WorldWideScience

Sample records for outcome system focuses

  1. Sleep quality, the neglected outcome variable in clinical studies focusing on locomotor system; a construct validation study

    Directory of Open Access Journals (Sweden)

    Röder Christoph

    2010-09-01

    Full Text Available Abstract Background In addition to general health and pain, sleep is highly relevant to judging the well-being of an individual. Of these three important outcome variables, however, sleep is neglected in most outcome studies. Sleep is a very important resource for recovery from daily stresses and strains, and any alteration of sleep will likely affect mental and physical health, especially during disease. Sleep assessment therefore should be standard in all population-based or clinical studies focusing on the locomotor system. Yet current sleep assessment tools are either too long or too specific for general use. Methods Based on a literature review and subsequent patient-based rating of items, an expert panel designed a four-item questionnaire about sleep. Construct validation of the questionnaire in a random sample of the German-speaking Swiss population was performed in 2003. Reliability, correlation, and tests for internal consistency and validity were analyzed. Results Overall, 16,634 (70% out of 23,763 eligible individuals participated in the study. Test-retest reliability coefficients ranged from 0.72 to 0.87, and a Cronbach's alpha of 0.83 indicates good internal consistency. Results show a moderate to good correlation between sleep disturbances and health perception, and between sleep disturbances and overall pain. Conclusions The Sleep Standard Evaluation Questionnaire (SEQ-Sleep is a reliable and short tool with confirmed construct validity for sleep assessment in population-based observational studies. It is easy to administer and therefore suitable for postal surveys of the general population. Criterion validity remains to be determined.

  2. Cosmological Final Focus Systems

    International Nuclear Information System (INIS)

    Irwin, J

    2004-01-01

    We develop the many striking parallels between the dynamics of light streams from distant galaxies and particle beams in accelerator final focus systems. Notably the deflections of light by mass clumps are identical to the kicks arising from the long-range beam-beam interactions of two counter-rotating particle beams (known as parasitic crossings). These deflections have sextupolar as well as quadrupolar components. We estimate the strength of such distortions for a variety of circumstances and argue that the sextupolar distortions from clumping within clusters may be observable. This possibility is enhanced by the facts that (1) the sextupolar distortions of background galaxies is a factor of 5 smaller than the quadrupolar distortion, (2) the angular orientation of the sextupolar and quadrupolar distortions from a mass distribution would be correlated, appearing as a slightly curved image, (3) these effects should be spatially clumped on the sky

  3. Focus On: Neurotransmitter Systems

    Science.gov (United States)

    Valenzuela, C. Fernando; Puglia, Michael P.; Zucca, Stefano

    2011-01-01

    Neurotransmitter systems have been long recognized as important targets of the developmental actions of alcohol (i.e., ethanol). Short- and long-term effects of ethanol on amino acid (e.g., γ-aminobutyric acid and glutamate) and biogenic amine (e.g., serotonin and dopamine) neurotransmitters have been demonstrated in animal models of fetal alcohol spectrum disorders (FASD). Researchers have detected ethanol effects after exposure during developmental periods equivalent to the first, second, and third trimesters of human pregnancy. Results support the recommendation that pregnant women should abstain from drinking—even small quantities—as effects of ethanol on neurotransmitter systems have been detected at low levels of exposure. Recent studies have elucidated new mechanisms and/or consequences of the actions of ethanol on amino acid and biogenic amine neurotransmitter systems. Alterations in these neurotransmitter systems could, in part, be responsible for many of the conditions associated with FASD, including (1) learning, memory, and attention deficits; (2) motor coordination impairments; (3) abnormal responsiveness to stress; and (4) increased susceptibility to neuropsychiatric disorders, such as substance abuse and depression, and also neurological disorders, such as epilepsy and sudden infant death syndrome. However, future research is needed to conclusively establish a causal relationship between these conditions and developmental dysfunctions in neurotransmitter systems. PMID:23580048

  4. MS PHD'S PDP: Vision, Design, Implementation, and Outcomes of a Minority-Focused Earth System Sciences Program

    Science.gov (United States)

    Habtes, S. Y.; Mayo, M.; Ithier-Guzman, W.; Pyrtle, A. J.; Williamson Whitney, V.

    2007-05-01

    As minorities are predicted to comprise at least 33% of the US population by the year 2010, their representation in the STEM fields, including the ocean sciences, is still poorly established. In order to advance the goal of better decision making, the Ocean Sciences community must achieve greater levels of diversity in membership. To achieve this objective of greater diversity in the sciences, the Minorities Striving and Pursuing Higher Degrees of Success in Earth System Science® Professional Development Program (MS PHD'S PDP), which was launched in 2003, is supported via grants from NASA's Office of Earth Science, and NSF's Directorate for Geosciences. The MS PHD'S PDP is designed to provide professional and mentoring experiences that facilitate the advancement of minorities committed to achieving outstanding Earth System Science careers. The MS PHD'S PDP is structured in three phases, connected by engagement in a virtual community, continuous peer and mentor to mentee interactions, and the professional support necessary for ensuring the educational success of the student participants. Since the pilot program in 2003, the MSPHD'S PDP, housed at the University of South Florida's College of Marine Science, has produced 4 cohorts of students. Seventy-five have completed the program; of those 6 have earned their doctoral degrees. Of the 45 current participants 10 are graduate students in Marine Science and 15 are still undergraduates, the remaining 10 participants are graduate students in other STEM fields. Since the implementation of the MSPHD'S PDP a total of 87 students and 33 scientist mentors have become part of the MSPHD'S virtual community, helping to improve the learning environment for current and future participants as well as build a community of minority students that encourages each other to pursue their academic degrees.

  5. Development of the FOCUS (Focus on the Outcomes of Communication under Six), a Communication Outcome Measure for Preschool Children

    Science.gov (United States)

    Thomas-Stonell, Nancy L.; Oddson, Bruce; Robertson, Bernadette; Rosenbaum, Peter L.

    2010-01-01

    Aim: Our aim was to develop an outcome measure, called Focus on the Outcomes of Communication Under Six (FOCUS), that captures real-world changes in preschool children's communication. Conceptually grounded in the World Health Organization International Classification of Functioning, Disability and Health framework, the FOCUS items were derived…

  6. Final focus system for TLC

    International Nuclear Information System (INIS)

    Oide, K.

    1988-11-01

    A limit of the chromaticity correction for the final focus system of a TeV Linear Collider (TLC) is investigated. As the result, it becomes possible to increase the aperture of the final doublet with a small increase of the horizontal β function. The new optics design uses a final doublet of 0.5 mm half-aperture and 1.4 T pole-tip field. The length of the system is reduced from 400 m to 200 m by several optics changes. Tolerances for various machine errors with this optics are also studied. 5 refs., 7 figs., 2 tabs

  7. Outcomes-focused knowledge translation: a framework for knowledge translation and patient outcomes improvement.

    Science.gov (United States)

    Doran, Diane M; Sidani, Souraya

    2007-01-01

    Regularly accessing information that is current and reliable continues to be a challenge for front-line staff nurses. Reconceptualizing how nurses access information and designing appropriate decision support systems to facilitate timely access to information may be important for increasing research utilization. An outcomes-focused knowledge translation framework was developed to guide the continuous improvement of patient care through the uptake of research evidence and feedback data about patient outcomes. The framework operationalizes the three elements of the PARIHS framework at the point of care. Outcomes-focused knowledge translation involves four components: (a) patient outcomes measurement and real-time feedback about outcomes achievement; (b) best-practice guidelines, embedded in decision support tools that deliver key messages in response to patient assessment data; (c) clarification of patients' preferences for care; and (d) facilitation by advanced practice nurses and practice leaders. In this paper the framework is described and evidence is provided to support theorized relationships among the concepts in the framework. The framework guided the design of a knowledge translation intervention aimed at continuous improvement of patient care and evidence-based practice, which are fostered through real-time feedback data about patient outcomes, electronic access to evidence-based resources at the point of care, and facilitation by advanced practice nurses. The propositions in the framework need to be empirically tested through future research.

  8. Focusing on outcomes: Making the most of COPD interventions

    Directory of Open Access Journals (Sweden)

    Noreen M Clark

    2008-10-01

    Full Text Available Noreen M Clark1, Julia A Dodge1, Martyn R Partridge2, Fernando J Martinez31Center for Managing Chronic Disease, University of Michigan, Ann Arbor, MI, USA; 2Imperial College of Science, Technology and Medicine, London, England, UK; 3Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, USAAbstract: A number of excellent intervention studies related to clinical and psychosocial aspects of chronic obstructive pulmonary disease (COPD have been undertaken in the recent past. A range of outcomes have been examined including pulmonary function, health care use, quality of life, anxiety and depression, ambulation, exercise capacity, and self-efficacy. The purpose of this narrative review was to a consider clinical, psychosocial, and educational interventions for people living with COPD in light of the health related outcomes that they have produced, b identify the type of interventions most associated with outcomes, c examine work related to COPD interventions as it has evolved regarding theory and models compared to work in asthma, and d explore implications for future COPD research. Studies reviewed comprised large scale comprehensive reviews including randomized clinical trials and meta-analysis as these forms of investigation engender the greatest confidence in clinicians and health care researchers. Extant research suggests that the most significant improvements in COPD health care utilization have been realized from interventions specifically designed to enhance disease management by patients. A range of interventions have produced modest changes in quality of life. Evidence of impact for other outcomes and for a particular type of intervention is not strong. Research in other chronic diseases, particularly asthma, suggests that interventions grounded in learning theory and models of behavior change can consistently produce desired results for patients and clinicians. Use of a model of self-regulation may

  9. Assessment of Outcome-Focused Library Instruction in Psychology.

    Science.gov (United States)

    Daugherty, Timothy K.; Carter, Elizabeth W.

    1997-01-01

    A sample of 49 non-psychology majors taking a course integrating library research skills with social science research showed increases in skill level, efficiency, and positive attitudes toward the library after a semester of outcome-focused instruction. The results suggest that co-development between course and library faculty can be an effective…

  10. Network operating system focus technology

    Science.gov (United States)

    1985-01-01

    An activity structured to provide specific design requirements and specifications for the Space Station Data Management System (DMS) Network Operating System (NOS) is outlined. Examples are given of the types of supporting studies and implementation tasks presently underway to realize a DMS test bed capability to develop hands-on understanding of NOS requirements as driven by actual subsystem test beds participating in the overall Johnson Space Center test bed program. Classical operating system elements and principal NOS functions are listed.

  11. System safety education focused on system management

    Science.gov (United States)

    Grose, V. L.

    1971-01-01

    System safety is defined and characteristics of the system are outlined. Some of the principle characteristics include role of humans in hazard analysis, clear language for input and output, system interdependence, self containment, and parallel analysis of elements.

  12. Final focus systems for linear colliders

    International Nuclear Information System (INIS)

    Erickson, R.A.

    1987-11-01

    The final focus system of a linear collider must perform two primary functions, it must focus the two opposing beams so that their transverse dimensions at the interaction point are small enough to yield acceptable luminosity, and it must steer the beams together to maintain collisions. In addition, the final focus system must transport the outgoing beams to a location where they can be recycled or safely dumped. Elementary optical considerations for linear collider final focus systems are discussed, followed by chromatic aberrations. The design of the final focus system of the SLAC Linear Collider (SLC) is described. Tuning and diagnostics and steering to collision are discussed. Most of the examples illustrating the concepts covered are drawn from the SLC, but the principles and conclusions are said to be generally applicable to other linear collider designs as well. 26 refs., 17 figs

  13. Automatic focusing system of BSST in Antarctic

    Science.gov (United States)

    Tang, Peng-Yi; Liu, Jia-Jing; Zhang, Guang-yu; Wang, Jian

    2015-10-01

    Automatic focusing (AF) technology plays an important role in modern astronomical telescopes. Based on the focusing requirement of BSST (Bright Star Survey Telescope) in Antarctic, an AF system is set up. In this design, functions in OpenCV is used to find stars, the algorithm of area, HFD or FWHM are used to degree the focus metric by choosing. Curve fitting method is used to find focus position as the method of camera moving. All these design are suitable for unattended small telescope.

  14. Focused labeled proof systems for modal logic

    OpenAIRE

    Miller , Dale; Volpe , Marco

    2015-01-01

    International audience; Focused proofs are sequent calculus proofs that group inference rules into alternating positive and negative phases. These phases can then be used to define macro-level inference rules from Gentzen's original and tiny introduction and structural rules. We show here that the inference rules of labeled proof systems for modal logics can similarly be described as pairs of such phases within the LKF focused proof system for first-order classical logic. We consider the syst...

  15. Final Focus Systems in Linear Colliders

    International Nuclear Information System (INIS)

    Raubenheimer, Tor

    1998-01-01

    In colliding beam facilities, the ''final focus system'' must demagnify the beams to attain the very small spot sizes required at the interaction points. The first final focus system with local chromatic correction was developed for the Stanford Linear Collider where very large demagnifications were desired. This same conceptual design has been adopted by all the future linear collider designs as well as the SuperConducting Supercollider, the Stanford and KEK B-Factories, and the proposed Muon Collider. In this paper, the over-all layout, physics constraints, and optimization techniques relevant to the design of final focus systems for high-energy electron-positron linear colliders are reviewed. Finally, advanced concepts to avoid some of the limitations of these systems are discussed

  16. Final focus systems for linear colliders

    International Nuclear Information System (INIS)

    Helm, R.; Irwin, J.

    1992-08-01

    Final focus systems for linear colliders present many exacting challenges in beam optics, component design, and beam quality. Efforts to resolve these problems as they relate to a new generation of linear colliders are under way at several laboratories around the world. We will outline criteria for final focus systems and discuss the current state of understanding and resolution of the outstanding problems. We will discuss tolerances on alignment, field quality and stability for optical elements, and the implications for beam parameters such as emittance, energy spread, bunch length, and stability in position and energy. Beam-based correction procedures, which in principle can alleviate many of the tolerances, will be described. Preliminary results from the Final Focus Test Beam (FFTB) under construction at SLAC will be given. Finally, we mention conclusions from operating experience at the Stanford Linear Collider (SLC)

  17. Final focus systems for linear colliders

    International Nuclear Information System (INIS)

    Helm, R.; Irwing, J.

    1992-01-01

    Final focus systems for linear colliders present many exacting challenges in beam optics, component design, and beam quality. Efforts to resolve these problems as they relate to a new generation of linear colliders are under way at several laboratories around the world. We outline criteria for final focus systems and discuss the current state of understanding and resolution of the outstanding problems. We discuss tolerances on alignment, field quality and stability for optical elements, and the implications for beam parameters such as emittance, energy spread , bunch length, and stability in position and energy. Beam-based correction procedures, which in principle can alleviate many of the tolerances, are described. Preliminary results from the Final Focus Test Beam (FFTB) under construction at SLAC are given. Finally, we mention conclusions from operating experience at the Stanford Linear Collider (SLC). (Author) 16 refs., 4 tabs., 6 figs

  18. Nova frequency conversion and focusing system

    International Nuclear Information System (INIS)

    Summers, M.A.; Seppala, L.G.; Williams, J.D.

    1985-01-01

    New developments in crystal array technology provided significant improvements in the mechanical design and optical performance of the Nova 2 omega/3 omega array hardware. The final Nova array configuration was tested on the Novette laser and on the first arm of Nova. Ten Nova 2 omega/3 omega crystal arrays were assembled and tested for crystal alignment and wave front distortion before installation on the Nova target chamber. Ten Nova focus lens positioners were assembled and tested last year. The positioning accuracy and repeatability of each assembly were evaluated before installation on the target chamber. A cylindrical focusing system was also developed for installation in the Nova lens positioner assembly. Finally, 10 completed frequency conversion and focusing systems were activated

  19. Radiation damping in focusing-dominated systems

    International Nuclear Information System (INIS)

    Huang, Zhirong; Chen, Pisin; Ruth, R.D.

    1995-01-01

    A quasi-classical method is developed to calculate the radiation damping of a relativistic particle in a straight, continuous focusing system. In one limiting case where the pitch angle of the particle θ p is much larger than the radiation opening angle 1/γ, the radiation power spectrum is similar to synchrotron radiation and the relative damping rate of the transverse action is proportional to the relative energy loss rate. In the other limiting case where θ p much-lt 1/γ, the radiation is dipole in nature and the relative damping rate of the transverse action is energy-independent and is much faster than the relative energy rate. Quantum excitation to the transverse action is absent in this focusing channel. These results can be extended to bent systems provided that the focusing field dominates over the bending field

  20. Validation of the Focus on the Outcomes of Communication under Six outcome measure

    Science.gov (United States)

    Thomas-Stonell, Nancy; Oddson, Bruce; Robertson, Bernadette; Rosenbaum, Peter

    2013-01-01

    Aim The aim of this study was to establish the construct validity of the Focus on the Outcomes of Communication Under Six (FOCUS©),a tool designed to measure changes in communication skills in preschool children. Method Participating families' children (n=97; 68 males, 29 females; mean age 2y 8mo; SD 1.04y, range 10mo–4y 11mo) were recruited through eight Canadian organizations. The children were on a waiting list for speech and language intervention. Parents completed the Ages and Stages Questionnaire – Social/Emotional (ASQ-SE) and the FOCUS three times: at assessment and at the start and end of treatment. A second sample (n=28; 16 males 12 females) was recruited from another organization to correlate the FOCUS scores with speech, intelligibility and language measures. Second sample participants ranged in age from 3 years 1 month to 4 years 9 months (mean 3y 11mo; SD 0.41y). At the start and end of treatment, children were videotaped to obtain speech and language samples. Parents and speech–language pathologists (SLPs) independently completed the FOCUS tool. SLPs who were blind to the pre/post order of the videotapes analysed the samples. Results The FOCUS measured significantly more change (p<0.01) during treatment than during the waiting list period. It demonstrated both convergent and discriminant validity against the ASQ-SE. The FOCUS change corresponded to change measured by a combination of clinical speech and language measures (κ=0.31, p<0.05). Conclusion The FOCUS shows strong construct validity as a change-detecting instrument. PMID:23461266

  1. The stabilisation of final focus system

    Indian Academy of Sciences (India)

    The StaFF (stabilisation of final focus) system will use interferometers to monitor the relative ... quadrupole magnets will be the most demanding application, where mutual and beam- ... interferometers to measure lines of a geodetic network to record relative motion between two beam ... coupled interferometer design.

  2. Plasma focus system: Design, construction and experiments

    International Nuclear Information System (INIS)

    Alacakir, A.; Akguen, Y.; Boeluekdemir, A. S.

    2007-01-01

    The aim of this work is to construct a compact experimental system for fusion research. The design, construction and experiments of the 3 kJ Mather type plasma focus machine is described. This machine is established for neutron yield and fast neutron radiography by D-D reaction which is given by D + D→ 3 He (0.82 MeV) + n (2.45 MeV) . Investigation of the geometry of plasma focus machine in the presence of high voltage drive and vacuum system setup is shown. 108 neutron per pulse and 200 kA peak current is obtained for many shots. Scintillator screen for fast neutron imaging, sensitive to 2.45 MeV neutrons, is also manufactured in our labs. Structural neutron shielding computations for safety is also completed

  3. Past-focused environmental comparisons promote proenvironmental outcomes for conservatives

    Science.gov (United States)

    Baldwin, Matthew; Lammers, Joris

    2016-01-01

    Conservatives appear more skeptical about climate change and global warming and less willing to act against it than liberals. We propose that this unwillingness could result from fundamental differences in conservatives’ and liberals’ temporal focus. Conservatives tend to focus more on the past than do liberals. Across six studies, we rely on this notion to demonstrate that conservatives are positively affected by past- but not by future-focused environmental comparisons. Past comparisons largely eliminated the political divide that separated liberal and conservative respondents’ attitudes toward and behavior regarding climate change, so that across these studies conservatives and liberals were nearly equally likely to fight climate change. This research demonstrates how psychological processes, such as temporal comparison, underlie the prevalent ideological gap in addressing climate change. It opens up a promising avenue to convince conservatives effectively of the need to address climate change and global warming. PMID:27956619

  4. [Combined forecasting system of peritonitis outcome].

    Science.gov (United States)

    Lebedev, N V; Klimov, A E; Agrba, S B; Gaidukevich, E K

    To create a reliable system for assessing of severity and prediction of the outcome of peritonitis. Critical analysis of the systems for peritonitis severity assessment is presented. The study included outcomes of 347 patients who admitted at the Department of Faculty Surgery of Peoples' Friendship University of Russia in 2015-2016. The cause of peritonitis were destructive forms of acute appendicitis, cholecystitis, perforated gastroduodenal ulcer, various perforation of small and large intestines (including tumor). Combined forecasting system for peritonitis severity assessment is created. The system includes clinical, laboratory data, assessment of systemic inflammatory response (SIRS) and severity of organ failure (qSOFA). The authors focused on easily identifiable parameters which are available in virtually any surgical hospital. Threshold value (lethal outcome probability over 50%) is 8 scores in this system. Sensitivity, specificity and accuracy were 93.3, 99.7 and 98.9%, respectively according to ROC-curve that exceeds those parameters of MPI and APACHE II.

  5. Implementation of Outcome-Based Education in Universiti Putra Malaysia: A Focus on Students' Learning Outcomes

    Science.gov (United States)

    Mohayidin, Mohd Ghazali; Suandi, Turiman; Mustapha, Ghazali; Konting, Mohd. Majid; Kamaruddin, Norfaryanti; Man, Nor Azirawani; Adam, Azura; Abdullah, Siti Norziah

    2008-01-01

    The move towards applying outcome-based education in teaching and learning at tertiary education level has become an important topic in Malaysia. Apart from the three learning domains; namely, cognitive, psychomotor and affective, the Ministry of Higher Education has determined eight learning outcomes which are important in providing wholesome…

  6. Outcome mapping for health system integration

    Directory of Open Access Journals (Sweden)

    Tsasis P

    2013-03-01

    Full Text Available Peter Tsasis,1 Jenna M Evans,2 David Forrest,3 Richard Keith Jones4 1School of Health Policy and Management, Faculty of Health, York University, Toronto, Canada; 2Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Canada; 3Global Vision Consulting Ltd, Victoria, Canada; 4R Keith Jones and Associates, Victoria, Canada Abstract: Health systems around the world are implementing integrated care strategies to improve quality, reduce or maintain costs, and improve the patient experience. Yet few practical tools exist to aid leaders and managers in building the prerequisites to integrated care, namely a shared vision, clear roles and responsibilities, and a common understanding of how the vision will be realized. Outcome mapping may facilitate stakeholder alignment on the vision, roles, and processes of integrated care delivery via participative and focused dialogue among diverse stakeholders on desired outcomes and enabling actions. In this paper, we describe an outcome-mapping exercise we conducted at a Local Health Integration Network in Ontario, Canada, using consensus development conferences. Our preliminary findings suggest that outcome mapping may help stakeholders make sense of a complex system and foster collaborative capital, a resource that can support information sharing, trust, and coordinated change toward integration across organizational and professional boundaries. Drawing from the theoretical perspectives of complex adaptive systems and collaborative capital, we also outline recommendations for future outcome-mapping exercises. In particular, we emphasize the potential for outcome mapping to be used as a tool not only for identifying and linking strategic outcomes and actions, but also for studying the boundaries, gaps, and ties that characterize social networks across the continuum of care. Keywords: integrated care, integrated delivery systems, complex adaptive systems, social capital

  7. Investing in a Surgical Outcomes Auditing System

    Science.gov (United States)

    Bermudez, Luis; Trost, Kristen; Ayala, Ruben

    2013-01-01

    Background. Humanitarian surgical organizations consider both quantity of patients receiving care and quality of the care provided as a measure of success. However, organizational efficacy is often judged by the percent of resources spent towards direct intervention/surgery, which may discourage investment in an outcomes monitoring system. Operation Smile's established Global Standards of Care mandate minimum patient followup and quality of care. Purpose. To determine whether investment of resources in an outcomes monitoring system is necessary and effectively measures success. Methods. This paper analyzes the quantity and completeness of data collected over the past four years and compares it against changes in personnel and resources assigned to the program. Operation Smile began investing in multiple resources to obtain the missing data necessary to potentially implement a global Surgical Outcomes Auditing System. Existing personnel resources were restructured to focus on postoperative program implementation, data acquisition and compilation, and training materials used to educate local foundation and international employees. Results. An increase in the number of postoperative forms and amount of data being submitted to headquarters occurred. Conclusions. Humanitarian surgical organizations would benefit from investment in a surgical outcomes monitoring system in order to demonstrate success and to ameliorate quality of care. PMID:23401763

  8. System safety education focused on industrial engineering

    Science.gov (United States)

    Johnston, W. L.; Morris, R. S.

    1971-01-01

    An educational program, designed to train students with the specific skills needed to become safety specialists, is described. The discussion concentrates on application, selection, and utilization of various system safety analytical approaches. Emphasis is also placed on the management of a system safety program, its relationship with other disciplines, and new developments and applications of system safety techniques.

  9. System safety education focused on flight safety

    Science.gov (United States)

    Holt, E.

    1971-01-01

    The measures necessary for achieving higher levels of system safety are analyzed with an eye toward maintaining the combat capability of the Air Force. Several education courses were provided for personnel involved in safety management. Data include: (1) Flight Safety Officer Course, (2) Advanced Safety Program Management, (3) Fundamentals of System Safety, and (4) Quantitative Methods of Safety Analysis.

  10. Y2K: Focus on systems

    International Nuclear Information System (INIS)

    Dillner, M.

    1999-01-01

    During the past three years the Pacific Northwest National Laboratory has been actively working with the US DOE to understand the Y2K impacts that exist and perform appropriate remediation of critical systems. The Y2K problem has the potential for affecting software, hardware, embedded chips, control devices as well as telephone and power equipment. Successful Y2K remediation requires that a risk assessment be performed based on a view of the 'complete' system (e.g. input, outputs, infrastructure, operating systems, communication mechanisms, and development tools as compilers). All DOE facilities have followed the Y2K life cycle of system inventory, assessment (system and risk), renovation, testing, transition planning, implementation, validation and business continuity planning. Within this process, each organization has used the particular systems life-cycle methodology. The Pacific Northwest National Laboratory would like to share lessons learned about the entire Year 2000 program particularly in the areas of performing Year 2000 assessments, the identification of appropriate system remediation, and project mechanisms

  11. Design of High Precise Focusing System in Laser Direct Writer

    International Nuclear Information System (INIS)

    Liang, Y Y; Tian, F; Luo, J B; Yang, G G

    2006-01-01

    In order to improve the accuracy and efficiency of fabricating lines with laser pattern generator, a novel focusing system was designed. Focusing system is based on optical off-axis detection principle. The detector is a two-quadrant photocell and the defocus signal is constructed by division. Focusing system has the character of second-order system with overdamp. The new embedded PID controller improves the performance of focusing system and upgrades the closed-loop precision to 0.2 μm. Furthermore focusing system has the fabrication capabilities for alterable-width lines under various defocus amount

  12. EC FP6 Siberia-focused Enviro-RISKS Project and its Outcomes

    Science.gov (United States)

    Baklanov, A. A.; Gordov, E. P.

    2009-04-01

    The FP6 Project "Man-induced Environmental Risks: Monitoring, Management and Remediation of Man-made Changes in Siberia" (Enviro-RISKS) strategic objective is to facilitate elaboration of solid scientific background and understanding of man-made associated environmental risks, their influence on all aspects of regional environment and optimal ways for it remediation by means of coordinated initiatives of a range of relevant RTD projects as well as to achieve their improved integration thus giving the projects additional synergy in current activities and potential for practical applications. List of Partners includes 3 leading European research organizations, 6 leading Russian research organizations (5 - located in Siberia) and 1 organization from Kazakhstan. Additionally several Russian and European research organizations joined to the Project as Associated Partners. Scientific background and foundation for the project performance is formed by a number of different levels RTD projects carried out by Partners and devoted to near all aspects of the theme. The set comprise coordinated/performed by partners EC funded thematic international projects, Russian national projects and other projects performed by NIS partners. Project outcomes include, in particular, development and support of the bilingual Enviro-RISKS web portal (http://risks.scert.ru/) as the major tool for disseminations of environmental information and project results; achieved level of development of Siberia Integrated Regional Study (SIRS, http://sirs.scert.ru/), which is the Siberia-focused NEESPI Environmental Mega-Project ongoing under the auspices of the Siberian Branch of the Russian Academy of Sciences. The main Project outcome are Memorandum on the state of the art of environmental RTD activity in Siberia and Recommendations on future environmental RTD activity in Siberia elaborated by four Working Experts Groups working in most important for Siberia Thematic Focuses. Three Thematic Focuses

  13. Autofocus system and autofocus method for focusing on a surface

    Science.gov (United States)

    O'Neill, Mary Morabito

    2017-05-23

    An autofocus system includes an imaging device, a lens system and a focus control actuator that is configured to change a focus position of the imaging device in relation to a stage. The electronic control unit is configured to control the focus control actuator to a plurality of predetermined focus positions, and activate the imaging device to obtain an image at predetermined positions and then apply a spatial filter to the obtained images. This generates a filtered image for the obtained images. The control unit determines a focus score for the filtered images such that the focus score corresponds to a degree of focus in the obtained images. The control unit identifies a best focus position by comparing the focus score of the filtered images, and controls the focus control actuator to the best focus position corresponding to the highest focus score.

  14. PREFACE: Focus section on superconducting power systems Focus section on superconducting power systems

    Science.gov (United States)

    Cardwell, D. A.; Amemiya, N.; Fair, R.

    2012-01-01

    This focus section of Superconductor Science and Technology looks at the properties, technology and applications of (RE)BCO and MgB2 based superconductors for power engineering systems. Both bulk and conductor forms of material are addressed, including elements of materials fabrication and processing, and the measurement of their applied properties for various levels of system application. The areas of research include ac losses in type II materials in power devices, cables and coated conductors, the development of high current dc cables and the application of superconductors in levitation devices, motors and fault current limiters. This focus section presents a broad cross-section of contemporary issues, that represent state-of-the-art for power applications of superconductors, and highlights the areas that require further development if commercial applications of these rapidly emerging materials are to be realised. It contains papers from some of the major groups in the field, including contributions from Europe, the USA and Japan, and describes devices that are relatively close to market.

  15. Real-time systems scheduling 2 focuses

    CERN Document Server

    Chetto, Maryline

    2014-01-01

    Real-time systems are used in a wide range of applications, including control, sensing, multimedia, etc. Scheduling is a central problem for these computing/communication systems since it is responsible for software execution in a timely manner. This book, the second of two volumes on the subject, brings together knowledge on specific topics and discusses the recent advances for some of them.  It addresses foundations as well as the latest advances and findings in real-time scheduling, giving comprehensive references to important papers, but the chapters are short and not overloaded with co

  16. A literature review of record linkage procedures focusing on infant health outcomes

    Directory of Open Access Journals (Sweden)

    Carla Jorge Machado

    Full Text Available Record linkage is a powerful tool in assembling information from different data sources and has been used by a number of public health researchers. In this review, we provide an overview of the record linkage methodologies, focusing particularly on probabilistic record linkage. We then stress the purposes and research applications of linking records by focusing on studies of infant health outcomes based on large data sets, and provide a critical review of the studies in Brazil.

  17. Effects of reducing blood pressure on renal outcomes in patients with type 2 diabetes: Focus on SGLT2 inhibitors and EMPA-REG OUTCOME.

    Science.gov (United States)

    Scheen, A J; Delanaye, P

    2017-04-01

    Empagliflozin, a sodium-glucose cotransporter type 2 (SGLT2) inhibitor, has enabled remarkable reductions in cardiovascular and all-cause mortality as well as in renal outcomes in patients with type 2 diabetes (T2D) and a history of cardiovascular disease in the EMPA-REG OUTCOME. These results have been attributed to haemodynamic rather than metabolic effects, in part due to the osmotic/diuretic action of empagliflozin and the reduction in arterial blood pressure (BP). The present narrative review includes the results of meta-analyses of trials evaluating the effects on renal outcomes of lowering BP in patients with T2D, with a special focus on the influence of baseline and achieved systolic BP, and compares the renal outcome results of the EMPA-REG OUTCOME with those of other major trials with inhibitors of the renin-angiotensin system in patients with T2D and the preliminary findings with other SGLT2 inhibitors, and also evaluates post hoc analyses from the EMPA-REG OUTCOME of special interest as regards the BP-lowering hypothesis and renal function. While systemic BP reduction associated to empagliflozin therapy may have contributed to the renal benefits reported in EMPA-REG OUTCOME, other local mechanisms related to kidney homoeostasis most probably also played a role in the overall protection observed in the trial. Copyright © 2017. Published by Elsevier Masson SAS.

  18. Development of a focused ion beam micromachining system

    Energy Technology Data Exchange (ETDEWEB)

    Pellerin, J.G.; Griffis, D.; Russell, P.E.

    1988-12-01

    Focused ion beams are currently being investigated for many submicron fabrication and analytical purposes. An FIB micromachining system consisting of a UHV vacuum system, a liquid metal ion gun, and a control and data acquisition computer has been constructed. This system is being used to develop nanofabrication and nanomachining techniques involving focused ion beams and scanning tunneling microscopes.

  19. Development of FOCUS-GC: Framework for Outcomes of Clinical Communication Services in Genetic Counseling.

    Science.gov (United States)

    Cragun, Deborah; Zierhut, Heather

    2018-02-01

    Conceptual frameworks bring together existing theories and models in order to identify, consolidate, and fill in gaps between theory, practice, and evidence. Given the vast number of possible outcomes that could be studied in genetic counseling, a framework for organizing outcomes and postulating relationships between communication services and genetic counseling outcomes was sought. Through an iterative approach involving literature review, thematic analysis, and consolidation, outcomes and processes were categorized to create and define components of a conceptual framework. The final product, "Framework for Outcomes of Clinical commUnication Services" (FOCUS) contains the following domains: communication strategy; communication process measures; patient care experience, patient changes, patient health; and family changes. A website was created to allow easier access and ongoing modifications to the framework. In addition, a step-by-step guide and two examples were created to show flexibility in how the framework can be used. FOCUS may help in conceptualizing, organizing and summarizing outcomes research related to risk communication and counseling in genetic service delivery as well as other healthcare settings.

  20. FOCUS: a fire management planning system -- final report

    Science.gov (United States)

    Frederick W. Bratten; James B. Davis; George T. Flatman; Jerold W. Keith; Stanley R. Rapp; Theodore G. Storey

    1981-01-01

    FOCUS (Fire Operational Characteristics Using Simulation) is a computer simulation model for evaluating alternative fire management plans. This final report provides a broad overview of the FOCUS system, describes two major modules-fire suppression and cost, explains the role in the system of gaming large fires, and outlines the support programs and ways of...

  1. HINS Linac front end focusing system R&D

    Energy Technology Data Exchange (ETDEWEB)

    Apollinari, G.; Carcagno, R.H.; Dimarco, J.; Huang, Y.; Kashikhin, V.V.; Orris, D.F.; Page, T.M.; Rabehl, R.; Sylvester, C.; Tartaglia, M.A.; Terechkine, I.; /Fermilab /Argonne

    2008-08-01

    This report summarizes current status of an R&D program to develop a focusing system for the front end of a superconducting RF linac. Superconducting solenoids will be used as focusing lenses in the low energy accelerating sections of the front end. The development of focusing lenses for the first accelerating section is in the production stage, and lens certification activities are in preparation at FNAL. The report contains information about the focusing lens design and performance, including solenoid, dipole corrector, and power leads, and about cryogenic system design and performance. It also describes the lens magnetic axis position measurement technique and discusses scope of an acceptance/certification process.

  2. HINS Linac front end focusing system R and D

    International Nuclear Information System (INIS)

    Apollinari, G.; Carcagno, R.H.; Dimarco, J.; Huang, Y.; Kashikhin, V.V.; Orris, D.F.; Page, T.M.; Rabehl, R.; Sylvester, C.; Tartaglia, M.A.; Terechkine, I.; Fermilab; Argonne

    2008-01-01

    This report summarizes current status of an R and D program to develop a focusing system for the front end of a superconducting RF linac. Superconducting solenoids will be used as focusing lenses in the low energy accelerating sections of the front end. The development of focusing lenses for the first accelerating section is in the production stage, and lens certification activities are in preparation at FNAL. The report contains information about the focusing lens design and performance, including solenoid, dipole corrector, and power leads, and about cryogenic system design and performance. It also describes the lens magnetic axis position measurement technique and discusses scope of an acceptance/certification process

  3. Feasibility of Focused Stepping Practice During Inpatient Rehabilitation Poststroke and Potential Contributions to Mobility Outcomes.

    Science.gov (United States)

    Hornby, T George; Holleran, Carey L; Leddy, Abigail L; Hennessy, Patrick; Leech, Kristan A; Connolly, Mark; Moore, Jennifer L; Straube, Donald; Lovell, Linda; Roth, Elliot

    2015-01-01

    Optimal physical therapy strategies to maximize locomotor function in patients early poststroke are not well established. Emerging data indicate that substantial amounts of task-specific stepping practice may improve locomotor function, although stepping practice provided during inpatient rehabilitation is limited (inpatient rehabilitation following implementation of a focused training program to maximize stepping practice during clinical physical therapy sessions. Primary outcomes included distance and physical assistance required during a 6-minute walk test (6MWT) and balance using the Berg Balance Scale (BBS). Retrospective data analysis included multiple regression techniques to evaluate the contributions of demographics, training activities, and baseline motor function to primary outcomes at discharge. Median stepping activity recorded from patients was 1516 steps/d, which is 5 to 6 times greater than that typically observed. The number of steps per day was positively correlated with both discharge 6MWT and BBS and improvements from baseline (changes; r = 0.40-0.87), independently contributing 10% to 31% of the total variance. Stepping activity also predicted level of assistance at discharge and discharge location (home vs other facility). Providing focused, repeated stepping training was feasible early poststroke during inpatient rehabilitation and was related to mobility outcomes. Further research is required to evaluate the effectiveness of these training strategies on short- or long-term mobility outcomes as compared with conventional interventions. © The Author(s) 2015.

  4. Beam dynamics in the SLC final focus system

    International Nuclear Information System (INIS)

    Bambade, P.S.

    1987-06-01

    The SLC luminosity is reached by colliding beams focused to about 2 μm transverse sizes. The Final Focus System (FFS) must enable, beyond its basic optical design, the detection and correction of errors accumulated in the system. In this paper, after summarizing the design, we review the sensitivity to such errors and the ability to correct them. The overall tuning strategy involves three phases: single beam spot minimization, steering the beams in collision and luminosity optimization with beam-beam effects

  5. Development of focused ion beam systems with various ion species

    International Nuclear Information System (INIS)

    Ji Qing; Leung, K.-N.; King, Tsu-Jae; Jiang Ximan; Appleton, Bill R.

    2005-01-01

    Conventional focused ion beam systems employ a liquid-metal ion source (LMIS) to generate high-brightness beams, such as Ga + beams. Recently there has been an increased need for focused ion beams in areas like biological studies, advanced magnetic-film manufacturing and secondary-ion mass spectroscopy (SIMS). In this article, status of development on focused ion beam systems with ion species such as O 2 + , P + , and B + will be reviewed. Compact columns for forming focused ion beams from low energy (∼3keV), to intermediate energy (∼35keV) are discussed. By using focused ion beams, a SOI MOSFET is fabricated entirely without any masks or resist

  6. Development of the focus system for heaven-I

    International Nuclear Information System (INIS)

    Xiang Yihuai; Zhou Chuangzhi; Gong Kun; Ma Jinglong; Dai Hui; Shan Yusheng; Wang Naiyan

    2003-01-01

    This paper introduces the method of guiding the six KrF laser beams into target chamber and the development of focus system in MOPA angular multiplex system for Heaven-I. The six beams are focused to the vacuum target chamber by six plane-convex lenses. The focal spot on the target is measured by UV CCD camera, the diameter of the focal spot of six beams is 290 μm, the focusing power density on the target is 8 x 10 12 W/cm 2

  7. General method for final focus system design for circular colliders

    Directory of Open Access Journals (Sweden)

    Riccardo de Maria

    2008-03-01

    Full Text Available Colliders use final focus systems to reduce the transverse beam sizes at the interaction point in order to increase collision event rates. The maximum focal strength (gradient of the quadrupoles, and the maximum beam size in them, together limit the beam size reduction that is possible. The goal of a final focus system design is to find the best compromise between quadrupole aperture and quadrupole gradient, for the magnet technology that is used. This paper develops a design method that identifies the intrinsic limitations of a final focus system, validates the results of the method against realistic designs, and reports its application to the upgrade of the Large Hadron Collider final focus.

  8. Feasibility study of a family-focused intervention to improve outcomes for children with FASD.

    Science.gov (United States)

    Reid, Natasha; Dawe, Sharon; Harnett, Paul; Shelton, Doug; Hutton, Lauren; O'Callaghan, Frances

    2017-08-01

    Growing evidence shows that children with fetal alcohol spectrum disorder (FASD) can benefit from interventions, and specifically interventions focused on improving self-regulation. However, novel ways of improving outcomes for children with FASD need further investigation so that programs target not only the individual child but also the family context, which includes the parent-child relationship. The current study aimed to evaluate the feasibility of an adapted version of the Parents under Pressure (PuP) program that addresses self-regulatory processes, through improving the parent-child relationship and the use of mindfulness-based strategies for both children and parents. This was a mixed methods study. Feasibility was examined by evaluating recruitment, data collection/outcome measures, and intervention procedures. The study used a phenomenological approach to obtain qualitative information from caregivers and a single-case experimental design to evaluate the preliminary participant responses to the intervention. Two out of three families completed treatment. The recruitment and intervention procedures were found to be suitable for and acceptable to the families involved. Some concerns were identified regarding the outcome measures that would need to be addressed in future research. Quantitative and qualitative outcomes were positive. The results provide preliminary support for the feasibility of an adapted version of the PuP program. Thus, offering a potential multi-component option, that aims to improve self-regulatory skills for children with FASD, through focusing on improving the parent-child relationship and incorporating mindfulness-based techniques for both parents and children. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. [A focused sound field measurement system by LabVIEW].

    Science.gov (United States)

    Jiang, Zhan; Bai, Jingfeng; Yu, Ying

    2014-05-01

    In this paper, according to the requirement of the focused sound field measurement, a focused sound field measurement system was established based on the LabVIEW virtual instrument platform. The system can automatically search the focus position of the sound field, and adjust the scanning path according to the size of the focal region. Three-dimensional sound field scanning time reduced from 888 hours in uniform step to 9.25 hours in variable step. The efficiency of the focused sound field measurement was improved. There is a certain deviation between measurement results and theoretical calculation results. Focal plane--6 dB width difference rate was 3.691%, the beam axis--6 dB length differences rate was 12.937%.

  10. Design and simulation of an accelerating and focusing system

    Directory of Open Access Journals (Sweden)

    A Sadeghipanah

    2011-06-01

    Full Text Available Electrostatic focusing lenses have a vast field of applications in electrostatic accelerators and particularly in electron guns. In this paper, we first express a parametric mathematical analysis of an electrostatic accelerator and focusing system for an electron beam. Next, we At design a system of electron emission slit, accelerating electrodes and focusing lens for an electron beam emitted from a cathode with 4 mm radius and 2 mA current, in a distance less than 10 cm and up to the energy of 30 keV with the beam divergence less than 5°. This is achieved by solving the yielded equations in mathematical analysis using MATLAB. At the end, we simulate the behavior of above electron beam in the designed accelerating and focusing system using CST EM Studio. The results of simulation are in high agreement with required specifications of the electron beam, showing the accuracy of the used method in analysis and design of the accelerating and focusing system.

  11. Who Are You More Likely to Help? The Effects of Expected Outcomes and Regulatory Focus on Prosocial Performance

    Science.gov (United States)

    Xiao, Fengqiu; Zheng, Zhiwei; Zhang, Heyi; Xin, Ziqiang; Chen, Yinghe; Li, Yiwei

    2016-01-01

    Prosocial behavior refers to a broad category of actions that benefit other people or the society. Compared with other factors that affect prosocial performance, prosocial outcomes, consisting of prosocial gains and prosocial non-losses have received less attention up to now. In the current research, we explored the influences of different types of expected outcomes and regulatory focus on prosocial performance. Studies 1a and 1b examined the differences in prosocial performance elicited by prosocial gain (e.g., enhancing others’ access to clean water) and prosocial non-loss outcomes (e.g., protecting others from suffering dirty water). We found that the expected prosocial non-loss outcomes induced greater prosocial performance compared with the expected prosocial gain outcomes. Studies 2a and 2b examined the effects of dispositional and situational regulatory focus on prosocial loss aversion. We found that differences in prosocial performance between two expected prosocial outcomes were reduced when promotion focus was primed; whereas a primed prevention focus did not significantly increase this difference. Additionally, participants displayed a greater prosocial loss aversion in the prevention focus condition than in the promotion focus condition. The reason for the non-significant interaction between regulatory focus and expected prosocial outcome was discussed. PMID:27824909

  12. Who Are You More Likely to Help? The Effects of Expected Outcomes and Regulatory Focus on Prosocial Performance.

    Directory of Open Access Journals (Sweden)

    Fengqiu Xiao

    Full Text Available Prosocial behavior refers to a broad category of actions that benefit other people or the society. Compared with other factors that affect prosocial performance, prosocial outcomes, consisting of prosocial gains and prosocial non-losses have received less attention up to now. In the current research, we explored the influences of different types of expected outcomes and regulatory focus on prosocial performance. Studies 1a and 1b examined the differences in prosocial performance elicited by prosocial gain (e.g., enhancing others' access to clean water and prosocial non-loss outcomes (e.g., protecting others from suffering dirty water. We found that the expected prosocial non-loss outcomes induced greater prosocial performance compared with the expected prosocial gain outcomes. Studies 2a and 2b examined the effects of dispositional and situational regulatory focus on prosocial loss aversion. We found that differences in prosocial performance between two expected prosocial outcomes were reduced when promotion focus was primed; whereas a primed prevention focus did not significantly increase this difference. Additionally, participants displayed a greater prosocial loss aversion in the prevention focus condition than in the promotion focus condition. The reason for the non-significant interaction between regulatory focus and expected prosocial outcome was discussed.

  13. Matching bunched beams to alternating gradient focusing systems

    International Nuclear Information System (INIS)

    Lysenko, W.P.

    1980-07-01

    A numerical procedure for generating phase-space distributions matched to alternating gradient focusing systems has been tested. For a smooth-focusing system a matched distribution can be calculated. With a particle tracing simulation code such a distribution can be followed while adiabatically deforming the focusing forces until an alternating gradient configuration is reached. The distribution remains matched; that is, the final distribution is periodic with the structure period. This method is useful because it can produce distributions matched to nonlinear forces. This is a feature that elliptical distributions, with ellipse parameters obtained from the Courant-Snyder theory, do not have. External nonlinearities, including nonlinear couplings, were included in our examples but space charge was not. This procedure is expected to work with space charge but will require a three-dimensional space charge calculation in the simulation code

  14. The Final Focus Test Beam laser referene system

    International Nuclear Information System (INIS)

    Bressler, V.E.; Ruland, R.E.

    1993-05-01

    The original design for the SLAC linac included an alignment reference system with 270 diffraction gratings situated along the 3000 meter linac. These gratings have provided SLAC with a global reference line repeatable to within 200 micro meters. For the Final Focus Test Beam, this laser system has been extended and 13 new diffraction gratings have been installed. Improvements targets and the availability of new instruments allows us to evaluate the performance of the laser reference system at the 510 micro meter level. An explanation of the system and the results of our evaluation are presented

  15. Comparison of models for predicting outcomes in patients with coronary artery disease focusing on microsimulation

    Directory of Open Access Journals (Sweden)

    Masoud Amiri

    2012-01-01

    Full Text Available Background: Physicians have difficulty to subjectively estimate the cardiovascular risk of their patients. Using an estimate of global cardiovascular risk could be more relevant to guide decisions than using binary representation (presence or absence of risk factors data. The main aim of the paper is to compare different models of predicting the progress of a coronary artery diseases (CAD to help the decision making of physician. Methods: There are different standard models for predicting risk factors such as models based on logistic regression model, Cox regression model, dynamic logistic regression model, and simulation models such as Markov model and microsimulation model. Each model has its own application which can or cannot use by physicians to make a decision on treatment of each patient. Results: There are five main common models for predicting of outcomes, including models based on logistic regression model (for short-term outcomes, Cox regression model (for intermediate-term outcomes, dynamic logistic regression model, and simulation models such as Markov and microsimulation models (for long-term outcomes. The advantages and disadvantages of these models have been discussed and summarized. Conclusion: Given the complex medical decisions that physicians face in everyday practice, the multiple interrelated factors that play a role in choosing the optimal treatment, and the continuously accumulating new evidence on determinants of outcome and treatment options for CAD, physicians may potentially benefit from a clinical decision support system that accounts for all these considerations. The microsimulation model could provide cardiologists, researchers, and medical students a user-friendly software, which can be used as an intelligent interventional simulator.

  16. A conceptual design of Final Focus Systems for linear colliders

    International Nuclear Information System (INIS)

    Brown, K.L.

    1987-06-01

    Linear colliders are a relatively recent development in the evolution of particle accelerators. This report discusses some of the approaches that have been considered for the design of Final Focus Systems to demagnify the beam exiting from a linac to the small size suitable for collisions at the interaction point. The system receiving the most attention is the one adopted for the SLAC Linear Collider. However, the theory and optical techniques discussed should be applicable to the design efforts for future machines

  17. Benefits of SGLT2 Inhibitors beyond glycemic control - A focus on metabolic, cardiovascular, and renal outcomes.

    Science.gov (United States)

    Minze, Molly G; Will, Kayley; Terrell, Brian T; Black, Robin L; Irons, Brian K

    2017-08-16

    Sodium-glucose co-transporter 2 (SGLT2) inhibitors are a new pharmacotherapeutic class for the treatment of type 2 diabetes mellitus (T2DM). To evaluate beneficial effects of the SGLT2 inhibitors on metabolic, cardiovascular, and renal outcomes. A Pub-Med search (1966 to July 2017) was performed of published English articles using keywords sodium-glucose co-transporter 2 inhibitors, canagliflozin, dapagliflozin, and empagliflozin. A review of literature citations provided further references. The search identified 17clinical trials and 2 meta-analysis with outcomes of weight loss and blood pressure reduction with dapagliflozin, canagliflozin, or empagliflozin. Three randomized trials focused on either empagliflozin or canagliflozin and reduction of cardiovascular disease and progression of renal disease. SGLT2 inhibitors have a beneficial profile in the treatment of T2DM. They have evidence of reducing weight between 2.9 kilograms when used as monotherapy to 4.7 kilograms when used in combination with metformin, and reduce systolic blood pressure between 3 to 5 mmHg and reduce diastolic blood pressure approximately 2 mmHg. To date, reduction of cardiovascular events was seen specifically with empagliflozin in patients with T2DM and a history of cardiovascular disease. In the same population, empagliflozin was associated with slowing the progression of kidney disease. Moreover, patients with increased risk of cardiovascular disease treated with canagliflozin has decreased risk of death from cardiovascular causes, nonfatal MI, or nonfatal stroke. Data regarding these outcomes with dapagliflozin are underway. SGLT2 inhibitors demonstrate some positive metabolic effects. In addition, empagliflozin specifically has demonstrated reduction in cardiovascular events and delay in the progression of kidney disease in patients with T2DM and a history of cardiovascular disease. Further data is needed to assess if this is a class effect. Copyright© Bentham Science Publishers

  18. A RECIPE FOR LINEAR COLLIDER FINAL FOCUS SYSTEM DESIGN

    International Nuclear Information System (INIS)

    Seryi, Andrei

    2003-01-01

    The design of Final Focus systems for linear colliders is challenging because of the large demagnifications needed to produce nanometer-sized beams at the interaction point. Simple first- and second-order matrix matching have proven insufficient for this task, and minimization of third- and higher-order aberrations is essential. An appropriate strategy is required for the latter to be successful. A recipe for Final Focus design, and a set of computational tools used to implement this approach, are described herein. An example of the use of this procedure is given

  19. Self-focusing and defect characterization with the FAUST system

    International Nuclear Information System (INIS)

    Mahaut, S.; Cattiaux, G.; Roy, O.; Benoist, PH.

    1996-01-01

    The FAUST (Focusing Adaptative UltraSonic Tomography) system was developed at the French Atomic Energy Commission (CEA) to improve performances of ultrasonic non destructive testing in terms of adaptability to various control configurations and defect characterization. Unlike conventional techniques only allowing fixed focusing, this system can dynamically modify the characteristics of the ultrasonic beam. This system relies on optimized phased array transducers connected to a multi-channel acquisition system supplying amplitude and delay laws allowing to drive the ultrasonic beam. Previous works have demonstrated the skills of this system for ultrasonic beam forming. The reliability of the procedure was proved by comparison with theoretical results, while comparisons with experimental results provided by conventional transducer pointed out the improved capacities of the system. In the first part of paper, we briefly present the model used for the system validation. This field computational model developed at the CEA is used to design optimized phased array transducers dedicated to NDE configurations (immersed transducers used to focus through Fluid/Solid interfaces). Theoretical delay laws and related ultrasonic fields are also calculated from this model. In addition to its ability to dynamically form the ultrasonic beam by taking account of the control configuration, we investigate in the second part of the paper the capabilities of the system to extract informations from he received signals. The ability of the system to store the signals received by all the elements of the array allows one to perform different reconstruction procedures. Useful informations can be extracted from the received signals: experimentally measured delay laws can be determined from reflected signals to obtain an optimal imaging, while the related amplitude distribution over the array points out geometrical characteristics of the reflector. (authors)

  20. The completed design of the SLC Final Focus System

    International Nuclear Information System (INIS)

    Murray, J.J.; Brown, K.L.; Fieguth, T.

    1987-02-01

    The design of the SLC Final Focus System has evolved from its initial conceptual design into its final form. This final design is described including a review of the critical decisions influencing the adoption of particular features. The creation of a feasible design has required that these decisions be tempered by practical considerations such as site constraints, correction of optical errors caused by imperfections, and accommodations requested by engineers and particle detector physicists. As this is the first such system to be built, it is hoped that the experience gained will be useful for the design of future systems

  1. Portable linear-focused solar thermal energy collecting system

    Science.gov (United States)

    Miller, C. G.; Pohl, J. G. (Inventor)

    1977-01-01

    A solar heat collection system is provided by utilizing a line-focusing device that is effectively a cylindrically curved concentrator within a protected environment formed by a transparent inflatable casing. A target, such as a fluid or gas carrying conduit is positioned within or near the casing containing the concentrator, at the line focus of the concentrator. The casing can be inflated at the site of use by a low pressure air supply to form a unitary light weight structure. The collector, including casing, concentrator and target, is readily transportable and can be used either at ground level or on rooftops. The inflatable concentrator can be replaced with a rigid metal or other concentrator while maintaining the novel advantages of the whole solar heat collection system.

  2. Airbreathing Hypersonic Systems Focus at NASA Langley Research Center

    Science.gov (United States)

    Hunt, James L.; Rausch, Vincent L.

    1998-01-01

    This paper presents the status of the airbreathing hypersonic airplane and space-access vehicle design matrix, reflects on the synergies and issues, and indicates the thrust of the effort to resolve the design matrix and to focus/advance systems technology maturation. Priority is given to the design of the vision operational vehicles followed by flow-down requirements to flight demonstrator vehicles and their design for eventual consideration in the Future-X Program.

  3. Alignment and focusing device for a multibeam laser system

    International Nuclear Information System (INIS)

    Sweatt, W.C.

    1980-01-01

    Large inertial confinement fusion laser systems have many beams focusing on a small target. The Antares system is a 24-beam CO 2 pulse laser. To produce uniform illumination, the 24 beams must be individually focused on (or near) the target's surface in a symmetric pattern. To assess the quality of a given beam, we will locate a Smartt (point diffraction) interferometer at the desired focal point and illuminate it with an alignment laser. The resulting fringe pattern shows defocus, lateral misalignment, and beam aberrations; all of which can be minimized by tilting and translating the focusing mirror and the preceding flat mirror. The device described in this paper will remotely translate the Smartt interferometer to any position in the target space and point it in any direction using a two-axis gimbal. The fringes produced by the interferometer are relayed out of the target vacuum shell to a vidicon by a train or prisms. We are designing four separate snap-in heads to mount on the gimbal; two of which are Smartt interferometers (for 10.6 μm and 633 nm) and two for pinholes, should we wish to put an alignment beam backwards through the system

  4. Limbic system, the main focus of dementia syndrome

    International Nuclear Information System (INIS)

    Matsuzawa, Taiju

    1990-01-01

    Alzheimer disease and multi-infarct dementia are two entirely different diseases producing almost the same abnormalities as dementia syndrome. The statistical studies with MRI to locate the focus of dementia syndrome in the neocortex was an absolute failure. With MRI there is drastic atrophy and destruction of the amygdala and hippocampus suggesting the limbic system as the focus of dementia syndrome. Destruction of the limbic system in particular amygdala and hippocampus produced the functional obstruction brought about by the marked reduction in the glucose utilization with PET in the bilateral temporal, parietal and occipital association cortices. Although this type constitutes only about 1/5 of all dementia patients. It is considered the fundamental type of dementia syndrome. Aside from this, there is a type wherein simultaneous and symmetrical reductions in glucose utilization of the frontal association cortex and the motor association cortex in the anterior part of the neocortex. This is referred to as type II. It constitutes about 4/5 of all dementia patients which is far more than type I. Based on these results, it is thought that limbic system is the main focus of dementia syndrome. (author)

  5. A Dynamic Alignment System for the Final Focus Test Beam

    International Nuclear Information System (INIS)

    Ruland, R.E.; Bressler, V.E.; Fischer, G.; Plouffe, D.; SLAC

    2005-01-01

    The Final Focus Test Beam (FFTB) was conceived as a technological stepping stone on the way to the next linear collider. Nowhere is this more evident than with the alignment subsystems. Alignment tolerances for components prior to beam turn are almost an order of magnitude smaller than for previous projects at SLAC. Position monitoring systems which operate independent of the beam are employed to monitor motions of the components locally and globally with unprecedented precision. An overview of the FFTB alignment system is presented herein

  6. 20 CFR 411.550 - How are the outcome payments calculated under the outcome payment system?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false How are the outcome payments calculated under the outcome payment system? 411.550 Section 411.550 Employees' Benefits SOCIAL SECURITY ADMINISTRATION... the outcome payments calculated under the outcome payment system? The amount of each monthly outcome...

  7. Regulation of Calcitriol Biosynthesis and Activity: Focus on Gestational Vitamin D Deficiency and Adverse Pregnancy Outcomes

    Directory of Open Access Journals (Sweden)

    Andrea Olmos-Ortiz

    2015-01-01

    Full Text Available Vitamin D has garnered a great deal of attention in recent years due to a global prevalence of vitamin D deficiency associated with an increased risk of a variety of human diseases. Specifically, hypovitaminosis D in pregnant women is highly common and has important implications for the mother and lifelong health of the child, since it has been linked to maternal and child infections, small-for-gestational age, preterm delivery, preeclampsia, gestational diabetes, as well as imprinting on the infant for life chronic diseases. Therefore, factors that regulate vitamin D metabolism are of main importance, especially during pregnancy. The hormonal form and most active metabolite of vitamin D is calcitriol. This hormone mediates its biological effects through a specific nuclear receptor, which is found in many tissues including the placenta. Calcitriol synthesis and degradation depend on the expression and activity of CYP27B1 and CYP24A1 cytochromes, respectively, for which regulation is tissue specific. Among the factors that modify these cytochromes expression and/or activity are calcitriol itself, parathyroid hormone, fibroblast growth factor 23, cytokines, calcium and phosphate. This review provides a current overview on the regulation of vitamin D metabolism, focusing on vitamin D deficiency during gestation and its impact on pregnancy outcomes.

  8. To craft or not to craft : The relationships between regulatory focus, job crafting and work outcomes

    NARCIS (Netherlands)

    Brenninkmeijer, Veerle; Hekkert-Koning, Marleen

    2015-01-01

    Purpose – The purpose of this paper is to examine relationships between regulatory focus, job crafting, work engagement and perceived employability. Regulatory focus theory distinguishes between promotion-focused individuals, who strive for growth and development, and preventionfocussed individuals,

  9. Comparison of the HiFocus Mid-Scala and HiFocus 1J Electrode Array: Angular Insertion Depths and Speech Perception Outcomes.

    Science.gov (United States)

    van der Jagt, M Annerie; Briaire, Jeroen J; Verbist, Berit M; Frijns, Johan H M

    2016-01-01

    The HiFocus Mid-Scala (MS) electrode array has recently been introduced onto the market. This precurved design with a targeted mid-scalar intracochlear position pursues an atraumatic insertion and optimal distance for neural stimulation. In this study we prospectively examined the angular insertion depth achieved and speech perception outcomes resulting from the HiFocus MS electrode array for 6 months after implantation, and retrospectively compared these with the HiFocus 1J lateral wall electrode array. The mean angular insertion depth within the MS population (n = 96) was found at 470°. This was 50° shallower but more consistent than the 1J electrode array (n = 110). Audiological evaluation within a subgroup, including only postlingual, unilaterally implanted, adult cochlear implant recipients who were matched on preoperative speech perception scores and the duration of deafness (MS = 32, 1J = 32), showed no difference in speech perception outcomes between the MS and 1J groups. Furthermore, speech perception outcome was not affected by the angular insertion depth or frequency mismatch. © 2016 S. Karger AG, Basel.

  10. Focusing Information Systems Post-Graduate Research Projects

    Directory of Open Access Journals (Sweden)

    Gail Ridley

    1996-11-01

    Full Text Available This paper reports on an investigation of mechanisms that assist Information Systems post-graduate research students to focus their projects. An evaluation is presented of the experiences of Information Systems research students in focussing their research projects based on a survey conducted of students who participated in two of the first three Information Systems doctoral consortia to be held in Australia. The survey sought to determine whether a doctoral consortium or 'systematic expert review' is the most valuable mechanism for focussing a research proposal. Systematic expert review was considered by the students to be more effective than the doctoral consortium process for the purpose of focussing their research project proposals.

  11. Probing LINEAR Collider Final Focus Systems in SuperKEKB

    CERN Document Server

    Thrane, Paul Conrad Vaagen

    2017-01-01

    A challenge for future linear collider final focus systems is the large chromaticity produced by the final quadrupoles. SuperKEKB will be correcting high levels of chromaticity using the traditional scheme which has been also proposed for the CLIC FFS. We present early simulation results indicating that lowering β*у in the SuperKEKB Low Energy Ring might be possible given on-axis injection and low bunch current, opening the possibility of testing chromaticity correction beyond FFTB level, similar to ILC and approaching that of CLIC. CLIC – Note – 1077

  12. Introduction to Focus Issue: Complex network perspectives on flow systems.

    Science.gov (United States)

    Donner, Reik V; Hernández-García, Emilio; Ser-Giacomi, Enrico

    2017-03-01

    During the last few years, complex network approaches have demonstrated their great potentials as versatile tools for exploring the structural as well as dynamical properties of dynamical systems from a variety of different fields. Among others, recent successful examples include (i) functional (correlation) network approaches to infer hidden statistical interrelationships between macroscopic regions of the human brain or the Earth's climate system, (ii) Lagrangian flow networks allowing to trace dynamically relevant fluid-flow structures in atmosphere, ocean or, more general, the phase space of complex systems, and (iii) time series networks unveiling fundamental organization principles of dynamical systems. In this spirit, complex network approaches have proven useful for data-driven learning of dynamical processes (like those acting within and between sub-components of the Earth's climate system) that are hidden to other analysis techniques. This Focus Issue presents a collection of contributions addressing the description of flows and associated transport processes from the network point of view and its relationship to other approaches which deal with fluid transport and mixing and/or use complex network techniques.

  13. The mechanical design for the WEAVE prime focus corrector system

    Science.gov (United States)

    Abrams, Don Carlos; Dee, Kevin; Agócs, Tibor; Lhome, Emilie; Peñate, José; Jaskó, Attila; Bányai, Evelin; Burgal, José A.; Dalton, Gavin; Middleton, Kevin; Bonifacio, Piercarlo; Aguerri, J. Alfonso L.; Trager, S. C.; Balcells, Marc

    2014-08-01

    WEAVE is the next-generation, wide-field, optical spectroscopy facility for the William Herschel Telescope (WHT) in La Palma, Canary Islands, Spain. The WHT will undergo a significant adaptation to accommodate this facility. A two- degree Prime Focus Corrector (PFC), that includes an Atmospheric Dispersion Compensator, is being planned and is currently in its final design phase. To compensate for the effects of temperature-induced image degradation, the entire PFC system will be translated along the telescope optical axis. The optical system comprises six lenses, the largest of which will have a diameter of 1.1m. Now that the optical elements are in production, the designs for the lens cells and the mounting arrangements are being analysed to ensure that the image quality of the complete system is better than 1.0 arcsec (80% encircled energy diameter) over the full field of view. The new PFC system is designed to be routinely interchanged with the existing top-end ring. This will maximise the versatility of the WHT and allow the two top-end systems to be interchanged as dictated by the scientific needs of the astronomers that will use WEAVE and other instruments on the telescope. This manuscript describes the work that has been carried out in developing the designs for the mechanical subsystems and the plans for mounting the lenses to attain an optical performance that is commensurate with the requirements derived from planning the WEAVE surveys.

  14. Electron beam final focus system for Thomson scattering at ELBE

    Energy Technology Data Exchange (ETDEWEB)

    Krämer, J.M., E-mail: jmkr@danfysik.dk [Danfysik A/S, Gregersensvej 8, 2630 Taastrup (Denmark); Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiation Physics, Bautzner Landstrasse 400, 01328 Dresden (Germany); Technische Universität Dresden, 01069 Dresden (Germany); Budde, M.; Bødker, F. [Danfysik A/S, Gregersensvej 8, 2630 Taastrup (Denmark); Irman, A.; Jochmann, A. [Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiation Physics, Bautzner Landstrasse 400, 01328 Dresden (Germany); Kristensen, J.P. [Danfysik A/S, Gregersensvej 8, 2630 Taastrup (Denmark); Lehnert, U.; Michel, P. [Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiation Physics, Bautzner Landstrasse 400, 01328 Dresden (Germany); Schramm, U. [Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiation Physics, Bautzner Landstrasse 400, 01328 Dresden (Germany); Technische Universität Dresden, 01069 Dresden (Germany)

    2016-09-11

    The design of an electron beam final focus system (FFS) aiming for high-flux laser-Thomson backscattering X-ray sources at ELBE is presented. A telescope system consisting of four permanent magnet based quadrupoles was found to have significantly less chromatic aberrations than a quadrupole doublet or triplet as commonly used. Focusing properties like the position of the focal plane and the spot size are retained for electron beam energies between 20 and 30 MeV by adjusting the position of the quadrupoles individually on a motorized stage. The desired ultra-short electron bunches require an increased relative energy spread up to a few percent and, thus, second order chromatic effects must be taken into account. We also present the design and test results of the permanent magnet quadrupoles. Adjustable shunts allow for correction of the field strength and compensation of deviations in the permanent magnet material. For a beam emittance of 13 mm mrad, we predict focal spot sizes of about 40 μm (rms) and divergences of about 10 mrad using the FFS.

  15. Electron beam final focus system for Thomson scattering at ELBE

    CERN Document Server

    Krämer, J.M.; Bødker, F.; Irman, A.; .Jochmann A.; Kristensen, J.P.; Lehnert U., HZDR; Michel, P.; Schrammb, U.; 10.1016/j.nima.2015.10.067

    2016-01-01

    The design of an electron beam final focus system (FFS) aiming for high-flux laser-Thomson backscattering X-ray sources at ELBE is presented. A telescope system consisting of four permanent magnet based quadrupoles was found to have significantly less chromatic aberrations than a quadrupole doublet or triplet as commonly used. Focusing properties like the position of the focal plane and the spot size are retained for electron beam energies between 20 and 30 MeV by adjusting the position of the quadrupoles individually on a motorized stage. The desired ultra-short electron bunches require an increased relative energy spread up to a few percent and, thus, second order chromatic effects must be taken into account. We also present the design and test results of the permanent magnet quadrupoles. Adjustable shunts allow for correction of the field strength and compensation of deviations in the permanent magnet material. For a beam emittance of 13 mm mrad, we predict focal spot sizes of about 40 μm (rms) and diverg...

