WorldWideScience

Sample records for outcomes latest evidence

  1. Emollient treatment of atopic dermatitis: latest evidence and clinical considerations

    Directory of Open Access Journals (Sweden)

    Kam Lun Hon

    2018-04-01

    Full Text Available Aim: To review current classes of emollients in the market, their clinical efficacy in atopic dermatitis (AD and considerations for choice of an emollient. Methods: PubMed Clinical Queries under Clinical Study Categories (with Category limited to Therapy and Scope limited to Narrow and Systematic Reviews were used as the search engine. Keywords of ‘emollient or moisturizer’ and ‘atopic dermatitis’ were used. Overview of findings: Using the keywords of ‘emollient’ and ‘atopic dermatitis’, there were 105 and 36 hits under Clinical Study Categories (with Category limited to Therapy and Scope limited to Narrow and Systematic Reviews, respectively. Plant-derived products, animal products and special ingredients were discussed. Selected proprietary products were tabulated. Conclusions: A number of proprietary emollients have undergone trials with clinical data available on PubMed-indexed journals. Most moisturizers showed some beneficial effects, but there was generally no evidence that one moisturizer is superior to another. Choosing an appropriate emollient for AD patients would improve acceptability and adherence for emollient treatment. Physician’s recommendation is the primary consideration for patients when selecting a moisturizer/ emollient; therefore, doctors should provide evidence-based information about these emollients.

  2. Fidaxomicin in Clostridium difficile infection: latest evidence and clinical guidance.

    Science.gov (United States)

    Mullane, Kathleen

    2014-03-01

    The incidence of Clostridium difficile infection (CDI) has risen 400% in the last decade. It currently ranks as the third most common nosocomial infection. CDI has now crossed over as a community-acquired infection. The major failing of current therapeutic options for the management of CDI is recurrence of disease after the completion of treatment. Fidaxomicin has been proven to be superior to vancomycin in successful sustained clinical response to therapy. Improved outcomes may be due to reduced collateral damage to the gut microflora by fidaxomicin, bactericidal activity, inhibition of Clostridial toxin formation and inhibition of new sporulation. This superiority is maintained in groups previously reported as being at high risk for CDI recurrence including those: with relapsed infection after a single treatment course; on concomitant antibiotic therapy; aged >65 years; with cancer; and with chronic renal insufficiency. Because the acquisition cost of fidaxomicin far exceeds that of metronidazole or vancomycin, in order to rationally utilize this agent, it should be targeted to those populations who are at high risk for relapse and in whom the drug has demonstrated superiority. In this manuscript is reviewed the changing epidemiology of CDI, current treatment options for this infection, proposed benefits of fidaxomicin over currently available antimicrobial options, available analysis of cost effectiveness of the drug, and is given recommendations for judicious use of the drug based upon the available published literature.

  3. Saw palmetto and lower urinary tract symptoms: what is the latest evidence?

    Science.gov (United States)

    Avins, Andrew L; Bent, Stephen

    2006-07-01

    The use of dietary supplements for treating a wide range of health conditions has grown rapidly in the United States. In the field of men's health, the most common dietary supplement used is an extract of the berry of the saw palmetto plant, with which men commonly self-medicate in order to treat lower urinary tract symptoms. Throughout the past two decades, substantial literature has emerged examining the biologic and clinical effects of saw palmetto extracts. Several lines of evidence suggest that saw palmetto may exert physiologic effects consistent with a beneficial clinical effect on the mechanisms of benign prostatic hyperplasia. Although most clinical studies tend to suggest a modest efficacy benefit of saw palmetto, more recent studies are less consistent and the precise clinical value of saw palmetto for treating lower urinary tract symptoms remains undefined. Overall, there appear to be few safety concerns with short-term use of this herbal medicine, although large-scale and longer-term safety studies have not been performed. Higher-quality studies are currently underway to better define the potential benefits and risks of plant-based extracts for treating symptoms related to benign prostatic hyperplasia.

  4. Ñuagapua (Chaco, Bolivia): Evidence for the latest occurrence of megafauna in association with human remains in South America

    Science.gov (United States)

    Coltorti, Mauro; Della Fazia, Jacopo; Paredes Rios, Freddy; Tito, Giuseppe

    2012-02-01

    Quebrada (stream) Ñuagapua, which is located in the Bolivian Chaco in the Andean foothill generates an alluvial fan many kilometres in length. Three major lithostratigraphic units characterise the sedimentary sequence in this region. The lower and upper parts are formed from predominantly sandy sediments that demonstrate rapid growth of the alluvial fan, associated with an intense erosion of barren slopes. The intermediate unit consists of forest soil that seals deep channels containing bones together with a forest association. The remains of a wooden plank, dated 140 yr BP, were found at the top of this soil, which laterally contains charcoals, ash layers and large charred trunks, sometimes in growth positions. Roots localised in this layer also sustain a number of very large still living trees. These findings are evidence of a recent phase of alluvial fan sedimentation resulting from slope erosion activated by forest clearing. The Chaco has been intensively settled for agricultural and pastoral purposes since the 18th century. The lower unit contains a hearth, scattered burnt bones, flint flakes and ceramic artefacts. Radiometric dating indicates a middle Holocene human occupation, between ca. 7.79 and 6.65 ka cal yr BP. We suggest that the sedimentary unit is associated with intense soil erosion processes triggered by early Neolithic deforestation. A sandy layer of the lower unit, slightly above the archaeological remains, contains transported bones of megafaunal elements that apparently represent the South American latest occurrence of some extinct taxa. The mammal association is highly heterogeneous, containing species living in aquatic, forest, prairie and savannah environments from a very specific layer that represents the almost simultaneous burial of animals killed slightly up-valley. This anomalous association is probably the result of human impact as opening the forest favoured the introduction of open environment fauna that had previously survived on

  5. Implantable loop recorders for assessment of syncope: increased diagnostic yield and less adverse outcomes with the latest generation devices.

    Science.gov (United States)

    Bartoletti, A; Bocconcelli, P; De Santo, T; Ghidini Ottonelli, A; Giuli, S; Massa, R; Svetlich, C; Tarsi, G; Corbucci, G; Tronconi, F; Vitale, E

    2013-08-01

    Aim of the study was to compare the diagnostic yield of implantable loop recorders (ILR) of two successive generations for the assessment of syncope. Data on patients who had undergone ILR implantation for unexplained syncope in four Italian public hospitals were retrospectively acquired from the Medtronic Clinical Service database. After implantation, routine follow-up examinations were performed every 90 days, while urgent examinations were carried out in the event of syncope recurrence. The following findings were regarded as diagnostic: ECG documentation of a syncope recurrence; documentation of any of the arrhythmias listed by the current guidelines as diagnostic findings even if asymptomatic. Between November 2002 and March 2010, 107 patients received an ILR (40 Medtronic Reveal® Plus; 67 Medtronic Reveal® DX/XT) and underwent at least one follow-up examination. Diagnoses were made in 7 (17.5%) and 24 (35.8%) (P=0.043) patients, with a median time of 228 and 65 days, respectively. Three (42.9%) and 21 (87.5%) (P=0.029) diagnoses were based on automatically detected events, while adverse outcomes occurred in 6 and in 1 (P=0.01) patients, respectively. Our results show that the new-generation device offer a higher diagnostic yield, mainly as a result of its improved automatic detection function, and is associated with fewer adverse outcomes.

  6. Effectiveness of balneotherapy and spa therapy for the treatment of chronic low back pain: a review on latest evidence.

    Science.gov (United States)

    Karagülle, Mine; Karagülle, Müfit Zeki

    2015-02-01

    In most European countries, balneotherapy and spa therapy are widely prescribed by physicians and preferred by European citizens for the treatment of musculoskeletal problems including chronic low back pain (LBP). We aimed to review and evaluate the recent evidence on the effectiveness of balneotherapy and spa therapy for patients with LBP. We comprehensively searched data bases for randomized controlled trials (RCTs) published in English between July 2005 and December 2013. We identified all trials testing balneotherapy or spa therapy for LBP that reported that the sequence of allocation was randomized. We finally included total of eight RCTs: two on balneotherapy and six on spa therapy. All reviewed trials reported that balneotherapy was superior in long term to tap water therapy in relieving pain and improving function and that spa therapy combining balneotherapy with mud pack therapy and/or exercise therapy, physiotherapy, and/or education was effective in the management of low back pain and superior or equally effective to the control treatments in short and long terms. We used Jadad scale to grade the methodological quality. Only three out of total eight had a score of above 3 indicating the good quality. The data from the RCTs indicates that overall evidence on effectiveness of balneotherapy and spa therapy in LBP is encouraging and reflects the consistency of previous evidence. However, the overall quality of trials is generally low. Better quality RCTs (well designed, conducted, and reported) are needed testing short- and long-term effects for relieving chronic back pain and proving broader beneficial effects.

  7. Latest Quaternary paleoseismology and evidence of distributed dextral shear along the Mohawk Valley fault zone, northern Walker Lane, California

    Science.gov (United States)

    Gold, Ryan D.; Briggs, Richard; Personius, Stephen; Crone, Anthony J.; Mahan, Shannon; Angster, Stephen

    2014-01-01

    The dextral-slip Mohawk Valley fault zone (MVFZ) strikes northwestward along the eastern margin of the Sierra Nevada in the northern Walker Lane. Geodetic block modeling indicates that the MVFZ may accommodate ~3 mm/yr of regional dextral strain, implying that it is the highest slip-rate strike-slip fault in the region; however, only limited geologic data are available to constrain the system’s slip rate and earthquake history. We mapped the MVFZ using airborne lidar data and field observations and identified a site near Sulphur Creek for paleoseismic investigation. At this site, oblique dextral-normal faulting on the steep valley margin has created a closed depression that floods annually during spring snowmelt to form an ephemeral pond. We excavated three fault-perpendicular trenches at the site and exposed pond sediment that interfingers with multiple colluvial packages eroded from the scarp that bounds the eastern side of the pond. We documented evidence for four surface-rupturing earthquakes on this strand of the MVFZ. OxCal modeling of radiocarbon and luminescence ages indicates that these earthquakes occurred at 14.0 ka, 12.8 ka, 5.7 ka, and 1.9 ka. The mean ~4 kyr recurrence interval is inconsistent with slip rates of ~3 mm/yr; these rates imply surface ruptures of more than 10 m per event, which is geologically implausible for the subdued geomorphic expression and 60 km length of the MVFZ. We propose that unidentified structures not yet incorporated into geodetic models may accommodate significant dextral shear across the northern Walker Lane, highlighting the role of distributed deformation in this region.

  8. [Evidence-based management of ST-segment elevation myocardial infarction (STEMI). Latest guidelines of the European Society of Cardiology (ESC) 2010].

    Science.gov (United States)

    Silber, S

    2010-12-01

    Acute myocardial infarction and its consequences (death, chronic ischemic coronary artery disease, heart failure) are still the number 1 causes of death and of cardiovascular diseases in Germany. In this context, patients with STEMI are at the highest risk. The first-line management of STEMI patients often determines if the outcome is life or death. This overview presents the current optimal evidence-based management of STEMI patients as a practice-oriented extract according to the latest ESC guidelines, fully published some weeks ago (http://www.escardio.org).All efforts must be made to keep the respective time intervals between the onset of symptoms and the beginning of reperfusion therapy as short as possible, i.e. best within a dedicated STEMI network. Two of the time intervals are particularly essential: the time delay between the onset of symptoms and the first medical contact (FMC) and the time delay between FMC and the beginning of reperfusion. The time delay between the onset of symptoms and FMC depends on the patient as well as on the organization of the emergency medical service (EMS). Unfortunately, too many patients/bystanders still hesitate to immediately call the EMS. More intense measures must therefore be taken to educate the public. The optimal FMC by medical doctors or paramedics reacts quickly and ideally arrives with ECG equipment for immediate diagnosis of STEMI (persistent ST-segment elevation or presumably new left bundle branch block) before hospital admission. Unfortunately in many cases, the FMC is the emergency room of a hospital. Further decisions can be made without laboratory findings. In Germany, the average time delay between onset of symptoms and FMC is 100 min and therefore longer than in some other European countries.The next critical time interval is that between FMC and the beginning of reperfusion: this interval depends solely on the EMS organization and the distance to the next catheter laboratory with 24 h PCI (percutaneous

  9. Evaluating outcomes from stakeholders' perception: evidence from ...

    African Journals Online (AJOL)

    The need for the appreciation of values and knowledge diversity has contributed to the increasing relevance of stakeholder participation in the monitoring and evaluation (M&E) of development projects. Using mixed methods research design and indicators, this paper assesses the outcomes of the participatory monitoring ...

  10. The Latest Forecast.

    Science.gov (United States)

    Laurence, David

    2002-01-01

    Discusses the "latest forecast" for the future of English departments. Addresses departmental and institutional staffing practices, employment opportunities for PhDs, the acceleration of change in the institution, and the general state of the study and teaching of English. (RS)

  11. Condom use at first and latest sexual events among young people: evidence from a rural and peri-urban setting in Uganda.

    Science.gov (United States)

    Tumwesigye, N M; Ingham, R; Holmes, D

    2013-06-01

    Condom use remains low among young people despite high prevalence of HIV, STIs, and unplanned pregnancy in Uganda. This paper presents patterns of condom use at first and latest sexual events and associated factors. The data were obtained from 445 sexually active unmarried people aged 15-24 from one peri-urban and another rural district. Stratified multi-stage cluster sampling technique was applied. Logistic regression was used to identify factors associated with condom use at each of the two sexual events, while multinomial logistic regression was used to establish factors correlated with condom use at both first and last sex. Factors associated with condom use at each event were residence in the peri-urban district and higher education attainment. Factors correlated with condom use at both first and last sex were residence in peri-urban district (pcondom use at first sex are different from those that affect condom use at latest sexual event. Prevention programmes against STIs, HIV and unplanned pregnancies among young people focus more on rural areas and those with minimal or no education.

  12. Twenty Years of Evidence on the Outcomes of Malpractice Claims

    Science.gov (United States)

    2008-01-01

    Two decades of social science research on the outcomes of medical malpractice claims show malpractice outcomes bear a surprisingly good correlation with the quality of care provided to the patient as judged by other physicians. Physicians win 80% to 90% of the jury trials with weak evidence of medical negligence, approximately 70% of the borderline cases, and even 50% of the trials in cases with strong evidence of medical negligence. With only one exception, all of the studies of malpractice settlements also find a correlation between the odds of a settlement payment and the quality of care provided to the plaintiff. Between 80% and 90% of the claims rated as defensible are dropped or dismissed without payment. In addition, the amount paid in settlement drops as the strength of the patient’s evidence weakens. PMID:19048355

  13. The latest radiation instrument

    International Nuclear Information System (INIS)

    Kang, Se Sik; Gwon, Dal Gwan; Kim, Gyeong Geum

    2008-08-01

    This book deals with the latest radiation instrument, which is comprised of eight chapters. It explains X rays instrument for medial treatment, X-ray tube instrument and permissible burden with its history, structure and characteristic high voltage apparatus with high voltage rectifier circuit, X-ray control apparatus for medical treatment, X-ray image equipment X-ray television apparatus and CCD 205, X-ray apparatus of install and types, Digital X-ray apparatus with CR 261 and DR 269, performance management on X-ray for medical treatment with its history, necessity and management in the radiation field.

  14. The latest general chemistry

    International Nuclear Information System (INIS)

    Ryu, Geun Bae; Choi, Se Yeong; Kim, Chin Yeong; Yoon, Gil Jung; Lee, Eun Seok; Seo, Moon Gyu

    1995-02-01

    This book deals with the latest general chemistry, which is comprised of twenty-three chapters, the contents of this book are introduction, theory of atoms and molecule, chemical formula and a chemical reaction formula, structure of atoms, nature of atoms and the periodic table, structure of molecule and spectrum, gas, solution, solid, chemical combination, chemical reaction speed, chemical equilibrium, thermal chemistry, oxidation-reduction, electrochemistry, acid-base, complex, aquatic chemistry, air chemistry, nuclear chemistry, metal and nonmetal, organic chemistry and biochemistry. It has exercise in the end of each chapter.

  15. Latest results from LUNA

    Science.gov (United States)

    Depalo, Rosanna; LUNA Collaboration

    2018-01-01

    A precise knowledge of the cross section of nuclear fusion reactions is a crucial ingredient in understanding stellar evolution and nucleosynthesis. At stellar temperatures, fusion cross sections are extremely small and difficult to measure. Measuring nuclear cross sections at astrophysical energies is a challenge that triggered a huge amount of experimental work. A breakthrough in this direction was the first operation of an underground accelerator at the Laboratory for Underground Nuclear Astrophysics (LUNA) in Gran Sasso, Italy. The 1400 meters of rocks above the laboratory act as a natural shield against cosmic radiation, suppressing the background by orders of magnitude. The latest results achieved at LUNA are discussed, with special emphasis on the 22Ne(p,γ)23Na reaction. Future perspectives of the LUNA experiment are also illustrated.

  16. ADHD, Multimodal Treatment, and Longitudinal Outcome: Evidence, Paradox, and Challenge.

    Science.gov (United States)

    Hinshaw, Stephen P; Arnold, L Eugene

    2015-01-01

    Given major increases in the diagnosis of attention-deficit hyperactivity disorder (ADHD) and in rates of medication for this condition, we carefully examine evidence for effects of single versus multimodal (i.e., combined medication and psychosocial/behavioral) interventions for ADHD. Our primary data source is the Multimodal Treatment Study of Children with ADHD (MTA), a 14-month, randomized clinical trial in which intensive behavioral, medication, and multimodal treatment arms were contrasted with one another and with community intervention (treatment-as-usual), regarding outcome domains of ADHD symptoms, comorbidities, and core functional impairments. Although initial reports emphasized the superiority of well-monitored medication for symptomatic improvement, reanalyses and reappraisals have highlighted (a) the superiority of combination treatment for composite outcomes and for domains of functional impairment (e.g., academic achievement, social skills, parenting practices); (b) the importance of considering moderator and mediator processes underlying differential patterns of outcome, including comorbid subgroups and improvements in family discipline style during the intervention period; (c) the emergence of side effects (e.g., mild growth suppression) in youth treated with long-term medication; and (d) the diminution of medication's initial superiority once the randomly assigned treatment phase turned into naturalistic follow-up. The key paradox is that whereas ADHD clearly responds to medication and behavioral treatment in the short term, evidence for long-term effectiveness remains elusive. We close with discussion of future directions and a call for greater understanding of relevant developmental processes in the attempt to promote optimal, generalized, and lasting treatments for this important and impairing neurodevelopmental disorder.

  17. 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.

  18. Immigration Ethnic Diversity and Political Outcomes: Evidence from Denmark

    DEFF Research Database (Denmark)

    Harmon, Nikolaj Arpe

    I study the impact of immigration and increasing ethnic diversity on political outcomes in immigrant-receiving countries, focusing on immigration and election outcomes in Danish municipalities 1981-2001. A rich set of control variables isolates ethnic diversity effects from those of other immigrant...... characteristics and a novel IV strategy based on historical housing stock data addresses issues of endogenous location choices of immigrants. Increases in local ethnic diversity lead to right-ward shifts in election outcomes by shifting electoral support away from traditional "big government" left-wing parties...... and towards anti-immigrant nationalist parties in particular. These effects appear in both local and national elections....

  19. Healthcare spending and health outcomes: evidence from selected ...

    African Journals Online (AJOL)

    Conclusion: The results of this study have important policy and management implications for the eight East African .... care expenditures and health outcomes in Middle Eastern .... 2 shows that our data is free of outliers, which allows us.

  20. Alternative outcomes create biased expectations regarding the received outcome: Evidence from event-related potentials.

    Science.gov (United States)

    Marciano, Déborah; Bentin, Shlomo; Deouell, Leon Y

    2018-05-01

    After choosing between uncertain options, one might get feedback on both the outcome of the chosen option and the outcome of the unchosen option (the alternative). Behavioral research has shown that in such cases people engage in outcome comparison, and that the alternative outcome influences the way one evaluates his own received outcome. Moreover, this influence differs whether one was responsible or not for the choice made. In two studies, we looked for the electrophysiological correlates of outcome comparison. Subjects chose one of two boxes shown on the screen, each box contained a gain or a loss. The alternative outcome was always revealed first, followed by the received outcome. In half of the trials the software picked one box instead of subjects. We tested whether the feedback-related negativity (FRN) and the P3 elicited by the received reflect outcome comparison. As expected, we found that the FRN and P3 were more positive when the received outcome was a gain (vs. a loss). The FRN and P3 were also sensitive to the value of the alternative outcome, but contrary to our predictions, they were more positive when the alternative outcome was a gain (vs. a loss). As the FRN and P3 are sensitive to expectations, we hypothesized that our findings might result from subjects' biased expectations: subjects might have wrongly believed that a good (bad) alternative outcome signaled a bad (good) received outcome. This hypothesis, coined as the Alternative Omen Effect, was confirmed in parallel in a series of behavioral experiments: people see an illusory negative correlation between the uncorrelated outcomes of choice options (reported in Marciano-Romm et al. (2016)). A challenge for future research will be to disentangle the effects of expectation from those of outcome comparison. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. Latest results from EXO-200

    International Nuclear Information System (INIS)

    TOSI, D.

    2014-01-01

    The Enriched Xenon Observatory (EXO) is an experimental program searching for neutrino-less double beta decay in xenon-136. The first stage of this program, EXO-200, has been in operation since early 2011. I present here the latest physics results from the experiment.

  2. Childhood maltreatment and educational outcomes: evidence from South Africa.

    Science.gov (United States)

    Pieterse, Duncan

    2015-07-01

    Many South African children experience maltreatment, but we know little about the effects on long-term child development. Using the only representative dataset that includes a module on childhood maltreatment for a metropolitan city in South Africa, we explore the association between different measures of childhood maltreatment and two educational outcomes (numeracy test scores and dropout). Our study provides an estimate of the association between childhood maltreatment and educational outcomes in a developing country where maltreatment is high. We control for potential confounders using a range of statistical techniques and add several robustness checks to evaluate the strength of our findings. Our results indicate that children who are maltreated suffer large adverse consequences in terms of their numeracy test scores and probability of dropout and that the estimated effects of maltreatment are larger and more consistent for the most severe type of maltreatment. Copyright © 2014 John Wiley & Sons, Ltd.

  3. Improving the use of research evidence in guideline development: 6. Determining which outcomes are important

    Directory of Open Access Journals (Sweden)

    Fretheim Atle

    2006-12-01

    Full Text Available Abstract Background The World Health Organization (WHO, like many other organisations around the world, has recognised the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the sixth of a series of 16 reviews that have been prepared as background for advice from the WHO Advisory Committee on Health Research to WHO on how to achieve this. Objectives We reviewed the literature on determining which outcomes are important for the development of guidelines. Methods We searched five databases of methodological studies for existing systematic reviews and relevant methodological research. We did not conduct a complete systematic review ourselves. Our conclusions are based on the available evidence, consideration of what WHO and other organisations are doing and logical arguments. Key questions and answers We did not find a systematic review that addresses any of the following key questions and we found limited relevant research evidence. What methods should WHO use to identify important outcomes? • Methods of outcome identification should be transparent and explicit. • The consultation process should start with identification of all relevant outcomes associated with an intervention. • Those affected, including consumers, should be involved in the selection of outcomes. • A question driven approach (what is important? is preferable to a data driven approach (what data are at hand? to identify important outcomes. What type of outcomes should WHO consider and how should cultural diversity be taken account of in the selection of outcomes? • Desirable (benefits, less burden and savings and undesirable effects should be considered in all guidelines. • Undesirable effects include harms (including the possibility of unanticipated adverse effects, greater burden (e.g. having to go to the doctor and costs (including opportunity costs. • Important outcomes (e

  4. Financial Literacy and Economic Outcomes: Evidence and Policy Implications.

    Science.gov (United States)

    Mitchell, Olivia S; Lusardi, Annamaria

    2015-01-01

    This paper reviews what we have learned over the past decade about financial literacy and its relationship to financial decision-making around the world. Using three questions, we have surveyed people in several countries to determine whether they have the fundamental knowledge of economics and finance needed to function as effective decision-makers. We find that levels of financial literacy are low not only in the United States. but also in many other countries including those with well-developed financial markets. Moreover, financial illiteracy is particularly acute for some demographic groups, especially women and the less-educated. These findings are important since financial literacy is linked to borrowing, saving, and spending patterns. We also offer new evidence on financial literacy among high school students drawing on the 2012 Programme for International Student Assessment implemented in 18 countries. Last, we discuss the implications of this research for policy.

  5. The latest electrical installation (I)

    International Nuclear Information System (INIS)

    Won, Jong Su

    1976-04-01

    This book deals with the latest electrical installation. The contents of this book are construction electrical installation, regulations related electrical installation, foundation and principle of wiring, main line feeder, lighting installation, power of wiring, main line feeder, lighting installation, power installation, method to read structure drawing for electrical construct drawing electric lamp wiring diagram, working drawing, material and tools and method of construction of electrical installation on types of wiring construction, metallic conduit, rigid poly-vinyl conduit wiring, bus duct work, cable work and insulation out of metal lathed.

  6. Tiotropium in COPD: clinical outcomes and economic evidence

    Directory of Open Access Journals (Sweden)

    Orietta Zaniolo

    2010-03-01

    Full Text Available Tiotropium bromide is a once-daily anticholinergic bronchodilator with duration of action of at least 24 hours. In clinical trials, tiotropium has been compared with placebo, ipratropium or salmeterol, the most frequently used long-acting β2 agonist. When compared with ipratropium or placebo in COPD management, tiotropium resulted associated with FEV1, dyspnoea and health-related quality of life (QoL improvement, along with reduced exacerbation and hospitalisation rates. In comparison to salmeterol, it proved to be superior in terms of lung function improvement and exacerbation risk reduction. Recently, the randomised, double-blind trial UPLIFT showed that 4 years of therapy with tiotropium were associated with improvements in lung function, QoL, and exacerbations, and with an effective reduction of mortality compared with control group in 5,993 patients with moderate to very-severe COPD. These encouraging clinical effects are to be traded against the pharmaceutical cost increase induced by the inclusion of tiotropium in routine care. However, published work indicates that this pharmaceutical cost increase may be totally or partially offset by the reduction in costs needed for exacerbations management and hospitalisations. Depending on the setting analysed, tiotropium is estimated to dominate ipratropium and salmeterol or to be associated with an incremental cost of less than € 2,500 per exacerbation avoided. An Italian model based on UPLIFT data shows that therapy including tiotropium induces an incremental cost of € 6,700 for year of life and of € 7,916 for Quality-adjusted Life Year gained, with respect to routine care alone. These values are much lower than commonly accepted thresholds and than cost/effectiveness results estimated for other long-acting bronchodilators. In conclusion, available evidence suggests that tiotropium may prove an appropriate therapeutic option with a largely affordable cost.

  7. PREVAIL: latest electron optics results

    Science.gov (United States)

    Pfeiffer, Hans C.; Golladay, Steven D.; Gordon, Michael S.; Kendall, Rodney A.; Lieberman, Jon E.; Rockrohr, James D.; Stickel, Werner; Yamaguchi, Takeshi; Okamoto, Kazuya; Umemoto, Takaaki; Shimizu, Hiroyasu; Kojima, Shinichi; Hamashima, Muneki

    2002-07-01

    The PREVAIL electron optics subsystem developed by IBM has been installed at Nikon's facility in Kumagaya, Japan, for integration into the Nikon commercial EPL stepper. The cornerstone of the electron optics design is the Curvilinear Variable Axis Lens (CVAL) technique originally demonstrated with a proof of concept system. This paper presents the latest experimental results obtained with the electron optical subsystem at Nikon's facility. The results include micrographs illustrating proper CVAL operation through the spatial resolution achieved over the entire optical field of view. They also include data on the most critical issue of the EPL exposure approach: subfield stitching. The methodology of distortion correction will be described and both micrographs and metrology data of stitched subfields will be presented. This paper represents a progress report of the IBM/Nikon alliance activity on EPL.

  8. Artificial sensory organs: latest progress.

    Science.gov (United States)

    Nakamura, Tatsuo; Inada, Yuji; Shigeno, Keiji

    2018-03-01

    This study introduces the latest progress on the study of artificial sensory organs, with a special emphasis on the clinical results of artificial nerves and the concept of in situ tissue engineering. Peripheral nerves have a strong potential for regeneration. An artificial nerve uses this potential to recover a damaged peripheral nerve. The polyglycolic acid collagen tube (PGA-C tube) is a bio-absorbable tube stuffed with collagen of multi-chamber structure that consists of thin collagen films. The clinical application of the PGA-C tube began in 2002 in Japan. The number of PGA-C tubes used is now beyond 300, and satisfactory results have been reported on peripheral nerve repairs. This PGA-C tube is also effective for patients suffering from neuropathic pain.

  9. Touch DNA collection versus firearm fingerprinting: comparing evidence production and identification outcomes.

    Science.gov (United States)

    Nunn, Samuel

    2013-05-01

    A project by a metropolitan police agency in 2008-2009 had police use touch DNA kits to collect cell samples from seized firearms. To assess outcomes, results of touch DNA swabbing of firearms were compared to fingerprinting firearm evidence. The rationale was that fingerprinting, as the older technology, was the baseline against which to compare touch DNA. But little is known about ways to measure touch DNA productivity compared to fingerprinting. To examine differences between the two requires comparable measurements. Two measures were used: quantity of probative or investigative evidence produced and identification outcomes. When applied to firearms seized within an Indianapolis, IN police district, touch DNA produced a larger volume of evidence than fingerprinting, but identification outcomes for the two methods were equal. Because touch DNA was deployed by police patrol officers, there are implications for firearm forensics and the choice of forensic approaches used by police. © 2013 American Academy of Forensic Sciences.

  10. Further evidence for periodontal disease as a risk indicator for adverse pregnancy outcomes.

    Science.gov (United States)

    Turton, Mervyn; Africa, Charlene W J

    2017-06-01

    Although there is increasing evidence to suggest an association between periodontal disease and adverse pregnancy outcomes, the issue remains controversial. This study tested the hypothesis that periodontal disease is a risk indicator for preterm delivery of low-birthweight infants. The study sample comprised 443 pregnant women with a mean (± standard deviation) age of 24.13 (±5.30) years. At first visit, maternal oral health status was assessed by the measurement of probing pocket depth and clinical attachment loss, and periodontal status was graded as absent, mild, moderate or severe. An association was sought between pregnancy outcomes and maternal periodontal status. While controlling for other factors, significant associations were found between pregnancy outcomes and maternal periodontal index scores. This study provides further evidence that periodontal disease is a risk indicator for adverse pregnancy outcomes. © 2016 FDI World Dental Federation.

  11. The latest figures on uranium

    International Nuclear Information System (INIS)

    Vance, R.

    2010-01-01

    According to the latest figures on uranium, soon to be published by the NEA, uranium resources, production and demand are all on the rise. Exploration efforts have increased recently in line with the expected expansion of nuclear energy in the coming years. Total identified resources have grown and are now sufficient to cover 100 years of supply at 2008 rates of consumption. Costs of production have, however, also increased. This article is based on the latest edition of the 'Red Book', Uranium 2009: Resources, Production and Demand, which presents the results of the most recent biennial review of world uranium market fundamentals and a statistical profile of the world uranium industry as of 1 January 2009. It contains official data provided by OECD Nuclear Energy Agency (NEA) and International Atomic Energy Agency (IAEA) member countries on uranium exploration, resources, production and reactor-related requirements. Projections of nuclear generating capacity and reactor-related uranium requirements through 2035 are also provided as well as a discussion of long-term uranium supply and demand issues. Despite recent declines stemming from the global financial crisis, world demand for electricity is expected to continue to grow significantly over the next several decades to meet the needs of an increasing population and economic growth. The recognition by an increasing number of governments that nuclear power can produce competitively priced, base-load electricity that is essentially free of greenhouse gas emissions, coupled with the role that nuclear can play in enhancing security of energy supply, increases the prospects for growth in nuclear generating capacity, although the magnitude of that growth remains to be determined. Regardless of the role that nuclear energy ultimately plays in meeting rising electricity demand, the uranium resource base is more than adequate to meet projected requirements. Meeting even high-case requirements to 2035 would consume less

  12. Zika virus: the latest newcomer

    Directory of Open Access Journals (Sweden)

    Juan-Carlos eSaiz

    2016-04-01

    Full Text Available Since the beginning of this century, humanity has been facing a new emerging, or re-emerging, virus threat almost every year: West Nile, Influenza A, avian flu, dengue, Chikungunya, SARS, MERS, Ebola, and now Zika, the latest newcomer. Zika virus (ZIKV, a flavivirus transmitted by Aedes mosquitoes, was identified in 1947 in a sentinel monkey in Uganda, and later on in humans in Nigeria. The virus was mainly confined to the African continent until it was detected in south-east Asia the 1980´s, then in the Micronesia in 2007 and, more recently in the Americas in 2014, where it has displayed an explosive spread, as advised by the World Health Organization (WHO, which resulted in the infection of hundreds of thousands of people. ZIKV infection was characterized by causing a mild disease presented with fever, headache, rash, arthralgia, and conjunctivitis, with exceptional reports of an association with Guillain-Barre syndrome (GBS and microcephaly. However, since the end of 2015, an increase in the number of GBS associated cases and an astonishing number of microcephaly in foetus and new-borns in Brazil have been related to ZIKV infection, raising serious worldwide public health concerns. Clarifying such worrisome relationships is, thus, a current unavoidable goal. Here, we extensively review what is currently known about ZIKV, from molecular biology, transmission routes, ecology and epidemiology, to clinical manifestations, pathogenesis, diagnosis, prophylaxis and public health.

  13. Latest design of gate valves

    Energy Technology Data Exchange (ETDEWEB)

    Kurzhofer, U.; Stolte, J.; Weyand, M.

    1996-12-01

    Babcock Sempell, one of the most important valve manufacturers in Europe, has delivered valves for the nuclear power industry since the beginning of the peaceful application of nuclear power in the 1960s. The latest innovation by Babcock Sempell is a gate valve that meets all recent technical requirements of the nuclear power technology. At the moment in the United States, Germany, Sweden, and many other countries, motor-operated gate and globe valves are judged very critically. Besides the absolute control of the so-called {open_quotes}trip failure,{close_quotes} the integrity of all valve parts submitted to operational forces must be maintained. In case of failure of the limit and torque switches, all valve designs have been tested with respect to the quality of guidance of the gate. The guidances (i.e., guides) shall avoid a tilting of the gate during the closing procedure. The gate valve newly designed by Babcock Sempell fulfills all these characteristic criteria. In addition, the valve has cobalt-free seat hardfacing, the suitability of which has been proven by friction tests as well as full-scale blowdown tests at the GAP of Siemens in Karlstein, West Germany. Babcock Sempell was to deliver more than 30 gate valves of this type for 5 Swedish nuclear power stations by autumn 1995. In the presentation, the author will report on the testing performed, qualifications, and sizing criteria which led to the new technical design.

  14. The Latest Books on Globalization

    Directory of Open Access Journals (Sweden)

    Elia Zaru

    2016-12-01

    Full Text Available The latest books published on globalization raise interesting issues which reflect upon the very complexity of the process we are facing. In The Great Convergence: Information Technology and the New Globalization Richard Baldwin proposes a history of globalization divided into two stages. As Baldwin argues, the process of globalization has to be divided into “old” and “new” age. The “old” globalization took place between 1820 and 1990. It was characterized by the “great divergence”, that is by the centralization of world income in today’s wealthy nations. However, since 1990 the sharing of world income has plummeted to where it was in 1900. According to Baldwin, this reversal of fortune is a symptom of a shift in the globalization process. The “new” globalization, driven by information technology, has combined high tech with low wages, and lead simultaneously to the industrialization of developing nations and deindustrialization of developed ones. This is the “great convergence”: in the “new” globalization rich and developing nations are alike and they face equal global challenges.

  15. What is the impact of professional nursing on patients' outcomes globally? An overview of research evidence.

    Science.gov (United States)

    Coster, Samantha; Watkins, Mary; Norman, Ian J

    2018-02-01

    Nursing is an integral part of all healthcare services, and has the potential of having a wide and enduring impact on health outcomes for a global ageing population. Over time nurses have developed new roles and assumed greater responsibilities. It is increasingly important to demonstrate the safety and overall impact of nurses' practice through research, to support the case for greater investment and development of nursing services around the world. To provide an overview of existing research evidence on the impact of nursing on patient outcomes, identify gaps in evidence, and point to future priorities for global research. Specifically to address two questions: what is the evidence that nursing contributes to improving the health and well-being of populations?; and where should research activity be focused to strengthen the evidence base for the impact of nursing? A search of the literature from 1996 using CINAHL, MEDLINE, the Cochrane Library, Google Scholar and the NICE evidence databases using the key words: nursing, nurse led, nursing interventions and patient outcomes. Initial analysis of the retrieved citations to reveal clusters of evidence of nursing impact in clinical areas which had been subject to systematic/integrative reviews or meta-analyses. Further analysis of these reviews to provide an overview of the research evidence for nurses' contributions to healthcare to inform discussion on future research agendas. We use the terms low, moderate and high quality evidence to reflect the assessments made by the review authors whose work is presented throughout. Analysis of 61 reviews, including ten Cochrane reviews and two scoping/selective reviews to provide a summary of the research evidence for nurses' contributions to healthcare in the following areas of practice: nursing in acute care settings; nurses' involvement in public health; the contribution of specialist nurse and nurse-led services to the management of chronic disease; comparison of care

  16. Situational and Generalised Conduct Problems and Later Life Outcomes: Evidence from a New Zealand Birth Cohort

    Science.gov (United States)

    Fergusson, David M.; Boden, Joseph M.; Horwood, L. John

    2009-01-01

    Background: There is considerable evidence suggesting that many children show conduct problems that are specific to a given context (home; school). What is less well understood is the extent to which children with situation-specific conduct problems show similar outcomes to those with generalised conduct problems. Methods: Data were gathered as…

  17. A note on risk aversion and labour market outcomes: further evidence from German survey data

    OpenAIRE

    Pfeifer, Christian

    2008-01-01

    Using the large-scale German Socio-Economic Panel, this note reports direct empirical evidence for significant correlations between risk aversion and labour market outcomes (full-time employment, temporary agency work, fixed-term contracts, employer change, quits, training, wages, and job satisfaction).

  18. SCIRehab uses practice-based evidence methodology to associate patient and treatment characteristics with outcomes.

    Science.gov (United States)

    Whiteneck, Gale G; Gassaway, Julie

    2013-04-01

    To describe the application of practice-based evidence (PBE) methodology to spinal cord injury (SCI) rehabilitation in the SCIRehab study, and to summarize associations of patient characteristics and treatment interventions to outcomes. Prospective observational study. Six SCI rehabilitation centers. Patients with traumatic SCI (N=1376) admitted for first rehabilitation. Not applicable. FIM and residence at discharge, and FIM, residence, Craig Handicap Assessment and Reporting Technique, work/school status, Patient Health Questionnaire-9, Diener Satisfaction with Life Scale, rehospitalization, and presence of pressure ulcers at 1 year postinjury. Patient demographic and injury characteristics explained significant variation in rehabilitation outcomes, particularly functional outcomes. Regression modeling also identified a large number of significant associations with outcomes when total time in each discipline was modeled and when models were developed for each discipline, examining time spent in the many specific interventions provided by each discipline. The application of PBE methodology in the SCIRehab study provided extensive information about the process of inpatient SCI rehabilitation. While patient demographic and injury characteristics explain substantial variation in rehabilitation outcomes, particularly functional outcomes, significant relations also were found between the type and quantity of treatment interventions delivered by each rehabilitation discipline and a broad range of outcomes. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  19. Teamwork assessment in internal medicine: a systematic review of validity evidence and outcomes.

    Science.gov (United States)

    Havyer, Rachel D A; Wingo, Majken T; Comfere, Nneka I; Nelson, Darlene R; Halvorsen, Andrew J; McDonald, Furman S; Reed, Darcy A

    2014-06-01

    Valid teamwork assessment is imperative to determine physician competency and optimize patient outcomes. We systematically reviewed published instruments assessing teamwork in undergraduate, graduate, and continuing medical education in general internal medicine and all medical subspecialties. We searched MEDLINE, MEDLINE In-process, CINAHL and PsycINFO from January 1979 through October 2012, references of included articles, and abstracts from four professional meetings. Two content experts were queried for additional studies. Included studies described quantitative tools measuring teamwork among medical students, residents, fellows, and practicing physicians on single or multi-professional (interprofessional) teams. Instrument validity and study quality were extracted using established frameworks with existing validity evidence. Two authors independently abstracted 30 % of articles and agreement was calculated. Of 12,922 citations, 178 articles describing 73 unique teamwork assessment tools met inclusion criteria. Interrater agreement was intraclass correlation coefficient 0.73 (95 % CI 0.63-0.81). Studies involved practicing physicians (142, 80 %), residents/fellows (70, 39 %), and medical students (11, 6 %). The majority (152, 85 %) assessed interprofessional teams. Studies were conducted in inpatient (77, 43 %), outpatient (42, 24 %), simulation (37, 21 %), and classroom (13, 7 %) settings. Validity evidence for the 73 tools included content (54, 74 %), internal structure (51, 70 %), relationships to other variables (25, 34 %), and response process (12, 16 %). Attitudes and opinions were the most frequently assessed outcomes. Relationships between teamwork scores and patient outcomes were directly examined for 13 (18 %) of tools. Scores from the Safety Attitudes Questionnaire and Team Climate Inventory have substantial validity evidence and have been associated with improved patient outcomes. Review is limited to quantitative assessments of teamwork in internal

  20. Neighborhood Quality and Labor Market Outcomes: Evidence from Quasi-Random Neighborhood Assignment of Immigrants

    DEFF Research Database (Denmark)

    Damm, Anna Piil

    2012-01-01

    of men living in the neighborhood, but positively affected by the employment rate of non-Western immigrant men and co-national men living in the neighborhood. This is strong evidence that immigrants find jobs in part through their employed immigrant and co-ethnic contacts in the neighborhood of residence...... successfully addresses the methodological problem of endogenous neighborhood selection. Taking account of location sorting, living in a socially deprived neighborhood does not affect labor market outcomes of refugee men. Furthermore, their labor market outcomes are not affected by the overall employment rate...

  1. [Latest advances in acute pancreatitis].

    Science.gov (United States)

    de-Madaria, Enrique

    2013-10-01

    The present article analyzes the main presentations on acute pancreatitis (AP) in Digestive Disease Week 2013. Perfusion computed tomography allows early diagnosis of pancreatic necrosis. Neutrophil gelatinase-associated lipocalin predicts the development of acute renal failure, severe AP and death. Factors associated with greater fluid sequestration in AP are alcoholic etiology, an elevated hematocrit, and the presence of criteria of systemic inflammatory response syndrome; fluid sequestration is associated with a worse outcome. True pseudocysts (fluid collections without necrosis for more than 4 weeks) are a highly infrequent complication in AP. Patients with necrotic collections have a poor prognosis, especially if associated with infection. A meta-analysis on fluid therapy suggests that early aggressive fluid administration is associated with higher mortality and more frequent respiratory complications. According to a meta-analysis, enteral nutrition initiated within 24 hours of admission improves the outcome of AP compared with later initiation of enteral nutrition. Pentoxifylline could be a promising alternative in AP; a double-blind randomized study showed that this drug reduced the length of hospital and intensive care unit stay, as well as the need for intensive care unit admission. The association of octreotide and celecoxib seems to reduce the frequency of organ damage compared with octreotide alone. Mild AP can be managed in the ambulatory setting through hospital-at-home units after a short, 24-hour admission. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  2. Association of Implementation of Practice Standards for Electrocardiographic Monitoring with Nurses’ Knowledge, Quality of Care, and Patient Outcomes: Findings from the Practical Use of the Latest Standards of Electrocardiography (PULSE) Trial

    Science.gov (United States)

    Funk, Marjorie; Fennie, Kristopher P.; Stephens, Kimberly E.; May, Jeanine L.; Winkler, Catherine G.; Drew, Barbara J.

    2017-01-01

    Background Although continuous electrocardiographic (ECG) monitoring is ubiquitous in hospitals, monitoring practices are inconsistent. We evaluated implementation of American Heart Association practice standards for ECG monitoring on nurses’ knowledge, quality of care, and patient outcomes. Methods and Results The PULSE Trial was a 6-year multi-site randomized clinical trial with crossover that took place in 65 cardiac units in 17 hospitals. We measured outcomes at baseline, Time 2 after Group 1 hospitals received the intervention, and Time 3 after Group 2 hospitals received the intervention. Measurement periods were 15 months apart. The 2-part intervention consisted of an online ECG monitoring education program and strategies to implement and sustain change in practice. Nurses’ knowledge (N=3,013 nurses) was measured by a validated 20-item online test, quality of care related to ECG monitoring (N=4,587 patients) by on-site observation, and patient outcomes (mortality, in-hospital myocardial infarction, and not surviving a cardiac arrest) (N=95,884 hospital admissions) by review of administrative, laboratory, and medical record data. Nurses’ knowledge improved significantly immediately following the intervention in both groups, but was not sustained 15 months later. For most measures of quality of care (accurate electrode placement, accurate rhythm interpretation, appropriate monitoring, and ST-segment monitoring when indicated), the intervention was associated with significant improvement, which was sustained 15 months later. Of the 3 patient outcomes, only in-hospital myocardial infarction declined significantly after the intervention, and was sustained. Conclusions Online ECG monitoring education and strategies to change practice can lead to improved nurses’ knowledge, quality of care, and patient outcomes. PMID:28174175

  3. Physiotherapy and low back pain - part 1 outcomes research in the quest for evidence

    Directory of Open Access Journals (Sweden)

    L. D. Bardin

    2002-01-01

    conditions treated by physiotherapists and is acknowledged as a major health problem. Much published research on LBP is of poor design and  optimal outcome measures are not selected for LBP patients. Effective and cost-effective interventions for LBP, particularly chronic LBP, need to be identified using appropriate, valid, reliable and responsive measures of  outcome.  These outcome measures should reflect the biopsychosocial model necessary for evaluating the broad impact of LBP, in particular chronic LBP, on a patient’s life. Outcomes research is a feasible and affordable analysis of clinical practice as it occurs, and provides an opportunity to evaluate the effectiveness of interventions for LBP. This is in contrast to a randomised, controlled trial (RCT that evaluates efficacy under controlled conditions that often do not reflect clinical practice. Using a battery of outcome measures appropriate for measuring change in the LBP population, outcomes research has the potential to identify effective and cost-effective interventions, promote and influence further research, and contribute to the demand for evidence-based practice.

  4. Outcome (competency) based education: an exploration of its origins, theoretical basis, and empirical evidence

    DEFF Research Database (Denmark)

    Mørcke, Anne Mette; Dornan, Tim; Eika, Berit

    2013-01-01

    and professional attributes as ‘‘competencies’’. OBE has been adopted by consensus in the face of weak empirical evidence. OBE, which has been advocated for over 50 years, can contribute usefully to defining requisite knowledge and skills, and blueprinting assessments. Its applicability to more complex aspects...... greatest benefits. Our aim was to explore the underpinnings of OBE: its historical origins, theoretical basis, and empirical evidence of its effects in order to answer the question: How can predetermined learning outcomes influence undergraduate medical education? This literature review had three...... components: A review of historical landmarks in the evolution of OBE; a review of conceptual frameworks and theories; and a systematic review of empirical publications from 1999 to 2010 that reported data concerning the effects of learning outcomes on undergraduate medical education. OBE had its origins...

  5. Evidence-based architectural and space design supports Magnet® empirical outcomes.

    Science.gov (United States)

    Ecoff, Laurie; Brown, Caroline E

    2010-12-01

    This department expands nursing leaders' knowledge and competencies in health facility design. The editor of this department, Dr Jaynelle Stichler, asked guest authors, Drs Ecoff and Brown, to describe the process of using the conceptual models of a nursing evidence-based practice model and the Magnet Recognition Program® as a structured process to lead decision making in the planning and design processes and to achieve desired outcomes in hospital design.

  6. Patient-Reported Outcome questionnaires for hip arthroscopy: a systematic review of the psychometric evidence

    Science.gov (United States)

    2011-01-01

    Background Hip arthroscopies are often used in the treatment of intra-articular hip injuries. Patient-reported outcomes (PRO) are an important parameter in evaluating treatment. It is unclear which PRO questionnaires are specifically available for hip arthroscopy patients. The aim of this systematic review was to investigate which PRO questionnaires are valid and reliable in the evaluation of patients undergoing hip arthroscopy. Methods A search was conducted in Pubmed, Medline, CINAHL, the Cochrane Library, Pedro, EMBASE and Web of Science from 1931 to October 2010. Studies assessing the quality of PRO questionnaires in the evaluation of patients undergoing hip arthroscopy were included. The quality of the questionnaires was evaluated by the psychometric properties of the outcome measures. The quality of the articles investigating the questionnaires was assessed by the COSMIN list. Results Five articles identified three questionnaires; the Modified Harris Hip Score (MHHS), the Nonarthritic Hip Score (NAHS) and the Hip Outcome Score (HOS). The NAHS scored best on the content validity, whereas the HOS scored best on agreement, internal consistency, reliability and responsiveness. The quality of the articles describing the HOS scored highest. The NAHS is the best quality questionnaire. The articles describing the HOS are the best quality articles. Conclusions This systematic review shows that there is no conclusive evidence for the use of a single patient-reported outcome questionnaire in the evaluation of patients undergoing hip arthroscopy. Based on available psychometric evidence we recommend using a combination of the NAHS and the HOS for patients undergoing hip arthroscopy. PMID:21619610

  7. Electronic patient portals: evidence on health outcomes, satisfaction, efficiency, and attitudes: a systematic review.

    Science.gov (United States)

    Goldzweig, Caroline Lubick; Orshansky, Greg; Paige, Neil M; Towfigh, Ali Alexander; Haggstrom, David A; Miake-Lye, Isomi; Beroes, Jessica M; Shekelle, Paul G

    2013-11-19

    Patient portals tied to provider electronic health record (EHR) systems are increasingly popular. To systematically review the literature reporting the effect of patient portals on clinical care. PubMed and Web of Science searches from 1 January 1990 to 24 January 2013. Hypothesis-testing or quantitative studies of patient portals tethered to a provider EHR that addressed patient outcomes, satisfaction, adherence, efficiency, utilization, attitudes, and patient characteristics, as well as qualitative studies of barriers or facilitators, were included. Two reviewers independently extracted data and addressed discrepancies through consensus discussion. From 6508 titles, 14 randomized, controlled trials; 21 observational, hypothesis-testing studies; 5 quantitative, descriptive studies; and 6 qualitative studies were included. Evidence is mixed about the effect of portals on patient outcomes and satisfaction, although they may be more effective when used with case management. The effect of portals on utilization and efficiency is unclear, although patient race and ethnicity, education level or literacy, and degree of comorbid conditions may influence use. Limited data for most outcomes and an absence of reporting on organizational and provider context and implementation processes. Evidence that patient portals improve health outcomes, cost, or utilization is insufficient. Patient attitudes are generally positive, but more widespread use may require efforts to overcome racial, ethnic, and literacy barriers. Portals represent a new technology with benefits that are still unclear. Better understanding requires studies that include details about context, implementation factors, and cost.

  8. Comparison and analysis of FDA reported visual outcomes of the three latest platforms for LASIK: wavefront guided Visx iDesign, topography guided WaveLight Allegro Contoura, and topography guided Nidek EC-5000 CATz

    Directory of Open Access Journals (Sweden)

    Moshirfar M

    2017-01-01

    Full Text Available Majid Moshirfar,1,2 Tirth J Shah,3 David Franklin Skanchy,4 Steven H Linn,1 Paul Kang,3 Daniel S Durrie5 1HDR Research Center, Hoopes Vision, Salt Lake City, UT, 2Department of Ophthalmology and Visual Sciences, John A Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, 3University of Arizona College of Medicine – Phoenix, Phoenix, AZ, 4McGovern Medical School, The University of Texas Health Science Center at Houston, TX, 5Durrie Vision, Kansas City, KS, USA Purpose: To compare and analyze the differences in visual outcomes between Visx iDesign Advanced WaveScan Studio™ System, Alcon Wavelight Allegro Topolyzer and Nidek EC-5000 using Final Fit™ Custom Ablation Treatment Software from the submitted summary of safety and effectiveness of the US Food and Drug Administration (FDA data.Methods: In this retrospective comparative study, 334 eyes from Visx iDesign, 212 eyes from Alcon Contour, and 135 eyes from Nidek CATz platforms were analyzed for primary and secondary visual outcomes. These outcomes were compared via side-by-side graphical and tabular representation of the FDA data. Statistical significance was calculated when appropriate to assess differences. A P-value <0.05 was considered statistically significant. Results: The mean postoperative uncorrected distance visual acuity (UDVA at 12 months was 20/19.25±8.76, 20/16.59±5.94, and 20/19.17±4.46 for Visx iDesign, Alcon Contoura, and Nidek CATz, respectively. In at least 90% of treated eyes at 3 months and 12 months, all three lasers showed either no change or a gain of corrected distance visual acuity (CDVA. Mesopic contrast sensitivity at 6 months showed a clinically significant increase of 41.3%, 25.1%, and 10.6% for eyes using Visx iDesign, Alcon Contoura, and Nidek CATz, respectively. Photopic contrast sensitivity at 6 months showed a clinically significant increase of 19.2%, 31.9%, and 10.6% for eyes using Visx iDesign, Alcon Contoura, and Nidek CATz

  9. Supersymmetry searches with ATLAS: overview and latest results

    CERN Multimedia

    CERN. Geneva

    2013-01-01

    Despite the absence of experimental evidence, weak scale supersymmetry remains one of the best motivated and studied Standard Model extensions. The ATLAS experiment searches for signs of supersymmetry in a large variety of signatures involving events with abnormal production of missing transverse momentum, jets, leptons, photons, third generation fermions, gauge bosons or massive long-lived particles. The talk presents the latest results obtained in these searches.

  10. Latest news on SUSY from the ATLAS experiment

    CERN Multimedia

    CERN. Geneva

    2016-01-01

    Despite the absence of experimental evidence, weak scale supersymmetry remains one of the best motivated and studied Standard Model extensions. This talk reports the latest ATLAS results for searches for supersymmetric (SUSY) particles, obtained with 13 to 18 fb-1 of 13 TeV data. Weak and strong production in both R-Parity conserving and R-Parity violating SUSY scenarios are considered. The searches involved final states including jets, missing transverse momentum, light leptons, taus or photons.

  11. Health-related quality of life outcomes and level of evidence in pediatric neurosurgery.

    Science.gov (United States)

    Hansen, Daniel; Vedantam, Aditya; Briceño, Valentina; Lam, Sandi K; Luerssen, Thomas G; Jea, Andrew

    2016-10-01

    OBJECTIVE The emphasis on health-related quality of life (HRQOL) outcomes is increasing, along with an emphasis on evidence-based medicine. However, there is a notable paucity of validated HRQOL instruments for the pediatric population. Furthermore, no standardization or consensus currently exists concerning which HRQOL outcome measures ought to be used in pediatric neurosurgery. The authors wished to identify HRQOL outcomes used in pediatric neurosurgery research over the past 10 years, their frequency, and usage trends. METHODS Three top pediatric neurosurgical journals were reviewed for the decade from 2005 to 2014 for clinical studies of pediatric neurosurgical procedures that report HRQOL outcomes. Similar studies in the peer-reviewed journal Pediatrics were also used as a benchmark. Publication year, level of evidence, and HRQOL outcomes were collected for each article. RESULTS A total of 31 HRQOL studies were published in the pediatric neurosurgical literature over the study period. By comparison, there were 55 such articles in Pediatrics. The number of publications using HRQOL instruments showed a significant positive trend over time for Pediatrics (B = 0.62, p = 0.02) but did not increase significantly over time for the 3 neurosurgical journals (B = 0.12, p = 0.5). The authors identified a total of 46 different HRQOL instruments used across all journals. Within the neurosurgical journals, the Hydrocephalus Outcome Questionnaire (HOQ) (24%) was the most frequently used, followed by the Health Utilities Index (HUI) (16%), the Pediatric Quality of Life Inventory (PedsQL) (12%), and the 36-Item Short Form Health Survey (SF-36) (12%). Of the 55 articles identified in Pediatrics, 22 (40%) used a version of the PedsQL. No neurosurgical study reached above Level 4 on the Oxford Centre for Evidence-Based Medicine (OCEBM) system. However, multiple studies from Pediatrics achieved OCEBM Level 3, several were categorized as Level 2, and one reached Level 1

  12. Investigating Climate Compatible Development Outcomes and their Implications for Distributive Justice: Evidence from Malawi

    Science.gov (United States)

    Wood, Benjamin T.; Quinn, Claire H.; Stringer, Lindsay C.; Dougill, Andrew J.

    2017-09-01

    Governments and donors are investing in climate compatible development in order to reduce climate and development vulnerabilities. However, the rate at which climate compatible development is being operationalised has outpaced academic enquiry into the concept. Interventions aiming to achieve climate compatible development "wins" (for development, mitigation, adaptation) can also create negative side-effects. Moreover, benefits and negative side-effects may differ across time and space and have diverse consequences for individuals and groups. Assessments of the full range of outcomes created by climate compatible development projects and their implications for distributive justice are scarce. This article develops a framework using a systematic literature review that enables holistic climate compatible development outcome evaluation over seven parameters identified. Thereafter, we explore the outcomes of two donor-funded projects that pursue climate compatible development triple-wins in Malawi using this framework. Household surveys, semi-structured interviews and documentary material are analysed. Results reveal that uneven outcomes are experienced between stakeholder groups and change over time. Although climate compatible development triple-wins can be achieved through projects, they do not represent the full range of outcomes. Ecosystem—and community-based activities are becoming popularised as approaches for achieving climate compatible development goals. However, findings suggest that a strengthened evidence base is required to ensure that these approaches are able to meet climate compatible development goals and further distributive justice.

  13. Contribution of health workforce to health outcomes: empirical evidence from Vietnam.

    Science.gov (United States)

    Nguyen, Mai Phuong; Mirzoev, Tolib; Le, Thi Minh

    2016-11-16

    In Vietnam, a lower-middle income country, while the overall skill- and knowledge-based quality of health workforce is improving, health workers are disproportionately distributed across different economic regions. A similar trend appears to be in relation to health outcomes between those regions. It is unclear, however, whether there is any relationship between the distribution of health workers and the achievement of health outcomes in the context of Vietnam. This study examines the statistical relationship between the availability of health workers and health outcomes across the different economic regions in Vietnam. We constructed a panel data of six economic regions covering 8 years (2006-2013) and used principal components analysis regressions to estimate the impact of health workforce on health outcomes. The dependent variables representing the outcomes included life expectancy at birth, infant mortality, and under-five mortality rates. Besides the health workforce as our target explanatory variable, we also controlled for key demographic factors including regional income per capita, poverty rate, illiteracy rate, and population density. The numbers of doctors, nurses, midwives, and pharmacists have been rising in the country over the last decade. However, there are notable differences across the different categories. For example, while the numbers of nurses increased considerably between 2006 and 2013, the number of pharmacists slightly decreased between 2011 and 2013. We found statistically significant evidence of the impact of density of doctors, nurses, midwives, and pharmacists on improvement to life expectancy and reduction of infant and under-five mortality rates. Availability of different categories of health workforce can positively contribute to improvements in health outcomes and ultimately extend the life expectancy of populations. Therefore, increasing investment into more equitable distribution of four main categories of health workforce

  14. Glaucoma: Symptoms, Diagnosis, Treatment and Latest Research

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Glaucoma Glaucoma: Symptoms, Diagnosis, Treatment and Latest Research Past Issues / Fall 2009 Table of Contents Symptoms and Diagnosis Glaucoma can develop in one or both eyes. Often ...

  15. Editorial: Latest methods and advances in biotechnology.

    Science.gov (United States)

    Lee, Sang Yup; Jungbauer, Alois

    2014-01-01

    The latest "Biotech Methods and Advances" special issue of Biotechnology Journal continues the BTJ tradition of featuring the latest breakthroughs in biotechnology. The special issue is edited by our Editors-in-Chief, Prof. Sang Yup Lee and Prof. Alois Jungbauer and covers a wide array of topics in biotechnology, including the perennial favorite workhorses of the biotech industry, Chinese hamster ovary (CHO) cell and Escherichia coli. Copyright © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  16. Nuclear trafficking latest statistics released

    International Nuclear Information System (INIS)

    2005-01-01

    Full text: Countries reported 121 incidents to the IAEA in 2004 of illicit trafficking and other unauthorized activities involving nuclear and other radioactive materials, newly released statistics from the Agency's Illicit Trafficking Database (ITDB) show. The ITDB report also shows that one incident was reported since 2003 that involved fissile material - highly enriched uranium (HEU) or plutonium - that is needed to make a nuclear weapon. It occurred in June 2003 when an individual was arrested in possession of 170 grams of HEU, attempting to illegally transport it across the border. During the two-year period 2003-2004, the number of incidents reported by States substantially increased compared with previous years. 'Improved reporting may in part account for it,' the report said. 'The majority of the incidents reported in 2003-2004 showed no evidence of criminal activity.' The Past Twelve Years: 1993 - 2004 Nuclear Weapons Grade Material. Since the database started in 1993, there have been eighteen confirmed incidents involving trafficking in HEU and plutonium. A few of these incidents involved seizures of kilogram quantities of weapons-usable nuclear material but most involved very small quantities. In some of the cases the seized material was allegedly a sample of larger quantities available for illegal sale or at risk of theft. More than two dozens incidents involved trace amounts of plutonium sources. Table can be viewed: Incidents involving HEU and Pu confirmed to the ITDB (1993-2004). Nuclear Materials. In the past twelve years, 220 incidents involved nuclear materials. The majority of confirmed cases with nuclear materials involved low-grade nuclear materials, mostly in the form of reactor fuel pellets, and natural uranium, depleted uranium and thorium. While the quantities of these materials have been rather small to be significant for nuclear proliferation or use in a terrorist nuclear explosive device, these cases are indicative of gaps in the control

  17. Volume and health outcomes: evidence from systematic reviews and from evaluation of Italian hospital data.

    Science.gov (United States)

    Amato, Laura; Fusco, Danilo; Acampora, Anna; Bontempi, Katia; Rosa, Alessandro Cesare; Colais, Paola; Cruciani, Fabio; D'Ovidio, Mariangela; Mataloni, Francesca; Minozzi, Silvia; Mitrova, Zuzana; Pinnarelli, Luigi; Saulle, Rosella; Soldati, Salvatore; Sorge, Chiara; Vecchi, Simona; Ventura, Martina; Davoli, Marina

    2017-01-01

    BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions. OBJECTIVES To identify conditions/interventions for which an association between volume and outcome has been investigated. To identify conditions/interventions for which an association between volume and outcome has been proved. To analyze the distribution of Italian health providers by volume of activity. To measure the association between volume of care and outcomes of the health providers of the Italian National Health Service (NHS). METHODS Systematic review An overview of systematic reviews was performed searching PubMed, EMBASE, and The Cochrane Library up to November 2016. Studies were evaluated by 2 researchers independently; quality assessment was performed using the AMSTAR checklist. For each health condition and outcome, if available, total number of studies, participants, high volume cut-off values, and metanalysis have been reported. According to the considered outcomes, health topics were classified into 3 groups: positive association: a positive association was demonstrated in the majority of studies/participants and/or a pooled measure (metanalysis) with positive results was reported; lack of association: both studies and/or metanalysis showed no association; no sufficient evidence of association: both results of single studies and metanalysis do not allow to draw firm conclusions

  18. Evidence on the Effectiveness of Water, Sanitation, and Hygiene (WASH Interventions on Health Outcomes in Humanitarian Crises: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Anita Ramesh

    Full Text Available Water, sanitation, and hygiene (WASH interventions are amongst the most crucial in humanitarian crises, although the impact of the different WASH interventions on health outcomes remains unclear.To examine the quantity and quality of evidence on WASH interventions on health outcomes in humanitarian crises, as well as evaluate current evidence on their effectiveness against health outcomes in these contexts.A systematic literature review was conducted of primary and grey quantitative literature on WASH interventions measured against health outcomes in humanitarian crises occurring from 1980-2014. Populations of interest were those in resident in humanitarian settings, with a focus on acute crisis and early recovery stages of humanitarian crises in low and middle-income countries. Interventions of interest were WASH-related, while outcomes of interest were health-related. Study quality was assessed via STROBE/CONSORT criteria. Results were analyzed descriptively, and PRISMA reporting was followed.Of 3963 studies initially retrieved, only 6 published studies measured a statistically significant change in health outcome as a result of a WASH intervention. All 6 studies employed point-of-use (POU water quality interventions, with 50% using safe water storage (SWS and 35% using household water treatment (HWT. All 6 studies used self-reported diarrhea outcomes, 2 studies also reported laboratory confirmed outcomes, and 2 studies reported health treatment outcomes (e.g. clinical admissions. 1 study measured WASH intervention success in relation to both health and water quality outcomes; 1 study recorded uptake (use of soap as well as health outcomes. 2 studies were unblinded randomized-controlled trials, while 4 were uncontrolled longitudinal studies. 2 studies were graded as providing high quality evidence; 3 studies provided moderate and 1 study low quality evidence.The current evidence base on the impact of WASH interventions on health outcomes in

  19. Evidence on the Effectiveness of Water, Sanitation, and Hygiene (WASH) Interventions on Health Outcomes in Humanitarian Crises: A Systematic Review.

    Science.gov (United States)

    Ramesh, Anita; Blanchet, Karl; Ensink, Jeroen H J; Roberts, Bayard

    2015-01-01

    Water, sanitation, and hygiene (WASH) interventions are amongst the most crucial in humanitarian crises, although the impact of the different WASH interventions on health outcomes remains unclear. To examine the quantity and quality of evidence on WASH interventions on health outcomes in humanitarian crises, as well as evaluate current evidence on their effectiveness against health outcomes in these contexts. A systematic literature review was conducted of primary and grey quantitative literature on WASH interventions measured against health outcomes in humanitarian crises occurring from 1980-2014. Populations of interest were those in resident in humanitarian settings, with a focus on acute crisis and early recovery stages of humanitarian crises in low and middle-income countries. Interventions of interest were WASH-related, while outcomes of interest were health-related. Study quality was assessed via STROBE/CONSORT criteria. Results were analyzed descriptively, and PRISMA reporting was followed. Of 3963 studies initially retrieved, only 6 published studies measured a statistically significant change in health outcome as a result of a WASH intervention. All 6 studies employed point-of-use (POU) water quality interventions, with 50% using safe water storage (SWS) and 35% using household water treatment (HWT). All 6 studies used self-reported diarrhea outcomes, 2 studies also reported laboratory confirmed outcomes, and 2 studies reported health treatment outcomes (e.g. clinical admissions). 1 study measured WASH intervention success in relation to both health and water quality outcomes; 1 study recorded uptake (use of soap) as well as health outcomes. 2 studies were unblinded randomized-controlled trials, while 4 were uncontrolled longitudinal studies. 2 studies were graded as providing high quality evidence; 3 studies provided moderate and 1 study low quality evidence. The current evidence base on the impact of WASH interventions on health outcomes in humanitarian

  20. Evidence, Goals, and Outcomes in Stuttering Treatment: Applications With an Adolescent Who Stutters.

    Science.gov (United States)

    Marcotte, Anne K

    2018-01-09

    The purpose of this clinical focus article is to summarize 1 possible process that a clinician might follow in designing and conducting a treatment program with John, a 14-year-old male individual who stutters. The available research evidence, practitioner experience, and consideration of individual preferences are combined to address goals, treatment procedures, and outcomes for John. The stuttering treatment research literature includes multiple well-designed reviews and individual studies that have shown the effectiveness of prolonged speech (and smooth speech and related variations) for improving stuttered speech and for improving social, emotional, cognitive, and related variables in adolescents who stutter. Based on that evidence, and incorporating the additional elements of practitioner experience and client preferences, this clinical focus article suggests that John would be likely to benefit from a treatment program based on prolonged speech. The basic structure of 1 possible such program is also described, with an emphasis on the goals and outcomes that John could be expected to achieve.

  1. Pediatric sexual assault nurse examiner care: trace forensic evidence, ano-genital injury, and judicial outcomes.

    Science.gov (United States)

    Hornor, Gail; Thackeray, Jonathan; Scribano, Philip; Curran, Sherry; Benzinger, Elizabeth

    2012-09-01

    Although pediatric sexual assault nurse examiners (P-SANEs) have been providing care for over two decades there remain major gaps in the literature describing the quality of P-SANE care and legal outcomes associated with their cases. The purpose of this study was to compare quality indicators of care in a pediatric emergency department (PED) before and after the implementation of a P-SANE program described in terms of trace forensic evidence yield, identification of perpetrator DNA, and judicial outcomes in pediatric acute sexual assault. A retrospective review of medical and legal records of all patients presenting to the PED at Nationwide Children's Hospital with concerns of acute sexual abuse/assault requiring forensic evidence collection from 1/1/04 to 12/31/07 was conducted. Detection and documentation of ano-genital injury, evaluation and documentation of pregnancy status, and testing for N. gonorrhea and C. trachomatis was significantly improved since implementation of the P-SANE Program compared to the historical control. The addition of a P-SANE to the emergency department (ED) provider team improved the quality of care to child/adolescent victims of acute sexual abuse/assault. © 2012 International Association of Forensic Nurses.

  2. Objections to routine clinical outcomes measurement in mental health services: any evidence so far?

    Science.gov (United States)

    MacDonald, Alastair J D; Trauer, Tom

    2010-12-01

    Routine clinical outcomes measurement (RCOM) is gaining importance in mental health services. To examine whether criticisms published in advance of the development of RCOM have been borne out by data now available from such a programme. This was an observational study of routine ratings using HoNOS65+ at inception/admission and again at discharge in an old age psychiatry service from 1997 to 2008. Testable hypotheses were generated from each criticism amenable to empirical examination. Inter-rater reliability estimates were applied to observed differences between scores between community and ward patients using resampling. Five thousand one hundred eighty community inceptions and 862 admissions had HoNOS65+ ratings at referral/admission and discharge. We could find no evidence of gaming (artificially worse scores at inception and better at discharge), selection, attrition or detection bias, and ratings were consistent with diagnosis and level of service. Anticipated low levels of inter-rater reliability did not vitiate differences between levels of service. Although only hypotheses testable from within RCOM data were examined, and only 46% of eligible episodes had complete outcomes data, no evidence of the alleged biases were found. RCOM seems valid and practical in mental health services.

  3. Anticholinergic drugs and negative outcomes in the older population: from biological plausibility to clinical evidence.

    Science.gov (United States)

    Collamati, Agnese; Martone, Anna Maria; Poscia, Andrea; Brandi, Vincenzo; Celi, Michela; Marzetti, Emanuele; Cherubini, Antonio; Landi, Francesco

    2016-02-01

    The use of medication with anticholinergic properties is widespread among older subjects. Many drugs of common use such as antispasmodics, bronchodilators, antiarrhythmics, antihistamines, anti-hypertensive drugs, antiparkinson agents, skeletal muscle relaxants, and psychotropic drugs have been demonstrated to have an anticholinergic activity. The most frequent adverse effects are dry mouth, nausea, vomiting, constipation, abdominal pain, urinary retention, blurred vision, tachycardia and neurologic impairment such as confusion, agitation and coma. A growing evidence from experimental studies and clinical observations suggests that drugs with anticholinergic properties can cause physical and mental impairment in the elderly population. However, the morbidity and management issues associated with unwanted anticholinergic activity are underestimated and frequently overlooked. Moreover, their possible relation with specific negative outcome in the elderly population is still not firmly established. The aim of the present review was to evaluate the relationship between the use of drugs with anticholinergic activity and negative outcomes in older persons. We searched PubMed and Cochrane combining the search terms "anticholinergic", "delirium", "cognitive impairment", "falls", "mortality" and "discontinuation". Medicines with anticholinergic properties may increase the risks of functional and cognitive decline, morbidity, institutionalization and mortality in older people. However, such evidences are still not conclusive probably due to possible confounding factors. In particular, more studies are needed to investigate the effects of discontinuation of drug with anticholinergic properties. Overall, minimizing anticholinergic burden should always be encouraged in clinical practice to improve short-term memory, confusion and delirium, quality of life and daily functioning.

  4. Attention-deficit hyperactivity disorder, multimodal treatment, and longitudinal outcome: evidence, paradox, and challenge.

    Science.gov (United States)

    Hinshaw, Stephen P; Arnold, L Eugene

    2015-01-01

    Given major increases in the diagnosis of attention-deficit hyperactivity disorder (ADHD) and in rates of medication for this condition, we carefully examine evidence for effects of single versus multimodal (i.e., combined medication and psychosocial/behavioral) interventions for ADHD. Our primary data source is the Multimodal Treatment Study of Children with ADHD (MTA), a 14-month, randomized clinical trial in which intensive behavioral, medication, and multimodal treatment arms were contrasted with one another and with community intervention (treatment-as-usual), regarding outcome domains of ADHD symptoms, comorbidities, and core functional impairments. Although initial reports emphasized the superiority of well-monitored medication for symptomatic improvement, reanalyses and reappraisals have highlighted (1) the superiority of combination treatment for composite outcomes and for domains of functional impairment (e.g., academic achievement, social skills, parenting practices); (2) the importance of considering moderator and mediator processes underlying differential patterns of outcome, including comorbid subgroups and improvements in family discipline style during the intervention period; (3) the emergence of side effects (e.g., mild growth suppression) in youth treated with long-term medication; and (4) the diminution of medication's initial superiority once the randomly assigned treatment phase turned into naturalistic follow-up. The key paradox is that while ADHD clearly responds to medication and behavioral treatment in the short term, evidence for long-term effectiveness remains elusive. We close with discussion of future directions and a call for greater understanding of relevant developmental processes in the attempt to promote optimal, generalized, and lasting treatments for this important and impairing neurodevelopmental disorder. © 2014 John Wiley & Sons, Ltd.

