Full Text Available AbstrakResep adalah suatu permintaan tertulis dari dokter, dokter gigi atau dokter hewan kepada apoteker untuk membuatkan obat dalam bentuk sediaan tertentu dan menyerahkannya kepada pasien. Resep merupakan perwujudan akhir dari kompetensi, pengetahuan dan keahlian dokter dalam menerapkan pengetahuannya dalam bidang farmakologi dan terapi.Penulisan resep harus ditulis dengan jelas sehingga dapat dibaca oleh petugas di apotek. Resep yang ditulis dengan tidak jelas akan menimbulkan terjadinya kesalahan saat peracikan / penyiapan obat dan penggunaan obat yang diresepkan.Ilmu pengetahuan tentang obat selalu berubah, obat – obat baru selalu muncul di pasaran.Secara umum, seorang dokter harus mengikuti perkembangan dalam terapi obat. Bila muncul efek samping akibat obat yang seharusnya diketahui dan dapat dicegah oleh dokter, maka dokter akan berhadapan dengan hukum.Agar penulisan resep tetap up to date, seorang dokter harus mengumpulkan berbagai informasi yang tersedia. Sumber informasi yang dapat digunakan adalah : Buku acuan, Kompendium obat, Daftar Obat Esensial Nasional (DOEN dan Pedoman terapi, Buletin obat, Jurnal Kedokteran, Pusat informasi obat,Informasi melalui komputer, Sumber informasi dari industri farmasi, dan informasi lisan.Bandingkan kelebihan dan kekurangan berbagai sumber informasi. Tugas seorang dokter adalah melakukan cara terbaik untuk tetap up to date dengan mendaftar sumber informasi yang dapat dimanfaatkan. Carilah sedikitnya satu dari yang berikut ini : (1 jurnal kedokteran: (2 buletin obat; (3 buku acuan farmakologi atau acuan klinis; (4 komisi terapi maupun konsultan, atau lulusan pasca sarjana farmakologi. Dengan bekal pengetahuan dan kemampuan untuk melakukan penilaian secara kritis setiap bentuk informasi, diharapkan dokter tetap up to date dalam menulis resepKata kunci : Resep – up to- date.Abstract Prescription is a written request from a doctor, dentist or veterinarian to the pharmacist to make a particular drug
Wallace, Katie L.; Beckett, Robert D.; Sheehan, Amy Heck
A cross-sectional survey of a convenience sample of 1,199 pharmacists was conducted to describe pharmacists' use and perception of UpToDate®. Of 472 (39%) respondents, 217 (46%) reported using UpToDate. Most respondents who used or had heard of UpToDate indicated willingness to change a treatment plan based on UpToDate recommendations (77%). Many believed that UpToDate is updated weekly (31%) or monthly (49%) and that all articles undergo external peer review (51%). In conclusion, the majorit...
Wallace, Katie L.; Beckett, Robert D.; Sheehan, Amy Heck
A cross-sectional survey of a convenience sample of 1,199 pharmacists was conducted to describe pharmacists' use and perception of UpToDate®. Of 472 (39%) respondents, 217 (46%) reported using UpToDate. Most respondents who used or had heard of UpToDate indicated willingness to change a treatment plan based on UpToDate recommendations (77%). Many believed that UpToDate is updated weekly (31%) or monthly (49%) and that all articles undergo external peer review (51%). In conclusion, the majority of respondents reported that they would adjust drug therapy based on UpToDate recommendations; however, many pharmacists may hold misconceptions regarding the updating and peer-review processes. PMID:25349549
Wallace, Katie L; Beckett, Robert D; Sheehan, Amy Heck
A cross-sectional survey of a convenience sample of 1,199 pharmacists was conducted to describe pharmacists' use and perception of UpToDate®. Of 472 (39%) respondents, 217 (46%) reported using UpToDate. Most respondents who used or had heard of UpToDate indicated willingness to change a treatment plan based on UpToDate recommendations (77%). Many believed that UpToDate is updated weekly (31%) or monthly (49%) and that all articles undergo external peer review (51%). In conclusion, the majority of respondents reported that they would adjust drug therapy based on UpToDate recommendations; however, many pharmacists may hold misconceptions regarding the updating and peer-review processes.
Full Text Available Transparent conducting oxides (TCOs are electrical conductive materials with comparably low absorption of electromagnetic waves within the visible region of the spectrum. They are usually prepared with thin film technologies and used in opto-electrical apparatus such as solar cells, displays, opto-electrical interfaces and circuitries. Here, based on a modern database-system, aspects of up-to-date material selections and applications for transparent conducting oxides are sketched, and references for detailed information are given. As n-type TCOs are of special importance for thin film solar cell production, indium-tin oxide (ITO and the reasonably priced aluminum-doped zinc oxide (ZnO:Al, are discussed with view on preparation, characterization and special occurrences. For completion, the recently frequently mentioned typical p-type delafossite TCOs are described as well, providing a variety of references, as a detailed discussion is not reasonable within an overview publication.
Full Text Available Hypertension remains one of the most important medical problems in spite of significant medical advances. In many studies, both systolic and diastolic blood pressures have been found to be closely related with cardiovascular (CV morbidity and mortality. The primary aim in the treatment of hypertension is to reduce CV disease risk and the related morbidity and mortality. Hypertension is one of the most common causes of death worldwide due to its high prevalence. Because it is thought that it will be an important public health problem in the future, as it is now, the need for developing new guidelines based on new studies emerges. Individualized treatment plans based on up-to-date guidelines would be the most appropriate approach for physicians. Herein, the current approach to the treatment of hypertension has been summarized in the light of recent guidelines.
Kensche, C.W. [Deutsche Forschungsanstalt fuer Luft- und Raumfahrt e.V. (DLR), Stuttgart (Germany). Inst. fuer Bauweisen- und Konstruktionsforschung; Soeker, H. [Deutsches Windenergie-Institut GmbH (DEWI), Wilhelmshaven (Germany)
The SISPER/WISPERX standard was introduced by an IEA working group in 1988 for calculating collective loads of wind power systems. The authors investigated whether the standard is still up to date. They were able to prove that WISPER results are still accurate. [German] 1988 ist der WISPER/WISPERX-Standard von einer IEA-Arbeitsgruppe als Windenergie-spezifisches Betriebslastkollektiv eingefuehrt worden, dem Messungen an WEA sehr unterschiedlicher Groessenordnungen zugrunde lagen. Es sollte ausschliesslich dem Zweck vergleichender Materialuntersuchungen bzw. Lebensdauervorhersagen dienen. Heute mehr als 10 (Entwicklungs-) Jahre und viele Vermessungen spaeter stellt sich die Frage, ob dieser Standard die Ermuedungsbelastung moderner Windenergieanlagen noch in realistischer Weise abbildet. Hierzu wurden Schaedigungsrechnungen durchgefuehrt, die einen Vergleich zwischen der Materialermuedung aufgrund WISPER bzw. ueber den Zeitraum von mehr als einem Monat vom DEWI online gemessenen Belastungen einer 33 m-Anlage erlauben. Als Basis fuer die Materialermuedung dienten Woehlerkurven bzw. daraus konstruierte Haigh-Diagramme fuer den Gurt und den Steg eines typischen GFK-Rotorblattholms. Darueber hinaus wurde mit Hilfe der in der Zwischenzeit entwickelten beschreibenden Parameter (Footprints) eine vergleichende Analyse der Strukturen der im Rainflow-Verfahren gezaehlten WISPER- und Langzeit-Lastkollektive durchgefuehrt. Die ersten soweit erzielten Ergebnisse zeigen, dass die auf gleiche Zeitabschnitte bezogene Ermuedung fast identisch ist. (orig.)
Full Text Available During the last decades, the effort of establishing satisfactory biomarkers for multiple sclerosis has been proven to be very difficult, due to the clinical and pathophysiological complexities of the disease. Recent knowledge acquired in the domains of genomics-immunogenetics and neuroimmunology, as well as the evolution in neuroimaging, has provided a whole new list of biomarkers. This variety, though, leads inevitably to confusion in the effort of decision making concerning strategic and individualized therapeutics. In this paper, our primary goal is to provide the reader with a list of the most important characteristics that a biomarker must possess in order to be considered as reliable. Additionally, up-to-date biomarkers are further divided into three subgroups, genetic-immunogenetic, laboratorial, and imaging. The most important representatives of each category are presented in the text and for the first time in a summarizing workable table, in a critical way, estimating their diagnostic potential and their efficacy to correlate with phenotypical expression, neuroinflammation, neurodegeneration, disability, and therapeutical response. Special attention is given to the “gold standards” of each category, like HLA-DRB1* polymorphisms, oligoclonal bands, vitamin D, and conventional and nonconventional imaging techniques. Moreover, not adequately established but quite promising, recently characterized biomarkers, like TOB-1 polymorphisms, are further discussed.
Schillhammer, Carl K; Reid, John B; Rister, Jamie; Jani, Sunil S; Marvil, Sean C; Chen, Austin W; Anderson, Chris G; D'Agostino, Sophia; Lubowitz, James H
To categorize and summarize up-to-date anterior cruciate ligament (ACL) research published in Arthroscopy and The American Journal of Sports Medicine and systematically review each subcategory, beginning with ACL anatomy. After searching for "anterior cruciate ligament" OR "ACL" in Arthroscopy and The American Journal of Sports Medicine from January 2012 through December 2014, we excluded articles more pertinent to ACL augmentation; open growth plates; and meniscal, chondral, or multiligamentous pathology. Studies were subcategorized for data extraction. We included 212 studies that were classified into 8 categories: anatomy; basic science and biomechanics; tunnel position; graft selection; graft fixation; injury risk and rehabilitation; practice patterns and outcomes; and complications. Anatomic risk factors for ACL injury and post-reconstruction graft failure include a narrow intercondylar notch, low native ACL volume, and increased posterior slope. Regarding anatomic footprints, the femoral attachment is 43% of the proximal-to-distal lateral femoral condylar length whereas the posterior border of the tendon is 2.5 mm from the articular margin. The tibial attachment of the ACL is two-fifths of the medial-to-lateral interspinous distance and 15 mm anterior to the posterior cruciate ligament. Anatomic research using radiology and computed tomography to evaluate ACL graft placement shows poor interobserver and intraobserver reliability. With a mind to improving outcomes, surgeons should be aware of anatomic risk factors (stenotic femoral notch, low ligament volume, and increased posterior slope) for ACL graft failure, have a precise understanding of arthroscopic landmarks identifying femoral and tibial footprint locations, and understand that imaging to evaluate graft placement is unreliable. Level III, systematic review of Level III evidence. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
The last decade has witnessed significant advancement of the acceptance of food irradiation processing. At present 37 countries have approved one or more food items for human consumption and 25 countries have commercialized this process. More developing countries are showing keen interest to introduce irradiation processing in order to reduce post-harvest food losses, to increase export potentials and to ensure safety of food to their people. Although progress towards acceptance of food irradiation by the industry is slow, actual market trials have shown that once consumers have understood this technology, they are willing to buy irradiated foods. This paper deals with the latest developments in the field of food irradiation with particular reference to legislation, consumer acceptance, commercialization and potential application in developing countries. This paper also deals with the role played by the International Organizations, aimed at facilitating the acceptance of food irradiation.
Isaac, Thomas; Zheng, Jie; Jha, Ashish
Computerized clinical knowledge mana-gement systems hold enormous potential for improving quality and efficiency. However, their impact on clinical practice is not well known. To examine the impact of UpToDate on outcomes of care. Retrospective study. National sample of US inpatient hospitals. Fee-for-service Medicare beneficiaries. Adoption of UpToDate in US hospitals. Risk-adjusted lengths of stay, mortality rates, and quality performance. We found that patients admitted to hospitals using UpToDate had shorter lengths of stay than patients admitted to non-UpToDate hospitals overall (5.6 days vs 5.7 days; P UpToDate hospitals had lower risk-adjusted mortality rate for 3 of the 6 conditions (range, -0.1% to -0.6% mortality reduction; P UpToDate had better quality performance for every condition on the Hospital Quality Alliance metrics. In subgroup analyses, we found that it was the smaller hospitals and the non-teaching hospitals where the benefits of the UpToDate seemed most pronounced, compared to the larger, teaching institutions where the benefits of UpToDate seemed small or nonexistent. We found a very small but consistent association between use of UpToDate and reduced length of stay, lower risk-adjusted mortality rates, and better quality performance, at least in the smaller, non-teaching institutions. These findings may suggest that computerized tools such as UpToDate could be helpful in improving care. Copyright © 2011 Society of Hospital Medicine.
Mishra, Rashmi; Del Fiol, Guilherme; Kilicoglu, Halil; Jonnalagadda, Siddhartha; Fiszman, Marcelo
Clinicians raise several information needs in the course of care. Most of these needs can be met by online health knowledge resources such as UpToDate. However, finding relevant information in these resources often requires significant time and cognitive effort. To design and assess algorithms for extracting from UpToDate the sentences that represent the most clinically useful information for patient care decision making. We developed algorithms based on semantic predications extracted with SemRep, a semantic natural language processing parser. Two algorithms were compared against a gold standard composed of UpToDate sentences rated in terms of clinical usefulness. Clinically useful sentences were strongly correlated with predication frequency (correlation= 0.95). The two algorithms did not differ in terms of top ten precision (53% vs. 49%; p=0.06). Semantic predications may serve as the basis for extracting clinically useful sentences. Future research is needed to improve the algorithms.
Full Text Available Abstract Background In this era of evidence-based medicine, doctors are increasingly using information technology to acquire medical knowledge. This study evaluates how residents and interns utilise and perceive the personal digital assistant (PDA and the online resource UpToDate. Methods This is a questionnaire survey of all residents and interns in a tertiary teaching hospital. Results Out of 168 doctors, 134 (79.8% responded to the questionnaire. Only 54 doctors (40.3% owned a PDA. Although these owners perceived that the PDA was most useful for providing drug information, followed by medical references, scheduling and medical calculators, the majority of them did not actually have medical software applications downloaded on their PDAs. The greatest concerns highlighted for the PDA were the fear of loss and breakage, and the preference for working with desktop computers and paper. Meanwhile, only 76 doctors (56.7% used UpToDate, even though the hospital had an institutional subscription for it. Although 93.4% of these users would recommend UpToDate to a colleague, only 57.9% stated that the use of UpToDate had led to a change in their management of patients. Conclusion Although UpToDate and various PDA software applications were deemed useful by some of the residents and interns in our study, both digital tools were under-utilised. More should be done to facilitate the use of medical software applications on PDAs, to promote awareness of tools for evidence-based medicine such as UpToDate, and to facilitate the application of evidence-based medicine in daily clinical practice.
Phua, Jason; Lim, Tow Keang
In this era of evidence-based medicine, doctors are increasingly using information technology to acquire medical knowledge. This study evaluates how residents and interns utilise and perceive the personal digital assistant (PDA) and the online resource UpToDate. This is a questionnaire survey of all residents and interns in a tertiary teaching hospital. Out of 168 doctors, 134 (79.8%) responded to the questionnaire. Only 54 doctors (40.3%) owned a PDA. Although these owners perceived that the PDA was most useful for providing drug information, followed by medical references, scheduling and medical calculators, the majority of them did not actually have medical software applications downloaded on their PDAs. The greatest concerns highlighted for the PDA were the fear of loss and breakage, and the preference for working with desktop computers and paper. Meanwhile, only 76 doctors (56.7%) used UpToDate, even though the hospital had an institutional subscription for it. Although 93.4% of these users would recommend UpToDate to a colleague, only 57.9% stated that the use of UpToDate had led to a change in their management of patients. Although UpToDate and various PDA software applications were deemed useful by some of the residents and interns in our study, both digital tools were under-utilised. More should be done to facilitate the use of medical software applications on PDAs, to promote awareness of tools for evidence-based medicine such as UpToDate, and to facilitate the application of evidence-based medicine in daily clinical practice.
Creemers, Mathijs; Jans, Mieke J.
Keeping an up-to-date overview of the knowledge and skills available in an organization is a difficult task. Looking at this problem we propose the use of data, that already exists in the organization’s information systems, as a means to keep user knowledge profiles up to date. To extract the required information from these information systems, we suggest the use of process mining. We illustrate the current state of our research and the end goals we aim to reach with it. We state a general...
Agoritsas, Thomas; Merglen, Arnaud; Heen, Anja Fog; Kristiansen, Annette; Neumann, Ignacio; Brito, Juan P; Brignardello-Petersen, Romina; Alexander, Paul E; Rind, David M; Vandvik, Per O; Guyatt, Gordon H
UpToDate is widely used by clinicians worldwide and includes more than 9400 recommendations that apply the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. GRADE guidance warns against strong recommendations when certainty of the evidence is low or very low (discordant recommendations) but has identified five paradigmatic situations in which discordant recommendations may be justified. Our objective was to document the strength of recommendations in UpToDate and assess the frequency and appropriateness of discordant recommendations. Analytical survey of all recommendations in UpToDate. We identified all GRADE recommendations in UpToDate and examined their strength (strong or weak) and certainty of the evidence (high, moderate or low certainty). We identified all discordant recommendations as of January 2015, and pairs of reviewers independently classified them either into one of the five appropriate paradigms or into one of three categories inconsistent with GRADE guidance, based on the evidence presented in UpToDate. UpToDate included 9451 GRADE recommendations, of which 6501 (68.8%) were formulated as weak recommendations and 2950 (31.2%) as strong. Among the strong, 844 (28.6%) were based on high certainty in effect estimates, 1740 (59.0%) on moderate certainty and 366 (12.4%) on low certainty. Of the 349 discordant recommendations 204 (58.5%) were judged appropriately (consistent with one of the five paradigms); we classified 47 (13.5%) as good practice statements; 38 (10.9%) misclassified the evidence as low certainty when it was at least moderate and 60 (17.2%) warranted a weak rather than a strong recommendation. The proportion of discordant recommendations in UpToDate is small (3.7% of all recommendations) and the proportion that is truly problematic (strong recommendations that would best have been weak) is very small (0.6%). Clinicians should nevertheless be cautious and look for clear explanations-in UpToDate and
Jordan, Niels V.; Rindel, Jens Holger
acoustical knowledge of that time, it had become clear that the halls suffered by several acoustical problems, and thus the government of Alberta wanted the halls to be brought up-to-date for the 100 years jubilee of the state. The Canadian architect Fred Valentine together with other North American...
Beall, D P; McRoberts, W P; Berven, S H; Ledlie, J T; Tutton, S M; Parsons, B P
The treatment of painful vertebral compression fractures has changed substantially since the introduction of vertebroplasty in the mid-1980s and balloon kyphoplasty in the late 1990s. Both procedures were widely accepted with the vertebral fractures treated reaching 150,000 per annum in 2009 prior to the publication of 2 randomized controlled trials comparing vertebroplasty with a sham treatment published in the New England Journal of Medicine in August 2009. Since then, there has been a flood of information on vertebral augmentation and balloon kyphoplasty. It is worth evaluating this information especially because it relates to current recommendations that are often followed blindly by medical and administrative groups unfamiliar with either the procedure or the high level of evidence surrounding vertebral augmentation. To streamline the evaluation of some current recommendations, we limited the analysis to the recommendations found on UpToDate.com. This Web site is an evidence-based, peer-reviewed source of information available for patients, doctors, health insurance companies, and population-based medical decision-making. © 2015 by American Journal of Neuroradiology.
Mishra, Rashmi; Fiol, Guilherme Del; Kilicoglu, Halil; Jonnalagadda, Siddhartha; Fiszman, Marcelo
Clinicians raise several information needs in the course of care. Most of these needs can be met by online health knowledge resources such as UpToDate. However, finding relevant information in these resources often requires significant time and cognitive effort. Objective: To design and assess algorithms for extracting from UpToDate the sentences that represent the most clinically useful information for patient care decision making. Methods: We developed algorithms based on semantic predications extracted with SemRep, a semantic natural language processing parser. Two algorithms were compared against a gold standard composed of UpToDate sentences rated in terms of clinical usefulness. Results: Clinically useful sentences were strongly correlated with predication frequency (correlation= 0.95). The two algorithms did not differ in terms of top ten precision (53% vs. 49%; p=0.06). Conclusions: Semantic predications may serve as the basis for extracting clinically useful sentences. Future research is needed to improve the algorithms. PMID:24551389
Ebrahim Aghazadeh Asl
Full Text Available Background and Objectives: Nursing is one of the largest groups of health care providers that needs updated information to improve quality and quantity of health care services, clinical activities, etc. In the meantime, evidence-based databases (such as Up-To-Date Database significantly contribute to improve performance and efficiency of health services by providing the latest findings on health issues. The present study aimed to survey the information seeking behavior and information needs of nurses working in Ahvaz hospitals affiliated with Jundishapur University of Medical Sciences in using Up-To-Date database. Material and Methods: In this descriptive-analytical study, the statistical population consisted of 1246 nurses working in hospitals of Ahvaz University of Medical Sciences among which 293 nurses were selected. The required data were collected using a questionnaire developed by the researcher. Validity and reliability of the questionnaire were confirmed by Cronbach's alpha coefficient as 0.71. Descriptive statistics and Kruskal-Wallis Test were used for data analysis. Results: The results showed that most of the nurses needed information about new developments in the field of nursing and medications. A majority of the nurses used simple searching technique to find the required information. Most of the nurses aimed to update their information using Up-To-Date Database. The main barrier to update information was shortage of time. Conclusion: Therefore, it is essential to teach information skills to nurses; so that they can access modern and updated information in the field of nursing and obtain
Warburton, J.; Timm, K.; Larson, A. M.
in today’s world, as well as increased self-reported knowledge and interest in numerous science content areas. PolarTREC provides a tested approach and a clear route for varying levels of researcher participation in the education community, therefore facilitating the types of positive benefits and understanding that ensure increased educator, student, and community understanding of science and the polar regions during times of interrelated global change.
Folan, Lorcan M.; Tsifrinovich, Vladimir I.
We observe a huge chasm between up-to-date science and undergraduate education. The result of this chasm is that current student interest in undergraduate science is low. Consequently, students who are graduating from college are often unable to take advantage of the many opportunities offered by science and technology. Cutting edge science and technology frequently use the methods learned in undergraduate courses, but up-to-date applications are not normally used as examples or for problems in undergraduate courses. There are many physics problems which contain information about the latest achievements in science and technology. But typically, the level of these problems is too advanced for undergraduates. We created physics problems for undergraduate science and engineering students, which are based on the latest achievements in science and technology. These problems have been successfully used in our courses at the Polytechnic University in New York. We believe that university faculty may suggest such problems in order to provide information about the frontiers of science and technological, demonstrate the importance of undergraduate physics in solving contemporary problems and raise the interest of talented students in science. From the other side, our approach may be considered an indirect way for advertising advanced technologies, which undergraduate students and, even more important, future college graduates could use in their working lives.
Hernandez Lopez, H.
Reactor cell analysis is the first step in determining reactor core behavior and is required in the reload licensing process. For best results, reactor cell analysis should be carried out with libraries of up to date, accurate cross sections produced with well described methods from standard evaluated nuclear data. At first step in this work were determined the library structure for RECORD and THERMOS and were prepared the cross sections libraries using the NJOY nuclear data processing system and the ENDF-B/IV evaluated nuclear data. These libraries were used by the codes and some samples were perform, the result show some differences against the results obtained using the previous libraries. By other hand the libraries contain various adjustments to correct for deficiencies in nuclear data or analytical methods. These adjustments doesn't have any documentation, although some of them were identified in this work. (Author). 25 refs, 78 figs, 55 tabs
Goodyear-Smith, Felicity; Kerse, Ngaire; Warren, Jim; Arroll, Bruce
To evaluate the acceptability and utilisation of three electronic textbooks: DynaMed, MD Consult (including FirstConsult) and UpToDate. Two hundred general practitioners accessed three e-textbooks through a web portal. General practitioners completed an electronic survey and used a random selection during a telephone interview to answer four clinical questions: screening, diagnosis, treatment and prognosis. One hundred and twenty-two GPs made at least one hit through the study website. Eighty-four GPs completed the emailed questionnaire and 77 completed the telephone interview (36% of enrolled, 61% of users). Fifty-one percent of users accessed the e-textbooks less than 10 times over 8 months. There was no significant difference in preference for, or usage levels of, the three e-textbooks. During the telephone interview the three texts performed similarly in terms of time to answer and satisfaction with answer. There was no clear 'winner' between the three e-textbooks.
Full Text Available This review addresses up-to-date applications of Protein Microarrays. Protein Microarrays play a significant role in basic research as well as in clinical applications and are applicable in a lot of fields, e.g., DNA, proteins and small molecules. Additionally they are on the way to enter clinics in routine diagnostics. Protein Microarrays can be powerful tools to improve healthcare. An overview of basic characteristics to mediate essential knowledge of this technique is given. To reach this goal, some challenges still have to be addressed. A few applications of Protein Microarrays in a medical context are shown. Finally, an outlook, where the potential of Protein Microarrays is depicted and speculations how the future of Protein Microarrays will look like are made.
LHC experiments are depending on a rich palette of software components to build their specific applications. These underlying software components include the ROOT analysis framework, the Geant4 simulation toolkit, Monte Carlo generators, grid middle-ware, graphics libraries, scripting languages, databases, tools, etc. which are provided centrally in up to date versions on multiple platforms (Linux, Mac, Windows). Until recently this set of packages has been tested and released in a tree like structure as a consistent set of versions across operating systems, architectures and compilers for LHC experiments only. Because of the tree like deployment these releases were only usable in connection with a configuration management tool which provided the proper build and run-time environments and was hindering other parties outside LHC from easily using this palette of packages. In a new approach the releases will be grouped in 'flat structure' such that interested parties can start using it without configuration management, retaining all the above mentioned advantages. In addition to an increased usability the software shall also be distributed via system provided package deployment systems (rpm, apt, etc.). The approach of software deployment is following the ideas of providing a wide range of HEP specific software packages and tools in a coherent, up to date and modular way on multiple platforms. The target audience for such software deployments are individual developers or smaller development groups / experiments who don't have the resources to maintain this kind of infrastructure. This new software deployment strategy has already been successfully implemented for groups at CERN.
Thorner, Anna R; Cao, Bin; Jiang, Terrence; Warner, Amy J; Bonis, Peter A
Background. UpToDate is an online clinical decision support resource that is used extensively by clinicians around the world. Digital surveillance techniques have shown promise to aid with the detection and monitoring of infectious disease outbreaks. We sought to determine whether UpToDate searches for Middle East respiratory syndrome (MERS) could be used to detect and monitor MERS outbreaks in Saudi Arabia. Methods. We analyzed daily searches related to MERS in Jeddah and Riyadh, Saudi Arabia during 3 outbreaks in these cities in 2014 and 2015 and compared them with reported cases during the same periods. We also compared UpToDate MERS searches in the affected cities to those in a composite of 4 negative control cities for the 2 outbreaks in 2014. Results. UpToDate MERS searches during all 3 MERS outbreaks in Saudi Arabia showed a correlation to reported cases. In addition, UpToDate MERS search volume in Jeddah and Riyadh during the outbreak periods in 2014 was significantly higher than the concurrent search volume in the 4 negative control cities. In contrast, during the baseline periods, there was no difference between UpToDate searches for MERS in the affected cities compared with the negative control cities. Conclusions. UpToDate search activity seems to be useful for detecting and monitoring outbreaks of MERS in Saudi Arabia.
Arno, Anna I; Gauglitz, Gerd G; Barret, Juan P; Jeschke, Marc G
Keloids and hypertrophic scars occur anywhere from 30 to 90% of patients, and are characterized by pathologically excessive dermal fibrosis and aberrant wound healing. Both entities have different clinical and histochemical characteristics, and unfortunately still represent a great challenge for clinicians due to lack of efficacious treatments. Current advances in molecular biology and genetics reveal new preventive and therapeutical options which represent a hope to manage this highly prevalent, chronic and disabling problem, with long-term beneficial outcomes and improvement of quality of life. While we wait for these translational clinical products to be marketed, however, it is imperative to know the basics of the currently existing wide array of strategies to deal with excessive scars: from the classical corticotherapy, to the most recent botulinum toxin and lasers. The main aim of this review paper is to offer a useful up-to-date guideline to prevent and treat keloids and hypertrophic scars. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.
As our repository matured we found that a concerted effort was needed to establish it as a resource that institutional stakeholders knew they could turn to for reliable information about the research outputs produced by researchers affiliated with or funded by our institution. The initial impetus for this project was the adoption of an institutional open access policy, which necessitated a process to track the publications of institutional authors, deposit items with applicable open access licenses, and notify authors when an accepted manuscript was needed. To support this process we developed a local publications tracking system independent of our hosted DSpace repository that regularly queries publisher and indexer APIs for new publications, checks for relevant permissions policies, identifies institutional authors and helps us send manuscript request emails. We also harvested records for past items and modified our repository to accommodate metadata-only records. The success of these tracking and harvesting services in making our repository comprehensive and up-to-date has allowed us to rely on our repository as the key source of publications information for additional integrations that update ORCID records with publication information, populate a PlumX metrics dashboard and, most recently, support the implementation of a current research information system (CRIS).
Tam, Wilson W S; Lo, Kenneth K H; Khalechelvam, Parames; Seah, Joey; Goh, Shawn Y S
(92-212), respectively. No significant association were revealed between the time lag and those potential factors. The median time from the last search to acceptance for systematic reviews published in nursing journals was 393 days. Readers for systematic reviews are advised to check the time taken from the last search date of the reviews in order to ensure that up-to-date evidence is consulted for effective clinical decision-making.
Winsemius, Hessel; Eilander, Dirk; Ward, Philip; Diaz Loaiza, Andres; Iliffe, Mark; Mawanda, Shaban; Luo, Tianyi; Kimacha, Nyambiri; Chen, Jorik
The world is urbanizing rapidly. According to the United Nation's World Urbanization Prospect, 50% of the global population already lives in urban areas today. This number is expected to grow to 66% by 2050. The rapid changes in these urban environments go hand in hand with rapid changes in natural hazard risks, in particular in informal unplanned neighbourhoods. In Dar Es Salaam - Tanzania, flood risk dominates and given the rapid changes in the city, continuous updates of detailed street level hazard and risk mapping are needed to adequately support decision making for urban planning, infrastructure design and disaster response. Over the past years, the Ramani Huria and Zuia Mafuriko projects have mapped the most flood prone neighbourhoods, including roads, buildings, drainage and land use and contributed data to the open-source OpenStreetMap database. In this contribution, we will demonstrate how we mobilize these contributed data to establish dynamic flood models for Dar Es Salaam and keep these up-to-date by making a direct link between the data, and model schematization. The tools automatically establish a sound 1D drainage network as well as a high resolution terrain dataset, by fusing the OpenStreetMap data with existing lower resolution terrain data such as the globally available satellite based SRTM 30. It then translates these fully automatically into the inputs required for the D-HYDRO modeling suite. Our tools are built such that community and stakeholder knowledge can be included in the model details through workshops with the tools so that missing essential information about the city's details can be augmented on-the-fly. This process creates a continuous dialogue between members of the community that collect data, and stakeholders requiring data for flood models. Moreover, used taxonomy and data filtering can be configured to conditions in other cities, making the tools generic and scalable. The tools are made available open-source.
Brekel, Guus van den
“I regularly try to keep up-to-date with my favourite journals by reading the articles via email alerts but I find this cumbersome and my mailbox keeps getting fuller and fuller!” “I find it difficult to get the full text articles on my tablet or via my email at home.” How do you keep up-to-date
Sreenivas P Veeranki
Conclusions: TN adults who are up-to-date status with CRC screening are increasing, but not across all socio-demographic subgroups. The results identified specific subgroups to be targeted by screening programs, along with continued efforts to educate public and providers about the importance of CRC screening.
Leijdesdorff, S.M.J.; Doesum, K.T.M. van; Popma, A.; Klaassen, R.M.C.; Amelsvoort, T.A.M.J. van
Purpose of review: Children of parents with a mental illness and/or addiction are at high risk for developing a mental illness themselves. Parental mental illness is highly prevalent leading to a serious number of children at high risk. The aim of this review is to give an up-to-date overview of
Fenton, Susan H.; Badgett, Robert G.
Objectives: The study sought to determine if two major resources for primary care questions have significant differences in information content and whether the number of documents found differs by disease category, patient age, or patient gender. Methods: Seven hundred fifty-two questions were randomly selected from the Clinical Questions Collection of the National Library of Medicine. UpToDate and the National Guidelines Clearinghouse (NGC) were searched utilizing keywords from the questions. The number of documents retrieved for each question in the resources was recorded. Chi-squared analysis was used to compare differences in retrieval between the resources. Logistic regression was used to evaluate the effect of patient age, patient gender, or disease category on the ability to find content. Results: UpToDate returned 1 or more documents for 580 questions, while NGC returned at least 1 document for 493 questions (77.1% versus 65.5% of question sampled, P = 0.001). In combination, the 2 resources returned content for 91% of searches (n = 685). NGC retrieved a mean of 16.3 documents per question versus 8.7 documents from UpToDate. Disease category was the only variable having a significant impact on the presence of online resource content. Conclusions: UpToDate had greater breadth of content than NGC, while neither resource provided complete coverage. Current practice guidelines, as reflected by those in the NGC, addressed at most two-thirds of the selected clinical questions. PMID:17641755
Fenton, Susan H; Badgett, Robert G
The study sought to determine if two major resources for primary care questions have significant differences in information content and whether the number of documents found differs by disease category, patient age, or patient gender. Seven hundred fifty-two questions were randomly selected from the Clinical Questions Collection of the National Library of Medicine. UpToDate and the National Guidelines Clearinghouse (NGC) were searched utilizing keywords from the questions. The number of documents retrieved for each question in the resources was recorded. Chi-squared analysis was used to compare differences in retrieval between the resources. Logistic regression was used to evaluate the effect of patient age, patient gender, or disease category on the ability to find content. UpToDate returned 1 or more documents for 580 questions, while NGC returned at least 1 document for 493 questions (77.1% versus 65.5% of question sampled, P = 0.001). In combination, the 2 resources returned content for 91% of searches (n = 685). NGC retrieved a mean of 16.3 documents per question versus 8.7 documents from UpToDate. Disease category was the only variable having a significant impact on the presence of online resource content. UpToDate had greater breadth of content than NGC, while neither resource provided complete coverage. Current practice guidelines, as reflected by those in the NGC, addressed at most two-thirds of the selected clinical questions.
Phua, J; See, K C; Khalizah, H J; Low, S P; Lim, T K
Clinical questions often arise at daily hospital bedside rounds. Yet, little information exists on how the search for answers may be facilitated. The aim of this prospective study was, therefore, to evaluate the overall utility, including the feasibility and usefulness of incorporating searches of UpToDate, a popular online information resource, into rounds. Doctors searched UpToDate for any unresolved clinical questions during rounds for patients in general medicine and respiratory wards, and in the medical intensive care unit of a tertiary teaching hospital. The nature of the questions and the results of the searches were recorded. Searches were deemed feasible if they were completed during the rounds and useful if they provided a satisfactory answer. A total of 157 UpToDate searches were performed during the study period. Questions were raised by all ranks of clinicians from junior doctors to consultants. The searches were feasible and performed immediately during rounds 44% of the time. Each search took a median of three minutes (first quartile: two minutes, third quartile: five minutes). UpToDate provided a useful and satisfactory answer 75% of the time, a partial answer 17% of the time and no answer 9% of the time. It led to a change in investigations, diagnosis or management 37% of the time, confirmed what was originally known or planned 38% of the time and had no effect 25% of the time. Incorporating UpToDate searches into daily bedside rounds was feasible and useful in clinical decision-making.
V. I. Тimoshpolsky
Full Text Available An analysis of development trends in the CIS machine-building industry and current status of the heating and heat treatment furnaces of main machine-building enterprises of the Republic of Belarus as of the 1st quarter of 2008 is given in the paper.The paper presents the most efficient engineering solutions from technological and economic point of view that concern calculation and designing of up-to-date gas-flame plants which are to be applied for modernization of the current heating and heat treatment furnaces of the machine-building enterprises in the Republic of Belarus.A thermo-technical calculation of main indices of the up-to-date gas-flame plant has been carried out in the paper.
Rothenstein, Bernhard; Nafornita, Corina
We present a way of teaching Einstein's special relativity. It starts with Galileo's relativity, the learners know from previous lectures. The lecture underlines that we can have three transformation equations for the space-time coordinates of the same event, which lead to absolute clock readings, time intervals and lengths (Galileo's relativity), to absolute clock readings but to relative time intervals and lengths (up-to-date Galileo transformations) and to relative clock readings time inte...
Thiele, Robert H; Poiro, Nathan C; Scalzo, David C; Nemergut, Edward C
The explosion of biomedical information has led to an 'information paradox'-the volume of biomedical information available has made it increasingly difficult to find relevant information when needed. It is thus increasingly critical for physicians to acquire a working knowledge of biomedical informatics. To evaluate four search tools commonly used to answer clinical questions, in terms of accuracy, speed, and user confidence. From December 2008 to June 2009, medical students, resident physicians, and attending physicians at the authors' institution were asked to answer a set of four anaesthesia and/or critical care based clinical questions, within 5 min, using Google, Ovid, PubMed, or UpToDate (only one search tool per question). At the end of each search, participants rated their results on a four point confidence scale. One to 3 weeks after answering the initial four questions, users were randomised to one of the four search tools, and asked to answer eight questions, four of which were repeated. The primary outcome was defined as a correct answer with the highest level of confidence. Google was the most popular search tool. Users of Google and UpToDate were more likely than users of PubMed to answer questions correctly. Subjects had the most confidence in UpToDate. Searches with Google and UpToDate were faster than searches with PubMed or Ovid. Non-Medline based search tools are not inferior to Medline based search tools for purposes of answering evidence based anaesthesia and critical care questions.
Stein-Zamir, Chen; Israeli, Avi
Routine childhood vaccinations schedules recommend that children receive the vaccine doses at specific ages. Vaccination coverage data are conventionally reported by the up-to-date method. We aimed to assess vaccination timeliness by the age-appropriate method and compare with the up-to-date vaccination coverage. Assessment of age-appropriate and up-to-date vaccination coverage among children born in Israel in 2009 and followed to age 48 months (national representative sample, n = 3892). The vaccinations included: Hepatitis B vaccine (HBV), Diphtheria-Tetanus-acellular Pertussis-Polio-Haemophilus-influenzae-b (DTaP-IPV-Hib), Pneumococcal conjugate vaccine (PCV), Measles-mumps-rubella-varicella vaccine (MMR/MMRV) and Hepatitis A vaccine (HAV). The categories defined: age-appropriate (at the recommended age and up to 1 month), delayed less than 6 months, delayed 6 months and above and unvaccinated (48 months). The age-specific vaccinations assessment showed considerable delay in receipt of routine vaccination. While most (96%, 95%, 91%, 96%, 94% and 86%) children were vaccinated up-to-date for HBV3, DTaP-IPV-Hib4, PCV3, MMR/MMRV1, HAV1and HAV2 vaccine doses; only 26%, 29%, 47%, 64%, 55% and 12% were vaccinated age-appropriate. Vaccination delay was more common in vaccines with multiple doses. Vaccination delay was associated with high child's birth order, low socio-economic rank, ethnicity (delay more common in Jews vs. Arabs), season of birth (winter) and delayed receipt of DTaP-IPV-Hib vaccine 1st dose. This study assessed age-appropriate childhood vaccination coverage in a national cohort of children. While the overall vaccination coverage stands in line with the WHO goals, vaccination timeliness and equity are inadequate and targeted public health intervention programs aimed at vaccination timeliness are necessary.
Park, Ah Young; Seo, Bo Kyoung
Ultrasonographic Doppler techniques have improved greatly over the years, allowing more sophisticated evaluation of breast tumor vascularity. Superb microvascular imaging (SMI) and contrast-enhanced ultrasound (CEUS) with second-generation contrast agents are two representative up-to-date techniques. SMI is a sensitive Doppler technique that adopts an intelligent filter system to separate low-flow signals from artifacts. With the development of second-generation contrast agents, CEUS has also emerged as a useful Doppler technique for evaluating tumor microcirculation. Both techniques can improve the diagnostic performance of gray-scale ultrasonography by providing vascular information useful not only for the morphologic assessment of microvessels, but also for the quantitative analysis of perfusion. In this review, we explain the imaging principles and previous research underlying these two vascular techniques, and describe our clinical experiences.
Hoogendam, A.; Stalenhoef, A.F.H.; Vries Robbe, P.F. de; Overbeke, A.J.P.M.
BACKGROUND: UpToDate and PubMed are popular sources for medical information. Data regarding the efficiency of PubMed and UpToDate in daily medical care are lacking. OBJECTIVE: The purpose of this observational study was to describe the percentage of answers retrieved by these information sources,
Postema, Pieter G; Wolpert, Christian; Amin, Ahmad S; Probst, Vincent; Borggrefe, Martin; Roden, Dan M; Priori, Silvia G; Tan, Hanno L; Hiraoka, Masayasu; Brugada, Josep; Wilde, Arthur A M
Worldwide, the Brugada syndrome has been recognized as an important cause of sudden cardiac death in individuals at a relatively young age. Importantly, many drugs have been reported to induce the characteristic Brugada syndrome-linked ECG abnormalities and/or (fatal) ventricular tachyarrhythmias. The purpose of this study was to review the literature on the use of drugs in Brugada syndrome patients, to make recommendations based on the literature and on expert opinion regarding drug safety, and to ensure worldwide online and up-to-date availability of this information to all physicians who treat Brugada syndrome patients. We performed an extensive review of the literature, formed an international expert panel to produce a consensus recommendation to each drug, and initiated a website (www.brugadadrugs.org). The literature search yielded 506 reports for consideration. Drugs were categorized into one of four categories: (1) drugs to be avoided (n = 18); (2) drugs preferably avoided (n = 23); (3) antiarrhythmic drugs (n = 4); and (4) diagnostic drugs (n = 4). Level of evidence for most associations was C (only consensus opinion of experts, case studies, or standard-of-care) as there are no randomized studies and few nonrandomized studies in Brugada syndrome patients. Many drugs have been associated with adverse events in Brugada syndrome patients. We have initiated a website (www.brugadadrugs.org) to ensure worldwide availability of information on safe drug use in Brugada syndrome patients.
Van So Le
Full Text Available A review on the Mo sources available today and on the Tc generators developed up to date for increasing the effectiveness of Mo utilisation is performed in the format of detailed description of the features and technical performance of the technological groups of the Mo production and Tc recovery. The latest results of the endeavour in this field are also surveyed in regard of the technical solution for overcoming the shortage of Mo supply. The technological topics are grouped and discussed in a way to reflect the similarity in the technological process of each group. The following groups are included in this review which are high specific activity Mo: the current issues of production, the efforts of more effective utilisation, and the high specific activity Mo-based Tc generator and Tc concentration units; low specific activity Mo: the Mo production based on neutron capture and accelerators and the direct production of Tc and the methods of increasing the specific activity of Mo using Szilard-Chalmers reaction and high electric power isotopic separator; up-to-date technologies of Tc recovery from low specific activity Mo: the solvent extraction-based Tc generator, the sublimation methods for Mo/Tc separation, the electrochemical method for Tc recovery, and the column chromatographic methods for Tc recovery. Besides the traditional Tc-generator systems, the integrated Tc generator systems (Tc generator column combined with postelution purification/concentration unit are discussed with the format of process diagram and picture of real generator systems. These systems are the technetium selective sorbent column-based generators, the high Mo-loading capacity column-based integrated Tc generator systems which include the saline-eluted generator systems, and the nonsaline aqueous and organic solvent eluent-eluted generator systems using high Mo-loading capacity molybdategel and recently developed sorbent columns. Tc concentration methods used in the
Hoogendam, Arjen; Stalenhoef, Anton F H; Robbé, Pieter F de Vries; Overbeke, A John P M
UpToDate and PubMed are popular sources for medical information. Data regarding the efficiency of PubMed and UpToDate in daily medical care are lacking. The purpose of this observational study was to describe the percentage of answers retrieved by these information sources, comparing search results with regard to different medical topics and the time spent searching for an answer. A total of 40 residents and 30 internists in internal medicine working in an academic medical center searched PubMed and UpToDate using an observation portal during daily medical care. The information source used for searching and the time needed to find an answer to the question were recorded by the portal. Information was provided by searchers regarding the topic of the question, the situation that triggered the question, and whether an answer was found. We analyzed 1305 patient-related questions sent to PubMed and/or UpToDate between October 1, 2005 and March 31, 2007 using our portal. A complete answer was found in 594/1125 (53%) questions sent to PubMed or UpToDate. A partial or full answer was obtained in 729/883 (83%) UpToDate searches and 152/242 (63%) PubMed searches (P UpToDate answered more questions than PubMed on all major medical topics, but a significant difference was detected only when the question was related to etiology (P UpToDate and 291 seconds (SD 7) for PubMed. Specialists and residents in internal medicine generally use less than 5 minutes to answer patient-related questions in daily care. More questions are answered using UpToDate than PubMed on all major medical topics.
Full Text Available Age-related macular degeneration (AMD is the most common cause of irreversible visual impairment among people over 50 years of age, accounting for up to 50% of all cases of legal blindness in Western countries. Although the aging represents the main determinant of AMD, it must be considered a multifaceted disease caused by interactions among environmental risk factors and genetic backgrounds. Mounting evidence and/or arguments document the crucial role of inflammation and immune-mediated processes in the pathogenesis of AMD. Proinflammatory effects secondary to chronic inflammation (e.g., alternative complement activation and heterogeneous types of oxidative stress (e.g., impaired cholesterol homeostasis can result in degenerative damages at the level of crucial macular structures, that is photoreceptors, retinal pigment epithelium, and Bruch’s membrane. In the most recent years, the association of AMD with genes, directly or indirectly, involved in immunoinflammatory pathways is increasingly becoming an essential core for AMD knowledge. Starting from the key basic-research notions detectable at the root of AMD pathogenesis, the present up-to-date paper reviews the best-known and/or the most attractive genetic findings linked to the mechanisms of inflammation of this complex disease.
Myer, Emily N B; Too, Gloria T; Hammad, Ibrahim A; Babbar, Shilpa; Martin, Charley E; Hill, James B; Blackwell, Sean B; Chauhan, Suneet P
To compare the obstetric recommendations in American Congress of Obstetricians and Gynecologists (ACOG) practice bulletins (PB) with similar topics in UpToDate (UTD). We accessed all obstetric PB and cross-searched UTD (May 1999-May 2013). We analyzed only the PB which had corresponding UTD chapter with graded recommendations (level A-C). To assess comparability of recommendations for each obstetric topic, two maternal-fetal medicine (MFM) subspecialists categorized the statement as similar, dissimilar, or incomparable. Simple and weighted kappa statistics were calculated to assess agreement between the two raters. We identified 46 ACOG obstetric PB and 86 UTD chapters. There were 50% fewer recommendations in UTD than in PB (181 vs. 365). The recommendations being categorized as level A, B, or C was significantly different (p < 0.001) for the two guidelines. While the overall concordance rate between the two MFM subspecialists was 83% regarding the recommendations for the same topic as similar, dissimilar, or incomparable, the agreement was moderate (kappa, 0.56; 95% confidence intervals, 0.48-0.65). Though obstetricians have two sources for graded recommendations, incongruity among them may be a source of consternation. Congruent recommendations from ACOG and UTD could enhance compliance and potentially optimize outcomes. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Castro, Clara; Antunes, Luís; Lunet, Nuno; Bento, Maria José
Decision making towards cancer prevention and control requires monitoring of trends in cancer incidence and accurate estimation of its burden in different settings. We aimed to estimate the number of incident cases in northern Portugal for 2015 and 2020 (all cancers except nonmelanoma skin and for the 15 most frequent tumours). Cancer cases diagnosed in 1994-2009 were collected by the North Region Cancer Registry of Portugal (RORENO) and corresponding population figures were obtained from Statistics Portugal. JoinPoint regression was used to analyse incidence trends. Population projections until 2020 were derived by RORENO. Predictions were performed using the Poisson regression models proposed by Dyba and Hakulinen. The number of incident cases is expected to increase by 18.7% in 2015 and by 37.6% in 2020, with lower increments among men than among women. For most cancers considered, the number of cases will keep rising up to 2020, although decreasing trends of age-standardized rates are expected for some tumours. Cervix was the only cancer with a decreasing number of incident cases in the entire period. Thyroid and lung cancers were among those with the steepest increases in the number of incident cases expected for 2020, especially among women. In 2020, the top five cancers are expected to account for 82 and 62% of all cases diagnosed in men and women, respectively. This study contributes to a broader understanding of cancer burden in the north of Portugal and provides the basis for keeping population-based incidence estimates up to date.
Wang, Zuo-Pei; Zhang, Hai-Feng; Zhang, Feng; Hu, Bao-Li; Wei, Hai-Tao; Guo, Yong-Yuan
The risk of anemia due to bevacizumab-based chemotherapy has not been well described, and new randomized controlled trials (RCTs) have been reported in recent years. We therefore conducted an up-to-date meta-analysis of RCTs to fully characterize the risk of anemia with bevacizumab. We carried out an electronic search of Medline, Embase, and The Cochrane Central Register of Controlled Trials to investigate the effects of RCTs on bevacizumab treatment on cancer patients up to October 2014, and random or fixed-effect meta-analytical models were used to assess the risk ratio (RR) of anemia due to the use of bevacizumab according to the heterogeneity of included studies. A total of 13,173 patients were included in this analysis from 18 RCTs. Among those patients receiving bevacizumab and chemotherapy, the incidences of all-grade and high-grade (grade 3 and above) anemia were 24% (95% confidence interval (CI) 13-41%) and 4.0% (95% CI 3.0-6.0%), respectively. Bevacizumab-containing therapy did not significantly decreased the risk of developing all-grade anemia (RR 0.872, 95% CI 0.739-1.029, P = 0.104) and high-grade anemia (RR 0.850, 95% CI 0.720-1.002, P = 0.053), which is not in agreement with previous meta-analysis. On subgroup analysis, we did not find significant risk differences based on bevacizumab dosage, tumor types, and concomitant drugs. When stratified by dose level, a significantly decreased risk of high-grade anemia with bevacizumab was obtained in a lower dose level (2.5 mg/kg/week, RR 0.773, 95% CI 0.611-0.978, P = 0.031) compared to control group. Bevacizumab did not significantly reduce the risk of anemia with chemotherapy in cancer patients.
Ladan Sayyah Ensan
Full Text Available PURPOSE: To compare PubMed Clinical Queries and UpToDate regarding the amount and speed of information retrieval and users' satisfaction. METHOD: A cross-over randomized trial was conducted in February 2009 in Tehran University of Medical Sciences that included 44 year-one or two residents who participated in an information mastery workshop. A one-hour lecture on the principles of information mastery was organized followed by self learning slide shows before using each database. Subsequently, participants were randomly assigned to answer 2 clinical scenarios using either UpToDate or PubMed Clinical Queries then crossed to use the other database to answer 2 different clinical scenarios. The proportion of relevantly answered clinical scenarios, time to answer retrieval, and users' satisfaction were measured in each database. RESULTS: Based on intention-to-treat analysis, participants retrieved the answer of 67 (76% questions using UpToDate and 38 (43% questions using PubMed Clinical Queries (P<0.001. The median time to answer retrieval was 17 min (95% CI: 16 to 18 using UpToDate compared to 29 min (95% CI: 26 to 32 using PubMed Clinical Queries (P<0.001. The satisfaction with the accuracy of retrieved answers, interaction with UpToDate and also overall satisfaction were higher among UpToDate users compared to PubMed Clinical Queries users (P<0.001. CONCLUSIONS: For first time users, using UpToDate compared to Pubmed Clinical Queries can lead to not only a higher proportion of relevant answer retrieval within a shorter time, but also a higher users' satisfaction. So, addition of tutoring pre-appraised sources such as UpToDate to the information mastery curricula seems to be highly efficient.
Bielicki, Julia A; Achermann, Rita; Berger, Christoph
Incomplete and delayed vaccination is a barrier to individual and population protection from vaccine-preventable diseases. We aimed to assess visit frequency and pattern in relation to vaccination status in a Swiss cohort of 2-year-old children in order to review opportunities for completion of scheduled immunizations. A retrospective dynamic cohort study design involving children insured with a single health insurer in Switzerland was chosen. Time-to-event analysis was used to evaluate timing of defined immunizations of interest from submitted invoices. Diphtheria, tetanus, acellular pertussis (DTaP) and measles, mumps and rubella (MMR) immunizations administered to children registered with this health insurer were assessed. The specified vaccines are recommended at 2, 4, 6 and 15-24 months, and 12 and 15-24 months of age, respectively. 21,588 children born between January 1st, 2006 and June 30th, 2008 and registered with the health insurer from no later than 4 weeks of age were included. Only 40.9% of the cohort was up-to-date for both vaccines (DTaP and MMR) at 2 years of age. The average number of visits made during up to 2 years of age was 14.7 (95% CI: 15.9-16.3). Less than 5% of children made fewer than 5 visits, the minimum number required to complete all recommended immunizations by 2 years of age. Although number of visits varied by final vaccination status, more than 90% of the cohort made sufficient visits to complete the specified courses, even when contraindications were assumed to be present at up to half the visits. Swiss children who are not fully immunized at 2 years of age make fewer visits to ambulatory health care up to that age, but they have more than sufficient opportunities to complete immunizations as scheduled. Ambulatory healthcare providers in Switzerland have ample opportunity to promote and administer vaccinations in a timely manner. Copyright © 2013 Elsevier Ltd. All rights reserved.
Point of Care Tools im Vergleich des Universitätsklinikums Hamburg-Eppendorf (UKE: UpToDate, ClinicalResource@Ovid/Clin-eguide und Dynamed / Point of Care Tools in comparison at the University Medical Center Hamburg-Eppendorf: UpToDate, ClinicalResource@Ovid and Dynamed
Full Text Available Point of Care Tools are used for clinical decision making – UpToDate is also used in continuing medical education. These databases compile only evidence-based knowledge which is updated regularly. Using Point of Care Tools promises to improve clinical outcomes. UpToDate has been used at the University Hospital Hamburg-Eppendorf for the last four years. In a recent trial the use of ClinicalResource@Ovid/Clin-eguide and Dynamed has been evaluated in comparison with UpToDate.
Bonthuis, Marjolein; van Stralen, Karlijn J.; Verrina, Enrico; Edefonti, Alberto; Molchanova, Elena A.; Hokken-Koelega, Anita C. S.; Schaefer, Franz; Jager, Kitty J.
Background: Growth charts based on data collected in different populations and time periods are key tools to assess children's linear growth. We analyzed the impact of geographic factors and the secular trend on height-for-age charts currently used in European populations, developed up-to-date
Ahmadi, Seyed-Foad; Faghankhani, Masoomeh; Javanbakht, Anna; Akbarshahi, Maryam; Mirghorbani, Maryam; Safarnejad, Bahareh; Baradaran, Hamid
The efficacy of bedside information products has not been properly evaluated, particularly in developing countries. To compare four evidence-based textbooks by comparing efficacy of their use by clinical residents, as measured by the proportion of questions for which relevant answers could be obtained within 20 min, the time to reach the answer and user satisfaction. One hundred and twelve residents were taught information mastery basics and were randomly allocated to four groups to use: (1) ACP PIER, (2) Essential Evidence Plus (formerly InfoRetriever), (3) First Consult, and (4) UpToDate. Participants received 3 of 24 questions randomly to retrieve the answers from the assigned textbook. Retrieved answers and time-to-answers were recorded by special designed software, and the researchers determined if each recorded answer was relevant. The rate of answer retrieval was 86% in UpToDate, 69% in First Consult, 49% in ACP PIER, and 45% in Essential Evidence Plus (p UpToDate, 15.9 min using First Consult, 16.3 min using Essential Evidence Plus, and 17.3 min using ACP PIER (p UpToDate seems more comprehensive in content and also faster than the other three evidence-based textbooks. Thus, it may be considered as one of the best sources for answering clinicians' questions at the point of care.