  16. Electron Beam Final Focus System For Thomson Scattering At Elbe

    CERN Document Server

    Krämer, J.M.; Bødkera, F.; Irman, A.; Jochmann, A.; Kristensena, J.P.; Lehnert, U.; Michel, P.; Schramm, U.; 10.1016/j.nima.2015.10.067

    2016-01-01

    The design of an electron beam final focus system (FFS) aiming for high-flux laser-Thomson backscattering X-ray sources at ELBE is presented. A telescope system consisting of four permanent magnet based quadrupoles was found to have significantly less chromatic aberrations than a quadrupole doublet or triplet as commonly used. Focusing properties like the position of the focal plane and the spot size are retained for electron beam energies between 20 and 30 MeV by adjusting the position of the quadrupoles individually on a motorized stage. The desired ultra-short electron bunches require an increased relative energy spread up to a few percent and, thus, second order chromatic effects must be taken into account. We also present the design and test results of the permanent magnet quadrupoles. Adjustable shunts allow for correction of the field strength and compensation of deviations in the permanent magnet material. For a beam emittance of 13 mm mrad, we predict focal spot sizes of about 40 μm (rms) and diverg...

  17. Relationship-Focused Child Care Practices: Quality of Care and Child Outcomes for Children in Poverty

    Science.gov (United States)

    Owen, Margaret Tresch; Klausli, Julia F.; Mata-Otero, Ana-Maria; Caughy, Margaret O'Brien

    2008-01-01

    Research Findings: Child care delivery practices promoting continuous, primary caregiver-child relationships (relationship-focused child care) were evaluated for 223 preschool-age children (45% African American, 55% Latino) attending child care centers serving low-income children. Both relationship-focused and non-relationship-focused centers were…

  18. On capillary self-focusing in a microfluidic system

    Energy Technology Data Exchange (ETDEWEB)

    Hein, M; Seemann, R [Experimental Physics, Saarland University, D-66123 Saarbrücken (Germany); Afkhami, S, E-mail: r.seemann@physik.uni-saarland.de, E-mail: shahriar.afkhami@njit.edu [Department of Mathematical Sciences, New Jersey Institute of Technology, Newark, NJ 07102 (United States)

    2016-12-15

    A computational framework is developed to address capillary self-focusing in step emulsification. The microfluidic system consists of a single shallow and wide microchannel that merges into a deep reservoir. A continuum approach coupled with a volume of fluid method is used to model the capillary self-focusing effect. The original governing equations are reduced using the Hele-Shaw approximation. We show that the interface between the two fluids takes the shape of a neck narrowing in the flow direction just before entering the reservoir, in agreement with our experimental observations. Our computational model relies on the assumption that the pressure at the boundary, where the fluid exits into the reservoir, is the uniform pressure in the reservoir. We investigate this hypothesis by comparing the numerical results with experimental data. We conjecture that the pressure boundary condition becomes important when the width of the neck is comparable to the depth of the microchannel. A correction to the exit pressure boundary condition is then proposed, which is determined by comparison with experimental data. We also present the experimental observations and the numerical results of the transitions of breakup regimes. (paper)

  19. Lung Infections in Systemic Rheumatic Disease: Focus on Opportunistic Infections.

    Science.gov (United States)

    Di Franco, Manuela; Lucchino, Bruno; Spaziante, Martina; Iannuccelli, Cristina; Valesini, Guido; Iaiani, Giancarlo

    2017-01-29

    Systemic rheumatic diseases have significant morbidity and mortality, due in large part to concurrent infections. The lung has been reported among the most frequent sites of infection in patients with rheumatic disease, who are susceptible to developing pneumonia sustained both by common pathogens and by opportunistic microorganisms. Patients with rheumatic disease show a peculiar vulnerability to infectious complications. This is due in part to intrinsic disease-related immune dysregulation and in part to the immunosuppressive treatments. Several therapeutic agents have been associated to a wide spectrum of infections, complicating the management of rheumatic diseases. This review discusses the most frequent pulmonary infections encountered in rheumatic diseases, focusing on opportunistic agents, consequent diagnostic challenges and appropriate therapeutic strategies.

  20. Expanded studies of linear collider final focus systems at the Final Focus Test Beam

    International Nuclear Information System (INIS)

    Tenenbaum, P.G.

    1995-12-01

    In order to meet their luminosity goals, linear colliders operating in the center-of-mass energy range from 3,50 to 1,500 GeV will need to deliver beams which are as small as a few Manometers tall, with x:y aspect ratios as large as 100. The Final Focus Test Beam (FFTB) is a prototype for the final focus demanded by these colliders: its purpose is to provide demagnification equivalent to those in the future linear collider, which corresponds to a focused spot size in the FFTB of 1.7 microns (horizontal) by 60 manometers (vertical). In order to achieve the desired spot sizes, the FFTB beam optics must be tuned to eliminate aberrations and other errors, and to ensure that the optics conform to the desired final conditions and the measured initial conditions of the beam. Using a combination of incoming-beam diagnostics. beam-based local diagnostics, and global tuning algorithms, the FFTB beam size has been reduced to a stable final size of 1.7 microns by 70 manometers. In addition, the chromatic properties of the FFTB have been studied using two techniques and found to be acceptable. Descriptions of the hardware and techniques used in these studies are presented, along with results and suggestions for future research

  1. Expanded studies of linear collider final focus systems at the Final Focus Test Beam

    Energy Technology Data Exchange (ETDEWEB)

    Tenenbaum, Peter Gregory [Stanford Univ., CA (United States)

    1995-12-01

    In order to meet their luminosity goals, linear colliders operating in the center-of-mass energy range from 3,50 to 1,500 GeV will need to deliver beams which are as small as a few Manometers tall, with x:y aspect ratios as large as 100. The Final Focus Test Beam (FFTB) is a prototype for the final focus demanded by these colliders: its purpose is to provide demagnification equivalent to those in the future linear collider, which corresponds to a focused spot size in the FFTB of 1.7 microns (horizontal) by 60 manometers (vertical). In order to achieve the desired spot sizes, the FFTB beam optics must be tuned to eliminate aberrations and other errors, and to ensure that the optics conform to the desired final conditions and the measured initial conditions of the beam. Using a combination of incoming-beam diagnostics. beam-based local diagnostics, and global tuning algorithms, the FFTB beam size has been reduced to a stable final size of 1.7 microns by 70 manometers. In addition, the chromatic properties of the FFTB have been studied using two techniques and found to be acceptable. Descriptions of the hardware and techniques used in these studies are presented, along with results and suggestions for future research.

  2. Mediterranea Forecasting System: a focus on wave-current coupling

    Science.gov (United States)

    Clementi, Emanuela; Delrosso, Damiano; Pistoia, Jenny; Drudi, Massimiliano; Fratianni, Claudia; Grandi, Alessandro; Pinardi, Nadia; Oddo, Paolo; Tonani, Marina

    2016-04-01

    The Mediterranean Forecasting System (MFS) is a numerical ocean prediction system that produces analyses, reanalyses and short term forecasts for the entire Mediterranean Sea and its Atlantic Ocean adjacent areas. MFS became operational in the late 90's and has been developed and continuously improved in the framework of a series of EU and National funded programs and is now part of the Copernicus Marine Service. The MFS is composed by the hydrodynamic model NEMO (Nucleus for European Modelling of the Ocean) 2-way coupled with the third generation wave model WW3 (WaveWatchIII) implemented in the Mediterranean Sea with 1/16 horizontal resolution and forced by ECMWF atmospheric fields. The model solutions are corrected by the data assimilation system (3D variational scheme adapted to the oceanic assimilation problem) with a daily assimilation cycle, using a background error correlation matrix varying seasonally and in different sub-regions of the Mediterranean Sea. The focus of this work is to present the latest modelling system upgrades and the related achieved improvements. In order to evaluate the performance of the coupled system a set of experiments has been built by coupling the wave and circulation models that hourly exchange the following fields: the sea surface currents and air-sea temperature difference are transferred from NEMO model to WW3 model modifying respectively the mean momentum transfer of waves and the wind speed stability parameter; while the neutral drag coefficient computed by WW3 model is passed to NEMO that computes the turbulent component. In order to validate the modelling system, numerical results have been compared with in-situ and remote sensing data. This work suggests that a coupled model might be capable of a better description of wave-current interactions, in particular feedback from the ocean to the waves might assess an improvement on the prediction capability of wave characteristics, while suggests to proceed toward a fully

  3. TRIGLYCERIDES, ATHEROSCLEROSIS, AND CARDIOVASCULAR OUTCOME STUDIES: FOCUS ON OMEGA-3 FATTY ACIDS.

    Science.gov (United States)

    Handelsman, Yehuda; Shapiro, Michael D

    2017-01-01

    To provide an overview of the roles of triglycerides and triglyceride-lowering agents in atherosclerosis in the context of cardiovascular outcomes studies. We reviewed the published literature as well as ClinicalTrials.gov entries for ongoing studies. Despite improved atherosclerotic cardiovascular disease (ASCVD) outcomes with statin therapy, residual risk remains. Epidemiologic data and recent genetic insights provide compelling evidence that triglycerides are in the causal pathway for the development of atherosclerosis, thereby renewing interest in targeting triglycerides to improve ASCVD outcomes. Fibrates, niacin, and omega-3 fatty acids (OM3FAs) are three classes of triglyceride-lowering drugs. Outcome studies with triglyceride-lowering agents have been inconsistent. With regard to OM3FAs, the JELIS study showed that eicosapentaenoic acid (EPA) significantly reduced major coronary events in statin-treated hypercholesterolemic patients. Regarding other agents, extended-release niacin and fenofibrate are no longer recommended as statin add-on therapy (by some guidelines, though not all) because of the lack of convincing evidence from outcome studies. Notably, subgroup analyses from the outcome studies have generated the hypothesis that triglyceride lowering may provide benefit in statin-treated patients with persistent hypertriglyceridemia. Two ongoing OM3FA outcome studies (REDUCE-IT and STRENGTH) are testing this hypothesis in high-risk, statin-treated patients with triglyceride levels of 200 to 500 mg/dL. There is consistent evidence that triglycerides are in the causal pathway of atherosclerosis but inconsistent evidence from cardiovascular outcomes studies as to whether triglyceride-lowering agents reduce cardiovascular risk. Ongoing outcomes studies will determine the role of triglyceride lowering in statin-treated patients with high-dose prescription OM3FAs in terms of improved ASCVD outcomes. AACE = American Association of Clinical Endocrinologists

  4. Final focus system tuning studies towards Compact Linear Collider feasibility

    Science.gov (United States)

    Marin, E.; Latina, A.; Tomás, R.; Schulte, D.

    2018-01-01

    In this paper we present the latest results regarding the tuning study of the baseline design of the final focus system of the Compact Linear Collider (CLIC-FFS). CLIC aims to provide collisions to the experiments at a luminosity above 1034 c m-2 s-1 . In order to deliver such luminosity in a single pass machine, the vertical beam size at the interaction point (IP) is reduced to about 1 nm, which imposes unprecedented tuning difficulties to the system. In previous studies, 90% of the machines reached 90% of the nominal luminosity at the expense of 18 000 luminosity measurements, when considering beam position monitor errors and transverse misalignments of magnets for a single beam case. In the present study, additional static imperfections as, roll misalignments, strength v2.epss are included. Moreover both e- and e+ beamlines are properly simulated. A new tuning procedure based on linear and nonlinear knobs is implemented to effectively cure the most relevant beam size aberrations at the IP. The obtained results for single and double beam studies under solely static imperfections are presented.

  5. Risk-perception and dangerous driving among adolescents: Outcome- and behavior-focused questions yield opposite results.

    Science.gov (United States)

    O'Brien, Fearghal; Gormley, Michael

    2016-10-01

    While some studies have found that those who perceive a behavior to be more risky are less likely to engage in it, others have found that those who engage in more risky behaviors see themselves as being more at-risk. Using an online questionnaire we investigated whether such conflicting findings may be due to the types of risk-questions employed in past studies. We assessed risk-perception using outcome-focused questions (e.g. the likelihood of being in an accident) and a behavior-focused question (the riskiness of speeding). Participants who reported engaging in more risky driving gave higher estimates of their chances of experiencing a negative outcome. However, those same participants gave lower estimates of the general riskiness of risky driving. Drivers may think about the risks of risky driving in different ways depending on the focus of the questions. Published by Elsevier Ltd.

  6. Multifunctional pulse generator for high-intensity focused ultrasound system

    Science.gov (United States)

    Tamano, Satoshi; Yoshizawa, Shin; Umemura, Shin-Ichiro

    2017-07-01

    High-intensity focused ultrasound (HIFU) can achieve high spatial resolution for the treatment of diseases. A major technical challenge in implementing a HIFU therapeutic system is to generate high-voltage high-current signals for effectively exciting a multichannel HIFU transducer at high efficiencies. In this paper, we present the development of a multifunctional multichannel generator/driver. The generator can produce a long burst as well as an extremely high-voltage short pulse of pseudosinusoidal waves (trigger HIFU) and second-harmonic superimposed waves for HIFU transmission. The transmission timing, waveform, and frequency can be controlled using a field-programmable gate array (FPGA) via a universal serial bus (USB) microcontroller. The hardware is implemented in a compact printed circuit board. The test results of trigger HIFU reveal that the power consumption and the temperature rise of metal-oxide semiconductor field-effect transistors were reduced by 19.9% and 38.2 °C, respectively, from the previous design. The highly flexible performance of the novel generator/driver is demonstrated in the generation of second-harmonic superimposed waves, which is useful for cavitation-enhanced HIFU treatment, although the previous design exhibited difficulty in generating it.

  7. Development of a High Intensity Focused Ultrasound (HIFU) Hydrophone System

    International Nuclear Information System (INIS)

    Schafer, Mark E.; Gessert, James

    2009-01-01

    The growing clinical use of High Intensity Focused Ultrasound (HIFU) has driven a need for reliable, reproducible measurements of HIFU acoustic fields. We have previously presented data on a reflective scatterer approach, incorporating several novel features for improved bandwidth, reliability, and reproducibility [Proc. 2005 IEEE Ultrasonics Symposium, 1739-1742]. We now report on several design improvements which have increase the signal to noise ratio of the system, and potentially reduced the cost of implementation. For the scattering element, we now use an artificial sapphire material to provide a more uniform radiating surface. The receiver is a segmented, truncated spherical structure with a 10 cm radius; the scattering element is positioned at the center of the sphere. The receiver is made from 25 micron thick, biaxially stretched PVDF, with a Pt-Au electrode on the front surface. In the new design, a specialized backing material provides the stiffness required to maintain structural stability, while at the same time providing both electrical shielding and ultrasonic absorption. Compared with the previous version, the new receiver design has improved the noise performance by 8-12 dB; the new scattering sphere has reduced the scattering loss by another 14 dB, producing an effective sensitivity of -298 dB re 1 microVolt/Pa. The design trade-off still involves receiver sensitivity with effective spot size, and signal distortion from the scatter structure. However, the reduced cost and improved repeatability of the new scatter approach makes the overall design more robust for routine waveform measurements of HIFU systems.

  8. Strategies to control costs and quality: a focus on outcomes research for disease management.

    Science.gov (United States)

    Villagra, Victor

    2004-04-01

    Rapid adoption of disease management has outpaced systematic evaluation of its net value in improving health outcomes and mitigating healthcare cost. This article identifies areas in which outcomes research in disease management is needed to demonstrate its value or to enhance its performance. Patient identification for disease management relies on administrative database queries but the trade-offs in sensitivity, specificity, and predictive value of alternative queries are not well known. Large-scale deployment, rapid patient engagement, and repeated interactions between patients and nurses could be important attributes for attaining measurable improvements in quality and cost reduction over short periods of time, but these hypothesis need to be tested. There is a trend toward integration of multiple chronic disease management programs onto a single platform. To support this trend, there is a need for a corresponding set of integrated clinical guidelines or "meta-guidelines" that combine the contents of individual practice guidelines. The relative contribution of various disease management interventions in improving clinical results, lowering costs, and their respective ease of implementation is not known. Research leading to a better understanding of tradeoffs could lead to more rational resource allocation and better overall outcomes. Coordination between disease management programs and physician practices is lacking. Research aimed at defining operational and technical interfaces and cultural and behavioral professional adjustments necessary to achieve integration and coordination is needed. The lack of a consistent analytical framework for evaluating clinical and financial outcomes has made comparisons of reported results impossible and has rendered many reports unreliable. Theoretical work on a standard methodology that integrates clinical and financial outcomes and empiric validation is needed.

  9. Effects of reducing blood pressure on cardiovascular outcomes and mortality in patients with type 2 diabetes: Focus on SGLT2 inhibitors and EMPA-REG OUTCOME.

    Science.gov (United States)

    Scheen, André J

    2016-11-01

    Empagliflozin, a sodium-glucose cotransporter type 2 (SGLT2) inhibitor, has shown a remarkable reduction in cardiovascular and all-cause mortality in patients with type 2 diabetes (T2D) and antecedents of cardiovascular disease in the EMPA-REG OUTCOME trial. This effect has been attributed to a hemodynamic rather than a metabolic effect, partly due to the osmotic/diuretic effect of empagliflozin and to the reduction in arterial blood pressure. The present review will: (1) summarize the results of specific studies having tested the blood pressure lowering effects of SGLT2 inhibitors; (2) describe the results of meta-analyses of trials having evaluated the effects on mortality and cardiovascular outcomes of lowering blood pressure in patients with T2D, with a special focus on baseline and target blood pressures; (3) compare the cardiovascular outcome results in EMPA-REG OUTCOME versus other major trials with antihypertensive agents in patients with T2D; and (4) evaluate post-hoc analyses from EMPA-REG OUTCOME, especially subgroups of patients of special interest regarding the blood pressure lowering hypothesis. Although BP reduction associated to empagliflozin therapy may partly contribute to the benefits reported in EMPA-REG OUTCOME, other mechanisms most probably play a greater role in the overall CV protection and reduction in mortality observed in this trial. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. 20 CFR 411.597 - Will SSA periodically review the outcome payment system and the outcome-milestone payment system...

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Will SSA periodically review the outcome payment system and the outcome-milestone payment system for possible modifications? 411.597 Section 411... Employment Network Payment Systems § 411.597 Will SSA periodically review the outcome payment system and the...

  11. EGUN, Charged Particle Trajectories in Electromagnetic Focusing System

    International Nuclear Information System (INIS)

    Herrmannsfeldt, W.B.

    2002-01-01

    1 - Description of problem or function: EGUN computes trajectories of charged particles in electrostatic and magnetostatic focusing systems including the effects of space charge and self-magnetic fields. Starting options include Child's Law conditions on cathodes of various shapes, user-specified conditions input for each ray, and a combination of Child's Law conditions and user specifications. Either rectangular or cylindrically symmetric geometry may be used. Magnetic fields may be specified using an arbitrary configuration of coils, or the output of a magnet program, such as Poisson, or by an externally calculated array of the axial fields. 2 - Method of solution: The program first solves Laplace's equation. Next, the first iteration of electron trajectories is started using one of the four starting options. On the first iteration cycle, space charge forces are calculated from the assumption of paraxial flow. As the rays are traced, space charge is computed and stored. After all the electron trajectories have been calculated, the program begins the second cycle by solving the Poisson equation with the space charge from the first iteration. Subsequent iteration cycles follow this pattern. The Poisson equation is solved by an alternate column relaxation technique known as the semi-iterative Chebyshev method. A fourth-order Runge-Kutta method is used to solve the relativistic differential equations of the trajectory calculations. 3 - Restrictions on the complexity of the problem - Maxima of: 9001 mesh points in a square mesh, 300 mesh points in the axial direction, 100 mesh points in the radial direction, 101 potentials, 51 rays. In the cylindrical coordinates, the magnetic fields are axially symmetric. In rectangular coordinates, the external field is assumed to be normal to the plane of the problem, which is assumed to be the median plane

  12. EDITORIAL: Focus on Mechanical Systems at the Quantum Limit FOCUS ON MECHANICAL SYSTEMS AT THE QUANTUM LIMIT

    Science.gov (United States)

    Aspelmeyer, Markus; Schwab, Keith

    2008-09-01

    diverse backgrounds and approaches of the researchers. As diverse as the approaches are the manifold of goals and perspectives for operating mechanical systems close to or within the quantum regime. Already now, nanomechanical sensors achieve single-molecule mass detection and magnetic resonance force detection from single-electron spins although they are operated far from quantum. Quantum-limited mechanical devices promise a new technology with hitherto unachieved performance for high-resolution sensing. This is also of high relevance for macroscopic mechanical resonators used in gravitational wave detectors. Furthermore, the increasing capability to couple mechanical modes to individual quantum systems raises the interesting question of whether mechanics can serve as a quantum bus in hybrid implementations of quantum information processing. Finally, the possibility of generating quantum superposition states that involve displacements of a massive macroscopic object (such as the center of mass of a mechanical beam) provides a completely new parameter regime for testing quantum theory over the amazing range from nanomechanical objects of several picograms up to gram-scale mirrors used in gravitational wave interferometers. We are looking forward to these fascinating developments! This Focus Issue is intended to highlight the present status of the field and to provide both introduction and motivation for students and researchers who want to get familiar with this exciting area or even want to join it. It also complements the conference activities of our community during the last year, where a series of dedicated invited sessions at several international conferences (APS March Meeting 2008, CLEO/QELS 2008, OSA Frontiers in Optics 2008, PQE 2008/2009 etc) culminated in the first Gordon Conference on 'Mechanical Systems at the Quantum Limit'. Given the fast development of the field it was not surprising to see that during the collection of the following contributions new

  13. Treatment of Phonological Disorder: A Feasibility Study With Focus on Outcome Measures.

    Science.gov (United States)

    Smit, Ann Bosma; Brumbaugh, Klaire Mann; Weltsch, Barbara; Hilgers, Melanie

    2018-02-20

    In a feasibility study for a randomized controlled trial of treatments for phonological disorders conducted over a period of 8 months, we examined 6 clinically relevant outcome measures. We took steps to reduce error variance and to maximize systematic variance. Six children received traditional treatment (Van Riper, 1939), and 7 received expansion points (Smit, 2000), a treatment program with both phonological and traditional elements. Outcome measures, which were applied to both word list and conversational samples, included percentage of consonants correct (PCC; Shriberg & Kwiatkowski, 1982), PCC for late and/or difficult (L/D) consonants and number of L/D consonants acquired. In repeated-measures analyses of variance, all measures showed significant differences from pretreatment to posttreatment, and the word list measures were associated with very high power values. In analyses of covariance for between-groups contrasts, the adjusted expansion points mean exceeded the adjusted traditional treatment mean for every measure; however, no differences reached significance. For the L/D PCC (conversation) measure, the contrast between groups was associated with a large effect size. We recommend that practitioners use outcome measures related to a word list. We recommend that researchers consider using L/D PCC on the basis of conversational samples to detect differences among treatment groups. https://doi.org/10.23641/asha.5872677.

  14. Work-Focused Treatment of Common Mental Disorders and Return to Work: A Comparative Outcome Study

    NARCIS (Netherlands)

    Lagerveld, S.E.; Blonk, R.W.B.; Brenninkmeijer, V.; Wijngaards-de Meij, L.; Schaufeli, W.B.

    2012-01-01

    The aim of this study was to compare the effectiveness of two individual-level psychotherapy interventions: (a) treatment as usual consisting of cognitive– behavioral therapy (CBT) and (b) work-focused CBT (W-CBT) that integrated work aspects early into the treatment. Both interventions were carried

  15. Project-Based Learning: A Promising Approach to Improving Student Outcomes. Issue Focus

    Science.gov (United States)

    Quint, Janet; Condliffe, Barbara

    2018-01-01

    The concept of project-based learning (PBL) has garnered wide support among a number of K-12 education policy advocates and funders. PBL is viewed as an approach that enables students to develop the "21st century competencies"--cognitive and socioemotional skills--needed for success in college and careers. This issue focus, pulling from…

  16. A final focus system for the Next Linear Collider

    International Nuclear Information System (INIS)

    Zimmermann, F.; Brown, K.; Emma, P.; Helm, R.; Irwin, J.; Tenenbaum, P.; Wilson, P.

    1995-06-01

    The final focus of the Next Linear Collider (NLC) demagnifies electron and positron beams of 250--750 GeV energy down to a transverse size of about 2.5 x 350 nm 2 at the interaction point (IP). The basic layout, momentum bandwidth, vibration tolerances, wakefield effects, and the tunability of the proposed final focus design are discussed. Also a perspective is given on the crab cavity and on effects of the solenoid field in the interaction region

  17. Optimization of an electrostatic quadrupole doublet focusing systems

    Energy Technology Data Exchange (ETDEWEB)

    Hussein, Oday A., E-mail: oah@sc.nahrainuniv.edu.iq [Department of Physics, College of Science, Al-Nahrain University, Baghdad (Iraq); Sise, Omer [Department of Science Education, Faculty of Education, Suleyman Demirel University, Isparta (Turkey)

    2017-05-15

    Highlights: • The imaging properties of an electrostatic quadrupole doublet lens were analyzed with the aid of computer simulation. • The optimal electrode voltages which lead to stigmatic image in both planes of the quadrupole doublet lens with minimum spot size at position sensitive detector (PSD) were found for two operation modes: point-to-point focusing and parallel-to-point focusing. • The imaging properties of are very sensitive to the lunching angle of the electron-beam. - Abstract: The imaging properties of an electrostatic quadrupole doublet lens were analyzed with the aid of computer simulation. The optimal electrode voltages which lead to stigmatic image in both planes of the quadrupole doublet lens with minimum spot size at position sensitive detector (PSD) were found for two operation modes: point-to-point focusing and parallel-to-point focusing. The optical properties as: Magnifications, spot sizes in the image plane and aberration figures were discussed. The results showed that the focusing of the lens was strong in the xy-plane in comparison with the focusing in the xz-plane. The distortion of the image was greater when the image position will be close to the lens in comparison with object position. Also, the imaging properties were very sensitive to the lunching angle of the electron-beam.

  18. Contrasting Internet and Face-to-Face Focus Groups for Children with Chronic Health Conditions: Outcomes and Participant Experiences

    Directory of Open Access Journals (Sweden)

    David B. Nicholas PhD

    2010-03-01

    Full Text Available In this study the authors examined Internet-mediated qualitative data collection methods among a sample of children with chronic health conditions. Specifically, focus groups via Internet technology were contrasted to traditional face-to-face focus groups. Internet focus groups consisted of asynchronous text-based chat rooms lasting a total of one week in duration. Participants comprised 23 children with cerebral palsy, spina bifida, or cystic fibrosis, who were assigned to either an Internet or face-to-face focus group. Focus group analysis and follow-up participant interviews identified a range of content outcomes and processes as well as participant experiences and preferences. Findings yielded differences in terms of the volume and nature of online and face-to-face data, and participants' affinity to focus group modality appeared to reflect differences in participant expectations for social engagement and interaction. This study identifies both benefits and limitations of asynchronous, text-based online focus groups. Implications and recommendations are discussed.

  19. Clinical significance of skin rash in dengue fever: A focus on discomfort, complications, and disease outcome.

    Science.gov (United States)

    Huang, Hsin-Wei; Tseng, Han-Chi; Lee, Chih-Hung; Chuang, Hung-Yi; Lin, Shang-Hung

    2016-07-01

    To assess whether the cutaneous features in patients with dengue fever are associated with abnormal blood biochemistry, complications, and poor disease outcome. Forty five patients with dengue fever were identified at a medical center in Kaohsiung, Taiwan, from September to November 2014. All cases were exclusively caused by type 1 dengue virus. Patients were classified into two groups, based on the presence or absence of skin rash, and their rash was subclassified into maculopapular, morbilliform, and petechial types. Clinical symptoms, laboratory data, disease outcome, and complications were compared between the two groups. Thirty two patients with dengue fever developed skin rash (SP group, n = 32) while the rest of 13 did not (SN group, n = 13). The patient numbers in the maculopapular, morbilliform, and petechial group were 4, 21, and 7, respectively. The SP group was younger (P = 0.001), experienced more pruritus (P = 0.008) and more swollen palms/soles (P = 0.015) than the SN group. However, the SN group had greater genital mucosa involvement (P = 0.008), higher platelet transfusion rate (P = 0.003), and lower hemoglobin and hematocrit levels (P = 0.030) than the SP group. Patients with morbilliform lesions had a higher incidence of palm/sole swelling, less genital mucosal involvement, and a lower platelet transfusion rate than did patients with maculopapular or petechial lesions. Cutaneous manifestations provide an important clue to dengue fever. In patients with dengue fever, those with skin rash tend to have itching and swelling of the palms/soles, however, those without skin rash tend to have more complications and poor disease outcomes. Copyright © 2016 Hainan Medical College. Production and hosting by Elsevier B.V. All rights reserved.

  20. The mechanical design for the WEAVE prime focus corrector system

    NARCIS (Netherlands)

    Abrams, Don Carlos; Dee, Kevin; Agócs, Tibor; Lhome, Emilie; Peñate, José; Jaskó, Attila; Bányai, Evelin; Burgal, José A.; Dalton, Gavin; Middleton, Kevin; Bonifacio, Piercarlo; Aguerri, J. Alfonso L.; Trager, S. C.; Balcells, Marc

    WEAVE is the next-generation, wide-field, optical spectroscopy facility for the William Herschel Telescope (WHT) in La Palma, Canary Islands, Spain. The WHT will undergo a significant adaptation to accommodate this facility. A two- degree Prime Focus Corrector (PFC), that includes an Atmospheric

  1. Product focused process improvement in the embedded systems industry

    NARCIS (Netherlands)

    Solingen, van D.M.; Derks, P.; Hirvensalo, J.; Kusters, R.J.; Cowderoy, A.; Heemstra, F.J.; Veenendaal, E.P.W.M.

    1999-01-01

    Software specific problems have been handled in the software community through focusing on the software process, and continuous improvement of that software process. However, the contribution of software process improvement (SPI) to product quality has not been proven yet. The PROFES project

  2. Regulatory focus, self-efficacy and outcome expectations as drivers of motivation to consume healthy food products.

    Science.gov (United States)

    Tudoran, Ana Alina; Scholderer, Joachim; Brunsø, Karen

    2012-10-01

    In this paper we apply the principle of Regulatory Focus Theory to investigate the interaction between self-efficacy and outcome expectations on individuals' intentions to adopt health behaviors. The participants, 959 individuals (Survey 1) and 2400 individuals (Survey 2), reported self-efficacy beliefs and outcome expectations with regard to the consumption of omega-3 supplements and omega-3-enriched food products. We found that the relationship prevention outcome expectations-intention was significantly attenuated at low levels of self-efficacy and strengthened at high levels of self-efficacy, respectively; whereas, the relationship promotion outcome expectations-intention was unaffected by the perceived levels of self-efficacy. The implications suggest that consumers' motivation to adopt healthy food products, such as omega-3 supplements and omega-3 enriched products, should be encouraged by stimulating promotion outcome expectations. However, when a prevention frame is used, the individuals' motivation should be significantly enhanced by self-efficacy beliefs. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Creating value-focused healthcare delivery systems: Part three--Core competencies.

    Science.gov (United States)

    Beveridge, R N

    1997-01-01

    Value is created through the delivery of high-quality, cost--effective healthcare services. The ability to create value from the providers' perspective is facilitated through the development and implementation of essential, customer-focused core competencies. These core competencies include customer relationship management, payer/provider relationship management, disease management, outcomes management, financial/cost management, and information management. Customer relationship management is the foundation upon which all core competencies must be built. All of the core competencies must focus on the needs of the customers, both internal and external. Structuring all processes involved in the core competencies from the perspective of the customer will ensure that value is created throughout the system. Payer/provider relationship management will become a crucial pillar for healthcare providers in the future. As more vertical integration among providers occurs, the management of the relationships among providers and with payers will become more important. Many of the integration strategies being implemented across the country involve the integration of hospitals, physicians, and payers to form accountable health plans. The relationships must be organized to form "win/win" situations, where all parties are focused on a shared vision of creating value and none of the parties benefits at the expense of the others. Disease management in creating value requires that we begin examining the disease process along the entire continuum. Not only must providers be able to provide high-quality acute and chronic care, but they must also begin to focus more heavily on programs of prevention. Value is created throughout the system through reducing the prevalence and incidence of disease. Only through managing the full continuum of health will value be created throughout the healthcare delivery system. Outcomes management ensures that the outcomes are the highest quality at a cost

  4. Focusing on the human factor in future expert systems

    International Nuclear Information System (INIS)

    Gordon, S.E.

    1987-01-01

    Technological advances in the area of artificial intelligence have produced expert systems that hold much promise for the design, operation, and maintenance of complex systems such as nuclear power plants. Such systems have been designed and implemented in a wide variety of task settings. In spite of the gains that have been made in the application of expert systems, there are still several difficult problems which have yet to be resolved. One of these problems is a frequently noted lack of user acceptance of newly fielded intelligent systems. This lack of acceptance can be attributed to a variety of factors, including unfamiliarity with computer technology, difficulty in adjusting to interface mechanisms, fear that the system was designed to replace the human operator, and a feeling that the human can perform the job better than the system. Some of the problems may be related to the fact that expert system design is essentially in it's infancy

  5. Automated System Marketplace 1993. Part I: Focus on Minicomputers.

    Science.gov (United States)

    Bridge, Frank R.

    1993-01-01

    The first part of the annual automation marketplace survey examines minicomputer systems in libraries. Highlights include vendor consolidation and acquisitions; system interconnection; networked databases; products related to the Americans with Disabilities Act; multimedia; vendor installations worldwide; academic versus public library…

  6. Organizational Behavior Analysis Focusing on the University of Texas System

    Science.gov (United States)

    Terry, Bobby K.

    2011-01-01

    This project analyzes the organizational behavior of the University of Texas System. The University of Texas System is comprised of nine academic and six health institutions. The University of Texas System has over 85,000 employees; the student enrollment is 202,240 with a budget of $2.25 billion dollars. This project has a total of four parts and…

  7. Maternal health issues and cardio-metabolic outcomes in the offspring: a focus on Indigenous populations.

    Science.gov (United States)

    Wicklow, Brandy A; Sellers, Elizabeth A C

    2015-01-01

    Non-communicable diseases (NCDs) including diabetes, obesity and cardiovascular disease are the leading causes of death worldwide. Indigenous populations are disproportionally affected. In an effort to halt the increasing disease burden, the mechanisms underlying the increasing rate of NCDs are an important area of study. Recent evidence has focused on the perinatal period as an influential period impacting the future cardio-metabolic health of the offspring. This concept has been defined as metabolic foetal programming and supports the importance of the developmental origins of health and disease in research and clinical practice, specifically in prevention efforts to protect future generations from NCDs. An understanding of the underlying mechanisms involved is not clear as of yet. However, an understanding of these mechanisms is imperative in order to plan effective intervention strategies. As much of the discussion below is gleaned from large epidemiological studies and animal studies, further research with prospective cohorts is necessary. Copyright © 2014. Published by Elsevier Ltd.

  8. Outcomes of an infection prevention project focusing on hand hygiene and isolation practices.

    Science.gov (United States)

    Aragon, Daleen; Sole, Mary Lou; Brown, Scott

    2005-01-01

    Nosocomial infections are a major health problem for hospitalized patients and their families. Since the 1800s, hand hygiene has been recognized as the single best method to prevent the spread of pathogens and nosocomial infections. Despite this fact, many healthcare workers do not adhere to hand hygiene policies. The Centers for Disease Control and Prevention issued a guideline for hand hygiene practices in 2002. Multifaceted approaches to improve hand hygiene have been shown to increase compliance among healthcare workers and subsequently reduce infections. A performance improvement project was initiated to implement this guideline and other strategies to prevent nosocomial infection. This article summarizes the performance improvement processes and the preliminary outcomes on adherence to infection prevention policies related to hand hygiene and isolation practices. Clinically and statistically significant increases were noted for hand hygiene prior to patient care and in wearing masks when indicated. Nurses and patient care technicians had the greatest increases in compliance. Increases in hand hygiene after patient contact and wearing of gown and gloves were also noted, but results were not statistically significant. Nosocomial infection rates from antibiotic-resistant organisms decreased in the first surveillance, but rates increased during the 1-year surveillance. Consumption of alcohol-based foam disinfectant doubled from baseline. Findings are consistent with other published studies. The project will continue with further reinforcement and education over the second year.

  9. Effectiveness of Focus-on-Forms Instruction: Different Outcomes on Constrained- and Free-Production Tasks?

    Directory of Open Access Journals (Sweden)

    Giselle Corbeil

    2005-06-01

    Full Text Available Abstract The purpose of this study is to investigate how focus-on-forms instruction in second language teaching affects attention to forms in two different types of task: constrained and free production. These two different types of task were administered to 87 university students enrolled in a first-year French as a second language course before and after instruction on qualifying adjective agreement. Comparisons were made between learning-gain differences from pre- to post-tests for both tasks. Significant differences between pre- and post-test scores were found for both tasks. Although the difference between the two tasks was not significant, the learning-gain difference was somewhat higher for the constrained-production task than for the free-production task. When the total number of adjectives used in the compositions was broken down into colour adjectives and non-colour adjectives, no significant learning gains were observed between the two categories, although the learning gains for the non-colour adjectives was twice as high as for the colour adjectives. Possible explanations for these results are discussed.

  10. Freshwater Institute: Focused on improving recirculating aquaculture system technology

    Science.gov (United States)

    Recirculating aquaculture system (RAS) technologies help to overcome barriers to domestic aquaculture expansion and enhance the sustainability of the modern fish farming industry through reduction in environmental impacts. With RAS, fish farm expansion is no longer highly constrained by competition ...

  11. MERIP - Design of Production Systems with focus on Human Ressources

    DEFF Research Database (Denmark)

    Jacobsen, Peter; Knudsen, Mads Kristian Lund

    1998-01-01

    ", "Employee-activated Production Development - MAPU", "Integrated Production Systems - IPS" and "Strategic Development of Staff - SUM". MERIP (Human resources in production) is a continuation of this type of projects, aiming at increasing the competitive power of the companies. However MERIP scientists want...... to involve the human resources in the production in new ways. Therefore the objective of the project is to develop methods for design of production systems, that use every possibility in human resources supported by the technology aiming at increasing the competitive power of the companies. The task force......The way in which the Industry has involved the human resources in production systems, has changed in last decades. Previously the human resources were mainly considered as means to link together the technical systems, while today they are key resources responsible for development, planning...

  12. The impact of childhood sexual abuse on the outcome of intensive trauma-focused treatment for PTSD.

    Science.gov (United States)

    Wagenmans, Anouk; Van Minnen, Agnes; Sleijpen, Marieke; De Jongh, Ad

    2018-01-01

    Background : It is assumed that PTSD patients with a history of childhood sexual abuse benefit less from trauma-focused treatment than those without such a history. Objective : To test whether the presence of a history of childhood sexual abuse has a negative effect on the outcome of intensive trauma-focused PTSD treatment. Method : PTSD patients, 83% of whom suffered from severe PTSD, took part in a therapy programme consisting of 2 × 4 consecutive days of Prolonged Exposure (PE) and EMDR therapy (eight of each). In between sessions, patients participated in sport activities and psycho-education sessions. No prior stabilization phase was implemented. PTSD symptom scores of clinician-administered and self-administered measures were analysed using the data of 165 consecutive patients. Pre-post differences were compared between four trauma groups; patients with a history of childhood sexual abuse before age 12 (CSA), adolescent sexual abuse (ASA; i.e. sexual abuse between 12 and 18 years of age), sexual abuse (SA) at age 18 and over, or no history of sexual abuse (NSA). Results : Large effect sizes were achieved for PTSD symptom reduction for all trauma groups (Cohen's d  = 1.52-2.09). For the Clinical Administered PTSD Scale (CAPS) and the Impact of Event Scale (IES), no differences in treatment outcome were found between the trauma (age) groups. For the PTSD Symptom Scale Self Report (PSS-SR), there were no differences except for one small effect between CSA and NSA. Conclusions : The results do not support the hypothesis that the presence of a history of childhood sexual abuse has a detrimental impact on the outcome of first-line (intensive) trauma-focused treatments for PTSD.

  13. Ageing and the immune system: focus on macrophages.

    Science.gov (United States)

    Linehan, E; Fitzgerald, D C

    2015-03-01

    A fully functioning immune system is essential in order to maintain good health. However, the immune system deteriorates with advancing age, and this contributes to increased susceptibility to infection, autoimmunity, and cancer in the older population. Progress has been made in identifying age-related defects in the adaptive immune system. In contrast, relatively little research has been carried out on the impact of ageing on the innate immune response. This area requires further research as the innate immune system plays a crucial role in protection against infection and represents a first line of defence. Macrophages are central effector cells of the innate immune system and have many diverse functions. As a result, age-related impairments in macrophage function are likely to have important consequences for the health of the older population. It has been reported that ageing in macrophages impacts on many processes including toll-like receptor signalling, polarisation, phagocytosis, and wound repair. A detailed understanding of the impact of ageing on macrophages is required in order to develop therapeutics that will boost immune responses in the older population.

  14. Focusing on Ciona intestinalis (Tunicata) innate immune system. Evolutionary implications

    OpenAIRE

    N Parrinello

    2009-01-01

    Phylogenetic analyses based on molecular data provide compelling evidence that ascidians are of critical importance for studying chordate immune system evolution. The Ciona intestinalis draft genome sequence allows searches for phylogenetic relationships, gene cloning and expression of immunorelevant molecules. Acidians lack of the pivotal components of the vertebrate recombinatory adaptive immunity, i.e., MHC, TCRs and dimeric immunoglobulins. However, bioinformatic sequence analyses recogni...

  15. Food micro systems : report on Focus Group on Consumers' Acceptance

    NARCIS (Netherlands)

    Fischer, A.R.H.

    2012-01-01

    This report forms part of the deliverables from a project called "FoodMicroSystems" which has received funding from the European Union’s Seventh Framework Programme FP7/2007-2013 under grant agreement n° 287634. The Community is not responsible for any use that might be made of the content of this

  16. Patient and health professional views on rehabilitation practices and outcomes following total hip and knee arthroplasty for osteoarthritis:a focus group study

    Directory of Open Access Journals (Sweden)

    Backman Catherine L

    2010-05-01

    Full Text Available Abstract Background There is worldwide variation in rehabilitation practices after total hip arthroplasty (THA and total knee arthroplasty (TKA and no agreement on which interventions will lead to optimal short and long term patient outcomes. As a first step in the development of clinical practice guidelines for post-acute rehabilitation after THA and TKA, we explored experiences and attitudes about rehabilitation practices and outcomes in groups of individuals identified as key stakeholders. Methods Separate focus groups and interviews were conducted with patients (THA or TKA within past year and three health professional groups: allied health professionals (AHPs, orthopaedic surgeons, and other physicians, in Canada and the United States. Pairs of moderators led the focus groups using a standardized discussion guide. Discussions were audiotaped and transcribed verbatim. A content analysis within and across groups identified key themes. Results Eleven focus groups and eight interviews took place in six sites. Patients (n = 32 varied in age, stage of recovery, and surgical and rehabilitation experiences. Health professionals (n = 44 represented a range of disciplines, practice settings and years of experience. Six key themes emerged: 1 Let's talk (issues related to patient-health professional and inter-professional communication; 2 Expecting the unexpected (observations about unanticipated recovery experiences; 3 It's attitude that counts (the importance of the patient's positive attitude and participation in recovery; 4 It takes all kinds of support (along the continuum of care; 5 Barriers to recovery (at patient, provider and system levels, and 6 Back to normal (reflecting diversity of expected outcomes. Patients offered different, but overlapping views compared to health professionals regarding rehabilitation practices and outcomes following THA and TKA. Conclusion Results will inform subsequent phases of guideline development and ensure

  17. Autophagy in health and disease: focus on the cardiovascular system.

    Science.gov (United States)

    Mialet-Perez, Jeanne; Vindis, Cécile

    2017-12-12

    Autophagy is a highly conserved mechanism of lysosome-mediated protein and organelle degradation that plays a crucial role in maintaining cellular homeostasis. In the last few years, specific functions for autophagy have been identified in many tissues and organs. In the cardiovascular system, autophagy appears to be essential to heart and vessel homeostasis and function; however defective or excessive autophagy activity seems to contribute to major cardiovascular disorders including heart failure (HF) or atherosclerosis. Here, we review the current knowledge on the role of cardiovascular autophagy in physiological and pathophysiological conditions. © 2017 The Author(s). Published by Portland Press Limited on behalf of the Biochemical Society.

  18. Periodic permanent magnet focusing system with high peak field

    International Nuclear Information System (INIS)

    Zhang Hong; Liu Weiwei; Bai Shuxin; Chen Ke

    2008-01-01

    In this study, hybrid periodic permanent magnet (PPM) system is studied, which has high axial magnetic field and low magnetic leakage. By simulation computation, some laws of magnetic field distribution vs. structure dimensions were obtained. A hybrid PPM is designed and constructed whose peak field reaches 0.6 T. The factors inducing discrepancies between computational results and practical measurements are analyzed. The magnetic field distribution is very sensitive to the variations of constructional parameters. Construction accuracy greatly influences the magnetic field distribution. Research results obtained here are potentially valuable for future work

  19. Physics Education: Desired outcomes, minds, and learning systems

    Science.gov (United States)

    van Heuvelen, Alan

    2000-11-01

    Recent studies and surveys indicate that the workplace is looking for different outcomes than are emphasized in traditional physics instruction. Cognitive science has learned much about the operation of our minds. Physicists have now systematically studied student learning in physics for about 30 years. What has been learned from these different studies that can help us achieve the desired outcomes in our large (and small) introductory physics courses? The talk will focus on these three ideas: the desired outcomes, student minds (very brief), and pedagogical strategies and activities that help achieve these outcomes.

  20. Development of a Multidisciplinary and Telemedicine Focused System Database.

    Science.gov (United States)

    Paštěka, Richard; Forjan, Mathias; Sauermann, Stefan

    2017-01-01

    Tele-rehabilitation at home is one of the promising approaches in increasing rehabilitative success and simultaneously decreasing the financial burden on the healthcare system. Novel and mostly mobile devices are already in use, but shall be used in the future to a higher extent for allowing at home rehabilitation processes at a high quality level. The combination of exercises, assessments and available equipment is the basic objective of the presented database. The database has been structured in order to allow easy-to-use and fast access for the three main user groups. Therapists - looking for exercise and equipment combinations - patients - rechecking their tasks for home exercises - and manufacturers - entering their equipment for specific use cases. The database has been evaluated by a proof of concept study and shows a high degree of applicability for the field of rehabilitative medicine. Currently it contains 110 exercises/assessments and 111 equipment/systems. Foundations of presented database are already established in the rehabilitative field of application, but can and will be enhanced in its functionality to be usable for a higher variety of medical fields and specifications.

  1. Management by process based systems and safety focus

    International Nuclear Information System (INIS)

    Rydnert, Bo; Groenlund, Bjoern

    2005-12-01

    An initiative from The Swedish Nuclear Power Inspectorate led to this study carried out in the late autumn of 2005. The objective was to understand in more detail how an increasing use of process management affects organisations, on the one hand regarding risks and security, on the other hand regarding management by objectives and other management and operative effects. The main method was interviewing representatives of companies and independent experts. More than 20 interviews were carried out. In addition a literature study was made. All participating companies are using Management Systems based on processes. However, the methods chosen, and the results achieved, vary extensively. Thus, there are surprisingly few examples of complete and effective management by processes. Yet there is no doubt that management by processes is effective and efficient. Overall goals are reached, business results are achieved in more reliable ways and customers are more satisfied. The weaknesses found can be translated into a few comprehensive recommendations. A clear, structured and acknowledged model should be used and the processes should be described unambiguously. The changed management roles should be described and obeyed extremely legibly. New types of process objectives need to be formulated. In addition one fact needs to be observed and effectively fended off. Changes are often met by mental opposition on management level, as well as among co-workers. This fact needs attention and leadership. Safety development is closely related to the design and operation of a business management system and its continual improvement. A deep understanding of what constitutes an efficient and effective management system affects the understanding of safety. safety culture and abilities to achieve safety goals. Concerning risk, the opinions were unambiguous. Management by processes as such does not result in any further risks. On the contrary. Processes give a clear view of production and

  2. Determinants of mortality in systemic sclerosis: a focused review.

    Science.gov (United States)

    Poudel, Dilli Ram; Jayakumar, Divya; Danve, Abhijeet; Sehra, Shiv Tej; Derk, Chris T

    2017-11-07

    Scleroderma (systemic sclerosis) is an autoimmune rheumatic disorder that is characterized by fibrosis, vascular dysfunction, and autoantibody production that involves most visceral organs. It is characterized by a high morbidity and mortality rate, mainly due to disease-related complications. Epidemiological data describing mortality and survival in this population have been based on both population and observational studies. Multiple clinical and non-clinical factors have been found to predict higher likelihood of death among thepatients. Here, we do an extensive review of the available literature, utilizing the PubMed database, to describe scleroderma and non-scleroderma related determinants of mortality in this population. We found that even though the mortality among the general population has declined, scleroderma continues to carry a very high morbidity and mortality rate, however we have made some slow progress in improving the mortality among scleroderma patients over the last few decades.

  3. Assessing the children's views on foods and consumption of selected food groups: outcome from focus group approach.

    Science.gov (United States)

    Sharif Ishak, Sharifah Intan Zainun; Shohaimi, Shamarina; Kandiah, Mirnalini

    2013-04-01

    The food choices in childhood have high a probability of being carried through into their adulthood life, which then contributes to the risk of many non-communicable diseases. Therefore, there is a need to gather some information about children's views on foods which may influence their food choices for planning a related dietary intervention or programme. This paper aimed to explore the views of children on foods and the types of foods which are usually consumed by children under four food groups (snacks, fast foods, cereals and cereal products; and milk and dairy products) by using focus group discussions. A total of 33 school children aged 7-9 years old from Selangor and Kuala Lumpur participated in the focus groups. Focus groups were audio-taped, transcribed and analyzed according to the listed themes. The outcomes show that the children usually consumed snacks such as white bread with spread or as a sandwich, local cakes, fruits such as papaya, mango and watermelon, biscuits or cookies, tea, chocolate drink and instant noodles. Their choices of fast foods included pizza, burgers, French fries and fried chicken. For cereal products, they usually consumed rice, bread and ready-to-eat cereals. Finally, their choices of dairy products included milk, cheese and yogurt. The reasons for the food liking were taste, nutritional value and the characteristics of food. The outcome of this study may provide additional information on the food choices among Malaysian children, especially in urban areas with regard to the food groups which have shown to have a relationship with the risk of childhood obesity.

  4. Assessing the children's views on foods and consumption of selected food groups: outcome from focus group approach

    Science.gov (United States)

    Sharif Ishak, Sharifah Intan Zainun; Kandiah, Mirnalini

    2013-01-01

    The food choices in childhood have high a probability of being carried through into their adulthood life, which then contributes to the risk of many non-communicable diseases. Therefore, there is a need to gather some information about children's views on foods which may influence their food choices for planning a related dietary intervention or programme. This paper aimed to explore the views of children on foods and the types of foods which are usually consumed by children under four food groups (snacks, fast foods, cereals and cereal products; and milk and dairy products) by using focus group discussions. A total of 33 school children aged 7-9 years old from Selangor and Kuala Lumpur participated in the focus groups. Focus groups were audio-taped, transcribed and analyzed according to the listed themes. The outcomes show that the children usually consumed snacks such as white bread with spread or as a sandwich, local cakes, fruits such as papaya, mango and watermelon, biscuits or cookies, tea, chocolate drink and instant noodles. Their choices of fast foods included pizza, burgers, French fries and fried chicken. For cereal products, they usually consumed rice, bread and ready-to-eat cereals. Finally, their choices of dairy products included milk, cheese and yogurt. The reasons for the food liking were taste, nutritional value and the characteristics of food. The outcome of this study may provide additional information on the food choices among Malaysian children, especially in urban areas with regard to the food groups which have shown to have a relationship with the risk of childhood obesity. PMID:23610606

  5. Sensor Selection method for IoT systemsfocusing on embedded system requirements

    Directory of Open Access Journals (Sweden)

    Hirayama Masayuki

    2016-01-01

    Full Text Available Recently, various types of sensors have been developed. Using these sensors, IoT systems have become hot topics in embedded system domain. However, sensor selections for embedded systems are not well discussed up to now. This paper focuses on embedded system’s features and architecture, and proposes a sensor selection method which is composed seven steps. In addition, we applied the proposed method to a simple example – a sensor selection for computer scored answer sheet reader unit. From this case study, an idea to use FTA in sensor selection is also discussed.

  6. Reliability of Cyber Physical Systems with Focus on Building Management Systems

    DEFF Research Database (Denmark)

    Lazarova-Molnar, Sanja; Shaker, Hamid Reza; Mohamed, Nader

    2016-01-01

    with our focus CPS, i.e. building management systems (BMS), which are not always safety critical per se, but under special circumstances they can become such. This certainly depends on the purpose of the building. We can easily imagine BMS of hospital buildings as safety-critical, but also BMS of buildings......Cyber-physical systems are slowly emerging to dominate our world. Cyber-physical systems (CPS) are systems that tightly integrates users, devices and software. Whereas many of these systems are obviously safety-critical systems, some of them become so under special circumstances. This is the case...... that store sensitive materials and equipment that could be of biological nature or encompassing sensitive technology that would need special temperature, humidity and light settings. For this reason, in this paper we would like to emphasize on the importance of reliability of CPS in general, with a special...

  7. Aberrations and focusability in large solid-state-laser systems

    International Nuclear Information System (INIS)

    Simmons, W.W.

    1981-01-01

    Solid state lasers for fusion experiments must reliably deliver maximum power to small (approximately .5 mm) targets from stand-off focal distances of 1 m or more. This requirement places stringent limits upon the optical quality of the several major components - amplifiers, Faraday isolators, spatial filters - in each amplifier train. Residual static aberrations in optical components are transferred to the beam as it traverses the optical amplifier chain. Although individual components are typically less than lambda/20 for components less than 10 cm clear aperture; and less than lambda/10 for components less than 20 cm clear aperture; the large number of such components in optical series results in a wavefront error that may exceed one wave for modern solid state lasers. For pulse operation, the focal spot is additionally broadened by intensity dependent nonlinearities. Specific examples of the performance of large aperture components will be presented within the context of the Argus and Shiva laser systems, which are presently operational at Lawrence Livermore National Laboratory. Design requirements upon the larger aperture Nova laser components, up to 74 cm in clear aperture, will also be discussed; these pose a significant challenge to the optical industry

  8. Preservice Teachers' Belief Systems toward Curricular Outcomes for Physical Education

    Science.gov (United States)

    Kulinna, Pamela Hodges; Brusseau, Timothy; Ferry, Matthew; Cothran, Donetta

    2010-01-01

    This study was grounded in the belief systems and physical activity literature and investigated preservice teachers' belief systems toward curricular outcomes for physical education programs. Preservice teachers (N = 486; men = 62%, women = 38%) from 18 U.S. colleges/universities shared their beliefs about curricular outcomes. Preservice teachers…

  9. Unmanned Carrier-Based Aircraft System: Debate over Systems Role Led to Focus on Aerial Refueling

    Science.gov (United States)

    2016-03-24

    Unmanned Carrier-Based Aircraft System: Debate over System’s Role Led to Focus on Aerial Refueling Prior to February 2016, the Navy had planned to...Background In a May 2015 report, we found that the intended mission and required capabilities of UCLASS were under review as there was debate ...environments, or largely strike with limited surveillance capability operating in highly contested environments.2 This debate delayed the expected

  10. Investigating the debate of home birth safety: A critical review of cohort studies focusing on selected infant outcomes.

    Science.gov (United States)

    Elder, Heather R; Alio, Amina P; Fisher, Susan G

    2016-07-01

    There is a debate within the medical community regarding the safety of planned home births. The presumption of increased risk of maternal and infant morbidity and mortality at home due to limited access to life-saving interventions is not clearly supported by research. The aim of the present study was to assess strengths and limitations of the methodological approaches of cohort studies that compare home births with hospital births by focusing on selected infant outcomes. Studies were identified that assess the risk for at least one of three infant outcomes (mortality, Apgar score, and admission to the neonatal intensive care unit [NICU]) of home births compared with hospital births. Fifteen cohort studies were included. Two studies of low-risk births and two including higher risk births found home births to be at an increased risk of neonatal mortality. However, mortality is rare in developed nations and may not be the best measure of safety. When studies focused on low-risk pregnancies, planned birth location, and well-trained birth attendants, there was no difference in neonatal morbidity (Apgar score and NICU admission). Many methodological challenges were identified among these studies. This review contributes to the home birth published work by identifying key strengths and limitations that need to be accounted for in the interpretation of study findings and the development of future studies. Based on this review, the key variables that would strengthen future studies are birth attendant identification, documented planned birth location, and specification of the birth risk level. Uniformity of data collection and minimizing missing data are also critical. © 2016 Japan Academy of Nursing Science.

  11. Immersion and distancing during assimilation of problematic experiences in a good-outcome case of emotion-focused therapy.

    Science.gov (United States)

    Barbosa, Eunice; Couto, Ana Bela; Basto, Isabel; Stiles, William B; Pinto-Gouveia, José; Salgado, João

    2018-03-01

    Some studies have suggested that a decrease in immersion (egocentric perspective on personal experiences) and an increase in distancing (observer perspective on personal experiences) are associated with the resolution of clinical problems and positive outcome in psychotherapy for depression. To help clarify how this change in perspectives relates to clinical change, the present study compared changes in immersion and distancing across therapy with progress in one client's assimilation of her problematic experiences. We analyzed all passages referring to the central problematic experience in a good-outcome case of emotion-focused therapy for depression using the Measure of Immersion and Distancing Speech and the Assimilation of Problematic Experiences Scale. Results showed that immersion and distancing were associated with different stages of assimilation. Immersion was associated with stages of emerging awareness and clarification of the problem and in the application of new understandings to daily life. Distancing was associated with problem-solving and attaining insight. The decrease of immersion and increase of distancing associated with therapeutic improvement should not be taken as a recommendation to avoid immersion and encourage distancing. Immersion and distancing may work as coordinated aspects of the processes of psychotherapeutic change.

  12. Patient-focused goal planning process and outcome after spinal cord injury rehabilitation: quantitative and qualitative audit.

    Science.gov (United States)

    Byrnes, Michelle; Beilby, Janet; Ray, Patricia; McLennan, Renee; Ker, John; Schug, Stephan

    2012-12-01

    To evaluate the process and outcome of a multidisciplinary inpatient goal planning rehabilitation programme on physical, social and psychological functioning for patients with spinal cord injury. Clinical audit: quantitative and qualitative analyses. Specialist spinal injury unit, Perth, Australia. Consecutive series of 100 newly injured spinal cord injury inpatients. MAIN MEASURE(S): The Needs Assessment Checklist (NAC), patient-focused goal planning questionnaire and goal planning progress form. The clinical audit of 100 spinal cord injured patients revealed that 547 goal planning meetings were held with 8531 goals stipulated in total. Seventy-five per cent of the goals set at the first goal planning meeting were achieved by the second meeting and the rate of goal achievements at subsequent goal planning meetings dropped to 56%. Based on quantitative analysis of physical, social and psychological functioning, the 100 spinal cord injury patients improved significantly from baseline to discharge. Furthermore, qualitative analysis revealed benefits consistently reported by spinal cord injury patients of the goal planning rehabilitation programme in improvements to their physical, social and psychological adjustment to injury. The findings of this clinical audit underpin the need for patient-focused goal planning rehabilitation programmes which are tailored to the individual's needs and involve a comprehensive multidisciplinary team.

  13. Organizational Climate, Services, and Outcomes in Child Welfare Systems

    Science.gov (United States)

    Glisson, Charles; Green, Philip

    2011-01-01

    Objective: This study examines the association of organizational climate, casework services, and youth outcomes in child welfare systems. Building on preliminary findings linking organizational climate to youth outcomes over a 3-year follow-up period, the current study extends the follow-up period to 7 years and tests main, moderating and…

  14. Calculation of the illuminance distribution in the focal spot of a focusing system taking into account aberrations in this system and divergence of a focused laser beam

    International Nuclear Information System (INIS)

    Gitin, Andrey V

    2007-01-01

    The dependence of the focal-spot size of a 'deep' parabolic mirror reflector on the laser-beam divergence is analysed by the method of elementary reflections. The dependence of the focal-beam diameter of an ideal focusing optical system on the laser-beam parameters is described. The expression is obtained for calculating the illumination distribution in the focal spot of a 'deep' mirror reflector which takes into account both aberrations and light-gathering power of the reflector and the divergence of a focused laser beam. (optical systems)

  15. Decentralization and health system performance - a focused review of dimensions, difficulties, and derivatives in India.

    Science.gov (United States)

    Panda, Bhuputra; Thakur, Harshad P

    2016-10-31

    One of the principal goals of any health care system is to improve health through the provision of clinical and public health services. Decentralization as a reform measure aims to improve inputs, management processes and health outcomes, and has political, administrative and financial connotations. It is argued that the robustness of a health system in achieving desirable outcomes is contingent upon the width and depth of 'decision space' at the local level. Studies have used different approaches to examine one or more facets of decentralization and its effect on health system functioning; however, lack of consensus on an acceptable framework is a critical gap in determining its quantum and quality. Theorists have resorted to concepts of 'trust', 'convenience' and 'mutual benefits' to explain, define and measure components of governance in health. In the emerging 'continuum of health services' model, the challenge lies in identifying variables of performance (fiscal allocation, autonomy at local level, perception of key stakeholders, service delivery outputs, etc.) through the prism of decentralization in the first place, and in establishing directed relationships among them. This focused review paper conducted extensive web-based literature search, using PubMed and Google Scholar search engines. After screening of key words and study objectives, we retrieved 180 articles for next round of screening. One hundred and four full articles (three working papers and 101 published papers) were reviewed in totality. We attempted to summarize existing literature on decentralization and health systems performance, explain key concepts and essential variables, and develop a framework for further scientific scrutiny. Themes are presented in three separate segments of dimensions, difficulties and derivatives. Evaluation of local decision making and its effect on health system performance has been studied in a compartmentalized manner. There is sparse evidence about innovations

  16. Decentralization and health system performance – a focused review of dimensions, difficulties, and derivatives in India

    Directory of Open Access Journals (Sweden)

    Bhuputra Panda

    2016-10-01

    Full Text Available Abstract Introduction One of the principal goals of any health care system is to improve health through the provision of clinical and public health services. Decentralization as a reform measure aims to improve inputs, management processes and health outcomes, and has political, administrative and financial connotations. It is argued that the robustness of a health system in achieving desirable outcomes is contingent upon the width and depth of ‘decision space’ at the local level. Studies have used different approaches to examine one or more facets of decentralization and its effect on health system functioning; however, lack of consensus on an acceptable framework is a critical gap in determining its quantum and quality. Theorists have resorted to concepts of ‘trust’, ‘convenience’ and ‘mutual benefits’ to explain, define and measure components of governance in health. In the emerging ‘continuum of health services’ model, the challenge lies in identifying variables of performance (fiscal allocation, autonomy at local level, perception of key stakeholders, service delivery outputs, etc. through the prism of decentralization in the first place, and in establishing directed relationships among them. Methods This focused review paper conducted extensive web-based literature search, using PubMed and Google Scholar search engines. After screening of key words and study objectives, we retrieved 180 articles for next round of screening. One hundred and four full articles (three working papers and 101 published papers were reviewed in totality. We attempted to summarize existing literature on decentralization and health systems performance, explain key concepts and essential variables, and develop a framework for further scientific scrutiny. Themes are presented in three separate segments of dimensions, difficulties and derivatives. Results Evaluation of local decision making and its effect on health system performance has been

  17. 20 CFR 411.545 - How are the outcome payments calculated under the outcome-milestone payment system?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false How are the outcome payments calculated under the outcome-milestone payment system? 411.545 Section 411.545 Employees' Benefits SOCIAL SECURITY... are the outcome payments calculated under the outcome-milestone payment system? The amount of each...

  18. Maternal arsenic exposure and birth outcomes: a comprehensive review of the epidemiologic literature focused on drinking water.

    Science.gov (United States)

    Bloom, Michael S; Surdu, Simona; Neamtiu, Iulia A; Gurzau, Eugen S

    2014-09-01

    Inorganic arsenic (iAs) is a human toxicant to which populations may be exposed through consumption of geogenically contaminated groundwater. A growing body of experimental literature corroborates the reproductive toxicity of iAs; however, the results of human studies are inconsistent. Therefore, we conducted a comprehensive review of epidemiologic studies focused on drinking water iAs exposure and birth outcomes to assess the evidence for causality and to make recommendations for future study. We reviewed 18 English language papers assessing birth weight, gestational age, and birth size. Thirteen of the studies were conducted among populations with frequent exposure to high-level groundwater iAs contamination (>10 μg/L) and five studies were conducted in areas without recognized contamination. Most studies comprised small samples and used cross-sectional designs, often with ecologic exposure assessment strategies, although several large prospective investigations and studies with individual-level measurements were also reported. We conclude that: (1) the epidemiologic evidence for an increased risk of low birth weight (water iAs contamination quality epidemiologic studies are necessary to more definitively assess the risk. Copyright © 2014 Elsevier GmbH. All rights reserved.

  19. Single High Intensity Focused Ultrasound Session as a Whole Gland Primary Treatment for Clinically Localized Prostate Cancer: 10-Year Outcomes

    Directory of Open Access Journals (Sweden)

    Ksenija Limani

    2014-01-01

    Full Text Available Objectives. To assess the treatment outcomes of a single session of whole gland high intensity focused ultrasound (HIFU for patients with localized prostate cancer (PCa. Methods. Response rates were defined using the Stuttgart and Phoenix criteria. Complications were graded according to the Clavien score. Results. At a median follow-up of 94months, 48 (44.4% and 50 (46.3% patients experienced biochemical recurrence for Phoenix and Stuttgart definition, respectively. The 5- and 10-year actuarial biochemical recurrence free survival rates were 57% and 40%, respectively. The 10-year overall survival rate, cancer specific survival rate, and metastasis free survival rate were 72%, 90%, and 70%, respectively. Preoperative high risk category, Gleason score, preoperative PSA, and postoperative nadir PSA were independent predictors of oncological failure. 24.5% of patients had self-resolving LUTS, 18.2% had urinary tract infection, and 18.2% had acute urinary retention. A grade 3b complication occurred in 27 patients. Pad-free continence rate was 87.9% and the erectile dysfunction rate was 30.8%. Conclusion. Single session HIFU can be alternative therapy for patients with low risk PCa. Patients with intermediate risk should be informed about the need of multiple sessions of HIFU and/or adjuvant treatments and HIFU performed very poorly in high risk patients.

  20. The Cold Mass Support System and the Helium Cooling System for the MICE Focusing Solenoid

    International Nuclear Information System (INIS)

    Yang, Stephanie Q.; Green, Michael A.; Lau, Wing W.; Senanayake, Rohan S.; Witte, Holger

    2006-01-01

    The heart of the absorber focus coil (AFC) module for the muon ionization cooling experiment (MICE) is the two-coil superconducting solenoid that surrounds the muon absorber. The superconducting magnet focuses the muons that are cooled using ionization cooling, in order to improve the efficiency of cooling. The coils of the magnet may either be run in the solenoid mode (both coils operate at the same polarity) or the gradient (the coils operate at opposite polarity). The AFC magnet cold mass support system is designed to carry a longitudinal force up to 700 kN. The AFC module will be cooled using three pulse tube coolers that produce 1.5 W of cooling at 4.2 K. One of the coolers will be used to cool the liquid (hydrogen or helium) absorber used for ionization cooling. The other two coolers will cool the superconducting solenoid. This report will describe the MICE AFC magnet. The cold mass supports will be discussed. The reasons for using a pulsed tube cooler to cool this superconducting magnet will also be discussed

  1. Note: Automated optical focusing on encapsulated devices for scanning light stimulation systems

    International Nuclear Information System (INIS)

    Bitzer, L. A.; Benson, N.; Schmechel, R.

    2014-01-01

    Recently, a scanning light stimulation system with an automated, adaptive focus correction during the measurement was introduced. Here, its application on encapsulated devices is discussed. This includes the changes an encapsulating optical medium introduces to the focusing process as well as to the subsequent light stimulation measurement. Further, the focusing method is modified to compensate for the influence of refraction and to maintain a minimum beam diameter on the sample surface

  2. Outcome of focused pre-Ramadan education on metabolic and glycaemic parameters in patients with type 2 diabetes mellitus.

    Science.gov (United States)

    El Toony, Lobna F; Hamad, Dina Ali; Omar, Omar Mohammed

    2018-04-25

    Ramadan fasting is associated with the risk of acute complications including hypoglycaemia. Therefore, patients' education before Ramadan and follow up during Ramadan is essential for safe fasting. To evaluate the effect of pre-Ramadan education program on biochemical parameters and the risk of hypoglycaemia in patients with type 2 diabetes mellitus. A prospective interventional controlled design was carried out on 320 Muslim patients with type 2 diabetes. They were divided into 2 groups; the control group (n = 200) who received standard diabetic care and the intervention group (n = 120) who received focused individualized diabetic education sessions before Ramadan. The study was carried out on 3 phases (before, during and after Ramadan). Post-education change of hypoglycaemia risk and biochemical parameters during Ramadan fasting were the primary outcomes. Fasting blood glucose decreased significantly during, and after Ramadan in both groups (P patients in the intervention group vs. 19.5% in the control group. Post Ramadan reduction of HbA1c patients before Ramadan to 55.8% after Ramadan). Low-density lipoprotein cholesterol decreased in the intervention group (P = 0.024). The body weight of the patients did not significantly change in both groups. There was a significant impact of pre-Ramadan educational program on reduction of hypoglycaemic risk and other acute complications, reduction of low-density lipoprotein cholesterol and improvement of high-density lipoprotein cholesterol. Therefore, it is recommended for the fasting patients especially those with high and very high risk during Ramadan. Copyright © 2018. Published by Elsevier Ltd.