  5. Latest innovations for tattoo and permanent makeup removal.

    Science.gov (United States)

    Mao, Johnny C; DeJoseph, Louis M

    2012-05-01

    The goal of this article is to reveal the latest techniques and advances in laser removal of both amateur and professional tattoos, as well as cosmetic tattoos and permanent makeup. Each pose different challenges to the removing physician, but the goal is always the same: removal without sequelae. The authors' technique is detailed, and discussion of basic principles of light reflection, ink properties, effects of laser energy and heat, and outcomes and complications of tattoo removal are presented. Copyright © 2012 Elsevier Inc. All rights reserved.

  6. The latest Light Robotics breakthroughs - Postdeadline

    DEFF Research Database (Denmark)

    Glückstad, Jesper; Palima, Darwin; Bañas, Andrew

    Contemporary nanoscopy provides functionalities, not only for observing life science on the smallest scales but also for actively reaching into and manipulating at subcellular levels. This post-deadline contribution describes the latest generation of 3D-printed micro-tools for enabling light-acti......-activated robotics on sub-diffraction scales: Light Robotics....

  7. Latest Surprises from Mira the Wonderful

    Science.gov (United States)

    Karovska, Margarita; Marengo, Massimo; Wood, Brian

    We report the latest results from our long-term study of Mira A and its companion Mira B. These include a study of the dust environment in mid-IR wavelengths (Marengo et al. 2001), and of the accretion processes in the Mira AB interacting system (Wood, Karovska, and Raymond 2002).

  8. The association between Vitamin D and health outcomes in women: A review on the related evidence

    Directory of Open Access Journals (Sweden)

    Nahid Ramezani Jolfaie

    2016-01-01

    Full Text Available Background: Vitamin D has a wide range of physiological functions in skeletal and nonskeletal tissues which may play a role in many diseases. The aim of this study was to evaluate the recent evidence regarding the effects of Vitamin D on several health outcomes in women including breast cancer, ovarian and endometrial cancers, hypertension, and osteoporosis. Materials and Methods: We searched PubMed and Google Scholar databases through March 2016. We included the most current systematic reviews and meta-analyses assessing the associations of Vitamin D intake and/or serum 25-hydroxyvitamin D (25(OHD levels with the risk of incidence of breast cancer, ovarian and endometrial cancers, hypertension, and osteoporosis. Results: Many studies have represented that Vitamin D supplementation and high 25(OHD levels can decrease the risk of breast cancer occurrence or mortality. However, there is no strong evidence to support the existence of a relationship between Vitamin D and ovarian or endometrial cancers. Furthermore, the results regarding the effects of Vitamin D on hypertension were inconsistent. Although observational studies have shown an association between Vitamin D and hypertension, there is no evidence regarding effectiveness of Vitamin D in lowering blood pressure in several clinical trials. On the other hand, the findings associating the impact of Vitamin D on osteoporosis were more definitive and most studies have represented that Vitamin D may have beneficial effects on osteoporosis. Conclusion: Although the adequate Vitamin D level can play a protective role in the incidence and development of breast cancer, hypertension, and osteoporosis, there is limited evidence regarding ovarian and endometrial cancers.

  9. Developing a framework to generate evidence of health outcomes from social media use in chronic disease management.

    Science.gov (United States)

    Merolli, Mark; Gray, Kathleen; Martin-Sanchez, Fernando

    2013-01-01

    While there is an abundance of evidence-based practice (EBP) recommendations guiding management of various chronic diseases, evidence suggesting best practice for using social media to improve health outcomes is inadequate. The variety of social media platforms, multiple potential uses, inconsistent definitions, and paucity of rigorous studies, make it difficult to measure health outcomes reliably in chronic disease management. Most published investigations report on an earlier generation of online tools, which are not as user-centered, participatory, engaging, or collaborative, and thus may work differently for health self-management. The challenge to establish a sound evidence base for social media use in chronic disease starts with the need to define criteria and methods to generate and evaluate evidence. The authors' key objective is to develop a framework for research and practice that addresses this challenge. This paper forms part of a larger research project that presents a conceptual framework of how evidence of health outcomes can be generated from social media use, allowing social media to be utilized in chronic disease management more effectively. Using mixed methods incorporating a qualitative literature review, a survey and a pilot intervention, the research closely examines the therapeutic affordances of social media, people with chronic pain (PWCP) as a subset of chronic disease management, valid outcome measurement of patient-reported (health) outcomes (PRO), the individual needs of people living with chronic disease, and finally translation of the combined results to improve evidence-based decision making about social media use in this context. Extensive review highlights various affordances of social media that may prove valuable to understanding social media's effect on individual health outcomes. However, without standardized PRO instruments, we are unable to definitively investigate these effects. The proposed framework that we offer outlines

  10. Self-reflection modulates the outcome evaluation process: Evidence from an ERP study.

    Science.gov (United States)

    Zhu, Xiangru; Gu, Ruolei; Wu, Haiyan; Luo, Yuejia

    2015-12-01

    Recent research demonstrated structural overlap between reward and self processing, but the functional relationship that explains how self processing influences reward processing remains unclear. The present study used an experimentally constrained reflection task to investigate whether individuals' outcome evaluations in a gambling task are modulated by task-unrelated self- and other-reflection processes. The self- and other-reflection task contained descriptions of the self or others, and brain event-related potentials (ERPs) were recorded while 16 normal adults performed a gambling task. The ERP analysis focused on the feedback-related negativity (FRN) component. We found that the difference wave of FRN increased in the self-reflection condition compared with the other-reflection condition. The present findings provide direct evidence that self processing can influence reward processing. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. An outcomes approach to stroke care: the importance of teamwork and evidence-based nursing care.

    Science.gov (United States)

    Middleton, Sandy

    2012-04-01

    The Quality in Acute Stroke Care (QASC) was a cluster randomised control trial (CRCT) which evaluated the effectiveness of evidence-based clinical treatment protocols for the management of fever, hyperglycaemia and swallowing, in conjunction with multidisciplinary team building workshops, and a standardised interactive staff education program (collectively known as the Fever, Sugar, Swallowing (FeSS) intervention) to improve patient outcomes 90-days. We found that patients cared for in stroke units who received our intervention were 15·7% more likely to be alive and independent 90 days following their stroke. They also had significantly: fewer episodes of fever, lower mean temperatures, lower mean blood glucose levels, and better screening for swallowing difficulties. © 2012 The Author. International Journal of Stroke © 2012 World Stroke Organization.

  12. A review of the evidence linking child stunting to economic outcomes

    Science.gov (United States)

    McGovern, Mark E; Krishna, Aditi; Aguayo, Victor M; Subramanian, SV

    2017-01-01

    Abstract Background To understand the full impact of stunting in childhood it is important to consider the long-run effects of undernutrition on the outcomes of adults who were affected in early life. Focusing on the costs of stunting provides a means of evaluating the economic case for investing in childhood nutrition. Methods We review the literature on the association between stunting and undernutrition in childhood and economic outcomes in adulthood. At the national level, we also evaluate the evidence linking stunting to economic growth. Throughout, we consider randomized controlled trials (RCTs), quasi-experimental approaches and observational studies. Results Long-run evaluations of two randomized nutrition interventions indicate substantial returns to the programmes (a 25% and 46% increase in wages for those affected as children, respectively). Cost-benefit analyses of nutrition interventions using calibrated return estimates report a median return of 17.9:1 per child. Assessing the wage premium associated with adult height, we find that a 1-cm increase in stature is associated with a 4% increase in wages for men and a 6% increase in wages for women in our preferred set of studies which attempt to address unobserved confounding and measurement error. In contrast, the evidence on the association between economic growth and stunting is mixed. Conclusions Countries with high rates of stunting, such as those in South Asia and sub-Saharan Africa, should scale up policies and programmes aiming to reduce child undernutrition as cost-beneficial investments that expand the economic opportunities of their children, better allowing them and their countries to reach their full potential. However, economic growth as a policy will only be effective at reducing the prevalence of stunting when increases in national income are directed at improving the diets of children, addressing gender inequalities and strengthening the status of women, improving sanitation and reducing

  13. A review of the evidence linking child stunting to economic outcomes.

    Science.gov (United States)

    McGovern, Mark E; Krishna, Aditi; Aguayo, Victor M; Subramanian, S V

    2017-08-01

    To understand the full impact of stunting in childhood it is important to consider the long-run effects of undernutrition on the outcomes of adults who were affected in early life. Focusing on the costs of stunting provides a means of evaluating the economic case for investing in childhood nutrition. We review the literature on the association between stunting and undernutrition in childhood and economic outcomes in adulthood. At the national level, we also evaluate the evidence linking stunting to economic growth. Throughout, we consider randomized controlled trials (RCTs), quasi-experimental approaches and observational studies. Long-run evaluations of two randomized nutrition interventions indicate substantial returns to the programmes (a 25% and 46% increase in wages for those affected as children, respectively). Cost-benefit analyses of nutrition interventions using calibrated return estimates report a median return of 17.9:1 per child. Assessing the wage premium associated with adult height, we find that a 1-cm increase in stature is associated with a 4% increase in wages for men and a 6% increase in wages for women in our preferred set of studies which attempt to address unobserved confounding and measurement error. In contrast, the evidence on the association between economic growth and stunting is mixed. Countries with high rates of stunting, such as those in South Asia and sub-Saharan Africa, should scale up policies and programmes aiming to reduce child undernutrition as cost-beneficial investments that expand the economic opportunities of their children, better allowing them and their countries to reach their full potential. However, economic growth as a policy will only be effective at reducing the prevalence of stunting when increases in national income are directed at improving the diets of children, addressing gender inequalities and strengthening the status of women, improving sanitation and reducing poverty and inequities. © The Author 2017

  14. The latest evidence for possible HIV-1 curative strategies.

    Science.gov (United States)

    Pham, Hanh Thi; Mesplède, Thibault

    2018-01-01

    Human immunodeficiency virus type 1 (HIV-1) infection remains a major health issue worldwide. In developed countries, antiretroviral therapy has extended its reach from treatment of people living with HIV-1 to post-exposure prophylaxis, treatment as prevention, and, more recently, pre-exposure prophylaxis. These healthcare strategies offer the epidemiological tools to curve the epidemic in rich settings and will be concomitantly implemented in developing countries. One of the remaining challenges is to identify an efficacious curative strategy. This review manuscript will focus on some of the current curative strategies aiming at providing a sterilizing or functional cure to HIV-1-positive individuals. These include the following: early treatment initiation in post-treatment controllers as a long-term HIV-1 remission strategy, latency reversal, gene editing with or without stem cell transplantation, and antibodies against either the viral envelope protein or the host integrin α4β7.

  15. Advanced maternal age and adverse pregnancy outcome: evidence from a large contemporary cohort.

    Directory of Open Access Journals (Sweden)

    Louise C Kenny

    Full Text Available BACKGROUND: Recent decades have witnessed an increase in mean maternal age at childbirth in most high-resourced countries. Advanced maternal age has been associated with several adverse maternal and perinatal outcomes. Although there are many studies on this topic, data from large contemporary population-based cohorts that controls for demographic variables known to influence perinatal outcomes is limited. METHODS: We performed a population-based cohort study using data on all singleton births in 2004-2008 from the North Western Perinatal Survey based at The University of Manchester, UK. We compared pregnancy outcomes in women aged 30-34, 35-39 and ≥40 years with women aged 20-29 years using log-linear binomial regression. Models were adjusted for parity, ethnicity, social deprivation score and body mass index. RESULTS: The final study cohort consisted of 215,344 births; 122,307 mothers (54.19% were aged 20-29 years, 62,371(27.63% were aged 30-34 years, 33,966(15.05% were aged 35-39 years and 7,066(3.13% were aged ≥40 years. Women aged 40+ at delivery were at increased risk of stillbirth (RR = 1.83, [95% CI 1.37-2.43], pre-term (RR = 1.25, [95% CI: 1.14-1.36] and very pre-term birth (RR = 1.29, [95% CI:1.08-1.55], Macrosomia (RR = 1.31, [95% CI: 1.12-1.54], extremely large for gestational age (RR = 1.40, [95% CI: 1.25-1.58] and Caesarean delivery (RR = 1.83, [95% CI: 1.77-1.90]. CONCLUSIONS: Advanced maternal age is associated with a range of adverse pregnancy outcomes. These risks are independent of parity and remain after adjusting for the ameliorating effects of higher socioeconomic status. The data from this large contemporary cohort will be of interest to healthcare providers and women and will facilitate evidence based counselling of older expectant mothers.

  16. Favorable neonatal outcomes among immigrants in Taiwan: evidence of healthy immigrant mother effect.

    Science.gov (United States)

    Hsieh, Wu-Shiun; Hsieh, Chia-Jung; Jeng, Suh-Fang; Liao, Hua-Fang; Su, Yi-Ning; Lin, Shio-Jean; Chang, Pei-Jen; Chen, Pau-Chung

    2011-07-01

    . Evidence of a healthy immigrant mother effect on neonatal health is clear. Despite lower parental education, advancing paternal age, and spatial distribution disparity, babies born to married immigrant mothers in Taiwan had favorable neonatal outcomes.

  17. The latest dictionary of nuclear energy term

    International Nuclear Information System (INIS)

    1996-06-01

    This book is the latest dictionary of nuclear energy term. It deals with explanations of nuclear energy term in alphabetical order. It also lists abbreviation of nuclear energy term. This book contains symbol and unit, radiation units, greek letters, the symbol of for element, the table of an isotope and the periodic table on nuclear power term. It includes glossary of nuclear power in Korean and French and conceptual map about development of nuclear power.

  18. Latest Proterozoic stratigraphy and earth history

    Science.gov (United States)

    Knoll, Andrew H.; Walter, Malcolm R.

    1992-01-01

    Novel biostratigraphic and chemostratigraphic data furnish an improved framework for stratigraphic correlation of the Proterozoic Eon as well as tools for a chronostratigraphic division of the late Proterozoic. It is argued that, in conjunction with geochronometric data, protistan microfossils and isotope geochemistry can furnish a means for an eventual integration of the latest Proterozoic Eon. Attention is given to the emerging methodologies of fossil protists and prokaryotes and of isotopic chemostratigraphy.

  19. Short- and long-term outcomes after enucleation of pancreatic tumors: An evidence-based assessment.

    Science.gov (United States)

    Zhou, Yanming; Zhao, Min; Wu, Lupeng; Ye, Feng; Si, Xiaoying

    Enucleation of pancreatic tumors is rarely performed. The aim of this study was to evaluate the published evidence for its short- and long-term outcomes. PubMed (MEDLINE) and EMBASE databases were searched from 1990 to March 2016. Studies including at least ten patients who underwent enucleation of pancreatic lesions were included. Data on the outcomes were synthesized and meta-analyzed where appropriate. Twenty-seven studies involving 1316 patients were included in the systematic review. The postoperative mortality was 0.3%, and the postoperative morbidity was 50.3%, mainly represented by pancreatic fistula (38.1%). Endocrine insufficiency, exocrine insufficiency and tumor recurrence was observed in 2.4%, 1.1% and 2.3% of the patients respectively. Compared with typical resection, the operation time, blood loss, length of hospital stay, and the incidence of endocrine and exocrine insufficiency were all significantly reduced after enucleation. The occurrence of pancreatic fistula was significantly higher in enucleation group, but overall morbidity, the reoperation rate and mortality were comparable between the two groups. There was no significant difference in disease recurrence between the two groups. Compared with central pancreatectomy, enucleation had a shorter operation time, lower blood loss, less morbidity, and better pancreatic function. Compared with open enucleation, minimally invasive enucleation had a shorter operation time and a shorter length of hospital stay. Enucleation is an appropriate surgical procedure in selected patients with benign or low-malignant lesions of the pancreas. The benefits of minimally invasive approach need to be validated in further investigations with larger groups of patients. Copyright © 2016 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  20. Empirical Evidence for the Outcomes of Therapeutic Video Games for Adolescents With Anxiety Disorders: Systematic Review

    Science.gov (United States)

    Barnes, Steven

    2018-01-01

    Background Extant evidence suggests that the proportion of adolescents suffering from anxiety disorders (ADs) has increased by up to 70% since the mid-1980s, with experience of anxiety at this stage associated with significant negative short- and long-term life outcomes. The existing therapeutic interventions (eg, cognitive behavioral therapy, CBT; attention bias modification, ABM) have proven to have clinically measurable benefits in reducing anxiety, but their efficacy is often compromised by social and practical barriers. The growing discrepancy between demand for, and access to, clinical interventions for anxiety has led to the development of a range of eHealth (health care practice supported by electronic processes and communication) and mHealth (versions of eHealth using mobile devices) interventions. One such protocol is therapeutic games, which aim to provide clinical frameworks in dynamic, adaptable, and personalized virtual environments. Although some evidence exists to suggest therapeutic games are associated with reductions in subjective anxiety and observed stress reactivity, there is currently, to our knowledge, no systematic review of the adherence to, and effectiveness of, therapeutic games for adolescent anxiety. Objective The aim of this review was to establish the effectiveness of therapeutic games in making clinically measurable reductions in anxiety symptoms in adolescent samples. Methods A systematic search of the existing academic literature published between 1990 and July 2017 was conducted using the databases Journal of Medical Internet Research, Journal Storage, Psychology Articles, Psychology Info, ScienceDIRECT, and Scopus. Records linked to empirical papers on therapeutic games for anxiety using adolescent samples were evaluated. Results A total of 5 studies (N=410 participants) met the inclusion criteria, and 3 gamified anxiety interventions for adolescents were identified. The papers included a mixture of randomized controlled trials

  1. Empirical Evidence for the Outcomes of Therapeutic Video Games for Adolescents With Anxiety Disorders: Systematic Review.

    Science.gov (United States)

    Barnes, Steven; Prescott, Julie

    2018-02-28

    Extant evidence suggests that the proportion of adolescents suffering from anxiety disorders (ADs) has increased by up to 70% since the mid-1980s, with experience of anxiety at this stage associated with significant negative short- and long-term life outcomes. The existing therapeutic interventions (eg, cognitive behavioral therapy, CBT; attention bias modification, ABM) have proven to have clinically measurable benefits in reducing anxiety, but their efficacy is often compromised by social and practical barriers. The growing discrepancy between demand for, and access to, clinical interventions for anxiety has led to the development of a range of eHealth (health care practice supported by electronic processes and communication) and mHealth (versions of eHealth using mobile devices) interventions. One such protocol is therapeutic games, which aim to provide clinical frameworks in dynamic, adaptable, and personalized virtual environments. Although some evidence exists to suggest therapeutic games are associated with reductions in subjective anxiety and observed stress reactivity, there is currently, to our knowledge, no systematic review of the adherence to, and effectiveness of, therapeutic games for adolescent anxiety. The aim of this review was to establish the effectiveness of therapeutic games in making clinically measurable reductions in anxiety symptoms in adolescent samples. A systematic search of the existing academic literature published between 1990 and July 2017 was conducted using the databases Journal of Medical Internet Research, Journal Storage, Psychology Articles, Psychology Info, ScienceDIRECT, and Scopus. Records linked to empirical papers on therapeutic games for anxiety using adolescent samples were evaluated. A total of 5 studies (N=410 participants) met the inclusion criteria, and 3 gamified anxiety interventions for adolescents were identified. The papers included a mixture of randomized controlled trials, quasi-experimental studies, and

  2. Outcome analysis of breast cancer patients who declined evidence-based treatment

    Directory of Open Access Journals (Sweden)

    Joseph Kurian

    2012-06-01

    Full Text Available Abstract Background To analyze the characteristics and outcomes of women with breast cancer in the Northern Alberta Health Region (NAHR who declined recommended primary standard treatments. Methods A chart review was performed of breast cancer patients who refused recommended treatments during the period 1980 to 2006. A matched pair analysis was performed to compare the survival data between those who refused or received standard treatments. Results A total of 185 (1.2% patients refused standard treatment. Eighty-seven (47% were below the age of 75 at diagnosis. The majority of those who refused standard treatments were married (50.6%, 50 years or older (60.9%, and from the urban area (65.5%. The 5-year overall survival rates were 43.2% (95% CI: 32.0 to 54.4% for those who refused standard treatments and 81.9% (95% CI: 76.9 to 86.9% for those who received them. The corresponding values for the disease-specific survival were 46.2% (95% CI: 34.9 to 57.6% vs. 84.7% (95% CI: 80.0 to 89.4%. Conclusions Women who declined primary standard treatment had significantly worse survival than those who received standard treatments. There is no evidence to support using Complementary and Alternative Medicine (CAM as primary cancer treatment.

  3. Decentralization of health care systems and health outcomes: Evidence from a natural experiment.

    Science.gov (United States)

    Jiménez-Rubio, Dolores; García-Gómez, Pilar

    2017-09-01

    While many countries worldwide are shifting responsibilities for their health systems to local levels of government, there is to date insufficient evidence about the potential impact of these policy reforms. We estimate the impact of decentralization of the health services on infant and neonatal mortality using a natural experiment: the devolution of health care decision making powers to Spanish regions. The devolution was implemented gradually and asymmetrically over a twenty-year period (1981-2002). The order in which the regions were decentralized was driven by political factors and hence can be considered exogenous to health outcomes. In addition, we exploit the dynamic effect of decentralization of health services and allow for heterogeneous effects by the two main types of decentralization implemented across regions: full decentralization (political and fiscal powers) versus political decentralization only. Our difference in differences results based on a panel dataset for the 50 Spanish provinces over the period 1980 to 2010 show that the lasting benefit of decentralization accrues only to regions which enjoy almost full fiscal and political powers and which are also among the richest regions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Implementation outcomes of evidence-based quality improvement for depression in VA community based outpatient clinics

    Directory of Open Access Journals (Sweden)

    Fortney John

    2012-04-01

    Full Text Available Abstract Background Collaborative-care management is an evidence-based practice for improving depression outcomes in primary care. The Department of Veterans Affairs (VA has mandated the implementation of collaborative-care management in its satellite clinics, known as Community Based Outpatient Clinics (CBOCs. However, the organizational characteristics of CBOCs present added challenges to implementation. The objective of this study was to evaluate the effectiveness of evidence-based quality improvement (EBQI as a strategy to facilitate the adoption of collaborative-care management in CBOCs. Methods This nonrandomized, small-scale, multisite evaluation of EBQI was conducted at three VA Medical Centers and 11 of their affiliated CBOCs. The Plan phase of the EBQI process involved the localized tailoring of the collaborative-care management program to each CBOC. Researchers ensured that the adaptations were evidence based. Clinical and administrative staff were responsible for adapting the collaborative-care management program for local needs, priorities, preferences and resources. Plan-Do-Study-Act cycles were used to refine the program over time. The evaluation was based on the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance Framework and used data from multiple sources: administrative records, web-based decision-support systems, surveys, and key-informant interviews. Results Adoption: 69.0% (58/84 of primary care providers referred patients to the program. Reach: 9.0% (298/3,296 of primary care patients diagnosed with depression who were not already receiving specialty care were enrolled in the program. Fidelity: During baseline care manager encounters, education/activation was provided to 100% (298/298 of patients, barriers were assessed and addressed for 100% (298/298 of patients, and depression severity was monitored for 100% (298/298 of patients. Less than half (42.5%, 681/1603 of follow-up encounters during the acute

  5. Cina Benteng: The Latest Generations and Acculturation

    Directory of Open Access Journals (Sweden)

    Billy Nathan Setiawan

    2015-05-01

    Full Text Available The aim of this paper was to investigate the acculturation process encountered by the two latest generations of Cina Benteng. A Skype interview was conducted with two young Cina Benteng descents. The analysis was also supported by insightful remark from the parents of the two interviewees. This study discovers that the two generations seem to respond to the acculturation process in different ways. However, although some traditions are no longer relevant to the later generation, their identity as a Chinese descent cannot be easily removed.

  6. Turbomachinery: latest developments in a changing scene

    International Nuclear Information System (INIS)

    1991-01-01

    The contributions to the 1991 European Conference on the latest developments in turbomachinery are presented. The topics covered include: computational fluid dynamics methods applied to the aerodynamics of turbine blades; developments associated with steam turbines and gas turbines; flow patterns for turbine blades; compressor design and development; turbine test facilities; film cooling; heat transfer; theoretical treatment of transonic and unsteady flow; condensation phenomena and wet steam flow; water extraction from steam turbine blades; wetness losses in steam turbines in nuclear power plants and pressure loss reduction; aerodynamic instabilities arising from governing valves in Pressurized Water Reactor steam turbines. (UK)

  7. Using theory and evidence to drive measurement of patient, nurse and organizational outcomes of professional nursing practice.

    Science.gov (United States)

    Jeffs, Lianne; Sidani, Souraya; Rose, Donald; Espin, Sherry; Smith, Orla; Martin, Kirsten; Byer, Charlie; Fu, Kaiyan; Ferris, Ella

    2013-04-01

    An evolving body of literature suggests that the implementation of evidence based clinical and professional guidelines and strategies can improve patient care. However, gaps exist in our understanding of the effect of implementation of guidelines on outcomes, particularly patient outcomes. To address this gap, a measurement framework was developed to assess the impact of an organization-wide implementation of two nursing-centric best-practice guidelines on patient, nurse and organizational level outcomes. From an implementation standpoint, we anticipate that our data will show improvements in the following: (i) patient satisfaction scores and safety outcomes; (ii) nurses ability to value and engage in evidence based practice; and (iii) organizational support for evidence-informed nursing care that results in quality patient outcomes. Our measurement framework and multifaceted methodological approach outlined in this paper might serve as a blueprint for other organizations in their efforts to evaluate the impacts associated with implementation of clinical and professional guidelines and best practices. © 2013 Wiley Publishing Asia Pty Ltd.

  8. Latest ATLAS results on $\\phi_s$

    CERN Document Server

    AUTHOR|(INSPIRE)INSPIRE-00222462; The ATLAS collaboration

    2017-01-01

    New Physics effects beyond the predictions of the Standard Model may manifest in the $CP$-violation of $b$-hadron decays. This paper presents the latest analysis of $B^0_s \\to J/\\psi\\phi$ decay at the ATLAS experiment, measuring the $CP$-violating phase $\\phi_s$, the decay width $\\Gamma_s$ and the difference of widths between the mass eigenstates $\\Delta\\Gamma_s$. The latest results are using integrated luminosity of 14.3 fb$^{-1}$ collected by the ATLAS detector from $\\sqrt{s}$ = 8 TeV $pp$ collisions at the Large Hadron Collider, and are statistically combined with the results from 4.9 fb$^{-1}$ of $\\sqrt{s}$ = 7 TeV data, leading to: \\begin{eqnarray*} \\phi_s & = & -0.090 \\pm 0.078 \\;\\mathrm{(stat.)} \\pm 0.041 \\;\\mathrm{(syst.)~rad} ,\\;\\;\\\\ \\Delta\\Gamma_s & = & 0.085 \\pm 0.011 \\;\\mathrm{(stat.)} \\pm 0.007 \\;\\mathrm{(syst.)~ps}^{-1} ,\\;\\;\\\\ \\Gamma_s & = & 0.675 \\pm 0.003 \\;\\mathrm{(stat.)} \\pm 0.003 \\;\\mathrm{(syst.)~ps}^{-1}. \\end{eqnarray*} The results are also presented in the form...

  9. Evident?

    DEFF Research Database (Denmark)

    Plant, Peter

    2012-01-01

    Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind......Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind...

  10. Supplements in pregnancy: the latest recommendations

    Science.gov (United States)

    Martínez García, Rosa María

    2016-07-12

    Pregnancy is a challenge from the nutritional point of view, because nutrient requirements are increased and alter its intake can affect maternal and fetal health. Micronutrient defi ciency states are related to preeclampsia, intrauterine growth restriction, abortion and congenital anomalies. Currently, the diet of many expectant mothers is insufficient in micronutrients, in this cases supplementation is necessary. It is recommended supplementation with folic acid in doses of 400 mcg / day and 5 mg/day in risk pregnant, and should begin at least one month before conception and during the first 12 weeks gestation, and extend it throughout pregnancy in mothers with nutritional risk. It is important to keep watch the proper dose of folic acid to prevent possible adverse effects of unmetabolized accumulation in plasma. A high percentage of pregnant women presented iron deficiency anemia, being recommended intermittent use of iron supplements (with lower gastrointestinal alteration and oxidative stress); not recommended for mothers without anemia (hemoglobin> 13.5 g / L). Since calcium absorption is increased up to 40% in gestation, its supplementation is not recommended for mothers with adequate intakes (3 dairy / day), and its use must be reserved to women with inadequate intakes and / or high risk of preeclampsia. Regarding the iodine, there are confl icting positions by different working groups established potassium iodide supplementation in women who do not reach their recommended intake (3 servings of milk and dairy products + 2 g of iodized salt), with their diets. Given that vitamin A and D can be toxic to mother and fetus, it is not recommended its supplementation except in cases of deficiency. Although the use of multiple micronutrients supplements may favorably impact the outcome of pregnancy, more scientific evidence is needed to establish the replacement of iron and folic acid with a multiple micronutrient supplement.

  11. The Association Between Adverse Child Health, Psychological, Educational and Social Outcomes, and Nondependent Parental Substance: A Rapid Evidence Assessment.

    Science.gov (United States)

    McGovern, Ruth; Gilvarry, Eilish; Addison, Michelle; Alderson, Hayley; Geijer-Simpson, Emma; Lingam, Raghu; Smart, Debbie; Kaner, Eileen

    2018-01-01

    Between 5% and 30% of children in high-income countries live with a substance misusing parent, the majority of which is below dependent levels. However, little is understood about the impact of nondependent parental substance misuse upon children. We searched the international literature using rigorous systematic methods to identify studies examining parental substance misuse and adverse outcomes in children. The inclusion criteria were cross-sectional, longitudinal, case-control, and cohort studies; of children aged 0-18 years whose parents are high-risk substance misusers; reporting on their health, psychological, substance use, educational, and social outcomes. We identified 36 papers (from 33 unique studies), most of which were assessed as being of medium to high methodological quality ( N= 28). Parental nondependent substance misuse was found to be associated with adversity in children, with strong evidence of an association with externalizing difficulties ( N = 7 papers, all finding an association) and substance use ( N = 23 papers, all finding an association) in adolescents and some evidence of adverse health outcomes in early childhood ( N = 6/8 papers finding an association). There is less evidence of an association between parental substance misuse and adverse educational and social outcomes. The body of evidence was largest for parental alcohol misuse, with research examining the impact of parental illicit drug use being limited. Methodological limitations restrict our ability to make causal inference. Nonetheless, the prevalence of adverse outcomes in children whose parents are nondependent substance misusers highlights the need for practitioners to intervene with this population before a parent has developed substance dependency.

  12. Mental Health Interventions in the Workplace and Work Outcomes: A Best-Evidence Synthesis of Systematic Reviews

    Directory of Open Access Journals (Sweden)

    SL Wagner

    2016-01-01

    Full Text Available Background: Mental health issues in the workplace are a growing concern among organizations and policymakers, but it remains unclear what interventions are effective in preventing mental health problems and their associated organizational consequences. This synthesis reports on workplace mental health interventions that impact absenteeism, productivity and financial outcomes. Objective: To determine the level of evidence supporting mental health interventions as valuable to work outcomes. Methods: Databases were searched for systematic reviews between 2000 and 2012: Medline, EMBASE, the Cochrane Database of Systematic Reviews, DARE, CINAHL, PsycINFO and TRIP. Grey literature searches included health-evidence.ca, Rehab+, National Rehabilitation Information Center (NARIC, and Institute for Work and Health. The assessment of articles for inclusion criteria and methodological quality was conducted independently by two or more researchers, with differences resolved through consensus. Results: The search resulted in 3363 titles, of which 3248 were excluded following title/abstract review, with 115 articles retrieved for full-text review. 14 articles finally met the inclusion criteria and are summarized in this synthesis. Conclusion: There is moderate evidence for the effectiveness of workplace mental health interventions on improved workplace outcomes. Certain types of programs, such as those incorporating both mental and physical health interventions, multicomponent mental health and/or psychosocial interventions, and exposure in vivo containing interventions for particular anxiety disorders had a greater level of research evidence to support their effectiveness.

  13. Mental Health Interventions in the Workplace and Work Outcomes: A Best-Evidence Synthesis of Systematic Reviews.

    Science.gov (United States)

    Wagner, S L; Koehn, C; White, M I; Harder, H G; Schultz, I Z; Williams-Whitt, K; Warje, O; Dionne, C E; Koehoorn, M; Pasca, R; Hsu, V; McGuire, L; Schulz, W; Kube, D; Wright, M D

    2016-01-01

    Mental health issues in the workplace are a growing concern among organizations and policymakers, but it remains unclear what interventions are effective in preventing mental health problems and their associated organizational consequences. This synthesis reports on workplace mental health interventions that impact absenteeism, productivity and financial outcomes. To determine the level of evidence supporting mental health interventions as valuable to work outcomes. Databases were searched for systematic reviews between 2000 and 2012: Medline, EMBASE, the Cochrane Database of Systematic Reviews, DARE, CINAHL, PsycINFO and TRIP. Grey literature searches included health-evidence.ca, Rehab+, National Rehabilitation Information Center (NARIC), and Institute for Work and Health. The assessment of articles for inclusion criteria and methodological quality was conducted independently by two or more researchers, with differences resolved through consensus. The search resulted in 3363 titles, of which 3248 were excluded following title/abstract review, with 115 articles retrieved for full-text review. 14 articles finally met the inclusion criteria and are summarized in this synthesis. There is moderate evidence for the effectiveness of workplace mental health interventions on improved workplace outcomes. Certain types of programs, such as those incorporating both mental and physical health interventions, multicomponent mental health and/or psychosocial interventions, and exposure in vivo containing interventions for particular anxiety disorders had a greater level of research evidence to support their effectiveness.

  14. The Impact of Digital Skills on Educational Outcomes: Evidence from Performance Tests

    Science.gov (United States)

    Pagani, Laura; Argentin, Gianluca; Gui, Marco; Stanca, Luca

    2016-01-01

    Digital skills are increasingly important for labour market outcomes and social participation. Do they also matter for academic performance? This paper investigates the effects of digital literacy on educational outcomes by merging data from the Italian National Assessment in secondary schools with an original data-set on performance tests of…

  15. Treadmill training of infants with Down syndrome: evidence-based developmental outcomes.

    Science.gov (United States)

    Ulrich, D A; Ulrich, B D; Angulo-Kinzler, R M; Yun, J

    2001-11-01

    On average, infants with Down syndrome (DS) learn to walk about 1 year later than nondisabled (ND) infants. The purpose of this study was to determine if practice stepping on a motorized treadmill could help reduce the delay in walking onset normally experienced by these infants. Thirty families of infants with DS were randomly assigned to the intervention or control group. All infants were karyotyped trisomy 21 and began participation in the study when they could sit alone for 30 seconds (Bayley Scales of Infant Development, Second Edition 1993, item 34). Infants received traditional physical therapy at least every other week. In addition, intervention infants received practice stepping on a small, motorized treadmill, 5 days per week, for 8 minutes a day, in their own homes. Parents were trained to support their infants on these specially engineered miniature treadmills. Every 2 weeks research staff went into the homes and tested infants' overall motor progress by administering the Bayley Scales of Infant Development, Second Edition, monitored growth status via a battery of 11 anthropometric measures, and checked parents' compliance with physical therapy and treadmill intervention. The primary measures of the intervention's effectiveness were comparisons between the groups on the length of time elapsed between sitting for 30 seconds (entry into the study) and 1) raising self to stand; 2) walking with help; and 3) walking independently. The experimental group learned to walk with help and to walk independently significantly faster (73.8 days and 101 days, respectively) than the control group, both of which also produced large effect size statistics for the group differences. The groups were not statistically different for rate of learning to raise self to stand but there was a moderate effect size statistic suggesting that the groups were meaningfully different in favor of the experimental group. These results provide evidence that, with training and support

  16. Organizational downsizing and age discrimination litigation: the influence of personnel practices and statistical evidence on litigation outcomes.

    Science.gov (United States)

    Wingate, Peter H; Thornton, George C; McIntyre, Kelly S; Frame, Jennifer H

    2003-02-01

    The present study examined relationships between reduction-in-force (RIF) personnel practices, presentation of statistical evidence, and litigation outcomes. Policy capturing methods were utilized to analyze the components of 115 federal district court opinions involving age discrimination disparate treatment allegations and organizational downsizing. Univariate analyses revealed meaningful links between RIF personnel practices, use of statistical evidence, and judicial verdict. The defendant organization was awarded summary judgment in 73% of the claims included in the study. Judicial decisions in favor of the defendant organization were found to be significantly related to such variables as formal performance appraisal systems, termination decision review within the organization, methods of employee assessment and selection for termination, and the presence of a concrete layoff policy. The use of statistical evidence in ADEA disparate treatment litigation was investigated and found to be a potentially persuasive type of indirect evidence. Legal, personnel, and evidentiary ramifications are reviewed, and a framework of downsizing mechanics emphasizing legal defensibility is presented.

  17. Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes

    DEFF Research Database (Denmark)

    Wood, Lesley; Egger, Matthias; Gluud, Lise Lotte

    2008-01-01

    To examine whether the association of inadequate or unclear allocation concealment and lack of blinding with biased estimates of intervention effects varies with the nature of the intervention or outcome....

  18. Molecular Evidence for Differential Long-term Outcomes of Early Life Severe Acute Malnutrition

    Directory of Open Access Journals (Sweden)

    Allan Sheppard

    2017-04-01

    Implications of All the Available Evidence: These data are compatible with the different clinical responses to SAM arising from developmentally-induced epigenetic changes laid down largely before birth and provide evidence for the predictive adaptive response model operating in human development.

  19. Demographic and Socioeconomic Outcomes Across the Indigenous Australian Lifecourse : Evidence from the 2006 Census

    OpenAIRE

    Biddle, Nicholas; Yap, Mandy

    2010-01-01

    Across almost all standard indicators, the Indigenous population of Australia has worse outcomes than the non-Indigenous population. Despite the abundance of statistics and a plethora of government reports on Indigenous outcomes, there is very little information on how Indigenous disadvantage accumulates or is mitigated through time at the individual level. The research that is available highlights two key findings. Firstly, that Indigenous disadvantage starts from a very early age and widens...

  20. Social distance influences the outcome evaluation of cooperation and conflict: Evidence from event-related potentials.

    Science.gov (United States)

    Chen, Yezi; Lu, Jiamei; Wang, Yiwen; Feng, Zhouqi; Yuan, Bo

    2017-04-24

    Previous research shows that social distance plays an important role in promoting cooperation and that subtle cues that reduce social distance increase the tendency to cooperate. However, it is unclear how social distance influences our outcome evaluation of cooperative and conflict feedback. The present study investigated the influence of social distance on cooperative and conflict behavior and the evaluation process of the cooperative and conflict outcomes, using the event-related potentials (ERPs) technique. We recorded ERPs from 14 normal adults playing a social game task against a friend and a stranger. The results showed that the FRN (Feedback Related Negativity) and P300 were affected by the opponent's choice to cooperate or aggress; however, only the P300 was affected by social distance. Specifically, when the opponent chose to cooperate, the feedback elicited a smaller FRN and a larger P300 amplitude; and compared with playing against friends, the P300 had a larger amplitude when participants gaming with strangers. Our results indicate that at the early stage of the evaluation of cooperation and conflict outcomes, individuals may initially and quickly encode the valence of outcomes, judging whether an outcome is consistent with their expectations. However, at the late stage, which involves a top-down cognitive appraisal process, some social factors, such as social distance, may moderate processing of attention resource allocation of feedback about outcomes, and of higher-level motivation/affective appraisal. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. A 10-Day Developmental Voyage: Converging Evidence from Three Studies Showing that Self-Esteem May Be Elevated and Maintained without Negative Outcomes

    Science.gov (United States)

    Kafka, S.; Hunter, J. A.; Hayhurst, J.; Boyes, M.; Thomson, R. L.; Clarke, H.; Grocott, A. M.; Stringer, M.; O'Brien, K. S.

    2012-01-01

    Empirical evidence shows that educational experiences in the context of the outdoors lead to elevated self-esteem. Although elevated self-esteem is widely assumed to promote beneficial outcomes, recent evidence suggests that elevated self-esteem may also facilitate a variety of negative outcomes (i.e., increased prejudice, aggression, drug and…

  2. Latest Insights on Adenovirus Structure and Assembly

    Directory of Open Access Journals (Sweden)

    Carmen San Martín

    2012-05-01

    Full Text Available Adenovirus (AdV capsid organization is considerably complex, not only because of its large size (~950 Å and triangulation number (pseudo T = 25, but also because it contains four types of minor proteins in specialized locations modulating the quasi-equivalent icosahedral interactions. Up until 2009, only its major components (hexon, penton, and fiber had separately been described in atomic detail. Their relationships within the virion, and the location of minor coat proteins, were inferred from combining the known crystal structures with increasingly more detailed cryo-electron microscopy (cryoEM maps. There was no structural information on assembly intermediates. Later on that year, two reports described the structural differences between the mature and immature adenoviral particle, starting to shed light on the different stages of viral assembly, and giving further insights into the roles of core and minor coat proteins during morphogenesis [1,2]. Finally, in 2010, two papers describing the atomic resolution structure of the complete virion appeared [3,4]. These reports represent a veritable tour de force for two structural biology techniques: X-ray crystallography and cryoEM, as this is the largest macromolecular complex solved at high resolution by either of them. In particular, the cryoEM analysis provided an unprecedented clear picture of the complex protein networks shaping the icosahedral shell. Here I review these latest developments in the field of AdV structural studies.

  3. Latest ATLAS measurements on top quark properties

    CERN Document Server

    Derue, Frederic; The ATLAS collaboration

    2017-01-01

    The top quark is unique among the known quarks in that it decays before it has an opportunity to form hadronic bound states. This makes measurements of its properties particularly interesting as one can access directly the properties of a bare quark. The latest measurements of these properties with the ATLAS detector at the LHC are presented using 8 TeV and 13 TeV data, excluding results from single top production. Measurements of top quark spin observables in top-antitop events, each sensitive to a different coefficient of the spin density matrix, are presented and compared to the Standard Model predictions. The helicity of the W boson from the top decays and the production angles of the top quark are further discussed. New results on the measurment of color flow effects in $t{\\bar t}$ events are presented. Limits on the rate of flavour changing neutral currents in the production or decay of the top quark are reported. The cross-section measurement of photons produced in association with top-quark pairs is a...

  4. Latest results from CERES/NA45

    CERN Document Server

    AUTHOR|(CDS)2074200; Adamova, D; Agakichiev, G; Appelshuser, H; Belaga, V; Braun-Munzinger, P; Campagnolo, R; Castillo, A; Cherlin, A; Damjanovic, S; Dietel, T; Dietrich, L; Drees, A; Esumi, S I; Filimonov, K; Fomenko, K; Fraenkel, Zeev; Garabatos, C; Glässel, P; Hering, G; Holeczek, J; Kushpil, V; Lenkeit, B C; Ludolphs, W; Maas, A; Marin, A; Messer, F; Milosevic, J; Milov, A; Mikowiec, D; Musa, L; Panebratsev, Yu A; Petchenova, O Yu; Petracek, V; Pfeiffer, A; Rak, J; Ravinovich, I; Rehak, P; Richter, M; Sako, H; Schmitz, W; Schükraft, J; Sedykh, S; Seipp, W; Sharma, A; Shimansky, S S; Slivova, J; Specht, H J; Stachel, J; Sumbera, M; Tilsner, H; Tserruya, Itzhak; Wienold, T; Windelband, B; Wurm, J P; Xie, W; Yurevich, S; Yurevich, V; Wessels, Johannes P.

    2003-01-01

    In this talk latest results from the analysis of $e^{+}e^{-}$ pairs emitted in Pb + Au collisions at 40 AGeV/c and a combined analysis of all data available at 158 AGeV/c are presented. The enhancement of low-mass $e^{+}e^{-}$ pairs $(m_{ee}>0.2 GeV/c^{2})$ with respect to the expected yield from hadron decays first reported at 158 AGeV/c is also found at 40 AGeV/c and is even larger there. Comparing to various theoretical models based on $\\pi^{+}\\pi^{-}$ annihilation, the data can only be reproduced, if the properties of the intermediate $\\rho$ in the hot and dense medium are modified. Theoretically, the modification is linked to baryon density rather than temperature. Constraints from hadron data taken at the same beam energies indeed indicate a fireball evolution along a trajectory of higher baryon density at 40 AGeV/c, consistent with the observed larger enhancement factor.

  5. The criminal justice outcomes of jail diversion programs for persons with mental illness: a review of the evidence.

    Science.gov (United States)

    Sirotich, Frank

    2009-01-01

    Diversion programs are initiatives in which persons with serious mental illness who are involved with the criminal justice system are redirected from traditional criminal justice pathways to the mental health and substance abuse treatment systems. This article is a review of the research literature conducted to determine whether the current evidence supports the use of diversion initiatives to reduce recidivism and to reduce incarceration among adults with serious mental illness with justice involvement. A structured literature search identified 21 publications or research papers for review that examined the criminal justice outcomes of various diversion models. The review revealed little evidence of the effectiveness of jail diversion in reducing recidivism among persons with serious mental illness. However, evidence was found that jail diversion initiatives can reduce the amount of jail time that persons with mental illness serve. Implications for practice and research are discussed.

  6. Evidence-based review of three-dimensional conformal radiotherapy for localized prostate cancer: An ASTRO outcomes initiative

    International Nuclear Information System (INIS)

    Morris, David E.; Emami, Bahman; Mauch, Peter M.; Konski, Andre A.; Tao, May L.; Ng, Andrea K.; Klein, Eric A.; Mohideen, Najeeb; Hurwitz, Mark D.; Fraas, Bendick A.; Roach, Mack; Gore, Elizabeth M.; Tepper, Joel E.

    2005-01-01

    Purpose: To perform a systematic review of the evidence to determine the efficacy and effectiveness of three-dimensional conformal radiotherapy (3D-CRT) for localized prostate cancer; provide a clear presentation of the key clinical outcome questions related to the use of 3D-CRT in the treatment of localized prostate cancer that may be answered by a formal literature review; and provide concise information on whether 3D-CRT improves the clinical outcomes in the treatment of localized prostate cancer compared with conventional RT. Methods and Materials: We performed a systematic review of the literature through a structured process developed by the American Society for Therapeutic Radiology and Oncology's Outcomes Committee that involved the creation of a multidisciplinary task force, development of clinical outcome questions, a formal literature review and data abstraction, data review, and outside peer review. Results: Seven key clinical questions were identified. The results and task force conclusions of the literature review for each question are reported. Conclusion: The technological goals of reducing morbidity with 3D-CRT have been achieved. Randomized trials and follow-up of completed trials remain necessary to address these clinical outcomes specifically with regard to patient subsets and the use of hormonal therapy

  7. Optimising the prescription of prosthetic technologies (opptec): Outcome measures for evidence based prosthetic practice and use

    LENUS (Irish Health Repository)

    Ryall, Dr Nicola

    2010-01-01

    This study provided a forum for patients and service providers to voice their opinions in what they believe to be the important predictors and outcomes involved in successful rehabilitation following limb loss. To develop a consensus on the most important outcomes and factors to address for both the lower limb and upper limb prosthetic prescription process, the above data relating to lower limb and upper prosthetics were subsequently used in the next phase of the research involving two Delphi surveys of 23 and 53 experts within the lower limb and upper limb amputation and prosthetic field respectively, including users, service providers and researchers.\\r\

  8. Latest advances in high brightness disk lasers

    Science.gov (United States)

    Kuhn, Vincent; Gottwald, Tina; Stolzenburg, Christian; Schad, Sven-Silvius; Killi, Alexander; Ryba, Tracey

    2015-02-01

    In the last decade diode pumped solid state lasers have become an important tool for many industrial materials processing applications. They combine ease of operation with efficiency, robustness and low cost. This paper will give insight in latest progress in disk laser technology ranging from kW-class CW-Lasers over frequency converted lasers to ultra-short pulsed lasers. The disk laser enables high beam quality at high average power and at high peak power at the same time. The power from a single disk was scaled from 1 kW around the year 2000 up to more than 10 kW nowadays. Recently was demonstrated more than 4 kW of average power from a single disk close to fundamental mode beam quality (M²=1.38). Coupling of multiple disks in a common resonator results in even higher power. As an example we show 20 kW extracted from two disks of a common resonator. The disk also reduces optical nonlinearities making it ideally suited for short and ultrashort pulsed lasers. In a joint project between TRUMPF and IFSW Stuttgart more than 1.3 kW of average power at ps pulse duration and exceptionally good beam quality was recently demonstrated. The extremely low saturated gain makes the disk laser ideal for internal frequency conversion. We show >1 kW average power and >6 kW peak power in multi ms pulsed regime from an internally frequency doubled disk laser emitting at 515 nm (green). Also external frequency conversion can be done efficiently with ns pulses. >500 W of average UV power was demonstrated.

  9. Tablet Use in Schools: A Critical Review of the Evidence for Learning Outcomes

    Science.gov (United States)

    Haßler, B.; Major, L.; Hennessy, S.

    2016-01-01

    The increased popularity of tablets in general has led to uptake in education. We critically review the literature reporting use of tablets by primary and secondary school children across the curriculum, with a particular emphasis on learning outcomes. The systematic review methodology was used, and our literature search resulted in 33 relevant…

  10. The Wages of Failure: New Evidence on School Retention and Long-Run Outcomes

    Science.gov (United States)

    Babcock, Philip; Bedard, Kelly

    2011-01-01

    By estimating differences in long-run education and labor market outcomes for cohorts of students exposed to differing state-level primary school retention rates, this article estimates the effects of retention on all students in a cohort, retained and promoted. We find that a 1 standard deviation increase in early grade retention is associated…

  11. The impact of prison reentry services on short-term outcomes: evidence from a multisite evaluation.

    Science.gov (United States)

    Lattimore, Pamela K; Visher, Christy A

    2013-01-01

    Renewed interest in prisoner rehabilitation to improve postrelease outcomes occurred in the 1990s, as policy makers reacted to burgeoning prison populations with calls to facilitate community reintegration and reduce recidivism. In 2003, the Federal government funded grants to implement locally designed reentry programs. Adult programs in 12 states were studied to determine the effects of the reentry programs on multiple outcomes. A two-stage matching procedure was used to examine the effectiveness of 12 reentry programs for adult males. In the first stage, "intact group matching" was used to identify comparison populations that were similar to program participants. In the second stage, propensity score matching was used to adjust for remaining differences between groups. Propensity score weighted logistic regression was used to examine the impact of reentry program participation on multiple outcomes measured 3 months after release. The study population was 1,697 adult males released from prisons in 2004-2005. Data consisted of interview data gathered 30 days prior to release and approximately 3 months following release, supplemented by administrative data from state departments of correction and the National Crime Information Center. Results suggest programs increased in-prison service receipt and produced modest positive outcomes across multiple domains (employment, housing, and substance use) 3 months after release. Although program participants reported fewer crimes, differences in postrelease arrest and reincarceration were not statistically significant. Incomplete implementation and service receipt by comparison group members may have resulted in insufficient statistical power to identify stronger treatment effects.

  12. How Can Placement Policy Improve Math Remediation Outcomes? Evidence from Experimentation in Community Colleges

    Science.gov (United States)

    Ngo, Federick; Melguizo, Tatiana

    2016-01-01

    Changing placement policy may help to improve developmental education student outcomes in community colleges, but there is little understanding of the impacts of these reforms. We take advantage of heterogeneous placement policy in a large urban community college district in California to compare the effects of math remediation under different…

  13. Does Uninsurance Affect the Health Outcomes of the Insured? Evidence from Heart Attack Patients in California

    NARCIS (Netherlands)

    Meltem Daysal, N.

    2012-01-01

    Abstract: In this paper, I examine the impact of uninsured patients on the health of the insured, focusing on one health outcome - the in-hospital mortality rate of insured heart attack patients. I employ panel data models using patient discharge and hospital financial data from California

  14. Apprenticeship, Vocational Training, and Early Labor Market Outcomes--Evidence from East and West Germany

    Science.gov (United States)

    Riphahn, Regina T.; Zibrowius, Michael

    2016-01-01

    We study the returns to apprenticeship and vocational training for three early labor market outcomes all measured at age 25 for East and West German youths: non-employment (i.e. unemployment or out of the labor force), permanent fulltime employment, and wages. We find strong positive effects of apprenticeship and vocational training. There are no…

  15. The effects of medical school on health outcomes: Evidence from admission lotteries

    NARCIS (Netherlands)

    Leuven, E.; Oosterbeek, H.; de Wolf, I.

    2013-01-01

    This paper estimates the effects of attending medical school on health outcomes by exploiting that admission to medical school in the Netherlands is determined by a lottery. Among the applicants for medical school, people who attended medical school have on average 1.5 more years of completed

  16. Outcome Evidence for Structured Pediatric to Adult Health Care Transition Interventions: A Systematic Review.

    Science.gov (United States)

    Gabriel, Phabinly; McManus, Margaret; Rogers, Katherine; White, Patience

    2017-09-01

    To identify statistically significant positive outcomes in pediatric-to-adult transition studies using the triple aim framework of population health, consumer experience, and utilization and costs of care. Studies published between January 1995 and April 2016 were identified using the CINAHL, Ovid MEDLINE, PubMed, Scopus, and Web of Science databases. Included studies evaluated pre-evaluation and postevaluation data, intervention and comparison groups, and randomized clinic trials. The methodological strength of each study was assessed using the Effective Public Health Practice Project Quality Assessment Tool. Out of a total of 3844 articles, 43 met our inclusion criteria. Statistically significant positive outcomes were found in 28 studies, most often related to population health (20 studies), followed by consumer experience (8 studies), and service utilization (9 studies). Among studies with moderate to strong quality assessment ratings, the most common positive outcomes were adherence to care and utilization of ambulatory care in adult settings. Structured transition interventions often resulted in positive outcomes. Future evaluations should consider aligning with professional transition guidance; incorporating detailed intervention descriptions about transition planning, transfer, and integration into adult care; and measuring the triple aims of population health, experience, and costs of care. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Maternal employment during pregnancy and birth outcomes: evidence from Danish siblings.

    Science.gov (United States)

    Wüst, Miriam

    2015-06-01

    I use Danish survey and administrative data to examine the impact of maternal employment during pregnancy on birth outcomes. As healthier mothers are more likely to work and health shocks to mothers may impact employment and birth outcomes, I combine two strategies: First, I control extensively for time-varying factors that may correlate with employment and birth outcomes, such as pre-pregnancy family income and maternal occupation, pregnancy-related health shocks, maternal sick listing, and health behaviors (smoking and alcohol consumption). Second, to account for remaining time-invariant heterogeneity between mothers, I compare outcomes of mothers' consecutive children. Mothers who work during the first pregnancy trimester have a lower risk of preterm birth. I find no effect on the probability of having a baby of small size for gestational age. To rule out that health selection of mothers between pregnancies drives the results, I focus on mothers whose change in employment status is likely not to be driven by underlying health (mothers who are students in one of their pregnancies and mothers with closely spaced births). Given generous welfare benefits and strict workplace regulations in Denmark, my findings support a residual explanation, namely, that exclusion from employment may stress mothers in countries with high-female employment rates. Copyright © 2014 John Wiley & Sons, Ltd.

  18. Do Gender and Business Trainings Affect Business Outcomes? Experimental Evidence from Vietnam

    NARCIS (Netherlands)

    Bulte, Erwin; Lensink, Robert; Nhung Vu, [No Value

    We use a randomized control trial to evaluate the impact of a business training for female clients of a microfinance institution in northern Vietnam, and we consider the impact on (i) business knowledge, (ii) practices, and (ii) outcomes, as well as (iv) firm entry and exit decisions. In addition,

  19. Colorism and Educational Outcomes of Asian Americans: Evidence from the National Longitudinal Study of Adolescent Health

    Science.gov (United States)

    Ryabov, Igor

    2016-01-01

    Using a nationally representative longitudinal data set, the current study examines the link between colorism and educational attainment of Asian American young adults. Three levels of educational attainment are used as outcomes: high school diploma, some college and a Bachelor's degree or higher. Independent variables include skin tone, ethnic…

  20. Moneyball for Head Start: Using Data, Evidence, and Evaluation to Improve Outcomes for Children and Families

    Science.gov (United States)

    Mead, Sara; Mitchel, Ashley LiBetti

    2016-01-01

    Head Start is a valuable federal program that improves the lives of our nation's most vulnerable children and their families. Research shows that Head Start programs improve children's learning at school entry and have a positive impact on long-term life outcomes. Research also suggests that Head Start could have a stronger impact on children's…

  1. Subjective Happiness Optimizes Educational Outcomes: Evidence from Filipino High School Students.

    Science.gov (United States)

    Datu, Jesus Alfonso D; Valdez, Jana Patricia; Cabrera, Ian Kenneth; Salanga, Maria Guadalupe

    2017-10-30

    Subjective happiness has been found to be associated with key psychological outcomes. However, there is paucity of research that assessed how subjective happiness is related to a number of positive student outcomes in the educational setting. The objective of the study was to assess the associations of subjective happiness with academic engagement, flourishing, and school resilience among 606 Filipino high school students (m age = 13.87; n boys = 300, n girls = 305, n missing = 1) in the Philippine context. Results of path analysis demonstrated that subjective happiness positively predicted behavioral engagement (β = .08, p < .01), emotional engagement (β = .08, p < .01), flourishing (β = .17, p < .01), and school resilience (β = .18, p < .01) even after controlling for gender. The theoretical and practical implications of the findings are discussed.

  2. The Impact of Adolescent Stuttering on Educational and Employment Outcomes: Evidence from a Birth Cohort Study

    Science.gov (United States)

    McAllister, Jan; Collier, Jacqueline; Shepstone, Lee

    2012-01-01

    Purpose: In interview and survey studies, people who stutter report the belief that stuttering has had a negative impact on their own education and employment. This population study sought objective evidence of such disadvantage for people who stutter as a group, compared with people who do not stutter. Method: A secondary analysis of a British…

  3. Does Private Schooling Narrow Wealth Inequalities in Learning Outcomes? Evidence from East Africa

    Science.gov (United States)

    Alcott, Benjamin; Rose, Pauline

    2016-01-01

    In many low- and lower-middle-income countries, private schools are often considered to offer better quality of education than government schools. Yet, there is a lack of evidence to date on their role in reducing inequalities: namely, the extent to which private schooling improves learning among the most disadvantaged children. Our paper uses…

  4. An evidence-based decision assistance model for predicting training outcome in juvenile guide dogs.

    Science.gov (United States)

    Harvey, Naomi D; Craigon, Peter J; Blythe, Simon A; England, Gary C W; Asher, Lucy

    2017-01-01

    Working dog organisations, such as Guide Dogs, need to regularly assess the behaviour of the dogs they train. In this study we developed a questionnaire-style behaviour assessment completed by training supervisors of juvenile guide dogs aged 5, 8 and 12 months old (n = 1,401), and evaluated aspects of its reliability and validity. Specifically, internal reliability, temporal consistency, construct validity, predictive criterion validity (comparing against later training outcome) and concurrent criterion validity (comparing against a standardised behaviour test) were evaluated. Thirty-nine questions were sourced either from previously published literature or created to meet requirements identified via Guide Dogs staff surveys and staff feedback. Internal reliability analyses revealed seven reliable and interpretable trait scales named according to the questions within them as: Adaptability; Body Sensitivity; Distractibility; Excitability; General Anxiety; Trainability and Stair Anxiety. Intra-individual temporal consistency of the scale scores between 5-8, 8-12 and 5-12 months was high. All scales excepting Body Sensitivity showed some degree of concurrent criterion validity. Predictive criterion validity was supported for all seven scales, since associations were found with training outcome, at at-least one age. Thresholds of z-scores on the scales were identified that were able to distinguish later training outcome by identifying 8.4% of all dogs withdrawn for behaviour and 8.5% of all qualified dogs, with 84% and 85% specificity. The questionnaire assessment was reliable and could detect traits that are consistent within individuals over time, despite juvenile dogs undergoing development during the study period. By applying thresholds to scores produced from the questionnaire this assessment could prove to be a highly valuable decision-making tool for Guide Dogs. This is the first questionnaire-style assessment of juvenile dogs that has shown value in predicting

  5. The effect of health care expenditure on patient outcomes : evidence from English neonatal care

    OpenAIRE

    Watson, Samuel I.; Arulampalam, Wiji; Petrou, Stavros; HASH(0x55897e290a30)

    2017-01-01

    The relationship between health care expenditure and health outcomes has been the subject of recent academic inquiry in order to inform cost-effectiveness thresholds for health technology assessment agencies. Previous studies in public health systems have relied upon data aggregated at the national or regional level; however, there remains debate about whether the supply side effect of changes to expenditure are identifiable using data at this level of aggregation. We use detailed patient dat...

  6. Divorced fathers' proximity and children's long-run outcomes: evidence from Norwegian registry data.

    Science.gov (United States)

    Kalil, Ariel; Mogstad, Magne; Rege, Mari; Votruba, Mark

    2011-08-01

    This study examines the link between divorced nonresident fathers' proximity and children's long-run outcomes, using high-quality data from Norwegian population registers. We follow (from birth to young adulthood) each of 15,992 children born into married households in Norway in the years 1975-1979 whose parents divorced during his or her childhood. We observe the proximity of the child to his or her father in each year following the divorce and link proximity to educational and economic outcomes for the child in young adulthood, controlling for a wide range of observable characteristics of the parents and the child. Our results show that closer proximity to the father following a divorce has, on average, a modest negative association with offspring's outcomes in young adulthood. The negative associations are stronger among children of highly educated fathers. Complementary Norwegian survey data show that highly educated fathers report more post-divorce conflict with their ex-wives as well as more contact with their children (measured in terms of the number of nights that the child spends at the father's house). Consequently, the father's relocation to a more distant location following the divorce may shelter the child from disruptions in the structure of the child's life as they split time between households and/or from post-divorce interparental conflict.

  7. Treatment staff turnover in organizations implementing evidence-based practices: Turnover rates and their association with client outcomes

    Science.gov (United States)

    Garner, Bryan R.; Hunter, Brooke D.; Modisette, Kathryn C.; Ihnes, Pamela C.; Godley, Susan H.

    2011-01-01

    High staff turnover has been described as a problem for the substance use disorder treatment field. This assertion is based primarily on the assumption that staff turnover adversely impacts treatment delivery and effectiveness. This assumption, however, has not been empirically tested. In this study, we computed annualized rates of turnover for treatment staff (n=249) participating in an evidence-based practice implementation initiative and examined the association between organizational-level rates of staff turnover and client-level outcomes. Annualized rates of staff turnover were 31% for clinicians and 19% for clinical supervisors. Additionally, multilevel analyses did not reveal the expected relationship between staff turnover and poorer client-level outcomes. Rather, organizational-level rates of staff turnover were found to have a significant positive association with two measures of treatment effectiveness: less involvement in illegal activity and lower social risk. Possible explanations for these findings are discussed. PMID:22154040

  8. Patient value: its nature, measurement, and role in real world evidence studies and outcomes-based reimbursement.

    Science.gov (United States)

    McKenna, Stephen P; Wilburn, Jeanette

    2018-05-01

    The assessment of "patient value" is fundamental to clinical trials, real world evidence studies, and outcomes-based reimbursement schemes. Measures of health-related quality-of-life (HRQoL) are widely used in health research. Such measures are effective in determining the presence or absence of symptoms and functional ability. However, HRQoL measures were not intended, nor designed, to determine the value to patients of alternative health states. Functions have no intrinsic value-they are a means to fulfil human needs. However, needs can be met in a variety of ways, for example by adopting different functions or by the provision of social services. It is possible to analyze all functions in terms of the needs they satisfy. A needs model has been applied in health research since the 1990s. It is concerned with the extent to which human needs are fulfilled in the presence of disease and its treatment. It is argued that this is the major concern of the patient. Needs-based measures are patient-centric and produce a valid unidimensional index of outcome. Consequently, they provide a direct means of measuring patient value. This approach provides the possibility of evaluating health services in terms of the value they provide to consumers and payers. It also has a role to play in real-world evidence studies and outcomes-based reimbursement. It is recommended that greater attention is given in future to the development of patient-reported outcome measures that provide direct assessments of patient value.

  9. Further evidence of the limited role of candidate genes in relation to infant-mother attachment outcomes.

    Science.gov (United States)

    Leerkes, Esther M; Gedaly, Lindsey R; Zhou, Nan; Calkins, Susan; Henrich, Vincent C; Smolen, Andrew

    2017-02-01

    In this paper, we examine the associations between specific candidate genes (DRD2, DRD4, COMT, biallelic and tri-allelic 5HTTLPR, and OXTR) and infant attachment outcomes as main effects and in conjunction with maternal sensitivity. The sample included 200 infants (97 European American, 94 African-American, and 9 biracial) and their mothers. Maternal sensitivity and overtly negative maternal behavior were observed when infants were 6 months and 1 year old in distress-eliciting contexts, attachment was assessed via the Strange Situation at age 1, and DNA samples were collected when children were 2 years old. Consistent with recent research in large samples, there was little evidence that these genes are associated with attachment security, disorganization, or distress as main effects (in additive, dominant, and homozygous models) or in conjunction with maternal sensitivity or overtly negative behavior (primarily dominance models). Furthermore, there was little evidence that associations vary as a function of race.

  10. Parental Leave and Children's Schooling Outcomes: Quasi-Experimental Evidence from a Large Parental Leave Reform

    OpenAIRE

    Natalia Danzer; Victor Lavy

    2013-01-01

    This paper investigates the question whether long-term human capital outcomes are affected by the duration of maternity leave, i.e. by the time mothers spend at home with their newborn before returning to work. Employing RD and difference-in-difference approaches, this paper exploits an unanticipated reform in Austria which extended the maximum duration of paid and job protected parental leave from 12 to 24 months for children born on July 1, 1990 or later. We use test scores from the Austria...

  11. Does initial job status affect midlife outcomes and mental health? Evidence from a survey in Japan

    OpenAIRE

    Oshio, Takashi; Inagaki, Seiichi

    2013-01-01

    This article examines how initial job status following graduation affects the midlife outcomes and mental health of Japanese workers, using micro data from a nationwide online survey of 3,117 men and 2,818 women aged 30-60. The focus was the impact of initial job status on socioeconomic/marital status and mental health during the person's midlife period. It was found that failure to obtain regular employment at the time of graduation raised the probabilities of unstable job status throughout ...

  12. Latest climate changes in Romania :tornadoes

    Science.gov (United States)

    Pop, Elena

    2014-05-01

    Latest climate changes in Romania :tornadoes As climate change has been considered a research priority in the European Strategy for enduring development , I have done a detailed research with my students of the new climate change that has been going on in Romania for the past decade. More precisely I have studied together with my students the phenomenon of tornadoes that have seriously affected on some occasions some our our country's locations, such as Facaeni, in the county of Ialomita, in August 2002. A quite unusual phenomenon occurred on that location situated at 44.56 degrees northern latitude and at 27.89 degrees eastern longitude, that caused severe damage to the local environment and three persons lost their lives in the process, as well as other thirty people suffering from bad injuries. The magnitude of that strong phenomenon rose on the Fujita scale at level F3 which implied wing gusts between 252-300 km/ hour . A main cause of occurrence of such a severe weather was the difference in temperature of two huge air masses, one of Polar origin, and other coming from tropical latitudes . Their crossroads was on that precise territory of Romania. The duration of the worst part of the tornado path lasted only for two minutes, but the consequences of its passage were colossal : total destruction of 33 households, and other 395 were partially damaged, 1,000 people afflicted by the devastation and 100 acres of acacia tree forest ripped off the ground. The first ever recorded tornado phenomenon in Romania was around 1894-1896, considered at that time " a freak of nature" was seen as a cloud formation abnormality , an uncontrolled force of nature that had a huge impact , and at the same time, it vanished into "thin air " fast. The most affected areas in Romania by tornadoes are the south-eastern planes where the cloud formations can create fast columns of air rotating up to 500 km/hour. The local people compared the cloud funnels created on the planes to "serpents

  13. The impact of childhood sickness on adult socioeconomic outcomes: Evidence from late 19th century America

    Science.gov (United States)

    Warren, John Robert; Knies, Laurie; Haas, Steven; Hernandez, Elaine M.

    2013-01-01

    We use family fixed-effects models to estimate the impact of childhood health on adult literacy, labor force outcomes, and marital status among pairs of white brothers observed as children in the 1880 U.S. Census and then as adults in the 1900–1930 Censuses. Given our focus on the 19th century, we observed a wider array of infectious, chronic, and traumatic health problems than is observed using data that are more recent; our results thus provide some insights into circumstances in modern developing countries where similar health problems are more frequently observed. Compared to their healthy siblings, sick brothers were less likely to be located (and thus more likely to be dead) 20–50 years after their 1880 enumeration. Sick brothers were also less likely to be literate, to have ever been married, and to have reported an occupation. However, among those with occupations, sick and healthy brothers tended to do similar kinds of work. We discuss the implications of our results for research on the impact of childhood health on socioeconomic outcomes in developed and developing countries. PMID:22809795

  14. Dimensions of Socioeconomic Status and Childhood Asthma Outcomes: Evidence for Distinct Behavioral and Biological Associations.

    Science.gov (United States)

    Chen, Edith; Shalowitz, Madeleine U; Story, Rachel E; Ehrlich, Katherine B; Levine, Cynthia S; Hayen, Robin; Leigh, Adam K K; Miller, Gregory E

    The objective of this study was to investigate 2 key dimensions of socioeconomic status (SES)-prestige and resources-and their associations with immune, behavioral, and clinical outcomes in childhood asthma. Children ages 9 to 17 years with a physician's diagnosis of asthma (N = 150), and one of their parents participated in this study. Children and parents completed interviews and questionnaires about SES (prestige = parent education; resources = family assets), environmental exposures, and clinical asthma measures. Spirometry was conducted to assess children's pulmonary function, and blood was collected to measure cytokine production in response to nonspecific stimulation, allergen-specific stimulation, and microbial stimulation. Higher scores on both dimensions of childhood SES were associated with better clinical outcomes in children (β's from |.18 to .27|, p values childhood family environments have different implications for behavioral and immunological processes relevant to childhood asthma. They also suggest that childhood SES relates to multiple aspects of immunologic regulation of relevance to the pathophysiology of asthma.

  15. Genetic risk for schizophrenia, obstetric complications, and adolescent school outcome: evidence for gene-environment interaction.

    Science.gov (United States)

    Forsyth, Jennifer K; Ellman, Lauren M; Tanskanen, Antti; Mustonen, Ulla; Huttunen, Matti O; Suvisaari, Jaana; Cannon, Tyrone D

    2013-09-01

    Low birth weight (LBW) and hypoxia are among the environmental factors most reliably associated with schizophrenia; however, the nature of this relationship is unclear and both gene-environment interaction and gene-environment covariation models have been proposed as explanations. High-risk (HR) designs that explore whether obstetric complications differentially predict outcomes in offspring at low risk (LR) vs HR for schizophrenia, while accounting for differences in rates of maternal risk factors, may shed light on this question. This study used prospectively obtained data to examine relationships between LBW and hypoxia on school outcome at age 15-16 years in a Finnish sample of 1070 offspring at LR for schizophrenia and 373 offspring at HR for schizophrenia, based on parental psychiatric history. Controlling for offspring sex, maternal smoking, social support, parity, age, and number of prenatal care visits, HR offspring performed worse than LR offspring across academic, nonacademic, and physical education domains. LBW predicted poorer academic and physical education performance in HR offspring, but not in LR offspring, and this association was similar for offspring of fathers vs mothers with schizophrenia. Hypoxia predicted poorer physical education score across risk groups. Rates of LBW and hypoxia were similar for LR and HR offspring and for offspring of fathers vs mothers with schizophrenia. Results support the hypothesis that genetic susceptibility to schizophrenia confers augmented vulnerability of the developing brain to the effects of obstetric complications, possibly via epigenetic mechanisms.

  16. Persistent use of evidence-based pharmacotherapy in heart failure is associated with improved outcomes

    DEFF Research Database (Denmark)

    Gislason, Gunnar H; Rasmussen, Jeppe Nørgaard; Abildstrom, Steen Z

    2007-01-01

    BACKGROUND: Undertreatment with recommended pharmacotherapy is a common problem in heart failure and may influence prognosis. We studied initiation and persistence of evidence-based pharmacotherapy in 107,092 patients discharged after first hospitalization for heart failure in Denmark from 1995 t...... persistence, but nonpersistence identified a high-risk population of patients who required special attention. A focused effort on early treatment initiation, appropriate dosages, and persistence with the regimen is likely to provide long-term benefit. Udgivelsesdato: 2007-Aug-14...

