Sample records for pacing improves regional

  1. Sequential biventricular pacing improves regional contractility, longitudinal function and dyssynchrony in patients with heart failure and prolonged QRS

    Directory of Open Access Journals (Sweden)

    Ring Margareta


    Full Text Available Abstract Aims Biventricular pacing (BiP is an effective treatment in systolic heart failure (HF patients with prolonged QRS. However, approximately 35% of the patients receiving BiP are classified as non-responders. The aim of this study is to evaluate the acute effects of VV-optimization on systolic heart function. Methods Twenty-one HF patients aged 72 (46-88 years, QRS 154 (120-190 ms, were studied with echocardiography, Tissue Doppler Imaging (TDI and 3D-echo the first day after receiving a BiP device. TDI was performed; during simultaneous pacing (LV-lead pacing 4 ms before the RV-lead and during sequential pacing (LV 20 and 40 ms before RV and RV 20 and 40 ms before LV-lead pacing. Systolic heart function was studied by tissue tracking (TT for longitudinal function and systolic maximal velocity (SMV for regional contractility and signs of dyssynchrony assessed by time-delays standard deviation of aortic valve opening to SMV, AVO-SMV/SD and tissue synchronization imaging (TSI. Results The TT mean value preoperatively was 4,2 ± 1,5 and increased at simultaneous pacing to 5,0 ± 1,2 mm (p Conclusions VV-optimization in the acute phase improves systolic heart function more than simultaneous BiP pacing. Long-term effects should be evaluated in prospective randomized trials.

  2. Bachmann's Bundle Pacing not Only Improves Interatrial Conduction but Also Reduces the Need for Ventricular Pacing. (United States)

    Sławuta, Agnieszka; Kliś, Magdalena; Skoczyński, Przemysław; Bańkowski, Tomasz; Moszczyńska-Stulin, Joanna; Gajek, Jacek


    Patients treated for sick sinus syndrome may have interatrial conduction disorder leading to atrial fibrillation. This study was aimed to assess the influence of the atrial pacing site on interatrial and atrioventricular conduction as well as the percentage of ventricular pacing in patients with sick sinus syndrome implanted with atrioventricular pacemaker. The study population: 96 patients (58 females, 38 males) aged 74.1 ± 11.8 years were divided in two groups: Group 1 (n = 44) with right atrial appendage pacing and group 2 (n = 52) with Bachmann's area pacing. We assessed the differences in atrioventricular conduction in sinus rhythm and atrial 60 and 90 bpm pacing, P-wave duration and percentage of ventricular pacing. No differences in baseline P-wave duration in sinus rhythm between the groups (102.4 ± 17 ms vs. 104.1 ± 26 ms, p = ns.) were noted. Atrial pacing 60 bpm resulted in longer P-wave in group 1 vs. group 2 (138.3 ± 21 vs. 106.1 ± 15 ms, p < 0.01). The differences between atrioventricular conduction time during sinus rhythm and atrial pacing at 60 and 90 bpm were significantly longer in patients with right atrial appendage vs. Bachmann's pacing (44.1 ± 17 vs. 9.2 ± 7 ms p < 0.01 and 69.2 ± 31 vs. 21.4 ± 12 ms p < 0.05, respectively). The percentage of ventricular pacing was higher in group 1 (21 vs. 4%, p < 0.01). Bachmann's bundle pacing decreases interatrial and atrioventricular conduction delay. Moreover, the frequency-dependent atrioventricular conduction lengthening is much less pronounced during Bachmann's bundle pacing. Right atrial appendage pacing in sick sinus syndrome patients promotes a higher percentage of ventricular pacing.

  3. Diaphragm pacing improves sleep in patients with amyotrophic lateral sclerosis. (United States)

    Gonzalez-Bermejo, Jesus; Morélot-Panzini, Capucine; Salachas, François; Redolfi, Stefania; Straus, Christian; Becquemin, Marie-Hélène; Arnulf, Isabelle; Pradat, Pierre-François; Bruneteau, Gaëlle; Ignagni, Anthony R; Diop, Moustapha; Onders, Raymond; Nelson, Teresa; Menegaux, Fabrice; Meininger, Vincent; Similowski, Thomas


    In amyotrophic lateral sclerosis (ALS) patients, respiratory insufficiency is a major burden. Diaphragm conditioning by electrical stimulation could interfere with lung function decline by promoting the development of type 1 muscle fibres. We describe an ancillary study to a prospective, non-randomized trial (NCT00420719) assessing the effects of diaphragm pacing on forced vital capacity (FVC). Sleep-related disturbances being early clues to diaphragmatic dysfunction, we postulated that they would provide a sensitive marker. Stimulators were implanted laparoscopically in the diaphragm close to the phrenic motor point in 18 ALS patients for daily conditioning. ALS functioning score (ALSFRS), FVC, sniff nasal inspiratory pressure (SNIP), and polysomnographic recordings (PSG, performed with the stimulator turned off) were assessed before implantation and after four months of conditioning (n = 14). Sleep efficiency improved (69 ± 15% to 75 ± 11%, p = 0.0394) with fewer arousals and micro-arousals. This occurred against a background of deterioration as ALSFRS-R, FVC, and SNIP declined. There was, however, no change in NIV status or the ALSFRS respiratory subscore, and the FVC decline was mostly due to impaired expiration. Supporting a better diaphragm function, apnoeas and hypopnoeas during REM sleep decreased. In conclusion, in these severe patients not expected to experience spontaneous improvements, diaphragm conditioning improved sleep and there were hints at diaphragm function changes.

  4. Does reducing unnecessary right ventricular pacing improve sympathetic activity and innervation of heart in sinus node disease patients? MVP and SafeR study. (United States)

    Miyamoto, Mihoko; Kimura, Yuichiro; Hosoda, Junya; Matsumoto, Katsumi; Matsushita, Kohei; Ishikawa, Toshiyuki; Umemura, Satoshi


    Ventricular desynchronization imposed by ventricular pacing causes regional disturbances of adrenergic innervation in the left ventricular myocardium and increases the risk of heart failure and atrial fibrillation (AF) in patients with sinus node disease (SND). As a result, decreased iodine-123 metaiodobenzylguanidine (I-(123 )MIBG) uptake occurs in patients with an implanted permanent pacemaker. Fourteen SND patients with an implanted pacemaker equipped with an algorithm for reducing unnecessary right ventricular pacing (RURVP) were enrolled. Pacemakers were programmed to RURVP mode for the first 12 weeks, and then reprogrammed to DDD for the last 12 weeks. At the end of each mode, data on cumulative percent ventricular pacing (%Vp), atrial high rate episodes (%AHR), I-(123 )MIBG myocardial scintigraphy, brain natriuretic peptide (BNP), human atrial natriuretic peptide (hANP), and myocardial damage indices typified by troponin T and C-reactive protein (CRP) were collected. %Vp was lower in RURVP than in DDD (0.2% versus 95.7%, P = 0.00098). BNP, hANP, troponin T, and CRP did not differ significantly between the pacing modes. However, I-(123 )MIBG findings of patients with full ventricular pacing in DDD improved in RURVP. In contrast, among patients without full ventricular pacing in DDD, their I-(123 )MIBG findings did not differ significantly between the pacing modes. In SND patients with normal cardiac function and intact atrioventricular conduction, the reduction of %Vp in RURVP was due to the reduction of ineffective pacing and fusion pacing in DDD. Therefore, these 2 types of pacing do not affect cardiac pump function.

  5. A fast-start pacing strategy speeds pulmonary oxygen uptake kinetics and improves supramaximal running performance.

    Directory of Open Access Journals (Sweden)

    Tiago Turnes

    Full Text Available The focus of the present study was to investigate the effects of a fast-start pacing strategy on running performance and pulmonary oxygen uptake (VO2 kinetics at the upper boundary of the severe-intensity domain. Eleven active male participants (28±10 years, 70±5 kg, 176±6 cm, 57±4 mL/kg/min visited the laboratory for a series of tests that were performed until exhaustion: 1 an incremental test; 2 three laboratory test sessions performed at 95, 100 and 110% of the maximal aerobic speed; 3 two to four constant speed tests for the determination of the highest constant speed (HS that still allowed achieving maximal oxygen uptake; and 4 an exercise based on the HS using a higher initial speed followed by a subsequent decrease. To predict equalized performance values for the constant pace, the relationship between time and distance/speed through log-log modelling was used. When a fast-start was utilized, subjects were able to cover a greater distance in a performance of similar duration in comparison with a constant-pace performance (constant pace: 670 m±22%; fast-start: 683 m±22%; P = 0.029; subjects also demonstrated a higher exercise tolerance at a similar average speed when compared with constant-pace performance (constant pace: 114 s±30%; fast-start: 125 s±26%; P = 0.037. Moreover, the mean VO2 response time was reduced after a fast start (constant pace: 22.2 s±28%; fast-start: 19.3 s±29%; P = 0.025. In conclusion, middle-distance running performances with a duration of 2-3 min are improved and VO2 response time is faster when a fast-start is adopted.

  6. Improvement of Left Ventricular Function by Permanent Direct His-Bundle Pacing in a Case with Dilated Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Yukiko Sashida, MD


    Full Text Available The patient was a 67-year-old female diagnosed with dilated cardiomyopathy. She had chronic atrial fibrillation (AF with bradycardia and low left ventricular function (left ventricular ejection fraction (LVEF 40%. She was admitted for congestive heart failure. She remained New York Heart Association (NYHA functional class III due to AF bradycardia. Pacemaker implantation was necessary for treatment of heart failure and administration of dose intensive β-blockers. As she had normal His-Purkinje activation, we examined the optimal pacing sites. Hemodynamics of His-bundle pacing and biventricular pacing were compared. Pulmonary capillary wedge pressure (PCWP was significantly lower on Hisbundle pacing than right ventricular (RV apical pacing and biventricular pacing (13mmHg, 19mmHg, and 19mmHg, respectively with an almost equal cardiac index. Based on the examination we implanted a permanent pacemaker for Direct His-bundle pacing (DHBP. After the DHBP implantation, the LVEF immediately improved from 40% to 55%, and BNP level decreased from 422 pg/ml to 42 pg/ml. The number of premature ventricular complex (PVC was decreased, and non sustained ventricular tachycardia (NSVT disappeared. Pacing threshold for His-bundle pacing has remained at the same level. His-bundle pacing has been maintained during 27 months and her long-term DHBP can improve cardiac function and the NYHA functional class.

  7. Temporary pacing

    Directory of Open Access Journals (Sweden)

    L.J. Workman


    Full Text Available Artificial cardiac pacing, the use of electrical stimuli to cause contraction of heart muscle, is a sophisticated therapeutic and diagnostic tool. Its rapid technologic improvement since first developed in the late 1930’s by Hyman, has made it possible not only to avoid certain cases of death due to heart block, but also to extend and improve the quality of life. Pacemaker therapy is generally used to treat heart rate or rhythm disturbances, being either tachy- or bradyarrhythmias that produce a detrimental drop in cardiac output. Of the many different types of pacemakers and electrodes currently available, ventricular demand pacing is the most commonly used.

  8. Automatic user customization for improving the performance of a self-paced brain interface system. (United States)

    Fatourechi, Mehrdad; Bashashati, Ali; Birch, Gary E; Ward, Rabab K


    Customizing the parameter values of brain interface (BI) systems by a human expert has the advantage of being fast and computationally efficient. However, as the number of users and EEG channels grows, this process becomes increasingly time consuming and exhausting. Manual customization also introduces inaccuracies in the estimation of the parameter values. In this paper, the performance of a self-paced BI system whose design parameter values were automatically user customized using a genetic algorithm (GA) is studied. The GA automatically estimates the shapes of movement-related potentials (MRPs), whose features are then extracted to drive the BI. Offline analysis of the data of eight subjects revealed that automatic user customization improved the true positive (TP) rate of the system by an average of 6.68% over that whose customization was carried out by a human expert, i.e., by visually inspecting the MRP templates. On average, the best improvement in the TP rate (an average of 9.82%) was achieved for four individuals with spinal cord injury. In this case, the visual estimation of the parameter values of the MRP templates was very difficult because of the highly noisy nature of the EEG signals. For four able-bodied subjects, for which the MRP templates were less noisy, the automatic user customization led to an average improvement of 3.58% in the TP rate. The results also show that the inter-subject variability of the TP rate is also reduced compared to the case when user customization is carried out by a human expert. These findings provide some primary evidence that automatic user customization leads to beneficial results in the design of a self-paced BI for individuals with spinal cord injury.

  9. Coronary grafts flow and cardiac pacing modalities: how to improve perioperative myocardial perfusion.

    LENUS (Irish Health Repository)

    D'Ancona, Giuseppe


    OBJECTIVE: Aim of this study was to investigate modifications of coronary grafts flow during different pacing modalities after CABG. MATERIALS AND METHODS: Two separate prospective studies were conducted in patients undergoing CABG and requiring intraoperative epicardial pacing. In a first study (22 patients) coronary grafts flows were measured during dual chamber pacing (DDD) and during ventricular pacing (VVI). In a second study (10 patients) flows were measured during DDD pacing at different atrio-ventricular (A-V) delay periods. A-V delay was adjusted in 25 ms increments from 25 to 250 ms and flow measurements were performed for each A-V delay increment. A transit time flowmeter was used for the measurements. RESULTS: An average of 3.4 grafts\\/patient were performed. In the first study, average coronary graft flow was 47.4+\\/-20.8 ml\\/min during DDD pacing and 41.8+\\/-18.2 ml\\/min during VVI pacing (P = 0.0004). Furthermore average systolic pressure was 94.3+\\/-10.1 mmHg during DDD pacing and 89.6+\\/-12.2 mmHg during VVV pacing (P = 0.0007). No significant differences in diastolic pressure were recorded during the two different pacing modalities. In the second study, maximal flows were achieved during DDD pacing with an A-V delay of 175 ms (54+\\/-9.6 ml\\/min) and minimal flows were detected at 25 ms A-V delay (38.1+\\/-4.7 ml\\/min) (P=ns). No significant differences in systolic or diastolic blood pressure were noticed during the different A-V delays. CONCLUSION: Grafts flowmetry provides an extra tool to direct supportive measures such as cardiac pacing after CABG. DDD mode with A-V delay around 175 ms. should be preferred to allow for maximal myocardial perfusion via the grafts.

  10. A Multi-Usable Cloud Service Platform: A Case Study on Improved Development Pace and Efficiency

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    John Lindström


    Full Text Available The case study, spanning three contexts, concerns a multi-usable cloud service platform for big data collection and analytics and how the development pace and efficiency of it has been improved by 50–75% by using the Arrowhead framework and changing development processes/practices. Furthermore, additional results captured during the case study are related to technology, competencies and skills, organization, management, infrastructure, and service and support. A conclusion is that when offering a complex offer such as an Industrial Product-Service System, comprising sensors, hardware, communications, software, cloud service platform, etc., it is necessary that the technology, business model, business setup, and organization all go hand in hand during the development and later operation, as all ‘components’ are required for a successful result.

  11. Recent developments in cardiac pacing. (United States)

    Rodak, D J


    Indications for cardiac pacing continue to expand. Pacing to improve functional capacity, which is now common, relies on careful patient selection and technical improvements, such as complex software algorithms and diagnostic capabilities.

  12. Let's Walk Outdoors! Self-Paced Walking Outdoors Improves Future Intention to Exercise in Women With Obesity. (United States)

    Krinski, Kleverton; Machado, Daniel G S; Lirani, Luciana S; DaSilva, Sergio G; Costa, Eduardo C; Hardcastle, Sarah J; Elsangedy, Hassan M


    In order to examine whether environmental settings influence psychological and physiological responses of women with obesity during self-paced walking, 38 women performed two exercise sessions (treadmill and outdoors) for 30 min, where oxygen uptake, heart rate, ratings of perceived exertion, affect, attentional focus, enjoyment, and future intentions to walk were analyzed. Physiological responses were similar during both sessions. However, during outdoor exercise, participants displayed higher externally focused attention, positive affect, and lower ratings of perceived exertion, followed by greater enjoyment and future intention to participate in outdoor walking. The more externally focused attention predicted greater future intentions to participate in walking. Therefore, women with obesity self-selected an appropriate exercise intensity to improve fitness and health in both environmental settings. Also, self-paced outdoor walking presented improved psychological responses. Health care professionals should consider promoting outdoor forms of exercise to maximize psychological benefits and promote long-term adherence to a physically active lifestyle.

  13. Orbitally-paced variations of water availability in the SE Asian Monsoon region following the Miocene Climate Transition (United States)

    Heitmann, Emma O.; Ji, Shunchuan; Nie, Junsheng; Breecker, Daniel O.


    Middle Miocene Earth had several boundary conditions similar to those predicted for future Earth including similar atmospheric pCO2 and substantial Antarctic ice cover but no northern hemisphere ice sheets. We describe a 12 m outcrop of the terrestrial Yanwan Section in the Tianshui Basin, Gansu, China, following the Miocene Climate Transition (13.9-13.7 Ma). It consists of ∼25 cm thick CaCO3-cemented horizons that overprint siltstones every ∼1 m. We suggest that stacked soils developed in siltstones under a seasonal climate with a fluctuating water table, evidenced by roots, clay films, mottling, presence of CaCO3 nodules, and stacked carbonate nodule δ13 C and δ18 O profiles that mimic modern soils. We suggest that the CaCO3-cemented horizons are capillary-fringe carbonates that formed in an arid climate with a steady water table and high potential evapotranspiration rates (PET), evidenced by sharp upper and basal contacts, micrite, sparite, and root-pore cements. The CaCO3 of the cemented horizons and the carbonate nodules have similar mean δ18 O and δ13 C values but the cements have significantly smaller variance in δ13 C and δ18 O values and a different δ18 O versus δ13 C slope, supporting the conclusion that these carbonates are from different populations. The magneto-stratigraphic age model indicates obliquity pacing of the arid conditions required to form the CaCO3-cemented horizons suggesting an orbital control on water availability. We suggest two possible drivers for the obliquity pacing of arid conditions: 1) variability in the cross-equatorial pressure gradient that controls summer monsoon (ASM) strength and is influenced by obliquity-paced variations of Antarctic ice volume and 2) variability in Western Pacific Ocean-East Asian continent pressure gradient controlled by the 25-45°N meridional insolation gradient. We also suggest that variations in aridity were influenced by variations in PET and sensible heating of the regional land

  14. Direct His bundle pacing post AVN ablation. (United States)

    Lakshmanadoss, Umashankar; Aggarwal, Ashim; Huang, David T; Daubert, James P; Shah, Abrar


    Atrioventricular nodal (AVN) ablation with concomitant pacemaker implantation is one of the strategies that reduce symptoms in patients with atrial fibrillation (AF). However, the long-term adverse effects of right ventricular (RV) apical pacing have led to the search for alternating sites of pacing. Biventricular pacing produces a significant improvement in functional capacity over RV pacing in patients undergoing AVN ablation. Another alternative site for pacing is direct His bundle to reduce the adverse outcome of RV pacing. Here, we present a case of direct His bundle pacing using steerable lead delivery system in a patient with symptomatic paroxysmal AF with concurrent AVN ablation.

  15. Pacing stress echocardiography

    Directory of Open Access Journals (Sweden)

    Agrusta Marco


    Full Text Available Abstract Background High-rate pacing is a valid stress test to be used in conjunction with echocardiography; it is independent of physical exercise and does not require drug administration. There are two main applications of pacing stress in the echo lab: the noninvasive detection of coronary artery disease through induction of a regional transient dysfunction; and the assessment of contractile reserve through peak systolic pressure/ end-systolic volume relationship at increasing heart rates to assess global left ventricular contractility. Methods The pathophysiologic rationale of pacing stress for noninvasive detection of coronary artery disease is obvious, with the stress determined by a controlled increase in heart rate, which is a major determinant of myocardial oxygen demand, and thereby tachycardia may exceed a fixed coronary flow reserve in the presence of hemodynamically significant coronary artery disease. The use of pacing stress echo to assess left ventricular contractile reserve is less established, but promising. Positive inotropic interventions are mirrored by smaller end-systolic volumes and higher end-systolic pressures. An increased heart rate progressively increases the force of ventricular contraction (Bowditch treppe or staircase phenomenon. To build the force-frequency relationship, the force is determined at different heart rate steps as the ratio of the systolic pressure (cuff sphygmomanometer/end-systolic volume index (biplane Simpson rule. The heart rate is determined from ECG. Conclusion Two-dimensional echocardiography during pacing is a useful tool in the detection of coronary artery disease. Because of its safety and ease of repeatability noninvasive pacing stress echo can be the first-line stress test in patients with permanent pacemaker. The force-frequency can be defined as up- sloping (normal when the peak stress pacing systolic pressure/end-systolic volume index is higher than baseline and intermediate stress

  16. PACE Status Update

    Energy Technology Data Exchange (ETDEWEB)

    M., Zimring,; Hoffman, I.; Fuller, M.


    The Federal Housing Finance Agency (FHFA) regulates Fannie Mae, Freddie Mac, and the 12 Federal Home Loan Banks (the government-sponsored enterprises - GSEs). On July 6, 2010, FHFA and the Office of the Comptroller of the Currency (OCC) concluded that Property Assessed Clean Energy (PACE) programs 'present significant safety and soundness concerns' to the housing finance industry. This statement came after a year of discussions with state and federal agencies in which PACE, a novel mechanism for financing energy efficiency and renewable energy improvements, has gone from receiving support from the White House, canonization as one of Scientific American's 'World Changing Ideas' and legislative adoption in 24 states to questionable relevance, at least in the residential sector. Whether PACE resumes its expansion as an innovative tool for financing energy efficiency and clean generation depends on outcomes in each of the three branches of government - discussions on a PACE pilot phase among federal agencies, litigation in federal court, and legislation in Congress - all highly uncertain. This policy brief addresses the practical impacts of these possible outcomes on existing and emerging PACE programs across the United States and potential paths forward.

  17. Using Degraded Music Quality to Encourage a Health Improving Walking Pace: BeatClearWalker

    Directory of Open Access Journals (Sweden)

    Andreas Komninos


    Full Text Available Meeting the target of 8000 steps/day, as recommended by many national governments and health authorities, can provide considerable physical and mental health benefits and is seen as a key target for reducing obesity levels and improving public health. However, to optimize the health benefits, walking should be performed at a “moderate” intensity. While there are numerous mobile fitness applications that monitor distance walked, none directly support walking at this cadence nor has there been any research into live feedback for walking cadence. We present a smartphone fitness application to help users learn how to walk at a moderate cadence and maintain that cadence. We apply real-time audio effects that diminish the audio quality of music when the target walking cadence is not being reached. This provides an immersive and intuitive application that can easily be integrated into everyday life as allows users to walk while listening to their own music and encourages eyes-free interaction. In this paper, we introduce our approach, design, initial lab evaluation and a controlled outdoor study. Results show that using music degradation decreases the number of below-cadence steps, that users felt they worked harder with our player and would use it while exercise walking.

  18. Regional integration, improving women's economic situation, and ...

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

    Regional integration, improving women's economic situation, and ... of the West African Economic and Monetary Union on their economic development, the ... production sectors, and commercialization networks affected by regional trade, the ...

  19. Atrial overexpression of angiotensin-converting enzyme 2 improves the canine rapid atrial pacing-induced structural and electrical remodeling. Fan, ACE2 improves atrial substrate remodeling. (United States)

    Fan, Jinqi; Zou, Lili; Cui, Kun; Woo, Kamsang; Du, Huaan; Chen, Shaojie; Ling, Zhiyu; Zhang, Quanjun; Zhang, Bo; Lan, Xianbin; Su, Li; Zrenner, Bernhard; Yin, Yuehui


    The purpose of this study was to investigate whether atrial overexpression of angiotensin-converting enzyme 2 (ACE2) by homogeneous transmural atrial gene transfer can reverse atrial remodeling and its mechanisms in a canine atrial-pacing model. Twenty-eight mongrel dogs were randomly divided into four groups: Sham-operated, AF-control, gene therapy with adenovirus-enhanced green fluorescent protein (Ad-EGFP) and gene therapy with Ad-ACE2 (Ad-ACE2) (n = 7 per subgroup). AF was induced in all dogs except the Sham-operated group by rapid atrial pacing at 450 beats/min for 2 weeks. Ad-EGFP and Ad-ACE2 group then received epicardial gene painting. Three weeks after gene transfer, all animals except the Sham group underwent rapid atrial pacing for another 3 weeks and then invasive electrophysiological, histological and molecular studies. The Ad-ACE2 group showed an increased ACE2 and Angiotensin-(1-7) expression, and decreased Angiotensin II expression in comparison with Ad-EGFP and AF-control group. ACE2 overexpression attenuated rapid atrial pacing-induced increase in activated extracellular signal-regulated kinases and mitogen-activated protein kinases (MAPKs) levels, and decrease in MAPK phosphatase 1(MKP-1) level, resulting in attenuation of atrial fibrosis collagen protein markers and transforming growth factor-β1. Additionally, ACE2 overexpression also modulated the tachypacing-induced up-regulation of connexin 40, down-regulation of connexin 43 and Kv4.2, and significantly decreased the inducibility and duration of AF. ACE2 overexpression could shift the renin-angiotensin system balance towards the protective axis, attenuate cardiac fibrosis remodeling associated with up-regulation of MKP-1 and reduction of MAPKs activities, modulate tachypacing-induced ion channels and connexin remodeling, and subsequently reduce the inducibility and duration of AF.

  20. Accumulation of Carbonates Contributes to Coastal Vegetated Ecosystems Keeping Pace With Sea Level Rise in an Arid Region (Arabian Peninsula)

    KAUST Repository

    Saderne, Vincent; Cusack, Michael; Almahasheer, Hanan; Serrano, Oscar; Masqué , Pere; Arias-Ortiz, Ariane; Krishnakumar, Periyadan Kadinjappalli; Rabaoui, Lotfi; Qurban, Mohammad Ali; Duarte, Carlos M.


    Anthropogenic sea level rise (SLR) presents one of the greatest risks to human lives and infrastructures. Coastal vegetated ecosystems, that is, tidal marshes, seagrass meadows, and mangrove forests, elevate the seabed through soil accretion, providing a natural coastline protection against SLR. The soil accretion of these ecosystems has never been assessed in hot desert climate regions, where water runoff is negligible. However, tropical marine ecosystems are areas of intense calcification that may constitute an important source of sediment supporting seabed elevation, compensating for the lack of terrestrial inputs. We estimated the long-term (C-centennial) and short-term (Pb-20th century) soil accretion rates (SARs) and inorganic carbon (C) burial in coastal vegetated ecosystems of the Saudi coasts of the central Red Sea and the Arabian Gulf. Short-term SARs (±SE) in mangroves of the Red Sea (0.27 ± 0.22 cm/year) were twofold the SLR for that region since 1925 (0.13 cm/year). In the Arabian Gulf, only mangrove forest SAR is equivalent to local SLR estimates for the period 1979-2007 (0.21 ± 0.09 compared to 0.22 ± 0.05 cm/year, respectively). Long-term SARs are comparable or higher than the global estimates of SLR for the late Holocene (0.01 cm/year). In all habitats of the Red Sea and Arabian Gulf, SARs are supported by high carbonate accretion rates, comprising 40% to 60% of the soil volume. Further studies on the role of carbonates in coastal vegetated ecosystems are required to understand their role in adaptation to SLR.

  1. Accumulation of Carbonates Contributes to Coastal Vegetated Ecosystems Keeping Pace With Sea Level Rise in an Arid Region (Arabian Peninsula)

    KAUST Repository

    Saderne, Vincent


    Anthropogenic sea level rise (SLR) presents one of the greatest risks to human lives and infrastructures. Coastal vegetated ecosystems, that is, tidal marshes, seagrass meadows, and mangrove forests, elevate the seabed through soil accretion, providing a natural coastline protection against SLR. The soil accretion of these ecosystems has never been assessed in hot desert climate regions, where water runoff is negligible. However, tropical marine ecosystems are areas of intense calcification that may constitute an important source of sediment supporting seabed elevation, compensating for the lack of terrestrial inputs. We estimated the long-term (C-centennial) and short-term (Pb-20th century) soil accretion rates (SARs) and inorganic carbon (C) burial in coastal vegetated ecosystems of the Saudi coasts of the central Red Sea and the Arabian Gulf. Short-term SARs (±SE) in mangroves of the Red Sea (0.27 ± 0.22 cm/year) were twofold the SLR for that region since 1925 (0.13 cm/year). In the Arabian Gulf, only mangrove forest SAR is equivalent to local SLR estimates for the period 1979-2007 (0.21 ± 0.09 compared to 0.22 ± 0.05 cm/year, respectively). Long-term SARs are comparable or higher than the global estimates of SLR for the late Holocene (0.01 cm/year). In all habitats of the Red Sea and Arabian Gulf, SARs are supported by high carbonate accretion rates, comprising 40% to 60% of the soil volume. Further studies on the role of carbonates in coastal vegetated ecosystems are required to understand their role in adaptation to SLR.

  2. Cardiac resynchronization therapy by multipoint pacing improves response of left ventricular mechanics and fluid dynamics: a three-dimensional and particle image velocimetry echo study. (United States)

    Siciliano, Mariachiara; Migliore, Federico; Badano, Luigi; Bertaglia, Emanuele; Pedrizzetti, Gianni; Cavedon, Stefano; Zorzi, Alessandro; Corrado, Domenico; Iliceto, Sabino; Muraru, Denisa


    To characterize the effect of multipoint pacing (MPP) compared to biventricular pacing (BiV) on left ventricle (LV) mechanics and intraventricular fluid dynamics by three-dimensional echocardiography (3DE) and echocardiographic particle imaging velocimetry (Echo-PIV). In 11 consecutive patients [8 men; median age 65 years (57-75)] receiving cardiac resynchronization therapy (CRT) with a quadripolar LV lead (Quartet,St.Jude Medical,Inc.), 3DE and Echo-PIV data were collected for each pacing configuration (CRT-OFF, BiV, and MPP) at follow-up after 6 months. 3DE data included LV volumes, LV ejection fraction (LVEF), strain, and systolic dyssynchrony index (SDI). Echo-PIV was used to evaluate the directional distribution of global blood flow momentum, ranging from zero, when flow force is predominantly along the base-apex direction, up to 90° when it becomes transversal. MPP resulted in significant reduction in end-diastolic and end-systolic volumes compared with both CRT-OFF (P = 0.02; P = 0.008, respectively) and BiV (P = 0.04; P = 0.03, respectively). LVEF and cardiac output were significant superior in MPP compared with CRT-OFF, but similar between MPP and BiV. Statistical significant differences when comparing global longitudinal and circumferential strain and SDI with MPP vs. CRT-OFF were observed (P = 0.008; P = 0.008; P = 0.01, respectively). There was also a trend towards improvement in strain between BiV and MPP that did not reach statistical significance. MPP reflected into a significant reduction of the deviation of global blood flow momentum compared with both CRT-OFF and BiV (P = 0.002) indicating a systematic increase of longitudinal alignment from the base-apex orientation of the haemodynamic forces. These preliminary results suggest that MPP resulted in significant improvement of LV mechanics and fluid dynamics compared with BiV. However, larger studies are needed to confirm this hypothesis. © Crown copyright 2016.

  3. Hemodynamic stress testing using pacing tachycardia

    International Nuclear Information System (INIS)

    McKay, R.G.; Grossman, W.


    A trial pacing was first introduced in 1967 by Sowton and co-workers as a stress test which could be used in the cardiac catheterization laboratory to evaluate patients with schemic heart disease. Sowton noted that artificially increasing the heart rate by pacing the right atrium could usually induce angina in patients with symptomatic coronary artery disease. Since Sowton's original description, numerous investigators have described characteristic pacing-induced electrocardiographic changes, derangements of myocardial lactate metabolism, hemodynamic abnormalities, regional wall abnormalities, and defects in thallium scintigraphy. Although agreement on the overall usefulness of atrial pacing has not been uniform, it is clear that the technique can safely and reliably induce ischemia in most patients with coronary artery disease and that information obtained during the pacing-induced ischemic state can often be helpful in the diagnosis and treatment of the patient's underlying disease

  4. Cardiac pacing in heart failure patients with left bundle branch block: impact of pacing site for optimizing left ventricular resynchronization. (United States)

    Pappone, C; Rosanio, S; Oreto, G; Tocchi, M; Gulletta, S; Salvati, A; Dicandia, C; Santinelli, V; Mazzone, P; Veglia, F; Ding, J; Sallusti, L; Spinelli, J; Vicedomini, G


    Acute left ventricular pacing has been associated with hemodynamic improvement in patients with congestive heart failure and wide QRS complex. We hypothesized that pacing two left ventricular sites simultaneously would produce faster activation and better systolic function than single-site pacing. We selected 14 heart failure patients (NYHA functional class III or IV) in normal sinus rhythm with left bundle branch block and QRS > 150 ms. An 8F dual micromanometer catheter was placed in the aorta for measuring +dP/dt (mmHg/s), aortic pulse pressure (mmHg), and end-diastolic pressure (mmHg). Pacing leads were positioned via coronary veins at the posterior base and lateral wall. Patients were acutely paced VDD at the posterior base, lateral wall, and both sites (dual-site) with 5 atrioventricular delays (from 8 ms to PR -30 ms). Pacing sequences were executed in randomized order using a custom external computer (FlexStim, Guidant CRM). Dual-site pacing increased peak +dP/dt significantly more than posterior base and lateral wall pacing. Dual-site and posterior base pacing raised aortic pulse pressure significantly more than lateral wall pacing. Dual-site pacing shortened QRS duration by 22 %, whereas posterior base and lateral wall pacing increased it by 2 and 12%, respectively (p = 0.006). In heart failure patients with left bundle branch block, dual-site pacing improves systolic function more than single-site stimulation. Improved ventricular activation synchrony, expressed by paced QRS narrowing, may account for the additional benefit of dual- vs single-site pacing in enhancing contractility. This novel approach deserves consideration for future heart failure pacing studies.

  5. Altering Pace Control and Pace Regulation: Attentional Focus Effects during Running. (United States)

    Brick, Noel E; Campbell, Mark J; Metcalfe, Richard S; Mair, Jacqueline L; Macintyre, Tadhg E


    To date, there are no published studies directly comparing self-controlled (SC) and externally controlled (EC) pace endurance tasks. However, previous research suggests pace control may impact on cognitive strategy use and effort perceptions. The primary aim of this study was to investigate the effects of manipulating perception of pace control on attentional focus, physiological, and psychological outcomes during running. The secondary aim was to determine the reproducibility of self-paced running performance when regulated by effort perceptions. Twenty experienced endurance runners completed four 3-km time trials on a treadmill. Subjects completed two SC pace trials, one perceived exertion clamped (PE) trial, and one EC pace time trial. PE and EC were completed in a counterbalanced order. Pacing strategy for EC and perceived exertion instructions for PE replicated the subjects' fastest SC time trial. Subjects reported a greater focus on cognitive strategies such as relaxing and optimizing running action during EC than during SC. The mean HR was 2% lower during EC than that during SC despite an identical pacing strategy. Perceived exertion did not differ between the three conditions. However, increased internal sensory monitoring coincided with elevated effort perceptions in some subjects during EC and a 10% slower completion time for PE (13.0 ± 1.6 min) than that for SC (11.8 ± 1.2 min). Altering pace control and pace regulation impacted on attentional focus. External control over pacing may facilitate performance, particularly when runners engage attentional strategies conducive to improved running efficiency. However, regulating pace based on effort perceptions alone may result in excessive monitoring of bodily sensations and a slower running speed. Accordingly, attentional focus interventions may prove beneficial for some athletes to adopt task-appropriate attentional strategies to optimize performance.

  6. Development and evaluation of the feasibility and effects on staff, patients, and families of a new tool, the Psychosocial Assessment and Communication Evaluation (PACE), to improve communication and palliative care in intensive care and during clinical uncertainty. (United States)

    Higginson, Irene J; Koffman, Jonathan; Hopkins, Philip; Prentice, Wendy; Burman, Rachel; Leonard, Sara; Rumble, Caroline; Noble, Jo; Dampier, Odette; Bernal, William; Hall, Sue; Morgan, Myfanwy; Shipman, Cathy


    There are widespread concerns about communication and support for patients and families, especially when they face clinical uncertainty, a situation most marked in intensive care units (ICUs). Therefore, we aimed to develop and evaluate an interventional tool to improve communication and palliative care, using the ICU as an example of where this is difficult. Our design was a phase I-II study following the Medical Research Council Guidance for the Development and Evaluation of Complex Interventions and the (Methods of Researching End-of-life Care (MORECare) statement. In two ICUs, with over 1900 admissions annually, phase I modeled a new intervention comprising implementation training and an assessment tool. We conducted a literature review, qualitative interviews, and focus groups with 40 staff and 13 family members. This resulted in the new tool, the Psychosocial Assessment and Communication Evaluation (PACE). Phase II evaluated the feasibility and effects of PACE, using observation, record audit, and surveys of staff and family members. Qualitative data were analyzed using the framework approach. The statistical tests used on quantitative data were t-tests (for normally distributed characteristics), the χ2 or Fisher's exact test (for non-normally distributed characteristics) and the Mann-Whitney U-test (for experience assessments) to compare the characteristics and experience for cases with and without PACE recorded. PACE provides individualized assessments of all patients entering the ICU. It is completed within 24 to 48 hours of admission, and covers five aspects (key relationships, social details and needs, patient preferences, communication and information status, and other concerns), followed by recording of an ongoing communication evaluation. Implementation is supported by a training program with specialist palliative care. A post-implementation survey of 95 ICU staff found that 89% rated PACE assessment as very or generally useful. Of 213 family members

  7. Lambayeque Region marketing: Improving Incoming Tourism

    Directory of Open Access Journals (Sweden)

    Roger Pingo Jara


    Full Text Available Up to now, the marketing of the Lambayeque region as a tourist destination has been able to make important progress in the growth of domestic tourists flow. 40% of these tourists come from the capital, mostly they arrive in this region, mainly for business reasons. However, little progress is shown in relation to Incoming tourism, because from 100% of visitors who arrive to this touristic destination only 5% are of foreign origin.Furthermore, in 2011, from the total foreign tourists that visited the Moche Route - La Libertad region and Lambayeque region, 70% remained in the first one and only 30% visited both regions, completing the touristic circuit. The recommendations of the teachers of the Universidad del Pacífico, Universidad Esan and Centrum Católica, who have been interviewed are compared with the businessmen’s opinions in the region, showing the importance of targeting the tourism marketing strategy. Thus, it seeks to create value in different niches of the source markets, to prioritize potential tourists from brotherly countries, to link emotionally the tourist with the city, to build brands for each touristic product, to invest in highly specialized tourism and to improve significantly the clusters organization of the tourism sector in the region.We conclude that, in the region of Lambayeque, isolated efforts have been made regarding the incoming marketing, but, according to the needs, tastes and preferences of the potential tourist, this does not fulfill the international standards. This is demonstrated by the results achieved up to now—in terms of the foreign visitors’ number—. To that extent, It emphasizes the importance of the design and the implementation of a marketing plan connected with market reality.It should profit from the national brand and develop regional and local brand based on the international touristic demand-supply relation to market niches.

  8. Impact of pacing modality and biventricular pacing on cardiac output and coronary conduit flow in the post-cardiotomy patient.

    LENUS (Irish Health Repository)

    Healy, David G


    We have previously demonstrated the role of univentricular pacing modalities in influencing coronary conduit flow in the immediate post-operative period in the cardiac surgery patient. We wanted to determine the mechanism of this improved coronary conduit and, in addition, to explore the possible benefits with biventricular pacing. Sixteen patients undergoing first time elective coronary artery bypass grafting who required pacing following surgery were recruited. Comparison of cardiac output and coronary conduit flow was performed between VVI and DDD pacing with a single right ventricular lead and biventricular pacing lead placement. Cardiac output was measured using arterial pulse waveform analysis while conduit flow was measured using ultrasonic transit time methodology. Cardiac output was greatest with DDD pacing using right ventricular lead placement only [DDD-univentricular 5.42 l (0.7), DDD-biventricular 5.33 l (0.8), VVI-univentricular 4.71 l (0.8), VVI-biventricular 4.68 l (0.6)]. DDD-univentricular pacing was significantly better than VVI-univentricular (P=0.023) and VVI-biventricular pacing (P=0.001) but there was no significant advantage to DDD-biventricular pacing (P=0.45). In relation to coronary conduit flow, DDD pacing again had the highest flow [DDD-univentricular 55 ml\\/min (24), DDD-biventricular 52 ml\\/min (25), VVI-univentricular 47 ml\\/min (23), VVI-biventricular 50 ml\\/min (26)]. DDD-univentricular pacing was significantly better than VVI-univentricular (P=0.006) pacing but not significantly different to VVI-biventricular pacing (P=0.109) or DDD-biventricular pacing (P=0.171). Pacing with a DDD modality offers the optimal coronary conduit flow by maximising cardiac output. Biventricular lead placement offered no significant benefit to coronary conduit flow or cardiac output.

  9. Enact legislation supporting residential property assessed clean energy financing (PACE)

    Energy Technology Data Exchange (ETDEWEB)

    Saha, Devashree


    Congress should enact legislation that supports residential property assessed clean energy (PACE) programs in the nation’s states and metropolitan areas. Such legislation should require the Federal Housing Finance Agency (FHFA) to allow Fannie Mae and Freddie Mac to purchase residential mortgages with PACE assessments while at the same time providing responsible underwriting standards and a set of benchmarks for residential PACE assessments in order to minimize financial risks to mortgage holders. Congressional support of residential PACE financing will improve energy efficiency, encourage job creation, and foster economic growth in the nation’s state and metropolitan areas.

  10. Noninvasive external cardiac pacing for thallium-201 scintigraphy

    International Nuclear Information System (INIS)

    Feldman, M.D.; Warren, S.E.; Gervino, E.V.


    Improvements in noninvasive external cardiac pacing have led to a technique with reliable electrical capture and tolerable patient discomfort. To assess the use of this modality of pacing in combination with thallium scintigraphy as a noninvasive pacing stress test, we applied simultaneous noninvasive cardiac pacing, hemodynamic monitoring, and thallium-201 scintigraphy in 14 patients undergoing cardiac catheterization for chest pain syndromes. Two patients had normal coronary arteries, while the remaining 12 had significant coronary artery disease. Thallium scintigraphic responses to pacing were compared to routine exercise thallium stress testing in nine of these 14 patients. All patients were noninvasively paced to more than 85% of the age-predicted maximum heart rate. Twelve patients demonstrated reversible thallium defects, which corresponded in 11 cases to significant lesions seen on coronary angiography. Of nine patients who underwent both pacing and exercise thallium stress tests, comparable maximal rate-pressure products were achieved. Moreover, thallium imaging at peak pacing and during delayed views did not differ significantly from exercise thallium scintigraphy. A limiting factor associated with the technique was local patient discomfort, which occurred to some degree in all patients. We conclude that noninvasive external cardiac pacing together with thallium scintigraphy is capable of detecting significant coronary artery disease and may be comparable to routine exercise thallium stress testing. This new modality of stress testing could be useful in patients unable to undergo the exercise required for standard exercise tolerance testing, particularly if improvements in the technology can be found to reduce further the local discomfort

  11. Pacing-induced Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Alex Koo


    Full Text Available We present a case of pacing-induced cardiomyopathy. The patient presented with clinical symptoms of dyspnea, leg swelling, and orthopnea several months after a dual-chambered pacemaker was placed for third-degree heart block. The echocardiogram demonstrated a depressed ejection fraction. Coronary angiography was performed, which showed widely patent vessels. Single- and dual-chambered pacemakers create ventricular dyssynchrony, which in turn can cause structural, molecular changes leading to cardiomyopathy. With early intervention of biventricular pacemaker replacement, these changes can be reversible; thus, a timely diagnosis and awareness is warranted.

  12. Self-Paced Instruction: Hello, Education (United States)

    Leuba, Richard J.; Flammer, Gordon H.


    Answers criticisms of self-paced instruction (SPI) by citing advantages of SPI over lecture methods. Concludes that criticisms of SPI are useful since they indicate in which areas further research should be conducted to improve this method of instruction. (MLH)

  13. Improving image segmentation by learning region affinities

    Energy Technology Data Exchange (ETDEWEB)

    Prasad, Lakshman [Los Alamos National Laboratory; Yang, Xingwei [TEMPLE UNIV.; Latecki, Longin J [TEMPLE UNIV.


    We utilize the context information of other regions in hierarchical image segmentation to learn new regions affinities. It is well known that a single choice of quantization of an image space is highly unlikely to be a common optimal quantization level for all categories. Each level of quantization has its own benefits. Therefore, we utilize the hierarchical information among different quantizations as well as spatial proximity of their regions. The proposed affinity learning takes into account higher order relations among image regions, both local and long range relations, making it robust to instabilities and errors of the original, pairwise region affinities. Once the learnt affinities are obtained, we use a standard image segmentation algorithm to get the final segmentation. Moreover, the learnt affinities can be naturally unutilized in interactive segmentation. Experimental results on Berkeley Segmentation Dataset and MSRC Object Recognition Dataset are comparable and in some aspects better than the state-of-art methods.

  14. Pneumothorax in cardiac pacing

    DEFF Research Database (Denmark)

    Kirkfeldt, Rikke Esberg; Johansen, Jens Brock; Nohr, Ellen Aagaard


    AIM: To identify risk factors for pneumothorax treated with a chest tube after cardiac pacing device implantation in a population-based cohort.METHODS AND RESULTS: A nationwide cohort study was performed based on data on 28 860 patients from the Danish Pacemaker Register, which included all Danish...... age was 77 years (25th and 75th percentile: 69-84) and 55% were male (n = 15 785). A total of 190 patients (0.66%) were treated for pneumothorax, which was more often in women [aOR 1.9 (1.4-2.6)], and in patients with age >80 years [aOR 1.4 (1.0-1.9)], a prior history of chronic obstructive pulmonary...

  15. Lowering Regional Inflation? Improve Budget Absorption

    Directory of Open Access Journals (Sweden)

    Vid Adrison


    Full Text Available The subnational government spending in Indonesia exhibit a highly skewed distribution, i.e., it is very low in the first two-quarters and then increases significantly in the last two-quarters. Such explosive pattern poses two disadvantages. First, the regional output will fall below its optimal level as the low government capital expenditure leads to a fewer provision of public goods. Second, a significant increase in government spending in the later quarter pushes the short run aggregate demand to the northeast and creates an inflationary pressure in the following quarters. In this study, we analyze the effect of quarterly regional government expenditure growth on regional inflation during 2010–2014. Using Arellano Bond GMM estimation, we find government expenditure growth leads to higher inflation in the same quarter. A percentage increase in non-capital expenditure spending results in a higher inflation than a percentage increase in capital spending.

  16. Paediatric regional anaesthesia: new developments and improving ...

    African Journals Online (AJOL)

    induced respiratory depression. The purpose of this paper is to (i) provide insight into some new techniques that may improve the success and accuracy of peripheral nerve blocks, with particular reference to the role of nerve mapping, nerve ...

  17. An Undergraduate Intern Program at PACES (United States)

    Starks, Scott A.


    The University of Texas at El Paso (UTEP) established the Pan American Center for Earth and Environmental Studies (PACES) in 1995 to conduct basic and applied research that contributes to NASA's Mission to Planet Earth. Specifically, PACES provides a repository of remote sensing and other information that supports investigations into an improved understanding of geological, ecological and environmental processes occurring in the southwestern United States and Northern Mexico. Approximately 85% of UTEP's students come from El Paso County, a fast growing urban region representative of many large cities in the Southwest that have, or will soon have, a majority of their population composed of groups currently underrepresented in the scientific and technical workforce. UTEP's student population has an ethnic distribution (63% Hispanic, 32% Anglo, 3% African American, 1.5 % Asian American, and less than 1% Native American) that closely matches the demographics of the region it serves. Thus, UTEP has a mission to serve a multicultural population where minority students comprise the majority. Most Hispanic students at UTEP are primarily of Mexican origin. A large number are first or second-generation U.S. citizens. Characteristics that unite Hispanic students, in particular those of Mexican-origin, are a strong sense of family loyalty and a belief that all family members are responsible for contributing to the economic stability and well-being of the family. Most of their families are larger in number than the national average, and a variety of generations live together or share considerable resources. Thus, many young people feel an obligation and a desire to go to work at a young age and to continue working while in college, thereby assisting their parents and other family members. Older siblings understand that they have responsibilities to do household chores, to aid their younger siblings economically, and to assist elderly family members. This "work ethic" within the

  18. A slow-releasing form of prostacyclin agonist (ONO1301SR) enhances endogenous secretion of multiple cardiotherapeutic cytokines and improves cardiac function in a rapid-pacing-induced model of canine heart failure. (United States)

    Shirasaka, Tomonori; Miyagawa, Shigeru; Fukushima, Satsuki; Saito, Atsuhiro; Shiozaki, Motoko; Kawaguchi, Naomasa; Matsuura, Nariaki; Nakatani, Satoshi; Sakai, Yoshiki; Daimon, Takashi; Okita, Yutaka; Sawa, Yoshiki


    Cardiac functional deterioration in dilated cardiomyopathy (DCM) is known to be reversed by intramyocardial up-regulation of multiple cardioprotective factors, whereas a prostacyclin analog, ONO1301, has been shown to paracrinally activate interstitial cells to release a variety of protective factors. We here hypothesized that intramyocardial delivery of a slow-releasing form of ONO1301 (ONO1301SR) might activate regional myocardium to up-regulate cardiotherapeutic factors, leading to regional and global functional recovery in DCM. ONO1301 elevated messenger RNA and protein level of hepatocyte growth factor, vascular endothelial growth factor, and stromal-derived factor-1 of normal human dermal fibroblasts in a dose-dependent manner in vitro. Intramyocardial delivery of ONO1301SR, which is ONO1301 mixed with polylactic and glycolic acid polymer (PLGA), but not that of PLGA only, yielded significant global functional recovery in a canine rapid pacing-induced DCM model, assessed by echocardiography and cardiac catheterization (n = 5 each). Importantly, speckle-tracking echocardiography unveiled significant regional functional recovery in the ONO1301-delivered territory, consistent to significantly increased vascular density, reduced interstitial collagen accumulation, attenuated myocyte hypertrophy, and reversed mitochondrial structure in the corresponding area. Intramyocardial delivery of ONO1301SR, which is a PLGA-coated slow-releasing form of ONO1301, up-regulated multiple cardiotherapeutic factors in the injected territory, leading to region-specific reverse left ventricular remodeling and consequently a global functional recovery in a rapid-pacing-induced canine DCM model, warranting a further preclinical study to optimize this novel drug-delivery system to treat DCM. Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  19. Improving stability of regional numerical ocean models (United States)

    Herzfeld, Mike


    An operational limited-area ocean modelling system was developed to supply forecasts of ocean state out to 3 days. This system is designed to allow non-specialist users to locate the model domain anywhere within the Australasian region with minimum user input. The model is required to produce a stable simulation every time it is invoked. This paper outlines the methodology used to ensure the model remains stable over the wide range of circumstances it might encounter. Central to the model configuration is an alternative approach to implementing open boundary conditions in a one-way nesting environment. Approximately 170 simulations were performed on limited areas in the Australasian region to assess the model stability; of these, 130 ran successfully with a static model parameterisation allowing a statistical estimate of the model’s approach toward instability to be determined. Based on this, when the model was deemed to be approaching instability a strategy of adaptive intervention in the form of constraint on velocity and elevation was invoked to maintain stability.

  20. Antiarrhythmic properties of atrial pacing. (United States)

    Kliś, Magdalena; Sławuta, Agnieszka; Gajek, Jacek


    Bradycardia, atrial stretch and dilatation, autonomic nervous system disorders, and the presence of triggers such as atrial premature contractions, are factors which predispose a person to paroxysmal AF. Atrial pacing not only eliminates bradycardia but also prevents atrial premature contractions and dispersion of refractoriness, which are a substrate for atrial fibrillation. As the prolonged duration of atrial activation during pacing, especially from locations changing the physiological pattern of this activation (right atrium lateral wall, right atrium appendage), negatively influences both a mechanical and an electrical function of the atria, the atrial pacing site affects an atrial arrhythmogenesis. A conventional atrial lead location in the right atrium appendage causes non-physiological activation propagation, resulting in a prolongation of the activation time of both atria. This location is optimal according to a passive fixation of the atrial lead but the available contemporary active fixation leads could potentially be located in any area of the atrium. There is growing evidence of the benefit of pacing, imitating the physiological propagation of impulses within the atria. It seems that the Bachmann's bundle pacing is the best pacing site within the atria, not only positively influencing the atrial mechanical function but also best fulfilling the so-called atrial resynchronization function, in particular in patients with interatrial conduction delay. It can be effectively achieved using only one atrial electrode, and the slight shortening of atrioventricular conduction provides an additional benefit of this atrial pacing site.

  1. Estrogen-induced improvement in coronary flow responses during atrial pacing in relation to endothelin-1 levels in postmenopausal women without coronary disease

    Directory of Open Access Journals (Sweden)

    Ioannis Kallikazaros


    Full Text Available Ioannis Kallikazaros, Costas Tsioufis, Panagiotis Zambaras, Ioannis Skiadas, Marina Toutouza, Dimitrios Tousoulis, Christodoulos Stefanadis, Pavlos ToutouzasCardiology Department and University Cardiology Clinic, Hippokration Hospital of Athens, GreeceBackground: The cardioprotective role of hormonal replacement therapy remains in doubt, but interest is increasing in the vascular effects of estrogens especially in coronary circulation.Methods: Coronary blood flow (CBF was measured in 24 postmenopausal women (age 55 ± 3 years, whose coronary arteries appeared angiographically normal, during incremental atrial pacing (AP before and 20 minutes after intracoronary administration of either 75 ng/mL 17-β estradiol (treated group, n = 18 or 0.9% saline (controls, n = 6.Results: Before estrogen, no differences in the coronary vasomotor responses at AP between the two groups (p = NS could be detected. After estrogen, in the treated group, at the peak of the second AP, the coronary artery diameter decreased by 0.17 mm (p < 0.005 while the CBF increased by 61 mL/min (p < 0.05. These changes differed significantly from thoseobserved at the peak of first AP (p < 0.001 for both cases. In contrast, in the control group no such changes were observed. The endothelin-1 (ET-1 levels in the coronary sinus were significantly reduced after estrogen infusion, which was negatively correlated with the degree of coronary artery constriction (r = −0.40, p = 0.03 and positively correlated with the increase in CBF (r = 0.54, p = 0.01.Conclusions: In postmenopausal women without coronary artery disease, the intracoronary estrogen infusion mediates a greater increase in CBF and is positively correlated with the reduction of the coronary sinus ET-1 levels at the peak of AP.Keywords: estrogens, coronary blood flow, endothelin-1, coronary interventions

  2. Optogenetic pacing in Drosophila melanogaster (United States)

    Alex, Aneesh; Li, Airong; Tanzi, Rudolph E.; Zhou, Chao


    Electrical stimulation is currently the gold standard for cardiac pacing. However, it is invasive and nonspecific for cardiac tissues. We recently developed a noninvasive cardiac pacing technique using optogenetic tools, which are widely used in neuroscience. Optogenetic pacing of the heart provides high spatial and temporal precisions, is specific for cardiac tissues, avoids artifacts associated with electrical stimulation, and therefore promises to be a powerful tool in basic cardiac research. We demonstrated optogenetic control of heart rhythm in a well-established model organism, Drosophila melanogaster. We developed transgenic flies expressing a light-gated cation channel, channelrhodopsin-2 (ChR2), specifically in their hearts and demonstrated successful optogenetic pacing of ChR2-expressing Drosophila at different developmental stages, including the larva, pupa, and adult stages. A high-speed and ultrahigh-resolution optical coherence microscopy imaging system that is capable of providing images at a rate of 130 frames/s with axial and transverse resolutions of 1.5 and 3.9 μm, respectively, was used to noninvasively monitor Drosophila cardiac function and its response to pacing stimulation. The development of a noninvasive integrated optical pacing and imaging system provides a novel platform for performing research studies in developmental cardiology. PMID:26601299

  3. Satellite Sounder Data Assimilation for Improving Alaska Region Weather Forecast (United States)

    Zhu, Jiang; Stevens, E.; Zavodsky, B. T.; Zhang, X.; Heinrichs, T.; Broderson, D.


    Data assimilation has been demonstrated very useful in improving both global and regional numerical weather prediction. Alaska has very coarser surface observation sites. On the other hand, it gets much more satellite overpass than lower 48 states. How to utilize satellite data to improve numerical prediction is one of hot topics among weather forecast community in Alaska. The Geographic Information Network of Alaska (GINA) at University of Alaska is conducting study on satellite data assimilation for WRF model. AIRS/CRIS sounder profile data are used to assimilate the initial condition for the customized regional WRF model (GINA-WRF model). Normalized standard deviation, RMSE, and correlation statistic analysis methods are applied to analyze one case of 48 hours forecasts and one month of 24-hour forecasts in order to evaluate the improvement of regional numerical model from Data assimilation. The final goal of the research is to provide improved real-time short-time forecast for Alaska regions.

  4. Haemodynamic effects of dual-chamber pacing versus ventricular pacing during a walk test in patients with depressed or normal left ventricular function

    Energy Technology Data Exchange (ETDEWEB)

    Ferro, Adele; Salvatore, Marco; Cuocolo, Alberto [University Federico II, Department of Biomorphological and Functional Sciences, Institute of Biostructure and Bioimages of the National Council of Research, Naples (Italy); Duilio, Carlo; Santomauro, Maurizio [University Federico II, Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Naples (Italy)


    Dual-chamber rate-modulated pacing provides haemodynamic benefits compared with ventricular pacing at rest, but it is unclear whether this also holds true during physical exercise in patients with heart failure. This study assessed the haemodynamic response to a walk test during dual-chamber pacing and ventricular pacing in patients with depressed or normal left ventricular (LV) function. Twelve patients with an LV ejection fraction <50% and 11 patients with an LV ejection fraction {>=}50% underwent two randomised 6-min walk tests under dual-chamber rate-modulated pacing and ventricular pacing at a fixed rate of 70 beats/min. All patients had a dual-chamber pacemaker implanted for complete heart block. LV function was monitored by a radionuclide ambulatory system. In patients with depressed LV function, the change from dual-chamber pacing to ventricular pacing induced a decrease in end-systolic volume at the peak of the walk test (P<0.05), with no difference in end-diastolic volume. As a consequence, higher increases in LV ejection fraction (P<0.0001) and stroke volume (P<0.01) were observed during ventricular pacing. No difference in cardiac output was found between the two pacing modes. In patients with normal LV function, the change from dual-chamber pacing to ventricular pacing induced a significant decrease in cardiac output (P<0.005 at rest and P<0.05 at the peak of the walk test). Compared with dual-chamber rate-modulated pacing, ventricular pacing improves cardiac function and does not affect cardiac output during physical activity in patients with depressed LV function, whereas it impairs cardiac output in those with normal function. (orig.)

  5. Haemodynamic effects of dual-chamber pacing versus ventricular pacing during a walk test in patients with depressed or normal left ventricular function

    International Nuclear Information System (INIS)

    Ferro, Adele; Salvatore, Marco; Cuocolo, Alberto; Duilio, Carlo; Santomauro, Maurizio


    Dual-chamber rate-modulated pacing provides haemodynamic benefits compared with ventricular pacing at rest, but it is unclear whether this also holds true during physical exercise in patients with heart failure. This study assessed the haemodynamic response to a walk test during dual-chamber pacing and ventricular pacing in patients with depressed or normal left ventricular (LV) function. Twelve patients with an LV ejection fraction <50% and 11 patients with an LV ejection fraction ≥50% underwent two randomised 6-min walk tests under dual-chamber rate-modulated pacing and ventricular pacing at a fixed rate of 70 beats/min. All patients had a dual-chamber pacemaker implanted for complete heart block. LV function was monitored by a radionuclide ambulatory system. In patients with depressed LV function, the change from dual-chamber pacing to ventricular pacing induced a decrease in end-systolic volume at the peak of the walk test (P<0.05), with no difference in end-diastolic volume. As a consequence, higher increases in LV ejection fraction (P<0.0001) and stroke volume (P<0.01) were observed during ventricular pacing. No difference in cardiac output was found between the two pacing modes. In patients with normal LV function, the change from dual-chamber pacing to ventricular pacing induced a significant decrease in cardiac output (P<0.005 at rest and P<0.05 at the peak of the walk test). Compared with dual-chamber rate-modulated pacing, ventricular pacing improves cardiac function and does not affect cardiac output during physical activity in patients with depressed LV function, whereas it impairs cardiac output in those with normal function. (orig.)

  6. Improving cumulative effects assessment in Alberta: Regional strategic assessment

    International Nuclear Information System (INIS)

    Johnson, Dallas; Lalonde, Kim; McEachern, Menzie; Kenney, John; Mendoza, Gustavo; Buffin, Andrew; Rich, Kate


    The Government of Alberta, Canada is developing a regulatory framework to better manage cumulative environmental effects from development in the province. A key component of this effort is regional planning, which will lay the primary foundation for cumulative effects management into the future. Alberta Environment has considered the information needs of regional planning and has concluded that Regional Strategic Assessment may offer significant advantages if integrated into the planning process, including the overall improvement of cumulative environmental effects assessment in the province.

  7. Presentation Time Concerning System-Paced Multimedia Instructions and the Superiority of Learner Pacing (United States)

    Stiller, Klaus D.; Petzold, Kirstin; Zinnbauer, Peter


    The superiority of learner-paced over system-paced instructions was demonstrated in multiple experiments. In these experiments, the system-paced presentations were highly speeded, causing cognitive overload, while the learner-paced instructions allowed adjustments of the presentational flow to the learner's needs by pacing facilities, mostly…

  8. Diagnostic accuracy of pace spikes in the electrocardiogram to diagnose paced rhythm

    DEFF Research Database (Denmark)

    Andersson, Hedvig Bille; Hansen, Marco Bo; Thorsberger, Mads


    OBJECTIVE: To determine how often cardiac resynchronization therapy (CRT) pacing systems generate visible pace spikes in the electrocardiogram (ECG). METHODS: In 46 patients treated with CRT pacing systems, we recorded ECGs during intrinsic rhythm, atrial pacing and ventricular pacing. ECGs were...

  9. Alternative right ventricular pacing sites. (United States)

    Łuciuk, Dariusz; Łuciuk, Marek; Gajek, Jacek


    The main adverse effect of chronic stimulation is stimulation-induced heart failure in case of ventricular contraction dyssynchrony. Because of this fact, new techniques of stimulation should be considered to optimize electrotherapy. One of these methods is pacing from alternative right ventricular sites. The purpose of this article is to review currently accumulated data about alternative sites of cardiac pacing. Medline and PubMed bases were used to search English and Polish reports published recently. Recent studies report a deleterious effect of long term apical pacing. It is suggested that permanent apical stimulation, by omitting physiological conduction pattern with His-Purkinie network, may lead to electrical and mechanical dyssynchrony of heart muscle contraction. In the long term this pathological situation can lead to severe heart failure and death. Because of this, scientists began to search for some alternative sites of cardiac pacing to reduce the deleterious effect of stimulation. Based on current accumulated data, it is suggested that the right ventricular outflow tract, right ventricular septum, direct His-bundle or biventricular pacing are better alternatives due to more physiological electrical impulse propagation within the heart and the reduction of the dyssynchrony effect. These methods should preserve a better left ventricular function and prevent the development of heart failure in permanent paced patients. As there is still not enough, long-term, randomized, prospective, cross-over and multicenter studies, further research is required to validate the benefits of using this kind of therapy. The article should pay attention to new sites of cardiac stimulation as a better and safer method of treatment.

  10. Pace studying worldwide coke production

    International Nuclear Information System (INIS)



    Pace Consultants Inc., Houston, has started a multiclient study of world-wide petroleum coke production, examining environmental initiatives and eventually forecasting prices of fuel grade coke. Pace expects coker expansions, increased operating severity, and reduced cycle times to boost coke supply to more than 50 million metric tons/year in 2000, compared with 39.7 million metric tons in 1992. Increased supply and tightened environmental rules in countries consuming large amounts of petroleum coke will be the main factors affecting coke markets. The paper discusses coke quality and the Japanese market

  11. Trust regions in Kriging-based optimization with expected improvement (United States)

    Regis, Rommel G.


    The Kriging-based Efficient Global Optimization (EGO) method works well on many expensive black-box optimization problems. However, it does not seem to perform well on problems with steep and narrow global minimum basins and on high-dimensional problems. This article develops a new Kriging-based optimization method called TRIKE (Trust Region Implementation in Kriging-based optimization with Expected improvement) that implements a trust-region-like approach where each iterate is obtained by maximizing an Expected Improvement (EI) function within some trust region. This trust region is adjusted depending on the ratio of the actual improvement to the EI. This article also develops the Kriging-based CYCLONE (CYClic Local search in OptimizatioN using Expected improvement) method that uses a cyclic pattern to determine the search regions where the EI is maximized. TRIKE and CYCLONE are compared with EGO on 28 test problems with up to 32 dimensions and on a 36-dimensional groundwater bioremediation application in appendices supplied as an online supplement available at The results show that both algorithms yield substantial improvements over EGO and they are competitive with a radial basis function method.

  12. Science Unit Plans. PACE '94. (United States)

    Schoon, Kenneth J., Ed.; Wiles, Clyde A., Ed.

    This booklet contains mathematics unit plans for Biology, Chemistry, and Physical Science developed by PACE (Promoting Academic Excellence In Mathematics, Science & Technology for Workers of the 21st Century). Each unit plan contains suggested timing, objectives, skills to be acquired, workplace relationships, learning activities with suggested…

  13. PACE: A Browsable Graphical Interface. (United States)

    Beheshti, Jamshid; And Others


    Describes PACE (Public Access Catalogue Extension), an alternative interface designed to enhance online catalogs by simulating images of books and library shelves to help users browse through the catalog. Results of a test in a college library against a text-based online public access catalog, including student attitudes, are described.…

  14. Assessing the PACE of California residential solar deployment: Impacts of Property Assessed Clean Energy programs on residential solar photovoltaic deployment in California, 2010-2015

    Energy Technology Data Exchange (ETDEWEB)

    Deason, Jeff; Murphy, Sean


    A new study by Berkeley Lab found that residential Property Assessed Clean Energy (R-PACE) programs increased deployment of residential solar photovoltaic (PV) systems in California, raising it by about 7-12% in cities that adopt these programs. R-PACE is a financing mechanism that uses a voluntary property tax assessment, paid off over time, to facilitate energy improvements and, in some jurisdictions, water and resilience measures. While previous studies demonstrated that early, regional R-PACE programs increased solar PV deployment, this new analysis is the first to demonstrate these impacts from the large, statewide R-PACE programs dominating the California market today, which use private capital to fund the upfront costs of the improvements. Berkeley Lab estimated the impacts using econometric techniques on two samples: -Large cities only, allowing annual demographic and economic data as control variables -All California cities, without these annual data Analysis of both samples controls for several factors other than R-PACE that would be expected to drive solar PV deployment. We infer that on average, cities with R-PACE programs were associated with greater solar PV deployment in our study period (2010-2015). In the large cities sample, solar PV deployment in jurisdictions with R-PACE programs was higher by 1.1 watts per owner-occupied household per month, or 12%. Across all cities, solar PV deployment in jurisdictions with R-PACE programs was higher by 0.6 watts per owner-occupied household per month, or 7%. The large cities results are statistically significant at conventional levels; the all-cities results are not. The estimates imply that the majority of solar PV deployment financed by R-PACE programs would likely not have occurred in their absence. Results suggest that R-PACE programs have increased PV deployment in California even in relatively recent years, as R-PACE programs have grown in market share and as alternate approaches for financing solar PV

  15. Improving the Assessment of the Level of Regional Resources Management

    Directory of Open Access Journals (Sweden)

    Taraday Vladimir N.


    Full Text Available The work improves the assessment of the level of managing development resources by regions of Ukraine, which is based on the use of a comprehensive assessment — multidimensional comparative analysis (namely the rank-sum test and allows comparing the effectiveness of managing resource development in regions of Ukraine using the available data, on their status on the basis of a unified system of indicators, as well as comparing the level of managing development resources by each region of Ukraine in time. The uneven development of regions of the country is investigated, the growth of inter-regional socio-economic disproportions is revealed. It is determined that, having a fundamentally different composition and volume of natural, human, financial resources, the state and effectiveness of managing development resources by regions of Ukraine is significantly different. The level of managing development resources by regions of Ukraine is proposed to be assessed by the aggregate indicators characterizing the increase in the productivity of the regional economy, profitability of local business, and level of incomes of the population; general increase in social standards, quality of life and business environment.

  16. Improving and Communicating Workforce Skills: A Regional Initiative (United States)

    Baird, Dee


    The demand for improved workplace skills in the U.S. is rapidly rising, and U.S. industries, employees, and educational systems are struggling to respond. This paper describes the Skills Advantage program, an effort led by employers and facilitated by Kirkwood Community College to address regional employment needs. This work-ready certificate…

  17. Improving the Assessment of Regional Economic Potential (on Example of Rostov Region

    Directory of Open Access Journals (Sweden)

    Nikolai A. Kurianov


    Full Text Available The article discusses a number of problematic issues concerning the possibility of improving existing approaches to assessing regional economic potential. Based on the analysis of existing approaches it is concluded that presence of a number of inherent common disadvantages, which include the exclusion of complex assessment elements of intangible resources, isolation from development goals in the region, ignoring the possibility of incremental reserves development static evaluation results. To overcome these ambiguities the authors' approach to improving assessment procedures based on the allocation of the essential nature of the category «regional economic potential», which unites, on the one hand, the resources available for regional development (actual potential, and on the other hand, resources in respect of which the region has the opportunity to attract them as a tool for further development of (stochastic potential. As the degree of implementation of this option is determined by the quality of regional governance, the most important element of the economic potential of the region is also an effective mechanism for management of existing and potential resources of various types. The practical implementation of the proposed methodology suppose, for example, estimate the economic potential of the Rostov region. At the first stage of the evaluation determine the most important elements of this potential and their ranking, on the second – assessment of the status of these elements from the point of view of their availability, ability to attract and management efficiency, and the third – the normalized assessment of regional economic potential.