  3. Family-Focused Autism Spectrum Disorder Research: A Review of the Utility of Family Systems Approaches

    Science.gov (United States)

    Cridland, Elizabeth K.; Jones, Sandra C.; Magee, Christopher A.; Caputi, Peter

    2014-01-01

    A family member with an autism spectrum disorder presents pervasive and bidirectional influences on the entire family system, suggesting a need for family-focused autism spectrum disorder research. While there has been increasing interest in this research area, family-focused autism spectrum disorder research can still be considered relatively…

  4. Master's Degree in Management Information Systems with a Supply Chain Management Focus

    Science.gov (United States)

    Ramaswamy, Kizhanatham V.; Boyd, Joseph L.; Desai, Mayur

    2007-01-01

    A graduate curriculum in Management Information Systems with a Supply Chain Management focus is presented. The motivation for this endeavor stems from the fact that the global scope of modern business organizations and the competitive environment in which they operate, requires an information system leveraged supply chain management system (SCM)…

  5. Solar thermal power systems point-focusing thermal and electric applications projects. Volume 1: Executive summary

    Science.gov (United States)

    Marriott, A.

    1980-01-01

    The activities of the Point-Focusing Thermal and Electric Applications (PETEA) project for the fiscal year 1979 are summarized. The main thrust of the PFTEA Project, the small community solar thermal power experiment, was completed. Concept definition studies included a small central receiver approach, a point-focusing distributed receiver system with central power generation, and a point-focusing distributed receiver concept with distributed power generation. The first experiment in the Isolated Application Series was initiated. Planning for the third engineering experiment series, which addresses the industrial market sector, was also initiated. In addition to the experiment-related activities, several contracts to industry were let and studies were conducted to explore the market potential for point-focusing distributed receiver (PFDR) systems. System analysis studies were completed that looked at PFDR technology relative to other small power system technology candidates for the utility market sector.

  6. Planar real polynomial differential systems of degree n > 3 having a weak focus of high order

    International Nuclear Information System (INIS)

    Llibre, J.; Rabanal, R.

    2008-06-01

    We construct planar polynomial differential systems of even (respectively odd) degree n > 3, of the form linear plus a nonlinear homogeneous part of degree n having a weak focus of order n 2 -1 (respectively (n 2 -1)/2 ) at the origin. As far as we know this provides the highest order known until now for a weak focus of a polynomial differential system of arbitrary degree n. (author)

  7. Computerized method and system for designing an aerodynamic focusing lens stack

    Science.gov (United States)

    Gard, Eric [San Francisco, CA; Riot, Vincent [Oakland, CA; Coffee, Keith [Diablo Grande, CA; Woods, Bruce [Livermore, CA; Tobias, Herbert [Kensington, CA; Birch, Jim [Albany, CA; Weisgraber, Todd [Brentwood, CA

    2011-11-22

    A computerized method and system for designing an aerodynamic focusing lens stack, using input from a designer related to, for example, particle size range to be considered, characteristics of the gas to be flowed through the system, the upstream temperature and pressure at the top of a first focusing lens, the flow rate through the aerodynamic focusing lens stack equivalent at atmosphere pressure; and a Stokes number range. Based on the design parameters, the method and system determines the total number of focusing lenses and their respective orifice diameters required to focus the particle size range to be considered, by first calculating for the orifice diameter of the first focusing lens in the Stokes formula, and then using that value to determine, in iterative fashion, intermediate flow values which are themselves used to determine the orifice diameters of each succeeding focusing lens in the stack design, with the results being output to a designer. In addition, the Reynolds numbers associated with each focusing lens as well as exit nozzle size may also be determined to enhance the stack design.

  8. Integrated single grating compressor for variable pulse front tilt in simultaneously spatially and temporally focused systems.

    Science.gov (United States)

    Block, Erica; Thomas, Jens; Durfee, Charles; Squier, Jeff

    2014-12-15

    A Ti:Al(3)O(2) multipass chirped pulse amplification system is outfitted with a single-grating, simultaneous spatial and temporal focusing (SSTF) compressor platform. For the first time, this novel design has the ability to easily vary the beam aspect ratio of an SSTF beam, and thus the degree of pulse-front tilt at focus, while maintaining a net zero-dispersion system. Accessible variation of pulse front tilt gives full spatiotemporal control over the intensity distribution at the focus and could lead to better understanding of effects such as nonreciprocal writing and SSTF-material interactions.

  9. Prosthetists' perceptions and use of outcome measures in clinical practice: Long-term effects of focused continuing education.

    Science.gov (United States)

    Hafner, Brian J; Spaulding, Susan E; Salem, Rana; Morgan, Sara J; Gaunaurd, Ignacio; Gailey, Robert

    2017-06-01

    Continuing education is intended to facilitate clinicians' skills and knowledge in areas of practice, such as administration and interpretation of outcome measures. To evaluate the long-term effect of continuing education on prosthetists' confidence in administering outcome measures and their perceptions of outcomes measurement in clinical practice. Pretest-posttest survey methods. A total of 66 prosthetists were surveyed before, immediately after, and 2 years after outcomes measurement education and training. Prosthetists were grouped as routine or non-routine outcome measures users, based on experience reported prior to training. On average, prosthetists were just as confident administering measures 1-2 years after continuing education as they were immediately after continuing education. In all, 20% of prosthetists, initially classified as non-routine users, were subsequently classified as routine users at follow-up. Routine and non-routine users' opinions differed on whether outcome measures contributed to efficient patient evaluations (79.3% and 32.4%, respectively). Both routine and non-routine users reported challenges integrating outcome measures into normal clinical routines (20.7% and 45.9%, respectively). Continuing education had a long-term impact on prosthetists' confidence in administering outcome measures and may influence their clinical practices. However, remaining barriers to using standardized measures need to be addressed to keep practitioners current with evolving practice expectations. Clinical relevance Continuing education (CE) had a significant long-term impact on prosthetists' confidence in administering outcome measures and influenced their clinical practices. In all, approximately 20% of prosthetists, who previously were non-routine outcome measure users, became routine users after CE. There remains a need to develop strategies to integrate outcome measurement into routine clinical practice.

  10. Multi-slit triode ion optical system with ballistic beam focusing

    Energy Technology Data Exchange (ETDEWEB)

    Davydenko, V., E-mail: V.I.Davydenko@inp.nsk.su; Amirov, V.; Gorbovsky, A.; Deichuli, P.; Ivanov, A.; Kolmogorov, A.; Kapitonov, V.; Mishagin, V.; Shikhovtsev, I.; Sorokin, A.; Stupishin, N. [Budker Institute of Nuclear Physics, Novosibirsk 630090 (Russian Federation); Karpushov, A. N. [Ecole Polytechnique Fédérale de Lausanne, Centre de Recherches en Physique des Plasmas (CRPP), CH-1015 Lausanne (Switzerland); Smirnov, A. [Tri Alpha Energy, Inc., Rancho Santa Margarita, California 92688 (United States); Uhlemann, R. [Institute of Energy and Climate Research-Plasma Physics, Research Center Juelich, 52425 Juelich (Germany)

    2016-02-15

    Multi-slit triode ion-optical systems with spherical electrodes are of interest for formation of intense focused neutral beams for plasma heating. At present, two versions of focusing multi-slit triode ion optical system are developed. The first ion optical system forms the proton beam with 15 keV energy, 140 A current, and 30 ms duration. The second ion optical system is intended for heating neutral beam injector of Tokamak Configuration Variable (TCV). The injector produces focused deuterium neutral beam with 35 keV energy, 1 MW power, and 2 s duration. In the later case, the angular beam divergence of the neutral beam is 20-22 mrad in the direction across the slits of the ion optical system and 12 mrad in the direction along the slits.

  11. Applying Diagnostics to Enhance Cable System Reliability (Cable Diagnostic Focused Initiative, Phase II)

    Energy Technology Data Exchange (ETDEWEB)

    Hartlein, Rick [Georgia Tech Research Corporation (GTRC), Atlanta, GA (United States). National Electric Energy Testing, Research and Applications Center (NEETRAC); Hampton, Nigel [Georgia Tech Research Corporation (GTRC), Atlanta, GA (United States). National Electric Energy Testing, Research and Applications Center (NEETRAC); Perkel, Josh [Georgia Tech Research Corporation (GTRC), Atlanta, GA (United States). National Electric Energy Testing, Research and Applications Center (NEETRAC); Hernandez, JC [Univ. de Los Andes, Merida (Venezuela); Elledge, Stacy [Georgia Tech Research Corporation (GTRC), Atlanta, GA (United States). National Electric Energy Testing, Research and Applications Center (NEETRAC); del Valle, Yamille [Georgia Tech Research Corporation (GTRC), Atlanta, GA (United States). National Electric Energy Testing, Research and Applications Center (NEETRAC); Grimaldo, Jose [Georgia Inst. of Technology, Atlanta, GA (United States). School of Electrical and Computer Engineering; Deku, Kodzo [Georgia Inst. of Technology, Atlanta, GA (United States). George W. Woodruff School of Mechanical Engineering

    2016-02-01

    The Cable Diagnostic Focused Initiative (CDFI) played a significant and powerful role in clarifying the concerns and understanding the benefits of performing diagnostic tests on underground power cable systems. This project focused on the medium and high voltage cable systems used in utility transmission and distribution (T&D) systems. While many of the analysis techniques and interpretations are applicable to diagnostics and cable systems outside of T&D, areas such as generating stations (nuclear, coal, wind, etc.) and other industrial environments were not the focus. Many large utilities in North America now deploy diagnostics or have changed their diagnostic testing approach as a result of this project. Previous to the CDFI, different diagnostic technology providers individually promoted their approach as the “the best” or “the only” means of detecting cable system defects.

  12. Structure and magnetic field of periodic permanent magnetic focusing system with open magnetic rings

    International Nuclear Information System (INIS)

    Peng Long; Li Lezhong; Yang Dingyu; Zhu Xinghua; Li Yuanxun

    2011-01-01

    The magnetic field along the central axis for an axially magnetized permanent magnetic ring was investigated by analytical and finite element methods. For open magnetic rings, both calculated and measured results show that the existence of the radial magnetic field creates a remarkable cosine distribution field along the central axis. A new structure of periodic permanent magnet focusing system with open magnetic rings is proposed. The structure provides a satisfactory magnetic field with a stable peak value of 120 mT for a traveling wave tube system. - Research highlights: → For open magnetic rings, both calculated and measured results show that the existence of the radial magnetic field creates a remarkable cosine distribution field along the central axis. → A new structure of periodic permanent magnet (PPM) focusing system with open magnetic rings is proposed. → The new PPM focusing system with open magnetic rings meets the requirements for TWT system.

  13. The Focus of Attention is similar to other memory systems rather than uniquely different

    Directory of Open Access Journals (Sweden)

    Olivia eBeaudry

    2014-02-01

    Full Text Available According to some current theories, the Focus of Attention, part of working memory, represents items in a privileged state that is more accessible than items stored in other memory systems. One line of evidence supporting the distinction between the focus of attention and other memory systems is the finding that items in the focus of attention are immune to proactive interference (when something learned earlier impairs the ability to remember something learned more recently. The focus of attention, then, is held to be unique: it is the only memory system that is not susceptible to proactive interference. We review the literature used to support this claim, and although there are many studies in which proactive interference was not observed, we found more studies in which it was observed. We conclude that the focus of attention is not immune to proactive interference: items in the focus of attention are susceptible to proactive interference just like items in every other memory system. And, just as in all other memory systems, it is how the items are represented and processed that plays a critical role in determining whether proactive interference will be observed.

  14. Clinical outcome of magnetic-resonance-guided focused ultrasound surgery (MRgFUS) in the treatment of symptomatic uterine fibroids

    International Nuclear Information System (INIS)

    Kamp, J.E.K.; Scheurig-Muenkler, C.; Beck, A.; David, M.; Hengst, S.

    2013-01-01

    Purpose: To investigate the clinical outcome of magnetic-resonance-guided focused ultrasound surgery (MRgFUS) treatment for symptomatic uterine fibroids in premenopausal women using the validated USF-QOL (Uterine Fibroid Symptom and Quality of Life) Questionnaire. Materials and Methods: 54 patients with symptomatic uterine fibroids were enrolled in this prospective study. The patients completed the UFS-QOL Questionnaire prior to MRgFUS treatment as well as after 3, 6, and 12 months. Results: The rate of technical success was 91.5 % (95.2 % after subtraction of screening errors). 6/54 patients (11 %) had other treatments (surgery, n = 4; UAE, n = 2), 8/54 (15 %) dropped out due to pregnancy, and 8/54 were lost to follow-up. The remaining group showed considerable symptom relief as early as after 3 months. The median overall quality of life score increased from 64.7 (quartile range QR: 49.8 - 77.6) before treatment to 77.6 (QR: 61.4 - 87.1) (p < 0.001), 78.4 (QR: 66.4 - 89.7) (p < 0.001), and 82.8 (QR: 69.8 - 92.2) (p < 0.001) at 3, 6, and 12 months, respectively. The corresponding median symptom severity score decreased from 46.9 (QR: 28.1 - 56.2) to 34.4 (QR: 21.9 - 43.7) at 3 months (p = 0.003) and 28.1 at 6 and 12 months (QR: 18.7 - 38.3, QR: 15.6 - 34.4) (p < 0.001, p = 0.002). The rate of complications requiring treatment was 9 %, and the rate of overall complications was 39 %. No major complications occurred. Conclusion: Our results indicate significant alleviation of fibroid-related symptoms within 12 months of MRgFUS with improvement beginning as early as 3 months after treatment. We observed no major complications, and some women became pregnant after MRgFUS. There was a low treatment failure rate of 11 %. (orig.)

  15. Acoustic field of focusing phased array probe and the scanning system

    International Nuclear Information System (INIS)

    Murai, J.; Miura, S.; Ida, T.; Shiraiwa, T.; Miya, T.

    1997-01-01

    Acoustic field of a point focusing cylindrical linear array probe, in which focusing in the axial direction of cylinder is done by the phased linear array and focusing in the orthogonal direction is done geometrically, was studied by numerical calculation and an optimum design of phased array probe for focusing has been obtained. In generally speaking, the beam width at focus point decreases with decrease of width of each transducer element and with increase of synthetic aperture made by total elements. If the number of total array elements excited as one pulse is limited, the above conditions are contradicted. Thus, an optimum element width exists for the best focusing. On the above consideration, we can get focusing ability of phased array nearly as same as geometrical focusing. A developed transducer is a linear array of polymer piezoelectric material of cylindrical shape, of which radius is from 50 mm to 75 mm. The frequency is 10 Mhz and the beam width of 0.5 mm (depending on aperture) in the orthogonal direction to the cylinder axis and 0.7 mm width in the cylinder axis (phased array focusing) have been obtained. A delay circuit for exciting the transducer was newly designed to give maximum performance to the array regarding to accuracy, stability, easy control and etc. A c-scan ultrasonic testing system equipped with this transducer has sixteen times inspection speed compared to the single probe instrument.

  16. Portable test bench for the studies concerning ion sources and ion beam extraction and focusing systems

    International Nuclear Information System (INIS)

    Cordero Lopez, F.

    1961-01-01

    A portable test bench is described, which was designed to check ion sources, ion beam extraction and focusing systems before its use in a 600 KeV Cockcroft-Walton accelerator. The vacuum possibilities of the system are specially analyzed in connection with its particular use. The whole can be considered as a portable accelerator of low energy (50 keV). (Author)

  17. Beyond 1984: The Positive and Negative Potential of Computer Supported School Focused Information Systems.

    Science.gov (United States)

    Klein, Susan S.

    Although educators' use of computers to track student and school information with the attendant positive and negative outcomes is still in an early stage of development, accessible data from such systems could improve the objective rationality of educational and instructional decision-making as long as no one places unwarranted credibility in the…

  18. The Financial Analysis with Focus of Risks in the Banking System

    Directory of Open Access Journals (Sweden)

    Aleisky González-Duany

    2017-06-01

    Full Text Available The article consists in exposes the importance, need and convenience to develop a financial analysis with focus of risks in the banking activity to avoid damages and to take exactly and opportunity decisions. This analysis linked with bank risks will allow to the banking system measuring the efficiency in the different services that you render, detecting the different inherent risks to the financial activity with a former focus before, for the sake of giving fulfillment to the organizational goals

  19. Beam-based alignment and tuning procedures for e+e- collider final focus systems

    International Nuclear Information System (INIS)

    Bulos, F.; Burke, D.; Helm, R.; Irwin, J.; Odian, A.; Roy, G.; Ruth, R.; Yamamoto, N.

    1991-05-01

    For future linear colliders, with very small emittances and beam sizes and demanding tolerances on final focus system alignment and magnet errors, it becomes increasingly important to use the beam as a diagnostic tool. We report here procedures we have identified and will be implemented in the Final Focus Test Beam at SLAC incorporating (1) quadrupole strength changes, (2) central orbit modifications, (3) spot size measurements, and (4) beam stability monitoring. 3 refs., 4 figs., 3 tabs

  20. Beam-based alignment and tuning procedures for e+e- collider final focus systems

    International Nuclear Information System (INIS)

    Bulos, F.; Burke, D.; Helm, R.; Irwin, J.; Odian, A.; Roy, G.; Ruth, R.; Yamamoto

    1991-01-01

    For future linear colliders, with very small emittances and beam sizes and demanding tolerances on final focus system alignment and magnet errors, it becomes increasingly important to use the beam as a diagnostic tool. The authors report here procedures they have identified and will be implemented in the Final Focus Test Beam at SLAC incorporating (1) quadrupole strength changes, (2) central orbit modifications, (3) spot size measurements, and (4) beam stability monitoring

  1. Association between Systemic Diseases and Endodontic Outcome: A Systematic Review.

    Science.gov (United States)

    Aminoshariae, Anita; Kulild, James C; Mickel, Andre; Fouad, Ashraf F

    2017-04-01

    To date, the relationships between systemic diseases and endodontic treatment outcomes remain poorly studied. Thus, the purpose of this systematic review was to evaluate the relationship between host-modifying factors and their association with endodontic outcomes. Two reviewers independently conducted a comprehensive literature search. The MEDLINE, Embase, Cochrane, and PubMed databases were searched. In addition, the bibliographies and gray literature of all relevant articles and textbooks were manually searched. There was no disagreement between the 2 reviewers. Sixteen articles met the inclusion criteria with moderate to high risk of bias. There was no article with low risk of bias. Available scientific evidence remains inconclusive as to whether diabetes and/or cardiovascular disease(s) may be associated with endodontic outcomes. Human immunodeficiency virus and oral bisphosphonate did not appear to be associated with endodontic outcomes. Although additional well-designed longitudinal clinical studies are needed, the results of this systematic review suggest that some systemic diseases may be correlated with endodontic outcomes. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  2. Comparing 2 Whiplash Grading Systems to Predict Clinical Outcomes.

    Science.gov (United States)

    Croft, Arthur C; Bagherian, Alireza; Mickelsen, Patrick K; Wagner, Stephen

    2016-06-01

    Two whiplash severity grading systems have been developed: Quebec Task Force on Whiplash-Associated Disorders (QTF-WAD) and the Croft grading system. The majority of clinical studies to date have used the modified grading system published by the QTF-WAD in 1995 and have demonstrated some ability to predict outcome. But most studies include only injuries of lower severity (grades 1 and 2), preventing a broader interpretation. The purpose of this study was assess the ability of these grading systems to predict clinical outcome within the context of a broader injury spectrum. This study evaluated both grading systems for their ability to predict the bivalent outcome, recovery, within a sample of 118 whiplash patients who were part of a previous case-control designed study. Of these, 36% (controls) had recovered, and 64% (cases) had not recovered. The discrete bivariate distribution between recovery status and whiplash grade was analyzed using the 2-tailed cross-tabulation statistics. Applying the criteria of the original 1993 Croft grading system, the subset comprised 1 grade 1 injury, 32 grade 2 injuries, 53 grade 3 injuries, and 32 grade 4 injuries. Applying the criteria of the modified (QTF-WAD) grading system, there were 1 grade 1 injury, 89 grade 2 injuries, and 28 grade 3 injuries. Both whiplash grading systems correlated negatively with recovery; that is, higher severity grades predicted a lower probability of recovery, and statistically significant correlations were observed in both, but the Croft grading system substantially outperformed the QTF-WAD system on this measure. The Croft grading system for whiplash injury severity showed a better predictive measure for recovery status from whiplash injuries as compared with the QTF-WAD grading system.

  3. Conceptual design of bend, compression, and final focus components of ILSE [Induction Linac System Experiment

    International Nuclear Information System (INIS)

    Lee, E.P.; Fong, C.; Mukherjee, S.; Thur, W.

    1989-03-01

    The Induction Linac System Experiment (ILSE) includes a 180/degree/ bend system, drift compression line and a final focus, which test the analogous features of a heavy ion driver for inertial fusion. These components are novel in their transport of a space-charge-dominated ion beam with large head-to-tail velocity tilt. Their conceptual design is presented, including calculations of the beam envelope, momentum dispersion, and engineering design of magnets, vacuum system, diagnostics, alignment, and support. 3 refs., 5 figs

  4. Why do some therapists not deal with outcome monitoring feedback? A feasibility study on the effect of regulatory focus and person–organization fit on attitude and outcome

    NARCIS (Netherlands)

    de Jong, Kim; de Goede, Marije

    2015-01-01

    Objective: Despite research on its effectiveness, many therapists still have negative attitudes toward using outcome monitoring feedback. The current study aims to investigate how the perceived match between values of an individual and those of the organization (Person–Organization fit; PO fit), and

  5. Focus detection by shearing interference of vortex beams for non-imaging systems.

    Science.gov (United States)

    Li, Xiongfeng; Zhan, Shichao; Liang, Yiyong

    2018-02-10

    In focus detection of non-imaging systems, the common image-based methods are not available. Also, interference techniques are seldom used because only the degree with hardly any direction of defocus can be derived from the fringe spacing. In this paper, we propose a vortex-beam-based shearing interference system to do focus detection for a focused laser direct-writing system, where a vortex beam is already involved. Both simulated and experimental results show that fork-like features are added in the interference patterns due to the existence of an optical vortex, which makes it possible to distinguish the degree and direction of defocus simultaneously. The theoretical fringe spacing and resolution of this method are derived. A resolution of 0.79 μm can be achieved under the experimental combination of parameters, and it can be further improved with the help of the image processing algorithm and closed-loop controlling in the future. Finally, the influence of incomplete collimation and the wedge angle of the shear plate is discussed. This focus detection approach is extremely appropriate for those non-imaging systems containing one or more focused vortex beams.

  6. Three-Dimensional Design of a Non-Axisymmetric Periodic Permanent Magnet Focusing System

    CERN Document Server

    Chen Chi Ping; Radovinsky, Alexey; Zhou, Jing

    2005-01-01

    A three-dimensional (3D) design is presented of a non-axisymmetric periodic permanent magnet focusing system which will be used to focus a large-aspect-ratio, ellipse-shaped, space-charge-dominated electron beam. In this design, an analytic theory is used to specify the magnetic profile for beam transport. The OPERA3D code is used to compute and optimize a realizable magnet system. Results of the magnetic design are verified by two-dimensional particle-in-cell and three-dimensional trajectory simulations of beam propagation using PFB2D and OMNITRAK, respectively. Results of fabrication tolerance studies are discussed.

  7. Do large-scale hospital- and system-wide interventions improve patient outcomes: a systematic review.

    Science.gov (United States)

    Clay-Williams, Robyn; Nosrati, Hadis; Cunningham, Frances C; Hillman, Kenneth; Braithwaite, Jeffrey

    2014-09-03

    While health care services are beginning to implement system-wide patient safety interventions, evidence on the efficacy of these interventions is sparse. We know that uptake can be variable, but we do not know the factors that affect uptake or how the interventions establish change and, in particular, whether they influence patient outcomes. We conducted a systematic review to identify how organisational and cultural factors mediate or are mediated by hospital-wide interventions, and to assess the effects of those factors on patient outcomes. A systematic review was conducted and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Database searches were conducted using MEDLINE from 1946, CINAHL from 1991, EMBASE from 1947, Web of Science from 1934, PsycINFO from 1967, and Global Health from 1910 to September 2012. The Lancet, JAMA, BMJ, BMJ Quality and Safety, The New England Journal of Medicine and Implementation Science were also hand searched for relevant studies published over the last 5 years. Eligible studies were required to focus on organisational determinants of hospital- and system-wide interventions, and to provide patient outcome data before and after implementation of the intervention. Empirical, peer-reviewed studies reporting randomised and non-randomised controlled trials, observational, and controlled before and after studies were included in the review. Six studies met the inclusion criteria. Improved outcomes were observed for studies where outcomes were measured at least two years after the intervention. Associations between organisational factors, intervention success and patient outcomes were undetermined: organisational culture and patient outcomes were rarely measured together, and measures for culture and outcome were not standardised. Common findings show the difficulty of introducing large-scale interventions, and that effective leadership and clinical champions, adequate

  8. Adjustable, short focal length permanent-magnet quadrupole based electron beam final focus system

    Directory of Open Access Journals (Sweden)

    J. K. Lim

    2005-07-01

    Full Text Available Advanced high-brightness beam applications such as inverse-Compton scattering (ICS depend on achieving of ultrasmall spot sizes in high current beams. Modern injectors and compressors enable the production of high-brightness beams having needed short bunch lengths and small emittances. Along with these beam properties comes the need to produce tighter foci, using stronger, shorter focal length optics. An approach to creating such strong focusing systems using high-field, small-bore permanent-magnet quadrupoles (PMQs is reported here. A final-focus system employing three PMQs, each composed of 16 neodymium iron boride sectors in a Halbach geometry has been installed in the PLEIADES ICS experiment. The field gradient in these PMQs is 560   T/m, the highest ever reported in a magnetic optics system. As the magnets are of a fixed field strength, the focusing system is tuned by adjusting the position of the three magnets along the beam line axis, in analogy to familiar camera optics. This paper discusses the details of the focusing system, simulation, design, fabrication, and experimental procedure in creating ultrasmall beams at PLEIADES.

  9. Non-uniform hybrid strategy for architecting and modeling flight vehicle focused system-of-systems operations

    Directory of Open Access Journals (Sweden)

    Tian Yifeng

    2016-02-01

    Full Text Available To balance the contradiction between comprehensiveness of system-of-systems (SoS description and cost of modeling and simulation, a non-uniform hybrid strategy (NUHYS is proposed. NUHYS groups elements of an SoS operation into system community or relatively independent system based on contributors complexity and focus relationship according to the focus of SoS problem. Meanwhile, modeling methods are categorized based on details attention rate and dynamic attention rate, seeking for matching contributors. Taking helicopter rescue in earthquake relief as an example, the procedure of applying NUHYS and its effectiveness are verified.

  10. Fertility and pregnancy outcome in women with systemic sclerosis.

    Science.gov (United States)

    Steen, V D; Medsger, T A

    1999-04-01

    To determine fertility and pregnancy outcome in women with systemic sclerosis (SSc; scleroderma) who had disease onset before age 45 years. All living women with scleroderma who had first been evaluated at the University of Pittsburgh Scleroderma Clinic after January 1, 1972 were sent a detailed self-administered questionnaire in 1986 specifically concerning pregnancy outcomes and infertility. This group was compared with 2 race- and age-matched control groups, one comprising women with rheumatoid arthritis (RA) and one comprising healthy neighborhood women identified by random-digit dialing. We determined the number, history, treatment, and outcome of women who either had never been pregnant or had attempted to become pregnant unsuccessfully for more than 1 year. We also obtained data regarding pregnancy outcomes, including the frequency of miscarriage, premature births, small full-term infants, perinatal deaths, and births of live healthy infants. The study group comprised 214 women with SSc, 167 with RA, and 105 neighborhood controls. There were no significant differences in the overall rates of miscarriage, premature births, small full-term births, or neonatal deaths between the 3 groups. Women with SSc were more likely than those without SSc to have adverse outcomes of pregnancy after the onset of their rheumatic disease, particularly premature births (also seen in RA women after disease onset) and small full-term infants. Although a significantly greater number of women with SSc had never been pregnant, there were no significant differences in the frequency of never having been pregnant or of infertility in the 3 groups after adjustment for contributing factors. This study indicates that women with SSc have acceptable pregnancy outcomes compared with those of women with other rheumatic disease and healthy neighborhood controls. Infertility was not a frequent problem. We believe that there are no excessive pregnancy risks to women with SSc or their infants

  11. Evaluating Red Reflex and Surgeon Preference Between Nearly-Collimated and Focused Beam Microscope Illumination Systems.

    Science.gov (United States)

    Cionni, Robert J; Pei, Ron; Dimalanta, Ramon; Lubeck, David

    2015-08-01

    To evaluate the intensity and stability of the red reflex produced by ophthalmic surgical microscopes with nearly-collimated versus focused illumination systems and to assess surgeon preference in a simulated surgical setting. This two-part evaluation consisted of postproduction surgical video analysis of red reflex intensity and a microscope use and preference survey completed by 13 experienced cataract surgeons. Survey responses were based on bench testing and experience in a simulated surgical setting. A microscope with nearly-collimated beam illumination and two focused beam microscopes were assessed. Red reflex intensity and stability were greater with the nearly-collimated microscope illumination system. In the bench testing survey, surgeons reported that the red reflex was maintained over significantly greater distances away from pupillary center, and depth of focus was numerically greater with nearly-collimated illumination relative to focused illumination. Most participating surgeons (≥64%) reported a preference for the microscope with nearly-collimated illumination with regard to red reflex stability, depth of focus, visualization, surgical working distance, and perceived patient comfort. The microscope with nearly-collimated illumination produced a more intense and significantly more stable red reflex and was preferred overall by more surgeons. This is the first report of an attempt to quantify red reflex intensity and stability and to evaluate surgically-relevant parameters between microscope systems. The data and methods presented here may provide a basis for future studies attempting to quantify differences between surgical microscopes that may affect surgeon preference and microscope use in ophthalmic surgery.

  12. A focused air-pulse system for optical-coherence-tomography-based measurements of tissue elasticity

    International Nuclear Information System (INIS)

    Wang, Shang; Larin, K V; Li, Jiasong; Vantipalli, S; Twa, M D; Manapuram, R K; Aglyamov, S; Emelianov, S

    2013-01-01

    Accurate non-invasive assessment of tissue elasticity in vivo is required for early diagnostics of many tissue abnormalities. We have developed a focused air-pulse system that produces a low-pressure and short-duration air stream, which can be used to excite transient surface waves (SWs) in soft tissues. System characteristics were studied using a high-resolution analog pressure transducer to describe the excitation pressure. Results indicate that the excitation pressure provided by the air-pulse system can be easily controlled by the air source pressure, the angle of delivery, and the distance between the tissue surface and the port of the air-pulse system. Furthermore, we integrated this focused air-pulse system with phase-sensitive optical coherence tomography (PhS-OCT) to make non-contact measurements of tissue elasticity. The PhS-OCT system is used to assess the group velocity of SW propagation, which can be used to determine Young’s modulus. Pilot experiments were performed on gelatin phantoms with different concentrations (10%, 12% and 14% w/w). The results demonstrate the feasibility of using this focused air-pulse system combined with PhS-OCT to estimate tissue elasticity. This easily controlled non-contact technique is potentially useful to study the biomechanical properties of ocular and other tissues in vivo. (letter)

  13. Possibilities of achieving fusion reaction with a 4{pi} focusing system

    Energy Technology Data Exchange (ETDEWEB)

    Barsanti, G; Barsella, B; Camerini, M; Federighi, U; Musumeci, L; Talini, N [CAMEN., Leghorn (Italy)

    1958-07-01

    The 4{pi} focusing by means of an electromagnetic field is analysed. The following points considered: (a) The general solutions of system for equations of motion of a mass m with charge +e valid for arbitrary initial conditions. This is necessary for the consideration of imperfectly focused primary trajectories, of the effect of collisions in the vicinity of the origin and of ions produced in the neutral gas which diffuses into the reaction chamber. (b) Investigation of the primary ion injection system, of the density of the ions in the chamber and of the energy balance as a matter of principle. (c) The experimental apparatus needed for 4{pi} focusing of deuterons and a sketch of a fusion reactor.

  14. System for deuterium-tritium mixture filling the working chamber of a dense plasma focus device

    International Nuclear Information System (INIS)

    Bondar', A.I.; Vyskubov, V.P.; Gerasimov, S.A.

    1981-01-01

    A gas-vacuum system designed for filling the gas-discharge chamber of a plasma focus device with equal-coaponent deuterium-tritium mixture is described. The system consists of a unit for gaseous mixture prepa ration and a unit for mixture absorption and device evacuation. The system provides the gaseous mixture purification of O 2 and N 2 impurities. Final tritium content in the gas-discharge chamber after tritium removal is not greater than 2x10 8 Bq/l. Tritium content in a sealed box in which the device is placed does not exceed 30 Bq/l that is less than limiting safe value. The conclusion is made that the described system design gives an opportunity to begin experimental studies at plasma focus devices with deuterium-tritium mixture [ru

  15. Association Between Physician Teamwork and Health System Outcomes After Coronary Artery Bypass Grafting.

    Science.gov (United States)

    Hollingsworth, John M; Funk, Russell J; Garrison, Spencer A; Owen-Smith, Jason; Kaufman, Samuel A; Pagani, Francis D; Nallamothu, Brahmajee K

    2016-11-01

    Patients undergoing coronary artery bypass grafting (CABG) must often see multiple providers dispersed across many care locations. To test whether teamwork (assessed with the bipartite clustering coefficient) among these physicians is a determinant of surgical outcomes, we examined national Medicare data from patients undergoing CABG. Among Medicare beneficiaries who underwent CABG between 2008 and 2011, we mapped relationships between all physicians who treated them during their surgical episodes, including both surgeons and nonsurgeons. After aggregating across CABG episodes in a year to construct the physician social networks serving each health system, we then assessed the level of physician teamwork in these networks with the bipartite clustering coefficient. Finally, we fit a series of multivariable regression models to evaluate associations between a health system's teamwork level and its 60-day surgical outcomes. We observed substantial variation in the level of teamwork between health systems performing CABG (SD for the bipartite clustering coefficient was 0.09). Although health systems with high and low teamwork levels treated beneficiaries with comparable comorbidity scores, these health systems differed over several sociocultural and healthcare capacity factors (eg, physician staff size and surgical caseload). After controlling for these differences, health systems with higher teamwork levels had significantly lower 60-day rates of emergency department visit, readmission, and mortality. Health systems with physicians who tend to work together in tightly-knit groups during CABG episodes realize better surgical outcomes. As such, delivery system reforms focused on building teamwork may have positive effects on surgical care. © 2016 American Heart Association, Inc.

  16. Learning-Focused Leadership and Leadership Support: Meaning and Practice in Urban Systems

    Science.gov (United States)

    Knapp, Michael S.; Copland, Michael A.; Honig, Meredith I.; Plecki, Margaret L.; Portin, Bradley S.

    2010-01-01

    This report synthesizes what has been learned about how leaders in urban systems focus their leadership on the improvement of learning, and what it takes to support their leadership in these settings. The report brings together findings from three sub-study strands, concerned with efforts in seven urban districts to: a) invest staffing and other…

  17. Optimising waste treatment and energy systems - focusing on spatial and temporal issues

    DEFF Research Database (Denmark)

    Pizarro Alonso, Amalia Rosa; Münster, Marie; Ravn, H.

    The aim of the TOPWASTE project is to evaluate current and future optimal treatment of waste fractions in terms of economy and the environment, with a focus on recycling versus Waste-to-Energy technologies. After optimization of the waste management system, results must be analysed so...

  18. A New Method for Research on the Center-Focus Problem of Differential Systems

    OpenAIRE

    Zhou, Zhengxin

    2014-01-01

    We will introduce Mironenko’s method to discuss the Poincaré center-focus problem, and compare the methods of Lyapunov and Mironenko. We apply the Mironenko method to discuss the qualitative behavior of solutions of some planar polynomial differential systems and derive the sufficient conditions for a critical point to be a center.

  19. Cofimvaba: Innovative and systemic technology application in rural, education focused, agri-based development initiatives

    CSIR Research Space (South Africa)

    Van Rensburg, J

    2012-10-01

    Full Text Available In this presentation the author shares current learning on the use of more targeted and systemic ICT for development as well as broader technology for development education and LED-focused interventions in the science, engineering and technology...

  20. On Energy Efficient Mobile Hydraulic Systems : with Focus on Linear Actuation

    OpenAIRE

    Heybroek, Kim

    2017-01-01

    In this dissertation, energy efficient hydraulic systems are studied. The research focuses on solutions for linear actuators in mobile applications, with emphasis on construction machines. Alongside the aspect of energy efficiency, the thesis deals with competing aspects in hydraulic system design found in the development of construction machines. Simulation models and controls for different concepts are developed, taking the whole machine into account. In line with this work, several proof o...

  1. Regulatory focus, self-efficacy and outcome expectations as drivers of motivation to consume healthy food products

    DEFF Research Database (Denmark)

    Tudoran, Ana Alina; Scholderer, Joachim; Brunsø, Karen

    2012-01-01

    In this paper we apply the principle of RegulatoryFocus Theory to investigate the interaction between self-efficacy and outcomeexpectations on individuals’ intentions to adopt health behaviors. The participants, 959 individuals (Survey 1) and 2400 individuals (Survey 2), reported self-efficacy be......In this paper we apply the principle of RegulatoryFocus Theory to investigate the interaction between self-efficacy and outcomeexpectations on individuals’ intentions to adopt health behaviors. The participants, 959 individuals (Survey 1) and 2400 individuals (Survey 2), reported self...

  2. Auras in temporal lobe epilepsy with hippocampal sclerosis: relation to seizure focus laterality and post surgical outcome.

    Science.gov (United States)

    Ferrari-Marinho, Taíssa; Caboclo, Luís Otávio S F; Marinho, Murilo M; Centeno, Ricardo S; Neves, Rafael S C; Santana, Maria Teresa C G; Brito, Fernanda S; Junior, Henrique Carrete; Yacubian, Elza Márcia T

    2012-05-01

    We examined the relationship between presence and frequency of different types of auras and side of lesion and post surgical outcomes in 205 patients with medically intractable mesial temporal lobe epilepsy (MTLE) with unilateral hippocampal sclerosis (HS). With respect to the number of auras, multiple auras were not associated with side of lesion (p=0.551). The side of HS was not associated with the type of auras reported. One hundred fifty-seven patients were operated. The occurrence of multiple auras was not associated with post-surgical outcome (p=0.740). The presence of extratemporal auras was significantly higher in patients with poor outcome. In conclusion, this study suggests that the presence of extratemporal auras in patients with MTLE-HS possibly reflects extratemporal epileptogenicity in these patients, who otherwise showed features suggestive of TLE. Therefore, TLE-HS patients undergoing pre-surgical evaluation and presenting clinical symptoms suggestive of extratemporal involvement should be more extensively evaluated to avoid incomplete resection of the epileptogenic zone. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. Comparison of focused cognitive training and portable "brain-games" on functional outcomes for vocational rehabilitation participants.

    Science.gov (United States)

    Bell, Morris D; Laws, Holly; Pittman, Brian; Johannesen, Jason K

    2018-01-29

    Cognitive remediation performed in a cognitive laboratory was compared with a sham control using portable brain games to study effects on vocational, neurocognitive, and functional outcomes for participants with psychotic disorders in vocational rehabilitation (VR). Seventy-seven participants (61% schizophrenia, 39% other psychosis) in transitional (45.5%) or supported employment (54.5%) were randomly assigned to 6 months of portable cognitive-games (CG) or cognitive remediation (CR) plus a weekly goal-setting group, and evaluated during training, post-training and at 12 months. Overall rates of employment did not differ significantly at 12-month follow-up; however, VR + CG attained employment more rapidly during training. A significant time by condition interaction favored VR + CR on Quality of Life Total Score and Instrumental Functioning over 12 months. Neurocognitive outcomes favored VR + CR, particularly on attention. Training hours related significantly to neurocognitive improvement regardless of condition. No differences were found in training adherence despite portability for VR + CG. Results indicate that VR + CR had significantly greater effect than VR + CG on neurocognition and community functioning, but not on employment outcome. Job attainment rates during the training period revealed a potential advantage for portable training raising new questions concerning how cognitive remediation can be most effectively integrated with VR.

  4. A new adaptive light beam focusing principle for scanning light stimulation systems.

    Science.gov (United States)

    Bitzer, L A; Meseth, M; Benson, N; Schmechel, R

    2013-02-01

    In this article a novel principle to achieve optimal focusing conditions or rather the smallest possible beam diameter for scanning light stimulation systems is presented. It is based on the following methodology: First, a reference point on a camera sensor is introduced where optimal focusing conditions are adjusted and the distance between the light focusing optic and the reference point is determined using a laser displacement sensor. In a second step, this displacement sensor is used to map the topography of the sample under investigation. Finally, the actual measurement is conducted, using optimal focusing conditions in each measurement point at the sample surface, that are determined by the height difference between camera sensor and the sample topography. This principle is independent of the measurement values, the optical or electrical properties of the sample, the used light source, or the selected wavelength. Furthermore, the samples can be tilted, rough, bent, or of different surface materials. In the following the principle is implemented using an optical beam induced current system, but basically it can be applied to any other scanning light stimulation system. Measurements to demonstrate its operation are shown, using a polycrystalline silicon solar cell.

  5. Air Pollution Monitoring Changes to Accompany the Transition from a Control to a Systems Focus

    Directory of Open Access Journals (Sweden)

    Daniel A. Vallero

    2016-11-01

    Full Text Available During the 20th century, air pollution control technologies grew at an amazingly rapid rate. Air quality in much of the industrialized world greatly improved as the efficiencies of these technologies improved. This continued improvement in pollution control has more recently been complemented with measures to prevent the emission of air pollutants. The previous, exclusive focus on treatment requires systems thinking. This review provides a framework for this Special Issue of Sustainability by describing the new tools that are needed to support this new, broader focus, including life cycle assessments, exposure models, and sustainable design.

  6. Gamified systems development focused on edutertainment and player: an analysis of Bartle and Marczewski archetipes

    Directory of Open Access Journals (Sweden)

    Shelley Navari Christianini

    2016-05-01

    Full Text Available This paper presents a development methodology about gamification systems, in which discuss the learning in these media from entertainment, concept defined as Edutertainment. By employing gamification in this type of production, it is believed that the investigation must be focused only on the playing techniques. However, from a literature review, it was found that the focus should be on the player, considering their feelings and real motivations to stay in the system. As a result, it is providing a comparative overview on the theories of Bartle (1996, 2005 and Marczewski (2015 with the main differences between player types in gaming environments and gamification systems, especially with regard to motivational strategies in the context of education.

  7. Extended capture range for focus-diverse phase retrieval in segmented aperture systems using geometrical optics.

    Science.gov (United States)

    Jurling, Alden S; Fienup, James R

    2014-03-01

    Extending previous work by Thurman on wavefront sensing for segmented-aperture systems, we developed an algorithm for estimating segment tips and tilts from multiple point spread functions in different defocused planes. We also developed methods for overcoming two common modes for stagnation in nonlinear optimization-based phase retrieval algorithms for segmented systems. We showed that when used together, these methods largely solve the capture range problem in focus-diverse phase retrieval for segmented systems with large tips and tilts. Monte Carlo simulations produced a rate of success better than 98% for the combined approach.

  8. Organizational culture focused on quality management and benefits derived from an ERP system implementation

    Directory of Open Access Journals (Sweden)

    Oscar F. Bustinza

    2013-01-01

    Full Text Available Purpose: Organizational culture focused on quality management aims to meet customer needs and enhance teamwork, being oriented toward a dynamic process of continuous improvement. The purpose of this paper is to analyze whether, indeed, the quality-oriented culture has an effect on the management of business processes. In doing so, we analyze their relationship with the benefits of a resource management system or ERP.Design/methodology/approach: A survey is used to collect data, with valid questionnaires obtained for 200 Spain based respondents. Empirical analysis utilises Structural Equation Modelling (SEM.Findings: The results confirm that firm's commitment with quality management, customer focus, and confidence of workers has a positive effect on the results of operational, strategic and managerial benefits derived from an ERP system implementation. However, there is not relationship between customer focus and organizational benefits, neither to increase system capacity.Originality/value: The present study analyzes the relationship between quality-oriented culture and the resource management systems of the firm clarifying their strengths and limitations. In this sense, the customer orientation may limit the flexibility of business as require a lot of resources, and generate dissatisfaction among workers resulting from the attention to customer complaints.

  9. Pregnancy in complex CHD: focus on patients with Fontan circulation and patients with a systemic right ventricle.

    Science.gov (United States)

    Khan, Abigail; Kim, Yuli Y

    2015-12-01

    The majority of children with congenital heart disease (CHD) now survive into adulthood, and many women with CHD want to pursue pregnancy. Pregnancy represents a complex issue for the CHD care provider. It requires balancing the interests of the woman against the risk to her health during pregnancy, while also factoring in the long-term risks to her health and the risk to her fetus. Our knowledge about this subject has been historically limited by lack of data regarding the outcome of pregnancy in CHD; however, in recent years, more data have begun to emerge. In this review, we will summarise what is known about risk assessment in pregnant CHD patients. We provide a framework for healthcare providers managing pregnancy in this population, with focus on the systemic right ventricle and the Fontan operation.

  10. Beam self-excited rf cavity driver for a deflector or focusing system

    International Nuclear Information System (INIS)

    Wadlinger, E.A.

    1996-01-01

    A bunched beam from and accelerator can excite and power an rf cavity which then drives either a deflecting or focusing (including nonlinear focusing) rf cavity with and amplitude related to beam current. Rf power, generated when a bunched beam loses energy to an rf field when traversing an electric field that opposes the particle's motion, is used to drive a separate (or the same) cavity to either focus or deflect the beam. The deflected beam can be stopped by an apertures or directed to a different area of a target depending on beam current. The beam-generated rf power can drive a radio-frequency quadrupole (RFQ) that can change the focusing properties of a beam channel as a function of beam current (space- charge force compensation or modifying the beam distribution on a target). An rf deflector can offset a beam to a downstream sextupole, effectively producing a position-dependent quadrupole field. The combination of rf deflector plus sextupole will produce a beam current dependent quadropole-focusing force. A static quadrupole magnet plus another rf deflector can place the beam back on the optic axis. This paper describes the concept, derives the appropriate equations for system analysis, and fives examples. A variation on this theme is to use the wake field generated in an rf cavity to cause growth in the beam emittance. The beam current would then be apertured by emittance defining slits

  11. Concepts in context: Processing mental state concepts with internal or external focus involves different neural systems

    Science.gov (United States)

    Oosterwijk, Suzanne; Mackey, Scott; Wilson-Mendenhall, Christine; Winkielman, Piotr; Paulus, Martin P.

    2015-01-01

    According to embodied cognition theories concepts are contextually-situated and grounded in neural systems that produce experiential states. This view predicts that processing mental state concepts recruits neural regions associated with different aspects of experience depending on the context in which people understand a concept. This neuroimaging study tested this prediction using a set of sentences that described emotional (e.g., fear, joy) and non-emotional (e.g., thinking, hunger) mental states with internal focus (i.e. focusing on bodily sensations and introspection) or external focus (i.e. focusing on expression and action). Consistent with our predictions, data suggested that the inferior frontal gyrus, a region associated with action representation, was engaged more by external than internal sentences. By contrast, the ventromedial prefrontal cortex, a region associated with the generation of internal states, was engaged more by internal emotion sentences than external sentence categories. Similar patterns emerged when we examined the relationship between neural activity and independent ratings of sentence focus. Furthermore, ratings of emotion were associated with activation in the medial prefrontal cortex, whereas ratings of activity were associated with activation in the inferior frontal gyrus. These results suggest that mental state concepts are represented in a dynamic way, using context-relevant interoceptive and sensorimotor resources. PMID:25748274

  12. Beam self-excited rf cavity driver for a deflector or focusing system

    International Nuclear Information System (INIS)

    Wadlinger, E.A.

    1996-01-01

    A bunched beam from an accelerator can excite and power an rf cavity which then drives either a deflecting or focusing (including nonlinear focusing) rf cavity with an amplitude related to beam current. Rf power, generated when a bunched beam loses energy to an rf field when traversing an electric field that opposes the particle's motion, is used to drive a separate (or the same) cavity to either focus or deflect the beam. The deflected beam can be stopped by an aperture or directed to a different area of a target depending on beam current. The beam-generated rf power can drive a radiofrequency quadrupole that can change the focusing properties of a beam channel as a function of beam current (space-charge-force compensation or modifying the beam distribution on a target). An rf deflector can offset a beam to a downstream sextupole, effectively producing a position-dependent quadrupole field. The combination of rf deflector plus sextupole will produce a beam current dependent quadrupole-focusing force. A static quadrupole magnet plus another rf deflector can place the beam back on the optic axis. This paper describes the concept, derives the appropriate equations for system analysis, and gives examples. A variation on this theme is to use the wake field generated in an rf cavity to cause growth in the beam emittance. The beam current would then be apertured by emittance defining slits. (author)

  13. Irrational reactions to negative outcomes: evidence for two conceptual systems.

    Science.gov (United States)

    Epstein, S; Lipson, A; Holstein, C; Huh, E

    1992-02-01

    According to cognitive-experiential self-theory (CEST), individuals have 2 systems for processing information, a rational system and an experiential system. Research conducted under norm theory (NT) has provided impressive evidence of an if only (IO) effect associated with postoutcome processing of aversive events that are highly consistent with formulations in CEST. Two studies involving vignettes adapted from NT were conducted that tested 4 hypotheses and corollaries derived from CEST. It was demonstrated, in support of hypotheses, that the IO effect can be obtained with ratings of one's own and of a protagonist's specific behaviors, as well as with ratings of a protagonist's diffuse emotions (the usual procedure); that a rational orientation decreases the IO effect; that increasing the intensity of outcomes increases it; and that priming the experiential system reduces people's ability to subsequently think rationally. The theoretical and research implications of these findings are discussed.

  14. Enhancing the Effectiveness of Consumer-Focused Health Information Technology Systems Through eHealth Literacy

    DEFF Research Database (Denmark)

    Kayser, Lars; Kushniruk, Andre; Osborne, Richard H

    2015-01-01

    BACKGROUND: eHealth systems and applications are increasingly focused on supporting consumers to directly engage with and use health care services. Involving end users in the design of these systems is critical to ensure a generation of usable and effective eHealth products and systems. Often...... the end users engaged for these participatory design processes are not actual representatives of the general population, and developers may have limited understanding about how well they might represent the full range of intended users of the eHealth products. As a consequence, resulting information...... model with the domains of a new concept of eHealth literacy. METHODS: This approach expands an existing method for supporting health IT system development, which advocates use of a three-dimensional user-task-context matrix to comprehensively identify the users of health IT systems, and what their needs...

  15. Preliminary study on development of 300 Kv compact focused gaseous ion beam system

    Energy Technology Data Exchange (ETDEWEB)

    Ohkubo, T.; Ishii, Y.; Kamiya, T. [Takasaki Advanced Radiation Research Institute, Japan Atomic Energy Agency (JAEA) 1233 Watanuki-machi, Takasaki, Gunma, 370-1292 (Japan); Miyake, Y. [Beam Seiko Instruments Inc., 2-10-1 Kamata, Ohta-ku, Tokyo, 144-0052 (Japan)

    2013-04-19

    A new 300 kV compact focused gaseous ion beam (gas-FIB) system with three-stage acceleration lens was constructed at JAEA. The preliminary experiments of formation of the focused gaseous ion beams were carried out to show the availability of the gas-FIB system as a writing tool for 3D proton lithography. As a result of the experiments, it was proved that the focal point was kept at the same position under changing the kinetic energy but with keeping the kinetic energy ratio constant, which was defined as the ratio of kinetic energy in object side to that in image side for the third acceleration lens. This characteristic of the gas-FIB is a good point to advance the 3D proton lithography changing penetration depth in a sample by varying the beam energy.

  16. Preliminary study on development of 300 Kv compact focused gaseous ion beam system

    International Nuclear Information System (INIS)

    Ohkubo, T.; Ishii, Y.; Kamiya, T.; Miyake, Y.

    2013-01-01

    A new 300 kV compact focused gaseous ion beam (gas-FIB) system with three-stage acceleration lens was constructed at JAEA. The preliminary experiments of formation of the focused gaseous ion beams were carried out to show the availability of the gas-FIB system as a writing tool for 3D proton lithography. As a result of the experiments, it was proved that the focal point was kept at the same position under changing the kinetic energy but with keeping the kinetic energy ratio constant, which was defined as the ratio of kinetic energy in object side to that in image side for the third acceleration lens. This characteristic of the gas-FIB is a good point to advance the 3D proton lithography changing penetration depth in a sample by varying the beam energy.

  17. Operational experience with optical matching in the SLC Final Focus System

    International Nuclear Information System (INIS)

    Bambade, P.; Burchat, P.; Burke, D.

    1989-01-01

    In the SLC Final Focus System, all components of transverse phase-space and the couplings between them must be controlled to minimize the beam size at the interaction point. After summarizing the experimental algorithm and the on-line tuning programs, we present a consistent set of measurements and describe our present understanding of the various contributions to this beam size. 17 refs., 9 figs

  18. Resilience assessment of interdependent infrastructure systems: With a focus on joint restoration modeling and analysis

    International Nuclear Information System (INIS)

    Ouyang, Min; Wang, Zhenghua

    2015-01-01

    As infrastructure systems are highly interconnected, it is crucial to analyze their resilience with the consideration of their interdependencies. This paper adapts an existing resilience assessment framework for single systems to interdependent systems and mainly focuses on modeling and resilience contribution analysis of multi-systems’ joint restoration processes, which are seldom addressed in the literature. Taking interdependent power and gas systems in Houston, Texas, USA under hurricane hazards as an illustrative exmaple, five types of joint restoration stategies are proposed, including random restoration strategy RS 1 , independent restoration strategy RS 2 , power first and gas second restoration strategy RS 3 , gas aimed restoration strategy RS 4 , and power and gas compromised restoration strategy RS 5 . Results show that under limited restoration resources, RS 1 produces the least resilience for both systems, RS 2 and RS 3 both generates the largest power system resilience while RS 4 is the best for the gas system; and if quantifying the total resilience as the evenly weighted sum of two systems’ individual resilience, RS 5 produces the largest total resilience. The proposed method can help decision makers search optimum joint restoration strategy, which can significantly enhance both systems’ resilience. - Highlights: • We propose a method to assess resilience of interdependent infrastructure systems. • We consider unidirectional interdependencies from power system to gas system. • Multi-systems’ restoration processes are solved by using genetic algorithm. • Effectiveness of five restoration strategies are compared and analyzed. • Interdependency-based strategies produce the largest total resilience

  19. A homogeneous focusing system for diode lasers and its applications in metal surface modification

    Science.gov (United States)

    Wang, Fei; Zhong, Lijing; Tang, Xiahui; Xu, Chengwen; Wan, Chenhao

    2018-06-01

    High power diode lasers are applied in many different areas, including surface modification, welding and cutting. It is an important technical trend in laser processing of metals in the future. This paper aims to analyze the impact of the shape and homogeneity of the focal spot of the diode laser on surface modification. A focusing system using the triplet lenses for a direct output diode laser which can be used to eliminate coma aberrations is studied. A rectangular stripe with an aspect ratio from 8:1 to 25:1 is obtained, in which the power is homogeneously distributed along the fast axis, the power is 1117.6 W and the peak power intensity is 1.1587 × 106 W/cm2. This paper also presents a homogeneous focusing system by use of a Fresnel lens, in which the incident beam size is 40 × 40 mm2, the focal length is 380 mm, and the dimension of the obtained focal spot is 2 × 10 mm2. When the divergence angle of the incident light is in the range of 12.5-20 mrad and the pitch is 1 mm, the obtained homogeneity in the focal spot is the optimum (about 95.22%). Experimental results show that the measured focal spot size is 2.04 × 10.39 mm2. This research presents a novel design of homogeneous focusing systems for high power diode lasers.

  20. Limbic system, the main focus of dementia syndrome; A study with MRI and PET

    Energy Technology Data Exchange (ETDEWEB)

    Matsuzawa, Taiju [Morinosato Hospital, Atsugi, Kanagawa (Japan)

    1990-12-01

    Alzheimer disease and multi-infarct dementia are two entirely different diseases producing almost the same abnormalities as dementia syndrome. The statistical studies with MRI to locate the focus of dementia syndrome in the neocortex was an absolute failure. With MRI there is drastic atrophy and destruction of the amygdala and hippocampus suggesting the limbic system as the focus of dementia syndrome. Destruction of the limbic system in particular amygdala and hippocampus produced the functional obstruction brought about by the marked reduction in the glucose utilization with PET in the bilateral temporal, parietal and occipital association cortices. Although this type constitutes only about 1/5 of all dementia patients. It is considered the fundamental type of dementia syndrome. Aside from this, there is a type wherein simultaneous and symmetrical reductions in glucose utilization of the frontal association cortex and the motor association cortex in the anterior part of the neocortex. This is referred to as type II. It constitutes about 4/5 of all dementia patients which is far more than type I. Based on these results, it is thought that limbic system is the main focus of dementia syndrome. (author).

  1. The proposed alignment system for the Final Focus Test Beam at SLAC

    International Nuclear Information System (INIS)

    Ruland, R.E.; Fischer, G.E.

    1990-09-01

    This report describes the current state of work in progress with respect to the geometry, alignment requirements, scenarios, and hardware for meeting the tolerances of the Final Focus Test Beam (FFTB) at SLAC. The methods and systems proposed acknowledge that component motion at the micron level, from whatever cause (ground motion, thermal effects, etc.) must be measured on-line and compensated for on relatively short time scales. To provide an integrated alignment/positioning package, some unique designs for reference systems, calibration of effect electric and magnetic centers, and component movers are introduced. 24 refs., 28 figs

  2. Study on Differential Algebraic Method of Aberrations up to Arbitrary Order for Combined Electromagnetic Focusing Systems

    Institute of Scientific and Technical Information of China (English)

    CHENG Min; TANG Tiantong; YAO Zhenhua; ZHU Jingping

    2001-01-01

    Differential algebraic method is apowerful technique in computer numerical analysisbased on nonstandard analysis and formal series the-ory. It can compute arbitrary high order derivativeswith excellent accuracy. The principle of differentialalgebraic method is applied to calculate high orderaberrations of combined electromagnetic focusing sys-tems. As an example, third-order geometric aberra-tion coefficients of an actual combined electromagneticfocusing system were calculated. The arbitrary highorder aberrations are conveniently calculated by dif-ferential algebraic method and the fifth-order aberra-tion diagrams are given.

  3. Spherical aberration of an optical system and its influence on depth of focus.

    Science.gov (United States)

    Mikš, Antonín; Pokorný, Petr

    2017-06-10

    This paper analyzes the influence of spherical aberration on the depth of focus of symmetrical optical systems for imaging of axial points. A calculation of a beam's caustics is discussed using ray equations in the image plane and considering longitudinal spherical aberration as well. Concurrently, the influence of aberration coefficients on extremes of such a curve is presented. Afterwards, conditions for aberration coefficients are derived if the Strehl definition should be the same in two symmetrically placed planes with respect to the paraxial image plane. Such conditions for optical systems with large aberrations are derived with the use of geometric-optical approximation where the gyration diameter of the beam in given planes of the optical system is evaluated. Therefore, one can calculate aberration coefficients in such a way that the optical system generates a beam of rays that has the gyration radius in a given interval smaller than the defined limit value. Moreover, one can calculate the maximal depth of focus of the optical system respecting the aforementioned conditions.

  4. A transactional framework for pediatric rehabilitation: shifting the focus to situated contexts, transactional processes, and adaptive developmental outcomes.

    Science.gov (United States)

    King, Gillian; Imms, Christine; Stewart, Debra; Freeman, Matt; Nguyen, Tram

    2018-07-01

    A paradigm shift is taking place in pediatric rehabilitation research, practice, and policy - a shift towards the real-life contexts of clients rather than requiring clients to navigate the world of pediatric rehabilitation. This article proposes a conceptual framework to bring about a broader awareness of clients' lives and transactional processes of change over the life course. The framework draws attention to transactional processes by which individuals, situated in life contexts, change and adapt over the life course and, in turn, influence their contextual settings and broader environments. This framework is based on (a) basic tenets derived from foundational theories taking a life course perspective to change, and (b) transactional processes identified from relevant pediatric rehabilitation models that bring these foundational theories into the pediatric rehabilitation sphere. The framework identifies three types of transactional processes relevant to pediatric rehabilitation: facilitative, resiliency, and socialization processes. These processes describe how contexts and people mutually influence each other via opportunities and situated experiences, thus facilitating capacity, adaptation to adversity, and socialization to new roles and life transitions. The utility of the framework is considered for research, practice, service organizations, and policy. Implications for Rehabilitation The framework supports practitioners going beyond person and environment as separate entities, to provide services to the "situated person" in real-life contexts The framework shifts the focus from "body structures/functions" and "person in activity" to "person in changing and challenging life contexts" Working from a transactional perspective, practitioner-client conversations will change; practitioners will view client situations through a lens of opportunities and experiences, assess client experiences in real-life contexts, and strive to create context-based therapy

  5. Protein energy wasting in chronic kidney disease: An update with focus on nutritional interventions to improve outcomes

    Directory of Open Access Journals (Sweden)

    Yashpal P Jadeja

    2012-01-01

    Full Text Available Protein-energy wasting (PEW is common in patients with chronic kidney disease (CKD. PEW is one of the strongest predictors of mortality in patients with CKD. The International Society of Renal Nutrition and Metabolism (ISRNM expert panel has defined PEW as a, "state of decreased body stores of protein and energy fuels (body protein and fat masses". The ISRNM panel has also proposed diagnostic criteria of PEW with four categories. Cachexia is a severe form of PEW. The proposed causes of PEW are multi-factorial and include nutritional and non-nutritional mechanisms. The literature indicates that PEW can be mitigated or corrected with an appropriate diet and enteral nutritional support that targets dietary protein intake. Dietary requirements and enteral nutritional support must also be considered in patients with CKD and diabetes mellitus and in children with CKD, in addition to dialysis patients. Features of ideal dietary supplement have also been discussed. Dietary interventions such as enteral feeding with high-protein meals or supplements might improve the nutritional status and outcomes in dialysis patients.

  6. Health systems performance in sub-Saharan Africa: governance, outcome and equity.

    Science.gov (United States)

    Olafsdottir, Anna E; Reidpath, Daniel D; Pokhrel, Subhash; Allotey, Pascale

    2011-04-16

    The literature on health systems focuses largely on the performance of healthcare systems operationalised around indicators such as hospital beds, maternity care and immunisation coverage. A broader definition of health systems however, needs to include the wider determinants of health including, possibly, governance and its relationship to health and health equity. The aim of this study was to examine the relationship between health systems outcomes and equity, and governance as a part of a process to extend the range of indicators used to assess health systems performance. Using cross sectional data from 46 countries in the African region of the World Health Organization, an ecological analysis was conducted to examine the relationship between governance and health systems performance. The data were analysed using multiple linear regression and a standard progressive modelling procedure. The under-five mortality rate (U5MR) was used as the health outcome measure and the ratio of U5MR in the wealthiest and poorest quintiles was used as the measure of health equity. Governance was measured using two contextually relevant indices developed by the Mo Ibrahim Foundation. Governance was strongly associated with U5MR and moderately associated with the U5MR quintile ratio. After controlling for possible confounding by healthcare, finance, education, and water and sanitation, governance remained significantly associated with U5MR. Governance was not, however, significantly associated with equity in U5MR outcomes. This study suggests that the quality of governance may be an important structural determinant of health systems performance, and could be an indicator to be monitored. The association suggests there might be a causal relationship. However, the cross-sectional design, the level of missing data, and the small sample size, forces tentative conclusions. Further research will be needed to assess the causal relationship, and its generalizability beyond U5MR as a health

  7. Health systems performance in sub-Saharan Africa: governance, outcome and equity

    Directory of Open Access Journals (Sweden)

    Pokhrel Subhash

    2011-04-01

    Full Text Available Abstract Background The literature on health systems focuses largely on the performance of healthcare systems operationalised around indicators such as hospital beds, maternity care and immunisation coverage. A broader definition of health systems however, needs to include the wider determinants of health including, possibly, governance and its relationship to health and health equity. The aim of this study was to examine the relationship between health systems outcomes and equity, and governance as a part of a process to extend the range of indicators used to assess health systems performance. Methods Using cross sectional data from 46 countries in the African region of the World Health Organization, an ecological analysis was conducted to examine the relationship between governance and health systems performance. The data were analysed using multiple linear regression and a standard progressive modelling procedure. The under-five mortality rate (U5MR was used as the health outcome measure and the ratio of U5MR in the wealthiest and poorest quintiles was used as the measure of health equity. Governance was measured using two contextually relevant indices developed by the Mo Ibrahim Foundation. Results Governance was strongly associated with U5MR and moderately associated with the U5MR quintile ratio. After controlling for possible confounding by healthcare, finance, education, and water and sanitation, governance remained significantly associated with U5MR. Governance was not, however, significantly associated with equity in U5MR outcomes. Conclusion This study suggests that the quality of governance may be an important structural determinant of health systems performance, and could be an indicator to be monitored. The association suggests there might be a causal relationship. However, the cross-sectional design, the level of missing data, and the small sample size, forces tentative conclusions. Further research will be needed to assess the

  8. Design optimization of the International Linear Collider Final Focus System with a long L*

    CERN Document Server

    Plassard, Fabien

    This Master's Thesis work has been done in the Aerospace Engineering master's programme framework and carried out at the European Organization for Nuclear Research (CERN). It was conducted under the 500 GeV e-e+ International Linear Collider (ILC) study and focused on the design and performance optimization of the Final Focus System (FFS). The purpose of the final focus system of the future linear colliders (ILC and CLIC) is to demagnify the beam to the required transverse size at the interaction point (IP). The FFS is designed for a flat-beam in a compact way based on a local chromaticity correction which corrects both horizontal and vertical chromaticities simultaneously. An alternative FFS configuration based on the traditional scheme with two dedicated chromatic correction sections for horizontal and vertical chromaticities and a long L * option has been developed. A longer free space between the last quadrupole and the IP allows to place the last quadrupole on a stable ground, with fewer engineering ...

  9. Outcome of the Pediatric Patients with Portal Cavernoma: The Retrospective Study for 10 Years Focusing on Recurrent Variceal Bleeding

    Directory of Open Access Journals (Sweden)

    Hongjie Guo

    2016-01-01

    Full Text Available Background. Portal cavernoma (PC is the most critical condition with risk or variceal hemorrhage in pediatric patients. We retrospectively investigated the patients with PC focusing on the predictors for recurrent variceal bleeding. Methods. Between July 2003 and June 2013, we retrospectively enrolled all consecutive patients admitted to our department with a diagnosis of PC without abdominal malignancy or liver cirrhosis. The primary endpoint of this observational study was recurrent variceal bleeding. Independent predictors of recurrent variceal bleeding were identified using the logistic regression model. Results. A total of 157 patients were enrolled in the study. During the follow-up period, 24 patients exhibited onset of recurrent variceal bleeding. Acute variceal bleeding was subjected to conservative symptomatic treatment and emergency endoscopic sclerotherapy. Surgical procedure selection was based on the severity of vascular dilation and collateral circulation. Multivariate logistic regression analysis demonstrated that the presence of ascites, collateral circulation, and portal venous pressure were independent prognostic factors of recurrent variceal bleeding for patients with portal cavernoma. Conclusions. The presence of ascites, collateral circulation, and portal venous pressure evaluation are important and could predict the postsurgical recurrent variceal bleeding in patients with portal cavernoma.

  10. Using the Human Systems Simulation Laboratory at Idaho National Laboratory for Safety Focused Research

    Energy Technology Data Exchange (ETDEWEB)

    Joe, Jeffrey .C; Boring, Ronald L.

