A Survey of Enhanced Recovery After Surgery Protocols for Cesarean Delivery in Serbia

Directory of Open Access Journals (Sweden)

Borislava Pujic

2018-04-01

Full Text Available Enhanced recovery after surgery (ERAS protocols have been described for patients undergoing colon surgery. Similar protocols for cesarean delivery (CD have been developed recently. CD is one of the most commonly performed surgical procedures, and adoption of ERAS protocols following CD might benefit patients and the health-care system. We aimed to determine which Serbian hospitals reported ERAS protocols, which elements of ERAS protocols were used in CD patients, and whether ERAS and non-ERAS hospitals differed. The survey was sent to all hospitals with obstetric services and 46 of 49 responded. The questionnaire asked whether ERAS protocols had been formally adopted for surgical patients and about their use in CD patients. Specific questions on elements described in other obstetric ERAS protocols for CD included preoperative patient preparation, type of anesthesia and temperature monitoring used for CD, maternal/neonatal contact, and time to discharge. ERAS protocols are used in 24% of surveyed hospitals, 84% admit the patient the day before elective CDs, 87% use a maternal bowel preparation morning on the day of CD, and 80% administer maternal deep venous thrombosis prophylaxis. Only 33% remove IV in the first postoperative day, and 89% of women do not eat solid food until the day following their CD. Neuraxial anesthesia is used in 46% of elective CDs in ERAS hospitals compared to 9% in non-ERAS hospitals (P < 0.01, and neuraxial narcotics for post CD analgesia are given more often in ERAS hospitals. Thirty-six percentage of ERAS patients are discharged within 3 days vs. none in the non-ERAS group. Few elements of ERAS protocols reported from other centers outside Serbia are employed in Serbian hospitals performing CD. Despite significant changes that have been made recently in CD care, enhanced recovery after CD could be significantly improved in Serbian hospitals.

64-section multidetector CT of the upper abdomen: optimization of a saline chaser injection protocol for improved vascular and parenchymal contrast enhancement

Energy Technology Data Exchange (ETDEWEB)

Marin, Daniele [Duke University Medical Center, Department of Radiology, Durham, NC (United States); University of Rome Sapienza, Department of Radiological Sciences, Rome (Italy); Nelson, Rendon C. [Duke University Medical Center, Department of Radiology, Durham, NC (United States); Guerrisi, Antonino; Passariello, Roberto; Catalano, Carlo [University of Rome Sapienza, Department of Radiological Sciences, Rome (Italy); Barnhart, Huiman [Duke University Medical Center, Department of Biostatistics and Bioinformatics, Durham, NC (United States); Schindera, Sebastian T. [University Hospital of Bern, Institute for Diagnostic, Interventional and Pediatric Radiology, Bern (Switzerland)

2011-09-15

To prospectively investigate the effect of varying the injection flow rates of a saline chaser on vascular and parenchymal contrast enhancement during abdominal MDCT. 100 consecutive patients were randomly assigned to four injection protocols. A fixed dose of contrast medium was administered followed by no saline (Protocol A) or 50 mL of saline at 2, 4, or 8 mL/s (Protocols B, C, and D). Peak, time-to-peak, and duration of 90% peak enhancement were determined for aorta, pancreas, and liver. Aortic peak enhancement was significantly higher for Protocol D (369.5 HU) compared with Protocols A and B (332.9 HU and 326.0 HU, respectively; P < 0.05). Pancreatic peak enhancement was significantly higher for Protocols C and D (110.6 HU and 110.9 HU, respectively) compared to Protocol A (92.5 HU; P < 0.05). Aortic and pancreatic time-to-peak enhancement occurred significantly later for Protocol D compared with Protocol A (42.8 s vs. 36.1 s [P < 0.001] and 49.7 s vs. 45.3 s [P = 0.003]). Injecting a saline chaser at high flow rates yields significantly higher peak aortic and pancreatic enhancement, with a slight longer time-to-peak enhancement. (orig.)

A protocol is not enough to implement an enhanced recovery programme for colorectal resection

DEFF Research Database (Denmark)

Maessen, J; Dejong, C.H.C.; Hausel, J

2007-01-01

BACKGROUND: Single-centre studies have suggested that enhanced recovery can be achieved with multimodal perioperative care protocols. This international observational study evaluated the implementation of an enhanced recovery programme in five European centres and examined the determinants...... with a shorter hospital stay. CONCLUSION: Functional recovery in 3 days after colorectal resection could be achieved in daily practice. A protocol is not enough to enable discharge of patients on the day of functional recovery; more experience and better organization of care may be required. Copyright (c) 2006...

Effects of a surgical ward care protocol following open colon surgery as part of an enhanced recovery after surgery programme.

Science.gov (United States)

Kim, BoYeoul; Park, SungHee; Park, KyuJoo; Ryoo, SeungBum

2017-11-01

To investigate the effects of a standardised care protocol as part of an enhanced recovery after surgery programme on the management of patients who underwent open colon surgery at the University Hospital, South Korea. Patients who undergo open colon surgery often have concerns about their care as they prepare for hospitalisation. By shortening hospital stay lengths, enhanced recovery after surgery programmes could reduce the number of opportunities for patient education and communication with nurses. Therefore, our surgical team developed an enhanced recovery after surgery programme, applied using a care protocol for patients with colorectal cancer, that spans the entire recovery process. A retrospective, comparative study was conducted using a care protocol as part of an enhanced recovery after surgery programme. Comparisons were made before and after the implementation of an enhanced recovery after surgery programme with a care protocol. Records of 219 patients who underwent open colon surgery were retrospectively audited. The records were grouped according to the care protocol used (enhanced recovery after surgery programme with a care protocol or traditional care programme). The outcomes, including postoperative bowel function recovery, postoperative pain control, recovery time and postoperative complications, were compared between two categories. Patients who were managed using the programme with a care protocol had shorter hospital stays, fewer complications, such as postoperative ileus wound infections, and emergency room visits than those who were managed using the traditional care programme. The findings can be used to facilitate the implementation of an enhanced recovery after surgery programme with a care protocol following open colon surgery. We present a care protocol that enables effective management using consistent and standardised education providing bedside care for patients who undergo open colon surgery. This care protocol empowers long

Gender-Specific Combination HIV Prevention for Youth in High-Burden Settings: The MP3 Youth Observational Pilot Study Protocol.

Science.gov (United States)

Buttolph, Jasmine; Inwani, Irene; Agot, Kawango; Cleland, Charles M; Cherutich, Peter; Kiarie, James N; Osoti, Alfred; Celum, Connie L; Baeten, Jared M; Nduati, Ruth; Kinuthia, John; Hallett, Timothy B; Alsallaq, Ramzi; Kurth, Ann E

2017-03-08

Nearly three decades into the epidemic, sub-Saharan Africa (SSA) remains the region most heavily affected by human immunodeficiency virus (HIV), with nearly 70% of the 34 million people living with HIV globally residing in the region. In SSA, female and male youth (15 to 24 years) are at a disproportionately high risk of HIV infection compared to adults. As such, there is a need to target HIV prevention strategies to youth and to tailor them to a gender-specific context. This protocol describes the process for the multi-staged approach in the design of the MP3 Youth pilot study, a gender-specific, combination, HIV prevention intervention for youth in Kenya. The objective of this multi-method protocol is to outline a rigorous and replicable methodology for a gender-specific combination HIV prevention pilot study for youth in high-burden settings, illustrating the triangulated methods undertaken to ensure that age, sex, and context are integral in the design of the intervention. The mixed-methods, cross-sectional, longitudinal cohort pilot study protocol was developed by first conducting a systematic review of the literature, which shaped focus group discussions around prevention package and delivery options, and that also informed age- and sex- stratified mathematical modeling. The review, qualitative data, and mathematical modeling created a triangulated evidence base of interventions to be included in the pilot study protocol. To design the pilot study protocol, we convened an expert panel to select HIV prevention interventions effective for youth in SSA, which will be offered in a mobile health setting. The goal of the pilot study implementation and evaluation is to apply lessons learned to more effective HIV prevention evidence and programming. The combination HIV prevention package in this protocol includes (1) offering HIV testing and counseling for all youth; (2) voluntary medical circumcision and condoms for males; (3) pre-exposure prophylaxis (Pr

A feasible repetitive transcranial magnetic stimulation clinical protocol in migraine prevention.

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Zardouz, Shawn; Shi, Lei; Leung, Albert

2016-01-01

This case series was conducted to determine the clinical feasibility of a repetitive transcranial magnetic stimulation protocol for the prevention of migraine (with and without aura). Five patients with migraines underwent five repetitive transcranial magnetic stimulation sessions separated in 1- to 2-week intervals for a period of 2 months at a single tertiary medical center. Repetitive transcranial magnetic stimulation was applied to the left motor cortex with 2000 pulses (20 trains with 1s inter-train interval) delivered per session, at a frequency of 10 Hz and 80% resting motor threshold. Pre- and post-treatment numerical rating pain scales were collected, and percent reductions in intensity, frequency, and duration were generated. An average decrease in 37.8%, 32.1%, and 31.2% were noted in the intensity, frequency, and duration of migraines post-repetitive transcranial magnetic stimulation, respectively. A mean decrease in 1.9±1.0 (numerical rating pain scale ± standard deviation; range: 0.4-2.8) in headache intensity scores was noted after the repetitive transcranial magnetic stimulation sessions. The tested repetitive transcranial magnetic stimulation protocol is a well-tolerated, safe, and effective method for migraine prevention.

Study protocol of a cluster randomized controlled trial evaluating the efficacy of a comprehensive pressure ulcer prevention programme for private for-profit nursing homes.

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Kwong, Enid Wai-yung; Lee, Paul Hong; Yeung, Kwan-mo

2016-01-18

Because the demand for government-subsidized nursing homes in Hong Kong outstrips the supply, the number of for-profit private nursing homes has been increasing rapidly. However, the standard of care in such homes is always criticized. Pressure ulcers are a major long-term care issue that is closely associated with the quality of care delivered in nursing home settings. The aim of this study is to evaluate the effectiveness of a pressure ulcer prevention programme for residents in private for-profit nursing homes. This is a two-arm cluster randomized controlled trial with an estimated sample size of 1088 residents and 74 care staff from eight for-profit private nursing homes. Eligible nursing homes will be those classified as category A2 homes in the Enhanced Bought Place Scheme (EBPS), having a capacity of around 130-150 beds, and no structured PU prevention protocol and/or programmes in place. Care staff will be health workers, personal care workers, and nurses who are front-line staff providing direct care to residents. Eight nursing homes will be randomly assigned to either an experimental or control group. The experimental group will be provided with an intensive training programme and will be involved in the implementation of a 16-week pressure ulcer prevention protocol, while the control group will deliver the usual pressure ulcer prevention care. The study outcomes are the pressure ulcer prevention knowledge and skills of the care staff and the prevalence and incidence of pressure ulcers. Data on the knowledge and skills of care staff, and prevalence of pressure ulcer will be collected at the base line, and then at the 8(th) week and at completion of the implementation of the protocol. The assessment of the incidence of pressures will start from before the commencement of the intensive training course to the end of the implementation of the protocol. In view of the negative impact of pressure ulcers, it is important to have an effective and evidence

A protocol to prevent and deal with aggressive behavior against health workers.

Science.gov (United States)

Altemir, María; Arteaga, Alfonso

Violence against health workers is a highly prevalent phenomenon with serious psychological and labour consequences among professionals. This paper aims, first, to find out the main studies undertaken to date to describe and analyse the phenomenon, as well as to present different initiatives and protocols of action carried out. The second objective is to offer a procedure of action both to prevent aggression and to intervene in the event of receiving an aggression at work. After a bibliographic search in PubMed, Scopus and SciELO databases, the impact of the aggressions suffered by health professionals, the contexts in which aggressions are more frequent, their main consequences and different strategies and protocols conducted in Spain are reviewed. Given that rigorous reviews supporting such procedures are lacking in scientific journals, different action guidelines for professionals to prevent and to deal with hostile behaviour based on available evidence are developed and proposed. Finally, an easily consultable and applicable action procedure for health workers attacked in the workplace is presented. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

South African Research Ethics Committee Review of Standards of Prevention in HIV Vaccine Trial Protocols.

Science.gov (United States)

Essack, Zaynab; Wassenaar, Douglas R

2018-04-01

HIV prevention trials provide a prevention package to participants to help prevent HIV acquisition. As new prevention methods are proven effective, this raises ethical and scientific design complexities regarding the prevention package or standard of prevention. Given its high HIV incidence and prevalence, South Africa has become a hub for HIV prevention research. For this reason, it is critical to study the implementation of relevant ethical-legal frameworks for such research in South Africa. This qualitative study used in-depth interviews to explore the practices and perspectives of eight members of South African research ethics committees (RECs) who have reviewed protocols for HIV vaccine trials. Their practices and perspectives are compared with ethics guideline requirements for standards of prevention.

Enhanced Recovery After Surgery Protocols in Major Urologic Surgery

Directory of Open Access Journals (Sweden)

Natalija Vukovic

2018-04-01

Full Text Available The purpose of the reviewThe analysis of the components of enhanced recovery after surgery (ERAS protocols in urologic surgery.Recent findingsERAS protocols has been studied for over 20 years in different surgical procedures, mostly in colorectal surgery. The concept of improving patient care and reducing postoperative complications was also applied to major urologic surgery and especially procedure of radical cystectomy. This procedure is technically challenging, due to a major surgical resection and high postoperative complication rate that may reach 65%. Several clinical pathways were introduced to improve perioperative course and reduce the length of hospital stay. These protocols differ from ERAS modalities in other surgeries. The reasons for this are longer operative time, increased risk of perioperative transfusion and infection, and urinary diversion achieved using transposed intestinal segments. Previous studies in this area analyzed the need for mechanical bowel preparation, postoperative nasogastric tube decompression, as well as the duration of urinary drainage. Furthermore, the attention has also been drawn to perioperative fluid optimization, pain management, and bowel function.SummaryNotwithstanding partial resemblance between the pathways in major urologic surgery and other pelvic surgeries, there are still scarce guidelines for ERAS protocols in urology, which is why further studies should assess the importance of preoperative medical optimization, implementation of thoracic epidural anesthesia and analgesia, and perioperative nutritional management.

Performance Analysis of an Enhanced PRMA-HS Protocol for LEO Satellite Communication

Institute of Scientific and Technical Information of China (English)

ZHUO Yong-ning; YAN Shao-hu; WU Shi-qi

2005-01-01

The packet reservation multiple access with hindering state (PRMA-HS) is a protocol suitable for LEO satellite mobile communication. Although working well with light system payload (amount of user terminals), the protocol imposes high channel congestion on system with heavy payload, thus degrades the system's quality of service. To controlling the channel congestion, a scheme of enhanced PRMA-HS protocol is proposed, which aims to reduce the collision of voice packets by adopting a mechanism of access control. Through theoretic analysis, the system's mathematic model is presented and the packet drop probability of the scheme is deduced. To testify the performance of the scheme, a simulation is performed and the results support our analysis.

An efficient RFID authentication protocol to enhance patient medication safety using elliptic curve cryptography.

Science.gov (United States)

Zhang, Zezhong; Qi, Qingqing

2014-05-01

Medication errors are very dangerous even fatal since it could cause serious even fatal harm to patients. In order to reduce medication errors, automated patient medication systems using the Radio Frequency Identification (RFID) technology have been used in many hospitals. The data transmitted in those medication systems is very important and sensitive. In the past decade, many security protocols have been proposed to ensure its secure transition attracted wide attention. Due to providing mutual authentication between the medication server and the tag, the RFID authentication protocol is considered as the most important security protocols in those systems. In this paper, we propose a RFID authentication protocol to enhance patient medication safety using elliptic curve cryptography (ECC). The analysis shows the proposed protocol could overcome security weaknesses in previous protocols and has better performance. Therefore, the proposed protocol is very suitable for automated patient medication systems.

Shared access protocol (SAP) in femtocell channel resources for cellular coverage enhancement

KAUST Repository

Magableh, Amer M.; Radaydeh, Redha Mahmoud Mesleh; Alouini, Mohamed-Slim

2012-01-01

protocol (SAP), that enables the unlicensed macro-cell user equipments (MC-UE) to communicate with partially closed access femtocell base stations and hence, improves and enhances the overall system performance in closed environments. For the proposed

The RAPID protocol enhances patient recovery after both laparoscopic and open colorectal resections.

LENUS (Irish Health Repository)

Lloyd, G M

2010-06-01

Enhanced recovery after surgery (ERAS) programs can accelerate recovery and shorten the hospital stay after colorectal resections. The RAPID (remove, ambulate, postoperative analgesia, introduce diet) protocol is a simplified ERAS program that consists of a simplified, user-friendly single-page pro forma schedule. This study aimed to evaluate the impact of the RAPID protocol on patients undergoing both laparoscopic and open colorectal resections in two specialized colorectal units.

An enhanced password authentication scheme for session initiation protocol with perfect forward secrecy.

Science.gov (United States)

Qiu, Shuming; Xu, Guoai; Ahmad, Haseeb; Guo, Yanhui

2018-01-01

The Session Initiation Protocol (SIP) is an extensive and esteemed communication protocol employed to regulate signaling as well as for controlling multimedia communication sessions. Recently, Kumari et al. proposed an improved smart card based authentication scheme for SIP based on Farash's scheme. Farash claimed that his protocol is resistant against various known attacks. But, we observe some accountable flaws in Farash's protocol. We point out that Farash's protocol is prone to key-compromise impersonation attack and is unable to provide pre-verification in the smart card, efficient password change and perfect forward secrecy. To overcome these limitations, in this paper we present an enhanced authentication mechanism based on Kumari et al.'s scheme. We prove that the proposed protocol not only overcomes the issues in Farash's scheme, but it can also resist against all known attacks. We also provide the security analysis of the proposed scheme with the help of widespread AVISPA (Automated Validation of Internet Security Protocols and Applications) software. At last, comparing with the earlier proposals in terms of security and efficiency, we conclude that the proposed protocol is efficient and more secure.

An enhanced password authentication scheme for session initiation protocol with perfect forward secrecy

Science.gov (United States)

2018-01-01

The Session Initiation Protocol (SIP) is an extensive and esteemed communication protocol employed to regulate signaling as well as for controlling multimedia communication sessions. Recently, Kumari et al. proposed an improved smart card based authentication scheme for SIP based on Farash’s scheme. Farash claimed that his protocol is resistant against various known attacks. But, we observe some accountable flaws in Farash’s protocol. We point out that Farash’s protocol is prone to key-compromise impersonation attack and is unable to provide pre-verification in the smart card, efficient password change and perfect forward secrecy. To overcome these limitations, in this paper we present an enhanced authentication mechanism based on Kumari et al.’s scheme. We prove that the proposed protocol not only overcomes the issues in Farash’s scheme, but it can also resist against all known attacks. We also provide the security analysis of the proposed scheme with the help of widespread AVISPA (Automated Validation of Internet Security Protocols and Applications) software. At last, comparing with the earlier proposals in terms of security and efficiency, we conclude that the proposed protocol is efficient and more secure. PMID:29547619

Prevention of cervical cancer in HIV-seropositive women from developing countries: a systematic review protocol.

Science.gov (United States)

Mapanga, Witness; Elhakeem, Ahmed; Feresu, Shingairai A; Maseko, Fresier; Chipato, Tsungai

2017-04-24

Over 85% of cervical cancer cases and deaths occur in developing countries. HIV-seropositive women are more likely to develop precancerous lesions that lead to cervical cancer than HIV-negative women. However, the literature on cervical cancer prevention in seropositive women in developing countries has not been reviewed. The aim of this study is to systematically review cervical cancer prevention modalities available for HIV-seropositive women in developing countries. This protocol was developed by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement, and the systematic review will be reported in accordance with the PRISMA guidelines. Embase, MEDLINE, PubMed, CINAHL and Cochrane Library will be searched from inception up to date of final search, and additional studies will be located through citation and reference list tracking. Eligible studies will be randomised controlled trials, prospective and retrospective cohort studies, case-control and cross-sectional studies carried out in developing countries. Studies will be included if they are published in English and examine cervical cancer prevention modalities in HIV-seropositive women. Results will be summarised in tables and, where appropriate, combined using meta-analysis. This review will address the gap in evidence by systematically reviewing the published literature on the different prevention modalities being used to prevent cervical cancer in HIV-seropositive women in developing countries. The findings may be used to inform evidence-based guidelines for prevention of cervical cancer in seropositive women as well as future research. PROSPERO CRD42017054678 .

Implementation of a protocol for the prevention and management of extravasation injuries in the neonatal intensive care patient.

Science.gov (United States)

Warren, Diane

2011-06-01

This project sought to determine nurses' understanding and management of infants with intravenous (IV) therapy. There were three specific aims: • To improve identification and management of extravasation injuries in neonates • To ensure management of extravasation injuries in neonates is classified according to IV extravasation staging guidelines • To develop a protocol that outlined actions required to manage extravasation injuries. This project utilised a pre- and post-implementation audit strategy using the Joanna Briggs Institute (JBI) Getting Research into Practice (GRIP) program. This method has been used to improve clinical practice by utilising an audit, feedback and re-audit sequence. The project was implemented in four stages over a 7-month period from 21 October 2009 to 30 May 2010. Initially, there was poor compliance with all four criteria, ranging from zero to 63%. The GRIP phase of the project identified five barriers which were addressed throughout this project. These related to education of staff and the development of a protocol for the prevention and management of extravasation injuries in the neonatal population. Following implementation of best practice, the second audit showed a marked improvement in all four criteria, ranging from 70 to 100% compliance. Overall, this project has led to improvements in clinical practice in line with current evidence. This has resulted in enhanced awareness of the risks associated with IV therapy and of measures to prevent an injury occurring within this clinical setting. © 2011 The Author. International Journal of Evidence-Based Healthcare © 2011 The Joanna Briggs Institute.

[Study protocol of a prevention of recurrent suicidal behaviour program based on case management (PSyMAC)].

Science.gov (United States)

Sáiz, Pilar A; Rodríguez-Revuelta, Julia; González-Blanco, Leticia; Burón, Patricia; Al-Halabí, Susana; Garrido, Marlen; García-Alvarez, Leticia; García-Portilla, Paz; Bobes, Julio

2014-01-01

Prevention of suicidal behaviour is a public health priority in the European Union. A previous suicide attempt is the best risk predictor for future attempts, as well as completed suicides. The primary aim of this article is to describe a controlled study protocol designed for prevention of recurrent suicidal behaviour that proposes case management, and includes a psychoeducation program, as compared with the standard intervention (PSyMAC). Patients admitted from January 2011 to June 2013 to the emergency room of the Hospital Universitario Central de Asturias were evaluated using a protocol including sociodemographic, psychiatric, and psychosocial assessment. Patients were randomly assigned to either a group receiving continuous case management including participation in a psychoeducation program (experimental group), or a control group receiving standard care. The primary objective is to examine whether or not the period of time until recurrent suicidal behaviour in the experimental group is significantly different from that of the control group. PSyMAC proposes low cost and easily adaptable interventions to the usual clinical setting that can help to compensate the shortcoming of specific action protocols and suicidal behaviour prevention programs in our country. The evaluation of PSyMAC results will determine their real effectivity as a case-magament program to reduce suicidal risk. Copyright © 2013 SEP y SEPB. Published by Elsevier España. All rights reserved.

Shared access protocol (SAP) in femtocell channel resources for cellular coverage enhancement

KAUST Repository

Magableh, Amer M.

2012-12-01

Femtocells are promising techniques employed in cellular systems to enhance the indoor coverage, especially in areas with high density and high traffic rates. In this paper, we propose an efficient resource utilization protocol, named shared access protocol (SAP), that enables the unlicensed macro-cell user equipments (MC-UE) to communicate with partially closed access femtocell base stations and hence, improves and enhances the overall system performance in closed environments. For the proposed system model, we obtain, in closed-form, the main signal-to-interference plus noise ratio (SINR) characteristics, including the probability density function (PDF) and the cumulative distribution function (CDF). In addition, these expressions are further used to derive several performance metrics in closed-form, such as, the average bit error rate (BER), outage probability, and the average channel capacity for the proposed SAP herein. Furthermore, Monte-carlo simulations as well as numerical results are provided showing a good match that ensures and confirms the correctness of the derived expressions. © 2012 IEEE.

A Guide to Writing a Qualitative Systematic Review Protocol to Enhance Evidence-Based Practice in Nursing and Health Care.

Science.gov (United States)

Butler, Ashleigh; Hall, Helen; Copnell, Beverley

2016-06-01

The qualitative systematic review is a rapidly developing area of nursing research. In order to present trustworthy, high-quality recommendations, such reviews should be based on a review protocol to minimize bias and enhance transparency and reproducibility. Although there are a number of resources available to guide researchers in developing a quantitative review protocol, very few resources exist for qualitative reviews. To guide researchers through the process of developing a qualitative systematic review protocol, using an example review question. The key elements required in a systematic review protocol are discussed, with a focus on application to qualitative reviews: Development of a research question; formulation of key search terms and strategies; designing a multistage review process; critical appraisal of qualitative literature; development of data extraction techniques; and data synthesis. The paper highlights important considerations during the protocol development process, and uses a previously developed review question as a working example. This paper will assist novice researchers in developing a qualitative systematic review protocol. By providing a worked example of a protocol, the paper encourages the development of review protocols, enhancing the trustworthiness and value of the completed qualitative systematic review findings. Qualitative systematic reviews should be based on well planned, peer reviewed protocols to enhance the trustworthiness of results and thus their usefulness in clinical practice. Protocols should outline, in detail, the processes which will be used to undertake the review, including key search terms, inclusion and exclusion criteria, and the methods used for critical appraisal, data extraction and data analysis to facilitate transparency of the review process. Additionally, journals should encourage and support the publication of review protocols, and should require reference to a protocol prior to publication of the

Suicide Risk Protocols: Addressing the Needs of High Risk Youths Identified through Suicide Prevention Efforts and in Clinical Settings

Science.gov (United States)

Heilbron, Nicole; Goldston, David; Walrath, Christine; Rodi, Michael; McKeon, Richard

2013-01-01

Several agencies have emphasized the importance of establishing clear protocols or procedures to address the needs of youths who are identified as suicidal through suicide prevention programs or in emergency department settings. What constitutes optimal guidelines for developing and implementing such protocols, however, is unclear. At the request…

A mixed methods protocol for developing and testing implementation strategies for evidence-based obesity prevention in childcare: a cluster randomized hybrid type III trial.