Addison, John; Whitcombe, Jo; William Glover, Steven
Online point-of-care evidence-based information tools are becoming increasingly popular. To discover how doctors actually use one such tool - UpToDate - in clinical practice. An online survey was distributed to doctors at healthcare organisations in the north-west of England which subscribed to UpToDate. Some survey questions asked for quantifiable data (e.g. demographic details), whilst other questions were open-ended and sought examples of clinical scenarios and actual point-of-care use of UpToDate. Open-ended responses were then analysed into emerging themes. The open-ended responses include evidence illustrating a large variety of clinical scenarios in which the use of UpToDate influenced clinical practice. These results show how just one point-of-care tool is used in a variety of ways that benefit the patient, the doctor and the healthcare organisation. Direct quotations reported will provide compelling evidence for librarians to present to senior managers who may be unsure of the value of point-of-care tools in clinical practice. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.
Sayyah Ensan, Ladan; Faghankhani, Masoomeh; Javanbakht, Anna; Ahmadi, Seyed-Foad; Baradaran, Hamid Reza
To compare PubMed Clinical Queries and UpToDate regarding the amount and speed of information retrieval and users' satisfaction. A cross-over randomized trial was conducted in February 2009 in Tehran University of Medical Sciences that included 44 year-one or two residents who participated in an information mastery workshop. A one-hour lecture on the principles of information mastery was organized followed by self learning slide shows before using each database. Subsequently, participants were randomly assigned to answer 2 clinical scenarios using either UpToDate or PubMed Clinical Queries then crossed to use the other database to answer 2 different clinical scenarios. The proportion of relevantly answered clinical scenarios, time to answer retrieval, and users' satisfaction were measured in each database. Based on intention-to-treat analysis, participants retrieved the answer of 67 (76%) questions using UpToDate and 38 (43%) questions using PubMed Clinical Queries (PUpToDate compared to 29 min (95% CI: 26 to 32) using PubMed Clinical Queries (PUpToDate and also overall satisfaction were higher among UpToDate users compared to PubMed Clinical Queries users (PUpToDate compared to Pubmed Clinical Queries can lead to not only a higher proportion of relevant answer retrieval within a shorter time, but also a higher users' satisfaction. So, addition of tutoring pre-appraised sources such as UpToDate to the information mastery curricula seems to be highly efficient.
Bartholow, S.; Warburton, J.; Beck, J.; Woods, J. E.
PolarTREC-Teachers and Researchers Exploring and Collaborating, a teacher professional development program, began with the International Polar Year in 2004 and continues today in the United States. PolarTREC has worked specifically with OIB for 3 years and looking forward to ongoing collaboration. PolarTREC brings U.S. K12 educators and polar researchers together through an innovative teacher research experience model. Participating teachers spend 3-6 weeks in the field with research teams conducting surveys and collecting data on various aspects of polar science. During their experience, teachers become research team members filling a variety of roles on the team. They also fulfill a unique role of public outreach officer, conducting live presentations about their field site and research as well as journaling, answering questions, and posting photos. Working with OIB has opened up the nature of science for the participating teachers. In developing the long-term relationship with OIB teams, teachers can now share (1) the diversity of training, backgrounds, and interests of OIB scientists, (2) identify the linkages between Greenlandic culture and community and cryospheric science and evidence of climate change, (3) network with Danish and Greenlandic educators on the mission (4) gain access to the full spectrum of a science project - development, implementation, analysis, networking, and dissemination of information. All aspects help these teachers become champions of NASA science and educational leaders in their communities. Evaluation data shows that PolarTREC has clearly achieved it goals with the OIB partnership and suggests that linking teachers and researchers can have the potential to transform the nature of science education. By giving teachers the content knowledge, pedagogical tools, confidence, understanding of science in the broader society, and experiences with scientific inquiry, participating teachers are using authentic scientific research in their
Norman L Jones
Full Text Available As a senior (read older practising respirologist, I have come to appreciate my position as editor, which keeps me current with present practice standards. Everyone talks about the volume and flow of new knowledge, and not a week goes by in which I feel that I know enough to treat my patients optimally. This is particularly the case when it comes to antibiotic usage: the number of antibiotics and the confident way that junior colleagues bandy them about leaves me distinctly depressed because most of the names mean little to me; even the families and generations of antibiotics seem beyond my grasp. That is why I welcomed the request from Dr Lionel Mandell to publish a summary statement on the use of antibiotics in community-acquired pneumonia (CAP, which appears on pages 371-382 of the current issue of the Canadian Respiratory Journal.
Full Text Available [english] UpToDate is an evidence-based resource to support clinical decision-making created by doctors. UpToDate has a wide dissemination in Germany. In a multicenter study, physicians, students, scientists and other healthcare professionals at four German universities were asked about their use of UpToDate. The survey was answered 1,083 times, including 540 doctors. 76% of the surveyed physicians (but only 54% of chief physicians used UpToDate. The lack of knowledge about UpToDate amounted to 10–41%, depending on the user group. 90 to 95% of all clinically active persons named the quick, general overview of diagnosis and therapy of diseases as the main advantage of UpToDate. Every fourth senior doctor pointed to reduced length of stay as a result of UpToDate, (almost every fourth chief physician stated that UpToDate saved costs. UpToDate is an important but expensive resource in patient care and should be promoted more aggressively by the librarians – given the existing lack of knowledge about the existence of this resource.
Vien X Nguyen
Full Text Available Vien X Nguyen1, Vi Thuy Le Nguyen2, Cuong C Nguyen11Department of Gastroenterology, Mayo Clinic, Scottsdale, AZ, USA; 2Department of Pharmacy, Banner Baywood Medical Center, Mesa, AZ, USAAbstract: The field of endoscopy has revolutionized the diagnosis and treatment of gastrointestinal (GI diseases in recent years. Besides the ‘traditional’ endoscopic procedures (esophagogastroduodenoscopy, colonoscopy, flexible sigmoidoscopy, and endoscopic retrograde cholangiopancreatography, advances in imaging technology (endoscopic ultrasonography, wireless capsule endoscopy, and double balloon enteroscopy have allowed GI specialists to detect and manage disorders throughout the digestive system. This article reviews various endoscopic procedures and provides up-to-date endoscopic indications based on the recommendations of American Society for Gastrointestinal Endoscopy and American Cancer Society for primary care providers in order to achieve high-quality and cost-effective care.Keywords: endoscopy, endoscopic indications, endoscopic procedures, imaging, primary care, gastrointestinal disorders, appropriate use
Hu, Yu; Wang, Ying; Chen, Yaping; Li, Qian
This study aimed to determine the degree and determinants of inequality in up-to-date fully immunization (UTDFI) coverage among children of Zhejiang province, east China. We used data from the Zhejiang provincial vaccination coverage survey of 2014 and the health outcome was the UTDFI status among children aged 24-35 months. The household income per month was used as an index of socio-economic status for the inequality analysis. The concentration index (CI) was used to quantify the degree of inequality and the decomposition approach was applied to quantify the contributions from demographic factors to inequality in UTDFI coverage. The UTDFI coverage was 80.63% and the CI for UTDFI coverage was 0.12028 (95% CI: 0.10852-0.13175), indicating that immunization practice significantly favored children with relatively higher socio-economic status. The results of decomposition analysis suggested that 68.2% of the socio-economic inequality in UTDFI coverage should be explained by the mother's education level. Furthermore, factors such as birth order, ethnic group, maternal employment status, residence, immigration status, GDP per-capital and percentage of public health spending of the total health spending also could explain the disparity in UTDFI coverage. There exists inequality in UTDFI coverage among the socio-economic disadvantage children. Health interventions of narrowing the socio-economic inequality in UTDFI coverage will benefit from being supplemented with strategies aimed at poverty and illiteracy reduction.
Eilers, A. A.
PolarTREC (Teachers and Researchers Exploring and Collaborating) is an NSF funded professional development opportunity in which K-12 teachers and informal educators participated in hands-on field research experiences in the Polar Regions. The program goal is to invigorate polar science education and understanding by bringing together educators and polar researchers. This unique opportunity for educators has two main components: a 4-6 week field experience and a classroom/community connection piece. In preparation for these experiences, museum educator Alex Eilers and science team lead Dr. Jennifer Burns planned, developed and executed extensive outreach efforts for both students and the community to highlight the Weddell seal research project during the 2012, 2014 and 2016 seasons. The following outreach activities summarize the team's most successful attempts at engaging schoolchildren, teachers and the public, creating a broader impact of the Weddell seal scientific project. On-line Daily journal entries were uploaded to the PolarTREC website encouraging an active interaction between the science team and participants. A Polar Connect event offered participants a real-time, interactive internet presentation with the team. Schools A multitude of on-site presentations were made in classrooms, at teacher workshops and faculty meetings. Two 45 minute labs were developed for students visiting the museum, Animals of the Antarctic and Journey to the Poles, the latter is now included in our ongoing program repertoire. Two travelling kits, Extreme Cold Weather Gear and The Weddell Seal, were developed by museum staff and continue to circulate through schools. A multi-lesson educational module was developed by museum staff to bridge the gap between the scientific research conducted in the field and students in grades 3-8. It contains curriculum-based lessons, field data and strategic methods to assist students in analyzing the data. Community Community-wide interest
Bonthuis, Marjolein; van Stralen, Karlijn J; Verrina, Enrico; Edefonti, Alberto; Molchanova, Elena A; Hokken-Koelega, Anita C S; Schaefer, Franz; Jager, Kitty J
Growth charts based on data collected in different populations and time periods are key tools to assess children's linear growth. We analyzed the impact of geographic factors and the secular trend on height-for-age charts currently used in European populations, developed up-to-date European growth charts, and studied the effect of using different charts in a sample of growth retarded children. In an international survey we obtained 18 unique national height-for-age charts from 28 European countries and compared them with charts from the World Health Organization (WHO), Euro-Growth reference, and Centers of Disease Control and Prevention (CDC). As an example, we obtained height data from 3,534 children with end-stage renal disease (ESRD) from 13 countries via the ESPN/ERA-EDTA registry, a patient group generally suffering from growth retardation. National growth charts showed a clear secular trend in height (mean height increased on average 0.6 cm/decade) and a North-South height gradient in Europe. For countries without a recent (>1990) national growth chart novel European growth charts were constructed from Northern and Southern European reference populations, reflecting geographic height differences in mean final height of 3.9 cm in boys and 3.8 cm in girls. Mean height SDS of 2- to 17-year-old ESRD patients calculated from recent national or derived European growth charts (-1.91, 95% CI: -1.97 to -1.85) was significantly lower than when using CDC or WHO growth charts (-1.55, 95% CI: -1.61 to -1.49) (Pdiseased European children.
Full Text Available BACKGROUND: Growth charts based on data collected in different populations and time periods are key tools to assess children's linear growth. We analyzed the impact of geographic factors and the secular trend on height-for-age charts currently used in European populations, developed up-to-date European growth charts, and studied the effect of using different charts in a sample of growth retarded children. METHODS AND FINDINGS: In an international survey we obtained 18 unique national height-for-age charts from 28 European countries and compared them with charts from the World Health Organization (WHO, Euro-Growth reference, and Centers of Disease Control and Prevention (CDC. As an example, we obtained height data from 3,534 children with end-stage renal disease (ESRD from 13 countries via the ESPN/ERA-EDTA registry, a patient group generally suffering from growth retardation. National growth charts showed a clear secular trend in height (mean height increased on average 0.6 cm/decade and a North-South height gradient in Europe. For countries without a recent (>1990 national growth chart novel European growth charts were constructed from Northern and Southern European reference populations, reflecting geographic height differences in mean final height of 3.9 cm in boys and 3.8 cm in girls. Mean height SDS of 2- to 17-year-old ESRD patients calculated from recent national or derived European growth charts (-1.91, 95% CI: -1.97 to -1.85 was significantly lower than when using CDC or WHO growth charts (-1.55, 95% CI: -1.61 to -1.49 (P<0.0001. CONCLUSION: Differences between height-for-age charts may reflect true population differences, but are also strongly affected by the secular trend in height. The choice of reference charts substantially affects the clinical decision whether a child is considered short-for-age. Therefore, we advocate using recent national or European height-for-age charts derived from recent national data when monitoring growth
Keogh, Ruth H; Szczesniak, Rhonda; Taylor-Robinson, David; Bilton, Diana
Cystic fibrosis (CF) is the most common inherited disease in Caucasians, affecting around 10,000 individuals in the UK today. Prognosis has improved considerably over recent decades with ongoing improvements in treatment and care. Providing up-to-date survival predictions is important for patients, clinicians and health services planning. Flexible parametric survival modelling of UK CF Registry data from 2011 to 2015, capturing 602 deaths in 10,428 individuals. Survival curves were estimated from birth; conditional on reaching older ages; and projected under different assumptions concerning future mortality trends, using baseline characteristics of sex, CFTR genotype (zero, one, two copies of F508del) and age at diagnosis. Male sex was associated with better survival, as was older age at diagnosis, but only in F508del non-homozygotes. Survival did not differ by genotype among individuals diagnosed at birth. Median survival ages at birth in F508del homozygotes were 46years (males) and 41years (females), and similar in non-homozygotes diagnosed at birth. F508del heterozygotes diagnosed aged 5 had median survival ages of 57 (males) and 51 (females). Conditional on survival to 30, median survival age rises to 52 (males) and 49 (females) in homozygotes. Mortality rates decreased annually by 2% during 2006-2015. Future improvements at this rate suggest median survival ages for F508del homozygous babies of 65 (males) and 56 (females). Over half of babies born today, and of individuals aged 30 and above today, can expect to survive into at least their fifth decade. Evidence before this study We searched PubMed with terms "(cystic fibrosis survival) and (projection OR model OR registry OR United Kingdom OR UK)" to identify relevant studies on survival estimates for individuals with cystic fibrosis (CF). We also considered the most recent annual report from the UK Cystic Fibrosis Registry (Cystic Fibrosis Trust, 2016), a review by Buzzetti and colleagues (2009), the chapter
A. V. Rezaykina
Full Text Available Most of the developed countries as well as Russian Federation have a dynamically developing quality assurance system for testing the quality of laboratory tests and safety of perfumery and cosmetic products entering the market comprising a regulatory and legal framework, physical infrastructure and appropriate methodical basis and staff. At the same time, it is necessary to develop alternative test methods adjusted to perfumery and cosmetic products on a regular basis. In addition, it is necessary to optimize methods for ensuring standard sample preparation conditions in response to new forms of cosmetic products when determining microbiological, physical, chemical and toxicological characteristics, and more accurate observation methods for clinical and laboratory indices to be approved by supervising authorities.
Shin, Hyoseung; Won, Chong Hyun; Chung, Woon-Kyung; Park, Byung-Soon
The primary roles of mesenchymal stem cells (MSCs) are to maintain the stem cell niche, facilitate recovery after injury, and ensure healthy aging and the homeostasis of organ and tissues. MSCs have recently emerged as a new therapeutic option for hair loss. Since adipose-derived stem cells (ADSCs) are the most accessible sources of MSCs, ADSCbased hair regeneration is investigated. Besides replacing degenerated cells in affected organs, ADSCs exhibit their beneficial effects through the paracrine actions of various cytokines and growth factors. Several laboratory experiments and animal studies have shown that ADSC-related proteins can stimulate hair growth. In addition, we introduce our clinical pilot studies using conditioned media of ADSCs for pattern hair loss in men and women. We believe that conditioned media of ADSCs represents a promising alternative therapeutic strategy for hair loss. We also discuss practical therapeutic challenges and the direction of future research. Copyright© Bentham Science Publishers; For any queries, please email at firstname.lastname@example.org.
Komac, Marko; Duffy, Tim; Robida, Francois; Harrison, Matt; Allison, Lee
OneGeology is an initiative of Geological Survey Organisations (GSO) around the globe that dates back to Brighton, UK in 2007. Since then OneGeology has been a leader in developing geological online map data using a new international standard - a geological exchange language known as the 'GeoSciML' (currently version 3.2 exists, which enables instant interoperability of the data). Increased use of this new language allows geological data to be shared and integrated across the planet with other organisations. One of very important goals of OneGeology was a transfer of valuable know-how to the developing world, hence shortening the digital learning curve. In autumn 2013 OneGeology was transformed into a Consortium with a clearly defined governance structure, making its structure more official, its operability more flexible and its membership more open where in addition to GSO also to other type of organisations that manage geoscience data can join and contribute. The next stage of the OneGeology initiative will hence be focused into increasing the openness and richness of that data from individual countries to create a multi-thematic global geological data resource on the rocks beneath our feet. Authoritative information on hazards and minerals will help to prevent natural disasters, explore for resources (water, minerals and energy) and identify risks to human health on a planetary scale. With this new stage also renewed OneGeology objectives were defined and these are 1) to be the provider of geosciences data globally, 2) to ensure exchange of know-how and skills so all can participate, and 3) to use the global profile of 1G to increase awareness of the geosciences and their relevance among professional and general public. We live in a digital world that enables prompt access to vast amounts of open access data. Understanding our world, the geology beneath our feet and environmental challenges related to geology calls for accessibility of geoscience data and One
Residents and Medical Students Correctly Answer Clinical Questions More Often with Google and UpToDate than With PubMed or Ovid MEDLINE. A Review of: Thiele, R. H., Poiro, N. C., Scalzo, D. C., & Nemergut, E. C. (2010. Speed, accuracy, and confidence in Google, Ovid, PubMed, and UpToDate: Results of a randomised trial. Postgraduate Medical Journal, 86(1018, 459-465. doi:10.1136/pgmj.2010.098053
Full Text Available Objective – To determine which search tool (Google, UpToDate, PubMed or Ovid-MEDLINE produces more accurate answers for residents, medical students, and attending physicians searching on clinical questions in anesthesiology and critical care. Searcher confidence in the answers and speed with which answers were found were also examined.Design – Randomized study without a control group.Setting – Large university medical center.Subjects –Subjects included 15 fourth year medical students (third and fourth year, 35 residents, and 4 attending physicians volunteered and completed the study. One additional attending withdrew halfway through the study. The authors were unsuccessful in recruiting an equal number of subjects from each group.Methods – A set of eight anesthesia and critical care questions was developed, based on their commonality and importance in clinical practice and their answerability. Four search tools were employed: Google, UpToDate, PubMed, and Ovid MEDLINE. In part I, subjects were given a random set of four of the questions to answer with the search tool(s of their choice, but could use only one search tool per question. In part II, several weeks later, the same subjects were randomly assigned a search tool with which to answer all 8 questions. The authors state that “for data analysis, PubMed was arbitrarily chosen to be the “reference standard.”” Statistical analysis was used to identify significant differences between PubMed and the other search tools.Main Results – Part I: Subjects choosing a search tool were more likely to find a correct answer with Google or UpToDate. There were no statistically significant differences in confidence with answers between any of the search tools and PubMed.Part II: Though subjects were assigned a search tool, some questions were repeated from part I. For repeated questions, Ovid users (compared to PubMed users were significantly less likely to find the correct answer for
Scaffidi, Michael A; Khan, Rishad; Wang, Christopher; Keren, Daniela; Tsui, Cindy; Garg, Ankit; Brar, Simarjeet; Valoo, Kamesha; Bonert, Michael; de Wolff, Jacob F; Heilman, James; Grover, Samir C
Web-based resources are commonly used by medical students to supplement curricular material. Three commonly used resources are UpToDate (Wolters Kluwer Inc), digital textbooks, and Wikipedia; there are concerns, however, regarding Wikipedia's reliability and accuracy. The aim of this study was to evaluate the impact of Wikipedia use on medical students' short-term knowledge acquisition compared with UpToDate and a digital textbook. This was a prospective, nonblinded, three-arm randomized trial. The study was conducted from April 2014 to December 2016. Preclerkship medical students were recruited from four Canadian medical schools. Convenience sampling was used to recruit participants through word of mouth, social media, and email. Participants must have been enrolled in their first or second year of medical school at a Canadian medical school. After recruitment, participants were randomized to one of the three Web-based resources: Wikipedia, UpToDate, or a digital textbook. During testing, participants first completed a multiple-choice questionnaire (MCQ) of 25 questions emulating a Canadian medical licensing examination. During the MCQ, participants took notes on topics to research. Then, participants researched topics and took written notes using their assigned resource. They completed the same MCQ again while referencing their notes. Participants also rated the importance and availability of five factors pertinent to Web-based resources. The primary outcome measure was knowledge acquisition as measured by posttest scores. The secondary outcome measures were participants' perceptions of importance and availability of each resource factor. A total of 116 medical students were recruited. Analysis of variance of the MCQ scores demonstrated a significant interaction between time and group effects (PUpToDate group; expert editing and references were rated significantly higher by the UpToDate group compared with the Wikipedia group (PUpToDate group, though this
Cardiac resynchronization therapy (CRT) has been first reported more than 10 years ago as a therapy for patients with severe chronic heart failure. The efficacy of CRT has been proven in many studies that it improves not only quality of life but also the prognosis of the patients. Its indication has been expanded for patients with mild heart failure. On the other hand, some patients cannot receive enough benefit through CRT. The position of the left ventricular lead is limited due to the anatomy of coronary sinus branches, pacing threshold of the myocardium, phrenic nerve stimulation, and so on. Also, the right selection of the candidates for CRT is critical to receive the most benefit of this therapy. The target of this review article is to describe the efficacy and the indication of CRT, which can be of any help to enroll more patients with heart failure who are likely to get benefits through CRT.
Burnei, G; Gavriliu, S; Vlad, C; Georgescu, I; Ghita, RA; Dughilă, C; Japie, EM; Onilă, A
Congenital scoliosis represents a spinal malformation due to defects of formation, segmentation or mixed ones. It is characterized by a longitudinal and rotational imbalance. 54 patients were analyzed and 39 out of them were operated by various approaches with anterior and posterior instrumentations during 2000 and 2012. The impossibility to appoint some patients encountered in the daily practice into the known classifications, allowed us to purpose two categories of congenital scoliosis related to the predominance of spinal deviances in the coronal and transversal views. No certain etiology of congenital scoliosis has been identified until today. The susceptibility of some polygenic defects is obvious due to the presence of a sum of defects associated to most of the congenital scoliosis cases and the rarity of the presence of a unique defect. The diagnosis requires a thorough clinical and imaging examination in order to establish an individualized therapeutic strategy. The treatment of congenital scoliosis is different from the adolescent idiopathic one. Therapeutic criteria are significantly different. It is essential to assess the difference in growth of the concavity related to the convexity when choosing a particular procedure. The magnitude of the curve and the progressive rate are fundamental issues to the surgeon PMID:26351546
Full Text Available The article focuses on the registration history and legal acts of Lithuanian cultural heritage and examines the register of estate cultural heritage and conditions for including estate cultural heritage into the register. The article also looks at the criteria of evaluating estate cultural heritage such as age limit, authentication features and the level of significance (national, regional, local. The paper presents information on the criteria applied for assessing heritage list in the United Kingdom, and UNESCO as well as introduces the Convention concerning the Protection of the World Cultural and Natural Heritage and the Nara Document. Article in Lithuanian
Alexandre Meneghello Fuentefria
Full Text Available Objective: To summarize the current knowledge about candiduria, describing theepidemiology in Brazil and worldwide, pathogenesis, laboratorial diagnosis and prescribed therapy. Data Synthesis: A non-systematic review carried out from the databases: Pubmed,Cochrane and Scielo in scientific articles related to the theme candiduria and published in the last twenty years. The terms “candiduria”, “Candida” and “hospital infection” were used as descriptors, individually or in association. Articles that addressed other types of Candida infection or were not suitable for the aim of the study were excluded. The studies reviewed indicate that the most prevalent species are in descending order Candida albicans,C. parasilosis, C. tropic alis, C. glabrata, C. krusei, C. guilliermondii, C. lusitaniae, C. dubliniensis, C. kefyr and C. rugosa. When treatment is indicated, the drug of choice isfluconazole, provided that the isolates do not possess intrinsic resistance. Conclusion: Despite its high incidence and clinical relevance, the candiduria is not yet been fully elucidated, remaining the need to clarify its epidemiology and pathogenesis in emergingspecies and reach consensus on treatment protocols.
EVALUATION OF CARDIOVASCULAR RISK FACTORS PREVALENCE AND EFFICACY OF THEIR CORRECTION IN PHYSICIANS. ESTIMATION OF PHYSICIANS’ EXPERTISE IN UP-TO-DATE CLINICAL GUIDELINES. RESULTS OF THE “PHYSICIAN’S HEALTH AND EDUCATION” STUDY
L. Y. Drozdova
Full Text Available Aim. To evaluate cardiovascular risk factors prevalence among physicians of therapeutic profile (cardiology , internal medicine, neurology , endocrinology etc, to estimate awareness of physicians about their own cardiovascular risk, and to simultaneously assess their expertise in up-to-date clinical guidelines. Material and methods. A total of 638 physicians working in out-patient and in-patient clinics of Moscow, Moscow region, St-Petersburg, Nizhniy Novgorod, Vladivostok, Irkutsk, Krasnoyarsk, Krasnodar and Perm were included into the study. The mean age of participants was 46 years. The mean professional experience – 20.4 years. We made an assessment of main cardiovascular risk factors, and conducted interactive inquiry , which included questions about preventive and treatment measures for cardiovascular diseases. Results. Arterial hypertension (HT was revealed for the first time in 178 physicians, 150 physicians indicated HT in anamnesis. Only 64 physicians had target levels of blood pressure. Hypercholesterolemia rate was 45%. The prevalence of obesity and overweight were 22% and 39%, respectively. Inquiry showed that 53% of physicians primarily use clinical guidelines to choose treatment options. 76% and 88% of physicians considered it possible to achieve target levels of blood pressure and of low-density lipoprotein-cholesterol, respectively. Conclusion. Prevalence of main risk factors among physicians was similar to that in the total population; correction of those risk factors was not satisfactory. Knowledge of cardiovascular risk problems and necessity of their correction was adequate in the whole; however physicians often failed to apply their knowledge to practice.
EVALUATION OF CARDIOVASCULAR RISK FACTORS PREVALENCE AND EFFICACY OF THEIR CORRECTION IN PHYSICIANS. ESTIMATION OF PHYSICIANS’ EXPERTISE IN UP-TO-DATE CLINICAL GUIDELINES. RESULTS OF THE “PHYSICIAN’S HEALTH AND EDUCATION” STUDY
L. Y. Drozdova
Full Text Available Aim. To evaluate cardiovascular risk factors prevalence among physicians of therapeutic profile (cardiology , internal medicine, neurology , endocrinology etc, to estimate awareness of physicians about their own cardiovascular risk, and to simultaneously assess their expertise in up-to-date clinical guidelines. Material and methods. A total of 638 physicians working in out-patient and in-patient clinics of Moscow, Moscow region, St-Petersburg, Nizhniy Novgorod, Vladivostok, Irkutsk, Krasnoyarsk, Krasnodar and Perm were included into the study. The mean age of participants was 46 years. The mean professional experience – 20.4 years. We made an assessment of main cardiovascular risk factors, and conducted interactive inquiry , which included questions about preventive and treatment measures for cardiovascular diseases. Results. Arterial hypertension (HT was revealed for the first time in 178 physicians, 150 physicians indicated HT in anamnesis. Only 64 physicians had target levels of blood pressure. Hypercholesterolemia rate was 45%. The prevalence of obesity and overweight were 22% and 39%, respectively. Inquiry showed that 53% of physicians primarily use clinical guidelines to choose treatment options. 76% and 88% of physicians considered it possible to achieve target levels of blood pressure and of low-density lipoprotein-cholesterol, respectively. Conclusion. Prevalence of main risk factors among physicians was similar to that in the total population; correction of those risk factors was not satisfactory. Knowledge of cardiovascular risk problems and necessity of their correction was adequate in the whole; however physicians often failed to apply their knowledge to practice.
PLSS Townships and Sections, This layer is kept up-to-date with the addition of new survey data, as the data comes in. We have all known data incorporated, but there still remains about 40% of the County that needs more work., Published in 2013, Not Applicable scale, Chippewa County Government.
NSGIC Local Govt | GIS Inventory — PLSS Townships and Sections dataset current as of 2013. This layer is kept up-to-date with the addition of new survey data, as the data comes in. We have all known...
Martin, Kevin; Amir, Michael M
Contract litigation can prove devastating for all but the deepest of pockets. Physicians need to prepare for war to ensure the most favorable outcome. This includes identifying your risks, negotiating from strength, and hedging your bets. Negotiate and read your contracts carefully. Beware of critical loser pays provisions in your contracts that will require you to pay your adversary's fees in the event of an adverse ruling at trial or summary judgment. Keep your insurance portfolio up to date, including the latest risk management tools, such as contract litigation insurance. Protect yourself and your practice by planning ahead.
Road and Street Centerlines, This dataset contains Georgia's most up-to-date GIS Road information in an ESRI ArcInfo Interchange (.e00) file format. The attribute updates contained in this file are the result of the GA. DOT's DLG-F/RC Reconciliation project. All of the counties poste, Published in 2004, 1:12000 (1in=1000ft) scale, University of Georgia.
NSGIC Education | GIS Inventory — Road and Street Centerlines dataset current as of 2004. This dataset contains Georgia's most up-to-date GIS Road information in an ESRI ArcInfo Interchange (.e00)...
Asmuss, Monika; Dehos, Anne; Geschwentner, Dirk; Kreuzer, Michaela; Matthes, Ruediger; Poelzl, Christiane; Pophof, Blanka
Starting point of the German Mobile Phone Research Project (DMF) were reported health effects from low level exposure. In mostly interdisciplinary projects, these effects were followed up. In addition the actual everyday exposure was evaluated and the risk perception within the society and possibilities for risk communication were investigated. Although there are still scientific questions unsolved, the DMF contributed significantly to an improvement of the risk assessment and the public communication. Overall, the results from DMF and other research projects do not give reason to doubt the effectiveness of the radiation protection limits. (orig.)
Over the past 15 years, various interfaces on digital industrial cameras have been available on the market. This tutorial will give an overview of interfaces such as LVDS (RS644), Channel Link and Camera Link. In addition, other interfaces such as FireWire, Gigabit Ethernet, and now USB 3.0 have become more popular. Owing to their ease of use, these interfaces cover most of the market. Nevertheless, for certain applications and especially for higher bandwidths, Camera Link and CoaXPress are very useful. This tutorial will give a description of the advantages and disadvantages, comment on bandwidths, and provide recommendations on when to use which interface.
Semyikoz, N.G.; Fefelova, Yi.Yi.; Jermyilova, S.Yu.; Teryanik, V.G.; Chistyakova, L.V.; Tyumentseva, Yu.V.; Nyil'sen, N.T.
The analysis of the incidence and causes of basal-cell skin cancer proves that it is necessary to consider the size of the primary and relapsing tumor, its location as well as histology to choose most effective protocols of BCC treatment, which allow prolonged clinical recovery and reduction of relapses incidence.
Full Text Available Abstract. Complex regional pain syndrome (CRPS was described for the first time in the 19th century by Silas Weir Mitchell. After the exclusion of other causes, CRPS is characterised by a typical clinical constellation of pain, sensory, autonomic, motor, or trophic symptoms which can no longer be explained by the initial trauma. These symptoms spread distally and are not limited to innervation territories. If CRPS is not improved in the acute phase and becomes chronic, the visible symptoms change throughout because of the changing pathophysiology; the pain, however, remains. The diagnosis is primarily clinical, although in complex cases further technical examination mainly for exclusion of alternative diagnoses is warranted. In the initial phase, the pathophysiology is dominated by a posttraumatic inflammatory reaction by the activation of the innate and adaptive immune system. In particular, without adequate treatment, central nociceptive sensitization, reorganisation, and implicit learning processes develop, whereas the inflammation moderates. The main symptoms then include movement disorders, alternating skin temperature, sensory loss, hyperalgesia, and body perception disturbances. Psychological factors such as posttraumatic stress or pain-related fear may impact the course and the treatability of CRPS. The treatment should be ideally adjusted to the pathophysiology. Pharmacological treatment maybe particularly effective in acute stages and includes steroids, bisphosphonates, and dimethylsulfoxide cream. Common anti-neuropathic pain drugs can be recommended empirically. Intravenous long-term ketamine administration has shown efficacy in randomised controlled trials, but its repeated application is demanding and has side effects. Important components of the treatment include physio- and occupational therapy including behavioural therapy (eg, graded exposure in vivo and graded motor imaging. If psychosocial comorbidities exist, patients should be appropriately treated and supported. Invasive methods should only be used in specialised centres and in carefully evaluated cases. Considering these fundamentals, CRPS often remains a chronic pain disorder but the devastating cases should become rare.
Dinh, A; Bouchand, F; Salomon, J; Bernard, L
Antibiotic treatment durations are not well documented. Yet, dramatic emergence of multi-drug resistant organisms should lead to tend to decrease antibiotic selection pressure. Furthermore, it could lower health costs and reduce associated adverse events. Unfortunately, only few studies with rigorous methodology have been performed. We present the available data on frequent infections such as urinary tract infections, community acquired pneumonia, bone and joint infections and intra-abdominal infections. We underline the difficulties to perform such trials and discuss original options to a better evaluation of treatment duration. Copyright © 2015 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.
Iacobone, Maurizio; Citton, Marilisa; Nitti, Donato
Pancreatic surgery represents one of the most challenging areas in digestive surgery. In recent years, an increasing number of laparoscopic pancreatic procedures have been performed and laparoscopic distal pancreatectomy (LDP) has gained world-wide acceptance because it does not require anastomosis or other reconstruction. To date, English literature reports more than 300 papers focusing on LDP, but only 6% included more than 30 patients. Literature review confirms that LDP is a feasible and safe procedure in patients with benign or low grade malignancies. Decreased blood loss and morbidity, early recovery and shorter hospital stay may be the main advantages. Several concerns still exist for laparoscopic pancreatic adenocarcinoma excision. The individual surgeon determines the technical conduction of LDP, with or without spleen preservation; currently robotic pancreatic surgery has gained diffusion. Additional researches are necessary to determine the best technique to improve the procedure results. PMID:23082049
OSINT has become a developing information collection agency throughout the modern world of intelligence. Intelligence bodies and individuals keep expanding their use of information, profiting from the various technological security and civil applications now available in cyberspace. Professional collaborations are recommended, as they would significantly enhance the filtering and processing of open-source information in this age of metadata.
Full Text Available The swimmer’s otitis or acute otitis externa, is a pathology that often occurs in those who practice swimming at a competitive level. The same problem often occurs in the summer with the attendance of swimming pools and bathing areas. A survey made in the United States in 2007 confirms the dynamics of the onset of this pathology, because the contamination of fungi and bacteria in the waters of the swimming pools and the sea cause the inflammation of the epithelium of the auditory canal. To face this issue, in addition to a correct diagnosis, and the necessary and appropriate therapies, it may follow the use of these medicinal preparations. The first one (A is protective-acting, the second one (B is characterized as a preventive, hygroscopic, moistening, antiseptic and antimycotic-acting solution. Swimmers who have been using the two (pre-and post preparations daily for about a year have reported sporadic episodes of otitis. However, there is no doubt that these two compounds deserve a meticulous clinical trial in order to confirm their preventive and therapeutic potentials in external acute otitis.
Bélanger-Quintana, Amaya; Burlina, Alberto; Harding, Cary O.; Muntau, Ania C.
Dietary management for phenylketonuria was established over half a century ago, and has rendered an immense success in the prevention of the severe mental retardation associated with the accumulation of phenylalanine. However, the strict low-phenylalanine diet has several shortcomings, not the least of which is the burden it imposes on the patients and their families consequently frequent dietary non-compliance. Imperfect neurological outcome of patients in comparison to non-PKU individuals and nutritional deficiencies associated to the PKU diet are other important reasons to seek alternative therapies. In the last decade there has been an impressive effort in the investigation of other ways to treat PKU that might improve the outcome and quality of life of these patients. These studies have lead to the commercialization of sapropterin dihydrochloride, but there are still many questions regarding which patients to challenge with sapropterin what is the best challenge protocol and what could be the implications of this treatment in the long-term. Current human trials of PEGylated phenylalanine ammonia lyase are underway, which might render an alternative to diet for those patients non-responsive to sapropterin dihydrochloride. Preclinical investigation of gene and cell therapies for PKU is ongoing. In this manuscript, we will review the current knowledge on novel pharmacologic approaches to the treatment of phenylketonuria. PMID:21967857
Full Text Available Sodium bicarbonate (SB, which has a vital role in the regulation of acid-base balance of all tissues and organs, is one of the most important buffering systems of the body. SB plays an important role in the treatment of poisoning caused by numerous agents including mainly salicylate and tricyclic antidepressants. In metabolic acidosis (MA occurred in patient with systemic and metabolic diseases, first, the primary disease should be treated and in the case of low bicarbonate levels such as diarrhea and renal tubular acidosis, missing SB should be recovered. As the kidney has an important role in acid-base balance, SB is widely used in the treatment of acute and chronic renal failure. Although there is no conclusive evidence to prevent contrast nephropathy, SB comes to the fore compared to other agents. SB is used due to MA and its effects occurring in acute renal failure. In addition, SB treatment applied to reduce the increased acid levels in chronic kidney failure may reduce mortality. While SB can be used as individualized in lactic acidosis and cardiac arrest cases, it can be used safely as a performance enhancer for athletes. SB is used widely in gastrointestinal tract diseases due to its antacid effects and its routine use is not recommended in diabetic ketoacidosis. These data demonstrate that SB is still popular and it will retain its popularity in the near future.
Tarce, M; Barbieri, C; Sardella, A
Atypical odontalgia (AO) is a little known chronic pain condition. It usually presents as pain in a site where a tooth was endodontically treated or extracted, in the absence of clinical or radiographic evidence of tooth pathology. It is a rare clinical challenge for most clinicians, which leads to the patients being referred to several specialists and sometimes undergoing unnecessary surgical procedures. The pain mechanisms involved in AO are far from clear, and numerous potential mechanisms have been suggested. Currently, the most accredited hypothesis is that AO is a neuropathic pain condition caused by deafferentation. The differential diagnosis of AO remains difficult, because it shares symptoms with many others pathologies affecting this area. Patients have difficulties accepting the AO diagnosis and treatment. As a result, they frequently change physicians, and may potentially also receive several invasive treatments, usually resulting in an aggravation of the pain. Although some patients do get complete pain relief following treatment, for most patients the goal should be to achieve adequate pain management. Currently, most management is based on expert opinion and case reports. More research and high quality randomized controlled trials are needed in order to develop evidence-based treatments, currently based on expert opinion or carried over from other neuropathic pain conditions in the orofacial region.
Ehlermann, D.A.E.; Gruenewald, T.
Public interest was focussed on food irradiation in the Federal Republic of Germany after petitions for the treatment of spices had been filed and after the Federal Government's attitude concerning radiation processing of food has been discussed in the Parliament. The review discusses potential and limitations of the method and presents literature references as examples for the relevant applications rather than listing all available references. Electron-, gamma-, Roentgen- and bremsstrahlung-rays are used to obtain desinfestation, shelf-life extension, eradication of pathogene microorganisms, and product improvement. The relation between dose and effected radiochemical changes on the one hand and estimation of the wholesomeness of radiation processed food on the other hand, is discussed. 'Codex Alimentarius', a world-wide body for the standardization of food regulations, has recommended the general use of food irradiation up to a maximum dose limit of 10 kGy which covers the most promising applications. Under the premises of the European Community harmonization of food law is indispensable which means that some clearances in several countries have to be accepted by all countries in the Community. There is no need, based on scientific considerations, to label radiation processed foods. However, with regard to the growing environmental concern of the consumer, labelling of radiation processed products is recommended. For practical reasons only 'first generation' products should be labeled.
Stephens, G. K.; Morrison, D.; Barnes, R. J.; Potter, M.; Schaefer, R. K.
Geomagnetic plasmas organize along magnetic field lines, thus, it is often appropriate to use magnetic field line conjunctions for comparisons between spacecraft observations. Due to the expense of tracing magnetic field lines, the Altitude-Adjusted Corrected GeoMagnetic (AACGM) coordinate system is used. The (AACGM) coordinates are defined by the best fit dipole of the Earth's magnetic field and have been a standard tool used by the SPA community for a long time. However, standard 5 year updated coefficients for this transform are no longer available after the 2010 set. A new version of AACGM (V2 - Shepard, 2014) has been defined. AACGM V2 is fit to a spherical harmonic expansion. A pitfall with this V2 coordinate system is that it is undefined near the magnetic equator, which is problematic for determining conjunctions for spacecraft that with ground stations that pass through these regions. We have derived a new set of coefficients valid for the current epoch that allow us to continue to use the original version of AACGM. We also explore the errors that are introduced by ignoring the magnetic field caused by magnetospheric electric currents. The derived coefficients are made available to the public along with Java software that can be used to evaluate the AACGM coordinates. Shepard, S., 2014, Altitude-Adjusted Corrected Geomagnetic Coordinates: Definition and Functional Approximations, Jour. Geophys. Res., 119, 020264, DOI:10.1002/2014JA020264
Kentin, Z H A; Dautzenberg, P L J; Boelens, H M; de Rooij, S E J A; van Munster, B C
Doel Onderzoeken in welke mate de essentiële wijzigingen in de nieuwe richtlijn ‘Delier voor volwassenen en ouderen’, die in april 2014 verscheen, zijn opgenomen in lokale ziekenhuisprotocollen om daarmee een inschatting te geven van de gevolgen hiervan voor de patiënt. Opzet Kwantitatief onderzoek.
M. A. Gurevich
Full Text Available The article reviews the use of cardiac glycosides in patients with chronic heart failure, paroxysmal tachyarrhythmia and chronic atrial fibrillation (rate control. According to the recent studies results cardiac glycosides may be substituted by angiotensin-converting enzyme inhibitors, angiotensin receptor antagonists, diuretics, calcium antagonists and beta-adrenoceptor blockers in order to decrease the risk of cardiac glycoside toxicity and, in some cases, to improve quality of life and prognosis of the patients.
Full Text Available Das Chorionkarzinom tritt in Europa bei einer von 30.000 Schwangerschaften auf. Betroffen sind vor allem junge und ältere Mütter sowie Patientinnen mit einer positiven Anamnese für Trophoblasterkrankungen. Kardinalsymptome sind persistierende vaginale Blutungen nach der Geburt. Bei Diagnosestellung liegen häufig bereits pulmonale Metastasen vor. In der Behandlung spielt die Chirurgie nur eine untergeordnete Rolle. Der rasche und ununterbrochene Beginn einer Chemotherapie ist hingegen entscheidend. Oft reicht eine Monochemotherapie aus. Hochrisikopatienten werden hingegen mit einer Kombinationschemotherapie (EMA/CO behandelt. Das Ansprechen auf diese Therapie ist ausgesprochen gut. Wichtig sind die weiteren Kontrollen der Patientinnen mithilfe von biochemischen Markern und radiologischer Diagnostik. Kinder betroffener Frauen sollten ebenfalls kontrolliert werden, da es auch bei ihnen zu einer intrauterinen Metastasierung gekommen sein kann. Wir stellen das diagnostische und therapeutische Vorgehen anhand eines aktuellen Fallbeispiels aus unserer Klinik dar.
Kentin, Z. H. A.; Dautzenberg, P. L. J.; Boelens, H. M.; de Rooij, S. E. J. A.; van Munster, B. C.
To describe the extent to which the essential changes in the new Dutch delirium guideline for adults and the elderly, published in April 2014, have been incorporated in local hospital protocols, so as to estimate the consequences this could have for patients. Quantitative study. Dutch hospital
UpToDate Rated Highest in a Combined Task Assessment/User‐satisfaction Study of Five Clinical Information Resources. A review of: Campbell, Rose, and Joan Ash. “An Evaluation of Five Bedside Information Products Using a User‐centered, Task‐orientated Approach.” Journal of the Medical Library Association 94.4 (Oct. 2006: 435‐41.
Full Text Available Objective – To compare users’ perceptions of 5 clinical information resources, and to assess the average number of questions answered after attempting 3 randomly assigned clinical questions on each resource.Design – A combined task assessment, based on the design specification published in the Sixth Text REtrieval Conference(TREC‐6 “interactive track,” and a user satisfaction questionnaire developed from previously published surveys.Setting – A health sciences library at a university in the United States of America.Subjects – A convenience sample of 18 volunteers, who were either university health care staff or students.Methods – A set of 15 clinical test questions was developed from previous studies. Participants were randomly allocated 3 testquestions, which they then attempted to answer using each of 5 commercially available clinical information resources. Each participant was allocated a different set of test questions for each resource and did not attempt the same question on more than one resource. As part of the overall study design, the questions were randomised such that each question was paired with each resource at least once. The order in which the resources were tested by participants was also randomised. The resources tested were ACP’s PIER, DISEASEDEX, FIRSTConsult, InfoRetriever and UpToDate. Training in use of the resources was not provided as part of the study; however, participants were allowed to familiarise themselves with each resource before attempting the test questions. To simulate a clinical situation, participants were asked to spend a maximum of 3 minutes on each question. The number of questions successfully answered using each resource was recorded. Participants were also asked to complete a user satisfaction questionnaire, based on previously published questionnaires, for each resource after attempting the 3 questions allocated to that resource. The questionnaire used a 5‐point Likert scale
Full Text Available At many points in the life of a software enterprise, determination of intellectual property (IP cleanliness becomes critical. The value of an enterprise that develops and sells software may depend on how clean the software is from the IP perspective. This article examines various methods of ensuring software IP cleanliness and discusses some of the benefits and shortcomings of current solutions.
Li Miao; Yu Ming
We show that the modular transformations for one point functions on the torus, S(n), satisfy the polynomial equations derived by Moore and Seiberg, provided the duality property of the model is ensured. The formula for S(n) is derived by us previously and should be valid for any conformal field theory. As a consequence, the full consistency conditions for modular invariance at higher genus are completely guaranteed by duality of the theory on the sphere. (orig.)
Valeriy Valentinovich Patsiorkovskiy
This paper is devoted to the questions of further development of agricultural and food policy in the Russian Federation. The subject of in-depth consideration is the problem related to ensuring food safety. A critical review and analysis of major regulations in the field of food safety is made, including in the implementation of sanitary and epidemiological surveillance. The necessity of the expansion of measures to improve the statistics of food poisoning is grounded. The basic reasons for t...
Hudoklin, Alenka; Stadler, Alenka
A methodology for the ensured security of a workstation connected in a computer network with in an organization is presented. A technique for the determination of the required security level for a workstation's tangible and intangible components is described. A set of security measures for each security level of the workstation's tangible and intangible components is selected. The methodology is applied to workstations in the computer network of a Slovenian state agency. The required security...
Petkovic, Jennifer; Epstein, Jonathan; Buchbinder, Rachelle
OBJECTIVE: The goal of the Outcome Measures in Rheumatology (OMERACT) 12 (2014) equity working group was to determine whether and how comprehensibility of patient-reported outcome measures (PROM) should be assessed, to ensure suitability for people with low literacy and differing cultures. METHODS......: The English, Dutch, French, and Turkish Health Assessment Questionnaires and English and French Osteoarthritis Knee and Hip Quality of Life questionnaires were evaluated by applying 3 readability formulas: Flesch Reading Ease, Flesch-Kincaid grade level, and Simple Measure of Gobbledygook; and a new tool......, the Evaluative Linguistic Framework for Questionnaires, developed to assess text quality of questionnaires. We also considered a study assessing cross-cultural adaptation with/without back-translation and/or expert committee. The results of this preconference work were presented to the equity working group...
Valeriy Valentinovich Patsiorkovskiy
Full Text Available This paper is devoted to the questions of further development of agricultural and food policy in the Russian Federation. The subject of in-depth consideration is the problem related to ensuring food safety. A critical review and analysis of major regulations in the field of food safety is made, including in the implementation of sanitary and epidemiological surveillance. The necessity of the expansion of measures to improve the statistics of food poisoning is grounded. The basic reasons for the spread of management practices of production and sale of food products that pose a threat to human life are revealed. The factors of unhindered penetration of local markets in the cities and the surrounding countrysides with counterfeiting, smuggling and production of global junk food manufacturers and consumer goods are defined. A systematic view is put on the problems of food production in the private farms, ways to limit direct access to the market of food and food raw materials, which production was not controlled and who have not passed state registration, are suggested. One of these problems is creation of independent industrial structures that link production and sales of small-scale sector goods.
van Mosseveld, C.; Hernández-Peña, P.; Arán, D.; Cherilova, V.; Mataria, A.
Policy makers need up-to-date and reliable information to formulate health policies and monitor their implementation. Given that financing is one of the pillars of the health system, quality of financing data is essential. Quality is a key element but difficult to measure. Increasing quality on
Paul Moore, managing director of standby power specialist, Dieselec Thistle, explains the business-critical nature of standby power systems in a hospital setting, and the specification criteria that should be considered to ensure that the installation meets the needs of the building, and takes account of its surroundings.
Defense AT&L: November-December 2016 14 Ensuring a Safe Technological Revolution William E. Frazier, Ph.D. n Elizabeth L. McMichael n Jennifer...agility for increased innovation and performance capabilities, is the cusp of the AM technology revolution . AM provides the opportunity to truly...develops strategic plans for the research, development and transition of naval aviation technologies . He is a graduate of Drexel University, the Naval
S. I. Voronov
Full Text Available The state policy of the Russian Federation to ensure population, living in the contaminated areas, life safety is implemented by means of federal programs.12 programs for overcoming the Chernobyl accident consequences, children’s population protection and housing provision for the Chernobyl accident liquidators are adopted and realized during this time. Total financing amount from the federal budget is more than 9,2 billion rubles. The main efforts are directed to create necessary infrastructure in settlements, development and deployment rehabilitation measures for agricultural lands and forests, creation of radiation situation monitoring systems, increase housekeeping safety culture in the contaminated territories, informational support and social and psychological rehabilitation of the population. Within the state programs are developing complex systems of a radiation situation monitoring in 12 subjects of the Russian Federation. Experts training for the outreach work with population, concerning radiation safety, increasing population knowledge level about radiation in a format of seminars, conferences, with use of online technologies is provided. The project on creation the uniform interdepartmental information system on overcoming radiation accidents aftermath, integrating the operating information systems of The Ministry of the Russian Federation for Civil Defence, Emergencies and Elimination of Consequences of Natural Disasters, Federal Service for Hydrometeorology and Environmental Monitoring, the Russian Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing and the Russian Academy of Sciences is realized.However, the problem of overcoming the radiation accidents aftermath remains relevant up to date.In 14 subjects of the Russian Federation there are territories contaminated by radioactive materials as a result of the Chernobyl accident where more than 1,5 million people live.
Konrad, Matthias; Pamminger, Tobias; Foitzik, Susanne
Reproductive division of labour is a characteristic trait of social insects. The dominant reproductive individual, often the queen, uses chemical communication and/or behaviour to maintain her social status. Queens of many social insects communicate their fertility status via cuticle-bound substances. As these substances usually possess a low volatility, their range in queen-worker communication is potentially limited. Here, we investigate the range and impact of behavioural and chemical queen signals on workers of the ant Temnothorax longispinosus. We compared the behaviour and ovary development of workers subjected to three different treatments: workers with direct chemical and physical contact to the queen, those solely under the influence of volatile queen substances and those entirely separated from the queen. In addition to short-ranged queen signals preventing ovary development in workers, we discovered a novel secondary pathway influencing worker behaviour. Workers with no physical contact to the queen, but exposed to volatile substances, started to develop their ovaries, but did not change their behaviour compared to workers in direct contact to the queen. In contrast, workers in queen-separated groups showed both increased ovary development and aggressive dominance interactions. We conclude that T. longispinosus queens influence worker ovary development and behaviour via two independent signals, both ensuring social harmony within the colony.
van der Linden, Josje
Lifelong learning is indispensable if one wants to keep oneself up-to-date in the changing reality of the world today. This is not only valid for the so-called Western world, but also for less privileged parts of the world where globalisation has penetrated with the accompanying requisite knowledge
Bonsi, P.; Stammati, A. [eds.] [Istituto Superiore di Sanita' , Rome (Italy). Lab. di Tossicologia Comparata ed Ecotossicologia; De Vincenzi, M. [Istituto Superiore di Sanita' , Rome (Italy). Lab. di Metabolismo e Biochimica Patologica; Zucco, F. [Consiglio Nazionale delle Ricerche, Rome (Italy). Ist. di Tecnologie Biomediche
Toxicological cards of the essential oil caraway and ten volatiles compounds components of essential oils, all with fungicide activity, are presented; carvacrol, D-carvone, cinnamaldehyde, 1,8-cineole, p-cymene, decanal, eugenol, 2-hexenal, linalool and thymol. The cards have been prepared in the context of the European Community project FAIR1-CT95-0722, which has the aim of implementing the use of natural pesticides for plant protection during cultivation and storage. Literature data have been collected from 1980, screening different archives (BIOSIS, CAB, CHEMABS, RTECS, MEDLINE) and Council of Europe classifications. [Italian] Il rapporto contiene le schede tossicologiche di un olio essenziale (caraway oil) e di dieci sostanze volatili, componenti di olii essenziali e tutti con attivita' fungicida: carvacrol, D-carvone, cinnamaldehyde, 1, 8-cineole, p-cymene, decanol, eugenol, 2-hexenal, linaool e thymol. Le schede sono state preparate nell'ambito del progetto europeo FAIR1-CT95-0722, che ha lo scopo di sviluppare l'uso di fungicidi naturali per la protezione delle piante durante la coltivazione e lo stoccaggio. Sono stati raccolti i dati della letteratura dal 1980 ad oggi, consultando diversi archivi (BIOSIS, CAB, CHEMABS, RTECS, MEDLINE) e le classificazioni del Consiglio d'Europa.
Hübler, Michael; Voigt, Sebastian; Löschel, Andreas
We assess recent Chinese climate policy proposals in a multi-region, multi-sector computable general equilibrium model with a Chinese carbon emissions trading scheme (ETS). When the emissions intensity per GDP in 2020 is required to be 45% lower than in 2005, the model simulations indicate that the climate policy induced welfare loss in 2020, measured as the level of GDP and welfare in 2020 under climate policy relative to their level under business-as-usual (BAU) in the same year, is about 1%. The Chinese welfare loss in 2020 slightly increases in the Chinese rate of economic growth in 2020. When keeping the emissions target fixed at the 2020 level after 2020 in absolute terms, the welfare loss will reach about 2% in 2030. If China's annual economic growth rate is 0.5 percentage points higher (lower), the climate policy-induced welfare loss in 2030 will rise (decline) by about 0.5 percentage points. Full auctioning of carbon allowances results in very similar macroeconomic effects as free allocation, but full auctioning leads to higher reductions in output than free allocation for ETS sectors. Linking the Chinese to the European ETS and restricting the transfer volume to one third of the EU's reduction effort creates at best a small benefit for China, yet with smaller sectoral output reductions than auctioning. These results highlight the importance of designing the Chinese ETS wisely. - Highlights: • 45% Chinese carbon intensity target for 2020 implemented via emissions trading. • 1% GDP/welfare loss in 2020 and 2% in 2030 for a fixed emissions target after 2020. • 0.5 percentage points higher (lower) growth, increases (decreases) climate policy-induced welfare loss in 2030 by about 0.5 percentage points. • Similar macroeconomic effects for free allocation and full auctioning, but higher reductions in output under full auctioning in ETS sectors. • Restricted linking to EU emissions trading creates at best a small benefit for China
We assess recent Chinese climate policy proposals in a multi-region, multi-sector computable general equilibrium model with a Chinese carbon emissions trading scheme (ETS). When the emissions intensity per GDP in 2020 is required to be 45% lower than in 2005, the model simulations indicate that the climate policy-induced welfare loss in 2020, measured as the level of GDP and welfare in 2020 under climate policy relative to their level under business-as-usual (BAU) in the same year, is about 1%. The Chinese welfare loss in 2020 slightly increases in the Chinese rate of economic growth in 2020. When keeping the emissions target fixed at the 2020 level after 2020 in absolute terms, the welfare loss will reach about 2% in 2030. If China's annual economic growth rate is 0.5 percentage points higher (lower), the climate policy-induced welfare loss in 2030 will rise (decline) by about 0.5 percentage points. Full auctioning of carbon allowances results in very similar macroeconomic effects as free allocation, but full auctioning leads to higher reductions in output than free allocation for ETS sectors. Linking the Chinese to the European ETS and restricting the transfer volume to one third of the EU's reduction effort creates at best a small benefit for China, yet with smaller sectoral output reductions than auctioning. These results highlight the importance of designing the Chinese ETS wisely.
