A 4-year non-randomized comparative phase-IV study of early rheumatoid arthritis: integrative anthroposophic medicine for patients with preference against DMARDs versus conventional therapy including DMARDs for patients without preference

Directory of Open Access Journals (Sweden)

Hamre HJ

2018-03-01

Full Text Available Harald J Hamre,1 Van N Pham,2 Christian Kern,3 Rolf Rau,4 Jörn Klasen,3 Ute Schendel,5 Lars Gerlach,6 Attyla Drabik,2 Ludger Simon6,† 1Institute for Applied Epistemology and Medical Methodology at the Witten/Herdecke University, Freiburg, Germany; 2Institute of Statistics in Medicine, Universitätsklinikum Düsseldorf, Düsseldorf, Germany; 3Department of Integrative Medicine, Asklepios Westklinikum, Hamburg, Germany; 4Department of Rheumatology, Evangelisches Fachkrankenhaus Ratingen, Ratingen, Germany; 5Department of Rheumatology, m&i-Fachklinik Bad Pyrmont, Bad Pyrmont, Germany; 6Department of Internal Medicine and Gastroenterology, Filderklinik, Filderstadt, Germany †Dr Ludger Simon passed away on June 10, 2016 Background: While disease-modifying antirheumatic drugs (DMARDs are a mainstay of therapy for rheumatoid arthritis (RA, some patients with early RA refuse DMARDs. In anthroposophic medicine (AM, a treatment strategy for early RA without DMARDs has been developed. Preliminary data suggest that RA symptoms and inflammatory markers can be reduced under AM, without DMARDs. Patients and methods: Two hundred and fifty-one self-selected patients aged 16–70 years, starting treatment for RA of <3 years duration, without prior DMARD therapy, participated in a prospective, non-randomized, comparative Phase IV study. C-patients were treated in clinics offering conventional therapy including DMARDs, while A-patients had chosen treatment in anthroposophic clinics, without DMARDs. Both groups received corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs. Primary outcomes were intensity of RA symptoms measured by self-rating on visual analog scales, C-reactive protein, radiological progression, study withdrawals, serious adverse events (SAE, and adverse drug reactions in months 0–48. Results: The groups were similar in most baseline characteristics, while A-patients had longer disease duration (mean 15.1 vs 10.8 months, p<0

Variation of mutational burden in healthy human tissues suggests non-random strand segregation and allows measuring somatic mutation rates.

Science.gov (United States)

Werner, Benjamin; Sottoriva, Andrea

2018-06-01

The immortal strand hypothesis poses that stem cells could produce differentiated progeny while conserving the original template strand, thus avoiding accumulating somatic mutations. However, quantitating the extent of non-random DNA strand segregation in human stem cells remains difficult in vivo. Here we show that the change of the mean and variance of the mutational burden with age in healthy human tissues allows estimating strand segregation probabilities and somatic mutation rates. We analysed deep sequencing data from healthy human colon, small intestine, liver, skin and brain. We found highly effective non-random DNA strand segregation in all adult tissues (mean strand segregation probability: 0.98, standard error bounds (0.97,0.99)). In contrast, non-random strand segregation efficiency is reduced to 0.87 (0.78,0.88) in neural tissue during early development, suggesting stem cell pool expansions due to symmetric self-renewal. Healthy somatic mutation rates differed across tissue types, ranging from 3.5 × 10-9/bp/division in small intestine to 1.6 × 10-7/bp/division in skin.

Variation of mutational burden in healthy human tissues suggests non-random strand segregation and allows measuring somatic mutation rates.

Directory of Open Access Journals (Sweden)

Benjamin Werner

2018-06-01

Full Text Available The immortal strand hypothesis poses that stem cells could produce differentiated progeny while conserving the original template strand, thus avoiding accumulating somatic mutations. However, quantitating the extent of non-random DNA strand segregation in human stem cells remains difficult in vivo. Here we show that the change of the mean and variance of the mutational burden with age in healthy human tissues allows estimating strand segregation probabilities and somatic mutation rates. We analysed deep sequencing data from healthy human colon, small intestine, liver, skin and brain. We found highly effective non-random DNA strand segregation in all adult tissues (mean strand segregation probability: 0.98, standard error bounds (0.97,0.99. In contrast, non-random strand segregation efficiency is reduced to 0.87 (0.78,0.88 in neural tissue during early development, suggesting stem cell pool expansions due to symmetric self-renewal. Healthy somatic mutation rates differed across tissue types, ranging from 3.5 × 10-9/bp/division in small intestine to 1.6 × 10-7/bp/division in skin.

Research Methods in Healthcare Epidemiology and Antimicrobial Stewardship – Quasi-Experimental Designs

Science.gov (United States)

Schweizer, Marin L.; Braun, Barbara I.; Milstone, Aaron M.

2016-01-01

Quasi-experimental studies evaluate the association between an intervention and an outcome using experiments in which the intervention is not randomly assigned. Quasi-experimental studies are often used to evaluate rapid responses to outbreaks or other patient safety problems requiring prompt non-randomized interventions. Quasi-experimental studies can be categorized into three major types: interrupted time series designs, designs with control groups, and designs without control groups. This methods paper highlights key considerations for quasi-experimental studies in healthcare epidemiology and antimicrobial stewardship including study design and analytic approaches to avoid selection bias and other common pitfalls of quasi-experimental studies. PMID:27267457

A nonrandomized trial of vitamin D supplementation for Barrett's esophagus.

Directory of Open Access Journals (Sweden)

Linda C Cummings

Full Text Available Vitamin D deficiency may increase esophageal cancer risk. Vitamin D affects genes regulating proliferation, apoptosis, and differentiation and induces the tumor suppressor 15-hydroxyprostaglandin dehydrogenase (PGDH in other cancers. This nonrandomized interventional study assessed effects of vitamin D supplementation in Barrett's esophagus (BE. We hypothesized that vitamin D supplementation may have beneficial effects on gene expression including 15-PGDH in BE.BE subjects with low grade or no dysplasia received vitamin D3 (cholecalciferol 50,000 international units weekly plus a proton pump inhibitor for 12 weeks. Esophageal biopsies from normal plus metaplastic BE epithelium and blood samples were obtained before and after vitamin D supplementation. Serum 25-hydroxyvitamin D was measured to characterize vitamin D status. Esophageal gene expression was assessed using microarrays.18 study subjects were evaluated. The baseline mean serum 25-hydroxyvitamin D level was 27 ng/mL (normal ≥30 ng/mL. After vitamin D supplementation, 25-hydroxyvitamin D levels rose significantly (median increase of 31.6 ng/mL, p<0.001. There were no significant changes in gene expression from esophageal squamous or Barrett's epithelium including 15-PGDH after supplementation.BE subjects were vitamin D insufficient. Despite improved vitamin D status with supplementation, no significant alterations in gene expression profiles were noted. If vitamin D supplementation benefits BE, a longer duration or higher dose of supplementation may be needed.

Research Methods in Healthcare Epidemiology and Antimicrobial Stewardship-Quasi-Experimental Designs.

Science.gov (United States)

Schweizer, Marin L; Braun, Barbara I; Milstone, Aaron M

2016-10-01

Quasi-experimental studies evaluate the association between an intervention and an outcome using experiments in which the intervention is not randomly assigned. Quasi-experimental studies are often used to evaluate rapid responses to outbreaks or other patient safety problems requiring prompt, nonrandomized interventions. Quasi-experimental studies can be categorized into 3 major types: interrupted time-series designs, designs with control groups, and designs without control groups. This methods paper highlights key considerations for quasi-experimental studies in healthcare epidemiology and antimicrobial stewardship, including study design and analytic approaches to avoid selection bias and other common pitfalls of quasi-experimental studies. Infect Control Hosp Epidemiol 2016;1-6.

Tests for nonrandomness in quantum jumps

International Nuclear Information System (INIS)

Berkeland, D.J.; Raymondson, D.A.; Tassin, V.M.

2004-01-01

In a fundamental test of quantum mechanics, we have observed 228 000 quantum jumps of a single trapped and laser cooled 88 Sr + ion. This represents a statistical increase of two orders of magnitude over previous similar analyses of quantum jumps. Compared to other searches for nonrandomness in quantum-mechanical processes, using quantum jumps simplifies the interpretation of data by eliminated multiparticle effects and providing near-unit detection efficiency of transitions. We measure the fractional reduction in the entropy of information to be -4 when the value of any interval between quantum jumps is known. We also find that the number of runs of successively increasing or decreasing interval times agrees with the theoretically expected values. Furthermore, we analyze 238 000 quantum jumps from two simultaneously confined ions and find that the number of apparently coincidental transitions is as expected. Finally, we observe 8400 spontaneous decays of two simultaneously trapped ions and find that the number of apparently coincidental decays from the metastable state agrees with the expected value. We find no evidence for short- or long-term correlations in the intervals of the quantum jumps or in the decay of the quantum states, in agreement with quantum theory

Non-random temporary emigration and the robust design: Conditions for bias at the end of a time series: Section VIII

Science.gov (United States)

Langtimm, Catherine A.

2008-01-01

Deviations from model assumptions in the application of capture–recapture models to real life situations can introduce unknown bias. Understanding the type and magnitude of bias under these conditions is important to interpreting model results. In a robust design analysis of long-term photo-documented sighting histories of the endangered Florida manatee, I found high survival rates, high rates of non-random temporary emigration, significant time-dependence, and a diversity of factors affecting temporary emigration that made it difficult to model emigration in any meaningful fashion. Examination of the time-dependent survival estimates indicated a suspicious drop in survival rates near the end of the time series that persisted when the original capture histories were truncated and reanalyzed under a shorter time frame. Given the wide swings in manatee emigration estimates from year to year, a likely source of bias in survival was the convention to resolve confounding of the last survival probability in a time-dependent model with the last emigration probabilities by setting the last unmeasurable emigration probability equal to the previous year’s probability when the equality was actually false. Results of a series of simulations demonstrated that if the unmeasurable temporary emigration probabilities in the last time period were not accurately modeled, an estimation model with significant annual variation in survival probabilities and emigration probabilities produced bias in survival estimates at the end of the study or time series being explored. Furthermore, the bias propagated back in time beyond the last two time periods and the number of years affected varied positively with survival and emigration probabilities. Truncating the data to a shorter time frame and reanalyzing demonstrated that with additional years of data surviving temporary emigrants eventually return and are detected, thus in subsequent analysis unbiased estimates are eventually realized.

Evaluating clinical and public health interventions: a practical guide to study design and statistics

National Research Council Canada - National Science Library

Katz, Mitchell H

2010-01-01

.... Because the choice of research design depends on the nature of the intervention, the book covers randomized and nonrandomized designs, prospective and retrospective studies, planned clinical trials...

A Bayesian Nonparametric Causal Model for Regression Discontinuity Designs

Science.gov (United States)

Karabatsos, George; Walker, Stephen G.

2013-01-01

The regression discontinuity (RD) design (Thistlewaite & Campbell, 1960; Cook, 2008) provides a framework to identify and estimate causal effects from a non-randomized design. Each subject of a RD design is assigned to the treatment (versus assignment to a non-treatment) whenever her/his observed value of the assignment variable equals or…

Translocation 1;7 in dyshematopoiesis: possibly induced with a nonrandom geographic distribution

International Nuclear Information System (INIS)

Scheres, J.M.; Hustinx, T.W.; Holdrinet, R.S.; Geraedts, J.P.; Hagemeijer, A.; van der Blij-Philipsen, M.

1984-01-01

Eight patients with various hematologic disorders had an identical chromosomal aberration in their bone marrow or unstimulated peripheral blood, a translocation t(1;7) interpreted as t(1;7)(p11;p11). The translocation chromosome replaced one normal chromosome number7; therefore, the karyotype of the abnormal cells was trisomic for 1q and monosomic for 7q. Including four cases from the literature, a total of 12 patients (4 women, 8 men) with this translocation are known at the moment. The translocation does not seem to be associated with a specific disorder, but almost all patients had a preleukemic syndrome during some stage of their disease. It is very remarkable that 11 of the 12 patients lived in the Netherlands, and 7 patients had a history of iatrogenic exposure to alkylating agents or irradiation; one patient was a radiation worker and another one had a history of toxic exposure to chloramphenicol. It is suggested, therefore, that the t(1;7) is a possibly induced chromosomal aberration with a clearly nonrandom geographic distribution

Statistical method on nonrandom clustering with application to somatic mutations in cancer

Directory of Open Access Journals (Sweden)

Rejto Paul A

2010-01-01

Full Text Available Abstract Background Human cancer is caused by the accumulation of tumor-specific mutations in oncogenes and tumor suppressors that confer a selective growth advantage to cells. As a consequence of genomic instability and high levels of proliferation, many passenger mutations that do not contribute to the cancer phenotype arise alongside mutations that drive oncogenesis. While several approaches have been developed to separate driver mutations from passengers, few approaches can specifically identify activating driver mutations in oncogenes, which are more amenable for pharmacological intervention. Results We propose a new statistical method for detecting activating mutations in cancer by identifying nonrandom clusters of amino acid mutations in protein sequences. A probability model is derived using order statistics assuming that the location of amino acid mutations on a protein follows a uniform distribution. Our statistical measure is the differences between pair-wise order statistics, which is equivalent to the size of an amino acid mutation cluster, and the probabilities are derived from exact and approximate distributions of the statistical measure. Using data in the Catalog of Somatic Mutations in Cancer (COSMIC database, we have demonstrated that our method detects well-known clusters of activating mutations in KRAS, BRAF, PI3K, and β-catenin. The method can also identify new cancer targets as well as gain-of-function mutations in tumor suppressors. Conclusions Our proposed method is useful to discover activating driver mutations in cancer by identifying nonrandom clusters of somatic amino acid mutations in protein sequences.

Network meta-analysis incorporating randomized controlled trials and non-randomized comparative cohort studies for assessing the safety and effectiveness of medical treatments: challenges and opportunities

OpenAIRE

Cameron, Chris; Fireman, Bruce; Hutton, Brian; Clifford, Tammy; Coyle, Doug; Wells, George; Dormuth, Colin R.; Platt, Robert; Toh, Sengwee

2015-01-01

Network meta-analysis is increasingly used to allow comparison of multiple treatment alternatives simultaneously, some of which may not have been compared directly in primary research studies. The majority of network meta-analyses published to date have incorporated data from randomized controlled trials (RCTs) only; however, inclusion of non-randomized studies may sometimes be considered. Non-randomized studies can complement RCTs or address some of their limitations, such as short follow-up...

Good research practices for comparative effectiveness research: approaches to mitigate bias and confounding in the design of nonrandomized studies of treatment effects using secondary data sources: the International Society for Pharmacoeconomics and Outcomes Research Good Research Practices for Retrospective Database Analysis Task Force Report--Part II.

Science.gov (United States)

Cox, Emily; Martin, Bradley C; Van Staa, Tjeerd; Garbe, Edeltraut; Siebert, Uwe; Johnson, Michael L

2009-01-01

The goal of comparative effectiveness analysis is to examine the relationship between two variables, treatment, or exposure and effectiveness or outcome. Unlike data obtained through randomized controlled trials, researchers face greater challenges with causal inference with observational studies. Recognizing these challenges, a task force was formed to develop a guidance document on methodological approaches to addresses these biases. The task force was commissioned and a Chair was selected by the International Society for Pharmacoeconomics and Outcomes Research Board of Directors in October 2007. This report, the second of three reported in this issue of the Journal, discusses the inherent biases when using secondary data sources for comparative effectiveness analysis and provides methodological recommendations to help mitigate these biases. The task force report provides recommendations and tools for researchers to mitigate threats to validity from bias and confounding in measurement of exposure and outcome. Recommendations on design of study included: the need for data analysis plan with causal diagrams; detailed attention to classification bias in definition of exposure and clinical outcome; careful and appropriate use of restriction; extreme care to identify and control for confounding factors, including time-dependent confounding. Design of nonrandomized studies of comparative effectiveness face several daunting issues, including measurement of exposure and outcome challenged by misclassification and confounding. Use of causal diagrams and restriction are two techniques that can improve the theoretical basis for analyzing treatment effects in study populations of more homogeneity, with reduced loss of generalizability.

Treatment of age-related subfoveal neovascular membranes by teletherapy. Results of a non-randomized study

Energy Technology Data Exchange (ETDEWEB)

Subasi, M.; Akmansu, M.; Or, M. [Gazi Univ., Ankara (Turkey). Medical Faculty

1999-03-01

This investigation was designed to determine whether low-dose radiation to the macular region could influence the natural course of age-related subfoveal neovascularization. Thirty-one patients with subfoveal membranes due to age-related macular degeneration (ARMD) were treated with 12 Gy of 6 MV X-rays, and 72 patients who were untreated served as a control group. Both groups were followed-up. At six months of follow-up visual acuity was maintained in 54.8% and improved 25.8% of patients treated by radiotherapy. In the control group, visual acuity showed deterioration in 55.5%. There was a significant difference between the treated and untreated groups (p<0.01). Significant neovascular membrane regression or stabilization was recorded in 61.3% of treated patients at six months post-radiation, whereas the membranes in all. 72 control patients showed progressive enlargement. This non-randomized study suggested that low doses of radiation may be an alternative treatment for ARMD without an immediate drop in visual acuity or significant radiation morbidity. (author)

p15PAF is an intrinsically disordered protein with nonrandom structural preferences at sites of interaction with other proteins.

Science.gov (United States)

De Biasio, Alfredo; Ibáñez de Opakua, Alain; Cordeiro, Tiago N; Villate, Maider; Merino, Nekane; Sibille, Nathalie; Lelli, Moreno; Diercks, Tammo; Bernadó, Pau; Blanco, Francisco J

2014-02-18

We present to our knowledge the first structural characterization of the proliferating-cell-nuclear-antigen-associated factor p15(PAF), showing that it is monomeric and intrinsically disordered in solution but has nonrandom conformational preferences at sites of protein-protein interactions. p15(PAF) is a 12 kDa nuclear protein that acts as a regulator of DNA repair during DNA replication. The p15(PAF) gene is overexpressed in several types of human cancer. The nearly complete NMR backbone assignment of p15(PAF) allowed us to measure 86 N-H(N) residual dipolar couplings. Our residual dipolar coupling analysis reveals nonrandom conformational preferences in distinct regions, including the proliferating-cell-nuclear-antigen-interacting protein motif (PIP-box) and the KEN-box (recognized by the ubiquitin ligase that targets p15(PAF) for degradation). In accordance with these findings, analysis of the (15)N R2 relaxation rates shows a relatively reduced mobility for the residues in these regions. The agreement between the experimental small angle x-ray scattering curve of p15(PAF) and that computed from a statistical coil ensemble corrected for the presence of local secondary structural elements further validates our structural model for p15(PAF). The coincidence of these transiently structured regions with protein-protein interaction and posttranslational modification sites suggests a possible role for these structures as molecular recognition elements for p15(PAF). Copyright © 2014 Biophysical Society. Published by Elsevier Inc. All rights reserved.

Classroom-based narrative and vocabulary instruction: results of an early-stage, nonrandomized comparison study.

Science.gov (United States)

Gillam, Sandra Laing; Olszewski, Abbie; Fargo, Jamison; Gillam, Ronald B

2014-07-01

This nonrandomized feasibility study was designed to provide a preliminary assessment of the impact of a narrative and vocabulary instruction program provided by a speech-language pathologist (SLP) in a regular classroom setting. Forty-three children attending 2 first-grade classrooms participated in the study. Children in each classroom were divided into high- and low-risk subgroups on the basis of their performance on a narrative test. Narrative and vocabulary instruction was provided by an SLP in 1 classroom for three 30-min periods per week for 6 weeks. The children in the experimental classroom made clinically significant improvements on narrative and vocabulary measures; children in the comparison classroom did not. Within the experimental classroom, children in the high-risk subgroup demonstrated greater gains in narration and fewer gains in vocabulary than children in the low-risk subgroup. There were no subgroup differences in the comparison classroom. These preliminary results provide early evidence of the feasibility of implementing a narrative instruction program in a classroom setting. Children at a high risk for language difficulties appeared to profit more from the narrative instruction than from the embedded vocabulary instruction. More extensive research on this instructional program is warranted.

Epidemic spreading in networks with nonrandom long-range interactions.

Science.gov (United States)

Estrada, Ernesto; Kalala-Mutombo, Franck; Valverde-Colmeiro, Alba

2011-09-01

An "infection," understood here in a very broad sense, can be propagated through the network of social contacts among individuals. These social contacts include both "close" contacts and "casual" encounters among individuals in transport, leisure, shopping, etc. Knowing the first through the study of the social networks is not a difficult task, but having a clear picture of the network of casual contacts is a very hard problem in a society of increasing mobility. Here we assume, on the basis of several pieces of empirical evidence, that the casual contacts between two individuals are a function of their social distance in the network of close contacts. Then, we assume that we know the network of close contacts and infer the casual encounters by means of nonrandom long-range (LR) interactions determined by the social proximity of the two individuals. This approach is then implemented in a susceptible-infected-susceptible (SIS) model accounting for the spread of infections in complex networks. A parameter called "conductance" controls the feasibility of those casual encounters. In a zero conductance network only contagion through close contacts is allowed. As the conductance increases the probability of having casual encounters also increases. We show here that as the conductance parameter increases, the rate of propagation increases dramatically and the infection is less likely to die out. This increment is particularly marked in networks with scale-free degree distributions, where infections easily become epidemics. Our model provides a general framework for studying epidemic spreading in networks with arbitrary topology with and without casual contacts accounted for by means of LR interactions.

Run charts revisited: a simulation study of run chart rules for detection of non-random variation in health care processes.

Science.gov (United States)

Anhøj, Jacob; Olesen, Anne Vingaard

2014-01-01

A run chart is a line graph of a measure plotted over time with the median as a horizontal line. The main purpose of the run chart is to identify process improvement or degradation, which may be detected by statistical tests for non-random patterns in the data sequence. We studied the sensitivity to shifts and linear drifts in simulated processes using the shift, crossings and trend rules for detecting non-random variation in run charts. The shift and crossings rules are effective in detecting shifts and drifts in process centre over time while keeping the false signal rate constant around 5% and independent of the number of data points in the chart. The trend rule is virtually useless for detection of linear drift over time, the purpose it was intended for.

Discovering non-random segregation of sister chromatids: The naïve treatment of a premature discovery

Directory of Open Access Journals (Sweden)

Karl G. Lark

2013-02-01

Full Text Available The discovery of non-random chromosome segregation is discussed from the perspective of what was known in1965 and1966. The distinction between daughter, parent or grandparent strands of DNA was developed in a bacterial system and led to the discovery that multiple copies of DNA elements of bacteria are not distributed randomly with respect to the age of the template strand. Experiments with higher eukaryotic cells demonstrated that during mitosis Mendel’s laws were violated; and the initial serendipitous choice of eukaryotic cell system led to the striking example of non-random segregation of parent and grand-parent DNA template strands in primary cultures of cells derived from mouse embryos. Attempts to extrapolate these findings to established TC lines demonstrated that the property could be lost. Experiments using plant root tips demonstrated that the phenomenon exists in plants and that it was, at some level, under genetic control. Despite publication in major journals and symposia (Lark et al. (1966a; Lark (1967a; 1967b; 1969, 1969a; 1969b the potential implications of these findings were ignored for several decades. Here we explore possible reasons for the pre-maturity (Stent, 1972 of this discovery.

An Approach to Distinguish between Plasticity and Non-random Distributions of Behavioral Types Along Urban Gradients in a Wild Passerine Bird

Directory of Open Access Journals (Sweden)

Philipp Sprau

2017-08-01

Full Text Available The impact of urbanization has been widely studied in the context of species diversity and life history evolution. Behavioral adaptation, by contrast, remains poorly understood because empirical studies rarely investigate the relative importance of two key mechanisms: plastic responses vs. non-random distributions of behavioral types. We propose here an approach that enables the simultaneous estimation of the respective roles of these distinct mechanisms. We investigated why risky behaviors are often associated with urbanization, using an urban nest box population of great tits (Parus major as a study system. We simultaneously and repeatedly quantified individual behavior (aggression and flight initiation distance as well as environmental factors characterizing level of urbanization (numbers of pedestrians, cars and cyclists. This enabled us to statistically distinguish plastic responses from patterns of non-random distributions of behavioral types. Data analyses revealed that individuals did not plastically adjust their behavior to the level of urbanization. Behavioral types were instead non-randomly distributed: bold birds occurred more frequently in areas with more cars and fewer pedestrians while shy individuals were predominantly found in areas with fewer cars and more pedestrians. These novel findings imply a major role for behavioral types in the evolutionary ecology of urban environments and call for the full integration of among- and within-individual variation in urban ecological studies.

Evaluation of the Prevention and Reactivation Care Program (PReCaP) for the hospitalized elderly: A prospective nonrandomized controlled trial

NARCIS (Netherlands)

K.J.E. Asmus-Szepesi (Kirsten); L.E. Flinterman (Linda); M.A. Koopmanschap (Marc); A.P. Nieboer (Anna); T.J.E.M. Bakker (Ton); J.P. Mackenbach (Johan); E.W. Steyerberg (Ewout)

2015-01-01

textabstractBackground: The hospitalized elderly are at risk of functional decline. We evaluated the effects and care costs of a specialized geriatric rehabilitation program aimed at preventing functional decline among at-risk hospitalized elderly. Methods: The prospective nonrandomized controlled

The Nonrandom Distribution of Interior Landforms for 100-km Diameter Craters on Mercury Suggests Regional Variations in Near-Surface Mechanical Properties

Science.gov (United States)

Herrick, R. R.

2018-05-01

There is great diversity of appearance in the interiors of 100-km diameter craters. The spatial distribution of interior landforms is clustered and nonrandom, but does not clearly correlate with Mercury's surface geology patterns.

Epidemic spreading in networks with nonrandom long-range interactions

Science.gov (United States)

Estrada, Ernesto; Kalala-Mutombo, Franck; Valverde-Colmeiro, Alba

2011-09-01

An “infection,” understood here in a very broad sense, can be propagated through the network of social contacts among individuals. These social contacts include both “close” contacts and “casual” encounters among individuals in transport, leisure, shopping, etc. Knowing the first through the study of the social networks is not a difficult task, but having a clear picture of the network of casual contacts is a very hard problem in a society of increasing mobility. Here we assume, on the basis of several pieces of empirical evidence, that the casual contacts between two individuals are a function of their social distance in the network of close contacts. Then, we assume that we know the network of close contacts and infer the casual encounters by means of nonrandom long-range (LR) interactions determined by the social proximity of the two individuals. This approach is then implemented in a susceptible-infected-susceptible (SIS) model accounting for the spread of infections in complex networks. A parameter called “conductance” controls the feasibility of those casual encounters. In a zero conductance network only contagion through close contacts is allowed. As the conductance increases the probability of having casual encounters also increases. We show here that as the conductance parameter increases, the rate of propagation increases dramatically and the infection is less likely to die out. This increment is particularly marked in networks with scale-free degree distributions, where infections easily become epidemics. Our model provides a general framework for studying epidemic spreading in networks with arbitrary topology with and without casual contacts accounted for by means of LR interactions.

Quasi-experimental study designs series-paper 6: risk of bias assessment.

Science.gov (United States)

Waddington, Hugh; Aloe, Ariel M; Becker, Betsy Jane; Djimeu, Eric W; Hombrados, Jorge Garcia; Tugwell, Peter; Wells, George; Reeves, Barney

2017-09-01

Rigorous and transparent bias assessment is a core component of high-quality systematic reviews. We assess modifications to existing risk of bias approaches to incorporate rigorous quasi-experimental approaches with selection on unobservables. These are nonrandomized studies using design-based approaches to control for unobservable sources of confounding such as difference studies, instrumental variables, interrupted time series, natural experiments, and regression-discontinuity designs. We review existing risk of bias tools. Drawing on these tools, we present domains of bias and suggest directions for evaluation questions. The review suggests that existing risk of bias tools provide, to different degrees, incomplete transparent criteria to assess the validity of these designs. The paper then presents an approach to evaluating the internal validity of quasi-experiments with selection on unobservables. We conclude that tools for nonrandomized studies of interventions need to be further developed to incorporate evaluation questions for quasi-experiments with selection on unobservables. Copyright © 2017 Elsevier Inc. All rights reserved.

Measurement network design including traveltime determinations to minimize model prediction uncertainty

NARCIS (Netherlands)

Janssen, G.M.C.M.; Valstar, J.R.; Zee, van der S.E.A.T.M.

2008-01-01

Traveltime determinations have found increasing application in the characterization of groundwater systems. No algorithms are available, however, to optimally design sampling strategies including this information type. We propose a first-order methodology to include groundwater age or tracer arrival

A school intervention for mental health literacy in adolescents: effects of a non-randomized cluster controlled trial

Science.gov (United States)

2013-01-01

Background “Mental health for everyone” is a school program for mental health literacy and prevention aimed at secondary schools (13–15 yrs). The main aim was to investigate whether mental health literacy, could be improved by a 3-days universal education programme by: a) improving naming of symptom profiles of mental disorder, b) reducing prejudiced beliefs, and c) improving knowledge about where to seek help for mental health problems. A secondary aim was to investigate whether adolescent sex and age influenced the above mentioned variables. A third aim was to investigate whether prejudiced beliefs influenced knowledge about available help. Method This non-randomized cluster controlled trial included 1070 adolescents (53.9% boys, M age14 yrs) from three schools in a Norwegian town. One school (n = 520) received the intervention, and two schools (n = 550) formed the control group. Pre-test and follow-up were three months apart. Linear mixed models and generalized estimating equations models were employed for analysis. Results Mental health literacy improved contingent on the intervention, and there was a shift towards suggesting primary health care as a place to seek help. Those with more prejudiced beleifs did not suggest places to seek help for mental health problems. Generally, girls and older adolescents recognized symptom profiles better and had lower levels of prejudiced beliefs. Conclusions A low cost general school program may improve mental health literacy in adolescents. Gender specific programs and attention to the age and maturity of the students should be considered when mental health literacy programmes are designed and tried out. Prejudice should be addressed before imparting information about mental health issues. PMID:24053381

Offender and offense characteristics of a nonrandom sample of adolescent mass murderers.

Science.gov (United States)

Meloy, J R; Hempel, A G; Mohandie, K; Shiva, A A; Gray, B T

2001-06-01

The authors conducted a descriptive, archival study of adolescent (murderers-subjects who intentionally killed three or more victims in one event-to identify demographic, clinical, and forensic characteristics. A nonrandom sample of convenience of adolescent mass murderers was utilized. Thirty-four subjects, acting alone or in pairs, committed 27 mass murders between 1958 and 1999. The sample consisted of males with a median age of 17. A majority were described as "loners" and abused alcohol or drugs; almost half were bullied by others, preoccupied with violent fantasy, and violent by history. Although 23% had a documented psychiatric history, only 6% were judged to have been psychotic at the time of the mass murder. Depressive symptoms and historical antisocial behaviors were predominant. There was a precipitating event in most cases--usually a perceived failure in love or school--and most subjects made threatening statements regarding the mass murder to third parties. The majority of the sample clustered into three types: the family annihilator, the classroom avenger, and the criminal opportunist. The adolescent mass murderer is often predatorily rather than affectively violent and typically does not show any sudden or highly emotional warning signs. Although the act of mass murder is virtually impossible to predict because of its extremely low frequency, certain clinical and forensic findings can alert the clinician to the need for further, intensified primary care, including family, school, community, law enforcement, and mental health intervention.

A prospective nonrandomized comparison of laparoscopic Nissen fundoplication and laparoscopic Toupet fundoplication in Indian population using detailed objective and subjective criteria

Directory of Open Access Journals (Sweden)

Pawanindra Lal

2012-01-01

Full Text Available Background: Laparoscopic Nissen fundoplication (LNF is a commonly performed procedure for the treatment of gastro esophageal reflux disease (GERD worldwide. However, unfavourable postoperative sequel, including gas bloat and dysphagia, has encouraged surgeons to perform alternative procedures such as laparoscopic Toupet fundoplication (LTF. This prospective nonrandomized study was designed to compare LNF with LTF in patients with GERD. Materials and Methods: Hundred and ten patients symptomatic for GERD were included in the study after having received intensive acid suppression therapy for a minimum of 8 weeks. A 24-hour pH metry was done on all patients. Fifty patients having reflux on 24-hour pH metry were taken up for the surgery. Patients were further divided into group-A (LNF and group-B (LTF. Results: The median percentage time with esophageal pH < 4 decreased from 10.18% and 12.31% preoperatively to 0.85% and 1.94% postoperatively in LNF and LTF-groups, respectively. There was a significant and comparable increase in length of lower esophageal sphincter (LES, length of intraabdominal part of LES and LES pressure at respiratory inversion point in both the groups. In LNF-group, five patients had early dysphagia that improved afterwards. There were no significant postoperative complications. Conclusion: LNF and LTF are highly effective in the management of GERD with significant improvement in symptoms and objective parameters. LNF may be associated with significantly higher incidence of short onset transient dysphagia that improves with time. Patients in both the groups showed excellent symptom and objective control on 24-hour pH metry on short term follow-up.

Selecting for extinction: nonrandom disease-associated extinction homogenizes amphibian biotas.

Science.gov (United States)

Smith, Kevin G; Lips, Karen R; Chase, Jonathan M

2009-10-01

Studying the patterns in which local extinctions occur is critical to understanding how extinctions affect biodiversity at local, regional and global spatial scales. To understand the importance of patterns of extinction at a regional spatial scale, we use data from extirpations associated with a widespread pathogenic agent of amphibian decline, Batrachochytrium dendrobatidis (Bd) as a model system. We apply novel null model analyses to these data to determine whether recent extirpations associated with Bd have resulted in selective extinction and homogenization of diverse tropical American amphibian biotas. We find that Bd-associated extinctions in this region were nonrandom and disproportionately, but not exclusively, affected low-occupancy and endemic species, resulting in homogenization of the remnant amphibian fauna. The pattern of extirpations also resulted in phylogenetic homogenization at the family level and ecological homogenization of reproductive mode and habitat association. Additionally, many more species were extirpated from the region than would be expected if extirpations occurred randomly. Our results indicate that amphibian declines in this region are an extinction filter, reducing regional amphibian biodiversity to highly similar relict assemblages and ultimately causing amplified biodiversity loss at regional and global scales.

A prospective, non-randomized phase II trial of Trastuzumab and Capecitabine in patients with HER2 expressing metastasized pancreatic cancer

Directory of Open Access Journals (Sweden)

Endlicher Esther

2009-01-01

Full Text Available Abstract Background Pancreatic cancer is the fourth most common cause of cancer related death in Western countries. Advantages in surgical techniques, radiation and chemotherapy had almost no impact on the long term survival of affected patients. Therefore, the need for better treatment strategies is urgent. HER2, a receptor tyrosine kinase of the EGFR family, involved in signal transduction pathways leading to cell growth and differentiation is overexpressed in a number of cancers, including breast and pancreatic cancer. While in breast cancer HER2 has already been successfully used as a treatment target, there are only limited data evaluating the effects of inhibiting HER2 tyrosine kinases in patients with pancreatic cancer. Methods Here we report the design of a prospective, non-randomized multi-centered Phase II clinical study evaluating the effects of the Fluoropyrimidine-carbamate Capecitabine (Xeloda ® and the monoclonal anti-HER2 antibody Trastuzumab (Herceptin® in patients with non-resectable, HER2 overexpressing pancreatic cancer. Patients eligible for the study will receive Trastuzumab infusions on day 1, 8 and 15 concomitant to the oral intake of Capecitabine from day 1 to day 14 of each three week cylce. Cycles will be repeated until tumor progression. A total of 37 patients will be enrolled with an interim analysis after 23 patients. Discussion Primary end point of the study is to determine the progression free survival after 12 weeks of bimodal treatment with the chemotherapeutic agent Capecitabine and the anti-HER2 antibody Trastuzumab. Secondary end points include patient's survival, toxicity analysis, quality of life, the correlation of HER2 overexpression and clinical response to Trastuzumab treatment and, finally, the correlation of CA19-9 plasma levels and progression free intervals.

Non-random intrachromosomal distribution of radiation-induced chromatid aberrations in Vicia faba. [Aberration clustering

Energy Technology Data Exchange (ETDEWEB)

Schubert, I; Rieger, R [Akademie der Wissenschaften der DDR, Gatersleben. Zentralinst. fuer Genetik und Kulturpflanzenforschung

1976-04-01

A reconstructed karyotype of Vicia faba, with all chromosomes individually distinguishable, was treated with X-rays, fast neutrons, (/sup 3/H) uridine (/sup 3/HU). The distribution within metaphase chromosomes of induced chromatid aberrations was non-random for all agents used. Aberration clustering, in part agent specific, occurred in chromosome segments containing heterochromatin as defined by the presence of G bands. The pattern of aberration clustering found after treatment with /sup 3/HU did not allow the recognition of chromosome regions active in transcription during treatment. Furthermore, it was impossible to obtain unambiguous indications of the presence of AT- and GC-base clusters from the patterns of /sup 3/HT- and /sup 3/HC-induced chromatid aberrations, respectively. Possible reasons underlying these observations are discussed.

Expansion of Treatment for Hepatitis C Virus Infection by Task Shifting to Community-Based Nonspecialist Providers: A Nonrandomized Clinical Trial.

Science.gov (United States)

Kattakuzhy, Sarah; Gross, Chloe; Emmanuel, Benjamin; Teferi, Gebeyehu; Jenkins, Veronica; Silk, Rachel; Akoth, Elizabeth; Thomas, Aurielle; Ahmed, Charisse; Espinosa, Michelle; Price, Angie; Rosenthal, Elana; Tang, Lydia; Wilson, Eleanor; Bentzen, Soren; Masur, Henry; Kottilil, Shyam

2017-09-05

Direct-acting antiviral (DAA) therapy for hepatitis C virus (HCV) infection has resulted in high rates of disease cure; however, not enough specialists currently are available to provide care. To determine the efficacy of HCV treatment independently provided by nurse practitioners (NPs), primary care physicians (PCPs), or specialist physicians using DAA therapy. Nonrandomized, open-label clinical trial initiated in 2015. (ClinicalTrials.gov: NCT02339038). 13 urban, federally qualified health centers (FQHCs) in the District of Columbia. A referred sample of 600 patients, of whom 96% were black, 69% were male, 82% were treatment naive, and 20% had cirrhosis. Seventy-two percent of the patients had HCV genotype 1a infection. The baseline characteristics of patients seen by each provider type were similar. Patients were assigned in a nonrandomized but specified manner to receive treatment from 1 of 5 NPs, 5 PCPs, or 6 specialists. All providers underwent an identical 3-hour training session based on guidelines. Patients received treatment with ledipasvir-sofosbuvir, which was provided on site, according to U.S. Food and Drug Administration labeling requirements. Sustained virologic response (SVR). 516 patients achieved SVR, a response rate of 86% (95% CI, 83.0% to 88.7%), with no major safety signals. Response rates were consistent across the 3 provider types: NPs, 89.3% (CI, 83.3% to 93.8%); PCPs, 86.9% (CI, 80.6% to 91.7%); and specialists, 83.8% (CI, 79.0% to 87.8%). Patient loss to follow-up was the major cause of non-SVR. Nonrandomized patient distribution; possible referral bias. In a real-world cohort of patients at urban FQHCs, HCV treatment administered by nonspecialist providers was as safe and effective as that provided by specialists. Nurse practitioners and PCPs with compact didactic training could substantially expand the availability of community-based providers to escalate HCV therapy, bridging existing gaps in the continuum of care for patients with

Meta-analytic comparison of randomized and nonrandomized studies of breast cancer surgery.

Science.gov (United States)

Edwards, Janet P; Kelly, Elizabeth J; Lin, Yongtao; Lenders, Taryn; Ghali, William A; Graham, Andrew J

2012-06-01

Randomized controlled trials (RCTs) are thought to provide the most accurate estimation of "true" treatment effect. The relative quality of effect estimates derived from nonrandomized studies (nRCTs) remains unclear, particularly in surgery, where the obstacles to performing high-quality RCTs are compounded. We performed a meta-analysis of effect estimates of RCTs comparing surgical procedures for breast cancer relative to those of corresponding nRCTs. English-language RCTs of breast cancer treatment in human patients published from 2003 to 2008 were identified in MEDLINE, EMBASE and Cochrane databases. We identified nRCTs using the National Library of Medicine's "related articles" function and reference lists. Two reviewers conducted all steps of study selection. We included studies comparing 2 surgical arms for the treatment of breast cancer. Information on treatment efficacy estimates, expressed as relative risk (RR) for outcomes of interest in both the RCTs and nRCTs was extracted. We identified 12 RCTs representing 10 topic/outcome combinations with comparable nRCTs. On visual inspection, 4 of 10 outcomes showed substantial differences in summary RR. The pooled RR estimates for RCTs versus nRCTs differed more than 2-fold in 2 of 10 outcomes and failed to demonstrate consistency of statistical differences in 3 of 10 cases. A statistically significant difference, as assessed by the z score, was not detected for any of the outcomes. Randomized controlled trials comparing surgical procedures for breast cancer may demonstrate clinically relevant differences in effect estimates in 20%-40% of cases relative to those generated by nRCTs, depending on which metric is used.

Offender and offense characteristics of a nonrandom sample of mass murderers.

Science.gov (United States)

Hempel, A G; Meloy, J R; Richards, T C

1999-01-01

A nonrandom sample (N = 30) of mass murderers in the United States and Canada during the past 50 years was studied. Data suggest that such individuals are single or divorced males in their fourth decade of life with various Axis I paranoid and/or depressive conditions and Axis II personality traits and disorders, usually Clusters A and B. The mass murder is precipitated by a major loss related to employment or relationship. A warrior mentality suffuses the planning and attack behavior of the subject, and greater deaths and higher casualty rates are significantly more likely if the perpetrator is psychotic at the time of the offense. Alcohol plays a very minor role. A large proportion of subjects will convey their central motivation in a psychological abstract, a phrase or sentence yelled with great emotion at the beginning of the mass murder; but in our study sample, only 20 percent directly threatened their victims before the offense. Death by suicide or at the hands of others is the usual outcome for the mass murderer.

Non-random alkylation of DNA sequences induced in vivo by chemical mutagens

Energy Technology Data Exchange (ETDEWEB)

Durante, M.; Geri, C.; Bonatti, S.; Parenti, R. (Universita di Pisa (Italy))

1989-08-01

Previous studies of the interaction of alkylating agents on the eukaryotic genome support the idea that induction of DNA adducts is at specific genomic sites. Here we show molecular and cytological evidence that alkylation is rather specific. Mammalian cell cultures were exposed to different doses of mutagens and the DNA was analyzed by density gradient ultracentrifugation, hydroxylapatite fractionation, and by restriction enzyme analysis. Studies with the labelled mutagens N-ethyl-N-nitrosourea and N-methyl-N'-nitro-N-nitrosoguanidine show that there is a non-random distribution of the adducts. The adducts are found more frequently in A-T, G-C rich satellite DNA and highly repetitive sequences. Analysis with restriction enzymes shows that both methyl and ethyl groups influence the restriction patterns of the enzymes HpaII and MspI that recognize specific endogenous DNA methylation. These data suggest, as a subsequent mechanism, a modification in the pattern of the normal endogenous methylation of 5-methylcytosine.

Script of Healthcare Technology: Do Designs of Robotic Beds Exclude or Include Users?

DEFF Research Database (Denmark)

Brodersen, Søsser Grith Kragh; Hansen, Meiken; Lindegaard, Hanne

2015-01-01

Many new product designs are currently being implemented in the healthcare sector, and this presents designers with challenges involved in socially innovative design. In this paper, we argue that designing assistive technologies requires focus on multiple users and use practices. We see the design...... of assistive technologies as design of socio-material assemblies , which include an analysis of the products already used in relation to multiple users, their practices and wishes. In the article we focus on the challenges in the implementation of two types of robotic beds used for disability care...

Evaluation of the Prevention and Reactivation Care Program (PReCaP) for the hospitalized elderly: A prospective nonrandomized controlled trial

OpenAIRE

Asmus-Szepesi, Kirsten; Flinterman, Linda; Koopmanschap, Marc; Nieboer, Anna; Bakker, Ton; Mackenbach, Johan; Steyerberg, Ewout

2015-01-01

textabstractBackground: The hospitalized elderly are at risk of functional decline. We evaluated the effects and care costs of a specialized geriatric rehabilitation program aimed at preventing functional decline among at-risk hospitalized elderly. Methods: The prospective nonrandomized controlled trial reported here was performed in three hospitals in the Netherlands. One hospital implemented the Prevention and Reactivation Care Program (PReCaP), while two other hospitals providing usual car...

Colonic stem cell data are consistent with the immortal model of stem cell division under non-random strand segregation.

Science.gov (United States)

Walters, K

2009-06-01

Colonic stem cells are thought to reside towards the base of crypts of the colon, but their numbers and proliferation mechanisms are not well characterized. A defining property of stem cells is that they are able to divide asymmetrically, but it is not known whether they always divide asymmetrically (immortal model) or whether there are occasional symmetrical divisions (stochastic model). By measuring diversity of methylation patterns in colon crypt samples, a recent study found evidence in favour of the stochastic model, assuming random segregation of stem cell DNA strands during cell division. Here, the effect of preferential segregation of the template strand is considered to be consistent with the 'immortal strand hypothesis', and explore the effect on conclusions of previously published results. For a sample of crypts, it is shown how, under the immortal model, to calculate mean and variance of the number of unique methylation patterns allowing for non-random strand segregation and compare them with those observed. The calculated mean and variance are consistent with an immortal model that incorporates non-random strand segregation for a range of stem cell numbers and levels of preferential strand segregation. Allowing for preferential strand segregation considerably alters previously published conclusions relating to stem cell numbers and turnover mechanisms. Evidence in favour of the stochastic model may not be as strong as previously thought.

Design and Optimization of Capacitated Supply Chain Networks Including Quality Measures

Directory of Open Access Journals (Sweden)

Krystel K. Castillo-Villar

2014-01-01

Full Text Available This paper presents (1 a novel capacitated model for supply chain network design which considers manufacturing, distribution, and quality costs (named SCND-COQ model and (2 five combinatorial optimization methods, based on nonlinear optimization, heuristic, and metaheuristic approaches, which are used to solve realistic instances of practical size. The SCND-COQ model is a mixed-integer nonlinear problem which can be used at a strategic planning level to design a supply chain network that maximizes the total profit subject to meeting an overall quality level of the final product at minimum costs. The SCND-COQ model computes the quality-related costs for the whole supply chain network considering the interdependencies among business entities. The effectiveness of the proposed solution approaches is shown using numerical experiments. These methods allow solving more realistic (capacitated supply chain network design problems including quality-related costs (inspections, rework, opportunity costs, and others within a reasonable computational time.

Nonrandom γ-TuNA-dependent spatial pattern of microtubule nucleation at the Golgi.

Science.gov (United States)

Sanders, Anna A W M; Chang, Kevin; Zhu, Xiaodong; Thoppil, Roslin J; Holmes, William R; Kaverina, Irina

2017-11-07

Noncentrosomal microtubule (MT) nucleation at the Golgi generates MT network asymmetry in motile vertebrate cells. Investigating the Golgi-derived MT (GDMT) distribution, we find that MT asymmetry arises from nonrandom nucleation sites at the Golgi (hotspots). Using computational simulations, we propose two plausible mechanistic models of GDMT nucleation leading to this phenotype. In the "cooperativity" model, formation of a single GDMT promotes further nucleation at the same site. In the "heterogeneous Golgi" model, MT nucleation is dramatically up-regulated at discrete and sparse locations within the Golgi. While MT clustering in hotspots is equally well described by both models, simulating MT length distributions within the cooperativity model fits the data better. Investigating the molecular mechanism underlying hotspot formation, we have found that hotspots are significantly smaller than a Golgi subdomain positive for scaffolding protein AKAP450, which is thought to recruit GDMT nucleation factors. We have further probed potential roles of known GDMT-promoting molecules, including γ-TuRC-mediated nucleation activator (γ-TuNA) domain-containing proteins and MT stabilizer CLASPs. While both γ-TuNA inhibition and lack of CLASPs resulted in drastically decreased GDMT nucleation, computational modeling revealed that only γ-TuNA inhibition suppressed hotspot formation. We conclude that hotspots require γ-TuNA activity, which facilitates clustered GDMT nucleation at distinct Golgi sites. © 2017 Sanders et al. This article is distributed by The American Society for Cell Biology under license from the author(s). Two months after publication it is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

The study protocol for a non-randomized controlled clinical trial using a genotype-guided strategy in a dataset of patients who undergone percutaneous coronary intervention with stent

Directory of Open Access Journals (Sweden)

Cristina Lucía Dávila-Fajardo

2017-02-01

Full Text Available This article contains data related to the research article entitled “Results of genotype–guided antiplatelet therapy in patients undergone percutaneous coronary intervention with stent” (J. Sánchez-Ramos, C.L. Dávila-Fajardo, P. Toledo Frías, X. Díaz Villamarín, L.J. Martínez-González, S. Martínez Huertas, F. Burillo Gómez, J. Caballero Borrego, A. Bautista Pavés, M.C. Marín Guzmán, J.A. Ramirez Hernández, C. Correa Vilches, J. Cabeza Barrera, 2016 (1. This data article reports, for the first time, about the non-randomized clinical trial protocol that check if CYP2C19/ABCB1 genotype–guided strategy in which the choice of antiplatelet therapy is based on the genetic test, reduces the rates of cardiovascular events and bleeding compared to a non-tailored strategy in patients undergone percutaneous coronary intervention (PCI with stent. The data included in this article are: design and setting of the study, study population, inclusion and exclusion criteria, definition of the intervention, objectives, variables (baseline characteristics and during the follow-up, study procedures, collection and treatment of the biological sample, genotyping, withdrawal criteria, sample size, statistic analysis, ethical aspects, information sheet and consent form. The authors confirm that this study has been registered in Eudra CT (Eudra CT: 2016-001294-33.

When users cannot be included in inclusive design

DEFF Research Database (Denmark)

Herriott, Richard

2012-01-01

and disabled users make the need for useability and pleasurability even more important since alternative products are comparatively few. This paper examines the workarounds two teams of designers have used to reduce the demands placed on emphysema patients and elderly users during inclusive design processes......Inclusive Design (ID) methods place a strong emphasis on user participation in designing mainstream products. In recent years researchers in the field of assistive technology (AT) have drawn on and contributed to the ID approach. There are good grounds for this association. However, the linkage...

Human heavy-chain variable region gene family nonrandomly rearranged in familial chronic lymphocytic leukemia

International Nuclear Information System (INIS)

Shen, A.; Humphries, C.; Tucker, P.; Blattner, F.

1987-01-01

The authors have identified a family of human immunoglobulin heavy-chain variable-region (V/sub H/) genes, one member of which is rearranged in two affected members of a family in which the father and four of five siblings developed chronic lymphocytic leukemia. Cloning and sequencing of the rearranged V/sub H/ genes from leukemic lymphocytes of three affected siblings showed that two siblings had rearranged V/sub H/ genes (V/sub H/TS1 and V/sub H/WS1) that were 90% homologous. The corresponding germ-line gene, V/sub H/251, was found to part of a small (four gene) V/sub H/ gene family, which they term V/sub H/V. The DNA sequence homology to V/sub H/WS1 (95%) and V/sub H/TS1 (88%) and identical restriction sites on the 5' side of V/sub H/ confirm that rearrangement of V/sub H/251 followed by somatic mutation produced the identical V/sub H/ gene rearrangements in the two siblings. V/sub H/TS1 is not a functional V/sub H/ gene; a functional V/sub H/ rearrangement was found on the other chromosome of this patient. The other two siblings had different V/sub H/ gene rearrangements. All used different diversity genes. Mechanisms proposed for nonrandom selection of a single V/sub H/ gene include developmental regulation of this V/sub H/ gene rearrangement or selection of a subpopulation of B cells in which this V/sub H/ has been rearranged

Microstructural descriptors and cellular automata simulation of the effects of non-random nuclei location on recrystallization in two dimensions

Directory of Open Access Journals (Sweden)

Paulo Rangel Rios

2006-06-01

Full Text Available The effect of non-random nuclei location and the efficiency of microstructural descriptors in assessing such a situation are studied. Cellular automata simulation of recrystallization in two dimensions is carried out to simulate microstrutural evolution for nuclei distribution ranging from a periodic arrangement to clusters of nuclei. The simulation results are compared in detail with microstrutural descriptors normally used to follow transformation evolution. It is shown that the contiguity is particularly relevant to detect microstructural deviations from randomness. This work focuses on recrystallization but its results are applicable to any nucleation and growth transformation.

Effectiveness of yoga program in the management of diabetes using community health workers in the urban slums of Bangalore city: A non-randomized controlled trial

Science.gov (United States)

Dasappa, Hemavathi; Fathima, Farah Naaz; Prabhakar, Rugmani

2016-01-01

Trial Design: Nonrandomized controlled trial. Methods: Nonrandomized controlled trial. This was an interventional study that was conducted in 4 slums of Bengaluru. Of the 256 diabetes participants, only 109 people agreed to participate in the program. Of 109 people, 52 people agreed to participate in the intervention (agreed to learn and practice Yoga) while the remaining 57 people were assigned to nonintervention group. Randomization and blinding could not be done. Objective and Outcome: The study was conducted with objective of assessing the effectiveness of Yoga, Pranayama, and Sudarshan Kriya in the community-based management of diabetes mellitus. The primary outcome variable was Hb1Ac and secondary outcome variables were systolic blood pressure (SBP), diastolic blood pressure (DBP), adherence to medication, and changes in lifestyle. Results: The study was conducted for 40 days. Community health workers made a total of 6 visits during the study. All the 109 participants were available for weekly follow-up. There were no drop outs among the study population. Statistically significant change was seen in the consumption of vegetable (χ2 = 15.326, P < 0.005), fruits (χ2 = 16.207, P < 0.005), salty food (χ2 = 14.823, P < 0.005), bakery food (χ2 = 10.429, P < 0.005) and fried food (χ2 = 15.470, P < 0.005), adherence to metformin (χ2 = 41.780, P < 0.005) and other medication(χ2 = 21.871, P < 0.005) and proportion of patients with DBP under control (χ2 = 9.396, P < 0.005) and proportion of people with glucose random blood sugar under control (χ2 = 29.693, P < 0.005) between the two groups following the intervention. Statistically significant change was also seen in the proportion of people with SBP/DBP ≤140/90 (χ2 = 10.635, P < 0.005) between the two groups. Conclusion: The Yoga program was successful in improving dietary practices and medication adherence and in increasing the proportion of diabetics and hypertensive patients under control. PMID:28217594

Effectiveness of yoga program in the management of diabetes using community health workers in the urban slums of Bangalore city: A non-randomized controlled trial

Directory of Open Access Journals (Sweden)

Hemavathi Dasappa

2016-01-01

Full Text Available Trial Design: Nonrandomized controlled trial. Methods: Nonrandomized controlled trial. This was an interventional study that was conducted in 4 slums of Bengaluru . Of the 256 diabetes participants, only 109 people agreed to participate in the program. Of 109 people, 52 people agreed to participate in the intervention (agreed to learn and practice Yoga while the remaining 57 people were assigned to nonintervention group. Randomization and blinding could not be done. Objective and Outcome: The study was conducted with objective of assessing the effectiveness of Yoga, Pranayama, and Sudarshan Kriya in the community-based management of diabetes mellitus. The primary outcome variable was Hb1Ac and secondary outcome variables were systolic blood pressure (SBP, diastolic blood pressure (DBP, adherence to medication, and changes in lifestyle. Results: The study was conducted for 40 days. Community health workers made a total of 6 visits during the study. All the 109 participants were available for weekly follow-up. There were no drop outs among the study population. Statistically significant change was seen in the consumption of vegetable (c2 = 15.326, P < 0.005, fruits (c2 = 16.207, P < 0.005, salty food (c2 = 14.823, P < 0.005, bakery food (c2 = 10.429, P < 0.005 and fried food (c2 = 15.470, P < 0.005, adherence to metformin (c2 = 41.780, P < 0.005 and other medication(c2 = 21.871, P < 0.005 and proportion of patients with DBP under control (c2 = 9.396, P < 0.005 and proportion of people with glucose random blood sugar under control (c2 = 29.693, P < 0.005 between the two groups following the intervention. Statistically significant change was also seen in the proportion of people with SBP/DBP ≤140/90 (c2 = 10.635, P < 0.005 between the two groups. Conclusion: The Yoga program was successful in improving dietary practices and medication adherence and in increasing the proportion of diabetics and hypertensive patients under control.

Random and non-random mating populations: Evolutionary dynamics in meiotic drive.

Science.gov (United States)

Sarkar, Bijan

2016-01-01

Game theoretic tools are utilized to analyze a one-locus continuous selection model of sex-specific meiotic drive by considering nonequivalence of the viabilities of reciprocal heterozygotes that might be noticed at an imprinted locus. The model draws attention to the role of viability selections of different types to examine the stable nature of polymorphic equilibrium. A bridge between population genetics and evolutionary game theory has been built up by applying the concept of the Fundamental Theorem of Natural Selection. In addition to pointing out the influences of male and female segregation ratios on selection, configuration structure reveals some noted results, e.g., Hardy-Weinberg frequencies hold in replicator dynamics, occurrence of faster evolution at the maximized variance fitness, existence of mixed Evolutionarily Stable Strategy (ESS) in asymmetric games, the tending evolution to follow not only a 1:1 sex ratio but also a 1:1 different alleles ratio at particular gene locus. Through construction of replicator dynamics in the group selection framework, our selection model introduces a redefining bases of game theory to incorporate non-random mating where a mating parameter associated with population structure is dependent on the social structure. Also, the model exposes the fact that the number of polymorphic equilibria will depend on the algebraic expression of population structure. Copyright © 2015 Elsevier Inc. All rights reserved.

Promoting motor skills in low-income, ethnic children: The Physical Activity in Linguistically Diverse Communities (PALDC) nonrandomized trial.