  17. Implementation and outcomes of an evidence-based precepting program for burn nurses.

    Science.gov (United States)

    Robbins, Johnnie R; Valdez-Delgado, Krystal K; Caldwell, Nicole W; Yoder, Linda H; Hayes, Elizabeth J; Barba, Michaèl G; Greeley, Hope L; Mitchell, Colleen; Mann-Salinas, Elizabeth A

    2017-11-01

    There is significant nationwide interest in transitioning new and new-to-specialty nurses into practice, especially in burn care. Lack of a structured transition program in our Burn Center was recognized as a contributing factor for nursing dissatisfaction and increased turnover compared to other hospital units. Employee evaluations exposed a need for more didactic instruction, hands-on learning, and preceptor support. The goal of this project was to implement an evidence-based transition to practice program specific to the burn specialty. The Iowa Model of Evidence-based Practice served as the model for this project. A working group was formed consisting of nurse scientists, clinical nurse leaders, clinical nurse specialists, lead preceptors, staff nurse preceptors and wound care coordinators. A systematic review of the literature was conducted focusing on nurse transition; preceptor development and transitioning nurse training programs with competency assessment, ongoing multifaceted evaluation and retention strategies were created. The evidence-based Vermont Nurses in Partnership (VNIP) Clinical Transition Framework was selected and subsequent education was provided to all Burn Center leaders and staff. Benchmarks for basic knowledge assessment (BKAT) and burn wound care were established among current staff by work site and education level to help evaluate transitioning nurses. Policies were modified to count each preceptor/transitioning nurse dyad as half an employee on the schedule. Multiple high-fidelity simulation scenarios were created to expand hands-on opportunities. From September 2012-December 2013, 110 (57% acute care nursing) Burn Center staff attended the VNIP Clinical Coaching Course, to include 34 interdisciplinary staff (rehabilitation, education, respiratory therapy, and outpatient clinic staff) and 100% of identified preceptors (n=33). A total of 30 new nurses participated in the transition program: 26 (87%) completed, 3 (10%) did not complete

  18. Parental health shocks, child labor and educational outcomes: Evidence from Tanzania.

    Science.gov (United States)

    Alam, Shamma Adeeb

    2015-12-01

    This paper examines the impact of parental illness on children's education. We find that only father's illness decreases children's school attendance. Father's illness also has long-term impacts on child education, as it decreases children's likelihood of completing primary school and leads to fewer years of schooling. However, we find no evidence that father's illness affects schooling through increased child labor. Instead, father's illness decreases household's income and reduces school attendance possibly because of the reduced ability of the family to afford education. In contrast, mother's illness and illness of other household members have no effect on children's schooling. Copyright © 2015. Published by Elsevier B.V.

  19. Further evidence that culture media affect perinatal outcome: findings after transfer of fresh and cryopreserved embryos.

    Science.gov (United States)

    Nelissen, Ewka C; Van Montfoort, Aafke P; Coonen, Edith; Derhaag, Josien G; Geraedts, Joep P; Smits, Luc J; Land, Jolande A; Evers, Johannes L; Dumoulin, John C

    2012-07-01

    We have previously shown that the medium used for culturing IVF embryos affects the birthweight of the resulting newborns. This observation with potentially far-reaching clinical consequences during later life, was made in singletons conceived during the first IVF treatment cycle after the transfer of fresh embryos. In the present study, we hypothesize that in vitro culture of embryos during the first few days of preimplantation development affects perinatal outcome, not only in singletons conceived in all rank order cycles but also in twins and in children born after transfer of frozen embryos. Furthermore, we investigated the effect of culture medium on gestational age (GA) at birth. Oocytes and embryos from consecutive treatment cycles were alternately assigned to culture in either medium from Vitrolife or from Cook. Data on a cohort of 294 live born singletons conceived after fresh transfer during any of a patient's IVF treatment cycles, as well as data of 67 singletons conceived after frozen embryo transfer (FET) and of 88 children of 44 twin pregnancies after fresh transfer were analysed by means of multiple linear regression. In vitro culture in medium from Cook resulted in singletons after fresh transfer with a lower mean birthweight (adjusted mean difference, 112 g, P= 0.03), and in more singletons with low birthweight (LBW) culture in medium from Vitrolife AB. GA at birth was not related to the medium used (adjusted difference, 0.05 weeks, P = 0.83). Among twins in the Cook group, higher inter-twin mean birthweight disparity and birthweight discordance were found. Z-scores after FET were -0.04 (± 0.14) in the Cook group compared with 0.18 (± 0.21) in the Vitrolife group (P> 0.05). Our findings support our hypothesis that culture medium influences perinatal outcome of IVF singletons and twins. A similar trend is seen in case of singletons born after FET. GA was not affected by culture medium. These results indicate that in vitro culture might be an

  20. Informal Care and Labor Market Outcomes: Evidence From Chinese Married Women.

    Science.gov (United States)

    Chen, Lu; Zhao, Na; Fan, Hongli; Coyte, Peter C

    2015-10-16

    Data were used from the 1991-2009 China Health and Nutrition Survey to examine the influence of informal care on labor market outcomes for married women of working aged, with emphasis on caregiving intensity. After accounting for potential endogeneity between caregiving and labor force participation (LFP) through simultaneous equations modeling, caregivers who provided more than 15 or 20 hr of caregiving per week were 4.5-7.7% less likely to be LFPs. Intensive caregivers who remained working had significantly lower (4.97-7.20) weekly hours of work. The significant positive effect of informal care on LFP only existed in the rural sample, and these women also had much lower hours of work than their urban counterparts. Opportunities exist for policy interventions that target intensive caregivers in order to allow them to balance both work and caregiving. © The Author(s) 2015.

  1. The impact of legalized abortion on child health outcomes and abandonment. Evidence from Romania.

    Science.gov (United States)

    Mitrut, Andreea; Wolff, François-Charles

    2011-12-01

    We use household survey data and a unique census of institutionalized children to analyze the impact of abortion legalization in Romania. We exploit the lift of the abortion ban in December 1989, when communist dictator Ceausescu and his regime were removed from power, to understand its impact on children's health at birth and during early childhood and whether the lift of the ban had an immediate impact on child abandonment. We find insignificant estimates for health at birth outcomes and anthropometric z-scores at age 4 and 5, except for the probability of low birth weight which is slightly higher for children born after abortion became legal. Additionally, our findings suggest that the lift of the ban had decreased the number of abandoned children. Copyright © 2011 Elsevier B.V. All rights reserved.

  2. The Effects of Prior Outcomes on Risky Choice: Evidence from the Stock Market

    Directory of Open Access Journals (Sweden)

    Fenghua Wen

    2014-01-01

    Full Text Available How do prior outcomes affect the risk choice? Research on this can help people to understand investors’ dynamic decisions in financial market. This paper puts forward a new value function. By analyzing the new value function, we find that the prior gains and losses have an impact on the form of value function and the current investors’ risk attitude. Then the paper takes the behavior of the whole stock market as the research object, adopts aggregative index number of 14 representative stocks around the world as samples, and establishes a TVRA-GARCH-M model to investigate the influences of prior gains and losses on the current risk attitude. The empirical study indicates that, at the whole market level, prior gains increase people’s current willingness to take risk assert; that is to say, the house money effect exists in the market, while people are more risk aversion following prior losses.

  3. Do continuous assessment results affect final exam outcomes? Evidence from a microeconomics course

    Directory of Open Access Journals (Sweden)

    Juan Carlos Reboredo

    2017-04-01

    Full Text Available Continuous assessment aims to enhance student learning and understanding of a subject and so achieve better educational outcomes. We investigated how continuous assessment grades affected final exam grades. Using a dataset for six academic post-Bologna Process years (2009-2015 for a first-year undergraduate microeconomics course offered at a Spanish public university, we examined conditional dependence between continuous assessment and final exam grades. Our results would indicate a limited contribution of continuous assessment results to final exam results: the probability of the final exam performance improving on the continuous assessment grade was lower than the probability of the opposite occurring. A consistent exception, however, was students who obtained an A grade for continuous assessment. Our results would cast some doubt on the beneficial effects of continuous assessment advocated by the Bologna Process.

  4. Malaria eradication and economic outcomes in sub-Saharan Africa: Evidence from Uganda.

    Science.gov (United States)

    Barofsky, Jeremy; Anekwe, Tobenna D; Chase, Claire

    2015-12-01

    This study evaluates the economic consequences of a 1959-1960 malaria eradication campaign in southwestern Uganda. The effort constitutes a rare, large-scale, and well-documented attempt to eliminate malaria in sub-Saharan Africa and produced an immediate disease reduction. We use this quasi-experimental health shock to identify long-term changes in educational and economic outcomes. Comparing the treatment district to a similar synthetic control, we find malaria eradication raised educational attainment by about a half year for both males and females, increased primary school completion among females and generated an almost 40% rise in the likelihood of male wage employment. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. Impact of Energy Production on Respiratory Outcomes: Evidence from the Flandres Refinery in France

    International Nuclear Information System (INIS)

    Lavaine, Emmanuelle

    2016-01-01

    This article examines the impact of sulphur dioxide (SO_2) concentration on respiratory admissions in the north of France at municipal level from 2007 to 2011. The Flandres refinery closure in the north of France, in September 2009, is used as a natural experiment. First, this study shows that the halt in the refinery's operations, followed by its closure in 2010, reduces SO_2 concentration. We then use this exogenous shock to analyse the health impact of the high SO_2 concentration generated by energy production. Our estimates highlight that the reduction in SO_2 concentration has significantly reduced the severity of respiratory outcomes. Additionally, the refinery closure has had statistically significant effects on the revenue of municipalities in the area

  6. Questioning gender norms with men to improve health outcomes: evidence of impact.

    Science.gov (United States)

    Barker, G; Ricardo, C; Nascimento, M; Olukoya, A; Santos, C

    2010-01-01

    This article describes a review of 58 evaluation studies of programmes with men and boys in sexual and reproductive health (including HIV prevention, treatment, care and support); father involvement; gender-based violence; maternal, newborn and child health; and gender socialisation more broadly. While few of the programmes go beyond the pilot stage, or a relatively short-term timeframe, they offer compelling evidence that well-designed programmes with men and boys can lead to positive changes in their behaviours and attitudes related to sexual and reproductive health; maternal, newborn and child health; their interaction with their children; their use of violence against women; their questioning of violence with other men; and their health-seeking behaviour. The evidence indicates that programmes that incorporate a gender-transformative approach and promote gender-equitable relationships between men and women are more effective in producing behaviour change than narrowly focused interventions, as are programmes which reach beyond the individual level to the social context.

  7. Evidence-based outcomes following inferior alveolar and lingual nerve injury and repair: a systematic review.

    Science.gov (United States)

    Kushnerev, E; Yates, J M

    2015-10-01

    The inferior alveolar nerve (IAN) and lingual (LN) are susceptible to iatrogenic surgical damage. Systematically review recent clinical evidence regarding IAN/LN repair methods and to develop updated guidelines for managing injury. Recent publications on IAN/LN microsurgical repair from Medline, Embase and Cochrane Library databases were screened by title/abstract. Main texts were appraised for exclusion criteria: no treatment performed or results provided, poor/lacking procedural description, cohort nerve recovery occurred after direct apposition and suturing if nerve ending gaps were nerve grafting (sural/greater auricular nerve). Timing of microneurosurgical repair after injury remains debated. Most authors recommend surgery when neurosensory deficit shows no improvement 90 days post-diagnosis. Nerve transection diagnosed intra-operatively should be repaired in situ; minor nerve injury repair can be delayed. No consensus exists regarding optimal methods and timing for IAN/LN repair. We suggest a schematic guideline for treating IAN/LN injury, based on the most current evidence. We acknowledge that additional RCTs are required to provide definitive confirmation of optimal treatment approaches. © 2015 John Wiley & Sons Ltd.

  8. The Latest IceCube Results and the Implications

    Science.gov (United States)

    Mase, Keiichi

    IceCube was built at the South Pole and aims to detect high energy neutrinos from the universe mainly above 100 GeV. The transparent ice media allows us to build a 1 km3 large detection volume to detect the rarely interacting particles. Neutrinos are thought to be generated at astrophysical sources such as active galactic nuclei and gamma-ray bursts. Nature of the rare interaction with matters and little deflection by a magnetic field makes it possible to explore such sources located at the deep universe. Since the neutrinos are produced through collisions of hadronic particles, the observation can elucidate the origin of cosmic rays, which is still mystery after the discovery 100 years ago. The detector was completed at the end of 2010 and is running smoothly. Recently, IceCube has found the first evidence of extraterrestrial neutrinos with energies above approximately 60 TeV. IceCube also contributes to elementary particle physics by searching for neutrinos produced in self-annihilation of SUSY particles such as neutralinos and by investigating atmospheric neutrino oscillations. The latest IceCube results and the corresponding implications are presented.

  9. Improving outcomes for people in mental health crisis: a rapid synthesis of the evidence for available models of care.

    Science.gov (United States)

    Paton, Fiona; Wright, Kath; Ayre, Nigel; Dare, Ceri; Johnson, Sonia; Lloyd-Evans, Brynmor; Simpson, Alan; Webber, Martin; Meader, Nick

    2016-01-01

    Crisis Concordat was established to improve outcomes for people experiencing a mental health crisis. The Crisis Concordat sets out four stages of the crisis care pathway: (1) access to support before crisis point; (2) urgent and emergency access to crisis care; (3) quality treatment and care in crisis; and (4) promoting recovery. To evaluate the clinical effectiveness and cost-effectiveness of the models of care for improving outcomes at each stage of the care pathway. Electronic databases were searched for guidelines, reviews and, where necessary, primary studies. The searches were performed on 25 and 26 June 2014 for NHS Evidence, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, NHS Economic Evaluation Database, and the Health Technology Assessment (HTA) and PROSPERO databases, and on 11 November 2014 for MEDLINE, PsycINFO and the Criminal Justice Abstracts databases. Relevant reports and reference lists of retrieved articles were scanned to identify additional studies. When guidelines covered a topic comprehensively, further literature was not assessed; however, where there were gaps, systematic reviews and then primary studies were assessed in order of priority. Systematic reviews were critically appraised using the Risk Of Bias In Systematic reviews assessment tool, trials were assessed using the Cochrane risk-of-bias tool, studies without a control group were assessed using the National Institute for Health and Care Excellence (NICE) prognostic studies tool and qualitative studies were assessed using the Critical Appraisal Skills Programme quality assessment tool. A narrative synthesis was conducted for each stage of the care pathway structured according to the type of care model assessed. The type and range of evidence identified precluded the use of meta-analysis. One review of reviews, six systematic reviews, nine guidelines and 15 primary studies were included. There was very limited evidence for access to support

  10. Improving Nigerian health policymakers' capacity to access and utilize policy relevant evidence: outcome of information and communication technology training workshop.

    Science.gov (United States)

    Uneke, Chigozie Jesse; Ezeoha, Abel Ebeh; Uro-Chukwu, Henry; Ezeonu, Chinonyelum Thecla; Ogbu, Ogbonnaya; Onwe, Friday; Edoga, Chima

    2015-01-01

    Information and communication technology (ICT) tools are known to facilitate communication and processing of information and sharing of knowledge by electronic means. In Nigeria, the lack of adequate capacity on the use of ICT by health sector policymakers constitutes a major impediment to the uptake of research evidence into the policymaking process. The objective of this study was to improve the knowledge and capacity of policymakers to access and utilize policy relevant evidence. A modified "before and after" intervention study design was used in which outcomes were measured on the target participants both before the intervention is implemented and after. A 4-point likert scale according to the degree of adequacy; 1 = grossly inadequate, 4 = very adequate was employed. This study was conducted in Ebonyi State, south-eastern Nigeria and the participants were career health policy makers. A two-day intensive ICT training workshop was organized for policymakers who had 52 participants in attendance. Topics covered included: (i). intersectoral partnership/collaboration; (ii). Engaging ICT in evidence-informed policy making; use of ICT for evidence synthesis; (iv) capacity development on the use of computer, internet and other ICT. The pre-workshop mean of knowledge and capacity for use of ICT ranged from 2.19-3.05, while the post-workshop mean ranged from 2.67-3.67 on 4-point scale. The percentage increase in mean of knowledge and capacity at the end of the workshop ranged from 8.3%-39.1%. Findings of this study suggest that policymakers' ICT competence relevant to evidence-informed policymaking can be enhanced through training workshop.

  11. IS THE WEBSITE MARKETING STRATEGY CORRELATED WITH THE COMPANIES OUTCOMES? EVIDENCE FROM ROMANIAN IT INDUSTRY

    Directory of Open Access Journals (Sweden)

    Constantinescu-Dobra Anca

    2012-07-01

    Full Text Available With a constant yearly growth of more than 20% over the last five years and adding up to10% of the GDP, the Romanian Information Technology (IT sector has an important potential for development. Emphasizing on websites marketing in this sector could enhance more profitability. Even though this tool is considered to be much depersonalized, the users like getting a sense of the company behind the website. Having a wide range of information facilitates this understanding. In a very competitive environment, the IT managers have to realize that the overall site is what represents their organization to users. Prospectors look at product pages and read the site content when they are evaluating an organization as a possible vendor, business partner, employer, investment opportunity. Therefore, websites marketing is one of aspects that need to be constantly reevaluated in an ever-changing word of communication. Given this facts, the present study identifies the extent to which the most valuable IT Romanian companies practice webpage’s marketing. Specifically, we examine the content, in-time communication tools, navigability and style of the websites in correlation with their outcome and size. Moreover, the paper analyzes the differences between websites characteristics of Romanian IT SMEs and large companies from top 100, according to their turnover. The specific objectives in order to investigate the websites marketing of Romanian IT companies are: -To evaluate the websites marketing policies of the software developer, hardware and IT distributors; -To analyze in depth the Romanian IT companies websites performance in correlation with their profit, turnover and number of employees; -To assess the differences between websites policy of SMEs and large companies from Romanian IT industry; This study is exploratory and consists in a qualitative assessment of websites from top100 software, hardware and IT distributor companies. The sample consists of

  12. Communicating Program Outcomes to Encourage Policymaker Support for Evidence-Based State Tobacco Control

    Directory of Open Access Journals (Sweden)

    Allison M. Schmidt

    2014-12-01

    Full Text Available Tobacco use, the leading cause of preventable death in the U.S., can be reduced through state-level tobacco prevention and cessation programs. In the absence of research about how to communicate the need for these programs to policymakers, this qualitative study aimed to understand the motivations and priorities of policymakers in North Carolina, a state that enacted a strong tobacco control program from 2003–2011, but drastically reduced funding in recent years. Six former legislators (three Democrats, three Republicans and three lobbyists for health organizations were interviewed about their attitudes towards tobacco use, support of state-funded programs, and reactions to two policy briefs. Five themes emerged: (1 high awareness of tobacco-related health concerns but limited awareness of program impacts and funding, (2 the primacy of economic concerns in making policy decisions, (3 ideological differences in views of the state’s role in tobacco control, (4 the impact of lobbyist and constituent in-person appeals, and (5 the utility of concise, contextualized data. These findings suggest that building relationships with policymakers to communicate ongoing program outcomes, emphasizing economic data, and developing a constituent advocacy group would be valuable to encourage continued support of state tobacco control programs.

  13. Communicating program outcomes to encourage policymaker support for evidence-based state tobacco control.

    Science.gov (United States)

    Schmidt, Allison M; Ranney, Leah M; Goldstein, Adam O

    2014-12-04

    Tobacco use, the leading cause of preventable death in the U.S., can be reduced through state-level tobacco prevention and cessation programs. In the absence of research about how to communicate the need for these programs to policymakers, this qualitative study aimed to understand the motivations and priorities of policymakers in North Carolina, a state that enacted a strong tobacco control program from 2003-2011, but drastically reduced funding in recent years. Six former legislators (three Democrats, three Republicans) and three lobbyists for health organizations were interviewed about their attitudes towards tobacco use, support of state-funded programs, and reactions to two policy briefs. Five themes emerged: (1) high awareness of tobacco-related health concerns but limited awareness of program impacts and funding, (2) the primacy of economic concerns in making policy decisions, (3) ideological differences in views of the state's role in tobacco control, (4) the impact of lobbyist and constituent in-person appeals, and (5) the utility of concise, contextualized data. These findings suggest that building relationships with policymakers to communicate ongoing program outcomes, emphasizing economic data, and developing a constituent advocacy group would be valuable to encourage continued support of state tobacco control programs.

  14. Social cognition and metacognition in schizophrenia: evidence of their independence and linkage with outcomes.

    Science.gov (United States)

    Lysaker, P H; Gumley, A; Luedtke, B; Buck, K D; Ringer, J M; Olesek, K; Kukla, M; Leonhardt, B L; Popolo, R; Dimaggio, G

    2013-03-01

    Research suggests that many with schizophrenia experience deficits in the ability to make discrete judgments about the thoughts and feelings of others as well as to form larger integrated representations of themselves and others. Little is known about whether these difficulties may be distinguished from one another and whether they are linked with different outcomes. We administered three assessments of social cognition which tapped the ability to identify emotions and intentions and two metacognitive tasks which called for the formation of more integrated and flexible representations of the self and others. We additionally assessed symptoms, social functioning and neurocognition. Participants were 95 individuals with a schizophrenia spectrum disorder. A principle components analysis followed by a varimax rotation revealed two factors which accounted for 62% of the variance. The first factor was comprised of the three social cognition tests and the second of two tasks that tapped the ability to create representations of oneself and others which integrate more discreet information. The first factor was uniquely correlated with negative symptoms, and the second was uniquely correlated with social function. Results suggest that deficits in social cognition and metacognition represent different forms of dysfunction in schizophrenia. © 2012 John Wiley & Sons A/S.

  15. EDUCATIONAL OUTCOMES OF SCHOOL FEEDING INTERVENTION: EVIDENCE FROM RURAL NORTHERN GHANA

    Directory of Open Access Journals (Sweden)

    Oloruntoba Abayomi

    2014-03-01

    Full Text Available The study investigated how policy intervention could have significant impact on beneficiaries. Using quasi-experimental design, 360 pupils from participating and non-participating schools in a feeding program were selected from a rural setting. Instrument for data collection was validated, pre-tested and administered on cross-section of respondents. Data were analyzed using descriptive statistics, t-test and regression analyses. Findings show that significant differences existed in educational outcomes as participating pupils performed better in core subjects of English Language, Mathematics and Integrated Science. In terms of socio-economic determinants, findings show that selected variables such as sex of pupils and number of dependents in the family had directly impacted on the performance of pupils. The study also found causal link between the school feeding intervention and others as one of the multiplier effects was not only an increased enrolments by almost a quarter, but reduced dropout and absenteeism rates. This implied that the policy environments was sufficiently pro-poor and effective since it has strengthened the standard of foundational primary school and completion rate envisaged in the educational policy. It is recommended that further policy options that would facilitate the scaling-up of the program in the entire intervention area be formulated.

  16. ICARUS T600: Latest physics results

    International Nuclear Information System (INIS)

    Zani, A.

    2014-01-01

    The ICARUS T600 detector is the largest Liquid Argon (LAr) Time Projection Chamber (TPC) ever built and operated to date. The detector, assembled underground in the Hall B of the Gran Sasso Laboratory (LNGS), has been collecting neutrino events with the CERN to Gran Sasso (CNGS) beam and from cosmic rays from May 2010 to June 2013. The ICARUS excellent spatial and calorimetric resolution, coupled to very refined 3D event reconstruction techniques, allows to search, among others, for ν μ →ν e transitions which may be related to the 'LSND anomaly'. Though no evidence of this is detected, an important region of the parameter space remains unexplored. For this reason the joint ICARUS-NESSiE collaboration is proposing an experiment, at the new foreseen CERN-SPS neutrino beam facility (CENF), to solve the sterile neutrino puzzle.

  17. Latest results from XENON100 data

    International Nuclear Information System (INIS)

    Scotto Lavina, L.

    2014-01-01

    XENON100 is the current phase of the XENON dark matter program, which aims for the direct detection of WIMPs with liquid xenon time-projection chambers. We present the status of the experiment after 224.6 live days taken in 2011 and 2012 during which the detector successfully improved in terms of more calibration data, higher xenon purity, lower threshold and better background removal. The analysis has yielded no evidence for dark matter interactions. The status of the next generation XENON1T detector will be briefly described. The goal of XENON1T is to increase the fiducial volume by a factor 10 and reduce the background noise by a factor 100

  18. Treatments for compulsive buying: A systematic review of the quality, effectiveness and progression of the outcome evidence.

    Science.gov (United States)

    Hague, Ben; Hall, Jo; Kellett, Stephen

    2016-09-01

    Background and aims This review appraises the progression and status of the evidence base for the treatment of compulsive buying disorder (CBD), in order to highlight what currently works and to prompt useful future research. Methods Online databases ISI Web of Knowledge, PsycINFO, and PubMed via Ovid were searched at two time points. Two quality checklists and an established model of therapy evaluation (hourglass model) evaluated the quality and progression of both psychotherapy and pharmacotherapy treatments for CBD. Uncontrolled effect sizes were calculated and meta-regression analyses were performed regarding treatment duration. Results A total of 29 articles met the inclusion criteria, which were divided into psychotherapy (n = 17) and pharmacotherapy treatments (n = 12). Of the 29 studies, only 5 studies have been tested under conditions of high methodological quality. Both forms of treatment had been evaluated in a haphazard manner across the stages of the hourglass model. Although large effects were demonstrated for group psychotherapy and pharmacotherapy, such evidence of effectiveness was undermined by poor study quality and risk of publication bias. Long-term CBD treatment was associated with improved outcome with pharmacotherapy, but not when delivering psychotherapy. Discussion Group psychotherapy currently appears the most promising treatment option for CBD. Poor methodological control and sporadic evaluation of specific treatments have slowed the generation of a convincing evidence base for CBD treatment. Defining the active ingredients of effective CBD treatment is a key research goal.

  19. Associations between adherence and outcomes among older, type 2 diabetes patients: evidence from a Medicare Supplemental database

    Directory of Open Access Journals (Sweden)

    Boye KS

    2016-08-01

    Full Text Available Kristina Secnik Boye,1 Sarah E Curtis,1 Maureen J Lage,2 Luis-Emilio Garcia-Perez3 1Global Patient Outcomes and Real World Evidence, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 2HealthMetrics Outcomes Research, LLC, Bonita Springs, FL, 3Global Medical Affairs, Lilly Diabetes, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA Objective: To examine the association between adherence to glucose-lowering agents and patient outcomes, including costs, acute-care resource utilization, and complications, in an older, type 2 diabetic population.Data and methods: The study used Truven’s Medicare Supplemental database from July 1, 2009 to June 30, 2014. Patients aged 65 years or older were included if they had at least two type 2 diabetes diagnoses and received a glucose-lowering agent from July 1, 2010 through June 30, 2011. Multivariable analyses examined the relationships among 3-year patient outcomes and levels of adherence, proxied by the proportion of days covered. Outcomes included all-cause medical costs, diabetes-related medical costs, acute-care resource utilization, and acute complications.Results: In this study (N=123,235, higher adherence was linked to reduced costs and improved health outcomes. For example, comparing an individual with adherence of proportion of days covered <20% to one with proportion of days covered ≥80% illustrates an average saving of $28,824 in total 3-year costs. Furthermore, a 1% increase in adherence among 1,000 patients was associated with all-cause savings of $65,464 over 3 years. The probability of a hospitalization, an emergency room (ER visit, or an acute complication decreased monotonically as adherence levels got higher, as did the number of hospitalizations, ER visits, and days hospitalized (P<0.005.Conclusion: Higher adherence was associated with substantially less need for acute care, as indicated by a lowered probability of hospitalization or ER use, a reduced

  20. Laparoscopic management of Müllerian duct remnants in the paediatric age: Evidence and outcome analysis

    Directory of Open Access Journals (Sweden)

    Maja Raicevic

    2018-01-01

    Full Text Available Background: This study performed a literature analysis to determine outcomes of laparoscopic management in Müllerian duct remnants (MDRs. Patients and Methods: Literature was searched for terms 'Müllerian' 'duct' 'remnants' and 'laparoscopy'. Primary end points were age at surgery, laparoscopic technique, intraoperative complications and postoperative morbidity. Results: The search revealed 10 articles (2003–2014 and included 23 patients with mean age of 1.5 years (0.5–18 at surgery. All patients were 46XY, n = 1 normal male karyotype with two cell lines. Explorative laparoscopy was performed in n = 2 and surgical management in n = 21. The 5-port technique was used in n = 10, 3-port in n = 9 and robot-assisted laparoscopic approach in n = 1 (n = 1 technique not described. Complete MDRs removal in n = 9, complete dissection and MDRs neck ligation with endoscopic loops in n = 11 and n = 1 uterus and cervix were split in the midline. After MDRs removal, there were n = 2 bilateral orchidopexy, n = 3 unilateral orchidopexy, n = 1 Fowler–Stephens stage-I and n = 1 orchiectomy. Mean operative time was 193 min (120–334, and there were no intraoperative complications. Mean follow-up was 20.5 months (3–54 and morbidity included 1 prostatic diverticula. There were 13 associations with hypospadias, of which 3 had mixed gonads and 3 bilateral cryptorchidism. Other associations were unilateral cryptorchidism and incarcerated inguinal hernia n = 1, right renal agenesis and left hydronephrosis n = 1 and n = 2 with transverse testicular ectopy. Conclusion: This MDRs analysis suggests that the laparoscopic approach is an effective and safe method of treatment as no intraoperative complication has reported, and there is low morbidity in the long-term follow-up.

  1. The SCIDOTS Project: Evidence of benefits of an integrated tobacco cessation intervention in tuberculosis care on treatment outcomes

    Directory of Open Access Journals (Sweden)

    Syed Sulaiman Syed Azhar

    2011-09-01

    Full Text Available Abstract Background There is substantial evidence to support the association between tuberculosis (TB and tobacco smoking and that the smoking-related immunological abnormalities in TB are reversible within six weeks of cessation. Therefore, connecting TB and tobacco cessation interventions may produce significant benefits and positively impact TB treatment outcomes. However, no study has extensively documented the evidence of benefits of such integration. SCIDOTS Project is a study from the context of a developing nation aimed to determine this. Methods An integrated TB-tobacco intervention was provided by trained TB directly observed therapy short-course (DOTS providers at five chest clinics in Malaysia. The study was a prospective non-randomized controlled intervention using quasi-experimental design. Using Transtheoretical Model approach, 120 eligible participants who were current smokers at the time of TB diagnosis were assigned to either of two treatment groups: conventional TB DOTS plus smoking cessation intervention (integrated intervention or SCIDOTS group or conventional TB DOTS alone (comparison or DOTS group. At baseline, newly diagnosed TB patients considering quitting smoking within the next 30 days were placed in the integrated intervention group, while those who were contemplating quitting were assigned to the comparison group. Eleven sessions of individualized cognitive behavioral therapy with or without nicotine replacement therapy were provided to each participant in the integrated intervention group. The impacts of the novel approach on biochemically validated smoking cessation and TB treatment outcomes were measured periodically as appropriate. Results A linear effect on both 7-day point prevalence abstinence and continuous abstinence was observed over time in the intervention group. At the end of 6 months, patients who received the integrated intervention had significantly higher rate of success in quitting smoking when

  2. Latest developments in silica fibre luminescence dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Bradley, D. A.; Abdul S, S. F.; Jafari, S. M.; Alanazi, A. [University of Surrey, Department of Physics, GU2 7XH Guildford, Surrey (United Kingdom); Amouzad M, G. [University of Malaya, Faculty of Engineering, Department of Electrical Engineering, Integrated Lightwave Research Group, 50603 Kuala Lumpur (Malaysia); Addul R, H. A.; Mizanur R, A. K. M.; Zubair, H. T.; Begum, M.; Yusoff, Z.; Omar, N. Y. M. [Multimedia University, Faculty of Engineering, 2010 Cyberjaya, Selangor (Malaysia); Maah, M. J. [University of Malaya, Department of Chemistry, 50603 Kuala Lumpur (Malaysia); Collin, S. [National Physical Laboratory, Hampton Road, Teddington, TW11 OLW Middlesex (United Kingdom); Mat-Sharif, K. A.; Muhd-Yassin, S. Z.; Zulkifli, M. I., E-mail: d.a.bradley@surrey.ac.uk [Telekom Malaysia Research and Development Sdn Bhd., 63000 Cyberjaya, Selangor (Malaysia)

    2015-10-15

    Full text: Using tailor made sub-mm diameter doped-silica fibres, we are carrying out luminescence dosimetry studies for a range of situations, including thermoluminescence (Tl)investigations on a liquid alpha source formed of {sup 223}RaCl (the basis of the Bayer Health care product Xofigo), the Tl response to a 62 MeV proton source and Tl response to irradiation from an {sup 241}Am-Be neutron source. In regard to the former, in accord with the intrinsic high linear energy transfer (Let) and short path length (<100 um) of the α-particles in calcified tissue, the product is in part intended as a bone-seeking radionuclide for treatment of metastatic cancer, offering high specificity and efficacy. The Tl yield of Ge-doped SiO{sub 2} fibres has been investigated including for photonic crystal fibre un collapsed, flat fibres and single mode fibres, these systems offering many advantages over conventional passive dosimetry types. In particular, one can mention comparable and even superior sensitivity, an effective atomic number Z{sub eff} of the silica dosimetric material close to that of bone, and the glassy nature of the fibres offering the additional advantage of being able to place such dosimeters directly into liquid environments. Finally we review the use of our tailor made fibres for on-line radioluminescence measurements of radiotherapy beams. The outcome from these various lines of research is expected to inform development of doped fiber radiation dosimeters of versatile utility, ranging from clinical applications through to industrial studies and environmental evaluations. (Author)

  3. Plasmapheresis in immune hematology: review of clinical outcome data with respect to evidence-based medicine and clinical experience.

    Science.gov (United States)

    von Baeyer, Hans

    2003-02-01

    The objective of this paper is to assess the role of plasmapheresis in immune hematology by reviewing published clinical outcome data and narrative review articles. This information will be used to define evidence levels for appraisal of the efficacy and rank of plasmapheresis among other management options. This evidence-based strategy conforms to the concepts of the American Society of Hematology (ASH). as put forward in 1996 in the context of immune thrombocytopenia (ITP) treatment. The term 'experimental' is used to describe indications where the only scientific evidence of the efficacy of plasmapheresis consists of pathophysiological reasoning and empiric clinical findings. We reviewed the available literature on the use of plasmapheresis in autoimmune hemolytic anemia (AIHA), hemolytic disease of the newborn (HDN), autoimmune thrombocytopenic purpura (AITP), heparin-induced thrombocytopenia type II (HIT II), post-transfusion purpura (PTP), refractoriness to platelet transfusion (RPT), coagulation factor inhibitor (CFI) and catastrophic antiphospholipid syndrome (CAS). Plasmapheresis completes the spectrum of management options as it eliminates physically circulating free antibodies involved in the pathogenesis of these immune hematological syndromes. Because of the paucity of data, evidence levels had to be defined based on the findings of uncontrolled case series and the opinions of independent experts. In many cases, randomized clinical trials were not feasible because the syndromes are so rare. When defined as an 'experimental indication', plasmapheresis has a firm scientific basis, but larger scale clinical experience with the method is still lacking. In these cases, the detection and monitoring of symptomatic disease-related circulating free antibodies or immune complexes is a mandatory prerequisite for the use of plasmapheresis. The therapeutic benefit of plasmapheresis is substantiated by the level V of evidence of its efficacy in treatment of HDN, HIV

  4. The effects of socioeconomic status on stroke risk and outcomes

    OpenAIRE

    Marshall, Iain James; Wang, Yanzhong; Crichton, Siobhan Laura; McKevitt, Christopher John; Rudd, Anthony; Wolfe, Charles David Alexander

    2015-01-01

    The latest evidence on socioeconomic status and stroke shows that stroke not only disproportionately affects low-income and middle-income countries, but also socioeconomically deprived populations within high-income countries. These disparities are reflected not only in risk of stroke but also in short-term and long-term outcomes after stroke. Increased average levels of conventional risk factors (eg, hypertension, hyperlipidaemia, excessive alcohol intake, smoking, obesity, and sedentary lif...

  5. VNS Therapy versus the latest antiepileptic drug.

    Science.gov (United States)

    Ben-Menachem, Elinor; French, Jacqueline A

    2005-09-01

    Pro AED: The central issue in medical decision-making is risk-benefit assessment. Surgery of any type is still considered to be a major undertaking. To warrant these risks, the patient has a right to expect that they have a greater chance of a good outcome with an invasive therapy than with a non-invasive one. The main question is when, if ever, this becomes the case when comparing implantation of a VNS Therapy System versus adding an antiepileptic drug (AED)? After the first drug? The second? After all AEDs have failed? To date, no randomized trial comparing the addition of an AED against vagus nerve stimulation (VNS Therapy) has been undertaken, although several are currently being contemplated. Without this information, it is more difficult to make a case for early implementation of VNS Therapy. Unfortunately, few data are available regarding the potential for patients to become seizure-free after implantation of a VNS Therapy System. Another issue is side effects. It is important to remember that VNS Therapy also produces adverse events, albeit very different in character than those associated with AEDs, to which physicians have become accustomed. These include cough, dyspnea, pharyngitis, voice alteration and sleep apnea. A less frequently discussed, potentially negative consequence of VNS Therapy relates to the ability to obtain imaging of the patient. Patients who have undergone VNS Therapy System implantation are not candidates for imaging of the chest, breast, or abdomen. A second issue is that imaging of the brain can only be performed with MRI scanners that meet certain requirements, and as MRI technology develops, scanners meeting these requirements may become harder to find. However, to summarize, VNS Therapy is an excellent and useful treatment choice. Fortunately, the choice between AEDs and VNS Therapy is not an "either/or" decision. Each has a role in the treatment of patients with epilepsy, and the advantages and disadvantages of each should be

  6. The role of evidence-based therapy relationships on treatment outcome for adults with trauma: A systematic review.

    Science.gov (United States)

    Ellis, Amy E; Simiola, Vanessa; Brown, Laura; Courtois, Christine; Cook, Joan M

    2018-01-01

    The purpose of this paper was to systematically review and synthesize the empirical literature on the effects of evidence-based therapy relationship (EBR) variables in the psychological treatment for adults who experienced trauma-related distress. Studies were identified using comprehensive searches of PsycINFO, Medline, Published International Literature on Traumatic Stress, and Cumulative Index to Nursing and Allied Health Literature databases. Included in the review were articles published between 1980 and 2015, in English that reported on the impact of EBRs on treatment outcome in clinical samples of adult trauma survivors. Nineteen unique studies met inclusion criteria. The bulk of the studies were on therapeutic alliance and the vast majority found that alliance was predictive of or associated with a reduction in various symptomotology. Methodological concerns included the use of small sample sizes, little information on EBRs beyond alliance as well as variability in its measurement, and non-randomized assignment to treatment conditions or the lack of a comparison group. More research is needed on the roles of client feedback, managing countertransference, and other therapist characteristics on treatment outcome with trauma survivors. Understanding the role of EBRs in the treatment of trauma survivors may assist researchers, clinicians, and psychotherapy educators to improve therapist training as well as client engagement and retention in treatment.

  7. Outcomes and Impact of HIV Prevention, ART and TB Programs in Swaziland – Early Evidence from Public Health Triangulation

    Science.gov (United States)

    van Schalkwyk, Cari; Mndzebele, Sibongile; Hlophe, Thabo; Garcia Calleja, Jesus Maria; Korenromp, Eline L.; Stoneburner, Rand; Pervilhac, Cyril

    2013-01-01

    Introduction Swaziland’s severe HIV epidemic inspired an early national response since the late 1980s, and regular reporting of program outcomes since the onset of a national antiretroviral treatment (ART) program in 2004. We assessed effectiveness outcomes and mortality trends in relation to ART, HIV testing and counseling (HTC), tuberculosis (TB) and prevention of mother to child transmission (PMTCT). Methods Data triangulated include intervention coverage and outcomes according to program registries (2001-2010), hospital admissions and deaths disaggregated by age and sex (2001-2010) and population mortality estimates from the 1997 and 2007 censuses and the 2007 demographic and health survey. Results By 2010, ART reached 70% of the estimated number of people living with HIV/AIDS with CD4<350/mm3, with progressively improving patient retention and survival. As of 2010, 88% of health facilities providing antenatal care offered comprehensive PMTCT services. The HTC program recorded a halving in the proportion of adults tested who were HIV-infected; similarly HIV infection rates among HIV-exposed babies halved from 2007 to 2010. Case fatality rates among hospital patients diagnosed with HIV/AIDS started to decrease from 2005–6 in adults and especially in children, contrasting with stable case fatality for other causes including TB. All-cause child in-patient case fatality rates started to decrease from 2005–6. TB case notifications as well as rates of HIV/TB co-infection among notified TB patients continued a steady increase through 2010, while coverage of HIV testing and CPT for co-infected patients increased to above 80%. Conclusion Against a background of high, but stable HIV prevalence and decreasing HIV incidence, we documented early evidence of a mortality decline associated with the expanded national HIV response since 2004. Attribution of impact to specific interventions (versus natural epidemic dynamics) will require additional data from future

  8. The SCIDOTS Project: evidence of benefits of an integrated tobacco cessation intervention in tuberculosis care on treatment outcomes.

    Science.gov (United States)

    Awaisu, Ahmed; Nik Mohamed, Mohamad Haniki; Mohamad Noordin, Noorliza; Abd Aziz, Noorizan; Syed Sulaiman, Syed Azhar; Muttalif, Abdul Razak; Ahmad Mahayiddin, Aziah

    2011-09-23

    There is substantial evidence to support the association between tuberculosis (TB) and tobacco smoking and that the smoking-related immunological abnormalities in TB are reversible within six weeks of cessation. Therefore, connecting TB and tobacco cessation interventions may produce significant benefits and positively impact TB treatment outcomes. However, no study has extensively documented the evidence of benefits of such integration. SCIDOTS Project is a study from the context of a developing nation aimed to determine this. An integrated TB-tobacco intervention was provided by trained TB directly observed therapy short-course (DOTS) providers at five chest clinics in Malaysia. The study was a prospective non-randomized controlled intervention using quasi-experimental design. Using Transtheoretical Model approach, 120 eligible participants who were current smokers at the time of TB diagnosis were assigned to either of two treatment groups: conventional TB DOTS plus smoking cessation intervention (integrated intervention or SCIDOTS group) or conventional TB DOTS alone (comparison or DOTS group). At baseline, newly diagnosed TB patients considering quitting smoking within the next 30 days were placed in the integrated intervention group, while those who were contemplating quitting were assigned to the comparison group. Eleven sessions of individualized cognitive behavioral therapy with or without nicotine replacement therapy were provided to each participant in the integrated intervention group. The impacts of the novel approach on biochemically validated smoking cessation and TB treatment outcomes were measured periodically as appropriate. A linear effect on both 7-day point prevalence abstinence and continuous abstinence was observed over time in the intervention group. At the end of 6 months, patients who received the integrated intervention had significantly higher rate of success in quitting smoking when compared with those who received the conventional TB

  9. Determining cosmological parameters with the latest observational data

    International Nuclear Information System (INIS)

    Xia Junqing; Li Hong; Zhao Gongbo; Zhang Xinmin

    2008-01-01

    In this paper, we combine the latest observational data, including the WMAP five-year data (WMAP5), BOOMERanG, CBI, VSA, ACBAR, as well as the baryon acoustic oscillations (BAO) and type Ia supernovae (SN) ''union'' compilation (307 sample), and use the Markov Chain Monte Carlo method to determine the cosmological parameters, such as the equation of state (EoS) of dark energy, the curvature of the universe, the total neutrino mass, and the parameters associated with the power spectrum of primordial fluctuations. In a flat universe, we obtain the tight limit on the constant EoS of dark energy as w=-0.977±0.056(stat)±0.057(sys). For the dynamical dark energy models with the time evolving EoS parametrized as w de (a)=w 0 +w 1 (1-a), we find that the best-fit values are w 0 =-1.08 and w 1 =0.368, while the ΛCDM model remains a good fit to the current data. For the curvature of the universe Ω k , our results give -0.012 k de =-1. When considering the dynamics of dark energy, the flat universe is still a good fit to the current data, -0.015 k s ≥1 are excluded at more than 2σ confidence level. However, in the framework of dynamical dark energy models, the allowed region in the parameter space of (n s ,r) is enlarged significantly. Finally, we find no strong evidence for the large running of the spectral index.

  10. Evidence for outcomes of motivational rehabilitation interventions for children and adolescents with cerebral palsy: an American Academy for Cerebral Palsy and Developmental Medicine systematic review.

    Science.gov (United States)

    Tatla, Sandy K; Sauve, Karen; Virji-Babul, Naznin; Holsti, Liisa; Butler, Charlene; Van Der Loos, Hendrik F Machiel

    2013-07-01

    This study reviewed evidence regarding the effect of motivational rehabilitation interventions on outcomes in children with cerebral palsy. Six databases were searched for literature published up to May 2012. Included studies measured the purported motivating effects of motor-based rehabilitation interventions and the measured impact on outcomes. The American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) systematic review methodology was used as a framework. Eight studies evaluated outcomes of studies using virtual reality interventions and one in a functional therapy context. Conflicting evidence from three (level II and level III) studies exists about the impact of these motivating interventions on motor outcomes measured in body functions. No statistical evidence regarding activity and participation outcomes exists. A single level II study found no significant difference in participants' motivation between motivational and conventional interventions. This review revealed a paucity of research on the effects of motivational interventions. Weaknesses include a lack of consistency in the examination of motivational interventions, limited use of definitions or theories to ground the concept of motivation, and reliance on non-validated methodological tools. This body of evidence would be strengthened by the use and development of robust outcome measures of motivation. © 2013 Mac Keith Press.

  11. Ocean anoxia did not cause the Latest Permian Extinction

    Science.gov (United States)

    Proemse, Bernadette C.; Grasby, Stephen E.; Wieser, Michael E.; Mayer, Bernhard; Beauchamp, Benoit

    2014-05-01

    oxic conditions throughout the LPE event, while anoxic conditions developed in the deep ocean. Hence, anoxic marine waters did not extend globally onto shelf environments and as such ocean anoxia cannot have been the main driver of the extinction event. While global systems were stressed by anoxia, the anoxic conditions may better represent a symptom of Siberian Trap eruptions that had catastrophic impact on the environment, potentially through nutrient loading and deposition of toxic substances into marine and terrestrial systems. Proemse et al., 2013: Molybdenum isotopic evidence for oxic marine conditions during the latest Permian extinction. Geology 41, 967-970.

  12. Perceived outcomes of web-based modules designed to enhance athletic trainers' knowledge of evidence-based practice.

    Science.gov (United States)

    Welch, Cailee E; Van Lunen, Bonnie L; Hankemeier, Dorice A; Wyant, Aimee L; Mutchler, Jessica M; Pitney, William A; Hays, Danica G

    2014-01-01

    The release of evidence-based practice (EBP) Web-based learning modules to the membership of the National Athletic Trainers' Association has provided athletic trainers (ATs) the opportunity to enhance their knowledge of the various EBP concepts. Whereas increasing the knowledge of EBP among ATs is important, assessing whether this newfound knowledge is being translated into clinical practice and didactic education is crucial. To explore the effectiveness of an educational intervention regarding EBP on the didactic instruction patterns of athletic training educators and the clinical practice behaviors of clinicians. Qualitative study. Individual telephone interviews. A total of 25 ATs (12 educators, 13 clinicians; experience as an AT = 16.00 ± 9.41 years) were interviewed. We conducted 1 individual telephone interview with each participant. After transcription, the data were analyzed and coded into common themes and categories. Triangulation of the data occurred via the use of multiple researchers and member checking to confirm the accuracy of the data. Participants perceived the EBP Web-based modules to produce numerous outcomes regarding education and clinical practice. These outcomes included perceived knowledge gain among participants, an increase in the importance and scope of EBP, a positive effect on educators' didactic instruction patterns and on instilling value and practice of EBP among students, and an enhanced ability among clinicians to implement EBP within clinical practice. However, some clinicians reported the Web-based modules had no current effect on clinical practice. Although the EBP Web-based modules were successful at enhancing knowledge among ATs, translation of knowledge into the classroom and clinical practice remains limited. Researchers should aim to identify effective strategies to help ATs implement EBP concepts into didactic education and clinical practice.

  13. Latest trends and directions of development of crowdfunding

    Directory of Open Access Journals (Sweden)

    Joanna Pieniążek

    2014-09-01

    Full Text Available The article discusses the latest trends and directions of development of crowdfunding on selected examples of English-language websites.The scope of work includes topics such as aggregates of crowdfunding sites, local investing, franchise, pre-sales platforms, open source sites and leveraging the competitive advantages of e-commerce platforms which offer product crowdfunding. This article aims to discuss the latest trends and directions of crowdfunding, assess their usefulness and the chances of popularising the ideas presented. The article provides an overview of the literature on the subject and an analysis of the selected sites, comparison sites and crowdfunding search engines.

  14. Dry Eye Post-Laser-Assisted In Situ Keratomileusis: Major Review and Latest Updates

    Science.gov (United States)

    Spierer, Oriel

    2018-01-01

    Dry eye is one of the most common complications occurring after laser-assisted in situ keratomileusis (LASIK), with virtually all patients experiencing some degree of postoperative dry eye symptoms. Enhanced understanding of the pathophysiology and mechanism of dry eye development in addition to preoperative screening of patients who are prone to dry eye is essential for better patient satisfaction and for improving short-term visual outcome postoperatively. This article reviews the latest studies published on LASIK-associated dry eye, including epidemiology, pathophysiology, risk factors, preoperative assessment, and management. PMID:29619255

  15. Latest German-English Terminology in CADCAM and Robotics

    International Nuclear Information System (INIS)

    Hussain, S M

    2014-01-01

    As a technical translator who speaks German fluently, the author would like to study and display the latest bilingual technical terminology in German being used in hardware, software and process technology involved in CADCAM and ROBOTICS. This will greatly help technical translators to correctly translate difficult texts from this area of technology

  16. (The latest developments of the physical aspects of electrochemistry)

    Energy Technology Data Exchange (ETDEWEB)

    Liu, S.H.

    1990-09-24

    The author was one of 26 invited lecturers to discuss the latest developments of the physical aspects of electrochemistry. He interacted extensively with other lecturers and many participants from developing countries. He also visited with the Director of the Italian Synchrotron Radiation Source now under construction in Trieste, Italy.

  17. Developmental outcome of low birth-weight and preterm newborns: a re-view of current evidence

    Directory of Open Access Journals (Sweden)

    Farin Soleimani

    2013-12-01

    Full Text Available Low birth weight (LBW and preterm birth are one the most important causes of death in the world and therefore are considered as one of the major health problems. Global statistics demonstrates an increase in the prevalence of low birth weight in the developing countries. Low birth weight infants are exposed to complications such as major neurosensory impairements, cerebral palsy, cognitive and language delays, neuromotor developmental delay, blindness and hearing loss, behavioral and psychosocial disorders, learning difficulties and dysfunction in scholastic performances. The majority of infant's death and developmental disorders were due to disorders relating to prematurity and unspecified low birth weight. Infants weighing less than 2500 g, is a major determinant of both neonatal and infant mortality rates and, together with congenital anomalies (e.g., cardiac, central nervous system, and respiratory, contributes significantly to childhood morbidity. Various studies indicate that low birth weight infants are suffering from physiological and psychosocial disabilities, two to three times more than the other children. At school age, preterm and low birth weight infants have poorer physical growth, cognitive function, and school performance. These disadvantages appear to persist into adulthood and therefore have broad implications for society. Although the survival rates have increased dramatically and the incidence of morbidities has decreased, the complications are still considered to be associated with economical and social burdens. Most children with Low birth weight suffer from multiple disabilities. Therefore, they need special and consistent care. On demand of reducing the infant mortality rate, the need to decrease the complications in low birth weight and preterm infants should be considered by the policy makers in health care system. In this review article, we assessed current evidences on developmental outcomes of low birth weight and

  18. Metabolic profiling of CSF: evidence that early intervention may impact on disease progression and outcome in schizophrenia.

    Directory of Open Access Journals (Sweden)

    Elaine Holmes

    2006-08-01

    Full Text Available The identification of schizophrenia biomarkers is a crucial step towards improving current diagnosis, developing new presymptomatic treatments, identifying high-risk individuals and disease subgroups, and assessing the efficacy of preventative interventions at a rate that is not currently possible.(1H nuclear magnetic resonance spectroscopy in conjunction with computerized pattern recognition analysis were employed to investigate metabolic profiles of a total of 152 cerebrospinal fluid (CSF samples from drug-naïve or minimally treated patients with first-onset paranoid schizophrenia (referred to as "schizophrenia" in the following text and healthy controls. Partial least square discriminant analysis showed a highly significant separation of patients with first-onset schizophrenia away from healthy controls. Short-term treatment with antipsychotic medication resulted in a normalization of the disease signature in over half the patients, well before overt clinical improvement. No normalization was observed in patients in which treatment had not been initiated at first presentation, providing the first molecular evidence for the importance of early intervention for psychotic disorders. Furthermore, the alterations identified in drug-naïve patients could be validated in a test sample set achieving a sensitivity and specificity of 82% and 85%, respectively.Our findings suggest brain-specific alterations in glucoregulatory processes in the CSF of drug-naïve patients with first-onset schizophrenia, implying that these abnormalities are intrinsic to the disease, rather than a side effect of antipsychotic medication. Short-term treatment with atypical antipsychotic medication resulted in a normalization of the CSF disease signature in half the patients well before a clinical improvement would be expected. Furthermore, our results suggest that the initiation of antipsychotic treatment during a first psychotic episode may influence treatment response

  19. A solid majority remit following evidence-based OCD treatments: a 3-year naturalistic outcome study in pediatric OCD.

    Science.gov (United States)

    Melin, Karin; Skarphedinsson, Gudmundur; Skärsäter, Ingela; Haugland, Bente Storm Mowatt; Ivarsson, Tord

    2018-03-03

    This study reports follow-up 2 and 3 years after the initial assessment of a sample of youth with a primary diagnosis of OCD. Participants were 109 children and adolescents, aged 5-17 years, recruited from a specialized, outpatient OCD clinic in Sweden. Patients were treated with cognitive behavioral therapy (CBT), augmented when indicated by selective serotonin reuptake inhibitor (SSRI). In cases where SSRIs were insufficient, augmentation with a second-generation antipsychotic (SGA) was applied. Participants were assessed with the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS), Children's OCD Impact Scale (COIS), and Children's Depressive Inventory (CDI) at follow-ups 2 and 3 years after baseline assessment. Treatment response was defined as CY-BOCS total score ≤ 15, and remission was defined as CY-BOCS total score ≤ 10. Analyzing the outcomes with linear mixed-effects models (LME) showed a decrease in OCD symptom load from 23 to 6.9 at the 3-year follow-up. Moreover, two of three (66.1%) participants were in remission, and another 19.2% had responded to treatment at the 3-year follow-up. Thus, 85.3% of participants responded to treatment. Moreover, during the follow-up period, participants' psychosocial functioning had significantly improved, and depressive symptoms had significantly decreased. The results suggest that evidence-based treatment for pediatric OCD, following expert consensus guidelines, has long-term positive effects for most children and adolescents diagnosed with OCD. The results also indicate that improvements are maintained over a 3-year period, at least, and that improvement is also found with regard to psychosocial functioning and depressive symptoms.

  20. Influence of caseload and surgical speciality on outcome following surgery for colorectal cancer: a review of evidence. Part 2: long-term outcome

    DEFF Research Database (Denmark)

    Iversen, Lene H.; Harling, H; Laurberg, S

    2007-01-01

    OBJECTIVE: We reviewed recent literature to assess the impact of hospital caseload, surgeon's caseload and education on long-term outcome following colorectal cancer surgery. METHOD: We searched the MEDLINE and Cochrane Library databases for relevant literature starting from 1992. We selected...

  1. Social Support and Supervisory Quality Interventions in the Workplace: A Stakeholder-Centered Best-Evidence Synthesis of Systematic Reviews on Work Outcomes

    Directory of Open Access Journals (Sweden)

    SL Wagner

    2015-10-01

    Full Text Available Background: There is controversy surrounding the impact of workplace interventions aimed at improving social support and supervisory quality on absenteeism, productivity and financial outcomes. Objective: To determine the value of social support interventions for work outcomes. Methods: Databases were searched for systematic reviews between 2000 and 2012 to complete a synthesis of systematic reviews guided by the PRISMA statement and the IOM guidelines for systematic reviews. Assessment of articles for inclusion and methodological quality was conducted independently by at least two researchers, with differences resolved by consensus. Results: The search resulted in 3363 titles of which 3248 were excluded following title/abstract review, leaving 115 articles that were retrieved and underwent full article review. 10 articles met the set inclusion criteria, with 7 focusing on social support, 2 on supervisory quality and 1 on both. We found moderate and limited evidence, respectively, that social support and supervisory quality interventions positively impact workplace outcomes. Conclusion: There is moderate evidence that social support and limited evidence that supervisory quality interventions have a positive effect on work outcomes.

  2. Social Support and Supervisory Quality Interventions in the Workplace: A Stakeholder-Centered Best-Evidence Synthesis of Systematic Reviews on Work Outcomes.

    Science.gov (United States)

    Wagner, S L; White, M I; Schultz, I Z; Williams-Whitt, K; Koehn, C; Dionne, C E; Koehoorn, M; Harder, H G; Pasca, R; Wärje, O; Hsu, V; McGuire, L; Lama, I; Schulz, W; Kube, D; Wright, M D

    2015-10-01

    There is controversy surrounding the impact of workplace interventions aimed at improving social support and supervisory quality on absenteeism, productivity and financial outcomes. To determine the value of social support interventions for work outcomes. Databases were searched for systematic reviews between 2000 and 2012 to complete a synthesis of systematic reviews guided by the PRISMA statement and the IOM guidelines for systematic reviews. Assessment of articles for inclusion and methodological quality was conducted independently by at least two researchers, with differences resolved by consensus. The search resulted in 3363 titles of which 3248 were excluded following title/abstract review, leaving 115 articles that were retrieved and underwent full article review. 10 articles met the set inclusion criteria, with 7 focusing on social support, 2 on supervisory quality and 1 on both. We found moderate and limited evidence, respectively, that social support and supervisory quality interventions positively impact workplace outcomes. There is moderate evidence that social support and limited evidence that supervisory quality interventions have a positive effect on work outcomes.

  3. The latest development of EAST neutral beam injector

    International Nuclear Information System (INIS)

    Hu Chundong; Xu Yongjian

    2014-01-01

    As the first full superconducting non-circular cross section Tokomak in the world, EAST is used to explore the forefront physics and engineering issues on the construction of Tokomak fusion reactor. Neutral beam injection has been recognized as one of the most effective means for plasma heating. According to the research plan of the EAST physics experiment, a set of neutral beam injector (4∼8 MW, 10∼100 s)will be built and operational in 2014. The paper presents the latest development of EAST neutral beam injector and the latest experiment results of long pulse beam extraction and high power beam extraction are reported, those results show that all targets reach or almost reach the design targets. All these will lay a solid foundation for the achievement of plasma heating and current drive for EAST in 2014. (authors)

  4. Modelling and simulation SSM: latest state of the art technology

    CSIR Research Space (South Africa)

    Jahajeeah, N

    2005-10-01

    Full Text Available as one phase ? One Phase model ?Wider volume solid fraction 0 – 1 ? Implementation in Power Law Cut-Off Model (PLCO) of Procast Supporting the Manufacturing and Materials Industry in its quest for global competitiveness Assumptions of the PLCO Model... and Materials Industry in its quest for global competitiveness Modelling and Simulation SSM Latest state of the art technology N Jahajeeah Supporting the Manufacturing and Materials Industry in its quest for global competitiveness BEHAVIOUR OF THIXOTROPIC...

  5. Latest research progress on food waste management: a comprehensive review

    Science.gov (United States)

    Zhu, Shangzhen; Gao, Hetong; Duan, Lunbo

    2018-05-01

    Since a large amount of food supplying is provided as a basic line measuring increasing residents’ life standard, food waste has become progressively numeral considerable. Much attention has been drawn to this problem. This work gave an overview on latest researches about anaerobic digestion, composting, generalized management and other developments on management of food waste. Different technologies were introduced and evaluated. Further views on future research in such a field were proposed.

  6. Latest development in project site radwaste treatment facility (SRTF) Sanmen

    International Nuclear Information System (INIS)

    Mennicken, K.; Lohmann, P.

    2015-01-01

    Westinghouse Electric Germany GmbH (WEG) was successful in being awarded a contract as to the planning, delivery, installation and commissioning of radwaste treatment systems for the AP1000 units at Sanmen site, PR China. Operational low and intermediate level radioactive waste will be processed in the Site Radwaste Treatment Facility (SRTF). This paper explains the latest developments of the project, especially the experience with customer-hired Chinese planning partners, installation companies and Customer operating personnel. (authors)

  7. Mobile application for reading latest news from multiple sources

    OpenAIRE

    Watzak, Aleš

    2013-01-01

    Thesis covers development of an application for mobile devices running Android operating system. It enables users to keep up to date with the latest news, weather and traffic report. News delivery service is available wherever there is Internet access and not limited to a physical location like an office with desktop computer. To this end we developed two applications. First represents server part of the application and runs on Apache web server. The second part is a client application which ...

  8. Do strategies to improve quality of maternal and child health care in lower and middle income countries lead to improved outcomes? A review of the evidence.

    Science.gov (United States)

    Dettrick, Zoe; Firth, Sonja; Jimenez Soto, Eliana

    2013-01-01

    Efforts to scale-up maternal and child health services in lower and middle income countries will fail if services delivered are not of good quality. Although there is evidence of strategies to increase the quality of health services, less is known about the way these strategies affect health system goals and outcomes. We conducted a systematic review of the literature to examine this relationship. We undertook a search of MEDLINE, SCOPUS and CINAHL databases, limiting the results to studies including strategies specifically aimed at improving quality that also reported a measure of quality and at least one indicator related to health system outcomes. Variation in study methodologies prevented further quantitative analysis; instead we present a narrative review of the evidence. Methodologically, the quality of evidence was poor, and dominated by studies of individual facilities. Studies relied heavily on service utilisation as a measure of strategy success, which did not always correspond to improved quality. The majority of studies targeted the competency of staff and adequacy of facilities. No strategies addressed distribution systems, public-private partnership or equity. Key themes identified were the conflict between perceptions of patients and clinical measures of quality and the need for holistic approaches to health system interventions. Existing evidence linking quality improvement strategies to improved MNCH outcomes is extremely limited. Future research would benefit from the inclusion of more appropriate indicators and additional focus on non-facility determinants of health service quality such as health policy, supply distribution, community acceptability and equity of care.

  9. Practical approaches to adverse outcome pathway development and weight‐of‐evidence evaluation as illustrated by ecotoxicological case studies

    Science.gov (United States)

    Adverse Outcome Pathways (AOPs) describe toxicant effects as a sequential chain of causally linked events beginning with a molecular perturbation and culminating in an adverse outcome at an individual or population level. Strategies for developing AOPs are still evolving and dep...

  10. The efficacy of hydroxychloroquine in altering pregnancy outcome in women with antiphospholipid antibodies. Evidence and clinical judgment

    NARCIS (Netherlands)

    Sciascia, Savino; Branch, D. Ware; Levy, Roger A.; Middeldorp, Saskia; Pavord, Sue; Roccatello, Dario; Ruiz-Irastorza, Guillermo; Tincani, Angela; Khamashta, Munther; Schreiber, Karen; Hunt, Beverley J.

    2016-01-01

    The use of low-dose aspirin and heparinoids has improved the pregnancy outcome in obstetric antiphospholipid syndrome (APS). However, current treatment fails in 20-30% of APS pregnancies, raising the need to explore other treatments to improve obstetrical outcome. Hydroxychloroquine (HCQ) is widely

  11. Exposure to Perfluoroalkyl Substances and Metabolic Outcomes in Pregnant Women: Evidence from the Spanish INMA Birth Cohorts.

    Science.gov (United States)

    Matilla-Santander, Nuria; Valvi, Damaskini; Lopez-Espinosa, Maria-Jose; Manzano-Salgado, Cyntia B; Ballester, Ferran; Ibarluzea, Jesús; Santa-Marina, Loreto; Schettgen, Thomas; Guxens, Mònica; Sunyer, Jordi; Vrijheid, Martine

    2017-11-13

    Exposure to perfluoroalkyl substances (PFASs) may increase risk for metabolic diseases; however, epidemiologic evidence is lacking at the present time. Pregnancy is a period of enhanced tissue plasticity for the fetus and the mother and may be a critical window of PFAS exposure susceptibility. We evaluated the associations between PFAS exposures and metabolic outcomes in pregnant women. We analyzed 1,240 pregnant women from the Spanish INMA [Environment and Childhood Project (INfancia y Medio Ambiente)] birth cohort study (recruitment period: 2003-2008) with measured first pregnancy trimester plasma concentrations of four PFASs (in nanograms/milliliter). We used logistic regression models to estimate associations of PFASs (log 10 -transformed and categorized into quartiles) with impaired glucose tolerance (IGT) and gestational diabetes mellitus (GDM), and we used linear regression models to estimate associations with first-trimester serum levels of triglycerides, total cholesterol, and C-reactive protein (CRP). Perfluorooctane sulfonate (PFOS) and perfluorohexane sulfonate (PFHxS) were positively associated with IGT (137 cases) [OR per log 10 -unit increase=1.99 (95% CI: 1.06, 3.78) and OR=1.65 ( 95% CI: 0.99, 2.76), respectively]. PFOS and PFHxS associations with GDM (53 cases) were in a similar direction, but less precise. PFOS and perfluorononanoate (PFNA) were negatively associated with triglyceride levels [percent median change per log 10 -unit increase=-5.86% (95% CI: -9.91%, -1.63%) and percent median change per log 10 -unit increase=-4.75% (95% CI: -8.16%, -0.61%, respectively], whereas perfluorooctanoate (PFOA) was positively associated with total cholesterol [percent median change per log 10 -unit increase=1.26% (95% CI: 0.01%, 2.54%)]. PFASs were not associated with CRP in the subset of the population with available data ( n =640). Although further confirmation is required, the findings from this study suggest that PFAS exposures during pregnancy may

  12. Exposure to Perfluoroalkyl Substances and Metabolic Outcomes in Pregnant Women: Evidence from the Spanish INMA Birth Cohorts

    Science.gov (United States)

    Matilla-Santander, Nuria; Valvi, Damaskini; Lopez-Espinosa, Maria-Jose; Manzano-Salgado, Cyntia B.; Ballester, Ferran; Ibarluzea, Jesús; Santa-Marina, Loreto; Schettgen, Thomas; Guxens, Mònica; Sunyer, Jordi

    2017-01-01

    Background: Exposure to perfluoroalkyl substances (PFASs) may increase risk for metabolic diseases; however, epidemiologic evidence is lacking at the present time. Pregnancy is a period of enhanced tissue plasticity for the fetus and the mother and may be a critical window of PFAS exposure susceptibility. Objective: We evaluated the associations between PFAS exposures and metabolic outcomes in pregnant women. Methods: We analyzed 1,240 pregnant women from the Spanish INMA [Environment and Childhood Project (INfancia y Medio Ambiente)] birth cohort study (recruitment period: 2003–2008) with measured first pregnancy trimester plasma concentrations of four PFASs (in nanograms/milliliter). We used logistic regression models to estimate associations of PFASs (log10-transformed and categorized into quartiles) with impaired glucose tolerance (IGT) and gestational diabetes mellitus (GDM), and we used linear regression models to estimate associations with first-trimester serum levels of triglycerides, total cholesterol, and C-reactive protein (CRP). Results: Perfluorooctane sulfonate (PFOS) and perfluorohexane sulfonate (PFHxS) were positively associated with IGT (137 cases) [OR per log10-unit increase=1.99 (95% CI: 1.06, 3.78) and OR=1.65 ( 95% CI: 0.99, 2.76), respectively]. PFOS and PFHxS associations with GDM (53 cases) were in a similar direction, but less precise. PFOS and perfluorononanoate (PFNA) were negatively associated with triglyceride levels [percent median change per log10-unit increase=−5.86% (95% CI: −9.91%, −1.63%) and percent median change per log10-unit increase=−4.75% (95% CI: −8.16%, −0.61%, respectively], whereas perfluorooctanoate (PFOA) was positively associated with total cholesterol [percent median change per log10-unit increase=1.26% (95% CI: 0.01%, 2.54%)]. PFASs were not associated with CRP in the subset of the population with available data (n=640). Conclusions: Although further confirmation is required, the findings from this

  13. Theory- and Evidence- Based Intervention: Practice-Based Evidence--Integrating Positive Psychology into a Clinical Psychological Assessment and Intervention Model and How to Measure Outcome

    Science.gov (United States)

    Nissen, Poul

    2011-01-01

    In this paper, a model for assessment and intervention is presented. This model explains how to perform theory- and evidence- based as well as practice-based assessment and intervention. The assessment model applies a holistic approach to treatment planning, which includes recognition of the influence of community, school, peers, family and the…

  14. Unconditional cash transfers and children's educational outcomes: Evidence from the old-age pension programme in South Africa .

    OpenAIRE

    Jessica Standish-White; Arden Finn

    2015-01-01

    We use longitudinal data from three waves of South Africa's National Income Dynamics Study to estimate the effect of pension receipt in the household on children's educational outcomes in South Africa. We find that children who co-reside with a pensioner achieve better educational outcomes than those who do not, while controlling for a wide number of individual and household characteristics. In particular, we find that the sex of the pension recipient matters - the positive impact on a child'...

  15. Toward an evidence-based patient-provider communication in rehabilitation: linking communication elements to better rehabilitation outcomes.

    Science.gov (United States)

    Jesus, Tiago Silva; Silva, Isabel Lopes

    2016-04-01

    There is a growing interest in linking aspects of patient-provider communication to rehabilitation outcomes. However, the field lacks a conceptual understanding on: (a) 'how' rehabilitation outcomes can be improved by communication; and (b) through 'which' elements in particular. This article elaborates on the conceptual developments toward informing further practice and research. Existing models of communication in healthcare were adapted to rehabilitation, and its outcomes through a comprehensive literature review. After depicting mediating mechanisms and variables (e.g. therapeutic engagement, adjustment toward disability), this article presents the '4 Rehab Communication Elements' deemed likely to underpin rehabilitation outcomes. The four elements are: (a) knowing the person and building a supportive relationship; (b) effective information exchange and education; (c) shared goal-setting and action planning; and (d) fostering a more positive, yet realistic, cognitive and self-reframing. This article describes an unprecedented, outcomes-oriented approach toward the design of rehabilitation communication, which has resulted in the development of a new intervention model: the '4 Rehab Communication Elements'. Further trials are needed to evaluate the impact of this whole intervention model on rehabilitation outcomes. © The Author(s) 2015.

  16. Household air pollution from solid fuel use and risk of adverse pregnancy outcomes: a systematic review and meta-analysis of the empirical evidence.

    Science.gov (United States)

    Amegah, Adeladza K; Quansah, Reginald; Jaakkola, Jouni J K

    2014-01-01

    About 41% of households globally, mainly in developing countries rely on solid fuels for cooking with consequences for fetal growth and development. Previous reviews were limited in scope, assessing only two outcomes (birth weight, stillbirth). With important evidence accumulating, there is a need to improve the previous estimates and assess additional outcomes. We conducted a systematic review and meta-analysis to evaluate the quality and strength of available evidence on household air pollution (HAP) and the whole range of adverse pregnancy outcomes. PubMed, Ovid Medline, Scopus and CINAHL were searched from their inception to the end of April 2013. All epidemiological study designs were eligible for inclusion in the review. The random-effects model was applied in computing the summary-effect estimates (EE) and their corresponding 95% confidence interval (CI). Of 1505 studies screened, 19 studies satisfied the inclusion criteria. Household combustion of solid fuels resulted in an 86.43 g (95% CI: 55.49, 117.37) reduction in birth weight, and a 35% (EE = 1.35, 95% CI: 1.23, 1.48) and 29% (EE = 1.29, 95% CI: 1.18, 1.41) increased risk of LBW and stillbirth respectively. Combustion of solid fuels at home increases the risk of a wide range of adverse pregnancy outcomes. Access to clean household energy solutions is the surest way to combat HAP and mitigate their adverse effects.

  17. Correlation of compliance with central line associated blood stream infection guidelines and outcomes: a review of the evidence

    Directory of Open Access Journals (Sweden)

    Gerkin R

    2012-05-01

    Full Text Available Background Clinical practice guidelines are developed to assist in patient care but the evidence basis for many guidelines has been called into question. Methods We conducted a literature review using PubMed and analyzed the overall quality of evidence and made strength of recommendation behind 8 Institute of Health Care (IHI guidelines for prevention of central line associated blood stream infection (CLABSI. Quality of evidence was assessed by the American Thoracic Society (ATS levels of evidence (levels I through III. We also examined data from our intensive care units (ICUs for evidence of a correlation between guideline compliance and the development of VAP.Results None of the guidelines was graded at level I. Two of the guidelines were graded at level II and the remaining 6 at level III. Despite the lack of evidence, 2 of the guidelines (hand hygiene, sterile gloves were given a strong recommendation. Chlorhexidine and use of nonfemoral sites were given a moderate recommendation. In our ICUs compliance with the use of chlorhexidine correlated with a reduction in CLABSI (p<0.02 but the remainder did not.Conclusions The IHI CLABSI guidelines are based on level II or III evidence. Data from our ICUs supported the use of chlorhexidine in reducing CLABSI. Until more data from well-designed controlled clinical trials become available, physicians should remain cautious when using current IHI guidelines to direct patient care decisions or as an assessment of the quality of care.