  18. Racing an Opponent Alters Pacing, Performance and Muscle Force Decline, But Not RPE

    NARCIS (Netherlands)

    Konings, Marco J; Parkinson, Jordan; Zijdewind, Inge; Hettinga, Florentina

    PURPOSE: Performing against a virtual opponent has been shown to invite a change in pacing and improve time trial (TT) performance. This study explored how this performance improvement is established by assessing changes in pacing, neuromuscular function and perceived exertion. METHODS: After a peak

  19. Breath pacing system and method for pacing the respiratory activity of a subject

    NARCIS (Netherlands)


    To provide a breath pacing system and a corresponding method for pacing the respiratory activity of a subject that provide the possibility to adapt the output signal to the respiration characteristics of the subject automatically and effectively a breath pacing system (10) for pacing the respiratory

  20. Hospital-Based Coalition to Improve Regional Surge Capacity

    Directory of Open Access Journals (Sweden)

    James M. Learning


    Full Text Available Introduction: Surge capacity for optimization of access to hospital beds is a limiting factor in response to catastrophic events. Medical facilities, communication tools, manpower, and resource reserves exist to respond to these events. However, these factors may not be optimally functioning to generate an effective and efficient surge response. The objective was to improve the function of these factors.Methods: Regional healthcare facilities and supporting local emergency response agencies developed a coalition (the Healthcare Facilities Partnership of South Central Pennsylvania; HCFP¬SCPA to increase regional surge capacity and emergency preparedness for healthcare facilities. The coalition focused on 6 objectives: (1 increase awareness of capabilities and assets, (2 develop and pilot test advanced planning and exercising of plans in the region, (3 augment written medical mutual aid agreements, (4 develop and strengthen partnership relationships, (5 ensure National Incident Management System compliance, and (6 develop and test a plan for effective utilization of volunteer healthcare professionals.Results: In comparison to baseline measurements, the coalition improved existing areas covered under all 6 objectives documented during a 24-month evaluation period. Enhanced communications between the hospital coalition, and real-time exercises, were used to provide evidence of improved preparedness for putative mass casualty incidents.Conclusion: The HCFP-SCPA successfully increased preparedness and surge capacity through a partnership of regional healthcare facilities and emergency response agencies.

  1. Improving of State Regional Policy Mechanism at Risks` Conditions

    Directory of Open Access Journals (Sweden)

    Roman Tarasovich Lukysha


    Full Text Available Modernization and innovatization were defined as the ways of improvement of the state policy of regional development from the safety perspective. They stipulate the following: 1 avoidance of the possible risks of the development of regions providing for the refusal of the unreliable programs and projects, unreasonable taking on credit and other kinds of loans; 2 risk sharing and convergence, as well as the reduction of their influence on the results of administrative activity; 3 determination and prevention of negative effect of risks. It was offered to carry out the improvement of the state policy of the development of regions with the help of the forming of stable organizational and informational network and system. It was specified that the difference between the latter is in the fact that the organizational and informational system concerns the financial side of administrative activity in regions. This means that it ensures the observance of the principle of transparency. While the organizational and informational network reflects its procedural side with the concept of openness being the basis of such activity. The improvement of the procedure of the organization of state administration of risks of the regional development was proved. It was established that organization of the state administration of the risks of regions development has a form of a chain: “provision of power and powers to the public authority → establishment of the new structural unit or addition of the existing administrative formations, approval of the functional regulations, official duties, etc. → competitive selection of the officials, their training, retraining, consulting → performance by them of the direct tasks on the detection and the prevention of the negative influence of dangers and threats.”

  2. Ischemic Stroke with Cardiac Pacemaker Implantation: Comparison of Physiological and Ventricular Pacing Modes. (United States)

    Kato, Yuji; Hayashi, Takeshi; Kato, Ritsushi; Tanahashi, Norio; Takao, Masaki


    The clinical characteristics of ischemic stroke in patients with a pacemaker (PM) are not well understood. Forty-six ischemic stroke patients with a PM were investigated retrospectively, and the impact of different pacing modes was compared. The patients were divided into a physiological pacing group (n = 22) and a ventricular pacing group (n = 24). The prevalence of atrial fibrillation (AF) was significantly higher in the ventricular pacing group (36% versus 75%; P = .008). The mean left atrial dimension was relatively large in the ventricular pacing group than in the physiological pacing group (44.5 ± 6.7 mm versus 39.1 ± 8.5 mm, respectively; P = .071). Twenty-four percent of the patients were receiving anticoagulants, whereas 41% of the patients were receiving antiplatelet drugs. Cardioembolism was the most common stroke subtype in both groups. Although there was no statistically significant difference, neurological severity on admission was higher in the ventricular pacing group than in the physiological pacing group (P = .061). Functional outcomes, excluding patients with transient ischemic attack or prior stroke, significantly declined in the ventricular pacing group compared with the physiological pacing group (P = .044). The avoidance of the ventricular pacing mode may result in improved clinical outcomes. In patients without persistent AF, it may be important to select physiological pacing instead of ventricular pacing to decrease potential stroke severity. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  3. Primary tasks of environmental improvement of the Aral Sea region

    International Nuclear Information System (INIS)

    Tauipbaev, S.T.; Turebaev, Sh.Kh.; Kusherbaev, A.E.


    Main reasons of environmental crisis in Aral Sea region are analyzed. Primary tasks of its environmental improvement are planed: - creation of conditions of guarantee ensuring (by territory and time) for all water consumers of water resources of the Syr-Dariya and Amu Dariya rivers at the expense of increase of water system efficiency and organization of Water Union of Basin Countries; - acceptance of regional measures on good quality water supply for the Aral Sea region population, mainly at expense of underground water use; -fulfillment of primary measures for Aral Sea save, envisaging building of land dam separating the Small Aral: - solution of unemployment problem by capacity of strengthening of farm economy and rebirth of native business

  4. Improving regional variation using quality of care measures

    Directory of Open Access Journals (Sweden)

    Scott A Berkowitz


    Full Text Available Scott A Berkowitz1, Gary Gerstenblith1, Robert Herbert2, Gerard Anderson1,21Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; 2Center for Hospital Finance and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USAAbstract: There is significant regional variability in the quality of care provided in the United States. This article compares regional performance for three measures that focus on transitions in care, and the care of patients with multiple conditions. Admissions for people with ambulatory care-sensitive conditions, hospital readmissions within 30 days of discharge, and compliance with practice guidelines for people with three chronic conditions (congestive heart failure, chronic obstructive pulmonary disease, and diabetes were analyzed using data drawn from the Centers for Medicare & Medicaid Services’ Standard Analytic Files for 5% of a 2004 national sample of Medicare beneficiaries which was divided by hospital referral regions and regional performance. There were significant regional differences in performance which we hypothesize could be improved through better care coordination and system management.Keywords: performance, quality, chronic condition, ambulatory care, sensitive conditions, readmissions

  5. IAEA instrumentation programme keeping pace with technology

    International Nuclear Information System (INIS)

    Fortakov, V.; Rundquist, D.E.


    Nuclear components, nuclear practices and nuclear facilities have all improved with the maturing of the industry. These improvements have been driven by forces, which are beyond the normal evolutionary pressures, such as increased safety, as low as possible radiation exposure for the workers as well as for the public and the increasing competiveness of alternative forms of energy generation. International nuclear safeguards has had to keep pace with these technological and administrative changes. Moreover, the political climate has changed since the initial implementation of safeguards under the Non-Proliferation Treaty. Implementation of safeguards agreements has accommodated to these changes as well as to the technical innovations. One important component of safeguards implementation, namely the instruments deployed by inspectors, has matured with the help of Member States. Continued efforts in the development and deployment of appropriate instruments are needed to maintain an acceptable level of efficiency and credibility. (orig.)

  6. Neurogenesis in the olfactory bulb induced by paced mating in the female rat is opioid dependent.

    Directory of Open Access Journals (Sweden)

    Marianela Santoyo-Zedillo

    Full Text Available The possibility to control the rate of sexual stimulation that the female rat receives during a mating encounter (pacing increases the number of newborn neurons that reach the granular layer of the accessory olfactory bulb (AOB. If females mate repeatedly, the increase in the number of neurons is observed in other regions of the AOB and in the main olfactory bulb (MOB. It has also been shown that paced mating induces a reward state mediated by opioids. There is also evidence that opioids modulate neurogenesis. In the present study, we evaluated whether the opioid receptor antagonist naloxone (NX could reduce the increase in neurogenesis in the AOB induced by paced mating. Ovariectomized female rats were randomly divided in 5 different groups: 1 Control (not mated treated with saline, 2 control (not mated treated with naloxone, 3 females that mated without controlling the sexual interaction (no-pacing, 4 females injected with saline before pacing the sexual interaction and 5 females injected with NX before a paced mating session. We found, as previously described, that paced mating induced a higher number of new cells in the granular layer of the AOB. The administration of NX before paced mating, blocked the increase in the number of newborn cells and prevented these cells from differentiating into neurons. These data suggest that opioid peptides play a fundamental role in the neurogenesis induced by paced mating in female rats.

  7. Selection of permanent pacing position of cardiac ventricle in patients with complete right bundle branch block

    International Nuclear Information System (INIS)

    Yang Minquan; Zhou Jun; Zhu Yan; Wang Jin; Rong Xin; Zhang Xiaoyi


    Objective: To find out the optimal pacing localization by comparing different pacing positions of the right ventricle in brady-cardiacarrhythmia patients with complete right bundle branch block. Methods: DDD type of double lumen permanent pacemaker was implanted in each of the 8 cases of sick sinus syndrome (SSS) and/or III degree atrioventricular block (III degree AVB) with complete right bundle branch block in normal heart function or class I. For each patient, four pacing positions in right ventricle were compared and the QRS pacing durations were recorded. The position with the shortest the QRS duration was chosen as the permanent pacing position. Heart function, chest X-rays and left ventricle ejection fraction (LVEF) were followed up after the operation. Results: In all the 8 cases, the posterior septum of the right ventricle were chosen as the permanent pacing position, with the shorter pacing QRS duration than that of pre-operation (P<0.05) and other pacing positions of the right ventricle. All parameters of this permanent pacing position were within the normal range. During the follow-up of 6-36 months, no abnormity was found in cardiac functions. Conclusion: In brady-cardiacarrhythmia patients with complete right bundle branch block, the implantation of permanent pacemaker should be at the junction region of inlet and outlet tracts, of the posterior septum of the right ventricle with ideal physiological function. (authors)

  8. Gait Coordination After Stroke: Benefits of Acoustically Paced Treadmill Walking

    NARCIS (Netherlands)

    Roerdink, M.; Lamoth, C.J.C.; Kwakkel, G.; van Wieringen, P.C.W.; Beek, P.J.


    Background and Purpose: Gait coordination often is compromised after stroke. The purpose of this study was to evaluate the efficacy of acoustically paced treadmill walking as a method for improving gait coordination in people after stroke. Participants: Ten people after stroke volunteered for the

  9. Gait coordination after stroke: benefits of acoustically paced treadmill walking.

    NARCIS (Netherlands)

    Roerdink, M.; Lamoth, C.J.; Kwakkel, G.; Wieringen, P.C. van; Beek, P.J.


    BACKGROUND AND PURPOSE: Gait coordination often is compromised after stroke. The purpose of this study was to evaluate the efficacy of acoustically paced treadmill walking as a method for improving gait coordination in people after stroke. PARTICIPANTS: Ten people after stroke volunteered for the

  10. Improving regional universal newborn hearing screening programmes in Italy. (United States)

    Molini, E; Cristi, M C; Lapenna, R; Calzolaro, L; Muzzi, E; Ciciriello, E; Della Volpe, A; Orzan, E; Ricci, G


    The Universal Newborn Hearing Screening (UNHS) programme aims at achieving early detection of hearing impairment. Subsequent diagnosis and intervention should follow promptly. Within the framework of the Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for early Identification, Intervention and Care of Hearing Impaired Children", the limitations and strengths of current UNHS programs in Italy have been analysed by a group of professionals working in tertiary centres involved in regional UNHS programmes, using SWOT analysis and a subsequent TOWS matrix. Coverage and lost-to-follow up rates are issues related to UNHS programmes. Recommendations to improve the effectiveness of the UNHS programme have been identified. The need for homogeneous policies, high-quality information and dissemination of knowledge for operators and families of hearing-impaired children emerged from the discussion. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale.

  11. Pacing and Self-regulation: Important Skills for Talent Development in Endurance Sports. (United States)

    Elferink-Gemser, Marije T; Hettinga, Florentina J


    Pacing has been characterized as a multifaceted goal-directed process of decision making in which athletes need to decide how and when to invest their energy during the race, a process essential for optimal performance. Both physiological and psychological characteristics associated with adequate pacing and performance are known to develop with age. Consequently, the multifaceted skill of pacing might be under construction throughout adolescence, as well. Therefore, the authors propose that the complex skill of pacing is a potential important performance characteristic for talented youth athletes that needs to be developed throughout adolescence. To explore whether pacing is a marker for talent and how talented athletes develop this skill in middle-distance and endurance sports, they aim to bring together literature on pacing and literature on talent development and self-regulation of learning. Subsequently, by applying the cyclical process of self-regulation to pacing, they propose a practical model for the development of performance in endurance sports in youth athletes. Not only is self-regulation essential throughout the process of reaching the long-term goal of athletic excellence, but it also seems crucial for the development of pacing skills within a race and the development of a refined performance template based on previous experiences. Coaches and trainers are advised to incorporate pacing as a performance characteristic in their talent-development programs by stimulating their athletes to reflect, plan, monitor, and evaluate their races on a regular basis to build performance templates and, as such, improve their performance.

  12. Quality assurance and improvement: the Pediatric Regional Anesthesia Network. (United States)

    Polaner, David M; Martin, Lynn D


    Quality assurance and improvement (QA/QI) is a critical activity in medicine. The use of large-scale collaborative databases is increasingly essential to obtain enough reports with which to establish standards of practice and define the incidence of complications and risk/benefit ratios for rare events. Such projects can enhance local QA/QI endeavors by enabling institutions to obtain benchmark data against which to compare their performance and can be used for prospective analyses of inter-institutional differences to determine 'best practice'. The pediatric regional anesthesia network (PRAN) is such a project. The first data cohort is currently being analyzed and offers insight into how such data can be used to detect trends in adverse events and improve care. © 2011 Blackwell Publishing Ltd.

  13. Risk perception influences athletic pacing strategy. (United States)

    Micklewright, Dominic; Parry, David; Robinson, Tracy; Deacon, Greg; Renfree, Andrew; St Clair Gibson, Alan; Matthews, William J


    The objective of this study is to examine risk taking and risk perception associations with perceived exertion, pacing, and performance in athletes. Two experiments were conducted in which risk perception was assessed using the domain-specific risk taking (DOSPERT) scale in 20 novice cyclists (experiment 1) and 32 experienced ultramarathon runners (experiment 2). In experiment 1, participants predicted their pace and then performed a 5-km maximum effort cycling time trial on a calibrated Kingcycle mounted bicycle. Split times and perceived exertion were recorded every kilometer. In experiment 2, each participant predicted their split times before running a 100-km ultramarathon. Split times and perceived exertion were recorded at seven checkpoints. In both experiments, higher and lower risk perception groups were created using median split of DOSPERT scores. In experiment 1, pace during the first kilometer was faster among lower risk perceivers compared with higher risk perceivers (t(18) = 2.0, P = 0.03) and faster among higher risk takers compared with lower risk takers (t(18) = 2.2, P = 0.02). Actual pace was slower than predicted pace during the first kilometer in both the higher risk perceivers (t(9) = -4.2, P = 0.001) and lower risk perceivers (t(9) = -1.8, P = 0.049). In experiment 2, pace during the first 36 km was faster among lower risk perceivers compared with higher risk perceivers (t(16) = 2.0, P = 0.03). Irrespective of risk perception group, actual pace was slower than predicted pace during the first 18 km (t(16) = 8.9, P risk perception groups. Initial pace is associated with an individual's perception of risk, with low perceptions of risk being associated with a faster starting pace. Large differences between predicted and actual pace suggest that the performance template lacks accuracy, perhaps indicating greater reliance on momentary pacing decisions rather than preplanned strategy.

  14. Improvements on mapping soil liquefaction at a regional scale (United States)

    Zhu, Jing

    Earthquake induced soil liquefaction is an important secondary hazard during earthquakes and can lead to significant damage to infrastructure. Mapping liquefaction hazard is important in both planning for earthquake events and guiding relief efforts by positioning resources once the events have occurred. This dissertation addresses two aspects of liquefaction hazard mapping at a regional scale including 1) predictive liquefaction hazard mapping and 2) post-liquefaction cataloging. First, current predictive hazard liquefaction mapping relies on detailed geologic maps and geotechnical data, which are not always available in at-risk regions. This dissertation improves the predictive liquefaction hazard mapping by the development and validation of geospatial liquefaction models (Chapter 2 and 3) that predict liquefaction extent and are appropriate for global application. The geospatial liquefaction models are developed using logistic regression from a liquefaction database consisting of the data from 27 earthquake events from six countries. The model that performs best over the entire dataset includes peak ground velocity (PGV), VS30, distance to river, distance to coast, and precipitation. The model that performs best over the noncoastal dataset includes PGV, VS30, water table depth, distance to water body, and precipitation. Second, post-earthquake liquefaction cataloging historically relies on field investigation that is often limited by time and expense, and therefore results in limited and incomplete liquefaction inventories. This dissertation improves the post-earthquake cataloging by the development and validation of a remote sensing-based method that can be quickly applied over a broad region after an earthquake and provide a detailed map of liquefaction surface effects (Chapter 4). Our method uses the optical satellite images before and after an earthquake event from the WorldView-2 satellite with 2 m spatial resolution and eight spectral bands. Our method

  15. Interatrial septum versus right atrial appendage pacing for prevention of atrial fibrillation : A meta-analysis of randomized controlled trials. (United States)

    Zhang, L; Jiang, H; Wang, W; Bai, J; Liang, Y; Su, Y; Ge, J


    Interatrial septum (IAS) pacing seems to be a promising strategy for the prevention of atrial fibrillation (AF); however, studies have yielded conflicting results. This meta-analysis was to compare IAS with right atrial appendage (RAA) pacing on the prevention of postpacing AF occurrence. Pubmed, MEDLINE, EMBASE and Web of Science databases were searched through October 2016 for randomized controlled trials comparing IAS with RAA pacing on the prevention of AF. Data concerning study design, patient characteristics and outcomes were extracted. Risk ratio (RR), weighted mean differences (WMD) or standardized mean differences (SMD) were calculated using fixed or random effects models. A total of 12 trials involving 1146 patients with dual-chamber pacing were included. Although IAS was superior to RAA pacing in terms of reducing the number of AF episodes (SMD = -0.29, P = 0.05), AF burden (SMD = -0.41, P = 0.008) and P -wave duration (WMD = -34.45 ms, P IAS pacing. Nevertheless, no differences were observed concerning all-cause death (RR = 1.04, P = 0.88), procedure-related events (RR = 1.17, P = 0.69) and pacing parameters between IAS and RAA pacing in the follow-up period. IAS pacing is safe and as well tolerated as RAA pacing. Although IAS pacing may fail to prevent permanent AF occurrence and recurrences of AF, it is able to not only improve interatrial conduction, but also reduce AF burden.

  16. CAMAC interface module for PACE ADC system

    Energy Technology Data Exchange (ETDEWEB)

    Dalton, C G; Mischke, R E [Los Alamos Scientific Lab., N.Mex. (USA); Scott, D T


    This report describes a CAMAC module designed to buffer and transfer data from the Tennelec multiplexed ADC system called PACE to a computer. It can be operated in either of two modes: as an eight-deep, first-in-first-out (FIFO) circular buffer, or in channel mode with a single buffer reserved for each PACE channel.

  17. Web Tools: Keeping Learners on Pace (United States)

    Kosloski, Mickey


    One of the greatest challenges in teaching technology and engineering is pacing. Some students grasp new technological concepts quickly, while others need repetition and may struggle to keep pace. This poses an obstacle for the technology and engineering teacher, and is particularly true when teaching students to build a website. However, there…

  18. Improving efficiency of a regional stand alone bone bank. (United States)

    Warnock, Jonathan M; Rowan, Clare H; Davidson, Helen; Millar, Ciara; McAlinden, M Gavan


    The introduction of a stand-alone Bone Bank in our Regional Orthopaedic Hospital has improved the availability of femoral head allograft. Benninger et al. (Bone Joint J 96-B:1307-1311, 2014), demonstrated their institutions bank to be cost effective despite a 30 % discard rate for harvested allograft. We sought to audit our own discard rates and subsequent cost-effectiveness of our bone bank. Donor recruitment. Before approaching a potential donor, our establishment's nurse specialists review their clinical notes and biochemical laboratory results, available on a regional Electronic Care Records. They view femoral head architecture on radiographs against set criteria, Patient Archive and Communication system (SECTRA, Sweden). In total 1383 femoral heads were harvested, 247 were discarded giving an overall rate of 17.9 %. The most common reasons for discard of harvested graft was a positive microbiology/bacteriology result, n = 96 (38.9 %). After a rise in discard rates in 2007, we have steadily reduced our discard rates since 2006/2007 (28.2 %), 2008/2009 (17 %), 2010/2011 (14.8 %), and finally to 10.3 % in 2012/2013. In the current financial year, our cost to harvest, test, store and release a femoral head is £ 610. With a structured donor recruitment process and unique pre-operative radiographic analysis we have successfully reduced our discard rates bi-annually making our bone bank increasingly cost-effective.

  19. 42 CFR 460.60 - PACE organizational structure. (United States)


    ... 42 Public Health 4 2010-10-01 2010-10-01 false PACE organizational structure. 460.60 Section 460... ELDERLY (PACE) PACE Administrative Requirements § 460.60 PACE organizational structure. (a) A PACE organization must be, or be a distinct part of, one of the following: (1) An entity of city, county, State, or...

  20. Earlier Right Ventricular Pacing in Cardiac Resynchronization Therapy for a Patient with Right Axis Deviation. (United States)

    Hattori, Yusuke; Ishibashi, Kohei; Noda, Takashi; Okamura, Hideo; Kanzaki, Hideaki; Anzai, Toshihisa; Yasuda, Satoshi; Kusano, Kengo


    We describe the case of a 37-year-old woman who presented with complete right bundle branch block and right axis deviation. She was admitted to our hospital due to severe heart failure and was dependent on inotropic agents. Cardiac resynchronization therapy was initiated but did not improve her condition. After the optimization of the pacing timing, we performed earlier right ventricular pacing, which led to an improvement of her heart failure. Earlier right ventricular pacing should be considered in patients with complete right bundle branch block and right axis deviation when cardiac resynchronization therapy is not effective.

  1. Improvement of snowpack simulations in a regional climate model

    Energy Technology Data Exchange (ETDEWEB)

    Jin, J.; Miller, N.L.


    To improve simulations of regional-scale snow processes and related cold-season hydroclimate, the Community Land Model version 3 (CLM3), developed by the National Center for Atmospheric Research (NCAR), was coupled with the Pennsylvania State University/NCAR fifth-generation Mesoscale Model (MM5). CLM3 physically describes the mass and heat transfer within the snowpack using five snow layers that include liquid water and solid ice. The coupled MM5–CLM3 model performance was evaluated for the snowmelt season in the Columbia River Basin in the Pacific Northwestern United States using gridded temperature and precipitation observations, along with station observations. The results from MM5–CLM3 show a significant improvement in the SWE simulation, which has been underestimated in the original version of MM5 coupled with the Noah land-surface model. One important cause for the underestimated SWE in Noah is its unrealistic land-surface structure configuration where vegetation, snow and the topsoil layer are blended when snow is present. This study demonstrates the importance of the sheltering effects of the forest canopy on snow surface energy budgets, which is included in CLM3. Such effects are further seen in the simulations of surface air temperature and precipitation in regional weather and climate models such as MM5. In addition, the snow-season surface albedo overestimated by MM5–Noah is now more accurately predicted by MM5–CLM3 using a more realistic albedo algorithm that intensifies the solar radiation absorption on the land surface, reducing the strong near-surface cold bias in MM5–Noah. The cold bias is further alleviated due to a slower snowmelt rate in MM5–CLM3 during the early snowmelt stage, which is closer to observations than the comparable components of MM5–Noah. In addition, the over-predicted precipitation in the Pacific Northwest as shown in MM5–Noah is significantly decreased in MM5 CLM3 due to the lower evaporation resulting from the

  2. Rhythm perturbations in acoustically paced treadmill walking after stroke. (United States)

    Roerdink, Melvyn; Lamoth, Claudine J C; van Kordelaar, Joost; Elich, Peter; Konijnenbelt, Manin; Kwakkel, Gert; Beek, Peter J


    In rehabilitation, acoustic rhythms are often used to improve gait after stroke. Acoustic cueing may enhance gait coordination by creating a stable coupling between heel strikes and metronome beats and provide a means to train the adaptability of gait coordination to environmental changes, as required in everyday life ambulation. To examine the stability and adaptability of auditory-motor synchronization in acoustically paced treadmill walking in stroke patients. Eleven stroke patients and 10 healthy controls walked on a treadmill at preferred speed and cadence under no metronome, single-metronome (pacing only paretic or nonparetic steps), and double-metronome (pacing both footfalls) conditions. The stability of auditory-motor synchronization was quantified by the variability of the phase relation between footfalls and beats. In a separate session, the acoustic rhythms were perturbed and adaptations to restore auditory-motor synchronization were quantified. For both groups, auditory-motor synchronization was more stable for double-metronome than single-metronome conditions, with stroke patients exhibiting an overall weaker coupling of footfalls to metronome beats than controls. The recovery characteristics following rhythm perturbations corroborated the stability findings and further revealed that stroke patients had difficulty in accelerating their steps and instead preferred a slower-step response to restore synchronization. In gait rehabilitation practice, the use of acoustic rhythms may be more effective when both footfalls are paced. In addition, rhythm perturbations during acoustically paced treadmill walking may not only be employed to evaluate the stability of auditory-motor synchronization but also have promising implications for evaluation and training of gait adaptations in neurorehabilitation practice.

  3. Applying Multimodel Ensemble from Regional Climate Models for Improving Runoff Projections on Semiarid Regions of Spain (United States)

    Garcia Galiano, S. G.; Olmos, P.; Giraldo Osorio, J. D.


    In the Mediterranean area, significant changes on temperature and precipitation are expected throughout the century. These trends could exacerbate the existing conditions in regions already vulnerable to climatic variability, reducing the water availability. Improving knowledge about plausible impacts of climate change on water cycle processes at basin scale, is an important step for building adaptive capacity to the impacts in this region, where severe water shortages are expected for the next decades. RCMs ensemble in combination with distributed hydrological models with few parameters, constitutes a valid and robust methodology to increase the reliability of climate and hydrological projections. For reaching this objective, a novel methodology for building Regional Climate Models (RCMs) ensembles of meteorological variables (rainfall an temperatures), was applied. RCMs ensembles are justified for increasing the reliability of climate and hydrological projections. The evaluation of RCMs goodness-of-fit to build the ensemble is based on empirical probability density functions (PDF) extracted from both RCMs dataset and a highly resolution gridded observational dataset, for the time period 1961-1990. The applied method is considering the seasonal and annual variability of the rainfall and temperatures. The RCMs ensembles constitute the input to a distributed hydrological model at basin scale, for assessing the runoff projections. The selected hydrological model is presenting few parameters in order to reduce the uncertainties involved. The study basin corresponds to a head basin of Segura River Basin, located in the South East of Spain. The impacts on runoff and its trend from observational dataset and climate projections, were assessed. Considering the control period 1961-1990, plausible significant decreases in runoff for the time period 2021-2050, were identified.


    Directory of Open Access Journals (Sweden)

    Robert R. Bakhtiev


    Full Text Available The article considers the basic ways of improving management quality via a regional innovation development based on the correlation analysis. The necessity of formation of qualitative information interaction of parts of a regional innovation system is proved. It allows creating more effective innovation process in the region.

  5. On the pace of fertility decline in sub-Saharan Africa


    David Shapiro; Andrew Hinde


    Background: This descriptive finding examines the comparative pace of fertility decline in sub-Saharan Africa, relative to Asia, Latin America and the Caribbean, and Northern Africa.Objective: We seek to determine if fertility decline has been slower in sub-Saharan Africa than elsewhere in the developing world.Methods: United Nations 2017 estimates of national fertility are used in assessing the comparative pace of fertility decline, and the four regions are compared in terms of how far they ...

  6. PACE: Proactively Secure Accumulo with Cryptographic Enforcement (United States)


    will be replaced with the values from the decrypted destination field. PACE encrypts data using AES and supports the following modes: CTR, CFB, CBC, OFB...2) Searchable Encryption : PACE also support searching for encrypted data. This is done using AES in SIV mode [11] to provide deterministic encryption ...row ”Alphabet”), then the search term is encrypted deterministically, and that term is searched on the server. Because AES does not preserve the

  7. Optogenetic pacing in Drosophila melanogaster (Conference Presentation) (United States)

    Alex, Aneesh; Li, Airong; Men, Jing; Jerwick, Jason; Tanzi, Rudolph E.; Zhou, Chao


    A non-invasive, contact-less cardiac pacing technology can be a powerful tool in basic cardiac research and in clinics. Currently, electrical pacing is the gold standard for cardiac pacing. Although highly effective in controlling the cardiac function, the invasive nature, non-specificity to cardiac tissues and possible tissue damage limits its capabilities. Optical pacing of heart is a promising alternative, which is non-invasive and more specific, has high spatial and temporal precision, and avoids shortcomings in electrical stimulation. Optical coherence tomography has been proved to be an effective technique in non-invasive imaging in vivo with ultrahigh resolution and imaging speed. In the last several years, non-invasive specific optical pacing in animal hearts has been reported in quail, zebrafish, and rabbit models. However, Drosophila Melanogaster, which is a significant model with orthologs of 75% of human disease genes, has rarely been studied concerning their optical pacing in heart. Here, we combined optogenetic control of Drosophila heartbeat with optical coherence microscopy (OCM) technique for the first time. The light-gated cation channel, channelrhodopsin-2 (ChR2) was specifically expressed by transgene as a pacemaker in drosophila heart. By stimulating the pacemaker with 472 nm pulsed laser light at different frequencies, we achieved non-invasive and more specific optical control of the Drosophila heart rhythm, which demonstrates the wide potential of optical pacing for studying cardiac dynamics and development. Imaging capability of our customized OCM system was also involved to observe the pacing effect visually. No tissue damage was found after long exposure to laser pulses, which proved the safety of optogenetic control of Drosophila heart.

  8. Sawtooth Pacing by Real-Time Auxiliary Power Control in a Tokamak Plasma

    International Nuclear Information System (INIS)

    Goodman, T. P.; Felici, F.; Sauter, O.; Graves, J. P.


    In the standard scenario of tokamak plasma operation, sawtooth crashes are the main perturbations that can trigger performance-degrading, and potentially disruption-generating, neoclassical tearing modes. This Letter demonstrates sawtooth pacing by real-time control of the auxiliary power. It is shown that the sawtooth crash takes place in a reproducible manner shortly after the removal of that power, and this can be used to precisely prescribe, i.e., pace, the individual sawteeth. In combination with preemptive stabilization of the neoclassical tearing modes, sawtooth pacing provides a new sawtooth control paradigm for improved performance in burning plasmas.

  9. Positive pacing in elite IRONMAN triathletes. (United States)

    Angehrn, Nicole; Rüst, Christoph A.; Nikolaidis, Pantelis T.; Rosemann, Thomas; Knechtle, Beat


    Pacing is known to influence athletic performance. For the Ironman triathlon program, a positive pacing strategy, i.e., the continuous decrease of speed over time was recommended. By analyzing split times, we assessed the pacing strategies of the top 100 finishers of the cycling part of 13 Ironman races and of the running part of 11 Ironman races taking place in 2014. Furthermore, sex-associated differences in performance and pacing strategies were calculated. We analyzed 7,687 cycling and 11,894 running split times of 1,392 triathletes (1,263 men, 129 women). Changes in speed were assessed using mixed-effects regression analyses. A continuous decrease in speed was observed during cycling in 10/13 races, and during running in 11/11 races. In 6/13 races, women decreased their speed during cycling significantly more than men. The running part showed no significant difference of changes in speed between the sexes. In summary, in the Ironman races evaluated, a positive pacing strategy was adopted in most races. Women were slower than men in 6/13 cycling races, but there was no difference between men and women in the run splits. Women used the same pacing strategy as men.

  10. Assessment of a Regional Transportation Education Alliance To Improve Mobility. (United States)

    Kuhn, Beverly T.

    This report examines issues related to transportation education, with the objective of developing and packaging transportation-related materials for use in college and university transportation education programs. The study was conducted by the Southwest Region University Transportation Center (SWUTC) region, but it is expected that the results…

  11. The pace of vocabulary growth helps predict later vocabulary skill (United States)

    Rowe, Meredith L.; Raudenbush, Stephen W.; Goldin-Meadow, Susan


    Children vary widely in the rate at which they acquire words—some start slow and speed up, others start fast and continue at a steady pace. Do early developmental variations of this sort help predict vocabulary skill just prior to kindergarten entry? This longitudinal study starts by examining important predictors (SES, parent input, child gesture) of vocabulary growth between 14 and 46 months (n=62), and then uses growth estimates to predict children's vocabulary at 54 months. Velocity and acceleration in vocabulary development at 30 months predicted later vocabulary, particularly for children from low socioeconomic backgrounds. Understanding the pace of early vocabulary growth thus improves our ability to predict school readiness, and may help identify children at risk for starting behind. PMID:22235920

  12. Synchronous intra-myocardial ventricular pacing without crossing the tricuspid valve or entering the coronary sinus

    Energy Technology Data Exchange (ETDEWEB)

    Konecny, Tomas; DeSimone, Christopher V.; Friedman, Paul A.; Bruce, Charles [Department of Medicine, Cardiovascular Diseases, Mayo Clinic, Rochester, MN (United States); Asirvatham, Samuel J., E-mail: [Department of Medicine, Cardiovascular Diseases, Mayo Clinic, Rochester, MN (United States); Department of Pediatric and Adolescent Medicine, Pediatric Cardiology, Mayo Clinic, Rochester, MN (United States)


    Ventricular pacing is most commonly performed at the right ventricular (RV) apex. This is not without risk as placement requires crossing the tricuspid valve (TV) and may cause valvular dysfunction and dyssynchronous activation of the ventricles. The fact that the tricuspid valve lies more apically than the mitral valve allows for the possibility of pacing the ventricles from the right atrium (RA) via the “atrio-ventricular septum” without crossing the TV or entering the coronary sinus (CS). In order to mitigate far field activation inherent to current pacing technology, we constructed a novel lead in which the cathode and anode are both intra-myocardial. We demonstrate safety and efficacy of this novel lead for ventricular pacing at the atrio-ventricular septum in canines, including improved synchronous activation of both ventricles, improved differentiation in ventricular versus atrial sensing, while providing reliable ventricular capture, opening novel and a potentially safer alternative to human cardiac resynchronization therapy.

  13. Improving Magnet Designs With High and Low Field Regions

    DEFF Research Database (Denmark)

    Bjørk, Rasmus; Bahl, Christian Robert Haffenden; Smith, Anders


    A general scheme for increasing the difference in magnetic flux density between a high and a low magnetic field region by removing unnecessary magnet material is presented. This is important in, e.g., magnetic refrigeration where magnet arrays have to deliver high field regions in close proximity...... to low field regions. Also, a general way to replace magnet material with a high permeability soft magnetic material where appropriate is discussed. As an example, these schemes are applied to a two dimensional concentric Halbach cylinder design resulting in a reduction of the amount of magnet material...

  14. Cardiac optogenetic pacing in drosophila melanogaster using red-shifted opsins (Conference Presentation) (United States)

    Men, Jing; Li, Airong; Jerwick, Jason; Tanzi, Rudolph E.; Zhou, Chao


    Electrical pacing is the current gold standard for investigation of mammalian cardiac electrical conduction systems as well as for treatment of certain cardiac pathologies. However, this method requires an invasive surgical procedure to implant the pacing electrodes. Recently, optogenetic pacing has been developed as an alternative, non-invasive method for heartbeat pacing in animals. It induces heartbeats by shining pulsed light on transgene-generated microbial opsins which in turn activate light gated ion channels in animal hearts. However, commonly used opsins, such as channelrhodopsin-2 (ChR2), require short light wavelength stimulation (475 nm), which is strongly absorbed and scattered by tissue. Here, we expressed recently engineered red-shifted opsins, ReaChR and CsChrimson, in the heart of a well-developed animal model, Drosophila melanogaster, for the first time. Optogenetic pacing was successfully conducted in both ReaChR and CsChrimson flies at their larval, pupal, and adult stages using 617 nm excitation light pulse, enabling a much deeper tissue penetration compared to blue stimulation light. A customized high speed and ultrahigh resolution OCM system was used to non-invasively monitor the heartbeat pacing in Drosophila. Compared to previous studies on optogenetic pacing of Drosophila, higher penetration depth of optogenetic excitation light was achieved in opaque late pupal flies. Lower stimulating power density is needed for excitation at each developmental stage of both groups, which improves the safety of this technique for heart rhythm studies.

  15. The Managed Ventricular pacing versus VVI 40 Pacing (MVP) Trial: clinical background, rationale, design, and implementation. (United States)

    Sweeney, Michael O; Ellenbogen, Kenneth A; Miller, Elaine Hogan; Sherfesee, Lou; Sheldon, Todd; Whellan, David


    Implantable cardioverter defibrillators (ICDs) reduce mortality among appropriately selected patients who have had or are at risk for life-threatening ventricular arrhythmia. Right ventricular apical (RVA) pacing has been implicated in worsening heart failure and death. The optimal pacemaker mode for bradycardia support while minimizing unnecessary and potentially harmful RVA pacing has not been determined. The Managed Ventricular pacing vs. VVI 40 Pacing Trial (MVP) is a prospective, multicenter, randomized, single-blind, parallel, controlled clinical trial designed to establish whether atrial-based dual-chamber managed ventricular pacing mode (MVP) is equivalent or superior to back-up only ventricular pacing (VVI 40) among patients with standard indications for ICD therapy and no indication for bradycardia pacing. The MVP Trial is designed with 80% power to detect a 10% reduction in the primary endpoint of new or worsening heart failure or all-cause mortality in the MVP-treated group. Approximately 1,000 patients at 80 centers in the United States, Canada, Western Europe, and Israel will be randomized to MVP or VVI 40 pacing after successful implantation of a dual-chamber ICD. Heart failure therapies will be optimized in accordance with evidence-based guidelines. Prespecified secondary endpoints will include ventricular arrhythmias, atrial fibrillation, new indication for bradycardia pacing, health-related quality of life, and cost effectiveness. Enrollment began in October 2004 and concluded in April 2006. The study will be terminated upon recommendation of the Data Monitoring Committee or when the last patient enrolled and surviving has reached a minimum 2 years of follow-up. The MVP Trial will meet the clinical need for carefully designed prospective studies to define the benefits of atrial-based dual-chamber minimal ventricular pacing versus single-chamber ventricular pacing in conventional ICD patients.


    Directory of Open Access Journals (Sweden)

    Yuliia Shapoval


    Full Text Available The research objective is the sight of theoretical aspects formulation and prediction of competitiveness of regions within the framework of modern marketing positions. The evolution, programs, strategies, and factors of marketing are analysed, which affects the attractiveness of the regions. Methodology. In the study process, a combination of the following methods is used: generalization and scientific abstraction to specify the key definitions and categories, monographic method – for presenting the opinion of scientists regarding the directions of application of marketing tools in the process of managing the competitiveness of regions, comparative analysis – to detect features of application programs and marketing strategies. Results. It is considered that regional marketing is a mechanism that provides a methodology and tools for ensuring the competitiveness of the territory. It allows determining the marketing type of territorial management, which is formed not from the wishes of the authorities (for example, in search for funds for the implementation of certain projects, but from the study of the needs of consumers (entrepreneurs, local residents, investors, tourists, which the territory has the opportunity to satisfy; analyse the market opportunities and determine the competitive advantages of the territory, as well as influence the sustainable economic growth. It is determined that the competitiveness of the region is defined as a potential opportunity to win in a competition between territories for the benefits that satisfy needs and are distributed among the population and business entities that identify themselves with the region, as well as visitors who have certain intentions in this region. In fact, we are talking about the choice of priorities, in which this territory has competitive advantages, the raise of which can lead to heightening living standards, which is an indicator of the competitiveness of the region. The practical

  17. MRI with cardiac pacing devices – Safety in clinical practice

    Energy Technology Data Exchange (ETDEWEB)

    Kaasalainen, Touko, E-mail: [HUS Medical Imaging Center, Helsinki University Central Hospital, POB 340 (Haartmaninkatu 4), 00290 Helsinki (Finland); Department of Physics, University of Helsinki (Finland); Pakarinen, Sami, E-mail: [HUS Department of Cardiology, Helsinki University Central Hospital, POB 340 (Haartmaninkatu 4), 00290 Helsinki (Finland); Kivistö, Sari, E-mail: [HUS Medical Imaging Center, Helsinki University Central Hospital, POB 340 (Haartmaninkatu 4), 00290 Helsinki (Finland); Holmström, Miia, E-mail: [HUS Medical Imaging Center, Helsinki University Central Hospital, POB 340 (Haartmaninkatu 4), 00290 Helsinki (Finland); Hänninen, Helena, E-mail: [HUS Department of Cardiology, Helsinki University Central Hospital, POB 340 (Haartmaninkatu 4), 00290 Helsinki (Finland); Peltonen, Juha, E-mail: [HUS Medical Imaging Center, Helsinki University Central Hospital, POB 340 (Haartmaninkatu 4), 00290 Helsinki (Finland); Department of Biomedical Engineering and Computational Science, School of Science, Aalto University, Helsinki (Finland); Lauerma, Kirsi, E-mail: [HUS Medical Imaging Center, Helsinki University Central Hospital, POB 340 (Haartmaninkatu 4), 00290 Helsinki (Finland); Sipilä, Outi, E-mail: [HUS Medical Imaging Center, Helsinki University Central Hospital, POB 340 (Haartmaninkatu 4), 00290 Helsinki (Finland)


    Objectives: The aim of this study was to introduce a single centre “real life” experience of performing MRI examinations in clinical practice on patients with cardiac pacemaker systems. Additionally, we aimed to evaluate the safety of using a dedicated safety protocol for these patients. Materials and methods: We used a 1.5 T MRI scanner to conduct 68 MRI scans of different body regions in patients with pacing systems. Of the cardiac devices, 32% were MR-conditional, whereas the remaining 68% were MR-unsafe. We recorded the functional parameters of the devices prior, immediately after, and approximately one month after the MRI scanning, and compared the device parameters to the baseline values. Results: All MRI examinations were completed safely, and each device could be interrogated normally following the MRI. We observed no changes in the programmed parameters of the devices. For most of the participants, the distributions of the immediate and one-month changes in the device parameters were within 20% of the baseline values, although some changes approached clinically important thresholds. Furthermore, we observed no differences in the variable changes between MR-conditional and MR-unsafe pacing systems, or between scans of the thorax area and other scanned areas. Conclusion: MRI in patients with MR-conditional pacing systems and selected MR-unsafe systems could be performed safely under strict conditions in this study.

  18. Regions Competitiveness Increase by Improving Conditions for Industry and Services

    Directory of Open Access Journals (Sweden)

    Jiraskova Eliska


    Full Text Available The main field of study regarding location theories is to define location factors and to determine the optimal location assuming rational behaviour of economic entities. The issue is to find outwhat place is suitable for localization of the economic entity in order to maximize its profits in relation to its spatial orientation. In the theoretical part, location theories for industry andservices with the impact of location factors are first briefly described. Mainly their development and significance in the competitive environment is discussed because the right selection of location factors can actually help to increase the competitiveness of regions. This paper analyses the actual soft regional and local location factors in individual economic sectors and focuses on thesecondary and tertiary sector because the primary sector is affected by other than the examined factors. The aim of this paper is to identify factors that affect industry and are more important to the service sector. Identifying these factors can actually help to attract new businesses and to increase regions competitiveness. It is, therefore, necessary to determine the key factors that have stimulating effects on the development of individual regions.

  19. Pacing in Swimming: A Systematic Review. (United States)

    McGibbon, Katie E; Pyne, D B; Shephard, M E; Thompson, K G


    Pacing strategy, or how energy is distributed during exercise, can substantially impact athletic performance and is considered crucial for optimal performance in many sports. This is particularly true in swimming given the highly resistive properties of water and low mechanical efficiency of the swimming action. The aim of this systematic review was to determine the pacing strategies utilised by competitive swimmers in competition and their reproducibility, and to examine the impact of different pacing strategies on kinematic, metabolic and performance variables. This will provide valuable and practical information to coaches and sports science practitioners. The databases Web of Science, Scopus, SPORTDiscus and PubMed were searched for published articles up to 1 August 2017. A total of 23 studies examining pool-based swimming competitions or experimental trials in English-language and peer-reviewed journals were included in this review. In short- and middle-distance swimming events maintenance of swimming velocity is critical, whereas in long-distance events a low lap-to-lap variability and the ability to produce an end spurt in the final lap(s) are key. The most effective strategy in the individual medley (IM) is to conserve energy during the butterfly leg to optimise performance in subsequent legs. The pacing profiles of senior swimmers remain relatively stable irrespective of opponents, competition stage or type, and performance time. Implementing event-specific pacing strategies should benefit the performance of competitive swimmers. Given differences between swimmers, there is a need for greater individualisation when considering pacing strategy selection across distances and strokes.

  20. Optimal Implantation Depth and Adherence to Guidelines on Permanent Pacing to Improve the Results of Transcatheter Aortic Valve Replacement With the Medtronic CoreValve System: The CoreValve Prospective, International, Post-Market ADVANCE-II Study. (United States)

    Petronio, Anna S; Sinning, Jan-Malte; Van Mieghem, Nicolas; Zucchelli, Giulio; Nickenig, Georg; Bekeredjian, Raffi; Bosmans, Johan; Bedogni, Francesco; Branny, Marian; Stangl, Karl; Kovac, Jan; Schiltgen, Molly; Kraus, Stacia; de Jaegere, Peter


    The aim of the CoreValve prospective, international, post-market ADVANCE-II study was to define the rates of conduction disturbances and permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement with the Medtronic CoreValve System (Minneapolis, Minnesota) using optimized implantation techniques and application of international guidelines on cardiac pacing. Conduction disturbances are a frequent complication of transcatheter aortic valve replacement. The rates of PPI in the published reports vary according to bioprosthesis type and the indications for PPI. The primary endpoint was the 30-day incidence of PPI with Class I/II indications when the Medtronic CoreValve System was implanted at an optimal depth (≤6 mm below the aortic annulus). The timing and resolution of all new-onset conduction disturbances were analyzed. A total of 194 patients were treated. The overall rate of PPI for Class I/II indications was 18.2%. An optimal depth was reached in 43.2% of patients, with a nonsignificantly lower incidence of PPI in patients with depths ≤6 mm, compared with those with deeper implants (13.3% vs. 21.1%; p = 0.14). In a paired analysis, new-onset left bundle branch block and first-degree atrioventricular block occurred in 45.4% and 39.0% of patients, respectively, and resolved spontaneously within 30 days in 43.2% and 73.9%, respectively. In patients with new PPI, the rate of intrinsic sinus rhythm increased from 25.9% at 7 days to 59.3% at 30 days (p = 0.004). Optimal Medtronic CoreValve System deployment and adherence to international guidelines on cardiac pacing are associated with a lower rate of new PPI after transcatheter aortic valve replacement, compared with results reported in previous studies. (CoreValve Advance-II Study: Prospective International Post-Market Study [ADVANCE II]; NCT01624870). Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  1. Improving Land Surface Temperature Retrievals over Mountainous Regions

    Directory of Open Access Journals (Sweden)

    Virgílio A. Bento


    Full Text Available Algorithms for Land Surface Temperature (LST retrieval from infrared measurements are usually sensitive to the amount of water vapor present in the atmosphere. The Satellite Application Facilities on Climate Monitoring and Land Surface Analysis (CM SAF and LSA SAF are currently compiling a 25 year LST Climate data record (CDR, which uses water vapor information from ERA-Int reanalysis. However, its relatively coarse spatial resolution may lead to systematic errors in the humidity profiles with implications in LST, particularly over mountainous areas. The present study compares LST estimated with three different retrieval algorithms: a radiative transfer-based physical mono-window (PMW, a statistical mono-window (SMW, and a generalized split-windows (GSW. The algorithms were tested over the Alpine region using ERA-Int reanalysis data and relied on the finer spatial scale Consortium for Small-Scale Modelling (COSMO model data as a reference. Two methods were developed to correct ERA-Int water vapor misestimation: (1 an exponential parametrization of total precipitable water (TPW appropriate for SMW/GSW; and (2 a level reduction method to be used in PMW. When ERA-Int TPW was used, the algorithm missed the right TPW class in 87% of the cases. When the exponential parametrization was used, the missing class rate decreased to 9%, and when the level reduction method was applied, the LST corrections went up to 1.7 K over the study region. Overall, the correction for pixel orography in TPW leads to corrections in LST estimations, which are relevant to ensure that long-term LST records meet climate requirements, particularly over mountainous regions.

  2. How do we perceive activity pacing in rheumatology care?

    DEFF Research Database (Denmark)

    Cuperus, N.; Vliet Vlieland, T.; Brodin, N.


    goals of activity pacing, behaviours of activity pacing (the actions people take to meet the goal of activity pacing), strategies to change behaviour in activity pacing (for example goal setting) and contextual factors that should be acknowledged when instructing activity pacing. Besides, topics......-management programs. However, despite its wide endorsement in clinical practice, to date activity pacing is still a poorly understood concept. Objectives: To achieve consensus by means of an international Delphi exercise on the most important aspects of activity pacing as an intervention within non...... for future research on activity pacing were formulated and prioritized. Results: Of the 60 panelists, nearly two third (63%) completed all four Delphi rounds. The panel prioritized 9 goals, 11 behaviours, 9 strategies to change behaviour and 10 contextual factors of activity pacing. These items were...

  3. Sustaining Continuous Improvement: A Longitudinal and Regional Study

    Directory of Open Access Journals (Sweden)

    Henry J. Quesada-Pineda


    companies, no changes in perception were found during the period of study for any of the factors. For the other two, however, changes were perceived in at least one of the five constructs in the study. Changes were also found across the regions included. By leveraging the quantitative analysis with qualitative data collected through interviews and visits to the case study companies, we were able to explain the changes in perception and single out the best CI management process to sustain CI in the long term.

  4. Regional hospital improves efficiency with co-generation retrofit. (United States)

    Knutson, D; Anderson, L


    Feasibility analysis of the co-generation retrofit of the Red Deer Regional Hospital pointed to a reasonable payback of capital cost and increased efficiency in operation of the facility. Budget restrictions nearly stopped the project from proceeding. Innovative construction procedures proposed by the Facility Management Group, in particular, Mr Keith Metcalfe, Director of Maintenance, allowed a worthwhile project to reach successful completion. We feel that this model can perhaps be used by similar facilities in the future to achieve their energy efficiency goals.


    Directory of Open Access Journals (Sweden)

    Bill Phillips


    Full Text Available Cardiolocomotor synchronization (CLS has been well established for individuals engaged in rhythmic activity, such as walking, running, or cycling. When frequency of the activity is at or near the heart rate, entrainment occurs. CLS has been shown in many cases to improve the efficiency of locomotor activity, improving stroke volume, reducing blood pressure variability, and lowering the oxygen uptake (VO2. Instead of a 1:1 frequency ratio of activity to heart rate, an investigation was performed to determine if different harmonic coupling at other simple integer ratios (e.g. 1:2, 2:3, 3:2 could achieve any performance benefits. CLS was ensured by pacing the stride rate according to the measured heartbeat (i.e., adaptive paced CLS, or forced CLS. An algorithm was designed that determined the simplest ratio (lowest denominator that, when multiplied by the heart rate will fall within an individualized, predetermined comfortable pacing range for the user. The algorithm was implemented on an iPhone 4, which generated a 'tick-tock' sound through the iPhone's headphones. A sham-controlled crossover study was performed with 15 volunteers of various fitness levels. Subjects ran a 3 mile (4.83 km simulated training run at their normal pace on two consecutive days (randomized one adaptive pacing, one sham. Adaptive pacing resulted in faster runs run times, with subjects running an average of 26:03 ± 3:23 for adaptive pacing and 26:38 ± 3:31 for sham (F = 5.46, p < 0.05. The increase in heart rate from the start of the race as estimated by an exponential time constant was significantly longer during adaptive pacing, τ = 0.99 ± 0.30, compared to sham, τ = 1.53 ± 0.34 (t = -6.62, p < 0.01. Eighty-seven percent of runners found it easy to adjust their stride length to match the pacing signal with seventy-nine percent reporting that pacing helped their performance. These results suggest that adaptive paced CLS may have a beneficial effect on running

  6. A regional programme to improve skin cancer management. (United States)

    McGeoch, Graham R; Sycamore, Mark J; Shand, Brett I; Simcock, Jeremy W


    In 2008, public specialist and general practice services in Canterbury were unable to manage demand for skin cancer treatment. Local clinicians decided the solution was to develop a see-and-treat skin excision clinic staffed by plastic surgeons and general practitioners (GPs), and the introduction of subsidised excisions in general practice. This paper describes the collaboration between clinicians, managers and funders and the results and quality management measures of these initiatives. There is an increasing incidence of skin cancer. GPs in Canterbury were unable to meet increasing demand for skin cancer treatment because some lacked confidence and competence in skin cancer management. There was no public funding for primary care management of skin cancer, driving patients to fully funded secondary care services. Secondary care services were at capacity, with no coordinated programme across primary and secondary care. The programme has resulted in a greater number of skin cancers being treated by the public health system, a reduction in waiting times for treatment, and fewer minor skin lesions being referred to secondary care. Quality measures have been achieved and are improving steadily. Development of the programme has improved working relationships between primary and secondary care clinicians. The strategy was to facilitate the working relationship between primary and secondary care and increase the capacity for skin lesion excisions in both sectors. Skin cancer management can be improved by a coordinated approach between primary and secondary care.

  7. Transportation Improvement Program of the Mid-Ohio Regional Planning Commission (United States)


    The MORPC Transportation Improvement program (TIP) is a staged, multi-year schedule of regionally significant transportation improvements in the Columbus area. The Federal-aid Highway Act of 1962 and the federal Urban Mass Transportation Act of 1964 ...

  8. Challenges and opportunities for improved understanding of regional climate dynamics (United States)

    Collins, Matthew; Minobe, Shoshiro; Barreiro, Marcelo; Bordoni, Simona; Kaspi, Yohai; Kuwano-Yoshida, Akira; Keenlyside, Noel; Manzini, Elisa; O'Reilly, Christopher H.; Sutton, Rowan; Xie, Shang-Ping; Zolina, Olga


    Dynamical processes in the atmosphere and ocean are central to determining the large-scale drivers of regional climate change, yet their predictive understanding is poor. Here, we identify three frontline challenges in climate dynamics where significant progress can be made to inform adaptation: response of storms, blocks and jet streams to external forcing; basin-to-basin and tropical-extratropical teleconnections; and the development of non-linear predictive theory. We highlight opportunities and techniques for making immediate progress in these areas, which critically involve the development of high-resolution coupled model simulations, partial coupling or pacemaker experiments, as well as the development and use of dynamical metrics and exploitation of hierarchies of models.

  9. The Platform-Aware Compilation Environment (PACE) (United States)


    The PACE Project provided full or partial support for the following graduate students: 1. Raj Barik (Rice) 2. Thomas Barr (Rice) 3...University, Houston, TX, Technical Report CS TR11-03, October 20, 2011. [7] Rajkishore Barik , Jisheng Zhao, and Vivek Sarkar, "Efficient Selection

  10. The pace and shape of ageing

    DEFF Research Database (Denmark)

    Baudisch, Annette


    exhibits negligible ageing - contrary to the commonly held view that long-lived species are good candidates for negligible ageing. 5.Analysis of species in pace-shape space provides a tool to identify key determinants of the evolution of ageing for species across the tree of life....

  11. Potenzielle Einflussfaktoren auf Pacing im ausdauersportlichen Wettkampf

    NARCIS (Netherlands)

    Thiel, C.; de Koning, J.J.; Foster, C.


    In competitive endurance sport, athletes permanently regulate their performance to achieve the best result without threatening organismic integrity. This conscious and subconscious allocation of energy reserves in relation to an endpoint is termed pacing and depends on sport-specific experience as

  12. Biventricular / Left Ventricular Pacing in Hypertrophic Obstructive Cardiomyopathy: An Overview

    Directory of Open Access Journals (Sweden)

    Radu Vatasescu, MD


    Full Text Available Hypertrophic cardiomyopathy (HCM is an autosomal dominant inherited genetic disease characterized by compensatory pathological left ventricle (LV hypertrophy due to sarcomere dysfunction. In an important proportion of patients with HCM, the site and extent of cardiac hypertrophy results in severe obstruction to LV outflow tract (LVOT, contributing to disabling symptoms and increasing the risk of sudden cardiac death (SCD. In patients with progressive and/or refractory symptoms despite optimal pharmacological treatment, invasive therapies that diminish or abolish LVOT obstruction relieve heart failure-related symptoms, improve quality of life and could be associated with long-term survival similar to that observed in the general population. The gold standard in this respect is surgical septal myectomy, which might be supplementary associated with a reduction in SCD. Percutaneous techniques, particularly alcohol septal ablation (ASA and more recently radiofrequency (RF septal ablation, can achieve LVOT gradient reduction and symptomatic benefit in a large proportion of HOCM patients at the cost of a supposedly limited septal myocardial necrosis and a 10-20% risk of chronic atrioventricular block. After an initial period of enthusiasm, standard DDD pacing failed to show in randomized trials significant LVOT gradient reductions and objective improvement in exercise capacity. However, case reports and recent small pilot studies suggested that atrial synchronous LV or biventricular (biV pacing significantly reduce LVOT obstruction and improve symptoms (acutely as well as long-term in a large proportion of severely symptomatic HOCM patients not suitable to other gradient reduction therapies. Moreover, biV/LV pacing in HOCM seems to be associated with significant LV reverse remodelling.

  13. A human factors experiment on the event-paced control tasks issue

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyun Chul; Park, Jae Chang; Oh, In Seok; Lee, Jung Woon; Lee, Ki Young; Park, Jong Kyun [Korea Atomic Energy Research Institute, Taejeon (Korea)


    KEPRI(Korea Electric Power Research Institute) requires human factors validation tests according to the progress of the KNGR MMI design. This report describes the experimental results of an human factors validation issue, Event-Paced Control Tasks issue. The Event-Paced Control Task issue is to test that the designed MMI shall support operators in performing control tasks in pace with the plant dynamics. Task completion time and successful execution are defined as performance measures on the issue. Through an experiment on the issue with 3 scenarios and 5 subjects, we report that the variation of task completion time between subjects has a narrow band for each scenarios, however two among the total 15 experimental runs result in the failure that subject does not reach to the predefined operational goal. Incorrect operational strategy, insufficient training, and MMI design discrepancies are inferred as the causes of the failures. However these experimental results don't indicate the close of the Event-Paced Control Tasks issue. The validation test results under the experimental environment composed of the partial MMI representations, an unstable simulator, and insufficient subject training, are significant in the limited conditions. Thus, for the purpose of the complete issue close, the validation test on the Event-Paced Control Tasks issue should be repeatedly carried out in pace with the performance improvement of the experimental environment. 13 figs., 4 tabs. (Author)

  14. Will the Conscious-Subconscious Pacing Quagmire Help Elucidate the Mechanisms of Self-Paced Exercise? New Opportunities in Dual Process Theory and Process Tracing Methods. (United States)

    Micklewright, Dominic; Kegerreis, Sue; Raglin, John; Hettinga, Florentina


    The extent to which athletic pacing decisions are made consciously or subconsciously is a prevailing issue. In this article we discuss why the one-dimensional conscious-subconscious debate that has reigned in the pacing literature has suppressed our understanding of the multidimensional processes that occur in pacing decisions. How do we make our decisions in real-life competitive situations? What information do we use and how do we respond to opponents? These are questions that need to be explored and better understood, using smartly designed experiments. The paper provides clarity about key conscious, preconscious, subconscious and unconscious concepts, terms that have previously been used in conflicting and confusing ways. The potential of dual process theory in articulating multidimensional aspects of intuitive and deliberative decision-making processes is discussed in the context of athletic pacing along with associated process-tracing research methods. In attempting to refine pacing models and improve training strategies and psychological skills for athletes, the dual-process framework could be used to gain a clearer understanding of (1) the situational conditions for which either intuitive or deliberative decisions are optimal; (2) how intuitive and deliberative decisions are biased by things such as perception, emotion and experience; and (3) the underlying cognitive mechanisms such as memory, attention allocation, problem solving and hypothetical thought.

  15. Toward a More Efficient Implementation of Antifibrillation Pacing.

    Directory of Open Access Journals (Sweden)

    Dan Wilson

    Full Text Available We devise a methodology to determine an optimal pattern of inputs to synchronize firing patterns of cardiac cells which only requires the ability to measure action potential durations in individual cells. In numerical bidomain simulations, the resulting synchronizing inputs are shown to terminate spiral waves with a higher probability than comparable inputs that do not synchronize the cells as strongly. These results suggest that designing stimuli which promote synchronization in cardiac tissue could improve the success rate of defibrillation, and point towards novel strategies for optimizing antifibrillation pacing.

  16. Toward a More Efficient Implementation of Antifibrillation Pacing (United States)

    Wilson, Dan; Moehlis, Jeff


    We devise a methodology to determine an optimal pattern of inputs to synchronize firing patterns of cardiac cells which only requires the ability to measure action potential durations in individual cells. In numerical bidomain simulations, the resulting synchronizing inputs are shown to terminate spiral waves with a higher probability than comparable inputs that do not synchronize the cells as strongly. These results suggest that designing stimuli which promote synchronization in cardiac tissue could improve the success rate of defibrillation, and point towards novel strategies for optimizing antifibrillation pacing. PMID:27391010

  17. Improved construction materials for polar regions using microcellular thermoplastic foams (United States)

    Cunningham, Daniel J.


    Microcellular polymer foams (MCF) are thermoplastic foams with very small cell diameters, less than 10 microns, and very large cell densities, 10(exp 9) to 10(exp 15) cells per cubic centimeter of unfoamed material. The concept of foaming polymers with microcellular voids was conceived to reduce the amount of material used for mass-produced items without compromising the mechanical properties. The reasoning behind this concept was that if voids smaller than the critical flaw size pre-existing in polymers were introduced into the matrix, they would not affect the overall strength of the product. MCF polycarbonate (PC), polystyrene (PS), and polyvinyl chloride (PVC) were examined to determine the effects of the microstructure towards the mechanical properties of the materials at room and arctic temperatures. Batch process parameters were discovered for these materials and foamed samples of three densities were produced for each material. To quantify the toughness and strength of these polymers, the tensile yield strength, tensile toughness, and impact resistance were measured at room and arctic temperatures. The feasibility of MCF polymers has been demonstrated by the consistent and repeatable MCF microstructures formed, but the improvements in the mechanical properties were not conclusive. Therefore the usefulness of the MCF polymers to replace other materials in arctic environments is questionable.


    Directory of Open Access Journals (Sweden)

    A. V. Russavskaya


    Full Text Available Interaction between credit and entrepreneurship organizations aimed at implementation of regional development programs should be improved according to the following main directions: better accessibility to financial resources; broader spectrum of consultancy, particularly business planning related services rendered to the business; more active cooperation with venture funds. Current regional crediting mechanisms are described for Kaluga Region as example.

  19. Pace of work stabilising, but not in all sectors

    NARCIS (Netherlands)

    Houtman, I.L.D.


    The Netherlands had the highest level of work pace in Europe but this position has levelled off in the last five years. There appears to be a general trend towards a decline in work pace. However, different sectors show varying trends, with work pace on the rise again in the education, health and

  20. On the pace of fertility decline in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    David Shapiro


    Full Text Available Background: This descriptive finding examines the comparative pace of fertility decline in sub-Saharan Africa, relative to Asia, Latin America and the Caribbean, and Northern Africa. Objective: We seek to determine if fertility decline has been slower in sub-Saharan Africa than elsewhere in the developing world. Methods: United Nations 2017 estimates of national fertility are used in assessing the comparative pace of fertility decline, and the four regions are compared in terms of how far they are into their fertility transition. Results: The data shows clearly that fertility decline in sub-Saharan Africa, still at a comparatively early stage, has been considerably slower than the earlier declines in Asia, Latin America and the Caribbean, and Northern Africa at comparable stages of the transition, and displays less within-region heterogeneity than the transitions in these other regions. Conclusions: The slower pace of fertility decline in sub-Saharan Africa, in conjunction with the high current fertility levels in the region, means that in the absence of policies seeking to accelerate fertility decline, sub-Saharan Africa will continue to experience rapid population growth that in turn will constrain its development. Contribution: Presentation of data in a novel way (Figures 2‒4, and associated calculations unambiguously demonstrates the slow pace of fertility decline in sub-Saharan Africa compared with other regions of the world.

  1. Visual aided pacing in respiratory maneuvers

    Energy Technology Data Exchange (ETDEWEB)

    Rambaudi, L R [Laboratorio de Biofisica y Fisiologia ' Antonio Sadi Frumento' (Argentina); Rossi, E [Catedra de Bioingenieria II (Argentina); Mantaras, M C [Catedra de Bioingenieria II (Argentina); Perrone, M S [Laboratorio de Biofisica y Fisiologia ' Antonio Sadi Frumento' (Argentina); Siri, L Nicola [Catedra de Bioingenieria II (Argentina)


    A visual aid to pace self-controlled respiratory cycles in humans is presented. Respiratory manoeuvres need to be accomplished in several clinic and research procedures, among others, the studies on Heart Rate Variability. Free running respiration turns to be difficult to correlate with other physiologic variables. Because of this fact, voluntary self-control is asked from the individuals under study. Currently, an acoustic metronome is used to pace respiratory frequency, its main limitation being the impossibility to induce predetermined timing in the stages within the respiratory cycle. In the present work, visual driven self-control was provided, with separate timing for the four stages of a normal respiratory cycle. This visual metronome (ViMet) was based on a microcontroller which power-ON and -OFF an eight-LED bar, in a four-stage respiratory cycle time series handset by the operator. The precise timing is also exhibited on an alphanumeric display.

  2. Visual aided pacing in respiratory maneuvers

    International Nuclear Information System (INIS)

    Rambaudi, L R; Rossi, E; Mantaras, M C; Perrone, M S; Siri, L Nicola


    A visual aid to pace self-controlled respiratory cycles in humans is presented. Respiratory manoeuvres need to be accomplished in several clinic and research procedures, among others, the studies on Heart Rate Variability. Free running respiration turns to be difficult to correlate with other physiologic variables. Because of this fact, voluntary self-control is asked from the individuals under study. Currently, an acoustic metronome is used to pace respiratory frequency, its main limitation being the impossibility to induce predetermined timing in the stages within the respiratory cycle. In the present work, visual driven self-control was provided, with separate timing for the four stages of a normal respiratory cycle. This visual metronome (ViMet) was based on a microcontroller which power-ON and -OFF an eight-LED bar, in a four-stage respiratory cycle time series handset by the operator. The precise timing is also exhibited on an alphanumeric display

  3. Leadless Pacing: Current State and Future Direction. (United States)

    Merkel, Matthias; Grotherr, Philipp; Radzewitz, Andrea; Schmitt, Claus


    Leadless pacing is now an established alternative to conventional pacing with subcutaneous pocket and transvenous lead for patients with class I or II single-chamber pacing indication. Available 12-month follow-up data shows a 48% fewer major complication rate in patients with Micra™ compared to a historical control group in a nonrandomized study [1]. There is one system with Food and Drug Administration (FDA) approval and two with the Communauté Européenne (CE) mark. The OPS code for the implantation is 8-83d.3 and the procedure has recently been rated as a "new Examination and Treatment Method (NUB)" in the German DRG system, meaning adequate reimbursement is negotiable with health insurance providers. The systems offer similar generator longevity and programming possibilities as conventional pacemaker systems, including rate response, remote monitoring, and MRI safety. The biggest downsides to date are limitations to single-chamber stimulation, lack of long-time data, and concerns of handling of the system at the end of its life span. However, implant procedure complication rates and procedure times do not exceed conventional pacemaker operations, and proper training and patient selection is provided.

  4. Temporary emergency pacing-an orphan in district hospitals

    DEFF Research Database (Denmark)

    Gjesdal, Knut; Johansen, Jens Brock; Gadler, Fredrik


    This editorial discusses a report on the 1 year experience with temporary pacing, especially in the emergency setting, in several Norwegian district hospitals. The vast majority of the patients received transvenous temporary pacing, and the majority of leads were placed by noncardiologists....... The procedure times were long and complications were frequent. The organization of emergency pacing is discussed, and we suggest that unless qualified physicians can establish transvenous pacing, the patients who need that should be transferred with transcutaneous pacing as back-up during transport...

  5. E-Business, the impact of regional growth on the improvement of Information and Communication Development (United States)

    Setiawan, MI; Hasyim, C.; Kurniasih, N.; Abdullah, D.; Napitupulu, D.; Rahim, R.; Sukoco, A.; Dhaniarti, I.; Suyono, J.; Sudapet, IN; Nasihien, RD; Wulandari, DAR; Reswanda; Mudjanarko, SW; Sugeng; Wajdi, MBN


    ICT becomes a key element to improve industrial infrastructure efficiency and sustainable economic productivity. This study aims to analysis the impact of regional improvement on information and communication development in Indonesia. This research is a correlational study. Population of this research include 151 regions in Indonesia. By using a total sampling, there were 151 sample regions. The results show there are the strong impact of regional growth on increasing Gross Regional Domestic Product (GRDP) of information and communication. It can be seen from all regional improvement sub variables that have a high correlation in increasing GRDP of Information and Communication in Indonesia. Only two sub-variables that have low correlation to GRDP of Information and Communication variable i.e. GRDP of Agriculture, Forestry and Fishing (0.01) and GRDP of Mining and Quarrying (0.04). The correlation coefficient (R) is 0.981, means the variable of information and communication GRDP has a very strong correlation with regional growth variable. Thus the value of Adjusted R Square is 95.8%, means there are impact of regional growth variables in increasing GRDPof Information and Communication, while the increase of 4.2% of Information and Communication GRDP is influenced by other factors aside from regional improvement.

  6. Pacing Strategy, Muscle Fatigue and Technique in 1500m Speed Skating and Cycling Time-Trials

    NARCIS (Netherlands)

    Stoter, Inge K; MacIntosh, Brian R; Fletcher, Jared R; Pootz, Spencer; Zijdewind, Inge; Hettinga, Florentina J


    PURPOSE: To evaluate pacing behavior and peripheral and central contributions to muscle fatigue in 1500m speed skating and cycling time-trials, when a faster or slower start is instructed. METHODS: Nine speed skaters and nine cyclists, all competing at regional or national level, performed two 1500m

  7. Report: Agency-Wide Application of Region 7 NPDES Program Process Improvements Could Increase EPA Efficiency (United States)

    Report #11-P-0315, July 6, 2011. Although Region 7 NPDES Kaizen event participants continued to follow up on the commitments and action items identified, no single authority was responsible for tracking the process improvement outcomes.

  8. The Denver region traffic signal system improvement program : planning for management and operations (United States)


    The Denver Regional Council of Governments (DRCOG) works with over 30 local jurisdictions on the Traffic Signal System Improvement Program (TSSIP), a combination of management and operations strategies designed to time and coordinate traffic signals ...

