI 0.86-1.59, or between immediate retreatment initiation versus interruption before re-treatment (hazard ratio 0.93; CI 0.68-1.30, or in the rate of non-HIV associated serious adverse events between re-treatment options.We did not observe clinical benefit or harm assessed by the primary outcome in this largest and longest trial exploring both ART interruption and intensification in advanced MDR HIV infection with poor retreatment options.Clinicaltrials.gov NCT00050089.

  19. A Wrist-Worn Thermohaptic Device for Graceful Interruption

    DEFF Research Database (Denmark)

    Bolton, Frank; Jalaliniya, Shahram; Pederson, Thomas

    2015-01-01

    Thermal haptics is a potential system output modality for wearable devices that promises to function at the periphery of human attention. When adequately combined with existing attention-governing mechanisms of the human mind, it could be used for interrupting the human agent at a time when......-worn thermohaptic actuator for self-mitigating interruption. We then develop a prototype and perform an insightful pilot study. We frame our empirical thermohaptic experimental work in terms of Peripheral Interaction concepts and show how this new approach to Human-Computer Interaction relates to the Context...

  20. HVDC interrupter experiments for large Magnetic Energy Transfer and Storage (METS) systems

    International Nuclear Information System (INIS)

    Swannack, C.E.; Haarman, R.A.; Lindsay, J.D.G.; Weldon, D.M.

    1975-01-01

    Proposed fusion-test reactors will require energy storage systems of hundreds of megajoules with transfer times of the order of one millisecond. The size of the energy storage submodule (and hence, the overall system cost and complexity) is directly determined by the voltage and current limits of the switch used for the energy transfer. Experiments are being conducted on high voltage dc circuit breakers as a major part of the energy storage, pulsed power program. DC circuit interruption characteristics of a commercially available ac power vacuum interrupter are discussed. Preliminary data of interruption characteristics are reported for an interrupter developed specifically to match a present METS circuit requirement

  1. Early counterpulse technique applied to vacuum interrupters

    International Nuclear Information System (INIS)

    Warren, R.W.

    1979-01-01

    Interruption of dc currents using counterpulse techniques is investigated with vacuum interrupters and a novel approach in which the counterpulse is applied before contact separation. Important increases have been achieved in this way in the maximum interruptible current and large reductions in contact erosion. The factors establishing these new limits are presented and ways are discussed to make further improvements to the maximum interruptible current

  2. A multi-dimensional framework to assist in the design of successful shared services centres

    Directory of Open Access Journals (Sweden)

    Mark Borman

    2012-04-01

    Full Text Available Organisations are increasingly looking to realise the benefits of shared services yet there is little guidance available as to the best way to proceed. A multi-dimensional framework is presented that considers the service provided, the design of the shared services centre and the organisational context it sits within. Case studies are then used to determine what specific attributes from each dimension are associated with success and how they should be aligned. It is concluded that there appears to be a single, broadly standard pattern of attributes for successful Shared Services Centres (SSCs across the proposed dimensions of Activity, Environment, History, Resources, Strategy, Structure, Management, Technology and Individual Skills. It should also be noted though that some deviation from the identified standard along some dimensions is possible without adverse effect – ie that the alignment identified appears to be relatively soft.

  3. General bulk service queueing system with N-policy, multiplevacations, setup time and server breakdown without interruption

    Science.gov (United States)

    Sasikala, S.; Indhira, K.; Chandrasekaran, V. M.

    2017-11-01

    In this paper, we have considered an MX / (a,b) / 1 queueing system with server breakdown without interruption, multiple vacations, setup times and N-policy. After a batch of service, if the size of the queue is ξ (customers in the queue. After a vacation, if the server finds at least N customers waiting for service, then the server needs a setup time to start the service. After a batch of service, if the amount of waiting customers in the queue is ξ (≥ a) then the server serves a batch of min(ξ,b) customers, where b ≥ a. We derived the probability generating function of queue length at arbitrary time epoch. Further, we obtained some important performance measures.

  4. COMPARATIVE STUDY OF RTOS AND PRIMITIVE INTERRUPT IN EMBEDDED SYSTEM

    Directory of Open Access Journals (Sweden)

    Dwi Purnomo

    2015-03-01

    Full Text Available Multitasking is one of the most challenging issues in the automation industry which is highly depended on the embedded system. There are two methods to perform multitasking in embedded system: RTOS and primitive interrupt. The main purpose of this research is to compare the performance of R¬TOS with primitive method while concurrently undertaking multiple tasks. The system, which is able to perform various tasks, has been built to evaluate the performance of both methods. There are four tasks introduced in the system: servo task, sensor task, LED task, and LCD task. The performance of each method is indicated by the success rate of the sensor task detection. Sensor task detection will be compared with the true value which is calculated and measured manually during observation time. Observation time was varied after several iterations and the data of the iteration are recorded for both RTOS and primitive interrupt methods. The results of the conducted experiments have shown that, RTOS is more accurate than interrupt method. However, the data variance of the primitive interrupt method is narrower than RTOS. Therefore, to choose a better method, an optimization is needed to be done and each product has its own standard.

  5. Just-in-time preemptive single machine problem with costs of earliness/tardiness, interruption and work-in-process

    Directory of Open Access Journals (Sweden)

    Mohammad Kazemi

    2012-04-01

    Full Text Available This paper considers preemption and idle time are allowed in a single machine scheduling problem with just-in-time (JIT approach. It incorporates Earliness/Tardiness (E/T penalties, interruption penalties and holding cost of jobs which are waiting to be processed as work-in-process (WIP. Generally in non-preemptive problems, E/T penalties are a function of the completion time of the jobs. Then, we introduce a non-linear preemptive scheduling model where the earliness penalty depends on the starting time of a job. The model is liberalized by an elaborately–designed procedure to reach the optimum solution. To validate and verify the performance of proposed model, computational results are presented by solving a number of numerical examples.

  6. The role of dosimetry audit in lung SBRT multi-centre clinical trials.

    Science.gov (United States)

    Clark, Catharine H; Hurkmans, Coen W; Kry, Stephen F

    2017-12-01

    Stereotactic Body Radiotherapy (SBRT) in the lung is a challenging technique which requires high quality clinical trials to answer the un-resolved clinical questions. Quality assurance of these clinical trials not only ensures the safety of the treatment of the participating patients but also minimises the variation in treatment, thus allowing the lowest number of patient treatments to answer the trial question. This review addresses the role of dosimetry audits in the quality assurance process and considers what can be done to ensure the highest accuracy of dose calculation and delivery and it's assessment in multi-centre trials. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  7. The impact of family policy and career interruptions on women's perceptions of negative occupational consequences of full-time home care

    DEFF Research Database (Denmark)

    Ejrnæs, Anders

    2011-01-01

    for their careers. On the one hand, our findings confirm the hypothesis that long-term absence from the labour market due to full-time care has negative consequences for women's occupational careers. On the other hand, our findings show that countries with well paid leave schemes combined with access to high...... quality childcare reduce the perceived negative occupational consequences of the time spent on full-time care. This is the case independently of the duration of the career interruption due to care-giving....

  8. Characterization of female breast lesions from multi-wavelength time-resolved optical mammography

    International Nuclear Information System (INIS)

    Spinelli, Lorenzo; Torricelli, Alessandro; Pifferi, Antonio; Taroni, Paola; Danesini, Gianmaria; Cubeddu, Rinaldo

    2005-01-01

    Characterization of both malignant and benign lesions in the female breast is presented as the result of a clinical study that involved more than 190 subjects in the framework of the OPTIMAMM European project. All the subjects underwent optical mammography, by means of a multi-wavelength time-resolved mammograph, in the range 637-985 nm. Optical images were processed by applying a perturbation model, relying on a nonlinear approximation of time-resolved transmittance curves in the presence of an inclusion, with the aim of estimating the major tissue constituents (i.e. oxy- and deoxy-haemoglobin, lipid and water) and structural parameters (linked to dimension and density of the scatterer centres) for both the lesion area and the surrounding tissue. The critical factors for the application of the perturbation model on in vivo data are also discussed. Forty-six malignant and 68 benign lesions were analysed. A subset of 32 cancers, 40 cysts and 14 fibroadenomas were found reliable for the perturbation analysis. For cancers, we show a higher blood content with respect to the surrounding tissue, while cysts are characterized by a lower concentration of scattering centres with respect to the surrounding tissue. For fibroadenomas, the low number of cases does not allow any definite conclusions

  9. Harmonization process and reliability assessment of anthropometric measurements in the elderly EXERNET multi-centre study.

    Directory of Open Access Journals (Sweden)

    Alba Gómez-Cabello

    Full Text Available BACKGROUND: The elderly EXERNET multi-centre study aims to collect normative anthropometric data for old functionally independent adults living in Spain. PURPOSE: To describe the standardization process and reliability of the anthropometric measurements carried out in the pilot study and during the final workshop, examining both intra- and inter-rater errors for measurements. MATERIALS AND METHODS: A total of 98 elderly from five different regions participated in the intra-rater error assessment, and 10 different seniors living in the city of Toledo (Spain participated in the inter-rater assessment. We examined both intra- and inter-rater errors for heights and circumferences. RESULTS: For height, intra-rater technical errors of measurement (TEMs were smaller than 0.25 cm. For circumferences and knee height, TEMs were smaller than 1 cm, except for waist circumference in the city of Cáceres. Reliability for heights and circumferences was greater than 98% in all cases. Inter-rater TEMs were 0.61 cm for height, 0.75 cm for knee-height and ranged between 2.70 and 3.09 cm for the circumferences measured. Inter-rater reliabilities for anthropometric measurements were always higher than 90%. CONCLUSION: The harmonization process, including the workshop and pilot study, guarantee the quality of the anthropometric measurements in the elderly EXERNET multi-centre study. High reliability and low TEM may be expected when assessing anthropometry in elderly population.

  10. Prevalence of maternal anaemia and its predictors: a multi-centre study.

    Science.gov (United States)

    Barroso, Filipa; Allard, Shubha; Kahan, Brennan C; Connolly, Catriona; Smethurst, Heather; Choo, Louise; Khan, Khalid; Stanworth, Simon

    2011-11-01

    To investigate the prevalence, predictors, and management of anaemia in pregnancy. A multi centre study across 11 maternity units in the UK. Data were collected over a two week study period in 2008 on maternal history, haemoglobin (Hb) and ferritin concentrations, iron therapy during pregnancy and in the postpartum period. Logistic regression models were used to explore factors associated with anaemia during pregnancy. Main outcomes included anaemia, defined as Hbanaemia by 32 weeks gestation included young maternal age (odds ratio 1.96, 95% CI 1.38-2.79), non-white ethnic origin (odds ratios varied 1.37-2.89 depending on ethnic origin) and increasing parity (odds ratio 1.24, 95% CI 1.08-1.41). Of women who had postnatal Hb levels checked, 30% (309/1031) were anaemic and, depending on centre, 16% to 86% of these received iron therapy. Anaemia was reported in nearly one in four women in the antenatal period, and nearly one in three of the women who had a postpartum Hb checked. Despite national guidelines, there was considerable variation in administration of iron including low utilisation of parenteral iron therapy. Future research needs to focus on the consequences of iron deficiency anaemia for maternal and infant health outcomes and effectiveness of implementation strategies to reduce anaemia. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  11. Examining the Internal Validity and Statistical Precision of the Comparative Interrupted Time Series Design by Comparison with a Randomized Experiment

    Science.gov (United States)

    St.Clair, Travis; Cook, Thomas D.; Hallberg, Kelly

    2014-01-01

    Although evaluators often use an interrupted time series (ITS) design to test hypotheses about program effects, there are few empirical tests of the design's validity. We take a randomized experiment on an educational topic and compare its effects to those from a comparative ITS (CITS) design that uses the same treatment group as the experiment…

  12. Mediated interruptions of anaesthesia providers using predictions of workload from anaesthesia information management system data.

    Science.gov (United States)

    Epstein, R H; Dexter, F

    2012-09-01

    Perioperative interruptions generated electronically from anaesthesia information management systems (AIMS) can provide useful feedback, but may adversely affect task performance if distractions occur at inopportune moments. Ideally such interruptions would occur only at times when their impact would be minimal. In this study of AIMS data, we evaluated the times of comments, drugs, fluids and periodic assessments (e.g. electrocardiogram diagnosis and train-of-four) to develop recommendations for the timing of interruptions during the intraoperative period. The 39,707 cases studied were divided into intervals between: 1) enter operating room; 2) induction; 3) intubation; 4) surgical incision; and 5) end surgery. Five-minute intervals of no documentation were determined for each case. The offsets from the start of each interval when >50% of ongoing cases had completed initial documentation were calculated (MIN50). The primary endpoint for each interval was the percentage of all cases still ongoing at MIN50. Results were that the intervals from entering the operating room to induction and from induction to intubation were unsuitable for interruptions confirming prior observational studies of anaesthesia workload. At least 13 minutes after surgical incision was the most suitable time for interruptions with 92% of cases still ongoing. Timing was minimally affected by the type of anaesthesia, surgical facility, surgical service, prone positioning or scheduled case duration. The implication of our results is that for mediated interruptions, waiting at least 13 minutes after the start of surgery is appropriate. Although we used AIMS data, operating room information system data is also suitable.

  13. Deformation of contact surfaces in a vacuum interrupter after high-current interruptions

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Haoran; Wang, Zhenxing, E-mail: zxwang@xjtu.edu.cn; Zhou, Zhipeng; Jiang, Yanjun; Wang, Jianhua; Geng, Yingsan; Liu, Zhiyuan [State Key Laboratory of Electrical Insulation and Power Equipment, Xi' an Jiaotong University, Xi' an 710049 (China)

    2016-08-07

    In a high-current interruption, the contact surface in a vacuum interrupter might be severely damaged by constricted vacuum arcs causing a molten area on it. As a result, a protrusion will be initiated by a transient recovery voltage after current zero, enhancing the local electric field and making breakdowns occur easier. The objective of this paper is to simulate the deformation process on the molten area under a high electric field by adopting the finite element method. A time-dependent Electrohydrodynamic model was established, and the liquid-gas interface was tracked by the level-set method. From the results, the liquid metal can be deformed to a Taylor cone if the applied electric field is above a critical value. This value is correlated to the initial geometry of the liquid metal, which increases as the size of the liquid metal decreases. Moreover, the buildup time of a Taylor cone obeys the power law t = k × E{sup −3}, where E is the initial electric field and k is a coefficient related to the material property, indicating a temporal self-similar characteristic. In addition, the influence of temperature has little impact on the deformation but has great impact on electron emission. Finally, the possible reason to initiate a delayed breakdown is associated with the deformation. The breakdown does not occur immediately when the voltage is just applied upon the gap but is postponed to several milliseconds later when the tip is formed on the liquid metal.

  14. Multi-technology control centre to integrate 460 MW renewables

    International Nuclear Information System (INIS)

    2016-01-01

    The new RWE Innogy Aersa Control Centre that has been certified to act as an interface with CECRE (the Renewable Energy Control Centre) since February 2015, connects RWE’s 20 renewable energy facilities with REE, the Spanish Electricity Grid. As a result, it ensures that wind farms, in addition to hydropower and solar plants, can inject the energy generated by its 460 MW installed safely and with no penalties. Green Eagle Solutions, a provider of software solutions for renewable energy companies, has collaborated with RWE in the development of this Control Centre, meeting the high standards of quality and safety required by RWE. This centre uses CompactSCADA® technology to integrate power generation facilities that need to be integrated in a Control Centre to communicate with REE’s CECRE. (Author)

  15. Heterogeneous FDG-guided dose-escalation for locally advanced NSCLC (the NARLAL2 trial): Design and early dosimetric results of a randomized, multi-centre phase-III study

    DEFF Research Database (Denmark)

    Møller, Ditte Sloth; Nielsen, Tine Bjørn; Brink, Carsten

    2017-01-01

    Background and purpose: Local recurrence is frequent in locally advanced NSCLC and is primarily located in FDG-avid parts of tumour and lymph nodes. Aiming at improving local control without increasing toxicity, we designed a multi-centre phase-III trial delivering inhomogeneous dose-escalation d......Background and purpose: Local recurrence is frequent in locally advanced NSCLC and is primarily located in FDG-avid parts of tumour and lymph nodes. Aiming at improving local control without increasing toxicity, we designed a multi-centre phase-III trial delivering inhomogeneous dose...

  16. Early counterpulse technique applied to vacuum interrupters

    International Nuclear Information System (INIS)

    Warren, R.W.

    1979-11-01

    Interruption of dc currents using counterpulse techniques is investigated with vacuum interrupters and a novel approach in which the counterpulse is applied before contact separation. Important increases have been achieved in this way in the maximum interruptible current as well as large reductions in contact erosion. The factors establishing these new limits are presented and ways are discussed to make further improvements

  17. The Scandinavian Propaten(®) trial - 1-year patency of PTFE vascular prostheses with heparin-bonded luminal surfaces compared to ordinary pure PTFE vascular prostheses - a randomised clinical controlled multi-centre trial

    DEFF Research Database (Denmark)

    Lindholt, J S; Gottschalksen, B; Johannesen, N

    2011-01-01

    To compare 1-year potencies' of heparin-bonded PTFE [(Hb-PTFE) (Propaten(®))] grafts with those of ordinary polytetraflouroethylene (PTFE) grafts in a blinded, randomised, clinically controlled, multi-centre study.......To compare 1-year potencies' of heparin-bonded PTFE [(Hb-PTFE) (Propaten(®))] grafts with those of ordinary polytetraflouroethylene (PTFE) grafts in a blinded, randomised, clinically controlled, multi-centre study....

  18. Optical Cutting Interruption Sensor for Fiber Lasers

    Directory of Open Access Journals (Sweden)

    Benedikt Adelmann

    2015-09-01

    Full Text Available We report on an optical sensor system attached to a 4 kW fiber laser cutting machine to detect cutting interruptions. The sensor records the thermal radiation from the process zone with a modified ring mirror and optical filter arrangement, which is placed between the cutting head and the collimator. The process radiation is sensed by a Si and InGaAs diode combination with the detected signals being digitalized with 20 kHz. To demonstrate the function of the sensor, signals arising during fusion cutting of 1 mm stainless steel and mild steel with and without cutting interruptions are evaluated and typical signatures derived. In the recorded signals the piercing process, the laser switch on and switch off point and waiting period are clearly resolved. To identify the cutting interruption, the signals of both Si and InGaAs diodes are high pass filtered and the signal fluctuation ranges being subsequently calculated. Introducing a correction factor, we identify that only in case of a cutting interruption the fluctuation range of the Si diode exceeds the InGaAs diode. This characteristic signature was successfully used to detect 80 cutting interruptions of 83 incomplete cuts (alpha error 3.6% and system recorded no cutting interruption from 110 faultless cuts (beta error of 0. This particularly high detection rate in combination with the easy integration of the sensor, highlight its potential for cutting interruption detection in industrial applications.

  19. Interrupting long periods of sitting: good STUFF

    Directory of Open Access Journals (Sweden)

    Rutten Geert M

    2013-01-01

    Full Text Available Abstract There is increasing evidence that sedentary behaviour is in itself a health risk, regardless of the daily amount of moderate to vigorous physical activity. Therefore, sedentary behaviour should be targeted as important health behaviour. It is known that even relatively small changes of health behaviour often require serious efforts from an individual and from people in their environment to become part of their lifestyle. Therefore, interventions to promote healthy behaviours should ideally be simple, easy to perform and easily available. Since sitting is likely to be highly habitual, confrontation with an intervention should almost automatically elicit a reaction of getting up, and thus break up and reduce sitting time. One important prerequisite for successful dissemination of such an intervention could be the use of a recognisable term relating to sedentary behaviour, which should have the characteristics of an effective brand name. To become wide spread, this term may need to meet three criteria: the “Law of the few”, the “Stickiness factor”, and the “Power of context”. For that purpose we introduce STUFF: Stand Up For Fitness. STUFF can be defined as “interrupting long sitting periods by short breaks”, for instance, interrupting sitting every 30 min by standing for at least five minutes. Even though we still need evidence to test the health-enhancing effects of interrupted sitting, we hope that the introduction of STUFF will facilitate the testing of the social, psychological and health effects of interventions to reduce sitting time.

  20. Floor heating in the multi-functional centre `Gelderhorst` in Ede, Netherlands; De Gelderhorst slaat bouwfase over

    Energy Technology Data Exchange (ETDEWEB)

    Wondergem, J. [Wondergem Intermedium, Weesp (Netherlands)

    1997-11-01

    The Gelderhorst is a multi-functional centre for elderly, deaf people. Building systems are installed normally after the rough building structure is finished. In the building process of Gelderhorst the floor heating is installed in a pre-phase of the construction of the building. Thereto, the cooperation between the installation company, the manufacturer, the wholesale business and the contractor had to be well planned. Also, problems had to be solved with respect to the choice of building materials and installation techniques. 4 ills.

  1. Qualitative insights into practice time management: does 'patient-centred time' in practice management offer a portal to improved access?

    Science.gov (United States)

    Buetow, S; Adair, V; Coster, G; Hight, M; Gribben, B; Mitchell, E

    2002-01-01

    BACKGROUND: Different sets of literature suggest how aspects of practice time management can limit access to general practitioner (GP) care. Researchers have not organised this knowledge into a unified framework that can enhance understanding of barriers to, and opportunities for, improved access. AIM: To suggest a framework conceptualising how differences in professional and cultural understanding of practice time management in Auckland, New Zealand, influence access to GP care for children with chronic asthma. DESIGN OF STUDY: A qualitative study involving selective sampling, semi-structured interviews on barriers to access, and a general inductive approach. SETTING: Twenty-nine key informants and ten mothers of children with chronic, moderate to severe asthma and poor access to GP care in Auckland. METHOD: Development of a framework from themes describing barriers associated with, and needs for, practice time management. The themes were independently identified by two authors from transcribed interviews and confirmed through informant checking. Themes from key informant and patient interviews were triangulated with each other and with published literature. RESULTS: The framework distinguishes 'practice-centred time' from 'patient-centred time.' A predominance of 'practice-centred time' and an unmet opportunity for 'patient-centred time' are suggested by the persistence of five barriers to accessing GP care: limited hours of opening; traditional appointment systems; practice intolerance of missed appointments; long waiting times in the practice; and inadequate consultation lengths. None of the barriers is specific to asthmatic children. CONCLUSION: A unified framework was suggested for understanding how the organisation of practice work time can influence access to GP care by groups including asthmatic children. PMID:12528583

  2. Qualitative insights into practice time management: does 'patient-centred time' in practice management offer a portal to improved access?

    Science.gov (United States)

    Buetow, S; Adair, V; Coster, G; Hight, M; Gribben, B; Mitchell, E

    2002-12-01

    Different sets of literature suggest how aspects of practice time management can limit access to general practitioner (GP) care. Researchers have not organised this knowledge into a unified framework that can enhance understanding of barriers to, and opportunities for, improved access. To suggest a framework conceptualising how differences in professional and cultural understanding of practice time management in Auckland, New Zealand, influence access to GP care for children with chronic asthma. A qualitative study involving selective sampling, semi-structured interviews on barriers to access, and a general inductive approach. Twenty-nine key informants and ten mothers of children with chronic, moderate to severe asthma and poor access to GP care in Auckland. Development of a framework from themes describing barriers associated with, and needs for, practice time management. The themes were independently identified by two authors from transcribed interviews and confirmed through informant checking. Themes from key informant and patient interviews were triangulated with each other and with published literature. The framework distinguishes 'practice-centred time' from 'patient-centred time.' A predominance of 'practice-centred time' and an unmet opportunity for 'patient-centred time' are suggested by the persistence of five barriers to accessing GP care: limited hours of opening; traditional appointment systems; practice intolerance of missed appointments; long waiting times in the practice; and inadequate consultation lengths. None of the barriers is specific to asthmatic children. A unified framework was suggested for understanding how the organisation of practice work time can influence access to GP care by groups including asthmatic children.

  3. Multi-time, multi-scale correlation functions in turbulence and in turbulent models

    NARCIS (Netherlands)

    Biferale, L.; Boffetta, G.; Celani, A.; Toschi, F.

    1999-01-01

    A multifractal-like representation for multi-time, multi-scale velocity correlation in turbulence and dynamical turbulent models is proposed. The importance of subleading contributions to time correlations is highlighted. The fulfillment of the dynamical constraints due to the equations of motion is

  4. The Use of Piecewise Growth Models to Estimate Learning Trajectories and RtI Instructional Effects in a Comparative Interrupted Time-Series Design

    Science.gov (United States)

    Zvoch, Keith

    2016-01-01

    Piecewise growth models (PGMs) were used to estimate and model changes in the preliteracy skill development of kindergartners in a moderately sized school district in the Pacific Northwest. PGMs were applied to interrupted time-series (ITS) data that arose within the context of a response-to-intervention (RtI) instructional framework. During the…

  5. Energy expenditure of interruptions to sedentary behavior

    Directory of Open Access Journals (Sweden)

    Strath Scott J

    2011-06-01

    Full Text Available Abstract Background Advances in technology, social influences and environmental attributes have resulted in substan-tial portions of the day spent in sedentary pursuits. Sedentary behavior may be a cause of many chronic diseases including obesity, insulin resistance, type 2 diabetes and the metabolic syndrome. Research demonstrated that breaking up sedentary time was beneficially associated with markers of body composition, cardiovascular health and type 2 diabetes. Therefore, the purpose of this study was to quantify the total energy expenditure of three different durations of physical activity within a 30-minute sedentary period and to examine the potential benefits of interrupting sedentary behavior with physical activity for weight control. Methods Participants completed four consecutive 30-minute bouts of sedentary behavior (reading, working on the computer, or doing other desk activities with and without interruptions of walking at a self-selected pace. Bout one contained no walking interruptions. Bout two contained a 1-minute walking period. Bout three contained a 2-minute walking period. Bout four contained a 5-minute walking period. Body composition and resting metabolic rate were assessed. Result Twenty males and females (18-39 years completed this study. Results of the repeated measures analysis of variance with post-hoc testing showed that significantly more energy was expended during each 30 minute sedentary bout with a walking break than in the 30 minute sedentary bout (p Conclusions This study demonstrated that making small changes, such as taking a five minute walking break every hour could yield beneficial weight control or weight loss results. Therefore, taking breaks from sedentary time is a potential outlet to prevent obesity and the rise of obesity in developed countries.

  6. Interrupter and hybrid-switch testing for fusion devices

    International Nuclear Information System (INIS)

    Parsons, W.M.; Warren, R.W.; Honig, E.M.; Lindsay, J.D.G.; Bellamo, P.; Cassel, R.L.

    1979-01-01

    This paper discusses recent and ongoing switch testing for fusion devices. The first part describes testing for the TFTR ohmic-heating circuit. In this set of tests, which simulated the stresses produced during a plasma initiation pulse, circuit breakers were required to interrupt a current of 24 kA with an associated recovery voltage of 25 kV. Two interrupter systems were tested for over 1000 operations each, and both appear to satisfy TFTR requirements. The second part discusses hybrid-switch development for superconducting coil protection. These switching systems must be capable of carrying large currents on a continuous basis as well as performing interruption duties. The third part presents preliminary results on an early-counterpulse technique applied to vacuum interrupters. Implementation of this technique has resulted in large increases in interruptible current as well as a marked reduction in contact erosion

  7. Effect of growth interruption on the crystalline quality and electrical properties of Ga-doped ZnO thin film deposited on quartz substrate by magnetron sputtering

    International Nuclear Information System (INIS)

    Lee, Geun-Hyoung

    2013-01-01

    Ga-doped ZnO(GZO) thin films were deposited on the quartz substrate by magnetron sputtering system with growth interruption technique. As the number of interruptions and interruption time increased, the carrier concentration and Hall mobility in GZO films significantly increased. As a result, the resistivity of GZO films decreased. The optical transmittance of GZO films also increased with the number of interruption and interruption time. The transmittance showed over 90% in visual region. Atomic force microscopy measurement showed that the film surface became smoother with an increase of the number of interruption. In addition, the crystalline quality and electrical properties of GZO films were more improved when the growth interruption was employed with a temperature gradient. - Highlights: • Ga-doped ZnO thin films were deposited with growth interruption technique. • The crystallinity of the films was improved with the number of interruptions. • The crystallinity of the films was improved as the interruption time increased. • The growth interruption with a temperature gradient more improved the film quality

  8. Species distribution and susceptibility profile to fluconazole, voriconazole and MXP-4509 of 551 clinical yeast isolates from a Romanian multi-centre study

    NARCIS (Netherlands)

    Minea, B; Nastasa, V; Moraru, R F; Kolecka, A; Flonta, M M; Marincu, I; Man, A; Toma, F; Lupse, M; Doroftei, B; Marangoci, N; Pinteala, M; Boekhout, T; Mares, M

    This is the first multi-centre study regarding yeast infections in Romania. The aim was to determine the aetiological spectrum and susceptibility pattern to fluconazole, voriconazole and the novel compound MXP-4509. The 551 isolates were identified using routine laboratory methods, matrix-assisted

  9. Earthquake and failure forecasting in real-time: A Forecasting Model Testing Centre

    Science.gov (United States)

    Filgueira, Rosa; Atkinson, Malcolm; Bell, Andrew; Main, Ian; Boon, Steven; Meredith, Philip

    2013-04-01

    Across Europe there are a large number of rock deformation laboratories, each of which runs many experiments. Similarly there are a large number of theoretical rock physicists who develop constitutive and computational models both for rock deformation and changes in geophysical properties. Here we consider how to open up opportunities for sharing experimental data in a way that is integrated with multiple hypothesis testing. We present a prototype for a new forecasting model testing centre based on e-infrastructures for capturing and sharing data and models to accelerate the Rock Physicist (RP) research. This proposal is triggered by our work on data assimilation in the NERC EFFORT (Earthquake and Failure Forecasting in Real Time) project, using data provided by the NERC CREEP 2 experimental project as a test case. EFFORT is a multi-disciplinary collaboration between Geoscientists, Rock Physicists and Computer Scientist. Brittle failure of the crust is likely to play a key role in controlling the timing of a range of geophysical hazards, such as volcanic eruptions, yet the predictability of brittle failure is unknown. Our aim is to provide a facility for developing and testing models to forecast brittle failure in experimental and natural data. Model testing is performed in real-time, verifiably prospective mode, in order to avoid selection biases that are possible in retrospective analyses. The project will ultimately quantify the predictability of brittle failure, and how this predictability scales from simple, controlled laboratory conditions to the complex, uncontrolled real world. Experimental data are collected from controlled laboratory experiments which includes data from the UCL Laboratory and from Creep2 project which will undertake experiments in a deep-sea laboratory. We illustrate the properties of the prototype testing centre by streaming and analysing realistically noisy synthetic data, as an aid to generating and improving testing methodologies in

  10. Centre-containing spiral-geometric structure of the space-time and nonrelativistic relativity of the unit time

    International Nuclear Information System (INIS)

    Shakhazizyan, S.R.

    1987-01-01

    The problem of nonrelativistic dependence of unit length and unit time on the position in the space is considered on the basis of centre-containing spiral-geometric structure of the space-time. The experimental results of variation of the unit time are analyzed which well agree with the requirements of the model proposed. 13 refs.; 12 figs

  11. The outcome of a multi-centre feasibility study of online adaptive radiotherapy for muscle-invasive bladder cancer TROG 10.01 BOLART

    International Nuclear Information System (INIS)

    Foroudi, Farshad; Pham, Daniel; Rolfo, Aldo; Bressel, Mathias; Tang, Colin I.; Tan, Alex; Turner, Sandra; Hruby, George; Williams, Stephen; Hayne, Dickon; Lehman, Margot; Skala, Marketa; Jose, Chakiath C.; Gogna, Kumar; Kron, Tomas

    2014-01-01

    Purpose: To assess whether online adaptive radiotherapy for bladder cancer is feasible across multiple Radiation Oncology departments using different imaging, delivery and recording technology. Materials and methods: A multi-centre feasibility study of online adaptive radiotherapy, using a choice of three “plan of the day”, was conducted at 12 departments. Patients with muscle-invasive bladder cancer were included. Departments were activated if part of the pilot study or after a site-credentialing visit. There was real time review of the first two cases from each department. Results: 54 patients were recruited, with 50 proceeding to radiotherapy. There were 43 males and 7 females with a mean age of 78 years. The tumour stages treated included T1 (1 patient), T2 (35), T3 (10) and T4 (4). One patient died of an unrelated cause during radiotherapy. The three adaptive plans were created before the 10th fraction in all cases. In 8 (16%) of the patients, a conventional plan using a ‘standard’ CTV to PTV margin of 1.5 cm was used for one or more fractions where the pre-treatment bladder CTV was larger than any of the three adaptive plans. The bladder CTV extended beyond the PTV on post treatment imaging in 9 (18%) of the 49 patients. Conclusions: From a technical perspective an online adaptive radiotherapy technique can be instituted in a multi-centre setting. However, without further bladder filling control or imaging, a CTV to PTV margin of 7 mm is insufficient

  12. Incidence of infective endocarditis in England, 2000-13: a secular trend, interrupted time-series analysis.

    Science.gov (United States)

    Dayer, Mark J; Jones, Simon; Prendergast, Bernard; Baddour, Larry M; Lockhart, Peter B; Thornhill, Martin H

    2015-03-28

    Antibiotic prophylaxis given before invasive dental procedures in patients at risk of developing infective endocarditis has historically been the focus of infective endocarditis prevention. Recent changes in antibiotic prophylaxis guidelines in the USA and Europe have substantially reduced the number of patients for whom antibiotic prophylaxis is recommended. In the UK, guidelines from the National Institute for Health and Clinical Excellence (NICE) recommended complete cessation of antibiotic prophylaxis for prevention of infective endocarditis in March, 2008. We aimed to investigate changes in the prescribing of antibiotic prophylaxis and the incidence of infective endocarditis since the introduction of these guidelines. We did a retrospective secular trend study, analysed as an interrupted time series, to investigate the effect of antibiotic prophylaxis versus no prophylaxis on the incidence of infective endocarditis in England. We analysed data for the prescription of antibiotic prophylaxis from Jan 1, 2004, to March 31, 2013, and hospital discharge episode statistics for patients with a primary diagnosis of infective endocarditis from Jan 1, 2000, to March 31, 2013. We compared the incidence of infective endocarditis before and after the introduction of the NICE guidelines using segmented regression analysis of the interrupted time series. Prescriptions of antibiotic prophylaxis for the prevention of infective endocarditis fell substantially after introduction of the NICE guidance (mean 10,900 prescriptions per month [Jan 1, 2004, to March 31, 2008] vs 2236 prescriptions per month [April 1, 2008, to March 31, 2013], pinfective endocarditis increased significantly above the projected historical trend, by 0·11 cases per 10 million people per month (95% CI 0·05-0·16, pinfective endocarditis was significant for both individuals at high risk of infective endocarditis and those at lower risk. Although our data do not establish a causal association, prescriptions

  13. Effect of Radiotherapy Interruptions on Survival in Medicare Enrollees With Local and Regional Head-and-Neck Cancer

    International Nuclear Information System (INIS)

    Fesinmeyer, Megan Dann; Mehta, Vivek; Blough, David; Tock, Lauri; Ramsey, Scott D.

    2010-01-01

    Purpose: To investigate whether interruptions in radiotherapy are associated with decreased survival in a population-based sample of head-and-neck cancer patients. Methods and Materials: Using the Surveillance, Epidemiology, and End Results-Medicare linked database we identified Medicare beneficiaries aged 66 years and older diagnosed with local-regional head-and-neck cancer during the period 1997-2003. We examined claims records of 3864 patients completing radiotherapy for the presence of one or more 5-30-day interruption(s) in therapy. We then performed Cox regression analyses to estimate the association between therapy interruptions and survival. Results: Patients with laryngeal tumors who experienced an interruption in radiotherapy had a 68% (95% confidence interval, 41-200%) increased risk of death, compared with patients with no interruptions. Patients with nasal cavity, nasopharynx, oral, salivary gland, and sinus tumors had similar associations between interruptions and increased risk of death, but these did not reach statistical significance because of small sample sizes. Conclusions: Treatment interruptions seem to influence survival time among patients with laryngeal tumors completing a full course of radiotherapy. At all head-and-neck sites, the association between interruptions and survival is sensitive to confounding by stage and other treatments. Further research is needed to develop methods to identify patients most susceptible to interruption-induced mortality.

  14. Short and long term variability of the interrupter technique under field and standardised conditions in 3-6 year old children

    NARCIS (Netherlands)

    Beelen, RMJ; Smit, HA; van Strien, RT; Koopman, LP; Brussee, JE; Brunekreef, B; Gerritsen, J; Merkus, PJFM

    2003-01-01

    Background: The short and long term variability of the interrupter technique was assessed to determine whether interrupter resistance is a stable individual characteristic over time. The effect of field and standardised measurement conditions on the within-subject variability of the interrupter

  15. 'Away Days' in multi-centre randomised controlled trials: a questionnaire survey of their use and a case study on the effect of one Away Day on patient recruitment.

    Science.gov (United States)

    Jefferson, Laura; Cook, Liz; Keding, Ada; Brealey, Stephen; Handoll, Helen; Rangan, Amar

    2015-11-06

    'Away Days' (trial promotion and training events for trial site personnel) are a well-established method used by trialists to encourage engagement of research sites in the recruitment of patients to multi-centre randomised controlled trials (RCTs). We explored the use of Away Days in multi-centre RCTs and analysed the effect on patient recruitment in a case study. Members of the United Kingdom Trial Managers' Network were surveyed in June 2013 to investigate their experiences in the design and conduct of Away Days in RCTs. We used data from a multi-centre pragmatic surgical trial to explore the effects of an Away Day on the screening and recruitment of patients. A total of 94 people responded to the survey. The majority (78%), who confirmed had organised an Away Day previously, found them to be useful. This is despite their costs.. There was no evidence, however, from the analysis of data from a surgical trial that attendance at an Away Day increased the number of patients screened or recruited at participating sites. Although those responsible for managing RCTs in the UK tend to believe that trial Away Days are beneficial, evidence from a multi-centre surgical trial shows no improvement on a key indicator of trial success. This points to the need to carefully consider the aims, design and conduct of Away Days. Further more rigorous research nested within RCTs would be valuable to evaluate the design and conduct of Away Days. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  16. Sequential hand hygiene promotion contributes to a reduced nosocomial bloodstream infection rate among very low-birth weight infants: an interrupted time series over a 10-year period

    NARCIS (Netherlands)

    Helder, Onno K.; Brug, Johannes; van Goudoever, Johannes B.; Looman, Caspar W. N.; Reiss, Irwin K. M.; Kornelisse, René F.

    2014-01-01

    Sustained high compliance with hand hygiene (HH) is needed to reduce nosocomial bloodstream infections (NBSIs). However, over time, a wash out effect often occurs. We studied the long-term effect of sequential HH-promoting interventions. An observational study with an interrupted time series

  17. The Time Division Multi-Channel Communication Model and the Correlative Protocol Based on Quantum Time Division Multi-Channel Communication

    International Nuclear Information System (INIS)

    Liu Xiao-Hui; Pei Chang-Xing; Nie Min

    2010-01-01

    Based on the classical time division multi-channel communication theory, we present a scheme of quantum time-division multi-channel communication (QTDMC). Moreover, the model of quantum time division switch (QTDS) and correlative protocol of QTDMC are proposed. The quantum bit error rate (QBER) is analyzed and the QBER simulation test is performed. The scheme shows that the QTDS can carry out multi-user communication through quantum channel, the QBER can also reach the reliability requirement of communication, and the protocol of QTDMC has high practicability and transplantable. The scheme of QTDS may play an important role in the establishment of quantum communication in a large scale in the future. (general)

  18. Interruptions and multitasking in surgery: a multicentre observational study of the daily work patterns of doctors and nurses.

    Science.gov (United States)

    Bellandi, Tommaso; Cerri, Alessandro; Carreras, Giulia; Walter, Scott; Mengozzi, Cipriana; Albolino, Sara; Mastrominico, Eleonora; Renzetti, Fernando; Tartaglia, Riccardo; Westbrook, Johanna

    2018-01-01

    The aim of this study was to obtain baseline data on doctors' and nurses' work activities and rates of interruptions and multitasking to improve work organisation and processes. Data were collected in six surgical units with the WOMBAT (Work Observation Method by Activity Timing) tool. Results show that doctors and nurses received approximately 13 interruptions per hour, or one interruption every 4.5 min. Compared to doctors, nurses were more prone to interruptions in most activities, while doctors performed multitasking (33.47% of their time, 95% CI 31.84-35.17%) more than nurses (15.23%, 95% CI 14.24-16.25%). Overall, the time dedicated to patient care is relatively limited for both professions (37.21%, 95% CI 34.95-39.60% for doctors, 27.22%, 95% CI 25.18-29.60% for nurses) compared to the time spent for registration of data and professional communication, that accounts for two-thirds of doctors' time and nearly half of nurses' time. Further investigation is needed on strategies to manage job demands and professional communications. Practitioner Summary: This study offers further findings on the characteristics and frequency of multitasking and interruptions in surgery, with a comparison of how they affect doctors and nurses. Further investigation is needed to improve the management of job demands and communications according to the results.

  19. The Effects of Career Interruptions on Young Men and Women.

    Science.gov (United States)

    Shorten, Brett; Lewis, Donald E.

    1991-01-01

    Data from a sample of 5,837 Australians showed that (1) women had longer career interruptions; (2) regardless of number of interruptions, men had higher wages; (3) longer interruptions had a negative effect on reentry wages; and (4) 1985-88 growth in wages for males was enhanced by increased numbers and length of interruptions, with the opposite…

  20. [Outbreak of follicular conjunctivitis caused by adenovirus in a geriatric centre].

    Science.gov (United States)

    Artieda, Juncal; Montes, Milagrosa; Vicente, Diego; Martínez, Consuelo; Piñeiro, Luis; Mendiola, Josune

    2010-12-01

    Adenovirus serotype 4a is a respiratory virus that occasionally causes conjunctivitis. This paper describes an outbreak of follicular conjunctivitis that occurred in a geriatric centre. Outbreak description and epidemiological research through a survey. For the microbiological study conjunctival swabs were collected using viral and bacterial transport media. Adenovirus was detected by real-time polymerase chain reaction. The serotype was determined by sequencing of a fragment of the hexon and E1 genes. In autumn 2008 an outbreak of follicular conjunctivitis caused by adenovirus serotype 4a was detected. Twenty three percent 23% (69/300) of residents and 5% (9/180) of workers in a geriatric centre in Gipuzkoa were affected. The clinical symptoms were of prolonged duration (11±5 days). The temporal association of the cases suggested transmission from person to person. The sanitary measures established (asepsis and frequent hand washing, cleaning and disinfection of objects and surfaces) were effective, interrupting the transmission of the disease within a short period of time. Rapid detection, identification of the causative agent and implementing appropriate control measures can significantly reduce the impact on both health and economic costs of these outbreaks. Copyright © 2009 Elsevier España, S.L. All rights reserved.

  1. Leisure-time youth centres as health-promoting settings: Experiences from multicultural neighbourhoods in Sweden.

    Science.gov (United States)

    Fredriksson, Ingela; Geidne, Susanna; Eriksson, Charli

    2018-02-01

    The aim of this paper is to advocate for the importance of meaningful leisure time for young people from a health-promotion perspective using experiences from two youth centres in multicultural neighbourhoods in Sweden. In this practice-based study, data were collected between 2012 and 2014 at two youth centres in multicultural, socially deprived suburbs in Sweden using surveys with 12- to 16-year-old adolescents ( n = 207), seven individual interviews with staff and three cooperation partners in the neighbourhoods, and six group interviews with adolescents (50% girls). Quantitative, qualitative and mixed methods were used for analysis. As part of the youth centres' strategies, they are open and inclusive, foster supportive relationships, emphasise youth empowerment, and integrate family, school and community in their work. The youth centres are health-promoting settings with regard to four of the action areas in the Ottawa Charter: build healthy public policy, create supportive environments, strengthen community actions and develop personal skills. There is a need for a variety and a combination of various structured and unstructured leisure-time activities because young people's background and life situation plays a role for their participation in leisure-time activities. We conclude that youth centres are well placed to be or to become health-promoting settings if the activities takes place in a structured environment.

  2. Cold standby repairable system with working vacations and vacation interruption

    Institute of Scientific and Technical Information of China (English)

    Baoliang Liu; Lirong Cui; Yanqing Wen

    2015-01-01

    This paper studies a cold standby repairable system with working vacations and vacation interruption. The repairman’s multiple vacations policy, the working vacations policy and the vacation interruption are considered simultaneously. The lifetime of components fol ows a phase-type (PH) distribution. The repair time in the regular repair period and the working vacation period fol ow other two PH distributions at different rates. For this sys-tem, the vector-valued Markov process governing the system is constructed. We obtain several important performance measures for the system in transient and stationary regimes applying matrix-analytic methods. Final y, a numerical example is given to il ustrate the results obtained.

  3. Customer interruption cost and results

    Energy Technology Data Exchange (ETDEWEB)

    Eua-Arporn, B.; Bisarnbutra, S. [Chulalongkorn Univ., Bangkok (Thailand)

    1997-12-31

    Results of a comprehensive study on short-term direct impacts and consumer interruption costs, incurred as a result of power supply interruption, were discussed. The emphasis was on questionnaire development, general responses and the average customer damage function of some selected sectors. The customer damage function was established for each category of customers (agriculture, industry, mining, wholesale, retail merchandising, residential, etc) as well as for different locations. Results showed that the average customer damage function depended mostly on customer category. Size and location were not significant factors. 5 refs., 7 tabs.

  4. Interrupting behaviour: Minimizing decision costs via temporal commitment and low-level interrupts

    Science.gov (United States)

    Dayan, Peter

    2018-01-01

    Ideal decision-makers should constantly assess all sources of information about opportunities and threats, and be able to redetermine their choices promptly in the face of change. However, perpetual monitoring and reassessment impose inordinate sensing and computational costs, making them impractical for animals and machines alike. The obvious alternative of committing for extended periods of time to limited sensory strategies associated with particular courses of action can be dangerous and wasteful. Here, we explore the intermediate possibility of making provisional temporal commitments whilst admitting interruption based on limited broader observation. We simulate foraging under threat of predation to elucidate the benefits of such a scheme. We relate our results to diseases of distractibility and roving attention, and consider mechanistic substrates such as noradrenergic neuromodulation. PMID:29338004

  5. Interrupting behaviour: Minimizing decision costs via temporal commitment and low-level interrupts.

    Science.gov (United States)

    Lloyd, Kevin; Dayan, Peter

    2018-01-01

    Ideal decision-makers should constantly assess all sources of information about opportunities and threats, and be able to redetermine their choices promptly in the face of change. However, perpetual monitoring and reassessment impose inordinate sensing and computational costs, making them impractical for animals and machines alike. The obvious alternative of committing for extended periods of time to limited sensory strategies associated with particular courses of action can be dangerous and wasteful. Here, we explore the intermediate possibility of making provisional temporal commitments whilst admitting interruption based on limited broader observation. We simulate foraging under threat of predation to elucidate the benefits of such a scheme. We relate our results to diseases of distractibility and roving attention, and consider mechanistic substrates such as noradrenergic neuromodulation.

  6. Interrupting behaviour: Minimizing decision costs via temporal commitment and low-level interrupts.

    Directory of Open Access Journals (Sweden)

    Kevin Lloyd

    2018-01-01

    Full Text Available Ideal decision-makers should constantly assess all sources of information about opportunities and threats, and be able to redetermine their choices promptly in the face of change. However, perpetual monitoring and reassessment impose inordinate sensing and computational costs, making them impractical for animals and machines alike. The obvious alternative of committing for extended periods of time to limited sensory strategies associated with particular courses of action can be dangerous and wasteful. Here, we explore the intermediate possibility of making provisional temporal commitments whilst admitting interruption based on limited broader observation. We simulate foraging under threat of predation to elucidate the benefits of such a scheme. We relate our results to diseases of distractibility and roving attention, and consider mechanistic substrates such as noradrenergic neuromodulation.

  7. Microprocessor multi-task monitor

    International Nuclear Information System (INIS)

    Ludemann, C.A.

    1983-01-01

    This paper describes a multi-task monitor program for microprocessors. Although written for the Intel 8085, it incorporates features that would be beneficial for implementation in other microprocessors used in controlling and monitoring experiments and accelerators. The monitor places permanent programs (tasks) arbitrarily located throughout ROM in a priority ordered queue. The programmer is provided with the flexibility to add new tasks or modified versions of existing tasks, without having to comply with previously defined task boundaries or having to reprogram all of ROM. Scheduling of tasks is triggered by timers, outside stimuli (interrupts), or inter-task communications. Context switching time is of the order of tenths of a milllisecond

  8. An Interrupted Time-Series Analysis of Durkheim's Social Deregulation Thesis: The Case of the Russian Federation.

    Science.gov (United States)

    Pridemore, William Alex; Chamlin, Mitchell B; Cochran, John K

    2007-06-01

    The dissolution of the Soviet Union resulted in sudden, widespread, and fundamental changes to Russian society. The former social welfare system-with its broad guarantees of employment, healthcare, education, and other forms of social support-was dismantled in the shift toward democracy, rule of law, and a free-market economy. This unique natural experiment provides a rare opportunity to examine the potentially disintegrative effects of rapid social change on deviance, and thus to evaluate one of Durkheim's core tenets. We took advantage of this opportunity by performing interrupted time-series analyses of annual age-adjusted homicide, suicide, and alcohol-related mortality rates for the Russian Federation using data from 1956 to 2002, with 1992-2002 as the postintervention time-frame. The ARIMA models indicate that, controlling for the long-term processes that generated these three time series, the breakup of the Soviet Union was associated with an appreciable increase in each of the cause-of-death rates. We interpret these findings as being consistent with the Durkheimian hypothesis that rapid social change disrupts social order, thereby increasing the level of crime and deviance.

  9. A multi-centre clinical follow-up database as a systematic approach to the evaluation of mid- and long-term health consequences in Chernobyl acute radiation syndrome patients

    International Nuclear Information System (INIS)

    Fischer, B.; Weiss, M.; Fliedner, T.M.; Belyi, D.A.; Kovalenko, A.N.; Bebeshko, V.G.; Nadejina, N.M.; Galstian, I.A.

    1996-01-01

    This paper describes scope, design and first results of a multi-centre follow-up database that has been established for the evaluation of mid- and long-term health consequences of acute radiation syndrome (ARS) survivors. After the Chernobyl accident on 26 April 1986, 237 cases with suspected acute radiation syndrome have been reported. For 134 of these cases the diagnosis of ARS was confirmed in a consensus conference three years after the accident. Nearly all survivors underwent regular follow-up examinations in two specialized centres in Kiev and in Moscow. In collaboration with these centres we established a multi-centre clinical follow-up database that records the results of the follow-up examinations in a standardized schema. This database is an integral part of a five step approach to patient evaluation and aims at a comprehensive base for scientific analysis of the mid- and long-term consequences of accidental ionizing radiation. It will allow for a dynamic view on the development of the health status of individuals and groups of patients as well as the identification of critical organ systems that need early support, and an improvement of acute and follow-up treatment protocols for radiation accident victims

  10. Nested Interrupt Analysis of Low Cost and High Performance Embedded Systems Using GSPN Framework

    Science.gov (United States)

    Lin, Cheng-Min

    Interrupt service routines are a key technology for embedded systems. In this paper, we introduce the standard approach for using Generalized Stochastic Petri Nets (GSPNs) as a high-level model for generating CTMC Continuous-Time Markov Chains (CTMCs) and then use Markov Reward Models (MRMs) to compute the performance for embedded systems. This framework is employed to analyze two embedded controllers with low cost and high performance, ARM7 and Cortex-M3. Cortex-M3 is designed with a tail-chaining mechanism to improve the performance of ARM7 when a nested interrupt occurs on an embedded controller. The Platform Independent Petri net Editor 2 (PIPE2) tool is used to model and evaluate the controllers in terms of power consumption and interrupt overhead performance. Using numerical results, in spite of the power consumption or interrupt overhead, Cortex-M3 performs better than ARM7.

  11. Systematic Quality Development Work in a Swedish Leisure-Time Centre

    Science.gov (United States)

    Lager, Karin; Sheridan, Sonja; Gustafsson, Jan

    2016-01-01

    There is increasing activity in the area of quality issues in education in Europe. Diverse discourses of policy for quality are encountered in daily practice. This article explores systematic quality development work in a Swedish educational setting: the leisure-time centre. By following 2 teachers' enactments of policy in planning, organising,…

  12. The effect of the development of an emergency transfer system on the travel time to tertiary care centres in Japan

    Directory of Open Access Journals (Sweden)

    Arima Hideaki

    2006-06-01

    Full Text Available Abstract Background In Japan, the emergency medical system is categorized into three levels: primary, secondary, and tertiary, depending on the severity of the condition of the patient. Tertiary care centres accept patients who require 24-h monitoring. In this research, the average travel times (minutes from the centroids of all municipalities in Japan to the nearest tertiary care centre were estimated, using the geographic information system. The systems affecting travel time to tertiary care centres were also examined. Regression analysis was performed to determine the factors affecting the travel time to tertiary care centres, using selected variables representing road conditions and the emergency transfer system. Linear regression analysis was performed to identify specific benchmarks that would be effective in reducing the average travel time to tertiary care centres in prefectures with travel times longer than the average 57 min. Results The mean travel time was 57 min, the range was 83 min, and the standard deviation was 20.4. As a result of multiple regression analysis, average coverage area per tertiary care centre, kilometres of highway road per square kilometre, and population were selected as variables with impact on the average travel time. Based on results from linear regression analysis, benchmarks for the emergency transfer system that would effectively reduce travel time to the mean value of 57 min were identified: 26% pavement ratio of roads (percentage of paved road to general roads, and three tertiary care centres and 108 ambulances. Conclusion Regional gaps in the travel time to tertiary care centres were identified in Japan. The systems we should focus on to reducing travel time were identified. Further reduction of travel time to tertiary care centres can be effectively achieved by improving these specific systems. Linear regression analysis showed that a 26% pavement ratio and three tertiary care centres are beneficial to

  13. Factors defining face-to-face interruptions in the office environment

    NARCIS (Netherlands)

    Matysiak, A.J.; Markopoulos, P.

    2006-01-01

    This paper presents an on-going investigation on interruptions in the office caused by face-to-face interactions between knowledge workers. The study aims to identify opportunities for interactive solutions that will support both, the interrupters and the interrupted. The study involves contextual

  14. Microsurgical Performance After Sleep Interruption: A NeuroTouch Simulator Study.

    Science.gov (United States)

    Micko, Alexander; Knopp, Karoline; Knosp, Engelbert; Wolfsberger, Stefan

    2017-10-01

    In times of the ubiquitous debate about doctors' working hour restrictions, it is still questionable if the physician's performance is impaired by high work load and long shifts. In this study, we evaluated the impact of sleep interruption on neurosurgical performance. Ten medical students and 10 neurosurgical residents were tested on the virtual-reality simulator NeuroTouch by performing an identical microsurgical task, well rested (baseline test), and after sleep interruption at night (stress test). Deviation of total score, timing, and excessive force on tissue were evaluated. In addition, vital parameters and self-assessment were analyzed. After sleep interruption, total performance score increased significantly (45.1 vs. 48.7, baseline vs. stress test, P = 0.048) while timing remained stable (10.1 vs. 10.4 minutes for baseline vs. stress test, P > 0.05) for both students and residents. Excessive force decreased in both groups during the stress test for the nondominant hand (P = 0.05). For the dominant hand, an increase of excessive force was encountered in the group of residents (P = 0.05). In contrast to their results, participants of both groups assessed their performance worse during the stress test. In our study, we found an increase of neurosurgical simulator performance in neurosurgical residents and medical students under simulated night shift conditions. Further, microsurgical dexterity remained unchanged. Based on our results and the data in the available literature, we cannot confirm that working hour restrictions will have a positive effect on neurosurgical performance. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Analysis of Data Interruption in an LTE Highway Scenario with Dual Connectivity

    DEFF Research Database (Denmark)

    Gimenez, Lucas Chavarria; Michaelsen, Per-Henrik; Pedersen, Klaus I.