  18. The latest full-scale PWR simulator in Japan

    International Nuclear Information System (INIS)

    Nishimuru, Y.; Tagi, H.; Nakabayashi, T.

    2004-01-01

    The latest MHI Full-scale Simulator has an excellent system configuration, in both flexibility and extendability, and has highly sophisticated performance in PWR simulation by the adoption of CANAC-II and PRETTY codes. It also has an instructive character to display the plant's internal status, such as RCS condition, through animation. Further, the simulation has been verified to meet a functional examination at model plant, and with a scale model test result in a two-phase flow event, after evaluation for its accuracy. Thus, the Simulator can be devoted to a sophisticated and broad training course on PWR operation. (author)

  19. Latest AMS Results on elementary particles in cosmic rays

    Science.gov (United States)

    Kounine, Andrei; AMS Collaboration

    2017-01-01

    AMS-02 is a particle physics detector collecting data on the International Space Station since May 2011. Precision measurements of all elementary charged cosmic ray particles have been performed by AMS using a data sample of 85 billion cosmic ray events collected during the first five years of operations on the Station. The latest AMS results on the fluxes and flux ratios of the elementary cosmic ray particles are presented. They show unique features that require accurate theoretical interpretation as to their origin, be it from dark matter collisions or new astrophysical sources. On behalf of the AMS Collaboration.

  20. Evidence-based decision making : developing a knowledge base for successful program outcomes in transportation asset management.

    Science.gov (United States)

    2015-12-01

    MAP-21 and AASHTOs framework for transportation asset management (TAM) offer opportunities to use more : rigorous approaches to collect and apply evidence within a TAM context. This report documents the results of a study : funded by the Georgia D...

  1. Outcomes and impact of HIV prevention, ART and TB programs in Swaziland--early evidence from public health triangulation.

    Science.gov (United States)

    van Schalkwyk, Cari; Mndzebele, Sibongile; Hlophe, Thabo; Garcia Calleja, Jesus Maria; Korenromp, Eline L; Stoneburner, Rand; Pervilhac, Cyril

    2013-01-01

    Swaziland's severe HIV epidemic inspired an early national response since the late 1980s, and regular reporting of program outcomes since the onset of a national antiretroviral treatment (ART) program in 2004. We assessed effectiveness outcomes and mortality trends in relation to ART, HIV testing and counseling (HTC), tuberculosis (TB) and prevention of mother to child transmission (PMTCT). Data triangulated include intervention coverage and outcomes according to program registries (2001-2010), hospital admissions and deaths disaggregated by age and sex (2001-2010) and population mortality estimates from the 1997 and 2007 censuses and the 2007 demographic and health survey. By 2010, ART reached 70% of the estimated number of people living with HIV/AIDS with CD4impact to specific interventions (versus natural epidemic dynamics) will require additional data from future household surveys, and improved routine (program, surveillance, and hospital) data at district level.

  2. Funding sources and financial disclosures, and their relationship to study outcomes and level of evidence in the Journal of Shoulder and Elbow Surgery.

    Science.gov (United States)

    Foughty, Zachary; Antalis, Matthew S; Ringenberg, Jonathan; Hall, Adam D

    2017-06-01

    Concern exists regarding the reliability of published manuscripts due to influence of industry funding and author financial conflicts of interest (COI). We aim to determine whether COI affect the outcome of a research study or the level of evidence (LOE). We reviewed 244 consecutive original articles in Journal of Shoulder and Elbow Surgery from January 2014 to December 2014. Articles included only those available in the printed journal. For LOE, 178 articles from the Shoulder and Elbow section were used (basic science articles were excluded). COI was determined by comparing financial disclosures and stated funding sources to the study content. COI were present in 44 of 244 articles (18%); of these, 24 (55%) had positive outcomes. Of the 200 without COI, 128 (64%) had positive outcomes. This difference in proportions was determined to be significant (P = .007). COI were present in 27 shoulder and elbow articles; of these, only 1 was LOE I or II (4%). Of the 151 without COI, 34 (23%) were LOE I or II. This difference in proportions was determined to be significant (P = .023). We found that Journal of Shoulder and Elbow Surgery articles with COI are neither more likely to have positive outcomes nor higher LOE than those with no COI. Although the χ 2 analysis found a statistically significant relationship between COI and study outcomes, the study outcomes were more often positive in articles without COI. This is contrary to previously published analyses that found outcomes to be more positive in articles with COI. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  3. The DAFT/FADA Survey status and latest results

    Science.gov (United States)

    Guennou, L.

    2011-12-01

    We present here the latest results obtained from the American French collaboration called the Dark energy American French Team/French American DArk energy Team (DAFT/FADA). The goal of the DAFT/FADA collaboration is to carry out a weak lensing tomography survey of z = 0.4-0.9 rich clusters of galaxies. Unlike supernovae or other methods such as cluster of galaxy counts, weak lensing tomography is purely based on geometry and does not depend on knowledge of the physics of the objects used as distance indicators. In addition, the reason for analyzing observations in the direction of clusters is that the shear signal is enhanced by about 10 over the field. Our work will eventually contain results obtained on 91 rich clusters from the HST archive combined with ground based work to obtain photo-zs. This combination of photo-z and weak lensing tomography will enable us to constrain the equation of state of dark energy. We present here the latest results obtained so far in this study.

  4. Latest Results in SLAC 75-MW PPM Klystrons

    International Nuclear Information System (INIS)

    Sprehn, D.; Caryotakis, G.; Haase, A.; Jongewaard, E.; Laurent, L.; Pearson, C.; Phillips, R.

    2006-01-01

    75 MW X-band klystrons utilizing Periodic Permanent Magnet (PPM) focusing have been undergoing design, fabrication and testing at the Stanford Linear Accelerator Center (SLAC) for almost nine years. The klystron development has been geared toward realizing the necessary components for the construction of the Next Linear Collider (NLC). The PPM devices built to date which fit this class of operation consist of a variety of 50 MW and 75 MW devices constructed by SLAC, KEK (Tsukuba, Japan) and industry. All these tubes follow from the successful SLAC design of a 50 MW PPM klystron in 1996. In 2004 the latest two klystrons were constructed and tested with preliminary results reported at EPAC2004. The first of these two devices was tested to the full NLC specifications of 75 MW, 1.6 microseconds pulse length, and 120 Hz. This 14.4 kW average power operation came with a tube efficiency >50%. The most recent testing of these last two devices will be presented here. Design and manufacturing issues of the latest klystron, due to be tested by the Fall of 2005, are also discussed

  5. Labour Market Outcomes of Vocational Education in Europe: Evidence from the European Union Labour Force Survey. Research Paper No 32

    Science.gov (United States)

    Cedefop - European Centre for the Development of Vocational Training, 2013

    2013-01-01

    This report focuses on the outcomes of vocational education and, in particular, on the transition from education to work in the current employment situation for young adults in the European Union. Using anonymised microdata from the EU labour force survey 2009 ad hoc module, this is one of the first studies to undertake a large cross-country…

  6. Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: meta-epidemiological study

    DEFF Research Database (Denmark)

    Wood, L.; Egger, M.; Gluud, L.L.

    2008-01-01

    OBJECTIVE: To examine whether the association of inadequate or unclear allocation concealment and lack of blinding with biased estimates of intervention effects varies with the nature of the intervention or outcome. DESIGN: Combined analysis of data from three meta-epidemiological studies based o...

  7. Testing Probation Outcomes in an Evidence-Based Practice Setting: Reduced Caseload Size and Intensive Supervision Effectiveness

    Science.gov (United States)

    Jalbert, Sarah Kuck; Rhodes, William; Flygare, Christopher; Kane, Michael

    2010-01-01

    Probation and parole professionals argue that supervision outcomes would improve if caseloads were reduced below commonly achieved standards. Criminal justice researchers are skeptical because random assignment and strong observation studies have failed to show that criminal recidivism falls with reductions in caseload sizes. One explanation is…

  8. Differential UCS expectancy bias in spider fearful individuals : Evidence toward an association between spiders and disgust-relevant outcomes

    NARCIS (Netherlands)

    van Overveld, M; de Jong, PJ; Peters, ML

    Recently, differential UCS expectancies were found for high- and low-predatory fear-relevant animals [Davey, G. C. L., Cavanagh, K., & Lamb, A. (2003). Differential aversive outcome expectancies for high- and low-predation fear-relevant animals. Journal of Behavior Therapy and Experimental

  9. The influence of patients' nutritional status on the prevalence, course and treatment outcomes of lower limb ischemia: an overview of current evidence.

    Science.gov (United States)

    Spychalska-Zwolińska, Marta; Zwoliński, Tomasz; Anaszewicz, Marzena; Budzyński, Jacek

    2018-04-01

    The association of lower limb ischemia (LLI) with disturbances in nutritional status, in respect to over- or undernutrition, is still uncertain. The aim of this study was to present the current state of knowledge on this issue. Systematic review of papers published between 2006 and 2018. The literature shows inconclusive evidence regarding the impact of nutritional status on the risk, course, prognosis and outcomes of conservative and invasive treatment of LLI. The majority of publications available demonstrate greater LLI prevalence in overweight and obese patients, a worse prognosis both in malnourished and severely obese patients, poorer outcomes of invasive treatment in underweight patients, and better results for endovascular and surgical treatment in patients with overweight and class I obesity, although without such a relationship for conservative therapy. Possible explanations linking nutritional status and LLI seem to be: the endocrine, paracrine, and autocrine activity of adipose tissue, a decrease in physical activity, and the effect of diet-dependent comorbidities, e.g. diabetes mellitus, hypertension and dyslipidemia. There is a growing body of evidence concerning an association between LLI and patients' nutritional status. A so-called "obesity paradox" or "BMI paradox" seems to exist among patients with LLI and mainly concerns outcomes of endovascular and surgical treatment. However, further studies are needed to evaluate the clinical importance of body composition, the distribution and endocrine activity of adipose tissue, and the effect of weight reduction and/or nutritional support in the LLI patient group.

  10. Improving healthcare and outcomes for high-risk children and teens: formation of the National Consortium for Pediatric and Adolescent Evidence-Based Practice.

    Science.gov (United States)

    Melnyk, Bernadette Mazurek; Fineout-Overholt, Ellen; Hockenberrry, Marilyn; Huth, Myra; Jamerson, Patricia; Latta, Linda; Lewandowski, Linda; Gance-Cleveland, Bonnie

    2007-01-01

    Although major healthcare and professional organizations as well as key leaders have long emphasized the importance of evidence-based practice (EBP) in improving patient care and outcomes, the majority of healthcare professionals do not implement EBP. There is a huge gap in time that exists between the generation of research findings and the translation of those findings into clinical practice. Many efficacious interventions are not being used in clinical practice even though research findings suggest that they improve child and adolescent health and development. Conversely, many clinical practices are being implemented without sufficient evidence to support their use. Because of the need to accelerate EBP and to generate evidence to support best practices, the first EBP Leadership Summit focused on children and adolescents was conducted in February 2007. Several nationally recognized EBP experts and healthcare leaders from a number of children's hospitals and colleges of nursing across the U.S. participated in the Summit. This article describes the process used and outcomes generated from this landmark event in child and adolescent healthcare, including the launching of the new National Consortium for Pediatric and Adolescent EBP (NCPAEP). Future directions of the consortium also are highlighted.

  11. Math skills and market and non-market outcomes: Evidence from an Amazonian society of forager-farmers.

    Science.gov (United States)

    Undurraga, Eduardo A; Behrman, Jere R; Grigorenko, Elena L; Schultz, Alan; Yiu, Julie; Godoy, Ricardo A

    2013-12-01

    Research in industrial nations suggests that formal math skills are associated with improvements in market and non-market outcomes. But do these associations also hold in a highly autarkic setting with a limited formal labor market? We examined this question using observational annual panel data (2008 and 2009) from 1,121 adults in a native Amazonian society of forager-farmers in Bolivia (Tsimane'). Formal math skills were associated with an increase in wealth in durable market goods and in total wealth between data collection rounds, and with improved indicators of own reported perceived stress and child health. These associations did not vary significantly by people's Spanish skills or proximity to town. We conclude that the positive association between math skills and market and non-market outcomes extends beyond industrial nations to even highly autarkic settings.

  12. Career-Technical Education and Labor Market Outcomes: Evidence from California Community Colleges. A CAPSEE Working Paper

    Science.gov (United States)

    Stevens, Ann; Kurlaender, Michal; Grosz, Michel

    2015-01-01

    This paper estimates the earnings returns to vocational, or career-technical, education programs in the nation's largest community college system. While career-technical education (CTE) programs have often been mentioned as an attractive alternative to four-year colleges for some students, very little systematic evidence exists on the returns to…

  13. Body Size at Birth, Physical Development and Cognitive Outcomes in Early Childhood: Evidence from the Longitudinal Survey of Australian Children

    Science.gov (United States)

    Ulker, Aydogan

    2016-01-01

    Using a rich sample created from the Longitudinal Survey of Australian Children, we investigate the extent to which the relationship between body size at birth and early childhood cognitive skills is mediated by physical development indicators. Consistent with existing evidence from other countries, we find a significant relationship between body…

  14. Exposure to Perfluoroalkyl Substances and Metabolic Outcomes in Pregnant Women: Evidence from the Spanish INMA Birth Cohorts

    NARCIS (Netherlands)

    Matilla-Santander, N. (Nuria); D. Valvi (Damaskini); M.-J. Lopez-Espinosa (Maria-Jose); Manzano-Salgado, C.B. (Cyntia B.); F. Ballester (Ferran); J. Ibarluzea (Jesús); L. Santa-Marina (Loreto); T. Schettgen (Thomas); M. Guxens Junyent (Mònica); J. Sunyer (Jordi); M. Vrijheid (Martine)

    2017-01-01

    textabstractBACKGROUND: Exposure to perfluoroalkyl substances (PFASs) may increase risk for metabolic diseases; however, epidemiologic evidence is lacking at the present time. Pregnancy is a period of enhanced tissue plasticity for the fetus and the mother and may be a critical window of PFAS

  15. Mother's education and the risk of several neonatal outcomes: an evidence from an Italian population-based study.

    Science.gov (United States)

    Cantarutti, Anna; Franchi, Matteo; Monzio Compagnoni, Matteo; Merlino, Luca; Corrao, Giovanni

    2017-07-12

    Maternal socioeconomic disparities strongly affect child health, particularly in low and middle income countries. We assessed whether neonatal outcomes varied by maternal education in a setting where healthcare system provides universal coverage of health services to all women, irrespective of their socioeconomic status. A population-based study was performed on 383,103 singleton live births occurring from 2005 to 2010 in Lombardy, an Italian region with approximately 10 million inhabitants. The association between maternal education, birthplace and selected neonatal outcomes (preterm birth, low birth weight, small-for-gestational age, low 5-min Apgar score, severe congenital anomalies, cerebral distress and respiratory distress) was estimated by fitting logistic regression models. Model adjustments were applied for sociodemographic, reproductive and medical maternal traits. Compared with low-level educated mothers, those with high education had reduced odds of preterm birth (Odds Ratio; OR = 0.81, 95% CI 0.77-0.85), low birth weight (OR = 0.78, 95% CI 0.70-0.81), small for gestational age (OR = 0.82, 95% CI 0.79-0.85), and respiratory distress (OR = 0.84, 95% CI 0.80-0.88). Mothers born in a foreign country had higher odds of preterm birth (OR = 1.16, 95% CI 1.11-1.20), low Apgar score (OR = 1.18, 95% CI 1.07-1.30) and respiratory distress (OR = 1.19, 95% CI 1.15-1.24) than Italian-born mothers. The influence of maternal education on neonatal outcomes was confirmed among both, Italian-born and foreign-born mothers. Low levels of education and maternal birthplace are important factors associated with adverse neonatal outcomes in Italy. Future studies are encouraged to investigate factors mediating the effects of socioeconomic inequality for identifying the main target groups for interventions.

  16. The latest technical solutions in rail vehicles drives

    Directory of Open Access Journals (Sweden)

    Andrzejewski Maciej

    2017-01-01

    Full Text Available The article discusses the latest trends and solutions used in the offers of rail vehicles manufacturers. The study is mainly concerned with the technical solutions used in hybrid rail vehicles, whose development has become one of the priorities for the development of rail vehicles in the European Union in recent years. Stricter emissions standards for harmful compounds in the European Union have forced manufacturers to use increasingly sophisticated technology, including hybrid drives and alternative fuels. The products and solutions offered by the major manufacturers on the market, along with their capabilities and future applications are described. The predicted trends in the development of propulsion technology for rail and road-rail vehicles are also indicated in view of the current legislative aspirations among the EU Member States.

  17. Latest-Generation Transcatheter Aortic Valve Replacement Devices and Procedures.

    Science.gov (United States)

    Chamandi, Chekrallah; Puri, Rishi; Rodriguez-Gabella, Tania; Rodés-Cabau, Josep

    2017-09-01

    Transcatheter aortic valve replacement (TAVR) is a well-established treatment for patients with severe symptomatic aortic stenosis who are at high or prohibitive surgical risk. More recently, TAVR has emerged as a valid alternative to surgical aortic valve replacement for treating intermediate-risk patients, and several studies are currently evaluating the role of TAVR in low-risk patients. Transcatheter heart valve (THV) technologies have evolved considerably over time, and important iterations have been implemented in many of the latest-generation devices to (1) reduce the size and improve delivery system properties; (2) improve valve deployment, repositioning, and retrievability; and (3) reduce paravalvular leaks. This article reviews the main characteristics of, and clinical results associated with, the newer-generation THVs while providing an overview of novel TAVR indications. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  18. Latest development on the membrane formation for gas separation

    Directory of Open Access Journals (Sweden)

    Ahmad Fausi Ismail

    2002-11-01

    Full Text Available The first scientific observation related to gas separation was encountered by J.K Mitchell in 1831. However, the most remarkable and influential contribution to membrane gas separation technology was the systematic study by Thomas Graham in 1860. However only in 1979, membrane based gas separation technology was available and recognized as one of the most recent and advanced unit operations for gas separation processes. Membrane is fabricated by various methods and the parameters involved to a certain extent are very complicated. The phase inversion technique that is normally employed to produce membranes are dry/wet, wet, dry and thermal induced phase separation. Other techniques used to produce membrane are also reviewed. This paper reports the latest development in membrane formation for gas separation. The route to produce defect-free and ultrathin-skinned asymmetric membrane is also presented that represents the cutting edge technology in membrane gas separation process

  19. The vehicle routing problem latest advances and new challenges

    CERN Document Server

    Golden, Bruce L; Wasil, Edward A

    2008-01-01

    The Vehicle Routing Problem (VRP) has been an especially active and fertile area of research. Over the past five to seven years, there have been numerous technological advances and exciting challenges that are of considerable interest to students, teachers, and researchers. The Vehicle Routing Problem: Latest Advances and New Challenges will focus on a host of significant technical advances that have evolved over the past few years for modeling and solving vehicle routing problems and variants. New approaches for solving VRPs have been developed from important methodological advances. These developments have resulted in faster solution algorithms, more accurate techniques, and an improvement in the ability to solve large-scale, complex problems. The book will systematically examine these recent developments in the VRP and provide the following in a unified and carefully developed presentation: Present novel problems that have arisen in the vehicle routing domain and highlight new challenges for the field; Pre...

  20. The status and latest issues on KAERI export control implementation

    International Nuclear Information System (INIS)

    Kim, Hyun Sook; Park, Ho Jun; Kim, Hyun Jo; Ko, Han Suk; Lee, Byung Doo

    2010-01-01

    There are four informal non-proliferation arrangements which seek to control the proliferation of weapons of mass destruction and their missile delivery systems and the transfer of conventional weapons and dual-use technologies. The four arrangements are Wassenaar Arrangement (WA) on export controls for conventional arms and dual use goods and technologies, Nuclear Supplies Group(NSG), Missile Technology Control Regime(MTCR) and Australia Group(AG) on chemical and biological weapons materials. ROK participates in four arrangements to seek to encourage responsible practice in the trade of strategic goods and technologies. It is achieved through the implementation of export control list. MKE Notification (Ministry of Knowledge Economy Notification No. 2009-250) specifies those items and technologies subject to control. In this paper, the status and latest issues on KAERI export control implementation are described

  1. Constraining viscous dark energy models with the latest cosmological data

    Science.gov (United States)

    Wang, Deng; Yan, Yang-Jie; Meng, Xin-He

    2017-10-01

    Based on the assumption that the dark energy possessing bulk viscosity is homogeneously and isotropically permeated in the universe, we propose three new viscous dark energy (VDE) models to characterize the accelerating universe. By constraining these three models with the latest cosmological observations, we find that they just deviate very slightly from the standard cosmological model and can alleviate effectively the current H_0 tension between the local observation by the Hubble Space Telescope and the global measurement by the Planck Satellite. Interestingly, we conclude that a spatially flat universe in our VDE model with cosmic curvature is still supported by current data, and the scale invariant primordial power spectrum is strongly excluded at least at the 5.5σ confidence level in the three VDE models as the Planck result. We also give the 95% upper limits of the typical bulk viscosity parameter η in the three VDE scenarios.

  2. Constraining viscous dark energy models with the latest cosmological data

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Deng [Nankai University, Theoretical Physics Division, Chern Institute of Mathematics, Tianjin (China); Yan, Yang-Jie; Meng, Xin-He [Nankai University, Department of Physics, Tianjin (China)

    2017-10-15

    Based on the assumption that the dark energy possessing bulk viscosity is homogeneously and isotropically permeated in the universe, we propose three new viscous dark energy (VDE) models to characterize the accelerating universe. By constraining these three models with the latest cosmological observations, we find that they just deviate very slightly from the standard cosmological model and can alleviate effectively the current H{sub 0} tension between the local observation by the Hubble Space Telescope and the global measurement by the Planck Satellite. Interestingly, we conclude that a spatially flat universe in our VDE model with cosmic curvature is still supported by current data, and the scale invariant primordial power spectrum is strongly excluded at least at the 5.5σ confidence level in the three VDE models as the Planck result. We also give the 95% upper limits of the typical bulk viscosity parameter η in the three VDE scenarios. (orig.)

  3. Latest improvements on TRACPWR six-equations thermohydraulic code

    International Nuclear Information System (INIS)

    Rivero, N.; Batuecas, T.; Martinez, R.; Munoz, J.; Lenhardt, G.; Serrano, P.

    1999-01-01

    The paper presents the latest improvements on TRACPWR aimed at adapting the code to present trends on computer platforms, architectures and training requirements as well as extending the scope of the code itself and its applicability to other technologies different from Westinghouse PWR one. Firstly major features of TRACPWR as best estimate and real time simulation code are summed, then the areas where TRACPWR is being improved are presented. These areas comprising: (1) Architecture: integrating TRACPWR and RELAP5 codes, (2) Code scope enhancement: modelling the Mid-Loop operation, (3) Code speed-up: applying parallelization techniques, (4) Code platform downswing: porting to Windows N1 platform, (5) On-line performance: allowing simulation initialisation from a Plant Process Computer, and (6) Code scope extension: using the code for modelling VVER and PHWR technology. (author)

  4. Targeting Nanomedicine to Brain Tumors: Latest Progress and Achievements.

    Science.gov (United States)

    Van't Root, Moniek; Lowik, Clemens; Mezzanotte, Laura

    2017-01-01

    Targeting nanomedicine to brain tumors is hampered by the heterogeneity of brain tumors and the blood brain barrier. These represent the main reasons of unsuccessful treatments. Nanomedicine based approaches hold promise for improved brain tissue distribution of drugs and delivery of combination therapies. In this review, we describe the recent advancements and latest achievements in the use of nanocarriers, virus and cell-derived nanoparticles for targeted therapy of brain tumors. We provide successful examples of nanomedicine based approaches for direct targeting of receptors expressed in brain tumor cells or modulation of pathways involved in cell survival as well as approaches for indirect targeting of cells in the tumor stroma and immunotherapies. Although the field is at its infancy, clinical trials involving nanomedicine based approaches for brain tumors are ongoing and many others will start in the near future. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  5. Latest NASA Instrument Cost Model (NICM): Version VI

    Science.gov (United States)

    Mrozinski, Joe; Habib-Agahi, Hamid; Fox, George; Ball, Gary

    2014-01-01

    The NASA Instrument Cost Model, NICM, is a suite of tools which allow for probabilistic cost estimation of NASA's space-flight instruments at both the system and subsystem level. NICM also includes the ability to perform cost by analogy as well as joint confidence level (JCL) analysis. The latest version of NICM, Version VI, was released in Spring 2014. This paper will focus on the new features released with NICM VI, which include: 1) The NICM-E cost estimating relationship, which is applicable for instruments flying on Explorer-like class missions; 2) The new cluster analysis ability which, alongside the results of the parametric cost estimation for the user's instrument, also provides a visualization of the user's instrument's similarity to previously flown instruments; and 3) includes new cost estimating relationships for in-situ instruments.

  6. Multifaceted bench comparative evaluation of latest intensive care unit ventilators.

    Science.gov (United States)

    Garnier, M; Quesnel, C; Fulgencio, J-P; Degrain, M; Carteaux, G; Bonnet, F; Similowski, T; Demoule, A

    2015-07-01

    Independent bench studies using specific ventilation scenarios allow testing of the performance of ventilators in conditions similar to clinical settings. The aims of this study were to determine the accuracy of the latest generation ventilators to deliver chosen parameters in various typical conditions and to provide clinicians with a comprehensive report on their performance. Thirteen modern intensive care unit ventilators were evaluated on the ASL5000 test lung with and without leakage for: (i) accuracy to deliver exact tidal volume (VT) and PEEP in assist-control ventilation (ACV); (ii) performance of trigger and pressurization in pressure support ventilation (PSV); and (iii) quality of non-invasive ventilation algorithms. In ACV, only six ventilators delivered an accurate VT and nine an accurate PEEP. Eleven devices failed to compensate VT and four the PEEP in leakage conditions. Inspiratory delays differed significantly among ventilators in invasive PSV (range 75-149 ms, P=0.03) and non-invasive PSV (range 78-165 ms, Pventilation algorithms efficiently prevented the decrease in pressurization capacities and PEEP levels induced by leaks in, respectively, 10 and 12 out of the 13 ventilators. We observed real heterogeneity of performance amongst the latest generation of intensive care unit ventilators. Although non-invasive ventilation algorithms appear to maintain adequate pressurization efficiently in the case of leakage, basic functions, such as delivered VT in ACV and pressurization in PSV, are often less reliable than the values displayed by the device suggest. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. Systematic review on human resources for health interventions to improve maternal health outcomes: evidence from low- and middle-income countries.

    Science.gov (United States)

    Lassi, Zohra S; Musavi, Nabiha B; Maliqi, Blerta; Mansoor, Nadia; de Francisco, Andres; Toure, Kadidiatou; Bhutta, Zulfiqar A

    2016-03-12

    There is a broad consensus and evidence that shows qualified, accessible, and responsive human resources for health (HRH) can make a major impact on the health of the populations. At the same time, there is widespread recognition that HRH crises particularly in low- and middle-income countries (LMICs) impede the achievement of better health outcomes/targets. In order to achieve the Sustainable Development Goals (SDGs), equitable access to a skilled and motivated health worker within a performing health system is need to be ensured. This review contributes to the vast pool of literature towards the assessment of HRH for maternal health and is focused on interventions delivered by skilled birth attendants (SBAs). Studies were included if (a) any HRH interventions in management system, policy, finance, education, partnership, and leadership were implemented; (b) these were related to SBA; (c) reported outcomes related to maternal health; (d) the studies were conducted in LMICs; and (e) studies were in English. Studies were excluded if traditional birth attendants and/or community health workers were trained. The review identified 25 studies which revealed reasons for poor maternal health outcomes in LMICs despite the efforts and policies implemented throughout these years. This review suggested an urgent and immediate need for formative evidence-based research on effective HRH interventions for improved maternal health outcomes. Other initiatives such as education and empowerment of women, alleviating poverty, establishing gender equality, and provision of infrastructure, equipment, drugs, and supplies are all integral components that are required to achieve SDGs by reducing maternal mortality and improving maternal health.

  8. The influence of the diffusion of responsibility effect on outcome evaluations: electrophysiological evidence from an ERP study.

    Science.gov (United States)

    Li, Peng; Jia, Shiwei; Feng, Tingyong; Liu, Qiang; Suo, Tao; Li, Hong

    2010-10-01

    Previous studies have revealed that personal responsibility has an influence on outcome evaluation, although the way this influence works is still unclear. This study imitated the phenomenon of responsibility diffusion in a laboratory to examine the influence of the effect of responsibility diffusion on the processing of outcome evaluation using the event-related potential (ERP) technique. Participants of the study were required to perform the gambling task individually in the high-responsibility condition and with others in the low-responsibility scenario. Self-rating results showed that the participants felt more responsible for monetary loss and believed that they had more contributions to the monetary gains in the high-responsibility condition than in the low-responsibility situation. Both the feedback-related negativity (FRN) and the P300 were sensitive to the responsibility level, as evidenced by the enhanced amplitudes in the high-responsibility condition for both components. Further correlation analysis showed a negative correlation between FRN amplitudes and subjective rating scores (i.e., the higher the responsibility level, the larger the FRN amplitude). The results probably indicate that the FRN and P300 reflect personal responsibility processing under the social context of diffusion of responsibility. Copyright 2010 Elsevier Inc. All rights reserved.

  9. Acculturation level and caregiver outcomes from a randomized intervention trial to enhance caregivers' health: evidence from REACH II.

    Science.gov (United States)

    Meyer, Oanh L; Liu, Xiaoyan Lucia; Tancredi, Daniel; Ramirez, A Susana; Schulz, Richard; Hinton, Ladson

    2018-06-01

    Latinos comprise a growing segment of the caregiver population and vary widely in acculturation, yet little is known regarding how acculturation might affect caregiver stress or intervention outcomes. This study examined the relationship between acculturation and burden, bother, and depression in Latino dementia caregivers at baseline and following an intervention. This was a secondary data analysis of 211 Latino caregivers of older adults with dementia from Resources for Enhancing Alzheimer's Caregiver Health (REACH) II, a multisite randomized trial of caregiver interventions. Baseline and follow-up data were used to run mixed-effects models examining the main and moderating effect of acculturation on caregiver stress. No significant main effect of acculturation was found for any of the outcome measures, controlling for demographic covariates. Acculturation moderated the effect of the intervention on caregiver burden: those who were more acculturated benefited more from the intervention. Differential acculturation for Latino caregivers was not directly associated with caregiver burden, bother, or depression, but was associated with reducing burden from the intervention. Future research should explore by what mechanism acculturation influences caregiver burden following an intervention.

  10. Monitoring of health and demographic outcomes in poor urban settlements: evidence from the Nairobi Urban Health and Demographic Surveillance System.

    Science.gov (United States)

    Emina, Jacques; Beguy, Donatien; Zulu, Eliya M; Ezeh, Alex C; Muindi, Kanyiva; Elung'ata, Patricia; Otsola, John K; Yé, Yazoumé

    2011-06-01

    The Nairobi Urban Health and Demographic Surveillance System (NUHDSS) was set up in Korogocho and Viwandani slum settlements to provide a platform for investigating linkages between urban poverty, health, and demographic and other socioeconomic outcomes, and to facilitate the evaluation of interventions to improve the wellbeing of the urban poor. Data from the NUHDSS confirm the high level of population mobility in slum settlements, and also demonstrate that slum settlements are long-term homes for many people. Research and intervention programs should take account of the duality of slum residency. Consistent with the trends observed countrywide, the data show substantial improvements in measures of child mortality, while there has been limited decline in fertility in slum settlements. The NUHDSS experience has shown that it is feasible to set up and implement long-term health and demographic surveillance system in urban slum settlements and to generate vital data for guiding policy and actions aimed at improving the wellbeing of the urban poor.

  11. Interpersonal problems and impacts: further evidence for the role of interpersonal functioning in treatment outcome in major depressive disorder.

    Science.gov (United States)

    Quilty, Lena C; Mainland, Brian J; McBride, Carolina; Bagby, R Michael

    2013-09-05

    Empirical research has converged to support the concurrent association between social difficulties and psychiatric symptoms; yet, longitudinal associations between interpersonal problems and treatment outcome require clarification. The current investigation evaluated the influence of interpersonal problems assessed prior to treatment on interpersonal impacts assessed during treatment as well as on treatment outcome in outpatients with major depressive disorder (MDD). 125 participants with a primary diagnosis of MDD were randomized to receive cognitive behavioural therapy or interpersonal therapy. Participants completed the Beck Depression Inventory-II, Hamilton Depression Rating Scale, and Inventory of Interpersonal Problems Circumplex before and after treatment. Therapists completed the Impact Message Inventory during and after treatment. Interpersonal distress improved over the course of treatment; all other interpersonal changes were non-significant when distress was taken into account. Pre-treatment rigidity and agentic problems predicted less reduction in depressive symptoms, whereas agentic and communal impacts upon therapists during treatment predicted greater symptom change. Overall interpersonal distress was only indirectly associated with treatment response later in treatment, through its association with agentic style. Results did not differ across therapy type, and were replicated across self-report and interviewer-rated measures of depression severity. Limitations include the brief duration of treatment, lack of medication arm, and potentially restricted generalizability of patients in a randomized control trial to those in routine practice. Interpersonal style demonstrated a trait-like stability over treatment, and appears to fluctuate due to co-occurring distress. Yet, specific interpersonal styles were negative prognostic indicators, even within therapy specifically targeting interpersonal functioning. Copyright © 2013 Elsevier B.V. All rights

  12. How food insecurity contributes to poor HIV health outcomes: Qualitative evidence from the San Francisco Bay Area.

    Science.gov (United States)

    Whittle, Henry J; Palar, Kartika; Seligman, Hilary K; Napoles, Tessa; Frongillo, Edward A; Weiser, Sheri D

    2016-12-01

    Food-insecure people living with HIV/AIDS (PLHIV) consistently exhibit worse clinical outcomes than their food-secure counterparts. This relationship is mediated in part through non-adherence to antiretroviral therapy (ART), sub-optimal engagement in HIV care, and poor mental health. An in-depth understanding of how these pathways operate in resource-rich settings, however, remains elusive. We aimed to understand the relationship between food insecurity and HIV health among low-income individuals in the San Francisco Bay Area using qualitative methods. Semi-structured in-depth interviews were conducted with 34 low-income PLHIV receiving food assistance from a non-profit organization. Interviews explored experiences with food insecurity and its perceived effects on HIV-related health, mental health, and health behaviors including taking ART and attending clinics. Thematic content analysis of transcripts followed an integrative inductive-deductive approach. Food insecurity was reported to contribute to poor ART adherence and missing scheduled clinic visits through various mechanisms, including exacerbated ART side effects in the absence of food, physical feelings of hunger and fatigue, and HIV stigma at public free-meal sites. Food insecurity led to depressive symptoms among participants by producing physical feelings of hunger, aggravating pre-existing struggles with depression, and nurturing a chronic self-perception of social failure. Participants further explained how food insecurity, depression, and ART non-adherence could reinforce each other in complex interactions. Our study demonstrates how food insecurity detrimentally shapes HIV health behavior and outcomes through complex and interacting mechanisms, acting via multiple socio-ecological levels of influence in this setting. The findings emphasize the need for broad, multisectoral approaches to tackling food insecurity among urban poor PLHIV in the United States. Copyright © 2016 Elsevier Ltd. All rights

  13. Sacubitril/valsartan in heart failure: latest evidence and place in therapy

    Science.gov (United States)

    Kaplinsky, Edgardo

    2016-01-01

    Despite significant therapeutic advances, patients with chronic heart failure (HF) remain at high risk for HF progression and death. Sacubitril/valsartan (previously known as LCZ696) is a first-in-class medicine that contains a neprilysin (NEP) inhibitor (sacubitril) and an angiotensin II (Ang-II) receptor blocker (valsartan). NEP is an endopeptidase that metabolizes different vasoactive peptides including natriuretic peptides, bradykinin and Ang-II. In consequence, its inhibition increases mainly the levels of both, natriuretic peptides (promoting diuresis, natriuresis and vasodilatation) and Ang-II whose effects are blocked by the angiotensin receptor blocker, valsartan (reducing vasoconstriction and aldosterone release). Results from the 8442 patient PARADIGM-HF study showed in patients with New York Heart Association (NYHA) class II–IV and reduced ejection fraction treated with LCZ696 (versus enalapril), the following benefits: reduction of the risk of death from cardiovascular causes by 20%; reduction of HF hospitalizations by 21%; reduction of the risk of all-cause mortality by 16%. Overall there was a 20% risk reduction on the primary endpoint, composite measure of cardiovascular (CV) death or time to first HF hospitalization. PARADIGM-HF was stopped early after a median follow up of 27 months. Post hoc analyses of PARADIGM-HF as well as the place in therapy of sacubitril/valsartan, including future directions, are included in the present review. PMID:27803793

  14. Small scale karst features (tube karren) as evidence of a latest Quaternary fossil landslide

    Science.gov (United States)

    Stöger, Tobias; Plan, Lukas; Draganits, Erich

    2017-04-01

    At least since 1933 numerous small dissolutional holes in the ceilings of overhangs and small caves have been known from a restricted area in the Northern Calcareous Alps in Lower Austria but not investigated yet. These tube-shaped structures are a few centimetres in diameter, more or less vertical, taper upwards, are closed at the top and penetrate some tens of centimetres into the Middle Triassic limestone. Very similar features were described by Simms (2002) from the shores of three lakes in western Ireland and termed Röhrenkarren or tube karren. According to his model they formed by condensation corrosion within air pockets trapped by seasonal floods. The features investigated in the present study occur on both sides of a valley in the north eastern part of the Northern Calcareous Alps south of the city Sankt Pölten. Presently there is no lake and so far no paleo lake is known from this area. Based on airborne laser scanning data and field observations in a narrow section of the valley downstream of the tube karren sites, a previously unknown potential fossil landslide was discovered. The clayey silty sediments upstream of the landslide are interpreted as palaeo-lake sediments. This interpretation is supported by the existence of abundant dragonfly eggs within these deposits. The same fine-grained sediments are partly also found inside the tube karren. These observations are interpreted that a landslide-dammed palaeo-lake formed due to the mass movement that blocked the river and the tube karren were formed by seasonal fluctuations of the lake level. Geochronological dating of calcite crusts covering the karren and of the organic material of the dragonfly eggs are on the way. As the karren features look quite fresh and unweathered and from the diffuse shape of the landslide a late Quaternary age is estimated. References Simms, M.J. 2002. The origin of enigmatic, tubular, lake-shore karren: a mechanism for rapid dissolution of limestone in carbonate-saturated waters. Physical Geography, 23(1), 1-20.

  15. The optimal approach to nutrition and cystic fibrosis : latest evidence and recommendations

    NARCIS (Netherlands)

    Kraaijeveld, FM; Ross, NM; Heijerman, Harry

    2017-01-01

    Purpose of review Cystic fibrosis (CF) is a progressive genetic disease that affects multiple organ systems. Therapy is directed to maintain and optimize nutritional status and pulmonary function, as these are key factors in survival. In this review, the most recent findings regarding nutritional

  16. Is There Evidence for Systematic Upcoding of ASA Physical Status Coincident with Payer Incentives? A Regression Discontinuity Analysis of the National Anesthesia Clinical Outcomes Registry.

    Science.gov (United States)

    Schonberger, Robert B; Dutton, Richard P; Dai, Feng

    2016-01-01

    Modifications in physician billing patterns have been shown to occur in response to payer incentives, but the phenomenon remains largely unexplored in billing for anesthesia services. Within the field of anesthesiology, Medicare's policy not to provide additional reimbursement for higher ASA physical status scores contrasts with the practices of most private payers, and this pattern of reimbursement introduces a change in billing incentives once patients attain Medicare eligibility. We hypothesized that, coincident with the onset of widespread Medicare eligibility at age 65 years, a discontinuity in reported ASA physical status scores would be observed after controlling for the underlying trend of increasing ASA physical status scores with age. This phenomenon would manifest as a pattern of upcoding of ASA physical status scores for patients younger than 65 years that would become less common in patients age 65 years and older. Using data on age, sex, ASA physical status scores, and type of surgery from the National Anesthesia Clinical Outcomes Registry, we used a quasi-experimental regression discontinuity design to analyze whether there was evidence for a discontinuity in reported ASA physical status scores occurring at age 65 years for the nondeferrable anesthesia services accompanying hip, femur, or lower leg fracture repair. A total of 49,850 records were analyzed. In models designed to detect regression discontinuity at 65 years of age, neither the binary variable "age ≥ 65" nor the interaction term of age × age ≥ 65 was a statistically significant predictor of the outcome of ASA physical status score. The statistical inference was unchanged when ASA physical status scores were reclassified as a binary outcome (I-II vs III-V) and when different bandwidths around age 65 years were used. To test the validity of our study design for detecting regression discontinuity, simulations of the occurrence of deliberate upcoding of ASA physical status scores

  17. Integrating Information Literacy and Evidence-Based Medicine Content within a New School of Medicine Curriculum: Process and Outcome.

    Science.gov (United States)

    Muellenbach, Joanne M; Houk, Kathryn M; E Thimons, Dana; Rodriguez, Bredny

    2018-01-01

    This column describes a process for integrating information literacy (IL) and evidence-based medicine (EBM) content within a new school of medicine curriculum. The project was a collaborative effort among health sciences librarians, curriculum deans, directors, and faculty. The health sciences librarians became members of the curriculum committees, developed a successful proposal for IL and EBM content within the curriculum, and were invited to become course instructors for Analytics in Medicine. As course instructors, the librarians worked with the other faculty instructors to design and deliver active learning class sessions based on a flipped classroom approach using a proprietary Information Mastery curriculum. Results of this collaboration may add to the knowledge base of attitudes and skills needed to practice as full faculty partners in curricular design and instruction.

  18. Outcomes From the First Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare Invitational Expert Forum.

    Science.gov (United States)

    Melnyk, Bernadette Mazurek; Gallagher-Ford, Lynn; Zellefrow, Cindy; Tucker, Sharon; Van Dromme, Laurel; Thomas, Bindu Koshy

    2018-02-01

    Even though multiple positive outcomes are the result of evidence-based care, including improvements in healthcare quality, safety, and costs, it is not consistently delivered by clinicians in healthcare systems throughout the world. In an attempt to accelerate the implementation of evidence-based practice (EBP) across the United States, an invitational Interprofessional National EBP Forum to determine major priorities for the advancement of EBP was held during the launch of the newly established Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare at The Ohio State University College of Nursing. Interprofessional leaders from national organizations and federal agencies across the United States were invited to participate in the Forum. A pre-Forum survey was disseminated to participants to assess their perceptions of the state of EBP and actions necessary to speed the translation of research into real-world clinical settings. Findings from a pre-Forum survey (n = 47) indicated ongoing low implementation of EBP in U.S. healthcare settings. These findings were shared with leaders from 45 organizations and agencies who attended the Forum. Breakout groups on practice, education, implementation science, and policy discussed the findings and responded to a set of standardized questions. High-priority action tactics were identified, including the need for: (a) enhanced reimbursement for EBP, (b) more interprofessional education and skills building in EBP, and (c) leaders to prioritize EBP and fuel it with resources. The delivery of and reimbursement for evidence-based care must become a high national priority. Academic faculty across all healthcare disciplines need to teach EBP, healthcare systems must invest in EBP resources, and payers must attach reimbursement to care that is evidence-based. An action collaborative of the participating organizations has been formed to accelerate EBP across the United States to achieve the

  19. Overview of the role of pre-operative breast MRI in the absence of evidence on patient outcomes.

    Science.gov (United States)

    Sardanelli, Francesco

    2010-02-01

    The role of pre-operative breast MRI is outlined on the basis of the existing evidence in favor of a superior capability in comparison with mammography and sonography to detect ipsilateral and contralateral malignant lesions and to evaluate the disease extent, including the extensive intraductal component associated with invasive cancers. Patients with a potential higher anticipated benefit from pre-operative MRI can be identified as those: with mammographically dense breasts; with a unilateral multifocal/multicentric cancer or a synchronous bilateral cancer already diagnosed at mammography and sonography; with a lobular invasive cancer; at high-risk for breast cancer; with a cancer which shows a discrepancy in size of >1 cm between mammography and sonography; or under consideration for partial breast irradiation. More limited evidence exists in favor of MRI for evaluating candidates for total skin sparing mastectomy or for patients with Paget's disease. Irrespective of whether the clinical team routinely uses preoperative MRI or not: women newly diagnosed with breast cancer should always be informed of the potential risks and benefits of pre-operative MRI; results of pre-operative MRI should be interpreted taking into account clinical breast examination, mammography, sonography and verified by percutaneous biopsy; MRI-only detected lesions require MR-guidance for needle biopsy and pre-surgical localization, and these should be available or potentially accessible if pre-operative MRI is to be implemented; total therapy delay due to pre-operative MRI (including MRI-induced work-up) should not exceed one month; changes in therapy planning resulting from pre-operative MRI should be decided by a multidisciplinary team. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

  20. Trehalose Analogues: Latest Insights in Properties and Biocatalytic Production

    Directory of Open Access Journals (Sweden)

    Maarten Walmagh

    2015-06-01

    Full Text Available Trehalose (α-d-glucopyranosyl α-d-glucopyranoside is a non-reducing sugar with unique stabilizing properties due to its symmetrical, low energy structure consisting of two 1,1-anomerically bound glucose moieties. Many applications of this beneficial sugar have been reported in the novel food (nutricals, medical, pharmaceutical and cosmetic industries. Trehalose analogues, like lactotrehalose (α-d-glucopyranosyl α-d-galactopyranoside or galactotrehalose (α-d-galactopyranosyl α-d-galactopyranoside, offer similar benefits as trehalose, but show additional features such as prebiotic or low-calorie sweetener due to their resistance against hydrolysis during digestion. Unfortunately, large-scale chemical production processes for trehalose analogues are not readily available at the moment due to the lack of efficient synthesis methods. Most of the procedures reported in literature suffer from low yields, elevated costs and are far from environmentally friendly. “Greener” alternatives found in the biocatalysis field, including galactosidases, trehalose phosphorylases and TreT-type trehalose synthases are suggested as primary candidates for trehalose analogue production instead. Significant progress has been made in the last decade to turn these into highly efficient biocatalysts and to broaden the variety of useful donor and acceptor sugars. In this review, we aim to provide an overview of the latest insights and future perspectives in trehalose analogue chemistry, applications and production pathways with emphasis on biocatalysis.

  1. Latest LHCb measurements of Electroweak Boson Production in Run-1

    CERN Document Server

    CERN. Geneva

    2015-01-01

    We present the latest LHCb measurements of forward Electroweak Boson Production using proton-proton collisions recorded in LHC Run-1. The seminar shall discuss measurements of the 8 TeV W & Z boson production cross-sections. These results make use of LHCb's excellent integrated luminosity determination to provide constraints on the parton distribution functions which describe the inner structure of the proton. These LHCb measurements probe a region of phase space at low Bjorken-x where the other LHC experiments have limited sensitivity. We also present measurements of cross-section ratios, and ratios of results in 7 TeV and 8 TeV proton-proton collisions. These results provide precision tests of the Standard Model. The seminar shall also present a measurement of the forward-backward asymmetry (A_FB) in Z boson decays to two muons. This result allows for precision tests of the coupling of the Z boson to left and right handed particles, providing sensitivity to the effective weak mixing angle (...

  2. A search for sterile neutrinos with the latest cosmological observations

    Energy Technology Data Exchange (ETDEWEB)

    Feng, Lu; Zhang, Jing-Fei [Northeastern University, Department of Physics, College of Sciences, Shenyang (China); Zhang, Xin [Northeastern University, Department of Physics, College of Sciences, Shenyang (China); Peking University, Center for High Energy Physics, Beijing (China)

    2017-06-15

    We report the result of a search for sterile neutrinos with the latest cosmological observations. Both cases of massless and massive sterile neutrinos are considered in the ΛCDM cosmology. The cosmological observations used in this work include the Planck 2015 temperature and polarization data, the baryon acoustic oscillation data, the Hubble constant direct measurement data, the Planck Sunyaev-Zeldovich cluster counts data, the Planck lensing data, and the cosmic shear data. We find that the current observational data give a hint of the existence of massless sterile neutrino (as dark radiation) at the 1.44σ level, and the consideration of an extra massless sterile neutrino can indeed relieve the tension between observations and improve the cosmological fit. For the case of massive sterile neutrino, the observations give a rather tight upper limit on the mass, which implies that actually a massless sterile neutrino is more favored. Our result is consistent with the recent result of neutrino oscillation experiment done by the Daya Bay and MINOS collaborations, as well as the recent result of cosmic ray experiment done by the IceCube collaboration. (orig.)

  3. Features of the latest version of the PHITS code

    International Nuclear Information System (INIS)

    Sato, Tatsuhiko; Matsuda, Norihiro; Hashimoto, Shintaro; Iwamoto, Yosuke; Noda, Shusaku; Ogawa, Tatsuhiko; Nakajima, Hiroshi; Fukahori, Tokio; Okumura, Keisuke; Kai, Tetsuya; Chiba, Satoshi; Niita, Koji; Iwase, Hiroshi; Furuta, Takuya

    2013-01-01

    A Multi-purpose Monte Carlo Particle and Heavy Ion Transport code System, PHITS, developed through collaborations between JAEA and several institutes in Japan and Europe, and upgraded recently and released as PHITS2.52 is presented as an overview. In the new version, higher accuracy of the simulation was achieved by implementing the latest nuclear reaction models such as Liege intra-nuclear cascade version 4.6 (INCL4.6) and a statistical multi-fragmentation model including JAM and JQMD for high-energy regions. The reliability of the simulation code was improved by modifying both the algorithms for the electron-, positron-, and photon-transport simulations in terms of not only the code itself but also the contents of its package, such as the attached data libraries. More than 800 researchers have been registered as PHITS users, and they apply the code to various research and development fields such as nuclear technology, accelerator design, medical physics, and cosmic-ray research. (S. Ohno)

  4. Operating experience on radiation reduction in the latest BWRs

    International Nuclear Information System (INIS)

    Ohsumi, K.; Uchida, S.; Aizawa, M.; Takagi, K.; Amano, O.; Yamashita, K.

    1988-01-01

    In Japan, BWR plants have been operated commercially since 1970, and the reduction of radiation exposure has been an important concern. The application of the procedure for reducing occupational exposure is incorporated in Japanese Improvement and Standardization Program for LWRs. No.2 and No.4 plants in Fukushima No.2 Nuclear Power Station were designed and constructed as the latest 1,100 MWe BWRs in conformity with the Improvement and Standardization Program. No.2 plant began the commercial operation in February, 1984, and experienced three times of the scheduled annual maintenance outage. No.4 plant began the commercial operation in September, 1987, and the first annual maintenance is scheduled from September, 1988. In this paper, discussion is focused on recent radiation reduction measures, that is the control of iron and nickel in primary coolant for reducing the radiation dose rate in primary systems, based on the experience with No.2 and No.4 plants. The design concept of a low radiation dose rate nuclear power plant, the experience on water chemistry in No.2 plant, the control of iron and nickel in No.4 plant operation and so on are reported. It is believed that these operation experiences contribute to the reduction of occupational exposure in BWR plants currently in operation and in future. (Kako, I.)

  5. Latest developments for a computer aided thermohydraulic network

    International Nuclear Information System (INIS)

    Alemberti, A.; Graziosi, G.; Mini, G.; Susco, M.

    1999-01-01

    Thermohydraulic networks are I-D systems characterized by a small number of basic components (pumps, valves, heat exchangers, etc) connected by pipes and limited spatially by a defined number of boundary conditions (tanks, atmosphere, etc). The network system is simulated by the well known computer program RELAPS/mod3. Information concerning the network geometry component behaviour, initial and boundary conditions are usually supplied to the RELAPS code using an ASCII input file by means of 'input cards'. CATNET (Computer Aided Thermalhydraulic NETwork) is a graphically user interface that, under specific user guidelines which completely define its range of applicability, permits a very high level of standardization and simplification of the RELAPS/mod3 input deck development process as well as of the output processing. The characteristics of the components (pipes, valves, pumps etc), defining the network system can be entered through CATNET. The CATNET interface is provided by special functions to compute form losses in the most typical bending and branching configurations. When the input of all system components is ready, CATNET is able to generate the RELAPS/mod3 input file. Finally, by means of CATNET, the RELAPS/mod3 code can be run and its output results can be transformed to an intuitive display form. The paper presents an example of application of the CATNET interface as well as the latest developments which greatly simplified the work of the users and allowed to reduce the possibility of input errors. (authors)

  6. Latest news on Arabidopsis brassinosteroid perception and signaling

    Directory of Open Access Journals (Sweden)

    Klaus eHarter

    2011-10-01

    Full Text Available Brassinosteroids (BR are plant hormones regulating growth and development. In interaction with other hormones, they are involved in environmental cue responses. The standard BR response pathway model in Arabidopsis includes the perception of the hormone by the plasma membrane receptor BRASSINOSTEROID INSENSITIVE 1 (BRI1 and its hetero-oligomerisation with the co-receptor BRI1-ASSOCIATED RECEPTOR KINASE 1 (BAK1, followed by the activation of a signaling cascade finally resulting in the expression of BR-responsive genes. Recent findings have shed new light on the molecular mechanism of BR perception, which includes the hormone-induced formation of a platform in BRI1 extracellular domain for interaction with BAK1, and on very early events of signaling at the plasma membrane-cytoplasm interface. In addition, a fast BR response pathway that modifies the membrane potential and the expansion of the cell wall – both crucial processes preceding cell elongation growth – was identified. In this review, these latest findings are summarized and discussed against the background of the standard model of BRI1-dependent signaling.

  7. Organizational Justice as an Outcome of Diversity Management for Female Employees: Evidence From U.S. Federal Agencies

    Directory of Open Access Journals (Sweden)

    Sungchan KIM

    2016-10-01

    Full Text Available Diversity management has been implemented vigorously in organizations with workforce diversity practices. One of the possible outcomes of diversity management is increased fairness in the organization. However, women perceive organizations as still being unfair, even though diverse managerial practices have been adopted to address equity related problems. In this article, we examine how female employees in federal agencies view diversity management and whether they believe that diversity management can lead to organizational justice. By using the 2013 Federal Employee Viewpoint Survey (FEVS data, we found that diversity management leads to a higher level of organizational justice for female employees. However, white female employees have a higher agreement on the effi cacy of diversity management in producing procedural and interactional justice than do non-white female employees. Also, female employees in the regulatory or redistributive agency category perceive less that diversity management leads to organizational justice than those in other agencies. We therefore conclude that diversity management is an effective tool to achieve organizational justice for particular groups.

  8. The dynamic influence of human resources on evidence-based intervention sustainability and population outcomes: an agent-based modeling approach.

    Science.gov (United States)

    McKay, Virginia R; Hoffer, Lee D; Combs, Todd B; Margaret Dolcini, M

    2018-06-05

    Sustaining evidence-based interventions (EBIs) is an ongoing challenge for dissemination and implementation science in public health and social services. Characterizing the relationship among human resource capacity within an agency and subsequent population outcomes is an important step to improving our understanding of how EBIs are sustained. Although human resource capacity and population outcomes are theoretically related, examining them over time within real-world experiments is difficult. Simulation approaches, especially agent-based models, offer advantages that complement existing methods. We used an agent-based model to examine the relationships among human resources, EBI delivery, and population outcomes by simulating provision of an EBI through a hypothetical agency and its staff. We used data from existing studies examining a widely implemented HIV prevention intervention to inform simulation design, calibration, and validity. Once we developed a baseline model, we used the model as a simulated laboratory by systematically varying three human resource variables: the number of staff positions, the staff turnover rate, and timing in training. We tracked the subsequent influence on EBI delivery and the level of population risk over time to describe the overall and dynamic relationships among these variables. Higher overall levels of human resource capacity at an agency (more positions) led to more extensive EBI delivery over time and lowered population risk earlier in time. In simulations representing the typical human resource investments, substantial influences on population risk were visible after approximately 2 years and peaked around 4 years. Human resources, especially staff positions, have an important impact on EBI sustainability and ultimately population health. A minimum level of human resources based on the context (e.g., size of the initial population and characteristics of the EBI) is likely needed for an EBI to have a meaningful impact on

  9. How the Mastery Rubric for Statistical Literacy Can Generate Actionable Evidence about Statistical and Quantitative Learning Outcomes

    Directory of Open Access Journals (Sweden)

    Rochelle E. Tractenberg

    2016-12-01

    Full Text Available Statistical literacy is essential to an informed citizenry; and two emerging trends highlight a growing need for training that achieves this literacy. The first trend is towards “big” data: while automated analyses can exploit massive amounts of data, the interpretation—and possibly more importantly, the replication—of results are challenging without adequate statistical literacy. The second trend is that science and scientific publishing are struggling with insufficient/inappropriate statistical reasoning in writing, reviewing, and editing. This paper describes a model for statistical literacy (SL and its development that can support modern scientific practice. An established curriculum development and evaluation tool—the Mastery Rubric—is integrated with a new, developmental, model of statistical literacy that reflects the complexity of reasoning and habits of mind that scientists need to cultivate in order to recognize, choose, and interpret statistical methods. This developmental model provides actionable evidence, and explicit opportunities for consequential assessment that serves students, instructors, developers/reviewers/accreditors of a curriculum, and institutions. By supporting the enrichment, rather than increasing the amount, of statistical training in the basic and life sciences, this approach supports curriculum development, evaluation, and delivery to promote statistical literacy for students and a collective quantitative proficiency more broadly.

  10. Evidence that COMT genotype and proline interact on negative-symptom outcomes in schizophrenia and bipolar disorder.

    Science.gov (United States)

    Clelland, C L; Drouet, V; Rilett, K C; Smeed, J A; Nadrich, R H; Rajparia, A; Read, L L; Clelland, J D

    2016-09-13

    Elevated peripheral proline is associated with psychiatric disorders, and there is evidence that proline is a neuromodulator. The proline dehydrogenase (PRODH) gene, which encodes the enzyme that catalyzes proline catabolism, maps to human chromosome 22q11.2, a region conferring risk of schizophrenia. In the Prodh-null mouse, an interaction between elevated peripheral proline and another 22q11.2 gene, catechol-O-methyltransferase (COMT), on neurotransmission and behavior has been reported. We explored the relationship between fasting plasma proline levels and COMT Val(158)Met genotype on symptoms (positive, negative and total) in schizophrenia patients. In an exploratory study we also examined symptom change in patients with bipolar disorder. There was a significant interaction between peripheral proline and COMT on negative symptoms in schizophrenia (PScale for the Assessment of Negative Symptom (SANS) scores. In contrast, high proline was associated with high SANS scores in patients carrying a Met allele. The relationship between proline and COMT also appears to modify negative symptoms across psychiatric illness. In bipolar disorder, a significant interaction was also observed on negative-symptom change (P=0.007, n=43). Negative symptoms are intractable and largely unaddressed by current medications. These data indicate a significant interaction between peripheral proline and COMT genotype, influencing negative symptoms in schizophrenia and bipolar disorder. That high proline has converse effects on symptoms by COMT genotype, may have implications for therapeutic decisions.

  11. Continuing evidence for poorer treatment outcomes for single male patients: Retreatment data from RTOG 97-14

    International Nuclear Information System (INIS)

    Konski, Andre; DeSilvio, Michelle; Hartsell, William; Watkins-Bruner, Deborah; Coyne, James; Scarantino, Charles; JanJan, Nora

    2006-01-01

    Purpose: The specific aim of this study was to evaluate outcome differences by gender and partner status for patients treated on Radiation Therapy Oncology Group (RTOG) protocol 97-14. Methods and Materials: RTOG 97-14 randomized patients with metastatic breast or prostate cancer to bone to receive 8 Gy in 1 fraction or 30 Gy in 10 fractions. Retreatment rates and overall survival were made based upon gender, marital status, and Karnofsky Performance Status (KPS). The cumulative incidence method was used to estimate retreatment time at 36 months from enrollment, and Gray's test was used to test for treatment differences within the same groupings. Marital status, gender, KPS, and treatment were variables tested in a univariate Cox model evaluating the time to retreatment. Results: Married men and women and single women receiving 30 Gy had significantly longer time to retreatment, p = 0.0067, p = 0.0052, and p = 0.0009 respectively. We failed to show a difference in retreatment rates over time in single men receiving either 30 Gy or 8 Gy. Univariate analysis of the entire group determined patients receiving 30 Gy in 10 fractions significantly less likely to receive retreatment, p < 0.0001, with a trend toward single patients less likely to be re-treated, p = 0.07. Conclusion: Non-disease-related variables, such as social support, might influence the results of clinical trials with subjective endpoints such as retreatment rates. The statistically nonsignificant difference in the 36-month retreatment rates observed in single male patients receiving 8 Gy may be a result of inadequate social support systems in place to facilitate additional care. Patients receiving 8 Gy in a single fraction had significantly higher retreatment rates compared with patients receiving 30 Gy in 10 fractions

  12. Educating Through Exploration: Emerging Evidence for Improved Learning Outcomes Using a New Theory of Digital Learning Design

    Science.gov (United States)

    Anbar, Ariel; Center for Education Through eXploration

    2018-01-01

    Advances in scientific visualization and public access to data have transformed science outreach and communication, but have yet to realize their potential impacts in the realm of education. Computer-based learning is a clear bridge between visualization and education that benefits students through adaptative personalization and enhanced access. Building this bridge requires close partnerships among scientists, technologists, and educators.The Infiniscope project fosters such partnerships to produce exploration-driven online learning experiences that teach basic science concepts using a combination of authentic space science narratives, data, and images, and a personalized guided inquiry approach. Infiniscope includes a web portal to host these digital learning experiences, as well as a teaching network of educators using and modifying these experiences. Infiniscope experiences are built around a new theory of digital learning design that we call “education through exploration” (ETX) developed during the creation of successful online, interactive science courses offered at ASU and other institutions. ETX builds on the research-based practices of active learning and guided inquiry to provide a set of design principles that aim to develop higher order thinking skills in addition to understanding of content. It is employed in these experiences by asking students to solve problems and actively discover relationships, supported by an intelligent tutoring system which provides immediate, personalized feedback and scaffolds scientific thinking and methods. The project is led by ASU’s School of Earth and Space Exploration working with learning designers in the Center for Education Through eXploration, with support from NASA’s Science Mission Directorate as part of the NASA Exploration Connection program.We will present an overview of ETX design, the Infinscope project, and emerging evidence of effectiveness.

  13. Raiders of the Latest Art: American Treasure Trove.

    Science.gov (United States)

    May, Mary Jo

    1986-01-01

    Lists writing exercises based on observations students can make in a shopping mall. Notes that the exercises are intended to become a springboard for study, description, conjecture, evidence, example, and innovation, and can be combined, expanded, or shortened. (EL)

  14. Latest Results from the Multi-Object Keck Exoplanet Tracker

    Science.gov (United States)

    Van Eyken, Julian C.; Ge, J.; Wan, X.; Zhao, B.; Hariharan, A.; Mahadevan, S.; DeWitt, C.; Guo, P.; Cohen, R.; Fleming, S. W.; Crepp, J.; Warner, C.; Kane, S.; Leger, F.; Pan, K.

    2006-12-01

    The W. M. Keck Exoplanet Tracker is a precision Doppler radial velocity instrument based on dispersed fixed-delay interferometry (DFDI) which takes advantage of the new technique to allow multi-object RV surveying. Installed at the 2.5m Sloan telescope at Apache Point Observatory, the combination of Michelson interferometer and medium resolution spectrograph allows design for simultaneous Doppler measurements of up to 60 targets, while maintaining high instrument throughput. Using a single-object prototype of the instrument at the Kitt Peak National Observatory 2.1m telescope, we previously discovered a 0.49MJup planet, HD 102195b (ET-1), orbiting with a 4.11d period, and other interesting targets are being followed up. From recent trial observations, the Keck Exoplanet Tracker now yields 59 usable simultaneous fringing stellar spectra, of a quality sufficient to attempt to detect short period hot-Jupiter type planets. Recent engineering improvements reduced errors by a factor of 2, and typical photon limits for stellar data are now at the 30m/s level for magnitude V 10.5 (depending on spectral type and v sin i), with a best value of 6.9m/s at V=7.6. Preliminary RMS precisions from solar data (daytime sky) are around 10m/s over a few days, with some spectra reaching close to their photon limit of 6-7m/s on the short term ( 1 hour). A number of targets showing interesting RV variability are currently being followed up independently. Additional engineering work is planned which should make for further significant gains in Doppler precision. Here we present the latest results and updates from the most recent engineering and observing runs with the Keck ET.

  15. Reassessment of Allied Health Professionals' Level of Self-Efficacy in, Outcome Expectancy in, and Use of Evidence-Based Practice.

    Science.gov (United States)

    Wilkinson, Shelley A; Hills, Andrew P; Street, Steven J; Hinchliffe, Fiona

    2016-01-01

    Evidence-based practice (EBP) is fundamental to improving patient outcomes. Factors affecting EBP capabilities are linked with institutional culture and barriers, personal self-belief, and individual ability. To effect change in capabilities, interventions must target barriers and be informed by behaviour change theory. This study measured the effect of training and organisational change on EBP measures amongst allied health professionals. All allied health staff (n=196) employed across the Mater Health Services (Brisbane, Queensland) were invited to complete a survey assessing EBP self-efficacy, outcome expectancy and use, as well as EBP training undertaken. Data were compared with those of surveys from 2010 and 2011. Response rate was 70.9% (n=139/196); 32 staff completed all surveys. Significant improvements were observed in staff undertaking training (EBP, p=0.008; research design and analysis, p=0.003) since the first survey. The significant increase in EBP self-efficacy that occurred from T1 to T2 remained at T3 (p=0.008). Fewer between-department differences were observed over time. This study identified sustained EBP self-efficacy improvements in this cohort and found that between-department differences have virtually disappeared. Ongoing interventions are required to sustain and improve staff's belief in their ability to deliver EBP.

  16. Counterfactual Processing of Economic Action-Outcome Alternatives in Obsessive-Compulsive Disorder: Further Evidence of Impaired Goal-Directed Behavior

    Science.gov (United States)

    Gillan, Claire M.; Morein-Zamir, Sharon; Kaser, Muzaffer; Fineberg, Naomi A.; Sule, Akeem; Sahakian, Barbara J.; Cardinal, Rudolf N.; Robbins, Trevor W.

    2014-01-01

    Background Obsessive-compulsive disorder (OCD) is a disorder of automatic, uncontrollable behaviors and obsessive rumination. There is evidence that OCD patients have difficulties performing goal-directed actions, instead exhibiting repetitive stimulus-response habit behaviors. This might result from the excessive formation of stimulus-response habit associations or from an impairment in the ability to use outcome value to guide behavior. We investigated the latter by examining counterfactual decision making, which is the ability to use comparisons of prospective action-outcome scenarios to guide economic choice. Methods We tested decision making (forward counterfactual) and affective responses (backward counterfactual) in 20 OCD patients and 20 matched healthy control subjects using an economic choice paradigm that previously revealed attenuation of both the experience and avoidance of counterfactual emotion in schizophrenia patients and patients with orbitofrontal cortex lesions. Results The use of counterfactual comparison to guide decision making was diminished in OCD patients, who relied primarily on expected value. Unlike the apathetic affective responses previously shown to accompany this decision style, OCD patients reported increased emotional responsivity to the outcomes of their choices and to the counterfactual comparisons that typify regret and relief. Conclusions Obsessive-compulsive disorder patients exhibit a pattern of decision making consistent with a disruption in goal-directed forward modeling, basing decisions instead on the temporally present (and more rational) calculation of expected value. In contrast to this style of decision making, emotional responses in OCD were more extreme and reactive than control subjects. These results are in line with an account of disrupted goal-directed cognitive control in OCD. PMID:23452663

  17. Current Evidence of Gait Modification with Real-time Biofeedback to Alter Kinetic, Temporospatial, and Function-Related Outcomes: A Review

    Directory of Open Access Journals (Sweden)

    Oladipo Eddo

    2017-07-01

    Full Text Available Background: Gait retraining using real-time biofeedback (RTB may have positive outcomes in decreasing knee adduction moment (KAM in healthy individuals and has shown equal likelihood in patients with knee osteoarthritis (OA. Currently, there is no consensus regarding the most effective gait modification strategy, mode of biofeedback or treatment dosage. Objective: The purpose of this review was: i to assess if gait retraining interventions using RTB are valuable to reduce KAM, pain, and improve function in individuals with knee osteoarthritis, ii to evaluate the effectiveness of different gait modifications and modes of RTB in reducing KAM in healthy individuals, and iii to assess the impact of gait retraining interventions with RTB on other variables that may affect clinical outcomes. Methods: Seven electronic databases were searched using five search terms. Studies that utilized any form of gait retraining with RTB to improve one or a combination of the following measures were included: KAM, knee pain, and function. Twelve studies met the inclusion criteria, evaluating eleven distinctive gait modifications and three modes of RTB. Results: All but one study showed positive outcomes. Self-selected and multi-parameter gait modifications showed the greatest reductions in KAM with visual and haptic RTB being more effective than auditory. Conclusions: Current evidence suggests that gait modification using RTB can Positively alter KAM in asymptomatic and symptomatic participants. However, the existing literature is limited and of low quality, with the optimal combination strategies remaining unclear (gait and biofeedback mode. Future studies should employ randomized controlled study designs to compare the effects of different gait modification strategies and biofeedback modes on individuals with knee OA.

  18. Counterfactual processing of economic action-outcome alternatives in obsessive-compulsive disorder: further evidence of impaired goal-directed behavior.

    Science.gov (United States)

    Gillan, Claire M; Morein-Zamir, Sharon; Kaser, Muzaffer; Fineberg, Naomi A; Sule, Akeem; Sahakian, Barbara J; Cardinal, Rudolf N; Robbins, Trevor W

    2014-04-15

    Obsessive-compulsive disorder (OCD) is a disorder of automatic, uncontrollable behaviors and obsessive rumination. There is evidence that OCD patients have difficulties performing goal-directed actions, instead exhibiting repetitive stimulus-response habit behaviors. This might result from the excessive formation of stimulus-response habit associations or from an impairment in the ability to use outcome value to guide behavior. We investigated the latter by examining counterfactual decision making, which is the ability to use comparisons of prospective action-outcome scenarios to guide economic choice. We tested decision making (forward counterfactual) and affective responses (backward counterfactual) in 20 OCD patients and 20 matched healthy control subjects using an economic choice paradigm that previously revealed attenuation of both the experience and avoidance of counterfactual emotion in schizophrenia patients and patients with orbitofrontal cortex lesions. The use of counterfactual comparison to guide decision making was diminished in OCD patients, who relied primarily on expected value. Unlike the apathetic affective responses previously shown to accompany this decision style, OCD patients reported increased emotional responsivity to the outcomes of their choices and to the counterfactual comparisons that typify regret and relief. Obsessive-compulsive disorder patients exhibit a pattern of decision making consistent with a disruption in goal-directed forward modeling, basing decisions instead on the temporally present (and more rational) calculation of expected value. In contrast to this style of decision making, emotional responses in OCD were more extreme and reactive than control subjects. These results are in line with an account of disrupted goal-directed cognitive control in OCD. Copyright © 2014 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  19. Demand-side financing measures to increase maternal health service utilisation and improve health outcomes: a systematic review of evidence from low- and middle-income countries.

    Science.gov (United States)

    Murray, Susan F; Hunter, Benjamin M; Bisht, Ramila; Ensor, Tim; Bick, Debra

    2012-01-01

    In many countries financing for health services has traditionally been disbursed directly from governmental and non-governmental funding agencies to providers of services: the 'supply-side' of healthcare markets. Demand-side financing offers a supplementary model in which some funds are instead channelled through, or to, prospective users. In this review we considered evidence on five forms of demand-side financing that have been used to promote maternal health in developing countries: OBJECTIVES: The overall review objective was to assess the effects of demand-side financing interventions on maternal health service utilisation and on maternal health outcomes in low- and middle-income countries. Broader effects on perinatal and infant health, the situation of underprivileged women and the health care system were also assessed. This review considered poor, rural or socially excluded women of all ages who were either pregnant or within 42 days of the conclusion of pregnancy, the limit for postnatal care as defined by the World Health Organization. The review also considered the providers of services.The intervention of interest was any programme that incorporated demand-side financing as a mechanism to increase the consumption of goods and services that could impact on maternal health outcomes. This included the direct consumption of maternal health care goods and services as well as related 'merit goods' such as improved nutrition. We included systems in which potential users of maternal health services are financially empowered to make restricted decisions on buying maternal health-related goods or services - sometimes known as consumer-led demand-side financing. We also included programmes that provided unconditional cash benefits to pregnant women (for example in the form of maternity allowances), or to families with children under five years of age where there was evidence concerning maternal health outcomes.We aimed to include quantitative studies (experimental

  20. Using Getting To Outcomes to facilitate the use of an evidence-based practice in VA homeless programs: a cluster-randomized trial of an implementation support strategy.