  9. Application of PACE Principles for Population Health Management of Frail Older Adults. (United States)

    Stefanacci, Richard G; Reich, Shelley; Casiano, Alex


    To determine which practices would have the most impact on reducing hospital and emergency department admissions and nursing home placement among older adults with multiple comorbid conditions, a literature search and survey were conducted to identify and prioritize comprehensive care principles as practiced in the Program of All-inclusive Care for the Elderly (PACE). PACE medical directors and members of the PACE interdisciplinary team (IDT) were surveyed to gain their insights on the most impactful practices, which were identified as: End-of-Life Management, Caregiver Support, Management of Red Flags, Medication Management, Participant and Caregiver Health Care System Literacy, and Care Coordination. In addition, this research evaluated measures that could be used to assess an organization's level of success with regard to each of the 6 PACE practices identified. The results reported in this article, found through a survey with PACE medical directors and IDT members concerning effective interventions, can be viewed as strategies to improve care for older adults, enabling them to maintain their independence in the community, avoid the expense of facility-based care, and enhance their quality of life.

  10. Percutaneous removal of a pacing electrode

    International Nuclear Information System (INIS)

    Hoehne, U.; Schild, H.; Hake, U.


    The large number of pace-makers introduced transvenously has resulted in increasing the number of complications, amongst which infections and dislocations are prominent. It is usually necessary to remove the electrode, which can be attempted percutaneously by using a Dormia basket, a loop or forceps. Amongst the complications of this procedure are tears to the myocardium, with the risk of pericardial tamponade, or tears of the tricuspid valve leading to tricuspid insufficiency. Consequently, thoracic surgical intervention should be available if necessary. Four successful procedures are described. (orig.) [de

  11. Improved local and regional control with radiotherapy for Merkel cell carcinoma of the head and neck. (United States)

    Strom, Tobin; Naghavi, Arash O; Messina, Jane L; Kim, Sungjune; Torres-Roca, Javier F; Russell, Jeffery; Sondak, Vernon K; Padhya, Tapan A; Trotti, Andy M; Caudell, Jimmy J; Harrison, Louis B


    We hypothesized that radiotherapy (RT) would improve both local and regional control with Merkel cell carcinoma of the head and neck. A single-institution institutional review board-approved study was performed including 113 patients with nonmetastatic Merkel cell carcinoma of the head and neck. Postoperative RT was delivered to the primary tumor bed (71.7% cases) ± draining lymphatics (33.3% RT cases). Postoperative local RT was associated with improved local control (3-year actuarial local control 89.4% vs 68.1%; p = .005; Cox hazard ratio [HR] 0.18; 95% confidence interval [CI] = 0.06-0.55; p = .002). Similarly, regional RT was associated with improved regional control (3-year actuarial regional control 95.0% vs 66.7%; p = .008; Cox HR = 0.09; 95% CI = 0.01-0.69; p = .02). Regional RT played an important role for both clinical node-negative patients (3-year regional control 100% vs 44.7%; p = .03) and clinical/pathological node-positive patients (3-year regional control 90.9% vs 55.6%; p = .047). Local RT was beneficial for all patients with Merkel cell carcinoma of the head and neck, whereas regional RT was beneficial for clinical node-negative and clinical/pathological node-positive patients. © 2016 Wiley Periodicals, Inc. Head Neck 39: 48-55, 2017. © 2016 Wiley Periodicals, Inc.

  12. The heart and cardiac pacing in Steinert disease. (United States)

    Nigro, Gerardo; Papa, Andrea Antonio; Politano, Luisa


    Myotonic dystrophy (Dystrophia Myotonica, DM) is the most frequently inherited neuromuscular disease of adult life. It is a multisystemic disease with major cardiac involvement. Core features of myotonic dystrophy are myotonia, muscle weakness, cataract, respiratory failure and cardiac conduction abnormalities. Classical DM, first described by Steinert and called Steinert's disease or DM1 (Dystrophia Myotonica type 1) has been identified as an autosomal dominant disorder associated with the presence of an abnormal expansion of a CTG trinucleotide repeat in the 3' untranslated region of DMPK gene on chromosome 19. This review will mainly focus on the various aspects of cardiac involvement in DM1 patients and the current role of cardiac pacing in their treatment.

  13. Pacing the US magnetic fusion program

    International Nuclear Information System (INIS)


    This study addresses the priority and pace of the nation's magnetic fusion research and development program in the context of long-term national energy policy. In particular, the committee interpreted its task as follows: To review the implications of long-term national energy policy for current research and development in magnetic fusion; to identify factors that should enter the further development of such policy to reduce risks associated with the future electricity supply system; to propose criteria applicable to research and develop in electric generation in reaching long-term energy policy goals; to apply these criteria to magnetic fusion and alternative electric generation technologies in order to develop recommendations on the priority pace of the magnetic fusion program; and to present its results in a final report. The most important goals of the US Department of Energy's current Magnetic Fusion Energy Program Plan are to demonstrate the scientific and engineering feasibility of fusion, Demonstrating engineering feasibility will require the design, construction, and operation of an engineering test reactor, which the plan envisions financing through a combination of domestic and international funding. The committee believes that current domestic program funding levels are inadequate to meet even the near-term objectives of the plan

  14. Interatrial septum pacing decreases atrial dyssynchrony on strain rate imaging compared with right atrial appendage pacing. (United States)

    Yasuoka, Yoshinori; Abe, Haruhiko; Umekawa, Seiko; Katsuki, Keiko; Tanaka, Norio; Araki, Ryo; Imanaka, Takahiro; Matsutera, Ryo; Morisawa, Daisuke; Kitada, Hirokazu; Hattori, Susumu; Noda, Yoshiki; Adachi, Hidenori; Sasaki, Tatsuya; Miyatake, Kunio


    Interatrial septum pacing (IAS-P) decreases atrial conduction delay compared with right atrial appendage pacing (RAA-P). We evaluate the atrial contraction with strain rate of tissue Doppler imaging (TDI) during sinus activation or with IAS-P or RAA-P. Fifty-two patients with permanent pacemaker for sinus node disease were enrolled in the study. Twenty-three subjects were with IAS-P and 29 with RAA-P. The time from end-diastole to peak end-diastolic strain rate was measured and corrected with RR interval on electrocardiogram. It was defined as the time from end-diastole to peak end-diastolic strain rate (TSRc), and the balance between maximum and minimum TSRc at three sites (ΔTSRc) was compared during sinus activation and with pacing rhythm in each group. There were no significant differences observed in general characteristics and standard echocardiographic parameters except the duration of pacing P wave between the two groups. The duration was significantly shorter in the IAS-P group compared with the RAA-P group (95 ± 34 vs 138 ± 41; P = 0.001). TSRc was significantly different between sinus activation and pacing rhythm (36.3 ± 35.7 vs 61.6 ± 36.3; P = 0.003) in the RAA-P group, whereas no significant differences were observed in the IAS-P group (25.4 ± 12.1 vs 27.7 ± 14.7; NS). During the follow-up (mean 2.4 ± 0.7 years), the incidence of paroxysmal atrial fibrillation (AF) conversion to permanent AF was not significantly different between the two groups. IAS-P decreased the contraction delay on atrial TDI compared to RAA-P; however, it did not contribute to the reduction of AF incidence in the present study. ©2010, The Authors. Journal compilation ©2010 Wiley Periodicals, Inc.

  15. State regulation as a tool for improving the economic security of the regions

    Directory of Open Access Journals (Sweden)

    Yu. M. Sokolinskaya


    Full Text Available Providing economic security for the development of regions, increasing their competitiveness, risk-free and sustainable activities are the main tasks of the regional program of social and economic development, which occupies a special place in the system of instruments for public management of these processes. The program of social and economic development is a unique strategy of the region aimed at security and optimization of the spatial structure and relations between the center and the regions in order to ensure economic security and growth by maximizing the effective use of existing internal and external factors. The institutional influence of the state in order to improve the economic security of regions and enterprises occurs palliatively when the business of the region is supported in direct – subsidies, and more often indirectly – compliance with the laws and regulations of the Russian Federation and the region, on the principles of institutional and market synergies. Adaptation of enterprises in the region to the market is difficult, when specific socio-organizational, economic, technical and technological, scientific, information activities in their interrelations function in the field of Russian laws. The search for ways to improve the economic security of the Russian Federation, regions and enterprises takes place in the context of global integration through the improvement of the mechanism of state regulation. An important task of the current stage of economic security of the country and regions is the construction of a system of its institutional organization that would be able to balance the levers of government with the opportunities of private enterprises, provide a quality level of providing the business with protection from terrorism, predation, financial risks, legal competition etc.

  16. Improving the Quality of the Deteriorated Regions of Multicrystalline Silicon Ingots during General Solar Cell Processes

    International Nuclear Information System (INIS)

    Wu Shan-Shan; Wang Lei; Yang De-Ren


    The behavior of wafers and solar cells from the border of a multicrystalline silicon (mc-Si) ingot, which contain deteriorated regions, is investigated. It is found that the diffusion length distribution of minority carriers in the cells is uniform, and high efficiency of the solar cells (about 16%) is achieved. It is considered that the quality of the deteriorated regions could be improved to be similar to that of adjacent regions. Moreover, it is indicated that during general solar cell fabrication, phosphorus gettering and hydrogen passivation could significantly improve the quality of deteriorated regions, while aluminum gettering by RTP could not. Therefore, it is suggested that the border of a mc-Si ingot could be used to fabricate high efficiency solar cells, which will increase mc-Si utilization effectively. (condensed matter: structure, mechanical and thermal properties)

  17. Current status of the traditional watermills of the Himalayan region and the need of technical improvements for increasing their energy efficiency

    International Nuclear Information System (INIS)

    Vashisht, A.K.


    Highlights: ► Analytical solutions for evaluating the traditional-watermill’s efficiency are derived. ► Blade surface modification from flat to circular-paraboloid increases efficiency by 7.51%. ► Water-jet angle alters the geometric dimensions of the blade due to abrasion. ► Replacement of chute with circular pipe increases the power generation by 0.366 kW. -- Abstract: Traditional watermills of the Himalayan region are centuries old water-power driven small-scale industry which is serving mountain inhabitants till date. But, day by day it is becoming tough for this eco-friendly technology to keep pace with modern technologies; hence its future is dubious now. Various organizations throughout the world are trying to rejuvenate and re-popularize this environment-friendly technology for multipurpose use. However, instead of improving its existing design, stress is being given to increase the adoptability of new-design watermill. In spite of all efforts, the new-design watermill has not shown any sharp impact on its adoptability rate. Certainly, there are issues which are not considered while implementing line of action. Before commencing the study, thorough discussions on the issues affecting the watermills’ existence in the region were made with the remotely residing watermill owners. Complete study is divided into two parts. In the first part, the issues that are deciding the fate of watermills’ existence in the region are discussed. Keeping all discussed-issues in mind, design of various components of an in-operation watermill is reviewed and modifications are proposed for increasing its efficiency. For the purpose, analytical expressions for evaluating watermill efficiency are also derived.

  18. Noninvasive imaging of three-dimensional cardiac activation sequence during pacing and ventricular tachycardia. (United States)

    Han, Chengzong; Pogwizd, Steven M; Killingsworth, Cheryl R; He, Bin


    Imaging cardiac excitation within ventricular myocardium is important in the treatment of cardiac arrhythmias and might help improve our understanding of arrhythmia mechanisms. This study sought to rigorously assess the imaging performance of a 3-dimensional (3D) cardiac electrical imaging (3DCEI) technique with the aid of 3D intracardiac mapping from up to 216 intramural sites during paced rhythm and norepinephrine (NE)-induced ventricular tachycardia (VT) in the rabbit heart. Body surface potentials and intramural bipolar electrical recordings were simultaneously measured in a closed-chest condition in 13 healthy rabbits. Single-site pacing and dual-site pacing were performed from ventricular walls and septum. VTs and premature ventricular complexes (PVCs) were induced by intravenous NE. Computed tomography images were obtained to construct geometry models. The noninvasively imaged activation sequence correlated well with invasively measured counterpart, with a correlation coefficient of 0.72 ± 0.04, and a relative error of 0.30 ± 0.02 averaged over 520 paced beats as well as 73 NE-induced PVCs and VT beats. All PVCs and VT beats initiated in the subendocardium by a nonreentrant mechanism. The averaged distance from the imaged site of initial activation to the pacing site or site of arrhythmias determined from intracardiac mapping was ∼5 mm. For dual-site pacing, the double origins were identified when they were located at contralateral sides of ventricles or at the lateral wall and the apex. 3DCEI can noninvasively delineate important features of focal or multifocal ventricular excitation. It offers the potential to aid in localizing the origins and imaging activation sequences of ventricular arrhythmias, and to provide noninvasive assessment of the underlying arrhythmia mechanisms. Copyright © 2011 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  19. Pro-region engineering for improved yeast display and secretion of brain derived neurotrophic factor. (United States)

    Burns, Michael L; Malott, Thomas M; Metcalf, Kevin J; Puguh, Arthya; Chan, Jonah R; Shusta, Eric V


    Brain derived neurotrophic factor (BDNF) is a promising therapeutic candidate for a variety of neurological diseases. However, it is difficult to produce as a recombinant protein. In its native mammalian context, BDNF is first produced as a pro-protein with subsequent proteolytic removal of the pro-region to yield mature BDNF protein. Therefore, in an attempt to improve yeast as a host for heterologous BDNF production, the BDNF pro-region was first evaluated for its effects on BDNF surface display and secretion. Addition of the wild-type pro-region to yeast BDNF production constructs improved BDNF folding both as a surface-displayed and secreted protein in terms of binding its natural receptors TrkB and p75, but titers remained low. Looking to further enhance the chaperone-like functions provided by the pro-region, two rounds of directed evolution were performed, yielding mutated pro-regions that further improved the display and secretion properties of BDNF. Subsequent optimization of the protease recognition site was used to control whether the produced protein was in pro- or mature BDNF forms. Taken together, we have demonstrated an effective strategy for improving BDNF compatibility with yeast protein engineering and secretion platforms. Copyright © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  20. Improving integrated waste management at the regional level: the case of Lombardia. (United States)

    Rigamonti, Lucia; Falbo, Alida; Grosso, Mario


    The article summarises the main results of the 'Gestione Rifiuti in Lombardia: Analisi del ciclo di vita' (Waste management in Lombardia region: Life cycle assessment; GERLA) project. Life cycle assessment (LCA) has been selected by Regione Lombardia as a strategic decision support tool in the drafting of its new waste management programme. The goal was to use the life cycle thinking approach to assess the current regional situation and thus to give useful strategic indications for the future waste management. The first phase of the study consisted of the LCA of the current management of municipal waste in the Lombardia region (reference year: 2009). The interpretation of such results has allowed the definition of four possible waste management scenarios for the year 2020, with the final goal being to improve the environmental performance of the regional system. The results showed that the current integrated waste management of Lombardia region is already characterised by good energy and environmental performances. However, there is still room for further improvement: actions based, on the one hand, on a further increase in recycling rates and, on the other hand, on a series of technological modifications, especially in food waste and residual waste management, can be undertaken to improve the overall system.

  1. Hibernia field construction pace picks up speed

    International Nuclear Information System (INIS)



    This paper reports that the pace of construction is increasing for the $5.2 billion (Canadian) Hibernia oil field development project off Newfoundland with a new partner close to signing on. Texaco, Inc. is reported ready to pick up a 25% interest in the project within a month. Construction activity for offshore systems was cut 50% last February when Gulf Canada Resources Inc. The it planned to withdraw from its 25% interest in Hibernia. Since then, remaining interest owners Mobil Oil Canada Ltd., Chevron Canada Resources Ltd., and Petro-Canada have been seeking new partners. The effort has focused on Texaco with Canadian Energy Minister Jake Epp playing a role in talks. Hibernia's construction work force has risen to 850 from a low of 600. A spokesman for Hibernia Management and Development Co., project manager, the a steady increase in the work force is planned

  2. Phrenic pacing compared with mechanical ventilation

    DEFF Research Database (Denmark)

    Andersen, Morten Packert; Laub, Michael; Biering-Sørensen, Fin


    mechanical ventilator dependent tetraplegics met the inclusion criteria. Data were retrieved from medical records and a structured follow-up interview with seven individuals from each group. RESULTS: No significant differences were found when comparing age at injury, time since injury, length...... of hospitalization, incidence of pneumonia, number of pneumonia hospitalizations, number of tracheal suctions, speech quality and activities of daily living or quality of life. On the Short Form Health Survey (SF36) mental health summary the median for both users of phrenic nerve pacing and users of mechanical...... ventilation was one s.d. above the mean of a standard population. CONCLUSIONS: Nine people have had a phrenic nerve pacer implanted. They do not significantly differ from a group of home mechanical ventilator dependent tetraplegics on a number of performance measures, but both groups seem to have better...

  3. Activation of the Prefrontal Cortex While Performing a Task at Preferred Slow Pace and Metronome Slow Pace: A Functional Near-Infrared Spectroscopy Study

    Directory of Open Access Journals (Sweden)

    Kaori Shimoda


    Full Text Available Individuals have a preferred pace at which they perform voluntary repetitive movements. Previous studies have reported that greater activation of the prefrontal cortex was observed during self-initiated movements than during externally triggered movements. The purpose of the present study is to compare the activation of the prefrontal cortex induced when the subjects performed a peg-board task at their preferred slow pace (PSP, the self-initiated condition with that induced when they performed the same task at metronome slow pace (MSP, the externally triggered condition using functional near-infrared spectroscopy. Healthy subjects performed the task while sitting in a chair. By assessing the activated channels individually, we confirmed that all of the prefrontal regions of interest were activated by both tasks. In the second-level analyses, we found that the activation detected in the frontopolar cortex (FPPFC; Brodmann area 10 was higher during the PSP task than during the MSP task. The FPPFC is known to be at the top of prefrontal hierarchy, and specifically involved in evaluating self-generated information. In addition, the FPPFC plays a role in coordinating lateral prefrontal cortex. In the present study, the subjects evaluated and managed the internally generated PSP by coordinating the activity of other lower level prefrontal regions.

  4. Activation of the prefrontal cortex while performing a task at preferred slow pace and metronome slow pace: a functional near-infrared spectroscopy study. (United States)

    Shimoda, Kaori; Moriguchi, Yoshiya; Tsuchiya, Kenji; Katsuyama, Shiori; Tozato, Fusae


    Individuals have a preferred pace at which they perform voluntary repetitive movements. Previous studies have reported that greater activation of the prefrontal cortex was observed during self-initiated movements than during externally triggered movements. The purpose of the present study is to compare the activation of the prefrontal cortex induced when the subjects performed a peg-board task at their preferred slow pace (PSP, the self-initiated condition) with that induced when they performed the same task at metronome slow pace (MSP, the externally triggered condition) using functional near-infrared spectroscopy. Healthy subjects performed the task while sitting in a chair. By assessing the activated channels individually, we confirmed that all of the prefrontal regions of interest were activated by both tasks. In the second-level analyses, we found that the activation detected in the frontopolar cortex (FPPFC; Brodmann area 10) was higher during the PSP task than during the MSP task. The FPPFC is known to be at the top of prefrontal hierarchy, and specifically involved in evaluating self-generated information. In addition, the FPPFC plays a role in coordinating lateral prefrontal cortex. In the present study, the subjects evaluated and managed the internally generated PSP by coordinating the activity of other lower level prefrontal regions.

  5. Combining super-ensembles and statistical emulation to improve a regional climate and vegetation model (United States)

    Hawkins, L. R.; Rupp, D. E.; Li, S.; Sarah, S.; McNeall, D. J.; Mote, P.; Betts, R. A.; Wallom, D.


    Changing regional patterns of surface temperature, precipitation, and humidity may cause ecosystem-scale changes in vegetation, altering the distribution of trees, shrubs, and grasses. A changing vegetation distribution, in turn, alters the albedo, latent heat flux, and carbon exchanged with the atmosphere with resulting feedbacks onto the regional climate. However, a wide range of earth-system processes that affect the carbon, energy, and hydrologic cycles occur at sub grid scales in climate models and must be parameterized. The appropriate parameter values in such parameterizations are often poorly constrained, leading to uncertainty in predictions of how the ecosystem will respond to changes in forcing. To better understand the sensitivity of regional climate to parameter selection and to improve regional climate and vegetation simulations, we used a large perturbed physics ensemble and a suite of statistical emulators. We dynamically downscaled a super-ensemble (multiple parameter sets and multiple initial conditions) of global climate simulations using a 25-km resolution regional climate model HadRM3p with the land-surface scheme MOSES2 and dynamic vegetation module TRIFFID. We simultaneously perturbed land surface parameters relating to the exchange of carbon, water, and energy between the land surface and atmosphere in a large super-ensemble of regional climate simulations over the western US. Statistical emulation was used as a computationally cost-effective tool to explore uncertainties in interactions. Regions of parameter space that did not satisfy observational constraints were eliminated and an ensemble of parameter sets that reduce regional biases and span a range of plausible interactions among earth system processes were selected. This study demonstrated that by combining super-ensemble simulations with statistical emulation, simulations of regional climate could be improved while simultaneously accounting for a range of plausible land

  6. Improving Smallholder Farmer Biosecurity in the Mekong Region Through Change Management. (United States)

    Young, J R; Evans-Kocinski, S; Bush, R D; Windsor, P A


    Transboundary animal diseases including foot-and-mouth disease and haemorrhagic septicaemia remain a major constraint for improving smallholder large ruminant productivity in the Mekong region, producing negative impacts on rural livelihoods and compromising efforts to reduce poverty and food insecurity. The traditional husbandry practices of smallholders largely exclude preventive health measures, increasing risks of disease transmission. Although significant efforts have been made to understand the social aspects of change development in agricultural production, attention to improving the adoption of biosecurity has been limited. This study reviews smallholder biosecurity risk factors identified in the peer-reviewed literature and from field research observations conducted in Cambodia and Laos during 2006-2013, considering these in the context of a change management perspective aimed at improving adoption of biosecurity measures. Motivation for change, resistance to change, knowledge management, cultural dimensions, systems theory and leadership are discussed. Due to geographical, physical and resource variability, the implementation of biosecurity interventions suitable for smallholders is not a 'one size fits all'. Smallholders should be educated in biosecurity principles and empowered to make personal decisions rather than adopt prescribed pre-defined interventions. Biosecurity interventions should be aligned with smallholder farmer motivations, preferably offering clear short-term risk management benefits that elicit interest from smallholders. Linking biosecurity and disease control with improved livestock productivity provides opportunities for sustainable improvements in livelihoods. Participatory research and extension that improves farmer knowledge and practices offers a pathway to elicit sustainable broad-scale social change. However, examples of successes need to be communicated both at the 'evidence-based level' to influence regional policy

  7. U.S. Forest Service Region 1 Lake Chemistry, NADP, and IMPROVE air quality data analysis (United States)

    Jill Grenon; Mark Story


    This report was developed to address the need for comprehensive analysis of U.S. Forest Service (USFS) Region 1 air quality monitoring data. The monitoring data includes Phase 3 (long-term data) lakes, National Atmospheric Deposition Program (NADP), and Interagency Monitoring of Protected Visual Environments (IMPROVE). Annual and seasonal data for the periods of record...

  8. Adjusting the Stems Regional Forest Growth Model to Improve Local Predictions (United States)

    W. Brad Smith


    A simple procedure using double sampling is described for adjusting growth in the STEMS regional forest growth model to compensate for subregional variations. Predictive accuracy of the STEMS model (a distance-independent, individual tree growth model for Lake States forests) was improved by using this procedure

  9. Structure with improved self-imaging in its graded-index multimode interference region

    International Nuclear Information System (INIS)

    Yin Rui; Jiang Xiaoqing; Yang Jianyi; Wang Minghua


    Propagation constant errors (PCEs) of guided modes in regions of multimode interference in optical networks were analyzed. Results show that a graded-index waveguide can effectively decrease the PCEs. An example based on an exponential function is presented. Numerical results show that addition of a graded-index waveguide greatly improves device performance in this structure

  10. PACE3 - front-end chip for the CMS Preshower

    CERN Multimedia

    Aspel, Paul


    This is PACE3 which is the front-end chip for the CMS Preshower. In fact PACE3 is the combination of two ASICs called Delta3 and PACEAM3. Delta3 is on the left and PACEAM3 is on the right. The two ASICs are bonded together and then packaged within a single 196 pin fpBGA package.

  11. Social Interaction in Self-Paced Distance Education (United States)

    Anderson, Terry; Upton, Lorne; Dron, Jon; Malone, Judi; Poelhuber, Bruno


    In this paper we present a case study of a self-paced university course that was originally designed to support independent, self-paced study at distance. We developed a social media intervention, in design-based research terms, that allows these independent students to contribute archived content to enhance the course, to engage in discussions…

  12. An improved principal component analysis based region matching method for fringe direction estimation (United States)

    He, A.; Quan, C.


    The principal component analysis (PCA) and region matching combined method is effective for fringe direction estimation. However, its mask construction algorithm for region matching fails in some circumstances, and the algorithm for conversion of orientation to direction in mask areas is computationally-heavy and non-optimized. We propose an improved PCA based region matching method for the fringe direction estimation, which includes an improved and robust mask construction scheme, and a fast and optimized orientation-direction conversion algorithm for the mask areas. Along with the estimated fringe direction map, filtered fringe pattern by automatic selective reconstruction modification and enhanced fast empirical mode decomposition (ASRm-EFEMD) is used for Hilbert spiral transform (HST) to demodulate the phase. Subsequently, windowed Fourier ridge (WFR) method is used for the refinement of the phase. The robustness and effectiveness of proposed method are demonstrated by both simulated and experimental fringe patterns.

  13. Towards PACE Atmospheric Correction, Aerosol and Cloud Products: Making Use of Expanded Spectral, Angular and Polarimetric Information. (United States)

    Remer, L. A.; Boss, E.; Ahmad, Z.; Cairns, B.; Chowdhary, J.; Coddington, O.; Davis, A. B.; Dierssen, H. M.; Diner, D. J.; Franz, B. A.; Frouin, R.; Gao, B. C.; Garay, M. J.; Heidinger, A.; Ibrahim, A.; Kalashnikova, O. V.; Knobelspiesse, K. D.; Levy, R. C.; Omar, A. H.; Meyer, K.; Platnick, S. E.; Seidel, F. C.; van Diedenhoven, B.; Werdell, J.; Xu, F.; Zhai, P.; Zhang, Z.


    NASA's Science Team for the Plankton, Aerosol, Clouds, ocean Ecosystem (PACE) mission is concluding three years of study exploring the science potential of expanded spectral, angular and polarization capability for space-based retrievals of water leaving radiance, aerosols and clouds. The work anticipates future development of retrievals to be applied to the PACE Ocean Color Instrument (OCI) and/or possibly a PACE Multi-Angle Polarimeter (MAP). In this presentation we will report on the Science Team's accomplishments associated with the atmosphere (significant efforts are also directed by the ST towards the ocean). Included in the presentation will be sensitivity studies that explore new OCI capabilities for aerosol and cloud layer height, aerosol absorption characterization, cloud property retrievals, and how we intend to move from heritage atmospheric correction algorithms to make use of and adjust to OCI's hyperspectral and UV wavelengths. We will then address how capabilities will improve with the PACE MAP, how these capabilities from both OCI and MAP correspond to specific societal benefits from the PACE mission, and what is still needed to close the gaps in our understanding before the PACE mission can realize its full potential.

  14. Advancing obstetric and neonatal care in a regional hospital in Ghana via continuous quality improvement. (United States)

    Srofenyoh, Emmanuel; Ivester, Thomas; Engmann, Cyril; Olufolabi, Adeyemi; Bookman, Laurel; Owen, Medge


    To reduce maternal and neonatal death at a large regional hospital through the use of quality improvement methodologies. In 2007, Kybele and the Ghana Health Service formed a partnership to analyze systems and patient care processes at a regional hospital in Accra, Ghana. A model encompassing continuous assessment, implementation, advocacy, outputs, and outcomes was designed. Key areas for improvement were grouped into "bundles" based on personnel, systems management, and service quality. Primary outcomes included maternal and perinatal mortality, and case fatality rates for hemorrhage and hypertensive disorders. Implementation and outcomes were evaluated tri-annually between 2007 and 2009. During the study period, there was a 34% decrease in maternal mortality despite a 36% increase in patient admission. Case fatality rates for pre-eclampsia and hemorrhage decreased from 3.1% to 1.1% (Pcontinuous quality improvement were developed and employed. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  15. Assessment and Improving Methods of Reliability Indices in Bakhtar Regional Electricity Company

    Directory of Open Access Journals (Sweden)

    Saeed Shahrezaei


    Full Text Available Reliability of a system is the ability of a system to do prospected duties in future and the probability of desirable operation for doing predetermined duties. Power system elements failures data are the main data of reliability assessment in the network. Determining antiseptic parameters is the goal of reliability assessment by using system history data. These parameters help to recognize week points of the system. In other words, the goal of reliability assessment is operation improving and decreasing of the failures and power outages. This paper is developed to assess reliability indices of Bakhtar Regional Electricity Company up to 1393 and the improving methods and their effects on the reliability indices in this network. DIgSILENT Power Factory software is employed for simulation. Simulation results show the positive effect of improving methods in reliability indices of Bakhtar Regional Electricity Company.

  16. Lessons in Commercial PACE Leadership: The Path from Legislation to Launch

    Energy Technology Data Exchange (ETDEWEB)

    Leventis, G; Schwartz, LC; Kramer, C; Deason, J


    Nonresidential buildings are responsible for over a quarter of primary energy consumption in the United States. Efficiency improvements in these buildings could result in significant energy and utility bill savings. To unlock those potential savings, a number of market barriers to energy efficiency must be addressed. Commercial Property Assessed Clean Energy (C-PACE) financing programs can help overcome several of these barriers with minimal investment from state and local governments. With programs established or under development in 22 states, and at least $521 million in investments so far, other state and local governments are interested in bringing the benefits of C-PACE to their jurisdictions. Lessons in Commercial PACE Leadership: The Path from Legislation to Launch, aims to fast track the set-up of C-PACE programs for state and local governments by capturing the lessons learned from leaders. The report examines the list of potential program design options and important decision points in setting up a C-PACE program, tradeoffs for available options, and experiences of stakeholders that have gone through (or are going through) the process. C-PACE uses a voluntary special property assessment to facilitate energy and other improvements in commercial buildings. For example: - Long financing terms under C-PACE can produce cash flow-positive -- projects to help overcome a focus on short paybacks. - Payment obligations can transfer to subsequent owners, mitigating concern about investing in improvements for a building that may be sold before the return on the investment is fully realized. - 100% of both hard and soft costs can be financed. To capture the benefits of C-PACE financing, state and local governments must navigate numerous decision points and engage with stakeholders to set-up or join a program. Researchers interviewed experts (including state and local sponsors, program administrators, capital providers and industry experts) on their lessons learned and

  17. Are global and regional improvements in life expectancy and in child, adult and senior survival slowing?

    Directory of Open Access Journals (Sweden)

    Ryan J Hum

    Full Text Available Improvements in life expectancy have been considerable over the past hundred years. Forecasters have taken to applying historical trends under an assumption of continuing improvements in life expectancy in the future. A linear mixed effects model was used to estimate the trends in global and regional rates of improvements in life expectancy, child, adult, and senior survival, in 166 countries between 1950 and 2010. Global improvements in life expectancy, including both child and adult survival rates, decelerated significantly over the study period. Overall life expectancy gains were estimated to have declined from 5.9 to 4.0 months per year for a mean deceleration of -0.07 months/year2; annual child survival gains declined from 4.4 to 1.6 deaths averted per 1000 for a mean deceleration of -0.06 deaths/1000/year2; adult survival gains were estimated to decline from 4.8 to 3.7 deaths averted per 1000 per year for a mean deceleration of -0.08 deaths/1000/year2. Senior survival gains however increased from 2.4 to 4.2 deaths averted per 1000 per year for an acceleration of 0.03 deaths/1000/year2. Regional variation in the four measures was substantial. The rates of global improvements in life expectancy, child survival, and adult survival have declined since 1950 despite an increase in the rate of improvements among seniors. We postulate that low-cost innovation, related to the last half-century progress in health-primarily devoted to children and middle age, is reaping diminishing returns on its investments. Trends are uneven across regions and measures, which may be due in part to the state of epidemiological transition between countries and regions and disparities in the diffusion of innovation, accessible only in high-income countries where life expectancy is already highest.

  18. A comparison of single-lead atrial pacing with dual-chamber pacing in sick sinus syndrome

    DEFF Research Database (Denmark)

    Nielsen, Jens Cosedis; Thomsen, Poul Erik B; Højberg, Søren


    In patients with sick sinus syndrome, bradycardia can be treated with a single-lead pacemaker or a dual-chamber pacemaker. Previous trials have revealed that pacing modes preserving atrio-ventricular synchrony are superior to single-lead ventricular pacing, but it remains unclear if there is any ...

  19. Problems and Ways of Improving the Business Climate in the Regions

    Directory of Open Access Journals (Sweden)

    Nazym Aminovna Uruzbaeva


    Full Text Available The existence of the specific conditions and development factors of small and medium-sized enterprises (SMEs in the regions of Kazakhstan supposes the differentiated state policy in order to maintain a favorable business climate. The article presents the results of the research whose purpose was to determine the main issues and directions of the improvement of the business climate in the regions. This allows to intensify the activities of local authorities in support of SMEs considering the peculiarities of the territories’ development. The subject matter of this research is the conditions and factors generating the business climate of the region. As a hypothesis, a direct connection between the prevailing regional business climate and the development of the quantitative indicators of active SMEs in the field was assumed. The study used the method of comparative analysis, sociological methods of focus groups, survey research, statistical methods and statistical methods of ranking and grouping. The article theoretically substantiates the correctness of the usage of «business climate» category as a scope of the study in the framework of the project of «Implementation of «Business Climate» as an Independent Rating», which makes possible the argumentation of the used methodology and concretization of the factors affecting the functioning of SMEs in the regions. This research has confirmed the direct correlation between the established business climate in the regions and quantitative indicators of the development of SMEs at the local level. Such factors as “financial resources” and “government support” have been determined as limiting the business development in a greater degree. In conclusion, a set of measures to improve the business climate in the region both at national and regional levels of government has been provided. In addition, it has been concluded that to generate a favorable business environment in the regions of

  20. Current State of Economic Returns from Education in China's Ethnic Regions and Explorations into Ways of Improvement (United States)

    Lijun, Zhang; Fei, Wang


    Economic development and social progress in China's ethnic minority regions depend on improvements in population attributes brought about by education. Developing education in China's ethnic regions is a project of fundamental significance for realizing sustainable economic and social development in the ethnic regions. Improving the economic…

  1. Basal metabolism in tropical birds: Latitude, altitude, and the 'pace of life'


    Londoño, GA; Chappell, MA; Castañeda, MDR; Jankowski, JE; Robinson, SK


    © 2014 The Authors. Life history varies across latitudes, with the 'pace of life' being 'slower' in tropical regions. Because life history is coupled to energy metabolism via allocation tradeoffs and links between performance capacity and energy use, low metabolic intensity is expected in tropical animals. Low metabolism has been reported for lowland tropical birds, but it is unclear if this is due to 'slow' life history or to a warm, stable environment. We measured basal metabolic rates (BMR...

  2. Improving of intellectual property marketing management in the agrarian sphere of region

    Directory of Open Access Journals (Sweden)

    Мakhnusha Svetlana Mikhailovna


    Full Text Available In the article the author proved that Ukraine’s economy needs to create more favorable conditions for the development of the agricultural sector by intensifying the development of innovation and implementation of intellectual property rights and effectively manage their marketing. It analyzes the main range of problems, which is embedded in an understanding of marketing management of intellectual property, and presents possible solutions and improvements in this background. It was formed mechanism of intellectual property marketing in the agricultural sector in the region and proposed approach to evaluating the effectiveness of measures to manage intellectual property marketing in the agricultural sector in the region.

  3. Pushing the pace of tree species migration.

    Directory of Open Access Journals (Sweden)

    Eli D Lazarus

    Full Text Available Plants and animals have responded to past climate changes by migrating with habitable environments, sometimes shifting the boundaries of their geographic ranges by tens of kilometers per year or more. Species migrating in response to present climate conditions, however, must contend with landscapes fragmented by anthropogenic disturbance. We consider this problem in the context of wind-dispersed tree species. Mechanisms of long-distance seed dispersal make these species capable of rapid migration rates. Models of species-front migration suggest that even tree species with the capacity for long-distance dispersal will be unable to keep pace with future spatial changes in temperature gradients, exclusive of habitat fragmentation effects. Here we present a numerical model that captures the salient dynamics of migration by long-distance dispersal for a generic tree species. We then use the model to explore the possible effects of assisted colonization within a fragmented landscape under a simulated tree-planting scheme. Our results suggest that an assisted-colonization program could accelerate species-front migration rates enough to match the speed of climate change, but such a program would involve an environmental-sustainability intervention at a massive scale.

  4. Parent Involvement Activities in School Improvement Plans in the Northwest Region. Summary. Issues & Answers. REL 2008-No. 064 (United States)

    Speth, Timothy; Saifer, Steffen; Forehand, Gregory


    This document presents a summary of the larger report, "Parent Involvement Activities in School Improvement Plans in the Northwest Region." Although the No Child Left Behind Act of 2001 (NCLB) spells out parent involvement requirements for schools in need of improvement, the majority of the Northwest Region school improvement plans…

  5. The pace of aging: Intrinsic time scales in demography

    Directory of Open Access Journals (Sweden)

    Tomasz Wrycza


    Full Text Available Background: The pace of aging is a concept that captures the time-related aspect of aging. It formalizesthe idea of a characteristic life span or intrinsic population time scale. In the rapidly developing field of comparative biodemography, measures that account for inter-speciesdifferences in life span are needed to compare how species age. Objective: We aim to provide a mathematical foundation for the concept of pace. We derive desiredmathematical properties of pace measures and suggest candidates which satisfy these properties. Subsequently, we introduce the concept of pace-standardization, which reveals differences in demographic quantities that are not due to pace. Examples and consequences are discussed. Conclusions: Mean life span (i.e., life expectancy from birth or from maturity is intuitively appealing,theoretically justified, and the most appropriate measure of pace. Pace-standardizationprovides a serviceable method for comparative aging studies to explore differences indemographic patterns of aging across species, and it may considerably alter conclusionsabout the strength of aging.

  6. Computer Literacy Improvement Needs: Physicians' Self Assessment in the Makkah Region

    Directory of Open Access Journals (Sweden)

    Hani Abdulsattar Shaker


    Full Text Available Objective: A confidential inquiry by the Directorate General of health affairs, Makkah region, Saudi Arabia, found physicians were resistant to enter patient-related information in the electronic medical records system at different hospitals. This study aims to highlight their computer literacy needs.Methods: This cross-sectional survey was conducted on physicians using a structured questionnaire bearing nine questions/stems with dichotomous answers, (i.e., yes/no that was distributed among physicians at six different Ministry of Health hospitals in the Makkah Region, Saudi Arabia, between May and August 2009. The results for future needs in computer skills were categorized as "none" if the rate of answer "yes" to any stem was 0-25%, "little" if 26-50%, "some" if 51-75% and "substantial" if >75% rated "yes".Results: The response rate of 82% of determined sample size (n = 451 was attained. Computer literacy improvement elements (CLIE, i.e., "word processing software skills (MS Word", "presentation software skills (Power Point", "internet search skills", "medical database search skills", "spreadsheet software skills (Excel" and "advanced e-mail management skills" were in "substantial" need of improvement among the majority of settings and categories. All other computer literacy improvement elements were in "some" need of improvement.Conclusion: The overall outcome of this study indicates that physicians need further computer literacy improvements.

  7. Pacing: a concept analysis of the chronic pain intervention. (United States)

    Jamieson-Lega, Kathryn; Berry, Robyn; Brown, Cary A


    The intervention of pacing is regularly recommended for chronic pain patients. However, pacing is poorly defined and appears to be interpreted in varying, potentially contradictory manners within the field of chronic pain. This conceptual lack of clarity has implications for effective service delivery and for researchers' ability to conduct rigorous study. An examination of the background literature demonstrates that while pacing is often one part of a multidisciplinary pain management program, outcome research is hindered by a lack of a clear and shared definition of this currently ill-defined construct. To conduct a formal concept analysis of the term 'pacing'. A standardized concept analysis process (including literature scoping to identify all uses of the concept, analysis to determine defining attributes of the concept and identification of model, borderline and contrary cases) was used to determine what the concept of pacing does and does not represent within the current evidence base. A conceptual model including the core attributes of action, time, balance, learning and self-management emerged. From these attributes, an evidence-based definition for pacing was composed and distributed to stakeholders for review. After consideration of stakeholder feedback, the emergent definition of pacing was finalized as follows: "Pacing is an active self-management strategy whereby individuals learn to balance time spent on activity and rest for the purpose of achieving increased function and participation in meaningful activities". The findings of the present concept analysis will help to standardize the use and definition of the term pacing across disciplines for the purposes of both pain management and research.

  8. Improvement of Global and Regional Mean Sea Level Trends Derived from all Altimetry Missions. (United States)

    Ablain, Michael; Benveniste, Jérôme; Faugere, Yannice; Larnicol, Gilles; Cazenave, Anny; Johannessen, Johnny A.; Stammer, Detlef; Timms, Gary


    The global mean sea level (GMSL) has been calculated on a continual basis since January 1993 using data from satellite altimetry missions. The global mean sea level (MSL) deduced from TOPEX/Poseidon, Jason-1 and Jason-2 is increasing with a global trend of 3.2 mm from 1993 to 2010 applying the post glacial rebound (MSL Aviso website Besides, the regional sea level trends bring out an inhomogeneous repartition of the ocean elevation with local MSL slopes ranging from +/- 8 mm/year. A study published in 2009 [Ablain et al., 2009] has shown that the global MSL trend uncertainty was estimated at +/-0.6 mm/year with a confidence interval of 90%. The main sources of errors at global and regional scales are due to the orbit calculation and the wet troposphere correction. But others sea-level components have also a significant impact on the long-term stability of MSL as for instance the stability of instrumental parameters and the atmospheric corrections. Thanks to recent studies performed in Sea Level Essential Climate Variable Project in the frame of the Climate Change Initiative, an ESA Programme, in addition to activities performed within the SALP/CNES, strong improvements have been provided for the estimation of the global and regional MSL trends. In this paper, we propose to describe them; they concern the orbit calculation thanks to new gravity fields, the atmospheric corrections thanks to ERA-interim reanalyses, the wet troposphere corrections thanks to the stability improvement, and also empirical corrections allowing us to link regional time series together better. These improvements are described at global and regional scale for all the altimetry missions.

  9. Pittsburgh Regional Healthcare Initiative puts new spin on improving healthcare quality. (United States)


    For nearly 4 years, the Pittsburgh Regional Healthcare Initiative (PRHI) has been working to improve the way healthcare is delivered in southwestern Pennsylvania by combining the voices and resources of hospitals, providers, the business community, insurers, health plans, and federal agencies. As one example of borrowing from business, the PRHI has created a new learning and management system, called Perfecting Patient Care, which is based on the Toyota Production System model and is now being used successfully in hospitals.

  10. Improving Regional Forecast by Assimilating Atmospheric InfraRed Sounder (AIRS) Profiles into WRF Model (United States)

    Chou, Shih-Hung; Zavodsky, Brad; Jedlovec, Gary J.


    In data sparse regions, remotely-sensed observations can be used to improve analyses and produce improved forecasts. One such source comes from the Atmospheric InfraRed Sounder (AIRS), which together with the Advanced Microwave Sounding Unit (AMSU), represents one of the most advanced space-based atmospheric sounding systems. The purpose of this paper is to describe a procedure to optimally assimilate high resolution AIRS profile data into a regional configuration of the Advanced Research WRF (ARW) version 2.2 using WRF-Var. The paper focuses on development of background error covariances for the regional domain and background type, and an optimal methodology for ingesting AIRS temperature and moisture profiles as separate overland and overwater retrievals with different error characteristics. The AIRS thermodynamic profiles are derived from the version 5.0 Earth Observing System (EOS) science team retrieval algorithm and contain information about the quality of each temperature layer. The quality indicators were used to select the highest quality temperature and moisture data for each profile location and pressure level. The analyses were then used to conduct a month-long series of regional forecasts over the continental U.S. The long-term impacts of AIRS profiles on forecast were assessed against verifying NAM analyses and stage IV precipitation data.


    Directory of Open Access Journals (Sweden)

    Ceausescu Aurelian Ionut


    Full Text Available This axis priority is to increase the main purpose of accessibility regions, the population mobility, goods and services to stimulate sustainable economic. Investment in transport infrastructure to facilitate mobility of people and goods, reducing the costs of transport of goods and passengers, improving access to the regional markets, increase the efficiency of economic activities, energy saving and time, creating conditions for expanding trade and implicitly productive investment. Developing transport networks will facilitate the cooperation interregional and will contribute significantly to increase competitiveness of enterprises/firms and the labour mobility, and, therefore, a development faster to Romania on the whole, but also of each region. The development of urban transport network will take into account the existing structure of public transportation to ensure where possible, improve the infrastructure of roads, which will contribute to use in a more efficient way of public transportation. Rehabilitation and upgrading urban streets, and construction, rehabilitation and upgrading of roads to his belt (the status of county Road will contribute to urban improve traffic, cut on the time of transport, road and face elimination in their localities crossing safely.

  12. Impact of pacing on systemic ventricular function in L-transposition of the great arteries. (United States)

    Hofferberth, Sophie C; Alexander, Mark E; Mah, Douglas Y; Bautista-Hernandez, Victor; del Nido, Pedro J; Fynn-Thompson, Francis


    To assess the impact of univentricular versus biventricular pacing (BiVP) on systemic ventricular function in patients with congenitally corrected transposition of the great arteries (ccTGA). We performed a retrospective review of all patients with a diagnosis of ccTGA who underwent pacemaker insertion. From 1993 to 2014, 53 patients were identified from the cardiology database and surgical records. Overall mortality was 7.5% (n = 4). One patient required transplantation and 3 late deaths occurred secondary to end-stage heart failure. Median follow-up was 3.7 years (range, 4 days to 22.5 years). Twenty-five (47%) underwent univentricular pacing only, of these, 8 (32%) developed significant systemic ventricular dysfunction. Twenty-eight (53%) received BiVP, 17 (26%) were upgraded from a dual-chamber system, 11 (21%) received primary BiVP. Fourteen (82%) of the 17 undergoing secondary BiVP demonstrated systemic ventricular dysfunction at the time of pacer upgrade, with 7 (50%) demonstrating improved systemic ventricular function after pacemaker upgrade. Overall, 42 (79%) patients underwent univentricular pacing, with 22 (52%) developing significant systemic ventricular dysfunction. In contrast, the 11 (21%) who received primary BiVP had preserved systemic ventricular function at latest follow-up. Late-onset systemic ventricular dysfunction is a major complication associated with the use of univentricular pacing in patients with ccTGA. All patients with ccTGA who develop heart block should undergo primary biventricular pacing, as this prevents late systemic ventricular dysfunction. Preemptive placement of BiVP leads at the time of anatomical repair or other permanent palliative procedure will facilitate subsequent BiVP should heart block develop. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  13. Directions of improvement for public administration institutional structure in field of ecology at regional level

    Directory of Open Access Journals (Sweden)

    O. I. Matyushenko


    methodological support and implementation of environmental policy in the region, sector logistics activities of the Department. Therefore such offered structure will improve the management relations between the national and regional levels of management. It is compared  the organizational structure of the Ministry of Ecology and Natural Resources and the Department of Ecology and Natural Resources of  Regional State Administration in order to compare management vertical. It has been developed the typical staff list for the Department of Ecology and Natural Resources of Regional State Administration.

  14. Antitachycardia pacing programming in implantable cardioverter defibrillator: A systematic review. (United States)

    De Maria, Elia; Giacopelli, Daniele; Borghi, Ambra; Modonesi, Letizia; Cappelli, Stefano


    Implantable cardioverter defibrillator (ICD) programming involves several parameters. In recent years antitachycardia pacing (ATP) has gained an increasing importance in the treatment of ventricular arrhythmias, whether slow or fast. It reduces the number of unnecessary and inappropriate shocks and improves both patient's quality of life and device longevity. There is no clear indication regarding the type of ATP to be used, except for the treatment of fast ventricular tachycardias (188 bpm-250 bpm) where it has been shown a greater efficacy and safety of burst compared to ramp; 8 impulses in each sequence of ATP appears to be the best programming option in this setting. Beyond ATP use, excellent clinical results were obtained with programming standardization following these principles: extended detection time in ventricular fibrillation (VF) zone; supraventricular discrimination criteria up to 200 bpm; first shock in VF zone at the maximum energy in order to reduce the risk of multiple shocks. The MADIT-RIT trial and some observational registries have also recently demonstrated that programming with a widespread use of ATP, higher cut-off rates or delayed intervention reduces the number of inappropriate and unnecessary therapies and improves the survival of patients during mid-term follow-up.

  15. Fast Paced, Low Cost Projects at MSFC (United States)

    Watson-Morgan, Lisa; Clinton, Raymond


    What does an orbiting microsatellite, a robotic lander and a ruggedized camera and telescope have in common? They are all fast paced, low cost projects managed by Marshall Space Flight Center (MSFC) teamed with successful industry partners. MSFC has long been synonymous with human space flight large propulsion programs, engineering acumen and risk intolerance. However, there is a growing portfolio/product line within MSFC that focuses on these smaller, fast paced projects. While launching anything into space is expensive, using a managed risk posture, holding to schedule and keeping costs low by stopping at egood enough f were key elements to their success. Risk is defined as the possibility of loss or failure per Merriam Webster. The National Aeronautics and Space Administration (NASA) defines risk using procedural requirement 8705.4 and establishes eclasses f to discern the acceptable risk per a project. It states a Class D risk has a medium to significant risk of not achieving mission success. MSFC, along with industry partners, has created a niche in Class D efforts. How did the big, cautious MSFC succeed on these projects that embodied the antithesis of its heritage in human space flight? A key factor toward these successful projects was innovative industry partners such as Dynetics Corporation, University of Alabama in Huntsville (UAHuntsville), Johns Hopkins Applied Physics Laboratory (JHU APL), Teledyne Brown Engineering (TBE), Von Braun Center for Science and Innovation (VCSI), SAIC, and Jacobs. Fast Affordable Satellite Technology (FastSat HSV01) is a low earth orbit microsatellite that houses six instruments with the primary scientific objective of earth observation and technology demonstration. The team was comprised of Dynetics, UAHuntsvile, SAIC, Goddard Space Flight Center (GSFC) and VCSI with the United States Air Force Space Test Program as the customer. The team completed design, development, manufacturing, environmental test and integration in

  16. Using an International Clinical Registry of Regional Anesthesia to Identify Targets for Quality Improvement (United States)

    Sites, Brian D.; Barrington, Michael J.; Davis, Matthew


    Background Despite the widespread use of regional anesthesia, limited information on clinical performance exists. Institutions, therefore, have little knowledge of how they are performing in regards to both safety and effectiveness. In this study, we demonstrate how a medical institution (or physician/physician group) may use data from a multi-center clinical registry of regional anesthesia to inform quality improvement strategies. Methods We analyzed data from the International Registry of Regional Anesthesia that includes prospective data on peripheral regional anesthesia procedures from 19 centers located around the world. Using data from the clinical registry, we present summary statistics of the overall safety and effectiveness of regional anesthesia. Furthermore, we demonstrate, using a variety of performance measures, how these data can be used by hospitals to identify areas for quality improvement. To do so, we compare the performance of one member institution (a United States medical center in New Hampshire) to that of the other 18 member institutions of the clinical registry. Results The clinical registry contained information on 23,271 blocks that were performed between June 1, 2011, and May 1, 2014, on 16,725 patients. The overall success rate was 96.7%, immediate complication rate was 2.2%, and the all-cause 60-day rate of neurological sequelae was 8.3 (95% CI, 7.2–9.7) per 10,000. Registry wide major hospital events included 7 wrong site blocks, 3 seizures, 1 complete heart block, 1 retroperitoneal hematoma, and 3 pneumothoraces. For our reference medical center, we identified areas meriting quality improvement. Specifically, after accounting for differences in the age, sex, and health status of patient populations, the reference medical center appeared to rely more heavily on opioids for post procedure management, had higher patient pain scores, and experienced delayed discharge when compared with other member institutions. Conclusions To our

  17. Improving the Regional Applicability of Satellite Precipitation Products by Ensemble Algorithm

    Directory of Open Access Journals (Sweden)

    Waseem Muhammad


    Full Text Available Satellite-based precipitation products (e.g., Integrated Multi-Satellite Retrievals for Global Precipitation Measurement (IMERG and its predecessor, Tropical Rainfall Measuring Mission (TRMM are a critical source of precipitation estimation, particularly for a region with less, or no, hydrometric networking. However, the inconsistency in the performance of these products has been observed in different climatic and topographic diverse regions, timescales, and precipitation intensities and there is still room for improvement. Hence, using a projected ensemble algorithm, the regional precipitation estimate (RP is introduced here. The RP concept is mainly based on the regional performance weights derived from the Mean Square Error (MSE and the precipitation estimate from the TRMM product, that is, TRMM 3B42 (TR, real-time (late (IT and the research (post-real-time (IR products of IMERG. The overall results of the selected contingency table (e.g., Probability of detection (POD and statistical indices (e.g., Correlation Coefficient (CC signposted that the proposed RP product has shown an overall better potential to capture the gauge observations compared with the TR, IR, and IT in five different climatic regions of Pakistan from January 2015 to December 2016, at a diurnal time scale. The current study could be the first research providing preliminary feedback from Pakistan for global precipitation measurement researchers by highlighting the need for refinement in the IMERG.

  18. A novel convective-scale regional reanalysis COSMO-REA2: Improving the representation of precipitation

    Directory of Open Access Journals (Sweden)

    Sabrina Wahl


    Full Text Available Atmospheric reanalyses are a state-of-the-art tool to generate consistent and realistic state estimates of the atmospheric system. They provide a synthesis of various heterogeneous observational systems and model simulations using a physical model together with a data assimilation scheme. Current reanalyses are mainly global, while regional reanalyses are emerging for North America, the polar region, and most recently for Europe. However, deep convection is still parameterized even in the regional reanalyses. A novel convective-scale regional reanalysis system for Central Europe (COSMO-REA2 has been developed by the Hans-Ertel Center for Weather Research – Climate Monitoring Branch. The system is based on the COSMO model and uses observational nudging for regional data assimilation. In addition to conventional observations, radar-derived rain rates are assimilated using latent heat nudging. With a horizontal grid-spacing of 2 km, the model runs without parameterization of deep moist convection. COSMO-REA2 produces horizontal wind fields that represent a realistic energy spectrum for horizontal scales above 14 km. COSMO-REA2 is currently available for seven years from 2007 to 2013.This study illustrates the improved representation of local precipitation over Germany by the convective-scale reanalysis COSMO-REA2 compared to coarser gridded European and global reanalyses. A systematic verification using rain gauge data reveals the added value of high-resolution regional atmospheric reanalyses on different time scales. On monthly to annual time scales, regional reanalyses yield better estimates of the spatial variability of precipitation patterns which can not be provided by coarser gridded global models. On hourly to daily time scales, the convective-scale reanalysis substantially improves the representation of local precipitation in two ways. On the one hand, COSMO-REA2 shows an enhanced representation of observed frequencies of local

  19. Improving nitrogen management via a regional management plan for Chinese rice production (United States)

    Wu, Liang; Chen, Xinping; Cui, Zhenling; Wang, Guiliang; Zhang, Weifeng


    A lack of basic information on optimal nitrogen (N) management often results in over- or under-application of N fertilizer in small-scale intensive rice farming. Here, we present a new database of N input from a survey of 6611 small-scale rice farmers and rice yield in response to added N in 1177 experimental on-farm tests across eight agroecological subregions of China. This database enables us to evaluate N management by farmers and develop an optimal approach to regional N management. We also investigated grain yield, N application rate, and estimated greenhouse gas (GHG) emissions in comparison to N application and farming practices. Across all farmers, the average N application rate, weighted by the area of rice production in each subregion, was 210 kg ha-1 and ranged from 30 to 744 kg ha-1 across fields and from 131 to 316 kg ha-1 across regions. The regionally optimal N rate (RONR) determined from the experiments averaged 167 kg ha-1 and varied from 114 to 224 kg N ha-1 for the different regions. If these RONR were widely adopted in China, approximately 56% of farms would reduce their use of N fertilizer, and approximately 33% would increase their use of N fertilizer. As a result, grain yield would increase by 7.4% from 7.14 to 7.67 Mg ha-1, and the estimated GHG emissions would be reduced by 11.1% from 1390 to 1236 kg carbon dioxide (CO2) eq Mg-1 grain. These results suggest that to achieve the goals of improvement in regional yield and sustainable environmental development, regional N use should be optimized among N-poor and N-rich farms and regions in China.

  20. Improving nitrogen management via a regional management plan for Chinese rice production

    International Nuclear Information System (INIS)

    Wu, Liang; Chen, Xinping; Cui, Zhenling; Wang, Guiliang; Zhang, Weifeng


    A lack of basic information on optimal nitrogen (N) management often results in over- or under-application of N fertilizer in small-scale intensive rice farming. Here, we present a new database of N input from a survey of 6611 small-scale rice farmers and rice yield in response to added N in 1177 experimental on-farm tests across eight agroecological subregions of China. This database enables us to evaluate N management by farmers and develop an optimal approach to regional N management. We also investigated grain yield, N application rate, and estimated greenhouse gas (GHG) emissions in comparison to N application and farming practices. Across all farmers, the average N application rate, weighted by the area of rice production in each subregion, was 210 kg ha −1 and ranged from 30 to 744 kg ha −1 across fields and from 131 to 316 kg ha −1 across regions. The regionally optimal N rate (RONR) determined from the experiments averaged 167 kg ha −1 and varied from 114 to 224 kg N ha −1 for the different regions. If these RONR were widely adopted in China, approximately 56% of farms would reduce their use of N fertilizer, and approximately 33% would increase their use of N fertilizer. As a result, grain yield would increase by 7.4% from 7.14 to 7.67 Mg ha −1 , and the estimated GHG emissions would be reduced by 11.1% from 1390 to 1236 kg carbon dioxide (CO 2 ) eq Mg −1 grain. These results suggest that to achieve the goals of improvement in regional yield and sustainable environmental development, regional N use should be optimized among N-poor and N-rich farms and regions in China. (letter)

  1. Improvement of the sensitivity of CdTe detectors in the high energy regions

    Energy Technology Data Exchange (ETDEWEB)

    Nishizawa, Hiroshi; Ikegami, Kazunori; Takashima, Kazuo; Usami, Teruo [Mitsubishi Electric Corp., Tokyo (Japan); Yamamoto, Takayoshi


    In order to improve the efficiency of the full energy peak in the high energy regions, we had previously suggested a multi-layered structure of CdTe elements and have since confirmed the sensitivity improvement of the full energy peak. And furthermore, we have suggested a new type structure of multi-layered elements in this paper and we confirmed that the efficiency of the full energy peak became higher and that more proper energy spectra were obtained by our current experiment than by the detector with the conventional structure. This paper describes a simulation and experiment to improve the efficiency of the full energy peak and to obtain the more proper energy spectra of {sup 137}Cs (662keV) and {sup 60}Co (1.17 and 1.33MeV) using the new structure of CdTe detector. (J.P.N.)

  2. The impact of SLMTA in improving laboratory quality systems in the Caribbean Region. (United States)

    Guevara, Giselle; Gordon, Floris; Irving, Yvette; Whyms, Ismae; Parris, Keith; Beckles, Songee; Maruta, Talkmore; Ndlovu, Nqobile; Albalak, Rachel; Alemnji, George

    Past efforts to improve laboratory quality systems and to achieve accreditation for better patient care in the Caribbean Region have been slow. To describe the impact of the Strengthening of Laboratory Management Toward Accreditation (SLMTA) training programme and mentorship amongst five clinical laboratories in the Caribbean after 18 months. Five national reference laboratories from four countries participated in the SLMTA programme that incorporated classroom teaching and implementation of improvement projects. Mentors were assigned to the laboratories to guide trainees on their improvement projects and to assist in the development of Quality Management Systems (QMS). Audits were conducted at baseline, six months, exit (at 12 months) and post-SLMTA (at 18 months) using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist to measure changes in implementation of the QMS during the period. At the end of each audit, a comprehensive implementation plan was developed in order to address gaps. Baseline audit scores ranged from 19% to 52%, corresponding to 0 stars on the SLIPTA five-star scale. After 18 months, one laboratory reached four stars, two reached three stars and two reached two stars. There was a corresponding decrease in nonconformities and development of over 100 management and technical standard operating procedures in each of the five laboratories. The tremendous improvement in these five Caribbean laboratories shows that SLMTA coupled with mentorship is an effective, user-friendly, flexible and customisable approach to the implementation of laboratory QMS. It is recommended that other laboratories in the region consider using the SLMTA training programme as they engage in quality systems improvement and preparation for accreditation.

  3. A positron emission tomography study of self-paced finger movements at different frequencies

    International Nuclear Information System (INIS)

    Kawashima, R.; Inoue, K.; Sugiura, M.; Okada, K.; Ogawa, A.; Fukuda, H.


    Regional cerebral blood flow was measured in six right-handed volunteers using positron emission tomography during tasks involving repetitive self-paced finger tapping at five different frequencies. The contralateral primary sensorimotor cortex, the pre-supplementary motor area and the cingulate motor area showed significant activation during self-paced finger tapping tasks, compared with the resting state. A positive correlation between the regional cerebral blood flow and the movement frequency was found only in the primary sensorimotor cortex. In the pre-supplementary motor area and the cingulate motor area, however, activity increased when the subject employed movement frequencies faster or slower than his own pace. The same tendency was noted with respect to the relative variability of the inter-tapping interval.The results therefore indicate that the activity of the pre-supplementary motor area and the cingulate motor area may well be related to the increased difficulty in motor control rather than to the execution of the movement itself. (Copyright (c) 1999 Elsevier Science B.V., Amsterdam. All rights reserved.)

  4. Implications of regional improvement in global climate models for agricultural impact research

    International Nuclear Information System (INIS)

    Ramirez-Villegas, Julian; Thornton, Philip K; Jarvis, Andy; Challinor, Andrew J


    Global climate models (GCMs) have become increasingly important for climate change science and provide the basis for most impact studies. Since impact models are highly sensitive to input climate data, GCM skill is crucial for getting better short-, medium- and long-term outlooks for agricultural production and food security. The Coupled Model Intercomparison Project (CMIP) phase 5 ensemble is likely to underpin the majority of climate impact assessments over the next few years. We assess 24 CMIP3 and 26 CMIP5 simulations of present climate against climate observations for five tropical regions, as well as regional improvements in model skill and, through literature review, the sensitivities of impact estimates to model error. Climatological means of seasonal mean temperatures depict mean errors between 1 and 18 ° C (2–130% with respect to mean), whereas seasonal precipitation and wet-day frequency depict larger errors, often offsetting observed means and variability beyond 100%. Simulated interannual climate variability in GCMs warrants particular attention, given that no single GCM matches observations in more than 30% of the areas for monthly precipitation and wet-day frequency, 50% for diurnal range and 70% for mean temperatures. We report improvements in mean climate skill of 5–15% for climatological mean temperatures, 3–5% for diurnal range and 1–2% in precipitation. At these improvement rates, we estimate that at least 5–30 years of CMIP work is required to improve regional temperature simulations and at least 30–50 years for precipitation simulations, for these to be directly input into impact models. We conclude with some recommendations for the use of CMIP5 in agricultural impact studies. (letter)

  5. The Efficacy of Self-Paced Study in Multitrial Learning (United States)

    de Jonge, Mario; Tabbers, Huib K.; Pecher, Diane; Jang, Yoonhee; Zeelenberg, René


    In 2 experiments we investigated the efficacy of self-paced study in multitrial learning. In Experiment 1, native speakers of English studied lists of Dutch-English word pairs under 1 of 4 imposed fixed presentation rate conditions (24 × 1 s, 12 × 2 s, 6 × 4 s, or 3 × 8 s) and a self-paced study condition. Total study time per list was equated for…

  6. Factors explaining voluntary participation in PACE-Vaquita


    Sara Avila


    Vaquita marina, a small species of porpoise endemic to the Northern Gulf of California in Mexico, is the world’s most endangered cetacean species. With the purpose of preserving vaquita, the Mexican government launched PACE-Vaquita in 2008. This voluntary program offers an innovative schedule of compensations: as in a payment for conservation program, PACE-Vaquita compensates for temporary reductions in fishing reductions in fishing effort; as in a program to accelerate technology adoption,PA...

  7. Pacing in swimming - variability and effects of manipulations


    Skorski, Sabrina


    Introduction: In any athletic event, the ability to appropriately distribute energy, is essential to prevent premature fatigue prior to the completion of the event. In sport science literature this is termed ‘pacing’. Within the past decade, research aiming to better understand the underlying mechanisms influencing the selection of an athlete’s pacing during exercise has dramatically increased. It is suggested that pacing is a combination of anticipation, knowledge of the end-point, prior exp...

  8. Improvement of global and regional mean sea level derived from satellite altimetry multi missions (United States)

    Ablain, M.; Faugere, Y.; Larnicol, G.; Picot, N.; Cazenave, A.; Benveniste, J.


    With the satellite altimetry missions, the global mean sea level (GMSL) has been calculated on a continual basis since January 1993. 'Verification' phases, during which the satellites follow each other in close succession (Topex/Poseidon--Jason-1, then Jason-1--Jason-2), help to link up these different missions by precisely determining any bias between them. Envisat, ERS-1 and ERS-2 are also used, after being adjusted on these reference missions, in order to compute Mean Sea Level at high latitudes (higher than 66°N and S), and also to improve spatial resolution by combining all these missions together. The global mean sea level (MSL) deduced from TOPEX/Poseidon, Jason-1 and Jason-2 provide a global rate of 3.2 mm from 1993 to 2010 applying the post glacial rebound (MSL aviso website Besides, the regional sea level trends bring out an inhomogeneous repartition of the ocean elevation with local MSL slopes ranging from + 8 mm/yr to - 8 mm/year. A study published in 2009 [Ablain et al., 2009] has shown that the global MSL trend unceratainty was estimated at +/-0.6 mm/year with a confidence interval of 90%. The main sources of errors at global and regional scales are due to the orbit calculation and the wet troposphere correction. But others sea-level components have also a significant impact on the long-term stability of MSL as for instance the stability of instrumental parameters and the atmospheric corrections. Thanks to recent studies performed in the frame of the SALP project (supported by CNES) and Sea-level Climate Change Initiative project (supported by ESA), strong improvements have been provided for the estimation of the global and regional MSL trends. In this paper, we propose to describe them; they concern the orbit calculation thanks to new gravity fields, the atmospheric corrections thanks to ERA-interim reanalyses, the wet troposphere corrections thanks to the stability improvement, and also empirical corrections

  9. Echocardiographic estimation of acute haemodynamic response during optimization of multisite pace-maker using different pacing modalities and atrioventricular delays

    Directory of Open Access Journals (Sweden)

    Šalinger-Martinović Sonja


    Full Text Available Background/Aim. Cardiac resynchronization therapy (CRT improves ventricular dyssynchrony and is associated with an improvement in symptoms, quality of life and prognosis in patients with severe heart failure and intraventricular conduction delay. Different pacing modalities produce variable activation patterns and may be a cause of different haemodynamic changes. The aim of our study was to investigate acute haemodynamic changes with different CRT configurations during optimization procedure. Methods. This study included 30 patients with severe left ventricular systolic dysfunction and left bundle branch block with wide QRS (EF 24.33 ± 3.7%, QRS 159 ± 17.3 ms, New York Heart Association III/IV 25/5 with implanted CRT device. The whole group of patients had severe mitral regurgitation in order to measure dP/dt. After implantation and before discharge all the patients underwent optimization procedure guided by Doppler echocardiography. Left and right ventricular pre-ejection intervals (LVPEI and RVPEI, interventricular mechanical delay (IVD and the maximal rate of ventricular pressure rise during early systole (max dP/dt were measured during left and biventricular pacing with three different atrioventricular (AV delays. Results. After CRT device optimization, optimal AV delay and CRT mode were defined. Left ventricular pre-ejection intervals changed from 170.5 ± 24.6 to 145.9 ± 9.5 (p < 0.001, RVPEI from 102.4 ± 15.9 to 119.8 ± 10.9 (p < 0.001, IVD from 68.1 ± 18.3 to 26.5 ± 8.2 (p < 0.001 and dP/dt from 524.2 ± 67 to 678.2 ± 88.5 (p < 0.01. Conclusion. In patients receiving CRT echocardiographic assessment of the acute haemodynamic response to CRT is a useful tool in optimization procedure. The variability of Doppler parameters with different CRT modalities emphasizes the necessity of individualized approach in optimization procedure.

  10. Quantifying 10 years of improved earthquake-monitoring performance in the Caribbean region (United States)

    McNamara, Daniel E.; Hillebrandt-Andrade, Christa; Saurel, Jean-Marie; Huerfano-Moreno, V.; Lynch, Lloyd


    Over 75 tsunamis have been documented in the Caribbean and adjacent regions during the past 500 years. Since 1500, at least 4484 people are reported to have perished in these killer waves. Hundreds of thousands are currently threatened along the Caribbean coastlines. Were a great tsunamigenic earthquake to occur in the Caribbean region today, the effects would potentially be catastrophic due to an increasingly vulnerable region that has seen significant population increases in the past 40–50 years and currently hosts an estimated 500,000 daily beach visitors from North America and Europe, a majority of whom are not likely aware of tsunami and earthquake hazards. Following the magnitude 9.1 Sumatra–Andaman Islands earthquake of 26 December 2004, the United Nations Educational, Scientific and Cultural Organization (UNESCO) Intergovernmental Coordination Group (ICG) for the Tsunami and other Coastal Hazards Early Warning System for the Caribbean and Adjacent Regions (CARIBE‐EWS) was established and developed minimum performance standards for the detection and analysis of earthquakes. In this study, we model earthquake‐magnitude detection threshold and P‐wave detection time and demonstrate that the requirements established by the UNESCO ICG CARIBE‐EWS are met with 100% of the network operating. We demonstrate that earthquake‐monitoring performance in the Caribbean Sea region has improved significantly in the past decade as the number of real‐time seismic stations available to the National Oceanic and Atmospheric Administration tsunami warning centers have increased. We also identify weaknesses in the current international network and provide guidance for selecting the optimal distribution of seismic stations contributed from existing real‐time broadband national networks in the region.