    2016-01-01

    This study evaluates whether last versions of Long Term Evolution with dual connectivity are able to support the latency and reliability requirements for the upcoming vehicular use-cases and time-critical applications. Data interruption times during handovers and cell management operations are ev...

  16. Repeat interruptions in spinocerebellar ataxia type 10 expansions are strongly associated with epileptic seizures

    Science.gov (United States)

    McFarland, Karen N.; Liu, Jilin; Landrian, Ivette; Zeng, Desmond; Raskin, Salmo; Moscovich, Mariana; Gatto, Emilia M.; Ochoa, Adriana; Teive, Hélio A. G.; Rasmussen, Astrid; Ashizawa, Tetsuo

    2014-01-01

    Spinocerebellar ataxia type 10 (SCA10), an autosomal dominant neurodegenerative disorder, is the result of a non-coding, pentanucleotide repeat expansion within intron 9 of the Ataxin 10 gene. SCA10 patients present with pure cerebellar ataxia; yet, some families also have a high incidence of epilepsy. SCA10 expansions containing penta- and heptanucleotide interruption motifs, termed “ATCCT interruptions,” experience large contractions during germline transmission, particularly in paternal lineages. At the same time, these alleles confer an earlier age at onset which contradicts traditional rules of genetic anticipation in repeat expansions. Previously, ATCCT interruptions have been associated with a higher prevalence of epileptic seizures in one Mexican-American SCA10 family. In a large cohort of SCA10 families, we analyzed whether ATCCT interruptions confers a greater risk for developing seizures in these families. Notably, we find that the presence of repeat interruptions within the SCA10 expansion confers a 6.3-fold increase in the risk of an SCA10 patient developing epilepsy (6.2-fold when considering patients of Mexican ancestry only) and a 13.7-fold increase in having a positive family history of epilepsy (10.5-fold when considering patients of Mexican ancestry only). We conclude that the presence of repeat interruptions in SCA10 repeat expansion indicates a significant risk for the epilepsy phenotype and should be considered during genetic counseling. PMID:24318420

  17. When daily planning improves employee performance: The importance of planning type, engagement, and interruptions.

    Science.gov (United States)

    Parke, Michael R; Weinhardt, Justin M; Brodsky, Andrew; Tangirala, Subrahmaniam; DeVoe, Sanford E

    2018-03-01

    Does planning for a particular workday help employees perform better than on other days they fail to plan? We investigate this question by identifying 2 distinct types of daily work planning to explain why and when planning improves employees' daily performance. The first type is time management planning (TMP)-creating task lists, prioritizing tasks, and determining how and when to perform them. We propose that TMP enhances employees' performance by increasing their work engagement, but that these positive effects are weakened when employees face many interruptions in their day. The second type is contingent planning (CP) in which employees anticipate possible interruptions in their work and plan for them. We propose that CP helps employees stay engaged and perform well despite frequent interruptions. We investigate these hypotheses using a 2-week experience-sampling study. Our findings indicate that TMP's positive effects are conditioned upon the amount of interruptions, but CP has positive effects that are not influenced by the level of interruptions. Through this study, we help inform workers of the different planning methods they can use to increase their daily motivation and performance in dynamic work environments. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  18. Real time data acquisition system for the High Current Test Facility proton accelerator

    International Nuclear Information System (INIS)

    Langlais, C.E.; Erickson, P.D.; Caissie, L.P.

    1975-01-01

    A real time data acquisition system was developed to monitor and control the High Current Test Facility Proton Accelerator. It is a PDP-8/E computer system with virtual memory capability that is fully interrupt driven and operates under a real-time, multi-tasking executive. The application package includes mode selection to automatically modify programs and optimize operation under varying conditions. (U.S.)

  19. Task Interruption: Resumption Lag and the Role of Cues

    National Research Council Canada - National Science Library

    Altmann, Erik M; Trafton, J. G

    2004-01-01

    ...), indicating a substantial disruptive effect. To probe the nature of the disruption, they examined the role of external cues associated with the interrupted task and found that cues available immediately before an interruption facilitate performance immediately afterwards, thus reducing the resumption lag. This "cue-availability" effect suggests that people deploy preparatory perceptual and memory processes, apparently spontaneously, to mitigate the disruptive effects of task interruption.

  20. Between-centre variability versus variability over time in DXA whole body measurements evaluated using a whole body phantom

    Energy Technology Data Exchange (ETDEWEB)

    Louis, Olivia [Department of Radiology, AZ-VUB, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussel (Belgium)]. E-mail: olivia.louis@az.vub.ac.be; Verlinde, Siska [Belgian Study Group for Pediatric Endocrinology (Belgium); Thomas, Muriel [Belgian Study Group for Pediatric Endocrinology (Belgium); De Schepper, Jean [Department of Pediatrics, AZ-VUB, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussel (Belgium)

    2006-06-15

    This study aimed to compare the variability of whole body measurements, using dual energy X-ray absorptiometry (DXA), among geographically distinct centres versus that over time in a given centre. A Hologic-designed 28 kg modular whole body phantom was used, including high density polyethylene, gray polyvinylchloride and aluminium. It was scanned on seven Hologic QDR 4500 DXA devices, located in seven centres and was also repeatedly (n = 18) scanned in the reference centre, over a time span of 5 months. The mean between-centre coefficient of variation (CV) ranged from 2.0 (lean mass) to 5.6% (fat mass) while the mean within-centre CV ranged from 0.3 (total mass) to 4.7% (total area). Between-centre variability compared well with within-centre variability for total area, bone mineral content and bone mineral density, but was significantly higher for fat (p < 0.001), lean (p < 0.005) and total mass (p < 0.001). Our results suggest that, even when using the same device, the between-centre variability remains a matter of concern, particularly where body composition is concerned.

  1. HIV models for treatment interruption: Adaptation and comparison

    Science.gov (United States)

    Hillmann, Andreas; Crane, Martin; Ruskin, Heather J.

    2017-10-01

    In recent years, Antiretroviral Therapy (ART) has become commonplace for treating HIV infections, although a cure remains elusive, given reservoirs of replicating latently-infected cells, which are resistant to normal treatment regimes. Treatment interruptions, whether ad hoc or structured, are known to cause a rapid increase in viral production to detectable levels, but numerous clinical trials remain inconclusive on the dangers inherent in this resurgence. In consequence, interest in examining interruption strategies has recently been rekindled. This overview considers modelling approaches, which have been used to explore the issue of treatment interruption. We highlight their purpose and the formalisms employed and examine ways in which clinical data have been used. Implementation of selected models is demonstrated, illustrative examples provided and model performance compared for these cases. Possible extensions to bottom-up modelling techniques for treatment interruptions are briefly discussed.

  2. Real-Time Multi-Target Localization from Unmanned Aerial Vehicles

    Directory of Open Access Journals (Sweden)

    Xuan Wang

    2016-12-01

    Full Text Available In order to improve the reconnaissance efficiency of unmanned aerial vehicle (UAV electro-optical stabilized imaging systems, a real-time multi-target localization scheme based on an UAV electro-optical stabilized imaging system is proposed. First, a target location model is studied. Then, the geodetic coordinates of multi-targets are calculated using the homogeneous coordinate transformation. On the basis of this, two methods which can improve the accuracy of the multi-target localization are proposed: (1 the real-time zoom lens distortion correction method; (2 a recursive least squares (RLS filtering method based on UAV dead reckoning. The multi-target localization error model is established using Monte Carlo theory. In an actual flight, the UAV flight altitude is 1140 m. The multi-target localization results are within the range of allowable error. After we use a lens distortion correction method in a single image, the circular error probability (CEP of the multi-target localization is reduced by 7%, and 50 targets can be located at the same time. The RLS algorithm can adaptively estimate the location data based on multiple images. Compared with multi-target localization based on a single image, CEP of the multi-target localization using RLS is reduced by 25%. The proposed method can be implemented on a small circuit board to operate in real time. This research is expected to significantly benefit small UAVs which need multi-target geo-location functions.

  3. Muscle-invasive bladder cancer treated with external beam radiation: influence of total dose, overall treatment time, and treatment interruption on local control

    International Nuclear Information System (INIS)

    Moonen, L.; Voet, H. van der; Nijs, R. de; Horenblas, S.; Hart, A.A.M.; Bartelink, H.

    1998-01-01

    Purpose: To evaluate and eventually quantify a possible influence of tumor proliferation during the external radiation course on local control in muscle invasive bladder cancer. Methods and Materials: The influence of total dose, overall treatment time, and treatment interruption has retrospectively been analyzed in a series of 379 patients with nonmetastasized, muscle-invasive transitional cell carcinoma of the urinary bladder. All patients received external beam radiotherapy at the Netherlands Cancer Institute between 1977 and 1990. Total dose varied between 50 and 75 Gy with a mean of 60.5 Gy and a median of 60.4 Gy. Overall treatment time varied between 20 and 270 days with a mean of 49 days and a median of 41 days. Number of fractions varied between 17 and 36 with a mean of 27 and a median of 26. Two hundred and forty-four patients had a continuous radiation course, whereas 135 had an intended split course or an unintended treatment interruption. Median follow-up was 22 months for all patients and 82 months for the 30 patients still alive at last follow-up. A stepwise procedure using proportional hazard regression has been used to identify prognostic treatment factors with respect to local recurrence as sole first recurrence. Results: One hundred and thirty-six patients experienced a local recurrence and 120 of these occurred before regional or distant metastases. The actuarial local control rate was 40.3% at 5 years and 32.3% at 10 years. In a multivariate analysis total dose showed a significant association with local control (p 0.0039), however in a markedly nonlinear way. In fact only those patients treated with a dose below 57.5 Gy had a significant higher bladder relapse rate, whereas no difference in relapse rate was found among patients treated with doses above 57.5 Gy. This remained the case even after adjustment for overall treatment time and all significant tumor and patient characteristics. The Normalized Tumor Dose (NTD) (α/β = 10) and NTD (

  4. Cerebrospinal fluid signs of neuronal damage after antiretroviral treatment interruption in HIV-1 infection

    Directory of Open Access Journals (Sweden)

    Deeks Steven G

    2005-08-01

    Full Text Available Abstract Background The neurofilament is a major structural component of myelinated axons. Increased cerebrospinal fluid (CSF concentrations of the light chain of the neurofilament protein (NFL can serve as a sensitive indicator of central nervous system (CNS injury. To assess whether interrupting antiretroviral treatment of HIV infection might have a deleterious effect on the CNS, we measured NFL levels in HIV-infected subjects interrupting therapy. We identified subjects who had CSF HIV RNA concentrations below 50 copies/mL at the time combination antiretroviral therapy was interrupted, and for whom CSF samples were available before and after the interruption. Results A total of 8 subjects were studied. The median (range CSF NFL level at baseline was Conclusion These findings suggest that resurgence of active HIV replication may result in measurable, albeit subclinical, CNS injury. Further studies are needed to define the frequency and pathobiological importance of the increase in CSF NFL.

  5. Tests of vacuum interrupters for the Tokamak Fusion Test Reactor

    International Nuclear Information System (INIS)

    Warren, R.; Parsons, M.; Honig, E.; Lindsay, J.

    1979-04-01

    The Tokamak Fusion Test Reactor (TFTR) project at Princeton University requires the insertion of a resistor in an excited ohmic-heating coil circuit to produce a plasma initiation pulse (PIP). It is expected that the maximum duty for the switching system will be an interruption of 24 kA with an associated recovery voltage of 25 kV. Vacuum interrupters were selected as the most economical means to satisfy these requirements. However, it was felt that some testing of available systems should be performed to determine their reliability under these conditions. Two interrupter systems were tested for over 1000 interruptions each at 24 kA and 25 kV. One system employed special Westinghouse type WL-33552 interrupters in a circuit designed by LASL. This circuit used a commercially available actuator and a minimum size counterpulse bank and saturable reactor. The other used Toshiba type VGB2-D20 interrupters actuated by a Toshiba mechanism in a Toshiba circuit using a larger counterpulse bank and saturable reactor

  6. Chemoradiotherapy in patients with anal cancer: Impact of length of unplanned treatment interruption on outcome

    Energy Technology Data Exchange (ETDEWEB)

    Meyer, Andreas; Meier Zu Eissen, Juergen; Karstens, Johann H.; Bremer, Michael [Medical School Hannover (Germany). Dept. of Radiation Oncology

    2006-09-15

    The aim of this retrospective analysis was to evaluate feasibility and effectiveness of definitive chemoradiotherapy without split-course technique in anal cancer patients. From 1993 to 2003, 81 patients were treated; 13 were excluded due to various chemotherapeutic regimes, thus 68 patients were analysed. In case of acute grade 3 toxicities, treatment was halted until improvement or resolution independent of dose. Short interruption was defined as completing treatment without exceeding eight cumulative treatment days beyond scheduled plan, other patients were considered to have had prolonged interruption. Median follow-up was 46 months. Median overall treatment time was 53 days corresponding to an interruption of eight cumulative treatment days. Thirty-five patients (51%) had treatment interruption of <8 days. No acute grade 4 toxicities were observed; one fatality occurred during treatment due to ileus-like symptoms according to acute grade 5 toxicity. Comparing patients with short vs. prolonged interruption 5-year actuarial rates for local control were 85% vs. 81% (p{approx}0.605) and for colostomy-free survival 85% vs. 87% (p{approx}0.762), respectively. Chemoradiotherapy with short individualised treatment interruptions seems to be feasible with acceptable acute or late toxicities. Treatment is highly effective in terms of local control and colostomy-free survival.

  7. Multi-objective genetic optimization of linear construction projects

    Directory of Open Access Journals (Sweden)

    Fatma A. Agrama

    2012-08-01

    Full Text Available In the real world, the majority cases of optimization problems, met by engineers, are composed of several conflicting objectives. This paper presents an approach for a multi-objective optimization model for scheduling linear construction projects. Linear construction projects have many identical units wherein activities repeat from one unit to another. Highway, pipeline, and tunnels are good examples that exhibit repetitive characteristics. These projects represent a large portion of the construction industry. The present model enables construction planners to generate optimal/near-optimal construction plans that minimize project duration, total work interruptions, and total number of crews. Each of these plans identifies, from a set of feasible alternatives, optimal crew synchronization for each activity and activity interruptions at each unit. This model satisfies the following aspects: (1 it is based on the line of balance technique; (2 it considers non-serial typical activities networks with finish–start relationship and both lag or overlap time between activities is allowed; (3 it utilizes a multi-objective genetic algorithms approach; (4 it is developed as a spreadsheet template that is easy to use. Details of the model with visual charts are presented. An application example is analyzed to illustrate the use of the model and demonstrate its capabilities in optimizing the scheduling of linear construction projects.

  8. Efficacy and safety of acupuncture for chronic pain caused by gonarthrosis: A study protocol of an ongoing multi-centre randomised controlled clinical trial [ISRCTN27450856

    Directory of Open Access Journals (Sweden)

    Krämer Jürgen

    2004-03-01

    Full Text Available Abstract Background Controlled clinical trials produced contradictory results with respect to a specific analgesic effect of acupuncture. There is a lack of large multi-centre acupuncture trials. The German Acupuncture Trial represents the largest multi-centre study of acupuncture in the treatment of chronic pain caused by gonarthrosis up to now. Methods 900 patients will be randomised to three treatment arms. One group receives verum acupuncture, the second sham acupuncture, and the third conservative standard therapy. The trial protocol is described with eligibility criteria, detailed information on the treatment definition, blinding, endpoints, safety evaluation, statistical methods, sample size determination, monitoring, legal aspects, and the current status of the trial. Discussion A critical discussion is given regarding the considerations about standardisation of the acupuncture treatment, the choice of the control group, and the blinding of patients and observers.

  9. Model-Checking of Linear-Time Properties in Multi-Valued Systems

    OpenAIRE

    Li, Yongming; Droste, Manfred; Lei, Lihui

    2012-01-01

    In this paper, we study model-checking of linear-time properties in multi-valued systems. Safety property, invariant property, liveness property, persistence and dual-persistence properties in multi-valued logic systems are introduced. Some algorithms related to the above multi-valued linear-time properties are discussed. The verification of multi-valued regular safety properties and multi-valued $\\omega$-regular properties using lattice-valued automata are thoroughly studied. Since the law o...

  10. Effects of interruption of irradiation on Harwell Red Perspex (PMMA)

    International Nuclear Information System (INIS)

    Khayet Tebourbi, Mohamed anouar abdelaziz

    2010-01-01

    Harwell Red Perspex PMMA (Polymethylmethacrylate) is a dosimeter very much used in the industrial treatments by Radiations ionizing. The purpose of this work is to test the response of this dosimeter for radiation processes having undergone one or more interruptions. This experimental study based on the development of a factorial experimental design on two levels showed that the response of this dosimeter increases for the interrupted treatments. The value of the estimated amount of response increase is all the more significant as the temperature during the interruption is high. Also it made possible to determine a mathematical model binding the value of the amount posted to the factors of influence: Temperature, target amount, a number of interruptions and duration of each interruption.

  11. Multi-centre evaluation of mass spectrometric identification of anaerobic bacteria using the VITEK® MS system.

    Science.gov (United States)

    Garner, O; Mochon, A; Branda, J; Burnham, C-A; Bythrow, M; Ferraro, M; Ginocchio, C; Jennemann, R; Manji, R; Procop, G W; Richter, S; Rychert, J; Sercia, L; Westblade, L; Lewinski, M

    2014-04-01

    Accurate and timely identification of anaerobic bacteria is critical to successful treatment. Classic phenotypic methods for identification require long turnaround times and can exhibit poor species level identification. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) is an identification method that can provide rapid identification of anaerobes. We present a multi-centre study assessing the clinical performance of the VITEK(®) MS in the identification of anaerobic bacteria. Five different test sites analysed a collection of 651 unique anaerobic isolates comprising 11 different genera. Multiple species were included for several of the genera. Briefly, anaerobic isolates were applied directly to a well of a target plate. Matrix solution (α-cyano-4-hydroxycinnamic acid) was added and allowed to dry. Mass spectra results were generated with the VITEK(®) MS, and the comparative spectral analysis and organism identification were determined using the VITEK(®) MS database 2.0. Results were confirmed by 16S rRNA gene sequencing. Of the 651 isolates analysed, 91.2% (594/651) exhibited the correct species identification. An additional eight isolates were correctly identified to genus level, raising the rate of identification to 92.5%. Genus-level identification consisted of Actinomyces, Bacteroides and Prevotella species. Fusobacterium nucleatum, Actinomyces neuii and Bacteroides uniformis were notable for an increased percentage of no-identification results compared with the other anaerobes tested. VITEK(®) MS identification of clinically relevant anaerobes is highly accurate and represents a dramatic improvement over other phenotypic methods in accuracy and turnaround time. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

  12. Instant Messaging Usage and Interruptions in the Workplace

    Directory of Open Access Journals (Sweden)

    Hui‐Jung Chang

    2014-12-01

    Full Text Available The goal of the present study is to explore IM interruption by relating it to media choices and purposes of IM use in the workplace. Two major media choice concepts were: media richness and social influence; while four purposes of IM use were: organization work, knowledge work, socializing, and boundary spanning activities. Data (N = 283 were collected via a combination of convenience and snowball sampling of “computer‐using workers” in Taiwan, based on the Standard Occupational Classification system published by the Taiwan government. Results indicated that media choice works better than purpose of IM use to explain IM interruption. Among them, social influence was the best predictor to IM interruption in the workplace. In addition, instant feedback and personalization provided by IM, and IM usage for the purposes of knowledge work and socializing, also relate to IM interruption in the workplace.

  13. Physician-staffed emergency helicopter reduces transportation time from alarm call to highly specialized centre

    DEFF Research Database (Denmark)

    Fjaeldstad, A.

    2013-01-01

    INTRODUCTION: Since 2007, the number of Danish emergency departments has decreased from 44 to 21. Longer distances to specialized treatment have increased the demand for advanced prehospital treatment. A Danish 24/7 Helicopter Emergency Medical System (HEMS) project in western Denmark was initiated......-to-centre) for patients with ST-elevation myocardial infarction (STEMI) or severe injury (Injury Severity Score > 15). MATERIAL AND METHODS: In this prospective study with a matched historical control group, the time-to-doctor and the time-to-centre for patients with STEMI or severe injury transported by HEMS were...

  14. An Interrupted Time-Series Analysis of Durkheim's Social Deregulation Thesis: The Case of the Russian Federation

    Science.gov (United States)

    Pridemore, William Alex; Chamlin, Mitchell B.; Cochran, John K.

    2009-01-01

    The dissolution of the Soviet Union resulted in sudden, widespread, and fundamental changes to Russian society. The former social welfare system-with its broad guarantees of employment, healthcare, education, and other forms of social support-was dismantled in the shift toward democracy, rule of law, and a free-market economy. This unique natural experiment provides a rare opportunity to examine the potentially disintegrative effects of rapid social change on deviance, and thus to evaluate one of Durkheim's core tenets. We took advantage of this opportunity by performing interrupted time-series analyses of annual age-adjusted homicide, suicide, and alcohol-related mortality rates for the Russian Federation using data from 1956 to 2002, with 1992-2002 as the postintervention time-frame. The ARIMA models indicate that, controlling for the long-term processes that generated these three time series, the breakup of the Soviet Union was associated with an appreciable increase in each of the cause-of-death rates. We interpret these findings as being consistent with the Durkheimian hypothesis that rapid social change disrupts social order, thereby increasing the level of crime and deviance. PMID:20165565

  15. Retrospective exposure assessment and quality control in an international multi-centre case-control study

    DEFF Research Database (Denmark)

    Tinnerberg, H; Heikkilä, P; Huici-Montagud, A

    2003-01-01

    The paper presents the exposure assessment method and quality control procedure used in an international, multi-centre case-control study within a joint Nordic and Italian cohort. This study was conducted to evaluate whether occupational exposure to carcinogens influenced the predictivity of high...... was higher among the original assessors (the assessor from the same country as the subject) than the average prevalence assessed by the other four in the quality control round. The original assessors classified more job situations as exposed than the others. Several reasons for this are plausible: real...... country-specific differences, differences in information available to the home assessor and the others and misunderstandings or difficulties in translation of information. To ensure the consistency of exposure assessments in international retrospective case-control studies it is important to have a well...

  16. Rotavirus vaccine impact and socioeconomic deprivation: an interrupted time-series analysis of gastrointestinal disease outcomes across primary and secondary care in the UK.

    Science.gov (United States)

    Hungerford, Daniel; Vivancos, Roberto; Read, Jonathan M; Iturriza-Gόmara, Miren; French, Neil; Cunliffe, Nigel A

    2018-01-29

    Rotavirus causes severe gastroenteritis in infants and young children worldwide. The UK introduced the monovalent rotavirus vaccine (Rotarix®) in July 2013. Vaccination is free of charge to parents, with two doses delivered at 8 and 12 weeks of age. We evaluated vaccine impact across a health system in relation to socioeconomic deprivation. We used interrupted time-series analyses to assess changes in monthly health-care attendances in Merseyside, UK, for all ages, from July 2013 to June 2016, compared to predicted counterfactual attendances without vaccination spanning 3-11 years pre-vaccine. Outcome measures included laboratory-confirmed rotavirus gastroenteritis (RVGE) hospitalisations, acute gastroenteritis (AGE) hospitalisations, emergency department (ED) attendances for gastrointestinal conditions and consultations for infectious gastroenteritis at community walk-in centres (WIC) and general practices (GP). All analyses were stratified by age. Hospitalisations were additionally stratified by vaccine uptake and small-area-level socioeconomic deprivation. The uptake of the first and second doses of rotavirus vaccine was 91.4% (29,108/31,836) and 86.7% (27,594/31,836), respectively. Among children aged impact was greatest during the rotavirus season and for vaccine-eligible age groups. In adults aged 65+ years, AGE hospitalisations fell by 25% (95% CI 19-30%; p socioeconomically deprived communities (adjusted incident rate ratio 1.57; 95% CI 1.51-1.64; p impact was greatest among the most deprived populations, despite lower vaccine uptake. Prioritising vaccine uptake in socioeconomically deprived communities should give the greatest health benefit in terms of population disease burden.

  17. Critical Care Health Informatics Collaborative (CCHIC): Data, tools and methods for reproducible research: A multi-centre UK intensive care database.

    Science.gov (United States)

    Harris, Steve; Shi, Sinan; Brealey, David; MacCallum, Niall S; Denaxas, Spiros; Perez-Suarez, David; Ercole, Ari; Watkinson, Peter; Jones, Andrew; Ashworth, Simon; Beale, Richard; Young, Duncan; Brett, Stephen; Singer, Mervyn

    2018-04-01

    To build and curate a linkable multi-centre database of high resolution longitudinal electronic health records (EHR) from adult Intensive Care Units (ICU). To develop a set of open-source tools to make these data 'research ready' while protecting patient's privacy with a particular focus on anonymisation. We developed a scalable EHR processing pipeline for extracting, linking, normalising and curating and anonymising EHR data. Patient and public involvement was sought from the outset, and approval to hold these data was granted by the NHS Health Research Authority's Confidentiality Advisory Group (CAG). The data are held in a certified Data Safe Haven. We followed sustainable software development principles throughout, and defined and populated a common data model that links to other clinical areas. Longitudinal EHR data were loaded into the CCHIC database from eleven adult ICUs at 5 UK teaching hospitals. From January 2014 to January 2017, this amounted to 21,930 and admissions (18,074 unique patients). Typical admissions have 70 data-items pertaining to admission and discharge, and a median of 1030 (IQR 481-2335) time-varying measures. Training datasets were made available through virtual machine images emulating the data processing environment. An open source R package, cleanEHR, was developed and released that transforms the data into a square table readily analysable by most statistical packages. A simple language agnostic configuration file will allow the user to select and clean variables, and impute missing data. An audit trail makes clear the provenance of the data at all times. Making health care data available for research is problematic. CCHIC is a unique multi-centre longitudinal and linkable resource that prioritises patient privacy through the highest standards of data security, but also provides tools to clean, organise, and anonymise the data. We believe the development of such tools are essential if we are to meet the twin requirements of

  18. Development of a QFD-based expert system for CNC turning centre selection

    Science.gov (United States)

    Prasad, Kanika; Chakraborty, Shankar

    2015-12-01

    Computer numerical control (CNC) machine tools are automated devices capable of generating complicated and intricate product shapes in shorter time. Selection of the best CNC machine tool is a critical, complex and time-consuming task due to availability of a wide range of alternatives and conflicting nature of several evaluation criteria. Although, the past researchers had attempted to select the appropriate machining centres using different knowledge-based systems, mathematical models and multi-criteria decision-making methods, none of those approaches has given due importance to the voice of customers. The aforesaid limitation can be overcome using quality function deployment (QFD) technique, which is a systematic approach for integrating customers' needs and designing the product to meet those needs first time and every time. In this paper, the adopted QFD-based methodology helps in selecting CNC turning centres for a manufacturing organization, providing due importance to the voice of customers to meet their requirements. An expert system based on QFD technique is developed in Visual BASIC 6.0 to automate the CNC turning centre selection procedure for different production plans. Three illustrative examples are demonstrated to explain the real-time applicability of the developed expert system.

  19. Impact of STROBE statement publication on quality of observational study reporting: interrupted time series versus before-after analysis.

    Directory of Open Access Journals (Sweden)

    Sylvie Bastuji-Garin

    Full Text Available In uncontrolled before-after studies, CONSORT was shown to improve the reporting of randomised trials. Before-after studies ignore underlying secular trends and may overestimate the impact of interventions. Our aim was to assess the impact of the 2007 STROBE statement publication on the quality of observational study reporting, using both uncontrolled before-after analyses and interrupted time series.For this quasi-experimental study, original articles reporting cohort, case-control, and cross-sectional studies published between 2004 and 2010 in the four dermatological journals having the highest 5-year impact factors (≥ 4 were selected. We compared the proportions of STROBE items (STROBE score adequately reported in each article during three periods, two pre STROBE period (2004-2005 and 2006-2007 and one post STROBE period (2008-2010. Segmented regression analysis of interrupted time series was also performed.Of the 456 included articles, 187 (41% reported cohort studies, 166 (36.4% cross-sectional studies, and 103 (22.6% case-control studies. The median STROBE score was 57% (range, 18%-98%. Before-after analysis evidenced significant STROBE score increases between the two pre-STROBE periods and between the earliest pre-STROBE period and the post-STROBE period (median score2004-05 48% versus median score2008-10 58%, p<0.001 but not between the immediate pre-STROBE period and the post-STROBE period (median score2006-07 58% versus median score2008-10 58%, p = 0.42. In the pre STROBE period, the six-monthly mean STROBE score increased significantly, by 1.19% per six-month period (absolute increase 95%CI, 0.26% to 2.11%, p = 0.016. By segmented analysis, no significant changes in STROBE score trends occurred (-0.40%; 95%CI, -2.20 to 1.41; p = 0.64 in the post STROBE statement publication.The quality of reports increased over time but was not affected by STROBE. Our findings raise concerns about the relevance of uncontrolled before

  20. Current management of intracerebral haemorrhage in China: a national, multi-centre, hospital register study

    Directory of Open Access Journals (Sweden)

    Heeley Emma L

    2011-01-01

    Full Text Available Abstract Background We aimed to examine current practice of the management and secondary prevention of intracerebral haemorrhage (ICH in China where the disease is more common than in Western populations. Methods Data on baseline characteristics, management in-hospital and post-stroke, and outcome of ICH patients are from the ChinaQUEST (QUality Evaluation of Stroke Care and Treatment study, a multi-centre, prospective, 62 hospital registry in China during 2006-07. Results Nearly all ICH patients (n = 1572 received an intravenous haemodiluting agent such as mannitol (96% or a neuroprotectant (72%, and there was high use of intravenous traditional Chinese medicine (TCM (42%. Neurosurgery was undertaken in 137 (9% patients; being overweight, having a low Glasgow Coma Scale (GCS score on admission, and Total Anterior Circulation Syndrome (TACS clinical pattern on admission, were the only baseline factors associated with this intervention in multivariate analyses. Neurosurgery was associated with nearly three times higher risk of death/disability at 3 months post-stroke (odd ratio [OR] 2.60, p Conclusions The management of ICH in China is characterised by high rates of use of intravenous haemodiluting agents, neuroprotectants, and TCM, and of antihypertensives for secondary prevention. The controversial efficacy of these therapies, coupled with the current lack of treatments of proven benefit, is a call for action for more outcomes based research in ICH.

  1. Sequential hand hygiene promotion contributes to a reduced nosocomial bloodstream infection rate among very low-birth weight infants: An interrupted time series over a 10-year period

    NARCIS (Netherlands)

    Helder, O.K.; Brug, J.; van Goudoever, J.B.; Looman, C.W.N.; Reiss, I.K.M.; Kornelisse, R.F.

    2014-01-01

    Background Sustained high compliance with hand hygiene (HH) is needed to reduce nosocomial bloodstream infections (NBSIs). However, over time, a wash out effect often occurs. We studied the long-term effect of sequential HH-promoting interventions. Methods An observational study with an interrupted

  2. Direct-Current Forced Interruption and Breaking Performance of Spiral-Type Contacts in Aero Applications

    Directory of Open Access Journals (Sweden)

    Wenlei Huo

    2017-05-01

    Full Text Available This paper analyses the transient characteristics and breaking performance of direct-current (DC forced-interruption vacuum interrupters in 270 V power-supply systems. Three stages are identified in forced interruption: the DC-arcing stage, current-commutation stage, and voltage-recovery stage. During the current-commutation stage, the reverse peak-current coefficient k, which is a key design factor, is used to calculate the rate of current at zero-crossing (di/dt. MATLAB/Simulink simulation models are established to obtain the transient characteristics influenced by the forced-commutation branch parameters and the coefficient k. To study the breaking performance of spiral-type contacts, experiments are conducted for different contact materials and arcing times for currents less than 3.5 kA. During the DC-arcing stage, a locally intensive burning arc is observed in the CuW80 contact; however, it is not observed in the CuCr50 contact. On examining the re-ignition interruption results of the CuW80 contact, the intensive burning arc is found to be positioned within a possible re-ignition region. When the arcing time is longer than 1 ms, the intensive burning arc occurs and affects the breaking performance of the spiral-type contacts. If the DC-arcing stage is prolonged, the total arcing energy increases, which leads to a lower breaking capacity.

  3. Physicians interrupted by mobile devices in hospitals: understanding the interaction between devices, roles, and duties.

    Science.gov (United States)

    Solvoll, Terje; Scholl, Jeremiah; Hartvigsen, Gunnar

    2013-03-07

    A common denominator of modern hospitals is a variety of communication problems. In particular, interruptions from mobile communication devices are a cause of great concern for many physicians. To characterize how interruptions from mobile devices disturb physicians in their daily work. The gathered knowledge will be subsequently used as input for the design and development of a context-sensitive communication system for mobile communications suitable for hospitals. This study adheres to an ethnographic and interpretive field research approach. The data gathering consisted of participant observations, non-structured and mostly ad hoc interviews, and open-ended discussions with a selected group of physicians. Eleven physicians were observed for a total of 135 hours during May and June 2009. The study demonstrates to what degree physicians are interrupted by mobile devices in their daily work and in which situations they are interrupted, such as surgery, examinations, and during patients/relatives high-importance level conversations. The participants in the study expected, and also indicated, that wireless phones probably led to more interruptions immediately after their introduction in a clinic, when compared to a pager, but this changed after a short while. The unpleasant feeling experienced by the caller when interrupting someone by calling them differs compared to sending a page message, which leaves it up to the receiver when to return the call. Mobile devices, which frequently interrupt physicians in hospitals, are a problem for both physicians and patients. The results from this study contribute to knowledge being used as input for designing and developing a prototype for a context-sensitive communication system for mobile communication suitable for hospitals. We combined these findings with results from earlier studies and also involved actual users to develop the prototype, CallMeSmart. This system intends to reduce such interruptions and at the same time

  4. Real-Time Multi-Directional Equipment Site

    Data.gov (United States)

    Federal Laboratory Consortium — As part of the George E. Brown, Jr. Network for Earthquake Engineering Simulation (NEES) Program, Lehigh University has established the Real-Time Multi-Directional...

  5. Pilates based core stability training in ambulant individuals with multiple sclerosis: protocol for a multi-centre randomised controlled trial.

    Science.gov (United States)

    Freeman, Jennifer; Fox, Esther; Gear, Margaret; Hough, Alan

    2012-04-05

    People with Multiple Sclerosis (MS) frequently experience balance and mobility impairments, including reduced trunk stability. Pilates-based core stability training, which is aimed at improving control of the body's stabilising muscles, is popular as a form of exercise with people with MS and therapists. A replicated single case series study facilitated by the Therapists in MS Group in the United Kingdom (UK) provides preliminary evidence that this approach can improve balance and mobility in ambulant people with MS; further evidence is needed to substantiate these findings to ensure that limited time, energy, finances and resources are used to best effect.This study builds upon the pilot work undertaken in the case series study by implementing a powered randomised controlled study, with the aims of: 1 Establishing the effectiveness of core stability training; 2 Comparing core stability training with standardised physiotherapy exercise; 3 Exploring underlying mechanisms of change associated with this intervention This is a multi-centre, double blind, block randomised, controlled trial. Eligible participants will be recruited from 4 UK centres. Participants will be randomly allocated to one of three groups: Pilates based core stability training, standardised physiotherapy exercise or contract-relax relaxation sessions (placebo control). All will receive face to face training sessions over a 12 week period; together with a 15 minute daily home programme. All will be assessed by a blinded assessor before training, at the end of the 12 week programme and at 4 week follow-up. The primary outcome measure is the 10 metre timed walk. Secondary outcome measures are the MS walking Scale (MSWS-12), the Functional Reach (forwards and lateral), a 10 point Numerical Rating Scale to determine "Difficulty in carrying a drink when walking", and the Activities-specific Balance Confidence (ABC) Scale. In addition, ultrasound imaging of the abdominal muscles will be performed before

  6. Pilates based core stability training in ambulant individuals with multiple sclerosis: protocol for a multi-centre randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Freeman Jennifer

    2012-04-01

    Full Text Available Abstract Background People with Multiple Sclerosis (MS frequently experience balance and mobility impairments, including reduced trunk stability. Pilates-based core stability training, which is aimed at improving control of the body's stabilising muscles, is popular as a form of exercise with people with MS and therapists. A replicated single case series study facilitated by the Therapists in MS Group in the United Kingdom (UK provides preliminary evidence that this approach can improve balance and mobility in ambulant people with MS; further evidence is needed to substantiate these findings to ensure that limited time, energy, finances and resources are used to best effect. This study builds upon the pilot work undertaken in the case series study by implementing a powered randomised controlled study, with the aims of: 1 Establishing the effectiveness of core stability training 2 Comparing core stability training with standardised physiotherapy exercise 3 Exploring underlying mechanisms of change associated with this intervention Methods This is a multi-centre, double blind, block randomised, controlled trial. Eligible participants will be recruited from 4 UK centres. Participants will be randomly allocated to one of three groups: Pilates based core stability training, standardised physiotherapy exercise or contract-relax relaxation sessions (placebo control. All will receive face to face training sessions over a 12 week period; together with a 15 minute daily home programme. All will be assessed by a blinded assessor before training, at the end of the 12 week programme and at 4 week follow-up. The primary outcome measure is the 10 metre timed walk. Secondary outcome measures are the MS walking Scale (MSWS-12, the Functional Reach (forwards and lateral, a 10 point Numerical Rating Scale to determine "Difficulty in carrying a drink when walking", and the Activities-specific Balance Confidence (ABC Scale. In addition, ultrasound imaging of the

  7. Time ordering in multi-electron dynamics

    International Nuclear Information System (INIS)

    McGuire, J H; Godunov, A L; Shakov, Kh Kh; Shipakov, V A; Merabet, H; Bruch, R; Hanni, J

    2003-01-01

    Time ordering of interactions in dynamic quantum multi-electron systems provides a constraint that interconnects the time evolution of different electrons. In energy space, time ordering appears as the principal value contribution from the Green function, which corresponds to the asymptotic condition that specifies whether the system has outgoing (or possibly incoming) scattered waves. We report evidence of effects of time correlation found by comparing calculations to recent spectropolarimetric data

  8. Time ordering in multi-electron dynamics

    Energy Technology Data Exchange (ETDEWEB)

    McGuire, J H [Department of Physics, Tulane University, New Orleans, LA (United States); Godunov, A L [Department of Physics, Tulane University, New Orleans, LA (United States); Shakov, Kh Kh [Department of Physics, Tulane University, New Orleans, LA (United States); Shipakov, V A [Troitsk Institute for Innovation and Fusion Research, Troitsk (Russian Federation); Merabet, H [Department of Physics, University of Nevada Reno, Reno, NV (United States); Bruch, R [Department of Physics, University of Nevada Reno, Reno, NV (United States); Hanni, J [Department of Physics, University of Nevada Reno, Reno, NV (United States)

    2003-01-28

    Time ordering of interactions in dynamic quantum multi-electron systems provides a constraint that interconnects the time evolution of different electrons. In energy space, time ordering appears as the principal value contribution from the Green function, which corresponds to the asymptotic condition that specifies whether the system has outgoing (or possibly incoming) scattered waves. We report evidence of effects of time correlation found by comparing calculations to recent spectropolarimetric data.

  9. Increased short-term risk of thrombo-embolism or death after interruption of warfarin treatment in patients with atrial fibrillation

    DEFF Research Database (Denmark)

    Raunsø, Jakob; Selmer, Christian; Olesen, Jonas Bjerring

    2012-01-01

    AimsIt is presently unknown whether patients with atrial fibrillation (AF) are at increased risk of thrombo-embolic adverse events after interruption of warfarin treatment. The purpose of this study was to assess the risk and timing of thrombo-embolism after warfarin treatment interruption.Method...

  10. Time can't be circular

    CERN Multimedia

    2003-01-01

    "Delivering the Albert Einstein lecture at the Centre for Philosophy and Foundations of Science on Tuesday, Nobel Laureate Professor Gerard Hooft said that any notion of time can not be circular or have loops or multi dimensionality" (1/2 page).

  11. A multi-centre, prospective, clinical in-market evaluation to assess the performance of Opsite™ Post-Op Visible dressings.

    LENUS (Irish Health Repository)

    O'Brien, Gillian

    2010-10-01

    The aim of this study was to assess the performance of Opsite™ Post-Op Visible as a post-surgical dressing in a typical clinical setting. In this multi-centre clinical evaluation, patients who underwent clean surgery were treated with Opsite Post-Op Visible dressing. Duration of dressing wear, visibility through the dressing and ability to handle exudate were assessed and the product was rated in comparison with those normally used. A total of 64 patients were recruited. Mean wear time was 4·5 days. Exudate management was rated very good or good at 96% of assessments. Visibility of the incision site was rated as very good or good at 72%, and as acceptable at 24%, of assessments. Patient comfort was rated very comfortable (63%) or comfortable (37%) at all assessments. Dressings were generally rated as satisfactory or exceeding expectations with clinicians stating that the Opsite Post-Op Visible dressing was better than the dressing they routinely used for 92% of patients. Opsite Post-Op Visible dressing is an innovative dressing combining good visibility with exudate management and patient comfort. It was found to have adequate wear time, visibility and exudate management properties making it suitable for use on a variety of surgical incision sites.

  12. Study protocol, rationale and recruitment in a European multi-centre randomized controlled trial to determine the efficacy and safety of azithromycin maintenance therapy for 6 months in primary ciliary dyskinesia

    DEFF Research Database (Denmark)

    Kobbernagel, Helene Elgaard; Buchvald, Frederik F; Haarman, Eric G

    2016-01-01

    maintenance therapy in PCD. METHODS: The BESTCILIA trial is a European multi-centre, double-blind, randomized, placebo-controlled, parallel group study. The intervention is tablets of azithromycin 250/500 mg according to body weight or placebo administered three times a week for 6 months. Subjects...... prescribed in other chronic respiratory disorders. Furthermore, the trial will utilize the Lung clearance index and new, PCD-specific quality of life instruments as outcome measures for PCD. Recruitment is hampered by frequent occurrence of Pseudomonas aeruginosa infection, exacerbations at enrolment...

  13. The culture contributing to interruptions in the nursing work environment: An ethnography.

    Science.gov (United States)

    Hopkinson, Susan G; Wiegand, Debra L

    2017-12-01

    To understand the occurrence of interruptions within the culture of the medical nursing unit work environment. Interruptions may lead to errors in nursing work. Little is known about how the culture of the nursing work environment contributes to interruptions. A micro-focused ethnographic study was conducted. Data collection involved extensive observation of a nursing unit, 1:1 observations of nurses and follow-up interviews with the nurses. Data were analysed from unstructured field notes and interview transcripts. The definitions of interruption and culture guided coding, categorising and identification of themes. A framework was developed that describes the medical nursing unit as a complex culture full of unpredictable, nonlinear changes that affect the entire interconnected system, often in the form of an interruption. The cultural elements contributing to interruptions included (i) the value placed on excellence in patient care and meeting personal needs, (ii) the beliefs that the nurses had to do everything by themselves and that every phone call was important, (iii) the patterns of changing patients, patient transport and coordination of resources and (iv) the normative practices of communicating and adapting. Interruptions are an integral part of the culture of a medical nursing unit. Uniformly decreasing interruptions may disrupt current practices, such as communication to coordinate care, that are central to nursing work. In future research, the nursing work environment must be looked at through the lens of a complex system. Interventions to minimise the negative impact of interruptions must take into account the culture of the nursing as a complex adaptive system. Nurses should be educated on their own contribution to interruptions and issues addressed at a system level, rather than isolating the interruption as the central issue. © 2017 John Wiley & Sons Ltd.

  14. Surveillance of hazardous substances releases due to system interruptions, 2002.

    Science.gov (United States)

    Orr, Maureen F; Ruckart, Perri Zeitz

    2007-04-11

    The Hazardous Substances Emergency Events Surveillance (HSEES) system collected information on 9014 acute hazardous substance releases in 15 participating states in 2002. There were 3749 fixed-facility manufacturing events, of which 2100 involved "interruptions" to normal processing and 1649 "comparisons" that did not involve interruption. Equipment failure (69%) or intentional acts (20%) were the main root factor. Many events occurred in October and November in three states (Texas, Louisiana, and New Jersey), in three manufacturing industries (industrial and miscellaneous chemicals; petroleum refining; and plastics, synthetics, and resins). In interruption events, the substance categories most often released were mixtures, other inorganic substances, and volatile organic compounds and those most often causing injury were acids, chlorine, bases, and ammonia. Comparison events resulted in more acutely injured persons (408 versus 59) and more evacuees (11,318 versus 335) than interruption events and therefore may receive more public health attention. Because of the large number of interruption events, targeted prevention activities, including management of change procedures, lessons-learned implementation, process hazards analysis, and appropriate protection for workers could be economically advantageous and improve environmental quality. Efforts should focus on the identified areas of greater occurrence. The relationship of weather and equipment failure with interruption events needs further investigation.

  15. Breeding limits foraging time : Evidence of interrupted foraging response from body mass variation in a tropical environment

    NARCIS (Netherlands)

    Nwaogu, Chima J.; Dietz, Maurine W.; Tieleman, B. Irene; Cresswell, Will

    Birds should store body reserves if starvation risk is anticipated; this is known as an ‘interrupted foraging response’. If foraging remains unrestricted, however, body mass should remain low to limit the predation risk that gaining and carrying body reserves entails. In temperate environments mass

  16. Reactor pressure elevation preventing device upon interruption of load

    International Nuclear Information System (INIS)

    Ota, Yasuo; Okukawa, Ryutaro.

    1996-01-01

    In a power load imbalance circuit of a steam turbine control device, a power load imbalance occurrence signal is outputted for a predetermined period of time upon occurrence of load interruption. A function for suppressing increase of number of rotation of a turbine due to load interruption is not disturbed, and the power load imbalance circuit is not operated at least after a primary peak where the number of rotation of the turbine is increased. Since a steam control valve flow rate demand signal and a turbine bypass valve flow rate demand signals are corporated subsequently to control the opening degree of the steam control valve and the turbine bypass valve, elevation of reactor pressure is always suppressed and maintained constant, as well as abrupt opening of the steam control valve due to cancel of the power load imbalance circuit when steam control valve opening demand is outputted can be prevented. (N.H.)

  17. Photodiode-based cutting interruption sensor for near-infrared lasers.

    Science.gov (United States)

    Adelmann, B; Schleier, M; Neumeier, B; Hellmann, R

    2016-03-01

    We report on a photodiode-based sensor system to detect cutting interruptions during laser cutting with a fiber laser. An InGaAs diode records the thermal radiation from the process zone with a ring mirror and optical filter arrangement mounted between a collimation unit and a cutting head. The photodiode current is digitalized with a sample rate of 20 kHz and filtered with a Chebyshev Type I filter. From the measured signal during the piercing, a threshold value is calculated. When the diode signal exceeds this threshold during cutting, a cutting interruption is indicated. This method is applied to sensor signals from cutting mild steel, stainless steel, and aluminum, as well as different material thicknesses and also laser flame cutting, showing the possibility to detect cutting interruptions in a broad variety of applications. In a series of 83 incomplete cuts, every cutting interruption is successfully detected (alpha error of 0%), while no cutting interruption is reported in 266 complete cuts (beta error of 0%). With this remarkable high detection rate and low error rate, the possibility to work with different materials and thicknesses in combination with the easy mounting of the sensor unit also to existing cutting machines highlight the enormous potential for this sensor system in industrial applications.

  18. The role of interruptions in polyQ in the pathology of SCA1.

    Directory of Open Access Journals (Sweden)

    Rajesh P Menon

    Full Text Available At least nine dominant neurodegenerative diseases are caused by expansion of CAG repeats in coding regions of specific genes that result in abnormal elongation of polyglutamine (polyQ tracts in the corresponding gene products. When above a threshold that is specific for each disease the expanded polyQ repeats promote protein aggregation, misfolding and neuronal cell death. The length of the polyQ tract inversely correlates with the age at disease onset. It has been observed that interruption of the CAG tract by silent (CAA or missense (CAT mutations may strongly modulate the effect of the expansion and delay the onset age. We have carried out an extensive study in which we have complemented DNA sequence determination with cellular and biophysical models. By sequencing cloned normal and expanded SCA1 alleles taken from our cohort of ataxia patients we have determined sequence variations not detected by allele sizing and observed for the first time that repeat instability can occur even in the presence of CAG interruptions. We show that histidine interrupted pathogenic alleles occur with relatively high frequency (11% and that the age at onset inversely correlates linearly with the longer uninterrupted CAG stretch. This could be reproduced in a cellular model to support the hypothesis of a linear behaviour of polyQ. We clarified by in vitro studies the mechanism by which polyQ interruption slows down aggregation. Our study contributes to the understanding of the role of polyQ interruption in the SCA1 phenotype with regards to age at disease onset, prognosis and transmission.

  19. HIV Reactivation from Latency after Treatment Interruption Occurs on Average Every 5-8 Days--Implications for HIV Remission.

    Directory of Open Access Journals (Sweden)

    Mykola Pinkevych

    2015-07-01

    Full Text Available HIV infection can be effectively controlled by anti-retroviral therapy (ART in most patients. However therapy must be continued for life, because interruption of ART leads to rapid recrudescence of infection from long-lived latently infected cells. A number of approaches are currently being developed to 'purge' the reservoir of latently infected cells in order to either eliminate infection completely, or significantly delay the time to viral recrudescence after therapy interruption. A fundamental question in HIV research is how frequently the virus reactivates from latency, and thus how much the reservoir might need to be reduced to produce a prolonged antiretroviral-free HIV remission. Here we provide the first direct estimates of the frequency of viral recrudescence after ART interruption, combining data from four independent cohorts of patients undergoing treatment interruption, comprising 100 patients in total. We estimate that viral replication is initiated on average once every ≈6 days (range 5.1- 7.6 days. This rate is around 24 times lower than previous thought, and is very similar across the cohorts. In addition, we analyse data on the ratios of different 'reactivation founder' viruses in a separate cohort of patients undergoing ART-interruption, and estimate the frequency of successful reactivation to be once every 3.6 days. This suggests that a reduction in the reservoir size of around 50-70-fold would be required to increase the average time-to-recrudescence to about one year, and thus achieve at least a short period of anti-retroviral free HIV remission. Our analyses suggests that time-to-recrudescence studies will need to be large in order to detect modest changes in the reservoir, and that macaque models of SIV latency may have much higher frequencies of viral recrudescence after ART interruption than seen in human HIV infection. Understanding the mean frequency of recrudescence from latency is an important first step in

  20. On randomly interrupted diffusion

    International Nuclear Information System (INIS)

    Luczka, J.

    1993-01-01

    Processes driven by randomly interrupted Gaussian white noise are considered. An evolution equation for single-event probability distributions in presented. Stationary states are considered as a solution of a second-order ordinary differential equation with two imposed conditions. A linear model is analyzed and its stationary distributions are explicitly given. (author). 10 refs

  1. Real-time visual communication to aid disaster recovery in a multi-segment hybrid wireless networking system

    Science.gov (United States)

    Al Hadhrami, Tawfik; Wang, Qi; Grecos, Christos

    2012-06-01

    When natural disasters or other large-scale incidents occur, obtaining accurate and timely information on the developing situation is vital to effective disaster recovery operations. High-quality video streams and high-resolution images, if available in real time, would provide an invaluable source of current situation reports to the incident management team. Meanwhile, a disaster often causes significant damage to the communications infrastructure. Therefore, another essential requirement for disaster management is the ability to rapidly deploy a flexible incident area communication network. Such a network would facilitate the transmission of real-time video streams and still images from the disrupted area to remote command and control locations. In this paper, a comprehensive end-to-end video/image transmission system between an incident area and a remote control centre is proposed and implemented, and its performance is experimentally investigated. In this study a hybrid multi-segment communication network is designed that seamlessly integrates terrestrial wireless mesh networks (WMNs), distributed wireless visual sensor networks, an airborne platform with video camera balloons, and a Digital Video Broadcasting- Satellite (DVB-S) system. By carefully integrating all of these rapidly deployable, interworking and collaborative networking technologies, we can fully exploit the joint benefits provided by WMNs, WSNs, balloon camera networks and DVB-S for real-time video streaming and image delivery in emergency situations among the disaster hit area, the remote control centre and the rescue teams in the field. The whole proposed system is implemented in a proven simulator. Through extensive simulations, the real-time visual communication performance of this integrated system has been numerically evaluated, towards a more in-depth understanding in supporting high-quality visual communications in such a demanding context.

  2. Interruption of People in Human-Computer Interaction: A General Unifying Definition of Human Interruption and Taxonomy

    National Research Council Canada - National Science Library

    McFarlane, Daniel

    1997-01-01

    .... This report asserts that a single unifying definition of user-interruption and the accompanying practical taxonomy would be useful theoretical tools for driving effective investigation of this crucial...

  3. Current interruption by density depression

    International Nuclear Information System (INIS)

    Wagner, J.S.; Tajima, T.; Akasofu, S.I.

    1985-04-01

    Using a one-dimensional electrostatic particle code, we examine processes associated with current interruption in a collisionless plasma when a density depression is present along the current channel. Current interruption due to double layers was suggested by Alfven and Carlqvist (1967) as a cause of solar flares. At a local density depression, plasma instabilities caused by an electron current flow are accentuated, leading to current disruption. Our simulation study encompasses a wide range of the parameters in such a way that under appropriate conditions, both the Alfven and Carlqvist (1967) regime and the Smith and Priest (1972) regime take place. In the latter regime the density depression decays into a stationary structure (''ion-acoustic layer'') which spawns a series of ion-acoustic ''solitons'' and ion phase space holes travelling upstream. A large inductance of the current circuit tends to enhance the plasma instabilities

  4. Effect of an evidence-based website on healthcare usage: an interrupted time-series study.

    Science.gov (United States)

    Spoelman, Wouter A; Bonten, Tobias N; de Waal, Margot W M; Drenthen, Ton; Smeele, Ivo J M; Nielen, Markus M J; Chavannes, Niels H

    2016-11-09

    Healthcare costs and usage are rising. Evidence-based online health information may reduce healthcare usage, but the evidence is scarce. The objective of this study was to determine whether the release of a nationwide evidence-based health website was associated with a reduction in healthcare usage. Interrupted time series analysis of observational primary care data of healthcare use in the Netherlands from 2009 to 2014. General community primary care. 912 000 patients who visited their general practitioners 18.1 million times during the study period. In March 2012, an evidence-based health information website was launched by the Dutch College of General Practitioners. It was easily accessible and understandable using plain language. At the end of the study period, the website had 2.9 million unique page views per month. Primary outcome was the change in consultation rate (consultations/1000 patients/month) before and after the release of the website. Additionally, a reference group was created by including consultations about topics not being viewed at the website. Subgroup analyses were performed for type of consultations, sex, age and socioeconomic status. After launch of the website, the trend in consultation rate decreased with 1.620 consultations/1000 patients/month (pHealthcare usage decreased by 12% after providing high-quality evidence-based online health information. These findings show that e-Health can be effective to improve self-management and reduce healthcare usage in times of increasing healthcare costs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  5. Multi-port versus single-port cholecystectomy: results of a multi-centre, randomised controlled trial (MUSIC trial).

    Science.gov (United States)

    Arezzo, Alberto; Passera, Roberto; Bullano, Alberto; Mintz, Yoav; Kedar, Asaf; Boni, Luigi; Cassinotti, Elisa; Rosati, Riccardo; Fumagalli Romario, Uberto; Sorrentino, Mario; Brizzolari, Marco; Di Lorenzo, Nicola; Gaspari, Achille Lucio; Andreone, Dario; De Stefani, Elena; Navarra, Giuseppe; Lazzara, Salvatore; Degiuli, Maurizio; Shishin, Kirill; Khatkov, Igor; Kazakov, Ivan; Schrittwieser, Rudolf; Carus, Thomas; Corradi, Alessio; Sitzman, Guenther; Lacy, Antonio; Uranues, Selman; Szold, Amir; Morino, Mario

    2017-07-01

    Single-port laparoscopic surgery as an alternative to conventional laparoscopic cholecystectomy for benign disease has not yet been accepted as a standard procedure. The aim of the multi-port versus single-port cholecystectomy trial was to compare morbidity rates after single-access (SPC) and standard laparoscopy (MPC). This non-inferiority phase 3 trial was conducted at 20 hospital surgical departments in six countries. At each centre, patients were randomly assigned to undergo either SPC or MPC. The primary outcome was overall morbidity within 60 days after surgery. Analysis was by intention to treat. The study was registered with ClinicalTrials.gov (NCT01104727). The study was conducted between April 2011 and May 2015. A total of 600 patients were randomly assigned to receive either SPC (n = 297) or MPC (n = 303) and were eligible for data analysis. Postsurgical complications within 60 days were recorded in 13 patients (4.7 %) in the SPC group and in 16 (6.1 %) in the MPC group (P = 0.468); however, single-access procedures took longer [70 min (range 25-265) vs. 55 min (range 22-185); P risk of incisional hernia following SPC do not appear to be justified. Patient satisfaction with aesthetic results was greater after SPC than after MPC.