    Science.gov (United States)

    Chinman, Matthew; McCarthy, Sharon; Hannah, Gordon; Byrne, Thomas Hugh; Smelson, David A

    2017-03-09

    Incorporating evidence-based integrated treatment for dual disorders into typical care settings has been challenging, especially among those serving Veterans who are homeless. This paper presents an evaluation of an effort to incorporate an evidence-based, dual disorder treatment called Maintaining Independence and Sobriety Through Systems Integration, Outreach, and Networking-Veterans Edition (MISSION-Vet) into case management teams serving Veterans who are homeless, using an implementation strategy called Getting To Outcomes (GTO). This Hybrid Type III, cluster-randomized controlled trial assessed the impact of GTO over and above MISSION-Vet Implementation as Usual (IU). Both conditions received standard MISSION-Vet training and manuals. The GTO group received an implementation manual, training, technical assistance, and data feedback. The study occurred in teams at three large VA Medical Centers over 2 years. Within each team, existing sub-teams (case managers and Veterans they serve) were the clusters randomly assigned. The trial assessed MISSION-Vet services delivered and collected via administrative data and implementation barriers and facilitators, via semi-structured interview. No case managers in the IU group initiated MISSION-Vet while 68% in the GTO group did. Seven percent of Veterans with case managers in the GTO group received at least one MISSION-Vet session. Most case managers appreciated the MISSION-Vet materials and felt the GTO planning meetings supported using MISSION-Vet. Case manager interviews also showed that MISSION-Vet could be confusing; there was little involvement from leadership after their initial agreement to participate; the data feedback system had a number of difficulties; and case managers did not have the resources to implement all aspects of MISSION-Vet. This project shows that GTO-like support can help launch new practices but that multiple implementation facilitators are needed for successful execution of a complex evidence

  1. Physical Activity and Exercise Interventions in the Workplace Impacting Work Outcomes: A Stakeholder-Centered Best Evidence Synthesis of Systematic Reviews.

    Science.gov (United States)

    White, M I; Dionne, C E; Wärje, O; Koehoorn, M; Wagner, S L; Schultz, I Z; Koehn, C; Williams-Whitt, K; Harder, H G; Pasca, R; Hsu, V; McGuire, L; Schulz, W; Kube, D; Wright, M D

    2016-04-01

    The prevention of work disability is beneficial to employees and employers, and mitigates unnecessary societal costs associated with social welfare. Many service providers and employers have initiated workplace interventions designed to reduce unnecessary work disability. To conduct a best-evidence synthesis of systematic reviews on workplace interventions that address physical activities or exercise and their impact on workplace absence, work productivity or financial outcomes. Using a participatory research approach, academics and stakeholders identified inclusion and exclusion criteria, built an abstraction table, evaluated systematic review quality and relevance, and interpreted the combined findings. A minimum of two scientists participated in a methodological review of the literature followed by a consensus process. Stakeholders and researchers participated as a collaborative team. 3363 unique records were identified, 115 full text articles and 46 systematic reviews were included, 18 assessed the impact of physical fitness or exercise interventions. 11 focused on general workers rather than workers who were absent from work at baseline; 16 of the reviews assessed work absence, 4 assessed productivity and 6 assessed financial impacts. The strongest evidence supports the use of short, simple exercise or fitness programs for both workers at work and those absent from work at baseline. For workers at work, simple exercise programs (1-2 modal components) appear to provide similar benefits to those using more complex multimodal interventions. For workers off-work with subacute low back pain, there is evidence that some complex exercise programs may be more effective than simple exercise interventions, especially if they involve workplace stakeholder engagement, communication and coordination with employers and other stakeholders. The development and utilization of standardized definitions, methods and measures and blinded evaluation would improve research quality

  2. Physical Activity and Exercise Interventions in the Workplace Impacting Work Outcomes: A Stakeholder-Centered Best Evidence Synthesis of Systematic Reviews

    Directory of Open Access Journals (Sweden)

    MI White

    2016-04-01

    Full Text Available Background: The prevention of work disability is beneficial to employees and employers, and mitigates unnecessary societal costs associated with social welfare. Many service providers and employers have initiated workplace interventions designed to reduce unnecessary work disability. Objective: To conduct a best-evidence synthesis of systematic reviews on workplace interventions that address physical activities or exercise and their impact on workplace absence, work productivity or financial outcomes. Methods: Using a participatory research approach, academics and stakeholders identified inclusion and exclusion criteria, built an abstraction table, evaluated systematic review quality and relevance, and interpreted the combined findings. A minimum of two scientists participated in a methodological review of the literature followed by a consensus process. Results: Stakeholders and researchers participated as a collaborative team. 3363 unique records were identified, 115 full text articles and 46 systematic reviews were included, 18 assessed the impact of physical fitness or exercise interventions. 11 focused on general workers rather than workers who were absent from work at baseline; 16 of the reviews assessed work absence, 4 assessed productivity and 6 assessed financial impacts. Conclusion: The strongest evidence supports the use of short, simple exercise or fitness programs for both workers at work and those absent from work at baseline. For workers at work, simple exercise programs (1–2 modal components appear to provide similar benefits to those using more complex multimodal interventions. For workers off-work with subacute low back pain, there is evidence that some complex exercise programs may be more effective than simple exercise interventions, especially if they involve workplace stakeholder engagement, communication and coordination with employers and other stakeholders. The development and utilization of standardized definitions

  3. Laparoscopic colorectal surgery: Current status and implementation of the latest technological innovations.

    Science.gov (United States)

    Pascual, Marta; Salvans, Silvia; Pera, Miguel

    2016-01-14

    The introduction of laparoscopy is an example of surgical innovation with a rapid implementation in many areas of surgery. A large number of controlled studies and meta-analyses have shown that laparoscopic colorectal surgery is associated with the same benefits than other minimally invasive procedures, including lesser pain, earlier recovery of bowel transit and shorter hospital stay. On the other hand, despite initial concerns about oncological safety, well-designed prospective randomized multicentre trials have demonstrated that oncological outcomes of laparoscopy and open surgery are similar. Although the use of laparoscopy in colorectal surgery has increased in recent years, the percentages of patients treated with surgery using minimally invasive techniques are still reduced and there are also substantial differences among centres. It has been argued that the limiting factor for the use of laparoscopic procedures is the number of surgeons with adequate skills to perform a laparoscopic colectomy rather than the tumour of patients' characteristics. In this regard, future efforts to increase the use of laparoscopic techniques in colorectal surgery will necessarily require more efforts in teaching surgeons. We here present a review of recent controversies of the use of laparoscopy in colorectal surgery, such as in rectal cancer operations, the possibility of reproducing complete mesocolon excision, and the benefits of intra-corporeal anastomosis after right hemicolectomy. We also describe the results of latest innovations such as single incision laparoscopic surgery, robotic surgery and natural orifice transluminal endoscopic surgery for colon and rectal diseases.

  4. The latest trends in nature-based outdoor recreation

    Science.gov (United States)

    H. Ken Cordell

    2008-01-01

    Considerable interest in better understanding current trends in nature-based outdoor recreation followed publication of Richard Louv’s book, Last Child in the Woods, and a recent paper by Oliver R.W. Pergams and Patricia A. Zaradic titled “Evidence for a Fundamental and Pervasive Shift away from Nature-Based Recreation.”

  5. Hegemonic Shifts: The Latest from the Walls of Northern Ireland

    Directory of Open Access Journals (Sweden)

    Tony Crowley

    2015-03-01

    Full Text Available This essay considers the changes that have taken place in the murals of Northern Ireland over the past decade or so. It will be argued that although there have been important developments in the murals that reflect the consolidation of ‘peace’ during this period, the walls also tell a different story.  It will be shown that, perhaps predictably, given the paralysis and stagnation that have characterised the power-sharing arrangements, and the disillusionment, cynicism and bitterness towards the political settlement which is now evident, a number of murals offer representations that indicate the growth of tendencies that present latent but real dangers.

  6. Latest Pleistocene and Holocene Glacier Fluctuations in southernmost Patagonia

    Science.gov (United States)

    Menounos, B.; Maurer, M.; Clague, J. J.; osborn, G.; Ponce, F.; Davis, P. T.; Rabassa, J.; Coronato, A.; Marr, R.

    2011-12-01

    Summer insolation has been proposed to explain long-term glacier fluctuations during the Holocene. If correct, the record of glacier fluctuations at high latitudes in the Southern Hemisphere should differ from that in the Northern Hemisphere. Testing this insolation hypothesis has been hampered by dating uncertainties of many Holocene glacier chronologies from Patagonia. We report on our ongoing research aimed at developing a regional glacier chronology at the southern end of the Andes north and west of Ushuaia, Argentina. We have found evidence for an advance of cirque glaciers at the end of the Pleistocene; one or locally two closely spaced moraines extend up to 2 km beyond Little Ice Age moraines. Radiocarbon dating of terrestrial macrofossils recovered from basal sediments behind two of these moraines yielded ages of 10,320 ± 25 and 10,330 ± 30 14C yr BP. These moraines may record glacier advances coeval with the Antarctic Cold Reversal; surface exposure dating of these moraines is currently in progress to test this hypothesis. We find no evidence of Holocene moraines older than 6800 14C yr BP, based on the distribution of Hudson tephra of that age. At some sites, there is evidence for an early Neoglacial advance of glaciers slightly beyond (Peru. We have documented multiple wood mats with stumps in growth position separated by till units in a 100 m section of the northeast lateral moraine at Stoppani Glacier (54.78 S, 68.98 W), 50 km west of Ushuaia. Ten radiocarbon ages on these wood mats range in age from 3510 ± 15 to 135 ± 15 14C yr BP. The mats decrease in age up-section; many overlap with published age ranges for Neoglacial advances in western Canada. Taken together, these data: a) do not support the summer insolation hypothesis for Holocene glacier fluctuations in southernmost Patagonia; b) confirm paleobotanical evidence for a warm, dry early Holocene; and c) suggest that many Neoglacial advances in southernmost Patagonia and western North America

  7. Catastrophic dispersion of coal fly ash into oceans during the latest Permian extinction

    Energy Technology Data Exchange (ETDEWEB)

    Grasby, S.E.; Sanei, H.; Beauchamp, B. [Geological Survey Canada Calgary, Calgary, AB (Canada)

    2011-02-15

    During the latest Permian extinction about 250 Myr ago, more than 90% of marine species went extinct, and biogeochemical cycles were disrupted globally. The cause of the disruption is unclear, but a link between the eruption of the Siberian Trap flood basalts and the extinction has been suggested on the basis of the rough coincidence of the two events. The flood basalt volcanism released CO{sub 2}. In addition, related thermal metamorphism of Siberian coal measures and organic-rich shales led to the emission of methane, which would have affected global climate and carbon cycling, according to model simulations. This scenario is supported by evidence for volcanic eruptions and gas release in the Siberian Tunguska Basin, but direct indicators of coal combustion have not been detected. Here we present analyses of terrestrial carbon in marine sediments that suggest a substantial amount of char was deposited in Permian aged rocks from the Canadian High Arctic immediately before the mass extinction. Based on the geochemistry and petrology of the char, we propose that the char was derived from the combustion of Siberian coal and organic-rich sediments by flood basalts, which was then dispersed globally. The char is remarkably similar to modern coal fly ash, which can create toxic aquatic conditions when released as slurries. We therefore speculate that the global distribution of ash could have created toxic marine conditions.

  8. Holographic dark energy models: a comparison from the latest observational data

    International Nuclear Information System (INIS)

    Li, Miao; Li, Xiao-Dong; Wang, Shuang; Zhang, Xin

    2009-01-01

    The holographic principle of quantum gravity theory has been applied to the dark energy (DE) problem, and so far three holographic DE models have been proposed: the original holographic dark energy (HDE) model, the agegraphic dark energy (ADE) model, and the holographic Ricci dark energy (RDE) model. In this work, we perform the best-fit analysis on these three models, by using the latest observational data including the Union+CFA3 sample of 397 Type Ia supernovae (SNIa), the shift parameter of the cosmic microwave background (CMB) given by the five-year Wilkinson Microwave Anisotropy Probe (WMAP5) observations, and the baryon acoustic oscillation (BAO) measurement from the Sloan Digital Sky Survey (SDSS). The analysis shows that for HDE, χ min 2 = 465.912; for RDE, χ min 2 = 483.130; for ADE, χ min 2 = 481.694. Among these models, HDE model can give the smallest χ 2 min . Besides, we also use the Bayesian evidence (BE) as a model selection criterion to make a comparison. It is found that for HDE, ADE, and RDE, Δln BE = −0.86, −5.17, and −8.14, respectively. So, it seems that the HDE model is more favored by the observational data

  9. The latest results from source term research. Overview and outlook

    Energy Technology Data Exchange (ETDEWEB)

    Herranz, Luis E. [Centro de Investigaciones Energeticas Medio Ambientales y Tecnologica (CIEMAT), Madrid (Spain); Haste, Tim [Centre d' Etudes de Cadarache, Paul-Lez-Durance (France). Institut de Radioprotection et de Surete Nucleaire (IRSN); Kaerkelae, Teemu [VTT Technical Research Centre of Finland Ltd, Espoo (Finland)

    2016-12-15

    Source term research has continued internationally for more than 30 years, increasing confidence in calculations of the potential radioactive release to the environment after a severe reactor accident. Important experimental data have been obtained, mainly under international frameworks such as OECD/NEA and EURATOM. Specifically, Phebus FP provides major insights into fission product release and transport. Results are included in severe accident analysis codes. Data from international projects are being interpreted with a view to further improvements in these codes. This paper synthesizes the recent main outcomes from source term research on these topics, and on source term mitigation. It highlights knowledge gaps remaining and discusses ways to proceed. Aside from this further knowledge-driven research, there is consensus on the need to assess the source term predictive ability of current system codes, taking account of scale-up from experiment to reactor conditions.

  10. Using an expanded outcomes framework and continuing education evidence to improve facilitation of patient-centered medical home recognition and transformation.

    Science.gov (United States)

    Van Hoof, Thomas J; Kelvey-Albert, Michele; Katz, Matthew; Lalime, Ken; Sacks, Ken; Meehan, Thomas P

    2014-01-01

    The patient-centered medical home is a model for delivering primary care in the United States. Primary care clinicians and their staffs require assistance in understanding the innovation and in applying it to practice. The purpose of this article is to describe and to critique a continuing education program that is relevant to, and will become more common in, primary care. A multifaceted educational strategy prepared 20 primary care private practices to achieve National Committee for Quality Assurance Level 3 recognition as Patient-Centered Medical Homes. Eighteen (90%) practices submitted an application to the National Committee for Quality Assurance. On the first submission attempt, 13 of 18 (72%) achieved Level 3 recognition and 5 (28%) achieved Level 1 recognition. An interactive multifaceted educational strategy can be successful in preparing primary care practices for Patient-Centered Medical Homes recognition, but the strategy may not ensure transformation. Future educational activities should consider an expanded outcomes framework and the evidence of effective continuing education to be more successful with recognition and transformation.

  11. The latest on the recent HR staff survey

    CERN Multimedia

    2009-01-01

    The data collected in the framework of the staff survey sent out by the Human Resources (HR) Department in March this year are currently being analysed. The first results concern the response rate and the breakdown of participants. 1328 staff members replied to the questionnaire, representing a response rate of close to 60%. Marie-Luce Falipou, who is in charge of the project within the HR Department, is evidently satisfied with the result: "The high response rate shows that the staff appreciated HR’s efforts to sound out their opinions and felt concerned by the subjects covered in the questionnaire". All the data are now being processed by the team led by Philippe Sarnin, Director of the Social Psychology Department at the University of Lyon2. "The number of responses submitted during the 15 days the form was available on line was very satisfactory. This is a vital factor in ensuring that we are able to build up an accurate pictu...

  12. Inferior outcome after hip resurfacing arthroplasty than after conventional arthroplasty. Evidence from the Nordic Arthroplasty Register Association (NARA) database, 1995 to 2007

    DEFF Research Database (Denmark)

    Johanson, Per-Erik; Fenstad, Anne Marie; Furnes, Ove

    2010-01-01

    The reported outcomes of hip resurfacing arthroplasty (HRA) vary. The frequency of this procedure in Denmark, Norway, and Sweden is low. We therefore determined the outcome of HRA in the NARA database, which is common to all 3 countries, and compared it to the outcome of conventional total hip...

  13. Sport nutrition: A review of the latest guidelines for exercise and ...

    African Journals Online (AJOL)

    Sport nutrition: A review of the latest guidelines for exercise and sport nutrition from the American College of Sport Nutrition, the International Olympic Committee and the International Society for Sports Nutrition.

  14. Industrial production of SC RF accelerating cavities at CERCA. Latest results

    International Nuclear Information System (INIS)

    Boutes, J.L.; Maccioni, P.

    1996-01-01

    CERCA is one of the most experienced companies throughout the world for the manufacture of superconducting RF accelerating devices. The latest results obtained during the past 2 years on CERCA's superconducting cavities are presented. (K.A.)

  15. Holocene and latest Pleistocene climate and glacier fluctuations in Iceland

    Science.gov (United States)

    Geirsdóttir, Áslaug; Miller, Gifford H.; Axford, Yarrow; Ólafsdóttir, Sædís

    2009-10-01

    Multiproxy climate records from Iceland document complex changes in terrestrial climate and glacier fluctuations through the Holocene, revealing some coherent patterns of change as well as significant spatial variability. Most studies on the Last Glacial Maximum and subsequent deglaciation reveal a dynamic Iceland Ice Sheet (IIS) that responded abruptly to changes in ocean currents and sea level. The IIS broke up catastrophically around 15 ka as the Polar Front migrated northward and sea level rose. Indications of regional advance or halt of the glaciers are seen in late Alleröd/early Younger Dryas time and again in PreBoreal time. Due to the apparent rise of relative sea level in Iceland during this time, most sites contain evidence for fluctuating, tidewater glacier termini occupying paleo fjords and bays. The time between the end of the Younger Dryas and the Preboreal was characterized by repeated jökulhlaups that eroded glacial deposits. By 10.3 ka, the main ice sheet was in rapid retreat across the highlands of Iceland. The Holocene thermal maximum (HTM) was reached after 8 ka with land temperatures estimated to be 3 °C higher than the 1961-1990 reference, and net precipitation similar to modern. Such temperatures imply largely ice-free conditions across Iceland in the early to mid-Holocene. Several marine and lacustrine sediment climate proxies record substantial summer temperature depression between 8.5 and 8 ka, but no moraines have been detected from that time. Termination of the HTM and onset of Neoglacial cooling took place sometime after 6 ka with increased glacier activity between 4.5 and 4.0 ka, intensifying between 3.0 and 2.5 ka. Although a distinct warming during the Medieval Warm Period is not dramatically apparent in Icelandic records, the interval from ca AD 0 to 1200 is commonly characterized by relative stability with slow rates of change. The literature most commonly describes Little Ice Age moraines (ca AD 1250-1900) as representing the

  16. Repeat transcatheter aortic valve implantation using a latest generation balloon-expandable device for treatment of failing transcatheter heart valves.

    Science.gov (United States)

    Schaefer, Andreas; Treede, Hendrik; Seiffert, Moritz; Deuschl, Florian; Schofer, Niklas; Schneeberger, Yvonne; Blankenberg, Stefan; Reichenspurner, Hermann; Schaefer, Ulrich; Conradi, Lenard

    2016-01-15

    Paravalvular leakage (PVL) is a known complication of transcatheter aortic valve implantation (TAVI) and is associated with poor outcome. Besides balloon-post-dilatation, valve-in-valve (ViV) procedures can be taken into consideration to control this complication. Herein we present initial experience with use of the latest generation balloon-expandable Edwards Sapien 3® (S3) transcatheter heart valve (THV) for treatment of failing THVs. Between 01/2014 and 12/2014 three patients (two male, age: 71-80 y, log EUROScore I: 11.89 - 32.63) with failing THVs were refered to our institution for further treatment. THV approach with secondary implantation of an S3 was chosen after mutual agreement of the local interdisciplinary heart team at an interval of 533-1119 days from the index procedure. The performed procedures consisted of: S3 in Sapien XT, JenaValve and CoreValve. Successful transfemoral implantation with significant reduction of PVL was achieved in all cases. No intraprocedural complications occurred regarding placement of the S3 with a postprocedural effective orifice area (EOA) of 1.5-2.5 cm(2) and pressure gradients of max/mean 14/6-36/16 mmHg. 30-day mortality was 0%. At the latest follow-up of 90-530 days, all patients are alive and well with satisfactory THV function. Regarding VARC-2 criteria one major bleeding and one TIA was reported. In the instance of moderate or severe aortic regurgitation after TAVI, S3 ViV deployment is an excellent option to reduce residual regurgitation to none or mild. For further assertions concerning functional outcomes long-term results have to be awaited.

  17. Proposed key characteristics of male reproductive toxicants as a method for organizing and screening mechanistic evidence for non-cancer outcomes.

    Science.gov (United States)

    The adoption of systematic review practices for risk assessment includes integration of evidence obtained from experimental, epidemiological, and mechanistic studies. Although mechanistic evidence plays an important role in mode of action analysis, the process of sorting and anal...

  18. The latest two GRB detected by Hete-2: GRB 051022 and GRB 051028

    International Nuclear Information System (INIS)

    Castro-Tirado, A. J.; Jelinek, M.; Pandey, S. B.; Ugarte Postigo, A. de; Gorosabel, J.; McBreen, S.; Bremer, M.; Guziy, S.; Bihain, G.; Caballero, J. A.; Ferrero, P.; Jong, J de; Misra, K.; Sahu, D. K.

    2006-01-01

    We present multiwavelength observations of the latest two GRB detected by Hete-2 in 2005. For GRB 051022, no optical/nIR afterglow has been detected, in spite of the strong gamma-ray emission and the reported X-ray afterglow discovered by Swift. A mm afterglow was discovered at PdB confirming the association of this event with a luminous (MV = - 21.5) galaxy within the X-ray error box. Spectroscopy of this galaxy shows strong a strong [O II] emission line at z = 0.807, besides weaker [O III] emission. The X-ray spectrum showed evidence of considerable absorption by neutral gas with NH,X-ray = 4.5 x 1022 cm2 (at rest frame). ISM absorption by dust in the host galaxy at z = 0.807 cannot certainly account for the non-detection of the optical afterglow, unless the dust-to-gas ratio is quite different than that seen in our Galaxy. It is possible then that GRB 051022 was produced in an obscured, stellar forming region in its parent host galaxy.For GRB 051028, the data can be interpreted by collimated emission (a jet model with p = 2.4) moving in an homogeneous ISM and with a cooling frequency vc still above the X-rays at 0.5 days after the burst onset. GRB 051028 can be classified as a 'gray' or 'potentially dark' GRB. The Swift/XRT data are consistent with the interpretation that the reason for the optical dimness is not extra absorption in the host galaxy, but rather the GRB taking place at high-redshift

  19. The Laminated Marca Shale: High-Frequency Climate Cycles From the Latest Cretaceous

    Science.gov (United States)

    Davies, A.; Kemp, A. E.; Weedon, G.; Barron, J. A.

    2005-12-01

    The Latest Cretaceous (Maastrichtian) Marca Shale Member, California, displays a well-preserved record of alternating terrigenous and diatomaceous laminae couplets, remarkably similar in lithology to recent laminated sediments from the Gulf of California and Santa Barbara Basin. This similarity, together with the recognition of intra- and inter-annual variability in the diatom flora, implies an annual origin for these couplets. High-resolution backscattered electron imagery has identified two sublaminae types within the varved succession; near monospecific lamina of Chaetoceros-type resting spore and of large Azpeitiopsis morenoensis. The composition and occurrence of these laminae is similar to ENSO forced intra-annual variability of diatom flora along the modern Californian margin. Relative thickness variations in terrigenous and biogenic laminae (proxies for precipitation and productivity respectively) also exhibit similar characteristics to variability in Quaternary varves from the Santa Barbara Basin, shown to be imparted by ENSO forcing. In order to track changes in the levels of bottom water oxygenation within the basin, a bioturbation index was established. Periods when bioturbation was minimal (enhanced benthic anoxia) coincide with times of greatest diatomaceous export flux and also lowest flux of detrital material. Conversely, periods of enhanced bioturbation correspond with reduced diatomaceous export flux and an increased flux of detrital material, comparable with ENSO forced variations in diatomaceous and terrigenous export flux and associated benthic oxygenation levels in Pleistocene varves off the Californian margin. Power spectra obtained from time-series analysis of the bioturbation index and laminae thickness variations exhibit strong signals within the ENSO band. This research implies that high-frequency climate perturbations are inherent components of the climate system and that ENSO-type variability was not confined to the dynamic climate

  20. Molecular sources of residual cardiovascular risk, clinical signals, and innovative solutions: relationship with subclinical disease, undertreatment, and poor adherence: implications of new evidence upon optimizing cardiovascular patient outcomes

    Directory of Open Access Journals (Sweden)

    Kones R

    2013-10-01

    would be cardioprotective. When LDL cholesterol is aggressively lowered to targets, low HDL cholesterol levels are still inversely related to MCVE. The efflux capacity, or ability to relocate cholesterol out of macrophages, is believed to be a major antiatherogenic mechanism responsible for reduction in MCVE mediated in part by healthy HDL. HDL cholesterol is a complex molecule with antioxidative, anti-inflammatory, antithrombotic, antiplatelet, and vasodilatory properties, among which is protection of LDL from oxidation. HDL-associated paraoxonase-1 has a major effect on endothelial function. Further, HDL promotes endothelial repair and progenitor cell health, and supports production of nitric oxide. HDL from patients with cardiovascular disease, diabetes, and autoimmune disease may fail to protect or even become proinflammatory or pro-oxidant. Mendelian randomization and other clinical studies in which raising HDL cholesterol has not been beneficial suggest that high plasma levels do not necessarily reduce cardiovascular risk. These data, coupled with extensive preclinical information about the functional heterogeneity of HDL, challenge the “HDL hypothesis”, ie, raising HDL cholesterol per se will reduce MCVE. After the equivocal AIM-HIGH (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides: Impact on Global Health Outcomes study and withdrawal of two major cholesteryl ester transfer protein compounds, one for off-target adverse effects and the other for lack of efficacy, development continues for two other agents, ie, anacetrapib and evacetrapib, both of which lower LDL cholesterol substantially. The negative but controversial HPS2-THRIVE (the Heart Protection Study 2-Treatment of HDL to Reduce the Incidence of Vascular Events trial casts further doubt on the HDL cholesterol hypothesis. The growing impression that HDL functionality, rather than abundance, is clinically important is supported by experimental evidence highlighting

  1. Systematic review and meta-analysis of the evidence for oral nutritional intervention on nutritional and clinical outcomes during chemo(radio)therapy: current evidence and guidance for design of future trials

    Science.gov (United States)

    de van der Schueren, M A E; Blanchard, H; Jourdan, M; Arends, J; Baracos, V E

    2018-01-01

    Abstract Background Driven by reduced nutritional intakes and metabolic alterations, malnutrition in cancer patients adversely affects quality of life, treatment tolerance and survival. We examined evidence for oral nutritional interventions during chemo(radio)therapy. Design We carried out a systematic review of randomized controlled trials (RCT) with either dietary counseling (DC), high-energy oral nutritional supplements (ONS) aiming at improving intakes or ONS enriched with protein and n-3 polyunsaturated fatty acids (PUFA) additionally aiming for modulation of cancer-related metabolic alterations. Meta-analyses were carried out on body weight (BW) response to nutritional interventions, with subgroup analyses for DC and/or high-energy ONS or high-protein n-3 PUFA-enriched ONS. Results Eleven studies were identified. Meta-analysis showed overall benefit of interventions on BW during chemo(radio)therapy (+1.31 kg, 95% CI 0.24–2.38, P = 0.02, heterogeneity Q = 21.1, P = 0.007). Subgroup analysis showed no effect of DC and/or high-energy ONS (+0.80 kg, 95% CI −1.14 to 2.74, P = 0.32; Q = 10.5, P = 0.03), possibly due to limited compliance and intakes falling short of intake goals. A significant effect was observed for high-protein n-3 PUFA-enriched intervention compared with isocaloric controls (+1.89 kg, 95% CI 0.51–3.27, P = 0.02; Q = 3.1 P = 0.37). High-protein, n-3 PUFA-enriched ONS studies showed attenuation of lean body mass loss (N = 2 studies) and improvement of some quality of life domains (N = 3 studies). Overall, studies were limited in number, heterogeneous, and inadequately powered to show effects on treatment toxicity or survival. Conclusion This systematic review suggests an overall positive effect of nutritional interventions during chemo(radio)therapy on BW. Subgroup analyses showed effects were driven by high-protein n-3 PUFA-enriched ONS, suggesting the benefit of targeting metabolic

  2. Summary of the evidence of breast cancer service screening outcomes in Europe and first estimate of the benefit and harm balance sheet

    DEFF Research Database (Denmark)

    Paci, Eugenio; Lynge, Elsebeth

    2012-01-01

    To construct a European 'balance sheet' of key outcomes of population-based mammographic breast cancer screening, to inform policy-makers, stakeholders and invited women.......To construct a European 'balance sheet' of key outcomes of population-based mammographic breast cancer screening, to inform policy-makers, stakeholders and invited women....

  3. Latest News

    CERN Multimedia

    Miele, P.

    B0 TOROID MODEL COIL The B0 toroid model coil was successfully tested with magnetic mirror at nominal current I=20.5 kA, up to a maximum current Imax=24 kA to verify a 10% BT force load current. An extensive campaign of measurements act to characterize the mechanical, thermal, electrical and magnetic properties of the coil was performed in the period April-Dec 2001, and handling and assembly trials to exercise BT underground installation were done in the period Jan-Feb 2002. NEW LAYOUT OF BT INTEGRATION - TESTING IN BUILDING 180 Integration 1 and Integration 2 of the BT coils, which are the assembly of the double pancakes into the coil casing (cold mass), and the assembly of the cold mass and related components into the vacuum vessel respectively, are both performed in Building 180. Thereafter the integrated coils are tested with magnetic mirror in the test bench. A new organizational scheme and detailed working plan are under definition to prepare and optimize the space available. BT PRODUCTION ...

  4. Current situation and prospect of market on the latest radiation measuring instrument

    International Nuclear Information System (INIS)

    Ha, Chang Ho; Kim, Wang Geum; Cho, Gyu Seong

    2009-12-01

    This book deals with current situation and prospect of market on the latest radiation measuring instrument. The contents of this book are basic of technology on radiation measuring instrument with basic principle of various measuring instrument, current situation of technology and prospect of radiation measuring instrument, effect of spreading and application field of radiation measuring instrument, facility for making and research and development of radiation measuring instrument, prospect of market about radiation measuring instrument, strategy for market entry with the latest radiation measuring instrument and general prospect for the future.

  5. Holocene and latest Pleistocene oblique dextral faulting on the southern Inyo Mountains fault, Owens Lake basin, California

    Science.gov (United States)

    Bacon, S.N.; Jayko, A.S.; McGeehin, J.P.

    2005-01-01

    The Inyo Mountains fault (IMF) is a more or less continuous range-front fault system, with discontinuous late Quaternary activity, at the western base of the Inyo Mountains in Owens Valley, California. The southern section of the IMF trends ???N20??-40?? W for at least 12 km at the base of and within the range front near Keeler in Owens Lake basin. The southern IMF cuts across a relict early Pliocene alluvial fan complex, which has formed shutter ridges and northeast-facing scarps, and which has dextrally offset, well-developed drainages indicating long-term activity. Numerous fault scarps along the mapped trace are northeast-facing, mountain-side down, and developed in both bedrock and younger alluvium, indicating latest Quaternary activity. Latest Quaternary multiple- and single-event scarps that cut alluvium range in height from 0.5 to 3.0 m. The penultimate event on the southern IMF is bracketed between 13,310 and 10,590 cal years B.P., based on radiocarbon dates from faulted alluvium and fissure-fill stratigraphy exposed in a natural wash cut. Evidence of the most recent event is found at many sites along the mapped fault, and, in particular, is seen in an ???0.5-m northeast-facing scarp and several right-stepping en echelon ???0.5-m-deep depressions that pond fine sediment on a younger than 13,310 cal years B.P. alluvial fan. A channel that crosses transverse to this scarp is dextrally offset 2.3 ?? 0.8 m, providing a poorly constrained oblique slip rate of 0.1-0. 3 m/ k.y. The identified tectonic geomorphology and sense of displacement demonstrate that the southern IMF accommodates predominately dextral slip and should be integrated into kinematic fault models of strain distribution in Owens Valley.

  6. Sport nutrition: A review of the latest guidelines for exercise and ...

    African Journals Online (AJOL)

    Sport nutrition: A review of the latest guidelines for exercise and sport nutrition from the American College of Sport Nutrition, the International Olympic Committee ... Habitual carbohydrate intake is essential for physically active individuals and should be timed according to training sessions to ensure optimal pre-, during, and ...

  7. LATEST TOURNAISIAN (EARLY CARBONIFEROUS CONODONTS FROM THE TABAI LIMESTONE, TIRAH, NORTHWESTERN PAKISTAN

    Directory of Open Access Journals (Sweden)

    FAZL-I-RABBI KHAN

    2004-11-01

    Full Text Available A new stratigraphic unit, the Tabai Limestone of the poorly known Tirah area of northwest Pakistan, is one of several Early Carboniferous carbonate units distributed along the North Gondwana margin, some connected with transgressive interludes. The Tabai Limestone has produced latest Tournaisian (Early Carboniferous conodonts indicative of the middle of the anchoralis-latus Zone.

  8. Latest status of manufacturing activity of ITER divertor and engineering issues on tungsten divertor

    International Nuclear Information System (INIS)

    Suzuki, Satoshi

    2011-01-01

    Divertors for ITER are now in construction. In the present chapter, the specification and the latest status of manufacturing of ITER divertors are presented. In addition, issues in the development of divertors for the fusion demo reactor are given on the basis of experiences on the ITER divertor development. (J.P.N.)

  9. School Issues Under [Section] 504 and the ADA: The Latest and Greatest.

    Science.gov (United States)

    Aleman, Steven R.

    This paper highlights recent guidance and rulings from the Office of Civil Rights (OCR) of interest to administrators, advocates, and attorneys. It is a companion piece to Student Issues on SectionNB504/ADA: The Latest and Greatest. Compliance with SectionNB504 and the Americans with Disabilities Act (ADA) continues to involve debate and dialog on…

  10. Non-Formal Education Implementations in Turkey: Issues and Latest Challenges

    Science.gov (United States)

    Bilir, Mehmet

    2007-01-01

    The aim of this article is to analyse the latest implementations and issues raised in Turkish non-formal education from a historical perspective in Turkey. The high population rate and lack of adequate educational opportunities for adults and migration from rural areas to urban areas caused many educational, social and cultural problems in…

  11. Latest polarization and beam characterization results of the Orsay polarized electron source

    International Nuclear Information System (INIS)

    Arianer, J.; Cohen, S.; Essabaa, S.; Frascaria, R.; Zerhouni, O.

    1995-01-01

    The Orsay polarized electron source based on the chemi-ionization of aligned He(2 3 S 1 ) atoms and CO 2 molecules is briefly described. The latest results concerning electron polarization and beam emittance are presented. The present development status is also discussed. (K.A.)

  12. The Category of Personality in the Semantics of Latest English Borrowings in the Russian Idiomatics

    Directory of Open Access Journals (Sweden)

    Вадим Викторович Дементьев

    2014-12-01

    Full Text Available The article examines some of the latest Russian idioms by English origin. The semantics of these idioms has been seen on the material of the informal (including informal political discourse, in terms of opposition personality - impersonality, in connection with some of the new trends in public life.

  13. Latest Cretaceous climatic and environmental change in the South Atlantic region

    NARCIS (Netherlands)

    Woelders, L.; Vellekoop, J.; Kroon, D.; Smit, J.; Casadío, S.; Prámparo, M. B.; Dinarès-Turell, J.; Peterse, F.; Sluijs, A.; Lenaerts, J.T.M.; Speijer, R. P.

    Latest Maastrichtian climate change caused by Deccan volcanism has been invoked as a cause of mass extinction at the Cretaceous-Paleogene (K-Pg) boundary (~66.0 Ma). Yet late Maastrichtian climate and ecological changes are poorly documented, in particular on the Southern Hemisphere. Here we present

  14. Latest Cretaceous climatic and environmental change in the South Atlantic region

    NARCIS (Netherlands)

    Woelders, L.; Vellekoop, J.; Kroon, D.; Smit, J.; Casadío, S.; Prámparo, M. B.; Dinarès-Turell, J.; Peterse, F.; Sluijs, A.; Lenaerts, J. T.M.; Speijer, R. P.

    2017-01-01

    Latest Maastrichtian climate change caused by Deccan volcanism has been invoked as a cause of mass extinction at the Cretaceous-Paleogene (K-Pg) boundary (~66.0 Ma). Yet late Maastrichtian climate and ecological changes are poorly documented, in particular on the Southern Hemisphere. Here we present

  15. U.S. Strategic Command Chief Talks Deterrence, Partnerships During Latest SGL

    OpenAIRE

    Ochoa, Victoria

    2017-01-01

    Today@NPS The Naval Postgraduate School (NPS) welcomed U.S. Air Force Gen. John E. Hyten, Commander, U.S. Strategic Command (USSTRATCOM), for its latest Secretary of the Navy Guest Lecture (SGL), May 18 in King Auditorium. Hyten spoke about the importance of maintaining strategic deterrence and NPS' inclusion into the USSTRATCOM's Academic Alliance.

  16. Osteoarthritis year in review 2015: rehabilitation and outcomes.

    Science.gov (United States)

    Bennell, K L; Hall, M; Hinman, R S

    2016-01-01

    The purpose of this narrative review was to highlight recent research in the rehabilitation of people with osteoarthritis (OA) by summarizing findings from selected key systematic reviews and randomized controlled trials (RCTs). A systematic search was conducted using the PubMed, Physiotherapy Evidence Database (PEDro) and Cochrane databases from April 1st 2014 to March 31st 2015. A selection of these is discussed based on study quality, relevance, contribution to new knowledge or controversial findings. Methodological quality of RCTs was assessed using guidelines from PEDro. From 274 articles, 74 were deemed to meet the eligibility criteria including 24 systematic reviews and 50 studies reporting on findings from RCTs. Overall the methodological quality of the RCTs was moderate. The studies were grouped into several themes covering; evidence of rehabilitation outcomes in less studied joints including the hand and hip; new insights into exercise in knee OA; effects of biomechanical treatments on symptoms and structure in knee OA; and effects of acupuncture. Exercise was the most common treatment evaluated. Although little evidence supported benefit of exercise for hand OA, exercise has positive effects for hip and knee OA symptoms and these benefits may depend upon patient phenotypes. The first evidence that a brace can influence knee joint structure emerged. The latest evidence suggests that acupuncture has, at best, small treatment effects on knee OA pain of unlikely clinical relevance. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  17. Outcomes in controlled and comparative studies on non-healing wounds: recommendations to improve the quality of evidence in wound management

    DEFF Research Database (Denmark)

    Gottrup, F; Apelqvist, J; Price, P

    2010-01-01

    was to produce recommendations on clinical data collection in wound care. This document, produced by the group and disseminated by JWC, identifies criteria for producing rigorous outcomes in both randomised controlled trials and clinical studies, and describes how to ensure studies are consistent...

  18. Outcome measures for clinical trials in paediatric IBD: an evidence-based, expert-driven practical statement paper of the paediatric ECCO committee

    NARCIS (Netherlands)

    Ruemmele, Frank M.; Hyams, Jeffrey S.; Otley, Anthony; Griffiths, Anne; Kolho, Kaija-Leena; Dias, Jorge Amil; Levine, Arie; Escher, Johanna C.; Taminiau, Jan; Veres, Gabor; Colombel, Jean-Frederic; Vermeire, Séverine; Wilson, David C.; Turner, Dan

    2015-01-01

    Objective Although paediatric-onset IBD is becoming more common, few medications have a registered paediatric indication. There are multiple hurdles to performing clinical trials in children, emphasising the importance of choosing an appropriate outcome measure, which can facilitate enrolment, and

  19. The Impact of Providing Vision Screening and Free Eyeglasses on Academic Outcomes: Evidence from a Randomized Trial in Title I Elementary Schools in Florida

    Science.gov (United States)

    Glewwe, Paul; West, Kristine L.; Lee, Jongwook

    2018-01-01

    More than 20 percent of all school-aged children in the United States have vision problems, and low-income and minority children are disproportionately likely to have unmet vision care needs. Vision screening is common in U.S. schools, but it remains an open question whether screening alone is sufficient to improve student outcomes. We implemented…

  20. Functional recovery measures for spinal cord injury : An evidence-based review for clinical practice and research - Functional recovery outcome measures work group

    NARCIS (Netherlands)

    Anderson, Kim; Aito, Sergio; Atkins, Michal; Biering-Sorensen, Fin; Charlifue, Susan; Curt, Armin; Ditunno, John; Glass, Clive; Marino, Ralph; Marshall, Ruth; Mulcahey, Mary Jane; Post, Marcel; Savic, Gordana; Scivoletto, Giorgio; Catz, Amiram

    2008-01-01

    Background/Objective: The end goal of clinical care and clinical research involving spinal cord injury (SCI) is to improve the overall ability of persons living with SCI to function on a daily basis. Neurologic recovery does not always translate into functional recovery. Thus, sensitive outcome

  1. Does a Fitness Factor Contribute to the Association between Intelligence and Health Outcomes? Evidence from Medical Abnormality Counts among 3654 US Veterans

    Science.gov (United States)

    Arden, Rosalind; Gottfredson, Linda S.; Miller, Geoffrey

    2009-01-01

    We suggest that an over-arching "fitness factor" (an index of general genetic quality that predicts survival and reproductive success) partially explains the observed associations between health outcomes and intelligence. As a proof of concept, we tested this idea in a sample of 3654 US Vietnam veterans aged 31-49 who completed five cognitive…

  2. Prevalence of violence in childhood and adolescence and the impact on educational outcomes: evidence from the 2013 Peruvian national survey on social relations.

    Science.gov (United States)

    Fry, Deborah; Anderson, Jeanine; Hidalgo, Rainaldo J T; Elizalde, Aldo; Casey, Tabitha; Rodriguez, Rosario; Martin, Amanda; Oroz, Carmen; Gamarra, Jhon; Padilla, Karina; Fang, Xiangming

    2016-01-01

    This study provides, for the first time, national population-based estimates describing violence during childhood and adolescence in Peru and the impact on educational outcomes. A population-based school survey was conducted among children aged 9-11 (n=1587) and adolescents aged 12-17 (n=1489). The relationship between violence and educational outcomes were analysed using bivariate logistic regressions, controlling for potential confounding factors. The results show that psychological (75.6%) and physical violence (72.5%) at home were the most prevalent forms of violence experienced by adolescent girls. Adolescent boys reported experiencing similar levels of psychological violence from their peers (69.4%) and at home (68.1%). For the younger cohort, peer-to-peer psychological violence was reported more frequently among girls (70.6%) and boys (74.0%) than other forms of violence. Equal percentages of adolescent girls and boys reported experiencing sexual violence in their lifetime (42.0%). The relationship between violence experiences and educational outcomes varied by gender with strong associations between violence at home and failing a course or repeating a grade for girls and being expelled for boys. Sexual violence experienced by boys was associated with all negative educational outcomes. The relationship between violence in childhood and poorer educational outcomes is multi-faceted, potentially bi-directional, and manifests differently between genders. This research highlights the need for targeted research, policy and programming responses for prevention of violence. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Switching From Age-Based Stimulus Dosing to Dose Titration Protocols in Electroconvulsive Therapy: Empirical Evidence for Better Patient Outcomes With Lower Peak and Cumulative Energy Doses.

    Science.gov (United States)

    O'Neill-Kerr, Alex; Yassin, Anhar; Rogers, Stephen; Cornish, Janie

    2017-09-01

    The aim of this study was to test the proposition that adoption of a dose titration protocol may be associated with better patient outcomes, at lower treatment dose, and with comparable cumulative dose to that in patients treated using an age-based stimulus dosing protocol. This was an analysis of data assembled from archived records and based on cohorts of patients treated respectively on an age-based stimulus dosing protocol and on a dose titration protocol in the National Health Service in England. We demonstrated a significantly better response in the patient cohort treated with dose titration than with age-based stimulus dosing. Peak doses were less and the total cumulative dose was less in the dose titration group than in the age-based stimulus dosing group. Our findings are consistent with superior outcomes in patients treated using a dose titration protocol when compared with age-based stimulus dosing in a similar cohort of patients.

  4. Outcomes of Treatment Targeting Syntax Production in People with Broca's-Type Aphasia: Evidence from Psycholinguistic Assessment Tasks and Everyday Conversation

    Science.gov (United States)

    Carragher, Marcella; Sage, Karen; Conroy, Paul

    2015-01-01

    Background: Capturing evidence of the effects of therapy within everyday communication is the holy grail of aphasia treatment design and evaluation. Whilst impaired sentence production is a predominant symptom of Broca's-type aphasia, the effects of sentence production therapy on everyday conversation have not been investigated. Given the…

  5. Selecting Treatments and Monitoring Outcomes: The Circle of Evidence-Based Practice and Client-Centered Care in Treating a Preschool Child Who Stutters

    Science.gov (United States)

    Ratner, Nan Bernstein

    2018-01-01

    Purpose: The purpose of the present clinical forum is to compare how 2 clinicians might select among therapy options for a preschool-aged child who presents with stuttering close to onset. Method: I discuss approaches to full evaluation of the child's profile, advisement of evidence-based practice options open to the family, the need for…

  6. Using an adverse outcome pathway network to describe the weight of evidence linking nicotinic acetylcholine receptor activation to honey bee colony failure

    Science.gov (United States)

    Significant and unsustainable losses of managed honey bee (Apis mellifera) colonies have been documented over recent years, which have led to scientific investigation to determine the contributing factors. Evidence suggests that both chemical and non-chemical stressors play a rol...

  7. Father involvement in early child-rearing and behavioural outcomes in their pre-adolescent children: evidence from the ALSPAC UK birth cohort

    Science.gov (United States)

    Redshaw, Maggie; Savage-McGlynn, Emily; Quigley, Maria A

    2016-01-01

    Objective To explore the nature of paternal involvement in early child-rearing adopting a social developmental perspective, and estimate its effect on behavioural outcomes of children aged 9 and 11 years. Setting The data come from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort recruited in the former county of Avon in the southwest of England. Participants Out of the 14 701 children in this cohort who were alive at 1 year, 10 440 children were living with both parents at 8 months and were therefore eligible. Outcome data were available for 6898 children at 9 years and 6328 children at 11 years. Main exposure Paternal involvement was measured using factor scores obtained through factor analysis of fathers’ responses on their participation in, understanding of, and feelings about their child's early upbringing. Outcome Behavioural problems were measured using the Strengths and Difficulties Questionnaire (SDQ) total difficulties score. Results 3 factors were identified in the factor analysis: Factor 1 described fathers’ emotional response to the child; factor 2 measured the frequency of fathers’ involvement in domestic and childcare activities; factor 3 characterised fathers’ feelings of security in their role as parent and partner. Children of fathers with high scores on factors 1 and 3 had 14% (OR 0.86, 95% CI 0.79 to 0.94, p=0.001) and 13% (OR 0.87, 95% CI 0.79 to 0.96, p=0.006), respectively, lower adjusted odds of behavioural problems at 9 years. Factors 1 and 3 were associated with comparable reduction in adjusted odds of behavioural problems at 11 years (OR 0.89, 95% CI 0.81 to 0.98, p=0.017 and OR 0.89, 95% CI 0.81 to 0.99, p=0.034, respectively). Factor 2 was not associated with the outcome. Conclusions Psychological and emotional aspects of paternal involvement in children's early upbringing, particularly how new fathers see themselves as parents and adjust to the role, rather than the quantity of direct

  8. Recent operating experience during startup testing at latest 1100 MWe BWR-5 nuclear power plants

    International Nuclear Information System (INIS)

    Tanabe, Akira; Tateishi, Mizuo; Kajikawa, Makoto; Hayase, Yuichi.

    1986-01-01

    In June and September 1985, the latest two 1100 Mwe BWR-5 nuclear power plants started commercial operation about ten days earlier than initially expected without any unscheduled shutdown. These latest plants, 2F-3 and K-1, are characterized by an improved core with new 8 x 8 fuel assemblies, highly reliable control systems, advanced control room system and turbine steam full bypass system for full load rejection (2F3). This paper describes the following operating experiences gained during their startup testing. 1) Continuous operation at full load rejection. 2) Stable operation at natural circulating flow condition. 3) 31 and 23 hour short time start up operation. 4) 100-75-100 %, 1-8-1-14 hours daily load following operation. (author)

  9. Latest Progress in Research on the SpaceLiner High-Speed Passenger Transportation Concept

    OpenAIRE

    Sippel, Martin; van Foreest, Arnold

    2007-01-01

    A vision aimed at revolutionizing ultra-long distance travel between different points on earth could be realized by a high-speed intercontinental passenger transport using rocket based, suborbital launchers. The paper gives an overview on the latest progress in conceptual design of the DLR SpaceLiner presenting geometrical size and mass data and describing results of trajectory simulations. The rockets are based on an advanced but technically conservative approach not relying on e...

  10. Elastic-plastic fracture analysis of carbon steel piping using the latest CEGB R6 approach

    International Nuclear Information System (INIS)

    Kanno, S.; Hasegawa, K.; Shimizu, T.; Kobayashi, H.

    1991-01-01

    The elastic-plastic fracture of carbon steel piping having various pipe diameters and circumferential crack angles and subjected to a bending moment is analyzed using the latest United Kingdom Central Electricity Generating Board R6 approach. The elastic-plastic fracture criterion must be applied instead of the plastic collapse criterion with increase of the pipe diameter and the crack angle. A simplified elastic-plastic fracture analysis procedure based on the R6 approach is proposed. (author)

  11. Use a renewable energy sources and latest power-saving technologies in the the Republic Kazakstan

    International Nuclear Information System (INIS)

    Gulevich, N.V.

    1996-01-01

    The subject of alternative power in Kazakstan is brought up. Wind-, hydro-, solar power, biogas installation can improve the Republic power base. The main directions of activity of A. Einstein International Power engineering Academy on involving renewable energy sources and latest power-saving technologies to Republic of Kazakstan's fuel-power balance is given. It should be noted that renewable power engineering usually handles reversible energy sources and reserved power cycles. (author)

  12. Globanomalina luxorensis, a Tethyan biostratigraphic marker of latest Paleocene global events

    OpenAIRE

    Speijer, Robert; Samir, AM

    1997-01-01

    The lowest common occurrence (LCO) of the planktonic foraminifera Globanomalina luxorensis marks the level of the latest Paleocene global benthic extinction event (BEE) and associated negative delta(13) C excursion in various bathyal and neritic successions in the Mediterranean region. Below the BEE level, G. luxorensis is extremely rare and subordinate in abundance relative to its precursor G, chapmani. From this level onwards, G. luxorensis generally constitutes a large proportion of the pl...

  13. Latest results on b-physics from the ATLAS and CMS experiments

    CERN Document Server

    Pasqualucci, E; The ATLAS collaboration

    2013-01-01

    This paper briefly reviews some of the latest measurements of the ATLAS and CMS experiments at LHC in the b-physics sector, namely the ones on rare and semi-rare B0(s) decays, the parity violation in the b decay and the CP violation parameters in the Bs --> J/psi (μ+μ−)phi(K+K−) process, some of the measurements on heavy quarkonia systems.

  14. Design process and philosophy of TVA's latest advance control room complex

    International Nuclear Information System (INIS)

    Owens, G.R.; Masters, D.W.

    1979-01-01

    TVA's latest nuclear power plant control room design includes a greater emphasis on human factors as compared to their earlier plant designs. This emphasis has resulted in changes in the overall design philosophy and design process. This paper discusses some of the prominent design features of both the control room and the surrounding control room complex. In addition, it also presents some of the important activities involved in the process of developing the advanced control room design

  15. HRM practices and knowledge processes outcomes: empirical evidence from a quasi-experiment on UK SMEs in the tourism hospitality and leisure sector

    OpenAIRE

    Andreas Georgiadis; Christos N. Pitelis

    2008-01-01

    This paper presents empirical evidence of the relationship between human resources practices and the effectiveness of a firm to capitalise on investment in knowledge as measured by the returns to innovation and business development expenditure. The empirical design is based on exploiting a natural experiment provided by a policy intervention that offers human resources-related support to small and medium sized enterprises in the UK Tourism Hospitality and Leisure sector. Our findings suggest ...

  16. Group Therapy Use and Its Impact on the Outcomes of Inpatient Rehabilitation After Traumatic Brain Injury: Data From Traumatic Brain Injury-Practice Based Evidence Project.

    Science.gov (United States)

    Hammond, Flora M; Barrett, Ryan; Dijkers, Marcel P; Zanca, Jeanne M; Horn, Susan D; Smout, Randall J; Guerrier, Tami; Hauser, Elizabeth; Dunning, Megan R

    2015-08-01

    To describe the amount and content of group therapies provided during inpatient rehabilitation for traumatic brain injury (TBI), and to assess the relations of group therapy with patient, injury, and treatment factors and outcomes. Prospective observational cohort. Inpatient rehabilitation. Consecutive admissions (N=2130) for initial TBI rehabilitation at 10 inpatient rehabilitation facilities (9 in the United States, 1 in Canada) from October 2008 to September 2011. Not applicable. Proportion of sessions that were group therapy (≥2 patients were treated simultaneously by ≥1 clinician); proportion of patients receiving group therapy; type of activity performed and amount of time spent in group therapy, by discipline; rehabilitation length of stay; discharge location; and FIM cognitive and motor scores at discharge. Of the patients, 79% received at least 1 session of group therapy, with group therapy accounting for 13.7% of all therapy sessions and 15.8% of therapy hours. On average, patients spent 2.9h/wk in group therapy. The greatest proportion of treatment time in group format was in therapeutic recreation (25.6%), followed by speech therapy (16.2%), occupational therapy (10.4%), psychology (8.1%), and physical therapy (7.9%). Group therapy time and type of treatment activities varied among admission FIM cognitive subgroups and treatment sites. Several factors appear to be predictive of receiving group therapy, with the treatment site being a major influence. However, group therapy as a whole offered little explanation of differences in the outcomes studied. Group therapy is commonly used in TBI rehabilitation, to varying degrees among disciplines, sites, and cognitive impairment subgroups. Various therapeutic activities take place in group therapy, indicating its perceived value in addressing many domains of functioning. Variation in outcomes is not explained well by overall percentage of therapy time delivered in groups. Copyright © 2015 American Congress

  17. The fungal and acritarch events as time markers for the latest Permian mass extinction: An update

    Directory of Open Access Journals (Sweden)

    Michael R. Rampino

    2018-01-01

    Full Text Available The latest Permian extinction (252 Myr ago was the most severe in the geologic record. On land, widespread Late Permian gymnosperm/seed-fern dominated forests appear to have suffered rapid and almost complete destruction, as evidenced by increased soil erosion and changes in fluvial style in deforested areas, signs of wildfires, replacement of trees by lower plants, and almost complete loss of peat-forming and fire-susceptible vegetation. Permian–Triassic boundary strata at many sites show two widespread palynological events in the wake of the forest destruction: The fungal event, evidenced by a thin zone with >95% fungal cells (Reduviasporonites and woody debris, found in terrestrial and marine sediments, and the acritarch event, marked by the sudden flood of unusual phytoplankton in the marine realm. These two events represent the global temporary explosive spread of stress-tolerant and opportunistic organisms on land and in the sea just after the latest Permian disaster. They represent unique events, and thus they can provide a time marker in correlating latest Permian marine and terrestrial sequences.

  18. Father involvement in early child-rearing and behavioural outcomes in their pre-adolescent children: evidence from the ALSPAC UK birth cohort.

    Science.gov (United States)

    Opondo, Charles; Redshaw, Maggie; Savage-McGlynn, Emily; Quigley, Maria A

    2016-11-22

    To explore the nature of paternal involvement in early child-rearing adopting a social developmental perspective, and estimate its effect on behavioural outcomes of children aged 9 and 11 years. The data come from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort recruited in the former county of Avon in the southwest of England. Out of the 14 701 children in this cohort who were alive at 1 year, 10 440 children were living with both parents at 8 months and were therefore eligible. Outcome data were available for 6898 children at 9 years and 6328 children at 11 years. Paternal involvement was measured using factor scores obtained through factor analysis of fathers' responses on their participation in, understanding of, and feelings about their child's early upbringing. Behavioural problems were measured using the Strengths and Difficulties Questionnaire (SDQ) total difficulties score. 3 factors were identified in the factor analysis: Factor 1 described fathers' emotional response to the child; factor 2 measured the frequency of fathers' involvement in domestic and childcare activities; factor 3 characterised fathers' feelings of security in their role as parent and partner. Children of fathers with high scores on factors 1 and 3 had 14% (OR 0.86, 95% CI 0.79 to 0.94, p=0.001) and 13% (OR 0.87, 95% CI 0.79 to 0.96, p=0.006), respectively, lower adjusted odds of behavioural problems at 9 years. Factors 1 and 3 were associated with comparable reduction in adjusted odds of behavioural problems at 11 years (OR 0.89, 95% CI 0.81 to 0.98, p=0.017 and OR 0.89, 95% CI 0.81 to 0.99, p=0.034, respectively). Factor 2 was not associated with the outcome. Psychological and emotional aspects of paternal involvement in children's early upbringing, particularly how new fathers see themselves as parents and adjust to the role, rather than the quantity of direct involvement in childcare, is associated with positive behavioural outcomes in children

  19. Better Outcomes through Learning, Data, Engagement, and Research (BOLDER – a system for improving evidence and clinical practice in low and middle income countries [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    BOLDER Research Group

    2016-04-01

    Full Text Available Despite the many thousands of research studies published every year, evidence for making clinical decisions is often lacking. The main problem is that the evidence available is generated in conditions very different from those that prevail in routine clinical practice and with patients who are different. This is particularly a problem for low and middle income countries as most evidence is generated in high income countries. A group of clinicians, researchers, and policy makers met at Bellagio in Italy to consider how more relevant evidence might be generated. One answer is to conduct more pragmatic trials—those undertaken in routine clinical practice. The group thought that this might best be achieved by developing “learning health systems” in low and middle income countries. Learning health systems develop in communities that include clinicians, patients, researchers, improvement specialists, information technology specialists, managers, and policy makers and have a governance system that gives a voice to all those in the community. The systems focus on improving outcomes for patients, use a common dataset, and promote quality improvement and pragmatic research. Plans have been developed to create at least two learning systems in Africa.

  20. Exposure to power-frequency magnetic fields and the risk of infertility and adverse pregnancy outcomes: update on the human evidence and recommendations for future study designs

    Science.gov (United States)

    Lewis, Ryan C.; Hauser, Russ; Maynard, Andrew D.; Neitzel, Richard L.; Wang, Lu; Kavet, Robert; Meeker, John D.

    2016-01-01

    Infertility and adverse pregnancy outcomes are significant public health concerns with global prevalence. Over the past 35 years, research has addressed whether exposure to power-frequency magnetic fields is one of the etiologic factors attributed to these conditions. However, no apparent authoritative reviews on this topic have been published in the peer-reviewed literature for nearly 15 years. This review provides an overview and critical analysis of human studies that were published in the peer-reviewed literature between 2002 and July 2015. Using PubMed, 13 epidemiology studies published during this timeframe that concern exposure to magnetic fields and adverse prenatal (e.g., miscarriage), neonatal (e.g., preterm birth or birth defects), and male fertility (e.g., poor semen quality) outcomes were identified. Some of these studies reported associations whereas others did not, and study design limitations may explain these inconsistencies. Future investigations need to be designed with these limitations in mind to address existing research gaps. In particular, the following issues are discussed: 1) importance of selecting the appropriate study population, 2) need for addressing confounding due to unmeasured physical activity, 3) importance of minimizing information bias from exposure measurement error, 4) consideration of alternative magnetic field exposure metrics, and 5) implications and applications of personal exposure data that is correlated within female-male couples. Further epidemiologic research is needed given the near ubiquitous exposures to power-frequency magnetic fields in the general population. PMID:27030583

  1. Danish Gulf War Veterans Revisited: No Evidence of Increased Sickness Absence or Reduced Labor Market Outcome After Deployment to the Persian Gulf.

    Science.gov (United States)

    Nissen, Lars Ravnborg; Stoltenberg, Christian; Nielsen, Anni B Sternhagen; Vedtofte, Mia S; Marott, Jacob L; Gyntelberg, Finn; Guldager, Bernadette

    2016-11-01

    To examine the assumption that postdeployment incidence of sickness and other absence from work are higher among Gulf War Veterans compared with nonveterans. A prospective registry study including a cohort of 721 Danish Gulf War Veterans and a control cohort of 3,629 nonveterans selected from the general Danish population. Outcome measures were up to 23 years postdeployment incidence of (1) long-term sickness absence and (2) long-term all types of absence from work. Long term with regard to sickness and other absence was defined as exceeding 8 weeks. The association between outcomes and information on deployment history was studied using time-to-event analysis. The index date was the return date from the last deployment to the Gulf. The follow-up period was the time from index date until April 27, 2014. As the main finding, no difference was found between veterans and nonveterans in the incidence rate of long-term sickness absence. After an initial short period (3 months) with elevated incidence rate of long-term absence from work among veterans, there was no difference between the cohorts. Among Danish Gulf War Veterans, no postdeployment increased risk of long-term sickness absence or long-term absence from work was found as compared with nonveterans. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  2. Web-Based Interventions to Improve Mental Health, General Caregiving Outcomes, and General Health for Informal Caregivers of Adults With Chronic Conditions Living in the Community: Rapid Evidence Review.

    Science.gov (United States)

    Ploeg, Jenny; Markle-Reid, Maureen; Valaitis, Ruta; McAiney, Carrie; Duggleby, Wendy; Bartholomew, Amy; Sherifali, Diana

    2017-07-28

    Most adults with chronic conditions live at home and rely on informal caregivers to provide support. Caregiving can result in negative impacts such as poor mental and physical health. eHealth interventions may offer effective and accessible ways to provide education and support to informal caregivers. However, we know little about the impact of Web-based interventions for informal caregivers of community-dwelling adults with chronic conditions. The purpose of this rapid evidence review was to assess the impact of Web-based interventions on mental health, general caregiving outcomes, and general health for informal caregivers of persons with chronic conditions living in the community. A rapid evidence review of the current literature was employed to address the study purpose. EMBASE, MEDLINE, PsychInfo, CINAHL, Cochrane, and Ageline were searched covering all studies published from January 1995 to July 2016. Papers were included if they (1) included a Web-based modality to deliver an intervention; (2) included informal, unpaid adult caregivers of community-living adults with a chronic condition; (3) were either a randomized controlled trial (RCT) or controlled clinical trial (CCT); and (4) reported on any caregiver outcome as a result of use or exposure to the intervention. A total of 20 papers (17 studies) were included in this review. Study findings were mixed with both statistically significant and nonsignificant findings on various caregiver outcomes. Of the 17 included studies, 10 had at least one significant outcome. The most commonly assessed outcome was mental health, which included depressive symptoms, stress or distress, and anxiety. Twelve papers examined the impact of interventions on the outcome of depressive symptoms; 4 found a significant decrease in depressive symptoms. Eight studies examined the outcome of stress or distress; 4 of these found a significant reduction in stress or distress as a result of the intervention. Three studies examined the

  3. Latest Pleistocene to Holocene Evolution of the Baie de Port au Prince, Haiti

    Science.gov (United States)

    Rios, J. K.; McHugh, C. M.; Seeber, L.; Blair, S.; Sorlien, C. C.

    2012-12-01

    The Baie de Port au Prince (BPP) is adjacent a restraining segment of the sinistral Caribbean-North America plate boundary and is therefore situated between converging high-relief thrust systems, the Massif Selle (Peninsula Range) to the south and the Chaine de Matheux (Hispaniola highlands) to the north. To evaluate neotectonic deformation, seismic hazards and sedimentation patterns for the BPP, six gravity cores were studied within the framework of chirp profiles collected from the R/V Endeavor in 2010. The cores were recovered from 76 m to 148 m of water depth sampling sediment from the carbonate platform that rims the BPP and from the slope. We studied the biostratigraphy (foraminifers, nannoplankton), geochemical elemental composition and physical properties of the sediment. An age model from the last glacial to the present (~20 ka BP) was derived from radiocarbon. Nannoplankton biostratigraphy provide constraints on the late Pleistocene. The BPP is 150 m maximum water depth and is rimmed by an ~30 m deep carbonate platform that has undergone dissolution. Terraces characterize the sub-bottom topography to the NE. This topography was covered by sediment during at least one relative sea-level cycle. Sediment progradation and mass-wasting on the northern and southern flanks of the BPP respectively, occurred during the latest Pleistocene low stand (~20 ka BP). Increased sedimentation from 0.2 mm/year to 0.8 mm/year occurred from 14.2 ka BP to 9.5 ka BP. This period also corresponds with a global rapid rate in sea-level rise from -94 m to -37 m. A basin wide acoustically transparent layer of sediment ~10 m thick covered the BPP. Mass-wasting, microfaulting, fluidization and turbidites caused by erosion triggered by pre-historic earthquakes possibly associated with EPG transform fault are found in the cores. One such deposit is possibly associated to the 2010 earthquake and another to an unconformable surface that separates early- from late-Holocene sediment on the

  4. Morbidity and mortality according to latest CD4+ cell count among HIV positive individuals in South Africa who enrolled in project Phidisa.

    Directory of Open Access Journals (Sweden)

    Patrick H Maduna

    Full Text Available Short-term morbidity and mortality rates for HIV positive soldiers in the South African National Defence Force (SANDF would inform decisions about deployment and HIV disease management. Risks were determined according to the latest CD4+ cell count and use of antiretroviral therapy (ART for HIV positive individuals in the SANDF and their dependents.A total of 7,114 participants were enrolled and followed for mortality over a median of 4.7 years (IQR: 1.9, 7.1 years. For a planned subset (5,976, progression of disease (POD and grade 4, potentially life-threatening events were also ascertained. CD4+ count and viral load were measured every 3 to 6 months. Poisson regression was used to compare event rates by latest CD4+ count (<50, 50-99, 100-199, 200-349, 350-499, 500+ with a focus on upper three strata, and to estimate relative risks (RRs (ART/no ART. Median entry CD4+ was 207 cells/mm3. During follow-up over 70% were prescribed ART. Over follow-up 1,226 participants died; rates ranged from 57.6 (< 50 cells to 0.8 (500+ cells per 100 person years (py. Compared to those with latest CD4+ 200-349 (2.2/100 py, death rates were significantly lower (p<0.001, as expected, for those with 350-499 (0.9/100 py and with 500+ cells (0.8/100 py. The composite outcome of death, POD or grade 4 events occurred in 2,302 participants (4,045 events; rates were similar in higher CD4+ count strata (9.4 for 350-499 and 7.9 for 500+ cells and lower than those with counts 200-349 cells (13.5 (p<0.001. For those with latest CD4+ 350+ cells, 63% of the composite outcomes (680 of 1,074 were grade 4 events.Rates of morbidity and mortality are lowest among those with CD4+ count of 350 or higher and rates do not differ for those with counts of 350-499 versus 500+ cells. Grade 4 events are the predominant morbidity for participants with CD4+ counts of 350+ cells.

  5. Promoting Evidence to Policy Link on the Control of Infectious Diseases of Poverty in Nigeria: Outcome of A Multi-Stakeholders Policy Dialogue

    Science.gov (United States)

    Uneke, Chigozie Jesse; Ebeh Ezeoha, Abel; Uro-Chukwu, Henry; Ezeonu, Chinonyelum Thecla; Ogbu, Ogbonnaya; Onwe, Friday; Edoga, Chima

    2015-01-01

    Background: In Nigeria, malaria, schistosomiasis and lymphatic filariasis are among infectious diseases of poverty (IDP) with severe health burden and require effective policy strategies for their control. In this study, we investigated the value of policy brief and policy dialogue as excellent policymaking mechanisms that enable policymakers to adapt effective evidence informed policy for IDP control. Methods: A policy brief was developed on the control of malaria, schistosomiasis and lymphatic filariasis and subjected to deliberations in a one-day multi-stakeholder policy dialogue held in Ebonyi State Nigeria. A modified cross sectional intervention study design was used in this investigation. Structured pre-tested questionnaires were used to evaluate the policy brief document and policy dialogue process at the end of the policy dialogue. Results: Forty-seven policymakers participated in the dialogue. An analysis of the response on the policy brief regarding context, different features of the problem; policy options and key implementation considerations indicated the mean ratings (MNRs) mostly ranged from 6.40-6.85 on 7 point scale. The over-all assessment of the policy brief had MNR at 6.54. The analysis of the response on the policy dialogue regarding the level of priority of policy issue, opportunity to discuss different features of the problem and options for addressing the problem, and the MNRs mostly ranged from 6.50-6.82. The overall assessment of the policy dialogue had MNR at 6.72. Conclusion: Policy dialogues can allow research evidence to be considered together with views, experiences and tacit knowledge of policymakers and can enhance evidence-to-policy link. PMID:26290826

  6. A Pilot Health Information Technology-Based Effort to Increase the Quality of Transitions From Skilled Nursing Facility to Home: Compelling Evidence of High Rate of Adverse Outcomes.

    Science.gov (United States)

    Donovan, Jennifer L; Kanaan, Abir O; Gurwitz, Jerry H; Tjia, Jennifer; Cutrona, Sarah L; Garber, Lawrence; Preusse, Peggy; Field, Terry S

    2016-04-01

    Older adults are often transferred from hospitals to skilled nursing facilities (SNFs) for post-acute care. Patients may be at risk for adverse outcomes after SNF discharges, but little research has focused on this period. Assessment of the feasibility of a transitional care intervention based on a combination of manual information transmission and health information technology to provide automated alert messages to primary care physicians and staff; pre-post analysis to assess potential impact. A multispecialty group practice. Adults aged 65 and older, discharged from SNFs to home; comparison group drawn from SNF discharges during the previous 1.5 years, matched on facility, patient age, and sex. For the pre-post analysis, we tracked rehospitalization within 30 days after discharge and adverse drug events within 45 days. The intervention was developed and implemented with manual transmission of information between 8 SNFs and the group practice followed by entry into the electronic health record. The process required a 5-day delay during which a large portion of the adverse events occurred. Over a 1-year period, automated alert messages were delivered to physicians and staff for the 313 eligible patients discharged from the 8 SNFs to home. We compared outcomes to those of individually matched discharges from the previous 1.5 years and found similar percentages with 30-day rehospitalizations (31% vs 30%, adjusted HR 1.06, 95% CI 0.80-1.4). Within the adverse drug event (ADE) study, 30% of the discharges during the intervention period and 30% of matched discharges had ADEs within 45 days. Older adults discharged from SNFs are at high risk of adverse outcomes immediately following discharge. Simply providing alerts to outpatient physicians, especially if delivered multiple days after discharge, is unlikely to have any impact on reducing these rates. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All

  7. Parabolic distribution of circumeastern Snake River Plain seismicity and latest Quaternary faulting: Migratory pattern and association with the Yellowstone hotspot

    Science.gov (United States)

    Anders, Mark H.; Geissman, John Wm.; Piety, Lucille A.; Sullivan, J. Timothy

    1989-02-01

    . Mapping of fault scarps and unfaulted deposits along the Grand Valley fault system shows that latest Quaternary fault scarps are restricted to the portion farthest from the eastern SRP, the southern part of the Star Valley fault. Surface displacements estimated from scarp profiles and deposit ages estimated from soil development suggest a latest Quaternary displacement rate of 0.6-1.2 mm/yr for the southern portion of the Star Valley fault. Morphologic evidence suggests that this displacement rate persisted on the Star Valley fault throughout most of the Quaternary. The latest Quaternary displacement rate calculated for the southern portion of the Star Valley fault is similar to the rate calculated for Swan Valley during the interval from 2.0 to 4.4 Ma. This similarity, together with evidence for a low Quaternary displacement rate on the fault system in Swan Valley, suggests that the location of the highest displacement rate has migrated away from the eastern SRP. Other normal faults in southeastern Idaho, northwestern Wyoming, and southwestern Montana, while less well described than the Grand Valley fault system, exhibit a similar outward migrating pattern of increased fault activity followed by quiescence. Furthermore, a temporal and spatial relationship between fault activity and the 3.5 cm/yr northeastward track of the Yellowstone hotspot is observable on the Grand Valley fault system and on other north-northwest trending late Cenozoic faults that border the eastern SRP. The temporal and spatial relationship of Miocene to present high displacement rates for other circumeastern SRP faults and the observable outwardly migrating pattern of fault activity suggest that a similar parabolic distribution of seismicity and high displacement rates was symmetrically positioned about the former position of the hotspot. Moreover, the tandem migration of the hotspot and the parabolic distribution of increased fault activity and seismicity are closely followed by a parabolic

  8. Knowledge creation through total clinical outcomes management: a practice-based evidence solution to address some of the challenges of knowledge translation.