  11. PACE and the Federal Housing Finance Agency (FHFA)

    Energy Technology Data Exchange (ETDEWEB)

    Zimring, Mark; Fuller, Merrian


    The FHFA regulates Fannie Mae, Freddie Mac, and the 12 Federal Home Loan Banks (the government-sponsored enterprises - GSEs). On June 18, 2009, James B. Lockhart III, then Director of FHFA, released a letter expressing concern about the negative impact of energy loan tax assessment programs (ELTAPs) - also known as Property Assessed Clean Energy (PACE) programs - on both the housing finance system and homeowner program participants. Subsequently, a number of PACE proponents responded to the concerns laid out in the FHFA letter. In early Fall 2009, word circulated that FHFA was planning to follow its June letter with guidance to other agencies, possibly including Fannie Mae and Freddie Mac, discouraging them from buying loans on properties subject to PACE-type assessment liens. This triggered a second round of stakeholder letters, several of which were addressed to President Obama. On October 18, 2009, the White House, in what some believe was an attempt to obviate the need for FHFA guidance, released a Policy Framework for PACE Financing Programs that outlined best practices guidance for homeowner and lender protection. As of February 2010, FHFA and the GSEs have agreed to monitor PACE programs and work with stakeholders and the Administration to consider additional guidance beyond the Policy Framework and to collect more information on PACE program efficacy and risks. A summary of the communications timeline and highlights of the communications are provided.

  12. Improvement of downscaled rainfall and temperature across generations over the Western Himalayan region of India (United States)

    Das, L.; Dutta, M.; Akhter, J.; Meher, J. K.


    It is a challenging task to create station level (local scale) climate change information over the mountainous locations of Western Himalayan Region (WHR) in India because of limited data availability and poor data quality. In the present study, missing values of station data were handled through Multiple Imputation Chained Equation (MICE) technique. Finally 22 numbers of rain gauge and 16 number of temperature station data having continuous record during 1901­2005 and 1969­2009 period respectively were considered as reference stations for developing downscaled rainfall and temperature time series from five commonly available GCMs in the IPCC's different generation assessment reports namely 2nd, 3rd, 4th and 5th hereafter known as SAR, TAR, AR4 and AR5 respectively. Downscaled models were developed using the combined data from the ERA-interim reanalysis and GCMs historical runs (in spite of forcing were not identical in different generation) as predictor and station level rainfall and temperature as predictands. Station level downscaled rainfall and temperature time series were constructed for five GCMs available in each generation. Regional averaged downscaled time series comprising of all stations was prepared for each model and generation and the downscaled results were compared with observed time series. Finally an Overall Model Improvement Index (OMII) was developed using the downscaling results, which was used to investigate the model improvement across generations as well as the improvement of downscaling results obtained from the Empirical Statistical Downscaling (ESD) methods. In case of temperature, models have improved from SAR to AR5 over the study area. In all most all the GCMs TAR is showing worst performance over the WHR by considering the different statistical indices used in this study. In case of precipitation, no model has shown gradual improvement from SAR to AR5 both for interpolated and downscaled values.

  13. Global and Regional 3D Tomography for Improved Seismic Event Location and Uncertainty in Explosion Monitoring (United States)

    Downey, N.; Begnaud, M. L.; Hipp, J. R.; Ballard, S.; Young, C. S.; Encarnacao, A. V.


    The SALSA3D global 3D velocity model of the Earth was developed to improve the accuracy and precision of seismic travel time predictions for a wide suite of regional and teleseismic phases. Recently, the global SALSA3D model was updated to include additional body wave phases including mantle phases, core phases, reflections off the core-mantle boundary and underside reflections off the surface of the Earth. We show that this update improves travel time predictions and leads directly to significant improvements in the accuracy and precision of seismic event locations as compared to locations computed using standard 1D velocity models like ak135, or 2½D models like RSTT. A key feature of our inversions is that path-specific model uncertainty of travel time predictions are calculated using the full 3D model covariance matrix computed during tomography, which results in more realistic uncertainty ellipses that directly reflect tomographic data coverage. Application of this method can also be done at a regional scale: we present a velocity model with uncertainty obtained using data obtained from the University of Utah Seismograph Stations. These results show a reduction in travel-time residuals for re-located events compared with those obtained using previously published models.

  14. The impact of SLMTA in improving laboratory quality systems in the Caribbean Region

    Directory of Open Access Journals (Sweden)

    Giselle Guevara


    Objective: To describe the impact of the Strengthening of Laboratory Management Toward Accreditation (SLMTA training programme and mentorship amongst five clinical laboratories in the Caribbean after 18 months. Method: Five national reference laboratories from four countries participated in the SLMTA programme that incorporated classroom teaching and implementation of improvement projects. Mentors were assigned to the laboratories to guide trainees on their improvement projects and to assist in the development of Quality Management Systems (QMS. Audits were conducted at baseline, six months, exit (at 12 months and post-SLMTA (at 18 months using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA checklist to measure changes in implementation of the QMS during the period. At the end of each audit, a comprehensive implementation plan was developed in order to address gaps. Results: Baseline audit scores ranged from 19% to 52%, corresponding to 0 stars on the SLIPTA five-star scale. After 18 months, one laboratory reached four stars, two reached three stars and two reached two stars. There was a corresponding decrease in nonconformities and development of over 100 management and technical standard operating procedures in each of the five laboratories. Conclusion: The tremendous improvement in these five Caribbean laboratories shows that SLMTA coupled with mentorship is an effective, user-friendly, flexible and customisable approach to the implementation of laboratory QMS. It is recommended that other laboratories in the region consider using the SLMTA training programme as they engage in quality systems improvement and preparation for accreditation.

  15. Improving physical health international students enrolled in a technical college in Baikal region

    Directory of Open Access Journals (Sweden)

    M.M. Kolokoltsev


    Full Text Available Purpose : to improve the physical health of foreign students enrolled in a technical college Baikal region using an extended motor mode. Material : in the experiment participated 57 students attending the training of South-East Asia, 74 - from Central Asia and 455 - Slavs, natives of the Irkutsk region. Results : it was found poor fitness and low functional performance among foreign students. For this purpose they had used advanced motoring. It included, besides training curriculum additional group activities in the form of sports, participating in sports events and guided independent study physical education. Conclusion : the end of follow foreign students involved in the extended motor mode, significantly outperform their peers engaged on normal functional parameters (heart rate, a test with 20 squats, the recovery time after exercise, dynamometry hands, breath tests, adaptive capacity as well as motor qualities.

  16. Improving satellite-based post-fire evapotranspiration estimates in semi-arid regions (United States)

    Poon, P.; Kinoshita, A. M.


    Climate change and anthropogenic factors contribute to the increased frequency, duration, and size of wildfires, which can alter ecosystem and hydrological processes. The loss of vegetation canopy and ground cover reduces interception and alters evapotranspiration (ET) dynamics in riparian areas, which can impact rainfall-runoff partitioning. Previous research evaluated the spatial and temporal trends of ET based on burn severity and observed an annual decrease of 120 mm on average for three years after fire. Building upon these results, this research focuses on the Coyote Fire in San Diego, California (USA), which burned a total of 76 km2 in 2003 to calibrate and improve satellite-based ET estimates in semi-arid regions affected by wildfire. The current work utilizes satellite-based products and techniques such as the Google Earth Engine Application programming interface (API). Various ET models (ie. Operational Simplified Surface Energy Balance Model (SSEBop)) are compared to the latent heat flux from two AmeriFlux eddy covariance towers, Sky Oaks Young (US-SO3), and Old Stand (US-SO2), from 2000 - 2015. The Old Stand tower has a low burn severity and the Young Stand tower has a moderate to high burn severity. Both towers are used to validate spatial ET estimates. Furthermore, variables and indices, such as Enhanced Vegetation Index (EVI), Normalized Difference Moisture Index (NDMI), and the Normalized Burn Ratio (NBR) are utilized to evaluate satellite-based ET through a multivariate statistical analysis at both sites. This point-scale study will able to improve ET estimates in spatially diverse regions. Results from this research will contribute to the development of a post-wildfire ET model for semi-arid regions. Accurate estimates of post-fire ET will provide a better representation of vegetation and hydrologic recovery, which can be used to improve hydrologic models and predictions.

  17. Towards Development of a 3-State Self-Paced Brain-Computer Interface

    Directory of Open Access Journals (Sweden)

    Ali Bashashati


    the presence of a right- or a left-hand movement and the second classifies the detected movement as a right or a left one. In an offline analysis of the EEG data collected from four able-bodied individuals, the 3-state brain-computer interface shows a comparable performance with a 2-state system and significant performance improvement if used as a 2-state BCI, that is, in detecting the presence of a right- or a left-hand movement (regardless of the type of movement. It has an average true positive rate of 37.5% and 42.8% (at false positives rate of 1% in detecting right- and left-hand extensions, respectively, in the context of a 3-state self-paced BCI and average detection rate of 58.1% (at false positive rate of 1% in the context of a 2-state self-paced BCI.

  18. Effects of self-paced interval and continuous training on health markers in women

    DEFF Research Database (Denmark)

    Connolly, Luke J; Bailey, Stephen J; Krustrup, Peter


    PURPOSE: To compare the effects of self-paced high-intensity interval and continuous cycle training on health markers in premenopausal women. METHODS: Forty-five inactive females were randomised to a high-intensity interval training (HIIT; n = 15), continuous training (CT; n = 15) or an inactive...... control (CON; n = 15) group. HIIT performed 5 × 5 min sets comprising repetitions of 30-s low-, 20-s moderate- and 10-s high-intensity cycling with 2 min rest between sets. CT completed 50 min of continuous cycling. Training was completed self-paced, 3 times weekly for 12 weeks. RESULTS: Peak oxygen...... uptake (16 ± 8 and 21 ± 12%), resting heart rate (HR) (-5 ± 9 and -4 ± 7 bpm) and visual and verbal learning improved following HIIT and CT compared to CON (P HIIT (P 

  19. Spontaneous Velocity Effect of Musical Expression on Self-Paced Walking (United States)

    Buhmann, Jeska; Desmet, Frank; Moens, Bart; Van Dyck, Edith; Leman, Marc


    The expressive features of music can influence the velocity of walking. So far, studies used instructed (and intended) synchronization. But is this velocity effect still present with non-instructed (spontaneous) synchronization? To figure that out, participants were instructed to walk in their own comfort tempo on an indoor track, first in silence and then with tempo-matched music. We compared velocities of silence and music conditions. The results show that some music has an activating influence, increasing velocity and motivation, while other music has a relaxing influence, decreasing velocity and motivation. The influence of musical expression on the velocity of self-paced walking can be predicted with a regression model using only three sonic features explaining 56% of the variance. Phase-coherence between footfall and beat did not contribute to the velocity effect, due to its implied fixed pacing. The findings suggest that the velocity effect depends on vigor entrainment that influences both stride length and pacing. Our findings are relevant for preventing injuries, for gait improvement in walking rehabilitation, and for improving performance in sports activities. PMID:27167064

  20. Spontaneous Velocity Effect of Musical Expression on Self-Paced Walking.

    Directory of Open Access Journals (Sweden)

    Jeska Buhmann

    Full Text Available The expressive features of music can influence the velocity of walking. So far, studies used instructed (and intended synchronization. But is this velocity effect still present with non-instructed (spontaneous synchronization? To figure that out, participants were instructed to walk in their own comfort tempo on an indoor track, first in silence and then with tempo-matched music. We compared velocities of silence and music conditions. The results show that some music has an activating influence, increasing velocity and motivation, while other music has a relaxing influence, decreasing velocity and motivation. The influence of musical expression on the velocity of self-paced walking can be predicted with a regression model using only three sonic features explaining 56% of the variance. Phase-coherence between footfall and beat did not contribute to the velocity effect, due to its implied fixed pacing. The findings suggest that the velocity effect depends on vigor entrainment that influences both stride length and pacing. Our findings are relevant for preventing injuries, for gait improvement in walking rehabilitation, and for improving performance in sports activities.

  1. Spontaneous Velocity Effect of Musical Expression on Self-Paced Walking. (United States)

    Buhmann, Jeska; Desmet, Frank; Moens, Bart; Van Dyck, Edith; Leman, Marc


    The expressive features of music can influence the velocity of walking. So far, studies used instructed (and intended) synchronization. But is this velocity effect still present with non-instructed (spontaneous) synchronization? To figure that out, participants were instructed to walk in their own comfort tempo on an indoor track, first in silence and then with tempo-matched music. We compared velocities of silence and music conditions. The results show that some music has an activating influence, increasing velocity and motivation, while other music has a relaxing influence, decreasing velocity and motivation. The influence of musical expression on the velocity of self-paced walking can be predicted with a regression model using only three sonic features explaining 56% of the variance. Phase-coherence between footfall and beat did not contribute to the velocity effect, due to its implied fixed pacing. The findings suggest that the velocity effect depends on vigor entrainment that influences both stride length and pacing. Our findings are relevant for preventing injuries, for gait improvement in walking rehabilitation, and for improving performance in sports activities.

  2. Improvement of dose distributions in abutment regions of intensity modulated radiation therapy and electron fields

    International Nuclear Information System (INIS)

    Dogan, Nesrin; Leybovich, Leonid B.; Sethi, Anil; Emami, Bahman


    In recent years, intensity modulated radiation therapy (IMRT) is used to radiate tumors that are in close proximity to vital organs. Targets consisting of a deep-seated region followed by a superficial one may be treated with abutting photon and electron fields. However, no systematic study regarding matching of IMRT and electron beams was reported. In this work, a study of dose distributions in the abutment region between tomographic and step-and-shoot IMRT and electron fields was carried out. A method that significantly improves dose homogeneity between abutting tomographic IMRT and electron fields was developed and tested. In this method, a target region that is covered by IMRT was extended into the superficial target area by ∼2.0 cm. The length and shape of IMRT target extension was chosen such that high isodose lines bent away from the region treated by the electrons. This reduced the magnitude of hot spots caused by the 'bulging effect' of electron field penumbra. To account for the uncertainties in positioning of the IMRT and electron fields, electron field penumbra was modified using conventional (photon) multileaf collimator (MLC). The electron beam was delivered in two steps: half of the dose delivered with MLCs in retracted position and another half with MLCs extended to the edge of electron field that abuts tomographic IMRT field. The experimental testing of this method using film dosimetry has demonstrated that the magnitude of the hot spots was reduced from ∼45% to ∼5% of the prescription dose. When an error of ±1.5 mm in field positioning was introduced, the dose inhomogeneity in the abutment region did not exceed ±15% of the prescription dose. With step-and-shoot IMRT, the most homogeneous dose distribution was achieved when there was a 3 mm gap between the IMRT and electron fields

  3. Improving aerosol interaction with clouds and precipitation in a regional chemical weather modeling system (United States)

    Zhou, C.; Zhang, X.; Gong, S.; Wang, Y.; Xue, M.


    A comprehensive aerosol-cloud-precipitation interaction (ACI) scheme has been developed under a China Meteorological Administration (CMA) chemical weather modeling system, GRAPES/CUACE (Global/Regional Assimilation and PrEdiction System, CMA Unified Atmospheric Chemistry Environment). Calculated by a sectional aerosol activation scheme based on the information of size and mass from CUACE and the thermal-dynamic and humid states from the weather model GRAPES at each time step, the cloud condensation nuclei (CCN) are interactively fed online into a two-moment cloud scheme (WRF Double-Moment 6-class scheme - WDM6) and a convective parameterization to drive cloud physics and precipitation formation processes. The modeling system has been applied to study the ACI for January 2013 when several persistent haze-fog events and eight precipitation events occurred.The results show that aerosols that interact with the WDM6 in GRAPES/CUACE obviously increase the total cloud water, liquid water content, and cloud droplet number concentrations, while decreasing the mean diameters of cloud droplets with varying magnitudes of the changes in each case and region. These interactive microphysical properties of clouds improve the calculation of their collection growth rates in some regions and hence the precipitation rate and distributions in the model, showing 24 to 48 % enhancements of threat score for 6 h precipitation in almost all regions. The aerosols that interact with the WDM6 also reduce the regional mean bias of temperature by 3 °C during certain precipitation events, but the monthly means bias is only reduced by about 0.3 °C.

  4. Improving aerosol interaction with clouds and precipitation in a regional chemical weather modeling system

    Directory of Open Access Journals (Sweden)

    C. Zhou


    Full Text Available A comprehensive aerosol–cloud–precipitation interaction (ACI scheme has been developed under a China Meteorological Administration (CMA chemical weather modeling system, GRAPES/CUACE (Global/Regional Assimilation and PrEdiction System, CMA Unified Atmospheric Chemistry Environment. Calculated by a sectional aerosol activation scheme based on the information of size and mass from CUACE and the thermal-dynamic and humid states from the weather model GRAPES at each time step, the cloud condensation nuclei (CCN are interactively fed online into a two-moment cloud scheme (WRF Double-Moment 6-class scheme – WDM6 and a convective parameterization to drive cloud physics and precipitation formation processes. The modeling system has been applied to study the ACI for January 2013 when several persistent haze-fog events and eight precipitation events occurred.The results show that aerosols that interact with the WDM6 in GRAPES/CUACE obviously increase the total cloud water, liquid water content, and cloud droplet number concentrations, while decreasing the mean diameters of cloud droplets with varying magnitudes of the changes in each case and region. These interactive microphysical properties of clouds improve the calculation of their collection growth rates in some regions and hence the precipitation rate and distributions in the model, showing 24 to 48 % enhancements of threat score for 6 h precipitation in almost all regions. The aerosols that interact with the WDM6 also reduce the regional mean bias of temperature by 3 °C during certain precipitation events, but the monthly means bias is only reduced by about 0.3 °C.

  5. Iraqi primary care system in Kurdistan region: providers' perspectives on problems and opportunities for improvement. (United States)

    Shabila, Nazar P; Al-Tawil, Namir G; Al-Hadithi, Tariq S; Sondorp, Egbert; Vaughan, Kelsey


    As part of a comprehensive study on the primary health care system in Iraq, we sought to explore primary care providers' perspectives about the main problems influencing the provision of primary care services and opportunities to improve the system. A qualitative study based on four focus groups involving 40 primary care providers from 12 primary health care centres was conducted in Erbil governorate in the Iraqi Kurdistan region between July and October 2010. A topic guide was used to lead discussions and covered questions on positive aspects of and current problems with the primary care system in addition to the priority needs for its improvement. The discussions were fully transcribed and the qualitative data was analyzed by content analysis, followed by a thematic analysis. Problems facing the primary care system included inappropriate health service delivery (irrational use of health services, irrational treatment, poor referral system, poor infrastructure and poor hygiene), health workforce challenges (high number of specialists, uneven distribution of the health workforce, rapid turnover, lack of training and educational opportunities and discrepancies in the salary system), shortage in resources (shortage and low quality of medical supplies and shortage in financing), poor information technology and poor leadership/governance. The greatest emphasis was placed on poor organization of health services delivery, particularly the irrational use of health services and the related overcrowding and overload on primary care providers and health facilities. Suggestions for improving the system included application of a family medicine approach and ensuring effective planning and monitoring. This study has provided a comprehensive understanding of the factors that negatively affect the primary care system in Iraq's Kurdistan region from the perspective of primary care providers. From their experience, primary care providers have a role in informing the community and

  6. Personal hand gel for improved hand hygiene compliance on the regional anesthesia team. (United States)

    Parks, Colby L; Schroeder, Kristopher M; Galgon, Richard E


    Hand hygiene reduces healthcare-associated infections, and several recent publications have examined hand hygiene in the perioperative period. Our institution's policy is to perform hand hygiene before and after patient contact. However, observation suggests poor compliance. This is a retrospective review of a quality improvement database showing the effect of personal gel dispensers on perioperative hand hygiene compliance on a regional anesthesia team. Healthcare providers assigned to the Acute Pain Service were observed for compliance with hand hygiene policy during a quality improvement initiative. Provider type and compliance were prospectively recorded in a database. Team members were then given a personal gel dispensing device and again observed for compliance. We have retrospectively reviewed this database to determine the effects of this intervention. Of the 307 encounters observed, 146 were prior to implementing personal gel dispensers. Compliance was 34%. Pre- and post-patient contact compliances were 23 and 43%, respectively. For 161 encounters after individual gel dispensers were provided, compliance was 63%. Pre- and post-patient contact compliances were 53 and 72%, respectively. Improvement in overall compliance from 34 to 63% was significant. On the Acute Pain Service, compliance with hand hygiene policy improves when individual sanitation gel dispensing devices are worn on the person.

  7. 42 CFR 460.90 - PACE benefits under Medicare and Medicaid. (United States)


    ... 42 Public Health 4 2010-10-01 2010-10-01 false PACE benefits under Medicare and Medicaid. 460.90 Section 460.90 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... FOR THE ELDERLY (PACE) PACE Services § 460.90 PACE benefits under Medicare and Medicaid. If a Medicare...

  8. New Local, National and Regional Cereal Price Indices for Improved Identification of Food Insecurity (United States)

    Brown, Molly E.; Tondel, Fabien; Thorne, Jennifer A.; Essam, Timothy; Mann, Bristol F.; Stabler, Blake; Eilerts, Gary


    Large price increases over a short time period can be indicative of a deteriorating food security situation. Food price indices developed by the United Nations Food and Agriculture Organization (FAO) are used to monitor food price trends at a global level, but largely reflect supply and demand conditions in export markets. However, reporting by the United States Agency for International Development (USAID)'s Famine Early Warning Systems Network (FEWS NET) indicates that staple cereal prices in many markets of the developing world, especially in surplus-producing areas, often have a delayed and variable response to international export market price trends. Here we present new price indices compiled for improved food security monitoring and assessment, and specifically for monitoring conditions of food access across diverse food insecure regions. We found that cereal price indices constructed using market prices within a food insecure region showed significant differences from the international cereals price, and had a variable price dispersion across markets within each marketshed. Using satellite-derived remote sensing information that estimates local production and the FAO Cereals Index as predictors, we were able to forecast movements of the local or national price indices in the remote, arid and semi-arid countries of the 38 countries examined. This work supports the need for improved decision-making about targeted aid and humanitarian relief, by providing earlier early warning of food security crises.

  9. Preliminary Magnitude of Completeness Quantification of Improved BMKG Catalog (2008-2016) in Indonesian Region (United States)

    Diantari, H. C.; Suryanto, W.; Anggraini, A.; Irnaka, T. M.; Susilanto, P.; Ngadmanto, D.


    We present a magnitude of completeness (Mc) quantification based on BMKG improved earthquake catalog which generated from Ina-TEWS seismograph network. The Mc quantification can help us determine the lowest magnitude which can be recorded perfectly as a function of space and time. We use the BMKG improved earthquake catalog from 2008 to 2016 which has been converted to moment magnitude (Mw) and declustered. The value of Mc is computed by determining the initial point of deviation patterns in Frequency Magnitude Distribution (FMD) chart following the Gutenberg-Richter equations. In the next step, we calculate the temporal variation of Mc and b-value using maximum likelihood method annually. We found that the Mc value is decreasing and produced a varying b-value. It indicates that the development of seismograph network from 2008 to 2016 can affect the value of Mc although it is not significant. We analyze temporal variation of Mc value, and correlate it with the spatial distribution of seismograph in Indonesia. The spatial distribution of seismograph installation shows that the western part of Indonesia has more dense seismograph compared to the eastern region. However, the eastern part of Indonesia has a high level of seismicity compared to the western region. Based upon the results, additional seismograph installation in the eastern part of Indonesia should be taken into consideration.


    Directory of Open Access Journals (Sweden)

    D. M. Plotnikov


    Full Text Available Acute disorders of cerebral circulation remain serious medical and social problem associated with high disability and mortality rates. Since 2011 Tomsk oblast is a participating member of the medical campaign aimed at improved medical services to the vascular patients. The preliminary implementation data analysis for 2012 revealed improvement of most of the indices of medical support to patients suffering from acute cerebral circulation; increased number of the in-patient cases (Regional Vascular Center and primary vascular department, decreased lethality rates from strokes, specifically hemorrhagic cases. Strict observance of the Regulations on Medical Assistance for stroke patients and the using of modern methods of therapy allowed to decrease hospital mortality in the Primary Vascular Departments and early mortality in the Regional Vascular Center. The active implementation of neurorehabilitation approaches resulted in the increased number of patients who do not require third parties’ assistance. Analysis of the work of the departments helped to identifying current problems and perspectives of further development of special medical care for stroke patients.

  11. Louisiana Speaks Regional Plan Vision New or Improved Roadways, UTM Zone 15N NAD 83, Louisiana Recovery Authority (2007), [louisiana_speaks_vision_roadway_improvements (United States)

    Louisiana Geographic Information Center — This GIS shapefile data illustrates new or improved roadways included in the Louisiana Speaks Regional Plan Vision. This network accommodates a land use pattern that...

  12. Genetic improvement of Nellore cattle in the semi-arid region of northeastern Brazil

    Directory of Open Access Journals (Sweden)

    Ana Carla Borges Barbosa


    Full Text Available The semi-arid region of Brazil represents approximately 57% of the northeastern territory. The main economic activity in this region is agriculture and livestock, in most cases, using traditional technologies. However, there is little published information currently available on cattle-raising in this part of Brazil. The objective of this study was to estimate genetic parameters and trends for productive and reproductive traits of Nellore cattle raised in semi-arid region of northeastern Brazil. Data were collected on weight-adjusted at 205 (W205, 365 (W365 and 550 (W550 days of life, age at first calving (AFC, calving interval (CI and scrotal circumference (SC at 550 days of life of cattle born between 1965 and 2011. Estimates of covariance and variance were obtained through univariate analysis using a Gibbs sampler. The estimated coefficients of heritability (mode were 0.27 (W205, 0.36 (W365 and 0.39 (W550, 0.37 (SC, 0.22 (AFC and 0.03 (CI. Little or no gain from selection is apparent in the genetic trend analysis over the 45 years of the study. However, environmental improvement has allowed phenotypic progress in growth traits and age at first age calving.

  13. An improved permanent magnet quadrupole design with larger good field region for high intensity proton linacs

    Energy Technology Data Exchange (ETDEWEB)

    Mathew, Jose V., E-mail:; Rao, S.V.L.S.; Krishnagopal, S.; Singh, P.


    The Low Energy High Intensity Proton Accelerator (LEHIPA), being developed at the Bhabha Atomic Research Centre (BARC) will produce a 20 MeV, 30 mA, continuous wave (CW) proton beam. At these low velocities, space-charge forces dominate, and could lead to larger beam sizes and beam halos. Hence in the design of the focusing lattice of the LEHIPA drift tube linac (DTL) using permanent magnet quadrupoles (PMQs), a larger good field region is preferred. Here we study, using the two dimensional (2D) and three dimensional (3D) simulation codes PANDIRA and RADIA, four different types of cylindrical PMQ designs: 16-segment trapezoidal Halbach configuration, bullet-nosed geometry and 8- and 16-segment rectangular geometries. The trapezoidal Halbach geometry is used in a variety of accelerators since it provides very high field gradients in small bores, while the bullet-nosed geometry, which is a combination of the trapezoidal and rectangular designs, is used in some DTLs. This study shows that a larger good field region is possible in the 16-segment rectangular design as compared to the Halbach and bullet-nosed designs, making it more attractive for high-intensity proton linacs. An improvement in good-field region by ∼16% over the Halbach design is obtained in the optimized 16-segment rectangular design, although the field gradient is lower by ∼20%. Tolerance studies show that the rectangular segment PMQ design is substantially less sensitive to the easy axis orientation errors and hence will be a better choice for DTLs. -- Highlights: • An improved permanent magnet quadrupole (PMQ) design with larger good field region is proposed. • We investigate four PMQ designs, including the widely used Halbach and bullet nosed designs. • Analytical calculations are backed by 2D as well as 3D numerical solvers, PANDIRA and RADIA. • The optimized 16 segment rectangular PMQ design is identified to exhibit the largest good field region. • The effect of easy axis orientation

  14. An improved permanent magnet quadrupole design with larger good field region for high intensity proton linacs

    International Nuclear Information System (INIS)

    Mathew, Jose V.; Rao, S.V.L.S.; Krishnagopal, S.; Singh, P.


    The Low Energy High Intensity Proton Accelerator (LEHIPA), being developed at the Bhabha Atomic Research Centre (BARC) will produce a 20 MeV, 30 mA, continuous wave (CW) proton beam. At these low velocities, space-charge forces dominate, and could lead to larger beam sizes and beam halos. Hence in the design of the focusing lattice of the LEHIPA drift tube linac (DTL) using permanent magnet quadrupoles (PMQs), a larger good field region is preferred. Here we study, using the two dimensional (2D) and three dimensional (3D) simulation codes PANDIRA and RADIA, four different types of cylindrical PMQ designs: 16-segment trapezoidal Halbach configuration, bullet-nosed geometry and 8- and 16-segment rectangular geometries. The trapezoidal Halbach geometry is used in a variety of accelerators since it provides very high field gradients in small bores, while the bullet-nosed geometry, which is a combination of the trapezoidal and rectangular designs, is used in some DTLs. This study shows that a larger good field region is possible in the 16-segment rectangular design as compared to the Halbach and bullet-nosed designs, making it more attractive for high-intensity proton linacs. An improvement in good-field region by ∼16% over the Halbach design is obtained in the optimized 16-segment rectangular design, although the field gradient is lower by ∼20%. Tolerance studies show that the rectangular segment PMQ design is substantially less sensitive to the easy axis orientation errors and hence will be a better choice for DTLs. -- Highlights: • An improved permanent magnet quadrupole (PMQ) design with larger good field region is proposed. • We investigate four PMQ designs, including the widely used Halbach and bullet nosed designs. • Analytical calculations are backed by 2D as well as 3D numerical solvers, PANDIRA and RADIA. • The optimized 16 segment rectangular PMQ design is identified to exhibit the largest good field region. • The effect of easy axis orientation

  15. Analysis of Stakeholder's Behaviours for an Improved Management of an Agricultural Coastal Region in Oman (United States)

    Khatri, Ayisha Al; Jens, Grundmann; der Weth Rüdiger, van; Niels, Schütze


    Al Batinah coastal area is the main agricultural region in Oman. Agriculture is concentrated in Al Batinah, because of more fertile soils and easier access to water in the form of groundwater compared to other administrative areas in the country. The region now is facing a problem as a result of over abstraction of fresh groundwater for irrigation from the main aquifer along the coast. This enforces the inflow of sea water into the coastal aquifer and causes salinization of the groundwater. As a consequence the groundwater becomes no longer suitable for irrigation which impacts the social and economical situation of farmers as well as the environment. Therefore, the existing situation generates conflicts between different stakeholders regarding water availability, sustainable aquifer management, and profitable agricultural production in Al Batinah region. Several management measures to maintain the groundwater aquifer in the region, were implemented by the government. However, these solutions showed only limited successes for the existing problem. The aim of this study now is to evaluate the implementation potential of several management interventions and their combinations by analysing opinions and responses of all relevant stakeholders in the region. This is done in order to identify potential conflicts among stakeholders to a participatory process within the frame of an integrated water resources management and to support decision makers in taking more informed decisions. Questionnaires were designed for collecting data from different groups of stakeholders e.g. water professionals, farmers from the study area and decision makers of different organizations and ministries. These data were analysed statistically for each group separately as well as regarding relations amongst groups by using the SPSS (Statistical Package for Social Science) software package. Results show, that the need to improve the situation is supported by all groups. However, significant

  16. Theory of the development of alternans in the heart during controlled diastolic interval pacing (United States)

    Otani, Niels F.


    The beat-to-beat alternation in action potential durations (APDs) in the heart, called APD alternans, has been linked to the development of serious cardiac rhythm disorders, including ventricular tachycardia and fibrillation. The length of the period between action potentials, called the diastolic interval (DI), is a key dynamical variable in the standard theory of alternans development. Thus, methods that control the DI may be useful in preventing dangerous cardiac rhythms. In this study, we examine the dynamics of alternans during controlled-DI pacing using a series of single-cell and one-dimensional (1D) fiber models of alternans dynamics. We find that a model that combines a so-called memory model with a calcium cycling model can reasonably explain two key experimental results: the possibility of alternans during constant-DI pacing and the phase lag of APDs behind DIs during sinusoidal-DI pacing. We also find that these results can be replicated by incorporating the memory model into an amplitude equation description of a 1D fiber. The 1D fiber result is potentially concerning because it seems to suggest that constant-DI control of alternans can only be effective over only a limited region in space.

  17. Prevalence of venous obstruction in permanent endovenous pacing in newborns and infants: follow-up study. (United States)

    Stojanov, Petar; Vranes, Mile; Velimirovic, Dusan; Zivkovic, Mirjana; Kocica, Mladen J; Davidovic, Lazar; Neskovic, Voislava; Stajevic, Mila


    We examined the prevalence of venous obstruction in 12 newborns and infants with permanent endovenous ventricular pacing, clinically, and by ultrasonographic assessment of hemodynamics (spontaneity, phasicity, velocity, and turbulence of flow) and morphologic parameters (compressibility, wall thickness, and thrombus presence). All implantations of single ventricular unipolar endovenous steroid leads, were performed via cephalic vein, and pacemakers were placed in subcutaneous pocket in right prepectoral region. After the vascular surgeon has carefully examined all children for presence of venous collaterals in the chest wall, morphologic and hemodynamic parameters of the subclavian, axillary, and internal jugular veins, were assessed by linear-array color Doppler. Lead capacity (LC) was calculated for each patient. Mean age of patients at implant was 6.2 months (range 1 day-12 months), mean weight 6.5 kg (range 2.25-10 kg), and mean height 60.9 cm (range 48-78 cm). Mean LC was 1.99 (range 1.14-3.07). Total follow-up was 1023 and mean follow-up 85.2 pacing months (range 3-156). No clinical signs of venous obstruction were observed. Mild stenosis (20%) of subclavian vein was found by color Doppler in 2/12 patients. Both had adequate lead diameter for body surface. Permanent endovenous pacing is a feasible procedure, even in children of body weight less than 10 kg, with quite acceptable impact on venous system patency.

  18. Pacing Strategy, Muscle Fatigue, and Technique in 1500-m Speed-Skating and Cycling Time Trials. (United States)

    Stoter, Inge K; MacIntosh, Brian R; Fletcher, Jared R; Pootz, Spencer; Zijdewind, Inge; Hettinga, Florentina J


    To evaluate pacing behavior and peripheral and central contributions to muscle fatigue in 1500-m speed-skating and cycling time trials when a faster or slower start is instructed. Nine speed skaters and 9 cyclists, all competing at regional or national level, performed two 1500-m time trials in their sport. Athletes were instructed to start faster than usual in 1 trial and slower in the other. Mean velocity was measured per 100 m. Blood lactate concentrations were measured. Maximal voluntary contraction (MVC), voluntary activation (VA), and potentiated twitch (PT) of the quadriceps muscles were measured to estimate central and peripheral contributions to muscle fatigue. In speed skating, knee, hip, and trunk angles were measured to evaluate technique. Cyclists showed a more explosive start than speed skaters in the fast-start time trial (cyclists performed first 300 m in 24.70 ± 1.73 s, speed skaters in 26.18 ± 0.79 s). Both trials resulted in reduced MVC (12.0% ± 14.5%), VA (2.4% ± 5.0%), and PT (25.4% ± 15.2%). Blood lactate concentrations after the time trial and the decrease in PT were greater in the fast-start than in the slow-start trial. Speed skaters showed higher trunk angles in the fast-start than in the slow-start trial, while knee angles remained similar. Despite similar instructions, behavioral adaptations in pacing differed between the 2 sports, resulting in equal central and peripheral contributions to muscle fatigue in both sports. This provides evidence for the importance of neurophysiological aspects in the regulation of pacing. It also stresses the notion that optimal pacing needs to be studied sport specifically, and coaches should be aware of this.

  19. Radiotherapy is associated with significant improvement in local and regional control in Merkel cell carcinoma

    International Nuclear Information System (INIS)

    Kang, Susan H; Haydu, Lauren E; Goh, Robin Yeong Hong; Fogarty, Gerald B


    Merkel cell carcinoma (MCC) is a rare tumour of skin. This study is a retrospective audit of patients with MCC from St Vincent’s and Mater Hospital, Sydney, Australia. The aim of this study was to investigate the influence of radiotherapy (RT) on the local and regional control of MCC lesions and survival of patients with MCC. The data bases in anatomical pathology, RT and surgery. We searched for patients having a diagnosis of MCC between 1996 and 2007. Patient, tumour and treatment characteristics were collected and analysed. Univariate survival analysis of categorical variables was conducted with the Kaplan-Meier method together with the Log-Rank test for statistical significance. Continuous variables were assessed using the Cox regression method. Multivariate analysis was performed for significant univariate results. Sixty seven patients were found. Sixty two who were stage I-III and were treated with radical intent were analysed. 68% were male. The median age was 74 years. Forty-two cases (68%) were stage I or II, and 20 cases (32%) were stage III. For the subset of 42 stage I and II patients, those that had RT to their primary site had a 2-year local recurrence free survival of 89% compared with 36% for patients not receiving RT (p<0.001). The cumulative 2-year regional recurrence free survival for patients having adjuvant regional RT was 84% compared with 43% for patients not receiving this treatment (p<0.001). Immune status at initial surgery was a significant predictor for OS and MCCSS. In a multivariate analysis combining macroscopic size (mm) and immune status at initial surgery, only immune status remained a significant predictor of overall survival (HR=2.096, 95% CI: 1.002-4.385, p=0.049). RT is associated with significant improvement in local and regional control in Merkel cell carcinoma. Immunosuppression is an important factor in overall survival

  20. A case study of population health improvement at a Midwest regional hospital employer. (United States)

    Long, D Adam; Sheehan, Paula


    This article reviews the population health improvement initiative of a Midwest regional hospital employer. Services included health risk assessments, health education, and motivational health coaching conducted telephonically. Outcomes categories for this program evaluation comprised participation rates, participant satisfaction, health status and behavior change, productivity change, health care claims savings, and return on investment. Participation rates varied widely with incentive structure, although retention of participants in coaching programs averaged 89%. The participant satisfaction rate for the last 14 months of interventions was 96%. Four years of population health status and behavior trending showed significant improvements in smoking status, dietary fat and fiber intake, exercise, mental health (ie, stress, effects depressive symptoms in the past year, life satisfaction), readiness to change (ie, diet, exercise, stress, smoking, body weight), perceptions of overall health, an index of good health habits, sum of lifestyle health risks, and sum of risks and chronic conditions. Body mass index showed nonsignificant improvements during the years of greatest participation (years 2 to 4). Indicators of productivity demonstrated improvements as well. These gains were noted for employees across all health risk statuses, which suggests population health improvement strategies can influence productivity even for healthy employees. Program year 3 was evaluated for health care claims savings using a 2-stage multivariate regression approach. Stage 1 was a computation of propensity-to-participate scores. Stage 2 was an estimation of per member per month (PMPM) claims savings for participant cohorts using a propensity score-weighted linear regression analysis. Participants averaged $40.65 PMPM savings over the control population. Program return on investment, including incentive costs and vendor fees, was 2.87:1.

  1. Improving performance of breast cancer risk prediction using a new CAD-based region segmentation scheme (United States)

    Heidari, Morteza; Zargari Khuzani, Abolfazl; Danala, Gopichandh; Qiu, Yuchen; Zheng, Bin


    Objective of this study is to develop and test a new computer-aided detection (CAD) scheme with improved region of interest (ROI) segmentation combined with an image feature extraction framework to improve performance in predicting short-term breast cancer risk. A dataset involving 570 sets of "prior" negative mammography screening cases was retrospectively assembled. In the next sequential "current" screening, 285 cases were positive and 285 cases remained negative. A CAD scheme was applied to all 570 "prior" negative images to stratify cases into the high and low risk case group of having cancer detected in the "current" screening. First, a new ROI segmentation algorithm was used to automatically remove useless area of mammograms. Second, from the matched bilateral craniocaudal view images, a set of 43 image features related to frequency characteristics of ROIs were initially computed from the discrete cosine transform and spatial domain of the images. Third, a support vector machine model based machine learning classifier was used to optimally classify the selected optimal image features to build a CAD-based risk prediction model. The classifier was trained using a leave-one-case-out based cross-validation method. Applying this improved CAD scheme to the testing dataset, an area under ROC curve, AUC = 0.70+/-0.04, which was significantly higher than using the extracting features directly from the dataset without the improved ROI segmentation step (AUC = 0.63+/-0.04). This study demonstrated that the proposed approach could improve accuracy on predicting short-term breast cancer risk, which may play an important role in helping eventually establish an optimal personalized breast cancer paradigm.

  2. Iraqi health system in kurdistan region: medical professionals' perspectives on challenges and priorities for improvement. (United States)

    Shabila, Nazar P; Al-Tawil, Namir G; Tahir, Rebaz; Shwani, Falah H; Saleh, Abubakir M; Al-Hadithi, Tariq S


    The views of medical professionals on efficiency of health system and needs for any changes are very critical and constitute a cornerstone for any health system improvement. This is particularly relevant to Iraqi Kurdistan case as the events of the last few decades have significantly devastated the national Iraqi health system while the necessity for adopting a new health care system is increasingly recognized since 2004. This study aims to examine the regional health system in Iraqi Kurdistan from medical professionals' perspectives and try to define its problems and priorities for improvement. A survey questionnaire was developed and administered to a convenience sample of 250 medical professionals in Erbil governorate. The questionnaire included four items; rating of the quality of services and availability of resources in the health institutions, view on different aspects of the health system, the perceived priority needs for health system improvement and gender and professional characteristics of the respondents. The response rate to the survey was 83.6%. A high proportion of respondents rated the different aspects of services and resources in the health institutions as weak or very weak including the availability of the required quantity and quality of medicines (68.7%), the availability of sufficient medical equipment and investigation tools (68.7%), and the quality of offered services (65.3%). Around 72% of respondents had a rather negative view on the overall health system. The weak role of medical research, the weak role of professional associations in controlling the system and the inefficient health education were identified as important problems in the current health system (87.9%, 87.1% and 84.9%, respectively). The priority needs of health system improvement included adoption of social insurance for medical care of the poor (82%), enhancing the role of family medicine (77.2%), adopting health insurance system (76.1%) and periodic scientific

  3. Temperature prediction model of asphalt pavement in cold regions based on an improved BP neural network

    International Nuclear Information System (INIS)

    Xu, Bo; Dan, Han-Cheng; Li, Liang


    Highlights: • Pavement temperature prediction model is presented with improved BP neural network. • Dynamic and static methods are presented to predict pavement temperature. • Pavement temperature can be excellently predicted in next 3 h. - Abstract: Ice cover on pavement threatens traffic safety, and pavement temperature is the main factor used to determine whether the wet pavement is icy or not. In this paper, a temperature prediction model of the pavement in winter is established by introducing an improved Back Propagation (BP) neural network model. Before the application of the BP neural network model, many efforts were made to eliminate chaos and determine the regularity of temperature on the pavement surface (e.g., analyze the regularity of diurnal and monthly variations of pavement temperature). New dynamic and static prediction methods are presented by improving the algorithms to intelligently overcome the prediction inaccuracy at the change point of daily temperature. Furthermore, some scenarios have been compared for different dates and road sections to verify the reliability of the prediction model. According to the analysis results, the daily pavement temperatures can be accurately predicted for the next 3 h from the time of prediction by combining the dynamic and static prediction methods. The presented method in this paper can provide technical references for temperature prediction of the pavement and the development of an early-warning system for icy pavements in cold regions.

  4. Improving quantum efficiency and spectral resolution of a CCD through direct manipulation of the depletion region (United States)

    Brown, Craig; Ambrosi, Richard M.; Abbey, Tony; Godet, Olivier; O'Brien, R.; Turner, M. J. L.; Holland, Andrew; Pool, Peter J.; Burt, David; Vernon, David


    Future generations of X-ray astronomy instruments will require position sensitive detectors in the form of charge-coupled devices (CCDs) for X-ray spectroscopy and imaging with the ability to probe the X-ray universe with greater efficiency. This will require the development of CCDs with structures that will improve their quantum efficiency over the current state of the art. The quantum efficiency improvements would have to span a broad energy range (0.2 keV to >15 keV). These devices will also have to be designed to withstand the harsh radiation environments associated with orbits that extend beyond the Earth's magnetosphere. This study outlines the most recent work carried out at the University of Leicester focused on improving the quantum efficiency of an X-ray sensitive CCD through direct manipulation of the device depletion region. It is also shown that increased spectral resolution is achieved using this method due to a decrease in the number of multi-pixel events. A Monte Carlo and analytical models of the CCD have been developed and used to determine the depletion depths achieved through variation of the device substrate voltage, Vss. The models are also used to investigate multi-pixel event distributions and quantum efficiency as a function of depletion depth.

  5. Use of wetlands for water quality improvement under the USEPA Region V Clean Lakes Program (United States)

    Landers, Judith C.; Knuth, Barbara A.


    The United States Environmental Protection Agency (USEPA) Region V Clean Lakes Program employs artificial and modified natural wetlands in an effort to improve the water quality of selected lakes. We examined use of wetlands at seven lake sites and evaluated the physical and institutional means by which wetland projects are implemented and managed, relative to USEPA program goals and expert recommendations on the use of wetlands for water quality improvement. Management practices recommended by wetlands experts addressed water level and retention, sheet flow, nutrient removal, chemical treatment, ecological and effectiveness monitoring, and resource enhancement. Institutional characteristics recommended included local monitoring, regulation, and enforcement and shared responsibilities among jurisdictions. Institutional and ecological objectives of the National Clean Lakes Program were met to some degree at every site. Social objectives were achieved to a lesser extent. Wetland protection mechanisms and appropriate institutional decentralization were present at all sites. Optimal management techniques were employed to varying degrees at each site, but most projects lack adequate monitoring to determine adverse ecological impacts and effectiveness of pollutant removal and do not extensively address needs for recreation and wildlife habitat. There is evidence that the wetland projects are contributing to improved lake water quality; however, more emphasis needs to be placed on wetland protection and long-term project evaluation.

  6. Regional scales of fire danger rating in the forest: improved technique

    Directory of Open Access Journals (Sweden)

    A. V. Volokitina


    Full Text Available Wildland fires distribute unevenly in time and over area under the influence of weather and other factors. It is unfeasible to air patrol the whole forest area daily during a fire season as well as to keep all fire suppression forces constantly alert. Daily work and preparedness of forest fire protection services is regulated by the level of fire danger according to weather conditions (Nesterov’s index. PV-1 index, fire hazard class (Melekhov’s scale, regional scales (earlier called local scales. Unfortunately, there is still no unified comparable technique of making regional scales. As a result, it is difficult to maneuver forest fire protection resources, since the techniques currently used are not approved and not tested for their performance. They give fire danger rating incomparable even for neighboring regions. The paper analyzes the state-of-the-art in Russia and abroad. It is stated the irony is that with factors of fire danger measured quantitatively, the fire danger itself as a function has no quantitative expression. Thus, selection of an absolute criteria is of high importance for improvement of daily fire danger rating. On the example of the Chunsky forest ranger station (Krasnoyarsk Krai, an improved technique is suggested of making comparable local scales of forest fire danger rating based on an absolute criterion of fire danger rating – a probable density of active fires per million ha. A method and an algorithm are described of automatized local scales of fire danger that should facilitate effective creation of similar scales for any forest ranger station or aviation regional office using a database on forest fires and weather conditions. The information system of distant monitoring by Federal Forestry Agency of Russia is analyzed for its application in making local scales. To supplement the existing weather station net it is suggested that automatic compact weather stations or, if the latter is not possible, simple

  7. Self-Paced Prioritized Curriculum Learning With Coverage Penalty in Deep Reinforcement Learning. (United States)

    Ren, Zhipeng; Dong, Daoyi; Li, Huaxiong; Chen, Chunlin; Zhipeng Ren; Daoyi Dong; Huaxiong Li; Chunlin Chen; Dong, Daoyi; Li, Huaxiong; Chen, Chunlin; Ren, Zhipeng


    In this paper, a new training paradigm is proposed for deep reinforcement learning using self-paced prioritized curriculum learning with coverage penalty. The proposed deep curriculum reinforcement learning (DCRL) takes the most advantage of experience replay by adaptively selecting appropriate transitions from replay memory based on the complexity of each transition. The criteria of complexity in DCRL consist of self-paced priority as well as coverage penalty. The self-paced priority reflects the relationship between the temporal-difference error and the difficulty of the current curriculum for sample efficiency. The coverage penalty is taken into account for sample diversity. With comparison to deep Q network (DQN) and prioritized experience replay (PER) methods, the DCRL algorithm is evaluated on Atari 2600 games, and the experimental results show that DCRL outperforms DQN and PER on most of these games. More results further show that the proposed curriculum training paradigm of DCRL is also applicable and effective for other memory-based deep reinforcement learning approaches, such as double DQN and dueling network. All the experimental results demonstrate that DCRL can achieve improved training efficiency and robustness for deep reinforcement learning.

  8. First reported experience with intramuscular diaphragm pacing in replacing positive pressure mechanical ventilators in children. (United States)

    Onders, Raymond P; Ponsky, Todd A; Elmo, MaryJo; Lidsky, Karen; Barksdale, Edward


    Diaphragm pacing (DP) has been shown to successfully replace mechanical ventilators for adult tetraplegic patients with chronic respiratory insufficiency. This is the first report of DP in ventilator-dependent children. This was a prospective interventional experience under institutional review board approval. Diaphragm pacing involves outpatient laparoscopic diaphragm motor point mapping to identify the site where stimulation causes maximum diaphragm contraction with implantation of 4 percutaneous intramuscular electrodes. Diaphragm conditioning ensues to wean the child from the ventilator. Six children were successfully implanted ranging from 5 to 17 years old with the smallest 15 kg in weight. Length of time on mechanical ventilation ranged from 11 days to 7.6 years with an average of 3.2 years. In all patients, DP provided tidal volumes above basal needs. Five of the patients underwent a home-based weaning program, whereas one patient who was implanted only 11 days post spinal cord injury never returned to the ventilator with DP use. Another patient was weaned from the ventilator full time but died of complications of his underlying brain stem tumor. The remaining patients weaned from the ventilator for over 14 hours a day and/or are actively conditioning their diaphragms. Diaphragm pacing successfully replaced mechanical ventilators, which improves quality of life. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Wrong, but useful: regional species distribution models may not be improved by range-wide data under biased sampling. (United States)

    El-Gabbas, Ahmed; Dormann, Carsten F


    Species distribution modeling (SDM) is an essential method in ecology and conservation. SDMs are often calibrated within one country's borders, typically along a limited environmental gradient with biased and incomplete data, making the quality of these models questionable. In this study, we evaluated how adequate are national presence-only data for calibrating regional SDMs. We trained SDMs for Egyptian bat species at two different scales: only within Egypt and at a species-specific global extent. We used two modeling algorithms: Maxent and elastic net, both under the point-process modeling framework. For each modeling algorithm, we measured the congruence of the predictions of global and regional models for Egypt, assuming that the lower the congruence, the lower the appropriateness of the Egyptian dataset to describe the species' niche. We inspected the effect of incorporating predictions from global models as additional predictor ("prior") to regional models, and quantified the improvement in terms of AUC and the congruence between regional models run with and without priors. Moreover, we analyzed predictive performance improvements after correction for sampling bias at both scales. On average, predictions from global and regional models in Egypt only weakly concur. Collectively, the use of priors did not lead to much improvement: similar AUC and high congruence between regional models calibrated with and without priors. Correction for sampling bias led to higher model performance, whatever prior used, making the use of priors less pronounced. Under biased and incomplete sampling, the use of global bats data did not improve regional model performance. Without enough bias-free regional data, we cannot objectively identify the actual improvement of regional models after incorporating information from the global niche. However, we still believe in great potential for global model predictions to guide future surveys and improve regional sampling in data

  10. The solarPACES strategy for the solar thermal breakthrough

    International Nuclear Information System (INIS)

    Burch, G.D.; Grasse, W.


    IEA(International Energy Agency)/SolarPACES(Solar Power and Chemical Energy systems)represents a world wide coalition for information sharing and collaboration on applications of concentrated solar energy. The current SolarPACES community has built up solar thermal system know-how over 15 years, is operating the three main solar test centres in the world. Its main activities are in the following four fields: solar thermal electric power systems, solar chemistry, solar technology and advanced applications and non-technical activities. The article presents the talk on the strategy of solarPACES given at the International Workshop on applied solar energy held in Tashkent(Uzbekistan) in June 1997. (A.A.D.)

  11. Improved quantification for local regions of interest in preclinical PET imaging (United States)

    Cal-González, J.; Moore, S. C.; Park, M.-A.; Herraiz, J. L.; Vaquero, J. J.; Desco, M.; Udias, J. M.


    In Positron Emission Tomography, there are several causes of quantitative inaccuracy, such as partial volume or spillover effects. The impact of these effects is greater when using radionuclides that have a large positron range, e.g. 68Ga and 124I, which have been increasingly used in the clinic. We have implemented and evaluated a local projection algorithm (LPA), originally evaluated for SPECT, to compensate for both partial-volume and spillover effects in PET. This method is based on the use of a high-resolution CT or MR image, co-registered with a PET image, which permits a high-resolution segmentation of a few tissues within a volume of interest (VOI) centered on a region within which tissue-activity values need to be estimated. The additional boundary information is used to obtain improved activity estimates for each tissue within the VOI, by solving a simple inversion problem. We implemented this algorithm for the preclinical Argus PET/CT scanner and assessed its performance using the radionuclides 18F, 68Ga and 124I. We also evaluated and compared the results obtained when it was applied during the iterative reconstruction, as well as after the reconstruction as a postprocessing procedure. In addition, we studied how LPA can help to reduce the ‘spillover contamination’, which causes inaccurate quantification of lesions in the immediate neighborhood of large, ‘hot’ sources. Quantification was significantly improved by using LPA, which provided more accurate ratios of lesion-to-background activity concentration for hot and cold regions. For 18F, the contrast was improved from 3.0 to 4.0 in hot lesions (when the true ratio was 4.0) and from 0.16 to 0.06 in cold lesions (true ratio  =  0.0), when using the LPA postprocessing. Furthermore, activity values estimated within the VOI using LPA during reconstruction were slightly more accurate than those obtained by post-processing, while also visually improving the image contrast and uniformity

  12. Questions of improvement of ecological situation in the industrial cities of the Tashkent region

    Directory of Open Access Journals (Sweden)

    Peremkulov J.A.


    Full Text Available the article analyzes ecological reforms of Uzbekistan’s industrial towns, especially towns of Tashkent region, during the years of Independence. The analysis shows the improvement of ecological balance, as a result of governmental arrangements undertaken for solving the ecological problems in the town. The article demonstrates the abatement of industrial pollution as a result of re-organizing industrial factories by investments. The statistical data shows the reduction of air pollution by deleterious waste in the town, which was caused by the effect of industrial plants reorganization that phase down during the first years of Independence, as a joint venture and technical and technological re-equipment of them. The ecological state of each industrial town is analyzed separately in the article. The author uses governmental decrees, periodicals, documents of town hall, archive data, as well newspapers and magazines that show eco-environment of the republic.

  13. Algorithm based on regional separation for automatic grain boundary extraction using improved mean shift method (United States)

    Zhenying, Xu; Jiandong, Zhu; Qi, Zhang; Yamba, Philip


    Metallographic microscopy shows that the vast majority of metal materials are composed of many small grains; the grain size of a metal is important for determining the tensile strength, toughness, plasticity, and other mechanical properties. In order to quantitatively evaluate grain size in metals, grain boundaries must be identified in metallographic images. Based on the phenomenon of grain boundary blurring or disconnection in metallographic images, this study develops an algorithm based on regional separation for automatically extracting grain boundaries by an improved mean shift method. Experimental observation shows that the grain boundaries obtained by the proposed algorithm are highly complete and accurate. This research has practical value because the proposed algorithm is suitable for grain boundary extraction from most metallographic images.

  14. Improved Regional Climate Model Simulation of Precipitation by a Dynamical Coupling to a Hydrology Model

    DEFF Research Database (Denmark)

    Larsen, Morten Andreas Dahl; Drews, Martin; Hesselbjerg Christensen, Jens

    convective precipitation systems. As a result climate model simulations let alone future projections of precipitation often exhibit substantial biases. Here we show that the dynamical coupling of a regional climate model to a detailed fully distributed hydrological model - including groundwater-, overland...... of local precipitation dynamics are seen for time scales of app. Seasonal duration and longer. We show that these results can be attributed to a more complete treatment of land surface feedbacks. The local scale effect on the atmosphere suggests that coupled high-resolution climate-hydrology models...... including a detailed 3D redistribution of sub- and land surface water have a significant potential for improving climate projections even diminishing the need for bias correction in climate-hydrology studies....

  15. Improving Shade Modelling in a Regional River Temperature Model Using Fine-Scale LIDAR Data (United States)

    Hannah, D. M.; Loicq, P.; Moatar, F.; Beaufort, A.; Melin, E.; Jullian, Y.


    Air temperature is often considered as a proxy of the stream temperature to model the distribution areas of aquatic species water temperature is not available at a regional scale. To simulate the water temperature at a regional scale (105 km²), a physically-based model using the equilibrium temperature concept and including upstream-downstream propagation of the thermal signal was developed and applied to the entire Loire basin (Beaufort et al., submitted). This model, called T-NET (Temperature-NETwork) is based on a hydrographical network topology. Computations are made hourly on 52,000 reaches which average 1.7 km long in the Loire drainage basin. The model gives a median Root Mean Square Error of 1.8°C at hourly time step on the basis of 128 water temperature stations (2008-2012). In that version of the model, tree shadings is modelled by a constant factor proportional to the vegetation cover on 10 meters sides the river reaches. According to sensitivity analysis, improving the shade representation would enhance T-NET accuracy, especially for the maximum daily temperatures, which are currently not very well modelized. This study evaluates the most efficient way (accuracy/computing time) to improve the shade model thanks to 1-m resolution LIDAR data available on tributary of the LoireRiver (317 km long and an area of 8280 km²). Two methods are tested and compared: the first one is a spatially explicit computation of the cast shadow for every LIDAR pixel. The second is based on averaged vegetation cover characteristics of buffers and reaches of variable size. Validation of the water temperature model is made against 4 temperature sensors well spread along the stream, as well as two airborne thermal infrared imageries acquired in summer 2014 and winter 2015 over a 80 km reach. The poster will present the optimal length- and crosswise scale to characterize the vegetation from LIDAR data.

  16. Pace: an advanced structure for handling multi-technique NDT

    International Nuclear Information System (INIS)

    Mayos, M.; Guisnel, F.


    The growing extent and complexity of NDT data analysis has reached a stage where dedicated systems are required. In the context of a European research program, EDF participated from 1992 to 1994 in one of the first international projects in this field, TRAPPIST and, in 1993, began developing An application for the electricity generating industry, giving rise to the PACE project. The prime objective specially targets the French electricity generating industry, where PACE was to be the reference system for analysis of NDE data concerning EdF power plants. The second objective is to promote the adoption of PACE by other industrial sectors and other countries. The analysis of needs shows that the required system must be designed to analyze data from widely different sources. The PACE entry point consequently has to be a standard format compatible with geometrical data as well as those provided by NDT. The TRAPPIST format constitutes the first version of this standard and is the first step towards European standardization in this respect. Consideration of the different user modes defined for PACE led to the design of a 2-part user structure comprising a database management system (Ingres/Windows 4GL) and a display/processing tool (AVS), also usable to construct analysis scenarios. The structure of PACE is defined nd seems well suited to industrial requirements, but before it is possible to proceed further towards its adoption for actual power plant inspections, it has to be validated on a more realistic application, the eddy current and ultrasonic testing of a full-scale T-joint. This is already under way, whilst work on format standardization and industrialization preparatory procedures are proceeding in parallel. (authors). 4 refs., 6 figs


    Directory of Open Access Journals (Sweden)

    Ferdinan Ferdinan


    Full Text Available CAMSHIFT algorithm has been widely used in object tracking. CAMSHIFT utilizescolor features as the model object. Thus, original CAMSHIFT may fail when the object color issimilar with the background color. In this study, we propose CAMSHIFT tracker combined withmean-shift segmentation, region growing, and SURF in order to improve the tracking accuracy.The mean-shift segmentation and region growing are applied in object localization phase to extractthe important parts of the object. Hue-distance, saturation, and value are used to calculate theBhattacharyya distance to judge whether the tracked object is lost. Once the object is judged lost,SURF is used to find the lost object, and CAMSHIFT can retrack the object. The Object trackingsystem is built with OpenCV. Some measurements of accuracy have done using frame-basedmetrics. We use datasets BoBoT (Bonn Benchmark on Tracking to measure accuracy of thesystem. The results demonstrate that CAMSHIFT combined with mean-shift segmentation, regiongrowing, and SURF method has higher accuracy than the previous methods.

  18. Planning Water Resources in an Agroforest Ecosystem for Improvement of Regional Ecological Function Under Uncertainties

    Directory of Open Access Journals (Sweden)

    Xueting Zeng


    Full Text Available In this study, an agroforestry ecosystem project (AEP is developed for confronting the conflict between agricultural development and forest protection. A fuzzy stochastic programming with Laplace scenario analysis (FSL is proposed for planning water resources in an AEP issue under uncertainties. FSL can not only deal with spatial and temporal variations of hydrologic elements and meteorological conditions; but also handle uncertainties that are expressed in terms of probability, possibility distributions and fuzzy sets; meanwhile, policy scenario analysis with Laplace’s criterion (PSL is introduced to handle probability of each scenario occurrence under the supposition of no data available. The developed FSL can be applied to an AEP issue in Xixian county, located in north of China. The result of ecological effects, water allocation patterns, pollution mitigation schemes and system benefits under various scenarios are obtained, which can support policymakers adjusting current strategy to improve regional ecological function with cost-effective and sustainable manners. Meanwhile, it can support generating a robust water plan for regional sustainability in an AEP issue under uncertainties.

  19. Depletion velocities for atmospheric pollutants oriented To improve the simplified regional dispersion modelling

    International Nuclear Information System (INIS)

    Sanchez Gacita, Madeleine; Turtos Carbonell, Leonor; Rivero Oliva, Jose de Jesus


    The present work is aimed to improve externalities assessment using Simplified Methodologies, through the obtaining of depletion velocities for primary pollutants SO 2 , NO X and TSP (Total Suspended Particles) and for sulfate and nitrate aerosols, the secondary pollutants created from the first ones. The main goal proposed was to estimate these values for different cases, in order to have an ensemble of values for the geographic area, among which the most representative could be selected for using it in future studies that appeal to a simplified methodology for the regional dispersion assessment, taking into account the requirements of data, qualified manpower and time for a detailed approach. The results where obtained using detailed studies of the regional dispersion that were conduced for six power facilities, three from Cuba (at the localities of Mariel, Santa Cruz and Tallapiedra) and three from Mexico (at the localities of Tuxpan, Tula and Manzanillo). The depletion velocity for SO 2 was similar for all cases. Results obtained for Tallapiedra, Santa Cruz, Mariel and Manzanillo were similar. For Tula and Tuxpan a high uncertainty was found

  20. The wind forecasting improvement project. Description and results from the Southern study region

    Energy Technology Data Exchange (ETDEWEB)

    Freedman, Jeffrey [AWS Truepower LLC, Albany, NY (United States); Benjamin, Stan; Wilczak, James [National Oceanic and Atmospheric Administration, Washington, DC and Boulder, CO (United States)] [and others


    The Wind Forecasting Improvement Project (WFIP) is a multi-year U.S. Department of Energy (DOE)/National Oceanographic and Atmospheric Administration (NOAA) sponsored study whose main purpose is to demonstrate the scientific and economic benefits of additional atmospheric observations and model enhancements on wind energy production forecasts. WFIP covers two geographical regions of the U.S.: (1) the upper Great Plains, or Northern Study Area, and (2) most of Texas-the Southern Study Area. The Southern campaign is being led by AWS Truepower LLC, and includes a team of private, government, and academic partners with collective experience and expertise in all facets required to ensure a successful completion of the project. In addition presenting a summary of the state-of-the-art forecasting techniques used and phenomena-based analysis mentioned above, a brief synopsis of how ''lessons learned'' from the WFIP Southern Study Area can be articulated and applied to other wind resource regions will be described. (orig.)

  1. International piping benchmarks: Use of simplified code PACE 2

    Energy Technology Data Exchange (ETDEWEB)

    Boyle, J; Spence, J [University of Strathclyde (United Kingdom); Blundell, C [Risley Nuclear Power Development Establishment, Central Technical Services, Risley, Warrington (United Kingdom)


    This report compares the results obtained using the code PACE 2 with the International Working Group on Fast Reactors (IWGFR) International Piping Benchmark solutions. PACE 2 is designed to analyse systems of pipework using a simplified method which is economical of computer time and hence inexpensive. This low cost is not achieved without some loss of accuracy in the solution, but for most parts of a system this inaccuracy is acceptable and those sections of particular importance may be reanalysed using more precise methods in order to produce a satisfactory analysis of the complete system at reasonable cost. (author)

  2. International piping benchmarks: Use of simplified code PACE 2

    International Nuclear Information System (INIS)

    Boyle, J.; Spence, J.; Blundell, C.


    This report compares the results obtained using the code PACE 2 with the International Working Group on Fast Reactors (IWGFR) International Piping Benchmark solutions. PACE 2 is designed to analyse systems of pipework using a simplified method which is economical of computer time and hence inexpensive. This low cost is not achieved without some loss of accuracy in the solution, but for most parts of a system this inaccuracy is acceptable and those sections of particular importance may be reanalysed using more precise methods in order to produce a satisfactory analysis of the complete system at reasonable cost. (author)

  3. Is right ventricular mid-septal pacing superior to apical pacing in patients with high degree atrio-ventricular block and moderately depressed left ventricular function? (United States)

    Chen, Kang; Mao, Ye; Liu, Shao-hua; Wu, Qiong; Luo, Qing-zhi; Pan, Wen-qi; Jin, Qi; Zhang, Ning; Ling, Tian-you; Chen, Ying; Gu, Gang; Shen, Wei-feng; Wu, Li-qun


    We are aimed to investigate whether right ventricular mid-septal pacing (RVMSP) is superior to conventional right ventricular apical pacing (RVAP) in improving clinical functional capacity and left ventricular ejection fraction (LVEF) for patients with high-degree atrio-ventricular block and moderately depressed left ventricle (LV) function. Ninety-two patients with high-degree atrio-ventricular block and moderately reduced LVEF (ranging from 35% to 50%) were randomly allocated to RVMSP (n=45) and RVAP (n=47). New York Heart Association (NYHA) functional class, echocardiographic LVEF, and distance during a 6-min walk test (6MWT) were determined at 18 months after pacemaker implantation. Serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured using an enzyme-linked immunosorbent assay (ELISA) kit. Compared with baseline, NYHA functional class remained unchanged at 18 months, distance during 6MWT (485 m vs. 517 m) and LVEF (36.7% vs. 41.8%) were increased, but BNP levels were reduced (2352 pg/ml vs. 710 pg/ml) in the RVMSP group compared with those in the RVAP group, especially in patients with LVEF 35%-40% (for all comparisons, Pfunction capacity and LV function measurements were not significantly changed in patients with RVAP, despite the pacing measurements being similar in both groups, such as R-wave amplitude and capture threshold. RVMSP provides a better clinical utility, compared with RVAP, in patients with high-degree atrioventricular block and moderately depressed LV function whose LVEF levels ranged from 35% to 40%.

  4. DiPALS: Diaphragm Pacing in patients with Amyotrophic Lateral Sclerosis - a randomised controlled trial. (United States)

    McDermott, Christopher J; Bradburn, Mike J; Maguire, Chin; Cooper, Cindy L; Baird, Wendy O; Baxter, Susan K; Cohen, Judith; Cantrill, Hannah; Dixon, Simon; Ackroyd, Roger; Baudouin, Simon; Bentley, Andrew; Berrisford, Richard; Bianchi, Stephen; Bourke, Stephen C; Darlison, Roy; Ealing, John; Elliott, Mark; Fitzgerald, Patrick; Galloway, Simon; Hamdalla, Hisham; Hanemann, C Oliver; Hughes, Philip; Imam, Ibrahim; Karat, Dayalan; Leek, Roger; Maynard, Nick; Orrell, Richard W; Sarela, Abeezar; Stradling, John; Talbot, Kevin; Taylor, Lyn; Turner, Martin; Simonds, Anita K; Williams, Tim; Wedzicha, Wisia; Young, Carolyn; Shaw, Pamela J


    Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease resulting in death, usually from respiratory failure, within 2-3 years of symptom onset. Non-invasive ventilation (NIV) is a treatment that when given to patients in respiratory failure leads to improved survival and quality of life. Diaphragm pacing (DP), using the NeuRx/4(®) diaphragm pacing system (DPS)™ (Synapse Biomedical, Oberlin, OH, USA), is a new technique that may offer additional or alternative benefits to patients with ALS who are in respiratory failure. The Diaphragm Pacing in patients with Amyotrophic Lateral Sclerosis (DiPALS) trial evaluated the effect of DP on survival over the study duration in patients with ALS with respiratory failure. The DiPALS trial was a multicentre, parallel-group, open-label, randomised controlled trial incorporating health economic analyses and a qualitative longitudinal substudy. Eligible participants had a diagnosis of ALS (ALS laboratory-supported probable, clinically probable or clinically definite according to the World Federation of Neurology revised El Escorial criteria), had been stabilised on riluzole for 30 days, were aged ≥ 18 years and were in respiratory failure. We planned to recruit 108 patients from seven UK-based specialist ALS or respiratory centres. Allocation was performed using 1 : 1 non-deterministic minimisation. Participants were randomised to either standard care (NIV alone) or standard care (NIV) plus DP using the NeuRX/4 DPS. The primary outcome was overall survival, defined as the time from randomisation to death from any cause. Secondary outcomes were patient quality of life [assessed by European Quality of Life-5 Dimensions, three levels (EQ-5D-3L), Short Form questionnaire-36 items and Sleep Apnoea Quality of Life Index questionnaire]; carer quality of life (EQ-5D-3L and Caregiver Burden Inventory); cost-utility analysis and health-care resource use; tolerability and adverse events. Acceptability and attitudes to

  5. Different horse's paces during hippotherapy on spatio-temporal parameters of gait in children with bilateral spastic cerebral palsy: A feasibility study. (United States)

    Antunes, Fabiane Nunes; Pinho, Alexandre Severo do; Kleiner, Ana Francisca Rozin; Salazar, Ana Paula; Eltz, Giovana Duarte; de Oliveira Junior, Alcyr Alves; Cechetti, Fernanda; Galli, Manuela; Pagnussat, Aline Souza


    Hippotherapy is often carried out for the rehabilitation of children with Cerebral Palsy (CP), with the horse riding at a walking pace. This study aimed to explore the immediate effects of a hippotherapy protocol using a walk-trot pace on spatio-temporal gait parameters and muscle tone in children with Bilateral Spastic CP (BS-CP). Ten children diagnosed with BS-CP and 10 healthy aged-matched children (reference group) took part in this study. The children with BS-CP underwent two sessions of hippotherapy for one week of washout between them. Two protocols (lasting 30min) were applied on separate days: Protocol 1: the horse's pace was a walking pace; and Protocol 2: the horse's pace was a walk-trot pace. Children from the reference group were not subjected to treatment. A wireless inertial measurement unit measured gait spatio-temporal parameters before and after each session. The Modified Ashworth Scale was applied for muscle tone measurement of hip adductors. The participants underwent the gait assessment on a path with surface irregularities (ecological context). The comparisons between BS-CP and the reference group found differences in all spatio-temporal parameters, except for gait velocity. Within-group analysis of children with BS-CP showed that the swing phase did not change after the walk pace and after the walk-trot pace. The percentage of rolling phase and double support improved after the walk-trot. The spasticity of the hip adductors was significantly reduced as an immediate result of both protocols, but this decrease was more evident after the walk-trot. The walk-trot protocol is feasible and is able to induce an immediate effect that improves the gait spatio-temporal parameters and the hip adductors spasticity. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Junction barrier Schottky rectifier with an improved P-well region

    International Nuclear Information System (INIS)

    Wang Ying; Li Ting; Cao Fei; Shao Lei; Chen Yu-Xian


    A junction barrier Schottky (JBS) rectifier with an improved P-well on 4H—SiC is proposed to improve the V F —I R trade-off and the breakdown voltage. The reverse current density of the proposed JBS rectifier at 300 K and 800 V is about 3.3×10 −8 times that of the common JBS rectifier at no expense of the forward voltage drop. This is because the depletion layer thickness in the P-well region at the same reverse voltage is larger than in the P + grid, resulting in a lower spreading current and tunneling current. As a result, the breakdown voltage of the proposed JBS rectifier is over 1.6 kV, that is about 0.8 times more than that of the common JBS rectifier due to the uniform electric field. Although the series resistance of the proposed JBS rectifier is a little larger than that of the common JBS rectifier, the figure of merit (FOM) of the proposed JBS rectifier is about 2.9 times that of the common JBS rectifier. Based on simulating the values of susceptibility of the two JBS rectifiers to electrostatic discharge (ESD) in the human body model (HBM) circuits, the failure energy of the proposed JBS rectifier increases 17% compared with that of the common JBS rectifier. (interdisciplinary physics and related areas of science and technology)

  7. White noise improves learning by modulating activity in dopaminergic midbrain regions and right superior temporal sulcus. (United States)

    Rausch, Vanessa H; Bauch, Eva M; Bunzeck, Nico


    In neural systems, information processing can be facilitated by adding an optimal level of white noise. Although this phenomenon, the so-called stochastic resonance, has traditionally been linked with perception, recent evidence indicates that white noise may also exert positive effects on cognitive functions, such as learning and memory. The underlying neural mechanisms, however, remain unclear. Here, on the basis of recent theories, we tested the hypothesis that auditory white noise, when presented during the encoding of scene images, enhances subsequent recognition memory performance and modulates activity within the dopaminergic midbrain (i.e., substantia nigra/ventral tegmental area, SN/VTA). Indeed, in a behavioral experiment, we can show in healthy humans that auditory white noise-but not control sounds, such as a sinus tone-slightly improves recognition memory. In an fMRI experiment, white noise selectively enhances stimulus-driven phasic activity in the SN/VTA and auditory cortex. Moreover, it induces stronger connectivity between SN/VTA and right STS, which, in addition, exhibited a positive correlation with subsequent memory improvement by white noise. Our results suggest that the beneficial effects of auditory white noise on learning depend on dopaminergic neuromodulation and enhanced connectivity between midbrain regions and the STS-a key player in attention modulation. Moreover, they indicate that white noise could be particularly useful to facilitate learning in conditions where changes of the mesolimbic system are causally related to memory deficits including healthy and pathological aging.