  6. Brain activity patterns induced by interrupting the cognitive processes with online advertising.

    Science.gov (United States)

    Rejer, Izabela; Jankowski, Jarosław

    2017-11-01

    As a result of the increasing role of online advertising and strong competition among advertisers, intrusive techniques are commonly used to attract web users' attention. Moreover, since marketing content is usually delivered to the target audience when they are performing typical online tasks, like searching for information or reading online content, its delivery interrupts the web user's current cognitive process. The question posed by many researchers in the field of online advertising is: how should we measure the influence of interruption of cognitive processes on human behavior and emotional state? Much research has been conducted in this field; however, most of this research has focused on monitoring activity in the simulated environment, or processing declarative responses given by users in prepared questionnaires. In this paper, a more direct real-time approach is taken, and the effect of the interruption on a web user is analyzed directly by studying the activity of his brain. This paper presents the results of an experiment that was conducted to find the brain activity patterns associated with interruptions of the cognitive process by showing internet advertisements during a text-reading task. Three specific aspects were addressed in the experiment: individual patterns, the consistency of these patterns across trials, and the intra-subject correlation of the individual patterns. Two main effects were observed for most subjects: a drop in activity in the frontal and prefrontal cortical areas across all frequency bands, and significant changes in the frontal/prefrontal asymmetry index.

  7. Effects of interruptible natural gas service: Winter 1989--1990

    International Nuclear Information System (INIS)

    1991-07-01

    During the extreme winter conditions experienced in December 1989, petroleum products showed dramatic price increases. Supply of certain products such as propane reached critical levels. Numerous factors contributed to the heating fuel situation, including well freeze-ups and refinery problems, as well as difficulties associated with delivery of the product. An area of concern identified in the ensuing debates was the impact of customer requirements for petroleum products resulting from curtailment of natural gas purchases under interruptible contracts. The lower rates associated with interruptible contracts make them an attractive choice for electric utilities. However, they require that the customer be prepared to obtain adequate fuel supplies in the event of curtailments. Electric utilities prepare for these contingencies with stocks of alternative fuels. Particularly in cold climates, interruptible has contracts are part of doing business. The extent and duration of the interruptions faced by customers relate principally to weather factors. Previous EIA studies investigated on a national level the causes of the dramatic price increases seen in petroleum product markets in the 1989--1990 heating season. This study is in response to a request from Senator Timothy Wirth, Chairman, Subcommittee on Energy Regulation and Conservation, to study in detail the impact of interruptible natural gas contracts as one of the factors cited as contributing to the price increases. A copy of the letter requesting the study is contained in Appendix A

  8. Contrasting Effects of Dual-task Paradigm and of Timing Interruption Paradigm in Interval Timing of the Context of Culti-modal Processing%跨通道情境下双任务范式与计时中断范式中的效应比较*

    Institute of Scientific and Technical Information of China (English)

    尹华站; 李丹; 袁祥勇; 黄希庭

    2013-01-01

    为了探讨跨通道情境下同一种刺激序列中双任务范式与计时中断范式中位置效应和间断效应的异同,研究设计了实验1和实验2。实验1以2500 ms和4500 ms为目标时距,采用相同的刺激序列(视觉呈现时距信号,听觉呈现干扰信号或中断信号),要求3组被试分别在控制、干扰及中断条件下完成相应任务,结果发现不管2500 ms或4500 ms时,中断条件较干扰条件和控制条件的间断效应更明显;同时发现在2500 ms时,不管控制、干扰还是中断条件下均发现了位置效应,而4500 ms时仅在中断条件下出现了位置效应,这可能由于实验1的控制及干扰任务中的4500 ms时的“晚”位置的时间确定性较高,以致掩盖了位置效应。为了降低“晚”位置出现的确定性,更好地对比两种范式中的效应,实验2将目标时距设置为1500 ms和2500 ms,结果发现在1500 ms或2500 ms时,不管控制、干扰还是中断条件下均发现了位置效应,且中断条件较干扰条件和控制条件下间断效应更明显。上述结果意味着跨通道情境下同一种刺激序列中双任务范式与计时中断范式中位置效应是否相同局限在一定时间范畴;计时中断范式中的中断效应对计时的消弱较双任务范式干扰效应更显著。%Distribution of attention in time information processing is one of the hot areas of research science, and the dual-task paradigm is one of the most common ways to study distribution of attention. It requires an individual to perform two tasks simultaneously, the less the attention allocated to a temporal interval, the shorter it is judged(Brown, 1997). The attention sharing effect is discussed within the framework of the scalar expectancy model of timing. In such paradigm the parallel processing itself may interfere with time perception and lead to unexpected deviations. In order to avoid such interference, the timing interruption paradigm would be a better

  9. Treatment interruptions: Statistics, causes and management in service radiotherapy

    International Nuclear Information System (INIS)

    Ferrando Sanchez, A.; Milanes Gaillet, A. I.; Eugui Martinez, R.; Crespo Diaz, M. P.

    2013-01-01

    Despite the clinical maximum administer the prescribed dose at a given time, treatment interruptions are unavoidable in practice. In tumors quickly reproduce no evidence that the prolongation thereof entails loss of tumor control. It has tracked two of these conditions: squamous cell cancer of the head and neck (SCCHN) and lung cancer (NSCLC) over 2011 and 2012 to evaluate both the number of stops treatment as the reason for them and its management. (Author)

  10. Psychological and psychosocial functioning of children with burn scarring using cosmetic camouflage: a multi-centre prospective randomised controlled trial.

    Science.gov (United States)

    Maskell, Jessica; Newcombe, Peter; Martin, Graham; Kimble, Roy

    2014-02-01

    Burns leave patients with long-term physical scarring. Children with scarring are required to face challenges of reintegration into their community, including acceptance of an altered appearance and acceptance by others. This can be difficult given society's preoccupation with physical appearance. Limited research exists investigating validity of cosmetic camouflage as a psychosocial intervention for children with scarring. This study investigated whether using cosmetic camouflage (Microskin™) had a positive impact on health-related quality of life, self-concept and psychopathology for children and adolescents (8-17 years) with burn scarring. A prospective multi-centre randomised controlled trial was conducted across Australian and New Zealand paediatric hospitals. 63 participants (49 females, mean age 12.7 ± 2.1 years) were enrolled. Data points were baseline (Time 1) and at 8 weeks (Time 2) using reliable and valid psychometric measures. Findings indicate there were significant improvements in socialisation, school and appearance scales on the Paediatric Quality of Life Inventory and psychopathology scores particularly peer problems decreased. However self-concept remained stable from baseline throughout intervention use. Cosmetic camouflage appears to have a positive impact on quality of life particularly socialisation. Cosmetic camouflage is a valid tool to assist children with scarring to actively participate socially within their communities. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  11. Increased short-term risk of thrombo-embolism or death after interruption of warfarin treatment in patients with atrial fibrillation.

    Science.gov (United States)

    Raunsø, Jakob; Selmer, Christian; Olesen, Jonas Bjerring; Charlot, Mette Gitz; Olsen, Anne-Marie S; Bretler, Ditte-Marie; Nielsen, Jørn Dalsgaard; Dominguez, Helena; Gadsbøll, Niels; Køber, Lars; Gislason, Gunnar H; Torp-Pedersen, Christian; Hansen, Morten Lock

    2012-08-01

    It is presently unknown whether patients with atrial fibrillation (AF) are at increased risk of thrombo-embolic adverse events after interruption of warfarin treatment. The purpose of this study was to assess the risk and timing of thrombo-embolism after warfarin treatment interruption. A retrospective, nationwide cohort study of all patients in Denmark treated with warfarin after a first hospitalization with AF in the period 1997-2008. Incidence rate ratios (IRRs) of thrombo-embolic events and all-cause mortality were calculated using the Poisson regression analyses. In total, 48 989 AF patients receiving warfarin treatment were included. Of these, 35 396 patients had at least one episode of warfarin treatment interruption. In all, 8255 deaths or thrombo-embolic events occurred during treatment interruption showing an initial clustering of events with 2717, 835, 500, and 427 events occurring during 0-90, 91-180, 181-270, and 271-360 days after treatment interruption, respectively. Correspondingly, the crude incidence rates were 31.6, 17.7, 12.3, and 11.4 events per 100 patient-years. In a multivariable analysis, the first 90-day interval of treatment interruption was associated with a markedly higher risk of death or thrombo-embolism (IRR 2.5; 95% confidence interval 2.3-2.8) vs. the interval of 271-360 days. In patients with AF, an interruption of warfarin treatment is associated with a significantly increased short-term risk of death or thrombo-embolic events within the first 90 days of treatment interruption.

  12. Accuracy of multi-point boundary crossing time analysis

    Directory of Open Access Journals (Sweden)

    J. Vogt

    2011-12-01

    Full Text Available Recent multi-spacecraft studies of solar wind discontinuity crossings using the timing (boundary plane triangulation method gave boundary parameter estimates that are significantly different from those of the well-established single-spacecraft minimum variance analysis (MVA technique. A large survey of directional discontinuities in Cluster data turned out to be particularly inconsistent in the sense that multi-point timing analyses did not identify any rotational discontinuities (RDs whereas the MVA results of the individual spacecraft suggested that RDs form the majority of events. To make multi-spacecraft studies of discontinuity crossings more conclusive, the present report addresses the accuracy of the timing approach to boundary parameter estimation. Our error analysis is based on the reciprocal vector formalism and takes into account uncertainties both in crossing times and in the spacecraft positions. A rigorous error estimation scheme is presented for the general case of correlated crossing time errors and arbitrary spacecraft configurations. Crossing time error covariances are determined through cross correlation analyses of the residuals. The principal influence of the spacecraft array geometry on the accuracy of the timing method is illustrated using error formulas for the simplified case of mutually uncorrelated and identical errors at different spacecraft. The full error analysis procedure is demonstrated for a solar wind discontinuity as observed by the Cluster FGM instrument.

  13. Measuring Quality Improvement in Acute Ischemic Stroke Care: Interrupted Time Series Analysis of Door-to-Needle Time

    Directory of Open Access Journals (Sweden)

    Anne Margreet van Dishoeck

    2014-06-01

    Full Text Available Background: In patients with acute ischemic stroke, early treatment with recombinant tissue plasminogen activator (rtPA improves functional outcome by effectively reducing disability and dependency. Timely thrombolysis, within 1 h, is a vital aspect of acute stroke treatment, and is reflected in the widely used performance indicator ‘door-to-needle time' (DNT. DNT measures the time from the moment the patient enters the emergency department until he/she receives intravenous rtPA. The purpose of the study was to measure quality improvement from the first implementation of thrombolysis in stroke patients in a university hospital in the Netherlands. We further aimed to identify specific interventions that affect DNT. Methods: We included all patients with acute ischemic stroke consecutively admitted to a large university hospital in the Netherlands between January 2006 and December 2012, and focused on those treated with thrombolytic therapy on admission. Data were collected routinely for research purposes and internal quality measurement (the Erasmus Stroke Study. We used a retrospective interrupted time series design to study the trend in DNT, analyzed by means of segmented regression. Results: Between January 2006 and December 2012, 1,703 patients with ischemic stroke were admitted and 262 (17% were treated with rtPA. Patients treated with thrombolysis were on average 63 years old at the time of the stroke and 52% were male. Mean age (p = 0.58 and sex distribution (p = 0.98 did not change over the years. The proportion treated with thrombolysis increased from 5% in 2006 to 22% in 2012. In 2006, none of the patients were treated within 1 h. In 2012, this had increased to 81%. In a logistic regression analysis, this trend was significant (OR 1.6 per year, CI 1.4-1.8. The median DNT was reduced from 75 min in 2006 to 45 min in 2012 (p Conclusion and Implications: The DNT steadily improved from the first implementation of thrombolysis. Specific

  14. The role of the sexual assault centre.

    LENUS (Irish Health Repository)

    Eogan, Maeve

    2013-02-01

    Sexual Assault Centres provide multidisciplinary care for men and women who have experienced sexual crime. These centres enable provision of medical, forensic, psychological support and follow-up care, even if patients chose not to report the incident to the police service. Sexual Support Centres need to provide a ring-fenced, forensically clean environment. They need to be appropriately staffed and available 24 hours a day, 7 days a week to allow prompt provision of medical and supportive care and collection of forensic evidence. Sexual Assault Centres work best within the context of a core agreed model of care, which includes defined multi-agency guidelines and care pathways, close links with forensic science and police services, and designated and sustainable funding arrangements. Additionally, Sexual Assault Centres also participate in patient, staff and community education and risk reduction. Furthermore, they contribute to the development, evaluation and implementation of national strategies on domestic, sexual and gender-based violence.

  15. Predicting Species Distributions Using Record Centre Data: Multi-Scale Modelling of Habitat Suitability for Bat Roosts.

    Science.gov (United States)

    Bellamy, Chloe; Altringham, John

    2015-01-01

    Conservation increasingly operates at the landscape scale. For this to be effective, we need landscape scale information on species distributions and the environmental factors that underpin them. Species records are becoming increasingly available via data centres and online portals, but they are often patchy and biased. We demonstrate how such data can yield useful habitat suitability models, using bat roost records as an example. We analysed the effects of environmental variables at eight spatial scales (500 m - 6 km) on roost selection by eight bat species (Pipistrellus pipistrellus, P. pygmaeus, Nyctalus noctula, Myotis mystacinus, M. brandtii, M. nattereri, M. daubentonii, and Plecotus auritus) using the presence-only modelling software MaxEnt. Modelling was carried out on a selection of 418 data centre roost records from the Lake District National Park, UK. Target group pseudoabsences were selected to reduce the impact of sampling bias. Multi-scale models, combining variables measured at their best performing spatial scales, were used to predict roosting habitat suitability, yielding models with useful predictive abilities. Small areas of deciduous woodland consistently increased roosting habitat suitability, but other habitat associations varied between species and scales. Pipistrellus were positively related to built environments at small scales, and depended on large-scale woodland availability. The other, more specialist, species were highly sensitive to human-altered landscapes, avoiding even small rural towns. The strength of many relationships at large scales suggests that bats are sensitive to habitat modifications far from the roost itself. The fine resolution, large extent maps will aid targeted decision-making by conservationists and planners. We have made available an ArcGIS toolbox that automates the production of multi-scale variables, to facilitate the application of our methods to other taxa and locations. Habitat suitability modelling has the

  16. A large multi-centre European study validates high-sensitivity C-reactive protein (hsCRP) as a clinical biomarker for the diagnosis of diabetes subtypes

    DEFF Research Database (Denmark)

    Thanabalasingham, G.; Shah, N.; Vaxillaire, M.

    2011-01-01

    CRP) levels are lower in UK patients with hepatocyte nuclear factor 1 alpha (HNF1A)-MODY than in other diabetes subtypes. In this large multi-centre study we aimed to assess the clinical validity of hsCRP as a diagnostic biomarker, examine the genotype-phenotype relationship and compare different hsCRP assays....... High-sensitivity CRP levels were analysed in individuals with HNF1A-MODY (n = 457), glucokinase (GCK)-MODY (n = 404), hepatocyte nuclear factor 4 alpha (HNF4A)-MODY (n = 54) and type 2 diabetes (n = 582) from seven European centres. Three common assays for hsCRP analysis were evaluated. We excluded 121......) a parts per thousand yenaEuro parts per thousand 0.91, p a parts per thousand currency signaEuro parts per thousand 1 x 10(-5)). Across the seven centres, the C-statistic for distinguishing HNF1A-MODY from young adult-onset type 2 diabetes ranged from 0.79 to 0.97, indicating high discriminative accuracy...

  17. Fast neutrons in the treatment of head and neck cancers: the results of a multi-centre randomly controlled trial

    International Nuclear Information System (INIS)

    Duncan, W.; Arnott, S.J.; Orr, J.A.; Kerr, G.R.; Schmitt, G.

    1984-01-01

    The results are presented of a multi-centre randomly controlled trial of fast neutron irradiation and mega-voltage X-rays in the treatment of patients with locally advanced squamous cell carcinoma of the head and neck region. No significant difference was observed in local tumour control rates. Salvage surgery was performed in a similar number of patients in the two groups. Late morbidity was also similar in the two treatment groups. Patients in a subgroup with cancer of the larynx treated by photons had a significantly better survival than those in the neutron treated group. (Auth.)

  18. NUMERICAL METHODS FOR SOLVING THE MULTI-TERM TIME-FRACTIONAL WAVE-DIFFUSION EQUATION.

    Science.gov (United States)

    Liu, F; Meerschaert, M M; McGough, R J; Zhuang, P; Liu, Q

    2013-03-01

    In this paper, the multi-term time-fractional wave-diffusion equations are considered. The multi-term time fractional derivatives are defined in the Caputo sense, whose orders belong to the intervals [0,1], [1,2), [0,2), [0,3), [2,3) and [2,4), respectively. Some computationally effective numerical methods are proposed for simulating the multi-term time-fractional wave-diffusion equations. The numerical results demonstrate the effectiveness of theoretical analysis. These methods and techniques can also be extended to other kinds of the multi-term fractional time-space models with fractional Laplacian.

  19. Recruiting ENT and Audiology patients into pharmaceutical trials: evaluating the multi-centre experience in the UK and USA.

    Science.gov (United States)

    Sanchez, Victoria A; Hall, Deborah A; Millar, Bonnie; Escabi, Celia D; Sharman, Alice; Watson, Jeannette; Thasma, Sornaraja; Harris, Peter

    2018-01-21

    Recruiting into clinical trials on time and on target is a major challenge and yet often goes unreported. This study evaluated the adjustment to procedures, recruitment and screening methods in two multi-centre pharmaceutical randomised controlled trials (RCTs) for hearing-related problems in adults. Recruitment monitoring and subsequent adjustment of various study procedures (e.g. eligibility criteria, increasing recruiting sites and recruitment methods) are reported. Participants were recruited through eight overarching methods: trial registration, posters/flyers, print publications, Internet, social media, radio, databases and referrals. The efficiency of the recruitment was measured by determining the number of people: (1) eligible for screening as a percentage of those who underwent telephone pre-screening and (2) randomised as a percentage of those screened. A total of 584 participants completed the pre-screening steps, 491 screened and 169 participants were randomised. Both RCTs completed adjustments to the participant eligibility, added new study sites and additional recruitment methods. No single recruitment method was efficient enough to serve as the only route to enrolment. A diverse portfolio of methods, continuous monitoring, mitigation strategy and adequate resourcing were essential for achieving our recruitment goals.

  20. Quantum state preparation using multi-level-atom optics

    International Nuclear Information System (INIS)

    Busch, Th; Deasy, K; Chormaic, S Nic

    2007-01-01

    One of the most important characteristics for controlling processes on the quantum scale is the fidelity or robustness of the techniques being used. In the case of single atoms localized in micro-traps, it was recently shown that the use of time-dependent tunnelling interactions in a multi-trap setup can be viewed as analogous to the area of multi-level optics. The atom's centre-of-mass can then be controlled with a high fidelity, using a STIRAP-type process. Here, we review previous work that led to the development of multi-level atom optics and present two examples of our most recent work on quantum state preparation

  1. The paediatric cardiac centre for Africa--proceedings of the March 2012 symposium.

    Science.gov (United States)

    Kinsley, Robin H; Edwin, Frank; Entsua-Mensah, Kow

    2013-04-01

    The Pediatric Cardiac Centre for Africa (PCCA) was opened by national patron Mr Nelson Mandela on November 7, 2003. In 2008, the Centre's international pediatric cardiac symposium was introduced as a learning forum for pediatric cardiac surgeons and cardiologists in the continent. The symposium has consistently grown in attendance and attracted distinguished leaders in the field. The 2012 symposium featured Dr. Thomas Spray of Children's Hospital of Philadelphia, Dr. David Barron of Birmingham Children's Hospital, and Dr. John Brown of Indiana University School of Medicine as guest speakers. Experience of the Fontan procedure, the small aortic root, hypoplastic left heart syndrome, right ventricular outflow tract reconstruction, transposition of the great arteries, and interrupted aortic arch were the highlights of the symposium. In the "African Corner," centers in South Africa, Ghana, and Angola presented work done from across the African continent.

  2. Workflow interruptions, cognitive failure and near-accidents in health care.

    Science.gov (United States)

    Elfering, Achim; Grebner, Simone; Ebener, Corinne

    2015-01-01

    Errors are frequent in health care. A specific model was tested that affirms failure in cognitive action regulation to mediate the influence of nurses' workflow interruptions and safety conscientiousness on near-accidents in health care. One hundred and sixty-five nurses from seven Swiss hospitals participated in a questionnaire survey. Structural equation modelling confirmed the hypothesised mediation model. Cognitive failure in action regulation significantly mediated the influence of workflow interruptions on near-accidents (p accidents via cognitive failure in action regulation was also significant (p accidents; moreover, cognitive failure mediated the association between compliance and near-accidents (p < .05). Contrary to expectations, compliance with safety regulations was not related to workflow interruptions. Workflow interruptions caused by colleagues, patients and organisational constraints are likely to trigger errors in nursing. Work redesign is recommended to reduce cognitive failure and improve safety of nurses and patients.

  3. Two-dimensional electron density characterisation of arc interruption phenomenon in current-zero phase

    Science.gov (United States)

    Inada, Yuki; Kamiya, Tomoki; Matsuoka, Shigeyasu; Kumada, Akiko; Ikeda, Hisatoshi; Hidaka, Kunihiko

    2018-01-01

    Two-dimensional electron density imaging over free burning SF6 arcs and SF6 gas-blast arcs was conducted at current zero using highly sensitive Shack-Hartmann type laser wavefront sensors in order to experimentally characterise electron density distributions for the success and failure of arc interruption in the thermal reignition phase. The experimental results under an interruption probability of 50% showed that free burning SF6 arcs with axially asymmetric electron density profiles were interrupted with a success rate of 88%. On the other hand, the current interruption of SF6 gas-blast arcs was reproducibly achieved under locally reduced electron densities and the interruption success rate was 100%.

  4. Multi-criteria decision analysis for bioenergy in the Centre Region of Portugal

    Science.gov (United States)

    Esteves, T. C. J.; Cabral, P.; Ferreira, A. J. D.; Teixeira, J. C.

    2012-04-01

    With the consumption of fossil fuels, the resources essential to Man's survival are being rapidly contaminated. A sustainable future may be achieved by the use of renewable energies, allowing countries without non-renewable energy resources to guarantee energetic sovereignty. Using bioenergy may mean a steep reduction and/or elimination of the external dependency, enhancing the countries' capital and potentially reducing of the negative effects that outcome from the use of fossil fuels, such as loss of biodiversity, air, water, and soil pollution, … This work's main focus is to increase bioenergy use in the centre region of Portugal by allying R&D to facilitate determination of bioenergy availability and distribution throughout the study area.This analysis is essential, given that nowadays this knowledge is still very limited in the study area. Geographic Information Systems (GIS) was the main tool used to asses this study, due to its unseeingly ability to integrate various types of information (such as alphanumerical, statistical, geographical, …) and various sources of biomass (forest, agricultural, husbandry, municipal and industrial residues, shrublands, used vegetable oil and energy crops) to determine the bioenergy potential of the study area, as well as their spatial distribution. By allying GIS with multi-criteria decision analysis, the initial table-like information of difficult comprehension is transformed into tangible and easy to read results: both intermediate and final results of the created models will facilitate the decision making process. General results show that the major contributors for the bioenergy potential in the Centre Region of Portugal are forest residues, which are mostly located in the inner region of the study area. However, a more detailed analysis should be made to analyze the viability to use energy crops. As a main conclusion, we can say that, although this region may not use only this type of energy to be completely

  5. Effect of an evidence-based website on healthcare usage: an interrupted time-series study

    Science.gov (United States)

    Spoelman, Wouter A; Bonten, Tobias N; de Waal, Margot W M; Drenthen, Ton; Smeele, Ivo J M; Nielen, Markus M J; Chavannes, Niels H

    2016-01-01

    Objectives Healthcare costs and usage are rising. Evidence-based online health information may reduce healthcare usage, but the evidence is scarce. The objective of this study was to determine whether the release of a nationwide evidence-based health website was associated with a reduction in healthcare usage. Design Interrupted time series analysis of observational primary care data of healthcare use in the Netherlands from 2009 to 2014. Setting General community primary care. Population 912 000 patients who visited their general practitioners 18.1 million times during the study period. Intervention In March 2012, an evidence-based health information website was launched by the Dutch College of General Practitioners. It was easily accessible and understandable using plain language. At the end of the study period, the website had 2.9 million unique page views per month. Main outcomes measures Primary outcome was the change in consultation rate (consultations/1000 patients/month) before and after the release of the website. Additionally, a reference group was created by including consultations about topics not being viewed at the website. Subgroup analyses were performed for type of consultations, sex, age and socioeconomic status. Results After launch of the website, the trend in consultation rate decreased with 1.620 consultations/1000 patients/month (p<0.001). This corresponds to a 12% decline in consultations 2 years after launch of the website. The trend in consultation rate of the reference group showed no change. The subgroup analyses showed a specific decline for consultations by phone and were significant for all other subgroups, except for the youngest age group. Conclusions Healthcare usage decreased by 12% after providing high-quality evidence-based online health information. These findings show that e-Health can be effective to improve self-management and reduce healthcare usage in times of increasing healthcare costs. PMID:28186945

  6. Measuring the relationship between interruptions, multitasking and prescribing errors in an emergency department: a study protocol.

    Science.gov (United States)

    Raban, Magdalena Z; Walter, Scott R; Douglas, Heather E; Strumpman, Dana; Mackenzie, John; Westbrook, Johanna I

    2015-10-13

    Interruptions and multitasking are frequent in clinical settings, and have been shown in the cognitive psychology literature to affect performance, increasing the risk of error. However, comparatively less is known about their impact on errors in clinical work. This study will assess the relationship between prescribing errors, interruptions and multitasking in an emergency department (ED) using direct observations and chart review. The study will be conducted in an ED of a 440-bed teaching hospital in Sydney, Australia. Doctors will be shadowed at proximity by observers for 2 h time intervals while they are working on day shift (between 0800 and 1800). Time stamped data on tasks, interruptions and multitasking will be recorded on a handheld computer using the validated Work Observation Method by Activity Timing (WOMBAT) tool. The prompts leading to interruptions and multitasking will also be recorded. When doctors prescribe medication, type of chart and chart sections written on, along with the patient's medical record number (MRN) will be recorded. A clinical pharmacist will access patient records and assess the medication orders for prescribing errors. The prescribing error rate will be calculated per prescribing task and is defined as the number of errors divided by the number of medication orders written during the prescribing task. The association between prescribing error rates, and rates of prompts, interruptions and multitasking will be assessed using statistical modelling. Ethics approval has been obtained from the hospital research ethics committee. Eligible doctors will be provided with written information sheets and written consent will be obtained if they agree to participate. Doctor details and MRNs will be kept separate from the data on prescribing errors, and will not appear in the final data set for analysis. Study results will be disseminated in publications and feedback to the ED. Published by the BMJ Publishing Group Limited. For permission

  7. Explicit/multi-parametric model predictive control (MPC) of linear discrete-time systems by dynamic and multi-parametric programming

    KAUST Repository

    Kouramas, K.I.; Faí sca, N.P.; Panos, C.; Pistikopoulos, E.N.

    2011-01-01

    This work presents a new algorithm for solving the explicit/multi- parametric model predictive control (or mp-MPC) problem for linear, time-invariant discrete-time systems, based on dynamic programming and multi-parametric programming techniques

  8. Measuring Performance of Soft Real-Time Tasks on Multi-core Systems

    OpenAIRE

    Rafiq, Salman

    2011-01-01

    Multi-core platforms are well established, and they are slowly moving into the area of embedded and real-time systems. Nowadays to take advantage of multi-core systems in terms of throughput, soft real-time applications are run together with general purpose applications under an operating system such as Linux. But due to shared hardware resources in multi-core architectures, it is likely that these applications will interfere and compete with each other. This can cause slower response times f...

  9. Rapid resumption of interrupted visual search. New insights on the interaction between vision and memory.

    Science.gov (United States)

    Lleras, Alejandro; Rensink, Ronald A; Enns, James T

    2005-09-01

    A modified visual search task demonstrates that humans are very good at resuming a search after it has been momentarily interrupted. This is shown by exceptionally rapid response time to a display that reappears after a brief interruption, even when an entirely different visual display is seen during the interruption and two different visual searches are performed simultaneously. This rapid resumption depends on the stability of the visual scene and is not due to display or response anticipations. These results are consistent with the existence of an iterative hypothesis-testing mechanism that compares information stored in short-term memory (the perceptual hypothesis) with information about the display (the sensory pattern). In this view, rapid resumption occurs because a hypothesis based on a previous glance of the scene can be tested very rapidly in a subsequent glance, given that the initial hypothesis-generation step has already been performed.

  10. Multi-peak pattern in Multi-gap RPC time-over-threshold distributions and an offline calibration method

    International Nuclear Information System (INIS)

    Yang, R.X.; Li, C.; Sun, Y.J.; Liu, Z.; Wang, X.Z.; Heng, Y.K.; Sun, S.S.; Dai, H.L.; Wu, Z.; An, F.F.

    2017-01-01

    The Beijing Spectrometer (BESIII) has just updated its end-cap Time-of-Flight (ETOF) system, using the Multi-gap Resistive Plate Chamber (MRPC) to replace the current scintillator detectors. These MRPCs shows multi-peak phenomena in their time-over-threshold (TOT) distribution, which was also observed in the Long-strip MRPC built for the RHIC-STAR Muon Telescope Detector (MTD). After carefully investigated the correlation between the multi-peak distribution and incident hit positions along the strips, we find out that it can be semi-quantitatively explained by the signal reflections on the ends of the readout strips. Therefore a new offline calibration method was implemented on the MRPC ETOF data in BESIII, making T-TOT correlation significantly improved to evaluate the time resolution.

  11. Testing the multi-configuration time-dependent Hartree-Fock method

    International Nuclear Information System (INIS)

    Zanghellini, Juergen; Kitzler, Markus; Brabec, Thomas; Scrinzi, Armin

    2004-01-01

    We test the multi-configuration time-dependent Hartree-Fock method as a new approach towards the numerical calculation of dynamical processes in multi-electron systems using the harmonic quantum dot and one-dimensional helium in strong laser pulses as models. We find rapid convergence for quantities such as ground-state population, correlation coefficient and single ionization towards the exact results. The method converges, where the time-dependent Hartree-Fock method fails qualitatively

  12. [Young first-time parents' experiences with family-centred postpartal health care in Switzerland].

    Science.gov (United States)

    Kläusler-Troxler, Marianne; Kurth, Elisabeth; Spirig, Rebecca

    2014-08-01

    Routine postnatal care normally addresses only the mother and her child. In Switzerland, counselling for all parents and their children is provided by family nurses in a community-based health care setting. We implemented a new approach to ensure father involvement within the framework of the Calgary Family Assessment (CFAM) and the Calgary Intervention Model CFIM of Wright and Leahey (2013) in the northwest of Switzerland. This qualitative study explored how mothers and fathers experienced the newly developed family-centred consultation. Data collection was performed by means of participant observation and semi- structured interviews with a sample of five first-time parents with healthy neonates. Data were analysed by using content analysis according to Mayring. Mothers and fathers experienced family-centred consultation as effective. They felt more secure and confident "to handle the new situation" and obtained trustful, concrete and professional support to take care of their baby, particularly with regard to breast feeding, crying and sleeping patterns. Fathers felt included into postnatal care from the beginning. Family nursing offers a useful framework for family-centred postnatal health care.

  13. Modeling stochastic lead times in multi-echelon systems

    NARCIS (Netherlands)

    Diks, E.B.; Heijden, van der M.C.

    1996-01-01

    In many multi-echelon inventory systems the lead times are random variables. A common and reasonable assumption in most models is that replenishment orders do not cross, which implies that successive lead times are correlated. However, the process which generates such lead times is usually not

  14. Modeling stochastic lead times in multi-echelon systems

    NARCIS (Netherlands)

    Diks, E.B.; van der Heijden, M.C.

    1997-01-01

    In many multi-echelon inventory systems, the lead times are random variables. A common and reasonable assumption in most models is that replenishment orders do not cross, which implies that successive lead times are correlated. However, the process that generates such lead times is usually not well

  15. Learning about interruptions

    DEFF Research Database (Denmark)

    Brandrup, Morten

    ‘Interruption’ is a well described phenomenon within health-care. This study describes a field study in which nurses at a surgical ward desired to gain insights to what they experienced as interruptions from phone calls of the coordinating nurse. Employing an effects-driven approach data about...... the frequency and types of phone calls was collected using a tailored experience sampling tool. The data as well as the data became a way for the nurses to learn about the problem and use it as a stepping stone for discussing possible solutions....

  16. Design and performance of a multi-centre randomised controlled trial and economic evaluation of joint tele-consultations [ISRCTN54264250

    Directory of Open Access Journals (Sweden)

    Thompson Simon

    2002-01-01

    Full Text Available Abstract Background Appropriate information flow is crucial to the care of patients, particularly at the interface between primary and secondary care. Communication problems can result from inadequate organisation and training, There is a major expectation that information and communication technologies may offer solutions, but little reliable evidence. This paper reports the design and performance of a multi-centre randomised controlled trial (RCT, unparalleled in telemedicine research in either scale or range of outcomes. The study investigated the effectiveness and cost implications in rural and inner-city settings of using videoconferencing to perform joint tele-consultations as an alternative to general practitioner referral to the hospital specialist in the outpatient clinic. Methods Joint tele-consultation services were established in both the Royal Free Hampstead NHS Trust in inner London, and the Royal Shrewsbury Hospitals Trust, in Shropshire. All the patients who gave consent to participate were randomised either to joint tele-consultation or to a routine outpatients appointment. The principal outcome measures included the frequency of decision by the specialist to offer a follow-up outpatient appointment, patient satisfaction (Ware Specific Questionnaire, wellbeing (SF12 and enablement (PEI, numbers of tests, investigations, procedures and treatments. Results A total of 134 general practitioners operating from 29 practices participated in the trial, referring a total of 3170 patients to 20 specialists in ENT medicine, general medicine (including endocrinology, and rheumatology, gastroenterology, orthopaedics, neurology and urology. Of these, 2094 patients consented to participate in the study and were correctly randomised. There was a 91% response rate to the initial assessment questionnaires, and analysis showed equivalence for all key characteristics between the treatment and control groups. Conclusion We have designed and

  17. The interrupted learner: How distractions during live and video lectures influence learning outcomes.

    Science.gov (United States)

    Zureick, Andrew H; Burk-Rafel, Jesse; Purkiss, Joel A; Hortsch, Michael

    2017-11-27

    New instructional technologies have been increasingly incorporated into the medical school learning environment, including lecture video recordings as a substitute for live lecture attendance. The literature presents varying conclusions regarding how this alternative experience impacts students' academic success. Previously, a multi-year study of the first-year medical histology component at the University of Michigan found that live lecture attendance was positively correlated with learning success, while lecture video use was negatively correlated. Here, three cohorts of first-year medical students (N = 439 respondents, 86.6% response rate) were surveyed in greater detail regarding lecture attendance and video usage, focusing on study behaviors that may influence histology learning outcomes. Students who reported always attending lectures or viewing lecture videos had higher average histology scores than students who employed an inconsistent strategy (i.e., mixing live attendance and video lectures). Several behaviors were negatively associated with histology performance. Students who engaged in "non-lecture activities" (e.g., social media use), students who reported being interrupted while watching the lecture video, or feeling sleepy/losing focus had lower scores than their counterparts not engaging in these behaviors. This study suggests that interruptions and distractions during medical learning activities-whether live or recorded-can have an important impact on learning outcomes. Anat Sci Educ 00: 000-000. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists.

  18. Fuzzy logic based power-efficient real-time multi-core system

    CERN Document Server

    Ahmed, Jameel; Najam, Shaheryar; Najam, Zohaib

    2017-01-01

    This book focuses on identifying the performance challenges involved in computer architectures, optimal configuration settings and analysing their impact on the performance of multi-core architectures. Proposing a power and throughput-aware fuzzy-logic-based reconfiguration for Multi-Processor Systems on Chip (MPSoCs) in both simulation and real-time environments, it is divided into two major parts. The first part deals with the simulation-based power and throughput-aware fuzzy logic reconfiguration for multi-core architectures, presenting the results of a detailed analysis on the factors impacting the power consumption and performance of MPSoCs. In turn, the second part highlights the real-time implementation of fuzzy-logic-based power-efficient reconfigurable multi-core architectures for Intel and Leone3 processors. .

  19. Effect of growth interruptions on TiO{sub 2} films deposited by plasma enhanced chemical vapour deposition

    Energy Technology Data Exchange (ETDEWEB)

    Li, D., E-mail: dyli@yzu.edu.cn [College of Mechanical Engineering, Yangzhou University, Yangzhou, 225127 (China); Goullet, A. [Institut des Matériaux Jean Rouxel (IMN), UMR CNRS 6502, 2 rue de la Houssinière, 44322, Nantes (France); Carette, M. [Institut d’Electronique, de Microélectronique et de Nanotechnologie (IEMN), UMR CNRS 8520, Avenue Poincaré, 59652, Villeneuve d' Ascq (France); Granier, A. [Institut des Matériaux Jean Rouxel (IMN), UMR CNRS 6502, 2 rue de la Houssinière, 44322, Nantes (France); Landesman, J.P. [Institut de Physique de Rennes, UMR CNRS 6251, 263 av. Général Leclerc, 35042, Rennes (France)

    2016-10-01

    TiO{sub 2} films of ∼300 nm were deposited at low temperature (<140 °C) and pressure (0.4 Pa) using plasma enhanced chemical vapour deposition at the floating potential (V{sub f}) or the substrate self-bias voltage (V{sub b}) of −50 V. The impact of growth interruptions on the morphology, microstructure and optical properties of the films was investigated. The interruptions were carried out by stopping the plasma generation and gas injection once the increase of the layer thickness during each deposition step was about ∼100 nm. In one case of V{sub f}, the films of ∼300 nm exhibit a columnar morphology consisting of a bottom dense layer, an intermediate gradient layer and a top roughness layer. But the growth interruptions result in an increase of the dense layer thickness and a decrease of surface roughness. The film inhomogeneity has been identified by the in-situ real-time evolution of the kinetic ellipsometry (KE) parameters and the modeling process of spectroscopic ellipsometry (SE). The discrepancy of the refractive index measured by SE between bottom and upper layers can be reduced by growth interruptions. In the other case of V{sub b} = −50 V, the films exhibit a more compact arrangement which is homogeneous along the growth direction as confirmed by KE and SE. Both of Fourier transform infrared spectra and X-ray diffraction illustrate a phase transformation from anatase to rutile with the bias of −50 V, and also evidenced on the evolution of the refractive index dispersion curves. And a greatly increase of the refractive indice in the transparent range can be identified. However, the growth interruptions seem to have no influence on the morphology and optical properties in this case. - Highlights: • TiO{sub 2} films deposited by plasma processes at low temperature and pressure. • Influence of growth interruptions on structural and optical properties. • In-situ real-time ellipsometry measurements on film properties. • Structural and

  20. Acute glucoregulatory and vascular outcomes of three strategies for interrupting prolonged sitting time in postmenopausal women: A pilot, laboratory-based, randomized, controlled, 4-condition, 4-period crossover trial.

    Directory of Open Access Journals (Sweden)

    Jacqueline Kerr

    Full Text Available Prolonged sitting is associated with cardiometabolic and vascular disease. Despite emerging evidence regarding the acute health benefits of interrupting prolonged sitting time, the effectiveness of different modalities in older adults (who sit the most is unclear.In preparation for a future randomized controlled trial, we enrolled 10 sedentary, overweight or obese, postmenopausal women (mean age 66 years ±9; mean body mass index 30.6 kg/m2 ±4.2 in a 4-condition, 4-period crossover feasibility pilot study in San Diego to test 3 different sitting interruption modalities designed to improve glucoregulatory and vascular outcomes compared to a prolonged sitting control condition. The interruption modalities included: a 2 minutes standing every 20 minutes; b 2 minutes walking every hour; and c 10 minutes standing every hour. During each 5-hr condition, participants consumed two identical, standardized meals. Blood samples, blood pressure, and heart rate were collected every 30 minutes. Endothelial function of the superficial femoral artery was measured at baseline and end of each 5-hr condition using flow-mediated dilation (FMD. Participants completed each condition on separate days, in randomized order. This feasibility pilot study was not powered to detect statistically significant differences in the various outcomes, however, analytic methods (mixed models were used to test statistical significance within the small sample size.Nine participants completed all 4 study visits, one participant completed 3 study visits and then was lost to follow up. Net incremental area under the curve (iAUC values for postprandial plasma glucose and insulin during the 5-hr sitting interruption conditions were not significantly different compared to the control condition. Exploratory analyses revealed that the 2-minute standing every 20 minutes and the 2-minute walking every hour conditions were associated with a significantly lower glycemic response to the second

  1. Using stockpile delegation to improve China's strategic oil policy: A multi-dimension stochastic dynamic programming approach

    International Nuclear Information System (INIS)

    Chen, Xin; Mu, Hailin; Li, Huanan; Gui, Shusen

    2014-01-01

    There has been much attention paid to oil security in China in recent years. Although China has begun to establish its own strategic petroleum reserve (SPR) to prevent potential losses caused by oil supply interruptions, the system aiming to ensure China's oil security is still incomplete. This paper describes and provides evidence for the benefits of an auxiliary strategic oil policy choice, which aims to strengthen China's oil supply security and offer a solution for strategic oil operations with different holding costs. In this paper, we develop a multi-dimension stochastic dynamic programming model to analyze the oil stockpile delegation policy, which is an intermediate policy between public and private oil stockpiles and is appropriate for the Chinese immature private oil stockpile sector. The model examines the effects of the oil stockpile delegation policy in the context of several distinct situations, including normal world oil market conditions, slight oil supply interruption, and serious oil supply interruption. Operating strategies that respond to different oil supply situations for both the SPR and the delegated oil stockpile were obtained. Different time horizons, interruption times and holding costs of delegated oil stockpiles were examined. The construction process of China's SPR was also taken into account. - Highlights: • We provided an auxiliary strategic oil policy rooted in Chinese local conditions. • The policy strengthen China's capability for preventing oil supply interruption. • We model to obtain the managing strategies for China's strategic petroleum reserve. • Both of the public and delegated oil stockpile were taken into consideration. • The three phase's construction process of China's SPR was taken into account

  2. NUMERICAL METHODS FOR SOLVING THE MULTI-TERM TIME-FRACTIONAL WAVE-DIFFUSION EQUATION

    OpenAIRE

    Liu, F.; Meerschaert, M.M.; McGough, R.J.; Zhuang, P.; Liu, Q.

    2013-01-01

    In this paper, the multi-term time-fractional wave-diffusion equations are considered. The multi-term time fractional derivatives are defined in the Caputo sense, whose orders belong to the intervals [0,1], [1,2), [0,2), [0,3), [2,3) and [2,4), respectively. Some computationally effective numerical methods are proposed for simulating the multi-term time-fractional wave-diffusion equations. The numerical results demonstrate the effectiveness of theoretical analysis. These methods and technique...

  3. Planning a multi-institutional information for development study centre

    CSIR Research Space (South Africa)

    Moreno, A

    2010-05-01

    Full Text Available . The I4D Study Centre tasks are to increase both the research expertise pool available for Meraka and the partner university, and the joint development of study programs with universities that will prepare students for a researcher career with an ICT4D...

  4. Approximator: Predicting Interruptibility in Software Development with Commodity Computers

    DEFF Research Database (Denmark)

    Tell, Paolo; Jalaliniya, Shahram; Andersen, Kristian S. M.

    2015-01-01

    Assessing the presence and availability of a remote colleague is key in coordination in global software development but is not easily done using existing computer-mediated channels. Previous research has shown that automated estimation of interruptibility is feasible and can achieve a precision....... These early but promising results represent a starting point for designing tools with support for interruptibility capable of improving distributed awareness and cooperation to be used in global software development....

  5. Basic interrupted versus continuous suturing techniques in bronchial anastomosis following sleeve lobectomy in dogs.

    Science.gov (United States)

    Bayram, Ahmet Sami; Erol, Mehmet Muharrem; Salci, Hakan; Ozyiğit, Ozgür; Görgül, Sacit; Gebitekin, Cengiz

    2007-12-01

    Sleeve resection with or without lung resection is a valid conservative operation for patients with benign or malignant tumors; it enables the preservation of lung parenchyma. The aim of this prospective randomized study was to compare complications, operating time, and bronchial healing between the techniques of interrupted and continuous suturing for bronchial anastomosis in dogs. Twenty adult mongrel dogs each weighing 18-22 kg (average: 20 kg) were divided into two groups according to the anastomosis technique performed: group A, interrupted suturing and group B, continuous suturing. Each group comprised of 10 dogs. Following right thoracotomy, sleeve resection of the right cranial lobe was performed in all dogs. Basic interrupted sutures using 4/0 Vicryl (Ethicon, USA) were used in group A, and continuous sutures were used in group B. The median anastomosis time was 15.2 min (range: 13-21 min) in group A and 9.6 min (range: 8-13 min) in group B. In all dogs, the anastomosis line was resected via right pneumonectomy for histopathological investigation 1 month after sleeve resection. Histopathological examination revealed that the healing of the anastomosis was not affected by the suturing technique applied. One dog from each group died on the fourth postoperative day; Fisher's exact test, p=0.763. Our research revealed that the healing of the anastomosis was not affected by the suturing technique performed.

  6. Interrupted or continuous-intradermal suturing? Statistical analysis of postoperative scars

    Directory of Open Access Journals (Sweden)

    Elif Sarı

    2014-12-01

    Full Text Available Background and Design: Postoperative scar development is an important problem for patients treated in plastic surgery clinics. Most patients think that continuous intradermal suturing is superior to interrupted suturing because they assume that it creates less scarring. We evaluated scars that form following intradermal and interrupted suturing. This article presents our controlled study that objectively compared the scars on patients' faces using a wound evaluation scale. Materials and Methods: Thirty-five patients, who had undergone operations on the bilateral cheeks, were included in this study. Thirty patients were female; five patients were male. Their mean age was 40.05 years. The average scar evaluation time after surgery was 9.05 months. Elliptical excisions were made on the lesions under local anesthesia. The incisions on the right cheeks were sutured with 6/0 monofilament nonabsorbable sutures using the continuous intradermal suturing technique. The left cheek incisions were sutured with same sutures using the interrupted suturing method. Results: The patients were evaluated 7–11 months after operation (mean: 9.05 months using the Stony Brook Scar Evaluation Scale. A Related Samples T-test was used for statistical evaluation of the differences between the suturing techniques. No significant differences were noted in scar formation between the two suturing methods (p>0.05. Conclusion: We found no differences in scar formation between the two frequently used suturing techniques studied here. We believe that the suturing technique is a less important determinant of scar formation than are other factors.

  7. Critical Causes and Consequences of Construction Project Interruption: Client, Contractor, Consultant and External Factors Standpoints

    Directory of Open Access Journals (Sweden)

    Nurbasirah Mohamed Alias

    2013-09-01

    Full Text Available It should be pointed out that the dilemma of interruption and stoppage in the construction industry is a large-scale trend. Construction interruption and stoppage is considered one of the most recurring problems in the construction industry. Construction Interruption and stoppage is always measured as costly to all parties concerned in the projects and very often it will result in clash, claims, total desertion and much difficult for the feasibility and it slows the growth of construction sector. The objective of the research work that underpins this paper was to investigate the Factors and Consequences of construction projects on local contractors. A construction project is commonly acknowledged as successful when the aim of the project is achieved in terms of predetermined objectives that are mainly completed the project on time, within budget and specified quality in accordance with the specifications and to stakeholders’ satisfaction. One of the most important problems that may arise in the construction project is delays and the magnitude of these delays varies considerably from project to project. According to delay categories that were contractor related, client related, consultant related, labour related and external related, the study revealed the six major effects of delay that were time overrun, cost overrun, dispute, arbitration, total abandonment, and litigation.

  8. Generation of Induced Progenitor-like Cells from Mature Epithelial Cells Using Interrupted Reprogramming

    Directory of Open Access Journals (Sweden)

    Li Guo

    2017-12-01

    Full Text Available Summary: A suitable source of progenitor cells is required to attenuate disease or affect cure. We present an “interrupted reprogramming” strategy to generate “induced progenitor-like (iPL cells” using carefully timed expression of induced pluripotent stem cell reprogramming factors (Oct4, Sox2, Klf4, and c-Myc; OSKM from non-proliferative Club cells. Interrupted reprogramming allowed controlled expansion yet preservation of lineage commitment. Under clonogenic conditions, iPL cells expanded and functioned as a bronchiolar progenitor-like population to generate mature Club cells, mucin-producing goblet cells, and cystic fibrosis transmembrane conductance regulator (CFTR-expressing ciliated epithelium. In vivo, iPL cells can repopulate CFTR-deficient epithelium. This interrupted reprogramming process could be metronomically applied to achieve controlled progenitor-like proliferation. By carefully controlling the duration of expression of OSKM, iPL cells do not become pluripotent, and they maintain their memory of origin and retain their ability to efficiently return to their original phenotype. A generic technique to produce highly specified populations may have significant implications for regenerative medicine. : In this article Waddell, Nagy, and colleagues present an “interrupted reprogramming” strategy to produce highly specified functional “induced progenitor-like cells” from mature quiescent cells. They propose that careful control of the duration of transient expression of iPSC reprogramming factors (OSKM allows controlled expansion yet preservation of parental lineage without traversing the pluripotent state. Keywords: generation of induced progenitor-like cells

  9. Optimal Conditional Reachability for Multi-Priced Timed Automata

    DEFF Research Database (Denmark)

    Larsen, Kim Guldstrand; Rasmussen, Jacob Illum

    2005-01-01

    In this paper, we prove decidability of the optimal conditional reachability problem for multi-priced timed automata, an extension of timed automata with multiple cost variables evolving according to given rates for each location. More precisely, we consider the problem of determining the minimal...

  10. [Structured care in an ISO certified centre for patients with cystic fibrosis and their families].

    Science.gov (United States)

    Ellemunter, H; Eder, J; Steinkamp, G

    2011-10-01

    Cystic fibrosis (CF) is a chronic, life-shortening disease of multiple organ systems. Guidelines recommend that patients should be treated in specialised CF centres with multi-professional teams. We describe the organisation of medical care at the CF centre of Innsbruck University as well as results of treatment. Procedures and delivery of multi-professional care have been elaborated and structured. Since 2006 the Centre has been repeatedly certified according to DIN ISO 9001:2000. The patient database is being used during the doctor's consultation and for the continuous monitoring of treatment results. In 2010, 71 of the 148 patients (48%) were between 18 and 56 years old. The total number of patients has doubled and the proportion of adults tripled since 1995. Nevertheless, median FEV1 remained stable (>80% of predicted) during the last 15 years. Compared with 18 CF centres of the German Benchmarking Group, patients treated in Innsbruck had favourable FEV1 values: 52% of adults had a normal FEV1 (>80% pred.) and only 23% an FEV1 <50% of predicted. A structured programme of multi-professional care was associated with favourable treatment results, both longitudinally and in comparison to other CF centres. © Georg Thieme Verlag KG Stuttgart · New York.

  11. Application of customer-interruption costs for optimum distribution planning

    International Nuclear Information System (INIS)

    Mok, Y.L.; Chung, T.S.

    1996-01-01

    We present a new methodology for obtaining optimum values of the integrated cost of utility investment with customer interruption in distribution planning for electric power systems by determining the reliability cost and worth of the distribution system. Reliability cost refers to investment cost of the utility in achieving a defined level of reliability. Reliability worth is the benefit gained by the utility customer from an increase of reliability. A computer program has been developed to determine comparative reliability indices for a typical distribution network. With the average interruption cost, outage duration, average disconnected load, cost data for distribution equipment, etc. being known, the relation between reliability cost, reliability worth and reliability at the specified load point are obtained. The optimum reliability of the distribution system is then determined from the minimum cost to the utility with customer interruption. The applicability of this approach is demonstrated by several practical networks. (Author)

  12. Interaction Control Protocols for Distributed Multi-user Multi-camera Environments

    Directory of Open Access Journals (Sweden)

    Gareth W Daniel

    2003-10-01

    Full Text Available Video-centred communication (e.g., video conferencing, multimedia online learning, traffic monitoring, and surveillance is becoming a customary activity in our lives. The management of interactions in such an environment is a complicated HCI issue. In this paper, we present our study on a collection of interaction control protocols for distributed multiuser multi-camera environments. These protocols facilitate different approaches to managing a user's entitlement for controlling a particular camera. We describe a web-based system that allows multiple users to manipulate multiple cameras in varying remote locations. The system was developed using the Java framework, and all protocols discussed have been incorporated into the system. Experiments were designed and conducted to evaluate the effectiveness of these protocols, and to enable the identification of various human factors in a distributed multi-user and multi-camera environment. This work provides an insight into the complexity associated with the interaction management in video-centred communication. It can also serve as a conceptual and experimental framework for further research in this area.

  13. Optimal treatment interruptions control of TB transmission model

    Science.gov (United States)

    Nainggolan, Jonner; Suparwati, Titik; Kawuwung, Westy B.

    2018-03-01

    A tuberculosis model which incorporates treatment interruptions of infectives is established. Optimal control of individuals infected with active TB is given in the model. It is obtained that the control reproduction numbers is smaller than the reproduction number, this means treatment controls could optimize the decrease in the spread of active TB. For this model, controls on treatment of infection individuals to reduce the actively infected individual populations, by application the Pontryagins Maximum Principle for optimal control. The result further emphasized the importance of controlling disease relapse in reducing the number of actively infected and treatment interruptions individuals with tuberculosis.

  14. Interruption Practice Reduces Errors

    Science.gov (United States)

    2014-01-01

    miscalculations (Koppel et al., 2005). There are cases where the user (medical staff, MD, Nurse , etc.) forgets to complete the PCS which is to log off or...13. SUPPLEMENTARY NOTES Proceedings of the Human Factors and Ergonomics Society Annual Meeting, vol. 58, 1 vol. pp. 265-269, 2014. 14. ABSTRACT...2000). The effects of interruptions in work activ- ity: Field and laboratory results. Applied Ergonomics , 31(5), 537– 543. González, V. M., & Mark, G

  15. Time-dependent density functional theory for multi-component systems

    International Nuclear Information System (INIS)

    Tiecheng Li; Peiqing Tong

    1985-10-01

    The Runge-Gross version of Hohenberg-Kohn-Sham's density functional theory is generalized to multi-component systems, both for arbitrary time-dependent pure states and for arbitrary time-dependent ensembles. (author)

  16. Evaluating the impact of flexible alcohol trading hours on violence: an interrupted time series analysis.

    Directory of Open Access Journals (Sweden)

    David K Humphreys

    Full Text Available On November 24(th 2005, the Government of England and Wales removed regulatory restrictions on the times at which licensed premises could sell alcohol. This study tests availability theory by treating the implementation of Licensing Act (2003 as a natural experiment in alcohol policy.An interrupted time series design was employed to estimate the Act's immediate and delayed impact on violence in the City of Manchester (Population 464,200. We collected police recorded rates of violence, robbery, and total crime between the 1st of February 2004 and the 31st of December 2007. Events were aggregated by week, yielding a total of 204 observations (95 pre-, and 109 post-intervention. Secondary analysis examined changes in daily patterns of violence. Pre- and post-intervention events were separated into four three-hour segments 18∶00-20∶59, 21∶00-23.59, 00∶00-02∶59, 03∶00-05∶59.Analysis found no evidence that the Licensing Act (2003 affected the overall volume of violence. However, analyses of night-time violence found a gradual and permanent shift of weekend violence into later parts of the night. The results estimated an initial increase of 27.5% between 03∶00 to 06∶00 (ω = 0.2433, 95% CI = 0.06, 0.42, which increased to 36% by the end of the study period (δ = -0.897, 95% CI = -1.02, -0.77.This study found no evidence that a national policy increasing the physical availability of alcohol affected the overall volume of violence. There was, however, evidence suggesting that the policy may be associated with changes to patterns of violence in the early morning (3 a.m. to 6 a.m..