Science.gov (United States)

Swindle, Taren; Johnson, Susan L; Whiteside-Mansell, Leanne; Curran, Geoffrey M

2017-07-18

Despite the potential to reach at-risk children in childcare, there is a significant gap between current practices and evidence-based obesity prevention in this setting. There are few investigations of the impact of implementation strategies on the uptake of evidence-based practices (EBPs) for obesity prevention and nutrition promotion. This study protocol describes a three-phase approach to developing and testing implementation strategies to support uptake of EBPs for obesity prevention practices in childcare (i.e., key components of the WISE intervention). Informed by the i-PARIHS framework, we will use a stakeholder-driven evidence-based quality improvement (EBQI) process to apply information gathered in qualitative interviews on barriers and facilitators to practice to inform the design of implementation strategies. Then, a Hybrid Type III cluster randomized trial will compare a basic implementation strategy (i.e., intervention as usual) with an enhanced implementation strategy informed by stakeholders. All Head Start centers (N = 12) within one agency in an urban area in a southern state in the USA will be randomized to receive the basic or enhanced implementation with approximately 20 classrooms per group (40 educators, 400 children per group). The educators involved in the study, the data collectors, and the biostastician will be blinded to the study condition. The basic and enhanced implementation strategies will be compared on outcomes specified by the RE-AIM model (e.g., Reach to families, Effectiveness of impact on child diet and health indicators, Adoption commitment of agency, Implementation fidelity and acceptability, and Maintenance after 6 months). Principles of formative evaluation will be used throughout the hybrid trial. This study will test a stakeholder-driven approach to improve implementation, fidelity, and maintenance of EBPs for obesity prevention in childcare. Further, this study provides an example of a systematic process to develop

Incidence of intraoperative hypothermia: adopting protocol for its prevention

International Nuclear Information System (INIS)

Al-Qahtani, Ali S.; Messahel, Farouk M.

2003-01-01

To determine the incidence of hypothermia during surgical procedures when adequate methods of preserving normothermia are applied .For this was a study in which patients ASA I-IV presented for surgery at the Armed Forces Hospital, Wadi Al- Dawasir, kingdom of Saudi Arabia ,during the period from July 2000 to February 2003 in whom body core temprature was between 35-37C ,were included. Ambient temperature of the operating room was thermostatically adjusted to record 26C and 24C if patents were < 10 year-old or above .Depending on type of surgery ;the patients were provided with space blankents and were lying on warm mattresses. Fluid or blood warmers and forced-air surface were used when needed for this. = Aggressive measures must be adopted to preserve normothermia as prevention of intraoperative hypothermia improves patients outcome .All patients shoud have their body temprature monitored during surgery .However application of available methods of keeping normothermia reduces the the incidence of intraoperative hypothermia but does not abolish it completely . Hypothermia patients should be closely moniterd during gradual rewarming preferably in the intensive care setting. A protocol for prevention of intraoperative hypothermia must be adopted by all operating theatres. (author)

Stress Prevention@Work: a study protocol for the evaluation of a multifaceted integral stress prevention strategy to prevent employee stress in a healthcare organization: a cluster controlled trial.

Science.gov (United States)

Hoek, Rianne J A; Havermans, Bo M; Houtman, Irene L D; Brouwers, Evelien P M; Heerkens, Yvonne F; Zijlstra-Vlasveld, Moniek C; Anema, Johannes R; van der Beek, Allard J; Boot, Cécile R L

2017-07-17

Adequate implementation of work-related stress management interventions can reduce or prevent work-related stress and sick leave in organizations. We developed a multifaceted integral stress-prevention strategy for organizations from several sectors that includes a digital platform and collaborative learning network. The digital platform contains a stepwise protocol to implement work-related stress-management interventions. It includes stress screeners, interventions and intervention providers to facilitate access to and the selection of matching work-related stress-management interventions. The collaborative learning network, including stakeholders from various organizations, plans meetings focussing on an exchange of experiences and good practices among organizations for the implementation of stress prevention measures. This paper describes the design of an integral stress-prevention strategy, Stress Prevention@Work, and the protocol for the evaluation of: 1) the effects of the strategy on perceived stress and work-related outcomes, and 2) the barriers and facilitators for implementation of the strategy. The effectiveness of Stress Prevention@Work will be evaluated in a cluster controlled trial, in a large healthcare organization in the Netherlands, at six and 12 months. An independent researcher will match teams on working conditions and size and allocate the teams to the intervention or control group. Teams in the intervention group will be offered Stress Prevention@Work. For each intervention team, one employee is responsible for applying the strategy within his/her team using the digital platform and visiting the collaborative learning network. Using a waiting list design, the control group will be given access to the strategy after 12 months. The primary outcome is the employees' perceived stress measured by the stress subscale of the Depression, Anxiety, and Stress Scale (DASS-21). Secondary outcome measures are job demands, job resources and the number

Breakthrough reactions of iodinated and gadolinium contrast media after oral steroid premedication protocol.

Science.gov (United States)

Jingu, Akiko; Fukuda, Junya; Taketomi-Takahashi, Ayako; Tsushima, Yoshito

2014-10-06

Adverse reactions to iodinated and gadolinium contrast media are an important clinical issue. Although some guidelines have proposed oral steroid premedication protocols to prevent adverse reactions, some patients may have reactions to contrast media in spite of premedication (breakthrough reaction; BTR).The purpose of this study was to assess the frequency, type and severity of BTR when following an oral steroid premedication protocol. All iodinated and gadolinium contrast-enhanced radiologic examinations between August 2011 and February 2013 for which the premedication protocol was applied in our institution were assessed for BTRs. The protocol was applied to a total of 252 examinations (153 patients, ages 15-87 years; 63 males, 90 females). Of these, 152 were for prior acute adverse reactions to contrast media, 85 were for a history of bronchial asthma, and 15 were for other reasons. There were 198 contrast enhanced CTs and 54 contrast enhanced MRIs. There were nine BTR (4.5%) for iodinated contrast media, and only one BTR (1.9%) for gadolinium contrast media: eight were mild and one was moderate. No patient who had a mild index reaction (IR) had a severe BTR. Incidence of BTRs when following the premedication protocol was low. This study by no means proves the efficacy of premedication, but provides some support for following a premedication protocol to improve safety of contrast-enhanced examinations when prior adverse reactions are mild, or when there is a history of asthma.

Breakthrough reactions of iodinated and gadolinium contrast media after oral steroid premedication protocol

International Nuclear Information System (INIS)

Jingu, Akiko; Fukuda, Junya; Taketomi-Takahashi, Ayako; Tsushima, Yoshito

2014-01-01

Adverse reactions to iodinated and gadolinium contrast media are an important clinical issue. Although some guidelines have proposed oral steroid premedication protocols to prevent adverse reactions, some patients may have reactions to contrast media in spite of premedication (breakthrough reaction; BTR). The purpose of this study was to assess the frequency, type and severity of BTR when following an oral steroid premedication protocol. All iodinated and gadolinium contrast-enhanced radiologic examinations between August 2011 and February 2013 for which the premedication protocol was applied in our institution were assessed for BTRs. The protocol was applied to a total of 252 examinations (153 patients, ages 15–87 years; 63 males, 90 females). Of these, 152 were for prior acute adverse reactions to contrast media, 85 were for a history of bronchial asthma, and 15 were for other reasons. There were 198 contrast enhanced CTs and 54 contrast enhanced MRIs. There were nine BTR (4.5%) for iodinated contrast media, and only one BTR (1.9%) for gadolinium contrast media: eight were mild and one was moderate. No patient who had a mild index reaction (IR) had a severe BTR. Incidence of BTRs when following the premedication protocol was low. This study by no means proves the efficacy of premedication, but provides some support for following a premedication protocol to improve safety of contrast-enhanced examinations when prior adverse reactions are mild, or when there is a history of asthma

School-based intervention to prevent overweight and disordered eating in secondary school Malaysian adolescents: a study protocol

OpenAIRE

Sharif Ishak, Sharifah Intan Zainun; Chin, Yit Siew; Mohd. Taib, Mohd. Nasir; Mohd. Shariff, Zalilah

2016-01-01

Abstract Background Obesity, eating disorders and unhealthy weight-loss practices have been associated with diminished growth in adolescents worldwide. Interventions that address relevant behavioural dimensions have been lacking in Malaysia. This paper describes the protocol of an integrated health education intervention namely ‘Eat Right, Be Positive About Your Body and Live Actively’ (EPaL), a primary prevention which aimed to promote healthy lifestyle in preventing overweight and disordere...

'Be active, eat right', evaluation of an overweight prevention protocol among 5-year-old children: design of a cluster randomised controlled trial

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Veldhuis Lydian

2009-06-01

Full Text Available Abstract Background The prevalence of overweight and obesity in children has at least doubled in the past 25 years with a major impact on health. In 2005 a prevention protocol was developed applicable within Youth Health Care. This study aims to assess the effects of this protocol on prevalence of overweight and health behaviour among children. Methods and design A cluster randomised controlled trial is conducted among 5-year-old children included by 44 Youth Health Care teams randomised within 9 Municipal Health Services. The teams are randomly allocated to the intervention or control group. The teams measure the weight and height of all children. When a child in the intervention group is detected with overweight according to the international age and gender specific cut-off points of BMI, the prevention protocol is applied. According to this protocol parents of overweight children are invited for up to three counselling sessions during which they receive personal advice about a healthy lifestyle, and are motivated for and assisted in behavioural change. The primary outcome measures are Body Mass Index and waist circumference of the children. Parents will complete questionnaires to assess secondary outcome measures: levels of overweight inducing/reducing behaviours (i.e. being physically active, having breakfast, drinking sweet beverages and watching television/playing computer games, parenting styles, parenting practices, and attitudes of parents regarding these behaviours, health-related quality of life of the children, and possible negative side effects of the prevention protocol. Data will be collected at baseline (when the children are aged 5 years, and after 12 and 24 months of follow-up. Additionally, a process and a cost-effectiveness evaluation will be conducted. Discussion In this study called 'Be active, eat right' we evaluate an overweight prevention protocol for use in the setting of Youth Health Care. It is hypothesized that the

'Be active, eat right', evaluation of an overweight prevention protocol among 5-year-old children: design of a cluster randomised controlled trial.

Science.gov (United States)

Veldhuis, Lydian; Struijk, Mirjam K; Kroeze, Willemieke; Oenema, Anke; Renders, Carry M; Bulk-Bunschoten, Anneke Mw; Hirasing, Remy A; Raat, Hein

2009-06-08

The prevalence of overweight and obesity in children has at least doubled in the past 25 years with a major impact on health. In 2005 a prevention protocol was developed applicable within Youth Health Care. This study aims to assess the effects of this protocol on prevalence of overweight and health behaviour among children. A cluster randomised controlled trial is conducted among 5-year-old children included by 44 Youth Health Care teams randomised within 9 Municipal Health Services. The teams are randomly allocated to the intervention or control group. The teams measure the weight and height of all children. When a child in the intervention group is detected with overweight according to the international age and gender specific cut-off points of BMI, the prevention protocol is applied. According to this protocol parents of overweight children are invited for up to three counselling sessions during which they receive personal advice about a healthy lifestyle, and are motivated for and assisted in behavioural change.The primary outcome measures are Body Mass Index and waist circumference of the children. Parents will complete questionnaires to assess secondary outcome measures: levels of overweight inducing/reducing behaviours (i.e. being physically active, having breakfast, drinking sweet beverages and watching television/playing computer games), parenting styles, parenting practices, and attitudes of parents regarding these behaviours, health-related quality of life of the children, and possible negative side effects of the prevention protocol. Data will be collected at baseline (when the children are aged 5 years), and after 12 and 24 months of follow-up. Additionally, a process and a cost-effectiveness evaluation will be conducted. In this study called 'Be active, eat right' we evaluate an overweight prevention protocol for use in the setting of Youth Health Care. It is hypothesized that the use of this protocol will result in a healthier lifestyle of the

Analysis of Pre-participation Screening Protocols for Football Players in Europe, USA, and Libya: Possible Implications for Preventing Sudden Cardiac Death

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Salaheddin Sharif

2017-06-01

Full Text Available Sudden cardiac death is the leading cause of death in sport participants and may result from undiagnosed cardiac diseases. It has been universally agreed upon that pre-participation screening can identify those athletes at risk of sudden cardiac death, and yet, there is no commonly accepted protocol to screen athletes. Although the European Society of Cardiology (ESC and the American Heart Association (AHA recommend the routine screening of athletes to prevent sudden death, there is significant disagreement regarding the guidelines of the protocols. The American Heart Association protocol includes a detailed medical history and a physical examination, whereas the European Society of Cardiology protocol includes 12-lead electrocardiography with a detailed medical history and a physical examination. The cost benefit of using electrocardiography is debatable, particularly if the screening is used to prevent sudden death associated with uncommon diseases. The Libyan Football Federation established a new seasonal pre-competition medical assessment protocol for Libyan football athletes during the 2013-2014 season, which includes a medical history, physical examination, 12 lead electrocardiography, echocardiography, and blood test. Regardless of cost and differences in protocol, there is a significant value in pre-participation screening for athletes in order to decrease the incidence of sudden cardiac death, and this report examines some of these different protocols as well as their potential for identifying athletes at risk for sudden cardiac death.

Stress Prevention@Work: a study protocol for the evaluation of a multifaceted integral stress prevention strategy to prevent employee stress in a healthcare organization: a cluster controlled trial

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Rianne J. A. Hoek

2017-07-01

Full Text Available Abstract Background Adequate implementation of work-related stress management interventions can reduce or prevent work-related stress and sick leave in organizations. We developed a multifaceted integral stress-prevention strategy for organizations from several sectors that includes a digital platform and collaborative learning network. The digital platform contains a stepwise protocol to implement work-related stress-management interventions. It includes stress screeners, interventions and intervention providers to facilitate access to and the selection of matching work-related stress-management interventions. The collaborative learning network, including stakeholders from various organizations, plans meetings focussing on an exchange of experiences and good practices among organizations for the implementation of stress prevention measures. This paper describes the design of an integral stress-prevention strategy, Stress Prevention@Work, and the protocol for the evaluation of: 1 the effects of the strategy on perceived stress and work-related outcomes, and 2 the barriers and facilitators for implementation of the strategy. Methods The effectiveness of Stress Prevention@Work will be evaluated in a cluster controlled trial, in a large healthcare organization in the Netherlands, at six and 12 months. An independent researcher will match teams on working conditions and size and allocate the teams to the intervention or control group. Teams in the intervention group will be offered Stress Prevention@Work. For each intervention team, one employee is responsible for applying the strategy within his/her team using the digital platform and visiting the collaborative learning network. Using a waiting list design, the control group will be given access to the strategy after 12 months. The primary outcome is the employees’ perceived stress measured by the stress subscale of the Depression, Anxiety, and Stress Scale (DASS-21. Secondary outcome measures

Tailoring International Pressure Ulcer Prevention Guidelines for Nigeria: A Knowledge Translation Study Protocol.

Science.gov (United States)

Ilesanmi, Rose Ekama; Gillespie, Brigid M; Adejumo, Prisca Olabisi; Chaboyer, Wendy

2015-07-28

The 2014 International Pressure Ulcer Prevention (PUP) Clinical Practice Guidelines (CPG) provides the most current evidence based strategies to prevent Pressure Ulcer (PU). The evidence upon which these guidelines have been developed has predominantly been generated from research conducted in developed countries. Some of these guidelines may not be feasible in developing countries due to structural and resource issues; therefore there is a need to adapt these guidelines to the context thus making it culturally acceptable. To present a protocol detailing the tailoring of international PUPCPG into a care bundle for the Nigerian context. Guided by the Knowledge to Action (KTA) framework, a two phased study will be undertaken. In Phase 1, the Delphi technique with stakeholder leaders will be used to review the current PUPCPG, identifying core strategies that are feasible to be adopted in Nigeria. These core strategies will become components of a PUP care bundle. In Phase 2, key stakeholder interviews will be used to identify the barriers, facilitators and potential implementation strategies to promote uptake of the PUP care bundle. A PUP care bundle, with three to eight components is expected to be developed from Phase 1. Implementation strategies to promote adoption of the PUP care bundle into clinical practice in selected Nigerian hospitals, is expected to result from Phase 2. Engagement of key stakeholders and consumers in the project should promote successful implementation and translate into better patient care. Using KTA, a knowledge translation framework, to guide the implementation of PUPCPG will enhance the likelihood of successful adoption in clinical practice. In implementing a PUP care bundle, developing countries face a number of challenges such as the feasibility of its components and the required resources.

Tailoring International Pressure Ulcer Prevention Guidelines for Nigeria: A Knowledge Translation Study Protocol

Directory of Open Access Journals (Sweden)

Rose Ekama Ilesanmi

2015-07-01

Full Text Available Background: The 2014 International Pressure Ulcer Prevention (PUP Clinical Practice Guidelines (CPG provides the most current evidence based strategies to prevent Pressure Ulcer (PU. The evidence upon which these guidelines have been developed has predominantly been generated from research conducted in developed countries. Some of these guidelines may not be feasible in developing countries due to structural and resource issues; therefore there is a need to adapt these guidelines to the context thus making it culturally acceptable. Aim: To present a protocol detailing the tailoring of international PUPCPG into a care bundle for the Nigerian context. Methods: Guided by the Knowledge to Action (KTA framework, a two phased study will be undertaken. In Phase 1, the Delphi technique with stakeholder leaders will be used to review the current PUPCPG, identifying core strategies that are feasible to be adopted in Nigeria. These core strategies will become components of a PUP care bundle. In Phase 2, key stakeholder interviews will be used to identify the barriers, facilitators and potential implementation strategies to promote uptake of the PUP care bundle. Results: A PUP care bundle, with three to eight components is expected to be developed from Phase 1. Implementation strategies to promote adoption of the PUP care bundle into clinical practice in selected Nigerian hospitals, is expected to result from Phase 2. Engagement of key stakeholders and consumers in the project should promote successful implementation and translate into better patient care. Conclusion: Using KTA, a knowledge translation framework, to guide the implementation of PUPCPG will enhance the likelihood of successful adoption in clinical practice. In implementing a PUP care bundle, developing countries face a number of challenges such as the feasibility of its components and the required resources.

Effectiveness of muscle strengthening and description of protocols for preventing falls in the elderly: a systematic review

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Erika Y. Ishigaki

2014-05-01

Full Text Available Background: Falls are a geriatric syndrome that is considered a significant public health problem in terms of morbidity and mortality because they lead to a decline in functional capacity and an impaired quality of life in the elderly. Lower limb muscle strengthening seems to be an effective intervention for preventing falls; however, there is no consensus regarding the best method for increasing lower limb muscle strength. Objectives: To analyze the effectiveness of lower limb muscle strengthening and to investigate and describe the protocols used for preventing falls in elderly subjects. Method: We performed a systematic review of randomized and controlled clinical trials published between 2002 and 2012 in the databases PubMed, EMBASE, Scopus, Web of Science, and PEDro that cited some type of lower limb muscle strengthening protocol and that evaluated the incidence of falls as the primary outcome exclusively in elderly subjects. Twelve studies met the inclusion criteria. Qualitative analysis was performed by independent reviewers applying the PEDro scale. Results: The data obtained from the selected studies showed lower fall rates in the intervention groups compared to controls. Six studies described the lower limb muscle strengthening protocol in detail. High methodological quality was found in 6 studies (PEDro score ≥7/10 points. Conclusions: The methodological quality of the studies in this area appears to leave little doubt regarding the effectiveness of lower limb strengthening exercises for preventing falls in elderly subjects, however the interventions in these studies were poorly reported.

An Enhanced Biometric Based Authentication with Key-Agreement Protocol for Multi-Server Architecture Based on Elliptic Curve Cryptography.

Science.gov (United States)

Reddy, Alavalapati Goutham; Das, Ashok Kumar; Odelu, Vanga; Yoo, Kee-Young

2016-01-01

Biometric based authentication protocols for multi-server architectures have gained momentum in recent times due to advancements in wireless technologies and associated constraints. Lu et al. recently proposed a robust biometric based authentication with key agreement protocol for a multi-server environment using smart cards. They claimed that their protocol is efficient and resistant to prominent security attacks. The careful investigation of this paper proves that Lu et al.'s protocol does not provide user anonymity, perfect forward secrecy and is susceptible to server and user impersonation attacks, man-in-middle attacks and clock synchronization problems. In addition, this paper proposes an enhanced biometric based authentication with key-agreement protocol for multi-server architecture based on elliptic curve cryptography using smartcards. We proved that the proposed protocol achieves mutual authentication using Burrows-Abadi-Needham (BAN) logic. The formal security of the proposed protocol is verified using the AVISPA (Automated Validation of Internet Security Protocols and Applications) tool to show that our protocol can withstand active and passive attacks. The formal and informal security analyses and performance analysis demonstrates that the proposed protocol is robust and efficient compared to Lu et al.'s protocol and existing similar protocols.

Caries risk assessment tool and prevention protocol for public health nurses in mother and child health centers, Israel.

Science.gov (United States)

Natapov, Lena; Dekel-Markovich, Dan; Granit-Palmon, Hadas; Aflalo, Efrat; Zusman, Shlomo Paul

2018-01-01

Dental caries is the most prevalent chronic disease in children. Caries risk assessment tools enable the dentists, physicians, and nondental health care providers to assess the individual's risk. Intervention by nurses in primary care settings can contribute to the establishment of oral health habits and prevention of dental disease. In Israel, Mother and Child Health Centers provide free preventive services for pregnant women and children by public health nurses. A caries prevention program in health centers started in 2015. Nurses underwent special training regarding caries prevention. A customized Caries Risk Assessment tool and Prevention Protocol for nurses, based on the AAPD tool, was introduced. A two-step evaluation was conducted which included a questionnaire and in-depth phone interviews. Twenty-eight (out of 46) health centers returned a completed questionnaire. Most nurses believed that oral health preventive services should be incorporated into their daily work. In the in-depth phone interviews, nurses stated that the integration of the program into their busy daily schedule was realistic and appropriate. The lack of specific dental module for computer program was mentioned as an implementation difficulty. The wide use of our tool by nurses supports its simplicity and feasibility which enables quick calculation and informed decision making. The nurses readily embraced the tool and it became an integral part of their toolkit. We provide public health nurses with a caries risk assessment tool and prevention protocol thus integrating oral health into general health of infants and toddlers. © 2017 Wiley Periodicals, Inc.

Enhancing the Detection of Dysmorphic Red Blood Cells and Renal Tubular Epithelial Cells with a Modified Urinalysis Protocol.

Science.gov (United States)

Chu-Su, Yu; Shukuya, Kenichi; Yokoyama, Takashi; Lin, Wei-Chou; Chiang, Chih-Kang; Lin, Chii-Wann

2017-01-11

Urinary sediment is used to evaluate patients with possible urinary tract diseases. Currently, numerous protocols are applied to detect dysmorphic red blood cells (RBCs) and renal tubular epithelial cells (RTECs) in urinary sediment. However, distinct protocols are used by nephrologists and medical technologists for specimen concentration and observation, which leads to major discrepancies in the differential counts of formed elements such as dysmorphic RBCs and RTECs and might interfere with an accurate clinical diagnosis. To resolve these problems, we first tested a modified urinalysis protocol with an increased relative centrifuge force and concentration factor in 20 biopsy-confirmed glomerulonephritis patients with haematuria. We successfully improved the recovery ratio of dysmorphic RBCs in clinical specimens from 34.7% to 42.0% (P dysmorphic RBCs were detected using a bright field microscope, with results comparable to those using a standard phase contrast microscope. Finally, we applied Sternheimer stain to enhance the contrast of RTECs in the urinary sediments. We concluded that this modified urinalysis protocol significantly enhanced the quality of urinalysis.

'Be active, eat right', evaluation of an overweight prevention protocol among 5-year-old children: design of a cluster randomised controlled trial

NARCIS (Netherlands)

Veldhuis, L.; Struijk, M.K.; Kroeze, W.; Oenema, A.; Renders, C.M.; Bunschoten, A.M.W.; Hira Sing, R.A.; Raat, H.

2009-01-01

Background. The prevalence of overweight and obesity in children has at least doubled in the past 25 years with a major impact on health. In 2005 a prevention protocol was developed applicable within Youth Health Care. This study aims to assess the effects of this protocol on prevalence of

'Be active, eat right', evaluation of an overweight prevention protocol among 5-year-old children : Design of a cluster randomised controlled trial

NARCIS (Netherlands)

L. Veldhuis (Lydian); M.K. Struijk (Mirjam); W. Kroeze (Willemieke); A. Oenema (Anke); C.M. Renders (Carry); A.M.W. Bulk-Bunschoten (Anneke); R.A. Hirasing (Remy); H. Raat (Hein)

2009-01-01

textabstractBACKGROUND: The prevalence of overweight and obesity in children has at least doubled in the past 25 years with a major impact on health. In 2005 a prevention protocol was developed applicable within Youth Health Care. This study aims to assess the effects of this protocol on prevalence

Performance analysis and implementation of proposed mechanism for detection and prevention of security attacks in routing protocols of vehicular ad-hoc network (VANET

Directory of Open Access Journals (Sweden)

Parul Tyagi

2017-07-01

Full Text Available Next-generation communication networks have become widely popular as ad-hoc networks, broadly categorized as the mobile nodes based on mobile ad-hoc networks (MANET and the vehicular nodes based vehicular ad-hoc networks (VANET. VANET is aimed at maintaining safety to vehicle drivers by begin autonomous communication with the nearby vehicles. Each vehicle in the ad-hoc network performs as an intelligent mobile node characterized by high mobility and formation of dynamic networks. The ad-hoc networks are decentralized dynamic networks that need efficient and secure communication requirements due to the vehicles being persistently in motion. These networks are more susceptible to various attacks like Warm Hole attacks, denial of service attacks and Black Hole Attacks. The paper is a novel attempt to examine and investigate the security features of the routing protocols in VANET, applicability of AODV (Ad hoc On Demand protocol to detect and tackle a particular category of network attacks, known as the Black Hole Attacks. A new algorithm is proposed to enhance the security mechanism of AODV protocol and to introduce a mechanism to detect Black Hole Attacks and to prevent the network from such attacks in which source node stores all route replies in a look up table. This table stores the sequences of all route reply, arranged in ascending order using PUSH and POP operations. The priority is calculated based on sequence number and discard the RREP having presumably very high destination sequence number. The result show that proposed algorithm for detection and prevention of Black Hole Attack increases security in Intelligent Transportation System (ITS and reduces the effect of malicious node in the VANET. NCTUNs simulator is used in this research work.

Enhancing Mental and Physical Health of Women through Engagement and Retention (EMPOWER): a protocol for a program of research.