  8. Collaborative Research: Improving Decadal Prediction of Arctic Climate Variability and Change Using a Regional Arctic

    Energy Technology Data Exchange (ETDEWEB)

    Gutowski, William J. [Iowa State Univ., Ames, IA (United States)


    This project developed and applied a regional Arctic System model for enhanced decadal predictions. It built on successful research by four of the current PIs with support from the DOE Climate Change Prediction Program, which has resulted in the development of a fully coupled Regional Arctic Climate Model (RACM) consisting of atmosphere, land-hydrology, ocean and sea ice components. An expanded RACM, a Regional Arctic System Model (RASM), has been set up to include ice sheets, ice caps, mountain glaciers, and dynamic vegetation to allow investigation of coupled physical processes responsible for decadal-scale climate change and variability in the Arctic. RASM can have high spatial resolution (~4-20 times higher than currently practical in global models) to advance modeling of critical processes and determine the need for their explicit representation in Global Earth System Models (GESMs). The pan-Arctic region is a key indicator of the state of global climate through polar amplification. However, a system-level understanding of critical arctic processes and feedbacks needs further development. Rapid climate change has occurred in a number of Arctic System components during the past few decades, including retreat of the perennial sea ice cover, increased surface melting of the Greenland ice sheet, acceleration and thinning of outlet glaciers, reduced snow cover, thawing permafrost, and shifts in vegetation. Such changes could have significant ramifications for global sea level, the ocean thermohaline circulation and heat budget, ecosystems, native communities, natural resource exploration, and commercial transportation. The overarching goal of the RASM project has been to advance understanding of past and present states of arctic climate and to improve seasonal to decadal predictions. To do this the project has focused on variability and long-term change of energy and freshwater flows through the arctic climate system. The three foci of this research are: - Changes

  9. Basal metabolism in tropical birds: latitude, altitude, and the ‘pace of life’


    Londoño, Gustavo Adolfo


    Life history varies across latitudes, with the ‘pace of life’ being ‘slower’ in tropical regions. Because life history is coupled to energy metabolism via allocation tradeoffs and links between performance capacity and energy use, low metabolic intensity is expected in tropical animals. Low metabolism has been reported for lowland tropical birds, but it is unclear if this is due to ‘slow’ life history or to a warm, stable environment. We measured basal metabolic rates (BMR) of 253 bird spe...

  10. Teachers' Perceptions of the Educational Platform--Is There a Connection between School Improvement and Regional Educational Development? (United States)

    Boström, Lena; Dalin, Rolf


    This research examined teachers' attitudes in a school development project, The best regional educational system in the world which focuses on regional development and school improvement. The project was performed in counties in Mid Sweden, which have a lower educational level and school achievements and a competence escape compare with other…

  11. Drought, Fire and Insects in Western US Forests: Observations to Improve Regional Land System Modeling (United States)

    Law, B. E.; Yang, Z.; Berner, L. T.; Hicke, J. A.; Buotte, P.; Hudiburg, T. W.


    Drought, fire and insects are major disturbances in the western US, and conditions are expected to get warmer and drier in the future. We combine multi-scale observations and modeling with CLM4.5 to examine the effects of these disturbances on forests in the western US. We modified the Community Land Model, CLM4.5, to improve simulated drought-related mortality in forests, and prediction of insect outbreaks under future climate conditions. We examined differences in plant traits that represent species variation in sensitivity to drought, and redefined plant groupings in PFTs. Plant traits, including sapwood area: leaf area ratio and stemwood density were strongly correlated with water availability during the ecohydrologic year. Our database of co-located observations of traits for 30 tree species was used to produce parameterization of the model by species groupings according to similar traits. Burn area predicted by the new fire model in CLM4.5 compares well with recent years of GFED data, but has a positive bias compared with Landsat-based MTBS. Biomass mortality over recent decades increased, and was captured well by the model in general, but missed mortality trends of some species. Comparisons with AmeriFlux data showed that the model with dynamic tree mortality only (no species trait improvements) overestimated GPP in dry years compared with flux data at semi-arid sites, and underestimated GPP at more mesic sites that experience dry summers. Simulations with both dynamic tree mortality and species trait parameters improved estimates of GPP by 17-22%; differences between predicted and observed NEE were larger. Future projections show higher productivity from increased atmospheric CO2 and warming that somewhat offsets drought and fire effects over the next few decades. Challenges include representation of hydraulic failure in models, and availability of species trait and carbon/water process data in disturbance- and drought-impacted regions.

  12. Heart rate autonomic regulation system at rest and during paced breathing among patients with CRPS as compared to age-matched healthy controls. (United States)

    Bartur, Gadi; Vatine, Jean-Jacques; Raphaely-Beer, Noa; Peleg, Sara; Katz-Leurer, Michal


    The objective of this study is to assess the autonomic nerve heart rate regulation system at rest and its immediate response to paced breathing among patients with complex regional pain syndrome (CRPS) as compared with age-matched healthy controls. Quasiexperimental. Outpatient clinic. Ten patients with CRPS and 10 age- and sex-matched controls. Participants underwent Holter ECG (NorthEast Monitoring, Inc., Maynard, MA, USA) recording during rest and biofeedback-paced breathing session. Heart rate variability (HRV), time, and frequency measures were assessed. HRV and time domain values were significantly lower at rest among patients with CRPS as compared with controls. A significant association was noted between pain rank and HRV frequency measures at rest and during paced breathing; although both groups reduced breathing rate significantly during paced breathing, HRV time domain parameters increased only among the control group. The increased heart rate and decreased HRV at rest in patients with CRPS suggest a general autonomic imbalance. The inability of the patients to increase HRV time domain values during paced breathing may suggest that these patients have sustained stress response with minimal changeability in response to slow-paced breathing stimuli. Wiley Periodicals, Inc.

  13. Antifibrillatory effects of renal denervation on ventricular fibrillation in a canine model of pacing-induced heart failure. (United States)

    Luo, Qingzhi; Jin, Qi; Zhang, Ning; Huang, Shangwei; Han, Yanxin; Lin, Changjian; Ling, Tianyou; Chen, Kang; Pan, Wenqi; Wu, Liqun


    What is the central question of this study? In the present study, we investigated the effects of renal denervation on the vulnerability to ventricular fibrillation and the ventricular electrical properties in a rapid pacing-induced heart failure canine model. What is the main finding and its importance? Renal denervation significantly attenuated the process of heart failure and improved left ventricular systolic dysfunction, stabilized ventricular electrophysiological properties and decreased the vulnerability of the heart to ventricular fibrillation during heart failure. Thus, renal denervation can attenuate ventricular electrical remodelling and exert a potential antifibrillatory action in a pacing-induced heart failure canine model. In this study, we investigated the effects of renal denervation (RDN) on the vulnerability to ventricular fibrillation (VF) and the ventricular electrical properties in a canine model of pacing-induced heart failure (HF). Eighteen beagles were divided into the following three groups: control (n = 6), HF (n = 6) and HF+RDN (n = 6). Heart failure was induced by rapid right ventricular pacing. Renal denervation was performed simultaneously with the pacemaker implantation in the HF+RDN group. A 64-unipolar basket catheter was used to perform global endocardial mapping of the left ventricle. The restitution properties and dispersion of refractoriness were estimated from the activation recovery intervals (ARIs) by a pacing protocol. The VF threshold (VFT) was defined as the maximal pacing cycle length required to induce VF using a specific pacing protocol. The defibrillation threshold (DFT) was measured by an up-down algorithm. Renal denervation partly restored left ventricular systolic function and attenuated the process of HF. Compared with the control group, the VFT in the HF group was decreased by 27% (106 ± 8.0 versus 135 ± 10 ms, P Renal denervation significantly flattened the ventricular ARI restitution curve by 15% (1

  14. [Improve the accessibility of essential drugs for the populations of one medical region in Burkina Faso]. (United States)

    Ridde, Valéry; Nitièma, Abdoulaye P; Dadjoari, Moussa


    Despite the formulation of the Bamako initiative in 1992 in Burkina Faso, not until 2001 and the launching of a project by a nongovernmental organization was the policy really implemented in a region of the country. One of the goals of this policy is to improve access to health care by using generic essential drugs. The objective of this article is to summarize the results of the evaluation of the project's ability to improve the population's access to drugs. The project lasted three years (2001-2003) and the interventions took place in 41 basic health centres of three districts. According to WHO, improving access to drugs requires consideration of four essential factors: rational use, affordable prices, financial viability, and effectiveness of the distribution. The average number of drugs prescribed per prescription sheet (n = 1061) was 2.4; 93% of the drugs were prescribed by their generic name (international non-proprietary names); 44% of infant diarrheas were treated with oral rehydration salt. National drug prices were respected but not the directives aiming at exempting from payment or subsidizing certain population sub-groups (children, indigents). The average annual cash flow of the basic health centres was 1.2 million F CFA and it increased by 854% compared to the beginning of the project. The cost-recovery scheme for administrative expenses was 106%. The average annual availability of the 10 essential drugs was 89%. Utilization rates increased (0.13 in 1999 to 0.21 in 2003) but not significantly differently than in other basic health centres of the area not supported by the project (p = 0.084). The project succeeded in improving access to these drugs for the overall population but not for the worst-off. The drugs are now geographically available for all and financially accessible for those who can afford to pay. The intervention strategy supported the sustainability of the project's activities but much remains to be done to provide the poorest with

  15. MFTF-B PACE tests and final cost report

    International Nuclear Information System (INIS)

    Krause, K.H.; Kozman, T.A.; Smith, J.L.; Horan, R.J.


    The Mirror Fusion Test Facility (MFTF-B) construction project was successfully completed in February 1986, with the conclusion of the Plant and Capital Equipment (PACE) Tests. This series of tests, starting in September 1985 and running through February 1986, demonstrated the overall machine capabilities and special facilities accomplishments for the Mirror Fusion Test Facility Project

  16. Self-Paced Physics, Segments 19-23. (United States)

    New York Inst. of Tech., Old Westbury.

    Five study segments of the Self-Paced Physics Course materials are presented in this fourth problems and solutions book used as a part of student course work. The subject matter is related to electric charges, insulators, Coulomb's law, electric fields, lines of force, solid angles, conductors, motion of charged particles, dipoles, electric flux,…

  17. The Effects of Self-Paced Blended Learning of Mathematics (United States)

    Balentyne, Phoebe; Varga, Mary Alice


    As online and blended learning gain more popularity in education, it becomes more important to understand their effects on student learning. The purpose of this study was to explore the effects of self-paced blended learning of mathematics on the attitudes and achievement of 26 high ability middle school students, and investigate the relationship…

  18. Hardware packet pacing using a DMA in a parallel computer (United States)

    Chen, Dong; Heidelberger, Phillip; Vranas, Pavlos


    Method and system for hardware packet pacing using a direct memory access controller in a parallel computer which, in one aspect, keeps track of a total number of bytes put on the network as a result of a remote get operation, using a hardware token counter.

  19. PACE: A dynamic programming algorithm for hardware/software partitioning

    DEFF Research Database (Denmark)

    Knudsen, Peter Voigt; Madsen, Jan


    This paper presents the PACE partitioning algorithm which is used in the LYCOS co-synthesis system for partitioning control/dataflow graphs into hardware and software parts. The algorithm is a dynamic programming algorithm which solves both the problem of minimizing system execution time...

  20. Self-Paced Physics, Segments 24-27. (United States)

    New York Inst. of Tech., Old Westbury.

    Four study segments of the Self-Paced Physics Course materials are presented in this fifth problems and solutions book used as a part of student course work. The subject matter is related to work in electric fields, potential differences, parallel plates, electric potential energies, potential gradients, capacitances, and capacitor circuits.…

  1. PACES: A Model of Student Well-Being (United States)

    Nelson, Mark D.; Tarabochia, Dawn W.; Koltz, Rebecca L.


    School counselors design, deliver, and evaluate comprehensive, developmental school counseling programs that are focused on enhancing student development and success. A model of student well-being, known as PACES, is defined and described that consists of five distinct and interactive domains: physical, affective, cognitive, economic, and social.…

  2. Determination of myocardial energetic output for cardiac rhythm pacing

    Czech Academy of Sciences Publication Activity Database

    Heřman, D.; Převorovská, Světlana; Maršík, František


    Roč. 7, č. 4 (2007), s. 156-161 ISSN 1567-8822 R&D Projects: GA ČR GA106/03/1073 Institutional research plan: CEZ:AV0Z20760514 Keywords : heart arrhythmia * cardiac pacing modes * numerical simulation Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery

  3. Keeping Pace with K-12 Online Learning, 2016 (United States)

    Gemin, Butch; Pape, Larry


    "Keeping Pace with K-12 Online Learning 2016" marks the thirteenth consecutive year Evergreen has published its annual research of the K-12 education online learning market. The thirteen years of researching, writing and publishing this report represents a time of remarkable change. There has been a constant presence that has become the…

  4. Optimizing Classroom Instruction through Self-Paced Learning Prototype (United States)

    Bautista, Romiro G.


    This study investigated the learning impact of self-paced learning prototype in optimizing classroom instruction towards students' learning in Chemistry. Two sections of 64 Laboratory High School students in Chemistry were used as subjects of the study. The Quasi-Experimental and Correlation Research Design was used in the study: a pre-test was…

  5. Amplitude and phase dynamics associated with acoustically paced finger tapping

    NARCIS (Netherlands)

    Boonstra, T.W.; Daffertshofer, A.; Peper, C.E.; Beek, P.J.


    To gain insight into the brain activity associated with the performance of an acoustically paced synchronization task, we analyzed the amplitude and phase dynamics inherent in magnetoencephalographic (MEG) signals across frequency bands in order to discriminate between evoked and induced responses.

  6. Self-Paced Physics, Segments 28-31. (United States)

    New York Inst. of Tech., Old Westbury.

    Four study segments of the Self-Paced Physics Course materials are presented in this sixth problems and solutions book used as a part of student course work. The subject matter is related to electric currents, current densities, resistances, Ohm's law, voltages, Joule heating, electromotive forces, single loop circuits, series and parallel…

  7. Introduction to Physics (Mechanics): A Semi-Self Paced Approach. (United States)

    Schlenker, Richard M.

    Presented is a guide for an introductory college level physics course in mechanics. The course is contract graded and allows students to proceed at their own pace; however, lectures, problem solving sessions, and laboratory sessions are included. Students on an independent basis review video tapes, film loops, library study, and conduct an…

  8. Design Recommendations for Self-Paced Online Faculty Development Courses (United States)

    Rizzuto, Melissa


    An increased need for self-paced, online professional development opportunities in higher education has emerged from a variety of factors including dispersed geographic locations of faculty, full teaching loads, and institutional evaluation requirements. This article is a report of the examination of the design and evaluation of a self-paced…

  9. Self-Paced Physics, Segments 37-40. (United States)

    New York Inst. of Tech., Old Westbury.

    Four study segments of the Self-Paced Physics Course materials are presented in this eighth problems and solutions book used as a part of course assignments. The content is related to magnetic induction, Faraday's law, induced currents, Lenz's law, induced electromotive forces, time-varying magnetic fields, self-inductance, inductors,…

  10. Polio Eradication Initiative: Contribution to improved communicable diseases surveillance in WHO African region. (United States)

    Mwengee, William; Okeibunor, Joseph; Poy, Alain; Shaba, Keith; Mbulu Kinuani, Leon; Minkoulou, Etienne; Yahaya, Ali; Gaturuku, Peter; Landoh, Dadja Essoya; Nsubuga, Peter; Salla, Mbaye; Mihigo, Richard; Mkanda, Pascal


    Since the launch of the Global Polio Eradication Initiative (GPEI) in 1988, there has been a tremendous progress in the reduction of cases of poliomyelitis. The world is on the verge of achieving global polio eradication and in May 2013, the 66th World Health Assembly endorsed the Polio Eradication and Endgame Strategic Plan (PEESP) 2013-2018. The plan provides a timeline for the completion of the GPEI by eliminating all paralytic polio due to both wild and vaccine-related polioviruses. We reviewed how GPEI supported communicable disease surveillance in seven of the eight countries that were documented as part of World Health Organization African Region best practices documentation. Data from WHO African region was also reviewed to analyze the performance of measles cases based surveillance. All 7 countries (100%) which responded had integrated communicable diseases surveillance core functions with AFP surveillance. The difference is on the number of diseases included based on epidemiology of diseases in a particular country. The results showed that the polio eradication infrastructure has supported and improved the implementation of surveillance of other priority communicable diseases under integrated diseases surveillance and response strategy. As we approach polio eradication, polio-eradication initiative staff, financial resources, and infrastructure can be used as one strategy to build IDSR in Africa. As we are now focusing on measles and rubella elimination by the year 2020, other disease-specific programs having similar goals of eradicating and eliminating diseases like malaria, might consider investing in general infectious disease surveillance following the polio example. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  11. Parent Involvement Activities in School Improvement Plans in the Northwest Region. Issues & Answers. REL 2008-No. 064 (United States)

    Speth, Timothy; Saifer, Steffen; Forehand, Gregory


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

  12. Seabed sets the pace for Ormen Lange

    International Nuclear Information System (INIS)

    Knott, T.


    The article describes Norway's Ormen Lange development with its 400 billion cubic metres of gas reserves. Its strategic importance is two-fold: (i) it will provide the infrastructure for Norway to unlock a new offshore region in mid-Norway and (ii) for Europe, it will coincide with an expected shortfall in gas supplies at a time of increasing energy demand. Ormen Lange is expected to be the driver for new gas developments for Norway in terms of production and exports. The Ormen Lange reservoir is 1900m below the seabed where the water depth is 800-1100m. At present, Norsk Hydro (the operator) is considering three main development options for the field's facilities and each is described. The seabed terrain presents some of the most difficult problems the industry has ever tackled

  13. Long pacing pulses reduce phrenic nerve stimulation in left ventricular pacing. (United States)

    Hjortshøj, Søren; Heath, Finn; Haugland, Morten; Eschen, Ole; Thøgersen, Anna Margrethe; Riahi, Sam; Toft, Egon; Struijk, Johannes Jan


    Phrenic nerve stimulation is a major obstacle in cardiac resynchronization therapy (CRT). Activation characteristics of the heart and phrenic nerve are different with higher chronaxie for the heart. Therefore, longer pulse durations could be beneficial in preventing phrenic nerve stimulation during CRT due to a decreased threshold for the heart compared with the phrenic nerve. We investigated if long pulse durations decreased left ventricular (LV) thresholds relatively to phrenic nerve thresholds in humans. Eleven patients, with indication for CRT and phrenic nerve stimulation at the intended pacing site, underwent determination of thresholds for the heart and phrenic nerve at different pulse durations (0.3-2.9 milliseconds). The resulting strength duration curves were analyzed by determining chronaxie and rheobase. Comparisons for those parameters were made between the heart and phrenic nerve, and between the models of Weiss and Lapicque as well. In 9 of 11 cases, the thresholds decreased faster for the LV than for the phrenic nerve with increasing pulse duration. In 3 cases, the thresholds changed from unfavorable for LV stimulation to more than a factor 2 in favor of the LV. The greatest change occurred for pulse durations up to 1.5 milliseconds. The chronaxie of the heart was significantly higher than the chronaxie of the phrenic nerve (0.47 milliseconds vs. 0.22 milliseconds [P = 0.029, Lapicque] and 0.79 milliseconds vs. 0.27 milliseconds [P = 0.033, Weiss]). Long pulse durations lead to a decreased threshold of the heart relatively to the phrenic nerve and may prevent stimulation of the phrenic nerve in a clinical setting. © 2013 Wiley Periodicals, Inc.

  14. Effects of self-paced interval and continuous training on health markers in women. (United States)

    Connolly, Luke J; Bailey, Stephen J; Krustrup, Peter; Fulford, Jonathan; Smietanka, Chris; Jones, Andrew M


    To compare the effects of self-paced high-intensity interval and continuous cycle training on health markers in premenopausal women. Forty-five inactive females were randomised to a high-intensity interval training (HIIT; n = 15), continuous training (CT; n = 15) or an inactive control (CON; n = 15) group. HIIT performed 5 × 5 min sets comprising repetitions of 30-s low-, 20-s moderate- and 10-s high-intensity cycling with 2 min rest between sets. CT completed 50 min of continuous cycling. Training was completed self-paced, 3 times weekly for 12 weeks. Peak oxygen uptake (16 ± 8 and 21 ± 12%), resting heart rate (HR) (-5 ± 9 and -4 ± 7 bpm) and visual and verbal learning improved following HIIT and CT compared to CON (P HIIT (P HIIT and CT, and there were no changes in fasting serum lipids, fasting blood [glucose] or [glucose] during an oral glucose tolerance test following either HIIT or CT (P > 0.05). No outcome variable changed in the CON group (P > 0.05). Twelve weeks of self-paced HIIT and CT were similarly effective at improving cardiorespiratory fitness, resting HR and cognitive function in inactive premenopausal women, whereas blood pressure, submaximal HR, well-being and body mass adaptations were training-type-specific. Both training methods improved established health markers, but the adaptations to HIIT were evoked for a lower time commitment.

  15. Pacing, Pixels, and Paper: Flexibility in Learning Words from Flashcards

    Directory of Open Access Journals (Sweden)

    Kara Sage


    Full Text Available The present study focused on how self-control over pace might help learners successfully extract information from digital learning aids. Past research has indicated that too much control over pace can be overwhelming, but too little control over pace can be ineffective. Within the popular self-testing domain of flashcards, we sought to elucidate the optimal level of user control for digital learning and compare learning outcomes between paper and digital flashcards. College students learned vocabulary from paper flashcards or one of several digital flashcard versions and were scored on their memory recall and asked about their perceptions of the learning process. With digital flashcards, students were randomly assigned to an automatic slideshow of cards with no user control, automatic slideshow with pre-set pauses, automatic slideshow where users could press the spacebar to pause at any time, or a self-paced slideshow with complete user control. Users reported feeling more in control when indeed having some control, but ultimately memory recall, cognitive load, and satisfaction were similar across the five versions. However, memory recall was positively related to user satisfaction with their specific flashcard set, and negatively related to users’ perceived mental effort and difficulty. Notably, whether paper or digital, students showed individual variability in how they advanced through the words. This research adds to the educational literature by suggesting that paper and digital flashcards are equally viable options for students. Given differences between individual users and the connection between satisfaction and recall, individualistic options that offer, but do not force, some control over pace seem ideal. Paper flashcards may already include such options, and e-flashcards should offer similar adaptive features to appeal to a wide variety of users.

  16. Improved Margins Detection of Regions Enriched with Gold Nanoparticles inside Biological Phantom

    Directory of Open Access Journals (Sweden)

    Yossef Danan


    Full Text Available Utilizing the surface plasmon resonance (SPR effect of gold nanoparticles (GNPs enables their use as contrast agents in a variety of biomedical applications for diagnostics and treatment. These applications use both the very strong scattering and absorption properties of the GNPs due to their SPR effects. Most imaging methods use the light-scattering properties of the GNPs. However, the illumination source is in the same wavelength of the GNPs’ scattering wavelength, leading to background noise caused by light scattering from the tissue. In this paper we present a method to improve border detection of regions enriched with GNPs aiming for the real-time application of complete tumor resection by utilizing the absorption of specially targeted GNPs using photothermal imaging. Phantoms containing different concentrations of GNPs were irradiated with a continuous-wave laser and measured with a thermal imaging camera which detected the temperature field of the irradiated phantoms. By modulating the laser illumination, and use of a simple post processing, the border location was identified at an accuracy of better than 0.5 mm even when the surrounding area got heated. This work is a continuation of our previous research.

  17. Diffuse intrinsic pontine glioma: is MRI surveillance improved by region of interest volumetry? (United States)

    Riley, Garan T; Armitage, Paul A; Batty, Ruth; Griffiths, Paul D; Lee, Vicki; McMullan, John; Connolly, Daniel J A


    Paediatric diffuse intrinsic pontine glioma (DIPG) is noteworthy for its fibrillary infiltration through neuroparenchyma and its resultant irregular shape. Conventional volumetry methods aim to approximate such irregular tumours to a regular ellipse, which could be less accurate when assessing treatment response on surveillance MRI. Region-of-interest (ROI) volumetry methods, using manually traced tumour profiles on contiguous imaging slices and subsequent computer-aided calculations, may prove more reliable. To evaluate whether the reliability of MRI surveillance of DIPGs can be improved by the use of ROI-based volumetry. We investigated the use of ROI- and ellipsoid-based methods of volumetry for paediatric DIPGs in a retrospective review of 22 MRI examinations. We assessed the inter- and intraobserver variability of the two methods when performed by four observers. ROI- and ellipsoid-based methods strongly correlated for all four observers. The ROI-based volumes showed slightly better agreement both between and within observers than the ellipsoid-based volumes (inter-[intra-]observer agreement 89.8% [92.3%] and 83.1% [88.2%], respectively). Bland-Altman plots show tighter limits of agreement for the ROI-based method. Both methods are reproducible and transferrable among observers. ROI-based volumetry appears to perform better with greater intra- and interobserver agreement for complex-shaped DIPG.

  18. Diffuse intrinsic pontine glioma: is MRI surveillance improved by region of interest volumetry?

    International Nuclear Information System (INIS)

    Riley, Garan T.; Armitage, Paul A.; Griffiths, Paul D.; Batty, Ruth; Connolly, Daniel J.A.; Lee, Vicki; McMullan, John


    Paediatric diffuse intrinsic pontine glioma (DIPG) is noteworthy for its fibrillary infiltration through neuroparenchyma and its resultant irregular shape. Conventional volumetry methods aim to approximate such irregular tumours to a regular ellipse, which could be less accurate when assessing treatment response on surveillance MRI. Region-of-interest (ROI) volumetry methods, using manually traced tumour profiles on contiguous imaging slices and subsequent computer-aided calculations, may prove more reliable. To evaluate whether the reliability of MRI surveillance of DIPGs can be improved by the use of ROI-based volumetry. We investigated the use of ROI- and ellipsoid-based methods of volumetry for paediatric DIPGs in a retrospective review of 22 MRI examinations. We assessed the inter- and intraobserver variability of the two methods when performed by four observers. ROI- and ellipsoid-based methods strongly correlated for all four observers. The ROI-based volumes showed slightly better agreement both between and within observers than the ellipsoid-based volumes (inter-[intra-]observer agreement 89.8% [92.3%] and 83.1% [88.2%], respectively). Bland-Altman plots show tighter limits of agreement for the ROI-based method. Both methods are reproducible and transferrable among observers. ROI-based volumetry appears to perform better with greater intra- and interobserver agreement for complex-shaped DIPG. (orig.)

  19. Diffuse intrinsic pontine glioma: is MRI surveillance improved by region of interest volumetry?

    Energy Technology Data Exchange (ETDEWEB)

    Riley, Garan T. [University Hospital of North Tees, Department of General Radiology, North Tees and Hartlepool NHS Foundation Trust, Stockton-on-Tees, Cleveland (United Kingdom); Armitage, Paul A.; Griffiths, Paul D. [University of Sheffield, Academic Unit of Radiology, Sheffield (United Kingdom); Batty, Ruth; Connolly, Daniel J.A. [Sheffield Children' s NHS Foundation Trust, Department of Radiology, Sheffield (United Kingdom); Lee, Vicki [Sheffield Children' s NHS Foundation Trust, Department of Oncology, Sheffield (United Kingdom); McMullan, John [Sheffield Children' s NHS Foundation Trust, Department of Neurosurgery, Sheffield (United Kingdom)


    Paediatric diffuse intrinsic pontine glioma (DIPG) is noteworthy for its fibrillary infiltration through neuroparenchyma and its resultant irregular shape. Conventional volumetry methods aim to approximate such irregular tumours to a regular ellipse, which could be less accurate when assessing treatment response on surveillance MRI. Region-of-interest (ROI) volumetry methods, using manually traced tumour profiles on contiguous imaging slices and subsequent computer-aided calculations, may prove more reliable. To evaluate whether the reliability of MRI surveillance of DIPGs can be improved by the use of ROI-based volumetry. We investigated the use of ROI- and ellipsoid-based methods of volumetry for paediatric DIPGs in a retrospective review of 22 MRI examinations. We assessed the inter- and intraobserver variability of the two methods when performed by four observers. ROI- and ellipsoid-based methods strongly correlated for all four observers. The ROI-based volumes showed slightly better agreement both between and within observers than the ellipsoid-based volumes (inter-[intra-]observer agreement 89.8% [92.3%] and 83.1% [88.2%], respectively). Bland-Altman plots show tighter limits of agreement for the ROI-based method. Both methods are reproducible and transferrable among observers. ROI-based volumetry appears to perform better with greater intra- and interobserver agreement for complex-shaped DIPG. (orig.)

  20. Improving plot- and regional-scale crop models for simulating impacts of climate variability and extremes (United States)

    Tao, F.; Rötter, R.


    Many studies on global climate report that climate variability is increasing with more frequent and intense extreme events1. There are quite large uncertainties from both the plot- and regional-scale models in simulating impacts of climate variability and extremes on crop development, growth and productivity2,3. One key to reducing the uncertainties is better exploitation of experimental data to eliminate crop model deficiencies and develop better algorithms that more adequately capture the impacts of extreme events, such as high temperature and drought, on crop performance4,5. In the present study, in a first step, the inter-annual variability in wheat yield and climate from 1971 to 2012 in Finland was investigated. Using statistical approaches the impacts of climate variability and extremes on wheat growth and productivity were quantified. In a second step, a plot-scale model, WOFOST6, and a regional-scale crop model, MCWLA7, were calibrated and validated, and applied to simulate wheat growth and yield variability from 1971-2012. Next, the estimated impacts of high temperature stress, cold damage, and drought stress on crop growth and productivity based on the statistical approaches, and on crop simulation models WOFOST and MCWLA were compared. Then, the impact mechanisms of climate extremes on crop growth and productivity in the WOFOST model and MCWLA model were identified, and subsequently, the various algorithm and impact functions were fitted against the long-term crop trial data. Finally, the impact mechanisms, algorithms and functions in WOFOST model and MCWLA model were improved to better simulate the impacts of climate variability and extremes, particularly high temperature stress, cold damage and drought stress for location-specific and large area climate impact assessments. Our studies provide a good example of how to improve, in parallel, the plot- and regional-scale models for simulating impacts of climate variability and extremes, as needed for

  1. Recommendations for pacemaker implantation for the treatment of atrial tachyarrhythmias and resynchronisation therapy for heart failure: A report from the task force on pacemaker indications of the Dutch Working Group on Cardiac Pacing. (United States)

    van Hemel, N M; Dijkman, B; de Voogt, W G; Beukema, W P; Bosker, H A; de Cock, C C; Jordaens, L J L M; van Gelder, I C; van Gelder, L M; van Mechelen, R; Ruiter, J H; Sedney, M I; Slegers, L C


    Today, new pacing algorithms and stimulation methods for the prevention and interruption of atrial tachyarrhythmias can be applied on patients who need bradycardia pacing for conventional reasons. In addition, biventricular pacing as additive treatment for patients with severe congestive heart failure due to ventricular systolic dysfunction and prolonged intraventricular conduction has shown to improve symptoms and reduce hospital admissions. These new pacing technologies and the optimising of the pacing programmes are complex, expensive and time-consuming. Based on many clinical studies the indications for these devices are beginning to emerge. To support the cardiologist's decision-making and to prevent waste of effort and resources, the 'ad hoc committee' has provided preliminary recommendations for implantable devices to treat atrial tachyarrhythmias and to extend the treatment of congestive heart failure respectively.

  2. Forty years of improvements in European air quality: regional policy-industry interactions with global impacts

    Directory of Open Access Journals (Sweden)

    M. Crippa


    Full Text Available The EDGARv4.3.1 (Emissions Database for Global Atmospheric Research global anthropogenic emissions inventory of gaseous (SO2, NOx, CO, non-methane volatile organic compounds and NH3 and particulate (PM10, PM2.5, black and organic carbon air pollutants for the period 1970–2010 is used to develop retrospective air pollution emissions scenarios to quantify the roles and contributions of changes in energy consumption and efficiency, technology progress and end-of-pipe emission reduction measures and their resulting impact on health and crop yields at European and global scale. The reference EDGARv4.3.1 emissions include observed and reported changes in activity data, fuel consumption and air pollution abatement technologies over the past 4 decades, combined with Tier 1 and region-specific Tier 2 emission factors. Two further retrospective scenarios assess the interplay of policy and industry. The highest emission STAG_TECH scenario assesses the impact of the technology and end-of-pipe reduction measures in the European Union, by considering historical fuel consumption, along with a stagnation of technology with constant emission factors since 1970, and assuming no further abatement measures and improvement imposed by European emission standards. The lowest emission STAG_ENERGY scenario evaluates the impact of increased fuel consumption by considering unchanged energy consumption since the year 1970, but assuming the technological development, end-of-pipe reductions, fuel mix and energy efficiency of 2010. Our scenario analysis focuses on the three most important and most regulated sectors (power generation, manufacturing industry and road transport, which are subject to multi-pollutant European Union Air Quality regulations. Stagnation of technology and air pollution reduction measures at 1970 levels would have led to 129 % (or factor 2.3 higher SO2, 71 % higher NOx and 69 % higher PM2.5 emissions in Europe (EU27, demonstrating the large

  3. Improved estimates of net primary productivity from MODIS satellite data at regional and local scales (United States)

    Yude Pan; Richard Birdsey; John Hom; Kevin McCullough; Kenneth Clark


    We compared estimates of net primary production (NPP) from the MODIS satellite with estimates from a forest ecosystem process model (PnET-CN) and forest inventory and analysis (FIA) data for forest types of the mid-Atlantic region of the United States. The regional means were similar for the three methods and for the dominant oak? hickory forests in the region. However...

  4. Effect of age and performance on pacing of marathon runners

    Directory of Open Access Journals (Sweden)

    Nikolaidis PT


    Full Text Available Pantelis Theodoros Nikolaidis,1 Beat Knechtle2,3 1Exercise Physiology Laboratory, Attiki, Greece; 2Gesundheitszentrum St. Gallen, St. Gallen, 3Institute of Primary Care, University of Zurich, Zurich, Switzerland Abstract: Pacing strategies in marathon runners have previously been examined, especially with regard to age and performance level separately. However, less information about the age × performance interaction on pacing in age-group runners exists. The aim of the present study was to examine whether runners with similar race time and at different age differ for pacing. Data (women, n=117,595; men, n=180,487 from the “New York City Marathon” between 2006 and 2016 were analyzed. A between–within subjects analysis of variance showed a large main effect of split on race speed (p<0.001, η2=0.538 with the fastest speed in the 5–10 km split and the slowest in the 35–40 km. A small sex × split interaction on race speed was found (p<0.001, η2=0.035 with men showing larger increase in speed at 5 km and women at 25 km and 40 km (end spurt. An age-group × performance group interaction on Δspeed was shown for both sexes at 5 km, 10 km, 15 km, 20 km, 25 km, 30 km, 35 km, and 40 km (p<0.001, 0.001≤η2≤0.004, where athletes in older age-groups presented a relatively more even pace compared with athletes in younger age-groups, a trend that was more remarkable in the relatively slow performance groups. So far, the present study is the first one to observe an age × performance interaction on pacing; ie, older runners pace differently (smaller changes than younger runners with similar race time. These findings are of great practical interest for coaches working with marathon runners of different age, but similar race time. Keywords: running, master athlete, endurance, aerobic capacity, fatigue, gender, race time

  5. Improving Focal Depth Estimates: Studies of Depth Phase Detection at Regional Distances (United States)

    Stroujkova, A.; Reiter, D. T.; Shumway, R. H.


    networks of regional stations using a Grid-search, Multiple-Event Location method (GMEL; Rodi and Toksöz, 2000; 2001). 3. Surface-wave dispersion inversion for event depth and focal mechanism (Herrmann and Ammon, 2002). To validate our approach and provide quality control for our solutions, we applied the techniques to moderated- sized events (mb between 4.5 and 6.0) with known focal mechanisms. We illustrate the techniques using events observed at regional distances from the KSAR (Wonju, South Korea) teleseismic array and other nearby broadband three-component stations. Our results indicate that the techniques can produce excellent agreement between the various depth estimates. In addition, combining the techniques into a "unified" estimate greatly reduced location errors and improved robustness of the solution, even if results from the individual methods yielded large standard errors.

  6. MICROX-2: an improved two-region flux spectrum code for the efficient calculation of group cross sections

    International Nuclear Information System (INIS)

    Mathews, D.; Koch, P.


    The MICROX-2 code is an improved version of the MICROX code. The improvements allow MICROX-2 to be used for the efficient and rigorous preparation of broad group neutron cross sections for poorly moderated systems such as fast breeder reactors in addition to the well moderated thermal reactors for which MICROX was designed. MICROX-2 is an integral transport theory code which solves the neutron slowing down and thermalization equations on a detailed energy grid for two-region lattice cells. The fluxes in the two regions are coupled by transport corrected collision probabilities. The inner region may include two different types of grains (particles). Neutron leakage effects are treated by performing B 1 slowing down and P 0 plus DB 2 thermalization calculations in each region. Cell averaged diffusion coefficients are prepared with the Benoist cell homogenization prescription

  7. Improved selection criteria for H II regions, based on IRAS sources (United States)

    Yan, Qing-Zeng; Xu, Ye; Walsh, A. J.; Macquart, J. P.; MacLeod, G. C.; Zhang, Bo; Hancock, P. J.; Chen, Xi; Tang, Zheng-Hong


    We present new criteria for selecting H II regions from the Infrared Astronomical Satellite (IRAS) Point Source Catalogue (PSC), based on an H II region catalogue derived manually from the all-sky Wide-field Infrared Survey Explorer (WISE). The criteria are used to augment the number of H II region candidates in the Milky Way. The criteria are defined by the linear decision boundary of two samples: IRAS point sources associated with known H II regions, which serve as the H II region sample, and IRAS point sources at high Galactic latitudes, which serve as the non-H II region sample. A machine learning classifier, specifically a support vector machine, is used to determine the decision boundary. We investigate all combinations of four IRAS bands and suggest that the optimal criterion is log(F_{60}/F_{12})≥ ( -0.19 × log(F_{100}/F_{25})+ 1.52), with detections at 60 and 100 {μ}m. This selects 3041 H II region candidates from the IRAS PSC. We find that IRAS H II region candidates show evidence of evolution on the two-colour diagram. Merging the WISE H II catalogue with IRAS H II region candidates, we estimate a lower limit of approximately 10 200 for the number of H II regions in the Milky Way.

  8. Improving breakdown voltage performance of SOI power device with folded drift region (United States)

    Qi, Li; Hai-Ou, Li; Ping-Jiang, Huang; Gong-Li, Xiao; Nian-Jiong, Yang


    A novel silicon-on-insulator (SOI) high breakdown voltage (BV) power device with interlaced dielectric trenches (IDT) and N/P pillars is proposed. In the studied structure, the drift region is folded by IDT embedded in the active layer, which results in an increase of length of ionization integral remarkably. The crowding phenomenon of electric field in the corner of IDT is relieved by the N/P pillars. Both traits improve two key factors of BV, the ionization integral length and electric field magnitude, and thus BV is significantly enhanced. The electric field in the dielectric layer is enhanced and a major portion of bias is borne by the oxide layer due to the accumulation of inverse charges (holes) at the corner of IDT. The average value of the lateral electric field of the proposed device reaches 60 V/μm with a 10 μm drift length, which increases by 200% in comparison to the conventional SOI LDMOS, resulting in a breakdown voltage of 607 V. Project supported by the Guangxi Natural Science Foundation of China (Grant Nos. 2013GXNSFAA019335 and 2015GXNSFAA139300), Guangxi Experiment Center of Information Science of China (Grant No. YB1406), Guangxi Key Laboratory of Wireless Wideband Communication and Signal Processing of China, Key Laboratory of Cognitive Radio and Information Processing (Grant No. GXKL061505), Guangxi Key Laboratory of Automobile Components and Vehicle Technology of China (Grant No. 2014KFMS04), and the National Natural Science Foundation of China (Grant Nos. 61361011, 61274077, and 61464003).

  9. Improving Satellite Retrieved Infrared Sea Surface Temperatures in Aerosol-Contaminated Regions (United States)

    Luo, B.; Minnett, P. J.; Szczodrak, G.; Kilpatrick, K. A.


    Infrared satellite observations of sea surface temperature (SST) have become essential for many applications in meteorology, climatology, and oceanography. Applications often require high accuracy SST data: for climate research and monitoring an absolute uncertainty of 0.1K and stability of better than 0.04K per decade are required. Tropospheric aerosol concentrations increase infrared signal attenuation and prevent the retrieval of accurate satellite SST. We compare satellite-derived skin SST with measurements from the Marine-Atmospheric Emitted Radiance Interferometer (M-AERI) deployed on ships during the Aerosols and Ocean Science Expeditions (AEROSE) and with quality-controlled drifter temperatures. After match-up with in-situ SST and filtering of cloud contaminated data, the results indicate that SST retrieved from MODIS (Moderate Resolution Imaging Spectroradiometer) aboard the Terra and Aqua satellites have negative (cool) biases compared to shipboard radiometric measurements. There is also a pronounced negative bias in the Saharan outflow area that can introduce SST errors >1 K at aerosol optical depths > 0.5. In this study, we present a new method to derive night-time Saharan Dust Index (SDI) algorithms based on simulated brightness temperatures at infrared wavelengths of 3.9, 10.8 and 12.0 μm, derived using RTTOV. We derived correction coefficients for Aqua MODIS measurements by regression of the SST errors against the SDI. The biases and standard deviations are reduced by 0.25K and 0.19K after the SDI correction. The goal of this study is to understand better the characteristics and physical mechanisms of aerosol effects on satellite retrieved infrared SST, as well as to derive empirical formulae for improved accuracies in aerosol-contaminated regions.

  10. Recombination region improvement for reduced efficiency roll-off in phosphorescent OLEDs with dual emissive layers

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Zhu; Zhou, Shunliang [State Key Laboratory of Electronic Thin Films and Integrated Devices, School of Optoelectronic Information, University of Electronic Science and Technology of China (UESTC), Chengdu 610054 (China); Hu, Song [Chengdu Institute of Optics and Electronics, Chinese Academy of Sciences, Chengdu 610209 (China); Yu, Junsheng, E-mail: [State Key Laboratory of Electronic Thin Films and Integrated Devices, School of Optoelectronic Information, University of Electronic Science and Technology of China (UESTC), Chengdu 610054 (China)


    High-performance phosphorescent organic light-emitting diodes (PhOLEDs) by using dual-emissive-layer (DEL) structure to reduce efficiency roll-off were fabricated. The DEL was comprised of a hole-transport-type host of N, N′-bis(naphthalen-1-yl)-N, N′-bis(phenyl)-benzidine (NPB) and a bipolar host of 4,4′-bis(carbazol-9-yl)biphenyl (CBP), which were both doped with an orange phosphorescent dopant of bis[2-(4-tert-butylphenyl)-benzothiazolato-N,C2′]iridium (acetylacetonate) [(t-bt){sub 2}Ir(acac)]. After the optimization of doping concentration of the first emissive layer (FEL), the device with DEL exhibited 11% lower roll-off power efficiency than single emissive layer devices (SED) when the luminance increased from 1000 cd/m{sup 2} to 10,000 cd/m{sup 2}. The hole–electron recombination zone in DEL was illuminated by inserting an ultrathin fluorescent probe of 4-(dicyanomethylene)-2-tert-butyl-6 (1,1,7,7-tetramethyljulolidin-4-yl-vinyl)-4H-pyran (DCJTB) in different emissive regions. The performance improvement was attributed to the optimization of energy barrier and the expansion of exciton formation zone within the DEL. - Highlights: • PhOLEDs by using a dual-emissive-layer structure to reduce efficiency roll-off were fabricated. • The DED exhibited 11% lower efficiency roll-off, 57% lower turn-on voltage, and 174% higher brightness than SED. • A DCJTB fluorescent probe was inserted at different positions of DED to investigate the expansion of exciton formation zone.

  11. The improvement gap in energy intensity: Analysis of China's thirty provincial regions using the improved DEA (data envelopment analysis) model

    International Nuclear Information System (INIS)

    Li, Ke; Lin, Boqiang


    Enacting a reduction target for energy intensity in provinces has become an important issue for the central and local governments in China. But the energy intensity index has provided little information about energy efficiency improvement potential. This study re-estimates the TFEE (total-factor energy efficiency) using an improved DEA (data envelopment analysis) model, which combines the super-efficiency and sequential DEA models to avoid “discriminating power problem” and “technical regress”, and then used it to calculated the TEI (target for energy intensity). The REI (improvement potential in energy intensity) is calculated by the difference between TEI and the actual level of energy intensity. In application, we calculate the REIs for different provinces under the metafrontier and group-frontier respectively, and their ratios are the technology gaps for energy use. The main result shows that China's REIs fluctuate around 21%, 7.5% and 12% for Eastern, Central and Western China respectively; and Eastern China has the highest level of energy technology. These findings reveal that energy intensities of China's provinces do not converge to the optimal level. Therefore, the target of energy-saving policy for regions should be enhancing the energy efficiency of the inefficient ones, and thereby reduce the gap for improvement in energy intensity across regions. - Highlights: • We present an improved DEA model to calculate the TFEE (total-factor energy efficiency). • The improved TFEE combines with a meta-frontier analysis. • We estabilish a new indicator for improvement gap in energy intensity. • Improvement in energy intensity of regions in China is analysed

  12. Permanent pacing in infants and children: A single center experience in implantation and follow up

    Directory of Open Access Journals (Sweden)

    Rania Samir


    Conclusion: Permanent pacing in pediatric age group is relatively safe. However, there is substantial higher incidence of suboptimal pacing parameters and pacing system failures especially in younger and smaller children. Epicardial steroid eluting leads are comparable to endocardial steroid eluting leads in performance.

  13. Optimal pacing strategy: From theoretical modeling to reality in 1500m speed skating

    NARCIS (Netherlands)

    Hettinga, F.J.; de Koning, J.J.; Schmidt, L.J.I.; Wind, N.A.C.; McIntosh, B.; Foster, C.


    Purpose: Athletes are trained to choose the pace which is perceived to be correct during a specific effort, such as the 1500-m speed skating competition. The purpose of the present study was to "override" self-paced (SP) performance by instructing athletes to execute a theoretically optimal pacing

  14. Optimal pacing strategy : from theoretical modelling to reality in 1500-m speed skating

    NARCIS (Netherlands)

    Hettinga, F. J.; De Koning, J. J.; Schmidt, L. J. I.; Wind, N. A. C.; MacIntosh, B. R.; Foster, C.

    Purpose Athletes are trained to choose the pace which is perceived to be correct during a specific effort, such as the 1500-m speed skating competition. The purpose of the present study was to "override" self-paced (SP) performance by instructing athletes to execute a theoretically optimal pacing

  15. Predicting Successful Completion Using Student Delay Indicators in Undergraduate Self-Paced Online Courses (United States)

    Lim, Janine M.


    Self-paced online courses meet flexibility and learning needs of many students, but skepticism persists regarding the quality and the tendency for students to procrastinate in self-paced courses. Research is needed to understand procrastination and delay patterns of students in online self-paced courses to predict successful completion and…


    Directory of Open Access Journals (Sweden)

    Michael Dementiev


    Full Text Available The article considers the issues of analyzing market environment and assess the current and strategic competitiveness of winemaking enterprises of Crimea region. On the basis of the conducted analysis, the grouping of winemaking enterprises on the level of potential use of the capabilities of the environment, as well as the proposed strategy for the development of wine-making enterprises of the Crimean region-based matching to realize the potential of market environment and competitive advantages of regional production.

  17. Improving cluster-based methods for investigating potential for insect pest species establishment: region-specific risk factors

    Directory of Open Access Journals (Sweden)

    Michael J. Watts


    Full Text Available Existing cluster-based methods for investigating insect species assemblages or profiles of a region to indicate the risk of new insect pest invasion have a major limitation in that they assign the same species risk factors to each region in a cluster. Clearly regions assigned to the same cluster have different degrees of similarity with respect to their species profile or assemblage. This study addresses this concern by applying weighting factors to the cluster elements used to calculate regional risk factors, thereby producing region-specific risk factors. Using a database of the global distribution of crop insect pest species, we found that we were able to produce highly differentiated region-specific risk factors for insect pests. We did this by weighting cluster elements by their Euclidean distance from the target region. Using this approach meant that risk weightings were derived that were more realistic, as they were specific to the pest profile or species assemblage of each region. This weighting method provides an improved tool for estimating the potential invasion risk posed by exotic species given that they have an opportunity to establish in a target region.

  18. Ice slurry ingestion does not enhance self-paced intermittent exercise in the heat. (United States)

    Gerrett, N; Jackson, S; Yates, J; Thomas, G


    This study aimed to determine if ice slurry ingestion improved self-paced intermittent exercise in the heat. After a familiarisation session, 12 moderately trained males (30.4 ± 3.4 year, 1.8 ± 0.1 cm, 73.5 ± 14.3 kg, V˙O 2max 58.5 ± 8.1 mL/kg/min) completed two separate 31 min self-paced intermittent protocols on a non-motorised treadmill in 30.9 ± 0.9 °C, 41.1 ± 4.0% RH. Thirty minutes prior to exercise, participants consumed either 7.5 g/kg ice slurry (0.1 ± 0.1 °C) (ICE) or 7.5 g/kg water (23.4 ± 0.9 °C) (CONTROL). Despite reductions in T c (ΔT c : -0.51 ± 0.3 °C, P exercise, ICE did not enhance self-paced intermittent exercise compared to CONTROL. The average speed during the walk (CONTROL: 5.90 ± 1.0 km, ICE: 5.90 ± 1.0 km), jog (CONTROL: 8.89 ± 1.7 km, ICE: 9.11 ± 1.5 km), run (CONTROL: 12.15 ± 1.7 km, ICE: 12.54 ± 1.5 km) and sprint (CONTROL: 17.32 ± 1.3 km, ICE: 17.18 ± 1.4 km) was similar between conditions (P > 0.05). Mean T sk , T b , blood lactate, heart rate and RPE were similar between conditions (P > 0.05). The findings suggest that lowering T c prior to self-paced intermittent exercise does not translate into an improved performance. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Organizational Learning: Keeping Pace with Change through Action Learning


    Yeadon-Lee, Annie


    In the current climate of economic ‘austerity’, organisational learning has increasingly gained importance, and a need for new ways of transferring learning has been identified. Organisational learning is seen as key to organisational success, ensuring both competitive advantage and organisational longevity. However, in order for organisations to keep pace with change they must not only strive to learn but also pay attention to how they might learn. A dominant view within the field of organis...

  20. San Francisco Bay Water Quality Improvement Fund Points, SF Bay CA, 2015, US EPA Region 9 (United States)

    U.S. Environmental Protection Agency — The San Francisco Bay Water Quality Improvement Fund is a competitive grant program that is helping implement TMDLs to improve water quality, protect wetlands, and...

  1. Strategic Priorities for Improving Access to Quality Education in the Kurdistan Region--Iraq. Monograph (United States)

    Vernez, Georges; Culbertson, Shelly; Constant, Louay


    The Kurdistan Regional Government (KRG) began an ambitious reform of the Kurdistan Region of Iraq's (KRI's) kindergarten through grade 12 (K-12) education system beginning in 2007 in an effort to modernize the curriculum, upgrade school facilities, and raise the quality of instruction. In 2010, RAND was asked to conduct a one-year study to assess…

  2. Factors affecting the regulation of pacing: current perspectives

    Directory of Open Access Journals (Sweden)

    Mauger AR


    Full Text Available Alexis R Mauger Endurance Research Group, School of Sport and Exercise Sciences, Faculty of Science, University of Kent, Chatham, UK Abstract: During prolonged dynamic and rhythmic exercise, muscular pain and discomfort arises as a result of an increased concentration of deleterious metabolites. Sensed by peripheral nociceptors and transmitted via afferent feedback to the brain, this provides important information regarding the physiological state of the muscle. These sensations ultimately contribute to what is termed "exercise-induced pain". Despite being well recognized by athletes and coaches, and suggested to be integral to exercise performance, this construct has largely escaped attention in experimental work. This perspective article highlights the current understanding of pacing in endurance performance, and the causes of exercise-induced pain. A new perspective is described, which proposes how exercise-induced pain may be a contributing factor in helping individuals to regulate their work rate during exercise and thus provides an important construct in pacing. Keywords: pain, exercise-induced pain, discomfort, exercise performance, self-paced

  3. Optimizing classroom instruction through self-paced learning prototype

    Directory of Open Access Journals (Sweden)

    Romiro Gordo Bautista


    Full Text Available This study investigated the learning impact of self-paced learning prototype in optimizing classroom instruction towards students’ learning in Chemistry. Two sections of 64 Laboratory High School students in Chemistry were used as subjects of the study. The Quasi-Experimental and Correlation Research Design was used in the study: a pre-test was conducted, scored and analyzed which served as the basis in determining the initial learning schema of the respondents. A questionnaire was adopted to find the learning motivation of the students in science. Using Pearson-r correlation, it was found out that there is a highly significant relationship between their internal drive and their academic performance. Moreover, a post-test was conducted after self-paced learning prototype was used in the development of select topics in their curricular plot. It was found out that the students who experienced the self-paced learning prototype performed better in their academic performance as evidenced by the difference of their mean post-test results. ANCOVA results on the post-test mean scores of the respondents were utilized in establishing the causal-effect of the learning prototype to the academic performance of the students in Chemistry. A highly significant effect on their academic performance (R-square value of 70.7% and significant interaction of the models to the experimental grouping and mental abilities of the respondents are concluded in the study.

  4. Unilateral Laryngeal Pacing System and Its Functional Evaluation

    Directory of Open Access Journals (Sweden)

    Taiping Zeng


    Full Text Available Goal. To establish a reliable instrumental system for synchronized reactivation of a unilaterally paralyzed vocal fold and evaluate its functional feasibility. Methods. Unilateral vocal fold paralysis model was induced by destruction of the left recurrent laryngeal nerve (RLN in anesthetized dogs. With a micro controller-based electronic system, electromyography (EMG signals from cricothyroid (CT muscle on the ipsilateral side were recorded and used to trigger pacing of paralyzed vocalis muscles. The dynamic movement of vocal folds was continuously monitored using an endoscope, and the opening and closing of the glottis were quantified with customized imaging processing software. Results. The recorded video images showed that left side vocal fold was obviously paralyzed after destructing the RLN. Using the pacing system with feedback triggering EMG signals from the ipsilateral CT muscle, the paralyzed vocal fold was successfully reactivated, and its movement was shown to be synchronized with the healthy side. Significance. The developed unilateral laryngeal pacing system triggered by EMG from the ipsilateral side CT muscle could be successfully used in unilateral vocal fold paralysis with the advantage of avoiding disturbance to the healthy side muscles.

  5. Pacing and awareness: brain regulation of physical activity. (United States)

    Edwards, A M; Polman, R C J


    The aim of this current opinion article is to provide a contemporary perspective on the role of brain regulatory control of paced performances in response to exercise challenges. There has been considerable recent conjecture as to the role of the brain during exercise, and it is now broadly accepted that fatigue does not occur without brain involvement and that all voluntary activity is likely to be paced at some level by the brain according to individualised priorities and knowledge of personal capabilities. This article examines the role of pacing in managing and distributing effort to successfully accomplish physical tasks, while extending existing theories on the role of the brain as a central controller of performance. The opinion proposed in this article is that a central regulator operates to control exercise performance but achieves this without the requirement of an intelligent central governor located in the subconscious brain. It seems likely that brain regulation operates at different levels of awareness, such that minor homeostatic challenges are addressed automatically without conscious awareness, while larger metabolic disturbances attract conscious awareness and evoke a behavioural response. This supports the view that the brain regulates exercise performance but that the interpretation of the mechanisms underlying this effect have not yet been fully elucidated.

  6. Comparison of Long-Term Effect of Dual-Chamber Pacing and Alcohol Septal Ablation in Patients with Hypertrophic Obstructive Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Jan Krejci


    Full Text Available Introduction. Nonpharmacological treatment of patients with hypertrophic obstructive cardiomyopathy (HOCM comprises surgical myectomy (SME, alcohol septal ablation (ASA, and dual-chamber (DDD pacing. The aim of the study was to compare the long-term effect of DDD pacing and ASA in symptomatic HOCM patients. Patients and Methods. We evaluated retrospective data from three cardiocenters; there were 24 patients treated with DDD pacing included and 52 treated with ASA followed for 101 ± 49 and 87 ± 23 months, respectively. Results. In the group treated with DDD pacing, the left ventricle outflow tract gradient (LVOTG decreased from 82 ± 44 mmHg to 21 ± 21 mmHg, and NYHA class improved from 2.7 ± 0.5 to 2.1 ± 0.6 (both P<0.001. In the ASA-treated group, a decline in LVOTG from 73 ± 38 mmHg to 24 ± 26 mmHg and reduction in NYHA class from 2.8 ± 0.5 to 1.7 ± 0.8 were observed (both P<0.001. The LVOTG change was similar in both groups (P=0.264, and symptoms were more affected by ASA (P=0.001. Conclusion. ASA and DDD pacing were similarly effective in reducing LVOTG. The symptoms improvement was more expressed in patients treated with ASA.

  7. Improvement of tool support of the spatial approach to regional planning: problems, specifics, trends

    Directory of Open Access Journals (Sweden)

    Nataliya Gennadievna Yushkova


    Full Text Available The emerging imperatives of innovation economic development in Russia determine the content of conceptual and institutional constraints to the development of regional economic systems (RES. They consider the regional planning system as a leading priority in its inseparable unity with modern public administration tasks. However, the practice of development of long-term plans in the RF subjects proves that the innovation challenges of economic policy are not reflected properly in them or they are significantly distorted. The following reasons reduce the effectiveness of modernization processes in the RF subjects and hamper the appropriate reaction of RES on their impact: the lack of coordination between socio-economic and spatial regional plans, the imbalance of interaction between state authorities engaged in long-term planning, the lack of real prerequisites for the implementation of innovation initiatives in the regions. Systematization and analysis of long-term plans make it possible to substantiate the consistency of the spatial approach to regional planning expressed in the dominance of the transformational function that synchronizes the configuration and parameters of RES, and to establish ways to integrate spatial components in the system of regional planning through optimization of its tool support. The change in the content of the instrumentation support is based on the synthesis of the predominant basic characteristics of the existing tools used in isolated subsystems of regional planning of socio-economic and territorial development. The study has established a system of tool support for regional planning that adapts to the changes in both internal and external factors in the development of RES. Three main groups of tools: organizing, regulating, and coordinating are defined by their typing in accordance with the groups of management functions. The article proposes the modeling of combinations of tools that are subordinated to the

  8. Flow conditioning for improved optical propagation of beams through regions bounded by surfaces of high solidity

    International Nuclear Information System (INIS)

    Robey, H.F.; Albrecht, G.F.; Freitas, B.L.


    A flow conditioning system has been designed to maximize the thermal homogeneity in an enclosed region through which a laser beam must propagate. In the present application, such an enclosed region exists between the Nd:glass disks of a high average power solid-state laser amplifier. Experiments have been conducted on a test facility to quantify the magnitude of the beam losses due to thermal scattering. It is shown that the intensity of the incoherent light which is thermally scattered from this region can be reduced to less than 0.1% of the incident-beam intensity under apropriate flow and cooling conditions

  9. Improving Estimation of Evapotranspiration under Water-Limited Conditions Based on SEBS and MODIS Data in Arid Regions

    Directory of Open Access Journals (Sweden)

    Chunlin Huang


    Full Text Available This study proposes a method for improving the estimation of surface turbulent fluxes in surface energy balance system (SEBS model under water stress conditions using MODIS data. The normalized difference water index (NDWI as an indicator of water stress is integrated into SEBS. To investigate the feasibility of the new approach, the desert-oasis region in the middle reaches of the Heihe River Basin (HRB is selected as the study area. The proposed model is calibrated with meteorological and flux data over 2008–2011 at the Yingke station and is verified with data from 16 stations of the Heihe Watershed Allied Telemetry Experimental Research (HiWATER project in 2012. The results show that soil moisture significantly affects evapotranspiration (ET under water stress conditions in the study area. Adding the NDWI in SEBS can significantly improve the estimations of surface turbulent fluxes in water-limited regions, especially for spare vegetation cover area. The daily ET maps generated by the new model also show improvements in drylands with low ET values. This study demonstrates that integrating the NDWI into SEBS as an indicator of water stress is an effective way to improve the assessment of the regional ET in semi-arid and arid regions.

  10. Improvement of the complex mechanism of state administration of E-government process on the regional level

    Directory of Open Access Journals (Sweden)

    K. G. Kondakov


    Suggested structure of the Department will contribute to the improvement of administrative relations between national and regional administration levels. According to the offered structure, main tasks of the structural sub-divisions in the above-mentioned Department have also been defined.

  11. Improved analysis of long-term monitoring data demonstrates marked regional declines of bat populations in the eastern United States (United States)

    Thomas E. Ingersoll; Brent J. Sewall; Sybill K. Amelon


    Bats are diverse and ecologically important, but are also subject to a suite of severe threats. Evidence for localized bat mortality from these threats is well-documented in some cases, but long-term changes in regional populations of bats remain poorly understood. Bat hibernation surveys provide an opportunity to improve understanding, but analysis is complicated by...

  12. Characterizing Spatial Dynamics of Bifurcation to Alternans in Isolated Whole Rabbit Hearts Based on Alternate Pacing

    Directory of Open Access Journals (Sweden)

    Kanchan Kulkarni


    Full Text Available Sudden cardiac death instigated by ventricular fibrillation (VF is the largest cause of natural death in the USA. Alternans, a beat-to-beat alternation in the action potential duration, has been implicated as being proarrhythmic. The onset of alternans is mediated via a bifurcation, which may occur through either a smooth or a border-collision mechanism. The objective of this study was to characterize the mechanism of bifurcation to alternans based on experiments in isolated whole rabbit hearts. High resolution optical mapping was performed and the electrical activity was recorded from the left ventricle (LV epicardial surface of the heart. Each heart was paced using an “alternate pacing protocol,” where the basic cycle length (BCL was alternatively perturbed by ±δ. Local onset of alternans in the heart, BCLstart, was measured in the absence of perturbations (δ=0 and was defined as the BCL at which 10% of LV exhibited alternans. The influences of perturbation size were investigated at two BCLs: one prior to BCLstart (BCLprior=BCLstart+20 ms and one preceding BCLprior (BCLfar=BCLstart+40 ms. Our results demonstrate significant spatial correlation of the region exhibiting alternans with smooth bifurcation characteristics, indicating that transition to alternans in isolated rabbit hearts occurs predominantly through smooth bifurcation.

  13. Coronal View Ultrasound Imaging of Movement in Different Segments of the Tongue during Paced Recital: Findings from Four Normal Speakers and a Speaker with Partial Glossectomy (United States)

    Bressmann, Tim; Flowers, Heather; Wong, Willy; Irish, Jonathan C.


    The goal of this study was to quantitatively describe aspects of coronal tongue movement in different anatomical regions of the tongue. Four normal speakers and a speaker with partial glossectomy read four repetitions of a metronome-paced poem. Their tongue movement was recorded in four coronal planes using two-dimensional B-mode ultrasound…


    Directory of Open Access Journals (Sweden)

    Ekaterina C. Chimitdorzhieva


    Full Text Available The problems of spatial socio-economic development of the region are considered in this article. Special attention is given to transport infrastructure. The authors propose methodical instruments for evaluating the influence of transport infrastructure on spatial development of region based on research of theoretic-methodical aspects of economic growth theory, location of economic activity and development concepts of infrastructural provision.

  15. Improving Public Health and Environment through Plastic Waste Management in Mumbai Metropolitan Region

    Directory of Open Access Journals (Sweden)

    Sanjay RODE


    Full Text Available The Mumbai Metropolitan Region is growing in terms of population, industry, educational and commercial units. The daily requirements of commodities and services by all units have increased fast. Plastic is used extensively for packing, protection and service of various commodities. The use of plastic is much higher by industry and households in region. In Brihan Mumbai Municipal Corporation, the density of population is higher. The concentration of small and large industries is more. Therefore the plastic use is much higher for different purposes. It leads to more waste of plastic. In Ulhasnagar Municipal Corporation, the population and industrial units are less. Therefore plastic waste is less generated. Theaters are generating less plastic waste in metropolitan region. The Brihan Mumbai Municipal Corporation (BMC and municipal corporations in Thane district will continuously generate more plastic waste in future. The Tobit regression model shows that plastic waste is positively co-related and statistically significant with pollution and industry in region. Therefore the comprehensive policies are required to reduce plastic waste. This is because plastic waste is affecting on the health of human being. It also affects negatively on soil, air and water. The entire food supply chain gets affected due to plastic waste. The water logging is common due to plastic waste in region. It chock ups the drainage system and it becomes the ground for mosquitoes. It further leads to dengue, malaria and other diseases in region. Municipal corporations must collect plastic in separate bins and process it. The plastic and e-waste can be utilized for road construction in region. All the policies will certainly help to reduce the plastic waste and maintain the clean environment in region.

  16. Improving Public Health and Environment through Plastic Waste Management in Mumbai Metropolitan Region


    Sanjay RODE


    The Mumbai Metropolitan Region is growing in terms of population, industry, educational and commercial units. The daily requirements of commodities and services by all units have increased fast. Plastic is used extensively for packing, protection and service of various commodities. The use of plastic is much higher by industry and households in region. In Brihan Mumbai Municipal Corporation, the density of population is higher. The concentration of small and large industries is more. Therefor...

  17. Improvement of Measurement and Evaluation of Regional Authorities Activity: Model and Statistical Approach

    Directory of Open Access Journals (Sweden)

    Petrova Elena Аleksandrovna


    Full Text Available Formation of strategy of long-term social and economic development is a basis for effective functioning of executive authorities and the assessment of its efficiency in general. Modern theories of assessment of public administration productivity are guided by the process approach when it is expedient to carry out the formation of business processes of regional executive authorities according to strategic indicators of territorial development. In this regard, there is a problem of modeling of interrelation of indicators of social and economic development of the region and quantitative indices of results of business processes of executive authorities. At the first stage of modeling, two main directions of strategic development, namely innovative and investment activity of regional economic systems are considered. In this regard, the work presents the results of modeling the interrelation between the indicators of regional social and economic development and innovative and investment activity. Therefore, for carrying out the analysis, the social and economic system of the region is presented in space of the main indicators of social and economic development of the territory and indicators of innovative and investment activity. The analysis is made on values of the indicators calculated for regions of the Russian Federation during 2000, 2005, 2008, 2010 and 2011. It was revealed that strategic indicators of innovative and investment activity have the most significant impact on key signs of social and economic development.

  18. Effect of short-term rapid ventricular pacing followed by pacing interruption on arterial blood pressure in healthy pigs and pigs with tachycardiomyopathy. (United States)

    Skrzypczak, P; Zyśko, D; Pasławska, U; Noszczyk-Nowak, A; Janiszewski, A; Gajek, J; Nicpoń, J; Kiczak, L; Bania, J; Zacharski, M; Tomaszek, A; Jankowska, E A; Ponikowski, P; Witkiewicz, W


    Ventricular tachycardia may lead to haemodynamic deterioration and, in the case of long term persistence, is associated with the development of tachycardiomyopathy. The effect of ventricular tachycardia on haemodynamics in individuals with tachycardiomyopathy, but being in sinus rhythm has not been studied. Rapid ventricular pacing is a model of ventricular tachycardia. The aim of this study was to determine the effect of rapid ventricular pacing on blood pressure in healthy animals and those with tachycardiomyopathy. A total of 66 animals were studied: 32 in the control group and 34 in the study group. The results of two groups of examinations were compared: the first performed in healthy animals (133 examinations) and the second performed in animals paced for at least one month (77 examinations). Blood pressure measurements were taken during chronic pacing--20 min after onset of general anaesthesia, in baseline conditions (20 min after pacing cessation or 20 min after onset of general anaesthesia in healthy animals) and immediately after short-term rapid pacing. In baseline conditions significantly higher systolic and diastolic blood pressure was found in healthy animals than in those with tachycardiomyopathy. During an event of rapid ventricular pacing, a significant decrease in systolic and diastolic blood pressure was found in both groups of animals. In the group of chronically paced animals the blood pressure was lower just after restarting ventricular pacing than during chronic pacing. Cardiovascular adaptation to ventricular tachycardia develops with the length of its duration. Relapse of ventricular tachycardia leads to a blood pressure decrease more pronounced than during chronic ventricular pacing.