  17. Trend of Antiretroviral therapy interruption in a clinic cohort of HIV ...

    African Journals Online (AJOL)

    Over subsequent years with increasing expertise coupled with more patient education and public awareness it is expected that these interruptions would decline. We therefore determined the trend in ART interruptions in a clinic cohort of HIV-1 infected children attending the Jos University Teaching Hospital (JUTH).

  18. Don’t Interrupt Me While I Type: Inferring Text Entered Through Gesture Typing on Android Keyboards

    Directory of Open Access Journals (Sweden)

    Simon Laurent

    2016-07-01

    Full Text Available We present a new side-channel attack against soft keyboards that support gesture typing on Android smartphones. An application without any special permissions can observe the number and timing of the screen hardware interrupts and system-wide software interrupts generated during user input, and analyze this information to make inferences about the text being entered by the user. System-wide information is usually considered less sensitive than app-specific information, but we provide concrete evidence that this may be mistaken. Our attack applies to all Android versions, including Android M where the SELinux policy is tightened.

  19. Children and Career Interruptions: The Family Gap in Denmark

    DEFF Research Database (Denmark)

    Gupta, Nabanita Datta; Smith, Nina

    2002-01-01

    Abstract: The effect of children and career interruptions on the family gap is analysed based on longitudinal data covering the years 1980-1995. The estimated model controls for unobserved time-constant heterogeneity. The results show that when controlling for unobserved heterogeneity, the negative...... effect of children on mothers' wages disappear, but there are large differences between educational groups and the public and private sector. The main effect of children seems to be a loss of human capital accumulation during child-birth periods. Beside this, there is no indication that children have...

  20. The costs of power interruptions in Germany. An assessment in the light of the Energiewende

    Energy Technology Data Exchange (ETDEWEB)

    Growitsch, Christian; Malischek, Raimund; Nick, Sebastian; Wetzel, Heike

    2013-04-15

    The German Energiewende's potential effects on the reliability of electricity supply as well as the corresponding economic consequences have recently entered both the political and scientific debate. However, empirical evidence of power outage costs in Germany is rather scarce. Following a macroeconomic approach, we analyse the economic costs imposed by potential power interruptions in Germany. Investigating a rich data set on industry and households we estimate both Values of Lost Load (VoLLs) and associated costs of power interruptions for different German regions and sectors and every hour of the year. This disaggregated approach allows for conclusions for optimal load shedding in case of technical necessity and the economic efficiency of measures to improve security of supply. We find that interruption costs vary significantly over time, between sectors and regions. Peaking on midday of a Monday in December at 750 Mio Euro per hour, the average of total national outage costs amount to approximately 430 Mio Euro per hour. The industrial sectors facing the highest outage costs are the machinery and transport equipment sectors. Their aggregated hourly outage costs average out at approximately 20 Mio Euro. Our results emphasize the prominent regional aspect of the German Energiewende as the regions with the highest estimated cost of interruptions in South and West Germany coincide with the areas which face nuclear power plant shut downs in the near future.

  1. How do cynical employees serve their customers?: a multi-method study

    NARCIS (Netherlands)

    Demerouti, E.; Xanthopoulou, D.; Bakker, A.B.

    2018-01-01

    In this multi-method study, we investigate how social job demands (i.e., social interruptions) and resources (i.e., colleague support) in the service context influence employee (negative) (re)actions to customers through cynicism towards the job. In addition, we investigate why customers are less

  2. Explicit/multi-parametric model predictive control (MPC) of linear discrete-time systems by dynamic and multi-parametric programming

    KAUST Repository

    Kouramas, K.I.

    2011-08-01

    This work presents a new algorithm for solving the explicit/multi- parametric model predictive control (or mp-MPC) problem for linear, time-invariant discrete-time systems, based on dynamic programming and multi-parametric programming techniques. The algorithm features two key steps: (i) a dynamic programming step, in which the mp-MPC problem is decomposed into a set of smaller subproblems in which only the current control, state variables, and constraints are considered, and (ii) a multi-parametric programming step, in which each subproblem is solved as a convex multi-parametric programming problem, to derive the control variables as an explicit function of the states. The key feature of the proposed method is that it overcomes potential limitations of previous methods for solving multi-parametric programming problems with dynamic programming, such as the need for global optimization for each subproblem of the dynamic programming step. © 2011 Elsevier Ltd. All rights reserved.

  3. Anticipating Interruptions. Security and risk in a liberalized electricity infrastructure

    Energy Technology Data Exchange (ETDEWEB)

    Silvast, A.

    2013-11-01

    During the past ten years, a number of social scientists have emphasized the importance of material infrastructures like electricity supply as a research topic for the social sciences. The developing of such new perspectives concerning infrastructures also includes uncertainties and risks. This research analyzes the management of uncertainties in the Finnish electricity infrastructure by posing the following research question: how are electricity interruptions, or blackouts, anticipated in Finland and how are these interruptions managed as risks? The main research methodology of the work is multi-sited field work. The empirical materials include interviews with experts and lay people (33 interviews); participant observation in two electricity control rooms; an electricity consumer survey (115 respondents); and also a number of infrastructure and security policy documents and observations from electricity security seminars. The materials were primarily gathered between 2004 and 2008. Social science research often links risks with major current social changes or socio-cultural risk perceptions. In recent international social science discussions, however, a new research topic has emerged - those styles of reasoning and techniques of governance that are deployed to manage risk as a practical matter. My study explores these themes empirically by focusing on the specific habitual practices of risk management in the Finnish electricity infrastructure. The work develops various also semi-ethnographic inquiries into infrastructure risk techniques like monitor screening of real-time risks in electricity control rooms; the management of risks in a liberalized electricity market; the emergence of Finnish reasoning about blackouts from a specific historical background; and the ways in which electricity consumers respond to blackouts in their homes. In addition, the work reflects upon the position of a risk researcher in those situations when the research subjects do not define

  4. Involving older people in a multi-centre randomised trial of a complex intervention in pre-hospital emergency care: implementation of a collaborative model.

    Science.gov (United States)

    Koniotou, Marina; Evans, Bridie Angela; Chatters, Robin; Fothergill, Rachael; Garnsworthy, Christopher; Gaze, Sarah; Halter, Mary; Mason, Suzanne; Peconi, Julie; Porter, Alison; Siriwardena, A Niroshan; Toghill, Alun; Snooks, Helen

    2015-07-10

    Health services research is expected to involve service users as active partners in the research process, but few examples report how this has been achieved in practice in trials. We implemented a model to involve service users in a multi-centre randomised controlled trial in pre-hospital emergency care. We used the generic Standard Operating Procedure (SOP) from our Clinical Trials Unit (CTU) as the basis for creating a model to fit the context and population of the SAFER 2 trial. In our model, we planned to involve service users at all stages in the trial through decision-making forums at 3 levels: 1) strategic; 2) site (e.g. Wales; London; East Midlands); 3) local. We linked with charities and community groups to recruit people with experience of our study population. We collected notes of meetings alongside other documentary evidence such as attendance records and study documentation to track how we implemented our model. We involved service users at strategic, site and local level. We also added additional strategic level forums (Task and Finish Groups and Writing Days) where we included service users. Service user involvement varied in frequency and type across meetings, research stages and locations but stabilised and increased as the trial progressed. Involving service users in the SAFER 2 trial showed how it is feasible and achievable for patients, carers and potential patients sharing the demographic characteristics of our study population to collaborate in a multi-centre trial at the level which suited their health, location, skills and expertise. A standard model of involvement can be tailored by adopting a flexible approach to take account of the context and complexities of a multi-site trial. Current Controlled Trials ISRCTN60481756. Registered: 13 March 2009.

  5. The interrupted properties of an extruded Mg alloy

    International Nuclear Information System (INIS)

    Xu, Shun; Liu, Tianmo; He, Jiejun; Lu, Liwei; Zeng, Wen

    2013-01-01

    Highlights: ► The reinforcement effect of {101 ¯ 2} twins on yield stress is reflected at low deformation. ► The recompressive yield stress equals to the stress when it is unloaded. ► The stress–strain curve of recompression seems like that without interruption. ► Twins generated in precompression could become thicker in recompression. -- Abstract: The current paper investigates the effect of {101 ¯ 2} extension twins identified by using electron backscattered diffraction on the interrupted properties of an extruded Mg–3Al–1Zn (AZ31) alloy. Compressive and recompressive tests are conducted along extrusion direction (ED). It is discovered that the yield strength of recompression is enhanced due to grain refinement by {101 ¯ 2} extension twins. The reinforcement effect of {101 ¯ 2} extension twins on the yield stress of recompression is mainly reflected at the stage of small deformation while the improvement of yield strength is mainly attributed to the pile-up and intersection of dislocations as large deformation occurs. Furthermore, the yield stress of recompression is identical to the interrupted stress of precompression. In situ observation reveals that some twins generated in precompression could also become thicker in the following recompression.

  6. A pragmatic multi-centre randomised controlled trial of fluid loading and level of dependency in high-risk surgical patients undergoing major elective surgery: trial protocol

    Directory of Open Access Journals (Sweden)

    Norrie John

    2010-04-01

    Full Text Available Abstract Background Patients undergoing major elective or urgent surgery are at high risk of death or significant morbidity. Measures to reduce this morbidity and mortality include pre-operative optimisation and use of higher levels of dependency care after surgery. We propose a pragmatic multi-centre randomised controlled trial of level of dependency and pre-operative fluid therapy in high-risk surgical patients undergoing major elective surgery. Methods/Design A multi-centre randomised controlled trial with a 2 * 2 factorial design. The first randomisation is to pre-operative fluid therapy or standard regimen and the second randomisation is to routine intensive care versus high dependency care during the early post-operative period. We intend to recruit 204 patients undergoing major elective and urgent abdominal and thoraco-abdominal surgery who fulfil high-risk surgical criteria. The primary outcome for the comparison of level of care is cost-effectiveness at six months and for the comparison of fluid optimisation is the number of hospital days after surgery. Discussion We believe that the results of this study will be invaluable in determining the future care and clinical resource utilisation for this group of patients and thus will have a major impact on clinical practice. Trial Registration Trial registration number - ISRCTN32188676

  7. Statistical method for the control of the electric power service interruptions (second part); Metodo de control estadistico de las interrupciones del servicio electrico (2a. parte)

    Energy Technology Data Exchange (ETDEWEB)

    Issouribehere, Pedro E.; Barbero, Juan C. [Universidad Nacional de La Plata (UNLP), Buenos Aires (Argentina). Facultad de Ingenieria. Inst. de Investigaciones Tecnologicas para Redes y Equipos Electricos (IITREE-LAT)]. E-mail: iitree@.ing.unlp.edu.ar; Martinez, Jorge L.; Galinski, Alejandro [Ente Nacional Regulador de la Electricidad (ENRE), Buenos Aires (Argentina)

    2001-07-01

    This paper presents the register of interruptions in application points of the concession areas of three concessionaires. The reliability indexes are presented of the controlled sites: interruption ratio {lambda}, time of average reposition r and unavailability Q obtained with the field information recompiled during three years from June 2000. The paper also obtains by concessionaire, the ratios of brief interruptions occurrence which constitutes another indicator of the Electric Service Quality.

  8. Reproducibility of a semi-automatic method for 6-point vertebral morphometry in a multi-centre trial

    International Nuclear Information System (INIS)

    Guglielmi, Giuseppe; Stoppino, Luca Pio; Placentino, Maria Grazia; D'Errico, Francesco; Palmieri, Francesco

    2009-01-01

    Purpose: To evaluate the reproducibility of a semi-automated system for vertebral morphometry (MorphoXpress) in a large multi-centre trial. Materials and methods: The study involved 132 clinicians (no radiologist) with different levels of experience across 20 osteo-centres in Italy. All have received training in using MorphoXpress. An expert radiologist was also involved providing data used as standard of reference. The test image originate from normal clinical activity and represent a variety of normal, under and over exposed films, indicating both normal anatomy and vertebral deformities. The image was represented twice to the clinicians in a random order. Using the software, the clinicians initially marked the midpoints of the upper and lower vertebrae to include as many of the vertebrae (T5-L4) as practical within each given image. MorphoXpress performs the localisation of all morphometric points based on statistical model-based vision system. Intra-operator as well inter-operator measurement of agreement was calculated using the coefficient of variation and the mean and standard deviation of the difference of two measurements to check their agreement. Results: The overall intra-operator mean differences in vertebral heights is 1.61 ± 4.27% (1 S.D.). The overall intra-operator coefficient of variation is 3.95%. The overall inter-operator mean differences in vertebral heights is 2.93 ± 5.38% (1 S.D.). The overall inter-operator coefficient of variation is 6.89%. Conclusions: The technology tested here can facilitate reproducible quantitative morphometry suitable for large studies of vertebral deformities

  9. SU-C-BRD-01: Multi-Centre Collaborative Quality Assurance Program for IMRT Planning and Delivery: Year 3 Results

    Energy Technology Data Exchange (ETDEWEB)

    McNiven, A; Jaffray, D; Letourneau, D [Princess Margaret Cancer Centre and Department of Radiation Oncology, University of Toronto, Toronto, ON (Canada)

    2015-06-15

    Purpose: A multi-centre quality assurance program was developed to enable quality improvement by coupling measurement of intensity modulated radiotherapy (IMRT) planning and delivery performance for site-specific planning exercises with diagnostic testing. The third year of the program specifically assessed the quality of spine stereotactic body radiotherapy (SBRT) planning and delivery amongst the participating centres. Methods: A spine SBRT planning exercise (24 Gy in 2 fractions) was created and completed by participants prior to an on-site visit. The delivery portion of the on-site visit included spine SBRT plan delivery and diagnostic testing, which included portal image acquisition for quantification of phantom positioning error and multi-leaf collimator (MLC) calibration accuracy. The measured dose was compared to that calculated in the treatment planning system (TPS) using 3%/2mm composite analysis and 3%/3mm gamma analysis. Results: Fourteen institutions participated, creating 17 spine SBRT plans (15 VMAT and 2 IMRT). Three different TPS, two beam energies (6 MV and 6 MV FFF), and four MLC designs from two linac vendors were tested. Large variation in total monitor units (MU) per plan (2494–6462 MU) and dose-volume parameters was observed. The maximum point dose in the plans ranged from 116–149% and was dependent upon the TPS used. Pass rates for measured to planned dose comparison ranged from 89.4–100% and 97.3–100% for 3%/2mm and 3%/3mm criteria respectively. The largest measured MLC error did Result in one of the poorer pass rates. No direct correlation between phantom positioning error and pass rates overall. Conclusion: Significant differences were observed in the planning exercise for some plan and dose-volume parameters based on the TPS used. Standard evaluation criteria showed good agreement between planned and measured dose for all participants, however on an individual plan basis, diagnostic tests were able to identify contributing

  10. SU-C-BRD-01: Multi-Centre Collaborative Quality Assurance Program for IMRT Planning and Delivery: Year 3 Results

    International Nuclear Information System (INIS)

    McNiven, A; Jaffray, D; Letourneau, D

    2015-01-01

    Purpose: A multi-centre quality assurance program was developed to enable quality improvement by coupling measurement of intensity modulated radiotherapy (IMRT) planning and delivery performance for site-specific planning exercises with diagnostic testing. The third year of the program specifically assessed the quality of spine stereotactic body radiotherapy (SBRT) planning and delivery amongst the participating centres. Methods: A spine SBRT planning exercise (24 Gy in 2 fractions) was created and completed by participants prior to an on-site visit. The delivery portion of the on-site visit included spine SBRT plan delivery and diagnostic testing, which included portal image acquisition for quantification of phantom positioning error and multi-leaf collimator (MLC) calibration accuracy. The measured dose was compared to that calculated in the treatment planning system (TPS) using 3%/2mm composite analysis and 3%/3mm gamma analysis. Results: Fourteen institutions participated, creating 17 spine SBRT plans (15 VMAT and 2 IMRT). Three different TPS, two beam energies (6 MV and 6 MV FFF), and four MLC designs from two linac vendors were tested. Large variation in total monitor units (MU) per plan (2494–6462 MU) and dose-volume parameters was observed. The maximum point dose in the plans ranged from 116–149% and was dependent upon the TPS used. Pass rates for measured to planned dose comparison ranged from 89.4–100% and 97.3–100% for 3%/2mm and 3%/3mm criteria respectively. The largest measured MLC error did Result in one of the poorer pass rates. No direct correlation between phantom positioning error and pass rates overall. Conclusion: Significant differences were observed in the planning exercise for some plan and dose-volume parameters based on the TPS used. Standard evaluation criteria showed good agreement between planned and measured dose for all participants, however on an individual plan basis, diagnostic tests were able to identify contributing

  11. Eventual Suicide in Interrupted and Uninterrupted Attempters: A Challenge to the Cry-for-Help Hypothesis.

    Science.gov (United States)

    Steer, Robert A.; And Others

    1988-01-01

    Followed patients (N=499) hospitalized for suicide attempts (attempters) between 1970 and 1975 until 1982. Found under six percent eventually committed suicide. Found the interrupted attempters were approximately three times more likely to commit suicide than were the uninterrupted attempters. (Author/ABL)

  12. Interrupted time-series analysis of regulations to reduce paracetamol (acetaminophen poisoning.

    Directory of Open Access Journals (Sweden)

    Oliver W Morgan

    2007-04-01

    Full Text Available Paracetamol (acetaminophen poisoning is the leading cause of acute liver failure in Great Britain and the United States. Successful interventions to reduced harm from paracetamol poisoning are needed. To achieve this, the government of the United Kingdom introduced legislation in 1998 limiting the pack size of paracetamol sold in shops. Several studies have reported recent decreases in fatal poisonings involving paracetamol. We use interrupted time-series analysis to evaluate whether the recent fall in the number of paracetamol deaths is different to trends in fatal poisoning involving aspirin, paracetamol compounds, antidepressants, or nondrug poisoning suicide.We calculated directly age-standardised mortality rates for paracetamol poisoning in England and Wales from 1993 to 2004. We used an ordinary least-squares regression model divided into pre- and postintervention segments at 1999. The model included a term for autocorrelation within the time series. We tested for changes in the level and slope between the pre- and postintervention segments. To assess whether observed changes in the time series were unique to paracetamol, we compared against poisoning deaths involving compound paracetamol (not covered by the regulations, aspirin, antidepressants, and nonpoisoning suicide deaths. We did this comparison by calculating a ratio of each comparison series with paracetamol and applying a segmented regression model to the ratios. No change in the ratio level or slope indicated no difference compared to the control series. There were about 2,200 deaths involving paracetamol. The age-standardised mortality rate rose from 8.1 per million in 1993 to 8.8 per million in 1997, subsequently falling to about 5.3 per million in 2004. After the regulations were introduced, deaths dropped by 2.69 per million (p = 0.003. Trends in the age-standardised mortality rate for paracetamol compounds, aspirin, and antidepressants were broadly similar to paracetamol

  13. Interruption or congenital stenosis of the inferior vena cava: Prevalence, imaging, and clinical findings

    International Nuclear Information System (INIS)

    Koc, Zafer; Oguzkurt, Levent

    2007-01-01

    Objective: To present the prevalence, clinical, and imaging findings of interruption or congenital stenotic lesions of the inferior vena cava (IVC), associated malformations, and their clinical relevance. Materials and methods: Between March 2004 and March 2006, 7972 patients who had undergone consecutive routine abdominal multidetector row computed tomography were analyzed for interruption or stenotic lesion of the IVC. Results: Prevalence of interruption (n = 8) or congenital stenosis (n = 4) of the IVC occurred in 12 (0.15%) of 7972 patients. Four patients with interruption and four patients with congenital stenosis of the IVC were symptomatic with DVT (n = 4), leg swelling (n = 4), leg pain (n = 2), lower extremity varices (n = 2), hepatic vein thrombosis (n = 1), and hematochezia (n = 1). All four of the asymptomatic patients were from the interruption group, and these patients had interrupted IVC with well-developed azygos/hemiazygos continuation. Eight symptomatic patients did not have a well-developed azygos/hemiazygos continuation, and drainage of lower extremity was mainly from collateral veins. Additional findings in eight symptomatic patients were abdominal venous collaterals (n = 8), venous aneurysm (n = 2), lower extremity varices (n = 2), varicocele (n = 2), and pelvic varices (n = 1). Conclusion: Interruption or stenosis of the IVC are rare on routine abdominal CT examinations and may cause different clinical findings depending on the variant drainage patterns or collaterals. Interrupted IVC is commonly asymptomatic if associated with well-developed azygos/hemiazygos continuation, whereas commonly symptomatic if well-developed azygos/hemiazygos continuation is not present

  14. Doxycycline in the treatment of respiratory tract infections. Results of a pan-European multi-centre trial.

    Science.gov (United States)

    Pestel, M

    1975-01-01

    In the winter of 1973-4, general practitioners from seven European countries took part in a multi-centre trial of doxycycline in the treatment of infections of the respiratory tract. The carefully designed protocol was observed by all participants. A total of 1,747 patients were admitted to the trial; their ages ranged from 6 years to over 80. The commonest diagnoses (50%) were acute bronchitis and acute exacerbations of chronic bronchitis. On the recommended dosage of 200 mg doxycycline on the first day, followed by 100 mg daily thereafter (though 200 mg could be continued daily in severe cases), 87% of patients achieved good or very good results. Both subjective (pain) and objective (sputum volume and viscosity, temperature, cough) measures showed rapid improvement, usually by the third to fifth days. Side-effects were minimal and mainly gastrointestinal and caused only 4 patients to discontinue treatment. Overall, doxycycline proved its effectiveness and rapidity of action.

  15. Obstetric risk indicators for labour dystocia in nulliparous women: A multi-centre cohort study

    Science.gov (United States)

    Kjærgaard, Hanne; Olsen, Jørn; Ottesen, Bent; Nyberg, Per; Dykes, Anna-Karin

    2008-01-01

    Background In nulliparous women dystocia is the most common obstetric problem and its etiology is largely unknown. The frequency of augmentation and cesarean delivery related to dystocia is high although it is not clear if a slow progress justifies the interventions. Studies of risk factors for dystocia often do not provide diagnostic criteria for the diagnosis. The aim of the present study was to identify obstetric and clinical risk indicators of dystocia defined by strict and explicit criteria. Methods A multi-centre population based cohort study with prospectively collected data from 2810 nulliparous women in term spontaneous labour with a singleton infant in cephalic presentation. Data were collected by self-administered questionnaires and clinical data-records. Logistic regression analyses were used to estimate adjusted Odds Ratios (OR) and 95% confidence intervals (CI) are given. Results The following characteristics, present at admission to hospital, were associated with dystocia during labour (OR, 95% CI): dilatation of cervix dystocia. Conclusion Vaginal examinations at admission provide useful information on risk indicators for dystocia. The strongest risk indicator was use of epidural analgesia and if part of that is causal, it is of concern. PMID:18837972

  16. Obstetric risk indicators for labour dystocia in nulliparous women: A multi-centre cohort study

    Directory of Open Access Journals (Sweden)

    Ottesen Bent

    2008-10-01

    Full Text Available Abstract Background In nulliparous women dystocia is the most common obstetric problem and its etiology is largely unknown. The frequency of augmentation and cesarean delivery related to dystocia is high although it is not clear if a slow progress justifies the interventions. Studies of risk factors for dystocia often do not provide diagnostic criteria for the diagnosis. The aim of the present study was to identify obstetric and clinical risk indicators of dystocia defined by strict and explicit criteria. Methods A multi-centre population based cohort study with prospectively collected data from 2810 nulliparous women in term spontaneous labour with a singleton infant in cephalic presentation. Data were collected by self-administered questionnaires and clinical data-records. Logistic regression analyses were used to estimate adjusted Odds Ratios (OR and 95% confidence intervals (CI are given. Results The following characteristics, present at admission to hospital, were associated with dystocia during labour (OR, 95% CI: dilatation of cervix Conclusion Vaginal examinations at admission provide useful information on risk indicators for dystocia. The strongest risk indicator was use of epidural analgesia and if part of that is causal, it is of concern.

  17. Improving prehospital trauma care in Rwanda through continuous quality improvement: an interrupted time series analysis.

    Science.gov (United States)

    Scott, John W; Nyinawankusi, Jeanne D'Arc; Enumah, Samuel; Maine, Rebecca; Uwitonze, Eric; Hu, Yihan; Kabagema, Ignace; Byiringiro, Jean Claude; Riviello, Robert; Jayaraman, Sudha

    2017-07-01

    Injury is a major cause of premature death and disability in East Africa, and high-quality pre-hospital care is essential for optimal trauma outcomes. The Rwandan pre-hospital emergency care service (SAMU) uses an electronic database to evaluate and optimize pre-hospital care through a continuous quality improvement programme (CQIP), beginning March 2014. The SAMU database was used to assess pre-hospital quality metrics including supplementary oxygen for hypoxia (O2), intravenous fluids for hypotension (IVF), cervical collar placement for head injuries (c-collar), and either splinting (splint) or administration of pain medications (pain) for long bone fractures. Targets of >90% were set for each metric and daily team meetings and monthly feedback sessions were implemented to address opportunities for improvement. These five pre-hospital quality metrics were assessed monthly before and after implementation of the CQIP. Met and unmet needs for O2, IVF, and c-collar were combined into a summative monthly SAMU Trauma Quality Scores (STQ score). An interrupted time series linear regression model compared the STQ score during 14 months before the CQIP implementation to the first 14 months after. During the 29-month study period 3,822 patients met study criteria. 1,028 patients needed one or more of the five studied interventions during the study period. All five endpoints had a significant increase between the pre-CQI and post-CQI periods (pRwanda. This programme may be used as an example for additional efforts engaging frontline staff with real-time data feedback in order to rapidly translate data collection efforts into improved care for the injured in a resource-limited setting. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Multi-Scale Dissemination of Time Series Data

    DEFF Research Database (Denmark)

    Guo, Qingsong; Zhou, Yongluan; Su, Li

    2013-01-01

    In this paper, we consider the problem of continuous dissemination of time series data, such as sensor measurements, to a large number of subscribers. These subscribers fall into multiple subscription levels, where each subscription level is specified by the bandwidth constraint of a subscriber......, which is an abstract indicator for both the physical limits and the amount of data that the subscriber would like to handle. To handle this problem, we propose a system framework for multi-scale time series data dissemination that employs a typical tree-based dissemination network and existing time...

  19. The effect of interruptions and breaks on insight and impasses: Do you need a break right now?

    NARCIS (Netherlands)

    Beeftink, F.; van Eerde, W.; Rutte, C.G.

    2008-01-01

    Some time away from a problem, or incubation time, is found to be beneficial to creative problem solving. But are interruptions as equally helpful as breaks? An experiment was conducted to gain more insight into the differences between imposed and self-initiated breaks, and their effects on

  20. Minimum ten-year follow-up of acetabular fracture fixation from the Irish tertiary referral centre.

    LENUS (Irish Health Repository)

    Magill, Paul

    2012-04-01

    Successful outcome from acetabular fracture fixation is multi-factorial. Long-term results are not frequently reported. Pooling such data from high output centres will help progress acetabular fixation. This paper presents the first ten-year data from the Irish tertiary referral centre.

  1. Changes in lipids and lipoprotein particle concentrations after interruption of antiretroviral therapy

    DEFF Research Database (Denmark)

    Lampe, Fiona C; Duprez, Daniel A; Kuller, Lewis H

    2010-01-01

    The effect of interruption of antiretroviral therapy (ART) on lipoprotein particle subclasses has not been studied. We examined short-term changes in lipids and lipoprotein particles among 332 HIV-infected individuals randomized to interrupt or continue ART in the "Strategies for Management...

  2. 77 FR 66080 - Certain Ground Fault Circuit Interrupters and Products Containing Same

    Science.gov (United States)

    2012-11-01

    ... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-739] Certain Ground Fault Circuit... States after importation of certain ground fault circuit interrupters and products containing the same by... issued a general exclusion order barring entry of ground fault circuit interrupters that infringe the...

  3. Cognitive load selectively influences the interruptive effect of pain on attention.

    Science.gov (United States)

    Moore, David J; Eccleston, Christopher; Keogh, Edmund

    2017-10-01

    Pain is known to interrupt attentional performance. Such interference effects seem to occur preferentially for tasks that are complex and/or difficult. However, few studies have directly manipulated memory load in the context of pain interference to test this view. Therefore, this study examines the effect of experimental manipulations of both memory load and pain on 3 tasks previously found to be sensitive to pain interference. Three experiments were conducted. A different task was examined in each experiment, each comprising of a high- and low-cognitive load versions of the task. Experiment 1 comprised an attention span (n-back) task, experiment 2 an attention switching task, and experiment 3 a divided attention task. Each task was conducted under painful and nonpainful conditions. Within the pain condition, an experimental thermal pain induction protocol was administered at the same time participants completed the task. The load manipulations were successful in all experiments. Pain-related interference occurred under the high-load condition but only for the attention span task. No effect of pain was found on either the attentional switching or divided attention task. These results suggest that while cognitive load may influence the interruptive effect of pain on attention, this effect may be selective. Because pain affected the high-load version of the n-back task but did not interrupt performance on attentional switching or dual-task paradigms, this means that our findings did not completely support our hypotheses. Future research should explore further the parameters and conditions under which pain-related interference occurs.

  4. Effectiveness of employer financial incentives in reducing time to report worker injury: an interrupted time series study of two Australian workers' compensation jurisdictions.

    Science.gov (United States)

    Lane, Tyler J; Gray, Shannon; Hassani-Mahmooei, Behrooz; Collie, Alex

    2018-01-05

    Early intervention following occupational injury can improve health outcomes and reduce the duration and cost of workers' compensation claims. Financial early reporting incentives (ERIs) for employers may shorten the time between injury and access to compensation benefits and services. We examined ERI effect on time spent in the claim lodgement process in two Australian states: South Australia (SA), which introduced them in January 2009, and Tasmania (TAS), which introduced them in July 2010. Using administrative records of 1.47 million claims lodged between July 2006 and June 2012, we conducted an interrupted time series study of ERI impact on monthly median days in the claim lodgement process. Time periods included claim reporting, insurer decision, and total time. The 18-month gap in implementation between the states allowed for a multiple baseline design. In SA, we analysed periods within claim reporting: worker and employer reporting times (similar data were not available in TAS). To account for external threats to validity, we examined impact in reference to a comparator of other Australian workers' compensation jurisdictions. Total time in the process did not immediately change, though trend significantly decreased in both jurisdictions (SA: -0.36 days per month, 95% CI -0.63 to -0.09; TAS: 0.35, -0.50 to -0.20). Claim reporting time also decreased in both (SA: -1.6 days, -2.4 to -0.8; TAS: -5.4, -7.4 to -3.3). In TAS, there was a significant increase in insurer decision time (4.6, 3.9 to 5.4) and a similar but non-significant pattern in SA. In SA, worker reporting time significantly decreased (-4.7, -5.8 to -3.5), but employer reporting time did not (-0.3, -0.8 to 0.2). The results suggest that ERIs reduced claim lodgement time and, in the long-term, reduced total time in the claim lodgement process. However, only worker reporting time significantly decreased in SA, indicating that ERIs may not have shortened the process through the intended target of

  5. Cardiogenic shock due to coronary artery disease associated with interrupted aortic arch

    Directory of Open Access Journals (Sweden)

    Luís Alberto Oliveira Dallan

    2013-06-01

    Full Text Available Acute pulmonary edema is a serious event. Its occurrence in association with interrupted aortic arch and coronary heart disease is rare. Recently, an old patient developed cardiogenic shock and acute pulmonary edema due to acute coronary insufficiency, associated with interrupted aortic arch. The coronary angiography revealed occlusion of the right coronary artery and 95% obstruction in the left main coronary artery, associated with interruption of the descending aorta. Coronary artery bypass graft was performed, without extracorporeal circulation, to the anterior descending coronary artery. We discuss the initial management, given the seriousness of the case.

  6. Smart Push, Smart Pull, Sensor to Shooter in a Multi-Level Secure/Safe (MLS) Infrastructure

    Science.gov (United States)

    2006-05-04

    Communication Periods Processing Resource Sanitization Minimum Interrupt Servicing Semaphores Multi-Core Synchronization Primitives Timers And nothing else...Communities of Interest Secure Configuration of all Nodes in Enclave Bandwidth provisioning & partitioning Secure Clock Synchronization Suppression of

  7. Development of a Multi-Centre Clinical Trial Data Archiving and Analysis Platform for Functional Imaging

    Science.gov (United States)

    Driscoll, Brandon; Jaffray, David; Coolens, Catherine

    2014-03-01

    Purpose: To provide clinicians & researchers participating in multi-centre clinical trials with a central repository for large volume dynamic imaging data as well as a set of tools for providing end-to-end testing and image analysis standards of practice. Methods: There are three main pieces to the data archiving and analysis system; the PACS server, the data analysis computer(s) and the high-speed networks that connect them. Each clinical trial is anonymized using a customizable anonymizer and is stored on a PACS only accessible by AE title access control. The remote analysis station consists of a single virtual machine per trial running on a powerful PC supporting multiple simultaneous instances. Imaging data management and analysis is performed within ClearCanvas Workstation® using custom designed plug-ins for kinetic modelling (The DCE-Tool®), quality assurance (The DCE-QA Tool) and RECIST. Results: A framework has been set up currently serving seven clinical trials spanning five hospitals with three more trials to be added over the next six months. After initial rapid image transfer (+ 2 MB/s), all data analysis is done server side making it robust and rapid. This has provided the ability to perform computationally expensive operations such as voxel-wise kinetic modelling on very large data archives (+20 GB/50k images/patient) remotely with minimal end-user hardware. Conclusions: This system is currently in its proof of concept stage but has been used successfully to send and analyze data from remote hospitals. Next steps will involve scaling up the system with a more powerful PACS and multiple high powered analysis machines as well as adding real-time review capabilities.

  8. Development of a Multi-Centre Clinical Trial Data Archiving and Analysis Platform for Functional Imaging

    International Nuclear Information System (INIS)

    Driscoll, Brandon; Jaffray, David; Coolens, Catherine

    2014-01-01

    Purpose: To provide clinicians and researchers participating in multi-centre clinical trials with a central repository for large volume dynamic imaging data as well as a set of tools for providing end-to-end testing and image analysis standards of practice. Methods: There are three main pieces to the data archiving and analysis system; the PACS server, the data analysis computer(s) and the high-speed networks that connect them. Each clinical trial is anonymized using a customizable anonymizer and is stored on a PACS only accessible by AE title access control. The remote analysis station consists of a single virtual machine per trial running on a powerful PC supporting multiple simultaneous instances. Imaging data management and analysis is performed within ClearCanvas Workstation® using custom designed plug-ins for kinetic modelling (The DCE-Tool®), quality assurance (The DCE-QA Tool) and RECIST. Results: A framework has been set up currently serving seven clinical trials spanning five hospitals with three more trials to be added over the next six months. After initial rapid image transfer (+ 2 MB/s), all data analysis is done server side making it robust and rapid. This has provided the ability to perform computationally expensive operations such as voxel-wise kinetic modelling on very large data archives (+20 GB/50k images/patient) remotely with minimal end-user hardware. Conclusions: This system is currently in its proof of concept stage but has been used successfully to send and analyze data from remote hospitals. Next steps will involve scaling up the system with a more powerful PACS and multiple high powered analysis machines as well as adding real-time review capabilities.

  9. A designated centre for people with disabilities operated by Sunbeam House Services Ltd, Wicklow

    LENUS (Irish Health Repository)

    Muller, Ueli C

    2011-04-07

    Abstract Background The International Multi-centre ADHD Genetics (IMAGE) project with 11 participating centres from 7 European countries and Israel has collected a large behavioural and genetic database for present and future research. Behavioural data were collected from 1068 probands with the combined type of attention deficit\\/hyperactivity disorder (ADHD-CT) and 1446 \\'unselected\\' siblings. The aim was to analyse the IMAGE sample with respect to demographic features (gender, age, family status, and recruiting centres) and psychopathological characteristics (diagnostic subtype, symptom frequencies, age at symptom detection, and comorbidities). A particular focus was on the effects of the study design and the diagnostic procedure on the homogeneity of the sample in terms of symptom-based behavioural data, and potential consequences for further analyses based on these data. Methods Diagnosis was based on the Parental Account of Childhood Symptoms (PACS) interview and the DSM-IV items of the Conners\\' teacher questionnaire. Demographics of the full sample and the homogeneity of a subsample (all probands) were analysed by using robust statistical procedures which were adjusted for unequal sample sizes and skewed distributions. These procedures included multi-way analyses based on trimmed means and winsorised variances as well as bootstrapping. Results Age and proband\\/sibling ratios differed between participating centres. There was no significant difference in the distribution of gender between centres. There was a significant interaction between age and centre for number of inattentive, but not number of hyperactive symptoms. Higher ADHD symptom frequencies were reported by parents than teachers. The diagnostic symptoms differed from each other in their frequencies. The face-to-face interview was more sensitive than the questionnaire. The differentiation between ADHD-CT probands and unaffected siblings was mainly due to differences in hyperactive

  10. Procedural Error and Task Interruption

    Science.gov (United States)

    2016-09-30

    interruption. A cognitive model we discuss below explains this effect in terms of increases in performance speed having the effect of compressing memory for...performance, and pilot data suggest that the task can distinguish between cognitive processes that are impaired by sleep deprivation and those that are...David Z. Hambrick Technical contact: Erik M. Altmann Michigan State University Department of Psychology 316 Physics Rd, Room 298A East Lansing

  11. Conceptual design of an ALICE Tier-2 centre. Integrated into a multi-purpose computing facility

    Energy Technology Data Exchange (ETDEWEB)

    Zynovyev, Mykhaylo

    2012-06-29

    This thesis discusses the issues and challenges associated with the design and operation of a data analysis facility for a high-energy physics experiment at a multi-purpose computing centre. At the spotlight is a Tier-2 centre of the distributed computing model of the ALICE experiment at the Large Hadron Collider at CERN in Geneva, Switzerland. The design steps, examined in the thesis, include analysis and optimization of the I/O access patterns of the user workload, integration of the storage resources, and development of the techniques for effective system administration and operation of the facility in a shared computing environment. A number of I/O access performance issues on multiple levels of the I/O subsystem, introduced by utilization of hard disks for data storage, have been addressed by the means of exhaustive benchmarking and thorough analysis of the I/O of the user applications in the ALICE software framework. Defining the set of requirements to the storage system, describing the potential performance bottlenecks and single points of failure and examining possible ways to avoid them allows one to develop guidelines for selecting the way how to integrate the storage resources. The solution, how to preserve a specific software stack for the experiment in a shared environment, is presented along with its effects on the user workload performance. The proposal for a flexible model to deploy and operate the ALICE Tier-2 infrastructure and applications in a virtual environment through adoption of the cloud computing technology and the 'Infrastructure as Code' concept completes the thesis. Scientific software applications can be efficiently computed in a virtual environment, and there is an urgent need to adapt the infrastructure for effective usage of cloud resources.

  12. Conceptual design of an ALICE Tier-2 centre. Integrated into a multi-purpose computing facility

    International Nuclear Information System (INIS)

    Zynovyev, Mykhaylo

    2012-01-01

    This thesis discusses the issues and challenges associated with the design and operation of a data analysis facility for a high-energy physics experiment at a multi-purpose computing centre. At the spotlight is a Tier-2 centre of the distributed computing model of the ALICE experiment at the Large Hadron Collider at CERN in Geneva, Switzerland. The design steps, examined in the thesis, include analysis and optimization of the I/O access patterns of the user workload, integration of the storage resources, and development of the techniques for effective system administration and operation of the facility in a shared computing environment. A number of I/O access performance issues on multiple levels of the I/O subsystem, introduced by utilization of hard disks for data storage, have been addressed by the means of exhaustive benchmarking and thorough analysis of the I/O of the user applications in the ALICE software framework. Defining the set of requirements to the storage system, describing the potential performance bottlenecks and single points of failure and examining possible ways to avoid them allows one to develop guidelines for selecting the way how to integrate the storage resources. The solution, how to preserve a specific software stack for the experiment in a shared environment, is presented along with its effects on the user workload performance. The proposal for a flexible model to deploy and operate the ALICE Tier-2 infrastructure and applications in a virtual environment through adoption of the cloud computing technology and the 'Infrastructure as Code' concept completes the thesis. Scientific software applications can be efficiently computed in a virtual environment, and there is an urgent need to adapt the infrastructure for effective usage of cloud resources.

  13. Reduction of Hospital Physicians' Workflow Interruptions: A Controlled Unit-Based Intervention Study

    Directory of Open Access Journals (Sweden)

    Matthias Weigl

    2012-01-01

    Full Text Available Highly interruptive clinical environments may cause work stress and suboptimal clinical care. This study features an intervention to reduce workflow interruptions by re-designing work and organizational practices in hospital physicians providing ward coverage. A prospective, controlled intervention was conducted in two surgical and two internal wards. The intervention was based on physician quality circles - a participative technique to involve employees in the development of solutions to overcome work-related stressors. Outcome measures were the frequency of observed workflow interruptions. Workflow interruptions by fellow physicians and nursing staff were significantly lower after the intervention. However, a similar decrease was also observed in control units. Additional interviews to explore process-related factors suggested that there might have been spill-over effects in the sense that solutions were not strictly confined to the intervention group. Recommendations for further research on the effectiveness and consequences of such interventions for professional communication and patient safety are discussed.

  14. Statistical post-processing of seasonal multi-model forecasts: Why is it so hard to beat the multi-model mean?

    Science.gov (United States)

    Siegert, Stefan

    2017-04-01

    Initialised climate forecasts on seasonal time scales, run several months or even years ahead, are now an integral part of the battery of products offered by climate services world-wide. The availability of seasonal climate forecasts from various modeling centres gives rise to multi-model ensemble forecasts. Post-processing such seasonal-to-decadal multi-model forecasts is challenging 1) because the cross-correlation structure between multiple models and observations can be complicated, 2) because the amount of training data to fit the post-processing parameters is very limited, and 3) because the forecast skill of numerical models tends to be low on seasonal time scales. In this talk I will review new statistical post-processing frameworks for multi-model ensembles. I will focus particularly on Bayesian hierarchical modelling approaches, which are flexible enough to capture commonly made assumptions about collective and model-specific biases of multi-model ensembles. Despite the advances in statistical methodology, it turns out to be very difficult to out-perform the simplest post-processing method, which just recalibrates the multi-model ensemble mean by linear regression. I will discuss reasons for this, which are closely linked to the specific characteristics of seasonal multi-model forecasts. I explore possible directions for improvements, for example using informative priors on the post-processing parameters, and jointly modelling forecasts and observations.

  15. Arithmetical unit, interrupt hardware and input-output channel for the computer Bel

    International Nuclear Information System (INIS)

    Fyroe, Karl-Johan

    1969-01-01

    This thesis contains a description of a small general purpose computer using characters, variable word-length and two-address instructions and which is working in decimal (NBCD). We have realized three interruption lines with a fixed priority. The channel is selective and has generally access to the entire memory. Using slow IO-devices, time sharing is possible between the channel and the processor in the central memory buffer area. (author) [fr

  16. Total and cause-specific mortality before and after the onset of the Greek economic crisis: an interrupted time-series analysis.

    Science.gov (United States)

    Laliotis, Ioannis; Ioannidis, John P A; Stavropoulou, Charitini

    2016-12-01

    Greece was one of the countries hit the hardest by the 2008 financial crisis in Europe. Yet, evidence on the effect of the crisis on total and cause-specific mortality remains unclear. We explored whether the economic crisis affected the trend of overall and cause-specific mortality rates. We used regional panel data from the Hellenic Statistical Authority to assess mortality trends by age, sex, region, and cause in Greece between January, 2001, and December, 2013. We used Eurostat data to calculate monthly age-standardised mortality rates per 100 000 inhabitants for each region. Data were divided into two subperiods: before the crisis (January, 2001, to August, 2008) and after the onset of the crisis (September, 2008, to December, 2013). We tested for changes in the slope of mortality by doing an interrupted time-series analysis. Overall mortality continued to decline after the onset of the financial crisis (-0·065, 95% CI -0·080 to -0·049), but at a slower pace than before the crisis (-0·13, -0·15 to -0·10; trend difference 0·062, 95% CI 0·041 to 0·083; pperiod after the onset of the crisis with extrapolated values based on the period before the crisis, we estimate that an extra 242 deaths per month occurred after the onset of the crisis. Mortality trends have been interrupted after the onset of compared with before the crisis, but changes vary by age, sex, and cause of death. The increase in deaths due to adverse events during medical treatment might reflect the effects of deterioration in quality of care during economic recessions. None. Copyright © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

  17. IAEA To Launch Centre On Ocean Acidification

    International Nuclear Information System (INIS)

    2012-01-01

    Full text: The International Atomic Energy Agency (IAEA) is to launch a new centre this summer to address the growing problem of ocean acidification. Operated by the Agency's Monaco Environmental Laboratories, the Ocean Acidification International Coordination Centre will serve the scientific community - as well as policymakers, universities, media and the general public - by facilitating, promoting and communicating global actions on ocean acidification. Growing amounts of carbon dioxide in the Earth's atmosphere are being absorbed in the planet's oceans which increases their acidity. According to the experts, ocean acidification may render most regions of the ocean inhospitable to coral reefs by 2050 if atmospheric carbon dioxide levels continue to increase. This could lead to substantial changes in commercial fish stocks, threatening food security for millions of people as well as the multi-billion dollar fishing industry. International scientists have been studying the effect and possible responses, and the new centre will help coordinate their efforts. ''During the past five years, numerous multinational and national research projects on ocean acidification have emerged and significant research advances have been made,'' said Daud bin Mohamad, IAEA Deputy Director General for Nuclear Sciences and Applications. ''The time is now ripe to provide international coordination to gain the greatest value from national efforts and research investments.'' The centre will be supported by several IAEA Member States and through the Peaceful Uses Initiative, and it will be overseen by an Advisory Board consisting of leading institutions, including the U.N. Intergovernmental Oceanographic Commission, the U.S. National Oceanic and Atmospheric Administration, the U.N. Food and Agriculture Organization, the Fondation Prince Albert II de Monaco, the OA-Reference User Group, as well as leading scientists and economists in the field. The new centre will focus on international

  18. An explicit multi-time-stepping algorithm for aerodynamic flows

    NARCIS (Netherlands)

    Niemann-Tuitman, B.E.; Veldman, A.E.P.

    1997-01-01

    An explicit multi-time-stepping algorithm with applications to aerodynamic flows is presented. In the algorithm, in different parts of the computational domain different time steps are taken, and the flow is synchronized at the so-called synchronization levels. The algorithm is validated for

  19. RTEMS CENTRE- Support and Maintenance CENTRE to RTEMS Operating System

    Science.gov (United States)

    Silva, H.; Constantino, A.; Coutunho, M.; Freitas, D.; Faustino, S.; Mota, M.; Colaço, P.; Zulianello, M.

    2008-08-01

    RTEMS stands for Real-Time Operating System for Multiprocessor Systems. It is a full featured Real Time Operating System that supports a variety of open APIs and interface standards. It provides a high performance environment for embedded applications, including a fixed-priority preemptive/non-preemptive scheduler, a comprehensive set of multitasking operations and a large range of supported architectures. Support and maintenance CENTRE to RTEMS operating system (RTEMS CENTRE) is a joint initiative of ESA-Portugal Task force, aiming to build a strong technical competence in the space flight (on- board) software, to offer support, maintenance and improvements to RTEMS. This paper provides a high level description of the current and future activities of the RTEMS CENTRE. It presents a brief description of the RTEMS operating system, a description of the tools developed and distributed to the community [1] and the improvements to be made to the operating system, including facilitation for the qualification of RTEMS (4.8.0) [2] for the space missions.

  20. Economic Impact Analyses of Interdisciplinary Multi-hazard Scenarios: ShakeOut and ARkStorm

    Science.gov (United States)

    Wein, A. M.; Rose, A.; Sue Wing, I.; Wei, D.

    2011-12-01

    U. S. Geological Survey (USGS) scientists are using an interdisciplinary strategy to develop and analyze multi-hazard scenarios to help communities enhance resilience to natural hazard disasters. Two such scenarios are the southern California ShakeOut earthquake and the California ARkStorm winter storm. Both scenarios are multi-hazard: Shakeout ground motions trigger landslides and liquefaction and ARkStorm involves wind, flood, landslide, and coastal hazards. A collaborative scenario-process engages partners and stakeholders throughout the development and use of the scenarios, In doing so, community resilience is enhanced by educating communities about hazards and hazard interdependencies, building networks from scientists to decision makers, exercising emergency management strategies, identifying emergency management issues, and motivating solutions prior to an event. In addition, interdisciplinary scenarios stimulate research on the various steps of analysis (e.g., natural hazard processes, physical damages, societal consequences, and policy connections). In particular, USGS scientists have collaborated with economists to advance methods to estimate the economic impacts (business interruption losses) of disasters. Our economic impact analyses evolved from the economic module in the Federal Emergency Management Agency's loss-estimation tool, HAZUS-MH, to a more encompassing input-output analysis for ShakeOut, to a more sophisticated Computable General Equilibrium model for ARkStorm. The analyses depend on physical damage and restoration time estimates from engineers and geographic analyses of economic assets in hazard zones. Economic resilience strategies are incorporated to represent resourcefulness and ingenuity that avoids potential losses during and after an event. Such strategies operate at three levels of the economy: micro (e.g., ability to catch up on lost production time), meso (e.g., coordination within a sector to share resources), and macro (e

  1. Neurocognition and quality of life after reinitiating antiretroviral therapy in children randomized to planned treatment interruption

    NARCIS (Netherlands)

    Ananworanich, Jintanat; Melvin, Diane; Amador, Jose T. R.; Childs, Tristan; Medin, Gabriela; Boscolo, Valentina; Compagnucci, Alexandra; Kanjanavanit, Suparat; Montero, Samuel; Gibb, Diana M.; Aboulker, J. -P.; Babiker, A.; Belfrage, E.; Bernardi, S.; Bologna, R.; Burger, D.; Butler, K.; Castelli-Gattinara, G.; Castro, H.; Clayden, P.; Compagnucci, A.; Cressey, T.; Darbyshire, J. H.; Debré, M.; de Groot, R.; della Negra, M.; Di Biagio, A.; de Rossi, A.; Duicelescu, D.; Faye, A.; Giaquinto, C.; Giacomet, V.; Gibb, D. M.; Grosch-Wörner, I.; Hainault, M.; Klein, N.; Lallemant, M.; Levy, J.; Lyall, H.; Marczynska, M.; Marques, L.; Mardarescu, M.; Mellado Peña, M. J.; Nadal, D.; Nastouli, E.; Naver, L.; Niehues, T.; Peckham, C.; Pillay, D.; Popieska, J.; Ramos Amador, J. T.; Rojo Conejo, P.; Rosado, L.; Rosso, R.; Rudin, C.; Scherpbier, H. J.; Sharland, M.; Stevanovic, M.; Thorne, C.; Tovo, P. A.; Tudor-Williams, G.; Turkova, A.; Valerius, N.; Volokha, A.; Walker, A. S.; Welch, S.; Wintergerst, U.; Aboulker, J. P.; Burger, D. M.; Green, H.; Harper, L.; Mofenson, L.; Moye, J.; Saïdi, Y.; Cressey, T. R.; Jacqz-Aigrain, E.; Khoo, S.; Regazzi, M.; Tréluyer, J. M.; Ngo-Giang-Huong, N.; Muñoz Fernandez, M. A.; Hill, C.; Lepage, P.; Pozniak, A.; Vella, S.; Chêne, G.; Vesikari, T.; Hadjou, G.; Léonardo, S.; Riault, Y.; Bleier, J.; Buck, L.; Duong, T.; Farrelly, L.; Forcat, S.; Harrison, L.; Horton, J.; Johnson, D.; Montero, S.; Taylor, C.; Chalermpantmetagul, S.; Peongjakta, R.; Khamjakkaew, W.; Than-in-at, K.; Chailert, S.; Jourdain, G.; Le Coeur, S.; Floret, D.; Costanzo, P.; Le Thi, T. T.; Monpoux, F.; Mellul, S.; Caranta, I.; Boudjoudi, N.; Firtion, G.; Denon, M.; Charlemaine, E.; Picard, F.; Hellier, E.; Heuninck, C.; Damond, F.; Alexandre, G.; Tricoire, J.; Antras, M.; Lachendowier, C.; Nicot, F.; Krivine, A.; Rivaux, D.; Notheis, G.; Strotmann, G.; Schlieben, S.; Rampon, O.; Boscolo, V.; Zanchetta, M.; Ginocchio, F.; Viscoli, C.; Martino, A.; Pontrelli, G.; Baldassar, S.; Concato, C.; Mazza, A.; Rossetti, G.; Dobosz, S.; Oldakowska, A.; Popielska, J.; Kaflik, M.; Stanczak, J.; Stanczack, G.; Dyda, T.; Kruk, M.; González Tomé, M. I.; Delgado García, R.; Fernandez Gonzalez, M. T.; Medin, G.; Mellado Peña, M. José; Martín Fontelos, P.; Garcia Mellado, M. I.; Medina, A. F.; Ascencion, B.; Garcia Bermejo, I.; Navarro Gomez, D. M. L.; Saavedra, J.; Prieto, C.; Jimenez, J. L.; Muñoz-Fernandez, M. A.; Garcia Torre, A.; de José Gómez, M. I.; García Rodriguez, M. C.; Moreno Pérez, D.; Núñez Cuadros, E.; Asensi-Botet, F.; Otero Reigada, C.; Pérez Tamarit, M. D.; Vilalta, R.; Molina Moreno, J. M.; Rainer, Truninger; Schupbach, J.; Rutishauser, M.; Bunupuradah, T.; Butterworth, O.; Phasomsap, C.; Prasitsuebsai, W.; Chuanjaroen, T.; Jupimai, T.; Ubolyam, S.; Phanuphak, P.; Puthanakit, T.; Pancharoen, C.; Mai, Chaing; Kanjanavanit, S.; Namwong, T.; Punsakoon, W.; Payakachat, S.; Chutima, D.; Raksasang, M.; Foster, C.; Hamadache, D.; Campbell, S.; Newbould, C.; Monrose, C.; Abdulla, A.; Walley, A.; Melvin, D.; Patel, D.; Kaye, S.; Seery, P.; Rankin, A.; Wildfire, A.; Novelli, V.; Shingadia, D.; Moshal, K.; Flynn, J.; Clapson, M.; Allen, A.; Spencer, L.; Rackstraw, C.; Ward, B.; Parkes, K.; Depala, M.; Jacobsen, M.; Poulsom, H.; Barkley, L.; Miah, J.; Lurie, P.; Keane, C.; McMaster, P.; Phipps, M.; Orendi, J.; Farmer, C.; Liebeschuetz, S.; Sodeinde, O.; Wong, S.; Bostock, V.; Heath, Y.; Scott, S.; Gandhi, K.; Lewis, P.; Daglish, J.; Miles, K.; Summerhill, L.; Subramaniam, B.; Weiner, L.; Famiglietti, M.; Rana, S.; Yu, P.; Roa, J.; Puga, A.; Haerry, A.