Science.gov (United States)

Hamilton, Alison B; Farmer, Melissa M; Moin, Tannaz; Finley, Erin P; Lang, Ariel J; Oishi, Sabine M; Huynh, Alexis K; Zuchowski, Jessica; Haskell, Sally G; Bean-Mayberry, Bevanne

2017-11-07

The Enhancing Mental and Physical health of Women through Engagement and Retention or EMPOWER program represents a partnership with the US Department of Veterans Health Administration (VA) Health Service Research and Development investigators and the VA Office of Women's Health, National Center for Disease Prevention and Health Promotion, Primary Care-Mental Health Integration Program Office, Women's Mental Health Services, and the Office of Patient Centered Care and Cultural Transformation. EMPOWER includes three projects designed to improve women Veterans' engagement and retention in evidence-based care for high-priority health conditions, i.e., prediabetes, cardiovascular, and mental health. The three proposed projects will be conducted in VA primary care clinics that serve women Veterans including general primary care and women's health clinics. The first project is a 1-year quality improvement project targeting diabetes prevention. Two multi-site research implementation studies will focus on cardiovascular risk prevention and collaborative care to address women Veterans' mental health treatment needs respectively. All projects will use the evidence-based Replicating Effective Programs (REP) implementation strategy, enhanced with multi-stakeholder engagement and complexity theory. Mixed methods implementation evaluations will focus on investigating primary implementation outcomes of adoption, acceptability, feasibility, and reach. Program-wide organizational-, provider-, and patient-level measures and tools will be utilized to enhance synergy, productivity, and impact. Both implementation research studies will use a non-randomized stepped wedge design. EMPOWER represents a coherent program of women's health implementation research and quality improvement that utilizes cross-project implementation strategies and evaluation methodology. The EMPOWER Quality Enhancement Research Initiative (QUERI) will constitute a major milestone for realizing women Veterans

The Achilles’ heel of prevention to mother-to-child transmission of HIV: Protocol implementation, uptake, and sustainability

Science.gov (United States)

Rodriguez, Violeta J.; LaCabe, Richard P.; Privette, C. Kyle; Douglass, K. Marie; Peltzer, Karl; Matseke, Gladys; Mathebula, Audrey; Ramlagan, Shandir; Sifunda, Sibusiso; Prado, Guillermo “Willy”; Horigian, Viviana; Weiss, Stephen M.; Jones, Deborah L.

2017-01-01

Abstract The Joint United Nations Programme on HIV and AIDS proposed to reduce the vertical transmission of HIV from ∼72,200 to ∼8300 newly infected children by 2015 in South Africa (SA). However, cultural, infrastructural, and socio-economic barriers hinder the implementation of the prevention of mother-to-child transmission (PMTCT) protocol, and research on potential solutions to address these barriers in rural areas is particularly limited. This study sought to identify challenges and solutions to the implementation, uptake, and sustainability of the PMTCT protocol in rural SA. Forty-eight qualitative interviews, 12 focus groups discussions (n = 75), and one two-day workshop (n = 32 participants) were conducted with district directors, clinic leaders, staff, and patients from 12 rural clinics. The delivery and uptake of the PMTCT protocol was evaluated using the Consolidated Framework for Implementation Research (CFIR); 15 themes associated with challenges and solutions emerged. Intervention characteristics themes included PMTCT training and HIV serostatus disclosure. Outer-setting themes included facility space, health record management, and staff shortage; inner-setting themes included supply use and availability, staff–patient relationship, and transportation and scheduling. Themes related to characteristics of individuals included staff relationships, initial antenatal care visit, adherence, and culture and stigma. Implementation process themes included patient education, test results delivery, and male involvement. Significant gaps in care were identified in rural areas. Information obtained from participants using the CFIR framework provided valuable insights into solutions to barriers to PMTCT implementation. Continuously assessing and correcting PMTCT protocol implementation, uptake and sustainability appear merited to maximize HIV prevention. PMID:28922974

The Achilles' heel of prevention to mother-to-child transmission of HIV: Protocol implementation, uptake, and sustainability.

Science.gov (United States)

Rodriguez, Violeta J; LaCabe, Richard P; Privette, C Kyle; Douglass, K Marie; Peltzer, Karl; Matseke, Gladys; Mathebula, Audrey; Ramlagan, Shandir; Sifunda, Sibusiso; Prado, Guillermo Willy; Horigian, Viviana; Weiss, Stephen M; Jones, Deborah L

2017-12-01

The Joint United Nations Programme on HIV and AIDS proposed to reduce the vertical transmission of HIV from ∼72,200 to ∼8300 newly infected children by 2015 in South Africa (SA). However, cultural, infrastructural, and socio-economic barriers hinder the implementation of the prevention of mother-to-child transmission (PMTCT) protocol, and research on potential solutions to address these barriers in rural areas is particularly limited. This study sought to identify challenges and solutions to the implementation, uptake, and sustainability of the PMTCT protocol in rural SA. Forty-eight qualitative interviews, 12 focus groups discussions (n = 75), and one two-day workshop (n = 32 participants) were conducted with district directors, clinic leaders, staff, and patients from 12 rural clinics. The delivery and uptake of the PMTCT protocol was evaluated using the Consolidated Framework for Implementation Research (CFIR); 15 themes associated with challenges and solutions emerged. Intervention characteristics themes included PMTCT training and HIV serostatus disclosure. Outer-setting themes included facility space, health record management, and staff shortage; inner-setting themes included supply use and availability, staff-patient relationship, and transportation and scheduling. Themes related to characteristics of individuals included staff relationships, initial antenatal care visit, adherence, and culture and stigma. Implementation process themes included patient education, test results delivery, and male involvement. Significant gaps in care were identified in rural areas. Information obtained from participants using the CFIR framework provided valuable insights into solutions to barriers to PMTCT implementation. Continuously assessing and correcting PMTCT protocol implementation, uptake and sustainability appear merited to maximize HIV prevention.

Preventive Biomechanics: A Paradigm Shift With a Translational Approach to Injury Prevention.

Science.gov (United States)

Hewett, Timothy E; Bates, Nathaniel A

2017-09-01

Preventive medicine techniques have alleviated billions of dollars' worth of the economic burden in the medical care system through the implementation of vaccinations and screenings before the onset of disease symptoms. Knowledge of biomechanical tendencies has progressed rapidly over the past 20 years such that clinicians can identify, in healthy athletes, the underlying mechanisms that lead to catastrophic injuries such as anterior cruciate ligament (ACL) ruptures. As such, preventive medicine concepts can be applied to noncontact musculoskeletal injuries to reduce the economic burden of sports medicine treatments and enhance the long-term health of athletes. To illustrate the practical medical benefits that could be gained from preventive biomechanics applied to the ACL as well as the need and feasibility for the broad implementation of these principles. Literature review. The recent literature pertinent to the screening and prevention of musculoskeletal injuries was reviewed and compiled into a clinical commentary on the current state and applicability of preventive biomechanics. Investigators have identified neuromuscular training protocols that screen for and correct the underlying biomechanical deficits that lead to ACL injuries. The literature shows that when athletes comply with these prescribed training protocols, the incidence of injuries is significantly reduced within that population. Such preventive biomechanics practices employ basic training methods that would be familiar to athletic coaches and have the potential to save billions of dollars in cost in sports medicine. The widespread implementation of preventive biomechanics concepts could profoundly affect the field of sports medicine with a minimum of initial investment.

Applying Semigroup Property of Enhanced Chebyshev Polynomials to Anonymous Authentication Protocol

Directory of Open Access Journals (Sweden)

Hong Lai

2012-01-01

Full Text Available We apply semigroup property of enhanced Chebyshev polynomials to present an anonymous authentication protocol. This paper aims at improving security and reducing computational and storage overhead. The proposed scheme not only has much lower computational complexity and cost in the initialization phase but also allows the users to choose their passwords freely. Moreover, it can provide revocation of lost or stolen smart card, which can resist man-in-the-middle attack and off-line dictionary attack together with various known attacks.

Background of the implementation of the Protocol the Convention against Torture: Monitoring places of detention and prevention of torture in Uruguay

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Álvaro Garcé García y Santos

2014-07-01

Full Text Available The ratification of the Optional Protocol of the Convention against Torture had for our country, the significance of an ethical and juridical commitment of giving priority to the prevention of abuses for all the people deprived from liberty who are in jails or in other places of detention, as a consequence of a judicial decision or by virtue of an administrative mandate. Among the obligations established by the said Protocol it is found the one of setting up a National Mechanism of Prevention, technically and economically independent, in charge of the systematic monitoring of the detention centers. The creation of the National Institution of Human Rights, together with the legal mandate the same bears to coordinate its duties with the pre-existing Parliamentary Commissioner, finally brings the certain possibility of fulfilling with the obligations arising from the Protocol. At the same time, the original national solution, unparalleled in the region, implies a series of juridical complexities approached in this work. The cooperation between the two State Institutions involved in the matter, so as to avoid a useless overlapping of duties, brings up a promising future in relation to the prevention of torture in Uruguay.

Secure Handshake in Wi-Fi Connection (A Secure and Enhanced Communication Protocol)

OpenAIRE

Ranbir Sinha; Nishant Behar; Devendra Singh

2012-01-01

This paper presents a concept of enhancing the security in wireless communication. A Computer Network is an interconnected group of autonomous computing nodes, which use a well-defined, mutually agreed set of rules and conventions known as protocols, interact with one-another meaningfully and allow resource sharing preferably in a predictable and controllable manner. Communication has a major impact on today’s business. It is desired to communicate data with high security. These days wireless...

Enhancing MAC performance of DCF protocol for IEEE 802.11 wireless LANs

Science.gov (United States)

Choi, Woo-Yong

2017-01-01

The DCF (Distributed Coordination Function) is the basic MAC (Medium Access Control) protocol of IEEE 802.11 wireless LANs and compatible with various IEEE 802.11 PHY extensions. The performance of the DCF degrades exponentially as the number of nodes participating in the DCF transmission procedure increases. To deal with this problem, we propose a simple, however efficient modification of the DCF by which the performance of the DCF is greatly enhanced.

Promoting communication with older adults: protocols for resolving interpersonal conflicts and for enhancing interactions with doctors.

Science.gov (United States)

Weitzman, Patricia Flynn; Weitzman, Eben A

2003-07-01

In this paper, we review the importance of effective communication in older adulthood, and ideas for promoting it. We focus on theoretical and applied work in two communicative encounters that have particular relevance for older adult health, i.e., interpersonal conflict and visits with a healthcare provider. Little applied work has aimed to adapt training protocols for older adults in these two areas. We will present training protocols we have developed in constructive conflict resolution for older adults, and on enhancing doctor-patient communication. We present these protocols to stimulate ideas on the part of the reader on how to further develop and refine training efforts for older adults in effective communication.

An Enhanced Biometric Based Authentication with Key-Agreement Protocol for Multi-Server Architecture Based on Elliptic Curve Cryptography

Science.gov (United States)

Reddy, Alavalapati Goutham; Das, Ashok Kumar; Odelu, Vanga; Yoo, Kee-Young

2016-01-01

Biometric based authentication protocols for multi-server architectures have gained momentum in recent times due to advancements in wireless technologies and associated constraints. Lu et al. recently proposed a robust biometric based authentication with key agreement protocol for a multi-server environment using smart cards. They claimed that their protocol is efficient and resistant to prominent security attacks. The careful investigation of this paper proves that Lu et al.’s protocol does not provide user anonymity, perfect forward secrecy and is susceptible to server and user impersonation attacks, man-in-middle attacks and clock synchronization problems. In addition, this paper proposes an enhanced biometric based authentication with key-agreement protocol for multi-server architecture based on elliptic curve cryptography using smartcards. We proved that the proposed protocol achieves mutual authentication using Burrows-Abadi-Needham (BAN) logic. The formal security of the proposed protocol is verified using the AVISPA (Automated Validation of Internet Security Protocols and Applications) tool to show that our protocol can withstand active and passive attacks. The formal and informal security analyses and performance analysis demonstrates that the proposed protocol is robust and efficient compared to Lu et al.’s protocol and existing similar protocols. PMID:27163786

An Enhanced Biometric Based Authentication with Key-Agreement Protocol for Multi-Server Architecture Based on Elliptic Curve Cryptography.

Directory of Open Access Journals (Sweden)

Alavalapati Goutham Reddy

Full Text Available Biometric based authentication protocols for multi-server architectures have gained momentum in recent times due to advancements in wireless technologies and associated constraints. Lu et al. recently proposed a robust biometric based authentication with key agreement protocol for a multi-server environment using smart cards. They claimed that their protocol is efficient and resistant to prominent security attacks. The careful investigation of this paper proves that Lu et al.'s protocol does not provide user anonymity, perfect forward secrecy and is susceptible to server and user impersonation attacks, man-in-middle attacks and clock synchronization problems. In addition, this paper proposes an enhanced biometric based authentication with key-agreement protocol for multi-server architecture based on elliptic curve cryptography using smartcards. We proved that the proposed protocol achieves mutual authentication using Burrows-Abadi-Needham (BAN logic. The formal security of the proposed protocol is verified using the AVISPA (Automated Validation of Internet Security Protocols and Applications tool to show that our protocol can withstand active and passive attacks. The formal and informal security analyses and performance analysis demonstrates that the proposed protocol is robust and efficient compared to Lu et al.'s protocol and existing similar protocols.

Enhancement of Adaptive Cluster Hierarchical Routing Protocol using Distance and Energy for Wireless Sensor Networks

International Nuclear Information System (INIS)

Nawar, N.M.; Soliman, S.E.; Kelash, H.M.; Ayad, N.M.

2014-01-01

The application of wireless networking is widely used in nuclear applications. This includes reactor control and fire dedication system. This paper is devoted to the application of this concept in the intrusion system of the Radioisotope Production Facility (RPF) of the Egyptian Atomic Energy Authority. This includes the tracking, monitoring and control components of this system. The design and implementation of wireless sensor networks has become a hot area of research due to the extensive use of sensor networks to enable applications that connect the physical world to the virtual world [1-2]. The original LEACH is named a communication protocol (clustering-based); the extended LEACH’s stochastic cluster head selection algorithm by a deterministic component. Depending on the network configuration an increase of network lifetime can be accomplished [3]. The proposed routing mechanisms after enhancement divide the nodes into clusters. A cluster head performs its task which is considerably more energy-intensive than the rest of the nodes inside sensor network. So, nodes rotate tasks at different rounds between a cluster head and other sensors throughout the lifetime of the network to balance the energy dissipation [4-5].The performance improvement when using routing protocol after enhancement of the algorithm which takes into consideration the distance and the remaining energy for choosing the cluster head by obtains from the advertise message. Network Simulator (Ns2 simulator) is used to prove that LEACH after enhancement performs better than the original LEACH protocol in terms of Average Energy, Network Life Time, Delay, Throughput and Overhead.

Development and validation of a remote home safety protocol.

Science.gov (United States)

Romero, Sergio; Lee, Mi Jung; Simic, Ivana; Levy, Charles; Sanford, Jon

2018-02-01

Environmental assessments and subsequent modifications conducted by healthcare professionals can enhance home safety and promote independent living. However, travel time, expense and the availability of qualified professionals can limit the broad application of this intervention. Remote technology has the potential to increase access to home safety evaluations. This study describes the development and validation of a remote home safety protocol that can be used by a caregiver of an elderly person to video-record their home environment for later viewing and evaluation by a trained professional. The protocol was developed based on literature reviews and evaluations from clinical and content experts. Cognitive interviews were conducted with a group of six caregivers to validate the protocol. The final protocol included step-by-step directions to record indoor and outdoor areas of the home. The validation process resulted in modifications related to safety, clarity of the protocol, readability, visual appearance, technical descriptions and usability. Our final protocol includes detailed instructions that a caregiver should be able to follow to record a home environment for subsequent evaluation by a home safety professional. Implications for Rehabilitation The results of this study have several implications for rehabilitation practice The remote home safety evaluation protocol can potentially improve access to rehabilitation services for clients in remote areas and prevent unnecessary delays for needed care. Using our protocol, a patient's caregiver can partner with therapists to quickly and efficiently evaluate a patient's home before they are released from the hospital. Caregiver narration, which reflects a caregiver's own perspective, is critical to evaluating home safety. In-home safety evaluations, currently not available to all who need them due to access barriers, can enhance a patient's independence and provide a safer home environment.

Financial incentive policies at workplace cafeterias for preventing obesity--a systematic review and meta-analysis (Protocol).

Science.gov (United States)

Sawada, Kimi; Ota, Erika; Shahrook, Sadequa; Mori, Rintaro

2014-10-28

Various studies are currently investigating ways to prevent lifestyle-related diseases and obesity among workers through interventions using incentive strategies, including price discounts for low-fat snacks and sugar-free beverages at workplace cafeterias or vending machines, and the provision of a free salad bar in cafeterias. Rather than assessing individual or group interventions, we will focus on the effectiveness of nutrition education programs at the population level, which primarily incorporate financial incentive strategies to prevent obesity. This paper describes the protocol of a systematic review that will examine the effectiveness of financial incentive programs at company cafeterias in improving dietary habits, nutrient intake, and obesity prevention. We will conduct searches in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and PsycINFO. Interventions will be assessed using data from randomized control trials (RCTs) and cluster RCTs. However, if few such trials exist, we will include quasi-RCTs. We will exclude controlled before-and-after studies and crossover RCTs. We will assess food-based interventions that include financial incentive strategies (discount strategies or social marketing) for workplace cafeterias, vending machines, and kiosks. Two authors will independently review studies for inclusion and will resolve differences by discussion and, if required, through consultation with a third author. We will assess the risk of bias of included studies according to the Cochrane Collaboration's "risk of bias" tool. The purpose of this paper is to outline the study protocol for a systematic review and meta-analysis that will investigate the effectiveness of population-level, incentive-focused interventions at the workplace cafeteria that aim to promote and prevent obesity. This review will give an important overview of the available evidence about the effectiveness of incentive-based environmental interventions to

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

OpenAIRE

Mustila, Taina; Keskinen, Päivi; Luoto, Riitta

2012-01-01

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

Engineering Enhanced Vaccine Cell Lines To Eradicate Vaccine-Preventable Diseases: the Polio End Game

NARCIS (Netherlands)

van der Sanden, Sabine M. G.; Wu, Weilin; Dybdahl-Sissoko, Naomi; Weldon, William C.; Brooks, Paula; O'Donnell, Jason; Jones, Les P.; Brown, Cedric; Tompkins, S. Mark; Oberste, M. Steven; Karpilow, Jon; Tripp, Ralph A.

2016-01-01

Vaccine manufacturing costs prevent a significant portion of the world's population from accessing protection from vaccine-preventable diseases. To enhance vaccine production at reduced costs, a genome-wide RNA interference (RNAi) screen was performed to identify gene knockdown events that enhanced

Cloud-assisted mutual authentication and privacy preservation protocol for telecare medical information systems.

Science.gov (United States)

Li, Chun-Ta; Shih, Dong-Her; Wang, Chun-Cheng

2018-04-01

 With the rapid development of wireless communication technologies and the growing prevalence of smart devices, telecare medical information system (TMIS) allows patients to receive medical treatments from the doctors via Internet technology without visiting hospitals in person. By adopting mobile device, cloud-assisted platform and wireless body area network, the patients can collect their physiological conditions and upload them to medical cloud via their mobile devices, enabling caregivers or doctors to provide patients with appropriate treatments at anytime and anywhere. In order to protect the medical privacy of the patient and guarantee reliability of the system, before accessing the TMIS, all system participants must be authenticated.  Mohit et al. recently suggested a lightweight authentication protocol for cloud-based health care system. They claimed their protocol ensures resilience of all well-known security attacks and has several important features such as mutual authentication and patient anonymity. In this paper, we demonstrate that Mohit et al.'s authentication protocol has various security flaws and we further introduce an enhanced version of their protocol for cloud-assisted TMIS, which can ensure patient anonymity and patient unlinkability and prevent the security threats of report revelation and report forgery attacks.  The security analysis proves that our enhanced protocol is secure against various known attacks as well as found in Mohit et al.'s protocol. Compared with existing related protocols, our enhanced protocol keeps the merits of all desirable security requirements and also maintains the efficiency in terms of computation costs for cloud-assisted TMIS.  We propose a more secure mutual authentication and privacy preservation protocol for cloud-assisted TMIS, which fixes the mentioned security weaknesses found in Mohit et al.'s protocol. According to our analysis, our authentication protocol satisfies most functionality features

Modified enhanced recovery after surgery (ERAS) protocols for patients with obstructive colorectal cancer.

Science.gov (United States)

Shida, Dai; Tagawa, Kyoko; Inada, Kentaro; Nasu, Keiichi; Seyama, Yasuji; Maeshiro, Tsuyoshi; Miyamoto, Sachio; Inoue, Satoru; Umekita, Nobutaka

2017-02-16

Enhanced recovery after surgery (ERAS) protocols are now well-known to be useful for elective colorectal surgery, as they result in shorter hospital stays without adversely affecting morbidity. However, the efficacy and safety of ERAS protocols for patients with obstructive colorectal cancer have yet to be clarified. We evaluated 122 consecutive resections for obstructive colorectal cancer performed between July 2008 and November 2012 at Tokyo Metropolitan Bokutoh Hospital. Patients with rupture or impending rupture and those who received simple colostomy were excluded. The first set of 42 patients was treated based on traditional protocols, and the latter 80 according to modified ERAS protocols. The main endpoints were length of postoperative hospital stay, postoperative short-term morbidity, rate of readmission within 30 days, and mortality. Differences in modified ERAS protocols relative to traditional care include intensive preoperative counseling (by both surgeons and anesthesiologists), perioperative fluid management (avoidance of sodium/fluid overload), shortening of postoperative fasting period and early provision of oral nutrition, intraoperative warm air body heating, enforced postoperative mobilization, stimulation of gut motility, early removal of urinary catheter, and a multidisciplinary team approach to care. Median (interquartile range) postoperative hospital stay was 10 (10-14.25) days in the traditional group, and seven (7-8.75) days in the ERAS group, showing a 3-day reduction in hospital stay (p < 0.01). According to the Clavien-Dindo classification, overall incidences of grade 2 or higher postoperative complications for the traditional and ERAS groups were 15 and 10% (p = 0.48), and 30-day readmission rates were 0 and 1.3% (p = 1.00), respectively. As for mortality, one patient in the traditional group died and none in the ERAS group (p = 0.34). Modified ERAS protocols for obstructive colorectal cancer reduced hospital stay

Protocolized hyperventilation enhances electroconvulsive therapy.

Science.gov (United States)

de Arriba-Arnau, Aida; Dalmau, Antonia; Soria, Virginia; Salvat-Pujol, Neus; Ribes, Carmina; Sánchez-Allueva, Ana; Menchón, José Manuel; Urretavizcaya, Mikel

2017-08-01

Hyperventilation is recommended in electroconvulsive therapy (ECT) to enhance seizures and to increase patients' safety. However, more evidence is needed regarding its effects and the optimum method of application. This prospective study involving 21 subjects compared two procedures, protocolized hyperventilation (PHV) and hyperventilation as usual (HVau), applied to the same patient in two consecutive sessions. Transcutaneous partial pressure of carbon dioxide (TcPCO 2 ) was measured throughout all sessions. Ventilation parameters, hemodynamic measures, seizure characteristics, and side effects were also explored. PHV resulted in lower TcPCO 2 after hyperventilation (p=.008) and over the whole session (p=.035). The lowest TcPCO 2 was achieved after voluntary hyperventilation. Changes in TcPCO 2 from baseline showed differences between HVau and PHV at each session time-point (all p<.05). Between- and within-subjects factors were statistically significant in a general linear model. Seizure duration was greater in PHV sessions (p=.028), without differences in other seizure quality parameters or adverse effects. Correlations were found between hypocapnia induction and seizure quality indexes. Secondary outcomes could be underpowered. PHV produces hypocapnia before the stimulus, modifies patients' TcPCO 2 values throughout the ECT session and lengthens seizure duration. Voluntary hyperventilation is the most important part of the PHV procedure with respect to achieving hypocapnia. A specific ventilation approach, CO 2 quantification and monitoring may be advisable in ECT. PHV is easy to apply in daily clinical practice and does not imply added costs. Ventilation management has promising effects in terms of optimizing ECT technique. Copyright © 2017 Elsevier B.V. All rights reserved.

Enhanced Secure Trusted AODV (ESTA Protocol to Mitigate Blackhole Attack in Mobile Ad Hoc Networks

Directory of Open Access Journals (Sweden)

Dilraj Singh

2015-09-01

Full Text Available The self-organizing nature of the Mobile Ad hoc Networks (MANETs provide a communication channel anywhere, anytime without any pre-existing network infrastructure. However, it is exposed to various vulnerabilities that may be exploited by the malicious nodes. One such malicious behavior is introduced by blackhole nodes, which can be easily introduced in the network and, in turn, such nodes try to crumble the working of the network by dropping the maximum data under transmission. In this paper, a new protocol is proposed which is based on the widely used Ad hoc On-Demand Distance Vector (AODV protocol, Enhanced Secure Trusted AODV (ESTA, which makes use of multiple paths along with use of trust and asymmetric cryptography to ensure data security. The results, based on NS-3 simulation, reveal that the proposed protocol is effectively able to counter the blackhole nodes in three different scenarios.

Adaptive enhancement of learning protocol in hippocampal cultured networks grown on multielectrode arrays

Science.gov (United States)

Pimashkin, Alexey; Gladkov, Arseniy; Mukhina, Irina; Kazantsev, Victor

2013-01-01

Learning in neuronal networks can be investigated using dissociated cultures on multielectrode arrays supplied with appropriate closed-loop stimulation. It was shown in previous studies that weakly respondent neurons on the electrodes can be trained to increase their evoked spiking rate within a predefined time window after the stimulus. Such neurons can be associated with weak synaptic connections in nearby culture network. The stimulation leads to the increase in the connectivity and in the response. However, it was not possible to perform the learning protocol for the neurons on electrodes with relatively strong synaptic inputs and responding at higher rates. We proposed an adaptive closed-loop stimulation protocol capable to achieve learning even for the highly respondent electrodes. It means that the culture network can reorganize appropriately its synaptic connectivity to generate a desired response. We introduced an adaptive reinforcement condition accounting for the response variability in control stimulation. It significantly enhanced the learning protocol to a large number of responding electrodes independently on its base response level. We also found that learning effect preserved after 4–6 h after training. PMID:23745105

Studying frequency processing of the brain to enhance long-term memory and develop a human brain protocol.

Science.gov (United States)

Friedrich, Wernher; Du, Shengzhi; Balt, Karlien

2015-01-01

The temporal lobe in conjunction with the hippocampus is responsible for memory processing. The gamma wave is involved with this process. To develop a human brain protocol, a better understanding of the relationship between gamma and long-term memory is vital. A more comprehensive understanding of the human brain and specific analogue waves it uses will support the development of a human brain protocol. Fifty-eight participants aged between 6 and 60 years participated in long-term memory experiments. It is envisaged that the brain could be stimulated through binaural beats (sound frequency) at 40 Hz (gamma) to enhance long-term memory capacity. EEG recordings have been transformed to sound and then to an information standard, namely ASCII. Statistical analysis showed a proportional relationship between long-term memory and gamma activity. Results from EEG recordings indicate a pattern. The pattern was obtained through the de-codification of an EEG recording to sound and then to ASCII. Stimulation of gamma should enhance long term memory capacity. More research is required to unlock the human brains' protocol key. This key will enable the processing of information directly to and from human memory via gamma, the hippocampus and the temporal lobe.

A cluster randomised controlled trial of advice, exercise or multifactorial assessment to prevent falls and fractures in community-dwelling older adults: protocol for the prevention of falls injury trial (PreFIT).