Science.gov (United States)

Okely, Anthony D; Hardy, Louise L; Batterham, Marijka; Pearson, Phillip; McKeen, Kim; Puglisi, Lauren

2017-11-01

This study reports the long-term effects of a professional learning program for classroom teachers on fundamental motor skill (FMS) proficiency of primary school students from ethnically diverse backgrounds. A cluster non-randomized trial using a nested cross-sectional design. The study was conducted in 8 primary schools located in disadvantaged and culturally diverse areas in Sydney, Australia. The intervention used an action learning framework, with each school developing and implementing an action plan for enhancing the teaching of FMS in their school. School teams comprised 4-5 teachers and were supported by a member of the research team. The primary outcome was total proficiency score for 7 FMS (run, jump, catch, throw, kick, leap, side gallop). Outcome data were analyzed using mixed effects models. Eight-hundred and sixty-two students (82% response rate) were assessed at baseline in 2006 and 830 (82%) at follow-up in 2010. Compared with students in the control schools, there was a significantly greater increase in total motor skill proficiency among children in the intervention schools at follow-up (adjusted difference=5.2 components, 95%CI [1.65, 8.75]; p=0.01) and in four of the seven motor skills. Training classroom teachers to develop and implement units of work based around individual FMS is a promising strategy for increasing FMS among ethnically diverse children over an extended period of time. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Multidisciplinary intervention reducing readmissions in medical inpatients: a prospective, non-randomized study

Directory of Open Access Journals (Sweden)

Torisson G

2013-09-01

Full Text Available Gustav Torisson,1 Lennart Minthon,1 Lars Stavenow,2 Elisabet Londos1 1Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, 2Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden Background: The purpose of this study was to examine whether a multidisciplinary intervention targeting drug-related problems, cognitive impairment, and discharge miscommunication could reduce readmissions in a general hospital population. Methods: This prospective, non-randomized intervention study was carried out at the department of general internal medicine at a tertiary university hospital. Two hundred medical inpatients living in the community and aged over 60 years were included. Ninety-nine patients received interventions and 101 received standard care. Control/intervention allocation was determined by geographic selection. Interventions consisted of a comprehensive medication review, improved discharge planning, post-discharge telephone follow-up, and liaison with the patient's general practitioner. The main outcome measures recorded were readmissions and hospital nights 12 months after discharge. Separate analyses were made for 12-month survivors and from an intention-to-treat perspective. Comparative analyses were made between groups as well as within groups over time. Results: After 12 months, survivors in the control group had 125 readmissions in total, compared with 58 in the intervention group (Mann–Whitney U test, P = 0.02. For hospital nights, the numbers were 1,228 and 492, respectively (P = 0.009. Yearly admissions had increased from the previous year in the control group from 77 to 125 (Wilcoxon signed-rank test, P = 0.002 and decreased from 75 to 58 in the intervention group (P = 0.25. From the intention-to-treat perspective, the same general pattern was observed but was not significant (1,827 versus 1,008 hospital nights, Mann–Whitney test, P = 0.054. Conclusion: A multidisciplinary approach

Electron ring design for HERA, including spin-matching

International Nuclear Information System (INIS)

Skuja, A.; Hand, L.; Steffen, K.; Barber, D.

1984-01-01

A. Skuja has been working in collaboration with Professor Lou Hand in obtaining an optics for the electron ring at HERA that satisfies the usual constraints of an electron storage ring, but in addition allows longitudinal polarization in the interaction region without depolarizing the electron beam completely. This collaboration effort grew out of their work on a possible electron ring at Fermilab. When this project was degraded in priority at Fermilab, they turned their attention to the HERA project at DESY. The HERA project will have an electron ring of about 30 GeV e - (or e + ) incident on 800 GeV protons. Recently it has been decided that the collisions should be head on (0 0 crossing), although all previous designs had a crossing angle of the 2 beams of 20 mrad. Professors Hand and Skuja implemented a complete program in the last year and a half that could fit the usual Turis parameters as well as the so called 12 spin-matching conditions of Chao and Yukoya for all possible machine elements including solenoids. The program has the possibility of fully coupling vertical and horizontal motion using the usual eigenvalue method

Optimal design of power system stabilizer for power systems including doubly fed induction generator wind turbines

International Nuclear Information System (INIS)

Derafshian, Mehdi; Amjady, Nima

2015-01-01

This paper presents an evolutionary algorithm-based approach for optimal design of power system stabilizer (PSS) for multi-machine power systems that include doubly fed induction generator wind turbines. The proposed evolutionary algorithm is an improved particle swarm optimization named chaotic particle swarm optimization with passive congregation (CPSO-PC) applied for finding the optimal settings of PSS parameters. Two different eigenvalue-based objectives are combined as the objective function for the optimization problem of tuning PSS parameters. The first objective function comprises the damping factor of lightly damped electro-mechanical modes and the second one includes the damping ratio of these modes. The effectiveness of the proposed method to design PSS for the power systems including DFIG (Doubly Fed Induction Generator) is extensively demonstrated through eigenvalue analysis and time-domain simulations and also by comparing its simulation results with the results of other heuristic optimization approaches. - Highlights: • A new optimization model for design of PSS in power systems including DFIG is proposed. • A detailed and realistic modeling of DFIG is presented. • A new evolutionary algorithm is suggested for solving the optimization problem of designing PSS

Evaluation of an advanced pressure ulcer management protocol followed by trained wound, ostomy, and continence nurses: a non-randomized controlled trial

Directory of Open Access Journals (Sweden)

Kaitani T

2015-02-01

Full Text Available Toshiko Kaitani,1 Gojiro Nakagami,2 Junko Sugama,3 Masahiro Tachi,4 Yutaka Matsuyama,5 Yoshiki Miyachi,6 Takashi Nagase,2 Yukie Takemura,7 Hiromi Sanada2 1School of Nursing, Sapporo City University, Hokkaido, Japan; 2Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; 3Department of Clinical Nursing, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan; 4Department of Plastic Surgery, Tohoku University Graduate School of Medicine, Miyagi, Japan; 5Department of Biostatistics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; 6Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan; 7Department of Nursing, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan Aims and objectives: We investigated the effectiveness and safety of an advanced pressure ulcer (PU management protocol comprising 1 ultrasonography to assess the deep tissue, 2 use of a non-contact thermometer to detect critical colonization, 3 conservative sharp debridement, 4 dressing selection, 5 negative pressure wound therapy, and 6 vibration therapy in comparison with those of a conventional approach. Each protocol was followed by trained wound, ostomy, and continence nurses (WOCNs. Background: At present, there is no systematic PU management protocol for nurses that includes appropriate assessment and intervention techniques for deep tissue injury and critical colonization. In Japan, there is no such protocol that the nurses can follow without a physician’s orders. Design and methods: This was a prospective non-randomized controlled trial. Over a 3-week period, we evaluated the effectiveness of an advanced protocol by comparing the PU severity and healing on the basis of the DESIGN-R scale and presence of patients' discomfort. We recruited ten WOCNs to follow

Effects of a School-Based Sexuality Education Program on Peer Educators: The Teen PEP Model

Science.gov (United States)

Jennings, J. M.; Howard, S.; Perotte, C. L.

2014-01-01

This study evaluated the impact of the Teen Prevention Education Program (Teen PEP), a peer-led sexuality education program designed to prevent unintended pregnancy and sexually transmitted infections (STIs) including HIV among high school students. The study design was a quasi-experimental, nonrandomized design conducted from May 2007 to May…

Gradually including potential users: A tool to counter design exclusions.

Science.gov (United States)

Zitkus, Emilene; Langdon, Patrick; Clarkson, P John

2018-01-01

The paper describes an iterative development process used to understand the suitability of different inclusive design evaluation tools applied into design practices. At the end of this process, a tool named Inclusive Design Advisor was developed, combining data related to design features of small appliances with ergonomic task demands, anthropometric data and exclusion data. When auditing a new design the tool examines the exclusion that each design feature can cause, followed by objective recommendations directly related to its features. Interactively, it allows designers or clients to balance design changes with the exclusion caused. It presents the type of information that enables designers and clients to discuss user needs and make more inclusive design decisions. Copyright © 2017. Published by Elsevier Ltd.

Evaluation oF FactORs ImpacTing CLinical Outcome and Cost EffectiveneSS of the S-ICD: Design and Rationale of the EFFORTLESS S-ICD Registry

DEFF Research Database (Denmark)

Pedersen, Susanne S; Lambiase, Pier; Boersma, Lucas V A

2012-01-01

utilization. Methods: The Registry is an observational, nonrandomized, standard of care evaluation to be conducted at approximately 50 investigational centers in Europe and New Zealand where the S-ICD is approved for use and distribution. Clinical Registry endpoints include perioperative (30 days postimplant......Background: Leads in and on the heart of the transvenous implantable cardioverter defibrillator (ICD) form the Achilles' heel of this system due to potential for peri- and postimplant complications. The S-ICD is a newer generation of the ICD that does not require leads on the heart...... or in the vasculature. We present the rationale and study design of the Evaluation oF FactORs ImpacTing CLinical Outcome and Cost EffectiveneSS of the S-ICD (EFFORTLESS S-ICD) Registry which was designed to evaluate the long-term performance of the S-ICD including patient quality of life and long-term resource...

Comparative Evaluation of Liposomal Albendazole and Tablet-Albendazole Against Hepatic Cystic Echinococcosis: A Non-Randomized Clinical Trial.

Science.gov (United States)

Li, Haitao; Song, Tao; Shao, Yingmei; Aili, Tuergan; Ahan, Ayifuhan; Wen, Hao

2016-01-01

In this study, we aimed to compare the clinical efficacy of liposomal albendazole (L-ABZ) and tablet-albendazole (T-ABZ) for the treatment of human hepatic cystic echinococcosis (CE). Sixty patients with single cyst (CE1) or daughter cyst (CE2) were included in this study and were nonrandomly divided into the L-ABZ group (n = 30, 10  mg/kg per day, p.o., b.i.d.) and T-ABZ group (n = 30, 12-20 mg/kg per day, p.o., b.i.d.), respectively. The treatment duration lasted for 6 months, during which dynamic follow-up was carried out to evaluate the clinical efficacy through calculating the total effective rates (TERs). Measurement data and numerous data were analyzed by the chi-square test. Two-sided tests were performed for all the statistical tests. In our study, 2 patients were lost in the follow-up in the L-ABZ group. One patient was lost in the follow-up in the T-ABZ group, and 1 patient was withdrawal from the study due to receiving surgery. Significant difference was identified in the 3-month TERs of L-ABZ group and T-ABZ group (33.3% vs 76.7%, P  0.05). Based on our study, both T-ABZ and L-ABZ are effective for treating human CE. The TER in the L-ABZ group is superior to that of T-ABZ.

Optimal Design and Real Time Implementation of Autonomous Microgrid Including Active Load

OpenAIRE

Mohamed A. Hassan; Muhammed Y. Worku; Mohamed A. Abido

2018-01-01

Controller gains and power-sharing parameters are the main parameters affect the dynamic performance of the microgrid. Considering an active load to the autonomous microgrid, the stability problem will be more involved. In this paper, the active load effect on microgrid dynamic stability is explored. An autonomous microgrid including three inverter-based distributed generations (DGs) with an active load is modeled and the associated controllers are designed. Controller gains of the inverters ...

Growth-induced strong pinning sites in laser ablated YBa2Cu3O7-δ films with a non-random distribution

International Nuclear Information System (INIS)

Huijbregtse, J.M.; Klaassen, F.C.; Geest, R.C.F. van der; Dam, B.; Griessen, R.

1999-01-01

Recently, the authors showed that natural linear defects are the origin of the high critical currents in laser ablated YGBa 2 Cu 3 O 7-δ films. Combining wet-chemical etching and Atomic Force Microscopy, they find that these dislocations are created by island coalescence during growth. Consequently, the defect density can be reproducibly varied by manipulating the density of growth islands, which in turn depends on the substrate temperature. Interestingly, the radial defect distribution function approaches zero at small distances, indicating short range order. Therefore, they are now able to study vortex matter in films with a tailored non-random distribution of natural strong pinning sites

Late Outcomes Following Hypofractionated Conformal Radiotherapy vs. Standard Fractionation for Localized Prostate Cancer: A Nonrandomized Contemporary Comparison

International Nuclear Information System (INIS)

Leborgne, Felix; Fowler, Jack

2009-01-01

Purpose: To study retrospectively late complications and biochemical control in patients treated with three-dimensional conformal external-beam radiotherapy for localized prostate cancer administered using hypofractionation vs. a standard fractionation regimen. The hypofractionation regimen (Hypo) was designed to avoid more late rectal reactions and to be done in half as many treatment sessions. Methods and Materials: Eighty-nine nonrandomized patients chose Hypo delivered in 20 fractions of 3 Gy (n = 52) or 3.15 Gy (n = 37) for a median overall treatment time of 33 days. One hundred thirty comparable patients were contemporaneously treated with standard fractionation to a median dose of 78 Gy delivered over 55 days. The median follow-up time was 49 months (range, 24-73 months). Results: The 5-year actuarial biochemical control rates were 96%, 84%, and 85% for low-, medium-, and high-risk disease in the Hypo group, respectively. The respective rates in the standard fractionation group were 98%, 84%, and 87%, with no statistical difference between the two groups. The rate of rectal Grade 2-4 complications was 5.5% in both treatment groups and of urinary Grade 2-4 complications was 5.6% in the Hypo and 3% in the standard group (p = 0.36). Similarly, there were no statistical differences in the rate of late complications between patients treated with 3 Gy/fraction vs. 3.15 Gy/fraction. Conclusions: Our preliminary results showed that the Hypo regimen is feasible and does not reduce biochemical control compared with standard fractionation. The incidence of late complications was not increased when the tumor normalized total doses at 2Gy/fraction was increased from 77.1 to 83.7 Gy in patients treated with either 3 or 3.15 Gy/fraction in the Hypo group, respectively.

Aero-structural optimization of wind turbine blades using a reduced set of design load cases including turbulence

DEFF Research Database (Denmark)

Sessarego, Matias; Shen, Wen Zhong

2018-01-01

Modern wind turbine aero-structural blade design codes generally use a smaller fraction of the full design load base (DLB) or neglect turbulent inflow as defined by the International Electrotechnical Commission standards. The current article describes an automated blade design optimization method...... based on surrogate modeling that includes a very large number of design load cases (DLCs) including turbulence. In the present work, 325 DLCs representative of the full DLB are selected based on the message-passing-interface (MPI) limitations in Matlab. Other methods are currently being investigated, e.......g. a Python MPI implementation, to overcome the limitations in Matlab MPI and ultimately achieve a full DLB optimization framework. The reduced DLB and the annual energy production are computed using the state-of-the-art aero-servo-elastic tool HAWC2. Furthermore, some of the interior dimensions of the blade...

Closed-form solutions for linear regulator design of mechanical systems including optimal weighting matrix selection

Science.gov (United States)

Hanks, Brantley R.; Skelton, Robert E.

1991-01-01

Vibration in modern structural and mechanical systems can be reduced in amplitude by increasing stiffness, redistributing stiffness and mass, and/or adding damping if design techniques are available to do so. Linear Quadratic Regulator (LQR) theory in modern multivariable control design, attacks the general dissipative elastic system design problem in a global formulation. The optimal design, however, allows electronic connections and phase relations which are not physically practical or possible in passive structural-mechanical devices. The restriction of LQR solutions (to the Algebraic Riccati Equation) to design spaces which can be implemented as passive structural members and/or dampers is addressed. A general closed-form solution to the optimal free-decay control problem is presented which is tailored for structural-mechanical system. The solution includes, as subsets, special cases such as the Rayleigh Dissipation Function and total energy. Weighting matrix selection is a constrained choice among several parameters to obtain desired physical relationships. The closed-form solution is also applicable to active control design for systems where perfect, collocated actuator-sensor pairs exist.

Increasing capacity to deliver diabetes self-management education: results of the DESMOND lay educator non-randomized controlled equivalence trial.

Science.gov (United States)

Carey, M E; Mandalia, P K; Daly, H; Gray, L J; Hale, R; Martin Stacey, L; Taub, N; Skinner, T C; Stone, M; Heller, S; Khunti, K; Davies, M J

2014-11-01

To develop and test a format of delivery of diabetes self-management education by paired professional and lay educators. We conducted an equivalence trial with non-randomized participant allocation to a Diabetes Education and Self Management for Ongoing and Newly Diagnosed Type 2 diabetes (DESMOND) course, delivered in the standard format by two trained healthcare professional educators (to the control group) or by one trained lay educator and one professional educator (to the intervention group). A total of 260 people with Type 2 diabetes diagnosed within the previous 12 months were referred for self-management education as part of routine care and attended either a control or intervention format DESMOND course. The primary outcome measure was change in illness coherence score (derived from the Diabetes Illness Perception Questionnaire-Revised) between baseline and 4 months after attending education sessions. Secondary outcome measures included change in HbA1c level. The trial was conducted in four primary care organizations across England and Scotland. The 95% CI for the between-group difference in positive change in coherence scores was within the pre-set limits of equivalence (difference = 0.22, 95% CI 1.07 to 1.52). Equivalent changes related to secondary outcome measures were also observed, including equivalent reductions in HbA1c levels. Diabetes education delivered jointly by a trained lay person and a healthcare professional educator with the same educator role can provide equivalent patient benefits. This could provide a method that increases capacity, maintains quality and is cost-effective, while increasing access to self-management education. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

A structural design and analysis of a piping system including seismic load

International Nuclear Information System (INIS)

Hsieh, B.J.; Kot, C.A.

1991-01-01

The structural design/analysis of a piping system at a nuclear fuel facility is used to investigate some aspects of current design procedures. Specifically the effect of using various stress measures including ASME Boiler ampersand Pressure Vessel (B ampersand PV) Code formulas is evaluated. It is found that large differences in local maximum stress values may be calculated depending on the stress criterion used. However, when the global stress maximum for the entire system are compared the differences are much smaller, being nevertheless, for some load combinations, of the order of 50 percent. The effect of using an Equivalent Static Method (ESM) analysis is also evaluated by comparing its results with those obtained from a Response Spectrum Method (RSM) analysis with the modal responses combined by using the absolute summation (ABS), by using the square root of the squares (SRSS), and by using the 10 percent method (10PC). It is shown that for a spectrum amplification factor (equivalent static coefficient greater than unity) of at least 1.32 must be used in the current application of the ESM analysis in order to obtain results which are conservative in all aspects relative to an RSM analysis based on ABS. However, it appears that an adequate design would be obtained from the ESM approach even without the use of a spectrum amplification factor. 7 refs., 3 figs., 3 tabs

When users can´t be included in inclusive design

DEFF Research Database (Denmark)

Herriott, Richard

2012-01-01

and disabled users make the need for useability and pleasurability even more important since alternative products are comparatively few. This paper examines the workarounds two teams of designers have used to reduce the demands placed on emphysema patients and elderly users during inclusive design processes......Inclusive Design (ID) methods place a strong emphasis on user participation in designing mainstream products. In recent years researchers in the field of assistive technology (AT) have drawn on and contributed to the ID approach. There are good grounds for this association. However, the linkage...

TS Fuzzy Model-Based Controller Design for a Class of Nonlinear Systems Including Nonsmooth Functions

DEFF Research Database (Denmark)

Vafamand, Navid; Asemani, Mohammad Hassan; Khayatiyan, Alireza

2018-01-01

This paper proposes a novel robust controller design for a class of nonlinear systems including hard nonlinearity functions. The proposed approach is based on Takagi-Sugeno (TS) fuzzy modeling, nonquadratic Lyapunov function, and nonparallel distributed compensation scheme. In this paper, a novel...... criterion, new robust controller design conditions in terms of linear matrix inequalities are derived. Three practical case studies, electric power steering system, a helicopter model and servo-mechanical system, are presented to demonstrate the importance of such class of nonlinear systems comprising...

Effectiveness of a 'Global Postural Reeducation' program for persistent Low Back Pain: a non-randomized controlled trial

Directory of Open Access Journals (Sweden)

Violante Francesco S

2010-12-01

Full Text Available Abstract Background The aim of this non-randomized controlled trial was to evaluate the effectiveness of a Global Postural Reeducation (GPR program as compared to a Stabilization Exercise (SE program in subjects with persistent low back pain (LBP at short- and mid-term follow-up (ie. 3 and 6 months. Methods According to inclusion and exclusion criteria, 100 patients with a primary complaint of persistent LBP were enrolled in the study: 50 were allocated to the GPR group and 50 to the SE group. Primary outcome measures were Roland and Morris Disability Questionnaire (RMDQ and Oswestry Disability Index (ODI. Secondary outcome measures were lumbar Visual Analogue Scale (VAS and Fingertip-to-floor test (FFT. Data were collected at baseline and at 3/6 months by health care professionals unaware of the study. An intention to treat approach was used to analyze participants according to the group to which they were originally assigned. Results Of the 100 patients initially included in the study, 78 patients completed the study: 42 in the GPR group and 36 in the SE group. At baseline, the two groups did not differ significantly with respect to gender, age, BMI and outcome measures. Comparing the differences between groups at short- and mid-term follow-up, the GPR group revealed a significant reduction (from baseline in all outcome measures with respect to the SE group. The ordered logistic regression model showed an increased likelihood of definitive improvement (reduction from baseline of at least 30% in RMDQ and VAS scores for the GPR group compared to the SE group (OR 3.9, 95% CI 2.7 to 5.7. Conclusions Our findings suggest that a GPR intervention in subjects with persistent LBP induces a greater improvement on pain and disability as compared to a SE program. These results must be confirmed by further studies with higher methodological standards, including randomization, larger sample size, longer follow-up and subgrouping of the LBP subjects. Trial

Probability calculus of fractional order and fractional Taylor's series application to Fokker-Planck equation and information of non-random functions

International Nuclear Information System (INIS)

Jumarie, Guy

2009-01-01

A probability distribution of fractional (or fractal) order is defined by the measure μ{dx} = p(x)(dx) α , 0 α (D x α h α )f(x) provided by the modified Riemann Liouville definition, one can expand a probability calculus parallel to the standard one. A Fourier's transform of fractional order using the Mittag-Leffler function is introduced, together with its inversion formula; and it provides a suitable generalization of the characteristic function of fractal random variables. It appears that the state moments of fractional order are more especially relevant. The main properties of this fractional probability calculus are outlined, it is shown that it provides a sound approach to Fokker-Planck equation which are fractional in both space and time, and it provides new results in the information theory of non-random functions.

Potential use of the non-random distribution of N2 and N2O mole masses in the atmosphere as a tool for tracing atmospheric mixing and isotope fractionation processes

International Nuclear Information System (INIS)

Well, R.; Langel, R.; Reineking, A.

2002-01-01

The variation in the natural abundance of 15 N in atmospheric gas species is often used to determine the mixing of trace gases from different sources. With conventional budget calculations one unknown quantity can be determined if the remaining quantities are known. From 15 N tracer studies in soils with highly enriched 15 N-nitrate a procedure is known to calculate the mixing of atmospheric and soil derived N 2 based on the measurement of the 30/28 and 29/28 ratios in gas samples collected from soil covers. Because of the non-random distribution of the mole masses 30 N 2 , 29 N 2 and 28 N 2 in the mixing gas it is possible to calculate two quantities simultaneously, i.e. the mixing ratio of atmospheric and soil derived N 2 , and the isotopic signature of the soil derived N 2 . Routine standard measurements of laboratory air had suggested a non-random distribution of N 2 -mole masses. The objective of this study was to investigate and explain the existence of non-random distributions of 15 N 15 N, 14 N 15 N and 14 N 14 N in N 2 and N 2 O in environmental samples. The calculation of theoretical isotope data resulting from hypothetical mixing of two sources differing in 15 N natural abundance demonstrated, that the deviation from an ideal random distribution of mole masses is not detectable with the current precision of mass spectrometry. 15 N-analysis of N 2 or N 2 O was conducted with randomised and non-randomised replicate samples of different origin. 15 N abundance as calculated from 29/28 ratios were generally higher in randomised samples. The differences between the treatments ranged between 0.05 and 0.17 δper mille 15 N. It was concluded that the observed randomisation effect is probably caused by 15 N 15 N fractionation during environmental processes. (author)

Sucralfate gel as a radioprotector against radiation induced dermatitis in a hypo-fractionated schedule: a non-randomized study.

Science.gov (United States)

Kouloulias, V; Asimakopoulos, C; Tolia, M; Filippou, G; Platoni, K; Dilvoi, M; Beli, I; Georgakopoulos, J; Patatoukas, G; Kelekis, N

2013-04-01

External beam radiotherapy with high doses provokes many acute skin reactions, such as erythema and moist desquamation. Many topical preparations are used in radiation oncology departments in the skin care. Sucralfate humid gel, a colloidal physical form of the anti-ulcer drug sucralfate, promotes epithelial regeneration and activates cell proliferation. Based on this knowledge, we performed a non-randomized clinical trial to evaluate the efficacy of topical sucralfate gel in 30 breast cancer patients receiving postoperative accelerated hypofractionated photon beam therapy. The comparison was performed with 30 patients as historical controls. The acute reaction of the skin was significantly lower in the group receiving the sucralfate gel (p<0.05, Mann Whitney test), while 90% of the patients had no evidence of radiation induced skin toxicity. There was no sucralfate gel related toxicity reported by any patient in this study. More patients in a randomized way are needed for more definite results.

A nonrandomized, open-label study to evaluate the effect of nasal stimulation on tear production in subjects with dry eye disease.

Science.gov (United States)

Friedman, Neil J; Butron, Karla; Robledo, Nora; Loudin, James; Baba, Stephanie N; Chayet, Arturo

2016-01-01

Dry eye disease (DED), a chronic disorder affecting the tear film and lacrimal functional unit, is a widely prevalent condition associated with significant burden and unmet treatment needs. Since specific neural circuits play an important role in maintaining ocular surface health, microelectrical stimulation of these pathways could present a promising new approach to treating DED. This study evaluated the efficacy and safety of nasal electrical stimulation in patients with DED. This prospective, open-label, single-arm, nonrandomized pilot study included 40 patients with mild to severe DED. After undergoing two screening visits, enrolled subjects were provided with a nasal stimulation device and instructed to use it at home four times daily (or more often as needed). Follow-up assessments were conducted up to day 180. The primary efficacy endpoint was the difference between unstimulated and stimulated tear production quantified by Schirmer scores. Additional efficacy endpoints included change from baseline in corneal and conjunctival staining, symptoms evaluated on a Visual Analog Scale, and Ocular Surface Disease Index scores. Safety parameters included adverse event (AE) rates, visual acuity, intraocular pressure, slit-lamp biomicroscopy, indirect ophthalmoscopy, and endoscopic nasal examinations. Mean stimulated Schirmer scores were significantly higher than the unstimulated scores at all visits, and corneal and conjunctival staining and symptom scores from baseline to day 180 were significantly reduced. No serious device-related AEs and nine nonserious AEs (three device-related) were reported. Intraocular pressure remained stable and most subjects showed little or no change in visual acuity at days 30 and 180. No significant findings from other clinical examinations were noted. Neurostimulation of the nasolacrimal pathway is a safe and effective means of increasing tear production and reducing symptoms of dry eye in patients with DED.

An intervention to reduce HIV risk behavior of substance-using men who have sex with men: a two-group randomized trial with a nonrandomized third group.

Directory of Open Access Journals (Sweden)

Gordon Mansergh

2010-08-01

Full Text Available Substance use during sex is associated with sexual risk behavior among men who have sex with men (MSM, and MSM continue to be the group at highest risk for incident HIV in the United States. The objective of this study is to test the efficacy of a group-based, cognitive-behavioral intervention to reduce risk behavior of substance-using MSM, compared to a randomized attention-control group and a nonrandomized standard HIV-testing group.Participants (n = 1,686 were enrolled in Chicago, Los Angeles, New York City, and San Francisco and randomized to a cognitive-behavioral intervention or attention-control comparison. The nonrandomized group received standard HIV counseling and testing. Intervention group participants received six 2-h group sessions focused on reducing substance use and sexual risk behavior. Attention-control group participants received six 2-h group sessions of videos and discussion of MSM community issues unrelated to substance use, sexual risk, and HIV/AIDS. All three groups received HIV counseling and testing at baseline. The sample reported high-risk behavior during the past 3 mo prior to their baseline visit: 67% reported unprotected anal sex, and 77% reported substance use during their most recent anal sex encounter with a nonprimary partner. The three groups significantly (p0.05 from each other at 3-, 6-, and 12-mo follow-up. Outcomes for the 2-arm comparisons were not significantly different at 12-mo follow-up (e.g., unprotected anal sex, odds ratio = 1.14, confidence interval = 0.86-1.51, nor at earlier time points. Similar results were found for each outcome variable in both 2- and 3-arm comparisons.These results for reducing sexual risk behavior of substance-using MSM are consistent with results of intervention trials for other populations, which collectively suggest critical challenges for the field of HIV behavioral interventions. Several mechanisms may contribute to statistically indistinguishable reductions in risk

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

International Nuclear Information System (INIS)

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

2003-01-01

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

Improving Sleep for Hospitalized Antepartum Patients: A Non-Randomized Controlled Pilot Study.

Science.gov (United States)

Lee, Kathryn A; Gay, Caryl L

2017-12-15

To evaluate feasibility and efficacy of a hospital-based protocol for improving sleep in high- risk antepartum patients. Sleep measures were compared during 1 week of hospitalization before and after implementing a Sleep Improvement Protocol for Antepartum Patients (SIP-AP). A non-randomized convenience sample of usual care controls was compared to a subsequent intervention sample after the protocol was implemented. Women were eligible if they spoke English, were medically stable, pregnant for at least 20 weeks, and hospitalized at least 24 hours; 25 pregnant women had sufficient data for analyses (11 controls, 14 intervention). Sleep was assessed in 3 ways: the Pittsburgh Sleep Quality Index was completed after obtaining consent to estimate sleep quality prior to hospital admission; sleep diary completed each hospital day; and General Sleep Disturbance Scale completed at 7 days or prior to hospital discharge. Symptoms that could affect sleep were assessed with the Memorial Symptom Assessment Scale. Both groups recorded similar sleep duration (7 hours) but the intervention group had fewer symptoms and significantly ( P = .015) lower sleep disturbance scores (53.1 ± 14.5) than controls (71.9 ± 18.8). Participant feedback about the intervention was positive, although adherence to components of the intervention protocol was variable. This pilot study provides evidence of the feasibility and preliminary efficacy of the SIP-AP intervention for reducing symptoms and improving sleep of antepartum patients during hospitalization. Further detailed evaluation of specific components of this protocol is warranted, and other types of hospitalized patients may benefit from unit-based modifications to this SIP-AP protocol. © 2017 American Academy of Sleep Medicine

Evaluation of physical activity interventions in children via the reach, efficacy/effectiveness, adoption, implementation, and maintenance (RE-AIM) framework: A systematic review of randomized and non-randomized trials.

Science.gov (United States)

McGoey, Tara; Root, Zach; Bruner, Mark W; Law, Barbi

2016-01-01

Existing reviews of physical activity (PA) interventions designed to increase PA behavior exclusively in children (ages 5 to 11years) focus primarily on the efficacy (e.g., internal validity) of the interventions without addressing the applicability of the results in terms of generalizability and translatability (e.g., external validity). This review used the RE-AIM (Reach, Efficacy/Effectiveness, Adoption, Implementation, Maintenance) framework to measure the degree to which randomized and non-randomized PA interventions in children report on internal and external validity factors. A systematic search for controlled interventions conducted within the past 12years identified 78 studies that met the inclusion criteria. Based on the RE-AIM criteria, most of the studies focused on elements of internal validity (e.g., sample size, intervention location and efficacy/effectiveness) with minimal reporting of external validity indicators (e.g., representativeness of participants, start-up costs, protocol fidelity and sustainability). Results of this RE-AIM review emphasize the need for future PA interventions in children to report on real-world challenges and limitations, and to highlight considerations for translating evidence-based results into health promotion practice. Copyright © 2015 Elsevier Inc. All rights reserved.

Spatially nonrandom tree mortality and ingrowth maintain equilibrium pattern in an old-growth Pseudotsuga-Tsuga forest.

Science.gov (United States)

Lutz, James A; Larson, Andrew J; Furniss, Tucker J; Donato, Daniel C; Freund, James A; Swanson, Mark E; Bible, Kenneth J; Chen, Jiquan; Franklin, Jerry F

2014-08-01

Mortality processes in old-growth forests are generally assumed to be driven by gap-scale disturbance, with only a limited role ascribed to density-dependent mortality, but these assumptions are rarely tested with data sets incorporating repeated measurements. Using a 12-ha spatially explicit plot censused 13 years apart in an approximately 500-year-old Pseudotsuga-Tsuga forest, we demonstrate significant density-dependent mortality and spatially aggregated tree recruitment. However, the combined effect of these strongly nonrandom demographic processes was to maintain tree patterns in a state of dynamic equilibrium. Density-dependent mortality was most pronounced for the dominant late-successional species, Tsuga heterophylla. The long-lived, early-seral Pseudotsuga menziesii experienced an annual stem mortality rate of 0.84% and no new recruitment. Late-seral species Tsuga and Abies amabilis had nearly balanced demographic rates of ingrowth and mortality. The 2.34% mortality rate for Taxus brevifolia was higher than expected, notably less than ingrowth, and strongly affected by proximity to Tsuga. Large-diameter Tsuga structured both the regenerating conspecific and heterospecific cohorts with recruitment of Tsuga and Abies unlikely in neighborhoods crowded with large-diameter competitors (P old-growth forests.

A Non-randomized Controlled Trial of EMDR on Affective Symptoms in Patients With Glioblastoma Multiforme

Directory of Open Access Journals (Sweden)

Monika Szpringer

2018-05-01

Full Text Available Glioblastoma multiforme (GBM is a highly aggressive brain cancer and its survival after diagnosis is less than 2 years. Therefore, GBM patients are especially prone to co-occurring psychological conditions such as anxiety and depressive disorders. Furthermore, aggressive medical therapies affect patients’ lives, undermining their sense of meaning and coherence. The main aim of this study was to determine the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR therapy on anxiety, depression and sense of coherence in patients with GBM. Thirty-seven GBM-diagnosed women were included in this trial and received standard medical care. Of those, 18 patients were treated during 4 months with 10–12 individual EMDR sessions (60–90 minutes each. Nineteen GBM patients were used as a non-randomized control group as they consented to psychological evaluations but not to a psychotherapeutic intervention. The groups were homogeneous in terms of gender, age, educational level and treatment, but not in anxiety and depressive levels at baseline. All patients were evaluated at baseline, after treatment (4 months and at follow-up (further 4 months by the Hospital Anxiety and Depression Scale (HADS-M and the Sense of Coherence Scale (SOC-29. Caregivers in both groups were interviewed by the Patient Caregiver Questionnaire after 4 months follow-up. Statistical analyses were conducted using ANOVA statistics, correlation and regression analysis. Results showed a statistically significant decrease in the EMDR group in anxiety, depression and anger, when compared to the experimental group. EMDR therapy also had a positive impact upon the sense of coherence level in the experimental group, whereas in the control group this declined. Finally, the caregivers reported beneficial outcomes of the EMDR therapy with less anxiety- and anger-related behaviors in patients in the experimental group compared to the control group. This study is the first to show

Should Intelligent Design Be Included in Today's Public School Curriculums?

Science.gov (United States)

Costley, Kevin C.; Killins, Pam

2010-01-01

The controversial concept of evolution makes up only a small part of the science curriculum stated in Arkansas. During the past few years, the curriculum topic of "Intelligent Design" has caught the attention of many science teachers in the public schools. The Intelligent Design Movement has been successful in attracting the attention of…

Design optimization of transformerless grid-connected PV inverters including reliability

DEFF Research Database (Denmark)

Koutroulis, Eftichios; Blaabjerg, Frede

2012-01-01

Of the Electricity (LCOE) generated during the PV system lifetime period is minimized. The LCOE is calculated also considering the failure rates of the components, which affect the reliability performance and lifetime maintenance cost of the PV inverter. A design example is presented, demonstrating that compared...... to the non-optimized PV inverter structures, the PV inverters designed using the proposed optimization methodology exhibit lower total manufacturing and lifetime maintenance cost and inject more energy into the electric-grid and by that minimizing LCOE.......This paper presents a new methodology for optimal design of transformerless Photovoltaic (PV) inverters targeting a cost-effective deployment of grid-connected PV systems. The optimal values and types of the PV inverter components are calculated such that the PV inverter Levelized Cost...

Design Optimization of Transformerless Grid-Connected PV Inverters Including Reliability

DEFF Research Database (Denmark)

Koutroulis, Eftichios; Blaabjerg, Frede

2013-01-01

such that the PV inverter LCOE generated during the PV system lifetime period is minimized. The LCOE is also calculated considering the failure rates of the components, which affect the reliability performance and lifetime maintenance cost of the PV inverter. A design example is presented, demonstrating...... that compared to the nonoptimized PV inverter structures, the PV inverters designed using the proposed optimization methodology exhibit lower total manufacturing and lifetime maintenance cost and inject more energy into the electric-grid and by that minimizing LCOE.......This paper presents a new methodology for optimal design of transformerless photovoltaic (PV) inverters targeting a cost-effective deployment of grid-connected PV systems. The optimal switching frequency as well as the optimal values and types of the PV inverter components is calculated...

How to include frequency dependent complex permeability Into SPICE models to improve EMI filters design?

Science.gov (United States)

Sixdenier, Fabien; Yade, Ousseynou; Martin, Christian; Bréard, Arnaud; Vollaire, Christian

2018-05-01

Electromagnetic interference (EMI) filters design is a rather difficult task where engineers have to choose adequate magnetic materials, design the magnetic circuit and choose the size and number of turns. The final design must achieve the attenuation requirements (constraints) and has to be as compact as possible (goal). Alternating current (AC) analysis is a powerful tool to predict global impedance or attenuation of any filter. However, AC analysis are generally performed without taking into account the frequency-dependent complex permeability behaviour of soft magnetic materials. That's why, we developed two frequency-dependent complex permeability models able to be included into SPICE models. After an identification process, the performances of each model are compared to measurements made on a realistic EMI filter prototype in common mode (CM) and differential mode (DM) to see the benefit of the approach. Simulation results are in good agreement with the measured ones especially in the middle frequency range.

Closed-form solutions for linear regulator-design of mechanical systems including optimal weighting matrix selection

Science.gov (United States)

Hanks, Brantley R.; Skelton, Robert E.

1991-01-01

This paper addresses the restriction of Linear Quadratic Regulator (LQR) solutions to the algebraic Riccati Equation to design spaces which can be implemented as passive structural members and/or dampers. A general closed-form solution to the optimal free-decay control problem is presented which is tailored for structural-mechanical systems. The solution includes, as subsets, special cases such as the Rayleigh Dissipation Function and total energy. Weighting matrix selection is a constrained choice among several parameters to obtain desired physical relationships. The closed-form solution is also applicable to active control design for systems where perfect, collocated actuator-sensor pairs exist. Some examples of simple spring mass systems are shown to illustrate key points.

Interactions between the Design and Operation of Shale Gas Networks, Including CO2 Sequestration

Directory of Open Access Journals (Sweden)

Sharifzadeh Mahdi

2017-04-01

Full Text Available As the demand for energy continues to increase, shale gas, as an unconventional source of methane (CH4, shows great potential for commercialization. However, due to the ultra-low permeability of shale gas reservoirs, special procedures such as horizontal drilling, hydraulic fracturing, periodic well shut-in, and carbon dioxide (CO2 injection may be required in order to boost gas production, maximize economic benefits, and ensure safe and environmentally sound operation. Although intensive research is devoted to this emerging technology, many researchers have studied shale gas design and operational decisions only in isolation. In fact, these decisions are highly interactive and should be considered simultaneously. Therefore, the research question addressed in this study includes interactions between design and operational decisions. In this paper, we first establish a full-physics model for a shale gas reservoir. Next, we conduct a sensitivity analysis of important design and operational decisions such as well length, well arrangement, number of fractures, fracture distance, CO2 injection rate, and shut-in scheduling in order to gain in-depth insights into the complex behavior of shale gas networks. The results suggest that the case with the highest shale gas production may not necessarily be the most profitable design; and that drilling, fracturing, and CO2 injection have great impacts on the economic viability of this technology. In particular, due to the high costs, enhanced gas recovery (EGR using CO2 does not appear to be commercially competitive, unless tax abatements or subsidies are available for CO2 sequestration. It was also found that the interactions between design and operational decisions are significant and that these decisions should be optimized simultaneously.

A new method for synthesizing radiation dose-response data from multiple trials applied to prostate cancer

DEFF Research Database (Denmark)

Diez, Patricia; Vogelius, Ivan S; Bentzen, Søren M

2010-01-01

A new method is presented for synthesizing dose-response data for biochemical control of prostate cancer according to study design (randomized vs. nonrandomized) and risk group (low vs. intermediate-high).......A new method is presented for synthesizing dose-response data for biochemical control of prostate cancer according to study design (randomized vs. nonrandomized) and risk group (low vs. intermediate-high)....

Impact of a Community-Based Prevention Marketing Intervention to Promote Physical Activity among Middle-Aged Women

Science.gov (United States)

Sharpe, Patricia A.; Burroughs, Ericka L.; Granner, Michelle L.; Wilcox, Sara; Hutto, Brent E.; Bryant, Carol A.; Peck, Lara; Pekuri, Linda

2010-01-01

A physical activity intervention applied principles of community-based participatory research, the community-based prevention marketing framework, and social cognitive theory. A nonrandomized design included women ages 35 to 54 in the southeastern United States. Women (n = 430 preprogram, n = 217 postprogram) enrolled in a 24-week behavioral…

A Novel Therapy for Chronic Sleep-Onset Insomnia: A Retrospective, Nonrandomized Controlled Study of Auto-Adjusting, Dual-Level, Positive Airway Pressure Technology.

Science.gov (United States)

Krakow, Barry; Ulibarri, Victor A; McIver, Natalia D; Nadorff, Michael R

2016-09-29

Evidence indicates that behavioral or drug therapy may not target underlying pathophysiologic mechanisms for chronic insomnia, possibly due to previously unrecognized high rates (30%-90%) of sleep apnea in chronic insomnia patients. Although treatment studies with positive airway pressure (PAP) demonstrate decreased severity of chronic sleep maintenance insomnia in patients with co-occurring sleep apnea, sleep-onset insomnia has not shown similar results. We hypothesized advanced PAP technology would be associated with decreased sleep-onset insomnia severity in a sample of predominantly psychiatric patients with comorbid sleep apnea. We reviewed charts of 74 severe sleep-onset insomnia patients seen from March 2011 to August 2015, all meeting American Academy of Sleep Medicine Work Group criteria for a chronic insomnia disorder and all affirming behavioral and psychological origins for insomnia (averaging 10 of 18 indicators/patient), as well as averaging 2 or more psychiatric symptoms or conditions: depression (65.2%), anxiety (41.9%), traumatic exposure (35.1%), claustrophobia (29.7%), panic attacks (28.4%), and posttraumatic stress disorder (20.3%). All patients failed continuous or bilevel PAP and were manually titrated with auto-adjusting PAP modes (auto-bilevel and adaptive-servo ventilation). At 1-year follow-up, patients were compared through nonrandom assignment on the basis of a PAP compliance metric of > 20 h/wk (56 PAP users) versus insomnia severity (Hedges' g = 1.72) and sleep-onset insomnia (g = 2.07) compared to partial users (g = 1.04 and 0.91, respectively). Both global and sleep-onset insomnia severity decreased below moderate levels in PAP users compared to partial users whose outcomes persisted at moderately severe levels. In a nonrandomized controlled retrospective study, advanced PAP technology (both auto-bilevel and adaptive servo-ventilation) were associated with large decreases in insomnia severity for sleep-onset insomnia patients who

Aneuploidy in immortalized human mesenchymal stem cells with non-random loss of chromosome 13 in culture.

Science.gov (United States)

Takeuchi, Masao; Takeuchi, Kikuko; Ozawa, Yutaka; Kohara, Akihiro; Mizusawa, Hiroshi

2009-01-01

Aneuploidy (an abnormal number of chromosomes) is commonly observed in most human cancer cells, highlighting the need to examine chromosomal instability in tumorigenesis. Previously, the immortalized human mesenchymal stem cell line UE6E7T-3 was shown to undergo a preferential loss of one copy of chromosome 13 after prolonged culture. Here, the loss of chromosome 13 was found to be caused by chromosome missegregation during mitosis, which involved unequal segregation, exclusion of the misaligned chromosome 13 on the metaphase plate, and trapping of chromosome 13 in the midbody region, as observed by fluorescence in situ hybridization. Near-diploid aneuploidy, not tetraploidy, was the direct result. The loss of chromosome 13 was non-random, and was detected by analysis of microsatellites and single nucleotide polymorphism-based loss of heterozygosity (LOH). Of the five microsatellite loci on chromosome 13, four loci showed microsatellite instability at an early stage in culture, and LOH was apparent at a late stage in culture. These results suggest that the microsatellite mutations cause changes in centromere integrity provoking loss of this chromosome in the UE6E7T-3 cell line. Thus, these results support the use of this cell line as a useful model for understanding the mechanism of aneuploid formation in cell cultures.

Failure of fluconazole in treating cutaneous leishmaniasis caused by Leishmania guyanensis in the Brazilian Amazon: An open, nonrandomized phase 2 trial.

Directory of Open Access Journals (Sweden)

Valeska Albuquerque Francesconi

2018-02-01

Full Text Available The treatment of Leishmaniasis caused by Leishmania (Viannia guyanensis is based on a weak strength of evidence from very few clinical trials and some case series reports. Current treatment guidelines recommend pentamidine isethionate or meglumine antimoniate (Glucantime as the first-line choices. Both are parenteral drugs with a low therapeutic indexes leading to a high risk of undesired effects. Imidazole derivatives interfere with the production of leishmanial ergosterol, an essential component of their membrane structure. One drug that has been studied in different clinical presentations of Leishmania is fluconazole, a hydrophilic bis-triazole, which is easily absorbed through the oral route with a low toxicity profile and is considered safe for children. This drug is readily available in poor countries with a reasonable cost making it a potential option for treating leishmaniasis.An adaptive nonrandomized clinical trial with sequential groups with dose escalation of oral fluconazole was designed to treat adult men with localized cutaneous leishmaniasis (LCL in Manaus, Brazil. Eligible participants were patients with LCL with confirmed Leishmania guyanensis infection.Twenty adult male patients were treated with 450 mg of fluconazole daily for 30 days. One patient (5% was cured within 30 days of treatment. Of the 19 failures (95%, 13 developed a worsening of ulcers and six evolved lymphatic spreading of the disease. Planned dose escalation was suspended after the disappointing failure rate during the first stage of the trial.Oral fluconazole, at the dose of 450mg per day, was not efficacious against LCL caused by Leishmania guyanensis in adult men.Brazilian Clinical Trial Registration (ReBec-RBR-8w292w; UTN number-1158-2421.

Modified Design of Hydroturbine Wicket Gates to Include Liquid Control Jets

Science.gov (United States)

Lewis, Bryan; Cimbala, John; Wouden, Alex

2013-11-01

With the ever-increasing penetration of alternative electricity generation, it is becoming more common to operate hydroturbines under off-design conditions in order to maintain stability in the electric power grid. Improving the off-design performance of these turbines is therefore of significant importance. As the runner blades of a Francis hydroturbine pass though the wakes created by the upstream guide vanes (wicket gates and stay vanes), they experience significant changes in the instantaneous values of absolute velocity, flow angle, and pressure. The concept of adding water jets to the trailing edge of the guide vanes is proposed as a method for reducing the dynamic load on the hydroturbine runner blades, as well as modifying the flow angle of the water entering the runner to improve turbine efficiency during off-design operation. In order to add water jets that are capable of turning the flow, a modified beveled trailing edge design is presented. Computational experiments show that a +/-5° change in swirl angle is achievable with the new design, as well as up to 4% improvement in turbine efficiency during off-design operation. This correlates to an overall improvement in machine efficiency of up to 2%, when the losses through the jet channels are taken into account. Funding for this work was provided by the DOD, through the National Defense Science and Engineering Graduate (NDSEG) Fellowship, and the DOE, through the Penn State Hydropower Research Grant.

Additive Complex Ayurvedic Treatment in Patients with Fibromyalgia Syndrome Compared to Conventional Standard Care Alone: A Nonrandomized Controlled Clinical Pilot Study (KAFA Trial

Directory of Open Access Journals (Sweden)

Christian S. Kessler

2013-01-01

Full Text Available Background. Fibromyalgia (FMS is a challenging condition for health care systems worldwide. Only limited trial data is available for FMS for outcomes of complex treatment interventions of complementary and integrative (CIM approaches. Methods. We conducted a controlled, nonrandomized feasibility study that compared outcomes in 21 patients treated with Ayurveda with those of 11 patients treated with a conventional approach at the end of a two-week inpatient hospital stay. Primary outcome was the impact of fibromyalgia on patients as assessed by the FIQ. Secondary outcomes included scores of pain intensity, pain perception, depression, anxiety, and quality of sleep. Follow-up assessments were done after 6 months. Results. At 2 weeks, there were comparable and significant improvements in the FIQ and for most of secondary outcomes in both groups with no significant in-between-group differences. The beneficial effects for both treatment groups were partly maintained for the main outcome and a number of secondary outcomes at the 6-month followup, again with no significant in-between-group differences. Discussion. The findings of this feasibility study suggest that Ayurvedic therapy is noninferior to conventional treatment in patients with severe FMS. Since Ayurveda was only used as add-on treatment, RCTs on Ayurveda alone are warranted to increase model validity. This trial is registered with NCT01389336.

EFFICACY AND SAFETY OF INHALED NITRIC OXIDE USE IN PATIENTS WITH PULMONARY HYPERTENSION AND CHRONIC HEART FAILURE III-IV FUNCTIONAL CLASS, SURVIVED LEFT VENTRICULAR MYOCARDIAL INFARCTION: RESULTS OF NON-RANDOMIZED COMAPARIVE STUDY

Directory of Open Access Journals (Sweden)

P. N. Pavlenko

2011-01-01

Full Text Available Aim – assessment of the influence of inhaled nitric oxide (NO on the course of pulmonary hypertension (PH in patients with chronic heartfailure (CHF III–IV functional class (FC, myocardial infarction (MI.Materials and methods. Results of comparative non-randomized study that included 45 patients (26 men and 19 women aged 51 to 98 years with PH III–IV functional class, left ventricular myocardial infarction. In the study, patients underwent physical examination and Doppler echocardiography, and assessed FC LH (carried out with six-minute walking test, to determine the degree of dyspnea by Borg.Results. Symptoms of CHF and PH regressed in both groups of patients against the background of the therapy. Conclusion. It is established that the use of inhaled NO is a safe therapy and helps to reduce mean pulmonary arterial pressure (PAPmean in patients with PH and CHF III–IV FC, myocardial infarction. The method of inhaled NO is simple and easy to use.

EFFICACY AND SAFETY OF INHALED NITRIC OXIDE USE IN PATIENTS WITH PULMONARY HYPERTENSION AND CHRONIC HEART FAILURE III-IV FUNCTIONAL CLASS, SURVIVED LEFT VENTRICULAR MYOCARDIAL INFARCTION: RESULTS OF NON-RANDOMIZED COMAPARIVE STUDY

Directory of Open Access Journals (Sweden)

P. N. Pavlenko

2014-07-01

Full Text Available Aim – assessment of the influence of inhaled nitric oxide (NO on the course of pulmonary hypertension (PH in patients with chronic heartfailure (CHF III–IV functional class (FC, myocardial infarction (MI.Materials and methods. Results of comparative non-randomized study that included 45 patients (26 men and 19 women aged 51 to 98 years with PH III–IV functional class, left ventricular myocardial infarction. In the study, patients underwent physical examination and Doppler echocardiography, and assessed FC LH (carried out with six-minute walking test, to determine the degree of dyspnea by Borg.Results. Symptoms of CHF and PH regressed in both groups of patients against the background of the therapy. Conclusion. It is established that the use of inhaled NO is a safe therapy and helps to reduce mean pulmonary arterial pressure (PAPmean in patients with PH and CHF III–IV FC, myocardial infarction. The method of inhaled NO is simple and easy to use.

Effects of a school-based sexuality education program on peer educators: the Teen PEP model

OpenAIRE

Jennings, J. M.; Howard, S.; Perotte, C. L.

2014-01-01

This study evaluated the impact of the Teen Prevention Education Program (Teen PEP), a peer-led sexuality education program designed to prevent unintended pregnancy and sexually transmitted infections (STIs) including HIV among high school students. The study design was a quasi-experimental, nonrandomized design conducted from May 2007 to May 2008. The sample consisted of 96 intervention (i.e. Teen PEP peer educators) and 61 comparison students from five high schools in New Jersey. Baseline a...

A nonrandomized controlled clinical pilot trial on 8 wk of intermittent fasting (24 h/wk).

Science.gov (United States)

Kessler, Christian S; Stange, Rainer; Schlenkermann, Maike; Jeitler, Michael; Michalsen, Andreas; Selle, Antonia; Raucci, Franca; Steckhan, Nico

2018-02-01

The aim of the study was to evaluate whether intermittent fasting (IF) is an effective preventive measure, and whether it is feasible for healthy volunteers under every day conditions. A nonrandomized controlled clinical trial on IF was performed with healthy volunteers over a period of 8 wk, and a subsequent 4-mo follow-up. Outcomes were assessed at baseline, after 8 wk, and after 6 mo. Volunteers who were not interested in fasting served as a control group. Participants in the fasting group were asked to continue their regular nutritional habits on the nonfasting days, whereas the control group maintained their habitual nutrition throughout the whole period. Outcomes included changes of metabolic parameters (insulin, glucose, insulin resistance, insulin-like growth factor-1, brain-derived neurotropic factor, lipids, liver enzymes, hemoglobin A1c) and coagulation markers; bioelectrical impedance analysis; body mass index; abdominal girth; blood pressure; general quality of life (five-item World Health Organization Well-Being Index [WHO-5] questionnaire), as well as mood and anxiety (Hospital Anxiety and Depression Scale [HADS], Profile of Mood States, Flourishing-Scale, visual analog scale, Likert scales). The intervention consisted of a fasting day, which was repeated every week for 8 wk, with abstinence from solid food between 00:00 and 23:59 at minimum and a maximum caloric intake of 300 kcal on each fasting day. A per-protocol analysis was performed. P < 0.05 was considered significant. Thirty-six volunteers were included; 22 allocated themselves to the fasting group, and 14 to the control group. Thirty-three data sets were included in the final analysis. Although significant in-group changes were observed in both groups for a number of outcomes after 8 wk and 6 mo, no significant between-group differences were observed for any outcome other than overall body fat mass after 8 wk as well as for the HADS total score and the WHO-5 total score after 6�

Incidence of primary hypothyroidism in patients exposed to therapeutic external beam radiation, where radiation portals include a part or whole of the thyroid gland

Directory of Open Access Journals (Sweden)

B A Laway

2012-01-01

Full Text Available Introduction: Hypothyroidism is a known consequence of external-beam radiotherapy to the neck encompassing a part or whole of the thyroid gland. In this non-randomized prospective study, we have tried to evaluate the response of the thyroid gland to radiation by assessing thyroid function before irradiation and at regular intervals after irradiation. Aims and Objectives: The aim of this study were to assess in the cancer patients, who were exposed to the therapeutic external beam radiation, where radiation portals include a part or whole of the thyroid gland: the incidence of primary hypothyroidism, the time required to become hypothyroid, any relation between the total dose for the development of hypothyroidism, and whether there are any patient or treatment-related factors that are predictive for the development of hypothyroidism, including the use of concurrent chemotherapy. Materials and Methods: This non-randomized, prospective study was conducted for a period of 2 years in which thyroid function was assessed in 59 patients (cases of head and neck cancer, breast cancer, lymphoma patients and other malignancies, who had received radiotherapy to the neck region. 59 euthyroid healthy patients (controls were also taken, who had not received the neck irradiation. These patients/controls were assessed periodically for 2 years. Results: The incidence of hypothyroidism after external beam radiation therapy (EBRT to neck where radiation portals include part or whole of the thyroid gland was 16.94%, seven cases had subclinical hypothyroidism (11.86% and three cases had clinical hypothyroidism (5.08%. Mean time for development of hypothyroidism was 4.5 months. There was no effect of age, gender, primary tumor site, radiation dose and chemotherapy, whether neoadjuvant or concurrent with the development of hypothyroidism. Conclusion: In summary, we found that thyroid dysfunction is a prevalent, yet easily treatable source of morbidity in patients

On Random Numbers and Design

Science.gov (United States)

Ben-Ari, Morechai

2004-01-01

The term "random" is frequently used in discussion of the theory of evolution, even though the mathematical concept of randomness is problematic and of little relevance in the theory. Therefore, since the core concept of the theory of evolution is the non-random process of natural selection, the term random should not be used in teaching the…

Randomly and Non-Randomly Missing Renal Function Data in the Strong Heart Study: A Comparison of Imputation Methods.

Directory of Open Access Journals (Sweden)

Nawar Shara

Full Text Available Kidney and cardiovascular disease are widespread among populations with high prevalence of diabetes, such as American Indians participating in the Strong Heart Study (SHS. Studying these conditions simultaneously in longitudinal studies is challenging, because the morbidity and mortality associated with these diseases result in missing data, and these data are likely not missing at random. When such data are merely excluded, study findings may be compromised. In this article, a subset of 2264 participants with complete renal function data from Strong Heart Exams 1 (1989-1991, 2 (1993-1995, and 3 (1998-1999 was used to examine the performance of five methods used to impute missing data: listwise deletion, mean of serial measures, adjacent value, multiple imputation, and pattern-mixture. Three missing at random models and one non-missing at random model were used to compare the performance of the imputation techniques on randomly and non-randomly missing data. The pattern-mixture method was found to perform best for imputing renal function data that were not missing at random. Determining whether data are missing at random or not can help in choosing the imputation method that will provide the most accurate results.

Comparative Genomic Hybridization of Human Malignant Gliomas Reveals Multiple Amplification Sites and Nonrandom Chromosomal Gains and Losses

Science.gov (United States)

Schròck, Evelin; Thiel, Gundula; Lozanova, Tanka; du Manoir, Stanislas; Meffert, Marie-Christine; Jauch, Anna; Speicher, Michael R.; Nürnberg, Peter; Vogel, Siegfried; Janisch, Werner; Donis-Keller, Helen; Ried, Thomas; Witkowski, Regine; Cremer, Thomas

1994-01-01

Nine human malignant gliomas (2 astrocytomas grade III and 7 glioblastomas) were analyzed using comparative genomic hybridization (CGH). In addition to the amplification of the EGFR gene at 7p12 in 4 of 9 cases, six new amplification sites were mapped to 1q32, 4q12, 7q21.1, 7q21.2-3, 12p, and 22q12. Nonrandom chromosomal gains and losses were identified with overrepresentation of chromosome 7 and underrepresentation of chromosome 10 as the most frequent events (1 of 2 astrocytomas, 7 of 7 glioblastomas). Gain of a part or the whole chromosome 19 and losses of chromosome bands 9pter-23 and 22q13 were detected each in five cases. Loss of chromosome band 17p13 and gain of chromosome 20 were revealed each in three cases. The validity of the CGH data was confirmed using interphase cytogenetics with YAC clones, chromosome painting in tumor metaphase spreads, and DNA fingerprinting. A comparison of CGH data with the results of chromosome banding analyses indicates that metaphase spreads accessible in primary tumor cell cultures may not represent the clones predominant in the tumor tissue ImagesFigure 1Figure 4Figure 6 PMID:8203461

Functional redundancy patterns reveal non-random assembly rules in a species-rich marine assemblage.

Directory of Open Access Journals (Sweden)

Nicolas Guillemot

Full Text Available The relationship between species and the functional diversity of assemblages is fundamental in ecology because it contains key information on functional redundancy, and functionally redundant ecosystems are thought to be more resilient, resistant and stable. However, this relationship is poorly understood and undocumented for species-rich coastal marine ecosystems. Here, we used underwater visual censuses to examine the patterns of functional redundancy for one of the most diverse vertebrate assemblages, the coral reef fishes of New Caledonia, South Pacific. First, we found that the relationship between functional and species diversity displayed a non-asymptotic power-shaped curve, implying that rare functions and species mainly occur in highly diverse assemblages. Second, we showed that the distribution of species amongst possible functions was significantly different from a random distribution up to a threshold of ∼90 species/transect. Redundancy patterns for each function further revealed that some functions displayed fast rates of increase in redundancy at low species diversity, whereas others were only becoming redundant past a certain threshold. This suggested non-random assembly rules and the existence of some primordial functions that would need to be fulfilled in priority so that coral reef fish assemblages can gain a basic ecological structure. Last, we found little effect of habitat on the shape of the functional-species diversity relationship and on the redundancy of functions, although habitat is known to largely determine assemblage characteristics such as species composition, biomass, and abundance. Our study shows that low functional redundancy is characteristic of this highly diverse fish assemblage, and, therefore, that even species-rich ecosystems such as coral reefs may be vulnerable to the removal of a few keystone species.