    2016-01-01

    Objective: Understanding the effects of antiretroviral treatment (ART) interruption on neurocognition and quality of life (QoL) are important for managing unplanned interruptions and planned interruptions in HIV cure research. Design: Children previously randomized to continuous (continuous ART, n =

  2. GIFT-Grab: Real-time C++ and Python multi-channel video capture, processing and encoding API

    Directory of Open Access Journals (Sweden)

    Dzhoshkun Ismail Shakir

    2017-10-01

    Full Text Available GIFT-Grab is an open-source API for acquiring, processing and encoding video streams in real time. GIFT-Grab supports video acquisition using various frame-grabber hardware as well as from standard-compliant network streams and video files. The current GIFT-Grab release allows for multi-channel video acquisition and encoding at the maximum frame rate of supported hardware – 60 frames per second (fps. GIFT-Grab builds on well-established highly configurable multimedia libraries including FFmpeg and OpenCV. GIFT-Grab exposes a simplified high-level API, aimed at facilitating integration into client applications with minimal coding effort. The core implementation of GIFT-Grab is in C++11. GIFT-Grab also features a Python API compatible with the widely used scientific computing packages NumPy and SciPy. GIFT-Grab was developed for capturing multiple simultaneous intra-operative video streams from medical imaging devices. Yet due to the ubiquity of video processing in research, GIFT-Grab can be used in many other areas. GIFT-Grab is hosted and managed on the software repository of the Centre for Medical Image Computing (CMIC at University College London, and is also mirrored on GitHub. In addition it is available for installation from the Python Package Index (PyPI via the pip installation tool. Funding statement: This work was supported through an Innovative Engineering for Health award by the Wellcome Trust [WT101957], the Engineering and Physical Sciences Research Council (EPSRC [NS/A000027/1] and a National Institute for Health Research Biomedical Research Centre UCLH/UCL High Impact Initiative. Sébastien Ourselin receives funding from the EPSRC (EP/H046410/1, EP/J020990/1, EP/K005278 and the MRC (MR/J01107X/1. Luis C. García-Peraza-Herrera is supported by the EPSRC-funded UCL Centre for Doctoral Training in Medical Imaging (EP/L016478/1.

  3. A development of time-resolved emulsion detector by multi-stage shifter

    International Nuclear Information System (INIS)

    Takahashi, Satoru; Aoki, Shigeki

    2017-01-01

    Nuclear emulsion is a powerful tracking device that can record the three-dimensional trajectory of charged particles within 1 μm spatial resolution. We are promoting GRAINE project which is 10 MeV-100 GeV cosmic γ-ray observations with a precise (0.08deg at 1-2 GeV) and polarization-sensitive large-aperture-area (∼10 m 2 ) emulsion telescope by repeating long duration balloon flights. We are developing multi-stage shifter which allows us to give a timing information to emulsion tracks with ∼seconds or below. The multi-stage shifter opened feasibilities of precise cosmic γ-ray observations, GRAINE, as well as precise measurements of ν-N interactions, J-PARC T60. ∼Millisecond time resolution in a balloon-borne experiment, ∼second time resolution for 126.7 days in an accelerator ν experiment and ∼10 6 time-resolved numbers are being achieved. New model of multi-stage shifter is also being developed for future experiments. (author)

  4. The role of interruptible natural gas customers in New England heating oil markets: A preliminary examination of events in January-February 2000

    Energy Technology Data Exchange (ETDEWEB)

    None

    2000-11-01

    This report provides an analysis of data collected from gas service providers and end-use customers in the six New England States and offers a preliminary assessment of the impact of interruptible gas customers on the distillate fuel oil market this past winter. Based on information collected and analyzed as of October 2000, the main findings areas follows: (1) For interruptible gas customers with distillate fuel oil as a backup fuel, their volume of interruptions was equivalent to about 1 to 2 percent of the total sales of distillate fuel oil in New England during January-February 2000. For the two peak weeks of gas supply interruptions, however, the equivalent volume of distillate fuel oil amounted to an estimated 3 to 6 percent of total sales in New England. There were no interruptions of the natural gas service during the 2-month period. (2) Purchases of distillate fuel oil by interruptible gas customers may have contributed somewhat to the spike in the price of distillate fuel oil in January-February 2000, especially during the peak weeks of gas interruptions. Nevertheless, other factors--a sudden drop in temperatures, low regional stocks of distillate fuels, and weather-related supply problems during a period of high customer demand--appear to have played a significant role in this price spike, as they have in previous spikes. (3) While this preliminary analysis suggests that interruptible natural gas service does not threaten the stability of the home heating oil market, several steps might be taken-without undermining the benefits of interruptible service--to reduce the potential adverse impacts of gas supply interruptions in times of market stress. Regardless of the magnitude of the impact of distillate fuel oil purchases by interruptible gas customers on Northeast heating oil markets, the threat of future heating oil price spikes and supply problems still remains. To help counter the threat, President Clinton in July 2000 directed Secretary Richardson to

  5. "Learning to Play with New Friends": Systematic Quality Development Work in a Leisure-Time Centre

    Science.gov (United States)

    Lager, Karin

    2016-01-01

    This article explores the recontextualisation of systematic quality development work (Sqdw) in a leisure-time centre. Two teachers' processes of planning, organisation, documentation and evaluation were investigated, the aim being to explore the recontextualisation of Sqdw in practice. The study is thus a case study of these teachers' practice…

  6. A novel SDN enabled hybrid oiptical packet/circuit switched data centre network - The LIGHTNESS approach

    NARCIS (Netherlands)

    Peng, S.; Simeonidou, D.; Zervas, G.; Nejabati, R.; Yan, Y; Shu, Yi; Spadaro, S.; Perelló, J.; Agraz, F.; Careglio, D.; Dorren, H.J.S.; Miao, W.; Calabretta, N.; Bernini, G.; Ciulli, N.; Sancho, J.C.; Iordache, S.; Becerra, Y.; Farreras, M.; Biancani, M.; Predieri, A.; Proietti, R.; Cao, Z.; Liu, L.; Yoo, S.J.B.

    2014-01-01

    Current over-provisioned and multi-tier data centre networks (DCN) deploy rigid control and management platforms, which are not able to accommodate the ever-growing workload driven by the increasing demand of high-performance data centre (DC) and cloud applications. In response to this, the EC FP7

  7. Training and evaluation of neural networks for multi-variate time series processing

    DEFF Research Database (Denmark)

    Fog, Torben L.; Larsen, Jan; Hansen, Lars Kai

    1995-01-01

    We study the training and generalization for multi-variate time series processing. It is suggested to used a quasi-maximum likelihood approach rather than the standard sum of squared errors, thus taking dependencies among the errors of the individual time series into account. This may lead...... to improved generalization performance. Further, we extend the optimal brain damage pruning technique to the multi-variate case. A key ingredient is an algebraic expression for the generalization ability of a multi-variate model. The variability of the suggested techniques are successfully demonstrated...

  8. Birth centre confinement at the Queen Victoria Medical Centre: four years' experience.

    Science.gov (United States)

    Morris, N; Campbell, J; Biro, M A; Lumley, J; Rao, J; Spensley, J

    1986-06-09

    A review of the first four years of the functioning of the birth centre at the Queen Victoria Medical Centre is presented. In that time, 1040 pregnant women were accepted for confinement there. Of these, 52 withdrew for non-obstetric reasons, while 470 were transferred to alternative obstetrical care--274 because of antepartum complications and 196 because of intrapartum problems. Therefore, 518 women were delivered in the birth centre. The care of the women is entrusted almost entirely to a team of midwives and this review demonstrates an enviable safety record.

  9. Validation and Assessment of Multi-GNSS Real-Time Precise Point Positioning in Simulated Kinematic Mode Using IGS Real-Time Service

    Directory of Open Access Journals (Sweden)

    Liang Wang

    2018-02-01

    Full Text Available Precise Point Positioning (PPP is a popular technology for precise applications based on the Global Navigation Satellite System (GNSS. Multi-GNSS combined PPP has become a hot topic in recent years with the development of multiple GNSSs. Meanwhile, with the operation of the real-time service (RTS of the International GNSS Service (IGS agency that provides satellite orbit and clock corrections to broadcast ephemeris, it is possible to obtain the real-time precise products of satellite orbits and clocks and to conduct real-time PPP. In this contribution, the real-time multi-GNSS orbit and clock corrections of the CLK93 product are applied for real-time multi-GNSS PPP processing, and its orbit and clock qualities are investigated, first with a seven-day experiment by comparing them with the final multi-GNSS precise product ‘GBM’ from GFZ. Then, an experiment involving real-time PPP processing for three stations in the Multi-GNSS Experiment (MGEX network with a testing period of two weeks is conducted in order to evaluate the convergence performance of real-time PPP in a simulated kinematic mode. The experimental result shows that real-time PPP can achieve a convergence performance of less than 15 min for an accuracy level of 20 cm. Finally, the real-time data streams from 12 globally distributed IGS/MGEX stations for one month are used to assess and validate the positioning accuracy of real-time multi-GNSS PPP. The results show that the simulated kinematic positioning accuracy achieved by real-time PPP on different stations is about 3.0 to 4.0 cm for the horizontal direction and 5.0 to 7.0 cm for the three-dimensional (3D direction.

  10. Task errors by emergency physicians are associated with interruptions, multitasking, fatigue and working memory capacity: a prospective, direct observation study.

    Science.gov (United States)

    Westbrook, Johanna I; Raban, Magdalena Z; Walter, Scott R; Douglas, Heather

    2018-01-09

    Interruptions and multitasking have been demonstrated in experimental studies to reduce individuals' task performance. These behaviours are frequently used by clinicians in high-workload, dynamic clinical environments, yet their effects have rarely been studied. To assess the relative contributions of interruptions and multitasking by emergency physicians to prescribing errors. 36 emergency physicians were shadowed over 120 hours. All tasks, interruptions and instances of multitasking were recorded. Physicians' working memory capacity (WMC) and preference for multitasking were assessed using the Operation Span Task (OSPAN) and Inventory of Polychronic Values. Following observation, physicians were asked about their sleep in the previous 24 hours. Prescribing errors were used as a measure of task performance. We performed multivariate analysis of prescribing error rates to determine associations with interruptions and multitasking, also considering physician seniority, age, psychometric measures, workload and sleep. Physicians experienced 7.9 interruptions/hour. 28 clinicians were observed prescribing 239 medication orders which contained 208 prescribing errors. While prescribing, clinicians were interrupted 9.4 times/hour. Error rates increased significantly if physicians were interrupted (rate ratio (RR) 2.82; 95% CI 1.23 to 6.49) or multitasked (RR 1.86; 95% CI 1.35 to 2.56) while prescribing. Having below-average sleep showed a >15-fold increase in clinical error rate (RR 16.44; 95% CI 4.84 to 55.81). WMC was protective against errors; for every 10-point increase on the 75-point OSPAN, a 19% decrease in prescribing errors was observed. There was no effect of polychronicity, workload, physician gender or above-average sleep on error rates. Interruptions, multitasking and poor sleep were associated with significantly increased rates of prescribing errors among emergency physicians. WMC mitigated the negative influence of these factors to an extent. These

  11. Effect of nocturnal sound reduction on the incidence of delirium in intensive care unit patients: An interrupted time series analysis.

    Science.gov (United States)

    van de Pol, Ineke; van Iterson, Mat; Maaskant, Jolanda

    2017-08-01

    Delirium in critically-ill patients is a common multifactorial disorder that is associated with various negative outcomes. It is assumed that sleep disturbances can result in an increased risk of delirium. This study hypothesized that implementing a protocol that reduces overall nocturnal sound levels improves quality of sleep and reduces the incidence of delirium in Intensive Care Unit (ICU) patients. This interrupted time series study was performed in an adult mixed medical and surgical 24-bed ICU. A pre-intervention group of 211 patients was compared with a post-intervention group of 210 patients after implementation of a nocturnal sound-reduction protocol. Primary outcome measures were incidence of delirium, measured by the Intensive Care Delirium Screening Checklist (ICDSC) and quality of sleep, measured by the Richards-Campbell Sleep Questionnaire (RCSQ). Secondary outcome measures were use of sleep-inducing medication, delirium treatment medication, and patient-perceived nocturnal noise. A significant difference in slope in the percentage of delirium was observed between the pre- and post-intervention periods (-3.7% per time period, p=0.02). Quality of sleep was unaffected (0.3 per time period, p=0.85). The post-intervention group used significantly less sleep-inducing medication (psound-reduction protocol. However, reported sleep quality did not improve. Copyright © 2017. Published by Elsevier Ltd.

  12. The accuracy evaluation according to dose delivery interruption and restart for volumetric modulated arc therapy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dong Hyung; Bae, Sun Myung; Kwak, Jung Won; Kang, Tae Young; Bck, Geum Mun [Dept. of Radiation Oncology, Asan Medical Center, Seoul(Korea, Republic of)

    2013-03-15

    The accurate movement of gantry rotation, collimator and correct application of dose rate are very important to approach the successful performance of Volumetric Modulated Arc Therapy (VMAT), because it is tightly interlocked with a complex treatment plan. The interruption and restart of dose delivery, however, are able to occur on treatment by various factors of a treatment machine and treatment plan. If unexpected problems of a treat machine or a patient interrupt the VMAT, the movement of treatment machine for delivering the remaining dose will be restarted at the start point. In this investigation, We would like to know the effect of interruptions and restart regarding dose delivery at VMAT. Treatment plans of 10 patients who had been treated at our center were used to measure and compare the dose distribution of each VMAT after converting to a form of digital image and communications in Medicine (DICOM) with treatment planning system (Eclipse V 10.0, Varian, USA). We selected the 6 MV photon energy of Trilogy (Varian, USA) and used OmniPro I'mRT system (V 1.7b, IBA dosimetry, Germany) to analyze the data that were acquired through this measurement with two types of interruptions four times for each case. The door interlock and the beam-off were used to stop and then to restart the dose delivery of VMAT. The gamma index in OmniPro I'mRT system and T-test in Microsoft Excel 2007 were used to evaluate the result of this investigation. The deviations of average gamma index in cases with door interlock, beam-off and without interruption on VMAT are 0.141, 0.128 and 0.1. The standard deviations of acquired gamma values are 0.099, 0.091, 0.071 and The maximum gamma value in each case is 0.413, 0.379, 0.286, respectively. This analysis has a 95-percent confidence level and the P-value of T-test is under 0.05. Gamma pass rate (3%, 3 mm) is acceptable in all of measurements. As a result, We could make sure that the interruption of this investgation are not

  13. Frequency of participation of 8-12-year-old children with cerebral palsy: a multi-centre cross-sectional European study

    DEFF Research Database (Denmark)

    Michelsen, Susan I; Flachs, Esben M; Uldall, Peter

    2008-01-01

    might influence participation. We undertook a multi-centre, population-based study in children with and without cerebral palsy. Working from the Life-H instrument, we developed a questionnaire to capture frequency of participation in 8-12-year-old children. In nine regions of seven European countries......, parents of 813 children with cerebral palsy and 2939 children from the general populations completed the questionnaire. Frequency of participation for each question was dichotomised about the median; multivariable logistic regressions were carried out. In the general population, frequency of participation...... varied between countries. Children with cerebral palsy participated less frequently in many but not all areas of everyday life, compared with children from the general population. There was regional variation in the domains with reduced participation and in the magnitude of the differences. We discuss...

  14. High-resolution time-frequency representation of EEG data using multi-scale wavelets

    Science.gov (United States)

    Li, Yang; Cui, Wei-Gang; Luo, Mei-Lin; Li, Ke; Wang, Lina

    2017-09-01

    An efficient time-varying autoregressive (TVAR) modelling scheme that expands the time-varying parameters onto the multi-scale wavelet basis functions is presented for modelling nonstationary signals and with applications to time-frequency analysis (TFA) of electroencephalogram (EEG) signals. In the new parametric modelling framework, the time-dependent parameters of the TVAR model are locally represented by using a novel multi-scale wavelet decomposition scheme, which can allow the capability to capture the smooth trends as well as track the abrupt changes of time-varying parameters simultaneously. A forward orthogonal least square (FOLS) algorithm aided by mutual information criteria are then applied for sparse model term selection and parameter estimation. Two simulation examples illustrate that the performance of the proposed multi-scale wavelet basis functions outperforms the only single-scale wavelet basis functions or Kalman filter algorithm for many nonstationary processes. Furthermore, an application of the proposed method to a real EEG signal demonstrates the new approach can provide highly time-dependent spectral resolution capability.

  15. Multi-Rate Acquisition for Dead Time Reduction in Magnetic Resonance Receivers: Application to Imaging With Zero Echo Time.

    Science.gov (United States)

    Marjanovic, Josip; Weiger, Markus; Reber, Jonas; Brunner, David O; Dietrich, Benjamin E; Wilm, Bertram J; Froidevaux, Romain; Pruessmann, Klaas P

    2018-02-01

    For magnetic resonance imaging of tissues with very short transverse relaxation times, radio-frequency excitation must be immediately followed by data acquisition with fast spatial encoding. In zero-echo-time (ZTE) imaging, excitation is performed while the readout gradient is already on, causing data loss due to an initial dead time. One major dead time contribution is the settling time of the filters involved in signal down-conversion. In this paper, a multi-rate acquisition scheme is proposed to minimize dead time due to filtering. Short filters and high output bandwidth are used initially to minimize settling time. With increasing time since the signal onset, longer filters with better frequency selectivity enable stronger signal decimation. In this way, significant dead time reduction is accomplished at only a slight increase in the overall amount of output data. Multi-rate acquisition was implemented with a two-stage filter cascade in a digital receiver based on a field-programmable gate array. In ZTE imaging in a phantom and in vivo, dead time reduction by multi-rate acquisition is shown to improve image quality and expand the feasible bandwidth while increasing the amount of data collected by only a few percent.

  16. RTtxGap: An android radiobiological tool for compensation of radiotherapy treatment interruption

    International Nuclear Information System (INIS)

    Yusoff, A L; Mohamad, M; Bhavaraju, V M K; Idris, N R Nik; Abdullah, R

    2016-01-01

    Treatment interruption is not uncommon in radiotherapy. Common reasons for treatment interruption include machine breakdown, holidays and patient severe radiation reactions. Here RTtxGap, an Android application to assist calculations of compensation for treatment gap, is reported. It uses linear quadratic (LQ) model to calculate the biological effective dose (BED) that is used to solve for treatment gap compensations. Solutions are calculated using BED equation, with consideration for tissue proliferation. The accuracy of results has been verified using LQL Equiv software to be accurate within 1%. Five treatment interruption examples were used to illustrate the capability of the software to calculate the treatment compensation schedules. Solving these examples also illustrates the general consensus regarding compensating for unscheduled treatment interruptions, which ultimately involves balancing the BEDs of tumour and organ at risk. In addition to compensation for treatment gap, RTtxGap can also be used to calculate equivalent total dose in 2-Gy fraction (EQD2), to modify treatment schedule and to calculate alternative dose prescriptions having the same isoeffect. (paper)

  17. The impact of an electronic health record on nurse sensitive patient outcomes: an interrupted time series analysis.

    Science.gov (United States)

    Dowding, Dawn W; Turley, Marianne; Garrido, Terhilda

    2012-01-01

    To evaluate the impact of electronic health record (EHR) implementation on nursing care processes and outcomes. Interrupted time series analysis, 2003-2009. A large US not-for-profit integrated health care organization. 29 hospitals in Northern and Southern California. An integrated EHR including computerized physician order entry, nursing documentation, risk assessment tools, and documentation tools. Percentage of patients with completed risk assessments for hospital acquired pressure ulcers (HAPUs) and falls (process measures) and rates of HAPU and falls (outcome measures). EHR implementation was significantly associated with an increase in documentation rates for HAPU risk (coefficient 2.21, 95% CI 0.67 to 3.75); the increase for fall risk was not statistically significant (0.36; -3.58 to 4.30). EHR implementation was associated with a 13% decrease in HAPU rates (coefficient -0.76, 95% CI -1.37 to -0.16) but no decrease in fall rates (-0.091; -0.29 to 0.11). Irrespective of EHR implementation, HAPU rates decreased significantly over time (-0.16; -0.20 to -0.13), while fall rates did not (0.0052; -0.01 to 0.02). Hospital region was a significant predictor of variation for both HAPU (0.72; 0.30 to 1.14) and fall rates (0.57; 0.41 to 0.72). The introduction of an integrated EHR was associated with a reduction in the number of HAPUs but not in patient fall rates. Other factors, such as changes over time and hospital region, were also associated with variation in outcomes. The findings suggest that EHR impact on nursing care processes and outcomes is dependent on a number of factors that should be further explored.

  18. INFLUENCE OF INTERRUPTED PULMONARY LYMPH-DRAINAGE ON ANTIBODY-RESPONSES IN HILAR-STRIPPED LUNGS

    NARCIS (Netherlands)

    WANG, FZ; WINTER, JB; WILDEVUUR, CRH; PROP, J

    1992-01-01

    Lung transplantation interrupts hilar lymphatics. This may have an impact on immune responses to antigens entering the lung because the antigens cannot reach the lung-associated lymph nodes where the immune response is generated. We investigated the interruption and regeneration of lymphatics and

  19. Predictors of perioperative major bleeding in patients who interrupt warfarin for an elective surgery or procedure: Analysis of the BRIDGE trial.

    Science.gov (United States)

    Clark, Nathan P; Douketis, James D; Hasselblad, Vic; Schulman, Sam; Kindzelski, Andrei L; Ortel, Thomas L

    2018-01-01

    The use of low-molecular weight heparin bridge therapy during warfarin interruption for elective surgery/procedures increases bleeding. Other predictors of bleeding in this setting are not well described. BRIDGE was a randomized, double-blind, placebo-controlled trial of bridge therapy with dalteparin 100 IU/kg twice daily in patients with atrial fibrillation requiring warfarin interruption. Bleeding outcomes were documented from the time of warfarin interruption until up to 37 days postprocedure. Multiple logistic regression and time-dependent hazard models were used to identify major bleeding predictors. We analyzed 1,813 patients of whom 895 received bridging and 918 received placebo. Median patient age was 72.6 years, and 73.3% were male. Forty-one major bleeding events occurred at a median time of 7.0 days (interquartile range, 4.0-18.0 days) postprocedure. Bridge therapy was a baseline predictor of major bleeding (odds ratio [OR]=2.4, 95% CI: 1.2-4.8), as were a history of renal disease (OR=2.9, 95% CI: 1.4-6.0), and high-bleeding risk procedures (vs low-bleeding risk procedures) (OR=2.9, 95% CI: 1.4-5.9). Perioperative aspirin use (OR=3.6, 95% CI: 1.1-11.9) and postprocedure international normalized ratio >3.0 (OR=2.1, 95% CI: 1.5-3.1) were time-dependent predictors of major bleeding. Major bleeding was most common in the first 10 days compared with 11-37 days postprocedure (OR=3.5, 95% CI: 1.8-6.9). In addition to bridge therapy, perioperative aspirin use, postprocedure international normalized ratio >3.0, a history of renal failure, and having a high-bleeding risk procedure increase the risk of major bleeding around the time of an elective surgery/procedure requiring warfarin interruption. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Mitigation of PID in commercial PV modules using current interruption method

    Science.gov (United States)

    Bora, Birinchi; Oh, Jaewon; Tatapudi, Sai; Sastry, Oruganty S.; Kumar, Rajesh; Prasad, Basudev; Tamizhmani, Govindasamy

    2017-08-01

    Potential-induced degradation (PID) is known to have a very severe effect on the reliability of PV modules. PID is caused due to the leakage of current from the cell circuit to the grounded frame under humid conditions of high voltage photovoltaic (PV) systems. There are multiple paths for the current leakage. The most dominant leakage path is from the cell to the frame through encapsulant, glass bulk and glass surface. This dominant path can be prevented by interrupting the electrical conductivity at the glass surface. In our previous works related to this topic, we demonstrated the effectiveness of glass surface conductivity interruption technique using one-cell PV coupons. In this work, we demonstrate the effectiveness of this technique using a full size commercial module susceptible to PID. The interruption of surface conductivity of the commercial module was achieved by attaching a narrow, thin flexible glass strips, from Corning, called Willow Glass on the glass surface along the inner edges of the frame. The flexible glass strip was attached to the module glass surface by heating the glass strip with an ionomer adhesive underneath using a handheld heat gun. The PID stress test was performed at 60°C and 85% RH for 96 hours at -600 V. Pre- and post-PID characterizations including I-V and electroluminescence were carried out to determine the performance loss and affected cell areas. This work demonstrates that the PID issue can be effectively addressed by using this current interruption technique. An important benefit of this approach is that this interruption technique can be applied after manufacturing the modules and after installing the modules in the field as well.

  1. 18 CFR 284.9 - Interruptible transportation service.

    Science.gov (United States)

    2010-04-01

    ... transportation service. 284.9 Section 284.9 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... AUTHORITIES CERTAIN SALES AND TRANSPORTATION OF NATURAL GAS UNDER THE NATURAL GAS POLICY ACT OF 1978 AND RELATED AUTHORITIES General Provisions and Conditions § 284.9 Interruptible transportation service. (a...

  2. Interruptions of activities experienced by nursing professionals in an intensive care unit.

    Science.gov (United States)

    Prates, Daniele de Oliveira; Silva, Ana Elisa Bauer de Camargo

    2016-09-09

    to analyze the interruptions experienced by nursing professionals while undertaking care activities. an observational study undertaken in two intensive care units. Two nurses observed 33 nursing professionals for three hours. The data were recorded in real time, using a semistructured instrument. after 99 hours of observation of 739 activities, it was identified that 46.82% were interrupted, resulting in 7.85 interruptions per hour. On average, the interruptions compromised 9.42% of the nursing professionals' worktime. The activities geared towards indirect care of the patient suffered the highest number of interruptions (56.65%), with the nursing records being the activity interrupted most. The principal source of the interruptions was external, coming from the health professionals (51%), and the main causes were those related to the patients (34.70%) and to interpersonal communication (26.47%). the activity of nursing suffers a high number of interruptions, mainly caused by the health professionals themselves, indicating that the work environment needs to undergo interventions aiming to reduce the risk of compromising of the professional's performance and to increase the patients' safety. analisar as interrupções experienciadas por profissionais de enfermagem durante realização de atividades assistenciais. estudo observacional realizado em duas unidades de tratamento intensivo. Dois enfermeiros observaram 33 profissionais de enfermagem, por três horas. Os dados foram registrados em tempo real, usando um instrumento semiestruturado. após 99 horas de observação de 739 atividades, foi identificado que 46,82% sofreram interrupções, perfazendo 7,85 interrupções por hora. As interrupções comprometeram, em média, 9,42% do tempo de trabalho dos profissionais de enfermagem. As atividades direcionadas ao cuidado indireto do paciente foram as que sofreram maior número de interrupções (56,65%), sendo o registro de enfermagem a atividade mais interrompida. A

  3. A multi-domain spectral method for time-fractional differential equations

    Science.gov (United States)

    Chen, Feng; Xu, Qinwu; Hesthaven, Jan S.

    2015-07-01

    This paper proposes an approach for high-order time integration within a multi-domain setting for time-fractional differential equations. Since the kernel is singular or nearly singular, two main difficulties arise after the domain decomposition: how to properly account for the history/memory part and how to perform the integration accurately. To address these issues, we propose a novel hybrid approach for the numerical integration based on the combination of three-term-recurrence relations of Jacobi polynomials and high-order Gauss quadrature. The different approximations used in the hybrid approach are justified theoretically and through numerical examples. Based on this, we propose a new multi-domain spectral method for high-order accurate time integrations and study its stability properties by identifying the method as a generalized linear method. Numerical experiments confirm hp-convergence for both time-fractional differential equations and time-fractional partial differential equations.

  4. Multi-centre evaluation of recent troponin assays for the diagnosis of NSTEMI

    Directory of Open Access Journals (Sweden)

    Camille Chenevier-Gobeaux

    2018-07-01

    Full Text Available Objectives: We aimed to compare the use of nine different cardiac troponin (cTn assays (2 cTnT and 7 cTnI for the diagnosis of NSTEMI in a single multi-centre population. Design and methods: One hundred and fifty-eight patients were included (mean age 60 years, SD 17 years, including 23 patients (14% with NSTEMI. Results: The analytical comparison highlighted a large heterogeneity of cTn assays, as reflected by percentages of patients with detectable cTn, correlation coefficients, Passing-Bablok comparisons and concordance coefficients. Correlations within cTnI assays were good and correlation within cTnT assays was excellent. Diagnostic performances demonstrated that each cTn assay has specific threshold values. Furthermore, some assays (HS-cTnI and T, cTnI-Pathfast and cTnI-Centaur indicated high sensitivity and negative predictive value using the limit of detection (LoD diagnostic strategy. For the latter assays, a significant increase in specificity was found when using the 99th percentile or the H0-H3 strategies, in comparison to the LoD strategy. When applying the European Society of Cardiology H0-H3 algorithm, comparable diagnostic performances were obtained. Conclusion: All 9 cTn assays indicated overall good diagnostic performances for the diagnosis of NSTEMI in emergency departments when the recommended algorithm based on the variation of cTn value between two measurements at admission and 3 h later was used. Keywords: Cardiac troponin, High-sensitivity assay, Chest pain, Emergency department, NSTEMI, Analytical evaluation

  5. A cryptic promoter in potato virus X vector interrupted plasmid construction

    Directory of Open Access Journals (Sweden)

    Schultz Ronald D

    2007-03-01

    Full Text Available Abstract Background Potato virus X has been developed into an expression vector for plants. It is widely used to express foreign genes. In molecular manipulation, the foreign genes need to be sub-cloned into the vector. The constructed plasmid needs to be amplified. Usually, during amplification stage, the foreign genes are not expressed. However, if the foreign gene is expressed, the construction work could be interrupted. Two different viral genes were sub-cloned into the vector, but only one foreign gene was successfully sub-cloned. The other foreign gene, canine parvovirus type 2 (CPV-2 VP1 could not be sub-cloned into the vector and amplified without mutation (frame shift mutation. Results A cryptic promoter in the PVX vector was discovered with RT-PCR. The promoter activity was studied with Northern blots and Real-time RT-PCR. Conclusion It is important to recognize the homologous promoter sequences in the vector when a virus is developed as an expression vector. During the plasmid amplification stage, an unexpected expression of the CPV-2 VP1 gene (not in the target plants, but in E. coli can interrupt the downstream work.

  6. Task and Interruption Management in Activity-Centric Computing

    DEFF Research Database (Denmark)

    Jeuris, Steven

    to address these not in isolation, but by fundamentally reevaluating the current computing paradigm. To this end, activity-centric computing has been brought forward as an alternative computing paradigm, addressing the increasing strain put on modern-day computing systems. Activity-centric computing follows...... the scalability and intelligibility of current research prototypes. In this dissertation, I postulate that such issues arise due to a lack of support for the full set of practices which make up activity management. Most notably, although task and interruption management are an integral part of personal...... information management, they have thus far been neglected in prior activity-centric computing systems. Advancing the research agenda of activity-centric computing, I (1) implement and evaluate an activity-centric desktop computing system, incorporating support for interruptions and long-term task management...

  7. An explicit multi-time-stepping algorithm for aerodynamic flows

    OpenAIRE

    Niemann-Tuitman, B.E.; Veldman, A.E.P.

    1997-01-01

    An explicit multi-time-stepping algorithm with applications to aerodynamic flows is presented. In the algorithm, in different parts of the computational domain different time steps are taken, and the flow is synchronized at the so-called synchronization levels. The algorithm is validated for aerodynamic turbulent flows. For two-dimensional flows speedups in the order of five with respect to single time stepping are obtained.

  8. The role of interruptible natural gas customers in New England heating oil markets: A preliminary examination of events in January-February 2000; TOPICAL

    International Nuclear Information System (INIS)

    None

    2000-01-01

    This report provides an analysis of data collected from gas service providers and end-use customers in the six New England States and offers a preliminary assessment of the impact of interruptible gas customers on the distillate fuel oil market this past winter. Based on information collected and analyzed as of October 2000, the main findings areas follows: (1) For interruptible gas customers with distillate fuel oil as a backup fuel, their volume of interruptions was equivalent to about 1 to 2 percent of the total sales of distillate fuel oil in New England during January-February 2000. For the two peak weeks of gas supply interruptions, however, the equivalent volume of distillate fuel oil amounted to an estimated 3 to 6 percent of total sales in New England. There were no interruptions of the natural gas service during the 2-month period. (2) Purchases of distillate fuel oil by interruptible gas customers may have contributed somewhat to the spike in the price of distillate fuel oil in January-February 2000, especially during the peak weeks of gas interruptions. Nevertheless, other factors-a sudden drop in temperatures, low regional stocks of distillate fuels, and weather-related supply problems during a period of high customer demand-appear to have played a significant role in this price spike, as they have in previous spikes. (3) While this preliminary analysis suggests that interruptible natural gas service does not threaten the stability of the home heating oil market, several steps might be taken-without undermining the benefits of interruptible service-to reduce the potential adverse impacts of gas supply interruptions in times of market stress. Regardless of the magnitude of the impact of distillate fuel oil purchases by interruptible gas customers on Northeast heating oil markets, the threat of future heating oil price spikes and supply problems still remains. To help counter the threat, President Clinton in July 2000 directed Secretary Richardson to

  9. Frequent hepatitis B virus rebound among HIV-hepatitis B virus-coinfected patients following antiretroviral therapy interruption

    DEFF Research Database (Denmark)

    Dore, Gregory J; Soriano, Vicente; Rockstroh, Jürgen

    2010-01-01

    .0002), nondetectable HBV DNA at baseline (P = 0.007), and black race (P = 0.03). Time to ART reinitiation was shorter (7.5, 15.6, and 17.8 months; P hepatitis C virus-positive and non-HBV/hepatitis...... C virus participants in the drug conservation arm. No hepatic decompensation events occurred among HBV-positive participants in either arm. CONCLUSION: HBV DNA rebound following ART interruption is common and may be associated with accelerated immune deficiency in HIV-HBV-coinfected patients.......BACKGROUND: The impact of antiretroviral therapy (ART) interruption in HIV-hepatitis B virus (HBV)-coinfected patients was examined in the Strategic Management of AntiRetroviral Therapy (SMART) study. METHODS: Plasma HBV DNA was measured in all hepatitis B surface antigen-positive (HBV...

  10. 30 CFR 18.48 - Circuit-interrupting devices.

    Science.gov (United States)

    2010-07-01

    ... energized. (f) Belt conveyors shall be equipped with control switches to automatically stop the driving motor in the event the belt is stopped, or abnormally slowed down. Note: Short transfer-type conveyors... Design Requirements § 18.48 Circuit-interrupting devices. (a) Each machine shall be equipped with a...

  11. Interactive or interruptive? Instant messaging at work

    NARCIS (Netherlands)

    Ou, C.X.J.; Davison, R.M.

    2011-01-01

    The use of instant messaging (IM) technology at work is controversial, due to the interruptions it may cause and the difficulties associated with quantifying its benefits for individuals, teams and organizations. In this study, we investigate the use and impact of IM tools in the workplace. Based on

  12. An Assessment of Instant Messaging Interruptions on Knowledge Workers' Task Performance in E-Learning-Based Training

    Science.gov (United States)

    Mansi, Gary R.

    2011-01-01

    The modern workplace environment is filled with interruptions due to the necessity of coworkers to communicate with each other. Studies have revealed that interruptions can disrupt the ability of a knowledge worker to concentrate on a task, which can impact task performance (TP). Communication interruptions are due, in part, to the unavoidable…

  13. Noisy time-dependent spectra

    International Nuclear Information System (INIS)

    Shore, B.W.; Eberly, J.H.

    1983-01-01

    The definition of a time-dependent spectrum registered by an idealized spectrometer responding to a time-varying electromagnetic field as proposed by Eberly and Wodkiewicz and subsequently applied to the spectrum of laser-induced fluorescence by Eberly, Kunasz, and Wodkiewicz is here extended to allow a stochastically fluctuating (interruption model) environment: we provide an algorithm for numerical determination of the time-dependent fluorescence spectrum of an atom subject to excitation by an intense noisy laser and interruptive relaxation

  14. Allocation of substance use disorder patients to appropriate levels of care: feasibility of matching guidelines in routine practice in Dutch treatment centres

    NARCIS (Netherlands)

    Merkx, Maarten J. M.; Schippers, Gerard M.; Koeter, Maarten J. W.; Vuijk, Pieter Jelle; Oudejans, Suzan; de Vries, Carlijn C. Q.; van den Brink, Wim

    2007-01-01

    AIMS: To examine the feasibility of implementing evidence-based guidelines for patient-treatment-matching to levels of care in two Dutch substance abuse treatment centres. DESIGN: Multi-centre observational follow-up study. SETTING: Two large substance abuse treatment centres (SATCs). PARTICIPANTS:

  15. Growth-interruption-induced low-density InAs quantum dots on GaAs

    International Nuclear Information System (INIS)

    Li, L. H.; Alloing, B.; Chauvin, N.; Fiore, A.; Patriarche, G.

    2008-01-01

    We investigate the use of growth interruption to obtain low-density InAs quantum dots (QDs) on GaAs. The process was realized by Ostwald-type ripening of a thin InAs layer. It was found that the optical properties of the QDs as a function of growth interruption strongly depend on InAs growth rate. By using this approach, a low density of QDs (4 dots/μm 2 ) with uniform size distribution was achieved. As compared to QDs grown without growth interruption, a larger energy separation between the QD confined levels was observed, suggesting a situation closer to the ideal zero-dimensional system. Combining with an InGaAs capping layer such as In-rich QDs enable 1.3 μm emission at 4 K

  16. Multi parametric card to personal computers interface based in ispLSI1016 circuits

    International Nuclear Information System (INIS)

    Osorio Deliz, J.F.; Toledo Acosta, R.B.; Arista Romeu, E.

    1997-01-01

    It is described the design and principal characteristic of the interface circuit for a 16 bit multi parametric add on card for IBM or compatible microcomputer which content two communication channels of direct memory access and bidirectional between the card and the computer, an interrupt controller, a programmable address register, a default add res register of the card, a four channels multiplexer, as well as the decoder logic of the 80C186 and computer. The circuit was designed with two programmable logic devices ispL1016, which allowed drastically to diminish the quantity of utilized components and get a more flexible design in less time better characteristics

  17. Programming a real-time operating system for satellite control applications Satellite Control Applications

    International Nuclear Information System (INIS)

    Omer, M.; Anjum, O.; Suddle, M.R.

    2004-01-01

    With the realization of ideas like formation flights and multi-body space vehicles the demands on an attitude control system have become increasingly complex. Even in its most simplified form, the control system for a typical geostationary satellite has to run various supervisory functions along with determination and control algorithms side by side. Within each algorithm it has to employ multiple actuation and sensing mechanisms and service real time interrupts, for example, in the case of actuator saturation and sensor data fusion. This entails the idea of thread scheduling and program synchronization, tasks specifically meant for a real time OS. This paper explores the embedding of attitude determination and control loop within the framework of a real time operating system provided for TI's DSP C6xxx series. The paper details out the much functionality provided within the scaleable real time kernel and the analysis and configuration tools available, It goes on to describe a layered implementation stack associated with a typical control for Geo Stationary satellites. An application for control is then presented in which state of the art analysis tools are employed to view program threads, synchronization semaphores, hardware interrupts and data exchange pipes operating in real time. (author)

  18. An inter-centre quality assurance network for IMRT verification: Results of the ESTRO QUASIMODO project

    International Nuclear Information System (INIS)

    Gillis, Sofie; Wagter, Carlos de; Bohsung, Joerg; Perrin, Bruce; Williams, Peter; Mijnheer, Ben J.

    2005-01-01

    Background and purpose: IMRT necessitates extension of existing inter-centre quality assurance programs due to its increased complexity. We assessed the feasibility of an inter-centre verification method for different IMRT techniques. Materials and methods: Eight European radiotherapy institutions of the QUASIMODO network, have designed an IMRT plan for a horseshoe-shaped PTV surrounding a cylindrical OAR in a simplified pelvic phantom. All centres applied common plan objectives but used their own equipment for planning and delivery. They verified the delivery of this plan according to a common protocol with radiographic film and ionisation chamber measurements. The irradiated films, the results of the ionisation chamber measurements and the computed dose distributions were sent to one analysis centre that compared the measured and computed dose distributions with the gamma method and composite dose-area histograms. Results: 4% (relative to the prescribed dose) and 3 mm (distance-to-agreement) were decided feasible gamma criteria. The composite dose-area histograms showed a maximum local deviation of 3.5% in the mean dose of the PTV and 5% in the OAR. Systematic differences could be identified, and in some cases explained. Conclusions: This multi-centre dosimetric verification study demonstrated both the feasibility of a multi-centre quality assurance network to evaluate any IMRT planning and delivery system combination, as well as the validity of the methodology involved

  19. Preserving the Context of Interrupted Business Process Activities

    NARCIS (Netherlands)

    Bassil, S.; Rinderle, S.B.; Keller, R.; Reichert, M.U.; Kropf, P.G.

    2005-01-01

    The capability to safely interrupt business process activities is an important requirement for advanced process-aware information systems. Indeed, exceptions stemming from the application environment often appear while one or more application-related process activities are running. Safely

  20. Preserving the Context of Interrupted Business Process Activities

    NARCIS (Netherlands)

    Bassil, S.; Rinderle, S.B.; Keller, R.; Kropf, P.G.; Reichert, M.U.; Chen, C.S.; Filipe, J.; Seruca, I.; Cordeiro, J.

    2006-01-01

    The capability to safely interrupt business process activities is an important requirement for advanced process-aware information systems. Indeed, exceptions stemming from the application environment often appear while one or more application-related process activities are running. Safely

  1. Waiting-time approximations in multi-queue systems with cyclic service

    NARCIS (Netherlands)

    Boxma, O.J.; Meister, B.W.

    1987-01-01

    This study is devoted to mean waiting-time approximations in a single-server multi-queue model with cyclic service and zero switching times of the server between consecutive queues. Two different service disciplines are considered: exhaustive service and (ordinary cyclic) nonexhaustive service. For

  2. Quality assurance in clinical trials : a multi-disciplinary approach

    International Nuclear Information System (INIS)

    Cornes, D.

    2001-01-01

    Full text: Multi-disciplinary groups, such as medical physicists and radiation therapists, which work effectively together, can ensure continued improvements in radiation therapy quality. The same is also true for clinical trials, which have the added complication of requiring multi-institutional participation to collate sufficient data to effectively assess treatment benefits. It can be difficult to manage quality across all aspects of a multi-disciplinary and multi-institutional trial. A planned system of quality assurance is necessary to provide support for participating centres and facilitate a collaborative approach. To ensure protocol compliance a good relationship between the clinical trial group and treatment centre is idea with definition of mutual goals and objectives before and during the trial, and ongoing consultation and feedback throughout the trial process. To ensure good quality data and maximise the validity of results the study protocol must be strictly adhered to. Because of the need for meticulous attention to detail, both in treatment delivery and standards of documentation, clinical trials are often seen to further complicate the process of delivery of radiation therapy treatment. The Declaration of Helsinki and Good Clinical Practise Guidelines (adopted in May 1996, ICH) provide 'international ethical and scientific standards for designing, conducting, recording and reporting clinical research' and multi-disciplinary groups in each participating centre should also adhere to these guidelines. Copyright (2001) Australasian College of Physical Scientists and Engineers in Medicine

  3. Compensability index for compensation radiotherapy after treatment interruptions

    International Nuclear Information System (INIS)

    Putora, Paul Martin; Schmuecking, Michael; Aebersold, Daniel; Plasswilm, Ludwig

    2012-01-01

    The goal of our work was to develop a simple method to evaluate a compensation treatment after unplanned treatment interruptions with respect to their tumour- and normal tissue effect. We developed a software tool in java programming language based on existing recommendations to compensate for treatment interruptions. In order to express and visualize the deviations from the originally planned tumour and normal tissue effects we defined the compensability index. The compensability index represents an evaluation of the suitability of compensatory radiotherapy in a single number based on the number of days used for compensation and the preference of preserving the originally planned tumour effect or not exceeding the originally planned normal tissue effect. An automated tool provides a method for quick evaluation of compensation treatments. The compensability index calculation may serve as a decision support system based on existing and established recommendations

  4. An electronic trigger tool to optimise intravenous to oral antibiotic switch: a controlled, interrupted time series study

    Directory of Open Access Journals (Sweden)

    Marvin A. H. Berrevoets

    2017-08-01

    Full Text Available Abstract Background Timely switch from intravenous (iv antibiotics to oral therapy is a key component of antimicrobial stewardship programs in order to improve patient safety, promote early discharge and reduce costs. We have introduced a time-efficient and easily implementable intervention that relies on a computerized trigger tool, which identifies patients who are candidates for an iv to oral antibiotic switch. Methods The intervention was introduced on all internal medicine wards in a teaching hospital. Patients were automatically identified by an electronic trigger tool when parenteral antibiotics were used for >48 h and clinical or pharmacological data did not preclude switch therapy. A weekly educational session was introduced to alert the physicians on the intervention wards. The intervention wards were compared with control wards, which included all other hospital wards. An interrupted time-series analysis was performed to compare the pre-intervention period with the post-intervention period using ‘% of i.v. prescriptions >72 h’ and ‘median duration of iv therapy per prescription’ as outcomes. We performed a detailed prospective evaluation on a subset of 244 prescriptions to evaluate the efficacy and appropriateness of the intervention. Results The number of intravenous prescriptions longer than 72 h was reduced by 19% in the intervention group (n = 1519 (p < 0.01 and the median duration of iv antibiotics was reduced with 0.8 days (p = <0.05. Compared to the control group (n = 4366 the intervention was responsible for an additional decrease of 13% (p < 0.05 in prolonged prescriptions. The detailed prospective evaluation of a subgroup of patients showed that adherence to the electronic reminder was 72%. Conclusions An electronic trigger tool combined with a weekly educational session was effective in reducing the duration of intravenous antimicrobial therapy.

  5. Hierarchical programming language for modal multi-rate real-time stream processing applications

    NARCIS (Netherlands)

    Geuns, S.J.; Hausmans, J.P.H.M.; Bekooij, Marco Jan Gerrit

    2014-01-01

    Modal multi-rate stream processing applications with real-time constraints which are executed on multi-core embedded systems often cannot be conveniently specified using current programming languages. An important issue is that sequential programming languages do not allow for convenient programming

  6. Closing the gender leadership gap: a multi-centre cross-country comparison of women in management and leadership in academic health centres in the European Union.

    Science.gov (United States)

    Kuhlmann, Ellen; Ovseiko, Pavel V; Kurmeyer, Christine; Gutiérrez-Lobos, Karin; Steinböck, Sandra; von Knorring, Mia; Buchan, Alastair M; Brommels, Mats

    2017-01-06

    Women's participation in medicine and the need for gender equality in healthcare are increasingly recognised, yet little attention is paid to leadership and management positions in large publicly funded academic health centres. This study illustrates such a need, taking the case of four large European centres: Charité - Universitätsmedizin Berlin (Germany), Karolinska Institutet (Sweden), Medizinische Universität Wien (Austria), and Oxford Academic Health Science Centre (United Kingdom). The percentage of female medical students and doctors in all four countries is now well within the 40-60% gender balance zone. Women are less well represented among specialists and remain significantly under-represented among senior doctors and full professors. All four centres have made progress in closing the gender leadership gap on boards and other top-level decision-making bodies, but a gender leadership gap remains relevant. The level of achieved gender balance varies significantly between the centres and largely mirrors country-specific welfare state models, with more equal gender relations in Sweden than in the other countries. Notably, there are also similar trends across countries and centres: gender inequality is stronger within academic enterprises than within hospital enterprises and stronger in middle management than at the top level. These novel findings reveal fissures in the 'glass ceiling' effects at top-level management, while the barriers for women shift to middle-level management and remain strong in academic positions. The uneven shifts in the leadership gap are highly relevant and have policy implications. Setting gender balance objectives exclusively for top-level decision-making bodies may not effectively promote a wider goal of gender equality. Academic health centres should pay greater attention to gender equality as an issue of organisational performance and good leadership at all levels of management, with particular attention to academic enterprises

  7. A modelling framework for mitigating customers' waiting time at a vehicle inspection centre

    Science.gov (United States)

    Ahmad, Norazura; Abidin, Norhaslinda Zainal; Ilyas, Khibtiyah; Abduljabbar, Waleed Khalid

    2017-11-01

    In Malaysia, an agency that is entrusted by the Government to perform mandatory vehicle inspection for public, commercial and private vehicles, receive many customers daily. Often complaints of problems received from the customers are associated with waiting time that leads to lost of business and dissatisfied customers. To address this issue, we propose a framework for modelling a vehicle inspection system using an integration of simulation and optimization approaches. The strengths of simulation and optimization are reviewed briefly that is hoped to reveal the synergy between the established methods in determining an appropriate customer's waiting time for inspection at a vehicle inspection centre. Relevant concepts and preliminary results are also presented and discussed in this paper.

  8. Non-equilibrium quantum dynamics of ultra-cold atomic mixtures: the multi-layer multi-configuration time-dependent Hartree method for bosons

    International Nuclear Information System (INIS)

    Krönke, Sven; Cao, Lushuai; Schmelcher, Peter; Vendrell, Oriol

    2013-01-01

    We develop and apply the multi-layer multi-configuration time-dependent Hartree method for bosons, which represents an ab initio method for investigating the non-equilibrium quantum dynamics of multi-species bosonic systems. Its multi-layer feature allows for tailoring the wave function ansatz to describe intra- and inter-species correlations accurately and efficiently. To demonstrate the beneficial scaling and efficiency of the method, we explored the correlated tunneling dynamics of two species with repulsive intra- and inter-species interactions, to which a third species with vanishing intra-species interaction was weakly coupled. The population imbalances of the first two species can feature a temporal equilibration and their time evolution significantly depends on the coupling to the third species. Bosons of the first and second species exhibit a bunching tendency, whose strength can be influenced by their coupling to the third species. (paper)

  9. Robust Automated Image Co-Registration of Optical Multi-Sensor Time Series Data: Database Generation for Multi-Temporal Landslide Detection

    Directory of Open Access Journals (Sweden)

    Robert Behling

    2014-03-01

    Full Text Available Reliable multi-temporal landslide detection over longer periods of time requires multi-sensor time series data characterized by high internal geometric stability, as well as high relative and absolute accuracy. For this purpose, a new methodology for fully automated co-registration has been developed allowing efficient and robust spatial alignment of standard orthorectified data products originating from a multitude of optical satellite remote sensing data of varying spatial resolution. Correlation-based co-registration uses world-wide available terrain corrected Landsat Level 1T time series data as the spatial reference, ensuring global applicability. The developed approach has been applied to a multi-sensor time series of 592 remote sensing datasets covering an approximately 12,000 km2 area in Southern Kyrgyzstan (Central Asia strongly affected by landslides. The database contains images acquired during the last 26 years by Landsat (ETM, ASTER, SPOT and RapidEye sensors. Analysis of the spatial shifts obtained from co-registration has revealed sensor-specific alignments ranging between 5 m and more than 400 m. Overall accuracy assessment of these alignments has resulted in a high relative image-to-image accuracy of 17 m (RMSE and a high absolute accuracy of 23 m (RMSE for the whole co-registered database, making it suitable for multi-temporal landslide detection at a regional scale in Southern Kyrgyzstan.

  10. Real-time pricing strategy of micro-grid energy centre considering price-based demand response

    Science.gov (United States)

    Xu, Zhiheng; Zhang, Yongjun; Wang, Gan

    2017-07-01

    With the development of energy conversion technology such as power to gas (P2G), fuel cell and so on, the coupling between energy sources becomes more and more closely. Centralized dispatch among electricity, natural gas and heat will become a trend. With the goal of maximizing the system revenue, this paper establishes the model of micro-grid energy centre based on energy hub. According to the proposed model, the real-time pricing strategy taking into account price-based demand response of load is developed. And the influence of real-time pricing strategy on the peak load shifting is discussed. In addition, the impact of wind power predicted inaccuracy on real-time pricing strategy is analysed.

  11. Interrupting Mythic Community

    Directory of Open Access Journals (Sweden)

    Linnell Secomb

    2013-09-01

    Full Text Available If nation is increasingly perceived as a less than honourable institution formed through war, invasion and geo-political territorialisation, and government is widely denounced as the site of political intrigue and the means of subjectification of citizen–voters, community appears to escape this critique and to be viewed as an idyllic formation based on bonds of affinity. However, this romancing of community is disrupted by trans-cultural and sub-cultural formations that expose the fantasy of a harmonious, homogenous community. While community is often conceived as arising organically from familial, tribal or cultural similarity, or as constituted through a common history and shared cultural institutions, this totalising conception of community is interrupted by the demands of difference and heterogeneity and by a questioning of the idyll of community authenticated in myths of archaic origin.

  12. Real-time video compressing under DSP/BIOS

    Science.gov (United States)

    Chen, Qiu-ping; Li, Gui-ju

    2009-10-01

    This paper presents real-time MPEG-4 Simple Profile video compressing based on the DSP processor. The programming framework of video compressing is constructed using TMS320C6416 Microprocessor, TDS510 simulator and PC. It uses embedded real-time operating system DSP/BIOS and the API functions to build periodic function, tasks and interruptions etcs. Realize real-time video compressing. To the questions of data transferring among the system. Based on the architecture of the C64x DSP, utilized double buffer switched and EDMA data transfer controller to transit data from external memory to internal, and realize data transition and processing at the same time; the architecture level optimizations are used to improve software pipeline. The system used DSP/BIOS to realize multi-thread scheduling. The whole system realizes high speed transition of a great deal of data. Experimental results show the encoder can realize real-time encoding of 768*576, 25 frame/s video images.

  13. A multi-centre phase 3 study comparing efficacy and safety of Bemfola® versus Gonal-f® in women undergoing ovarian stimulation for IVF

    DEFF Research Database (Denmark)

    Rettenbacher, M; Andersen, A N; Garcia-Velasco, J A

    2015-01-01

    injection (n = 372) showed Bemfola yielding similar efficacy and safety profiles to Gonal-f. Women aged 20-38 years of age were randomized 2:1 to receive a single, daily, subcutaneous 150 IU dose of either Bemfola or Gonal-f. This study tested equivalence in the number of retrieved oocytes using a pre......Bemfola (follitropin alfa) (Finox AG, Switzerland), a new recombinant FSH, has a comparable pharmacological profile to that of Gonal-f (Merck Serono, Germany), the current standard for ovarian stimulation. A randomized, multi-centre, Phase 3 study in women undergoing IVF or intracytoplasmic sperm...

  14. Do Work Beliefs Moderate the Relationship Between Work Interruptions, Wellbeing and Psychosomatic Symptoms?

    Science.gov (United States)

    Zoupanou, Zoi(e); Rydstedt, Leif W.

    2017-01-01

    The purpose of this study was to explore the moderating effects of work beliefs in the relationship between work interruptions and general health, wellbeing and reports of psychosomatic symptoms. Self-report data were gathered from 310 employees from different occupational sectors. Results revealed that beliefs in hard work and morality ethic moderated the positive appraisal of work interruptions and acted as protective factors on impaired general health and wellbeing. The relationship was stronger among employees who endorsed strong beliefs in hard work and did not have regard for morality/ethics as a value. Likewise, beliefs in delay of gratification and morality/ethics moderated positive appraisal of work interruptions and reduced psychosomatic complaints. More specifically, the relationship was stronger among employees who had strong belief in the values of delayed gratification and weaker morality/ethics. These findings indicate that organisations should adopt work ideology or practices focused on work values particularly of hard work, delay of gratification and conformity to morality as protective factors that reduce the impact of work interruptions on employees’ general health and wellbeing. PMID:28580023

  15. The interrupted power law and the size of shadow banking.

    Science.gov (United States)

    Fiaschi, Davide; Kondor, Imre; Marsili, Matteo; Volpati, Valerio

    2014-01-01

    Using public data (Forbes Global 2000) we show that the asset sizes for the largest global firms follow a Pareto distribution in an intermediate range, that is "interrupted" by a sharp cut-off in its upper tail, where it is totally dominated by financial firms. This flattening of the distribution contrasts with a large body of empirical literature which finds a Pareto distribution for firm sizes both across countries and over time. Pareto distributions are generally traced back to a mechanism of proportional random growth, based on a regime of constant returns to scale. This makes our findings of an "interrupted" Pareto distribution all the more puzzling, because we provide evidence that financial firms in our sample should operate in such a regime. We claim that the missing mass from the upper tail of the asset size distribution is a consequence of shadow banking activity and that it provides an (upper) estimate of the size of the shadow banking system. This estimate-which we propose as a shadow banking index-compares well with estimates of the Financial Stability Board until 2009, but it shows a sharper rise in shadow banking activity after 2010. Finally, we propose a proportional random growth model that reproduces the observed distribution, thereby providing a quantitative estimate of the intensity of shadow banking activity.