Science.gov (United States)

Bruce, Julie; Lall, Ranjit; Withers, Emma J; Finnegan, Susanne; Underwood, Martin; Hulme, Claire; Sheridan, Ray; Skelton, Dawn A; Martin, Finbarr; Lamb, Sarah E

2016-01-18

Falls are the leading cause of accident-related mortality in older adults. Injurious falls are associated with functional decline, disability, healthcare utilisation and significant National Health Service (NHS)-related costs. The evidence base for multifactorial or exercise interventions reducing fractures in the general population is weak. This protocol describes a large-scale UK trial investigating the clinical and cost-effectiveness of alternative falls prevention interventions targeted at community dwelling older adults. A three-arm, pragmatic, cluster randomised controlled trial, conducted within primary care in England, UK. Sixty-three general practices will be randomised to deliver one of three falls prevention interventions: (1) advice only; (2) advice with exercise; or (3) advice with multifactorial falls prevention (MFFP). We aim to recruit over 9000 community-dwelling adults aged 70 and above. Practices randomised to deliver advice will mail out advice booklets. Practices randomised to deliver 'active' interventions, either exercise or MFFP, send all trial participants the advice booklet and a screening survey to identify participants with a history of falling or balance problems. Onward referral to 'active' intervention will be based on falls risk determined from balance screen. The primary outcome is peripheral fracture; secondary outcomes include number with at least one fracture, falls, mortality, quality of life and health service resource use at 18 months, captured using self-report and routine healthcare activity data. The study protocol has approval from the National Research Ethics Service (REC reference 10/H0401/36; Protocol V.3.1, 21/May/2013). User groups and patient representatives were consulted to inform trial design. Results will be reported at conferences and in peer-reviewed publications. A patient-friendly summary of trial findings will be published on the prevention of falls injury trial (PreFIT) website. This protocol adheres to the

Minimal intervention dentistry: part 3. Paediatric dental care--prevention and management protocols using caries risk assessment for infants and young children.

Science.gov (United States)

Ramos-Gomez, F J; Crystal, Y O; Domejean, S; Featherstone, J D B

2012-11-01

Recent increases in caries prevalence in young children throughout the world highlight the need for a simple but effective infant oral care programme. This programme needs to include a medical disease prevention management model with an early establishment of a dental home and a treatment approach based on individual patient risk. This article presents an updated approach with practical forms and tools based on the principles of caries management by risk assessment, CAMBRA. This method will aid the general practitioner to develop and maintain a comprehensive protocol adequate for infant and young children oral care visits. Perinatal oral health is vitally important in preventing early childhood caries (ECC) in young children. Providing dental treatment to expectant mothers and their young children in a 'dual parallel track' is an effective innovative strategy and an efficient practice builder. It promotes prevention rather than intervention, and this may be the best way to achieve long-lasting oral health for young patients. General dental practice can adopt easy protocols that will promote early preventive visits and anticipatory guidance/counselling rather than waiting for the need for restorative treatment.

Project of law authorizing the adhesion to the protocol of 1997 modifying the international convention of 1973 for the prevention of the pollution by ships, such as modified by the related protocol of 1978; Projet de loi autorisant l'adhesion au protocole de 1997 modifiant la convention internationale de 1973 pour la prevention de la pollution par les navires, telle que modifiee par le protocole de 1978 y relatif

Energy Technology Data Exchange (ETDEWEB)

NONE

2004-04-01

The first international agreement of May 12, 1954, for the protection of the marine and coastal environments against pollution was replaced on November 2, 1973 by a more detailed convention for the prevention of the pollution by ships. The 25 rules defined in the appendix 1 of this last document were modified and completed by the protocol of February 17, 1978. To make this system even more constraining for the atmospheric pollution, a diplomatic conference took place in September 1997 at the head office of the international maritime organization in London (UK). This conference has adopted a protocol which introduced a new appendix no. 6 in the text of the 1973 convention for the abatement of the emissions of sulfur compounds and other polluting combustion products in case of oil-tank burning. This document is a project of law authorizing the adhesion of France to the protocol of 1997. It summarizes the main content of the articles of this protocol, and in particular the rules introduced in the new appendix. The full text of the protocol and of its appendixes are also attached. (J.S.)

Effect of Fatigue Protocols on Lower Limb Neuromuscular Function and Implications for Anterior Cruciate Ligament Injury Prevention Training: A Systematic Review.

Science.gov (United States)

Barber-Westin, Sue D; Noyes, Frank R

2017-12-01

Approximately two-thirds of anterior cruciate ligament (ACL) tears are sustained during noncontact situations when an athlete is cutting, pivoting, decelerating, or landing from a jump. Some investigators have postulated that fatigue may result in deleterious alterations in lower limb biomechanics during these activities that could increase the risk of noncontact ACL injuries. However, prior studies have noted a wide variation in fatigue protocols, athletic tasks studied, and effects of fatigue on lower limb kinetics and kinematics. First, to determine if fatigue uniformly alters lower limb biomechanics during athletic tasks that are associated with noncontact ACL injuries. Second, to determine if changes should be made in ACL injury prevention training programs to alter the deleterious effects of fatigue on lower limb kinetics and kinematics. Systematic review; Level of evidence, 4. A systematic review of the literature using MEDLINE was performed. Key terms were fatigue, neuromuscular, exercise, hop test, and single-legged function tests. Inclusion criteria were original research studies involving healthy participants, use of a fatigue protocol, study of at least 1 lower limb task that involved landing from a hop or jump or cutting, and analysis of at least 1 biomechanical variable. Thirty-seven studies involving 806 athletes (485 female, 321 male; mean age, 22.7 years) met the inclusion criteria. General fatigue protocols were used in 20 investigations, peripheral protocols were used in 17 studies, and 21 different athletic tasks were studied (13 single-legged, 8 double-legged). There was no consistency among investigations regarding the effects of fatigue on hip, knee, or ankle joint angles and moments or surface electromyography muscle activation patterns. The fatigue protocols typically did not produce statistically significant changes in ground-reaction forces. Published fatigue protocols did not uniformly produce alterations in lower limb neuromuscular

Compliance with the national palestinian infection prevention and control protocol at governmental paediatric hospitals in gaza governorates.

Science.gov (United States)

Eljedi, Ashraf; Dalo, Shareef

2014-08-01

Nosocomial infections are a significant burden for both patients and the healthcare system. For this reason, infection prevention and control (IPC) practices are extremely important. The Palestinian Ministry of Health adopted the national IPC Protocol in 2004. This study aimed to assess the compliance of healthcare providers (HCPs) with the Protocol in three governmental paediatric hospitals in Gaza governorates. This descriptive cross-sectional study was conducted from February to November 2010. Data were collected from a sample of doctors, nurses and physiotherapists (N = 334) using a self-administered questionnaire and observation checklists to record HCP practices and assess the hospital environment. The response rate was 92%. The most important reasons for non-compliance with the IPC Protocol were the absence of an education programme (61.5%), lack of knowledge (52.4%) and the scarcity of required supplies (46.9%). Only 2.3% of respondents had a copy of the IPC Protocol, while 65.8% did not know of its existence. Only 16.9% had participated in training sessions regarding general IPC practices. The observation checklist regarding HCP practices revealed low levels of compliance in hand washing (45.9%), wearing gloves (40.7%) and using antiseptics/disinfectants (49.16%). The health facilities checklist indicated that there was a lack of certain essential equipment and materials, such as covered waste containers and heavy-duty gloves. Due to the lack of HPC knowledge, the authors recommend that the IPC Protocol be made available in all hospitals. In addition, a qualified team should implement intensive IPC education and training programmes and facilities should provide the required equipment and materials.

Real Time MODBUS Transmissions and Cryptography Security Designs and Enhancements of Protocol Sensitive Information

Directory of Open Access Journals (Sweden)

Aamir Shahzad

2015-07-01

Full Text Available Information technology (IT security has become a major concern due to the growing demand for information and massive development of client/server applications for various types of applications running on modern IT infrastructure. How has security been taken into account and which paradigms are necessary to minimize security issues while increasing efficiency, reducing the influence on transmissions, ensuring protocol independency and achieving substantial performance? We have found cryptography to be an absolute security mechanism for client/server architectures, and in this study, a new security design was developed with the MODBUS protocol, which is considered to offer phenomenal performance for future development and enhancement of real IT infrastructure. This study is also considered to be a complete development because security is tested in almost all ways of MODBUS communication. The computed measurements are evaluated to validate the overall development, and the results indicate a substantial improvement in security that is differentiated from conventional methods.

Policies and protocols for preventing transmission of HIV infection in oral health care in South Africa.

Science.gov (United States)

Ogunbodede, E O; Rudolph, M J

2002-12-01

Human immunodeficiency virus (HIV) infection constitutes an unparalleled public health challenge. The unique nature of most oral health procedures, instrumentation and patient-care settings requires specific strategies and protocols aimed at preventing the transmission of HIV/AIDS between oral health care providers and patients, as well as between patients themselves. The present study investigated the level of information and training about protocols and policies for preventing the transmission of HIV/AIDS in oral health care settings in South Africa. The data collection techniques utilised available information, in-depth interviews and an open-ended questionnaire. The respondents were 20 purposively selected key informants who were senior officers for HIV/AIDS programmes and/or oral health organisations. Sixteen (80%) of the respondents reported that there were no existing oral health policies on HIV/AIDS in their health care institutions or organisations. None of the interviewees knew of any specific protocols on HIV/AIDS in the oral health care setting that emanated from South Africa. In addition, none of the dental professional associations had established an infection control committee or a support system for members who might become infected with HIV and develop AIDS. Territorial boundaries existed between sectors within the medical disciplines, as well as between the medical and oral health disciplines. Numerous general impediments were identified, such as prejudice, denial and fear, inadequate training and/or information about the infection, lack of representation and resources for policy planning, a lack of interest from the business sector, and approaching HIV/AIDS in the workplace as a 'one-time issue' Other obstacles identified included unemployment, poverty, illiteracy, disempowerment of women and inadequate communication of policies to service providers. Additional issues raised included the migrant labour systeM, complexities of language and culture

Receptivity of African American Adolescents to an HIV-Prevention Curriculum Enhanced by Text Messaging

Science.gov (United States)

Cornelius, Judith B.; St Lawrence, Janet S.

2013-01-01

PURPOSE This study assessed African American adolescents’ receptivity to an HIV-prevention curriculum enhanced by text messaging. DESIGN AND METHODS Two focus groups were conducted with 14 African American adolescents regarding how an HIV-prevention curriculum could be enhanced for text messaging delivery. RESULTS The adolescents were receptive to the idea of text messaging HIV-prevention information but wanted to receive a maximum of three messages per day during the hours of 4:00–6:00 p.m. PRACTICE IMPLICATIONS By taking the findings of this study, nurses, other healthcare providers, and community-based organizations can adapt evidence-based interventions for text messaging delivery to individuals at high risk for HIV infection. PMID:19356206

Exploring facilitating factors and barriers to the nationwide dissemination of a Dutch school-based obesity prevention program "DOiT": a study protocol

NARCIS (Netherlands)

van Nassau, F.; Singh, A.S.; van Mechelen, W.; Paulussen, T.G.; Brug, J.; Chinapaw, M.J.

2013-01-01

Background: The evidence-based Dutch Obesity Intervention in Teenagers (DOiT) program is a school-based obesity prevention program for 12 to 14-year olds attending the first two years of prevocational education. This paper describes the study protocol applied to evaluate (a) the nationwide

Enhanced DSR Routing Protocol for the Short Time Disconnected MANET

Directory of Open Access Journals (Sweden)

PAPAJ Ján

2013-05-01

Full Text Available Data delivery in Mobile Ad-Hoc network (MANET is a very difficult task due to the fact the sporadic connections between mobile nodes. For this reason, we introduce the new modified routing protocol that enables the data delivery in the case that the connections are disconnected. A key aspect of the protocol is a process of finding connections between source and destination nodes that can provide low end-to-end delay and better delivery performance in a disconnected MANET. The protocol provides the concepts of opportunistic routing of the routing packets in disconnected MANETs. In this paper we present a modification of the DSR routing protocol and also some results of a simulation.

Supporting Tablet Configuration, Tracking, and Infection Control Practices in Digital Health Interventions: Study Protocol.

Science.gov (United States)

Furberg, Robert D; Ortiz, Alexa M; Zulkiewicz, Brittany A; Hudson, Jordan P; Taylor, Olivia M; Lewis, Megan A

2016-06-27

Tablet-based health care interventions have the potential to encourage patient care in a timelier manner, allow physicians convenient access to patient records, and provide an improved method for patient education. However, along with the continued adoption of tablet technologies, there is a concomitant need to develop protocols focusing on the configuration, management, and maintenance of these devices within the health care setting to support the conduct of clinical research. Develop three protocols to support tablet configuration, tablet management, and tablet maintenance. The Configurator software, Tile technology, and current infection control recommendations were employed to develop three distinct protocols for tablet-based digital health interventions. Configurator is a mobile device management software specifically for iPhone operating system (iOS) devices. The capabilities and current applications of Configurator were reviewed and used to develop the protocol to support device configuration. Tile is a tracking tag associated with a free mobile app available for iOS and Android devices. The features associated with Tile were evaluated and used to develop the Tile protocol to support tablet management. Furthermore, current recommendations on preventing health care-related infections were reviewed to develop the infection control protocol to support tablet maintenance. This article provides three protocols: the Configurator protocol, the Tile protocol, and the infection control protocol. These protocols can help to ensure consistent implementation of tablet-based interventions, enhance fidelity when employing tablets for research purposes, and serve as a guide for tablet deployments within clinical settings.

Nonblocking and orphan free message logging protocols

Science.gov (United States)

Alvisi, Lorenzo; Hoppe, Bruce; Marzullo, Keith

1992-12-01

Currently existing message logging protocols demonstrate a classic pessimistic vs. optimistic tradeoff. We show that the optimistic-pessimistic tradeoff is not inherent to the problem of message logging. We construct a message-logging protocol that has the positive features of both optimistic and pessimistic protocol: our protocol prevents orphans and allows simple failure recovery; however, it requires no blocking in failure-free runs. Furthermore, this protocol does not introduce any additional message overhead as compared to one implemented for a system in which messages may be lost but processes do not crash.

Mobile Health, a Key Factor Enhancing Disease Prevention Campaigns: Looking for Evidences in Kidney Disease Prevention

Directory of Open Access Journals (Sweden)

Nicole Roque Matias

2017-01-01

Full Text Available Background: Progressive chronic kidney disease (CKD failure and kidney diseases are increasing at an alarming rate all over the world. However, despite the remarkable advance in health technology, where it has become possible to successfully screen patients and predict kidney progression, a large portion of the world population is still unaware of their disease and risk exposure. Mobile Health (mHealth solutions associated with health campaigns and programs proved to be an effective mean to enhance awareness and behaviour change at individual and social level. Objective: The aim of this survey was to present the results of an environmental scan of what has been happening in the field of kidney disease prevention campaigns in recent years, with a focus on the use of mobile health as a tool to enhance the campaign's effects on targeting people and change their behaviour. Methodology: It was conducted a systematic and comprehensive review, combining experimental studies with theoretical perspectives, to look for evidence regarding the evaluation of kidney disease prevention campaigns. The databases consulted for the present survey were: MEDLINE, PubMed, Google Scholar, PsycINFO, SAGE Journals Online, and Web of Science among other sources, for an analysis period from January 2000 to June 2016. Results: Concerning the 14 analyzed examples with impact on kidney disease prevention campaign evaluation, two main campaigns were referred: The World Kidney Day (WKD campaign, and the Kidney Early Evaluation Program (KEEP. The indicators used in this analisys were in most cases comparable regarding the campaign messages, objectives and interventions tools, although em both cases the use of mHealth or other technologies is residually comparing to other diseases prevention campaigns or programs. Conclusions: This review pointed to the inexistence of behavioural change evidence as a target of the kidney disease prevention campaigns and their evaluation. General

An Enhanced LoRaWAN Security Protocol for Privacy Preservation in IoT with a Case Study on a Smart Factory-Enabled Parking System.

Science.gov (United States)

You, Ilsun; Kwon, Soonhyun; Choudhary, Gaurav; Sharma, Vishal; Seo, Jung Taek

2018-06-08

The Internet of Things (IoT) utilizes algorithms to facilitate intelligent applications across cities in the form of smart-urban projects. As the majority of devices in IoT are battery operated, their applications should be facilitated with a low-power communication setup. Such facility is possible through the Low-Power Wide-Area Network (LPWAN), but at a constrained bit rate. For long-range communication over LPWAN, several approaches and protocols are adopted. One such protocol is the Long-Range Wide Area Network (LoRaWAN), which is a media access layer protocol for long-range communication between the devices and the application servers via LPWAN gateways. However, LoRaWAN comes with fewer security features as a much-secured protocol consumes more battery because of the exorbitant computational overheads. The standard protocol fails to support end-to-end security and perfect forward secrecy while being vulnerable to the replay attack that makes LoRaWAN limited in supporting applications where security (especially end-to-end security) is important. Motivated by this, an enhanced LoRaWAN security protocol is proposed, which not only provides the basic functions of connectivity between the application server and the end device, but additionally averts these listed security issues. The proposed protocol is developed with two options, the Default Option (DO) and the Security-Enhanced Option (SEO). The protocol is validated through Burrows⁻Abadi⁻Needham (BAN) logic and the Automated Validation of Internet Security Protocols and Applications (AVISPA) tool. The proposed protocol is also analyzed for overheads through system-based and low-power device-based evaluations. Further, a case study on a smart factory-enabled parking system is considered for its practical application. The results, in terms of network latency with reliability fitting and signaling overheads, show paramount improvements and better performance for the proposed protocol compared with the two

An Enhanced LoRaWAN Security Protocol for Privacy Preservation in IoT with a Case Study on a Smart Factory-Enabled Parking System

Directory of Open Access Journals (Sweden)

Ilsun You

2018-06-01

Full Text Available The Internet of Things (IoT utilizes algorithms to facilitate intelligent applications across cities in the form of smart-urban projects. As the majority of devices in IoT are battery operated, their applications should be facilitated with a low-power communication setup. Such facility is possible through the Low-Power Wide-Area Network (LPWAN, but at a constrained bit rate. For long-range communication over LPWAN, several approaches and protocols are adopted. One such protocol is the Long-Range Wide Area Network (LoRaWAN, which is a media access layer protocol for long-range communication between the devices and the application servers via LPWAN gateways. However, LoRaWAN comes with fewer security features as a much-secured protocol consumes more battery because of the exorbitant computational overheads. The standard protocol fails to support end-to-end security and perfect forward secrecy while being vulnerable to the replay attack that makes LoRaWAN limited in supporting applications where security (especially end-to-end security is important. Motivated by this, an enhanced LoRaWAN security protocol is proposed, which not only provides the basic functions of connectivity between the application server and the end device, but additionally averts these listed security issues. The proposed protocol is developed with two options, the Default Option (DO and the Security-Enhanced Option (SEO. The protocol is validated through Burrows–Abadi–Needham (BAN logic and the Automated Validation of Internet Security Protocols and Applications (AVISPA tool. The proposed protocol is also analyzed for overheads through system-based and low-power device-based evaluations. Further, a case study on a smart factory-enabled parking system is considered for its practical application. The results, in terms of network latency with reliability fitting and signaling overheads, show paramount improvements and better performance for the proposed protocol compared with

[Multicenter survey on ventilator-associated pneumonia prevention in intensive care].

Science.gov (United States)

Fischer, M-O; Garreau, N; Jarno, P; Villers, D; Dufour Trivini, M; Gérard, J-L; Fellahi, J-L; Hanouz, J-L; Parienti, J-J

2013-12-01

Ventilator-associated pneumonia (VAP) is the most common hospital-acquired infection in intensive care unit (ICU). The aim of the study was to evaluate the follow-up of the guidelines for VAP prevention. Retrospective, observational and multicenter study. During one year, all patients with mechanical ventilation over 48 hours were included in the CCLIN-Ouest Network. The demographic characteristics of the patients, the use of specific protocol for VAP prevention and the density of incidence of VAP were recorded. The use of a protocol for preventing VAP (absence, incomplete, complete and care bundle (i.e. complete prevention of VAP with weaning mechanical protocol and sedation protocol)) was collected. 26 ICU with 5742 patients were included. Ten ICU (38%; 2595 patients) had no protocol for VAP prevention, eight ICU (31%; 1821 patients) had an incomplete protocol, five ICU (19%; 561 patients) had a complete protocol and three ICU (12%; 765 patients) had a care bundle. The density of incidence of VAP was 14.8‰ (Interquartile range [IQR]: 10.2-0.1) for no protocol group, 15.6‰ [IQR: 12.6-6.2] for incomplete protocol group, 11.0‰ [IQR: 9.1-14.0] for complete protocol group and 12.9‰ [5-7,7-9,9-12] for care bundle group (P=0.742). The compliance to prevention of VAP was poor. Proposals for improving practice are discussed. Copyright © 2013. Published by Elsevier SAS.

Using a Simple, Free Voice-over-Internet Protocol Service to Add Interest to Lectures and Enhance Student Engagement

Science.gov (United States)

Beaton, Susan J.; Forster, Peter M.

2013-01-01

A large proportion of students in higher education report feeling bored during lectures, for example, Mann and Robinson (2009) put this figure at 60 per cent. This short article reviews our experiences of using a simple, free Voice-over-Internet Protocol (VoIP) service, Skype, to enhance the interest and engagement of students by holding a…

Can cognitive enhancers reduce the risk of falls in older people with Mild Cognitive Impairment? A protocol for a randomised controlled double blind trial

Directory of Open Access Journals (Sweden)

Wells Jennie L

2009-08-01

vulnerable population as a function of the reduced gait variability achieved by treatment with cognitive enhancers. This study may contribute to a new approach to prevent and treat fall risk in seniors in early stages of dementia. Trial Registration The protocol for this study is registered with the Clinical Trials Registry, identifier number: NCT00934531 http://www.clinicaltrials.gov

Mobile Health Technology Interventions for Suicide Prevention: Protocol for a Systematic Review and Meta-Analysis.

Science.gov (United States)

Melia, Ruth; Francis, Kady; Duggan, Jim; Bogue, John; O'Sullivan, Mary; Chambers, Derek; Young, Karen

2018-01-26

Previous research has reported that two of the major barriers to help-seeking for individuals at risk of suicide are stigma and geographical isolation. Mobile technology offers a potential means of delivering evidence-based interventions with greater specificity to the individual, and at the time that it is needed. Despite documented motivation by at-risk individuals to use mobile technology to track mental health and to support psychological interventions, there is a shortfall of outcomes data on the efficacy of mobile health (mHealth) technology on suicide-specific outcomes. The objective of this study is to develop a protocol for a systematic review and meta-analysis that aims to evaluate the effectiveness of mobile technology-based interventions for suicide prevention. The search includes the Cochrane Central Register of Controlled Trials (CENTRAL: The Cochrane Library), MEDLINE, Embase, PsycINFO, CRESP and relevant sources of gray literature. Studies that have evaluated psychological or nonpsychological interventions delivered via mobile computing and communication technology, and have suicidality as an outcome measure will be included. Two authors will independently extract data and assess the study suitability in accordance with the Cochrane Collaboration Risk of Bias Tool. Studies will be included if they measure at least one suicide outcome variable (ie, suicidal ideation, suicidal intent, nonsuicidal self-injurious behavior, suicidal behavior). Secondary outcomes will be measures of symptoms of depression. Where studies are sufficiently homogenous and reported outcomes are amenable for pooled synthesis, meta-analysis will be performed. A narrative synthesis will be conducted if the data is unsuitable for a meta-analysis. The review is in progress, with findings expected by summer 2018. To date, evaluations of mobile technology-based interventions in suicide prevention have focused on evaluating content as opposed to efficacy. Indeed, previous research has

An iPTH based protocol for the prevention and treatment of symptomatic hypocalcemia after thyroidectomy

Science.gov (United States)

Carter, Yvette; Chen, Herbert; Sippel, Rebecca S.

2013-01-01

Background Symptomatic hypocalcemia after thyroidectomy is a barrier to same day surgery, and the cause of ER visits. A standard protocol of calcium and vitamin D supplementation, dependent on intact parathyroid hormone (iPTH) levels, can address this issue. How effective is it? When does it fail? Methods We performed a retrospective review of the prospective Thyroid Database from January 2006 to December 2010. 620 patients underwent completion (CT) or total thyroidectomy (TT), and followed our post-operative protocol of calcium carbonate administration for iPTH levels ≥10pg/ml and calcium carbonate and 0.25μg calcitriol BID for iPTH hypocalcemia. The symptomatic (SX) and asymptomatic (ASX) groups were similar with regard to gender, cancer diagnosis, and pre-operative calcium and iPTH. The symptomatic group was significantly younger (39.6 ± 2.8 vs. 49 ± 0.6 years, p=0.01), with lower post-operative iPTH levels. 33% (n=8) of SX patients had an iPTH ≤5 pg/ml vs. only 6% (n=37) of ASX patients. While the majority of patients with a PTH hypocalcemia after thyroidectomy. An iPTH ≤ 5pg/ml may warrant higher initial doses of calcitriol in order to prevent symptoms. PMID:24144426

Novel Techniques with the Aid of a Staged CBCT Guided Surgical Protocol

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Evdokia Chasioti

2015-01-01

Full Text Available The case report will present some novel techniques for using a “staged” protocol utilizing strategic periodontally involved teeth as transitional abutments in combination with CBCT guided implant surgery. Staging the case prevented premature loading of the grafted sites during the healing phase. A CBCT following a tenting screw guided bone regeneration procedure ensured adequate bone to place an implant fixture. Proper assessment of the CBCT allowed the surgeon to do an osteotome internal sinus lift in an optimum location. The depth of the bone needed for the osteotome sinus floor elevation was planned. The staged appliance allowed these sinus-augmented sites to heal for an extended period of time compared to implants, which were uncovered and loaded at an earlier time frame. The staged protocol and CBCT analysis enabled the immediate implants to be placed in proper alignment to the adjacent fixture. After teeth were extracted, the osseointegrated implants were converted to abutments for the transitional appliance. Finally, the staged protocol allowed for soft tissue enhancement in the implant and pontic areas prior to final insertion of the prosthesis.

A New MAC Protocol with Pseudo-TDMA Behavior for Supporting Quality of Service in 802.11 Wireless LANs

Directory of Open Access Journals (Sweden)

2006-01-01

Full Text Available A new medium access control (MAC protocol is proposed for quality-of-service (QoS support in wireless local area networks (WLAN. The protocol is an alternative to the recent enhancement 802.11e. A new priority policy provides the system with better performance by simulating time division multiple access (TDMA functionality. Collisions are reduced and starvation of low-priority classes is prevented by a distributed admission control algorithm. The model performance is found analytically extending previous work on this matter. The results show that a better organization of resources is achieved through this scheme. Throughput analysis is verified with OPNET simulations.