Nuclear waste glass melter design including the power and control systems

International Nuclear Information System (INIS)

Chapman, C.C.

1982-01-01

An energy balance of a joule-heated nuclear waste glass melter is used to discuss the problems in the design of the melter geometry and in the specifications of the power and control systems. The relationships between geometry, electrode current density, production rate, load voltage, and load power are presented graphically. The influence of liquid feeding on the surface of the glass and the variability of nuclear waste glass on the design and control during operation is discussed. 10 refs

A nonrandomized, open-label study to evaluate the effect of nasal stimulation on tear production in subjects with dry eye disease

Directory of Open Access Journals (Sweden)

Friedman NJ

2016-05-01

Full Text Available Neil J Friedman,1 Karla Butron,2 Nora Robledo,2 James Loudin,3 Stephanie N Baba,3 Arturo Chayet2 1Department of Ophthalmology, Stanford University, Mid-Peninsula Ophthalmology Medical Group, Palo Alto, CA, USA; 2Codet Vision Institute, Tijuana, Mexico; 3Oculeve, Inc., South San Francisco, CA, USA Background: Dry eye disease (DED, a chronic disorder affecting the tear film and lacrimal functional unit, is a widely prevalent condition associated with significant burden and unmet treatment needs. Since specific neural circuits play an important role in maintaining ocular surface health, microelectrical stimulation of these pathways could present a promising new approach to treating DED. This study evaluated the efficacy and safety of nasal electrical stimulation in patients with DED. Methods: This prospective, open-label, single-arm, nonrandomized pilot study included 40 patients with mild to severe DED. After undergoing two screening visits, enrolled subjects were provided with a nasal stimulation device and instructed to use it at home four times daily (or more often as needed. Follow-up assessments were conducted up to day 180. The primary efficacy endpoint was the difference between unstimulated and stimulated tear production quantified by Schirmer scores. Additional efficacy endpoints included change from baseline in corneal and conjunctival staining, symptoms evaluated on a Visual Analog Scale, and Ocular Surface Disease Index scores. Safety parameters included adverse event (AE rates, visual acuity, intraocular pressure, slit-lamp biomicroscopy, indirect ophthalmoscopy, and endoscopic nasal examinations. Results: Mean stimulated Schirmer scores were significantly higher than the unstimulated scores at all visits, and corneal and conjunctival staining and symptom scores from baseline to day 180 were significantly reduced. No serious device-related AEs and nine nonserious AEs (three device-related were reported. Intraocular pressure remained

A multicenter randomized clinical trial of etonogestrel- and levonorgestrel- contraceptive implants with nonrandomized copper-IUD controls: effect on weight variations up to three years after placement.

Science.gov (United States)

Bahamondes, Luis; Brache, Vivian; Ali, Moazzam; Habib, Ndema

2018-05-16

To evaluate weight changes in women randomized to either the etonogestrel (ENG)- or the levonorgestrel (LNG)-releasing contraceptive implants and to compare with users of the TCu380A intrauterine device (IUD). A multi-center randomized trial with 1:1 allocation ratio of the ENG- and the LNG- implants with non-randomized, age-matched control group of women choosing TCu380A IUD. The primary objective was to assess contraceptive efficacy and method continuation rates, and secondarily the incidence of common complaints and side effects (including weight changes) associated with use of the three contraceptives. All women were enrolled in nine centers at seven countries. Weight change was evaluated from time at device(s) placement. Confounders were socio-demographic, baseline weight and body mass index, center, and time from insertion. We used a linear mixed effects regression modeling with random intercept and slope. Weight was compared between the two implants groups and between the implants and the IUD-groups, through linear mixed multivariable regression model. A total of 995, 997 and 971 users in the ENG-, LNG-implant and IUD-groups respectively, were included. At 36months of use, ENG- and LNG-implants users had similar significant mean weight increase of 3.0 kg (95% CI 2.5-3.5) and 2.9 kg (95% CI 2.4-3.4), respectively (p than 50 kg. These findings must be useful for clinicians to counsel implant-users which could improve method continuation. Copyright © 2018. Published by Elsevier Inc.

Does balneotherapy with low radon concentration in water influence the endocrine system? A controlled non-randomized pilot study.

Science.gov (United States)

Nagy, Katalin; Berhés, István; Kovács, Tibor; Kávási, Norbert; Somlai, János; Bender, Tamás

2009-08-01

Radon bath is a well-established modality of balneotherapy for the management of degenerative musculoskeletal disorders. The present study was conducted to ascertain whether baths of relatively low (80 Bq/l) radon concentration have any influence on the functioning of the endocrine system. In the study, a non-randomized pilot study, 27 patients with degenerative musculoskeletal disorders received 30-min radon baths (of 31-32 degrees C temperature and 80 Bq/l average radon concentration) daily, for 15 days. Twenty-five patients with matching pathologies were subjected to balneotherapy according to the same protocol, using thermal water with negligible radon content (6 Bq/l). Serum thyroid stimulating hormone, prolactin, cortisol, adrenocorticotropic hormone, and dehydroepiandrosterone levels were measured before and after a balneotherapy course of 15 sessions. Comparison of the accumulated data using the Wilcoxon test did not reveal any significant difference between pre- and post-treatment values or between the two patient groups. It is noted that while the beneficial effects of balneotherapy with radon-containing water on degenerative disorders is widely known, only few data have been published in the literature on its effect on endocrine functions. The present study failed to demonstrate any substantial effect of thermal water with relatively low radon content on the functioning of the endocrine system.

Women, Co-occurring Disorders, and Violence Study: evaluation design and study population.

Science.gov (United States)

McHugo, G J; Kammerer, N; Jackson, E W; Markoff, L S; Gatz, M; Larson, M J; Mazelis, R; Hennigan, K

2005-03-01

The Women, Co-occurring Disorders, and Violence Study (WCDVS) was a multi-site cooperative study to evaluate new service models for women with co-occurring mental health and substance use disorders and a history of physical and/or sexual abuse. Despite common features in the service interventions and evaluation procedures, diversity across the nine sites plus differences introduced by non-random assignment led to numerous methodological challenges. This article describes the design, measurement, and analysis decisions behind the WCDVS and lays the foundation for understanding participant-level outcomes and service costs. This article also describes the study population, as recruited and following attrition at the 6-month follow-up, in order to address the threat of selection bias to inferences drawn from this multi-site study.

Self-administered foot reflexology for the management of chronic health conditions: a systematic review.

Science.gov (United States)

Song, Hyun Jin; Choi, Sun Mi; Seo, Hyun-Ju; Lee, Heeyoung; Son, Heejeong; Lee, Sanghun

2015-02-01

To systematically review the effect of self-administered foot reflexology in patients with chronic health conditions. Electronic databases were searched for literature published from 1948 to January 2014. The databases included MEDLINE, EMBASE, the Cochrane Library, CINAHL, CNKI, J-STAGE, Koreamed, Kmbase, KISS, NDSL, KISTI, and OASIS. Key search terms were "exp/relaxation therapy," "foot," "reflexology," "zone therapy," and "self." All study designs were included. Two raters independently extracted data and assessed study quality by using the Cochrane risk of bias tool (for randomized controlled trials) and the risk of bias assessment tool for nonrandomized studies (for nonrandomized and before-and-after studies). A qualitative and descriptive analysis was performed because of the clinical diversity associated with chronic health conditions. Of the 224 records assessed, 4 trials met the inclusion criteria: 3 nonrandomized controlled trials and 1 before-and-after study without comparison. Self-administered foot reflexology might have a positive effect in type 2 diabetes, but the low quality of the included study and the lack of adequately reported clinical outcomes obscure the results. Two studies of hypertensive patients and 1 study of patients with urinary incontinence showed that self-performed foot reflexology may exert a beneficial effect on lowering blood pressure and urinary incontinence; however, given the small sample size and the lack of any description of medications and other cointerventions, there was insufficient evidence to conclusively determine whether foot reflexology had any effect. The included studies on self-administered foot reflexology in patients with type 2 diabetes, hypertension, or urinary incontinence provided insufficient evidence to determine a treatment effect. Therefore, a well-designed, large-scale, and randomized controlled trial is needed to confirm the effect of self-administered foot reflexology for chronic conditions.

Theory, design, and operation of liquid metal fast breeder reactors, including operational health physics

International Nuclear Information System (INIS)

Adams, S.R.

1985-10-01

A comprehensive evaluation was conducted of the radiation protection practices and programs at prototype LMFBRs with long operational experience. Installations evaluated were the Fast Flux Test Facility (FFTF), Richland, Washington; Experimental Breeder Reactor II (EBR-II), Idaho Falls, Idaho; Prototype Fast Reactor (PFR) Dounreay, Scotland; Phenix, Marcoule, France; and Kompakte Natriumgekuhlte Kernreak Toranlange (KNK II), Karlsruhe, Federal Republic of Germany. The evaluation included external and internal exposure control, respiratory protection procedures, radiation surveillance practices, radioactive waste management, and engineering controls for confining radiation contamination. The theory, design, and operating experience at LMFBRs is described. Aspects of LMFBR health physics different from the LWR experience in the United States are identified. Suggestions are made for modifications to the NRC Standard Review Plan based on the differences

Theory, design, and operation of liquid metal fast breeder reactors, including operational health physics

Energy Technology Data Exchange (ETDEWEB)

Adams, S.R.

1985-10-01

A comprehensive evaluation was conducted of the radiation protection practices and programs at prototype LMFBRs with long operational experience. Installations evaluated were the Fast Flux Test Facility (FFTF), Richland, Washington; Experimental Breeder Reactor II (EBR-II), Idaho Falls, Idaho; Prototype Fast Reactor (PFR) Dounreay, Scotland; Phenix, Marcoule, France; and Kompakte Natriumgekuhlte Kernreak Toranlange (KNK II), Karlsruhe, Federal Republic of Germany. The evaluation included external and internal exposure control, respiratory protection procedures, radiation surveillance practices, radioactive waste management, and engineering controls for confining radiation contamination. The theory, design, and operating experience at LMFBRs is described. Aspects of LMFBR health physics different from the LWR experience in the United States are identified. Suggestions are made for modifications to the NRC Standard Review Plan based on the differences.

State of the Art of Short Dental Implants: A Systematic Review of the Literature

DEFF Research Database (Denmark)

Neldam, Camilla Albeck; Pinholt, Else Marie

2012-01-01

restorations, supporting overdentures, splinted implants, and implants used for prostheses. Results: The 27 included studies represent zero randomized clinical trial studies, 15 prospective nonrandomized, noncontrolled clinical trials, 11 retrospective nonrandomized, noncontrolled clinical trials, and one...

An integrated optimum design approach for high speed prop-rotors including acoustic constraints

Science.gov (United States)

Chattopadhyay, Aditi; Wells, Valana; Mccarthy, Thomas; Han, Arris

1993-01-01

The objective of this research is to develop optimization procedures to provide design trends in high speed prop-rotors. The necessary disciplinary couplings are all considered within a closed loop multilevel decomposition optimization process. The procedures involve the consideration of blade-aeroelastic aerodynamic performance, structural-dynamic design requirements, and acoustics. Further, since the design involves consideration of several different objective functions, multiobjective function formulation techniques are developed.

Large-area imaging reveals biologically driven non-random spatial patterns of corals at a remote reef

Science.gov (United States)

Edwards, Clinton B.; Eynaud, Yoan; Williams, Gareth J.; Pedersen, Nicole E.; Zgliczynski, Brian J.; Gleason, Arthur C. R.; Smith, Jennifer E.; Sandin, Stuart A.

2017-12-01

For sessile organisms such as reef-building corals, differences in the degree of dispersion of individuals across a landscape may result from important differences in life-history strategies or may reflect patterns of habitat availability. Descriptions of spatial patterns can thus be useful not only for the identification of key biological and physical mechanisms structuring an ecosystem, but also by providing the data necessary to generate and test ecological theory. Here, we used an in situ imaging technique to create large-area photomosaics of 16 plots at Palmyra Atoll, central Pacific, each covering 100 m2 of benthic habitat. We mapped the location of 44,008 coral colonies and identified each to the lowest taxonomic level possible. Using metrics of spatial dispersion, we tested for departures from spatial randomness. We also used targeted model fitting to explore candidate processes leading to differences in spatial patterns among taxa. Most taxa were clustered and the degree of clustering varied by taxon. A small number of taxa did not significantly depart from randomness and none revealed evidence of spatial uniformity. Importantly, taxa that readily fragment or tolerate stress through partial mortality were more clustered. With little exception, clustering patterns were consistent with models of fragmentation and dispersal limitation. In some taxa, dispersion was linearly related to abundance, suggesting density dependence of spatial patterning. The spatial patterns of stony corals are non-random and reflect fundamental life-history characteristics of the taxa, suggesting that the reef landscape may, in many cases, have important elements of spatial predictability.

Telomere disruption results in non-random formation of de novo dicentric chromosomes involving acrocentric human chromosomes.

Directory of Open Access Journals (Sweden)

Kaitlin M Stimpson

2010-08-01

Full Text Available Genome rearrangement often produces chromosomes with two centromeres (dicentrics that are inherently unstable because of bridge formation and breakage during cell division. However, mammalian dicentrics, and particularly those in humans, can be quite stable, usually because one centromere is functionally silenced. Molecular mechanisms of centromere inactivation are poorly understood since there are few systems to experimentally create dicentric human chromosomes. Here, we describe a human cell culture model that enriches for de novo dicentrics. We demonstrate that transient disruption of human telomere structure non-randomly produces dicentric fusions involving acrocentric chromosomes. The induced dicentrics vary in structure near fusion breakpoints and like naturally-occurring dicentrics, exhibit various inter-centromeric distances. Many functional dicentrics persist for months after formation. Even those with distantly spaced centromeres remain functionally dicentric for 20 cell generations. Other dicentrics within the population reflect centromere inactivation. In some cases, centromere inactivation occurs by an apparently epigenetic mechanism. In other dicentrics, the size of the alpha-satellite DNA array associated with CENP-A is reduced compared to the same array before dicentric formation. Extra-chromosomal fragments that contained CENP-A often appear in the same cells as dicentrics. Some of these fragments are derived from the same alpha-satellite DNA array as inactivated centromeres. Our results indicate that dicentric human chromosomes undergo alternative fates after formation. Many retain two active centromeres and are stable through multiple cell divisions. Others undergo centromere inactivation. This event occurs within a broad temporal window and can involve deletion of chromatin that marks the locus as a site for CENP-A maintenance/replenishment.

Effects of study design and trends for EVAR versus OSR

Directory of Open Access Journals (Sweden)

Robert Hopkins

2008-10-01

Full Text Available Robert Hopkins1, James Bowen1, Kaitryn Campbell1, Gord Blackhouse4, Guy De Rose2,3, Teresa Novick2, Daria O’Reilly1,4, Ron Goeree1,4, Jean-Eric Tarride1,41Programs for the Assessment of Technology in Health (PATH Research Institute, Department of Clinical Epidemiology and Biostatistics; 2Division of Vascular Surgery, Department of Surgery, London Health Sciences Centre, London, Ontario, Canada; 3Division of Vascular Surgery, Department of Surgery, Faculty of Medicine, University of Western Ontario, London, Ontario, Canada; 4Department of Clinical Epidemiology and Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, CanadaPurpose: To investigate if study design factors such as randomization, multi-centre versus single centre evidence, institutional surgical volume, and patient selection affect the outcomes for endovascular repair (EVAR versus open surgical repair (OSR. Finally, we investigate trends over time in EVAR versus OSR outcomes.Methods: Search strategies for comparative studies were performed individually for: OVID’s MEDLINE, EMBASE, CINAHL, HAPI, and Evidence Based Medicine (EBM Reviews (including Cochrane DSR, ACP Journal Club, DARE and CCTR, limited to 1990 and November 2006.Results: Identified literature: 84 comparative studies pertaining to 57,645 patients. These include 4 randomized controlled trials (RCTs, plus 2 RCTs with long-term follow-up. The other 78 comparative studies were nonrandomized with 75 reporting perioperative outcomes, of which 16 were multi-centre, and 59 single-centre studies. Of the single-centre studies 31 were low-volume and 28 were high-volume centres. In addition, 5 studies had all patients anatomically eligible for EVAR, and 8 studies included high-risk patients only. Finally, 25 long term observational studies reported outcomes up to 3 years.Outcomes: Lower perioperative mortality and rates of complications for EVAR versus OSR varied across study designs and patient

Optimal Design and Real Time Implementation of Autonomous Microgrid Including Active Load

Directory of Open Access Journals (Sweden)

Mohamed A. Hassan

2018-05-01

Full Text Available Controller gains and power-sharing parameters are the main parameters affect the dynamic performance of the microgrid. Considering an active load to the autonomous microgrid, the stability problem will be more involved. In this paper, the active load effect on microgrid dynamic stability is explored. An autonomous microgrid including three inverter-based distributed generations (DGs with an active load is modeled and the associated controllers are designed. Controller gains of the inverters and active load as well as Phase Locked Loop (PLL parameters are optimally tuned to guarantee overall system stability. A weighted objective function is proposed to minimize the error in both measured active power and DC voltage based on time-domain simulations. Different AC and DC disturbances are applied to verify and assess the effectiveness of the proposed control strategy. The results demonstrate the potential of the proposed controller to enhance the microgrid stability and to provide efficient damping characteristics. Additionally, the proposed controller is compared with the literature to demonstrate its superiority. Finally, the microgrid considered has been established and implemented on real time digital simulator (RTDS. The experimental results validate the simulation results and approve the effectiveness of the proposed controllers to enrich the stability of the considered microgrid.

Laparoscopic Complete Mesocolic Excision versus Open Complete Mesocolic Excision for Transverse Colon Cancer: Long-Term Survival Results of a Prospective Single Centre Non-Randomized Study.

Science.gov (United States)

Storli, Kristian Eeg; Eide, Geir Egil

2016-01-01

Laparoscopic complete mesocolic excision (CME) used in the treatment of transverse colon cancer has been questioned on the basis of the technical challenges. The aim of this study was to evaluate the medium- and long-term clinical and survival outcomes after laparoscopic and open CME for transverse colon cancer and to compare the 2 approaches. This study was a retrospective non-randomized study of patients with prospectively registered data on open and laparoscopic CME for transverse colon cancer tumour-node-metastasis stages I-III operated on between 2007 and 2014. This was a single-centre study in a community teaching hospital. A total of 56 patients with transverse colon cancer were included, excluding those with tumours in the colonic flexures. The outcome aims were 4-year time to recurrence (TTR) and cancer-specific survival (CSS). Morbidity was also measured. The 4-year TTR was 93.9% in the laparoscopic group and 91.3% in the open group (p = 0.71). The 4-year CSS was 97.0% in the laparoscopic group and 91.3% in the open group (p = 0.42). This was a prospective single-institution study with a small sample size. Results of the study suggest that the laparoscopic CME approach might be the preferred approach for transverse colon cancer, especially regarding its benefits in terms of short-term morbidity, length of stay and oncological outcome. © 2016 S. Karger AG, Basel.

Prospective Nonrandomized Trial of Manual Compression and Angio-Seal and Starclose Arterial Closure Devices in Common Femoral Punctures

International Nuclear Information System (INIS)

Ratnam, Lakshmi A.; Raja, Jowad; Munneke, Graham J.; Morgan, Robert A.; Belli, Anna-Maria

2007-01-01

We compared the use of manual compression and Angio-Seal and Starclose arterial closure devices to achieve hemostasis following common femoral artery (CFA) punctures in order to evaluate safety and efficacy. A prospective nonrandomized, single-center study was carried out on all patients undergoing CFA punctures over 1 year. Hemostasis was achieved using manual compression in 108 cases, Angio-Seal in 167 cases, and Starclose in 151 cases. Device-failure rates were low and not significantly different in the two groups (manual compression and closure devices; p = 0.8). There were significantly more Starclose (11.9%) patients compared to Angio-Seal (2.4%), with successful initial deployment subsequently requiring additional manual compression to achieve hemostasis (p < 0.0001). A significant number of very thin patients failed to achieve hemostasis (p = 0.014). Major complications were seen in 2.9% of Angio-Seal, 1.9% of Starclose, and 3.7% of manual compression patients, with no significant difference demonstrated; 4.7% of the major complications were seen in female patients compared to 1.3% in males (p = 0.0415). All three methods showed comparable safety and efficacy. Very thin patients are more likely to have failed hemostasis with the Starclose device, although this did not translate into an increased complication rate. There is a significant increased risk of major puncture-site complications in women with peripheral vascular disease

Design Optimization of Transformerless Grid-Connected PV Inverters Including Reliability

OpenAIRE

Koutroulis, Eftichios; Blaabjerg, Frede

2013-01-01

This paper presents a new methodology for optimal design of transformerless photovoltaic (PV) inverters targeting a cost-effective deployment of grid-connected PV systems. The optimal switching frequency as well as the optimal values and types of the PV inverter components is calculated such that the PV inverter LCOE generated during the PV system lifetime period is minimized. The LCOE is also calculated considering the failure rates of the components, which affect the reliability performance...

Evaluation of the Prevention and Reactivation Care Program (PReCaP for the hospitalized elderly: a prospective nonrandomized controlled trial

Directory of Open Access Journals (Sweden)

Asmus-Szepesi KJ

2015-03-01

Full Text Available Kirsten J Asmus-Szepesi,1 Linda E Flinterman,1 Marc A Koopmanschap,2 Anna P Nieboer,2 Ton J Bakker,3 Johan P Mackenbach,1 Ewout W Steyerberg1 1Department of Public Health, Erasmus University Medical Center, 2Institute of Health Policy and Management, Erasmus University, 3Stichting Wetenschap Balans, Rotterdam, the Netherlands Background: The hospitalized elderly are at risk of functional decline. We evaluated the effects and care costs of a specialized geriatric rehabilitation program aimed at preventing functional decline among at-risk hospitalized elderly.Methods: The prospective nonrandomized controlled trial reported here was performed in three hospitals in the Netherlands. One hospital implemented the Prevention and Reactivation Care Program (PReCaP, while two other hospitals providing usual care served as control settings. Within the PReCaP hospital we compared patients pre-implementation with patients post-implementation of the PReCaP (“within-hospital analysis”, while our nonrandomized controlled trial compared patients of the PReCaP hospital post-implementation with patients from the two control hospitals providing usual care (“between-hospital analysis”. Hospitalized patients 65 years or older and at risk of functional decline were interviewed at baseline and at 3 and 12 months using validated questionnaires to score functioning, depression, and health-related quality of life (HRQoL. We estimated costs per unit of care from hospital information systems and national data sources. We used adjusted general linear mixed models to analyze functioning and HRQoL.Results: Between-hospital analysis showed no difference in activities of daily living (ADL or instrumental activities of daily living (IADL between PReCaP patients and control groups. PReCaP patients did have slightly better cognitive functioning (Mini Mental State Examination; 0.4 [95% confidence interval (CI 0.2–0.6], lower depression (Geriatric Depression Scale 15; -0

The nucleoid protein Dps binds genomic DNA of Escherichia coli in a non-random manner

Science.gov (United States)

Kondrashov, F. A.; Toshchakov, S. V.; Dominova, I.; Shvyreva, U. S.; Vrublevskaya, V. V.; Morenkov, O. S.; Panyukov, V. V.

2017-01-01

Dps is a multifunctional homododecameric protein that oxidizes Fe2+ ions accumulating them in the form of Fe2O3 within its protein cavity, interacts with DNA tightly condensing bacterial nucleoid upon starvation and performs some other functions. During the last two decades from discovery of this protein, its ferroxidase activity became rather well studied, but the mechanism of Dps interaction with DNA still remains enigmatic. The crucial role of lysine residues in the unstructured N-terminal tails led to the conventional point of view that Dps binds DNA without sequence or structural specificity. However, deletion of dps changed the profile of proteins in starved cells, SELEX screen revealed genomic regions preferentially bound in vitro and certain affinity of Dps for artificial branched molecules was detected by atomic force microscopy. Here we report a non-random distribution of Dps binding sites across the bacterial chromosome in exponentially growing cells and show their enrichment with inverted repeats prone to form secondary structures. We found that the Dps-bound regions overlap with sites occupied by other nucleoid proteins, and contain overrepresented motifs typical for their consensus sequences. Of the two types of genomic domains with extensive protein occupancy, which can be highly expressed or transcriptionally silent only those that are enriched with RNA polymerase molecules were preferentially occupied by Dps. In the dps-null mutant we, therefore, observed a differentially altered expression of several targeted genes and found suppressed transcription from the dps promoter. In most cases this can be explained by the relieved interference with Dps for nucleoid proteins exploiting sequence-specific modes of DNA binding. Thus, protecting bacterial cells from different stresses during exponential growth, Dps can modulate transcriptional integrity of the bacterial chromosome hampering RNA biosynthesis from some genes via competition with RNA polymerase

Modelling of Water Cooled Fuel Including Design Basis and Severe Accidents. Proceedings of a Technical Meeting

International Nuclear Information System (INIS)

2015-11-01

The demands on nuclear fuel have recently been increasing, and include transient regimes, higher discharge burnup and longer fuel cycles. This has resulted in an increase of loads on fuel and core internals. In order to satisfy these demands while ensuring compliance with safety criteria, new national and international programmes have been launched and advanced modelling codes are being developed. The Fukushima Daiichi accident has particularly demonstrated the need for adequate analysis of all aspects of fuel performance to prevent a failure and also to predict fuel behaviour were an accident to occur.This publication presents the Proceedings of the Technical Meeting on Modelling of Water Cooled Fuel Including Design Basis and Severe Accidents, which was hosted by the Nuclear Power Institute of China (NPIC) in Chengdu, China, following the recommendation made in 2013 at the IAEA Technical Working Group on Fuel Performance and Technology. This recommendation was in agreement with IAEA mid-term initiatives, linked to the post-Fukushima IAEA Nuclear Safety Action Plan, as well as the forthcoming Coordinated Research Project (CRP) on Fuel Modelling in Accident Conditions. At the technical meeting in Chengdu, major areas and physical phenomena, as well as types of code and experiment to be studied and used in the CRP, were discussed. The technical meeting provided a forum for international experts to review the state of the art of code development for modelling fuel performance of nuclear fuel for water cooled reactors with regard to steady state and transient conditions, and for design basis and early phases of severe accidents, including experimental support for code validation. A round table discussion focused on the needs and perspectives on fuel modelling in accident conditions. This meeting was the ninth in a series of IAEA meetings, which reflects Member States’ continuing interest in nuclear fuel issues. The previous meetings were held in 1980 (jointly with

Case-based learning and simulation: useful tools to enhance nurses' education? Nonrandomized controlled trial.

Science.gov (United States)

Raurell-Torredà, Marta; Olivet-Pujol, Josep; Romero-Collado, Àngel; Malagon-Aguilera, Maria Carmen; Patiño-Masó, Josefina; Baltasar-Bagué, Alícia

2015-01-01

To compare skills acquired by undergraduate nursing students enrolled in a medical-surgical course. To compare skills demonstrated by students with no previous clinical practice (undergraduates) and nurses with clinical experience enrolled in continuing professional education (CPE). In a nonrandomized clinical trial, 101 undergraduates enrolled in the "Adult Patients 1" course were assigned to the traditional lecture and discussion (n = 66) or lecture and discussion plus case-based learning (n = 35) arm of the study; 59 CPE nurses constituted a comparison group to assess the effects of previous clinical experience on learning outcomes. Scores on an objective structured clinical examination (OSCE), using a human patient simulator and cases validated by the National League for Nursing, were compared for the undergraduate control and intervention groups, and for CPE nurses (Student's t test). Controls scored lower than the intervention group on patient assessment (6.3 ± 2.3 vs 7.5 ± 1.4, p = .04, mean difference, -1.2 [95% confidence interval (CI) -2.4 to -0.03]) but the intervention group did not differ from CPE nurses (7.5 ± 1.4 vs 8.8 ± 1.5, p = .06, mean difference, -1.3 [95% CI -2.6 to 0.04]). The CPE nurses committed more "rules-based errors" than did undergraduates, specifically patient identifications (77.2% vs 55%, p = .7) and checking allergies before administering medication (68.2% vs 60%, p = .1). The intervention group developed better patient assessment skills than the control group. Case-based learning helps to standardize the process, which can contribute to quality and consistency in practice: It is essential to correctly identify a problem in order to treat it. Clinical experience of CPE nurses was not associated with better adherence to safety protocols. Case-based learning improves the patient assessment skills of undergraduate nursing students, thereby preparing them for clinical practice. © 2014 Sigma Theta Tau International.

Design of a high-lift experiment in water including active flow control

International Nuclear Information System (INIS)

Beutel, T; Schwerter, M; Büttgenbach, S; Leester-Schädel, M; Sattler, S; El Sayed, Y; Radespiel, R; Zander, M; Sinapius, M; Wierach, P

2014-01-01

This paper describes the structural design of an active flow-control experiment. The aim of the experiment is to investigate the increase in efficiency of an internally blown Coanda flap using unsteady blowing. The system uses tailor-made microelectromechanical (MEMS) pressure sensors to determine the state of the oncoming flow and an actuated lip to regulate the mass flow and velocity of a stream near a wall over the internally blown flap. Sensors and actuators are integrated into a highly loaded system that is extremely compact. The sensors are connected to a bus system that feeds the data into a real-time control system. The piezoelectric actuators using the d 33 effect at a comparable low voltage of 120 V are integrated into a lip that controls the blowout slot height. The system is designed for closed-loop control that efficiently avoids flow separation on the Coanda flap. The setup is designed for water-tunnel experiments in order to reduce the free-stream velocity and the system’s control frequency by a factor of 10 compared with that in air. This paper outlines the function and verification of the system’s main components and their development. (technical note)

Exceptional diversity, non-random distribution, and rapid evolution of retroelements in the B73 maize genome.

Directory of Open Access Journals (Sweden)

Regina S Baucom

2009-11-01

Full Text Available Recent comprehensive sequence analysis of the maize genome now permits detailed discovery and description of all transposable elements (TEs in this complex nuclear environment. Reiteratively optimized structural and homology criteria were used in the computer-assisted search for retroelements, TEs that transpose by reverse transcription of an RNA intermediate, with the final results verified by manual inspection. Retroelements were found to occupy the majority (>75% of the nuclear genome in maize inbred B73. Unprecedented genetic diversity was discovered in the long terminal repeat (LTR retrotransposon class of retroelements, with >400 families (>350 newly discovered contributing >31,000 intact elements. The two other classes of retroelements, SINEs (four families and LINEs (at least 30 families, were observed to contribute 1,991 and approximately 35,000 copies, respectively, or a combined approximately 1% of the B73 nuclear genome. With regard to fully intact elements, median copy numbers for all retroelement families in maize was 2 because >250 LTR retrotransposon families contained only one or two intact members that could be detected in the B73 draft sequence. The majority, perhaps all, of the investigated retroelement families exhibited non-random dispersal across the maize genome, with LINEs, SINEs, and many low-copy-number LTR retrotransposons exhibiting a bias for accumulation in gene-rich regions. In contrast, most (but not all medium- and high-copy-number LTR retrotransposons were found to preferentially accumulate in gene-poor regions like pericentromeric heterochromatin, while a few high-copy-number families exhibited the opposite bias. Regions of the genome with the highest LTR retrotransposon density contained the lowest LTR retrotransposon diversity. These results indicate that the maize genome provides a great number of different niches for the survival and procreation of a great variety of retroelements that have evolved to

Mindfulness Training for Health Profession Students-The Effect of Mindfulness Training on Psychological Well-Being, Learning and Clinical Performance of Health Professional Students: A Systematic Review of Randomized and Non-randomized Controlled Trials.

Science.gov (United States)

McConville, Janet; McAleer, Rachael; Hahne, Andrew

High levels of stress have been identified in medical students and increasingly in other health profession student population groups. As stress can affect psychological well-being and interfere with learning and clinical performance, there is a clear argument for universities to include health professional student well-being as an outcome in core curriculum. Mindfulness training is a potential construct to manage stress and enhance academic success. The aims of this systematic review were to assess the effectiveness of mindfulness training in medical and other health professional student population groups and to compare the effectiveness of the different mindfulness-based programs. A literature search was completed using The Cochrane library, Medline, Cinahl, Embase, Psychinfo, and ERIC (proquest) electronic databases from inception to June 2016. Randomized and non-randomized controlled trials were included. Of the potential 5355 articles, 19 met the inclusion criteria. Studies focused on medical (n = 10), nursing (n = 4), social work (n = 1), psychology (n = 1), and medical plus other health (n = 3) students. Interventions were based on mindfulness. The 19 studies included 1815 participants. Meta-analysis was performed evaluating the effect of mindfulness training on mindfulness, anxiety, depression, stress, mood, self-efficacy, and empathy. The effect of mindfulness on academic performance was discussed. Mindfulness-based interventions decrease stress, anxiety, and depression and improve mindfulness, mood, self-efficacy, and empathy in health profession students. Due to the range of presentation options, mindfulness training can be relatively easily adapted and integrated into health professional training programs. Copyright © 2017 Elsevier Inc. All rights reserved.

Design strategies from sexual exploitation and sex work studies among women and girls: Methodological considerations in a hidden and vulnerable population.

Science.gov (United States)

Gerassi, Lara; Edmond, Tonya; Nichols, Andrea

2017-06-01

The study of sex trafficking, prostitution, sex work, and sexual exploitation is associated with many methodological issues and challenges. Researchers' study designs must consider the many safety issues related to this vulnerable and hidden population. Community advisory boards and key stakeholder involvement are essential to study design to increase safety of participants, usefulness of study aims, and meaningfulness of conclusions. Nonrandomized sampling strategies are most often utilized when studying exploited women and girls, which have the capacity to provide rich data and require complex sampling and recruitment methods. This article reviews the current methodological issues when studying this marginalized population as well as strategies to address challenges while working with the community in order to bring about social change. The authors also discuss their own experiences in collaborating with community organizations to conduct research in this field.

Optimum Design of Braced Steel Space Frames including Soil-Structure Interaction via Teaching-Learning-Based Optimization and Harmony Search Algorithms

Directory of Open Access Journals (Sweden)

Ayse T. Daloglu

2018-01-01

Full Text Available Optimum design of braced steel space frames including soil-structure interaction is studied by using harmony search (HS and teaching-learning-based optimization (TLBO algorithms. A three-parameter elastic foundation model is used to incorporate the soil-structure interaction effect. A 10-storey braced steel space frame example taken from literature is investigated according to four different bracing types for the cases with/without soil-structure interaction. X, V, Z, and eccentric V-shaped bracing types are considered in the study. Optimum solutions of examples are carried out by a computer program coded in MATLAB interacting with SAP2000-OAPI for two-way data exchange. The stress constraints according to AISC-ASD (American Institute of Steel Construction-Allowable Stress Design, maximum lateral displacement constraints, interstorey drift constraints, and beam-to-column connection constraints are taken into consideration in the optimum design process. The parameters of the foundation model are calculated depending on soil surface displacements by using an iterative approach. The results obtained in the study show that bracing types and soil-structure interaction play very important roles in the optimum design of steel space frames. Finally, the techniques used in the optimum design seem to be quite suitable for practical applications.

High-resolution characterization of sequence signatures due to non-random cleavage of cell-free DNA.

Science.gov (United States)

Chandrananda, Dineika; Thorne, Natalie P; Bahlo, Melanie

2015-06-17

High-throughput sequencing of cell-free DNA fragments found in human plasma has been used to non-invasively detect fetal aneuploidy, monitor organ transplants and investigate tumor DNA. However, many biological properties of this extracellular genetic material remain unknown. Research that further characterizes circulating DNA could substantially increase its diagnostic value by allowing the application of more sophisticated bioinformatics tools that lead to an improved signal to noise ratio in the sequencing data. In this study, we investigate various features of cell-free DNA in plasma using deep-sequencing data from two pregnant women (>70X, >50X) and compare them with matched cellular DNA. We utilize a descriptive approach to examine how the biological cleavage of cell-free DNA affects different sequence signatures such as fragment lengths, sequence motifs at fragment ends and the distribution of cleavage sites along the genome. We show that the size distributions of these cell-free DNA molecules are dependent on their autosomal and mitochondrial origin as well as the genomic location within chromosomes. DNA mapping to particular microsatellites and alpha repeat elements display unique size signatures. We show how cell-free fragments occur in clusters along the genome, localizing to nucleosomal arrays and are preferentially cleaved at linker regions by correlating the mapping locations of these fragments with ENCODE annotation of chromatin organization. Our work further demonstrates that cell-free autosomal DNA cleavage is sequence dependent. The region spanning up to 10 positions on either side of the DNA cleavage site show a consistent pattern of preference for specific nucleotides. This sequence motif is present in cleavage sites localized to nucleosomal cores and linker regions but is absent in nucleosome-free mitochondrial DNA. These background signals in cell-free DNA sequencing data stem from the non-random biological cleavage of these fragments. This

GreenLight laser vs diode laser vaporization of the prostate: 3-year results of a prospective nonrandomized study.

Science.gov (United States)

Guo, Sanwei; Müller, Georg; Bonkat, Gernot; Püschel, Heike; Gasser, Thomas; Bachmann, Alexander; Rieken, Malte

2015-04-01

Laser vaporization of the prostate is one of the alternatives to transurethral resection of the prostate. Short-term studies report a comparable outcome after laser vaporization with the 532 nm 120-W GreenLight high-performance system (HPS) laser and the 980 nm 200 W high-intensity diode (diode) laser. In this study, we analyzed the intermediate-term results of both techniques. From January 2007 to January 2008, 112 consecutive patients with symptomatic benign prostate enlargement were nonrandomly assigned to treatment with the GreenLight laser or the diode laser. Perioperative parameters, postoperative functional outcome, complications, and the reoperation rate at 3 years were analyzed. Improvement of voiding symptoms (International Prostate Symptom Score, quality-of-life) and micturition parameters (maximum flow rate, postvoid residual volume) showed no significant difference between the HPS group and the diode group. A significantly higher reoperation rate was observed in the diode group in comparison to the HPS group (37.5% vs 8.9%, p=0.0003) due to obstructive necrotic tissue (16.1% vs 0%, p=0.0018), bladder neck stricture (16.1% vs 1.8%, p=0.008), and persisting or recurrent adenoma (5.4% vs 7.1%, p=0.70), respectively. Both lasers lead to comparable improvement of voiding parameters and micturition symptoms. Treatment with the 200 W diode laser led to a significantly higher reoperation rate, which might be attributed to a higher degree of coagulation necrosis. Thus, a careful clinical application of this diode laser type is warranted.

Childhood obesity prevention interventions in childcare settings: systematic review of randomized and nonrandomized controlled trials.

Science.gov (United States)

Zhou, Yuan E; Emerson, Janice S; Levine, Robert S; Kihlberg, Courtney J; Hull, Pamela C

2014-01-01

Childcare settings are an opportune location for early intervention programs seeking to prevent childhood obesity. This article reports on a systematic review of controlled trials of obesity prevention interventions in childcare settings. The review was limited to English language articles published in PubMed, Web of Science, and Education Resources Information Center (ERIC) between January 2000 and April 2012. childhood obesity prevention interventions in childcare settings using controlled designs that reported adiposity and behavior outcomes. no interventions, non-childcare settings, clinical weight loss programs, non-English publications. Publications were identified by key word search. Two authors reviewed eligible studies to extract study information and study results. Qualitative synthesis was conducted, including tabulation of information and a narrative summary. Fifteen studies met the eligibility criteria. Seven studies reported improvements in adiposity. Six of the 13 interventions with dietary components reported improved intake or eating behaviors. Eight of the 12 interventions with physical activity components reported improved activity levels or physical fitness. Evidence was mixed for all outcomes. Results should be interpreted cautiously given the high variability in study designs and interventions. Further research needs long-term follow-up, multistrategy interventions that include changes in the nutrition and physical activity environment, reporting of cost data, and consideration of sustainability.

Use of simulation-based education to improve outcomes of central venous catheterization: a systematic review and meta-analysis.

Science.gov (United States)

Ma, Irene W Y; Brindle, Mary E; Ronksley, Paul E; Lorenzetti, Diane L; Sauve, Reg S; Ghali, William A

2011-09-01

Central venous catheterization (CVC) is increasingly taught by simulation. The authors reviewed the literature on the effects of simulation training in CVC on learner and clinical outcomes. The authors searched computerized databases (1950 to May 2010), reference lists, and considered studies with a control group (without simulation education intervention). Two independent assessors reviewed the retrieved citations. Independent data abstraction was performed on study design, study quality score, learner characteristics, sample size, components of interventional curriculum, outcomes assessed, and method of assessment. Learner outcomes included performance measures on simulators, knowledge, and confidence. Patient outcomes included number of needle passes, arterial puncture, pneumothorax, and catheter-related infections. Twenty studies were identified. Simulation-based education was associated with significant improvements in learner outcomes: performance on simulators (standardized mean difference [SMD] 0.60 [95% CI 0.45 to 0.76]), knowledge (SMD 0.60 [95% CI 0.35 to 0.84]), and confidence (SMD 0.41 [95% CI 0.30 to 0.53] for studies with single-group pretest and posttest design; SMD 0.52 (95% CI 0.23 to 0.81) for studies with nonrandomized, two-group design). Furthermore, simulation-based education was associated with improved patient outcomes, including fewer needle passes (SMD -0.58 [95% CI -0.95 to -0.20]), and pneumothorax (relative risk 0.62 [95% CI 0.40 to 0.97]), for studies with nonrandomized, two-group design. However, simulation-based training was not associated with a significant reduction in risk of either arterial puncture or catheter-related infections. Despite some limitations in the literature reviewed, evidence suggests that simulation-based education for CVC provides benefits in learner and select clinical outcomes.

A multinational clinical approach to assessing the effectiveness of catheter-based ultrasound renal denervation: The RADIANCE-HTN and REQUIRE clinical study designs.

Science.gov (United States)

Mauri, Laura; Kario, Kazuomi; Basile, Jan; Daemen, Joost; Davies, Justin; Kirtane, Ajay J; Mahfoud, Felix; Schmieder, Roland E; Weber, Michael; Nanto, Shinsuke; Azizi, Michel

2018-01-01

Catheter-based renal denervation is a new approach to treat hypertension via modulation of the renal sympathetic nerves. Although nonrandomized and small, open-label randomized studies resulted in significant reductions in office blood pressure 6months after renal denervation with monopolar radiofrequency catheters, the first prospective, randomized, sham-controlled study (Symplicity HTN-3) failed to meet its blood pressure efficacy end point. New clinical trials with new catheters have since been designed to address the limitations of earlier studies. Accordingly, the RADIANCE-HTN and REQUIRE studies are multicenter, blinded, randomized, sham-controlled trials designed to assess the blood pressure-lowering efficacy of the ultrasound-based renal denervation system (Paradise) in patients with established hypertension either on or off antihypertensive medications, is designed to evaluate patients in 2 cohorts-SOLO and TRIO, in the United States and Europe. The SOLO cohort includes patients with essential hypertension, at low cardiovascular risk, and either controlled on 1 to 2 antihypertensive medications or uncontrolled on 0 to 2 antihypertensive medications. Patients undergo a 4-week medication washout period before randomization to renal denervation (treatment) or renal angiogram (sham). The TRIO cohort includes patients with hypertension resistant to at least 3 antihypertensive drugs including a diuretic. Patients will be stabilized on a single-pill, triple-antihypertensive-drug combination for 4weeks before randomization to treatment or sham. Reduction in daytime ambulatory systolic blood pressure (primary end point) will be assessed at 2months in both cohorts. A predefined medication escalation protocol, as needed for blood pressure control, is implemented between 2 and 6months in both cohorts by a study staff member blinded to the randomization process. At 6months, daytime ambulatory blood pressure and antihypertensive treatment score will be assessed. REQUIRE

Systematic review of stigma reducing interventions for African/Black diasporic women.

Science.gov (United States)

Loutfy, Mona; Tharao, Wangari; Logie, Carmen; Aden, Muna A; Chambers, Lori A; Wu, Wei; Abdelmaseh, Marym; Calzavara, Liviana

2015-01-01

Literature indicates that racism, sexism, homophobia and HIV-related stigma have adverse impacts on health, well-being, and quality of life among HIV-positive women of African descent (African/Black diaspora). However, limited evidence exists on the effectiveness of interventions aimed at reducing stigma tailored for these women. This study systematically reviewed randomized controlled trials (RCTs), non-randomized observational and quasi-experimental studies evaluating the effectiveness of interventions aimed at reducing stigma experienced by this population. The Cochrane methodology was used to develop a search strategy in consultation with a librarian scientist. Databases searched included the Cochrane Library, Ovid EMBASE, PsycInfo, and 10 others. Two reviewers independently assessed the studies for potential relevance and conducted the Cochrane grading of RCTs to assess risk of bias and the Newcastle-Ottawa scale to assess the quality of non-randomized studies. Eligible papers were selected if they employed an intervention design with African/Black diasporic women living with HIV as the target population and had a primary outcome of stigma reduction. Of the five studies that met all of the eligibility criteria, four demonstrated the effectiveness of interventions in reducing HIV-related stigma. Only two of the five studies were designed specifically for HIV-positive African/Black diasporic women. Limitations included the absence of interventions addressing other forms of stigma and discrimination (e.g. gender discrimination, racism, heterosexism). Our findings suggest that there are limited interventions designed to address multiple forms of stigma, including gender and racial discrimination, experienced by HIV-positive African/Black diasporic women.

Identification of internal variation in the pseudoautosomal VNTR DXYS17, with nonrandom distribution of the alleles on the X and the Y chromosomes

Energy Technology Data Exchange (ETDEWEB)

Decorte, R.; Wu, R.; Marynen, P.; Cassiman, J.J.

1994-03-01

The PCR technique was used to analyze the DXYS17 locus in the pseudoautosomal region of the X and the Y chromosomes. Analysis on an automated DNA sequencer allowed for sensitive and highly accurate typing of 16 different alleles with a size between 480 and 1,100 bp. Two DXYS17 alleles migrated with the same size on agarose or denaturing polyacrylamide gels but with different mobilities on nondenaturing polyacrylamide gels. Sequence analysis showed that, while an identical number of repeats were present in both alleles, differences in the composition of the units were observed. The origin of these differences was found in the 28- and 33-bp units, which only had a specific repeat pattern at the 5' and 3' ends of the region. The genotype distribution for DXYS17 in a Caucasian population did not deviate from the values expected under Hardy-Weinberg equilibrium. However, the frequency of one allele and one genotype was significantly different between males and females. Segregation analysis showed that this difference was the result of a nonrandom distribution of certain alleles on the sex chromosomes in males. 31 refs., 4 figs., 2 tabs.

Treatment of substance use disorders in schizophrenia.

Science.gov (United States)

Bennett, Melanie E; Bradshaw, Kristen R; Catalano, Lauren T

2017-07-01

Substance use disorders (SUDs) represent a great barrier to functional recovery for individuals with schizophrenia. It is important to use research on treatment of SUDs in schizophrenia to guide treatment recommendations and program planning. We review studies of pharmacological and psychosocial interventions to treat SUDs in individuals with schizophrenia. The criteria used to select studies for inclusion are (1) the percentage of the sample with a schizophrenia spectrum diagnosis is at least 25%; (2) participants have a comorbid SUD or problem use of substances; (3) an intervention for SUD is provided; (4) a substance use-related outcome is measured; and (5) the study design enabled examination of pre-post outcome measures including open label trials, nonrandomized evaluations (quasi-experimental designs, nonrandom assignment to groups), or randomized controlled trials. There are few psychopharmacology outcomes studies. Most have examined use of antipsychotic medications to treat SUDs in schizophrenia. Several trials have yielded positive findings for naltrexone in reducing drinking compared to placebo in this population. Motivational and cognitive-behavioral interventions are associated with decreased substance use in several trials. Treatment for SUDs is feasible within a range of settings and acceptable to many individuals with schizophrenia. All individuals with schizophrenia should be offered brief or more extended psychosocial interventions that incorporate discussion of personal reasons to change and training in cognitive-behavioral strategies to reduce use, cope with cravings and stress, and avoid relapse. Future research must include larger samples, longitudinal designs, and similar outcome measures across studies.

A psycho-educational HIV/STI prevention intervention for internally displaced women in Leogane, Haiti: results from a non-randomized cohort pilot study.

Science.gov (United States)

Logie, Carmen H; Daniel, CarolAnn; Newman, Peter A; Weaver, James; Loutfy, Mona R

2014-01-01

Little evidence exists regarding efficacious HIV and sexually transmitted infections (STI) prevention interventions with internally displaced populations. Internally displaced women are at elevated risk for HIV/STI due to limited access to health services, heightened poverty and social network breakdown. The FASY (Famn an Aksyon Pou Sante' Yo) (Women Taking Action For Their Health) study examined the effectiveness of a peer health worker (PHW) delivered psycho-educational HIV/STI pilot study with internally displaced women in Leogane, Haiti. This was a non-randomized cohort pilot study. Participants completed a computer-assisted pre-test programmed on Android tablet PCs followed by an HIV/STI educational video-based session and a 6-week psycho-educational group program of weekly meetings. Participants completed a post-test upon completion of group sessions. The primary outcome was HIV knowledge; our pre-specified index of clinically significant change was an effect size of 0.30. Secondary outcomes included: STI knowledge, condom use, social support, resilient coping, depression and relationship control. We used mixed-effects regression to calculate mean outcome pre-post score change. This study was registered (clinicaltrials.gov, NCT01492829). Between January 1-April 30, 2012 we assigned 200 participants to the study. The majority of participants (n = 176, 88%) completed the study and were followed up at 8 weeks, finishing April 30, 2012. Adjusted for socio-demographic characteristics, HIV knowledge (β = 4.81; 95% CI 4.36-5.26), STI knowledge (β = 0.84; 95% CI 0.70-0.99), condom use (AOR = 4.05, 95% CI 1.86-8.83), and depression (β = -0.63, 95% CI -0.88--0.39) scores showed statistically significant change post-intervention (pHaiti. Pilot studies are an important approach to understand feasibility and scientific impacts of HIV prevention strategies in disaster contexts. Study results may inform HIV prevention interventions among internally displaced women in

Changes in body weight and body mass index among psychiatric patients receiving lithium, valproate, or topiramate: an open-label, nonrandomized chart review.

Science.gov (United States)

Chengappa, K N Roy; Chalasani, L; Brar, Jaspreet S; Parepally, H; Houck, Patricia; Levine, Joseph

2002-10-01

Subsets of psychiatric patients gain excess body weight while receiving mood-stabilizing agents such as lithium carbonate or valproate sodium. Patients who gain excess weight may discontinue therapy, with severe consequences. Among the newer anticonvulsant agents, topiramate is a candidate agent for bipolar disorder and is associated with weight loss when used as adjunctive treatment. This open-label, nonrandomized, chart-review study assessed changes in body weight and body mass index (BMI) in patients receiving topiramate, lithium, or valproate. Data were extracted from the medical charts of patients admitted in 1999 and 2000 to a state psychiatric hospital with either schizophrenia, schizoaffective disorder, bipolar disorder, or other psychiatric diagnoses who were prescribed valproate, lithium, or topiramate and were reviewed for changes in body weight and BMI. The use of concomitant psychotropic medicines was recorded (eg, antipsychotic agents, antidepressant agents, other mood stabilizers such as gabapentin or carbamazepine). Continuous variables were analyzed using a factorial analysis of variance and the Student t test. Contingency statistics were used to analyze categorical variables. A total of 214 patients were included in the chart review (123 men, 91 women; mean age, 39.4 years). Significantly more women than men received topiramate (P = 0.004). Patients receiving either lithium or valproate gained a mean (SD) of 6.3 (9.0) kg and 6.4 (9.0) kg, respectively, whereas patients receiving topiramate lost a mean 1.2 (6.3) kg (F = 11.54, df = 2,198; P 8% of their baseline body weight (8.2% [11.5%] for lithium-treated patients and 8.5% [11.9%] for valproate-treated patients), whereas topiramate-treated patients lost 0.7% (7.2%) of their body weight (F = 9.93, df= 2,198; P weight loss and a reduction in BMI. This advantage of topiramate may promote long-term adherence to treatment among psychiatric patients and possibly decrease the medical risks associated

Prophylactic antibiotics in vesicoureteric reflux: Evidence-based analysis

Directory of Open Access Journals (Sweden)

M S Ansari

2009-01-01

Full Text Available Objectives: The aim of this review was to systematically examine the available evidence for the effectiveness of prophylactic antibiotics in cases of vesicoureteric reflux (VUR. Materials and Methods: We searched the relevant data on medical management of VUR and the date of last search was June 2008. The search included both randomized controlled trials as well as the nonrandomized trials and the data sources were; MEDLINE, online peer reviewed journals, Cochrane database and abstracts from conference proceedings. Results: Barring few most of the studies published on medical management were nonrandomized. Besides being small in number many of these studies were of poor-quality and poorly designed eventually failing in giving a reliable answer in this regard. Few of the studies suggest that the children with low grade VUR might do well even without antibiotic prophylaxis. Conclusions : In the absence of properly designed, randomized controlled trials and long-term follow-up the question of antibiotic prophylaxis in cases of VUR remains unanswered in large part of it. Whether to give prophylactic antibiotics or not would ultimately need a shared decision-making involving both the treating physician and the parents assessing both the risks and the benefits.

Complex Systems Analysis of Cell Cycling Models in Carcinogenesis:II. Cell Genome and Interactome, Neoplastic Non-random Transformation Models in Topoi with Lukasiewicz-Logic and MV Algebras

CERN Document Server

Baianu, I C

2004-01-01

Quantitative Biology, abstract q-bio.OT/0406045 From: I.C. Baianu Dr. [view email] Date (v1): Thu, 24 Jun 2004 02:45:13 GMT (164kb) Date (revised v2): Fri, 2 Jul 2004 00:58:06 GMT (160kb) Complex Systems Analysis of Cell Cycling Models in Carcinogenesis: II. Authors: I.C. Baianu Comments: 23 pages, 1 Figure Report-no: CC04 Subj-class: Other Carcinogenesis is a complex process that involves dynamically inter-connected modular sub-networks that evolve under the influence of micro-environmentally induced perturbations, in non-random, pseudo-Markov chain processes. An appropriate n-stage model of carcinogenesis involves therefore n-valued Logic treatments of nonlinear dynamic transformations of complex functional genomes and cell interactomes. Lukasiewicz Algebraic Logic models of genetic networks and signaling pathways in cells are formulated in terms of nonlinear dynamic systems with n-state components that allow for the generalization of previous, Boolean or "fuzzy", logic models of genetic activities in vivo....

The Effect of STEM Learning through the Project of Designing Boat Model toward Student STEM Literacy

Science.gov (United States)

Tati, T.; Firman, H.; Riandi, R.

2017-09-01

STEM Learning focusses on development of STEM-literate society, the research about implementation of STEM learning to develope students’ STEM literacy is still limited. This study is aimed to examine the effect of implementation STEM learning through the project of designing boat model on students STEM literacy in energy topic. The method of this study was a quasi-experiment with non-randomized pretest-posttest control group design. There were two classes involved, the experiment class used Project Based Learning with STEM approach and control class used Project-Based Learning without STEM approach. A STEM Literacy test instrument was developed to measure students STEM literacy which consists of science literacy, mathematics literacy, and technology-engineering literacy. The analysis showed that there were significant differences on improvement science literacy, mathematics technology-engineering between experiment class and control class with effect size more than 0.8 (large effect). The difference of improvement of STEM literacy between experiment class and control class is caused by the existence of design engineering activity which required students to apply the knowledge from every field of STEM. The challenge that was faced in STEM learning through design engineering activity was how to give the students practice to integrate STEM field in solving the problems. In additional, most of the students gave positive response toward implementation of STEM learning through design boat model project.

An open-label, non-randomized study of the pharmacokinetics of the nutritional supplement nicotinamide riboside (NR) and its effects on blood NAD+ levels in healthy volunteers.

Science.gov (United States)

Airhart, Sophia E; Shireman, Laura M; Risler, Linda J; Anderson, Gail D; Nagana Gowda, G A; Raftery, Daniel; Tian, Rong; Shen, Danny D; O'Brien, Kevin D

2017-01-01

The co-primary objectives of this study were to determine the human pharmacokinetics (PK) of oral NR and the effect of NR on whole blood nicotinamide adenine dinucleotide (NAD+) levels. Though mitochondrial dysfunction plays a critical role in the development and progression of heart failure, no mitochondria-targeted therapies have been translated into clinical practice. Recent murine studies have reported associations between imbalances in the NADH/NAD+ ratio with mitochondrial dysfunction in multiple tissues, including myocardium. Moreover, an NAD+ precursor, nicotinamide mononucleotide, improved cardiac function, while another NAD+ precursor, nicotinamide riboside (NR), improved mitochondrial function in muscle, liver and brown adipose. Thus, PK studies of NR in humans is critical for future clinical trials. In this non-randomized, open-label PK study of 8 healthy volunteers, 250 mg NR was orally administered on Days 1 and 2, then uptitrated to peak dose of 1000 mg twice daily on Days 7 and 8. On the morning of Day 9, subjects completed a 24-hour PK study after receiving 1000 mg NR at t = 0. Whole-blood levels of NR, clinical blood chemistry, and NAD+ levels were analyzed. Oral NR was well tolerated with no adverse events. Significant increases comparing baseline to mean concentrations at steady state (Cave,ss) were observed for both NR (p = 0.03) and NAD+ (p = 0.001); the latter increased by 100%. Absolute changes from baseline to Day 9 in NR and NAD+ levels correlated highly (R2 = 0.72, p = 0.008). Because NR increases circulating NAD+ in humans, NR may have potential as a therapy in patients with mitochondrial dysfunction due to genetic and/or acquired diseases.

An open-label, non-randomized study of the pharmacokinetics of the nutritional supplement nicotinamide riboside (NR and its effects on blood NAD+ levels in healthy volunteers.

Directory of Open Access Journals (Sweden)

Sophia E Airhart

Full Text Available The co-primary objectives of this study were to determine the human pharmacokinetics (PK of oral NR and the effect of NR on whole blood nicotinamide adenine dinucleotide (NAD+ levels.Though mitochondrial dysfunction plays a critical role in the development and progression of heart failure, no mitochondria-targeted therapies have been translated into clinical practice. Recent murine studies have reported associations between imbalances in the NADH/NAD+ ratio with mitochondrial dysfunction in multiple tissues, including myocardium. Moreover, an NAD+ precursor, nicotinamide mononucleotide, improved cardiac function, while another NAD+ precursor, nicotinamide riboside (NR, improved mitochondrial function in muscle, liver and brown adipose. Thus, PK studies of NR in humans is critical for future clinical trials.In this non-randomized, open-label PK study of 8 healthy volunteers, 250 mg NR was orally administered on Days 1 and 2, then uptitrated to peak dose of 1000 mg twice daily on Days 7 and 8. On the morning of Day 9, subjects completed a 24-hour PK study after receiving 1000 mg NR at t = 0. Whole-blood levels of NR, clinical blood chemistry, and NAD+ levels were analyzed.Oral NR was well tolerated with no adverse events. Significant increases comparing baseline to mean concentrations at steady state (Cave,ss were observed for both NR (p = 0.03 and NAD+ (p = 0.001; the latter increased by 100%. Absolute changes from baseline to Day 9 in NR and NAD+ levels correlated highly (R2 = 0.72, p = 0.008.Because NR increases circulating NAD+ in humans, NR may have potential as a therapy in patients with mitochondrial dysfunction due to genetic and/or acquired diseases.