Full Text Available Central nervous system (CNS tuberculosis, particularly tuberculous meningitis (TBM, is the severest form of Mycobacterium tuberculosis (M.Tb infection, causing death or severe neurological defects in more than half of those affected, in spite of recent advancements in available anti-tuberculosis treatment. The definitive diagnosis of CNS tuberculosis depends upon the detection of M.Tb bacilli in the cerebrospinal fluid (CSF. At present, the diagnosis of CNS tuberculosis remains a complex issue because the most widely used conventional “gold standard” based on bacteriological detection methods, such as direct smear and culture identification, cannot rapidly detect M.Tb in CSF specimens with sufficient sensitivity in the acute phase of TBM. Recently, instead of the conventional “gold standard”, the various molecular-based methods including nucleic acid amplification (NAA assay technique, particularly polymerase chain reaction (PCR assay, has emerged as a promising new method for the diagnosis of CNS tuberculosis because of its rapidity, sensitivity and specificity. In addition, the innovation of nested PCR assay technique is worthy of note given its contribution to improve the diagnosis of CNS tuberculosis. In this review, an overview of recent progress of the NAA methods, mainly highlighting the PCR assay technique, was presented.
Mighell, A J; Gallagher, J E
Oral cancer is increasingly common. The need for early detection and promoting prevention is greater than ever and relevant to all who are responsible for the care of patients. Recent addition of oral cancer detection to the list of continuing professional development (CPD) topics recommended by the General Dental Council (GDC) reflects this importance.
Zsakó, László; Horváth, Gyozo
Informatics education has been in a cul-de-sac for several years (not only in Hungary), being less and less able to meet the needs of the industry and higher education. In addition, the latest PISA survey shows that--to put it a little strongly--the majority of the x-, y- and z generations are digital illiterates. The aim of this paper to examine…
Canavese, Federico; Samba, Antoine; Khan, Ahmad; Dechelotte, Pierre; Krajbich, Joseph I
We report a case of a 15-year-old girl who is a known case for proximal focal femoral deficiency. She underwent several surgical lengthening procedures. Her course was complicated by femur nonunion, knee joint dislocation, stiff knee, and final lower limb discrepancy of over 15 cm. Rotationplasty was performed to salvage her previous surgical failures and restore her function. Surgery was uneventful and the patient was able to walk with the prosthesis in a few months after index surgery. Although the outcome of rotationplasty is visually unusual, for some children restored function and physical capabilities outweigh cosmetic concerns. The aim of the present study was to report a case of rotationplasty in salvaging a failed primary limb reconstruction in a patient with proximal femur focal deficiency.
Misbah, S.; Kuijpers, T.; van der Heijden, J.; Grimbacher, B.; Guzman, D.; Orange, J.
Immunoglobulin (Ig) therapy is constantly evolving. Advances in the basic and clinical science of immunoglobulins have provided new perspectives in using polyclonal IgG to treat patients with primary immunodeficiencies. Recent meta-analyses of patient data and outcomes, optimization of IgG
Sano, Kaori; Ainai, Akira; Suzuki, Tadaki; Hasegawa, Hideki
Influenza virus causes an acute respiratory infection in humans. Frequent point mutations in the influenza genome and occasional exchange of genetic segments between virus strains help the virus evade the pre-existing immunity, resulting in epidemics and pandemics. Although vaccination is the most effective intervention, mismatches between circulating viruses and vaccine strains reduce vaccine efficacy. Furthermore, current injectable vaccines induce IgG antibodies in serum (which limit progression of influenza symptoms) but not secretory IgA antibodies in the respiratory mucosa (which prevent virus infection efficiently). Therefore, numerous studies have attempted to improve influenza vaccines. The discovery of broadly neutralizing antibodies has progressed research into antigen design. Studies designed to improve vaccine efficacy by changing the vaccine administration route have also been conducted. A thorough understanding of the mechanisms underlying the action of various vaccines is essential if we are to develop a universal influenza vaccine. Therefore, evaluating the quality and quantity of antibodies induced by vaccines, which determine vaccine efficacy, is critical. However, at present vaccine evaluation relies on hemagglutination inhibition tests, which only measure the quantity of antibody produced. Antibody repertoires comprise a set of antibodies with specific genetic or molecular features that correspond to their functions. Genetically and functionally similar antibodies may be produced by multiple individuals exposed to an identical stimulus. Therefore, it may be possible to evaluate and compare multiple vaccine strategies in terms of the quality and quantity of an antibody response induced by a vaccine by examining antibody repertoires. Recent studies have used single cell expression and high-throughput immunoglobulin sequencing to provide a detailed picture of antibody responses. These novel methods may be critical for detailed characterization of antibody repertoires induced by various vaccination strategies. Copyright © 2017 Elsevier Ltd. All rights reserved.
Guerrini, Gian Piero; Lauretta, Andrea; Belluco, Claudio; Olivieri, Matteo; Forlin, Marco; Basso, Stefania; Breda, Bruno; Bertola, Giulio; Di Benedetto, Fabrizio
Laparoscopic distal pancreatectomy (LDP) reduces postoperative morbidity, hospital stay and recovery as compared with open distal pancreatectomy. Many authors believe that robotic surgery can overcome the difficulties and technical limits of LDP thanks to improved surgical manipulation and better visualization. Few studies in the literature have compared the two methods in terms of surgical and oncological outcome. The aim of this study was to compare the results of robotic (RDP) and laparoscopic distal pancreatectomy. A systematic review and meta-analysis was conducted of control studies published up to December 2016 comparing LDP and RDP. Two Reviewers independently assessed the eligibility and quality of the studies. The meta-analysis was conducted using either the fixed-effect or the random-effect model. Ten studies describing 813 patients met the inclusion criteria. This meta-analysis shows that the RDP group had a significantly higher rate of spleen preservation [OR 2.89 (95% confidence interval 1.78-4.71, p < 0.0001], a lower rate of conversion to open OR 0.33 (95% CI 0.12-0.92), p = 0.003] and a shorter hospital stay [MD -0.74; (95% CI -1.34 -0.15), p = 0.01] but a higher cost than the LDP group, while other surgical outcomes did not differ between the two groups. This meta-analysis suggests that the RDP procedure is safe and comparable in terms of surgical results to LDP. However, even if the RDP has a higher cost compared to LDP, it increases the rate of spleen preservation, reduces the risk of conversion to open surgery and is associated to shorter length of hospital stay.
Sardella, A; Demarosi, F; Barbieri, C; Lodi, G
Previously called atypical facial pain, persistent idiopathic facial pain (PIFP) is a common, but poorly defined entity. The cause of PIFP is unknown, but surgery or injury in the distribution of the trigeminal nerve could be reported as early event. Treatment is often unsatisfactory and quality research relating management of this condition is missing. Psychologi-cal distress is frequently observed in patients suffering from persistent idiopathic facial pain. The present review aims at presenting the available knowledge of this elusive orofacial pain condition.
Adriaanse, B.M.; Vugt, J.M.G. van; Haak, M.C.
Congenital heart diseases (CHD) are the most commonly overlooked lesions in prenatal screening programs. Real-time two-dimensional ultrasound (2DUS) is the conventionally used tool for fetal echocardiography. Although continuous improvements in the hardware and post-processing software have resulted
China's rate of natural increase was 11.45/1000 in 1993, as a result of the crude birth rate of 18.09/1000 and a crude death rate of 6.64/1000. The total population in 1993 was 1,185.17 million. There was an increase of 13.46 million between 1992 and 1993. Personal income increased by 28% to RMB 2337 yuan in 1993, which was a real growth of 10.2%. Rural income increased by 3.2% (adjusted for inflation to 921 yuan). The urban and rural gap widened and living standards declined for some populations. Urban unemployment was 2.6% in 1993, and 128,000 unemployed persons received some assistance. Employment increased to 150.4 million, which was an increase of 2.48 million workers. Private sector and state owned business employment increased. Wages increased by 21.1% to RMB 477 billion yuan for all workers. The average per person wage increased by 19.4% to RMB 3236 yuan. Living conditions as measured by total floor space improved for the urban and rural populations. Social welfare beds available also increased. 40.51 million people received relief funds in rural and urban areas. 31.5% of townships and towns had a social security system. 97,000 community service networks were established in 1993. The number of retired urban persons receiving old age pensions from the community increased. This constituted a change from retirees receiving pensions from their work units. The number of environmental protection workers amounted to 81,000 by the end of 1993. 2290 environmental monitoring stations employed 33,000 workers. 77 national natural reserves were secured by 1993, of which 10 are members of the Man and Biosphere International Protection Network. Standards have been established for assuring environmental quality in 313 ways. Soot control zones were established in 472 cities and numbered 2935. Environmental noise control zones in 363 cities were established; the zones numbered 1774 and covered 3689 sq. miles. 5737 projects were established dealing with environmental pollution; the total investment in environmental protection was RMB 2.54 billion yuan.
Sterodimas, Aris; De Faria, Jose; Correa, Wanda Elizabeth; Pitanguy, Ivo
Tissue engineering is an interdisciplinary field that applies the principles of engineering and life sciences toward the development of biological substitutes that restore, maintain, or improve tissue function. This field has enjoyed tremendous growth in the past 10 years fuelled by its potential role in regenerating new tissues and naturally healing injured or diseased organs. Stem cells due to their pluripotentiality and unlimited capacity for self-renewal, may allow significant advances for distinct reconstructive and cosmetic procedures. This review aims at outlining the principles of tissue engineering, focusing on the use of adult-derived stem cells as applied to the research and practice of plastic surgery. Review categories have been divided into tissue engineering of the skin and connective tissue, bone marrow, cartilage, adipose tissue, and breast tissue. An analytical review of the current literature on stem cell technology on the above mentioned areas is presented. There have been reports of side effects and unsuccessful treatments. The key to the progress of tissue engineering is an understanding between basic scientists, biochemical engineers, clinicians, and industry. Although there has been an ongoing research pointing to the enormous potential of using stem cells in cosmetic and reconstructive surgery, at this stage, stem cell therapy is still a hope that has not been fully studied and approved. More long-term studies are needed and many questions remain to be answered.
Lebsir, A; Bentounsi, A; Benbouzid, Mohamed; Mangel, H
International audience; This paper describes a comparative study allowing the selection of the most appropriate innovative structures for electrical machines for a wind turbine system. This study is based on an exhaustive review of the state of the art and on an effective comparison of the performances of the three main conventional electric generator in wind energy application system that are the Doubly-Fed Induction Generator (DFIG), the Squirrel-Cage Induction Generator (SCIG), the Permane...
Lipedema is a chronic disorder of subcutaneous adipose tissue of unknown etiology not uncommon among post-puberty women. The disease has a negative impact on self-esteem, mobility, and quality of life. Lipedema is characterized by symmetrical, disfiguring hyperplastic adipose tissue combined with bruising and pain. Untreated lipedema fosters osteoarthritis, secondary lymphedema, limited mobility, and psychosocial stigmatization. Treatment consists of conservative complex decongestive therapy and surgery by microcannular tumescent liposuction. Liposuction is the only available treatment capable to reduce the pathological adipose tissue durable and to prevent complications.
Wilmes, H.; Falk, R.; Wziontek, H.
The determination of precise gravity field parameters is of great importance in a period in which earth sciences are achieving the necessary accuracy to monitor and document global change processes. This is the reason why experts from geodesy and metrology joined in a successful cooperation to make absolute gravity observations traceable to SI quantities, to improve the metrological kilogram definition and to monitor mass movements and smallest height changes for geodetic and geophysical applications. How can we determine such a gravity reference system and secure it over multiple decades? Precise knowledge of the gravity acceleration and definition of standards, models and corrections are an important prerequisite to the definition of the gravity system. Over more than three decades, the absolute gravity community cooperated successfully to obtain the gravity reference in comparisons at intervals of 4 years and to certify metrological equivalence between National Metrology Institutes. With increasing resolution of the absolute gravimeter sensors and new measurement principles it becomes obvious that such comparisons are not sufficient for all applications. Mainly for geodetic purposes it is necessary to sub-divide comparison intervals and maintain a connected network of gravity reference sites where compared absolute gravimeters operate together with superconducting gravimeters to derive a continuous gravity reference function. By means of this distributed monitoring of the gravity reference it will also be possible to relate observations of earlier absolute gravimeters to the present-day and to future instruments. It will be possible to include new sensors like atom interferometers and in future to relate the results of precise optical clocks. With co-located space geodetic sensors like GNSS, SLR and VLBI, these reference sites fulfill the conditions of a geodetic fundamental station as a component of IAG's Global Geodetic Observing System.
Kolanowski, Tomasz J; Antos, Christopher L; Guan, Kaomei
In vitro generation of cardiomyocytes (CMs) from human cells opens the possibility to develop patient-specific therapies to various cardiomyopathies. By establishing the in vitro reprograming methods that produce human CMs, we learn about what is involved in the development of specific CM subtypes. In this review, we summarize the latest achievements in CM generation technologies, emphasizing the differentiation methods of specific CM subtypes. We also relate the biological properties and functions of the in vitro-generated CMs to those of their in vivo counterparts. Furthermore, we describe the main problem of current CM derivation methods - maturation of CMs. We subsequently discuss biochemical and physical stimuli that are used to overcome the maturation problems of in vitro-derived CMs. As a result, a more holistic approach with controllable environment and timing of specific stimuli for creation of more mature engineered heart tissues is described as well. Finally, we propose a novel approach in which enhancing energy transfer mechanisms in the immature CMs might help to overcome the current hurdle of incomplete in vitro differentiation. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.
Iara Moreno Linhares
Full Text Available O objetivo desta revisão foi apresentar os novos conhecimentos sobre o ecossistema vaginal, enfatizando os métodos não cultiváveis de identificação microbiana (amplificação de genes, as várias espécies de Lactobacillus que podem compor a flora vaginal e a interação desta com os mecanismos locais de imunidade inata e adquirida, dependentes dos constituintes genéticos. Foram pesquisados no Medline (Pubmed os artigos relacionados ao tema publicados entre 1997 e 2009, selecionando-se apenas os considerados relevantes. A utilização de técnicas não cultiváveis (técnicas de amplificação de genes tem possibilitado o melhor conhecimento sobre a composição do ecossistema vaginal. Na maioria das mulheres no menacme predominam na vagina uma ou mais espécies de Lactobacillus: L. crispatus, . L. inners e L gasseri. Entretanto, em outras mulheres aparentemente saudáveis pode haver deficiência ou mesmo ausência de Lactobacillus, que são substituídos por outras bactérias produtoras de ácido lático: espécies de Atopobium, Megasphaera e/ou Leptotrichia. A infecção e/ou a proliferação de bactérias patogênicas na vagina são suprimidas pela produção de ácido lático, por produtos gerados pelas bactérias e pela atividade local das imunidades inata e adquirida. As células epiteliais vaginais produzem diversos componentes com atividade antimicrobiana. Tais células ainda possuem receptores de membrana ("Toll-like receptors" que reconhecem padrões moleculares associados aos patógenos. O reconhecimento leva à produção de citocinas proinflamatórias e à estimulação da imunidade antigenoespecífica. A produção de anticorpos IgG e IgA também pode ser iniciada na endocérvice e na vagina em resposta à infecção. Conclui-se que a composição da flora vaginal e os mecanismos de imunidade representam importantes mecanismos de defesa. Os critérios de "flora normal" e "flora anormal" devem ser revistos; os polimorfismos genéticos podem explicar variações na composições da flora. Ressalta-se a necessidade de que tais conhecimentos sejam incorporados à pratica clínica do ginecologista e obstetra para o aprimoramento do cuidado às pacientes.The aim of this review is to update knowledge about the vaginal ecosystem, non-cultivation methods for bacterial identification (gene amplification, the Lactobacillus species that comprise normal vaginal flora and influence of host genetics on bacterial interactions with local innate and acquired immune defenses. A Medline (Pubmed search from 1997-2009 for relevant articles was performed and the most informative articles were selected. Non-culture techniques (gene amplification allow a comprehensive analysis of the vaginal ecosystem's composition. In the majority of women in the reproductive age there is a predominance of one or more species of Lactobacillus: L. crispatus, L. inners and L gasseri. However, in other apparently healthy women there is a deficiency or complete absence of Lactobacilli. Instead, there is a substitution by other lactic acid-producing bacteria: Atobium, Megasphaera and/or Leptotrichia species. The infectivity and/or proliferation of pathogenic bacteria in the vagina is suppressed by lactic acid production, by products of endogenous bacteria and by activation of local innate and acquired immunity. Vaginal epithelial cells produce several compounds with anti-microbial activity. These cells have Toll-like receptors on their membrane that recognize molecular patterns associated with pathogens. Recognition leads to production of pro-inflammatory cytokines and stimulation of antigen-specific immunity. The production of IgG and IgA antibodies is also triggered in the endocervix and vagina in response to infection. Vaginal flora composition and the immune mechanisms constitute important defenses. Criteria of normal and abnormal flora have to be reviewed and genetic polymorphism can explain variations in flora composition. This new knowledge should be included in the clinical practice of gynecologists and obstetricians to improve patients care.
Xiu Juan Li
Full Text Available OBJECTIVES: This updated meta-analysis was conducted to assess the association between coffee consumption and breast cancer risk. METHODS: We conducted a systematic search updated July 2012 to identify observational studies providing quantitative estimates for breast cancer risk in relation to coffee consumption. Pooled relative risks (RRs with 95% confidence intervals (CIs were calculated using a random-effects model, and generalized least square trend estimation was used to assess dose-response relationships. RESULTS: A total of 26 studies (16 cohort and 10 case-control studies on coffee intake with 49497 breast cancer cases were included in the meta-analysis. The pooled RR showed a borderline significant influence of highest coffee consumption (RR = 0.96; 95% CI 0.93-1.00, low-to moderate coffee consumption (RR = 0.99; 95% CI 0.95-1.04, or an increment of 2 cups/day of coffee consumption (RR = 0.98; 95% CI 0.97-1.00 on the risk of breast cancer. In stratified analysis, a significant inverse association was observed in ER-negative subgroup. However, no significant association was noted in the others. CONCLUSIONS: Our findings suggest that increased coffee intake is not associated with a significantly reduced risk of breast cancer, but we observe an inverse association in ER-negative subgroup analysis. More large studies are needed to determine subgroups to obtain more valuable data on coffee drinking and breast cancer risk.
Full Text Available Anastasios Koulaouzidis, Sarah DouglasCentre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, UKAbstract: Until recently, the small bowel was considered a ‘no man’s land’ as the imaging modalities available for its investigation were laborious, invasive, costly, or involve significant radiation exposure. Wireless capsule endoscopy (WCE has changed the field dramatically, over the last eight years. The established indications for small bowel WCE are obscure gastrointestinal bleed/anemia, Crohn’s disease, hereditary polyposis syndromes, and to a lesser extent, evaluation of side effects of nonsteroidal anti-inflammatory medications and coeliac disease. We herein present an overview of the capsule examination, which seems to be a quickly improving area.Keywords: capsule, imaging, small bowel, Crohn’s, celiac, GI bleed
This article overviews current comprehension of altitude training, which is quite contradictory: many sources declare that altitude training provides no benefits to sea level performances compared to appropriate conventional training while others consider altitude training to be an efficacious and proven tool to enhance high-performance preparation. This contradiction can be partly explained by the variety of individual training responses, i.e., individual predispositions among some athletes ...
Huebler, Michael [Zentrum fuer Europaeische Wirtschaftsforschung GmbH (ZEW), Mannheim (Germany); Hannover Univ. (Germany). Inst. for Environmental Economics and World Trade; Loeschel, Andreas; Voigt, Sebastian [Zentrum fuer Europaeische Wirtschaftsforschung GmbH (ZEW), Mannheim (Germany)
We assess recent Chinese climate policy proposals in a multi-region, multi-sector computable general equilibrium model with a Chinese carbon emissions trading scheme (ETS). When the emissions intensity per GDP in 2020 is required to be 45% lower than in 2005, the model simulations indicate that the climate policy-induced welfare loss in 2020, measured as the level of GDP and welfare in 2020 under climate policy relative to their level under business-as-usual (BAU) in the same year, is about 1%. The Chinese welfare loss in 2020 slightly increases in the Chinese rate of economic growth in 2020. When keeping the emissions target fixed at the 2020 level after 2020 in absolute terms, the welfare loss will reach about 2% in 2030. If China's annual economic growth rate is 0.5 percentage points higher (lower), the climate policy-induced welfare loss in 2030 will rise (decline) by about 0.5 percentage points. Full auctioning of carbon allowances results in very similar macroeconomic effects as free allocation, but full auctioning leads to higher reductions in output than free allocation for ETS sectors. Linking the Chinese to the European ETS and restricting the transfer volume to one third of the EU's reduction effort creates at best a small benefit for China, yet with smaller sectoral output reductions than auctioning. These results highlight the importance of designing the Chinese ETS wisely.
Full Text Available Primary fallopian tube carcinoma (PFTC is a rare gynecological malignancy with the following characteristics: its preoperative diagnosis is easy to miss or delay because of a lack of specific symptoms and signs; it is difficult to distinguish from serous epithelial ovarian cancer or primary peritoneal serous carcinoma during or even after operation because they have the same histopathological features; and there is uncertainty regarding the optimal management because of the lack of available standard guidelines. All of these factors contribute to the major challenge of undertaking a comprehensive study of this disease. To improve our understanding of this rare disease, the domestic data were summarized first. We searched PubMed on this topic, using the term “primary fallopian tube tumor and Taiwan” (from January 1, 1990 to November 3, 2013 and identified 15 published articles, but only 11 studies focused on the outcome of patients with PFTC in Taiwan. These limited data were not enough to increase our knowledge in dealing with this disease; therefore, the addition of large series or published review articles addressing this topic was needed. According to these reports, we concluded: (1 the main type of PFTC was serous type, often poorly differentiated; (2 the diagnosis of PFTC is frequently missed or delayed; (3 PFTC is often of an earlier International Federation of Gynecology and Obstetrics (FIGO stage than is epithelial ovarian cancer (EOC, because of the appearance of earlier but nonspecific symptoms or signs, such as abdominal pain, vaginal bleeding, and watery discharge or mass; (4 the most important clinicopathological prognostic factor was FIGO stage; (5 the therapeutic strategy is still uncertain, but is often based on the guidelines for treating EOC. An intensive surgical effort such as a complete surgical resection or optimal cytoreduction surgery with a minimal residual tumor followed by a platinum-paclitaxel combination chemotherapy with/without targeted therapy (for example, antiangiogenesis agents may provide the best possibility of disease-free or overall survival.
This book aims to set the climate discussion within a large and often neglected framework and to show connections, based strictly on modern scientific knowledge. This includes, as well as the human factor, rather importantly the natural climate occurrences which cannot simply be ignored; also the classification of climatic occurences within the extensive area of environmental problems. This breadth of discussion for general comprehensiveness has been freely at the expense of its depth. Detailed specialist information can be found in the references; further depth is detailed in the diagrams and documentation in the book's appendix. (orig.) [de
Tadayoni, Reza; Kloch, Christian
-to-date infrastructure technology and is carried by lay-mans, like the smart-phones (with GPS receiver, Wi-Fi, Bluetooth, high speed cellular data connection and a large touch screen). With an 18 month replacement rate , and possibilities of combining navigational system, one-to-one communication, broadcast receiver...
Contal, E; Putot, A; Dipanda, M; Perrin, S; Asgassou, S; Sordet-Guépet, H; Manckoundia, P
Flu vaccinations for healthcare professionals seems to be one of the most effective preventive actions in the face of a disease that carries a high risk of a potentially serious nosocomial epidemic in a geriatric environment. The aim of this study was to take stock of the flu vaccination status among caregivers in the geriatric units and to understand the reasons for their reluctance to be vaccinated, in order to put forward proposals to improve vaccination coverage. A literature search of articles published since 2000 in the area of geriatrics, infectious diseases or pneumology was mainly conducted on PubMed using the keywords "caregivers", "elderly", "flu", "influenza", "nosocomial" and "vaccination". After reading all abstracts in English or French and ruling out irrelevant articles, only 64 relevant articles have been listed in bibliography section. Despite official recommendations, the literature reveals insufficient vaccination coverage of healthcare personnel at both the national and international level. Vaccination coverage seems to be lower among younger female non-medical staff. The factors that determine the likelihood of vaccination are the wish to protect one's self, one's family and patients/residents, as well as the experience of earlier bouts of flu. Factors that oppose vaccination are complex and related to the fear of side effects, the use of other preventive measures, the feeling that vaccination is ineffective, poor understanding of the disease and the vaccine, forgetfulness and problems of organization. Campaigns to promote vaccination that target healthcare professionals must be multidimensional and very incentive. The pedagogical message must be centered on the benefits to the individual and adjusted to socio-professional categories. Mobile strategies in the different departments to encourage staff are a pragmatic solution to this challenge. The referring doctor has an essential role to play, as does the occupational doctor in association with the hospital hygiene services. Flu vaccinations must be included in the education and training of caregivers. Copyright Â© 2016 Elsevier Masson SAS. All rights reserved.
Mueller, Michael; Schmiechen, Katharina
In accordance with alterations of the political and economical settings of Central Europe in the last decades, the characteristics of NBC hazards have changed. Since war appears unlikely, possible new scenarios involve pandemics, chemical transport accidents or distribution of CB warfare agents and radioactive materials by terroristic acts. Meeting this situation requires new protection and self aid equipment for the German civilian disaster relief forces. The German government has reacted to these risks by designing personal protection equipment for the civilian voluntary and professional disaster relief forces. The new NBC self aid kit will be part of this effort. The scientific approach of the project consisted of an updated risk analysis, a questionnaire for the professionals and volunteers involved in disaster management, a thorough evaluation of commercially available kits and single components, final design of the new kit including user instructions, and validation of a prototype kit in a disaster relief exercise. Results of the questionnaire stressed the need for a NBC self aid kit fulfilling the demands of easy handling, use of commercially available components, stability of materials, consumption adapted supply and portable size and weight of the complete kit. The evaluation of international NBC equipment could not identify any current NBC self aid kit which satisfies all needs of the German civilian disaster relief forces. The authors therefore compiled a new kit consisting of commercially available components. The newly developed kit was evaluated in a disaster relief exercise.
María Paula Martínez Linares
Full Text Available Preeclampsia is a disease with a highincidence for maternal and fetal morbidity and mortality, mainly indeveloping countries. Although its etiology remains unclear, severalstudies have shown that endothelial cell dysfunction plays an important role in the genesis, development and complications relatedto this disease. Among the different processes, lipid per oxidation is involved in what could be an increase in serum lipid concentrations in pregnant women, especially triglycerides. The aim of this review is to describe the role of lipids in the pathophysiology of preeclampsia and the current evidence about the finding of hypertriglyceridemia and its development.
Full Text Available Abstract Background The poor recognition and related underdiagnosis of COPD contributes to an underestimation of mortality in subjects with COPD. Data derived from population studies can advance our understanding of the true burden of COPD. The objective of this report was to evaluate the impact of COPD on mortality and its predictors in a cohort of subjects with and without COPD recruited during the twenty first century. Methods All subjects with COPD (n = 993 defined according to the GOLD spirometric criteria, FEV1/FVC 1 % predicted and reported heart disease. Results The mortality was significantly higher among subjects with COPD, 10.9%, compared to subjects without COPD, 5.8% (p 1 % predicted in the multivariate model resulted in the decreasing level of FEV1 being a significant risk factor for death, while heart disease was not a significant risk factor for death in any of the models. Conclusions In this cohort COPD and decreased FEV1 were significant risk factors for death when adjusted for age, gender, smoking habits and reported heart disease.
Full Text Available Cystic fibrosis (CF is a multi-organ disease, affecting mostly lungs and gastrointestinal tract. Data from patient registries show that the survival of patients with CF has progressively improved over the past several decades, as a result of advances in antibiotic treatment, supplementation of pancreatic enzymes, better nutrition and a holistic approach to treatment in CF centres.The purpose of this review is to survey recent developments in the treatment of lung disease in children and adolescents with CF.We describe newborn screening for CF.When chronic respiratory insufficiency occurs, lung transplantation becomes a very important issue.Lung disease is the most common cause of morbidity and mortality in CF patients. Emerging new therapies are targeted at all points in the pathogenesis of lung disease, from drugs that treat infection and inflammation in the airways to gene transfer studies and to drugs that augment airway surface liquid height. A number of antibacterial agents formulated for inhalation are at various stages of study and there are several anti-inflammatory candidate drugs in clinical trials. The most important development in the recent years is modulation of the abnormal protein that causes CF, the cystic fibrosis transmembrane regulator (CFTR, where drugs are targeted at specific defects in the transcription, processing or functioning.When chronic respiratory insufficiency occurs, lung transplantation becomes a very important issue. The role of the CF nurse, who has responsibilities in educating and teaching clinical skills to patients and families, is described.
Full Text Available Background: In the last few years new approaches to the diagnosis and management of abdominal trauma were introduced, and in addition, monitoring of individual organ function in the intensive care units has become an almost daily practice. In our article we review the principles of assessment and management of injured individual abdominal organs from surgical and intensive care medicine’s point of view. Conclusions: Appropriate diagnostics and, precise and timely decision for surgery are the most important factors in the management of patients with blunt abdominal trauma. The mechanism of injury, presence of concomitant injuries, lifethreatening condition and competence of medical staff have to be taken into consideration. The most often injured organs, spleen and liver, are nowadays managed mostly non-operatively. Such an approach has resulted in an increased admission of patients to the intensive care unit, with an attempt to prevent secondary organ dysfunction and multiple-organ failure. These new treatment options have contributed to lower morbidity and mortality and improved quality of life.
V. D. Sizov
Full Text Available The paper considers existing systems of smoke removal from heat-generating plants of various heat power. Advantages and disadvantages of every system are specified in the paper. The paper analyzes properties of fiberglass smoke stacks.
Full Text Available Abstract. The paper discusses the indices for assessment of the ecological status of seawater which are applied in the studies of algae and macrozoobenthic communities in the Bulgarian Black Sea territorial waters. They are applicable to contemporary environmental assessments in accordance with the European directives on environmental protection. Presented are also studies carried out in recent years on marine plants and bottom organisms and the resulting conclusions. The result was that we identified the ecological status of the marine ecosystem on BQE phytoplankton, macrophytobenthos and macrozoobentos from “moderate” to “good” in the period of investigation.
Full Text Available Open Innovation (OI is recently recognized as a key factor in the competitiveness of companies. Firms that are not engaged in OI practice risk of becoming uncompetitive. However, innovating firms are likely to face several challenges often illustrated by barriers. Many researchers studied OI barriers without giving importance to their category. The main objective of this survey is to identify and categorize some barriers to OI practice by analysing how the literature on this topic has evolved for the last seven years (2009-2015. Our understanding of OI barriers can be insightful for future research on OI and it can assist managers, in fostering an innovative culture by supporting new ideas and avoiding an attitude that creates resistance towards these ideas.
Full Text Available The aim of the work was assaying motivational aspects of senior pupils’ career guidance. Today the emotional focus of young people is pragmatic: material and personal well-being, the ability to survive in modern society, profitable employment, meeting well-to-do life partner, "having good sponsors," " rich patron", "avoiding army service". Civil loadings such as service of the country and society aren’t appreciated. The lack of sufficiently deep professional orientation of graduates does not preclude its formation during pariod of training at higher educational institutions. Therefore, the task of the school (family and community consists in choosing of profession which is logical consequence of gradually increasing professional orientation. To solve these problems, first of all, it is necessary to conduct systematic vocational guidance at schools, starting to gradually introduce children into the world of professions beginning with middle classes.
Full Text Available Objectives. To describe 2 cases of thyrotoxic periodic paralysis. Methods. We report of 2 cases of thyrotoxic periodic paralysis in 2 individuals from 2 different backgrounds with emphasis on their presentation and treatment. We also conducted a literature search to put together an update review of thyrotoxic periodic paralysis. Results. A 47-year-old Chinese and 28-year-old Caucasian male presented with profound yet reversible weakness associated with hypokalemia on admission bloods and thyrotoxicosis. Both were given definitive therapy to prevent recurrence of attacks with any future relapse of thyrotoxicosis. Conclusion. Thyrotoxic periodic paralysis (TPP is a rare but potentially serious complication of thyrotoxicosis resulting in temporary but severe muscle weakness. Recent discovery of a novel mutation in the KCNJ18 gene which codes for an inwardly rectifying potassium channel and is controlled by thyroid hormones may provide greater insight into the pathogenesis of TPP.
Full Text Available Autoinflammatory diseases (AID are characterized by seemingly unprovoked self-limited attacks of fever and systemic inflammation potentially leading to amyloidosis. Familial Mediterranean fever (FMF is the most common AID and therefore the most studied. Besides FMF, the other main hereditary AID are tumor necrosis factor-associated periodic fever syndrome (TRAPS, mevalonate kinase deficiency (MKD, and cryopyrin-associated periodic fever syndrome (CAPS. These hereditary diseases result from a mutant gene that is involved in the regulation of inflammation, resulting in a characteristic clinical phenotype. The differential diagnosis of AID can be challenging due to a wide overlap in clinical manifestations. Moreover, a considerable proportion of patients present with autoinflammatory symptoms but without a pathogenetic variant on genetic analysis. Furthermore, non-hereditary AID, such as the periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA syndrome, which is the most common AID in children worldwide, must be excluded in certain circumstances. Herein we shall review the main AID and describe a practical approach to diagnosis in a patient with a clinical suspicion of AID.
Wiegerinck, Esther M. A.; van Kesteren, Floortje; van Mourik, Martijn S.; Vis, Marije M.; Baan, Jan
Over the past decade transcatheter aortic valve implantation (TAVI) has evolved towards the routine therapy for high-risk patients with severe aortic valve stenosis. Technical refinements in TAVI are rapidly evolving with a simultaneous expansion of the number of available devices. This review will
Full Text Available Amyand’s hernia is defined as an inguinal hernia, containing the appendix within the hernia sac. Incidence of this rare condition rises up to 1% (0.19–1.7% of all inguinal hernia cases. Inflammation of the appendix within the inguinal sac is even rarer, as it corresponds to 0.1% (0.07–0.13% of all Amyand’s hernia cases. After a comprehensive review of the limited relevant literature, we aim through this review study to describe the pathophysiology of inflammation of the appendix – contained in the hernia sac – and present the latest data about the diagnostic approach and surgical treatment of Amyand’s hernia.
Full Text Available This paper addresses the subject of electromagnetic wave scattering in layered media, thus covering the recent progress achieved with different approaches. Existing theories and models are analyzed, classified, and summarized on the basis of their characteristics. Emphasis is placed on both theoretical and practical application. Finally, patterns and trends in the current literature are identified and critically discussed.
Full Text Available Objective: To summarize the current knowledge about candiduria, describing the epidemiology in Brazil and worldwide, pathogenesis, laboratorial diagnosis and prescribed therapy. Data Synthesis: A non-systematic review carried out from the databases: Pubmed, Cochrane and Scielo in scientific articles related to the theme candiduria and published in the last twenty years. The terms “candiduria”, “Candida” and “hospital infection” were used as descriptors, individually or in association. Articles that addressed other types of Candida infection or were not suitable for the aim of the study were excluded. The studies reviewed indicate that the most prevalent species are in descending order Candida albicans, C. parasilosis, C. tropic alis, C. glabrata, C. krusei, C. guilliermondii, C. lusitaniae, C. dubliniensis, C. kefyr and C. rugosa. When treatment is indicated, the drug of choice is fluconazole, provided that the isolates do not possess intrinsic resistance. Conclusion: Despite its high incidence and clinical relevance, the candiduria is not yet been fully elucidated, remaining the need to clarify its epidemiology and pathogenesis in emerging species and reach consensus on treatment protocols.
Full Text Available The etiology of keratoconus is unknown. Different factors have been shown to play a role in the etiology and pathogenesis. Both genetic and environmental factors are thought to play a role in the formation of the disease. The research studies that have been done so far suggest a multifactorial phenotypic expression. Research studies have been conducted to find the possible genetic factors for keratoconus in various aspects: Analysis of diseases coexisting with keratoconus, gene research, protein and enzyme studies are some of the studies in this direction. Recent research in the pathophysiology of keratoconus on the basis of cell has shown oxidative stress as a cause of ectatic changes. In the etiology apart from genetic factors, hormones and hormonal balances are investigated, as well as chronic trauma (contact lens use and eye rubbing is examined as a possible cause. (Turk J Oph thal mol 2011; 41: 339-47
A. L. Bakulev
Full Text Available Goal. The authors conducted a comparative assessment of the efficacy and safety of 2% silver sulfathiazole in a prospective parallel-group observational study of patients with microbial eczema at the exacerbation stage. Materials and methods. The efficacy of the therapy was assessed on Day 7 and Day 14 based on dynamic calculations of the EASI index and ultrasonic assessment of the intensity of pathological processes in the epidermis and derma; the life quality was assessed based on DLQI and EQ-5D indices, respectively. The microbial composition in the lesions was assessed based on bacterioscopy tests of the contents of blains and erosion fluids. The safety of the therapy was assessed based on the frequency of adverse effects. Results. The administration of 2% silver sulfathiazole arrested both eczematous and pyogenic processes in the lesions within a short period of time, which was confirmed by ultrasonic tests: the depth and density of epidermis and derma were normalized. When applications were performed twice a day, the efficacy with regard to gram-positive bacteria was higher as compared to “classical” topical antibiotics. An evident therapeutic effect with regard to gram-positive bacteria and absence of adverse effects substantially improved the life quality of patients suffering from microbial eczema.
Full Text Available Pulmonary involvement is common in rheumatoid arthritis (RA and affects all the components of the lung. Interstitial lung disease (ILD is the most predominant pulmonary manifestation and has been identified as the main cause of morbidity and mortality in RA. Clinically significant RA-ILD occurs in approximately 10% of RA patients. Several risk factors, such as old age, male gender, and smoking, have been reported to date. Histologically, the proportion of the usual interstitial pneumonia (UIP pattern is higher in RA-ILD than in ILD associated with other connective tissue diseases, and RA-ILD also shows nonspecific interstitial pneumonia and organizing pneumonia patterns. High-resolution computed tomography scans are highly predictive of the histological UIP pattern with a specificity of 96%-100%. Acute exacerbation, which is the acute deterioration of the respiratory status characterized by newly developed bilateral infiltrates with unknown etiologies, has been reported in RA-ILD. Although acute exacerbation of RA-ILD has high mortality, similar to that of idiopathic pulmonary fibrosis, its incidence is lower in RA-ILD than in idiopathic pulmonary fibrosis. A consensus treatment has not yet been established. Current therapeutic regimens typically include corticosteroids with or without cytotoxic agents. Recent large longitudinal studies reported that the prognosis of RA-ILD was poor with a median survival of 2.6-3.0 years. Furthermore, histological and/or radiological patterns, such as UIP or non-UIP, have significant prognostic implications. RA-ILD patients with histological or radiological UIP patterns have poorer prognoses than those with non-UIP patterns. This review assessed the characteristics of RA-ILD by overviewing recent studies in the field and focused on the clinical significance of histological and/or radiological patterns in RA-ILD.
Trimmel, H; Baubin, M; Kreutziger, J; Frank, G; Prause, G
During the last 20 years Austrian prehospital emergency medical services (EMS) have significantly improved. The structure and organization of Austrian EMS comply with European standards but training requirements for prehospital EMS physicians are insufficient when compared with other countries. Although some EMS systems follow the German or Swiss postgraduate training concepts, the legal requirements in Austria defining the scope of mandatory training for physicians in the prehospital setting are only minimal. Thus, besides board certification as a general practitioner or specialist of any discipline, the only formal requirement is a 1-week theoretical course comprising some manikin simulations. Experience in anesthesia or intensive care medicine is still not mandatory. The Austrian Society of Anesthesiology, Resuscitation and Intensive Care Medicine (ÖGARI) drafted a reform paper in 2009, which was adapted by the Austrian Chamber of Physicians, section of emergency medicine, and subsequently presented to the Austrian Ministry of Health. Due to the slowness of the legislation process, the relevant § 40 of the Austrian Physician 's Act is still unchanged. In the meantime, Austrian specialist training regulations were restructured in 2015 with significant consequences. Due to changes in the residency programs, board certification and subsequent full working permit becomes more difficult to obtain, thus further aggravating the shortage of emergency physicians in Austria. In order to counteract the threatening shortage of prehospital EMS physicians, the ÖGARI section of emergency medicine was requested by the Ministry of Health to develop a reasonable model for how physicians could be qualified and subsequently employed in EMS prior to full board certification. Presently, the Austrian Ministry of Health, the Chamber of Physicians and medical societies are in discussion on whether this approach might fit into the legal framework. This manuscript details the development and present status as well as key points of an ongoing discussion on how high-quality EMS care in Austria can be safeguarded in the future or could even make it impossible.
Shkolnik, V.S.; Kadyrzhanov, K.K.; Kadyshevskii, V.G.; Itkis, M.G.; Zholdasbekov, M.Zh.
The results of fundamental and applied investigations on the beams of low and moderate energies of heavy ions received last time are very promising and encourage further development in this field. Leading nuclear physical centers in the world realize the program investigations directed to obtaining new experimental data explaining mechanisms of heavy ions interaction with different materials and creating enough preconditions for application of heavy ions in high technologies. One of the main directions of investigation is elaboration of production methods of track diaphragms and their application in various fields. This direction appeared as a result of the hard body detector technique development in applied nuclear physical researches. It is based on the result of accelerated heavy ions interaction with polymers. The report is devoted to elaboration of new ion-implantation methods and 'pattern' technology which are applied to problems of forming and synthesizing in volume and on surface of heavy solids of nanocrystalline structures. There is growing interest in application of nuclear tracks for formation with the a high base dimensional relation of one-dimensional nano-structures from different materials, particularly, metals and alloys in the form of nano-wires and micro-tubes using so-called pattern technology. For this purpose etched nuclear tracks in polymer materials is considered as a possible porous matrix use. This method could be an alternative to lithographic one. According ion-implantation nano-technology there are developed works connected with search of new contemporary approaches to fundamental quality control of solids (semiconductors, metals, polymers, etc.) based on forming and synthesizing in their volume of nano-dimensional many-component precipitate compounds, crystals, imperfect structures. Nowadays this direction forms one of the main problems of leading scientific centers in the world in the field of nano-technology. The effects of nanoparticle self-organization in ion implantation take a special place, which allow avoiding considerable technological problems in quantum engineering. Actually, the there been appeared the possibility for creation of the three-dimensional superlattice of nano-composite fields for different purposes with the density of active elements, which exceed physical limits of planar technologies on some orders and opening wide possibilities for creation of nano-electron systems and devices of new generation
Tsukamoto, Taiji; Kato, Ryuichi; Kobayashi, Koh
Selective androgen receptor modulators (SARMs) with tissue or organ-specificity are expected for their development. Indeed, they will be widely applied for patients with late onset of hypodonadism and those with prostate cancer who have hormone treatment-induced osteoporosis. SARMs having anabolic action on the bone or muscle but no or weak androgenic action on the prostate will be welcomed in the clinical setting.
Alonso-Padilla, Julio; Gallego, Montserrat; Schijman, Alejandro G; Gascon, Joaquim
Chagas disease is caused by the parasite Trypanosoma cruzi. It affects 7 million people, mainly in Latin America. Diagnosis is usually made serologically, but at some clinical scenarios serology cannot be used. Then, molecular detection is required for early detection of congenital transmission, treatment response follow up, and diagnosis of immune-suppression reactivation. However, present tests are technically demanding and require well-equipped laboratories which make them unfeasible in low-resources endemic regions. Areas covered: Available molecular tools for detection of T. cruzi DNA, paying particular attention to quantitative PCR protocols, and to the latest developments of user-friendly molecular diagnostic methodologies. Expert commentary: In the absence of appropriate biomarkers, molecular diagnosis is the only option for the assessment of treatment response. Besides, it is very useful for the early detection of acute infections, like congenital cases. Since current Chagas disease molecular tests are restricted to referential labs, research efforts must focus in the implementation of easy-to-use diagnostic tools in order to overcome the access to diagnosis gap.
VanEperen, Alison S; Segreti, John
Methicillin-resistant Staphylococcus aureus (MRSA) continues to be an important pathogen worldwide, with high prevalence of infection in both community and hospital settings. Timely and appropriate choice of empirical therapy in the setting of MRSA infection is imperative due to the high rate of associated morbidity and mortality with MRSA infections. Initial choices should be made based on the site and severity of the infection, most notably moderate skin and soft tissue infections which may be treated with oral antibiotics (trimethoprim-sulfamethoxazole, clindamycin, doxycycline/minocycline, linezolid) in the outpatient setting, versus choice of parenteral therapy in the inpatient setting of more invasive or severe disease. Though the current recommendations continue to strongly rely on vancomycin as a standard empiric choice in the setting of severe/invasive infections, alternative therapies exist with studies supporting their non-inferiority. This includes the use of linezolid in pneumonia and severe skin and skin structure infections (SSSI) and daptomycin for MRSA bacteremia, endocarditis, SSSIs and bone/joint infections. Additionally, concerns continue to arise in regards to vancomycin, such as increasing isolate MICs, and relatively high rates of clinical failures with vancomycin. Thus, the growing interest in vanomycin alternatives, such as ceftaroline, ceftobribole, dalbavancin, oritavancin, and tedizolid, and their potential role in treating MRSA infections. Copyright © 2016. Published by Elsevier Ltd.
Current benchmark reports of classification algorithms generally concern common classifiers and their variants but do not include many algorithms that have been introduced in recent years. Moreover, important properties such as the dependency on number of classes and features and CPU running time are typically not examined. In this paper, we carry out a comparative empirical study on both established classifiers and more recently proposed ones on 71 data sets originating from different domains, publicly available at UCI and KEEL repositories. The list of 11 algorithms studied includes Extreme Learning Machine (ELM), Sparse Representation based Classification (SRC), and Deep Learning (DL), which have not been thoroughly investigated in existing comparative studies. It is found that Stochastic Gradient Boosting Trees (GBDT) matches or exceeds the prediction performance of Support Vector Machines (SVM) and Random Forests (RF), while being the fastest algorithm in terms of prediction efficiency. ELM also yields good accuracy results, ranking in the top-5, alongside GBDT, RF, SVM, and C4.5 but this performance varies widely across all data sets. Unsurprisingly, top accuracy performers have average or slow training time efficiency. DL is the worst performer in terms of accuracy but second fastest in prediction efficiency. SRC shows good accuracy performance but it is the slowest classifier in both training and testing.
Bianchi, A-J; Guépet-Sordet, H; Manckoundia, P
Olfaction is a complex sensory system, and increasing interest is being shown in the link between olfaction and cognition, notably in the elderly. In this literature review, we revisit the specific neurophysiological features of the olfactory system and odorants that lead to a durable olfactory memory and an emotional memory, for which the implicit component produces subconscious olfactory conditioning. Olfaction is known to affect cognitive abilities and mood. We also consider the impairment of olfactory function due to ageing and to neurodegenerative diseases, in particular Alzheimer's disease and Parkinson's disease, through anatomopathological changes in the peripheral and central olfactory structures. The high frequency of these olfactory disorders as well as their early occurrence in Alzheimer disease and Parkinson disease are in favour of their clinical detection in subjects suffering from these two neurodegenerative diseases. Finally, we analyse the impact of olfactory stimulation on cognitive performance and attention. Current observational data from studies in elderly patients with Alzheimer-type dementia are limited to multiple sensory stimulation methods, such as the Snoezelen method, and aromatherapy. These therapies have shown benefits for dementia-related mood and behaviour disorders in the short term, with few side effects. Since olfactory chemosensory stimulation may be beneficial, it may be proposed in patients with dementia, especially Alzheimer-type dementia, as a complementary or even alternative therapy to existing medical strategies. Copyright © 2014 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.
The article covers some aspects of agricultural companies' fixed assets revaluation practice and grounds for trends on enhancing institutional provision of such revaluation. Actual state has been researched of carrying out revaluation of industry fixed assets whose accounting cost influences indexes of agricultural production efficiency. It has been founder that today there is a lack of efficient practice of revaluation in agricultural businesses while the priority in application is given to ...
Full Text Available The aim of the systematic ensuring of knowledge continuity is the continuity of an organisation’s development, the quality of managerial positions and the continuity of decision-making. By ensuring knowledge continuity, organisations may gain a performance-enhancing factor. The objective of the article is to identify the level of impact of decisive internal factors determining knowledge continuity ensuring and contributing to the efficiency of the organisations. Knowledge continuity ensuring as an internal force, however, can together with the right employees, help adapt more quickly to external conditions that organisations can hardly control. Monitoring and ensuring knowledge continuity can contribute to a higher quality of processes in general, in particular processes exploiting knowledge, and thus help improve the level of management. The first part of the article presents theoretical views on the aspects of knowledge continuity ensuring in organisations while the second part analyses the findings of the surveys carried out among managers in organisations in the Czech Republic. Based on the summary of the outcomes obtained it is possible to say that internal factors influence knowledge continuity ensuring in organisations, however, the level of impact of individual factors is determined by their size. The findings regarding the impact of each of the factors show that the most significant barriers to knowledge continuity ensuring are those associated with the human factor.
Lauenstein, J M.
An overview is presented of the space radiation environment and its effects on electrical, electronic, and electromechanical parts. Relevant test standards and guidelines are listed. Test standards and guidelines are necessary to ensure best practices, minimize and bound systematic and random errors, and to ensure comparable results from different testers and vendors. Test standards are by their nature static but exist in a dynamic environment of advancing technology and radiation effects research. New technologies, failure mechanisms, and advancement in our understanding of known failure mechanisms drive the revision or development of test standards. Changes to standards must be weighed against their impact on cost and existing part qualifications. There must be consensus on new best practices. The complexity of some new technologies exceeds the scope of existing test standards and may require development of a guideline specific to the technology. Examples are given to illuminate the value and limitations of key radiation test standards as well as the challenges in keeping these standards up to date.
Perez, Della; Holmes, Melissa
Ensuring that English language learning (ELL) students have equal access to content-area curriculum continues to be a challenge for many secondary educators. Although efforts to develop students' English skills are well intentioned, they frequently fall short of addressing each of the four interrelated dimensions of the culturally and…
Beste, A.; Runge, K.; Bartlett, R.
The energy of a system which is described by a Hamiltonian which includes at most two-particle interactions can be expressed in terms of the second order reduced density matrix. However, for the 2-matrix to have proper symmetry is a weaker condition than requiring that the wavefunction be antisymmetric, which is called the N-representability problem, a problem of long term interest. Coleman [Reduced Density Matrices: Coulson's Challenge, Springer, New York, 2000] however, proposed an algorithm which ensures N-representability. In this Letter we examine the algorithm and show its connection to the full configuration interaction method and the contracted Schroedinger equation.
Ancilla Systems, Inc., Elk Grove Village, Il, developed a mission-based performance evaluation program to provide tangible evidence of mission fulfillment and ensure the provision of high-quality healthcare. the program--Characteristics of Service--translates the language of healthcare action and evaluates corporate culture to ensure that it fulfills the expectations of its sponsor. The nine Characteristics of Service are: Respect for the dignity of all persons. Orientation toward the family unit. Quality and personalized services. Local health systems with a spectrum of services responsive to the unique needs of the community. Formal and informal partnerships with physicians. Active participation and collaboration with related community service agencies and other healthcare providers. Faithfulness to Catholic identity through close relationships with Church and religious institute resources. Effective political advocacy through education. Research and development of innovative approaches to healthcare. In establishing the behavior standards that would exemplify the characteristics, program developers used terms that correspond to specific, observable, measurable performance. All healthcare facilities are evaluated on how well they meet the behavior standards. The evaluation process includes data collection, analysis, and a final report. Data collection begins with a review of regular hospital-conducted surveys, which provide quantifiable information to measure performance against key expected behaviors. Additional data are derived from medical staff development plans and the monthly quality assurance audit. On-site surveys fill information gaps that remain after all written reports are collected.
Shendurnikar, Niranjan; Thakkar, Pareshkumar A
Every pediatrician would want to satisfy their patients and their parents to sustain good practice, earn name and fame and simultaneously to avoid litigation in this era of consumer protection act. This can be achieved only by use of good communication skills. Today the patients demand time, information and want their questions to be answered. They expect politeness, empathy and human touch from doctors. Time constraints, arrogance, telephone calls, language barriers and cultural insensitivity are the important barriers to good communication. Research has shown that doctor, who undergoes training to acquire good communication skills, can better satisfy his patients. Good communication skill is an art which can be acquired or improved by putting conscious efforts in day to day practice. Such skills should also be incorporated as part of medical teaching curriculum. Asking open ended questions, effective listening, appropriate praise, providing enough information as part of advice and finally checking their understanding, are the key areas of communication during medical interview. During this process pediatrician should ensure to address the parental concerns, should empathize with parents and involve parents in decision making. This will not only ensure satisfaction of parents but also their adherence to the therapy and to the pediatrician.
Ivan Vadimovich Kochikin
Full Text Available Relevance of the topic is determined by the need for sustainable development of the country’s banking system, capable of ensuring the process of raising funds to producers and the public for their projects. One of the implementation of this objective is to discourage unfair behavior in financial markets. Trust is a key factor in the development of financial markets, therefore it is necessary to suppress the appearance of unfair practices and participants – black creditors, falsification of financial statements, trading on insider information and market manipulation. It requires a whole range of activities, and above all ensuring the inevitability and proportionality of punishment for unscrupulous players, the introduction of requirements for the business reputation of the management of financial institutions.The article is devoted to structuring legal violations in the lending sphere. The analysis of indicators of credit organizations in Russia was conducted to fulfill this aim. This analysis revealed the causes of sustainable growth of overdue accounts payable – job cuts in enterprises, violations in the financial sector, various errors in the credit granting / raising. The authors carry out the systematization and classification of offenses in the area of lending, provide examples, as well as factual material illustrating the violations in the lending process having the characteristics of a fraud. The article substantiates the obligations of employees of the credit institution, in the result of which risks of granting credit to fraudsters can be reduced. The methods of fraud prevention should include the identified methods of protection against fraud in the area under consideration – exchange of information by banks associated with the criminal intentions of customers; technology development and technical support, training, and personnel responsibilities.
Doronin, Maxim; Popov, Alexander
Today one of the main areas of application of two-photon microscopy is biology. This is due to the fact that this technique allows to obtain 3D images of tissues due to laser focus change, that is possible due to substantially greater penetration depth on the main wavelength into biological tissues. Self-developed microscopy system provides possibility to service it and modify the structure of microscope depending on highly specialized experimental design and scientific goals. This article may be regarded as a quick reference to laboratory staff who are wishing to develop their own microscopy system for self-service and modernization of the system and in order to save the lab budget.
Miettinen, Karel; Iñigo, Sabrina; Kreft, Lukasz; Pollier, Jacob; De Bo, Christof; Botzki, Alexander; Coppens, Frederik; Bak, Søren; Goossens, Alain
Triterpenes constitute a large and important class of plant natural products with diverse structures and functions. Their biological roles range from membrane structural components over plant hormones to specialized plant defence compounds. Furthermore, triterpenes have great potential for a variety of commercial applications such as vaccine adjuvants, anti-cancer drugs, food supplements and agronomic agents. Their biosynthesis is carried out through complicated, branched pathways by multiple enzyme types that include oxidosqualene cyclases, cytochrome P450s, and UDP-glycosyltransferases. Given that the number of characterized triterpene biosynthesis enzymes has been growing fast recently, the need for a database specifically focusing on triterpene enzymology became eminent. Here, we present the TriForC database (http://bioinformatics.psb.ugent.be/triforc/), encompassing a comprehensive catalogue of triterpene biosynthesis enzymes. This highly interlinked database serves as a user-friendly access point to versatile data sets of enzyme and compound features, enabling the scanning of a complete catalogue of experimentally validated triterpene enzymes, their substrates and products, as well as the pathways they constitute in various plant species. The database can be accessed by direct browsing or through convenient search tools including keyword, BLAST, plant species and substructure options. This database will facilitate gene mining and creating genetic toolboxes for triterpene synthetic biology. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.