    2016-07-01

    Under the United States (U.S.) Department of Energy (DOE) Light Water Reactor Sustainability (LWRS) program, researchers at Idaho National Laboratory (INL) have been using the Human Systems Simulation Laboratory (HSSL) to conduct critical safety focused Human Factors research and development (R&D) for the nuclear industry. The LWRS program has the overall objective to develop the scientific basis to extend existing nuclear power plant (NPP) operating life beyond the current 60-year licensing period and to ensure their long-term reliability, productivity, safety, and security. One focus area for LWRS is the NPP main control room (MCR), because many of the instrumentation and control (I&C) system technologies installed in the MCR, while highly reliable and safe, are now difficult to replace and are therefore limiting the operating life of the NPP. This paper describes how INL researchers use the HSSL to conduct Human Factors R&D on modernizing or upgrading these I&C systems in a step-wise manner, and how the HSSL has addressed a significant gap in how to upgrade systems and technologies that are built to last, and therefore require careful integration of analog and new advanced digital technologies.

  11. Public outcomes: Building a 21st century national innovation system that serves the public

    Energy Technology Data Exchange (ETDEWEB)

    Gover, J. [Sandia National Labs., Albuquerque, NM (United States); Huray, P.; Carayannis, E. [George Washington Univ., Washington, DC (United States)

    1997-09-01

    Federal R and D must be principally focused on solving public problems that the marketplace is failing to address. With few exceptions programs must be supported by roadmaps that show how the R and D is linked to public outcomes. Federal R and D and those who perform it must be judged in terms of the public outcomes. The overarching issues of federal R and D policy, what it should address, how to manage it, who should perform it, how to perform it, what works best, etc. are highly complex and lack a strong theoretical foundation. (In fact, the linear, assembly-line model used by policymakers is wrong.) It is time that policymakers recognize and acknowledge the uncertainty of their work and conduct a wide array of policy experiments (the authors consider SEMATECH such an experiment) that are supported by public outcome metrics. In addition to making federal R and D better address public needs, such an approach to policy making could raise the public`s interest in T and S policy. Of course, as in any experiment the results may be measured and if failures aren`t observed, it is likely that policies lack vision and imagination. It is time to abandon the budget driven federal R and D system where performers of federal R and D are treated as constituents, and replace it with a public problem--public outcome driven system where public problems are prioritized and the budget is distributed to agencies according to these priorities.

  12. Inertial confinement fusion driver enhancements: Final focusing systems and compact heavy-ion driver designs

    International Nuclear Information System (INIS)

    Bieri, R.L.

    1991-01-01

    Required elements of an inertial confinement fusion power plant are modeled and discussed. A detailed analysis of two critical elements of candidate drivers is done, and new component designs are proposed to increase the credibility and feasibility of each driver system. An analysis of neutron damage to the final elements of a laser focusing system is presented, and multilayer -- dielectric mirrors are shown to have damage lifetimes which axe too short to be useful in a commercial power plant. A new final-focusing system using grazing incidence metal mirrors to protect sensitive laser optics is designed and shown to be effective in extending the lifetime of the final focusing system. The reflectivities and damage limits of grazing incidence metal mirrors are examined in detail, and the required mirror sizes are shown to be compatible with the beam sizes and illumination geometries currently envisioned for laser drivers. A detailed design and analysis is also done for compact arrays of superconducting magnetic quadrupoles, which are needed in a multi-beam heavy-ion driver. The new array model is developed in more detail than some previous conceptual designs and models arrays which are more compact than arrays scaled from existing single -- quadrupole designs. The improved integrated model for compact arrays is used to compare the effects of various quadrupole array design choices on the size and cost of a heavy-ion driver. Array design choices which significantly affect the cost of a heavy-ion driver include the choice of superconducting material and the thickness of the collar used to support the winding stresses. The effect of these array design choices on driver size and cost is examined and the array model is used to estimate driver cost savings and performance improvements attainable with aggressive quadrupole array designs with high-performance superconductors

  13. Pathways towards chronic care-focused healthcare systems: evidence from Spain.

    Science.gov (United States)

    García-Goñi, Manuel; Hernández-Quevedo, Cristina; Nuño-Solinís, Roberto; Paolucci, Francesco

    2012-12-01

    Increasing healthcare expenditure is a matter of concern in many countries, particularly in relation to the underlying drivers of such escalation that include ageing, medical innovation, and changes in the burden of disease, such as the growing prevalence of chronic diseases. Most healthcare systems in developed countries have been designed to 'cure' acute episodes, rather than to 'manage' chronic conditions, and therefore they are not suitably or efficiently organized to respond to the changing needs and preferences of users. New models of chronic care provision have been developed to respond to the changing burden of disease and there is already considerable practical experience in several different countries showing their advantages but also the difficulties associated with their implementation. In this paper, we focus on the Spanish experience in terms of policy changes and pilot studies focused on testing the feasibility of moving towards chronic care models. In particular, we discuss a framework that identifies and analyses ten key prerequisites to achieving high performing chronic care-based healthcare systems and apply it to the current Spanish National Health System (NHS). We find that the design of the Spanish NHS already meets some of these pre-requisites. However, other features are still in their early stages of development or are being applied only in limited geographical and clinical contexts. We outline the policies that are being implemented and the pathway that the Spanish NHS is taking to address the crucial challenge of the transition towards an optimal health system focused on chronic care. Given the current evidence and trends, we expect that the pathway for developing a chronicity strategy being followed by the Spanish NHS will significantly transform its current healthcare delivery model in the next few years. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  14. Pediatric Early Warning Score Systems, Nurses Perspective - A Focus Group Study

    DEFF Research Database (Denmark)

    Jensen, Claus Sixtus; Nielsen, Pia Bonde; Olesen, Hanne Vebert

    2018-01-01

    PURPOSE: Pediatric early warning score (PEWS) systems are used to monitor pediatric patients' vital signs and facilitate the treatment of patients at risk of deteriorating. The aim of this study was to gain knowledge about nurses' experiences with PEWS and to highlight factors facilitating...... and impeding the use of PEWS tools in clinical practice. DESIGN AND METHODS: An exploratory qualitative design was chosen using focus group interviews to gain a deeper understanding of nurses' experiences with PEWS. A total of five focus group interviews were conducted at three hospitals, and a qualitative......'s - a challenge, v) PEWS helps to visualize the need for escalating care, vi) an inflexible and challenging tool, and vii) supportive tools enhance the nurses' experiences of PEWS positively. CONCLUSIONS: Our findings suggest that attention should be given to nurses' perceptions of how both clinical judgment...

  15. ACCOUNTING INFORMATION SYSTEMS: AN APPROACH FOCUSED ON OBJECTS WITH INTELLIGENT AGENTS

    Directory of Open Access Journals (Sweden)

    Marcelo Botelho da Costa Moraes

    2010-01-01

    Full Text Available Accounting aims at the treatment of information related to economic events within organizations. In order to do so, the double entry method is used (debt and credit accounting, which only considers monetary variations. With the development of information technologies, accounting information systems are born. In the 1980’s, the REA model (economic Resources, economic Events and economic Agents is created, which focuses on accounting information records, based on the association of economic resources, economic events and economic agents. The objective of this work is to demonstrate an object-oriented modeling with intelligent agents use, for information development and analysis focused on users. The proposed model is also analyzed according to accounting information quality, necessary for accounting information users, capable to comply with the needs of different user groups, with advantages in applications.

  16. Analytical approach to chromatic correction in the final focus system of circular colliders

    Directory of Open Access Journals (Sweden)

    Yunhai Cai

    2016-11-01

    Full Text Available A conventional final focus system in particle accelerators is systematically analyzed. We find simple relations between the parameters of two focus modules in the final telescope. Using the relations, we derive the chromatic Courant-Snyder parameters for the telescope. The parameters are scaled approximately according to (L^{*}/β_{y}^{*}δ, where L^{*} is the distance from the interaction point to the first quadrupole, β_{y}^{*} the vertical beta function at the interaction point, and δ the relative momentum deviation. Most importantly, we show how to compensate its chromaticity order by order in δ by a traditional correction module flanked by an asymmetric pair of harmonic multipoles. The method enables a circular Higgs collider with 2% momentum aperture and illuminates a path forward to 4% in the future.

  17. Does rural generalist focused medical school and family medicine training make a difference? Memorial University of Newfoundland outcomes.

    Science.gov (United States)

    Rourke, James; Asghari, Shabnam; Hurley, Oliver; Ravalia, Mohamed; Jong, Michael; Graham, Wendy; Parsons, Wanda; Duggan, Norah; O'Keefe, Danielle; Moffatt, Scott; Stringer, Katherine; Sturge Sparkes, Carolyn; Hippe, Janelle; Harris Walsh, Kristin; McKay, Donald; Samarasena, Asoka

    2018-03-01

    Rural recruitment and retention of physicians is a global issue. The Faculty of Medicine at Memorial University of Newfoundland, Canada, was established as a rural-focused medical school with a social accountability mandate that aimed to meet the healthcare needs of a sparse population distributed over a large landmass as well as the needs of other rural and remote areas of Canada. This study aimed to assess whether Memorial medical degree (MD) and postgraduate (PG) programs were effective at producing physicians for their province and rural physicians for Canada compared with other Canadian medical schools. This retrospective cohort study included medical school graduates who completed their PG training between 2004 and 2013 in Canada. Practice locations of study subjects were georeferenced and assigned to three geographic classes: Large Urban; Small City/Town; and Rural. Analyses were performed at two levels. (1) Provincial level analysis compared Memorial PG graduates practicing where they received their MD and/or PG training with other medical schools who are the only medical school in their province (n=4). (2) National-level analysis compared Memorial PG graduates practicing in rural Canada with all other Canadian medical schools (n=16). Descriptive and bivariate analyses were performed. Overall, 18 766 physicians practicing in Canada completed Canadian PG training (2004-2013), and of those, 8091 (43%) completed Family Medicine (FM) training. Of all physicians completing Canadian PG training, 1254 (7%) physicians were practicing rurally and of those, 1076 were family physicians. There were 379 Memorial PG graduates and of those, 208 (55%) completed FM training and 72 (19%) were practicing rurally, and of those practicing rurally, 56 were family physicians. At the national level, the percentage of all Memorial PG graduates (19.0%) and FM PG graduates (26.9%) practicing rurally was significantly better than the national average for PG (6.4%, p<0.000) and FM (12

  18. Leaf LIMS: A Flexible Laboratory Information Management System with a Synthetic Biology Focus.

    Science.gov (United States)

    Craig, Thomas; Holland, Richard; D'Amore, Rosalinda; Johnson, James R; McCue, Hannah V; West, Anthony; Zulkower, Valentin; Tekotte, Hille; Cai, Yizhi; Swan, Daniel; Davey, Robert P; Hertz-Fowler, Christiane; Hall, Anthony; Caddick, Mark

    2017-12-15

    This paper presents Leaf LIMS, a flexible laboratory information management system (LIMS) designed to address the complexity of synthetic biology workflows. At the project's inception there was a lack of a LIMS designed specifically to address synthetic biology processes, with most systems focused on either next generation sequencing or biobanks and clinical sample handling. Leaf LIMS implements integrated project, item, and laboratory stock tracking, offering complete sample and construct genealogy, materials and lot tracking, and modular assay data capture. Hence, it enables highly configurable task-based workflows and supports data capture from project inception to completion. As such, in addition to it supporting synthetic biology it is ideal for many laboratory environments with multiple projects and users. The system is deployed as a web application through Docker and is provided under a permissive MIT license. It is freely available for download at https://leaflims.github.io .

  19. Open-source, small-animal magnetic resonance-guided focused ultrasound system.

    Science.gov (United States)

    Poorman, Megan E; Chaplin, Vandiver L; Wilkens, Ken; Dockery, Mary D; Giorgio, Todd D; Grissom, William A; Caskey, Charles F

    2016-01-01

    MR-guided focused ultrasound or high-intensity focused ultrasound (MRgFUS/MRgHIFU) is a non-invasive therapeutic modality with many potential applications in areas such as cancer therapy, drug delivery, and blood-brain barrier opening. However, the large financial costs involved in developing preclinical MRgFUS systems represent a barrier to research groups interested in developing new techniques and applications. We aim to mitigate these challenges by detailing a validated, open-source preclinical MRgFUS system capable of delivering thermal and mechanical FUS in a quantifiable and repeatable manner under real-time MRI guidance. A hardware and software package was developed that includes closed-loop feedback controlled thermometry code and CAD drawings for a therapy table designed for a preclinical MRI scanner. For thermal treatments, the modular software uses a proportional integral derivative controller to maintain a precise focal temperature rise in the target given input from MR phase images obtained concurrently. The software computes the required voltage output and transmits it to a FUS transducer that is embedded in the delivery table within the magnet bore. The delivery table holds the FUS transducer, a small animal and its monitoring equipment, and a transmit/receive RF coil. The transducer is coupled to the animal via a water bath and is translatable in two dimensions from outside the magnet. The transducer is driven by a waveform generator and amplifier controlled by real-time software in Matlab. MR acoustic radiation force imaging is also implemented to confirm the position of the focus for mechanical and thermal treatments. The system was validated in tissue-mimicking phantoms and in vivo during murine tumor hyperthermia treatments. Sonications were successfully controlled over a range of temperatures and thermal doses for up to 20 min with minimal temperature overshoot. MR thermometry was validated with an optical temperature probe, and focus

  20. Progress and outcomes of health systems reform in the United Arab Emirates: a systematic review.

    Science.gov (United States)

    Koornneef, Erik; Robben, Paul; Blair, Iain

    2017-09-20

    The United Arab Emirates (UAE) government aspires to build a world class health system to improve the quality of healthcare and the health outcomes for its population. To achieve this it has implemented extensive health system reforms in the past 10 years. The nature, extent and success of these reforms has not recently been comprehensively reviewed. In this paper we review the progress and outcomes of health systems reform in the UAE. We searched relevant databases and other sources to identify published and unpublished studies and other data available between 01 January 2002 and 31 March 2016. Eligible studies were appraised and data were descriptively and narratively synthesized. Seventeen studies were included covering the following themes: the UAE health system, population health, the burden of disease, healthcare financing, healthcare workforce and the impact of reforms. Few, if any, studies prospectively set out to define and measure outcomes. A central part of the reforms has been the introduction of mandatory private health insurance, the development of the private sector and the separation of planning and regulatory responsibilities from provider functions. The review confirmed the commitment of the UAE to build a world class health system but amongst researchers and commentators opinion is divided on whether the reforms have been successful although patient satisfaction with services appears high and there are some positive indications including increasing coverage of hospital accreditation. The UAE has a rapidly growing population with a unique age and sex distribution, there have been notable successes in improving child and maternal mortality and extending life expectancy but there are high levels of chronic diseases. The relevance of the reforms for public health and their impact on the determinants of chronic diseases have been questioned. From the existing research literature it is not possible to conclude whether UAE health system reforms are

  1. Training and Maintaining System-Wide Reliability in Outcome Management.

    Science.gov (United States)

    Barwick, Melanie A; Urajnik, Diana J; Moore, Julia E

    2014-01-01

    The Child and Adolescent Functional Assessment Scale (CAFAS) is widely used for outcome management, for providing real time client and program level data, and the monitoring of evidence-based practices. Methods of reliability training and the assessment of rater drift are critical for service decision-making within organizations and systems of care. We assessed two approaches for CAFAS training: external technical assistance and internal technical assistance. To this end, we sampled 315 practitioners trained by external technical assistance approach from 2,344 Ontario practitioners who had achieved reliability on the CAFAS. To assess the internal technical assistance approach as a reliable alternative training method, 140 practitioners trained internally were selected from the same pool of certified raters. Reliabilities were high for both practitioners trained by external technical assistance and internal technical assistance approaches (.909-.995, .915-.997, respectively). 1 and 3-year estimates showed some drift on several scales. High and consistent reliabilities over time and training method has implications for CAFAS training of behavioral health care practitioners, and the maintenance of CAFAS as a global outcome management tool in systems of care.

  2. Economic and ecological outcomes of flexible biodiversity offset systems.

    Science.gov (United States)

    Habib, Thomas J; Farr, Daniel R; Schneider, Richard R; Boutin, Stan

    2013-12-01

    The commonly expressed goal of biodiversity offsets is to achieve no net loss of specific biological features affected by development. However, strict equivalency requirements may complicate trading of offset credits, increase costs due to restricted offset placement options, and force offset activities to focus on features that may not represent regional conservation priorities. Using the oil sands industry of Alberta, Canada, as a case study, we evaluated the economic and ecological performance of alternative offset systems targeting either ecologically equivalent areas (vegetation types) or regional conservation priorities (caribou and the Dry Mixedwood natural subregion). Exchanging dissimilar biodiversity elements requires assessment via a generalized metric; we used an empirically derived index of biodiversity intactness to link offsets with losses incurred by development. We considered 2 offset activities: land protection, with costs estimated as the net present value of profits of petroleum and timber resources to be paid as compensation to resource tenure holders, and restoration of anthropogenic footprint, with costs estimated from existing restoration projects. We used the spatial optimization tool MARXAN to develop hypothetical offset networks that met either the equivalent-vegetation or conservation-priority targets. Networks that required offsetting equivalent vegetation cost 2-17 times more than priority-focused networks. This finding calls into question the prudence of equivalency-based systems, particularly in relatively undeveloped jurisdictions, where conservation focuses on limiting and directing future losses. Priority-focused offsets may offer benefits to industry and environmental stakeholders by allowing for lower-cost conservation of valued ecological features and may invite discussion on what land-use trade-offs are acceptable when trading biodiversity via offsets. Resultados Económicos y Ecológicos de Sistemas de Compensación de

  3. Drug delivery from the oral cavity: a focus on mucoadhesive buccal drug delivery systems.

    Science.gov (United States)

    Shinkar, Dattatraya Manohar; Dhake, Avinash Sridhar; Setty, Chitral Mallikarjuna

    2012-01-01

    Since the early 1980s the concept of mucoadhesion has gained considerable interest in pharmaceutical technology. The various advantages associated with these systems made buccal drug delivery as a novel route of drug administration. It prolongs the residence time of the dosage form at the site of application. These systems remain in close contact with the absorption tissue, the mucous membrane, and thus contribute to improved and/or better therapeutic performance of the drug and of both local and systemic effects. This review highlights the anatomy and structure of oral mucosa, mechanism and theories of mucoadhesion, factors affecting mucoadhesion, characteristics and properties of desired mucoadhesive polymers, various types of dosage forms, and general considerations in design of mucoadhesive buccal dosage forms, permeation enhancers, and evaluation methods. Over the past few decades the mucoadhesive buccal drug delivery system has received a great deal of attention to develop mucoadhesive dosage forms to enable the prolonged retention at the site of action, providing a controlled release of drug for improved therapeutic outcome. Mucoadhesive drug delivery gives facility to include a permeation enhancer/enzyme inhibitor or pHmodifier in the formulation and versatility in designing as multidirectional or unidirectional release systems for local and systemic action. Local delivery to tissues of the oral cavity has a number of applications, including treatment of local conditions such as periodontal disease, bacterial and fungal infections, and aphthous stomatitis and vesiculo bullous diseases. For the treatment of chronic diseases, the mucoadhesive buccal drug delivery system allows easily accessibility and is generally well-accepted for administeringdrugs by systemic action.

  4. "I am a scientist": How setting conditions that enhance focused concentration positively relate to student motivation and achievement outcomes in inquiry-based science

    Science.gov (United States)

    Ellwood, Robin B.

    This research investigated how student social interactions within two approaches to an inquiry-based science curriculum could be related to student motivation and achievement outcomes. This qualitative case study consisted of two cases, Off-Campus and On-Campus, and used ethnographic techniques of participant observation. Research participants included eight eighth grade girls, aged thirteen to fourteen years old. Data sources included formal and informal participant interviews, participant journal reflections, curriculum artifacts including quizzes, worksheets, and student-generated research posters, digital video and audio recordings, photographs, and researcher field notes. Data were transcribed verbatim and coded, then collapsed into emergent themes using NVIVO 9. The results of this research illustrate how setting conditions that promote focused concentration and communicative interactions can be positively related to student motivation and achievement outcomes in inquiry-based science. Participants in the Off-Campus case experienced more frequent states of focused concentration and out performed their peers in the On-Campus case on forty-six percent of classroom assignments. Off-Campus participants also designed and implemented a more cognitively complex research project, provided more in-depth analyses of their research results, and expanded their perceptions of what it means to act like a scientist to a greater extent than participants in the On-Campus case. These results can be understood in relation to Flow Theory. Student interactions that promoted the criteria necessary for initiating flow, which included having clearly defined goals, receiving immediate feedback, and maintaining a balance between challenges and skills, fostered enhanced student motivation and achievement outcomes. This research also illustrates the positive gains in motivation and achievement outcomes that emerge from student experiences with extended time in isolated areas referred to

  5. Drift compression and final focus systems for heavy ion inertial fusion

    Energy Technology Data Exchange (ETDEWEB)

    de Hoon, Michiel Jan Laurens [Univ. of California, Berkeley, CA (United States)

    2001-01-01

    Longitudinal compression of space-charge dominated beams can be achieved by imposing a head-to-tail velocity tilt on the beam. This tilt has to be carefully tailored, such that it is removed by the longitudinal space-charge repulsion by the time the beam reaches the end of the drift compression section. The transverse focusing lattice should be designed such that all parts of the beam stay approximately matched, while the beam smoothly expands transversely to the larger beam radius needed in the final focus system following drift compression. In this thesis, several drift compression systems were designed within these constraints, based on a given desired pulse shape at the end of drift compression systems were designed within these constraints, based on a given desired pulse shape at the end of drift compression. The occurrence of mismatches due to a rapidly increasing current was analyzed. In addition, the sensitivity of drift compression to errors in the initial velocity tilt and current profile was studied. These calculations were done using a new computer code that accurately calculates the longitudinal electric field in the space-charge dominated regime.

  6. Advances in research methods for information systems research data mining, data envelopment analysis, value focused thinking

    CERN Document Server

    Osei-Bryson, Kweku-Muata

    2013-01-01

    Advances in social science research methodologies and data analytic methods are changing the way research in information systems is conducted. New developments in statistical software technologies for data mining (DM) such as regression splines or decision tree induction can be used to assist researchers in systematic post-positivist theory testing and development. Established management science techniques like data envelopment analysis (DEA), and value focused thinking (VFT) can be used in combination with traditional statistical analysis and data mining techniques to more effectively explore

  7. The Signal Detection and Control Circuit Design for Confocal Auto-Focus System

    OpenAIRE

    Yin Liu; Jin Yu; Zeqiang Mo

    2016-01-01

    Based on the demands of Confocal Auto-Focus system, the implementation method of signal measurement circuit and control circuit is given. Using the high performance instrumental amplifier AD620BN, low noise precision FET Op amplifier AD795JRZ and ultralow offset voltage Op amplifier OP07EP, a signal measurement circuit used to converse the two differential light intensity signal to electric signal is designed. And a control circuit which takes MCU MSP430F149 as core processes the former signa...

  8. Better Policies Accelerate Clean Energy Transition. Policy brief - Focus on energy system flexibility

    DEFF Research Database (Denmark)

    Karimi, Farid; Lund, Peter; Skytte, Klaus

    2018-01-01

    The use of variable renewable energy sources will increase in the Nordic and Baltic countries in the future. This will call for increased flexibility in the electricity market to ensure both high energy security and efficient use of renewable power in all circumstances. The barriers and hence also...... policies to energy system flexibility are numerous. In this brief, we focus on policy recommendations for two important barriers to flexibility in the Nordic electricity market, namely insufficient market signals to some stakeholders, and uneven market frameworks for different renewable energy resources...

  9. Radiation damage and waste management options for the sombrero final focus system and neutron dumps

    International Nuclear Information System (INIS)

    Reyes, S.; Latkowski, J.F.; Meier, W.R.; Reyes, S.

    2000-01-01

    Previous studies of the safety and environmental aspects of the SOMBRERO inertial fusion energy (IFE) power plant design did not completely address the issues associated with the final focus system. While past work calculated neutron fluences for a grazing incidence metal mirror (GIMM) and a final focus mirror, scattering off of the final optical component was not included, and thus, fluences in the final focus mirror were significantly underestimated. In addition, past work did not consider neutron-induced gamma-rays. Finally, power plant lifetime waste volumes may have been underestimated as neutron activation of the neutron dumps and building structure were not addressed. In the present work, a modified version of the SOMBRERO target building is presented where a significantly larger open solid-angle fraction (5%) is used to enhance beam smoothing of a diode-pumped solid-state laser (DPSSL). The GIMMs are replaced with transmissive fused silica wedges and have been included in three-dimensional neutron and photon transport calculations. This work shows that a power plant with a large open solid-angle fraction, needed for beam smoothing with a DPSSL, is acceptable from tritium breeding, and neutron activation points-of-view. (authors)

  10. Clinical outcomes of hydronephrosis in patients with systemic lupus erythematosus.

    Science.gov (United States)

    Hong, Seokchan; Kim, Yong-Gil; Ahn, Soo Min; Bae, Seung-Hyeon; Lim, Doo-Ho; Kim, Jeong Kon; Lee, Chang-Keun; Yoo, Bin

    2016-12-01

    Hydronephrosis is a rare complication of systemic lupus erythematosus (SLE). Bladder and/or gastrointestinal involvement in SLE are associated with development of hydronephrosis, but the management and treatment outcomes of hydronephrosis are largely unknown. Therefore, we investigated the clinical manifestations and factors associated with the treatment response in patients with SLE complicated by hydronephrosis. A retrospective analysis was performed of all 634 SLE patients who underwent computed tomography and/or ultrasonography between January 1998 and December 2013. We reviewed the clinical characteristics and treatment outcomes of patients with SLE-associated hydronephrosis. Hydronephrosis was identified in 15 patients with SLE complicated by cystitis and/or enteritis. All patients were treated initially with moderate to high doses of corticosteroids. A follow-up imaging study showed that 11 (73.3%) of 15 patients experienced improvements in hydronephrosis, and urinary obstruction was resolved without urological intervention in the majority of these patients (8/11, 72.7%). The four patients who experienced no improvement in hydronephrosis were older than those who responded to treatment (median age [interquartile range]; 43.0 [37.5-53.0] years vs. 28.0 [21.0-38.5] years; P = 0.026). In addition, delayed treatment (≥ 1 month after onset of symptoms) with corticosteroids was more frequently observed in the non-responding patients than in the responding patients (P = 0.011). Our findings suggest that treatment with corticosteroids alone leads to favorable outcomes in patients with SLE-associated hydronephrosis, except when treatment is delayed, particularly in elderly patients. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  11. 'No touch' technologies for environmental decontamination: focus on ultraviolet devices and hydrogen peroxide systems.

    Science.gov (United States)

    Weber, David J; Kanamori, Hajime; Rutala, William A

    2016-08-01

    This article reviews 'no touch' methods for disinfection of the contaminated surface environment of hospitalized patients' rooms. The focus is on studies that assessed the effectiveness of ultraviolet (UV) light devices, hydrogen peroxide systems, and self-disinfecting surfaces to reduce healthcare-associated infections (HAIs). The contaminated surface environment in hospitals plays an important role in the transmission of several key nosocomial pathogens including methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus spp., Clostridium difficile, Acinetobacter spp., and norovirus. Multiple clinical trials have now demonstrated the effectiveness of UV light devices and hydrogen peroxide systems to reduce HAIs. A limited number of studies have suggested that 'self-disinfecting' surfaces may also decrease HAIs. Many studies have demonstrated that terminal cleaning and disinfection with germicides is often inadequate and leaves environmental surfaces contaminated with important nosocomial pathogens. 'No touch' methods of room decontamination (i.e., UV devices and hydrogen peroxide systems) have been demonstrated to reduce key nosocomial pathogens on inoculated test surfaces and on environmental surfaces in actual patient rooms. Further UV devices and hydrogen peroxide systems have been demonstrated to reduce HAI. A validated 'no touch' device or system should be used for terminal room disinfection following discharge of patients on contact precautions. The use of a 'self-disinfecting' surface to reduce HAI has not been convincingly demonstrated.

  12. System geometry optimization for molecular breast tomosynthesis with focusing multi-pinhole collimators

    Science.gov (United States)

    van Roosmalen, Jarno; Beekman, Freek J.; Goorden, Marlies C.

    2018-01-01

    Imaging of 99mTc-labelled tracers is gaining popularity for detecting breast tumours. Recently, we proposed a novel design for molecular breast tomosynthesis (MBT) based on two sliding focusing multi-pinhole collimators that scan a modestly compressed breast. Simulation studies indicate that MBT has the potential to improve the tumour-to-background contrast-to-noise ratio significantly over state-of-the-art planar molecular breast imaging. The aim of the present paper is to optimize the collimator-detector geometry of MBT. Using analytical models, we first optimized sensitivity at different fixed system resolutions (ranging from 5 to 12 mm) by tuning the pinhole diameters and the distance between breast and detector for a whole series of automatically generated multi-pinhole designs. We evaluated both MBT with a conventional continuous crystal detector with 3.2 mm intrinsic resolution and with a pixelated detector with 1.6 mm pixels. Subsequently, full system simulations of a breast phantom containing several lesions were performed for the optimized geometry at each system resolution for both types of detector. From these simulations, we found that tumour-to-background contrast-to-noise ratio was highest for systems in the 7 mm-10 mm system resolution range over which it hardly varied. No significant differences between the two detector types were found.

  13. Association Between Physician Teamwork and Health System Outcomes Following Coronary Artery Bypass Grafting

    Science.gov (United States)

    Hollingsworth, John M.; Funk, Russell J.; Garrison, Spencer A.; Owen-Smith, Jason; Kaufman, Samuel A.; Pagani, Francis D.; Nallamothu, Brahmajee K.

    2017-01-01

    Background Patients undergoing coronary artery bypass grafting (CABG) must often see multiple providers dispersed across many care locations. To test whether “teamwork” (assessed with the bipartite clustering coefficient) among these physicians is a determinant of surgical outcomes, we examined national Medicare data from patients undergoing CABG. Methods and Results Among Medicare beneficiaries who underwent CABG between 2008 and 2011, we mapped relationships between all physicians who treated them during their surgical episodes, including both surgeons and nonsurgeons. After aggregating across CABG episodes in a year to construct the physician social networks serving each health system, we then assessed the level of physician teamwork in these networks with the bipartite clustering coefficient. Finally, we fit a series of multivariable regression models to evaluate associations between a health system’s teamwork level and its 60-day surgical outcomes. We observed substantial variation in the level of teamwork between health systems performing CABG (standard deviation for the bipartite clustering coefficient was 0.09). While health systems with high and low teamwork levels treated beneficiaries with comparable comorbidity scores, these health systems differed over several sociocultural and healthcare capacity factors (e.g., physician staff size, surgical caseload). After controlling for these differences, health systems with higher teamwork levels had significantly lower 60-day rates of emergency department visit, readmission, and mortality. Conclusions Health systems with physicians who tend to work together in tightly knit groups during CABG episodes realize better surgical outcomes. As such, delivery system reforms focused on building teamwork may have positive effects on surgical care. PMID:28263939

  14. A combined hands-on teaching programme and clinical pathway focused on pleural ultrasound and procedure supervision transforms pleural procedure outcomes.

    Science.gov (United States)

    Edwards, Timothy; Cook, Alistair; Salamonsen, Matthew; Bashirzadeh, Farzad; Fielding, David

    2017-11-01

    Management of pleural effusions is a common diagnostic and management problem. We reviewed the outcomes from pleural procedures after the instigation of pleural effusion management guidelines, focusing on pleural ultrasound and a hands-on teaching programme followed by procedure supervision that enabled many operators to perform such procedures. This is a retrospective analysis of all procedures performed for pleural effusions on medical patients. Outcomes were assessed prior to the instigation of pleural effusion management guidelines (pleural pathway) and hands-on teaching (January 2010 to June 2011) and following these interventions (January 2012 to June 2013). A total of 171 procedures involving 129 patients (pre-pathway group) and 146 procedures involving 115 patients (post-pathway group) was analysed. The rate of complications prior to the pleural pathway was 22.2% (38 of 171 procedures). Following the pathway, the rate of complications declined to 7.5% (11 of 146 procedures, P < 0.003). The use of pleural ultrasound increased dramatically (72.5 vs 90.2%). The number of patients who underwent repeated procedures (defined as ≥3) reduced dramatically (21 vs 7, P < 0.01). This improvement occurred using many supervised operators who completed the hands-on teaching programme (n = 32) and followed the pleural pathway (127 of 146 procedures). The instigation of a clinical pathway focused on the use of bedside pleural ultrasound, and teaching of drainage techniques with procedure supervision vastly improved patient outcomes. This not only allowed better quality of care for patients, it also provided the acquisition of new skills to medical staff, not limiting these skills to specialised staff. © 2017 Royal Australasian College of Physicians.

  15. Ion beam transport and focus for LMF using an achromatic solenoidal lens system

    International Nuclear Information System (INIS)

    Olson, C.L.

    1990-01-01

    The light ion LMF (Laboratory Microfusion Facility) requires an ion beam transport length for bunching and standoff to be about four meters from the diode to the target. The baseline LMF transport scheme uses an achromatic two lens system consisting of the diode (a self-field lens) and a solenoidal lens. Charge and current neutralization are provided by a background gas. A detailed analysis of this system is presented here. The effects of additional magnetic fields are examined, including those produced by non-zero net currents, applied B effects near the diode, and diamagnetic effects in the solenoidal lens. Instabilities are analyzed including the filamentation instability, the two-stream instability (beam ions, plasma electrons), the plasma two-stream instability (plasma electrons, plasma ions), and the ion acoustic instability. Scattering in the foil and gas are shown to be negligible. Gas breakdown processes are analyzed in detail, including ion impact ionization, electron avalanching, and ohmic heating. Special diode requirements are examined, including voltage accuracy, energy spread, and aiming tolerances. The neutral gas and gas pressure are chosen to satisfy several constraints, one being that the net current must be small, and another being that the filamentation instability should be avoided. With the present choice of 1 Torr He, it is concluded that the complete achromatic lens system appears to be viable, simple, and efficient transport and focusing system for LMF

  16. Patient Care Outcomes: Implications for the Military Health Services Systems

    Science.gov (United States)

    1991-05-05

    regionalization as a data driven decision. There is a growing body of information that supports the use of regionalization.7- 13 Overall, higher volume is...outcomes. American Journal of Hospital Pharmacy, 45, 1376-1378. 59. Epstein, A. M. (1990). The outcomes movement --will it get us where we want to go...Outcome assessment. (1987). New England Journal of Medicine, 317(4), 251-252. 177. Partridge, C. J. (1982). The outcome of physiotherapy and its

  17. Intensive Care Nurses’ Belief Systems Regarding the Health Economics: A Focused Ethnography

    Science.gov (United States)

    Heydari, Abbas; Vafaee-Najar, Ali; Bakhshi, Mahmoud

    2016-01-01

    Background: Health care beliefs can have an effect on the efficiency and effectiveness of nursing practices. Nevertheless, how belief systems impact on the economic performance of intensive care unit (ICU) nurses is not known. This study aimed to explore the ICU nurses’ beliefs and their effect on nurse’s: practices and behavior patterns regarding the health economics. Methods: In this study, a focused ethnography method was used. Twenty-four informants from ICU nurses and other professional individuals were purposively selected and interviewed. As well, 400 hours of ethnographic observations were used for data collection. Data analysis was performed using the methods described by Miles and Huberman (1994). Findings: Eight beliefs were found that gave meaning to ICU nurse’s practices regarding the health economics. 1. The registration of medications and supplies disrupt the nursing care; 2. Monitoring and auditing improve consumption; 3. There is a fear of possible shortage in the future; 4. Supply and replacement of equipment is difficult; 5. Higher prices lead to more accurate consumption; 6. The quality of care precedes the costs; 7. Clinical Guidelines are abundant but useful; and 8. Patient economy has priority over hospital economy. Maintaining the quality of patient care with least attention to hospital costs was the main focus of the beliefs formed up in the ICU regarding the health economics. Conclusions: ICU nurses’ belief systems have significantly shaped in relation to providing a high-quality care. Although high quality of care can lead to a rise in the effectiveness of nursing care, cost control perspective should also be considered in planning for improve the quality of care. Therefore, it is necessary to involve the ICU nurses in decision-making about unit cost management. They must become familiar with the principles of heath care economics and productivity by applying an effective cost management program. It may be optimal to implement the

  18. Intensive Care Nurses' Belief Systems Regarding the Health Economics: A Focused Ethnography.

    Science.gov (United States)

    Heydari, Abbas; Vafaee-Najar, Ali; Bakhshi, Mahmoud

    2016-09-01

    Health care beliefs can have an effect on the efficiency and effectiveness of nursing practices. Nevertheless, how belief systems impact on the economic performance of intensive care unit (ICU) nurses is not known. This study aimed to explore the ICU nurses' beliefs and their effect on nurse's practices and behavior patterns regarding the health economics. In this study, a focused ethnography method was used. Twenty-four informants from ICU nurses and other professional individuals were purposively selected and interviewed. As well, 400 hours of ethnographic observations were used for data collection. Data analysis was performed using the methods described by Miles and Huberman (1994). Eight beliefs were found that gave meaning to ICU nurse's practices regarding the health economics. 1. The registration of medications and supplies disrupt the nursing care; 2.Monitoring and auditing improve consumption; 3.There is a fear of possible shortage in the future; 4.Supply and replacement of equipment is difficult; 5.Higher prices lead to more accurate consumption; 6.The quality of care precedes the costs; 7. Clinical Guidelines are abundant but useful; and 8.Patient economy has priority over hospital economy. Maintaining the quality of patient care with least attention to hospital costs was the main focus of the beliefs formed up in the ICU regarding the health economics. ICU nurses' belief systems have significantly shaped in relation to providing a high-quality care. Although high quality of care can lead to a rise in the effectiveness of nursing care, cost control perspective should also be considered in planning for improve the quality of care. Therefore, it is necessary to involve the ICU nurses in decision-making about unit cost management. They must become familiar with the principles of heath care economics and productivity by applying an effective cost management program. It may be optimal to implement the reforms in various aspects, such as the hospital

  19. The Role of Physiotherapy Extended Scope Practitioners in Musculoskeletal care with Focus on Decision Making and Clinical Outcomes: A Systematic Review of Quantitative and Qualitative Research.

    Science.gov (United States)

    Thompson, Jonathan; Yoward, Samantha; Dawson, Pamela

    2017-06-01

    Physiotherapy extended scope practitioner (ESP) roles are widely utilized in the management of musculoskeletal conditions. The present article reviews the current literature, with particular emphasis on the decision-making process, patient/clinician interaction and clinical outcomes. A systematic review of musculoskeletal extended scope practice was carried out. The review focused on the outcome of interventions, and the interactions and decision-making processes between ESPs and their patients. A wide search strategy was employed, through multiple databases, grey literature and experts in the field. Qualitative and quantitative studies alike were included and a mixed-methods synthesis approach was undertaken in analysing the findings of included studies. A total of 476 articles were identified for inclusion, 25 of which (22 quantitative and three qualitative) meeting the criteria for full quality appraisal and synthesis. It was not possible to conduct a meta-analysis owing to data heterogeneity. The results showed high patient satisfaction with the ESP role, support for ESP staff listing patients for orthopaedic surgery, a high positive correlation of decision making between ESPs and orthopaedic surgeons and evidence of a positive impact on patient outcomes. Qualitative themes reflected the importance of ESP clinical decision making and interpersonal skills and their role in patient education. There is broad support for the physiotherapy ESP role and evidence of favourable outcomes from ESP intervention. Clinical decisions made by ESPs correlate well with those of medical colleagues, although there is a lack of detail explaining the ESP decision-making process itself and the influences and mechanisms by which this occurs. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  20. The transition from diffuse to focused extension: Modeled evolution of the West Antarctic Rift system

    Science.gov (United States)

    Huerta, Audrey D.; Harry, Dennis L.

    2007-03-01

    Two distinct stages of extension are recognized in the West Antarctic Rift system (WARS). During the first stage, beginning in the Late Cretaceous, extension was broadly distributed throughout much of West Antarctica. A second stage of extension in the late Paleogene was focused primarily in the Victoria Land Basin, near the boundary with the East Antarctic craton. The transition to focused extension was roughly coeval with volcanic activity and strike-slip faulting in the adjacent Transantarctic Mountains. This spatial and temporal correspondence suggests that the transition in extensional style could be the result of a change in plate motions or impingement of a plume. Here we use finite element models to study the processes and conditions responsible for the two-stage evolution of rifting in the WARS. Model results indicate that the transition from a prolonged period of broadly distributed extension to a later period of focused rifting did not require a change in the regional stress regime (changes in plate motion), or deep mantle thermal state (impingement of a plume). Instead, we attribute the transition from diffuse to focused extension to an early stage dominated by the initially weak accreted lithosphere of West Antarctica, and a later stage that concentrated around a secondary weakness located at the boundary between the juvenile West Antarctica lithosphere and Precambrian East Antarctic craton. The modeled transition in extension from the initially weak West Antarctica region to the secondary weakness at the West Antarctic-East Antarctic boundary is precipitated by strengthening of the West Antarctica lithosphere during syn-extensional thinning and cooling. The modeled syn-extensional strengthening of the WARS lithosphere promotes a wide-rift mode of extension between 105 and ˜ 65 Ma. By ˜ 65 Ma most of the extending WARS region becomes stronger than the area immediately adjacent to the East Antarctic craton and extension becomes concentrated near the

  1. Quality and integration of public health information systems: A systematic review focused on immunization and vital records systems.

    Science.gov (United States)

    Vest, Joshua R; Kirk, Hilary M; Issel, L Michele

    2012-01-01

    Public health professionals rely on quantitative data for the daily practice of public health as well as organizational decision making and planning. However, several factors work against effective data sharing among public health agencies in the US. This review characterizes the reported barriers and enablers of effective use of public health IS from an informatics perspective. A systematic review of the English language literature for 2005 to 2011 followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) format. The review focused on immunization information systems (IIS) and vital records information systems (VRIS). Systems were described according to the structural aspects of IS integration and data quality. Articles describing IIS documented issues pertaining to the distribution of the system, the autonomy of the data providers, the heterogeneous nature of information sharing as well as the quality of the data. Articles describing VRIS were focused much more heavily on data quality, particularly whether or not the data were free from errors. For state and local practitioners to effectively utilize data, public health IS will have to overcome the challenges posed by a large number of autonomous data providers utilizing a variety of technologies.

  2. Gene-environment interaction in Major Depression: focus on experience-dependent biological systems

    Directory of Open Access Journals (Sweden)

    Nicola eLopizzo

    2015-05-01

    Full Text Available Major Depressive Disorder (MDD is a multifactorial and polygenic disorder, where multiple and partially overlapping sets of susceptibility genes interact each other and with the environment, predisposing individuals to the development of the illness. Thus, MDD results from a complex interplay of vulnerability genes and environmental factors that act cumulatively throughout individual's lifetime. Among these environmental factors, stressful life experiences, especially those occurring early in life, have been suggested to exert a crucial impact on brain development, leading to permanent functional changes that may contribute to life long risk for mental health outcomes. In this review we will discuss how genetic variants (polymorphisms, SNPs within genes operating in neurobiological systems that mediate stress response and synaptic plasticity, can impact, by themselves, the vulnerability risk for MDD; we will also consider how this MDD risk can be further modulated when gene X environment interaction is taken into account. Finally, we will discuss the role of epigenetic mechanisms, and in particular of DNA methylation and miRNAs expression changes, in mediating the effect of the stress on the vulnerability risk to develop MDD. Taken together, in this review we aim to underlie the role of genetic and epigenetic processes involved in stress and neuroplasticity related biological systems on development of MDD after exposure to early life stress, thereby building the basis for future research and clinical interventions.

  3. Sex Differences in Psychiatric Disease: A Focus on the Glutamate System

    Directory of Open Access Journals (Sweden)

    Megan M. Wickens

    2018-06-01

    Full Text Available Alterations in glutamate, the primary excitatory neurotransmitter in the brain, are implicated in several psychiatric diseases. Many of these psychiatric diseases display epidemiological sex differences, with either males or females exhibiting different symptoms or disease prevalence. However, little work has considered the interaction of disrupted glutamatergic transmission and sex on disease states. This review describes the clinical and preclinical evidence for these sex differences with a focus on two conditions that are more prevalent in women: Alzheimer's disease and major depressive disorder, and three conditions that are more prevalent in men: schizophrenia, autism spectrum disorder, and attention deficit hyperactivity disorder. These studies reveal sex differences at multiple levels in the glutamate system including metabolic markers, receptor levels, genetic interactions, and therapeutic responses to glutamatergic drugs. Our survey of the current literature revealed a considerable need for more evaluations of sex differences in future studies examining the role of the glutamate system in psychiatric disease. Gaining a more thorough understanding of how sex differences in the glutamate system contribute to psychiatric disease could provide novel avenues for the development of sex-specific pharmacotherapies.

  4. Positioning device for MRI-guided high intensity focused ultrasound system

    Energy Technology Data Exchange (ETDEWEB)

    Damianou, Christakis [Frederick Institute of Technology (FIT), Limassol (Cyprus); MEDSONIC, LTD, Limassol (Cyprus); Ioannides, Kleanthis [Polikliniki Igia, Limassol (Cyprus); Milonas, Nicos [Frederick Institute of Technology (FIT), Limassol (Cyprus)

    2008-04-15

    A prototype magnetic resonance imaging (MRI)- compatible positioning device was used to move an MRI-guided high intensity focused ultrasound (HIFU) transducer. The positioning device has three user-controlled degrees of freedom that allow access to various targeted lesions. The positioning device was designed and fabricated using construction materials selected for compatibility with high magnetic fields and fast switching magnetic field gradients encountered inside MRI scanners. The positioning device incorporates only MRI compatible materials such as piezoelectric motors, plastic sheets, brass screws, plastic pulleys and timing belts. The HIFU/MRI system includes the multiple subsystems (a) HIFU system, (b) MR imaging, (c) Positioning device (robot) and associate drivers, (d) temperature measurement, (e) cavitation detection, (f) MRI compatible camera, and (g) Soft ware. The MRI compatibility of the system was successfully demonstrated in a clinical high-field MRI scanner. The ability of the robot to accurately move the transducer thus creating discrete and overlapping lesions in biological tissue was tested successfully. A simple, cost effective, portable positioning device has been developed which can be used in virtually any clinical MRI scanner since it can be sited on the scanner's table. The propagation of HIFU can use either a lateral or superior-inferior approach. Discrete and large lesions were created successfully with reproducible results. (orig.)

  5. A modeling approach for district heating systems with focus on transient heat transfer in pipe networks

    DEFF Research Database (Denmark)

    Mohammadi, Soma; Bojesen, Carsten

    2015-01-01

    the temperature in DH systems. The main focus is on modeling transient heat transfer in pipe networks regarding the time delays between the heat supply unit and the consumers, the heat loss in the pipe networks and the consumers’ dynamic heat loads. A pseudo-dynamic approach is adopted and also the implicit...... district heating networks [DHN] characteristics. This paper is presenting a new developed model, which reflects the thermo-dynamic behavior of DHN. It is designed for tree network topologies. The purpose of the model is to serve as a basis for applying a variety of scenarios towards lowering...... finite element method is applied to simulate transient temperature changes in pipe networks. The model is calculating time series data related to supply temperature to the DHN from heat production units, heat loads and return temperature related to each consumer to calculate dynamic temperature changes...

  6. Medical consequences of Chernobyl with focus on the endocrine system: Part 1.

    Science.gov (United States)

    Foley, Thomas P; Límanová, Zdeňka; Potluková, Eliška

    2015-01-01

    In the last 70 years, atomic disasters have occurred several times. The nuclear power plant accident at Chernobyl in 1986 in North-Central Ukraine was a unique experience in population exposures to radiation by all ages, and ongoing studies have brought a large amount of information on effects of radiation on human organism. Concerning the deteriorating global security situation and the strong rhetoric of some of the world leaders, the knowledge on the biological effects of ionizing radiation and the preventive measures designed to decrease the detrimental effects of radiation gains a new dimension, and involves all of us. This review focuses on the long-term effects of Chernobyl catastrophe especially on the endocrine system in children and in adults, and includes a summary of preventive measures in case of an atomic disaster.

  7. Medical Consequences of Chernobyl with Focus on the Endocrine System - Part 2.

    Science.gov (United States)

    Foley, Thomas P; Límanová, Zdeňka; Potluková, Eliška

    2015-01-01

    In the last 70 years, atomic disasters have occurred several times. The nuclear power plant accident at Chernobyl in 1986 in North-Central Ukraine was a unique experience in population exposures to radiation by all ages, and ongoing studies have brought a large amount of information effects of radiation on human organism. Concerning the deteriorating global security situation and the strong rhetoric of some of the world leaders, the knowledge on the biological effects of ionizing radiation and the preventive measures designed to decrease the detrimental effects of radiation gains a new dimension, and involves all of us. This review focuses on the long-term effects of Chernobyl catastrophe especially on the endocrine system in children and in adults, and includes a summary of preventive measures in case of an atomic disaster.

  8. Design and Performance of a Focus-Detection System for Use in Laser Micromachining

    Directory of Open Access Journals (Sweden)

    Binh Xuan Cao

    2016-01-01

    Full Text Available We describe a new approach for locating the focal position in laser micromachining. This approach is based on a feedback system that uses a charge-coupled device (CCD camera, a beam splitter, and a mirror to focus a laser beam on the surface of a work piece. We tested the proposed method for locating the focal position by using Zemax simulations, as well as physically carrying out drilling processes. Compared with conventional methods, this approach is advantageous because: the implementation is simple, the specimen can easily be positioned at the focal position, and the dynamically adjustable scan amplitude and the CCD camera can be used to monitor the laser beam’s profile. The proposed technique will be particularly useful for locating the focal position on any surface in laser micromachining.

  9. B Lymphocytes: Development, Tolerance, and Their Role in Autoimmunity—Focus on Systemic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    Gabriel J. Tobón

    2013-01-01

    Full Text Available B lymphocytes are the effectors of humoral immunity, providing defense against pathogens through different functions including antibody production. B cells constitute approximately 15% of peripheral blood leukocytes and arise from hemopoietic stem cells in the bone marrow. It is here that their antigen receptors (surface immunoglobulin are assembled. In the context of autoimmune diseases defined by B and/or T cell autoreactive that upon activation lead to chronic tissue inflammation and often irreversible structural and functional damage, B lymphocytes play an essential role by not only producing autoantibodies but also functioning as antigen-presenting cells (APC and as a source of cytokines. In this paper, we describe B lymphocyte functions in autoimmunity and autoimmune diseases with a special focus on their abnormalities in systemic lupus erythematosus.

  10. Diagnosis of common hemoglobinopathies among South East Asian population using capillary isoelectric focusing system.

    Science.gov (United States)

    Srivorakun, H; Fucharoen, G; Sanchaisuriya, K; Fucharoen, S

    2017-02-01

    We have evaluated an automated capillary isoelectric focusing (cIEF)-based Hb analyzer in diagnosis of hemoglobinopathies commonly found among South East Asian population. Study was performed on a cohort of 665 adult Thai subjects and 13 fetal blood specimens obtained at routine thalassemia diagnostic laboratory. Hb analysis was performed using the cIEF system. Thalassemia genotypes were defined by DNA analysis. The system revealed satisfactorily within-run and between-run precision for quantitation of Hb A 2 and Hb E (CV: 0.02-0.09%). The reference ranges of Hb A 2 and Hb E were 2.6-4.0% and 25.7-33.1%, respectively. The system identified the cases of β-thalassemia and Hb E disorders correctly. Several thalassemia genotypes and Hb variants were identifiable. However, Hb Constant Spring was separated closely to Hb A 2 and Hbs Bart's and H were relatively difficult to be reported due to interfering peaks separating at the same regions. Prenatal diagnosis by fetal blood analysis was found to be accurate for Hb Bart's hydrops fetalis and Hb E-β 0 -thalassemia disease. The cIEF system could accurately diagnose β-thalassemia and Hb E carriers and demonstrate many Hb variants found in the region. The system cannot report Hb A 2 in the presence of Hb E whereas Hbs Lepore and F are comigrated. Diagnosis of α-thalassemia disease based on Hb H and Hb Bart's might be difficult. © 2016 John Wiley & Sons Ltd.

  11. Predictors of public support for nutrition-focused policy, systems and environmental change strategies in Los Angeles County, 2013.

    Science.gov (United States)

    Robles, Brenda; Kuo, Tony

    2017-01-13

    Since 2010, federal and local agencies have invested broadly in a variety of nutrition-focused policy, systems and environmental change (PSE) initiatives in Los Angeles County (LAC). To date, little is known about whether the public supports such efforts. We address this gap in the literature by examining predictors of support for a variety of PSEs. Voters residing in LAC (n=1007) were randomly selected to participate in a cross-sectional telephone survey commissioned by the LAC Department of Public Health. The survey asked questions about attitudes towards the obesity epidemic, nutrition knowledge and behaviours, public opinions about changing business practices/government policies related to nutrition, and sociodemographics. A factor analysis informed outcome variable selection (ie, type of PSEs). Multivariable regression analyses were performed to examine predictors of public support. Predictors in the regression models included (primary regressor) community economic hardship; (control variables) political affiliation, sex, age, race and income; and (independent variables) perceptions about obesity, perceived health and weight status, frequency reading nutrition labels, ease of finding healthy and unhealthy foods, and food consumption behaviours (ie, fruit and vegetables, non-diet soda, fast-food and sit-down restaurant meals). 3 types of PSE outcome variables were identified: promotional/incentivising, limiting/restrictive and business practices. Community economic hardship was not found to be a significant predictor of public support for any of the 3 PSE types. However, Republican party affiliation, being female and perceiving obesity as a serious health problem were. These findings have implications for public health practice and community planning in local health jurisdictions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  12. INTRODUCTION: Focus on Climate Engineering: Intentional Intervention in the Climate System

    Science.gov (United States)

    2009-12-01

    Geoengineering techniques for countering climate change have been receiving much press recently as a `Plan B' if a global deal to tackle climate change is not agreed at the COP15 negotiations in Copenhagen this December. However, the field is controversial as the methods may have unforeseen consequences, potentially making temperatures rise in some regions or reducing rainfall, and many aspects remain under-researched. This focus issue of Environmental Research Letters is a collection of research articles, invited by David Keith, University of Calgary, and Ken Caldeira, Carnegie Institution, that present and evaluate different methods for engineering the Earth's climate. Not only do the letters in this issue highlight various methods of climate engineering but they also detail the arguments for and against climate engineering as a concept. Further reading Focus on Geoengineering at http://environmentalresearchweb.org/cws/subject/tag=geoengineering IOP Conference Series: Earth and Environmental Science is an open-access proceedings service available at www.iop.org/EJ/journal/ees Focus on Climate Engineering: Intentional Intervention in the Climate System Contents Modification of cirrus clouds to reduce global warming David L Mitchell and William Finnegan Climate engineering and the risk of rapid climate change Andrew Ross and H Damon Matthews Researching geoengineering: should not or could not? Martin Bunzl Of mongooses and mitigation: ecological analogues to geoengineering H Damon Matthews and Sarah E Turner Toward ethical norms and institutions for climate engineering research David R Morrow, Robert E Kopp and Michael Oppenheimer On the possible use of geoengineering to moderate specific climate change impacts Michael C MacCracken The impact of geoengineering aerosols on stratospheric temperature and ozone P Heckendorn, D Weisenstein, S Fueglistaler, B P Luo, E Rozanov, M Schraner, L W Thomason and T Peter The fate of the Greenland Ice Sheet in a geoengineered

  13. 'Focus on feet'--the effects of systemic lupus erythematosus: a narrative review of the literature.

    Science.gov (United States)

    Williams, A E; Crofts, G; Teh, L S

    2013-09-01

    The manifestations of systemic lupus erythematosus (SLE) vary between individuals, from the severe and life-threatening renal and central nervous system involvement, to the involvement of skin, musculoskeletal and vascular system, and the complications of infection influencing the quality of life. However, as specific manifestations affecting the lower limb are perceived as receiving little focus, the purpose of this narrative literature review is to identify the specific factors associated with SLE that may have implications for lower limb and foot morbidity. A structured search of databases was conducted. The inclusion was restricted to publications in the English language, those that specifically investigate the feet as affected with SLE. No restriction on year of publication was imposed to reduce publication bias and to capture as many publication in relation to feet. Eleven papers fulfilled the inclusion criteria. There were seven additional papers that made observations related to the articular or vascular complications of the feet. This narrative review provides some information on how SLE affects the lower limb and foot in relation to the musculoskeletal and vascular systems. However, there is a lack of literature that specifically focuses on all the manifestations of SLE and the complications associated with its management. There are indications that SLE affects lower limb and foot morbidity but the scale of these problems is unclear and this is partly because of the absence of research and the lack of a 'gold standard' framework for the assessment of the lower limb and foot. In addition to clinical foot health assessment, ultrasonography may be a useful alternative to plain film radiography or magnetic resonance imaging (MRI) in capturing the extent of articular and extra-articular manifestations. Further, the Ankle Brachial Pressure Index (ABPI) may be useful in identifying those with atherosclerosis and ischaemia. There are indications that SLE affects

  14. FOCUS, Neutron Transport System for Complex Geometry Reactor Core and Shielding Problems by Monte-Carlo

    International Nuclear Information System (INIS)

    Hoogenboom, J.E.

    1980-01-01

    1 - Description of problem or function: FOCUS enables the calculation of any quantity related to neutron transport in reactor or shielding problems, but was especially designed to calculate differential quantities, such as point values at one or more of the space, energy, direction and time variables of quantities like neutron flux, detector response, reaction rate, etc. or averages of such quantities over a small volume of the phase space. Different types of problems can be treated: systems with a fixed neutron source which may be a mono-directional source located out- side the system, and Eigen function problems in which the neutron source distribution is given by the (unknown) fundamental mode Eigen function distribution. Using Monte Carlo methods complex 3- dimensional geometries and detailed cross section information can be treated. Cross section data are derived from ENDF/B, with anisotropic scattering and discrete or continuous inelastic scattering taken into account. Energy is treated as a continuous variable and time dependence may also be included. 2 - Method of solution: A transformed form of the adjoint Boltzmann equation in integral representation is solved for the space, energy, direction and time variables by Monte Carlo methods. Adjoint particles are defined with properties in some respects contrary to those of neutrons. Adjoint particle histories are constructed from which estimates are obtained of the desired quantity. Adjoint cross sections are defined with which the nuclide and reaction type are selected in a collision. The energy after a collision is selected from adjoint energy distributions calculated together with the adjoint cross sections in advance of the actual Monte Carlo calculation. For multiplying systems successive generations of adjoint particles are obtained which will die out for subcritical systems with a fixed neutron source and will be kept approximately stationary for Eigen function problems. Completely arbitrary problems can

  15. Genetic Variation in the Dopamine System Influences Intervention Outcome in Children with Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Rochellys Diaz Heijtz

    2018-02-01

    Interpretation: Naturally occurring genetic variation in the dopamine system can influence treatment outcomes in children with cerebral palsy. A polygenic dopamine score might be valid for treatment outcome prediction and for designing individually tailored interventions for children with cerebral palsy.

  16. Collecting, Integrating, and Disseminating Patient-Reported Outcomes for Research in a Learning Healthcare System.

    Science.gov (United States)

    Harle, Christopher A; Lipori, Gloria; Hurley, Robert W

    2016-01-01

    Advances in health policy, research, and information technology have converged to increase the electronic collection and use of patient-reported outcomes (PROs). Therefore, it is important to share lessons learned in implementing PROs in research information systems. The purpose of this case study is to describe a novel information system for electronic PROs and lessons learned in implementing that system to support research in an academic health center. The system incorporates freely available and commercial software and involves clinical and research workflows that support the collection, transformation, and research use of PRO data. The software and processes that comprise the system serve three main functions, (i) collecting electronic PROs in clinical care, (ii) integrating PRO data with non-patient generated clinical data, and (iii) disseminating data to researchers through the institution's research informatics infrastructure, including the i2b2 (Informatics for Integrating Biology and the Bedside) system. Our successful design and implementation was driven by three overarching strategies. First, we selected and implemented multiple interfaced technologies to support PRO collection, management, and research use. Second, we aimed to use standardized approaches to measuring PROs, sending PROs between systems, and disseminating PROs. Finally, we focused on using technologies and processes that aligned with existing clinical research information management strategies within our organization. These experiences and lessons may help future implementers and researchers enhance the scale and sustainable use of systems for research use of PROs.

  17. Testing an mHealth momentary assessment Routine Outcome Monitoring application: a focus on restoration of daily life positive mood states.

    Directory of Open Access Journals (Sweden)

    Jim van Os

    Full Text Available Routine Outcome Monitoring (ROM is used as a means to enrich the process of treatment with feedback on patient outcomes, facilitating patient involvement and shared decision making. While traditional ROM measures focus on retrospective accounts of symptoms, novel mHealth technology makes it possible to collect real life, in-the-moment ambulatory data that allow for an ecologically valid assessment of personalized and contextualized emotional and behavioural adjustment in the flow daily life (mROM.In a sample of 34 patients with major depressive disorder, treated with antidepressants, the combined effect of treatment and natural course was examined over a period of 18 weeks with Ecological Momentary Assessment (EMA. EMA consisted of repeated, within-subject, mini-measurements of experience (eg positive affect, negative affect, medication side effects and context (eg stressors, situations, activities at 10 unselected semi-random moments per day, for a period of six days, repeated three times over the 18-week period (baseline, week 6 and week 18.EMA measures of emotional and behavioural adjustment were sensitive to the effects of treatment and natural course over the 18-week period, particularly EMA measures focussing on positive mood states and the ability to use natural rewards (impact of positive events on positive mood states, with standardized effect sizes of 0.4-0.5. EMA measures of activities, social interaction, stress-sensitivity and negative mood states were also sensitive to change over time.This study supports the use of mROM as a means to involve the patient in the process of needs assessment and treatment. EMA data are meaningful to the patient, as they reflect daily life circumstances. Assessment of treatment response with mROM data allows for an interpretation of the effect of treatment at the level of daily life emotional and social adjustment--as an index of health, obviating the need for an exclusive focus on traditional measures

  18. Decision support systems and applications in ophthalmology: literature and commercial review focused on mobile apps.

    Science.gov (United States)

    de la Torre-Díez, Isabel; Martínez-Pérez, Borja; López-Coronado, Miguel; Díaz, Javier Rodríguez; López, Miguel Maldonado

    2015-01-01

    The growing importance that mobile devices have in daily life has also reached health care and medicine. This is making the paradigm of health care change and the concept of mHealth or mobile health more relevant, whose main essence is the apps. This new reality makes it possible for doctors who are not specialist to have easy access to all the information generated in different corners of the world, making them potential keepers of that knowledge. However, the new daily information exceeds the limits of the human intellect, making Decision Support Systems (DSS) necessary for helping doctors to diagnose diseases and also help them to decide the attitude that has to be taken towards these diagnoses. These could improve the health care in remote areas and developing countries. All of this is even more important in diseases that are more prevalent in primary care and that directly affect the people's quality of life, this is the case in ophthalmological problems where in first patient care a specialist in ophthalmology is not involved. The goal of this paper is to analyse the state of the art of DSS in Ophthalmology. Many of them focused on diseases affecting the eye's posterior pole. For achieving the main purpose of this research work, a literature review and commercial apps analysis will be done. The used databases and systems will be IEEE Xplore, Web of Science (WoS), Scopus, and PubMed. The search is limited to articles published from 2000 until now. Later, different Mobile Decision Support System (MDSS) in Ophthalmology will be analyzed in the virtual stores for Android and iOS. 37 articles were selected according their thematic (posterior pole, anterior pole, Electronic Health Records (EHRs), cloud, data mining, algorithms and structures for DSS, and other) from a total of 600 found in the above cited databases. Very few mobile apps were found in the different stores. It can be concluded that almost all existing mobile apps are focused on the eye's posterior

  19. CO{sub 2} laser beam cutting with long-focused optics system

    Energy Technology Data Exchange (ETDEWEB)

    Okimura, Koji [Mitsubishi Heavy Industries, Ltd., Kobe Shipyard and Machinery Works, Kobe, Hyogo (Japan); Nagura, Yasumi; Ishide, Takashi; Hiramoto, Yoneo

    1999-07-01

    In cutting the decommissioned nuclear facility, it is required to ensure the safety for dismantling workers, to control the amount of wastes generated by cutting, to reduce the costs, etc. Recently, the laser power has increased remarkably and its application tests are carried out at various fields. In this work, cutting tests were carried out with the CO{sub 2} laser having a long-focused optics system of the meter scale. Then, in the optics system of 5 m focal length, it is possible to cut the steel plates of 30 and 40 mm thickness with the laser power of 20 and 40 kW respectively and 42 mm out diameter steel pipe of 5 mm thickness with that of 20 kW without using assistant gas. This cutting process can be developed such a new dismantling method that may dismantle crowded overhead pipes without a scaffolding, so it is expected to ensure the safety for dismantling workers, to decrease the amount of total radiation exposure and to reduce the costs. (author)

  20. Strengthening the Focus on Business Results: The Need for Systems Approaches in Organizational Behavior Management

    Science.gov (United States)

    Hyten, Cloyd

    2009-01-01

    Current Organizational Behavior Management (OBM) research and practice may be characterized as either behavior focused or results focused. These two approaches stem from different origins and have different characteristics. The behavior-focused approach stems from applied behavior analysis (ABA) methods and emphasizes direct observation of and…

  1. RU COOL's scalable educational focus on immersing society in the ocean through ocean observing systems

    Science.gov (United States)

    Schofield, O.; McDonnell, J. D.; Kohut, J. T.; Glenn, S. M.

    2016-02-01

    Many regions of the ocean are exhibiting significant change, suggesting the need to develop effective focused education programs for a range of constituencies (K-12, undergraduate, and general public). We have been focused on developing a range of educational tools in a multi-pronged strategy built around using streaming data delivered through customized web services, focused undergraduate tiger teams, teacher training and video/documentary film-making. Core to the efforts is on engaging the undergraduate community by leveraging the data management tools of the U.S. Integrated Ocean Observing System (IOOS) and the education tools of the U.S. National Science Foundation's (NSF) Ocean Observing Initiative (OOI). These intuitive interactive browser-based tools reduce the barriers for student participation in sea exploration and discovery, and allowing them to become "field going" oceanographers while sitting at their desk. Those undergraduate student efforts complement efforts to improve educator and student engagement in ocean sciences through exposure to scientists and data. Through professional development and the creation of data tools, we will reduce the logistical costs of bringing ocean science to students in grades 6-16. We are providing opportunities to: 1) build capacity of scientists in communicating and engaging with diverse audiences; 2) create scalable, in-person and virtual opportunities for educators and students to engage with scientists and their research through data visualizations, data activities, educator workshops, webinars, and student research symposia. We are using a blended learning approach to promote partnerships and cross-disciplinary sharing. Finally we use data and video products to entrain public support through the development of science documentaries about the science and people who conduct it. For example Antarctic Edge is a feature length award-winning documentary about climate change that has garnered interest in movie theatres

  2. Sensor-Based Auto-Focusing System Using Multi-Scale Feature Extraction and Phase Correlation Matching

    Directory of Open Access Journals (Sweden)

    Jinbeum Jang

    2015-03-01

    Full Text Available This paper presents a novel auto-focusing system based on a CMOS sensor containing pixels with different phases. Robust extraction of features in a severely defocused image is the fundamental problem of a phase-difference auto-focusing system. In order to solve this problem, a multi-resolution feature extraction algorithm is proposed. Given the extracted features, the proposed auto-focusing system can provide the ideal focusing position using phase correlation matching. The proposed auto-focusing (AF algorithm consists of four steps: (i acquisition of left and right images using AF points in the region-of-interest; (ii feature extraction in the left image under low illumination and out-of-focus blur; (iii the generation of two feature images using the phase difference between the left and right images; and (iv estimation of the phase shifting vector using phase correlation matching. Since the proposed system accurately estimates the phase difference in the out-of-focus blurred image under low illumination, it can provide faster, more robust auto focusing than existing systems.

  3. Scanner focus metrology and control system for advanced 10nm logic node

    Science.gov (United States)

    Oh, Junghun; Maeng, Kwang-Seok; Shin, Jae-Hyung; Choi, Won-Woong; Won, Sung-Keun; Grouwstra, Cedric; El Kodadi, Mohamed; Heil, Stephan; van der Meijden, Vidar; Hong, Jong Kyun; Kim, Sang-Jin; Kwon, Oh-Sung

    2018-03-01

    Immersion lithography is being extended beyond the 10-nm node and the lithography performance requirement needs to be tightened further to ensure good yield. Amongst others, good on-product focus control with accurate and dense metrology measurements is essential to enable this. In this paper, we will present new solutions that enable onproduct focus monitoring and control (mean and uniformity) suitable for high volume manufacturing environment. We will introduce the concept of pure focus and its role in focus control through the imaging optimizer scanner correction interface. The results will show that the focus uniformity can be improved by up to 25%.