Optimum Design of Braced Steel Space Frames including Soil-Structure Interaction via Teaching-Learning-Based Optimization and Harmony Search Algorithms

OpenAIRE

Ayse T. Daloglu; Musa Artar; Korhan Ozgan; Ali İ. Karakas

2018-01-01

Optimum design of braced steel space frames including soil-structure interaction is studied by using harmony search (HS) and teaching-learning-based optimization (TLBO) algorithms. A three-parameter elastic foundation model is used to incorporate the soil-structure interaction effect. A 10-storey braced steel space frame example taken from literature is investigated according to four different bracing types for the cases with/without soil-structure interaction. X, V, Z, and eccentric V-shaped...

Evaluation of an educational "toolbox" for improving nursing staff competence and psychosocial work environment in elderly care: results of a prospective, non-randomized controlled intervention.

Science.gov (United States)

Arnetz, J E; Hasson, H

2007-07-01

Lack of professional development opportunities among nursing staff is a major concern in elderly care and has been associated with work dissatisfaction and staff turnover. There is a lack of prospective, controlled studies evaluating the effects of educational interventions on nursing competence and work satisfaction. The aim of this study was to evaluate the possible effects of an educational "toolbox" intervention on nursing staff ratings of their competence, psychosocial work environment and overall work satisfaction. The study was a prospective, non-randomized, controlled intervention. Nursing staff in two municipal elderly care organizations in western Sweden. In an initial questionnaire survey, nursing staff in the intervention municipality described several areas in which they felt a need for competence development. Measurement instruments and educational materials for improving staff knowledge and work practices were then collated by researchers and managers in a "toolbox." Nursing staff ratings of their competence and work were measured pre and post-intervention by questionnaire. Staff ratings in the intervention municipality were compared to staff ratings in the reference municipality, where no toolbox was introduced. Nursing staff ratings of their competence and psychosocial work environment, including overall work satisfaction, improved significantly over time in the intervention municipality, compared to the reference group. Both competence and work environment ratings were largely unchanged among reference municipality staff. Multivariate analysis revealed a significant interaction effect between municipalities over time for nursing staff ratings of participation, leadership, performance feedback and skills' development. Staff ratings for these four scales improved significantly in the intervention municipality as compared to the reference municipality. Compared to a reference municipality, nursing staff ratings of their competence and the

Design and construction of a photobioreactor for hydrogen production, including status in the field.

Science.gov (United States)

Skjånes, Kari; Andersen, Uno; Heidorn, Thorsten; Borgvang, Stig A

Several species of microalgae and phototrophic bacteria are able to produce hydrogen under certain conditions. A range of different photobioreactor systems have been used by different research groups for lab-scale hydrogen production experiments, and some few attempts have been made to upscale the hydrogen production process. Even though a photobioreactor system for hydrogen production does require special construction properties (e.g., hydrogen tight, mixing by other means than bubbling with air), only very few attempts have been made to design photobioreactors specifically for the purpose of hydrogen production. We have constructed a flat panel photobioreactor system that can be used in two modes: either for the cultivation of phototrophic microorganisms (upright and bubbling) or for the production of hydrogen or other anaerobic products (mixing by "rocking motion"). Special emphasis has been taken to avoid any hydrogen leakages, both by means of constructional and material choices. The flat plate photobioreactor system is controlled by a custom-built control system that can log and control temperature, pH, and optical density and additionally log the amount of produced gas and dissolved oxygen concentration. This paper summarizes the status in the field of photobioreactors for hydrogen production and describes in detail the design and construction of a purpose-built flat panel photobioreactor system, optimized for hydrogen production in terms of structural functionality, durability, performance, and selection of materials. The motivations for the choices made during the design process and advantages/disadvantages of previous designs are discussed.

The steps to health employee weight management randomized control trial: rationale, design and baseline characteristics.

Science.gov (United States)

Østbye, Truls; Stroo, Marissa; Brouwer, Rebecca J N; Peterson, Bercedis L; Eisenstein, Eric L; Fuemmeler, Bernard F; Joyner, Julie; Gulley, Libby; Dement, John M

2013-07-01

The workplace can be an important setting for addressing obesity. An increasing number of employers offer weight management programs. Present the design, rationale and baseline characteristics of the Steps to Health study (STH), a randomized trial to evaluate the effectiveness of two preexisting employee weight management programs offered at Duke University and Medical Center. 550 obese (BMI ≥30) employee volunteers were randomized 1:1 to two programs. Baseline data, collected between January 2011 and July 2012, included height/weight, accelerometry, workplace injuries, health care utilization, and questionnaires querying socio-cognitive factors, perceptions of health climate, physical activity, and dietary intake. In secondary analyses participants in the two programs will also be compared to a non-randomized observational control group of obese employees. At baseline, the mean age was 45 years, 83% were female, 41% white, and 53% black. Mean BMI was 37.2. Participants consumed a mean of 2.37 servings of fruits and vegetables per day (in the past week), participated in 11.5 min of moderate-to-vigorous physical activity, and spent 620 min being sedentary. STH addresses the need for evaluation of worksite interventions to promote healthy weight. In addition to having direct positive effects on workers' health, worksite programs have the potential to increase productivity and reduce health care costs. Copyright © 2013 Elsevier Inc. All rights reserved.

EC6 safety enhancement - including impact of Fukushima lessons learned

Energy Technology Data Exchange (ETDEWEB)

Yu, S.; Zemdegs, R.; Boyle, S.; Soulard, M., E-mail: stephen.yu@candu.com [Candu Energy Inc., Mississauga, Ontario (Canada)

2012-09-15

The Enhanced CANDU 6 (EC6) is the new Generation III CANDU reactor design that meets the most up to date regulatory requirements and customer expectations. EC6 builds on the proven high performance design inch as the Qinshan CANDU 6 units and has made improvements to safety and operational performance, and has incorporated extensive operational feedback including Fukushima. The Fukushima Dai-ichi March 11, 2011 event has demonstrated the importance of defence-in-depth considerations for beyond-design basis events, including severe accidents. The EC6 design is based on the defence-in-depth principles and provides further design features that address the lessons learned from Fukushima. (author)

Effect of Nigella sativa supplementation over a one-year period on lipid levels, blood pressure and heart rate in type-2 diabetic patients receiving oral hypoglycemic agents: nonrandomized clinical trial.

Science.gov (United States)

Badar, Ahmed; Kaatabi, Huda; Bamosa, Abdullah; Al-Elq, Abdulmohsen; Abou-Hozaifa, Bodour; Lebda, Fatma; Alkhadra, Akram; Al-Almaie, Sameeh

2017-01-01

Diabetic patients with hypertension and dyslipidemia are at a high risk of cardiovascular complications. To determine the effect of Nigella sativa supplementation on the lipid profile, mean arterial pressure, and heart rate in persons with type 2 diabetes on oral hypoglycemic agents (OHA). Single-blind, nonrandomized. Diabetes clinic of a university hospital in Saudi Arabia. Type-2 diabetic patients were recruited by purposive sampling and assigned to treatment or control at the discretion of the investigator with the patient blinded to treatment. Before the in.tervention and every 3 months thereafter until the end of the treatment period, the following parameters were measured: triglycerides (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and body mass index (BMI). Results at the baseline and each subsequent visit were compared between the two groups. Lipid and cardiovascular parameters, and BMI. Fifty-seven patients were assigned to receive N sativa 2 g daily for one year and 57 were assigned to receive an identical regimen of placebo, along with OHA. A significant decrease in HDL-C and increase in the TC/HDL-C and LDL-C/HDL-C ratios were seen in the control group. The N sativa group had a signifi.cant decline in TC, LDL-C, TC/HDL-C and LDL-C/HDL-C ratios, compared with the respective baseline data and the control group. HDL-C was significantly elevated in the N sativa group. The control group showed a significant elevation in MAP. The N sativa group had a significant reduction in SBP, DBP, MAP and HR and a significant decrease in DBP, MAP and HR as compared with the control group. N sativa supplementation improves total cholesterol, mean arterial pressure and heart rate in type 2 diabetes patients on oral hypoglycemic agents. There were 9 subjects in each group lost to follow up

RANDOMNESS of Numbers DEFINITION(QUERY:WHAT? V HOW?) ONLY Via MAXWELL-BOLTZMANN CLASSICAL-Statistics(MBCS) Hot-Plasma VS. Digits-Clumping Log-Law NON-Randomness Inversion ONLY BOSE-EINSTEIN QUANTUM-Statistics(BEQS) .

Science.gov (United States)

Siegel, Z.; Siegel, Edward Carl-Ludwig

2011-03-01

RANDOMNESS of Numbers cognitive-semantics DEFINITION VIA Cognition QUERY: WHAT???, NOT HOW?) VS. computer-``science" mindLESS number-crunching (Harrel-Sipser-...) algorithmics Goldreich "PSEUDO-randomness"[Not.AMS(02)] mea-culpa is ONLY via MAXWELL-BOLTZMANN CLASSICAL-STATISTICS(NOT FDQS!!!) "hot-plasma" REPULSION VERSUS Newcomb(1881)-Weyl(1914;1916)-Benford(1938) "NeWBe" logarithmic-law digit-CLUMPING/ CLUSTERING NON-Randomness simple Siegel[AMS Joint.Mtg.(02)-Abs. # 973-60-124] algebraic-inversion to THE QUANTUM and ONLY BEQS preferentially SEQUENTIALLY lower-DIGITS CLUMPING/CLUSTERING with d = 0 BEC, is ONLY VIA Siegel-Baez FUZZYICS=CATEGORYICS (SON OF TRIZ)/"Category-Semantics"(C-S), latter intersection/union of Lawvere(1964)-Siegel(1964)] category-theory (matrix: MORPHISMS V FUNCTORS) "+" cognitive-semantics'' (matrix: ANTONYMS V SYNONYMS) yields Siegel-Baez FUZZYICS=CATEGORYICS/C-S tabular list-format matrix truth-table analytics: MBCS RANDOMNESS TRUTH/EMET!!!

Estimating the treatment effect from non-randomized studies: The example of reduced intensity conditioning allogeneic stem cell transplantation in hematological diseases

Directory of Open Access Journals (Sweden)

Resche-Rigon Matthieu

2012-08-01

Full Text Available Abstract Background In some clinical situations, for which RCT are rare or impossible, the majority of the evidence comes from observational studies, but standard estimations could be biased because they ignore covariates that confound treatment decisions and outcomes. Methods Three observational studies were conducted to assess the benefit of Allo-SCT in hematological malignancies of multiple myeloma, follicular lymphoma and Hodgkin’s disease. Two statistical analyses were performed: the propensity score (PS matching approach and the inverse probability weighting (IPW approach. Results Based on PS-matched samples, a survival benefit in MM patients treated by Allo-SCT, as compared to similar non-allo treated patients, was observed with an HR of death at 0.35 (95%CI: 0.14-0.88. Similar results were observed in HD, 0.23 (0.07-0.80 but not in FL, 1.28 (0.43-3.77. Estimated benefits of Allo-SCT for the original population using IPW were erased in HR for death at 0.72 (0.37-1.39 for MM patients, 0.60 (0.19-1.89 for HD patients, and 2.02 (0.88-4.66 for FL patients. Conclusion Differences in estimated benefits rely on whether the underlying population to which they apply is an ideal randomized experimental population (PS or the original population (IPW. These useful methods should be employed when assessing the effects of innovative treatment in non-randomized experiments.

Conceptual design of heterogeneous azeotropic distillation process for ethanol dehydration using 1-butanol as entrainer

Directory of Open Access Journals (Sweden)

Paritta Prayoonyong

2014-12-01

Full Text Available The synthesis of a heterogeneous azeotropic distillation process for ethanol dehydration using 1-butanol as entrainer is presented. The residue curve map of the ethanol/water/1-butanol mixture is computationally generated using non-random twoliquid thermodynamic model. It is found that 1-butanol leads to a residue curve map topological structure different from that generated by typical entrainers used in ethanol dehydration. Synthesised by residue curve map analysis, the distillation flowsheet for ethanol dehydration by 1-butanol comprises a double-feed column integrated with an overhead decanter and a simple column. The double-feed column is used to recover water as the top product, whereas the simple column is used for recovering ethanol and 1-butanol. The separation feasibility and the economically near-optimal designs of distillation columns in the flowsheet are evaluated and identified by using the boundary value design method. The distillation flowsheet using 1-butanol is compared with the conventional process using benzene as entrainer. Based on their total annualised costs, the ethanol dehydration process using 1-butanol is less economically attractive than the process using benzene. However, 1-butanol is less toxic than benzene.

Reduced Availability of Sugar-Sweetened Beverages and Diet Soda Has a Limited Impact on Beverage Consumption Patterns in Maine High School Youth

Science.gov (United States)

Whatley Blum, Janet E.; Davee, Anne-Marie; Beaudoin, Christina M.; Jenkins, Paul L.; Kaley, Lori A.; Wigand, Debra A.

2008-01-01

Objective: To examine change in high school students' beverage consumption patterns pre- and post-intervention of reduced availability of sugar-sweetened beverages (SSB) and diet soda in school food venues. Design: A prospective, quasi-experimental, nonrandomized study design. Setting: Public high schools. Participants: A convenience sample from…

The insulin-like growth factor axis and collagen turnover in asthmatic children treated with inhaled budesonide

DEFF Research Database (Denmark)

Wolthers, O D; Juul, A; Hansen, M

1995-01-01

) and the amino terminal propeptide of type III procollagen (PIIINP) were studied in 14 prepubertal children with asthma (mean age 9.7 years) during treatment with inhaled budesonide. The study design was a randomized, crossover trial with two double-blind treatment periods (200 and 800 micrograms) and one open......, non-randomized treatment period (400 micrograms). All periods were 18 days' duration. Budesonide treatment was associated with a dose-related suppressive trend in serum concentrations of PIIINP when the 400 micrograms period was included (p

Statistical grand rounds: understanding the mechanism: mediation analysis in randomized and nonrandomized studies.

Science.gov (United States)

Mascha, Edward J; Dalton, Jarrod E; Kurz, Andrea; Saager, Leif

2013-10-01

In comparative clinical studies, a common goal is to assess whether an exposure, or intervention, affects the outcome of interest. However, just as important is to understand the mechanism(s) for how the intervention affects outcome. For example, if preoperative anemia was shown to increase the risk of postoperative complications by 15%, it would be important to quantify how much of that effect was due to patients receiving intraoperative transfusions. Mediation analysis attempts to quantify how much, if any, of the effect of an intervention on outcome goes though prespecified mediator, or "mechanism" variable(s), that is, variables sitting on the causal pathway between exposure and outcome. Effects of an exposure on outcome can thus be divided into direct and indirect, or mediated, effects. Mediation is claimed when 2 conditions are true: the exposure affects the mediator and the mediator (adjusting for the exposure) affects the outcome. Understanding how an intervention affects outcome can validate or invalidate one's original hypothesis and also facilitate further research to modify the responsible factors, and thus improve patient outcome. We discuss the proper design and analysis of studies investigating mediation, including the importance of distinguishing mediator variables from confounding variables, the challenge of identifying potential mediators when the exposure is chronic versus acute, and the requirements for claiming mediation. Simple designs are considered, as well as those containing multiple mediators, multiple outcomes, and mixed data types. Methods are illustrated with data collected by the National Surgical Quality Improvement Project (NSQIP) and utilized in a companion paper which assessed the effects of preoperative anemic status on postoperative outcomes.

Three-dimensional cross point readout detector design for including depth information

Science.gov (United States)

Lee, Seung-Jae; Baek, Cheol-Ha

2018-04-01

We designed a depth-encoding positron emission tomography (PET) detector using a cross point readout method with wavelength-shifting (WLS) fibers. To evaluate the characteristics of the novel detector module and the PET system, we used the DETECT2000 to perform optical photon transport in the crystal array. The GATE was also used. The detector module is made up of four layers of scintillator arrays, the five layers of WLS fiber arrays, and two sensor arrays. The WLS fiber arrays in each layer cross each other to transport light to each sensor array. The two sensor arrays are coupled to the forward and left sides of the WLS fiber array, respectively. The identification of three-dimensional pixels was determined using a digital positioning algorithm. All pixels were well decoded, with the system resolution ranging from 2.11 mm to 2.29 mm at full width at half maximum (FWHM).

A design of a computer complex including vector processors

International Nuclear Information System (INIS)

Asai, Kiyoshi

1982-12-01

We, members of the Computing Center, Japan Atomic Energy Research Institute have been engaged for these six years in the research of adaptability of vector processing to large-scale nuclear codes. The research has been done in collaboration with researchers and engineers of JAERI and a computer manufacturer. In this research, forty large-scale nuclear codes were investigated from the viewpoint of vectorization. Among them, twenty-six codes were actually vectorized and executed. As the results of the investigation, it is now estimated that about seventy percents of nuclear codes and seventy percents of our total amount of CPU time of JAERI are highly vectorizable. Based on the data obtained by the investigation, (1)currently vectorizable CPU time, (2)necessary number of vector processors, (3)necessary manpower for vectorization of nuclear codes, (4)computing speed, memory size, number of parallel 1/0 paths, size and speed of 1/0 buffer of vector processor suitable for our applications, (5)necessary software and operational policy for use of vector processors are discussed, and finally (6)a computer complex including vector processors is presented in this report. (author)

A psycho-educational HIV/STI prevention intervention for internally displaced women in Leogane, Haiti: results from a non-randomized cohort pilot study.

Directory of Open Access Journals (Sweden)

Carmen H Logie

Full Text Available Little evidence exists regarding efficacious HIV and sexually transmitted infections (STI prevention interventions with internally displaced populations. Internally displaced women are at elevated risk for HIV/STI due to limited access to health services, heightened poverty and social network breakdown. The FASY (Famn an Aksyon Pou Sante' Yo (Women Taking Action For Their Health study examined the effectiveness of a peer health worker (PHW delivered psycho-educational HIV/STI pilot study with internally displaced women in Leogane, Haiti.This was a non-randomized cohort pilot study. Participants completed a computer-assisted pre-test programmed on Android tablet PCs followed by an HIV/STI educational video-based session and a 6-week psycho-educational group program of weekly meetings. Participants completed a post-test upon completion of group sessions. The primary outcome was HIV knowledge; our pre-specified index of clinically significant change was an effect size of 0.30. Secondary outcomes included: STI knowledge, condom use, social support, resilient coping, depression and relationship control. We used mixed-effects regression to calculate mean outcome pre-post score change. This study was registered (clinicaltrials.gov, NCT01492829.Between January 1-April 30, 2012 we assigned 200 participants to the study. The majority of participants (n = 176, 88% completed the study and were followed up at 8 weeks, finishing April 30, 2012. Adjusted for socio-demographic characteristics, HIV knowledge (β = 4.81; 95% CI 4.36-5.26, STI knowledge (β = 0.84; 95% CI 0.70-0.99, condom use (AOR = 4.05, 95% CI 1.86-8.83, and depression (β = -0.63, 95% CI -0.88--0.39 scores showed statistically significant change post-intervention (p<0.05.This pilot study evaluated a PHW psycho-educational HIV/STI prevention intervention among internally displaced women in post-earthquake Haiti. Pilot studies are an important approach to understand feasibility and scientific

Job rotation designed to prevent musculoskeletal disorders and control risk in manufacturing industries: A systematic review.

Science.gov (United States)

Padula, Rosimeire Simprini; Comper, Maria Luiza Caires; Sparer, Emily H; Dennerlein, Jack T

2017-01-01

To better understand job rotation in the manufacturing industry, we completed a systematic review asking the following questions: 1) How do job-rotation programs impact work-related musculoskeletal disorders (MSDs) and related risk control for these MSDs, as well as psychosocial factors? and 2) How best should the job rotation programs be designed? We searched MEDLINE, EMBASE, Business Source Premier, ISI Web of Knowledge, CINAHL, PsyINFO, Scopus, and SciELO databases for articles published in peer-reviewed journals. Eligible studies were examined by two independent reviewers for relevance (population of manufacturing workers, outcomes of musculoskeletal disorders, physical factors, psychosocial factors, and strategies used in job-rotation implantation) and methodological quality rating. From 10,809 potential articles, 71 were read for full text analysis. Of the 14 studies included for data extraction, two were non-randomized control trial studies, one was a case-control study, and 11 were cross-sectional comparisons. Only one, with a case-control design, was scored with good methodological quality. Currently, weak evidence exists supporting job rotation as a strategy for the prevention and control of musculoskeletal disorders. Job rotation did not appear to reduce the exposure of physical risk factors; yet, there are positive correlations between job rotation and higher job satisfaction. Worker training has been described as a crucial component of a successful job-rotation program. The studies reported a range of parameters used to implement and measure job-rotation programs. More rigorous studies are needed to better understand the full impact of job rotation on production and health. CRD42014013319. Copyright © 2016 Elsevier Ltd. All rights reserved.

Stepped-wedge cluster randomised controlled trials: a generic framework including parallel and multiple-level designs.

Science.gov (United States)

Hemming, Karla; Lilford, Richard; Girling, Alan J

2015-01-30

Stepped-wedge cluster randomised trials (SW-CRTs) are being used with increasing frequency in health service evaluation. Conventionally, these studies are cross-sectional in design with equally spaced steps, with an equal number of clusters randomised at each step and data collected at each and every step. Here we introduce several variations on this design and consider implications for power. One modification we consider is the incomplete cross-sectional SW-CRT, where the number of clusters varies at each step or where at some steps, for example, implementation or transition periods, data are not collected. We show that the parallel CRT with staggered but balanced randomisation can be considered a special case of the incomplete SW-CRT. As too can the parallel CRT with baseline measures. And we extend these designs to allow for multiple layers of clustering, for example, wards within a hospital. Building on results for complete designs, power and detectable difference are derived using a Wald test and obtaining the variance-covariance matrix of the treatment effect assuming a generalised linear mixed model. These variations are illustrated by several real examples. We recommend that whilst the impact of transition periods on power is likely to be small, where they are a feature of the design they should be incorporated. We also show examples in which the power of a SW-CRT increases as the intra-cluster correlation (ICC) increases and demonstrate that the impact of the ICC is likely to be smaller in a SW-CRT compared with a parallel CRT, especially where there are multiple levels of clustering. Finally, through this unified framework, the efficiency of the SW-CRT and the parallel CRT can be compared. © 2014 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.

Including sustainability issues in nurse education: A comparative study of first year student nurses' attitudes in four European countries.

Science.gov (United States)

Richardson, Janet; Heidenreich, Thomas; Álvarez-Nieto, Carmen; Fasseur, Fabienne; Grose, Jane; Huss, Norma; Huynen, Maud; López-Medina, Isabel M; Schweizer, Angélick

2016-02-01

Education in sustainable development is a goal recognised by a large number of countries and a vital concept in healthcare. It is therefore important that nurse education incorporates elements of sustainable development into nursing education curricula. However, there is limited research on student nurses' attitudes towards sustainability and no comparison of attitudes towards sustainability and its inclusion in the nursing curriculum across Europe. This project aims to assess student nurses' attitudes towards sustainability, its relevance to nursing and its inclusion in the nursing curricula. 1. To assess base-line attitudes at the start of nursing and midwifery training; 2. To compare sustainability awareness between students participating in training in a number of European universities. A comparative survey design using the Sustainability Attitudes in Nursing Survey (SANS_2) questionnaire. Nursing classes of Universities and Nursing Schools in four European countries were investigated using a questionnaire consisting of five sustainability-related items. 916 nursing students (UK: 450, Germany: 196, Spain: 124, Switzerland: 146). Standard descriptive and inferential statistical methods were used to establish psychometric quality (Principal Components Analysis, Cronbach's alpha, Pearson correlations) and compare student nurses from the four countries. The reliability of SANS_2 was good (Cronbach's alpha=.82) and the five items loaded on a single factor which explained 58% of variance. ANOVA of the SANS_2 total score showed significant differences between countries with German nursing students showing more sustainability awareness than students from the UK and Spain. SANS_2 is a reliable instrument to assess nursing students' sustainability awareness; there are significant differences in sustainability awareness of students of different European countries. Limitations of the study include non-random sampling, possible method effects and social desirability effects

Can teaching research methodology influence students' attitude toward science? Cohort study and nonrandomized trial in a single medical school.

Science.gov (United States)

Vujaklija, Ana; Hren, Darko; Sambunjak, Dario; Vodopivec, Ivana; Ivanis, Ana; Marusić, Ana; Marusić, Matko

2010-02-01

Medical teaching aims to develop attitudes and behaviors underlying professional competence of future physicians. We investigated whether a mandatory course on scientific methodology in the second study year could affect students' attitudes toward science in medicine. In a longitudinal study, students (n = 241) enrolling in 2001-2002 academic year at a single medical school were followed up until graduation in 2006-2007. Each year, they filled out a Likert-type questionnaire of 18 statements evaluating attitude toward science. Direct influence of the course on students' attitudes was tested in a nonrandomized controlled trial with the 2006-2007 second year student cohort. Positive students' attitudes toward science increased during study years (mean [SD] score of the maximum score of 90): from 57.6 (6.0) in the first to 69.8 (10.4) in the sixth year. There was a significant trend of increase in attitudes with the years of study (cubic trend by polynomial contrasts analysis, P = 0.011). Attendance of a course on research methodology significantly increased positive attitudes (score, 67.0 [7.0] before and 70.8 [7.5] after course, P = 0.032 vs control group), regardless of grade point average. The intervention had an effect even when the influence of the initial attitude was accounted for (F1,140 = 9.25, P = 0.003; analysis of covariance). The attitude changes after the course was greatest in students with low initial attitude scores (Spearman rinitial score, score difference, -0.44). Medical students have positive attitudes toward science and scientific method in medicine. Attendance of a course on research methodology had positive short-term effect on students' attitudes toward science. This positive effect should be maintained by vertical integration of the course in the medical curriculum.

A Complex Multiherbal Regimen Based on Ayurveda Medicine for the Management of Hepatic Cirrhosis Complicated by Ascites: Nonrandomized, Uncontrolled, Single Group, Open-Label Observational Clinical Study.

Science.gov (United States)

Patel, Manish V; Patel, Kalapi B; Gupta, Shivenarain; Michalsen, Andreas; Stapelfeldt, Elmar; Kessler, Christian S

2015-01-01

Hepatic cirrhosis is one of the leading causes of death worldwide, especially if complicated by ascites. This chronic condition can be related to the classical disease entity jalodara in Traditional Indian Medicine (Ayurveda). The present paper aims to evaluate the general potential of Ayurvedic therapy for overall clinical outcomes in hepatic cirrhosis complicated by ascites (HCcA). In form of a nonrandomized, uncontrolled, single group, open-label observational clinical study, 56 patients fulfilling standardized diagnostic criteria for HCcA were observed during their treatment at the P. D. Patel Ayurveda Hospital, Nadiad, India. Based on Ayurvedic tradition, a standardized treatment protocol was developed and implemented, consisting of oral administration of single and compound herbal preparations combined with purificatory measures as well as dietary and lifestyle regimens. The outcomes were assessed by measuring liver functions through specific clinical features and laboratory parameters and by evaluating the Child-Pugh prognostic grade score. After 6 weeks of treatment and a follow-up period of 18 weeks, the outcomes showed statistically significant and clinically relevant improvements. Further larger and randomized trials on effectiveness, safety, and quality of the Ayurvedic approach in the treatment of HCcA are warranted to support these preliminary findings.

Designing monitoring programs for chemicals of emerging concern in potable reuse--what to include and what not to include?

Science.gov (United States)

Drewes, J E; Anderson, P; Denslow, N; Olivieri, A; Schlenk, D; Snyder, S A; Maruya, K A

2013-01-01

This study discussed a proposed process to prioritize chemicals for reclaimed water monitoring programs, selection of analytical methods required for their quantification, toxicological relevance of chemicals of emerging concern regarding human health, and related issues. Given that thousands of chemicals are potentially present in reclaimed water and that information about those chemicals is rapidly evolving, a transparent, science-based framework was developed to guide prioritization of which compounds of emerging concern (CECs) should be included in reclaimed water monitoring programs. The recommended framework includes four steps: (1) compile environmental concentrations (e.g., measured environmental concentration or MEC) of CECs in the source water for reuse projects; (2) develop a monitoring trigger level (MTL) for each of these compounds (or groups thereof) based on toxicological relevance; (3) compare the environmental concentration (e.g., MEC) to the MTL; CECs with a MEC/MTL ratio greater than 1 should be prioritized for monitoring, compounds with a ratio less than '1' should only be considered if they represent viable treatment process performance indicators; and (4) screen the priority list to ensure that a commercially available robust analytical method is available for that compound.

Improvement of functional constipation with kiwifruit intake in a Mediterranean patient population: An open, non-randomized pilot study

Directory of Open Access Journals (Sweden)

Oriol Cunillera

2015-07-01

Full Text Available Introduction: Kiwifruit consumption has shown to improve functional constipation in healthy elderly population, according to studies in New Zealand and China. The aim of this study was to evaluate the effect of kiwifruit intake on functional constipation in a Mediterranean patient population characterized by its distinctive nutritional habits.Material and Methods: An open, non-controlled and non-randomized longitudinal study was conducted in 46 patients with constipation (Rome III criteria. Patients monitored for five weeks: weeks 1 and 2 no kiwifruit and weeks 3-5 three kiwifruit per day (Green kiwifruit, Actinidia deliciosa var Hayward. Bristol Scale, volume of stools, and ease of defecation was self- reported daily. The evolution of the categorical variables was tested using the Bhapkar test; functional data methodology was used for continuous variables, and Generalized Estimating Equation (GEE models were adjusted.Results: The percentage of patients with ≥3 stools per week increased from 82.61% (95% CI: 69–91.2 at week 1 to 97.78% (95% CI: 87.4–99.9 at week 2 of kiwifruit intake, with 76.09% (95% CI: 61.9–86.2 responding during the first week. The reporting of stable ideal stools increased from 17.39% (95% CI: 8.8–31 at week 2 to 33.33% (95% CI: 21.3–48 at week 5. According to GEE models, the number of depositions increased significantly (p-values<0.001 in 0.398 daily units at week 1 the first week of intake, up to 0.593 daily units at week 5; significant improvements on facility in evacuation and volume of evacuation were found from the firstweek of intake (all p-values<0.001.Conclusions: The intake of three kiwifruits per day significantly improves the quality of evacuation (number of depositions, volume, consistency and ease in a Mediterranean patient population suffering from functional constipation.

Including alternative resources in state renewable portfolio standards: Current design and implementation experience

International Nuclear Information System (INIS)

Heeter, Jenny; Bird, Lori

2013-01-01

As of October 2012, 29 states, the District of Columbia, and Puerto Rico have instituted a renewable portfolio standard (RPS). Each state policy is unique, varying in percentage targets, timetables, and eligible resources. Increasingly, new RPS polices have included alternative resources. Alternative resources have included energy efficiency, thermal resources, and, to a lesser extent, non-renewables. This paper examines state experience with implementing renewable portfolio standards that include energy efficiency, thermal resources, and non-renewable energy and explores compliance experience, costs, and how states evaluate, measure, and verify energy efficiency and convert thermal energy. It aims to gain insights from the experience of states for possible federal clean energy policy as well as to share experience and lessons for state RPS implementation. - Highlights: • Increasingly, new RPS policies have included alternative resources. • Nearly all states provide a separate tier or cap on the quantity of eligible alternative resources. • Where allowed, non-renewables and energy efficiency are being heavily utilized

30 CFR 250.1007 - What to include in applications.

Science.gov (United States)

2010-07-01

... features and other pertinent data including area, lease, and block designations; water depths; route...) submitted for a pipeline right-of-way shall bear a signed certificate upon its face by the engineer who made... additional design precautions you took to enable the pipeline to withstand the effects of water currents...

Design of A District Heating System Including The Upgrading of Residual Industrial Waste Heat

NARCIS (Netherlands)

Falcao, P.W.; Mesbah, A.; Suherman, M.V.; Wennekes, S.

2005-01-01

This study was aimed to evaluate the feasibility of using a waste heat stream from DSM for a District Heating System. A conceptual design was carried out with emphasis on the unit for upgrading the residual waste heat. Having reviewed heat pump technology, mechanical heat pump was found to be the

Design and modeling of an advanced marine machinery system including waste heat recovery and removal of sulphur oxides

DEFF Research Database (Denmark)

Frimann Nielsen, Rasmus; Haglind, Fredrik; Larsen, Ulrik

2014-01-01

the efficiency of machinery systems. The wet sulphuric acid process is an effective way of removing flue gas sulphur oxides from land-based coal-fired power plants. Moreover, organic Rankine cycles (ORC) are suitable for heat to power conversion for low temperature heat sources. This paper describes the design...... that an ORC placed after the conventional waste heat recovery system is able to extract the sulphuric acid from the exhaust gas, while at the same time increase the combined cycle thermal efficiency by 2.6%. The findings indicate that the technology has potential in marine applications regarding both energy...... and modeling of a highly efficient machinery system which includes the removal of exhaust gas sulphur oxides. The system consists of a two-stroke diesel engine, the wet sulphuric process for sulphur removal, a conventional steam Rankine cycle and an ORC. Results of numerical modeling efforts suggest...

A non-randomized study in consecutive patients with postcholecystectomy refractory biliary leaks who were managed endoscopically with the use of multiple plastic stents or fully covered self-expandable metal stents (with videos).

Science.gov (United States)

Canena, Jorge; Liberato, Manuel; Meireles, Liliane; Marques, Inês; Romão, Carlos; Coutinho, António Pereira; Neves, Beatriz Costa; Veiga, Pedro Mota

2015-07-01

Endoscopic management of postcholecystectomy biliary leaks is widely accepted as the treatment of choice. However, refractory biliary leaks after a combination of biliary sphincterotomy and the placement of a large-bore (10F) plastic stent can occur, and the optimal rescue endotherapy for this situation is unclear. To compare the clinical effectiveness of the use of a fully covered self-expandable metal stent (FCSEMS) with the placement of multiple plastic stents (MPS) for the treatment of postcholecystectomy refractory biliary leaks. Prospective study. Two tertiary-care referral academic centers and one general district hospital. Forty consecutive patients with refractory biliary leaks who underwent endoscopic management. Temporary placement of MPS (n = 20) or FCSEMSs (n = 20). Clinical outcomes of endotherapy as well as the technical success, adverse events, need for reinterventions, and prognostic factors for clinical success. Endotherapy was possible in all patients. After endotherapy, closure of the leak was accomplished in 13 patients (65%) who received MPS and in 20 patients (100%) who received FCSEMSs (P = .004). The Kaplan-Meier (log-rank) leak-free survival analysis showed a statistically significant difference between the 2 patient populations (χ(2) [1] = 8.30; P stents (P = .024), a plastic stent diameter <20F (P = .006), and a high-grade biliary leak (P = .015) were shown to be significant predictors of treatment failure with MPS. The 7 patients in whom placement of MPS failed were retreated with FCSEMSs, resulting in closure of the leaks in all cases. Non-randomized design. In our series, the results of the temporary placement of FCSEMSs for postcholecystectomy refractory biliary leaks were superior to those from the use of MPS. A randomized study is needed to confirm our results before further recommendations. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Lifetime health effects and medical costs of integrated stroke services - a non-randomized controlled cluster-trial based life table approach

Directory of Open Access Journals (Sweden)

Dirks Maaike

2010-11-01

Full Text Available Abstract Background Economic evaluation of stroke services indicates that such services may lead to improved quality of life at affordable cost. The present study assesses lifetime health impact and cost consequences of stroke in an integrated service setting. Methods The EDISSE study is a prospective non-randomized controlled cluster trial that compared stroke services (n = 151 patients to usual care (n = 187 patients. Health status and cost trial-data were entered in multi-dimensional stroke life-tables. The tables distinguish four levels of disability which are defined by the modified Rankin scale. Quality-of-life scores (EuroQoL-5D, transition and survival probabilities are based on concurrent Dutch follow-up studies. Outcomes are quality-adjusted life years lived and lifetime medical cost by disability category. An economic analysis compares outcomes from a successful stroke service to usual care, by bootstrapping individual costs and effects data from patients in each arm. Results Lifetime costs and QALYs after stroke depend on age-of-onset of first-ever stroke. Lifetime QALYs after stroke are 2.42 (90% CI - 0.49 - 2.75 for male patients in usual care and 2.75 (-0.61; 6.26 for females. Lifetime costs for men in the usual care setting are €39,335 (15,951; 79,837 and €42,944 (14,081; 95,944 for women. A comparison with the stroke service results in an ICER of €11,685 saved per QALY gained (€14,211 and €7,745 for men and women respectively. This stroke service is with 90% certainty cost-effective. Conclusions Our analysis shows the potential of large health benefits and cost savings of stroke services, taking a lifetime perspective, also in other European settings.

Effectiveness of a peer-led HIV prevention intervention in secondary schools in Rwanda: results from a non-randomized controlled trial

Directory of Open Access Journals (Sweden)

Michielsen Kristien

2012-09-01

Full Text Available Abstract Background While the HIV epidemic is levelling off in sub-Saharan Africa, it remains at an unacceptably high level. Young people aged 15-24 years remain particularly vulnerable, resulting in a regional HIV prevalence of 1.4% in young men and 3.3% in young women. This study assesses the effectiveness of a peer-led HIV prevention intervention in secondary schools in Rwanda on young people’s sexual behavior, HIV knowledge and attitudes. Methods In a non-randomized longitudinal controlled trial, fourteen schools were selected in two neighboring districts in Rwanda Bugesera (intervention and Rwamagana (control. Students (n = 1950 in eight intervention and six control schools participated in three surveys (baseline, six and twelve months in the intervention. Analysis was done using linear and logistic regression using generalized estimation equations adjusted for propensity score. Results The overall retention rate was 72%. Time trends in sexual risk behavior (being sexually active, sex in last six months, condom use at last sex were not significantly different in students from intervention and control schools, nor was the intervention associated with increased knowledge, perceived severity or perceived susceptibility. It did significantly reduce reported stigma. Conclusions Analyzing this and other interventions, we identified several reasons for the observed limited effectiveness of peer education: 1 intervention activities (spreading information are not tuned to objectives (changing behavior; 2 young people prefer receiving HIV information from other sources than peers; 3 outcome indicators are not adequate and the context of the relationship in which sex occurs and the context in which sex occurs is ignored. Effectiveness of peer education may increase through integration in holistic interventions and redefining peer educators’ role as focal points for sensitization and referral to experts and services. Finally, we argue that a

Two-stage revision surgery with preformed spacers and cementless implants for septic hip arthritis: a prospective, non-randomized cohort study

Directory of Open Access Journals (Sweden)

Logoluso Nicola

2011-05-01

Full Text Available Abstract Background Outcome data on two-stage revision surgery for deep infection after septic hip arthritis are limited and inconsistent. This study presents the medium-term results of a new, standardized two-stage arthroplasty with preformed hip spacers and cementless implants in a consecutive series of adult patients with septic arthritis of the hip treated according to a same protocol. Methods Nineteen patients (20 hips were enrolled in this prospective, non-randomized cohort study between 2000 and 2008. The first stage comprised femoral head resection, debridement, and insertion of a preformed, commercially available, antibiotic-loaded cement hip spacer. After eradication of infection, a cementless total hip arthroplasty was implanted in the second stage. Patients were assessed for infection recurrence, pain (visual analog scale [VAS] and hip joint function (Harris Hip score. Results The mean time between first diagnosis of infection and revision surgery was 5.8 ± 9.0 months; the average duration of follow up was 56.6 (range, 24 - 104 months; all 20 hips were successfully converted to prosthesis an average 22 ± 5.1 weeks after spacer implantation. Reinfection after total hip joint replacement occurred in 1 patient. The mean VAS pain score improved from 48 (range, 35 - 84 pre-operatively to 18 (range, 0 - 38 prior to spacer removal and to 8 (range, 0 - 15 at the last follow-up assessment after prosthesis implantation. The average Harris Hip score improved from 27.5 before surgery to 61.8 between the two stages to 92.3 at the final follow-up assessment. Conclusions Satisfactory outcomes can be obtained with two-stage revision hip arthroplasty using preformed spacers and cementless implants for prosthetic hip joint infections of various etiologies.

Standalone Effects of a Cognitive Behavioral Intervention Using a Mobile Phone App on Psychological Distress and Alcohol Consumption Among Japanese Workers: Pilot Nonrandomized Controlled Trial.

Science.gov (United States)

Hamamura, Toshitaka; Suganuma, Shinichiro; Ueda, Mami; Mearns, Jack; Shimoyama, Haruhiko

2018-03-22

Research that investigates standalone effects of a mobile phone-based cognitive behavioral therapy without any human contact for reducing both psychological distress and risky drinking has been advancing; however, the number of studies is still limited. A mobile phone app called Self Record that facilitates cognitive restructuring through self-monitoring of daily thoughts and activities was developed in Japan. This study conducted a nonrandomized controlled pilot trial of the Self Record app to investigate standalone effects of the intervention on psychological distress and alcohol consumption among Japanese workers. Additionally, we examined moderating effects of negative mood regulation expectancies, which are beliefs about one's ability to control one's negative mood. A quasi-experimental design with a 1-month follow-up was conducted online in Japan from February 2016 to March 2016. A research marketing company recruited participants. The selection criteria were being a Japanese full-time worker (age 20-59 years), experiencing mild to moderate psychological distress, and having some interest in self-record apps. Assignment to group was based on participants' willingness to use the app in the study. All participants completed outcome measures of negative mood regulation expectancies, positive well-being, general distress, depression, anxiety, and typical/most weekly alcohol consumption. From the recruitment, 15.65% (1083/6921) of participants met the inclusion criteria. Of these, 51.43% (557/1083) enrolled in the study: 54.9% (306/557) in the intervention group and 45.1% (251/557) in the control group. At the 1-month follow-up, 15.3% (85/557) of participants had dropped out. Intention-to-treat analyses revealed that participants in the intervention group reported increased typical drinking (η2=.009) and heavy drinking (η2=.001). Adherence to using the app was low; 64.8% (199/306) of participants in the intervention group discontinued using the app on the first

Human factors design of nuclear power plant control rooms including computer-based operator aids

International Nuclear Information System (INIS)

Bastl, W.; Felkel, L.; Becker, G.; Bohr, E.

1983-01-01

The scientific handling of human factors problems in control rooms began around 1970 on the basis of safety considerations. Some recent research work deals with the development of computerized systems like plant balance calculation, safety parameter display, alarm reduction and disturbance analysis. For disturbance analysis purposes it is necessary to homogenize the information presented to the operator according to the actual plant situation in order to supply the operator with the information he most urgently needs at the time. Different approaches for solving this problem are discussed, and an overview is given on what is being done. Other research projects concentrate on the detailed analysis of operators' diagnosis strategies in unexpected situations, in order to obtain a better understanding of their mental processes and the influences upon them when such situations occur. This project involves the use of a simulator and sophisticated recording and analysis methods. Control rooms are currently designed with the aid of mock-ups. They enable operators to contribute their experience to the optimization of the arrangement of displays and controls. Modern control rooms are characterized by increasing use of process computers and CRT (Cathode Ray Tube) displays. A general concept for the integration of the new computerized system and the conventional control panels is needed. The technical changes modify operators' tasks, and future ergonomic work in nuclear plants will need to consider the re-allocation of function between man and machine, the incorporation of task changes in training programmes, and the optimal design of information presentation using CRTs. Aspects of developments in control room design are detailed, typical research results are dealt with, and a brief forecast of the ergonomic contribution to be made in the Federal Republic of Germany is given

A Design Study of the Inflated Sphere Landing Vehicle, Including the Landing Performance and the Effects of Deviations from Design Conditions

Science.gov (United States)

Martin, E. Dale

1961-01-01

The impact motion of the inflated sphere landing vehicle with a payload centrally supported from the spherical skin by numerous cords has been determined on the assumption of uniform isentropic gas compression during impact. The landing capabilities are determined for a system containing suspension cords of constant cross section. The effects of deviations in impact velocity and initial gas temperature from the design conditions are studied. Also discussed are the effects of errors in the time at which the skin is ruptured. These studies indicate how the design parameters should be chosen to insure reliability of the landing system. Calculations have been made and results are presented for a sphere inflated with hydrogen, landing on the moon in the absence of an atmosphere. The results are presented for one value of the skin-strength parameter.

Including customers in health service design.

Science.gov (United States)

Perrott, Bruce E

2013-01-01

This article will explore the concept and meaning of codesign as it applies to the delivery of health services. The results of a pilot study in health codesign will be used as a research based case discussion, thus providing a platform to suggest future research that could lead to building more robust knowledge of how the consumers of health services may be more effectively involved in the process of developing and delivering the type of services that are in line with expectations of the various stakeholder groups.

Designing monitoring programs for chemicals of emerging concern in potable reuse ⋯ What to include and what not to include?

KAUST Repository

Drewes, Jorg; Anderson, Paul D.; Denslow, Nancy D.; Olivieri, Adam W.; Schlenk, Daniel K.; Snyder, Shane A.; Maruya, Keith

2012-01-01

This study discussed a proposed process to prioritize chemicals for reclaimed water monitoring programs, selection of analytical methods required for their quantification, toxicological relevance of chemicals of emerging concern regarding human health, and related issues. Given that thousands of chemicals are potentially present in reclaimed water and that information about those chemicals is rapidly evolving, a transparent, science-based framework was developed to guide prioritization of which compounds of emerging concern (CECs) should be included in reclaimed water monitoring programs. The recommended framework includes four steps: (1) compile environmental concentrations (e.g., measured environmental concentration or MEC) of CECs in the source water for reuse projects; (2) develop a monitoring trigger level (MTL) for each of these compounds (or groups thereof) based on toxicological relevance; (3) compare the environmental concentration (e.g., MEC) to the MTL; CECs with a MEC/MTL ratio greater than 1 should be prioritized for monitoring, compounds with a ratio less than '1' should only be considered if they represent viable treatment process performance indicators; and (4) screen the priority list to ensure that a commercially available robust analytical method is available for that compound. © IWA Publishing 2013.

Designing monitoring programs for chemicals of emerging concern in potable reuse ⋯ What to include and what not to include?

KAUST Repository

Drewes, Jorg

2012-11-01

This study discussed a proposed process to prioritize chemicals for reclaimed water monitoring programs, selection of analytical methods required for their quantification, toxicological relevance of chemicals of emerging concern regarding human health, and related issues. Given that thousands of chemicals are potentially present in reclaimed water and that information about those chemicals is rapidly evolving, a transparent, science-based framework was developed to guide prioritization of which compounds of emerging concern (CECs) should be included in reclaimed water monitoring programs. The recommended framework includes four steps: (1) compile environmental concentrations (e.g., measured environmental concentration or MEC) of CECs in the source water for reuse projects; (2) develop a monitoring trigger level (MTL) for each of these compounds (or groups thereof) based on toxicological relevance; (3) compare the environmental concentration (e.g., MEC) to the MTL; CECs with a MEC/MTL ratio greater than 1 should be prioritized for monitoring, compounds with a ratio less than \\'1\\' should only be considered if they represent viable treatment process performance indicators; and (4) screen the priority list to ensure that a commercially available robust analytical method is available for that compound. © IWA Publishing 2013.

Pectinolytic bacteria and their secreted pectate lyases: agents for the maceration and solubilization of phytomass for fuels production

Energy Technology Data Exchange (ETDEWEB)

Preston, J.F. III; Rice, J.D.; Chow, M.C. (Florida Univ., Gainesville, FL (United States). Dept. of Microbiology and Cell Science)

1993-01-01

The objectives of this research have been to identify the pectinolytic enzymes secreted by bacteria and apply these towards the enhanced maceration and solubilization of plant material, focusing on the pectate lyases secreted by the phytopathogenic strains of Erwinia chrysanthemi, the ruminant resident Lachnospira multiparus, and the wood digestor isolate, Clostridium populeti. An HPLC approach has been developed that permits the kinetic analysis of each enzyme with respect to the formation of individual products during the pectate depolymerization process. This approach has demonstrated that each of these organisms secretes a nonrandom trimer-generating pectate lyase with a combination of endolytic and exolytic depolymerizing mechanisms. Two different strains of E. chrysanthemi secrete a battery of pectate lyases that include random endolytic as well as nonrandom dimer - and nonrandom trimer-generating endolytic/exolytic mechanisms. (author)

Method for including detailed evaluation of daylight levels in Be06

DEFF Research Database (Denmark)

Petersen, Steffen

2008-01-01

Good daylight conditions in office buildings have become an important issue due to new European regulatory demands which include energy consumption for electrical lighting in the building energy frame. Good daylight conditions in offices are thus in increased focus as an energy conserving measure....... In order to evaluate whether a certain design is good daylight design or not building designers must perform detailed evaluation of daylight levels, including the daylight performance of dynamic solar shadings, and include these in the energy performance evaluation. However, the mandatory national...... calculation tool in Denmark (Be06) for evaluating the energy performance of buildings is currently using a simple representation of available daylight in a room and simple assumptions regarding the control of shading devices. In a case example, this is leading to an overestimation of the energy consumption...

Clinical and theoretical results of intraocular lens power calculation for cataract surgery after photorefractive keratectomy for myopia.

NARCIS (Netherlands)

Odenthal, M.T.; Eggink, C.A.; Melles, G.R.J.; Pameyer, J.H.; Geerards, A.J.; Beekhuis, W.H.

2002-01-01

OBJECTIVES: To describe the refractive results of cataract surgery after photorefractive keratectomy (PRK) for patients with myopia, and to find a more accurate method to predict intraocular lens (IOL) power in these cases. DESIGN: Nonrandomized, retrospective clinical study. PATIENTS AND METHODS:

Cultural schema and design activity in an architectural design studio

Directory of Open Access Journals (Sweden)

Gökçe Ketizmen Önal

2017-06-01

Full Text Available Research on the cognitive activities and on the structure and quality of knowledge flow involved in architectural design education is increasing. These studies generally focus on the interaction between student and instructor, including processes such as producing ideas, solving display problems, and integrating design strategies. These studies commonly include computational evaluations and confirmation of the coding of knowledge. They may also include the determination of designer׳s thoughts and cognitive actions of design process, as well as the analysis and digitization of verbal protocols during the design process. In most of these studies, the designer׳s cultural and psychological components are not considered. Accordingly, research on the effects of designers’ cultural schema on design activity in design studios is limited. This study aimed to solve this problem by analyzing the relationship between design activity and the designer׳s cultural schema in a design studio. We performed an experimental study based on a specific conceptual framework and a research model aimed at identifying the relationships among cultural schemas, the architectural design process, and design studios.

Lifestyle intervention for adults with spinal cord injury: Results of the USC-RLANRC Pressure Ulcer Prevention Study.

Science.gov (United States)

Carlson, Mike; Vigen, Cheryl Lp; Rubayi, Salah; Blanche, Erna Imperatore; Blanchard, Jeanine; Atkins, Michal; Bates-Jensen, Barbara; Garber, Susan L; Pyatak, Elizabeth A; Diaz, Jesus; Florindez, Lucia I; Hay, Joel W; Mallinson, Trudy; Unger, Jennifer B; Azen, Stanley Paul; Scott, Michael; Cogan, Alison; Clark, Florence

2017-04-17

Medically serious pressure injuries (MSPrIs), a common complication of spinal cord injury (SCI), have devastating consequences on health and well-being and are extremely expensive to treat. We aimed to test the efficacy of a lifestyle-based intervention designed to reduce incidence of MSPrIs in adults with SCI. A randomized controlled trial (RCT), and a separate study wing involving a nonrandomized standard care control group. Rancho Los Amigos National Rehabilitation Center, a large facility serving ethnically diverse, low income residents of Los Angeles County. Adults with SCI, with history of one or more MSPrIs over the past 5 years: N=166 for RCT component, N=66 in nonrandomized control group. The Pressure Ulcer Prevention Program, a 12-month lifestyle-based treatment administered by healthcare professionals, largely via in-home visits and phone contacts. Blinded assessments of annualized MSPrI incidence rates at 12 and 24 months, based on: skin checks, quarterly phone interviews with participants, and review of medical charts and billing records. Secondary outcomes included number of surgeries and various quality-of-life measures. Annualized MSPrI rates did not differ significantly between study groups. At 12 months, rates were .56 for intervention recipients, .48 for randomized controls, and .65 for nonrandomized controls. At follow-up, rates were .44 and .39 respectively for randomized intervention and control participants. Evidence for intervention efficacy was inconclusive. The intractable nature of MSPrI threat in high-risk SCI populations, and lack of statistical power, may have contributed to this inability to detect an effect. ClinicalTrials.gov NCT01999816.

Albumin in Burn Shock Resuscitation: A Meta-Analysis of Controlled Clinical Studies.

Science.gov (United States)

Navickis, Roberta J; Greenhalgh, David G; Wilkes, Mahlon M

2016-01-01

Critical appraisal of outcomes after burn shock resuscitation with albumin has previously been restricted to small relatively old randomized trials, some with high risk of bias. Extensive recent data from nonrandomized studies assessing the use of albumin can potentially reduce bias and add precision. The objective of this meta-analysis was to determine the effect of burn shock resuscitation with albumin on mortality and morbidity in adult patients. Randomized and nonrandomized controlled clinical studies evaluating mortality and morbidity in adult patients receiving albumin for burn shock resuscitation were identified by multiple methods, including computer database searches and examination of journal contents and reference lists. Extracted data were quantitatively combined by random-effects meta-analysis. Four randomized and four nonrandomized studies with 688 total adult patients were included. Treatment effects did not differ significantly between the included randomized and nonrandomized studies. Albumin infusion during the first 24 hours showed no significant overall effect on mortality. However, significant statistical heterogeneity was present, which could be abolished by excluding two studies at high risk of bias. After those exclusions, albumin infusion was associated with reduced mortality. The pooled odds ratio was 0.34 with a 95% confidence interval of 0.19 to 0.58 (P Albumin administration was also accompanied by decreased occurrence of compartment syndrome (pooled odds ratio, 0.19; 95% confidence interval, 0.07-0.50; P albumin can improve outcomes of burn shock resuscitation. However, the scope and quality of current evidence are limited, and additional trials are needed.

BIOLOGIC AND ECONOMIC EFFECTS OF INCLUDING DIFFERENT ...

African Journals Online (AJOL)

The biologic and economic effects of including three agro-industrial by-products as ingredients in turkey poult diets were investigated using 48 turkey poults in a completely randomised design experiment. Diets were formulated to contain the three by-products – wheat offal, rice husk and palm kernel meal, each at 20% level ...

Conceptual design of heterogeneous azeotropic distillation process for ethanol dehydration using 1-butanol as entrainer

OpenAIRE

Paritta Prayoonyong

2014-01-01

The synthesis of a heterogeneous azeotropic distillation process for ethanol dehydration using 1-butanol as entrainer is presented. The residue curve map of the ethanol/water/1-butanol mixture is computationally generated using non-random twoliquid thermodynamic model. It is found that 1-butanol leads to a residue curve map topological structure different from that generated by typical entrainers used in ethanol dehydration. Synthesis...

Design of a Class of Antennas Utilizing MEMS, EBG and Septum Polarizers including Near-field Coupling Analysis

Science.gov (United States)

Kim, Ilkyu

Recent developments in mobile communications have led to an increased appearance of short-range communications and high data-rate signal transmission. New technologies provides the need for an accurate near-field coupling analysis and novel antenna designs. An ability to effectively estimate the coupling within the near-field region is required to realize short-range communications. Currently, two common techniques that are applicable to the near-field coupling problem are 1) integral form of coupling formula and 2) generalized Friis formula. These formulas are investigated with an emphasis on straightforward calculation and accuracy for various distances between the two antennas. The coupling formulas are computed for a variety of antennas, and several antenna configurations are evaluated through full-wave simulation and indoor measurement in order to validate these techniques. In addition, this research aims to design multi-functional and high performance antennas based on MEMS (Microelectromechanical Systems) switches, EBG (Electromagnetic Bandgap) structures, and septum polarizers. A MEMS switch is incorporated into a slot loaded patch antenna to attain frequency reconfigurability. The resonant frequency of the patch antenna can be shifted using the MEM switch, which is actuated by the integrated bias networks. Furthermore, a high gain base-station antenna utilizing beam-tilting is designed to maximize gain for tilted beam applications. To realize this base-station antenna, an array of four dipole-EBG elements is constructed to implement a fixed down-tilt main beam with application in base station arrays. An improvement of the operating range with the EBG-dipole array is evaluated using a simple linkbudget analysis. The septum polarizer has been widely used in circularly polarized antenna systems due to its simple and compact design and high quality of circularity. In this research, the sigmoid function is used to smoothen the edge in the septum design, which

Rationale and Design of the Reduce Elevated Left Atrial Pressure in Patients With Heart Failure (Reduce LAP-HF) Trial

DEFF Research Database (Denmark)

Hasenfuss, Gerd; Gustafsson, Finn; Kaye, David

2015-01-01

OBJECTIVE: Heart failure with preserved ejection fraction (HFpEF) is characterized by elevated left atrial pressure during rest and/or exercise. The Reduce LAP-HF (Reduce Elevated Left Atrial Pressure in Patients With Heart Failure) trial will evaluate the safety and performance of the Interatrial...... Shunt Device (IASD) System II, designed to directly reduce elevated left atrial pressure, in patients with HFpEF. METHODS: The Reduce LAP-HF Trial is a prospective, nonrandomized, open-label trial to evaluate a novel device that creates a small permanent shunt at the level of the atria. A minimum of 60...... patients with ejection fraction ≥40% and New York Heart Association functional class III or IV heart failure with a pulmonary capillary wedge pressure (PCWP) ≥15 mm Hg at rest or ≥25 mm Hg during supine bike exercise will be implanted with an IASD System II, and followed for 6 months to assess the primary...

Heritability of autistic traits in the general population.

NARCIS (Netherlands)

Hoekstra, R.A.; Bartels, M.; Verweij, C.J.H.; Boomsma, D.I.

2007-01-01

Objective: To explore genetic and environmental influences on individual differences in autistic traits in early adulthood and to test if there is assortative mating (non-random partner choice) for autistic traits in the general population. Design: Twin family study using structural equation

The Effects of Mindfulness-Based Cognitive Therapy on Depressive Symptoms in Elderly Bereaved People with Loss-Related Distress: a Controlled Pilot Study

DEFF Research Database (Denmark)

O Connor, Maja; Piet, Jacob; Hougaard, Esben

2014-01-01

We examined the effects of mindfulness-based cognitive therapy (MBCT) on symptom severity of depression, complicated grief, posttraumatic stress, and working memory in elderly bereaved people with long-term bereavement-related distress. A non-randomized, controlled pilot design was used in a sample...

Sharps injury reduction using a sharps container with enhanced engineering: a 28 hospital nonrandomized intervention and cohort study.