  16. Feasibility and Preliminary Efficacy of Visual Cue Training to Improve Adaptability of Walking after Stroke: Multi-Centre, Single-Blind Randomised Control Pilot Trial

    Science.gov (United States)

    Hollands, Kristen L.; Pelton, Trudy A.; Wimperis, Andrew; Whitham, Diane; Tan, Wei; Jowett, Sue; Sackley, Catherine M.; Wing, Alan M.; Tyson, Sarah F.; Mathias, Jonathan; Hensman, Marianne; van Vliet, Paulette M.

    2015-01-01

    Objectives Given the importance of vision in the control of walking and evidence indicating varied practice of walking improves mobility outcomes, this study sought to examine the feasibility and preliminary efficacy of varied walking practice in response to visual cues, for the rehabilitation of walking following stroke. Design This 3 arm parallel, multi-centre, assessor blind, randomised control trial was conducted within outpatient neurorehabilitation services Participants Community dwelling stroke survivors with walking speed adaptability practice using visual cues are feasible and may improve mobility and balance. Future studies should continue a carefully phased approach using identified methods to improve retention. Trial Registration Clinicaltrials.gov NCT01600391 PMID:26445137

  17. Multi-hit time-to-amplitude CAMAC module (MTAC)

    International Nuclear Information System (INIS)

    Kang, H.

    1980-10-01

    A Multi-Hit Time-to-Amplitude Module (MTAC) for the SLAC Mark III drift chamber system has been designed to measure drift time by converting time-proportional chamber signals into analog levels, and converting the analog data by slow readout via a semi-autonomous controller in a CAMAC crate. The single width CAMAC module has 16 wire channels, each with a 4-hit capacity. An externally generated common start initiates an internal precision ramp voltage which is then sampled using a novel shift register gating scheme and CMOS sampling switches. The detailed design and performance specifications are described

  18. Design and implementation of real-time multi-sensor vision systems

    CERN Document Server

    Popovic, Vladan; Cogal, Ömer; Akin, Abdulkadir; Leblebici, Yusuf

    2017-01-01

    This book discusses the design of multi-camera systems and their application to fields such as the virtual reality, gaming, film industry, medicine, automotive industry, drones, etc.The authors cover the basics of image formation, algorithms for stitching a panoramic image from multiple cameras, and multiple real-time hardware system architectures, in order to have panoramic videos. Several specific applications of multi-camera systems are presented, such as depth estimation, high dynamic range imaging, and medical imaging.

  19. Analysis of multi lobe journal bearings with surface roughness using finite difference method

    Science.gov (United States)

    PhaniRaja Kumar, K.; Bhaskar, SUdaya; Manzoor Hussain, M.

    2018-04-01

    Multi lobe journal bearings are used for high operating speeds and high loads in machines. In this paper symmetrical multi lobe journal bearings are analyzed to find out the effect of surface roughnessduring non linear loading. Using the fourth order RungeKutta method, time transient analysis was performed to calculate and plot the journal centre trajectories. Flow factor method is used to evaluate the roughness and the finite difference method (FDM) is used to predict the pressure distribution over the bearing surface. The Transient analysis is done on the multi lobe journal bearings for threedifferent surface roughness orientations. Longitudinal surface roughness is more effective when compared with isotopic and traverse surface roughness.

  20. Stated preferences based estimation of power interruption costs in private households: An example from Germany

    International Nuclear Information System (INIS)

    Praktiknjo, Aaron J.

    2014-01-01

    Concerns regarding supply security are increasingly raised in reaction to the transition of the German energy system toward a renewable and nuclear-free system called “Energiewende”. The goal of this work is to contribute to a measurability of supply security by quantifying the consequences of power interruptions monetarily. The focus lies within the investigation of power interruption costs in private households. An online survey with 859 participants in 2011 is used to gather the necessary data. Based on this data, a two-staged bottom-up regression model was estimated to describe interruption costs for durations of 15 min, 1 h, 4 h, 1 day and 4 days. Finally, micro-data from 55,000 households were used to perform Monte Carlo simulations to increase the representativeness of the estimations. The frequency distributions of the estimated interruption costs indicate potentials for load-shedding measures. Such measures could be an economically viable contribution to a successful integration of large shares of renewable fluctuating generation like wind or solar power. - Highlights: • Power interruption costs have been analyzed for private households in Germany. • Five different interruption durations have been analyzed. • An online survey, a regression and a bottom-up simulation model has been used. • The results indicate interesting potentials for demand response measures. • Such measures might contribute to the integration of large shares of renewables

  1. Design, application and testing of the Work Observation Method by Activity Timing (WOMBAT) to measure clinicians' patterns of work and communication.

    Science.gov (United States)

    Westbrook, Johanna I; Ampt, Amanda

    2009-04-01

    Evidence regarding how health information technologies influence clinicians' patterns of work and support efficient practices is limited. Traditional paper-based data collection methods are unable to capture clinical work complexity and communication patterns. The use of electronic data collection tools for such studies is emerging yet is rarely assessed for reliability or validity. Our aim was to design, apply and test an observational method which incorporated the use of an electronic data collection tool for work measurement studies which would allow efficient, accurate and reliable data collection, and capture greater degrees of work complexity than current approaches. We developed an observational method and software for personal digital assistants (PDAs) which captures multiple dimensions of clinicians' work tasks, namely what task, with whom, and with what; tasks conducted in parallel (multi-tasking); interruptions and task duration. During field-testing over 7 months across four hospital wards, fifty-two nurses were observed for 250 h. Inter-rater reliability was tested and validity was measured by (i) assessing whether observational data reflected known differences in clinical role work tasks and (ii) by comparing observational data with participants' estimates of their task time distribution. Observers took 15-20 h of training to master the method and data collection process. Only 1% of tasks observed did not match the classification developed and were classified as 'other'. Inter-rater reliability scores of observers were maintained at over 85%. The results discriminated between the work patterns of enrolled and registered nurses consistent with differences in their roles. Survey data (n=27) revealed consistent ratings of tasks by nurses, and their rankings of most to least time-consuming tasks were significantly correlated with those derived from the observational data. Over 40% of nurses' time was spent in direct care or professional communication

  2. CADC and CANFAR: Extending the role of the data centre

    Science.gov (United States)

    Gaudet, Severin

    2015-12-01

    Over the past six years, the CADC has moved beyond the astronomy archive data centre to a multi-service system for the community. This evolution is based on two major initiatives. The first is the adoption of International Virtual Observatory Alliance (IVOA) standards in both the system and data architecture of the CADC, including a common characterization data model. The second is the Canadian Advanced Network for Astronomical Research (CANFAR), a digital infrastructure combining the Canadian national research network (CANARIE), cloud processing and storage resources (Compute Canada) and a data centre (Canadian Astronomy Data Centre) into a unified ecosystem for storage and processing for the astronomy community. This talk will describe the architecture and integration of IVOA and CANFAR services into CADC operations, the operational experiences, the lessons learned and future directions

  3. Compensability index for compensation radiotherapy after treatment interruptions

    Directory of Open Access Journals (Sweden)

    Putora Paul

    2012-12-01

    Full Text Available Abstract Background The goal of our work was to develop a simple method to evaluate a compensation treatment after unplanned treatment interruptions with respect to their tumour- and normal tissue effect. Methods We developed a software tool in java programming language based on existing recommendations to compensate for treatment interruptions. In order to express and visualize the deviations from the originally planned tumour and normal tissue effects we defined the compensability index. Results The compensability index represents an evaluation of the suitability of compensatory radiotherapy in a single number based on the number of days used for compensation and the preference of preserving the originally planned tumour effect or not exceeding the originally planned normal tissue effect. An automated tool provides a method for quick evaluation of compensation treatments. Conclusions The compensability index calculation may serve as a decision support system based on existing and established recommendations.

  4. A combined teamwork training and work standardisation intervention in operating theatres: controlled interrupted time series study.

    Science.gov (United States)

    Morgan, Lauren; Pickering, Sharon P; Hadi, Mohammed; Robertson, Eleanor; New, Steve; Griffin, Damian; Collins, Gary; Rivero-Arias, Oliver; Catchpole, Ken; McCulloch, Peter

    2015-02-01

    Teamwork training and system standardisation have both been proposed to reduce error and harm in surgery. Since the approaches differ markedly, there is potential for synergy between them. Controlled interrupted time series with a 3 month intervention and observation phases before and after. Operating theatres conducting elective orthopaedic surgery in a single hospital system (UK Hospital Trust). Teamwork training based on crew resource management plus training and follow-up support in developing standardised operating procedures. Focus of subsequent standardisation efforts decided by theatre staff. Paired observers watched whole procedures together. We assessed non-technical skills using NOTECHS II, technical performance using glitch rate and compliance with WHO checklist using a simple quality tool. We measured complication and readmission rates and hospital stay using hospital administrative records. Before/after change was compared in the active and control groups using two-way ANOVA and regression models. 1121 patients were operated on before and 1100 after intervention. 44 operations were observed before and 50 afterwards. Non-technical skills (p=0.002) and WHO compliance (pteamwork and system improvement causes marked improvements in team behaviour and WHO performance, but not technical performance or outcome. These findings are consistent with the synergistic hypothesis, but larger controlled studies with a strong implementation strategy are required to test potential outcome effects. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  5. Mental health impacts of flooding: a controlled interrupted time series analysis of prescribing data in England.

    Science.gov (United States)

    Milojevic, Ai; Armstrong, Ben; Wilkinson, Paul

    2017-10-01

    There is emerging evidence that people affected by flooding suffer adverse impacts on their mental well-being, mostly based on self-reports. We examined prescription records for drugs used in the management of common mental disorder among primary care practices located in the vicinity of recent large flood events in England, 2011-2014. A controlled interrupted time series analysis was conducted of the number of prescribing items for antidepressant drugs in the year before and after the flood onset. Pre-post changes were compared by distance of the practice from the inundated boundaries among 930 practices located within 10 km of a flood. After control for deprivation and population density, there was an increase of 0.59% (95% CI 0.24 to 0.94) prescriptions in the postflood year among practices located within 1 km of a flood over and above the change observed in the furthest distance band. The increase was greater in more deprived areas. This study suggests an increase in prescribed antidepressant drugs in the year after flooding in primary care practices close to recent major floods in England. The degree to which the increase is actually concentrated in those flooded can only be determined by more detailed linkage studies. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. Are Technology Interruptions Impacting Your Bottom Line? An Innovative Proposal for Change.

    Science.gov (United States)

    Ledbetter, Tamera; Shultz, Sarah; Beckham, Roxanne

    2017-10-01

    Nursing interruptions are a costly and dangerous variable in acute care hospitals. Malfunctioning technology equipment interrupts nursing care and prevents full utilization of computer safety systems to prevent patient care errors. This paper identifies an innovative approach to nursing interruptions related to computer and computer cart malfunctions. The impact on human resources is defined and outcome measures were proposed. A multifaceted proposal, based on a literature review, aimed at reducing nursing interruptions is presented. This proposal is expected to increase patient safety, as well as patient and nurse satisfaction. Acute care hospitals utilizing electronic medical records and bar-coded medication administration technology. Nurses, information technology staff, nursing informatics staff, and all leadership teams affected by technology problems and their proposed solutions. Literature from multiple fields was reviewed to evaluate research related to computer/computer cart failures, and the approaches used to resolve these issues. Outcome measured strategic goals related to patient safety, and nurse and patient satisfaction. Specific help desk metrics will demonstrate the effect of interventions. This paper addresses a gap in the literature and proposes practical and innovative solutions. A comprehensive computer and computer cart repair program is essential for patient safety, financial stewardship, and utilization of resources. © 2015 Wiley Periodicals, Inc.

  7. Time-aware multi-viewpoint summarization of multilingual social text streams

    NARCIS (Netherlands)

    Ren, Zhaochun; Inel, Oana; Aroyo, Lora; De Rijke, Maarten

    2016-01-01

    A viewpoint is a triple consisting of an entity, a topic related to this entity and sentiment towards this topic. In time-aware multi-viewpoint summarization one monitors viewpoints for a running topic and selects a small set of informative documents. In this paper, we focus on time-aware

  8. Fast and interrupted expansion in cyclic void growth in dusty plasma

    International Nuclear Information System (INIS)

    Van de Wetering, F M J H; Brooimans, R J C; Nijdam, S; Beckers, J; Kroesen, G M W

    2015-01-01

    Low-pressure acetylene plasmas are able to spontaneously form dust particles. This will result in a dense cloud of solid particles that is levitated in the plasma. The formed particles can grow up to micrometers. We observed a spontaneous interruption in the expansion of the so-called dust void. A dust void is a macroscopic region in the plasma that is free of nanoparticles. The phenomenon is periodical and reproducible. We refer to the expansion interruption as ‘hiccup’. The expanding void is an environment in which a new cycle of dust particle formation can start. At a certain moment in time, this cycle reaches the (sudden) coagulation phase and as a result the void will temporarily shrink. To substantiate this reasoning, the electron density is determined non-intrusively using microwave cavity resonance spectroscopy. Moreover, video imaging of laser light scattering of the dust particles provides their spatial distribution. The emission intensity of a single argon transition is measured similarly. Our results support the aforementioned hypothesis for what happens during the void hiccup. The void dynamics preceding the hiccup are modeled using a simple analytical model for the two dominant forces (ion drag and electric) working on a nanoparticle in a plasma. The model results qualitatively reproduce the measurements. (paper)

  9. Project Based Learning in Multi-Grade Class

    Science.gov (United States)

    Ciftci, Sabahattin; Baykan, Ayse Aysun

    2013-01-01

    The purpose of this study is to evaluate project based learning in multi-grade classes. This study, based on a student-centered learning approach, aims to analyze students' and parents' interpretations. The study was done in a primary village school belonging to the Centre of Batman, already adapting multi-grade classes in their education system,…

  10. Interrupted reperfusion reduces the activation of NADPH oxidase after cerebral I/R injury.

    Science.gov (United States)

    Shen, Jia; Bai, Xiao-Yin; Qin, Yuan; Jin, Wei-Wei; Zhou, Jing-Yin; Zhou, Ji-Ping; Yan, Ying-Gang; Wang, Qiong; Bruce, Iain C; Chen, Jiang-Hua; Xia, Qiang

    2011-06-15

    Interrupted reperfusion reduces ischemia/reperfusion (I/R) injury. This study was designed to determine whether NADPH oxidase participates in the neural protection against global I/R injury after interrupted reperfusion. Mice were randomly divided into five groups: sham (sham-operated), I/R (20-min global I/R), RR (I/R+interrupted reperfusion), Apo (I/R+apocynin administration), and RR+Apo. Behavioral tests (pole test, beam walking, and Morris water maze) and Nissl staining were undertaken in all five groups; superoxide levels, expression of gp91(phox) and p47(phox), p47(phox) translocation, and Rac1 activation were measured in the sham, I/R, and RR groups. The motor coordination, bradykinesia, and spatial learning and memory, as well as the neuron survival rates, were better in the RR, Apo, and RR+Apo groups than in the I/R group. The NADPH oxidase-dependent superoxide levels, p47(phox) and gp91(phox) expression, p47(phox) translocation, and Rac1 activation were lower in the RR group than in the I/R group. In conclusion, the neural protective effect of interrupted reperfusion is at least partly mediated by decreasing the expression and assembly of NADPH oxidase and the levels of NADPH oxidase-derived superoxide. The most striking reduction Rac1-GTP in the RR group suggests that interrupted reperfusion also acts on the activation of assembled NADPH oxidase by reducing the availability of Rac1-GTP. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. A multi-channel high-resolution time recorder system

    International Nuclear Information System (INIS)

    Zhang Lingyun; Yang Xiaojun; Song Kezhu; Wang Yanfang

    2004-01-01

    This paper introduces a multi-channel and high-speed time recorder system, which was originally designed to work in the experiments of quantum cryptography research. The novelty of the system is that all the hardware logic is performed by only one FPGA. The system can achieve several desirable features, such as simplicity, high resolution and high processing speed. (authors)

  12. RTEMS Centre - Support and Maintenance Centre to RTEMS Operating System

    Science.gov (United States)

    Silva, H.; Constantino, A.; Freitas, D.; Coutinho, M.; Faustino, S.; Mota, M.; Colaço, P.; Sousa, J.; Dias, L.; Damjanovic, B.; Zulianello, M.; Rufino, J.

    2009-05-01

    RTEMS CENTRE - Support and Maintenance Centre to RTEMS Operating System is a joint ESA/Portuguese Task Force initiative to develop a support and maintenance centre to the Real-Time Executive for Multiprocessor Systems (RTEMS). This paper gives a high level visibility of the progress, the results obtained and the future work in the RTEMS CENTRE [6] and in the RTEMS Improvement [7] projects. RTEMS CENTRE started officially in November 2006, with the RTEMS 4.6.99.2 version. A full analysis of RTEMS operating system was produced. The architecture was analysed in terms of conceptual, organizational and operational concepts. The original objectives [1] of the centre were primarily to create and maintain technical expertise and competences in this RTOS, to develop a website to provide the European Space Community an entry point for obtaining support (http://rtemscentre.edisoft.pt), to design, develop, maintain and integrate some RTEMS support tools (Timeline Tool, Configuration and Management Tools), to maintain flight libraries and Board Support Packages, to develop a strong relationship with the World RTEMS Community and finally to produce some considerations in ARINC-653, DO-178B and ECSS E-40 standards. RTEMS Improvement is the continuation of the RTEMS CENTRE. Currently the RTEMS, version 4.8.0, is being facilitated for a future qualification. In this work, the validation material is being produced following the Galileo Software Standards Development Assurance Level B [5]. RTEMS is being completely tested, errors analysed, dead and deactivated code removed and tests produced to achieve 100% statement and decision coverage of source code [2]. The SW to exploit the LEON Memory Management Unit (MMU) hardware will be also added. A brief description of the expected implementations will be given.

  13. Linux real-time framework for fusion devices

    Energy Technology Data Exchange (ETDEWEB)

    Neto, Andre [Associacao Euratom-IST, Instituto de Plasmas e Fusao Nuclear, Av. Rovisco Pais, 1049-001 Lisboa (Portugal)], E-mail: andre.neto@cfn.ist.utl.pt; Sartori, Filippo; Piccolo, Fabio [Euratom-UKAEA, Culham Science Centre, Abingdon, Oxon OX14 3DB (United Kingdom); Barbalace, Antonio [Euratom-ENEA Association, Consorzio RFX, 35127 Padova (Italy); Vitelli, Riccardo [Dipartimento di Informatica, Sistemi e Produzione, Universita di Roma, Tor Vergata, Via del Politecnico 1-00133, Roma (Italy); Fernandes, Horacio [Associacao Euratom-IST, Instituto de Plasmas e Fusao Nuclear, Av. Rovisco Pais, 1049-001 Lisboa (Portugal)

    2009-06-15

    A new framework for the development and execution of real-time codes is currently being developed and commissioned at JET. The foundations of the system are Linux, the Real Time Application Interface (RTAI) and a wise exploitation of the new i386 multi-core processors technology. The driving motivation was the need to find a real-time operating system for the i386 platform able to satisfy JET Vertical Stabilisation Enhancement project requirements: 50 {mu}s cycle time. Even if the initial choice was the VxWorks operating system, it was decided to explore an open source alternative, mostly because of the costs involved in the commercial product. The work started with the definition of a precise set of requirements and milestones to achieve: Linux distribution and kernel versions to be used for the real-time operating system; complete characterization of the Linux/RTAI real-time capabilities; exploitation of the multi-core technology; implementation of all the required and missing features; commissioning of the system. Latency and jitter measurements were compared for Linux and RTAI in both user and kernel-space. The best results were attained using the RTAI kernel solution where the time to reschedule a real-time task after an external interrupt is of 2.35 {+-} 0.35 {mu}s. In order to run the real-time codes in the kernel-space, a solution to provide user-space functionalities to the kernel modules had to be designed. This novel work provided the most common functions from the standard C library and transparent interaction with files and sockets to the kernel real-time modules. Kernel C++ support was also tested, further developed and integrated in the framework. The work has produced very convincing results so far: complete isolation of the processors assigned to real-time from the Linux non real-time activities, high level of stability over several days of benchmarking operations and values well below 3 {mu}s for task rescheduling after external interrupt. From

  14. Linux real-time framework for fusion devices

    International Nuclear Information System (INIS)

    Neto, Andre; Sartori, Filippo; Piccolo, Fabio; Barbalace, Antonio; Vitelli, Riccardo; Fernandes, Horacio

    2009-01-01

    A new framework for the development and execution of real-time codes is currently being developed and commissioned at JET. The foundations of the system are Linux, the Real Time Application Interface (RTAI) and a wise exploitation of the new i386 multi-core processors technology. The driving motivation was the need to find a real-time operating system for the i386 platform able to satisfy JET Vertical Stabilisation Enhancement project requirements: 50 μs cycle time. Even if the initial choice was the VxWorks operating system, it was decided to explore an open source alternative, mostly because of the costs involved in the commercial product. The work started with the definition of a precise set of requirements and milestones to achieve: Linux distribution and kernel versions to be used for the real-time operating system; complete characterization of the Linux/RTAI real-time capabilities; exploitation of the multi-core technology; implementation of all the required and missing features; commissioning of the system. Latency and jitter measurements were compared for Linux and RTAI in both user and kernel-space. The best results were attained using the RTAI kernel solution where the time to reschedule a real-time task after an external interrupt is of 2.35 ± 0.35 μs. In order to run the real-time codes in the kernel-space, a solution to provide user-space functionalities to the kernel modules had to be designed. This novel work provided the most common functions from the standard C library and transparent interaction with files and sockets to the kernel real-time modules. Kernel C++ support was also tested, further developed and integrated in the framework. The work has produced very convincing results so far: complete isolation of the processors assigned to real-time from the Linux non real-time activities, high level of stability over several days of benchmarking operations and values well below 3 μs for task rescheduling after external interrupt. From being the

  15. Action detection by double hierarchical multi-structure space-time statistical matching model

    Science.gov (United States)

    Han, Jing; Zhu, Junwei; Cui, Yiyin; Bai, Lianfa; Yue, Jiang

    2018-03-01

    Aimed at the complex information in videos and low detection efficiency, an actions detection model based on neighboring Gaussian structure and 3D LARK features is put forward. We exploit a double hierarchical multi-structure space-time statistical matching model (DMSM) in temporal action localization. First, a neighboring Gaussian structure is presented to describe the multi-scale structural relationship. Then, a space-time statistical matching method is proposed to achieve two similarity matrices on both large and small scales, which combines double hierarchical structural constraints in model by both the neighboring Gaussian structure and the 3D LARK local structure. Finally, the double hierarchical similarity is fused and analyzed to detect actions. Besides, the multi-scale composite template extends the model application into multi-view. Experimental results of DMSM on the complex visual tracker benchmark data sets and THUMOS 2014 data sets show the promising performance. Compared with other state-of-the-art algorithm, DMSM achieves superior performances.

  16. Influence of dispatching rules on average production lead time for multi-stage production systems.

    Science.gov (United States)

    Hübl, Alexander; Jodlbauer, Herbert; Altendorfer, Klaus

    2013-08-01

    In this paper the influence of different dispatching rules on the average production lead time is investigated. Two theorems based on covariance between processing time and production lead time are formulated and proved theoretically. Theorem 1 links the average production lead time to the "processing time weighted production lead time" for the multi-stage production systems analytically. The influence of different dispatching rules on average lead time, which is well known from simulation and empirical studies, can be proved theoretically in Theorem 2 for a single stage production system. A simulation study is conducted to gain more insight into the influence of dispatching rules on average production lead time in a multi-stage production system. We find that the "processing time weighted average production lead time" for a multi-stage production system is not invariant of the applied dispatching rule and can be used as a dispatching rule independent indicator for single-stage production systems.

  17. Virological failure of staggered and simultaneous treatment interruption in HIV patients who began Efavirenz-based regimens after allergic reactions to nevirapine

    Directory of Open Access Journals (Sweden)

    Siripassorn Krittaecho

    2013-01-01

    Full Text Available Abstract Objective The objective of this work was to study the virological outcomes associated with two different types of treatment interruption strategies in patients with allergic reactions to nevirapine (NVP. We compared the virological outcomes of (1 HIV-1-infected patients who discontinued an initial NVP-based regimen because of cutaneous allergic reactions to NVP; different types of interruption strategies were used, and second-line regimen was based on efavirenz (EFV; and (2 HIV-1-infected patients who began an EFV-based regimen as a first-line therapy (controls. Methods This retrospective cohort included patients who began an EFV-based regimen, between January 2002 and December 2008, as either an initial regimen or as a subsequent regimen after resolving a cutaneous allergic reaction against an initial NVP-based regimen. The study ended in March 2010. The primary outcome was virological failure, which was defined as either (a two consecutive plasma HIV-1 RNA levels >400 copies/mL or (b a plasma HIV-1 RNA level >1,000 copies/mL plus any genotypic resistance mutation. Results A total of 559 patients were stratified into three groups: (a Simultaneous Interruption, in which the subjects simultaneously discontinued all the drugs in an NVP-based regimen following an allergic reaction (n=161; (b Staggered Interruption, in which the subjects discontinued NVP treatment while continuing nucleoside reverse transcriptase inhibitor (NRTI backbone therapy for a median of 7 days (n=82; and (c Control, in which the subjects were naïve to antiretroviral therapy (n=316. The overall median follow-up time was 43 months. Incidence of virological failure in Simultaneous Interruption was 12.9 cases per 1,000 person-years, which trended toward being higher than the incidences in Staggered Interruption (5.4 and Control (6.6. However, differences were not statistically significant. Conclusions Among the patients who had an acute allergic reaction to first

  18. Design Optimization of Multi-Cluster Embedded Systems for Real-Time Applications

    DEFF Research Database (Denmark)

    Pop, Paul; Eles, Petru; Peng, Zebo

    2004-01-01

    We present an approach to design optimization of multi-cluster embedded systems consisting of time-triggered and event-triggered clusters, interconnected via gateways. In this paper, we address design problems which are characteristic to multi-clusters: partitioning of the system functionality...... into time-triggered and event-triggered domains, process mapping, and the optimization of parameters corresponding to the communication protocol. We present several heuristics for solving these problems. Our heuristics are able to find schedulable implementations under limited resources, achieving...... an efficient utilization of the system. The developed algorithms are evaluated using extensive experiments and a real-life example....

  19. Design Optimization of Multi-Cluster Embedded Systems for Real-Time Applications

    DEFF Research Database (Denmark)

    Pop, Paul; Eles, Petru; Peng, Zebo

    2006-01-01

    We present an approach to design optimization of multi-cluster embedded systems consisting of time-triggered and event-triggered clusters, interconnected via gateways. In this paper, we address design problems which are characteristic to multi-clusters: partitioning of the system functionality...... into time-triggered and event-triggered domains, process mapping, and the optimization of parameters corresponding to the communication protocol. We present several heuristics for solving these problems. Our heuristics are able to find schedulable implementations under limited resources, achieving...... an efficient utilization of the system. The developed algorithms are evaluated using extensive experiments and a real-life example....

  20. A multi-element cosmological model with a complex space-time topology

    Science.gov (United States)

    Kardashev, N. S.; Lipatova, L. N.; Novikov, I. D.; Shatskiy, A. A.

    2015-02-01

    Wormhole models with a complex topology having one entrance and two exits into the same space-time of another universe are considered, as well as models with two entrances from the same space-time and one exit to another universe. These models are used to build a model of a multi-sheeted universe (a multi-element model of the "Multiverse") with a complex topology. Spherical symmetry is assumed in all the models. A Reissner-Norström black-hole model having no singularity beyond the horizon is constructed. The strength of the central singularity of the black hole is analyzed.

  1. Multi-channel time-division integrator in HL-2A

    International Nuclear Information System (INIS)

    Yan Ji

    2008-01-01

    HL-2A is China's first Tokamak device with divertor configuration (magnetic confinement controlled nuclear fusion device). To find out the details of on-going fusion reaction at different times is of important significance in achieving controlled nuclear fusion. We developed a new type multi-channel time-division integrator for HL-2A. It has functions of automatic cutting off negative pulse of the input signals, optional integrating time division spacing 0.2-1 ms, TTL starting trigger signal, automatic regularly work 20 s, and integrating 10 channel at the same time. (authors)

  2. Temporal analysis and scheduling of hard real-time radios running on a multi-processor

    NARCIS (Netherlands)

    Moreira, O.

    2012-01-01

    On a multi-radio baseband system, multiple independent transceivers must share the resources of a multi-processor, while meeting each its own hard real-time requirements. Not all possible combinations of transceivers are known at compile time, so a solution must be found that either allows for

  3. Sequential hand hygiene promotion contributes to a reduced nosocomial bloodstream infection rate among very low-birth weight infants: an interrupted time series over a 10-year period.

    Science.gov (United States)

    Helder, Onno K; Brug, Johannes; van Goudoever, Johannes B; Looman, Caspar W N; Reiss, Irwin K M; Kornelisse, René F

    2014-07-01

    Sustained high compliance with hand hygiene (HH) is needed to reduce nosocomial bloodstream infections (NBSIs). However, over time, a wash out effect often occurs. We studied the long-term effect of sequential HH-promoting interventions. An observational study with an interrupted time series analysis of the occurrence of NBSI was performed in very low-birth weight (VLBW) infants. Interventions consisted of an education program, gain-framed screen saver messages, and an infection prevention week with an introduction on consistent glove use. A total of 1,964 VLBW infants admitted between January 1, 2002, and December 31, 2011, were studied. The proportion of infants with ≥1 NBSI decreased from 47.6%-21.2% (P Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  4. A multi-objective genetic approach to domestic load scheduling in an energy management system

    International Nuclear Information System (INIS)

    Soares, Ana; Antunes, Carlos Henggeler; Oliveira, Carlos; Gomes, Álvaro

    2014-01-01

    In this paper a multi-objective genetic algorithm is used to solve a multi-objective model to optimize the time allocation of domestic loads within a planning period of 36 h, in a smart grid context. The management of controllable domestic loads is aimed at minimizing the electricity bill and the end-user’s dissatisfaction concerning two different aspects: the preferred time slots for load operation and the risk of interruption of the energy supply. The genetic algorithm is similar to the Elitist NSGA-II (Nondominated Sorting Genetic Algorithm II), in which some changes have been introduced to adapt it to the physical characteristics of the load scheduling problem and improve usability of results. The mathematical model explicitly considers economical, technical, quality of service and comfort aspects. Illustrative results are presented and the characteristics of different solutions are analyzed. - Highlights: • A genetic algorithm similar to the NSGA-II is used to solve a multi-objective model. • The optimized time allocation of domestic loads in a smart grid context is achieved. • A variable preference profile for the operation of the managed loads is included. • A safety margin is used to account for the quality of the energy services provided. • A non-dominated front with the solutions in the two-objective space is obtained

  5. The group-based social skills training SOSTA-FRA in children and adolescents with high functioning autism spectrum disorder--study protocol of the randomised, multi-centre controlled SOSTA--net trial.

    Science.gov (United States)

    Freitag, Christine M; Cholemkery, Hannah; Elsuni, Leyla; Kroeger, Anne K; Bender, Stephan; Kunz, Cornelia Ursula; Kieser, Meinhard

    2013-01-07

    Group-based social skills training (SST) has repeatedly been recommended as treatment of choice in high-functioning autism spectrum disorder (HFASD). To date, no sufficiently powered randomised controlled trial has been performed to establish efficacy and safety of SST in children and adolescents with HFASD. In this randomised, multi-centre, controlled trial with 220 children and adolescents with HFASD it is hypothesized, that add-on group-based SST using the 12 weeks manualised SOSTA-FRA program will result in improved social responsiveness (measured by the parent rated social responsiveness scale, SRS) compared to treatment as usual (TAU). It is further expected, that parent and self reported anxiety and depressive symptoms will decline and pro-social behaviour will increase in the treatment group. A neurophysiological study in the Frankfurt HFASD subgroup will be performed pre- and post treatment to assess changes in neural function induced by SST versus TAU. The SOSTA - net trial is designed as a prospective, randomised, multi-centre, controlled trial with two parallel groups. The primary outcome is change in SRS score directly after the intervention and at 3 months follow-up. Several secondary outcome measures are also obtained. The target sample consists of 220 individuals with ASD, included at the six study centres. This study is currently one of the largest trials on SST in children and adolescents with HFASD worldwide. Compared to recent randomised controlled studies, our study shows several advantages with regard to in- and exclusion criteria, study methods, and the therapeutic approach chosen, which can be easily implemented in non-university-based clinical settings. ISRCTN94863788--SOSTA--net: Group-based social skills training in children and adolescents with high functioning autism spectrum disorder.

  6. Protection of spermatogenisis during X-irradiation and chemotherapy by temporary blood flow interruption

    International Nuclear Information System (INIS)

    Vliet, J. van.

    1989-01-01

    In an animal model the possibility was tested to interrupt the blood flow to the testis temporarily and repeatedly. Subsequently, it was investigated whether blood flow interuption during irradiation or during cytostatic drug administration could limit the damage induced to the spermatogonial stem cells. The effect of repeatedly blood flow interruptions on spermatogenesis was evaluated. (author). 192 refs.; 15 figs.; 11 tabs

  7. Effects of elevated temperatures during interruption of irradiation on Harwell Red 4034 PMMA and Kodak Biomax alanine film dosimetry systems

    Science.gov (United States)

    Sidereas, P.; Patil, D. S.; Garcia, R.; Tracy, R. P.; Holzman, J. M.

    2007-11-01

    In the industrial setting it is not uncommon for a process interruption to occur during irradiation. In this event, dosimeters may be exposed to prolonged periods of elevated temperature without exposure to ionizing radiation. Once the process is restarted, the same dosimeters are exposed to ionizing radiation in order to achieve target dose. The goal of this experiment was to simulate a process interruption within limits and quantify the effects of a combination of factors (heat, time, and fractionation) on dosimeter response. We present an in-depth experimental study on the response of dosimeters that have been irradiated, stored for a fixed period of time at several temperatures, and then re-irradiated. This study was performed using Harwell Red 4034 polymethylmethacrylate (PMMA) and Kodak BioMax alanine film dosimeters.

  8. Short video interventions to reduce mental health stigma: a multi-centre randomised controlled trial in nursing high schools.

    Science.gov (United States)

    Winkler, Petr; Janoušková, Miroslava; Kožený, Jiří; Pasz, Jiří; Mladá, Karolína; Weissová, Aneta; Tušková, Eva; Evans-Lacko, Sara

    2017-12-01

    We aimed to assess whether short video interventions could reduce stigma among nursing students. A multi-centre, randomised controlled trial was conducted. Participating schools were randomly selected and randomly assigned to receive: (1) an informational leaflet, (2) a short video intervention or (3) a seminar involving direct contact with a service user. The Community Attitudes towards Mental Illness (CAMI) and Reported and Intended Behaviour Scale (RIBS) were selected as primary outcome measures. SPANOVA models were built and Cohen's d calculated to assess the overall effects in each of the trial arms. Compared to the baseline, effect sizes immediately after the intervention were small in the flyer arm (CAMI: d = 0.25; RIBS: d = 0.07), medium in the seminar arm (CAMI: d = 0.61; RIBS: d = 0.58), and medium in the video arm (CAMI: d = 0.49 RIBS: d = 0.26; n = 237). Effect sizes at the follow-up were vanishing in the flyer arm (CAMI: d = 0.05; RIBS: d = 0.04), medium in the seminar arm (CAMI: d = 0.43; RIBS: d = 0.26; n = 254), and small in the video arm (CAMI: d = 0.22 RIBS: d = 0.21; n = 237). Seminar had the strongest and relatively stable effect on students' attitudes and intended behaviour, but the effect of short video interventions was also considerable and stable over time. Since short effective video interventions are relatively cheap, conveniently accessible and easy to disseminate globally, we recommend them for further research and development.

  9. Expanding the Use of Time-Based Metering: Multi-Center Traffic Management Advisor

    Science.gov (United States)

    Landry, Steven J.; Farley, Todd; Hoang, Ty

    2005-01-01

    Time-based metering is an efficient air traffic management alternative to the more common practice of distance-based metering (or "miles-in-trail spacing"). Despite having demonstrated significant operational benefit to airspace users and service providers, time-based metering is used in the United States for arrivals to just nine airports and is not used at all for non-arrival traffic flows. The Multi-Center Traffic Management Advisor promises to bring time-based metering into the mainstream of air traffic management techniques. Not constrained to operate solely on arrival traffic, Multi-Center Traffic Management Advisor is flexible enough to work in highly congested or heavily partitioned airspace for any and all traffic flows in a region. This broader and more general application of time-based metering is expected to bring the operational benefits of time-based metering to a much wider pool of beneficiaries than is possible with existing technology. It also promises to facilitate more collaborative traffic management on a regional basis. This paper focuses on the operational concept of the Multi-Center Traffic Management Advisor, touching also on its system architecture, field test results, and prospects for near-term deployment to the United States National Airspace System.

  10. Impact of pharmaceutical policy interventions on utilization of antipsychotic medicines in Finland and Portugal in times of economic recession: interrupted time series analyses.

    Science.gov (United States)

    Leopold, Christine; Zhang, Fang; Mantel-Teeuwisse, Aukje K; Vogler, Sabine; Valkova, Silvia; Ross-Degnan, Dennis; Wagner, Anita K

    2014-07-25

    To analyze the impacts of pharmaceutical sector policies implemented to contain country spending during the economic recession--a reference price system in Finland and a mix of policies including changes in reimbursement rates, a generic promotion campaign and discounts granted to the public payer in Portugal - on utilization of, as a proxy for access to, antipsychotic medicines. We obtained monthly IMS Health sales data in standard units of antipsychotic medicines in Portugal and Finland for the period January 2007 to December 2011. We used an interrupted time series design to estimate changes in overall use and generic market shares by comparing pre-policy and post-policy levels and trends. Both countries' policy approaches were associated with slight, likely unintended, decreases in overall use of antipsychotic medicines and with increases in generic market shares of major antipsychotic products. In Finland, quetiapine and risperidone generic market shares increased substantially (estimates one year post-policy compared to before, quetiapine: 6.80% [3.92%, 9.68%]; risperidone: 11.13% [6.79%, 15.48%]. The policy interventions in Portugal resulted in a substantially increased generic market share for amisulpride (estimate one year post-policy compared to before: 22.95% [21.01%, 24.90%]; generic risperidone already dominated the market prior to the policy interventions. Different policy approaches to contain pharmaceutical expenditures in times of the economic recession in Finland and Portugal had intended--increased use of generics--and likely unintended--slightly decreased overall sales, possibly consistent with decreased access to needed medicines--impacts. These findings highlight the importance of monitoring and evaluating the effects of pharmaceutical policy interventions on use of medicines and health outcomes.

  11. Prediction of SFL Interruption Performance from the Results of Arc Simulation during High-Current Phase

    Science.gov (United States)

    Lee, Jong-Chul; Lee, Won-Ho; Kim, Woun-Jea

    2015-09-01

    The design and development procedures of SF6 gas circuit breakers are still largely based on trial and error through testing although the development costs go higher every year. The computation cannot cover the testing satisfactorily because all the real processes arc not taken into account. But the knowledge of the arc behavior and the prediction of the thermal-flow inside the interrupters by numerical simulations are more useful than those by experiments due to the difficulties to obtain physical quantities experimentally and the reduction of computational costs in recent years. In this paper, in order to get further information into the interruption process of a SF6 self-blast interrupter, which is based on a combination of thermal expansion and the arc rotation principle, gas flow simulations with a CFD-arc modeling are performed during the whole switching process such as high-current period, pre-current zero period, and current-zero period. Through the complete work, the pressure-rise and the ramp of the pressure inside the chamber before current zero as well as the post-arc current after current zero should be a good criterion to predict the short-line fault interruption performance of interrupters.

  12. Deconsolidation and combustion performance of thermally consolidated propellants deterred by multi-layers coating

    Directory of Open Access Journals (Sweden)

    Zheng-gang Xiao

    2014-06-01

    Full Text Available Both heating and solvent-spray methods are used to consolidate the standard grains of double-base oblate sphere propellants plasticized with triethyleneglycol dinitrate (TEGDN (TEGDN propellants to high density propellants. The obtained consolidated propellants are deterred and coated with the slow burning multi-layer coating. The maximum compaction density of deterred and coated consolidated propellants can reach up to 1.39 g/cm3. Their mechanic, deconsolidation and combustion performances are tested by the materials test machine, interrupted burning set-up and closed vessel, respectively. The static compression strength of consolidated propellants deterred by multi-layer coating increases significantly to 18 MPa, indicating that they can be applied in most circumstances of charge service. And the samples are easy to deconsolidate in the interrupted burning test. Furthermore, the closed bomb burning curves of the samples indicate a two-stage combustion phenomenon under the condition of certain thickness of coated multi-layers. After the outer deterred multi-layer coating of consolidated samples is finished burning, the inner consolidated propellants continue to burn and breakup into aggregates and grains. The high burning progressivity can be carefully obtained by the smart control of deconsolidation process and duration of consolidated propellants. The preliminary results of consolidated propellants show that a rapid deconsolidation process at higher deconsolidation pressure is presented in the dynamic vivacity curves of closed bomb test. Higher density and higher macro progressivity of consolidated propellants can be obtained by the techniques in this paper.

  13. Reconfiguration in FPGA-Based Multi-Core Platforms for Hard Real-Time Applications

    DEFF Research Database (Denmark)

    Pezzarossa, Luca; Schoeberl, Martin; Sparsø, Jens

    2016-01-01

    -case execution-time of tasks of an application that determines the systems ability to respond in time. To support this focus, the platform must provide service guarantees for both communication and computation resources. In addition, many hard real-time applications have multiple modes of operation, and each......In general-purpose computing multi-core platforms, hardware accelerators and reconfiguration are means to improve performance; i.e., the average-case execution time of a software application. In hard real-time systems, such average-case speed-up is not in itself relevant - it is the worst...... mode has specific requirements. An interesting perspective on reconfigurable computing is to exploit run-time reconfiguration to support mode changes. In this paper we explore approaches to reconfiguration of communication and computation resources in the T-CREST hard real-time multi-core platform...

  14. Pattern of intensive phase treatment outcomes of multi-drug resistant ...

    African Journals Online (AJOL)

    Pattern of intensive phase treatment outcomes of multi-drug resistant tuberculosis in University of Port Harcourt Treatment Centre: a review of records from ... Data on patients' age, sex, HIV status, treatment outcomes were extracted from the hospital book records into a computer data sheet at the UPTH treatment centre.

  15. Accommodating interruptions: A grounded theory of young people with asthma.

    Science.gov (United States)

    Hughes, Mary; Savage, Eileen; Andrews, Tom

    2018-01-01

    The aim of this study was to develop an explanatory theory on the lives of young people with asthma, issues affecting them and the impact of asthma on their day-to-day lives. Accommodating Interruptions is a theory that explains young people's concerns about living with asthma. Although national and international asthma management guidelines exist, it is accepted that the symptom control of asthma among the young people population is poor. This study was undertaken using Classic Grounded Theory. Data were collected through in-depth interviews and clinic consultations with young people aged 11-16 years who had asthma for over 1 year. Data were also collected from participant diaries. Constant comparative analysis, theoretical coding and memo writing were used to develop the substantive theory. The theory explains how young people resolve their main concern of being restricted by Accommodating Interruptions in their lives. They do this by assimilating behaviours in balance finding, moderating influence, fitting in and assuming control minimising the effects of asthma on their everyday lives. The theory of Accommodating Interruptions explains young people's asthma management behaviours in a new way. It allows us to understand how and why young people behave the way they do because they want to participate and be included in everyday activities, events and relationships. The theory adds to the body of knowledge on how young people with asthma live their day-to-day lives and it challenges some existing viewpoints in the literature regarding their behaviours. The findings have implications for developing services to support young people in a more meaningful way as they accommodate the interruptions associated with asthma in their lives. © 2017 John Wiley & Sons Ltd.

  16. Differentiating between adductor and abductor spasmodic dysphonia using airflow interruption

    Science.gov (United States)

    Hoffman, Matthew R.; Jiang, Jack J.; Rieves, Adam L.; McElveen, Kelsey A.B.; Ford, Charles N.

    2009-01-01

    Objective To measure the laryngeal resistance (RL), subglottal pressure (Ps), and mean flow rate (MFR) of adductor (ADSD) and abductor (ABSD) spasmodic dysphonia patients using the airflow interrupter. Methods The RL of six ABSD and seven ADSD patients was measured using the airflow interrupter, a noninvasive device designed to measure MFR and Ps via mechanical balloon valve interruption. Subjects performed ten trials at each of two intensity levels, with each trial consisting of a sustained /a/ during which phonation was interrupted for 500 ms. Laryngeal resistance was calculated as subglottal pressure divided by airflow. Results Mean RL for the ADSD and ABSD subtypes at 65 dB were 24.78 cmH2O/l/s and 14.51 cmH2O/l/s, respectively (p = 0.04). Mean RL at 70 dB were 40.02 cmH2O/l/s and 15.84 cmH2O/l/s (p = 0.014). Ps for the ADSD and ABSD subtypes at 65 dB were 10.23 cmH2O and 8.32 cmH2O, respectively (p = 0.582). At the 70 dB level, Ps were 12.39 cmH2O and 11.78 cmH2O (p = 0.886). MFR for the ADSD and ABSD subtypes at 65 dB were 435 ml/s and 746 ml/s (p = 0.205). Mean MFR at 70 dB were 518 ml/s and 848 ml/s (p = 0.198). Conclusion Noninvasive measurements of RL may be useful for differentiating between ADSD and ABSD. This simple objective test which produces a quantitative output could be used to evaluate laryngeal function in patients with spasmodic dysphonia. PMID:19554636

  17. 33-GVA interrupter test facility

    International Nuclear Information System (INIS)

    Parsons, W.M.; Honig, E.M.; Warren, R.W.

    1979-01-01

    The use of commercial ac circuit breakers for dc switching operations requires that they be evaluated to determine their dc limitations. Two 2.4-GVA facilities have been constructed and used for this purpose at LASL during the last several years. In response to the increased demand on switching technology, a 33-GVA facility has been constructed. Novel features incorporated into this facility include (1) separate capacitive and cryogenic inductive energy storage systems, (2) fiber-optic controls and optically-coupled data links, and (3) digital data acquisition systems. Facility details and planned tests on an experimental rod-array vacuum interrupter are presented

  18. 76 FR 35014 - Certain Ground Fault Circuit Interrupters and Products Containing Same; Notice of Commission...

    Science.gov (United States)

    2011-06-15

    ... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-739] Certain Ground Fault Circuit Interrupters and Products Containing Same; Notice of Commission Determination Not To Review an Initial... fault circuit interrupters and products containing the same by reason of infringement of various claims...

  19. The impact of public transportation strikes on use of a bicycle share program in London: interrupted time series design.

    Science.gov (United States)

    Fuller, Daniel; Sahlqvist, Shannon; Cummins, Steven; Ogilvie, David

    2012-01-01

    To investigate the immediate and sustained effects of two London Underground strikes on use of a public bicycle share program. An interrupted time series design was used to examine the impact of two 24 hour strikes on the total number of trips per day and mean trip duration per day on the London public bicycle share program. The strikes occurred on September 6th and October 4th 2010 and limited service on the London Underground. The mean total number of trips per day over the whole study period was 14,699 (SD=5390) while the mean trip duration was 18.5 minutes (SD=3.7). Significant increases in daily trip count were observed following strike 1 (3864: 95% CI 125 to 7604) and strike 2 (11,293: 95% CI 5169 to 17,416). Events that greatly constrain the primary motorised mode of transportation for a population may have unintended short-term effects on travel behaviour. These findings suggest that limiting transportation options may have the potential to increase population levels of physical activity by promoting the use of cycling. Copyright © 2011 Elsevier Inc. All rights reserved.

  20. The impact of "Option B" on HIV transmission from mother to child in Rwanda: An interrupted time series analysis.

    Science.gov (United States)

    Abimpaye, Monique; Kirk, Catherine M; Iyer, Hari S; Gupta, Neil; Remera, Eric; Mugwaneza, Placidie; Law, Michael R

    2018-01-01

    Nearly a quarter of a million children have acquired HIV, prompting the implementation of new protocols-Option B and B+-for treating HIV+ pregnant women. While efficacy has been demonstrated in randomized trials, there is limited real-world evidence on the impact of these changes. Using longitudinal, routinely collected data we assessed the impact of the adoption of WHO Option B in Rwanda on mother to infant transmission. We used interrupted time series analysis to evaluate the impact of Option B on mother-to-child HIV transmission in Rwanda. Our primary outcome was the proportion of HIV tests in infants with positive results at six weeks of age. We included data for 20 months before and 22 months after the 2010 policy change. Of the 15,830 HIV tests conducted during our study period, 392 tested positive. We found a significant decrease in both the level (-2.08 positive tests per 100 tests conducted, 95% CI: -2.71 to -1.45, p Option B in Rwanda contributed to an immediate decrease in the rate of HIV transmission from mother to child. This suggests other countries may benefit from adopting these WHO guidelines.

  1. A designated centre for people with disabilities operated by Daughters of Charity Disability Support Services Ltd., Dublin 7

    LENUS (Irish Health Repository)

    Muller, Ueli C

    2011-04-07

    Abstract Background The International Multi-centre ADHD Genetics (IMAGE) project with 11 participating centres from 7 European countries and Israel has collected a large behavioural and genetic database for present and future research. Behavioural data were collected from 1068 probands with the combined type of attention deficit\\/hyperactivity disorder (ADHD-CT) and 1446 \\'unselected\\' siblings. The aim was to analyse the IMAGE sample with respect to demographic features (gender, age, family status, and recruiting centres) and psychopathological characteristics (diagnostic subtype, symptom frequencies, age at symptom detection, and comorbidities). A particular focus was on the effects of the study design and the diagnostic procedure on the homogeneity of the sample in terms of symptom-based behavioural data, and potential consequences for further analyses based on these data. Methods Diagnosis was based on the Parental Account of Childhood Symptoms (PACS) interview and the DSM-IV items of the Conners\\' teacher questionnaire. Demographics of the full sample and the homogeneity of a subsample (all probands) were analysed by using robust statistical procedures which were adjusted for unequal sample sizes and skewed distributions. These procedures included multi-way analyses based on trimmed means and winsorised variances as well as bootstrapping. Results Age and proband\\/sibling ratios differed between participating centres. There was no significant difference in the distribution of gender between centres. There was a significant interaction between age and centre for number of inattentive, but not number of hyperactive symptoms. Higher ADHD symptom frequencies were reported by parents than teachers. The diagnostic symptoms differed from each other in their frequencies. The face-to-face interview was more sensitive than the questionnaire. The differentiation between ADHD-CT probands and unaffected siblings was mainly due to differences in hyperactive

  2. Environmental gamma radiation levels around various DAE research centres

    International Nuclear Information System (INIS)

    Takale, R.A.; Swarnakar, M.; Shetty, P.G.; Sahu, S.K.; Pandit, G.G.

    2014-01-01

    This paper presents the gamma radiation levels of four research centres viz. Bhabha Atomic Research Centre (BARC), Trombay; Indira Gandhi Centre for Atomic Research (IGCAR), Kalpakkam; Variable Energy Cyclotron Centre (VECC), Kolkata; Raja Ramanna Centre for Advanced Technology (RRCAT), Indore; and an industry Board of Radiation and Isotope Technology (BRIT), Vashi. BARC is India's premier nuclear research facility and is a multi-disciplinary research centre with extensive infrastructure for advanced research and development (R and D). IGCAR, Kalpakkam is engaged in scientific research and advanced engineering programme towards the development of Fast Breeder Reactor technology. VECC Kolkata is dedicated to carry out frontier R and D in the fields of Accelerator Science and Technology, Nuclear Science (Theoretical and Experimental), and Material Science etc. RRCAT, Indore has rapidly grown into a premier institute for R and D in lasers, accelerators and their applications. BRIT, Vashi unit is involved in production, development, and supply of radioisotope based products and provision of isotope applications, radiation processing, radio analytical services etc. With an objective to keep a watch on the prevailing environmental background gamma radiation level around all the DAE installations, routine monitoring programme are being carried out using the Thermo Luminescent Dosimeters (TLDs). TLDs provide the simple, inexpensive and precise measurement of small, integrated, external gamma radiation dose rate. The general practice of this programme is to observe the outdoor gamma radiation levels. This paper summarizes the methodology and gamma radiation levels of four research centres viz. BARC, IGCAR, VECC, RRCAT and an industry BRIT, Vashi

  3. The multi temporal/multi-model approach to predictive uncertainty assessment in real-time flood forecasting

    Science.gov (United States)

    Barbetta, Silvia; Coccia, Gabriele; Moramarco, Tommaso; Brocca, Luca; Todini, Ezio

    2017-08-01

    This work extends the multi-temporal approach of the Model Conditional Processor (MCP-MT) to the multi-model case and to the four Truncated Normal Distributions (TNDs) approach, demonstrating the improvement on the single-temporal one. The study is framed in the context of probabilistic Bayesian decision-making that is appropriate to take rational decisions on uncertain future outcomes. As opposed to the direct use of deterministic forecasts, the probabilistic forecast identifies a predictive probability density function that represents a fundamental knowledge on future occurrences. The added value of MCP-MT is the identification of the probability that a critical situation will happen within the forecast lead-time and when, more likely, it will occur. MCP-MT is thoroughly tested for both single-model and multi-model configurations at a gauged site on the Tiber River, central Italy. The stages forecasted by two operative deterministic models, STAFOM-RCM and MISDc, are considered for the study. The dataset used for the analysis consists of hourly data from 34 flood events selected on a time series of six years. MCP-MT improves over the original models' forecasts: the peak overestimation and the rising limb delayed forecast, characterizing MISDc and STAFOM-RCM respectively, are significantly mitigated, with a reduced mean error on peak stage from 45 to 5 cm and an increased coefficient of persistence from 0.53 up to 0.75. The results show that MCP-MT outperforms the single-temporal approach and is potentially useful for supporting decision-making because the exceedance probability of hydrometric thresholds within a forecast horizon and the most probable flooding time can be estimated.

  4. Impact of a COPD discharge care bundle on readmissions following admission with acute exacerbation: interrupted time series analysis.

    Directory of Open Access Journals (Sweden)

    Anthony A Laverty

    Full Text Available We evaluated the impact of a COPD discharge care bundle on readmission rates following hospitalisation with an acute exacerbation.Interrupted time series analysis, comparing readmission rates for COPD exacerbations at nine trusts that introduced the bundle, to two comparison groups; (1 other NHS trusts in London and (2 all other NHS trusts in England. Care bundles were implemented at different times for different NHS trusts, ranging from October 2009 to April 2011.Nine NHS acute trusts in the London, England.Patients aged 45 years and older admitted to an NHS acute hospital in England for acute exacerbation of COPD. Data come from Hospital Episode Statistics, April 2002 to March 2012.Annual trend readmission rates (and in total bed days within 7, 28 and 90 days, before and after implementation.In hospitals introducing the bundle readmission rates were rising before implementation and falling afterwards (e.g. readmissions within 28 days +2.13% per annum (pa pre and -5.32% pa post (p for difference in trends = 0.012. Following implementation, readmission rates within 7 and 28 day were falling faster than among other trusts in London, although this was not statistically significant (e.g. readmissions within 28 days -4.6% pa vs. -3.2% pa, p = 0.44. Comparisons with a national control group were similar.The COPD discharge care bundle appeared to be associated with a reduction in readmission rate among hospitals using it. The significance of this is unclear because of changes to background trends in London and nationally.