Connectivity-Based Reliable Multicast MAC Protocol for IEEE 802.11 Wireless LANs

Directory of Open Access Journals (Sweden)

Woo-Yong Choi

2009-01-01

Full Text Available We propose the efficient reliable multicast MAC protocol based on the connectivity information among the recipients. Enhancing the BMMM (Batch Mode Multicast MAC protocol, the reliable multicast MAC protocol significantly reduces the RAK (Request for ACK frame transmissions in a reasonable computational time and enhances the MAC performance. By the analytical performance analysis, the throughputs of the BMMM protocol and our proposed MAC protocol are derived. Numerical examples show that our proposed MAC protocol increases the reliable multicast MAC performance for IEEE 802.11 wireless LANs.

Scanning and contrast enhancement protocols for multi-slice CT in evaluation of the upper abdomen

International Nuclear Information System (INIS)

Awai, Kazuo; Onishi, Hiromitsu; Takada, Koichi; Yamaguchi, Yasuo; Eguchi, Nobuko; Hiraishi, Kumiko; Hori, Shinichi

2000-01-01

The advent of multi-slice CT is one of the quantum leaps in computed tomography since the introduction of helical CT. Multi-slice CT can rapidly scan a large longitudinal (z-axis) volume with high longitudinal resolution and low image artifacts. The rapid volume coverage speed of multi-slice CT can increase the difficulty in optimizing the delay time between the beginning of contrast material injection and the acquisition of images and we need accurate knowledge about optimal temporal window for adequate contrast enhancement. High z-axis resolution of multi-slice can improve the quality of three-dimensional images and MPR images and we must select adequate slice thickness and slice intervals in each case. We discuss basic considerations for adequate contrast enhancement and scanning protocols by multi-slice CT scanner in the upper abdomen. (author)

Performance Analysis of the Enhanced DSR Routing Protocol for the Short Time Disconnected MANET to the OPNET Modeler

Directory of Open Access Journals (Sweden)

PAPAJ Ján

2013-05-01

Full Text Available Disconnected mobile ad-hoc networks (MANET are very important areas of the research. In this article, the performance analysis of the enhanced dynamic source routing protocol (OPP_DSR is introduced. This modification enables the routing process in the case when there are no connections to other mobile nodes. It also will enable the routing mechanisms when the routes, selected by routing mechanisms, are disconnected for some time. Disconnection can be for a short time and standard routing protocol DSR cannot reflect on this situation.The main idea is based on opportunistic forwarding where the nodes not only forward data but it's stored in the cache during long time. The network parameters throughput, routing load and are analysed.

A customised cold-water immersion protocol favours one-size-fits-all protocols in improving acute performance recovery

NARCIS (Netherlands)

Zandvoort, Coen S.; de Zwart, Jelmer R.; van Keeken, Brenda L.; Viroux, Patrick J.F.; Tiemessen, Ivo J.H.

The purpose of the present study was to investigate whether a customised cold-water immersion (CWIc) protocol was more effective in enhancing acute performance recovery than a one-size-fits-all CWI (CWIs) or active recovery (AR) protocol. On three separate testing days, 10 healthy, physically

Clinical Trials Management | Division of Cancer Prevention

Science.gov (United States)

Information for researchers about developing, reporting, and managing NCI-funded cancer prevention clinical trials. Protocol Information Office The central clearinghouse for clinical trials management within the Division of Cancer Prevention.Read more about the Protocol Information Office. | Information for researchers about developing, reporting, and managing NCI-funded

WHY DO YOU NEED TO USE A CARIES RISK ASSESSMENT PROTOCOL TO PROVIDE AN EFFECTIVE CARIES PREVENTIVE REGIME?

Science.gov (United States)

Afuakwah, Charles; Welbury, Richard

2015-11-01

Clinical guidelines recommend an individual is given a caries risk status based on analysis of defined clinical and social criteria before implementing a tailored preventive plan. Improve documentation of caries risk assessment (CRA) in a general dental practice setting, using a systems-based approach to quality improvement methods. Investigate the impact of quality improvement efforts on subsequent design and delivery of preventive care. Identify barriers to delivery of CRA and provision of preventive care. Data for patients aged 0-16 years was collected over two cycles using standard audit methodology. The first cycle was a retrospective analysis (n = 400) using random sampling. The second cycle a prospective analysis (n = 513) using consecutive sampling over a 15-week period. Five staff meetings with feedback occurred between cycles. In cycle one, no specific CRA system was identified. CRA status was not stated widely, risk factors were not analysed and there was variation with respect to the prescription and delivery of preventive strategies. These discrepancies were demonstrable for all four participating dentists and at all ages. In cycle two, 100% recorded CRA. All risk factors were analysed and individual caries risk was correctly annotated. There was 100% compliance with the protocol for preventive plans. The use of CRA improved documentation of caries risk status. This has improved subsequent prescription of age specific evidence-based preventive care appropriate to the risk status of that individual. Barriers were identified to the delivery of CRA and the provision of comprehensive preventive care by the dentists and other healthcare professionals.

The FLASSH study: protocol for a randomised controlled trial evaluating falls prevention after stroke and two sub-studies

Directory of Open Access Journals (Sweden)

Mackintosh Shylie F

2009-03-01

Full Text Available Abstract Background Falls are common in stroke survivors returning home after rehabilitation, however there is currently a lack of evidence about preventing falls in this population. This paper describes the study protocol for the FLASSH (FaLls prevention After Stroke Survivors return Home project. Methods and design This randomised controlled trial aims to evaluate the effectiveness of a multi-factorial falls prevention program for stroke survivors who are at high risk of falling when they return home after rehabilitation. Intervention will consist of a home exercise program as well as individualised falls prevention and injury minimisation strategies based on identified risk factors for falls. Additionally, two sub-studies will be implemented in order to explore other key areas related to falls in this population. The first of these is a longitudinal study evaluating the relationship between fear of falling, falls and function over twelve months, and the second evaluates residual impairment in gait stability and obstacle crossing twelve months after discharge from rehabilitation. Discussion The results of the FLASSH project will inform falls prevention practice for stroke survivors. If the falls prevention program is shown to be effective, low cost strategies to prevent falls can be implemented for those at risk around the time of discharge from rehabilitation, thus improving safety and quality of life for stroke survivors. The two sub-studies will contribute to the overall understanding and management of falls risk in stroke survivors. Trial registration This trial is registered with the Australian and New Zealand Clinical Trials Registry (ACTRN012607000398404.

Marine Pollution Prevention Act

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Marine Pollution Prevention Act of 2008 implements the International Convention for the Prevention of Pollution from Ships, including related Protocols (MARPOL)...

Vaccines for preventing hepatitis B in healthcare workers (an updated protocol)

DEFF Research Database (Denmark)

Borch, Anders; Kolster, Chastine; Gluud, Christian

2017-01-01

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the beneficial and harmful effects of hepatitis B vaccines in healthcare workers.......This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the beneficial and harmful effects of hepatitis B vaccines in healthcare workers....

Women's perspectives on falls and fall prevention during pregnancy.

Science.gov (United States)

Brewin, Dorothy; Naninni, Angela

2014-01-01

Falls are the leading cause of unintentional injury in women. During pregnancy, even a minor fall can result in adverse consequences. Evidence to inform effective and developmentally appropriate pregnancy fall prevention programs is lacking. Early research on pregnancy fall prevention suggests that exercise may reduce falls. However, acceptability and effectiveness of pregnancy fall prevention programs are untested. To better understand postpartum women's perspective and preferences on fall prevention strategies during pregnancy to formulate an intervention. Focus groups and individual interviews were conducted with 31 postpartum women using descriptive qualitative methodology. Discussion of falls during pregnancy and fall prevention strategies was guided by a focus group protocol and enhanced by 1- to 3-minute videos on proposed interventions. Focus groups were audio recorded, transcribed, and analyzed using NVivo 10 software. Emerging themes were environmental circumstances and physical changes of pregnancy leading to a fall, prevention strategies, barriers, safety concerns, and marketing a fall prevention program. Wet surfaces and inappropriate footwear commonly contributed to falls. Women preferred direct provider counseling and programs including yoga and Pilates. Fall prevention strategies tailored to pregnant women are needed. Perspectives of postpartum women support fall prevention through provider counseling and individual or supervised exercise programs.

Enhancing research quality and reporting: why the Journal of Comorbidity is now publishing study protocols

Directory of Open Access Journals (Sweden)

Susan Smith

2014-08-01

Full Text Available The Journal of Comorbidity was launched in 2011 and has since become established as a high-quality journal that publishes open-access, peer-reviewed articles, with a focus on advancing the clinical management of patients with comorbidity/multimorbidity. To further enhance research quality and reporting of studies in this field, the journal is now offering authors the opportunity to publish a summary of their study protocols – a move designed to generate interest and raise awareness in ongoing clinical research and to enable researchers to detail their methodologies in order that replication by scientific peers is possible.

Development of measurement protocols for quantum magnetometry

DEFF Research Database (Denmark)

Stark, Alexander

and protocols to enhance the lifetime and the coherences of the NV center with the overall goal of enhancing the capabilities of this sensor in the field of magnetometry. In order to realize complex protocols, a sophisticated software control of the measurement setup is required. A general software framework......, is serving as rigorous framework to reduce the complexity of the setup configuration by a fundamental separation of tasks. As a consequence, the general idea of this framework is not limited to experiments with color centers in diamond, but can find application in any laboratory environment. The measurement...... of magnetic fields in the high-frequency GHz regimes is challenging. In this thesis, a continuous dynamical decoupling protocol is developed and implemented, which extends the capabilities of the NV sensor to probe GHz signals with a narrow bandwidth. Moreover, the protocol protects the system from noise...

A web-based computer-tailored smoking prevention programme for primary school children: intervention design and study protocol

Science.gov (United States)

2012-01-01

Background Although the number of smokers has declined in the last decade, smoking is still a major health problem among youngsters and adolescents. For this reason, there is a need for effective smoking prevention programmes targeting primary school children. A web-based computer-tailored feedback programme may be an effective intervention to stimulate youngsters not to start smoking, and increase their knowledge about the adverse effects of smoking and their attitudes and self-efficacy regarding non-smoking. Methods & design This paper describes the development and evaluation protocol of a web-based out-of-school smoking prevention programme for primary school children (age 10-13 years) entitled ‘Fun without Smokes’. It is a transformation of a postal mailed intervention to a web-based intervention. Besides this transformation the effects of prompts will be examined. This web-based intervention will be evaluated in a 2-year cluster randomised controlled trial (c-RCT) with three study arms. An intervention and intervention + prompt condition will be evaluated for effects on smoking behaviour, compared with a no information control condition. Information about pupils’ smoking status and other factors related to smoking will be obtained using a web-based questionnaire. After completing the questionnaire pupils in both intervention conditions will receive three computer-tailored feedback letters in their personal e-mail box. Attitudes, social influences and self-efficacy expectations will be the content of these personalised feedback letters. Pupils in the intervention + prompt condition will - in addition to the personalised feedback letters - receive e-mail and SMS messages prompting them to revisit the ‘Fun without Smokes’ website. The main outcome measures will be ever smoking and the utilisation of the ‘Fun without Smokes’ website. Measurements will be carried out at baseline, 12 months and 24 months of follow-up. Discussion The present study

A web-based computer-tailored smoking prevention programme for primary school children: intervention design and study protocol

Directory of Open Access Journals (Sweden)

Cremers Henricus-Paul

2012-06-01

Full Text Available Abstract Background Although the number of smokers has declined in the last decade, smoking is still a major health problem among youngsters and adolescents. For this reason, there is a need for effective smoking prevention programmes targeting primary school children. A web-based computer-tailored feedback programme may be an effective intervention to stimulate youngsters not to start smoking, and increase their knowledge about the adverse effects of smoking and their attitudes and self-efficacy regarding non-smoking. Methods & design This paper describes the development and evaluation protocol of a web-based out-of-school smoking prevention programme for primary school children (age 10-13 years entitled ‘Fun without Smokes’. It is a transformation of a postal mailed intervention to a web-based intervention. Besides this transformation the effects of prompts will be examined. This web-based intervention will be evaluated in a 2-year cluster randomised controlled trial (c-RCT with three study arms. An intervention and intervention + prompt condition will be evaluated for effects on smoking behaviour, compared with a no information control condition. Information about pupils’ smoking status and other factors related to smoking will be obtained using a web-based questionnaire. After completing the questionnaire pupils in both intervention conditions will receive three computer-tailored feedback letters in their personal e-mail box. Attitudes, social influences and self-efficacy expectations will be the content of these personalised feedback letters. Pupils in the intervention + prompt condition will - in addition to the personalised feedback letters - receive e-mail and SMS messages prompting them to revisit the ‘Fun without Smokes’ website. The main outcome measures will be ever smoking and the utilisation of the ‘Fun without Smokes’ website. Measurements will be carried out at baseline, 12 months and 24 months of follow

Thoraco-abdominal high-pitch dual-source CT angiography: Experimental evaluation of injection protocols with an anatomical human vascular phantom

Energy Technology Data Exchange (ETDEWEB)

Puippe, Gilbert D., E-mail: gilbert.puippe@usz.ch [Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland Raemistrasse 100, CH-8091 Zurich (Switzerland); Winklehner, Anna [Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland Raemistrasse 100, CH-8091 Zurich (Switzerland); Hasenclever, Peter; Plass, André [Division of Cardiac and Vascular Surgery, University Hospital Zurich, Switzerland Raemistrasse 100, CH-8091 Zurich (Switzerland); Frauenfelder, Thomas; Baumueller, Stephan [Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland Raemistrasse 100, CH-8091 Zurich (Switzerland)

2012-10-15

Objective: To experimentally evaluate three different contrast injection protocols at thoraco-abdominal high-pitch dual-source computed tomography angiography (CTA), with regard to level and homogeneity of vascular enhancement at different cardiac outputs. Materials and methods: A uniphasic, a biphasic as well as an individually tailored contrast protocol were tested using a human vascular phantom. Each protocol was scanned at 5 different cardiac outputs (3–5 L/min, steps of 0.5 L/min) using an extracorporeal cardiac pump. Vascular enhancement of the thoraco-abdominal aorta was measured every 5 cm. Overall mean enhancement of each protocol and mean enhancement for each cardiac output within each protocol were calculated. Enhancement homogeneity along the z-axis was evaluated for each cardiac output and protocol. Results: Overall mean enhancement was significantly higher in the uniphasic than in the other two protocols (all p < .05), whereas the difference between the biphasic and tailored protocol was not significant (p = .76). Mean enhancement among each of the 5 cardiac outputs within each protocol was significantly different (all p < .05). Only within the tailored protocol mean enhancement differed not significantly at cardiac outputs of 3.5 L/min vs. 5 L/min (484 ± 25 HU vs. 476 ± 19 HU, p = .14) and 4 vs. 5 L/min (443 ± 49 HU vs. 476 ± 19 HU, p = .05). Both, uniphasic and tailored protocol yielded homogenous enhancement at all cardiac outputs, whereas the biphasic protocol failed to achieve homogenous enhancement. Conclusion: This phantom study suggests that diagnostic and homogenous enhancement at thoraco-abdominal high-pitch dual-source CTA is feasible with either a uniphasic or an individually tailored contrast protocol.

Formative research to develop theory-based messages for a Western Australian child drowning prevention television campaign: study protocol.

Science.gov (United States)

Denehy, Mel; Crawford, Gemma; Leavy, Justine; Nimmo, Lauren; Jancey, Jonine

2016-05-20

Worldwide, children under the age of 5 years are at particular risk of drowning. Responding to this need requires the development of evidence-informed drowning prevention strategies. Historically, drowning prevention strategies have included denying access, learning survival skills and providing supervision, as well as education and information which includes the use of mass media. Interventions underpinned by behavioural theory and formative evaluation tend to be more effective, yet few practical examples exist in the drowning and/or injury prevention literature. The Health Belief Model and Social Cognitive Theory will be used to explore participants' perspectives regarding proposed mass media messaging. This paper describes a qualitative protocol to undertake formative research to develop theory-based messages for a child drowning prevention campaign. The primary data source will be focus group interviews with parents and caregivers of children under 5 years of age in metropolitan and regional Western Australia. Qualitative content analysis will be used to analyse the data. This study will contribute to the drowning prevention literature to inform the development of future child drowning prevention mass media campaigns. Findings from the study will be disseminated to practitioners, policymakers and researchers via international conferences, peer and non-peer-reviewed journals and evidence summaries. The study was submitted and approved by the Curtin University Human Research Ethics Committee. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Alcohol handrubbing and chlorhexidine handwashing protocols for routine hospital practice: A randomized clinical trial of protocol efficacy and time effectiveness

NARCIS (Netherlands)

Chow, Angela; Arah, Onyebuchi A.; Chan, Siew-Pang; Poh, Bee-Fong; Krishnan, Prabha; Ng, Woei-Kian; Choudhury, Saugata; Chan, Joey; Ang, Brenda

2012-01-01

Background: The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) recommend the use of alcohol handrubs to prevent health care-associated infections. However, the efficacy and time effectiveness of different alcohol handrubbing protocols have yet to be

Enhancing empowerment in eating disorder prevention: Another examination of the REbeL peer education model.

Science.gov (United States)

Breithaupt, Lauren; Eickman, Laura; Byrne, Catherine E; Fischer, Sarah

2017-04-01

Previously validated eating disorder (ED) prevention programs utilize either a targeted or universal approach. While both approaches have shown to be efficacious, implementing either style of program within a school setting remains a challenge. The current study describes an enhanced version of REbeL, a module based, continuous ED prevention program which utilizes a self-selection model of prevention in high school settings. The purpose of this study was to determine if an enhanced empowerment model of REbeL could increase feelings of empowerment and reduce eating disorder risk. We also aimed to assess the feasibility and acceptability of the intervention. High school peer-educators self-selected into the semi-manualized dissonance based intervention. Following feedback from a pilot trailed, enhanced peer-led group activities, designed to critique the thin ideal and designed to empower macro-changes in societal structures that emphasize the thin ideal, were added. The study (N=83) indicates that the program appears to be effective at reducing eating disorder risk factors and increasing empowerment. Participants reported reductions in body checking and internalization of the thin ideal. Copyright © 2016 Elsevier Ltd. All rights reserved.

Engineering Enhanced Vaccine Cell Lines To Eradicate Vaccine-Preventable Diseases: the Polio End Game.

Science.gov (United States)

van der Sanden, Sabine M G; Wu, Weilin; Dybdahl-Sissoko, Naomi; Weldon, William C; Brooks, Paula; O'Donnell, Jason; Jones, Les P; Brown, Cedric; Tompkins, S Mark; Oberste, M Steven; Karpilow, Jon; Tripp, Ralph A

2016-02-15

Vaccine manufacturing costs prevent a significant portion of the world's population from accessing protection from vaccine-preventable diseases. To enhance vaccine production at reduced costs, a genome-wide RNA interference (RNAi) screen was performed to identify gene knockdown events that enhanced poliovirus replication. Primary screen hits were validated in a Vero vaccine manufacturing cell line using attenuated and wild-type poliovirus strains. Multiple single and dual gene silencing events increased poliovirus titers >20-fold and >50-fold, respectively. Host gene knockdown events did not affect virus antigenicity, and clustered regularly interspaced short palindromic repeat (CRISPR)-Cas9-mediated knockout of the top candidates dramatically improved viral vaccine strain production. Interestingly, silencing of several genes that enhanced poliovirus replication also enhanced replication of enterovirus 71, a clinically relevant virus to which vaccines are being targeted. The discovery that host gene modulation can markedly increase virus vaccine production dramatically alters mammalian cell-based vaccine manufacturing possibilities and should facilitate polio eradication using the inactivated poliovirus vaccine. Using a genome-wide RNAi screen, a collection of host virus resistance genes was identified that, upon silencing, increased poliovirus and enterovirus 71 production by from 10-fold to >50-fold in a Vero vaccine manufacturing cell line. This report provides novel insights into enterovirus-host interactions and describes an approach to developing the next generation of vaccine manufacturing through engineered vaccine cell lines. The results show that specific gene silencing and knockout events can enhance viral titers of both attenuated (Sabin strain) and wild-type polioviruses, a finding that should greatly facilitate global implementation of inactivated polio vaccine as well as further reduce costs for live-attenuated oral polio vaccines. This work

Mothers After Gestational Diabetes in Australia Diabetes Prevention Program (MAGDA-DPP) post-natal intervention: an update to the study protocol for a randomized controlled trial.

Science.gov (United States)

Shih, Sophy T F; Davis-Lameloise, Nathalie; Janus, Edward D; Wildey, Carol; Versace, Vincent L; Hagger, Virginia; Asproloupos, Dino; O'Reilly, Sharleen L; Phillips, Paddy A; Ackland, Michael; Skinner, Timothy; Oats, Jeremy; Carter, Rob; Best, James D; Dunbar, James A

2014-06-30

The Mothers After Gestational Diabetes in Australia Diabetes Prevention Program (MAGDA-DPP) is a randomized controlled trial (RCT) that aims to assess the effectiveness of a structured diabetes prevention intervention for women who had gestational diabetes. The original protocol was published in Trials (http://www.trialsjournal.com/content/14/1/339). This update reports on an additional exclusion criterion and change in first eligibility screening to provide greater clarity. The new exclusion criterion "surgical or medical intervention to treat obesity" has been added to the original protocol. The risks of developing diabetes will be affected by any medical or surgical intervention as its impact on obesity will alter the outcomes being assessed by MAGDA-DPP. The screening procedures have also been updated to reflect the current recruitment operation. The first eligibility screening is now taking place either during or after pregnancy, depending on recruitment strategy. Australian New Zealand Clinical Trials Registry ANZCTRN 12610000338066.

e-SCP-ECG+ Protocol: An Expansion on SCP-ECG Protocol for Health Telemonitoring—Pilot Implementation

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George J. Mandellos

2010-01-01

Full Text Available Standard Communication Protocol for Computer-assisted Electrocardiography (SCP-ECG provides standardized communication among different ECG devices and medical information systems. This paper extends the use of this protocol in order to be included in health monitoring systems. It introduces new sections into SCP-ECG structure for transferring data for positioning, allergies, and five additional biosignals: noninvasive blood pressure (NiBP, body temperature (Temp, Carbon dioxide (CO2, blood oxygen saturation (SPO2, and pulse rate. It also introduces new tags in existing sections for transferring comprehensive demographic data. The proposed enhanced version is referred to as e-SCP-ECG+ protocol. This paper also considers the pilot implementation of the new protocol as a software component in a Health Telemonitoring System.

Network Coding Protocols for Smart Grid Communications

DEFF Research Database (Denmark)

Prior, Rui; Roetter, Daniel Enrique Lucani; Phulpin, Yannick

2014-01-01

We propose a robust network coding protocol for enhancing the reliability and speed of data gathering in smart grids. At the heart of our protocol lies the idea of tunable sparse network coding, which adopts the transmission of sparsely coded packets at the beginning of the transmission process b...

Network Coding to Enhance Standard Routing Protocols in Wireless Mesh Networks

DEFF Research Database (Denmark)

Pahlevani, Peyman; Roetter, Daniel Enrique Lucani; Fitzek, Frank

2013-01-01

This paper introduces a design and simulation of a locally optimized network coding protocol, called PlayNCool, for wireless mesh networks. PlayN-Cool is easy to implement and compatible with existing routing protocols and devices. This allows the system to gain from network coding capabilities i...

Mobile Augmented Reality as Usability to Enhance Nurse Prevent Violence Learning Satisfaction.

Science.gov (United States)

Hsu, Han-Jen; Weng, Wei-Kai; Chou, Yung-Lang; Huang, Pin-Wei

2018-01-01

Violence in hospitals, nurses are at high risk of patient's aggression in the workplace. This learning course application Mobile Augmented Reality to enhance nurse to prevent violence skill. Increasingly, mobile technologies introduced and integrated into classroom teaching and clinical applications. Improving the quality of learning course and providing new experiences for nurses.

An investigation into the nutritional status of patients receiving an Enhanced Recovery After Surgery (ERAS) protocol versus standard care following Oesophagectomy.

Science.gov (United States)

Benton, Katie; Thomson, Iain; Isenring, Elisabeth; Mark Smithers, B; Agarwal, Ekta

2018-06-01

Enhanced Recovery After Surgery (ERAS) protocols have been effectively expanded to various surgical specialities including oesophagectomy. Despite nutrition being a key component, actual nutrition outcomes and specific guidelines are lacking. This cohort comparison study aims to compare nutritional status and adherence during implementation of a standardised post-operative nutritional support protocol, as part of ERAS, compared to those who received usual care. Two groups of patients undergoing resection of oesophageal cancer were studied. Group 1 (n = 17) underwent oesophagectomy between Oct 2014 and Nov 2016 during implementation of an ERAS protocol. Patients in group 2 (n = 16) underwent oesophagectomy between Jan 2011 and Dec 2012 prior to the implementation of ERAS. Demographic, nutritional status, dietary intake and adherence data were collected. Ordinal data was analysed using independent t tests, and categorical data using chi-square tests. There was no significant difference in nutrition status, dietary intake or length of stay following implementation of an ERAS protocol. Malnutrition remained prevalent in both groups at day 42 post surgery (n = 10, 83% usual care; and n = 9, 60% ERAS). A significant difference was demonstrated in adherence with earlier initiation of oral free fluids (p nutrition protocol, within an ERAS framework, results in earlier transition to oral intake; however, malnutrition remains prevalent post surgery. Further large-scale studies are warranted to examine individualised decision-making regarding nutrition support within an ERAS protocol.

Security of the arbitrated quantum signature protocols revisited

International Nuclear Information System (INIS)

Kejia, Zhang; Dan, Li; Qi, Su

2014-01-01

Recently, much attention has been paid to the study of arbitrated quantum signature (AQS). Among these studies, the cryptanalysis of some AQS protocols and a series of improved ideas have been proposed. Compared with the previous analysis, we present a security criterion, which can judge whether an AQS protocol is able to prevent the receiver (i.e. one participant in the signature protocol) from forging a legal signature. According to our results, it can be seen that most AQS protocols which are based on the Zeng and Keitel (ZK) model are susceptible to a forgery attack. Furthermore, we present an improved idea of the ZK protocol. Finally, some supplement discussions and several interesting topics are provided. (paper)

Effectiveness of the universal prevention program 'Healthy School and Drugs': Study protocol of a randomized clustered trial

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Malmberg Monique

2010-09-01

Full Text Available Abstract Background Substance use is highly prevalent among Dutch adolescents. The Healthy School and Drugs program is a nationally implemented school-based prevention program aimed at reducing early and excessive substance use among adolescents. Although the program's effectiveness was tested in a quasi-experimental design before, many program changes were made afterwards. The present study, therefore, aims to test the effects of this widely used, renewed universal prevention program. Methods/Design A randomized clustered trial will be conducted among 3,784 adolescents of 23 secondary schools in The Netherlands. The trial has three conditions; two intervention conditions (i.e., e-learning and integral and a control condition. The e-learning condition consists of three digital learning modules (i.e., about alcohol, tobacco, and marijuana that are sequentially offered over the course of three school years (i.e., grade 1, grade 2, and grade 3. The integral condition consists of parental participation in a parental meeting on substance use, regulation of substance use, and monitoring and counseling of students' substance use at school, over and above the three digital modules. The control condition is characterized as business as usual. Participating schools were randomly assigned to either an intervention or control condition. Participants filled out a digital questionnaire at baseline and will fill out the same questionnaire three more times at follow-up measurements (8, 20, and 32 months after baseline. Outcome variables included in the questionnaire are the percentage of binge drinking (more than five drinks per occasion, the average weekly number of drinks, and the percentage of adolescents who ever drunk a glass of alcohol and the percentage of adolescents who ever smoked a cigarette or a joint respectively for tobacco and marijuana. Discussion This study protocol describes the design of a randomized clustered trial that evaluates the

Repeated 28-day oral toxicity study of vinclozolin in rats based on the draft protocol for the "Enhanced OECD Test Guideline No. 407" to detect endocrine effects.