Science.gov (United States)

Grimmond, Terry; Bylund, Suzann; Anglea, Candace; Beeke, Lou; Callahan, Angela; Christiansen, Erik; Flewelling, Kelly; McIntosh, Kathleen; Richter, Kay; Vitale, Monica

2010-12-01

The decrease in reported sharps injuries (SI) in the United States has markedly slowed. Additional devices and strategies need investigation. Sharps containers are associated with SI, and more than 90% of these injuries are related to container design. This study addresses the hypothesis that containers with enhanced engineering can reduce SI. In a before/after intervention study from 2006 to 2008, we examined the impact of conversion to a sharps container with enhanced engineering (the Device) on SI categories in 14 Ascension Health hospitals (study group). The Device's safety features included large horizontal aperture, sensitive counterbalanced door, large atrium, and passive overfill prevention. Study group results were also compared with a control cohort of 14 contemporaneous size-matched, Ascension Health hospitals (control group). The Device was associated with significant reductions in after-procedure (-30%), disposal-related (-57%), and container-associated (-81%) SI in the study group. No significant reductions occurred in container-associated sharps injuries in the control group. Hospitals using the Device had significantly fewer total SI than control hospitals. Enhanced aperture design can significantly reduce container-associated sharps injuries. Other factors contributing to reduced injuries may include 1-hand deposit, safe closure, hand restriction, and preassembly. These results, from a country where sharps safety devices are widespread, are particularly applicable to countries where safety devices are not extensively used. Copyright © 2010 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Impact of a Multifaceted and Clinically Integrated Training Program in Evidence-Based Practice on Knowledge, Skills, Beliefs and Behaviour among Clinical Instructors in Physiotherapy: A Non-Randomized Controlled Study.

Science.gov (United States)

Olsen, Nina Rydland; Bradley, Peter; Espehaug, Birgitte; Nortvedt, Monica Wammen; Lygren, Hildegunn; Frisk, Bente; Bjordal, Jan Magnus

2015-01-01

Physiotherapists practicing at clinical placement sites assigned the role as clinical instructors (CIs), are responsible for supervising physiotherapy students. For CIs to role model evidence-based practice (EBP) they need EBP competence. The aim of this study was to assess the short and long term impact of a six-month multifaceted and clinically integrated training program in EBP on the knowledge, skills, beliefs and behaviour of CIs supervising physiotherapy students. We invited 37 CIs to participate in this non-randomized controlled study. Three self-administered questionnaires were used pre- and post-intervention, and at six-month follow-up: 1) The Adapted Fresno test (AFT), 2) the EBP Belief Scale and 3) the EBP Implementation Scale. The analysis approach was linear regression modeling using Generalized Estimating Equations. In total, 29 CIs agreed to participate in the study: 14 were invited to participate in the intervention group and 15 were invited to participate in the control group. One in the intervention group and five in the control group were lost to follow-up. At follow-up, the group difference was statistically significant for the AFT (mean difference = 37, 95% CI (15.9 -58.1), p students.

Targeted prevention of lifestyle related diseases in the primary care sector – results from the TOF pilot project

DEFF Research Database (Denmark)

Bruun Larsen, Lars; Thilsing, Trine

This abstract reports on the results of a non-randomized pilot study carried out to test the acceptability, feasibility and short-term effects of a healthcare intervention in primary care. The intervention is designed to systematically identify persons at risk of developing lifestyle-related dise...... is facilitated by a digital support system. The pilot makes use of both quantitative and qualitative research methods....... prevention and health promotion is required. This has been attempted in past efforts by offering individual preventive health checks to the general population. However, the evidence on the effectiveness of this approach is mixed. Several systematic reviews, on the other hand, suggest that health checks......This abstract reports on the results of a non-randomized pilot study carried out to test the acceptability, feasibility and short-term effects of a healthcare intervention in primary care. The intervention is designed to systematically identify persons at risk of developing lifestyle...

Solar Design Workbook

Energy Technology Data Exchange (ETDEWEB)

Franta, G.; Baylin, F.; Crowther, R.; Dubin, F.; Grace, A., Griffith, J.W.; Holtz, M.; Kutscher, C.; Nordham, D.; Selkowitz, S.; Villecco, M.

1981-06-01

This Solar Design Workbook presents solar building design applications for commercial buildir^s. The book is divided into four sections. The first section describes the variety of solar applications in buildings including conservation aspects, solar fundamentals, passive systems, active systems, daylighting, and other solar options. Solar system design evaluation techniques including considerations for building energy requirements, passive systems, active systems, and economics are presented in Section II. The third section attempts to assist the designer in the building design process for energy conservation and solar applications including options and considerations for pre-design, design, and post-design phases. The information required for the solar design proee^ has not been fully developed at this time. Therefore, Section III is incomplete, but an overview of the considerations with some of the design proces elements is presented. Section IV illustrates ease studies that utilize solar applications in the building design.

Economic assessment of S-prism including development and generating costs

Energy Technology Data Exchange (ETDEWEB)

Boardman, Ch.E. [GE Nuclear Energy San Jose (United States)

2001-07-01

S-PRISM is an advanced Fast Reactor plant design that utilizes compact modular pool-type reactors sized to enable factory fabrication and an affordable prototype test of a single Nuclear Steam Supply System (NSSS) for design certification at minimum cost and risk. S-PRISM retains all of the key ALMR (advanced liquid metal reactor) design features including passive reactor shutdown, passive shutdown heat removal, and passive reactor cavity cooling that were developed under an earlier DOE program. Key factors that make S-PRISM competitive include: 1) The use of passive safety systems that eliminate the need for diesel generators and hardened active heat sinks to assure that sufficient heat is removed from the core, reactor, and containment systems following design and beyond design basis events. 2) A seven point advantage in the plant capacity factor (93 versus 86%) over a single large plant. 3) A much shorter construction schedule (45%) made possible by a modular design that allows near parallel (sequenced) construction of three relatively small, simple factory fabricated NSSSs instead of one large complex NSSS. This paper describes the approach, methods, and results of an in-depth economic assessment of S-PRISM. The assessment found that the generation cost from an NOAK plant would be less than 3 cents/kW-hr and that a design certification could be obtained in less than 15 years at a cost of 2.1 billion dollars. (authors)

Economic assessment of S-prism including development and generating costs

International Nuclear Information System (INIS)

Boardman, Ch.E.

2001-01-01

S-PRISM is an advanced Fast Reactor plant design that utilizes compact modular pool-type reactors sized to enable factory fabrication and an affordable prototype test of a single Nuclear Steam Supply System (NSSS) for design certification at minimum cost and risk. S-PRISM retains all of the key ALMR (advanced liquid metal reactor) design features including passive reactor shutdown, passive shutdown heat removal, and passive reactor cavity cooling that were developed under an earlier DOE program. Key factors that make S-PRISM competitive include: 1) The use of passive safety systems that eliminate the need for diesel generators and hardened active heat sinks to assure that sufficient heat is removed from the core, reactor, and containment systems following design and beyond design basis events. 2) A seven point advantage in the plant capacity factor (93 versus 86%) over a single large plant. 3) A much shorter construction schedule (45%) made possible by a modular design that allows near parallel (sequenced) construction of three relatively small, simple factory fabricated NSSSs instead of one large complex NSSS. This paper describes the approach, methods, and results of an in-depth economic assessment of S-PRISM. The assessment found that the generation cost from an NOAK plant would be less than 3 cents/kW-hr and that a design certification could be obtained in less than 15 years at a cost of 2.1 billion dollars. (authors)

75 FR 38129 - Freescale Semiconductor, Inc., Hardware/Software Design and Manufacturing A Including On-Site...

Science.gov (United States)

2010-07-01

... Manufacturing A, Austin, Texas. The notice was published in the Federal Register on May 28, 2010 (75 FR 30070...Logic, Inc., Austin, TX; Amended Certification Regarding Eligibility To Apply for Worker Adjustment..., Design Solutions, Inc., Veriseo, SilconElite and MicroLogic, Inc. were employed on-site at the Austin...

The Medical Treatment of New-Onset Peripartum Cardiomyopathy: A Systematic Review of Prospective Studies.

Science.gov (United States)

Desplantie, Olivier; Tremblay-Gravel, Maxime; Avram, Robert; Marquis-Gravel, Guillaume; Ducharme, Anique; Jolicoeur, E Marc

2015-12-01

Peripartum cardiomyopathy (PPCM) is a rare disorder with potentially fatal consequences, which occurs mainly in previously healthy women. The aetiology of PPCM remains unknown and various pathologic mechanisms have been proposed, including immune-mediated injuries and impaired response to oxidative stress and inflammatory cytokines. Several therapies have been studied, but few have been validated in a well-designed randomized controlled trial. In the present study we sought to review the medical treatment intended for acute PPCM. To this end, we performed a systematic review of the literature of randomized and nonrandomized prospective clinical studies. We identified 2 randomized controlled trials that evaluated the dopamine agonist bromocriptine and the inotrope levosimendan, respectively, and 1 nonrandomized study that evaluated the nonselective phosphodiesterase inhibitor pentoxifylline. We reviewed the pathophysiological, pharmacological, and clinical properties for each treatment option identified. Bromocriptine and pentoxifylline both improved left ventricular systolic function and patient-oriented clinical end points and levosimendan did not improve mortality or echocardiographic findings of PPCM. In this review we identified bromocriptine and pentoxifylline, but not levosimendan, as potentially useful agents to improve left ventricle function and outcomes in PPCM. Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

An open-label, non-randomized comparison of venlafaxine and gabapentin as monotherapy or adjuvant therapy in the management of neuropathic pain in patients with peripheral neuropathy

Directory of Open Access Journals (Sweden)

William Eardley

2010-04-01

Full Text Available William Eardley, Cory TothDepartment of Clinical Neurosciences and the University of Calgary, Calgary, AB, CanadaAbstract: Although many therapies are used in the management of neuropathic pain (NeP due to polyneuropathy (PN, few comparison studies exist. We performed a prospective, non-randomized, unblended, efficacy comparison of the serotonin-norepinephrine reuptake inhibitor venlafaxine, as either monotherapy or adjuvant therapy, with a first-line medication for NeP, gabapentin, in patients with PN-related NeP. VAS pain scores were assessed after 3 and 6 months in intervention groups and in a cohort of patients receiving no pharmacotherapy. In a total of 223 patients, we analyzed pain quantity and quality (visual analogue scale [VAS] score, Brief Pain Inventory [BPI], quality of life and health status measures [EuroQol 5 Domains, EQ-5D], Medical Outcomes Sleep Study Scale [MOSSS], Hospital Anxiety and Depression Scale [HADS] and Short Form 36 Health Survey [SF-36] after 6 months of therapy. Significant improvements in VAS pain scores occurred for all treatment groups after 6 months. Improvements in aspects of daily life and anxiety were identified in all treatment groups. Our data suggest that monotherapy or adjuvant therapy with venlafaxine is comparable to gabapentin for NeP management. We advocate for head-to-head, randomized, double-blinded studies of current NeP therapies.Keywords: peripheral neuropathy, neuropathic pain, pharmacotherapy, venlafaxine, gabapentin

The COLOFOL trial: study design and comparison of the study population with the source cancer population

Directory of Open Access Journals (Sweden)

Hansdotter Andersson P

2016-01-01

Full Text Available Pernilla Hansdotter Andersson,1 Peer Wille-Jørgensen,2 Erzsébet Horváth-Puhó,3 Sune Høirup Petersen,2 Anna Martling,4 Henrik Toft Sørensen,3 Ingvar Syk1 On behalf of the COLOFOL Study Group 1Department of Surgery, Skåne University Hospital, Malmö, Sweden; 2Abdominal Disease Center K, Bispebjerg University Hospital, Copenhagen, Denmark; 3Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 4Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden Introduction: The COLOFOL trial, a prospective randomized multicenter trial comparing two follow-up regimes after curative surgical treatment for colorectal cancer, focuses on detection of asymptomatic recurrences. This paper aims to describe the design and recruitment procedure in the COLOFOL trial, comparing demographic characteristics between randomized patients and eligible patients not included in the study. Materials and methods: COLOFOL was designed as a pragmatic trial with wide inclusion criteria and few exclusion criteria, in order to obtain a sample reflecting the general patient population. To be eligible, patients had to be 75 years or younger and curatively resected for stage II or III colorectal cancer. Exclusion criteria were hereditary colorectal cancer, no signed consent, other malignancy, and life expectancy less than 2 years due to concomitant disease. In four of the 24 participating centers, we scrutinized hospital inpatient data to identify all colorectal cancer patients who underwent surgery, in order to ascertain all eligible patients who were not included in the study and to compare them with enrolled patients. Results: Of a total of 4,445 eligible patients, 2,509 patients were randomized (56.4% inclusion rate. A total of 1,221 eligible patients were identified in the scrutinized hospitals, of which 684 (56% were randomized. No difference in age or sex distribution was observed between randomized and nonrandomized

The Need for Design Cases: Disseminating Design Knowledge

Directory of Open Access Journals (Sweden)

Elizabeth Boling

2010-01-01

Full Text Available This article covers the definition of a design case as a specialized and critical form of design knowledge, including discussion of similar types of scholarship that are not design cases and the characteristic ways in which design cases are used. Arguments for developing rigorous design cases are presented.

Story immersion may be effective in promoting diet and physical activity in Chinese children

Science.gov (United States)

This study evaluated the effect of playing a health video game embedded with story immersion, Escape from Diab (Diab), on children's diet and physical activity (PA), and also explored whether children immersed in Diab had greater positive outcomes. The study design employed two groups, nonrandomized...

Radiopharmacy design

International Nuclear Information System (INIS)

Lazarus, C.R.

1985-01-01

The factors which should be considered when designing a radiopharmacy are examined. These include the levels and types of radioactivity and the functions, location, size and layout of the radiopharmacy. Aspects of the design process including environmental cleanliness in enclosed spaces and microbiological safety cabinets are also discussed. Finally the current publications available on recommendations and guidelines for radiopharmacy designs are briefly reviewed. (UK)

Implementation of knowledge-based palliative care in nursing homes and pre-post post evaluation by cross-over design: a study protocol.

Science.gov (United States)

Ahlström, Gerd; Nilsen, Per; Benzein, Eva; Behm, Lina; Wallerstedt, Birgitta; Persson, Magnus; Sandgren, Anna

2018-03-22

The demography of the world is changing as the population is ageing. Because of this change to a higher proportion of older people, the WHO has called for improved palliative care for older persons. A large number of all deaths in the industrialised world occur while older people are living in nursing homes and therefore a key question becomes how the principles of palliative care can be implemented in that context. The aims of this study are: a) to describe a model of an educational intervention with the goal of implementing knowledge-based palliative care in nursing homes, and b) to describe the design of the evaluation of the effectiveness regarding the implementation of knowledge-based palliative care. A complex intervention is evaluated by means of a cross-over design. An educational intervention concerning palliative care consisting of five seminars during 6 months for staff and managers has been developed and conducted in 20 nursing homes in two counties. Before the intervention started, the feasibility was tested in a pilot study conducted in nursing homes not included in the main study. The intervention is evaluated through a non-randomized experimental design with intervention and control groups and pre- and post-assessments. The evaluation includes older persons living in nursing homes, next-of-kin, staff and managers. Data collection consists of quantitative methods such as questionnaires and register data and qualitative methods in the form of individual interviews, focus-group interviews and participant observations. The research will contribute to new knowledge about how to implement knowledge-based palliative care in a nursing home setting. A strength of this project is that the Medical Research Council framework of complex intervention is applied. The four recommended stages, Development, Feasibility and piloting, Evaluation and Implementation, are combined for the educational intervention, which functions as a strategy to achieve knowledge

Assessing the Eventual Publication of Clinical Trial Abstracts Submitted to a Large Annual Oncology Meeting.

Science.gov (United States)

Massey, Paul R; Wang, Ruibin; Prasad, Vinay; Bates, Susan E; Fojo, Tito

2016-03-01

Despite the ethical imperative to publish clinical trials when human subjects are involved, such data frequently remain unpublished. The objectives were to tabulate the rate and ascertain factors associated with eventual publication of clinical trial results reported as abstracts in the Proceedings of the American Society of Clinical Oncology (American Society of Clinical Oncology). Abstracts describing clinical trials for patients with breast, lung, colorectal, ovarian, and prostate cancer from 2009 to 2011 were identified by using a comprehensive online database (http://meetinglibrary.asco.org/abstracts). Abstracts included reported results of a treatment or intervention assessed in a discrete, prospective clinical trial. Publication status at 4-6 years was determined by using a standardized search of PubMed. Primary outcomes were the rate of publication for abstracts of randomized and nonrandomized clinical trials. Secondary outcomes included factors influencing the publication of results. A total of 1,075 abstracts describing 378 randomized and 697 nonrandomized clinical trials were evaluated. Across all years, 75% of randomized and 54% of nonrandomized trials were published, with an overall publication rate of 61%. Sample size was a statistically significant predictor of publication for both randomized and nonrandomized trials (odds ratio [OR] per increase of 100 participants = 1.23 [1.11-1.36], p publication (OR 2.37, p = .013; and 2.21, p = .01, respectively). Among nonrandomized studies, phase II trials were more likely to be published than phase I (p publication in randomized (OR 0.76 [0.38-1.52]; p = .441) or nonrandomized trials (OR 0.89 [0.61-1.29]; p = .532). This is the largest reported study examining why oncology trials are not published. The data show that 4-6 years after appearing as abstracts, 39% of oncology clinical trials remain unpublished. Larger sample size and advanced trial phase were associated with eventual publication; among randomized

Does Increased Exercise or Physical Activity Alter Ad-Libitum Daily Energy Intake or Macronutrient Composition in Healthy Adults? A Systematic Review

Science.gov (United States)

Donnelly, Joseph E.; Herrmann, Stephen D.; Lambourne, Kate; Szabo, Amanda N.; Honas, Jeffery J.; Washburn, Richard A.

2014-01-01

Background The magnitude of the negative energy balance induced by exercise may be reduced due to compensatory increases in energy intake. Objective To address the question: Does increased exercise or physical activity alter ad-libitum daily energy intake or macronutrient composition in healthy adults? Data Sources PubMed and Embase were searched (January 1990–January 2013) for studies that presented data on energy and/or macronutrient intake by level of exercise, physical activity or change in response to exercise. Ninety-nine articles (103 studies) were included. Study Eligibility Criteria Primary source articles published in English in peer-reviewed journals. Articles that presented data on energy and/or macronutrient intake by level of exercise or physical activity or changes in energy or macronutrient intake in response to acute exercise or exercise training in healthy (non-athlete) adults (mean age 18–64 years). Study Appraisal and Synthesis Methods Articles were grouped by study design: cross-sectional, acute/short term, non-randomized, and randomized trials. Considerable heterogeneity existed within study groups for several important study parameters, therefore a meta-analysis was considered inappropriate. Results were synthesized and presented by study design. Results No effect of physical activity, exercise or exercise training on energy intake was shown in 59% of cross-sectional studies (n = 17), 69% of acute (n = 40), 50% of short-term (n = 10), 92% of non-randomized (n = 12) and 75% of randomized trials (n = 24). Ninety-four percent of acute, 57% of short-term, 100% of non-randomized and 74% of randomized trials found no effect of exercise on macronutrient intake. Forty-six percent of cross-sectional trials found lower fat intake with increased physical activity. Limitations The literature is limited by the lack of adequately powered trials of sufficient duration, which have prescribed and measured exercise energy expenditure

TOOLS TO INCLUDE BLIND STUDENTS IN SCHOOL BUILDING PERFORMANCE ASSESSMENTS

Directory of Open Access Journals (Sweden)

Tania Pietzschke Abate

2016-05-01

Full Text Available This article discusses the design of data collection instruments that include the opinions of blind students, in accordance with the principles of Universal Design (UD. The aim of this study is to understand the importance of adapting data collection instruments for the inclusion of disabled persons in field research in Architecture and Design, among other fields. The data collection instruments developed were a play interview with a tactile map and a 3D survey with the use of tactile models. These instruments sought to assess the school environment experienced by blind students. The study involved students from the early years of a school for the blind who had not yet mastered the Braille system. The participation of these students was evaluated. A multidisciplinary team consisting of architects, designers, educators, and psychologists lent support to the study. The results showed that the data collection instruments adapted to blind students were successful in making the group of authors examine questions regarding UD. An analysis of the participatory phase showed that the limitations resulting from blindness determine the specificities in the adaptation and implementation process of the instruments in schools. Practical recommendations for future studies related to instruments in the UD thematic are presented. This approach is in line with the global trend of including disabled persons in society based on these users’ opinions concerning what was designed by architects and designers.

Effect of cognitive behavioral group therapy for recovery of self-esteem on community-living individuals with mental illness: Non-randomized controlled trial.

Science.gov (United States)

Kunikata, Hiroko; Yoshinaga, Naoki; Nakajima, Kazuo

2016-10-01

The aim of this study was to examine over a 12-month post-intervention period whether the participation of community-living individuals with mental illness in cognitive behavioral group therapy for recovery of self-esteem (CBGTRS) resulted in improved outcomes. This was a non-randomized controlled trial. The participants were persons with mental illness who resided in communities in the Chugoku region of Japan. In total, 41 were assigned to an experimental group (CBGTRS intervention, 12 group sessions), and 21 to a control group. Outcome indices (self-esteem, moods, cognition, subjective well-being, psychiatric symptoms) were measured for the experimental group prior to intervention (T0), immediately post-intervention (T1), and at 3 (T2) and 12 (T3) months post-intervention. The control group was measured at the same intervals. For the experimental group, self-esteem scores at T1, T2, and T3 were significantly higher than at T0. Moods and cognition scores remained significantly low until T2. Scores for Inadequate Mental Mastery in the subjective well-being index had not decreased by T3. Confidence in Coping remained significantly high until T2. Psychiatric symptoms scores at T0, T1, T2, and T3 were significantly lower than at T0. The means and standard errors for self-esteem and Inadequate Mental Mastery increased until T3, and those for Tension-Anxiety, Depression-Dejection, and Confusion decreased until T2. From within-group trends and between-group differences in self-esteem, we conclude that CBGTRS may have a relatively long-term effect on self-esteem recovery. T2 is the turning point for moods and cognition; thus, follow-up is needed 3 months following the initial program. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

Design theory

CERN Document Server

2009-01-01

This book deals with the basic subjects of design theory. It begins with balanced incomplete block designs, various constructions of which are described in ample detail. In particular, finite projective and affine planes, difference sets and Hadamard matrices, as tools to construct balanced incomplete block designs, are included. Orthogonal latin squares are also treated in detail. Zhu's simpler proof of the falsity of Euler's conjecture is included. The construction of some classes of balanced incomplete block designs, such as Steiner triple systems and Kirkman triple systems, are also given.

Analog circuit design designing dynamic circuit response

CERN Document Server

Feucht, Dennis

2010-01-01

This second volume, Designing Dynamic Circuit Response builds upon the first volume Designing Amplifier Circuits by extending coverage to include reactances and their time- and frequency-related behavioral consequences.

Knowledge translation strategies for enhancing nurses' evidence-informed decision making: a scoping review.

Science.gov (United States)

Yost, Jennifer; Thompson, David; Ganann, Rebecca; Aloweni, Fazila; Newman, Kristine; McKibbon, Ann; Dobbins, Maureen; Ciliska, Donna

2014-06-01

Nurses are increasingly expected to engage in evidence-informed decision making (EIDM); the use of research evidence with information about patient preferences, clinical context and resources, and their clinical expertise in decision making. Strategies for enhancing EIDM have been synthesized in high-quality systematic reviews, yet most relate to physicians or mixed disciplines. Existing reviews, specific to nursing, have not captured a broad range of strategies for promoting the knowledge and skills for EIDM, patient outcomes as a result of EIDM, or contextual information for why these strategies "work." To conduct a scoping review to identify and map the literature related to strategies implemented among nurses in tertiary care for promoting EIDM knowledge, skills, and behaviours, as well as patient outcomes and contextual implementation details. A search strategy was developed and executed to identify relevant research evidence. Participants included registered nurses, clinical nurse specialists, nurse practitioners, and advanced practice nurses. Strategies were those enhancing nurses' EIDM knowledge, skills, or behaviours, as well as patient outcomes. Relevant studies included systematic reviews, randomized controlled trials, cluster randomized controlled trials, non-randomized trials (including controlled before and after studies), cluster non-randomized trials, interrupted time series designs, prospective cohort studies, mixed-method studies, and qualitative studies. Two reviewers performed study selection and data extraction using standardized forms. Disagreements were resolved through discussion or third party adjudication. Using a narrative synthesis, the body of research was mapped by design, clinical areas, strategies, and provider and patient outcomes to determine areas appropriate for a systematic review. There are a sufficiently high number of studies to conduct a more focused systematic review by care settings, study design, implementation strategies

Long-term effectiveness of a quality improvement program for patients with type 2 diabetes in general practice.

NARCIS (Netherlands)

Renders, C.M.; Valk, G.D.; Franse, L.V.; Schellevis, F.; Eijk, J.T.M. van; Wal, G. van der

2001-01-01

OBJECTIVE— To assess the long-term effectiveness of a quality improvement program on care provided and patient outcomes in patients with diabetes. RESEARCH DESIGN AND METHODS— A nonrandomized trial was performed with 312 patients with type 2 diabetes in the intervention group and 77 patients with

TP53 status and taxane-platinum versus platinum-based therapy in ovarian cancer patients: A non-randomized retrospective study

Directory of Open Access Journals (Sweden)

Markowska Janina

2008-01-01

Full Text Available Abstract Background Taxane-platinum therapy (TP has replaced platinum-based therapy (PC or PAC, DNA damaging chemotherapy in the postoperative treatment of ovarian cancer patients; however, it is not always effective. TP53 protein plays a differential role in response to DNA-damaging agents and taxanes. We sought to define profiles of patients who benefit the most from TP and also of those who can be treated with PC. Methods We compared the effectiveness of PC/PAC (n = 253 and TP (n = 199 with respect to tumor TP53 accumulation in ovarian cancer patients with FIGO stage IIB-IV disease; this was a non-randomized retrospective study. Immunohistochemical analysis was performed on 452 archival tumors; univariate and multivariate analysis by the Cox's and logistic regression models was performed in all patients and in subgroups with [TP53(+] and without TP53 accumulation [TP53(-]. Results The advantage of taxane-platinum therapy over platinum-based therapy was seen in the TP53(+, and not in the TP53(- group. In the TP53(+ group taxane-platinum therapy enhanced the probability of complete remission (p = .018, platinum sensitivity (p = .014, platinum highly sensitive response (p = .038 and longer survival (OS, p = .008. Poor tumor differentiation diminished the advantage from taxane-platinum therapy in the TP53(+ group. In the TP53(- group PC/PAC was at least equally efficient as taxane-platinum therapy and it enhanced the chance of platinum highly sensitive response (p = .010. However, in the TP53(- group taxane-platinum therapy possibly diminished the risk of death in patients over 53 yrs (p = .077. Among factors that positively interacted with taxane-platinum therapy in some analyses were endometrioid and clear cell type, FIGO III stage, bulky residual tumor, more advanced age of patient and moderate tumor differentiation. Conclusion Our results suggest that taxane-platinum therapy is particularly justified in patients with TP53(+ tumors or older

The effects of a life goal-setting technique in a preventive care program for frail community-dwelling older people: a cluster nonrandomized controlled trial.

Science.gov (United States)

Yuri, Yoshimi; Takabatake, Shinichi; Nishikawa, Tomoko; Oka, Mari; Fujiwara, Taro

2016-05-12

Frailty among older people is associated with an increased risk of needing care. There have been many reports on preventive care programs for frail older people, but few have shown positive effects on disability prevention. Physical exercise programs for frail older people affect elements such as physical fitness and balance, but are less effective for disability outcomes and are not followed up in the longer term. We developed a life goal-setting technique (LGST). Our objective was to determine the effect of a LGST plus standard preventive care program for community-dwelling frail older people. We used a cluster nonrandomized controlled trial with seven intervention and nine matched control groups, with baseline assessment and follow-up at 3, 6, and 9 months. Participants were 176 frail older people, aged 65 years or over, living in the community in Izumi, Osaka, Japan. All participants attended regular 120 min preventive care exercise classes each week, over 3 months. They also received oral care and nutrition education. The intervention groups alone received life goal-setting support. We assessed outcomes longitudinally, comparing pre-intervention with follow-up. The primary outcome measure was health improvement according to the Japanese Ministry of Health, Labour and Welfare's "Kihon Checklist" for assessment of frailty and quality of life (QOL), analyzed with a two-way ANOVA and post-test comparison. Secondary outcomes included physical functions and assessment of life goals. The improvement on the Kihon Checklist for the intervention group was approximately 60 % from baseline to 9-months follow-up; the control group improved by approximately 40 %. The difference between groups was significant at 3-month (p = 0.043) and 6-month (p = 0.015) follow-ups but not at 9-month (p = 0.098) follow-up. Analysis of QOL yielded a significant time × group interaction effect (p = 0.022). The effect was significant at 3 months in the intervention

Overweight and obesity in Slovak high school students and body composition indicators: a non-randomized cross-sectional study

Directory of Open Access Journals (Sweden)

Bibiana Vadasova

2016-08-01

Full Text Available Abstract Background Physical development can be considered as an indicator of the overall health status of the youth population. Currently, it appears that the increasing trend of the prevalence of obesity among children and youths has stopped in a number of countries worldwide. Studies point to the fact that adolescence is a critical period for the development of obesity. Body mass index (BMI seems to be an orientation parameter in the assessment of prevalence of obesity which is not sufficient for more accurate identification of at risk individuals. The purpose of this study was to evaluate association between BMI percentile zones as health-risk for being overweight and obese and body composition indicators in high-school students from the Prešov (Slovakia region. Methods A non-randomized cross-sectional study in high school students from the Prešov (Slovakia region was conducted. The research sample consisted of 1014 participants (boys n = 466, girls n = 549. Body composition was measured using direct segmental multi-frequency bioelectrical impedance analysis (DSM-BIA. To examine the association between obesity and selected body composition indicators, Kruskal-Wallis ANOVA and Eta2 were used. The relationship between selected body composition indicators and percentile BMI zones was determined using the Kendall tau correlation. Results In groups with different BMI percentile zones (normal weight, overweight, obese, ANOVA showed significant differences for girls and boys (p ˂.05 with high effect size (η2 ˂.26 in body weight, body fat mass index, body fat percentage, fat free mass index, fat-free mass percentage, visceral fat area, waist-to-hip ratio, waist circumference, protein mass and mineral mass. The highest degree of correlation among boys was between BMI values indicating overweight and obesity and fat free mass index and waist circumference, respectively (τ = .71, τ = .70, respectively. In girls, the highest

Evaluating the Effectiveness of an Antimicrobial Stewardship Program on Reducing the Incidence Rate of Healthcare-Associated Clostridium difficile Infection: A Non-Randomized, Stepped Wedge, Single-Site, Observational Study.

Science.gov (United States)

DiDiodato, Giulio; McArthur, Leslie

2016-01-01

The incidence rate of healthcare-associated Clostridium difficile infection (HA-CDI) is estimated at 1 in 100 patients. Antibiotic exposure is the most consistently reported risk factor for HA-CDI. Strategies to reduce the risk of HA-CDI have focused on reducing antibiotic utilization. Prospective audit and feedback is a commonly used antimicrobial stewardship intervention (ASi). The impact of this ASi on risk of HA-CDI is equivocal. This study examines the effectiveness of a prospective audit and feedback ASi on reducing the risk of HA-CDI. Single-site, 339 bed community-hospital in Barrie, Ontario, Canada. Primary outcome is HA-CDI incidence rate. Daily prospective and audit ASi is the exposure variable. ASi implemented across 6 wards in a non-randomized, stepped wedge design. Criteria for ASi; any intravenous antibiotic use for ≥ 48 hrs, any oral fluoroquinolone or oral second generation cephalosporin use for ≥ 48 hrs, or any antimicrobial use for ≥ 5 days. HA-CDI cases and model covariates were aggregated by ward, year and month starting September 2008 and ending February 2016. Multi-level mixed effect negative binomial regression analysis was used to model the primary outcome, with intercept and slope coefficients for ward-level random effects estimated. Other covariates tested for inclusion in the final model were derived from previously published risk factors. Deviance residuals were used to assess the model's goodness-of-fit. The dataset included 486 observation periods, of which 350 were control periods and 136 were intervention periods. After accounting for all other model covariates, the estimated overall ASi incidence rate ratio (IRR) was 0.48 (95% 0.30, 0.79). The ASi effect was independent of antimicrobial utilization. The ASi did not seem to reduce the risk of Clostridium difficile infection on the surgery wards (IRR 0.87, 95% CI 0.45, 1.69) compared to the medicine wards (IRR 0.42, 95% CI 0.28, 0.63). The ward-level burden of Clostridium

Evaluating the Effectiveness of an Antimicrobial Stewardship Program on Reducing the Incidence Rate of Healthcare-Associated Clostridium difficile Infection: A Non-Randomized, Stepped Wedge, Single-Site, Observational Study.

Directory of Open Access Journals (Sweden)

Giulio DiDiodato

Full Text Available The incidence rate of healthcare-associated Clostridium difficile infection (HA-CDI is estimated at 1 in 100 patients. Antibiotic exposure is the most consistently reported risk factor for HA-CDI. Strategies to reduce the risk of HA-CDI have focused on reducing antibiotic utilization. Prospective audit and feedback is a commonly used antimicrobial stewardship intervention (ASi. The impact of this ASi on risk of HA-CDI is equivocal. This study examines the effectiveness of a prospective audit and feedback ASi on reducing the risk of HA-CDI.Single-site, 339 bed community-hospital in Barrie, Ontario, Canada. Primary outcome is HA-CDI incidence rate. Daily prospective and audit ASi is the exposure variable. ASi implemented across 6 wards in a non-randomized, stepped wedge design. Criteria for ASi; any intravenous antibiotic use for ≥ 48 hrs, any oral fluoroquinolone or oral second generation cephalosporin use for ≥ 48 hrs, or any antimicrobial use for ≥ 5 days. HA-CDI cases and model covariates were aggregated by ward, year and month starting September 2008 and ending February 2016. Multi-level mixed effect negative binomial regression analysis was used to model the primary outcome, with intercept and slope coefficients for ward-level random effects estimated. Other covariates tested for inclusion in the final model were derived from previously published risk factors. Deviance residuals were used to assess the model's goodness-of-fit.The dataset included 486 observation periods, of which 350 were control periods and 136 were intervention periods. After accounting for all other model covariates, the estimated overall ASi incidence rate ratio (IRR was 0.48 (95% 0.30, 0.79. The ASi effect was independent of antimicrobial utilization. The ASi did not seem to reduce the risk of Clostridium difficile infection on the surgery wards (IRR 0.87, 95% CI 0.45, 1.69 compared to the medicine wards (IRR 0.42, 95% CI 0.28, 0.63. The ward-level burden of

Design of systems on a chip design and test

CERN Document Server

Reis, Ricardo; Jess, Jochen AG

2007-01-01

Addresses the design challenges associated with generations of the semiconductor technology. This book includes contributions on three different, but complementary axes: core design, computer-aided design tools and test methods. A collection of chapters deal with the heterogeneity aspect of core designs.

Peer tutoring – assisted instruction, parent supportiveness and ...

African Journals Online (AJOL)

The study investigated the effect of peer tutoring-assisted instruction, parent supportiveness and students locus of control on achievement in Senior Secondary Mathematics. It adopted a non-randomized pretest posttest control group design in a quasi experimental setting. It involves 300 senior secondary II students from six ...

The Role of Need for Contraception in the Evaluation of Interventions to Improve Access to Family-Planning Methods

Science.gov (United States)

Leon, Federico R.; Lundgren, Rebecka; Sinai, Irit; Jennings, Victoria

2011-01-01

A nonrandomized experiment carried out in Jharkhand, India, shows how the effects of interventions designed to improve access to family-planning methods can be erroneously regarded as trivial when contraceptive use is utilized as dependent variable, ignoring women's need for contraception. Significant effects of the intervention were observed on…

Testing the "Learning Journey" of MSW Students in a Rural Program

Science.gov (United States)

Wall, Misty L.; Rainford, Will

2013-01-01

Using a quasi-experimental one-group, pretest-posttest design with non-random convenience sampling, the researchers assessed 61 advanced standing MSW students who matriculated at a rural intermountain Northwest school of social work. Changes in students' knowledge and attitudes toward lesbian, gay, and bisexual (LGB) people were measured using…

The effects of early prevention programs for families with young children at risk for physical child abuse and neglect : A meta-analysis

NARCIS (Netherlands)

Geeraert, L; Van den Noortgate, W; Grietens, H; Onghena, P

In this article, a meta-analysis is presented on 40 evaluation studies of early prevention programs for families with young children at risk for physical child abuse and neglect with mostly nonrandomized designs. The main aim of all programs was to prevent physical child abuse and neglect by

A recurrent deletion syndrome at chromosome bands 2p11.2-2p12 flanked by segmental duplications at the breakpoints and including REEP1.

Science.gov (United States)

Stevens, Servi J C; Blom, Eveline W; Siegelaer, Ingrid T J; Smeets, Eric E J G L

2015-04-01

We identified an identical and recurrent 9.4-Mbp deletion at chromosome bands 2p11.2-2p12, which occurred de novo in two unrelated patients. It is flanked at the distal and proximal breakpoints by two homologous segmental duplications consisting of low copy repeat (LCR) blocks in direct orientation, which have >99% sequence identity. Despite the fact that the deletion was almost 10 Mbp in size, the patients showed a relatively mild clinical phenotype, that is, mild-to-moderate intellectual disability, a happy disposition, speech delay and delayed motor development. Their phenotype matches with that of previously described patients. The 2p11.2-2p12 deletion includes the REEP1 gene that is associated with spastic paraplegia and phenotypic features related to this are apparent in most 2p11.2-2p12 deletion patients, but not in all. Other hemizygous genes that may contribute to the clinical phenotype include LRRTM1 and CTNNA2. We propose a recurrent but rare 2p11.2-2p12 deletion syndrome based on (1) the identical, non-random localisation of the de novo deletion breakpoints in two unrelated patients and a patient from literature, (2) the patients' phenotypic similarity and their phenotypic overlap with other 2p deletions and (3) the presence of highly identical LCR blocks flanking both breakpoints, consistent with a non-allelic homologous recombination (NAHR)-mediated rearrangement.

Weight management for adolescents with intellectual and developmental disabilities: Rationale and design for an 18month randomized trial.

Science.gov (United States)

Donnelly, J E; Ptomey, L T; Goetz, J R; Sullivan, D K; Gibson, C A; Greene, J L; Lee, R H; Mayo, M S; Honas, J J; Washburn, R A

2016-11-01

Adolescents with intellectual and developmental disabilities (IDD) are an underserved group in need of weight management. However, information regarding effective weight management for this group is limited, and is based primarily on results from small, non-powered, non-randomized trials that were not conducted in accordance with current weight management guidelines. Additionally, the comparative effectiveness of emerging dietary approaches, such as portion-controlled meals (PCMs) or program delivery strategies such as video chat using tablet computers have not been evaluated. Therefore, we will conduct an 18month trial to compare weight loss (6months) and maintenance (7-18months) in 123 overweight/obese adolescents with mild to moderate IDD, and a parent, randomized to a weight management intervention delivered remotely using FaceTime™ on an iPad using either a conventional meal plan diet (RD/CD) or a Stop Light diet enhanced with PCMs (RD/eSLD), or conventional diet delivered during face-to-face home visits (FTF/CD). This design will provide an adequately powered comparison of both diet (CD vs. eSLD) and delivery strategy (FTF vs. RD). Exploratory analyses will examine the influence of behavioral session attendance, compliance with recommendations for diet (energy intake), physical activity (min/day), self-monitoring of diet and physical activity, medications, and parental variables including diet quality, physical activity, baseline weight, weight change, and beliefs and attitudes regarding diet and physical activity on both weight loss and maintenance. We will also complete a cost and contingent valuation analysis to compare costs between RD and FTF delivery. Copyright © 2016. Published by Elsevier Inc.

VLSI design

CERN Document Server

Chandrasetty, Vikram Arkalgud

2011-01-01

This book provides insight into the practical design of VLSI circuits. It is aimed at novice VLSI designers and other enthusiasts who would like to understand VLSI design flows. Coverage includes key concepts in CMOS digital design, design of DSP and communication blocks on FPGAs, ASIC front end and physical design, and analog and mixed signal design. The approach is designed to focus on practical implementation of key elements of the VLSI design process, in order to make the topic accessible to novices. The design concepts are demonstrated using software from Mathworks, Xilinx, Mentor Graphic

Project Interface Requirements Process Including Shuttle Lessons Learned

Science.gov (United States)

Bauch, Garland T.

2010-01-01

Most failures occur at interfaces between organizations and hardware. Processing interface requirements at the start of a project life cycle will reduce the likelihood of costly interface changes/failures later. This can be done by adding Interface Control Documents (ICDs) to the Project top level drawing tree, providing technical direction to the Projects for interface requirements, and by funding the interface requirements function directly from the Project Manager's office. The interface requirements function within the Project Systems Engineering and Integration (SE&I) Office would work in-line with the project element design engineers early in the life cycle to enhance communications and negotiate technical issues between the elements. This function would work as the technical arm of the Project Manager to help ensure that the Project cost, schedule, and risk objectives can be met during the Life Cycle. Some ICD Lessons Learned during the Space Shuttle Program (SSP) Life Cycle will include the use of hardware interface photos in the ICD, progressive life cycle design certification by analysis, test, & operations experience, assigning interface design engineers to Element Interface (EI) and Project technical panels, and linking interface design drawings with project build drawings

Relationship of nocturnal concentrations of melatonin, gamma-aminobutyric acid and total antioxidants in peripheral blood with insomnia after stroke: study protocol for a prospective non-randomized controlled trial

Institute of Scientific and Technical Information of China (English)

Wei Zhang; Fang Li; Tong Zhang

2017-01-01

Melatonin and gamma-aminobutyric acid (GABA) have been shown to regulate sleep. The nocturnal concentrations of melatonin, GABA and total antioxidants may relate to insomnia in stroke patients. In this prospective single-center non-randomized controlled clinical trial performed in the China Rehabilitation Research Center, we analyzed the relationship of nocturnal concentrations of melatonin, GABA and total antioxidants with insomnia after stroke. Patients during rehabilitation of stroke were recruited and assigned to the insomnia group or non-insomnia group. Simultaneously, persons without stroke or insomnia served as normal controls. Each group contained 25 cases. The primary outcome was nocturnal concentrations of melatonin, GABA and total antioxidants in peripheral blood. The secondary outcomes were Pittsburgh Sleep Quality Index, Insomnia Severity Index, Epworth Sleepiness Scale, Fatigue Severity Scale, Morningness-Eveningness Questionnaire (Chinese version), and National Institute of Health Stroke Scale. The relationship of nocturnal concentrations of melatonin, GABA and total antioxidants with insomnia after stroke was analyzed and showed that they were lower in the insomnia group than in the non-insomnia group. The severity of stroke was higher in the insomnia group than in the non-insomnia group. Correlation analysis demonstrated that the nocturnal concentrations of melatonin and GABA were associated with insomnia after stroke. This trial was regis-tered at ClinicalTrials.gov, identifier: NCT03202121.

Long-Term Effects of Neurofeedback Treatment in Autism

Science.gov (United States)

Kouijzer, Mirjam E. J.; de Moor, Jan M. H.; Gerrits, Berrie J. L.; Buitelaar, Jan K.; van Schie, Hein T.

2009-01-01

Previously we demonstrated significant improvement of executive functions and social behavior in children with autism spectrum disorders (ASD) treated with 40 sessions of EEG neurofeedback in a nonrandomized waiting list control group design. In this paper we extend these findings by reporting the long-term results of neurofeedback treatment in…

Stage-Based Healthy Lifestyles Program for Non-College Young Adults

Science.gov (United States)

Walsh, Jennifer; Kattelmann, Kendra; White, Adrienne

2017-01-01

Purpose: The purpose of this paper is to test the feasibility of implementing a healthy lifestyles intervention to maintain or achieve healthy weight for low-income young adults in vocational education. Design/methodology/approach: Non-randomized, quasi-experimental feasibility test of a ten-week intervention with follow-up assessment designed…

Effect of Programmed Instruction on Students' Attitude towards Structure of the Atom and the Periodic Table among Kenyan Secondary Schools

Science.gov (United States)

Wangila, M. J.; Martin, W.; Ronald, M.

2015-01-01

This study examined the effect of Programmed Instruction on students' attitude towards Structure of the Atom and the Periodic Table (SAPT) among mixed (co-educational) secondary schools of Butere district, Kakamega county, Kenya. The quasi-experimental research design was adopted, using the nonrandomized Solomon four-group as a model. The sample…

Effects of Teaching Gardening on Science Students' Attitudes toward Entrepreneurial Skills Acquisition in Jos South, Plateau State, Nigeria

Science.gov (United States)

Charity, Dimlong; Ozoji, Bernadette Ebele; Osasebor, Florence Osaze; Ibn Umar, Suleiman

2017-01-01

This study investigated the effects of teaching gardening on science students' attitudes toward entrepreneurial skills acquisition in Jos South, Plateau State, Nigeria. The study employed the non-randomized pre-test post-test non-equivalent control group design. A sample of 75 senior secondary school students from two intact classes, randomly…

Participatory Design of Websites with Web Design Workshops

Directory of Open Access Journals (Sweden)

Alison Bersani

2008-03-01

Full Text Available At the University of Rochester's River Campus Libraries we have included users in technology development with great success. "Participatory design" entails collaboration among designers, developers, and users from the earliest stages of conception through to implementation of websites and other technology. Using participatory methods, a project to redesign the library website began with workshops to identify user needs and preferences. The results of these workshops led to the identification of key tasks for the main page. They also generated a hierarchy of tasks for sub-pages and rich information about how students and faculty members use current websites in their work. In our article, we explain our reasons for running participatory design workshops, describe our methods, review participants and recruitment, and summarize key findings. We also include information about our local implementation and general conclusions about the value of design workshops for website design and development.

Shoreline ecology program for Prince William Sound, Alaska, following the Exxon Valdez oil spill. Part 3: Biology

International Nuclear Information System (INIS)

Gilfillan, E.S.; Page, D.S.; Harner, E.J.; Boehm, P.D.

1995-01-01

This study describes the biological results of a comprehensive shoreline ecology program designed to assess ecological recovery in Prince William Sound following the Exxon Valdez oil spill on march 24, 1989. The program is an application of the ''Sediment Quality Triad'' approach, combining chemical, toxicological, and biological measurements. The study was designed so that results could be extrapolated to the entire spill zone in Prince William Sound. The spill affected four major shoreline habitat types in Prince William Sound: pebble/gravel, boulder/cobble, sheltered bedrock, and exposed bedrock. The study design had two components: (1) one-time stratified random sampling at 64 sites representing four habitats and four oiling levels (including unoiled reference sites) and (2) periodic sampling at 12 nonrandomly chosen sites that included some of the most heavily oiled locations in the sound. Biological communities on rock surfaces and in intertidal and shallow subtidal sediments were analyzed for differences resulting from to oiling in each of 16 habitat/tide zone combinations. Statistical methods included univariate analyses of individual species abundances and community parameter variables (total abundance, species richness, and Shannon diversity), and multivariate correspondence analysis of community structure. 58 refs., 13 figs., 9 tabs

Algorithms in combinatorial design theory

CERN Document Server

Colbourn, CJ

1985-01-01

The scope of the volume includes all algorithmic and computational aspects of research on combinatorial designs. Algorithmic aspects include generation, isomorphism and analysis techniques - both heuristic methods used in practice, and the computational complexity of these operations. The scope within design theory includes all aspects of block designs, Latin squares and their variants, pairwise balanced designs and projective planes and related geometries.

Sensorless Speed Control including zero speed of Non Salient PM Synchronous Drives

DEFF Research Database (Denmark)

Rasmussen, Henrik

This paper presents a position sensorless drive of non salient pole PM synchronous motors for all speeds including zero speed. Using adaptive Lyapunov design a new approach for the design of an observer is developed. The resulting scheme leads to a nonlinear full order observer for the motor states...

Sensorless Speed Control including zero speed of Non Salient PM Synchronous Drives

DEFF Research Database (Denmark)

Rasmussen, Henrik

2005-01-01

This paper presents a position sensorless drive of non salient pole PM synchronous motors for all speeds including zero speed. Using adaptive Lyapunov design a new approach for the design of an observer is developed. The resulting scheme leads to a nonlinear full order observer for the motor states...

Sensorless speed Control including Zero Speed on Non Salient PM Synchronous Drives

DEFF Research Database (Denmark)

Rasmussen, Henrik

2006-01-01

This paper presents a position sensorless drive of non salient pole PM synchronous motors for all speeds including zero speed. Using adaptive Lyapunov design a new approach for the design of an observer is developed. The resulting scheme leads to a nonlinear full order observer for the motor states...

Structural design principles of complex bird songs: a network-based approach.

Directory of Open Access Journals (Sweden)

Kazutoshi Sasahara

Full Text Available Bird songs are acoustic communication signals primarily used in male-male aggression and in male-female attraction. These are often monotonous patterns composed of a few phrases, yet some birds have extremely complex songs with a large phrase repertoire, organized in non-random fashion with discernible patterns. Since structure is typically associated with function, the structures of complex bird songs provide important clues to the evolution of animal communication systems. Here we propose an efficient network-based approach to explore structural design principles of complex bird songs, in which the song networks--transition relationships among different phrases and the related structural measures--are employed. We demonstrate how this approach works with an example using California Thrasher songs, which are sequences of highly varied phrases delivered in succession over several minutes. These songs display two distinct features: a large phrase repertoire with a 'small-world' architecture, in which subsets of phrases are highly grouped and linked with a short average path length; and a balanced transition diversity amongst phrases, in which deterministic and non-deterministic transition patterns are moderately mixed. We explore the robustness of this approach with variations in sample size and the amount of noise. Our approach enables a more quantitative study of global and local structural properties of complex bird songs than has been possible to date.

Network optimization including gas lift and network parameters under subsurface uncertainty

Energy Technology Data Exchange (ETDEWEB)

Schulze-Riegert, R.; Baffoe, J.; Pajonk, O. [SPT Group GmbH, Hamburg (Germany); Badalov, H.; Huseynov, S. [Technische Univ. Clausthal, Clausthal-Zellerfeld (Germany). ITE; Trick, M. [SPT Group, Calgary, AB (Canada)

2013-08-01

Optimization of oil and gas field production systems poses a great challenge to field development due to complex and multiple interactions between various operational design parameters and subsurface uncertainties. Conventional analytical methods are capable of finding local optima based on single deterministic models. They are less applicable for efficiently generating alternative design scenarios in a multi-objective context. Practical implementations of robust optimization workflows integrate the evaluation of alternative design scenarios and multiple realizations of subsurface uncertainty descriptions. Production or economic performance indicators such as NPV (Net Present Value) are linked to a risk-weighted objective function definition to guide the optimization processes. This work focuses on an integrated workflow using a reservoir-network simulator coupled to an optimization framework. The work will investigate the impact of design parameters while considering the physics of the reservoir, wells, and surface facilities. Subsurface uncertainties are described by well parameters such as inflow performance. Experimental design methods are used to investigate parameter sensitivities and interactions. Optimization methods are used to find optimal design parameter combinations which improve key performance indicators of the production network system. The proposed workflow will be applied to a representative oil reservoir coupled to a network which is modelled by an integrated reservoir-network simulator. Gas-lift will be included as an explicit measure to improve production. An objective function will be formulated for the net present value of the integrated system including production revenue and facility costs. Facility and gas lift design parameters are tuned to maximize NPV. Well inflow performance uncertainties are introduced with an impact on gas lift performance. Resulting variances on NPV are identified as a risk measure for the optimized system design. A

Divergence of Scientific Heuristic Method and Direct Algebraic Instruction

Science.gov (United States)

Calucag, Lina S.

2016-01-01

This is an experimental study, made used of the non-randomized experimental and control groups, pretest-posttest designs. The experimental and control groups were two separate intact classes in Algebra. For a period of twelve sessions, the experimental group was subjected to the scientific heuristic method, but the control group instead was given…

The Relationship between Faculty's Pedagogical Content Knowledge and Students' Knowledge about Diversity in Online Courses

Science.gov (United States)

Chaudhery, Mitali

2012-01-01

The purpose of this proposed study will be to examine the relationship between faculty's pedagogical content knowledge and the design of online curriculum to teach students about diversity in a higher education environment. One hundred twenty-seven faculty teaching online courses at a Midwestern state will be selected on non-random sampling to…

Learning to Design Together: Introducing Conditional Design as a Method for Co-design Activities

DEFF Research Database (Denmark)

Akoglu, Canan

2017-01-01

In today’s world, designing include participation of users and stakeholders at different levels varying from minimum participation to co-creating with these actors. In such a context, it becomes crucial to include related educational modules to be able to prepare design students for their future...... as the empirical study of this paper. The participants of the workshops were students from Communication Design and Industrial Design undergraduate programs with different seniorities in the same faculty. In terms of its content and operative flow, all the workshops were organized in a way that would enable equal...... contribution from each student and an active learning space was provided to the students. Based on the feedbacks, it is possible to foresee that the workshops were positive experiences especially in terms of understanding the importance of collective creativity and beyond the educational purposes...

Manufacturing system design based on axiomatic design: Case of assembly line

Energy Technology Data Exchange (ETDEWEB)

Hager, T.; Wafik, H.; Faouzi, M.

2017-07-01

In this paper, a combined Production Line Design (PLD) process which includes many design aspects is presented, developed and validated. Design/methodology/approach: The PLD process is based on the SADT (Structured Analysis and Design Technique) diagram and the Axiomatic Design (AD) method. Practical implications: For a purpose of validation, this proposed process has been applied in a manufacturing company and it has been validated by simulation. Findings: The results of the validation indicated that the production line designed by this process is outperformed the initial line of the company. Originality/value: Recently, the problems of production line design (PLD) have attracted the attention of many researchers. However, only a few studies have treated the PLD which includes all design aspects. In this work, a combined PLD process is presented. It should be noted that the proposed process is simple and effective.

Manufacturing system design based on axiomatic design: Case of assembly line

International Nuclear Information System (INIS)

Hager, T.; Wafik, H.; Faouzi, M.

2017-01-01

In this paper, a combined Production Line Design (PLD) process which includes many design aspects is presented, developed and validated. Design/methodology/approach: The PLD process is based on the SADT (Structured Analysis and Design Technique) diagram and the Axiomatic Design (AD) method. Practical implications: For a purpose of validation, this proposed process has been applied in a manufacturing company and it has been validated by simulation. Findings: The results of the validation indicated that the production line designed by this process is outperformed the initial line of the company. Originality/value: Recently, the problems of production line design (PLD) have attracted the attention of many researchers. However, only a few studies have treated the PLD which includes all design aspects. In this work, a combined PLD process is presented. It should be noted that the proposed process is simple and effective.

Analysis of the spatial distribution of infant mortality by cause of death in Austria in 1984 to 2006

Directory of Open Access Journals (Sweden)

Heinzl Harald

2008-05-01

Full Text Available Abstract Background In Austria, over the last 20 years infant mortality declined from 11.2 per 1,000 life births (1985 to 4.7 per 1,000 in1997 but remained rather constant since then. In addition to this time trend we already reported a non-random spatial distribution of infant mortality rates in a recent study covering the time period 1984 to 2002. This present study includes four additional years and now covers about 1.9 million individual birth certificates. It aimes to elucidate the observed non-random spatial distribution in more detail. We split up infant mortality into six groups according to the underlying cause of death. The underlying spatial distribution of standardized mortality ratios (SMR is estimated by univariate models as well as by two models incorporating all six groups simultaneously. Results We observe strong correlations between the individual spatial patterns of SMR's except for "Sudden Infant Death Syndrome" and to some extent for "Peripartal Problems". The spatial distribution of SMR's is non-random with an area of decreased risk in the South-East of Austria. The group "Sudden Infant Death Syndrome" clearly and the group "Peripartal Problems" slightly show deviations from the common pattern. When comparing univariate and multivariate SMR estimates we observe that the resulting spatial distributions are very similar. Conclusion We observe different non-random spatial distributions of infant mortality rates when grouped by cause of death. The models applied were based on individual data thereby avoiding ecological regression bias. The estimated spatial distributions do not substantially depend on the employed estimation method. The observed non-random spatial patterns of Austrian infant mortality remain to appear ambiguous.

Designing with video focusing the user-centred design process

CERN Document Server

Ylirisku, Salu Pekka

2007-01-01

Digital video for user-centered co-design is an emerging field of design, gaining increasing interest in both industry and academia. It merges the techniques and approaches of design ethnography, participatory design, interaction analysis, scenario-based design, and usability studies. This book covers the complete user-centered design project. It illustrates in detail how digital video can be utilized throughout the design process, from early user studies to making sense of video content and envisioning the future with video scenarios to provoking change with video artifacts. The text includes

PENGARUH KONSELING MENYUSUI TERHADAP SIKAP MENYUSUI IBU POSTPARTUM YANG DIRAWAT

OpenAIRE

Mulyani, Sri

2016-01-01

Abstract:   Breastfeeding is important for mothers giving birth. Breastfeeding counseling is one of the efforts for the success of breastfeeding. The purpose of this study was to determine the effect of breastfeeding counseling on maternal breastfeeding attitudes treated. Design research is a quasi-experimental design with post-test-only approach to non equivalent control group. Total sample of 60 people were taken using a technique nonprobability sampling (non-random sample) with consecutive...

Updated Design Standards and Guidance from the What Works Clearinghouse: Regression Discontinuity Designs and Cluster Designs

Science.gov (United States)

Cole, Russell; Deke, John; Seftor, Neil

2016-01-01

The What Works Clearinghouse (WWC) maintains design standards to identify rigorous, internally valid education research. As education researchers advance new methodologies, the WWC must revise its standards to include an assessment of the new designs. Recently, the WWC has revised standards for two emerging study designs: regression discontinuity…

Designing Interfaces

CERN Document Server

Tidwell, Jenifer

2010-01-01

Despite all of the UI toolkits available today, it's still not easy to design good application interfaces. This bestselling book is one of the few reliable sources to help you navigate through the maze of design options. By capturing UI best practices and reusable ideas as design patterns, Designing Interfaces provides solutions to common design problems that you can tailor to the situation at hand. This updated edition includes patterns for mobile apps and social media, as well as web applications and desktop software. Each pattern contains full-color examples and practical design advice th

Enhancing Transfer of Knowledge in Physics through Effective Teaching Strategies

Science.gov (United States)

Akinbobola, Akinyemi Olufunminiyi

2015-01-01

The study assessed the enhancement of transfer of knowledge in physics through the use of effective teaching strategies in Nigerian senior secondary schools. Non-randomized pretest-posttest control group design was adopted for the study. A total of 278 physics students took part in the study. Transfer of Knowledge Test in Physics (TKTP) with the…

On-chip high-voltage generator design design methodology for charge pumps

CERN Document Server

Tanzawa, Toru

2016-01-01

This book provides various design techniques for switched-capacitor on-chip high-voltage generators, including charge pump circuits, regulators, level shifters, references, and oscillators.  Readers will see these techniques applied to system design in order to address the challenge of how the on-chip high-voltage generator is designed for Flash memories, LCD drivers, and other semiconductor devices to optimize the entire circuit area and power efficiency with a low voltage supply, while minimizing the cost.  This new edition includes a variety of useful updates, including coverage of power efficiency and comprehensive optimization methodologies for DC-DC voltage multipliers, modeling of extremely low voltage Dickson charge pumps, and modeling and optimum design of AC-DC switched-capacitor multipliers for energy harvesting and power transfer for RFID.