  4. Review of vascularised bone tissue-engineering strategies with a focus on co-culture systems.

    Science.gov (United States)

    Liu, Yuchun; Chan, Jerry K Y; Teoh, Swee-Hin

    2015-02-01

    Poor angiogenesis within tissue-engineered grafts has been identified as a main challenge limiting the clinical introduction of bone tissue-engineering (BTE) approaches for the repair of large bone defects. Thick BTE grafts often exhibit poor cellular viability particularly at the core, leading to graft failure and lack of integration with host tissues. Various BTE approaches have been explored for improving vascularisation in tissue-engineered constructs and are briefly discussed in this review. Recent investigations relating to co-culture systems of endothelial and osteoblast-like cells have shown evidence of BTE efficacy in increasing vascularization in thick constructs. This review provides an overview of key concepts related to bone formation and then focuses on the current state of engineered vascularized co-culture systems using bone repair as a model. It will also address key questions regarding the generation of clinically relevant vascularized bone constructs as well as potential directions and considerations for research with the objective of pursuing engineered co-culture systems in other disciplines of vascularized regenerative medicine. The final objective is to generate serious and functional long-lasting vessels for sustainable angiogenesis that will enable enhanced cellular survival within thick voluminous bone grafts, thereby aiding in bone formation and remodelling in the long term. However, more evidence about the quality of blood vessels formed and its associated functional improvement in bone formation as well as a mechanistic understanding of their interactions are necessary for designing better therapeutic strategies for translation to clinical settings. Copyright © 2012 John Wiley & Sons, Ltd.

  5. Environmental Outcomes in the South African Learnership System ...

    African Journals Online (AJOL)

    Since 1994, the published environmental goals and objectives of the South African Government include environmental education outcomes in all education and ... of manifest and latent environmental outcomes distributed across learnerships and SETAs; a strong influence of occupational health and safety legislation; and a ...

  6. A large waterborne outbreak of campylobacteriosis in Norway: The need to focus on distribution system safety

    Directory of Open Access Journals (Sweden)

    Lund Helge

    2008-09-01

    of water distribution systems. Good quality source water alone is not enough to ensure water safety. For a better risk management, more focus should be put on the distribution system security. Waterworks personnel should monitor the pressure regularly; reduce the leakage by upgrading the distribution network and use chlorination when conducting maintenance work.

  7. Incorporation of ice sheet models into an Earth system model: Focus on methodology of coupling

    Science.gov (United States)

    Rybak, Oleg; Volodin, Evgeny; Morozova, Polina; Nevecherja, Artiom

    2018-03-01

    Elaboration of a modern Earth system model (ESM) requires incorporation of ice sheet dynamics. Coupling of an ice sheet model (ICM) to an AOGCM is complicated by essential differences in spatial and temporal scales of cryospheric, atmospheric and oceanic components. To overcome this difficulty, we apply two different approaches for the incorporation of ice sheets into an ESM. Coupling of the Antarctic ice sheet model (AISM) to the AOGCM is accomplished via using procedures of resampling, interpolation and assigning to the AISM grid points annually averaged meanings of air surface temperature and precipitation fields generated by the AOGCM. Surface melting, which takes place mainly on the margins of the Antarctic peninsula and on ice shelves fringing the continent, is currently ignored. AISM returns anomalies of surface topography back to the AOGCM. To couple the Greenland ice sheet model (GrISM) to the AOGCM, we use a simple buffer energy- and water-balance model (EWBM-G) to account for orographically-driven precipitation and other sub-grid AOGCM-generated quantities. The output of the EWBM-G consists of surface mass balance and air surface temperature to force the GrISM, and freshwater run-off to force thermohaline circulation in the oceanic block of the AOGCM. Because of a rather complex coupling procedure of GrIS compared to AIS, the paper mostly focuses on Greenland.

  8. Focusing Conservation Efforts on Ecosystem Service Supply May Increase Vulnerability of Socio-Ecological Systems.

    Directory of Open Access Journals (Sweden)

    Pedro Laterra

    Full Text Available Growing concern about the loss of ecosystem services (ES promotes their spatial representation as a key tool for the internalization of the ES framework into land use policies. Paradoxically, mapping approaches meant to inform policy decisions focus on the magnitude and spatial distribution of the biophysical supply of ES, largely ignoring the social mechanisms by which these services influence human wellbeing. If social mechanisms affecting ES demand, enhancing it or reducing it, are taken more into account, then policies are more effective. By developing and applying a new mapping routine to two distinct socio-ecological systems, we show a strong spatial uncoupling between ES supply and socio-ecological vulnerability to the loss of ES, under scenarios of land use and cover change. Public policies based on ES supply might not only fail at detecting priority conservation areas for the wellbeing of human societies, but may also increase their vulnerability by neglecting areas of currently low, but highly valued ES supply.

  9. New classification system-based visual outcome in Eales′ disease

    Directory of Open Access Journals (Sweden)

    Saxena Sandeep

    2007-01-01

    Full Text Available Purpose: A retrospective tertiary care center-based study was undertaken to evaluate the visual outcome in Eales′ disease, based on a new classification system, for the first time. Materials and Methods: One hundred and fifty-nine consecutive cases of Eales′ disease were included. All the eyes were staged according to the new classification: Stage 1: periphlebitis of small (1a and large (1b caliber vessels with superficial retinal hemorrhages; Stage 2a: capillary non-perfusion, 2b: neovascularization elsewhere/of the disc; Stage 3a: fibrovascular proliferation, 3b: vitreous hemorrhage; Stage 4a: traction/combined rhegmatogenous retinal detachment and 4b: rubeosis iridis, neovascular glaucoma, complicated cataract and optic atrophy. Visual acuity was graded as: Grade I 20/20 or better; Grade II 20/30 to 20/40; Grade III 20/60 to 20/120 and Grade IV 20/200 or worse. All the cases were managed by medical therapy, photocoagulation and/or vitreoretinal surgery. Visual acuity was converted into decimal scale, denoting 20/20=1 and 20/800=0.01. Paired t-test / Wilcoxon signed-rank tests were used for statistical analysis. Results: Vitreous hemorrhage was the commonest presenting feature (49.32%. Cases with Stages 1 to 3 and 4a and 4b achieved final visual acuity ranging from 20/15 to 20/40; 20/80 to 20/400 and 20/200 to 20/400, respectively. Statistically significant improvement in visual acuities was observed in all the stages of the disease except Stages 1a and 4b. Conclusion: Significant improvement in visual acuities was observed in the majority of stages of Eales′ disease following treatment. This study adds further to the little available evidences of treatment effects in literature and may have effect on patient care and health policy in Eales′ disease.

  10. Focus on focusing

    International Nuclear Information System (INIS)

    Anon.

    1985-01-01

    The discovery and impact of the principle of strong focusing was celebrated at a history Symposium at Stanford on 25 July in the course of the 1985 US Summer School on Particle Accelerators. Burt Richter, Stanford Linac Director, who introduced all the speakers with well chosen reminders about their various contributions related to the theme of the symposium, remarked that it was an appropriate time to be lauding the great contributions of accelerator physicists following the Nobel Prize award to Simon van der Meer for outstanding achievements in accelerator physics

  11. Focus on focusing

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1985-10-15

    The discovery and impact of the principle of strong focusing was celebrated at a history Symposium at Stanford on 25 July in the course of the 1985 US Summer School on Particle Accelerators. Burt Richter, Stanford Linac Director, who introduced all the speakers with well chosen reminders about their various contributions related to the theme of the symposium, remarked that it was an appropriate time to be lauding the great contributions of accelerator physicists following the Nobel Prize award to Simon van der Meer for outstanding achievements in accelerator physics.

  12. Educational outcomes in a system of care for children with emotional disturbance.

    Science.gov (United States)

    Strompolis, Melissa; Vishnevsky, Tanya; Reeve, Charlie L; Munsell, Eylin Palamaro; Cook, James R; Kilmer, Ryan P

    2012-01-01

    In North Carolina, only 69% of high school students graduate in 4 years; however, recent data suggest that only 42% of students with mental and emotional disabilities graduate. MeckCARES, a system of care (SOC) in Mecklenburg County, North Carolina, is designed to serve youth with severe emotional disturbances and their families. The SOC philosophy is a prominent family-focused approach intended to provide comprehensive, coordinated networks of services, tailored to the needs of the child and family, while emphasizing the strengthening of natural community supports. In addition to other mental health objectives, a particular goal of MeckCARES is to address specific school-based needs of system-identified youth to improve educational outcomes and reduce the risk of dropping out. This study sought to assess empirically the impact that enrollment in MeckCARES has on graduation precursors; namely, grades, suspensions, and absences. This study found that, on average, enrollment in MeckCARES is not associated with positive changes in educational variables. Implications of these findings are discussed, as are future directions. For example, additional research is needed with more sensitive measurement and data collection procedures (i.e., access to graduation rates and Medicaid information) to adequately assess the impact of enrollment in MeckCARES on educational outcomes. © 2012 American Orthopsychiatric Association.

  13. Managing Safety and Operations: The Effect of Joint Management System Practices on Safety and Operational Outcomes.

    Science.gov (United States)

    Tompa, Emile; Robson, Lynda; Sarnocinska-Hart, Anna; Klassen, Robert; Shevchenko, Anton; Sharma, Sharvani; Hogg-Johnson, Sheilah; Amick, Benjamin C; Johnston, David A; Veltri, Anthony; Pagell, Mark

    2016-03-01

    The aim of this study was to determine whether management system practices directed at both occupational health and safety (OHS) and operations (joint management system [JMS] practices) result in better outcomes in both areas than in alternative practices. Separate regressions were estimated for OHS and operational outcomes using data from a survey along with administrative records on injuries and illnesses. Organizations with JMS practices had better operational and safety outcomes than organizations without these practices. They had similar OHS outcomes as those with operations-weak practices, and in some cases, better outcomes than organizations with safety-weak practices. They had similar operational outcomes as those with safety-weak practices, and better outcomes than those with operations-weak practices. Safety and operations appear complementary in organizations with JMS practices in that there is no penalty for either safety or operational outcomes.

  14. Treatment with budesonide/formoterol pressurized metered-dose inhaler in patients with asthma: a focus on patient-reported outcomes

    Directory of Open Access Journals (Sweden)

    Richard D O'Connor

    2011-01-01

    Full Text Available Richard D O'ConnorSharp Rees-Stealy Medical Group, San Diego, CA, USAAbstract: In the United States, budesonide/formoterol pressurized metered-dose inhaler (pMDI is approved for treatment of asthma in patients aged ≥12 years whose asthma is not adequately controlled with an inhaled corticosteroid (ICS or whose disease severity clearly warrants treatment with an ICS and a long-acting β2-adrenergic agonist. This article reviews studies of budesonide/formoterol pMDI in patients with persistent asthma, with a particular focus on patient-reported outcomes (eg, perceived onset of effect, patient satisfaction with treatment, health-related quality of life [HRQL], global assessments, sleep quality and quantity, as these measures reflect patient perceptions of asthma control and disease burden. A search of PubMed and respiratory meetings was performed to identify relevant studies. In two pivotal budesonide/formoterol pMDI studies in adolescents and adults, greater efficacy and similar tolerability were shown with budesonide/formoterol pMDI 160/9 µg and 320/9 µg twice daily versus its monocomponents or placebo. In those studies, improvements in HRQL, patient satisfaction, global assessments of asthma control, and quality of sleep also favored budesonide/formoterol pMDI compared with one or both of its monocomponents or placebo. Budesonide/formoterol pMDI has a rapid onset of effect (within 15 minutes that patients can feel, an attribute that may have benefits for treatment adherence. In summary, budesonide/formoterol pMDI is effective and well tolerated and has additional therapeutic benefits that may be important from the patient’s perspective.Keywords: budesonide, formoterol, patient-reported outcomes, efficacy, tolerability, onset of effect

  15. The Immune System Bridges the Gut Microbiota with Systemic Energy Homeostasis: Focus on TLRs, Mucosal Barrier, and SCFAs.

    Science.gov (United States)

    Spiljar, Martina; Merkler, Doron; Trajkovski, Mirko

    2017-01-01

    The gut microbiota is essential for the development and regulation of the immune system and the metabolism of the host. Germ-free animals have altered immunity with increased susceptibility to immunologic diseases and show metabolic alterations. Here, we focus on two of the major immune-mediated microbiota-influenced components that signal far beyond their local environment. First, the activation or suppression of the toll-like receptors (TLRs) by microbial signals can dictate the tone of the immune response, and they are implicated in regulation of the energy homeostasis. Second, we discuss the intestinal mucosal surface is an immunologic component that protects the host from pathogenic invasion, is tightly regulated with regard to its permeability and can influence the systemic energy balance. The short chain fatty acids are a group of molecules that can both modulate the intestinal barrier and escape the gut to influence systemic health. As modulators of the immune response, the microbiota-derived signals influence functions of distant organs and can change susceptibility to metabolic diseases.

  16. Avatar Web-Based Self-Report Survey System Technology for Public Health Research: Technical Outcome Results and Lessons Learned.

    Science.gov (United States)

    Savel, Craig; Mierzwa, Stan; Gorbach, Pamina M; Souidi, Samir; Lally, Michelle; Zimet, Gregory; Interventions, Aids

    2016-01-01

    This paper reports on a specific Web-based self-report data collection system that was developed for a public health research study in the United States. Our focus is on technical outcome results and lessons learned that may be useful to other projects requiring such a solution. The system was accessible from any device that had a browser that supported HTML5. Report findings include: which hardware devices, Web browsers, and operating systems were used; the rate of survey completion; and key considerations for employing Web-based surveys in a clinical trial setting.

  17. The Alsep Data Recovery Focus Group of NASA's Solar System Exploration Research Virtual Institute

    Science.gov (United States)

    Nagihara, S.; Lewis, L. R.; Nakamura, Y.; Williams, D. R.; Taylor, P. T.; Hills, H. K.; Kiefer, W. S.; Neal, C. R.; Schmidt, G. K.

    2014-12-01

    Astronauts on Apollo 12, 14, 15, 16, and 17 deployed instruments on the Moon for 14 geophysical experiments (passive & active seismic, heat flow, magnetics, etc.) from 1969 to 1972. These instruments were called Apollo Lunar Surface Experiments Packages (ALSEPs). ALSEPs kept transmitting data to the Earth until September 1977. When the observation program ended in 1977, a large portion of these data were not delivered to the National Space Science Data Center for permanent archive. In 2010, for the purpose of searching, recovering, preserving, and analyzing the data that were not previously archived, NASA's then Lunar Science Institute formed the ALSEP Data Recovery Focus Group. The group consists of current lunar researchers and those involved in the ALSEP design and data analysis in the 1960s and 1970s. Among the data not previously archived were the 5000+ 7-track open-reel tapes that recorded raw data from all the ALSEP instruments from April 1973 to February 1976 ('ARCSAV tapes'). These tapes went missing in the decades after Apollo. One of the major achievements of the group so far is that we have found 450 ARCSAV tapes from April to June 1975 and that we are extracting data from them. There are 3 other major achievements by the group. First, we have established a web portal at the Lunar and Planetary Institute, where ~700 ALSEP-related documents, totaling ~40,000 pages, have been digitally scanned and cataloged. Researchers can search and download these documents at www.lpi.usra.edu/ lunar/ALSEP/. Second, we have been retrieving notes and reports left behind by the now deceased/retired ALSEP investigators at their home institutions. Third, we have been re-analyzing the ALSEP data using the information from the recently recovered metadata (instrument calibration data, operation logs, etc.). Efforts are ongoing to get these data permanently archived in the Planetary Data System (PDS).

  18. Simulations of adaptive temperature control with self-focused hyperthermia system for tumor treatment.

    Science.gov (United States)

    Hu, Jiwen; Ding, Yajun; Qian, Shengyou; Tang, Xiangde

    2013-01-01

    The control problem in ultrasound therapy is to destroy the tumor tissue while not harming the intervening healthy tissue with a desired temperature elevation. The objective of this research is to present a robust and feasible method to control the temperature distribution and the temperature elevation in treatment region within the prescribed time, which can improve the curative effect and decrease the treatment time for heating large tumor (≥2.0cm in diameter). An adaptive self-tuning-regulator (STR) controller has been introduced into this control method by adding a time factor with a recursive algorithm, and the speed of sound and absorption coefficient of the medium is considered as a function of temperature during heating. The presented control method is tested for a self-focused concave spherical transducer (0.5MHz, 9cm aperture, 8.0cm focal length) through numerical simulations with three control temperatures of 43°C, 50°C and 55°C. The results suggest that this control system has adaptive ability for variable parameters and has a rapid response to the temperature and acoustic power output in the prescribed time for the hyperthermia interest. There is no overshoot during temperature elevation and no oscillation after reaching the desired temperatures. It is found that the same results can be obtained for different frequencies and temperature elevations. This method can obtain an ellipsoid-shaped ablation region, which is meaningful for the treatment of large tumor. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. Issues connected with indirect cost quantification: a focus on the transportation system

    Science.gov (United States)

    Křivánková, Zuzana; Bíl, Michal; Kubeček, Jan; Vodák, Rostislav

    2017-04-01

    Transportation and communication networks in general are vital parts of modern society. The economy relies heavily on transportation system performance. A number of people commutes to work regularly. Stockpiles in many companies are being reduced as the just-in-time production process is able to supply resources via the transportation network on time. Natural hazards have the potential to disturb transportation systems. Earthquakes, flooding or landsliding are examples of high-energetic processes which are capable of causing direct losses (i.e. physical damage to the infrastructure). We have focused on quantification of the indirect cost of natural hazards which are not easy to estimate. Indirect losses can also emerge as a result of meteorological hazards with low energy which only seldom cause direct losses, e.g. glaze, snowfall. Whereas evidence of repair work and general direct costs usually exist or can be estimated, indirect costs are much more difficult to identify particularly when they are not covered by insurance agencies. Delimitations of alternative routes (detours) are the most frequent responses to blocked road links. Indirect costs can then be related to increased fuel consumption and additional operating costs. Detours usually result in prolonged travel times. Indirect costs quantification has to therefore cover the value of the time. The costs from the delay are a nonlinear function of travel time, however. The existence of an alternative transportation pattern may also result in an increased number of traffic crashes. This topic has not been studied in depth but an increase in traffic crashes has been reported when people suddenly changed their traffic modes, e.g. when air traffic was not possible. The lost user benefit from those trips that were cancelled or suppressed is also difficult to quantify. Several approaches, based on post-event questioner surveys, have been applied to communities and companies affected by transportation accessibility

  20. Using focus groups to design systems science models that promote oral health equity.

    Science.gov (United States)

    Kum, Susan S; Northridge, Mary E; Metcalf, Sara S

    2018-06-04

    While the US population overall has experienced improvements in oral health over the past 60 years, oral diseases remain among the most common chronic conditions across the life course. Further, lack of access to oral health care contributes to profound and enduring oral health inequities worldwide. Vulnerable and underserved populations who commonly lack access to oral health care include racial/ethnic minority older adults living in urban environments. The aim of this study was to use a systematic approach to explicate cause and effect relationships in creating a causal map, a type of concept map in which the links between nodes represent causality or influence. To improve our mental models of the real world and devise strategies to promote oral health equity, methods including system dynamics, agent-based modeling, geographic information science, and social network simulation have been leveraged by the research team. The practice of systems science modeling is situated amidst an ongoing modeling process of observing the real world, formulating mental models of how it works, setting decision rules to guide behavior, and from these heuristics, making decisions that in turn affect the state of the real world. Qualitative data were obtained from focus groups conducted with community-dwelling older adults who self-identify as African American, Dominican, or Puerto Rican to elicit their lived experiences in accessing oral health care in their northern Manhattan neighborhoods. The findings of this study support the multi-dimensional and multi-level perspective of access to oral health care and affirm a theorized discrepancy in fit between available dental providers and patients. The lack of information about oral health at the community level may be compromising the use and quality of oral health care among racial/ethnic minority older adults. Well-informed community members may fill critical roles in oral health promotion, as they are viewed as highly credible

  1. A Design of Real-time Automatic Focusing System for Digital Still Camera Using the Passive Sensor Error Minimization

    Energy Technology Data Exchange (ETDEWEB)

    Kim, K.S. [Samsung Techwin Co., Ltd., Seoul (Korea); Kim, D.Y. [Bucheon College, Bucheon (Korea); Kim, S.H. [University of Seoul, Seoul (Korea)

    2002-05-01

    In this paper, the implementation of a new AF(Automatic Focusing) system for a digital still camera is introduced. The proposed system operates in real-time while adjusting focus after the measurement of distance to an object using a passive sensor, which is different from a typical method. In addition, measurement errors were minimized by using the data acquired empirically, and the optimal measuring time was obtained using EV(Exposure Value) which is calculated from CCD luminance signal. Moreover, this system adopted an auxiliary light source for focusing in absolute dark conditions, which is very hard for CCD image processing. Since this is an open-loop system adjusting focus immediately after the distance measurement, it guarantees real-time operation. The performance of this new AF system was verified by comparing the focusing value curve obtained from AF experiment with the one from the measurement by MF(Manual-Focusing). In both case, edge detector was used for various objects and backgrounds. (author). 9 refs., 11 figs., 5 tabs.

  2. Profession differences in family focused practice in the adult mental health system.

    Science.gov (United States)

    Maybery, Darryl; Goodyear, Melinda; O'Hanlon, Brendan; Cuff, Rose; Reupert, Andrea

    2014-12-01

    There is a large gulf between what psychiatric services should (or could) provide and what they do in practice. This article sought to determine practice differences between the differing professions working in adult mental health services in terms of their family focused work. Three hundred and seven adult mental health professionals completed a cross-sectional survey of family focused practices in adult mental health services. Findings highlight that social workers engaged in more family focused practice compared to psychiatric nurses, who performed consistently the lowest on direct family care, compared to both social workers and psychologists. Clear skill, knowledge, and confidence differences are indicated between the professions. The article concludes by offering direction for future profession education and training in family focused practices. © 2014 Family Process Institute.

  3. Severity scoring in the critically ill: part 2: maximizing value from outcome prediction scoring systems.

    Science.gov (United States)

    Breslow, Michael J; Badawi, Omar

    2012-02-01

    Part 2 of this review of ICU scoring systems examines how scoring system data should be used to assess ICU performance. There often are two different consumers of these data: lCU clinicians and quality leaders who seek to identify opportunities to improve quality of care and operational efficiency, and regulators, payors, and consumers who want to compare performance across facilities. The former need to know how to garner maximal insight into their care practices; this includes understanding how length of stay (LOS) relates to quality, analyzing the behavior of different subpopulations, and following trends over time. Segregating patients into low-, medium-, and high-risk populations is especially helpful, because care issues and outcomes may differ across this severity continuum. Also, LOS behaves paradoxically in high-risk patients (survivors often have longer LOS than nonsurvivors); failure to examine this subgroup separately can penalize ICUs with superior outcomes. Consumers of benchmarking data often focus on a single score, the standardized mortality ratio (SMR). However, simple SMRs are disproportionately affected by outcomes in high-risk patients, and differences in population composition, even when performance is otherwise identical, can result in different SMRs. Future benchmarking must incorporate strategies to adjust for differences in population composition and report performance separately for low-, medium- and high-acuity patients. Moreover, because many ICUs lack the resources to care for high-acuity patients (predicted mortality >50%), decisions about where patients should receive care must consider both ICU performance scores and their capacity to care for different types of patients.

  4. Forest Focus Monitoring Database System - Technical Report 2003 Level II Data

    OpenAIRE

    HIEDERER ROLAND; DURRANT TRACY; GRANKE O.; LAMBOTTE Michel; LORENZ M.; MIGNON B.; OEHMICHEN K.

    2007-01-01

    Forest Focus (Regulation (EC) No 2152/2003) is a Community scheme for harmonized, broad-based, comprehensive and long-term monitoring of European forest ecosystems. Under this scheme the monitoring of air pollution effects on forests is carried out by participating countries on the basis of the systematic network of observation points (Level I) and of the network of observation plots for intensive and continuous monitoring (Level II). According to Article 15(1) of the Forest Focus Regulat...

  5. Forest Focus Monitoring Database System - Technical Report 2006 Level II Data

    OpenAIRE

    HIEDERER Roland; DURRANT Tracy; GRANKE Oliver; LAMBOTTE Michel; LORENZ Martin; MIGNON Bertrand

    2008-01-01

    Forest Focus (Regulation (EC) No 2152/2003) is a Community scheme for harmonized, broadbased, comprehensive and long-term monitoring of European forest ecosystems. Under this scheme the monitoring of air pollution effects on forests is carried out by participating countries on the basis of the systematic network of observation points (Level I) and of the network of observation plots for intensive and continuous monitoring (Level II). According to Article 15(1) of the Forest Focus Regulatio...

  6. The Single Logon Application: an enabler for access to disparate systems in a patient-focused care environment.

    Science.gov (United States)

    SooHoo, S. L.; Aabedi, F.; Wagenet, R. C.; Dorst, M.; Stempson, M.

    1995-01-01

    The presence of separate, independent systems for patient results is a common problem in many institutions. The Single Logon Application (SLA) was developed to mitigate the problems presented by these disparate systems, and its use was a key component in a Patient-Focused Care (PFC) implementation. PMID:8563263

  7. Mind-Body Medicine and Immune System Outcomes: A Systematic Review

    OpenAIRE

    Wahbeh, Helané; Haywood, Ashley; Kaufman, Karen; Zwickey, Heather

    2009-01-01

    This study is a systematic review of mind-body interventions that used immune outcomes in order to: 1) characterize mind-body medicine studies that assessed immune outcomes, 2) evaluate the quality of mind-body medicine studies measuring immune system effects, and 3) systematically evaluate the evidence for mind-body interventions effect on immune system outcomes using existing formal tools. 111 studies with 4,777 subjects were reviewed. The three largest intervention type categories were Rel...

  8. Outcome of limb reconstruction system in open tibial diaphyseal fractures

    Directory of Open Access Journals (Sweden)

    Anand Ajmera

    2015-01-01

    Full Text Available Background: Management of open tibial diaphyseal fractures with bone loss is a matter of debate. The treatment options range from external fixators, nailing, ring fixators or grafting with or without plastic reconstruction. All the procedures have their own set of complications, like acute docking problems, shortening, difficulty in soft tissue management, chronic infection, increased morbidity, multiple surgeries, longer hospital stay, mal union, nonunion and higher patient dissatisfaction. We evaluated the outcome of the limb reconstruction system (LRS in the treatment of open fractures of tibial diaphysis with bone loss as a definative mode of treatment to achieve union, as well as limb lengthening, simultaneously. Materials and Methods: Thirty open fractures of tibial diaphysis with bone loss of at least 4 cm or more with a mean age 32.5 years were treated by using the LRS after debridement. Distraction osteogenesis at rate of 1 mm/day was done away from the fracture site to maintain the limb length. On the approximation of fracture ends, the dynamized LRS was left for further 15-20 weeks and patient was mobilized with weight bearing to achieve union. Functional assessment was done by Association for the Study and Application of the Methods of Illizarov (ASAMI criteria. Results: Mean followup period was 15 months. The mean bone loss was 5.5 cm (range 4-9 cm. The mean duration of bone transport was 13 weeks (range 8-30 weeks with a mean time for LRS in place was 44 weeks (range 24-51 weeks. The mean implant index was 56.4 days/cm. Mean union time was 52 weeks (range 31-60 weeks with mean union index of 74.5 days/cm. Bony results as per the ASAMI scoring were excellent in 76% (19/25, good in 12% (3/25 and fair in 4% (1/25 with union in all except 2 patients, which showed poor results (8% with only 2 patients having leg length discrepancy more than 2.5 cm. Functional results were excellent in 84% (21/25, good in 8% (2/25, fair in 8% (2/25. Pin

  9. Outcome of limb reconstruction system in open tibial diaphyseal fractures.

    Science.gov (United States)

    Ajmera, Anand; Verma, Ankit; Agrawal, Mukul; Jain, Saurabh; Mukherjee, Arunangshu

    2015-01-01

    Management of open tibial diaphyseal fractures with bone loss is a matter of debate. The treatment options range from external fixators, nailing, ring fixators or grafting with or without plastic reconstruction. All the procedures have their own set of complications, like acute docking problems, shortening, difficulty in soft tissue management, chronic infection, increased morbidity, multiple surgeries, longer hospital stay, mal union, nonunion and higher patient dissatisfaction. We evaluated the outcome of the limb reconstruction system (LRS) in the treatment of open fractures of tibial diaphysis with bone loss as a definative mode of treatment to achieve union, as well as limb lengthening, simultaneously. Thirty open fractures of tibial diaphysis with bone loss of at least 4 cm or more with a mean age 32.5 years were treated by using the LRS after debridement. Distraction osteogenesis at rate of 1 mm/day was done away from the fracture site to maintain the limb length. On the approximation of fracture ends, the dynamized LRS was left for further 15-20 weeks and patient was mobilized with weight bearing to achieve union. Functional assessment was done by Association for the Study and Application of the Methods of Illizarov (ASAMI) criteria. Mean followup period was 15 months. The mean bone loss was 5.5 cm (range 4-9 cm). The mean duration of bone transport was 13 weeks (range 8-30 weeks) with a mean time for LRS in place was 44 weeks (range 24-51 weeks). The mean implant index was 56.4 days/cm. Mean union time was 52 weeks (range 31-60 weeks) with mean union index of 74.5 days/cm. Bony results as per the ASAMI scoring were excellent in 76% (19/25), good in 12% (3/25) and fair in 4% (1/25) with union in all except 2 patients, which showed poor results (8%) with only 2 patients having leg length discrepancy more than 2.5 cm. Functional results were excellent in 84% (21/25), good in 8% (2/25), fair in 8% (2/25). Pin tract infection was seen in 5 cases, out of which 4

  10. Outcome of Pregnancy in Patients with Systemic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    Chiong-Hee Wong

    2006-06-01

    Conclusion: Pregnancy is relatively safe in women with SLE in remission but should be considered as a high-risk pregnancy. APS is associated with poor pregnancy outcome. The patient needs to cooperate with obstetricians and physicians for optimal disease control and detailed monitoring throughout the gestation.

  11. Systemic effects of periodontitis: Lessons learned from research on atherosclerotic vascular disease and adverse pregnancy outcomes

    Science.gov (United States)

    Papapanou, Panos N.

    2015-01-01

    Studies conducted over the past 25 years have focused on the role of periodontitis, an inflammatory condition of microbial etiology that destroys the tooth supporting tissues, as a systemic inflammatory stressor that can act as an independent risk factor of atherosclerotic vascular disease (AVSD) and adverse pregnancy outcomes (APOs). It has been suggested that periodontitis-associated bacteremias and systemic dissemination of inflammatory mediators produced in the periodontal tissues may result in systemic inflammation and endothelial dysfunction, while bacteria of oral origin may translocate into the feto-placental unit. Epidemiologic studies largely support an association between periodontitis and ASVD / APOs independent of known confounders; indeed, periodontitis has been shown to confer statistically significantly elevated risk for clinical events associated with ASVD and APOs in multivariable adjustments. On the other hand, intervention studies demonstrate that although periodontal therapy reduces systemic inflammation and improves endothelial function, it has no positive effect on the incidence of APOs. Studies of the effects of periodontal interventions on ASVD-related clinical events are lacking. This review summarizes key findings from mechanistic, association and intervention studies and attempts to reconcile the seemingly contradictory evidence that originates from different lines of investigation. PMID:26388299

  12. Improved self-control system for the DR1 high resolution focusing neutron crystal diffractometer operation

    International Nuclear Information System (INIS)

    Ionita, I; Florescu, V.

    2010-01-01

    During the last decade new principles for the design of high-resolution configurations for crystal neutron diffractometry have been developed leading to the concept of Q-space high-resolution configuration which proved to be an alternative to the existing conventional configuration. The characteristics of such a focusing configuration are the use of open beam geometry (absence of the Soller collimators), use of the bent crystals in asymmetric reflection as monochromators and the rotation of the sample during the diffraction pattern raise, to fulfill the focusing conditions. High-resolution is obtained with no collimators by controlling the curvature and reflectivity of bent monochromators. At the sample position the beam width is rather wide offering the possibility to use wide plate-like samples with a significant raise of intensity; still high-resolution can be obtained by rotating the sample to get the focusing condition (to compensate the sample width contribution to the line-width) for each value of the scattering angle. This paper aims to clarify in which conditions such a Q-space focusing configuration, particularly that existing at INR Pitesti, can be used for stress determinations. Taking account of the characteristics of such measurements, it is quite obvious that the sample cannot be placed in focusing position appearing a limitation of the dimension of the sample region for which stress determinations are made, if we want still to have a reasonable good resolution. This can be done by using corresponding diaphragms in front of the sample holder but, if an optimal use of the available neutron beam is desired, a real-space focusing at sample position is required. For a two crystals monochromators unit the conditions to get real-space focusing were extensively analyzed by M. Popovici and W.B.Yelon. For the case of a single crystal monochromator, though such instruments are used at HMI Berlin or NRI Rez, a real space focusing is not possible to be achieved

  13. Audit filters for improving processes of care and clinical outcomes in trauma systems.

    Science.gov (United States)

    Evans, Christopher; Howes, Daniel; Pickett, William; Dagnone, Luigi

    2009-10-07

    intervention for improving processes of care, morbidity, or mortality for severely injured patients. Two authors independently screened the search results, applied inclusion criteria, and extracted data. There were no studies identified that met the inclusion criteria for this review. We were unable to identify any studies of sufficient methodological quality to draw conclusions regarding the effectiveness of audit filters as a performance improvement intervention in trauma systems. Future research using rigorous study designs should focus on the relative effectiveness of audit filters in comparison to alternative quality improvement strategies at improving processes of care, functional outcomes, and mortality for injured patients.

  14. Daily Management System of the Henry Ford Production System: QTIPS to Focus Continuous Improvements at the Level of the Work.

    Science.gov (United States)

    Zarbo, Richard J; Varney, Ruan C; Copeland, Jacqueline R; D'Angelo, Rita; Sharma, Gaurav

    2015-07-01

    To support our Lean culture of continuous improvement, we implemented a daily management system designed so critical metrics of operational success were the focus of local teams to drive improvements. We innovated a standardized visual daily management board composed of metric categories of Quality, Time, Inventory, Productivity, and Safety (QTIPS); frequency trending; root cause analysis; corrective/preventive actions; and resulting process improvements. In 1 year (June 2013 to July 2014), eight laboratory sections at Henry Ford Hospital employed 64 unique daily metrics. Most assessed long-term (>6 months), monitored process stability, while short-term metrics (1-6 months) were retired after successful targeted problem resolution. Daily monitoring resulted in 42 process improvements. Daily management is the key business accountability subsystem that enabled our culture of continuous improvement to function more efficiently at the managerial level in a visible manner by reviewing and acting based on data and root cause analysis. Copyright© by the American Society for Clinical Pathology.

  15. A cross-cultural validation of the Technology-Rich Outcomes-Focused Learning Environment Inventory (TROFLEI) in Turkey and the USA

    Science.gov (United States)

    Welch, Anita G.; Cakir, Mustafa; Peterson, Claudette M.; Ray, Chris M.

    2012-04-01

    Background . Studies exploring the relationship between students' achievement and the quality of the classroom learning environments have shown that there is a strong relationship between these two concepts. Learning environment instruments are constantly being revised and updated, including for use in different cultures, which requires continued validation efforts. Purpose The purpose of this study was to establish cross-cultural reliability and validity of the Technology-Rich Outcomes-Focused Learning Environment Inventory (TROFLEI) in both Turkey and the USA. Sample Approximately 980 students attending grades 9-12 in Turkey and 130 students attending grades 9-12 in the USA participated in the study. Design and method Scale reliability analyses and confirmatory factor analysis (CFA) were performed separately for Turkish and US participants for both actual and preferred responses to each scale to confirm the structure of the TROFLEI across these two distinct samples. Results Cronbach's alpha reliability coefficients, ranging from α = 0.820 to 0.931 for Turkish participants and from α = 0.778 to 0.939 for US participants, indicated that all scales have satisfactory internal consistency for both samples. Confirmatory factor analyses resulted in evidence of adequate model fit across both samples for both actual and preferred responses, with the root mean square error of approximation ranging from 0.052 to 0.057 and the comparative fit index ranging from 0.920 to 0.982. Conclusions This study provides initial evidence that the TROFLEI is valid for use in both the Turkish and US high-school populations (grades 9-12). However, the psychometric properties should be examined further with different populations, such as middle-school students (grades 6-8).

  16. WITHDRAWN: Nursing record systems: effects on nursing practice and healthcare outcomes.

    Science.gov (United States)

    Urquhart, Christine; Currell, Rosemary; Grant, Maria J; Hardiker, Nicholas R

    2018-05-15

    A nursing record system is the record of care that was planned or given to individual patients and clients by qualified nurses or other caregivers under the direction of a qualified nurse. Nursing record systems may be an effective way of influencing nurse practice. To assess the effects of nursing record systems on nursing practice and patient outcomes. For the original version of this review in 2000, and updates in 2003 and 2008, we searched: the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register; MEDLINE, EMBASE, CINAHL, BNI, ISI Web of Knowledge, and ASLIB Index of Theses. We also handsearched: Computers, Informatics, Nursing (Computers in Nursing); Information Technology in Nursing; and the Journal of Nursing Administration. For this update, searches can be considered complete until the end of 2007. We checked reference lists of retrieved articles and other related reviews. Randomised controlled trials (RCTs), controlled before and after studies, and interrupted time series comparing one kind of nursing record system with another in hospital, community or primary care settings. The participants were qualified nurses, students or healthcare assistants working under the direction of a qualified nurse, and patients receiving care recorded or planned using nursing record systems. Two review authors (in two pairs) independently assessed trial quality and extracted data. We included nine trials (eight RCTs, one controlled before and after study) involving 1846 people. The studies that evaluated nursing record systems focusing on relatively discrete and focused problems, for example effective pain management in children, empowering pregnant women and parents, reducing loss of notes, reducing time spent on data entry of test results, reducing transcription errors, and reducing the number of pieces of paper in a record, all demonstrated some degree of success in achieving the desired results. Studies of nursing care planning

  17. Chronic stress impacts the cardiovascular system: animal models and clinical outcomes.

    Science.gov (United States)

    Golbidi, Saeid; Frisbee, Jefferson C; Laher, Ismail

    2015-06-15

    Psychological stresses are associated with cardiovascular diseases to the extent that cardiovascular diseases are among the most important group of psychosomatic diseases. The longstanding association between stress and cardiovascular disease exists despite a large ambiguity about the underlying mechanisms. An array of possibilities have been proposed including overactivity of the autonomic nervous system and humoral changes, which then converge on endothelial dysfunction that initiates unwanted cardiovascular consequences. We review some of the features of the two most important stress-activated systems, i.e., the humoral and nervous systems, and focus on alterations in endothelial function that could ensue as a result of these changes. Cardiac and hematologic consequences of stress are also addressed briefly. It is likely that activation of the inflammatory cascade in association with oxidative imbalance represents key pathophysiological components of stress-induced cardiovascular changes. We also review some of the commonly used animal models of stress and discuss the cardiovascular outcomes reported in these models of stress. The unique ability of animals for adaptation under stressful conditions lessens the extrapolation of laboratory findings to conditions of human stress. An animal model of unpredictable chronic stress, which applies various stress modules in a random fashion, might be a useful solution to this predicament. The use of stress markers as indicators of stress intensity is also discussed in various models of animal stress and in clinical studies. Copyright © 2015 the American Physiological Society.

  18. SRC: FenixOS - A Research Operating System Focused on High Scalability and Reliability

    DEFF Research Database (Denmark)

    Passas, Stavros; Karlsson, Sven

    2011-01-01

    Computer systems keep increasing in size. Systems scale in the number of processing units, memories and peripheral devices. This creates many and diverse architectural trade-offs that the existing operating systems are not able to address. We are designing and implementing, FenixOS, a new operating...... of the operating system....... system that aims to improve the state of the art in scalability and reliability. We achieve scalability through limiting data sharing when possible, and through extensive use of lock-free data structures. Reliability is addressed with a careful re-design of the programming interface and structure...

  19. Evolving Systems of Care with Total Clinical Outcomes Management

    Science.gov (United States)

    Lyons, John S.; Epstein, Richard A.; Jordan, Neil

    2010-01-01

    The current article proposes that further specification of the system of care concept is required. Based on the assertions that the system of care concept (a) refers to an ideal as opposed to an observable phenomenon, and (b) is engaged in offering transformational experiences, the authors propose that the system of care definition must be…

  20. Use of animal models for space flight physiology studies, with special focus on the immune system

    Science.gov (United States)

    Sonnenfeld, Gerald

    2005-01-01

    Animal models have been used to study the effects of space flight on physiological systems. The animal models have been used because of the limited availability of human subjects for studies to be carried out in space as well as because of the need to carry out experiments requiring samples and experimental conditions that cannot be performed using humans. Experiments have been carried out in space using a variety of species, and included developmental biology studies. These species included rats, mice, non-human primates, fish, invertebrates, amphibians and insects. The species were chosen because they best fit the experimental conditions required for the experiments. Experiments with animals have also been carried out utilizing ground-based models that simulate some of the effects of exposure to space flight conditions. Most of the animal studies have generated results that parallel the effects of space flight on human physiological systems. Systems studied have included the neurovestibular system, the musculoskeletal system, the immune system, the neurological system, the hematological system, and the cardiovascular system. Hindlimb unloading, a ground-based model of some of the effects of space flight on the immune system, has been used to study the effects of space flight conditions on physiological parameters. For the immune system, exposure to hindlimb unloading has been shown to results in alterations of the immune system similar to those observed after space flight. This has permitted the development of experiments that demonstrated compromised resistance to infection in rodents maintained in the hindlimb unloading model as well as the beginning of studies to develop countermeasures to ameliorate or prevent such occurrences. Although there are limitations to the use of animal models for the effects of space flight on physiological systems, the animal models should prove very valuable in designing countermeasures for exploration class missions of the future.

  1. Available transfer capability evaluation and enhancement using various FACTS controllers: Special focus on system security

    Directory of Open Access Journals (Sweden)

    M. Venkateswara Rao

    2016-03-01

    Full Text Available Nowadays, because of the deregulation of the power industry the continuous increase of the load increases the necessity of calculation of available transfer capability (ATC of a system to analyze the system security. With this calculation, the scheduling of generator can be decided to decrease the system severity. Further, constructing new transmission lines, new substations are very cost effective to meet the increasing load and to increase the transfer capability. Hence, an alternative way to increase the transfer capability is use of flexible ac transmission system (FACTS controllers. In this paper, SSSC, STACOM and UPFC are considered to show the effect of these controllers in enhancing system ATC. For this, a novel current based modeling and optimal location strategy of these controllers are presented. The proposed methodology is tested on standard IEEE-30 bus and IEEE-57 bus test systems with supporting numerical and graphical results.

  2. Field test analysis of concentrator photovoltaic system focusing on average photon energy and temperature

    Science.gov (United States)

    Husna, Husyira Al; Ota, Yasuyuki; Minemoto, Takashi; Nishioka, Kensuke

    2015-08-01

    The concentrator photovoltaic (CPV) system is unique and different from the common flat-plate PV system. It uses a multi-junction solar cell and a Fresnel lens to concentrate direct solar radiation onto the cell while tracking the sun throughout the day. The cell efficiency could reach over 40% under high concentration ratio. In this study, we analyzed a one year set of environmental condition data of the University of Miyazaki, Japan, where the CPV system was installed. Performance ratio (PR) was discussed to describe the system’s performance. Meanwhile, the average photon energy (APE) was used to describe the spectrum distribution at the site where the CPV system was installed. A circuit simulator network was used to simulate the CPV system electrical characteristics under various environmental conditions. As for the result, we found that the PR of the CPV systems depends on the APE level rather than the cell temperature.

  3. Developing a plasma focus research training system for the fusion energy age

    International Nuclear Information System (INIS)

    Lee, S.

    2014-01-01

    The 3 kJ UNU/ICTP Plasma Focus Facility is the most significant device associated with the AAAPT (Asian African Association for Plasma Training). In original and modified/upgraded form it has trained generations of plasma focus (PF) researchers internationally, producing many PhD theses and peer-reviewed papers. The Lee Model code was developed for the design of this PF. This code has evolved to cover all PF machines for design, interpretation and optimization, for derivation of radiation scaling laws; and to provide insights into yield scaling limitations, radiative collapse, speed-enhanced and current-stepped PF variants. As example of fresh perspectives derivable from this code, this paper presents new results on energy transfers of the axial and radial phases of generalized PF devices. As the world moves inexorably towards the Fusion Energy Age it becomes ever more important to train plasma fusion researchers. A recent workshop in Nepal shows that demand for such training continues. Even commercial project development consultants are showing interest. We propose that the AAAPT-proven research package be upgraded, by modernizing the small PF for extreme modes of operation, switchable from the typical strong-focus mode to a slow-mode which barely pinches, thus producing a larger, more uniform plasma stream with superior deposition properties. Such a small device would be cost-effective and easily duplicated, and have the versatility of a range of experiments from intense multi-radiation generation and target damage studies to superior advanced-materials deposition. The complementary code is used to reference experiments up to the largest existing machine. This is ideal for studying machine limitations and scaling laws and to suggest new experiments. Such a modernized versatile PF machine complemented by the universally versatile code would extend the utility of the PF experience; so that AAAPT continues to provide leadership in pulsed plasma research training in

  4. Radiation Load Optimization in the Final Focus System of FCC-hh

    CERN Document Server

    Martin, Roman; Cerutti, Francesco; Tomás, Rogelio

    2016-01-01

    With a center-of-mass energy of up to 100 TeV, FCC-hh will produce highly energetic collision debris at the Interaction Point (IP). Protecting the final focus quadrupoles from this radiation is challenging, since the required amount of shielding placed inside the magnets will reduce the free aperture, thereby limiting the β^{*} reach and luminosity. Hence, radiation mitigation strategies that make best use of the available aperture are required. In this paper, we study the possibility to split the first quadrupole Q1 into two quadrupoles with individual apertures, in order to distribute the radiation load more evenly and reduce the peak dose.

  5. Implementation of Automatic Focusing Algorithms for a Computer Vision System with Camera Control.

    Science.gov (United States)

    1983-08-15

    obtainable from real data, rather than relying on a stock database. Often, computer vision and image processing algorithms become subconsciously tuned to...two coils on the same mount structure. Since it was not possible to reprogram the binary system, we turned to the POPEYE system for both its grey

  6. Training Effectiveness Evaluation (TEE) of the Advanced Fire Fighting Training System. Focus on the Trained Person.

    Science.gov (United States)

    Cordell, Curtis C.; And Others

    A training effectiveness evaluation of the Navy Advanced Fire Fighting Training System was conducted. This system incorporates simulated fires as well as curriculum materials and instruction. The fires are non-pollutant, computer controlled, and installed in a simulated shipboard environment. Two teams of 15 to 16 persons, with varying amounts of…

  7. Industrial & Engineering Systems Career Cluster ITAC for Career-Focused Education: Transportation Sub-Cluster. Integrated Technical & Academic Competencies.

    Science.gov (United States)

    Ohio State Univ., Columbus. Vocational Instructional Materials Lab.

    Designed for Ohio educators responsible for planning programs to prepare high school students for careers in transportation, this document presents an overview of Ohio's Integrated Technical and Academic Competencies (ITAC) system of career-focused education and specific information about the transportation subcluster of the industrial and…

  8. Program Evaluation of Group-based Cognitive Behavioral Therapy for Insomnia: a Focus on Treatment Adherence and Outcomes in Older Adults with Co-morbidities.

    Science.gov (United States)

    Ludwin, Brian M; Bamonti, Patricia; Mulligan, Elizabeth A

    2017-11-21

    To describe a program evaluation of the interrelationship of adherence and treatment outcomes in a sample of veteran older adults with co-morbidities who participated in group-based cognitive behavioral therapy for insomnia. Retrospective data extraction was performed for 14 older adults. Adherence measures and sleep outcomes were measured with sleep diaries and Insomnia Severity Index. Demographic and clinical information was extracted through chart review. Adherence with prescribed time in bed, daily sleep diaries, and maintaining consistent time out of bed and time in bed was generally high. There were moderate, though not significant, improvements in consistency of time in bed and time out of bed over time. Adherence was not significantly associated with sleep outcomes despite improvements in most sleep outcomes. The non-significant relationship between sleep outcomes and adherence may reflect the moderating influence of co-morbidities or may suggest a threshold effect beyond which stricter adherence has a limited impact on outcomes. Development of multi-method adherence measures across all treatment components will be important to understand the influence of adherence on treatment outcomes as monitoring adherence to time in bed and time out of bed had limited utility for understanding treatment outcomes in our sample.

  9. Pediatric Intubation by Paramedics in a Large Emergency Medical Services System: Process, Challenges, and Outcomes.

    Science.gov (United States)

    Prekker, Matthew E; Delgado, Fernanda; Shin, Jenny; Kwok, Heemun; Johnson, Nicholas J; Carlbom, David; Grabinsky, Andreas; Brogan, Thomas V; King, Mary A; Rea, Thomas D

    2016-01-01

    Pediatric intubation is a core paramedic skill in some emergency medical services (EMS) systems. The literature lacks a detailed examination of the challenges and subsequent adjustments made by paramedics when intubating children in the out-of-hospital setting. We undertake a descriptive evaluation of the process of out-of-hospital pediatric intubation, focusing on challenges, adjustments, and outcomes. We performed a retrospective analysis of EMS responses between 2006 and 2012 that involved attempted intubation of children younger than 13 years by paramedics in a large, metropolitan EMS system. We calculated the incidence rate of attempted pediatric intubation with EMS and county census data. To summarize the intubation process, we linked a detailed out-of-hospital airway registry with clinical records from EMS, hospital, or autopsy encounters for each child. The main outcome measures were procedural challenges, procedural success, complications, and patient disposition. Paramedics attempted intubation in 299 cases during 6.3 years, with an incidence of 1 pediatric intubation per 2,198 EMS responses. Less than half of intubations (44%) were for patients in cardiac arrest. Two thirds of patients were intubated on the first attempt (66%), and overall success was 97%. The most prevalent challenge was body fluids obscuring the laryngeal view (33%). After a failed first intubation attempt, corrective actions taken by paramedics included changing equipment (33%), suctioning (32%), and repositioning the patient (27%). Six patients (2%) experienced peri-intubation cardiac arrest and 1 patient had an iatrogenic tracheal injury. No esophageal intubations were observed. Of patients transported to the hospital, 86% were admitted to intensive care and hospital mortality was 27%. Pediatric intubation by paramedics was performed infrequently in this EMS system. Although overall intubation success was high, a detailed evaluation of the process of intubation revealed specific

  10. Transitions of interaction outcomes in a uni-directional consumer-resource system

    Science.gov (United States)

    Wang, Y.; DeAngelis, D.L.

    2011-01-01

    A uni-directional consumer-resource system of two species is analyzed. Our aim is to understand the mechanisms that determine how the interaction outcomes depend on the context of the interaction; that is, on the model parameters. The dynamic behavior of the model is described and, in particular, it is demonstrated that no periodic orbits exist. Then the parameter (factor) space is shown to be divided into four regions, which correspond to the four forms of interaction outcomes; i.e. mutualism, commensalism, parasitism and amensalism. It is shown that the interaction outcomes of the system transition smoothly among these four forms when the parameters of the system are varied continuously. Varying each parameter individually or varying pairs of parameters can also lead to smooth transitions between the interaction outcomes. The analysis leads to both conditions for which each species achieves its maximal density, and situations in which periodic oscillations of the interaction outcomes emerge. ?? 2011 Elsevier Ltd.

  11. The small-animal radiation research platform (SARRP): dosimetry of a focused lens system

    Energy Technology Data Exchange (ETDEWEB)

    Deng Hua [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins Medicine, Baltimore, MD (United States); Kennedy, Christopher W [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins Medicine, Baltimore, MD (United States); Armour, Elwood [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins Medicine, Baltimore, MD (United States); Tryggestad, Erik [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins Medicine, Baltimore, MD (United States); Ford, Eric [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins Medicine, Baltimore, MD (United States); McNutt, Todd [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins Medicine, Baltimore, MD (United States); Jiang Licai [OSMIC Inc., 1900 Taylor Rd., Auburn Hills, MI (United States); Wong, John [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins Medicine, Baltimore, MD (United States)

    2007-05-21

    A small animal radiation platform equipped with on-board cone-beam CT and conformal irradiation capabilities is being constructed for translational research. To achieve highly localized dose delivery, an x-ray lens is used to focus the broad beam from a 225 kVp x-ray tube down to a beam with a full width half maximum (FWHM) of approximately 1.5 mm in the energy range 40-80 keV. Here, we report on the dosimetric characteristics of the focused beam from the x-ray lens subsystem for high-resolution dose delivery. Using the metric of the average dose within a 1.5 mm diameter area, the dose rates at a source-to-surface distance (SSD) of 34 cm are 259 and 172 cGy min{sup -1} at 6 mm and 2 cm depths, respectively, with an estimated uncertainty of {+-}5%. The per cent depth dose is approximately 56% at 2 cm depth for a beam at 34 cm SSD.

  12. The small-animal radiation research platform (SARRP): dosimetry of a focused lens system.

    Science.gov (United States)

    Deng, Hua; Kennedy, Christopher W; Armour, Elwood; Tryggestad, Erik; Ford, Eric; McNutt, Todd; Jiang, Licai; Wong, John

    2007-05-21

    A small animal radiation platform equipped with on-board cone-beam CT and conformal irradiation capabilities is being constructed for translational research. To achieve highly localized dose delivery, an x-ray lens is used to focus the broad beam from a 225 kVp x-ray tube down to a beam with a full width half maximum (FWHM) of approximately 1.5 mm in the energy range 40-80 keV. Here, we report on the dosimetric characteristics of the focused beam from the x-ray lens subsystem for high-resolution dose delivery. Using the metric of the average dose within a 1.5 mm diameter area, the dose rates at a source-to-surface distance (SSD) of 34 cm are 259 and 172 cGy min(-1) at 6 mm and 2 cm depths, respectively, with an estimated uncertainty of +/-5%. The per cent depth dose is approximately 56% at 2 cm depth for a beam at 34 cm SSD.

  13. A Modernized National Spatial Reference System in 2022: Focus on the Caribbean Terrestrial Reference Frame

    Science.gov (United States)

    Roman, D. R.

    2017-12-01

    In 2022, the National Geodetic Survey will replace all three NAD 83 reference frames the four new terrestrial reference frames. Each frame will be named after a tectonic plate (North American, Pacific, Caribbean and Mariana) and each will be related to the IGS frame through three Euler Pole parameters (EPPs). This talk will focus on practical application in the Caribbean region. A working group is being re-established for development of the North American region and will likely also result in analysis of the Pacific region as well. Both of these regions are adequately covered with existing CORS sites to model the EPPs. The Mariana region currently lacks sufficient coverage, but a separate project is underway to collect additional information to help in defining EPPs for that region at a later date. The Caribbean region has existing robust coverage through UNAVCO's COCONet and other data sets, but these require further analysis. This discussion will focus on practical examination of Caribbean sites to establish candidates for determining the Caribbean frame EPPs as well as an examination of any remaining velocities that might inform a model of the remaining velocities within that frame (Intra-Frame Velocity Model). NGS has a vested interest in defining such a model to meet obligations to U.S. citizens in Puerto Rico and the U.S. Virgin Islands. Beyond this, NGS aims to collaborate with other countries in the region through efforts with SIRGAS and UN-GGIM-Americas for a more acceptable regional model to serve everyone's needs.

  14. The small-animal radiation research platform (SARRP): dosimetry of a focused lens system

    International Nuclear Information System (INIS)

    Deng Hua; Kennedy, Christopher W; Armour, Elwood; Tryggestad, Erik; Ford, Eric; McNutt, Todd; Jiang Licai; Wong, John

    2007-01-01

    A small animal radiation platform equipped with on-board cone-beam CT and conformal irradiation capabilities is being constructed for translational research. To achieve highly localized dose delivery, an x-ray lens is used to focus the broad beam from a 225 kVp x-ray tube down to a beam with a full width half maximum (FWHM) of approximately 1.5 mm in the energy range 40-80 keV. Here, we report on the dosimetric characteristics of the focused beam from the x-ray lens subsystem for high-resolution dose delivery. Using the metric of the average dose within a 1.5 mm diameter area, the dose rates at a source-to-surface distance (SSD) of 34 cm are 259 and 172 cGy min -1 at 6 mm and 2 cm depths, respectively, with an estimated uncertainty of ±5%. The per cent depth dose is approximately 56% at 2 cm depth for a beam at 34 cm SSD

  15. Stem cell transplantation as a dynamical system: are clinical outcomes deterministic?

    Science.gov (United States)

    Toor, Amir A; Kobulnicky, Jared D; Salman, Salman; Roberts, Catherine H; Jameson-Lee, Max; Meier, Jeremy; Scalora, Allison; Sheth, Nihar; Koparde, Vishal; Serrano, Myrna; Buck, Gregory A; Clark, William B; McCarty, John M; Chung, Harold M; Manjili, Masoud H; Sabo, Roy T; Neale, Michael C

    2014-01-01

    Outcomes in stem cell transplantation (SCT) are modeled using probability theory. However, the clinical course following SCT appears to demonstrate many characteristics of dynamical systems, especially when outcomes are considered in the context of immune reconstitution. Dynamical systems tend to evolve over time according to mathematically determined rules. Characteristically, the future states of the system are predicated on the states preceding them, and there is sensitivity to initial conditions. In SCT, the interaction between donor T cells and the recipient may be considered as such a system in which, graft source, conditioning, and early immunosuppression profoundly influence immune reconstitution over time. This eventually determines clinical outcomes, either the emergence of tolerance or the development of graft versus host disease. In this paper, parallels between SCT and dynamical systems are explored and a conceptual framework for developing mathematical models to understand disparate transplant outcomes is proposed.

  16. Design of an Acceleration / Deceleration Lens System for Ion Beam Focusing Emerging from Penning Ion Source

    International Nuclear Information System (INIS)

    El-Khabeary, H.

    2007-01-01

    In this study, design of the deceleration lens system has been done by using SIMION 3D version 7.0 computer program. A parallel beam of singly charged argon ions of diameter 2. mm with energy of 5 KeV emerging from Penning ion source was started at a distance of 140 mm before entering the Einzel lens system (three cylinder electrodes ). In order to design this deceleration lens system, two and three cylinder lenses with different parameters are studied. Ion beam emittance as a function of the gap width of the deceleration lens system has been studied for singly charged argon ion trajectories. Influence of the deceleration voltage applied on the deceleration electrode with different voltages of the four electrodes on the ion beam emittance has been investigated with gap widths of 3, 7, 9, 11 and 15 nun. The deceleration lens system was also used as an acceleration lens system by changing and optimising the voltage on each electrode of the deceleration lens system and of the intermediate electrode of the Einzel lens

  17. Outcomes in Diabetic Patients Undergoing Orbital Atherectomy System.

    Science.gov (United States)

    Lee, Michael S; Shlofmitz, Evan; Nguyen, Heajung; Shlofmitz, Richard A

    2016-10-01

    We evaluated the angiographic and clinical outcomes of orbital atherectomy to treat severely calcified coronary lesions in diabetic and non-diabetic patients. Diabetics have increased risk for death, myocardial infarction, and target vessel revascularization after percutaneous coronary intervention. Severely calcified coronary lesions are associated with increased cardiac events. Orbital atherectomy facilitates stent delivery and optimizes stent expansion by modifying severely calcified plaque. Outcomes in diabetic patients who undergo orbital atherectomy have not been reported. Our retrospective multicenter registry included 458 consecutive real-world patients with severely calcified coronary arteries who underwent orbital atherectomy. The primary safety endpoint was the rate of major adverse cardiac and cerebrovascular events at 30 days. Diabetics represented 42.1% (193/458) of the entire cohort. The primary endpoint was similar in diabetics and non-diabetics (1.0% vs. 3.0%%, P = 0.20), as were 30-day rates of death (0.5% vs. 1.9%, P = 0.41), myocardial infarction (0.5% vs. 1.5%, P = 0.40), target vessel revascularization (0% vs. 0%, P = 1), and stroke (0% vs. 0.4%, P > 0.9). Angiographic complications and stent thrombosis rate were low and did not differ between the 2 groups. Diabetics represented a sizeable portion of patients who underwent orbital atherectomy. Diabetics who had severely calcified coronary arteries and underwent orbital atherectomy had low event rates that were similar to non-diabetics. Orbital atherectomy appears to be a viable treatment strategy for diabetic patients. Randomized trials with longer-term follow-up are needed to determine the ideal treatment strategy for diabetics. © 2016, Wiley Periodicals, Inc.

  18. Design approaches for solar industrial process-heat systems: nontracking and line-focus collector technologies

    Energy Technology Data Exchange (ETDEWEB)

    Kutscher, C.F.; Davenport, R.L.; Dougherty, D.A.; Gee, R.C.; Masterson, P.M.; May, E.K.

    1982-08-01

    The design methodology for solar industrial process heat systems is described, and an overview is given of the use of solar energy in industry. A way to determine whether solar energy makes sense for a particular application is described. The basic system configurations used to supply hot water or steam are discussed, and computer-generated graphs are supplied that allow the user to select a collector type. Detailed energy calculations are provided, including the effects of thermal losses and storage. The selection of subsystem components is described, and control systems, installation and start-up details, economics, and safety and environmental issues are explained. (LEW)

  19. NASA's Radioisotope Power Systems Program Overview - A Focus on RPS Users

    Science.gov (United States)

    Hamley, John A.; McCallum, Peter W.; Sandifer, Carl E., II; Sutliff, Thomas J.; Zakrajsek, June F.

    2016-01-01

    The goal of NASA's Radioisotope Power Systems (RPS) Program is to make RPS ready and available to support the exploration of the solar system in environments where the use of conventional solar or chemical power generation is impractical or impossible to meet potential future mission needs. To meet this goal, the RPS Program manages investments in RPS technologies and RPS system development, working closely with the Department of Energy. This paper provides an overview of the RPS Program content and status, its collaborations with potential RPS users, and the approach employed to maintain the readiness of RPS to support future NASA mission concepts.

  20. A method to assess obstetric outcomes using the 10-Group Classification System: a quantitative descriptive study.

    LENUS (Irish Health Repository)

    Rossen, Janne

    2017-01-01

    Internationally, the 10-Group Classification System (TGCS) has been used to report caesarean section rates, but analysis of other outcomes is also recommended. We now aim to present the TGCS as a method to assess outcomes of labour and delivery using routine collection of perinatal information.

  1. The National Outcomes Measurement System for Pediatric Speech-Language Pathology

    Science.gov (United States)

    Mullen, Robert; Schooling, Tracy

    2010-01-01

    Purpose: The American Speech-Language-Hearing Association's (ASHA's) National Outcomes Measurement System (NOMS) was developed in the late 1990s. The primary purpose was to serve as a source of data for speech-language pathologists (SLPs) who found themselves called on to provide empirical evidence of the functional outcomes associated with their…

  2. Design of Static Wireless Charging System for Electric Vehicles with Focus on Magnetic Coupling and Emissions

    DEFF Research Database (Denmark)

    Batra, Tushar

    summarizes the research findings of the study. Wireless charging system as per state of art design approach consists of four major blocks: primary power electronics, inductors, secondary power electronics including load and resonant circuits (capacitors). The first contribution of this project is addition...... as an equivalent power source and transmission system including the load similar to other electric system like grids. Secondly, design parameters of output power, circuit efficiency and voltage or current stress across resonant components can be expressed as simple functions of the five blocks. Inductors......-parallel are compared in term of the emissions for similar power rating. Series-parallel topology has slight advantage over its series-series counterpart on account of additional inductive secondary current component as advised by the results. At the end, a wireless charging system has been designed and constructed...

  3. The Past, Present and Future of Cyber-Physical Systems: A Focus on Models

    Science.gov (United States)

    Lee, Edward A.

    2015-01-01

    This paper is about better engineering of cyber-physical systems (CPSs) through better models. Deterministic models have historically proven extremely useful and arguably form the kingpin of the industrial revolution and the digital and information technology revolutions. Key deterministic models that have proven successful include differential equations, synchronous digital logic and single-threaded imperative programs. Cyber-physical systems, however, combine these models in such a way that determinism is not preserved. Two projects show that deterministic CPS models with faithful physical realizations are possible and practical. The first project is PRET, which shows that the timing precision of synchronous digital logic can be practically made available at the software level of abstraction. The second project is Ptides (programming temporally-integrated distributed embedded systems), which shows that deterministic models for distributed cyber-physical systems have practical faithful realizations. These projects are existence proofs that deterministic CPS models are possible and practical. PMID:25730486

  4. The Past, Present and Future of Cyber-Physical Systems: A Focus on Models

    Directory of Open Access Journals (Sweden)

    Edward A. Lee

    2015-02-01

    Full Text Available This paper is about better engineering of cyber-physical systems (CPSs through better models. Deterministic models have historically proven extremely useful and arguably form the kingpin of the industrial revolution and the digital and information technology revolutions. Key deterministic models that have proven successful include differential equations, synchronous digital logic and single-threaded imperative programs. Cyber-physical systems, however, combine these models in such a way that determinism is not preserved. Two projects show that deterministic CPS models with faithful physical realizations are possible and practical. The first project is PRET, which shows that the timing precision of synchronous digital logic can be practically made available at the software level of abstraction. The second project is Ptides (programming temporally-integrated distributed embedded systems, which shows that deterministic models for distributed cyber-physical systems have practical faithful realizations. These projects are existence proofs that deterministic CPS models are possible and practical.

  5. The past, present and future of cyber-physical systems: a focus on models.

    Science.gov (United States)

    Lee, Edward A

    2015-02-26

    This paper is about better engineering of cyber-physical systems (CPSs) through better models. Deterministic models have historically proven extremely useful and arguably form the kingpin of the industrial revolution and the digital and information technology revolutions. Key deterministic models that have proven successful include differential equations, synchronous digital logic and single-threaded imperative programs. Cyber-physical systems, however, combine these models in such a way that determinism is not preserved. Two projects show that deterministic CPS models with faithful physical realizations are possible and practical. The first project is PRET, which shows that the timing precision of synchronous digital logic can be practically made available at the software level of abstraction. The second project is Ptides (programming temporally-integrated distributed embedded systems), which shows that deterministic models for distributed cyber-physical systems have practical faithful realizations. These projects are existence proofs that deterministic CPS models are possible and practical.

  6. Central nervous system histoplasmosis: Multicenter retrospective study on clinical features, diagnostic approach and outcome of treatment.

    Science.gov (United States)

    Wheat, Joseph; Myint, Thein; Guo, Ying; Kemmer, Phebe; Hage, Chadi; Terry, Colin; Azar, Marwan M; Riddell, James; Ender, Peter; Chen, Sharon; Shehab, Kareem; Cleveland, Kerry; Esguerra, Eden; Johnson, James; Wright, Patty; Douglas, Vanja; Vergidis, Pascalis; Ooi, Winnie; Baddley, John; Bamberger, David; Khairy, Raed; Vikram, Holenarasipur R; Jenny-Avital, Elizabeth; Sivasubramanian, Geetha; Bowlware, Karen; Pahud, Barbara; Sarria, Juan; Tsai, Townson; Assi, Maha; Mocherla, Satish; Prakash, Vidhya; Allen, David; Passaretti, Catherine; Huprikar, Shirish; Anderson, Albert

    2018-03-01

    Central nervous system (CNS) involvement occurs in 5 to 10% of individuals with disseminated histoplasmosis. Most experience has been derived from small single center case series, or case report literature reviews. Therefore, a larger study of central nervous system (CNS) histoplasmosis is needed in order to guide the approach to diagnosis, and treatment.A convenience sample of 77 patients with histoplasmosis infection of the CNS was evaluated. Data was collected that focused on recognition of infection, diagnostic techniques, and outcomes of treatment.Twenty nine percent of patients were not immunosuppressed. Histoplasma antigen, or anti-Histoplasma antibodies were detected in the cerebrospinal fluid (CSF) in 75% of patients. One year survival was 75% among patients treated initially with amphotericin B, and was highest with liposomal, or deoxycholate formulations. Mortality was higher in immunocompromised patients, and patients 54 years of age, or older. Six percent of patients relapsed, all of whom had the acquired immunodeficiency syndrome (AIDS), and were poorly adherent with treatment.While CNS histoplasmosis occurred most often in immunocompromised individuals, a significant proportion of patients were previously, healthy. The diagnosis can be established by antigen, and antibody testing of the CSF, and serum, and antigen testing of the urine in most patients. Treatment with liposomal amphotericin B (AMB-L) for at least 1 month; followed by itraconazole for at least 1 year, results in survival among the majority of individuals. Patients should be followed for relapse for at least 1 year, after stopping therapy.

  7. Water in the Solar System: The Development of Science Education Curriculum Focused on Planetary Exploration

    Science.gov (United States)

    Edgar, L. A.; Anderson, R. B.; Gaither, T. A.; Milazzo, M. P.; Vaughan, R. G.; Rubino-Hare, L.; Clark, J.; Ryan, S.