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Shin, Jae-Ho; Moon, Hyun Ju; Kim, Tae Sung; Kang, Il Hyun; Ki, Ho Yeon; Choi, Kwang Sik; Han, Soon Young

2006-09-01

We performed a 28-day repeated-dose toxicity study of vinclozolin, a widely used fungicide, based on the draft protocol of the "Enhanced OECD Test Guideline 407" (Enhanced TG407) to investigate whether vinclozolin has endocrine-mediated properties according to this assay. Seven-week-old SD rats were administered with vinclozolin daily by oral gavage at dose rates of 0, 3.125, 12.5, 50 and 200 mg/kg/day for at least 28 days. The vinclozolin-treated male rats showed a reduction of epididymis and accessory sex organ weights and an alteration of hormonal patterns. A slight prolongation of the estrous cycle and changes in the estrogen/testosterone ratio and luteinizing hormone level were observed in vinclozolin-treated female rats. Thyroxin concentrations were decreased and thyroid-stimulating hormone concentrations were increased in both sexes; however, there were no compound-related microscopic lesions in the thyroid gland or changes in the thyroid weight. The endocrine-related effects of vinclozolin could be detected by the parameters examined in the present study based on the OECD protocol, suggesting the Enhanced TG407 protocol should be a suitable screening test for the detection of endocrine-mediated effects of chemicals.

Cluster randomized trial in the general practice research database: 2. Secondary prevention after first stroke (eCRT study: study protocol for a randomized controlled trial

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Dregan Alex

2012-10-01

Full Text Available Abstract Background The purpose of this research is to develop and evaluate methods for conducting pragmatic cluster randomized trials in a primary care electronic database. The proposal describes one application, in a less frequent chronic condition of public health importance, secondary prevention of stroke. A related protocol in antibiotic prescribing was reported previously. Methods/Design The study aims to implement a cluster randomized trial (CRT using the electronic patient records of the General Practice Research Database (GPRD as a sampling frame and data source. The specific objective of the trial is to evaluate the effectiveness of a computer-delivered intervention at enhancing the delivery of stroke secondary prevention in primary care. GPRD family practices will be allocated to the intervention or usual care. The intervention promotes the use of electronic prompts to support adherence with the recommendations of the UK Intercollegiate Stroke Working Party and NICE guidelines for the secondary prevention of stroke in primary care. Primary outcome measure will be the difference in systolic blood pressure between intervention and control trial arms at 12-month follow-up. Secondary outcomes will be differences in serum cholesterol, prescribing of antihypertensive drugs, statins, and antiplatelet therapy. The intervention will continue for 12 months. Information on the utilization of the decision-support tools will also be analyzed. Discussion The CRT will investigate the effectiveness of using a computer-delivered intervention to reduce the risk of stroke recurrence following a first stroke event. The study will provide methodological guidance on the implementation of CRTs in electronic databases in primary care. Trial registration Current Controlled Trials ISRCTN35701810

FODA: a novel efficient multiple access protocol for highly dynamic self-organizing networks

Science.gov (United States)

Li, Hantao; Liu, Kai; Zhang, Jun

2005-11-01

Based on the concept of contention reservation for polling transmission and collision prevention strategy for collision resolution, a fair on-demand access (FODA) protocol for supporting node mobility and multihop architecture in highly dynamic self-organizing networks is proposed. In the protocol, a distributed clustering network architecture formed by self-organizing algorithm and a main idea of reserving channel resources to get polling service are adopted, so that the hidden terminal (HT) and exposed terminal (ET) problems existed in traffic transmission due to multihop architecture and wireless transmission can be eliminated completely. In addition, an improved collision prevention scheme based on binary countdown algorithm (BCA), called fair collision prevention (FCP) algorithm, is proposed to greatly eliminate unfair phenomena existed in contention access of newly active ordinary nodes and completely resolve access collisions. Finally, the performance comparison of the FODA protocol with carrier sense multiple access with collision avoidance (CSMA/CA) and polling protocols by OPNET simulation are presented. Simulation results show that the FODA protocol can overcome the disadvantages of CSMA/CA and polling protocols, and achieve higher throughput, lower average message delay and less average message dropping rate.

Quality assurance in MRI breast screening: comparing signal-to-noise ratio in dynamic contrast-enhanced imaging protocols

Science.gov (United States)

Kousi, Evanthia; Borri, Marco; Dean, Jamie; Panek, Rafal; Scurr, Erica; Leach, Martin O.; Schmidt, Maria A.

2016-01-01

MRI has been extensively used in breast cancer staging, management and high risk screening. Detection sensitivity is paramount in breast screening, but variations of signal-to-noise ratio (SNR) as a function of position are often overlooked. We propose and demonstrate practical methods to assess spatial SNR variations in dynamic contrast-enhanced (DCE) breast examinations and apply those methods to different protocols and systems. Four different protocols in three different MRI systems (1.5 and 3.0 T) with receiver coils of different design were employed on oil-filled test objects with and without uniformity filters. Twenty 3D datasets were acquired with each protocol; each dataset was acquired in under 60 s, thus complying with current breast DCE guidelines. In addition to the standard SNR calculated on a pixel-by-pixel basis, we propose other regional indices considering the mean and standard deviation of the signal over a small sub-region centred on each pixel. These regional indices include effects of the spatial variation of coil sensitivity and other structured artefacts. The proposed regional SNR indices demonstrate spatial variations in SNR as well as the presence of artefacts and sensitivity variations, which are otherwise difficult to quantify and might be overlooked in a clinical setting. Spatial variations in SNR depend on protocol choice and hardware characteristics. The use of uniformity filters was shown to lead to a rise of SNR values, altering the noise distribution. Correlation between noise in adjacent pixels was associated with data truncation along the phase encoding direction. Methods to characterise spatial SNR variations using regional information were demonstrated, with implications for quality assurance in breast screening and multi-centre trials.

A Lightweight Buyer-Seller Watermarking Protocol

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Yongdong Wu

2008-01-01

Full Text Available The buyer-seller watermarking protocol enables a seller to successfully identify a traitor from a pirated copy, while preventing the seller from framing an innocent buyer. Based on finite field theory and the homomorphic property of public key cryptosystems such as RSA, several buyer-seller watermarking protocols (N. Memon and P. W. Wong (2001 and C.-L. Lei et al. (2004 have been proposed previously. However, those protocols require not only large computational power but also substantial network bandwidth. In this paper, we introduce a new buyer-seller protocol that overcomes those weaknesses by managing the watermarks. Compared with the earlier protocols, ours is n times faster in terms of computation, where n is the number of watermark elements, while incurring only O(1/lN times communication overhead given the finite field parameter lN. In addition, the quality of the watermarked image generated with our method is better, using the same watermark strength.

Adaptive Suspicious Prevention for Defending DoS Attacks in SDN-Based Convergent Networks.

Science.gov (United States)

Dao, Nhu-Ngoc; Kim, Joongheon; Park, Minho; Cho, Sungrae

2016-01-01

The convergent communication network will play an important role as a single platform to unify heterogeneous networks and integrate emerging technologies and existing legacy networks. Although there have been proposed many feasible solutions, they could not become convergent frameworks since they mainly focused on converting functions between various protocols and interfaces in edge networks, and handling functions for multiple services in core networks, e.g., the Multi-protocol Label Switching (MPLS) technique. Software-defined networking (SDN), on the other hand, is expected to be the ideal future for the convergent network since it can provide a controllable, dynamic, and cost-effective network. However, SDN has an original structural vulnerability behind a lot of advantages, which is the centralized control plane. As the brains of the network, a controller manages the whole network, which is attractive to attackers. In this context, we proposes a novel solution called adaptive suspicious prevention (ASP) mechanism to protect the controller from the Denial of Service (DoS) attacks that could incapacitate an SDN. The ASP is integrated with OpenFlow protocol to detect and prevent DoS attacks effectively. Our comprehensive experimental results show that the ASP enhances the resilience of an SDN network against DoS attacks by up to 38%.

A Forward-secure Grouping-proof Protocol for Multiple RFID Tags

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Liu Ya-li

2012-09-01

Full Text Available Designing secure and robust grouping-proof protocols based on RFID characteristics becomes a hotspot in the research of security in Internet of Things (IOT. The proposed grouping-proof protocols recently have security and/or privacy omission and these schemes afford order-dependence by relaying message among tags through an RFID reader. In consequence, aiming at enhancing the robustness, improving scalability, reducing the computation costs on resource-constrained devices, and meanwhile combing Computational Intelligence (CI with Secure Multi-party Communication (SMC, a Forward-Secure Grouping-Proof Protocol (FSGP for multiple RFID tags based on Shamir's (, secret sharing is proposed. In comparison with the previous grouping-proof protocols, FSGP has the characteristics of forward-security and order-independence addressing the scalability issue by avoiding relaying message. Our protocol provides security enhancement, performance improvement, and meanwhile controls the computation cost, which equilibrates both security and low cost requirements for RFID tags.

Glutathione depletion prevents diet-induced obesity and enhances insulin sensitivity.

Science.gov (United States)

Findeisen, Hannes M; Gizard, Florence; Zhao, Yue; Qing, Hua; Jones, Karrie L; Cohn, Dianne; Heywood, Elizabeth B; Bruemmer, Dennis

2011-12-01

Excessive accumulation of reactive oxygen species (ROS) in adipose tissue has been implicated in the development of insulin resistance and type 2 diabetes. However, emerging evidence suggests a physiologic role of ROS in cellular signaling and insulin sensitivity. In this study, we demonstrate that pharmacologic depletion of the antioxidant glutathione in mice prevents diet-induced obesity, increases energy expenditure and locomotor activity, and enhances insulin sensitivity. These observations support a beneficial role of ROS in glucose homeostasis and warrant further research to define the regulation of metabolism and energy balance by ROS.

A secure key agreement protocol based on chaotic maps

International Nuclear Information System (INIS)

Wang Xing-Yuan; Luan Da-Peng

2013-01-01

To guarantee the security of communication in the public channel, many key agreement protocols have been proposed. Recently, Gong et al. proposed a key agreement protocol based on chaotic maps with password sharing. In this paper, Gong et al.'s protocol is analyzed, and we find that this protocol exhibits key management issues and potential security problems. Furthermore, the paper presents a new key agreement protocol based on enhanced Chebyshev polynomials to overcome these problems. Through our analysis, our key agreement protocol not only provides mutual authentication and the ability to resist a variety of common attacks, but also solve the problems of key management and security issues existing in Gong et al.'s protocol

The CAP study, evaluation of integrated universal and selective prevention strategies for youth alcohol misuse: study protocol of a cluster randomized controlled trial

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Newton Nicola C

2012-08-01

Full Text Available Abstract Background Alcohol misuse amongst young people is a serious concern. The need for effective prevention is clear, yet there appear to be few evidenced-based programs that prevent alcohol misuse and none that target both high and low-risk youth. The CAP study addresses this gap by evaluating the efficacy of an integrated approach to alcohol misuse prevention, which combines the effective universal internet-based Climate Schools program with the effective selective personality-targeted Preventure program. This article describes the development and protocol of the CAP study which aims to prevent alcohol misuse and related harms in Australian adolescents. Methods/Design A cluster randomized controlled trial (RCT is being conducted with Year 8 students aged 13 to 14-years-old from 27 secondary schools in New South Wales and Victoria, Australia. Blocked randomisation was used to assign schools to one of four groups; Climate Schools only, Preventure only, CAP (Climate Schools and Preventure, or Control (alcohol, drug and health education as usual. The primary outcomes of the trial will be the uptake and harmful use of alcohol and alcohol related harms. Secondary outcomes will include alcohol and cannabis related knowledge, cannabis related harms, intentions to use, and mental health symptomatology. All participants will complete assessments on five occasions; baseline; immediately post intervention, and at 12, 24 and 36 months post baseline. Discussion This study protocol presents the design and current implementation of a cluster RCT to evaluate the efficacy of the CAP study; an integrated universal and selective approach to prevent alcohol use and related harms among adolescents. Compared to students who receive the stand-alone universal Climate Schools program or alcohol and drug education as usual (Controls, we expect the students who receive the CAP intervention to have significantly less uptake of alcohol use, a reduction in average

Education and empowerment of the nursing assistant: validating their important role in skin care and pressure ulcer prevention, and demonstrating productivity enhancement and cost savings.

Science.gov (United States)

Howe, Lynn

2008-06-01

This article details an educational program designed to utilize nonlicensed personnel (certified nursing assistants [CNAs] and nursing assistants [NAs]) in the prevention of pressure ulcers and improved skin care in a 250-bed acute care facility in a suburban setting. The article is divided into 2 parts: A and B. Part A addresses the educational program, which was part of a major initiative for improving patient outcomes that included a review and standardization of skin care products and protocols. Part B addresses productivity enhancement and cost savings experienced because of changing bathing and incontinence care products and procedures. The educational program included instruction on time-saving methods for increasing productivity in bathing and incontinence care, and effectively promoted the importance of proper skin care and pressure ulcer prevention techniques. Methods incorporated into the educational training targeted different reading and comprehension levels, ranging from the use of PowerPoint slides, hands-on return demonstration, and group discussion related to pressure ulcer staging and wound treatment. These educational methods provided the participants with significant reinforcement of each day's learning objectives. Productivity enhancement and cost savings are addressed in part B, as well as the results of a time-motion study. Because of the program, CNAs/NAs were empowered in their integral caregiver roles. This program was part of a larger, major process improvement initiative, but the rate of acquired pressure ulcers declined from 2.17% in 2002 to 1.71% in 2003. This educational program was considered a contributor to the improved patient outcomes.

Consideration of the effect for enhancing the disaster prevention awareness by visualization of the tsunami lore

Science.gov (United States)

Chiharu, M.

2017-12-01

One effective measure for enhancing the residents' disaster prevention awareness is to know the natural hazard which has occurred in the past at residence. Mie Disaster Mitigation Center had released the digital archive for promoting an understanding of disaster prevention on April 28, 2015. This archive is recording the past disaster information as digital catalog. An effective contribution to enhancement of the inhabitants' disaster prevention awareness is expected. It includes the following contents (1) The interview with disaster victim (the 1944 Tonankai Earthquake, The Ise Bay Typhoon and so on) (2) The information on "monument of Tsunami" (3) The description of disaster on the local history material (the school history books, municipal history books, and so on). These contents are being dropped on a map and it is being shown clearly geographically. For all age groups, this way makes it easy to understand that the past disaster information relates to their residence address.

Prediction Schemes to Enhance the Routing Process in Geographical GPSR Ad Hoc Protocol

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Raed Saqour

2007-01-01

Full Text Available Geographical routing protocols have received a serious attention due to more advantages they have in comparison to the conventional routing protocols. They require information about the physical position of nodes needed to be available. Commonly, each node determines its own position through the use of Global Positioning System (GPS or some other type of positioning service. Greedy Perimeter Stateless Routing (GPSR protocol, which is one of geographical routing protocols, limits the forwarding decision of the packet based on the node's own position, the destination's position and the position of the forwarding node's neighbors. Location information has some inaccuracy depending on the localization system and the environment exists in. This paper aims to study the impact of mobility metrics (beacon interval, and node speed on introducing location information error in GPSR protocol using different mobility models. The effect of these metrics is identified in GPSR as Neighbor Break Link (NBL problem. Based on simulation analysis, mobility prediction schemes are proposed to migrate the observed problem.

Using the intervention mapping protocol to develop a maintenance programme for the SLIMMER diabetes prevention intervention.

Science.gov (United States)

Elsman, Ellen B M; Leerlooijer, Joanne N; Ter Beek, Josien; Duijzer, Geerke; Jansen, Sophia C; Hiddink, Gerrit J; Feskens, Edith J M; Haveman-Nies, Annemien

2014-10-27

Although lifestyle interventions have shown to be effective in reducing the risk for type 2 diabetes mellitus, maintenance of achieved results is difficult, as participants often experience relapse after the intervention has ended. This paper describes the systematic development of a maintenance programme for the extensive SLIMMER intervention, an existing diabetes prevention intervention for high-risk individuals, implemented in a real-life setting in the Netherlands. The maintenance programme was developed using the Intervention Mapping protocol. Programme development was informed by a literature study supplemented by various focus group discussions and feedback from implementers of the extensive SLIMMER intervention. The maintenance programme was designed to sustain a healthy diet and physical activity pattern by targeting knowledge, attitudes, subjective norms and perceived behavioural control of the SLIMMER participants. Practical applications were clustered into nine programme components, including sports clinics at local sports clubs, a concluding meeting with the physiotherapist and dietician, and a return session with the physiotherapist, dietician and physical activity group. Manuals were developed for the implementers and included a detailed time table and step-by-step instructions on how to implement the maintenance programme. The Intervention Mapping protocol provided a useful framework to systematically plan a maintenance programme for the extensive SLIMMER intervention. The study showed that planning a maintenance programme can build on existing implementation structures of the extensive programme. Future research is needed to determine to what extent the maintenance programme contributes to sustained effects in participants of lifestyle interventions.

Rethinking transitions of care: An interprofessional transfer triage protocol in post-acute care.

Science.gov (United States)

Patel, Radha V; Wright, Lauri; Hay, Brittany

2017-09-01

Readmissions to hospitals from post-acute care (PAC) units within long-term care settings have been rapidly increasing over the past decade, and are drivers of increased healthcare costs. With an average of $11,000 per admission, there is a need for strategies to reduce 30-day preventable hospital readmission rates. In 2018, incentives and penalties will be instituted for long-term care facilities failing to meet all-cause, all-condition hospital readmission rate performance measures. An interprofessional team (IPT) developed and implemented a Transfer Triage Protocol used in conjunction with the INTERACT programme to enhance clinical decision-making and assess the potential to reduce the facility's 30-day preventable hospital readmission rates by 10% within 6 weeks of implementation. Results from quantitative analysis demonstrated an overall 35.2% reduction in the 30-day preventable hospital readmission rate. Qualitative analysis revealed the need for additional staff education, improved screening and communication upon admission and prior to hospital transfer, and the need for more IPT on-site availability. This pilot study demonstrates the benefits and implications for practice of an IPT to improve the quality of care within PAC and decrease 30-day preventable hospital readmissions.

Privacy-Enhancing Security Protocol in LTE Initial Attack

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Uijin Jang

2014-12-01

Full Text Available Long-Term Evolution (LTE is a fourth-generation mobile communication technology implemented throughout the world. It is the communication means of smartphones that send and receive all of the private date of individuals. M2M, IOT, etc., are the base technologies of mobile communication that will be used in the future cyber world. However, identification parameters, such as International Mobile Subscriber Identity (IMSI, Radio Network Temporary Identities (RNTI, etc., in the initial attach section for accessing the LTE network are presented with the vulnerability of being exposed as clear text. Such vulnerability does not end in a mere identification parameter, but can lead to a secondary attack using the identification parameter, such as replication of the smartphone, illegal use of the mobile communication network, etc. This paper proposes a security protocol to safely transmit identification parameters in different cases of the initial attach. The proposed security protocol solves the exposed vulnerability by encrypting the parameters in transmission. Using an OPNET simulator, it is shown that the average rate of delay and processing ratio are efficient in comparison to the existing process.

Towards a Fraud-Prevention Framework for Software Defined Radio Mobile Devices

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Brawerman Alessandro

2005-01-01

Full Text Available The superior reconfigurability of software defined radio mobile devices has made it the most promising technology on the wireless network and in the communication industry. Despite several advantages, there are still a lot to discuss regarding security, for instance, the radio configuration data download, storage and installation, user's privacy, and cloning. The objective of this paper is to present a fraud-prevention framework for software defined radio mobile devices that enhances overall security through the use of new pieces of hardware, modules, and protocols. The framework offers security monitoring against malicious attacks and viruses, protects sensitive information, creates and protects an identity for the system, employs a secure protocol for radio configuration download, and finally, establishes an anticloning scheme, which besides guaranteeing that no units can be cloned over the air, also elevates the level of difficulty to clone units if the attacker has physical access to the mobile device. Even if cloned units exist, the anticloning scheme is able to identify and deny services to those units. Preliminary experiments and proofs that analyze the correctness of the fraud-prevention framework are also presented.

Preventing falls in older multifocal glasses wearers by providing single-lens distance glasses: the protocol for the VISIBLE randomised controlled trial

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Lee Bonsan B

2009-03-01

Full Text Available Abstract Background Recent research has shown that wearing multifocal glasses increases the risk of trips and falls in older people. The aim of this study is to determine whether the provision of single-lens distance glasses to older multifocal glasses wearers, with recommendations for wearing them for walking and outdoor activities, can prevent falls. We will also measure the effect of the intervention on health status, lifestyle activities and fear of falling, as well as the extent of adherence to the program. Methods/Design Approximately 580 older people who are regular wearers of multifocal glasses people will be recruited. Participants will be randomly allocated to either an intervention group (provision of single lens glasses, with counselling and advice about appropriate use or a control group (usual care. The primary outcome measure will be falls (measured with 13 monthly calendars. Secondary measures will be quality of life, falls efficacy, physical activity levels and adverse events. Discussions The study will determine the impact of providing single-lens glasses, with advice about appropriate use, on preventing falls in older regular wearers of multifocal glasses. This pragmatic intervention, if found to be effective, will guide practitioners with regard to recommending appropriate glasses for minimising the risk of falls in older people. Trial Registration The protocol for this study was registered with the Clinical Trials.gov Protocol Registration System on June 7th 2006 (#350855.

Intervention development for the indicated prevention of depression in later life: The “DIL” protocol in Goa, India

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Amit Dias, MD

2017-06-01

Full Text Available Because depression is a major source of the global burden of illness-related disability, developing effective strategies for reducing its incidence is an important public health priority, especially in low-income countries, where resources for treating depression are scarce. We describe in this report an intervention development project, funded by the US National Institute of Mental Health, to address “indicated” prevention of depression in older adults attending rural and urban primary care clinics in Goa, India. Specifically, participants in the “DIL” (“Depression in Later Life” trial were older adults living with mild, subsyndromal symptoms of depression and anxiety and thus at substantial risk for transitioning to fully syndromal major depression and anxiety disorders. Building upon the MANAS treatment trial (“Promoting Mental Health” led by Patel et al. in the same locale, we present here lessons learned in the development and implementation of a protocol utilizing lay health counsellors (LHCs who deliver a multi-component depression prevention intervention organized conceptually around Problem Solving Therapy for Primary Care (PST, with additional components addressing brief behavioural treatment of sleep disturbances such as insomnia, meeting basic social casework needs, and education in self-management of prevalent comorbid chronic diseases, such as diabetes mellitus. To our knowledge, DIL is the first randomized clinical trial addressing the prevention of depressive disorders ever conducted in a low- or middle-income country.

Technologies, Methodologies and Challenges in Network Intrusion Detection and Prevention Systems

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Nicoleta STANCIU

2013-01-01

Full Text Available This paper presents an overview of the technologies and the methodologies used in Network Intrusion Detection and Prevention Systems (NIDPS. Intrusion Detection and Prevention System (IDPS technologies are differentiated by types of events that IDPSs can recognize, by types of devices that IDPSs monitor and by activity. NIDPSs monitor and analyze the streams of network packets in order to detect security incidents. The main methodology used by NIDPSs is protocol analysis. Protocol analysis requires good knowledge of the theory of the main protocols, their definition, how each protocol works.

Depression and anxiety, an Indicated Prevention (DIP protocol in homes for the elderly: feasibility and (cost effectiveness of a stepped care programme

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Beekman Aartjan TF

2007-03-01

Full Text Available Abstract Background Depressive and anxiety disorders are a very common, serious and underdetected problem in homes for the elderly. Elderly persons in residential homes are at high risk for developing major depressive and anxiety disorders, and, therefore, deserve attention with regard to prevention. Methods/Design This protocol describes a randomised trial on the feasibility and (cost effectiveness of a stepped-care programme for prevention of depressive and anxiety disorders in homes for the elderly. The main outcome measure is the incidence of depressive and anxiety disorder in one year with a two years follow up. Secondary outcomes are symptoms of depression and anxiety, quality of life, direct health care costs and satisfaction with treatment. Discussion The number of studies examining the effects of preventive interventions on the incidence of mental disorders in the elderly population is very small. However, indicated prevention by means of a stepped-care programme seems to be an important option for decreasing the burden of illness for residents and their caregivers. This study contributes to the body of knowledge in this field. Positive effects may contribute to further use and development of tailored, (cost- effective and easy to use interventions in a preventive stepped-care programme. Trial Registration The Dutch Cochrane Centre, ISRCTN27540731

Enhanced recovery from surgery in the UK: an audit of the enhanced recovery partnership programme 2009-2012.

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Simpson, J C; Moonesinghe, S R; Grocott, M P W; Kuper, M; McMeeking, A; Oliver, C M; Galsworthy, M J; Mythen, M G

2015-10-01

The UK Department of Health Enhanced Recovery Partnership Programme collected data on 24 513 surgical patients in the UK from 2009-2012. Enhanced Recovery is an approach to major elective surgery aimed at minimizing perioperative stress for the patient. Previous studies have shown Enhanced Recovery to be associated with reduced hospital length of stay and perioperative morbidity. In this national clinical audit, National Health Service hospitals in the UK were invited to submit patient-level data. The data regarding length of stay and compliance with each element of Enhanced Recovery protocols for colorectal, orthopaedic, urological and gynaecological surgery patients were analysed. The relationship between Enhanced Recovery protocol compliance and length of stay was measured. From 16 267 patients from 61 hospital trusts, three out of four surgical specialties showed Enhanced Recovery, compliance being weakly associated with shorter length of stay (correlation coefficients -0.18, -0.14, -0.25 in colorectal, orthopaedics and gynaecology respectively). At a cut-off of 80% compliance, good compliance was associated with two, one and three day reductions in median length of stay respectively in colorectal, orthopaedic and urological surgeries, with no saving in gynaecology. This study is the largest assessment of the relationship between Enhanced Recovery protocol compliance and outcome in four surgical specialties. The data suggest that higher compliance with an Enhanced Recovery protocol has a weak association with shorter length of stay. This suggests that changes in process, resulting from highly protocolised pathways, may be as important in reducing perioperative length of stay as any individual element of Enhanced Recovery protocols in isolation. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

OPTIMISATION OF BUFFER SIZE FOR ENHANCING QOS OF VIDEO TRAFFIC USING CROSS LAYERED HYBRID TRANSPORT LAYER PROTOCOL APPROACH

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S. Matilda

2011-03-01

Full Text Available Video streaming is gaining importance, with the wide popularity of multimedia rich applications in the Internet. Video streams are delay sensitive and require seamless flow for continuous visualization. Properly designed buffers offer a solution to queuing delay. The diagonally opposite QoS metrics associated with video traffic poses an optimization problem, in the design of buffers. This paper is a continuation of our previous work [1] and deals with the design of buffers. It aims at finding the optimum buffer size for enhancing QoS offered to video traffic. Network-centric QoS provisioning approach, along with hybrid transport layer protocol approach is adopted, to arrive at an optimum size which is independent of RTT. In this combinational approach, buffers of routers and end devices are designed to satisfy the various QoS parameters at the transport layer. OPNET Modeler is used to simulate environments for testing the design. Based on the results of simulation it is evident that the hybrid transport layer protocol approach is best suited for transmitting video traffic as it supports the economical design.