Meta-analysis of the INSIG2 association with obesity including 74,345 individuals: does heterogeneity of estimates relate to study design?

DEFF Research Database (Denmark)

Heid, Iris M; Huth, Cornelia; Loos, Ruth J F

2009-01-01

with subjects selected for conditions related to a better health status ('healthy population', HP), and obesity studies (OB). We tested five hypotheses to explore potential sources of heterogeneity. The meta-analysis of 27 studies on Caucasian adults (n = 66,213) combining the different study designs did......The INSIG2 rs7566605 polymorphism was identified for obesity (BMI> or =30 kg/m(2)) in one of the first genome-wide association studies, but replications were inconsistent. We collected statistics from 34 studies (n = 74,345), including general population (GP) studies, population-based studies...... not support overall association of the CC-genotype with obesity, yielding an odds ratio (OR) of 1.05 (p-value = 0.27). The I(2) measure of 41% (p-value = 0.015) indicated between-study heterogeneity. Restricting to GP studies resulted in a declined I(2) measure of 11% (p-value = 0.33) and an OR of 1.10 (p...

MOS modeling hierarchy including radiation effects

International Nuclear Information System (INIS)

Alexander, D.R.; Turfler, R.M.

1975-01-01

A hierarchy of modeling procedures has been developed for MOS transistors, circuit blocks, and integrated circuits which include the effects of total dose radiation and photocurrent response. The models were developed for use with the SCEPTRE circuit analysis program, but the techniques are suitable for other modern computer aided analysis programs. The modeling hierarchy permits the designer or analyst to select the level of modeling complexity consistent with circuit size, parametric information, and accuracy requirements. Improvements have been made in the implementation of important second order effects in the transistor MOS model, in the definition of MOS building block models, and in the development of composite terminal models for MOS integrated circuits

Designed to deter. Community barriers to physical activity for people with visual or motor impairments.

Science.gov (United States)

Kirchner, Corinne E; Gerber, Elaine G; Smith, Brooke C

2008-04-01

People with disabilities are more likely to be obese, in poor health, and get less physical activity than the general population. However, research on community factors for physical activity has generally either excluded most people with disabilities, or overlooked relevant factors of community accessibility. This exploratory study investigated environmental factors affecting people with motor impairments and people with visual impairments in urban neighborhoods. Quantitative and qualitative methods were used with a nonrandom sample (n=134) of users of four types of assistive mobility technologies: guide dogs, long canes, and motorized and manual wheelchairs. From July 2005 to August 2006, the sample participated in two telephone surveys. Between the surveys, a stratified random subsample (n =32) engaged in an ethnographic phase of observation and interviews. Most participants in all groups using assistive mobility technologies rated their neighborhoods as accessible, although they also reported many specific barriers. Users of assistive mobility technologies differed in the amount of reported physical activity and on specific barriers. Problems with sidewalk pavement and puddles/poor drainage were the most frequently mentioned environmental barriers, by 90% and 80%, respectively. Users of assistive mobility technologies were more similar on main strategies for dealing with barriers. All groups reported having to plan routes for outings, to alter planned routes, to go more slowly than planned, or to wait for a different time. Despite legislative requirements for accommodation, people with disabilities face barriers to physical activity, both in the built and social environments. Determined people with disabilities were able to overcome barriers, but required additional expenditure of resources to do so. Community design that can include people with disabilities requires detailed understanding of barriers specific both to types of impairments and to different types

SSC design update

International Nuclear Information System (INIS)

Syphers, M.J.

1992-11-01

Recent developments in the design and construction of the SSC are presented. Topics include status of the 20 TeV Collider rings, including interaction regions, utility regions, and main arcs, plus some remarks on the injector accelerators. Remaining issues facing the design of the colliding beams synchrotron and its injectors are discussed

Dynamic model of a micro-tubular solid oxide fuel cell stack including an integrated cooling system

Science.gov (United States)

Hering, Martin; Brouwer, Jacob; Winkler, Wolfgang

2017-02-01

A novel dynamic micro-tubular solid oxide fuel cell (MT-SOFC) and stack model including an integrated cooling system is developed using a quasi three-dimensional, spatially resolved, transient thermodynamic, physical and electrochemical model that accounts for the complex geometrical relations between the cells and cooling-tubes. The modeling approach includes a simplified tubular geometry and stack design including an integrated cooling structure, detailed pressure drop and gas property calculations, the electrical and physical constraints of the stack design that determine the current, as well as control strategies for the temperature. Moreover, an advanced heat transfer balance with detailed radiative heat transfer between the cells and the integrated cooling-tubes, convective heat transfer between the gas flows and the surrounding structures and conductive heat transfer between the solid structures inside of the stack, is included. The detailed model can be used as a design basis for the novel MT-SOFC stack assembly including an integrated cooling system, as well as for the development of a dynamic system control strategy. The evaluated best-case design achieves very high electrical efficiency between around 75 and 55% in the entire power density range between 50 and 550 mW /cm2 due to the novel stack design comprising an integrated cooling structure.

Technical basis for the ITER-FEAT outline design. Progress in resolving open design issues from the outline design report

International Nuclear Information System (INIS)

2000-01-01

In this publication the technical basis for the ITER-FEAT outline design is presented. It comprises the Plant Design Specifications, the Safety Principles and Environmental Criteria, the Site Requirements and Site Design Assumptions. The outline of the key features of the ITER-FEAT design includes main physical parameters and assessment, design overview and preliminary safety assessment, cost and schedule

Extensions of MAD Version 8 to Include Beam Acceleration

International Nuclear Information System (INIS)

Raubenheimer, Tor O

2000-01-01

In this paper, the authors describe modifications to MAD version 8.23 to include linear accelerator cavities and beam acceleration. An additional energy variable has been added which is modified as the beam passes through LCAV elements (linear accelerator cavities) and can be used as a constraint in matching commands. The calculation of the beta functions and phase advance is consistent with that in other codes that treat acceleration such as TRANSPORT or DIMAD. These modifications allow this version of MAD to be used for the design and modeling of linacs and the authors present examples from the Next Linear Collider design as well as a muon acceleration complex. The code is available from CERN or SLAC

A meta-analysis of the effects of classroom management strategies and classroom management programs on students’ academic, behavioral, emotional, and motivational outcomes

NARCIS (Netherlands)

Korpershoek, Hanke; Harms, Truus; de Boer, Hester; van Kuijk, Mechteld; Doolaard, Simone

This meta-analysis examined which classroom management strategies and programs enhanced students’ academic, behavioral, social-emotional, and motivational outcomes in primary education. The analysis included 54 random and nonrandom controlled intervention studies published in the past decade

System 80+trademark Standard Design: CESSAR design certification. Volume 16

International Nuclear Information System (INIS)

1997-01-01

This report has been prepared in support of the industry effort to standardize nuclear plant designs. This document describes the Combustion Engineering, Inc. System 80+trademark Standard Design. This volume contain Chapter 18 -- Human Factors Engineering. Topics covered include: design team organization and responsibilities; design goals and design bases; design process and application to human factors engineering; functional task analysis; control room configuration; information presentation and panel layout evaluation; control and monitoring outside the main control room; and verification and validation

The Communication Between Designer and Design Receiver

DEFF Research Database (Denmark)

Dai, Zheng; Dai, Yan

2009-01-01

When people think about a product,the first impression always mainly influences the result.Product is the medium of communication between designer and designer receiver.Because both of them have varied different experience and background,the information would be biased during the transferring...... process.The common symbols which can be recognized by both of designer and receiver are the key tools for communication.In some case,the same symbol in one product would be leads to different receiver impression.Generally,impression includes 3 aspects:aesthetics,function, and emotion.Designer needs...... to create an attractive and accurate impression in product from these 3 aspects.For facing the dilemma of communication,some experimental approaches can help designer deal with unique and diversity situations.Solving the detail problem in each step could keep the original meaning of designer....

Breakwater design

OpenAIRE

Verhagen, H.J.; van den Bos, J.P.

2017-01-01

For this book we have deliberately chosen that the text should follow a more or less logical design procedure for breakwaters. It follows the required design steps from the system level down to the individual crosssection level, and in time from conceptual design to construction. This systematic approach starts at the functional description of breakwaters, system analysis including side-effects and derivation of boundary conditions and continues to the actual design, first of the main armour ...

Is the alpha-beta ratio of prostate cancer really low? A prospective, non-randomized trial comparing standard and hyperfractionated conformal radiation therapy

International Nuclear Information System (INIS)

Valdagni, Riccardo; Italia, Corrado; Montanaro, Paolo; Lanceni, Angelo; Lattuada, Paola; Magnani, Tiziana; Fiorino, Claudio; Nahum, Alan

2005-01-01

Background and purpose: The objectives of the current study were to compare genito-urinary (GU) and gastro-intestinal (GI) toxicities as well as biochemical control (bRFS) in prostate cancer, utilizing conventional (2.0 Gy daily) (STD) or hyperfractionated (HFX) conformal irradiation (CRT). HFX (1.2 Gy BID) was chosen as a radiobiological method to try to reduce long term sequelae without compromising local control. Patients and methods: Three-hundred-and-seventy consecutive patients (pts) entered this prospective, non-randomized trial in the period January 1993-January 2003; 209 were treated with STD and 161 with HFX CRT. All were evaluable for acute toxicity analysis, 179 (STD) and 151 pts (HFX) being evaluable for late sequelae and bRFS analyses. Pt characteristics were not statistically different in the two groups. CRT consisted of a 4-field technique for prostate and/or pelvic nodes and a 5-field boost with rectal shielding. Median doses were 74 and 79.2 Gy for STD and HFX patients respectively, the latter dose being isoeffective for tumour control assuming α/β=10 (EQD 2 =73.9 Gy). Median follow-up was 29.4 months (25.2 mos for STD; 37.7 mos for HFX; P<0.01). The two regimens were compared in terms of acute and late GU and GI toxicities and 5-year bRFS by univariate and multivariate analyses. Results: Acute grade≥2 GU toxicity was higher in the STD group (48.6% versus 37.3% in HFX, P=0.03), while no significant difference was found for acute GI toxicity. Late grade≥2 GU and GI toxicities were lower in the HFX group (5-year actuarial rate: GU: 10.1% versus 20.3%, P=0.05; GI: 6.0% versus 10.6%, P=0.18). Five-year bRFS were 70% (±13.8%, 95% CI) and 82.6% (±7.2%) for STD and HFX, respectively (P=0.44); a trend favouring HFX was found in the subgroup of pts who did not receive hormonal therapy (5-year bRFS: 85.9%±12.4% versus 63.9%±23.8%, P=0.15). Multivariate analysis revealed only risk groups and age statistically related to bRFS but not fractionation

Including Alternative Resources in State Renewable Portfolio Standards: Current Design and Implementation Experience

Energy Technology Data Exchange (ETDEWEB)

Heeter, J.; Bird, L.

2012-11-01

Currently, 29 states, the District of Columbia, and Puerto Rico have instituted a renewable portfolio standard (RPS). An RPS sets a minimum threshold for how much renewable energy must be generated in a given year. Each state policy is unique, varying in percentage targets, timetables, and eligible resources. This paper examines state experience with implementing renewable portfolio standards that include energy efficiency, thermal resources, and non-renewable energy and explores compliance experience, costs, and how states evaluate, measure, and verify energy efficiency and convert thermal energy. It aims to gain insights from the experience of states for possible federal clean energy policy as well as to share experience and lessons for state RPS implementation.

Textiles and Apparel Design.

Science.gov (United States)

Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

This document contains teacher's materials for a seven-unit secondary education vocational home economics course on textiles and apparel design. The units cover: (1) fiber/fiber characteristics and textile development (including fabrication and dyeing, printing, and finishing); (2) textile and apparel design industries (including their history and…

Comparison of Problem Solving from Engineering Design to Software Design

DEFF Research Database (Denmark)

Ahmed-Kristensen, Saeema; Babar, Muhammad Ali

2012-01-01

Observational studies of engineering design activities can inform the research community on the problem solving models that are employed by professional engineers. Design is defined as an ill-defined problem which includes both engineering design and software design, hence understanding problem...... solving models from other design domains is of interest to the engineering design community. For this paper an observational study of two software design sessions performed for the workshop on “Studying professional Software Design” is compared to analysis from engineering design. These findings provide...... useful insights of how software designers move from a problem domain to a solution domain and the commonalities between software designers’ and engineering designers’ design activities. The software designers were found to move quickly to a detailed design phase, employ co-.evolution and adopt...

Comparison of Problem Solving from Engineering Design to Software Design

DEFF Research Database (Denmark)

Ahmed-Kristensen, Saeema; Babar, Muhammad Ali

2012-01-01

solving models from other design domains is of interest to the engineering design community. For this paper an observational study of two software design sessions performed for the workshop on “Studying professional Software Design” is compared to analysis from engineering design. These findings provide......Observational studies of engineering design activities can inform the research community on the problem solving models that are employed by professional engineers. Design is defined as an ill-defined problem which includes both engineering design and software design, hence understanding problem...... useful insights of how software designers move from a problem domain to a solution domain and the commonalities between software designers’ and engineering designers’ design activities. The software designers were found to move quickly to a detailed design phase, employ co-.evolution and adopt...

International Spinal Cord Injury Core Data Set (version 2.0)-including standardization of reporting

NARCIS (Netherlands)

Biering-Sorensen, F.; DeVivo, M. J.; Charlifue, S.; Chen, Y.; New, P. W.; Noonan, V.; Post, M. W. M.; Vogel, L.

Study design: The study design includes expert opinion, feedback, revisions and final consensus. Objectives: The objective of the study was to present the new knowledge obtained since the International Spinal Cord Injury (SCI) Core Data Set (Version 1.0) published in 2006, and describe the

International Spinal Cord Injury Core Data Set (version 2.0)-including standardization of reporting

NARCIS (Netherlands)

Biering-Sørensen, F; DeVivo, M J; Charlifue, Susan; Chen, Y; New, P.W.; Noonan, V.; Post, M W M; Vogel, L.

STUDY DESIGN: The study design includes expert opinion, feedback, revisions and final consensus. OBJECTIVES: The objective of the study was to present the new knowledge obtained since the International Spinal Cord Injury (SCI) Core Data Set (Version 1.0) published in 2006, and describe the

Regression to the Mean in SYMPLICITY HTN-3: Implications for Design and Reporting of Future Trials.

Science.gov (United States)

Pocock, Stuart J; Bakris, George; Bhatt, Deepak L; Brar, Sandeep; Fahy, Martin; Gersh, Bernard J

2016-11-01

Regression to the mean (RTM) describes the tendency for an extreme measurement on 1 occasion to become less extreme when measured again. RTM may affect clinical trial data interpretation when the outcome measure has high variability. We investigated RTM in the SYMPLICITY HTN-3 (Renal Denervation in Patients With Uncontrolled Hypertension) trial of renal denervation versus a sham procedure. Analysis of covariance was performed on the 6-month change in systolic blood pressure, estimating a mean treatment difference of -4.11 mm Hg (95% confidence interval: -8.44 to 0.22 mm Hg; p = 0.064), which was similar to the unadjusted difference but with a smaller confidence interval. RTM occurred in both arms, but it had a negligible effect on the observed treatment difference. A second example concerns changes in hemoglobin A1c in a nonrandomized study. These findings emphasize the importance of incorporating RTM and analysis of covariance into the design and reporting of clinical studies of how treatments affect time changes in quantitative outcomes. (Renal Denervation in Patients With Uncontrolled Hypertension [SYMPLICITY HTN-3]; NCT01418261). Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Timber designers' manual

CERN Document Server

Ozelton, E C

2008-01-01

This major reference manual covers both overall and detail design of structural timber, including aspects such as shear deflection, creep, dynamic and lateral stability considerations for flexural members.Available for the first time in paperback, the Third Edition was substantially revised to take account of the many changes since the previous edition was published in 1984. It is based on British Standard BS 5268-2: 2002, which brought design concepts closer to European practice and Eurocode 5.Features of the Third Edition include:* information on bolt values including

Detection of three common translocation breakpoints in non-Hodgkin's lymphomas by fluorescence in situ hybridization on routine paraffin-embedded tissue sections

NARCIS (Netherlands)

Haralambieva, E; Kleiverda, K; Mason, DY; Schuuring, E; Kluin, PM

2002-01-01

Non-random chromosomal translocations are specifically involved in the pathogenesis of many non-Hodgkin's lymphomas and have clinical implications as diagnostic and/or prognostic markers. Their detection is often impaired by technical problems, including the distribution of the breakpoints over

Population and family structure of brown trout, Salmo trutta, in a Mediterranean stream

DEFF Research Database (Denmark)

Vera, Manuel; Sanz, Nuria; Hansen, Michael Møller

2010-01-01

The physical arrangement of closely related individuals is expected to significantly influence the pattern of population genetic structure. For example, if related individuals are non-randomly distributed and included in samples, this may lead to exaggerated conclusions about genetic differentiat...

Thermal enhanced vapor extraction systems: Design, application and performance prediction including contaminant behavior

International Nuclear Information System (INIS)

Phelan, J.M.; Webb, S.W.

1994-01-01

Soil heating technologies have been proposed as a method to accelerate contaminant removal from subsurface soils. These methods include the use of hot air, steam, conductive heaters, in-situ resistive heating and in-situ radiofrequency heating (Buettner et.al., EPA, Dev et.al., Heath et.al.). Criteria for selection of a particular soil heating technology is a complex function of contaminant and soil properties, and efficiency in energy delivery and contaminant removal technologies. The work presented here seeks to expand the understanding of the interactions of subsurface water, contaminant, heat and vacuum extraction through model predictions and field data collection. Field demonstration will involve the combination of two soil heating technologies (resistive and dielectric) with a vacuum vapor extraction system and will occur during the summer of 1994

Non-random walk diffusion enhances the sink strength of semicoherent interfaces

Science.gov (United States)

Vattré, A.; Jourdan, T.; Ding, H.; Marinica, M.-C.; Demkowicz, M. J.

2016-01-01

Clean, safe and economical nuclear energy requires new materials capable of withstanding severe radiation damage. One strategy of imparting radiation resistance to solids is to incorporate into them a high density of solid-phase interfaces capable of absorbing and annihilating radiation-induced defects. Here we show that elastic interactions between point defects and semicoherent interfaces lead to a marked enhancement in interface sink strength. Our conclusions stem from simulations that integrate first principles, object kinetic Monte Carlo and anisotropic elasticity calculations. Surprisingly, the enhancement in sink strength is not due primarily to increased thermodynamic driving forces, but rather to reduced defect migration barriers, which induce a preferential drift of defects towards interfaces. The sink strength enhancement is highly sensitive to the detailed character of interfacial stresses, suggesting that `super-sink' interfaces may be designed by optimizing interface stress fields. Such interfaces may be used to create materials with unprecedented resistance to radiation-induced damage.

DOE handbook: Design considerations

International Nuclear Information System (INIS)

1999-04-01

The Design Considerations Handbook includes information and suggestions for the design of systems typical to nuclear facilities, information specific to various types of special facilities, and information useful to various design disciplines. The handbook is presented in two parts. Part 1, which addresses design considerations, includes two sections. The first addresses the design of systems typically used in nuclear facilities to control radiation or radioactive materials. Specifically, this part addresses the design of confinement systems and radiation protection and effluent monitoring systems. The second section of Part 1 addresses the design of special facilities (i.e., specific types of nonreactor nuclear facilities). The specific design considerations provided in this section were developed from review of DOE 6430.1A and are supplemented with specific suggestions and considerations from designers with experience designing and operating such facilities. Part 2 of the Design Considerations Handbook describes good practices and design principles that should be considered in specific design disciplines, such as mechanical systems and electrical systems. These good practices are based on specific experiences in the design of nuclear facilities by design engineers with related experience. This part of the Design Considerations Handbook contains five sections, each of which applies to a particular engineering discipline

DOE handbook: Design considerations

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-04-01

The Design Considerations Handbook includes information and suggestions for the design of systems typical to nuclear facilities, information specific to various types of special facilities, and information useful to various design disciplines. The handbook is presented in two parts. Part 1, which addresses design considerations, includes two sections. The first addresses the design of systems typically used in nuclear facilities to control radiation or radioactive materials. Specifically, this part addresses the design of confinement systems and radiation protection and effluent monitoring systems. The second section of Part 1 addresses the design of special facilities (i.e., specific types of nonreactor nuclear facilities). The specific design considerations provided in this section were developed from review of DOE 6430.1A and are supplemented with specific suggestions and considerations from designers with experience designing and operating such facilities. Part 2 of the Design Considerations Handbook describes good practices and design principles that should be considered in specific design disciplines, such as mechanical systems and electrical systems. These good practices are based on specific experiences in the design of nuclear facilities by design engineers with related experience. This part of the Design Considerations Handbook contains five sections, each of which applies to a particular engineering discipline.

Integrated Design

DEFF Research Database (Denmark)

Jørgensen, Michael; Nielsen, M. W.; Strømann-Andersen, Jakob Bjørn

2011-01-01

and describe the decision process. Specific attention is given to how the engineering input was presented and how it was able to facilitate the design development. Site and context, building shape, organization of functions and HVAC-systems were all included to obtain a complete picture of the building......, low-energy consumption, and high-quality indoor environment. We use this case study to investigate how technical knowledge about building performance can be integrated into the conceptual design stage. We have selected certain points during the design process that represented design challenges...

The Process of Designing for Learning: Understanding University Teachers' Design Work

Science.gov (United States)

Bennett, Sue; Agostinho, Shirley; Lockyer, Lori

2017-01-01

Interest in how to support the design work of university teachers has led to research and development initiatives that include technology-based design-support tools, online repositories, and technical specifications. Despite these initiatives, remarkably little is known about the design work that university teachers actually do. This paper…

A Guide to Running a Recycling Project. [Includes Recycling Handbook].

Science.gov (United States)

Oregon Recycling Information and Organizing Network, Portland.

This guide, designed for both students and adults, is intended for individuals who feel they might be interested in establishing a recycling depot. The guide includes such pertinent information as deciding how to set up a depot, markets and transportation, preparation of materials, where to place the depot and when to operate it, publicity and…

Measuring Stigma in Older and Younger Adults with HIV/AIDS: An Analysis of an HIV Stigma Scale and Initial Exploration of Subscales

Science.gov (United States)

Emlet, Charles A.

2005-01-01

The purpose of this study is to explore the validity of a scale designed to measure HIV stigma and identify potential subscales. A nonrandom sample of 88 individuals, 44 between the ages of 20 and 39 and 44 ages 50 and older, living with HIV/AIDS were interviewed and completed a 13-item HIV Stigma Scale. An exploratory factor analysis (EFA) found…

Design with the feet: walking methods and participatory design

DEFF Research Database (Denmark)

Kanstrup, Anne Marie; Bertelsen, Pernille; Madsen, Jacob Østergaard

2014-01-01

This paper presents an analysis of walking methods and their relation to participatory design (PD). The paper includes a study of walking methods found in the literature and an empirical study of transect walks in a PD project. From this analysis, we identify central attributes of, and challenges...... to, PD walks. Walking with people in the context of design is a natural activity for the participatory designer, who acknowledges the importance of immersion and relationships in design. However, the various intentions of walking approaches indicate an underacknowledged awareness of walking methods...

Design of canals

CERN Document Server

Swamee, P K

2015-01-01

The book presents firsthand material from the authors on design of hydraulic canals. The book discusses elements of design based on principles of hydraulic flow through canals. It covers optimization of design based on usage requirements and economic constraints. The book includes explicit design equations and design procedures along with design examples for varied cases. With its comprehensive coverage of the principles of hydraulic canal design, this book will prove useful to students, researchers, and practicing engineers. End-of-chapter pedagogical elements make it ideal for use in graduate courses on hydraulic structures offered by most civil engineering departments across the world.

[The Munich/San Diego/Iowa City Collaboration (MuSIC). MuSIC Report I: Design , characteristics of the collective and preliminary results].

Science.gov (United States)

Mueller, A J; Freeman, W R; Folberg, R; Schaller, U C; Kampik, A

2002-03-01

We have previously shown that histologically described microcirculation patterns (MCP) can be visualized with indocyanine green (ICG) angiography. We have designed a prospective study to evaluate the prognostic value of these angiographically imaged MCP in small choroidal melanocytic lesions. In this report we describe the design of the study, characterize the patient collective, and present the first results. In this prospective nonrandomized observational study, unilateral choroidal melanocytic lesions with 1.5-5.5 mm maximum apical height are observed until growth is determined according to defined criteria. Variables are demographic parameters, subjective symptoms, subretinal fluid, location and dimension of tumor, hemorrhage, color, orange pigment, and MCP determined by ICG angiography: normal, straight, parallel without crosslinking, parallel with crosslinking, arcs without branching, arcs with branching, loop, and network. Seventy patients (22 males, 48 females; age: 33-88 years, median: 64 years) have been included up to now: 19 tumors showed growth so far (time to growth: 51-946 days, median: 127 days). The following parameters were statistically significantly correlated with time to tumor growth: flashes (p = 0.082), orange pigment (p = 0.012), subretinal fluid (p < 0.001), maximum basal tumor diameter (p = 0.001), maximum apical tumor height (p < 0.001), parallel with crosslinking (p < 0.001), arcs with branching (p = 0.006), loop (p < 0.001), and network (p < 0.001). Of these, complex MCP (parallel with crosslinking, arcs with branching, loop and/or network) showed the strongest correlation with time to tumor growth in a Cox regression model. Based on our data, the positive predictive value of imaging complex MCP (for growth within 12 months) is 78% and the negative predictive value is 98%. Our patient collective demonstrates comparable prognostic parameters for time to growth as described in the literature. In addition, the ICG angiographic detection

Randomization tests

CERN Document Server

Edgington, Eugene

2007-01-01

Statistical Tests That Do Not Require Random Sampling Randomization Tests Numerical Examples Randomization Tests and Nonrandom Samples The Prevalence of Nonrandom Samples in Experiments The Irrelevance of Random Samples for the Typical Experiment Generalizing from Nonrandom Samples Intelligibility Respect for the Validity of Randomization Tests Versatility Practicality Precursors of Randomization Tests Other Applications of Permutation Tests Questions and Exercises Notes References Randomized Experiments Unique Benefits of Experiments Experimentation without Mani

Camera trap arrays improve detection probability of wildlife: Investigating study design considerations using an empirical dataset.

Science.gov (United States)

O'Connor, Kelly M; Nathan, Lucas R; Liberati, Marjorie R; Tingley, Morgan W; Vokoun, Jason C; Rittenhouse, Tracy A G

2017-01-01

Camera trapping is a standard tool in ecological research and wildlife conservation. Study designs, particularly for small-bodied or cryptic wildlife species often attempt to boost low detection probabilities by using non-random camera placement or baited cameras, which may bias data, or incorrectly estimate detection and occupancy. We investigated the ability of non-baited, multi-camera arrays to increase detection probabilities of wildlife. Study design components were evaluated for their influence on wildlife detectability by iteratively parsing an empirical dataset (1) by different sizes of camera arrays deployed (1-10 cameras), and (2) by total season length (1-365 days). Four species from our dataset that represented a range of body sizes and differing degrees of presumed detectability based on life history traits were investigated: white-tailed deer (Odocoileus virginianus), bobcat (Lynx rufus), raccoon (Procyon lotor), and Virginia opossum (Didelphis virginiana). For all species, increasing from a single camera to a multi-camera array significantly improved detection probability across the range of season lengths and number of study sites evaluated. The use of a two camera array increased survey detection an average of 80% (range 40-128%) from the detection probability of a single camera across the four species. Species that were detected infrequently benefited most from a multiple-camera array, where the addition of up to eight cameras produced significant increases in detectability. However, for species detected at high frequencies, single cameras produced a season-long (i.e, the length of time over which cameras are deployed and actively monitored) detectability greater than 0.75. These results highlight the need for researchers to be critical about camera trap study designs based on their intended target species, as detectability for each focal species responded differently to array size and season length. We suggest that researchers a priori identify

Camera trap arrays improve detection probability of wildlife: Investigating study design considerations using an empirical dataset.

Directory of Open Access Journals (Sweden)

Kelly M O'Connor

Full Text Available Camera trapping is a standard tool in ecological research and wildlife conservation. Study designs, particularly for small-bodied or cryptic wildlife species often attempt to boost low detection probabilities by using non-random camera placement or baited cameras, which may bias data, or incorrectly estimate detection and occupancy. We investigated the ability of non-baited, multi-camera arrays to increase detection probabilities of wildlife. Study design components were evaluated for their influence on wildlife detectability by iteratively parsing an empirical dataset (1 by different sizes of camera arrays deployed (1-10 cameras, and (2 by total season length (1-365 days. Four species from our dataset that represented a range of body sizes and differing degrees of presumed detectability based on life history traits were investigated: white-tailed deer (Odocoileus virginianus, bobcat (Lynx rufus, raccoon (Procyon lotor, and Virginia opossum (Didelphis virginiana. For all species, increasing from a single camera to a multi-camera array significantly improved detection probability across the range of season lengths and number of study sites evaluated. The use of a two camera array increased survey detection an average of 80% (range 40-128% from the detection probability of a single camera across the four species. Species that were detected infrequently benefited most from a multiple-camera array, where the addition of up to eight cameras produced significant increases in detectability. However, for species detected at high frequencies, single cameras produced a season-long (i.e, the length of time over which cameras are deployed and actively monitored detectability greater than 0.75. These results highlight the need for researchers to be critical about camera trap study designs based on their intended target species, as detectability for each focal species responded differently to array size and season length. We suggest that researchers a priori

Prestressed concrete design

CERN Document Server

Hurst, MK

1998-01-01

This edition provides up-to-date guidance on the detailed design of prestressed concrete structures. All major topics are dealt with, including prestressed flat slabs, an important and growing application in the design of buildings.

Conducting Accessible Research: Including People With Disabilities in Public Health, Epidemiological, and Outcomes Studies.

Science.gov (United States)

Rios, Dianne; Magasi, Susan; Novak, Catherine; Harniss, Mark

2016-12-01

People with disabilities are largely absent from mainstream health research. Exclusion of people with disabilities may be explicit, attributable to poorly justified exclusion criteria, or implicit, attributable to inaccessible study documents, interventions, or research measures. Meanwhile, people with disabilities experience poorer health, greater incidence of chronic conditions, and higher health care expenditure than people without disabilities. We outline our approach to "accessible research design"-research accessible to and inclusive of people with disabilities. We describe a model that includes 3 tiers: universal design, accommodations, and modifications. Through our work on several large-scale research studies, we provide pragmatic examples of accessible research design. Making efforts to include people with disabilities in public health, epidemiological, and outcomes studies will enhance the interpretability of findings for a significant patient population.

Design professional activity analysis in design management

Directory of Open Access Journals (Sweden)

Claudia de Souza Libanio

2013-08-01

Full Text Available Design use perception, as an essential element for achieving competitive advantage, also suggests the need to manage the design activities in companies. However, a few is discussed about the activity of these design professionals who participate in this process, their roles, functions and competencies, including  their connections to a company and other involved sectors. This article aims to analyze, during the design management processes, the work relations of design professionals connected to organizations both internal and externally, in order to comprehend the structure and intervenient factors on the activity of these professionals, as well as the interactions with their main coworkers. The methodology was exploratory and qualitative, using in-depth interviews with three design professionals. Subsequently, the responses were analyzed allowing the comparison of these obtained data to the theoretical bases researched. Through this case study, it was possible to realize the aspects and the structure of the design professional activity, connected intern and externally to organizations, as well as its relations with the main coworkers.

Positive design : An introduction to design for subjective well-being

NARCIS (Netherlands)

Desmet, P.M.A.; Pohlmeyer, A.E.

2013-01-01

This paper addresses the question of how design can contribute to the happiness of individuals–to their subjective well-being. A framework for positive design is introduced that includes three main components of subjective well-being: pleasure, personal significance and virtue. Each component

User Experience Design (UX Design) in a Website Development : Website redesign

OpenAIRE

Orlova, Mariia

2016-01-01

The purpose of the study was to implement an approach of user experience for a website design. Mostly, I concentrated on revealing and understanding the concepts of UX design which include usability, visual design and human factors affecting the user experience. Another aim of the study was to investigate people’s behaviour related to web design. The thesis based on a project. The project was to redesign an existing web design for a company called Positive Communications. They provide differe...

Instructions for submittal and control of FFTF design documents and design related documentation

International Nuclear Information System (INIS)

Grush, R.E.

1976-10-01

This document provides the system and requirements for management of FFTF technical data prepared by Westinghouse Hanford (HEDL), and design contractors, the construction contractor and lower tier equipment suppliers. Included in this document are provisions for the review, approval, release, change control, and accounting of FFTF design disclosure and base documentation. Also included are provisions for submittal of other design related documents for review and approval consistent with applicable requirements of RDT-Standard F 2-2, ''Quality Assurance Program Requirements.''

Learning Layouts for Single-Page Graphic Designs.

Science.gov (United States)

O'Donovan, Peter; Agarwala, Aseem; Hertzmann, Aaron

2014-08-01

This paper presents an approach for automatically creating graphic design layouts using a new energy-based model derived from design principles. The model includes several new algorithms for analyzing graphic designs, including the prediction of perceived importance, alignment detection, and hierarchical segmentation. Given the model, we use optimization to synthesize new layouts for a variety of single-page graphic designs. Model parameters are learned with Nonlinear Inverse Optimization (NIO) from a small number of example layouts. To demonstrate our approach, we show results for applications including generating design layouts in various styles, retargeting designs to new sizes, and improving existing designs. We also compare our automatic results with designs created using crowdsourcing and show that our approach performs slightly better than novice designers.

Designing Online Education Courses.

Science.gov (United States)

Trentin, Guglielmo

2001-01-01

Focuses on the main elements that characterize online course design. Topics include design constraints; analysis of learning needs; defining objectives; course prerequisites; content structuring; course flexibility; learning strategies; evaluation criteria; course activities; course structure; communication architecture; and design evaluation.…

Microwave technology for waste management applications including disposition of electronic circuitry

International Nuclear Information System (INIS)

Wicks, G.G.; Clark, D.E.; Schulz, R.L.; Folz, D.C.

1995-01-01

Microwave technology is being developed nationally and internationally for a variety of environmental remediation purposes. These efforts include treatment and destruction of a vast array of gaseous, liquid and solid hazardous wastes as well as subsequent immobilization of selected components. Microwave technology provides an important contribution to an arsenal of existing remediation methods that are designed to protect the public and environment from undesirable consequences of hazardous materials. Applications of microwave energy for environmental remediation will be discussed. Emphasized will be a newly developed microwave process designed to treat discarded electronic circuitry and reclaim the precious metals within for reuse

Advances in chemical product design

DEFF Research Database (Denmark)

Zhang, Lei; Fung, Ka Yip; Wibowo, Christianto

2018-01-01

The nature of chemical product design problems is diverse and multidisciplinary. It involves many design issues such as project management, market study, product design, process design, and economic analysis for better organizing the product design project and achieving better products. This arti......The nature of chemical product design problems is diverse and multidisciplinary. It involves many design issues such as project management, market study, product design, process design, and economic analysis for better organizing the product design project and achieving better products....... This article provides an overview of chemical product design with a multidisciplinary hierarchical framework including all the design issues and tasks. Each of the design issues and tasks are introduced and discussed, methods and tools are summarized and compared, challenges and perspectives are presented...... to help the chemical product design researchers on finding more novel, innovative and sustainable products, by the combined effort from academia and industry to develop a systematic generic framework, and tools including product simulator, process simulator, database manager, modeling tool, and templates...

The evacuation of British children during World War II: a preliminary investigation into the long-term psychological effects.

Science.gov (United States)

Foster, D; Davies, S; Steele, H

2003-09-01

The authors used attachment theory to hypothesize about the possible long-term psychological effects of evacuation during World War II, focusing on children who were evacuated unaccompanied by their parents. The study aimed to establish whether this experience had long-term effects on psychological well-being, and to investigate mediating and moderating factors. The study utilized a retrospective non-randomized design, comparing 169 former evacuees with 43 people who were children during the war but not evacuated. No differences between the groups were found in terms of demographic variables or exposure to war-related events. All participants completed a range of standardized self-report questionnaires. Findings indicated that former evacuees were more likely to have insecure attachment styles and lower levels of present psychological well-being. Satisfaction with, but not quantity of, current social support was found to mediate the relationship between attachment style and present psychological well-being. Conclusions are limited due to the method of measurement of attachment style, non-randomized design and method of recruitment. Nevertheless, findings offer an indication that the experience of evacuation is associated with long-term psychological vulnerability through its relationship with insecure attachment.

Design tools

Science.gov (United States)

Anton TenWolde; Mark T. Bomberg

2009-01-01

Overall, despite the lack of exact input data, the use of design tools, including models, is much superior to the simple following of rules of thumbs, and a moisture analysis should be standard procedure for any building envelope design. Exceptions can only be made for buildings in the same climate, similar occupancy, and similar envelope construction. This chapter...

Analysis of Smart Composite Structures Including Debonding

Science.gov (United States)

Chattopadhyay, Aditi; Seeley, Charles E.

1997-01-01

Smart composite structures with distributed sensors and actuators have the capability to actively respond to a changing environment while offering significant weight savings and additional passive controllability through ply tailoring. Piezoelectric sensing and actuation of composite laminates is the most promising concept due to the static and dynamic control capabilities. Essential to the implementation of these smart composites are the development of accurate and efficient modeling techniques and experimental validation. This research addresses each of these important topics. A refined higher order theory is developed to model composite structures with surface bonded or embedded piezoelectric transducers. These transducers are used as both sensors and actuators for closed loop control. The theory accurately captures the transverse shear deformation through the thickness of the smart composite laminate while satisfying stress free boundary conditions on the free surfaces. The theory is extended to include the effect of debonding at the actuator-laminate interface. The developed analytical model is implemented using the finite element method utilizing an induced strain approach for computational efficiency. This allows general laminate geometries and boundary conditions to be analyzed. The state space control equations are developed to allow flexibility in the design of the control system. Circuit concepts are also discussed. Static and dynamic results of smart composite structures, obtained using the higher order theory, are correlated with available analytical data. Comparisons, including debonded laminates, are also made with a general purpose finite element code and available experimental data. Overall, very good agreement is observed. Convergence of the finite element implementation of the higher order theory is shown with exact solutions. Additional results demonstrate the utility of the developed theory to study piezoelectric actuation of composite

Design in the planning arena : how regional designing influences strategic spatial planning

NARCIS (Netherlands)

Kempenaar, Annet

2017-01-01

Regional designing is a form of spatial design that engages with the future physical form and arrangement of regions, including its aesthetic appearances and how it can come about. As such it is closely entangled with spatial planning. This thesis studies the influence of regional designing on

Improved flare tip design

Energy Technology Data Exchange (ETDEWEB)

Gogolek, P. [Natural Resources Canada, Ottawa, ON (Canada). CANMET Energy Technology Centre

2004-07-01

This paper discusses the testing procedures and development of an improved flare tip design. Design objectives included performance equal to or better than utility flares at low wind speed; conversion efficiency; fuel slip; smoking; significant improvement at high wind speed; and no increase in trace emissions. A description of the testing facility of the flare tip was provided, with reference to the fact that the facility allowed for realistic near full scale gas flares in a single-pass flare test facility. Other details of the facility included: an adjustable ceiling; high capacity variable speed fan; sampling ports along working section in stack; windows along working section; and air cooled walls, floor, and ceiling. The fuels used in the flare tip included natural gas, propane, gasoline and inert gases. Details of wind speed, appurtenances and turbulence generating grids were presented, with reference to continuous gas emission measurements. A list of design constraints was provided. Flare performance included wind speed, turbulence and fuel composition. A chart of conversion inefficiencies with a correlation of wind speed and turbulence, fuel flow and pipe size was also presented. Several new tip designs were fabricated for testing, with screening tests for comparison to basic pipe and ranking designs. Significant improvements were found in one of the new designs, including results with 30 per cent propane in fuel. Emissions reduction from 10 to 35 per cent were noted. It was concluded that future work should focus on evaluating improved tip for stability at low wind speeds. Fuel slips are the primary source of emissions, and it was recommended that further research is necessary to improve existing flare tips. tabs, figs.

Exemplary Design Practice

DEFF Research Database (Denmark)

Jørgensen, Niels

The didactic principle of exemplary learning may be defined briefly as 'learning by example'. In design education, working with a practical example is particularly appropriate, because design by definition is about creating a solution to a practical problem. Indeed, some design theorists claim......, including: If design knowing is bound to a given practical design context, how is it possible to generalize such knowing, as presumably required by an exemplary learning approach? To explore these questions, an account is given of the theories of exemplary learning proposed by Martin Wagenschein and Oskar...

CMOS analog circuit design

CERN Document Server

Allen, Phillip E

1987-01-01

This text presents the principles and techniques for designing analog circuits to be implemented in a CMOS technology. The level is appropriate for seniors and graduate students familiar with basic electronics, including biasing, modeling, circuit analysis, and some familiarity with frequency response. Students learn the methodology of analog integrated circuit design through a hierarchically-oriented approach to the subject that provides thorough background and practical guidance for designing CMOS analog circuits, including modeling, simulation, and testing. The authors' vast industrial experience and knowledge is reflected in the circuits, techniques, and principles presented. They even identify the many common pitfalls that lie in the path of the beginning designer--expert advice from veteran designers. The text mixes the academic and practical viewpoints in a treatment that is neither superficial nor overly detailed, providing the perfect balance.

Family Behavior Therapy (FBT) for young people in treatment for non-opioid drug use:

DEFF Research Database (Denmark)

Lindstrøm, Maia; Saidj, Madina; Kowalski, Krystyna

2015-01-01

-control. FBT is designed to accommodate diverse populations of youth with a variety of behavioral, cultural and individual preferences. FBT incorporates behavioral theory (reduction of undesired behavior by manipulating external reinforcement), structural family theory (in which the structure of the family...... for non-opioid drug use; • have used experimental, quasi-experimental or non-randomized controlled designs; • have reported at least one eligible outcome variable measuring abstinence, reduction of drug use, family functioning, education or vocational involvement, retention, risk behavior or any other...

Pneumatic conveying design guide

CERN Document Server

Mills, David

1990-01-01

Pneumatic Conveying Design Guide is a guide for the design of pneumatic conveying systems and includes detailed data and information on the conveying characteristics of a number of materials with a wide range of properties. This book includes logic diagrams for design procedures and scaling parameters for the conveying line configuration. It also explains how to improve the performance of pneumatic conveyors by optimizing, uprating, and extending the system or adapting it for a change of material. This book consists of 15 chapters divided into three sections and opens with an overview of the s

Buffer design 2012

International Nuclear Information System (INIS)

Juvankoski, M.

2013-08-01

Posiva's spent nuclear fuel disposal is based on the KBS-3V concept and on the characteristics of the Olkiluoto site. In this concept single canisters containing spent nuclear fuel surrounded by a bentonite buffer are emplaced in individual vertical boreholes drilled in the floor of deposition tunnels in bedrock at about 420 m depth below ground level. Disk type bentonite blocks are installed at the bottom of the hole and on the top of the disposal canister. Ring type bentonite blocks surround the canisters. This report describes the detailed design of the buffer for a KBS-3V repository. The report presents the design basis, the reference design, and summarises the performance analyses carried out for the design. This report addresses aspects concerning the manufacture, quality control, mechanical strength, chemical resistance, thermal dimensioning, handling of buffer components and material ageing phenomena including the effect of radiation. Interaction of buffer and other engineered barriers are included in the study. The long-term evolution of the repository and its effective drivers are considered if they have an impact on the buffer performance but operational safety aspects are also included because they may affect long-term safety. (orig.)

Space Station Engineering Design Issues

Science.gov (United States)

Mcruer, Duane T.; Boehm, Barry W.; Debra, Daniel B.; Green, C. Cordell; Henry, Richard C.; Maycock, Paul D.; Mcelroy, John H.; Pierce, Chester M.; Stafford, Thomas P.; Young, Laurence R.

1989-01-01

Space Station Freedom topics addressed include: general design issues; issues related to utilization and operations; issues related to systems requirements and design; and management issues relevant to design.

Optimal experimental design with R

CERN Document Server

Rasch, Dieter; Verdooren, L R; Gebhardt, Albrecht

2011-01-01

Experimental design is often overlooked in the literature of applied and mathematical statistics: statistics is taught and understood as merely a collection of methods for analyzing data. Consequently, experimenters seldom think about optimal design, including prerequisites such as the necessary sample size needed for a precise answer for an experimental question. Providing a concise introduction to experimental design theory, Optimal Experimental Design with R: Introduces the philosophy of experimental design Provides an easy process for constructing experimental designs and calculating necessary sample size using R programs Teaches by example using a custom made R program package: OPDOE Consisting of detailed, data-rich examples, this book introduces experimenters to the philosophy of experimentation, experimental design, and data collection. It gives researchers and statisticians guidance in the construction of optimum experimental designs using R programs, including sample size calculations, hypothesis te...

Teachers’ Learning Design Practice for Students as Learning Designers

DEFF Research Database (Denmark)

Levinsen, Karin Tweddell; Sørensen, Birgitte Holm

2018-01-01

This paper contributes with elements of an emerging learning design methodology. The paper takes as its starting point the theory of Students as Learning Designers, which was developed by Sørensen and Levinsen and based on more than a decade of research-and-development projects in Danish primary...... schools (first to 10th grade). The research focussed on information and communication technology (ICT) within the Scandinavian tradition of Problem Oriented Project Pedagogy (POPP), Problem Based Learning (PBL) and students’ production. In recent years, the projects that provide the grounding...... for the theory have focussed specifically on learning designs that constitute students as learning designers of digital productions (both multimodal and coded productions). This includes learning designs that contribute to students’ empowerment, involvement and autonomy within the teacher-designed frameworks...

Superconducting accelerator magnet design

International Nuclear Information System (INIS)

Wolff, S.

1994-01-01

Superconducting dipoles, quadrupoles and correction magnets are necessary to achieve the high magnetic fields required for big accelerators presently in construction or in the design phase. Different designs of superconducting accelerator magnets are described and the designs chosen at the big accelerator laboratories are presented. The most frequently used cosθ coil configuration is discussed in detail. Approaches for calculating the magnetic field quality including coil end fields are presented. Design details of the cables, coils, mechanical structures, yokes, helium vessels and cryostats including thermal radiation shields and support structures used in superconducting magnets are given. Necessary material properties are mentioned. Finally, the main results of magnetic field measurements and quench statistics are presented. (orig.)

A Meta-Analysis of the Effects of Classroom Management Strategies and Classroom Management Programs on Students' Academic, Behavioral, Emotional, and Motivational Outcomes

Science.gov (United States)

Korpershoek, Hanke; Harms, Truus; de Boer, Hester; van Kuijk, Mechteld; Doolaard, Simone

2016-01-01

This meta-analysis examined which classroom management strategies and programs enhanced students' academic, behavioral, social-emotional, and motivational outcomes in primary education. The analysis included 54 random and nonrandom controlled intervention studies published in the past decade (2003-2013). Results showed small but significant…

Design Knowledge and Design Change Management in the Operation of Nuclear Fleets

International Nuclear Information System (INIS)

Pelin, H.

2016-01-01

Full text: The operating lifetime of a nuclear plant spans several decades. During this time, the plant may undergo design changes resulting from experience feedback, new knowledge or requirements, and safety reviews. To ensure that safety remains optimized, these changes must be carried out with a full understanding of and without compromising the design intent. The licensee holds prime responsibility for the safety of the plant, and fully responsible for design change management. It fulfils this responsibility by establishing a formal system for ensuring the safety of the plant design throughout its lifetime, which includes establishing a formally designated entity within its management system, referred to as the Design Authority. The establishment of a Design Authority may be challenging for many operators. Therefore the licensee may allocate tasks to external organizations—the original designers—that have a specialized knowledge of specific parts of the plant, including vendors and equipment suppliers. Utilities operating plants of similar design should take advantage of this similarity to manage their knowledge through an international fleet-wide approach, facilitating sharing of experience and enabling similar solutions to be adopted for design changes. Opportunities for exchanges brought by owners’ groups, and other operators’ groups should be fully developed. (author

Design of chemical plant

International Nuclear Information System (INIS)

Lee, Dong Il; Kim, Seung Jae; Yang, Jae Ho; Ryu, Hwa Won

1993-01-01

This book describes design of chemical plant, which includes chemical engineer and plan for chemical plant, development of chemical process, cost engineering pattern, design and process development, general plant construction plan, project engineering, foundation for economy on assets and depreciation, estimation for cost on capital investment and manufacturing cost, design with computers optimal design and method like fluid mechanics design chemical device and estimation for cost, such as dispatch of material and device writing on design report and appendixes.

On designing open-ended interpretations for collaborative design exploration

DEFF Research Database (Denmark)

Mattelmäki, Tuuli; Brandt, Eva; Vaajakallio, Kirsikka

2011-01-01

User-centred design is a widely acknowledged practice. Much attention has been paid to the methods, tools and processes on how to conduct design research and field studies with and about ‘users’ and existing or possible ‘contexts of use’. The underlying driver is that the design team will be bett...... interpretations which lead to empathic understanding and engagement. Rather than communicating the final results, design in supporting collaboration is applied in a process of exploring what it is that will create value for specific people....... at designing if they have an empathic understanding of the people to design with and for. Currently, more effort is invested in engaging various stakeholders in collaborative design activities that nurture an attitude of human-centredness as a strategy. Empathic design approaches are essential...... that they can allow and inspire new individual interpretations for various participants in the collaborative design processes, which include users, designers and other stakeholders. What is argued for here is the value of incompleteness of field study outcomes as it invites sense-making through making new...

Designing Human Technologies

DEFF Research Database (Denmark)

Simonsen, Jesper

and the design process, in ethical and society-related concerns, and in evaluating how designs fulfill needs and solve problems. Designing Human Technologies subscribes to a broad technology concept including information and communication, mobile, environmental/sustainable and energy technologies......Design is increasingly becoming a part of the university curriculum and research agenda. The keynote present and discuss Designing Human Technologies – an initiative aiming at establishing a design oriented main subject area alongside traditional main subject areas such as Natural Science......, the Humanities, and Social Science. The initiative broadens the perspective of IS and recognize reflections on aesthetics, ethics, values, connections to politics, and strategies for enabling a better future as legitimate parts of the research agenda. Designing Human Technologies is a design-oriented Strategic...

An assessment of design control practices and design reconstitution programs in the nuclear power industry

International Nuclear Information System (INIS)

Imbro, E.V.

1991-02-01

The US Nuclear Regulatory Commission (NRC) and the utilities have identified shortcomings involving the maintenance of well-defined design bases and the availability of the necessary supporting design documentation. Many utilities have embarked on design-document reconstitution programs although there has been no clear consensus regarding what information should be included in design-bases documents, what is the minimum set of necessary design documents to support the design bases, or how missing or deficient design documentation should be handled. The NRC initiated a survey to ascertain the status of design control programs within the industry and the approaches to design-bases documentation used by some utilities. The survey scope included six utilities and one nuclear steam supply system vendor. Conclusions and observations resulting from the survey assessments are provided so that utilities and the NRC can consider actions to improve these programs. 12 refs

Embedded Systems Design with FPGAs

CERN Document Server

Pnevmatikatos, Dionisios; Sklavos, Nicolas

2013-01-01

This book presents methodologies for modern applications of embedded systems design, using field programmable gate array (FPGA) devices.  Coverage includes state-of-the-art research from academia and industry on a wide range of topics, including advanced electronic design automation (EDA), novel system architectures, embedded processors, arithmetic, dynamic reconfiguration and applications. Describes a variety of methodologies for modern embedded systems design;  Implements methodologies presented on FPGAs; Covers a wide variety of applications for reconfigurable embedded systems, including Bioinformatics, Communications and networking, Application acceleration, Medical solutions, Experiments for high energy physics, Astronomy, Aerospace, Biologically inspired systems and Computational fluid dynamics (CFD).

Educating Instructional Designers: Different Methods for Different Outcomes.

Science.gov (United States)

Rowland, Gordon; And Others

1994-01-01

Suggests new methods of teaching instructional design based on literature reviews of other design fields including engineering, architecture, interior design, media design, and medicine. Methods discussed include public presentations, visiting experts, competitions, artifacts, case studies, design studios, and internships and apprenticeships.…

Clothing Systems Design Lab

Data.gov (United States)

Federal Laboratory Consortium — The Clothing Systems Design Lab houses facilities for the design and rapid prototyping of military protective apparel.Other focuses include: creation of patterns and...

Graphic Design Career Guide 2. Revised Edition.

Science.gov (United States)

Craig, James

The graphic design field is diverse and includes many areas of specialization. This guide introduces students to career opportunities in graphic design. The guide is organized in four parts. "Part One: Careers in Graphic Design" identifies and discusses the various segments of the graphic design industry, including: Advertising, Audio-Visual, Book…

Participatory workspace design

DEFF Research Database (Denmark)

Seim, Rikke; Broberg, Ole

2010-01-01

Ergonomics are rarely addressed directly in the design and re-design of workspaces in Denmark. Often architects, engineers and other actors design the workspaces on the basis of for example spatial, technological or finan-cial considerations, thereby making ergonomics a by-product of the design...... process. However, by introducing ergonomists in the role of ‘workspace de-signers’ early in the design process, ergonomic considerations as well as the involvement of employees, can be integrated in the design process. In this article we demonstrate the use of the workspace design approach in a case study...... where an industrial manufacturer is undergoing a major technological change: going from labour intensive manual work to a highly automated production. The workspace design team, which included the company’s OHS consultant, designed the intervention as a participatory design process by using visually...

Truck Drivers And Risk Of STDs Including HIV

Directory of Open Access Journals (Sweden)

Bansal R.K

1995-01-01

Full Text Available Research Question: Whether long distance truck drivers are at a higher risk of contracting and transmitting STDs including HIV? Objectives: i To study the degree of knowledge of HIV and AIDS among long- distance truck drivers. ii Assess their sexual behaviour including condom use. iii Explore their prevailing social influences and substance abuse patterns. iv Explore their treatment seeking bahaviour as regards STDs. v Deduce their risk of contracting and transmitting STDs including HIV. Study Design: Cross- sectional interview. Setting: Transport Nagar, Indore (M.P Participants: 210 senior drivers (First drivers and 210 junior drivers (Second drivers. Study Variables: Extra-Marital sexual intercourse, condom usage, past and present history of STDs, treatment and counseling, substance abuse, social â€" cultural milieu. Outcome Variables: Risk of contraction of STDs. Statistical Analysis: Univariate analysis. Results: 94% of the drivers were totally ignorant about AIDS. 82.9% and 43.8 % of the senior and junior drivers had a history of extra- marital sex and of these only 2 regularly used condoms. 13.8% and 3.3 % of the senior and junior drivers had a past or present history suggestive of STD infection. Alcohol and Opium were regularly used by them. Conclusion: The studied drivers are at a high risk of contracting and transmitting STDs including HIV.

Evaluation of design parameters of eight dental implant designs: A ...

African Journals Online (AJOL)

Aim: Implants could be considered predictable tools for replacing missing teeth or teeth that are irrational to treat. Implant macrodesign includes thread, body shape and thread design. Implant threads should be designed to maximize the delivery of optimal favorable stresses. The aim of this finite element model study was to ...

Design of the integration interface between the EU HCPB TBM and the ITER TBM port plug including hot cell operations for connection

International Nuclear Information System (INIS)

Neuberger, H.; Boccaccini, L.V.; Roccella, R.

2007-01-01

In the frame of the activities of the EU Breeder Blanket Programme and of the Test Blanket Working Group, the Helium Cooled Pebble Bed Test Blanket Module- (HCPB-TBM) System is developed. The TBM test schedule foresees four different campaigns for simulation of DEMO relevant conditions, campaign requires a dedicate TBM. Therefore a concept for TBM integration into ITER is designed with attention to simplify the mounting/dismounting operations. This paper presents the status of this concept with regard to the operations in hot cell required to install a new TBM into an equatorial TBM Port Plug (PP). This includes the establishment of the connection for the attachment, supply- and diagnostic lines in the environment of the interface (IF 1) between the TBM rear part and the PP backside shield. The connection of IF 1 has to be designed to cope with a temperature difference between TBM and PP (∝200 K) and the EM-loads during normal operation and disruption scenarios. The reference attachment concept based on shear keys and flexible cartridges is revised to cope with new conditions on the load and at the interface to the PP. According to the latest results of EM analysis, a radial component of the Maxwell forces (due to the ferromagnetic structural material) has been identified as an additional challenging load for the attachment. Furthermore, the replacing operations at IF 1 are influenced by the design of the PP; the recent ITER proposal based on a removable back side shield allows access to the IF 1 from the periphery after the frame of the PP surrounding the TBM is removed. As for the mechanical attachment, the tools and operations for connection of the TBM supply lines (Helium-, Purge- and measurement lines for different purpose depending on the test schedule) are strongly influenced by the restrictions to access IF 1, too. Dismantling of the frame would allow direct access to the interface by e.g. orbital welding tools. The concept for connection of the TBM

Issues in environmental survey design

International Nuclear Information System (INIS)

Iachan, R.

1989-01-01

Several environmental survey design issues are discussed and illustrated with surveys designed by Research Triangle Institute statisticians. Issues related to sampling and nonsampling errors are illustrated for indoor air quality surveys, radon surveys, pesticide surveys, and occupational and personal exposure surveys. Sample design issues include the use of auxiliary information (e.g. for stratification), and sampling in time. We also discuss the reduction and estimation of nonsampling errors, including nonresponse and measurement bias

DNA asymmetry in stem cells - immortal or mortal?

Science.gov (United States)

Yadlapalli, Swathi; Yamashita, Yukiko M

2013-09-15

The immortal strand hypothesis proposes that stem cells retain a template copy of genomic DNA (i.e. an 'immortal strand') to avoid replication-induced mutations. An alternative hypothesis suggests that certain cells segregate sister chromatids non-randomly to transmit distinct epigenetic information. However, this area of research has been highly controversial, with conflicting data even from the same cell types. Moreover, historically, the same term of 'non-random sister chromatid segregation' or 'biased sister chromatid segregation' has been used to indicate distinct biological processes, generating a confusion in the biological significance and potential mechanism of each phenomenon. Here, we discuss the models of non-random sister chromatid segregation, and we explore the strengths and limitations of the various techniques and experimental model systems used to study this question. We also describe our recent study on Drosophila male germline stem cells, where sister chromatids of X and Y chromosomes are segregated non-randomly during cell division. We aim to integrate the existing evidence to speculate on the underlying mechanisms and biological relevance of this long-standing observation on non-random sister chromatid segregation.

Design of joints in steel and composite structures Eurocode 3 : design of steel structures : part 1-8 : design of joints, Eurocode 4 : design of composite steel and concrete structures : part 1-1 : general rules and rules for buildings

CERN Document Server

Jaspart, Jean-Pierre

2016-01-01

This book details the basic concepts and the design rules included in Eurocode 3 Design of steel structures Part 1-8 Design of joints. Joints in composite construction are also addressed through references to Eurocode 4 Design of composite steel and concrete structures Part 1-1 General rules and rules for buildings. Attention has to be duly paid to the joints when designing a steel or composite structure, in terms of the global safety of the construction, and also in terms of the overall cost, including fabrication, transportation and erection. Therefore, in this book, the design of the joints themselves is widely detailed, and aspects of selection of joint configuration and integration of the joints into the analysis and the design process of the whole construction are also fully covered. Connections using mechanical fasteners, welded connections, simple joints, moment-resisting joints and lattice girder joints are considered. Various joint configurations are treated, including beam-to-column, beam-to-beam, ...