Campbell, William Giles; And Others
The eighth edition of this manual, which incorporates recent changes in bibliographical format made by "The Chicago Manual of Style" and the Modern Language Association of America, provides guidance to writers of research papers and reports in college, graduate school, business, government, and the professions. The review of the…
Full Text Available Tuberculosis morbidity rates in Poland have been gradually decreasing. Nevertheless, there are approximately 8 thousand cases being registered annually, which includes almost 3 thousand massively infectious patients. In the last 3 years, around 100 cases/year have been reported among children below 14 years of age. Infection with Mycobacterium tuberculosis should be considered in all patients who present symptoms suggesting tuberculosis, have had recent contact with a person suffering from lung tuberculosis or are planned to undergo an immunosuppressive treatment. HIV infected patients are also supposed to have screening tests for M. tuberculosis infection performed. For over a 100 years tuberculin skin test (TST was the only test capable of confirming tuberculous infection. TST is based on the assessment of skin reaction to intracutaneous injection of tuberculin. Due to cross-reaction to the injected tuberculin in BCG vaccinated individuals, the correct interpretation of the test is difficult. Since 13 years new immunological assays have been available. They are based on detecting interferon gamma (Interferon Gamma Release Assay – IGRA concentration in blood serum, which has previously been incubated with Mycobacterium tuberculosis antigens absent in the BCG strain. In infected individuals interferon gamma is intensively produced by memory cells in reaction to the contact with previously met Mycobacterium antigens. Many trials have proved IGRA’s high sensitivity and, higher than TST, specificity. Recent guidelines promote the usage of IGRAs, even in children.
New approach to the problem of composition of present-day materials, which are working in high temperatures assumes that their microstructure becomes a subject of analysis-not an object-as it was before. Nowadays many industrial and university laboratories deal with these problems, individually or in the cooperation, in framework of the different types of projects, financed by the international organizations. In the report, research realized over the last 20 years in USA, Europe and japan have been reviewed. This research focused on the working in high temperatures steels as a constructional materials for pipes and other units of the power plants. According to the newest achievement in this domain we could expect that the ferritic and ferro-martensitic alloy steels will become new generation of the high-temperature creep-resisting steels (author)
Adam G. Harris, MBChB
Conclusion: There is moderate evidence to suggest that skin needling is beneficial and safe for the treatment of acne scarring. However, double-blinded, randomized controlled trials are required to make more definitive conclusions.
In the chapter the analytical survey on ionizing radiation action on men sexual function is made. It is known, that the ionizing irradiation destructs both the sexual and the reproductive functions of men. Literature analysis indicates on high frequency of liquidators' complaints on sexual dysfunctions, and that the problem of clinical and pathogenetic regularities of sexual dysfunctions is unexplored. It is noted, that this problem is not only medical problem but it is the social one
The invention of ventilation cannot be ascribed to a certain date. It started with simple aeration when man brought fire into his abode and continued through different stages including air cooling using ice to finally arrive at the time when ventilation and air conditioning has become an essential part of our life and plays an important role in human evolution. This paper presents the history of ventilation and air conditioning, explains the key constraints over the centuries, and shows its influence on everyday life. Some examples of previous air-conditioning plants are described and different approaches to the way of calculation of ventilation systems discussed. It gives an overview of the Heating, Ventilation and Air Conditioning (HVAC) installations at CERN and points out their particularities. It also compares them with the latest technological developments in the field as well as showing the new trends that are being applied at CERN.
Full Text Available Uterine fibroids (UFs are the most common tumors of the female genital tract. The effect of UFs on the quality of life and the overall cost of treatment are significant issues worldwide. Tumor size and location are the two specific factors which influence the occurrence of symptoms, the need for, and method of, treatment (some tumors require surgery while some can be treated with selected drugs. Primary prevention and treatment of early UF disease are worthy goals that might have a great impact on health care systems. Several treatments and prophylactic methods can be used in this endeavor. This publication presents current data about lesser-known substances which may have a beneficial effect on the treatment or prophylaxis of UFs and can be administered orally, serving as an alternative to (or complement of surgery or selective progesterone receptor modulators (SPRMs. Early prevention and treatment of UFs in women from high-risk groups should be our priority. Innovative forms of UF management are under intensive investigation and may be promising options in the near future. Many of them evaluated vitamin D, paricalcitol, epigallocatechin gallate (EGCG, elagolix, aromatase inhibitors (AIs, and cabergoline and deemed them to be safe and effective. The next step in such projects should be properly constructed randomized control trials (RCTs, carried out by successive phases.
M. A. Chekalova
Full Text Available We analyzed the results of ultrasound and postoperative histological studies of 14 patients with primary diagnosis of gastric cancer who received treatment at the cancer research center in 2014. Metastases to the ovaries detected in all cases with disseminated gastric cancer as the primary diagnosis, and in monitoring the effectiveness of treatment. The most characteristic ultrasound signs of metastatic ovarian tumors. When elastography in all cases, metastatic the affected ovaries were determined in the solid sections of the component of high-density (stiffness, charterhouses type 5 (blue, the average rigidity coefficient was 10.2–32.2. Solid-cystic masses in cases of tumor were mapped to 4 of Krukenberg type (which met as the dense and elastic stretches, charterhouses blue and green colors.
Yu. V. Alymov
Full Text Available Background. Incidence of oral cancer in Russia is 4.52 and mortality – 2.44. Head and neck cancer is characterized by the high risk of development of metastases in regional lymph nodes. Lymph nodes status exerts influence on the treatment plan and appears to be the major predictive factor. Regional metastases result into two-fold decrease of five-year survival. Therefore, evaluation and treatment of metastatic lymph nodes is of prime importance. Objective. The aim of this manuscript was to illustrate and summarize publications devoted to modern methods of ultrasound evaluation of cervical lymph node status in patients with squamous cell carcinoma of the oral cavity. Results. Numerous studies have demonstrated, that standard ultrasound investigation (in B-mode is characterized by high sensitivity and specificity (specificity varies from 71.0 to 96.4 %, and specificity – from 46.6 to 91.0 %, according to different studies. In addition, ultrasound efficiency exceeds that of CT. Accuracy of ultrasound as the method of cervical lymph node investigation has increased after implementation of such methods, as elastography and elastometry (this techniques allow to achieve sensitivity of 98.1 % and specificity of 100 %.
Станислав Александрович Филиппов
Full Text Available The article contain developed by NRNU «MEPhI» jointly ANI «ITE» and SBFO MER MCPE multilevel model of teachers training (tutors, specialist teachers to organize work with gifted children.
Full Text Available Radiochemical methods for the determination of long-lived radionuclides have been briefly reviewed. Developments in nuclear measuring techniques such as alpha spectrometry and liquid scintillation counting as well as in chemical separations have been comparatively evaluated.
Full Text Available A multidisciplinary group of teachers and scientists from the Faculty for Higher Education (FES Zaragoza from the National Autonomous University of Mexico (UNAM has been working during several years, forwarding and testing strategies for the continuous improvement of biochemistry theoretical and experimental teaching, within the various levels from the chemistry, pharmacy and biology (QFB curricula at our University. To provide our teachers with modern teaching abilities to satisfy current national demands of high-level education is our top priority. Therefore, we offer various activities to promote their continuous scientific and didactic updating. We also encourage self-awareness on the strong need for continuous adaptation and utilization of information and communication technologies (ICT that have become very popular among young generations. Teaching is not an isolated discipline. On the contrary, teaching is intimately related with social and economical circumstances. Teachers and students must be aware of their social environment, studying and applying modern techniques, improving their scientific capabilities, which are all necessary to approach national problems with an accurate utilization of national resources. Research and development have to be linked to the best teaching techniques that stimulate teachers and scientists to grow as educators and experimenters continuously looking for feedback from their students and colleagues. Our scientific meetings and advanced and basic courses on scientific topics and teaching techniques have contributed not only to promote individual teaching and scientific capabilities but also to update the study plans from the QFB curricula at our University.
Full Text Available Background. We conducted a meta-analysis, in order to appraise the effect of microvessel density (MVD on the survival of patients with cutaneous melanoma. Methods. This study was conducted according to the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. A systematic literature search in electronic databases (MEDLINE, Web of Science, and Cochrane Central Register of Controlled Clinical Trials was performed. Fixed Effects or Random Effects model was used, based on the Cochran Q test. Results. In total 9 studies (903 patients were included. Pooled HR for overall survival (OS and disease-free survival (DFS were 2.62 (95% CI: 0.71–9.60, p=0.15 and 2.64 (95% CI: 0.82–8.47, p=0.10, respectively. Odds ratios of overall survival between high and low MVD groups, at 12 (1.45, 95% CI: 0.16–13.24, 36 (2.93, 95% CI: 0.63–13.59, and 60 (4.09, 95% CI: 0.85–19.77 months did not reach statistical significance. Significant superiority of low MVD group, in terms of DFS, at all time intervals (OR: 4.69, p<0.0001; OR: 2.18, p=0.004; OR: 7.46, p=0.01, resp. was documented. Discussion. MVD does not affect the HR of OS and DFS. A strong correlation with DFS rates at 12, 36, and 60 months was recorded.
S. Yu. Martsevich
Full Text Available Aim. To assess the real rate of dual antiplatelet therapy (DAT, acetylsalicylic acid + clopidogrel use in patients having appropriate indications according to current clinical guidelines and to study the possibility of prescription rate improvement by education activity directed to doctors. Material and methods. The study consisted of 3 parts. Parts I and II present the results of two questionnaire surveys of patients with acute myocardial infarction, or stenting, who needed in DAT according to current clinical guidelines. The real use of the DAT was assessed in part III on the basis of the multicenter study conducted in different regions of Russia (ROMB study in a large sample of patients having DAT indications. Results. Part I - PROGNOZ-IBS study. According to the questionnaire survey only 112 out of 239 patients (47% having an absolute indications, received DOT. Part II - phone survey of patients with acute myocardial infarction in two towns of Lyubertsy and Podolsk. 28 of 71 patients (39% took the DAT (from some days to 6 months and 35 patients (49% — did not take it. Part III - ROMB study. 519 patients did not take DAT, at that 259 (50% in hospital and 260 (50% - in out-patient clinic. 521 patients took DAT according to indications, at that 238 (46% in hospital and 283 (54% - in out-patient clinic. Conclusion. Less than 50% of patients, having direct indications, received DAT in the real clinical practice. The prescription rate can be improved due to education activity directed to doctors and increase in clopidogrel drugs affordability.
Redreev, G. V.
the operability of the machine and tractor aggregates is ensured by processes which occur in machine units and considered as technical systems. In order to develop theoretical understanding of the processes in technical systems as the basis and purpose of the repairserving actions, the author's concept is presented which relies on on the basic concepts of "processes in technical systems", "maintenance and repair of performers", "maintenance and repair of technology" "objectives of the maintenance and repair". Analysis of the basic concepts of "processes in technical systems" made possible to distinguishing four types of relations: of order, stipulation, exactingness, and non-contradiction. It is shown that the implementation of maintenance and repair of technology should be conducted according to the assessment of the effectiveness of processes in technical systems, revealed in complex diagnosis. The perfection of the design of the machine in terms of its technical operation can be estimated according to the degree of consistency of processes in technical systems, purposes of maintenance and repair. In order to increase the efficiency of the lubrication system,the modernised design of the centrifugal oil filter with permanent control of its cleaning power is offered, which allows changing the technology of the maintenance of engine lubrication system by separating the operations of crankcase oil replacement and the rotor filter cleaning.
Andris, Deborah A
In the United States, obesity has reached epidemic proportions. Serious medical complications, impaired quality of life, and premature mortality are all associated with obesity. Medical conditions such as type 2 diabetes mellitus, hypertension, hyperlipidemia, or sleep apnea can improve or be cured with weight loss. Medical treatment programs focused on diet, behavior modification, and/or pharmacologic intervention have met with limited long-term success. Although surgical treatments for obesity have become popular in recent years, they should only be used as a last resort for weight loss. Not all patients can be considered appropriate candidates for surgery; therefore, guidelines based on criteria from the National Institutes of Health should be used preoperatively to help identify suitable persons. Most individuals who opt for weight-loss surgery have usually struggled for many years with losing weight and keeping it off, but surgery alone will not ensure successful weight loss. Patient education is imperative for long-term success. Moreover, any such educational regimen should include information on diet, vitamin and mineral supplementation, and lifestyle changes, as well as expected weight-loss results and improvements in comorbid conditions. Patients must be willing to commit to a long-term follow-up program intended to promote successful weight loss and weight maintenance and to prevent metabolic and nutritional complications.
Jankauskiene, Zymante; Kubiliene, Erika; Juozulynas, Algirdas; Venalis, Algirdas
The aim of this study was to evaluate professional socialization of nurses and its association with assurance of practice activity. The study was carried out in randomly selected Lithuanian health care institutions from January to June 2007. A total of 1300 nurses, enrolled in the study, were divided into three groups according to the position held by participants: general practice nurses, 77.8%; senior nurses and leaders, 10.7%; and 4th-year students of general nurse education program, 11.5%. A questionnaire-based survey was carried out. The data were processed with SPSS 15.0 statistical software. Descriptive and multidimensional statistical methods were applied in the study. The matrix model, integrating characteristics of nurses' professional socialization and dimensions of practice activity and disclosing parameters and indicators of assurance of these processes, was applied for data analysis. The respondents favorably evaluated the aspects ensuring professional socialization and practice activity such as "professional activity," "motivators of professional activity," "professional characteristic," "system of professional values," and "professional behavior." The respondents unfavorably evaluated the following parameters: "security of professional self-expression and self-education," "professional development," "professional expectations," and "implementation of institution strategies." For the evaluation of nurses' professional socialization and practice activity, a theoretical model was created, and nine diagnostic criteria, integrating the characteristics of professional socialization and dimensions of practice activity, were formulated. A significant positive correlation was determined among the majority of the diagnostic criteria of the intercorrelation matrix of theoretical model. Having summarized the attitude of nurses toward professional socialization and the provision of practice activity, both favorable and unfavorable aspects of assessment
Marshall, Timothy J.
process; and the reductions in wind tunnel testing requirements within the largest consumer of ATP wind tunnel test time, the Aeronautics Research Mission Directorate (ARMD). Retirement of the Space Shuttle Program and recent perturbations of NASA's Constellation Program will exacerbate this downward trend. Therefore it is crucial that ATP periodically revisit and determine which of its test capabilities are strategically important, which qualify as low-risk redundancies that could be put in an inactive status or closed, and address the challenges associated with both sustainment and improvements to the test capabilities that must remain active. This presentation will provide an overview of the ATP vision, mission, and goals as well as the challenges and opportunities the program is facing both today and in the future. We will discuss the strategy ATP is taking over the next five years to address the National aeronautics test capability challenges and what the program will do to capitalize on its opportunities to ensure a ready, robust and relevant portfolio of National aeronautics test capabilities.
T N Kirabaev
Full Text Available Barcelona process was aimed to become an important mechanism in the realization of ideas of peace, stability and security ensuring in the Mediterranean Sea region. Cooperation in the sphere of security ensuring means openness of the regional states, social and economic reforms, human rights protection. The article deals with the problem of security ensuring by nonmilitary means.
Kelley, A E; Will, M J; Steininger, T L; Zhang, M; Haber, S N
Brain opioid peptide systems are known to play an important role in motivation, emotion, attachment behaviour, the response to stress and pain, and the control of food intake. Opioid peptides within the ventral striatum are thought to play a key role in the latter function, regulating the affective response to highly palatable, energy-dense foods such as those containing fat and sugar. It has been shown previously that stimulation of mu opiate receptors within the ventral striatum increases intake of palatable food. In the present study, we examined enkephalin peptide gene expression within the striatum in rats that had been given restricted daily access to an energy-dense, palatable liquid food, chocolate Ensure(R). Rats maintained on an ad libitum diet of rat chow and water were given 3-h access to Ensure(R) daily for two weeks. One day following the end of this period, preproenkephalin gene expression was measured with quantitative in situ hybridization. Compared with control animals, rats that had been exposed to Ensure(R) had significantly reduced enkephalin gene expression in several striatal regions including the ventral striatum (nucleus accumbens), a finding that was confirmed in a different group with Northern blot analysis. Rats fed this regimen of Ensure(R) did not differ in weight from controls. In contrast to chronic Ensure(R), acute ingestion of Ensure(R) did not appear to affect enkephalin peptide gene expression. These results suggest that repeated consumption of a highly rewarding, energy-dense food induces neuroadaptations in cognitive-motivational circuits.
Moroz Maxim O.
Full Text Available The article explores approaches to modelling the system of ensuring the investment security. Necessity of observance of investment security of Ukraine has been substantiated. The author’s own vision of the modelling essentials has been provided. The eligibility for consideration of the system of ensuring the investment security of Ukraine in the functional, structural, process, formative, and factor aspects has been proved. The target setting and tasks of a functional model of the system of ensuring the investment security have been defined. The functions, subjects, organizational-economic mechanisms of the system of ensuring the investment security of Ukraine have been characterized. A structural model of the system of ensuring the investment security has been presented. Special attention has been given to the definition of objects of direct and indirect influence, control and controlled subsystems, aggregate of indicators, safe levels, principles of formation of the investment security system. The process and formative models of the system of ensuring the investment security, as well as the algorithm of the complex assessment of the level of investment security, were analyzed in detail. Measures to ensure the investment security of Ukraine have been defined.
Webinar series on communications strategies and methods addresses how communications tools can be used throughout the implementation of climate and clean energy programs to achieve behavior change and ensure sustained.
? Rapports. Research, capacity-building, advocacy and dissemination by LIRNEasia : advancing evidence-based policymaking and regulation in the emerging Asia-Pacific to ensure greater participation in ICTs (Phase II); final technical report ...
Full Text Available This paper assessed factors that influence the internal controls in ensuring good corporate governance in financial institutions in developing economies with special reference to Zimbabwe. The research paper assessed how lack of internal controls affected good corporate governance and aimed to bring out elements of good corporate governance. It emerged that failure to effectively implement internal controls contributed significantly to poor corporate governance. The study discovered that internal control system overrides and the issue of “fact cat” directors also contributed to poor corporate governance. The study recommended that there is need for the board of directors to guarantee an organizational structure that clearly defines management responsibilities, authority and reporting relationships. There is also need to ensure that delegated responsibilities are effectively carried out to ensure compliance with internal controls of the financial institution concerned.
Hajos, Antal K; Kamble, Sujal K
The topic of ensuring quality and compliance is and must be a top priority in the conduct of clinical trials, as warranted by regulatory guidelines as well as the inherent responsibility of the professionals conducting such research. Fast-growing emerging clinical geographies such as India demand special attention due to rapid growth and associated factors that may put study quality at risk. In this paper, we used the basic principle of PDCA (Plan, Do, Check, and Adjust) to structure the processes of a clinical trial from protocol to final analysis in order to highlight the interactive nature of involved people and processes required to ensure quality of data and site functioning.
Do freequent Antenatal Care Visits ensure access and adherence to Intermittent preventive treatment of Malaria in pregnancy in an Urban Hospital in South West Nigeria? ... Respondents were enrolled over a period of three months in a secondary healthcare facility within 24 hours of delivery. Demographic details, delivery ...
Kor, Jacob; Opare, James K.
The school climate is outlined in literature as one of the most important within school factors required for effective teaching in learning. As leaders in any organisations are assigned the role of ensuring sound climates for work, head teachers also have the task of creating and maintaining an environment conducive for effective academic work…
Advancing Evidence Based Policymaking and Regulation to Ensure Greater Participation in ICTs (LIRNEasia Phase II). Significant strides have been made in closing the digital divide in Asia, mainly due to the proliferation of mobile telephones. Close to a billion people, some among the poorest segments of society, have ...
The study focused on water institutions mandated to deliver on water policies rather than the quantitative aspects of water scarcity. The study revealed that although there is some attention to water security in the water policy there is lack of commitment in terms of how climate change will be mitigated to ensure water security.
In Berberis lycium anthers on alternate stamens dehisce, thus prolonging the male function so that pollination is affected and reproduction is ensured. The large pollen sac of each bithecous anther after the appearance of longitudinal dehiscence slit moves away from the filament while remaining attached at the tip of the ...
This paper concerns itself only with ascertaining the strategies that could ensure effective mentoring in tertiary institutions. The survey method was employed. The study population comprised 78 teacher educators in tertiary institutions in Anambra State. One research question guided the study while one null hypothesis was ...
Radhakrishna, Rama; Tobin, Daniel; Brennan, Mark; Thomson, Joan
This article presents a checklist as a guide for Extension professionals to use in research and evaluation studies they carry out. A total of 40 statements grouped under eight data quality components--relevance, objectivity, validity, reliability, integrity, generalizability, completeness, and utility--are identified to ensure that research…
V.R. Tolbert; D.A. Mays; A. Houston; D.D. Tyler; C.H. Perry; K.E. Brooks; F.C. Thornton; B.R. Bock; J.D. Joslin; Carl C. Trettin; J. Isebrands
Ensuring acceptance of dedicated biomass feedstocks by landowners, agricultural communities, environmental and public interest groups, requires that the environmental benefits, concerns, and risks associated with their production be quantified. Establishment and management measures to benefit soil and water quality are being identified by ongoing research. Field...
May 15, 2015 ... Appropriate training will ensure that CBSWOs have the technical skills to support investments in water infrastructure. ... They are also developing an audio-visual program and a documentary to highlight the challenges faced by CBWSOs in improving efficiency and adapting to climate change, and to ...
This study focuses on ensuring quality control of forensic accounting for efficient and effective corporate ... quality control.. Hauser (2006) Quality control is a means by which a firm obtains a reasonable assurance that the expression of expert opinion always reflects the .... Evan, (1990) provide a comprehensive review of.
Academic Senate for California Community Colleges, 2016
Curriculum is the heart of the mission of every college. College curriculum approval processes have been established to ensure that rigorous, high quality curriculum is offered that meets the needs of students. While some concerns may exist regarding the effectiveness and efficiency of local curriculum processes, all participants in the process…
This study focuses on ensuring quality control of forensic accounting for efficient and effective corporate management. Over the years, fraud has taken the center stage in every discussion whether in business or social. “3m” have been identified to be the tool used to effect this crime namely; misappropriation, misapplication ...
Full Text Available With the rapid growth of network technologies, users are used to accessing various services with their mobile devices. To ensure security and privacy in mobility networks, proper mechanisms to authenticate the mobile user are essential. In this paper, a mobility network authentication scheme based on elliptic curve cryptography is proposed. In the proposed scheme, a mobile user can be authenticated without revealing who he is for user anonymity, and a session key is also negotiated to protect the following communications. The proposed mobility network authentication scheme is analyzed to show that it can ensure security, user anonymity, and convenience. Moreover, Burrows-Abadi-Needham logic (BAN logic is used to deduce the completeness of the proposed authentication scheme.
Antal K Hajos
Full Text Available The topic of ensuring quality and compliance is and must be a top priority in the conduct of clinical trials, as warranted by regulatory guidelines as well as the inherent responsibility of the professionals conducting such research. Fast-growing emerging clinical geographies such as India demand special attention due to rapid growth and associated factors that may put study quality at risk. In this paper, we used the basic principle of PDCA (Plan, Do, Check, and Adjust to structure the processes of a clinical trial from protocol to final analysis in order to highlight the interactive nature of involved people and processes required to ensure quality of data and site functioning.
Tamura, Shinsuke; Yanase, Tatsuro; Nishi, Naoya
This paper discusses a mechanism to ensure safe behaviors of HMSs (Holonic Manufacturing Systems). The change from low-variety high-volume to high-variety low-volume production requires highly flexible and adaptive manufacturing systems. Multi agent systems, in which decisions are made through cooperation among autonomous and cooperative elements, fulfill these requirements by exploiting full abilities of individual elements while eliminating various bottlenecks that exist in conventional systems. However, highly adaptive features induce non-deterministic behaviors of systems, and make it difficult to adopt multi agent systems as primary bases of manufacturing systems. In order to apply these systems to large and complicated applications, mechanisms that make their behaviors more predictable are essential. HMSs are a kind of multi agent systems, and an HMS safety ensuring mechanism proposed here is one of the attempts to make behaviors of multi agent systems more predictable.
Andreasen, Martin Møller
& Primiceri (American Economic Review, forth- coming) and Fernández-Villaverde & Rubio-Ramírez (Review of Economic Studies, 2007) do not satisfy these sufficient conditions, or any other known set of conditions ensuring finite values for the objective functions. Thus, the validity of the micro foundation......The presence of i) stochastic trends, ii) deterministic trends, and/or iii) stochastic volatil- ity in DSGE models may imply that the agents' objective functions attain infinite values. We say that such models do not have a valid micro foundation. The paper derives sufficient condi- tions which...... ensure that the objective functions of the households and the firms are finite even when various trends and stochastic volatility are included in a standard DSGE model. Based on these conditions we test the validity of the micro foundation in six DSGE models from the literature. The models of Justiniano...
Hsieh, Terry; Vaickus, Max H; Remick, Daniel G
Progress in science is dependent on a strong foundation of reliable results. The publish or perish paradigm in research, coupled with an increase in retracted articles from the peer-reviewed literature, is beginning to erode the trust of both the scientific community and the public. The NIH is combating errors by requiring investigators to follow new guidelines addressing scientific premise, experimental design, biological variables, and authentication of reagents. Herein, we discuss how implementation of NIH guidelines will help investigators proactively address pitfalls of experimental design and methods. Careful consideration of the variables contributing to reproducibility helps ensure robust results. The NIH, investigators, and journals must collaborate to ensure that quality science is funded, explored, and published. Copyright © 2018 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.
Johnson, Kain; Sully, Andrew; Anthenat, Bruce
The safety and effectiveness of customized formulations have always been priorities for compounding pharmacists, perhaps even more so since a tragic outbreak of meningitis in 2012 was traced to preparations from the New England Compounding Center in Framingham, Massachusetts. Since that time, pharmaceutical compounding in the U.S. has been the focus of renewed interest from the public and from government organizations and regulatory bodies created to ensure patient safety. As a result, responsible compounders have responded to ensure--to even greater levels--the purity and safety of the formulations they prepare. One tool useful in doing so is the mechanical vial washer, which can produce cleaner vials (and/or ampules, syringes, and cartridges, depending on the washer model) more consistently than does washing vessels by hand. In this article, several such washers appropriate for use in a compounding pharmacy are profiled, and a pharmacist's experience in using one of those models is described.
Hadi, Muhammad Abdul; José Closs, S
The use of qualitative research methodology is well established for data generation within healthcare research generally and clinical pharmacy research specifically. In the past, qualitative research methodology has been criticized for lacking rigour, transparency, justification of data collection and analysis methods being used, and hence the integrity of findings. Demonstrating rigour in qualitative studies is essential so that the research findings have the "integrity" to make an impact on practice, policy or both. Unlike other healthcare disciplines, the issue of "quality" of qualitative research has not been discussed much in the clinical pharmacy discipline. The aim of this paper is to highlight the importance of rigour in qualitative research, present different philosophical standpoints on the issue of quality in qualitative research and to discuss briefly strategies to ensure rigour in qualitative research. Finally, a mini review of recent research is presented to illustrate the strategies reported by clinical pharmacy researchers to ensure rigour in their qualitative research studies.
Full Text Available Informal educational programs that reach out to minority youth in low-income urban areas need to anticipate diversity. Not only will participants exhibit a range of abilities and needs, but some, just like in any population, are likely to have learning disabilities. ScienceQuest, an informal science education program funded by the National Science Foundation, was designed to ensure that youth aged 10 to 14 with diverse abilities and needs, including learning disabilities, can successfully participate and succeed in inquiry-based learning. The program uses the I-Search curriculum as the basis of its inquiry process. Embedded in this curriculum are the following inclusive practices: youth are motivated to explore their topic; they use varied media that supports their learning styles; they are guided to process information through multiple means; and they have access to technology tools. These ongoing inclusive practices ensure that everyone successfully explores the world around them.
Bock, H.-W.; Richter, S.
With putting in operation the first digital TELEPERM XS I and C systems for functions important to safety in nuclear power plants, ensuring long-term availability and reliable operation of TELEPERM XS systems gains increasing importance. On the one hand, the modular structure of TELEPERM XS has already been optimized during system development such that the application-specific functions are independent of the version of hardware components and system software. On the other hand, hardware-independent, tool-based engineering procedures ensure that the application software of installed I and C systems can be flexibly adapted to modified plant requirements while at the same time the very high software quality is retained. Quality-assured procedures and an actively organized configuration management guarantee that the functionality and the availability of the I and C systems keep their qualified standard. This paper discusses aspects of the configuration management for TELEPERM XS I and C systems. (author)
Full Text Available The paper is based on the review of the foreign and national academic literature and intended to emphasize the issues of ensuring energy efficiency of buildings and structures applicable to all the countries as for reconstruction of existing buildings as for erection of new ones . The author highlights the key aspects of the provision of energy efficiency of buildings and structures in some foreign countries. The conclusion is made that the studies are mainly aimed at discovering new heat insulation materials, whereby polystyrene insulation is found to be the most widespread wall insulation material in a number of countries. At the same time, it is observed that the ongoing research is focused on solutions to optimize the structure of walling systems in terms of both insulant thickness and the number and sequence of insulation layers in the walling structure. A conclusion is made that hyper insulation of external walls leads to considerable expenses arising due to cooling during the summer season. The use of prefabricated vacuum panels as a heat insulation layer and off-the-shelf single-layer structures, subject to their heat insulation characteristics, appears a more constructive way to meet the energy efficiency requirements, as the arrangement of ideal air space in multilayered walls proves a significant challenge today. One of the most promising ways to ensure energy efficiency is the use of multifunctional polyvalent walls and provision of polyvalent heat supply from renewable energy sources. Since energy efficiency depends on the spatial arrangement of buildings, construction must ensure a minimum ratio of the area of enclosing structures to the overall building volume (by adding on new facilities in case of reconstruction. It is noted that a systemic approach to ensuring energy efficiency of buildings is impossible without proper regard to the environmental parameters of heat insulation materials.
Schaefer, Andreas T; Angelo, Kamilla; Spors, Hartwig
--permitted accurate discernment of up to 1,000 different stimuli. At low oscillation frequencies, stimulus discrimination showed a clear phase dependence whereby inputs arriving during the trough and the early rising phase of an oscillation cycle were most robustly discriminated. Thus, by ensuring AP precision......, membrane potential oscillations dramatically enhance the discriminatory capabilities of individual neurons and networks of cells and provide one attractive explanation for their abundance in neurophysiological systems....
Full Text Available Urban planning includes land use management and environmental change. It makes arrangement for community facilities and services. Since, sustainable development has been included as a vital end product of all planning goals it also provides for balanced use of land, housing and transportation and better quality of life. Present urban planning in Pakistan is not ensuring sustainable development in Pakistan. This is tested through the case study of master planning in Rawalpindi and its implementation through housing schemes in Rawalpindi, Pakistan. Large portions of provisions of master plans are not implemented. This paper explains how the urban planning will be made enabled to ensure sustainable development in Pakistan. Six numbers of housing schemes and two squatter settlements have been surveyed through questionnaires, secondary data, the opinions of the experts from related fields and site observations. Amenities and social services at far distance, very less green area, Less quantity and bad quality of water, absence of comprehensive solid waste management and sewage disposal system and nontreatment of solid waste, effluent and sewage, prevalent unhygienic conditions and air and water pollution are the existing factors effecting the sustainability. There is a need to revisit the urban planning and a comprehensive Urban and Environment Planning Law at national level and at provincial level is recommended to enable the urban planning to ensure the sustainable development in Pakistan
Qasim, M.; Zaidi, S.S.U.
Urban planning includes land use management and environmental change. It makes arrangement for community facilities and services. Since, sustainable development has been included as a vital end product of all planning goals it also provides for balanced use of land, housing and transportation and better quality of life. Present urban planning in Pakistan is not ensuring sustainable development in Pakistan. This is tested through the case study of master planning in Rawalpindi and its implementation through housing schemes in Rawalpindi, Pakistan. Large portions of provisions of master plans are not implemented. This paper explains how the urban planning will be made enabled to ensure sustainable development in Pakistan. Six numbers of housing schemes and two squatter settlements have been surveyed through questionnaires, secondary data, the opinions of the experts from related fields and site observations. Amenities and social services at far distance, very less green area, Less quantity and bad quality of water, absence of comprehensive solid waste management and sewage disposal system and non- treatment of solid waste, effluent and sewage, prevalent unhygienic conditions and air and water pollution are the existing factors effecting the sustainability. There is a need to revisit the urban planning and a comprehensive Urban and Environment Planning Law at national level and at provincial level is recommended to enable the urban planning to ensure the sustainable development in Pakistan. (author)
Nicola J Brown
Full Text Available Centrosomes consist of two centrioles embedded in pericentriolar material and function as the main microtubule organising centres in dividing animal cells. They ensure proper formation and orientation of the mitotic spindle and are therefore essential for the maintenance of genome stability. Centrosome function is crucial during embryonic development, highlighted by the discovery of mutations in genes encoding centrosome or spindle pole proteins that cause autosomal recessive primary microcephaly, including Cep63 and Cep152. In this study we show that Cep63 functions to ensure that centriole duplication occurs reliably in dividing mammalian cells. We show that the interaction between Cep63 and Cep152 can occur independently of centrosome localisation and that the two proteins are dependent on one another for centrosomal localisation. Further, both mouse and human Cep63 and Cep152 cooperate to ensure efficient centriole duplication by promoting the accumulation of essential centriole duplication factors upstream of SAS-6 recruitment and procentriole formation. These observations describe the requirement for Cep63 in maintaining centriole number in dividing mammalian cells and further establish the order of events in centriole formation.
Klymchuk Alyona O.
Full Text Available The article considers evolution of development of the paradigm of ensuring competitive advantages of an enterprise. Foreign and domestic scientists focus on individual directions of development of competitive advantages and pay insufficient attention to new management concepts – development of the information society, knowledge economy and dynamism of integration processes. The goal of the study is formation of the modern paradigm of ensuring competitive advantages of an enterprise with consideration of tendencies of development of the knowledge economy, information society and integration processes. Enterprise competitiveness is a synergetic characteristic, which reflects enterprise capability of dynamic response to changes of the market situation with the aim of keeping predominance over other economic subjects. Management of the future, on the basis of the management 2.0 concept, should take into account interests not only of top management and shareholders but also employees, local communities and territories and meet requirements of the society in general, individual groups of consumers and tendencies of development of managerial and information technologies. The paradigm of the modern theory of ensuring competitive advantages should include models of keeping competitive advantages in the existing markets and models of development of future markets; strategy of development of enterprise competitiveness, human capital development and efficient enterprise management.
Mikš-Krajnik, Marta; Yuk, Hyun-Gyun; Kumar, Amit; Yang, Yishan; Zheng, Qianwang; Kim, Min-Jeong; Ghate, Vinayak; Yuan, Wenqian; Pang, Xinyi
Food safety and food security are interrelated concepts with a profound impact on the quality of human life. Food security describes the overall availability of food at different levels from global to individual household. While, food safety focuses on handling, preparation and storage of foods in order to prevent foodborne illnesses. This review focuses on innovative thermal and non-thermal technologies in the area of food processing as the means to ensure food security through improving food safety with emphasis on the reduction and control of microbiological risks. The antimicrobial efficiency and mechanism of new technologies to extend the shelf life of food product were also discussed.
Kurenkov, A V; Iuriatin, A A
The work conditions often may compromise a company ability to supply their employees with adequate, hot meals. For heavy labor workers and some office employees it is important to restore energy and nutrients with food, balanced in nutrients. The lack of adequate nutritive support can give a negative impact on different organs functions. One of the main principles of healthy nutrition is - diet must be balanced in nutrients. Which is easy to say, but difficult to implement, especially on some industries. Complete and balanced liquid and ready-to-use nutrition is new trend in nutrition of healthy people who cannot consume optimal diet, and in people with the risk of nutrient deficiencies. One-two packs of Ensure daily can significantly improve a worker ration. 2 and more packs could serve as a real complete and balanced lunch (>or=780 kcal). Also Ensure is easy to store and to deliver in distant places of work and can be recommended for use as a convenient, complete and balanced nutrition on work.
Kozyk Vasyl V.
Full Text Available The article considers the process of formation of the investment-innovation mechanism of ensuring competitiveness of industrial enterprises. It identifies the essence, composition, goals and means of functioning of this mechanism. It establishes sequence of the process of functioning of the investment-innovation mechanism of ensuring competitiveness of economic subjects. It marks out such particular types of this mechanism: mechanism of renovation of fixed assets of an enterprise, mechanism of formation of channels and network of sales of enterprise products, mechanism of expansion of production capacity of the enterprise on manufacture of traditional types of products, mechanism of introduction of new progressive production processes, mechanism of development and production of innovation products, and mechanism of reduction of the level of risk of investment activity of the enterprise. The article conducts modelling of the process of development and realisation of investment solutions on introduction of progressive technologies of manufacture of products at the enterprise. It offers a method of selection of the most competitive variant of technology of manufacture of products depending on the level of quality and also specific current capital outlays for their manufacture.
Z. L. Garipova
Full Text Available The decision of the important social task - ensuring the availability of housing for the mass of the population of the country, on the one hand, allowed to launch investment, savings, financial and credit mechanisms for ensuring economic growth of the Russian economy on the other. Despite the high degree of sophistication in the scientific literature of the organization of mortgage lending system, a study of its impact on economic growth factors in the scientific literature clearly insufficient. The original article was the theory of economic growth, which allowed on the basis of research of interaction of demand for residential property, it deals with the housing mortgage credit to justify a conclusion about its importance not only for solution of social tasks, availability of housing, but also a significant impact on the demand and supply on the residential property market. Based on the analysis of statistical data for the period from 2006 to 2012, and their correlation analysis carried out research of factors of development of housing markets and mortgage lending, namely incomes, housing prices, interest rates on loans, «channel lending conditions, the terms of banking mortgage.Purchase on Elibrary.ru > Buy now
Tatiana Anatol’evna Naidenova
Full Text Available The main tools of sustainable development of the country as a whole and its individual regions are federal and regional budgets. At the same time a prerequisite for the use of this tool is its equilibrium. It is the basic principle of a responsible fiscal policy. The article describes the factors to equilibrium. on the budgets of the northern regions of the Russian Federation. The measures to ensure budgetary equilibrium in the northern regions of the Russian Federation are offered.The purpose of the article. Substantiating the measures to balance the budgets of the northern Russian Federation subjects on the basis of analysis of the factors that directly affect the mobilization of potential tax revenues to regional budgets.Method and methodology of work. Theoretical and empirical methods, analysis, synthesis, induction, deduction.Results of the study. To ensure factors unbalanced budgets northern territories. The proposals the balance of revenues and expenditures of the regional budgets of the northern regions of the Russian Federation are submitted.Application area. Finance authorities of subjects of the Russian Federation.
Scheers, B.; Bloemen, S.; Mühleisen, H.; Schellart, P.; van Elteren, A.; Kersten, M.; Groot, P. J.
Coming high-cadence wide-field optical telescopes will image hundreds of thousands of sources per minute. Besides inspecting the near real-time data streams for transient and variability events, the accumulated data archive is a wealthy laboratory for making complementary scientific discoveries. The goal of this work is to optimise column-oriented database techniques to enable the construction of a full-source and light-curve database for large-scale surveys, that is accessible by the astronomical community. We adopted LOFAR's Transients Pipeline as the baseline and modified it to enable the processing of optical images that have much higher source densities. The pipeline adds new source lists to the archive database, while cross-matching them with the known cataloguedsources in order to build a full light-curve archive. We investigated several techniques of indexing and partitioning the largest tables, allowing for faster positional source look-ups in the cross matching algorithms. We monitored all query run times in long-term pipeline runs where we processed a subset of IPHAS data that have image source density peaks over 170,000 per field of view (500,000 deg-2). Our analysis demonstrates that horizontal table partitions of declination widths of one-degree control the query run times. Usage of an index strategy where the partitions are densely sorted according to source declination yields another improvement. Most queries run in sublinear time and a few (processing IPHAS data is 25 s.
About 60% of the discovered geologic reserves of crude in Serbo Croatia is under the influence of efficient water drive conditions, as in reservoirs with large oil reserves, where dissolved gas drive is prevalent. The method of formation pressure maintenance by waterflooding and that of gas injection is applied, its purpose being to increase oil recovery and the profit of exploitation. Waterflooding also will be used in other reservoirs where possible; however, 50 to 60% of the initial oil reserves is still retained in the reservoirs. An analysis has been made of possibilities of the well-known and currently used methods for increasing oil recovery without studying the economic aspects of the procedures, the quality of oil, the extent of reservoir recovery, and the methods of reservoir exploitation. In view of the large reserves available, carbon dioxide is especially interesting. The use of liquefied hydrocarbon gases is not possible because no sufficient amounts are available. The use of sodium hydroxide and thermic methods is reserved for special types of oil.
Sehnal, David; Svobodová Vařeková, Radka; Pravda, Lukáš; Ionescu, Crina-Maria; Geidl, Stanislav; Horský, Vladimír; Jaiswal, Deepti; Wimmerová, Michaela; Koča, Jaroslav
Following the discovery of serious errors in the structure of biomacromolecules, structure validation has become a key topic of research, especially for ligands and non-standard residues. ValidatorDB (freely available at http://ncbr.muni.cz/ValidatorDB) offers a new step in this direction, in the form of a database of validation results for all ligands and non-standard residues from the Protein Data Bank (all molecules with seven or more heavy atoms). Model molecules from the wwPDB Chemical Component Dictionary are used as reference during validation. ValidatorDB covers the main aspects of validation of annotation, and additionally introduces several useful validation analyses. The most significant is the classification of chirality errors, allowing the user to distinguish between serious issues and minor inconsistencies. Other such analyses are able to report, for example, completely erroneous ligands, alternate conformations or complete identity with the model molecules. All results are systematically classified into categories, and statistical evaluations are performed. In addition to detailed validation reports for each molecule, ValidatorDB provides summaries of the validation results for the entire PDB, for sets of molecules sharing the same annotation (three-letter code) or the same PDB entry, and for user-defined selections of annotations or PDB entries. © The Author(s) 2014. Published by Oxford University Press on behalf of Nucleic Acids Research.
Full Text Available Yucai Zhang,1 Xiaorui Zhang,1 Anqi Zhang,2 Ke Li,2 Kai Qu3 1Department of Health, 2Department of Central Laboratory, Liaocheng People’s Hospital of Taishan Medical University, Liaocheng, Shandong, 3Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China Purpose: This study aimed to systematically evaluate the efficacy and safety of dendritic cells–cytokine-induced killer (DC–CIK cells immunotherapy in treating pancreatic cancer (PC patients. Methods: Data were collected from published articles of clinical trials. Databases including Web of Science, EMBASE, PubMed, Cochrane Library, Wanfang, and CNKI were searched. The main outcome measures in this research included the overall response rate (ORR, disease control rate (DCR, overall survival (OS, patients’ quality of life (QoL, immune function, and adverse events. Comparative analysis was conducted between DC–CIK immunotherapy and chemotherapy (combined therapy and chemotherapy alone. Results: This analysis covered 14 trials with 1,088 PC patients involved. The combined therapy showed advantages over chemotherapy alone in ORR (odds ratio [OR] =1.69, 95% confidence interval [CI] =1.20–2.38, P=0.003, DCR (OR =2.33, 95% CI =1.63–3.33, P<0.00001, OS (1-year OS, OR =3.61, 95% CI =2.41–5.40, P<0.00001; 3-year OS, OR =2.65, 95% CI =1.56–4.50, P=0.0003 and patients’ QoL (P<0.01 with statistical significance. After immunotherapy, lymphocyte subsets’ percentages of CD3+ (P<0.00001, CD4+ (P=0.01, CD3+CD56+ (P<0.00001, and cytokine levels of IFN-γ (P<0.00001 were significantly increased, and the percentages of CD4+CD25+CD127low (P<0.00001 and levels of IL-4 (P<0.0001 were significantly decreased, whereas analysis on CD8+ (P=0.59 and CD4+/CD8+ ratio (P=0.64 did not show a significant difference. Conclusion: The combination of DC–CIK immunotherapy and chemotherapy is effective for PC treatment, indicated by prolonging the PC patients’ survival time, which benefit from reconstructed immune function of patients. Keywords: cytokine-induced killer cells, dendritic cells, pancreatic cancer, immunotherapy, meta-analysis
Csako, D.; Torok, A.; Vasvari, V.
Hungarian engineers enumerate the factors to consider in the planning, construction, and expansion of gas pipeline systems to obtain an optimum solution, both technically and economically. Future development of pipeline systems in Hungary will place equal emphasis on system quality and network expansion.
This paper provides further compelling evidence for 'an immediate, massive effort to control CO2 emissions, stopped by mid-century' (Cai, Lenton & Lontzek, 2016). Atmospheric CO2 which is above 405 ppm (actual and trend) still accelerating, despite flat emissions since 2014, with a 2015 >3ppm unprecedented spike in Earth history (A. Glikson),is on the worst case IPCC scenario. Atmospheric methane is increasing faster than its past 20-year rate, almost on the worst-case IPCC AR5 scenario (Global Carbon Project, 2016). Observed effects of atmospheric greenhouse gas (GHG) pollution are increasing faster. This includes long-lived atmospheric GHG concentrations, radiative forcing, surface average warming, Greenland ice sheet melting, Arctic daily sea ice anomaly, ocean heat (and rate of going deeper), ocean acidification, and ocean de-oxygenation. The atmospheric GHG concentration of 485 ppm CO2 eq (WMO, 2015) commits us to 'about 2°C' equilibrium (AR5). 2°C by 2100 would require 'substantial emissions reductions over the next few decades' (AR5). Instead, the May 2016 UN update on 'intended' national emissions targets under the Paris Agreement projects global emissions will be 16% higher by 2030 and the November 2016 International Energy Agency update projects energy-related CO2 eq emissions will be 30% higher by 2030, leading to 'around 2.7°C by 2100 and above 3°C thereafter'. Climate change feedback will be positive this century and multiple large vulnerable sources of amplifying feedback exist (AR5). 'Extensive tree mortality and widespread forest die-back linked to drought and temperature stress have been documented on all vegetated continents' (AR5). 'Recent studies suggest a weakening of the land sink, further amplifying atmospheric growth of CO2' (WMO, 2016). Under all but the best-case IPCC AR5 scenario, surface temperature is projected to increase above 2°C by 2100, which is above 3°C (equilibrium) after 2100, with ocean acidification still increasing at 2100. Ocean heat is increasing under all scenarios at 2100. For all producing regions 'With or without adaptation, negative impacts on average crop yields become likely from the 2030s' (AR5). Crop models do not capture all adverse effects. The climate change of 2030 is practically locked in. NASA NEX downscaled daily maximum temperature projections at 1.5°C are incompatible with today's crop yields in major agricultural regions. Climate-change-related impacts from extreme events are high at 1.5°C (AR5) and add to modeled crop declines. 'Some unique and threatened systems are already at risk from climate change (high confidence)' with 'risk of severe consequences' higher with warming of around 1.5°C (AR5). At today's surface temperature increase, 'risks associated with tipping points become moderate' and 'increase disproportionately' as temperature increases above 1.5°C (AR5). According to mitigation projections, global emissions would decline forthwith for a better than 66% chance of a 2°C limit by 2100 (over 3°C after 2100). Failure to do so would risk the future sustainability of civilization and the human population. The IPCC does not make recommendations so this falls on scientists. By recommending immediate (emergency) massive action on CO2, the science community would make a momentous contribution to the future of humanity.
E. de Vries (Esther); S. Houterman (Saskia); M.L.G. Janssen-Heijnen (Maryska); T.E.C. Nijsten (Tamar); S.A.M. van de Schans (Saskia); A.M.M. Eggermont (Alexander); J.W.W. Coebergh (Jan Willem)
textabstractBackground: We present survival outcomes of patients registered in the Dutch population-based Eindhoven Cancer Registry (ECR). Patients and methods: Data on patients diagnosed with a melanoma between 1980 and 2002 were obtained from the ECR. Data on vital status up to 1 January 2005 were
Juan Manuel Toro Escobar
Full Text Available Adequate use of antihypertensive drugs is one of the key elements to guarantee the achievement of blood pressure goals and the adherence of patients to treatment, in order to diminish the absolute cardiovascular risk. This article is a narrative review based on a systematic literature search in which randomized, controlled studies of initial antihypertensive therapy were selected and treatments with drugs of two or more groups were compared having as outcome the reduction of cardiovascular events. El uso adecuado de los medicamentos antihipertensivos es fundamental para garantizar el cumplimiento de las metas de presión arterial y la adherencia de los pacientes al tratamiento de la hipertensión, elementos necesarios para cumplir con el objetivo fundamental de disminuir el riesgo absoluto cardiovascular de los pacientes. Esta es una revisión narrativa basada en una búsqueda sistemática de la literatura, en la cual se seleccionaron los estudios aleatorizados controlados de terapia antihipertensiva inicial y se compararon tratamientos entre fármacos de dos o más grupos, que tengan como desenlace la reducción de eventos cardiovasculares.
Mueller, Michael; Schmiechen, Katharina
In accordance with alterations of the political and economical settings of Central Europe in the last decades, the characteristics of NBC hazards have changed. Since war appears unlikely, possible new scenarios involve pandemics, chemical transport accidents or distribution of CB warfare agents and radioactive materials by terroristic acts. Meeting this situation requires new protection and self aid equipment for the German civilian disaster relief forces. The German government has reacted to these risks by designing personal protection equipment for the civilian voluntary and professional disaster relief forces. The new NBC self aid kit will be part of this effort. The scientific approach of the project consisted of an updated risk analysis, a questionnaire for the professionals and volunteers involved in disaster management, a thorough evaluation of commercially available kits and single components, final design of the new kit including user instructions, and validation of a prototype kit in a disaster relief exercise. Results of the questionnaire stressed the need for a NBC self aid kit fulfilling the demands of easy handling, use of commercially available components, stability of materials, consumption adapted supply and portable size and weight of the complete kit. The evaluation of international NBC equipment could not identify any current NBC self aid kit which satisfies all needs of the German civilian disaster relief forces. The authors therefore compiled a new kit consisting of commercially available components. The newly developed kit was evaluated in a disaster relief exercise.
Full Text Available Cardiac surgical operations are associated with the development of a systemic inflammatory response syndrome (SIRS. In most cases, the inflammatory response is apparent only in its subclinical form. In some cases, however, it can become clinically manifest or even life-threatening. This review article presents some new data regarding its biological importance, along with an insight into the recently discovered role played by heat shock proteins 60 and 70.
Postema, Pieter G.; Wolpert, Christian; Amin, Ahmad S.; Probst, Vincent; Borggrefe, Martin; Roden, Dan M.; Priori, Silvia G.; Tan, Hanno L.; Hiraoka, Masayasu; Brugada, Josep; Wilde, Arthur A. M.
BACKGROUND Worldwide, the Brugada syndrome has been recognized as an important cause of sudden cardiac death in individuals at a relatively young age. Importantly, many drugs have been reported to induce the characteristic Brugada syndrome-linked ECG abnormalities and/or (fatal) ventricular
Full Text Available Angiolymphoid hyperplasia with eosinophilia (ALHE is a rare and idiopathic vascular disorder. It is characterized by red to brown papules or nodules dislocated in the dermis or subcutaneous tissue. These lesions are typically localized on the head and neck, particularly around the ear as singular or multiple nodules. Although ALHE is a benign disease, lesions are often persistent and difficult to eradicate. ALHE can occur in all races, but it is reported more frequently in Asians. Young to middle-aged women are more commonly affected. The histological examination corresponds to a florid vascular proliferation with atypical endothelial cells surrounded by a lymphocytic and eosinophilic infiltrate. We describe the case of a 67-year-old Caucasian man with a nodular lesion in the right postauricular region for 3 years. The histological examination was consistent with ALHE. Monthly intralesional corticosteroid injections were performed for 6 months, and complete remission was achieved. After 10 years of follow-up, the patient is free of recurrence.
Full Text Available Adverse perinatal outcomes in singleton IVF pregnancies have been most often explained by parental underlying diseases and so far laboratory conditions during embryo culture are still not explored well. The following review discusses the current state of knowledge on the influence of IVF laboratory procedures on the possible perinatal outcome. The role of improved media for human embryo culture is unquestionable. Addition of certain components to culture media and their effect on embryo survival and implantation rates have been taken into consideration recently and studied on animal model. Impact of media on perinatal outcome in IVF offspring has also been studied. It has been discovered that epigenetic changes and neonatal birth weight are probably associated with the use of specific culture media, as is the relation between placental size and its influence on perinatal outcome. There are still questions in the discussion about duration of embryo culture (cleavage stage versus blastocyst transfer. Some of the IVF methods, such as in vitro maturation of oocytes and freezing/thawing procedures, also require well-powered randomized controlled trials in order to define their exact impact on perinatal outcome. Constant further research is needed to assess the impact of laboratory environment on fetal and postnatal development.
Aibek E. Mirrakhimov
Full Text Available Patients with nephrotic syndrome are at an increased risk for thrombotic events; deep venous thrombosis, renal vein thrombosis, and pulmonary embolism are quite common in patients with nephrotic syndrome. It is important to note that nephrotic syndrome secondary to membranous nephropathy may impose a greater thrombotic risk for unclear reasons. Increased platelet activation, enhanced red blood cell aggregation, and an imbalance between procoagulant and anticoagulant factors are thought to underlie the excessive thrombotic risk in patients with nephrotic syndrome. The current scientific literature suggests that patients with low serum albumin levels and membranous nephropathy may benefit from primary prophylactic anticoagulation. A thorough approach which includes accounting for all additional thrombotic risk factors is, therefore, essential. Patient counseling regarding the pros and cons of anticoagulation is of paramount importance. Future prospective randomized studies should address the question regarding the utility of primary thromboprophylaxis in patients with nephrotic syndrome.
Full Text Available Cystic fibrosis (CF is the most common autosomal recessive lethal hereditary disorder among whites. Survival of patients with CF has progressively improved over the last four decades.As life expectancy has been greatly extended, complications like osteopenia and CF-related diabetes mellitus (CFRDM occur. In our article, a new management of these two complications is described.Gastrointestinal tract, exocrine pancreas and liver are also affected in CF.Maintaining good nutrition while treating pancreatic insufficiency, treating gastroesophageal reflux disease and treating liver disease are very important issues in the treatment gastrointestinal tract disease in CF.As the CF patient population median survival increases, a growing number of adolescents require care in the adult health care system which must be capable of responding appropriately to their needs.We present a model of transition from paediatric to adult medical care in our CF center.
Full Text Available Learn how Heriot-Watt University Library's WattJournals could be just the search tool your patrons need to efficiently find the content that your library subscribes to. Built on top of a RESTful search API created by the JISC-sponsored JournalTOCs Project, WattJournals is a toolkit for connecting fulltext articles to the people who need them. This article provides a technical overview of the system, showing how it uses citation data pulled from the JournalTOCs table of contents awareness service to provide access to just your library's subscriptions.
Nachman, C.; Holman, A.; DeMaster, D.