  19. [Genetic improvement of cotton varieties in Huang-Huai region in China since 1950's. III. Improvement on agronomy properties, disease resistance and stability]. (United States)

    Jiang, B G; Kong, F L; Zhang, Q Y; Yang, F X; Jiang, R Q


    Data from a set of 5-location and 2-year experiments on 10 representative historical cotton varieties and the data of Huang-Huai Regional Cotton Trials from 1973 to 1996 were analyzed to estimate the effects of genetic improvement in agronomy properties, disease resistance and stability of cotton in Huang-Huai Region in China. The results indicated that a great genetic progress of earliness and disease resistance had been achieved by breeding programs since 1950's. The maturity was shortened 3-5 days; The rate of preforst yield was increased about 7 percentages. The problem of resistance to Fususium wilt has been solved and the resistance to Verticillum wilt was improving. Some progress in stability of cotton varieties also has been achieved by breeding programs since 1950.

  20. From community-based pilot testing to region-wide systems change: lessons from a local quality improvement collaborative. (United States)

    Keyser, Donna J; Pincus, Harold Alan


    A community-based collaborative conducted a 2-year pilot study to inform efforts for improving maternal and child health care practice and policy in Allegheny County, Pennsylvania. (1) To test whether three small-scale versions of an evidence-based, systems improvement approach would be workable in local community settings and (2) to identify specific policy/infrastructure reforms for sustaining improvements. A mixed methods approach was used, including quantitative performance measurement supplemented with qualitative data about factors related to outcomes of interest, as well as key stakeholder interviews and a literature review/Internet search. Quantitative performance results varied; qualitative data revealed critical factors for the success and failure of the practices tested. Policy/infrastructure recommendations were developed to address specific practice barriers. This information was important for designing a region-wide quality improvement initiative focused on maternal depression. The processes and outcomes provide valuable insights for other communities interested in conducting similar quality improvement initiatives.

  1. Neoindustrialization as a factor in improving economic security of old-industrial regions

    Directory of Open Access Journals (Sweden)

    Ol’ga Aleksandrovna Romanova


    Full Text Available This paper proves that the paradigm of the world of the XXIcentury is neoindustrialization on the basis of alternativestrategic goals of the global economy associated with the formation of post-industrial society and financialization neoindustrialization. A systematic proposal for the driving forces and mechanisms for its implementation is suggested. It is shown that target-oriented approach can be successfully used at the regional level as a mechanism for economic neoindustrialization of an old-industrial region. Conceptual approach to developing comprehensive program of industrial development in the industrial region that implements the ideas of neoindustrialization in relation to industry of Sverdlovsk region is presented. It was found that the regional technology platform can be an effective tool for combining the interests of territorial and sectoral development. It is proved that the idea of neoindustrialization can be realized only as a result of wise industrial policy and road map formation for the movement to an entirely new high-tech based industrial development. In the process of forming, the problem of neoindustrialization of a «pure» market as a factor in increasing the economic security is actualized.

  2. Improving Innovation in University Spin-Offs. The Fostering Role of University and Region

    Directory of Open Access Journals (Sweden)

    Antonio Prencipe


    Full Text Available University spin-offs (USOs are companies created to commercialize knowledge or technology developed in academia; thus, their major contribution to the knowledge economy is their ability to generate innovation. Following the Resource-Based View of the Firm and the Knowledge Spillover Theory of Entrepreneurship, it was stated that fostering mechanisms at university level and at regional level may positively influence the USOs innovation. Based on a sample of 621 Italian USOs, we show that the positive impact of the university context is more crucial compared with those of the regional context. In particular, the university affiliated business incubators and Science Parks, jointly with the university financial resources, seem to promote the innovation efforts of USOs. These evidences rise the need of a resilient partnership among all the contextual players involved in the spillover processes, mainly at regional level, in order to effectively exploit the potential innovative efforts of the university start-ups.

  3. Ways to improve the use of donor resources in the Nizhny Novgorod Region

    Directory of Open Access Journals (Sweden)

    S. V. Romanov


    Full Text Available The article analyzes the system of organ transplantation in the Nizhny Novgorod Region in order to determine the ways to optimize the use of donor resource. The authors found that the most difficult are the program activities, the success of which depends on the attitude of health care employees and the population of the region. In this regard, a questionnaire survey was conducted; its results indicated a lack of awareness among doctors and the public about the transplantation role in modern medicine and the legislation in this sphere of relations. The authors come to the conclusion on the importance of the outreach and promotion of the posthumous organ donation program among health care employees and all population groups to optimize the use of donor resource of the region

  4. A novel nanoscale SOI MOSFET by embedding undoped region for improving self-heating effect (United States)

    Ghaffari, Majid; Orouji, Ali A.


    Because of the low thermal conductivity of the SiO2 (oxide), the Buried Oxide (BOX) layer in a Silicon-On-Insulator Metal-Oxide Semiconductor Field-Effect Transistor (SOI MOSFET) prevents heat dissipation in the silicon layer and causes increase in the device lattice temperature. In this paper, a new technique is proposed for reducing Self-Heating Effects (SHEs). The key idea in the proposed structure is using a Silicon undoped Region (SR) in the nanoscale SOI MOSFET under the drain and channel regions in order to decrease the SHE. The novel transistor is named Silicon undoped Region SOI-MOSFET (SR-SOI). Due to the embedded silicon undoped region in the suitable place, the proposed structure has decreased the device lattice temperature. The location and dimensions of the proposed region have been carefully optimized to achieve the best results. This work has explored enhancement such as decreased maximum lattice temperature, increased electron mobility, increased drain current, lower DC drain conductance and higher DC transconductance and also decreased bandgap energy variations. Also, for modeling of the structure in the SPICE tools, the main characterizations have been extracted such as thermal resistance (RTH), thermal capacitance (CTH), and SHE characteristic frequency (fTH). All parameters are extracted in relation with the AC operation indicate excellent performance of the SR-SOI device. The results show that proposed region is a suitable alternative to oxide as a part of the buried oxide layer in SOI structures and has better performance in high temperature. Using two-dimensional (2-D) and two-carrier device simulation is done comparison of the SR-SOI structure with a Conventional SOI (C-SOI). As a result, the SR-SOI device can be regarded as a useful substitution for the C-SOI device in nanoscale integrated circuits as a reliable device.

  5. Structured Approach vs. Self-Paced Modular Approach in Teaching Trigonometry

    Directory of Open Access Journals (Sweden)

    Rodin M. Paspasan


    Full Text Available The study aimed to determine which approach in the teaching of Mathematics allowed students to achieve a higher mathematical performance and to establish the learning styles of the students to showed greater confidence on a written posttest - the self-paced modular approach or the structured lecture demonstration based approach. The instruments used in the study are Trigonometry Achievement Test (PTAT designed by the researcher and the Grasha - Reichmann Student Learning Style Survey. Hence. the result shows on the test of significant difference on the respondents learning styles and level of performance established independent learning conditions and demonstrate remarkably higher mathematical performance, respectively. In the light of the statistical analysis and the findings of the study, it could be generalized that SPMA made the students learning styles more independent because they prefer to work at their own pace. Hence, SPMA help them also improve their level of performance in relation to plane trigonometry regardless of their mathematical abilities compared to structured approach. Along these lines, the subsequent recommendations are presented for consideration: The teachers should use collective learning style inventories so that students remain interested throughout their mathematics course. And should use SPMA in teaching trigonometry and other disciplines in the field of mathematics.

  6. Novel Insights into Structure-Activity Relationships of N-Terminally Modified PACE4 Inhibitors. (United States)

    Kwiatkowska, Anna; Couture, Frédéric; Levesque, Christine; Ly, Kévin; Beauchemin, Sophie; Desjardins, Roxane; Neugebauer, Witold; Dory, Yves L; Day, Robert


    PACE4 plays important roles in prostate cancer cell proliferation. The inhibition of this enzyme has been shown to slow prostate cancer progression and is emerging as a promising therapeutic strategy. In previous work, we developed a highly potent and selective PACE4 inhibitor, the multi-Leu (ML) peptide, an octapeptide with the sequence Ac-LLLLRVKR-NH2 . Here, with the objective of developing a useful compound for in vivo administration, we investigate the effect of N-terminal modifications. The inhibitory activity, toxicity, stability, and cell penetration properties of the resulting analogues were studied and compared to the unmodified inhibitor. Our results show that the incorporation of a polyethylene glycol (PEG) moiety leads to a loss of antiproliferative activity, whereas the attachment of a lipid chain preserves or improves it. However, the lipidated peptides are significantly more toxic when compared with their unmodified counterparts. Therefore, the best results were achieved not by the N-terminal extension but by the protection of both ends with the d-Leu residue and 4-amidinobenzylamide, which yielded the most stable inhibitor, with an excellent activity and toxicity profile. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  7. Improving A Priori Demand Estimates Transport Models using Mobile Phone Data : A Rotterdam-Region Case

    NARCIS (Netherlands)

    Wismans, Luc Johannes Josephus; Friso, K.; Rijsdijk, J.; de Graaf, S.W.; Keij, J.


    Mobile phone data are a rich source to infer all kinds of mobility related information. In this research we present an approach where mobile phone data is used and analysed for enriching the transport model of the region of Rotterdam. In our research we used Call Detail Records (CDR) from one of the

  8. Improving Technical Vocational Education and Training in the Kurdistan Region--Iraq (United States)

    Constant, Louay; Culbertson, Shelly; Stasz, Cathleen; Vernez, Georges


    As Iraq's Kurdistan region develops rapidly, it is creating jobs that require a solid education and technical skills. The government has launched an ambitious reform of basic and secondary education to increase its quality and has expanded opportunities for tertiary technical and university education. But expansion of secondary vocational…

  9. Improving A Priori Demand Estimates Transport Models using Mobile Phone Data : A Rotterdam-Region Case

    NARCIS (Netherlands)

    Wismans, Luc Johannes Josephus; Friso, K.; Rijsdijk, J.; de Graaf, S.W.; Keij, J.


    Mobile phone data are a rich source to infer all kinds of mobility- related information. In this research, we present an approach where mobile phone data are used and analyzed for enriching the transport model of the region of Rotterdam. In this research Call Detail Records (CDR) are used from a

  10. Municipal tobacco control in the Capital Region of Denmark can be improved

    DEFF Research Database (Denmark)

    Pisinger, Charlotta; Robinson, Kirstine Magtengaard; Jørgensen, Torben


    Smoking remains the single preventable factor with the highest impact on morbidity and mortality in Denmark. The aims of this study were to assess the quality of municipal tobacco control (TC) in the 29 municipalities of the Capital Region of Denmark, and to compare the quality of the TC...

  11. Machine learning and hurdle models for improving regional predictions of stream water acid neutralizing capacity (United States)

    Nicholas A. Povak; Paul F. Hessburg; Keith M. Reynolds; Timothy J. Sullivan; Todd C. McDonnell; R. Brion Salter


    In many industrialized regions of the world, atmospherically deposited sulfur derived from industrial, nonpoint air pollution sources reduces stream water quality and results in acidic conditions that threaten aquatic resources. Accurate maps of predicted stream water acidity are an essential aid to managers who must identify acid-sensitive streams, potentially...

  12. Oceanic Area System Improvement Study (OASIS). Volume IV. Caribbean Region Air Traffic Services System Description. (United States)


    OASIS) U Final Report This report i.s one of a set of companion documents which includes the following volumes: Volume I Executive Summary and...Northern Coastal Region of 4 the Directorate of Engineering and Systems (Direccion de Ingenieria y Sistemas ), which is responsible for maintenance of the

  13. Improved management of winter operations to limit subsurface contamination with degradable deicing chemicals in cold regions

    NARCIS (Netherlands)

    French, H.K.; Zee, van der S.E.A.T.M.


    This paper gives an overview of management considerations required for better control of deicing chemicals in the unsaturated zone at sites with winter maintenance operations in cold regions. Degradable organic deicing chemicals are the main focus. The importance of the heterogeneity of both the

  14. Successful pacing using a batteryless sunlight-powered pacemaker. (United States)

    Haeberlin, Andreas; Zurbuchen, Adrian; Schaerer, Jakob; Wagner, Joerg; Walpen, Sébastien; Huber, Christoph; Haeberlin, Heinrich; Fuhrer, Juerg; Vogel, Rolf


    Today's cardiac pacemakers are powered by batteries with limited energy capacity. As the battery's lifetime ends, the pacemaker needs to be replaced. This surgical re-intervention is costly and bears the risk of complications. Thus, a pacemaker without primary batteries is desirable. The goal of this study was to test whether transcutaneous solar light could power a pacemaker. We used a three-step approach to investigate the feasibility of sunlight-powered cardiac pacing. First, the harvestable power was estimated. Theoretically, a subcutaneously implanted 1 cm(2) solar module may harvest ∼2500 µW from sunlight (3 mm implantation depth). Secondly, ex vivo measurements were performed with solar cells placed under pig skin flaps exposed to a solar simulator and real sunlight. Ex vivo measurements under real sunlight resulted in a median output power of 4941 µW/cm(2) [interquartile range (IQR) 3767-5598 µW/cm(2), median skin flap thickness 3.0 mm (IQR 2.7-3.3 mm)]. The output power strongly depended on implantation depth (ρSpearman = -0.86, P pacemaker powered by a 3.24 cm(2) solar module was implanted in vivo in a pig to measure output power and to pace. In vivo measurements showed a median output power of >3500 µW/cm(2) (skin flap thickness 2.8-3.84 mm). Successful batteryless VVI pacing using a subcutaneously implanted solar module was performed. Based on our results, we estimate that a few minutes of direct sunlight (irradiating an implanted solar module) allow powering a pacemaker for 24 h using a suitable energy storage. Thus, powering a pacemaker by sunlight is feasible and may be an alternative energy supply for tomorrow's pacemakers. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email:

  15. Approach of regional gravity field modeling from GRACE data for improvement of geoid modeling for Japan (United States)

    Kuroishi, Y.; Lemoine, F. G.; Rowlands, D. D.


    The latest gravimetric geoid model for Japan, JGEOID2004, suffers from errors at long wavelengths (around 1000 km) in a range of +/- 30 cm. The model was developed by combining surface gravity data with a global marine altimetric gravity model, using EGM96 as a foundation, and the errors at long wavelength are presumably attributed to EGM96 errors. The Japanese islands and their vicinity are located in a region of plate convergence boundaries, producing substantial gravity and geoid undulations in a wide range of wavelengths. Because of the geometry of the islands and trenches, precise information on gravity in the surrounding oceans should be incorporated in detail, even if the geoid model is required to be accurate only over land. The Kuroshio Current, which runs south of Japan, causes high sea surface variability, making altimetric gravity field determination complicated. To reduce the long-wavelength errors in the geoid model, we are investigating GRACE data for regional gravity field modeling at long wavelengths in the vicinity of Japan. Our approach is based on exclusive use of inter- satellite range-rate data with calibrated accelerometer data and attitude data, for regional or global gravity field recovery. In the first step, we calibrate accelerometer data in terms of scales and biases by fitting dynamically calculated orbits to GPS-determined precise orbits. The calibration parameters of accelerometer data thus obtained are used in the second step to recover a global/regional gravity anomaly field. This approach is applied to GRACE data obtained for the year 2005 and resulting global/regional gravity models are presented and discussed.

  16. Managing innovation: lessons from the cardiac-pacing industry. (United States)

    Gobeli, D H; Rudelius, W


    In this article, the authors argue that innovation is a surefire way for a firm to increase its sales and market share. This, in turn, can stimulate American industries and make American firms more competitive in international markets. Through their study of the cardiac-pacing industry, they draw conclusions about what factors contribute to a successful innovation in other industries besides medical electronics. They identify general patterns and stages of the innovation process, key roles top management must fill in an organization, and effective policies that foster important innovations.

  17. Structural analysis of cell wall polysaccharides using PACE

    Energy Technology Data Exchange (ETDEWEB)

    Mortimer, Jennifer C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Joint BioEnergy Institute


    The plant cell wall is composed of many complex polysaccharides. The composition and structure of the polysaccharides affect various cell properties including cell shape, cell function and cell adhesion. Many techniques to characterize polysaccharide structure are complicated, requiring expensive equipment and specialized operators e.g. NMR, MALDI-MS. PACE (Polysaccharide Analysis using Carbohydrate gel Electrophoresis) uses a simple, rapid technique to analyze polysaccharide quantity and structure (Goubet et al. 2002). Whilst the method here describes xylan analysis, it can be applied (by use of the appropriate glycosyl hydrolase) to any cell wall polysaccharide.

  18. Setting the right path and pace for integration. (United States)

    Cwiek, Katherine A; Inniger, Meredith C; Zismer, Daniel K


    Far from being a monolithic trend, integration in health care today is progressing in various forms, and at different rates in different markets within and across the range of healthcare organizations. Each organization should develop a tailored strategy that delineates the level and type of integration it will pursue and at what pace to pursue it. This effort will require evaluation of external market conditions with respect to integration and competition and a candid assessment of intraorganizational integration. The compared results of the two analyses will provide the basis for formulating strategy.

  19. Ecuador steps up pace of oil development activity

    International Nuclear Information System (INIS)



    This paper reports that oil companies operating in Ecuador plan to quicken the pace of oil development this year. After delays in 1991, companies plan a series of projects to develop reserves discovered the past 3 years estimated at more than 600 million bbl. Oil and Gas Journal estimated Ecuador's proved crude reserves at 1.55 billion bbl as of Jan. 1, 1992. The development push is part of a larger effort needed to ensure Ecuador's status as an oil exporter into the next century. Ecuador is the smallest crude oil producer and exporter in the Organization of Petroleum Exporting Countries

  20. The Influence of a Pacesetter on Psychological Responses and Pacing Behavior during a 1600 m Run

    Directory of Open Access Journals (Sweden)

    Christopher L. Fullerton, Andrew M. Lane, Tracey J. Devonport


    Full Text Available This study compared the effects of following a pacer versus following a self-paced plan on psychological responses and pacing behavior in well-trained distance runners. Pacing in the present study was individually tailored where each participant developed a personal strategy to ensure their goal time was achieved. We expected that following a pacer would associate with goal achievement, higher pre-run confidence, positive emotions and lower perceived exertion during performance. In a mixed-design repeated-measures study, nineteen well-trained runners completed two 1600m running time trials. Ten runners had a pacer (paced group who supported their individual pacing strategy, and nine participants self-paced running alone (control group. Both groups could check pace using their wrist watch. In contrast to our expectation, results indicated that the paced group reported higher pre-run anxiety with no significant differences in finish time, goal confidence, goal difficulty, perceived exertion, and self-rated performance between groups. We suggest that following a pacer is a skill that requires learning. Following a personalised pacer might associate with higher anxiety due to uncertainty in being able to keep up with the pacer and public visibility of dropping behind, something that is not so observable in a self-paced run completed alone. Future research should investigate mechanisms associated with effective pacing.

  1. An improved method for pancreas segmentation using SLIC and interactive region merging (United States)

    Zhang, Liyuan; Yang, Huamin; Shi, Weili; Miao, Yu; Li, Qingliang; He, Fei; He, Wei; Li, Yanfang; Zhang, Huimao; Mori, Kensaku; Jiang, Zhengang


    Considering the weak edges in pancreas segmentation, this paper proposes a new solution which integrates more features of CT images by combining SLIC superpixels and interactive region merging. In the proposed method, Mahalanobis distance is first utilized in SLIC method to generate better superpixel images. By extracting five texture features and one gray feature, the similarity measure between two superpixels becomes more reliable in interactive region merging. Furthermore, object edge blocks are accurately addressed by re-segmentation merging process. Applying the proposed method to four cases of abdominal CT images, we segment pancreatic tissues to verify the feasibility and effectiveness. The experimental results show that the proposed method can make segmentation accuracy increase to 92% on average. This study will boost the application process of pancreas segmentation for computer-aided diagnosis system.

  2. Improving Regional Security in Central America: Military Engagement Options for Nicaragua (United States)


    of Disasters) Guatemala, Guatemala. Secretaria de Integracion Economica Centroamericana. 68 Smith, Peter H. 2000. Talons of the Eagle: Dynamics of...for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the essential role in the stability and security of the Central American sub region. The de -stabilizing influence of Sandinista policies in the 1980s

  3. Improving preparedness of farmers to Climate Variability: A case study of Vidarbha region of Maharashtra, India (United States)

    Swami, D.; Parthasarathy, D.; Dave, P.


    A key objective of the ongoing research is to understand the risk and vulnerability of agriculture and farming communities with respect to multiple climate change attributes, particularly monsoon variability and hydrology such as ground water availability. Climate Variability has always been a feature affecting Indian agriculture but the nature and characteristics of this variability is not well understood. Indian monsoon patterns are highly variable and most of the studies focus on larger domain such as Central India or Western coast (Ghosh et al., 2009) but district level analysis is missing i.e. the linkage between agriculture and climate variables at finer scale has not been investigated comprehensively. For example, Eastern Vidarbha region in Maharashtra is considered as one of the most agriculturally sensitive region in India, where every year a large number of farmers commit suicide. The main reasons for large number of suicides are climate related stressors such as droughts, hail storms, and monsoon variability aggravated with poor socio-economic conditions. Present study has tried to explore the areas in Vidarbha region of Maharashtra where famers and crop productivity, specifically cotton, sorghum, is highly vulnerable to monsoon variability, hydrological and socio-economic variables which are further modelled to determine the maximal contributing factor towards crops and farmers' vulnerability. After analysis using primary and secondary data, it will aid in decision making regarding field operations such as time of sowing, harvesting and irrigation requirements by optimizing the cropping pattern with climatic, hydrological and socio-economic variables. It also suggests the adaptation strategies to farmers regarding different types of cropping and water harvesting practices, optimized dates and timings for harvesting, sowing, water and nutrient requirements of particular crops according to the specific region. Primarily along with secondary analysis

  4. Using AIRS retrievals in the WRF-LETKF system to improve regional numerical weather prediction

    Directory of Open Access Journals (Sweden)

    Takemasa Miyoshi


    Full Text Available In addition to conventional observations, atmospheric temperature and humidity profile data from the Atmospheric Infrared Sounder (AIRS Version 5 retrieval products are assimilated into the Weather Research and Forecasting (WRF model, using the local ensemble transform Kalman filter (LETKF. Although a naive assimilation of all available quality-controlled AIRS retrieval data yields an inferior analysis, the additional enhancements of adaptive inflation and horizontal data thinning result in a general improvement of numerical weather prediction skill due to AIRS data. In particular, the adaptive inflation method is enhanced so that it no longer assumes temporal homogeneity of the observing network and allows for a better treatment of the temporally inhomogeneous AIRS data. Results indicate that the improvements due to AIRS data are more significant in longer-lead forecasts. Forecasts of Typhoons Sinlaku and Jangmi in September 2008 show improvements due to AIRS data.

  5. Changes in Hypertension Treatment in the Yaroslavl Region of Russia: Improvements Observed Between 2 Cross-Sectional Surveys


    Mozheyko, Maria; Eregin, Sergey; Vigdorchik, Alexey; Tobe, Sheldon; Campbell, Norman; Riahi, Farhad; Hughes, David


    This prospective before-and-after survey of hypertensive patients visiting government-run outpatient health facilities in the Yaroslavl Region of Russia assessed blood pressure (BP)–related endpoints following initiation of a comprehensive health system improvement program for hypertension. Two cross-sectional surveys, one at baseline and the other approximately 1 year after program initiation, evaluated the primary measure of BP control rate. Secondary measures included mean BP levels and di...

  6. The contribution of educational class in improving accuracy of cardiovascular risk prediction across European regions

    DEFF Research Database (Denmark)

    Ferrario, Marco M; Veronesi, Giovanni; Chambless, Lloyd E


    OBJECTIVE: To assess whether educational class, an index of socioeconomic position, improves the accuracy of the SCORE cardiovascular disease (CVD) risk prediction equation. METHODS: In a pooled analysis of 68 455 40-64-year-old men and women, free from coronary heart disease at baseline, from 47...

  7. The influence of collective behaviour on pacing in endurance competitions

    Directory of Open Access Journals (Sweden)

    Andrew eRenfree


    Full Text Available A number of theoretical models have been proposed to explain pacing strategies in individual competitive endurance events. These have typically related to internal regulatory processes informing the making of decisions relating to muscular work rate. Despite a substantial body of research investigating the influence of collective group dynamics on individual behaviours in various animal species, this issue has not been comprehensively studied in individual athletic events. This is surprising given that athletes directly compete in close proximity to one another, and that collective behaviour has also been observed in other human environments. Whilst reasons for adopting collective behaviour are not fully understood, it is thought to result from individual agents following simple local rules resulting in seemingly complex large systems acting to confer some biological advantage to the collective as a whole. Although such collective behaviours may generally be beneficial, endurance events are complicated by the fact that increasing levels of physiological disruption as activity progresses may compromise the ability of individuals to continue to interact with other group members. This could result in early fatigue and relative underperformance due to suboptimal utilisation of physiological resources by some athletes. Alternatively, engagement with a collective behaviour may benefit all due to a reduction in the complexity of decisions to be made and a subsequent reduction in cognitive loading and mental fatigue. This paper seeks evidence for collective behaviour in previously published analyses of pacing behaviour and proposes mechanisms through which it could potentially be either beneficial, or detrimental to individual performance.

  8. Pilot trial of an age-paced parenting newsletter. (United States)

    Keane, Brigid; Waterston, Tony; McConachie, Helen; Towner, Elizabeth; Cook, Margaret; Birks, Eileen


    Supporting parents in the first three years of a child's life has the potential to produce successful outcomes. Present government initiatives such as Sure Start focus on this age group. An American educational intervention, in the style of a monthly newsletter, was adapted for use in the UK for parents of young children. Topics were presented in an easy-to-read format and focused on infant emotional development, parent interaction and play. Newsletters, called Baby Express were posted at monthly intervals to the family home providing age-paced information which could meet the specific needs of parents at that stage of their child's life. The aim of the study was to determine the applicability of the newsletter to UK parents and evaluate their satisfaction. Sixty home-based interviews were conducted and 95 per cent of mothers reported reading all or part of the newsletter. Changes in parenting style were spontaneously reported by 28 per cent of mothers. This study found that an aged-paced parenting newsletter was an acceptable and useful method of supporting parents in the early months of a child's life and promotes positive changes in parenting behaviour.

  9. Social Interaction in Self-paced Distance Education

    Directory of Open Access Journals (Sweden)

    Terry Anderson


    Full Text Available In this paper we present a case study of a self-paced university course that was originally designed to support independent, self-paced study at distance. We developed a social media intervention, in design-based research terms, that allows these independent students to contribute archived content to enhance the course, to engage in discussions with other students and to share as little or as much personal information with each other as they wished. We describe the learning design for the intervention and present survey data of student and tutor perception of value and content analysis of the archived contributions. The results indicate that the intervention was positively received by tutors and by the majority (but not all students and that the archive created by the students’ contributions was adding value to the course. We conclude that the intervention was a modest, yet manageable example of a learning enhancement to a traditional cognitive-behavioral, course that has positive impact and potential with little negative impact on workload.

  10. The SolarPACES strategy for the solar thermal breakthrough

    Energy Technology Data Exchange (ETDEWEB)

    Burch, G.D. [U.S. Department of Energy, Washington, DC (United States)


    Our national solar thermal research programs and our combined efforts conducted through IEA/SolarPACES have brought about many breakthroughs in the development of solar thermal technology. We have components and systems that are much more efficient, much more reliable, and can be built much more cost-efficiently than just a few years ago. As our technology development proceeds, we undoubtedly will continue to make significant progress, breakthroughs in fact, in all these areas - progress that will bring us even closer to economic parity with more conventional forms of energy. And while this progress is absolutely necessary, the question is whether it will be enough to allow solar thermal to break into the mainstream of global energy supply. Our new IEA/SolarPACES strategy, crafted and approved over the course of the past year, has recognized the changes we must face and given us license to begin to make those changes. We must begin addressing financial hurdles, work to create a more favorable regulatory and tax environment, support development of international partnerships, and expand the visibility and excitement of solar thermal technology to achieve the final breakthroughs we need to allow solar thermal energy to live up to its vast potential. (orig./AKF)

  11. Identifying Isotropic Events using an Improved Regional Moment Tensor Inversion Technique

    Energy Technology Data Exchange (ETDEWEB)

    Dreger, Douglas S. [Univ. of California, Berkeley, CA (United States); Ford, Sean R. [Univ. of California, Berkeley, CA (United States); Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Walter, William R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)


    Research was carried out investigating the feasibility of using a regional distance seismic waveform moment tensor inverse procedure to estimate source parameters of nuclear explosions and to use the source inversion results to develop a source-type discrimination capability. The results of the research indicate that it is possible to robustly determine the seismic moment tensor of nuclear explosions, and when compared to natural seismicity in the context of the a Hudson et al. (1989) source-type diagram they are found to separate from populations of earthquakes and underground cavity collapse seismic sources.

  12. Leadless Cardiac Pacemakers: Current status of a modern approach in pacing

    Directory of Open Access Journals (Sweden)

    Skevos Sideris


    Full Text Available Since the first transvenous pacemaker implantation, which took place 50 years ago, important progress has been achieved in pacing technology. Consequently, at present, more than 700,000 pacemakers are implanted annually worldwide. However, conventional pacemakers' implantation has a non-negligible risk of periprocedural and long-term complications associated with the transvenous leads and pacemaker pocket. Recently, leadless pacing systems have emerged as a therapeutic alternative to conventional pacing systems that provide therapy for patients with bradyarrhythmias, while eliminating potential transvenous lead- and pacemaker pocket-related complications. Initial studies have demonstrated favorable efficacy and safety of currently developed leadless pacing systems, compared to transvenous pacemakers. In the present paper, we review the current evidence and highlight the advantages and disadvantages of this novel technology. New technological advances may allow the next generation of leadless pacemakers to further expand, thereby offering a wireless cardiac pacing in future. Keywords: cardiac pacing, pacemaker, leadless pacemaker, bradycardia

  13. Pacing a data transfer operation between compute nodes on a parallel computer (United States)

    Blocksome, Michael A [Rochester, MN


    Methods, systems, and products are disclosed for pacing a data transfer between compute nodes on a parallel computer that include: transferring, by an origin compute node, a chunk of an application message to a target compute node; sending, by the origin compute node, a pacing request to a target direct memory access (`DMA`) engine on the target compute node using a remote get DMA operation; determining, by the origin compute node, whether a pacing response to the pacing request has been received from the target DMA engine; and transferring, by the origin compute node, a next chunk of the application message if the pacing response to the pacing request has been received from the target DMA engine.

  14. Improving the principles of short-term electric load forecasting of the Irkutsk region

    Directory of Open Access Journals (Sweden)

    Kornilov Vladimir


    Full Text Available Forecasting of electric load (EL is an important task for both electric power entities and large consumers of electricity [1]. Large consumers are faced with the need to compose applications for the planned volume of EL, and the deviation of subsequent real consumption from previously announced leads to the appearance of penalties from the wholesale market. In turn, electricity producers are interested in forecasting the demand for electricity for prompt response to its fluctuations and for the purpose of optimal infrastructure development. The most difficult and urgent task is the hourly forecasting of EL, which is extremely important for the successful solution of problems of optimization of generating capacities, minimization of power losses, dispatching control, security assessment of power supply, etc. Ultimately, such forecasts allow optimizing the cash costs for electricity and fuel or water consumption during generation. This paper analyzes the experience of the branch of JSC "SO UPS" Irkutsk Regional Dispatch Office of the procedure for short-term forecasting of the EL of the Irkutsk region.

  15. Improvement of Core Performance by Introduction of Moderators in a Blanket Region of Fast Reactors

    Directory of Open Access Journals (Sweden)

    Toshio Wakabayashi


    Full Text Available An application of deuteride moderator for fast reactor cores is proposed for power flattening that can mitigate thermal spikes and alleviate the decrease in breeding ratio, which sometimes occurs when hydrogen moderator is applied as a moderator. Zirconium deuteride is employed in a form of pin arrays at the inner most rows of radial blanket fuel assemblies, which works as a reflector in order to flatten the radial power distribution in the outer core region of MONJU. The power flattening can be utilized to increase core average burn-up by increasing operational time. The core characteristics have been evaluated with a continuous-energy model Monte Carlo code MVP and the JENDL-3.3 cross-section library. The result indicates that the discharged fuel burn-up can be increased by about 7% relative to that of no moderator in the blanket region due to the power flattening when the number of deuteride moderator pins is 61. The core characteristics and core safety such as void reactivity, Doppler coefficient, and reactivity insertion that occurred at dissolution of deuteron were evaluated. It was clear that the serious drawback did not appear from the viewpoints of the core characteristics and core safety.

  16. Improved management of winter operations to limit subsurface contamination with degradable deicing chemicals in cold regions. (United States)

    French, Helen K; van der Zee, Sjoerd E A T M


    This paper gives an overview of management considerations required for better control of deicing chemicals in the unsaturated zone at sites with winter maintenance operations in cold regions. Degradable organic deicing chemicals are the main focus. The importance of the heterogeneity of both the infiltration process, due to frozen ground and snow melt including the contact between the melting snow cover and the soil, and unsaturated flow is emphasised. In this paper, the applicability of geophysical methods for characterising soil heterogeneity is considered, aimed at modelling and monitoring changes in contamination. To deal with heterogeneity, a stochastic modelling framework may be appropriate, emphasizing the more robust spatial and temporal moments. Examples of a combination of different field techniques for measuring subsoil properties and monitoring contaminants and integration through transport modelling are provided by the SoilCAM project and previous work. Commonly, the results of flow and contaminant fate modelling are quite detailed and complex and require post-processing before communication and advising stakeholders. The managers' perspectives with respect to monitoring strategies and challenges still unresolved have been analysed with basis in experience with research collaboration with one of the case study sites, Oslo airport, Gardermoen, Norway. Both scientific challenges of monitoring subsoil contaminants in cold regions and the effective interaction between investigators and management are illustrated.

  17. Managed ventricular pacing vs. conventional dual-chamber pacing for elective replacements: the PreFER MVP study: clinical background, rationale, and design. (United States)

    Quesada, Aurelio; Botto, Gianluca; Erdogan, Ali; Kozak, Milan; Lercher, Peter; Nielsen, Jens Cosedis; Piot, Olivier; Ricci, Renato; Weiss, Christian; Becker, Daniel; Wetzels, Gwenn; De Roy, Luc


    Several clinical studies have shown that, in patients with intact atrioventricular (AV) conduction, unnecessary chronic right ventricular (RV) pacing can be detrimental. The managed ventricular pacing (MVP) algorithm is designed to give preference to spontaneous AV conduction, thus minimizing RV pacing. The clinical outcomes of MVP are being studied in several ongoing trials in patients undergoing a first device implantation, but it is unknown to what extent MVP is beneficial in patients with a history of ventricular pacing. The purpose of the Prefer for Elective Replacement MVP (PreFER MVP) study is to assess the superiority of the MVP algorithm to conventional pacemaker and implantable cardioverter-defibrillator programming in terms of freedom from hospitalization for cardiovascular causes in a population of patients exposed to long periods of ventricular pacing. PreFER MVP is a prospective, 1:1 parallel, randomized (MVP ON/MVP OFF), single-blinded multi-centre trial. The study population consists of patients with more than 40% ventricular pacing documented with their previous device. Approximately, 600 patients will be randomized and followed for at least 24 months. The primary endpoint comprises cardiovascular hospitalization. The PreFER MVP trial is the first large prospective randomized clinical trial evaluating the effect of MVP in patients with a history of RV pacing.

  18. Comparison of pacing algorithms to avoid unnecessary ventricular pacing in patients with sick sinus node syndrome: a single-centre, observational, parallel study. (United States)

    Poghosyan, Hermine R; Jamalyan, Smbat V


    Reduction of unnecessary ventricular pacing (uVP) is an essential component in the treatment strategy in any pacing population in general. The aim of this study was to evaluate the efficacy of different algorithms to reduce uVP in an adult population with sick sinus syndrome (SSS) treated outside of clinical trials. Evaluation of the relationship between different types of pacing algorithms and clinical outcomes is also provided. This was a single-centre, observational, parallel study, based on retrospective analysis of the Arrhythmology Cardiology Center of Armenia electronic clinical database. This study evaluated atrial pacing percentage (AP%), ventricular pacing percentage (VP%), and the incidence of atrial high rate episodes in 56 patients with SSS using three different pacing strategies: managed VP, search atrioventricular (AV), and fixed long AV. We did not find statistically significant differences in the amount of VP between the groups. Although the atrial high rate percentage (AHR%) tended to be higher in the fixed long AV group, this difference was not statistically significant. Mean VP% and AP% were similar in all three groups. In our study, all three programmed strategies produced the same mean AP% and VP%, and were equally efficient in uVP reduction. There was no relationship between chosen algorithms and the incidence of pacemaker syndrome, hospitalizations, or change in New York Heart Association class. The percentage of AHR was not associated with pacing strategy or co-morbidities but showed borderline correlation with left atrial size.

  19. The pacing stress test: thallium-201 myocardial imaging after atrial pacing. Diagnostic value in detecting coronary artery disease compared with exercise testing

    International Nuclear Information System (INIS)

    Heller, G.V.; Aroesty, J.M.; Parker, J.A.; McKay, R.G.; Silverman, K.J.; Als, A.V.; Come, P.C.; Kolodny, G.M.; Grossman, W.


    Many patients suspected of having coronary artery disease are unable to undergo adequate exercise testing. An alternate stress, pacing tachycardia, has been shown to produce electrocardiographic changes that are as sensitive and specific as those observed during exercise testing. To compare thallium-201 imaging after atrial pacing stress with thallium imaging after exercise stress, 22 patients undergoing cardiac catheterization were studied with both standard exercise thallium imaging and pacing thallium imaging. Positive ischemic electrocardiographic changes (greater than 1 mm ST segment depression) were noted in 11 of 16 patients with coronary artery disease during exercise, and in 15 of the 16 patients during atrial pacing. One of six patients with normal or trivial coronary artery disease had a positive electrocardiogram with each test. Exercise thallium imaging was positive in 13 of 16 patients with coronary artery disease compared with 15 of 16 patients during atrial pacing. Three of six patients without coronary artery disease had a positive scan with exercise testing, and two of these same patients developed a positive scan with atrial pacing. Of those patients with coronary artery disease and an abnormal scan, 85% showed redistribution with exercise testing compared with 87% during atrial pacing. Segment by segment comparison of thallium imaging after either atrial pacing or exercise showed that there was a good correlation of the location and severity of the thallium defects (r . 0.83, p . 0.0001, Spearman rank correlation). It is concluded that the location and presence of both fixed and transient thallium defects after atrial pacing are closely correlated with the findings after exercise testing

  20. Spanish Pacemaker Registry. Twelfth Official Report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2014). (United States)

    Cano Pérez, Óscar; Pombo Jiménez, Marta; Coma Samartín, Raúl


    This report describes the results of the analysis of pacemaker implant and replacement data submitted to the Spanish Pacemaker Registry in 2014, with special reference to pacing mode selection. The report is based on the processing of information provided by the European Pacemaker Patient Identification Card. Information was received from 117 hospitals, with a total of 12 358 cards, representing 34% of estimated activity. Use of conventional generators and resynchronization devices was 784 and 64.4 units per million population, respectively. The mean age of patients receiving an implant was 77.3 years. Men received 59% of implants and 56.4% of replacements. Most patients receiving generator implants and replacements were in the age range 80 to 89 years. Most endocardial leads used were bipolar, and 84.2% had an active fixation system. Pacing was in VVI/R mode despite being in sinus rhythm in 24.7% of patients with sick sinus syndrome and 24% of those with atrioventricular block. The use of pacemaker generators and resynchronization devices per million population continued to increase. Most implanted leads had active fixation and approximately 20% had magnetic resonance imaging protection. Age and sex directly influenced pacing mode selection, which could have been improved in more than 20% of cases. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  1. Harnessing genomics to improve health in the Eastern Mediterranean Region – an executive course in genomics policy

    Directory of Open Access Journals (Sweden)

    Singer Peter A


    Full Text Available Abstract Background While innovations in medicine, science and technology have resulted in improved health and quality of life for many people, the benefits of modern medicine continue to elude millions of people in many parts of the world. To assess the potential of genomics to address health needs in EMR, the World Health Organization's Eastern Mediterranean Regional Office and the University of Toronto Joint Centre for Bioethics jointly organized a Genomics and Public Health Policy Executive Course, held September 20th–23rd, 2003, in Muscat, Oman. The 4-day course was sponsored by WHO-EMRO with additional support from the Canadian Program in Genomics and Global Health. The overall objective of the course was to collectively explore how to best harness genomics to improve health in the region. This article presents the course findings and recommendations for genomics policy in EMR. Methods The course brought together senior representatives from academia, biotechnology companies, regulatory bodies, media, voluntary, and legal organizations to engage in discussion. Topics covered included scientific advances in genomics, followed by innovations in business models, public sector perspectives, ethics, legal issues and national innovation systems. Results A set of recommendations, summarized below, was formulated for the Regional Office, the Member States and for individuals. • Advocacy for genomics and biotechnology for political leadership; • Networking between member states to share information, expertise, training, and regional cooperation in biotechnology; coordination of national surveys for assessment of health biotechnology innovation systems, science capacity, government policies, legislation and regulations, intellectual property policies, private sector activity; • Creation in each member country of an effective National Body on genomics, biotechnology and health to: - formulate national biotechnology strategies - raise

  2. Spanish Pacemaker Registry. Thirteenth Official Report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2015). (United States)

    Pombo Jiménez, Marta; Cano Pérez, Óscar; Fidalgo Andrés, María Luisa; Lorente Carreño, Diego; Coma Samartín, Raúl


    We describe the results of the analysis of the devices implanted and conveyed to the Spanish Pacemaker Registry in 2015. The report is based on the processing of information provided by the European Pacemaker Patient Identification Card. We received information from 111 hospitals, with a total of 12 555 cards, representing 32.1% of all the estimated activity. The use of conventional generators and resynchronization devices was 820 and 73 units per million population, respectively. The mean age of the patients receiving an implantation was 77.7 years, and more than 50% of the devices were implanted in patients over 80 years of age. Overall, 58.6% of the implants and 58.8% of the replacements were performed in men. All of the endocardial leads employed were bipolar, 81.5% had an active fixation system, and 16.5% were compatible with magnetic resonance. Although dual chamber sequential pacing continues to be more widespread, pacing with VVI/R mode is used because up to 23.8% of the patients with sinus node disease are in sinus rhythm, as are 24.1% of those with atrioventricular block. The total use of pacemaker generators in Spain has increased by about 5% with respect to 2014. The majority of the leads implanted are of active fixation, and less than 20% are protected from magnetic resonance. The factors directly related to the selection of pacing mode are age and sex. In around 20% of patients, the choice of the pacing mode could be improved. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.


    Directory of Open Access Journals (Sweden)

    Butenko E.


    Full Text Available Land Reform in Ukraine is already a considerable period of time. Priority land reform was to be the formation of land market relations that would ensure continued efficient reallocation of land resources based on market self-regulation. Implementation of large-scale land reforms in these areas has caused huge problems of acute social, economic and environmental. Properly not the rational use and protection of land resources, reproduction of the productive potential of agricultural lands. Particularly acute problem of management and expanded reproduction of land resources as a basis for sustainable development of Ukraine. Pressing problem today is to resolve these matters in accordance with the principles of sustainable development. Particulary attention should be focused on the implementation of integrated land use by solving problems of the rational use of land, an important aspect of which is to optimize land use. Irrational land use system has led to serious environmental consequences, namely the presence of such manifestations of land degradation as erosion, technogenic pollution, secondary alkalinity, flooding and landslides. The high level of tilled land, including hills, a significant expansion of crops cultivated crops and almost complete cessation of work package for soil protection, violation of the cultivation leads to land degradation. The current state of land use Cherkasy region does not meet the requirements of environmental management. Violated environmentally acceptable ratio of arable land, natural grasslands, which adversely affects the stability of agricultural landscapes. Optimizing the efficiency of land use requires evidence-based approach to land. So based on upgraded inventory system and effective land management by taking into account environmental and economic component of their assessment, you can achieve a significant positive impact on the economy of the region and the state as a whole. The current system of land

  4. Improving microcystin monitoring relevance in recreative waters: A regional case-study (Brittany, Western France, Europe). (United States)

    Pitois, Frédéric; Vezie, Chantal; Thoraval, Isabelle; Baurès, Estelle


    Cyanobacteria and their toxins are known as a health hazard in recreative and distributed waters. Monitoring data from 2004 to 2011 were collected at regional scale to characterize exposition parameters to microcystins in Brittany (Western France). The data show that cyanobacteria populations are experiencing a composition shift leading to a longer duration of cell densities higher than WHO alert levels 2 and 3. Microcystins however appear to be more frequently detected with subacute concentrations in low cell density samples than in high cell density samples or during bloom episodes. Positive relations are described between microcystin concentrations, detection frequencies and cyanobacteria biovolumes, allowing for a novel definition of alert levels and decision framework following WHO recommendations. Copyright © 2015 Elsevier GmbH. All rights reserved.

  5. Land-estimation questions in improvement of the Trazzera’s regional property in Sicily

    Directory of Open Access Journals (Sweden)

    Salvatore Giuffrida


    Full Text Available The “demanio trazzerale” (herd way regional property in Sicily constitutes a significant quota of the territorial social capital, due to its historical and cultural origin.A recent law draft considers its new and diverse potentiality to be assumed in the re-planning of the territory at inter-municipal scale, but some criticalities concern the calculation of the legitimization corresponding sale price.The contribution provides appraisal tools for: the legitimizations in urban areas, with a valuation model of the fair market value; b the valuation of the territorial value of a “trazzera”, in order to select the ones more suitable to be included within a recovery land plan for a new and different territorial policy, which the administration will have to undertake if the law draft is validated.

  6. Improved hydrological modeling for remote regions using a combination of observed and simulated precipitation data

    DEFF Research Database (Denmark)

    van der Linden, Sandra; Christensen, Jens Hesselbjerg


    -resolution regional climate model (HIRHAM4) with a mean-field bias correction using observed precipitation. A hydrological model (USAFLOW) was applied to simulate runoff using observed precipitation and a combination of observed and simulated precipitation as input. The method was illustrated for the remote Usa basin......, situated in the European part of Arctic Russia, close to the Ural Mountains. It was shown that runoff simulations agree better with observations when the combined precipitation data set was used than when only observed precipitation was used. This appeared to be because the HIRHAM4 model data compensated...... for the absence of observed data from mountainous areas where precipitation is orographically enhanced. In both cases, the runoff simulated by USAFLOW was superior to the runoff simulated within the HIRHAM4 model itself. This was attributed to the rather simplistic description of the water balance in the HIRHAM4...

  7. Regionalization of Emergent Vascular Surgery for Patients With Ruptured AAA Improves Outcomes. (United States)

    Warner, Courtney J; Roddy, Sean P; Chang, Benjamin B; Kreienberg, Paul B; Sternbach, Yaron; Taggert, John B; Ozsvath, Kathleen J; Stain, Steven C; Darling, R Clement


    Safe and efficient endovascular aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (r-AAA) requires advanced infrastructure and surgical expertise not available at all US hospitals. The objective was to assess the impact of regionalizing r-AAA care to centers equipped for both open surgical repair (r-OSR) and EVAR (r-EVAR) by vascular surgeons. A retrospective review of all patients with r-AAA undergoing open or endovascular repair in a 12-hospital region. Patient demographics, transfer status, type of repair, and intraoperative variables were recorded. Outcomes included perioperative morbidity and mortality. Four hundred fifty-one patients with r-AAA were treated from 2002 to 2015. Three hundred twenty-one patients (71%) presented initially to community hospitals (CHs) and 130 (29%) presented to the tertiary medical center (MC). Of the 321 patients presenting to CH, 133 (41%) were treated locally (131 OSR; 2 EVAR) and 188 (59%) were transferred to the MC. In total, 318 patients were treated at the MC (122 OSR; 196 EVAR). At the MC, r-EVAR was associated with a lower mortality rate than r-OSR (20% vs 37%, P = 0.001). Transfer did not influence r-EVAR mortality (20% in r-EVAR presenting to MC vs 20% in r-EVAR transferred, P > 0.2). Overall, r-AAA mortality at the MC was 20% lower than CH (27% vs 46%, P AAA repair to centers equipped for both r-EVAR and r-OSR decreased mortality by approximately 20%. Transfer did not impact the mortality of r-EVAR at the tertiary center. Care of r-AAA in the US should be centralized to centers equipped with available technology and vascular surgeons.

  8. Ventricular Pacing via the Coronary Sinus in a Patient with a Mechanical Tricuspid Valve Prosthesis

    Directory of Open Access Journals (Sweden)

    Janice Swampillai, MD


    Full Text Available Implantation of a transvenous endocardial pacing lead in the right ventricle is contra-indicated after mechanical tricuspid valve replacement; therefore a surgical approach to the epicardium is usually required. This case report describes ventricular pacing via a branch of the coronary sinus in a patient with mechanical mitral, aortic and tricuspid valve replacements. In conclusion, this approach is minimally invasive, provides effective ventricular stimulation with low pacing threshold and stable lead position, and is a feasible option when transvenous right ventricular pacing is not possible.

  9. Pacing in Olympic track races: competitive tactics versus best performance strategy. (United States)

    Thiel, Christian; Foster, Carl; Banzer, Winfried; De Koning, Jos


    The purpose of this study was to describe pacing strategies in the 800 to 10,000-m Olympic finals. We asked 1) if Olympic finals differed from World Records, 2) how variable the pace was, 3) whether runners faced catastrophic events, and 4) for the winning strategy. Publically available data from the Beijing 2008 Olympic Games gathered by four transponder antennae under the 400-m track were analysed to extract descriptors of pacing strategies. Individual pacing patterns of 133 finalists were visualised using speed by distance plots. Six of eight plots differed from the patterns reported for World Records. The coefficient of running speed variation was 3.6-11.4%. In the long distance finals, runners varied their pace every 100 m by a mean 1.6-2.7%. Runners who were 'dropped' from the field achieved a stable running speed and displayed an endspurt. Top contenders used variable pacing strategies to separate themselves from the field. All races were decided during the final lap. Olympic track finalists employ pacing strategies which are different from World Record patterns. The observed micro- and macro-variations of pace may have implications for training programmes. Dropping off the pace of the leading group is an active step, and the result of interactive psychophysiological decision making.

  10. Using nudging to improve global-regional dynamic consistency in limited-area climate modeling: What should we nudge? (United States)

    Omrani, Hiba; Drobinski, Philippe; Dubos, Thomas


    Regional climate modelling sometimes requires that the regional model be nudged towards the large-scale driving data to avoid the development of inconsistencies between them. These inconsistencies are known to produce large surface temperature and rainfall artefacts. Therefore, it is essential to maintain the synoptic circulation within the simulation domain consistent with the synoptic circulation at the domain boundaries. Nudging techniques, initially developed for data assimilation purposes, are increasingly used in regional climate modeling and offer a workaround to this issue. In this context, several questions on the "optimal" use of nudging are still open. In this study we focus on a specific question which is: What variable should we nudge? in order to maintain the consistencies between the regional model and the driving fields as much as possible. For that, a "Big Brother Experiment", where a reference atmospheric state is known, is conducted using the weather research and forecasting (WRF) model over the Euro-Mediterranean region. A set of 22 3-month simulations is performed with different sets of nudged variables and nudging options (no nudging, indiscriminate nudging, spectral nudging) for summer and winter. The results show that nudging clearly improves the model capacity to reproduce the reference fields. However the skill scores depend on the set of variables used to nudge the regional climate simulations. Nudging the tropospheric horizontal wind is by far the key variable to nudge to simulate correctly surface temperature and wind, and rainfall. To a lesser extent, nudging tropospheric temperature also contributes to significantly improve the simulations. Indeed, nudging tropospheric wind or temperature directly impacts the simulation of the tropospheric geopotential height and thus the synoptic scale atmospheric circulation. Nudging moisture improves the precipitation but the impact on the other fields (wind and temperature) is not significant. As

  11. Transesophageal Echocardiography-Guided Epicardial Left Ventricular Lead Placement by Video-Assisted Thoracoscopic Surgery in Nonresponders to Biventricular Pacing and Previous Chest Surgery. (United States)

    Schroeder, Carsten; Chung, Jane M; Mackall, Judith A; Cakulev, Ivan T; Patel, Aaron; Patel, Sunny J; Hoit, Brian D; Sahadevan, Jayakumar


    The aim of the study was to study the feasibility, safety, and efficacy of transesophageal echocardiography-guided intraoperative left ventricular lead placement via a video-assisted thoracoscopic surgery approach in patients with failed conventional biventricular pacing. Twelve patients who could not have the left ventricular lead placed conventionally underwent epicardial left ventricular lead placement by video-assisted thoracoscopic surgery. Eight patients had previous chest surgery (66%). Operative positioning was a modified far lateral supine exposure with 30-degree bed tilt, allowing for groin and sternal access. To determine the optimal left ventricular location for lead placement, the left ventricular surface was divided arbitrarily into nine segments. These segments were transpericardially paced using a hand-held malleable pacing probe identifying the optimal site verified by transesophageal echocardiography. The pacing leads were screwed into position via a limited pericardiotomy. The video-assisted thoracoscopic surgery approach was successful in all patients. Biventricular pacing was achieved in all patients and all reported symptomatic benefit with reduction in New York Heart Association class from III to I-II (P = 0.016). Baseline ejection fraction was 23 ± 3%; within 1-year follow-up, the ejection fraction increased to 32 ± 10% (P = 0.05). The mean follow-up was 566 days. The median length of hospital stay was 7 days with chest tube removal between postoperative days 2 and 5. In patients who are nonresponders to conventional biventricular pacing, intraoperative left ventricular lead placement using anatomical and functional characteristics via a video-assisted thoracoscopic surgery approach is effective in improving heart failure symptoms. This optimized left ventricular lead placement is feasible and safe. Previous chest surgery is no longer an exclusion criterion for a video-assisted thoracoscopic surgery approach.

  12. Climate Impact of a Regional Nuclear Weapons Exchange: An Improved Assessment Based On Detailed Source Calculations (United States)

    Reisner, Jon; D'Angelo, Gennaro; Koo, Eunmo; Even, Wesley; Hecht, Matthew; Hunke, Elizabeth; Comeau, Darin; Bos, Randall; Cooley, James


    We present a multiscale study examining the impact of a regional exchange of nuclear weapons on global climate. Our models investigate multiple phases of the effects of nuclear weapons usage, including growth and rise of the nuclear fireball, ignition and spread of the induced firestorm, and comprehensive Earth system modeling of the oceans, land, ice, and atmosphere. This study follows from the scenario originally envisioned by Robock, Oman, Stenchikov, et al. (2007,, based on the analysis of Toon et al. (2007,, which assumes a regional exchange between India and Pakistan of fifty 15 kt weapons detonated by each side. We expand this scenario by modeling the processes that lead to production of black carbon, in order to refine the black carbon forcing estimates of these previous studies. When the Earth system model is initiated with 5 × 109 kg of black carbon in the upper troposphere (approximately from 9 to 13 km), the impact on climate variables such as global temperature and precipitation in our simulations is similar to that predicted by previously published work. However, while our thorough simulations of the firestorm produce about 3.7 × 109 kg of black carbon, we find that the vast majority of the black carbon never reaches an altitude above weather systems (approximately 12 km). Therefore, our Earth system model simulations conducted with model-informed atmospheric distributions of black carbon produce significantly lower global climatic impacts than assessed in prior studies, as the carbon at lower altitudes is more quickly removed from the atmosphere. In addition, our model ensembles indicate that statistically significant effects on global surface temperatures are limited to the first 5 years and are much smaller in magnitude than those shown in earlier works. None of the simulations produced a nuclear winter effect. We find that the effects on global surface temperatures

  13. Social Comparison in Coping With Occupational Uncertainty: Self-Improvement, Self-Enhancement, and the Regional Context. (United States)

    Pavlova, Maria K; Lechner, Clemens M; Silbereisen, Rainer K


    Taking into account the regional context, we investigated whether social comparison in coping with occupational uncertainty served self-improvement (i.e., adaptive coping) or self-enhancement (i.e., subjective well-being). Respondents were 620 German adults aged 16 to 43, 59% female, who participated in three yearly follow-ups of a larger survey. The number of observations was 1,309 for contemporaneous and 1,079 for longitudinal analyses. Participants reported on perceived occupational uncertainty (e.g., risk of losing a job and difficulties with career planning), strategies for coping with it, and whether, and in which direction, they made social comparisons in coping with occupational uncertainty. Making social comparisons (vs. not) was associated with higher goal engagement and lower goal disengagement. Upward (as opposed to downward) comparison prospectively predicted higher goal engagement. Under high regional unemployment, upward comparison prospectively predicted lower goal disengagement, whereas making social comparisons was contemporaneously associated with higher subjective well-being. Higher regional unemployment rates predicted more frequent comparison, whereas comparison direction was predicted only by situational variables, especially personal control over the outcomes. When operationalized as a conscious mental action and put in the context of coping with occupational uncertainty, social comparison serves primarily self-improvement. © 2017 Wiley Periodicals, Inc.

  14. Simulating future wheat yield under climate change, carbon dioxide enrichment and technology improvement in Iran. Case study: Azarbaijan region

    Energy Technology Data Exchange (ETDEWEB)

    Mansouri, H.; Raei, Y.; Zaeim, A.N.


    Climate change and technology development can affect crop productivity in future conditions. Precise estimation of crops yield change as affected by climate and technology in the future is an effective approach for management strategies. The aim of this study was to estimate the impacts of climate change, technology improvement, CO2 enrichment, and overall impacts on wheat yield under future conditions. Wheat yield was projected for three future time periods (2020, 2050 and 2080) compared to baseline year (2011) under two scenarios of IPCC Special Report on Emission Scenarios (SRES) including SRES-A2 as regional economic scenario and SRES-B1 as global environmental scenario in Azarbaijan region (NW of Iran). A linear regression model, describing the relationship between wheat yield and historical year, was developed to investigate technology development effect. The decision support system for agro-technology transfer (DSSAT4.5) was used to evaluate the influence of climate change on wheat yield. The most positive effects were found for wheat yield as affected by technology in all studied regions. Under future climate change, the SRES projected a decrease in yield, especially in West Azarbaijan region. When the effects of elevated CO2 were considered, all regions resulted to increase in wheat yield. Considering all components effect in comparison with baseline (2011), yield increase would range from 5% to 38% across all times, scenarios and regions. According to our findings, it seems that we may expect a higher yield of wheat in NW Iran in the future if technology development continues as well as past years. (Author)

  15. Improved PPP Ambiguity Resolution Considering the Stochastic Characteristics of Atmospheric Corrections from Regional Networks (United States)

    Li, Yihe; Li, Bofeng; Gao, Yang


    With the increased availability of regional reference networks, Precise Point Positioning (PPP) can achieve fast ambiguity resolution (AR) and precise positioning by assimilating the satellite fractional cycle biases (FCBs) and atmospheric corrections derived from these networks. In such processing, the atmospheric corrections are usually treated as deterministic quantities. This is however unrealistic since the estimated atmospheric corrections obtained from the network data are random and furthermore the interpolated corrections diverge from the realistic corrections. This paper is dedicated to the stochastic modelling of atmospheric corrections and analyzing their effects on the PPP AR efficiency. The random errors of the interpolated corrections are processed as two components: one is from the random errors of estimated corrections at reference stations, while the other arises from the atmospheric delay discrepancies between reference stations and users. The interpolated atmospheric corrections are then applied by users as pseudo-observations with the estimated stochastic model. Two data sets are processed to assess the performance of interpolated corrections with the estimated stochastic models. The results show that when the stochastic characteristics of interpolated corrections are properly taken into account, the successful fix rate reaches 93.3% within 5 min for a medium inter-station distance network and 80.6% within 10 min for a long inter-station distance network. PMID:26633400

  16. Regional climate model downscaling may improve the prediction of alien plant species distributions (United States)

    Liu, Shuyan; Liang, Xin-Zhong; Gao, Wei; Stohlgren, Thomas J.


    Distributions of invasive species are commonly predicted with species distribution models that build upon the statistical relationships between observed species presence data and climate data. We used field observations, climate station data, and Maximum Entropy species distribution models for 13 invasive plant species in the United States, and then compared the models with inputs from a General Circulation Model (hereafter GCM-based models) and a downscaled Regional Climate Model (hereafter, RCM-based models).We also compared species distributions based on either GCM-based or RCM-based models for the present (1990-1999) to the future (2046-2055). RCM-based species distribution models replicated observed distributions remarkably better than GCM-based models for all invasive species under the current climate. This was shown for the presence locations of the species, and by using four common statistical metrics to compare modeled distributions. For two widespread invasive taxa ( Bromus tectorum or cheatgrass, and Tamarix spp. or tamarisk), GCM-based models failed miserably to reproduce observed species distributions. In contrast, RCM-based species distribution models closely matched observations. Future species distributions may be significantly affected by using GCM-based inputs. Because invasive plants species often show high resilience and low rates of local extinction, RCM-based species distribution models may perform better than GCM-based species distribution models for planning containment programs for invasive species.

  17. Improve earthquake hypocenter using adaptive simulated annealing inversion in regional tectonic, volcano tectonic, and geothermal observation

    Energy Technology Data Exchange (ETDEWEB)

    Ry, Rexha Verdhora, E-mail: [Master Program of Geophysical Engineering, Faculty of Mining and Petroleum Engineering, Institut Teknologi Bandung, Jalan Ganesha No.10, Bandung 40132 (Indonesia); Nugraha, Andri Dian, E-mail: [Global Geophysical Research Group, Faculty of Mining and Petroleum Engineering, Institut Teknologi Bandung, Jalan Ganesha No.10, Bandung 40132 (Indonesia)


    Observation of earthquakes is routinely used widely in tectonic activity observation, and also in local scale such as volcano tectonic and geothermal activity observation. It is necessary for determining the location of precise hypocenter which the process involves finding a hypocenter location that has minimum error between the observed and the calculated travel times. When solving this nonlinear inverse problem, simulated annealing inversion method can be applied to such global optimization problems, which the convergence of its solution is independent of the initial model. In this study, we developed own program codeby applying adaptive simulated annealing inversion in Matlab environment. We applied this method to determine earthquake hypocenter using several data cases which are regional tectonic, volcano tectonic, and geothermal field. The travel times were calculated using ray tracing shooting method. We then compared its results with the results using Geiger’s method to analyze its reliability. Our results show hypocenter location has smaller RMS error compared to the Geiger’s result that can be statistically associated with better solution. The hypocenter of earthquakes also well correlated with geological structure in the study area. Werecommend using adaptive simulated annealing inversion to relocate hypocenter location in purpose to get precise and accurate earthquake location.

  18. Bulk GaN alpha-particle detector with large depletion region and improved energy resolution

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Qiang; Mulligan, Padhraic [Nuclear Engineering Program, Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, OH 43210 (United States); Wang, Jinghui [Department of Radiology, Stanford University, 1201 Welch Rd, Stanford, CA 94305 (United States); Chuirazzi, William [Nuclear Engineering Program, Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, OH 43210 (United States); Cao, Lei, E-mail: [Nuclear Engineering Program, Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, OH 43210 (United States)


    An alpha-particle detector was fabricated using a freestanding n-type bulk GaN wafer with a Au/Ni/GaN sandwich Schottky structure. Current–voltage measurements at room temperature revealed a Schottky contact with a leakage current of 7.53±0.3 nA at a reverse bias of 200 V. The detector had a large depletion depth that can capture much of the energy from 5.486 MeV alpha particles emitted from a {sup 241}Am source. The resolution of its alpha-particle energy spectrum was improved to 2.2±0.2% at 5.486 MeV under a bias of 550 V. This superior resolution was attributed to the shortening of the carrier transit time and the large energy deposition within the large depletion depth, i.e., 27 µm at −550 V, which all resulted in a more complete charge collection. A model developed using the ATLAS simulation framework from Silvaco Inc. was employed to study the charge collection process. The simulation results were found to agree closely with the experimental results. This detector will be beneficial for research at neutron scattering facilities, the International Thermonuclear Experimental Reactor, and the Large Hadron Collider, among other institutions, where the Si-based charged particle detectors could be quickly degraded in an intense radiation field. - Highlights: • An alpha-particle detector based on a Schottky-structured GaN wafer was tested. • The detector's large depletion depth enables fuller energy spectra to be obtained. • The best resolution yet attained in GaN alpha-particle spectrometry was achieved. • The detector's short carrier transit time resulted in improved charge collection. • This detector is usable in extreme conditions, including intense radiation fields.

  19. Feedback intervention to doctors improves patient satisfaction among outpatients in Inner Mongolia Autonomous Region, China. (United States)

    Qiao, T; Geater, A F; Chongsuvivatwong, V; Fan, Y; Guo, Z


    The doctor-patient relationship (DPR) in China is known to be tense. We tested whether an intervention program providing individualized feedback to doctors by patients could improve patients' satisfaction in an outpatient setting. A non-randomized controlled prepost intervention study in a tertiary hospital. Six surgery clinics were chosen as the intervention group and eight internal medicine clinics as the control group. Before the program started, patients attending each group of clinics were asked to fill in the Short-Form Patient Satisfaction Questionnaire (PSQ-18). In the experimental period, patients attending the intervention clinics were requested to rate their perception of the doctor's quality of care in various domains on an 8-question feedback card immediately after exiting from the examination room and to drop the completed card into the feedback box for the particular doctor. The cards were then collected by the doctor confidentially at the end of each day. There was no feedback in the control clinics. After the experimental period ended, the doctors in both groups of clinics were reassessed by a new series of patients using PSQ-18. The PSQ-18 scores were compared within the same group of clinics over time, and the changes in satisfaction score compared between intervention and control clinics. There were 189 and 190 responders in the intervention group and 190 and 200 in the control group, before and after the intervention period, respectively. Scores in all domains increased significantly (P patient satisfaction scores in the intervention clinics compared with the control clinics was confirmed by mixed-effects linear regression controlling for the effects of gender, age, marital status, education, and household income in the domains of general satisfaction, technical quality, communication, and accessibility and convenience. Timely feedback to doctors of patients' perception of quality of care received can improve outpatient satisfaction in a

  20. An Improved Estimation of Regional Fractional Woody/Herbaceous Cover Using Combined Satellite Data and High-Quality Training Samples

    Directory of Open Access Journals (Sweden)

    Xu Liu


    Full Text Available Mapping vegetation cover is critical for understanding and monitoring ecosystem functions in semi-arid biomes. As existing estimates tend to underestimate the woody cover in areas with dry deciduous shrubland and woodland, we present an approach to improve the regional estimation of woody and herbaceous fractional cover in the East Asia steppe. This developed approach uses Random Forest models by combining multiple remote sensing data—training samples derived from high-resolution image in a tailored spatial sampling and model inputs composed of specific metrics from MODIS sensor and ancillary variables including topographic, bioclimatic, and land surface information. We emphasize that effective spatial sampling, high-quality classification, and adequate geospatial information are important prerequisites of establishing appropriate model inputs and achieving high-quality training samples. This study suggests that the optimal models improve estimation accuracy (NMSE 0.47 for woody and 0.64 for herbaceous plants and show a consistent agreement with field observations. Compared with existing woody estimate product, the proposed woody cover estimation can delineate regions with subshrubs and shrubs, showing an improved capability of capturing spatialized detail of vegetation signals. This approach can be applicable over sizable semi-arid areas such as temperate steppes, savannas, and prairies.

  1. Using the Regional Ocean Modelling System (ROMS to improve the sea surface temperature predictions of the MERCATOR Ocean System

    Directory of Open Access Journals (Sweden)

    Pedro Costa


    Full Text Available Global models are generally capable of reproducing the observed trends in the globally averaged sea surface temperature (SST. However, the global models do not perform as well on regional scales. Here, we present an ocean forecast system based on the Regional Ocean Modelling System (ROMS, the boundary conditions come from the MERCATOR ocean system for the North Atlantic (1/6° horizontal resolution. The system covers the region of the northwestern Iberian Peninsula with a horizontal resolution of 1/36°, forced with the Weather Research and Forecasting Model (WRF and the Soil Water Assessment Tool (SWAT. The ocean model results from the regional ocean model are validated using real-time SST and observations from the MeteoGalicia, INTECMAR and Puertos Del Estado real-time observational networks. The validation results reveal that over a one-year period the mean absolute error of the SST is less than 1°C, and several sources of measured data reveal that the errors decrease near the coast. This improvement is related to the inclusion of local forcing not present in the boundary condition model.

  2. An Improved Privacy-Preserving Framework for Location-Based Services Based on Double Cloaking Regions with Supplementary Information Constraints

    Directory of Open Access Journals (Sweden)

    Li Kuang


    Full Text Available With the rapid development of location-based services in the field of mobile network applications, users enjoy the convenience of location-based services on one side, while being exposed to the risk of disclosure of privacy on the other side. Attacker will make a fierce attack based on the probability of inquiry, map data, point of interest (POI, and other supplementary information. The existing location privacy protection techniques seldom consider the supplementary information held by attackers and usually only generate single cloaking region according to the protected location point, and the query efficiency is relatively low. In this paper, we improve the existing LBSs system framework, in which we generate double cloaking regions by constraining the supplementary information, and then k-anonymous task is achieved by the cooperation of the double cloaking regions; specifically speaking, k dummy points of fixed dummy positions in the double cloaking regions are generated and the LBSs query is then performed. Finally, the effectiveness of the proposed method is verified by the experiments on real datasets.

  3. The Pace and Shape of Senescence in Angiosperms

    DEFF Research Database (Denmark)

    Baudisch, Annette; Salguero-Gómez, Roberto; Jones, Owen


    1. Demographic senescence, the decay in fertility and increase in the risk of mortality with age, is one of the most striking phenomena in ecology and evolution. Comparative studies of senescence patterns of plants are scarce, and consequently, little is known about senescence and its determinants...... (‘senescence’), decreases (‘negative senescence’) or remains constant over age (‘negligible senescence’). 3. We extract mortality trajectories from ComPADRe III, a data base that contains demographic information for several hundred plant species. We apply age-from-stage matrix decomposition methods to obtain...... age-specific trajectories from 290 angiosperm species of various growth forms distributed globally. From these trajectories, we survey pace and shape values and investigate how growth form and ecoregion influence these two aspects of mortality using a Bayesian regression analysis that accounts...

  4. Quick pace of property acquisitions requires two-stage evaluations

    International Nuclear Information System (INIS)

    Hollo, R.; Lockwood, S.