Energy design for architects

Energy Technology Data Exchange (ETDEWEB)

Shaw, A. (ed.)

1989-01-01

This book contains techniques for energy efficiency in architectural design. Many aspects are covered including: cost; comfort and health; energy use; the design process; and analytical techniques. 202 figs. (JF)

Constraining designs for synthesis and timing analysis a practical guide to synopsys design constraints (SDC)

CERN Document Server

Gangadharan, Sridhar

2013-01-01

This book serves as a hands-on guide to timing constraints in integrated circuit design.  Readers will learn to maximize performance of their IC designs, by specifying timing requirements correctly.  Coverage includes key aspects of the design flow impacted by timing constraints, including synthesis, static timing analysis and placement and routing.  Concepts needed for specifying timing requirements are explained in detail and then applied to specific stages in the design flow, all within the context of Synopsys Design Constraints (SDC), the industry-leading format for specifying constraints.  ·         Provides a hands-on guide to synthesis and timing analysis, using Synopsys Design Constraints (SDC), the industry-leading format for specifying constraints; ·         Includes key topics of interest to a synthesis, static timing analysis or  place and route engineer; ·         Explains which constraints command to use for ease of maintenance and reuse, given several options pos...

ITER Conceptual design: Interim report

International Nuclear Information System (INIS)

1990-01-01

This interim report describes the results of the International Thermonuclear Experimental Reactor (ITER) Conceptual Design Activities after the first year of design following the selection of the ITER concept in the autumn of 1988. Using the concept definition as the basis for conceptual design, the Design Phase has been underway since October 1988, and will be completed at the end of 1990, at which time a final report will be issued. This interim report includes an executive summary of ITER activities, a description of the ITER device and facility, an operation and research program summary, and a description of the physics and engineering design bases. Included are preliminary cost estimates and schedule for completion of the project

Exploratory shaft facility preliminary designs - Permian Basin

International Nuclear Information System (INIS)

1983-09-01

The purpose of the Preliminary Design Report, Permian Basin, is to provide a description of the preliminary design for an Exploratory Shaft Facility in the Permian Basin, Texas. This issue of the report describes the preliminary design for constructing the exploratory shaft using the Large Hole Drilling method of construction and outlines the preliminary design and estimates of probable construction cost. The Preliminary Design Report is prepared to complement and summarize other documents that comprise the design at the preliminary stage of completion, December 1982. Other design documents include drawings, cost estimates and schedules. The preliminary design drawing package, which includes the construction schedule drawing, depicts the descriptions in this report. For reference, a list of the drawing titles and corresponding numbers are included in the Appendix. The report is divided into three principal sections: Design Basis, Facility Description, and Construction Cost Estimate. 30 references, 13 tables

Fulltext PDF

Indian Academy of Sciences (India)

IAS Admin

lecture, including connections with completely nonrandom problems like calculating electrostatic potential inside a region. It is indeed appropriate that that audience of mathematics teachers were exposed to an expert view of a rich field, and we are happy to reach many more by reprinting Prof. Parthasarathy's lecture.

The Relationship between Critical Thinking Abilities and Classroom Management Skills of High School Teachers

Science.gov (United States)

Demirdag, Seyithan

2015-01-01

High school teachers experience difficulties while providing effective teaching approaches in their classrooms. Some of the difficulties are associated with the lack of classroom management skills and critical thinking abilities. This quantitative study includes non-random selection of the participants and aims to examine critical thinking…

Design Anthropology

DEFF Research Database (Denmark)

This edited volume provides an introduction to the emerging field of design anthropology from the point of view of anthropologists engaging in its development. Contributors include young anthropologists with experience in the field and leading theoreticians, who combine to articulate the specific...... style of knowing involved in doing design anthropology. So far design anthropology has been developed mostly in the practice of industry and the public sector, in particular in Scandinavia and the US, and the sustained academic reflection to support this practice is still in its early stages. This book...... will contribute to this theoretical reflection and provide a reference for practitioners, teachers and students of anthropology, as well as design and innovation....

Handbook of optical design

CERN Document Server

Malacara-Hernández, Daniel

2013-01-01

Handbook of Optical Design, Third Edition covers the fundamental principles of geometric optics and their application to lens design in one volume. It incorporates classic aspects of lens design along with important modern methods, tools, and instruments, including contemporary astronomical telescopes, Gaussian beams, and computer lens design. Written by respected researchers, the book has been extensively classroom-tested and developed in their lens design courses. This well-illustrated handbook clearly and concisely explains the intricacies of optical system design and evaluation. It also di

Quasi-experimental designs in practice-based research settings: design and implementation considerations.

Science.gov (United States)

Handley, Margaret A; Schillinger, Dean; Shiboski, Stephen

2011-01-01

Although randomized controlled trials are often a gold standard for determining intervention effects, in the area of practice-based research (PBR), there are many situations in which individual randomization is not possible. Alternative approaches to evaluating interventions have received increased attention, particularly those that can retain elements of randomization such that they can be considered "controlled" trials. Methodological design elements and practical implementation considerations for two quasi-experimental design approaches that have considerable promise in PBR settings--the stepped-wedge design, and a variant of this design, a wait-list cross-over design, are presented along with a case study from a recent PBR intervention for patients with diabetes. PBR-relevant design features include: creation of a cohort over time that collects control data but allows all participants (clusters or patients) to receive the intervention; staggered introduction of clusters; multiple data collection points; and one-way cross-over into the intervention arm. Practical considerations include: randomization versus stratification, training run in phases; and extended time period for overall study completion. Several design features of practice based research studies can be adapted to local circumstances yet retain elements to improve methodological rigor. Studies that utilize these methods, such as the stepped-wedge design and the wait-list cross-over design, can increase the evidence base for controlled studies conducted within the complex environment of PBR.

Nasal vs Oronasal CPAP for OSA Treatment: A Meta-Analysis.

Science.gov (United States)

Andrade, Rafaela G S; Viana, Fernanda M; Nascimento, Juliana A; Drager, Luciano F; Moffa, Adriano; Brunoni, André R; Genta, Pedro R; Lorenzi-Filho, Geraldo

2018-03-01

Nasal CPAP is the "gold standard" treatment for OSA. However, oronasal masks are frequently used in clinical practice. The aim of this study was to perform a meta-analysis of all randomized and nonrandomized trials that compared nasal vs oronasal masks on CPAP level, residual apnea-hypopnea index (AHI), and CPAP adherence to treat OSA. The Cochrane Central Register of Controlled Trials, Medline, and Web of Science were searched for relevant studies in any language with the following terms: "sleep apnea" and "CPAP" or "sleep apnea" and "oronasal mask" or "OSA" and "oronasal CPAP" or "oronasal mask" and "adherence." Studies on CPAP treatment for OSA were included, based on the following criteria: (1) original article; (2) randomized or nonrandomized trials; and (3) comparison between nasal and oronasal CPAP including pressure level, and/or residual AHI, and/or CPAP adherence. We identified five randomized and eight nonrandomized trials (4,563 patients) that reported CPAP level and/or residual AHI and/or CPAP adherence. Overall, the random-effects meta-analysis revealed that as compared with nasal, oronasal masks were associated with a significantly higher CPAP level (Hedges' g, -0.59; 95% CI, -0.82 to -0.37; P CPAP level, higher residual AHI, and poorer adherence than nasal masks. PROSPERO database; No.: CRD42017064584; URL: https://www.crd.york.ac.uk/prospero/. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Modification of SKYSHINE-III to include cask array shadowing

Energy Technology Data Exchange (ETDEWEB)

Hertel, N.E. [Georgia Institute of Technology, Atlanta, GA (United States); Pfeifer, H.J. [NAC International, Norcross, GA (United States); Napolitano, D.G. [NISYS Corporation, Duluth, GA (United States)

2000-03-01

The NAC International version of SKYSHINE-III has been expanded to represent the radiation emissions from ISFSI (Interim Spent Fuel Storage Installations) dry storage casks using surface source descriptions. In addition, this modification includes a shadow shielding algorithm of the casks in the array. The resultant code is a flexible design tool which can be used to rapidly assess the impact of various cask loadings and arrangements. An example of its use in calculating dose rates for a 10x8 cask array is presented. (author)

Engineering Design Thinking

Science.gov (United States)

Lammi, Matthew; Becker, Kurt

2013-01-01

Engineering design thinking is "a complex cognitive process" including divergence-convergence, a systems perspective, ambiguity, and collaboration (Dym, Agogino, Eris, Frey, & Leifer, 2005, p. 104). Design is often complex, involving multiple levels of interacting components within a system that may be nested within or connected to other systems.…

EMI filter design

CERN Document Server

Ozenbaugh, Richard Lee

2011-01-01

With today's electrical and electronics systems requiring increased levels of performance and reliability, the design of robust EMI filters plays a critical role in EMC compliance. Using a mix of practical methods and theoretical analysis, EMI Filter Design, Third Edition presents both a hands-on and academic approach to the design of EMI filters and the selection of components values. The design approaches covered include matrix methods using table data and the use of Fourier analysis, Laplace transforms, and transfer function realization of LC structures. This edition has been fully revised

Designated Places

Data.gov (United States)

California Natural Resource Agency — Census 2000 Place Names provides a seamless statewide GIS layer of places, including census designated places (CDP), consolidated cities, and incorporated places,...

Combinatorial designs a tribute to Haim Hanani

CERN Document Server

Hartman, A

1989-01-01

Haim Hanani pioneered the techniques for constructing designs and the theory of pairwise balanced designs, leading directly to Wilson''s Existence Theorem. He also led the way in the study of resolvable designs, covering and packing problems, latin squares, 3-designs and other combinatorial configurations.The Hanani volume is a collection of research and survey papers at the forefront of research in combinatorial design theory, including Professor Hanani''s own latest work on Balanced Incomplete Block Designs. Other areas covered include Steiner systems, finite geometries, quasigroups, and t-designs.

The Design of Akhmat Tower

Science.gov (United States)

Beardsley, Sara; Stochetti, Alejandro; Cerone, Marc

2018-03-01

Akhmat Tower is a 435m supertall building designed by Adrian Smith + Gordon Gill Architecture. It is currently under construction in the city of Grozny, in the Chechen Republic, in the North Caucasus region of Russia. The design of the tower was done during a collaborative process by a multi-disciplinary architectural and engineering team, based primarily in the United States and Russia. During this process, the designers considered many factors including, most primarily, the cultural and historical context, the structural requirements given the high seismicity of the region, and the client's programmatic needs. The resulting crystalline-shaped tower is both an aesthetic statement and a performative architectural solution which will be a new landmark for Chechnya. "The Design of Akhmat Tower" describes in detail the design process including structural considerations, exterior wall design, building program, interior design, the tuned mass damper, and the use of building information modeling.

Ergonomic Product Design 21

International Nuclear Information System (INIS)

Kwon, Yeong Guk

1996-09-01

This book explains basic of ergonomic product design with human engineering, image engineering and strategy of that design, ergonomic industrial design, which includes product design to access the human engineering in development of new product and customer satisfaction, application technology of image engineering, industrial design of human engineering item and strategy of human engineering, a good ergonomic design. It also tells of examples of convenient design for human such as hardware product and software product in automobile, telephones for ergonomic product in the future, new goods and new technology, ergonomic product in house and office, and computers and robots in the future.

Photonic Design for Photovoltaics

Energy Technology Data Exchange (ETDEWEB)

Kosten, E.; Callahan, D.; Horowitz, K.; Pala, R.; Atwater, H.

2014-08-28

We describe photonic design approaches for silicon photovoltaics including i) trapezoidal broadband light trapping structures ii) broadband light trapping with photonic crystal superlattices iii) III-V/Si nanowire arrays designed for broadband light trapping.

Optical system design

CERN Document Server

Fischer, Robert F

2008-01-01

Honed for more than 20 years in an SPIE professional course taught by renowned optical systems designer Robert E. Fischer, Optical System Design, Second Edition brings you the latest cutting-edge design techniques and more than 400 detailed diagrams that clearly illustrate every major procedure in optical design. This thoroughly updated resource helps you work better and faster with computer-aided optical design techniques, diffractive optics, and the latest applications, including digital imaging, telecommunications, and machine vision. No need for complex, unnecessary mathematical derivations-instead, you get hundreds of examples that break the techniques down into understandable steps. For twenty-first century optical design without the mystery, the authoritative Optical Systems Design, Second Edition features: Computer-aided design use explained through sample problems Case studies of third-millennium applications in digital imaging, sensors, lasers, machine vision, and more New chapters on optomechanic...

Interior design for dentistry.

Science.gov (United States)

Unthank, M; True, G

1999-11-01

In the increasingly complex, competitive and stressful field of dentistry, effectively designed dental offices can offer significant benefits. Esthetic, functional and life-cycle cost issues to be considered when developing your interior design scheme include color, finishes, lighting, furnishings, art and accessories. An appropriately designed dental office serves as a valuable marketing tool for your practice, as well as a safe and enjoyable work environment. Qualified interior design professionals can help you make design decisions that can yield optimum results within your budget.

Geosynthetic applications in landfill design

International Nuclear Information System (INIS)

Alshunnar, I.S.; Afifi, S.S.; Tiseo, B.

1996-01-01

Landfills are designed to contain waste and to provide protection against discharges of leachate into the environment. Main components of a landfill include a liner system, a leachate collection system, and a cover system. Traditional designs have typically incorporated clay soils for containment and sands with embedded piping for leachate collection. As a result of recent advances in design, geosynthetic materials are now widely used for components. While these materials present cost and feasibility advantages, they also pose significant challenges in stability evaluations, handing during installation, and quality assurance. This paper presents an overview of applications of geosynthetics in design and construction, including: Advantages, disadvantages, design criteria, possible economic benefits of various systems, and related construction considerations. 2 figs., 1 tab

A designated centre for people with disabilities operated by S.O.S. Kilkenny Ltd, Kilkenny

LENUS (Irish Health Repository)

Pursell, Lisa

2007-01-01

BACKGROUND: Objectives: To compare support for, and perceptions of, the impacts of smoke-free workplace legislation among bar workers in the Republic of Ireland (ROI) pre- and post-implementation, and to identify predictors of support for the legislation. METHODS: Setting: Public houses (pubs) in three areas of the ROI. Design: Comparisons pre- and post-implementation of smoke-free workplace legislation. Participants: From a largely non-random selection, 288 bar workers volunteered for the baseline survey; 220 were followed up one year later (76.4%). Outcome measures: Level of support for the legislation, attitude statements concerning potential impacts of the law and modelled predictors of support for the legislation. RESULTS: Pre-implementation 59.5% of participants supported the legislation, increasing to 76.8% post-implementation. Support increased among smokers by 27.3 percentage points from 39.4% to 66.7% (p < 0.001) and among non-smokers by 12.4% percentage points from 68.8% to 81.2% (p = 0.003).Pre-legislation three-quarters of participants agreed that the legislation would make bars more comfortable and was needed to protect workers\\' health. Post-legislation these proportions increased to over 90% (p < 0.001). However, negative perceptions also increased, particularly for perceptions that the legislation has a negative impact on business (from 50.9% to 62.7%, p = 0.008) and that fewer people would visit pubs (41.8% to 62.7%, p < 0.001). After adjusting for relevant covariates, including responses to the attitude statements, support for the ban increased two to three-fold post-implementation. Regardless of their views on the economic impact, most participants agreed, both pre- and post-implementation, that the legislation was needed to protect bar workers\\' health. CONCLUSION: Smoke-free legislation had the support of three-quarters of a large sample of bar workers in the ROI. However, this group holds complex sets of both positive and negative

Designing the Electronic Classroom: Applying Learning Theory and Ergonomic Design Principles.

Science.gov (United States)

Emmons, Mark; Wilkinson, Frances C.

2001-01-01

Applies learning theory and ergonomic principles to the design of effective learning environments for library instruction. Discusses features of electronic classroom ergonomics, including the ergonomics of physical space, environmental factors, and workstations; and includes classroom layouts. (Author/LRW)

Review and Analysis of Publication Trends over Three Decades in Three High Impact Medicine Journals.

Directory of Open Access Journals (Sweden)

Alexander Ivanov

Full Text Available Over the past three decades, industry sponsored research expanded in the United States. Financial incentives can lead to potential conflicts of interest (COI resulting in underreporting of negative study results.We hypothesized that over the three decades, there would be an increase in: a reporting of conflict of interest and source of funding; b percentage of randomized control trials c number of patients per study and d industry funding.Original articles published in three calendar years (1988, 1998, and 2008 in The Lancet, New England Journal of Medicine and Journal of American Medical Association were collected.Studies were reviewed and investigational design categorized as prospective and retrospective clinical trials. Prospective trials were categorized into randomized or non-randomized and single-center or multi-center trials. Retrospective trials were categorized as registries, meta-analyses and other studies, mostly comprising of case reports or series. Study outcomes were categorized as positive or negative depending on whether the pre-specified hypothesis was met. Financial disclosures were researched for financial relationships and profit status, and accordingly categorized as government, non-profit or industry sponsored. Studies were assessed for reporting COI.1,671 original articles were included in this analysis. Total number of published studies decreased by 17% from 1988 to 2008. Over 20 year period, the proportion of prospective randomized trials increased from 22 to 46% (p < 0.0001; whereas the proportion of prospective non-randomized trials decreased from 59% to 27% (p < 0.001. There was an increase in the percentage of prospective randomized multi-center trials from 11% to 41% (p < 0.001. Conversely, there was a reduction in non-randomized single-center trials from 47% to 10% (p < 0.001. Proportion of government funded studies remained constant, whereas industry funded studies more than doubled (17% to 40%; p < 0.0001. The

Exploring the Evidence Base for Acupuncture in the Treatment of Ménière's Syndrome—A Systematic Review

Directory of Open Access Journals (Sweden)

Andrew F. Long

2011-01-01

Full Text Available Ménière's syndrome is a long-term, progressive disease that damages the balance and hearing parts of the inner ear. To address the paucity of information on which evidence-based treatment decisions should be made, a systematic review of acupuncture for Ménière's syndrome was undertaken. The method used was a systematic review of English and Chinese literature, from six databases for randomized, non-randomized and observational studies. All studies were critically appraised and a narrative approach to data synthesis was adopted. Twenty-seven studies were included in this review (9 in English and 18 in Chinese languages: three randomized controlled trials, three non-randomized controlled studies and four pre-test, post-test designs. All but one of the studies was conducted in China. The studies covered body acupuncture, ear acupuncture, scalp acupuncture, fluid acupuncture point injection and moxibustion. The studies were of varying quality. The weight of evidence, across all study types, is of beneficial effect from acupuncture, for those in an acute phase or those who have had Ménière's syndrome for a number of years. The review reinforces the importance of searching for studies from English and Chinese literature. The transferability of the findings from China to a Western context needs confirmation. Further research is also needed to clarify questions around the appropriate frequency and number of treatment/courses of acupuncture. The weight of evidence suggests a potential benefit of acupuncture for persons with Ménière's disease, including those in an acute phase and reinforces the importance of searching for published studies in the Chinese language.

Clinical outcomes after estimated versus calculated activity of radioiodine for the treatment of hyperthyroidism: systematic review and meta-analysis.

Science.gov (United States)

de Rooij, A; Vandenbroucke, J P; Smit, J W A; Stokkel, M P M; Dekkers, O M

2009-11-01

Despite the long experience with radioiodine for hyperthyroidism, controversy remains regarding the optimal method to determine the activity that is required to achieve long-term euthyroidism. To compare the effect of estimated versus calculated activity of radioiodine in hyperthyroidism. Design Systematic review and meta-analysis. We searched the databases Medline, EMBASE, Web of Science, and Cochrane Library for randomized and nonrandomized studies, comparing the effect of activity estimation methods with dosimetry for hyperthyroidism. The main outcome measure was the frequency of treatment success, defined as persistent euthyroidism after radioiodine treatment at the end of follow-up in the dose estimated and calculated dosimetry group. Furthermore, we assessed the cure rates of hyperthyroidism. Three randomized and five nonrandomized studies, comparing the effect of estimated versus calculated activity of radioiodine on clinical outcomes for the treatment of hyperthyroidism, were included. The weighted mean relative frequency of successful treatment outcome (euthyroidism) was 1.03 (95% confidence interval (CI) 0.91-1.16) for estimated versus calculated activity; the weighted mean relative frequency of cure of hyperthyroidism (eu- or hypothyroidism) was 1.03 (95% CI 0.96-1.10). Subgroup analysis showed a relative frequency of euthyroidism of 1.03 (95% CI 0.84-1.26) for Graves' disease and of 1.05 (95% CI 0.91-1.19) for toxic multinodular goiter. The two main methods used to determine the activity in the treatment of hyperthyroidism with radioiodine, estimated and calculated, resulted in an equally successful treatment outcome. However, the heterogeneity of the included studies is a strong limitation that prevents a definitive conclusion from this meta-analysis.

Selected pharmacokinetic issues of the use of antiepileptic drugs and parenteral nutrition in critically ill patients.

Science.gov (United States)

Salih, Muhannad R M; Bahari, Mohd Baidi; Abd, Arwa Y

2010-12-31

To conduct a systematic review for the evidence supporting or disproving the reality of parenteral nutrition- antiepileptic drugs interaction, especially with respect to the plasma protein-binding of the drug. The articles related to the topic were identified through Medline and PubMed search (1968-Feburary 2010) for English language on the interaction between parenteral nutrition and antiepileptic drugs; the search terms used were anti-epileptic drugs, parenteral nutrition, and/or interaction, and/or in vitro. The search looked for prospective randomized and nonrandomized controlled studies; prospective nonrandomized uncontrolled studies; retrospective studies; case reports; and in vitro studies. Full text of the articles were then traced from the Universiti Sains Malaysia (USM) library subscribed databases, including Wiley-Blackwell Library, Cochrane Library, EBSCOHost, OVID, ScienceDirect, SAGE Premier, Scopus, SpringerLINK, and Wiley InterScience. The articles from journals not listed by USM library were traced through inter library loan. There were interactions between parenteral nutrition and drugs, including antiepileptics. Several guidelines were designed for the management of illnesses such as traumatic brain injuries or cancer patients, involving the use of parenteral nutrition and antiepileptics. Moreover, many studies demonstrated the in vitro and in vivo parenteral nutrition -drugs interactions, especially with antiepileptics. There was no evidence supporting the existence of parenteral nutrition-antiepileptic drugs interaction. The issue has not been studied in formal researches, but several case reports and anecdotes demonstrate this drug-nutrition interaction. However, alteration in the drug-free fraction result from parenteral nutrition-drug (i.e. antiepileptics) interactions may necessitate scrupulous reassessment of drug dosages in patients receiving these therapies. This reassessment may be particularly imperative in certain clinical situations

Bringing Value-Based Perspectives to Care: Including Patient and Family Members in Decision-Making Processes

Directory of Open Access Journals (Sweden)

Graeme Kohler

2017-11-01

Full Text Available n a gap in consistent application of system-level strategies that can effectively translate organizational policies around patient and family engagement into practice. Methods The broad objective of this initiative was to develop a system-level implementation strategy to include patient and family advisors (PFAs at decision-making points in primary healthcare (PHC based on wellestablished evidence and literature. In this opportunity sponsored by the Canadian Foundation for Healthcare Improvement (CFHI a co-design methodology, also well-established was applied in identifying and developing a suitable implementation strategy to engage PFAs as members of quality teams in PHC. Diabetes management centres (DMCs was selected as the pilot site to develop the strategy. Key steps in the process included review of evidence, review of the current state in PHC through engagement of key stakeholders and a co-design approach. Results The project team included a diverse representation of members from the PHC system including patient advisors, DMC team members, system leads, providers, Public Engagement team members and CFHI improvement coaches. Key outcomes of this 18-month long initiative included development of a working definition of patient and family engagement, development of a Patient and Family Engagement Resource Guide and evaluation of the resource guide. Conclusion This novel initiative provided us an opportunity to develop a supportive system-wide implementation plan and a strategy to include PFAs in decision-making processes in PHC. The well-established co-design methodology further allowed us to include value-based (customer driven quality and experience of care perspectives of several important stakeholders including patient advisors. The next step will be to implement the strategy within DMCs, spread the strategy PHC, both locally and provincially with a focus on sustainability.

Preliminary analysis of the nestedness patterns of Montane forest ...

African Journals Online (AJOL)

Results show that the species ordering is significantly non-random. The discussion and conclusions focus on the nested subset patterns exhibited by 14 species and, to a lesser extent, 'idiosyncratic' species and islands. Factors that may have contributed to this pattern include selective extinction and colonisation; however, ...

Pengaruh Pembelajaran Reciprocal Teaching Berbantuan Peta Pikiran (Mind Map) terhadap Kemampuan Metakognitif dan Hasil Belajar Siswa SMA

OpenAIRE

Anita Dian Sukardi; Herawati Susilo; Siti Zubaidah

2015-01-01

Abstract: Metacognitive skill is required for improving students’ learning outcome. To enhance the metacognitive skill, it can be done through reciprocal teaching model. This study aims at examining the influence of mind map assisted reciprocal teaching toward students’ metacognitive and learning outcome. This study used semi-experimental design using non-randomized control group pretest-posttest. This study was conducted within Senior High School whose students possess a low level of metacog...

Behavioral counseling to prevent childhood obesity – study protocol of a pragmatic trial in maternity and child health care

OpenAIRE

Mustila, Taina; Keskinen, Päivi; Luoto, Riitta

2012-01-01

Abstract Background Prevention is considered effective in combating the obesity epidemic. Prenatal environment may increase offspring's risk for obesity. A child starts to adopt food preferences and other behavioral habits affecting weight gain during preschool years. We report the study protocol of a pragmatic lifestyle intervention aiming at primary prevention of childhood obesity. Methods/Design A non-randomized controlled pragmatic trial in maternity and child health care clinics. The con...

The Design of Akhmat Tower

Directory of Open Access Journals (Sweden)

Beardsley Sara

2018-01-01

Full Text Available Akhmat Tower is a 435m supertall building designed by Adrian Smith + Gordon Gill Architecture. It is currently under construction in the city of Grozny, in the Chechen Republic, in the North Caucasus region of Russia. The design of the tower was done during a collaborative process by a multi-disciplinary architectural and engineering team, based primarily in the United States and Russia. During this process, the designers considered many factors including, most primarily, the cultural and historical context, the structural requirements given the high seismicity of the region, and the client’s programmatic needs. The resulting crystalline-shaped tower is both an aesthetic statement and a performative architectural solution which will be a new landmark for Chechnya. “The Design of Akhmat Tower” describes in detail the design process including structural considerations, exterior wall design, building program, interior design, the tuned mass damper, and the use of building information modeling.

Reengineering the Project Design Process

Science.gov (United States)

Casani, E.; Metzger, R.

1994-01-01

In response to NASA's goal of working faster, better and cheaper, JPL has developed extensive plans to minimize cost, maximize customer and employee satisfaction, and implement small- and moderate-size missions. These plans include improved management structures and processes, enhanced technical design processes, the incorporation of new technology, and the development of more economical space- and ground-system designs. The Laboratory's new Flight Projects Implementation Office has been chartered to oversee these innovations and the reengineering of JPL's project design process, including establishment of the Project Design Center and the Flight System Testbed. Reengineering at JPL implies a cultural change whereby the character of its design process will change from sequential to concurrent and from hierarchical to parallel. The Project Design Center will support missions offering high science return, design to cost, demonstrations of new technology, and rapid development. Its computer-supported environment will foster high-fidelity project life-cycle development and cost estimating.

Rendering Systems Visible for Design: Synthesis Maps as Constructivist Design Narratives

Directory of Open Access Journals (Sweden)

Peter Jones

Full Text Available Synthesis maps integrate research evidence, system expertise, and design proposals into visual narratives. These narratives support communication and decision-making among stakeholders. Synthesis maps evolved from earlier visualization tools in systemics and design. They help stakeholders to understand design options for complex sociotechnical systems. Other visual approaches map complexity for effective collaboration across perspectives and knowledge domains. These help stakeholder groups to work in higher-order design contexts for sociotechnical or human-ecological systems. This article describes a constructivist pedagogy for collaborative learning in small teams of mixed-discipline designers. Synthesis mapping enables these teams to learn systems methods for design research in complex problem domains. Synthesis maps integrate knowledge from research cycles and iterative sensemaking to define a coherent design narrative. While synthesis maps may include formal system modeling techniques, they do not require them. Synthesis maps tangibly render research observations and design choices. As a hybrid system design method, synthesis maps are a contribution to the design genre of visual systems thinking.

A calculation technique to improve continuous monitoring of containment integrity

International Nuclear Information System (INIS)

Dick, J.E.

1990-01-01

The containment envelope of nuclear plants is a passive and extremely effective safety feature. World experience indicates, however, that inadvertent breaches of envelope integrity can go undetected for substantial time periods. Consequently, continuous monitoring of integrity is being closely examined by many containment designers and operators. The most promising approach is to use sensors and systems that automatically measure changes in the mass of air in containment, time integrate any known air mass flow rates across containment boundaries, and perform a mass balance to obtain the air mass leaked. As fluctuations in such measurements are typically too large to enable leakage to be calculated to the desired precision, filtering and statistical techniques must be used to filter out random and time-dependent fluctuations. Current approaches cannot easily deal with nonrandom or systematic fluctuations in the measurements, including pressure changes within the containment. As a result, sampling periods must be kept short, or data measured during periods of varying containment pressure must be discarded. The technique described allows for much longer sampling periods under conditions of fluctuating containment pressure and eliminates the invalidation of data when the containment pressure fluctuation is nonrandom. It should therefore yield a much more precise value for the containment leakage characteristic. It also promises to be able to distinguish the presence of systematic errors unrelated to systematic pressure changes and to establish whether the containment leakage characteristic is laminar or turbulent

Influence of Music on Preoperative Anxiety and Physiologic Parameters in Women Undergoing Gynecologic Surgery.

Science.gov (United States)

Labrague, Leodoro J; McEnroe-Petitte, Denise M

2016-04-01

The aim of this study was to determine the influence of music on anxiety levels and physiologic parameters in women undergoing gynecologic surgery. This study employed a pre- and posttest experimental design with nonrandom assignment. Ninety-seven women undergoing gynecologic surgery were included in the study, where 49 were allocated to the control group (nonmusic group) and 48 were assigned to the experimental group (music group). Preoperative anxiety was measured using the State Trait Anxiety Inventory (STAI) while noninvasive instruments were used in measuring the patients' physiologic parameters (blood pressure [BP], pulse [P], and respiration [R]) at two time periods. Women allocated in the experimental group had lower STAI scores (t = 17.41, p music during the preoperative period in reducing anxiety and unpleasant symptoms in women undergoing gynecologic surgery. © The Author(s) 2014.

Effect of phase coupling on surface amplitude distribution of wind waves

Digital Repository Service at National Institute of Oceanography (India)

Varkey, M.J.

Nonlinear features of wind generated surface waves are considered here to be caused by nonrandomness (non-Uniform) in the phase spectrum. Nonrandomness in recorded waves, if present, would be generally obscured within the error level of observations...

Radiological design guide

International Nuclear Information System (INIS)

Evans, R.A.

1994-01-01

The purpose of this design guide is to provide radiological safety requirements, standards, and information necessary for designing facilities that will operate without unacceptable risk to personnel, the public, or the environment as required by the US Department of Energy (DOE). This design guide, together with WHC-CM-4-29, Nuclear Criticality Safety, WHC-CM-4-46, Nonreactor Facility Safety Analysis, and WHC-CM-7-5, Environmental Compliance, covers the radiation safety design requirements at Westinghouse Hanford Company (WHC). This design guide applies to the design of all new facilities. The WHC organization with line responsibility for design shall determine to what extent this design guide shall apply to the modifications to existing facilities. In making this determination, consideration shall include a cost versus benefit study. Specifically, facilities that store, handle, or process radioactive materials will be covered. This design guide replaces WHC-CM-4-9 and is designated a living document. This design guide is intended for design purposes only. Design criteria are different from operational criteria and often more stringent. Criteria that might be acceptable for operations might not be adequate for design

Professional ASPNET Design Patterns

CERN Document Server

Millett, Scott

2010-01-01

Professional ASP.NET Design Patterns will show you how to implement design patterns in real ASP.NET applications by introducing you to the basic OOP skills needed to understand and interpret design patterns. A sample application used throughout the book is an enterprise level ASP.NET website with multi-tiered, SOA design techniques that can be applied to your future ASP.NET projects. Read about each design pattern in detail, including how to interpret the UML design, how to implement it in ASP.NET, its importance for ASP.NET development, and how it's integrated into the final project.

Furniture design

CERN Document Server

Smardzewski, Jerzy

2015-01-01

Maximizing reader insights into the principles of designing furniture as wooden structures, this book discusses issues related to the history of furniture structures, their classification and characteristics, ergonomic approaches to anthropometric requirements and safety of use. It presents key methods and highlights common errors in designing the characteristics of the materials, components, joints and structures, as well as looking at the challenges regarding developing associated design documentation. Including analysis of how designers may go about calculating the stiffness and endurance of parts, joints and whole structures, the book analyzes questions regarding the loss of furniture stability and the resulting threats to health of the user, putting forward a concept of furniture design as an engineering processes. Creating an attractive, functional, ergonomic and safe piece of furniture is not only the fruit of the work of individual architects and artists, but requires an effort of many people working ...

Preliminary design review: Brayton Isotope Power System

International Nuclear Information System (INIS)

The design aspects covered include flight system design, design criteria/margins/reliability, GDS design, system analysis, materials, system assembly procedure, and government furnished equipment-BTPS

Digital system design with VHDL

International Nuclear Information System (INIS)

Kang, Jin Gu; Lee, Da Young; Song, Je Chel

2000-09-01

This book is comprised of eleven chapters, which are review of basic logic design including combinational logic circuit, KARNAUGH MAPS, Hazard of combinational circuit, Melay order circuit design and synchronous design, introduction of VHDL like VHDL module of Multiplexer and VHDL Function, design with PLD for program, circuit design for arithmetical operation, digital design using SM chart, PGA and CPLD design, Floating-point calculation, extra issues on VHDL, VHDL module for memory and bus,design for hardware test and a testing and examples for design such as UART design and M68HC05 micro controller.

Evil by design interaction design to lead us into temptation

CERN Document Server

Nodder, Chris

2013-01-01

How to make customers feel good about doing what you want Learn how companies make us feel good about doing what they want. Approaching persuasive design from the dark side, this book melds psychology, marketing, and design concepts to show why we're susceptible to certain persuasive techniques. Packed with examples from every nook and cranny of the web, it provides easily digestible and applicable patterns for putting these design techniques to work. Organized by the seven deadly sins, it includes: Pride - use social proof to position your product in line with your visitor

Intuitive analog circuit design

CERN Document Server

Thompson, Marc

2013-01-01

Intuitive Analog Circuit Design outlines ways of thinking about analog circuits and systems that let you develop a feel for what a good, working analog circuit design should be. This book reflects author Marc Thompson's 30 years of experience designing analog and power electronics circuits and teaching graduate-level analog circuit design, and is the ideal reference for anyone who needs a straightforward introduction to the subject. In this book, Dr. Thompson describes intuitive and ""back-of-the-envelope"" techniques for designing and analyzing analog circuits, including transistor amplifi

Considerations on Fail Safe Design for Design Basis Accident (DBA) vs. Design Extension Condition (DEC): Lesson Learnt from the Fukushima Accident

International Nuclear Information System (INIS)

Ha, Jun Su; Kim, Sungyeop

2014-01-01

The fail safety design is referred to as an inherently safe design concept where the failure of an SSC (System, Structure or Component) leads directly to a safe condition. Usually the fail safe design has been devised based on the design basis accident (DBAs), because the nuclear safety has been assured by securing the capability to safely cope with DBAs. Currently regards have been paid to the DEC (Design Extension Condition) as an extended design consideration. Hence additional attention should be paid to the concept of the fail safe design in order to consider the DEC, accordingly. In this study, a case chosen from the Fukushima accident is studied to discuss the issue associated with the fail safe design in terms of DBA and DEC standpoints. For the fail safe design to be based both on the DBA and the DEC, a Mode Changeable Fail Safe Design (MCFSD) is proposed in this study. Additional discussions on what is needed for the MCFSD to be applied in the nuclear safety are addressed as well. One of the lessons learnt from the Fukushima accident should include considerations on the fail-safe design in a changing regulatory framework. Currently the design extension condition (DEC) including severe accidents should be considered during designing and licensing NPPs. Hence concepts on the fail safe design need to be changed to be based on not only the DBA but also the DEC. In this study, a case on a fail-safe design chosen from the Fukushima accident is studied to discuss the issue associated with the fail safe design in terms of DBA and DEC conditions. For the fail safe design to be based both on the DBA and the DEC, a Mode Changeable Fail Safe Design (MCFSD) is proposed in this study. Additional discussions on what is needed for the MCFSD to be applied in the nuclear safety are addressed as well

Job and Work Design

OpenAIRE

Van den Broeck, Anja; Parker, Sharon K.

2017-01-01

Job design or work design refers to the content, structure, and organization of tasks and activities. It is mostly studied in terms of job characteristics, such as autonomy, workload, role problems, and feedback. Throughout history, job design has moved away from a sole focus on efficiency and productivity to more motivational job designs, including the social approach toward work, Herzberg’s two-factor model, Hackman and Oldham’s job characteristics model, the job demand control model of Kar...

EcoDesign and future environmental impacts

DEFF Research Database (Denmark)

Jeswiet, Jack; Hauschild, Michael Zwicky

2005-01-01

This paper describes the relation between EcoDesign and Life Cycle Engineering; both include Product Engineering as a focal point. Product Engineering includes both product design and manufacture, two fields which are changing quickly. In addition, this paper shows where future changes can be exp...

Fire Safety Design of Wood Structures

DEFF Research Database (Denmark)

Hertz, Kristian Dahl

2006-01-01

Lecture Notes on Fire Safety Design of Wood Structures including charring of wood and load bearing capacity of beams, columns, and connections.......Lecture Notes on Fire Safety Design of Wood Structures including charring of wood and load bearing capacity of beams, columns, and connections....

CERN Technical Training: LABVIEW courses include RADE

CERN Multimedia

HR Department

2009-01-01

The contents of the "LabView Basic I" and "LabView Intermediate II" courses have recently been changed to include, respectively, an introduction to and expert training in the Rapid Application Development Environment (RADE). RADE is a LabView-based application developed at CERN to integrate LabView in the accelerator and experiment control infrastructure. It is a suitable solution to developing expert tools, machine development analysis and independent test facilities. The course names have also been changed to "LabVIEW Basics I with RADE Introduction" and "LabVIEW Intermediate II with Advanced RADE Application". " LabVIEW Basics I with RADE Introduction" is designed for: Users preparing to develop applications using LabVIEW, or NI Developer Suite; users and technical managers evaluating LabVIEW or NI Developer Suite in purchasing decisions; users pursuing the Certified LabVIEW Developer certification. The course pr...

CERN Technical Training: LABVIEW courses include RADE

CERN Multimedia

HR Department

2009-01-01

The contents of "LabView Basic I" and "LabView Intermediate II" trainings have been recently changed to include, respectively, an introduction and an expert training on the Rapid Application Development Environment (RADE). RADE is a LabView-based application developed at CERN to integrate LabView in the accelerator and experiment control infrastructure. It is a suitable solution to develop expert tools, machine development analysis and independent test facilities. The course names have also been changed to "LabVIEW Basics I with RADE Introduction" and "LabVIEW Intermediate II with Advanced RADE Application". " LabVIEW Basics I with RADE Introduction" is designed for: Users preparing to develop applications using LabVIEW, or NI Developer Suite; users and technical managers evaluating LabVIEW or NI Developer Suite in purchasing decisions; users pursuing the Certified LabVIEW Developer certification. The course prepare...

Impact of cooking and home food preparation interventions among adults: outcomes and implications for future programs

Science.gov (United States)

Reicks, Marla; Trofholz, Amanda C.; Stang, Jamie S; Laska, Melissa N.

2014-01-01

Objective Cooking programs are growing in popularity; however an extensive review has not examined overall impact. Therefore, this study reviewed previous research on cooking/home food preparation interventions and diet and health-related outcomes among adults and identified implications for practice and research. Design Literature review and descriptive summative method. Main outcome measures Dietary intake, knowledge/skills, cooking attitudes and self-efficacy/confidence, health outcomes. Analysis Articles evaluating effectiveness of interventions that included cooking/home food preparation as the primary aim (January 1980 through December 2011) were identified via OVID MEDLINE, Agricola and Web of Science databases. Studies grouped according to design and outcomes were reviewed for validity using an established coding system. Results were summarized for several outcome categories. Results Of 28 studies identified, 12 included a control group with six as non-randomized and six as randomized controlled trials. Evaluation was done post-intervention for five studies, pre- and post-intervention for 23 and beyond post-intervention for 15. Qualitative and quantitative measures suggested a positive influence on main outcomes. However, non-rigorous study designs, varying study populations, and use of non-validated assessment tools limited stronger conclusions. Conclusions and Implications Well-designed studies are needed that rigorously evaluate long-term impact on cooking behavior, dietary intake, obesity and other health outcomes. PMID:24703245

Nanopatterned Bulk Metallic Glass Biosensors.

Science.gov (United States)

Kinser, Emily R; Padmanabhan, Jagannath; Yu, Roy; Corona, Sydney L; Li, Jinyang; Vaddiraju, Sagar; Legassey, Allen; Loye, Ayomiposi; Balestrini, Jenna; Solly, Dawson A; Schroers, Jan; Taylor, André D; Papadimitrakopoulos, Fotios; Herzog, Raimund I; Kyriakides, Themis R

2017-12-22

Nanopatterning as a surface area enhancement method has the potential to increase signal and sensitivity of biosensors. Platinum-based bulk metallic glass (Pt-BMG) is a biocompatible material with electrical properties conducive for biosensor electrode applications, which can be processed in air at comparably low temperatures to produce nonrandom topography at the nanoscale. Work presented here employs nanopatterned Pt-BMG electrodes functionalized with glucose oxidase enzyme to explore the impact of nonrandom and highly reproducible nanoscale surface area enhancement on glucose biosensor performance. Electrochemical measurements including cyclic voltammetry (CV) and amperometric voltammetry (AV) were completed to compare the performance of 200 nm Pt-BMG electrodes vs Flat Pt-BMG control electrodes. Glucose dosing response was studied in a range of 2 mM to 10 mM. Effective current density dynamic range for the 200 nm Pt-BMG was 10-12 times greater than that of the Flat BMG control. Nanopatterned electrode sensitivity was measured to be 3.28 μA/cm 2 /mM, which was also an order of magnitude greater than the flat electrode. These results suggest that nonrandom nanotopography is a scalable and customizable engineering tool which can be integrated with Pt-BMGs to produce biocompatible biosensors with enhanced signal and sensitivity.

Intermediate-Size Inducer Pump design report. [LMFBR

Energy Technology Data Exchange (ETDEWEB)

Boardman, T.J.

1979-06-15

This report summarizes the mechanical, structural, and hydrodynamic design of the Intermediate-Size Inducer Pump (ISIP). The design was performed under Atomics International's DOE Base Technology Program by the Atomics International and Rocketdyne Divisions of Rockwell International. The pump was designed to utilize the FFTF prototype pump frame as a test vehicle to test the inducer, impeller, and diffuser plus necessary adapter hardware under simulated Large Scale Liquid Metal Fast Breeder Reactor service conditions. The report describes the design requirements including the purpose and objectives, and discusses those design efforts and considerations made to meet the requirements. Included in the report are appendices showing calculative methods and results. Also included are overall assembly and layout drawings plus some details used as illustrations for discussion of the design results and the results of water tests performed on a model of the inducer.

Algebraic design theory

CERN Document Server

Launey, Warwick De

2011-01-01

Combinatorial design theory is a source of simply stated, concrete, yet difficult discrete problems, with the Hadamard conjecture being a prime example. It has become clear that many of these problems are essentially algebraic in nature. This book provides a unified vision of the algebraic themes which have developed so far in design theory. These include the applications in design theory of matrix algebra, the automorphism group and its regular subgroups, the composition of smaller designs to make larger designs, and the connection between designs with regular group actions and solutions to group ring equations. Everything is explained at an elementary level in terms of orthogonality sets and pairwise combinatorial designs--new and simple combinatorial notions which cover many of the commonly studied designs. Particular attention is paid to how the main themes apply in the important new context of cocyclic development. Indeed, this book contains a comprehensive account of cocyclic Hadamard matrices. The book...

An experiment in multidisciplinary digital design

NARCIS (Netherlands)

Tuncer, B.; De Ruiter, P.; Mulders, S.

2008-01-01

The design and realization of complex buildings requires multidisciplinary design collaboration from early on in the design process. The intensive use of digital design environments in this process demands new knowledge and skills from the involved players including integrating and managing digital

CANDU fuel : design/manufacturing interaction

International Nuclear Information System (INIS)

Graham, N.A.

1999-01-01

The design of CANDU fuel has been the product of intense cooperation among fuel designers and fuel manufacturers. The developments of some of the novel processes in fuel manufacture are outlined. These include the brazed-split-spacer design, the resistance welded endcap and CANLUB coatings. (author)

Thermal Insulation System for Non-Vacuum Applications Including a Multilayer Composite

Science.gov (United States)

Fesmire, James E. (Inventor)

2017-01-01

The thermal insulation system of the present invention is for non-vacuum applications and is specifically tailored to the ambient pressure environment with any level of humidity or moisture. The thermal insulation system includes a multilayered composite including i) at least one thermal insulation layer and at least one compressible barrier layer provided as alternating, successive layers, and ii) at least one reflective film provided on at least one surface of the thermal insulation layer and/or said compressible barrier layer. The different layers and materials and their combinations are designed to provide low effective thermal conductivity for the system by managing all modes of heat transfer. The thermal insulation system includes an optional outer casing surrounding the multilayered composite. The thermal insulation system is particularly suited for use in any sub-ambient temperature environment where moisture or its adverse effects are a concern. The thermal insulation system provides physical resilience against damaging mechanical effects including compression, flexure, impact, vibration, and thermal expansion/contraction.

Method card design dimensions

DEFF Research Database (Denmark)

Wölfel, Christiane; Merritt, T.

2013-01-01

There are many examples of cards used to assist or provide structure to the design process, yet there has not been a thorough articulation of the strengths and weaknesses of the various examples. We review eighteen card-based design tools in order to understand how they might benefit designers....... The card-based tools are explained in terms of five design dimensions including the intended purpose and scope of use, duration of use, methodology, customization, and formal/material qualities. Our analysis suggests three design patterns or archetypes for existing card-based design method tools...... and highlights unexplored areas in the design space. The paper concludes with recommendations for the future development of card-based methods for the field of interaction design....

Analysis of digester design concepts

Energy Technology Data Exchange (ETDEWEB)

Ashare, E.; Wilson, E. H.

1979-01-29

Engineering economic analyses were performed on various digester design concepts to determine the relative performance for various biomass feedstocks. A comprehensive literature survey describing the state-of-the-art of the various digestion designs is included. The digester designs included in the analyses are CSTR, plug flow, batch, CSTR in series, multi-stage digestion and biomethanation. Other process options investigated included pretreatment processes such as shredding, degritting, and chemical pretreatment, and post-digestion processes, such as dewatering and gas purification. The biomass sources considered include feedlot manure, rice straw, and bagasse. The results of the analysis indicate that the most economical (on a unit gas cost basis) digester design concept is the plug flow reactor. This conclusion results from this system providing a high gas production rate combined with a low capital hole-in-the-ground digester design concept. The costs determined in this analysis do not include any credits or penalties for feedstock or by-products, but present the costs only for conversion of biomass to methane. The batch land-fill type digester design was shown to have a unit gas cost comparable to that for a conventional stirred tank digester, with the potential of reducing the cost if a land-fill site were available for a lower cost per unit volume. The use of chemical pretreatment resulted in a higher unit gas cost, primarily due to the cost of pretreatment chemical. A sensitivity analysis indicated that the use of chemical pretreatment could improve the economics provided a process could be developed which utilized either less pretreatment chemical or a less costly chemical. The use of other process options resulted in higher unit gas costs. These options should only be used when necessary for proper process performance, or to result in production of a valuable by-product.

Teaching ethical-participatory social design

DEFF Research Database (Denmark)

Dupret, Katia; Chimirri, Niklas Alexander

2018-01-01

, and by fostering ongoing mutual reflection. These workshops are inspired by participatory design, political theory, disability studies and psychological practice research. By drawing on empirical material from a design workshop with Bachelor students and external collaborators including psychologically vulnerable...... stakeholders, we argue for an adaptive framework of analytical-pedagogical inquiry that can be continuously co-designed. In particular, ethical design requires a broad and emergent definition of participation. Ethical design is participatory-democratic co-design, which acknowledges and bridges across...

Using Multiple Types of Studies in Systematic Reviews of Health Care Interventions – A Systematic Review

Science.gov (United States)

Peinemann, Frank; Tushabe, Doreen Allen; Kleijnen, Jos

2013-01-01

Background A systematic review may evaluate different aspects of a health care intervention. To accommodate the evaluation of various research questions, the inclusion of more than one study design may be necessary. One aim of this study is to find and describe articles on methodological issues concerning the incorporation of multiple types of study designs in systematic reviews on health care interventions. Another aim is to evaluate methods studies that have assessed whether reported effects differ by study types. Methods and Findings We searched PubMed, the Cochrane Database of Systematic Reviews, and the Cochrane Methodology Register on 31 March 2012 and identified 42 articles that reported on the integration of single or multiple study designs in systematic reviews. We summarized the contents of the articles qualitatively and assessed theoretical and empirical evidence. We found that many examples of reviews incorporating multiple types of studies exist and that every study design can serve a specific purpose. The clinical questions of a systematic review determine the types of design that are necessary or sufficient to provide the best possible answers. In a second independent search, we identified 49 studies, 31 systematic reviews and 18 trials that compared the effect sizes between randomized and nonrandomized controlled trials, which were statistically different in 35%, and not different in 53%. Twelve percent of studies reported both, different and non-different effect sizes. Conclusions Different study designs addressing the same question yielded varying results, with differences in about half of all examples. The risk of presenting uncertain results without knowing for sure the direction and magnitude of the effect holds true for both nonrandomized and randomized controlled trials. The integration of multiple study designs in systematic reviews is required if patients should be informed on the many facets of patient relevant issues of health care

Control design for a mobile robot Including tire behavior

NARCIS (Netherlands)

Ploeg, J.; Schouten, H.E.; Nijmeijer, H.

2008-01-01

In order to support the development process of Advanced Driver Assistance systems for road vehicles, TNO is operating a hardware-in-the-loop test setup. In this facility, called VeHIL, vehicles in the direct neighborhood of the test vehicle are simulated using wheeled mobile robots. Due to the

Control design for a mobile robot including tire behavior

NARCIS (Netherlands)

Ploeg, J.; Schouten, H.E.; Nijmeijer, H.

2008-01-01

In order to support the development process of Advanced Driver Assistance systems for road vehicles, TNO is operating a hardware-in-the-loop test setup. In this facility, called VeHIL, vehicles in the direct neighborhood of the test vehicle are simulated using wheeled mobile robots. Due to the

Key Characteristics of Combined Accident including TLOFW accident for PSA Modeling

Energy Technology Data Exchange (ETDEWEB)

Kim, Bo Gyung; Kang, Hyun Gook [KAIST, Daejeon (Korea, Republic of); Yoon, Ho Joon [Khalifa University of Science, Technology and Research, Abu Dhabi (United Arab Emirates)

2015-05-15

The conventional PSA techniques cannot adequately evaluate all events. The conventional PSA models usually focus on single internal events such as DBAs, the external hazards such as fire, seismic. However, the Fukushima accident of Japan in 2011 reveals that very rare event is necessary to be considered in the PSA model to prevent the radioactive release to environment caused by poor treatment based on lack of the information, and to improve the emergency operation procedure. Especially, the results from PSA can be used to decision making for regulators. Moreover, designers can consider the weakness of plant safety based on the quantified results and understand accident sequence based on human actions and system availability. This study is for PSA modeling of combined accidents including total loss of feedwater (TLOFW) accident. The TLOFW accident is a representative accident involving the failure of cooling through secondary side. If the amount of heat transfer is not enough due to the failure of secondary side, the heat will be accumulated to the primary side by continuous core decay heat. Transients with loss of feedwater include total loss of feedwater accident, loss of condenser vacuum accident, and closure of all MSIVs. When residual heat removal by the secondary side is terminated, the safety injection into the RCS with direct primary depressurization would provide alternative heat removal. This operation is called feed and bleed (F and B) operation. Combined accidents including TLOFW accident are very rare event and partially considered in conventional PSA model. Since the necessity of F and B operation is related to plant conditions, the PSA modeling for combined accidents including TLOFW accident is necessary to identify the design and operational vulnerabilities.The PSA is significant to assess the risk of NPPs, and to identify the design and operational vulnerabilities. Even though the combined accident is very rare event, the consequence of combined

Fusion target design

International Nuclear Information System (INIS)

Bangerter, R.O.

1978-01-01

Most detailed fusion target design is done by numerical simulation using large computers. Although numerical simulation is briefly discussed, this lecture deals primarily with the way in which basic physical arguments, driver technology considerations and economical power production requirements are used to guide and augment the simulations. Physics topics discussed include target energetics, preheat, stability and symmetry. A specific design example is discussed

System-level design methodologies for telecommunication

CERN Document Server

Sklavos, Nicolas; Goehringer, Diana; Kitsos, Paris

2013-01-01

This book provides a comprehensive overview of modern networks design, from specifications and modeling to implementations and test procedures, including the design and implementation of modern networks on chip, in both wireless and mobile applications.  Topical coverage includes algorithms and methodologies, telecommunications, hardware (including networks on chip), security and privacy, wireless and mobile networks and a variety of modern applications, such as VoLTE and the internet of things.

DECA - The design change assistant

International Nuclear Information System (INIS)

Brtis, J.S.; Dickson, A.C.; Beasant, R.P.; Waninski, R.E.

1993-01-01

This paper discusses the design change assistant (DECA), an expert-system-based program that allows the computerization of engineering design reviews. Included in the discussion are what DECA is, how it works, what its benefits are, and how it has been applied to Commonwealth Edison's engineering design reviews, which are part of their design change packages for modifications. Preparing plant modifications is one important example of proceduralized engineering activities that require complex reviews and documentation. Preparing for plant modifications requires the determination that the modification does not adversely affect safety or operations or deviate from standard station practices. Performing such reviews adds significantly to the expense and lead time of even simple modifications. Indirect burdens of these reviews include the time and expense of training the reviewers

CRISPR/Cas9 gene drives in genetically variable and nonrandomly mating wild populations.

Science.gov (United States)

Drury, Douglas W; Dapper, Amy L; Siniard, Dylan J; Zentner, Gabriel E; Wade, Michael J

2017-05-01

Synthetic gene drives based on CRISPR/Cas9 have the potential to control, alter, or suppress populations of crop pests and disease vectors, but it is unclear how they will function in wild populations. Using genetic data from four populations of the flour beetle Tribolium castaneum , we show that most populations harbor genetic variants in Cas9 target sites, some of which would render them immune to drive (ITD). We show that even a rare ITD allele can reduce or eliminate the efficacy of a CRISPR/Cas9-based synthetic gene drive. This effect is equivalent to and accentuated by mild inbreeding, which is a characteristic of many disease-vectoring arthropods. We conclude that designing such drives will require characterization of genetic variability and the mating system within and among targeted populations.

Novel integrated design framework for radio frequency quadrupoles

International Nuclear Information System (INIS)

Jolly, Simon; Easton, Matthew; Lawrie, Scott; Letchford, Alan; Pozimski, Jürgen; Savage, Peter

2014-01-01

A novel design framework for Radio Frequency Quadrupoles (RFQs), developed as part of the design of the FETS RFQ, is presented. This framework integrates several previously disparate steps in the design of RFQs, including the beam dynamics design, mechanical design, electromagnetic, thermal and mechanical modelling and beam dynamics simulations. Each stage of the design process is described in detail, including the various software options and reasons for the final software suite selected. Results are given for each of these steps, describing how each stage affects the overall design process, with an emphasis on the resulting design choices for the FETS RFQ

Operator Station Design System - A computer aided design approach to work station layout

Science.gov (United States)

Lewis, J. L.

1979-01-01

The Operator Station Design System is resident in NASA's Johnson Space Center Spacecraft Design Division Performance Laboratory. It includes stand-alone minicomputer hardware and Panel Layout Automated Interactive Design and Crew Station Assessment of Reach software. The data base consists of the Shuttle Transportation System Orbiter Crew Compartment (in part), the Orbiter payload bay and remote manipulator (in part), and various anthropometric populations. The system is utilized to provide panel layouts, assess reach and vision, determine interference and fit problems early in the design phase, study design applications as a function of anthropometric and mission requirements, and to accomplish conceptual design to support advanced study efforts.

Effectiveness of the “What’s Up!” Intervention to Reduce Stigma and Psychometric Properties of the Youth Program Questionnaire (YPQ: Results from a Cluster Non-randomized Controlled Trial Conducted in Catalan High Schools

Directory of Open Access Journals (Sweden)

Laura Andrés-Rodríguez

2017-09-01

Full Text Available Mental disorders are highly prevalent in the general population, and people who experience them are frequently stigmatized. Stigma has a very negative impact on social, academic/professional, and personal life. Considering the high rates of mental disorders among children and adolescents (13.4% and how critical this age is in the formation of nuclear beliefs, many campaigns to combat stigma have been developed in the last decade, with mixed results. The OBERTAMENT initiative has produced various anti-stigma campaigns in Catalonia (Spain. In the present study, the main objective was to report on the effectiveness of the OBERTAMENT “What’s up!” intervention, a curricular intervention including education and social contact conducted by the teachers in the classroom with teenagers aged between 14 and 18. Prior to this, we examined the psychometric properties of the Youth Program Questionnaire (YPQ, our main outcome measure, in terms of dimensionality, reliability, and validity. A cluster non-randomized controlled trial was conducted to assess this intervention, which was tested in nine high schools situated in the Barcelona region. A convenience sample of 261 students formed the intervention group and 132 the control group (52% women, mean age = 14, SD = 0.47. The assignment to study conditions was conducted by Departament d’Ensenyament (Department of Education, Generalitat de Catalunya (Catalan Government. Participants were evaluated at baseline, post-intervention, and 9-month follow-up. The main outcome measure of this study was the YPQ. The Reported and Intended Behavior Scale (RIBS was used as secondary outcome measure. The statistical analysis indicated that the YPQ possesses a two-factor structure (stereotypical attitudes and intended behavior and sound psychometric properties. The multilevel mixed-effects models revealed statistically significant interactions for both study measures and post hoc intragroup analyses revealed a

Teaching Creative Thinking through Architectural Design

Science.gov (United States)

Jeon, Kijeong; Cotner, Teresa L.