Commercial, industrial, and research interests in the Arctic are expanding rapidly. Potentials are numerous and exciting, giving rise to the need for guidelines to ensure interactions among waterway users do not conflict. Of particular concern is the potential for adverse impacts to U.S. Arctic coastal communities that rely on living marine resources for nutritional and cultural health, through subsistence hunts from small craft, ice edges, and shore. Recent events raised concerns over research surveys potentially interfering with subsistence hunts in the Bering, Chukchi, and Beaufort Seas. Incidents led to calls by Native Alaskan communities to restrict science activities with a mixed response from the scientific community (i.e., some sympathetic, some defensive). With a common goal of wanting to mitigate this potential interaction, Federal agencies made a commitment in the National Strategy for the Arctic Region to coordinate and consult with Alaska Natives and also to pursue responsible Arctic stewardship, with understanding through scientific research and traditional knowledge. The effort to create a "Standard of Care" for research surveys incorporates years of experience by subsistence hunters working to mitigate impacts of other anthropogenic activities in the region, as well as best practices by many in the research community. The protocols are designed to ensure potential conflicts between the scientific research community and subsistence hunters are avoided and to encourage mutual assistance and collaboration between researchers and hunters. The guidelines focus on enhancing communication between researchers and subsistence hunters before, during, and after research occurs. The best management practices outlined in the Standard of Care assist those overseeing and funding scientific research in making decisions about how best to accomplish the goals of the research while ensuring protection of the Alaska subsistence lifestyle. These protocols could also be
E. V. Sibirskaia
Full Text Available Summary. At the present stage of development of economy by the main criterion of its efficiency competitiveness is. In process of involvement of Russia in world economic communications the accent in questions of competitiveness moves on the enterprises of small innovative business and to large economic entities. In this article the typology of ensuring competitiveness of small innovative and large business on the basis of forms of their interaction as one of competitiveness methodology elements is considered. The classifications of the competition and competitiveness offered by various authors that is obvious from the material given in article, have something in common with each other. Formation of the competitive relations promotes creation of the developed, civilized market that includes various spheres of managing. Thanks to active interest in problems of increase of competitiveness of subjects of small innovative and large business who arose in a consequence of development of the market relations, there was a large number of the development directed on the solution of this methodological problem. The typology of researches is one of the key moments of methodology of research. Researches can be different. It is necessary to see and understand this variety to choose the ensuring competitiveness of small innovative and large business, most suitable to process. It is possible to order all set of the most various types of researches in the table of the typological analysis. It represents dichotomizing representation of various types of ensuring competitiveness allocated by various criteria. Criteria reflect the main characteristics of research and its practical requirements. In conclusion of consideration of historical prerequisites to formation of ideas of the competition we will note that ideas of the competition evolved owing to complication of the social economic relations in society. Thus, now in social and economic space it is possible to
Lee, Joon-Goo; Kim, Sheen-Hee; Kim, Hae-Jung; Yoon, Hae-Jung
With the diversification and internationalization of the food industry and the increased focus on health from a majority of consumers, food safety policies are being implemented based on scientific evidence. Risk analysis represents the most useful scientific approach for making food safety decisions. Total diet study (TDS) is often used as a risk assessment tool to evaluate exposure to hazardous elements. Many countries perform TDSs to screen for chemicals in foods and analyze exposure trends to hazardous elements. TDSs differ from traditional food monitoring in two major aspects: chemicals are analyzed in food in the form in which it will be consumed and it is cost-effective in analyzing composite samples after processing multiple ingredients together. In Korea, TDSs have been conducted to estimate dietary intakes of heavy metals, pesticides, mycotoxins, persistent organic pollutants, and processing contaminants. TDSs need to be carried out periodically to ensure food safety.
CMS utilizes a distributed infrastructure of computing centers to custodially store data, to provide organized processing resources, and to provide analysis computing resources for users. Integrated over the whole system, even in the first year of data taking, the available disk storage approaches 10 petabytes of space. Maintaining consistency between the data bookkeeping, the data transfer system, and physical storage is an interesting technical and operations challenge. In this paper we will discuss the CMS effort to ensure that data is consistently available at all computing centers. We will discuss the technical tools that monitor the consistency of the catalogs and the physical storage as well as the operations model used to find and solve inconsistencies.
Kato, A.; Lazare, B.; Oltrogge, D.; Stokes, H.
The ISO / Technical Committee 20 / Sub-committee 14 develops debris-related standards and technical reports to mitigate debris and help ensure mission and space sustainability. While UN Guidelines and the IADC Guidelines encourage national governments and agencies to promote debris mitigation design and operation, the ISO standards will help the global space industry promote and sustain its space-related business. In this paper the scope and status of each ISO standard is discussed within an overall framework. A comparison with international guidelines is also provided to demonstrate the level of consistency. Finally, as a case study, the ISO standards are applied to a CubeSat mission, thus demonstrating their usability on a relatively recent and popular class of satellite.
Imran Ali Jokhio
Full Text Available A central authentication service to EPC (Electronic Product Code system architecture is proposed in our previous work. A challenge for a central service always arises that how it can ensure a certain level of delay while processing emergent data. The increasing data in the EPC system architecture is tags data. Therefore, authenticating increasing number of tag in the central authentication service with a deterministic time response is investigated and a distributed authentication service is designed in a layered approach. A distributed design of tag searching services in SOA (Service Oriented Architecture style is also presented. Using the SOA architectural style a self-adaptive authentication service over Cloud is also proposed for the central authentication service, that may also be extended for other applications.
Full Text Available Pain management in the context of pediatric palliative care can be challenging. The present article reviews, through a case-based presentation, the nonpharmacological and pharmacological methods used to ensure adequate pain control in children facing end of life. Details on the impressive range of opioid dosages required and routes of administration are highlighted from published literature and clinical experience. Where available, evidence-based recommendations are provided. Potential side effects of pain medication and barriers to good pain control are discussed. Novel analgesics and innovative delivery methods are presented as future tools enhancing pain relief at the end of life. Some challenges to ethically grounded research in this important context of care are reviewed.
Terzic, Andre; Behfar, Atta
Patient-derived stem cells enable promising regenerative strategies, but display heterogenous cardiac reparative proficiency, leading to unpredictable therapeutic outcomes impeding practice adoption. Means to establish and certify the regenerative potency of emerging biotherapies are thus warranted. In this era of clinomics, deconvolution of variant cytoreparative performance in clinical trials offers an unprecedented opportunity to map pathways that segregate regenerative from non-regenerative states informing the evolution of cardio-regenerative quality systems. A maiden example of this approach is cardiopoiesis-mediated lineage specification developed to ensure regenerative performance. Successfully tested in pre-clinical and early clinical studies, the safety and efficacy of the cardiopoietic stem cell phenotype is undergoing validation in pivotal trials for chronic ischemic cardiomyopathy offering the prospect of a next-generation regenerative solution for heart failure. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
de Wilde, Sofieke; de Jong, Maria G H; Le Brun, Paul P H; Guchelaar, Henk-Jan; Schimmel, Kirsten J M
Most medicinal products dispensed to patients have marketing authorization (MA) to ensure high quality of the product, safety, and efficacy. However, in daily practice, to treat patients adequately, there is a medical need for drugs that do not hold MA. To meet this medical need, medicinal products are used in clinical care without MA (unlicensed), such as products prepared by (local) pharmacies: the pharmaceutical preparations. Three types of pharmaceutical preparations are distinguished: (i) reconstitution in excess of summary of product characteristics; (ii) adaptation of a licensed medicinal product (outside its official labeling); (iii) medicinal products from an active pharmaceutical ingredient. Although unlicensed, patients may expect the same quality for these unlicensed pharmaceutical preparations as for the licensed medicinal products. To assure this quality, a proper risk-benefit assessment and proper documentation in (centralized) patient registries and linking to a national pharmacovigilance database should be in place. Based on a risk assessment matrix, requirements for quality assurance can be determined, which has impact on the level of documentation of a pharmaceutical preparation. In this paper, the approach for good documentation including quality assurance and benefit-risk assessment will be discussed and possibilities for patient registries are described to make these crucial preparations available for regular patient care. KEY POINTS Ensuring pharmaceutical quality and performing a proper benefit-risk assessment will guarantee safe use of pharmaceutical preparations. Good documentation of (ultra-)orphan treatments can be collected in centralized patient registries and should be combined with existing information in (inter)national databases and self-reflection of patients. Linking patient registries to a centralized database for adverse drug events is highly recommended as it increases safety control of the (ultra) orphan pharmaceutical
Joseph, Danson Michael; Haigh, Peter; McCullagh, Joseph [National Grid Electricity Transmission, Warwick (United Kingdom). Electricity Network Investment
The prevalence of cabled infrastructure associated with wind farms, combined with the surge in power-electronic interfaces in wind turbines and reactive power plant, has highlighted the pervasive nature of harmonics on electricity networks. Insufficient consideration is given to the effects of harmonics through the low prioritisation of power quality in the Front-End Engineering and Design (FEED) and a lack of awareness of the obligations of the respective parties involved. The resulting designs are incompatible with the requirements of the relevant Grid Codes. This can lead to delays, commercial exposure, restricted network access and subsequent loss of revenue. The obligations of the Transmission Owner (TO), System Operator (SO), and wind farm developer are discussed with respect to Grid Code requirements and the responsibilities of each party in ensuring compliance. The technical aspects of accessing harmonic compliance are described in the context of the design considerations which are made at the various stages of the project development. These include the shift in resonances within the host network, the modification of existing harmonic distortion, and the propagation of injected harmonics into the network and through to the EHV, HV and MV substations. The ensuing challenges associated with ensuring compliance through filter design are discussed in the context of relevant international standards, including UK ER G5/4-1, IEEE 519, EN 50160 and IEC 61000-3-6. The results indicate that shifts in resonances are more problematic to resolve, compared to the propagation of injected harmonics: Injected harmonics are readily absorbed through local filtering and thus the emissions are typically low; in contrast, the affects of shifts in resonances must be transferred back to the point of common coupling, resulting in complex local filtering. Early selection by the developer of appropriate transmission infrastructure and technology can lower the filtering requirement
Methodical Support of Using of Up-to-Date Recruiting Methods at the Machine-Building Enterprises Методическое обеспечение использования современных методов подбора персонала на машиностроительных предприятиях
Zhilyaeva Irina Y.
Full Text Available The methodical approach for assessment of recruiting state using the integral index of recruiting quality, and methodical approach for choice of recruiting methods using factor analysis are proposed in the article. The methodical approach for using up-to-date recruiting methods is proposed.В статье предложены методические подходы к оценке состояния рекрутинга персонала с помощью введения интегрального показателя качества рекрутинга персонала и выбора методов подбора персонала на стадии оценивания кандидатов с помощью факторного анализа. Предложен методический поход по использованию современных методов подбора персонала.
Tatyana A. Salimova
Full Text Available Objective to substantiate the functional directions of activities of the enterprises of dealer chain of an automotive company aimed at ensuring the quality of logistics servicing of automobiles. Methods the study is based on the use of general scientific methods comparison scientific generalization logical analysis analogy and specific scientific methods systemic functional simulation. Results the article states that one of the key criteria of consumer behavior of car buyers is the availability of presales and aftersales service. The current research works in the sphere of logistics services are analyzed which refer to the approaches to its definition as well as selecting the criteria for its functional quality. It is established that the increase of interest in the activities of logistics centers of car service is due to several reasons such as the growing complexity of their construction and the increased competition in this area. The critical review of the scientific literature was conducted as well as the analysis of the scientific problem of determining the functional areas of logistics service of an automobile company with a view to ensuring quality and enhancing the satisfaction of end users of automobiles. The key areas of corporate logistics services were systematized and classified detailing for each of these areas was made. Different approaches were described to defining the range of services at different stages of the life cycle of technical means. Basing on the studied viewpoints four components of the functional activities of service centers were formulated presales service car sales aftersales maintenance and disposal of vehicles. Basing on these components a model of brand service of a car company was formed taking into account the functional characteristics of each component. Scientific novelty a functional model was developed of the system of service vehicles in a brand servicesales chain automotive company allowing to provide
Ferraro, Simona; Panteghini, Mauro
This review highlights the role of laboratory professionals and the strategies to be promoted in strict cooperation with clinicians for auditing, monitoring and improving the appropriateness of test request. The introduction of local pathways and care maps in agreement with international and national guidelines as well as the implementation of reflex testing and algorithms have a central role in guiding test request and in correcting the overuse/misuse of tests. Furthermore, removing obsolete tests from laboratory menu and vetting of restricted tests is recommended to increase cost-effectiveness. This saves costs and permits to introduce new biomarkers with increased diagnostic accuracy with a better impact on patient outcome. An additional issue is concerning the periodicity of (re)testing, accounting that only a minority of tests may be ordered as often as necessary. In the majority of cases, a minimum retesting interval should be introduced. The availability of effective computerised order entry systems is relevant in ensuring appropriate test requests and in providing an aid by automated rules that may stop inappropriate requests before they reach the laboratory. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
Cell cycle events are driven by Cyclin dependent kinases (CDKs and by their counter-acting phosphatases. Activation of the Cdk1:Cyclin B complex during mitotic entry is controlled by the Wee1/Myt1 inhibitory kinases and by Cdc25 activatory phosphatase, which are themselves regulated by Cdk1:Cyclin B within two positive circuits. Impairing these two feedbacks with chemical inhibitors induces a transient entry into M phase referred to as mitotic collapse. The pathology of mitotic collapse reveals that the positive circuits play a significant role in maintaining the M phase state. To better understand the function of these feedback loops during G2/M transition, we propose a simple model for mitotic entry in mammalian cells including spatial control over Greatwall kinase phosphorylation. After parameter calibration, the model is able to recapture the complex and non-intuitive molecular dynamics reported by Potapova et al. (Potapova et al., 2011. Moreover, it predicts the temporal patterns of other mitotic regulators which have not yet been experimentally tested and suggests a general design principle of cell cycle control: latching switches buffer the cellular stresses which accompany cell cycle processes to ensure that the transitions are smooth and robust.
The life extension of the power plants is considered whereas EDF must face an acceleration of the retirement rates due to the fact that the first generations of the baby-boom are ageing 60 years, now. Between 2000 and 2006, EDF gradually set up a system of management of competencies. On the one hand, EDF moved from logic of relatively standardized training to a more individualized logic of acquisition of competencies. In addition, the objective of maintenance of internat competencies defined in 2000 was supplemented in 2003 by a prospective dimension intended to anticipate the departures in inactivity. Then in 2006 competencies of sub-contractors were taken into account. During this period I.R.S.N. has assessed 3 times this system of management. This article briefly presents the principal lessons driven from these evaluations. It accounts for the undeniable effort made by EDF to ensure the maintenance of its competencies. However, it stresses that a high level of vigilance is still needed because it is not stabilized already. (author)
Hammad, A. A.; Swailam, H.M.; Aly, W. F.
Egg shell sanitizing practices are necessary to improve microbiological safety of fresh eggs. In this work, fifteen fresh eggs samples of each (Balady, White and Brown eggs) were collected from different local supermarkets to evaluate their microbiological quality. The results indicated that Balady eggs were higher in microbial population in comparison with the two other varieties. Salmonella spp. was detected in 9 (60%) samples of Balady eggs. The effect of gamma irradiation at dose of 0, 2, 3 and 4 kGy on microbiological quality of Balady eggs during storage at 4±1 degree C for 35 days was studied. The effects of irradiation and storage on total cholesterol, and total carotenoids contents in Balady eggs were also investigated. The results showed that irradiation at 3 kGy reduced total aerobic bacterial counts. Coliform bacteria, E. coli and Salmonella spp. were completely eliminated. Total cholesterol and total carotenoids were decreased in yolk egg as a result of irradiation. Treated Balady eggs with irradiation dose of 3 kGy were efficient and sufficient for ensuring safety, maintain quality and extend shelf-life.
This report discusses several methodologies which may be used to ensure the structural integrity of containment systems to be used for the transport and storage of high-level radioactive substances. For economic reasons, shipping containers constructed of ferritic materials are being considered for manufacture by vendors in the US and Europe. Ferritic show an inherent transition from a ductile, high energy failure mode to a brittle, low energy fracture mode with decreasing temperature. Therefore, formal consideration of means by which to avoid unstable brittle fracture is necessary prior to the licensing of ferritic casks. It is suggested that failure of a shipping container wall be defined as occurring when a flaw extends through the outer wall of the containment system. Crack initiation which may lead to unstable brittle crack growth should therefore be prevented. It is suggested that a fundamental linear elastic fracture mechanics (lefm) approach be adopted on a case-by-case basis, applied perhaps by means of appropriate modifications to ASMA Section III or Section XI. A lefm analysis requires information concerning service temperatures, loading rates, flaw sizes, and applied stresses. Tentative judgments regarding these parameters for typical shipping containers have been made
Hammad, A.A; Swailam, H.M.; Abd El-Rahim, E.A.; Shallan, M.A; Aly, W.F.
Egg shell sanitizing practices are necessary to improve microbiological safety of fresh eggs. In this work, fifteen fresh eggs samples of each (balady, white and brown eggs) were collected from different local supermarkets to evaluate their microbiological quality. The results indicated that balady eggs were higher in microbial population in comparison with the two other varieties. Salmonella spp. was detected in 9 (60%) samples of balady eggs. The effect of gamma irradiation at dose of 0,2,3 and 4 kGy on microbiological quality of balady eggs during storage at 4± 1 deg c for 35 days as well as on total cholesterol , ph, and total carotenoids contents were also investigated. The results showed that irradiation at 3 kGy reduced total aerobic bacterial counts. Whereas completely eliminated coliform bacteria, E.coli and salmonella spp. Total cholesterol and total carotenoids were decreased in yolk egg. irradiation dose of 3 kGy were efficient and sufficient for ensuring safety, maintain quality and extend shelf-life of balady eggs
Sambala, Evanson Z; Sapsed, Susan; Mkandawire, Mercy L
To examine ways of ensuring access to health services within the framework of primary health care (PHC), since the goal of PHC to make universal health care available to all people has become increasingly neglected amid emerging themes of globalization, trade, and foreign policy. From a public health point of view, we argue that the premise of PHC can unlock barriers to health care services and contribute greatly to determining collective health through the promotion of universal basic health services. PHC has the most sophisticated and organized infrastructure, theories, and political principles, with which it can deal adequately with the issues of inequity, inequality, and social injustice which emerge from negative economic externalities and neo-liberal economic policies. Addressing these issues, especially the complex social and political influences that restrict access to medicines, may require the integration of different health initiatives into PHC. Based on current systems, PHC remains the only conventional health delivery service that can deal with resilient public health problems adequately. However, to strengthen its ability to do so, we propose the revitalization of PHC to incorporate scholarship that promotes human rights, partnerships, research and development, advocacy, and national drug policies. The concept of PHC can improve access; however, this will require the urgent interplay among theoretical, practical, political, and sociological influences arising from the economic, social, and political determinants of ill health in an era of globalization.
Debra Frances Campbell
Full Text Available The field of qualitative scientific inquiry employs a fast-growing variety of approaches, whose traditions, procedures, and structures vary, depending on the type of study design and methodology (i.e., phenomenological, ethnographic, grounded theory, case study, action research, etc.. With the interpretive approach, researchers do not utilize the same measures of validity used in positivist approaches to scientific inquiry, since there is "...no one standard or accepted structure as one typically finds in quantitative research" (Creswell, 2007. With the absence of a single standard, how, then, is it possible for qualitative researchers to know whether or not their study was done with rigor, that it has validity, that it is ready to submit to their peers? The research literature is sprinkled with references to quality in qualitative inquiry, which helps to construe a study's validity. Markula (2008 suggests that we validate our study's findings by assuring readers that it was done "in the best possible way." While each research tradition has its own set of criteria for judging quality, we present here general concepts drawn from the literature. We hope this article will provide a framework from which qualitative researchers can judge their work before submitting it to their peers¸ one which will help ensure that their study was done "in the best possible way."
March 2017 Task Force on Defense Strategies for Ensuring the Resilience of National Space Capabilities OFFICE OF THE UNDER SECRETARY OF...the Department of Defense. The DSB Task Force on Defense Strategies for Ensuring the Resilience of National Space Capabilities completed its formal...Ensuring the Resilience of National Space Capabilities | i DSB Task Force on Defense Strategies for Ensuring the
Full Text Available Indian health system is characterized by a vast public health infrastructure which lies underutilized, and a largely unregulated private market which caters to greater need for curative treatment. High out-of-pocket (OOP health expenditures poses barrier to access for healthcare. Among those who get hospitalized, nearly 25% are pushed below poverty line by catastrophic impact of OOP healthcare expenditure. Moreover, healthcare costs are spiraling due to epidemiologic, demographic, and social transition. Hence, the need for risk pooling is imperative. The present article applies economic theories to various possibilities for providing risk pooling mechanism with the objective of ensuring equity, efficiency, and quality care. Asymmetry of information leads to failure of actuarially administered private health insurance (PHI. Large proportion of informal sector labor in India′s workforce prevents major upscaling of social health insurance (SHI. Community health insurance schemes are difficult to replicate on a large scale. We strongly recommend institutionalization of tax-funded Universal Health Insurance Scheme (UHIS, with complementary role of PHI. The contextual factors for development of UHIS are favorable. SHI schemes should be merged with UHIS. Benefit package of this scheme should include preventive and in-patient curative care to begin with, and gradually include out-patient care. State-specific priorities should be incorporated in benefit package. Application of such an insurance system besides being essential to the goals of an effective health system provides opportunity to regulate private market, negotiate costs, and plan health services efficiently. Purchaser-provider split provides an opportunity to strengthen public sector by allowing providers to compete.
Prinja, Shankar; Kaur, Manmeet; Kumar, Rajesh
Indian health system is characterized by a vast public health infrastructure which lies underutilized, and a largely unregulated private market which caters to greater need for curative treatment. High out-of-pocket (OOP) health expenditures poses barrier to access for healthcare. Among those who get hospitalized, nearly 25% are pushed below poverty line by catastrophic impact of OOP healthcare expenditure. Moreover, healthcare costs are spiraling due to epidemiologic, demographic, and social transition. Hence, the need for risk pooling is imperative. The present article applies economic theories to various possibilities for providing risk pooling mechanism with the objective of ensuring equity, efficiency, and quality care. Asymmetry of information leads to failure of actuarially administered private health insurance (PHI). Large proportion of informal sector labor in India's workforce prevents major upscaling of social health insurance (SHI). Community health insurance schemes are difficult to replicate on a large scale. We strongly recommend institutionalization of tax-funded Universal Health Insurance Scheme (UHIS), with complementary role of PHI. The contextual factors for development of UHIS are favorable. SHI schemes should be merged with UHIS. Benefit package of this scheme should include preventive and in-patient curative care to begin with, and gradually include out-patient care. State-specific priorities should be incorporated in benefit package. Application of such an insurance system besides being essential to the goals of an effective health system provides opportunity to regulate private market, negotiate costs, and plan health services efficiently. Purchaser-provider split provides an opportunity to strengthen public sector by allowing providers to compete.
Downs, R. R.; Chen, R. S.
environmental stewardship by 2030. These efforts suggest the need for a holistic approach towards improving and implementing strategies, policies, and practices that will ensure long-term sustainability and interoperability of scientific data repositories and networks across multiple scientific domains.
significant role in improving blood safety. Centers that have incorporated antibody screen test and identification have ensured safe transfusion. Identified patients should be flagged in a database and information shared. Such patients can be given carry-on cards and educated about the names of the identified antibodies. Full red cell phenotyping of individuals, patients and donors, can be feasibility.
Full text: Uranium resources and production are on the rise with the security of uranium supply ensured for the long term, according to a new report by the OECD Nuclear Energy Agency (NEA) and the International Atomic Energy Agency (IAEA). Uranium 2011: Resources, Production and Demand, commonly referred to as the ''Red Book'', shows that total identified uranium resources have grown 12.5% since 2008. However, the costs of production have also increased, leading to reductions in lower cost category resources. These figures, which reflect the situation as of 1 January 2011, mean that total identified resources are sufficient for over 100 years of supply based on current requirements. Global uranium mine production increased by over 25% between 2008 and 2010 because of significantly increased production in Kazakhstan, currently the world's leading producer. The increased resource base has been achieved thanks to a 22% increase in uranium exploration and mine development expenditures between 2008 and 2010, which in 2010 totalled over $2 billion. Demand for uranium is expected to continue to rise for the foreseeable future. Although the Fukushima Daiichi nuclear accident has affected nuclear power projects and policies in some countries, nuclear power remains a key part of the global energy mix. Several governments have plans for new nuclear power plant construction, with the strongest expansion expected in China, India, the Republic of Korea and the Russian Federation. The speed and magnitude of growth in generating capacity elsewhere is still to be determined. By the year 2035, according to the joint NEA-IAEA Secretariat, world nuclear electricity generating capacity is projected to grow from 375 GWe net (at the end of 2010) to between 540 GWe net in the low demand case and 746 GWe net in the high demand case, increases of 44% and 99% respectively. Accordingly, world annual reactor-related uranium requirements are projected to rise from 63 875 tonnes of uranium metal
... 25 Indians 1 2010-04-01 2010-04-01 false How does the OIEP Director ensure accountability? 39.409... EQUALIZATION PROGRAM Accountability § 39.409 How does the OIEP Director ensure accountability? (a) The Director of OIEP must ensure accountability in student counts and student transportation by doing all of the...
The global population growth rate has been 1.7% since 1975, while for developing countries it is 2.1%. UN projections are for population to grow from 5.5 billion in 1992 to 10 billion by 2050. Sustainable development is only possible when population growth is balanced with available resources. UN medium population projections of 7.8 billion by 2050 can be reached with 187 million more couples practicing family planning (FP) by the year 2000. Within the past 20 years, 1 billion people, mostly from developed countries, have enjoyed economic growth, but have contributed polluting technologies, excessive waste, and environmentally dangerous economic practices. The generations to come will be affected by the continuance of these practices by the 1 billion affluent population. The bottom billion are mired in poverty and high population growth and survival, needs that hinder their country's economic development, upset fragile ecosystems, and destroy the balance between human beings and the environment. International migration on a large scale could be the by-product of population growth. Progress has been made since the 1974 UN Conference on Population in Bucharest. There are still, however, vulnerable populations, the poorest households, the landless and small-holder families, urban squatters and slum dwellers, those living in low lying deltas and along coasts, and women. Women control family resources and their micro environment. Sustainable development is not possible without the elimination of prejudice against women. Reproductive freedom for women must be a priority. High quality, readily available FP services are also needed for those desiring this. The difficulty is in providing FP services that conform to a woman's social and cultural background and personal needs; success is dependent on involving women in the process and holding men more responsible for FP. Development means allowing for the legitimate aspirations of the majority not just the specialized concerns of the destitute. The environmental cost of development must be reduced and there must be a more equitable distribution of benefits. Borders do not confine problems and governments must work together. 1 billion of the global budget of 4.5 billion dollars is contributed by developed countries, and that amount needs to be increased by 50%. Population aid should be 4% not 2% of all assistance.
... specified actions to ensure fair and objective ``make-buy'' decisions by prime contractors on MDAPs; and (2... decisions. (3) In order to ensure fair and objective ``make-or-buy'' decisions by prime contractors... such development or construction in-house or through a subcontract; and (iii) Provide for the...
Sharma, Gagan Deep; Uppal, Raminder Singh; Mahendru, Mandeep
This paper notes that education needs to essentially lead to sustainable development serving two-fold purpose--eradicating the problems of unemployment and poverty; and ensuring equitable distribution of wealth while ensuring the right understanding leading to a peaceful, prosperous and developed world. In its current state, technical education…
... ensuring that scholarship recipients become successful teachers in high-need schools? 611.52 Section 611.52... EDUCATION, DEPARTMENT OF EDUCATION TEACHER QUALITY ENHANCEMENT GRANTS PROGRAM Scholarships § 611.52 What are a grantee's programmatic responsibilities for ensuring that scholarship recipients become successful...
... 34 Education 3 2010-07-01 2010-07-01 false Ensuring consistency in decision-making. 602.18 Section... relies on for making accrediting decisions is accurate; and (e) Provides the institution or program with... Criteria for Recognition Required Standards and Their Application § 602.18 Ensuring consistency in decision...
Achieve, Inc., 2013
The call to ensure that every student, including students with disabilities, graduates from high school well prepared for college and careers is acknowledged by policymakers, professionals and business leaders. This policy brief was developed to provide guidance to state education policy leaders to support the goal of ensuring that students with…
Medical practices receive hundreds if not thousands of calls every week from patients, payers, pharmacies, and others. Outsourcing call centers can be a smart move to improve efficiency, lower costs, improve customer care, ensure proper payer management, and ensure regulatory compliance. This article discusses how to know when it's time to move to an outsourced call center, the benefits of making the move, how to choose the right call center, and how to make the transition. It also provides tips on how to manage the call center to ensure the objectives are being met.
Russian Standards and design practice of ensuring NPP reliability under severe external loading conditions are described. The main attention is paid to the seismic design requirements. Explosions, aircraft impact, and tornado are briefly examined too (author)
E V Lyzhina
Full Text Available The article focuses on analyses of the peacekeeping activities of the European Union in order to ensure global and regional security from the point of interests of the EU member states.
Full Text Available Abstract Issues of weak login passwords arising from default passwords in wired and wireless routers has been a concern for more than a decade. In this research we develop and test an algorithm to ensure and enforce passwords in routers that are resistant to brute-force attack. A comparative analysis is performed to show the improved strengths of passwords derived via this algorithm. Implementation of this algorithm in routers will ensure setup of brute-force attack resistant passwords.
Mohammed Farik; ABM Shawkat Ali
Abstract Issues of weak login passwords arising from default passwords in wired and wireless routers has been a concern for more than a decade. In this research we develop and test an algorithm to ensure and enforce passwords in routers that are resistant to brute-force attack. A comparative analysis is performed to show the improved strengths of passwords derived via this algorithm. Implementation of this algorithm in routers will ensure setup of brute-force attack resistant passwords.
March 2017 Task Force on Defense Strategies for Ensuring the Resilience of National Space Capabilities OFFICE OF THE UNDER SECRETARY OF...the Department of Defense. The DSB Task Force on Defense Strategies for Ensuring the Resilience of National Space Capabilities completed its formal...Ensuring the Resilience of National Space Capabilities | i DSB Task Force on Defense Strategies for Ensuring the
Jakobsen, Neel Kolthoff; Jensen, Lena Sundby; Kayser, Lars
INTRODUCTION: Telemedicine is often seen as the solution to the challenge of providing health care for an increasing number of people with chronic conditions. Projects are often organised locally and based on the involvement of stakeholders with a wide range of backgrounds. It can be challenging...... to ensure that projects are based on previous experience and that they do not repeat previous studies. To better understand these challenges and current practice, we examined telemedicine projects funded in the 2008-2010 period to explore where, how and to what extent results from the projects were....... The investigators should ensure proper documentation and dissemination of changes both during and after the projects in order to ensure transparency, and national or international organisations should establish a database with relevant data fields. FUNDING: not relevant. TRIAL REGISTRATION: not relevant....
Fatima A Sulaiman
Full Text Available The forelimbs and hindlimbs of vertebrates are bilaterally symmetric. The mechanisms that ensure symmetric limb formation are unknown but they can be disrupted in disease. In Holt-Oram Syndrome (HOS, caused by mutations in TBX5, affected individuals have left-biased upper/forelimb defects. We demonstrate a role for the transcription factor Tbx5 in ensuring the symmetric formation of the left and right forelimb. In our mouse model, bilateral hypomorphic levels of Tbx5 produces asymmetric forelimb defects that are consistently more severe in the left limb than the right, phenocopying the left-biased limb defects seen in HOS patients. In Tbx hypomorphic mutants maintained on an INV mutant background, with situs inversus, the laterality of defects is reversed. Our data demonstrate an early, inherent asymmetry in the left and right limb-forming regions and that threshold levels of Tbx5 are required to overcome this asymmetry to ensure symmetric forelimb formation.
Hanada, Eisuke; Kudou, Takato; Tsumoto, Shusaku
Wireless technologies as part of the data communication infrastructure of modern hospitals are being rapidly introduced. Even though there are concerns about problems associated with wireless communication security, the demand is remarkably large. Herein we discuss security countermeasures that must be taken and issues concerning availability that must be considered to ensure safe hospital/business use of wireless LAN systems, referring to the procedures introduced at a university hospital. Security countermeasures differ according to their purpose, such as preventing illegal use or ensuring availability, both of which are discussed. The main focus of the availability discussion is on signal reach, electromagnetic noise elimination, and maintaining power supply to the network apparatus. It is our hope that this information will assist others in their efforts to ensure safe implementation of wireless LAN systems, especially in hospitals where they have the potential to greatly improve information sharing and patient safety.
Full Text Available The study aims to examine the role that local government plays in ensuring the economic freedom. It briefly examines the status of local authorities, deliberative and executive, and also the powers that they have to create the conditions for the exercise of economic freedom. The study also examines the constitutional regime of this fundamental freedom which is part of the rights and freedoms of the first generation. The purpose of the research aimed both identifying the role of local government in ensuring this basic freedom but also to determine possible means of action to be considered by the government within the territory.
Kumar, Praveen; Calais, Eric
To ensure the highest standards for publication, AGU has begun screening manuscript submissions using CrossCheck (http://www.crossref.org/crosscheck.html) for possible verbatim use of previously published material. Water Resources Research and Geophysical Research Letters have tested this technology since summer 2010. It has proven very useful in ensuring the highest integrity in publication standards and compliance with the AGU dual publication policy (http://www.agu.org/pubs/authors/policies/dualpub_policy.shtml). According to Barbara Major, assistant director of journals, other AGU journals will adopt this screening process in the near future.
Full Text Available In this work the urgent issues of ensuring the economic security are considered for the Ukrainian Railways, which presently are in the crisis state. The process chart of ensuring the economic security of enterprise is offered with performers for a railway. The analyses of both the fixed assets on example of the Dnepropetrovsk Office of Railway Transportation and the availability of rolling stock of the Ukrainian Railways are performed. The chart of dependence of the economic security level on the level of reproduction of the fixed assets is built as well.
Kritek, William J.
This paper describes the Ensuring Quality Leadership (EQL) program implemented cooperatively by faculty at the University of Wisconsin-Milwaukee School of Education and School of Business Administration, business executives from the Milwaukee area, and principals from Milwaukee's Public Schools (MPS). The program was designed to: (1) provide…
Caddell, Esther Harte; And Others
Describes the rationale for, development of, and activities of the Renaissance Educational Consortium Ensuring Individualized Progress in Technology and Science (RECEIPTS). The effort is designed to build a consortium of community resources with a focus on science and technology in order to combat the problems of low academic motivation and…
Simonova, Marina V.; Sankova, Larisa V.; Mirzabalaeva, Farida I.; Shchipanova, Dina Ye.; Dorozhkin, Vladimir E.
The relevance of the research problem is inspired by the need to ensure decent work principles in Russia. The purpose of this article is to develop evaluation methodologies and identify areas to implement key principles of decent work at the regional level in modern Russia. A leading approach to study this problem is the development of a new…
... quality? 212.20 Section 212.20 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... DRUGS (Eff. 12-12-2011) Quality Assurance § 212.20 What activities must I perform to ensure drug quality... actions. (e) Quality assurance. You must establish and follow written quality assurance procedures. ...
Nakano, Yukiko; Rehm, Matthias
In this paper we propose the method of multimodal corpus analysis to collect enough empirical data for modeling the behavior of embodied conversational agents. This is a prerequisite to ensure the usability of such complex interactive systems. So far, the development of embodied agents suffers fr...
Sergey Dmitrievich Kulik
Full Text Available This article deals with the special means, which allow to protect the information in the document. They are an integral part of the automated tools of ensuring the information security. It is proposed the use of a special input device PC Notes Taker. The results of experimental verification of the effectiveness of forensic handwriting techniques are described.
Boris Mikhailovich Egorov
Full Text Available Enterprise Continuity Program, Information and Telecommunication System of Bank of Russia The results of the analysis of the main directions to ensure business continuity for the information and telecommunication systems of high availability in relation to expansion of the problems range, their intellectualization and the modern IT implementation are given.
Berdiyarova, Zhamilya; Serikbekova, Samal; Babajanyan, Yester
The purpose of this research is to examine the legal problems of ensuring the right to work of citizens in the Republic of Kazakhstan and to find the conformity of labor laws in the Republic of Kazakhstan to international standards. Using the method of comparison analysis of the legislation of the Republic of Kazakhstan and norms of international…
“In order to ensure accountability and transparency, it is necessary to stipulate that forecasts from models can be made public, if and only if, information about the performance of the model and the objectively assessed error levels is included.” ...
Slessarev, Yuri Vassilyevich; Moisseyev, Vassily Borisovich; Vostroknutov, Evgeniy Vladimirovich
This article describes pedagogical conditions of ensuring students readiness for scientific researches on the basis of scientific literature and experience of Penza State Technological University students. Introduction of suggested conditions favors the process of training of highly skilled expert who is ready for generation of new ideas in fields…
Results show that the following challenges need attention to ensure the continuation of the farm as a family farm in the future: corporate governance; performance measurement and compensation of family members; ownership succession; family harmony between all family members and management succession planning.
Solonina S. V.; Ovsyanitsky E. S.; Anufrieva A. P.
The article discusses the factors to ensure solvency and financial stability of the insurance company's howl. It shows the classification of types of financial stability and solvency of insurance companies; as-sesses the tariff policy of organizations and reveals the essence of reinsurance
With increasing numbers of women entering the workforce in Turkey, efforts have been made to provide services for children and their families. In 2016, 33.2% of 3- to 5-year olds in Turkey were attending preschool. This figure is lower than that of most OECD countries, but the important point is to increase the attendance rate by ensuring quality.…
Poulsen, Signe; Ipsen, Christine
Organizations develop and adapt to societal changes and technological developments, where one consequence is that dispersed workers are more common than never before. It is difficult to ensure employee wellbeing and performance, when separating managers from employees by either time or geography....
Schools are rapidly becoming a kaleidoscope of ethnicities and cultures represented by demographic changes in America's schools. As educators in this era of change, a unique opportunity exists to ensure quality physical education for all students. Culturally responsive practices in the classroom can assist in minimizing students' alienation as…
National Academies Press, 2009
As digital technologies are expanding the power and reach of research, they are also raising complex issues. These include complications in ensuring the validity of research data; standards that do not keep pace with the high rate of innovation; restrictions on data sharing that reduce the ability of researchers to verify results and build on…
... accountability? 36.120 Section 36.120 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION... SITUATIONS Homeliving Programs Waivers and Accountability § 36.120 What type of reporting is required to ensure accountability? The homeliving program must provide to the appropriate local school board or...
Identifies five types of museum accessibility: (1) physical; (2) socio-cultural; (3) economic; (4) sensory; and (5) intelligence/learning accessibility. Considers ways to coordinate museum services to ensure accessibility for potential museum patrons who are disabled. Describes various programs launched by the National Museum of Natural History in…
Natker, Elana; Baker, Susan S.; Auld, Garry; McGirr, Kathryn; Sutherland, Barbara; Cason, Katherine L.
The project reported here served to assess a curriculum for EFNEP to ensure theory compliance and content validity. Adherence to Adult Learning Theory and Social Cognitive Theory tenets was determined. A curriculum assessment tool was developed and used by five reviewers to assess initial and revised versions of the curriculum. T-tests for…
Steyn, H. J.; van der Walt, J. L.; Wolhuter, C. C.
Benchmarking is one way of ensuring academic depth and rigour in teacher education. After making a case for setting benchmarks in teacher education based on the widely recognised intra-education system contextual factors, the importance of also taking into account the external (e.g. the national-social) context in which teacher education occurs is…
Barlow, S.M.; Boobis, A.R.; Bridges, J.; Cockburn, A.; Dekant, W.; Hepburn, P.; Houben, G.F.; König, J.; Nauta, M.J.; Schuermans, J.; Bánáti, D.
Background: Food legislation in the European Union and elsewhere includes both hazard- and risk-based approaches for ensuring safety. In hazard-based approaches, simply the presence of a potentially harmful agent at a detectable level in food is used as a basis for legislation and/or risk management
... 34 Education 1 2010-07-01 2010-07-01 false Requirements to ensure that funds do not benefit a private school. 200.66 Section 200.66 Education Regulations of the Offices of the Department of Education OFFICE OF ELEMENTARY AND SECONDARY EDUCATION, DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC...
Bikse, Veronika; Lusena-Ezera, Inese; Rivza, Baiba; Volkova, Tatjana
This paper aims to investigate the experience and to identify the drivers of transforming traditional universities into Entrepreneurial Universities for ensuring sustainable higher education in Latvia. Due to the wide scope, Entrepreneurial University characteristics, the present research study is limited and focuses on the university providing…
...] Draft Guidance for Industry on Planning for the Effects of High Absenteeism to Ensure Availability of... industry entitled ``Planning for the Effects of High Absenteeism to Ensure Availability of Medically... in high absenteeism at one or more production [[Page 1061
Full Text Available The negative sociocultural transformations that are taking place in modern society and the resulting psychological transformation of personality and mode of life strongly require searching for ways of providing social safety to the next generation, with teachers being the implementers of this process. Teachers’ professionalism is determined by their willingness to solve personal and socially relevant problems, including the willingness to provide social security for other people, to thwart social risks, and to build constructive interpersonal relationships. The aim of our research was to reveal and to analyze the psychological factors affecting the readiness of teachers to ensure social security in educational environments. The environmental factors of social risk have been theoretically characterized. It has been shown that the essential factor in ensuring students’ social security is providing a safe social environment in educational institutions; such an environment provides the learners and the teachers with sociopsychological security and psychosocial well-being. The empirical part of our study was devoted to identifying negative social phenomena in the schools in the Ivanovo region (with the help of a questionnaire administered to 700 students and to identifying the personally and professionally important qualities of the teachers and the subjective psychological factors of their readiness to ensure social security in the educational environment (through interviewing 300 teachers; the administration of the questionnaires and the interviewing were followed by an assessment of their significance (with the help of a questionnaire administered to 140 teachers. Using factor analysis we identified the relevant indicators and grouped them into six factors of the readiness of teachers to ensure a safe educational environment. Relevant personal and professional qualities of teachers were revealed; these are the subjective factors of the
Full Text Available In the financial market of insurance, consumer protection represents an important component contributing to the stability, discipline and efficiency of the market. In this respect, the activity of educating and informing insurance consumers on ensuring and exercising their right to claim plays a leading role in the mechanism of consumer protection. This study aims to improve the decision-making capacity of the financial services consumers from the Romanian insurance market through better information on ensuring and exercising their right to claim under the legislation. Thus, by applying three data analysis techniques – principal components analysis, cluster analysis and discriminant analysis – to the data regarding the petitions that were registered by the 41 insurance companies which operated in the Romanian market in 2012, a classification that assesses the insurance market transparency is achieved, resulting in a better information for consumers and, hence, the improvement of their protection through reducing the level of transactions that are harmful to consumers
Pape-Haugaard, Louise; Frank, Lars
A major obstacle in ensuring ubiquitous information is the utilization of heterogeneous systems in eHealth. The objective in this paper is to illustrate how an architecture for distributed eHealth databases can be designed without lacking the characteristic features of traditional sustainable databases. The approach is firstly to explain traditional architecture in central and homogeneous distributed database computing, followed by a possible approach to use an architectural framework to obtain sustainability across disparate systems i.e. heterogeneous databases, concluded with a discussion. It is seen that through a method of using relaxed ACID properties on a service-oriented architecture it is possible to achieve data consistency which is essential when ensuring sustainable interoperability.
Full Text Available The purpose of the article is analyzing the prospect of reforming the organizational and legal mechanism for ensuring the rights and freedoms of individuals and citizens of Ukraine from the systemic approach. Based on the methodology of system analysis, the prospects of reforming the organizational and legal mechanism for ensuring the rights and freedoms of men and citizens of Ukraine in the context of association with the European Union are considered. The key factors that influence the effectiveness of the submitted organizational and legal mechanism are analyzed. The measures aimed at the improvement of normative-legal regulation, which shall promote the maintenance of constitutional rights and freedoms in the conditions of reforming all spheres of society's life, are presented.
American Society for Testing and Materials. Philadelphia
1.1 This practice sets forth requirements to ensure consistency in neutron-induced displacement damage testing of silicon and gallium arsenide electronic piece parts. This requires controls on facility, dosimetry, tester, and communications processes that affect the accuracy and reproducibility of these tests. It provides background information on the technical basis for the requirements and additional recommendations on neutron testing. In addition to neutrons, reactors are used to provide gamma-ray pulses of intensities and durations that are not achievable elsewhere. This practice also provides background information and recommendations on gamma-ray testing of electronics using nuclear reactors. 1.2 Methods are presented for ensuring and validating consistency in neutron displacement damage testing of electronic parts such as integrated circuits, transistors, and diodes. The issues identified and the controls set forth in this practice address the characterization and suitability of the radiation environm...
Full Text Available Synaptotagmin 7 (Syt7 is thought to be a Ca2+ sensor that mediates asynchronous transmitter release and facilitation at synapses. However, Syt7 is strongly expressed in fast-spiking, parvalbumin-expressing GABAergic interneurons, and the output synapses of these neurons produce only minimal asynchronous release and show depression rather than facilitation. To resolve this apparent contradiction, we examined the effects of genetic elimination of Syt7 on synaptic transmission at the GABAergic basket cell (BC-Purkinje cell (PC synapse in cerebellum. Our results indicate that at the BC-PC synapse, Syt7 contributes to asynchronous release, pool replenishment, and facilitation. In combination, these three effects ensure efficient transmitter release during high-frequency activity and guarantee frequency independence of inhibition. Our results identify a distinct function of Syt7: ensuring the efficiency of high-frequency inhibitory synaptic transmission.
Bandekar, J.R.; Saroj, S.D.; Shashidhar, R.; Dhokane, V.S.; Hajare, S.N.; Nagar, V.; Sharma, A.
Minimally processed fruits and vegetables are in demand as they offer ready rich source of nutrients and convenience to consumers. However, these products are often unsafe due to contamination with harmful pathogens. Therefore, a study was carried out to analyze microbiological quality of minimally processed fruits, vegetables and sprouts and to optimize radiation dose necessary to ensure safety of these commodities. Microbiological quality of these products was found to be poor. Decimal reduction dose (D 10 ) for Salmonella Typhimurium and Listeria monocytogenes in these minimally processed foods (MPF) were in the range of 164 to 588 Gy. Radiation processing with 2 kGy dose of gamma radiation resulted in 5 log reduction of S. Typhimurium and 4 log reduction of L. monocytogenes. The treatment did not significantly affect nutritional, organoleptic and textural properties. These results suggest that radiation processing can ensure safety of these products. (author)
Hersh, Bradley S; Carr, Richard M; Fitzner, Julia; Goodman, Tracey S; Mayers, Gillian F; Everts, Hans; Laurent, Eric; Larsen, Gordon A; Bilous, Julian B
Measles immunization campaigns are effective elements of a comprehensive strategy for preventing measles cases and deaths. However, if immunizations are not properly administered or if immunization waste products are not safely managed, there is the potential to transmit bloodborne pathogens (e.g., human immunodeficiency virus and hepatitis B and hepatitis C). A safe injection can be defined as one that results in no harm to the recipient, the vaccinator, and the surrounding community. Proper equipment, such as the exclusive use of auto-disable syringes and safety boxes, is necessary, but these alone are not sufficient to ensure injection safety in immunization campaigns. Equally important are careful planning and managerial activities that include policy and strategy development, financing, budgeting, logistics, training, supervision, and monitoring. The key elements that must be in place to ensure injection safety in measles immunization campaigns are outlined.
AUTHOR|(CDS)2080423; Romaniuk, Ryszard
The current control and timing system at the European Organization for Nuclear Research (CERN) has been serving its accelerators for several decades and is reaching its design limits. In preparation is the next generation system, called White Rabbit. White Rabbit is intentionally based on commonly used networking technologies to ensure the flexibility, maintainability and wide commercial support that were missing in the old system. The new system is meant to coordinate the actions of thousands of individual devices constituting the CERN accelerator complex in a timely manner for several decades. At the time of White Rabbit’s conception in 2008, none of the existing networking standards could provide the unprecedented characteristics required by a future-proof accelerator control and timing system. Therefore, the most suitable solutions needed to be enhanced with new specialized services. Two non-existent enhancements are proposed and developed in the context of this thesis. The first ensures that critical i...
Krishan, Kewal; Kanchan, Tanuj; Baryah, Neha; Mukhra, Richa
Plagiarism is a serious threat plaguing the research in publication of science globally. There is an increasing need to address the issue of plagiarism especially among young researchers in the developing part of the world. Plagiarism needs to be earnestly discouraged to ensure a plagiarism free research environment. We provide further suggestions to combat student plagiarism at Master's level and the regulations/guidelines regarding plagiarism in India.
L. B. Panfilova; E. A. Sychev
The article attempts to reveal the concept of administrative and jurisdictional activity of the police to ensure public safety on water transport, the features of the stages of proceedings on administrative offenses. Under the administrative process is commonly understood outside the law enforcement activities of the executive authorities, local government agencies and other entities authorized by the state to resolve the limits of their competence in specific legal cases arising on the basis...
Gutsaliuk Oleksii M.
Full Text Available The objective growth of the number of displays and influence of negative factors of threats from the environment actualizes the issue of ensuring economic safety of national economic entities. The article notes that simultaneously with counteracting threats enterprises are working for development, one form of which is the establishment of corporate structures and implementation of integration processes. It is proposed to ensure achieving the desired level of the corporate structure economic safety through optimizing the correlation of resources and competencies, skills and technologies for their use within the integrated logistics value chain. In this case it is the implementation of the integration process that serves as an instrument for achieving this optimal correlation, and the level of economic safety is considered as one of the optimization criteria. The system of authors’ hypotheses is taken as the basis for ensuring economic safety of the corporate integration process. Each of the hypotheses corresponds to a set of conceptual principles aimed at practical implementation of the proposed approaches. Within these conceptual principles the relationship between incentives and benefits of integration and the basis for ensuring their safety is presented, the differences between safety of functioning and safety of development are studied, the use of the methodology of logistics to harmonize the interests of participants of the corporate structure is justified, the relevance of applying the resource approach to manage the integration and development safety is proved. The graphical representation of causal relationships between the proposed conceptual principles allowed formalizing the subject area of studying corporate integration safety
Bolton, Linda Burnes; Swanson, Jane; Zamora, Elizabeth
The Institute of Medicine report on the Future of Nursing identified the need to increase the preparation of nurses, create pathways for nurses to lead as partners to improve health by promoting interprofessional education and practice, and to remove barriers to full practice of nurses across the continuum. This case study shares the experience of large systems and their creativity using philanthropy in their quest to ensure the availability of a qualified nursing workforce.
The Paks Nuclear Power Plant strategy is to extend the operational lifetime of the plant and renew the operational license for 20 years over the designed and licensed lifetime. In the paper the preconditions of long-term operation are discussed and the basic findings and experience of the license renewal works are also presented. The further plans fo NPP Paks for ensuring safe operation in long-term are discussed. (author)
Full Text Available In the article are viewed topical question ensuring competitive capacity the structure of entrepreneur of microbiological field. At the heart of the question lies the achievement of the idea of economical production. Authors are called attention optimizing direction of making value of microbiological production, which offers substantively increase the efficiency and competitive capacity the structure of entrepreneur in present field of economics.
Dudin Sergey; Bahmat Gennady; Zemenkov Yury; Voronin Konstantin; Shipovalov Anton
The authors examined the legislative framework of the Russian Federation operating in the field of industrial safety, and described how to obtain a license to operate hazardous production facilities. The paper demonstrates that the importance should be given to the quality and completeness of the background information, as well as the choice of inspection strategy in evaluating the technical condition of the line section of main gas pipelines. As a part of a package of measures to ensure indu...
Anatoliy Petrovich Sterkhov
Full Text Available From the viewpoint of ensuring complex business security, the relevance of the present work is associated with the rationale of multilevel hierarchical approach to the classification of security threats in the age of globalization. The specificity of the threats specific to one or another level of the economy, helps to better understand and consequently to build an effective system of ensuring complex business security. For each of the nine hierarchical levels of the economy the author identifies the main threats to the business, as well as the objects and subjects of this study. It is noted that the performance of the business in the form of a complex hierarchical system depends on the principle of specification. The author gives examples of the use of the basic principles of specification. It is noted that the decomposition of the economic system from the viewpoint of its hierarchical nature is of great importance not only to the distribution of the goals and objectives of security of business levels of the system, but their subordination corresponding to each level. The result is the development of specific recommendations and elaboration of the main directions to ensure complex business security for mega-, macro-, micro-, mini-, nano - and mesoeconomic levels. Although the priority of action in multi-level hierarchical system is directed from the upper to the lower levels, the success of the system as a whole depends on the behavior of all system components. It is stated that the interaction with the environment in business occurs mainly in the lower levels of the hierarchy. The quality system of ensuring complex business security which deals with hierarchical positions, will depend not so much on top-level elements, but on response to intervention on the part of lower level, more precisely from their total effect. In other words, the quality of the system of integrated safety management business provides organized feedbacks in the system.
Ensuring the Trust of NAND Flash Memory : Going Beyond the Published Interface Austin H. Roach, Matthew J. Gadlage, James D. Ingalls, Aaron...can be used to measure subtle changes in the memory cells of advanced Flash memories caused by program/erase stress, radiation exposure, or process...from COTS assemblies without publically available datasheets. Keywords: NAND Flash; partial program; partial erase; interrupted program; interrupted
Rahayu; Soeprobowati Tri Retnaningsih
This article aims to analyze the implementation of state obligations and responsibility ensuring the availability of clean water as part of human rights in Karimunjawa islands. The analysis based on principle of the State obligations and responsibility to fulfill their citizen right. Water sources in Karimunjawa Islands is very limited. It depend on forest conservation. Around 9.600 peoples live in Karimunjawa Islands, but Karimunjawa is non groundwater basin region. It means, Karimunjawa doe...
Salnazaryan Ashot; Aramyan Haykaz
This research aims to reveal the importance of securities market in ensuring economic growth in Armenia. In order to make the research more substantial, we also examined the impact of other financial market segments, such as insurance market and credit market, on the economic growth. To estimate the relationship between financial market segments and economic growth, an empirical research was conducted using correlation and regression techniques. The research reveals that the most significant ...
Людмила Володимирівна Зубик
Full Text Available The ways of solving the problem of ensuring the reliability of remembering of technical knowledges was defined. Comparative analysis of available modern software was completed for its involvement in the educational process. Innovation technologies of preserving knowledges were proposed, which based on analysis and synthesis of scientific achievements and pedagogical experience. The part of transformation of educational process by engaging of popular web services was considered
Fuhrer, Tobias; Sauer, Uwe
To sustain growth, the catabolic formation of the redox equivalent NADPH must be balanced with the anabolic demand. The mechanisms that ensure such network-wide balancing, however, are presently not understood. Based on 13C-detected intracellular fluxes, metabolite concentrations, and cofactor specificities for all relevant central metabolic enzymes, we have quantified catabolic NADPH production in Agrobacterium tumefaciens, Bacillus subtilis, Escherichia coli, Paracoccus versutus, Pseudomona...
Kesselheim, Aaron S; Tan, Yongtian Tina; Darrow, Jonathan J; Avorn, Jerry
Specialty drugs are notable among prescription drugs in that they offer the possibility of substantial clinical improvement, come with important risks of adverse events and mortality, can be complex to manufacture or administer, and are usually extremely costly. The Food and Drug Administration (FDA) plays a critical role in ensuring that patients who could benefit from specialty drugs have access to them in a timely fashion. In this article we review the different strategies that the FDA can use to approve and influence the post-approval prescribing of specialty drugs. When specialty drugs show promise in early clinical trials, the FDA can expedite the drugs' availability to patients through expanded access programs and expedited approval pathways that speed regulatory authorization. After approval, to ensure that specialty drugs are directed to the patients who are most likely to benefit from them, the FDA can limit the scope of the drugs' indications, encourage the development of companion diagnostic tests to indicate which patients should receive the drugs, or require that manufacturers subject them to Risk Evaluation and Mitigation Strategies to ensure that their use is appropriately limited to a restricted population that is aware of the drugs' risks and benefits. Implementing these existing regulatory approaches can promote timely patient access to specialty drugs while preventing expensive and potentially inappropriate overuse. Project HOPE—The People-to-People Health Foundation, Inc.
Full Text Available The purpose of the present study is to define, based on a theoretical identification, the significance of production diversification in ensuring financial security of agricultural farms and a presentation of the specificity of multi-directional farms in Poland. The entities included in the research were the ones conducting agricultural activity of a mixed type: mixed cropping and mixed crops-livestock in the years 2007-2013. The analysis was carried out based on data obtained from the statistical publications of the Central Statistical Office. On the basis of an analysis of the structure and dynamics. The size of utilised agriculturally area and their use, economicsize, the type and structure of plantation as well as the species and number of farm animals were all taken into consideration in the analysis. Based on the theoretical considerations presented it is evident that production diversification plays an important role in the reduction of the agricultural activity risk, and thus it contributes to maintaining stability and thereby preserving the financial security of farms. The results of empirical research prove that those farms that diversify their production are mainly farms of small economic size, producing for their own use. Diversification acts as a safety buffer in the case of these farms. It ensures self-sufficiency in terms of consumption and fodder production as well as small income. In the case of farms with bigger UAA it ensures proper functioning and survival on the market.