Assistance protocol for venous ulcers patients: validation of contents

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Daniele Vieira Dantas

2013-07-01

Full Text Available Venous ulcers require complex treatment and are responsible for significant morbidity and mortality rates. This study aims at identifying aspects validated by the jury for the preparation of an assistance protocol for venous ulcer sufferers. It is a descriptive and quantitative research, with 39 professionals (30 nurses, 7 doctors and two physiotherapists, held at the Onofre Lopes University Hospital, between April and July/2010. Data collection began through a questionnaire checklist. Analysis was performed through Statistical Package for Social Science 15.0, assessing compliance with guidelines. Results were the compositional aspects of the protocol: assessment of patient and lesion history/documentation, wound care/perilesional skin, dressing suggestion, use of antibiotics and pain treatment, surgical treatment/medication, improving venous return and relapse prevention, patient referral, professional training and referral/counter-referral. It was concluded that to compose the protocol, aspects related to diagnosis, treatment and injury prevention must be considered.

A Fully Automated Diabetes Prevention Program, Alive-PD: Program Design and Randomized Controlled Trial Protocol.

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Block, Gladys; Azar, Kristen Mj; Block, Torin J; Romanelli, Robert J; Carpenter, Heather; Hopkins, Donald; Palaniappan, Latha; Block, Clifford H

2015-01-21

In the United States, 86 million adults have pre-diabetes. Evidence-based interventions that are both cost effective and widely scalable are needed to prevent diabetes. Our goal was to develop a fully automated diabetes prevention program and determine its effectiveness in a randomized controlled trial. Subjects with verified pre-diabetes were recruited to participate in a trial of the effectiveness of Alive-PD, a newly developed, 1-year, fully automated behavior change program delivered by email and Web. The program involves weekly tailored goal-setting, team-based and individual challenges, gamification, and other opportunities for interaction. An accompanying mobile phone app supports goal-setting and activity planning. For the trial, participants were randomized by computer algorithm to start the program immediately or after a 6-month delay. The primary outcome measures are change in HbA1c and fasting glucose from baseline to 6 months. The secondary outcome measures are change in HbA1c, glucose, lipids, body mass index (BMI), weight, waist circumference, and blood pressure at 3, 6, 9, and 12 months. Randomization and delivery of the intervention are independent of clinic staff, who are blinded to treatment assignment. Outcomes will be evaluated for the intention-to-treat and per-protocol populations. A total of 340 subjects with pre-diabetes were randomized to the intervention (n=164) or delayed-entry control group (n=176). Baseline characteristics were as follows: mean age 55 (SD 8.9); mean BMI 31.1 (SD 4.3); male 68.5%; mean fasting glucose 109.9 (SD 8.4) mg/dL; and mean HbA1c 5.6 (SD 0.3)%. Data collection and analysis are in progress. We hypothesize that participants in the intervention group will achieve statistically significant reductions in fasting glucose and HbA1c as compared to the control group at 6 months post baseline. The randomized trial will provide rigorous evidence regarding the efficacy of this Web- and Internet-based program in reducing or

PAAPPAS community trial protocol: a randomized study of obesity prevention for adolescents combining school with household intervention

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Michele R. Sgambato

2016-08-01

Full Text Available Abstract Background The prevalence of childhood obesity is increasing at a high rate in Brazil, making prevention a health priority. Schools are the central focus of interventions aiming the prevention and treatment of childhood obesity, however, randomized trials and cohort studies have not yet provided clear evidence of strategies to reduce prevalence of obesity. The aim of this study is to present a protocol to evaluate the efficacy of combining school and household level interventions to reduce excessive weight gain among students. Methods The intervention target fifth and sixth graders from 18 public schools (9 interventions and 9 controls in the municipality of Duque de Caxias, metropolitan area of Rio de Janeiro, Brazil. A sample size of 2500 students will be evaluated at school for their weight status and those from the intervention group who are overweight or obese will be followed monthly at home by community health agents. Demographic, socioeconomic, anthropometric, eating behavior and food consumption data will be collected at school using a standardized questionnaire programmed in personal digital assistant. At school, all students from the intervention group will be encouraged to change eating habits and food consumption and to increase physical activity and reducing sedentary behavior. Discussion This study will provide evidence whether integration of school with primary health care can prevent excessive weight gain among adolescents. Positive results will inform a sustainable strategy to be disseminated in the health care system in Brazil. Trial registration ClinicalTrials.gov, NCT02711488 . Date of registration: March 11, 2016.

A Quantum Private Query Protocol for Enhancing both User and Database Privacy

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Zhou, Yi-Hua; Bai, Xue-Wei; Li, Lei-Lei; Shi, Wei-Min; Yang, Yu-Guang

2018-01-01

In order to protect the privacy of query user and database, some QKD-based quantum private query (QPQ) protocols were proposed. Unfortunately some of them cannot resist internal attack from database perfectly; some others can ensure better user privacy but require a reduction of database privacy. In this paper, a novel two-way QPQ protocol is proposed to ensure the privacy of both sides of communication. In our protocol, user makes initial quantum states and derives the key bit by comparing initial quantum state and outcome state returned from database by ctrl or shift mode instead of announcing two non-orthogonal qubits as others which may leak part secret information. In this way, not only the privacy of database be ensured but also user privacy is strengthened. Furthermore, our protocol can also realize the security of loss-tolerance, cheat-sensitive, and resisting JM attack etc. Supported by National Natural Science Foundation of China under Grant Nos. U1636106, 61572053, 61472048, 61602019, 61502016; Beijing Natural Science Foundation under Grant Nos. 4152038, 4162005; Basic Research Fund of Beijing University of Technology (No. X4007999201501); The Scientific Research Common Program of Beijing Municipal Commission of Education under Grant No. KM201510005016

A randomized efficacy trial of a cognitive-behavioral group intervention to prevent Internet Use Disorder onset in adolescents: The PROTECT study protocol.

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Lindenberg, Katajun; Halasy, Katharina; Schoenmaekers, Sophie

2017-06-01

The reduction of prevalence rates of Internet Use Disorder (IUD) and its effective treatment are at high priority in both public health and educational policies. School-based preventive interventions facilitate a low-threshold approach for individuals with IUD, who are typically characterized by high therapy avoidance. Moreover, indicated approaches which target adolescents at high-risk show larger effects than universal prevention programs. Simultaneously, they reduce unnecessary burden for the majority of high-school students that is not at-risk. The PROTECT group intervention for indicated prevention of IUD in school settings was developed based on these preventive strategies. Three-hundred and forty adolescents, aged 12-18 years, from 40 secondary schools in Germany, screened for high-risk of IUD onset, are randomly assigned to a) PROTECT preventive intervention group or b) assessment only control group. The tested intervention consists of a cognitive-behavioral 4-session brief-protocol. Follow-up assessments are at 1, 4 and 12 months after admission. Primary outcome is the 12-months incidence rate of IUD. Secondary outcomes are the reduction of IUD and comorbid symptoms as well as the promotion of problem solving, cognitive restructuring and emotion regulation skills. The indicated preventive intervention PROTECT follows the APA-guidelines for psychological prevention, i.e., it is theory- and evidence-based and addresses both risk-reduction and strength-promotion, it considers current research and epidemiology and ethical standards such as professional secrecy and is designed as a systemic intervention at the school-level. It is expected that the intervention decreases risk of IUD onset (incidence rate). ClinicalTrials.gov: NCT02907658.

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

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Mustila Taina

2012-07-01

Full Text Available Abstract Background Prevention is considered effective in combating the obesity epidemic. Prenatal environment may increase offspring's risk for obesity. A child starts to adopt food preferences and other behavioral habits affecting weight gain during preschool years. We report the study protocol of a pragmatic lifestyle intervention aiming at primary prevention of childhood obesity. Methods/Design A non-randomized controlled pragmatic trial in maternity and child health care clinics. The control group was recruited among families who visited the same clinics one year earlier. Eligibility criteria was mother at risk for gestational diabetes: body mass index ≥ 25 kg/m2, macrosomic newborn in any previous pregnancy, immediate family history of diabetes and/or age ≥ 40 years. All maternity clinics in town involved in recruitment. The gestational intervention consisted of individual counseling on diet and physical activity by a public health nurse, and of two group counseling sessions. Intervention continues until offspring’s age of five years. An option to participate a group counseling at child’s age 1 to 2 years was offered. The intervention includes advice on healthy diet, physical activity, sedentary behavior and sleeping pattern. The main outcome measure is offspring BMI z-score and its changes by the age of six years. Discussion Early childhood is a critical time period for prevention of obesity. Pragmatic trials targeting this period are necessary in order to find effective obesity prevention programs feasible in normal health care practice. Trial registration Clinical Trials gov NCT00970710

Effects of falls prevention interventions on falls outcomes for hospitalised adults: protocol for a systematic review with meta-analysis.

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Slade, Susan C; Carey, David L; Hill, Anne-Marie; Morris, Meg E

2017-11-12

Falls are a major global public health problem and leading cause of accidental or unintentional injury and hospitalisation. Falls in hospital are associated with longer length of stay, readmissions and poor outcomes. Falls prevention is informed by knowledge of reversible falls risk factors and accurate risk identification. The extent to which hospital falls are prevented by evidence-based practice, patient self-management initiatives, environmental modifications and optimisation of falls prevention systems awaits confirmation. Published reviews have mainly evaluated community settings and residential care facilities. A better understanding of hospital falls and the most effective strategies to prevent them is vital to keeping people safe. To evaluate the effectiveness of falls prevention interventions on reducing falls in hospitalised adults (acute and subacute wards, rehabilitation, mental health, operating theatre and emergency departments). We also summarise components of effective falls prevention interventions. This protocol has been registered. The systematic review will be informed by Cochrane guidelines and reported according to the Preferred Reporting Items for Systematic review and Meta-Analysis statement. randomised controlled trials, quasi-randomised trials or controlled clinical trials that evaluate falls prevention interventions for use by hospitalised adults or employees. Electronic databases will be searched using key terms including falls, accidental falls, prevention, hospital, rehabilitation, emergency, mental health, acute and subacute. Pairs of independent reviewers will conduct all review steps. Included studies will be evaluated for risk of bias. Data for variables such as age, participant characteristics, settings and interventions will be extracted and analysed with descriptive statistics and meta-analysis where possible. The results will be presented textually, with flow charts, summary tables, statistical analysis (and meta

Preventing transfusion-associated graft-versus-host disease: state of the art

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Fast LD

2015-01-01

Full Text Available Loren D Fast Division of Hematology/Oncology, Rhode Island Hospital and Warren Alpert School of Medicine at Brown University, Providence, RI, USA Abstract: The transfer of pathogens and the induction of immune responses are deleterious consequences that can result from the transfusion of blood products. Transfusion-associated graft-versus-host disease (TA-GVHD, the most severe immune consequence, occurs when recipient immune responses are incapable of effectively eliminating donor leukocytes, permitting unabated responses of the donor T lymphocytes. Currently, prevention of TA-GVHD is routinely accomplished by exposing blood products to γ-irradiation in order to prevent donor T cell proliferation. Alternative protocols are being developed to meet the challenges associated with the use of γ-irradiation. Use of pathogen reduction protocols, which interfere with nucleic acid replication by modifying nucleic acids, are increasing. Comparison of pathogen reduction protocols with γ-irradiation have found that both protocols are equally effective in preventing T lymphocyte proliferation and GVHD responses when testing in both in vitro and in vivo models. The potential use of pathogen reduction protocols to treat whole blood prior to separation into its components could provide a cost-effective method for preventing TA-GVHD in the future. Keywords: blood transfusion, GVHD, pathogen reduction, irradiation

Development and Pilot Implementation of a Search Protocol to Improve Patient Safety on a Psychiatric Inpatient Unit.

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Abela-Dimech, Frances; Johnston, Kim; Strudwick, Gillian

A mental health organization in Ontario, Canada, noted an increase in unsafe items entering locked inpatient units. The purpose of this project was to develop and implement a search protocol to improve patient, staff, and visitor safety by preventing unsafe items from entering a locked inpatient unit. Under the guidance of a clinical nurse specialist, an interprofessional team used the Failure Mode and Effects Analysis framework to identify what items were considered unsafe, how these unsafe items were entering the unit, and what strategies could be used to prevent these items from entering the unit. A standardized search protocol was identified as a strategy to prevent items from entering the unit. The standardized search protocol was developed and piloted on 1 unit. To support the search protocol, an interprofessional team created a poster using a mnemonic aid to educate patients, staff, and visitors about which items could not be brought onto the unit. Educational sessions on the search protocol were provided for staff. The difference between the number of incidents before and after the implementation of the search protocol was statistically significant. Safety on an inpatient unit was increased as incidents of unsafe items entering the unit decreased.

Evaluating Protocol Lifecycle Time Intervals in HIV/AIDS Clinical Trials

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Schouten, Jeffrey T.; Dixon, Dennis; Varghese, Suresh; Cope, Marie T.; Marci, Joe; Kagan, Jonathan M.

2014-01-01

Background Identifying efficacious interventions for the prevention and treatment of human diseases depends on the efficient development and implementation of controlled clinical trials. Essential to reducing the time and burden of completing the clinical trial lifecycle is determining which aspects take the longest, delay other stages, and may lead to better resource utilization without diminishing scientific quality, safety, or the protection of human subjects. Purpose In this study we modeled time-to-event data to explore relationships between clinical trial protocol development and implementation times, as well as identify potential correlates of prolonged development and implementation. Methods We obtained time interval and participant accrual data from 111 interventional clinical trials initiated between 2006 and 2011 by NIH’s HIV/AIDS Clinical Trials Networks. We determined the time (in days) required to complete defined phases of clinical trial protocol development and implementation. Kaplan-Meier estimates were used to assess the rates at which protocols reached specified terminal events, stratified by study purpose (therapeutic, prevention) and phase group (pilot/phase I, phase II, and phase III/ IV). We also examined several potential correlates to prolonged development and implementation intervals. Results Even though phase grouping did not determine development or implementation times of either therapeutic or prevention studies, overall we observed wide variation in protocol development times. Moreover, we detected a trend toward phase III/IV therapeutic protocols exhibiting longer developmental (median 2 ½ years) and implementation times (>3years). We also found that protocols exceeding the median number of days for completing the development interval had significantly longer implementation. Limitations The use of a relatively small set of protocols may have limited our ability to detect differences across phase groupings. Some timing effects

School-based intervention to prevent overweight and disordered eating in secondary school Malaysian adolescents: a study protocol.

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Sharif Ishak, Sharifah Intan Zainun; Chin, Yit Siew; Mohd Taib, Mohd Nasir; Mohd Shariff, Zalilah

2016-10-20

Obesity, eating disorders and unhealthy weight-loss practices have been associated with diminished growth in adolescents worldwide. Interventions that address relevant behavioural dimensions have been lacking in Malaysia. This paper describes the protocol of an integrated health education intervention namely 'Eat Right, Be Positive About Your Body and Live Actively' (EPaL), a primary prevention which aimed to promote healthy lifestyle in preventing overweight and disordered eating among secondary school adolescents aged 13-14 years old. Following quasi-experimental design, the intervention is conducted in two secondary schools located in the district of Hulu Langat, Selangor, Malaysia. Adolescents aged 13-14 years will be included in the study. A peer-education strategy is adopted to convey knowledge and teach skills relevant to achieving a healthy lifestyle. The intervention mainly promoted: healthy eating, positive body image and active lifestyle. The following parameters will be assessed: body weight, disordered eating status, stages of change (for healthy diet, breakfast, food portion size, screen viewing and physical activity), body image, health-related quality of life, self-esteem, eating and physical activity behaviours; and knowledge, attitude and practice towards a healthy lifestyle. Assessment will be conducted at three time points: baseline, post-intervention and 3-month follow-up. It is hypothesized that EPaL intervention will contribute in preventing overweight and disordered eating by giving the positive effects on body weight status, healthy lifestyle behaviour, as well as health-related quality of life of peer educators and participants. It may serve as a model for similar future interventions designed for the Malaysian community, specifically adolescents. UMIN Clinical Trial Registration UMIN000024349 (Date of registration: 11th. October 2016, retrospectively registered).

Protocol for Addressing Induced Seismicity Associated with Enhanced Geothermal Systems

Energy Technology Data Exchange (ETDEWEB)

Majer, Ernie [Office of Energy Efficiency and Renewable Energy (EERE), Washington, DC (United States); Nelson, James [Office of Energy Efficiency and Renewable Energy (EERE), Washington, DC (United States); Robertson-Tait, Ann [Office of Energy Efficiency and Renewable Energy (EERE), Washington, DC (United States); Savy, Jean [Office of Energy Efficiency and Renewable Energy (EERE), Washington, DC (United States); Wong, Ivan [Office of Energy Efficiency and Renewable Energy (EERE), Washington, DC (United States)

2012-01-01

This Protocol is a living guidance document for geothermal developers, public officials, regulators and the general public that provides a set of general guidelines detailing useful steps to evaluate and manage the effects of induced seismicity related to EGS projects.

Sibanye Methods for Prevention Packages Program Project Protocol: Pilot Study of HIV Prevention Interventions for Men Who Have Sex With Men in South Africa.

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McNaghten, Ad; Kearns, Rachel; Siegler, Aaron J; Phaswana-Mafuya, Nancy; Bekker, Linda-Gail; Stephenson, Rob; Baral, Stefan D; Brookmeyer, Ron; Yah, Clarence S; Lambert, Andrew J; Brown, Benjamin; Rosenberg, Eli; Blalock Tharp, Mondie; de Voux, Alex; Beyrer, Chris; Sullivan, Patrick S

2014-10-16

-negative men. Formative qualitative research consisted of 79 in-depth interviews, and six focus group discussions in Cape Town and Port Elizabeth. Analysis of these data has informed pilot study protocol development and has been documented in peer-reviewed manuscripts. Qualitative work regarding stigma faced by South African MSM resulted in finalized scales for use in the pilot study questionnaire. A total of 37 health care providers completed training designed to facilitate clinically and culturally competent care for MSM in the Eastern Cape. The design of a future, larger study of the HIV prevention package will be conducted at the end of the pilot study, powered to detect efficacy of the prevention package. Data from the updated mathematical model, results of the pilot study, acceptability data, and advancements in HIV prevention sciences will be considered in developing the final proposed package and study design. ClinicalTrials.gov NCT02043015; http://clinicaltrials.gov/show/NCT02043015 (Archived by WebCite at http://www.webcitation.org/6THvp7rAj).

Enhancement of a locally developed HIV prevention intervention for Hispanic/Latino MSM: A partnership of community-based organizations, a university, and the Centers for Disease Control and Prevention

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Rhodes, Scott D.; Alonzo, Jorge; Mann, Lilli; Freeman, Arin; Sun, Christina J.; Garcia, Manuel; Painter, Thomas M.

2015-01-01

Hispanic/Latino men who have sex with men (MSM) in the United States are disproportionately affected by HIV and other sexually transmitted diseases (STDs); however, no efficacious behavioral interventions are currently available for use with this vulnerable population. We describe the development and enhancement of HOLA en Grupos, a community-based behavioral HIV/STD prevention intervention for Spanish-speaking Hispanic/Latino MSM that is currently being implemented and evaluated. Our enhancement process included incorporating local data on risks and context; identifying community priorities; defining intervention core elements and key characteristics; developing a logic model; developing an intervention logo; enhancing intervention activities and materials; scripting intervention delivery; expanding the comparison intervention; and establishing a materials review committee. If efficacious, HOLA en Grupos will be the first behavioral intervention to be identified for potential use with Hispanic/Latino MSM, thereby contributing to the body of evidence-based resources that may be used for preventing HIV/STD infection among these MSM and their sex partners. PMID:26241382

The Effectiveness of Matrix Model in Relapse Prevention and Coping Skills Enhancement in Participants with Substance Dependency

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Ali Farnam

2013-05-01

Full Text Available Aim: The aim of this study was to determine the effectiveness of Matrix model in relapse prevention and enhancement of coping skills in participants with opiate substance dependency. Method: In a semi-experimental study, 23 participants with diagnosis of opiate dependency who successfully detoxified, selected by cluster random sampling and they were divided into two experimental and control groups. The experimental group received 32 sessions of Matrix model training and the control group did not receive any treatment. All subjects were assessed by alcohol abuse coping response inventory (AACRI and Morphine test before treatment, randomly during treatment, after treatment, and after 3-months follow up stage. Results: The results showed that experimental and control groups had a significant differed in relapse rates. In addition, Analysis of Covariance (ANCOVA showed a significant difference between two groups in coping skills enhancement at periods of post test and follow up. Conclusion: With consideration of the results of the present study indicated that matrix model is effective in relapse prevention and coping skills enhancement in people with opiate substance dependency.

Controlled Delegation Protocol in Mobile RFID Networks

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Yang MingHour

2010-01-01

Full Text Available To achieve off-line delegation for mobile readers, we propose a delegation protocol for mobile RFID allowing its readers access to specific tags through back-end server. That is to say, reader-tag mutual authentication can be performed without readers being connected to back-end server. Readers are also allowed off-line access to tags' data. Compared with other delegation protocols, our scheme uniquely enables back-end server to limit each reader's reading times during delegation. Even in a multireader situation, our protocol can limit reading times and reading time periods for each of them and therefore makes back-end server's delegation more flexible. Besides, our protocol can prevent authorized readers from transferring their authority to the unauthorized, declining invalid access to tags. Our scheme is proved viable and secure with GNY logic; it is against certain security threats, such as replay attacks, denial of service (DoS attacks, Man-in-the-Middle attacks, counterfeit tags, and breaches of location and data privacy. Also, the performance analysis of our protocol proves that current tags can afford the computation load required in this scheme.

SPIRIT 2013 Statement: defining standard protocol items for clinical trials.

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Chan, An-Wen; Tetzlaff, Jennifer M; Altman, Douglas G; Laupacis, Andreas; Gøtzsche, Peter C; Krle A-Jerić, Karmela; Hrobjartsson, Asbjørn; Mann, Howard; Dickersin, Kay; Berlin, Jesse A; Dore, Caroline J; Parulekar, Wendy R; Summerskill, William S M; Groves, Trish; Schulz, Kenneth F; Sox, Harold C; Rockhold, Frank W; Rennie, Drummond; Moher, David

2015-12-01

The protocol of a clinical trial serves as the foundation for study planning, conduct, reporting, and appraisal. However, trial protocols and existing protocol guidelines vary greatly in content and quality. This article describes the systematic development and scope of SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) 2013, a guideline for the minimum content of a clinical trial protocol. The 33-item SPIRIT checklist applies to protocols for all clinical trials and focuses on content rather than format. The checklist recommends a full description of what is planned; it does not prescribe how to design or conduct a trial. By providing guidance for key content, the SPIRIT recommendations aim to facilitate the drafting of high-quality protocols. Adherence to SPIRIT would also enhance the transparency and completeness of trial protocols for the benefit of investigators, trial participants, patients, sponsors, funders, research ethics committees or institutional review boards, peer reviewers, journals, trial registries, policymakers, regulators, and other key stakeholders.

Training and technical assistance to enhance capacity building between prevention research centers and their partners.

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Spadaro, Antonia J; Grunbaum, Jo Anne; Dawkins, Nicola U; Wright, Demia S; Rubel, Stephanie K; Green, Diane C; Simoes, Eduardo J

2011-05-01

The Centers for Disease Control and Prevention has administered the Prevention Research Centers Program since 1986. We quantified the number and reach of training programs across all centers, determined whether the centers' outcomes varied by characteristics of the academic institution, and explored potential benefits of training and technical assistance for academic researchers and community partners. We characterized how these activities enhanced capacity building within Prevention Research Centers and the community. The program office collected quantitative information on training across all 33 centers via its Internet-based system from April through December 2007. Qualitative data were collected from April through May 2007. We selected 9 centers each for 2 separate, semistructured, telephone interviews, 1 on training and 1 on technical assistance. Across 24 centers, 4,777 people were trained in 99 training programs in fiscal year 2007 (October 1, 2006-September 30, 2007). Nearly 30% of people trained were community members or agency representatives. Training and technical assistance activities provided opportunities to enhance community partners' capacity in areas such as conducting needs assessments and writing grants and to improve the centers' capacity for cultural competency. Both qualitative and quantitative data demonstrated that training and technical assistance activities can foster capacity building and provide a reciprocal venue to support researchers' and the community's research interests. Future evaluation could assess community and public health partners' perception of centers' training programs and technical assistance.

Development of a monitoring protocol to enhance mentoring in the IRIS REU site

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Hubenthal, M.; Brudzinski, M. R.; Colella, H.

2013-12-01

Research Experiences for Undergraduate (REU) sites pair interns with scientists expected to oversee and guide an intern's scientific research, and assist in the development of skills, knowledge, and connections that will enhance the intern's professional and personal growth. This aspect of REU sites is generally recognized as a powerful, yet complicated, component that has a strong influence on the overall success of the intern's experience. Evaluations indicate that the quality and consistency of mentoring in REU sites can be highly variable. Traditional strategies to influence mentorship generally include reading lists or short trainings at the beginning of the summer. The efficacy of these approaches is questionable. As a result many REU Site facilitators are deeply interested in the question 'How can REU programs challenge scientists to raise their participation to the level of (truly) mentoring?' The Incorporated Research Institutions for Seismology (IRIS) REU site is developing a 13-item rubric measuring research skills, and a protocol of training and intern-mentor meetings to discuss progress. The goal of the intervention is to both increase the extent to which the mentoring relationship is centered on the intern, and to enable interns and mentors to feel more effective monitoring interns' personal/professional growth. This intervention was piloted in 2011, refined, and fully implemented in 2012. During the initial week of the program, interns assess their skills, complete the rubric independently, and discuss the completed rubric with their mentor. Midway through the summer interns and mentors each review the rubric and assess the intern's skills. The intern-mentor pairs then meet to collaborate and complete the rubric together. Finally, in the last week of the program, interns and mentors independently assess the intern's skills and complete the rubric, and the pairs again meet to discuss and negotiate these independent assessments. Survey data from 2012

Web-based cognitive behavioral relapse prevention program with tailored feedback for people with methamphetamine and other drug use problems: protocol for a multicenter randomized controlled trial in Japan.