  5. Methodology for the study of the dolomite porosity in essay of interrupted sulfation

    OpenAIRE

    Ávila, Ivonete; Crnkovic, Paula M.; Milioli, Fernando E.

    2010-01-01

    The aim of this work is to propose a methodology to evaluate the evolution of the pore blockage of limestone during the sulfation reaction. The experiments were performed for a national limestone (dolomite) with average particle size of 545 μm in interrupted sulfation tests were conducted at seven different times and at three different temperatures of the process. The empirical data were obtained from porosimetry tests to establish BET surface area, volume and average size of pore and di...

  6. HIV reservoirs and immune surveillance evasion cause the failure of structured treatment interruptions: a computational study.

    Directory of Open Access Journals (Sweden)

    Emiliano Mancini

    Full Text Available Continuous antiretroviral therapy is currently the most effective way to treat HIV infection. Unstructured interruptions are quite common due to side effects and toxicity, among others, and cannot be prevented. Several attempts to structure these interruptions failed due to an increased morbidity compared to continuous treatment. The cause of this failure is poorly understood and often attributed to drug resistance. Here we show that structured treatment interruptions would fail regardless of the emergence of drug resistance. Our computational model of the HIV infection dynamics in lymphoid tissue inside lymph nodes, demonstrates that HIV reservoirs and evasion from immune surveillance themselves are sufficient to cause the failure of structured interruptions. We validate our model with data from a clinical trial and show that it is possible to optimize the schedule of interruptions to perform as well as the continuous treatment in the absence of drug resistance. Our methodology enables studying the problem of treatment optimization without having impact on human beings. We anticipate that it is feasible to steer new clinical trials using computational models.

  7. An investigation into the opportunities and barriers to participation in a radiographer comment scheme, in a multi-centre NHS trust

    International Nuclear Information System (INIS)

    Lancaster, Anne; Hardy, Maryann

    2012-01-01

    Introduction and purpose: Despite the United Kingdom College of Radiographers aspiration that first line reporting or commenting by radiographers be normal practice, radiographers have not as yet embraced these opportunities in clinical practice and the number of radiographer commenting (initial reporting) schemes in operation is currently limited. This study explores radiographer opinion with regard to commenting with the aim of establishing the perceived opportunities and barriers to operating a commenting scheme with respect to trauma radiography. Method: A survey of 79 radiographers working within a single multi-centre Trust in the north of England was undertaken using a questionnaire. Attitudinal statements were used to elicit information on perceived opportunities and barriers to the implementation of radiographer commenting. Results: Fifty three questionnaires were returned within the specified time frame (n-53/79; 67.1%). A number of barriers to implementing a commenting scheme were identified including time, technology, anatomical confidence and training. Opportunities included improving professional profile and increased professional contribution to decision making within the patient pathway. No correlation was demonstrated between respondent demographic and responses suggesting that opinions expressed were not influenced by hospital site, radiographer grade or years experience. Conclusion: Radiographers generally had a positive attitude towards the implementation of radiographer commenting and felt that their operation was both beneficial to patient care and the professional profile of radiographers. However, a number of barriers were identified and while concerns regarding training may be increasingly addressed by the Department of Health’s e-learning image interpretation package, the impact of changes in technology and subsequent service operation have not yet been fully evaluated.

  8. Finite element analyses of a heater-interruption in the HAW test field

    International Nuclear Information System (INIS)

    Horn, B.A. van den.

    1991-09-01

    In this report the results of two finite element analyses of the HAW field are presented. The determination of the influence of a heater-interruption on the tube load as well as the differences in the evaluation of the tube load for both types of boreholes (type A and type B) are the main objectives of this report. Axisymmetric models are made for both type of boreholes in order to simulate this heater-interruption. It appeared that a heater-interruption of 4 hours leads to a temperature drop of 17.2deg C at the borehole wall and to a maximum reduction of the tube load of 1.76 MPa. About 20 days after reparation of the heaters of the heaters the evolution of the maximum temperature and the maximum tube load will be rehabilitated; the difference with the corresponding evolutions due to an uninterrupted heat-production are negligible. (author). 9 refs.; 25 figs.; 5 tabs

  9. Feasibility analysis of a novel hybrid-type superconducting circuit breaker in multi-terminal HVDC networks

    Science.gov (United States)

    Khan, Umer Amir; Lee, Jong-Geon; Seo, In-Jin; Amir, Faisal; Lee, Bang-Wook

    2015-11-01

    Voltage source converter-based HVDC systems (VSC-HVDC) are a better alternative than conventional thyristor-based HVDC systems, especially for developing multi-terminal HVDC systems (MTDC). However, one of the key obstacles in developing MTDC is the absence of an adequate protection system that can quickly detect faults, locate the faulty line and trip the HVDC circuit breakers (DCCBs) to interrupt the DC fault current. In this paper, a novel hybrid-type superconducting circuit breaker (SDCCB) is proposed and feasibility analyses of its application in MTDC are presented. The SDCCB has a superconducting fault current limiter (SFCL) located in the main current path to limit fault currents until the final trip signal is received. After the trip signal the IGBT located in the main line commutates the current into a parallel line where DC current is forced to zero by the combination of IGBTs and surge arresters. Fault simulations for three-, four- and five-terminal MTDC were performed and SDCCB performance was evaluated in these MTDC. Passive current limitation by SFCL caused a significant reduction of fault current interruption stress in the SDCCB. It was observed that the DC current could change direction in MTDC after a fault and the SDCCB was modified to break the DC current in both the forward and reverse directions. The simulation results suggest that the proposed SDCCB could successfully suppress the DC fault current, cause a timely interruption, and isolate the faulty HVDC line in MTDC.

  10. Time stamp technique using a nuclear emulsion multi-stage shifter for gamma-ray telescope

    International Nuclear Information System (INIS)

    Takahashi, Satoru; Aoki, Shigeki; Rokujo, Hiroki; Hamada, Kaname; Komatsu, Masahiro; Morishima, Kunihiro; Nakamura, Mitsuhiro; Nakano, Toshiyuki; Niwa, Kimio; Sato, Osamu; Yoshioka, Teppei; Kodama, Koichi

    2010-01-01

    Nuclear emulsion has a potential use as a gamma-ray telescope with high angular resolution. For this application it is necessary to know the time when each track was recorded in the emulsion. In previous experiments using nuclear emulsion, various efforts were used to associate time to nuclear emulsion tracks and to improve the time resolution. Using a high speed readout system for nuclear emulsion together with a clock-based multi-stage emulsion shifter, we invented a technique to give a time-stamp to emulsion tracks and greatly improve the time resolution. A test experiment with a 2-stage shifter was used to demonstrate the principle of multi-stage shifting, and we achieved a time resolution 1.5 s for 12.1 h (about 1 part in 29 000) with the time stamp reliability 97% and the time stamp efficiency 98%. This multi-stage shifter can achieve the time resolution required for a gamma-ray telescope and can also be applied to another cosmic ray observations and accelerator experiments using nuclear emulsion.

  11. A complexity analysis of the Gauss-Bessel quadrature as applied to the evaluation of multi-centre integrals over STFs

    International Nuclear Information System (INIS)

    Bouferguene, Ahmed; Safouhi, Hassan

    2006-01-01

    In a previous work (Bouferguene 2005 J. Phys. A: Math. Gen. 38 3923), we have shown that in the framework of the Gaussian integral transform, multi-centre integrals over Slater type functions can be evaluated to an acceptable accuracy using a tailored Gauss quadrature in which the weight function has the form W(σ, τ; z) = z ν exp(-σz - τ/z). To be considered a solution worth implementing within a software for routine use in ab initio molecular simulations, the method must also prove to be at least as efficient as those methods previously published in the literature. Two major results are provided in this paper. Firstly, an improvement of the procedure used to generate the roots and weights of the Gauss-Bessel quadrature is proposed. Secondly, a computational cost analysis of the present method and the SD-bar (Safouhi 2001 J. Phys. A: Math. Gen. 34 2801) based approach are compared, hence proving the equivalence of the two from a complexity point of view

  12. Multi-Core Emptiness Checking of Timed Büchi Automata using Inclusion Abstraction

    DEFF Research Database (Denmark)

    Laarman, Alfons; Olesen, Mads Chr.; Dalsgaard, Andreas

    2013-01-01

    This paper contributes to the multi-core model checking of timed automata (TA) with respect to liveness properties, by investigating checking of TA Büchi emptiness under the very coarse inclusion abstraction or zone subsumption, an open problem in this field. We show that in general Büchi emptiness...... parallel LTL model checking algorithm for timed automata. The algorithms are implemented in LTSmin, and experimental evaluations show the effectiveness and scalability of both contributions: subsumption halves the number of states in the real-world FDDI case study, and the multi-core algorithm yields...

  13. Brief Lags in Interrupted Sequential Performance: Evaluating a Model and Model Evaluation Method

    Science.gov (United States)

    2015-01-05

    interruption where they had left off. The experimenter remained present during this period to provide answers if necessary. A sheet of paper with the choice...the probabilities of different possible “paths” through predecessor/successor pairs. For exam - ple, the most likely path to selection of the correct...participant’s interruption durations. References Altmann, E.M., 2004. The preparation effect in task switching: Carryover of SOA . Memory & Cognition 32, 153

  14. 77 FR 26579 - Certain Ground Fault Circuit Interrupters and Products Containing Same; Notice of Final...

    Science.gov (United States)

    2012-05-04

    ... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-739] Certain Ground Fault Circuit... importation of certain ground fault circuit interrupters and products containing the same by reason of... entry of ground fault circuit interrupters and products containing the same that infringe one or more of...

  15. The impact of a local sugar sweetened beverage health promotion and price increase on sales in public leisure centre facilities.

    Science.gov (United States)

    Breeze, Penny; Womack, Robert; Pryce, Robert; Brennan, Alan; Goyder, Elizabeth

    2018-01-01

    We aimed to evaluate the impact of a local sugar sweetened beverages (SSB) health promotion and 20p price increase in leisure centre venues and estimate the impact on consumption. Monthly cold drinks sales data and attendance at leisure centres across the city of Sheffield were analysed over the period January 2015-July 2017. Interrupted time-series methods were employed to estimate changes in consumption per attendance of SSB and non-SSB cold drinks following the introduction of the SSB policy from August 2016 adjusting for seasonal variation and autocorrelation. SSB price elasticities were estimated with fixed effects log-log models by SSB product type (soda can, soda bottle, soda post mix, energy drinks, juice from concentrate). We estimated a 31% (95% CI 4%, 59%) reduction in units of SSB sold per attendance in the year since the policy was introduced. We did not observe substitution effects to fruit juice or water but found sales of other artificially sweetened non-SSB products increased by 27% (95% CI 6%, 47%) after the introduction of the tax. Price elasticity analysis identified that a 1% increase in price alongside health promotion leads to a 3.8% (95% CI 3.1% 4.4%) decrease in demand for SSB's. Price elasticity of demand was highest for child friendly and high caffeine energy drinks. Demand for SSB drinks at leisure centre venues is highly responsive to the policy, particularly for child-friendly and high caffeine energy drinks, compared with other SSB tax policy evaluations. The policy also increased purchases of carbonated non-SSB.

  16. Time to learn: the outlook for renewal of patient-centred education in the digital age.

    Science.gov (United States)

    Glick, T H; Moore, G T

    2001-05-01

    Major forces in society and within health systems are fragmenting patient care and clinical learning. The distancing of physician and trainee from the patient undermines learning about the patient-doctor relationship. The disconnection of care and learning from one successive venue to another impedes the ability of trainees to learn about illness longitudinally. As a conceptual piece, our methods have been those of witnessing the experiences of patients, practitioners, and students over time and observing the impact of fragmented systems and changing expectations on care and learning. We have reflected on the opportunities created by digital information systems and interactive telemedicine to help renew essential relationships. Although there is, as yet, little in the literature on educational or health outcomes of this kind of technological enablement, we anticipate opportunities for a renewed focus on the patient in that patient's own space and time. Multimedia applications can achieve not only real-time connections, but can help construct a "virtual patient" as a platform for supervision and assessment, permitting preceptors to evaluate trainee-patient interactions, utilization of Web-based data and human resources, and on-line professionalism. Just as diverse elements in society are capitalizing upon digital technology to create advantageous relationships, all of the elements in the complex systems of health care and medical training can be better connected, so as to put the patient back in the centre of care and the trainee's ongoing relationship to the patient back in the centre of education.

  17. Protective Effect of Dual-Strain Probiotics in Preterm Infants: A Multi-Center Time Series Analysis

    Science.gov (United States)

    Schwab, Frank; Garten, Lars; Geffers, Christine; Gastmeier, Petra; Piening, Brar

    2016-01-01

    Objective To determine the effect of dual-strain probiotics on the development of necrotizing enterocolitis (NEC), mortality and nosocomial bloodstream infections (BSI) in preterm infants in German neonatal intensive care units (NICUs). Design A multi-center interrupted time series analysis. Setting 44 German NICUs with routine use of dual-strain probiotics on neonatal ward level. Patients Preterm infants documented by NEO-KISS, the German surveillance system for nosocomial infections in preterm infants with birth weights below 1,500 g, between 2004 and 2014. Intervention Routine use of dual-strain probiotics containing Lactobacillus acidophilus and Bifidobacterium spp. (Infloran) on the neonatal ward level. Main outcome measures Incidences of NEC, overall mortality, mortality following NEC and nosocomial BSI. Results Data from 10,890 preterm infants in 44 neonatal wards was included in this study. Incidences of NEC and BSI were 2.5% (n = 274) and 15.0%, (n = 1631), respectively. Mortality rate was 6.1% (n = 665). The use of dual-strain probiotics significantly reduced the risk of NEC (HR = 0.48; 95% CI = 0.38–0.62), overall mortality (HR = 0.60, 95% CI = 0.44–0.83), mortality after NEC (HR = 0.51, 95% CI = 0.26–0.999) and nosocomial BSI (HR = 0.89, 95% CI = 0.81–0.98). These effects were even more pronounced in the subgroup analysis of preterm infants with birth weights below 1,000 g. Conclusion In order to reduce NEC and mortality in preterm infants, it is advisable to add routine prophylaxis with dual-strain probiotics to clinical practice in neonatal wards. PMID:27332554

  18. Conveying Sacred Knowledge through Contemporary Architectural Design: The Garma Cultural Knowledge Centre

    Directory of Open Access Journals (Sweden)

    Elizabeth Grant

    2016-01-01

    Full Text Available The Indigenous peoples of north east Arnhem Land in Australia (Yolngu overlay their culture with the customs and social behaviour of other societies to achieve positive outcomes and autonomy. Passing down cultural knowledge is intrinsic to the cultural identity of Yolngu. The paper discusses the recently completed Garma Cultural Knowledge Centre and examines the cultural knowledge conveyed through the medium of contemporary architecture design. The paper finds that the Garma Cultural Knowledge Centre combined aspects of non-Aboriginal and Aboriginal cultures to form a coherent whole with multi-facetted meanings.

  19. Viral resuppression and detection of drug resistance following interruption of a suppressive non-nucleoside reverse transcriptase inhibitor-based regimen

    DEFF Research Database (Denmark)

    Fox, Zoe; Phillips, Andrew; Cohen, Cal

    2008-01-01

    the NRTIs, or by replacing the NNRTI with another drug before interruption. Simultaneous interruption of all antiretrovirals was discouraged. Resuppression rates 4-8 months after reinitiating NNRTI-therapy were assessed, as was the detection of drug-resistance mutations within 2 months of the treatment...... regimen. NNRTI drug-resistance mutations were observed in a relatively high proportion of patients. These data provide additional support for a staggered or switched interruption strategy for NNRTI drugs.......BACKGROUND: Interruption of a non-nucleoside reverse transcriptase inhibitor (NNRTI)-regimen is often necessary, but must be performed with caution because NNRTIs have a low genetic barrier to resistance. Limited data exist to guide clinical practice on the best interruption strategy to use...

  20. The group-based social skills training SOSTA-FRA in children and adolescents with high functioning autism spectrum disorder - study protocol of the randomised, multi-centre controlled SOSTA - net trial

    Directory of Open Access Journals (Sweden)

    Freitag Christine M

    2013-01-01

    Full Text Available Abstract Background Group-based social skills training (SST has repeatedly been recommended as treatment of choice in high-functioning autism spectrum disorder (HFASD. To date, no sufficiently powered randomised controlled trial has been performed to establish efficacy and safety of SST in children and adolescents with HFASD. In this randomised, multi-centre, controlled trial with 220 children and adolescents with HFASD it is hypothesized, that add-on group-based SST using the 12 weeks manualised SOSTA–FRA program will result in improved social responsiveness (measured by the parent rated social responsiveness scale, SRS compared to treatment as usual (TAU. It is further expected, that parent and self reported anxiety and depressive symptoms will decline and pro-social behaviour will increase in the treatment group. A neurophysiological study in the Frankfurt HFASD subgroup will be performed pre- and post treatment to assess changes in neural function induced by SST versus TAU. Methods/design The SOSTA – net trial is designed as a prospective, randomised, multi-centre, controlled trial with two parallel groups. The primary outcome is change in SRS score directly after the intervention and at 3 months follow-up. Several secondary outcome measures are also obtained. The target sample consists of 220 individuals with ASD, included at the six study centres. Discussion This study is currently one of the largest trials on SST in children and adolescents with HFASD worldwide. Compared to recent randomised controlled studies, our study shows several advantages with regard to in- and exclusion criteria, study methods, and the therapeutic approach chosen, which can be easily implemented in non-university-based clinical settings. Trial registration ISRCTN94863788 – SOSTA – net: Group-based social skills training in children and adolescents with high functioning autism spectrum disorder.

  1. Developing person-centred practice: nursing outcomes arising from changes to the care environment in residential settings for older people.

    Science.gov (United States)

    McCormack, Brendan; Dewing, Jan; Breslin, Liz; Coyne-Nevin, Ann; Kennedy, Kate; Manning, Mary; Peelo-Kilroe, Lorna; Tobin, Catherine; Slater, Paul

    2010-06-01

    To present the nursing outcomes from the evaluation of developments in the care environment in residential settings for older people. The evaluation data reported here is derived from a larger national programme of work that focused on the development of person-centred practice in residential services for older people using an emancipatory practice development framework. A multi-method evaluation framework was utilised. Outcome data were collected at three time points between December 2007 and September 2009. The data reported here were collected using an instrument called the 'Person-Centred Nursing Index'. Heavy workload was the main cause of stress among nurses. Personal and professional satisfaction with the job was scored highest by the total sample of nurses. Nineteen factors were examined using the Person-Centred Nursing Index. Statistically significant changes were observed in 12 of these. In addition, there were statistically significant changes in nurses' perceptions of caring, indicating a shift from a dominant focus on 'technical' aspects of care, to one where 'intimate' aspects of care were more highly valued. The findings highlight the importance of the development of effective teamwork, workload management, time management and staff relationships in order to create a culture where there is a more democratic and inclusive approach to practice and space for the formation of person-centred relationships. © 2010 Blackwell Publishing Ltd.

  2. The costs of electricity interruptions in Spain. Are we sending the right signals?

    International Nuclear Information System (INIS)

    Linares, Pedro; Rey, Luis

    2013-01-01

    One of the objectives of energy security is the uninterrupted physical availability of energy. However, there is limited information about how much is the cost of energy supply interruptions. This information is essential to optimize investment and operating decisions to prevent energy shortages, or, alternatively, to determine the strength of the signals to be sent to the agents so that they may invest accordingly. In this paper, we estimate the economic impact of an electricity interruption in different sectors and regions of Spain. Although there are several caveats in our analysis, we find that in 2008 the cost for the Spanish economy of one kWh of electricity not supplied was above €4 even in a conservative scenario, which is higher than the signals currently being sent as incentives to avoid these interruptions. This might result in an underinvestment in short-term energy security, particularly when we add the usual risk aversion of most consumers. - Highlights: • We calculate the costs of electricity interruptions in Spain. • We find that in 2008 the cost for the Spanish economy of one kWh of electricity not supplied was around €6. • The results imply that Spain is underinvesting in short-term energy security

  3. Role of working memory and lexical knowledge in perceptual restoration of interrupted speech.

    Science.gov (United States)

    Nagaraj, Naveen K; Magimairaj, Beula M

    2017-12-01

    The role of working memory (WM) capacity and lexical knowledge in perceptual restoration (PR) of missing speech was investigated using the interrupted speech perception paradigm. Speech identification ability, which indexed PR, was measured using low-context sentences periodically interrupted at 1.5 Hz. PR was measured for silent gated, low-frequency speech noise filled, and low-frequency fine-structure and envelope filled interrupted conditions. WM capacity was measured using verbal and visuospatial span tasks. Lexical knowledge was assessed using both receptive vocabulary and meaning from context tests. Results showed that PR was better for speech noise filled condition than other conditions tested. Both receptive vocabulary and verbal WM capacity explained unique variance in PR for the speech noise filled condition, but were unrelated to performance in the silent gated condition. It was only receptive vocabulary that uniquely predicted PR for fine-structure and envelope filled conditions. These findings suggest that the contribution of lexical knowledge and verbal WM during PR depends crucially on the information content that replaced the silent intervals. When perceptual continuity was partially restored by filler speech noise, both lexical knowledge and verbal WM capacity facilitated PR. Importantly, for fine-structure and envelope filled interrupted conditions, lexical knowledge was crucial for PR.

  4. Multifaceted academic detailing program to increase pharmacotherapy for alcohol use disorder: interrupted time series evaluation of effectiveness.

    Science.gov (United States)

    Harris, Alex H S; Bowe, Thomas; Hagedorn, Hildi; Nevedal, Andrea; Finlay, Andrea K; Gidwani, Risha; Rosen, Craig; Kay, Chad; Christopher, Melissa

    2016-09-15

    Active consideration of effective medications to treat alcohol use disorder (AUD) is a consensus standard of care, yet knowledge and use of these medications are very low across diverse settings. This study evaluated the overall effectiveness a multifaceted academic detailing program to address this persistent quality problem in the US Veterans Health Administration (VHA), as well as the context and process factors that explained variation in effectiveness across sites. An interrupted time series design, analyzed with mixed-effects segmented logistic regression, was used to evaluate changes in level and rate of change in the monthly percent of patients with a clinically documented AUD who received naltrexone, acamprosate, disulfiram, or topiramate. Using data from a 20 month post-implementation period, intervention sites (n = 37) were compared to their own 16 month pre-implementation performance and separately to the rest of VHA. From immediately pre-intervention to the end of the observation period, the percent of patients in the intervention sites with AUD who received medication increased over 3.4 % in absolute terms and 68 % in relative terms (i.e., 4.9-8.3 %). This change was significant compared to the pre-implementation period in the intervention sites and secular trends in control sites. Sites with lower pre-implementation adoption, more person hours of detailing, but fewer people detailed, had larger immediate increases in medication receipt after implementation. The average number of detailing encounters per person was associated with steeper increases in slope over time. This study found empirical support for a multifaceted quality improvement strategy aimed at increasing access to and utilization of pharmacotherapy for AUD. Future studies should focus on determining how to enhance the programs effects, especially in non-responsive locations.

  5. Effectiveness of Cepharanthin in decreasing interruptions during radiation therapy for oral cancer

    International Nuclear Information System (INIS)

    Uchiyama, Yuka; Murakami, Shumei; Kamimoto, Naoya; Nakatani, Atsutoshi; Furukawa, Souhei

    2005-01-01

    The objectives of this study was to examine the effectiveness of Cepharanthin (Kakensyoyaku, Tokyo, Japan) at decreasing side effects during radiation therapy for oral cancer and thereby allowing the completion of radiation therapy without interruption. Two hundred fifteen patients diagnosed with oral cancers were assigned to either Cepharanthin or control groups and underwent external beam irradiation. The completion of the course of radiation therapy and the occurrence of side effects such as mucositis, dysgeusia, and xerostomia during the radiation therapy were evaluated and compared. The completion rate was 87.4% for the Cepharanthin group versus 67.0% for the control group, and the difference was statistically significant (P<0.01). Mucositis did not appear in 58 of 127 cases (45.7%) in the Cepharanthin group or in 21 of 88 cases (23.9%) in the control group. Mucositis developed in 24.6% of the Cepharanthin group and 53.7% of the control group within 2 weeks of irradiation. There were significant relationships between the use of Cepharanthin and the development and timing of mucositis (both P<0.01). Cepharanthin improved the completion of radiation therapy without interruption and reduced or delayed the development of mucositis during radiation therapy for oral cancer. (author)

  6. [Deliberate interruptions and changes of dose of inhaled corticosteroids by asthma patients: "a community pharmacy study"].

    Science.gov (United States)

    Laforest, L; Van Ganse, É; Devouassoux, G; Chatté, G; Tamberou, C; Belhassen, M; Chamba, G

    2015-01-01

    Adherence to inhaled corticosteroids (ICS) remains a major issue for asthma management, even among patients receiving a regular prescription from their doctor. The frequency of deliberate interruption of ICS, and of spontaneous changes of dose, were studied in a population of asthma patients recruited in community pharmacies. Asthma patients (aged 18-50) recruited in community pharmacies reported in self-administered questionnaires their spontaneous interruptions and changes of doses of ICS during the past 3 months. The characteristics of patients who interrupted their therapy or who modified the dose were compared with other patients. The studied population included 252 patients (mean age 35 year-old, females: 59%), of whom 62% had inadequately controlled asthma. Among these patients, 25% had interrupted ICS therapy during the past 3 months, while 21% spontaneously changed the dose. The most reported reason for interrupting ICS was the cessation of symptoms (50%). In multivariate analysis, interrupting ICS was mainly associated with inadequate asthma control (OR=3.1, 95% CI 1.5-6.4), while the strongest association with changing ICS doses was the patients' perception of asthma as a concern in their lives (OR=3.2, 95% CI 1.2-8.4). These results underline a poor understanding of the purpose of ICS therapy by patients. They also highlight the need of therapeutic education to improve the management of the disease. Copyright © 2014 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  7. Simulation of Valve Operation for Flow Interrupt Test in Nuclear Power Plant

    International Nuclear Information System (INIS)

    Kim, Jae Hyung; Shin, Dae Yong; Shin, Dong Woo; Kim, Charn Jung; Lee, Jung Hee

    2012-01-01

    The valve used in nuclear power plant must be qualified for the function according to the KEPIC MF. The test valve must be selected by shape and size, which is given by KEPIC MF. In the functional test, the mathematical model for the valve operation is needed. The mathematical model must be verified by the test, whose method and procedure is defined in KEPIC MF. The lack of analytical technique has lead to the poor mathematical model, with which the functional test for the big valve is impossible with analytical method. Especially, the tank and rupture disk in the flow test is not considered and the result of the analysis is so different to the real one. In these days, the 3D model for the flow interrupt test makes more accurate analysis. And no facility about functional test reduces the research will for the nuclear power plant valve. For this problem, the test facility for the functional test of the valve and pump in nuclear power plant has been made until 2012. With the test facility, the research project related the valve were initiated in KIMM( Korea Institute of Machinery and Materials). And the joint project to SNU(Seoul National University) has been going on the numerical analysis for the valve in nuclear power plant. Using the commercial software and user subroutine, UDF, the co-simulation with multi-body dynamic and fluid flow analysis and the addition of tank and rupture disk to the user subroutine make possible to simulate the flow interrupt test numerically. This is not simple and regular analysis, which was introduced in user subroutine. In order to simulate the real situation, the engineering work, related mathematical model, and the programming in the user subroutine are needed. This study is on the making the mathematical model for the functional test of the valve in nuclear power plan. The functional test is the real test procedure and defined in KEPIC MF

  8. Use of platelet rich plasma to treat plantar fasciitis: design of a multi centre randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Peerbooms Joost C

    2010-04-01

    Full Text Available Abstract Background If conservative treatment for chronic plantar fasciitis fails, often a corticosteroid injection is given. Corticosteroid injection gives temporarily pain reduction, but no healing. Blood platelets initiate the natural healing rate. GPS® gives an eightfold concentrate platelets of patients own blood. Injection of these platelets in the attachment of the fascia to the os calcis might induce a healing rate. Methods and design A randomized controlled multi centre trial will be performed. The study population consists of 120 patients of 18 years and older. Patients with chronic plantar fasciitis will be allocated randomly to have a steroid injection or an autologous platelet concentrate injections. Data will be collected before the procedure, 4,8,12,26 weeks and 1 year after the procedure. The main outcome measures of this study are pain and function measured with questionnaires. Conclusion Recent literature show positive effects for the treatment of tendinosis with autologous platelet injections. The forthcoming trial will compare treatment for chronic plantar fasciitis with a steroid injection versus an autologous platelet injection. Our results will be published as soon as they become available. Trial Registration Trial registration number: http://www.clinicaltrials.gov NCT00758641.

  9. A survey of Tumult, a real-time multi-processor system

    International Nuclear Information System (INIS)

    Jansen, P.G.

    1986-01-01

    Tumult (Twente University MULTi processor system) is the name of an ongoing project aiming at the design and implementation of a modular extendible multiprocessor system. All memory is distributed and processors communicate in parallel via a fast and reliable local switching network instead of a shared bus. A distributed real-time operating system is being designed and implemented, consisting of a multi-tasking subsystem per processor. Processes can communicate via a message passing mechanism. Communication links and processes are dynamically created and disposed by the application. In this article a brief description of the system is given; communication aspects are emphasized. (Auth.)

  10. Arch reconstruction with autologous pulmonary artery patch in interrupted aortic arch.

    Science.gov (United States)

    Lee, Won-Young; Park, Jeong-Jun

    2014-04-01

    Various surgical techniques have been developed for the repair of an interrupted aortic arch. However, tension and Gothic arch formation at the anastomotic site have remained major problems for these techniques: Excessive tension causes arch stenosis and left main bronchus compression, and Gothic arch configuration is related to cardiovascular complications. To resolve these problems, we adopted a modified surgical technique of distal aortic arch augmentation using an autologous main pulmonary artery patch. The descending aorta was then anastomosed to the augmented aortic arch in an end-to-side manner. Here, we report two cases of interrupted aortic arch that were repaired using this technique.

  11. Embedded interruptions and task complexity influence schema-related cognitive load progression in an abstract learning task.

    Science.gov (United States)

    Wirzberger, Maria; Esmaeili Bijarsari, Shirin; Rey, Günter Daniel

    2017-09-01

    Cognitive processes related to schema acquisition comprise an essential source of demands in learning situations. Since the related amount of cognitive load is supposed to change over time, plausible temporal models of load progression based on different theoretical backgrounds are inspected in this study. A total of 116 student participants completed a basal symbol sequence learning task, which provided insights into underlying cognitive dynamics. Two levels of task complexity were determined by the amount of elements within the symbol sequence. In addition, interruptions due to an embedded secondary task occurred at five predefined stages over the task. Within the resulting 2x5-factorial mixed between-within design, the continuous monitoring of efficiency in learning performance enabled assumptions on relevant resource investment. From the obtained results, a nonlinear change of learning efficiency over time seems most plausible in terms of cognitive load progression. Moreover, different effects of the induced interruptions show up in conditions of task complexity, which indicate the activation of distinct cognitive mechanisms related to structural aspects of the task. Findings are discussed in the light of evidence from research on memory and information processing. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Neglect in human communication: quantifying the cost of cell-phone interruptions in face to face dialogs.

    Science.gov (United States)

    Lopez-Rosenfeld, Matías; Calero, Cecilia I; Fernandez Slezak, Diego; Garbulsky, Gerry; Bergman, Mariano; Trevisan, Marcos; Sigman, Mariano

    2015-01-01

    There is a prevailing belief that interruptions using cellular phones during face to face interactions may affect severely how people relate and perceive each other. We set out to determine this cost quantitatively through an experiment performed in dyads, in a large audience in a TEDx event. One of the two participants (the speaker) narrates a story vividly. The listener is asked to deliberately ignore the speaker during part of the story (for instance, attending to their cell-phone). The speaker is not aware of this treatment. We show that total amount of attention is the major factor driving subjective beliefs about the story and the conversational partner. The effects are mostly independent on how attention is distributed in time. All social parameters of human communication are affected by attention time with a sole exception: the perceived emotion of the story. Interruptions during day-to-day communication between peers are extremely frequent. Our data should provide a note of caution, by indicating that they have a major effect on the perception people have about what they say (whether it is interesting or not . . .) and about the virtues of the people around them.

  13. Neglect in human communication: quantifying the cost of cell-phone interruptions in face to face dialogs.

    Directory of Open Access Journals (Sweden)

    Matías Lopez-Rosenfeld

    Full Text Available There is a prevailing belief that interruptions using cellular phones during face to face interactions may affect severely how people relate and perceive each other. We set out to determine this cost quantitatively through an experiment performed in dyads, in a large audience in a TEDx event. One of the two participants (the speaker narrates a story vividly. The listener is asked to deliberately ignore the speaker during part of the story (for instance, attending to their cell-phone. The speaker is not aware of this treatment. We show that total amount of attention is the major factor driving subjective beliefs about the story and the conversational partner. The effects are mostly independent on how attention is distributed in time. All social parameters of human communication are affected by attention time with a sole exception: the perceived emotion of the story. Interruptions during day-to-day communication between peers are extremely frequent. Our data should provide a note of caution, by indicating that they have a major effect on the perception people have about what they say (whether it is interesting or not . . . and about the virtues of the people around them.

  14. Dynamical decoupling sequences for multi-qubit dephasing suppression and long-time quantum memory

    International Nuclear Information System (INIS)

    Paz-Silva, Gerardo A; Lee, Seung-Woo; Green, Todd J; Viola, Lorenza

    2016-01-01

    We consider a class of multi-qubit dephasing models that combine classical noise sources and linear coupling to a bosonic environment, and are controlled by arbitrary sequences of dynamical decoupling pulses. Building on a general transfer filter-function framework for open-loop control, we provide an exact representation of the controlled dynamics for arbitrary stationary non-Gaussian classical and quantum noise statistics, with analytical expressions emerging when all dephasing sources are Gaussian. This exact characterization is used to establish two main results. First, we construct multi-qubit sequences that ensure maximum high-order error suppression in both the time and frequency domain and that can be exponentially more efficient than existing ones in terms of total pulse number. Next, we show how long-time multi-qubit storage may be achieved by meeting appropriate conditions for the emergence of a fidelity plateau under sequence repetition, thereby generalizing recent results for single-qubit memory under Gaussian dephasing. In both scenarios, the key step is to endow multi-qubit sequences with a suitable displacement anti-symmetry property, which is of independent interest for applications ranging from environment-assisted entanglement generation to multi-qubit noise spectroscopy protocols. (paper)

  15. The Australian centre for RF bioeffects research (ACRBR) - an NHMRC centre of research excellence

    International Nuclear Information System (INIS)

    Wood, A.; Croft, R.; Abramson, M.; Anderson, V.; Cosic, I.; Finnie, J.; McKenzie, R.

    2004-01-01

    Full text: The Australian Centre for Radiofrequency Bioeffects Research (ACRBR) is a newly established multi-institutional research centre which seeks to research questions pertaining to possible health effects of exposure to radiofrequency devices, such as mobile phones and which is funded under the Australian National Health and Medical Research Council (NHMRC) Centres of Research Excellence funding program. The Centre of Research Excellence in Electromagnetic Energy is combining the efforts of engineers, epidemiologists, physicists, psychophysiologists and veterinary pathologists from RMIT University, the Institute of Medical and Veterinary Science in South Australia (IMVS), Monash University, Swinburne University of Technology and Telstra Research Laboratories (TRL). The centre is funded at $2.5 M over five years and will undertake a program of research to address the issue of exposure to radiofrequency (RF) devices and health. It will also train new scientists, keep the community informed of ongoing developments and help the development of government policies in this area of considerable public concern. The 5-year program has the following components: Neurobiology: One important area where there is a perceived research gap is in the area of potential neurological effects, which will hence be a major focus of this Centre. The proposed studies range from in vitro and in vivo research studies of RF effects on neuron and neural system functioning in rodents, to that of RF effects on simple neural function, cognition and subjective report in humans. The latter series of studies have been developed to account for the consensus view that more emphasis needs to be placed on possible differences in RF population sensitivity (e.g. youth versus aged, and ' electromagnetic hypersensitives'). Epidemiological studies are an important tool in studying the impact on public health from exposure of whole populations to modern radio technologies. Cancer outcomes in this area of

  16. CGG repeat length and AGG interruptions as indicators of fragile X-associated diminished ovarian reserve.

    Science.gov (United States)

    Lekovich, Jovana; Man, Limor; Xu, Kangpu; Canon, Chelsea; Lilienthal, Debra; Stewart, Joshua D; Pereira, Nigel; Rosenwaks, Zev; Gerhardt, Jeannine

    2017-12-21

    PurposeFragile X premutation (PM) carriers may experience difficulties conceiving a child probably due to fragile X-associated diminished ovarian reserve (FXDOR). We investigated which subgroups of carriers with a PM are at higher risk of FXDOR, and whether the number of AGG interruptions within the repeat sequence further ameliorates the risk.MethodsWe compared markers of ovarian reserve, including anti-Müllerian hormone, antral follicle count, and number of oocytes retrieved between different subgroups of patients with a PM.ResultsWe found that carriers with midrange repeats size (70-90 CGG) demonstrate significantly lower ovarian reserve. Additionally, the number of AGG interruptions directly correlated with parameters of ovarian reserve. Patients with longer uninterrupted CGG repeats post-AGG interruptions had the lowest ovarian reserve.ConclusionThis study connects AGG interruptions and certain CGG repeat length to reduced ovarian reserve in carriers with a PM. A possible explanation for our findings is the proposed gonadotoxicity of the FMR1 transcripts. Reduction of AGG interruptions could increase the likelihood that secondary RNA structures in the FMR1 messenger RNA are formed, which could cause cell dysfunction within the ovaries. These findings may provide women with guidance regarding their fertility potential and accordingly assist with their family planning.GENETICS in MEDICINE advance online publication, 21 December 2017; doi:10.1038/gim.2017.220.

  17. Multi-granularity Bandwidth Allocation for Large-Scale WDM/TDM PON

    Science.gov (United States)

    Gao, Ziyue; Gan, Chaoqin; Ni, Cuiping; Shi, Qiongling

    2017-12-01

    WDM (wavelength-division multiplexing)/TDM (time-division multiplexing) PON (passive optical network) is being viewed as a promising solution for delivering multiple services and applications, such as high-definition video, video conference and data traffic. Considering the real-time transmission, QoS (quality of services) requirements and differentiated services model, a multi-granularity dynamic bandwidth allocation (DBA) in both domains of wavelengths and time for large-scale hybrid WDM/TDM PON is proposed in this paper. The proposed scheme achieves load balance by using the bandwidth prediction. Based on the bandwidth prediction, the wavelength assignment can be realized fairly and effectively to satisfy the different demands of various classes. Specially, the allocation of residual bandwidth further augments the DBA and makes full use of bandwidth resources in the network. To further improve the network performance, two schemes named extending the cycle of one free wavelength (ECoFW) and large bandwidth shrinkage (LBS) are proposed, which can prevent transmission from interruption when the user employs more than one wavelength. The simulation results show the effectiveness of the proposed scheme.

  18. Time's up. descriptive epidemiology of multi-morbidity and time spent on health related activity by older Australians: a time use survey.

    Directory of Open Access Journals (Sweden)

    Tanisha Jowsey

    Full Text Available Most Western health systems remain single illness orientated despite the growing prevalence of multi-morbidity. Identifying how much time people with multiple chronic conditions spend managing their health will help policy makers and health service providers make decisions about areas of patient need for support. This article presents findings from an Australian study concerning the time spent on health related activity by older adults (aged 50 years and over, most of whom had multiple chronic conditions. A recall questionnaire was developed, piloted, and adjusted. Sampling was undertaken through three bodies; the Lung Foundation Australia (COPD sub-sample, National Diabetes Services Scheme (Diabetes sub-sample and National Seniors Australia (Seniors sub-sample. Questionnaires were mailed out during 2011 to 10,600 older adults living in Australia. 2540 survey responses were received and analysed. Descriptive analyses were completed to obtain median values for the hours spent on each activity per month. The mean number of chronic conditions was 3.7 in the COPD sub-sample, 3.4 in the Diabetes sub-sample and 2.0 in the NSA sub-sample. The study identified a clear trend of increased time use associated with increased number of chronic conditions. Median monthly time use was 5-16 hours per month overall for our three sub-samples. For respondents in the top decile with five or more chronic conditions the median time use was equivalent to two to three hours per day, and if exercise is included in the calculations, respondents spent from between five and eight hours per day: an amount similar to full-time work. Multi-morbidity imposes considerable time burdens on patients. Ageing is associated with increasing rates of multi-morbidity. Many older adults are facing high demands on their time to manage their health in the face of decreasing energy and mobility. Their time use must be considered in health service delivery and health system reform.

  19. Effectiveness of a Hospital-Based Work Support Intervention for Female Cancer Patients – A Multi-Centre Randomised Controlled Trial

    Science.gov (United States)

    Tamminga, Sietske J.; Verbeek, Jos H. A. M.; Bos, Monique M. E. M.; Fons, Guus; Kitzen, Jos J. E. M.; Plaisier, Peter W.; Frings-Dresen, Monique H. W.; de Boer, Angela G. E. M.

    2013-01-01

    Objective One key aspect of cancer survivorship is return-to-work. Unfortunately, many cancer survivors face problems upon their return-to-work. For that reason, we developed a hospital-based work support intervention aimed at enhancing return-to-work. We studied effectiveness of the intervention compared to usual care for female cancer patients in a multi-centre randomised controlled trial. Methods Breast and gynaecological cancer patients who were treated with curative intent and had paid work were randomised to the intervention group (n = 65) or control group (n = 68). The intervention involved patient education and support at the hospital and improvement of communication between treating and occupational physicians. In addition, we asked patient's occupational physician to organise a meeting with the patient and the supervisor to make a concrete gradual return-to-work plan. Outcomes at 12 months of follow-up included rate and time until return-to-work (full or partial), quality of life, work ability, work functioning, and lost productivity costs. Time until return-to-work was analyzed with Kaplan-Meier survival analysis. Results Return-to-work rates were 86% and 83% (p = 0.6) for the intervention group and control group when excluding 8 patients who died or with a life expectancy of months at follow-up. Median time from initial sick leave to partial return-to-work was 194 days (range 14–435) versus 192 days (range 82–465) (p = 0.90) with a hazard ratio of 1.03 (95% CI 0.64–1.6). Quality of life and work ability improved statistically over time but did not differ statistically between groups. Work functioning and costs did not differ statistically between groups. Conclusion The intervention was easily implemented into usual psycho-oncological care and showed high return-to-work rates. We failed to show any differences between groups on return-to-work outcomes and quality of life scores. Further research is needed to study which aspects of

  20. Sex Discrimination and Women's Labor Market Interruptions

    OpenAIRE

    David Neumark

    1993-01-01

    The human capital explanation of sex differences in wages is that women intend to work in the labor market more intermittently than men, and therefore invest less. This lower investment leads to lower wages and wage growth. The alternative "feedback" hypothesis consistent with the same facts is that women experience labor market discrimination and respond with career interruptions and specialization in household production. This paper explores the relationship between self-reported discrimina...

  1. TimeLapseAnalyzer: Multi-target analysis for live-cell imaging and time-lapse microscopy

    DEFF Research Database (Denmark)

    Huth, Johannes; Buchholz, Malte; Kraus, Johann M.

    2011-01-01

    The direct observation of cells over time using time-lapse microscopy can provide deep insights into many important biological processes. Reliable analyses of motility, proliferation, invasive potential or mortality of cells are essential to many studies involving live cell imaging and can aid in...... counting and tube formation analysis in high throughput screening of live-cell experiments. TimeLapseAnalyzer is freely available (MATLAB, Open Source) at http://www.informatik.uniulm. de/ni/mitarbeiter/HKestler/tla......., we developed TimeLapseAnalyzer. Apart from general purpose image enhancements and segmentation procedures, this extensible, self-contained, modular cross-platform package provides dedicated modalities for fast and reliable analysis of multi-target cell tracking, scratch wound healing analysis, cell...

  2. Impact of the zero-markup drug policy on hospitalisation expenditure in western rural China: an interrupted time series analysis.

    Science.gov (United States)

    Yang, Caijun; Shen, Qian; Cai, Wenfang; Zhu, Wenwen; Li, Zongjie; Wu, Lina; Fang, Yu

    2017-02-01

    To assess the long-term effects of the introduction of China's zero-markup drug policy on hospitalisation expenditure and hospitalisation expenditures after reimbursement. An interrupted time series was used to evaluate the impact of the zero-markup drug policy on hospitalisation expenditure and hospitalisation expenditure after reimbursement at primary health institutions in Fufeng County of Shaanxi Province, western China. Two regression models were developed. Monthly average hospitalisation expenditure and monthly average hospitalisation expenditure after reimbursement in primary health institutions were analysed covering the period 2009 through to 2013. For the monthly average hospitalisation expenditure, the increasing trend was slowed down after the introduction of the zero-markup drug policy (coefficient = -16.49, P = 0.009). For the monthly average hospitalisation expenditure after reimbursement, the increasing trend was slowed down after the introduction of the zero-markup drug policy (coefficient = -10.84, P = 0.064), and a significant decrease in the intercept was noted after the second intervention of changes in reimbursement schemes of the new rural cooperative medical insurance (coefficient = -220.64, P markup drug policy in western China. However, hospitalisation expenditure and hospitalisation expenditure after reimbursement were still increasing. More effective policies are needed to prevent these costs from continuing to rise. © 2016 John Wiley & Sons Ltd.

  3. Information report on nuclear safety and radiation protection of the Manche storage Centre - 2012

    International Nuclear Information System (INIS)

    2013-06-01

    After a presentation of the Manche Storage Centre (CSM), the first French centre of surface storage of weakly and moderately radioactive wastes, of its history, its buildings and activities, of the multi-layer cover, of the water management system (installation, controls, sampling), this report describes the measures related to nuclear safety (principles and objectives, prevention measures, technical measures, regulatory plan of control of the Centre and of its environment, control of releases from storage installations, quality organisation, archiving system). It describes measures related to radiation protection: principles, staff dosimetry, and personnel safety. The next part presents the nuclear event scale (INES) and indicates that no incident occurred. The effluents and releases from the Centre are then addressed: origin, locations and results of radiological controls of rainfalls, of risky effluents, of underground waters, of rivers, impacts of the Centre on its environment (releases in the sea, in rivers). The management of conventional and nuclear wastes produced by the Centre is reviewed as well as the actions related to information and transparency. Recommendations of the CHSCT are reported

  4. Phlebitis risk varies by peripheral venous catheter site and increases after 96 hours: a large multi-centre prospective study.

    Science.gov (United States)

    Cicolini, Giancarlo; Manzoli, Lamberto; Simonetti, Valentina; Flacco, Maria Elena; Comparcini, Dania; Capasso, Lorenzo; Di Baldassarre, Angela; Eltaji Elfarouki, Ghaleb

    2014-11-01

    This multi-centre prospective field study evaluated whether peripheral venous catheter site of insertion influences the risk of catheter-related phlebitis. Potential predictors of phlebitis were also investigated. Millions of patients worldwide use peripheral venous catheters, which frequently cause local complications including phlebitis, infection and obstruction. Although phlebitis predictors have been broadly investigated, uncertainties remain on the potential effect of cannulation anatomical site, duration and the appropriate time for catheter removal. A prospective cohort design was carried out from January-June 2012. The clinical course of each patient who received a new peripheral venous catheter for any cause in five Italian hospitals was followed by trained nurses until catheter removal. The presence of phlebitis was assessed every 24 hours using the Visual Infusion Phlebitis score. Analyses were based upon multilevel mixed-effects regression. The final sample consisted of 1498 patients. The average time for catheters in situ was 65·6 hours and 23·6% of the catheters were in place beyond 96 hours. Overall phlebitis incidence was 15·4%, 94·4% of which were grade 1. The likelihood of phlebitis independently increased with increasing catheter duration, being highest after 96 hours. Compared with patients with catheter placed in the dorsum of the hand (22·8% of the sample), those with the catheter located in the antecubital fossa (34·1%) or forearm were less likely to have a phlebitis of any grade. Antecubital fossa and forearm veins may be preferential sites for peripheral venous cannulation. Our results support Centers for Disease Control and Prevention recommendations to replace catheters in adults no later than 96 hours. A relevant proportion of healthcare personnel did not adhere to such guidelines - more attention to this issue is required. © 2014 John Wiley & Sons Ltd.

  5. Timing of intervention in high-risk non-ST-elevation acute coronary syndromes in PCI versus non-PCI centres : Sub-group analysis of the ELISA-3 trial.

    Science.gov (United States)

    Badings, E A; Remkes, W S; Dambrink, J-H E; The, S H K; Van Wijngaarden, J; Tjeerdsma, G; Rasoul, S; Timmer, J R; van der Wielen, M L J; Lok, D J A; van 't Hof, A W J

    2016-03-01

    To compare the effect of timing of intervention in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) in percutaneous coronary intervention (PCI) versus non-PCI centres. A post-hoc sub-analysis was performed of the ELISA III trial, a randomised multicentre trial investigating outcome of early ( 48 h) angiography and revascularisation in 542 patients with high-risk NSTE-ACS. 90 patients were randomised in non-PCI centres and tended to benefit more from an early invasive strategy than patients included in the PCI centre (relative risk 0.23 vs. 0.85 [p for interaction = 0.089] for incidence of the combined primary endpoint of death, reinfarction and recurrent ischaemia after 30 days of follow-up). This was largely driven by reduction in recurrent ischaemia. In non-PCI centres, patients randomised to the late group had a 4 and 7 day longer period until PCI or coronary artery bypass grafting, respectively. This difference was less pronounced in the PCI centre. This post-hoc analysis from the ELISA-3 trial suggests that NSTE-ACS patients initially hospitalised in non-PCI centres show the largest benefit from early angiography and revascularisation, associated with a shorter waiting time to revascularisation. Improved patient logistics and transfer between non-PCI and PCI centres might therefore result in better clinical outcome.

  6. Do flow principles of operations management apply to computing centres?

    CERN Document Server

    Abaunza, Felipe; Hameri, Ari-Pekka; Niemi, Tapio

    2014-01-01

    By analysing large data-sets on jobs processed in major computing centres, we study how operations management principles apply to these modern day processing plants. We show that Little’s Law on long-term performance averages holds to computing centres, i.e. work-in-progress equals throughput rate multiplied by process lead time. Contrary to traditional manufacturing principles, the law of variation does not hold to computing centres, as the more variation in job lead times the better the throughput and utilisation of the system. We also show that as the utilisation of the system increases lead times and work-in-progress increase, which complies with traditional manufacturing. In comparison with current computing centre operations these results imply that better allocation of jobs could increase throughput and utilisation, while less computing resources are needed, thus increasing the overall efficiency of the centre. From a theoretical point of view, in a system with close to zero set-up times, as in the c...

  7. Finite-time consensus of second-order leader-following multi-agent systems without velocity measurements

    International Nuclear Information System (INIS)

    Zhang, Yanjiao; Yang, Ying

    2013-01-01

    This Letter investigates the finite-time consensus problems of second-order multi-agent systems in the presence of one and multiple leaders under a directed graph. Specifically, we propose two bounded control laws, which are independent of velocity information, to deal with the finite-time consensus tracking problem with one leader and the finite-time containment control problem with multiple leaders, respectively. With the aid of homogeneous theory, some sufficient conditions are established for the achievement of the finite-time tracking control problem of second-order multi-agent systems. Numerical examples are finally provided to illustrate the theoretical results.

  8. Comparison of planned menus and centre characteristics with foods and beverages served in New York City child-care centres.

    Science.gov (United States)

    Breck, Andrew; Dixon, L Beth; Kettel Khan, Laura

    2016-10-01

    The present study evaluated the extent to which child-care centre menus prepared in advance correspond with food and beverage items served to children. The authors identified centre and staff characteristics that were associated with matches between menus and what was served. Menus were collected from ninety-five centres in New York City (NYC). Direct observation of foods and beverages served to children were conducted during 524 meal and snack times at these centres between April and June 2010, as part of a larger study designed to determine compliance of child-care centres with city health department regulations for nutrition. Child-care centres were located in low-income neighbourhoods in NYC. Overall, 87 % of the foods and beverages listed on the menus or allowed as substitutions were served. Menu items matched with foods and beverages served for all major food groups by >60 %. Sweets and water had lower match percentages (40 and 32 %, respectively), but water was served 68 % of the time when it was not listed on the menu. The staff person making the food and purchasing decisions predicted the match between the planned or substituted items on the menus and the foods and beverages served. In the present study, child-care centre menus included most foods and beverages served to children. Menus planned in advance have potential to be used to inform parents about which child-care centre to send their child or what foods and beverages their enrolled children will be offered throughout the day.

  9. Comparison of planned menus and centre characteristics with foods and beverages served in New York City child-care centres

    Science.gov (United States)

    Breck, Andrew; Dixon, L Beth; Khan, Laura Kettel

    2016-01-01

    Objective The present study evaluated the extent to which child-care centre menus prepared in advance correspond with food and beverage items served to children. The authors identified centre and staff characteristics that were associated with matches between menus and what was served. Design Menus were collected from ninety-five centres in New York City (NYC). Direct observation of foods and beverages served to children were conducted during 524 meal and snack times at these centres between April and June 2010, as part of a larger study designed to determine compliance of child-care centres with city health department regulations for nutrition. Setting Child-care centres were located in low-income neighbourhoods in NYC. Results Overall, 87% of the foods and beverages listed on the menus or allowed as substitutions were served. Menu items matched with foods and beverages served for all major food groups by > 60%. Sweets and water had lower match percentages (40 and 32%, respectively), but water was served 68% of the time when it was not listed on the menu. The staff person making the food and purchasing decisions predicted the match between the planned or substituted items on the menus and the foods and beverages served. Conclusions In the present study, child-care centre menus included most foods and beverages served to children. Menus planned in advance have potential to be used to inform parents about which child-care centre to send their child or what foods and beverages their enrolled children will be offered throughout the day. PMID:27280341

  10. Decreasing Beam Auto Tuning Interruption Events with In-Situ Chemical Cleaning on Axcelis GSD

    International Nuclear Information System (INIS)

    Fuchs, Dieter; Spreitzer, Stefan; Vogl, Josef; Bishop, Steve; Eldridge, David; Kaim, Robert

    2008-01-01

    Ion beam auto tuning time and success rate are often major factors in the utilization and productivity of ion implanters. Tuning software frequently fails to meet specified setup times or recipe parameters, causing production stoppages and requiring manual intervention. Build-up of conductive deposits in the arc chamber and extraction gap can be one of the main causes of auto tuning problems. The deposits cause glitching and ion beam instabilities, which lead to errors in the software optimization routines. Infineon Regensburg has been testing use of XeF 2 , an in-situ chemical cleaning reagent, with positive results in reducing auto tuning interruption events.

  11. The adaptive reuse of historic city centres. Bologna and Lisbon: solutions for urban regeneration

    Directory of Open Access Journals (Sweden)

    Andrea Boeri

    2016-11-01

    Full Text Available The European historic city centres are currently experiencing innovative approaches for rehabilitation of urban spaces afflicted by social and physical decay. The revitalization challenges are a consequence of the integration of contemporary technologies and solutions to achieve new requirements and of the impacts of socio-economic dynamics. Understanding and boosting the drivers connected to the cultural potential of the historic city centres can play an important role in adaptive re-use. This paper focuses on the synergy between cultural heritage and urban development, cultural heritage preservation and local economic growth, proposing adaptive reuse design practices applied in historic city centre, through the adoption of a multi-criteria methodology for heritage-led regeneration.

  12. Microdose flare protocol with interrupted follicle stimulating hormone and added androgen for poor responders--an observational pilot study.