    Science.gov (United States)

    Lyons, John S

    2009-02-01

    The challenges of knowledge translation in behavioural health care are unique to this field for a variety of reasons including the fact that effective treatment is invariably embedded in a strong relationship between practitioners and the people they serve. Practitioners' knowledge gained from experience and intuition become an even more important consideration in the knowledge translation process since clinicians are, in fact, a component of most treatments. Communication of findings from science must be conceptualized with sensitivity to this reality. Considering knowledge translation as a communication process suggests the application of contemporary theories of communication which emphasize the creation of shared meaning over the transmission of knowledge from one person to the next. In this context outcomes management approaches to create a learning environment within clinical practices that facilitate the goals of knowledge transfer while respecting that the scientific enterprise is neither the sole nor primary repository of knowledge.

  9. The impact of the Quality and Outcomes Framework on practice organisation and service delivery: summary of evidence from two qualitative studies.

    Science.gov (United States)

    Checkland, Kath; Harrison, Stephen

    2010-01-01

    In 2003, the new General Medical Services Contract introduced a pay-for-performance programme know as the Quality and Outcomes Framework (QOF) into UK general practice, with payment for meeting a number of both clinical and organisational quality standards. To investigate in detail the impact of the QOF on practice organisation and service delivery. Two linked qualitative case studies in England and Scotland, using interviews and observation to investigate in depth the impact of the QOF in four general medical practices. A number of significant changes to practice organisation and service delivery were observed, including: changes to practice organisational structures; an increased role for information technology; a move towards a more biomedical form of medical care; and changes to roles and relationships, including the introduction of internal peer-review and surveillance. In spite of this, the practices maintained a narrative of 'no change', arguing that they had 'fitted QOF in' to their routines with little trouble.

  10. Summary of the evidence of breast cancer service screening outcomes in Europe and first estimate of the benefit and harm balance sheet.

    Science.gov (United States)

    Paci, Eugenio

    2012-01-01

    To construct a European 'balance sheet' of key outcomes of population-based mammographic breast cancer screening, to inform policy-makers, stakeholders and invited women. From the studies reviewed, the primary benefit of screening, breast cancer mortality reduction, was compared with the main harms, over-diagnosis and false-positive screening results (FPRs). Pooled estimates of breast cancer mortality reduction among invited women were 25% in incidence-based mortality studies and 31% in case-control studies (38% and 48% among women actually screened). Estimates of over-diagnosis ranged from 1% to 10% of the expected incidence in the absence of screening. The combined estimate of over-diagnosis for screened women, from European studies correctly adjusted for lead time and underlying trend, was 6.5%. For women undergoing 10 biennial screening tests, the estimated cumulative risk of a FPR followed by non-invasive assessment was 17%, and 3% having an invasive assessment. For every 1000 women screened biennially from age 50-51 until age 68-69 and followed up to age 79, an estimated seven to nine lives are saved, four cases are over-diagnosed, 170 women have at least one recall followed by non-invasive assessment with a negative result and 30 women have at least one recall followed by invasive procedures yielding a negative result. The chance of saving a woman's life by population-based mammographic screening of appropriate quality is greater than that of over-diagnosis. Service screening in Europe achieves a mortality benefit at least as great as the randomized controlled trials. These outcomes should be communicated to women offered service screening in Europe.

  11. Center Variation and the Effect of Center and Provider Characteristics on Clinical Outcomes in Kidney Transplantation: A Systematic Review of the Evidence

    Directory of Open Access Journals (Sweden)

    Anne Tsampalieros

    2017-10-01

    Full Text Available Background: Kidney transplantation is the best treatment option for patients with end-stage renal disease. While patient-level factors affecting survival are established, the presence of variation in the management of transplant recipients remains unknown. Objective: The objective of this study was to examine center variation in kidney transplantation and identify center and provider characteristics that may be associated with clinical outcomes. Design: This is a systematic review. Data sources: Ovid Medline, Embase, and Cochrane library from inception to June 2016 were used. Study eligibility: Any study examining the association between center or provider characteristics and graft or patient survival, quality of life, or functional status were included. Results: We identified 6327 records and 24 studies met eligibility. Most studies used data registries. Characteristics evaluated include center volume (n = 17, provider volume (n = 2, provider experience (n = 1, center type (n = 2, and location of follow-up (n = 1. Outcomes assessed included graft survival (n = 24 and patient survival (n = 9. Significant center variation was described in 12 of 15 and 5 of 7 studies for graft and patient survival. There was a significant and positive association between center volume and graft and patient survival in 8 and 2 studies, respectively. Provider experience and volume were significantly associated with less allograft loss and provider volume with lower risk of death. There was no association between graft survival and location of follow-up or center type. Limitations: There was substantial heterogeneity in the variables assessed and methodology used to analyze associations. Conclusion: This systematic review found center variation in kidney transplantation. Future studies in the current era are necessary to better evaluate this important topic.

  12. Different outcomes for different health measures in immigrants: evidence from a longitudinal analysis of the National Population Health Survey (1994-2006).

    Science.gov (United States)

    Setia, Maninder Singh; Quesnel-Vallee, Amelie; Abrahamowicz, Michal; Tousignant, Pierre; Lynch, John

    2012-02-01

    The response of immigrants to new societies is dynamic. There may be an initial period of happiness followed by peaks of stressful periods. These reactions along with socio-economic changes are likely to influence their health, which may start converging towards the average health of the host population. We used a longitudinal analysis to assess the differences in health outcomes (mental health and self-rated health), separately in men and women, in Canadian born and immigrants over a 12-year period (and the associated socio-economic factors). We used random effects logistic regression models for evaluation of these health outcomes in 3,081 men and 4,187 women from the National Population Health Survey (1994/95 to 2006/07). After adjusting for all the covariates, non-white immigrants were less likely to have severe psychological distress compared with the Canadian born individuals [odds ratio (OR) Men: 0.49, 95% confidence intervals (CI) 0.24-1.00, Women-OR: 0.54; 95% CI: 0.32-0.92]. Immigrant women (white and non-white) were more likely to rate their health as poor through this 12-year period than the Canadian born women (White-OR: 1.64, 95% CI: 1.17-2.64; Non-white-OR: 1.82, 95% CI: 1.01-3.28). Immigrants in the lowest income adequacy category reported higher psychological distress and poorer health than those in the highest income categories. We did not find any significant differences in the mental health and self-rated health of Canadian men and white male immigrants throughout this 12-year period. Though, non-white immigrant women were less likely to have severe psychological distress through this 12 year period, they were the ones most likely to rate their health as poor.

  13. Criminal outcomes and costs of treatment services for injecting and non-injecting heroin users: evidence from a national prospective cohort survey.

    Science.gov (United States)

    Healey, Andrew; Knapp, Martin; Marsden, John; Gossop, Michael; Stewart, Duncan

    2003-07-01

    To assess the incremental cost-effectiveness of drug addiction treatment programmes provided in the UK by the National Health Service and not-for-profit agencies in terms of crime-related outcomes. All costs and crime-related outcomes were implicitly evaluated relative to a 'no treatment' alternative. Longitudinal observational data on a national sample of heroin addicts referred to addiction treatment services throughout England were re-analysed. Predictions from a Poisson random-effects model were used to estimate the incremental effectiveness and cost-effectiveness of treatment programmes. Interaction variables were used to assess whether the injecting of heroin on entry to treatment had an impact on cost-effectiveness. The findings rejected the null hypothesis that increasing time in treatment (and therefore treatment cost) has no mean crime prevention effect on clients referred for community-based methadone treatment, treatment delivered within specialist drug dependency units and residential rehabilitation programmes (P reduction in treatment cost-effectiveness across all treatment programmes for clients who reported injecting drugs at treatment intake. Whilst the analyses did not include an evaluation of the effect of treatment programmes on client health and quality of life and stopped short of providing a social weighting for the predicted reduction in crimes, they do offer a useful starting point for establishing the cost-effectiveness of treating heroin addiction. The onus is on public decision-makers to decide whether the predicted reductions in crime are worth the opportunity costs of investing extra resources in a major expansion of treatment services.

  14. More evidence on the impact of India's conditional cash transfer program, Janani Suraksha Yojana: quasi-experimental evaluation of the effects on childhood immunization and other reproductive and child health outcomes.

    Directory of Open Access Journals (Sweden)

    Natalie Carvalho

    Full Text Available In 2005, India established a conditional cash transfer program called Janani Suraksha Yojana (JSY, to increase institutional delivery and encourage the use of reproductive and child health-related services.To assess the effect of maternal receipt of financial assistance from JSY on childhood immunizations, post-partum care, breastfeeding practices, and care-seeking behaviors.We use data from the latest district-level household survey (2007-2008 to conduct a propensity score matching analysis with logistic regression. We conduct the analyses at the national level as well as separately across groups of states classified as high-focus and non-high-focus. We carry out several sensitivity analyses including a subgroup analysis stratified by possession of an immunization card.Receipt of financial assistance from JSY led to an increase in immunization rates ranging from 3.1 (95%CI 2.2-4.0 percentage points for one dose of polio vaccine to 9.1 (95%CI 7.5-10.7 percentage points in the proportion of fully vaccinated children. Our findings also indicate JSY led to increased post-partum check-up rates and healthy early breastfeeding practices around the time of childbirth. No effect of JSY was found on exclusive breastfeeding practices and care-seeking behaviors. Effect sizes were consistently larger in states identified as being a key focus for the program. In an analysis stratified by possession of an immunization card, there was little to no effect of JSY among those with vaccination cards, while the effect size was much larger than the base case results for those missing vaccination cards, across nearly all immunization outcomes.Early results suggest the JSY program led to a significant increase in childhood immunization rates and some healthy reproductive health behaviors, but the structuring of financial incentives to pregnant women and health workers warrants further review. Causal interpretation of our results relies on the assumption that

  15. Adapting an Evidence-Based HIV Prevention Intervention Targeting High-Risk Migrant Workers: The Process and Outcome of Formative Research

    Directory of Open Access Journals (Sweden)

    Roman eShrestha

    2016-03-01

    Full Text Available BackgroundHistorically, HIV prevention efforts in Nepal have primarily focused on heterosexual transmission, particularly, among female sex workers (FSWs and their male clients, with little acknowledgment of the contribution of migrant workers to the epidemic. The very few HIV prevention efforts that have been attempted with migrants have been unsuccessful primarily due to stigma, discrimination, and insufficient availability of culturally relevant evidence-based interventions (EBIs. As an initial step toward addressing this unmet need, we conducted formative research aimed at adapting an evidence-based HIV risk reduction intervention for implementation among migrants in Nepal.MethodsOur formative work involved a critical examination of established EBIs and associated published reports complemented by data elicited through structured interviews with members of the target population and key stakeholders. Between July and August, 2014, we conducted structured one-on-one interview with migrants (n = 5 and key stakeholder (e.g., counselors, field workers, and project coordinator; n = 5, which focused on the HIV risk profiles of the migrants and on ways to optimize intervention content, delivery, and placement within the community-based settings. Data analysis followed a thematic analysis approach utilizing several qualitative data analysis techniques, including inductive analysis, cross-case analysis, and analytical coding of textual data.ResultsBased on formative research, we adapted the Holistic Health Recovery Program (HHRP, an EBI, to consist of four 30-minute sessions that cover a range of topics relevant to migrants in Nepal. The intervention was adapted with flexibility so that it could be provided in an individual format, implemented within or outside the CBO, and can be delivered in either consecutive or weekly sessions based on time constraints. ConclusionsThis paper provides a detailed description of the formative research process

  16. Impact of health insurance for tertiary care on postoperative outcomes and seeking care for symptoms: quasi-experimental evidence from Karnataka, India.

    Science.gov (United States)

    Sood, Neeraj; Wagner, Zachary

    2016-01-06

    To evaluate the effects of a government insurance programme covering tertiary care for the poor in Karnataka, India--Vajpayee Arogyashree Scheme (VAS)--on treatment seeking and postoperative outcomes. Geographic regression discontinuity. 572 villages in Karnataka, India. 3478 households in 300 villages where VAS was implemented and 3486 households in 272 neighbouring matched villages ineligible for VAS. A government insurance programme that provided free tertiary care to households below the poverty line in half of villages in Karnataka from February 2010 to August 2012. Seeking treatment for symptoms, posthospitalisation well-being, occurrence of infections during hospitalisation and need for rehospitalisation. The prevalence of symptoms was nearly identical for households in VAS-eligible villages compared with households in VAS-ineligible villages. However, households eligible for VAS were 4.96 percentage points (95% CI 1 to 8.9; p=0.014) more likely to seek treatment for their symptoms. The increase in treatment seeking was more pronounced for symptoms of cardiac conditions, the condition most frequently covered by VAS. Respondents from VAS-eligible villages reported greater improvements in well-being after a hospitalisation in all categories assessed and they were statistically significant in 3 of the 6 categories (walking ability, pain and anxiety). Respondents eligible for VAS were 9.4 percentage points less likely to report any infection after their hospitalisation (95% CI -20.2 to 1.4; p=0.087) and 16.5 percentage points less likely to have to be rehospitalised after the initial hospitalisation (95% CI -28.7 to -4.3; p<0.01). Insurance for tertiary care increased treatment seeking among eligible households. Moreover, insured patients experienced better posthospitalisation outcomes, suggesting better quality of care received. These results suggest that there are several pathways through which tertiary care insurance could improve health, aside from

  17. Clinical outcomes in patients with node-negative breast cancer treated based on the recurrence score results: evidence from a large prospectively designed registry.

    Science.gov (United States)

    Stemmer, Salomon M; Steiner, Mariana; Rizel, Shulamith; Soussan-Gutman, Lior; Ben-Baruch, Noa; Bareket-Samish, Avital; Geffen, David B; Nisenbaum, Bella; Isaacs, Kevin; Fried, Georgeta; Rosengarten, Ora; Uziely, Beatrice; Svedman, Christer; McCullough, Debbie; Maddala, Tara; Klang, Shmuel H; Zidan, Jamal; Ryvo, Larisa; Kaufman, Bella; Evron, Ella; Karminsky, Natalya; Goldberg, Hadassah; Shak, Steven; Liebermann, Nicky

    2017-01-01

    The 21-gene Recurrence Score® (RS) assay is a validated prognostic/predictive tool in ER + early-stage breast cancer. However, clinical outcome data from prospective studies in RS ≥ 11 patients are lacking, as are relevant real-life clinical practice data. In this retrospective analysis of a prospectively designed registry, we evaluated treatments/clinical outcomes in patients undergoing RS-testing through Clalit Health Services. The analysis included N0 ER + HER2-negative breast cancer patients who were RS-tested from 1/2006 through 12/2010. Medical records were reviewed to verify treatments/recurrences/survival. The cohort included 1801 patients (median follow-up, 6.2 years). Median age was 60 years, 50.4% were grade 2 and 81.1% had invasive ductal carcinoma; 48.9% had RS < 18, 40.7% RS 18-30, and 10.4% RS ≥ 31, with chemotherapy use of 1.4, 23.7, and 87.2%, respectively. The 5-year Kaplan-Meier estimates for distant recurrence were 0.8, 3.0, and 8.6%, for patients with RS < 18, RS 18-30 and RS ≥ 31, respectively; the corresponding 5-year Kaplan-Meier estimates for breast cancer death were 0.0, 0.9, and 6.2%. Chemotherapy-untreated patients with RS < 11 ( n  = 304) and 11-25 ( n  = 1037) (TAILORx categorizatio n ) had 5-year Kaplan-Meier estimates for distant recurrence risk/breast cancer death of 1.0%/0.0% and 1.3%/0.4%, respectively. Our results extend those of the prospective TAILORx trial: the 5-year Kaplan-Meier estimates for distant recurrence and breast cancer death rate for the RS < 18 patients were very low supporting the use of endocrine therapy alone. Furthermore, in chemotherapy-untreated patients with RS 11-25 (where TAILORx patients were randomized to chemoendocrine or endocrine therapy alone), 5-year distant recurrence rates were also very low, suggesting that chemotherapy would not have conferred clinically meaningful benefit.

  18. Prospective association of the SHARE-operationalized frailty phenotype with adverse health outcomes: evidence from 60+ community-dwelling Europeans living in 11 countries.

    Science.gov (United States)

    Macklai, Nejma S; Spagnoli, Jacques; Junod, Julien; Santos-Eggimann, Brigitte

    2013-01-03

    Among the many definitions of frailty, the frailty phenotype defined by Fried et al. is one of few constructs that has been repeatedly validated: first in the Cardiovascular Health Study (CHS) and subsequently in other large cohorts in the North America. In Europe, the Survey of Health, Aging and Retirement in Europe (SHARE) is a gold mine of individual, economic and health information that can provide insight into better understanding of frailty across diverse population settings. A recent adaptation of the original five CHS-frailty criteria was proposed to make use of SHARE data and measure frailty in the European population. To test the validity of the SHARE operationalized frailty phenotype, this study aims to evaluate its prospective association with adverse health outcomes. Data are from 11,015 community-dwelling men and women aged 60+ participating in wave 1 and 2 of the Survey of Health, Aging and Retirement in Europe, a population-based survey. Multivariate logistic regression analyses were used to assess the 2-year follow up effect of SHARE-operationalized frailty phenotype on the incidence of disability (disability-free at baseline) and on worsening disability and morbidity, adjusting for age, sex, income and baseline morbidity and disability. At 2-year follow up, frail individuals were at increased risk for: developing mobility (OR 3.07, 95% CI, 1.02-9.36), IADL (OR 5.52, 95% CI, 3.76-8.10) and BADL (OR 5.13, 95% CI, 3.53-7.44) disability; worsening mobility (OR 2.94, 95% CI, 2.19- 3.93) IADL (OR 4.43, 95% CI, 3.19-6.15) and BADL disability (OR 4.53, 95% CI, 3.14-6.54); and worsening morbidity (OR 1.77, 95% CI, 1.35-2.32). These associations were significant even among the prefrail, but with a lower magnitude of effect. The SHARE-operationalized frailty phenotype is significantly associated with all tested health outcomes independent of baseline morbidity and disability in community-dwelling men and women aged 60 and older living in Europe. The

  19. Prospective association of the SHARE-operationalized frailty phenotype with adverse health outcomes: evidence from 60+ community-dwelling Europeans living in 11 countries

    Directory of Open Access Journals (Sweden)

    Macklai Nejma S

    2013-01-01

    Full Text Available Abstract Background Among the many definitions of frailty, the frailty phenotype defined by Fried et al. is one of few constructs that has been repeatedly validated: first in the Cardiovascular Health Study (CHS and subsequently in other large cohorts in the North America. In Europe, the Survey of Health, Aging and Retirement in Europe (SHARE is a gold mine of individual, economic and health information that can provide insight into better understanding of frailty across diverse population settings. A recent adaptation of the original five CHS-frailty criteria was proposed to make use of SHARE data and measure frailty in the European population. To test the validity of the SHARE operationalized frailty phenotype, this study aims to evaluate its prospective association with adverse health outcomes. Methods Data are from 11,015 community-dwelling men and women aged 60+ participating in wave 1 and 2 of the Survey of Health, Aging and Retirement in Europe, a population-based survey. Multivariate logistic regression analyses were used to assess the 2-year follow up effect of SHARE-operationalized frailty phenotype on the incidence of disability (disability-free at baseline and on worsening disability and morbidity, adjusting for age, sex, income and baseline morbidity and disability. Results At 2-year follow up, frail individuals were at increased risk for: developing mobility (OR 3.07, 95% CI, 1.02-9.36, IADL (OR 5.52, 95% CI, 3.76-8.10 and BADL (OR 5.13, 95% CI, 3.53-7.44 disability; worsening mobility (OR 2.94, 95% CI, 2.19- 3.93 IADL (OR 4.43, 95% CI, 3.19-6.15 and BADL disability (OR 4.53, 95% CI, 3.14-6.54; and worsening morbidity (OR 1.77, 95% CI, 1.35-2.32. These associations were significant even among the prefrail, but with a lower magnitude of effect. Conclusions The SHARE-operationalized frailty phenotype is significantly associated with all tested health outcomes independent of baseline morbidity and disability in community-dwelling men

  20. Evidence on acne therapy

    Directory of Open Access Journals (Sweden)

    Caroline Sousa Costa

    Full Text Available Among the current treatments available for acne vulgaris, many widely practiced options lack support from studies at the best level of scientific evidence. The aim of this narrative review was to present the very latest information on topical and systemic treatments for acne vulgaris. Information from systematic reviews and well-designed clinical trials, obtained through a systematic search of the major medical databases, is emphasized. There are important issues regarding the clinical management of acne that still lack consistent grounding in scientific evidence. Among these are the optimum dose and duration of treatment with oral antibiotics that can be given without inducing bacterial resistance, and the safety of oral isotretinoin.

  1. A Hierarchy of Patient-Reported Outcomes for Meta-Analysis of Knee Osteoarthritis Trials: Empirical Evidence from a Survey of High Impact Journals

    Directory of Open Access Journals (Sweden)

    Carsten Juhl

    2012-01-01

    Full Text Available Objectives. To develop a prioritised list based on responsiveness for extracting patient-reported outcomes (PROs measuring pain and disability for performing meta-analyses in knee osteoarthritis (OA. Methods. A systematic search was conducted in 20 highest impact factor general and rheumatology journals chosen a priori. Eligible studies were randomised controlled trials, using two or more PROs measuring pain and/or disability. Results. A literature search identified 402 publications and 38 trials were included, resulting in 54 randomised comparisons. Thirty-five trials had sufficient data on pain and 15 trials on disability. The WOMAC “pain” and “function” subscales were the most responsive composite scores. The following list was developed. Pain: (1 WOMAC “pain” subscale, (2 pain during activity (VAS, (3 pain during walking (VAS, (4 general knee pain (VAS, (5 pain at rest (VAS, (6 other composite pain scales, and (7 other single item measures. Disability: (1 WOMAC “function” subscale, (2 SF-36 “physical function” subscale, (3 SF-36 (Physical composite score, and (4 Other composite disability scores. Conclusions. As choosing the PRO most favourable for the intervention from individual trials can lead to biased estimates, using a prioritised list as developed in this study is recommended to reduce risk of biased selection of PROs in meta-analyses.

  2. Growth and neurological outcome in ELBW preterms fed with human milk and extra-protein supplementation as routine practice: do we need further evidence?

    Science.gov (United States)

    Biasini, Augusto; Marvulli, Lucia; Neri, Erica; China, Mariachiara; Stella, Marcello; Monti, Fiorella

    2012-10-01

    Extremely-low-birth-weight infants (ELBW) should be given nutrients to enable them to grow at the same rate as foetuses of the same gestational age, and lean body components, particularly the brain, are dependent on protein intake. Fortified human milk remains the best food for these preterms. Two groups of preterm infants weighing 580-1250 g and with a gestational age of 23-32 weeks were fed with different protein intakes in fortified human/maternal milk (3.5 g kg(-1) per day and 4.8 g kg(-1) per day in the control and extra-protein groups, respectively). The tolerance, intrahospital growth, neurological outcome and anthropometric data until 9 months corrected age were evaluated. The extra-protein regime showed an intrahospital growth advantage (mostly in growth of head circumference, p 0.02, and length, p 0.04) only in the preterms weighing 580-980 g and aged 23-30 weeks. In the same preterms, the Griffith Development Mental Score at 3 months corrected age showed higher scores than in the control group (p 0.04). Growth during the post-discharge period for the experimental group at 9 months corrected age showed mean z-score values for length higher than those in the control group (p 0.04).

  3. Interethnic mating and risk for preterm birth among Arab-American mothers: evidence from the Arab-American Birth Outcomes Study.

    Science.gov (United States)

    El-Sayed, Abdulrahman M; Galea, Sandro

    2011-06-01

    Arab ethnicity (AE) mothers have lower preterm birth (PTB) risk than white mothers. Little is known about the determinants of PTB among AE women or the role of interethnic mating in shaping PTB risk among this group. We assessed the relationship between interethnic mating and risk for PTB, very PTB, and late PTB among AE mothers. Data was collected for all births (N = 21,621) to AE women in Michigan between 2000 and 2005. Self-reported ancestry was used to determine paternal AE as well as to identify AE mothers. We used bivariate chi-square tests and multivariable logistic regression to assess the relationship between paternal non-AE and risk for PTB, very PTB, and late PTB among AE mothers. All analyses were also conducted among non-Arab white mothers as a control. Among AE mothers, paternal non-Arab ethnicity was associated with higher risk of PTB (OR = 1.18, 95% CI = 1.06, 1.30) and late PTB (OR = 1.24, 95% CI = 1.20, 1.38) compared to paternal Arab ethnicity. Paternal non-Arab ethnicity was not associated with risk for any outcome among non-Arab white mothers. Future studies could assess the causal mechanisms underlying the association between interethnic mating and risk for PTB.

  4. Latest Cretaceous climatic and environmental change in the South Atlantic region

    Science.gov (United States)

    Woelders, L.; Vellekoop, J.; Kroon, D.; Smit, J.; Casadío, S.; Prámparo, M. B.; Dinarès-Turell, J.; Peterse, F.; Sluijs, A.; Lenaerts, J. T. M.; Speijer, R. P.

    2017-05-01

    Latest Maastrichtian climate change caused by Deccan volcanism has been invoked as a cause of mass extinction at the Cretaceous-Paleogene (K-Pg) boundary ( 66.0 Ma). Yet late Maastrichtian climate and ecological changes are poorly documented, in particular on the Southern Hemisphere. Here we present upper Maastrichtian-lower Danian climate and biotic records from the Bajada del Jagüel (BJ) shelf site (Neuquén Basin, Argentina), employing the TEX86 paleothermometer, marine palynology (dinoflagellate cysts), and micropaleontology (foraminifera). These records are correlated to the astronomically tuned Ocean Drilling Program Site 1262 (Walvis Ridge). Collectively, we use these records to assess climatic and ecological effects of Deccan volcanism in the Southern Atlantic region. Both the TEX86-based sea surface temperature (SST) record at BJ and the bulk carbonate δ18O-based SST record of Site 1262 show a latest Maastrichtian warming of 2.5-4°C, at 450 to 150 kyr before the K-Pg boundary, coinciding with the a large Deccan outpouring phase. Benthic foraminiferal and dinocyst assemblage changes indicate that this warming resulted in enhanced runoff and stratification of the water column, likely resulting from more humid climate conditions in the Neuquén Basin. These climate conditions could have been caused by an expanding and strengthening thermal low over the South American continent. Biotic changes in response to late Maastrichtian environmental changes are rather limited, when compared to the major turnovers observed at many K-Pg boundary sites worldwide. This suggests that environmental perturbations during the latest Maastrichtian warming event were less severe than those following the K-Pg boundary impact.

  5. The Role of Preference on Outcomes of People Receiving Evidence-Informed Community Wound Care in Their Home or in a Nurse-Clinic Setting: A Cohort Study (n = 230

    Directory of Open Access Journals (Sweden)

    Margaret B. Harrison

    2014-09-01

    Full Text Available This study followed a cohort of community-dwelling individuals receiving wound-care in a large urban-rural region. During a randomized control trial (RCT evaluating outcomes of receiving care in a nurse-clinic or at home, many approached were willing to participate if they could choose their location of care. This provided a unique opportunity to enroll them as a “choice” cohort, following them in the same manner as the trial participants but allowing them to select their setting of care. The objective was to investigate the role of preference and location of care on care outcomes, including satisfaction with care, healing, health-related quality of life (HRQL, pain, and resource use. This is a secondary analysis of a prospective cohort of 126 individuals enrolled in an RCT to receive care at home or in a nurse-clinic (Allocated group, and an additional 104 who received care at home or in a nurse-clinic based on their preference (Choice group. Mobile individuals with a leg ulcer of venous or mixed venous etiology, referred for community leg ulcer care, were eligible. Specially-trained nurses provided care to both groups using an evidence-informed protocol. Baseline data included socio-demographic, circumstance-of-living and a detailed wound assessment. Mean age of the cohort was 68 years. Satisfaction, healing, recurrence, pain, HRQL, and resource utilization did not differ between groups. If available, individuals should have an option of care venue given almost half of those approached indicated a clear preference for clinic or home. With outcomes being similar, health care planners and decision-makers, as well as individuals and their families, can feel confident that the setting of care will not impact the outcomes. However, larger studies in other contexts are needed to explore the interaction between choice and setting.

  6. The Role of Preference on Outcomes of People Receiving Evidence-Informed Community Wound Care in Their Home or in a Nurse-Clinic Setting: A Cohort Study (n = 230).

    Science.gov (United States)

    Harrison, Margaret B; VanDenKerkhof, Elizabeth G; Hopman, Wilma M; Carley, Meg E

    2014-09-19

    This study followed a cohort of community-dwelling individuals receiving wound-care in a large urban-rural region. During a randomized control trial (RCT) evaluating outcomes of receiving care in a nurse-clinic or at home, many approached were willing to participate if they could choose their location of care. This provided a unique opportunity to enroll them as a "choice" cohort, following them in the same manner as the trial participants but allowing them to select their setting of care. The objective was to investigate the role of preference and location of care on care outcomes, including satisfaction with care, healing, health-related quality of life (HRQL), pain, and resource use. This is a secondary analysis of a prospective cohort of 126 individuals enrolled in an RCT to receive care at home or in a nurse-clinic (Allocated group), and an additional 104 who received care at home or in a nurse-clinic based on their preference (Choice group). Mobile individuals with a leg ulcer of venous or mixed venous etiology, referred for community leg ulcer care, were eligible. Specially-trained nurses provided care to both groups using an evidence-informed protocol. Baseline data included socio-demographic, circumstance-of-living and a detailed wound assessment. Mean age of the cohort was 68 years. Satisfaction, healing, recurrence, pain, HRQL, and resource utilization did not differ between groups. If available, individuals should have an option of care venue given almost half of those approached indicated a clear preference for clinic or home. With outcomes being similar, health care planners and decision-makers, as well as individuals and their families, can feel confident that the setting of care will not impact the outcomes. However, larger studies in other contexts are needed to explore the interaction between choice and setting.

  7. The latest progress of TILLING technique and its prospects in irradiation mutation breeding

    International Nuclear Information System (INIS)

    Du Yan; Yu Lixia; Liu Qingfang; Zhou Libin; Li Wenjian

    2011-01-01

    TILLING (Targeting Induced Local Lesions IN Genomes) is a novel, high-throughput and low-cost reverse genetics technique. In recent years, with innovation of the mutation screening techniques, TILLING platform has become more diversified, which makes the operation of TILLING technique more simple and rapid. For this reason, it is widely used in crop breeding research. In this paper, we summarized the latest progress of TILLING technique, meanwhile, we also discussed the prospect of combining irradiation mutation with the high-throughput TILLING technique in mutation breeding. (authors)

  8. Latest results on the performance of the multigap resistive plate chamber used for the ALICE TOF

    International Nuclear Information System (INIS)

    Akindinov, A.N.; Alici, A.; Anselmo, F.

    2004-01-01

    For the identification of particles in the momentum range 0.5-2.5GeV/c, the ALICE experiment uses a Time Of Flight array consisting of Multigap Resistive Plate Chambers (MRPC) in the form of long strips. The design of the detector elements is as follows : double stack MRPCs with glass resistive plates and 5 gas gaps of 250μm per stack. The latest results on the performance of these MRPCs are presented. Typical values of time resolution σ are better than 50ps, with an efficiency of 99.9% and a long, more than 1.5kV, streamer-free plateau

  9. Latest developments in GaN-based quantum devices for infrared optoelectronics

    OpenAIRE

    Monroy, Eva; Guillot, Fabien; Leconte, Sylvain; Nevou, Laurent; Doyennette, Laeticia; Tchernycheva, Maria; Julien, François H.; Baumann, Esther; Giorgetta, Fabrizio R.; Hofstetter, Daniel

    2011-01-01

    In this work, we summarize the latest progress in intersubband devices based on GaN/AlN nanostructures for operation in the near-infrared. We first discuss the growth and characterization of ultra-thin GaN/AlN quantum well and quantum dot superlattices by plasma-assisted molecular-beam epitaxy. Then, we present the performance of nitride-based infrared photodetectors and electro-optical modulators operating at 1.55 μm. Finally, we discuss the progress towards intersubband light emitters, incl...

  10. Performance of the latest MPPCs with reduced dark counts and improved photon detection efficiency

    International Nuclear Information System (INIS)

    Tsujikawa, T.; Funamoto, H.; Kataoka, J.; Fujita, T.; Nishiyama, T.; Kurei, Y.; Sato, K.; Yamamura, K.; Nakamura, S.

    2014-01-01

    We have tested the performance of two types of the latest Multi-Pixel Photon Counters (MPPCs; measuring 3×3 mm 2 in size) developed by Hamamatsu Photonics K.K. The new S12572-050C is a successor to the S10362-33-050C (i.e., conventional 3×3-mm 2 pixel MPPC of 50 μm pitch), comprises 3600 Geiger mode avalanche photodiodes (APDs), and also features high gain (up to 1.25×10 6 ), a low dark count (up to 10 6 cps), and improved photon detection efficiency (PDE) by up to 30%. The S12572-015C is a new type of fine-pitch (15 μm) MPPC featuring a wide dynamic range and fast timing response. This paper first presents the detailed performance of these latest MPPCs as photon counting devices. It then describes our fabrication of a prototype detector consisting of a MPPC optically coupled with a Ce:GAGG scintillator. We obtained average FWHM energy resolutions of 7.3% (15 μm) and 6.7% (new-50 μm), as compared to 6.9% (old-50 μm) for 662-keV gamma rays from the 137 Cs source, as measured at 20 °C. Moreover, the number of fired pixels for 662-keV gamma rays increased by 30% for the new-50 μm (as compared to the old-50 μm). We confirmed that the low energy threshold improved from 10 keV to 4 keV, when using the latest MPPC device (new-50 μm). We also confirmed that the timing resolution of the new MPPC is 50 ps or even better, as compared to 89 ps of the old MPPC. The results thus confirm that these new types of MPPCs are promising for various applications as scintillation detectors. - Highlights: • We tested the performance of the latest MPPC. • We confirmed that the new MPPC is superior to the old MPPC. • We plan to apply the new MPPC for a next-generation PET and a handy Compton camera

  11. Performance of the latest MPPCs with reduced dark counts and improved photon detection efficiency

    Energy Technology Data Exchange (ETDEWEB)

    Tsujikawa, T., E-mail: takayuki-t.w@asagi.waseda.jp [Research Institute for Science and Engineering, Waseda University, 3-4-1, Ohkubo, Shinjuku, Tokyo (Japan); Funamoto, H.; Kataoka, J.; Fujita, T.; Nishiyama, T.; Kurei, Y. [Research Institute for Science and Engineering, Waseda University, 3-4-1, Ohkubo, Shinjuku, Tokyo (Japan); Sato, K.; Yamamura, K.; Nakamura, S. [Solid State Division, Hamamatsu Photonics K. K., 1126-1, Ichino-cho, Hamamatsu, Shizuoka (Japan)

    2014-11-21

    We have tested the performance of two types of the latest Multi-Pixel Photon Counters (MPPCs; measuring 3×3 mm{sup 2} in size) developed by Hamamatsu Photonics K.K. The new S12572-050C is a successor to the S10362-33-050C (i.e., conventional 3×3-mm{sup 2} pixel MPPC of 50 μm pitch), comprises 3600 Geiger mode avalanche photodiodes (APDs), and also features high gain (up to 1.25×10{sup 6}), a low dark count (up to 10{sup 6} cps), and improved photon detection efficiency (PDE) by up to 30%. The S12572-015C is a new type of fine-pitch (15 μm) MPPC featuring a wide dynamic range and fast timing response. This paper first presents the detailed performance of these latest MPPCs as photon counting devices. It then describes our fabrication of a prototype detector consisting of a MPPC optically coupled with a Ce:GAGG scintillator. We obtained average FWHM energy resolutions of 7.3% (15 μm) and 6.7% (new-50 μm), as compared to 6.9% (old-50 μm) for 662-keV gamma rays from the {sup 137}Cs source, as measured at 20 °C. Moreover, the number of fired pixels for 662-keV gamma rays increased by 30% for the new-50 μm (as compared to the old-50 μm). We confirmed that the low energy threshold improved from 10 keV to 4 keV, when using the latest MPPC device (new-50 μm). We also confirmed that the timing resolution of the new MPPC is 50 ps or even better, as compared to 89 ps of the old MPPC. The results thus confirm that these new types of MPPCs are promising for various applications as scintillation detectors. - Highlights: • We tested the performance of the latest MPPC. • We confirmed that the new MPPC is superior to the old MPPC. • We plan to apply the new MPPC for a next-generation PET and a handy Compton camera.

  12. Latest developments at GANIL for stable and radioactive ion beam production

    International Nuclear Information System (INIS)

    Jardin, P.; Barue, C.; Bajeat, O.; Canet, C.; Clement, E.; Cornell, J. C.; Delahaye, P.; Dubois, M.; Dupuis, M.; Flambard, J. L.; Fraanberg, H.; Frigot, R.; Leboucher, C.; Lecesne, N.; Lecomte, P.; Leherissier, P.; Lemagnen, F.; Leroy, R.; Maunoury, L.; Mery, A.

    2010-01-01

    In the frame of the SPIRAL II (Systeme de Production d'Ions Radioactifs Acceleres en Ligne Partie II) project, several developments of stable and radioactive ion production systems have been started up. In parallel, GANIL has the ambition to preserve the existing stable and radioactive beams and also to increase its range by offering new ones. In order to identify the best directions for this development, a new group called GANISOL has been formed. Its preliminary conclusions and the latest developments at GANIL are presented.

  13. Current knowledge from experimental works with radioprotective drugs from the viewpoint of latest scientific research

    International Nuclear Information System (INIS)

    Skalka, J.

    2008-01-01

    The protection of both human and animal population against a radiation impairment proves to be an impulse for continuous intensive searching for plants with radioprotective properties, identification of their radioprotective components and examination of their effects both in vivo an in vitro. I am presenting the results as well as knowledge of a latest scientific research in this field with testing the following plants: Vigna radiata, Mentha piperita, Citrus aurantium var. amara, Syzygium cumini, Tinospora cordifolia, Aegle marmelos, Phyllanthus amarus, Aloe vera, Angelica sinensis, Rosemarinus officinalis, Panax ginseng, Hippophae rhamnoides, Ocimum sanctum, Crataegus microphylla. (authors)

  14. Operational experience for the latest generation of ATRIUM trademark 10 fuel assemblies

    International Nuclear Information System (INIS)

    Schoss, Volker; Hoffmann, Petra Britt; Schaefer, Jens

    2011-01-01

    AREVA NP's ATRIUM trademark 10 product family was first introduced to the BWR market in 1992. Lead test campaigns confirmed the outstanding product performance and justified introduction of reload quantities. Further development of particular product features was demonstrated and implemented in the fuel design to meet highest expectations for reliability and fuel economics. The latest generation called ATRIUM trademark 10XP and subsequently ATRIUM trademark 10XM was introduced in 2002 and 2005, respectively. The first lead test assemblies completed their operation successfully after seven cycles. (orig.)

  15. Latest results on the performance of the multigap resistive plate chamber used for the ALICE TOF

    CERN Document Server

    Akindinov, A; Anselmo, F; Antonioli, P; Basile, M; Cara Romeo, G; Cifarelli, Luisa; Cindolo, F; Cosenza, F; D'Antone, I; De Caro, A; De Pasquale, S; Di Bartolomeo, A; Fusco-Girard, M; Golovine, V; Guerzoni, M; Guida, M; Hatzifotiadou, D; Kaidalov, A B; Kim, D H; Kim, D W; Kisselev, S M; Laurenti, G; Lioublev, E; Lee, K; Lee, S C; Luvisetto, M L; Margotti, A; Martemyanov, A N; Massera, F; Meneghini, S; Michinelli, R; Nania, R; Otiougova, P; Pancaldi, G; Pesci, A; Pilastrini, R; Pinazza, O; Polozov, P A; Rizzi, M; Scapparone, E; Scioli, G; Sellitto, S B; Semeria, F; Serra, S; Smirnitsky, A V; Tchoumakov, M M; Ugolini, E; Usenko, E; Valenti, G; Voloshin, K G; Williams, M C S; Zagreev, B V; Zampolli, C; Zichichi, A; Zucchini, A; Zuffa, M

    2004-01-01

    For the identification of particles in the momentum range 0.5-2.5 GeV /c, the ALICE experiment uses a Time Of Flight array consisting of Multigap Resistive Plate Chambers (MRPC) in the form of long strips. The design of the detector elements is as follows: double stack MRPCs with glass resistive plates and 5 gas gaps of 250 mum per stack. The latest results on the performance of these MRPCs are presented. Typical values of time resolution sigma are better than 50 ps, with an efficiency of 99.9% and a long, more than 1.5kV, streamer-free plateau.

  16. Latest approaches on green chemistry preconcentration methods for trace metal determination in seawater--a review.

    Science.gov (United States)

    La Colla, Noelia Soledad; Domini, Claudia Elizabeth; Marcovecchio, Jorge Eduardo; Botté, Sandra Elizabeth

    2015-03-15

    Evaluation of trace metal levels in seawater samples is undertaken regularly by research groups all over the world, leading to a growing demand for techniques involving fewer toxic reagents, less time-consuming protocols and lower limits of detection. This review focuses on providing a brief but concise description of the latest methodologies developed to this end, outlining the advantages and disadvantages of the various protocols, chelating and dispersive agents and instruments used. Conclusions are drawn on the basis of the articles reviewed, highlighting improvements introduced in order to enhance the performance of the protocols. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Latest Advances in the Generation of Single Photons in Silicon Carbide

    Directory of Open Access Journals (Sweden)

    Albert Boretti

    2016-06-01

    Full Text Available The major barrier for optical quantum information technologies is the absence of reliable single photons sources providing non-classical light states on demand which can be easily and reliably integrated with standard processing protocols for quantum device fabrication. New methods of generation at room temperature of single photons are therefore needed. Heralded single photon sources are presently being sought based on different methods built on different materials. Silicon Carbide (SiC has the potentials to serve as the preferred material for quantum applications. Here, we review the latest advances in single photon generation at room temperatures based on SiC.

  18. Expression of PAM50 Genes in Lung Cancer: Evidence that Interactions between Hormone Receptors and HER2/HER3 Contribute to Poor Outcome

    Directory of Open Access Journals (Sweden)

    Jill M. Siegfried

    2015-11-01

    Full Text Available Non–small cell lung cancers (NSCLCs frequently express estrogen receptor (ER β, and estrogen signaling is active in many lung tumors. We investigated the ability of genes contained in the prediction analysis of microarray 50 (PAM50 breast cancer risk predictor gene signature to provide prognostic information in NSCLC. Supervised principal component analysis of mRNA expression data was used to evaluate the ability of the PAM50 panel to provide prognostic information in a stage I NSCLC cohort, in an all-stage NSCLC cohort, and in The Cancer Genome Atlas data. Immunohistochemistry was used to determine status of ERβ and other proteins in lung tumor tissue. Associations with prognosis were observed in the stage I cohort. Cross-validation identified seven genes that, when analyzed together, consistently showed survival associations. In pathway analysis, the seven-gene panel described one network containing the ER and progesterone receptor, as well as human epidermal growth factor receptor (HER2/HER3 and neuregulin-1. NSCLC cases also showed a significant association between ERβ and HER2 protein expression. Cases positive for HER2 expression were more likely to express HER3, and ERβ-positive cases were less likely to be both HER2 and HER3 negative. Prognostic ability of genes in the PAM50 panel was verified in an ERβ-positive cohort representing all NSCLC stages. In The Cancer Genome Atlas data sets, the PAM50 gene set was prognostic in both adenocarcinoma and squamous cell carcinoma, whereas the seven-gene panel was prognostic only in squamous cell carcinoma. Genes in the PAM50 panel, including those linking ER and HER2, identify lung cancer patients at risk for poor outcome, especially among ERβ-positive cases and squamous cell carcinoma.

  19. Building capacity for education research among clinical educators in the health professions: A BEME (Best Evidence Medical Education) Systematic Review of the outcomes of interventions: BEME Guide No. 34.

    Science.gov (United States)

    Ahmed, Rabia; Farooq, Ameer; Storie, Dale; Hartling, Lisa; Oswald, Anna

    2016-01-01

    There is a growing desire for health professions educators to generate high-quality education research; yet, few of them encounter the training to do so. In response, health professions faculties have increasingly been devoting resources to provide members with the skills necessary for education research. The form and impact of these efforts have not been reviewed, though such a synthesis could be useful for practice. The objectives of this systematic review were to (1) identify interventions aimed at building capacity for education research among health professions clinical educators and (2) review the outcomes of these interventions. We developed a systematic review protocol based on our pilot scoping search. This protocol underwent peer review and was prospectively registered with the Best Evidence Medical Education Collaboration. Based on this protocol, we conducted a comprehensive search of health professions' databases and related grey literature. Systematic methods were applied: two independent reviewers completed title screening and full text review for inclusion, data extraction, and methodological quality assessment. Studies were included if they reported outcomes for interventions designed to increase capacity for health professions clinical educators to conduct education research. We conducted a qualitative synthesis of the evidence which included detailed reporting of intervention characteristics and outcomes. Our search returned 14, 149 results, 241 of which were retained after title and abstract screening, and 30 of which met inclusion criteria after full text review. Seven groups of interventions were identified, the most frequent being teaching scholars programs (n = 10), health professions education fellowships (n = 3) or master's programs (n = 4). The most commonly measured outcome was change related to enhanced scholarly outputs (grants, papers, abstracts, and presentations) post-intervention. Unfortunately, most of the included

  20. Improved outcomes in patients with ST-elevation myocardial infarction during the last 20 years are related to implementation of evidence-based treatments: experiences from the SWEDEHEART registry 1995–2014

    Science.gov (United States)

    Szummer, Karolina; Wallentin, Lars; Lindhagen, Lars; Alfredsson, Joakim; Erlinge, David; Held, Claes; James, Stefan; Kellerth, Thomas; Lindahl, Bertil; Ravn-Fischer, Annica; Rydberg, Erik; Yndigegn, Troels; Jernberg, Tomas

    2017-01-01

    Abstract Aims Impact of changes of treatments on outcomes in ST-elevation myocardial infarction (STEMI) patients in real-life health care has not been documented. Methods and results All STEMI cases (n = 105.674) registered in the nation-wide SWEDEHEART registry between 1995 and 2014 were included and followed for fatal and non-fatal outcomes for up to 20 years. Most changes in treatment and outcomes occurred from 1994 to 2008. Evidence-based treatments increased: reperfusion from 66.2 to 81.7%; primary percutaneous coronary intervention: 4.5 to 78.0%; dual antiplatelet therapy from 0 to 89.6%; statin: 14.1 to 93.6%; beta-blocker: 78.2 to 91.0%, and angiotensin-converting-enzyme/angiotensin-2-receptor inhibitors: 40.8 to 85.2% (P-value for-trend <0.001 for all). One-year mortality decreased from 22.1 to 14.1%. Standardized incidence ratio compared with the general population decreased from 5.54 to 3.74 (P < 0.001). Cardiovascular (CV) death decreased from 20.1 to 11.1%, myocardial infarction (MI) from 11.5 to 5.8%; stroke from 2.9 to 2.1%; heart failure from 7.1 to 6.2%. After standardization for differences in demography and baseline characteristics, the change of 1-year CV-death or MI corresponded to a linear trend of 0.915 (95% confidence interval: 0.906–0.923) per 2-year period which no longer was significant, 0.997 (0.984–1.009), after adjustment for changes in treatment. The changes in treatment and outcomes were most pronounced from 1994 to 2008. Conclusion Gradual implementation of new and established evidence-based treatments in STEMI patients during the last 20 years has been associated with prolonged survival and lower risk of recurrent ischaemic events, although a plateauing is seen since around 2008. PMID:29020314

  1. Barriers and outcomes of an evidence-based approach to diagnosis and management of chronic obstructive pulmonary disease (COPD) in Australia: a qualitative study.

    Science.gov (United States)

    Dennis, Sarah; Reddel, Helen K; Middleton, Sandy; Hasan, Iqbal; Hermiz, Oshana; Phillips, Rosemary; Crockett, Alan J; Vagholkar, Sanjyot; Marks, Guy B; Zwar, Nicholas

    2017-08-01

    Chronic obstructive pulmonary disease (COPD) is commonly managed in primary care but there is poor awareness of evidence-based guidelines and the quality and interpretation of spirometry is suboptimal. The aims of this qualitative study were to explore how an intervention involving case finding and management of COPD was implemented, and the extent to which the GPs and practice nurses (PNs) worked in partnership to diagnose and manage COPD. Semi-structured interviews with PNs (n = 7), GPs (n = 4) and patients (n = 26) who had participated in the Primary care EarLy Intervention for Copd mANagement (PELICAN) study. The Theoretical Domains Framework was used to guide the coding and analysis of the interviews with PN and GPs. The patient interviews were analysed thematically. PNs developed technical skills and understood the requirements for good-quality spirometry. However, many lacked confidence in its interpretation and felt this was not part of their professional role. This was reflected in responses from the GPs. Once COPD was diagnosed, the GPs tended to manage the patients with the PNs less involved. This was in contrast with PNs' active role in managing patients with other chronic diseases such as diabetes. The extent to which the GPs and PNs worked in partnership to manage COPD varied. PNs improved their skills and confidence in performing spirometry. Beliefs about their professional role, identity and confidence influenced the extent to which PNs were involved in interpretation of the spirometry results and managing the patient in partnership with the GP. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. A systematic review and meta-analysis of the effects of pasteurization on milk vitamins, and evidence for raw milk consumption and other health-related outcomes.

    Science.gov (United States)

    Macdonald, Lauren E; Brett, James; Kelton, David; Majowicz, Shannon E; Snedeker, Kate; Sargeant, Jan M

    2011-11-01

    Pasteurization of milk ensures safety for human consumption by reducing the number of viable pathogenic bacteria. Although the public health benefits of pasteurization are well established, pro-raw milk advocate organizations continue to promote raw milk as "nature's perfect food." Advocacy groups' claims include statements that pasteurization destroys important vitamins and that raw milk consumption can prevent and treat allergies, cancer, and lactose intolerance. A systematic review and meta-analysis was completed to summarize available evidence for these selected claims. Forty studies assessing the effects of pasteurization on vitamin levels were found. Qualitatively, vitamins B12 and E decreased following pasteurization, and vitamin A increased. Random effects meta-analysis revealed no significant effect of pasteurization on vitamin B6 concentrations (standardized mean difference [SMD], -2.66; 95% confidence interval [CI], -5.40, 0.8; P = 0.06) but a decrease in concentrations of vitamins B1 (SMD, -1.77; 95% CI, -2.57, -0.96; P pasteurization on milk's nutritive value was minimal because many of these vitamins are naturally found in relatively low levels. However, milk is an important dietary source of vitamin B2, and the impact of heat treatment should be further considered. Raw milk consumption may have a protective association with allergy development (six studies), although this relationship may be potentially confounded by other farming-related factors. Raw milk consumption was not associated with cancer (two studies) or lactose intolerance (one study). Overall, these findings should be interpreted with caution given the poor quality of reported methodology in many of the included studies.

  3. Latest experience on insertion devices at the National Synchrotron Light Source-II

    International Nuclear Information System (INIS)

    Tanabe, Toshiya; Cappadoro, Peter; Corwin, Todd

    2016-01-01

    National Synchrotron Light Source-II (NSLS-II) is the latest storage ring of 3 GeV energy with the horizontal emittance of the electron beam being 0.9 nm.rad. Nine In-Vacuum Undulators (IVUs) are utilized at the NSLS-II as of February 2016. All IVUs have a unique side window derived from the experience from the CHESS facility in Cornell University. An R and D activity called 'Vacuum Seal Test' was conducted to ensure the viability of aluminum wire seal. Another R and D activity to develop a measurement system for Cryogenic Permanent Magnet Undulator (CPMU) was also performed. Other in-air devices, namely damping wigglers (DWs) and elliptically polarizing undulators (EPUs) utilize extruded aluminum chambers with Non-Evaporable Getter (NEG) coating. The beam-based integral estimates were obtained from the virtual kicks at the upstream and downstream of the undulator that best fit the measured orbit distortion in a model lattice with Tracy. In some cases, there are fairly large discrepancies between magnetic measurement data and observed integrals by the beam. Beam studies were carried out to explain the discrepancies mentioned earlier. The latest experiences on ID development and commissioning are discussed in conjunction with related activities in the world. (author)

  4. New Mid-Cretaceous (Latest Albian) Dinosaurs from Winton, Queensland, Australia

    Science.gov (United States)

    Hocknull, Scott A.; White, Matt A.; Tischler, Travis R.; Cook, Alex G.; Calleja, Naomi D.; Sloan, Trish; Elliott, David A.

    2009-01-01

    Background Australia's dinosaurian fossil record is exceptionally poor compared to that of other similar-sized continents. Most taxa are known from fragmentary isolated remains with uncertain taxonomic and phylogenetic placement. A better understanding of the Australian dinosaurian record is crucial to understanding the global palaeobiogeography of dinosaurian groups, including groups previously considered to have had Gondwanan origins, such as the titanosaurs and carcharodontosaurids. Methodology/Principal Findings We describe three new dinosaurs from the late Early Cretaceous (latest Albian) Winton Formation of eastern Australia, including; Wintonotitan wattsi gen. et sp. nov., a basal titanosauriform; Diamantinasaurus matildae gen. et sp. nov., a derived lithostrotian titanosaur; and Australovenator wintonensis gen. et sp. nov., an allosauroid. We compare an isolated astragalus from the Early Cretaceous of southern Australia; formerly identified as Allosaurus sp., and conclude that it most-likely represents Australovenator sp. Conclusion/Significance The occurrence of Australovenator from the Aptian to latest Albian confirms the presence in Australia of allosauroids basal to the Carcharodontosauridae. These new taxa, along with the fragmentary remains of other taxa, indicate a diverse Early Cretaceous sauropod and theropod fauna in Australia, including plesiomorphic forms (e.g. Wintonotitan and Australovenator) and more derived forms (e.g. Diamantinasaurus). PMID:19584929

  5. New Mid-Cretaceous (latest Albian dinosaurs fromWinton, Queensland, Australia.

    Directory of Open Access Journals (Sweden)

    Scott A Hocknull

    Full Text Available BACKGROUND: Australia's dinosaurian fossil record is exceptionally poor compared to that of other similar-sized continents. Most taxa are known from fragmentary isolated remains with uncertain taxonomic and phylogenetic placement. A better understanding of the Australian dinosaurian record is crucial to understanding the global palaeobiogeography of dinosaurian groups, including groups previously considered to have had Gondwanan origins, such as the titanosaurs and carcharodontosaurids. METHODOLOGY/PRINCIPAL FINDINGS: We describe three new dinosaurs from the late Early Cretaceous (latest Albian Winton Formation of eastern Australia, including; Wintonotitan wattsi gen. et sp. nov., a basal titanosauriform; Diamantinasaurus matildae gen. et sp. nov., a derived lithostrotian titanosaur; and Australovenator wintonensis gen. et sp. nov., an allosauroid. We compare an isolated astragalus from the Early Cretaceous of southern Australia; formerly identified as Allosaurus sp., and conclude that it most-likely represents Australovenator sp. CONCLUSION/SIGNIFICANCE: The occurrence of Australovenator from the Aptian to latest Albian confirms the presence in Australia of allosauroids basal to the Carcharodontosauridae. These new taxa, along with the fragmentary remains of other taxa, indicate a diverse Early Cretaceous sauropod and theropod fauna in Australia, including plesiomorphic forms (e.g. Wintonotitan and Australovenator and more derived forms (e.g. Diamantinasaurus.

  6. A Gentle Frost: Poet Helen Frost Talks about the Healing Power of Poetry and Her Latest Novel

    Science.gov (United States)

    Margolis, Rick

    2006-01-01

    This article presents an interview with poet Helen Frost. Frost talked about how poetry can help at-risk children. She also related the challenges she faced when she wrote her latest book titled "The Braid."

  7. A STUDY PAPER HOW LATEST TECHNOLOGIES LIKES TABS AND DIGITAL MEDIA CAN PROVIDE EFFICIENT WAY TO LEARNING AND EDUCATION

    OpenAIRE

    Aditya Jain*, Aditya Sharma, Aditya Singh Baghel, Ambar Pathak

    2016-01-01

    The use of latest trends and technologies in academic research may now be changing with such a frequency in the universities in terms of faculties who teaches and students that learn. Each and every universities wants to not only improve the syllabus but they also want to upgrade their labs with latest use of hardware and software. They are also focusing upon the technological growth of the students and their students can also develop their applications in different zones like traffic managem...

  8. Clinical outcomes in ER+ HER2 -node-positive breast cancer patients who were treated according to the Recurrence Score results: evidence from a large prospectively designed registry.

    Science.gov (United States)

    Stemmer, Salomon M; Steiner, Mariana; Rizel, Shulamith; Geffen, David B; Nisenbaum, Bella; Peretz, Tamar; Soussan-Gutman, Lior; Bareket-Samish, Avital; Isaacs, Kevin; Rosengarten, Ora; Fried, Georgeta; McCullough, Debbie; Svedman, Christer; Shak, Steven; Liebermann, Nicky; Ben-Baruch, Noa

    2017-01-01

    The Recurrence Score® is increasingly used in node-positive ER+ HER2-negative breast cancer. This retrospective analysis of a prospectively designed registry evaluated treatments/outcomes in node-positive breast cancer patients who were Recurrence Score-tested through Clalit Health Services from 1/2006 through 12/2011 ( N  = 709). Medical records were reviewed to verify treatments/recurrences/survival. Median follow-up, 5.9 years; median age, 62 years; 53.9% grade 2; 69.8% tumors ≤ 2 cm; 84.5% invasive ductal carcinoma; 42.0% N1mi, and 37.2%/15.5%/5.2% with 1/2/3 positive nodes; 53.4% Recurrence Score < 18, 36.4% Recurrence Score 18-30, and 10.2% Recurrence Score ≥ 31. Overall, 26.9% received adjuvant chemotherapy: 7.1%, 39.5%, and 86.1% in the Recurrence Score < 18, 18-30, and ≥ 31 group, respectively. The 5-year Kaplan-Meier estimates for distant recurrence were 3.2%, 6.3%, and 16.9% for these respective groups and the corresponding 5-year breast cancer death estimates were 0.5%, 3.4%, and 5.7%. In Recurrence Score < 18 patients, 5-year distant-recurrence rates for N1mi/1 positive node/2-3 positive nodes were 1.2%/4.4%/5.4%. As patients were not randomized to treatment and treatment decision is heavily influenced by Recurrence Score, analysis of 5-year distant recurrence by chemotherapy use was exploratory and should be interpreted cautiously: In Recurrence Score < 18, recurrence rate was 7.7% in chemotherapy-treated ( n  = 27) and 2.9% in chemotherapy-untreated patients ( n  = 352); P  = 0.245. In Recurrence Score 18-30, recurrence rate in chemotherapy-treated patients ( n  = 102) was significantly lower than in untreated patients ( n  = 156) (1.0% vs. 9.7% P  = 0.019); in Recurrence Score ≤ 25 (the RxPONDER study cutoff), recurrence rate was 2.3% in chemotherapy-treated ( n  = 89) and 4.4% in chemotherapy-untreated patients ( n  = 488); P  = 0.521. In conclusion, our findings

  9. [Latest trends and recommendations on epidemiology, diagnosis, and treatment of benign prostatic hyperplasia (BPH)].

    Science.gov (United States)

    Gabuev, A; Oelke, M

    2011-05-01

    A re-evaluation of established tests and treatments has become necessary after publication of several new guidelines on BPH during the past two years. This article describes the latest developments concerning epidemiology, diagnosis, and treatment of BPH. Diagnostic and treatment guidelines on BPH of the German, European, or North American urologists as well as UK doctors were reviewed according to key articles and latest modifications. The only German epidemiological trial on BPH demonstrated that all components of the BPH disease (symptoms - prostate enlargement - bladder outlet obstruction) increase with ageing. 27 % of German men will have disease progression within the next 5 years. Risk factors for disease progression are: age, symptoms, prostate size, PSA, urinary flow rate, and postvoiding residual urine. Diagnosis aims to distinguish BPH from other diseases with similar symptoms, quantify the BPH components, and estimate the individual risk of disease progression. BPH is an exclusion diagnosis. Ultrasonic measurement of detrusor wall thickness at the anterior wall of bladders filled with ≥ 250 mL can securely detect bladder outlet obstruction if the value is ≥ 2 mm. Watchful waiting and lifestyle modifications are suitable for men with mild symptoms and low disease progression risk. All drugs used in BPH treatment reduce symptoms but have no influence on bladder outlet obstruction. α-blockers are first-line drugs and may be combined with muscarinic receptor antagonists or 5α-reductase inhibitors to further increase efficacy. Prostate surgery is indicated when drug treatment is insufficient, the patient develops complications in the upper or lower urinary tract (absolute indications), or has severe bladder outlet obstruction. Standard operations are TURP in small (≤ 80 mL) or open prostatectomy in large prostates (> 80 mL). Minimally invasive, alter-native surgeries may be considered in selected men and -offer advantages with regard to the risk of

  10. The latest results on top quark pair cross-section measurement

    CERN Document Server

    Yamauchi, Katsuya; The ATLAS collaboration

    2015-01-01

    The latest results on top quark pair production cross-section measurement in proton-proton collisions at $\\sqrt{s} = 7\\ TeV$ and $\\sqrt{s} = 8\\ TeV$ with the ATLAS detector are reported. The inclusive cross-section was measured with 4% of uncertainty using di-lepton e-mu events. The measurement of the differential cross-section as functions of various observables such as transverse momentum and rapidity of the top quark and invariant mass of the pseudo-top-quark pair system including the results in boosted topologies are also reported. These results are compared with the various generators such as Powheg, Alpgen and MC@NLO and the various PDF sets.

  11. Implementation of T-box/T/sup -1/-box based AES design on latest xilinx fpga

    International Nuclear Information System (INIS)

    Kundi, D.E.; Aziz, A.

    2015-01-01

    This work presents an efficient implementation of the AES (Advance Encryption Standard) based on Tbox/T-1-box design for both the encryption and decryption on FPGA (Field Programmable Gate Array). The proposed architecture not only make efficient use of full capacity of dedicated 32 Kb BRAM (Block RAM) of latest Xilinx FPGAs (Virtex-5, Virtex-6 and 7 Series) but also saves considerable amount of BRAM and logical resources by using multiple accesses from single BRAM in one cycle of system clock as compared to conventional LUT (Look-Up-Table) techniques. The proposed T-box/T-1-box based AES design for both the encryption and decryption fits into just 4 BRAMs on FPGA and results in good efficiency TPS (Throughput per Slice) with less power consumption. (author)

  12. The influence of the latest information and communication technology on the libraries in the primary schools

    Directory of Open Access Journals (Sweden)

    Franceska Žumer

    2000-01-01

    Full Text Available The article presents the information and communication equipment in primary school libraries and the end usage of the above mentioned technology. A detailed research, including 109 primary schools throughout Slovenia, was performed. The research showed that the schools do not have the basic information technology needed to perform the latest and up-to-date services. Not a single library, included in the research, has a completely automated library collection. But the percentage of libraries, which do not perform automated lending and do not use the various offered possibilites of the already existing technology, automated collections and on-line library, is significantly lower. A systematic solution of the present situation is needed. Only in this way will school libraries be successfully included in the educational system of schools and will be able to perform the library inter-subject information knowledge and information literacy programs in the new nine-year primary school.

  13. Suicide among young people in Spain: Facts and possible causes. An analysis of latest data available

    Directory of Open Access Journals (Sweden)

    Noelia Navarro-Gómez

    2017-03-01

    Full Text Available Suicide is the third leading cause of death in the age group between 15 to 29 years, surpassed only by external causes of death and tumors according to the National Institute of Statistics. The latest data available shows that 310 children and young people under 30 took their own lives, which represents 7.77% of all suicide victims. This article aims to extensively describe the state of the art from the data available in the literature, based on the overview worldwide. The causes that can lead to such acts are discussed, indicating the presence of psychological disorders, specific personality variables, the high burden of emotional stress or bullying, lately displaced by new variants such as cyberbullying or sexting.

  14. Latest astronomical constraints on some non-linear parametric dark energy models

    Science.gov (United States)

    Yang, Weiqiang; Pan, Supriya; Paliathanasis, Andronikos

    2018-04-01

    We consider non-linear redshift-dependent equation of state parameters as dark energy models in a spatially flat Friedmann-Lemaître-Robertson-Walker universe. To depict the expansion history of the universe in such cosmological scenarios, we take into account the large-scale behaviour of such parametric models and fit them using a set of latest observational data with distinct origin that includes cosmic microwave background radiation, Supernove Type Ia, baryon acoustic oscillations, redshift space distortion, weak gravitational lensing, Hubble parameter measurements from cosmic chronometers, and finally the local Hubble constant from Hubble space telescope. The fitting technique avails the publicly available code Cosmological Monte Carlo (COSMOMC), to extract the cosmological information out of these parametric dark energy models. From our analysis, it follows that those models could describe the late time accelerating phase of the universe, while they are distinguished from the Λ-cosmology.

  15. Controlled thermonuclear fusion and the latest progress on China's HT-7 superconducting tokamak

    International Nuclear Information System (INIS)

    Li Jiangang; Yang Yu

    2003-01-01

    After 50 years of research on controlled thermonuclear fusion, a new stage will be reached in 2003, when a site for the International Thermonuclear Experimental Reactor project will be chosen to start the construction. Scientists hope that this project could herald a new era in which the energy problem will be solved completely. The great progress made on the HT-7 superconducting tokamak in China has provided positive and powerful support for fusion research. The HT-7 is one of the only two superconducting tokamaks in the world that can carry out minute-scale high temperature plasma research, and has achieved a duration of 63.95s for the hot plasma discharge. This is a major step towards real steady-state operation of the tokamak configuration. We present an overview of the latest progress on the tokamak experiments in the Institute of Plasma Physics, Chinese Academy of Sciences

  16. Evaluation of Risk Metrics for KHNP Reference Plants Using the Latest Plant Specific Data

    International Nuclear Information System (INIS)

    Jeon, Ho Jun; Hwang, Seok Won; Ghi, Moon Goo

    2010-01-01

    As Risk-Informed Applications (RIAs) are actively implemented in the nuclear industry, an issue associated with the technical adequacy of the Probabilistic Safety Assessment (PSA) arises in its data sources. The American Society of Mechanical Engineers (ASME) PRA standard suggests the use of component failure data that represent the as-built and as-operated plant conditions. Furthermore, the peer reviews for the KHNP reference plants stated that the component failure data should be updated to reflect the latest plant specific data available. For ensuring the technical adequacy in PSA data elements, we try to update component failure data to reflect the as-operated plant conditions, and a trend analysis of the failure data is implemented. In addition, by applying the updated failure data to the PSA models of the KHNP reference plants, the risk metrics of Core Damage Frequency (CDF) and Large Early Release Frequency (LERF) are evaluated

  17. The latest occupational radiation exposure data from U.S. Nuclear Regulatory Commission Licensees

    International Nuclear Information System (INIS)

    Brock, T.

    2007-01-01

    This presentation summarizes the latest - 2005 occupational exposure data that are maintained in the U.S. Nuclear Regulatory Commission (NRC) Radiation Exposure Information and Reporting System. The bulk of the information contained in the paper was compiled from the 2005 annual reports submitted by NRC licensees subject to the reporting requirements of U.S. regulations (10 CFR 20.2206). Those licensees subject to reporting include commercial nuclear power plants, industrial radiographers, fuel processors, independent spent fuel storage installations, manufacturers and distributors of by-product material, facilities for low-level waste disposal, and geologic repositories for high-level waste. The annual reports submitted by these licensees consist of radiation exposure records for each monitored individual. These records are analyzed for trends and presented in terms of collective dose and the distribution of doses by licensee category. (author)

  18. Testing cosmic transparency with the latest baryon acoustic oscillations and type Ia supernovae data

    International Nuclear Information System (INIS)

    Chen Jun; Yu Hong-Wei; Li Zheng-Xiang; Wu Pu-Xun

    2013-01-01

    Observations show that Type Ia supernovae (SNe Ia) are dimmer than expected from a matter dominated Universe. It has been suggested that this observed phenomenon can also be explained using light absorption instead of dark energy. However, there is a serious degeneracy between the cosmic absorption parameter and the present matter density parameter Ω m when one tries to place constraints on the cosmic opacity using SNe Ia data. We combine the latest baryon acoustic oscillation (BAO) and Union2 SNe Ia data in order to break this degeneracy. Assuming a flat ΛCDM model, we find that, although an opaque Universe is favored by SNe Ia+BAO since the best fit value of the cosmic absorption parameter is larger than zero, Ω m = 1 is ruled out at the 99.7% confidence level. Thus, cosmic opacity is not sufficient to account for the present observations and dark energy or modified gravity is still required.

  19. Latest developments in on- and off-line inspection of bank notes during production

    Science.gov (United States)

    Brown, Stephen C.

    2004-06-01

    The inspection of bank notes is a highly labour intensive process where traditionally every note on every sheet is inspected manually. However with the advent of more and more sophisticated security features, both visible and invisible, and the requirement of cost reduction in the printing process, it is clear that automation is required. Machines for the automatic inspection of bank notes have been on the market for the past 10 to 12 years, but recent developments in technology have enabled a new generation of detectors and machines to be developed. This paper focuses on the latest developments in both the off-line and on-line inspection of bank notes covering not only the visible spectrum but also a new range of detectors for inspection some of the more common invisible features used as covert features in today's bank notes.

  20. Latest Results of Open Heavy Flavor and Quarkonia from the PHENIX Experiment at RHIC

    International Nuclear Information System (INIS)

    Nouicer, Rachid

    2017-01-01

    The PHENIX Collaboration carries out a comprehensive physics program which studies heavy flavor production in relativistic heavy ion collisions at RHIC. The discovery at RHIC of large high-p T suppression and flow of electrons from heavy quarks flavors have altered our view of the hot and dense matter formed in central Au+Au collisions at GeV. These results suggest a large energy loss and flow of heavy quarks in the hot, dense matter. In recent years, the PHENIX has installed a silicon vertex tracker both in central rapidity (VTX) and in forward rapidity (FVTX) regions, and has collected large data samples. These two silicon trackers enhance the capability of heavy flavor measurements via precision tracking. This paper summarizes some of the latest PHENIX results concerning open heavy flavor and quarkonia production as a function of rapidity, energy and system size. (paper)

  1. Latest progress of BIGH3 gene in corneal diseases and diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Fan-Qian Song

    2017-03-01

    Full Text Available BIGH3 gene plays an important role in ocular diseases. On the one hand, it is closely related to the occurrence of corneal diseases. BIGH3 gene can inhibit corneal neovascularization, lead to corneal dystrophy, participate in keratoconus formation. On the other hand, it can lead to the formation of neovascularization in diabetic retinopathy. The latest experiments show that TGF beta secreted by macrophages can promote the expression of BIGH3 mRNA and BIGH3 protein, and promote apoptosis of retinal endothelial cells and pericytes, which leads to the formation of neovascularization in diabetic retinopathy. This article will describe the new progress of BIGH3 gene in ocular diseases from several aspects as mentioned above.

  2. Latest Results on Top Quark Properties: \\\\ Deciphering the DNA of the heaviest quark

    CERN Document Server

    Gallinaro, Michele

    2017-01-01

    The top quark, the heaviest known elementary particle discovered at the Fermilab Tevatron more than twenty years ago, has taken a central role in the study of fundamental interactions. Due to its large mass, the top quark provides a unique environment for tests of the standard model. With a cumulative luminosity of more than 100~fb$^{-1}$ collected at $\\sqrt{s}=7,8,13$~TeV by each of the ATLAS and CMS experiments at the Large Hadron Collider in the first ten years of operation, top quark physics is probing uncharted territories in precision and rare measurements with sensitivity to New Physics processes. This document summarizes the latest experimental measurements and studies of top quark properties.

  3. The extended range neutron rem counter LINUS: overview and latest developments

    International Nuclear Information System (INIS)

    Birattari, C.; Rancati, T.; Esposito, A.; Pelliccioni, M.; Ferrari, A.; Silari, M.

    1997-01-01

    The 'history' of the extended range neutron rem counter LINUS, since its first conception in 1990 is reviewed, along with the latest developments. These include the calibration of the initially cylindrical version with nearly monoenergetic neutrons in the energy range 34-66 MeV, a detailed evaluation of the anisotropy of its response function, the construction and calibration of an improved spherical version, and recent measurements in reference high energy stray radiation fields. The instrument can now be considered as being fully characterized. Similar monitors built by other laboratories following the present design have confirmed its performances. The instrument is now in semi-routine use at a number of particle accelerator facilities and is one of several devices used on-board of aircrafts for assessing the exposure to cosmic rays at commercial flight altitudes. (author)

  4. Latest Development in Superconducting RF Structures for beta=1 Particle Acceleration

    International Nuclear Information System (INIS)

    Peter Kneisel

    2006-01-01

    Superconducting RF technology is since nearly a decade routinely applied to different kinds of accelerating devices: linear accelerators, storage rings, synchrotron light sources and FEL's. With the technology recommendation for the International Linear Collider (ILC) a year ago, new emphasis has been placed on improving the performance of accelerating cavities both in Q-value and in accelerating gradients with the goal to achieve performance levels close to the fundamental limits given by the material parameters of the choice material, niobium. This paper will summarize the challenges to SRF technology and will review the latest developments in superconducting structure design. Additionally, it will give an overview of the newest results and will report on the developments in alternative materials and technologies

  5. Beam calorimetry at the large negative ion source test facility ELISE: Experimental setup and latest results

    International Nuclear Information System (INIS)

    Nocentini, Riccardo; Bonomo, Federica; Ricci, Marina; Pimazzoni, Antonio; Fantz, Ursel; Heinemann, Bernd; Riedl, Rudolf; Wünderlich, Dirk

    2016-01-01

    Highlights: • ELISE is the first step in the European roadmap for the development of the ITER NBI. • Several beam diagnostic tools have been installed, the latest results are presented. • A gaussian fit procedure has been implemented to characterize the large ion beam. • Average beamlet group inhomogeneity is maximum 13%, close to the ITER target of 10%. • Beam divergence measured by calorimeter agrees with the BES measurements within 30%. - Abstract: The test facility ELISE is the first step within the European roadmap for the development of the ITER NBI system. ELISE is equipped with a 1 × 0.9 m"2 radio frequency negative ion source (half the ITER source size) and an ITER-like 3-grid extraction system which can extract an H"− or D"− beam for 10 s every 3 min (limited by available power supplies) with a total acceleration voltage of up to 60 kV. In the beam line of ELISE several beam diagnostic tools have been installed with the aim to evaluate beam intensity, divergence and uniformity. A copper diagnostic calorimeter gives the possibility to measure the beam power density profile with high resolution. The measurements are performed by an IR micro-bolometer camera and 48 thermocouples embedded in the calorimeter. A gaussian fit procedure has been implemented in order to characterize the large negative ion beam produced by ELISE. The latest results obtained from the beam calorimetry at ELISE show that the average beamlet group inhomogeneity is maximum 13%. The measured beam divergence agrees with the one measured by beam emission spectroscopy within 30%.