    The traditional method of evaluating oil and gas reserves may be too cumbersome for the quick pace of oil and gas property acquisition. An acquisition evaluator must decide quickly if a property meets basic purchase criteria. The current business climate requires a two-stage approach. First, the evaluator makes a quick assessment of the property and submits a bid. If the bid is accepted then the evaluator goes on with a detailed analysis, which represents the second stage. Acquisition of producing properties has become an important activity for many independent oil and gas producers, who must be able to evaluate reserves quickly enough to make effective business decisions yet accurately enough to avoid costly mistakes. Independent thus must be familiar with how transactions usually progress as well as with the basic methods of property evaluation. The paper discusses acquisition activity, the initial offer, the final offer, property evaluation, and fair market value

  5. The pace of shifting climate in marine and terrestrial ecosystems

    DEFF Research Database (Denmark)

    Burrows, Michael T.; Schoeman, David S.; Buckley, Lauren B.


    Climate change challenges organisms to adapt or move to track changes in environments in space and time. We used two measures of thermal shifts from analyses of global temperatures over the past 50 years to describe the pace of climate change that species should track: the velocity of climate...... change (geographic shifts of isotherms over time) and the shift in seasonal timing of temperatures. Both measures are higher in the ocean than on land at some latitudes, despite slower ocean warming. These indices give a complex mosaic of predicted range shifts and phenology changes that deviate from...... simple poleward migration and earlier springs or later falls. They also emphasize potential conservation concerns, because areas of high marine biodiversity often have greater velocities of climate change and seasonal shifts....

  6. Pacing and Defibrillators in Complex Congenital Heart Disease (United States)

    Chubb, Henry; O’Neill, Mark; Rosenthal, Eric


    Device therapy in the complex congenital heart disease (CHD) population is a challenging field. There is a myriad of devices available, but none designed specifically for the CHD patient group, and a scarcity of prospective studies to guide best practice. Baseline cardiac anatomy, prior surgical and interventional procedures, existing tachyarrhythmias and the requirement for future intervention all play a substantial role in decision making. For both pacing systems and implantable cardioverter defibrillators, numerous factors impact on the merits of system location (endovascular versus non-endovascular), lead positioning, device selection and device programming. For those with Fontan circulation and following the atrial switch procedure there are also very specific considerations regarding access and potential complications. This review discusses the published guidelines, device indications and the best available evidence for guidance of device implantation in the complex CHD population. PMID:27403295

  7. Improving mortality outcomes of Stevens Johnson syndrome/toxic epidermal necrolysis: A regional burns centre experience. (United States)

    Nizamoglu, M; Ward, J A; Frew, Q; Gerrish, H; Martin, N; Shaw, A; Barnes, D; Shelly, O; Philp, B; El-Muttardi, N; Dziewulski, P


    Stevens Johnson Syndrome/toxic epidermal necrolysis (SJS/TEN) are rare, potentially fatal desquamative disorders characterised by large areas of partial thickness skin and mucosal loss. The degree of epidermal detachment that occurs has led to SJS/TEN being described as a burn-like condition. These patients benefit from judicious critical care, early debridement and meticulous wound care. This is best undertaken within a multidisciplinary setting led by clinicians experienced in the management of massive skin loss and its sequelae. In this study, we examined the clinical outcomes of SJS/TEN overlap & TEN patients managed by our regional burns service over a 12-year period. We present our treatment model for other burn centres treating SJS/TEN patients. A retrospective case review was performed for all patients with a clinical diagnosis of TEN or SJS/TEN overlap admitted to our paediatric and adult burns centre between June 2004 and December 2016. Patient demographics, percentage total body surface area (%TBSA), mucosal involvement, causation, severity of illness score (SCORTEN), length of stay and survival were appraised with appropriate statistical analysis performed using Graph Pad Prism 7.02 Software. During the study period, 42 patients (M26; F: 16) with TEN (n=32) and SJS/TEN overlap (n=10) were managed within our burns service. Mean %TBSA of cutaneous involvement was 57% (range 10-100%) and mean length of stay (LOS) was 27 days (range 1-144 days). We observed 4 deaths in our series compared to 16 predicted by SCORTEN giving a standardised mortality ratio (SMR) of 24%. Management in our burns service with an aggressive wound care protocol involving debridement of blistered epidermis and wound closure with synthetic and biological dressings seems to have produced benefits in mortality when compared to predicted outcomes. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  8. Influence of internal current and pacing current on pacemaker longevity. (United States)

    Schuchert, A; Kuck, K H


    The effects of lower pulse amplitude on battery current and pacemaker longevity were studied comparing the new, small-sized VVI pacemaker, Minix 8341, with the former model, Pasys 8329. Battery current was telemetrically measured at 0.8, 1.6, 2.5, and 5.0 V pulse amplitude and 0.05, 0.25, 0.5, and 1.0 msec pulse duration. Internal current was assumed to be equal to the battery current at 0.8 V and 0.05 msec. Pacing current was calculated subtracting internal current from battery current. The Minix pacemaker had a significantly lower battery current because of a lower internal current (Minix: 4.1 +/- 0.1 microA; Pasys: 16.1 +/- 0.1 microA); pacing current of both units was similar. At 0.5 msec pulse duration, the programming from 5.0-2.5 V pulse amplitude resulted in a greater relative reduction of battery current in the newer pacemaker (51% vs 25%). Projected longevity of each pacemaker was 7.9 years at 5.0 V and 0.5 msec. The programming from 5.0-2.5 V extended the projected longevity by 2.3 years (Pasys) and by 7.1 years (Minix). The longevity was negligibly longer after programming to 1.6 V. extension of pacemaker longevity can be achieved with the programming to 2.5 V or less if the connected pacemakers need a low internal current for their circuitry.

  9. Improving spatial prioritisation for remote marine regions: optimising biodiversity conservation and sustainable development trade-offs (United States)

    Moore, Cordelia H.; Radford, Ben T.; Possingham, Hugh P.; Heyward, Andrew J.; Stewart, Romola R.; Watts, Matthew E.; Prescott, Jim; Newman, Stephen J.; Harvey, Euan S.; Fisher, Rebecca; Bryce, Clay W.; Lowe, Ryan J.; Berry, Oliver; Espinosa-Gayosso, Alexis; Sporer, Errol; Saunders, Thor


    Creating large conservation zones in remote areas, with less intense stakeholder overlap and limited environmental information, requires periodic review to ensure zonation mitigates primary threats and fill gaps in representation, while achieving conservation targets. Follow-up reviews can utilise improved methods and data, potentially identifying new planning options yielding a desirable balance between stakeholder interests. This research explored a marine zoning system in north-west Australia-a biodiverse area with poorly documented biota. Although remote, it is economically significant (i.e. petroleum extraction and fishing). Stakeholder engagement was used to source the best available biodiversity and socio-economic data and advanced spatial analyses produced 765 high resolution data layers, including 674 species distributions representing 119 families. Gap analysis revealed the current proposed zoning system as inadequate, with 98.2% of species below the Convention on Biological Diversity 10% representation targets. A systematic conservation planning algorithm Maxan provided zoning options to meet representation targets while balancing this with industry interests. Resulting scenarios revealed that conservation targets could be met with minimal impacts on petroleum and fishing industries, with estimated losses of 4.9% and 7.2% respectively. The approach addressed important knowledge gaps and provided a powerful and transparent method to reconcile industry interests with marine conservation.

  10. Bulk GaN alpha-particle detector with large depletion region and improved energy resolution (United States)

    Xu, Qiang; Mulligan, Padhraic; Wang, Jinghui; Chuirazzi, William; Cao, Lei


    An alpha-particle detector was fabricated using a freestanding n-type bulk GaN wafer with a Au/Ni/GaN sandwich Schottky structure. Current-voltage measurements at room temperature revealed a Schottky contact with a leakage current of 7.53±0.3 nA at a reverse bias of 200 V. The detector had a large depletion depth that can capture much of the energy from 5.486 MeV alpha particles emitted from a 241Am source. The resolution of its alpha-particle energy spectrum was improved to 2.2±0.2% at 5.486 MeV under a bias of 550 V. This superior resolution was attributed to the shortening of the carrier transit time and the large energy deposition within the large depletion depth, i.e., 27 μm at -550 V, which all resulted in a more complete charge collection. A model developed using the ATLAS simulation framework from Silvaco Inc. was employed to study the charge collection process. The simulation results were found to agree closely with the experimental results. This detector will be beneficial for research at neutron scattering facilities, the International Thermonuclear Experimental Reactor, and the Large Hadron Collider, among other institutions, where the Si-based charged particle detectors could be quickly degraded in an intense radiation field.

  11. Investment in epilepsy monitoring units improves epilepsy care—experience in a regional neuroscience centre

    LENUS (Irish Health Repository)

    McGinty, RN


    An evaluation of the clinical yield of inpatient long-term video-EEG (vEEG) in a new epilepsy monitoring unit (EMU) was undertaken, with findings compared to the centre’s prior method of bedside vEEG recording in a standard neurology ward, as reported in 2004. A retrospective analysis of neurophysiology reports for all adults who underwent elective vEEG monitoring in the EMU at Cork University Hospital between January 2015 and July 2016 was conducted. Of 115 vEEG studies in the EMU, 100 (87.0%) were deemed diagnostically conclusive, 14 (12.2%) failed to catch any clinical events and showed normal EEG throughout, and one (0.9%) captured spells of unclear clinical significance—the corresponding figures reported in 2004 for bedside vEEGs were 21.3%, 77% and 1.6%, respectively. The EMU offers a more effective method of recording inpatient vEEG, which aids decision-making and improves clinical outcomes. Some evidence-based measures which could further enhance diagnostic yield are discussed.

  12. Regional Social Infrastructure Management as the Instrument for Improving the Quality of Life in the Ural Federal District

    Directory of Open Access Journals (Sweden)

    Valentina Sergeyevna Antonyuk


    Full Text Available The article analyzes the processes of the social sphere and the effective operation of social infrastructure in order to improve the quality of life of the population in the Russian regions. Particular attention is paid to the role of the organizational and managerial component affecting usage performance of infrastructure objects and including regulation of the institutions of social infrastructure, planning and software. The purpose of the study is to evaluate the effectiveness of management of social infrastructure through the conjugation of immediate results (the dynamics of indicators of social services and outcomes (parameters of the quality of life of the population. The hypothesis of the study was the violation of the principle of infra-systematicity in the infrastructural support of the improvement of the quality of life in the Russian regions, due to the lack of effectiveness of public administration. In the study, the following methodological approaches are used: structural, factoral, systematic and evolutionary approaches to justify the conception, develop methodology and determine the impact of changes in the parameters of social infrastructure availability for the provided services, shifts in indexes of quality of life. The paper proposes the quantitative evaluation of the effectiveness of organizational management based on the diagnosis of the adequacy of the implementation of the principle of infra-systematicity in the functioning of social infrastructure on the basis of the elasticity coefficient. The proposed approach and the received analytical data on health, education, commerce, housing, culture and sport fields have allowed to range the regions of the Ural Federal District and highlight the areas of insufficient effectiveness of the organizational and management tool for improvement of life quality. The findings of the research may serve as a core for practical recommendations for executive bodies of administrative units of

  13. StaMPS Improvement for Deformation Analysis in Mountainous Regions: Implications for the Damavand Volcano and Mosha Fault in Alborz

    Directory of Open Access Journals (Sweden)

    Sanaz Vajedian


    Full Text Available Interferometric Synthetic Aperture Radar (InSAR capability to detect slow deformation over terrain areas is limited by temporal decorrelation, geometric decorrelation and atmospheric artefacts. Multitemporal InSAR methods such as Persistent Scatterer (PS-InSAR and Small Baseline Subset (SBAS have been developed to deal with various aspects of decorrelation and atmospheric problems affecting InSAR observations. Nevertheless, the applicability of both PS-InSAR and SBAS in mountainous regions is still challenging. Correct phase unwrapping in both methods is hampered due to geometric decorrelation in particular when using C-band SAR data for deformation analysis. In this paper, we build upon the SBAS method implemented in StaMPS software and improved the technique, here called ISBAS, to assess tectonic and volcanic deformation in the center of the Alborz Mountains in Iran using both Envisat and ALOS SAR data. We modify several aspects within the chain of the processing including: filtering prior to phase unwrapping, topographic correction within three-dimensional phase unwrapping, reducing the atmospheric noise with the help of additional GPS data, and removing the ramp caused by ionosphere turbulence and/or orbit errors to better estimate crustal deformation in this tectonically active region. Topographic correction is done within the three-dimensional unwrapping in order to improve the phase unwrapping process, which is in contrast to previous methods in which DEM error is estimated before/after phase unwrapping. Our experiments show that our improved SBAS approach is able to better characterize the tectonic and volcanic deformation in the center of the Alborz region than the classical SBAS. In particular, Damavand volcano shows an average uplift rate of about 3 mm/year in the year 2003–2010. The Mosha fault illustrates left-lateral motion that could be explained with a fault that is locked up to 17–18 km depths and slips with 2–4 mm

  14. Comparison of carotid endarterectomy and stenting in real world practice using a regional quality improvement registry (United States)

    Nolan, Brian W.; De Martino, Randall R.; Goodney, Philip P.; Schanzer, Andres; Stone, David H.; Butzel, David; Kwolek, Christopher J.; Cronenwett, Jack L.


    in patients undergoing carotid revascularization. Conclusions In our regional vascular surgical practices, the overall outcomes of CAS and CEA are similar for asymptomatic patients. However, symptomatic patients treated with CAS are at a higher risk for stroke or death. (J Vasc Surg 2012;56:990-6.) PMID:22579135

  15. Effect of right ventricular pacing lead site on left ventricular function in patients with high-grade atrioventricular block: results of the Protect-Pace study. (United States)

    Kaye, Gerald C; Linker, Nicholas J; Marwick, Thomas H; Pollock, Lucy; Graham, Laura; Pouliot, Erika; Poloniecki, Jan; Gammage, Michael


    Chronic right ventricle (RV) apical (RVA) pacing is standard treatment for an atrioventricular (AV) block but may be deleterious to left ventricle (LV) systolic function. Previous clinical studies of non-apical pacing have produced conflicting results. The aim of this randomized, prospective, international, multicentre trial was to compare change in LV ejection fraction (LVEF) between right ventricular apical and high septal (RVHS) pacing over a 2-year study period. We randomized 240 patients (age 74 ± 11 years, 67% male) with a high-grade AV block requiring >90% ventricular pacing and preserved baseline LVEF >50%, to receive pacing at the RVA (n = 120) or RVHS (n = 120). At 2 years, LVEF decreased in both the RVA (57 ± 9 to 55 ± 9%, P = 0.047) and the RVHS groups (56 ± 10 to 54 ± 10%, P = 0.0003). However, there was no significant difference in intra-patient change in LVEF between confirmed RVA (n = 85) and RVHS (n = 83) lead position (P = 0.43). There were no significant differences in heart failure hospitalization, mortality, the burden of atrial fibrillation, or plasma brain natriutetic peptide levels between the two groups. A significantly greater time was required to place the lead in the RVHS position (70 ± 25 vs. 56 ± 24 min, P function requiring a high percentage of ventricular pacing, RVHS pacing does not provide a protective effect on left ventricular function over RVA pacing in the first 2 years. number NCT00461734. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email:

  16. Borders as membranes :metaphors and models for improved policy in border regions.

    Energy Technology Data Exchange (ETDEWEB)

    Malczynski, Leonard A.; Passell, Howard David; Forster, Craig B. (University of Utah, Salt Lake City, UT); Cockerill, Kristan (Cockerill Consulting, Boone, NC)


    Political borders are controversial and contested spaces. In an attempt to better understand movement along and through political borders, this project applied the metaphor of a membrane to look at how people, ideas, and things ''move'' through a border. More specifically, the research team employed this metaphor in a system dynamics framework to construct a computer model to assess legal and illegal migration on the US-Mexico border. Employing a metaphor can be helpful, as it was in this project, to gain different perspectives on a complex system. In addition to the metaphor, the multidisciplinary team utilized an array of methods to gather data including traditional literature searches, an experts workshop, a focus group, interviews, and culling expertise from the individuals on the research team. Results from the qualitative efforts revealed strong social as well as economic drivers that motivate individuals to cross the border legally. Based on the information gathered, the team concluded that legal migration dynamics were of a scope we did not want to consider hence, available demographic models sufficiently capture migration at the local level. Results from both the quantitative and qualitative data searches were used to modify a 1977 border model to demonstrate the dynamic nature of illegal migration. Model runs reveal that current US-policies based on neo-classic economic theory have proven ineffective in curbing illegal migration, and that proposed enforcement policies are also likely to be ineffective. We suggest, based on model results, that improvement in economic conditions within Mexico may have the biggest impact on illegal migration to the U.S. The modeling also supports the views expressed in the current literature suggesting that demographic and economic changes within Mexico are likely to slow illegal migration by 2060 with no special interventions made by either government.

  17. Brief communication: Using averaged soil moisture estimates to improve the performances of a regional-scale landslide early warning system (United States)

    Segoni, Samuele; Rosi, Ascanio; Lagomarsino, Daniela; Fanti, Riccardo; Casagli, Nicola


    We communicate the results of a preliminary investigation aimed at improving a state-of-the-art RSLEWS (regional-scale landslide early warning system) based on rainfall thresholds by integrating mean soil moisture values averaged over the territorial units of the system. We tested two approaches. The simplest can be easily applied to improve other RSLEWS: it is based on a soil moisture threshold value under which rainfall thresholds are not used because landslides are not expected to occur. Another approach deeply modifies the original RSLEWS: thresholds based on antecedent rainfall accumulated over long periods are substituted with soil moisture thresholds. A back analysis demonstrated that both approaches consistently reduced false alarms, while the second approach reduced missed alarms as well.

  18. Improved simulation of tropospheric ozone by a global-multi-regional two-way coupling model system

    Directory of Open Access Journals (Sweden)

    Y. Yan


    with the ground measurements from 0.53 to 0.68, and it reduces the mean model bias from 10.8 to 6.7 ppb. Regionally, the coupled system reduces the bias by 4.6 ppb over Europe, 3.9 ppb over North America and 3.1 ppb over other regions. The two-way coupling brings O3 vertical profiles much closer to the HIPPO (for remote areas and MOZAIC (for polluted regions data, reducing the tropospheric (0–9 km mean bias by 3–10 ppb at most MOZAIC sites and by 5.3 ppb for HIPPO profiles. The two-way coupled simulation also reduces the global tropospheric column ozone by 3.0 DU (9.5 %, annual mean, bringing them closer to the OMI data in all seasons. Additionally, the two-way coupled simulation also reduces the global tropospheric mean hydroxyl radical by 5 % with improved estimates of methyl chloroform and methane lifetimes. Simulation improvements are more significant in the Northern Hemisphere, and are mainly driven by improved representation of spatial inhomogeneity in chemistry/emissions. Within the nested domains, the two-way coupled simulation reduces surface ozone biases relative to typical GEOS-Chem one-way nested simulations, due to much improved LBCs. The bias reduction is 1–7 times the bias reduction from the global to the one-way nested simulation. Improving model representations of small-scale processes is important for understanding the global and regional tropospheric chemistry.

  19. How Pacing of Multimedia Instructions Can Influence Modality Effects: A Case of Superiority of Visual Texts (United States)

    Stiller, Klaus D.; Freitag, Annika; Zinnbauer, Peter; Freitag, Christian


    "Present text accompanying pictures aurally to promote learning" is a well established principle of instructional design. But recently, it was shown that under certain conditions visual texts can be preferable. Instructional pacing seems to be one of these conditions that mediate effects. Especially, enabling learners to pace an…

  20. Differential effects of film on preschool children's behaviour dependent on editing pace. (United States)

    Kostyrka-Allchorne, Katarzyna; Cooper, Nicholas R; Gossmann, Anna Maria; Barber, Katy J; Simpson, Andrew


    Evidence on how the pace of television and film editing affects children's behaviour and attention is inconclusive. We examined whether a fast-paced film affected how preschool-aged children interacted with toys. The study comprised 70 children (36 girls) aged two to four-and-a-half years who attended preschools in Essex, United Kingdom. The children were paired up and tested with either a fast- or a slow-paced film of a narrator reading a children's story. The fast-paced version had 102 camera cuts and 16 still images, and the slow-paced version had 22 camera cuts and four still images. Each dyad took part in two video-recorded free-play sessions, before and after they watched one of the specially edited four-minute films. The number of toys the children played with before and after the film sessions was recorded. Before they watched the films, the children's behaviour did not differ between the groups. However, after watching the film, the children in the fast-paced group shifted their attention between toys more frequently than the children who watched the slow-paced film. Even a brief exposure to differently paced films had an immediate effect on how the children interacted with their toys. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  1. Levodopa reinstates connectivity from prefrontal to premotor cortex during externally paced movement in Parkinson's disease

    DEFF Research Database (Denmark)

    Herz, Damian M; Siebner, Hartwig R; Hulme, Oliver J


    , which were externally paced at a rate of 0.5Hz. This required participants to align their movement velocity to the slow external pace. Patients were studied after at least 12-hour withdrawal of dopaminergic medication (OFF state) and after intake of the dopamine precursor levodopa (ON state) in order...

  2. Child and Parental Outcomes Following Involvement in a Preventive Intervention: Efficacy of the PACE Program (United States)

    Begle, Angela Moreland; Dumas, Jean E.


    This study evaluated whether engagement (i.e., attendance and quality of participation) in the Parenting our Children to Excellence (PACE) program predicted positive child and parent outcomes. PACE in an 8-week preventive intervention aimed at parents of preschool children. The study investigated the relation of engagement to outcomes in an…

  3. Challenge of Engaging All Students via Self-Paced Interactive Electronic Learning Tutorials for Introductory Physics (United States)

    DeVore, Seth; Marshman, Emily; Singh, Chandralekha


    As research-based, self-paced electronic learning tools become increasingly available, a critical issue educators encounter is implementing strategies to ensure that all students engage with them as intended. Here, we first discuss the effectiveness of electronic learning tutorials as self-paced learning tools in large enrollment brick and mortar…

  4. Financing the Business. PACE Revised. Level 1. Unit 8. Research & Development Series No. 240AB8. (United States)

    Ashmore, M. Catherine; Pritz, Sandra G.

    This lesson on financing a business, the eighth in a series of 18 units, is part of the first level of a comprehensive entrepreneurship curriculum entitled: A Program for Acquiring Competence in Entrepreneurship (PACE). (Designed for use with secondary students, the first level of PACE introduces students to the concepts involved in…

  5. New method for cardiac resynchronization therapy: Transapical endocardial lead implantation for left ventricular free wall pacing

    NARCIS (Netherlands)

    I. Kassai (Imre); C. Foldesi (Csaba); A. Szekely (Andrea); T. Szili-Torok (Tamas)


    textabstractCoronary sinus lead placement for transvenous left ventricular (LV) pacing in cardiac resynchronization therapy (CRT) has a significant failure rate at implant and a significant dislocation rate during follow-up. For these patients, epicardial pacing lead implantation is the most

  6. Keeping Pace with K-12 Online & Blended Learning: An Annual Review of Policy and Practice, 2013 (United States)

    Watson, John; Murin, Amy; Vashaw, Lauren; Gemin, Butch; Rapp, Chris


    This is the 10th annual "Keeping Pace" report. "Keeping Pace" has several goals: (1) add to the body of knowledge about online education policy and practice, and make recommendations for advances; (2) serve as a reference source for information about programs and policies across the country, both for policymakers and…

  7. Active Self-Paced Learning for Cost-Effective and Progressive Face Identification. (United States)

    Lin, Liang; Wang, Keze; Meng, Deyu; Zuo, Wangmeng; Zhang, Lei


    This paper aims to develop a novel cost-effective framework for face identification, which progressively maintains a batch of classifiers with the increasing face images of different individuals. By naturally combining two recently rising techniques: active learning (AL) and self-paced learning (SPL), our framework is capable of automatically annotating new instances and incorporating them into training under weak expert recertification. We first initialize the classifier using a few annotated samples for each individual, and extract image features using the convolutional neural nets. Then, a number of candidates are selected from the unannotated samples for classifier updating, in which we apply the current classifiers ranking the samples by the prediction confidence. In particular, our approach utilizes the high-confidence and low-confidence samples in the self-paced and the active user-query way, respectively. The neural nets are later fine-tuned based on the updated classifiers. Such heuristic implementation is formulated as solving a concise active SPL optimization problem, which also advances the SPL development by supplementing a rational dynamic curriculum constraint. The new model finely accords with the "instructor-student-collaborative" learning mode in human education. The advantages of this proposed framework are two-folds: i) The required number of annotated samples is significantly decreased while the comparable performance is guaranteed. A dramatic reduction of user effort is also achieved over other state-of-the-art active learning techniques. ii) The mixture of SPL and AL effectively improves not only the classifier accuracy compared to existing AL/SPL methods but also the robustness against noisy data. We evaluate our framework on two challenging datasets, which include hundreds of persons under diverse conditions, and demonstrate very promising results. Please find the code of this project at:

  8. Integrating mobile technology with routine dietetic practice: the case of myPace for weight management. (United States)

    Harricharan, Michelle; Gemen, Raymond; Celemín, Laura Fernández; Fletcher, David; de Looy, Anne E; Wills, Josephine; Barnett, Julie


    The field of Mobile health (mHealth), which includes mobile phone applications (apps), is growing rapidly and has the potential to transform healthcare by increasing its quality and efficiency. The present paper focuses particularly on mobile technology for body weight management, including mobile phone apps for weight loss and the available evidence on their effectiveness. Translation of behaviour change theory into weight management strategies, including integration in mobile technology is also discussed. Moreover, the paper presents and discusses the myPace platform as a case in point. There is little clinical evidence on the effectiveness of currently available mobile phone apps in enabling behaviour change and improving health-related outcomes, including sustained body weight loss. Moreover, it is unclear to what extent these apps have been developed in collaboration with health professionals, such as dietitians, and the extent to which apps draw on and operationalise behaviour change techniques has not been explored. Furthermore, presently weight management apps are not built for use as part of dietetic practice, or indeed healthcare more widely, where face-to-face engagement is fundamental for instituting the building blocks for sustained lifestyle change. myPace is an innovative mobile technology for weight management meant to be embedded into and to enhance dietetic practice. Developed out of systematic, iterative stages of engagement with dietitians and consumers, it is uniquely designed to complement and support the trusted health practitioner-patient relationship. Future mHealth technology would benefit if engagement with health professionals and/or targeted patient groups, and behaviour change theory stood as the basis for technology development. Particularly, integrating technology into routine health care practice, rather than replacing one with the other, could be the way forward.

  9. The corticospinal responses of metronome-paced, but not self-paced strength training are similar to motor skill training. (United States)

    Leung, Michael; Rantalainen, Timo; Teo, Wei-Peng; Kidgell, Dawson


    The corticospinal responses to skill training may be different to strength training, depending on how the strength training is performed. It was hypothesised that the corticospinal responses would not be different following skill training and metronome-paced strength training (MPST), but would differ when compared with self-paced strength training (SPST). Corticospinal excitability, short-interval intra-cortical inhibition (SICI) and strength and tracking error were measured at baseline and 2 and 4 weeks. Participants (n = 44) were randomly allocated to visuomotor tracking, MPST, SPST or a control group. MPST increased strength by 7 and 18%, whilst SPST increased strength by 12 and 26% following 2 and 4 weeks of strength training. There were no changes in strength following skill training. Skill training reduced tracking error by 47 and 58% at 2 and 4 weeks. There were no changes in tracking error following SPST; however, tracking error reduced by 24% following 4 weeks of MPST. Corticospinal excitability increased by 40% following MPST and by 29% following skill training. There was no change in corticospinal excitability following 4 weeks of SPST. Importantly, the magnitude of change between skill training and MPST was not different. SICI decreased by 41 and 61% following 2 and 4 weeks of MPST, whilst SICI decreased by 41 and 33% following 2 and 4 weeks of skill training. Again, SPST had no effect on SICI at 2 and 4 weeks. There was no difference in the magnitude of SICI reduction between skill training and MPST. This study adds new knowledge regarding the corticospinal responses to skill and MPST, showing they are similar but different when compared with SPST.

  10. Can exposure variation be promoted in the shoulder girdle muscles by modifying work pace and inserting pauses during simulated assembly work? (United States)

    Januario, Leticia Bergamin; Madeleine, Pascal; Cid, Marina Machado; Samani, Afshin; Oliveira, Ana Beatriz


    This study investigated the acute effects of changing the work pace and implementing two pause types during an assembly task. Eighteen healthy women performed a simulated task in four different conditions: 1) slow or 2) fast work pace with 3) passive or 4) active pauses every two minutes. The root mean square (RMS) and exposure variation analysis (EVA) from the trapezius and serratus anterior muscles, as well as the rate of perceived exertion (RPE) from the neck-shoulder region, were observed. Decreased RMS and RPE as well as more variable muscle activity (EVA) were observed in the slow work pace compared with the fast one. The pause types had a limited effect, but active pauses resulted in increased RMS of the clavicular trapezius. The findings revealed the importance of work pace in the reduction of perceived exertion and promotion of variation in muscle activation during assembly tasks. However, the pause types had no important effect on the evaluated outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Improvement of IDC/CTBTO Event Locations in Latin America and the Caribbean Using a Regional Seismic Travel Time Model (United States)

    Given, J. W.; Guendel, F.


    The International Data Centre is a vital element of the Comprehensive Test Ban Treaty (CTBT) verification mechanism. The fundamental mission of the International Data Centre (IDC) is to collect, process, and analyze monitoring data and to present results as event bulletins to Member States. For the IDC and in particular for waveform technologies, a key measure of the quality of its products is the accuracy by which every detected event is located. Accurate event location is crucial for purposes of an On Site Inspection (OSI), which would confirm the conduct of a nuclear test. Thus it is important for the IDC monitoring and data analysis to adopt new processing algorithms that improve the accuracy of event location. Among them the development of new algorithms to compute regional seismic travel times through 3-dimensional models have greatly increased IDC's location precision, the reduction of computational time, allowing forward and inverse modeling of large data sets. One of these algorithms has been the Regional Seismic Travel Time model (RSTT) of Myers et al., (2011). The RSTT model is nominally a global model; however, it currently covers only North America and Eurasia in sufficient detail. It is the intention CTBTO's Provisional Technical Secretariat and the IDC to extend the RSTT model to other regions of the earth, e.g. Latin America-Caribbean, Africa and Asia. This is particularly important for the IDC location procedure, as there are regions of the earth for which crustal models are not well constrained. For this purpose IDC has launched a RSTT initiative. In May 2012, a technical meeting was held in Vienna under the auspices of the CTBTO. The purpose of this meeting was to invite National Data Centre experts as well as network operators from Africa, Europe, the Middle East, Asia, Australia, Latin and North America to discuss the context under which a project to extend the RSTT model would be implemented. A total of 41 participants from 32 Member States

  12. DEM-based delineation for improving geostatistical interpolation of rainfall in mountainous region of Central Himalayas, India (United States)

    Kumari, Madhuri; Singh, Chander Kumar; Bakimchandra, Oinam; Basistha, Ashoke


    In mountainous region with heterogeneous topography, the geostatistical modeling of the rainfall using global data set may not confirm to the intrinsic hypothesis of stationarity. This study was focused on improving the precision of the interpolated rainfall maps by spatial stratification in complex terrain. Predictions of the normal annual rainfall data were carried out by ordinary kriging, universal kriging, and co-kriging, using 80-point observations in the Indian Himalayas extending over an area of 53,484 km2. A two-step spatial clustering approach is proposed. In the first step, the study area was delineated into two regions namely lowland and upland based on the elevation derived from the digital elevation model. The delineation was based on the natural break classification method. In the next step, the rainfall data was clustered into two groups based on its spatial location in lowland or upland. The terrain ruggedness index (TRI) was incorporated as a co-variable in co-kriging interpolation algorithm. The precision of the kriged and co-kriged maps was assessed by two accuracy measures, root mean square error and Chatfield's percent better. It was observed that the stratification of rainfall data resulted in 5-20 % of increase in the performance efficiency of interpolation methods. Co-kriging outperformed the kriging models at annual and seasonal scale. The result illustrates that the stratification of the study area improves the stationarity characteristic of the point data, thus enhancing the precision of the interpolated rainfall maps derived using geostatistical methods.

  13. Collaborative Proposal: Improving Decadal Prediction of Arctic Climate Variability and Change Using a Regional Arctic System Model (RASM)

    Energy Technology Data Exchange (ETDEWEB)

    Maslowski, Wieslaw [Naval Postgraduate School, Monterey, CA (United States)


    This project aims to develop, apply and evaluate a regional Arctic System model (RASM) for enhanced decadal predictions. Its overarching goal is to advance understanding of the past and present states of arctic climate and to facilitate improvements in seasonal to decadal predictions. In particular, it will focus on variability and long-term change of energy and freshwater flows through the arctic climate system. The project will also address modes of natural climate variability as well as extreme and rapid climate change in a region of the Earth that is: (i) a key indicator of the state of global climate through polar amplification and (ii) which is undergoing environmental transitions not seen in instrumental records. RASM will readily allow the addition of other earth system components, such as ecosystem or biochemistry models, thus allowing it to facilitate studies of climate impacts (e.g., droughts and fires) and of ecosystem adaptations to these impacts. As such, RASM is expected to become a foundation for more complete Arctic System models and part of a model hierarchy important for improving climate modeling and predictions.

  14. Addressing the Clinical Burden of Child Physical Abuse and Neglect in a Large Metropolitan Region: Improving the Evidence-Base

    Directory of Open Access Journals (Sweden)

    Shanti Raman


    Full Text Available Children at risk of abuse are more likely to be hospitalized and utilize health services according to international research. In a large metropolitan health region in New South Wales, Australia, there was little known of the clinical burden of child physical abuse and/or neglect (PAN, or of systems for clinical assessment of children presenting with abuse/neglect. We aimed to identify the number of children presenting with suspected PAN to emergency departments (EDs and paediatric services in this region, to determine enablers and barriers to assessment for children with PAN presenting to frontline services, and to identify best practices to address gaps. We collated available data on children presenting to EDs and paediatric services with suspected PAN in 2007. We interviewed 36 health professionals from nine hospitals and 12 statutory child protection professionals, across the region before undertaking relevant document analysis. Of 64,700 paediatric ED presentations, a quarter were due to injury; 2%–5% of these were due to maltreatment. Clinician estimates and assessments of PAN varied widely; health and welfare workers identified major practice gaps, as well as good local practice. We identified feasible minimum standards for improving clinical assessment and follow-up for children presenting with PAN, given the right organizational support.


    Directory of Open Access Journals (Sweden)

    Zahro Varisna Rohmadani


    Full Text Available Penelitian ini bertujuan untuk mengetahui efektivitas metode future pacing hypnotherapy dalam menurunkan tingkat kecemasan pada mahasiswa baru. Subjek penelitian adalah 20 mahasiswa/i baru, 10 mahasiswa di kelompok eksperimen dan 10 mahasiswa di kelompok kontrol. Peserta mendapatkan penanganan untuk penurunan kecemasan dengan metode berupa future pacing hypnotherapy. Metode analisis data yang digunakan adalah statistik nonparametrik teknik Wilcoxon Signed Rank Test untuk menguji perbedaan skor cemas kelompok subjek saat pretest dan posttest serta Mann Whitney U untuk melihat perbedaan penurunan kecemasan pada kelompok eksperimen dan kelompok kontrol. Hasil Wilcoxon Signed Rank Test menunjukkan bahwa future pacing hypnotherapy efektif dalam menurunkan kecemasan dengan p=0,012. Sedangkan hasil Mann Whitney U menunjukkan bahwa future pacing hypnotherapy efektif dalam menurunkan kecemasan dengan p=0,003 dan kelompok eksperimen mengalami penurunan kecemasan yang lebih besar dengan mean rank = 14,25.Kata kunci : future pacing hypnotherapy, kecemasan, mahasiswa baru

  16. Transition towards improved regional wood flows by integrating material flux analysis and agent analysis. The case of Appenzell Ausserrhoden, Switzerland

    International Nuclear Information System (INIS)

    Binder, Claudia R.; Hofer, Christoph; Wiek, Arnim; Scholz, Roland W.


    This paper discusses the integration of material flux analysis and agent analysis as the basis for a transition towards improved regional wood management in Appenzell Ausserrhoden (AR), a small Swiss canton located in the Pre-Alps of Switzerland. We present a wood flow analysis for forests, wood processing industries and consumption in AR, accounting for different wood products. We find that the forest is currently significantly underutilized although there are sizeable imports of wood and fuel to this small region. The underutilization of the forest contributes to a skewed age distribution, jeopardizing long-term sustainable development of the forest, as the fulfillment of its protective and production function are likely to be at risk. The wood resources, however, are capable of satisfying current wood demand among the population of AR and wood could even be exported. Underutilization has two main causes: first, wood prices are so low that harvesting trees is a money-losing proposition; second, consumer wood demand and the current supply from forest owners are not aligned. Furthermore, cultural values, lifestyle trends and traditions make an alignment of supply and demand difficult. Consensus and strategy building with the relevant stakeholders on the basis of the results obtained from the wood flow analysis and agent analysis is a reasonable next step to take. We conclude that wood flow analysis combined with agent analysis provide a useful and straightforward tool to be used as the basis of a transition process towards improved regional wood flows, which in turn should contribute to sustainable forest management

  17. Increased base rate of atrial pacing for prevention of atrial fibrillation after implantation of a dual-chamber pacemaker: insights from the Atrial Overdrive Pacing Study. (United States)

    Kantharia, Bharat K; Freedman, Roger A; Hoekenga, David; Tomassoni, Gery; Worley, Seth; Sorrentino, Robert; Steinhaus, David; Wolkowicz, Joel M; Syed, Zaffer A


    Different pacing sites and various algorithms have been utilized to prevent atrial fibrillation (AF) in pacemaker recipients. However, the optimal pacing rate settings have not yet been established. In this randomized, prospective, multicentre, single-blinded, cross over study, rate-adaptive pacing at a high base rate (BR) in patients, age 60 years or above, or a history of paroxysmal AF, who underwent dual-chamber (DDD) pacemaker implantation for standard pacing indications, was evaluated for prevention of AF. In the study cohort of 145 patients implanted with DDD pacemakers with a programmable rest rate (RR) feature, the BR/RR settings were sequentially but randomly adjusted as follows: 60 bpm/Off for the baseline quarter (initial 3 months) and then to either 'A-B-C' or 'C-B-A' settings (A = 70/65 bpm, B = 70/Off, C = 80/65 bpm) for the subsequent quarters each of 3 months duration. Data on automatic mode switch episodes, device diagnostics, and a questionnaire evaluating pacemaker awareness and palpitations were collected. Ninety-nine patients, mean age 77 +/- 10 years, who completed the study protocol and followed for 12 months did not show significant differences in the number of mode switch episodes between any settings used. The percentage of atrial pacing was lower during baseline pacing compared to settings A, B, and C (P < 0.0001). Setting C produced a higher percentage of atrial pacing than A and B (P < 0.01). Although a higher percentage of atrial pacing correlated with a lower incidence of mode switch episodes, there was no statistically significant difference in the number of mode switch episodes between settings A, B, and C. There were no significant differences in the questionnaire scores relating to pacemaker awareness or palpitation. Overdrive single-site pacing in the right atrium achieved by programming analysed settings in the present study did not reduce AF as assessed by mode switch episodes. Additionally, no change in the symptoms of

  18. Peri-infarct zone pacing to prevent adverse left ventricular remodelling in patients with large myocardial infarction

    DEFF Research Database (Denmark)

    Stone, Gregg W; Chung, Eugene S; Stancak, Branislav


    AIMS: We sought to determine whether peri-infarct pacing prevents left ventricular (LV) remodelling and improves functional and clinical outcomes in patients with large first myocardial infarction (MI). METHODS AND RESULTS: A total of 126 patients at 27 international sites within 10 days of onset.......92). There were also no significant between-group differences in the change in LV end-systolic volume or ejection fraction over time. Quality of life, as assessed by the Minnesota Living with Heart Failure (HF) and European Quality of Life-5 Dimension questionnaires and New York Heart Association class, was also...

  19. Criteria for definition of regional functional improvement on quantitative post-stress gated myocardial SPET after bypass surgery in patients with ischaemic cardiomyopathy

    International Nuclear Information System (INIS)

    Lee, Dong Soo; Cheon, Gi Jeong; Paeng, Jin Chul; Chung, June-Key; Lee, Myung Chul; Kim, Ki Bong


    Myocardial viability can be defined as functional improvement of dysfunctional myocardium after revascularization. The purpose of this study was to define the optimal criteria for definition of regional functional improvement after coronary artery bypass graft (CABG) surgery on quantitative gated single-photon emission tomography (SPET). Thirty-two patients (26 men, 6 women; age 56±13 years) with coronary artery disease (three-vessel disease, 17; two-vessel disease, 15; previous history of myocardial infarction, 9) and severe left ventricular dysfunction (LVEF≤35%) underwent CABG. Rest thallium-201/dipyridamole stress technetium-99m methoxyisobutylisonitrile gated myocardial SPET was performed before and 3 months after CABG. Global LV functional improvement was defined as either an improvement in LVEF of 10% (n=15) or an improvement in LVEF of 5% combined with a decrease in end-systolic volume of 10 ml (n=2) after CABG on quantitative gated SPET. Postoperative regional wall thickening improvement (ΔRWT), regional wall motion improvement (ΔRWM) and regional resting (ΔRP) and stress perfusion improvement (ΔRstrP) were used to determine global functional improvement by ROC curve analysis, and the optimal criteria for definition of viable regional dysfunctional myocardium were defined on the ROC curves. Correlations were verified by determining the number of improved myocardial regions and LVEF improvement. LVEF was improved from 25%±6% to 34%±11% after CABG. A total of 229 segments were dysfunctional (wall motion ≤2 mm, thickening ≤20%) before CABG. On ROC curve analysis using global functional improvement as an indicator of viability, the areas under the ROC curves (AUCs) of ΔRWT and ΔRWM were 0.717 and 0.620, respectively. The AUC of ΔRWT was significantly larger than that of ΔRWM (P=0.009) and the optimal cut-off value of ΔRWT was 15%. The AUCs of ΔRP and ΔRstrP were not significant. The correlation coefficients between summed ΔRWT and

  20. Food banking for improved nutrition of HIV infected orphans and vulnerable children; emerging evidence from quality improvement teams in high food insecure regions of Kiambu, Kenya. (United States)

    Akulima, Muhamed; Ikamati, Rudia; Mungai, Margaret; Samuel, Muhula; Ndirangu, Meshack; Muga, Richard


    Estimated 236,548 People Living with HIV (PLHIV) were in Central-Eastern Kenya in 2013. Kiambu County had 46,656 PLHIV with 42,400 (91%) adults and 4,200(9%) children (1-14yrs). Amref Health Africa in Kenya, supported through USAID-APHIAplus KAMILI project, initiated two food banks to respond to poor nutritional status of the HIV infected children. Quality Improvement Teams were used to facilitate food-banking initiatives. The study aimed at assessing and demonstrating roles of community food-banking in improving nutrition status of HIV-infected children in food insecure regions. A pre and post-test study lasting 12 months (Oct 2013 to September 2014) conducted in Kiambu County, Kenya covering 103 HIV infected children. Two assessments were conducted before and after the food banking initiative and results compared. Child Status Index (CSI) and the Middle Upper Arm Circumference (MUAC) tools were used in data collection at households. Paired T-test and Wilcoxon test were applied for analysing MUAC and CSI scores respectively using the SPSS. There was a significant improvement in the children's nutrition status from a rating of 'bad' in CSI Median (IQR) score 2(2-1) before food banking to a rating of 'fair' in CSI Median (IQR) score 3(4-3) after food banking intervention (p=banking (p=banking is a community-based nutritional intervention that can address factors of food access, affordability and availability. Food banking is a sustainable way to contribute to quality nutrition and reduced related deaths among HIV infected children.

  1. Exploiting the synergy between SMAP and SMOS to improve brightness temperature simulations and soil moisture retrievals in arid regions (United States)

    Ebrahimi, Mohsen; Alavipanah, Seyed Kazem; Hamzeh, Saeid; Amiraslani, Farshad; Neysani Samany, Najmeh; Wigneron, Jean-Pierre


    The objective of this study was to exploit the synergy between SMOS and SMAP based on vegetation optical depth (VOD) to improve brightness temperature (TB) simulations and land surface soil moisture (SM) retrievals in arid regions of the world. In the current operational algorithm of SMAP (level 2), vegetation water content (VWC) is considered as a proxy to compute VOD which is calculated by an empirical conversion function of NDVI. Avoiding the empirical estimation of VOD, the SMOS algorithm is used to retrieve simultaneously SM and VOD from TB observations. The present study attempted to improve SMAP TB simulations and SM retrievals by benefiting from the advantages of the SMOS (L-MEB) algorithm. This was achieved by using a synergy method based on replacing the default value of SMAP VOD with the retrieved value of VOD from the SMOS multi angular and bi-polarization observations of TB. The insitu SM measurements, used as reference SM in this study, were obtained from the International Soil Moisture Network (ISMN) over 180 stations located in arid regions of the world. Furthermore, four stations were randomly selected to analyze the temporal variations in VOD and SM. Results of the synergy method showed that the accuracy of the TB simulations and SM retrievals was respectively improved at 144 and 124 stations (out of a total of 180 stations) in terms of coefficient of determination (R2) and unbiased root mean squared error (UbRMSE). Analyzing the temporal variations in VOD showed that the SMOS VOD, conversely to the SMAP VOD, can better illustrate the presence of herbaceous plants and may be a better indicator of the seasonal changes in the vegetation density and biomass over the year.

  2. Improved Method for Direct Detection of Environmental Microorganisms Using an Amplification of 16S rDNA Region (United States)

    Tsujimura, M.; Akutsu, J.; Zhang, Z.; Sasaki, M.; Tajima, H.; Kawarabayasi, Y.


    The thermostable proteins or enzymes were expected to be capable to be utilized in many areas of industries. Many thermophilic microorganisms, which possess the thermostable proteins or enzymes, were identified from the extreme environment. However, many unidentified and uncultivable microorganisms are still remaining in the environment on the earth. It is generally said that the cultivable microorganisms are less than 1% of entire microorganisms living in the earth, remaining over 99% are still uncultivable. As an approach to the uncultivable microorganisms, the PCR amplification of 16S rDNA region using primer sets designed from the conserved region has been generally utilized for detection and community analysis of microorganism in the environment. However, the facts, that PCR amplification introduces the mutation in the amplified DNA fragment and efficiency of PCR amplification is depend on the sequences of primer sets, indicated that the improving of PCR analysis was necessary for more correct detection of microorganisms. As the result of evaluation for the quality of DNA polymerases, sequences of primers used for amplification and conditions of PCR amplification, the DNA polymerase, the primer set and the conditions for amplification, which did not amplify the DNA fragment from the DNA contaminated within the DNA polymerase itself, were successfully selected. Also the rate of mutation in the DNA fragment amplified was evaluated using this conditions and the genomic DNA from cultivable microbes as a template. The result indicated the rate of mutation introduced by PCR was approximately 0.1% to 0.125%. The improved method using these conditions and error rate calculated was applied for the analysis of microorganisms in the geothermal environment. The result indicated that four kinds of dominant microorganisms, including both of bacteria and archaea, were alive within soil in the hot spring in Tohoku Area. We would like to apply this improved method to detection

  3. Effect of biventricular pacing on heart function evaluated by gated blood pool study in patients with end-stage heart failure

    International Nuclear Information System (INIS)

    Cholewinski, W.; Tarkowska, A.; Stefaniak, B.; Poniatowicz-Frasunek, E.; Kutarski, A.; Oleszczak, K.


    Biventricular cardiac pacing has been used as a complementary form of therapy in patients with severe heart failure. The aim of this study was to evaluate the effect of the synchronous stimulation of both ventricles on the heart function measured by gated blood pool study (GBP). Ten patients (9 men and 1 woman aged 53-74 years) with end-stage heart failure (HF) were studied. In all patients long-term biventricular pacing (BV) was applied. The obtained results were compared with single-chamber stimulation in 5 patients and with sinus rhythm (SR) in 8 patients. All patients underwent repeated GBP with RBC labelled with 740 MBq of 99m Tc-pertechnetate. The LVEF was calculated according to the standard method based on the count rates. Phase analysis was performed with the standard method using first Fourier element. Clinically in almost all patients moderate to important symptomatic improvement has been observed. The analysis of LVEF values revealed that BV pacing resulted in significantly higher values only in comparison with SR (21.6% ±10.3 v. 20.1% ± 10.1; p o± 29.6 v. 13.4 o± 37.6 and 7.4 o± 26.5 v. 6.0 o± 17.1, respectively). However, in comparison with LV pacing, BV stimulation revealed a change of dominant conduction abnormalities with a delay of RV contraction in relation to LV (9.0 o± 17.5 v. -3.0 o± 11.4). Biventricular pacing results in slight improvement of LVEF in patients with heart failure and can be considered a promising approach in patients with end-stage heart failure. Synchronous stimulation of both ventricles not always results in decrease of interventricular shift, however that observation requires further studies on a larger population. (author)

  4. Common and rare variants in the exons and regulatory regions of osteoporosis-related genes improve osteoporotic fracture risk prediction. (United States)

    Lee, Seung Hun; Kang, Moo Il; Ahn, Seong Hee; Lim, Kyeong-Hye; Lee, Gun Eui; Shin, Eun-Soon; Lee, Jong-Eun; Kim, Beom-Jun; Cho, Eun-Hee; Kim, Sang-Wook; Kim, Tae-Ho; Kim, Hyun-Ju; Yoon, Kun-Ho; Lee, Won Chul; Kim, Ghi Su; Koh, Jung-Min; Kim, Shin-Yoon


    Osteoporotic fracture risk is highly heritable, but genome-wide association studies have explained only a small proportion of the heritability to date. Genetic data may improve prediction of fracture risk in osteopenic subjects and assist early intervention and management. To detect common and rare variants in coding and regulatory regions related to osteoporosis-related traits, and to investigate whether genetic profiling improves the prediction of fracture risk. This cross-sectional study was conducted in three clinical units in Korea. Postmenopausal women with extreme phenotypes (n = 982) were used for the discovery set, and 3895 participants were used for the replication set. We performed targeted resequencing of 198 genes. Genetic risk scores from common variants (GRS-C) and from common and rare variants (GRS-T) were calculated. Nineteen common variants in 17 genes (of the discovered 34 functional variants in 26 genes) and 31 rare variants in five genes (of the discovered 87 functional variants in 15 genes) were associated with one or more osteoporosis-related traits. Accuracy of fracture risk classification was improved in the osteopenic patients by adding GRS-C to fracture risk assessment models (6.8%; P risk in an osteopenic individual.

  5. Comparison of right ventricular septal pacing and right ventricular apical pacing in patients receiving cardiac resynchronization therapy defibrillators: the SEPTAL CRT Study (United States)

    Leclercq, Christophe; Sadoul, Nicolas; Mont, Lluis; Defaye, Pascal; Osca, Joaquim; Mouton, Elisabeth; Isnard, Richard; Habib, Gilbert; Zamorano, Jose; Derumeaux, Genevieve; Fernandez-Lozano, Ignacio; Dupuis, Jean-Marc; Rouleau, Frédéric; Tassin, Aude; Bordachar, Pierre; Clémenty, Jacques; Lafitte, Stephane; Ploux, Sylvan; Reant, Patricia; Ritter, Philippe; Defaye, Pascal; Jacon, Peggy; Mondesert, Blandine; Saunier, Carole; Vautrin, Estelle; Kacet, Salem; Guedon-Moreau, Laurence; Klug, Didier; Kouakam, Claude; Marechaux, Sylvestre; Marquie, Christelle; Polge, Anne Sophie; Richardson, Marjorie; Chevallier, Philippe; De Breyne, Brigitte; Lotek, Marcin M.; Nonin, Emilie; Pineau, Julien; Deharo, Jean-Claude; Bastard, Emilie; Franceschi, Frédéric; Habib, Gilbert; Jego, Christophe; Peyrouse, Eric; Prevot, Sebastien; Saint-Joseph, Hôpital; Bremondy, Michel; Faure, Jacques; Ferracci, Ange; Lefevre, Jean; Pisapia, Andre; Davy, Jean-Marc; Cransac, Frederic; Cung, Tien Tri; Georger, Frederic; Pasquie, Jean-Luc; Raczka, Franck; Sportouch-Dukhan, Catherine; Sadoul, Nicolas; Blangy, Hugues; Bruntz, Jean-François; Freysz, Luc; Groben, Laurent; Huttin, Olivier; Bammert, Antoine; Burban, Marc; Cebron, Jean-Pierre; Gras, Daniel; Frank, Robert; Duthoit, Guillaume; Hidden-Lucet, Françoise; Himbert, Caroline; Isnard, Richard; Lacotte, Jérôme; Pousset, Françoise; Zerah, Thierry; Leclercq, Christophe; Bellouin, Annaïk; Crocq, Christophe; Deplace, Christian; Donal, Erwan; Hamon, Cécile; Mabo, Philippe; Romain, Olivier; Solnon, Aude; Frederic, Anselme; Bauer, Fabrice; Bernard, Mathieu; Godin, Benedicte; Kurtz, Baptiste; Savoure, Arnaud; Copie, Xavier; Lascault, Gilles; Paziaud, Olivier; Piot, Olivier; Touche, Thierry; Delay, Toulouse Marc; Chilon, Talia; Detis, Nicolas; Duparc, Alexandre; Hebrard, Aurélien; Massabuau, Pierre; Maury, Philippe; Mondoly, Pierre; Rumeau, Philippe; Pasteur, Clinique; Boveda, Serge; Adrover, Laurence; Combes, Nicolas; Deplagne, Antoine; Marco-Baertich, Isabelle; Fondard, Olivier; Martínez, Juan Gabriel; Ibañez Criado, José Luis; Ortuño, Diego; Mont, Lluis; Berruezo, Antonio; Eduard, Belu; Martín, Ana; Merschon, Franco M.; Sitges, Marta; Tolosana, José María; Vidal, Bárbara; Hebron, H. Valle; i Mitjans, Angel Moya; Rodriguez, Oscar Alcalde; Rodriguez Palomares, José Fernando; Rivas, Nuria; Teixidó, Gisela; de Hierro, H. Puerta; Lozano, Ignacio Fernández; Ruiz Bautista, Maria Lorena; Castro, Victor; Cavero, Miguel Angel; Gutierrez, Carlos; Ros, Natalia; de la Victoria, H. Virgen; Alzueta Rodriguez, Francisco Javier; Cabrera, Fernando; Cordero, Alberto Barrera; Peña, José Luis; de Valme Sevilla, H.; Gonzáles, Juan Lealdel Ojo; Garcia Medina, Mª Dolores; Jiménez, Ricardo Pavón; Villagomez, David; de la Salud Toledo, H. Virgen; Castellanos Martinez, Eduardo; Alcalá, Juan; Maicas, Carolina; Arias Palomares, Miguel Angel; Puchol, Alberto; Valencia, H. La Fé; OscaAsensi, Joaquim; Carmona, Anastasio Quesada; De Carranza, Mª José Sancho-Tello; De Ros, José Olagüe; Pareja, Enrique Castro; Pérez, Oscar Cano; Saez, Ana Osa; Hortega, H. Rio; Guilarte, Benito Herreros; Muñoz San Jose, Juan Francisco; Pérez Sanz, Teresa Myriam; Logeart, Damien; Gil, Maria Lopez; Leclercq, Christophe; Lozano, Ignacio Fernandez; de Hierro, H. Puerta; Derumeaux, Genevieve


    Abstract Aims Cardiac resynchronization therapy (CRT) is a recommended treatment of heart failure (HF) patients with depressed left ventricular ejection fraction and wide QRS. The optimal right ventricular (RV) lead position being a matter of debate, we sought to examine whether RV septal (RVS) pacing was not inferior to RV apical (RVA) pacing on left ventricular reverse remodelling in patients receiving a CRT-defibrillator. Methods and results Patients (n = 263, age = 63.4 ± 9.5 years) were randomly assigned in a 1:1 ratio to RVS (n = 131) vs. RVA (n = 132) pacing. Left ventricular end-systolic volume (LVESV) reduction between baseline and 6 months was not different between the two groups (−25.3 ± 39.4 mL in RVS group vs. −29.3 ± 44.5 mL in RVA group, P = 0.79). Right ventricular septal pacing was not non-inferior (primary endpoint) to RVA pacing with regard to LVESV reduction (average difference = −4.06 mL; P = 0.006 with a −20 mL non-inferiority margin). The percentage of ‘echo-responders’ defined by LVESV reduction >15% between baseline and 6 months was similar in both groups (50%) with no difference in the time to first HF hospitalization or death (P = 0.532). Procedural or device-related serious adverse events occurred in 68 patients (RVS = 37) with no difference between the two groups (P = 0.401). Conclusion This study demonstrates that septal RV pacing in CRT is non-inferior to apical RV pacing for LV reverse remodelling at 6 months with no difference in the clinical outcome. No recommendation for optimal RV lead position can hence be drawn from this study. ClinicalTrials. gov number NCT 00833352. PMID:26374852

  6. Evolutionary traces decode molecular mechanism behind fast pace of myosin XI

    Directory of Open Access Journals (Sweden)

    Syamaladevi Divya P


    Full Text Available Abstract Background Cytoplasmic class XI myosins are the fastest processive motors known. This class functions in high-velocity cytoplasmic streaming in various plant cells from algae to angiosperms. The velocities at which they process are ten times faster than its closest class V homologues. Results To provide sequence determinants and structural rationale for the molecular mechanism of this fast pace myosin, we have compared the sequences from myosin class V and XI through Evolutionary Trace (ET analysis. The current study identifies class-specific residues of myosin XI spread over the actin binding site, ATP binding site and light chain binding neck region. Sequences for ET analysis were accumulated from six plant genomes, using literature based text search and sequence searches, followed by triple validation viz. CDD search, string-based searches and phylogenetic clustering. We have identified nine myosin XI genes in sorghum and seven in grape by sequence searches. Both the plants possess one gene product each belonging to myosin type VIII as well. During this process, we have re-defined the gene boundaries for three sorghum myosin XI genes using fgenesh program. Conclusion Molecular modelling and subsequent analysis of putative interactions involving these class-specific residues suggest a structural basis for the molecular mechanism behind high velocity of plant myosin XI. We propose a model of a more flexible switch I region that contributes to faster ADP release leading to high velocity movement of the algal myosin XI.

  7. Better temperature predictions in geothermal modelling by improved quality of input parameters: a regional case study from the Danish-German border region (United States)

    Fuchs, Sven; Bording, Thue S.; Balling, Niels


    Thermal modelling is used to examine the subsurface temperature field and geothermal conditions at various scales (e.g. sedimentary basins, deep crust) and in the framework of different problem settings (e.g. scientific or industrial use). In such models, knowledge of rock thermal properties is prerequisites for the parameterisation of boundary conditions and layer properties. In contrast to hydrogeological ground-water models, where parameterization of the major rock property (i.e. hydraulic conductivity) is generally conducted considering lateral variations within geological layers, parameterization of thermal models (in particular regarding thermal conductivity but also radiogenic heat production and specific heat capacity) in most cases is conducted using constant parameters for each modelled layer. For such constant thermal parameter values, moreover, initial values are normally obtained from rare core measurements and/or literature values, which raise questions for their representativeness. Some few studies have considered lithological composition or well log information, but still keeping the layer values constant. In the present thermal-modelling scenario analysis, we demonstrate how the use of different parameter input type (from literature, well logs and lithology) and parameter input style (constant or laterally varying layer values) affects the temperature model prediction in sedimentary basins. For this purpose, rock thermal properties are deduced from standard petrophysical well logs and lithological descriptions for several wells in a project area. Statistical values of thermal properties (mean, standard deviation, moments, etc.) are calculated at each borehole location for each geological formation and, moreover, for the entire dataset. Our case study is located at the Danish-German border region (model dimension: 135 x115 km, depth: 20 km). Results clearly show that (i) the use of location-specific well-log derived rock thermal properties and (i

  8. The neural bases of the constructive nature of autobiographical memories studied with a self-paced fMRI design

    Energy Technology Data Exchange (ETDEWEB)

    Botzung, A.; Denkova, E.; Ciuciu, P.; Scheiber, C.; Manning, L. [CNRS, Strasbourg (France)


    In Conway and Pleydell-Pearce's model (2000), autobiographical memories are viewed as transitory mental representations, more often generated in an effort-full way. An important claim of the model concerns the dynamic process that evolves over time, from the left prefrontal areas to posterior regions, to retrieve specific memories. The present work aims at investigating, using fMRI, the temporal distribution of effort-full autobiographical memory construction. In addition, a self-paced design was implemented to elucidate the question of the timing window required to evoke recollections. The results showed a large pattern of brain regions, which included the two major poles of activation predicted by Conway and Pleydell-Pearce's model. Likewise, we were able to detect the earlier implication of the left dorso-lateral prefrontal cortex, by comparison with posterior structures, which seemed to confirm its involvement in the effort-full retrieval process. Finally, the self-paced procedure allowed us to refine the timing window necessary to construct past events. (authors)

  9. The neural bases of the constructive nature of autobiographical memories studied with a self-paced fMRI design

    International Nuclear Information System (INIS)

    Botzung, A.; Denkova, E.; Ciuciu, P.; Scheiber, C.; Manning, L.


    In Conway and Pleydell-Pearce's model (2000), autobiographical memories are viewed as transitory mental representations, more often generated in an effort-full way. An important claim of the model concerns the dynamic process that evolves over time, from the left prefrontal areas to posterior regions, to retrieve specific memories. The present work aims at investigating, using fMRI, the temporal distribution of effort-full autobiographical memory construction. In addition, a self-paced design was implemented to elucidate the question of the timing window required to evoke recollections. The results showed a large pattern of brain regions, which included the two major poles of activation predicted by Conway and Pleydell-Pearce's model. Likewise, we were able to detect the earlier implication of the left dorso-lateral prefrontal cortex, by comparison with posterior structures, which seemed to confirm its involvement in the effort-full retrieval process. Finally, the self-paced procedure allowed us to refine the timing window necessary to construct past events. (authors)

  10. Effect of chronic right ventricular apical pacing on left ventricular function. (United States)

    O'Keefe, James H; Abuissa, Hussam; Jones, Philip G; Thompson, Randall C; Bateman, Timothy M; McGhie, A Iain; Ramza, Brian M; Steinhaus, David M


    The determinants of change in left ventricular (LV) ejection fraction (EF) over time in patients with impaired LV function at baseline have not been clearly established. Using a nuclear database to assess changes in LV function over time, we included patients with a baseline LVEF of 25% to 40% on a gated single-photon emission computed tomographic study at rest and only if second-gated photon emission computed tomography performed approximately 18 months after the initial study showed an improvement in LVEF at rest of > or =10 points or a decrease in LVEF at rest of > or =7 points. In all, 148 patients qualified for the EF increase group and 59 patients for the EF decrease group. LVEF on average increased from 33 +/- 4% to 51 +/- 8% in the EF increase group and decreased from 35 +/- 4% to 25 +/- 5% in the EF decrease group. The strongest multivariable predictor of improvement of LVEF was beta-blocker therapy (odds ratio 3.9, p = 0.002). The strongest independent predictor of LVEF decrease was the presence of a permanent right ventricular apical pacemaker (odds ratio 6.6, p = 0.002). Thus, this study identified beta-blocker therapy as the major independent predictor for improvement in LVEF of > or =10 points, whereas a permanent pacemaker (right ventricular apical pacing) was the strongest predictor of a LVEF decrease of > or =7 points.

  11. Effects of a 4-week high-intensity interval training on pacing during 5-km running trial

    Directory of Open Access Journals (Sweden)

    R. Silva


    Full Text Available This study analyzed the influence of a 4-week high-intensity interval training on the pacing strategy adopted by runners during a 5-km running trial. Sixteen male recreational long-distance runners were randomly assigned to a control group (CON, n=8 or a high-intensity interval training group (HIIT, n=8. The HIIT group performed high-intensity interval-training twice per week, while the CON group maintained their regular training program. Before and after the training period, the runners performed an incremental exercise test to exhaustion to measure the onset of blood lactate accumulation, maximal oxygen uptake (VO2max, and peak treadmill speed (PTS. A submaximal constant-speed test to measure the running economy (RE and a 5-km running trial on an outdoor track to establish pacing strategy and performance were also done. During the 5-km running trial, the rating of perceived exertion (RPE and time to cover the 5-km trial (T5 were registered. After the training period, there were significant improvements in the HIIT group of ∼7 and 5% for RE (P=0.012 and PTS (P=0.019, respectively. There was no significant difference between the groups for VO2max (P=0.495 or onset of blood lactate accumulation (P=0.101. No difference was found in the parameters measured during the 5-km trial before the training period between HIIT and CON (P>0.05. These findings suggest that 4 weeks of HIIT can improve some traditional physiological variables related to endurance performance (RE and PTS, but it does not alter the perception of effort, pacing strategy, or overall performance during a 5-km running trial.

  12. Exploring the potential of a multi-level approach to improve capability for continuous organizational improvement and learning in a Swedish healthcare region. (United States)

    Nyström, M E; Höög, E; Garvare, R; Andersson Bäck, M; Terris, D D; Hansson, J


    Eldercare and care of people with functional impairments is organized by the municipalities in Sweden. Improving care in these areas is complex, with multiple stakeholders and organizations. Appropriate strategies to develop capability for continuing organizational improvement and learning (COIL) are needed. The purpose of our study was to develop and pilot-test a flexible, multilevel approach for COIL capability building and to identify what it takes to achieve changes in key actors' approaches to COIL. The approach, named "Sustainable Improvement and Development through Strategic and Systematic Approaches" (SIDSSA), was applied through an action-research and action-learning intervention. The SIDSSA approach was tested in a regional research and development (R&D) unit, and in two municipalities handling care of the elderly and people with functional impairments. Our approach included a multilevel strategy, development loops of five flexible phases, and an action-learning loop. The approach was designed to support systems understanding, strategic focus, methodological practices, and change process knowledge - all of which required double-loop learning. Multiple qualitative methods, i.e., repeated interviews, process diaries, and documents, provided data for conventional content analyses. The new approach was successfully tested on all cases and adopted and sustained by the R&D unit. Participants reported new insights and skills. The development loop facilitated a sense of coherence and control during uncertainty, improved planning and problem analysis, enhanced mapping of context and conditions, and supported problem-solving at both the individual and unit levels. The systems-level view and structured approach helped participants to explain, motivate, and implement change initiatives, especially after working more systematically with mapping, analyses, and goal setting. An easily understood and generalizable model internalized by key organizational actors is an

  13. Mechanical Alterations during 800-m Self-Paced Track Running. (United States)

    Girard, Olivier; Millet, Gregoire P; Micallef, Jean-Paul


    We assessed the time course of running mechanical alterations during an 800-m. On a 200-m indoor track, 18 physical education students performed an 800-m self-paced run. Once per lap, ground reaction forces were measured by a 5-m-long force platform system, and used to determine running kinetics/kinematics and spring-mass characteristics. Compared with 100 m (19.4±1.8 km.h -1 ) running velocity progressively decreased at 300, 500 m but levelled-off at 700 m marks (-5.7±4.6, -10.4±8.3, and -9.1±13.5%, respectively; Ppush-off forces (-5.1±7.2%, P0.05) and leg compression (+2.8±3.9%; P>0.05) remained unchanged, whereas centre of mass vertical displacement (+24.0±7.0%; P0.05). During an 800 m by physical education students, highest running velocity was achieved early during the run, with a progressive decrease in the second half of the trial. While vertical ground force characteristics remained unchanged, non-specialist runners produced lower peak braking and push-off forces, in turn leading to shorter stride length. Spring-mass model characteristics changed toward lower vertical stiffness values, whereas leg stiffness did not change. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Implementation of the World Health Organization Regional Office for Africa Stepwise Laboratory Quality Improvement Process Towards Accreditation. (United States)

    Ndihokubwayo, Jean-Bosco; Maruta, Talkmore; Ndlovu, Nqobile; Moyo, Sikhulile; Yahaya, Ali Ahmed; Coulibaly, Sheick Oumar; Kasolo, Francis; Turgeon, David; Abrol, Angelii P


    The increase in disease burden has continued to weigh upon health systems in Africa. The role of the laboratory has become increasingly critical in the improvement of health for diagnosis, management and treatment of diseases. In response, the World Health Organization Regional Office for Africa (WHO AFRO) and its partners created the WHO AFRO Stepwise Laboratory (Quality) Improvement Process Towards Accreditation (SLIPTA) program. WHO AFRO defined a governance structure with roles and responsibilities for six main stakeholders. Laboratories were evaluated by auditors trained and certified by the African Society for Laboratory Medicine. Laboratory performance was measured using the WHO AFRO SLIPTA scoring checklist and recognition certificates rated with 1-5 stars were issued. By March 2015, 27 of the 47 (57%) WHO AFRO member states had appointed a SLIPTA focal point and 14 Ministers of Health had endorsed SLIPTA as the desired programme for continuous quality improvement. Ninety-eight auditors from 17 African countries, competent in the Portuguese (3), French (12) and English (83) languages, were trained and certified. The mean score for the 159 laboratories audited between May 2013 and March 2015 was 69% (median 70%; SD 11.5; interquartile range 62-77). Of these audited laboratories, 70% achieved 55% compliance or higher (2 or more stars) and 1% scored at least 95% (5 stars). The lowest scoring sections of the WHO AFRO SLIPTA checklist were sections 6 (Internal Audit) and 10 (Corrective Action), which both had mean scores below 50%. The WHO AFRO SLIPTA is a process that countries with limited resources can adopt for effective implementation of quality management systems. Political commitment, ownership and investment in continuous quality improvement are integral components of the process.