Gagim, Ion; Cozma, Carmen; Abdullin, Eduard; Stupacenco, Lidia; Tetelea, Margarita; Coroi, Eugen
Abstract: Lucrarea include materialele ştiinţifice prezentate la Conferinţa Internaţională "Educaţia artistic-spirituală în contextul învăţămîntului contemporan", cu genericul "Probleme generale ale educaţiei artistic-spirituale", care a avut loc pe 19-21 mai, 2005 în incinta Universităţii de Stat "Alecu Russo" din Bălţi.
Gagim, Ion; Cozma, Carmen; Abdullin, Eduard; Stupacenco, Lidia; Tetelea, Margarita; Guţu, Vladimir; Coroi, Eugen
Abstract: Lucrarea include materialele ştiinţifice prezentate la Conferinţa Internaţională „Educaţia artistic-spirituală în contextul învăţămîntului contemporan”, cu genericul „Probleme curriculare ale educaţiei artistic-spirituale”, care a avut loc pe 19-21 mai, 2005 în incinta Universităţii de Stat „Alecu Russo” din Bălţi.
Gagim, Ion; Cozma, Carmen; Abdullin, Eduard; Stupacenco, Lidia; Tetelea, Margarita; Guţu, Vladimir; Coroi, Eugen
Abstract: Lucrarea include materialele ştiinţifice prezentate la Conferinţa Internaţională „Educaţia artistic-spirituală în contextul învăţămîntului contemporan”, cu genericul „Aspecte metodologice ale educaţiei artistic-spirituale”, care a avut loc pe 19-21 mai, 2005 în incinta Universităţii de Stat „Alecu Russo” din Bălţi.
Il “Manifesto” contro la disoccupazione nell’UE sette anni dopo: quali suggerimenti sono sempre attuali? (The "Manifesto" against unemployment in the EU seven years on: what suggestions are always up to date?
Full Text Available L’articolo analizza retrospettivamente dopo sette anni l’impatto che la pubblicazione del “Manifesto contro la disoccupazione nell’UE” ha avuto sulle politiche economiche attivate nei vari paesi europei.Dal lato dell’offerta, si prende atto che molti suggerimenti del “Manifesto” sono stati messi in pratica, tra cui risultano particolarmente significative le riforme del mercato del lavoro approvate di recente in Italia, Germania e Francia. Tali riforme hanno introdotto più flessibilità nei contratti di lavoro, che ha favorito l’aumento dell’occupazione e la discesa del tasso di disoccupazione in tutti i paesi. Non altrettanto soddisfacenti, invece, sono stati i risultati conseguiti nelle politiche di gestione della domanda aggregata. Alle politiche fiscali restrittive imposte dal rispetto dei parametri di Maastricht, infatti, ha fatto riscontro una politica monetaria della BCE altrettanto restrittiva, che ha fatto apprezzare l’euro e fatto perdere competitività alle merci europee nel mercato internazionale. Altrettanto deludenti sono giudicate le politiche regionali di sviluppo, per le quali si suggerisce un uso più appropriato della politica d’incentivazione fiscale per attirare nuovi investimenti nelle aree sottosviluppate. The article analyzes retrospectively after seven years the impact that the publication of the "Manifesto against unemployment in the EU" has had on economic policies enabled in the various European countries. On the supply side, it is recognized that many suggestions of the "Manifesto" were put into practice, such as are particularly significant reforms of the labor market recently adopted in Italy, Germany and France. Such reforms have introduced more flexibility in contracts of employment, which has favored the increase in employment and the decline in unemployment in all countries. Not so satisfactory, however, were the results achieved in the policies of aggregate demand management. The restrictive fiscal policies imposed by the requirements of the Maastricht criteria, in fact, has been matched by equally restrictive monetary policy of the ECB, which has made appreciate the euro and made European goods less competitive in the international market. Equally disappointing are judged regional development policies, for which we suggest a more appropriate use of the policy of tax incentives to attract new investment in underdeveloped areas. JEL Codes: J68, E58, E62, H71, O23Keywords: riforme, mercato del lavoro, disoccupazione
Jakobsen, Neel Kolthoff; Jensen, Lena Sundby; Kayser, Lars
Telemedicine is often seen as the solution to the challenge of providing health care for an increasing number of people with chronic conditions. Projects are often organised locally and based on the involvement of stakeholders with a wide range of backgrounds. It can be challenging to ensure that projects are based on previous experience and that they do not repeat previous studies. To better understand these challenges and current practice, we examined telemedicine projects funded in the 2008-2010 period to explore where, how and to what extent results from the projects were documented and disseminated. Public and private funds were contacted for information about telemedicine studies focusing on people residing in their homes. After an initial screening of titles and abstracts, 19 projects were identified. The managers of the projects were contacted and information about project results and dissemination were obtained. More than half of all projects were disseminated to professionals as well as to the public and used two-way communication. However, it was generally difficult to obtain an overview of the projects due to dynamic changes in names and scopes. We propose that the funding authorities require designs comprising proper evaluation models that will subsequently allow the investigators to publish their findings. Furthermore, a dissemination plan comprising both peers and other professions should be made mandatory. The investigators should ensure proper documentation and dissemination of changes both during and after the projects in order to ensure transparency, and national or international organisations should establish a database with relevant data fields. not relevant. not relevant.
Full Text Available A banking system is one of the key elements of a financial market of any country. Effectiveness and functional orientation of a banking system provide continuous and targeted financial resources flowing between different sectors of economy and this allows to perform economic activities of various entities. Thus, a banking system plays an essential role in the formation of market relations. A question of stable functioning of a banking system can be defined as a key one. The basic task is to improve the management of a banking system by achieving its stability. The disclosure of formalized description of the definition of tools to influence the selection procedure for ensuring stability of a banking system should be determined as the primary objective. For reaching the goal a comparative study has been introduced and generalized concerning the concept definition of «banking system» and the ideology of its management according to the circumstances and factors of influence. The combination of individual components is to determine the instruments of influence on the banking system activity in the form of chain ties. On the base of the analysis carried out the article grounds the necessity of the generalized use of formalized description of the procedures for selecting instruments for ensuring stability of a banking system. For the purpose of this procedure the author has also grounded, determined and disclosed some of its components. To implement the relevant qualitative phase of formalization the author has proposed the use of chain patterns, and to quantify the individual parameters of such a procedure the methodology of border stochastic analysis has been offered. As a scientific novelty of the present research it is necessary to note the qualitative and quantitative phases for formal presentation of describing procedures for the selection of tools to ensure banking system stability as well as the introduction of chain schemes for the
Full Text Available Aim/purpose - The purpose of this paper is to recognize and compare the best practices that ensure the flexibility and continuity of supplies. Although the flexibility drivers and continuity risk drivers, according to the literature, are actually the same, there is a lack of research articles on this aspect. Design/methodology/approach - A two-phase methodology design, based on the literature review and in-depth interviews, was used, and seven in-depth interviews with the representatives of manufacturing companies that operate in different sectors were conducted. Findings - Supply flexibility and continuity are presented in the literature, mainly as the responses to the business environmental events/changes that have already occurred. Nevertheless, the researched manufacturing companies recognize their use in terms of prevention as well. The researched enterprises use traditional ways of dealing with supply problems (alternative supplier, inventory buffers. They do not really connect ensuring supply continuity with long-term disruptions, but rather understand it as prevention of typical supply delays and quality problems. The respondents regard supplier flexibility not only as a way of responding to the forecasted demand changes but also to unexpected situations. The companies ensure supply continuity and supply flexibility using similar but not exactly the same strategies. For the reactive strategies, sourcing decisions are crucial, whereas for preventive strategies - it is supplier performance management. Research implications/limitations - The small number of conducted interviews is a limitation of performed research, however, some directions for future research can be noted. Apart from other implications described in the paper, it is deduced that sourcing flexibility positively influences supply continuity. Nevertheless, this hypothesis needs quantitative verification.Originality/value/contribution - The paper compares the issue of supply
Humphries, Linda K; Mansavage, Vicki L
DESPITE FEDERAL REGULATIONS for tissue-banking practices, inadequate quality control led to the largest allograft tissue recall in history in October 2005. THE RECALL INCLUDED all allograft tissues obtained from 761 donors and distributed by five tissue banks. Many of these tissues already had been implanted and were unrecoverable. THIS ARTICLE DESCRIBES the many tissue-banking industry variables, including donor selection and testing and tissue recovery, processing, and preservation. QUESTIONS THAT HEALTH CARE providers can ask to determine which tissue banks' quality control measures best ensure the safety of the allografts they provide also are included.
Gao, Peng; Zhongde, Zhao; Chunliang, Sun; Juexin, Shen
Compared with North America or Europe in respect of natural gas resources, markets and pipeline networks, the current China stands in a special period with natural gas market in quick development, accordingly, it's recommended to strengthen cooperation and coordination between investors by way of diversified investment and joint adventures and on the basis of diversified resource supply modes, so as to accelerate the construction of infrastructures including the natural gas pipeline networks and the storage and peak-shaving facilities, quick up the market development, realize the situation of mutual-win-win, and finally ensure safety of natural gas utilization in the domestic markets.
Knee injuries can sideline anyone. Physical therapists are leading the way to ensure that people with knee ligament injuries, including competitive and recreational athletes, receive the best care to optimize their recovery. JOSPT and the Orthopaedic Section of the American Physical Therapy Association first published clinical practice guidelines about knee ligament sprains in 2010. Now, revised guidelines in JOSPT's November 2017 issue provide updated recommendations based on best practices for evaluating, diagnosing, and treating knee ligament injuries. They also suggest how to determine when patients are ready to return to activities after injury. J Orthop Sports Phys Ther 2017;47(11):824. doi:10.2519/jospt.2017.0511.
Barlow, Susan M.; Boobis, Alan R.; Bridges, Jim; Cockburn, Andrew; Dekant, Wolfgang; Hepburn, Paul; Houben, Geert F.; König, Jürgen; Nauta, Maarten; Schuermans, Jeroen; Bánáti, Diána
BackgroundFood legislation in the European Union and elsewhere includes both hazard- and risk-based approaches for ensuring safety. In hazard-based approaches, simply the presence of a potentially harmful agent at a detectable level in food is used as a basis for legislation and/or risk management action. Risk-based approaches allow consideration of exposure in assessing whether there may be unacceptable risks to health.Scope and approachThe advantages and disadvantages of hazard- and risk-ba...
Full Text Available The growing emphasis on off-site and off-shore clinical data management activities mandates a paramount need for adequate solutions geared toward on-time, quality deliverables. The author has been leading large teams that have been involved in successful global clinical data management endeavors. While each study scenario is unique and has to be approached as such, there are several elements in defining strategy and team structure in global clinical data management that can be applied universally. In this article, key roles, practices, and high-level procedures are laid out as a road map to ensure success with the model.
Gajadhar, A. A.; Pozio, E.; Gamble, H. R.
Because of its role in human disease, there are increasing global requirements for reliable diagnostic and control methods for Trichinella in food animals to ensure meat safety and to facilitate trade. Consequently, there is a need for standardization of methods, programs, and best practices used...... in various porcine and equine pre- and post-slaughter programs, including farm or herd certification programs is also discussed. A brief review of the effectiveness of meat processing methods, such as freezing, cooking and preserving is provided. The importance of proper quality assurance and its application...
O. I. Kharchenko
Full Text Available Purpose. Every year more attention is paid for the theoretical and practical issue of sustainable development of railway transport. But today the mechanisms of financial support of this development are poorly understood. Therefore, the aim of this article is to determine the optimal investment allocation to ensure sustainable development of the railway transport on the example of State Enterprise «Prydniprovsk Railway» and the creation of preconditions for the mathematical model development. Methodology. The ensuring task for sustainable development of railway transport is solved on the basis of the integral indicator of sustainable development effectiveness and defined as the maximization of this criterion. The optimization of measures technological and technical characters are proposed to carry out for increasing values of the integral performance measure components. To the optimization activities of technological nature that enhance the performance criteria belongs: optimization of the number of train and shunting locomotives, optimization of power handling mechanisms at the stations, optimization of routes of train flows. The activities related to the technical nature include: modernization of railways in the direction of their electrification and modernization of the running gear and coupler drawbars of rolling stock, as well as means of separators mechanization at stations to reduce noise impacts on the environment. Findings. The work resulted in the optimal allocation of investments to ensure the sustainable development of railway transportation of State Enterprise «Prydniprovsk Railway». This allows providing such kind of railway development when functioning of State Enterprise «Prydniprovsk Railway» is characterized by a maximum value of the integral indicator of efficiency. Originality. The work was reviewed and the new approach was proposed to determine the optimal allocation of capital investments to ensure sustainable
Full Text Available The issues of the influence of the changed conditions for obtaining probably-determined information on the operation of generating equipment and power consumption regimes on the decisions taken to ensure the required level of reservation of the territorial zones of the UES of Russia in the current regulatory environment to the indicators of balance reliability are considered. Comparison of the present conditions for presenting the initial information for the estimation of the balance sheet reliability of electric power systems with the conditions for the development of methodological recommendations (MR for the design of power systems in 2003 and not approved by the Ministry of Energy of Russia MR 2012.
Vitaly V. Kabernik
Full Text Available The article deals with security, including informational, educational environment. The article considers experience of the United States and Europe, including specific examples. Given a classification of the major threats and they are allocated on the basis of foreign and domestic experience. The article also determines the range of problems actually facing educational institutions and regularly described in special reports on the subject. Provides an overview of a set of measures designed to regulate access to inappropriate content, with special attention given to the phenomenon of social networks that put new challenges in ensuring security of the educational environment.
In the second of a two-part article on adverse drug reactions Agnes Kanneh describes the six 'rights' of the recipient of a drug. These are: that the right person should receive the right drug, in the right dose, at the right time within the right intervals, via the right route, followed by the right (correct) documentation. The author argues that the observance of these 'rights' by children's nurses ensures the best pharmacotherapeutic practice, thus a robust practical safeguard in adverse drug reactions and threats to the good reputation of the nursing profession.
Bentancourt, L.A.; Quevedo, J.R.; La Fuente, A. de
In the middle of the 80's in Cuba takes place a widespread use of nuclear techniques in the national economy, particularly in nuclear medicine practice. In order to harmonize the constructive projects of the nuclear medical facilities, the National Regulatory Authority for Radiation Protection assessed the requirements to be adopted for the purpose of ensuring the optimum fulfillment of the radiation protection regulations in force in the country. As a result of this work a functional solution was developed for the distribution of the sites for the storage, dosage and handling of radioactive substances and the temporary deposit of the radioactive wastes produced. (authors). 4 refs., 1 tab
This is a comprehensive textbook on designing interaction to ensure a quality user experience. Combining breadth, depth, and practical applications, this book takes a time-tested process-and-guidelines approach that provides readers with actionable methods and techniques while retaining a firm grounding in HCI concepts and theory. The authors will guide you through the UX lifecycle process, including contextual inquiry and analysis, requirements extraction, design ideation and creation, practical design production, prototyping, and UX evaluation. Development activities are linked via handof
Burke, Stephen; Pradillo, Maria Alandes; Field, Laurence; Keeble, Oliver
The GLUE 2 information model is now fully supported in the production EGI/WLCG information system. However, to make it usable and allow clients to rely on the published information it is important that the meaning is clearly defined, and that information providers and site configurations are validated to ensure as far as possible that what they publish is correct. In this paper we describe the definition of a detailed schema usage profile, the implementation of a software tool to validate published information according to the profile and the use of the tool in the production Grid, and also summarise the overall state of GLUE 2 deployment.
Full Text Available Abstract This article provides an overview on the regulations of Chinese medicinal materials (CMMs in various countries and regions. Harmonization of CMM monographs would provide standards for the quality control of CMM products and play an important role in the modernization and globalization of Chinese medicine. A harmonized regulatory system would improve the quality of CMMs thereby ensuring the safety of the products and assisting Chinese medicine practitioners in their practice. The fast growing demand worldwide for traditional medicines calls for harmonized monographic standards to safeguard the safety and quality of CMM products.
Rydin, Claudia Alves de Jesus; Farina Busto, Luis; El Mjiyad, Nadia; Kota, Jhansi; Thelen, Lionel
The European Research Council (ERC), Europe's premiere funding agency for frontier research, views equality of opportunities as an important challenge. The ERC monitors closely gender figures on every call and has taken actions to tackle imbalances and potential unconscious biases. The ERC talk is focused on efforts made to understand and ensure equal treatment of all candidates, with particular focus on gender balance and with specific attention to geosciences. Data and statistics collected in running highly competitive and internationally recognised funding schemes are presented. Recent initiatives to tackle geographical imbalances will also be presented.
Pharmaceutical research and development has entered a new era, shifting from the one-size-fits-all approach of traditional medicine to patient-specific therapeutics. This change in treatment methodologies has placed an increased emphasis on well-preserved, well-documented biospecimens. Due to these advancements in medicine, specimen handling processes need to be in accordance with current Good Practice (GXP) quality guidelines and regulations, including Good Manufacturing Practices (GMPs), Good Laboratory Practices (GLPs), and Good Clinical Practices (GCPs), to ensure the safety of valuable biospecimen samples and their associated data. GXP guidelines delineate most aspects of clinical research. This is especially true for chain-of-custody documentation, as it provides a traceable record that guarantees unbroken control over a document, raw data, or a sample and its containers from initial collection to final disposition. Although establishing chain-of-custody can be a demanding practice, the process of verifying who has possession of specimens can be streamlined if an organization outlines chain-of-custody guidelines in their Standard Operating Procedures (SOPs). These processes and procedures ensure uniform application of best practices and successful knowledge transfer. As such, this article will outline the necessary components of establishing a highly visible and compliant chain-of-custody, including: maintaining 21 CFR Part 11 compliance; installing validated, redundant equipment for specimen storage and transportation; employing temperature-monitoring and -tracking devices; and best practices for implementing inventory and data management systems as well as audit trails.
Masum, Abdul Kadar Muhammad; Azad, Md Abul Kalam; Hoque, Kazi Enamul; Beh, Loo-See
The paper aims to examine the influence of human resource management (HRM) practices on bank efficiency using Malmquist index of total factor productivity. The model comprises HRM index that represents the quality of HRM practices. The results are decomposed into three efficiency scores, namely, technical efficiency, pure efficiency, and scale efficiency. In this study, panel data for 44 banks in Bangladesh are used for the period 2008-2013. This paper reveals that foreign banks are ahead in converting the influence of HRM practices into efficiency scores (0.946>0.833). On the other hand, domestic banks performed better than foreign banks in terms of pure efficiency and scale efficiency. But, in terms of technical efficiency, the domestic banks are regressed by 6.7% annually whereas foreign banks are progressed with a yearly value of 5.8%. The results are robust, because the Mann-Whitney test and Kruskall-Wallis test (non-parametric tests) also confirm the same results. This study emphasizes HRM practices in the banking industry to ensure efficiency in the long-term scenario. Domestic banks are suggested to ensure continuous development in HRM practices in order to compete with foreign banks.
Abdul Kadar Muhammad Masum
Full Text Available The paper aims to examine the influence of human resource management (HRM practices on bank efficiency using Malmquist index of total factor productivity. The model comprises HRM index that represents the quality of HRM practices. The results are decomposed into three efficiency scores, namely, technical efficiency, pure efficiency, and scale efficiency. In this study, panel data for 44 banks in Bangladesh are used for the period 2008-2013. This paper reveals that foreign banks are ahead in converting the influence of HRM practices into efficiency scores (0.946>0.833. On the other hand, domestic banks performed better than foreign banks in terms of pure efficiency and scale efficiency. But, in terms of technical efficiency, the domestic banks are regressed by 6.7% annually whereas foreign banks are progressed with a yearly value of 5.8%. The results are robust, because the Mann-Whitney test and Kruskall-Wallis test (non-parametric tests also confirm the same results. This study emphasizes HRM practices in the banking industry to ensure efficiency in the long-term scenario. Domestic banks are suggested to ensure continuous development in HRM practices in order to compete with foreign banks.
Konjar, Miha; Nikšič, Matej; Grom, Janez Peter; Mujkić, Sabina; Fikfak, Alenka
Lack of financial resources has become one of the main issues in fulfilling social and physical needs in urban development. The declining levels of public resources make the collaboration between public and private investors necessary. When facing the challenges of ageing population, shared investment may contribute to the appropriate development of sheltered housing to meet the goals of spatial planning as well as certain standards at the level of urban design. By ensuring appropriate living conditions for all generations such urban PPP projects may contribute to the fulfilment of the public interest. The paper presents practice of PPP implementation in Ljubljana, Slovenia, where local authority with the collaboration of private partners ensured more than 400 sheltered apartments in the last years. Examples show the extension of the idea from the 70s onwards in finding new models of housing for the aging population. The development of new models can be a good example of strengthening the cooperation between public and private partners in the field of urban development practice.
Dovgal Olеna A.
Full Text Available The article focuses on the analysis of institutional means for ensuring the technological leadership of Germany in the economic system of the EU. The main idea of all the programs and strategies of the European Union is to ensure competitive and dynamic development. Germany occupies a leading position in many respects both in the European and global technology market, which is due to the country’s strong scientific potential and the high level of spending on R&D. The article compares the tasks of the national high-tech strategy of the FRG and the strategy of the EU Innovation Union. There generalized the functions of the main components of the system of scientific associations of the Federal Republic of Germany, which are an effective tool for implementing the state policy in the field of innovation investment. An approach to qualitative assessment of the level of information interaction of the subjects in the system of R&D institutes and the diffusion of technologies using the criterion of information communication is proposed. A prospect for further research on this issue is a comprehensive analysis of the main components of Germany’s innovation strategy in the EU economic system.
Ademola P. Abidoye
Full Text Available The sensitivity of health-care information and its accessibility via the Internet and mobile technology systems is a cause for concern in these modern times. The privacy, integrity and confidentiality of a patient’s data are key factors to be considered in the transmission of medical information for use by authorised health-care personnel. Mobile communication has enabled medical consultancy, treatment, drug administration and the provision of laboratory results to take place outside the hospital. With the implementation of electronic patient records and the Internet and Intranets, medical information sharing amongst relevant health-care providers was made possible. But the vital issue in this method of information sharing is security: the patient’s privacy, as well as the confidentiality and integrity of the health-care information system, should not be compromised. We examine various ways of ensuring the security and privacy of a patient’s electronic medical information in order to ensure the integrity and confidentiality of the information.
Kurth, Ann E; Jacob, Sheena; Squires, Allison P; Sliney, Anne; Davis, Sheila; Stalls, Suzanne; Portillo, Carmen J
Nurses and midwives constitute the majority of the global health workforce and the largest health care expenditure. Efficient production, successful deployment, and ongoing retention based on carefully constructed policies regarding the career opportunities of nurses, midwives, and other providers in health care systems are key to ensuring universal health coverage. Yet nurses are constrained by practice regulations, workplaces, and career ladder barriers from contributing to primary health care delivery. Evidence shows that quality HIV care, comparable to that of physicians, is provided by trained nurses and associate clinicians, but many African countries' health systems remain dependent on limited numbers of physicians and fail to meet the demand for treatment. The World Health Organization endorses task sharing to ensure universal health coverage in HIV and maternal health, which requires an investment in nursing education, retention, and professional growth opportunities. Exemplars from Haiti, Rwanda, Republic of Georgia, and multi-country efforts are described. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.
Weaver, Jamie L.; McCloy, John S.; Ryan, Joseph V.; Kruger, Albert A.
How does glass alter with time? For the last hundred years this has been an important question to the fields of object conservation and archeology to ensure the preservation of glass artifacts. This same question is part of the development and assessment of durable glass waste forms for the immobilization of nuclear wastes. Researchers have developed experiments ranging from simple to highly sophisticated to answer this question, and, as a result, have gained significant insight into the mechanisms that drive glass alteration. However, the gathered data have been predominately applicable to only short-term alteration times, i.e. over the course of decades. What has remained elusive is the long-term mechanisms of glass alteration. These mechanisms are of particular interest to the international nuclear waste glass community as they strive to ensure that vitrified products will be durable for thousands to tens of thousands of years. For the last thirty years this community has been working to fill this research gap by partnering with archeologists, museum curators, and geologists to identify hundred to million-year old glass analogues that have altered in environments representative of those expected at potential nuclear waste disposal sites. The process of identifying a waste glass relevant analogue is challenging as it requires scientists to relate data collected from short-term laboratory experiments to observations made from long-term analogues and extensive geochemical modeling.
Hess, Susan M.
As the nuclear industry continues to grow throughout the world, we find that support from government officials, local business leaders and the general public is becoming more and more important. In order to help raise awareness and inform these various publics, AREVA expanded upon a best practice from its worldwide operations and recently established a Community Advisory Council in the United States. The member organizations represent a variety of grassroots and minority organizations from across the United States and are active in various ways in local, state and federal arenas. AREVA's objective for the Council is simple - listen to concerns, engage in dialogue and raise awareness about the intrinsic link existing between energy, CO 2 emissions, global warming, and economic growth, so these same people can make decisions when it comes to energy sources in the future. We want our members to help us better understand their communities, listen to their concerns and answer their questions openly and honestly. AREVA understands that this outreach and education are just the first steps toward helping clean energy sources grow. We must maintain regular dialog and operate in a safe manner, because in the long run, it is these community members who will ensure energy security for the country. And it is only by working together as an industry that we can ensure a safe, clean air future for generations to come, no matter where in the world we live. (authors)
Amar, Praveen Kumar
Disaster scenarios are dismal and often result in mass displacement and migration of people. In eventuality of emergency situations, people need to be rehabilitated and provided with an adequate supply of drinking water, the most essential natural resource needed for survival, which is often not easily available even during non-disaster periods. In the aftermath of a natural or human-made disaster affecting mankind and livestock, the prime aim is to ensure supply of safe water to reduce the occurrence and spread of water borne disease due to interrupted, poor and polluted water supply. Chemical, biological, radiological and nuclear (CBRN) emergencies augment the dilemma as an additional risk of "contamination" is added. The associated risks posed to health and life should be reduced to as low as reasonably achievable. Maintaining a high level of preparedness is the crux of quick relief and efficient response to ensure continuous supply of safe water, enabling survival and sustenance. The underlying objective would be to educate and train the persons concerned to lay down the procedures for the detection, cleaning, and treatment, purification including desalination, disinfection, and decontamination of water. The basic information to influence the organization of preparedness and execution of relief measures at all levels while maintaining minimum standards in water management at the place of disaster, are discussed in this article.
Praveen Kumar Amar
Full Text Available Disaster scenarios are dismal and often result in mass displacement and migration of people. In eventuality of emergency situations, people need to be rehabilitated and provided with an adequate supply of drinking water, the most essential natural resource needed for survival, which is often not easily available even during non-disaster periods. In the aftermath of a natural or human-made disaster affecting mankind and livestock, the prime aim is to ensure supply of safe water to reduce the occurrence and spread of water borne disease due to interrupted, poor and polluted water supply. Chemical, biological, radiological and nuclear (CBRN emergencies augment the dilemma as an additional risk of "contamination" is added. The associated risks posed to health and life should be reduced to as low as reasonably achievable. Maintaining a high level of preparedness is the crux of quick relief and efficient response to ensure continuous supply of safe water, enabling survival and sustenance. The underlying objective would be to educate and train the persons concerned to lay down the procedures for the detection, cleaning, and treatment, purification including desalination, disinfection, and decontamination of water. The basic information to influence the organization of preparedness and execution of relief measures at all levels while maintaining minimum standards in water management at the place of disaster, are discussed in this article.
With one in six people over 80 now suffering from dementia, advance directives provide an important means of empowerment. Upholding directives in the context of dementia, however, raises extra challenges, given the potential for the directive to conflict with an assessment of what is in the person's current best interests. Given the profound harm that tying a person with dementia to their previous wishes can do, it is essential that we have sufficient safeguards in place to ensure that we only uphold such directives where we can be sure they are truly autonomous and are intended to apply to the situation at hand-safeguards which are at present, severely lacking. This article will consider various mechanisms by which safeguards can be built into the legal regime to ensure that the original decision is autonomous, including making it mandatory for the person to undergo a consultation with a healthcare professional, which would involve a contemporaneous capacity assessment. Clinicians must also be confident that the directive applies to the situation at hand. Introducing formalities, including a standardised (though not mandatory) proforma, may help to enhance specificity about when the directive is triggered, and to what treatments it relates, to enable clinicians to better assess the directive's applicability. A national registry for advance directives might also be beneficial. It will be argued that health care professionals will have to play a much greater role in the drafting and registering of advance directives, if we are to feel comfortable in upholding them.
Ramskiy Andriy Yu.
Full Text Available The article is devoted to finances of homesteads as the main prerequisite of ensuring demand and supply in the investment market in Ukraine. It pays significant attention to clarification of the “finances of homesteads” definition. It detect the sources of formation and directions of use of financial resources of homesteads. It clarifies the composition of own and attracted financial resources of homesteads. Directions of use of financial resources by the balance approach include consumer expenditures, expenditures for acquisition of long-life commodities, real estate, land lots and investments (acquisition of investment products. The article reveals the dual role of non-circulating assets of homesteads depending on their use (personal or entrepreneurial for getting income. It also reveals factors that influence changing movement (flows of financial resources of homesteads. It develops a format for balancing financial resources of homesteads by the indirect method and by the end use (assessment of financial state, formation of income and expenditures and movement of financial resources. It identifies the role of finances of homesteads in ensuring demand and supply in the investment market.
Full Text Available It is established, that the management of commercial assortment (range of consumer goods should be implemented through an integrated (complex management system, through the implementation of a range of special functions. This range of special functions includes several ensurance functions which, in the case of management of the commercial assortment of consumer goods, are: logistical and financial provision for the generation and systematic improvement of commercial assortment of consumer goods; staffing, specialised training and continuing professional education of the personnel; technological assurance of the systematic formation and improvement of the commercial assortment of consumer goods; methodological provision of systematic formation and improvement of commercial assortment of consumer goods; legal assurance of systematic formation and improvement of commercial assortment of consumer goods; information assurance of systematic formation and improvement of commercial assortment of consumer goods; ideological assurance of systematic formation and improvement of commercial assortment of consumer goods. The development of a complex system for management of the commercial range of consumer goods implies, first of all, formulation of definition and determination of content (aim, tasks and elements of each special and specific system functions. This paper contains definitions and content of special functions supporting the complex system for the management of commercial range of consumer goods, the implementation of which is aimed at ensuring the effective management of commercial range of consumer goods in the retail trade network.
This report thoughtfully examines the challenges posed in ensuring that the search for truth reflects adherence to ethical standards. In recent years, we have learned, sometimes painfully, that not all scientists adhere to this obligation. Reports of falsified research results and plagiarism involving both junior and senior scientists have stimulated doubts and criticism about the ways in which misconduct in science is addressed by the research community. Misconduct in science is now being publicly examined in all of its aspects; how misconduct is defined, the process by which misconduct is discovered, and procedures for judging innocence or guilt and assessing penalties. Also being explored are the appropriate roles of individuals, research institutions, journals, government research agencies, and the legal system. Issues of misconduct and integrity in science present complex questions. These issues require the sustained attention of all members of the research community as well as of leaders in the public and private sector who are concerned with safeguarding the health of science. In this regard ensuring the integrity of the research process is similar to assuring safety in the workplace: it is a process that requires continued participation from all levels of the entire research enterprise--the practitioners, the host institutions, the sponsors in government, and the legislators who provide the funds.
Mathisen, Bernice; Carey, Lindsay B; Carey-Sargeant, Christa L; Webb, Gwendalyn; Millar, CaraJane; Krikheli, Lilli
This paper presents a viewpoint concerning the largely neglected clinical relevance of spirituality and religious belief in speech-language pathology (SLP) assessments, interventions and outcomes across the lifespan. An overview of the refereed SLP literature is presented with regard to religion and spirituality. It was found that while there is increasing research with regard to spirituality, health and well-being, there is very little specific to SLP. What is available and clinically relevant, generally relates to holistic care and/or cultural and linguistic diversity. Amidst the health care literature, however, there is a growing number of recommended instruments (for religious/spiritual screening) sensitive to intercultural and interfaith issues that are currently available to medical, nursing, allied health and chaplaincy practitioners. These instruments can also be of value to SLPs to ensure holistic assessments and interventions. It would seem timely for SLPs (and other allied health practitioners) to consider including spiritual screenings/assessments as part of their clinical practice so as to ensure appropriate holistic care. This would also mean undertaking research and including relevant education within tertiary institutions and professional development programs.
Graff, Pierre; Hu Weigang; Yom, Sue S.; Pouliot, Jean
Purpose: To determine if image-guided radiotherapy (IGRT) ensures dose coverage to the target, and to assess the dosimetric impact of anatomic changes using megavoltage cone-beam CT (MVCBCT) for patient positioning during head and neck IMRT. Methods and materials: Forty-eight MVCBCT from 10 head and neck IMRT/IGRT patients were analyzed off-line. Target volumes and organs at risk (OARs) contours delineated on CT were transferred and adjusted on MVCBCT images. Each MVCBCT was processed to allow dose recalculation, resulting in 469 dose–volume histograms (DVHs). The concept of dosimetric latitude was introduced to provide a clinical perspective. Results: MVCBCT target DVHs showed a moderate level of difference in D95 (dose to ⩾95% of volume), generally less than a 5% difference from the planned dose. Delivered-dose increases to the spinal cord and brainstem showed no apparent time trend. The 4 mm margin around OARs was a useful precaution to prevent exceeding critical dose thresholds. The parotid glands showed progressive increases in mean dose related to shrinkage of the external contours. Conclusion: IGRT repositioning ensured target volume coverage, but significant dose variations were observed for OARs. The dosimetric impact of anatomic changes during radiotherapy was of lesser importance than the effects of IGRT repositioning.
Muhammad Rehan Masoom
Full Text Available Successful women empowerment relies on providing quality infrastructure facilities to avail maternal healthcare on the national level. In this regard, ensuring women’s access to quality midwifery services is an important consideration. The major intervention for safe maternity is to be enhanced to enable the presence of the skilled midwifery to ensure the quality emergency obstetric care. Therefore, the scope of practice of a midwife is very critical in the supervision of the orderly physiological processes of pregnancy, labor, birth, and the postpartum phase. The midwife as an autonomous practitioner is expected to be competent and accountable for her practice. In Bangladesh, the number of women having the baby at home by unskilled personnel is quite high. Therefore, the government strives to educate midwives and commits to reducing maternal and newborn mortality and morbidity. This study explores the contemporary situation of maternity health to provide a critical understanding of the growing importance of the role of midwifery in Bangladesh. With this, the paper examines the way maternity services in Bangladesh transformed from a social to a medical model over the twentieth century and infers how the social agenda was part of this process.
L. E. Mistrov
Full Text Available The analysis of the purposes, tasks, functions and ways of ensuring conflict stability of func-tioning of information systems on the ba-sis of application of a complex of technical means is carried out. The main contours of management of elements of the organizational and technical systems (OTS in various forms of actions are defined. It is noted that a basis of functioning of OTS, infor-mation sup-port makes, classes of the data making him are defined. It is shown that ensuring conflict stability of functioning of the information sys-tems (IS is carried out by the complex of technical means (CTM, as a part of subsystems of reception / transfer, collecting and de-struction / distortion of information, their main functions are defined. Wednesday in which KTS function, is defined as an information and target situation which is understood as the part of a social and economic situa-tion characterized by existence of KTS providing functioning with IS, their location, operating modes, parameters of the information streams (IS, characteristics of technical means of processing, storage, submission of information realized by ways of the information security (IS for the solution of tasks in dynamics of information conflict. At the same time the information conflict is part target (the difficult conflict OTS representing information ex-change of KTS providing conflict steady functioning of IS at realization of processes of collection of information, transfer and counter-action to carrying out similar actions by the competing party with means of the destroying / distorting in-fluences (RIV. The special at-tention is paid to research of actions of a subsystem of collection of information, methods of collection of information are defined, con-ditions of application of methods of processing of the collected data are shown, features of functioning of subsystems of KTS at vari-ous stages of application are considered. The conclusion is drawn that
... aggregate workforce in each trade on all construction work in the covered area, are as follows: Goals for... Affirmative Action To Ensure Equal Employment Opportunity for Construction. 52.222-23 Section 52.222-23... Affirmative Action To Ensure Equal Employment Opportunity for Construction. As prescribed in 22.810(b), insert...
...] Guidance for Industry on Planning for the Effects of High Absenteeism To Ensure Availability of Medically... entitled ``Planning for the Effects of High Absenteeism to Ensure Availability of Medically Necessary Drug... components to develop production plans in the event of an emergency that results in high absenteeism at one...
... 49 Transportation 1 2010-10-01 2010-10-01 false How do PVOs ensure that passengers with disabilities are able to use accessible cabins? 39.39 Section 39.39 Transportation Office of the Secretary of... to Services § 39.39 How do PVOs ensure that passengers with disabilities are able to use accessible...
Jean-Arthur eMicoulaud Franchi
Full Text Available Neuromodulation therapeutics—as repeated Transcranial Magnetic Stimulation (rTMS and neurofeedback—are valuable tools for psychiatry. Nevertheless, they currently face some limitations: rTMS has confounding effects on neural activation patterns, and neurofeedback fails to change neural dynamics in some cases. Here we propose how coupling rTMS and neurofeedback can tackle both issues by adapting neural activations during rTMS and actively guiding individuals during neurofeedback. An algorithmic challenge then consists in designing the proper recording, processing, feedback, and control of unwanted effects. But this new neuromodulation technique also poses an ethical challenge: ensuring treatment occurs within a biopsychosocial model of medicine, while considering both the interaction between the patients and the psychiatrist, and the maintenance of individuals’ autonomy. Our solution is the concept of Cyborg psychiatry, which embodies the technique and includes a self-engaged interaction between patients and the neuromodulation device.
Full Text Available The paper analyses potentials, challenges and problems of the rural tourism from the point of view of its impact on sustainable rural development. It explores alternative sources of income for rural people by means of tourism and investigates effects of the rural tourism on agricultural production in local rural communities. The aim is to identify the existing and potential tourist attractions within the rural areas in Southern Russia and to provide solutions to be introduced in particular rural settlements in order to make them attractive for tourists. The paper includes the elaboration and testing of a methodology for evaluating the rural tourism potentials using the case of rural settlements of Stavropol Krai, Russia. The paper concludes with a ranking of the selected rural settlements according to their rural tourist capacity and substantiation of the tourism models to be implemented to ensure a sustainable development of the considered rural areas.
Rico, Ana María Blass
The number of tattooed persons has been continuously increasing in the last few years, particularly in the younger population. At the same time, the possibility of purchasing tattoo inks online is easier than ever worldwide. Consumers are not always sufficiently aware of the possible health problems associated with this 'cool fashion' if hygiene conditions are not respected and/or if the injected mixtures contain dangerous chemicals. Concerns about the possible health risks associated with such practices arise from the absence of a clear legislative framework, the lack of proper risk assessment of the chemicals used, and non-harmonised or missing hygiene and purity requirements, among other factors. There is a general consensus among all active stakeholders that EU harmonised rules would help to ensure a consistent high level of protection of consumers across the EU. © 2015 S. Karger AG, Basel.
Full Text Available The role of state partnership with a private sector in ensuring s development of territorial socio-economic systems was grounded. The process of interaction between local authorities and private operators was considered in the context of three stages: justification of the partnership necessity, conclusion a partnership agreement and monitoring the commitments implementation. The situation regarding distribution of PPP projects on the scope of partnership was described that allow to consider the instrument as a basis for joint responsibility for the development of priority sectors of the regional economy. The major issues of interaction between public and private operators that require legislative regulation were identified. The main components of evaluating the effectiveness of PPP projects from a government position and their logical sequence were suggested.
been growing over the last decade. Against this backdrop, the UN General Assembly invited states in December 2006 to consider the feasibility of an instrument establishing common international standards for conventional arms transfers-also known as the ‘Arms Trade Treaty' (ATT). The legality of arms...... transfers has traditionally been treated as a question of arms control law, but in the recent debate about legal restrictions on states' liberty to transfer arms, norms of international humanitarian and human rights law have frequently been invoked. This article surveys the existing international legal...... regulation of state-authorised conventional arms transfers, examines how humanitarian law, and in particular states' duty to ensure respect for humanitarian law, affects the legality of these transfers and shows why human rights law does not make a significant contribution to the legal regulation...
Saurabh RamBihariLal Shrivastava
Full Text Available Worldwide, the incidence of suicide has increased at an alarming rate and in the year 2012 close to 1 million people died because of suicide. Although, it is a well-acknowledged fact that suicides are completely preventable, the public health authorities have failed to halt the rising trend of the suicide because of the presence of various social and health related factors. As suicide is a complex issue, in the low and middle-income nations, the most cost-effective approach is to ensure the integration of suicide prevention program into the primary health care network. To conclude, suicide is an important public health concern which is definitively preventable. However, the need of the hour is that all the stakeholders should take collective responsibility, and work in collaboration to develop and implement a comprehensive multi-sectoral suicide prevention strategy.
Full Text Available This research aims to reveal the importance of securities market in ensuring economic growth in Armenia. In order to make the research more substantial, we also examined the impact of other financial market segments, such as insurance market and credit market, on the economic growth. To estimate the relationship between financial market segments and economic growth, an empirical research was conducted using correlation and regression techniques. The research reveals that the most significant impact on the economic growth among Armenian financial market segments has the credit market of Armenia. There is no significant relationship between economic growth and insurance, as well as corporate securities market. It is pointed out in the research, that the evolving importance of the role of securities market in the economic growth is not yet demonstrated in Armenia, which, perhaps, results from the absence of interaction between securities market and economy in Armenia.
Hofstra, Patricia S; Hart, Elinor L
In this increasingly complex world of Medicare reimbursement, physicians must constantly review their billing practices to ensure compliance with all Medicare requirements. "Incident-to" billing and provider-based billing are two areas that present unique challenges for providers, especially those practicing in hospital-owned practices such as hospital outpatient departments. Both incident-to and provider-based billing limit providers' abilities to bill for and receive reimbursement in those practice settings. The Office of Inspector General's 2012 Work Plan Report identified both incident-to billing and place-of-service errors as two of the many areas for investigation and compliance efforts in 2012. This article focuses on identifying the unique point-of-service challenges presented by physicians practicing in hospital outpatient departments or hospital-owned clinics.
Alongside the central focus on the persons requiring nursing care in professional nursing practice, the perspective of the sustainability of interventions and the use of materials (for example, nursing aids and hygiene articles) is gaining prominence in nursing decision-making processes. This contribution makes the principle of sustainability concrete and delineates its importance in the context of professional nursing practice and decision-making. It further suggests the development of an ethical policy in order to systematically ensure that sustainability has a place in ethical reflection and decision-making, and describes the elements involved. Finally, a synthesis is made between the importance of the principle of sustainability, suggested ethical policies (system of ethical reflection) as they affect nursing practice and professional reflection, decision-making, and practice. PMID:27417590
Lybecker, Kristina M; Fowler, Elisabeth
This paper examines two recent examples of compulsory licensing legislation: one globally embraced regime and one internationally controversial regime operating under the same WTO rules. In particular, we consider Canadian legislation and the use of compulsory licensing for HIV/AIDS drugs destined for a developing country. This is then contrasted with the conditions under which Thai authorities are pursuing compulsory licenses, the outcomes of their compulsory licenses, as well as the likely impact of the Thai policy. Finally, we construct a rubric to evaluate characteristics of a successful regime. This is used to analyze the Canadian and Thai regimes and frame the expected implications of each national policy. It is hoped that the assessment will guide changes to compulsory licensing design to ensure that legitimate regimes are embraced while illegitimate ones are disallowed.
In 1992, the Canadian Firearms Act aimed at ensuring safe storage of firearms was promulgated. This study compares suicide methods 6 years prior to the enactment of the law and 5 years after its enactment. The study encompassed 426 suicide cases from Abitibi-Témiscamingue (Northern Quebec), the region with the highest suicide rate and the highest firearm suicide rate in Quebec. Suicide by firearms decreased in the male and female population. Suicide by hanging increased among youths of both sexes, and suicide by poisoning doubled in the female population. A decrease in firearm suicides was most noticeable in the under-25 age group, although it was in this same age group that the general suicide rate increased the most. The reduction of firearm suicides was not accompanied by a decrease in overall suicide rates.
Chernetckaia, E.D.; Belyh, T.
To ensure the safe and efficient operation of nuclear power plants, since 1982 the laboratories of psycho-physiological support (LPPS) started being established at Russian NPPs. The methodological background for this was later summarised. The LPPS’ activity and professional development of LPPS specialists are currently supported by the scientific methodological centre “Psycho-Physiological Support of Professional Personnel Reliability” (PPSPPR) of Rosatom Central Institute for Continuing Education and Training (ROSATOMCICE& T). The present paper gives the outlines of the main LPPS tasks performed by above mentioned organizations at Russian NPPs: • psycho-physiological examination of candidates and employees (PFE); • psychological and physiological support of workers (PPS); • socio-psychological aspects of safety culture; • psycho-pedagogical support of the educational process.
Schovsbo, Jens Hemmingsen; Petersen, Clement Salung
The Unified Patent Court (UPC) will become a central player in the future development of European patent law. For this reason it becomes important to ensure that UPC‘s decision-making reflects the double-function of the Court as an adjudicator of individual disputes and a policy maker. Because...... of its institutional design, the UPC will be biased towards technology based values. Therefore, there is a risk that non-technical values and interests will be either overlooked or underdeveloped in UPC decision-making which is likely to jeopardize public trust and legitimacy of its decisions. This paper...... analyses how these blind spots can be covered in patent litigation before the UPC within the current legislative framework. The paper focuses on the role of UPC judges as case-managers and decision-makers, on the potential role of third party interveners, and addresses the key role of the parties...
Novoseltsev, V. I.; Orlova, D. E.; Dubrovin, A. S.; Irkhin, V. P.
The mathematical model of coordination when ensuring complex security of the organization is considered. On the basis of use of a method of casual search three types of algorithms of effective coordination adequate to mismatch level concerning security are developed: a coordination algorithm at domination of instructions of the coordinator; a coordination algorithm at domination of decisions of performers; a coordination algorithm at parity of interests of the coordinator and performers. Assessment of convergence of the algorithms considered above it was made by carrying out a computing experiment. The described algorithms of coordination have property of convergence in the sense stated above. And, the following regularity is revealed: than more simply in the structural relation the algorithm, for the smaller number of iterations is provided to those its convergence.
Mangipudy, Raja; Burkhardt, John; Kadambi, Vivek J
There is an active debate in toxicology literature about the utility of animal testing vis-a-vis alternative in vitro paradigms. To provide a balanced perspective and add to this discourse it is important to review the current paradigms, explore pros and cons of alternatives, and provide a vision for the future. The fundamental goal of toxicity testing is to ensure safety in humans. In this article, IQ Consortium DruSafe, while submitting the view that nonclinical testing in animals is an important and critical component of the risk assessment paradigm in developing new drugs, also discusses its views on alternative approaches including a roadmap for what would be required to enhance the utilization of alternative approaches in the safety assessment process. Copyright © 2014 Elsevier Inc. All rights reserved.
Barlow, Susan M.; Boobis, Alan R.; Bridges, Jim
Background Food legislation in the European Union and elsewhere includes both hazard- and risk-based approaches for ensuring safety. In hazard-based approaches, simply the presence of a potentially harmful agent at a detectable level in food is used as a basis for legislation and/or risk management...... explored at an ILSI Europe workshop. Key findings and conclusions It was concluded that both types of approach have their place, depending on the context. However, problems can arise when both types of approach are used in regulation by separate agencies that address different aspects of the same agent....... Use of hazard-based approaches for foods also means that comparisons with benefits for nutrition and food security cannot be undertaken. This has the potential to lead to bias in the overall conclusions of regulators and risk managers, who may not have been presented with the benefits of particular...
Full Text Available Conducting clinical trial feasibility is one of the first steps in clinical trial conduct. This process includes assessing internal and environmental capacity, alignment of the clinical trial in terms of study design, dose of investigational product, comparator, patient type, with the local environment and assessing potential of conducting clinical trial in a specific country. A robust feasibility also ensures a realistic assessment and capability to conduct the clinical trial. For local affiliates of pharmaceutical organizations, and contract research organizations, this is a precursor to study placement and influences the decision of study placement. This article provides details on different types of feasibilities, information which is to be included and relevance of each. The article also aims to provide practical hands-on suggestions to make feasibilities more realistic and informative.
Full Text Available PLK4 is the major kinase driving centriole duplication. Duplication occurs only once per cell cycle, forming one new (or daughter centriole that is tightly engaged to the preexisting (or mother centriole. Centriole engagement is known to block the reduplication of mother centrioles, but the molecular identity responsible for the block remains unclear. Here, we show that the centriolar cartwheel, the geometric scaffold for centriole assembly, forms the identity of daughter centrioles essential for the block, ceasing further duplication of the mother centriole to which it is engaged. To ensure a steady block, we found that the cartwheel requires constant maintenance by PLK4 through phosphorylation of the same substrate that drives centriole assembly, revealing a parsimonious control in which “assembly” and “block for new assembly” are linked through the same catalytic reaction to achieve homeostasis. Our results support a recently deduced model that the cartwheel-bound PLK4 directly suppresses centriole reduplication.
D. N. Shvayba1
Full Text Available Formation of an independent democratic Belarusian state is inextricably linked with transformations in all aspects of public life and, first of all, in economy. Economic reforms in Belarus are directed on creation of socially oriented market economic system, which will ensure the most efficient usage of resources at minimum social cost. In the social economy concepts of “equality” and “poverty” are considered as basic ones. Social security services are based on these concepts and role of the social security in any country is to reduce poverty and increase equality. In modern world poverty is uniquely associated with a low level of economic development and its eradication is the first step on the path to economic growth. As for inequality, such clear connection of this concept with economic development can not be traced. There are various theories explaining the impact of inequality on economic growth. However, they cannot be considered satisfactory because they predict opposite results. Several studies have universally postulated a security as protection of vital interests of a human being, society and State from internal and external threats. Vital interests comprise a set of needs and satisfaction of these needs reliably ensures existence and possibility of progressive development of a human being, society and State which are the main objects of the security. Presence of a hierarchical structure for organization of the system or its subsystems is an essential feature for any socio-economic system. The economy is a poly-hierarchical system. When considering the hierarchical structure of production management it is important to consider one property of the economic system that is incompleteness of information.
In the past 20 years the water quality of the United States has improved remarkably-the waters are safer for drinking, swimming, and fishing. However, despite many accomplishments, it is still difficult to answer such basic questions as: 'How clean is the water?' and 'How is it changing over time?' These same questions exist on a global scale as well. In order to focus water-data issues in the United States, a national Intergovernmental Task Force on Monitoring Water Quality (ITFM) was initiated for public and private organizations, whereby key elements involved in data collection, analysis, storage, and management could be made consistent and comparable. The ITFM recommended and its members are implementing a nationwide strategy to improve water-quality monitoring, assessment, and reporting activities. The intent of this paper is to suggest that a voluntary effort be initiated to ensure the comparability and utility of hydrological data on a global basis. Consistent, long-term data sets that are comparable are necessary in order to formulate ideas regarding regional and global trends in water quantity and quality. The author recommends that a voluntary effort similar to the ITFM effort be utilized. The strategy proposed would involve voluntary representation from countries and international organizations (e.g. World Health Organization) involved in drinking-water assessments and/or ambient water-quality monitoring. Voluntary partnerships such as this will improve curability to reduce health risks and achieve a better return on public and private investments in monitoring, environmental protection, and natural resource management, and result in a collaborative process that will save millions of dollars.In this work it is suggested that a voluntary effort be initiated to ensure the comparability and utility of hydrological data on a global basis. The strategy proposed would involve voluntary representation from countries and international organizations involved in
Henley, Patricia; Elango, Varalakshmi; Horstick, Olaf; Ahmad, Riris Andono; Maure, Christine; Launois, Pascal; Merle, Corinne; Nabieva, Jamila; Mahendradhata, Yodi
Quality and ethics need to be embedded into all areas of research with human participants. Good Clinical Practice (GCP) guidelines are international ethical and scientific quality standards for designing, conducting, recording and reporting trials involving human participants. Compliance with GCP is expected to provide public assurance that the rights, safety and wellbeing of participants are protected and that the clinical research data are credible. However, whilst GCP guidelines, particularly their principles, are recommended across all research types, it is difficult for non-clinical trial research to fit in with the exacting requirements of GCP. There is therefore a need for guidance that allows health researchers to adhere to the principles of GCP, which will improve the quality and ethical conduct of all research involving human participants. These concerns have led to the development of the Good Health Research Practice (GHRP) course. Its goal is to ensure that research is conducted to the highest possible standards, similar to the conduct of trials to GCP. The GHRP course provides training and guidance to ensure quality and ethical conduct across all health-related research. The GHRP course has been run so far on eight occasions. Feedback from delegates has been overwhelmingly positive, with most delegates stating that the course was useful in developing their research protocols and documents. Whilst most training in research starts with a guideline, GHRP has started with a course and the experience gained over running the courses will be used to write a standardised guideline for the conduct of health-related research outside the realm of clinical trials, so that researchers, funders and ethics committees do not try to fit non-trials into clinical trials standards.
Hunt, C. A.; Durham, W. H.; Gaffikin, L.
When then president José Figueres Ferrer invited the world to use Costa Rica as a "laboratory for sustainable development" in 1997, the country's fame as a biodiversity mecca was firmly established. Yet despite vast investment, conservation-related interventions in the cantons of Osa and Golfito along the country's southern Pacific coast have been seen as overly conservation-oriented and carried out "with its back to the communities." By ignoring human well-being, these interventions have been unable to overcome the region's vast disparities in access to resources and general state of underdevelopment despite investments of many millions of dollars in recent decades. With the country's third international airport and Central America's largest hydroelectric project proposed for the region, as well as other infrastructure-driven development currently underway, the region is poised to undergo rapid change. This presentation first describes the Osa-Golfito Initiative (INOGO), an interdisciplinary effort facilitated by the Stanford Woods Institute for the Environment to development a long term strategic action plan that ensures a development trajectory focused on human and environmental well-being. Whereas a concurrent presentation will focus on biophysical components of INOGO, the focus here is on the often-overlooked contributions of social science for ensuring the region's future sustainability. An anthropological approach is taken to assess the assets and resources of the region's residents, and the obstacles and challenges as they perceive them. This groundwork provides a crucial link between individual and local realities, and the regional and national political economy, and thus provides greater probability of sustainable development occurring with its "face to the communities.";
Full Text Available The present study is focusing on analysing the role played by the foreign banks within the national and international banking system as well the impact the foreign banks have on the autochthon banking system, on the financial activity, on the real economy and on the financial stability on long terms. The research conducted highlights the fact that along the positive impact on the banking system and on the economy of the host country, generated by their quality as vectors of mobilizing and directioning the international financial flows towards the host country, there can also be considered a negative impact. The study shows that the impact of the negative effects, that have as main cause the reversibility of the international financial flows, depends, on a great extent, on the specific conditions of the host country, on the characteristics of the foreign banks, but mostly, by the share held by the foreign countries within the framework of the host banking system. Starting from the role played by the capitalization of the banking system to ensure financial stability, the research made on Romania’s case shows both, the positive effects generated by the presence of the foreign banks and also, their vulnerability in front of this excessive dependence on the foreign capital induced by this presence. The solution to reduce this dependence can only come from the autochthon capital direction whose mobilization may countervail the gap made by the foreign banks and, by surceasing the process of financial disintermediation, to ensure the maintenance of the financial stability on long term.