2010-01-01

Art and art education are open to broader definitions in the twenty-first century. It is time that teachers seriously think about including built environment design in K-12 art education. The term "built environment" includes interior design, architecture, landscape architecture, and urban planning. Due to increased exposure to built environment…

CERN Technical Training: LABVIEW courses include RADE

CERN Multimedia

HR Department

2009-01-01

The contents of the "LabView Basic I" and "LabView Intermediate II" courses have recently been changed to include, respectively, an introduction to and expert training in the Rapid Application Development Environment (RADE). RADE is a LabView-based application developed at CERN to integrate LabView in the accelerator and experiment control infrastructure. It is a suitable solution to developing expert tools, machine development analysis and independent test facilities. The course names have also been changed to "LabVIEW Basics I with RADE Introduction" and "LabVIEW Intermediate II with Advanced RADE Application". " LabVIEW Basics I with RADE Introduction" is designed for: Users preparing to develop applications using LabVIEW, or NI Developer Suite; users and technical managers evaluating LabVIEW or NI Developer Suite in purchasing decisions; users pursuing the Certified LabVIEW Developer certification. The course prepares participants to develop test and measurement, da...

Designing robots for care: care centered value-sensitive design.

Science.gov (United States)

van Wynsberghe, Aimee

2013-06-01

The prospective robots in healthcare intended to be included within the conclave of the nurse-patient relationship--what I refer to as care robots--require rigorous ethical reflection to ensure their design and introduction do not impede the promotion of values and the dignity of patients at such a vulnerable and sensitive time in their lives. The ethical evaluation of care robots requires insight into the values at stake in the healthcare tradition. What's more, given the stage of their development and lack of standards provided by the International Organization for Standardization to guide their development, ethics ought to be included into the design process of such robots. The manner in which this may be accomplished, as presented here, uses the blueprint of the Value-sensitive design approach as a means for creating a framework tailored to care contexts. Using care values as the foundational values to be integrated into a technology and using the elements in care, from the care ethics perspective, as the normative criteria, the resulting approach may be referred to as care centered value-sensitive design. The framework proposed here allows for the ethical evaluation of care robots both retrospectively and prospectively. By evaluating care robots in this way, we may ultimately ask what kind of care we, as a society, want to provide in the future.

Reactor System Design

International Nuclear Information System (INIS)

Chi, S. K.; Kim, G. K.; Yeo, J. W.

2006-08-01

SMART NPP(Nuclear Power Plant) has been developed for duel purpose, electricity generation and energy supply for seawater desalination. The objective of this project IS to design the reactor system of SMART pilot plant(SMART-P) which will be built and operated for the integrated technology verification of SMART. SMART-P is an integral reactor in which primary components of reactor coolant system are enclosed in single pressure vessel without connecting pipes. The major components installed within a vessel includes a core, twelve steam generator cassettes, a low-temperature self pressurizer, twelve control rod drives, and two main coolant pumps. SMART-P reactor system design was categorized to the reactor coe design, fluid system design, reactor mechanical design, major component design and MMIS design. Reactor safety -analysis and performance analysis were performed for developed SMART=P reactor system. Also, the preparation of safety analysis report, and the technical support for licensing acquisition are performed

Effectiveness of a Therapeutic Summer Camp for Children with ADHD: Phase I Clinical Intervention Trial

Science.gov (United States)

Hantson, Julie; Wang, Pan Pan; Grizenko-Vida, Michael; Ter-Stepanian, Marina; Harvey, William; Joober, Ridha; Grizenko, Natalie

2012-01-01

Objective: The objective of this study was to evaluate the effectiveness of a 2-week therapeutic summer day camp for children with ADHD, which included a social skills training program and parent psychoeducation and training program. This was an open-label, nonrandomized Phase I Clinical Intervention Trial. Method: Parents completed the Weiss…

Including severe accidents in the design basis of nuclear power plants: An organizational factors perspective after the Fukushima accident

International Nuclear Information System (INIS)

Alvarenga, M.A.B.; Frutuoso e Melo, P.F.

2015-01-01

Highlights: • The Fukushima accident was man-made and not caused by natural phenomena. • Vulnerabilities were known by regulator and licensee but measures were not taken. • There was lack of independence and transparency of the regulatory body. • Laws and regulations have not been updated to international standards. • Organizational failures have played an important role in the Fukushima accident. - Abstract: The Fukushima accident was clearly an accident made by humans and not caused by natural phenomena as was initially thought. Vulnerabilities were known by both regulators and operator but they postponed measures. The emergency plan was not effective in protecting the public, because the involved parties were not sufficiently prepared to make the right decisions. The shortcomings and faults mentioned above resulted from the lack of independence and transparency of the regulatory body. Even laws and regulations, and technical standards, have not been upgraded to international standards. Regulators have not defined requirements and left for the operator to decide what would be more appropriate. In this aspect, there was clearly a lack of independence between these bodies and operator’s lobby power. The above situation raised the question of urgent updating of institutions, in particular those responsible for nuclear safety. The above evidences show that several nuclear safety principles were not followed. This paper intends to highlight some existing safety criteria that were developed from the operational experience of the severe accidents that occurred at TMI and Chernobyl that should be incorporated in the design of new nuclear power plants and to provide appropriate design changes (backfittings) for reactors that belong to the previous generation prior to the occurrence of these accidents, through the study of design vulnerabilities. Furthermore, the main criteria that define an effective regulatory agency are also discussed. Although these

Design of modern experiments(revised version)

International Nuclear Information System (INIS)

Park, Sung Hweon

1984-03-01

This book mentions design of modern experiments. It includes conception of design of experiments, a key statistics theory, one way design of experiment, two-way layout without repetition and with repetition, multi layout and analysis of enumerated data, partition, correlation and regression analysis, latin squares, factorial design, design of experiment by table of orthogonal arrays I, II, incomplete block design, design of response surface, design of compound experiment, Evop and steepest ascent or descent method and design of experiment of taguchi.

Preliminary Safety Information Document for the Standard MHTGR. Volume 1, (includes latest Amendments)

Energy Technology Data Exchange (ETDEWEB)

None

1986-01-01

With NRC concurrence, the Licensing Plan for the Standard HTGR describes an application program consistent with 10CFR50, Appendix O to support a US Nuclear Regulatory Commission (NRC) review and design certification of an advanced Standard modular High Temperature Gas-Cooled Reactor (MHTGR) design. Consistent with the NRC's Advanced Reactor Policy, the Plan also outlines a series of preapplication activities which have as an objective the early issuance of an NRC Licensability Statement on the Standard MHTGR conceptual design. This Preliminary Safety Information Document (PSID) has been prepared as one of the submittals to the NRC by the US Department of Energy in support of preapplication activities on the Standard MHTGR. Other submittals to be provided include a Probabilistic Risk Assessment, a Regulatory Technology Development Plan, and an Emergency Planning Bases Report.

Impact of a Multifaceted and Clinically Integrated Training Program in Evidence-Based Practice on Knowledge, Skills, Beliefs and Behaviour among Clinical Instructors in Physiotherapy: A Non-Randomized Controlled Study.

Directory of Open Access Journals (Sweden)

Nina Rydland Olsen

Full Text Available Physiotherapists practicing at clinical placement sites assigned the role as clinical instructors (CIs, are responsible for supervising physiotherapy students. For CIs to role model evidence-based practice (EBP they need EBP competence. The aim of this study was to assess the short and long term impact of a six-month multifaceted and clinically integrated training program in EBP on the knowledge, skills, beliefs and behaviour of CIs supervising physiotherapy students.We invited 37 CIs to participate in this non-randomized controlled study. Three self-administered questionnaires were used pre- and post-intervention, and at six-month follow-up: 1 The Adapted Fresno test (AFT, 2 the EBP Belief Scale and 3 the EBP Implementation Scale. The analysis approach was linear regression modeling using Generalized Estimating Equations.In total, 29 CIs agreed to participate in the study: 14 were invited to participate in the intervention group and 15 were invited to participate in the control group. One in the intervention group and five in the control group were lost to follow-up. At follow-up, the group difference was statistically significant for the AFT (mean difference = 37, 95% CI (15.9 -58.1, p < 0.001 and the EBP Beliefs scale (mean difference = 8.1, 95% CI (3.1 -13.2, p = 0.002, but not for the EBP Implementation scale (mean difference = 1.8. 95% CI (-4.5-8.1, p = 0.574. Comparing measurements over time, we found a statistically significant increase in mean scores related to all outcome measures for the intervention group only.A multifaceted and clinically integrated training program in EBP was successful in improving EBP knowledge, skills and beliefs among CIs. Future studies need to ensure long-term EBP behaviour change, in addition to assessing CIs' abilities to apply EBP knowledge and skills when supervising students.

The design explorer project

DEFF Research Database (Denmark)

Pejtersen, Annelise Mark; Sonnenwald, Diane H.; Buur, Jacob

1997-01-01

the 'Design Explorer' research project whose goal is to specify requirements for an information system that will effectively help design team members from different domains and organizational cultures to locate and utilize diverse information sources and interact more effectively throughout the design process....... The project introduces a new approach to support of design; instead of design guidelines, support is given by creating a transparent information environment in which designers can navigate freely according to their individual preferences. The project is based on a framework that structures the dimensions......, or categories, of domain information which need to be available for a system or product designer/design team in order to determine the characteristics of the artefact, or object of design. These dimensions include information about the different work domains in which the product plays a role during its lifetime...

Topology Optimization including Inequality Buoyancy Constraints

NARCIS (Netherlands)

Picelli, R.; Van Dijk, R.; Vicente, W.M.; Pavanello, R.; Langelaar, M.; Van Keuen, A.

2014-01-01

This paper presents an evolutionary topology optimization method for applications in design of completely submerged buoyant devices with design-dependent fluid pressure loading. This type of structures aid rig installations and pipeline transportation in all water depths in offshore structural

DNA sequence analyses of blended herbal products including synthetic cannabinoids as designer drugs.

Science.gov (United States)

Ogata, Jun; Uchiyama, Nahoko; Kikura-Hanajiri, Ruri; Goda, Yukihiro

2013-04-10

In recent years, various herbal products adulterated with synthetic cannabinoids have been distributed worldwide via the Internet. These herbal products are mostly sold as incense, and advertised as not for human consumption. Although their labels indicate that they contain mixtures of several potentially psychoactive plants, and numerous studies have reported that they contain a variety of synthetic cannabinoids, their exact botanical contents are not always clear. In this study, we investigated the origins of botanical materials in 62 Spice-like herbal products distributed on the illegal drug market in Japan, by DNA sequence analyses and BLAST searches. The nucleotide sequences of four regions were analyzed to identify the origins of each plant species in the herbal mixtures. The sequences of "Damiana" (Turnera diffusa) and Lamiaceae herbs (Mellissa, Mentha and Thymus) were frequently detected in a number of products. However, the sequences of other plant species indicated on the packaging labels were not detected. In a few products, DNA fragments of potent psychotropic plants were found, including marijuana (Cannabis sativa), "Diviner's Sage" (Salvia divinorum) and "Kratom" (Mitragyna speciosa). Their active constituents were also confirmed using gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-mass spectrometry (LC-MS), although these plant names were never indicated on the labels. Most plant species identified in the products were different from the plants indicated on the labels. The plant materials would be used mainly as diluents for the psychoactive synthetic compounds, because no reliable psychoactive effects have been reported for most of the identified plants, with the exception of the psychotropic plants named above. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Higher 5-hydroxymethylcytosine identifies immortal DNA strand chromosomes in asymmetrically self-renewing distributed stem cells.

Science.gov (United States)

Huh, Yang Hoon; Cohen, Justin; Sherley, James L

2013-10-15

Immortal strands are the targeted chromosomal DNA strands of nonrandom sister chromatid segregation, a mitotic chromosome segregation pattern unique to asymmetrically self-renewing distributed stem cells (DSCs). By nonrandom segregation, immortal DNA strands become the oldest DNA strands in asymmetrically self-renewing DSCs. Nonrandom segregation of immortal DNA strands may limit DSC mutagenesis, preserve DSC fate, and contribute to DSC aging. The mechanisms responsible for specification and maintenance of immortal DNA strands are unknown. To discover clues to these mechanisms, we investigated the 5-methylcytosine and 5-hydroxymethylcytosine (5hmC) content on chromosomes in mouse hair follicle DSCs during nonrandom segregation. Although 5-methylcytosine content did not differ significantly, the relative content of 5hmC was significantly higher in chromosomes containing immortal DNA strands than in opposed mitotic chromosomes containing younger mortal DNA strands. The difference in relative 5hmC content was caused by the loss of 5hmC from mortal chromosomes. These findings implicate higher 5hmC as a specific molecular determinant of immortal DNA strand chromosomes. Because 5hmC is an intermediate during DNA demethylation, we propose a ten-eleven translocase enzyme mechanism for both the specification and maintenance of nonrandomly segregated immortal DNA strands. The proposed mechanism reveals a means by which DSCs "know" the generational age of immortal DNA strands. The mechanism is supported by molecular expression data and accounts for the selection of newly replicated DNA strands when nonrandom segregation is initiated. These mechanistic insights also provide a possible basis for another characteristic property of immortal DNA strands, their guanine ribonucleotide dependency.

Design

Science.gov (United States)

Buchanan, Richard; Cross, Nigel; Durling, David; Nelson, Harold; Owen, Charles; Valtonen, Anna; Boling, Elizabeth; Gibbons, Andrew; Visscher-Voerman, Irene

2013-01-01

Scholars representing the field of design were asked to identify what they considered to be the most exciting and imaginative work currently being done in their field, as well as how that work might change our understanding. The scholars included Richard Buchanan, Nigel Cross, David Durling, Harold Nelson, Charles Owen, and Anna Valtonen. Scholars…

Design data and safety features of commercial nuclear power plants including cumulative index for Volumes I--VI

International Nuclear Information System (INIS)

Heddleson, F.A.

1977-01-01

Design data, safety features, and site characteristics are summarized for 12 nuclear power units in 6 power stations in the United States. Six pages of data are presented for each station, consisting of thermal-hydraulic and nuclear factors, containment features, emergency-core-cooling systems, site features, circulating water system data, and miscellaneous factors. In addition, an aerial perspective is presented for each plant. This volume covers plants with docket numbers 50-553 through 50-569 (Phipps Bend, Black Fox, Yellow Creek, and NEP) and two earlier plants not previously reported--Hope Creek (50-354, 50-355) and WPPSS 1 and 4 (50-460, 50-513). Indexes for this volume and the five earlier volumes are presented in three forms--by docket number, by plant name, and by participating utility

Multidisciplinary Conceptual Design for Reduced-Emission Rotorcraft

Science.gov (United States)

Silva, Christopher; Johnson, Wayne; Solis, Eduardo

2018-01-01

Python-based wrappers for OpenMDAO are used to integrate disparate software for practical conceptual design of rotorcraft. The suite of tools which are connected thus far include aircraft sizing, comprehensive analysis, and parametric geometry. The tools are exercised to design aircraft with aggressive goals for emission reductions relative to fielded state-of-the-art rotorcraft. Several advanced reduced-emission rotorcraft are designed and analyzed, demonstrating the flexibility of the tools to consider a wide variety of potentially transformative vertical flight vehicles. To explore scale effects, aircraft have been sized for 5, 24, or 76 passengers in their design missions. Aircraft types evaluated include tiltrotor, single-main-rotor, coaxial, and side-by-side helicopters. Energy and drive systems modeled include Lithium-ion battery, hydrogen fuel cell, turboelectric hybrid, and turboshaft drive systems. Observations include the complex nature of the trade space for this simple problem, with many potential aircraft design and operational solutions for achieving significant emission reductions. Also interesting is that achieving greatly reduced emissions may not require exotic component technologies, but may be achieved with a dedicated design objective of reducing emissions.

KBS-3H design description 2005

Energy Technology Data Exchange (ETDEWEB)

Autio, Jorma (Saanio and Riekkola Oy, Helsinki (Finland))

2008-05-15

SKB and Posiva are performing an RandD program over the period of 2002-2007 with the overall aim to develop the KBS-3H to an alternative to the KBS-3V concept for disposal of spent nuclear fuel. A feasibility study of the KBS-3H concept was carried out in 2002, followed by the setting up of basic design in 2003. Several problems related to the behavior of the design and scope of future research and development work were addressed. Therefore the design basis was developed further and two candidate designs were developed: 1) previous Basic Design (BD) was developed more robust and tolerable to inflows. Parallel to that a novel modified 2) DAWE design with Drainage, Air evacuation and Watering and was developed to function robustly at various inflow situations. The candidate designs presented in this report include several novel components, such as fixing rings and steel plugs which have been designed without support of applicable design guidelines, regulations or standards available. The design basis and performance of these components include uncertainties, which should be studied and verified. It is possible that a feasible site specific design can be based on using both alternatives

KBS-3H design description 2005

International Nuclear Information System (INIS)

Autio, Jorma

2008-05-01

SKB and Posiva are performing an RandD program over the period of 2002-2007 with the overall aim to develop the KBS-3H to an alternative to the KBS-3V concept for disposal of spent nuclear fuel. A feasibility study of the KBS-3H concept was carried out in 2002, followed by the setting up of basic design in 2003. Several problems related to the behavior of the design and scope of future research and development work were addressed. Therefore the design basis was developed further and two candidate designs were developed: 1) previous Basic Design (BD) was developed more robust and tolerable to inflows. Parallel to that a novel modified 2) DAWE design with Drainage, Air evacuation and Watering and was developed to function robustly at various inflow situations. The candidate designs presented in this report include several novel components, such as fixing rings and steel plugs which have been designed without support of applicable design guidelines, regulations or standards available. The design basis and performance of these components include uncertainties, which should be studied and verified. It is possible that a feasible site specific design can be based on using both alternatives

Building a Practical Natural Laminar Flow Design Capability

Science.gov (United States)

Campbell, Richard L.; Lynde, Michelle N.

2017-01-01

A preliminary natural laminar flow (NLF) design method that has been developed and applied to supersonic and transonic wings with moderate-to-high leading-edge sweeps at flight Reynolds numbers is further extended and evaluated in this paper. The modular design approach uses a knowledge-based design module linked with different flow solvers and boundary layer stability analysis methods to provide a multifidelity capability for NLF analysis and design. An assessment of the effects of different options for stability analysis is included using pressures and geometry from an NLF wing designed for the Common Research Model (CRM). Several extensions to the design module are described, including multiple new approaches to design for controlling attachment line contamination and transition. Finally, a modification to the NLF design algorithm that allows independent control of Tollmien-Schlichting (TS) and cross flow (CF) modes is proposed. A preliminary evaluation of the TS-only option applied to the design of an NLF nacelle for the CRM is performed that includes the use of a low-fidelity stability analysis directly in the design module.

Interim design report: fuel particle crushing

International Nuclear Information System (INIS)

Baer, J.W.; Strand, J.B.; Cook, E.J.; Miller, C.M.

1977-11-01

The double-roll fuel particle crusher was developed to fracture the silicon carbide coatings of Fort St. Vrain (FSV) fertile and fissile and large high-temperature gas-cooled reactor (LHTGR) fissile fuel particles. The report details the design task for the fuel particle crusher, including historical test information on double-roll crushers for carbide-coated fuels and the design approach selected for the cold pilot plant crusher, and shows how the design addresses the equipment goals and operational objectives. Design calculations and considerations are included to support the selection of crusher drive and gearing, the materials chosen for crushing rolls and housing, and the bearing selection. The results of the initial testing for compliance with design objectives and operational capabilities are also presented. 8 figures, 4 tables

Preliminary design data package. Appendix C

Energy Technology Data Exchange (ETDEWEB)

1979-07-25

The design requirements, design philosophy, method and assumptions, and preliminary computer-aided design of the Near-Term Hybrid Vehicle including its electric and heat power units, control equipment, transmission system, body, and overall vehicle characteristics are presented. (LCL)

Forum on Specifications and Design Languages 2012

CERN Document Server

2014-01-01

This book brings together a selection of the best papers from the fifteenth edition of the Forum on specification and Design Languages Conference (FDL), which was held in September 2012 at Vienna University of Technology, Vienna, Austria.  FDL is a well-established international forum devoted to dissemination of research results, practical experiences and new ideas in the application of specification, design and verification languages to the design, modeling and verification of integrated circuits, complex hardware/software embedded systems, and mixed-technology systems.  ·         Covers Assertion Based Design, Verification & Debug; ·         Includes language-based modeling and design techniques for embedded systems; ·         Covers design, modeling and verification of mixed physical domain and mixed signal systems that include significant analog parts in electrical and non-electrical domains; ·         Includes formal and semi-formal system level design methods fo...

VLSI design

CERN Document Server

Einspruch, Norman G

1986-01-01

VLSI Electronics Microstructure Science, Volume 14: VLSI Design presents a comprehensive exposition and assessment of the developments and trends in VLSI (Very Large Scale Integration) electronics. This volume covers topics that range from microscopic aspects of materials behavior and device performance to the comprehension of VLSI in systems applications. Each article is prepared by a recognized authority. The subjects discussed in this book include VLSI processor design methodology; the RISC (Reduced Instruction Set Computer); the VLSI testing program; silicon compilers for VLSI; and special

Design of apron feeders

Energy Technology Data Exchange (ETDEWEB)

Ramos, C.M.

1987-12-01

This paper discusses practical aspects of apron feeder design, and includes information on how to make the first selection. Various aspects of design such as feeder speed, material depth, chain-pitch, roller loading, wheels/sprockets and chain roller friction are elaborated in detail. 8 refs., 14 figs., 12 tabs.

HVAC systems design handbook

CERN Document Server

Haines, Roger W

2010-01-01

Thoroughly updated with the latest codes, technologies, and practices, this all-in-one resource provides details, calculations, and specifications for designing efficient and effective residential, commercial, and industrial HVAC systems. HVAC Systems Design Handbook, Fifth Edition, features new information on energy conservation and computer usage for design and control, as well as the most recent International Code Council (ICC) Mechanical Code requirements. Detailed illustrations, tables, and essential HVAC equations are also included. This comprehensive guide contains everything you need to design, operate, and maintain peak-performing HVAC systems.

The Bolton Treovance abdominal stent-graft: European clinical trial design.

Science.gov (United States)

Chiesa, R; Riambau, V; Coppi, G; Zipfel, B; Llagostera, S; Marone, E M; Kahlberg, A

2012-10-01

Endovascular aortic repair (EVAR) has emerged as a promising, less invasive alternative to conventional open surgery for the treatment of infrarenal abdominal aortic aneurysms (AAAs). In the last 20 years, the application rate of EVAR and its clinical results have significantly improved thanks to the evolution of stent-grafts and endovascular delivery systems. However, further development is still needed to reduce the incidence of complications and secondary re-interventions. The Treovance abdominal aortic stent-graft (Bolton Medical, Barcelona, Spain) is a new-generation endovascular device, developed to increase flexibility, lower profile, improve deployment and sealing mechanisms. In particular, it is provided with some innovative features as a double layer of proximal barbs (suprarenal and infrarenal) for supplemental fixation, dull barbs between modules to avoid potential leg disconnections, detachable outer sheath provided with a new-design hemostatic valve, and a double improved mechanism (slow motion and "pin and pull") for precise stent-graft deployment. A European prospective, non-randomized, multi-institutional, "first-in-human" trial (the ADVANCE trial) was conducted from March to December 2011 to assess the safety and performance of the Treovance stent-graft system before commercialization. Thirty patients with anatomically suitable non-ruptured AAAs were enrolled at five clinical sites in Italy, Spain, and Germany. EVAR was completed successfully in all patients. The stent-graft was delivered and deployed safely even in heavily angulated or calcified anatomies. No 30-day device-related complications nor deaths were observed. Preliminary experience with the Treovance abdominal stent-graft within the ADVANCE trial was satisfactory with regard to technical success and perioperative clinical results. Follow-up data are needed to assess mid- and long-term clinical outcomes, along with durability of this new-generation endovascular device.

Use of probabilistic design methods for NASA applications. [to be used in design phase of Space Transportation Main Engine

Science.gov (United States)

Safie, Fayssal M.

1992-01-01

This paper presents a reliability evaluation process designed to improve the reliability of advanced launch systems. The work performed includes the development of a reliability prediction methodology to be used in the design phase of the Space Transportation Main Engine (STME). This includes prediction techniques which use historical data bases as well as deterministic and probabilistic engineering models for predicting design reliability. In summary, this paper describes a probabilistic design approach for the next-generation liquid rocket engine, the STME.

Respondent driven sampling: determinants of recruitment and a method to improve point estimation.

Directory of Open Access Journals (Sweden)

Nicky McCreesh

Full Text Available Respondent-driven sampling (RDS is a variant of a link-tracing design intended for generating unbiased estimates of the composition of hidden populations that typically involves giving participants several coupons to recruit their peers into the study. RDS may generate biased estimates if coupons are distributed non-randomly or if potential recruits present for interview non-randomly. We explore if biases detected in an RDS study were due to either of these mechanisms, and propose and apply weights to reduce bias due to non-random presentation for interview.Using data from the total population, and the population to whom recruiters offered their coupons, we explored how age and socioeconomic status were associated with being offered a coupon, and, if offered a coupon, with presenting for interview. Population proportions were estimated by weighting by the assumed inverse probabilities of being offered a coupon (as in existing RDS methods, and also of presentation for interview if offered a coupon by age and socioeconomic status group.Younger men were under-recruited primarily because they were less likely to be offered coupons. The under-recruitment of higher socioeconomic status men was due in part to them being less likely to present for interview. Consistent with these findings, weighting for non-random presentation for interview by age and socioeconomic status group greatly improved the estimate of the proportion of men in the lowest socioeconomic group, reducing the root-mean-squared error of RDS estimates of socioeconomic status by 38%, but had little effect on estimates for age. The weighting also improved estimates for tribe and religion (reducing root-mean-squared-errors by 19-29%, but had little effect for sexual activity or HIV status.Data collected from recruiters on the characteristics of men to whom they offered coupons may be used to reduce bias in RDS studies. Further evaluation of this new method is required.

LUCID - an optical design and raytrace code

International Nuclear Information System (INIS)

Nicholas, D.J.; Duffey, K.P.

1980-11-01

A 2D optical design and ray trace code is described. The code can operate either as a geometric optics propagation code or provide a scalar diffraction treatment. There are numerous non-standard options within the code including design and systems optimisation procedures. A number of illustrative problems relating to the design of optical components in the field of high power lasers is included. (author)

Performative Computation-aided Design Optimization

Directory of Open Access Journals (Sweden)

Ming Tang

2012-12-01

Full Text Available This article discusses a collaborative research and teaching project between the University of Cincinnati, Perkins+Will’s Tech Lab, and the University of North Carolina Greensboro. The primary investigation focuses on the simulation, optimization, and generation of architectural designs using performance-based computational design approaches. The projects examine various design methods, including relationships between building form, performance and the use of proprietary software tools for parametric design.

Developing a weighting strategy to include mobile phone numbers into an ongoing population health survey using an overlapping dual-frame design with limited benchmark information.

Science.gov (United States)

Barr, Margo L; Ferguson, Raymond A; Hughes, Phil J; Steel, David G

2014-09-04

In 2012 mobile phone numbers were included into the ongoing New South Wales Population Health Survey (NSWPHS) using an overlapping dual-frame design. Previously in the NSWPHS the sample was selected using random digit dialing (RDD) of landline phone numbers. The survey was undertaken using computer assisted telephone interviewing (CATI). The weighting strategy needed to be significantly expanded to manage the differing probabilities of selection by frame, including that of children of mobile-only phone users, and to adjust for the increased chance of selection of dual-phone users. This paper describes the development of the final weighting strategy to properly combine the data from two overlapping sample frames accounting for the fact that population benchmarks for the different sampling frames were not available at the state or regional level. Estimates of the number of phone numbers for the landline and mobile phone frames used to calculate the differing probabilities of selection by frame, for New South Wales (NSW) and by stratum, were obtained by apportioning Australian estimates as none were available for NSW. The weighting strategy was then developed by calculating person selection probabilities, selection weights, applying a constant composite factor to the dual-phone users sample weights, and benchmarking to the latest NSW population by age group, sex and stratum. Data from the NSWPHS for the first quarter of 2012 was used to test the weighting strategy. This consisted of data on 3395 respondents with 2171 (64%) from the landline frame and 1224 (36%) from the mobile frame. However, in order to calculate the weights, data needed to be available for all core weighting variables and so 3378 respondents, 2933 adults and 445 children, had sufficient data to be included. Average person weights were 3.3 times higher for the mobile-only respondents, 1.3 times higher for the landline-only respondents and 1.7 times higher for dual-phone users in the mobile frame

Application of core structural design guidelines in conceptual fuel pin design

International Nuclear Information System (INIS)

Patel, M.R.; Stephen, J.D.

1979-01-01

The paper describes an application of the Draft RDT Standards F9-7, -8, and -9 to conceptual design of Fast Breeder Reactor (FBR) fuel pins. The Standards are being developed to provide guidelines for structural analysis and design of the FBR core components which have limited ductility at high fluences and are not addressed by the prevalent codes. The development is guided by a national working group sponsored by the Division of Reactor Researcch and Technology of the Department of Energy. The development program summarized in the paper includes establishment of design margins consistent with the test data and component performance requirements, and application of the design rules in various design activities. The application program insures that the quantities required for proper application of the design rules are available from the analysis methods and test data, and that the use of the same design rules in different analysis tools used at different stages of a component design producees consistent results. This is illustrated in the paper by application of the design rules in the analysis methods developed for conceptual and more detailed designs of an FBR fuel pin

Reengineering the project design process

Science.gov (United States)

Kane Casani, E.; Metzger, Robert M.

1995-01-01

In response to the National Aeronautics and Space Administration's goal of working faster, better, and cheaper, the Jet Propulsion Laboratory (JPL) has developed extensive plans to minimize cost, maximize customer and employee satisfaction, and implement small- and moderate-size missions. These plans include improved management structures and processes, enhanced technical design processes, the incorporation of new technology, and the development of more economical space- and ground-system designs. The Laboratory's new Flight Projects Implementation Development Office has been chartered to oversee these innovations and the reengineering of JPL's project design process, including establishment of the Project Design Center (PDC) and the Flight System Testbed (FST). Reengineering at JPL implies a cultural change whereby the character of the Laboratory's design process will change from sequential to concurrent and from hierarchical to parallel. The Project Design Center will support missions offering high science return, design to cost, demonstrations of new technology, and rapid development. Its computer-supported environment will foster high-fidelity project life-cycle development and more accurate cost estimating. These improvements signal JPL's commitment to meeting the challenges of space exploration in the next century.

CAD: Designs on Business.

Science.gov (United States)

Milburn, Ken

1988-01-01

Provides a general review of the field of Computer-Aided Design Software including specific reviews of "Autosketch,""Generic CADD,""Drafix 1 Plus,""FastCAD," and "Autocad Release 9." Brief articles include "Blueprint for Generation,""CAD for Every Department,""Ideas…

Designing automatic resupply systems.

Science.gov (United States)

Harding, M L

1999-02-01

This article outlines the process for designing and implementing autoresupply systems. The planning process includes determination of goals and appropriate participation. Different types of autoresupply mechanisms include kanban, breadman, consignment, systems contracts, and direct shipping from an MRP schedule.

Pre-Employment Laboratory Education. Clothing/Fashion Design Guidebook.

Science.gov (United States)

Texas Tech Univ., Lubbock. Home Economics Instructional Materials Center.

This guidebook is designed for use in teaching students enrolled in preemployment laboratory education (PELE) clothing/fashion design programs. The first of two major sections includes an overview for teachers on planning, conducting, and evaluating a PELE clothing/fashion design program. Specific topics discussed in section 1 include (1)…

Platelet rich fibrin in jaw defects

Science.gov (United States)

Nica, Diana; Ianes, Emilia; Pricop, Marius

2016-03-01

Platelet rich fibrin (PRF) is a tissue product of autologous origin abundant in growth factors, widely used in regenerative procedures. Aim of the study: Evaluation of the regenerative effect of PRF added in the bony defects (after tooth removal or after cystectomy) Material and methods: The comparative nonrandomized study included 22 patients divided into 2 groups. The first group (the test group) included 10 patients where the bony defects were treated without any harvesting material. The second group included 12 patients where the bony defects were filled with PRF. The bony defect design was not critical, with one to two walls missing. After the surgeries, a close clinically monitoring was carried out. The selected cases were investigated using both cone beam computer tomography (CBCT) and radiographic techniques after 10 weeks postoperatively. Results: Faster bone regeneration was observed in the bony defects filled with PRF comparing with the not grafted bony defects. Conclusions: PRF added in the bony defects accelerates the bone regeneration. This simplifies the surgical procedures and decreases the economic costs.

Ayurvedic interventions for osteoarthritis: a systematic review and meta-analysis.

Science.gov (United States)

Kessler, Christian S; Pinders, Lea; Michalsen, Andreas; Cramer, Holger

2015-02-01

Ayurveda is one of the fastest growing systems within complementary and alternative medicine. However, the evidence for its effectiveness is unsatisfactory. The aim of this work was to review and meta-analyze the effectiveness and safety of different Ayurvedic interventions in patients with osteoarthritis (OA). 138 electronic databases were searched through August 2013. Randomized controlled trials, randomized crossover studies, cluster-randomized trials, and non-randomized controlled clinical trials were eligible. Adults with pre-diagnosed OA were included as participants. Interventions were included as Ayurvedic if they were explicitly labeled as such. Main outcome measures were pain, physical function, and global improvement. Risk of bias was assessed using the Cochrane risk of bias tool. 19 randomized and 14 non-randomized controlled trials on 12 different drugs and 3 non-pharmaceutical interventions with a total of 2,952 patients were included. For the compound preparation, Rumalaya, large and apparently unbiased effects beyond placebo were found for pain (standardized mean difference [SMD] -3.73; 95 % confidence interval [CI] -4.97, -2.50; P Ayurveda. Well-planned, well-conducted and well-published trials are warranted to improve the evidence for Ayurvedic interventions.

Systems design for remote healthcare

CERN Document Server

Bonfiglio, Silvio

2014-01-01

This book provides a multidisciplinary overview of the design and implementation of systems for remote patient monitoring and healthcare. Readers are guided step-by-step through the components of such a system and shown how they could be integrated in a coherent framework for deployment in practice. The authors explain planning from subsystem design to complete integration and deployment, given particular application constraints. Readers will benefit from descriptions of the clinical requirements underpinning the entire application scenario, physiological parameter sensing techniques, information processing approaches and overall, application dependent system integration. Each chapter ends with a discussion of practical design challenges and two case studies are included to provide practical examples and design methods for two remote healthcare systems with different needs. ·         Provides a multi-disciplinary overview of next-generation mobile healthcare system design; ·         Includes...

Inpatient Portals for Hospitalized Patients and Caregivers: A Systematic Review.

Science.gov (United States)

Kelly, Michelle M; Coller, Ryan J; Hoonakker, Peter Lt

2018-06-01

Patient portals, web-based personal health records linked to electronic health records (EHRs), provide patients access to their healthcare information and facilitate communication with providers. Growing evidence supports portal use in ambulatory settings; however, only recently have portals been used with hospitalized patients. Our objective was to review the literature evaluating the design, use, and impact of inpatient portals, which are patient portals designed to give hospitalized patients and caregivers inpatient EHR clinical information for the purpose of engaging them in hospital care. Literature was reviewed from 2006 to 2017 in PubMed, Web of Science, CINALPlus, Cochrane, and Scopus to identify English language studies evaluating patient portals, engagement, and inpatient care. Data were analyzed considering the following 3 themes: inpatient portal design, use and usability, and impact. Of 731 studies, 17 were included, 9 of which were published after 2015. Most studies were qualitative with small samples focusing on inpatient portal design; 1 nonrandomized trial was identified. Studies described hospitalized patients' and caregivers' information needs and design recommendations. Most patient and caregiver participants in included studies were interested in using an inpatient portal, used it when offered, and found it easy to use and/or useful. Evidence supporting the role of inpatient portals in improving patient and caregiver engagement, knowledge, communication, and care quality and safety is limited. Included studies indicated providers had concerns about using inpatient portals; however, the extent to which these concerns have been realized remains unclear. Inpatient portal research is emerging. Further investigation is needed to optimally design inpatient portals to maximize potential benefits for hospitalized patients and caregivers while minimizing unintended consequences for healthcare teams. © 2017 Society of Hospital Medicine.

Exploring the influence of design culture on ICT healthcare product and service design for rural China

NARCIS (Netherlands)

Jiang, J.; Kandachar, P.V.; Freudenthal, A.

2010-01-01

Design culture is usually considered as one of the important aspects that influence designers’ decisions and actions, especially in Design for Base of the Pyramid projects including ICT Healthcare Product Design in Rural China (IHDRC). There are two research questions in this issue: what are the

TPX: Contractor preliminary design review. Volume 3, Design and analysis

International Nuclear Information System (INIS)

1995-01-01

Several models have been formed for investigating the maximum electromagnetic loading and magnetic field levels associated with the Tokamak Physics eXperiment (TPX) superconducting Poloidal Field (PF) coils. The analyses have been performed to support the design of the individual fourteen hoop coils forming the PF system. The coils have been sub-divided into three coil systems consisting of the central solenoid (CS), PF5 coils, and the larger radius PF6 and PF7 coils. Various electromagnetic analyses have been performed to determine the electromagnetic loadings that the coils will experience during normal operating conditions, plasma disruptions, and fault conditions. The loadings are presented as net body forces acting individual coils, spatial variations throughout the coil cross section, and force variations along the path of the conductor due to interactions with the TF coils. Three refined electromagnetic models of the PF coil system that include a turn-by-turn description of the fields and forces during a worst case event are presented in this report. A global model including both the TF and PF system was formed to obtain the force variations along the path of the PF conductors resulting from interactions with the TF currents. In addition to spatial variations, the loadings are further subdivided into time-varying and steady components so that structural fatigue issues can be addressed by designers and analysts. Other electromagnetic design issues such as the impact of the detailed coil designs on field errors are addressed in this report. Coil features that are analyzed include radial transitions via short jogs vs. spiral type windings and the effects of layer-to-layer rotations (i.e clocking) on the field errors

TPX: Contractor preliminary design review. Volume 3, Design and analysis

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-06-30

Several models have been formed for investigating the maximum electromagnetic loading and magnetic field levels associated with the Tokamak Physics eXperiment (TPX) superconducting Poloidal Field (PF) coils. The analyses have been performed to support the design of the individual fourteen hoop coils forming the PF system. The coils have been sub-divided into three coil systems consisting of the central solenoid (CS), PF5 coils, and the larger radius PF6 and PF7 coils. Various electromagnetic analyses have been performed to determine the electromagnetic loadings that the coils will experience during normal operating conditions, plasma disruptions, and fault conditions. The loadings are presented as net body forces acting individual coils, spatial variations throughout the coil cross section, and force variations along the path of the conductor due to interactions with the TF coils. Three refined electromagnetic models of the PF coil system that include a turn-by-turn description of the fields and forces during a worst case event are presented in this report. A global model including both the TF and PF system was formed to obtain the force variations along the path of the PF conductors resulting from interactions with the TF currents. In addition to spatial variations, the loadings are further subdivided into time-varying and steady components so that structural fatigue issues can be addressed by designers and analysts. Other electromagnetic design issues such as the impact of the detailed coil designs on field errors are addressed in this report. Coil features that are analyzed include radial transitions via short jogs vs. spiral type windings and the effects of layer-to-layer rotations (i.e clocking) on the field errors.

Does a diet low in FODMAPs reduce symptoms associated with functional gastrointestinal disorders? A comprehensive systematic review and meta-analysis.

Science.gov (United States)

Marsh, Abigail; Eslick, Enid M; Eslick, Guy D

2016-04-01

Functional gastrointestinal symptoms such as abdominal pain, bloating, distension, constipation, diarrhea and flatulence have been noted in patients with irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD). The diversity of symptoms has meant that finding an effective treatment has been challenging with most treatments alleviating only the primary symptom. A novel treatment option for IBS and IBD currently generating much excitement is the low fermentable, oligo-, di-, mono-saccharides and polyol (FODMAP) diet. The aim of this meta-analysis was to determine the evidence of the efficacy of such a diet in the treatment of functional gastrointestinal symptoms. Electronic databases were searched through to March 2015 to identify relevant studies. Pooled odds ratios (ORs) and 95 % confidence intervals were calculated for the effect of a low FODMAP diet on the reduction in IBS [Symptoms Severity Score (SSS)] score and increase in IBS quality of life (QOL) score for both randomized clinical trials (RCTs) and non-randomized interventions using a random-effects model. Six RCTs and 16 non-randomized interventions were included in the analysis. There was a significant decrease in IBS SSS scores for those individuals on a low FODMAP diet in both the RCTs (OR 0.44, 95 % CI 0.25-0.76; I (2) = 35.52, p = 0.00) and non-randomized interventions (OR 0.03, 95 % CI 0.01-0.2; I (2) = 69.1, p = 0.02). In addition, there was a significant improvement in the IBS-QOL score for RCTs (OR 1.84, 95 % CI 1.12-3.03; I (2) = 0.00, p = 0.39) and for non-randomized interventions (OR 3.18, 95 % CI 1.60-6.31; I (2) = 0.00, p = 0.89). Further, following a low FODMAP diet was found to significantly reduce symptom severity for abdominal pain (OR 1.81, 95 % CI 1.13-2.88; I (2) = 0.00, p = 0.56), bloating (OR 1.75, 95 % CI 1.07-2.87; I (2) = 0.00, p = 0.45) and overall symptoms (OR 1.81, 95 % CI 1.11-2.95; I (2) = 0.00, p = 0.4) in the RCTs. In the non-randomized interventions similar

Design for Additive Bio-Manufacturing: From Patient-Specific Medical Devices to Rationally Designed Meta-Biomaterials.

Science.gov (United States)

Zadpoor, Amir A

2017-07-25

Recent advances in additive manufacturing (AM) techniques in terms of accuracy, reliability, the range of processable materials, and commercial availability have made them promising candidates for production of functional parts including those used in the biomedical industry. The complexity-for-free feature offered by AM means that very complex designs become feasible to manufacture, while batch-size-indifference enables fabrication of fully patient-specific medical devices. Design for AM (DfAM) approaches aim to fully utilize those features for development of medical devices with substantially enhanced performance and biomaterials with unprecedented combinations of favorable properties that originate from complex geometrical designs at the micro-scale. This paper reviews the most important approaches in DfAM particularly those applicable to additive bio-manufacturing including image-based design pipelines, parametric and non-parametric designs, metamaterials, rational and computationally enabled design, topology optimization, and bio-inspired design. Areas with limited research have been identified and suggestions have been made for future research. The paper concludes with a brief discussion on the practical aspects of DfAM and the potential of combining AM with subtractive and formative manufacturing processes in so-called hybrid manufacturing processes.

Design for Additive Bio-Manufacturing: From Patient-Specific Medical Devices to Rationally Designed Meta-Biomaterials

Directory of Open Access Journals (Sweden)

Amir A. Zadpoor

2017-07-01

Full Text Available Recent advances in additive manufacturing (AM techniques in terms of accuracy, reliability, the range of processable materials, and commercial availability have made them promising candidates for production of functional parts including those used in the biomedical industry. The complexity-for-free feature offered by AM means that very complex designs become feasible to manufacture, while batch-size-indifference enables fabrication of fully patient-specific medical devices. Design for AM (DfAM approaches aim to fully utilize those features for development of medical devices with substantially enhanced performance and biomaterials with unprecedented combinations of favorable properties that originate from complex geometrical designs at the micro-scale. This paper reviews the most important approaches in DfAM particularly those applicable to additive bio-manufacturing including image-based design pipelines, parametric and non-parametric designs, metamaterials, rational and computationally enabled design, topology optimization, and bio-inspired design. Areas with limited research have been identified and suggestions have been made for future research. The paper concludes with a brief discussion on the practical aspects of DfAM and the potential of combining AM with subtractive and formative manufacturing processes in so-called hybrid manufacturing processes.

Theory and design of microwave filters

CERN Document Server

Hunter, Ian

2000-01-01

This is a thorough, graduate-level text which provides a single source for filter design including basic circuit theory, network synthesis and the design of a variety of microwave filter structures. The aim is to present design theories followed by specific examples with numerical simulations of the designs, with pictures of real devices wherever possible. The book is aimed at designers, engineers and researchers working in microwave electronics who need to design or specify filters.

Design of the FMIT lithium target

International Nuclear Information System (INIS)

Hassberger, J.A.; Annese, C.E.; Greenwell, R.K.; Ingham, J.G.; Miles, R.R.; Miller, W.C.

1981-01-01

Development of the liquid lithium target for the Fusion Materials Irradiation Test (FMIT) Facility is described. The target concept, major design goals and design requirements are presented. Progress made in the research and development areas leading to detailed design of the target is discussed. This progress, including experimental and analytic results, demonstrates that the FMIT target design is capable of meeting its major design goals and requirements

Designing social play through interpersonal touch

DEFF Research Database (Denmark)

Padfield, Nicolas; Löwgren, Jonas; Hobye, Mads

2013-01-01

We present five design cases as an annotated portfolio, exploring ways to design for intimate, interpersonal touch and social intimacy in interaction design. Five key qualities are elicited from the cases, including novel connotations sparking curiosity; providing an excuse to interact; unfolding...

Test design requirements: Thermal conductivity probe testing

International Nuclear Information System (INIS)

Heath, R.E.

1985-01-01

This document establishes the test design requirements for development of a thermal conductivity probe test. The thermal conductivity probe determines in situ thermal conductivity using a line source transient heat conduction analysis. This document presents the rationale for thermal conductivity measurement using a thermal conductivity probe. A general test description is included. Support requirements along with design constraints are detailed to allow simple design of the thermal conductivity probe and test. The schedule and delivery requirements of the responsible test designer are also included. 7 refs., 1 fig

Design for manufacturability with advanced lithography

CERN Document Server

Yu, Bei

2016-01-01

This book introduces readers to the most advanced research results on Design for Manufacturability (DFM) with multiple patterning lithography (MPL) and electron beam lithography (EBL).  The authors describe in detail a set of algorithms/methodologies to resolve issues in modern design for manufacturability problems with advanced lithography.  Unlike books that discuss DFM from the product level, or physical manufacturing level, this book describes DFM solutions from a circuit design level, such that most of the critical problems can be formulated and solved through combinatorial algorithms. Enables readers to tackle the challenge of layout decompositions for different patterning techniques; Presents a coherent framework, including standard cell compliance and detailed placement, to enable Triple Patterning Lithography (TPL) friendly design; Includes coverage of the design for manufacturability with E-Beam lithography.

Biomedical Optical Imaging Technologies Design and Applications

CERN Document Server

2013-01-01

This book provides an introduction to design of biomedical optical imaging technologies and their applications. The main topics include: fluorescence imaging, confocal imaging, micro-endoscope, polarization imaging, hyperspectral imaging, OCT imaging, multimodal imaging and spectroscopic systems. Each chapter is written by the world leaders of the respective fields, and will cover: principles and limitations of optical imaging technology, system design and practical implementation for one or two specific applications, including design guidelines, system configuration, optical design, component requirements and selection, system optimization and design examples, recent advances and applications in biomedical researches and clinical imaging. This book serves as a reference for students and researchers in optics and biomedical engineering.

Design for Visual Arts.

Science.gov (United States)

Skeries, Larry

Experiences suggested within this visual arts packet provide high school students with awareness of visual expression in graphic design, product design, architecture, and crafts. The unit may be used in whole or in part and includes information about art careers and art-related jobs found in major occupational fields. Specific lesson topics…

Designing Data Visualizations Representing Informational Relationships

CERN Document Server

Steele, Julie

2011-01-01

Data visualization is an efficient and effective medium for communicating large amounts of information, but the design process can often seem like an unexplainable creative endeavor. This concise book aims to demystify the design process by showing you how to use a linear decision-making process to encode your information visually. Delve into different kinds of visualization, including infographics and visual art, and explore the influences at work in each one. Then learn how to apply these concepts to your design process. Learn data visualization classifications, including explanatory, expl

Beginning SharePoint Designer 2010

CERN Document Server

Windischman, Woodrow W; Rehmani, Asif

2010-01-01

Teaching Web designers, developers, and IT professionals how to use the new version of SharePoint Designer. Covering both the design and business applications of SharePoint Designer, this complete Wrox guide brings readers thoroughly up to speed on how to use SharePoint Designer in an enterprise. You'll learn to create and modify web pages, use CSS editing tools to modify themes, use Data View to create interactivity with SharePoint and other data, and much more. Coverage includes integration points with Visual Studio, Visio, and InfoPath.: Shows web designers, developers, and IT professionals

3D for Graphic Designers

CERN Document Server

Connell, Ellery

2011-01-01

Helping graphic designers expand their 2D skills into the 3D space The trend in graphic design is towards 3D, with the demand for motion graphics, animation, photorealism, and interactivity rapidly increasing. And with the meteoric rise of iPads, smartphones, and other interactive devices, the design landscape is changing faster than ever.2D digital artists who need a quick and efficient way to join this brave new world will want 3D for Graphic Designers. Readers get hands-on basic training in working in the 3D space, including product design, industrial design and visualization, modeling, ani

KALIMER-600 Conceptual Design Report

Energy Technology Data Exchange (ETDEWEB)

Hahn, Do Hee; Kim, Yeong Il; Kim, Young Gyun (and others)

2007-02-15

This report, which summarizes the design concepts developed during Phase 4, follows the format of a safety analysis report. The purpose of publishing this report is to gather all of design information developed, so far in a systematic way, so that KALIMER-600 designers have a common and consistent source of for design information necessary for their future design and technology development activities on a SFR. Chapter 1 describes the KALIMER-600 Project. Chapter 2 includes the top-tier design requirements of KALIMER-600 and a general plant description. Chapter 3 summarizes the designs of the structures, components, equipment and systems. And the remaining chapters present the results of the design and safety analysis.

KALIMER-600 Conceptual Design Report

International Nuclear Information System (INIS)

Hahn, Do Hee; Kim, Yeong Il; Kim, Young Gyun

2007-02-01

This report, which summarizes the design concepts developed during Phase 4, follows the format of a safety analysis report. The purpose of publishing this report is to gather all of design information developed, so far in a systematic way, so that KALIMER-600 designers have a common and consistent source of for design information necessary for their future design and technology development activities on a SFR. Chapter 1 describes the KALIMER-600 Project. Chapter 2 includes the top-tier design requirements of KALIMER-600 and a general plant description. Chapter 3 summarizes the designs of the structures, components, equipment and systems. And the remaining chapters present the results of the design and safety analysis

HF filter design and computer simulation

CERN Document Server

Rhea, Randall W

1994-01-01

A book for engineers who design and build filters of all types, including lumped element, coaxial, helical, dielectric resonator, stripline and microstrip types. A thorough review of classic and modern filter design techniques, containing extensive practical design information of passband characteristics, topologies and transformations, component effects and matching. An excellent text for the design and construction of microstrip filters.

KBS-3H design description 2005

International Nuclear Information System (INIS)

Autio, J.

2007-03-01

SKB and Posiva are performing an R and D program over the period of 2002-2007 with the overall aim to develop the KBS-3H to an alternative to the KBS-3V concept for disposal of spent nuclear fuel. A feasibility study of the KBS-3H concept was carried out in 2002, followed by the setting up of basic design in 2003. Several problems related to the behavior of the design and scope of future research and development work were addressed. Therefore the design basis was developed further and two candidate designs were developed: (1) previous Basic Design (BD) was developed more robust and tolerable to inflows. Parallel to that a novel modified (2) DAWE design with Drainage, Air evacuation and Watering and was developed to function robustly at various inflow situations. The candidate designs presented in this report include several novel components, such as fixing rings and steel plugs which have been designed without support of applicable design guidelines, regulations or standards available. The design basis and performance of these components include uncertainties, which should be studied and verified. It is possible that a feasible site specific design can be based on using both alternatives. (orig.)

Exploratory shaft facility preliminary designs - Paradox Basin. Technical report

International Nuclear Information System (INIS)

1983-09-01

The purpose of the Preliminary Design Report, Paradox Basin, is to provide a description of the preliminary design for an Exploratory Shaft Facility in the Paradox Basin, Utah. This issue of the report describes the preliminary design for constructing the exploratory shaft using the Large Hole Drilling Method of construction and outlines the preliminary design and estimates of probable construction cost. The Preliminary Design Report is prepared to complement and summarize other documents that comprise the design at the preliminary stage of completion, December 1982. Other design documents include drawings, cost estimates and schedules. The preliminary design drawing package, which includes the construction schedule drawing, depicts the descriptions in this report. For reference, a list of the drawing titles and corresponding numbers is included in the Appendix. The report is divided into three principal sections: Design Basis, Facility Description, and Construction Cost Estimate. 30 references

Rationale and design of a patient-centered medical home intervention for patients with end-stage renal disease on hemodialysis.

Science.gov (United States)

Porter, Anna C; Fitzgibbon, Marian L; Fischer, Michael J; Gallardo, Rani; Berbaum, Michael L; Lash, James P; Castillo, Sheila; Schiffer, Linda; Sharp, Lisa K; Tulley, John; Arruda, Jose A; Hynes, Denise M

2015-05-01

In the U.S., more than 400,000 individuals with end-stage renal disease (ESRD) require hemodialysis (HD) for renal replacement therapy. ESRD patients experience a high burden of morbidity, mortality, resource utilization, and poor quality of life (QOL). Under current care models, ESRD patients receive fragmented care from multiple providers at multiple locations. The Patient-Centered Medical Home (PCMH) is a team approach, providing coordinated care across the healthcare continuum. While this model has shown some early benefits for complex chronic diseases such as diabetes, it has not been applied to HD patients. This study is a non-randomized quasi-experimental intervention trial implementing a Patient-Centered Medical Home for Kidney Disease (PCMH-KD). The PCMH-KD extends the existing dialysis care team (comprised of a nephrologist, dialysis nurse, dialysis technician, social worker, and dietitian) by adding a general internist, pharmacist, nurse coordinator, and a community health worker, all of whom will see the patients together, and separately, as needed. The primary goal is to implement a comprehensive, multidisciplinary care team to improve care coordination, quality of life, and healthcare use for HD patients. Approximately 240 patients will be recruited from two sites; a non-profit university-affiliated dialysis center and an independent for-profit dialysis center. Outcomes include (i) patient-reported outcomes, including QOL and satisfaction; (ii) clinical outcomes, including blood pressure and diet; (iii) healthcare use, including emergency room visits and hospitalizations; and (iv) staff perceptions. Given the significant burden that patients with ESRD on HD experience, enhanced care coordination provides an opportunity to reduce this burden and improve QOL. Copyright © 2015 Elsevier Inc. All rights reserved.

5-year results comparing mineral trioxide aggregate and adhesive resin composite for root-end sealing in apical surgery

DEFF Research Database (Denmark)

von Arx, Thomas; Hänni, Stefan; Jensen, Simon Storgård

2014-01-01

was designed to re-examine a large sample of teeth treated with apical surgery after 5 years. METHODS: Patients were recalled 5 years after apical surgery, and treated teeth were classified as healed or not healed based on clinical and radiographic examination. (The latter was performed independently by 3......, age, type of tooth treated, post/screw, type of surgery). CONCLUSIONS: The results from this prospective nonrandomized clinical study with a 5-year follow-up of 271 teeth indicate that MTA exhibited a higher healing rate than COMP in the longitudinal prognosis of root-end sealing.......INTRODUCTION: Recent meta-analyses of the outcome of apical surgery using modern techniques including microsurgical principles and high-power magnification have yielded higher rates of healing. However, the information is mainly based on 1- to 2-year follow-up data. The present prospective study...

Effects of surgery on ischaemic mitral regurgitation: a prospective multicentre registry (SIMRAM registry)

DEFF Research Database (Denmark)

Lancellotti, P.; Donal, E.; Cosyns, B.

2008-01-01

at rest. Exercise echocardiography may help identify a subset of patients at higher risk of cardiovascular events by revealing the dynamic component of IMR. METHODS: A large prospective, multicentre, non-randomized registry is designed to evaluate the effects of surgery on IMR at rest and on its dynamic......AIMS: Functional ischaemic mitral regurgitation (IMR) is common in patients with ischaemic left ventricular dysfunction undergoing coronary artery bypass surgery. Although the presence of IMR negatively affects prognosis, the additional benefit of valve repair is debated, particularly with mild IMR...... component at exercise (z). SIMRAM will enrol approximately 550 patients with IMR in up to 17 centres with clinical and exercise follow-up for 1 year. Three sets of outcomes will be prospectively assessed and several hypotheses will be tested including determinants of adverse outcome and progressive left...

Efficacy of Submucosal Sodium Tetradecyl Sulfate in the Soft Palate as a Treatment of the Mild Obstructive Sleep Apnea Syndrome: A Pilot Study

Directory of Open Access Journals (Sweden)

Alberto Labra

2012-01-01

Full Text Available Background. As described by Mair et al. in 2001, snoreplasty, the application of sclerosant agents in the palate is a promising and cheap alternative to treat snoring. We decided to try this kind of therapy for the management of mild sleep apnea. Study Design. Experimental, longitudinal, prospective, nonrandomized, self-controlled pilot study. Methods. 11 patients were included, all of them with a polysomnographic study showing an Apnea-Hypopnea Index (AHI from 5 to 20, and with a Müller maneuver showing only retropalatal collapse. Results. We found significant decrease in the number of apneas hypopneas and oxygen desaturation as well as in the snoring index (<0.05, although no differences were found in the number of arousals. Conclusion. Sclerosant agents might become a relevant part in the treatment of sleep apnea, in very well-selected patients.

Selected pharmacokinetic issues of the use of antiepileptic drugs and parenteral nutrition in critically ill patients

Directory of Open Access Journals (Sweden)

Abd Arwa Y

2010-12-01

Full Text Available Abstract Objectives To conduct a systematic review for the evidence supporting or disproving the reality of parenteral nutrition- antiepileptic drugs interaction, especially with respect to the plasma protein-binding of the drug. Methods The articles related to the topic were identified through Medline and PubMed search (1968-Feburary 2010 for English language on the interaction between parenteral nutrition and antiepileptic drugs; the search terms used were anti-epileptic drugs, parenteral nutrition, and/or interaction, and/or in vitro. The search looked for prospective randomized and nonrandomized controlled studies; prospective nonrandomized uncontrolled studies; retrospective studies; case reports; and in vitro studies. Full text of the articles were then traced from the Universiti Sains Malaysia (USM library subscribed databases, including Wiley-Blackwell Library, Cochrane Library, EBSCOHost, OVID, ScienceDirect, SAGE Premier, Scopus, SpringerLINK, and Wiley InterScience. The articles from journals not listed by USM library were traced through inter library loan. Results There were interactions between parenteral nutrition and drugs, including antiepileptics. Several guidelines were designed for the management of illnesses such as traumatic brain injuries or cancer patients, involving the use of parenteral nutrition and antiepileptics. Moreover, many studies demonstrated the in vitro and in vivo parenteral nutrition -drugs interactions, especially with antiepileptics. Conclusions There was no evidence supporting the existence of parenteral nutrition-antiepileptic drugs interaction. The issue has not been studied in formal researches, but several case reports and anecdotes demonstrate this drug-nutrition interaction. However, alteration in the drug-free fraction result from parenteral nutrition-drug (i.e. antiepileptics interactions may necessitate scrupulous reassessment of drug dosages in patients receiving these therapies. This