    2017-12-01

    "Water in the Solar System" is an out-of-school time (OST) science education activity for middle school students that was developed as part of the Planetary Learning that Advances the Nexus of Engineering, Technology, and Science (PLANETS) project. The PLANETS project was selected in support of the NASA Science Mission Directorate's Science Education Cooperative Agreement Notice, with the goal of developing and disseminating OST curriculum and related professional development modules that integrate planetary science, technology, and engineering. "Water in the Solar System" is a science activity that addresses the abundance and availability of water in the solar system. The activity consists of three exercises based on the following guiding questions: 1) How much water is there on the Earth? 2) Where can you find water in the solar system? and 3) What properties affect whether or not water can be used by astronauts? The three exercises involve a scaling relationship demonstration about the abundance of useable water on Earth, a card game to explore where water is found in the solar system, and a hands-on exercise to investigate pH and salinity. Through these activities students learn that although there is a lot of water on Earth, most of it is not in a form that is accessible for humans to use. They also learn that most water in the solar system is actually farther from the sun, and that properties such as salinity and pH affect whether water can be used by humans. In addition to content for students, the activity includes background information for educators, and links to in-depth descriptions of the science content. "Water in the Solar System" was developed through collaboration between subject matter experts at the USGS Astrogeology Science Center, and curriculum and professional development experts in the Center for Science Teaching and Learning at Northern Arizona University. Here we describe our process of curriculum development, education objectives of

  8. The Characterisation of a PEM Fuel-Cell System with a Focus on UAS Applications

    Science.gov (United States)

    2014-01-01

    low specific power (W/kg) [3-6]. This has stimulated the development of hybrid systems that utilise a combination of battery and fuel - cell ...battery-powered systems (i.e., electric motors and batteries). However, the great advantage of fuel - cell -based powerplants is their specific energy...alkaline-electrolyte, direct- methanol , and sulphur-oxide fuel cells ) are also required so that a broad assessment of fuel - cell types and their likely

  9. A study on the social risk comparison for various power systems: focusing on the social acceptance

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Young Soo [Myongji Univ., Seoul (Korea, Republic of); Kim, Young Pyung [Korea Univ, Seoul (Korea, Republic of); Lee, Jae Eun [Chungbuk Nat. Univ., Cheongju (Korea, Republic of)

    2007-02-15

    The objective of this study is to develop measurement indices for social risk acceptance of various power systems(nuclear, coal, oil, LNG, hydro, wind, solar) and compare them empirically. In order to measure social risk acceptance of various power systems, four measurement fields and twelve measurement indices were developed. Measurement areas contains rationality, emotion, trust, communication. Each measurement field has two or three measurement indices. Rationality field has indices of amount of knowledge, recognition of technological utility, risk controllability. Emotion field has indices of experiences, risk recognition. Trust field has indices of openness, sincerity, willingness of sharing knowledge and experiences. Communication field has indices of scientist's roll, media's roll, public relations. Based on these measurement field and indices, this study made questionnaire and surveyed citizens to compare deciding factors of social acceptance on risk of various power systems. Questionnaire respondents were sampled from six different groups, including power system specialists, highschool students, university students, general citizen, professors and environmental NGOs. The methodologies used to analyze the deciding factors of social acceptance on risk of various power systems were frequency analysis, cross-tab analysis, t-test and ANOVA analysis. AHP method was used to analyze power system specialists' perception on relative severance and priority among measurement fields and indices.

  10. A study on the social risk comparison for various power systems: focusing on the social acceptance

    International Nuclear Information System (INIS)

    Jung, Young Soo; Kim, Young Pyung; Lee, Jae Eun

    2007-02-01

    The objective of this study is to develop measurement indices for social risk acceptance of various power systems(nuclear, coal, oil, LNG, hydro, wind, solar) and compare them empirically. In order to measure social risk acceptance of various power systems, four measurement fields and twelve measurement indices were developed. Measurement areas contains rationality, emotion, trust, communication. Each measurement field has two or three measurement indices. Rationality field has indices of amount of knowledge, recognition of technological utility, risk controllability. Emotion field has indices of experiences, risk recognition. Trust field has indices of openness, sincerity, willingness of sharing knowledge and experiences. Communication field has indices of scientist's roll, media's roll, public relations. Based on these measurement field and indices, this study made questionnaire and surveyed citizens to compare deciding factors of social acceptance on risk of various power systems. Questionnaire respondents were sampled from six different groups, including power system specialists, highschool students, university students, general citizen, professors and environmental NGOs. The methodologies used to analyze the deciding factors of social acceptance on risk of various power systems were frequency analysis, cross-tab analysis, t-test and ANOVA analysis. AHP method was used to analyze power system specialists' perception on relative severance and priority among measurement fields and indices

  11. The Role of Organizational Control Systems in Employees’ Organizational Trust and Performance Outcomes

    NARCIS (Netherlands)

    Verburg, R.M.; Nienaber, Ann Marie; Searle, Rosalind H.; Weibel, Antoinette; Den Hartog, Deanne N.; Rupp, Deborah E.

    2018-01-01

    This study examined how organizational control is related to employees’ organizational trust. We specifically focus on how different forms of control (process, outcome, and normative) relate to employees’ trust in their employing organizations and examine whether such trust in turn relates

  12. The role of organizational control systems in employees’ organizational trust and performance outcomes

    NARCIS (Netherlands)

    Verburg, R.M.; Nienaber, A.; Searle, R.H.; Weibel, A.; Den Hartog, D.N.; Rupp, D.E.

    2018-01-01

    This study examined how organizational control is related to employees’ organizational trust. We specifically focus on how different forms of control (process, outcome, and normative) relate to employees’ trust in their employing organizations and examine whether such trust in turn relates

  13. Analyzer-based phase-contrast imaging system using a micro focus x-ray source

    International Nuclear Information System (INIS)

    Zhou, Wei; Majidi, Keivan; Brankov, Jovan G.

    2014-01-01

    Here we describe a new in-laboratory analyzer based phase contrast-imaging (ABI) instrument using a conventional X-ray tube source (CXS) aimed at bio-medical imaging applications. Phase contrast-imaging allows visualization of soft tissue details usually obscured in conventional X-ray imaging. The ABI system design and major features are described in detail. The key advantage of the presented system, over the few existing CXS ABI systems, is that it does not require high precision components, i.e., CXS, X-ray detector, and electro-mechanical components. To overcome a main problem introduced by these components, identified as temperature stability, the system components are kept at a constant temperature inside of three enclosures, thus minimizing the electrical and mechanical thermal drifts. This is achieved by using thermoelectric (Peltier) cooling/heating modules that are easy to control precisely. For CXS we utilized a microfocus X-ray source with tungsten (W) anode material. In addition the proposed system eliminates tungsten's multiple spectral lines by selecting monochromator crystal size appropriately therefore eliminating need for the costly mismatched, two-crystal monochromator. The system imaging was fine-tuned for tungsten Kα 1 line with the energy of 59.3 keV since it has been shown to be of great clinical significance by a number of researchers at synchrotron facilities. In this way a laboratory system that can be used for evaluating and quantifying tissue properties, initially explored at synchrotron facilities, would be of great interest to a larger research community. To demonstrate the imaging capability of our instrument we use a chicken thigh tissue sample

  14. Analyzer-based phase-contrast imaging system using a micro focus x-ray source

    Science.gov (United States)

    Zhou, Wei; Majidi, Keivan; Brankov, Jovan G.

    2014-08-01

    Here we describe a new in-laboratory analyzer based phase contrast-imaging (ABI) instrument using a conventional X-ray tube source (CXS) aimed at bio-medical imaging applications. Phase contrast-imaging allows visualization of soft tissue details usually obscured in conventional X-ray imaging. The ABI system design and major features are described in detail. The key advantage of the presented system, over the few existing CXS ABI systems, is that it does not require high precision components, i.e., CXS, X-ray detector, and electro-mechanical components. To overcome a main problem introduced by these components, identified as temperature stability, the system components are kept at a constant temperature inside of three enclosures, thus minimizing the electrical and mechanical thermal drifts. This is achieved by using thermoelectric (Peltier) cooling/heating modules that are easy to control precisely. For CXS we utilized a microfocus X-ray source with tungsten (W) anode material. In addition the proposed system eliminates tungsten's multiple spectral lines by selecting monochromator crystal size appropriately therefore eliminating need for the costly mismatched, two-crystal monochromator. The system imaging was fine-tuned for tungsten Kα1 line with the energy of 59.3 keV since it has been shown to be of great clinical significance by a number of researchers at synchrotron facilities. In this way a laboratory system that can be used for evaluating and quantifying tissue properties, initially explored at synchrotron facilities, would be of great interest to a larger research community. To demonstrate the imaging capability of our instrument we use a chicken thigh tissue sample.

  15. Analyzer-based phase-contrast imaging system using a micro focus x-ray source

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Wei [BME Department, Illinois Institute of Technology, Chicago, Illinois 60616 (United States); Majidi, Keivan; Brankov, Jovan G., E-mail: brankov@iit.edu [ECE Department, Illinois Institute of Technology, Chicago, Illinois 60616 (United States)

    2014-08-15

    Here we describe a new in-laboratory analyzer based phase contrast-imaging (ABI) instrument using a conventional X-ray tube source (CXS) aimed at bio-medical imaging applications. Phase contrast-imaging allows visualization of soft tissue details usually obscured in conventional X-ray imaging. The ABI system design and major features are described in detail. The key advantage of the presented system, over the few existing CXS ABI systems, is that it does not require high precision components, i.e., CXS, X-ray detector, and electro-mechanical components. To overcome a main problem introduced by these components, identified as temperature stability, the system components are kept at a constant temperature inside of three enclosures, thus minimizing the electrical and mechanical thermal drifts. This is achieved by using thermoelectric (Peltier) cooling/heating modules that are easy to control precisely. For CXS we utilized a microfocus X-ray source with tungsten (W) anode material. In addition the proposed system eliminates tungsten's multiple spectral lines by selecting monochromator crystal size appropriately therefore eliminating need for the costly mismatched, two-crystal monochromator. The system imaging was fine-tuned for tungsten Kα{sub 1} line with the energy of 59.3 keV since it has been shown to be of great clinical significance by a number of researchers at synchrotron facilities. In this way a laboratory system that can be used for evaluating and quantifying tissue properties, initially explored at synchrotron facilities, would be of great interest to a larger research community. To demonstrate the imaging capability of our instrument we use a chicken thigh tissue sample.

  16. Environmental Outcomes in the South African Learnership System

    African Journals Online (AJOL)

    ... responsible for the implementation of government policy on environmental management. ... responsibility towards the environment and health of others. ... social, economic and political systems and in the world views, institutions and lifestyle.

  17. Evolving Systems: An Outcome of Fondest Hopes and Wildest Dreams

    Science.gov (United States)

    Frost, Susan A.; Balas, Mark J.

    2012-01-01

    New theory is presented for evolving systems, which are autonomously controlled subsystems that self-assemble into a new evolved system with a higher purpose. Evolving systems of aerospace structures often require additional control when assembling to maintain stability during the entire evolution process. This is the concept of Adaptive Key Component Control that operates through one specific component to maintain stability during the evolution. In addition, this control must often overcome persistent disturbances that occur while the evolution is in progress. Theoretical results will be presented for Adaptive Key Component control for persistent disturbance rejection. An illustrative example will demonstrate the Adaptive Key Component controller on a system composed of rigid body and flexible body modes.

  18. Health Worker Focused Distributed Simulation for Improving Capability of Health Systems in Liberia.

    Science.gov (United States)

    Gale, Thomas C E; Chatterjee, Arunangsu; Mellor, Nicholas E; Allan, Richard J

    2016-04-01

    The main goal of this study was to produce an adaptable learning platform using virtual learning and distributed simulation, which can be used to train health care workers, across a wide geographical area, key safety messages regarding infection prevention control (IPC). A situationally responsive agile methodology, Scrum, was used to develop a distributed simulation module using short 1-week iterations and continuous synchronous plus asynchronous communication including end users and IPC experts. The module contained content related to standard IPC precautions (including handwashing techniques) and was structured into 3 distinct sections related to donning, doffing, and hazard perception training. Using Scrum methodology, we were able to link concepts applied to best practices in simulation-based medical education (deliberate practice, continuous feedback, self-assessment, and exposure to uncommon events), pedagogic principles related to adult learning (clear goals, contextual awareness, motivational features), and key learning outcomes regarding IPC, as a rapid response initiative to the Ebola outbreak in West Africa. Gamification approach has been used to map learning mechanics to enhance user engagement. The developed IPC module demonstrates how high-frequency, low-fidelity simulations can be rapidly designed using scrum-based agile methodology. Analytics incorporated into the tool can help demonstrate improved confidence and competence of health care workers who are treating patients within an Ebola virus disease outbreak region. These concepts could be used in a range of evolving disasters where rapid development and communication of key learning messages are required.

  19. TU-CD-BRD-02: Henry Ford Hospital System Experience, with Focus On Motivating and Reviewing

    International Nuclear Information System (INIS)

    Miller, B.

    2015-01-01

    It has long been standard practice in radiation oncology to report internally when a patient’s treatment has not gone as planned and to report events to regulatory agencies when legally required. Most potential errors are caught early and never affect the patient. Quality assurance steps routinely prevent errors from reaching the patient, and these “near misses” are much more frequent than treatment errors. A growing number of radiation oncology facilities have implemented incident learning systems to report and analyze both errors and near misses. Using the term “incident learning” instead of “event reporting” emphasizes the need to use these experiences to change the practice and make future errors less likely and promote an educational, non-punitive environment. There are challenges in making such a system practical and effective. Speakers from institutions of different sizes and practice environments will share their experiences on how to make such a system work and what benefits their clinics have accrued. Questions that will be addressed include: How to create a system that is easy for front line staff to access How to motivate staff to report How to promote the system as positive and educational and not punitive or demeaning How to organize the team for reviewing and responding to reports How to prioritize which reports to discuss in depth How not to dismiss the rest How to identify underlying causes How to design corrective actions and implement change How to develop useful statistics and analysis tools How to coordinate a departmental system with a larger risk management system How to do this without a dedicated quality manager Some speakers’ experience is with in-house systems and some will share experience with the AAPM/ASTRO national Radiation Oncology Incident Learning System (RO-ILS). Reports intended to be of value nationally need to be comprehensible to outsiders; examples of useful reports will be shown. There will be ample time set

  20. TU-CD-BRD-02: Henry Ford Hospital System Experience, with Focus On Motivating and Reviewing

    Energy Technology Data Exchange (ETDEWEB)

    Miller, B. [Henry Ford Health System (United States)

    2015-06-15

    It has long been standard practice in radiation oncology to report internally when a patient’s treatment has not gone as planned and to report events to regulatory agencies when legally required. Most potential errors are caught early and never affect the patient. Quality assurance steps routinely prevent errors from reaching the patient, and these “near misses” are much more frequent than treatment errors. A growing number of radiation oncology facilities have implemented incident learning systems to report and analyze both errors and near misses. Using the term “incident learning” instead of “event reporting” emphasizes the need to use these experiences to change the practice and make future errors less likely and promote an educational, non-punitive environment. There are challenges in making such a system practical and effective. Speakers from institutions of different sizes and practice environments will share their experiences on how to make such a system work and what benefits their clinics have accrued. Questions that will be addressed include: How to create a system that is easy for front line staff to access How to motivate staff to report How to promote the system as positive and educational and not punitive or demeaning How to organize the team for reviewing and responding to reports How to prioritize which reports to discuss in depth How not to dismiss the rest How to identify underlying causes How to design corrective actions and implement change How to develop useful statistics and analysis tools How to coordinate a departmental system with a larger risk management system How to do this without a dedicated quality manager Some speakers’ experience is with in-house systems and some will share experience with the AAPM/ASTRO national Radiation Oncology Incident Learning System (RO-ILS). Reports intended to be of value nationally need to be comprehensible to outsiders; examples of useful reports will be shown. There will be ample time set

  1. Pipe Crawler internal piping characterization system. Deactivation and decommissioning focus area. Innovative Technology Summary Report

    International Nuclear Information System (INIS)

    1998-02-01

    Pipe Crawler reg-sign is a pipe surveying system for performing radiological characterization and/or free release surveys of piping systems. The technology employs a family of manually advanced, wheeled platforms, or crawlers, fitted with one or more arrays of thin Geiger Mueller (GM) detectors operated from an external power supply and data processing unit. Survey readings are taken in a step-wise fashion. A video camera and tape recording system are used for video surveys of pipe interiors prior to and during radiological surveys. Pipe Crawler reg-sign has potential advantages over the baseline and other technologies in areas of cost, durability, waste minimization, and intrusiveness. Advantages include potentially reduced cost, potential reuse of the pipe system, reduced waste volume, and the ability to manage pipes in place with minimal disturbance to facility operations. Advantages over competing technologies include potentially reduced costs and the ability to perform beta-gamma surveys that are capable of passing regulatory scrutiny for free release of piping systems

  2. Conceptual foundations of inclusive systems in and around schools for early school leaving prevention: An emotional-relational focus

    Directory of Open Access Journals (Sweden)

    Downes Paul

    2017-01-01

    Full Text Available Against the background of the EU2020 headline target of reducing early school leaving to 10% across Europe, this article examines the conceptual foundations of the understanding of inclusive systems for early school leaving prevention that has emerged in EU policy documents and research reports in recent years. Traditionally, inclusive education has referred to a focus on children with special educational needs. However, this conceptual review examines how inclusion is increasingly being examined in broader terms.This review seeks to critically reconstruct foundational understandings of systems and resilience in developmental and educational psychology. A systems focus on inclusion needs to address the neglect in psychology of system blockages and power imbalances. Resilience is typically framed as the capacity of the individual to navigate their way to environmental resources. This places the onus of accessibility onto the individual’s efforts rather than a concern with responsive systems accessible to marginalised groups. A concern with inclusive systems goes beyond not only the well-established framework of individual resilience in developmental psychology, but also beyond its expansion into resilient systems, as these omit a focus on outreach and multidisciplinary teams in systems of care for integrated services. Common principles for a framework of inclusive systems include children’s voices, equality and non-discrimination, parental involvement that is integrated holistically with family support, and lifelong learning principles for schools. Illustrative examples of these principles for reforming authoritarian teaching and discriminatory bullying, for opening schools to the local community and for targeting those with highest levels of need are highlighted.

  3. Environmental Assessment of Sewage Sludge Management – Focusing on Sludge Treatment Reed Bed Systems

    DEFF Research Database (Denmark)

    Larsen, Julie Dam

    profiles of the STRB system technology and a mechanical treatment technology, constituting a basis for decision-making in relation to choice of technology. A major part of the project involved performance of fieldwork and laboratory work. Data were collected at three Danish, well-operated STRB systems...... assessment were based on international acknowledged standards and recommendations. An attributional LCA approach was chosen, and the loadings and savings for all impact categories were normalised to people equivalents (PE) (the annual loadings and savings provided by one average person). Three sludge...... gasses CH4 and N2O were larger for mechanical dewatered sludge, the net environmental loadings provided to the impact category Climate Change by this technology (S-CEN) and the STRB system technology (S-STRB and S-SPA) ended up being equally sized (9.010-4 PE), despite of higher biological activity...

  4. The multiple functions of the endocannabinoid system: a focus on the regulation of food intake

    Directory of Open Access Journals (Sweden)

    Tibiriça Eduardo

    2010-01-01

    Full Text Available Abstract Background Cannabis sativa (also known as marijuana has been cultivated by man for more than 5,000 years. However, there was a rise in its use in the 20th century for recreational, religious or spiritual, and medicinal purposes. The main psychoactive constituent of cannabis, whose structure was identified in the 1960's, is Δ9-tetrahydrocannabinol. On the other hand, the discovery of cannabinoid receptors and their endogenous agonists took place only very recently. In fact, the first cannabinoid receptor (CB1 was cloned in 1990, followed 3 years later by the characterization of a second cannabinoid receptor (CB2. Since the 19th century, the use of cannabis has been reported to stimulate appetite and increase the consumption of sweet and tasty food, sometimes resulting in significant weight gain. The recent description of the endocannabinoid system, not only in the central nervous system but also in peripheral tissues, points to its involvement in the regulation of appetite, food intake and energy metabolism. Consequently, the pharmacological modulation of the over-activity of this system could be useful in the treatment of the metabolic syndrome. Conclusions The endocannabinoid system has important physiological functions not only in the central nervous system but also in peripheral tissues. The activation of central CB1 receptors, particularly in hypothalamic nuclei and in the limbic system, is involved in the regulation of feeding behavior, and especially in the control of the intake of palatable food. In the periphery, cannabinoid receptors are present in adipocytes, skeletal muscle, gastrointestinal tract and liver, modulating energy metabolism.

  5. Prosthetics socket that incorporates an air splint system focusing on dynamic interface pressure.

    Science.gov (United States)

    Razak, Nasrul Anuar Abd; Osman, Noor Azuan Abu; Gholizadeh, Hossein; Ali, Sadeeq

    2014-08-01

    The interface pressure between the residual limb and prosthetic socket has a significant effect on an amputee's satisfaction and comfort. This paper presents the design and performance of a new prosthetic socket that uses an air splint system. The air splint prosthetic socket system was implemented by combining the air splint with a pressure sensor that the transhumeral user controls through the use of a microcontroller. The modular construction of the system developed allows the FSR pressure sensors that are placed inside the air splint socket to determine the required size and fitting for the socket used. Fifteen transhumeral amputees participated in the study. The subject's dynamic pressure on the socket that's applied while wearing the air splint systems was recorded using F-socket transducers and microcontroller analysis. The values collected by the F-socket sensor for the air splint prosthetic socket system were determined accordingly by comparing the dynamic pressure applied using statically socket. The pressure volume of the air splint fluctuated and was recorded at an average of 38 kPa (2.5) to 41 kPa (1.3) over three hours. The air splint socket might reduce the pressure within the interface of residual limb. This is particularly important during the daily life activities and may reduce the pain and discomfort at the residual limb in comparison to the static socket. The potential development of an auto-adjusted socket that uses an air splint system as the prosthetic socket will be of interest to researchers involved in rehabilitation engineering, prosthetics and orthotics.

  6. Trends in biomedical engineering: focus on Patient Specific Modeling and Life Support Systems.

    Science.gov (United States)

    Dubini, Gabriele; Ambrosi, Davide; Bagnoli, Paola; Boschetti, Federica; Caiani, Enrico G; Chiastra, Claudio; Conti, Carlo A; Corsini, Chiara; Costantino, Maria Laura; D'Angelo, Carlo; Formaggia, Luca; Fumero, Roberto; Gastaldi, Dario; Migliavacca, Francesco; Morlacchi, Stefano; Nobile, Fabio; Pennati, Giancarlo; Petrini, Lorenza; Quarteroni, Alfio; Redaelli, Alberto; Stevanella, Marco; Veneziani, Alessandro; Vergara, Christian; Votta, Emiliano; Wu, Wei; Zunino, Paolo

    2011-01-01

    Over the last twenty years major advancements have taken place in the design of medical devices and personalized therapies. They have paralleled the impressive evolution of three-dimensional, non invasive, medical imaging techniques and have been continuously fuelled by increasing computing power and the emergence of novel and sophisticated software tools. This paper aims to showcase a number of major contributions to the advancements of modeling of surgical and interventional procedures and to the design of life support systems. The selected examples will span from pediatric cardiac surgery procedures to valve and ventricle repair techniques, from stent design and endovascular procedures to life support systems and innovative ventilation techniques.

  7. Past, present, and future design of urban drainage systems with focus on Danish experiences

    DEFF Research Database (Denmark)

    Arnbjerg-Nielsen, Karsten

    2011-01-01

    over time? Based on an analysis of the underlying key drivers of changes that are expected to affect urban drainage systems the current problems and their predicted development over time are presented. One key issue is management of risk and uncertainties and therefore a framework for design......Climate change will influence the water cycle substantially, and extreme precipitation will become more frequent in many regions in the years to come. How should this fact be incorporated into design of urban drainage systems, if at all? And how important is climate change compared to other changes...... and analysis of urban structures in light of present and future uncertainties is presented....

  8. Value-Focused Thinking Model to Evaluate SHM System Alternatives From Military end User Requirements Point of View

    Directory of Open Access Journals (Sweden)

    Klimaszewski Sławomir

    2016-12-01

    Full Text Available The article describes Value-Focused Thinking (VFT model developed in order to evaluate various alternatives for implementation of Structural Health Monitoring (SHM system on a military aircraft. Four SHM system alternatives are considered based on: visual inspection (current approach, piezoelectric (PZT sensors, Fiber Bragg Grating (FBG sensors and Comparative Vacuum Monitoring (CVM sensors. A numerical example is shown to illustrate the model capability. Sensitivity analyses are performed on values such as Cost, Performance, Aircraft Availability and Technology Readiness Level in order to examine influence of these values on overall value of structural state of awareness provided by particular SHM system alternative.

  9. Introduction to focus issue: intrinsic and designed computation: information processing in dynamical systems--beyond the digital hegemony.

    Science.gov (United States)

    Crutchfield, James P; Ditto, William L; Sinha, Sudeshna

    2010-09-01

    How dynamical systems store and process information is a fundamental question that touches a remarkably wide set of contemporary issues: from the breakdown of Moore's scaling laws--that predicted the inexorable improvement in digital circuitry--to basic philosophical problems of pattern in the natural world. It is a question that also returns one to the earliest days of the foundations of dynamical systems theory, probability theory, mathematical logic, communication theory, and theoretical computer science. We introduce the broad and rather eclectic set of articles in this Focus Issue that highlights a range of current challenges in computing and dynamical systems.

  10. Least cost analysis of Belarus electricity generation system with focus on nuclear option

    International Nuclear Information System (INIS)

    Mikhalevich, A.; Yakushau, A.

    2004-01-01

    A basic feature of the Belarus electricity system is that about 50% of the installed power capacity is used to produce heat for the central heating supply system. The Republic has one of the most developed districts heating system in Europe. The installation started in 1930, and developed very fast after 1945. Co-generation of electricity and thermal energy in central power plants has played a fundamental role in the local economy. Presently, Belarus electricity generation system includes: Total installed capacities of condensing turbines 3665 MW; Total installed capacities of co-generation turbines 3889 MW. It is expected that in 2020 in accordance with electricity demand forecast peak load demand will be equaled approximately 9500 MW. Taking into account that operation time of 60 % existent co-generation turbine and 70 % of condensing turbine can be extended up to 2020 during the period 2005 - 2020 it is necessity to install about 1500 MW of new co-generation units and about 2000 MW of condensing turbines. To select the least cost scenario for electricity generation system expansion improved computer code WASP-IV for Windows had been used. As far code WASP-IV do not allow finding out optimal solution for electricity generation system with high share of co-generation directly the methodology of application of this program for this case had been developed. Methodology is based on utilization of code WASP-IV for simulation condensing turbines and module BALANCE for modeling co-generation part of the system. The scenarios for the electricity system expansion plan included only conventional technologies. Presently, the works connected with the preparedness for NPP construction in the Republic including site survey for NPP are being carried out. The first stage of siting process according to the IAEA classification has been completed. It was based on a set of criteria answered to A Safety Guide of the IAEA Site Survey for Nuclear Power Plants and requirements to be

  11. Potential of extensification of European agriculture for a more sustainable food system, focusing on nitrogen

    Science.gov (United States)

    van Grinsven, Hans J. M.; Willem Erisman, Jan; de Vries, Wim; Westhoek, Henk

    2015-02-01

    Most global strategies for future food security focus on sustainable intensification of production of food and involve increased use of nitrogen fertilizer and manure. The external costs of current high nitrogen (N) losses from agriculture in the European Union, are 0.3-1.9% of gross domestic product (GDP) in 2008. We explore the potential of sustainable extensification for agriculture in the EU and The Netherlands by analysing cases and scenario studies focusing on reducing N inputs and livestock densities. Benefits of extensification are higher local biodiversity and less environmental pollution and therefore less external costs for society. Extensification also has risks such as a reduction of yields and therewith a decrease of the GDP and farm income and a smaller contribution to the global food production, and potentially an i0ncrease of global demand for land. We demonstrate favourable examples of extensification. Reducing the N fertilization rate for winter wheat in Northwest Europe to 25-30% below current N recommendations accounts for the external N cost, but requires action to compensate for a reduction in crop yield by 10-20%. Dutch dairy and pig farmers changing to less intensive production maintain or even improve farm income by price premiums on their products, and/or by savings on external inputs. A scenario reducing the Dutch pig and poultry sector by 50%, the dairy sector by 20% and synthetic N fertilizer use by 40% lowers annual N pollution costs by 0.2-2.2 billion euro (40%). This benefit compensates for the loss of GDP in the primary sector but not in the supply and processing chain. A 2030 scenario for the EU27 reducing consumption and production of animal products by 50% (demitarean diet) reduces N pollution by 10% and benefits human health. This diet allows the EU27 to become a food exporter, while reducing land demand outside Europe in 2030 by more than 100 million hectares (2%), which more than compensates increased land demand when

  12. Potential of extensification of European agriculture for a more sustainable food system, focusing on nitrogen

    International Nuclear Information System (INIS)

    Van Grinsven, Hans J M; Westhoek, Henk; Erisman, Jan Willem; De Vries, Wim

    2015-01-01

    Most global strategies for future food security focus on sustainable intensification of production of food and involve increased use of nitrogen fertilizer and manure. The external costs of current high nitrogen (N) losses from agriculture in the European Union, are 0.3–1.9% of gross domestic product (GDP) in 2008. We explore the potential of sustainable extensification for agriculture in the EU and The Netherlands by analysing cases and scenario studies focusing on reducing N inputs and livestock densities. Benefits of extensification are higher local biodiversity and less environmental pollution and therefore less external costs for society. Extensification also has risks such as a reduction of yields and therewith a decrease of the GDP and farm income and a smaller contribution to the global food production, and potentially an i0ncrease of global demand for land. We demonstrate favourable examples of extensification. Reducing the N fertilization rate for winter wheat in Northwest Europe to 25–30% below current N recommendations accounts for the external N cost, but requires action to compensate for a reduction in crop yield by 10–20%. Dutch dairy and pig farmers changing to less intensive production maintain or even improve farm income by price premiums on their products, and/or by savings on external inputs. A scenario reducing the Dutch pig and poultry sector by 50%, the dairy sector by 20% and synthetic N fertilizer use by 40% lowers annual N pollution costs by 0.2–2.2 billion euro (40%). This benefit compensates for the loss of GDP in the primary sector but not in the supply and processing chain. A 2030 scenario for the EU27 reducing consumption and production of animal products by 50% (demitarean diet) reduces N pollution by 10% and benefits human health. This diet allows the EU27 to become a food exporter, while reducing land demand outside Europe in 2030 by more than 100 million hectares (2%), which more than compensates increased land demand when

  13. Integrative invasion science: model systems, multi-site studies, focused meta-analysis, and invasion syndromes

    Czech Academy of Sciences Publication Activity Database

    Kueffer, C.; Pyšek, Petr; Richardson, D. M.

    2013-01-01

    Roč. 200, č. 3 (2013), s. 615-633 ISSN 1469-8137 R&D Projects: GA ČR(CZ) GAP504/11/1028; GA ČR GA206/09/0563 Institutional support: RVO:67985939 Keywords : model systems * invasion syndromes * multi-site studies Subject RIV: EF - Botanics Impact factor: 6.545, year: 2013

  14. Evaluating electronic performance support systems: A methodology focused on future use-in-practice

    NARCIS (Netherlands)

    Collis, Betty; Verwijs, C.A.

    1995-01-01

    Electronic performance support systems, as an emerging type of software environment, present many new challenges in relation to effective evaluation. In this paper, a global approach to a 'usage-orientated' evaluation methodology for software product is presented, followed by a specific example of

  15. Epidemic Protocols for Pervasive Computing Systems - Moving Focus from Architecture to Protocol

    DEFF Research Database (Denmark)

    Mogensen, Martin

    2009-01-01

    Pervasive computing systems are inherently running on unstable networks and devices, subject to constant topology changes, network failures, and high churn. For this reason, pervasive computing infrastructures need to handle these issues as part of their design. This is, however, not feasible, si...

  16. Social acceptance of negotiation support systems : Scenario-based exploration with focus groups and online survey

    NARCIS (Netherlands)

    Pommeranz, A.; Wiggers, P.; Brinkman, W.P.; Jonker, C.M.

    2011-01-01

    We investigate people’s attitudes toward the possible use of negotiation support systems (NSS) in different social contexts and the consequences for their design. To explore functional requirements and social acceptance in different use contexts, we followed a threestep approach. In the first step,

  17. Modelling Systems of Classical/Quantum Identical Particles by Focusing on Algorithms

    Science.gov (United States)

    Guastella, Ivan; Fazio, Claudio; Sperandeo-Mineo, Rosa Maria

    2012-01-01

    A procedure modelling ideal classical and quantum gases is discussed. The proposed approach is mainly based on the idea that modelling and algorithm analysis can provide a deeper understanding of particularly complex physical systems. Appropriate representations and physical models able to mimic possible pseudo-mechanisms of functioning and having…

  18. The characterization of new hormonal systems in arthropods with a focus on neuropeptide GPCRs

    DEFF Research Database (Denmark)

    Stafflinger, Elisabeth

    Anopheles gambiae, Aedes aegypti, and Culex pipiens, the silkworm Bombyx mori, T. castaneum, N. vitripennis, and the bug Rhodnius prolixus but not in all the other sequenced insect genomes. Bioassays showed that only ACP can activate the ACPR, but not AKH or corazonin, showing that this system...

  19. The Multi-Element Electronstatic Lens Systems for Controlling and Focusing Charged Particle

    International Nuclear Information System (INIS)

    Sise, O.

    2004-01-01

    Particle optics are very close anolog of photon optics and most of the principles of an barged particle beam can be understood by thinking of the particles as rays of light. There are similar behaviours between particle and photon optics in controlling beams of light and charged particles, such as lenses and mirrors. Extensive information about the properties of charged particle optics, from which appropriate systems can be designed for any specific problem. In this way electrostatic lens systems are used to control beams of c/iarged particle with various energy and directions in several fields, for example electron microscopy, cathode ray tubes, ion accelerators and electron impact studies. In an electrostatic lens system quantative information is required over a wide energy range and a zoom-type of optics is needed. If the magnification is to remain constant over a wide range of energies, quite complicated electrostatic lens systems are required, .containing three, four, five, or even more lens elements. We firstly calculated the optical properties of three and four element cylinder electrostatic lenses with the help of the SIMION and LENSYS programs and developed the method for the calculation of the focal properties of five and more element lenses with afocal mode. In this method we used the combination of three and four element lenses to derive focal properties of multi-element lenses and presented this data over a wide range of energy

  20. in_focus - Fixing Health Systems (2nd edition) | CRDI - Centre de ...

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

    1 janv. 2008 ... ... of Fixing Health Systems revealed, the TEHIP program provided powerful evidence in support of that hypothesis. In TEHIP 's two Tanzanian test districts, for example, modest funding increases and sweeping organizational changes contributed to decreases in child mortality of more than 40%. Multimedia:.

  1. The stress system in depression and neurodegeneration: Focus on the human hypothalamus

    NARCIS (Netherlands)

    Bao, A.-M.; Meynen, G.; Swaab, D.F.

    2008-01-01

    The stress response is mediated by the hypothalamo-pituitary-adrenal (HPA) system. Activity of the corticotropin-releasing hormone (CRH) neurons in the hypothalamic paraventricular nucleus (PVN) forms the basis of the activity of the HPA-axis. The CRH neurons induce adrenocorticotropin (ACTH)

  2. Focus of the ECEL systems in rural environment: rational advantage of resources

    International Nuclear Information System (INIS)

    Vinas, R.

    1994-01-01

    Although the eolic resource is distributed in our country, its effective use goes by a serious technical and economic evaluation that takes to the correct design and operation of the generating system. Different use alternatives are explored in this work relating them to the analysis of the resource carried out in the Uruguay

  3. Aligning Order Picking Methods, Incentive Systems, and Regulatory Focus to Increase Performance

    NARCIS (Netherlands)

    de Vries, J.; de Koster, R.; Stam, D.

    2016-01-01

    A controlled field experiment investigates order picking performance in terms of productivity. We examined three manual picker-to-parts order picking methods (parallel, zone, and dynamic zone picking) under two different incentive systems (competition-based vs. cooperation-based) for pickers with

  4. Aligning order picking methods, incentive systems, and regulatory focus to increase performance

    NARCIS (Netherlands)

    J. de Vries (Jelle); M.B.M. de Koster (René); D.A. Stam (Daan)

    2015-01-01

    textabstractA unique controlled field experiment investigates order picking performance (in terms of productivity and quality). We examined three manual picker-to-parts order picking methods (parallel, zone, and dynamic zone picking) under two different incentive systems (competition- based versus

  5. Summary of Electric Distribution System Analyses with a focus on DERs

    Energy Technology Data Exchange (ETDEWEB)

    Tang, Yingying [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Homer, Juliet S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); McDermott, Thomas E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Coddington, Michael [National Renewable Energy Lab. (NREL), Golden, CO (United States); Sigrin, Benjamin [National Renewable Energy Lab. (NREL), Golden, CO (United States); Mather, Barry [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2017-04-28

    The purpose of this document is to summarize types of electric distribution system analyses along with their application and relative maturity. Particular emphasis is placed on analyses associated with distributed energy resources (DERs). Analyses are separated into the categories of power flow, power quality, fault analysis, dynamic analysis and market analysis. Studies associated with DERs are called out in a separate section.

  6. The internal and external customer focused process improvement and the performance analysis studies in healthcare systems

    Directory of Open Access Journals (Sweden)

    Piril Tekin

    2017-07-01

    Full Text Available Purpose: The main contribution of this paper is to generate an optimum solution for capacity planning and appointment scheduling issues, which are frequently encountered in clinical flows with various route and treatment periods at dental hospitals. Design/methodology/approach: It is essential to define the system well in order to ensure that the working staff and patients use their time very efficiently and that the process flows continuously. By having examined a sample healthcare system through the help of a study addressed in such context, studies on process improvement in line with the dissatisfactions of the working staff and patients have been carried out. Within the scope of the study, the operation of 7 Departments in a dental hospital undergoing a treatment process have been reviewed and examined. The problems encountered as result of the observations made are discussed in detail, and formerly and recently designed system performance analyses are conducted by having performed the respective process improvement studies. The relevant samplings of this study are modeled via the Arena Simulation Program. The data of the previous four months is used in the parameters, which are used through the modellings. The system data are entered by taking into account seasonal characteristics of the data. Findings: The analyses are made as a consequence of such study that has been addressed, it is established that the efficiency of the internal customers of the hospital increases substantially, and that the waiting durations of the dental patients decrease and in turn, the external customer satisfaction increases drastically. Research limitations/implications: Under the scope of the present study, 7 different treatment processes are analysed in a dental hospital in Cukurova Region with a significant patient potential. The treatment clinics present in the hospital are radiology, periodontology, surgery, treatment, orthodontics and prosthesis. These

  7. Comparative analyses of forest fuels in a life cycle perspective with a focus on transport systems

    Energy Technology Data Exchange (ETDEWEB)

    Eriksson, Lisa Naeslund [Ecotechnology, Department of Engineering, Physics and Mathematics, Mid Sweden University, SE-831 25 Oestersund (Sweden)

    2008-08-15

    Local, national and international transportation of forest fuels with regard to costs, primary energy use and CO{sub 2} emission was analysed. The main issue was the extent to which both mode and distance of transport affect the monetary cost, CO{sub 2} emission and primary energy use arising from the use of various types of forest residues for energy purpose. Local applications proved the most efficient options of those studied. Chipping of bundles at a terminal, for transport by rail and sea to national or international end-users, has low costs and produces only modest CO{sub 2} emissions. For the pellet options, the cost is about the same as for chipping, but require more primary energy and emit more CO{sub 2}. The traditional chipping system is more expensive than the other options. The costs of the international options over a transport distance of 1100 km vary between 21 and 28 EUR{sub 2007}/MWh, whereas pellet options cost between 22 and 25 EUR{sub 2007}/MWh. The primary energy required for transport of logging residues vis-a-vis pellets falls in the range 4-7% and 2-4%, respectively, of the bio-energy delivered. The primary energy needed to produce pellets gives them a lower fossil fuel substitution rate per hectare, compared with bundle systems. Similarly, for chip systems vis-a-vis bundle systems, the biomass delivered to the conversion plant is reduced by the greater physical dry-matter losses entailed by chipping systems in the forest-fuel chain. (author)

  8. Study on optimum aseismic design of complex structure system focusing on damping effect

    International Nuclear Information System (INIS)

    Takahashi, Yoshitaka; Suzuki, Kohei

    1995-01-01

    Optimum design technique for the purpose of aseismic design of complex plant structures such as piping and boiler structures is proposed. Particular attention is focused on the evaluation of the optimum damping and stiffness of the structures and components. Pseudo least square algorithm is introduced to determine the optimum design parameters. Under the requirement of certain allowable maximum response to a given earthquake excitation, optimum stiffness and damping values of the structure can be simultaneously calculated by this proposed method. The applicability of the method is demonstrated through three structural models; (1) linear multi-storied building model in which stiffness and damping constant of each floor are optimized; (2) nonlinear multi-storied building model having the isolated floor in which hysteretic energy absorber of the isolator is optimized; (3) combined boiler-supporting structure model connected by the inelastic seismic ties with each other is optimized. In this model, optimum values of damping characteristic of the seismic ties are evaluated. This work is particularly important for the aseismic design of complex plant structures like integrated boiler-supporting structure in thermal power plant and piping-containment vessel structure in nuclear power plant

  9. The Implementation of Data Warehouse and OLAP for Rehabilitation Outcome Evaluation: ReDWinE System

    Science.gov (United States)

    Guo, Fei-Ran; Parmanto, Bambang; Irrgang, James J.; Wang, Jiunjie; Fang, Huaijin

    2000-01-01

    We created a data warehouse and OLAP system on the web for outcome evaluation of rehabilitation services. Thirteen outcome indicators were use in this research. Efficiency of therapists and clinics, expected utility of treatments and graphic patterns were generated for data exploration, data mining and decision support. Users can retrieve plenty of graphs and statistical tables without knowing database structure or attributes. Our experiences showed that multi-dimensional database and OLAP could serve as a decision support system.

  10. Air Force Reusable Booster System: A Quick-look, Design Focused Modeling and Cost Analysis Study

    Science.gov (United States)

    Zapata, Edgar

    2011-01-01

    This paper presents a method and an initial analysis of the costs of a reusable booster system (RBS) as envisioned by the US Department of Defense (DoD) and numerous initiatives that form the concept of Operationally Responsive Space (ORS). This paper leverages the knowledge gained from decades of experience with the semi-reusable NASA Space Shuttle to understand how the costs of a military next generation semi-reusable space transport might behave in the real world - and how it might be made as affordable as desired. The NASA Space Shuttle had a semi-expendable booster, that being the reusable Solid Rocket MotorslBoosters (SRMlSRB) and the expendable cryogenic External Tank (ET), with a reusable cargo and crew capable orbiter. This paper will explore DoD concepts that invert this architectural arrangement, using a reusable booster plane that flies back to base soon after launch, with the in-space elements of the launch system being the expendable portions. Cost estimating in the earliest stages of any potential, large scale program has limited usefulness. As a result, the emphasis here is on developing an approach, a structure, and the basic concepts that could continue to be matured as the program gains knowledge. Where cost estimates are provided, these results by necessity carry many caveats and assumptions, and this analysis becomes more about ways in which drivers of costs for diverse scenarios can be better understood. The paper is informed throughout with a design-for-cost philosophy whereby the design and technology features of the proposed RBS (who and what, the "architecture") are taken as linked at the hip to a desire to perform a certain mission (where and when), and together these inform the cost, responsiveness, performance and sustainability (how) of the system. Concepts for developing, acquiring, producing or operating the system will be shown for their inextricable relationship to the "architecture" of the system, and how these too relate to costs

  11. Online System Adoption and K-12 Academic Outcomes

    Science.gov (United States)

    Kimmons, R.

    2015-01-01

    This study seeks to understand the relationship between K-12 online system adoption (e.g., Blackboard, Edmodo, WordPress) and school-level academic achievement ratings. Utilizing a novel approach to data collection via website data extraction and indexing of all school websites in a target state in the United States (n?=?732) and merging these…

  12. Treatment outcome in early diffuse cutaneous systemic sclerosis

    DEFF Research Database (Denmark)

    Herrick, Ariane L; Pan, Xiaoyan; Peytrignet, Sébastien

    2017-01-01

    OBJECTIVES: The rarity of early diffuse cutaneous systemic sclerosis (dcSSc) makes randomised controlled trials very difficult. We aimed to use an observational approach to compare effectiveness of currently used treatment approaches. METHODS: This was a prospective, observational cohort study...

  13. Dry Powder Inhalers: A Focus on Advancements in Novel Drug Delivery Systems

    Directory of Open Access Journals (Sweden)

    Piyush Mehta

    2016-01-01

    Full Text Available Administration of drug molecules by inhalation route for treatment of respiratory diseases has the ability to deliver drugs, hormones, nucleic acids, steroids, proteins, and peptides, particularly to the site of action, improving the efficacy of the treatment and consequently lessening adverse effects of the treatment. Numerous inhalation delivery systems have been developed and studied to treat respiratory diseases such as asthma, COPD, and other pulmonary infections. The progress of disciplines such as biomaterials science, nanotechnology, particle engineering, molecular biology, and cell biology permits further improvement of the treatment capability. The present review analyzes modern therapeutic approaches of inhaled drugs with special emphasis on novel drug delivery system for treatment of various respiratory diseases.

  14. National innovation system as a focus of state in-novation policy

    Directory of Open Access Journals (Sweden)

    Olexandr Fedirko

    2007-02-01

    Full Text Available The article offers a systematic review of tools and mechanisms utilised by developed countries (United States, Japan, EU to pursue their innovation policies, and classifies methods which support innovation and ways that help to strengthen the innovation capacity. It describes the evolution of research and development (R&D policy in other countries. The article examines arguments in support of a trend in the innovation policy which promotes the development of national innovation systems. It reviews the substance and components of the national innovation system. It also explores the trends of R&D cooperation. The article outlines the variety of domestic tools which regulate innovation in EU countries (framework programs, the European Research Area Initiative.

  15. Cabinet of Curiosities: Venom Systems and Their Ecological Function in Mammals, with a Focus on Primates.

    Science.gov (United States)

    Rode-Margono, Johanna E; Nekaris, K Anne-Isola

    2015-07-17

    Venom delivery systems (VDS) are common in the animal kingdom, but rare amongst mammals. New definitions of venom allow us to reconsider its diversity amongst mammals by reviewing the VDS of Chiroptera, Eulipotyphla, Monotremata, and Primates. All orders use modified anterior dentition as the venom delivery apparatus, except Monotremata, which possesses a crural system. The venom gland in most taxa is a modified submaxillary salivary gland. In Primates, the saliva is activated when combined with brachial gland exudate. In Monotremata, the crural spur contains the venom duct. Venom functions include feeding, intraspecific competition, anti-predator defense and parasite defense. Including mammals in discussion of venom evolution could prove vital in our understanding protein functioning in mammals and provide a new avenue for biomedical and therapeutic applications and drug discovery.

  16. Focus on CSIR research in pollution waste: Water resource governance systems

    CSIR Research Space (South Africa)

    Rascher, J

    2007-08-01

    Full Text Available series of high level research programmes for ecosystem governance. These are illustrated in the fi gure below. The size of the individual circles indicates the priority attributed to the specifi c research theme by the symposium participants... Governance Socio-econ Define Economy of scale Context application Generic strategies/methods Link to democracy 3 Science Communication, learning & knowledge sharing 4 Integration of formal & traditional systems Hydrological boundaries Value...

  17. Leadership – dedication to the Quality Management System and customer focus in Macedonian companies

    OpenAIRE

    Mitreva, Elizabeta; Filiposki, Oliver; Krivokapić, Zdravko; Jovanovic, Jelena; Taskov, Nako

    2017-01-01

    This study presents the research findings regarding the capacity of leadership in Macedonian companies, their ability to make decisions and practice team work in accordance with the criteria for obtaining the European Quality Award. The results of the research should provide useful directions that will serve Macedonian companies to improve products, services and business processes. The solution was found in the development of the management system through TQM (Total Quality Management) strate...

  18. The Energy Audit Activity Focused on the Lighting Systems in Historical Buildings

    Directory of Open Access Journals (Sweden)

    Giacomo Salvadori

    2016-11-01

    Full Text Available The energy audit for a building is a procedure designed mainly to obtain adequate knowledge of the energy consumption profile, identify, and quantify opportunities for energy savings by a cost-benefit analysis and report, clearly and comprehensively, about the obtained results. If the audit is referred to a building with a significant historical and artistic value, a compatibility evaluation of the energy saving interventions with the architectural features should also be developed. In this paper, analysing the case study of a historical building used as public offices in Pisa (Italy, the authors describe how it is possible to conduct an energy audit activity (especially dedicated to the lighting system and they show how, for this type of buildings, it is possible to obtain significant energy savings with a refurbishment of the lighting system. A total number of seven interventions on indoor and outdoor lighting sub-systems were analysed in the paper. They are characterised by absolute compatibility with the historical and artistic value of the building and they show short payback times, variable between 4 and 34 months, allowing a reduction of the electrical energy consumption for the artificial indoor and outdoor lighting variable from 1.1 MWh/year to 39.0 MWh/year. The followed methodology and the evaluation results described in the paper, although based on a case study, can be extended to numerous historical buildings used as public offices, a recurring situation in the centres of Italian historical cities.

  19. [Priorities for health policy and systems research focused on human resources in health].

    Science.gov (United States)

    Reveiz, Ludovic; Chapman, Evelina; Flórez, Carlos E Pinzón; Torres, Rubén

    2013-11-01

    Identify priorities for health policy and systems research related to human resources in Latin America and Caribbean countries. An online survey was designed based on a search in PubMed, Cochrane Library, and LILACS that contributed previously prioritized research questions. Respondents, mainly researchers and decision-makers, were identified through various sources. The first round, directed at researchers, aimed at refining and adding research questions and prioritizing questions that researchers regarded as relevant or very relevant. The second round was directed at researchers and decision-makers. A question was considered a priority when 50% (or more) of respondents described it as "relevant" or "very relevant." The first round included 20 questions on human resources and 33/66 researchers responded. Questions suggested by the researchers were added, resulting in 26 questions for the second round, which were sent to 121 researchers and decision-makers. Respondent representation by country was uniform in both rounds. In the second round, 14/26 (54%) questions were described as very relevant. Priority issues related to regulation of the market, integration of education and health care needs, and distribution of human resources. The response rate was 50% in the first round (33/66), and 34% in the second round (41/121). The results of this exercise provide a starting point for mobilization of resources for health policy and systems research. Identification of health systems research priorities is an effective and efficient strategy for reorienting political, financial, management, and social organization efforts for attaining universal health coverage.

  20. Targeted therapy for Hodgkin lymphoma and systemic anaplastic large cell lymphoma: focus on brentuximab vedotin

    Directory of Open Access Journals (Sweden)

    Chen X

    2013-12-01

    Full Text Available Xueyan Chen, Lorinda A Soma, Jonathan R FrommDepartment of Laboratory Medicine, University of Washington Medical Center, Seattle, WA, USAAbstract: Despite the relative success of chemotherapy for Hodgkin lymphoma (HL and systemic anaplastic large cell lymphoma (ALCL, novel therapeutic agents are needed for refractory or relapsed patients. Targeted immunotherapy has emerged as a novel treatment option for these patients. Although unconjugated anti-cluster of differentiation (CD30 antibodies showed minimal antitumor activity in early clinical trials, development of antibody–drug conjugates (ADCs appears promising. Brentuximab vedotin is an ADC composed of an anti-CD30 antibody linked to a potent microtubule-disrupting agent monomethyl auristatin E (MMAE. It has the ability to target CD30-positive tumor cells and, once bound to CD30, brentuximab vedotin is internalized and MMAE is released to induce cell cycle arrest and apoptosis. In two phase II trials, objective response was reported in 75% and 86% of patients with refractory or relapsed HL and systemic ALCL, respectively, with an acceptable toxicity profile. Based on these studies, the US Food and Drug Administration (FDA granted accelerated approval of brentuximab vedotin in August 2011 for the treatment of refractory and relapsed HL and ALCL. We review the key characteristics of brentuximab vedotin, clinical data supporting its therapeutic efficacy, and current ongoing trials to explore its utility in other CD30-positive malignancies.Keywords: classical Hodgkin lymphoma, systemic anaplastic large cell lymphoma, CD30, brentuximab vedotin, SGN-35

  1. Glucose metabolism: focus on gut microbiota, the endocannabinoid system and beyond.

    Science.gov (United States)

    Cani, P D; Geurts, L; Matamoros, S; Plovier, H; Duparc, T

    2014-09-01

    The gut microbiota is now considered as a key factor in the regulation of numerous metabolic pathways. Growing evidence suggests that cross-talk between gut bacteria and host is achieved through specific metabolites (such as short-chain fatty acids) and molecular patterns of microbial membranes (lipopolysaccharides) that activate host cell receptors (such as toll-like receptors and G-protein-coupled receptors). The endocannabinoid (eCB) system is an important target in the context of obesity, type 2 diabetes (T2D) and inflammation. It has been demonstrated that eCB system activity is involved in the control of glucose and energy metabolism, and can be tuned up or down by specific gut microbes (for example, Akkermansia muciniphila). Numerous studies have also shown that the composition of the gut microbiota differs between obese and/or T2D individuals and those who are lean and non-diabetic. Although some shared taxa are often cited, there is still no clear consensus on the precise microbial composition that triggers metabolic disorders, and causality between specific microbes and the development of such diseases is yet to be proven in humans. Nevertheless, gastric bypass is most likely the most efficient procedure for reducing body weight and treating T2D. Interestingly, several reports have shown that the gut microbiota is profoundly affected by the procedure. It has been suggested that the consistent postoperative increase in certain bacterial groups such as Proteobacteria, Bacteroidetes and Verrucomicrobia (A. muciniphila) may explain its beneficial impact in gnotobiotic mice. Taken together, these data suggest that specific gut microbes modulate important host biological systems that contribute to the control of energy homoeostasis, glucose metabolism and inflammation in obesity and T2D. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  2. Feasibility of an Autism-Focused Augmented Reality Smartglasses System for Social Communication and Behavioral Coaching

    Directory of Open Access Journals (Sweden)

    Runpeng Liu

    2017-06-01

    Full Text Available BackgroundAutism spectrum disorder (ASD is a childhood-onset neurodevelopmental disorder with a rapidly rising prevalence, currently affecting 1 in 68 children, and over 3.5 million people in the United States. Current ASD interventions are primarily based on in-person behavioral therapies that are both costly and difficult to access. These interventions aim to address some of the fundamental deficits that clinically characterize ASD, including deficits in social communication, and the presence of stereotypies, and other autism-related behaviors. Current diagnostic and therapeutic approaches seldom rely on quantitative data measures of symptomatology, severity, or condition trajectory.MethodsGiven the current situation, we report on the Brain Power System (BPS, a digital behavioral aid with quantitative data gathering and reporting features. The BPS includes customized smartglasses, providing targeted personalized coaching experiences through a family of gamified augmented-reality applications utilizing artificial intelligence. These applications provide children and adults with coaching for emotion recognition, face directed gaze, eye contact, and behavioral self-regulation. This preliminary case report, part of a larger set of upcoming research reports, explores the feasibility of the BPS to provide coaching in two boys with clinically diagnosed ASD, aged 8 and 9 years.ResultsThe coaching intervention was found to be well tolerated and rated as being both engaging and fun. Both males could easily use the system, and no technical problems were noted. During the intervention, caregivers reported improved non-verbal communication, eye contact, and social engagement during the intervention. Both boys demonstrated decreased symptoms of ASD, as measured by the aberrant behavior checklist at 24-h post-intervention. Specifically, both cases demonstrated improvements in irritability, lethargy, stereotypy, hyperactivity/non-compliance, and

  3. A compact ESQ system for transport and focusing of H- beam from ion source to RFQ

    International Nuclear Information System (INIS)

    Guharay, S.K.; Allen, C.K.; Reiser, M.; Saadatmand, K.; Chang, C.R.

    1992-01-01

    A compact, 6-lens electrostatic quadrupole (ESQ) LEBT (low energy beam transport) system has been constructed at the University of Maryland to transport a 30 mA, 35 kV H - beam over a distance of about 30 cm. A short einzel lens section is included at the end of the ESQ LEBT to establish a good matching of the beam to the radio frequency quadrupole (RFQ) accelerator, and to meet the emittance requirements of the linac in the Super-conducting Super Collider. Computer code predictions on the beam dynamics through the LEBT with experimentally measured input beam data are discussed. (Author) 5 figs., 6 refs

  4. Feasibility of an Autism-Focused Augmented Reality Smartglasses System for Social Communication and Behavioral Coaching.

    Science.gov (United States)

    Liu, Runpeng; Salisbury, Joseph P; Vahabzadeh, Arshya; Sahin, Ned T

    2017-01-01

    Autism spectrum disorder (ASD) is a childhood-onset neurodevelopmental disorder with a rapidly rising prevalence, currently affecting 1 in 68 children, and over 3.5 million people in the United States. Current ASD interventions are primarily based on in-person behavioral therapies that are both costly and difficult to access. These interventions aim to address some of the fundamental deficits that clinically characterize ASD, including deficits in social communication, and the presence of stereotypies, and other autism-related behaviors. Current diagnostic and therapeutic approaches seldom rely on quantitative data measures of symptomatology, severity, or condition trajectory. Given the current situation, we report on the Brain Power System (BPS), a digital behavioral aid with quantitative data gathering and reporting features. The BPS includes customized smartglasses, providing targeted personalized coaching experiences through a family of gamified augmented-reality applications utilizing artificial intelligence. These applications provide children and adults with coaching for emotion recognition, face directed gaze, eye contact, and behavioral self-regulation. This preliminary case report, part of a larger set of upcoming research reports, explores the feasibility of the BPS to provide coaching in two boys with clinically diagnosed ASD, aged 8 and 9 years. The coaching intervention was found to be well tolerated and rated as being both engaging and fun. Both males could easily use the system, and no technical problems were noted. During the intervention, caregivers reported improved non-verbal communication, eye contact, and social engagement during the intervention. Both boys demonstrated decreased symptoms of ASD, as measured by the aberrant behavior checklist at 24-h post-intervention. Specifically, both cases demonstrated improvements in irritability, lethargy, stereotypy, hyperactivity/non-compliance, and inappropriate speech. Smartglasses using augmented

  5. Modal Vibration Control in Periodic Time-Varying Structures with Focus on Rotor Blade Systems

    DEFF Research Database (Denmark)

    Christensen, Rene Hardam; Santos, Ilmar

    2004-01-01

    of active modal controllers. The main aim is to reduce vibrations in periodic time-varying structures. Special emphasis is given to vibration control of coupled bladed rotor systems. A state feedback modal control law is developed based on modal analysis in periodic time-varying structures. The first step...... in the procedure is a transformation of the model into a time-invariant modal form by applying the modal matrices, which are also periodic time-variant. Due to coupled rotor and blade motions complex vibration modes occur in the modal transformed state space model. This implies that the modal transformed model...

  6. Annual Systems Engineering Conference (9th): Focusing on Improving Performance of Defense Systems Programs. Volume 3. Wednesday

    Science.gov (United States)

    2006-10-26

    Bubble and Requirements Management by Mr. Jimmy Thai Cost Efficient Risk Management Through Integrated T&E Throughout the Systems Engineering Life-Cycle...ACSG/ Miller Seven Steps of an Effective Lessons Learned Process by Mr. Jimmy Thai Lessons Learned from a Mature DMSMS Program by SQNLDR P.D.Weeding...Aircraft AAR-47 Missile Warning System (MWS) GTRI_B-9 Lessons Learned with System Integration - 9 Theatre Airborne Reconnaissance System (TARS

  7. Measurement of the speed of sound in trabecular bone by using a time reversal acoustics focusing system

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kang Il [Kangwon National University, Chuncheon (Korea, Republic of); Choi, Bok-Kyoung [Maritime Security Research Center, KIOST, Ansan (Korea, Republic of)

    2014-10-15

    A new method for measuring the speed of sound (SOS) in trabecular bone by using a time reversal acoustics (TRA) focusing system was proposed and validated with measurements obtained by using the conventional pulse-transmission technique. The SOS measured in 14 bovine femoral trabecular bone samples by using the two methods was highly correlated each other, although the SOS measured by using the TRA focusing system was slightly lower by an average of 2.2 m/s. The SOS measured by using the two methods showed high correlation coefficients of r = 0.92 with the apparent bone density, consistent with the behavior in human trabecular bone in vitro. These results prove the efficacy of the new method based on the principle of TRA to measure the SOS in trabecular bone.

  8. Prospects and Agendas of Korea Energy Policy for the 21st Century - Focused on the Nuclear Administrative system.

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Moon Suk [Korean Association for Policy Studies, Seoul (Korea, Republic of); Kim, Tae Young [University of Seoul, Seoul (Korea, Republic of); Lee, Kee Sik; Lee, Sang Pal [Korea University, Seoul (Korea, Republic of); Kang, Kun Bok [ChungNam University, Taejon (Korea, Republic of); Kim, Jong Sun [Defnense Staff Institute, Seoul (Korea, Republic of); Park, Kuk Hum [Ansung University, Ansung (Korea, Republic of)

    1997-12-01

    It is often said that the 21st century will be an era of harsh competition among countries under the WTO regime. Thus, energy problems might become the very problem of national survival, particularly to those counties like korea which have achieved economic growth through export-oriented policies, but with few energy resources. Recognizing that energy security is one of the demanding problems Korea faces, this study analyzes current and future energy problems, pinpoints policy agendas on which the Korean government has to focus, and suggests alternative administrative systems which can effectively deal with energy problems. In doing so, this study focuses more on nuclear energy and its administrative system. 31 refs., 8 tabs., 6 figs. (author)

  9. Meiobenthos assemblages in the mekong estuarine system with special focus on free-living marine nematodes

    Science.gov (United States)

    Quang, Ngo Xuan; Vanreusel, Ann; Smol, Nic; Chau, Nguyen Ngoc

    2010-12-01

    Meiobenthos assemblages in eight estuaries of the Mekong river system were investigated in August 2008 (from the Cua Tieu estuary to the Tran De estuary). In each estuary, one sampling station was established for meiobenthos sampling. Twelve major taxa of meiobenthos were recorded in this estuarine system, including Nematoda, Copepoda, Turbellaria, Polychaeta, Oligochaeta, Tardigrada, Bivalvia, Ostracoda, Amphipoda, Cumacea, Gastrotricha, Gastropoda, and Crustacean Nauplii larvae. The densities of the meiobenthos range from 581 to 3168 inds/10 cm2. Nematodes always occupy the highest numbers with a percentage ranging from 64-99%. There are 135 nematode genera recorded in this study with the following as dominant genera Desmodora, Leptolaimus, Halalaimus, Thalassomonhystera, Theristus, Daptonema, Rhynchonema, Parodontophora, and Oncholaimus. Although the biodiversity of the meiobenthos at higher taxa level is not high compared to other marine environments, the estimates of nematode biodiversity at the genus level indicates high values. The increase in number of genera with increasing sampling intensity illustrate that the diversity is underestimated and would have been higher if the authors had considered a larger number of individuals, more replicates per station, and more sampling stations.

  10. Optimization of a Point Focus Concentration Photovoltaic System with Passive Cooling

    International Nuclear Information System (INIS)

    Chenlo, F.

    2015-01-01

    The objective of this work is modeling the temperature of photovoltaic (PV) solar cells operating in concentration systems with circular geometry and coupled to a heat sink plate for passive cooling. The proposed thermal behavior model analyses the temperature surface distribution of both PV solar cell and heat sink plate as function of light concentration. The model also allows analyzing the influence of other parameters such as uniform and non-uniform variation of the heat sink plate thickness or variation of the thermal transmission coefficient. The optimal range of the concentration factor is studied using simple models for the PV solar cell efficiency and Fresnel lens concentrator performance together with a function of costs applied to medium concentration silicon crystalline PV cells and high efficiency and high concentration multi-junction PV cells. Finally, experimental main parameters and its procedures measurement for concentration systems are presented. Modeling results show that the use of a high conductivity disk thermally coupled between the rear side of the cell and the cooling plate reduces the working cell temperature. Results also indicates that use of a light redirecting prism by total internal reflection of sunlight, reduces optical losses due to concentrator defects and chromatic aberration and increases the angle tracking error acceptance without having to increase the area of the PV solar cell

  11. Management by process based systems and safety focus; Verksamhetsstyrning med process-baserade ledningssystem och saekerhetsfokus

    Energy Technology Data Exchange (ETDEWEB)

    Rydnert, Bo; Groenlund, Bjoern [SIS Forum AB, Stockholm (Sweden)

    2005-12-15

    An initiative from The Swedish Nuclear Power Inspectorate led to this study carried out in the late autumn of 2005. The objective was to understand in more detail how an increasing use of process management affects organisations, on the one hand regarding risks and security, on the other hand regarding management by objectives and other management and operative effects. The main method was interviewing representatives of companies and independent experts. More than 20 interviews were carried out. In addition a literature study was made. All participating companies are using Management Systems based on processes. However, the methods chosen, and the results achieved, vary extensively. Thus, there are surprisingly few examples of complete and effective management by processes. Yet there is no doubt that management by processes is effective and efficient. Overall goals are reached, business results are achieved in more reliable ways and customers are more satisfied. The weaknesses found can be translated into a few comprehensive recommendations. A clear, structured and acknowledged model should be used and the processes should be described unambiguously. The changed management roles should be described and obeyed extremely legibly. New types of process objectives need to be formulated. In addition one fact needs to be observed and effectively fended off. Changes are often met by mental opposition on management level, as well as among co-workers. This fact needs attention and leadership. Safety development is closely related to the design and operation of a business management system and its continual improvement. A deep understanding of what constitutes an efficient and effective management system affects the understanding of safety. safety culture and abilities to achieve safety goals. Concerning risk, the opinions were unambiguous. Management by processes as such does not result in any further risks. On the contrary. Processes give a clear view of production and

  12. The stress system in depression and neurodegeneration: focus on the human hypothalamus.

    Science.gov (United States)

    Bao, A-M; Meynen, G; Swaab, D F

    2008-03-01

    The stress response is mediated by the hypothalamo-pituitary-adrenal (HPA) system. Activity of the corticotropin-releasing hormone (CRH) neurons in the hypothalamic paraventricular nucleus (PVN) forms the basis of the activity of the HPA-axis. The CRH neurons induce adrenocorticotropin (ACTH) release from the pituitary, which subsequently causes cortisol release from the adrenal cortex. The CRH neurons co-express vasopressin (AVP) which potentiates the CRH effects. CRH neurons project not only to the median eminence but also into brain areas where they, e.g., regulate the adrenal innervation of the autonomic system and affect mood. The hypothalamo-neurohypophysial system is also involved in stress response. It releases AVP from the PVN and the supraoptic nucleus (SON) and oxytocin (OXT) from the PVN via the neurohypophysis into the bloodstream. The suprachiasmatic nucleus (SCN), the hypothalamic clock, is responsible for the rhythmic changes of the stress system. Both centrally released CRH and increased levels of cortisol contribute to the signs and symptoms of depression. Symptoms of depression can be induced in experimental animals by intracerebroventricular injection of CRH. Depression is also a frequent side effect of glucocorticoid treatment and of the symptoms of Cushing's syndrome. The AVP neurons in the hypothalamic PVN and SON are also activated in depression, which contributes to the increased release of ACTH from the pituitary. Increased levels of circulating AVP are also associated with the risk for suicide. The prevalence, incidence and morbidity risk for depression are higher in females than in males and fluctuations in sex hormone levels are considered to be involved in the etiology. About 40% of the activated CRH neurons in mood disorders co-express nuclear estrogen receptor (ER)-alpha in the PVN, while estrogen-responsive elements have been found in the CRH gene promoter region, and estrogens stimulate CRH production. An androgen

  13. From Focused Thought to Reveries: A Memory System for a Conscious Robot

    Directory of Open Access Journals (Sweden)

    Christian Balkenius

    2018-04-01

    Full Text Available We introduce a memory model for robots that can account for many aspects of an inner world, ranging from object permanence, episodic memory, and planning to imagination and reveries. It is modeled after neurophysiological data and includes parts of the cerebral cortex together with models of arousal systems that are relevant for consciousness. The three central components are an identification network, a localization network, and a working memory network. Attention serves as the interface between the inner and the external world. It directs the flow of information from sensory organs to memory, as well as controlling top-down influences on perception. It also compares external sensations to internal top-down expectations. The model is tested in a number of computer simulations that illustrate how it can operate as a component in various cognitive tasks including perception, the A-not-B test, delayed matching to sample, episodic recall, and vicarious trial and error.