Julia M Lee
Full Text Available BACKGROUND: Plants, due to their immobility, have evolved mechanisms allowing them to adapt to multiple environmental and management conditions. Short-term undesirable conditions (e.g. moisture deficit, cold temperatures generally reduce photosynthetic carbon supply while increasing soluble carbohydrate accumulation. It is not known, however, what strategies plants may use in the long-term to adapt to situations resulting in net carbon depletion (i.e. reduced photosynthetic carbon supply and carbohydrate accumulation. In addition, many transcriptomic experiments have typically been undertaken under laboratory conditions; therefore, long-term acclimation strategies that plants use in natural environments are not well understood. METHODOLOGY/PRINCIPAL FINDINGS: Perennial ryegrass (Lolium perenne L. was used as a model plant to define whether plants adapt to repetitive carbon depletion and to further elucidate their long-term acclimation mechanisms. Transcriptome changes in both lamina and stubble tissues of field-grown plants with depleted carbon reserves were characterised using reverse transcription-quantitative polymerase chain reaction (RT-qPCR. The RT-qPCR data for select key genes indicated that plants reduced fructan degradation, and increased photosynthesis and fructan synthesis capacities following carbon depletion. This acclimatory response was not sufficient to prevent a reduction (P<0.001 in net biomass accumulation, but ensured that the plant survived. CONCLUSIONS: Adaptations of plants with depleted carbon reserves resulted in reduced post-defoliation carbon mobilization and earlier replenishment of carbon reserves, thereby ensuring survival and continued growth. These findings will help pave the way to improve plant biomass production, for either grazing livestock or biofuel purposes.
Suprayitno, Hitapriya; Ratnasari, Vita
Transport Modelling is important. For certain cases, the conventional model still has to be used, in which having a good trip production model is capital. A good model can only be obtained from a good sample. Two of the basic principles of a good sampling is having a sample capable to represent the population characteristics and capable to produce an acceptable error at a certain confidence level. It seems that this principle is not yet quite understood and used in trip production modeling. Therefore, investigating the Trip Production Modelling practice in Indonesia and try to formulate a better modeling method for ensuring the Model Quality is necessary. This research result is presented as follows. Statistics knows a method to calculate span of prediction value at a certain confidence level for linear regression, which is called Confidence Interval of Predicted Value. The common modeling practice uses R2 as the principal quality measure, the sampling practice varies and not always conform to the sampling principles. An experiment indicates that small sample is already capable to give excellent R2 value and sample composition can significantly change the model. Hence, good R2 value, in fact, does not always mean good model quality. These lead to three basic ideas for ensuring good model quality, i.e. reformulating quality measure, calculation procedure, and sampling method. A quality measure is defined as having a good R2 value and a good Confidence Interval of Predicted Value. Calculation procedure must incorporate statistical calculation method and appropriate statistical tests needed. A good sampling method must incorporate random well distributed stratified sampling with a certain minimum number of samples. These three ideas need to be more developed and tested.
Tella, Susanna; Smith, Nancy-Jane; Partanen, Pirjo; Jamookeeah, David; Lamidi, Marja-Leena; Turunen, Hannele
To explore and compare Finnish and British nursing students' perceptions of their learning about patient safety in clinical settings. Patient safety culture and practices in different health care organisations and clinical units varies, posing challenges for nursing students' learning about patient safety during their clinical placements. Patient safety as a growing international concern has challenged health care professionals globally requiring a comprehensive review. International studies comparing nursing education about patient safety are lacking. A cross-sectional comparative study. The participants were final year preregistration nursing students from two universities of applied sciences in Finland (n = 195) and from two universities in England, UK (n = 158). The data were collected with the Patient Safety in Nursing Education Questionnaire and analysed with principal component analysis, Pearson Chi-Square and Mann-Whitney U tests and logistic regression. Finnish nursing students had significantly more critical perceptions on their learning about patient safety in clinical settings than their British peers. A strong predictor for differences was supportive and systems-based approaches in learning to ensure patient safety. Notably, fewer Finnish students had practiced reporting of incidents in clinical settings compared to British students. In both countries, the students held learning about patient safety in higher esteem compared to their learning experiences in clinical settings. Nursing students appear to want more learning opportunities related to patient safety compared to the reality in clinical settings. Learning systematically from errors in a supportive environment and having systems-based approaches to ensure patient safety are essential elements for nursing students' learning about safe practice. Finnish students seem to experience more barriers in learning about safe practices and to report errors than the British students. Health care
The elements that determine the success of development projects on goats and the prerequisites for ensuring this are discussed in the context of the bewildering diversity of goat genetic resources, production systems, multifunctionality, and opportunities for responding to constraints for productivity enhancement. Key determinants for the success of pro-poor projects are the imperatives of realistic project design, resolution of priorities and positive impacts to increase investments and spur agricultural growth, and appropriate policy. Throughout the developing world, there exist 97% of the total world population of 921 million goats across all agro-ecological zones (AEZs), including 570 breeds and 64% share of the breeds. They occupy a very important biological and socio-economic niche in farming systems making significant multifunctional contributions especially to food, nutrition and financial security, stability of farm households, and survival of the poor in the rural areas. Definitions are given of successful and failed projects. The analyses highlighted in successful projects the value of strong participatory efforts with farmers and climate change. Climate change effects on goats are inevitable and are mediated through heat stress, type of AEZ, water availability, quantity and quality of the available feed resources and type of production system. Within the prevailing production systems, improved integrated tree crops - ruminant systems are underestimated and are an important pathway to enhance C sequestration. Key development strategies and opportunities for research and development (R and D) are enormous, and include inter alia defining a policy framework, resolution of priority constraints using systems perspectives and community-based participatory activities, application of yield-enhancing technologies, intensification, scaling up, and impacts. The priority for development concerns the rainfed areas with large concentrations of ruminants in which
Full Text Available The elements that determine the success of development projects on goats and the prerequisites for ensuring this are discussed in the context of the bewildering diversity of goat genetic resources, production systems, multifunctionality, and opportunities for responding to constraints for productivity enhancement. Key determinants for the success of pro-poor projects are the imperatives of realistic project design, resolution of priorities and positive impacts to increase investments and spur agricultural growth, and appropriate policy. Throughout the developing world, there exist 97% of the total world population of 921 million goats across all agro-ecological zones (AEZs, including 570 breeds and 64% share of the breeds. They occupy a very important biological and socio-economic niche in farming systems making significant multifunctional contributions especially to food, nutrition and financial security, stability of farm households, and survival of the poor in the rural areas. Definitions are given of successful and failed projects. The analyses highlighted in successful projects the value of strong participatory efforts with farmers and climate change. Climate change effects on goats are inevitable and are mediated through heat stress, type of AEZ, water availability, quantity and quality of the available feed resources and type of production system. Within the prevailing production systems, improved integrated tree crops - ruminant systems are underestimated and are an important pathway to enhance C sequestration. Key development strategies and opportunities for research and development (R and D are enormous, and include inter alia defining a policy framework, resolution of priority constraints using systems perspectives and community-based participatory activities, application of yield-enhancing technologies, intensification, scaling up, and impacts. The priority for development concerns the rainfed areas with large concentrations of
Full Text Available Rachel K Voss,1 Tessa N Woods,1 Kate D Cromwell,1 Kelly C Nelson,2 Janice N Cormier1 1Department of Surgical Oncology, 2Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Abstract: Patients with thin, low-risk melanomas have an excellent long-term prognosis and higher quality of life than those who are diagnosed at later stages. From an economic standpoint, treatment of early stage melanoma consumes a fraction of the health care resources needed to treat advanced disease. Consequently, early diagnosis of melanoma is in the best interest of patients, payers, and health care systems. This review describes strategies to ensure that patients receive an early diagnosis through interventions ranging from better utilization of primary care clinics, to in vivo diagnostic technologies, to new “apps” available in the market. Strategies for screening those at high risk due to age, male sex, skin type, nevi, genetic mutations, or family history are discussed. Despite progress in identifying those at high risk for melanoma, there remains a lack of general consensus worldwide for best screening practices. Strategies to ensure early diagnosis of recurrent disease in those with a prior melanoma diagnosis are also reviewed. Variations in recurrence surveillance practices by type of provider and country are featured, with evidence demonstrating that various imaging studies, including ultrasound, computed tomography, positron emission tomography, and magnetic resonance imaging, provide only minimal gains in life expectancy, even for those with more advanced (stage III disease. Because the majority of melanomas are attributable to ultraviolet radiation in the form of sunlight, primary prevention strategies, including sunscreen use and behavioral interventions, are reviewed. Recent international government regulation of tanning beds is described, as well as issues surrounding the continued use artificial ultraviolet
Muldowney, J; Mounsey, J; Kinsella, L
With the human population predicted to reach nine billion by 2050, demand for food is predicted to more than double over this time period, a trend which will lead to increased greenhouse gas (GHG) emissions from agriculture. Furthermore, expansion in food production is predicted to occur primarily in the developing world, where adaptation to climate change may be more difficult and opportunities to mitigate emissions limited. In the establishment of the United Nations Framework Convention on Climate Change (UNFCCC), 'ensuring that food production is not threatened' is explicitly mentioned in the objective of the Convention. However, the focus of negotiations under the Convention has largely been on reducing GHG emissions from energy, and industrial activities and realizing the potential of forestry as a carbon sink. There has been little attention by the UNFCCC to address the challenges and opportunities for the agriculture sector. Since 2006, concerted efforts have been made to raise the prominence of agriculture within the negotiations. The most recent The Intergovernmental Panel on Climate Change report and 'The Emissions Gap Report' by the UNEP highlighted the significant mitigation potential of agriculture, which can help contribute towards keeping global temperature rises below the 2°C limit agreed in Cancun. Agriculture has to be a part of the solution to address climate change, but this will also require a focus on how agriculture systems can adapt to climate change in order to continue to increase food output. However, to effectively realize this potential, systematic and dedicated discussion and decisions within the UNFCCC are needed. UNFCCC discussions on a specific agriculture agenda item started in 2012, but are currently inconclusive. However, Parties are generally in agreement on the importance of agriculture in contributing to food security and employment as well as the need to improve understanding of agriculture and how it can contribute to
Orlov Vladimir Aleksandrovich
Full Text Available The authors present an analysis of various types of internal protective pipeline coatings to ensure the strength and hydraulic characteristics of a remodeled pipeline and related coating methods for effective trenchless renovation of engineering systems, water supply systems and sanitation. As protective coating the authors considered a round profile tube of a smaller diameter than of the old pipe, close to the old pipe, sprayed lining on the basis of inorganic and inorganic materials. The article analyzes the methods of trenchless renovation for applying protective coatings: routing in the old pipeline of new pipes made of polymeric materials or polymeric sleeves, centrifugal spraying on the inner surface of pipelines’ inorganic and organic protective coatings. Special attention was paid to bag technology, providing the required strength properties at specific values of the modulus of elasticity and a number of external factors such as the depth of the existing pipe, the existence and magnitude of the horizon groundwater over it. Also attention is paid to the application technology of tape coatings ribbed profile on the inner surface of pipelines. This technology has a unique feature, which is the ability of recoverable pipeline functioning during its renovation by winding an endless belt and the formation of a new pipe. The tape coating winding is carried out by different types of spiral winding machines. The thickness of the protective coating layer forming the tube remains minimal. Inorganic cement-sand and organic coatings were considered as alternative options for repair of pipelines, which allow to localize the defects in the form of a fistula, minor cracks and other damages. However it is noted that a cement-sandy covering is inferior to organic, because it does not provide the strength characteristics of the pipeline system. The main advantage of the organic coating is mudding fistula of a large diameter, making a high wear
Full Text Available This paper describes USP-NF compendial updates to six ‘high-priority” excipient monographs: Glycerin, Propylene Glycol, Sorbitol Solution, Sorbitol Sorbitan Solution, Noncrystallizing Sorbitol Solution and Maltitol Solution. The USP-NF revisions arose from the Food and Drug Administration’s (FDA’s requests to include, as part of each monograph’s Identification test, a limit test to detect the presence of Diethylene Glycol (DEG, a toxic adulterant. These revisions align with the 2007 FDA Guidance for Industry: Testing of Glycerin for Diethylene Glycol (1, that drug product manufacturers perform a specific identity test for DEG on all containers of all lots of glycerin before glycerin is used in the manufacture and preparation of drug products. This paper describes several risk factors due to a complex global excipient supply chain, nonspecific specifications, inadequate supply chain qualification, and poor understanding of regulations. Strengthening and conformance to compendial specifications is one of the tools necessary to mitigate risk and help prevent the next DEG adulteration that is part of USP’s efforts to ensure safe medicines.
Full Text Available Todd M Sabato, Tanis J Walch, Dennis J Caine Department of Kinesiology and Public Health Education, University of North Dakota, Grand Forks, ND, USA Abstract: This article presents a current review of the risk of physical and psychological injury associated with participation in elite youth sport, and suggests strategies to ensure the physical and emotional health of these young athletes. Although there is lack of epidemiological data, especially with regard to psychological injury, preliminary data suggest that the risk of injury is high in this population. While there is lack of incident and follow-up data, there is also concern regarding burnout, disordered eating, and the long-term consequences of injury. Modifiable injury risk factors identified include postural control, competition anxiety, life events, previous injury, and volume of training. There are presently no studies designed to determine the effectiveness of injury prevention measures in elite youth sports. However, there is adequate evidence arising from injury prevention studies of youth sports participants – including neuromuscular training, protective equipment, mental training to enhance self-esteem, and sport rules modification – to prevent injuries in elite youth sports settings. Although not tested, psychosocial prevention strategies such as adoption of task-oriented coping mechanisms, autonomous support from parents, and a proactive organizational approach also show promise in injury prevention. Keywords: elite, young athlete, athletic injury, psychological, risk factors, injury prevention
Sabato, Todd M; Walch, Tanis J; Caine, Dennis J
This article presents a current review of the risk of physical and psychological injury associated with participation in elite youth sport, and suggests strategies to ensure the physical and emotional health of these young athletes. Although there is lack of epidemiological data, especially with regard to psychological injury, preliminary data suggest that the risk of injury is high in this population. While there is lack of incident and follow-up data, there is also concern regarding burnout, disordered eating, and the long-term consequences of injury. Modifiable injury risk factors identified include postural control, competition anxiety, life events, previous injury, and volume of training. There are presently no studies designed to determine the effectiveness of injury prevention measures in elite youth sports. However, there is adequate evidence arising from injury prevention studies of youth sports participants - including neuromuscular training, protective equipment, mental training to enhance self-esteem, and sport rules modification - to prevent injuries in elite youth sports settings. Although not tested, psychosocial prevention strategies such as adoption of task-oriented coping mechanisms, autonomous support from parents, and a proactive organizational approach also show promise in injury prevention.
Tapan Kumar Jain
Full Text Available The research work proposes a cluster head selection algorithm for a wireless sensor network. A node can be a cluster head if it is connected to at least one unique neighbor node where the unique neighbor is the one that is not connected to any other node. If there is no connected unique node then the CH is selected on the basis of residual energy and the number of neighbor nodes. With the increase in number of clusters, the processing energy of the network increases; hence, this algorithm proposes minimum number of clusters which further leads to increased network lifetime. The major novel contribution of the proposed work is an algorithm that ensures a completely connected network with minimum number of isolated nodes. An isolated node will remain only if it is not within the transmission range of any other node. With the maximum connectivity, the coverage of the network is automatically maximized. The superiority of the proposed design is verified by simulation results done in MATLAB, where it clearly depicts that the total numbers of rounds before the network dies out are maximum compared to other existing protocols.
Barton, G; Lonsdale, B
The purpose of this presentation is to address two important issues. The first issue is nationwide availability of urea. The second is assurance by the engine maker that the engine cannot operate without urea. In regard to the first issue, North American urea production can support SCR needs for the Heavy Duty truck industry. The existing distribution methods, pathways and technology could be utilized for urea supply with no new invention required. Urea usage and storage capacity on vehicles would support long distances between tank refills, as SCR could be initially rolled out with a limited infrastructure. The price of urea should be less than diesel fuel and urea SCR should have a fuel economy advantage over competing technologies. It can be in place by 2007. In regard to the second issue, sensor technology exists to monitor urea tank level and verify that the fluid in the tank is urea. NOx sensors are available to monitor tailpipe NOx, ensuring the entire SCR system is functioning properly, and inferring that urea is in the system. The monitoring system could be used to monitor compliance, record faults, and initiate enforcement actions as necessary. The monitoring system could initiate actions to encourage compliance.
Harada, Ryoko; Ishikura, Kenji; Shinozuka, Shunsuke; Mikami, Naoaki; Hamada, Riku; Hataya, Hiroshi; Morikawa, Yoshihiko; Omori, Tae; Takahashi, Hirotaka; Hamasaki, Yuko; Kaneko, Tetsuji; Iijima, Kazumoto; Honda, Masataka
In pediatric patients, due to variations in baseline serum creatinine (Cr) reference values, renal dysfunctions sometimes go unnoticed. In addition, renally excreted drugs need dose adjustment while nephrotoxic drugs should be avoided altogether in patients with impaired renal function. However, most physicians are apparently unaware of these facts and may administer these drugs to vulnerable patients. We administered a questionnaire to all physicians and pharmacists specializing in pediatric medical care at six Tokyo metropolitan government-run hospitals in Japan. 276 (59%) of 470 physicians and pharmacists participated. The rate of correct answers given by physicians who were asked to state the serum Cr reference range for 4-year-olds and 8-year-olds was 83 and 74%, respectively. On the other hand, the rate of correct answers given by pharmacists to the same question was only 27 and 24%, respectively. Only about 50% of physicians were aware that histamine H 2 -receptor antagonists and oseltamivir are renally excreted or that acyclovir and angiotensin II receptor blocker are nephrotoxic. However, most of the pharmacists recognized that histamine H 2 -receptor antagonists and oseltamivir are renally excreted drugs. For the majority of the investigated drugs, the awareness that we need to reduce dosages for patients with renal dysfunction was insufficient. To ensure safe drug administration, communication between physicians and pharmacists is paramount. There is an urgent need for the creation of a safe drug administration protocol for pediatric patients with renal dysfunction.
Liebhard, Peter; Sager, Manfred
Soils at geogenically metalliferous sites might exceed heavy metal threshold levels with respect to agricultural use, apart from anthropogenic contamination sources. As a fundamental substrate for green plants and green plant production, soil is not easily renewable, its formation needs long time (e.g. 500 years for 20 mm). In Austria, about 10ha of soil get sealed every day, resulting in complete loss of its biological functions. Excavated soil material has been classified as waste from a legal point of view, which made 33 mill. tons resp. 48% of total waste in Austria in 2010. Recycling of excavated soil material for agricultural use will be an important task to reduce future waste and to enlarge agricultural substrate volumes, but methods to ensure proper qualities are needed to improve regulations. Within this investigation, the transfer of various metals from geogenically metalliferous soils to various crop plants will be investigated, and correlated with various simple soil test methods. Four excavated soil materials from the metalliferous schist zone within the Austrian province of Styria (Kraubath/Mur, Übelbach) and a low-metal reference sample have been taken as substrates to grow raygrass (lolium multiflorum) as a green cover, salad (Lactuca sativa) as a vegetable food item, oats (Avena sativa), maize (Zea mais) and stinging nettle (Urtica dioica) as a hyperaccumulating species. Results and recommendations will be presented.
Estévez, J.; Gavilán, P.; García-Marín, A. P.
Quality assurance of meteorological data is crucial for ensuring the reliability of applications and models that use such data as input variables, especially in the field of environmental sciences. Spatial validation of meteorological data is based on the application of quality control procedures using data from neighbouring stations to assess the validity of data from a candidate station (the station of interest). These kinds of tests, which are referred to in the literature as spatial consistency tests, take data from neighbouring stations in order to estimate the corresponding measurement at the candidate station. These estimations can be made by weighting values according to the distance between the stations or to the coefficient of correlation, among other methods. The test applied in this study relies on statistical decision-making and uses a weighting based on the standard error of the estimate. This paper summarizes the results of the application of this test to maximum, minimum and mean temperature data from the Agroclimatic Information Network of Andalusia (southern Spain). This quality control procedure includes a decision based on a factor f, the fraction of potential outliers for each station across the region. Using GIS techniques, the geographic distribution of the errors detected has been also analysed. Finally, the performance of the test was assessed by evaluating its effectiveness in detecting known errors.
Fernández, Fátima; Pinacho, Daniel G; Gratacós-Cubarsí, Marta; García-Regueiro, José-Antonio; Castellari, Massimo; Sánchez-Baeza, Francisco; Marco, M-Pilar
Enrofloxacin (ERFX) is a synthetic antibiotic of the fluoroquinolone (FQ) family, which is commonly administered in veterinary medicine. ERFX and its metabolite, ciprofloxacin (CPFX), have been reported to accumulate in hair of treated animals. Therefore, hair analysis is an attractive non-invasive alternative to control misuse of such antibiotic and to ensure food safety by preventing such food derived products arrive to the consumer. In this context, an immunochemical analytical protocol has been established to detect ERFX and CPFX residues in cattle hair samples. Unpigmented and pigmented hair were collected from ERFX-treated and non-treated calves, and the aqueous NH4OH extracts were directly analyzed by ELISA, being possible to achieve limits of detection in the range of 10-30 μg kg(-1). A good concordance between HPLC and ELISA measurements was observed. The results demonstrate the potential of the immunochemical procedure reported here to rapidly screen and quantitate FQ residues in hair samples. Copyright © 2014 Elsevier Ltd. All rights reserved.
Knutson, D J
The Chronic Illness Management Research and Development Project (CIMRDP) was created as part of an effort to implement clinical process improvements in HealthSystems Minnesota, a vertically integrated care system in Minneapolis. CIMRDP's objective is to introduce sustainable improvements in the management of chronic illness. These types of quality improvement efforts require fundamental change at the organizational level, which often does not occur, and the programs do not continue beyond the initial stage. Using CIMRDP as a model for a sustainable chronic illness management program, this paper explores the process of implementing clinical guidelines for the management of chronic illness and contending with the complex problem of initiating change at an organizational level. It reviews factors critical to the success of such a program, including the use of focus groups to ensure a patient-centered approach, the advantage of hiring an outside consultant, the question of whether to accept external funding, and an evaluation outline of the six main tasks the program requires. Methods for marketing and integration are also presented.
Academic freedom is generally regarded as being of critical importance to the development, improved understanding, and dissemination of new knowledge in a field. Although of obvious importance to the discipline of nursing, the nature, extent and value of academic freedom and the controversies surrounding it have rarely been considered in the nursing literature. It is a key aim of this paper to redress this oversight by providing a brief examination of: (i) the principle of academic freedom; (ii) the distinction between academic freedom, freedom of speech, and the academic freedom to publish; (iii) the problem of ideological judgments being dressed up as scientific or discipline judgments to supports 'bad' conclusions; and (iv) the standards that might otherwise be appealed to for determining whether maverick manuscripts supporting morally abhorrent conclusions should be accepted for publication. It is suggested that the tenets of academic freedom require robust international debate, with due attention being given to such issues as the development of an international declaration on academic freedom to publish in nursing, how to ensure a robust rebuttal system in nursing journals to counter specious scholarship, and how to better promote the letters pages of nursing journals as a venue for facilitating debate on controversial issues. © 2011 Blackwell Publishing Ltd.
Full Text Available Nowadays, service providers offer a lot of IT services in the public or private cloud. The client can buy various kinds of services like SaaS, PaaS, etc. Recently there was introduced Backup as a Service (BaaS as a variety of SaaS. At the moment there are available several different BaaSes for archiving the data in the cloud, but they provide only a basic level of service quality. In the paper we propose a model which ensures QoS for BaaS and some methods for management of storage resources aimed at achieving the required SLA. This model introduces a set of parameters responsible for SLA level which can be offered on the basic or higher level of quality. The storage systems (typically HSM, which are distributed between several Data Centres, are built based on disk arrays, VTLs, and tape libraries. The RSMM model does not assume bandwidth reservation or control, but is rather focused on the management of storage resources.
Kumar, Sanjeev; Gautam, Satyendra
Shelled sweet corn kernels are prone to microbial contaminations due to high moisture and nutrient contents. Post harvest handling further aggravates the condition and makes the product highly perishable and unsafe. In freshly shelled kernels total aerobic plate count, yeast mold count and presumptive coliforms were found to be ∼ 8, 7, and 4 log cfu/g, respectively. IMViC analysis confirmed presence of opportunistic pathogens like Escherichia coli and Enterobacteraerogenes in these samples. Besides, occurrence of mycotoxin such as ochratoxin A (OTA), classified as a possible carcinogenic compound, was found to be high in sweet corn samples spiked with toxigenic strain. To address this issue, a combination process including NaOCl washing (200 ppm for 5 min), hot water blanching (60℃ for 5 min), air drying, LDPE packaging, and finally gamma radiation (5 kGy) treatment was developed. The developed combination process was found to reduce microbial load to below detectable level and quite effectively inactivated Aspergillusochraceus spores as well as pre-formed toxin. These treatments were not found to affect the contents of biochemical constituents such as total and reducing sugars, proteins, phenolics, and flavonoids during storage. Prophylactic properties in terms of antioxidant capacity and potential to suppress chemical induced mutagenesis were not affected in these samples. Physical properties and sensory qualities were also found to be similar to fresh (control). Thus, the developed combination process ensured microbiological safety and extended shelf life of sweet corn kernels up to 30 days at 4℃ . (author)
Redmayne, Nichola; Robertson, Sherryl; Kockler, Jutta; Llewelyn, Victoria; Haywood, Alison; Glass, Beverley
Sodium valproate, which is commonly repacked to assist with adherence to ensure seizure control, is hygroscopic and therefore sensitive to moisture. The aim of this study was thus to determine the stability implications of removing the enteric coated tablets from their original packaging and repackaging into a Dose Administration Aid (DAA) with storage under various environmental conditions. Physicochemical stability of enteric coated sodium valproate tablets repackaged into a DAA and stored at controlled room temperature, accelerated and refrigerated conditions was evaluated for 28 days. A validated high performance liquid chromatography method was used for the quantitation of the drug content. Although the chemical stability (sodium valproate between 95 and 105% of labelled content) was maintained for 28 days for all storage conditions, for those tablets stored under accelerated conditions the integrity of the enteric coat was compromised after only 8 days. Repackaging of enteric coated sodium valproate should be undertaken with caution and be informed by storage climate. This is particularly relevant for those patients living in hot, humid environments where they should be advised to store their DAA in a refrigerator. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
The Polar Cap (PC) indices, PCN (North) and PCS (South) are based on polar geomagnetic observations from Qaanaaq (Thule) and Vostok, respectively, processed to measure the transpolar plasma convection that may seriously affect space weather conditions. To establish reliable space weather forecasts based on PC indices, and also to ensure credibility of their use for scientific analyses of solar wind-magnetosphere interactions, additional sources of data for the PC indices are investigated. In the search for alternative index sources, objective quality criteria are established here to be used for the selection among potential candidates. These criteria are applied to existing PC index series to establish a quality scale. In the Canadian region, the data from Resolute Bay magnetometer are shown to provide alternative PCN indices of adequate quality. In Antarctica, the data from Concordia Dome-C observatory are shown to provide basis for alternative PCS indices. In examples to document the usefulness of these alternative index sources it is shown that PCN indices in a real-time version based on magnetometer data from Resolute Bay could have given 6 h of early warning, of which the last 2 h were "red alert", up to the onset of the strong substorm event on 13 March 1989 that caused power outage in Quebec. The alternative PCS indices based on data from Dome-C have helped to disclose that presently available Vostok-based PCS index values are corrupted throughout most of 2011.
Crusius, John; Kenna, Timothy C.
Sedimentary records of naturally occurring and fallout-derived radionuclides are widely used as tools for estimating both the ages of recent sediments and rates of sedimentation and bioturbation. Developing these records to the point of data interpretation requires careful sample collection, processing, analysis and data modeling. In this work, we document a number of potential pitfalls that can impact sediment core records and their interpretation. This paper is not intended as an exhaustive treatment of these potential problems. Rather, the emphasis is on potential problems that are not well documented in the literature, as follows: (1) the mere sampling of sediment cores at a resolution that is too coarse can result in an apparent diffusive mixing of the sedimentary record at rates comparable to diffusive bioturbation rates observed in many locations; (2) 210Pb profiles in slowly accumulating sediments can easily be misinterpreted to be driven by sedimentation, when in fact bioturbation is the dominant control. Multiple isotopes of different half lives and/or origin may help to distinguish between these two possible interpretations; (3) apparent mixing can occur due simply to numerical artifacts inherent in the finite difference approximations of the advection diffusion equation used to model sedimentation and bioturbation. Model users need to be aware of this potential problem. Solutions to each of these potential pitfalls are offered to ensure the best possible sediment age estimates and/or sedimentation and bioturbation rates can be obtained.
Full Text Available Luciana Baroni,1 Cristina Zuliani2 1Primary Care Unit, Northern District, Azienda ULSS 9 Treviso, Italy; 2Department of Neurology, General Hospital, Mirano, Venice, Italy Abstract: Nutrition is becoming an important tool in the management of the main chronic diseases, including Parkinson's disease (PD. Nutritional status has been shown to deteriorate with the progression of PD, due to motor and nonmotor complications. Dietary protein can reduce the effectiveness of levodopa treatment in PD patients, since the large neutral amino acids and levodopa share the same saturated carrier system, while fiber can improve the drug bioavailability. Moreover, nutrition seems to be directly involved in PD risk: high dietary intakes of animal fat, iron, mercury, and dairy, as well as western dietary patterns can increase it, while intake of some antioxidant compounds and plant-based dietary patterns can be protective. The means of ensuring good nutritional status in PD range from providing adequate energy and nutrients for the body, to considering in a broader perspective, the management of motor and nonmotor symptoms and chronic levodopa treatment complications, as well as pursuing potential neuroprotection. This review summarizes the most relevant results in the literature, and discusses the contribution of diet in the management of PD. Keywords: levodopa, Mediterranean diet, plant-based diet, protein-redistribution diet, vegetarian diet
The impacts of trade liberalization and open markets on global, regional, and local economies are a key consideration for those involved in government, business, and financial sectors. However, their impacts on health and social well-being of populations are not well-evidenced acknowledged within the health sector, let alone the impact on developing countries. As free trade becomes an inevitable outcome for many developing nations, the full implications of trade on economies, environments, and population health needs to be better articulated in order to ensure fully informed trade negotiations that support equitable outcomes. This article takes a broad look at the key issues for Papua New Guinea (PNG) in trade and how these translate to discrepancies in economic, health, and social benefits for its population. Despite its active trading and high GDP, only 10% of the population experience better economic and social outcomes. The bulk of PNG's population lives in poverty, challenged by geographical, cultural, and political barriers to better income, education, and health. Progress needs to be made to minimize these barriers and to allow more of PNG's population to experience the economic benefits generated through trade activities. A balance needs to be maintained between the desire of developed countries to broaden their markets, and the efforts of developing countries to promote and protect the health and well-being of their populations through increasing participation in global markets. PACER Plus presents an opportunity for pursuing alternative models of trade agreements that support and develop Pacific health.
Herrera-Sánchez, Isabel M.; León-Pérez, José M.; León-Rubio, José M.
There is increasing meta-analytic evidence that addresses the positive impact of evidence-based occupational health and safety interventions on employee health and well-being. However, such evidence is less clear when interventions are approached at an organizational level and are aimed at changing organizational policies and processes. Given that occupational health and safety interventions are usually tailored to specific organizational contexts, generalizing and transferring such interventions to other organizations is a complex endeavor. In response, several authors have argued that an evaluation of the implementation process is crucial for assessing the intervention’s effectiveness and for understanding how and why the intervention has been (un)successful. Thus, this paper focuses on the implementation process and attempts to move this field forward by identifying the main factors that contribute toward ensuring a greater success of occupational health and safety interventions conducted at the organizational level. In doing so, we propose some steps that can guide a successful implementation. These implementation steps are illustrated using examples of evidence-based best practices reported in the literature that have described and systematically evaluated the implementation process behind their interventions during the last decade. PMID:29375413
Miller, Kyle; Elias, Paul; Fonseca, Ricardo; Winjum, Benjamin; Tsung, Frank; Decyk, Viktor; Mori, Warren
Electromagnetic particle-in-cell (PIC) simulations compute the trajectories of particles as they interact via fields calculated by numerically solving Maxwell's equations on a grid using currents (and charge densities) from the particles. Within PICKSC, UCLA maintains a variety of open-source and open-access codes. These include OSIRIS-developed in partnership with IST-and UPIC-EMMA. Standard OSIRIS uses a rigorous charge-conserving current deposit to ensure the consistency of Gauss's law together with a finite-difference (FD) solution to Maxwell's equations. It also contains options for spectral (FFT) and hybrid (FFT and FD) field solvers, as well as a customized, higher-order FD field solver to help mitigate the numerical Cerenkov instability. The standard charge conserving current deposit is only valid for second-order accurate FD solvers. Another option for maintaining the consistency of Gauss's law is the Boris correction, where a ``direct'' current deposit is used and the electric field is corrected through the use of a Poisson solve. The Boris correction-with both exact and iterative multigrid Poisson solves-has been implemented into OSIRIS. Preliminary analyses of timing and fluctuations levels will be presented, including the effects of different particle orders. Work supported by NSF and DOE.
Lu, Yonglong; Jenkins, Alan; Ferrier, Robert C; Bailey, Mark; Gordon, Iain J; Song, Shuai; Huang, Jikun; Jia, Shaofeng; Zhang, Fusuo; Liu, Xuejun; Feng, Zhaozhong; Zhang, Zhibin
China's increasingly urbanized and wealthy population is driving a growing and changing demand for food, which might not be met without significant increase in agricultural productivity and sustainable use of natural resources. Given the past relationship between lack of access to affordable food and political instability, food security has to be given a high priority on national political agendas in the context of globalization. The drive for increased food production has had a significant impact on the environment, and the deterioration in ecosystem quality due to historic and current levels of pollution will potentially compromise the food production system in China. We discuss the grand challenges of not only producing more food but also producing it sustainably and without environmental degradation. In addressing these challenges, food production should be considered as part of an environmental system (soil, air, water, and biodiversity) and not independent from it. It is imperative that new ways of meeting the demand for food are developed while safeguarding the natural resources upon which food production is based. We present a holistic approach to both science and policy to ensure future food security while embracing the ambition of achieving environmental sustainability in China. It is a unique opportunity for China to be a role model as a new global player, especially for other emerging economies.
Modern safety and security systems are composed of a large number of various components designed for detection, localization, tracking, collecting, and processing of information from the systems of monitoring, telemetry, control, etc. They are required to be highly reliable in a view to correctly perform data aggregation, processing and analysis for subsequent decision making support. On design and construction phases of the manufacturing of such systems a various types of components (elements, devices, and subsystems) are considered and used to ensure high reliability of signals detection, noise isolation, and erroneous commands reduction. When generating design solutions for highly reliable systems a number of restrictions and conditions such as types of components and various constrains on resources should be considered. Various types of components perform identical functions; however, they are implemented using diverse principles, approaches and have distinct technical and economic indicators such as cost or power consumption. The systematic use of different component types increases the probability of tasks performing and eliminates the common cause failure. We consider type-variety principle as an engineering principle of system analysis, mathematical models based on this principle, and algorithms for solving optimization problems of highly reliable safety and security systems design. Mathematical models are formalized in a class of two-level discrete optimization problems of large dimension. The proposed approach, mathematical models, algorithms can be used for problem solving of optimal redundancy on the basis of a variety of methods and control devices for fault and defects detection in technical systems, telecommunication networks, and energy systems.
Full Text Available In the performance a variety of technological operations a human may come into contact with a variety of factors caus-ing deterioration of safety at work. As an example of which is described in article, adhesive bonding operations are re-quiring use of specific chemicals, which are adhesives. They are produced on the basis of a variety of compounds, often hazardous to human health. Furthermore, adhesive bonding requires a series of preparatory operations such as degreas-ing or surface preparation with a specific structure and roughness and auxiliary operations such as measurement of the wettability of surface. In this paper are described examples of risks occurring during adhesive bonding, it is a simple way to estimate the risks associated with the performance of operations. The examples of the determination by the produc-ers of chemicals are described which are used in adhesive bonding and fragment of international chemical safety card (ICSC, as a source of information important to the workplace organization and ensuring safety during adhesive bonding.
Ramapriyan, Hampapuram K.; Behnke, Jeanne
Program, NASA has followed an open data policy, with non-discriminatory access to data with no period of exclusive access. NASA has well-established processes for assigning and or accepting datasets into one of 12 Distributed Active Archive Centers (DAACs) that are parts of EOSDIS. EOSDIS has been evolving through several information technology cycles, adapting to hardware and software changes in the commercial sector. NASA is responsible for maintaining Earth science data as long as users are interested in using them for research and applications, which is well beyond the life of the data gathering missions. For science data to remain useful over long periods of time, steps must be taken to preserve: (1) Data bits with no corruption, (2) Discoverability and access, (3) Readability, (4) Understandability, (5) Usability' and (6). Reproducibility of results. NASAs Earth Science data and Information System (ESDIS) Project, along with the 12 EOSDIS Distributed Active Archive Centers (DAACs), has made significant progress in each of these areas over the last decade, and continues to evolve its active archive capabilities. Particular attention is being paid in recent years to ensure that the datasets are published in an easily accessible and citable manner through a unified metadata model, a common metadata repository (CMR), a coherent view through the earthdata.gov website, and assignment of Digital Object Identifiers (DOI) with well-designed landing product information pages.
Cutler, Cathy S; Schwarz, Sally W
The uncertain availability of (99m)Tc has become a concern for nuclear medicine departments across the globe. An issue for the United States is that currently it is dependent on a supply of (99m)Tc (from (99)Mo) that is derived solely by production outside the United States. Since the United States uses half the world's (99)Mo production, the U.S. (99)Mo supply chain would be greatly enhanced if a producer were located within the United States. The fragility of the old (99)Mo supply chain is being addressed as new facilities are constructed and new processes are developed to produce (99)Mo without highly enriched uranium. The conversion to low-enriched uranium is necessary to minimize the potential misuse of highly enriched uranium in the world for nonpeaceful means. New production facilities, new methods for the production of (99)Mo, and a new generator elution system for the supply of (99m)Tc are currently being pursued. The progress made in all these areas will be discussed, as they all highlight the need to embrace diversity to ensure that we have a robust and reliable supply of (99m)Tc in the future. © 2014 by the Society of Nuclear Medicine and Molecular Imaging, Inc.
For the past several years, both the U.S. nuclear power industry and the U.S. Nuclear Regulatory Commission have devoted significant attention and resources toward improving the performance of motor-operated valves (MOVs). Clearly, the level of attention and resources given to MOVs has resulted in an improved understanding of the design, operation, and maintenance of these components. The enhanced knowledge of these types of valves provides the engineering basis for maintaining reliable performance over their service lives. The accumulation of this knowledge, however, has come at a tremendous expense that continues to absorb industry and regulatory attention and resources. Given that the contribution to safety of individual MOVs varies widely, a number of questions have been raised concerning whether this expenditure results in commensurate benefits and to what extent this expenditure should continue. This paper proposes to apply resources in a manner that is commensurate with the safety-significance of individual MOVs. This approach should not only lead to increased levels of confidence in plant safety, but should also result in a more efficient use of industry and regulatory resources. This paper recommends using a graded approach that can optimize the safety benefits in ensuring MOV performance. The graded approach is founded on a blend of probabilistic and deterministic methods
Hjeresen, D.; Roybal, S.; Bertino, P.; Gherman, C.; Hosteny, B.
Los Alamos National Laboratory (LANL or the Laboratory) is developing and implementing a comprehensive, Integrated Standards-Based Management System (ISBMS) to enhance environmental, safety, and health (ESH) compliance efforts and streamline management of ESH throughout the Laboratory. The Laboratory recognizes that to be competitive in today's business environment and attractive to potential Partnerships, Laboratory operations must be efficient and cost-effective. The Laboratory also realizes potential growth opportunities for developing ESH as a strength in providing new or improved services to its customers. Overall, the Laboratory desires to establish and build upon an ESH management system which ensures continuous improvement in protecting public health and safety and the environment and which fosters a working relationship with stakeholders. A team of process experts from the LANL Environmental Management (EM) Program Office, worked with management system consultants, and the Department of Energy (DOE) to develop an ESH management systems process to compare current LANL ESH management Systems and programs against leading industry standards. The process enabled the Laboratory to gauge its performance in each of the following areas: Planning and Policy Setting; Systems and Procedures; Implementation and Education; and Monitoring and Reporting. The information gathered on ESH management systems enabled LANL to pinpoint and prioritize opportunities for improvement in the provision of ESH services throughout the Laboratory and ultimately overall ESH compliance
Full Text Available Sustainability relies on the environmental, social and economical systems: the three pillars of sustainability. The social sustainability mostly advocates the people’s welfare, health, safety, and quality of life. In the agricultural food industry, the aspects of social sustainability, such as consumer health and safety have gained substantial attention due to the frequent cases of food-borne diseases. The food-borne diseases due to the food degradation, chemical contamination and adulteration of food products pose a serious threat to the consumer’s health, safety, and quality of life. To ensure the consumer’s health and safety, it is essential to develop an efficient system which can address these critical social issues in the food distribution networks. This research proposes an ePedigree (electronic pedigree traceability system based on the integration of RFID and sensor technology for real-time monitoring of the agricultural food to prevent the distribution of hazardous and adulterated food products. The different aspects regarding implementation of the proposed system in food chains are analyzed and a feasible integrated solution is proposed. The performance of the proposed system is evaluated and finally, a comprehensive analysis of the proposed ePedigree system’s impact on the social sustainability in terms of consumer health and safety is presented.
Ross, Warren E; Huang, Karen H C; Jones, Greg H
The success of newly recruited medical school department chairs has become increasingly important for achievement of organizational goals. An effective onboarding program for these chairs can greatly facilitate early success, as well as satisfaction of the new hire with the position and the school. Onboarding programs can include traditional orientation items such as payroll signup and parking details, but should focus heavily on sharing organizational structure, culture, and how things get done. The goals of onboarding will be well served by implementation of three roles in the process. An Orientation Navigator can assist the new chair in the orientation phase, completing new employee documents and navigating the day-to-day challenges of working at the location. A Peer Mentor, generally a sitting chair, serves as both "buddy" and mentor, providing moral support as well as ensuring that the new chair gains an understanding of the people and processes important for getting things done. A Transition Mentor serves over a longer term as a sounding board and coach outside the peer group, assisting in a variety of ways to promote the chair's growth, development, and success as a leader. Finally, any onboarding process is significantly compromised without the active participation of the dean, meeting regularly with the chair to clarify expectations, promote assimilation, and solve problems. Successful onboarding begins with a mindfulness of the needs of the newly hired chair, and a well-designed and well-implemented plan will have wide-ranging benefits for the chair and the organization.
Full Text Available The purpose of the article is to deepen theoretical and methodological provisions and to develop tools for ensuring the quality of labor potential of industrial enterprises. It was established that the basis of the development of tools for quality assurance of labor potential (within the framework of the development of industrial enterprises lies the system of goals of managerial diagnostics of an industrial enterprise, which includes such key diagnostic objectives as: 1 diagnostics of the effectiveness of controlling the internal business processes of the enterprise; 2 diagnostics of the effectiveness of the typical organizational structure of enterprise management; 3 diagnostics of the efficiency of standardization of the work of linear and functional managers and specialists at the enterprise; 4 diagnostics of the enterprise in the areas of vocational education, labor activity and motivation, innovation work and social development; 5 diagnostics of management policies in the areas of social responsibility, information security and labor protection; 6 diagnostics of the level of conflict in the team at the enterprise 7 diagnosis of the effectiveness of the use of information technology in the management of the enterprise. It was determined that effective management of the quality of labor potential of the personnel (on the basis of its objective assessment is one of the key conditions that determines the success of industrial enterprises. The prospect of further research in this direction is improving the system of diagnostics and planning of reserves for improving the quality of labor potential of an industrial enterprise in crisis conditions.
Kaur, Manpreet; Devi, Raksha; Ghosh, Tanushree; Khan, Md Muntaz; Kumar, Praveen; Priyanka; Kar, Ananya; Sharma, Aparna; Varshney, Akhil; Kumar, Vipin; Saxena, Sandeep
The migration of chromosomes during mitosis is mediated primarily by kinesins that bind to the chromosomes and move along the microtubules, exerting pulling and pushing forces on the centrosomes. We report that a DNA replication protein, Sld5, localizes to the centrosomes, resisting the microtubular pulling forces experienced during chromosome congression. In the absence of Sld5, centriolar satellites, which normally cluster around the centrosomes, are dissipated throughout the cytoplasm, resulting in the loss of their known function of recruiting the centrosomal protein, pericentrin. We observed that Sld5-deficient centrosomes lacking pericentrin were unable to endure the CENP-E- and Kid-mediated microtubular forces that converge on the centrosomes during chromosome congression, resulting in monocentriolar and acentriolar spindle poles. The minus-end-directed kinesin-14 motor protein, HSET, sustains the traction forces that mediate centrosomal fragmentation in Sld5-depleted cells. Thus, we report that a DNA replication protein has an as yet unknown function of ensuring spindle pole resistance to traction forces exerted during chromosome congression. Copyright © 2017 American Society for Microbiology.
Paula A. Ortiz-Valencia
Full Text Available The main objective of the controllers in photovoltaic systems (PV is to ensure the maximum extraction of the available power. Those controllers usually combine the action of a maximum power point tracking algorithm (MPPT with a voltage regulator, which has the function of rejecting disturbances at the panel terminals. Such controllers are commonly based on PI and PID structures, it requiring linearized models at an operating point. But, due to disturbances generated by the environment and the load, the operating point of the system changes drastically, which hinder to obtain the desired system performance. This paper proposes to regulate the PV system using a Fuzzy PID controller, which adapts to changes in solar irradiance and load oscillations. This characteristic guarantees a constant settling time, which is required to precisely define the period of the MPPT algorithm. In the case of classical linear controllers, the period of the MPPT algorithm is set to the worst case (longest period which generates additional power losses by slowing down the tracking of the optimal operating point. Therefore, the solution proposed in this paper improves the overall system efficiency. Finally, such a solution is validated through simulations in Matlab®.
Moitrier, C.; Tirel, I.; Villard, C.
The objective of the CEA studies carried out under research topic 3 (long-term interim storage) of the 1991 French radioactive waste management law is to demonstrate the industrial feasibility of a comprehensive, flexible interim storage facility by thoroughly evaluating and comparing all the basic components of various interim storage concepts. In this context, the CEA is considering reference solutions or concepts based on three primary components (the package, the interim storage facility and the site) suitable for determining the specifications of a very long-term solution. Some aspects are examined in greater detail, such as the implementation of long-term technologies, conditioning processes ensuring the absence of water and contamination in the facility, or allowance for radioactive decay of the packages. The results obtained are continually compiled in reports substantiating the design options. These studies should also lead to an overall economic assessment in terms of the capital and operating cost requirements, thereby providing an additional basis for selecting the design options. The comparison with existing industrial facilities highlights the technical and economic progress represented by the new generation of interim storage units. (authors)
Full Text Available The Polar Cap (PC indices, PCN (North and PCS (South are based on polar geomagnetic observations from Qaanaaq (Thule and Vostok, respectively, processed to measure the transpolar plasma convection that may seriously affect space weather conditions. To establish reliable space weather forecasts based on PC indices, and also to ensure credibility of their use for scientific analyses of solar wind-magnetosphere interactions, additional sources of data for the PC indices are investigated. In the search for alternative index sources, objective quality criteria are established here to be used for the selection among potential candidates. These criteria are applied to existing PC index series to establish a quality scale. In the Canadian region, the data from Resolute Bay magnetometer are shown to provide alternative PCN indices of adequate quality. In Antarctica, the data from Concordia Dome-C observatory are shown to provide basis for alternative PCS indices. In examples to document the usefulness of these alternative index sources it is shown that PCN indices in a real-time version based on magnetometer data from Resolute Bay could have given 6 h of early warning, of which the last 2 h were “red alert”, up to the onset of the strong substorm event on 13 March 1989 that caused power outage in Quebec. The alternative PCS indices based on data from Dome-C have helped to disclose that presently available Vostok-based PCS index values are corrupted throughout most of 2011.
Mansurov Ruslan Evgenyevich
Full Text Available The article presents the results of the research on the current state of the beet sugar subcomplex of Ryazan region in the context of the need of improving its efficiency. The study let the author determine that currently the beet sugar subcomplex of Ryazan region does not ensure domestic demand in sand sugar. However, there are reserves of providing more efficient use of soil and climate capacity as well as the productivity potential of the region. When applying the technology of field beet piling, the period of sugar production at sugar factories may be extended up to 200 days. At this, up to 51 thousand tons of sand sugar can be produced. This amount will completely cover the annual demand for sugar in Ryazan region. In order to further study the feasibility of this approach, zoning was carried out and let allocate the zones of beet seeding. As a result, it was determined that a number of areas are far removed from the place of treatment, and in terms of transportation costs minimization the sugar beet cultivation in these areas is not rational. As an alternative, the author proposes to consider the possibility of building a new sugar factory in Ryazhsky district with the processing capacity of 1,000 tons of sugar beet per day. Taking this into account, the recommended acreage of sugar beet by districts and zones of raw material supply were obtained through corresponding calculations.
Wada, Ryutaro; Tanaka, Satoru; Nagasaki, Shinya
Generally speaking, a vast, advanced and unfamiliar science and technology are unacceptable to the public for fear of their unknown nature. Here, the social acceptance process model was examined on the basis of the analysis of the cause phenomenon and numerical grounds, by referring to the problems on the application of literature documentation for location examination of a high-level radioactive waste disposal site in Toyo town in Kochi Pref. in April 2007. In analyzing the Toyo town case, we have found a possibility that the majority of local residents knew very little about the object opposed by the fringe route processing. To ensure a healthy decision making by the public, it is vital to convey fundamental information using sufficient wide-area PR media before the issue becomes actual. After the issue becomes actual, dialog with residents through a careful technology assessment is indispensable. The authors focus attention on the decision-making process of human beings from the social and psychological viewpoints, and point out that it is desirable for promoting social acceptance by adopting two approaches: a direct approach aiming at better intelligibility for the different resident layers and a deductive approach in technological essence. (author)
Andrei Teofil Postolachi
Full Text Available The problematic of energy policy is nowadays widely disputed in the European Union community. In a global context characterized by highly and raising dependency of the economic activity on the energetic resources, the European authorities had launched a strategy in this sector which regards the problems of access to secure and affordable energy products. The aim of this paper is linked to the natural gas field of the European energetic concerns, and it assumes the high dependency of internal consumption on imports, more than half of the natural gas that is used in the 27 states comes from abroad. Ensuring a higher level of security in the supply is one of the goals that European Union wants to achieve on medium and long term. In these circumstances, actual measurements take into account different type of actions: stabilize relations with existing partner gas exporters (Russia, Algeria, Norway; diversification of transport routes coming from these countries, especially in the idea of trying to avoid transit countries (mainly Ukraine and Belarus; and finally opening discussions and investing in alternative routes which should transport the gas from new suppliers placed in the Caspian Sea or Central Asia region.
Jeong, Sohyun; Ji, Eunhee
The distribution of counterfeit or falsified drugs is increasing worldwide. This can contribute to the high burden of disease and cost to society and is of global concern with the worldwide circulation of pharmaceuticals. The preparation and implementation of good distribution practice should be one of the most important aspects of ensuring safe drug circulation and administration. This research aimed to compare and analyze good distribution practice guidelines from advanced countries and international organizations, and to evaluate the status of the current good distribution practice guidelines in the world. Advanced pharmaceutical countries and international organizations, such as the World Health Organization, European Union, Pharmaceutical Inspection Co-operation Scheme, United States of America, Canada, and Australia, which have stable good distribution practice guidelines and public confidence, were included in the analysis. The World Health Organization and European Union guidelines are models for standardized good distribution practice for nations worldwide. The United States of America has a combination of four different series of distribution practices which have a unique structure and detailed content compared to those of other countries. The Canadian guidelines focus on temperature control during storage and transportation. The Australian guidelines apply to both classes of medicinal products and medical devices and need separate standardization. Transparent information about the Internet chain, international cooperation regarding counterfeiting, a high-standard qualification of sellers and customers, and technology to track and trace the whole life cycle of drugs should be the main focus of future good distribution practice guidelines worldwide. .
Vaisnys, P.; Bieth, M.; Kosilov, A.; Lipar, M.
Full text: Maintaining nuclear competencies in the nuclear industry and nuclear regulatory authorities will be one of the most critical challenges in the near future. The adequate management of human resources, proper educational system and training approaches and methods to achieve and maintain the proper competencies of personnel are indispensable elements of knowledge management for nuclear industry. To transfer the knowledge from the experience to the newcomers, to establish the consistent links between the national educational system and qualification needs, to respond to the changes in the nuclear technology, to ensure the adequate level of corporate memory are the examples of the links between the knowledge management and the training. The paper presents the extensive information on the challenges, the nuclear industry encounters in the training and qualification (T and Q) of the personnel, and the good practises that are in use at nuclear power plants to respond to these challenges. The information presented is based on the experience from the IAEA OSART missions which review the training and qualification matters at the nuclear power plants among the other operational management programmes. IE/JRC-EC supports the OSART activities by providing the experts for the specific operational areas and participating in the development of the IAEA Safety Standards. New Project launched in the IE in 2007, SONIS (Safety of nuclear installations) is focused on the operational aspects of nuclear power plants, in particular maintenance, and the qualification and training of the maintenance personnel is of the particular interest of SONIS. The information presented in the paper is the result of the thorough analysis of the OSMIR Data Base. This database is a compilation of recommendations, suggestions and good practices from OSART mission reports, and covers all missions from January 1991 to the most recent missions for which an official reports have been published. It was
Chen, Ken; Pan, Longfa; Xu, Bin; Liu, Wei
"Quality requirements and handling regulation of archival optical disc for electronic records filing" is released by The State Archives Administration of the People's Republic of China (SAAC) on its network in March 2007. This document established a complete operative managing process for optical disc data storage in archives departments. The quality requirements of the optical disc used in archives departments are stipulated. Quality check of the recorded disc before filing is considered to be necessary and the threshold of the parameter of the qualified filing disc is set down. The handling regulations for the staffs in the archives departments are described. Recommended environment conditions of the disc preservation, recording, accessing and testing are presented. The block error rate of the disc is selected as main monitoring parameter of the lifetime of the filing disc and three classes pre-alarm lines are created for marking of different quality check intervals. The strategy of monitoring the variation of the error rate curve of the filing discs and moving the data to a new disc or a new media when the error rate of the disc reaches the third class pre-alarm line will effectively guarantee the data migration before permanent loss. Only when every step of the procedure is strictly implemented, it is believed that long-term reliability of the data storage on optical disc for archives departments can be effectively ensured.
Full Text Available This article aims to analyze the implementation of state obligations and responsibility ensuring the availability of clean water as part of human rights in Karimunjawa islands. The analysis based on principle of the State obligations and responsibility to fulfill their citizen right. Water sources in Karimunjawa Islands is very limited. It depend on forest conservation. Around 9.600 peoples live in Karimunjawa Islands, but Karimunjawa is non groundwater basin region. It means, Karimunjawa doesn’t have groundwater potential. The quantity of water depends on the season. The solution to maintain the sustainability of clean water is piping from water reservoir to residential areas. The problem is there are so many hotels in Karimunjawa islands, it disrupted the fulfillment of clean water. Besides utilizing water from reservoir, many hotels drilled the ground to get water. It had impact to the availibity of water in dry season and affected to fulfillment of water supply for Karimunjawa people. There is no specific regulation and policy to solve this problem. Clean water management is doing by Karimunjawa’s people. Meanwhile, based on Mahkamah Konstitusi Decree number 85/PUU-XI/2013, state is a rights holder to dominate the water in accordance with the Articles 33 paragraph (2 and (3 UUD NRI 1945, so the government has an obligation to make a policy, regulations, management, and supervision.
Nedelin Mikhail, D.
Full Text Available The process of modernization and greening of business activity is considered in the paper. This process requires in terms of the development dynamics of Russian regions, the implementation of directed towards the modern transformation of the municipal infrastructure in the region, which allows to transform the reform processes on different objects to achieve well-being in the Russian regions from the perspective of state interests, business and civil society. The effective direction for the modernization of the system to ensure the regional social-economic development is the creation of our proposed mechanism of cluster interaction of state and business structures in the sphere of housing and communal services of municipalities. Therefore, in this study, an analysis of the directions of state support for the development of cluster cooperation in the sphere of housing and communal services of municipalities, aimed at achieving a multiplier effect, in the exercise of entrepreneurial activity in the region socially significant areas, in particular - in the landscaping and planting areas is carried out.