  15. An improved anisotropy-resolving subgrid-scale model for flows in laminar–turbulent transition region

    International Nuclear Information System (INIS)

    Inagaki, Masahide; Abe, Ken-ichi


    Highlights: • An anisotropy-resolving subgrid-scale model, covering a wide range of grid resolutions, is improved. • The new model enhances its applicability to flows in the laminar-turbulent transition region. • A mixed-timescale subgrid-scale model is used as the eddy viscosity model. • The proposed model successfully predicts the channel flows at transitional Reynolds numbers. • The influence of the definition of the grid-filter width is also investigated. - Abstract: Some types of mixed subgrid-scale (SGS) models combining an isotropic eddy-viscosity model and a scale-similarity model can be used to effectively improve the accuracy of large eddy simulation (LES) in predicting wall turbulence. Abe (2013) has recently proposed a stabilized mixed model that maintains its computational stability through a unique procedure that prevents the energy transfer between the grid-scale (GS) and SGS components induced by the scale-similarity term. At the same time, since this model can successfully predict the anisotropy of the SGS stress, the predictive performance, particularly at coarse grid resolutions, is remarkably improved in comparison with other mixed models. However, since the stabilized anisotropy-resolving SGS model includes a transport equation of the SGS turbulence energy, k SGS , containing a production term proportional to the square root of k SGS , its applicability to flows with both laminar and turbulent regions is not so high. This is because such a production term causes k SGS to self-reproduce. Consequently, the laminar–turbulent transition region predicted by this model depends on the inflow or initial condition of k SGS . To resolve these issues, in the present study, the mixed-timescale (MTS) SGS model proposed by Inagaki et al. (2005) is introduced into the stabilized mixed model as the isotropic eddy-viscosity part and the production term in the k SGS transport equation. In the MTS model, the SGS turbulence energy, k es , estimated by

  16. Electronic health records and technical assistance to improve quality of primary care: Lessons for regional extension centers. (United States)

    Boas, Samuel J; Bishop, Tara F; Ryan, Andrew M; Shih, Sarah C; Casalino, Lawrence P


    In 2009, the American Recovery and Reinvestment Act apportioned $643 million for a Health Information Technology Extension Program, which established Regional Extension Centers (RECs) to support the implementation and use of electronic health records (EHRs). Little is known, however, about how RECs should assist in EHR implementation and how they should structure ongoing support. The purpose of this paper is to describe physicians' experiences with the Primary Care Information Project (PCIP), an REC run by the New York City Department of Health and Mental Hygiene. We interviewed 17 physicians enrolled in PCIP to understand the role of the EHRon quality of care and their experience with technical assistance from PCIP. All physicians stated that they felt that the EHR improved the quality of care they delivered to their patients particularly because it helped them track patients. All the physicians found technical assistance helpful but most wanted ongoing assistance months or years after they adopted the EHR. © 2013 Published by Elsevier Inc.

  17. Southeast Regional Wastewater Treatment Plant Facilities Improvements Project and Geysers Effluent Pipeline Project. Final EIR/EIS

    International Nuclear Information System (INIS)


    On May 26, 1994, the Lake County Sanitation District and the US Bureau of Land Management released for public review a Draft Environmental Impact Report/Environmental Impact Statement (EIR/EIS) on the proposed Southeast Regional Wastewater Treatment Plant Facilities Improvements Project and Geysers Effluent Pipeline Project. A minimum 45-day review and comment period began on that date and notices were published in the Federal Register. The public review and comment period closed on July 26, 1994. Public hearings on the Draft EIMIS were held in Lakeport, CA, on June 30 and July 14, 1994. The first part of this document contains copies of the written comments submitted on the Draft EIR/EIS. It also contains summary paraphrased comments of the public hearings. The second part of this document contains responses to the comments

  18. Improving estimations of greenhouse gas transfer velocities by atmosphere-ocean couplers in Earth-System and regional models (United States)

    Vieira, V. M. N. C. S.; Sahlée, E.; Jurus, P.; Clementi, E.; Pettersson, H.; Mateus, M.


    Earth-System and regional models, forecasting climate change and its impacts, simulate atmosphere-ocean gas exchanges using classical yet too simple generalizations relying on wind speed as the sole mediator while neglecting factors as sea-surface agitation, atmospheric stability, current drag with the bottom, rain and surfactants. These were proved fundamental for accurate estimates, particularly in the coastal ocean, where a significant part of the atmosphere-ocean greenhouse gas exchanges occurs. We include several of these factors in a customizable algorithm proposed for the basis of novel couplers of the atmospheric and oceanographic model components. We tested performances with measured and simulated data from the European coastal ocean, having found our algorithm to forecast greenhouse gas exchanges largely different from the forecasted by the generalization currently in use. Our algorithm allows calculus vectorization and parallel processing, improving computational speed roughly 12× in a single cpu core, an essential feature for Earth-System models applications.

  19. Development of Pathways to Achieve the SE4ALL Energy Efficiency Objective: Global and Regional Potential for Energy Efficiency Improvements

    DEFF Research Database (Denmark)

    Gregg, Jay Sterling; Balyk, Olexandr; Pérez, Cristian Hernán Cabrera

    This study examines the three objectives of the UN Sustainable Energy for All (SE4ALL) initiative: 1. Ensure universal access to modern energy services by 2030. 2. Double the global rate of improvement in energy efficiency (from 1.3% to 2.6% annual reduction in energy intensity of GDP) by 2030. 3....... Double the share of renewable energy in global final energy from 18% to 36% by 2030. The integrated assessment model, ETSAP-TIAM, was used in this study to compare, from an economic optimization point of view, different scenarios for the development of the energy system between 2010 and 2030....... This analysis is conducted on a global and regional scale. The scenarios were constructed to analyze the effect of achieving the SE4ALL energy efficiency objective, the SE4ALL renewable energy objective, both together, and all three SE4ALL objectives. Synergies exist between renewable energy and energy...

  20. Automated grain extraction and classification by combining improved region growing segmentation and shape descriptors in electromagnetic mill classification system (United States)

    Budzan, Sebastian


    In this paper, the automatic method of grain detection and classification has been presented. As input, it uses a single digital image obtained from milling process of the copper ore with an high-quality digital camera. The grinding process is an extremely energy and cost consuming process, thus granularity evaluation process should be performed with high efficiency and time consumption. The method proposed in this paper is based on the three-stage image processing. First, using Seeded Region Growing (SRG) segmentation with proposed adaptive thresholding based on the calculation of Relative Standard Deviation (RSD) all grains are detected. In the next step results of the detection are improved using information about the shape of the detected grains using distance map. Finally, each grain in the sample is classified into one of the predefined granularity class. The quality of the proposed method has been obtained by using nominal granularity samples, also with a comparison to the other methods.

  1. Integrating palliative care in long-term care facilities across Europe (PACE): protocol of a cluster randomized controlled trial of the 'PACE Steps to Success' intervention in seven countries. (United States)

    Smets, Tinne; Onwuteaka-Philipsen, Bregje B D; Miranda, Rose; Pivodic, Lara; Tanghe, Marc; van Hout, Hein; Pasman, Roeline H R W; Oosterveld-Vlug, Mariska; Piers, Ruth; Van Den Noortgate, Nele; Wichmann, Anne B; Engels, Yvonne; Vernooij-Dassen, Myrra; Hockley, Jo; Froggatt, Katherine; Payne, Sheila; Szczerbińska, Katarzyna; Kylänen, Marika; Leppäaho, Suvi; Barańska, Ilona; Gambassi, Giovanni; Pautex, Sophie; Bassal, Catherine; Deliens, Luc; Van den Block, Lieve


    Several studies have highlighted the need for improvement in palliative care delivered to older people long-term care facilities. However, the available evidence on how to improve palliative care in these settings is weak, especially in Europe. We describe the protocol of the PACE trial aimed to 1) evaluate the effectiveness and cost-effectiveness of the 'PACE Steps to Success' palliative care intervention for older people in long-term care facilities, and 2) assess the implementation process and identify facilitators and barriers for implementation in different countries. We will conduct a multi-facility cluster randomised controlled trial in Belgium, Finland, Italy, the Netherlands, Poland, Switzerland and England. In total, 72 facilities will be randomized to receive the 'Pace Steps to Success intervention' or to 'care as usual'. Primary outcome at resident level: quality of dying (CAD-EOLD); and at staff level: staff knowledge of palliative care (Palliative Care Survey). resident's quality of end-of-life care, staff self-efficacy, self-perceived educational needs, and opinions on palliative care. Economic outcomes: direct costs and quality-adjusted life years (QALYs). Measurements are performed at baseline and after the intervention. For the resident-level outcomes, facilities report all deaths of residents in and outside the facilities over a previous four-month period and structured questionnaires are sent to (1) the administrator, (2) staff member most involved in care (3) treating general practitioner, and (4) a relative. For the staff-level outcomes, all staff who are working in the facilities are asked to complete a structured questionnaire. A process evaluation will run alongside the effectiveness evaluation in the intervention group using the RE-AIM framework. The lack of high quality trials in palliative care has been recognized throughout the field of palliative care research. This cross-national cluster RCT designed to evaluate the impact of the

  2. Kinematic hand parameters in front crawl at different paces of swimming. (United States)

    Samson, Mathias; Monnet, Tony; Bernard, Anthony; Lacouture, Patrick; David, Laurent


    The aim of this study was to investigate the evolution of kinematic hand parameters (sweepback angle, angle of attack, velocity, acceleration and orientation of the hand relative to the absolute coordinate system) throughout an aquatic stroke and to study the possible modifications caused by a variation of the swimming pace. Seventeen competitive swimmers swam at long distance, middle distance and sprint paces. Parameters were calculated from the trajectory of seven markers on the hand measured with an optoelectronic system. Results showed that kinematic hand parameters evolve differently depending on the pace. Angle of attack, sweepback angle, acceleration and orientation of the hand do not vary significantly. The velocity of the hand increases when the pace increases, but only during the less propulsive phases (entry and stretch and downsweep to catch). The more the pace increases and the more the absolute durations of the entry and stretch and downsweep to catch phases decrease. Absolute durations of the insweep and upsweep phases remain constant. During these phases, the propulsive hand forces calculated do not vary significantly when the pace increases. The increase of swimming pace is then explained by the swimmer's capacity to maintain propulsive phases rather than increasing the force generation within each cycle. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. The impact of a community intervention to improve cervical cancer screening uptake in the Amazon region of Brazil

    Directory of Open Access Journals (Sweden)

    Marcus Vinicius Von Zuben

    Full Text Available CONTEXT AND OBJECTIVE: In the northern region of Brazil, cervical cancer is the most important cause of cancer-related deaths among women. There is considerable likelihood, however, that official incidence and mortality figures are greatly underestimated. The aim of this study was to estimate the repercussions from improvement in cervical cancer screening programs on the incidence of pre-invasive and invasive cervical lesions in a municipality in this region. DESIGN AND SETTING: This was a quasi-experimental study that assessed process dimensions relevant to the program objectives. The study comprised a sample of 2,226 women seen at primary healthcare units in Cruzeiro do Sul, a small city in the Brazilian Amazon region, from April 2003 to July 2004. METHODS: Women were recruited through local radio advertisements and by oral communication from the investigators. The women answered a structured questionnaire and underwent pelvic examination, which included Papanicolaou (Pap smears and naked-eye inspection of the cervix after applying diluted acetic acid. Women with positive Pap smears or abnormal gynecological examination were referred for colposcopy and possible biopsy, diathermic large loop excision of the transformation zone or conization. RESULTS: The results obtained were compared with historical official data retrieved from the Brazilian Ministry of Health’s database. Intervention resulted in a 40% increase in positive Pap smears and detection of cancer was nine times higher than had been observed in routine screening. CONCLUSIONS: Detection of pre-invasive and invasive cervical lesions in the intervention group was remarkably higher than among women seen during routine screening.

  4. Improving regional climate and hydrological forecasting following the record setting flooding across the Lake Ontario - St. Lawrence River system (United States)

    Gronewold, A.; Seglenieks, F.; Bruxer, J.; Fortin, V.; Noel, J.


    In the spring of 2017, water levels across Lake Ontario and the upper St. Lawrence River exceeded record high levels, leading to widespread flooding, damage to property, and controversy over regional dam operating protocols. Only a few years earlier, water levels on Lakes Superior, Michigan, and Huron (upstream of Lake Ontario) had dropped to record low levels leading to speculation that either anthropogenic controls or climate change were leading to chronic water loss from the Great Lakes. The contrast between low water level conditions across Earth's largest lake system from the late 1990s through 2013, and the rapid rise prior to the flooding in early 2017, underscores the challenges of quantifying and forecasting hydrologic impacts of rising regional air and water temperatures (and associated changes in lake evaporation) and persistent increases in long-term precipitation. Here, we assess the hydrologic conditions leading to the recent record flooding across the Lake Ontario - St. Lawrence River system, with a particular emphasis on understanding the extent to which those conditions were consistent with observed and anticipated changes in historical and future climate, and the extent to which those conditions could have been anticipated through improvements in seasonal climate outlooks and hydrological forecasts.

  5. Efficacy and cost effectiveness of telemedicine for improving access to care in the Paris region: study protocols for eight trials. (United States)

    Charrier, Nathanael; Zarca, Kevin; Durand-Zaleski, Isabelle; Calinaud, Christine


    With the development of information and communication technologies, telemedicine has been proposed as a way to improve patient management by facilitating access to appropriate diagnosis and treatment. The Paris Ile de France Regional Health Agency is currently funding a comprehensive program of telemedicine experiments. This article describes the protocols for the evaluation of the implementation of telemedicine in the Paris region. Over 2,500 patients have been included in eight studies addressing the use of telemedicine in the context of specific diseases or settings. Two projects are randomized controlled trials, while the six other projects are based on before-after designs (differences in differences studies). Based on the MAST model and the French national framework, we identified endpoints to assess the impact of telemedicine on five dimensions: clinical effectiveness, cost-effectiveness, security of the application, patient satisfaction and quality of life and perception of professionals. Telemedicine encompasses a wide range of services and stakeholders, and thus study protocols must be tailored to the specific constraints and interests of the users. NCT02110433 (03/07/2014), NCT02157740 (05/27/2014), NCT02374697 (02/05/2015), NCT02157727 (05/27/2014), NCT02229279 (08/28/2014), NCT02368769 (02/05/2015), NCT02164747 (NCT02164747), NCT02309905 (11/27/2014).

  6. A Closer Look at Split Visual Attention in System- and Self-Paced Instruction in Multimedia Learning (United States)

    Schmidt-Weigand, Florian; Kohnert, Alfred; Glowalla, Ulrich


    Two experiments examined visual attention distribution in learning from text and pictures. Participants watched a 16-step multimedia instruction on the formation of lightning. In Experiment 1 (N=90) the instruction was system-paced (fast, medium, slow pace), while it was self-paced in Experiment 2 (N=31). In both experiments the text modality was…

  7. Merits and limitations of the mode switching rate stabilization pacing algorithms in the implantable cardioverter defibrillator. (United States)

    Dijkman, B; Wellens, H J


    The 7250 Jewel AF Medtronic model of ICD is the first implantable device in which both therapies for atrial arrhythmias and pacing algorithms for atrial arrhythmia prevention are available. Feasibility of that extensive atrial arrhythmia management requires correct and synergic functioning of different algorithms to control arrhythmias. The ability of the new pacing algorithms to stabilize the atrial rate following termination of treated atrial arrhythmias was evaluated in the marker channel registration of 600 spontaneously occurring episodes in 15 patients with the Jewel AF. All patients (55+/-15 years) had structural heart disease and documented atrial and ventricular arrhythmias. Dual chamber rate stabilization pacing was present in 245 (41 %) of episodes following arrhythmia termination and was a part of the mode switching operation during which pacing was provided in the dynamic DDI mode. This algorithm could function as the atrial rate stabilization pacing only when there was a slow spontaneous atrial rhythm or in presence of atrial premature beats conducted to the ventricles with a normal AV time. In case of atrial premature beats with delayed or absent conduction to the ventricles and in case of ventricular premature beats, the algorithm stabilized the ventricular rate. The rate stabilization pacing in DDI mode during sinus rhythm following atrial arrhythmia termination was often extended in time due to the device-based definition of arrhythmia termination. This was also the case in patients, in whom the DDD mode with true atrial rate stabilization algorithm was programmed. The rate stabilization algorithms in the Jewel AF applied after atrial arrhythmia termination provide pacing that is not based on the timing of atrial events. Only under certain circumstances the algorithm can function as atrial rate stabilization pacing. Adjustments in availability and functioning of the rate stabilization algorithms might be of benefit for the clinical performance of

  8. Substituting Both the N-Terminal and "Cord" Regions of a Xylanase from Aspergillus oryzae to Improve Its Temperature Characteristics. (United States)

    Li, Chuang; Li, Jianfang; Wang, Rui; Li, Xueqing; Li, Jinping; Deng, Chao; Wu, Minchen


    To improve the temperature characteristics of AoXyn11A, a mesophilic glycoside hydrolase family (GHF) 11 xylanase from Aspergillus oryzae CICC40186, its N-terminal and "cord" regions were selected to be substituted by means of the computer-aided analysis and calculation. In brief, one mutant, named ATX11A 41 , possessing the lowest root-mean-square deviation (RMSD) value was designed based on the molecular dynamics (MD) simulation by substituting the N-terminal 41 amino acids of AoXyn11A with the corresponding 42 ones of pXYL11, a thermophilic GHF11 xylanase from Thermobifida fusca. On the basis of the primary structure alignment of pXYL11 with ATX11A 41 (or AoXyn11A), another mutant, named ATX11A 41/cord , was designed by substituting the cord region ( 93 GTYNPGSGG 101 ) of ATX11A 41 with the corresponding one ( 93 GTYRPTG 99 ) of pXYL11. Both mutant-encoding genes, ATx11A 41 and ATx11A 41/cord , were constructed as designed theoretically by a megaprimer PCR technique and were expressed in Pichia pastoris GS115. The specific activities of recombinant (re) AoXyn11A, ATX11A 41 , and ATX11A 41/cord were 2916.7, 2667.6, and 2457.0 U/mg, respectively. The analysis of temperature characteristics displayed that the temperature optimum (T opt ) of reATX11A 41 or reATX11A 41/cord was 65 °C, which was 15 °C higher than that of reAoXyn11A. The thermal inactivation half-life (t 1/2 ) values of reATX11A 41 and reATX11A 41/cord at 60 °C were 55 and 83 min, respectively, whereas that of reAoXyn11A was only 18 min at 50 °C. The melting temperature (T m ) values of reAoXyn11A, reATX11A 41 , and reATX11A 41/cord were 54.2, 66.7, and 71.9 °C, respectively. In conclusion, the above findings indicated that the substitution of both the N-terminal and cord regions of a mesophilic AoXyn11A greatly contributed to its improved temperature characteristics.

  9. An Investigation on Exhaustion of SAP ERP Users: Influence of Pace of Change and Technostress

    Directory of Open Access Journals (Sweden)

    Prashanta Kumar Roy


    Full Text Available Despite recent growing research interest on ERP research, the understanding on ERP induced exhaustion is still limited. This study examines how the pace of change of ERP functionalities and interface causes exhaustion in workplace. For this purpose, we conducted an investigation on 128 ERP users from two different organizations in Bangladesh. We extended theory of technostress by integrating pace of change of ERP system. Result suggests that pace of change on ERP system significantly affect work-overload, work-life conflict and role ambiguity on ERP users. Result also shows that work-overload and role ambiguity are strong predictors for ERP induced exhaustion.

  10. Improvement in regional CBF by L-serine contributes to its neuroprotective effect in rats after focal cerebral ischemia.

    Directory of Open Access Journals (Sweden)

    Tao-Jie Ren

    Full Text Available To investigate the mechanisms underlying the neuroprotective effect of L-serine, permanent focal cerebral ischemia was induced by occlusion of the middle cerebral artery while monitoring cerebral blood flow (CBF. Rats were divided into control and L-serine-treated groups after middle cerebral artery occlusion. The neurological deficit score and brain infarct volume were assessed. Nissl staining was used to quantify the cortical injury. L-serine and D-serine levels in the ischemic cortex were analyzed with high performance liquid chromatography. We found that L-serine treatment: 1 reduced the neurological deficit score, infarct volume and cortical neuron loss in a dose-dependent manner; 2 improved CBF in the cortex, and this effect was inhibited in the presence of apamin plus charybdotoxin while the alleviation of both neurological deficit score and infarct volume was blocked; and 3 increased the amount of L-serine and D-serine in the cortex, and inhibition of the conversion of L-serine into D-serine by aminooxyacetic acid did not affect the reduction of neurological deficit score and infarct volume by L-serine. In conclusion, improvement in regional CBF by L-serine may contribute to its neuroprotective effect on the ischemic brain, potentially through vasodilation which is mediated by the small- and intermediate-conductance Ca(2+-activated K(+ channels on the cerebral blood vessel endothelium.

  11. Improvement of photoneutron spectrum measurement produced by bombardment of 2 GeV electrons above giant dipole resonance region

    International Nuclear Information System (INIS)

    Lee, H. S.; Park, J. S.; Choi, H. D.; Sato, Tatsuhiko; Shin, Kasuo; Ban, Syuichi


    Above the Giant Dipole Resonance (GDR) region, high energy photoneutron spectra produced by irradiation of 2.04 GeV electrons into Pb target were measured by Time-of-Flight (TOF) technique. The differential photoneutron yields were obtained at a fixed angle of 90 degrees to the electron beam direction. The TOF system consists of Pilot-U plastic scintillation detector, which has fast response time, and the high speed multiscaler or CAMAC TDC. In the improvement of experimental setup to extend the flight distance to 10.4 m lead to make the measurable energy to 500 MeV from 300 MeV. And using the TDC based electronics lead to use a veto counter. The results were compared with the calculated one by using EGS4 and Modified PICA95. The characteristics of this TOF system was introduced in this paper and the results for several measuring conditions, which are flight distance, TOF electronics, and type of neutron detector, were discussed to improve the accuracy of this measurement

  12. Southeast Regional Wastewater Treatment Plant Facilities Improvements Project and Geysers Effluent Pipeline Project. Draft EIR/EIS: Executive summary

    International Nuclear Information System (INIS)


    The Southeast Regional Wastewater Treatment Plant (SERWTP) Facilities Improvement Plan and Geysers Effluent Pipeline and Effluent Injection Project are proposed as a plan to provide expanded wastewater treatment capabilities and to dispose of the effluent by injection in The Geysers geothermal field for purposes of power production. The project is located predominantly in the County of Lake, California, and also in part of Sonoma County. The plan includes various conventional facilities improvements in wastewater treatment to a secondary level of treatment at the SWERWTP. The plan includes facilities to convey the treated effluent in a 26-mile, 24-inch inside diameter pipeline to the Southeast Geysers. The wastewater from the SERWTP would be supplemented by raw lake water diverted from nearby Clear Lake. At The Geysers, the effluent would be directed into a system of distribution lines to wells. In the geothermal reservoir, the water will be converted to steam and collected in production wells that will direct the steam to six existing power plants. This document is a summary of a combined full Environmental Impact Report (EIR) and Environmental Impact Statement (EIS). The EIR/EIS describes the environmental impacts of the various components of the project. Mitigation measures are suggested for reducing impacts to a less than significant level

  13. Pace-capture-guided ablation after contact-force-guided pulmonary vein isolation: results of the randomized controlled DRAGON trial. (United States)

    Masuda, Masaharu; Fujita, Masashi; Iida, Osamu; Okamoto, Shin; Ishihara, Takayuki; Nanto, Kiyonori; Kanda, Takashi; Sunaga, Akihiro; Tsujimura, Takuya; Matsuda, Yasuhiro; Ohashi, Takuya; Uematsu, Masaaki


    Before the discovery of contact-force guidance, eliminating pacing capture along the pulmonary vein (PV) isolation line had been reported to improve PV isolation durability and rhythm outcomes. DRAGON (UMIN-CTR, UMIN000015332) aimed to elucidate the efficacy of pace-capture-guided ablation following contact-force-guided PV isolation ablation in paroxysmal atrial fibrillation (AF) patients. A total of 156 paroxysmal AF patients with AF-trigger ectopies from any of the four PVs induced by isoproterenol were randomly assigned to undergo pace-capture-guided ablation along a contact-force-guided isolation line around AF-trigger PVs (PC group, n = 76) or contact-force-guided PV isolation ablation alone (control group, n = 80). Follow-up of at least 1 year commenced with serial 24 h Holter and symptom-triggered ambulatory monitoring. There was no significant difference in acute PV reconnection rates during a 20 min waiting period after the last ablation or adenosine infusion testing between the PC and the control groups (per patient, 21% vs. 27%, P = 0.27; per AF-trigger PV, 5.9% vs. 7.3%, P = 0.70; and per non-AF-trigger PV, 7.1% vs. 7.4%, P = 0.92). Atrial tachyarrhythmia-free survival rates off antiarrhythmic drugs after the initial session were comparable at 19.3 ± 6.2 months between the two groups (82% vs. 80%, P = 0.80). Among 22 patients who required a second ablation procedure, there was no difference between the PC and the control groups in the PV reconnection rates at both previously AF-trigger (29% vs. 43%, P = 0.70) and non-AF-trigger PVs (18% vs. 19%, P = 0.88). Pace-capture-guided ablation performed after contact-force-guided PV isolation demonstrated no improvement in PV isolation durability or rhythm outcome. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email:

  14. Impact of operator experience and training strategy on procedural outcomes with leadless pacing: Insights from the Micra Transcatheter Pacing Study. (United States)

    El-Chami, Mikhael; Kowal, Robert C; Soejima, Kyoko; Ritter, Philippe; Duray, Gabor Z; Neuzil, Petr; Mont, Lluis; Kypta, Alexander; Sagi, Venkata; Hudnall, John Harrison; Stromberg, Kurt; Reynolds, Dwight


    Leadless pacemaker systems have been designed to avoid the need for a pocket and transvenous lead. However, delivery of this therapy requires a new catheter-based procedure. This study evaluates the role of operator experience and different training strategies on procedural outcomes. A total of 726 patients underwent implant attempt with the Micra transcatheter pacing system (TPS; Medtronic, Minneapolis, MN, USA) by 94 operators trained in a teaching laboratory using a simulator, cadaver, and large animal models (lab training) or locally at the hospital with simulator/demo model and proctorship (hospital training). Procedure success, procedure duration, fluoroscopy time, and safety outcomes were compared between training methods and experience (implant case number). The Micra TPS procedure was successful in 99.2% of attempts and did not differ between the 55 operators trained in the lab setting and the 39 operators trained locally at the hospital (P = 0.189). Implant case number was also not a determinant of procedural success (P = 0.456). Each operator performed between one and 55 procedures. Procedure time and fluoroscopy duration decreased by 2.0% (P = 0.002) and 3.2% (P safety outcomes by training method. Among a large group of operators, implantation success was high regardless of experience. While procedure duration and fluoroscopy times decreased with implant number, complications were low and not associated with case number. Procedure and safety outcomes were similar between distinct training methodologies. © 2017 Wiley Periodicals, Inc.

  15. Shared Learning and the Drive to Improve Patient Safety: Lessons Learned from the Pittsburgh Regional Healthcare Initiative

    National Research Council Canada - National Science Library

    Sirio, Carl A; Keyser, Donna J; Norman, Heidi; Weber, Robert J; Muto, Carlene A


    Based on lessons learned through implementation of the Pittsburgh Regional Healthcare Initiative's region-wide shared learning model, we have identified the environmental, cultural, and infrastructure...

  16. Multidisciplinary analysis of invasive meningococcal disease as a framework for continuous quality and safety improvement in regional Australia. (United States)

    Taylor, Kathryn A; Durrheim, David N; Merritt, Tony; Massey, Peter; Ferguson, John; Ryan, Nick; Hullick, Carolyn


    System factors in a regional Australian health district contributed to avoidable care deviations from invasive meningococcal disease (IMD) management guidelines. Traditional root cause analysis (RCA) is not well-suited to IMD, focusing on individual cases rather than system improvements. As IMD requires complex care across healthcare silos, it presents an opportunity to explore and address system-based patient safety issues. Baseline assessment of IMD cases (2005-2006) identified inadequate triage, lack of senior clinician review, inconsistent vital sign recording and laboratory delays as common issues, resulting in antibiotic administration delays and inappropriate or premature discharge. Clinical governance, in partnership with clinical and public health services, established a multidisciplinary Meningococcal Reference Group (MRG) to routinely review management of all IMD cases. The MRG comprised representatives from primary care, acute care, public health, laboratory medicine and clinical governance. Baseline data were compared with two subsequent evaluation points (2011-2012 and 2013-2015). Phase I involved multidisciplinary process mapping and development of a standardised audit tool from national IMD management guidelines. Phase II involved formalisation of group processes and advocacy for operational change. Phase III focused on dissemination of findings to clinicians and managers. Greatest care improvements were observed in the final evaluation. Median antibiotic delay decreased from 72 to 42 min and proportion of cases triaged appropriately improved from 38% to 75% between 2013 and 2015. Increasing fatal outcomes were attributed to the emergence of more virulent meningococcal serotypes. The MRG was a key mechanism for identifying system gaps, advocating for change and enhancing communication and coordination across services. Employing IMD case review as a focus for district-level process reflection presents an innovative patient safety approach

  17. Trace elements in native and improved paddy rice from different climatic regions of Sri Lanka: implications for public health. (United States)

    Diyabalanage, Saranga; Navarathna, Thamara; Abeysundara, Hemalika T K; Rajapakse, Sanath; Chandrajith, Rohana


    Samples of 226 new improved and 21 indigenous rice ( Oryza sativa L.) varieties were collected from the rice fields in three climatic zones of Sri Lanka and concentrations of 18 trace elements (Li, B, Al, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Se, Sr, Mo, Cd, Ba, Pb and Bi) were measured giving particular emphasis on Se, Cd and As using ICP-MS. The two way multivariate analysis of variance (MANOVA) method was employed to identify the differences in composition among rice from different climatic zones. The mean values obtained for both white and red rice were Se (36; 25 µg/kg), As (42; 45 µg/kg) and Cd (70; 123 µg/kg) on dry weight basis. However mean content of Se, As and Cd of native rice varieties were 69, 74 and 33 µg/kg, respectively. Statistical interpretations showed that in the majority of cases, there was a significant difference in Cd content among climatic zones whereas Se and Pb show differences between white and red rice varieties. Arsenic did not indicate any significant difference either between rice types or among climatic regions. Notably Se and As contents in indigenous rice were higher than that of improved rice types. To assess the safety of dietary of intake, daily intake of Se, Cd and As by rice were calculated. Non-gender specific Estimated Daily Intake (EDI) of Se, Cd and As consuming improved rice are 9.31, 24.1 and 12.2 µg day -1 , respectively. Since over 50 % of daily meals of people contain rice or rice based products, Se intake is expected to be deficient among the Sri Lankan population.

  18. CO{sub 2}MPARE. CO2 Model for Operational Programme Assessment in EU Regions. Improved carbon management with EU Regional Policy. Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Hekkenberg, M. [ECN Policy Studies, Amsterdam (Netherlands); Schram, J. [Energies Demain, Montreuil Sous Bois (France); Amerighi, O. [Italian National Agency for New Technologies, Energy and Sustainable Economic Development ENEA, Rome (Italy); Keppo, I. [University College London UCL, London (United Kingdom); Papagianni, S. [Centre for Renewable Energy Sources and Saving CRES, Pikermi Attiki (Greece); Ten Donkelaar, M. [ENVIROS, Prague (Czech Republic)


    The CO2MPARE model supports national and regional authorities in making balanced decisions for their investment portfolio under their regional development programmes, in particular under their Operational Programmes of EU Regional Policy. The EU's climate objectives require that investments across the EU are channeled towards low-carbon development. The carbon impacts of investments should therefore be seriously considered in the decision making process of regional development programmes. The CO2MPARE model informs national and regional authorities on the impacts that the investments under various Operational Programmes can have in terms of CO2 emissions. Knowing which investments lead either to additional emissions or rather to emission reductions, and what the overall impact of a programme is, represents the first step towards investment decisions that have decarbonisation co-benefits. CO2MPARE estimates the combined carbon impact of all activities that take place under a programme, and provides insights into the relative contributions of the different themes. Through its high aggregation level, it allows comparison of investment scenarios rather than individual projects. As such, it aims to support informed decisions on investment strategies rather than project investment decisions. In doing so, it also helps to build and develop a 'carbon culture' within the authorities directly or indirectly in charge of managing Regional Policy Operational Programmes. The model is primarily aimed at Operational Programmes co-financed by the European Regional Development Fund (ERDF)

  19. Effects of home-based pulmonary rehabilitation with a metronome-guided walking pace in chronic obstructive pulmonary disease. (United States)

    Lee, Sung-soon; Kim, Changhwan; Jin, Young-Soo; Oh, Yeon-Mok; Lee, Sang-Do; Yang, Yun Jun; Park, Yong Bum


    Despite documented efficacy and recommendations, pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease (COPD) has been underutilized. Home-based PR was proposed as an alternative, but there were limited data. The adequate exercise intensity was also a crucial issue. The aim of this study was to investigate the effects of home-based PR with a metronome-guided walking pace on functional exercise capacity and health-related quality of life (HRQOL) in COPD. The subjects participated in a 12-week home-based PR program. Exercise intensity was initially determined by cardiopulmonary exercise test, and was readjusted (the interval of metronome beeps was reset) according to submaximal endurance test. Six-minute walk test, pulmonary function test, cardiopulmonary exercise test, and St. George's Respiratory Questionnaire (SGRQ) were done before and after the 12-week program, and at 6 months after completion of rehabilitation. Thirty-three patients participated in the program. Six-minute walking distance was significantly increased (48.8 m; P = 0.017) and the SGRQ score was also improved (-15; P metronome-guided walking pace for COPD patients. This rehabilitation program may improve functional exercise capacity and HRQOL.

  20. Atrial antitachycardia pacing and managed ventricular pacing in bradycardia patients with paroxysmal or persistent atrial tachyarrhythmias: the MINERVA randomized multicentre international trial (United States)

    Boriani, Giuseppe; Tukkie, Raymond; Manolis, Antonis S.; Mont, Lluis; Pürerfellner, Helmut; Santini, Massimo; Inama, Giuseppe; Serra, Paolo; de Sousa, João; Botto, Giovanni Luca; Mangoni, Lorenza; Grammatico, Andrea; Padeletti, Luigi


    Aims Atrial fibrillation (AF) is a common comorbidity in bradycardia patients. Advanced pacemakers feature atrial preventive pacing and atrial antitachycardia pacing (DDDRP) and managed ventricular pacing (MVP), which minimizes unnecessary right ventricular pacing. We evaluated whether DDDRP and MVP might reduce mortality, morbidity, or progression to permanent AF when compared with standard dual-chamber pacing (Control DDDR). Methods and results In a randomized, parallel, single-blind, multi-centre trial we enrolled 1300 patients with bradycardia and previous atrial tachyarrhythmias, in whom a DDDRP pacemaker had recently been implanted. History of permanent AF and third-degree atrioventricular block were exclusion criteria. After a 1-month run-in period, 1166 eligible patients, aged 74 ± 9 years, 50% females, were randomized to Control DDDR, DDDRP + MVP, or MVP. Analysis was intention-to-treat. The primary outcome, i.e. the 2-year incidence of a combined endpoint composed of death, cardiovascular hospitalizations, or permanent AF, occurred in 102/385 (26.5%) Control DDDR patients, in 76/383 (19.8%) DDDRP + MVP patients [hazard ratio (HR) = 0.74, 95% confidence interval 0.55–0.99, P = 0.04 vs. Control DDDR] and in 85/398 (21.4%) MVP patients (HR = 0.89, 95% confidence interval 0.77–1.03, P = 0.125 vs. Control DDDR). When compared with Control DDDR, DDDRP + MVP reduced the risk for AF longer than 1 day (HR = 0.66, 95% CI 0.52–0.85, P MVP is superior to standard dual-chamber pacing. The primary endpoint was significantly lowered through the reduction of the progression of atrial tachyarrhythmias to permanent AF. Identifier NCT00262119. PMID:24771721

  1. To pace or not to pace: a pilot study of four- and five-gaited Icelandic horses homozygous for the DMRT3 'Gait Keeper' mutation. (United States)

    Jäderkvist Fegraeus, K; Hirschberg, I; Árnason, T; Andersson, L; Velie, B D; Andersson, L S; Lindgren, G


    The Icelandic horse is a breed known mainly for its ability to perform the ambling four-beat gait 'tölt' and the lateral two-beat gait pace. The natural ability of the breed to perform these alternative gaits is highly desired by breeders. Therefore, the discovery that a nonsense mutation (C>A) in the DMRT3 gene was the main genetic factor for horses' ability to perform gaits in addition to walk, trot and canter was of great interest. Although several studies have demonstrated that homozygosity for the DMRT3 mutation is important for the ability to pace, only about 70% of the homozygous mutant (AA) Icelandic horses are reported to pace. The aim of the study was to genetically compare four- and five-gaited (i.e. horses with and without the ability to pace) AA Icelandic horses by performing a genome-wide association (GWA) analysis. All horses (n = 55) were genotyped on the 670K Axiom Equine Genotyping Array, and a GWA analysis was performed using the genabel package in r. No SNP demonstrated genome-wide significance, implying that the ability to pace goes beyond the presence of a single gene variant. Despite its limitations, the current study provides additional information regarding the genetic complexity of pacing ability in horses. However, to fully understand the genetic differences between four- and five-gaited AA horses, additional studies with larger sample materials and consistent phenotyping are needed. © 2017 Stichting International Foundation for Animal Genetics.

  2. 42 CFR 460.132 - Quality assessment and performance improvement plan. (United States)


    ... 42 Public Health 4 2010-10-01 2010-10-01 false Quality assessment and performance improvement plan... assessment and performance improvement plan. (a) Basic rule. A PACE organization must have a written quality assessment and performance improvement plan. (b) Annual review. The PACE governing body must review the plan...

  3. Addressing scale in open pace preservation: learning from the Hague region in the Netherlands

    NARCIS (Netherlands)

    Westerink - Petersen, J.; Padt, F.J.G.


    Landscapes can be understood as the dynamic interplay between biophysical, social, policy and political processes. The ‘politics of scale’ approach is a promising approach to study these dynamics. Biophysical processes are often excluded from the politics of scale however. This study seeks to follow

  4. Effects of postshock atrial pacing on atrial defibrillation outcome in the isolated sheep heart

    NARCIS (Netherlands)

    Skanes, A. C.; Gray, R. A.; Zuur, C. L.; Jalife, J.


    BACKGROUND: Failed atrial defibrillation shocks are associated with organization of postshock activity and a substantial postshock electrical quiescence. We investigated the ability of a train of pacing stimuli to capture or locally entrain atrial myocardium during the quiescent period after

  5. Photovoltaics (PV) as an Eligible Measure in Residential PACE Programs: Benefits and Challenges (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    Coughlin, J.


    Property Assessed Clean Energy (PACE) financing is one of several new financial models broadening access to clean energy by addressing the barrier of initial capital cost. The majority of the PACE programs in the market today include PV as an eligible measure. PV appeals to homeowners as a way to reduce utility bills, self-generate sustainable power, increase energy independence and demonstrate a commitment to the environment. If substantial state incentives for PV exist, PV projects can be economic under PACE, especially when partnered with good net metering policies. At the same time, PV is expensive relative to other eligible measures with a return on investment horizon that might exceed program targets. This fact sheet reviews the benefits and potential challenges of including PV in PACE programs.

  6. PACE and the Medicare+Choice risk-adjusted payment model. (United States)

    Temkin-Greener, H; Meiners, M R; Gruenberg, L


    This paper investigates the impact of the Medicare principal inpatient diagnostic cost group (PIP-DCG) payment model on the Program of All-Inclusive Care for the Elderly (PACE). Currently, more than 6,000 Medicare beneficiaries who are nursing home certifiable receive care from PACE, a program poised for expansion under the Balanced Budget Act of 1997. Overall, our analysis suggests that the application of the PIP-DCG model to the PACE program would reduce Medicare payments to PACE, on average, by 38%. The PIP-DCG payment model bases its risk adjustment on inpatient diagnoses and does not capture adequately the risk of caring for a population with functional impairments.

  7. Effects of Bepridil on Atrial Electrical Remodeling in Short-Term Rapid Pacing

    Directory of Open Access Journals (Sweden)

    Hiroto Tsuchiya, MD


    Conclusions: Bepridil prevented the shortening of the ERP and MAPD90 induced by rapid atrial pacing in the acute phase. The results of this study might explain the efficacy of bepridil for preventing the recurrence of paroxysmal AF.

  8. Acquired tricuspid valve stenosis associated with two ventricular endocardial pacing leads in a dog. (United States)

    Tompkins, Emily; Dulake, Michelle I; Ghaffari, Shadie; Nakamura, Reid K


    Acquired tricuspid valve stenosis (TVS) is a rare complication of endocardial pacing lead implantation in humans that has only been described once previously in the veterinary literature in a dog with excessive lead redundancy. A 12 yr old terrier presented with right-sided congestive heart failure 6 mo after implantation of a second ventricular endocardial pacing lead. The second lead was placed due to malfunction of the first lead, which demonstrated abnormally low impedance. Transthoracic echocardiography identified hyperechoic tissue associated with the pacing leads as they crossed the tricuspid valve annulus as well as a stenotic tricuspid inflow pattern via spectral Doppler interrogation. Medical management was ultimately unsuccessful and the dog was euthanized 6 wk after TVS was diagnosed. The authors report the first canine case of acquired TVS associated with two ventricular endocardial pacing leads.

  9. Improving automatic earthquake locations in subduction zones: a case study for GEOFON catalog of Tonga-Fiji region (United States)

    Nooshiri, Nima; Heimann, Sebastian; Saul, Joachim; Tilmann, Frederik; Dahm, Torsten


    Automatic earthquake locations are sometimes associated with very large residuals up to 10 s even for clear arrivals, especially for regional stations in subduction zones because of their strongly heterogeneous velocity structure associated. Although these residuals are most likely not related to measurement errors but unmodelled velocity heterogeneity, these stations are usually removed from or down-weighted in the location procedure. While this is possible for large events, it may not be useful if the earthquake is weak. In this case, implementation of travel-time station corrections may significantly improve the automatic locations. Here, the shrinking box source-specific station term method (SSST) [Lin and Shearer, 2005] has been applied to improve relative location accuracy of 1678 events that occurred in the Tonga subduction zone between 2010 and mid-2014. Picks were obtained from the GEOFON earthquake bulletin for all available station networks. We calculated a set of timing corrections for each station which vary as a function of source position. A separate time correction was computed for each source-receiver path at the given station by smoothing the residual field over nearby events. We begin with a very large smoothing radius essentially encompassing the whole event set and iterate by progressively shrinking the smoothing radius. In this way, we attempted to correct for the systematic errors, that are introduced into the locations by the inaccuracies in the assumed velocity structure, without solving for a new velocity model itself. One of the advantages of the SSST technique is that the event location part of the calculation is separate from the station term calculation and can be performed using any single event location method. In this study, we applied a non-linear, probabilistic, global-search earthquake location method using the software package NonLinLoc [Lomax et al., 2000]. The non-linear location algorithm implemented in NonLinLoc is less

  10. Infants' Visual Attention to Baby DVDs as a Function of Program Pacing (United States)

    Gola, Alice Ann Howard; Calvert, Sandra L.


    This study examined the effects of program pacing, defined as the rate of scene and character change per minute, on infants' visual attention to video presentations. Seventy-two infants (twenty-four 6-month-olds, twenty-four 9-month-olds, twenty-four 12-month-olds) were exposed to one of two sets of high- and low-paced commercial infant DVDs. Each…

  11. Pacing-induced chronic atrial fibrillation impairs sinus node function in dogs. Electrophysiological remodeling. (United States)

    Elvan, A; Wylie, K; Zipes, D P


    We assessed the effects of pacing-induced chronic atrial fibrillation (AF) on sinus node function, intra-atrial conduction, and atrial refractoriness. In 15 mongrel dogs (20 to 30 kg), AV nodal block was produced by radiofrequency catheter ablation, and a ventricular-inhibited (VVI) pacemaker (Minix 8330, Medtronic) was implanted and programmed to pace at 80 pulses per minute. In 11 of these dogs, right atrial endocardial pacing leads were connected to a pulse generator (Itrel 7432, Medtronic) and set at a rate of 20 Hz to induce AF. Corrected sinus node recovery time, P-wave duration, 24-hour Holter ECG to assess AF duration, maximal heart rate in response to isoproterenol (10 micrograms/min), intrinsic heart rate after administration of atropine (0.04 mg/kg) and propranolol (0.1 mg/kg), and atrial effective refractory periods (ERPs) were obtained at baseline (EPS-1) and after 2 to 6 weeks (EPS-2) of VVI pacing alone (n = 4) or VVI pacing and rapid atrial pacing (n = 11). At EPS-2, corrected sinus node recovery time and P-wave duration were prolonged, maximal heart rate and intrinsic heart rate were decreased, atrial ERPs were shortened, and the duration of AF was increased significantly compared with EPS-1. These changes partially reversed toward baseline 1 week after conversion to sinus rhythm. Sinus node function and AF inducibility observed in the control dogs that underwent ventricular pacing alone (n = 4) did not change. Pacing-induced chronic AF induces sinus node dysfunction, prolongs intra-atrial conduction time, shortens atrial refractoriness, and perpetuates AF, changes that reverse gradually after termination of AF.

  12. Effect of Music Tempo on Attentional Focus and Perceived Exertion during Self-selected Paced Walking




    This study investigated the influence of music on the rating of perceived exertion (RPE) and attentional focus during walking at a self-selected pace. Fifteen overweight and obese women volunteered to participate in the study. They underwent four sessions: the first for incremental maximal test and anthropometric measurement followed by three experimental sessions. After the first session, they were exposed to three 30-minute walking sessions at a self-selected pace in a counterbalanced order...

  13. Improving performance of content-based image retrieval schemes in searching for similar breast mass regions: an assessment

    International Nuclear Information System (INIS)

    Wang Xiaohui; Park, Sang Cheol; Zheng Bin


    This study aims to assess three methods commonly used in content-based image retrieval (CBIR) schemes and investigate the approaches to improve scheme performance. A reference database involving 3000 regions of interest (ROIs) was established. Among them, 400 ROIs were randomly selected to form a testing dataset. Three methods, namely mutual information, Pearson's correlation and a multi-feature-based k-nearest neighbor (KNN) algorithm, were applied to search for the 15 'the most similar' reference ROIs to each testing ROI. The clinical relevance and visual similarity of searching results were evaluated using the areas under receiver operating characteristic (ROC) curves (A Z ) and average mean square difference (MSD) of the mass boundary spiculation level ratings between testing and selected ROIs, respectively. The results showed that the A Z values were 0.893 ± 0.009, 0.606 ± 0.021 and 0.699 ± 0.026 for the use of KNN, mutual information and Pearson's correlation, respectively. The A Z values increased to 0.724 ± 0.017 and 0.787 ± 0.016 for mutual information and Pearson's correlation when using ROIs with the size adaptively adjusted based on actual mass size. The corresponding MSD values were 2.107 ± 0.718, 2.301 ± 0.733 and 2.298 ± 0.743. The study demonstrates that due to the diversity of medical images, CBIR schemes using multiple image features and mass size-based ROIs can achieve significantly improved performance.

  14. High-Frequency Repetitive Sensory Stimulation as Intervention to Improve Sensory Loss in Patients with Complex Regional Pain Syndrome I. (United States)

    David, Marianne; Dinse, Hubert R; Mainka, Tina; Tegenthoff, Martin; Maier, Christoph


    Achieving perceptual gains in healthy individuals or facilitating rehabilitation in patients is generally considered to require intense training to engage neuronal plasticity mechanisms. Recent work, however, suggested that beneficial outcome similar to training can be effectively acquired by a complementary approach in which the learning occurs in response to mere exposure to repetitive sensory stimulation (rSS). For example, high-frequency repetitive sensory stimulation (HF-rSS) enhances tactile performance and induces cortical reorganization in healthy subjects and patients after stroke. Patients with complex regional pain syndrome (CRPS) show impaired tactile performance associated with shrinkage of cortical maps. We here investigated the feasibility and efficacy of HF-rSS, and low-frequency rSS (LF-rSS) to enhance tactile performance and reduce pain intensity in 20 patients with CRPS type I. Intermittent high- or low-frequency electrical stimuli were applied for 45 min/day to all fingertips of the affected hand for 5 days. Main outcome measures were spatial two-point-discrimination thresholds and mechanical detection thresholds measured on the tip of the index finger bilaterally. Secondary endpoint was current pain intensity. All measures were assessed before and on day 5 after the last stimulation session. HF-rSS applied in 16 patients improved tactile discrimination on the affected hand significantly without changes contralaterally. Current pain intensity remained unchanged on average, but decreased in four patients by ≥30%. This limited pain relief might be due to the short stimulation period of 5 days only. In contrast, after LF-rSS, tactile discrimination was impaired in all four patients, while detection thresholds and pain were not affected. Our data suggest that HF-rSS could be used as a novel approach in CRPS treatment to improve sensory loss. Longer treatment periods might be required to induce consistent pain relief.

  15. High frequency repetitive sensory stimulation as intervention to improve sensory loss in patients with complex regional pain syndrome (CRPS I

    Directory of Open Access Journals (Sweden)

    Marianne eDavid


    Full Text Available Achieving perceptual gains in healthy individuals, or facilitating rehabilitation in patients is generally considered to require intense training to engage neuronal plasticity mechanisms. Recent work, however, suggested that beneficial outcome similar to training can be effectively acquired by a complementary approach in which the learning occurs in response to mere exposure to repetitive sensory stimulation (rSS. For example, high-frequency repetitive sensory stimulation (HF-rSS enhances tactile performance and induces cortical reorganization in healthy subjects and patients after stroke. Patients with complex regional pain syndrome (CRPS show impaired tactile performance associated with shrinkage of cortical maps. We here investigated the feasibility and efficacy of HF-rSS, and low-frequency rSS (LF-rSS to enhance tactile performance and reduce pain intensity in 20 patients with CRPS type I. Intermittent high or low frequency electrical stimuli were applied for 45min/day to all fingertips of the affected hand for 5 days. Main outcome measures were spatial 2-point-discrimination thresholds and mechanical detection thresholds measured on the tip of the index finger bilaterally. Secondary endpoint was current pain intensity. All measures were assessed before and on day 5 after the last stimulation session. HF-rSS applied in 16 patients improved tactile discrimination on the affected hand significantly without changes contralaterally. Current pain intensity remained unchanged on average, but decreased in 4 patients by 30%. This limited pain relief might be due to the short stimulation period of 5 days only. In contrast, after LF-rSS, tactile discrimination was impaired in all 4 patients, while detection thresholds and pain were not affected. Our data suggest that HF-rSS could be used as a novel approach in CRPS treatment to improve sensory loss. Longer treatment periods might be required to induce consistent pain relief.

  16. Effect of the Pacing Strategies on the Open Water 10km World Swimming Championships Performances. (United States)

    Rodriguez, Luis; Veiga, Santiago


    The aim of the present research was 1) to compare the pacing strategies of different level open water swimmers during the 10km race of the FINA 2015 World Swimming Championships (WCH), and 2) to relate these pacing strategies to the race performance. Final and intermediate split times as well as intermediate race positions from the 10-kilometer race participants (69 men and 51 women) were collected from the public domain and were divided into five groups (G1 to G5) depending on their finishing positions. Medalists and finalists (G1 and G2, respectively) presented an even pacing profile with similar swimming velocities to the less successful swimmers (G3 to G5) on the initial and mid stages of the race but a 1.5-3% increase in swimming velocity in the last quarter of the race. This fast end spurt was largely related to the race performance and was not observed in the G3 and G4 (even-paced profile) or in the G5 (positive pacing profile) groups. Intermediate race positions and lap rankings were negatively related to finishing position indicating a delayed positioning of the most successful swimmers at 25%, 50% and 75% of race distance. The adoption of a conservative starting strategy by open water swimmers with a negative pacing profile and delayed partial positioning seems to increase the chances of overall race success as it allows a fast end spurt that is highly related to successful finishing race positions.

  17. Extending the use of the pacing pulmonary artery catheter for safe minimally invasive cardiac surgery. (United States)

    Levin, Ricardo; Leacche, Marzia; Petracek, Michael R; Deegan, Robert J; Eagle, Susan S; Thompson, Annemarie; Pretorius, Mias; Solenkova, Nataliya V; Umakanthan, Ramanan; Brewer, Zachary E; Byrne, John G


    In this study, the therapeutic use of pacing pulmonary artery catheters in association with minimally invasive cardiac surgery was evaluated. A retrospective study. A single institutional university hospital. Two hundred twenty-four consecutive patients undergoing minimally invasive cardiac surgery through a small (5-cm) right anterolateral thoracotomy using fibrillatory arrest without aortic cross-clamping. Two hundred eighteen patients underwent mitral valve surgery (97%) alone or in combination with other procedures. Six patients underwent other cardiac operations. In all patients, the pacing pulmonary artery catheter was used intraoperatively to induce ventricular fibrillation during the cooling period, and in the postoperative period it also was used in 37 (17%) patients who needed to be paced, mainly for bradyarrhythmias (51%). There were no complications related to the insertion of the catheters. Six (3%) patients experienced a loss of pacing capture, and 2 (1%) experienced another complication requiring the surgical removal of the catheter. Seven (3%) patients needed postoperative implantation of a permanent pacemaker. In combination with minimally invasive cardiac surgery, pacing pulmonary artery catheters were therapeutically useful to induce ventricular fibrillatory arrest intraoperatively and for obtaining pacing capability in the postoperative period. Their use was associated with a low number of complications. Copyright 2010 Elsevier Inc. All rights reserved.

  18. Optimal pacing strategy: from theoretical modelling to reality in 1500-m speed skating. (United States)

    Hettinga, F J; De Koning, J J; Schmidt, L J I; Wind, N A C; Macintosh, B R; Foster, C


    Athletes are trained to choose the pace which is perceived to be correct during a specific effort, such as the 1500-m speed skating competition. The purpose of the present study was to "override" self-paced (SP) performance by instructing athletes to execute a theoretically optimal pacing profile. Seven national-level speed-skaters performed a SP 1500-m which was analysed by obtaining velocity (every 100 m) and body position (every 200 m) with video to calculate total mechanical power output. Together with gross efficiency and aerobic kinetics, obtained in separate trials, data were used to calculate aerobic and anaerobic power output profiles. An energy flow model was applied to SP, simulating a range of pacing strategies, and a theoretically optimal pacing profile was imposed in a second race (IM). Final time for IM was ∼2 s slower than SP. Total power distribution per lap differed, with a higher power over the first 300 m for IM (637.0 (49.4) vs 612.5 (50.0) W). Anaerobic parameters did not differ. The faster first lap resulted in a higher aerodynamic drag coefficient and perhaps a less effective push-off. Experienced athletes have a well-developed performance template, and changing pacing strategy towards a theoretically optimal fast start protocol had negative consequences on speed-skating technique and did not result in better performance.

  19. A Pilot Study on the Effects of Slow Paced Breathing on Current Food Craving. (United States)

    Meule, Adrian; Kübler, Andrea


    Heart rate variability biofeedback (HRV-BF) involves slow paced breathing (approximately six breaths per minute), thereby maximizing low-frequent heart rate oscillations and baroreflex gain. Mounting evidence suggests that HRV-BF promotes symptom reductions in a variety of physical and mental disorders. It may also positively affect eating behavior by reducing food cravings. The aim of the current study was to investigate if slow paced breathing can be useful for attenuating momentary food craving. Female students performed paced breathing either at six breaths per minute (n = 32) or at nine breaths per minute (n = 33) while watching their favorite food on the computer screen. Current food craving decreased during a first resting period, increased during paced breathing, and decreased during a second resting period in both conditions. Although current hunger increased in both conditions during paced breathing as well, it remained elevated after the second resting period in the nine breaths condition only. Thus, breathing rate did not influence specific food craving, but slow paced breathing appeared to have a delayed influence on state hunger. Future avenues are suggested for the study of HRV-BF in the context of eating behavior.

  20. Improvement of Alternative Crop Phenology Detection Algorithms using MODIS NDVI Time Series Data in US Corn Belt Region (United States)

    Lee, J.; Kang, S.; Seo, B.; Lee, K.


    Predicting crop phenology is important for understanding of crop development and growth processes and improving the accuracy of crop model. Remote sensing offers a feasible tool for monitoring spatio-temporal patterns of crop phenology in region and continental scales. Various methods have been developed to determine the timing of crop phenological stages using spectral vegetation indices (i.e. NDVI and EVI) derived from satellite data. In our study, it was compared four alternative detection methods to identify crop phenological stages (i.e. the emergence and harvesting date) using high quality NDVI time series data derived from MODIS. Also we investigated factors associated with crop development rate. Temperature and photoperiod are the two main factors which would influence the crop's growth pattern expressed in the VI data. Only the effect of temperature on crop development rate was considered. The temperature response function in the Wang-Engel (WE) model was used, which simulates crop development using nonlinear models with response functions that range from zero to one. It has attempted at the state level over 14 years (2003-2016) in Iowa and Illinois state of USA, where the estimated phenology date by using four methods for both corn and soybean. Weekly crop progress reports produced by the USDA NASS were used to validate phenology detection algorithms effected by temperature. All methods showed substantial uncertainty but the threshold method showed relatively better agreement with the State-level data for soybean phenology.

  1. Improved regional-scale Brazilian cropping systems' mapping based on a semi-automatic object-based clustering approach (United States)

    Bellón, Beatriz; Bégué, Agnès; Lo Seen, Danny; Lebourgeois, Valentine; Evangelista, Balbino Antônio; Simões, Margareth; Demonte Ferraz, Rodrigo Peçanha


    Cropping systems' maps at fine scale over large areas provide key information for further agricultural production and environmental impact assessments, and thus represent a valuable tool for effective land-use planning. There is, therefore, a growing interest in mapping cropping systems in an operational manner over large areas, and remote sensing approaches based on vegetation index time series analysis have proven to be an efficient tool. However, supervised pixel-based approaches are commonly adopted, requiring resource consuming field campaigns to gather training data. In this paper, we present a new object-based unsupervised classification approach tested on an annual MODIS 16-day composite Normalized Difference Vegetation Index time series and a Landsat 8 mosaic of the State of Tocantins, Brazil, for the 2014-2015 growing season. Two variants of the approach are compared: an hyperclustering approach, and a landscape-clustering approach involving a previous stratification of the study area into landscape units on which the clustering is then performed. The main cropping systems of Tocantins, characterized by the crop types and cropping patterns, were efficiently mapped with the landscape-clustering approach. Results show that stratification prior to clustering significantly improves the classification accuracies for underrepresented and sparsely distributed cropping systems. This study illustrates the potential of unsupervised classification for large area cropping systems' mapping and contributes to the development of generic tools for supporting large-scale agricultural monitoring across regions.

  2. Improving the Outcomes of Organs Obtained From Controlled Donation After Circulatory Death Donors Using Abdominal Normothermic Regional Perfusion. (United States)

    Miñambres, E; Suberviola, B; Dominguez-Gil, B; Rodrigo, E; Ruiz-San Millan, J C; Rodríguez-San Juan, J C; Ballesteros, M A


    The use of donation after circulatory death (DCD) has increased significantly during the past decade. However, warm ischemia results in a greater risk for transplantation. Indeed, controlled DCD (cDCD) was associated with inferior outcomes compared with donation after brain death. The use of abdominal normothermic regional perfusion (nRP) to restore blood flow before organ recovery in cDCD has been proposed as better than rapid recovery to reverse the effect of ischemia and improve recipients' outcome. Here, the first Spanish series using abdominal nRP as an in situ conditioning method is reported. A specific methodology to avoid restoring circulation to the brain after death determination is described. Twenty-seven cDCD donors underwent abdominal nRP during at least 60 min. Thirty-seven kidneys, 11 livers, six bilateral lungs, and one pancreas were transplanted. The 1-year death-censored kidney survival was 91%, and delayed graft function rate was 27%. The 1-year liver survival rate was 90.1% with no cases of ischemic cholangiopathy. Transplanted lungs and pancreas exhibited primary function. The use of nRP may represent an advance to increase the number and quality of grafts in cDCD. Poor results in cDCD livers could be reversed with nRP. Concerns about restoring brain circulation after death are easily solved. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  3. Collaborative Proposal: Improving Decadal Prediction of Arctic Climate Variability and Change Using a Regional Arctic System Model (RASM)

    Energy Technology Data Exchange (ETDEWEB)

    Robertson, William [Univ. of Texas, El Paso, TX (United States)


    RASM is a multi-disciplinary project, which brings together researchers from six state universities, one military postgraduate school, and one DoE laboratory to address the core modeling objectives of the arctic research community articulated in the Arctic System Modeling report by Roberts et al. (2010b). This report advocates the construction of a regional downscaling tool to generate probabilistic decadal projections of Greenland ice sheet retreat, evolution of arctic sea ice cover, changes in land surface vegetation, and regional processes leading to arctic amplification. Unified coupled models such as RASM are ideal for this purpose because they simulate fine-scale physics, essential for the realistic representation of intra-annual variability, in addition to processes fundamental to long term climatic shifts (Hurrell et al. 2009). By using RASM with boundary conditions from a global model, we can generate many-member ensembles essential for understanding uncertainty in regional climate projections (Hawkins and Sutton 2009). This probabilistic approach is computationally prohibitive for high-resolution global models in the foreseeable future, and also for regional models interactively nested within global simulations. Yet it is fundamental for quantifying uncertainty in decadal forecasts to make them useful for decision makers (Doherty et al. 2009). For this reason, we have targeted development of ensemble generation techniques as a core project task (Task 4.5). Environmental impact assessment specialists need high-fidelity regional ensemble projections to improve the accuracy of their work (Challinor et al. 2009; Moss et al. 2010). This is especially true of the Arctic, where economic, social and national interests are rapidly reshaping the high north in step with regional climate change. During the next decade, considerable oil and gas discoveries are expected across many parts of the marine and terrestrial Arctic (Gautier et al. 2009), the economics of the

  4. Visual bottle inspection performance in highly paced belt-conveyor systems. (United States)

    Saito, M; Tanaka, T


    The relation between visual work performance and a few variables with immediate effects, i.e, lighting, work speed, work spell, etc. was studied. At the same time, some physiological and behavioral variations obtained in the study were also discussed. Through experiments and surveys, the optimum conditions were found for each variable. Work performance, however, is affected in such a subtle, interactive and dynamic manner that the working conditions are to be adjusted by taking into account not only these variables having immediate effects but also those indirectly relating ones meeting real needs in the practical working fields. Improvement of some physical working conditions, such as lighting, produces only a transitory increase of performance which is very unstable unless other determinants of performance are simultaneously managed in a proper manner. The same applied to arrangement of the optimum work speed and work spell for highly paced visual inspection, variations in rejection rate and in physiological functions interacting with individual and other determinants. In order to maximize understanding of the integrated and synthesized manner of determinants, it is emphasized that work performance must be pursued in a considerably comprehensive framework from a long-term perspective.


    Directory of Open Access Journals (Sweden)

    Tomislav Kostić


    Full Text Available mulate two heart chambers (usually the right atrium and right ventricle were de-signed. Those pacemakers were able to detect signals from the same heart chamber, and each of its functions (detection of intrinsing and application of artificial pacemaker signal was performed as previously programmed. Essential hemodynamic improvement of this type of stimulation was the achievement of AV synchronization allowing that optimized function of the atria and ventricles mimics their natural functioning - timely contraction of the atria in relation to the AV valves and the ventricular outflow tracts. This study included 130 patients who had VDD pacemaker implanted at the Department of Cardiology, Clinical Center Niš, during 2009-2013. At the time of implantation, atrial sensing was 2.1±1.2 mV. Patients had follow up visits at one month, six months and one year after pacemaker implantation. After one year, the floating sensing in the atrium was 1.6±0.7 mV which was lower but not clinically significant. Bearing in mind the aforementioned, VVD pacing systems may be considered as the first line therapy in patients with AV block and normal SA node function, particularly in elderly patients and in patients with unsuitable anatomical structures of musculoskeletal and venous systems of the upper thoracic part, in cases of which it is sometimes difficult to place two DDDR electrode systems.

  6. Diaphragmatic pacing stimulation in spinal cord injury: anesthetic and perioperative management

    Directory of Open Access Journals (Sweden)

    Miguel L. Tedde


    Full Text Available OBJECTIVE: The standard therapy for patients with high-level spinal cord injury is long-term mechanical ventilation through a tracheostomy. However, in some cases, this approach results in death or disability. The aim of this study is to highlight the anesthetics and perioperative aspects of patients undergoing insertion of a diaphragmatic pacemaker. METHODS: Five patients with quadriplegia following high cervical traumatic spinal cord injury and ventilator-dependent chronic respiratory failure were implanted with a laparoscopic diaphragmatic pacemaker after preoperative assessments of their phrenic nerve function and diaphragm contractility through transcutaneous nerve stimulation. NCT01385384. RESULTS: The diaphragmatic pacemaker placement was successful in all of the patients. Two patients presented with capnothorax during the perioperative period, which resolved without consequences. After six months, three patients achieved continuous use of the diaphragm pacing system, and one patient could be removed from mechanical ventilation for more than 4 hours per day. CONCLUSIONS: The implantation of a diaphragmatic phrenic system is a new and safe technique with potential to improve the quality of life of patients who are dependent on mechanical ventilation because of spinal cord injuries. Appropriate indication and adequate perioperative care are fundamental to achieving better results.

  7. Activity Pacing Self-Management in Chronic Fatigue Syndrome: A Randomized Controlled Trial (United States)

    van Eupen, Inge; Meirte, Jill; Van Cauwenbergh, Deborah; Moorkens, Greta; Meeus, Mira; Nijs, Jo


    OBJECTIVE. The objective of this study was to evaluate the effectiveness of an activity pacing self-management (APSM) intervention in improving performance of daily life activities in women with chronic fatigue syndrome (CFS). METHOD. A total of 33 women with CFS (age 41.1 ± 11.2 yr) were randomly allocated to APSM (experimental group; n = 16) or relaxation (control group; n = 17). Main outcome measures included the Canadian Occupational Performance Measure (COPM; primary) and Checklist Individual Strength (CIS). RESULTS. COPM scores changed significantly over time in both groups (p = .03). The change in Satisfaction scores showed a significant difference in favor only of APSM (effect size = 0.74 [0.11, 1.4]). CIS scores decreased significantly in the experimental group only (p < .01). CONCLUSION. APSM was found to be feasible and effective in optimizing participation in desired daily life activities in women with CFS. Replication in a larger sample with long-term follow-up is required. PMID:26356665

  8. Activity Pacing Self-Management in Chronic Fatigue Syndrome: A Randomized Controlled Trial. (United States)

    Kos, Daphne; van Eupen, Inge; Meirte, Jill; Van Cauwenbergh, Deborah; Moorkens, Greta; Meeus, Mira; Nijs, Jo


    To evaluate the effectiveness of an activity pacing self-management (APSM) intervention in improving performance of daily life activities in women with chronic fatigue syndrome (CFS). A total of 33 women with CFS (age 41.1±11.2 yr) were randomly allocated to APSM (experimental group; n=16) or relaxation (control group; n=17). Main outcome measures included the Canadian Occupational Performance Measure (COPM; primary) and Checklist Individual Strength (CIS). COPM scores changed significantly over time in both groups (p=.03). The change in Satisfaction scores showed a significant difference in favor only of APSM (effect size=0.74 [0.11, 1.4]). CIS scores decreased significantly in the experimental group only (p<.01). APSM was found to be feasible and effective in optimizing participation in desired daily life activities in women with CFS. Replication in a larger sample with long-term follow-up is required. Copyright © 2015 by the American Occupational Therapy Association, Inc.

  9. Comparison of objective methods to classify the pattern of respiratory sinus arrhythmia during mechanical ventilation and paced spontaneous breathing

    International Nuclear Information System (INIS)

    Carvalho, N C; Beda, A; Granja-Filho, P; Jandre, F C; Giannella-Neto, A; De Abreu, M G; Spieth, P M


    Respiratory sinus arrhythmia (RSA) is a fluctuation of heart period that occurs during a respiratory cycle. It has been suggested that inspiratory heart period acceleration and expiratory deceleration during spontaneous ventilation (henceforth named positive RSA) improve the efficiency of gas exchange compared to the absence or the inversion of such a pattern (negative RSA). During mechanical ventilation (MV), for which maximizing the efficiency of gas exchange is of critical importance, the pattern of RSA is still the object of debate. In order to gain a better insight into this matter, we compared five different methods of RSA classification using the data of five mechanically ventilated piglets. The comparison was repeated using the data of 15 volunteers undergoing a protocol of paced spontaneous breathing, which is expected to result in a positive RSA pattern. The results showed that the agreement between the employed methods is limited, suggesting that the lack of a consensus about the RSA pattern during MV is, at least in part, of methodological origin. However, independently of the method used, the pattern of RSA within the respiratory cycle was not consistent among the subjects and conditions of MV considered. Also, the outcomes showed that even during paced spontaneous breathing a negative RSA pattern might be present, when a low respiratory frequency is imposed

  10. Application of decision-making theory to the regulation of muscular work rate during self-paced competitive endurance activity. (United States)

    Renfree, Andrew; Martin, Louise; Micklewright, Dominic; St Clair Gibson, Alan


    Successful participation in competitive endurance activities requires continual regulation of muscular work rate in order to maximise physiological performance capacities, meaning that individuals must make numerous decisions with regards to the muscular work rate selected at any point in time. Decisions relating to the setting of appropriate goals and the overall strategic approach to be utilised are made prior to the commencement of an event, whereas tactical decisions are made during the event itself. This review examines current theories of decision-making in an attempt to explain the manner in which regulation of muscular work is achieved during athletic activity. We describe rational and heuristic theories, and relate these to current models of regulatory processes during self-paced exercise in an attempt to explain observations made in both laboratory and competitive environments. Additionally, we use rational and heuristic theories in an attempt to explain the influence of the presence of direct competitors on the quality of the decisions made during these activities. We hypothesise that although both rational and heuristic models can plausibly explain many observed behaviours in competitive endurance activities, the complexity of the environment in which such activities occur would imply that effective rational decision-making is unlikely. However, at present, many proposed models of the regulatory process share similarities with rational models. We suggest enhanced understanding of the decision-making process during self-paced activities is crucial in order to improve the ability to understand regulation of performance and performance outcomes during athletic activity.

  11. Using self-paced, `flipped' teaching to promote deep learning in an Earth Sciences programming course (United States)

    Kalnins, L. M.


    Over the last year we implemented a complete restructuring of a second year Matlab-based course on numerical modelling of Earth processes, with changes aimed at 1) strengthening students' independence as programmers, 2) addressing student concerns about support in developing coding skills, and 3) improving key modelling skills such as choosing boundary conditions. To address this, we designed a mastery-based approach where students progress through a series of small programming projects at their own pace. As part of this, all lectures are `flipped' into short videos, allowing all contact hours to be spent on programming. The projects themselves are structured based on a `bottlenecks to learning' approach, explicitly separating out the steps of learning new commands and code structures, creating a conceptual and mathematical model of the problem, and development of more generic programmings skills such as debugging before asking the students to combine all of the above to build a numerical model of an Earth Sciences problem. Compared with the previous, traditionally taught cohort, student questionnaires show a strong improvement in overall satisfaction. Free text responses show a focus on learning for understanding, and that students particularly valued the encouragement to slow down and work towards understanding when they encountered a difficult topic, rather than being pressured by a set timetable to move on. Quantitatively, exam performance improved on key conceptual questions, such as boundary conditions and discretisation, and overall achievement also rose, with 25% of students achieving an `A+' standard of work. Many of the final projects also demonstrated programming and modelling skills that had not been directly taught, ranging from use of new commands to extension of techniques taught in 1D to the 2D case: strong confirmation of the independent skills we aimed to foster with this new approach.

  12. Variables affecting the manifestation of and intensity of pacing behavior: A preliminary case study in zoo-housed polar bears. (United States)

    Cless, Isabelle T; Lukas, Kristen E


    High-speed video analysis was us