  14. Using Corporate Social Responsibility strategy with a climate focus for Enterprise Systems

    DEFF Research Database (Denmark)

    Zambach, Sine; Holst, Philip; Francker, Zenia Worm

     Corporate Social Responsibility (CSR) as a term has existed for only a couple of decades but in practice CSR has existed for more than 100 years. Through the 90's, CSR became common among businesses while evolving from a philanthropic to a pragmatic dimension. Recent research suggests a transfor...... Corporate Social Responsibility (CSR) as a term has existed for only a couple of decades but in practice CSR has existed for more than 100 years. Through the 90's, CSR became common among businesses while evolving from a philanthropic to a pragmatic dimension. Recent research suggests...... a transformation of CSR, which combines CSR with the core business of the company in order to increase and maintain societal legitimacy. Enterprise resource planning (ERP) systems are organization tools of a company's resources. The most basic parts concern finance and payments. Today, these ERPs are widely...

  15. A closed-loop model of the respiratory system: focus on hypercapnia and active expiration.

    Directory of Open Access Journals (Sweden)

    Yaroslav I Molkov

    Full Text Available Breathing is a vital process providing the exchange of gases between the lungs and atmosphere. During quiet breathing, pumping air from the lungs is mostly performed by contraction of the diaphragm during inspiration, and muscle contraction during expiration does not play a significant role in ventilation. In contrast, during intense exercise or severe hypercapnia forced or active expiration occurs in which the abdominal "expiratory" muscles become actively involved in breathing. The mechanisms of this transition remain unknown. To study these mechanisms, we developed a computational model of the closed-loop respiratory system that describes the brainstem respiratory network controlling the pulmonary subsystem representing lung biomechanics and gas (O2 and CO2 exchange and transport. The lung subsystem provides two types of feedback to the neural subsystem: a mechanical one from pulmonary stretch receptors and a chemical one from central chemoreceptors. The neural component of the model simulates the respiratory network that includes several interacting respiratory neuron types within the Bötzinger and pre-Bötzinger complexes, as well as the retrotrapezoid nucleus/parafacial respiratory group (RTN/pFRG representing the central chemoreception module targeted by chemical feedback. The RTN/pFRG compartment contains an independent neural generator that is activated at an increased CO2 level and controls the abdominal motor output. The lung volume is controlled by two pumps, a major one driven by the diaphragm and an additional one activated by abdominal muscles and involved in active expiration. The model represents the first attempt to model the transition from quiet breathing to breathing with active expiration. The model suggests that the closed-loop respiratory control system switches to active expiration via a quantal acceleration of expiratory activity, when increases in breathing rate and phrenic amplitude no longer provide sufficient

  16. Clinician Perspectives of Barriers to Effective Implementation of a Rapid Response System in an Academic Health Centre: A Focus Group Study

    Directory of Open Access Journals (Sweden)

    John Rihari-Thomas

    2017-08-01

    Full Text Available Background Systemic and structural issues of rapid response system (RRS models can hinder implementation. This study sought to understand the ways in which acute care clinicians (physicians and nurses experience and negotiate care for deteriorating patients within the RRS. Methods Physicians and nurses working within an Australian academic health centre within a jurisdictional-based model of clinical governance participated in focus group interviews. Verbatim transcripts were analysed using thematic content analysis. Results Thirty-four participants (21 physicians and 13 registered nurses [RNs] participated in six focus groups over five weeks in 2014. Implementing the RRS in daily practice was a process of informal communication and negotiation in spite of standardised protocols. Themes highlighted several systems or organisational-level barriers to an effective RRS, including (1 responsibility is inversely proportional to clinical experience; (2 actions around system flexibility contribute to deviation from protocol; (3 misdistribution of resources leads to perceptions of inadequate staffing levels inhibiting full optimisation of the RRS; and (4 poor communication and documentation of RRS increases clinician workloads. Conclusion Implementing a RRS is complex and multifactorial, influenced by various inter- and intra-professional factors, staffing models and organisational culture. The RRS is not a static model; it is both reflexive and iterative, perpetually transforming to meet healthcare consumer and provider demands and local unit contexts and needs. Requiring more than just a strong initial implementation phase, new models of care such as a RRS demand good governance processes, ongoing support and regular evaluation and refinement. Cultural, organizational and professional factors, as well as systems-based processes, require consideration if RRSs are to achieve their intended outcomes in dynamic healthcare settings.

  17. Prediction of outcome in individuals with diabetic foot ulcers: focus on the differences between individuals with and without peripheral arterial disease. The EURODIALE Study

    DEFF Research Database (Denmark)

    Prompers, L.; Schaper, N.; Apelqvist, J.

    2008-01-01

    ulcer size, peripheral neuropathy and PAD. When analyses were performed according to PAD status, infection emerged as a specific predictor of non-healing in PAD patients only. Conclusions/Interpretation Predictors of healing differ between patients with and without PAD, suggesting that diabetic foot......Aims/hypothesis Outcome data on individuals with diabetic foot ulcers are scarce, especially in those with peripheral arterial disease (PAD). We therefore examined the clinical characteristics that best predict poor outcome in a large population of diabetic foot ulcer patients and examined whether...

  18. SU-F-T-211: Evaluation of a Dual Focusing Magnet System for the Treatment of Small Proton Targets

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, TT; McAuley, GA; Heczko, S; Slater, J [Loma Linda University, Loma Linda, CA (United States); Wroe, A [Loma Linda University, Loma Linda, CA (United States); Loma Linda University Medical Center, Loma Linda, CA (United States)

    2016-06-15

    Purpose: To investigate magnetic focusing for small volume proton targets using a doublet combination of quadrupole rare earth permanent magnet Halbach cylinder assemblies Methods: Monte Carlo computer simulations were performed using the Geant4 toolkit to compare dose depositions of proton beams transported through two focusing magnets or in their absence. Proton beams with energies of 127 MeV and initial diameters of 5, 8 and 10 mm were delivered through two identical focusing magnets similar to those currently in experimental use at Loma Linda University Medical Center. Analogous experiments used optimized configurations based on the simulation results. Dose was measured by a diode detector and Gafchromic EBT3 film and compared to simulation data. Based on results from the experimental data, an additional set of simulations was performed with an initial beam diameter of 18 mm and a two differing length magnets (40mm & 68mm). Results: Experimental data matched well with Monte Carlo simulations. However, under conditions necessary to produce circular beam spots at target depth, magnetically focused beams using two identical 40 mm length magnets did not meet all of our performance criteria of circular beam spots, improved peak to entrance (P/E) dose ratios and dose delivery efficiencies. The simulations using the longer 68 mm 2nd magnet yielded better results with 34% better P/E dose ratio and 20–50% better dose delivery efficiencies when compared to unfocused 10 mm beams. Conclusion: While magnetic focusing using two magnets with identical focusing power did not yield desired results, ongoing Monte Carlo simulations suggest that increasing the length of the 2nd magnet to 68 mm could improve P/E dose ratios and dose efficiencies. Future work includes additional experimental validation of the longer 2nd magnet setup as well as experiments with triplet magnet systems. This project was sponsored with funding from the Department of Defense (DOD# W81XWH-BAA-10-1).

  19. How Do Clinical Information Systems Affect the Cognitive Demands of General Practitioners?: Usability Study with a Focus on Cognitive Workload

    Directory of Open Access Journals (Sweden)

    Ferran Ariza

    2015-11-01

    Full Text Available Background Clinical information systems in the National Health Service do not need to conform to any explicit usability requirements. Poor usability can increase the mental workload experienced by clinicians and cause fatigue, increase error rates and impact the overall patient safety. Mental workload can be used as a measure of usability.Objective To assess the subjective cognitive workload experienced by general practitioners (GPs with their systems. To raise awareness of the importance of usability in system design among users, designers, developers and policymakers.Methods We used a modified version of the NASA Task Load Index, adapted for web. We developed a set of common clinical scenarios and computer tasks on an online survey. We emailed the study link to 199 clinical commissioning groups and 1,646 GP practices in England. Results Sixty-seven responders completed the survey. The respondents had spent an average of 17 years in general practice, had experience of using a mean of 1.5 GP computer systems and had used their current system for a mean time of 6.7 years. The mental workload score was not different among systems. There were significant differences among the task scores, but these differences were not specific to particular systems. The overall score and task scores were related to the length of experience with their present system. Conclusion Four tasks imposed a higher mental workload on GPs: ‘repeat prescribing’, ‘find episode’, ‘drug management’ and ‘overview records’. Further usability studies on GP systems should focus on these tasks. Users, policymakers, designers and developers should remain aware of the importance of usability in system design.What does this study add?• Current GP systems in England do not need to conform to explicit usability requirements. Poor usability can increase the mental workload of clinicians and lead to errors.• Some clinical computer tasks incur more cognitive workload

  20. Dynamic focus scanning laser imaging (SLI) system: An old concept with a new approach

    International Nuclear Information System (INIS)

    Tomei, L.D.; Jagadeesh, J.M.

    1986-01-01

    A processor board was designed based on the Motorola 68020 32 bit microprocessor and 68881 floating point co-processor. It provides data collection at a burst rate of one million 12 bit words per second with 256K bytes on board memory accessible with no wait states. A dual-ported memory card was designed to support image updating via a random port while display is refreshed through a sequential port, each accessed independently. The RAM port features one megabyte dual-ported memory utilizing 32 64K x 4 RAM chips, two bit error detection and one bit error correction circuitry. The sequential (video) port features a row-access to memory providing four 1024 pixels/line data in internal buffer. With a newly designed VMEbus display controller board, several display options are provided for in the system: any continuous 8 bit display out of 16 bit video information available per pixel is under software control; two display formats are provided for, 512 x 480 and 1024 x 960; B/W and color displays are provided; pixel resolution user selectable 8-24 bits

  1. Thyroid Hormones and Antioxidant Systems: Focus on Oxidative Stress in Cardiovascular and Pulmonary Diseases

    Directory of Open Access Journals (Sweden)

    Antonio Mancini

    2013-12-01

    Full Text Available In previous works we demonstrated an inverse correlation between plasma Coenzyme Q10 (CoQ10 and thyroid hormones; in fact, CoQ10 levels in hyperthyroid patients were found among the lowest detected in human diseases. On the contrary, CoQ10 is elevated in hypothyroid subjects, also in subclinical conditions, suggesting the usefulness of this index in assessing metabolic status in thyroid disorders. A Low-T3 syndrome is a condition observed in several chronic diseases: it is considered an adaptation mechanism, where there is a reduction in pro-hormone T4 conversion. Low T3-Syndrome is not usually considered to be corrected with replacement therapy. We review the role of thyroid hormones in regulation of antioxidant systems, also presenting data on total antioxidant capacity and Coenzyme Q10. Published studies suggest that oxidative stress could be involved in the clinical course of different heart diseases; our data could support the rationale of replacement therapy in low-T3 conditions.

  2. Patient-specific system for prognosis of surgical treatment outcomes of human cardiovascular system

    Science.gov (United States)

    Golyadkina, Anastasiya A.; Kalinin, Aleksey A.; Kirillova, Irina V.; Kossovich, Elena L.; Kossovich, Leonid Y.; Menishova, Liyana R.; Polienko, Asel V.

    2015-03-01

    Object of study: Improvement of life quality of patients with high stroke risk ia the main goal for development of system for patient-specific modeling of cardiovascular system. This work is dedicated at increase of safety outcomes for surgical treatment of brain blood supply alterations. The objects of study are common carotid artery, internal and external carotid arteries and bulb. Methods: We estimated mechanical properties of carotid arteries tissues and patching materials utilized at angioplasty. We studied angioarchitecture features of arteries. We developed and clinically adapted computer biomechanical models, which are characterized by geometrical, physical and mechanical similarity with carotid artery in norm and with pathology (atherosclerosis, pathological tortuosity, and their combination). Results: Collaboration of practicing cardiovascular surgeons and specialists in the area of Mathematics and Mechanics allowed to successfully conduct finite-element modeling of surgical treatment taking into account various features of operation techniques and patching materials for a specific patient. Numerical experiment allowed to reveal factors leading to brain blood supply decrease and atherosclerosis development. Modeling of carotid artery reconstruction surgery for a specific patient on the basis of the constructed biomechanical model demonstrated the possibility of its application in clinical practice at approximation of numerical experiment to the real conditions.

  3. Development and application of the adverse outcome pathway framework for understanding and predicting chronic toxicity: II. A focus on growth impairment in fish

    NARCIS (Netherlands)

    Groh, K.J.; Carvalho, R.N.; Chipman, J.K.; Denslow, N.D.; Halder, M.; Murphy, C.A.; Roelofs, D.; Rolaki, A.; Schirmer, K.; Watanabe, K.H.

    2015-01-01

    Adverse outcome pathways (AOPs) organize knowledge on the progression of toxicity through levels of biological organization. By determining the linkages between toxicity events at different levels, AOPs lay the foundation for mechanism-based alternative testing approaches to hazard assessment. Here,

  4. Identification of the Most Effective Point of Connection for Battery Energy Storage Systems Focusing on Power System Frequency Response Improvement

    Directory of Open Access Journals (Sweden)

    Thiago Pieroni

    2018-03-01

    Full Text Available With the massive penetration of intermittent generation (wind and solar, the reduction of Electrical Power Systems’ (EPSs inertial frequency response represents a new challenge. One alternative to deal with this scenario may be the application of a Battery Energy Storage System (BESS. However, the main constraint for the massive deployment of BESSs is the high acquisition cost of these storage systems which in some situations, can preclude their use in transmission systems. The main goal of this paper is to propose a systematic procedure to include BESSs in power system aiming to improve the power system frequency response using full linear models and geometric measures. In this work, a generic battery model is developed in a two-area test system with assumed high wind penetration and full conventional generators models. The full power system is linearized, and the geometric measures of controllability associated with of the frequency regulation mode are estimated. Then, these results are used to identify the most effective point of connection for a BESS aiming at the improvement of the power system frequency response. Nonlinear time-domain simulations are carried out to evaluate and validate the results.

  5. The impact of tackle football injuries on the American healthcare system with a neurological focus.

    Directory of Open Access Journals (Sweden)

    Michael J McGinity

    Full Text Available Recent interest in the study of concussion and other neurological injuries has heightened awareness of the medical implications of American tackle football injuries amongst the public.Using the National Emergency Department Sample (NEDS and the National Inpatient Sample (NIS, the largest publicly available all-payer emergency department and inpatient healthcare databases in the United States, we sought to describe the impact of tackle football injuries on the American healthcare system by delineating injuries, specifically neurological in nature, suffered as a consequence of tackle football between 2010 and 2013.The NEDS and NIS databases were queried to collect data on all patients presented to the emergency department (ED and/or were admitted to hospitals with an ICD code for injuries related to American tackle football between the years 2010 and 2013. Subsequently those with football-related neurological injuries were abstracted using ICD codes for concussion, skull/face injury, intracranial injury, spine injury, and spinal cord injury (SCI. Patient demographics, length of hospital stay (LOS, cost and charge data, neurosurgical interventions, hospital type, and disposition were collected and analyzed.A total of 819,000 patients presented to EDs for evaluation of injuries secondary to American tackle football between 2010 and 2013, with 1.13% having injuries requiring inpatient admission (average length of stay 2.4 days. 80.4% of the ED visits were from the pediatric population. Of note, a statistically significant increase in the number of pediatric concussions over time was demonstrated (OR = 1.1, 95% CI 1.1 to 1.2. Patients were more likely to be admitted to trauma centers, teaching hospitals, the south or west regions, or with private insurance. There were 471 spinal cord injuries and 1,908 total spine injuries. Ten patients died during the study time period. The combined ED and inpatient charges were $1.35 billion.Injuries related to

  6. The impact of tackle football injuries on the American healthcare system with a neurological focus.

    Science.gov (United States)

    McGinity, Michael J; Grandhi, Ramesh; Michalek, Joel E; Rodriguez, Jesse S; Trevino, Aron M; McGinity, Ashley C; Seifi, Ali

    2018-01-01

    Recent interest in the study of concussion and other neurological injuries has heightened awareness of the medical implications of American tackle football injuries amongst the public. Using the National Emergency Department Sample (NEDS) and the National Inpatient Sample (NIS), the largest publicly available all-payer emergency department and inpatient healthcare databases in the United States, we sought to describe the impact of tackle football injuries on the American healthcare system by delineating injuries, specifically neurological in nature, suffered as a consequence of tackle football between 2010 and 2013. The NEDS and NIS databases were queried to collect data on all patients presented to the emergency department (ED) and/or were admitted to hospitals with an ICD code for injuries related to American tackle football between the years 2010 and 2013. Subsequently those with football-related neurological injuries were abstracted using ICD codes for concussion, skull/face injury, intracranial injury, spine injury, and spinal cord injury (SCI). Patient demographics, length of hospital stay (LOS), cost and charge data, neurosurgical interventions, hospital type, and disposition were collected and analyzed. A total of 819,000 patients presented to EDs for evaluation of injuries secondary to American tackle football between 2010 and 2013, with 1.13% having injuries requiring inpatient admission (average length of stay 2.4 days). 80.4% of the ED visits were from the pediatric population. Of note, a statistically significant increase in the number of pediatric concussions over time was demonstrated (OR = 1.1, 95% CI 1.1 to 1.2). Patients were more likely to be admitted to trauma centers, teaching hospitals, the south or west regions, or with private insurance. There were 471 spinal cord injuries and 1,908 total spine injuries. Ten patients died during the study time period. The combined ED and inpatient charges were $1.35 billion. Injuries related to tackle

  7. Mind-Body Medicine and Immune System Outcomes: A Systematic Review.

    Science.gov (United States)

    Wahbeh, Helané; Haywood, Ashley; Kaufman, Karen; Zwickey, Heather

    2009-01-01

    This study is a systematic review of mind-body interventions that used immune outcomes in order to: 1) characterize mind-body medicine studies that assessed immune outcomes, 2) evaluate the quality of mind-body medicine studies measuring immune system effects, and 3) systematically evaluate the evidence for mind-body interventions effect on immune system outcomes using existing formal tools. 111 studies with 4,777 subjects were reviewed. The three largest intervention type categories were Relaxation Training (n=25), Cognitive Based Stress Management (n=22), and Hypnosis (n=21). Half the studies were conducted with healthy subjects (n=51). HIV (n=18), cancer (n=13) and allergies (n=7) were the most prominent conditions examined in the studies comprising of non-healthy subjects. Natural killer cell and CD4 T lymphocyte measures were the most commonly studied outcomes. Most outcome and modality categories had limited or inconclusive evidence. Relaxation training had the strongest scientific evidence of a mind-body medicine affecting immune outcomes. Immunoglobulin A had the strongest scientific evidence for positive effects from mind-body medicine. Issues for mind-body medicine studies with immune outcomes are discussed and recommendations are made to help improve future clinical trials.

  8. Beyond the bench and the bedside: economic and health systems dimensions of global childhood cancer outcomes.

    Science.gov (United States)

    Denburg, Avram E; Knaul, Felicia M; Atun, Rifat; Frazier, Lindsay A; Barr, Ronald D

    2014-03-01

    Globally, the number of new cases of childhood cancer continues to rise, with a widening gulf in outcomes across countries, despite the availability of effective cure options for many pediatric cancers. Economic forces and health system realities are deeply embedded in the foundation of disparities in global childhood cancer outcomes. A truly global effort to close the childhood cancer divide therefore requires systemic solutions. Analysis of the economic and health system dimensions of childhood cancer outcomes is essential to progress in childhood cancer survival around the globe. The conceptual power of this approach is significant. It provides insight into how and where pediatric oncology entwines with broader political and economic conditions, and highlights the mutual benefit derived from systems-oriented solutions. © 2013 Wiley Periodicals, Inc.

  9. Comparison of HIV-1 genotypic resistance test interpretation systems in predicting virological outcomes over time

    NARCIS (Netherlands)

    D. Frentz (Dineke); C.A.B. Boucher (Charles); M. Assel (Matthias); A. de Luca (Andrea); M. Fabbiani (Massimiliano); F. Incardona (Francesca); P. Libin (Pieter); N. Manca (Nino); V. Müller (Viktor); B.O. Nualláin (Breanndán); R. Paredes (Roger); M. Prosperi (Mattia); E. Quiros-Roldan (Eugenia); L. Ruiz (Lidia); P.M.A. Sloot (Peter); C. Torti (Carlo); A.M. Vandamme (Anne Mieke); K. Laethem (Kristel); M. Zazzi (Maurizio); D.A.M.C. van de Vijver (David)

    2010-01-01

    textabstractBackground: Several decision support systems have been developed to interpret HIV-1 drug resistance genotyping results. This study compares the ability of the most commonly used systems (ANRS, Rega, and Stanford's HIVdb) to predict virological outcome at 12, 24, and 48 weeks.

  10. Progress and outcomes of health systems reform in the United Arab Emirates: A systematic review

    NARCIS (Netherlands)

    E.J. Koornneef (Erik J.); P.B.M. Robben (Paul); Blair, I. (Iain)

    2017-01-01

    textabstractBackground: The United Arab Emirates (UAE) government aspires to build a world class health system to improve the quality of healthcare and the health outcomes for its population. To achieve this it has implemented extensive health system reforms in the past 10 years. The nature, extent

  11. Establishing and evaluating the key functions of an interactive systems framework using an assets-getting to outcomes intervention.

    Science.gov (United States)

    Chinman, Matthew; Acosta, Joie; Ebener, Patricia; Q Burkhart; Clifford, Michael; Corsello, Maryann; Duffey, Tim; Hunter, Sarah; Jones, Margaret; Lahti, Michel; Malone, Patrick S; Paddock, Susan; Phillips, Andrea; Savell, Susan; Scales, Peter C; Tellett-Royce, Nancy

    2012-12-01

    Community practitioners can face difficulty in achieving outcomes demonstrated by prevention science. Building a community practitioner's prevention capacity-the knowledge and skills needed to conduct critical prevention practices-could improve the quality of prevention and its outcomes. The purpose of this article is to: (1) describe how an intervention called Assets-Getting To Outcomes (AGTO) was used to establish the key functions of the ISF and present early lessons learned from that intervention's first 6 months and (2) examine whether there is an empirical relationship between practitioner capacity at the individual level and the performance of prevention at the program level-a relationship predicted by the ISF but untested. The article describes an operationalization of the ISF in the context of a five-year randomized controlled efficacy trial that combines two complementary models designed to build capacity: Getting To Outcomes (GTO) and Developmental Assets. The trial compares programs and individual practitioners from six community-based coalitions using AGTO with programs and practitioners from six similar coalitions that are not. In this article, we primarily focus on what the ISF calls innovation specific capacity and discuss how the combined AGTO innovation structures and uses feedback about its capacity-building activities, which can serve as a model for implementing the ISF. Focus group discussions used to gather lessons learned from the first 6 months of the AGTO intervention suggest that while the ISF may have been conceptualized as three distinct systems, in practice they are less distinct. Findings from the baseline wave of data collection of individual capacity and program performance suggest that practitioner capacity predicts, in part, performance of prevention programs. Empirically linking practitioner capacity and performance of prevention provides empirical support for both the ISF and AGTO.

  12. Maternal nutrition among women from Sub-Saharan Africa, with a focus on Nigeria, and potential implications for pregnancy outcomes among immigrant populations in developed countries.

    LENUS (Irish Health Repository)

    Lindsay, K L

    2012-12-01

    Pregnant women in countries of Sub-Saharan Africa (SSA) are at risk of poor nutritional status and adverse outcomes as a result of poverty, food insecurity, sub-optimal healthcare facilities, frequent infections and frequent pregnancies. Studies from Nigeria, for example, have revealed a high prevalence of both under- and over-nutrition, as well as nutrient deficiencies, including iron, folate, vitamin D and vitamin A. Subsequently, obstetric complications, including hypertension, anaemia, neural tube defects, night-blindness, low birth weight and maternal and perinatal mortality, are common. Migration patterns from SSA to the Western world are on the rise in recent years, with Nigerians now representing the most prevalent immigrant African population in many developed countries. However, the effect of immigration, if any, on the nutritional status and pregnancy outcomes of these women in their host countries has not yet been studied. Consequently, it is unknown to what extent the nutritional deficiencies and pregnancy complications occurring in Nigeria, and other countries of SSA, present in these women post-emigration. This may result in missed opportunities for appropriate antenatal care of a potential high-risk group in pregnancy. The present review discusses the literature regarding nutrition in pregnancy among SSA women, using Nigeria as an example, the common nutrition-related complications that arise and the subsequent obstetric outcomes. The concept of dietary acculturation among immigrant groups is also discussed and deficiencies in the literature regarding studies on the diets of pregnant immigrant women are highlighted.

  13. Spanning maternal, newborn and child health (MNCH) and health systems research boundaries: conducive and limiting health systems factors to improving MNCH outcomes in West Africa.

    Science.gov (United States)

    Agyepong, Irene Akua; Kwamie, Aku; Frimpong, Edith; Defor, Selina; Ibrahim, Abdallah; Aryeetey, Genevieve C; Lokossou, Virgil; Sombie, Issiaka

    2017-07-12

    Despite improvements over time, West Africa lags behind global as well as sub-Saharan averages in its maternal, newborn and child health (MNCH) outcomes. This is despite the availability of an increasing body of knowledge on interventions that improve such outcomes. Beyond our knowledge of what interventions work, insights are needed on others factors that facilitate or inhibit MNCH outcome improvement. This study aimed to explore health system factors conducive or limiting to MNCH policy and programme implementation and outcomes in West Africa, and how and why they work in context. We conducted a mixed methods multi-country case study focusing predominantly, but not exclusively, on the six West African countries (Burkina Faso, Benin, Mali, Senegal, Nigeria and Ghana) of the Innovating for Maternal and Child Health in Africa initiative. Data collection involved non-exhaustive review of grey and published literature, and 48 key informant interviews. We validated our findings and conclusions at two separate multi-stakeholder meetings organised by the West African Health Organization. To guide our data collection and analysis, we developed a unique theoretical framework of the link between health systems and MNCH, in which we conceptualised health systems as the foundations, pillars and roofing of a shelter for MNCH, and context as the ground on which the foundation is laid. A multitude of MNCH policies and interventions were being piloted, researched or implemented at scale in the sub-region, most of which faced multiple interacting conducive and limiting health system factors to effective implementation, as well as contextual challenges. Context acted through its effect on health system factors as well as on the social determinants of health. To accelerate and sustain improvements in MNCH outcomes in West Africa, an integrated approach to research and practice of simultaneously addressing health systems and contextual factors alongside MNCH service delivery

  14. Line-focus solar central power systems, Phase I. Monthly technical progress report, 31 January 1979-28 February 1979

    Energy Technology Data Exchange (ETDEWEB)

    Slemmons, A J

    1979-03-01

    The work performed during the fifth month of the Phase I study of the High Temperature Line-Focus Solar Central Power System is summarized. During the reporting period, the optical and receiver computer analysis programs and parametricized data have been combined in a computer program to give the projected annualized Bus Bar Energy Costs for a specified design. Although some of the data are incomplete or need further refinement, the program has been used to examine the sensitivity of some parameters, and to make preliminary optimizations.

  15. Implementation of learning outcome attainment measurement system in aviation engineering higher education

    Science.gov (United States)

    Salleh, I. Mohd; Mat Rani, M.

    2017-12-01

    This paper aims to discuss the effectiveness of the Learning Outcome Attainment Measurement System in assisting Outcome Based Education (OBE) for Aviation Engineering Higher Education in Malaysia. Direct assessments are discussed to show the implementation processes that become a key role in the successful outcome measurement system. A case study presented in this paper involves investigation on the implementation of the system in Aircraft Structure course for Bachelor in Aircraft Engineering Technology program in UniKL-MIAT. The data has been collected for five semesters, starting from July 2014 until July 2016. The study instruments used include the report generated in Learning Outcomes Measurements System (LOAMS) that contains information on the course learning outcomes (CLO) individual and course average performance reports. The report derived from LOAMS is analyzed and the data analysis has revealed that there is a positive significant correlation between the individual performance and the average performance reports. The results for analysis of variance has further revealed that there is a significant difference in OBE grade score among the report. Independent samples F-test results, on the other hand, indicate that the variances of the two populations are unequal.

  16. Focusing ethnography

    DEFF Research Database (Denmark)

    Woermann, Niklas

    2018-01-01

    underpinnings of focusing ethnographic research by comparing different schools of thought and suggesting a practice theory-based approach. It argues that many research projects are focused but do not reflect on the process of focusing, describes how to identify focal settings or practices, and introduces......Building theory with ethnography and filmic research increasingly requires focussing on key practices or settings, instead of painting a broad panorama of a culture. But few authors discuss why and how to focus. This article provides a systematic discussion of the theoretical and methodological...

  17. Aerobic Interval vs. Continuous Training in Patients with Coronary Artery Disease or Heart Failure: An Updated Systematic Review and Meta-Analysis with a Focus on Secondary Outcomes.

    Science.gov (United States)

    Pattyn, Nele; Beulque, Randy; Cornelissen, Véronique

    2018-05-01

    In a previous meta-analysis including nine trials comparing aerobic interval training with aerobic continuous training in patients with coronary artery disease, we found a significant difference in peak oxygen uptake favoring aerobic interval training. The objective of this study was to (1) update the original meta-analysis focussing on peak oxygen uptake and (2) evaluate the effect on secondary outcomes. We conducted a systematic review with a meta-analysis by searching PubMed and SPORTDiscus databases up to March 2017. We included randomized trials comparing aerobic interval training and aerobic continuous training in patients with coronary artery disease or chronic heart failure. The primary outcome was change in peak oxygen uptake. Secondary outcomes included cardiorespiratory parameters, cardiovascular risk factors, cardiac and vascular function, and quality of life. Twenty-four papers were identified (n = 1080; mean age 60.7 ± 10.7 years). Aerobic interval training resulted in a higher increase in peak oxygen uptake compared with aerobic continuous training in all patients (1.40 mL/kg/min; p aerobic interval training in all patients. Other cardiorespiratory parameters, cardiovascular risk factors, and quality of life were equally affected. This meta-analysis adds further evidence to the clinically significant larger increase in peak oxygen uptake following aerobic interval training vs. aerobic continuous training in patients with coronary artery disease and chronic heart failure. More well-designed randomized controlled trials are needed to establish the safety of aerobic interval training and the sustainability of the training response over longer periods.

  18. Maternal nutrition among women from Sub-Saharan Africa, with a focus on Nigeria, and potential implications for pregnancy outcomes among immigrant populations in developed countries.

    Science.gov (United States)

    Lindsay, K L; Gibney, E R; McAuliffe, F M

    2012-12-01

    Pregnant women in countries of Sub-Saharan Africa (SSA) are at risk of poor nutritional status and adverse outcomes as a result of poverty, food insecurity, sub-optimal healthcare facilities, frequent infections and frequent pregnancies. Studies from Nigeria, for example, have revealed a high prevalence of both under- and over-nutrition, as well as nutrient deficiencies, including iron, folate, vitamin D and vitamin A. Subsequently, obstetric complications, including hypertension, anaemia, neural tube defects, night-blindness, low birth weight and maternal and perinatal mortality, are common. Migration patterns from SSA to the Western world are on the rise in recent years, with Nigerians now representing the most prevalent immigrant African population in many developed countries. However, the effect of immigration, if any, on the nutritional status and pregnancy outcomes of these women in their host countries has not yet been studied. Consequently, it is unknown to what extent the nutritional deficiencies and pregnancy complications occurring in Nigeria, and other countries of SSA, present in these women post-emigration. This may result in missed opportunities for appropriate antenatal care of a potential high-risk group in pregnancy. The present review discusses the literature regarding nutrition in pregnancy among SSA women, using Nigeria as an example, the common nutrition-related complications that arise and the subsequent obstetric outcomes. The concept of dietary acculturation among immigrant groups is also discussed and deficiencies in the literature regarding studies on the diets of pregnant immigrant women are highlighted. © 2012 The Authors. Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

  19. Positive Social Interactions in a Lifespan Perspective with a Focus on Opioidergic and Oxytocinergic Systems: Implications for Neuroprotection

    Science.gov (United States)

    Colonnello, Valentina; Petrocchi, Nicola; Farinelli, Marina; Ottaviani, Cristina

    2017-01-01

    In recent years, a growing interest has emerged in the beneficial effects of positive social interactions on health. The present work aims to review animal and human studies linking social interactions and health throughout the lifespan, with a focus on current knowledge of the possible mediating role of opioids and oxytocin. During the prenatal period, a positive social environment contributes to regulating maternal stress response and protecting the fetus from exposure to maternal active glucocorticoids. Throughout development, positive social contact with the caregiver acts as a “hidden regulator” and promotes infant neuroaffective development. Postnatal social neuroprotection interventions involving caregiver–infant physical contact seem to be crucial for rescuing preterm infants at risk for neurodevelopmental disorders. Attachment figures and friendships in adulthood continue to have a protective role for health and brain functioning, counteracting brain aging. In humans, implementation of meditative practices that promote compassionate motivation and prosocial behavior appears beneficial for health in adolescents and adults. Human and animal studies suggest the oxytocinergic and opioidergic systems are important mediators of the effects of social interactions. However, most of the studies focus on a specific phase of life (i.e., adulthood). Future studies should focus on the role of opioids and oxytocin in positive social interactions adopting a lifespan perspective. PMID:27538784

  20. New treatment of iliac artery disease: focus on the Absolute Pro® Vascular Self-Expanding Stent System

    Directory of Open Access Journals (Sweden)

    Gates L

    2013-09-01

    Full Text Available Lindsay Gates, Jeffrey Indes Vascular and Endovascular Surgery, Yale University School of Medicine, New Haven, CT, USA Abstract: Management of iliac artery disease has evolved over the years, from a surgical-only approach to a primarily endovascular-only approach as the first line treatment option. This has been continuously improved upon with the advent of new devices and applied technologies. Most recently in particular, the literature has shown good, reliable outcomes with the use of self-expandable stents in iliac artery atherosclerotic lesions. Nevertheless, no device is without its limitations, and the Absolute Pro® Vascular Self-Expanding Stent System was designed with the intent of overcoming some of the shortcomings of other available stents while maintaining acceptable postprocedural outcomes. Based on preliminary industry-acquired data, it has achieved these goals and appears to be an emergent competitor for the treatment of both focal and complex iliac artery lesions. Keywords: Absolute-Pro®, iliac stent, self-expanding stents, atherosclerotic disease

  1. Setting the vision: applied patient-reported outcomes and smart, connected digital healthcare systems to improve patient-centered outcomes prediction in critical illness.

    Science.gov (United States)

    Wysham, Nicholas G; Abernethy, Amy P; Cox, Christopher E

    2014-10-01

    Prediction models in critical illness are generally limited to short-term mortality and uncommonly include patient-centered outcomes. Current outcome prediction tools are also insensitive to individual context or evolution in healthcare practice, potentially limiting their value over time. Improved prognostication of patient-centered outcomes in critical illness could enhance decision-making quality in the ICU. Patient-reported outcomes have emerged as precise methodological measures of patient-centered variables and have been successfully employed using diverse platforms and technologies, enhancing the value of research in critical illness survivorship and in direct patient care. The learning health system is an emerging ideal characterized by integration of multiple data sources into a smart and interconnected health information technology infrastructure with the goal of rapidly optimizing patient care. We propose a vision of a smart, interconnected learning health system with integrated electronic patient-reported outcomes to optimize patient-centered care, including critical care outcome prediction. A learning health system infrastructure integrating electronic patient-reported outcomes may aid in the management of critical illness-associated conditions and yield tools to improve prognostication of patient-centered outcomes in critical illness.

  2. Cost-effective solar furnace system using fixed geometry Non-Imaging Focusing Heliostat and secondary parabolic concentrator

    Energy Technology Data Exchange (ETDEWEB)

    Chong, K.K.; Lim, C.Y.; Hiew, C.W. [Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Off Jalan Genting Kelang, Setapak, Kuala Lumpur 53300 (Malaysia)

    2011-05-15

    A novel cost-effective solar furnace system is proposed to be consisted of a Non-Imaging Focusing Heliostat (NIFH) and a much smaller parabolic concentrator. In order to simplify the design and hence leading to the cost reduction, a fixed geometry of the NIFH heliostat is adopted in the novel solar furnace system by omitting the requirement of continuous astigmatic correction throughout the year with the use of local controllers. The performance of this novel solar furnace configuration can be optimized when the heliostat's spinning-axis is orientated in such a way that the annual variations of incident angle and therefore the annual variations of aberrant image size are the least. To verify the new configuration, a prototype solar furnace has been constructed at Universiti Tunku Abdul Rahman. (author)

  3. The Challenges of Recombinant Endostatin in Clinical Application: Focus on the Different Expression Systems and Molecular Bioengineering

    Directory of Open Access Journals (Sweden)

    Abbas Mohajeri

    2017-04-01

    Full Text Available Angiogenesis plays an essential role in rapid growing and metastasis of the tumors. Inhibition of angiogenesis is a putative strategy for cancer therapy. Endostatin (Es is an attractive anti-angiogenesis protein with some clinical application challenges including; short half-life, instability in serum and requirement to high dosage. Therefore, production of recombinant endostatin (rEs is necessary in large scale. The production of rEs is difficult because of its structural properties and is high-cost. Therefore, this review focused on the different expression systems that involved in rEs production including; mammalian, baculovirus, yeast, and Escherichia coli (E. coli expression systems. The evaluating of the results of different expression systems declared that none of the mentioned systems can be considered to be generally superior to the other. Meanwhile with considering the advantages and disadvantage of E. coli expression system compared with other systems beside the molecular properties of Es, E. coli expression system can be a preferred expression system for expressing of the Es in large scale. Also, the molecular bioengineering and sustained release formulations that lead to improving of its stability and bioactivity will be discussed. Point mutation (P125A of Es, addition of RGD moiety or an additional zinc biding site to N-terminal of Es , fusing of Es to anti-HER2 IgG or heavy-chain of IgG, and finally loading of the endostar by PLGA and PEG- PLGA nanoparticles and gold nano-shell particles are the effective bioengineering methods to overcome to clinical changes of endostatin.

  4. Focused Ethnography

    Directory of Open Access Journals (Sweden)

    Hubert Knoblauch

    2005-09-01

    Full Text Available In this paper I focus on a distinctive kind of sociological ethnography which is particularly, though not exclusively, adopted in applied research. It has been proposed that this branch of ethno­graphy be referred to as focused ethnography. Focused ethnography shall be delineated within the context of other common conceptions of what may be called conventional ethnography. However, rather than being opposed to it, focused ethno­graphy is rather complementary to conventional ethnography, particularly in fields that are charac­teristic of socially and functionally differentiated contemporary society. The paper outlines the back­ground as well as the major methodological features of focused ethnography, such as short-term field visits, data intensity and time intensity, so as to provide a background for future studies in this area. URN: urn:nbn:de:0114-fqs0503440

  5. The Return-risk Performance of Selected Pension Fund in OECD with Focus on the Czech Pension System

    Directory of Open Access Journals (Sweden)

    Petr Kupčík

    2016-01-01

    Full Text Available This paper focuses on the measuring and comparing investment performance of pension funds in selected European countries. Comparison of the investment performance of pension funds is determined by means of the Sharpe ratio and the Sortino ratio. We used data of nominal appreciation of pension funds from the Czech Republic, Slovakia, Poland, Sweden, Switzerland and the Netherlands in the period 2005−2013. These countries were selected because they have many common features but Sweden, Switzerland and the Netherlands were added to the analysis because we wanted to show the differences between a developed and less developed fully funded system. The last part of this article presents the main causes of the differences in investment performance of pension funds. Conclusions of the paper are focused on a comparison of the results of the Sharpe ratio and the Sortino ratio of pension funds from selected countries and recommendations for the Czech pension system. The article proposes a mechanism for determining the order of the negative Sharpe ratio and the Sortino ratio.

  6. [Practical usage of a quality management system according to ISO 9001 : 2000 focusing on the double contrast (barium) enema].

    Science.gov (United States)

    Heinzle, G; Hergan, K; Fleisch, M; Hubmann, M; Oser, W

    2001-12-01

    We describe the implementation of quality improvement measures in a quality management system. With questionnaires for radiologists and patients, we investigated the relations between patient preparation and diagnostic quality serving the main purpose, to improve diagnostic quality with the help of more detailed patient information (e.g., changing preparation sheets and handling out "peri-med" information sheets to the patients). Furthermore, a comparative data ascertainment at other institutes was integrated. For the group of outpatients, increasing process quality (patient information) and outcome (diagnostic quality) could be achieved. Taking aspects of quality costs into consideration, a decrease in costs due to failures was achieved. More detailed patient information has positive effects on diagnostic quality of the double contrast (barium) enema.

  7. System-justifying ideologies and academic outcomes among first-year Latino college students.

    Science.gov (United States)

    O'Brien, Laurie T; Mars, Dustin E; Eccleston, Collette

    2011-10-01

    The present study examines the relationship between system-justifying ideologies and academic outcomes among 78 first-year Latino college students (21 men, 57 women, mean age = 18.1 years) attending a moderately selective West Coast university. Endorsement of system-justifying ideologies was negatively associated with grade point average (GPA); however it was positively associated with feelings of belonging at the university. In addition, system-justifying ideologies were negatively associated with perceptions of personal discrimination. In contrast, ethnic identity centrality was unrelated to GPA, feelings of belonging, and perceptions of personal discrimination once the relationship between system-justifying ideologies and these outcomes was statistically taken into account. The results of the present study suggest that endorsement of system-justifying ideologies may be a double-edged sword for Latino college students, involving trade-offs between academic success and feelings of belonging.

  8. Outcomes of cryptococcosis in renal transplant recipients in a less-resourced health care system.

    Science.gov (United States)

    Ponzio, Vinicius; Camargo, Luis F A; Medina-Pestana, José O; Perfect, John R; Colombo, Arnaldo L

    2018-04-20

    Cryptococcosis is the second most common cause of invasive fungal infections in renal transplant recipients in many countries, and data on graft outcome after treatment for this infection is lacking in less-resourced health care settings. Data from 47 renal transplant recipients were retrospectively collected at a single institution during a period of 13 years. Graft dysfunction, graft loss and mortality rates were evaluated. Predictors of mortality and graft loss were estimated. A total of 38 (97.4%) patients treated with amphotericin B deoxycholate (AMBd) showed graft dysfunction after antifungal initiation and 8 (18.2%) had kidney graft loss. Graft loss within 30 days after cryptococcosis onset was significantly associated with disseminated infection, greater baseline creatinine levels and graft dysfunction concomitant to AMBd therapy and an additional nephrotoxic condition. The 30-day mortality rate was 19.2% and it was significantly associated with disseminated and pulmonary infections, somnolence at admission, high CSF opening pressure, positive CSF India ink, creatinine levels greater than 2.0 mg/dL at admission, graft dysfunction in patients treated with AMBd and an additional nephrotoxic condition and graft loss within 30 days. Graft dysfunction was common in renal transplant recipients with cryptococcosis treated with AMBd. The rate of graft loss rate was high, most frequently in patients with concomitant nephrotoxic conditions. Therefore, the clinical focus should be on the use of less nephrotoxic lipid formulations of amphotericin B in this specific population requiring a polyene induction regimen for treatment of severe cryptococcosis in all health care systems caring for transplantation recipients. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  9. Evaluation of Long-Term Cochlear Implant Use in Subjects With Acquired Unilateral Profound Hearing Loss: Focus on Binaural Auditory Outcomes.

    Science.gov (United States)

    Mertens, Griet; De Bodt, Marc; Van de Heyning, Paul

    Cochlear implantation (CI) in subjects with unilateral profound sensorineural hearing loss was investigated. The authors of the present study demonstrated the binaural auditory outcomes in a 12- and 36-month prospective cohort outcome study. The present study aimed to do a long-term (LT) evaluation of the auditory outcomes in an analogous study group. LT evaluation was derived from 12 single-sided deaf (SSD) CI recipients and from 11 CI recipients with asymmetric hearing loss (AHL). A structured interview was conducted with each subjects. Speech perception in noise and sound localization were assessed in a CIOFF and in a CION condition. Four binaural effects were calculated: summation effect (S0N0), squelch effect (S0NCI), combined head shadow effect (SCIN0), and spatial release from masking (SRM). At the LT evaluation, the contribution of a CI or a bone conduction device on speech perception in noise was investigated in two challenging spatial configurations in the SSD group. All (23/23) subjects wore their CI 7 days a week at LT follow-up evaluation, which ranged from 3 to 10 years after implantation. In the SSD group, a significant combined head shadow effect of 3.17 dB and an SRM benefit of 4.33 dB were found. In the AHL group, on the other hand, the summation effect (2.00 dB), the squelch effect (2.67 dB), the combined head shadow effect (3.67 dB), and SRM benefit (2.00 dB) were significant at LT testing. In both the spatial challenging configurations, the speech in noise results was significantly worse in the condition with the bone conduction device compared with the unaided condition. No negative effect was found for the CION condition. A significant benefit in the CION condition was found for sound localization compared with the CIOFF condition in the SSD group and in the AHL group. All subjects wore their CI 7 days a week at LT follow-up evaluation. The presence of binaural effects has been demonstrated with speech in noise testing, sound localization

  10. Donabedian's structure-process-outcome quality of care model: Validation in an integrated trauma system.

    Science.gov (United States)

    Moore, Lynne; Lavoie, André; Bourgeois, Gilles; Lapointe, Jean

    2015-06-01

    According to Donabedian's health care quality model, improvements in the structure of care should lead to improvements in clinical processes that should in turn improve patient outcome. This model has been widely adopted by the trauma community but has not yet been validated in a trauma system. The objective of this study was to assess the performance of an integrated trauma system in terms of structure, process, and outcome and evaluate the correlation between quality domains. Quality of care was evaluated for patients treated in a Canadian provincial trauma system (2005-2010; 57 centers, n = 63,971) using quality indicators (QIs) developed and validated previously. Structural performance was measured by transposing on-site accreditation visit reports onto an evaluation grid according to American College of Surgeons criteria. The composite process QI was calculated as the average sum of proportions of conformity to 15 process QIs derived from literature review and expert opinion. Outcome performance was measured using risk-adjusted rates of mortality, complications, and readmission as well as hospital length of stay (LOS). Correlation was assessed with Pearson's correlation coefficients. Statistically significant correlations were observed between structure and process QIs (r = 0.33), and process and outcome QIs (r = -0.33 for readmission, r = -0.27 for LOS). Significant positive correlations were also observed between outcome QIs (r = 0.37 for mortality-readmission; r = 0.39 for mortality-LOS and readmission-LOS; r = 0.45 for mortality-complications; r = 0.34 for readmission-complications; 0.63 for complications-LOS). Significant correlations between quality domains observed in this study suggest that Donabedian's structure-process-outcome model is a valid model for evaluating trauma care. Trauma centers that perform well in terms of structure also tend to perform well in terms of clinical processes, which in turn has a favorable influence on patient outcomes

  11. Propulsion and Power Generation Capabilities of a Dense Plasma Focus (DPF) Fusion System for Future Military Aerospace Vehicles

    International Nuclear Information System (INIS)

    Knecht, Sean D.; Mead, Franklin B.; Thomas, Robert E.; Miley, George H.; Froning, David

    2006-01-01

    The objective of this study was to perform a parametric evaluation of the performance and interface characteristics of a dense plasma focus (DPF) fusion system in support of a USAF advanced military aerospace vehicle concept study. This vehicle is an aerospace plane that combines clean 'aneutronic' dense plasma focus (DPF) fusion power and propulsion technology, with advanced 'lifting body'-like airframe configurations utilizing air-breathing MHD propulsion and power technology within a reusable single-stage-to-orbit (SSTO) vehicle. The applied approach was to evaluate the fusion system details (geometry, power, T/W, system mass, etc.) of a baseline p-11B DPF propulsion device with Q = 3.0 and thruster efficiency, ηprop = 90% for a range of thrust, Isp and capacitor specific energy values. The baseline details were then kept constant and the values of Q and ηprop were varied to evaluate excess power generation for communication systems, pulsed-train plasmoid weapons, ultrahigh-power lasers, and gravity devices. Thrust values were varied between 100 kN and 1,000 kN with Isp of 1,500 s and 2,000 s, while capacitor specific energy was varied from 1 - 15 kJ/kg. Q was varied from 3.0 to 6.0, resulting in gigawatts of excess power. Thruster efficiency was varied from 0.9 to 1.0, resulting in hundreds of megawatts of excess power. Resulting system masses were on the order of 10's to 100's of metric tons with thrust-to-weight ratios ranging from 2.1 to 44.1, depending on capacitor specific energy. Such a high thrust/high Isp system with a high power generation capability would allow military versatility in sub-orbital space, as early as 2025, and beyond as early as 2050. This paper presents the results that coincide with a total system mass between 15 and 20 metric tons

  12. Randomized trial comparing caregiver-only family-focused treatment to standard health education on the 6-month outcome of bipolar disorder.

    Science.gov (United States)

    Perlick, Deborah A; Jackson, Carlos; Grier, Savannah; Huntington, Brittney; Aronson, Andrew; Luo, Xiaodong; Miklowitz, David J

    2018-03-12

    Caregivers of people with bipolar disorder often have depression and health problems. This study aimed to evaluate the sustained effects of a 12-15 week psychoeducational intervention on the health and mental health of caregivers of persons with bipolar disorder. We also evaluated the effects of the intervention on patients' mood symptoms over 6 months post-treatment. Caregivers of 46 persons with bipolar disorder were randomized to 12-15 weeks of a caregiver-only adaptation of family-focused treatment (FFT), in which caregivers were instructed on self-care strategies and ways to assist the patient in managing the illness, or to 8-12 sessions of standard health education. Independent evaluators assessed caregivers' depression and physical health and patients' mood symptoms before treatment, immediately after the treatment, and at 6 months post-treatment. Randomization to FFT was associated with greater decreases in depression for both caregivers and patients over a 6-month follow-up period post-treatment. Reductions in patients' depression scores over 6 months post-treatment were mediated by reductions in caregivers' depression scores (z = -2.74, P bipolar disorder. Specifically, a treatment focused on caregiver education about bipolar disorder and the need for the caregiver to attend to his/her own health and mental health can benefit patients, even without their direct participation. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. A Paradigm for Student Learning Outcome Assessment in Information Systems Education: Continuous Improvement or Chasing Rainbows?

    Science.gov (United States)

    Saulnier, Bruce

    2014-01-01

    A paradigm is presented for student learning outcome assessment in information systems education. Successful deployment of the paradigm is illustrated using the author's home institution. The paradigm is consistent with both the scholarship of teaching and learning and the scholarship of assessment. It is concluded that the deployment of the…

  14. Systems of educational specialization and labor market outcomes in Norway, Australia and the Netherlands

    NARCIS (Netherlands)

    van de Werfhorst, H.G.

    2004-01-01

    To account for differences between systems of education of highly educated societies, we argue that the impact of academic discipline (field of study) on labor market outcomes should be central. Three modifications of earlier typologies are needed to account for cross-national differences in the

  15. Persistent systemic inflammation is associated with poor clinical outcomes in COPD

    DEFF Research Database (Denmark)

    Agustí, Alvar; Edwards, Lisa D; Rennard, Stephen I

    2012-01-01

    Because chronic obstructive pulmonary disease (COPD) is a heterogeneous condition, the identification of specific clinical phenotypes is key to developing more effective therapies. To explore if the persistence of systemic inflammation is associated with poor clinical outcomes in COPD we assessed...

  16. "AfterZone:" Outcomes for Youth Participating in Providence's Citywide After-School System. Executive Summary

    Science.gov (United States)

    Kauh, Tina J.

    2011-01-01

    This executive summary highlights the main findings from our participation and outcomes analysis of the "AfterZone" initiative--a citywide system-building effort in Providence, Rhode Island, that aims to provide high-quality, accessible out-of-school-time services to middle school youth. The summary briefly defines the AfterZone's unique…

  17. Meningococcal Two-Partner Secretion Systems and Their Association with Outcome in Patients with Meningitis

    Science.gov (United States)

    Piet, Jurgen R.; van Ulsen, Peter; ur Rahman, Sadeeq; Bovenkerk, Sandra; Bentley, Stephen D.

    2016-01-01

    Two-partner secretion (TPS) systems export large TpsA proteins to the surface and extracellular milieu. In meningococci, three different TPS systems exist, and of these, TPS system 2 (TPS2) and TPS3 can be detected by the host's immune system. We evaluated the distribution of TPS systems among clinical isolates from two prospective cohort studies comprising 373 patients with meningococcal meningitis. TPS system 1 was present in 91% of isolates, and system 2 and/or 3 was present in 67%. The TPS system distribution was related to clonal complexes. Infection with strains with TPS2 and/or TPS3 resulted in less severe disease and better outcomes than infection with strains without these systems. Using whole-blood stimulation experiments, we found no differences in the host cytokine response between patients infected with TPS system 2 and 3 knockout strains and patients infected with a wild-type strain. In conclusion, meningococcal TPS system 2 and/or 3 is associated with disease severity and outcome in patients with meningitis. PMID:27324486

  18. Percutaneous Image-Guided Screw Fixation of Bone Lesions in Cancer Patients: Double-Centre Analysis of Outcomes including Local Evolution of the Treated Focus

    Energy Technology Data Exchange (ETDEWEB)

    Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it; Koch, Guillaume, E-mail: guillaume.koch@chru-strasbourg.fr [Hôpitaux Universitaires de Strasbourg, HUS, Department of Interventional Radiology, Nouvel Hôpital Civil (France); Buy, Xavier, E-mail: x.buy@bordeaux.unicancer.fr [Institut Bergonié, Department of Radiology (France); Ramamurthy, Nitin, E-mail: nitin-ramamurthy@hotmail.com [Norfolk and Norwich University Hospital, Department of Radiology (United Kingdom); Tsoumakidou, Georgia, E-mail: georgia.tsoumakidou@chru-strasbourg.fr; Caudrelier, Jean, E-mail: jean.caudrelier@chru-strasbourg.fr [Hôpitaux Universitaires de Strasbourg, HUS, Department of Interventional Radiology, Nouvel Hôpital Civil (France); Catena, Vittorio, E-mail: v.catena@bordeaux.unicancer.fr [Institut Bergonié, Department of Radiology (France); Garnon, Julien, E-mail: juleiengarnon@gmail.com [Hôpitaux Universitaires de Strasbourg, HUS, Department of Interventional Radiology, Nouvel Hôpital Civil (France); Palussiere, Jean, E-mail: j.palussiere@bordeaux.unicancer.fr [Institut Bergonié, Department of Radiology (France); Gangi, Afshin, E-mail: gangi@unistra.fr [Hôpitaux Universitaires de Strasbourg, HUS, Department of Interventional Radiology, Nouvel Hôpital Civil (France)

    2016-10-15

    AimTo review outcomes and local evolution of treated lesions following percutaneous image-guided screw fixation (PIGSF) of pathological/insufficiency fractures (PF/InF) and impeding fractures (ImF) in cancer patients at two tertiary centres.Materials and methodsThirty-two consecutive patients (mean age 67.5 years; range 33–86 years) with a range of tumours and prognoses underwent PIGSF for non/minimally displaced PF/InF and ImF. Screws were placed under CT/fluoroscopy or cone-beam CT guidance, with or without cementoplasty. Clinical outcomes were assessed using a simple 4-point scale (1 = worse; 2 = stable; 3 = improved; 4 = significantly improved). Local evolution was reviewed on most recent follow-up imaging. Technical success, complications, and overall survival were evaluated.ResultsThirty-six lesions were treated with 74 screws mainly in the pelvis and femoral neck (58.2 %); including 47.2 % PF, 13.9 % InF, and 38.9 % ImF. Cementoplasty was performed in 63.9 % of the cases. Technical success was 91.6 %. Hospital stay was ≤3 days; 87.1 % of lesions were improved at 1-month follow-up; three major complications (early screw-impingement radiculopathy; accelerated coxarthrosis; late coxofemoral septic arthritis) and one minor complication were observed. Unfavourable local evolution at imaging occurred in 3/24 lesions (12.5 %) at mean 8.7-month follow-up, including poor consolidation (one case) and screw loosening (two cases, at least 1 symptomatic). There were no cases of secondary fractures.ConclusionsPIGSF is feasible for a wide range of oncologic patients, offering good short-term efficacy, acceptable complication rates, and rapid recovery. Unfavourable local evolution at imaging may be relatively frequent, and requires close clinico-radiological surveillance.

  19. User Impact of Literacy on Treatment Outcomes Quality Regional Financial Information System

    Directory of Open Access Journals (Sweden)

    Iskandar MUDA

    2017-06-01

    Full Text Available This study aims to determine the effectiveness of the Outcomes of the Quality Regional Financial Information System. The research is an explanatory survey exploration that explains the relationship between some variables. The population of this study is formed by 7 District Municipalities in North Sumatra. The sample comprises 197 respondents; the sampling process is a purposive random one. Variables used include User Literacy, Regional Information System, Role Ambiguity, Training and Local Government Finance Report. Treatment Outcomes Quality systems have a significant effect on the accuracy of Local Government Financial Statement Presentation. Role Ambiguity has no significant effect on the accuracy of Local Government Financial Statement Presentation. Training does not significantly influence the accuracy of Government Financial Statements literacy. The findings of this study provide recommendations for improvement of the performance manager in North Sumatra, which thus supporting the implementation of a good government system.

  20. A new pathological scoring system by the Japanese classification to predict renal outcome in diabetic nephropathy.

    Science.gov (United States)

    Hoshino, Junichi; Furuichi, Kengo; Yamanouchi, Masayuki; Mise, Koki; Sekine, Akinari; Kawada, Masahiro; Sumida, Keiichi; Hiramatsu, Rikako; Hasegawa, Eiko; Hayami, Noriko; Suwabe, Tatsuya; Sawa, Naoki; Hara, Shigeko; Fujii, Takeshi; Ohashi, Kenichi; Kitagawa, Kiyoki; Toyama, Tadashi; Shimizu, Miho; Takaichi, Kenmei; Ubara, Yoshifumi; Wada, Takashi

    2018-01-01

    The impact of the newly proposed pathological classification by the Japan Renal Pathology Society (JRPS) on renal outcome is unclear. So we evaluated that impact and created a new pathological scoring to predict outcome using this classification. A multicenter cohort of 493 biopsy-proven Japanese patients with diabetic nephropathy (DN) were analyzed. The association between each pathological factor-Tervaert' and JRPS classifications-and renal outcome (dialysis initiation or 50% eGFR decline) was estimated by adjusted Cox regression. The overall pathological risk score (J-score) was calculated, whereupon its predictive ability for 10-year risk of renal outcome was evaluated. The J-scores of diffuse lesion classes 2 or 3, GBM doubling class 3, presence of mesangiolysis, polar vasculosis, and arteriolar hyalinosis were, respectively, 1, 2, 4, 1, and 2. The scores of IFTA classes 1, 2, and 3 were, respectively, 3, 4, and 4, and those of interstitial inflammation classes 1, 2, and 3 were 5, 5, and 4 (J-score range, 0-19). Renal survival curves, when dividing into four J-score grades (0-5, 6-10, 11-15, and 16-19), were significantly different from each other (prenal outcome. Ability to predict 10-year renal outcome was improved when the J-score was added to the basic model: c-statistics from 0.661 to 0.685; category-free net reclassification improvement, 0.154 (-0.040, 0.349, p = 0.12); and integrated discrimination improvement, 0.015 (0.003, 0.028, p = 0.02). Mesangiolysis, polar vasculosis, and doubling of GBM-features of the JRPS system-were significantly associated with renal outcome. Prediction of DN patients' renal outcome was better with the J-score than without it.

  1. Total hip arthroplasty outcomes assessment using functional and radiographic scores to compare canine systems.

    Science.gov (United States)

    Iwata, D; Broun, H C; Black, A P; Preston, C A; Anderson, G I

    2008-01-01

    A retrospective multi-centre study was carried out in order to compare outcomes between cemented and uncemented total hip arthoplasties (THA). A quantitative orthopaedic outcome assessment scoring system was devised in order to relate functional outcome to a numerical score, to allow comparison between treatments and amongst centres. The system combined a radiographic score and a clinical score. Lower scores reflect better outcomes than higher scores. Consecutive cases of THA were included from two specialist practices between July 2002 and December 2005. The study included 46 THA patients (22 uncemented THA followed for 8.3 +/- 4.7M and 24 cemented THA for 26.0 +/- 15.7M) with a mean age of 4.4 +/- 3.3 years at surgery. Multi-variable linear and logistical regression analyses were performed with adjustments for age at surgery, surgeon, follow-up time, uni- versus bilateral disease, gender and body weight. The differences between treatment groups in terms of functional scores or total scores were not significant (p > 0.05). Radiographic scores were different between treatment groups. However, these scores were usually assessed within two months of surgery and proved unreliable predictors of functional outcome (p > 0.05). The findings reflect relatively short-term follow-up, especially for the uncemented group, and do not include clinician-derived measures, such as goniometry and thigh circumference. Longer-term follow-up for the radiographic assessments is essential. A prospective study including the clinician-derived outcomes needs to be performed in order to validate the outcome instrument in its modified form.

  2. Lens subluxation grading system: predictive value for ectopia lentis surgical outcomes

    OpenAIRE

    Mauro Waiswol; Niro Kasahara

    2009-01-01

    Objective: To present a classification system to grade ectopia lentis and to assess its usefulness as a predictor for surgical outcomes. Methods: Fifty-one eyes of 28 patients with either simple (19 patients) or Marfan syndrome-associated ectopia lentis (nine patients) with variable degrees of subluxation were operated on. Lens subluxation intensity was graded according to the lens subluxation grading system (LSGS) from grade 1 (lens on the whole pupillary area) up to grade 4 (lens absent fro...

  3. a Review of Late Holocene Fluvial Systems in the Karst Maya Lowlands with Focus on the Rio Bravo, Belize

    Science.gov (United States)

    Beach, T.; Luzzadder-Beach, S.; Krause, S.; Doyle, C.

    2015-12-01

    The Maya Lowlands is mostly an internally draining karst region with about 400 m of regional relief. Fluvial and fluviokarst systems drain the edges of this landscape either from low limestone uplands or igneous and metamorphic complexes. Thus far most fluvial research has focused around archaeology projects, and here we review the extant research conducted across the region and new research on the transboundary Rio Bravo watershed of Belize and Guatemala. The Rio Bravo drains a largely old growth tropical forest today, but was partly deforested around ancient Maya cities and farms from 3,000 to 1000 BP. Several studies estimate that 30 to 40 percent of forest survived through the Maya period. Work here has focused on soils and sediment movement along slope catenas, in floodplain sites, and on contributions from groundwater with high dissolved loads of sulfate and calcium. We review radiocarbon dates and present new dates and soil stratigraphy from these sequences to date slope and floodplain movement, and we estimate ancient land use from carbon isotopic and pollen evidence. Aggradation in this watershed occurred by flooding, gypsum precipitation, upland erosion, and ancient Maya canal building and filling for wetland farming. Soil erosion and aggradation started at least by 3,000 BP and continued through the ancient Maya period, though reduced locally by soil conservation, post urban construction, and source reduction, especially in Maya Classic period from 1700 to 1000 BP.

  4. Parents Plus Systemic, Solution-Focused Parent Training Programs: Description, Review of the Evidence Base, and Meta-Analysis.

    Science.gov (United States)

    Carr, Alan; Hartnett, Dan; Brosnan, Eileen; Sharry, John

    2017-09-01

    Parents Plus (PP) programs are systemic, solution-focused, group-based interventions. They are designed for delivery in clinical and community settings as treatment programs for families with child-focused problems, such as behavioral difficulties, disruptive behavior disorders, and emotional disorders in young people with and without developmental disabilities. PP programs have been developed for families of preschoolers, preadolescent children, and teenagers, as well as for separated or divorced families. Seventeen evaluation studies involving over 1,000 families have shown that PP programs have a significant impact on child behavior problems, goal attainment, and parental satisfaction and stress. The effect size of 0.57 (p < .001) from a meta-analysis of 10 controlled studies for child behavior problems compares favorably with those of meta-analyses of other well-established parent training programs with large evidence bases. In controlled studies, PP programs yielded significant (p < .001) effect sizes for goal attainment (d = 1.51), parental satisfaction (d = 0.78), and parental stress reduction (d = 0.54). PP programs may be facilitated by trained front-line mental health and educational professionals. © 2016 Family Process Institute.

  5. Feasibility study of a single-element transcranial focused ultrasound system for blood-brain barrier opening

    Science.gov (United States)

    Marquet, Fabrice; Tung, Yao-Sheng; Teichert, Tobias; Ferrera, Vincent P.; Konofagou, Elisa E.

    2012-10-01

    The blood-brain barrier (BBB) is a specialized vascular system that impedes entry of all large and the vast majority of small molecules including the most potent CNS disease therapeutic agents from entering from the lumen into the brain parenchyma. Microbubble-enhanced, focused ultrasound (ME-FUS) has been previously shown to disrupt noninvasively, selectively, and transiently the BBB in small animals in vivo. The study addresses the focusing properties of single-element transducers at intermediate frequencies (500 kHz) through primate and human skulls, targeting clinically relevant targets extracted from 3D brain atlases such as the hippocampus and the basal ganglia, which are typically affected by early Alzheimer's and Parkinson's disease, respectively. A preliminary in vivo study was performed to study the frequency dependence of BBB opening parameters in mice. Then, feasibility of transcranial ME-FUS BBB opening in non-human primates was demonstrated with subsequent BBB recovery. Sonications were combined with two different types of microbubbles (custom made 4-5 μm and Definity®). 3T MRI was used to confirm the BBB disruption and to assess brain damage.

  6. Implementing a Childhood Cancer Outcomes Surveillance System Within a Population-Based Cancer Registry

    Directory of Open Access Journals (Sweden)

    Oscar Ramirez

    2018-03-01

    Full Text Available Purpose: Approximately 80% of cases of childhood cancer occur in low- and middle-income countries and are associated with high mortality rates. Assessing outcomes is essential for designing effective strategies to improve outcomes equally worldwide. We implemented a real-time surveillance system, VIGICANCER, embedded in a population-based cancer registry (PBCR to assess childhood cancer outcomes. Methods: VIGICANCER was established in 2009 as an integral part of Cali’s PBCR to collect real-time data on outcomes of patients (age < 19 years with a new diagnosis of cancer treated in pediatric oncology units in Cali, Colombia. Baseline and follow-up data (death, relapse, treatment abandonment, second neoplasms were collected from medical records, hospital discharge logs, pathology reports, death certificates, and the National Public Health Insurance database. A quality assurance process was implemented for the system. Results: From 2009 to 2013, data from 1,242 patients were included in VIGICANCER: 32% of patients were younger than 5 years, 55% were male, and 15% were Afro-descendants. International Classification of Childhood Cancer group I diagnoses predominated in all age groups except children younger than 1 year old, in whom CNS tumors predominated. Five-year overall survival for all cancers was 51.7% (95% CI, 47.9% to 55.4% for children (< 15 years, and 39.4% (95% CI, 29.8% to 50.5% for adolescents (15 to 18.9 years. Five-year overall survival for acute lymphoblastic leukemia was 55.6% (95% CI, 48.5% to 62.2%. Conclusion: Our study demonstrates the feasibility of implementing a real-time childhood cancer outcomes surveillance system embedded in a PBCR that can guide interventions to improve clinical outcomes in low- and middle-income countries.

  7. The SAFT-UT (synthetic aperture focusing technique for ultrasonic testing) real-time inspection system: Operational principles and implementation

    Energy Technology Data Exchange (ETDEWEB)

    Hall, T. E.; Reid, L. D.; Doctor, S. R.

    1988-06-01

    This document provides a technical description of the real-time imaging system developed for rapid flaw detection and characterization utilizing the synthetic aperture focusing technique for ultrasonic testing (SAFT-UT). The complete fieldable system has been designed to perform inservice inspection of light-water reactor components. Software was written on a DEC LSI 11/23 computer system to control data collection. The unprocessed data is transferred to a VAX 11/730 host computer to perform data processing and image display tasks. A parallel architecture peripheral to the host computer, referred to as the Real-Time SAFT Processor, rapidly performs the SAFT processing function. From the host's point of view, this device operates on the SAFT data in such a way that one may consider it to be a specialized or SAFT array processor. A guide to SAFT-UT theory and conventions is included, along with a detailed description of the operation of the software, how to install the software, and a detailed hardware description.

  8. Dosimetry in radiotherapy using a-Si EPIDs: Systems, methods, and applications focusing on 3D patient dose estimation

    Science.gov (United States)

    McCurdy, B. M. C.