  6. Relationship between the latest activity of mare volcanism and topographic features of the Moon

    Science.gov (United States)

    Kato, Shinsuke; Morota, Tomokatsu; Yamaguchi, Yasushi; Watanabe, Sei-ichiro; Otake, Hisashi; Ohtake, Makiko

    2016-04-01

    Lunar mare basalts provide insights into compositions and thermal history of lunar mantle. According to crater counting analysis with remote sensing data, the model ages of mare basalt units indicate a second peak of magma activity at the end of mare volcanism (~2 Ga), and the latest eruptions were limited in the Procellarum KREEP Terrane (PKT), which has high abundances of heat-producing elements. In order to understand the mechanism for causing the second peak and its magma source, we examined the correlation between the titanium contents and eruption ages of mare basalt units using compositional and chronological data updated by SELENE/Kaguya. Although no systematic relationship is observed globally, a rapid increase in mean titanium (Ti) content occurred at 2.3 Ga in the PKT, suggesting that the magma source of mare basalts changed at that time. The high-Ti basaltic eruption, which occurred at the late stage of mare volcanism, can be correlated with the second peak of volcanic activity at ~2 Ga. The latest volcanic activity can be explained by a high-Ti hot plume originated from the core-mantle boundary. If the hot plume was occurred, the topographic features formed by the hot plume may be remained. We calculated the difference between topography and selenoid and found the circular feature like a plateau in the center of the PKT, which scale is ~1000 km horizontal and ~500 m vertical. We investigated the timing of ridge formation in the PKT by using stratigraphic relationship between mare basalts and ridges. The ridges were formed before and after the high-Ti basaltic eruptions and seem to be along with the plateau. These results suggest that the plateau formation is connected with the high-Ti basaltic eruptions.

  7. Characteristics in mineral compositions of lunar latest mare volcanism revealed from spectral data

    Science.gov (United States)

    Kato, S.; Morota, T.; Yamaguchi, Y.; Watanabe, S.; Otake, H.; Ohtake, M.; Nimura, T.

    2016-12-01

    Lunar mare basalts provide insights into the composition and thermal history of the lunar mantle. According to crater counting analysis with remote sensing data, the ages of mare basalts suggest a first peak of magma activity at 3.2-3.8 Ga and a second peak at 2 Ga. In order to understand the mechanism for causing the second peak and its magma source, we reassess the correlation between the titanium contents and the eruption ages of mare basalt units using the compositional and chronological data updated by SELENE (Kaguya). In the Procellarum KREEP Terrane, where the latest mare basalt units are concentrated, an increase in the mean titanium content is observed in the Eratosthenian Period, as reported by previous studies. We found that, however, a rapid increase in mean titanium content occurred near 2.3 Ga. This result suggests that the magma source of the mare basalts changed at this particular age. Moreover, the high-titanium basaltic eruptions are correlated with the second peak in mare volcanism at 2 Ga. The latest mare volcanism may have been induced by a super-hot plume originating from the core-mantle boundary. In this study, to reveal the difference between the volcanic activities before and after 2.3 Ga, we developed the method to estimate the mineral components and elemental compositions of lunar mare basalts by using the Kaguya Spectral Profiler data. We will introduce the detail of the method and discuss about the difference between the mineral compositions of mare basalts before and after 2.3 Ga based on our preliminary results.

  8. A fuel thermal conductivity correlation based on the latest experimental results

    International Nuclear Information System (INIS)

    Sontheimer, F.; Landskron, H.; Billaux, M.R.

    2000-01-01

    A new fuel thermal conductivity (ftc) correlation for UO 2 and (U,Gd)O 2 is presented, which is based on the relaxation-time theory of Klemens. The correlation is chosen because of its validity in a wide range of defect concentrations as for instance encountered in fuel with a wide range of burnup and gadolinia additions, as has been shown by Ishimoto. The phonon term of the new correlation has the form 1/x·arctan(x) , where x is a measure of the defect concentration introduced by burnup and gadolinia additions. For low defect concentrations, this term is identical with the classical form for the phonon term 1/(A+B.T). At high defect concentrations, however, when phonon-point defect scattering starts dominating over phonon-phonon scattering, the new correlation deviates from the classical formulation and has a distinctly weaker dependence on temperature and defect concentration than the classical form. The new arctan correlation in combination with an appropriate electronic ftc term is fitted to the Halden data base of fuel centre-line temperature measurements (represented by the ''Halden ftc correlation recommendation''). Agreement is very good up to a burnup of about 60 MWd/kgU; beyond, the arctan form has a saturating burnup degradation. The new arctan correlation in combination with an appropriate electronic ftc term is also shown to describe very well our latest ftc measurements on unirradiated gadolinia fuel up to 9% gadolinia content. Application to Halden measurements up to very high burnup is successful, when combined with the so-called ''rim-effect'', which counteracts the saturation tendency of the new correlation at high burnup. Latest laser thermal diffusivity measurements on irradiated gadolinia fuel in the frame of the NFIR program, although not yet open for literature and not discussed in the paper, indicate very good agreement with the new arctan correlation. (author)

  9. Evaluating Outcomes from Stakeholders' Perception: Evidence from ...

    African Journals Online (AJOL)

    2016-10-02

    Oct 2, 2016 ... Using mixed methods research design and indicators, this paper assesses the .... PME approaches are used for improving project planning, implementation .... Ijaiya (2006) combined quantitative and qualitative research ...

  10. Betting Decision Under Break-Streak Pattern: Evidence from Casino Gaming.

    Science.gov (United States)

    Fong, Lawrence Hoc Nang; So, Amy Siu Ian; Law, Rob

    2016-03-01

    Cognitive bias is prevalent among gamblers, especially those with gambling problems. Grounded in the heuristics theories, this study contributes to the literature by examining a cognitive bias triggered by the break streak pattern in the casino setting. We postulate that gamblers tend to bet on the latest outcome when there is a break-streak pattern. Moreover, three determinants of the betting decision under break-streak pattern, including the streak length of the alternative outcome, the frequency of the latest outcome, and gender, were identified and examined in this study. A non-participatory observational study was conducted among the Cussec gamblers in a casino in Macao. An analysis of 1229 bets confirms our postulation, particularly when the streak of the alternative outcome is long, the latest outcome is frequent, and the gamblers are females. The findings provide meaningful implications for casino management and public policymakers regarding the minimization of gambling harm.

  11. Content validity--establishing and reporting the evidence in newly developed patient-reported outcomes (PRO) instruments for medical product evaluation: ISPOR PRO good research practices task force report: part 1--eliciting concepts for a new PRO instrument.

    Science.gov (United States)

    Patrick, Donald L; Burke, Laurie B; Gwaltney, Chad J; Leidy, Nancy Kline; Martin, Mona L; Molsen, Elizabeth; Ring, Lena

    2011-12-01

    The importance of content validity in developing patient reported outcomes (PRO) instruments is stressed by both the US Food and Drug Administration and the European Medicines Agency. Content validity is the extent to which an instrument measures the important aspects of concepts that developers or users purport it to assess. A PRO instrument measures the concepts most significant and relevant to a patient's condition and its treatment. For PRO instruments, items and domains as reflected in the scores of an instrument should be important to the target population and comprehensive with respect to patient concerns. Documentation of target population input in item generation, as well as evaluation of patient understanding through cognitive interviewing, can provide the evidence for content validity. Developing content for, and assessing respondent understanding of, newly developed PRO instruments for medical product evaluation will be discussed in this two-part ISPOR PRO Good Research Practices Task Force Report. Topics include the methods for generating items, documenting item development, coding of qualitative data from item generation, cognitive interviewing, and tracking item development through the various stages of research and preparing this tracking for submission to regulatory agencies. Part 1 covers elicitation of key concepts using qualitative focus groups and/or interviews to inform content and structure of a new PRO instrument. Part 2 covers the instrument development process, the assessment of patient understanding of the draft instrument using cognitive interviews and steps for instrument revision. The two parts are meant to be read together. They are intended to offer suggestions for good practices in planning, executing, and documenting qualitative studies that are used to support the content validity of PRO instruments to be used in medical product evaluation. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR

  12. Evaluation of MR issues for the latest standard brands of orthopedic metal implants: plates and screws.

    Science.gov (United States)

    Zou, Yue-Fen; Chu, Bin; Wang, Chuan-Bing; Hu, Zhi-Yi

    2015-03-01

    The study was performed to evaluate magnetic resonance (MR) issues for the latest standard brands of plates and screws used in orthopedic surgery at a 1.5-T MR system, including the safety and metallic artifacts. The plates and screws (made of titanium alloy and stainless steel materials, according to the latest standard brands) were assessed for displacement in degrees, MRI-related heating and artifacts at a 1.5-T MR system. The displacement in degrees of the plates and screws was evaluated on an angel-measurement instrument at the entrance of the MR scanner. The MRI-related heating was assessed on a swine leg fixed with a plate by using a "worst-case" pulse sequence. A rectangular water phantom was designed to evaluate metallic artifacts of a screw on different sequences (T1/T2-weighted FSE, STIR, T2-FSE fat saturation, GRE, DWI) and then artifacts were evaluated on T2-weighted FSE sequence by modifying the scanning parameters including field of view (FOV), echo train length (ETL) and bandwidth to identify the influence of parameters on metallic artifacts. 15 volunteers with internal vertebral fixation (titanium alloy materials) were scanned with MR using axial and sagittal T2-FSE, sagittal T2-FSE fat suppression and STIR with conventional and optimized parameters, respectively. Then all images were graded by two experienced radiologists having the experience of more than 7 years under double-blind studies that is neither of them knew which was conventional parameter group and optimized parameter group. The average deflection angle of titanium alloy and stainless steel implants were 4.3° and 7.7°, respectively, (less than 45°) which indicated that the magnetically induced force was less than the weight of the object. The deflection angle of the titanium alloy implants was less than the stainless steel one (t=9.69, Ptitanium alloy before and after the scan was 0.48°C and stainless steel implants was 0.74°C, respectively, with the background temperature

  13. Latest Results on 2-FGHP Tetrode To Fulfill ITER ICRH Requirements

    International Nuclear Information System (INIS)

    Robert, Ch.

    2006-01-01

    The requirements for the RF generation of ITER ICRH include several parameters that are not compatible for a tetrode to fulfill. High power, from 1.7 to 2.5 MW according to the ICRH design options, have to combined with, both, a cw operation (more than 1000 seconds of continuous running time) and a high VSWR (higher than 1:2.0), over the required frequency range of 40 to 56 MHz. The proposed paper will overview the existing tetrodes on the market used in similar type of operations, i.e. in fusion applications. This analysis shows clearly the limitations of the conventional tetrode technology that can only fulfill some of the ICRH requirements, but not all together. The first part of the paper will describe the latest results on conventional tetrodes, after years of operation at TORE SUPRA and JET, for which tetrodes such as TH 525 and TH 526 are used. The results clearly indicate that tetrodes are well suited for Fusion applications but not with the combination of parameters necessary for ITER ICRH. The second part will describe the extended performance tetrodes, based on a Double Folded Grid High Performance (2-FGHP) tetrode technology, used for scientific and TV broadcast applications for years. This 2-FGHP concept extends drastically the performance of tetrodes, either in terms of frequency, or power or pulse duration, allowing such tetrodes to be used in ITER. The third part shows results of operation in these scientific and broadcast areas of 2-FGHP tetrodes in order to demonstrate the advantages of this technology over conventional tetrodes. Real operation data allow to give performance together with duration of operation in full service, on a 24 hour per day basis. Finally the last part will be dedicated to present the latest results obtained in a Fusion type tests at Thales Electron Devices in 2006 of a 2-FGHP tetrode. These results show the possibilities of this technology to fulfill ITER ICRH requirements and its capabilities to allow some evolutions of

  14. Evidence for the MSW effect

    International Nuclear Information System (INIS)

    Fogli, Gianluigi; Lisi, Eligio

    2004-01-01

    Recent solar and reactor neutrino data have convincingly established that electron neutrinos and antineutrinos are subject to flavour transitions driven by neutrino masses and mixing. In addition, such data can be used to prove that the interaction of neutrinos in matter modifies the flavour transition pattern with respect to the case of propagation in vacuum, as predicted long ago by Mikheyev, Smirnov and Wolfenstein (MSW). We present a brief review of how the current evidence for MSW solar neutrino transitions has developed in recent years, and how it has been strengthened by the latest reactor neutrino data presented at the Neutrino 2004 Conference

  15. Evidence for the MSW effect

    Science.gov (United States)

    Fogli, Gianluigi; Lisi, Eligio

    2004-10-01

    Recent solar and reactor neutrino data have convincingly established that electron neutrinos and antineutrinos are subject to flavour transitions driven by neutrino masses and mixing. In addition, such data can be used to prove that the interaction of neutrinos in matter modifies the flavour transition pattern with respect to the case of propagation in vacuum, as predicted long ago by Mikheyev, Smirnov and Wolfenstein (MSW). We present a brief review of how the current evidence for MSW solar neutrino transitions has developed in recent years, and how it has been strengthened by the latest reactor neutrino data presented at the Neutrino 2004 Conference.

  16. Evidence-based management.

    Science.gov (United States)

    Pfeffer, Jeffrey; Sutton, Robert I

    2006-01-01

    For the most part, managers looking to cure their organizational ills rely on obsolete knowledge they picked up in school, long-standing but never proven traditions, patterns gleaned from experience, methods they happen to be skilled in applying, and information from vendors. They could learn a thing or two from practitioners of evidence-based medicine, a movement that has taken the medical establishment by storm over the past decade. A growing number of physicians are eschewing the usual, flawed resources and are instead identifying, disseminating, and applying research that is soundly conducted and clinically relevant. It's time for managers to do the same. The challenge is, quite simply, to ground decisions in the latest and best knowledge of what actually works. In some ways, that's more difficult to do in business than in medicine. The evidence is weaker in business; almost anyone can (and many people do) claim to be a management expert; and a motley crew of sources--Shakespeare, Billy Graham,Jack Welch, Attila the Hunare used to generate management advice. Still, it makes sense that when managers act on better logic and strong evidence, their companies will beat the competition. Like medicine, management is learned through practice and experience. Yet managers (like doctors) can practice their craft more effectively if they relentlessly seek new knowledge and insight, from both inside and outside their companies, so they can keep updating their assumptions, skills, and knowledge.

  17. Constraints on inflation revisited. An analysis including the latest local measurement of the Hubble constant

    Energy Technology Data Exchange (ETDEWEB)

    Guo, Rui-Yun [Northeastern University, Department of Physics, College of Sciences, Shenyang (China); Zhang, Xin [Northeastern University, Department of Physics, College of Sciences, Shenyang (China); Peking University, Center for High Energy Physics, Beijing (China)

    2017-12-15

    We revisit the constraints on inflation models by using the current cosmological observations involving the latest local measurement of the Hubble constant (H{sub 0} = 73.00 ± 1.75 km s{sup -1} Mpc{sup -1}). We constrain the primordial power spectra of both scalar and tensor perturbations with the observational data including the Planck 2015 CMB full data, the BICEP2 and Keck Array CMB B-mode data, the BAO data, and the direct measurement of H{sub 0}. In order to relieve the tension between the local determination of the Hubble constant and the other astrophysical observations, we consider the additional parameter N{sub eff} in the cosmological model. We find that, for the ΛCDM+r+N{sub eff} model, the scale invariance is only excluded at the 3.3σ level, and ΔN{sub eff} > 0 is favored at the 1.6σ level. Comparing the obtained 1σ and 2σ contours of (n{sub s},r) with the theoretical predictions of selected inflation models, we find that both the convex and the concave potentials are favored at 2σ level, the natural inflation model is excluded at more than 2σ level, the Starobinsky R{sup 2} inflation model is only favored at around 2σ level, and the spontaneously broken SUSY inflation model is now the most favored model. (orig.)

  18. Latest Pleistocene and Holocene glacial events in the Colonia valley, Northern Patagonia Icefield, southern Chile

    Science.gov (United States)

    Nimick, David A.; Mcgrath, Daniel; Mahan, Shannon; Friesen, Beverly A.; Leidich, Jonathan

    2016-01-01

    The Northern Patagonia Icefield (NPI) is the primary glaciated terrain worldwide at its latitude (46.5–47.5°S), and constraining its glacial history provides unique information for reconstructing Southern Hemisphere paleoclimate. The Colonia Glacier is the largest outlet glacier draining the eastern NPI. Ages were determined using dendrochronology, lichenometry, radiocarbon, cosmogenic 10Be and optically stimulated luminescence. Dated moraines in the Colonia valley defined advances at 13.2 ± 0.95, 11.0 ± 0.47 and 4.96 ± 0.21 ka, with the last being the first constraint on the onset of Neoglaciation for the eastern NPI from a directly dated landform. Dating in the tributary Cachet valley, which contains an ice-dammed lake during periods of Colonia Glacier expansion, defined an advance at ca. 2.95 ± 0.21 ka, periods of advancement at 810 ± 49 cal a BP and 245 ± 13 cal a BP, and retreat during the intervening periods. Recent Colonia Glacier thinning, which began in the late 1800s, opened a lower-elevation outlet channel for Lago Cachet Dos in ca. 1960. Our data provide the most comprehensive set of Latest Pleistocene and Holocene ages for a single NPI outlet glacier and expand previously developed NPI glacial chronologies.

  19. Chemical sensors for breath gas analysis: the latest developments at the Breath Analysis Summit 2013.

    Science.gov (United States)

    Tisch, Ulrike; Haick, Hossam

    2014-06-01

    Profiling the body chemistry by means of volatile organic compounds (VOCs) in the breath opens exciting new avenues in medical diagnostics. Gas sensors could provide ideal platforms for realizing portable, hand-held breath testing devices in the near future. This review summarizes the latest developments and applications in the field of chemical sensors for diagnostic breath testing that were presented at the Breath Analysis Summit 2013 in Wallerfangen, Germany. Considerable progress has been made towards clinically applicable breath testing devices, especially by utilizing chemo-sensitive nanomaterials. Examples of several specialized breath testing applications are presented that are either based on stand-alone nanomaterial-based sensors being highly sensitive and specific to individual breath compounds over others, or on combinations of several highly specific sensors, or on experimental nanomaterial-based sensors arrays. Other interesting approaches include the adaption of a commercially available MOx-based sensor array to indirect breath testing applications, using a sample pre-concentration method, and the development of compact integrated GC-sensor systems. The recent trend towards device integration has led to the development of fully integrated prototypes of point-of-care devices. We describe and compare the performance of several prototypes that are based on different sensing technologies and evaluate their potential as low-cost and readily available next-generation medical devices.

  20. Error Analysis and Evaluation of the Latest GSMap and IMERG Precipitation Products over Eastern China

    Directory of Open Access Journals (Sweden)

    Shaowei Ning

    2017-01-01

    Full Text Available The present study comprehensively analyzes error characteristics and performance of the two latest GPM-era satellite precipitation products over eastern China from April 2014 to March 2016. Analysis results indicate that the two products have totally different spatial distributions of total bias. Many of the underestimations for the GSMap-gauged could be traced to significant hit bias, with a secondary contribution from missed precipitation. For IMERG, total bias illustrates significant overestimation over most of the eastern part of China, except upper reaches of Yangtze and Yellow River basins. GSMap-gauged tends to overestimate light precipitation (<16 mm/day and underestimate precipitation with rain rate larger than 16 mm/day; however, IMERG underestimates precipitation at rain rate between 8 and 64 mm/day and overestimates precipitation at rain rate more than 64 mm/day. IMERG overestimates extreme precipitation indices (RR99P and R20TOT, with relative bias values of 17.9% and 11.5%, respectively. But GSMap-gauged shows significant underestimation of these indices. In addition, both products performed well in the Huaihe, Liaohe, and Yangtze River basins for extreme precipitation detection. At basin scale comparisons, the GSMap-gauged data has a relatively higher accuracy than IMERG, especially at the Haihe, Huaihe, Liaohe, and Yellow River basins.

  1. Latest status of the Japanese LCT coil and the domestic test facility

    International Nuclear Information System (INIS)

    Shimamoto, S.; Ando, T.; Hiyama, T.

    1981-01-01

    The Japan Atomic Energy Research Institute (JAERI), representing Japan, is now making one of six test coils for the International Energy Agency's (IEA) Large Coil Task(LCT). The Japanese LCT coil, which has a stored energy of 120 MJ, is based on a NgTi conductor, is pool-cooled, has a maximum field of 8T, and is edgewise, double-pancake wound, was completed in October, 1981. The LCT coil will be tested in the newly constructed domestic test facility up to its rated current in November, 1981, before transportation ORNL. The domestic test facility, which is composed of a cryogenic system a vacuum system, a power supply with protection system, and a data acqusition and control system, was completed and its performance measured at a new building for the LCT test at JSAERI in June, 1981. This paper describes the latest construction status of the Japanese LCT coil and the domestic test facility. The performance of the domestic test facility is described in this paper

  2. Intermittent transport across the scrape-off layer: latest results from ASDEX Upgrade

    International Nuclear Information System (INIS)

    Kočan, M.; Müller, H.W.; Lunt, T.; Bernert, M.; Conway, G.D.; De Marné, P.; Eich, T.; Herrmann, A.; Kallenbach, A.; Maraschek, M.; Müller, S.; Nold, B.; Huang, Z.; Adámek, J.; Horacek, J.; Komm, M.; Allan, S.Y.; Elmore, S.; Gennrich, F.P; Mehlmann, F.

    2013-01-01

    We report the latest results of turbulence and transport studies in the ASDEX Upgrade scrape-off layer (SOL). Dissimilarity between the plasma and the floating potential fluctuations is studied experimentally and by gyrofluid simulations. Measurements by a retarding field analyser reveal that both, edge-localized mode (ELM) and turbulent filaments, convey hot ions over large radial distances in the SOL. The measured far SOL ELM ion temperature increases with the ELM energy, consistent with earlier observations that large ELMs deposit a large fraction of their energy outside the divertor. In the SOL, the ELM suppression by magnetic perturbations (MPs) results in lower ELM ion energy in the far SOL. At the same time, large filaments of ion saturation current are replaced by more continuous bursts. Splitting of the divertor strike zones observed by the infrared imaging in H-mode with MPs agree with predictions from the EMC3-Eirene simulations. This suggests that the ‘lobe’ structures due to perturbation fields observed near the X-point are not significantly affected by plasma screening, and can be described by a vacuum approach, as in the EMC3-Eirene. Finally, some effects of the MPs on the L-mode SOL are addressed. (paper)

  3. Latest experiences and future plans on NSLS-II insertion devices

    Energy Technology Data Exchange (ETDEWEB)

    Tanabe, T.; Hidaka, Y.; Kitegi, C.; Hidas, D.; Musardo, M.; Harder, D. A.; Rank, J.; Cappadoro, P.; Fernandes, H.; Corwin, T. [Energy Sciences Directorate, Brookhaven National Laboratory, Upton, NY 11973, U.S.A (United States)

    2016-07-27

    National Synchrotron Light Source-II (NSLS-II) is the latest storage ring of 3 GeV energy at the Brookhaven National Laboratory (BNL). The horizontal emittance of the electron beam with the currently installed six damping wigglers is 0.9 nm.rad, which could be further reduced to 0.5 nm.rad with more insertion devices (IDs). With only one RF cavity the beam current is restricted to 200 mA. Five hundred mA operation is envisaged for next year with an addition of the second cavity. Six (plus two branches) beamlines have been commissioned in the initial phase of the project. In July 2015, three NIH funded beamlines called “Advanced Beamlines for Biological Investigations with X-rays” (ABBIX) will be added for operation. This paper describes the experiences of ID development, installation, and commissioning for the NSLS-II project as well as our future plans to improve the performance of the facility in terms of source development.

  4. Review of Rifaximin: Latest Treatment Frontier for Irritable Bowel Syndrome Mechanism of Action and Clinical Profile

    Directory of Open Access Journals (Sweden)

    Kamesh Gupta

    2017-08-01

    Full Text Available Background: Irritable bowel syndrome is classified as a functional gastrointestinal disorder with the primary symptom of abdominal pain in conjunction with bloating and bowel movement disorder. It affects up to 15% of the world’s population. Among its subtypes, the most common is diarrhoea predominant. However, the current treatment options for diarrhoea-predominant irritable bowel syndrome have had not very promising results; most, such as antispasmodics, only provide partial symptomatic relief. Treatment with antidepressants and alosetron (a 5HT3 antagonist has shown the most promise to date. The latest drug to be approved for the treatment of irritable bowel syndrome-diarrhoea is rifaximin, which was approved in May 2015. It is a minimally absorbed antibiotic that is used to change the gut microbiota. Small intestinal bacterial overgrowth is one of the causes suggested for irritable bowel syndrome, particularly for the diarrhoea-predominant type. There are various methods for detecting bacterial overgrowth, the simplest of which is breath tests. Rifaximin has been shown to be of benefit to these patients. Purpose: The purpose of the study is to discuss the potential mechanism of action of rifaximin, a minimally absorbed antibiotic. In addition, we evaluate the various clinical trials undertaken to study the efficacy and safety profile of rifaximin.

  5. Cryogen free high magnetic field and low temperature sample environments for neutron scattering - latest developments

    International Nuclear Information System (INIS)

    Burgoyne, John

    2016-01-01

    Continuous progress has been made over many years now in the provision of low- and ultra-low temperature sample environments, together with new high-field superconducting magnets and increased convenience for both the user and the neutron research facility via new cooling technologies. Within Oxford Instrument's experience, this has been achieved in many cases through close collaboration with neutron scientists, and with the neutron facilities' sample environment leaders in particular. Superconducting magnet designs ranging from compact Small Angle (SANS) systems up to custom-engineered wide-angle scattering systems have been continuously developed. Recondensing, or 'zero boil-off' (ZBO), systems are well established for situations in which a high field magnet is not conducive to totally cryogen free cooling solutions, and offer a reliable route with the best trade-offs of maximum system capability versus running costs and user convenience. Fully cryogen free solutions for cryostats, dilution refrigerators, and medium-field magnets are readily available. Here we will present the latest technology developments in these options, describing the state-of-the art, the relative advantages of each, and the opportunities they offer to the neutron science community. (author)

  6. [Latest trends in the surgical management of mandibular condyle fractures in France, 2005-2012].

    Science.gov (United States)

    Trost, O; Péron, J-M

    2013-12-01

    The surgical treatment of mandibular condylar fractures is commonly performed. We had for aim to present the latest trends in the surgical management of condylar fractures in France, between 2005 and 2012. A survey was performed among the 49 members of the French college of oral and maxillofacial surgeons between January and September 2012, with a questionnaire sent by email. We analyzed the therapeutic management, the surgical indications; the techniques used according to the fracture, and the postoperative treatment protocols. The data was compared to that of a similar study performed in 2005. The overall reply rate was 86%. Low subcondylar fractures were operated on in all institutions (100%), compared to 76% in 2005. The most popular technique was the high submandibular approach with intraoral miniplate fixation osteosynthesis. High subcondylar and diacapitular fractures were operated on in respectively 82% and 35% of the cases compared to 29% and 10% in 2005 with various surgical techniques and postoperative management. French maxillofacial surgeons operated on more mandibular condylar fractures in 2012 than in 2005. As observed in 2005, the lower and the more dislocated the fractures were, the more they were operated on. The high submandibular approach has become the most popular approach. The use of miniplates for bone fixation has become common. Diacapitular fractures were usually treated functionally. The postoperative management varied greatly from one team to the other. Copyright © 2013. Published by Elsevier Masson SAS.

  7. Global nickel anomaly links Siberian Traps eruptions and the latest Permian mass extinction.

    Science.gov (United States)

    Rampino, Michael R; Rodriguez, Sedelia; Baransky, Eva; Cai, Yue

    2017-09-29

    Anomalous peaks of nickel abundance have been reported in Permian-Triassic boundary sections in China, Israel, Eastern Europe, Spitzbergen, and the Austrian Carnic Alps. New solution ICP-MS results of enhanced nickel from P-T boundary sections in Hungary, Japan, and Spiti, India suggest that the nickel anomalies at the end of the Permian were a worldwide phenomenon. We propose that the source of the nickel anomalies at the P-T boundary were Ni-rich volatiles released by the Siberian volcanism, and by coeval Ni-rich magma intrusions. The peaks in nickel abundance correlate with negative δ 13 C and δ 18 O anomalies, suggesting that explosive reactions between magma and coal during the Siberian flood-basalt eruptions released large amounts of CO 2 and CH 4 into the atmosphere, causing severe global warming and subsequent mass extinction. The nickel anomalies may provide a timeline in P-T boundary sections, and the timing of the peaks supports the Siberian Traps as a contributor to the latest Permian mass extinction.

  8. Latest Development and Application of Nb-Bearing High Strength Pipeline Steels

    Science.gov (United States)

    Zhang, Yongqing; Shang, Chengjia; Guo, Aimin; Zheng, Lei; Niu, Tao; Han, Xiulin

    In order to solve the pollution problem emerging in China recently, China's central government is making great efforts to raise the percentage of natural gas consumption in the China's primary energy mix, which needs to construct big pipelines to transport natural gas from the nation's resource-rich western regions to the energy-starved east, as well as import from the Central Asia and Russia. With this mainstream trend, high strength, high toughness, heavy gauge, and large diameter pipeline steels are needed to improve the transportation efficiency. This paper describes the latest progresses in Nb-bearing high strength pipeline steels with regard to metallurgical design, development and application, including X80 coil with a thickness up to 22.0mm, X80 plate with a diameter as much as 1422mm, X80 plate with low-temperature requirements and low-Mn sour service X65 for harsh sour service environments. Moreover, based on widely accepted TMCP and HTP practices with low carbon and Nb micro-alloying design, this paper also investigated some new metallurgical phenomena based on powerful rolling mills and heavy ACC equipment.

  9. Latest Developments on Obtaining Accurate Measurements with Pitot Tubes in ZPG Turbulent Boundary Layers

    Science.gov (United States)

    Nagib, Hassan; Vinuesa, Ricardo

    2013-11-01

    Ability of available Pitot tube corrections to provide accurate mean velocity profiles in ZPG boundary layers is re-examined following the recent work by Bailey et al. Measurements by Bailey et al., carried out with probes of diameters ranging from 0.2 to 1.89 mm, together with new data taken with larger diameters up to 12.82 mm, show deviations with respect to available high-quality datasets and hot-wire measurements in the same Reynolds number range. These deviations are significant in the buffer region around y+ = 30 - 40 , and lead to disagreement in the von Kármán coefficient κ extracted from profiles. New forms for shear, near-wall and turbulence corrections are proposed, highlighting the importance of the latest one. Improved agreement in mean velocity profiles is obtained with new forms, where shear and near-wall corrections contribute with around 85%, and remaining 15% of the total correction comes from turbulence correction. Finally, available algorithms to correct wall position in profile measurements of wall-bounded flows are tested, using as benchmark the corrected Pitot measurements with artificially simulated probe shifts and blockage effects. We develop a new scheme, κB - Musker, which is able to accurately locate wall position.

  10. The infrared imaging spectrograph (IRIS) for TMT: latest science cases and simulations

    Science.gov (United States)

    Wright, Shelley A.; Walth, Gregory; Do, Tuan; Marshall, Daniel; Larkin, James E.; Moore, Anna M.; Adamkovics, Mate; Andersen, David; Armus, Lee; Barth, Aaron; Cote, Patrick; Cooke, Jeff; Chisholm, Eric M.; Davidge, Timothy; Dunn, Jennifer S.; Dumas, Christophe; Ellerbroek, Brent L.; Ghez, Andrea M.; Hao, Lei; Hayano, Yutaka; Liu, Michael; Lopez-Rodriguez, Enrique; Lu, Jessica R.; Mao, Shude; Marois, Christian; Pandey, Shashi B.; Phillips, Andrew C.; Schoeck, Matthias; Subramaniam, Annapurni; Subramanian, Smitha; Suzuki, Ryuji; Tan, Jonathan C.; Terai, Tsuyoshi; Treu, Tommaso; Simard, Luc; Weiss, Jason L.; Wincentsen, James; Wong, Michael; Zhang, Kai

    2016-07-01

    The Thirty Meter Telescope (TMT) first light instrument IRIS (Infrared Imaging Spectrograph) will complete its preliminary design phase in 2016. The IRIS instrument design includes a near-infrared (0.85 - 2.4 micron) integral field spectrograph (IFS) and imager that are able to conduct simultaneous diffraction-limited observations behind the advanced adaptive optics system NFIRAOS. The IRIS science cases have continued to be developed and new science studies have been investigated to aid in technical performance and design requirements. In this development phase, the IRIS science team has paid particular attention to the selection of filters, gratings, sensitivities of the entire system, and science cases that will benefit from the parallel mode of the IFS and imaging camera. We present new science cases for IRIS using the latest end-to-end data simulator on the following topics: Solar System bodies, the Galactic center, active galactic nuclei (AGN), and distant gravitationally-lensed galaxies. We then briefly discuss the necessity of an advanced data management system and data reduction pipeline.

  11. Cometary dust at the smallest scale - latest results of the MIDAS Atomic Force Microscope onboard Rosetta

    Science.gov (United States)

    Bentley, Mark; Torkar, Klaus; Jeszenszky, Harald; Romstedt, Jens; Schmied, Roland; Mannel, Thurid

    2015-04-01

    The MIDAS instrument onboard the Rosetta orbit is a unique combination of a dust collection and handling system and a high resolution Atomic Force Microscope (AFM). By building three-dimensional images of the dust particle topography, MIDAS addresses a range of fundamental questions in Solar System and cometary science. The first few months of dust collection and scanning revealed a deficit of smaller (micron and below) particles but eventually several 10 µm-class grains were discovered. In fact these were unexpectedly large and close to the limit of what is observable with MIDAS. As a result the sharp tip used by the AFM struck the particles from the side, causing particle breakage and distortion. Analyses so far suggest that the collected particles are fluffy aggregates of smaller sub-units, although determination of the size of these sub-units and high resolution re-imaging remains to be done. The latest findings will be presented here, including a description of the particles collected and the implications of these observations for cometary science and the Rosetta mission at comet 67P.

  12. Latest results of SEE measurements obtained by the STRURED demonstrator ASIC

    Energy Technology Data Exchange (ETDEWEB)

    Candelori, A. [INFN, Section of Padova, Via Marzolo 8, c.a.p. 35131, Padova (Italy); De Robertis, G. [INFN Section of Bari, Via Orabona 4, c.a.p. 70126, Bari (Italy); Gabrielli, A. [Physics Department, University of Bologna, Viale Berti Pichat 6/2, c.a.p. 40127, Bologna (Italy); Mattiazzo, S.; Pantano, D. [INFN, Section of Padova, Via Marzolo 8, c.a.p. 35131, Padova (Italy); Ranieri, A., E-mail: antonio.ranieri@ba.infn.i [INFN Section of Bari, Via Orabona 4, c.a.p. 70126, Bari (Italy); Tessaro, M. [INFN, Section of Padova, Via Marzolo 8, c.a.p. 35131, Padova (Italy)

    2011-01-21

    With the perspective to develop a radiation-tolerant circuit for High Energy Physics (HEP) applications, a test digital ASIC VLSI chip, called STRURED, has been designed and fabricated using a standard-cell library of commercial 130 nm CMOS technology by implementing three different radiation-tolerant architectures (Hamming, Triple Modular Redundancy and Triple Time Redundancy) in order to correct circuit malfunctions induced by the occurrence of Soft Errors (SEs). SEs are one of the main reasons of failures affecting electronic digital circuits operating in harsh radiation environments, such as in experiments performed at HEP colliders or in apparatus to be operated in space. In this paper we present and discuss the latest results of SE cross-section measurements performed using the STRURED digital device, exposed to high energy heavy ions at the SIRAD irradiation facility of the INFN National Laboratories of Legnaro (Padova, Italy). In particular the different behaviors of the input part and the core of the three radiation-tolerant architectures are analyzed in detail.

  13. Current status of electron beam processing applications and the latest accelerator technologies in Japan

    International Nuclear Information System (INIS)

    Hoshi, Yasuhisa

    1998-01-01

    Electron Beam (EB) processing has been increasing in popularity as a cross-linking process since the beginning of its industrial use. Examples are heat resistance improvement of electric wires, high quality foamed polyethylene (PE) and polypropylene (PP), automotive tire manufacturing and heat shrinkable products. EB is also used in the tire manufacturing process as a pre-vulcanisation of rubber sheet before forming process. Cross-linking of electric wire insulators is the most popular industrial application of electron beam accelerators in Japan. EB cross-linked wires are widely used in electrical appliances and automotive wire harnesses. Curing of inks or coating is a promising application of low energy EB. EB cure is often compared with Ultra-Violet (UV) curing. Both has a common advantage compared with a conventional heat curing process such as no solvent requirement. A typical advantage is that no initiators are required to start curing process. EB can also be used to remove SO 2 and NO x from coal flue gas. This paper reports some of these applications and discusses the latest equipment design. (author)

  14. The latest succession of dinosaur tracksites in Europe: Hadrosaur ichnology, track production and palaeoenvironments.

    Directory of Open Access Journals (Sweden)

    Bernat Vila

    Full Text Available A comprehensive review and study of the rich dinosaur track record of the Tremp Formation in the southern Pyrenees of Spain (Southwestern Europe shows a unique succession of footprint localities prior to the end-Cretaceous mass extinction event. A description of some 30 new tracksites and data on sedimentary environments, track occurrence and preservation, ichnology and chronostratigraphy are provided. These new track localities represent various facies types within a diverse set of fluvial environments. The footprint discoveries mostly represent hadrosaurian and, less abundantly, to sauropod dinosaurs. The hadrosaur tracks are significantly smaller in size than, but morphologically similar to, those of North America and Asia and are attributable to the ichnogenus Hadrosauropodus. The track succession, with more than 40 distinct track levels, indicates that hadrosaur footprints in the Ibero-Armorican region occur predominantly in the late Maaastrichtian (at least above the early Maastrichtian-late Maastrichtian boundary. The highest abundance is found noticeably found in the late Maastrichtian, with tracks occurring in the C29r magnetochron, within about the latest 300,000 years of the Cretaceous.

  15. Solar photovoltaic (PV) energy; latest developments in the building integrated and hybrid PV systems

    International Nuclear Information System (INIS)

    Zahedi, A.

    2006-01-01

    Environmental concerns are growing and interest in environmental issues is increasing and the idea of generating electricity with less pollution is becoming more and more attractive. Unlike conventional generation systems, fuel of the solar photovoltaic energy is available at no cost. And solar photovoltaic energy systems generate electricity pollution-free and can easily be installed on the roof of residential as well as on the wall of commercial buildings as grid-connected PV application. In addition to grid-connected rooftop PV systems, solar photovoltaic energy offers a solution for supplying electricity to remote located communities and facilities, those not accessible by electricity companies. The interest in solar photovoltaic energy is growing worldwide. Today, more than 3500MW of photovoltaic systems have been installed all over the world. Since 1970, the PV price has continuously dropped [8]. This price drop has encouraged worldwide application of small-scale residential PV systems. These recent developments have led researchers concerned with the environment to undertake extensive research projects for harnessing renewable energy sources including solar energy. The usage of solar photovoltaic as a source of energy is considered more seriously making future of this technology looks promising. The objective of this contribution is to present the latest developments in the area of solar photovoltaic energy systems. A further objective of this contribution is to discuss the long-term prospect of the solar photovoltaic energy as a sustainable energy supply. [Author

  16. Alignment of the CMS Tracker: Latest results from LHC Run-II

    CERN Document Server

    Mittag, Gregor

    2017-01-01

    The all-silicon design of the tracking system of the CMS experiment provides excellent measurements of charged-particle tracks and an efficient tagging of jets. Conditions of the CMS tracker changed repeatedly during the 2015/2016 shutdown and the 2016 data-taking period. Still the true position and orientation of each of the 15 148 silicon strip and 1440 silicon pixel modules need to be known with high precision for all intervals. The alignment constants also need to be promptly re-adjusted each time the state of the CMS magnet is changed between 0T and 3.8 T. Latest Run-II results of the CMS tracker alignment and resolution performance are presented, which are obtained using several millions of reconstructed tracks from collision and cosmic-ray data of 2016. The geometries and the resulting performance of physics observables are carefully validated. In addition to the offline alignment, an online procedure has been put in place which continuously monitors movements of the pixel high-level structures and tri...

  17. Influence of radiotherapy on the latest generation of implantable cardioverter-defibrillators

    International Nuclear Information System (INIS)

    Hurkmans, Coen W.; Scheepers, Egon; Springorum, Bob G.F.; Uiterwaal, Hans

    2005-01-01

    Purpose: Radiotherapy can influence the functioning of pacemakers and implantable cardioverter-defibrillators (ICDs). ICDs offer the same functionality as pacemakers, but are also able to deliver a high-voltage shock to the heart if needed. Guidelines for radiotherapy treatment of patients with an implanted rhythm device have been published in 1994 by The American Association of Physicists in Medicine, and are based only on experience with pacemakers. Data on the influence of radiotherapy on ICDs are limited. The objective of our study is to determine the influence of radiotherapy on the latest generation of ICDs. Methods and Materials: Eleven modern ICDs have been irradiated in our department. The irradiation was performed with a 6-MV photon beam. The given dose was fractionated up to a cumulative dose of 120 Gy. Two to 5 days passed between consecutive irradiations. Frequency, output, sensing, telemetry, and shock energy were monitored. Results: Sensing interference by ionizing radiation on all ICDs has been demonstrated. For four ICDs, this would have caused the inappropriate delivery of a shock because of interference. At the end of the irradiation sessions, all devices had reached their point of failure. Complete loss of function was observed for four ICDs at dose levels between 0.5 Gy and 1.5 Gy. Conclusions: The effect of radiation therapy on the newest generation of ICDs varies widely. If tachycardia monitoring and therapy are functional (programmed on) during irradiation, the ICD might inappropriately give antitachycardia therapy, often resulting in a shock. Although most ICDs did not fail below 80 Gy, some devices had already failed at doses below 1.5 Gy. Guidelines are formulated for the treatment of patients with an ICD

  18. Innovative swine nutrition: some present and potential applications of latest scientific findings for safe pork production

    Directory of Open Access Journals (Sweden)

    Veronika Halas

    2010-01-01

    Full Text Available One of the biggest challenges facing animal agriculture in the 21st century is to produce safe and traceable foodstuffs of animal origin in sufficient volumes and quality besides the lowest possible load on the environment. A point to consider is how animal feeding and nutrition can contribute to the solution of this challenge. Another question is, that the results of which new scientific fields should be used in the area of innovation to achieve the desired product quality. The article answers these questions based on the latest data in the scientific literature and on the authors’ own research results. Having reviewed and processed the data, the authors drew the following conclusions: 1. The impact of climate changes on crop production and consequently on animal nutrition needs to be studied in comprehensive, systematic research programs, and based on their results animal feeding systems should be modified if necessary. 2. The role of molecular nutrition and the immunological role of nutrition for enhancing the efficiency of production will gain in importance. 3. The cooperation between nutritionists and geneticists needs to be strengthened in order to satisfy the nutrient requirements more accurately, and thus to improve the profitability of production. 4. New mathematical growth models, also incorporating the quality of animal products, need to be developed for better production estimates. 5. The integrated “from farm to fork” programs will be essential in the production of safe and high quality animal food products. Animal nutrition will play a key role in these product development and monitoring programs. 6. The production of environmentally friendly animal products will become a social imperative. Animal nutrition still has huge unexploited reserves in this field, for instance in the development of novel animal feeding systems and technologies. 7. T he practical implementation of precision nutrition can be of great help in achieving

  19. Reconstruction of the Dark Energy Equation of State from the Latest Observations

    Science.gov (United States)

    Dai, Ji-Ping; Yang, Yang; Xia, Jun-Qing

    2018-04-01

    Since the discovery of the accelerating expansion of our universe in 1998, studying the features of dark energy has remained a hot topic in modern cosmology. In the literature, dark energy is usually described by w ≡ P/ρ, where P and ρ denote its pressure and energy density. Therefore, exploring the evolution of w is the key approach to understanding dark energy. In this work, we adopt three different methods, polynomial expansion, principal component analysis, and the correlated prior method, to reconstruct w with a collection of the latest observations, including the type-Ia supernova, cosmic microwave background, large-scale structure, Hubble measurements, and baryon acoustic oscillations (BAOs), and find that the concordance cosmological constant model (w = ‑1) is still safely consistent with these observational data at the 68% confidence level. However, when we add the high-redshift BAO measurement from the Lyα forest (Lyα FB) of BOSS DR11 quasars into the calculation, there is a significant impact on the reconstruction result. In the standard ΛCDM model, since the Lyα FB data slightly prefer a negative dark energy density, in order to avoid this problem, a dark energy model with a w significantly smaller than ‑1 is needed to explain this Lyα FB data. In this work, we find the consistent conclusion that there is a strong preference for the time-evolving behavior of dark energy w at high redshifts, when including the Lyα FB data. Therefore, we think that this Lyα FB data needs to be watched carefully attention when studying the evolution of the dark energy equation of state.

  20. Latest developments in prestressed concrete vessels for gas-cooled reactors

    International Nuclear Information System (INIS)

    Ople, F.S. Jr.

    1979-01-01

    This paper is an update of the design development of prestressed concrete vessels, commonly referred to as 'PCRVs' starting with the first single-cavity PCRV for the Fort St. Vrain Nuclear Generating Station to the latest multi-cavity PCRV configurations being utilized as the primary reactor vessels for both the High Temperature Gas-Cooled Reactor (HTGR) and the Gas-Cooled Fast Breeder Reactor (GCFR) in the U.S.A. The complexity of PCRV design varies not only due to the type of vessel configuration (single versus multi-cavity) but also on the application to the specific type of reactor concept. PCRV technology as applied to the Steam Cycle HTGR is fairly well established; however, some significant technical complexities are associated with PCRV design for the Gas Turbine HTGR and the GCFR. For the Gas Turbine HTGR, for instance, the fluid dynamics of the turbo-machinery cause multi-pressure conditions to exist in various portions of the power conversion loops during operation. This condition complicates the design approach and the proof test specification for the PCRV. The geometric configuration of the multi-cavity PCRV is also more complex due to the introduction of large horizontal cylindrical cavities (housing the turbo/machines for the Gas Turbine HTGR and circulators for the GCFR) in addition to the vertical cylindrical cavities for the core and heat exchangers. Because of this complex geometry, it becomes difficult to achieve an optimum prestressing arrangement for the PCRV. Other novel features of the multi-cavity PCRV resulting from the continuing design optimization effort are the incorporation of an asymmetric (offset core) configuration and the use of large vessel cavity/penetration concrete closures directly held down by prestressing tendons for both economic and safety reasons. (orig.)

  1. Estimating Latest Cretaceous and Tertiary Atmospheric PCO2 from Stomatal Indices

    Science.gov (United States)

    Royer, D. L.; Wing, S. L.; Beerling, D. J.

    2001-05-01

    Most modern C3 seed plants show an inverse relationship between PCO2 and stomatal index (SI), where SI is the proportion of epidermal cells that are stomatal packages. This plant-atmosphere response therefore provides a reliable approach for estimating paleo-CO2 levels. Since stomatal responses to CO2 are generally species-specific, one is limited in paleo-reconstructions to species that exist both in the fossil record and living today. Fossils morphologically similar to living Ginkgo biloba and Metasequoia glyptostroboides extend back to the early and late Cretaceous, respectively, indicating that the fossil and living forms are very closely related. Measurements of SI made on fossil Ginkgo and Metasequoia were calibrated with historical collections of G. biloba and M. glyptostroboides leaves from sites that developed during the anthropogenically-driven CO2 increases of the past 145 years (288-369 ppmv) and with saplings of G. biloba and M. glyptostroboides grown in CO2 controlled growth chambers (350-800 ppmv). Both nonlinear regressions are highly significant (Ginkgo: n = 40, r2 = 0.91; Metasequoia: n = 18; r2 = 0.85). Results from a sequence of 23 latest Cretaceous to early Eocene-aged Ginkgo-bearing sites indicate that CO2 remained between 300 and 450 ppmv with the exception of one high estimate ( ~800 ppmv) near the Paleocene/Eocene boundary, and results from 4 middle Miocene-aged Ginkgo- and Metasequoia-bearing sites indicate that CO2 was between 320 and 400 ppmv. If correct, the CO2 values estimated here are too low to explain via the CO2 greenhouse effect alone the higher global mean temperatures (e.g., 3-4 ° C for the early Eocene) inferred from models and geological data for these two intervals.

  2. Evaluation of the Latest Generic Data for PSA Applications of Domestic Nuclear Plants

    International Nuclear Information System (INIS)

    Hwang, Seok Won; Oh, Ji Yong; Lee, Byung Sik

    2009-01-01

    Generic data of domestic PSAs have mostly referred to 'Advanced Light Water Reactor (ALWR) Utility Requirements Document (URD) 'issued by EPRI. Generally, current data of domestic PSA have been customized with the generic and plant specific data through Bayesian analysis. The generic reference has established by collecting US nuclear plant practices from mid 1980s to early 1990s. Over the decade, US plants had showed low performances and capabilities in operation. On the other hand, the current domestic nuclear plants shows world class performance in operation and maintenance compared with the corresponding US nuclear plants in URD. Therefore, it is necessary to apply proper generic sources which can represent the current domestic plant performances and status. In 2007, the latest generic source (NUREG/CR-6928) is published by US NRC, which deals with new types of failure modes and analysis methods. A fundamental improvement in NUREG/CR-6928 compared with previous data source is the distinction between standby and alternating/running component basic events, which shows different failure mechanisms. Significant differences were also noted running failure events occurred within and beyond the first hour for emergency diesel generators, cooling units, and pumps. This was done because the historical perspective on running failure rates indicated approximately a factor of 15 differences between the two failure rates for several component types. ALWR URD uses lognormal distribution in the estimation of failure rates. On the contrary, NUREG/CR-6928 uses beta and gamma distributions for demand and running failures, respectively. This work has proposed an approach to the application of NUREG/CR-6928 to current PSA practice by comparing it with URD data. Moreover, this attempt results in eliciting substantial insights of the establishment of the domestic generic database

  3. Latest developments of neutron scattering instrumentation at the Juelich Centre for Neutron Science

    International Nuclear Information System (INIS)

    Ioffe, Alexander

    2013-01-01

    Jülich Centre for Neutron Science (JCNS) is operating a number of world-class neutron scattering instruments situated at the most powerful and advanced neutron sources (FRM II, ILL and SNS) and is continuously undertaking significant efforts in the development and upgrades to keep this instrumentation in line with the continuously changing scientific request. These developments are mostly based upon the latest progress in neutron optics and polarized neutron techniques. For example, the low-Q limit of the suite of small angle-scattering instruments has been extended to 4·10 -5 Å -1 by the successful use of focusing optics. A new generation of correction elements for the neutron spin-echo spectrometer has allowed for the use of the full field integral available, thus pushing further the instrument resolution. A significant progress has been achieved in the developments of 3 He neutron spin filters for purposes of the wide-angle polarization analysis for off-specular reflectometry and (grazing incidence) small-angle neutron scattering, e.g. the on-beam polarization of 3 He in large cells is allowing to achieve a high neutron beam polarization without any degradation in time. The wide Q-range polarization analysis using 3 He neutron spin filters has been implemented for small-angle neutron scattering that lead to the reduction up to 100 times of the intrinsic incoherent background from non-deuterated biological molecules. Also the work on wide-angle XYZ magnetic cavities (Magic PASTIS) will be presented. (author)

  4. Latest Developments in Data Analysis and Structure Determination and Refinement: Software for Chemical Crystallography

    International Nuclear Information System (INIS)

    Dix, I.; Adam, M.; Jacob, H. F.; Roter, A.

    2003-01-01

    The introduction of a two-dimensional CCD X-ray detector nearly 10 years ago by Bruker started a revolution in chemical crystallography. Since then, crystallographers can accomplish a complete data collection even of small and poorly scattering crystals in a few hours instead of days. The launch of the kappa geometry by Nonius a few years ago beforehand equally revolutionized the field of single crystal diffractometry. Currently Bruker Nonius has far more than 500 CCD systems installed. The latest development of Bruker Nonius, the X8 APEX, is the powerful combination of both: the APEX CCD detector and the unique Kappa four-circle goniometer. The APEX 4K CCD detector provides the utmost sensitivity, while the Kappa four-circle goniometer offers a very open geometry, granting all the flexibility to align any crystallographic axis. This provides a more efficient data collection for axial photographs to investigate e.g. diffuse scattering or incommensurate structures. Even the crystal-detector distance is computer-controlled for precise and superior data collection. The X8 APEX software suite gives a whole new look to the CCD users interface. It not only has improved data collection abilities, but also guides the chemist or mineralogist through gathering the raw crystal data to producing the final crystal structure. It provides context-dependent menus, which are well-known from business software packages such as Outlook. The tools for unit cell determination, views into reciprocal space, optimisation of the data collection strategy, data integration, scaling and correcting (SADABS) as well as tools for structure solving and refining (SHELXTL package) will be presented. Low temperature work has become an essential tool for challenging samples. The Bruker Nonius Kryo-Flex cryogenic device makes chemical crystallography at low temperatures a routine method in your laboratory. Of course, the Kryo-Flex is fully controlled by the new graphical user interface of the X8 APEX

  5. Latest Pleistocene and Holocene surficial deposits and landforms of Yosemite Valley, California

    Science.gov (United States)

    Haddon, E. K.; Stock, G. M.; Booth, D. B.

    2016-12-01

    Field studies on the surficial geology and geomorphology of Yosemite Valley since the 1870's formed an early basis for our understanding of Quaternary landscape evolution in the central Sierra Nevada. These landmark studies described the erosional origin of Yosemite's iconic scenery, but left details of the latest Pleistocene and Holocene sedimentary record for later investigation. We combined mapping of deposits and landforms with geochronology to reconstruct the geomorphic evolution of Yosemite Valley since the 15 ka retreat of the Last Glacial Maximum (LGM) valley glacier. We document a sustained period of relative landscape stability, characterized by valley-bottom aggradation of glacial till, fluvial sediments, and lacustrine silts, as well as valley-margin accumulation of talus and fan alluvium. Recessional moraines, episodically emplaced rock avalanches, and alluvial fans impeded surface flow and controlled the local base level. This predominantly aggradational regime then shifted to incision in the earliest Holocene, likely due to a diminishing supply of glacial sediment, and created a flight of fluvial terraces inset by up to 9 m. The volume of fringing talus and fan alluvium in comparison with fluvial terrace sequences emphasizes the importance of valley-wall erosion as a sediment source. Cosmogenic 10Be exposure ages from rock avalanche boulders and 14C charcoal ages from deltaic sequences and inset fluvial gravels suggest variable rates of Holocene river incision. Although some incision events likely record local base level changes at the El Capitan LGM recessional moraine, the presence of perched, well-developed outwash terraces downstream indicates a more regional climatic forcing. These findings, including the depositional record of land-use disturbances over the past two centuries, help illuminate the geologic evolution of this celebrated landscape and inform ongoing river-restoration work.

  6. Evaluation of MR issues for the latest standard brands of orthopedic metal implants: Plates and screws

    Energy Technology Data Exchange (ETDEWEB)

    Zou, Yue-fen, E-mail: zou_yf@163.com [Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing (China); Chu, Bin, E-mail: 18262636700@163.com [Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing (China); Wang, Chuan-bing, E-mail: wangchuanb_csr@163.com [Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing (China); Hu, Zhi-yi, E-mail: huzhiyi@medmail.com.cn [Department of Spine Surgery, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing (China)

    2015-03-15

    Highlights: •Although previous studies have indicated that most of the orthopedic implants are compatible in MR imaging system especially for titanium alloy, there are still concerns about the safety of patients with stainless steel implants, who were refused to a MR scan in most cases in our country. •In this study, it was verified that both titanium alloy and stainless steel materials (plates and screws) cause a weak force and low MRI-related heating at a 1.5-T or less, which do not pose an additional hazard or risk to patients. In addition, we also had explored the influence of different sequences and parameters on size of metallic artifacts to obtain optimized pulse sequences with appropriate parameters for reducing artifacts, which would be convenient and useful in clinical work. -- Abstract: Purpose: The study was performed to evaluate magnetic resonance (MR) issues for the latest standard brands of plates and screws used in orthopedic surgery at a 1.5-T MR system, including the safety and metallic artifacts. Methods: The plates and screws (made of titanium alloy and stainless steel materials, according to the latest standard brands) were assessed for displacement in degrees, MRI-related heating and artifacts at a 1.5-T MR system. The displacement in degrees of the plates and screws was evaluated on an angel-measurement instrument at the entrance of the MR scanner. The MRI-related heating was assessed on a swine leg fixed with a plate by using a “worst-case” pulse sequence. A rectangular water phantom was designed to evaluate metallic artifacts of a screw on different sequences (T1/T2-weighted FSE, STIR, T2-FSE fat saturation, GRE, DWI) and then artifacts were evaluated on T2-weighted FSE sequence by modifying the scanning parameters including field of view (FOV), echo train length (ETL) and bandwidth to identify the influence of parameters on metallic artifacts. 15 volunteers with internal vertebral fixation (titanium alloy materials) were scanned

  7. Evaluation of MR issues for the latest standard brands of orthopedic metal implants: Plates and screws

    International Nuclear Information System (INIS)

    Zou, Yue-fen; Chu, Bin; Wang, Chuan-bing; Hu, Zhi-yi

    2015-01-01

    Highlights: •Although previous studies have indicated that most of the orthopedic implants are compatible in MR imaging system especially for titanium alloy, there are still concerns about the safety of patients with stainless steel implants, who were refused to a MR scan in most cases in our country. •In this study, it was verified that both titanium alloy and stainless steel materials (plates and screws) cause a weak force and low MRI-related heating at a 1.5-T or less, which do not pose an additional hazard or risk to patients. In addition, we also had explored the influence of different sequences and parameters on size of metallic artifacts to obtain optimized pulse sequences with appropriate parameters for reducing artifacts, which would be convenient and useful in clinical work. -- Abstract: Purpose: The study was performed to evaluate magnetic resonance (MR) issues for the latest standard brands of plates and screws used in orthopedic surgery at a 1.5-T MR system, including the safety and metallic artifacts. Methods: The plates and screws (made of titanium alloy and stainless steel materials, according to the latest standard brands) were assessed for displacement in degrees, MRI-related heating and artifacts at a 1.5-T MR system. The displacement in degrees of the plates and screws was evaluated on an angel-measurement instrument at the entrance of the MR scanner. The MRI-related heating was assessed on a swine leg fixed with a plate by using a “worst-case” pulse sequence. A rectangular water phantom was designed to evaluate metallic artifacts of a screw on different sequences (T1/T2-weighted FSE, STIR, T2-FSE fat saturation, GRE, DWI) and then artifacts were evaluated on T2-weighted FSE sequence by modifying the scanning parameters including field of view (FOV), echo train length (ETL) and bandwidth to identify the influence of parameters on metallic artifacts. 15 volunteers with internal vertebral fixation (titanium alloy materials) were scanned

  8. Small theropod teeth from the Late Cretaceous of the San Juan Basin, northwestern New Mexico and their implications for understanding latest Cretaceous dinosaur evolution.

    Science.gov (United States)

    Williamson, Thomas E; Brusatte, Stephen L

    2014-01-01

    Studying the evolution and biogeographic distribution of dinosaurs during the latest Cretaceous is critical for better understanding the end-Cretaceous extinction event that killed off all non-avian dinosaurs. Western North America contains among the best records of Late Cretaceous terrestrial vertebrates in the world, but is biased against small-bodied dinosaurs. Isolated teeth are the primary evidence for understanding the diversity and evolution of small-bodied theropod dinosaurs during the Late Cretaceous, but few such specimens have been well documented from outside of the northern Rockies, making it difficult to assess Late Cretaceous dinosaur diversity and biogeographic patterns. We describe small theropod teeth from the San Juan Basin of northwestern New Mexico. These specimens were collected from strata spanning Santonian - Maastrichtian. We grouped isolated theropod teeth into several morphotypes, which we assigned to higher-level theropod clades based on possession of phylogenetic synapomorphies. We then used principal components analysis and discriminant function analyses to gauge whether the San Juan Basin teeth overlap with, or are quantitatively distinct from, similar tooth morphotypes from other geographic areas. The San Juan Basin contains a diverse record of small theropods. Late Campanian assemblages differ from approximately coeval assemblages of the northern Rockies in being less diverse with only rare representatives of troodontids and a Dromaeosaurus-like taxon. We also provide evidence that erect and recurved morphs of a Richardoestesia-like taxon represent a single heterodont species. A late Maastrichtian assemblage is dominated by a distinct troodontid. The differences between northern and southern faunas based on isolated theropod teeth provide evidence for provinciality in the late Campanian and the late Maastrichtian of North America. However, there is no indication that major components of small-bodied theropod diversity were lost

  9. Clinical outcome and evidence of high rate post-surgical anterior hypopituitarism in a cohort of TSH-secreting adenoma patients: Might somatostatin analogs have a role as first-line therapy?

    Science.gov (United States)

    Gatto, Federico; Grasso, Ludovica F; Nazzari, Elena; Cuny, Thomas; Anania, Pasquale; Di Somma, Carolina; Colao, Annamaria; Zona, Gianluigi; Weryha, Georges; Pivonello, Rosario; Ferone, Diego

    2015-10-01

    Thyrotropin-secreting pituitary adenomas (TSHomas) represent a rare subtype of pituitary tumors. Neurosurgery (NCH) is still considered the first-line therapy. In this study we aimed to investigate the outcome of different treatment modalities, including first line somatostatin analogs (SSA) treatment, with a specific focus on neurosurgery-related complications. We retrospectively evaluated thirteen patients diagnosed for TSHomas (9 M; age range 27-61). Ten patients had a magnetic resonance evidence of macroadenoma, three with slight visual field impairment. In the majority of patients, thyroid ultrasonography showed the presence of goiter and/or increased gland vascularization. Median TSH value at diagnosis was 3.29 mU/L (normal ranges 0.2-4.2 mIU/L), with median fT4 2.52 ng/dL (0.9-1.7 ng/dL). Three patients (two microadenoma) were primarily treated with NCH and achieved disease remission, whereas ten patients (nine macroadenomas) were initially treated with SSA. Despite the optimal biochemical response observed during medical treatment in most patients (mean TSH decrease -72%), only two stayed on medical therapy alone, achieving stable biochemical control at the end of the follow-up. The remaining patients (n = 7) underwent NCH later on during their clinical history, followed by radiotherapy or adjuvant SSA treatment in two cases. Noteworthy, five of them developed hypopituitarism. All patients reached a biochemical control, after a multimodal therapeutic approach. Neurosurgery ultimately led to complete disease remission or to biochemical control in majority of patients, whereas resulting in a considerable percentage of post-operative complications (mainly hypopituitarism, 50%). In the light of the optimal results unanimously reported for medical treatment with SSA, our experience suggests that a careful evaluation of risk/benefit ratio should be taken into consideration when directing the treatment approach in patients with TSHoma.

  10. Latest Miocene-Pliocene Tiliviche Paleolake, Atacama Desert, Northern Chile 19.5°S: Paleoclimatic and Paleohydrologic Implications

    Science.gov (United States)

    Kirk-Lawlor, N. E.; Jordan, T. E.; Rech, J.; Lehmann, S.

    2010-12-01

    Endorheic paleolake deposits of diatomite, mudstone, sandstone, and evaporites are exposed in the Atacama Desert of northern Chile. This study focuses on a major latest Miocene-Pliocene paleolake system centered at 19.5°S, near Tiliviche. A diatiomite unit, up to 35m thick, composed of 0.2-1.5m thick beds of massive, white diatiomite, free of plant matter and root traces, is interpreted have formed from lacustrine diatom blooms. At its maximum extent, the lake would have had a surface area of roughly 200 km2, based on the extent of the diatomite unit, and might have been 50-100 m deep, as inferred by the relationship between the diatomite unit and modern topography. The Tiliviche paleolake initially formed before 6.4 Ma, and much of its sedimentary record formed under a wetter climatic and hydrologic regime than the present. Prior to 3.5 Ma, the lake had evolved into a groundwater-fed saltpan. Polygonally fractured efflorescent halite evaporite and bedded gypsum and gypsarenite evaporite deposits that overlie the diatomite unit are evidence of this saltpan environment. The modern Atacama Desert is hyperarid, with an average precipitation of 2 mm/yr in the driest areas. The paleosol record demonstrates that hyperarid conditions dominated this region since the middle Miocene, albeit with multiple fluctuations to less arid conditions of short to moderately long duration. This hyperaridity is due to the desert’s latitude, ocean currents and the rainshadow created by the Andes. There is no evidence that the rainshadow effect has diminished since the late Miocene, hence global climate changes affecting ocean temperatures and atmospheric patterns likely caused the wetter periods in the Atacama. In particular, prior workers noted wetter conditions in the region ~6-5 Ma, followed by a return to hyper-arid conditions. The regional Pliocene return to hyperaridity coincided with the desiccation of the Tiliviche endorheic lake system. During the late Miocene (~6-5 Ma) wetter

  11. Functional pancreatic insufficiency after surgical treatment in the light of the latest international recommendations

    Directory of Open Access Journals (Sweden)

    D. S. Bordin

    2017-01-01

    Full Text Available Exocrine  and  endocrine   insufficiencies  are  frequent complications of surgical treatment for pancreatic diseases. The presence  and  extent  of the insufficiency depend on the underlying  disorder, type of surgical procedure, extent of pancreatic resection, and anatomical reconstruction. Increased surgical  activity  determines  the  importance  of the  evidence-based guidelines  for management of patients  after  pancreatic  surgery. The article presents  an  overview of international Evidence-based Guidelines for the Management of Exocrine Pancreatic  Insufficiency after  Pancreatic  Surgery (2016 and United European Gastroenterology evidence-based guidelines  for the  diagnosis  and therapy of chronic pancreatitis (HaPanEU, 2017.

  12. Recommendations on evidence needed to support measurement equivalence between electronic and paper-based patient-reported outcome (PRO) measures: ISPOR ePRO Good Research Practices Task Force report.

    Science.gov (United States)

    Coons, Stephen Joel; Gwaltney, Chad J; Hays, Ron D; Lundy, J Jason; Sloan, Jeff A; Revicki, Dennis A; Lenderking, William R; Cella, David; Basch, Ethan

    2009-06-01

    Patient-reported outcomes (PROs) are the consequences of disease and/or its treatment as reported by the patient. The importance of PRO measures in clinical trials for new drugs, biological agents, and devices was underscored by the release of the US Food and Drug Administration's draft guidance for industry titled "Patient-Reported Outcome Measures: Use in Medical Product Development to Support Labeling Claims." The intent of the guidance was to describe how the FDA will evaluate the appropriateness and adequacy of PRO measures used as effectiveness end points in clinical trials. In response to the expressed need of ISPOR members for further clarification of several aspects of the draft guidance, ISPOR's Health Science Policy Council created three task forces, one of which was charged with addressing the implications of the draft guidance for the collection of PRO data using electronic data capture modes of administration (ePRO). The objective of this report is to present recommendations from ISPOR's ePRO Good Research Practices Task Force regarding the evidence necessary to support the comparability, or measurement equivalence, of ePROs to the paper-based PRO measures from which they were adapted. The task force was composed of the leadership team of ISPOR's ePRO Working Group and members of another group (i.e., ePRO Consensus Development Working Group) that had already begun to develop recommendations regarding ePRO good research practices. The resulting task force membership reflected a broad array of backgrounds, perspectives, and expertise that enriched the development of this report. The prior work became the starting point for the Task Force report. A subset of the task force members became the writing team that prepared subsequent iterations of the report that were distributed to the full task force for review and feedback. In addition, review beyond the task force was sought and obtained. Along with a presentation and discussion period at an ISPOR meeting

  13. The Titan Haze Simulation Experiment: Latest Laboratory Results and Dedicated Plasma Chemistry Model

    Science.gov (United States)

    Sciamma-O'Brien, Ella; Raymond, Alexander; Mazur, Eric; Salama, Farid

    2018-06-01

    Here, we present the latest results on the gas and solid phase analyses in the Titan Haze Simulation (THS) experiment. The THS experiment, developed at NASA Ames’ COSmIC facility is a unique experimental platform that allows us to simulate Titan’s complex atmospheric chemistry at Titan-like temperature (200 K) by cooling down N2-CH4-based mixtures in a supersonic expansion before inducing the chemistry by plasma.Gas phase: The residence time of the jet-accelerated gas in the active plasma region is less than 4 µs, which results in a truncated chemistry enabling us to control how far in the chain of reactions the chemistry is processing. By adding heavier molecules in the initial gas mixture, it is then possible to study the first and intermediate steps of Titan’s atmospheric chemistry as well as specific chemical pathways, as demonstrated by mass spectrometry and comparison to Cassini CAPS data [1]. A new model was recently developed to simulate the plasma chemistry in the THS. Calculated mass spectra produced by this model are in good agreement with the experimental THS mass spectra, confirming that the short residence time in the plasma cavity limits the growth of larger species [2].Solid phase: Scanning electron microscopy and infrared spectroscopy have been used to investigate the effect of the initial gas mixture on the morphology of the THS Titan aerosol analogs as well as on the level and nature of the nitrogen incorporation into these aerosols. A comparison to Cassini VIMS observational data has shown that the THS aerosols produced in simpler mixtures, i.e., that contain more nitrogen and where the N-incorporation is in isocyanide-type molecules instead of nitriles, are more representative of Titan’s aerosols [3]. In addition, a new optical constant facility has been developed at NASA Ames that allows us to determine the complex refractive indices of THS Titan aerosol analogs from NIR to FIR (0.76-222 cm-1). The facility and preliminary results

  14. Fasting for weight loss: an effective strategy or latest dieting trend?

    Science.gov (United States)

    Johnstone, A

    2015-05-01

    With the increasing obesity epidemic comes the search for effective dietary approaches for calorie restriction and weight loss. Here I examine whether fasting is the latest 'fad diet' as portrayed in popular media and discuss whether it is a safe and effective approach or whether it is an idiosyncratic diet trend that promotes short-term weight loss, with no concern for long-term weight maintenance. Fasting has long been used under historical and experimental conditions and has recently been popularised by 'intermittent fasting' or 'modified fasting' regimes, in which a very low-calorie allowance is allowed, on alternate days (ADF) or 2 days a week (5:2 diet), where 'normal' eating is resumed on non-diet days. It is a simple concept, which makes it easy to follow with no difficult calorie counting every other day. This approach does seem to promote weight loss, but is linked to hunger, which can be a limiting factor for maintaining food restriction. The potential health benefits of fasting can be related to both the acute food restriction and chronic influence of weight loss; the long-term effect of chronic food restriction in humans is not yet clear, but may be a potentially interesting future dietary strategy for longevity, particularly given the overweight epidemic. One approach does not fit all in the quest to achieve body weight control, but this could be a dietary strategy for consideration. With the obesity epidemic comes the search for dietary strategies to (i) prevent weight gain, (ii) promote weight loss and (iii) prevent weight regain. With over half of the population of the United Kingdom and other developed countries being collectively overweight or obese, there is considerable pressure to achieve these goals, from both a public health and a clinical perspective. Certainly not one dietary approach will solve these complex problems. Although there is some long-term success with gastric surgical options for morbid obesity, there is still a requirement

  15. Latest Paleocene lithologic and biotic events in neritic deposits of southwestern New Jersey

    Science.gov (United States)

    Gibson, Thomas G.; Bybell, Laurel M.; Owens, James P.