    Science.gov (United States)

    Mitri, Frederic; Behan, Lucy Ann; Murphy, Courtney A; Hershko-Klement, Anat; Casper, Robert F; Bentov, Yaakov

    2016-01-01

    To investigate whether temporarily withholding FSH and adding androgen could improve follicular response during a microdose flare protocol in women with slow follicular growth or asynchronous follicular development. Observational pilot study. University-affiliated private fertility center. Twenty-six women aged 34-47 years with poor response to stimulation or a previous cancelled IVF cycle and with slow or asynchronous follicular growth during a microdose flare cycle. For 13 women, after initiation of ovarian stimulation using the microdose flare protocol, gonadotropin administration was interrupted and transdermal testosterone gel was added for several days (4.4 ± 1.2 d) starting after cycle day 7 (mean cycle day 10 ± 2.6). FSH, E2, follicular growth, and total number of mature oocytes retrieved were determined for all of the patients. Cycle cancellation rate as well as pregnancy rate following embryo transfer were also documented when applicable. FSH levels declined (25.2 ± 6.5 to 6.8 ± 3.2 IU/L), E2 levels increased (896 ± 687 to 2,163 ± 1,667 pmol/L), and follicular growth improved significantly during gonadotropin interruption and were tracked for 2 days during this time frame. The average number of oocytes retrieved was 5.3 ± 2.6, and the ratio of mature to total oocytes was 4:5. Four of the 13 women in the interruption group conceived following frozen embryo transfer, whereas none in the control group did. The androgen-interrupted FSH protocol may improve follicular response to gonadotropins in cycles that might otherwise be cancelled. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  13. How much should customers be compensated for interruptions in the drinking water supply?

    Science.gov (United States)

    Molinos-Senante, María; Sala-Garrido, Ramon

    2017-05-15

    Water supply interruptions directly affect customers, and customers should be compensated accordingly. However, few water regulators have applied compensation policies given the difficulty of estimating the economic value of compensation to customers. In this study, a pioneering approach based on the concept of shadow prices is proposed to determine the compensation that customers should receive for unplanned water interruptions. The Chilean water industry was selected as a case study because there is an ongoing policy discussion between the use of penalties or compensation as an incentive to prevent water supply interruptions. The estimated results indicate that for 2014, the value of compensation ranges between 2.4% and 35.4% of the fixed charge of the water tariff. The methodology and findings of this study are of great relevance to water regulators in defining incentives to prompt water companies to provide reliable water service. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Is travel-time to a specialist centre a risk factor for non-referral, non-attendance and loss to follow-up among patients with hepatitis C (HCV) infection?

    Science.gov (United States)

    Astell-Burt, Thomas; Flowerdew, Robin; Boyle, Paul; Dillon, John

    2012-07-01

    Little is known about why many people diagnosed with hepatitis C virus (HCV) infection fail to reach and stay within specialist care services. We used a Geographic Information System and logit regression to investigate whether travel-time to a specialist centre was associated with an increased likelihood of non-referral, non-attendance and loss to follow-up among persons diagnosed with HCV between 1991 and 2003 in Tayside, Scotland (UK). Information was available on referral to, and utilisation of, the single HCV specialist centre in Tayside between 1991 and 2006. Longer travel-time to a specialist centre was associated with an increased likelihood of non-referral to a specialist centre following diagnosis (Odds Ratio: 1.25, 95% Confidence Interval: 1.09, 1.44). Patients living further from an HCV specialist centre were less likely to be referred to it for treatment that could cure their HCV infection. Neither a history of intravenous drug use (IDU), nor area deprivation predicted non-referral. Subsequent to referral, travel-time to a specialist centre was not associated with either non-attendance (0.83 (0.56, 1.21)) or loss to follow-up (0.98 (0.78, 1.22)), although a history of IDU was a strong predictor of both non-attendance and loss to follow-up. Non-attendance was less likely among older patients, while loss to follow-up was more common among those living in deprived areas. Once referred, patients appear able to cope with stress and financial cost of long and frequent journeys to hospital. However, as rates of referral improve from more geographically remote areas, long travel-times to an HCV specialist centre may become an important factor determining future utilisation. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Combining social strategies and workload: a new design to reduce the negative effects of task interruptions

    NARCIS (Netherlands)

    de Vries, R.A.J.; Lohse, M.; Winterboer, Andi; Groen, Frans C.A.; Evers, Vanessa

    2013-01-01

    Being interrupted by notifications and reminders is common while working. In this study we consider whether system politeness reduces (negative) effects of being interrupted by system requests. We carried out a 2 (polite vs. neutral system request) x 2 (high vs. low mental load) between-participants

  16. Diabetic retinopathy screening in New Zealand requires improvement: results from a multi-centre audit.

    Science.gov (United States)

    Hutchins, Edward; Coppell, Kirsten J; Morris, Ainsley; Sanderson, Gordon

    2012-06-01

    To determine whether diabetic retinal screening services and retinopathy referral centres in New Zealand meet the national guidelines for referral and assessment of screen detected moderate retinal and mild macular diabetic eye disease. Diabetic retinal screening pathways and the data collected at four main centre retinal screening services were described and compared with recommendations in the national diabetes retinal screening guidelines. A retrospective audit of photoscreen detected moderate retinopathy (grade R3), and mild maculopathy (grades M2B and M3) during May to August 2008 was undertaken. Data collected by retinopathy referral centres were used to examine the follow-up of screen detected cases and to make comparisons with the national recommendations. All four screening services used the guidelines for grading, but the recommended dataset was incomplete. Not all recorded data were readily accessible. The retinal photos of 157 (2.4%) patients were graded as R3, M2B, M3 or a combination. The proportion of those screened with these grades varied across the four centres from 1.2% to 3.4%. Follow-up of the 157 screen positive patients did not always comply with guideline recommendations. Seventy five (48%) were referred for review by an ophthalmologist as recommended, 45 (60% of referred) were seen within the recommended six months. Nine patients (15% of the 60 with a documented assessment) were referred for or received laser treatment at 12-months follow-up. Quality diabetic retinal screening data systems and quality assurance programs are required to improve the monitoring and quality of retinal screening in New Zealand. © 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia.

  17. 'Keeping healthy in the backseat': How motherhood interrupted HIV ...

    African Journals Online (AJOL)

    This study explores how motherhood in newly delivered HIV-infected mothers in Kenya interrupted their antiretroviral treatment (ART). Qualitative interviews were performed with 26 mothers on ART in a rural or urban area. The data were organised and interpreted using content analysis. The study found that adherence to ...

  18. A study on DC hybrid three-phase fault current limiting interrupter for a power distribution system

    International Nuclear Information System (INIS)

    Shao, Hongtian; Satoh, Tomoyuki; Yamaguchi, Mitsugi; Fukui, Satoshi; Ogawa, Jun; Satoh, Takao; Ishikawa, Hiroyuki

    2005-01-01

    For the purpose of protecting electric power system, many researches and developments of fault current limiters are being performed. The authors studied a dc hybrid three-phase fault current limiting interrupter (FCLI) composed of a superconducting reactor and an S/N transition element, connected in series each other. The dc hybrid type fault current limiting interrupter can limit a fault current by means of the inductance of high temperature superconducting (HTS) coil together with the normal transition of HTS bulk material (HTSB). In the case of an accident, the normal transition of the bulk material can be accelerated by the magnetic field of the HTS coil. In this paper, the dc hybrid type fault current limiting interrupter for 5.5 km long 6.6 kV-600 A power distribution system is analyzed, and performances of fault current limitation and interruption are confirmed. Moreover, a reclosing operation is discussed for this power distribution system

  19. The effects of pay for performance on disparities in stroke, hypertension, and coronary heart disease management: interrupted time series study.

    Science.gov (United States)

    Lee, John Tayu; Netuveli, Gopalakrishnan; Majeed, Azeem; Millett, Christopher

    2011-01-01

    The Quality and Outcomes Framework (QOF), a major pay-for-performance programme, was introduced into United Kingdom primary care in April 2004. The impact of this programme on disparities in health care remains unclear. This study examines the following questions: has this pay for performance programme improved the quality of care for coronary heart disease, stroke and hypertension in white, black and south Asian patients? Has this programme reduced disparities in the quality of care between these ethnic groups? Did general practices with different baseline performance respond differently to this programme? Retrospective cohort study of patients registered with family practices in Wandsworth, London during 2007. Segmented regression analysis of interrupted time series was used to take into account the previous time trend. Primary outcome measures were mean systolic and diastolic blood pressure, and cholesterol levels. Our findings suggest that the implementation of QOF resulted in significant short term improvements in blood pressure control. The magnitude of benefit varied between ethnic groups with a statistically significant short term reduction in systolic BP in white and black but not in south Asian patients with hypertension. Disparities in risk factor control were attenuated only on few measures and largely remained intact at the end of the study period. Pay for performance programmes such as the QOF in the UK should set challenging but achievable targets. Specific targets aimed at reducing ethnic disparities in health care may also be needed.

  20. Design of Networks-on-Chip for Real-Time Multi-Processor Systems-on-Chip

    DEFF Research Database (Denmark)

    Sparsø, Jens

    2012-01-01

    This paper addresses the design of networks-on-chips for use in multi-processor systems-on-chips - the hardware platforms used in embedded systems. These platforms typically have to guarantee real-time properties, and as the network is a shared resource, it has to provide service guarantees...... (bandwidth and/or latency) to different communication flows. The paper reviews some past work in this field and the lessons learned, and the paper discusses ongoing research conducted as part of the project "Time-predictable Multi-Core Architecture for Embedded Systems" (T-CREST), supported by the European...

  1. This art of psychoanalysis. Dreaming undreamt dreams and interrupted cries.

    Science.gov (United States)

    Ogden, Thomas H

    2004-08-01

    It is the art of psychoanalysis in the making, a process inventing itself as it goes, that is the subject of this paper. The author articulates succinctly how he conceives of psychoanalysis, and offers a detailed clinical illustration. He suggests that each analysand unconsciously (and ambivalently) is seeking help in dreaming his 'night terrors' (his undreamt and undreamable dreams) and his 'nightmares' (his dreams that are interrupted when the pain of the emotional experience being dreamt exceeds his capacity for dreaming). Undreamable dreams are understood as manifestations of psychotic and psychically foreclosed aspects of the personality; interrupted dreams are viewed as reflections of neurotic and other non-psychotic parts of the personality. The analyst's task is to generate conditions that may allow the analysand--with the analyst's participation--to dream the patient's previously undreamable and interrupted dreams. A significant part of the analyst's participation in the patient's dreaming takes the form of the analyst's reverie experience. In the course of this conjoint work of dreaming in the analytic setting, the analyst may get to know the analysand sufficiently well for the analyst to be able to say something that is true to what is occurring at an unconscious level in the analytic relationship. The analyst's use of language contributes significantly to the possibility that the patient will be able to make use of what the analyst has said for purposes of dreaming his own experience, thereby dreaming himself more fully into existence.

  2. Multi-configuration time-dependent density-functional theory based on range separation

    DEFF Research Database (Denmark)

    Fromager, E.; Knecht, S.; Jensen, Hans Jørgen Aagaard

    2013-01-01

    Multi-configuration range-separated density-functional theory is extended to the time-dependent regime. An exact variational formulation is derived. The approximation, which consists in combining a long-range Multi-Configuration- Self-Consistent Field (MCSCF) treatment with an adiabatic short...... (srGGA) approximations. As expected, when modeling long-range interactions with the MCSCF model instead of the adiabatic Buijse-Baerends density-matrix functional as recently proposed by Pernal [J. Chem. Phys. 136, 184105 (2012)10.1063/1.4712019], the description of both the 1D doubly-excited state...

  3. Interrupted inferior vena cava with hemiazygos continuation in an adult with a persistent left superior vena cava and left single coronary artery: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yeo Jin; Kwon, Se Hwan; Ahn, Sung Eun; Kim, Soo Joong; Oh, Joo Hyeong [College of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Shin, Jong Soo [Dept. of Radiology, Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of)

    2016-06-15

    A 50-year-old woman was referred to our institution for medical screening due to an incidental finding on abdominal ultrasonography. She underwent chest, abdomen and cardiac multi-detector computed tomography (MDCT). Her MDCT revealed absence of the hepatic segment of the inferior vena cava (IVC), with hemiazygos continuation and a left single coronary artery. The dilated hemiazygos vein drained directly into the persistent left superior vena cava (SVC). Herein, we reported a very rare case combining an incidentally found interrupted IVC with hemiazygos vein continuation, persistent left SVC and a left single coronary artery diagnosed by MDCT.

  4. Time-dependent evolution of rock slopes by a multi-modelling approach

    Science.gov (United States)

    Bozzano, F.; Della Seta, M.; Martino, S.

    2016-06-01

    This paper presents a multi-modelling approach that incorporates contributions from morpho-evolutionary modelling, detailed engineering-geological modelling and time-dependent stress-strain numerical modelling to analyse the rheological evolution of a river valley slope over approximately 102 kyr. The slope is located in a transient, tectonically active landscape in southwestern Tyrrhenian Calabria (Italy), where gravitational processes drive failures in rock slopes. Constraints on the valley profile development were provided by a morpho-evolutionary model based on the correlation of marine and river strath terraces. Rock mass classes were identified through geomechanical parameters that were derived from engineering-geological surveys and outputs of a multi-sensor slope monitoring system. The rock mass classes were associated to lithotechnical units to obtain a high-resolution engineering-geological model along a cross section of the valley. Time-dependent stress-strain numerical modelling reproduced the main morpho-evolutionary stages of the valley slopes. The findings demonstrate that a complex combination of eustatism, uplift and Mass Rock Creep (MRC) deformations can lead to first-time failures of rock slopes when unstable conditions are encountered up to the generation of stress-controlled shear zones. The multi-modelling approach enabled us to determine that such complex combinations may have been sufficient for the first-time failure of the S. Giovanni slope at approximately 140 ka (MIS 7), even without invoking any trigger. Conversely, further reactivations of the landslide must be related to triggers such as earthquakes, rainfall and anthropogenic activities. This failure involved a portion of the slope where a plasticity zone resulted from mass rock creep that evolved with a maximum strain rate of 40% per thousand years, after the formation of a river strath terrace. This study demonstrates that the multi-modelling approach presented herein is a useful

  5. Fractional governing equations of transient groundwater flow in confined aquifers with multi-fractional dimensions in fractional time

    OpenAIRE

    M. L. Kavvas; T. Tu; A. Ercan; J. Polsinelli

    2017-01-01

    Using fractional calculus, a dimensionally consistent governing equation of transient, saturated groundwater flow in fractional time in a multi-fractional confined aquifer is developed. First, a dimensionally consistent continuity equation for transient saturated groundwater flow in fractional time and in a multi-fractional, multidimensional confined aquifer is developed. For the equation of water flux within a multi-fractional multidimensional confined aquifer, a dimensionally...

  6. Evidence - competence - discourse: the theoretical framework of the multi-centre clinical ethics support project METAP.

    Science.gov (United States)

    Reiter-Theil, Stella; Mertz, Marcel; Schürmann, Jan; Stingelin Giles, Nicola; Meyer-Zehnder, Barbara

    2011-09-01

    In this paper we assume that 'theory' is important for Clinical Ethics Support Services (CESS). We will argue that the underlying implicit theory should be reflected. Moreover, we suggest that the theoretical components on which any clinical ethics support (CES) relies should be explicitly articulated in order to enhance the quality of CES. A theoretical framework appropriate for CES will be necessarily complex and should include ethical (both descriptive and normative), metaethical and organizational components. The various forms of CES that exist in North-America and in Europe show their underlying theory more or less explicitly, with most of them referring to some kind of theoretical components including 'how-to' questions (methodology), organizational issues (implementation), problem analysis (phenomenology or typology of problems), and related ethical issues such as end-of-life decisions (major ethical topics). In order to illustrate and explain the theoretical framework that we are suggesting for our own CES project METAP, we will outline this project which has been established in a multi-centre context in several healthcare institutions. We conceptualize three 'pillars' as the major components of our theoretical framework: (1) evidence, (2) competence, and (3) discourse. As a whole, the framework is aimed at developing a foundation of our CES project METAP. We conclude that this specific integration of theoretical components is a promising model for the fruitful further development of CES. © 2011 Blackwell Publishing Ltd.

  7. Defining and describing birth centres in the Netherlands - a component study of the Dutch Birth Centre Study.

    Science.gov (United States)

    Hermus, M A A; Boesveld, I C; Hitzert, M; Franx, A; de Graaf, J P; Steegers, E A P; Wiegers, T A; van der Pal-de Bruin, K M

    2017-07-03

    During the last decade, a rapid increase of birth locations for low-risk births, other than conventional obstetric units, has been seen in the Netherlands. Internationally some of such locations are called birth centres. The varying international definitions for birth centres are not directly applicable for use within the Dutch obstetric system. A standard definition for a birth centre in the Netherlands is lacking. This study aimed to develop a definition of birth centres for use in the Netherlands, to identify these centres and to describe their characteristics. International definitions of birth centres were analysed to find common descriptions. In July 2013 the Dutch Birth Centre Questionnaire was sent to 46 selected Dutch birth locations that might qualify as birth centre. Questions included: location, reason for establishment, women served, philosophies, facilities that support physiological birth, hotel-facilities, management, environment and transfer procedures in case of referral. Birth centres were visited to confirm the findings from the Dutch Birth Centre Questionnaire and to measure distance and time in case of referral to obstetric care. From all 46 birth locations the questionnaires were received. Based on this information a Dutch definition of a birth centre was constructed. This definition reads: "Birth centres are midwifery-managed locations that offer care to low risk women during labour and birth. They have a homelike environment and provide facilities to support physiological birth. Community midwives take primary professional responsibility for care. In case of referral the obstetric caregiver takes over the professional responsibility of care." Of the 46 selected birth locations 23 fulfilled this definition. Three types of birth centres were distinguished based on their location in relation to the nearest obstetric unit: freestanding (n = 3), alongside (n = 14) and on-site (n = 6). Transfer in case of referral was necessary for all

  8. Time characteristics of a multi-wire 4πβ-counter

    International Nuclear Information System (INIS)

    Miyahara, Hiroshi; Watanabe, Tamaki

    1981-01-01

    In order to examine the time characteristics of a multi-wire 4πβ-counter for the 4πβ-γ coincidence system, measurement was made on the time distributions of the pulses from the individual anodes. The time distribution obtained by each anode was explained mainly by the distribution of primary ionizing position. A similar time distribution was obtained in the case that the alternating wires cathodes, when the individual anodes had the same effective detection region. Spurious pulses were observed in 90% argon plus 10% methane mixture at the end voltage of the plateau region and not methane gas. (author)

  9. Continuous data recording on fast real-time systems

    Energy Technology Data Exchange (ETDEWEB)

    Zabeo, L., E-mail: lzabeo@jet.u [Euratom-CCFE, Culham Science Centre, Abingdon, Oxon OX14 3DB (United Kingdom); Sartori, F. [Euratom-CCFE, Culham Science Centre, Abingdon, Oxon OX14 3DB (United Kingdom); Neto, A. [Associacao Euratom-IST, Instituto de Plasmas e Fusao Nuclear, Av. Rovisco Pais, 1049-001 Lisboa (Portugal); Piccolo, F. [Euratom-CCFE, Culham Science Centre, Abingdon, Oxon OX14 3DB (United Kingdom); Alves, D. [Associacao Euratom-IST, Instituto de Plasmas e Fusao Nuclear, Av. Rovisco Pais, 1049-001 Lisboa (Portugal); Vitelli, R. [Dipartimento di Informatica, Sistemi e Produzione, Universita di Roma, Tor Vergata, Via del Politecnico, 1-00133 Roma (Italy); Barbalace, A. [Euratom-ENEA Association, Consorzio RFX, 35127 Padova (Italy); De Tommasi, G. [Associazione EURATOM/ENEA/CREATE, Universita di Napoli Federico II, Napoli (Italy)

    2010-07-15

    The PCU-Project launched for the enhancement of the vertical stabilisation system at JET required the design of a new real-time control system with the challenging specifications of 2Gops and a cycle time of 50 {mu}s. The RTAI based architecture running on an x86 multi-core processor technology demonstrated to be the best platform for meeting the high requirements. Moreover, on this architecture thanks to the smart allocation of the interrupts it was possible to demonstrate simultaneous data streaming at 50 MBs on Ethernet while handling a real-time 100 kHz interrupt source with a maximum jitter of just 3 {mu}s. Because of the memory limitation imposed by 32 bit version Linux running in kernel mode, the RTAI-based new controller allows a maximum practical data storage of 800 MB per pulse. While this amount of data can be accepted for JET normal operation it posed some limitations in the debugging and commissioning of the system. In order to increase the capability of the data acquisition of the system we have designed a mechanism that allows continuous full bandwidth (56 MB/s) data streaming from the real-time task (running in kernel mode) to either a data collector (running in user mode) or an external data acquisition server. The exploited architecture involves a peer to peer mechanisms where the sender running in RTAI kernel mode broadcasts large chunks of data using UDP packets, implemented using the 'fcomm' RTAI extension , to a receiver that will store the data. The paper will present the results of the initial RTAI operating system tests, the design of the streaming architecture and the first experimental results.

  10. The CCCB is a cultural centre, not a tourist centre

    Directory of Open Access Journals (Sweden)

    Elena Xirau

    2004-04-01

    Full Text Available Last February, Barcelona's Centre of Contemporary Culture (CCCB celebrated its first ten years in existence. During this time, this institution has looked to be a showcase to the most modern and innovative cultural expressions focused on reflecting on the concept of the city. In this interview, Josep Ramoneda offers his personal view, as the CCCB's director. He talks of how this cultural project was born, of how the concept of the institution took shape in the CCCB, of its relations with Barcelona's Strategic Plan, of how the project has evolved, of the architectural remodelling of the Casa de la Caritat building for its conversion into a cultural centre, of the relations with other institutions and its future.

  11. Analytical Solutions for Multi-Time Scale Fractional Stochastic Differential Equations Driven by Fractional Brownian Motion and Their Applications

    OpenAIRE

    Xiao-Li Ding; Juan J. Nieto

    2018-01-01

    In this paper, we investigate analytical solutions of multi-time scale fractional stochastic differential equations driven by fractional Brownian motions. We firstly decompose homogeneous multi-time scale fractional stochastic differential equations driven by fractional Brownian motions into independent differential subequations, and give their analytical solutions. Then, we use the variation of constant parameters to obtain the solutions of nonhomogeneous multi-time scale fractional stochast...

  12. Free-time and fixed end-point multi-target optimal control theory: Application to quantum computing

    International Nuclear Information System (INIS)

    Mishima, K.; Yamashita, K.

    2011-01-01

    Graphical abstract: The two-state Deutsch-Jozsa algortihm used to demonstrate the utility of free-time and fixed-end point multi-target optimal control theory. Research highlights: → Free-time and fixed-end point multi-target optimal control theory (FRFP-MTOCT) was constructed. → The features of our theory include optimization of the external time-dependent perturbations with high transition probabilities, that of the temporal duration, the monotonic convergence, and the ability to optimize multiple-laser pulses simultaneously. → The advantage of the theory and a comparison with conventional fixed-time and fixed end-point multi-target optimal control theory (FIFP-MTOCT) are presented by comparing data calculated using the present theory with those published previously [K. Mishima, K. Yamashita, Chem. Phys. 361 (2009) 106]. → The qubit system of our interest consists of two polar NaCl molecules coupled by dipole-dipole interaction. → The calculation examples show that our theory is useful for minor adjustment of the external fields. - Abstract: An extension of free-time and fixed end-point optimal control theory (FRFP-OCT) to monotonically convergent free-time and fixed end-point multi-target optimal control theory (FRFP-MTOCT) is presented. The features of our theory include optimization of the external time-dependent perturbations with high transition probabilities, that of the temporal duration, the monotonic convergence, and the ability to optimize multiple-laser pulses simultaneously. The advantage of the theory and a comparison with conventional fixed-time and fixed end-point multi-target optimal control theory (FIFP-MTOCT) are presented by comparing data calculated using the present theory with those published previously [K. Mishima, K. Yamashita, Chem. Phys. 361, (2009), 106]. The qubit system of our interest consists of two polar NaCl molecules coupled by dipole-dipole interaction. The calculation examples show that our theory is useful for minor

  13. Effects of a partially supervised conditioning programme in cystic fibrosis: an international multi-centre randomised controlled trial (ACTIVATE-CF): study protocol.

    Science.gov (United States)

    Hebestreit, Helge; Lands, Larry C; Alarie, Nancy; Schaeff, Jonathan; Karila, Chantal; Orenstein, David M; Urquhart, Don S; Hulzebos, Erik H J; Stein, Lothar; Schindler, Christian; Kriemler, Susi; Radtke, Thomas

    2018-02-08

    Physical activity (PA) and exercise have become an accepted and valued component of cystic fibrosis (CF) care. Regular PA and exercise can positively impact pulmonary function, improve physical fitness, and enhance health-related quality of life (HRQoL). However, motivating people to be more active is challenging. Supervised exercise programs are expensive and labour intensive, and adherence falls off significantly once supervision ends. Unsupervised or partially supervised programs are less costly and more flexible, but compliance can be more problematic. The primary objective of this study is to evaluate the effects of a partially supervised exercise intervention along with regular motivation on forced expiratory volume in 1 s (FEV 1 ) at 6 months in a large international group of CF patients. Secondary endpoints include patient reported HRQoL, as well as levels of anxiety and depression, and control of blood sugar. It is planned that a total of 292 patients with CF 12 years and older with a FEV 1  ≥ 35% predicted shall be randomised. Following baseline assessments (2 visits) patients are randomised into an intervention and a control group. Thereafter, they will be seen every 3 months for assessments in their centre for one year (4 follow-up visits). Along with individual counselling to increase vigorous PA by at least 3 h per week on each clinic visit, the intervention group documents daily PA and inactivity time and receives a step counter to record their progress within a web-based diary. They also receive monthly phone calls from the study staff during the first 6 months of the study. After 6 months, they continue with the step counter and web-based programme for a further 6 months. The control group receives standard care and keeps their PA level constant during the study period. Thereafter, they receive the intervention as well. This is the first large, international multi-centre study to investigate the effects of a PA intervention in CF with

  14. Research on climate change and variability at the Ab dus Salam International Centre for Theoretical Physics

    International Nuclear Information System (INIS)

    Giorgi, F.; Molteni, F.

    2002-01-01

    The Physics of Weather and Climate Section at the Abdus Salam International Centre for Theoretical Physics, established in 1998, is currently performing research on different aspects of climate variability, dealing with both natural and anthropogenic aspects of climate changes. In addition to performing diagnostic work on multi-decadal observational datasets and climate simulations carried out in major research centres, the PWC section has been developing its own climate modeling capability, which is focused on three main areas: a) modeling of regional climate change; b) seasonal forecasting at global and regional scale; c) development of simplified models of the general circulation. On topic a), research on different aspects of anthropogenic climate change is being carried out using the Regional Climate (RegCM) developed by Giorgi and collaborators at the National Centre for Atmospheric Research. Time-slice experiments with a high-resolution atmospheric GCM, comparing current climate conditions with future climate scenarios in selected decades, are also planned for the near future. On topic b), a strategy based on ensembles of high-resolution simulations with atmospheric GCM's, using sea surface temperature anomalies predicted by lower-resolution coupled models from other institutions, is currently under experimentation. A one-way nesting of RegCM into the GCM simulations will also be tested. On item c), a 5-layer atmospheric GCM with simplified physical parameterizations has been developed. This model has a very small computational cost compared with state-of-the-art GCMs, and is suitable for studies of natural climate variability on inter-decadal and intercentennial time scales. It is planned to couple this model to simplified ocean models of different complexity, from a simple, static mixed layer model, to simplified models of the tropical Pacific circulation suited to the simulation of the El Nino phenomenon. A joint project with the IAEA-MEL Laboratory in

  15. Electric circuit breaker comprising a plurality of vacuum interrupters simultaneously operated by a common operator

    Science.gov (United States)

    Barkan, Philip; Imam, Imdad

    1980-01-01

    This circuit breaker comprises a plurality of a vacuum-type circuit interrupters, each having a movable contact rod. A common operating device for the interrupters comprises a linearly-movable operating member. The interrupters are mounted at one side of the operating member with their movable contact rods extending in a direction generally toward the operating member. Means is provided for mechanically coupling the operating member to the contact rods, and this means comprises a plurality of insulating operating rods, each connected at one end to the operating member and at its opposite end to one of the movable contact rods. The operating rods are of substantially equal length and have longitudinal axes that converge and intersect at substantially a common point.

  16. Synchrotron radiation-based quasi-elastic scattering using time-domain interferometry with multi-line gamma rays.

    Science.gov (United States)

    Saito, Makina; Masuda, Ryo; Yoda, Yoshitaka; Seto, Makoto

    2017-10-02

    We developed a multi-line time-domain interferometry (TDI) system using 14.4 keV Mössbauer gamma rays with natural energy widths of 4.66 neV from 57 Fe nuclei excited using synchrotron radiation. Electron density fluctuations can be detected at unique lengths ranging from 0.1 nm to a few nm on time scales from several nanoseconds to the sub-microsecond order by quasi-elastic gamma-ray scattering (QGS) experiments using multi-line TDI. In this report, we generalize the established expression for a time spectrum measured using an identical single-line gamma-ray emitter pair to the case of a nonidentical pair of multi-line gamma-ray emitters by considering the finite energy width of the incident synchrotron radiation. The expression obtained illustrates the unique characteristics of multi-line TDI systems, where the finite incident energy width and use of a nonidentical emitter pair produces further information on faster sub-picosecond-scale dynamics in addition to the nanosecond dynamics; this was demonstrated experimentally. A normalized intermediate scattering function was extracted from the spectrum and its relaxation form was determined for a relaxation time of the order of 1 μs, even for relatively large momentum transfer of ~31 nm -1 . The multi-line TDI method produces a microscopic relaxation picture more rapidly and accurately than conventional single-line TDI.

  17. Differences in care burden of patients undergoing dialysis in different centres in the netherlands.

    Science.gov (United States)

    de Kleijn, Ria; Uyl-de Groot, Carin; Hagen, Chris; Diepenbroek, Adry; Pasker-de Jong, Pieternel; Ter Wee, Piet

    2017-06-01

    A classification model was developed to simplify planning of personnel at dialysis centres. This model predicted the care burden based on dialysis characteristics. However, patient characteristics and different dialysis centre categories might also influence the amount of care time required. To determine if there is a difference in care burden between different categories of dialysis centres and if specific patient characteristics predict nursing time needed for patient treatment. An observational study. Two hundred and forty-two patients from 12 dialysis centres. In 12 dialysis centres, nurses filled out the classification list per patient and completed a form with patient characteristics. Nephrologists filled out the Charlson Comorbidity Index. Independent observers clocked the time nurses spent on separate steps of the dialysis for each patient. Dialysis centres were categorised into four types. Data were analysed using regression models. In contrast to other dialysis centres, academic centres needed 14 minutes more care time per patient per dialysis treatment than predicted in the classification model. No patient characteristics were found that influenced this difference. The only patient characteristic that predicted the time required was gender, with more time required to treat women. Gender did not affect the difference between measured and predicted care time. Differences in care burden were observed between academic and other centres, with more time required for treatment in academic centres. Contribution of patient characteristics to the time difference was minimal. The only patient characteristics that predicted care time were previous transplantation, which reduced the time required, and gender, with women requiring more care time. © 2017 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  18. Implementation of a high precision multi-measurement time-to-digital convertor on a Kintex-7 FPGA

    Science.gov (United States)

    Kuang, Jie; Wang, Yonggang; Cao, Qiang; Liu, Chong

    2018-05-01

    Time-to-digital convertors (TDCs) based on field programmable gate array (FPGA) are becoming more and more popular. Multi-measurement is an effective method to improve TDC precision beyond the cell delay limitation. However, the implementation of TDC with multi-measurement on FPGAs manufactured with 28 nm and more advanced process is facing new challenges. Benefiting from the ones-counter encoding scheme, which was developed in our previous work, we implement a ring oscillator multi-measurement TDC on a Xilinx Kintex-7 FPGA. Using the two TDC channels to measure time-intervals in the range (0 ns-30 ns), the average RMS precision can be improved to 5.76 ps, meanwhile the logic resource usage remains the same with the one-measurement TDC, and the TDC dead time is only 22 ns. The investigation demonstrates that the multi-measurement methods are still available for current main-stream FPGAs. Furthermore, the new implementation in this paper could make the trade-off among the time precision, resource usage and TDC dead time better than ever before.

  19. Reference ranges for interrupter resistance technique: the Asthma UK Initiative.

    NARCIS (Netherlands)

    Merkus, P.J.F.M.; Stocks, J.; Beydon, N.; Lombardi, E.; Jones, M.; McKenzie, S.A.; Kivastik, J.; Arets, B.G.; Stanojevic, S.

    2010-01-01

    Measuring interrupter resistance (R(int)) is an increasingly popular lung function technique and especially suitable for preschool children because it is simple, quick and requires only passive cooperation. A European Respiratory Society (ERS)/American Thoracic Society (ATS) Task Force recently

  20. Adaptive Multi-Layered Space-Time Block Coded Systems in Wireless Environments

    KAUST Repository

    Al-Ghadhban, Samir

    2014-01-01

    © 2014, Springer Science+Business Media New York. Multi-layered space-time block coded systems (MLSTBC) strike a balance between spatial multiplexing and transmit diversity. In this paper, we analyze the block error rate performance of MLSTBC

  1. Efficacy and safety of rasagiline as an adjunct to levodopa treatment in Chinese patients with Parkinson's disease: a randomized, double-blind, parallel-controlled, multi-centre trial.

    Science.gov (United States)

    Zhang, Lina; Zhang, Zhiqin; Chen, Yangmei; Qin, Xinyue; Zhou, Huadong; Zhang, Chaodong; Sun, Hongbin; Tang, Ronghua; Zheng, Jinou; Yi, Lin; Deng, Liying; Li, Jinfang

    2013-08-01

    Rasagiline mesylate is a highly potent, selective and irreversible monoamine oxidase type B (MAOB) inhibitor and is effective as monotherapy or adjunct to levodopa for patients with Parkinson's disease (PD). However, few studies have evaluated the efficacy and safety of rasagiline in the Chinese population. This study was designed to investigate the safety and efficacy of rasagiline as adjunctive therapy to levodopa treatment in Chinese PD patients. This was a randomized, double-blind, placebo-controlled, parallel-group, multi-centre trial conducted over a 12-wk period that enrolled 244 PD patients with motor fluctuations. Participants were randomly assigned to oral rasagiline mesylate (1 mg) or placebo, once daily. Altogether, 219 patients completed the trial. Rasagiline showed significantly greater efficacy compared with placebo. During the treatment period, the primary efficacy variable--mean adjusted total daily off time--decreased from baseline by 1.7 h in patients treated with 1.0 mg/d rasagiline compared to placebo (p rasagiline treatment. Rasagiline was well tolerated. This study demonstrated that rasagiline mesylate is effective and well tolerated as an adjunct to levodopa treatment in Chinese PD patients with fluctuations.

  2. Patient-centred performance monitoring systems and multi-agency care provision: a case study using a stakeholder participative approach.

    Science.gov (United States)

    Connell, N A; Goddard, A R; Philp, I; Bray, J

    1998-05-01

    We describe the processes involved in the development of an information system which can assess how care given by a number of agencies could be monitored by those agencies. In particular, it addresses the problem of sharing information as the boundaries of each agency are crossed. It focuses on the care of one specific patient group--the rehabilitation of elderly patients in the community, which provided an ideal multi-agency setting. It also describes: how a stakeholder participative approach to information system development was undertaken, based in part on the Soft Systems Methodology (SSM) approach (Checkland, 1981, 1990); some of the difficulties encountered in using such an approach; and the ways in which these were addressed. The paper goes on to describe an assessment tool called SCARS (the Southampton Community Ability Rating Scale). It concludes by reflecting on the management lessons arising from this project. It also observes, inter alia, how stakeholders have a strong preference for simpler, non-IT based systems, and comments on the difficulties encountered by stakeholders in attempting to reconcile their perceptions of the needs of their discipline or specialty with a more patient-centred approach of an integrated system.

  3. Stochastic partial differential fluid equations as a diffusive limit of deterministic Lagrangian multi-time dynamics.

    Science.gov (United States)

    Cotter, C J; Gottwald, G A; Holm, D D

    2017-09-01

    In Holm (Holm 2015 Proc. R. Soc. A 471 , 20140963. (doi:10.1098/rspa.2014.0963)), stochastic fluid equations were derived by employing a variational principle with an assumed stochastic Lagrangian particle dynamics. Here we show that the same stochastic Lagrangian dynamics naturally arises in a multi-scale decomposition of the deterministic Lagrangian flow map into a slow large-scale mean and a rapidly fluctuating small-scale map. We employ homogenization theory to derive effective slow stochastic particle dynamics for the resolved mean part, thereby obtaining stochastic fluid partial equations in the Eulerian formulation. To justify the application of rigorous homogenization theory, we assume mildly chaotic fast small-scale dynamics, as well as a centring condition. The latter requires that the mean of the fluctuating deviations is small, when pulled back to the mean flow.

  4. The driving and controlling techniques of compactPCI bus in VxWorks real-time operating system

    International Nuclear Information System (INIS)

    Li Anzong; Ju Xiaodong; Qiao Wenxiao

    2005-01-01

    CompactPCI bus and interface featuring, the content and function of PCI configuration register are introduced herein. The driving and controlling techniques of CompactPCI bus in VxWorks real-time operating system are detailed. Hardware interrupt handling is one of key significance in real-time systems, because it is usually through interrupts that the system is informed of external events. VxWorks allows C functions to be connected to any interrupt. A routine connected to an interrupt in this way is called an interrupt service routine (ISR). For response of interrupt, interrupt control/status register of PCI 9054 interface chip needs to be set. The general-purpose binary semaphore used in ISR is capable of addressing the requirements of both forms of task coordination: mutual exclusion and synchronization. Therefore, the system runs stably and reliably. (authors)

  5. Splinting after contracture release for Dupuytren's contracture (SCoRD: protocol of a pragmatic, multi-centre, randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Chojnowski Adrian J

    2008-04-01

    Full Text Available Abstract Background Splinting as part of the overall post-surgical management of patients after release of Dupuytren's contracture has been widely reported, though there is variation in practice and criteria for using it. The evidence on its effectiveness is sparse, of poor quality and contradictory with studies reporting negative and positive effects. Methods/Design A multi-centre, pragmatic, randomized, controlled trial is being conducted to evaluate the effect of static night splinting for six months on hand function, range of movement, patient satisfaction and recurrence at 1 year after fasciectomy or dermofasciectomy. Using a centrally administered computer randomization system consented patients will be allocated to one of two groups: i splint group who will be given a static splint at approximately 10 to 14 days after surgery to be worn for 6 months at night time only as well as hand therapy; ii non-splint group, who will receive hand therapy only. The primary outcome measure is the patient-reported Disabilities of the Arm, Hand and Shoulder Questionnaire (DASH. Secondary outcomes are total active flexion and extension of fingers, patient satisfaction and recurrence of contracture. Outcome measures will be collected prior to surgery, 3 months, 6 months and 1 year after surgery. Using the DASH as the primary outcome measure, where a difference of 15 points is considered to be a clinically important difference a total of 51 patients will be needed in each group for a power of 90%. An intention-to-treat analysis will be used. Discussion This pragmatic randomized controlled trial will provide much needed evidence on the clinical effectiveness of post-operative night splinting in patients who have undergone fasciectomy or dermofasciectomy for Dupuytren's contracture of the hand. Trial Registration Current Controlled Trials ISRCTN 57079614

  6. Model-based framework for multi-axial real-time hybrid simulation testing

    Science.gov (United States)

    Fermandois, Gaston A.; Spencer, Billie F.

    2017-10-01

    Real-time hybrid simulation is an efficient and cost-effective dynamic testing technique for performance evaluation of structural systems subjected to earthquake loading with rate-dependent behavior. A loading assembly with multiple actuators is required to impose realistic boundary conditions on physical specimens. However, such a testing system is expected to exhibit significant dynamic coupling of the actuators and suffer from time lags that are associated with the dynamics of the servo-hydraulic system, as well as control-structure interaction (CSI). One approach to reducing experimental errors considers a multi-input, multi-output (MIMO) controller design, yielding accurate reference tracking and noise rejection. In this paper, a framework for multi-axial real-time hybrid simulation (maRTHS) testing is presented. The methodology employs a real-time feedback-feedforward controller for multiple actuators commanded in Cartesian coordinates. Kinematic transformations between actuator space and Cartesian space are derived for all six-degrees-offreedom of the moving platform. Then, a frequency domain identification technique is used to develop an accurate MIMO transfer function of the system. Further, a Cartesian-domain model-based feedforward-feedback controller is implemented for time lag compensation and to increase the robustness of the reference tracking for given model uncertainty. The framework is implemented using the 1/5th-scale Load and Boundary Condition Box (LBCB) located at the University of Illinois at Urbana- Champaign. To demonstrate the efficacy of the proposed methodology, a single-story frame subjected to earthquake loading is tested. One of the columns in the frame is represented physically in the laboratory as a cantilevered steel column. For realtime execution, the numerical substructure, kinematic transformations, and controllers are implemented on a digital signal processor. Results show excellent performance of the maRTHS framework when six

  7. Period of an Interrupted Pendulum

    Science.gov (United States)

    Miller, Bradley E.

    2002-11-01

    While demonstrating a classic conservation-of-energy problem to my AP Physics students, I became curious about the periodic motion that ensued for certain initial conditions. The original problem consists of releasing a mass at the end of a string from an initial position horizontal to the plane of a table. The string comes in contact with a peg some distance below the point where the string is attached at the top. One is asked to find what minimum fraction of the string's length should the peg be placed to have the mass complete a circle about the peg. However, when the mass is released from much lower heights, the system undergoes periodic motion that can be thought of as an interrupted pendulum.

  8. Prevalence of bovine mastitis and multi-antibiotic resistant ...

    African Journals Online (AJOL)

    Prevalence of bovine mastitis and multi-antibiotic resistant Staphylococcus and ... Bulletin of Animal Health and Production in Africa ... their antibiotic sensitivities and management practices of sahiwal and dairy cattle kept at a centre of Kenya ...

  9. Entangled time in flocking: Multi-time-scale interaction reveals emergence of inherent noise.

    Science.gov (United States)

    Niizato, Takayuki; Murakami, Hisashi

    2018-01-01

    Collective behaviors that seem highly ordered and result in collective alignment, such as schooling by fish and flocking by birds, arise from seamless shuffling (such as super-diffusion) and bustling inside groups (such as Lévy walks). However, such noisy behavior inside groups appears to preclude the collective behavior: intuitively, we expect that noisy behavior would lead to the group being destabilized and broken into small sub groups, and high alignment seems to preclude shuffling of neighbors. Although statistical modeling approaches with extrinsic noise, such as the maximum entropy approach, have provided some reasonable descriptions, they ignore the cognitive perspective of the individuals. In this paper, we try to explain how the group tendency, that is, high alignment, and highly noisy individual behavior can coexist in a single framework. The key aspect of our approach is multi-time-scale interaction emerging from the existence of an interaction radius that reflects short-term and long-term predictions. This multi-time-scale interaction is a natural extension of the attraction and alignment concept in many flocking models. When we apply this method in a two-dimensional model, various flocking behaviors, such as swarming, milling, and schooling, emerge. The approach also explains the appearance of super-diffusion, the Lévy walk in groups, and local equilibria. At the end of this paper, we discuss future developments, including extending our model to three dimensions.

  10. Time-courses of lung function and respiratory muscle pressure generating capacity after spinal cord injury : a prospective cohort study

    NARCIS (Netherlands)

    Mueller, Gabi; de Groot, Sonja; van der Woude, Lucas; Hopman, Maria T E

    OBJECTIVE: To investigate the time-courses of lung function and respiratory muscle pressure generating capacity after spinal cord injury. DESIGN: Multi-centre, prospective cohort study. SUBJECTS: One hundred and nine subjects with recent, motor complete spinal cord injury. METHODS: Lung function and

  11. Real-time data acquisition and control system for the 349-pixel TACTIC atmospheric Cherenkov imaging telescope

    Energy Technology Data Exchange (ETDEWEB)

    Yadav, K.K.; Koul, R.; Kanda, A.; Kaul, S.R.; Tickoo, A.K. E-mail: aktickoo@apsara.barc.ernet.in; Rannot, R.C.; Chandra, P.; Bhatt, N.; Chouhan, N.; Venugopal, K.; Kothari, M.; Goyal, H.C.; Dhar, V.K.; Kaul, S.K

    2004-07-21

    An interrupt-based multinode data acquisition and control system has been developed for the imaging element of the TACTIC {gamma}-ray telescope. The system which has been designed around a 3-node network of PCs running the QNX real-time operating system, provides single-point control with elaborate GUI facilities for operating the multi-pixel camera of the telescope. In addition to acquiring data from the 349-pixel photomultiplier tube based imaging camera in real time, the system also provides continuous monitoring and control of several vital parameters of the telescope for ensuring the quality of the data. The paper describes the salient features of the hardware and software of the data acquisition and control system of the telescope.

  12. Effect of a population-level performance dashboard intervention on maternal-newborn outcomes: an interrupted time series study.

    Science.gov (United States)

    Weiss, Deborah; Dunn, Sandra I; Sprague, Ann E; Fell, Deshayne B; Grimshaw, Jeremy M; Darling, Elizabeth; Graham, Ian D; Harrold, JoAnn; Smith, Graeme N; Peterson, Wendy E; Reszel, Jessica; Lanes, Andrea; Walker, Mark C; Taljaard, Monica

    2018-06-01

    To assess the effect of the Maternal Newborn Dashboard on six key clinical performance indicators in the province of Ontario, Canada. Interrupted time series using population-based data from the provincial birth registry covering a 3-year period before implementation of the Dashboard and 2.5 years after implementation (November 2009 through March 2015). All hospitals in the province of Ontario providing maternal-newborn care (n=94). A hospital-based online audit and feedback programme. Rates of the six performance indicators included in the Dashboard. 2.5 years after implementation, the audit and feedback programme was associated with statistically significant absolute decreases in the rates of episiotomy (decrease of 1.5 per 100 women, 95% CI 0.64 to 2.39), induction for postdates in women who were less than 41 weeks at delivery (decrease of 11.7 per 100 women, 95% CI 7.4 to 16.0), repeat caesarean delivery in low-risk women performed before 39 weeks (decrease of 10.4 per 100 women, 95% CI 9.3 to 11.5) and an absolute increase in the rate of appropriately timed group B streptococcus screening (increase of 2.8 per 100, 95% CI 2.2 to 3.5). The audit and feedback programme did not significantly affect the rates of unsatisfactory newborn screening blood samples or formula supplementation at discharge. No statistically significant effects were observed for the two internal control outcomes or the four external control indicators-in fact, two external control indicators (episiotomy and postdates induction) worsened relative to before implementation. An electronic audit and feedback programme implemented in maternal-newborn hospitals was associated with clinically relevant practice improvements at the provincial level in the majority of targeted indicators. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. A Multiple-Reception Access Protocol with Interruptions with Mixed Priorities in CDMA Networks

    Institute of Scientific and Technical Information of China (English)

    Lu Xiaowen; Zhu Jinkang

    2003-01-01

    A novel access protocol called Multiple-Reception Access Protocol (MRAP) and its modification MRAP/WI are proposed. In this protocol, all colliding users with a common code can be identified by the base station due to the offset of arrival time Thus they can retransmit access requests under the base station's control. Furthermore new arrivals with higher priority level can interrupt the lower retransmission in order to reduce its access delay although it increases the lower priority's delay. Simulation results of MRAP and MRAP/WI are given in order to highlight the superior performance of the proposed approach.

  14. Institutional Narcissism, Arrogant Organization Disorder and Interruptions in Organizational Learning

    Science.gov (United States)

    Godkin, Lynn; Allcorn, Seth

    2009-01-01

    Purpose: This article aims to present an alternative approach to diagnosing behavioral barriers to organizational learning. Design/methodology/approach: The paper juxtaposes interruptions in organizational learning with characteristics of narcissism and arrogant organization disorder. Psychoanalytically informed theory and DSM-IV criteria are…

  15. Smartphone addiction, daily interruptions and self-reported productivity

    Directory of Open Access Journals (Sweden)

    Éilish Duke

    2017-12-01

    Full Text Available The advent of the smartphone has dramatically altered how we communicate, navigate, work and entertain ourselves. While the advantages of this new technology are clear, constant use may also bring negative consequences, such as a loss of productivity due to interruptions in work life. A link between smartphone overuse and loss of productivity has often been hypothesized, but empirical evidence on this question is scarce. The present study addressed this question by collecting self-report data from N=262 participants, assessing private and work-related smartphone use, smartphone addiction and self-rated productivity. Our results indicate a moderate relationship between smartphone addiction and a self-reported decrease in productivity due to spending time on the smartphone during work, as well as with the number of work hours lost to smartphone use. Smartphone addiction was also related to a greater amount of leisure time spent on the smartphone and was strongly related to a negative impact of smartphone use on daily non-work related activities. These data support the idea that tendencies towards smartphone addiction and overt checking of the smartphone could result in less productivity both in the workplace and at home. Results are discussed in relation to productivity and technostress.

  16. Smartphone addiction, daily interruptions and self-reported productivity.

    Science.gov (United States)

    Duke, Éilish; Montag, Christian

    2017-12-01

    The advent of the smartphone has dramatically altered how we communicate, navigate, work and entertain ourselves. While the advantages of this new technology are clear, constant use may also bring negative consequences, such as a loss of productivity due to interruptions in work life. A link between smartphone overuse and loss of productivity has often been hypothesized, but empirical evidence on this question is scarce. The present study addressed this question by collecting self-report data from N  = 262 participants, assessing private and work-related smartphone use, smartphone addiction and self-rated productivity. Our results indicate a moderate relationship between smartphone addiction and a self-reported decrease in productivity due to spending time on the smartphone during work, as well as with the number of work hours lost to smartphone use. Smartphone addiction was also related to a greater amount of leisure time spent on the smartphone and was strongly related to a negative impact of smartphone use on daily non-work related activities. These data support the idea that tendencies towards smartphone addiction and overt checking of the smartphone could result in less productivity both in the workplace and at home. Results are discussed in relation to productivity and technostress.

  17. Greater physiological and behavioral effects of interrupted stress pattern compared to daily restraint stress in rats.

    Directory of Open Access Journals (Sweden)

    Wei Zhang

    Full Text Available Repeated stress can trigger a range of psychiatric disorders, including anxiety. The propensity to develop abnormal behaviors after repeated stress is related to the severity, frequency and number of stressors. However, the pattern of stress exposure may contribute to the impact of stress. In addition, the anxiogenic nature of repeated stress exposure can be moderated by the degree of coping that occurs, and can be reflected in homotypic habituation to the repeated stress. However, expectations are not clear when a pattern of stress presentation is utilized that diminishes habituation. The purpose of these experiments is to test whether interrupted stress exposure decreases homotypic habituation and leads to greater effects on anxiety-like behavior in adult male rats. We found that repeated interrupted restraint stress resulted in less overall homotypic habituation compared to repeated daily restraint stress. This was demonstrated by greater production of fecal boli and greater corticosterone response to restraint. Furthermore, interrupted restraint stress resulted in a lower body weight and greater adrenal gland weight than daily restraint stress, and greater anxiety-like behavior in the elevated plus maze. Control experiments demonstrated that these effects of the interrupted pattern could not be explained by differences in the total number of stress exposures, differences in the total number of days that the stress periods encompased, nor could it be explained as a result of only the stress exposures after an interruption from stress. These experiments demonstrate that the pattern of stress exposure is a significant determinant of the effects of repeated stress, and that interrupted stress exposure that decreases habituation can have larger effects than a greater number of daily stress exposures. Differences in the pattern of stress exposure are therefore an important factor to consider when predicting the severity of the effects of repeated

  18. A New Generation of Real-Time Systems in the JET Tokamak

    Science.gov (United States)

    Alves, Diogo; Neto, Andre C.; Valcarcel, Daniel F.; Felton, Robert; Lopez, Juan M.; Barbalace, Antonio; Boncagni, Luca; Card, Peter; De Tommasi, Gianmaria; Goodyear, Alex; Jachmich, Stefan; Lomas, Peter J.; Maviglia, Francesco; McCullen, Paul; Murari, Andrea; Rainford, Mark; Reux, Cedric; Rimini, Fernanda; Sartori, Filippo; Stephen, Adam V.; Vega, Jesus; Vitelli, Riccardo; Zabeo, Luca; Zastrow, Klaus-Dieter

    2014-04-01

    Recently, a new recipe for developing and deploying real-time systems has become increasingly adopted in the JET tokamak. Powered by the advent of x86 multi-core technology and the reliability of JET's well established Real-Time Data Network (RTDN) to handle all real-time I/O, an official Linux vanilla kernel has been demonstrated to be able to provide real-time performance to user-space applications that are required to meet stringent timing constraints. In particular, a careful rearrangement of the Interrupt ReQuests' (IRQs) affinities together with the kernel's CPU isolation mechanism allows one to obtain either soft or hard real-time behavior depending on the synchronization mechanism adopted. Finally, the Multithreaded Application Real-Time executor (MARTe) framework is used for building applications particularly optimised for exploring multi-core architectures. In the past year, four new systems based on this philosophy have been installed and are now part of JET's routine operation. The focus of the present work is on the configuration aspects that enable these new systems' real-time capability. Details are given about the common real-time configuration of these systems, followed by a brief description of each system together with results regarding their real-time performance. A cycle time jitter analysis of a user-space MARTe based application synchronizing over a network is also presented. The goal is to compare its deterministic performance while running on a vanilla and on a Messaging Real time Grid (MRG) Linux kernel.

  19. A Neural Mechanism for Surprise-related Interruptions of Visuospatial Working Memory.

    Science.gov (United States)

    Wessel, Jan R

    2018-01-01

    Surprising perceptual events recruit a fronto-basal ganglia mechanism for inhibition, which suppresses motor activity following surprise. A recent study found that this inhibitory mechanism also disrupts the maintenance of verbal working memory (WM) after surprising tones. However, it is unclear whether this same mechanism also relates to surprise-related interruptions of non-verbal WM. We tested this hypothesis using a change-detection task, in which surprising tones impaired visuospatial WM. Participants also performed a stop-signal task (SST). We used independent component analysis and single-trial scalp-electroencephalogram to test whether the same inhibitory mechanism that reflects motor inhibition in the SST relates to surprise-related visuospatial WM decrements, as was the case for verbal WM. As expected, surprising tones elicited activity of the inhibitory mechanism, and this activity correlated strongly with the trial-by-trial level of surprise. However, unlike for verbal WM, the activity of this mechanism was unrelated to visuospatial WM accuracy. Instead, inhibition-independent activity that immediately succeeded the inhibitory mechanism was increased when visuospatial WM was disrupted. This shows that surprise-related interruptions of visuospatial WM are not effected by the same inhibitory mechanism that interrupts verbal WM, and instead provides evidence for a 2-stage model of distraction. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  20. Evaluation of probiotic survivability in yogurt exposed to cold chain interruption.

    Science.gov (United States)

    Ferdousi, Rohollah; Rouhi, Millad; Mohammadi, Reza; Mortazavian, Amir Mohamad; Khosravi-Darani, Kianosh; Homayouni Rad, Aziz

    2013-01-01

    In this research, the survival of probiotic microorganisms in yogurts stored at room temperature (cold chain interruption conditions) was studied. Milk inoculated with yogurt bacteria (mixed culture of Streptococcus thermophilus and Lactobacillus delbrueckii ssp. bulgaricus) and a single probiotic culture (L. acidophilus LA-5 or Bifidobacterium lactis Bb- 12 or L. rhamnosus HN001 or L. paracasei Lpc-37) were incubated till pH of 4.5 was reached. Probiotic yogurts were stored at two different temperatures including cold (control) and room temperatures (5 and 20°C, respectively). Changes in pH decrease, titratable acidity increase and redox potential increase as well as the viability of probiotics per 6 h intervals during an assumptive interrupted cold storage (24 h) were monitored. The survival of probiotics was strongly dependent on the storage temperature and remarkable viability loss occurred in room temperature compared to refrigerated storage. In addition, the survivability was dependent on probiotic strain. Among our experimental strains, B. lactis Bb-12 showed the less resistance to be stored at 20°C (24 h) and referring to the recommended minimum numbers of 10(7) cfu mL(-) (1), L. rhamnosus HN001 was the most suitable probiotic strain to be used in probiotic yogurts especially in countries having high possibility of cold chain interruption during storage.