    2013-06-01

    An overview is provided of the use of amorphous silicon electronic portal imaging devices (EPIDs) for dosimetric purposes in radiation therapy, focusing on 3D patient dose estimation. EPIDs were originally developed to provide on-treatment radiological imaging to assist with patient setup, but there has also been a natural interest in using them as dosimeters since they use the megavoltage therapy beam to form images. The current generation of clinically available EPID technology, amorphous-silicon (a-Si) flat panel imagers, possess many characteristics that make them much better suited to dosimetric applications than earlier EPID technologies. Features such as linearity with dose/dose rate, high spatial resolution, realtime capability, minimal optical glare, and digital operation combine with the convenience of a compact, retractable detector system directly mounted on the linear accelerator to provide a system that is well-suited to dosimetric applications. This review will discuss clinically available a-Si EPID systems, highlighting dosimetric characteristics and remaining limitations. Methods for using EPIDs in dosimetry applications will be discussed. Dosimetric applications using a-Si EPIDs to estimate three-dimensional dose in the patient during treatment will be overviewed. Clinics throughout the world are implementing increasingly complex treatments such as dynamic intensity modulated radiation therapy and volumetric modulated arc therapy, as well as specialized treatment techniques using large doses per fraction and short treatment courses (ie. hypofractionation and stereotactic radiosurgery). These factors drive the continued strong interest in using EPIDs as dosimeters for patient treatment verification.

  9. Diagnostic systems for the nuclear fusion and plasma research in the PF-24 plasma focus laboratory at the IFJ PAN

    Directory of Open Access Journals (Sweden)

    Marciniak Łukasz

    2016-12-01

    Full Text Available This paper presents a set of diagnostics dedicated to PF-24 - new medium size - plasma focus (PF device built and operated at the Institute of Nuclear Physics Polish Academy of Sciences (IFJ PAN. The PF-24 can operate at energy level up to 93 kJ and charging voltage up to 40 kV. Each condenser is connected with a specially designed spark gap with a very small jitter, which ensures a high effi ciency and a low current rise time. The working parameters of PF-24 generator make it a suitable tool for testing new detection systems to be used in fusion research. Four types of such detection systems are presented in this article: three diagnostic systems used to measure electric quantities (Rogowski coil, magnetic probe, capacitance probe, neutron counter based on beryllium activation, fast neutron pinhole camera based on small-area BCF-12 plastic scintillation detectors and high-speed four-frame soft X-ray camera with microchannel plate.

  10. In search of a consumer-focused food classification system. An experimental heuristic approach to differentiate degrees of quality.

    Science.gov (United States)

    Torres-Ruiz, Francisco J; Marano-Marcolini, Carla; Lopez-Zafra, Esther

    2018-06-01

    The present paper focuses on the problems that arise in food classification systems (FCSs), especially when the food product type has different levels or grades of quality. Despite the principal function of these systems being to assist the consumer (to inform, clarify and facilitate choice and purchase), they frequently have the opposite effect. Thus, the main aim of the present research involves providing orientations for the design of effective food classification systems. To address this objective, considering the context of food product consumption (related to heuristic processing), we conducted an experimental study with 720 participants. We analysed the usefulness of heuristic elements by a factorial 2 (category length: short and long) × 3 (visual signs: colours, numbers and images) design in relation to recall and recognition activities. The results showed that the elements used to make the classification more effective for consumers vary depending on whether the user seeks to prioritize the recall or the recognition of product categories. Thus, long categories with images significantly improve recognition, and short categories with colours improve recall. A series of recommendations are provided that can help to enhance FCSs and to make them more intuitive and easier to understand for consumers. Implications with regard to theory and practice are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

  11. A Study On the Effectiveness of Emotionally Focused Couple Therapy and Integrated Systemic Couple Therapy on reducing Intimacy Anxiety

    Directory of Open Access Journals (Sweden)

    هاجر فلاح زاده

    2015-04-01

    Full Text Available This study examined the effectiveness of emotionally focused couple therapy (EFT and integrated systemic couple therapy (IST on resolving intimacy anxiety. For this purpose, 30 couples were randomly selected and based on their pretests were assigned into two experimental and one control groups. Research instruments were Fear of Intimacy Scale (FIS (Descutner & Thelen, and the Dyadic Adjustment Scale (DAS (Spanier, 1976. A Nine-session of EFT was conducted for one experiment group and eight sessions of IST for the other. The control group did not receive any treatment. These three groups completed post test at the end of the experiment, and follow-up test 3 months later. Results indicated that EFT and IST significantly decreased intimacy anxiety in couples, and the treatment effect was consistent after 3 months follow-up.

  12. Alternate financial incentives in multi-tiered formulary systems to improve accountability for outcomes.

    Science.gov (United States)

    Chung, Richard S; Taira, Deborah A; Noh, Charles

    2003-01-01

    Drug manufacturer rebates paid to health plans and pharmacy benefit management companies have come under increased public scrutiny. Over the past several years, numerous articles have appeared in the literature encouraging a shift to a more quality-based decision-making process for health plan drug formularies. To propose a new basis for formulary placement decisions that would include consideration of health-plan-specific measures (clinical outcomes, total cost, adherence, and appropriateness of care) and align incentives for health plans, physicians, pharmacists, and pharmaceutical companies to promote high-quality care. The proposed approach builds on key components of the Pharmacy's Framework for Drug Therapy Management in the 21st Century and the Academy of Managed Care Pharmacy's Format for Formulary Submission, including a focus on patient outcomes and evidence-based decision making. The proposed approach would lessen the influence of drug manufacturer rebates on formulary placement by shifting the focus to appropriateness of care, clinical outcomes, patient adherence, and total cost of care. Pharmaceutical manufacturers would benefit from the focus on adherence to drug therapy and total cost of care. Health plans and pharmacy benefit management companies would gain in that they may be able to reduce efforts in drug utilization review as pharmaceutical manufacturers are given incentives to market their drugs more appropriately. Physicians and pharmacists would benefit because the rebate money would be used to provide quality-based financial incentives related to adherence and appropriate use of drugs. The implementation of this approach would be difficult and require cooperation from employers, pharmacists, pharmaceutical manufacturers, health plans, and pharmacy benefit management companies. Aspects of this approach could be incorporated into existing pharmacy benefit management processes to encourage the delivery of high-quality health care.

  13. Lung and colorectal cancer treatment and outcomes in the Veterans Affairs health care system

    International Nuclear Information System (INIS)

    Zullig, Leah L; Williams, Christina D; Fortune-Britt, Alice G

    2015-01-01

    Lung cancer (LC) and colorectal cancer (CRC) are the second- and third-most commonly diagnosed cancers in the Veterans Affairs (VA) health care system. While many studies have evaluated the treatment quality and outcomes of various aspects of VA LC and CRC care, there are no known reviews synthesizing this information across studies. The purpose of this literature review was to describe LC and CRC treatment (ie, surgical and nonsurgical) and outcomes (eg, mortality, psychosocial, and other) in the VA health care system as reported in the existing peer-reviewed scientific literature. We identified potential articles through a search of published literature using the PubMed electronic database. Our search strategy identified articles containing Medical Subject Headings terms and keywords addressing veterans or veterans’ health and LC and/or CRC. We limited articles to those published in the previous 11 years (January 1, 2003 through December 31, 2013). A total of 230 articles were retrieved through the search. After applying the selection criteria, we included 74 studies (34 LC, 47 CRC, and seven both LC and CRC). VA provides a full array of treatments, often with better outcomes than other health care systems. More work is needed to assess patient-reported outcomes

  14. Social Work Assessment Notes: A Comprehensive Outcomes-Based Hospice Documentation System.

    Science.gov (United States)

    Hansen, Angela Gregory; Martin, Ellen; Jones, Barbara L; Pomeroy, Elizabeth C

    2015-08-01

    This article describes the development of an integrated psychosocial patient and caregiver assessment and plan of care for hospice social work documentation. A team of hospice social workers developed the Social Work Assessment Notes as a quality improvement project in collaboration with the information technology department. Using the Social Work Assessment Tool as an organizing framework, this comprehensive hospice social work documentation system is designed to integrate assessment, planning, and outcomes measurement. The system was developed to guide the assessment of patients' and caregivers' needs related to end-of-life psychosocial issues, to facilitate collaborative care plan development, and to measure patient- and family-centered outcomes. Goals established with the patient and the caregiver are documented in the plan of care and become the foundation for patient-centered, strengths-based interventions. Likert scales are used to assign numerical severity levels for identified issues and progress made toward goals and to track the outcome of social work interventions across nine psychosocial constructs. The documentation system was developed for use in an electronic health record but can be used for paper charting. Future plans include automated aggregate outcomes measurement to identify the most effective interventions and best practices in end-of-life care.

  15. Mild-moderate congenital hearing loss: secular trends in outcomes across four systems of detection.

    Science.gov (United States)

    Carew, P; Mensah, F K; Rance, G; Flynn, T; Poulakis, Z; Wake, M

    2018-01-01

    Universal newborn hearing screening (UNHS) targets moderate or greater hearing loss. However, UNHS also frequently detects children with mild loss that results in many receiving early treatment. The benefits of this approach are not yet established. We aimed to (i) compare language and psychosocial outcomes between four hearing loss detection systems for children aged 5-8 years with congenital mild-moderate hearing loss; (ii) determine whether age of detection predicts outcomes; and (iii) compare outcomes between children identified via well-established UNHS and the general population. Linear regression adjusted for potential confounding factors was used throughout. Via a quasi-experimental design, language and psychosocial outcomes were compared across four population-based Australian systems of hearing loss detection: opportunistic detection, born 1991-1993, n = 50; universal risk factor referral, born 2003-2005, n = 34; newly established UNHS, born 2003-2005, n = 41; and well-established UNHS, born 2007-2010, n = 21. In pooled analyses, we examined whether age of detection predicted outcomes. Outcomes were similarly compared between the current well-established UNHS system and typically developing children in the Early Language in Victoria Study, born 2003, n = 1217. Age at diagnosis and hearing aid fitting fell steadily across the four systems. For moderate losses, mean expressive language (P for trend .05) and receptive vocabulary (P for trend .06) improved across the four systems, but benefit was not obvious for mild losses. In pooled analyses, diagnosis before age six months predicted better language outcomes for moderate losses. Children with mild-moderate losses exposed to well-established UNHS continue to experience expressive language scores well below children in the general population (adjusted mean difference -8.9 points, 95% CI -14.7 to -3.1). Treatment arising from UNHS appears to be clearly benefitting children with moderate hearing

  16. Clinical outcomes and cost-effectiveness of brief guided parent-delivered cognitive behavioural therapy and solution-focused brief therapy for treatment of childhood anxiety disorders: a randomised controlled trial.

    Science.gov (United States)

    Creswell, Cathy; Violato, Mara; Fairbanks, Hannah; White, Elizabeth; Parkinson, Monika; Abitabile, Gemma; Leidi, Alessandro; Cooper, Peter J

    2017-07-01

    Half of all lifetime anxiety disorders emerge before age 12 years; however, access to evidence-based psychological therapies for affected children is poor. We aimed to compare the clinical outcomes and cost-effectiveness of two brief psychological treatments for children with anxiety referred to routine child mental health settings. We hypothesised that brief guided parent-delivered cognitive behavioural therapy (CBT) would be associated with better clinical outcomes than solution-focused brief therapy and would be cost-effective. We did this randomised controlled trial at four National Health Service primary child and mental health services in Oxfordshire, UK. Children aged 5-12 years referred for anxiety difficulties were randomly allocated (1:1), via a secure online minimisation tool, to receive brief guided parent-delivered CBT or solution-focused brief therapy, with minimisation for age, sex, anxiety severity, and level of parental anxiety. The allocation sequence was not accessible to the researcher enrolling participants or to study assessors. Research staff who obtained outcome measurements were masked to group allocation and clinical staff who delivered the intervention did not measure outcomes. The primary outcome was recovery, on the basis of Clinical Global Impressions of Improvement (CGI-I). Parents recorded patient-level resource use. Quality-adjusted life-years (QALYs) for use in cost-utility analysis were derived from the Child Health Utility 9D. Assessments were done at baseline (before randomisation), after treatment (primary endpoint), and 6 months after treatment completion. We did analysis by intention to treat. This trial is registered with the ISCRTN registry, number ISRCTN07627865. Between March 23, 2012, and March 31, 2014, we randomly assigned 136 patients to receive brief guided parent-delivered CBT (n=68) or solution-focused brief therapy (n=68). At the primary endpoint assessment (June, 2012, to September, 2014), 40 (59%) children in

  17. Without 'Focus'

    Directory of Open Access Journals (Sweden)

    Aldo Sevi

    2010-12-01

    Full Text Available It is widely accepted that a notion of 'focus', more or less as conceived of in Jackendoff (1972, must be incorporated into our theory of grammar, as a means of accounting for certain observed correlations between prosodic facts and semantic/pragmatic facts. In this paper, we put forth the somewhat radical idea that the time has come to give up this customary view, and eliminate 'focus' from our theory of grammar. We argue that such a move is both economical and fruitful.Research over the years has revealed that the correlations between prosody, 'focus', and the alleged semantic/pragmatic effects of focus are much less clear and systematic than we may have initially hoped. First we argue that this state of affairs detracts significantly from the utility of our notion of 'focus', to the point of calling into question the very motivation for including it in the grammar. Then we look at some of the central data, and show how they might be analyzed without recourse to a notion of 'focus'. We concentrate on (i the effect of pitch accent placement on discourse congruence, and (ii the choice of 'associate' for the so-called 'focus sensitive' adverb only. We argue that our focus-free approach to the data improves empirical coverage, and begins to reveal patterns that have previously been obscured by preconceptions about 'focus'.ReferencesBeaver, D. & Clark, B. 2008. Sense and Sensitivity: How Focus Determines Meaning. Blackwell.Beaver, D., Clark, B., Flemming, E., Jaeger, T. F. & Wolters, M. 2007. ‘When semantics meets phonetics: Acoustical studies of second occurrence focus’. Language 83.2: 245–76.http://dx.doi.org/10.1353/lan.2007.0053Beckman, M. & Hirschberg, J. 1994. ‘The ToBI Annotation Conventions’. Ms.,http://www.cs.columbia.edu/~julia/files/conv.pdf.Bolinger, D. 1972. ‘Accent is predictable (if you are a mind-reader’. Language 48.3: 633–44.http://dx.doi.org/10.2307/412039Büring, D. 2006. ‘Focus projection and default

  18. Maternal, Fetal and Neonatal Outcomes in Pregnant Women with Systemic Lupus Erythematosus: A Comprehensive Review Study

    Directory of Open Access Journals (Sweden)

    Fatemeh Zahra Karimi

    2017-11-01

    Full Text Available Background:Systemic lupus erythematosus (SLE is an autoimmune disease with multiple organ involvement and periods of relapse and remission that mainly affects young women of childbearing age. In this regard the reproductive health is an important issue. Although diagnosis, treatment and management of pregnancy in SLE women have been improved recently, but the main concern is effects of SLE on maternal, fetal and neonatal outcomes. This study aimed to investigate the maternal, fetal and neonatal outcomes in pregnant women with SLE. Materials and Methods: The databases of PubMed, Medline, Scopus and Web of Science as well as domestic database (Persian such as SID, Magiran, Irandoc, and Google Scholar were searched with using keywords such as" Systemic lupus erythematosus"; "Pregnancy"; "Neonatal lupus"; "maternal, fetus or neonatal outcome";  and equivalent Persian words. Included were all Persian and English articles, published between 2000 and May 2017. Finally, a total of 77 studies were included. Results: Adverse perinatal outcomes increase in pregnancies with lupus. Outcomes include respiratory, cardiovascular, blood and skin disorders in mothers; stillbirth, spontaneous, and recurrent abortion in fetuses and neonatal lupus, prematurity, intrauterine growth restriction (IUGR, and small for gestational age (SGA in neonates, respectively. Conclusion: Pregnant women with SLE are at high risk due to increased complications for both mother and fetus. It seems broad control of the women before fertilization, so that they be at full remission in the beginning of pregnancy and the disease activity be in complete control, it can help to improve outcomes of pregnancy and so better results can be expected.

  19. Developing Energy Technology Course for Undergraduate Engineering Management Study Program in Lake Toba Area with Particular Focus to Sustainable Energy Systems in Development Context

    Science.gov (United States)

    Manik, Yosef; Sinaga, Rizal; Saragi, Hadi

    2018-02-01

    Undergraduate Engineering Management Study Program of Institut Teknologi Del is one of the pioneers for its field in Indonesia. Located in Lake Toba Area, this study program has a mission to provide high quality Engineering Management education that produces globally competitive graduates who in turn will contribute to local development. Framing the Energy Technology course—one of the core subjects in Engineering Management Body of Knowledge—in the context of sustainable development of Lake Toba Area is very essential. Thus, one particular focus in this course is sustainable energy systems in local development context that incorporates identification and analysis of locally available energy resources. In this paper we present our experience in designing such course. In this work, we introduce the domains that shape the Engineering Management Body of Knowledge. Then, we explain the results of our evaluation on the key considerations to meet the rapidly changing needs of society in local context. Later, we present the framework of the learning outcomes and the syllabus as a result of mapping the road map with the requirement. At the end, the summary from the first two semesters of delivering this course in academic year 2015/2016 and 2016/2017 are reported.

  20. Dynamic analysis of the urban-based low-carbon policy using system dynamics: Focused on housing and green space

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Taehoon, E-mail: hong7@yonsei.ac.kr [Associate Professor, Department of Architectural Engineering, Yonsei University, Seoul, 120-749 (Korea, Republic of); Kim, Jimin, E-mail: cookie6249@yonsei.ac.kr; Jeong, Kwangbok, E-mail: kbjeong7@yonsei.ac.kr [Research Assistant and Ph.D. Student, Department of Architectural Engineering, Yonsei University, Seoul, 120-749 (Korea, Republic of); Koo, Choongwan, E-mail: cwkoo@yonsei.ac.kr [Postdoctoral Fellow, Department of Architectural Engineering, Yonsei University, Seoul, 120-749 (Korea, Republic of)

    2015-02-09

    To systematically manage the energy consumption of existing buildings, the government has to enforce greenhouse gas reduction policies. However, most of the policies are not properly executed because they do not consider various factors from the urban level perspective. Therefore, this study aimed to conduct a dynamic analysis of an urban-based low-carbon policy using system dynamics, with a specific focus on housing and green space. This study was conducted in the following steps: (i) establishing the variables of urban-based greenhouse gases (GHGs) emissions; (ii) creating a stock/flow diagram of urban-based GHGs emissions; (iii) conducting an information analysis using the system dynamics; and (iv) proposing the urban-based low-carbon policy. If a combined energy policy that uses the housing sector (30%) and the green space sector (30%) at the same time is implemented, 2020 CO{sub 2} emissions will be 7.23 million tons (i.e., 30.48% below 2020 business-as-usual), achieving the national carbon emissions reduction target (26.9%). The results of this study could contribute to managing and improving the fundamentals of the urban-based low-carbon policies to reduce greenhouse gas emissions.

  1. First clinical experience with a dedicated MRI-guided high-intensity focused ultrasound system for breast cancer ablation

    Energy Technology Data Exchange (ETDEWEB)

    Merckel, Laura G.; Knuttel, Floor M.; Peters, Nicky H.G.M.; Mali, Willem P.T.M.; Bosch, Maurice A.A.J. van den [University Medical Center Utrecht, Department of Radiology, HP E 01.132, Utrecht (Netherlands); Deckers, Roel; Moonen, Chrit T.W.; Bartels, Lambertus W. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Dalen, Thijs van [Diakonessenhuis Utrecht, Department of Surgery, Utrecht (Netherlands); Schubert, Gerald [Philips Healthcare, Best (Netherlands); Weits, Teun [Diakonessenhuis Utrecht, Department of Radiology, Utrecht (Netherlands); Diest, Paul J. van [University Medical Center Utrecht, Department of Pathology, Utrecht (Netherlands); Vaessen, Paul H.H.B. [University Medical Center Utrecht, Department of Anesthesiology, Utrecht (Netherlands); Gorp, Joost M.H.H. van [Diakonessenhuis Utrecht, Department of Pathology, Utrecht (Netherlands)

    2016-11-15

    To assess the safety and feasibility of MRI-guided high-intensity focused ultrasound (MR-HIFU) ablation in breast cancer patients using a dedicated breast platform. Patients with early-stage invasive breast cancer underwent partial tumour ablation prior to surgical resection. MR-HIFU ablation was performed using proton resonance frequency shift MR thermometry and an MR-HIFU system specifically designed for breast tumour ablation. The presence and extent of tumour necrosis was assessed by histopathological analysis of the surgical specimen. Pearson correlation coefficients were calculated to assess the relationship between sonication parameters, temperature increase and size of tumour necrosis at histopathology. Ten female patients underwent MR-HIFU treatment. No skin redness or burns were observed in any of the patients. No correlation was found between the applied energy and the temperature increase. In six patients, tumour necrosis was observed with a maximum diameter of 3-11 mm. In these patients, the number of targeted locations was equal to the number of areas with tumour necrosis. A good correlation was found between the applied energy and the size of tumour necrosis at histopathology (Pearson = 0.76, p = 0.002). Our results show that MR-HIFU ablation with the dedicated breast system is safe and results in histopathologically proven tumour necrosis. (orig.)

  2. Dynamic analysis of the urban-based low-carbon policy using system dynamics: Focused on housing and green space

    International Nuclear Information System (INIS)

    Hong, Taehoon; Kim, Jimin; Jeong, Kwangbok; Koo, Choongwan

    2015-01-01

    To systematically manage the energy consumption of existing buildings, the government has to enforce greenhouse gas reduction policies. However, most of the policies are not properly executed because they do not consider various factors from the urban level perspective. Therefore, this study aimed to conduct a dynamic analysis of an urban-based low-carbon policy using system dynamics, with a specific focus on housing and green space. This study was conducted in the following steps: (i) establishing the variables of urban-based greenhouse gases (GHGs) emissions; (ii) creating a stock/flow diagram of urban-based GHGs emissions; (iii) conducting an information analysis using the system dynamics; and (iv) proposing the urban-based low-carbon policy. If a combined energy policy that uses the housing sector (30%) and the green space sector (30%) at the same time is implemented, 2020 CO 2 emissions will be 7.23 million tons (i.e., 30.48% below 2020 business-as-usual), achieving the national carbon emissions reduction target (26.9%). The results of this study could contribute to managing and improving the fundamentals of the urban-based low-carbon policies to reduce greenhouse gas emissions

  3. Final focus test beam

    International Nuclear Information System (INIS)

    1991-03-01

    This report discusses the following: the Final Focus Test Beam Project; optical design; magnets; instrumentation; magnetic measurement and BPM calibration; mechanical alignment and stabilization; vacuum system; power supplies; control system; radiation shielding and personnel protection; infrastructure; and administration

  4. Novel receptor targets for production and action of allopregnanolone in the central nervous system: a focus on pregnane xenobiotic receptor

    Directory of Open Access Journals (Sweden)

    Cheryl A Frye

    2014-04-01

    Full Text Available Neurosteroids are cholesterol-based hormones that can be produced in the brain, independent of secretion from peripheral endocrine glands, such as the gonads and adrenals. A focus in our laboratory for over 25 years has been how production of the pregnane neurosteroid, allopregnanolone, is regulated and the novel (i.e. non steroid receptor targets for steroid action for behavior. One endpoint of interest has been lordosis, the mating posture of female rodents. Allopregnanolone is necessary and sufficient for lordosis, and the brain circuitry underlying it, such as actions in the midbrain ventral tegmental area (VTA, has been well-characterized. Published and recent findings supporting a dynamic role of allopregnanolone are included in this review. First, contributions of ovarian and adrenal sources of precursors of allopregnanolone, and the requisite enzymatic actions for de novo production in the central nervous system will be discussed. Second, how allopregnanolone produced in the brain has actions on behavioral processes that are independent of binding to steroid receptors, but instead involve rapid modulatory actions via neurotransmitter targets (e.g. -amino butyric acid-GABA, n-methyl-D-aspartate- NMDA will be reviewed. Third, a recent focus on characterizing the role of a promiscuous nuclear receptor, pregnane xenobiotic receptor (PXR, involved in cholesterol metabolism and expressed in the VTA, as a target for allopregnanolone and how this relates to both actions and production of allopregnanolone will be addressed. For example, allopregnanolone can bind PXR and knocking down expression of PXR in the midbrain VTA attenuates actions of allopregnanolone via NMDA and/or GABAA for lordosis. Our understanding of allopregnanolone’s actions in the VTA for lordosis has been extended to reveal the role of allopregnanolone for broader, clinically-relevant questions, such as neuropsychiatric disorders, epilepsy, and aging.

  5. Pulmonary function tests as outcomes for systemic sclerosis interstitial lung disease.

    Science.gov (United States)

    Caron, Melissa; Hoa, Sabrina; Hudson, Marie; Schwartzman, Kevin; Steele, Russell

    2018-06-30

    Interstitial lung disease (ILD) is the leading cause of morbidity and mortality in systemic sclerosis (SSc). We performed a systematic review to characterise the use and validation of pulmonary function tests (PFTs) as surrogate markers for systemic sclerosis-associated interstitial lung disease (SSc-ILD) progression.Five electronic databases were searched to identify all relevant studies. Included studies either used at least one PFT measure as a longitudinal outcome for SSc-ILD progression ( i.e. outcome studies) and/or reported at least one classical measure of validity for the PFTs in SSc-ILD ( i.e. validation studies).This systematic review included 169 outcome studies and 50 validation studies. Diffusing capacity of the lung for carbon monoxide ( D LCO ) was cumulatively the most commonly used outcome until 2010 when it was surpassed by forced vital capacity (FVC). FVC (% predicted) was the primary endpoint in 70.4% of studies, compared to 11.3% for % predicted D LCO Only five studies specifically aimed to validate the PFTs: two concluded that D LCO was the best measure of SSc-ILD extent, while the others did not favour any PFT. These studies also showed respectable validity measures for total lung capacity (TLC).Despite the current preference for FVC, available evidence suggests that D LCO and TLC should not yet be discounted as potential surrogate markers for SSc-ILD progression. Copyright ©ERS 2018.

  6. Technological Innovation in the downstream gas market: Studying the economics of LNG distribution systems with a focus on Norway

    International Nuclear Information System (INIS)

    Madlener, Reinhard; Jarlsby, Erik

    2005-01-01

    Prospects for the market diffusion of natural gas, apart from other factors, depend strongly on the limitations set by the supply infrastructure. One of these limitations is determined by the economic viability of extending the distribution infrastructure, which can vary widely depending on the technology chosen and the prevailing local circumstances. While large-scale pipeline-based systems benefit from economies of scale, they require huge initial capital investments and may in certain cases not be economical at all, or only after excessively long payback periods, especially when end-use energy densities are low, growth in demand slow, and the topography difficult. This paper focuses on the economics of adoption and diffusion of innovative small- and medium-scale liquefied natural gas (LNG) distribution systems, as compared to large pipeline-based distribution systems, with a particular focus on the situation in Norway. We address issues such as scale economies, learning effects, technological lock-in, niche market formation, and flexibility. Besides, we look at both the complementarity and competition among grid-based and LNG-based gas distribution systems. Finally, we briefly touch upon tax issues and political considerations. In Norway, the debate on natural gas extension has become controversial and politicized in recent years. On the one hand, certain stakeholders lobby for heavy, state-sponsored investment into one or more pipelines, which would bring large quantities of natural gas to industrial centers, at least some of which have struggled to maintain their market position in the past. On the other hand, there are stakeholders that have argued for the promotion of modular and more flexible small-scale LNG technology systems that could enhance competition in the gas market, and provide end-users with natural gas that would otherwise not be connected to the grid. Under present regulatory and market conditions in Norway, LNG supply to end users is

  7. A register based epidemiological description of risk factors and outcomes for major psychiatric disorders, focusing on a comparison between bipolar affective disorder and schizophrenia

    DEFF Research Database (Denmark)

    Laursen, Thomas Munk

    2006-01-01

    of schizophrenia and bipolar affective disorder. The studies were based on four Danish registers: the Psychiatric Central Register, the Danish Civil Registration System, the Cause of Death Register, and the Danish Medical Birth Register. From the registers, large population based cohorts were identified...... and followed over several decades. Survival analysis techniques were applied to identify risk factors and mortality rates. The results demonstrated an overlap in risk factors for schizophrenia and bipolar affective disorder. Excess mortality (compared to persons never admitted with a psychiatric disorder......), and environmental factors act (or interact) with this predisposition. However, large differences in gender distribution and age at onset are present, and differences and similarities between the disorders should be further examined before the Kraepelinian dichotomization can be disregarded....

  8. Material focus

    DEFF Research Database (Denmark)

    Sokoler, Tomas; Vallgårda, Anna K. A.

    2009-01-01

    In this paper we build on the notion of computational composites, which hold a material perspective on computational technology. We argue that a focus on the material aspects of the technology could be a fruitful approach to achieve new expressions and to gain a new view on the technology's role...... in design. We study two of the computer's material properties: computed causality and connectability and through developing two computational composites that utilize these properties we begin to explore their potential expressions....

  9. Artificial Neural Network System to Predict the Postoperative Outcome of Percutaneous Nephrolithotomy.

    Science.gov (United States)

    Aminsharifi, Alireza; Irani, Dariush; Pooyesh, Shima; Parvin, Hamid; Dehghani, Sakineh; Yousofi, Khalilolah; Fazel, Ebrahim; Zibaie, Fatemeh

    2017-05-01

    To construct, train, and apply an artificial neural network (ANN) system for prediction of different outcome variables of percutaneous nephrolithotomy (PCNL). We calculated predictive accuracy, sensitivity, and precision for each outcome variable. During the study period, all adult patients who underwent PCNL at our institute were enrolled in the study. Preoperative and postoperative variables were recorded, and stone-free status was assessed perioperatively with computed tomography scans. MATLAB software was used to design and train the network in a feed forward back-propagation error adjustment scheme. Preoperative and postoperative data from 200 patients (training set) were used to analyze the effect and relative relevance of preoperative values on postoperative parameters. The validated adequately trained ANN was used to predict postoperative outcomes in the subsequent 254 adult patients (test set) whose preoperative values were serially fed into the system. To evaluate system accuracy in predicting each postoperative variable, predicted values were compared with actual outcomes. Two hundred fifty-four patients (155 [61%] males) were considered the test set. Mean stone burden was 6702.86 ± 381.6 mm 3 . Overall stone-free rate was 76.4%. Fifty-four out of 254 patients (21.3%) required ancillary procedures (shockwave lithotripsy 5.9%, transureteral lithotripsy 10.6%, and repeat PCNL 4.7%). The accuracy and sensitivity of the system in predicting different postoperative variables ranged from 81.0% to 98.2%. As a complex nonlinear mathematical model, our ANN system is an interconnected data mining tool, which prospectively analyzes and "learns" the relationships between variables. The accuracy and sensitivity of the system for predicting the stone-free rate, the need for blood transfusion, and post-PCNL ancillary procedures ranged from 81.0% to 98.2%.The stone burden and the stone morphometry were among the most significant preoperative characteristics that

  10. Predicting IVF Outcome: A Proposed Web-based System Using Artificial Intelligence.

    Science.gov (United States)

    Siristatidis, Charalampos; Vogiatzi, Paraskevi; Pouliakis, Abraham; Trivella, Marialenna; Papantoniou, Nikolaos; Bettocchi, Stefano

    2016-01-01

    To propose a functional in vitro fertilization (IVF) prediction model to assist clinicians in tailoring personalized treatment of subfertile couples and improve assisted reproduction outcome. Construction and evaluation of an enhanced web-based system with a novel Artificial Neural Network (ANN) architecture and conformed input and output parameters according to the clinical and bibliographical standards, driven by a complete data set and "trained" by a network expert in an IVF setting. The system is capable to act as a routine information technology platform for the IVF unit and is capable of recalling and evaluating a vast amount of information in a rapid and automated manner to provide an objective indication on the outcome of an artificial reproductive cycle. ANNs are an exceptional candidate in providing the fertility specialist with numerical estimates to promote personalization of healthcare and adaptation of the course of treatment according to the indications. Copyright © 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  11. Peritumoral Artery Scoring System: a Novel Scoring System to Predict Renal Function Outcome after Laparoscopic Partial Nephrectomy.

    Science.gov (United States)

    Zhang, Ruiyun; Wu, Guangyu; Huang, Jiwei; Shi, Oumin; Kong, Wen; Chen, Yonghui; Xu, Jianrong; Xue, Wei; Zhang, Jin; Huang, Yiran

    2017-06-06

    The present study aimed to assess the impact of peritumoral artery characteristics on renal function outcome prediction using a novel Peritumoral Artery Scoring System based on computed tomography arteriography. Peritumoral artery characteristics and renal function were evaluated in 220 patients who underwent laparoscopic partial nephrectomy and then validate in 51 patients with split and total glomerular filtration rate (GFR). In particular, peritumoral artery classification and diameter were measured to assign arteries into low, moderate, and high Peritumoral Artery Scoring System risk categories. Univariable and multivariable logistic regression analyses were then used to determine risk factors for major renal functional decline. The Peritumoral Artery Scoring System and four other nephrometry systems were compared using receiver operating characteristic curve analysis. The Peritumoral Artery Scoring System was significantly superior to the other systems for predicting postoperative renal function decline (p system was a superior independent predictor of estimated glomerular filtration rate (eGFR) decline (area-under-the-curve = 0.865, p renal function outcome after laparoscopic partial nephrectomy.

  12. The role of employee HR attributions in the relationship between high-performance work systems and employee outcomes

    NARCIS (Netherlands)

    van de Voorde, F.C.; Beijer, Susanne

    2015-01-01

    Although research has shown that the use of high-performance work systems (HPWS) is associated with employee outcomes, our knowledge of the meanings employees attach to HPWS systems and how these shape employee outcomes is still limited. This study examines the signalling impact of enacted HPWS on

  13. Continuous Improvement and Employee Engagement, Part 2: Design, Implementation, and Outcomes of a Daily Management System.

    Science.gov (United States)

    Maurer, Marsha; Browall, Pamela; Phelan, Cynthia; Sanchez, Sandra; Sulmonte, Kimberlyann; Wandel, Jane; Wang, Allison

    2018-04-01

    A daily management system (DMS) can be used to implement continuous quality improvement and advance employee engagement. It can empower staff to identify problems in the care environment that impact quality or work flow and to address them on a daily basis. Through a DMS, improvement becomes the work of everyone, every day. The authors of this 2-part series describe their work to develop a DMS. Part 2 describes the implementation and outcomes of the program.

  14. A balance of activity in brain control and reward systems predicts self-regulatory outcomes

    OpenAIRE

    Lopez, Richard B.; Chen, Pin-Hao A.; Huckins, Jeremy F.; Hofmann, Wilhelm; Kelley, William M.; Heatherton, Todd F.

    2017-01-01

    Abstract Previous neuroimaging work has shown that increased reward-related activity following exposure to food cues is predictive of self-control failure. The balance model suggests that self-regulation failures result from an imbalance in reward and executive control mechanisms. However, an open question is whether the relative balance of activity in brain systems associated with executive control (vs reward) supports self-regulatory outcomes when people encounter tempting cues in daily lif...

  15. A commercial outcome prediction system for university technology transfer using neural networks

    OpenAIRE

    Chu, Ling

    2007-01-01

    This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University, 26/03/2007. This thesis presents a commercial outcome prediction system (CPS) capable of predicting the likely future monetary return that would be generated by an invention. The CPS is designed to be used by university technology transfer offices for invention assessment purposes, and is based on the data from their historical invention cases. It is aimed at improving technology transfer off...

  16. Domains of health-related quality of life important and relevant to multiethnic English-speaking Asian systemic lupus erythematosus patients: a focus group study.

    Science.gov (United States)

    Ow, Yen Ling Mandy; Thumboo, Julian; Cella, David; Cheung, Yin Bun; Yong Fong, Kok; Wee, Hwee Lin

    2011-06-01

    To identify health-related quality of life (HRQOL) domains of importance to multiethnic Asian systemic lupus erythematosus (SLE) patients, to identify content gaps in existing SLE-specific HRQOL measures, and to determine whether the Patient-Reported Outcomes Measurement Information System (PROMIS) item banks could serve as a core set of questions for HRQOL assessment among SLE patients. English-speaking patients with physician-diagnosed SLE from a specialist clinic in a tertiary care hospital in Singapore and a patient support group were recruited. Thematic analysis was performed to distill themes from transcripts through open coding by 2 independent coders and axial coding for refinement of categories. Items from 3 existing SLE-specific measures and PROMIS Version 1.0 Item Banks were compared with identified subthemes. Twenty-seven female and 2 male participants (21 Chinese, 4 Malay, 3 Indian, 1 other) ages 23-62 years participated in 6 focus groups and 2 individual interviews, respectively. Twenty-one domains and 92 subthemes were identified. Domains of family, relationships, stigma and discrimination, and freedom were unaddressed by existing SLE-specific measures. Forty subthemes from 14 domains were addressed by the PROMIS Version 1.0 Item Banks (Physical Function, Pain, Fatigue, Sleep Disturbance, Sleep-Related Impairment, Anger, Anxiety, and Depression banks). Family and stigma and discrimination (identified as content gaps) may be accentuated in the Asian sociocultural context. PROMIS item banks have tremendous potential to serve as a core set of items for HRQOL assessment in SLE patients. Additional items may be written to fill the gaps in existing PROMIS item banks. Copyright © 2011 by the American College of Rheumatology.

  17. Human factors in computing systems: focus on patient-centered health communication at the ACM SIGCHI conference.

    Science.gov (United States)

    Wilcox, Lauren; Patel, Rupa; Chen, Yunan; Shachak, Aviv

    2013-12-01

    Health Information Technologies, such as electronic health records (EHR) and secure messaging, have already transformed interactions among patients and clinicians. In addition, technologies supporting asynchronous communication outside of clinical encounters, such as email, SMS, and patient portals, are being increasingly used for follow-up, education, and data reporting. Meanwhile, patients are increasingly adopting personal tools to track various aspects of health status and therapeutic progress, wishing to review these data with clinicians during consultations. These issues have drawn increasing interest from the human-computer interaction (HCI) community, with special focus on critical challenges in patient-centered interactions and design opportunities that can address these challenges. We saw this community presenting and interacting at the ACM SIGCHI 2013, Conference on Human Factors in Computing Systems, (also known as CHI), held April 27-May 2nd, 2013 at the Palais de Congrès de Paris in France. CHI 2013 featured many formal avenues to pursue patient-centered health communication: a well-attended workshop, tracks of original research, and a lively panel discussion. In this report, we highlight these events and the main themes we identified. We hope that it will help bring the health care communication and the HCI communities closer together. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  18. Experimental investigation of the ternary system Ni–Pd–Sn with special focus on the B8-type phase

    International Nuclear Information System (INIS)

    Jandl, Isabella; Ipser, Herbert; Richter, Klaus W.

    2015-01-01

    The ternary alloy system Ni–Pd–Sn was investigated experimentally from 700 °C upwards, with special focus on the general NiAs-type compounds. The phase diagram and crystallographic parameters were studied by means of powder X-ray diffraction (XRD), differential thermal analysis (DTA), light optical microscopy (LOM) and scanning electron microscopy (SEM) in combination with energy dispersive X-ray spectroscopy (EDX). An isothermal section at 700 °C was constructed wherein a continuous phase field between the binary NiAs-type compounds γ (PdSn) and Ni 3 Sn 2 (high temperature modification) was detected. A series of samples throughout this phase field was used to investigate lattice parameter variations, occupation of the atomic sites and the melting behaviour. A partial ordering of the transition metals was observed. Moreover, three vertical sections at 30 at.%, 40 at.% and 50 at.% Sn were determined. Altogether, seven ternary invariant phase reactions were discovered: two ternary eutectic reactions, one ternary eutectoid reaction, three ternary transition reactions and one maximum. A complete reaction scheme for the investigated temperature range is given. Furthermore, a partial liquidus surface projection, except for the low-temperature Sn-rich region, was developed. - Highlights: • Detailed study of the ternary alloy system Ni–Pd–Sn. • 1 Isotherm, 3 vertical sections, a partial liquidus projection and a reaction scheme. • A continuous phase field, between γ and Ni 3 Sn 2 , was discovered. • Lattice parameters and structural features in this phase field were analysed. • A partial order of Ni and Pd in this phase field was observed

  19. The impact of phosphorus on the immune system and the intestinal microbiota with special focus on the pig.

    Science.gov (United States)

    Heyer, Charlotte M E; Weiss, Eva; Schmucker, Sonja; Rodehutscord, Markus; Hoelzle, Ludwig E; Mosenthin, Rainer; Stefanski, Volker

    2015-06-01

    There is increasing interest in dietary ingredients that are appropriate to support digestive and immune functions, but also maintain a stable microbial ecosystem in the gastrointestinal tract (GIT), particularly in weaned pigs. P is an essential nutrient for both microbes and their host, as it is involved, for example, in bone formation, energy metabolism, cellular signalling and stabilisation of cell membranes. Non-ruminant animals have limited access to phytate, the main storage form of P in plant seeds. The release of P bound to phytate requires phytase activity of plant or microbial origin, resulting in the formation of variable phosphorylated inositol phosphates (InsPs). The present review focuses on interactions between variations in dietary P supply, the immune system of the host, and the intestinal microbial ecosystem. Although results on the interaction between P and the immune system are inconsistent, several studies in different species have shown a positive impact of dietary P and phytase addition on the adaptive immune response. Recent studies with pigs suggest that P supply may influence intestinal microbial composition and activity. Individual InsPs or phosphate may also affect properties of pathogenic micro-organisms, such as metabolism or virulence. In conclusion, P may be considered as part of an integrated approach to support immune functions and maintain a stable microbial ecosystem in the GIT, thereby providing a barrier against potential pathogens. Within this regard, differences in phytate-P content and intrinsic phytase activity of plant feedstuffs, as well as the formation of individual InsPs, have to be taken into account.

  20. Plasma Focus

    International Nuclear Information System (INIS)

    Bernard, Alain; Jolas, Alain; Garconnet, J.-P.; Mascureau, J. de; Nazet, Christian; Coudeville, Alain; Bekiarian, Andre.

    1977-01-01

    The present report is the edition of the lectures given in a conference on the Focus experiment held at the Centre d'etudes de Limeil, on Oct. 1975. After a survey of the early laboratories one will find the main results obtained in Limeil concerning interferometry, laser scattering, electric and magnetic-measurements, X-ray and neutron emission and also the possible use of explosive current generators instead of capacitor banks at high energy levels. The principal lines of future research are given in the conclusion [fr

  1. Focus: Digital

    DEFF Research Database (Denmark)

    Technology has been an all-important and defining element within the arts throughout the 20th century, and it has fundamentally changed the ways in which we produce and consume music. With this Focus we investigate the latest developments in the digital domain – and their pervasiveness and rapid...... production and reception of contemporary music and sound art. With ‘Digital’ we present four composers' very different answers to how technology impact their work. To Juliana Hodkinson it has become an integral part of her sonic writing. Rudiger Meyer analyses the relationships between art and design and how...

  2. Validation of Patient-Reported Outcomes Measurement Information System Computerized Adaptive Tests Against the Foot and Ankle Outcome Score for 6 Common Foot and Ankle Pathologies.

    Science.gov (United States)

    Koltsov, Jayme C B; Greenfield, Stephen T; Soukup, Dylan; Do, Huong T; Ellis, Scott J

    2017-08-01

    The field of foot and ankle surgery lacks a widely accepted gold-standard patient-reported outcome instrument. With the changing infrastructure of the medical profession, more efficient patient-reported outcome tools are needed to reduce respondent burden and increase participation while providing consistent and reliable measurement across multiple pathologies and disciplines. The primary purpose of the present study was to validate 3 Patient-Reported Outcomes Measurement Information System computer adaptive tests (CATs) most relevant to the foot and ankle discipline against the Foot and Ankle Outcome Score (FAOS) and the Short Form 12 general health status survey in patients with 6 common foot and ankle pathologies. Patients (n = 240) indicated for operative treatment for 1 of 6 common foot and ankle pathologies completed the CATs, FAOS, and Short Form 12 at their preoperative surgical visits, 1 week subsequently (before surgery), and at 6 months postoperatively. The psychometric properties of the instruments were assessed and compared. The Patient-Reported Outcomes Measurement Information System CATs each took less than 1 minute to complete, whereas the FAOS took 6.5 minutes, and the Short Form 12 took 3 minutes. CAT scores were more normally distributed and had fewer floor and ceiling effects than those on the FAOS, which reached as high as 24%. The CATs were more precise than the FAOS and had similar responsiveness and test-retest reliability. The physical function and mobility CATs correlated strongly with the activities subscale of the FAOS, and the pain interference CAT correlated strongly with the pain subscale of the FAOS. The CATs and FAOS were responsive to changes with operative treatment for 6 common foot and ankle pathologies. The CATs performed as well as or better than the FAOS in all aspects of psychometric validity. The Patient-Reported Outcomes Measurement Information System CATs show tremendous potential for improving the study of patient

  3. Is Textbook Outcome a valuable composite measure for short-term outcomes of gastrointestinal treatments in the Netherlands using hospital information system data? A retrospective cohort study.

    Science.gov (United States)

    Salet, Nèwel; Bremmer, Rolf H; Verhagen, Marc A M T; Ekkelenkamp, Vivian E; Hansen, Bettina E; de Jonge, Pieter J F; de Man, Rob A

    2018-03-01

    To develop a feasible model for monitoring short-term outcome of clinical care trajectories for hospitals in the Netherlands using data obtained from hospital information systems for identifying hospital variation. Retrospective analysis of collected data from hospital information systems combined with clinical indicator definitions to define and compare short-term outcomes for three gastrointestinal pathways using the concept of Textbook Outcome. 62 Dutch hospitals. 45 848 unique gastrointestinal patients discharged in 2015. A broad range of clinical outcomes including length of stay, reintervention, readmission and doctor-patient counselling. Patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) for gallstone disease (n=4369), colonoscopy for inflammatory bowel disease (IBD; n=19 330) and colonoscopy for colorectal cancer screening (n=22 149) were submitted to five suitable clinical indicators per treatment. The percentage of all patients who met all five criteria was 54%±9% (SD) for ERCP treatment. For IBD this was 47%±7% of the patients, and for colon cancer screening this number was 85%±14%. This study shows that reusing data obtained from hospital information systems combined with clinical indicator definitions can be used to express short-term outcomes using the concept of Textbook Outcome without any excess registration. This information can provide meaningful insight into the clinical care trajectory on the level of individual patient care. Furthermore, this concept can be applied to many clinical trajectories within gastroenterology and beyond for monitoring and improving the clinical pathway and outcome for patients. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. [Clinical skills and outcomes of chair-side computer aided design and computer aided manufacture system].

    Science.gov (United States)

    Yu, Q

    2018-04-09

    Computer aided design and computer aided manufacture (CAD/CAM) technology is a kind of oral digital system which is applied to clinical diagnosis and treatment. It overturns the traditional pattern, and provides a solution to restore defect tooth quickly and efficiently. In this paper we mainly discuss the clinical skills of chair-side CAD/CAM system, including tooth preparation, digital impression, the three-dimensional design of prosthesis, numerical control machining, clinical bonding and so on, and review the outcomes of several common kinds of materials at the same time.

  5. Using value-based analysis to influence outcomes in complex surgical systems.

    Science.gov (United States)

    Kirkpatrick, John R; Marks, Stanley; Slane, Michele; Kim, Donald; Cohen, Lance; Cortelli, Michael; Plate, Juan; Perryman, Richard; Zapas, John

    2015-04-01

    Value-based analysis (VBA) is a management strategy used to determine changes in value (quality/cost) when a usual practice (UP) is replaced by a best practice (BP). Previously validated in clinical initiatives, its usefulness in complex systems is unknown. To answer this question, we used VBA to correct deficiencies in cardiac surgery at Memorial Healthcare System. Cardiac surgery is a complex surgical system that lends itself to VBA because outcomes metrics provided by the Society of Thoracic Surgeons provide an estimate of quality; cost is available from Centers for Medicare and Medicaid Services and other contemporary sources; the UP can be determined; and the best practice can be established. Analysis of the UP at Memorial Healthcare System revealed considerable deficiencies in selection of patients for surgery; the surgery itself, including choice of procedure and outcomes; after care; follow-up; and control of expenditures. To correct these deficiencies, each UP was replaced with a BP. Changes included replacement of most of the cardiac surgeons; conversion to an employed physician model; restructuring of a heart surgery unit; recruitment of cardiac anesthesiologists; introduction of an interactive educational program; eliminating unsafe practices; and reducing cost. There was a significant (p value (quality/cost) in a complex surgical system. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  6. Reconciliation of international administrative coding systems for comparison of colorectal surgery outcome.

    Science.gov (United States)

    Munasinghe, A; Chang, D; Mamidanna, R; Middleton, S; Joy, M; Penninckx, F; Darzi, A; Livingston, E; Faiz, O

    2014-07-01

    Significant variation in colorectal surgery outcomes exists between different countries. Better understanding of the sources of variable outcomes using administrative data requires alignment of differing clinical coding systems. We aimed to map similar diagnoses and procedures across administrative coding systems used in different countries. Administrative data were collected in a central database as part of the Global Comparators (GC) Project. In order to unify these data, a systematic translation of diagnostic and procedural codes was undertaken. Codes for colorectal diagnoses, resections, operative complications and reoperative interventions were mapped across the respective national healthcare administrative coding systems. Discharge data from January 2006 to June 2011 for patients who had undergone colorectal surgical resections were analysed to generate risk-adjusted models for mortality, length of stay, readmissions and reoperations. In all, 52 544 case records were collated from 31 institutions in five countries. Mapping of all the coding systems was achieved so that diagnosis and procedures from the participant countries could be compared. Using the aligned coding systems to develop risk-adjusted models, the 30-day mortality rate for colorectal surgery was 3.95% (95% CI 0.86-7.54), the 30-day readmission rate was 11.05% (5.67-17.61), the 28-day reoperation rate was 6.13% (3.68-9.66) and the mean length of stay was 14 (7.65-46.76) days. The linkage of international hospital administrative data that we developed enabled comparison of documented surgical outcomes between countries. This methodology may facilitate international benchmarking. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

  7. Use of the quality management system "JACIE" and outcome after hematopoietic stem cell transplantation.

    Science.gov (United States)

    Gratwohl, Alois; Brand, Ronald; McGrath, Eoin; van Biezen, Anja; Sureda, Anna; Ljungman, Per; Baldomero, Helen; Chabannon, Christian; Apperley, Jane

    2014-05-01

    Competent authorities, healthcare payers and hospitals devote increasing resources to quality management systems but scientific analyses searching for an impact of these systems on clinical outcome remain scarce. Earlier data indicated a stepwise improvement in outcome after allogeneic hematopoietic stem cell transplantation with each phase of the accreditation process for the quality management system "JACIE". We therefore tested the hypothesis that working towards and achieving "JACIE" accreditation would accelerate improvement in outcome over calendar time. Overall mortality of the entire cohort of 107,904 patients who had a transplant (41,623 allogeneic, 39%; 66,281 autologous, 61%) between 1999 and 2006 decreased over the 14-year observation period by a factor of 0.63 per 10 years (hazard ratio: 0.63; 0.58-0.69). Considering "JACIE"-accredited centers as those with programs having achieved accreditation by November 2012, at the latest, this improvement was significantly faster in "JACIE"-accredited centers than in non-accredited centers (approximately 5.3% per year for 49,459 patients versus approximately 3.5% per year for 58,445 patients, respectively; hazard ratio: 0.83; 0.71-0.97). As a result, relapse-free survival (hazard ratio 0.85; 0.75-0.95) and overall survival (hazard ratio 0.86; 0.76-0.98) were significantly higher at 72 months for those patients transplanted in the 162 "JACIE"-accredited centers. No significant effects were observed after autologous transplants (hazard ratio 1.06; 0.99-1.13). Hence, working towards implementation of a quality management system triggers a dynamic process associated with a steeper reduction in mortality over the years and a significantly improved survival after allogeneic stem cell transplantation. Our data support the use of a quality management system for complex medical procedures.

  8. Focusing horn

    CERN Multimedia

    1980-01-01

    This was the first magnetic horn developed by Simon Van der Meer to collect antiprotons in the AD complex. It was used for the AA (antiproton accumulator). Making an antiproton beam took a lot of time and effort. Firstly, protons were accelerated to an energy of 26 GeV/c (protons at 26GeV/c, antiprotons at 3.6GeV/c) in the PS and ejected onto a metal target. From the spray of emerging particles, a magnetic horn picked out 3.6 GeV antiprotons for injection into the AA through a wide-aperture focusing quadrupole magnet. For a million protons hitting the target, just one antiproton was captured, 'cooled' and accumulated. It took 3 days to make a beam of 3 x 10^11 -, three hundred thousand million - antiprotons. The development of this technology was a key step to the functioning of CERN's Super Proton Synchrotron as a proton - antiproton collider.

  9. State Systems Change Spotlight: Nevada. Transforming State Systems to Improve Outcomes for Children with Disabilities

    Science.gov (United States)

    Ruedel, Kristin; Nelson, Gena; Bailey, Tessie; Pierce, Jennifer

    2018-01-01

    Data show that effective and ongoing communication and evaluation can have a positive impact on local and statewide systems change. Local and statewide systems change requires ongoing communication and evaluation. The Nevada Department of Education (NDE) used a communication protocol to support implementation of the Assess-Plan-Teach (APT) model.…

  10. Integrating patient reported outcomes with clinical cancer registry data: a feasibility study of the electronic Patient-Reported Outcomes From Cancer Survivors (ePOCS) system.

    Science.gov (United States)

    Ashley, Laura; Jones, Helen; Thomas, James; Newsham, Alex; Downing, Amy; Morris, Eva; Brown, Julia; Velikova, Galina; Forman, David; Wright, Penny

    2013-10-25

    Routine measurement of Patient Reported Outcomes (PROs) linked with clinical data across the patient pathway is increasingly important for informing future care planning. The innovative electronic Patient-reported Outcomes from Cancer Survivors (ePOCS) system was developed to integrate PROs, collected online at specified post-diagnostic time-points, with clinical and treatment data in cancer registries. This study tested the technical and clinical feasibility of ePOCS by running the system with a sample of potentially curable breast, colorectal, and prostate cancer patients in their first 15 months post diagnosis. Patients completed questionnaires comprising multiple Patient Reported Outcome Measures (PROMs) via ePOCS within 6 months (T1), and at 9 (T2) and 15 (T3) months, post diagnosis. Feasibility outcomes included system informatics performance, patient recruitment, retention, representativeness and questionnaire completion (response rate), patient feedback, and administration burden involved in running the system. ePOCS ran efficiently with few technical problems. Patient participation was 55.21% (636/1152) overall, although varied by approach mode, and was considerably higher among patients approached face-to-face (61.4%, 490/798) than by telephone (48.8%, 21/43) or letter (41.0%, 125/305). Older and less affluent patients were less likely to join (both Pplanning and for targeting service provision.

  11. Development, Characterization, and Implementation of a System for Focused Ultrasound-Mediated Blood-Brain Barrier Opening in Mice

    Science.gov (United States)

    Valdez, Michael Aaron

    The blood-brain barrier BBB refers to the set of specialized endothelial cells that line the vasculature in the brain and effectively control movement of molecules into and out of the brain. While necessary for proper brain function, the BBB blocks 98% of drugs from entering the brain and is the most significant barrier to developing therapies for neurodegenerative diseases. Active transport allows some specific molecules to cross the BBB, but therapeutic development using this route has had limited success. A number of techniques have been used to bypass the BBB, but are often highly invasive and ineffective. Over the last two decades, a minimally invasive technique to transiently open the BBB has been under development that utilizes transcranial focused ultrasound (FUS) in combination with intravascular microbubble contrast agents. This method is often carried out in conjunction with magnetic resonance imaging (MRI) to guide and assess BBB opening and has been referred to as MRI guided FUS (MRgFUS). Because of the utility of mouse models of neurological disease and the exploratory nature of MRgFUS, systems that allow BBB opening in mice are a useful and necessary tool to develop and evaluate this method for clinical application. In this dissertation project, a custom built, cost-effective FUS system for opening the BBB in mice was developed, with the objective of using this device to deliver therapeutics to the brain. Being a custom device, it was necessary to evaluate the ultrasound output, verify in vivo safety, and anticipate the therapeutic effect. The scope of the work herein consists of the design, construction, and evaluation of system that fulfills these requirements. The final constructed system cost was an order of magnitude less than any commercially available MRgFUS system. At this low price point, the hardware could allow the implementation of the methodology in many more research areas than previously possible. Additionally, to anticipate the

  12. Pediatric Neurosurgical Outcomes Following a Neurosurgery Health System Intervention at Mulago National Referral Hospital in Uganda.

    Science.gov (United States)

    Fuller, Anthony T; Haglund, Michael M; Lim, Stephanie; Mukasa, John; Muhumuza, Michael; Kiryabwire, Joel; Ssenyonjo, Hussein; Smith, Emily R

    2016-11-01

    Pediatric neurosurgical cases have been identified as an important target for impacting health disparities in Uganda, with over 50% of the population being less than 15 years of age. The objective of the present study was to evaluate the effects of the Duke-Mulago collaboration on pediatric neurosurgical outcomes in Mulago National Referral Hospital. We performed retrospective analysis of all pediatric neurosurgical cases who presented at Mulago National Referral Hospital in Kampala, Uganda, to examine overall, preprogram (2005-2007), and postprogram (2008-2013) outcomes. We analyzed mortality, presurgical infections, postsurgical infections, length of stay, types of procedures, and significant predictors of mortality. Data on neurosurgical cases was collected from surgical logbooks, patient charts, and Mulago National Referral Hospital's yearly death registry. Of 820 pediatric neurosurgical cases, outcome data were complete for 374 children. Among children who died within 30 days of a surgical procedure, the largest group was less than a year old (45%). Postinitiation of the Duke-Mulago collaboration, we identified an overall increase in procedures, with the greatest increase in cases with complex diagnoses. Although children ages 6-18 years of age were 6.66 times more likely to die than their younger counterparts preprogram, age was no longer a predictive variable postprogram. When comparing pre- and postprogram outcomes, mortality among pediatric patients within 30 days after a neurosurgical procedure increased from 4.3% to 10.0%, mortality after 30 days increased slightly from 4.9% to 5.0%, presurgical infections decreased by 4.6%, and postsurgery infections decreased slightly by 0.7%. Our data show the provision of more complex neurological procedures does not necessitate improved outcomes. Rather, combining these higher-level procedures with essential pre- and postoperative care and continued efforts in health system strengthening for pediatric neurosurgical

  13. Cultural Resilience of Nenets Social-Ecological Systems in Arctic Russia: A Focus on Reindeer Nomads of the Tundra

    Science.gov (United States)

    Forbes, B. C.

    2013-12-01

    Empirical data on resilience in social-ecological systems (SESs) are reviewed from local and regional scale case studies among full-time nomads in the neighbouring Nenets and Yamal-Nenets Autonomous Okrugs, Russia. The focus is on critical cultural factors contributing to SES resilience. In particular, this work presents an integrated view of people situated in specific tundra landscapes that face significantly different prospects for adaptation depending on existing or planned infrastructure associated with oil and gas development. Factors contributing to general resilience are compared to those that are adapted to certain spatial and temporal contexts. Environmental factors include ample space and an abundance of resources, such as fish and game (e.g. geese), to augment the diet of not only the migratory herders, but also residents from coastal settlements. In contrast to other regions, such as the Nenets Okrug, Yamal Nenets households consist of intact nuclear families with high retention among youth in the nomadic tundra population. Accepting attitudes toward exogenous drivers such as climate change and industrial development appear to play a significant role in how people react to both extreme weather events and piecemeal confiscation or degradation of territory. Consciousness of their role as responsible stewards of the territories they occupy has likely been a factor in maintaining viable wildlife populations over centuries. Institutions administering reindeer herding have remained flexible, especially on Yamal, and so accommodate decision-making that is sensitive to herders' needs and timetables. This affects factors such as herd demography, mobility and energetics. Resilience is further facilitated within the existing governance regimes by herders' own agency, most recently in the post-Soviet shift to smaller, privately managed herds that can better utilize available pastures in a highly dynamic environment experiencing rapid socio-economic, climate and

  14. Predicting Positive Education Outcomes for Emerging Adults in Mental Health Systems of Care.

    Science.gov (United States)

    Brennan, Eileen M; Nygren, Peggy; Stephens, Robert L; Croskey, Adrienne

    2016-10-01

    Emerging adults who receive services based on positive youth development models have shown an ability to shape their own life course to achieve positive goals. This paper reports secondary data analysis from the Longitudinal Child and Family Outcome Study including 248 culturally diverse youth ages 17 through 22 receiving mental health services in systems of care. After 12 months of services, school performance was positively related to youth ratings of school functioning and service participation and satisfaction. Regression analysis revealed ratings of young peoples' perceptions of school functioning, and their experience in services added to the significant prediction of satisfactory school performance, even controlling for sex and attendance. Finally, in addition to expected predictors, participation in planning their own services significantly predicted enrollment in higher education for those who finished high school. Findings suggest that programs and practices based on positive youth development approaches can improve educational outcomes for emerging adults.

  15. The Role of Organizational Control Systems in Employees' Organizational Trust and Performance Outcomes.

    Science.gov (United States)

    Verburg, Robert M; Nienaber, Ann-Marie; Searle, Rosalind H; Weibel, Antoinette; Den Hartog, Deanne N; Rupp, Deborah E

    2018-04-01

    This study examined how organizational control is related to employees' organizational trust. We specifically focus on how different forms of control (process, outcome, and normative) relate to employees' trust in their employing organizations and examine whether such trust in turn relates positively to employee job performance (task performance and organizational citizenship behavior). In addition, and in response to the recommendations of past research, we examined these relationships in a high control and compliance-based cultural context. Using data from 105 employee-supervisor dyads from professional services firms in Singapore, we find support for our hypothesized model. The implications of the results for theory and practice, and directions for future research, are discussed.

  16. The Role of Organizational Control Systems in Employees’ Organizational Trust and Performance Outcomes

    Science.gov (United States)

    Verburg, Robert M.; Nienaber, Ann-Marie; Searle, Rosalind H.; Weibel, Antoinette; Den Hartog, Deanne N.; Rupp, Deborah E.

    2017-01-01

    This study examined how organizational control is related to employees’ organizational trust. We specifically focus on how different forms of control (process, outcome, and normative) relate to employees’ trust in their employing organizations and examine whether such trust in turn relates positively to employee job performance (task performance and organizational citizenship behavior). In addition, and in response to the recommendations of past research, we examined these relationships in a high control and compliance-based cultural context. Using data from 105 employee–supervisor dyads from professional services firms in Singapore, we find support for our hypothesized model. The implications of the results for theory and practice, and directions for future research, are discussed. PMID:29568213

  17. Impact of collateral circulation on early outcome and risk of hemorrhagic complications after systemic thrombolysis.

    Science.gov (United States)

    Brunner, Freimuth; Tomandl, Bernd; Hanken, Katrin; Hildebrandt, Helmut; Kastrup, Andreas

    2014-12-01

    In stroke patients, collateral flow can rapidly be assessed on computed tomography angiography (CTA). In this study, the impact of baseline collaterals on early outcome and risk of symptomatic intracerebral hemorrhages after systemic thrombolysis in patients with proximal arterial occlusions within the anterior circulation were analyzed. Collateralization scores were determined on the CT angiography source images (0 = absent; 1 ≤ 50%, 2 > 50% but collateral filling) of patients with distal intracranial carotid artery and/or M1 segment occlusions treated from 2008 to December 2011. A collateral score of 0 to 1 was designated as poor and 2 to 3 as good collateral vessel status. Outcome variables included in hospital mortality, favorable outcome at discharge (modified Rankin score ≤ 2), and rates of symptomatic intracerebral hemorrhage based on the European-Australasian Acute Stroke Study II definition. Among 246 subjects (mean age of 74 years; median National Institutes of Health Stroke Scale N at admission 14), 205 patients (83%) had good collaterals, whereas 41 patients (17%) had poor collaterals, respectively. Patients with poor collaterals had significantly higher rates of in-hospital mortality (41% vs. 12%, P collaterals. The grade of collateralization was independently associated with in-hospital mortality (P collaterals have a poor early functional outcome and high rates of symptomatic intracerebral hemorrhage after systemic thrombolysis. Since similar findings have also been reported after endovascular therapy, strategies to improve collateral blood flow should be assessed in this patient population. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.

  18. Overview of the Publications From the Anthroposophic Medicine Outcomes Study (AMOS): A Whole System Evaluation Study.

    Science.gov (United States)

    Hamre, Harald Johan; Kiene, Helmut; Ziegler, Renatus; Tröger, Wilfried; Meinecke, Christoph; Schnürer, Christof; Vögler, Hendrik; Glockmann, Anja; Kienle, Gunver Sophia

    2014-01-01

    Anthroposophic medicine is a physician-provided complementary therapy system that was founded by Rudolf Steiner and Ita Wegman. Anthroposophic therapy includes special medicinal products, artistic therapies, eurythmy movement exercises, and special physical therapies. The Anthroposophic Medicine Outcomes Study (AMOS) was a prospective observational multicenter study of 1631 outpatients starting anthroposophic therapy for anxiety disorders, asthma, attention deficit hyperactivity disorder, depression, low back pain, migraine, and other chronic indications under routine conditions in Germany. AMOS INCORPORATED TWO FEATURES PROPOSED FOR THE EVALUATION OF INTEGRATIVE THERAPY SYSTEMS: (1) a sequential approach, starting with the whole therapy system (use, safety, outcomes, perceived benefit), addressing comparative effectiveness and proceeding to the major system components (physician counseling, anthroposophic medicinal products, art therapy, eurythmy therapy, rhythmical massage therapy) and (2) a mix of different research methods to build an information synthesis, including pre-post analyses, prospective comparative analyses, economic analyses, and safety analyses of individual patient data. AMOS fostered two methodological innovations for the analysis of single-arm therapy studies (combined bias suppression, systematic outcome comparison with corresponding cohorts in other studies) and the first depression cost analysis worldwide comparing primary care patients treated for depression vs depressed patients treated for another disorder vs nondepressed patients. A total of 21 peer-reviewed publications from AMOS have resulted. This article provides an overview of the main research questions, methods, and findings from these publications: anthroposophic treatment was safe and was associated with clinically relevant improvements in symptoms and quality of life without cost increase; improvements were found in all age, diagnosis, and therapy modality groups and were

  19. Modified Early Warning System improves patient safety and clinical outcomes in an academic community hospital

    Directory of Open Access Journals (Sweden)

    Chirag Mathukia

    2015-04-01

    Full Text Available Background and objective: Severe adverse events such as cardiac arrest and death are often heralded by abnormal vital signs hours before the event. This necessitates an organized track and trigger approach of early recognition and response to subtle changes in a patient's condition. The Modified Early Warning System (MEWS is one of such systems that use temperature, blood pressure, pulse, respiratory rate, and level of consciousness with each progressive higher score triggering an action. Root cause analysis for mortalities in our institute has led to the implementation of MEWS in an effort to improve patient outcomes. Here we discuss our experience and the impact of MEWS implementation on patient care at our community academic hospital. Methods: MEWS was implemented in a protocolized manner in June 2013. The following data were collected from non-ICU wards on a monthly basis from January 2010 to June 2014: 1 number of rapid response teams (RRTs per 100 patient-days (100PD; 2 number of cardiopulmonary arrests ‘Code Blue’ per 100PD; and 3 result of each RRT and Code Blue (RRT progressed to Code Blue, higher level of care, ICU transfer, etc.. Overall inpatient mortality data were also analyzed. Results: Since the implementation of MEWS, the number of RRT has increased from 0.24 per 100PD in 2011 to 0.38 per 100PD in 2013, and 0.48 per 100PD in 2014. The percentage of RRTs that progressed to Code Blue, an indicator of poor outcome of RRT, has been decreasing. In contrast, the numbers of Code Blue in non-ICU floors has been progressively decreasing from 0.05 per 100PD in 2011 to 0.02 per 100PD in 2013 and 2014. These improved clinical outcomes are associated with a decline of overall inpatient mortality rate from 2.3% in 2011 to 1.5% in 2013 and 1.2% in 2014. Conclusions: Implementation of MEWS in our institute has led to higher rapid response system utilization but lower cardiopulmonary arrest events; this is associated with a lower mortality

  20. Action, outcome, and value: a dual-system framework for morality.

    Science.gov (United States)

    Cushman, Fiery

    2013-08-01

    Dual-system approaches to psychology explain the fundamental properties of human judgment, decision making, and behavior across diverse domains. Yet, the appropriate characterization of each system is a source of debate. For instance, a large body of research on moral psychology makes use of the contrast between "emotional" and "rational/cognitive" processes, yet even the chief proponents of this division recognize its shortcomings. Largely independently, research in the computational neurosciences has identified a broad division between two algorithms for learning and choice derived from formal models of reinforcement learning. One assigns value to actions intrinsically based on past experience, while another derives representations of value from an internally represented causal model of the world. This division between action- and outcome-based value representation provides an ideal framework for a dual-system theory in the moral domain.