    1993-01-01

    In the southwestern New Jersey Coastal Plain, four drill holes contain continuous neritic sedimentation across the Paleocene/Eocene boundary (calcareous nannofossil Zone NP 9/NP 10 boundary). Significant lithologic and biotic changes occur in these strata near the top of the Paleocene. Global warming, increased precipitation, and other oceanographic and climatic events that have been recognized in high-latitude, deep-oceanic deposits of the latest Paleocene also influenced mid-latitude, shallow-marine, and terrestrial environments of the western North Atlantic. The diverse, well-preserved calcareous nannofossil flora that is present throughout the entire New Jersey boundary section accurately places these events within the uppermost part of the upper Paleocene Zone NP 9. Several rapid but gradational changes occur within a 1.1-m interval near the top of Zone NP 9. The changes include (1) a change in lithology from glauconitic quartz sand to clay, (2) a change in clay mineral suites from illite/smectite-dominated to kaolinite-dominated, (3) a change in benthic foraminiferal assemblages to a lower diversity fauna suggestive of low-oxygen environments, (4) a significant increase in planktonic foraminiferal abundance, and (5) an increased species turnover rate in marine calcareous nannofossils. Pollen was sparse in the New Jersey drill holes, but terrestrial sporomorph species in Virginia exhibit increased turnover rates at a correlative level. Foraminiferal assemblages and lithology indicate that relative sea level rose in New Jersey at the same time as these late Paleocene events occurred in late Biochron NP 9. The higher sea levels influenced sediment type and absolute abundance of planktonic foraminifers in the deposits. Above the initial increase of kaolinite in the upper part of Zone NP 9, the kaolinite percentage continues to increase, and the maximum kaolinite value occurs in the uppermost part of Zone NP 9. There are few changes in either the sediments or the

  16. Latest developments in image processing for the next generation of devices with a view on DEMO

    International Nuclear Information System (INIS)

    Murari, A.; Vega, J.; Mazon, D.; Arena, P.; Craciunescu, T.; Gabellieri, L.; Gelfusa, M.; Pacella, D.; Palazzo, S.; Romano, A.

    2012-01-01

    Highlights: ► Pattern recognition methods have been successfully applied to retrieve frames in massime databases. ► The technology of Cellular Nonlinear Networks (CNNs) has been upgraded to solve space variant problem. ► The CNNs have then been successfully applied to various tasks, from the real time hot spot detection to the automatic identification of instabilities. ► The method of the optical flow permits to derive information about the speed of the objects moving in the frames of a single camera. ► Since the next generation of devices will emit a lot of SXR radiation, also from the edge, new technologies (Gas Electron Multiplier detectors and policapillary lenses) are being developed to perform imaging over this region of the spectrum for a global view of the entire plasma column. - Abstract: In magnetic confinement fusion devices the use of cameras, both visible and infrared, has increased very significantly in the last years. The large amount of data (in the range of tens of Gbytes per shot) and the difficulty of the analysis tasks (ambiguity, ill posed problems, etc.), require new solutions. The technology of Cellular Nonlinear Networks (CNNs) has been successfully applied to various tasks, from the real time hot spot detection to the automatic identification of instabilities. The accuracy obtained is comparable to the one of more traditional serial algorithms but the CCNs guarantee deterministic computational times independently from the image contents. Moreover the latest developments have allowed obtaining these results also in the case of space variant image analysis, without compromising the computational speed (of the order of ten thousand frames per second). The method of the optical flow permits to derive information about the speed of the objects moving in the frames of a single camera. The results of previous applications have been so successful that the approach has been extended to videos in compressed format (MPEG) to reduce the

  17. Systematic review of psychological and social outcomes of adolescents undergoing bariatric surgery, and predictors of success.

    Science.gov (United States)

    White, B; Doyle, J; Colville, S; Nicholls, D; Viner, R M; Christie, D

    2015-12-01

    The psychological and social outcomes of bariatric surgery in adolescents, together with psychological and social predictors of success, were systematically reviewed. PubMed, EMBASE, ISI Web of Science and PsychInfo were searched on July 2014. Existing data were sparse; 15 were suitable for qualitative review and six for meta-analysis (four quality of life [QOL], two depression). One study was a randomized controlled trial. A total of 139 subjects underwent Roux-en-Y gastric bypass, 202 underwent adjustable gastric band and 64 underwent sleeve gastrectomy. Overall QOL improved after bariatric surgery, regardless of surgical type with peak improvement at 6-12 months. Meta-analysis of four studies showed changed in overall QOL at latest follow-up of 2.80 standard deviation (SD) (95% confidence interval [CI] 1.23-4.37). Depression improved across all studies, regardless of procedure (effect size -0.47 SD [95% CI -0.76, -0.18] at 4-6 months). Two cohorts reported changes in both overall QOL and depression following a quadratic trajectory, with overall improvement over 2 years and deterioration in the second post-operative year. There were limited data on other psychological and social outcomes. There were insufficient data on psychosocial predictors of outcome to form evidence-based recommendations for patient selection for bariatric surgery at this time. © 2015 World Obesity.

  18. Reconciling divergent results of the latest parenteral nutrition studies in the ICU.

    Science.gov (United States)

    Singer, Pierre; Pichard, Claude

    2013-03-01

    Recent studies on the optimal modalities to feed patients during the ICU stay show divergent results. The level and the timing of energy provision is a critical issue, associated with the clinical outcome. These results questioned the clinical relevance of the recent guidelines issued by American, Canadian and European academic societies. Four recent prospective randomized studies enrolled critically ill patients who received various nutritional regimens and tested the effect of nutritional support on outcome. The Tight Calorie balance Control Study (TICACOS) targeted on calorie administration according to measured energy expenditure and found increased ICU morbidity but improved hospital mortality. The large EpaNIC study compared 'early' with 'late' (parenteral nutrition) nutrition, mostly in patients after cardiac surgery, and found an increased morbidity associated with early parenteral nutrition. The supplemental parenteral nutrition (SPN) study randomized the patients after 3 days and targeted the calories administered by parenteral nutrition as a complement to unsuccessful enteral nutrition using indirect calorimetry. The SPN resulted in less nosocomial infections and shorter duration of mechanical ventilation. Finally, a recent Australian study enrolled patients unable to be early fed enterally to receive, or not, parenteral nutrition targeted at 1500 kcal. No complications were noted in the parenteral nutrition group. Lessons from all these studies are summarized and should help in designing better studies and guidelines. The critical analysis of recent prospective studies comparing various levels of calorie administration, enteral versus parenteral nutrition and enteral versus SPN confirms the recommendations to avoid underfeeding and overfeeding. Parenteral nutrition, required if enteral feeding is failing, and if adjusted up to a measured optimal level, may improve outcome. More studies on the optimal level of energy and protein administration to

  19. Tumour characteristics and survival in patients with invasive interval breast cancer classified according to mammographic findings at the latest screening

    DEFF Research Database (Denmark)

    Vitak, B; Olsen, K E; Månson, J C

    1999-01-01

    with invasive interval cancer detected from May 1978 to August 1995 (n = 544). The tumours were evaluated with regard to age, radiological category, interval between the latest screen and diagnosis and tumour characteristics at the time of diagnosis. We investigated possible relationships between the survival...... screen and diagnosis were not genuine predictors of the prognosis in patients with invasive interval breast cancer. No certain prognostic difference existed between true interval cancers and overlooked or misinterpreted interval breast cancers, despite higher proportions of grade-I tumours, ER positive......The aim of this study was to investigate whether different mammographic categories of interval cancer classified according to findings at the latest screening are associated with different distributions of prognostic factors or with different survival rates. The series consisted of all patients...

  20. Latest Trends in the Monitoring of Ships’s Hull Underwater Part and Analysis of Its Effectiveness

    OpenAIRE

    Urbahs, A; Carjova, K; Vulans, P; Straume, R

    2012-01-01

    Ship operation is not possible without regular maintenance, inspection and certification, established by international and domestic law, where one of the main goals is an effective operation of a ship. To achieve this, it is important to reduce time and costs involved in carrying out the surveys. This paper explores the law under which it’s required for ship to have inspection of underwater part; identifies problems of ship’s hull underwater part; analyze latest trends in ship's hull underwat...

  1. The latest Paleocene benthic extinction event: Punctuated turnover in outer neritic benthic foraminiferal faunas from Gebel Aweina, Egypt

    OpenAIRE

    Speijer, Robert; Schmitz, B; Aubry, MP; Charisi, SD

    1995-01-01

    We investigated the benthic foraminiferal record of the neritic sequence at Gebel Aweina (Nile Valley, Egypt) in relation to the latest Paleocene deep-sea benthic extinction event (BEE). At Gebel Aweina an expanded sequence, spanning calcareous nannofossil Zones NP8-NPlO, is continuously exposed and yields calcareous microfauna throughout. The BEE level is situated about halfway through Zone NP9 at 17m above the base of the Esna Formation. Detailed biostratigraphic and isotopic studies have i...

  2. LGM permafrost distribution: how well can the latest PMIP multi-model ensembles perform reconstruction?

    OpenAIRE

    Saito, K.; Sueyoshi, T.; Marchenko, S.; Romanovsky, V.; Otto-Bliesner, B.; Walsh, J.; Bigelow, N.; Hendricks, A.; Yoshikawa, K.

    2013-01-01

    Here, global-scale frozen ground distribution from the Last Glacial Maximum (LGM) has been reconstructed using multi-model ensembles of global climate models, and then compared with evidence-based knowledge and earlier numerical results. Modeled soil temperatures, taken from Paleoclimate Modelling Intercomparison Project phase III (PMIP3) simulations, were used to diagnose the subsurface thermal regime and determine underlying frozen ground types for the present day (pre-industrial; 0 kya) an...

  3. LGM permafrost distribution: how well can the latest PMIP multi-model ensembles reconstruct?

    OpenAIRE

    K. Saito; T. Sueyoshi; S. Marchenko; V. Romanovsky; B. Otto-Bliesner; J. Walsh; N. Bigelow; A. Hendricks; K. Yoshikawa

    2013-01-01

    Global-scale frozen ground distribution during the Last Glacial Maximum (LGM) was reconstructed using multi-model ensembles of global climate models, and then compared with evidence-based knowledge and earlier numerical results. Modeled soil temperatures, taken from Paleoclimate Modelling Intercomparison Project Phase III (PMIP3) simulations, were used to diagnose the subsurface thermal regime and determine underlying frozen ground types for the present-day (pre-industrial; 0 k) and the LGM (...

  4. Exploiting the information revolution: call for independent evaluation of the latest English national experiment.

    Science.gov (United States)

    Scott, Philip

    2015-02-19

    The English National Health Service (NHS) has a long history of national experiments with information technology; some successful, others less so. The NHS England Five Year Forward View aspires to 'Exploit the information revolution' through the transformational work of the National Information Board (NIB). NIB has published a 'Framework for Action' that promotes citizen empowerment, information availability, transparency, public trust, innovation, informatics skills and societal value. The framework sets out many laudable and common sense ambitions, but is light on evidence to support its aspirations, or plans for its evaluation. Considerable resource was invested in evaluation studies in the later stages of the National Programme for IT in England, but the analyses do not seem to have been included. Most of the cited evidence is from an unpublished report by management consultants rather than independent peer-reviewed work. National experiments of this importance should be evidence based and properly evaluated so that each iteration of 'information revolution' produces an evidence base to inform subsequent generations of care provision models and technology innovation. Evaluation should be planned from the very start rather than added in as an afterthought. Like any good business plan there should be defined critical success factors for health and social care, and a declaration of how they might be measured. Unintended consequences should be qualitatively explored. Evaluation should also consider critical-interpretive social perspectives to understand the human factors in technology deployment and should seek a theoretically informed insight into the mechanisms of change. The NHS Five Year Forward View and the NIB framework set out challenging ambitions based on transformative use of information technology and collaborative partnerships with commissioners and providers. The framework stands up very well against the Hayes principles, but the learning opportunities

  5. Target Therapies for Uterine Carcinosarcomas: Current Evidence and Future Perspectives

    Directory of Open Access Journals (Sweden)

    Salvatore Giovanni Vitale

    2017-05-01

    Full Text Available Carcinosarcomas (CS in gynecology are very infrequent and represent only 2–5% of uterine cancers. Despite surgical cytoreduction and subsequent chemotherapy being the primary treatment for uterine CS, the overall five-year survival rate is 30 ± 9% and recurrence is extremely common (50–80%. Due to the poor prognosis of CS, new strategies have been developed in the last few decades, targeting known dysfunctional molecular pathways for immunotherapy. In this paper, we aimed to gather the available evidence on the latest therapies for the treatment of CS. We performed a systematic review using the terms “uterine carcinosarcoma”, “uterine Malignant Mixed Müllerian Tumors”, “target therapies”, “angiogenesis therapy”, “cancer stem cell therapy”, “prognostic biomarker”, and “novel antibody-drug”. Based on our results, the differential expression and accessibility of epithelial cell adhesion molecule-1 on metastatic/chemotherapy-resistant CS cells in comparison to normal tissues and Human Epidermal Growth Factor Receptor 2 (HER2 open up new possibilities in the field of target therapy. Nevertheless, future investigations are needed to clarify the impact of these new therapies on survival rate and medium-/long-term outcomes.

  6. Endovascular Treatment of Various Aortic Pathologies: Review of the Latest Data and Technologies.

    Science.gov (United States)

    Maeda, Koji; Ohki, Takao; Kanaoka, Yuji

    2018-06-01

    The technologies and innovations applicable to endovascular treatment for complex aortic pathologies have progressed rapidly over the last two decades. Although the initial outcomes of an endovascular aortic repair have been excellent, as long-term data became available, complications including endoleaks, endograft migration, and endograft infection have become apparent and are of concern. Previously, the indication for endovascular therapy was restricted to descending thoracic aortic aneurysms and abdominal aortic aneurysms. However, its indication has expanded along with the improvement of techniques and devices, and currently, it has become possible to treat pararenal aortic aneurysms and Crawford type 4 thoracoabdominal aortic aneurysm (TAAA) using the off-the-shelf devices. Additionally, custom-made devices allow for the treatment of arch or more extensive TAAAs. Endovascular treatment is applied not only to aneurysms but also to acute/chronic dissections. However, long-term outcomes are still unclear. This article provides an overview of available devices and the results of endovascular treatment for various aortic pathologies.

  7. A Call for Barriers in Implementation of Education Regulation: The Latest English Textbook as Main Instructional Media in Schools in Indonesia

    Directory of Open Access Journals (Sweden)

    Fadel Muslaini

    2018-05-01

    Full Text Available Education in Indonesia is much influenced by the implementation of the latest curriculum namely 2013 curriculum with integrated skills approach. The implementation condition must be overseen through time to measure how effective the progress and the result are. To find out the condition, this study involved the teacher and students in the implementation of this issue to find out their perspective and their experience in the real condition of learning process. This paper explores the significant impact of implementation policy in the textbook in Indonesia as the main instructional media applied in the entire country. This study on the other hand tried to reveal the authentic condition in the process of learning and teaching by focusing on English materials. Both quantitative and qualitative methods were used in the process of data collection. This research found many barriers faced by the teacher and students in the policy implementation of textbook in the school as the national sample. The special purposes and the local situation influenced a lot the impact of this country-scale regulation. This study result is expected to provide additional information and evidence to fulfill the aim of the learning process effectively in the future that will be beneficial for authority of education policy, teachers, students, organization, and etc.

  8. Determinants of Network Outcomes

    DEFF Research Database (Denmark)

    Ysa, Tamyko; Sierra, Vicenta; Esteve, Marc

    2014-01-01

    The literature on network management is extensive. However, it generally explores network structures, neglecting the impact of management strategies. In this article we assess the effect of management strategies on network outcomes, providing empirical evidence from 119 urban revitalization...... networks. We go beyond current work by testing a path model for the determinants of network outcomes and considering the interactions between the constructs: management strategies, trust, complexity, and facilitative leadership. Our results suggest that management strategies have a strong effect on network...... outcomes and that they enhance the level of trust. We also found that facilitative leadership has a positive impact on network management as well as on trust in the network. Our findings also show that complexity has a negative impact on trust. A key finding of our research is that managers may wield more...

  9. Improving surgical outcomes

    Directory of Open Access Journals (Sweden)

    Tony Walia

    2008-12-01

    Full Text Available Outcomes of cataract surgery are worse than we would like them to be. Community-based studies show that up to 40% of eyes have a postoperative presenting vision of < 6/60. Eyes with intraocular lenses (IOLs do better; however, it has been shown that even in prosperous middle-income countries, such as Venezuela, in 20% of pseudophakic eyes presenting vision was < 6/60 and in 15% best corrected vision was worse than 6/60.Poor outcomes matter. Patients deserve improved vision whenever possible and poor outcomes deter prospective patients from coming for surgery and probably reduce their willingness to pay for their treatment – particularly if they have to pay in advance!In this article, we offer some suggestions for improving the quality of cataract surgery. We admit that there is little evidence base for most of these suggestions and that some of them are controversial. However, we hope to stimulate debate.

  10. Rectal cancer surgery: volume-outcome analysis.

    LENUS (Irish Health Repository)

    Nugent, Emmeline

    2010-12-01

    There is strong evidence supporting the importance of the volume-outcome relationship with respect to lung and pancreatic cancers. This relationship for rectal cancer surgery however remains unclear. We review the currently available literature to assess the evidence base for volume outcome in relation to rectal cancer surgery.

  11. Management of Gliomas: Overview of the Latest Technological Advancements and Related Behavioral Drawbacks

    Directory of Open Access Journals (Sweden)

    L. Ganau

    2015-01-01

    Full Text Available The advancements in basic sciences and the availability of sophisticated technological aids to surgical removal of gliomas have led over the last few years to the rise of innovative surgical strategies, the identification of better prognostic/predictive biomolecular factors, and the development of novel drugs and all are meant to profoundly impact the outcome of patients diagnosed with these aggressive tumours. Unfortunately, the treatment protocols available nowadays still confer only a small survival advantage at a potentially high cost in terms of overall well-being. In this review we identified the potential and limits of the most promising research trends in the management of glioma patients, also highlighting the related externalities. Finally, we focused our attention on the imbalance between the technical and behavioral aspects pertinent to this research area, which ultimately represent the two sides of the same coin.

  12. LGM permafrost distribution: how well can the latest PMIP multi-model ensembles reconstruct?

    Science.gov (United States)

    Saito, K.; Sueyoshi, T.; Marchenko, S.; Romanovsky, V.; Otto-Bliesner, B.; Walsh, J.; Bigelow, N.; Hendricks, A.; Yoshikawa, K.

    2013-03-01

    Global-scale frozen ground distribution during the Last Glacial Maximum (LGM) was reconstructed using multi-model ensembles of global climate models, and then compared with evidence-based knowledge and earlier numerical results. Modeled soil temperatures, taken from Paleoclimate Modelling Intercomparison Project Phase III (PMIP3) simulations, were used to diagnose the subsurface thermal regime and determine underlying frozen ground types for the present-day (pre-industrial; 0 k) and the LGM (21 k). This direct method was then compared to the earlier indirect method, which categorizes the underlying frozen ground type from surface air temperature, applied to both the PMIP2 (phase II) and PMIP3 products. Both direct and indirect diagnoses for 0 k showed strong agreement with the present-day observation-based map, although the soil temperature ensemble showed a higher diversity among the models partly due to varying complexity of the implemented subsurface processes. The area of continuous permafrost estimated by the multi-model analysis was 25.6 million km2 for LGM, in contrast to 12.7 million km2 for the pre-industrial control, whereas seasonally, frozen ground increased from 22.5 million km2 to 32.6 million km2. These changes in area resulted mainly from a cooler climate at LGM, but other factors as well, such as the presence of huge land ice sheets and the consequent expansion of total land area due to sea-level change. LGM permafrost boundaries modeled by the PMIP3 ensemble-improved over those of the PMIP2 due to higher spatial resolutions and improved climatology-also compared better to previous knowledge derived from the geomorphological and geocryological evidences. Combinatorial applications of coupled climate models and detailed stand-alone physical-ecological models for the cold-region terrestrial, paleo-, and modern climates will advance our understanding of the functionality and variability of the frozen ground subsystem in the global eco-climate system.

  13. Stratigraphy and structural development of the southwest Isla Tiburón marine basin: Implications for latest Miocene tectonic opening and flooding of the northern Gulf of California

    Science.gov (United States)

    Bennett, Scott E. K.; Oskin, Michael; Dorsey, Rebecca; Iriondo, Alexander; Kunk, Michael J.

    2015-01-01

    Accurate information on the timing of earliest marine incursion into the Gulf of California (northwestern México) is critical for paleogeographic models and for understanding the spatial and temporal evolution of strain accommodation across the obliquely divergent Pacific-North America plate boundary. Marine strata exposed on southwest Isla Tiburón (SWIT) have been cited as evidence for a middle Miocene marine incursion into the Gulf of California at least 7 m.y. prior to plate boundary localization ca. 6 Ma. A middle Miocene interpretation for SWIT marine deposits has played a large role in subsequent interpretations of regional tectonics and rift evolution, the ages of marine basins containing similar fossil assemblages along ~1300 km of the plate boundary, and the timing of marine incursion into the Gulf of California. We report new detailed geologic mapping and geochronologic data from the SWIT basin, an elongate sedimentary basin associated with deformation along the dextral-oblique La Cruz fault. We integrate these results with previously published biostratigraphic and geochronologic data to bracket the age of marine deposits in the SWIT basin and show that they have a total maximum thickness of ~300 m. The 6.44 ± 0.05 Ma (Ar/Ar) tuff of Hast Pitzcal is an ash-flow tuff stratigraphically below the oldest marine strata, and the 6.01 ± 0.20 Ma (U/Pb) tuff of Oyster Amphitheater, also an ash-flow tuff, is interbedded with marine conglomerate near the base of the marine section. A dike-fed rhyodacite lava flow that caps all marine strata yields ages of 3.51 ± 0.05 Ma (Ar/Ar) and 4.13 ± 0.09 Ma (U/Pb) from the base of the flow, consistent with previously reported ages of 4.16 ± 1.81 Ma (K-Ar) from the flow top and (K-Ar) 3.7 ± 0.9 Ma from the feeder dike. Our new results confirm a latest Miocene to early Pliocene age for the SWIT marine basin, consistent with previously documented latest Miocene to early Pliocene (ca. 6.2-4.3 Ma) planktonic and benthic

  14. Multiple episodes of extensive marine anoxia linked to global warming and continental weathering following the latest Permian mass extinction.

    Science.gov (United States)

    Zhang, Feifei; Romaniello, Stephen J; Algeo, Thomas J; Lau, Kimberly V; Clapham, Matthew E; Richoz, Sylvain; Herrmann, Achim D; Smith, Harrison; Horacek, Micha; Anbar, Ariel D

    2018-04-01

    Explaining the ~5-million-year delay in marine biotic recovery following the latest Permian mass extinction, the largest biotic crisis of the Phanerozoic, is a fundamental challenge for both geological and biological sciences. Ocean redox perturbations may have played a critical role in this delayed recovery. However, the lack of quantitative constraints on the details of Early Triassic oceanic anoxia (for example, time, duration, and extent) leaves the links between oceanic conditions and the delayed biotic recovery ambiguous. We report high-resolution U-isotope (δ 238 U) data from carbonates of the uppermost Permian to lowermost Middle Triassic Zal section (Iran) to characterize the timing and global extent of ocean redox variation during the Early Triassic. Our δ 238 U record reveals multiple negative shifts during the Early Triassic. Isotope mass-balance modeling suggests that the global area of anoxic seafloor expanded substantially in the Early Triassic, peaking during the latest Permian to mid-Griesbachian, the late Griesbachian to mid-Dienerian, the Smithian-Spathian transition, and the Early/Middle Triassic transition. Comparisons of the U-, C-, and Sr-isotope records with a modeled seawater PO 4 3- concentration curve for the Early Triassic suggest that elevated marine productivity and enhanced oceanic stratification were likely the immediate causes of expanded oceanic anoxia. The patterns of redox variation documented by the U-isotope record show a good first-order correspondence to peaks in ammonoid extinctions during the Early Triassic. Our results indicate that multiple oscillations in oceanic anoxia modulated the recovery of marine ecosystems following the latest Permian mass extinction.

  15. Side event from the Coordination office at Warsaw: Latest developments on the French Wind Power Market: New rules, new challenges

    International Nuclear Information System (INIS)

    Cassin, Fabrice; Elfassi, Paul; Froeding, Veronique; Petit, Jean-Francois

    2010-01-01

    At the occasion of the 2010 edition of the European Wind energy Conference (EWEC 2010), the French-German office for Renewable energies (OFAEnR) organised a Side event on the latest developments of the French Wind Power Market. This document brings together the available presentations (slides) made during this event: 1 - The new regulatory framework under the 'Grenelle' laws: Wind energy planning. French National Action Plan: the wind energy challenge (Fabrice Cassin); 2 - The upcoming enforcement of the dangerous installations rules (ICPe) to wind power plants (Veronique Froeding); 3 - New tax system for wind energy projects and local acceptance (Jean-Francois Petit)

  16. Latest developments on the highly granular Silicon-Tungsten Electromagnetic Calorimeter technological prototype for the International Large Detector

    CERN Document Server

    Irles, Adrián

    2017-01-01

    High precision physics at future colliders requires unprecedented highly granular calorimeters for the application of the Particle Flow (PF) algorithm. The physical proof of concept was given in the previous campaign of beam tests of physic prototypes within the CALICE collaboration. We present here the latest beam and laboratory test results and R&D developments for the Silicon-Tungsten Electromagnetic Calorimeter technological prototype with fully embedded very front-end (VFE) electronics for the International Large Detector at the International Linear Collider project.

  17. Craniopharyngioma and hypothalamic injury: latest insights into consequent eating disorders and obesity

    Science.gov (United States)

    Müller, Hermann L.

    2016-01-01

    Purpose of review Hypothalamic alterations, pathological or treatment induced, have major impact on prognosis in craniopharyngioma patients mainly because of consequent hypothalamic obesity. Recent insight in molecular genetics, treatment strategies, risk factors and outcomes associated with hypothalamic obesity provide novel therapeutic perspectives. This review includes relevant publications since 2013. Recent findings Recent findings confirm that alterations in posterior hypothalamic areas because of tumour location and/or treatment-related injuries are associated with severe hypothalamic obesity, reduced overall survival and impaired quality of life in long-term survivors of childhood-onset craniopharyngioma. However, eating disorders are observed because of hypothalamic obesity without clear disease-specific patterns. Treatment options for hypothalamic obesity are very limited. Treatment with invasive, nonreversible bariatric methods such as Roux-en-Y gastric bypass is most efficient in weight reduction, but controversial in the paediatric population because of medical, ethical, and legal considerations. Accordingly, treatment in craniopharyngioma should focus on prevention of (further) hypothalamic injury. Presurgical imaging for grading of hypothalamic involvement should be the basis for hypothalamus-sparing strategies conducted by experienced multidisciplinary teams. Summary Until a nonsurgical therapeutic option for hypothalamic obesity for paediatric patients is found, prevention of hypothalamic injury should be the preferred treatment strategy, conducted exclusively by experienced multidisciplinary teams. PMID:26574645

  18. Integrated Care for older people in Europe – latest trends and perceptions

    Directory of Open Access Journals (Sweden)

    Kai Leichsenring

    2012-01-01

    Full Text Available As a researcher and consultant I have coordinated local pilots and European research projects to analyse and improve long-term care for older people by better integrating health and social care systems. One of my conclusions from the wide range of initiatives that have been taken over the past two decades in Europe has been the need to treat long-term care as a system in its own right.  Long-term care systems require a discernable identity; specific policies, structures, processes and pathways; and the leadership and resources that can underpin expectations, drive performance and achieve better outcomes for people that are living with (and working for those with long-term care needs. Progress in developing LTC systems can be identified today in all European countries. Integrated care solutions at the interface between health and social care, and between formal and informal care, have appeared. These have been achieved partly by means of (slow political reforms, partly as a response to market-oriented governance, and in many cases through pioneering community and civil society initiatives. It will depend on such initiatives, and their ability to convince both citizens and policy-makers, whether new societal approaches to long-term care are created that meet the demands of ageing societies.

  19. Latest results and developments from the Hybrid Illinois Device for Research and Applications

    Science.gov (United States)

    Rizkallah, Rabel; Andruczyk, Daniel; Jeckell, Zachary Jon; Shone, Andrew John; Johnson, Daniel Scott; Allain, Jean Paul; Curreli, Davide; Ruzic, David N.; The Hidra Team

    2017-10-01

    The Hybrid Illinois Device for Research and Applications (HIDRA) is a five-period, l = 2, m = 5, toroidal fusion device operated at the University of Illinois at Urbana-Champaign (UIUC). It has a major radius R0 = 0.72 m and minor radius a = 0.19 m. Initial heating is achieved with 2.45 GHz electron cyclotron resonance heating (ECRH) at an on-axis magnetic field of B0 = 0.087 T which can go as high as B0 = 0.5 T. HIDRA will mainly be used as a classical stellarator, but can also run as a tokamak. This allows for both steady-state and transient regime operations. Experiments on HIDRA will primarily tackle the issue of plasma-material interactions (PMI) in fusion, and focus on developing innovative plasma facing component (PFC) technologies. Currently, research on flowing liquid lithium PFCs meant to be tested inside the machine in real-time operation, is being carried on. The first experiments run on HIDRA started in early 2016 in the low field region. Now, HIDRA is also capable of running in the high field zone, allowing for more interesting experiments and meaningful outcomes. Here, we present some of the initial results coming from the machine.

  20. LGM permafrost distribution: how well can the latest PMIP multi-model ensembles perform reconstruction?

    Directory of Open Access Journals (Sweden)

    K. Saito

    2013-08-01

    Full Text Available Here, global-scale frozen ground distribution from the Last Glacial Maximum (LGM has been reconstructed using multi-model ensembles of global climate models, and then compared with evidence-based knowledge and earlier numerical results. Modeled soil temperatures, taken from Paleoclimate Modelling Intercomparison Project phase III (PMIP3 simulations, were used to diagnose the subsurface thermal regime and determine underlying frozen ground types for the present day (pre-industrial; 0 kya and the LGM (21 kya. This direct method was then compared to an earlier indirect method, which categorizes underlying frozen ground type from surface air temperature, applying to both the PMIP2 (phase II and PMIP3 products. Both direct and indirect diagnoses for 0 kya showed strong agreement with the present-day observation-based map. The soil temperature ensemble showed a higher diversity around the border between permafrost and seasonally frozen ground among the models, partly due to varying subsurface processes, implementation, and settings. The area of continuous permafrost estimated by the PMIP3 multi-model analysis through the direct (indirect method was 26.0 (17.7 million km2 for LGM, in contrast to 15.1 (11.2 million km2 for the pre-industrial control, whereas seasonally frozen ground decreased from 34.5 (26.6 million km2 to 18.1 (16.0 million km2. These changes in area resulted mainly from a cooler climate at LGM, but from other factors as well, such as the presence of huge land ice sheets and the consequent expansion of total land area due to sea-level change. LGM permafrost boundaries modeled by the PMIP3 ensemble – improved over those of the PMIP2 due to higher spatial resolutions and improved climatology – also compared better to previous knowledge derived from geomorphological and geocryological evidence. Combinatorial applications of coupled climate models and detailed stand-alone physical-ecological models for the cold-region terrestrial

  1. LGM permafrost distribution: how well can the latest PMIP multi-model ensembles perform reconstruction?

    Science.gov (United States)

    Saito, K.; Sueyoshi, T.; Marchenko, S.; Romanovsky, V.; Otto-Bliesner, B.; Walsh, J.; Bigelow, N.; Hendricks, A.; Yoshikawa, K.

    2013-08-01

    Here, global-scale frozen ground distribution from the Last Glacial Maximum (LGM) has been reconstructed using multi-model ensembles of global climate models, and then compared with evidence-based knowledge and earlier numerical results. Modeled soil temperatures, taken from Paleoclimate Modelling Intercomparison Project phase III (PMIP3) simulations, were used to diagnose the subsurface thermal regime and determine underlying frozen ground types for the present day (pre-industrial; 0 kya) and the LGM (21 kya). This direct method was then compared to an earlier indirect method, which categorizes underlying frozen ground type from surface air temperature, applying to both the PMIP2 (phase II) and PMIP3 products. Both direct and indirect diagnoses for 0 kya showed strong agreement with the present-day observation-based map. The soil temperature ensemble showed a higher diversity around the border between permafrost and seasonally frozen ground among the models, partly due to varying subsurface processes, implementation, and settings. The area of continuous permafrost estimated by the PMIP3 multi-model analysis through the direct (indirect) method was 26.0 (17.7) million km2 for LGM, in contrast to 15.1 (11.2) million km2 for the pre-industrial control, whereas seasonally frozen ground decreased from 34.5 (26.6) million km2 to 18.1 (16.0) million km2. These changes in area resulted mainly from a cooler climate at LGM, but from other factors as well, such as the presence of huge land ice sheets and the consequent expansion of total land area due to sea-level change. LGM permafrost boundaries modeled by the PMIP3 ensemble - improved over those of the PMIP2 due to higher spatial resolutions and improved climatology - also compared better to previous knowledge derived from geomorphological and geocryological evidence. Combinatorial applications of coupled climate models and detailed stand-alone physical-ecological models for the cold-region terrestrial, paleo-, and modern

  2. How to Justify Purchase of an iPad: Users of the Latest Launch

    Directory of Open Access Journals (Sweden)

    Emílio José Montero Arruda Filho

    2014-09-01

    Full Text Available Contemporary technology innovation is increasingly based on convergence and the multiple uses of products. This change is detailed in the literature about new product development, as well as that on systems integration. This article focuses on the factors that determine the justification for using advanced technology products in which the perceived value of the product is not based on its functionality, as much as on its hedonistic or social value as an “all-in-one” product. In this study, consumer behaviors toward the Apple iPad are analyzed using netnographic evidence taken from internet postings by the consumers themselves. Since Apple initially marketed the iPad as a revolutionary product, with integrated services and features, our analysis concentrates on how consumers perceived these new, innovative features, in an effort to justify their purchase of the product. Our findings indicate that consumers’ justifications are based not only on the iPad’s functionality, but also its hedonic traits, and its similarity to the previously released innovative product, the iPhone.

  3. ICMI 1966-2016: A Double Insiders' View of the Latest Hal Century of the International Commission on Mathematical Instruction

    DEFF Research Database (Denmark)

    Hodgson, Bernard; Niss, Mogens Allan

    2018-01-01

    This paper concentrates on the latest five decades of the International Commission on Mathematical Instruction. We had the privilege of occupying leading positions within ICMI for roughly half the period under consideration, which has provided us with a unique standpoint for identifying and refle......This paper concentrates on the latest five decades of the International Commission on Mathematical Instruction. We had the privilege of occupying leading positions within ICMI for roughly half the period under consideration, which has provided us with a unique standpoint for identifying...... and reflecting on main trends and developments of the relationship between ICMI and mathematics education. The years 1966–2016 have seen marked trends and developments in mathematics teaching and learning around the world, at the same time as mathematics education as a scientific discipline came of age...... and matured. ICMI as an organisation has not only observed these developments but has also been a key player in charting and analysing them, as well as in fostering and facilitating (some of) them. We offer, here, observations, analyses and reflections on key issues in mathematics education as perceived by us...

  4. Evidence logics with relational evidence

    DEFF Research Database (Denmark)

    Baltag, Alexandru; Occhipinti, Andrés

    2017-01-01

    We introduce a family of logics for reasoning about relational evidence: evidence that involves an ordering of states in terms of their relative plausibility. We provide sound and complete axiomatizations for the logics. We also present several evidential actions and prove soundness...

  5. Digital evidence

    Directory of Open Access Journals (Sweden)

    Lukić Tatjana

    2012-01-01

    Full Text Available Although computer makes human activities faster and easier, innovating and creating new forms of work and other kinds of activities, it also influenced the criminal activity. The development of information technology directly affects the development of computer forensics without which, it can not even imagine the discovering and proving the computer offences and apprehending the perpetrator. Information technology and computer forensic allows us to detect and prove the crimes committed by computer and capture the perpetrators. Computer forensics is a type of forensics which can be defined as a process of collecting, preserving, analyzing and presenting digital evidence in court proceedings. Bearing in mind, that combat against crime, in which computers appear as an asset or object of the offense, requires knowledge of digital evidence as well as specific rules and procedures, the author in this article specifically addresses the issues of digital evidence, forensic (computer investigation, specific rules and procedures for detecting, fixing and collecting digital evidence and use of this type of evidence in criminal proceedings. The author also delas with international standards regarding digital evidence and cyber-space investigation.

  6. Latest Results from and Plans for the New Horizons Pluto-Kuiper Belt Mission

    Science.gov (United States)

    Weaver, Harold; Stern, Alan

    2016-07-01

    On 2015 July 14 NASA's New Horizons spacecraft flew 12,500 km above the surface of Pluto revealing a world of remarkable complexity and diversity. A giant basin filled with nitrogen ice dominated the encounter hemisphere and is the site of vigorous ongoing solid state convection that generates glacier-like transport along the surface. Giant mountains of water ice appear to be floating in the nitrogen ice. The periphery of the basin has a wide variety of landforms, including ice flow channels and chaotically arranged blocks of water ice. Extensive sublimation pitting is observed within the nitrogen ice sheet, testifying to active volatile transport. Peculiar bladed terrain to the east of the nitrogen ice sheet appears to be coated by methane ice. Pluto's equatorial region is dominated by an ancient dark red belt of material, probably tholins created either by irradiation of surface ices or by haze precipitation from the atmosphere. Pluto sports a wide variety of surface craters with some terrains dating back approximately 4 billion years while some terrains are geologically young. New Horizons discovered trace hydrocarbons in Pluto's atmosphere, multiple global haze layers, and a surface pressure near 10 microbars. Charon, Pluto's largest moon, displays tectonics, evidence for a heterogeneous crustal composition, and a puzzling giant hood of dark material covering its North Pole. Crater density statistics for Charon's surface give a crater retention age of 4-4.5 Ga, indicating that Charon's geological evolution largely ceased early in its history. All of Pluto's four small moons (Styx, Nix, Kerberos, and Hydra) have high albedos, highly elongated shapes, and are rotating much faster then synchronous with their orbital periods, with rotational poles clustered near the Pluto-Charon orbital plane. The surfaces of Nix and Hydra are coated with nearly pristine crystalline water ice, despite having crater retention ages greater than 4 billion years. The New Horizons

  7. Discovery of Latest Cretaceous OIB-type alkaline gabbros in the Eastern Pontides Orogenic Belt, NE Turkey: Evidence for tectonic emplacement of seamounts

    Science.gov (United States)

    Eyuboglu, Yener; Dudas, Francis O.; Chatterjee, Nilanjan; Liu, Ze; Yılmaz-Değerli, Sedanur

    2018-06-01

    The Meso-Cenozoic geodynamic evolution of the Eastern Pontides Orogenic Belt, a mountain chain extending parallel to the southeastern margin of the Black Sea, has been controversial for the last forty years. Here we present data for a newly discovered alkaline gabbro body and its surrounding basaltic rocks in the northern part of the Eastern Pontides Orogenic Belt. We also provide a comprehensive assessment of the Late Mesozoic-Cenozoic geodynamic evolution of the Eastern Mediterranean region. The gabbroic body is bounded by reverse faults along its northern and southern borders and is surrounded by vesicular, pillow-fragment breccias and pillow basalts. Mineral compositions suggest that crystallization of the gabbros began at about 1170 °C, and the lowest preserved crystallization T is near 1000 °C. Estimated pressure at the beginning of crystallization is 5.7-7.4 kb. The 40Ar/39Ar dating of kaersutite and plagioclase and Usbnd Pb dating of titanite indicated that the Hayrat gabbro crystallized at 67 Ma (Late Maastrichtian). Whole rock major-trace-rare earth element and Sr-Nd-Pb isotope data indicate that the gabbros and basalts have different origins. The gabbros are alkaline and exhibit the geochemical features of OIB, whereas the basalts are tholeiitic and reveal depletions of HFSE that are similar to those of arc rocks. The gabbros are strongly fractionated, and derive from an enriched, lithospheric mantle source, with partial melting occurring in a garnet-stable environment. The basalts are less fractionated, and probably derive from a shallower source in which spinel peridotite was the predominant lithology. Considering all new and old geological, geochemical, geochronological and geophysical data from the Black Sea Basin and the Eastern Pontides-Lesser Caucasus-Alborz Orogenic Belt, we suggest that the alkaline Hayrat gabbro formed in an oceanic intraplate setting, and was accreted to the forearc region of the Eastern Pontides Orogenic Belt during southward subduction of Paleotethyan lithosphere. It was later tectonically juxtaposed with subaqueously erupted, arc-related basalts.

  8. Teleophthalmology: improving patient outcomes?

    Directory of Open Access Journals (Sweden)

    Sreelatha OK

    2016-02-01

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

  9. New phiomorph rodents from the latest Eocene of Egypt, and the impact of Bayesian "clock"-based phylogenetic methods on estimates of basal hystricognath relationships and biochronology.

    Science.gov (United States)

    Sallam, Hesham M; Seiffert, Erik R

    2016-01-01

    The Fayum Depression of Egypt has yielded fossils of hystricognathous rodents from multiple Eocene and Oligocene horizons that range in age from ∼37 to ∼30 Ma and document several phases in the early evolution of crown Hystricognathi and one of its major subclades, Phiomorpha. Here we describe two new genera and species of basal phiomorphs, Birkamys korai and Mubhammys vadumensis, based on rostra and maxillary and mandibular remains from the terminal Eocene (∼34 Ma) Fayum Locality 41 (L-41). Birkamys is the smallest known Paleogene hystricognath, has very simple molars, and, like derived Oligocene-to-Recent phiomorphs (but unlike contemporaneous and older taxa) apparently retained dP(4)∕4 late into life, with no evidence for P(4)∕4 eruption or formation. Mubhammys is very similar in dental morphology to Birkamys, and also shows no evidence for P(4)∕4 formation or eruption, but is considerably larger. Though parsimony analysis with all characters equally weighted places Birkamys and Mubhammys as sister taxa of extant Thryonomys to the exclusion of much younger relatives of that genus, all other methods (standard Bayesian inference, Bayesian "tip-dating," and parsimony analysis with scaled transitions between "fixed" and polymorphic states) place these species in more basal positions within Hystricognathi, as sister taxa of Oligocene-to-Recent phiomorphs. We also employ tip-dating as a means for estimating the ages of early hystricognath-bearing localities, many of which are not well-constrained by geological, geochronological, or biostratigraphic evidence. By simultaneously taking into account phylogeny, evolutionary rates, and uniform priors that appropriately encompass the range of possible ages for fossil localities, dating of tips in this Bayesian framework allows paleontologists to move beyond vague and assumption-laden "stage of evolution" arguments in biochronology to provide relatively rigorous age assessments of poorly-constrained faunas. This

  10. New phiomorph rodents from the latest Eocene of Egypt, and the impact of Bayesian “clock”-based phylogenetic methods on estimates of basal hystricognath relationships and biochronology

    Directory of Open Access Journals (Sweden)

    Hesham M. Sallam

    2016-03-01

    Full Text Available The Fayum Depression of Egypt has yielded fossils of hystricognathous rodents from multiple Eocene and Oligocene horizons that range in age from ∼37 to ∼30 Ma and document several phases in the early evolution of crown Hystricognathi and one of its major subclades, Phiomorpha. Here we describe two new genera and species of basal phiomorphs, Birkamys korai and Mubhammys vadumensis, based on rostra and maxillary and mandibular remains from the terminal Eocene (∼34 Ma Fayum Locality 41 (L-41. Birkamys is the smallest known Paleogene hystricognath, has very simple molars, and, like derived Oligocene-to-Recent phiomorphs (but unlike contemporaneous and older taxa apparently retained dP4∕4 late into life, with no evidence for P4∕4 eruption or formation. Mubhammys is very similar in dental morphology to Birkamys, and also shows no evidence for P4∕4 formation or eruption, but is considerably larger. Though parsimony analysis with all characters equally weighted places Birkamys and Mubhammys as sister taxa of extant Thryonomys to the exclusion of much younger relatives of that genus, all other methods (standard Bayesian inference, Bayesian “tip-dating,” and parsimony analysis with scaled transitions between “fixed” and polymorphic states place these species in more basal positions within Hystricognathi, as sister taxa of Oligocene-to-Recent phiomorphs. We also employ tip-dating as a means for estimating the ages of early hystricognath-bearing localities, many of which are not well-constrained by geological, geochronological, or biostratigraphic evidence. By simultaneously taking into account phylogeny, evolutionary rates, and uniform priors that appropriately encompass the range of possible ages for fossil localities, dating of tips in this Bayesian framework allows paleontologists to move beyond vague and assumption-laden “stage of evolution” arguments in biochronology to provide relatively rigorous age assessments of poorly

  11. New phiomorph rodents from the latest Eocene of Egypt, and the impact of Bayesian “clock”-based phylogenetic methods on estimates of basal hystricognath relationships and biochronology

    Science.gov (United States)

    2016-01-01

    The Fayum Depression of Egypt has yielded fossils of hystricognathous rodents from multiple Eocene and Oligocene horizons that range in age from ∼37 to ∼30 Ma and document several phases in the early evolution of crown Hystricognathi and one of its major subclades, Phiomorpha. Here we describe two new genera and species of basal phiomorphs, Birkamys korai and Mubhammys vadumensis, based on rostra and maxillary and mandibular remains from the terminal Eocene (∼34 Ma) Fayum Locality 41 (L-41). Birkamys is the smallest known Paleogene hystricognath, has very simple molars, and, like derived Oligocene-to-Recent phiomorphs (but unlike contemporaneous and older taxa) apparently retained dP4∕4 late into life, with no evidence for P4∕4 eruption or formation. Mubhammys is very similar in dental morphology to Birkamys, and also shows no evidence for P4∕4 formation or eruption, but is considerably larger. Though parsimony analysis with all characters equally weighted places Birkamys and Mubhammys as sister taxa of extant Thryonomys to the exclusion of much younger relatives of that genus, all other methods (standard Bayesian inference, Bayesian “tip-dating,” and parsimony analysis with scaled transitions between “fixed” and polymorphic states) place these species in more basal positions within Hystricognathi, as sister taxa of Oligocene-to-Recent phiomorphs. We also employ tip-dating as a means for estimating the ages of early hystricognath-bearing localities, many of which are not well-constrained by geological, geochronological, or biostratigraphic evidence. By simultaneously taking into account phylogeny, evolutionary rates, and uniform priors that appropriately encompass the range of possible ages for fossil localities, dating of tips in this Bayesian framework allows paleontologists to move beyond vague and assumption-laden “stage of evolution” arguments in biochronology to provide relatively rigorous age assessments of poorly-constrained faunas

  12. The effects of prenatal cannabis exposure on fetal development and pregnancy outcomes: a protocol.

    Science.gov (United States)

    Gunn, Jayleen K L; Rosales, Cecilia B; Center, Katherine E; Nuñez, Annabelle V; Gibson, Steven J; Ehiri, John E

    2015-03-13

    The effects of exposure to marijuana in utero on fetal development are not clear. Given that the recent legislation on cannabis in the US is likely to result in increased use, there is a need to assess the effects of prenatal cannabis exposure on fetal development and pregnancy outcomes. The objective of this review is to assess the effects of prenatal exposure to cannabis on pregnancy outcomes (including maternal and child outcomes). Major databases will be searched from inception to the latest issue, with the aim of identifying studies that reported the effects of prenatal exposure to cannabis on fetal development and pregnancy outcomes. Two investigators will independently review all titles and abstracts to identify potential articles. Discrepancies will be resolved by repeated review, discussion and consensus. Study quality assessment will be undertaken, using standard protocols. To qualify for inclusion, studies must report at least one maternal or neonatal outcome post partum. Cross-sectional, case-control, cohort and randomised controlled trials published in English will be included. In order to rule out the effects of other drugs that may affect fetal development and pregnancy outcomes, studies will only be included if they report outcomes of prenatal exposure to cannabis while excluding other illicit substances. Data from eligible studies will be extracted, and data analysis will include a systematic review and critical appraisal of evidence, and meta-analysis if data permit. Meta-analysis will be conducted if three or more studies report comparable statistics on the same outcome. The review which will result from this protocol has not already been conducted. Preparation of the review will follow the procedures stated in this protocol, and will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Ethical approval of data will not be required since the review will use data that are already available in the

  13. The latest results on top quark pair cross-section measurement at the LHC-ATLAS experiment

    CERN Document Server

    Yamauchi, Katsuya; The ATLAS collaboration

    2015-01-01

    The latest results on top quark pair production cross-section measurement in proton-proton collisions at $\\sqrt{s}$ = 7\\,TeV and $\\sqrt{s}$ = 8\\,TeV with the ATLAS detector are reported. The inclusive cross-section was measured with relative uncertainty of 4\\% using the final state of the top quark pair including an electron and a muon. The measurement of the differential cross-section as functions of various observables such as the transverse momentum and the rapidity of the top quark and the invariant mass of the top quark pair system are also reported. These results are compared with various generators such as {\\sc Powheg}, {\\sc Alpgen} and {\\sc MC@NLO} and various sets of parton distribution functions.

  14. Latest LHCf results and preparation to the LHC run for 13 TeV proton–proton interactions

    Directory of Open Access Journals (Sweden)

    Bonechi L.

    2015-01-01

    Full Text Available The LHCf experiment is a CERN experiment dedicated to forward physics which is optimized to measure the neutral particle flow at extreme pseudo-rapidity values, ranging from 8.4 up to infinity. LHCf results are extremely important for the calibration of the hadronic interaction models used for the study of the development of atmospheric showers in the Earth atmosphere. Starting from the recent run of proton-Lead nucleus interactions at LHC, the LHCf and ATLAS collaborations have performed a common data taking which allows a combined study of the central and forward regions of the interaction. The latest results of LHCf, the upgrade of the detectors for the next 6.5 TeV + 6.5 TeV proton–proton run and the status of the LHCf-ATLAS common activities are summarized in this paper.

  15. The Histoty of Ventilation and Air Conditioning is CERN Up to Date with the latest Technological Developments?

    CERN Document Server

    Kühnl-Kinel, J

    2000-01-01

    The invention of ventilation cannot be ascribed to a certain date. It started with simple aeration when man brought fire into his abode and continued through different stages including air cooling using ice to finally arrive at the time when ventilation and air conditioning has become an essential part of our life and plays an important role in human evolution. This paper presents the history of ventilation and air conditioning, explains the key constraints over the centuries, and shows its influence on everyday life. Some examples of previous air-conditioning plants are described and different approaches to the way of calculation of ventilation systems discussed. It gives an overview of the Heating, Ventilation and Air Conditioning (HVAC) installations at CERN and points out their particularities. It also compares them with the latest technological developments in the field as well as showing the new trends that are being applied at CERN.

  16. THE LATEST ADVANCEMENTS IN THE ACYLATION REACTIONS VIA CROSS-DEHYDROGENATIVE COUPLING AND/OR METAL CATALYSTS

    Directory of Open Access Journals (Sweden)

    Soykan Ağar

    2017-12-01

    Full Text Available There are quite many examples in the scientific literature regarding the acylation reactions, especially the metal-catalyzed acylation reactions, metal-free acylation reactions, metal-catalyzed acylation via cross-dehydrogenative coupling (CDC reactions and metal-free acylation via cross-dehydrogenative coupling (CDC reactions. In this review paper, the most important examples of these domains were brought together and their mechanisms were exhibited in a clear, chronological format. Following these, the best example study towards green chemistry with a metal-free and high-yielding route was mentioned and discussed to demonstrate what has achieved in this field regarding the new acylation reaction mechanisms using the advantages of cross-dehydrogenative coupling (CDC reactions. The most prominent studies regarding these domains have been examined thoroughly and the latest progress in this field was explained in detail.

  17. The latest application of Hitachi's state-of-the-art construction technology and further evolution towards new build NPP projects

    International Nuclear Information System (INIS)

    Akagi, K.; Morita, K.; Miyahara, R.; Murayama, K.; Deir, C.; Akahori, S.

    2008-01-01

    Shika Nuclear Power Station Unit No.2 began commercial operation in March 2006 as one of the latest new-build projects in the world. Hitachi-GE Nuclear Energy Ltd. (Hitachi) was the main contractor and supplied the entire plant including engineering, manufacturing of all major reactor and turbine-generator components, and executed the installation and commissioning. Hitachi completed the project on schedule and on budget owing in large part to its highly reliable advanced construction technology. This article describes Hitachi's unsurpassed advanced construction technology being applied to the current new-build projects in Japan. Furthermore, this article addresses a possible form of applications to new build nuclear power plants in North America. (author)

  18. Latest Performance Results from the FONT5 Intra-train Beam Position and Angle Feedback System at ATF2

    CERN Document Server

    Christian, G B; Bett, D R; Blaskovic Kraljevic, N; Burrows, P N; Davis, M R; Gerbershagen, A; Perry, C; Constance, B; Resta-Lopez, J

    2012-01-01

    A prototype Interaction Point beam-based feedback system for future electron-positron colliders, such as the International Linear Collider, has been designed and tested on the extraction line of the KEK Accelerator Test Facility (ATF). The FONT5 intra-train feedback system aims to stabilize the beam orbit by correcting both the position and angle jitter in the vertical plane on bunch-tobunch time scales, providing micron-level stability at the entrance to the ATF2 final-focus system. The system comprises three stripline beam position monitors (BPMs) and two stripline kickers, custom low-latency analogue front-end BPM processors, a custom FPGA-based digital processing board with fast ADCs, and custom kickerdrive amplifiers. The latest results from beam tests at ATF2 will be presented, including the system latency and correction performance.

  19. A high resolution radiation hybrid map of bovine chromosome 14 identifies scaffold rearrangement in the latest bovine assembly

    Directory of Open Access Journals (Sweden)

    Wang Zhiquan

    2007-07-01

    Full Text Available Abstract Background Radiation hybrid (RH maps are considered to be a tool of choice for fine mapping closely linked loci, considering that the resolution of linkage maps is determined by the number of informative meiosis and recombination events which may require very large mapping populations. Accurately defining the marker order on chromosomes is crucial for correct identification of quantitative trait loci (QTL, haplotype map construction and refinement of candidate gene searches. Results A 12 k Radiation hybrid map of bovine chromosome 14 was constructed using 843 single nucleotide polymorphism markers. The resulting map was aligned with the latest version of the bovine assembly (Btau_3.1 as well as other previously published RH maps. The resulting map identified distinct regions on Bovine chromosome 14 where discrepancies between this RH map and the bovine assembly occur. A major region of discrepancy was found near the centromere involving the arrangement and order of the scaffolds from the assembly. The map further confirms previously published conserved synteny blocks with human chromosome 8. As well, it identifies an extra breakpoint and conserved synteny block previously undetected due to lower marker density. This conserved synteny block is in a region where markers between the RH map presented here and the latest sequence assembly are in very good agreement. Conclusion The increase of publicly available markers shifts the rate limiting step from marker discovery to the correct identification of their order for further use by the research community. This high resolution map of bovine chromosome 14 will facilitate identification of regions in the sequence assembly where additional information is required to resolve marker ordering.

  20. Proposal for the use in emergency departments of cardiac troponins measured with the latest generation methods in patients with suspected acute coronary syndrome without persistent ST-segment elevation

    Directory of Open Access Journals (Sweden)

    Ivo Casagranda

    2013-10-01

    Full Text Available The purpose of this document is to develop recommendations on the use of the latest generation of cardiac troponins in emergency room settings for the diagnosis of myocardial infarction in patients with suspected acute coronary syndrome without persistent ST-segment elevation (NSTE-ACS. The main points which have been addressed reaching a consensus are: i suitability and appropriateness of the terminology; ii appropriateness of the request; iii confirmation of the diagnosis of myocardial infarction (rule-in; iv exclusion of the diagnosis of myocardial infarction (rule-out. Each point has been analyzed by taking into account the evidence presented in medical publications. Recommendations were developed using the criteria adopted by the European Society of Cardiology and the American Heart Association/American College of Cardiology. Each point of the recommendation was submitted for validation to an external audit by a Group of Experts (named above.

  1. The Role of Preference on Outcomes of People Receiving Evidence-Informed Community Wound Care in Their Home or in a Nurse-Clinic Setting: A Cohort Study (n = 230)

    OpenAIRE

    Harrison, Margaret B.; VanDenKerkhof, Elizabeth G.; Hopman, Wilma M.; Carley, Meg E.

    2014-01-01

    This study followed a cohort of community-dwelling individuals receiving wound-care in a large urban-rural region. During a randomized control trial (RCT) evaluating outcomes of receiving care in a nurse-clinic or at home, many approached were willing to participate if they could choose their location of care. This provided a unique opportunity to enroll them as a “choice” cohort, following them in the same manner as the trial participants but allowing them to select their setting of care. Th...

  2. Glycemic Control for Patients With Type 2 Diabetes Mellitus: Our Evolving Faith in the Face of Evidence.

    Science.gov (United States)

    Rodríguez-Gutiérrez, René; Montori, Victor M

    2016-09-01

    We sought to determine the concordance between the accumulating evidence about the impact of tight versus less tight glycemic control in patients with type 2 diabetes mellitus since the publication of UKPDS (UK Prospective Diabetes Study) in 1998 until 2015 with the views about that evidence published in journal articles and practice guidelines. We searched in top general medicine and specialty journals for articles referring to glycemic control appearing between 2006 and 2015 and identified the latest practice guidelines. To summarize the evidence, we included all published systematic reviews and meta-analyses of contemporary randomized trials of glycemic control measuring patient-important microvascular and macrovascular outcomes, and completed a meta-analysis of their follow-up extensions. We identified 16 guidelines and 328 statements. The body of evidence produced estimates warranting moderate confidence. This evidence reported no significant impact of tight glycemic control on the risk of dialysis/transplantation/renal death, blindness, or neuropathy. In the past decade, however, most published statements (77%-100%) and guidelines (95%) unequivocally endorsed benefit. There is also no significant effect on all-cause mortality, cardiovascular mortality, or stroke; however, there is a consistent 15% relative-risk reduction of nonfatal myocardial infarction. Between 2006 and 2008, most statements (47%-83%) endorsed the benefit; after 2008 (ACCORD), only a minority (21%-36%) did. Discordance exists between the research evidence and academic and clinical policy statements about the value of tight glycemic control to reduce micro- and macrovascular complications. This discordance may distort priorities in the research and practice agendas designed to improve the lives of patients with type 2 diabetes mellitus. © 2016 American Heart Association, Inc.

  3. Latest Rate, Extent, and Temporal Evolution of Growth Faulting over Greater Houston Region Revealed by Multi- Band InSAR Time-Series Analysis

    Science.gov (United States)

    Qu, F.; Lu, Z.; Kim, J. W.

    2017-12-01

    Growth faults are common and continue to evolve throughout the unconsolidated sediments of Greater Houston (GH) region in Texas. Presence of faults can induce localized surface displacements, aggravate localized subsidence, and discontinue the integrity of ground water flow. Property damages due to fault creep have become more evident during the past few years over the GH area, portraying the necessity of further study of these faults. Interferometric synthetic aperture radar (InSAR) has been proven to be effective in mapping creep along and/or across faults. However, extracting a short wavelength, as well as small amplitude of the creep signal (about 10-20 mm/year) from long time span interferograms is extremely difficult, especially in agricultural or vegetated areas. This paper aims to map and monitor the latest rate, extent, and temporal evolution of faulting at a highest spatial density over GH region using an improved Multi-temporal InSAR (MTI) technique. The method, with maximized usable signal and correlation, has the ability to identify and monitor the active faults to provide an accurate and elaborate image of the faults. In this study, two neighboring ALOS tracks and Sentinel-1A datasets are used. Many zones of steep phase gradients and/or discontinuities have been recognized from the long term velocity maps by both ALOS (2007-2011) and Sentinei-1A (2015-2017) imagery. Not only those previously known faults position but also the new fault traces that have not been mapped by other techniques are imaged by our MTI technique. Fault damage and visible cracking of ground were evident at most locations through our field survey. The discovery of new fault activation, or faults moved from earlier locations is a part of the Big Barn Fault and Conroe fault system, trending from southwest to northeast between Hockley and Conroe. The location of area of subsidence over GH is also shrinking and migrating toward the northeast (Montgomery County) after 2000. The

  4. Culturally Sensitive and Environment-Friendly Outcome Measures in

    African Journals Online (AJOL)

    Dr Olaleye

    A systematic review of evidence on culturally sensitive and environment-friendly outcome measures in ..... which included manual grass cutting/hoeing, assuming the Islamic ... who opined that the starting point for any outcome measure is to ...

  5. Development of the Veritas plot and its application in cardiac surgery: an evidence-synthesis graphic tool for the clinician to assess multiple meta-analyses reporting on a common outcome.

    Science.gov (United States)

    Panesar, Sukhmeet S; Rao, Christopher; Vecht, Joshua A; Mirza, Saqeb B; Netuveli, Gopalakrishnan; Morris, Richard; Rosenthal, Joe; Darzi, Ara; Athanasiou, Thanos

    2009-10-01

    Meta-analyses may be prone to generating misleading results because of a paucity of experimental studies (especially in surgery); publication bias; and heterogeneity in study design, intervention and the patient population of included studies. When investigating a specific clinical or scientific question on which several relevant meta-analyses may have been published, value judgments must be applied to determine which analysis represents the most robust evidence. These value judgments should be specifically acknowledged. We designed the Veritas plot to explicitly explore important elements of quality and to facilitate decision-making by highlighting specific areas in which meta-analyses are found to be deficient. Furthermore, as a graphic tool, it may be more intuitive than when similar data are presented in a tabular or text format. The Veritas plot is an adaption of the radar plot, a graphic tool for the description of multiattribute data. Key elements of meta-analytical quality such as heterogeneity, publication bias and study design are assessed. Existing qualitative methods such as the Assessment of Multiple Systematic Reviews (AMSTAR) tool have been incorporated in addition to important considerations when interpreting surgical meta-analyses such as the year of publication and population characteristics. To demonstrate the potential of the Veritas plot to inform clinical practice, we apply the Veritas plot to the meta-analytical literature comparing the incidence of 30-day stroke in off-pump coronary artery bypass surgery and conventional coronary artery bypass surgery. We demonstrate that a visually-stimulating and practical evidence-synthesis tool can direct the clinician and scientist to a particular meta-analytical study to inform clinical practice. The Veritas plot is also cumulative and allowed us to assess the quality of evidence over time. We have presented a practical graphic application for scientists and clinicians to identify and interpret

  6. The Latest from ATLAS

    CERN Multimedia

    2009-01-01

    Since November 2008, ATLAS has undertaken detailed maintenance, consolidation and repair work on the detector (see Bulletin of 20 July 2009). Today, the fraction of the detector that is operational has increased compared to last year: less than 1% of dead channels for most of the sub-systems. "We are going to start taking data this year with a detector which is even more efficient than it was last year," agrees ATLAS Spokesperson, Fabiola Gianotti. By mid-September the detector was fully closed again, and the cavern sealed. The magnet system has been operated at nominal current for extensive periods over recent months. Once the cavern was sealed, ATLAS began two weeks of combined running. Right now, subsystems are joining the run incrementally until the point where the whole detector is integrated and running as one. In the words of ATLAS Technical Coordinator, Marzio Nessi: "Now we really start physics." In parallel, the analysis ...

  7. Latest Magnet News

    CERN Multimedia

    Miele, P.

    PRODUCTION OF TB COMPONENTS Production of the main components of the Barrel Toroid coils is well advanced in industry. They are being delivered to CERN and piled up in Building 180 ready for integration. Three coil casings have been completed at ALSTOM Power Switzerland and are standing in Building 180 waiting for integration (left photo). Ten double pancakes out of 16 have been completed at ANSALDO. Four of them have been delivered to CERN (right photo). Two vacuum vessels have been delivered to CERN by Felguera Construcciones Mecanicas, Spain. TB INTEGRATION Integrations of the TB components are performed at CERN in Building 180. Integration 1, which is the assembly of the two double pancakes into the coil casing (cold mass), has started. Preparation work is ongoing at the moment and the turning frame will be delivered to CERN mid-July 2002, ready for operation. Integration 2, which is the assembly of the cold mass and related components into the vacuum vessel, started with assembly of the cool...

  8. Latest results from HERA

    Indian Academy of Sciences (India)

    Standard Model where particles that have quantum numbers of both leptons and quarks are produced. Then a search ..... The limits from HERA can be seen to be very competitive with limits from other colliders especially for low values ... the decay t —bW. A similar decay chain is possible for the production of a single stop in.

  9. Nuclear valves latest development

    International Nuclear Information System (INIS)

    Isaac, F.; Monier, M.

    1993-01-01

    In the frame of Nuclear Power Plant upgrade (Emergency Power Supply and Emergency Core Cooling), Westinghouse had to face a new valve design philosophy specially for motor operated valves. The valves have to been designed to resist any operating conditions, postulated accident or loss of control. The requirements for motor operated valves are listed and the selected model and related upgrading explained. As part of plant upgrade and valves replacement, Westinghouse has sponsored alternative hardfacing research programme. Two types of materials have been investigated: nickel base alloys and iron base alloys. Programme requirements and test results are given. A new globe valve model (On-Off or regulating) is described developed by Alsthom Velan permitting the seat replacement in less than 10 min. (Z.S.) 2 figs

  10. Latest results from JET

    International Nuclear Information System (INIS)

    Bickerton, R.J.

    1989-01-01

    The Joint European Torus (JET) is a large tokamak designed with the essential objective of obtaining and studying plasmas with parameters close to those envisaged for an eventual power-generating, nuclear-fusion reactor. JET is situated on a site near Abingdon, Oxon, UK. JET is the largest single project of the nuclear fusion research programme of the European Atomic Energy Community (EURATOM). The tokamak started operation in mid 1983 after a five year construction period. The scientific and technical results achieved so far are summarised in this article. (orig.)

  11. Adejobi latest.pmd

    African Journals Online (AJOL)

    ACSS

    2013-05-03

    May 3, 2013 ... statistics and the logistic model. The results obtained ... addition to the reduction in the cost of production. (Diamini, 1976 ... development and growth may be studied either through the ... Considering a case of only one input flow in which a current ... firm's demand curve of an input shows the quantity which it ...

  12. Latest advances in edema

    Science.gov (United States)

    Villavicencio, J. L.; Hargens, A. R.; Pikoulicz, E.

    1996-01-01

    Basic concepts in the physiopathology of edema are reviewed. The mechanisms of fluid exchange across the capillary endothelium are explained. Interstitial flow and lymph formation are examined. Clinical disorders of tissue and lymphatic transport, microcirculatory derangements in venous disorders, protein disorders, and lymphatic system disorders are explored. Techniques for investigational imaging of the lymphatic system are explained.

  13. The Latest from ALICE

    CERN Multimedia

    2009-01-01

    After intensive installation operations from October 2008 until July 2009 (see Bulletin 31/7/2009), ALICE started a full-detector cosmics run in August, which is scheduled to last until the end of October. In addition to the Silicon Pixel and ACORDE detectors, the latter specially built for triggering on cosmic muons, ALICE is now making extensive use of the trigger provided by the Time Of Flight array. The high granularity and the low noise (0.1 Hz/cm2) of the TOF MRPCs, combined with the large coverage (~150 m2), offers a wide range of trigger combinations. This extended cosmic run serves many purposes: to test the performance of each individual detector; to ensure their integration in the central Data Acquisition; to perform alignment and calibration; to check the reconstruction software; to fine-tune the tracking algorithms; and last but not least, to train the personnel for the long shifts ahead. More than 100 million events h...

  14. Latest results from ALICE

    CERN Document Server

    Scapparone, Eugenio

    2011-01-01

    In this paper selected results obtained by the ALICE experiment at the LHC will be presented. Data collected during the pp runs taken at sqrt(s)=0.9, 2.76 and 7 TeV and Pb-Pb runs at sqrt(s_NN)=2.76 TeV allowed interesting studies on the properties of the hadronic and nuclear matter: proton runs gave us the possibility to explore the ordinary matter at very high energy and up to very low pt, while Pb-Pb runs provided spectacular events where several thousands of particles produced in the interaction revealed how a very dense medium behaves, providing a deeper picture on the quark gluon plasma(QGP) chemical composition and dynamics.

  15. The Latest from LHCb

    CERN Multimedia

    2009-01-01

    This month the LHCb Collaboration has observed the first Cherenkov rings from the RICH1 detector. These rings were emitted by cosmic particles passing through the detector. Cherenkov radiation occurs when a charged particle passes through a medium faster than the speed of light. As it travels, the particle emits photons along a cone. This cone is measured and, along with a measurement of momentum, is used to identify the particle. There are two types of radiators in RICH1, the first gaseous and the other made from aerogel. Both rings seen on the picture are from the same particle passing through the two different radiators. This is the fist time that the RICH detector has seen a particle as it will see them when the LHC re-starts. It has also been a time for the experiment to begin commissioning. After network upgrades, LHCb held a commissioning week, an opportunity for physicists working on all the different detectors within LHCb...

  16. New Bulletin: Latest News

    CERN Multimedia

    2005-01-01

    The paper version of the CERN Bulletin will be published twice a month with effect from 18 April 2005. The electronic version will be updated weekly. This year will see many changes in the Bulletin, designed to make it more economical, more compact and more attractive. From 18 April the paper version of the Bulletin will be published twice monthly, so we shall have to stop calling it the "Weekly". The purpose of this change in publication frequency is to redistribute the resources of the Publications Section of the Communications Group so that it can produce new brochures for the general public. However, so as not to compromise on topicality and communication of information, the Official News and General Information sections, the Pension Fund and training announcements and the seminar schedule will continue to be updated weekly. If you have signed up to be informed of the updates, you will continue to receive a weekly e-mail reminding you that the electronic version of the Bulletin has been updated. Offici...

  17. New Bulletin: Latest News

    CERN Multimedia

    2005-01-01

    The paper version of the CERN Bulletin will be published twice a month with effect from 18 April 2005. The electronic version will be updated weekly. This year will see many changes in the Bulletin, designed to make it more economical, more compact and more attractive.

  18. Latest Developments in Probiotics

    Science.gov (United States)

    Leroy, Frédéric; Falony, Gwen; Vuyst, Luc De

    Probiotic foods are a group of health-promoting, so-called functional foods, with large commercial interest and growing market shares (Arvanitoyannis & van Houwelingen-Koukaliaroglou, 2005). In general, their health benefits are based on the presence of selected strains of lactic acid bacteria (LAB), that, when taken up in adequate amounts, confer a health benefit on the host. They are administered mostly through the consumption of fermented milks or yoghurts (Mercenier, Pavan, & Pot, 2003). In addition to their common use in the dairy industry, probiotic LAB strains may be used in other food products too, including fermented meats (Hammes & Hertel, 1998; Incze, 1998; Kröckel, 2006; Työppönen, Petäjä,& Mattila- Sandholm, 2003).

  19. SNAP Telescope Latest Developments

    Science.gov (United States)

    Lampton, M.; SNAP Collaboration

    2004-12-01

    The coming era of precision cosmology imposes new demands on space telescopes with regard to spectrophotometric accuracy and image stability. To meet these requirements for SNAP we have developed an all reflecting two-meter-class space telescope of the three-mirror anastigmat type. Our design features a large flat annular field (1.5 degrees = 580mm diameter) and a telephoto advantage of 6, delivering a 22m focal length within an optical package length of only 3.5 meters. The use of highly stable materials (Corning ULE glass and carbon-fiber reinforced cyanate ester resin for the metering structure) combined with agressive distributed thermal control and an L2 orbit location will lead to unmatched figure stability. Owing to our choice of rigid structure with nondeployable solar panels, finite-element models show no structural resonances below 10Hz. An exhaustive stray light study has been completed. Beginning in 2005, two industry studies will develop plans for fabrication, integration and test, bringing SNAP to a highly realistic level of definition. SNAP is supported by the Office of Science, US DoE, under contract DE-AC03-76SF00098.

  20. Latest data on obesity

    Directory of Open Access Journals (Sweden)

    Evangelos Fousteris

    2017-01-01

    Full Text Available Obesity is a chronic and morbid disease which has reached epidemic dimensions nowadays, becoming the springboard for the emergence of other unfavorable metabolic diseases such as type 2 diabetes mellitus. In 2014 overweight and obese people in the world were estimated at 2.022 billion while prediction for 2025 is to reach 2.693 billion. Regarding the statistical data from Greece, we should note that overweight and obese individuals are estimated at 5.266 million for 2014. Obesity is a systemic disease with significant impact on human health, such as increased incidence of type 2 diabetes, osteoarthritis ( knee, hip, cancers (mostly breast and endometrium for women and colon and kidney for men, cognitive disorders (dementia, Alzheimer's, mood disorders (anxiety, depression, emotional eating disorders, sleep apnea syndrome, cardiovascular disease (myocardial infarction, stroke and increased incidence of all-cause mortality, reducing in this patern the overall life expectancy. The underlying pathophysiological disorders of obesity are complex and mostly not understood well. The main disorder is the disturbance of the human energy balance when intake calories are more than the calories consumed, thus an excess of energy is generated daily, which is stored by the body in the form of triglycerides in adipose tissue of the body. On the other hand, weight loss is very important since even moderate weight loss significantly reduces the comorbidities of obesity. For the treatment of obesity, we have dietary interventions (hypocaloric diets, very low calorie diets, special diets, exercise interventions, pharmacological interventions (Orlistat, Liraglutide, Naltrexone / Boupropion, Phentermine / Topiramate, Lorcaserin and bariatric surgery (gastric banding, gastric Roux-en-Y by pass, sleeve gastrectomy. Despite all these, obesity remains an unsolved problem of our time with unmet needs that need combined global awareness from both the scientific community and the state.