The availability of several techniques for residual stress control is discussed in this paper. The effectiveness of these techniques in protecting from fatigue and stress-corrosion cracking is verified by numerical analysis and actual experiment. In-process control during welding for residual stress reduction is easier to apply than using post-weld treatment. As an example, control of the welding pass sequence for multi-pass welding is applied to cruciform joints and butt-joints with an X-shaped groove. However, residual stress improvement is confirmed for post-weld processes. Water jet peening is useful for obtaining a compressive residual stress on the surface, and the tolerance against both fatigue and stress-corrosion cracking is verified. Because cladding with a corrosion-resistant material is also effective for preventing stress-corrosion cracking from a metallurgical perspective, the residual stress at the interface of the base metal is carefully considered. The residual stress of the base metal near the clad edge is confirmed to be within the tolerance of crack generation. Controlling methods both during and after welding processes are found to be effective for ensuring the integrity of welded components
Trubetskoy, Kliment; Rylnikova, Marina; Esina, Ekaterina
The growing environmental pressure of mineral deposit surface mining and severization of industrial safety requirements dictate the necessity of refining the regulatory framework governing safe and efficient development of underground resources. The applicable regulatory documentation governing the procedure of ore open-pit wall and bench stability design for the stage of pit reaching its final boundary was issued several decades ago. Over recent decades, mining and geomechanical conditions have changed significantly in surface mining operations, numerous new software packages and computer developments have appeared, opportunities of experimental methods of source data collection and processing, grounding of the permissible parameters of open pit walls have changed dramatically, and, thus, methods of risk assessment have been perfected [10-13]. IPKON RAS, with the support of the Federal Service for Environmental Supervision, assumed the role of the initiator of the project for the development of Federal norms and regulations of industrial safety "Rules for ensuring the stability of walls and benches of open pits, open-cast mines and spoil banks", which contribute to the improvement of economic efficiency and safety of mineral deposit surface mining and enhancement of the competitiveness of Russian mines at the international level that is very important in the current situation.
Full Text Available How epigenetic information is propagated during somatic cell divisions is still unclear but is absolutely critical for preserving gene expression patterns and cellular identity. Here we show an unanticipated mechanism for inheritance of DNA methylation patterns where the epigenetic mark not only recruits the catalyzing enzyme but also regulates the protein level, i.e. the enzymatic product (5-methylcytosine determines the level of the methylase, thus forming a novel homeostatic inheritance system. Nucleosomes containing methylated DNA stabilize de novo DNA methyltransferases, DNMT3A/3B, allowing little free DNMT3A/3B enzymes to exist in the nucleus. Stabilization of DNMT3A/3B on nucleosomes in methylated regions further promotes propagation of DNA methylation. However, reduction of cellular DNA methylation levels creating more potential CpG substrates counter-intuitively results in a dramatic decrease of DNMT3A/3B proteins due to diminished nucleosome binding and subsequent degradation of the unstable free proteins. These data show an unexpected self-regulatory inheritance mechanism that not only ensures somatic propagation of methylated states by DNMT1 and DNMT3A/3B enzymes but also prevents aberrant de novo methylation by causing degradation of free DNMT3A/3B enzymes.
Lee, Hayun; Zhou, Yi; Taylor, David W; Sashital, Dipali G
CRISPR-Cas immune systems integrate short segments of foreign DNA as spacers into the host CRISPR locus to provide molecular memory of infection. Cas4 proteins are widespread in CRISPR-Cas systems and are thought to participate in spacer acquisition, although their exact function remains unknown. Here we show that Bacillus halodurans type I-C Cas4 is required for efficient prespacer processing prior to Cas1-Cas2-mediated integration. Cas4 interacts tightly with the Cas1 integrase, forming a heterohexameric complex containing two Cas1 dimers and two Cas4 subunits. In the presence of Cas1 and Cas2, Cas4 processes double-stranded substrates with long 3' overhangs through site-specific endonucleolytic cleavage. Cas4 recognizes PAM sequences within the prespacer and prevents integration of unprocessed prespacers, ensuring that only functional spacers will be integrated into the CRISPR array. Our results reveal the critical role of Cas4 in maintaining fidelity during CRISPR adaptation, providing a structural and mechanistic model for prespacer processing and integration. Copyright © 2018 Elsevier Inc. All rights reserved.
Sabato, Todd M; Walch, Tanis J; Caine, Dennis J
This article presents a current review of the risk of physical and psychological injury associated with participation in elite youth sport, and suggests strategies to ensure the physical and emotional health of these young athletes. Although there is lack of epidemiological data, especially with regard to psychological injury, preliminary data suggest that the risk of injury is high in this population. While there is lack of incident and follow-up data, there is also concern regarding burnout, disordered eating, and the long-term consequences of injury. Modifiable injury risk factors identified include postural control, competition anxiety, life events, previous injury, and volume of training. There are presently no studies designed to determine the effectiveness of injury prevention measures in elite youth sports. However, there is adequate evidence arising from injury prevention studies of youth sports participants – including neuromuscular training, protective equipment, mental training to enhance self-esteem, and sport rules modification – to prevent injuries in elite youth sports settings. Although not tested, psychosocial prevention strategies such as adoption of task-oriented coping mechanisms, autonomous support from parents, and a proactive organizational approach also show promise in injury prevention. PMID:27621677
Karakış, R; Güler, I; Çapraz, I; Bilir, E
This study aims to secure medical data by combining them into one file format using steganographic methods. The electroencephalogram (EEG) is selected as hidden data, and magnetic resonance (MR) images are also used as the cover image. In addition to the EEG, the message is composed of the doctor׳s comments and patient information in the file header of images. Two new image steganography methods that are based on fuzzy-logic and similarity are proposed to select the non-sequential least significant bits (LSB) of image pixels. The similarity values of the gray levels in the pixels are used to hide the message. The message is secured to prevent attacks by using lossless compression and symmetric encryption algorithms. The performance of stego image quality is measured by mean square of error (MSE), peak signal-to-noise ratio (PSNR), structural similarity measure (SSIM), universal quality index (UQI), and correlation coefficient (R). According to the obtained result, the proposed method ensures the confidentiality of the patient information, and increases data repository and transmission capacity of both MR images and EEG signals. Copyright © 2015 Elsevier Ltd. All rights reserved.
Rahayu; Soeprobowati, Tri Retnaningsih
This article aims to analyze the implementation of state obligations and responsibility ensuring the availability of clean water as part of human rights in Karimunjawa islands. The analysis based on principle of the State obligations and responsibility to fulfill their citizen right. Water sources in Karimunjawa Islands is very limited. It depend on forest conservation. Around 9.600 peoples live in Karimunjawa Islands, but Karimunjawa is non groundwater basin region. It means, Karimunjawa doesn't have groundwater potential. The quantity of water depends on the season. The solution to maintain the sustainability of clean water is piping from water reservoir to residential areas. The problem is there are so many hotels in Karimunjawa islands, it disrupted the fulfillment of clean water. Besides utilizing water from reservoir, many hotels drilled the ground to get water. It had impact to the availibity of water in dry season and affected to fulfillment of water supply for Karimunjawa people. There is no specific regulation and policy to solve this problem. Clean water management is doing by Karimunjawa's people. Meanwhile, based on Mahkamah Konstitusi Decree number 85/PUU-XI/2013, state is a rights holder to dominate the water in accordance with the Articles 33 paragraph (2) and (3) UUD NRI 1945, so the government has an obligation to make a policy, regulations, management, and supervision.
Full Text Available The authors examined the legislative framework of the Russian Federation operating in the field of industrial safety, and described how to obtain a license to operate hazardous production facilities. The paper demonstrates that the importance should be given to the quality and completeness of the background information, as well as the choice of inspection strategy in evaluating the technical condition of the line section of main gas pipelines. As a part of a package of measures to ensure industrial safety and technical reliability of existing gas pipelines it is proposed to carry out conditioning of their line sections. The paper describes general requirements for pipeline inspection, which include: detection efficiency of dangerous damages and major leaks, maximum accuracy of detection of the defect location, continuity of monitoring throughout the entire range of operation modes of the pipeline, cost recovery at the stages of development and operation of control systems, forecasting the state of the pipeline and the effects of accidents. In practice, these parameters have the prevailing significance.
In 1992, a clean air strategy will be developed to incorporate views of British Columbians on ways to meet goals related to air quality. A discussion paper is presented to provide information to those interested in participation in developing this strategy. The paper gives information on air quality issues important to the province, including local air quality, urban smog, ozone layer depletion, and global climate change. The views and concerns expressed by stakeholders who attended the Clean Air Conference in 1991 are summarized. The process used to develop the clean air strategy is outlined and some outcomes to be anticipated from the strategy are suggested, including policies and priorities for action to ensure clean air. Air pollutants of concern are total reduced sulfur, mainly from pulp mills and gas processing plants; smoke from wood burning; sulfur dioxide from pulp mills and gas plants; hydrogen fluoride from aluminum smelting; ground-level ozone in urban areas; and acid rain. Elements of a clean air strategy include a smoke management policy, management strategies for greenhouse gases and ozone smog, ozone layer protection measures, regional air quality management plans, and long-term planning efforts in energy use, transportation modes, community design, and land use. 12 refs., 14 figs., 2 tabs
Luke, D.E.; Dixon, B.W.; Murphy, J.A.
Roadmapping is a powerful tool to manage technical risks and opportunities associated with complex problems. Roadmapping identifies technical capabilities required for both project- and program-level efforts and provides the basis for plans that ensure the necessary enabling activities will be done when needed. Roadmapping reveals where to focus further development of the path forward by evaluating uncertainties for levels of complexity, impacts, and/or the potential for large payback. Roadmaps can be customized to the application, a ''graded approach'' if you will. Some roadmaps are less detailed. We have called these less detailed, top-level roadmaps ''mini-roadmaps''. These mini roadmaps are created to tie the needed enablers (e.g., technologies, decisions, etc.) to the functions. If it is found during the mini-roadmapping that areas of significant risk exist, then those can be roadmapped further to a lower level of detail. Otherwise, the mini-roadmap may be sufficient to manage the project/program risk. Applying a graded approach to the roadmapping can help keep the costs down. Experience has indicated that it is best to do mini-roadmapping first and then evaluate the risky areas to determine whether to further evaluate those areas. Roadmapping can be especially useful for programs/projects that have participants from multiple sites, programs, or other entities which are involved. Increased synergy, better communications, and increased cooperation are the results from roadmapping a program/project with these conditions
Full Text Available Epigenetics is the study of the transmission of cell memory through mitosis or meiosis that is not based on the DNA sequence. At the molecular level the epigenetic memory of a cell is embedded in DNA methylation, histone post-translational modifications, RNA interference and histone isoform variation. There is a tight link between histone post-translational modifications (the histone code and DNA methylation, as modifications of histones contribute to the establishment of DNA methylation patterns and vice versa. Interestingly, proteins have recently been identified that can simultaneously read both methylated DNA and the histone code. UHRF1 fulfills these requirements by having unique structural domains that allow concurrent recognition of histone modifications and methylated DNA. Herein, we review our current knowledge of UHRF1 and discuss how this protein ensures the link between histone marks and DNA methylation. Understanding the molecular functions of this protein may reveal the physiological relevance of the linkage between these layers of epigenetic marks.
Fuhrer, Tobias; Sauer, Uwe
To sustain growth, the catabolic formation of the redox equivalent NADPH must be balanced with the anabolic demand. The mechanisms that ensure such network-wide balancing, however, are presently not understood. Based on 13C-detected intracellular fluxes, metabolite concentrations, and cofactor specificities for all relevant central metabolic enzymes, we have quantified catabolic NADPH production in Agrobacterium tumefaciens, Bacillus subtilis, Escherichia coli, Paracoccus versutus, Pseudomonas fluorescens, Rhodobacter sphaeroides, Sinorhizobium meliloti, and Zymomonas mobilis. For six species, the estimated NADPH production from glucose catabolism exceeded the requirements for biomass synthesis. Exceptions were P. fluorescens, with balanced rates, and E. coli, with insufficient catabolic production, in which about one-third of the NADPH is supplied via the membrane-bound transhydrogenase PntAB. P. versutus and B. subtilis were the only species that appear to rely on transhydrogenases for balancing NADPH overproduction during growth on glucose. In the other four species, the main but not exclusive redox-balancing mechanism appears to be the dual cofactor specificities of several catabolic enzymes and/or the existence of isoenzymes with distinct cofactor specificities, in particular glucose 6-phosphate dehydrogenase. An unexpected key finding for all species, except E. coli and B. subtilis, was the lack of cofactor specificity in the oxidative pentose phosphate pathway, which contrasts with the textbook view of the pentose phosphate pathway dehydrogenases as being NADP+ dependent.
Report #16-P-0126, March 31, 2016. Management Alert. Environmental and extensive financial risks exist from the EPA's failure to have accurate and complete data to monitor and ensure compliance with RCRA and CERCLA financial assurance requirements.
Brillouin-scattering Optical Time Domain Reflectometry (BOTDR) is a viable technology for simultaneous, distributed : strain and temperature measurements for miles-long transportation structures. It is a promising tool to ensure the smooth : operatio...
Roth, W.H. [Bonn Univ. (Germany). Inst. fuer Internationales Privatrecht und Rechtsvergleichung
The title of this paper - cartel law as an instrument for ensuring security of supply - may seem surprising to some. After all, the concepts of security of supply and cartel law are generally viewed as conflicting with one another, as when prohibitive or interdictive norms of cartel law are restricted or suspended in the name of ensuring security of supply. The title implies that there is also another perspective on this relationship, namely that cartel is geared to the goal of maintaining a viable competitive environment. To the extent that competition serves the purpose of ensuring consumers' greatest possible security of supply, even though this may not be its only purpose, any economic system that is driven by competition will also work towards ensuring the security of the energy supply. Seen from this perspective the paper's title is aptly worded, speaking of security of supply through competition rather than through its (justified) restriction. The creation of a European internal energy market in which energy resources are offered and demanded across borders will contribute to ensuring the security of the energy supply. To the extent that cartel law acts towards keeping markets open and safeguarding competition it will also serve the purpose of ensuring security of supply. This applies in particular in cases where contractual bonds act as a repellent, preventing other suppliers from entering the market and thus also counteracting the diversification of buying sources.
Perera, Jeevan; Holsomback, Jerry D.
Most project managers know that Risk Management (RM) is essential to good project management. At NASA, standards and procedures to manage risk through a tiered approach have been developed - from the global agency-wide requirements down to a program or project's implementation. The basic methodology for NASA's risk management strategy includes processes to identify, analyze, plan, track, control, communicate and document risks. The identification, characterization, mitigation plan, and mitigation responsibilities associated with specific risks are documented to help communicate, manage, and effectuate appropriate closure. This approach helps to ensure more consistent documentation and assessment and provides a means of archiving lessons learned for future identification or mitigation activities.A new risk database and management tool was developed by NASA in 2002 and since has been used successfully to communicate, document and manage a number of diverse risks for the International Space Station, Space Shuttle, and several other NASA projects and programs including at the Johnson Space Center. Organizations use this database application to effectively manage and track each risk and gain insight into impacts from other organization's viewpoint to develop integrated solutions. Schedule, cost, technical and safety issues are tracked in detail through this system.Risks are tagged within the system to ensure proper review, coordination and management at the necessary management level. The database is intended as a day-to- day tool for organizations to manage their risks and elevate those issues that need coordination from above. Each risk is assigned to a managing organization and a specific risk owner who generates mitigation plans as appropriate. In essence, the risk owner is responsible for shepherding the risk through closure. The individual that identifies a new risk does not necessarily get assigned as the risk owner. Whoever is in the best position to effectuate
A. V. Kalach
Full Text Available Living standards depends on the state of the country’s industrial complex. In a message to Russian President Vladimir Putin's Federal Assembly was asked to implement in 2015 a national technological initiative, the development of industries of the new technological order. As a result of the predominance of the industry of the sixth technological order should occur major changes in the structure of production factors and significance. It follows the inevitability of structural changes in the system of economic institutions and mechanisms of economic security and competitiveness of the state achieve the main goal of the state program “The development of industry and increase its competitiveness” is carried out through the following the directions of sub-programs: investment goods (chemical complex development composite materials, industrial biotechnology, power engineering, machine tool industry, agricultural machinery, machinery specialized production, transport engineering; goods (light industry, children;s products industry, the automotive industry; military-industrial complex; infrastructure (development of engineering activities, industrial parks; semi-finished goods and materials (timber industry, metallurgy, industrial development of rare-earth metals. At the current pace of technological and economic development, the 6 th technological structure will come into proliferation phase in 2010–2020, and in the phase of maturity – 40-ies of XXI century. At the same time in 2020–2025 there will be a new scientific-technical and technological revolution, which will become the basis for developing, synthesizing advances in the above basic technologies. In this paper, we proposed as a tool to ensure the economic security of the state to use the acceleration system of technical development of the industrial complex.
Full Text Available BACKGROUND: Outcrossing is known to carry genetic advantages in comparison with inbreeding. In many cases, flowering plants develop a self-incompatibility mechanism, along with a floral component adaptation mechanism, to avoid self-pollination and to promote outbreeding. Orchids commonly have a lip in their flower that functions as the a visiting plate for insect pollinators. Aside from the lip, however, many species (including Coelogyne rigida have sheaths around the axis of inflorescence. The function of these sheaths remains unknown, and has long been a puzzle to researchers. METHODOLOGY/PRINCIPAL FINDINGS: We investigated the function of these sheaths in relation to the lip and the pollinators, as well as their role in the modes of pollination and reproduction of Coelogyne rigida in 30 flowering populations of orchids in the limestone area of Southeast Yunnan, China. We found that self-incompatible C. rigida developed specialized bird perches around the basal axis of inflorescence to attract sunbirds and to complement their behavioral tendency to change foraging locations frequently. This self-incompatibility mechanism operates separately from the floral component adaptation mechanism. This mechanism thus prevents bees from repeatedly visiting the floral lip of the same plant which, in turn, results in autogamy. In this way, instead of preventing autogamy, C. rigida responds to these negative effects through a highly efficient cross-pollination method that successfully transfers pollen to different plants. CONCLUSIONS: The proposed method ensures reproductive success, while offsetting the infertile self-pollination by insects, thereby reducing mating costs and addressing the lack of cross-pollination. The adaptation provides a novel and striking example of structural adaptation that promotes cross-pollination in angiosperms.
Jutla, A.; Nguyen, T. H.; Colwell, R. R.; Akanda, A. S.
Human well-being is one of the key long-term indicators of a sustainable environment. John Snow, a prominent 19th century physician, provided insights on the role of drinking contaminated water and cholera outbreak(s). Extrapolation of Snow's discovery on locating source of cholera bacteria (in local wells) lead to the tenets of traditional doctrines of environmental sustainability of water where source capacities (such as physical condition of water) are directly linked to sink capacities (e.g., bacterial growth in water) of a system, a balance that must be maintained to sustain human life supporting mechanisms. With a changing climate, stress on availability of safe drinking water is likely to increase, particularly where population vulnerability intersects with hydroclimatic extremes. This raises a critical question on how environmental sustainability of water will affect human societies. A dynamic equilibrium exists between large scale geophysical (e.g., sea surface temperature-SST; precipitation, evaporative fluxes) and local scale water-ecological processes (salinity, plankton, organic matter) in water resources (ponds, rivers, lakes). The ecological processes aid in growth and proliferation of water based pathogens (such as cholera, Rotavirus, Shigella and other vibrios). Societal determinants, such as access to safe drinking water and sanitation facilities, defines interaction of human population with water. The feedback loop, between geophysical and water-ecological processes is fundamental to ensure a sustainable environment for human well-being. However, the feedback loops are often misconstrued resulting in massive loss of human life, and further leading to outbreak of diseases at various spatial and temporal scales across region(s). Using historical data on Cholera and Zika virus as examples, we will demonstrate the intricacies involved in understanding coupled human-natural system. The two infections result from a very different asymmetric
Full Text Available The purpose of the paper is legal base in the context of the system of ensuring standards of living standards of the population of Ukraine. Methodology. The analysis of normative – legal documents on the basic level of life of different population groups. The legislative field is investigated through the official web portal of the Verkhovna Rada of Ukraine, the State statistics service of Ukraine clarified the period from 1991 to the present. Results. Functioning laws of the last century – outdated, not consistent with the goals of social policy and the contemporary economy. It is important to modernize the laws, concerning basic living standards of the population to the country's foreign policy, according to the EU methodology. Apply state social standard as a tool for poverty reduction, and the perspective tool starter package with a guaranteed standard of living government to its citizens. The practical implications. Different stages of development of economy of independent Ukraine, laid the foundations of the legislative framework of normative documents concerning social protection of the population. A country's legal framework contains a set of laws belonging to the last century, policy and regulatory documents that comply with EU standards. In turn, the regulatory framework has tenedency to the modernization of laws that establish the guaranteed state social standards and guarantees for every citizen. Value/originality. Analysis of the legislative base, revealed the ineffectiveness of the law guaranteeing basic social standard to citizens. Understanding of the process of modernization of a relatively large part of the laws adopted in the last century.
Full Text Available Introduction. Development of dry mixes for making spumy and emulsion products are topical, because nowadays there is a tendency to minimize the time spent on the process of cooking, which is achieved by the use of semi finished products high degree of readiness. Materials and methods. Foaming ability was determined by the method of multiplicity of the foam, the stability of unstable foam-by the half-life method of foam, highly resistant foam - as a ratio of the height of the column of foam after exposure for 24 hours. Results. Was determined the influence of sunflower oil on the foaming ability and half-life foam of systems «sodium caseinate-oil». It was found that getting systems with high index of foaming capacity and foam stability in the presence of oil in the system is impossible without the use of low molecular weight surfactants. Substantiated recommendations regarding the feasibility of using two surfactants in systems «sodium caseinate-surfactants-oil», which provide the necessary kinship surfaces air, fat and water phases. it has been found that the use of 2,5...3,5% mono-and diglycerides of fatty acid sand Lecithin’s 0.15...0.25% in the content of sodium caseinate about 0.5% allows to receive the stable foam-emulsive systems containing sunflower oil 7...8% and foaming ability about 640±1%. Conclusions. It is established that for ensuring high indicators foaming capacity and stability of foam-emulsive systems required the use of low-molecular surfactants. The research results, is recommended to use when developing technology of foam-emulsive products.
Lee, S. I.; Ji, H. W.
The integration of ASTR (Aquifer Storage Transfer and Recovery) and HACCP (Hazard Analysis and Critical Control Point) is being attempted to ensure drinking water quality in a delta area. ASTR is a water supply system in which surface water is injected into a well for storage and recovered from a different well. During the process natural water treatment is achieved in the aquifer. ASTR has advantages over surface reservoirs in that the water is protected from external contaminants and free from water loss by evaporation. HACCP, originated from the food industry, can efficiently manage hazards and reduce risks when it is introduced to the drinking water production. The study area is the located in the Nakdong River Delta, South Korea. Water quality of this region has been deteriorated due to the increased pollution loads from the upstream cities and industrial complexes. ASTR equipped with HACCP system is suggested as a means to heighten the public trust in drinking water. After the drinking water supply system using ASTR was decomposed into ten processes, principles of HACCP were applied. Hazardous event analysis was conducted for 114 hazardous events and nine major hazardous events were identified based on the likelihood and the severity assessment. Potential risk of chemical hazards, as a function of amounts, travel distance and toxicity, was evaluated and the result shows the relative threat a city poses to the drinking water supply facility. Next, critical control points were determined using decision tree analysis. Critical limits, maximum and/or minimum values to which biological, chemical or physical parameters must be controlled, were established. Other procedures such as monitoring, corrective actions and will be presented.
Katherine S Lawrence
Full Text Available Errors in replication or segregation lead to DNA damage, mutations, and aneuploidies. Consequently, cells monitor these events and delay progression through the cell cycle so repair precedes division. The DNA damage response (DDR, which monitors DNA integrity, and the spindle assembly checkpoint (SAC, which responds to defects in spindle attachment/tension during metaphase of mitosis and meiosis, are critical for preventing genome instability. Here we show that the DDR and SAC function together throughout the cell cycle to ensure genome integrity in C. elegans germ cells. Metaphase defects result in enrichment of SAC and DDR components to chromatin, and both SAC and DDR are required for metaphase delays. During persistent metaphase arrest following establishment of bi-oriented chromosomes, stability of the metaphase plate is compromised in the absence of DDR kinases ATR or CHK1 or SAC components, MAD1/MAD2, suggesting SAC functions in metaphase beyond its interactions with APC activator CDC20. In response to DNA damage, MAD2 and the histone variant CENPA become enriched at the nuclear periphery in a DDR-dependent manner. Further, depletion of either MAD1 or CENPA results in loss of peripherally associated damaged DNA. In contrast to a SAC-insensitive CDC20 mutant, germ cells deficient for SAC or CENPA cannot efficiently repair DNA damage, suggesting that SAC mediates DNA repair through CENPA interactions with the nuclear periphery. We also show that replication perturbations result in relocalization of MAD1/MAD2 in human cells, suggesting that the role of SAC in DNA repair is conserved.
Massimo Trabalza Marinucci
Full Text Available Wild ungulate populations are increasing in Europe and Italy, with a consequent increase in culling rates and availability of their meats. Objectives of this review were to evaluate the trends of availability of meat from wild ungulates in Italy, to review the present knowledge on nutritional properties, sensorial characteristics, and hygiene problems of wild ungulate meat and to examine the critical steps that influence their hygiene and quality. Wild ungulate meat in Italy derives mainly from wild boar, roe deer and red deer and its availability has been increasing in the last decade. Total consumption of wild ungulate meat is low (0.1-0.3 kg per capita/year, but in some regions rises to significant levels, especially for hunters’ families (1.0-4.0 kg per capita/year. Wild ungulate meats generally have a low fat content, although with a certain variability associated with gender, hunting season, age and physiological conditions, and a favourable fatty acid composition. In general, they are darker, less tender and characterised by a more intense and peculiar flavour than meats from domestic ruminants. However, these properties also show a great inter- and intra-specific variability. Risks for the consumer associated with contaminants (heavy metals, radionuclides, organochlorine pesticides and polychlorinated biphenyls and zoonoses are considered to be low. Critical steps from shooting in the field to the final marketing should be considered to ensure hygiene and quality of meats. Future research should focus on the variability of hunting modes, accuracy of shooting, field dressing and carcass processing, in order to understand how these practices influence the final microbiological and sensorial quality of wild ungulate meats.
Li, Li-Qiang; Rao, Wen-Hui; Zhang, Yu-Ting; Tang, Guang-Da; Huang, Lai-Qiang
Background Outcrossing is known to carry genetic advantages in comparison with inbreeding. In many cases, flowering plants develop a self-incompatibility mechanism, along with a floral component adaptation mechanism, to avoid self-pollination and to promote outbreeding. Orchids commonly have a lip in their flower that functions as the a visiting plate for insect pollinators. Aside from the lip, however, many species (including Coelogyne rigida) have sheaths around the axis of inflorescence. The function of these sheaths remains unknown, and has long been a puzzle to researchers. Methodology/Principal Findings We investigated the function of these sheaths in relation to the lip and the pollinators, as well as their role in the modes of pollination and reproduction of Coelogyne rigida in 30 flowering populations of orchids in the limestone area of Southeast Yunnan, China. We found that self-incompatible C. rigida developed specialized bird perches around the basal axis of inflorescence to attract sunbirds and to complement their behavioral tendency to change foraging locations frequently. This self-incompatibility mechanism operates separately from the floral component adaptation mechanism. This mechanism thus prevents bees from repeatedly visiting the floral lip of the same plant which, in turn, results in autogamy. In this way, instead of preventing autogamy, C. rigida responds to these negative effects through a highly efficient cross-pollination method that successfully transfers pollen to different plants. Conclusions The proposed method ensures reproductive success, while offsetting the infertile self-pollination by insects, thereby reducing mating costs and addressing the lack of cross-pollination. The adaptation provides a novel and striking example of structural adaptation that promotes cross-pollination in angiosperms. PMID:23308277
Ramapriyan, H.; Behnke, J.
NASA's Earth Observing System Data and Information System (EOSDIS) has been in operation since 1994. EOSDIS manages data from pre-EOS missions dating back to 1960s, EOS missions that started in 1997, and missions from the post-EOS era. Its data holdings come from many different sources - satellite and airborne instruments, in situ measures, field experiments, science investigations, etc. Since the beginning of the EOS Program, NASA has followed an open data policy, with non-discriminatory access to data with no period of exclusive access. NASA has well-established processes for assigning and/or accepting datasets into one of 12 Distributed Active Archive Centers (DAACs) that are parts of EOSDIS. EOSDIS has been evolving through several information technology cycles, adapting to hardware and software changes in the commercial sector. NASA is responsible for maintaining Earth science data as long as users are interested in using them for research and applications, which is well beyond the life of the data gathering missions. For science data to remain useful over long periods of time, steps must be taken to preserve: 1. Data bits with no corruption, 2. Discoverability and access, 3. Readability, 4. Understandability, 5. Usability and 6. Reproducibility of results. NASA's Earth Science data and Information System (ESDIS) Project, along with the 12 EOSDIS Distributed Active Archive Centers (DAACs), has made significant progress in each of these areas over the last decade, and continues to evolve its active archive capabilities. Particular attention is being paid in recent years to ensure that the datasets are "published" in an easily accessible and citable manner through a unified metadata model, a common metadata repository (CMR), a coherent view through the earthdata.gov website, and assignment of Digital Object Identifiers (DOI) with well-designed landing/product information pages.
Stuckenholz, Carsten; Labhart, Paul; Alexiadis, Vassili; Martin, René; Knölker, Hans-Joachim; Fisher, Alfred L.
The nuclear receptor DAF-12 has roles in normal development, the decision to pursue dauer development in unfavorable conditions, and the modulation of adult aging. Despite the biologic importance of DAF-12, target genes for this receptor are largely unknown. To identify DAF-12 targets, we performed chromatin immunoprecipitation followed by hybridization to whole-genome tiling arrays. We identified 1,175 genomic regions to be bound in vivo by DAF-12, and these regions are enriched in known DAF-12 binding motifs and act as DAF-12 response elements in transfected cells and in transgenic worms. The DAF-12 target genes near these binding sites include an extensive network of interconnected heterochronic and microRNA genes. We also identify the genes encoding components of the miRISC, which is required for the control of target genes by microRNA, as a target of DAF-12 regulation. During reproductive development, many of these target genes are misregulated in daf-12(0) mutants, but this only infrequently results in developmental phenotypes. In contrast, we and others have found that null daf-12 mutations enhance the phenotypes of many miRISC and heterochronic target genes. We also find that environmental fluctuations significantly strengthen the weak heterochronic phenotypes of null daf-12 alleles. During diapause, DAF-12 represses the expression of many heterochronic and miRISC target genes, and prior work has demonstrated that dauer formation can suppress the heterochronic phenotypes of many of these target genes in post-dauer development. Together these data are consistent with daf-12 acting to ensure developmental robustness by committing the animal to adult or dauer developmental programs despite variable internal or external conditions. PMID:21814518
Zhang, Nianshu; Cao, Lu
Studies on replicative and chronological aging in Saccharomyces cerevisiae have greatly advanced our understanding of how longevity is regulated in all eukaryotes. Chronological lifespan (CLS) of yeast is defined as the age-dependent viability of non-dividing cell populations. A number of nutrient sensing and signal transduction pathways (mainly TOR and PKA) have been shown to regulate CLS, yet it is poorly understood how the starvation signals transduced via these pathways lead to CLS extension. Using reporters whose expressions are induced by glucose starvation, we have screened the majority of the 'signaling' mutants in the yeast genome and identified many genes that are necessary for stress response. Subsequent analyses of the 'signaling' mutants not only revealed novel regulators of CLS, such as the GSK-3 ortholog Mck1, but also demonstrated that starvation signals transmitted by SNF1/AMPK, PKC1 and those negatively regulated by TOR/PKA, including Rim15, Yak1 and Mck1 kinases, are integrated to enable metabolic reprogramming and the acquisition of stress resistance. Coordinated metabolic reprogramming ensures the accumulation of storage carbohydrates for quiescent cells to maintain viability. We provide new evidence that Yak1, Rim15 and Mck1 kinases cooperate to activate H 2 O 2 -scanvenging activities, thus limiting the levels of ROS in cells entering quiescence. These findings support the recent advances in higher organisms that the flexibility of metabolic reprogramming and the balance between energetics and stress resistance are the unifying principles of lifespan extension. Future work to reveal how the metabolic switch and stress response is coordinated will help delineate the molecular mechanisms of aging in yeast and shed novel insight into aging/anti-aging principles in higher organisms.
Locufier, Arnaud; Javanni, Jean
3 nuclear operators in France (EDF, AREVA, CEA) and a national agency for radioactive waste management (ANDRA). Supervision of the operators by the Government Departments and regulatory control of safety through the Nuclear Safety Authority (ASN). Funding: No legal requirements for the operators to create a specific fund for D and D and waste long term management. However, EDF, AREVA and CEA already set up funds with specific assets. These funds are managed by the companies, supervised by a special committee (CEA and AREVA) which play an advisory role for the Board of Directors. Evolutions: Open competition on European electricity market, evolution of EDF status, AREVA could go public, 2006 debate on HLW-LL long term management. It is essential to redefine the French approach. The time constant is quite long. A European frame could be used. France Favours a Harmonised European Legal Frame. France shared the intentions of Mrs. De Palacio in launching the 'Nuclear Package' (continuation to the Green Paper). France favoured the inclusion of the dismantling issue in this Package: Lack of provisions on this issue is a matter of concern, mandatory segregation of funds is not suitable for all MS, a balance had been found. But the Nuclear Package has not been voted: Council Conclusion of 28 June 2004. Member States to work together in a 'Bottom-Up' Approach. Commission issued its report 3 Nov. 2004. Pending legal issues: Legal base for European legislation: safety (Euratom) or competition law (EC)?; Where/which are State Aids that may distort competition? Support an 'Action Plan' for the implementation of the Conclusions of the Council (towards 2006-2007). France is committed to come to a European consensus on the implementation of the following: 'to ensure that adequate financial resources are available as to cover when needed the decommissioning costs'
Full Text Available Many enveloped viruses invade cells via endocytosis and use different environmental factors as triggers for virus-endosome fusion that delivers viral genome into cytosol. Intriguingly, dengue virus (DEN, the most prevalent mosquito-borne virus that infects up to 100 million people each year, fuses only in late endosomes, while activation of DEN protein fusogen glycoprotein E is triggered already at pH characteristic for early endosomes. Are there any cofactors that time DEN fusion to virion entry into late endosomes? Here we show that DEN utilizes bis(monoacylglycerophosphate, a lipid specific to late endosomes, as a co-factor for its endosomal acidification-dependent fusion machinery. Effective virus fusion to plasma- and intracellular- membranes, as well as to protein-free liposomes, requires the target membrane to contain anionic lipids such as bis(monoacylglycerophosphate and phosphatidylserine. Anionic lipids act downstream of low-pH-dependent fusion stages and promote the advance from the earliest hemifusion intermediates to the fusion pore opening. To reach anionic lipid-enriched late endosomes, DEN travels through acidified early endosomes, but we found that low pH-dependent loss of fusogenic properties of DEN is relatively slow in the presence of anionic lipid-free target membranes. We propose that anionic lipid-dependence of DEN fusion machinery protects it against premature irreversible restructuring and inactivation and ensures viral fusion in late endosomes, where the virus encounters anionic lipids for the first time during entry. Currently there are neither vaccines nor effective therapies for DEN, and the essential role of the newly identified DEN-bis(monoacylglycerophosphate interactions in viral genome escape from the endosome suggests a novel target for drug design.
Wilson, Daniel L. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Rapp, Vi H. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Caubel, Julien J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Chen, Sharon S. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Gadgil, Ashok J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)
A well-mixed diluted sample is essential for unbiased measurement of cookstove emissions. Most cookstove testing labs employ a dilution tunnel, also referred to as a “duct,” to mix clean dilution air with cookstove emissions before sampling. It is important that the emissions be well-mixed and unbiased at the sampling port so that instruments can take representative samples of the emission plume. Some groups have employed mixing baffles to ensure the gaseous and aerosol emissions from cookstoves are well-mixed before reaching the sampling location [2, 4]. The goal of these baffles is to to dilute and mix the emissions stream with the room air entering the fume hood by creating a local zone of high turbulence. However, potential drawbacks of mixing baffles include increased flow resistance (larger blowers needed for the same exhaust flow), nuisance cleaning of baffles as soot collects, and, importantly, the potential for loss of PM2.5 particles on the baffles themselves, thus biasing results. A cookstove emission monitoring system with baffles will collect particles faster than the duct’s walls alone. This is mostly driven by the available surface area for deposition by processes of Brownian diffusion (through the boundary layer) and turbophoresis (i.e. impaction). The greater the surface area available for diffusive and advection-driven deposition to occur, the greater the particle loss will be at the sampling port. As a layer of larger particle “fuzz” builds on the mixing baffles, even greater PM2.5 loss could occur. The micro structure of the deposited aerosol will lead to increased rates of particle loss by interception and a tendency for smaller particles to deposit due to impaction on small features of the micro structure. If the flow stream could be well-mixed without the need for baffles, these drawbacks could be avoided and the cookstove emissions sampling system would be more robust.
Full Text Available Background: Mathematical modelling aids diagnostics the track and rolling stock, as it often for technical reasons it is not possible to obtain a complete set of measurement data required to diagnose the rail and wheel deformation caused by the impact of a rail vehicle on the track. The important issue in a railway diagnostics is to study the effects of contact wheel and rail. Diagnostics investigations of track and rolling stock have a fundamental role in ensuring the safety of transport of passengers and goods. The aim of the study presented in the paper was to develop simulation methods of mathematical modelling of the wheel-rail system useful in the diagnostics of the track and a railway vehicle. Methods: In the paper two ways of modelling were presented and discussed. One of these ways is the method which consists in reducing the contact issue to field issue and solving the identification of the field source in 2-D system. Also presented a different method designed on the basis of the methods using one period energy concept. This method is adapted for modelling the dynamics of the contact wheel-rail for the normal force. It has been shown that the developed modelling methods to effectively support the study on the effects of mechanical and thermal of contact wheel-rail and contribute to the safety of operations. Results and conclusions: In the case of field sources identifications two specific issues were examined: the issue of rail torsion and the identification of heat sources in the rail due to exposure the rolling contact wheel-rail. In the case of the method using one period energy concept it was demonstrated the usefulness of this method to the study of energy processes in the contact wheel-rail under the normal periodic force. The future direction of research is to establish cooperation with research teams entrusted with the diagnostic measurements of track and rolling stock.
Nadezhda A. Kizatova
Full Text Available The results of the research presented in this article are within the framework of the research area engaged in development of basic provisions and methodologies for managing educational institutions and, in particular, working out methods and algorithms for financial analysis and educational and research management in universities. Drawing upon the per-capita normative financing methodology, which is currently used in Russia, as well as the structure of the existing and prospective educational standards and curricular, main provisions of strategic development plans for university structural subdivisions, the authors propose a dynamic financial and mathematical model of building salary funds for departments, institutes and university in general. The article specifically describes the methodology of financial support of effective medium-term contracts for academic and teaching staff. The practical implementation of this model will result in higher motivation of the staff and will ensure improvement in educational institutions performance. An effective contract contributes to better staff’s performance, their input in implementing strategies, programmes and projects for developing institutes, departments and university as a whole, which gives rise to the effectiveness of the whole educational institution. Besides, the developed dynamic financial and mathematical model makes it possible to offer methodology for planning financial support for implementing effective medium-term contract for academic and teaching staff. The methodology takes into account the specific features of educational process organization in the long-term, the incorporation of various disciplines in the curriculum, with possible curriculum changes during the planning period, the student contingent adjustment, and admissible integration of different student groups into academic shifts. In its turn, all this provides an educational institution with an opportunity of planning a
Kim, K. H.
The project was first conceived in the Global Framework for Climate Services Regional Consultation in the Cook Islands in March 2014. In this meeting, key officials from the Ministry of Agriculture and Food, Forests, and Fisheries and the Tonga Meteorological Services had a meeting with the APEC Climate Center scientists with the idea to collaborate on a joint project. The project evolved to include the following components: assessment of users' needs and capacities, development of an agricultural database, research on the core relationships between agriculture and climate through modeling and field trials, and the development and delivery of agro-meteorological services. Envisioned outputs include a 2-7 day warning for pests and diseases, a suite of tools supporting decisions on planting dates and crop varieties, and other advisory services derived from seasonal climate forecasts. As one of the climate adaptation projects under its Pacific Island portfolio, the project will deliver urgent information services for Tongan agricultural growers and exporters. The project comes into greater importance and urgency, as the 2014 drought event resulted in the destruction of 80% of squash in Tonga, a main export crop from which the country derives foreign exchange earnings. Since 2014, some of the project achievements include the first agro-met data collection in Tonga, the development of an agricultural DB management system that houses archived agriculture data, and key meetings with stakeholders to ensure alignment of the project objectives and design with the interests of the Tongan government and other stakeholders. In addition, rigorous scientific research through modeling and field trials has been conducted to address the twin goals of supporting Tonga's economy as well as food security. Based on the findings from the research, tools will be developed to translate the science into knowledge that supports decisions on the farm scale.
Trapasso, T. J.
With the introduction of new tools, faster computing, and less expensive storage, increased volumes of data are expected to be managed with existing or fewer resources. Metadata management is becoming a heightened challenge from the increase in data volume, resulting in more metadata records needed to be curated for each product. To address metadata availability and completeness, NASA ESDIS has taken significant strides with the creation of the United Metadata Model (UMM) and Common Metadata Repository (CMR). These UMM helps address hurdles experienced by the increasing number of metadata dialects and the CMR provides a primary repository for metadata so that required metadata fields can be served through a growing number of tools and services. However, metadata quality remains an issue as metadata is not always inherent to the end-user. In response to these challenges, the NASA Atmospheric Science Data Center (ASDC) created the Collaboratory for quAlity Metadata Preservation (CAMP) and defined the Product Lifecycle Process (PLP) to work congruently. CAMP is unique in that it provides science team members a UI to directly supply metadata that is complete, compliant, and accurate for their data products. This replaces back-and-forth communication that often results in misinterpreted metadata. Upon review by ASDC staff, metadata is submitted to CMR for broader distribution through Earthdata. Further, approval of science team metadata in CAMP automatically triggers the ASDC PLP workflow to ensure appropriate services are applied throughout the product lifecycle. This presentation will review the design elements of CAMP and PLP as well as demonstrate interfaces to each. It will show the benefits that CAMP and PLP provide to the ASDC that could potentially benefit additional NASA Earth Science Data and Information System (ESDIS) Distributed Active Archive Centers (DAACs).
The influence of nanotechnology spans numerous fields and is increasing rapidly due to the financial and research contributions to the field. The impact of nanotechnologybased products on human health and the environment is far from being understood. Research output related to environmental, health, and safety issues is too slow and far behind developments to address the vast number of types of nanoparticles and new uses being discovered. This thesis summarizes nanotechnology related regulations, applications, and current research related to environmental and human toxicity in order to put into perspective the gaping holes existing in the safe production, use, and disposal of nanotechnology. There were a number of conclusions that were determined following the literature survey of this thesis. There is currently a lack of international cooperation between regulatory agencies and research institutions who are involved with nanotechnology. The only entities that have made regulatory progress include the United States, European Union, and Australia. The toxicological impacts of nanotechnology are not fully understood due to the dearth of research, as well as the absence of testing and measuring infrastructure. Chapter 6 of this thesis proposes an effective and specific research strategy to expedite the creation of enforceable regulations in order to protect the environment, workers, and general public based on the conclusions described in the paragraph above. The strategy outlines the need for the development of an interagency committee, precationary limits, nanomaterial tracer system, nanomaterial data gathering, priority list, funds for toxicity research, and open database to information and materials. The aspects of the outline strategy will ensure the successful and efficient regulation of nanotechnology.
Stroeve, J. C.; Kaleschke, L.
The multi-channel satellite passive microwave record has been of enormous benefit to the science community and society at large since the late 1970s. Starting with the launch of the Nimbus-7 Scanning Multi-Channel Microwave Radiometer (SMMR) in October 1978, and continuing with the launch of a series of Special Sensor Microwave Imagers (SSM/Is) in June 1987 by the Defense Meteorological Satellite Program (DMSP), places previously difficult to monitor year-round, such as the polar regions, came to light. Together these sensors have provided nearly 4 decades of climate data records on the state of sea ice cover over the ocean and snow on land. This data has also been used to map melt extent on the large ice sheets, timing of snow melt onset over land and sea ice. Application also extend well beyond the polar regions, mapping important climate variables, such as soil moisture content, oceanic wind speed, rainfall, water vapor, cloud liquid water and total precipitable water. Today the current SSMIS operational satellite (F18) is 7 years old and there is no follow-on mission planned by the DMSP. With the end of the SSMI family of Sensors, will the polar regions once again be in the dark? Other sensors that may contribute to the long-term data record include the JAXA AMSR2 (5 years old as of May 2017), the Chinese Fen-Yung-3 and the Russian Meteor-N2. Scatterometry and L-band radiometry from SMOS and NASA's SMOS may also provide some potential means of extending the sea ice extent data record, as well as future sensors by the DoD, JAXA and ESA. However, this will require considerable effort to intercalibrate the different sensors to ensure consistency in the long-term data record. Differences in measurement approach, frequency and spatial resolution make this a non-trivial matter. The passive microwave sea ice extent data record is one of the longest and most consistent climate data records available. It provides daily monitoring of one of the most striking changes in
Role of nuclear power in ensuring energy security to the world is inevitable due to a) dwindling fossil fuel resources and b) need for minimising green house gas emission that poses the risk of global climate change. India, keeping in mind its limited uranium and vast thorium resources, is pursuing a three stage nuclear power programme. The first stage is based on reactors that use uranium as fuel. It comprises of the indigenous Pressurised Heavy Water Reactors using natural uranium as fuel and light water reactors that employ enriched uranium as fuel and are to be set up in technical collaboration with other countries. The second stage is based on fast breeder reactors that employ plutonium derived from reprocessing of spent fuel from the first stage reactors. The third stage envisages reactors which will employ thorium based fuel after its irradiation in the second stage reactors. This programme is sequential in nature and has an ultimate objective of securing long term energy security to India through judicial use of its thorium resources. Thorium based reactors offer advantages in terms of better neutronic characteristics of thorium, it being better fertile host for plutonium disposition and better thermo-mechanical properties and slower fuel deterioration of thorium oxide. It is planned to introduce thorium in the Indian Nuclear Power Programme after sufficient (about 200 GWe) capacity build-up in the second stage. DAE is a global leader in the development of the entire thorium fuel cycle. It has a mature technology for extraction of thorium and preparation of thoria pellets. It has long back carried out irradiation of thoria pellets in its research reactors and also in PHWRs, post irradiation examination and reprocessing of irradiated thoria, fabrication of 233 U based fuel. It has KAMINI - the world's only operating reactor employing 233 U as fuel. An Advanced Heavy Water Reactor (AHWR) has been designed as a technology demonstrator for large scale
Drewry, D.; Duveiller, G.
Aqua platforms. As a whiskbroom imaging instrument, MODIS has a complex viewing geometry which affects its spatial response, i.e. the way the electromagnetic radiation reflected from the surface is ultimately encoded in the remotely-sensed image. A model of this spatial response is used here to ensure that the footprint of the satellite observations matches adequately with the coupled model simulations of the target fields. The relationship between the purity of the remote sensing observation, with respect to the target field, and the quality of the biophysical variable inversion is also investigated.
Full Text Available The formation of the economy based on knowledge-based innovative economy, new economy, at the present stage of social development is defining the international concept, according to which knowledge play a primary role, and their production is a source of economic growth and competitiveness. The economy is based on knowledge that provides a smart, sustainable and inclusive development. The purpose of the study. Showing that the implementation of the Strategy «Europe 2020», the main directions of the Fourth Industrial Revolution in the Ukraine will be able to provide smart, sustainable, inclusive development of the regions of Ukraine, will help to overcome the crisis and become a source for economic growth. Research methods. In the process of writing were used scientific methods, methods of analysis and synthesis, method of scientific abstraction. The results of the study. Macroeconomic instability has been transformed at the regional level, which led to the deepening of regions differentiation, particularly as it affected old industrial regions, including Donetsk and Luhansk. The crisis of public finances does not allow attracting of financial resources for economic development. As a result of hybrid war, the outflow of foreign investment amounted to 12.6 billion dollars USA. A significant part of the Donetsk and Luhansk regions is completely destroyed. Along with this, it's perfect conditions in order to abandon the old and build new. There are all conditions to implement actively the European strategy «Europe 2020» and the main directions of the Fourth Industrial Revolution to a new stage of economic development, and ensure smart, sustainable and inclusive development of the regions of Ukraine. Conclusions and discussion position. The future of Ukraine and its regions depends on the activity of the Strategy «Europe 2020» and the main directions of the Fourth Industrial Revolution. In Ukraine, in the regions, the main emphasis is on export
Gowin, Ewelina; Wysocki, Jacek; Kałużna, Ewelina; Świątek-Kościelna, Bogna; Wysocka-Leszczyńska, Joanna; Michalak, Michał; Januszkiewicz-Lewandowska, Danuta
Abstract Vaccination effectiveness is proven when the disease does not develop after a patient is exposed to the pathogen. In the case of rare diseases, vaccination effectiveness is assessed by monitoring specific antibody levels in the population. Such recurrent analyses allow the evaluation of vaccination programs. The primary schedule of diphtheria and tetanus vaccinations is similar in various countries, with differences mainly in the number and timing of booster doses. The aim of the study was to assess diphtheria and tetanus antibody concentrations in a population of healthy children. Diphtheria and tetanus antibody levels were analyzed in a group of 324 children aged 18 to 180 months. All children were vaccinated in accordance with the Polish vaccination schedule. Specific antibody concentrations greater than 0.1 IU/mL were considered protective against tetanus or diphtheria. Levels above 1.0 were considered to ensure long-term protection. Protective levels of diphtheria antibodies were found in 229 patients (70.46%), and of tetanus in 306 patients (94.15%). Statistically significant differences were found in tetanus antibody levels in different age groups. Mean concentrations and the percentage of children with high tetanus antibody titers increased with age. No similar correlation was found for diphtheria antibodies. High diphtheria antibody levels co-occurred in 72% of the children with high tetanus antibody levels; 95% of the children with low tetanus antibody levels had low levels of diphtheria antibodies. The percentage of children with protective diphtheria antibody levels is lower than that in the case of tetanus antibodies, both in Poland and abroad, but the high proportion of children without diphtheria protection in Poland is an exception. This is all the more puzzling when taking into account that Polish children are administered a total of 5 doses containing a high concentration of diphtheria toxoid, at intervals shorter than 5 years. The
Smeulers, Marian; Lucas, Cees; Vermeulen, Hester
assessed trial quality and extracted data. The search identified 2178 citations, 28 of which were considered potentially relevant. After independent review of the full text of these studies, no eligible studies were identified for inclusion in this review due to the absence of studies with a randomised controlled study design. There was no evidence available to support conclusions about the effectiveness of nursing handover styles for ensuring continuity of information in hospitalised patients because we found no studies that fulfilled the methodological criteria for this review. As a consequence, uncertainty about the most effective practice remains. Research efforts should focus on strengthening the evidence abut the effectiveness of nursing handover styles using well designed, rigorous studies. According to current knowledge, the following guiding principles can be applied when redesigning the nursing handover process: face-to-face communication, structured documentation, patient involvement and use of IT technology to support the process.
Denize Bouttelet Munari
, preparing and facilitating exchange of experiences between generations in order to plan and ensure a promising future for the career(1,8-9. Factors such as the ageing workforce(8,10-13, the imminent retirement of a large number of nurses in the coming years(11-12,14, coupled with the low level of interest demonstrated by younger nurses in leadership positions and lack of investment in professional training and improving leadership performance(15 are a foreshadowing of an unprecedented crisis in nursing worldwide(13,16. This crisis tends to make future nursing leaders alienated and ill-prepared for the role, pointing to impacts in services in general, ranging from healthcare institutions to universities and centers for training and research, where professors/researchers are going through the same retirement process(17. One possibility to mitigate the situation is to implement projects to stimulate the sharing of experiences among professionals from different generations, ensuring leadership succession in nursing(8,17. Even though this matter is of the utmost relevance, leadership succession planning has not received the attention it warrants. This can be observed in the scarce scientific production on the theme, and low levels of investment in health and educational institutions in preparing future leadership, and, furthermore, the issue is not addressed in ongoing education programs(9,11,17. A systematic review of literature on the theme showed that it is an innovative yet incipient theme, even in developed countries. The review produced some theoretical and conceptual articles about leadership succession planning in nursing, however, few studies portrayed experiences with the implementation and monitoring of succession planning (SP, even though there is consensus on the importance of the topic for the future of the profession. The purpose of SP is to ensure continuity of leadership in institutions through the development and assessment of individuals with the potential
Cork, Christopher; Zimmermann, Rainer; Mei, Xin; Shahin, Alexander
The continual shrinking of design rules as the industry follows Moore's Law and the associated need for low k1 processes, have resulted in more layout configurations becoming difficult to print within the required tolerances. OPC recipes have needed to become more complex as tolerances decreased and acceptable corrections harder to find with simple algorithms. With this complexity comes the possibility of coding errors and ensuring the solutions are truly general. OPC Verification tools can check the quality of a correction based on pre-determined specifications for CD variation, line-end pullback and Edge Placement Error and then highlight layout configuration where violations are found. The problem facing a Mask Tape-Out group is that they usually have little control over the Design Styles coming in. Different approaches to eliminating problematic layouts have included highly restrictive Design Rules , whereby certain pitches or orientations are disallowed. Now these design rules are either becoming too complex or they overly restrict the designer from benefiting from the reduced pitch of the new node. The tight link between Design and Mask Tape-Out found in Integrated Device Manufacturers  (IDMs) i.e. companies that control both design and manufacturing can do much to dictate manufacturing friendly layout styles, and push ownership of problem resolution back to design groups. In fact this has been perceived as such an issue that a new class of products for designers that perform Lithographic Compliance Check on design layout is an emerging technology . In contrast to IDMs, Semiconductor Foundries are presented with a much larger variety of design styles and a set of Fabless customers who generally are less knowledgeable in terms of understanding the impact of their layout on manufacturability and how to correct issues. The robustness requirements of a foundry's OPC correction recipe, therefore needs to be greater than that for an IDM's tape-out group
Garland, Sid; Brown, Sally; Sims, Lynn; Darby, Jason
Long-term stewardship is the set of activities necessary to return contaminated land to safe and beneficial use. The activities include physical and legal controls to prevent inappropriate exposure to contamination left in place at a site. It is the longest phase of the Department of Energy's Environmental Management Program and ensures the protection of human health and the environment for varied end uses. At the Department of Energy's Oak Ridge Reservation an automated program has been developed and implemented that tracks the multitude of long-term stewardship activities. The Oak Ridge Reservation is a large site that currently has over 50 actions requiring long-term stewardship activities. The Oak Ridge Reservation consists primarily of three plant sites, and long-term stewardship will enable these sites to be leased to private entities (East Tennessee Technology Park), modernized for an evolving national security mission (Y-12 National Security Complex), and revitalized to continue multi-disciplinary research (Oak Ridge National Laboratory). The varied site end uses of the individual plant sites coupled with the multitude of controls required by leaving waste in place presents challenges. A single remedial action may include surveillance and maintenance activities, media monitoring, property record notices as well as physical controls such as fences and signs. Thus, the array of long-term stewardship activities is complex and intermingled (over 200 inspections each year at various frequencies are required currently) and requires an effective tracking program, termed the Land Use Manager. The Land Use Manager is a web-based data management application for use by personnel responsible for implementing, maintaining, and verifying engineering and land use controls on the Oak Ridge Reservation. The program is a data entry and tracking tool, as well as a notification tool. The status and performance of engineering and land use controls are checked annually for