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Takano, Ayumi; Miyamoto, Yuki; Kawakami, Norito; Matsumoto, Toshihiko; Shinozaki, Tomohiro; Sugimoto, Takashi

2016-04-04

Despite the effectiveness of psychosocial programs for recovery from drug use problems, there have been challenges in implementation of treatment. Internet-based and computerized approaches have been known to be effective in treatment dissemination. The study purpose is to assess the effects of a web-based psychosocial relapse prevention program with a multicenter randomized controlled trial. Recruitment began in January 2015 for outpatient participants diagnosed with drug abuse or dependence who have used a primary abused drug in the past year at psychiatric hospitals and a clinic. Participants are randomized either to a web-based relapse prevention program or a self-monitoring group. The intervention is a web-based relapse prevention program named "e-SMARPP" that consists of six relapse prevention program modules with tailored feedback from health care professionals and 8 weeks of self-monitoring. The content is adapted from a face-to-face relapse prevention program which is based on cognitive behavioral therapy and motivational enhancement. The primary outcomes are relapse risk assessed by the Stimulant Relapse Risk Scale (baseline, 2-, 5- and 8-month) and the longest duration of consecutive abstinent days from primary abused drug during the intervention. Secondary outcomes will include motivation to change, self-efficacy for drug use and craving, abstinent days in the past 28 or 56 days, quality of life, sense of coherence, cost of substance use, medical cost, retention of treatment and use of self-help group. Completion, usability and satisfaction of the program will be also assessed to explore feasibility. This study protocol was approved by the Ethics Committee of The University of Tokyo and each recruiting hospital and clinic. To our knowledge, this study is the first clinical trial to assess the effects of a web-based therapeutic program for drug users in Japan. If successful, this program is a promising approach for drug user treatment in Japan, where the

School-based intervention to prevent overweight and disordered eating in secondary school Malaysian adolescents: a study protocol

Directory of Open Access Journals (Sweden)

Sharifah Intan Zainun Sharif Ishak

2016-10-01

Full Text Available Abstract Background Obesity, eating disorders and unhealthy weight-loss practices have been associated with diminished growth in adolescents worldwide. Interventions that address relevant behavioural dimensions have been lacking in Malaysia. This paper describes the protocol of an integrated health education intervention namely ‘Eat Right, Be Positive About Your Body and Live Actively’ (EPaL, a primary prevention which aimed to promote healthy lifestyle in preventing overweight and disordered eating among secondary school adolescents aged 13–14 years old. Methods/Design Following quasi-experimental design, the intervention is conducted in two secondary schools located in the district of Hulu Langat, Selangor, Malaysia. Adolescents aged 13–14 years will be included in the study. A peer-education strategy is adopted to convey knowledge and teach skills relevant to achieving a healthy lifestyle. The intervention mainly promoted: healthy eating, positive body image and active lifestyle. The following parameters will be assessed: body weight, disordered eating status, stages of change (for healthy diet, breakfast, food portion size, screen viewing and physical activity, body image, health-related quality of life, self-esteem, eating and physical activity behaviours; and knowledge, attitude and practice towards a healthy lifestyle. Assessment will be conducted at three time points: baseline, post-intervention and 3-month follow-up. Discussion It is hypothesized that EPaL intervention will contribute in preventing overweight and disordered eating by giving the positive effects on body weight status, healthy lifestyle behaviour, as well as health-related quality of life of peer educators and participants. It may serve as a model for similar future interventions designed for the Malaysian community, specifically adolescents. Trial registration UMIN Clinical Trial Registration UMIN000024349 (Date of registration: 11th. October 2016

Using the intervention mapping protocol to develop a community-based intervention for the prevention of childhood obesity in a multi-centre European project: the IDEFICS intervention.

Science.gov (United States)

Verbestel, Vera; De Henauw, Stefaan; Maes, Lea; Haerens, Leen; Mårild, Staffan; Eiben, Gabriele; Lissner, Lauren; Moreno, Luis A; Frauca, Natalia Lascorz; Barba, Gianvincenzo; Kovács, Eva; Konstabel, Kenn; Tornaritis, Michael; Gallois, Katharina; Hassel, Holger; De Bourdeaudhuij, Ilse

2011-08-01

The prevalence of childhood obesity has increased during the past decades and is now considered an urgent public health problem. Although stabilizing trends in obesity prevalence have been identified in parts of Europe, preventive efforts in children are still needed. Using the socio-ecological approach as the underlying theoretical perspective, the IDEFICS project aimed to develop, implement and evaluate a community-based intervention for the prevention of childhood obesity in eight European countries. The aim of the present manuscript was to describe the content and developmental process of the IDEFICS intervention. The intervention mapping protocol (IMP) was used to develop the community-based intervention for the prevention of childhood obesity in 3 to 10 years old children. It is a theory- and evidence-based tool for the structured planning and development of health promotion programs that requires the completion of six different steps. These steps were elaborated by two coordinating centers and discussed with the other participating centers until agreement was reached. Focus group research was performed in all participating centers to provide an informed basis for intervention development. The application of the IMP resulted in an overall intervention framework with ten intervention modules targeting environmental and personal factors through the family, the school and the community. The summary results of the focus group research were used to inform the development of the overall intervention. The cultural adaptation of the overall intervention was realised by using country specific focus group results. The need for cultural adaptation was considered during the entire process to improve program adoption and implementation. A plan was developed to evaluate program effectiveness and quality of implementation. The IDEFICS project developed a community-based intervention for the prevention of childhood obesity by using to the intervention mapping heuristic. The

Team Training and Institutional Protocols to Prevent Shoulder Dystocia Complications.

Science.gov (United States)

Smith, Samuel

2016-12-01

Shoulder dystocia is an obstetrical emergency that may result in significant neonatal complications. It requires rapid recognition and a coordinated response. Standardization of care, teamwork and communication, and clinical simulation are the key components of patient safety programs in obstetrics. Simulation-based team training and institutional protocols for the management of shoulder dystocia are emerging as integral components of many labor and delivery safety initiatives because of their impact on technical skills and team performance.

Achieving sink node anonymity in tactical wireless sensor networks using a reactive routing protocol

Science.gov (United States)

2017-06-01

node anonymity, base station anonymity, Wireless Sensor Networks (WSN), Mobile Ad hoc Network (MANET), Lightweight Ad hoc On-Demand – Next Generation ... Generation (LOADng) reactive-routing protocol to achieve anonymity. This modified protocol prevents an attacker from identifying the sink node without...within the constraints of WSN communication protocols, specifically IEEE 802.15.4. We use and modify the Lightweight Ad hoc On-Demand – Next Generation

Efficacy of long-acting release octreotide for preventing chemotherapy-induced diarrhoea: protocol for a systematic review.

Science.gov (United States)

Deng, Chao; Deng, Bo; Jia, Liqun; Tan, Huangying

2017-06-21

Diarrhoea is a common adverse effect induced by chemotherapy that can reduce the dose of chemotherapeutic drugs or interrupt the chemotherapy schedule. The current treatment strategies have various limitations. It has been shown that long-acting release octreotide (octreotide LAR) can decrease the occurrence and severity of diarrhoea, yet the efficacy of octreotide LAR in preventing chemotherapy-induced diarrhoea (CID) remains to be assessed. The main objective of this paper was to draw up a protocol for systematic review to evaluate the protective effects of octreotide LAR on CID. We searched Medline, EMBASE, the Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang Data and the VIP Database without language restrictions from inception until 1 September 2016. The references of relevant studies were also manually searched. Two investigators independently accessed the selected studies, extracted data and assessed the reliability of the studies. Any discrepancies were resolved by a third investigator. The effect size of the selected studies was assessed by different measures based on the type of data. The selected studies were descriptively analysed. We then chose a fixed-effect model or a random-effect model based on statistical homogeneity, and pooled data from the studies for meta-analysis, if possible. The primary outcome was the incidence of diarrhoea. The secondary outcomes were the duration of diarrhoea, incidence of diarrhoea-associated symptoms, physical function and quality of life. All statistical analyses were performed by Review Manager V.5.3. This systematic review did not require ethics approval, because it included aggregated published data, and not individual patient data. The review was published in a peer-reviewed journal. This systematic review protocol was registered with PROSPERO (registration number: CRD 42016048573). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights

Prevention of hypertension in patients with pre-hypertension: protocol for the PREVER-prevention trial

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Neto José

2011-03-01

Full Text Available Abstract Background Blood pressure (BP within pre-hypertensive levels confers higher cardiovascular risk and is an intermediate stage for full hypertension, which develops in an annual rate of 7 out of 100 individuals with 40 to 50 years of age. Non-drug interventions to prevent hypertension have had low effectiveness. In individuals with previous cardiovascular disease or diabetes, the use of BP-lowering agents reduces the incidence of major cardiovascular events. In the absence of higher baseline risk, the use of BP agents reduces the incidence of hypertension. The PREVER-prevention trial aims to investigate the efficacy, safety and feasibility of a population-based intervention to prevent the incidence of hypertension and the development of target-organ damage. Methods This is a randomized, double-blind, placebo-controlled clinical trial, with participants aged 30 to 70 years, with pre-hypertension. The trial arms will be chlorthalidone 12.5 mg plus amiloride 2.5 mg or identical placebo. The primary outcomes will be the incidence of hypertension, adverse events and development or worsening of microalbuminuria and of left ventricular hypertrophy in the EKG. The secondary outcomes will be fatal or non-fatal cardiovascular events: myocardial infarction, stroke, heart failure, evidence of new sub-clinical atherosclerosis, and sudden death. The study will last 18 months. The sample size was calculated on the basis of an incidence of hypertension of 14% in the control group, a size effect of 40%, power of 85% and P alpha of 5%, resulting in 625 participants per group. The project was approved by the Ethics committee of each participating institution. Discussion The early use of blood pressure-lowering drugs, particularly diuretics, which act on the main mechanism of blood pressure rising with age, may prevent cardiovascular events and the incidence of hypertension in individuals with hypertension. If this intervention shows to be effective and safe

A communication protocol for mobile satellite systems affected by rain attenuation

Science.gov (United States)

Lay, Norman; Dessouky, Khaled

1992-01-01

A communication protocol is described that has been developed as part of a K/Ka-band mobile terminal breadboard system to be demonstrated through NASA's Advanced Communications Technology Satellite (ACTS) in 1993. The protocol is aimed at providing the means for enhancing link availability and continuity by supporting real-time data rate selection and changes during rain events. Particular attention is given to the system architecture; types of links, connections, and packets; the protocol procedures; and design rationales.

Enhancing Network Communication in NPSNET-V Virtual Environments Using XML-Described Dynamic Behavior (DBP) Protocols

National Research Council Canada - National Science Library

Fischer, William

2001-01-01

.... Specifically, it describes design of the NPS Dynamic-Behavior-Protocol (DBP) protocols, which are multicast / unicast capable and can be added at runtime to the distributed operating environment...

Protocol to Exploit Waiting Resources for UASNs

Directory of Open Access Journals (Sweden)

Li-Ling Hung

2016-03-01

Full Text Available The transmission speed of acoustic waves in water is much slower than that of radio waves in terrestrial wireless sensor networks. Thus, the propagation delay in underwater acoustic sensor networks (UASN is much greater. Longer propagation delay leads to complicated communication and collision problems. To solve collision problems, some studies have proposed waiting mechanisms; however, long waiting mechanisms result in low bandwidth utilization. To improve throughput, this study proposes a slotted medium access control protocol to enhance bandwidth utilization in UASNs. The proposed mechanism increases communication by exploiting temporal and spatial resources that are typically idle in order to protect communication against interference. By reducing wait time, network performance and energy consumption can be improved. A performance evaluation demonstrates that when the data packets are large or sensor deployment is dense, the energy consumption of proposed protocol is less than that of existing protocols as well as the throughput is higher than that of existing protocols.

A police education programme to integrate occupational safety and HIV prevention: protocol for a modified stepped-wedge study design with parallel prospective cohorts to assess behavioural outcomes

Science.gov (United States)

Strathdee, Steffanie A; Arredondo, Jaime; Rocha, Teresita; Abramovitz, Daniela; Rolon, Maria Luisa; Patiño Mandujano, Efrain; Rangel, Maria Gudelia; Olivarria, Horcasitas Omar; Gaines, Tommi; Patterson, Thomas L; Beletsky, Leo

2015-01-01

Introduction Policing practices are key drivers of HIV among people who inject drugs (PWID). This paper describes the protocol for the first study to prospectively examine the impact of a police education programme (PEP) to align law enforcement and HIV prevention. PEPs incorporating HIV prevention (including harm reduction programmes like syringe exchange) have been successfully piloted in several countries but were limited to brief pre–post assessments; the impact of PEPs on policing behaviours and occupational safety is unknown. Objectives Proyecto ESCUDO (SHIELD) aims to evaluate the efficacy of the PEP on uptake of occupational safety procedures, as assessed through the incidence of needle stick injuries (NSIs) (primary outcome) and changes in knowledge of transmission, prevention and treatment of HIV and viral hepatitis; attitudes towards PWID, adverse behaviours that interfere with HIV prevention and protective behaviours (secondary outcomes). Methods/analysis ESCUDO is a hybrid type I design that simultaneously tests an intervention and an implementation strategy. Using a modified stepped-wedge design involving all active duty street-level police officers in Tijuana (N=∼1200), we will administer one 3 h PEP course to groups of 20–50 officers until the entire force is trained. NSI incidence and geocoded arrest data will be assessed from department-wide de-identified data. Of the consenting police officers, a subcohort (N=500) will be randomly sampled from each class to undergo pre-PEP and post-PEP surveys with a semiannual follow-up for 2 years to assess self-reported NSIs, attitudes and behaviour changes. The impact on PWIDs will be externally validated through a parallel cohort of Tijuana PWIDs. Ethics/dissemination Research ethics approval was obtained from the USA and Mexico. Findings will be disseminated through open access to protocol materials through the Law Enforcement and HIV Network. Trial registration number NCT02444403. PMID:26260350

Effectiveness of the home-based alcohol prevention program "In control: No alcohol!": study protocol of a randomized controlled trial

Directory of Open Access Journals (Sweden)

Verdurmen Jacqueline EE

2011-08-01

Full Text Available Abstract Background In the Netherlands, children start to drink at an early age; of the Dutch 12-year olds, 40% reports lifetime alcohol use, while 9.7% reports last-month drinking. Starting to drink at an early age puts youth at risk of developing several alcohol-related problems later in life. Recently, a home-based prevention program called "In control: No alcohol!" was developed to delay the age of alcohol onset in children. The main aim of this project is to conduct a Randomized Controlled Trial (RCT to evaluate the effectiveness of the program. Methods/Design The prevention program will be tested with an RCT among mothers and their 6 grade primary school children (11-12 years old, randomly assigned to the prevention or control condition. The program consists of five printed magazines and an activity book designed to improve parental alcohol-specific socialization. Parent-child dyads in the control group receive a factsheet information brochure, which is the standard alcohol brochure of the Trimbos Institute (the Netherlands Institute for Mental Health and Addiction. Outcome measures are initiation of alcohol use (have been drinking at least one glass of alcohol, alcohol-specific parenting, susceptibility to drinking alcohol, alcohol expectancies, self-efficacy, and frequency and intensity of child alcohol use. Questionnaires will be administered online on secured Internet webpages, with personal login codes for both mothers and children. Mothers and children in both the experimental and control condition will be surveyed at baseline and after 6, 12, and 18 months (follow-ups. Discussion The present study protocol presents the design of an RCT evaluating the effectiveness of the home-based "In control: No alcohol!" program for 6 grade primary school children (11-12 years old. It is hypothesized that children in the prevention condition will be less likely to have their first glass of alcohol, compared to the control condition. When the

Design and Analysis of an Enhanced Patient-Server Mutual Authentication Protocol for Telecare Medical Information System.

Science.gov (United States)

Amin, Ruhul; Islam, S K Hafizul; Biswas, G P; Khan, Muhammad Khurram; Obaidat, Mohammad S

2015-11-01

In order to access remote medical server, generally the patients utilize smart card to login to the server. It has been observed that most of the user (patient) authentication protocols suffer from smart card stolen attack that means the attacker can mount several common attacks after extracting smart card information. Recently, Lu et al.'s proposes a session key agreement protocol between the patient and remote medical server and claims that the same protocol is secure against relevant security attacks. However, this paper presents several security attacks on Lu et al.'s protocol such as identity trace attack, new smart card issue attack, patient impersonation attack and medical server impersonation attack. In order to fix the mentioned security pitfalls including smart card stolen attack, this paper proposes an efficient remote mutual authentication protocol using smart card. We have then simulated the proposed protocol using widely-accepted AVISPA simulation tool whose results make certain that the same protocol is secure against active and passive attacks including replay and man-in-the-middle attacks. Moreover, the rigorous security analysis proves that the proposed protocol provides strong security protection on the relevant security attacks including smart card stolen attack. We compare the proposed scheme with several related schemes in terms of computation cost and communication cost as well as security functionalities. It has been observed that the proposed scheme is comparatively better than related existing schemes.

An Evaluation of Protocols for UAV Science Applications

Science.gov (United States)

Ivancic, William D.; Stewart, David E.; Sullivan, Donald V.; Finch, Patrick E.

2012-01-01

This paper identifies data transport needs for current and future science payloads deployed on the NASA Global Hawk Unmanned Aeronautical Vehicle (UAV). The NASA Global Hawk communication system and operational constrains are presented. The Genesis and Rapid Intensification Processes (GRIP) mission is used to provide the baseline communication requirements as a variety of payloads were utilized in this mission. User needs and desires are addressed. Protocols are matched to the payload needs and an evaluation of various techniques and tradeoffs are presented. Such techniques include utilization rate-base selective negative acknowledgement protocols and possible use of protocol enhancing proxies. Tradeoffs of communication architectures that address ease-of-use and security considerations are also presented.

Rationale, design, and protocol for the prevention of low back pain in the military (POLM trial (NCT00373009

Directory of Open Access Journals (Sweden)

Dugan Jessica L

2007-09-01

. Soldiers will receive a monthly email that queries whether any LBP was experienced in the previous calendar month. Soldiers reporting LBP will enter episode-specific data related to pain intensity, pain-related disability, fear-avoidance beliefs, and pain catastrophizing. We are hypothesizing that Soldiers receiving the CSEP and PSEP will report the longest duration to first episode of LBP, the lowest frequency of LBP, and the lowest severity of LBP episodes. Statistical comparisons will be made between each of the randomly assigned prevention programs to test our hypotheses related to determining which of the 4 programs is most effective. Discussion We have presented the design and protocol for the POLM trial. Completion of this trial will provide important information on how to effectively train Soldiers for the prevention of LBP. Trial registration NCT00373009

The research and application of the NDP protocol vulnerability attack and the defense technology based on SEND

Science.gov (United States)

Xi, Huixing

2017-05-01

Neighbor discovery protocol (NDP) is the underlying protocol in the IPv6 protocol, which is mainly used to solve the problem of interconnection between nodes on the same link. But with wide use of IPV6, NDP becomes the main objects of a variety of attacks due to a lack of security mechanism. The paper introduces the working principle of the NDP and methods of how the SEND protocol to enhance NDP security defense. It also analyzes and summarizes the security threats caused by the defects of the protocol itself. On the basis of the SEND protocol, the NDP data packet structure is modified to enhance the security of the SEND. An improved NDP cheating defense technology is put forward to make up the defects of the SEND protocol which can't verify the correctness of the public key and cannot bind the MAC address.

Prevention and assessment of infectious diseases among children and adult migrants arriving to the European Union/European Economic Association: a protocol for a suite of systematic reviews for public health and health systems.

Science.gov (United States)

Pottie, Kevin; Mayhew, Alain D; Morton, Rachael L; Greenaway, Christina; Akl, Elie A; Rahman, Prinon; Zenner, Dominik; Pareek, Manish; Tugwell, Peter; Welch, Vivian; Meerpohl, Joerg; Alonso-Coello, Pablo; Hui, Charles; Biggs, Beverley-Ann; Requena-Méndez, Ana; Agbata, Eric; Noori, Teymur; Schünemann, Holger J

2017-09-11

The European Centre for Disease Prevention and Control is developing evidence-based guidance for voluntary screening, treatment and vaccine prevention of infectious diseases for newly arriving migrants to the European Union/European Economic Area. The objective of this systematic review protocol is to guide the identification, appraisal and synthesis of the best available evidence on prevention and assessment of the following priority infectious diseases: tuberculosis, HIV, hepatitis B, hepatitis C, measles, mumps, rubella, diphtheria, tetanus, pertussis, poliomyelitis (polio), Haemophilus influenza disease, strongyloidiasis and schistosomiasis. The search strategy will identify evidence from existing systematic reviews and then update the effectiveness and cost-effectiveness evidence using prospective trials, economic evaluations and/or recently published systematic reviews. Interdisciplinary teams have designed logic models to help define study inclusion and exclusion criteria, guiding the search strategy and identifying relevant outcomes. We will assess the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. There are no ethical or safety issues. We anticipate disseminating the findings through open-access publications, conference abstracts and presentations. We plan to publish technical syntheses as GRADEpro evidence summaries and the systematic reviews as part of a special edition open-access publication on refugee health. We are following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols reporting guideline. This protocol is registered in PROSPERO: CRD42016045798. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A pressure ulcer prevention programme specially designed for nursing homes: does it work?

Science.gov (United States)

Kwong, Enid W-Y; Lau, Ada T-Y; Lee, Rainbow L-P; Kwan, Rick Y-C

2011-10-01

The aim of this study was to evaluate a pressure ulcer prevention programme for nursing homes to ascertain the feasibility of its implementation, impact on care staff and outcomes for pressure ulcer knowledge and skills and pressure ulcer reduction. No pressure ulcer prevention protocol for long-term care settings has been established to date. The first author of this study thus developed a pressure ulcer prevention programme for nursing homes. A quasi-experimental pretest and post-test design was adopted. Forty-one non-licensed care providers and eleven nurses from a government-subsidised nursing home voluntarily participated in the study. Knowledge and skills of the non-licensed care providers were assessed before, immediately after and six weeks after the training course, and pressure ulcer prevalence and incidence were recorded before and during the protocol implementation. At the end of the programme implementation, focus group interviews with the subjects were conducted to explore their views on the programme. A statistically significant improvement in knowledge and skills scores amongst non-licensed care providers was noted. Pressure ulcer prevalence and incidence rates dropped from 9-2·5% and 2·5-0·8%, respectively, after programme implementation. The focus group findings indicated that the programme enhanced the motivation of non-licensed care providers to improve their performance of pressure ulcer prevention care and increased communication and cooperation amongst care staff, but use of the modified Braden scale was considered by nurses to increase their workload. A pressure ulcer prevention programme for nursing homes, which was feasible and acceptable, with positive impact and outcome in a nursing home was empirically developed. The study findings can be employed to modify the programme and its outcomes for an evaluation of effectiveness of the programme through a randomised controlled trial. © 2011 Blackwell Publishing Ltd.

A Secure ECC-based RFID Mutual Authentication Protocol to Enhance Patient Medication Safety.

Science.gov (United States)

Jin, Chunhua; Xu, Chunxiang; Zhang, Xiaojun; Li, Fagen

2016-01-01

Patient medication safety is an important issue in patient medication systems. In order to prevent medication errors, integrating Radio Frequency Identification (RFID) technology into automated patient medication systems is required in hospitals. Based on RFID technology, such systems can provide medical evidence for patients' prescriptions and medicine doses, etc. Due to the mutual authentication between the medication server and the tag, RFID authentication scheme is the best choice for automated patient medication systems. In this paper, we present a RFID mutual authentication scheme based on elliptic curve cryptography (ECC) to enhance patient medication safety. Our scheme can achieve security requirements and overcome various attacks existing in other schemes. In addition, our scheme has better performance in terms of computational cost and communication overhead. Therefore, the proposed scheme is well suitable for patient medication systems.

Study of Mobility Enhancements for RPL in Convergecast Scenarios

Directory of Open Access Journals (Sweden)

Jinpeng Wang

2017-11-01

Full Text Available In recent years, mobility support has become an important requirement in various wireless sensor network (WSN applications. However, due to the strict resource constraints of power, memory, and processing resources in WSNs, routing protocols are mainly designed without considering mobility. Low-Power and Lossy Networks (LLNs are a special type of WSNs that tolerate data loss. The Routing Protocol for Low-Power and Lossy Networks (RPL is a routing protocol for LLNs that adapts IPv6 (Internet Protocol version 6 and runs on top of the IEEE (Institute of Electrical and Electronics Engineers 802.15.4 standard. RPL supports multipoint-to-point traffic and point-to-multipoint traffic. In this paper we propose a mobility enhancement mechanism in order to improve data collection applications in highly mobile scenarios. The enhancement is based on signal strength monitoring and depth updating in order to improve the routing protocol performance in mobile scenarios. This enhancement helps routing protocols to cope better with topology changes and makes proactive decisions on updating next-hop neighbours. We integrated this mechanism into the RPL and compared it with other existing RPL mobility support enhancements. Results obtained through simulation using Cooja show that our work outperforms other existing RPL mobility supports on different performance metrics. Results also prove the efficiency of our proposal in highly mobile scenarios.

Reducing cannabinoid abuse and preventing relapse by enhancing endogenous brain levels of kynurenic acid

Science.gov (United States)

Justinova, Zuzana; Mascia, Paola; Wu, Hui-Qiu; Secci, Maria E.; Redhi, Godfrey H.; Panlilio, Leigh V.; Scherma, Maria; Barnes, Chanel; Parashos, Alexandra; Zara, Tamara; Fratta, Walter; Solinas, Marcello; Pistis, Marco; Bergman, Jack; Kangas, Brian D.; Ferré, Sergi; Tanda, Gianluigi; Schwarcz, Robert; Goldberg, Steven R.

2013-01-01

In the reward circuitry of the brain, alpha-7-nicotinic acetylcholine receptors (α7nAChRs) modulate effects of delta-9-tetrahydrocannabinol (THC), marijuana’s main psychoactive ingredient. Kynurenic acid (KYNA) is an endogenous negative allosteric modulator of α7nAChRs. Here we report that the kynurenine 3-monooxygenase (KMO) inhibitor Ro 61-8048 increases brain KYNA levels and attenuates cannabinoid-induced increases in extracellular dopamine in reward-related brain areas. In the self-administration model of drug abuse, Ro 61-8048 reduced the rewarding effects of THC and the synthetic cannabinoid WIN 55,212-2 in squirrel monkeys and rats, respectively, and it also prevented relapse to drug-seeking induced by re-exposure to cannabinoids or cannabinoid-associated cues. The effects of enhancing endogenous KYNA levels with Ro 61-8048 were prevented by positive allosteric modulators of α7nAChRs. Despite a clear need, there are currently no medications approved for treatment of marijuana dependence. Modulation of KYNA provides a novel pharmacological strategy for achieving abstinence from marijuana and preventing relapse. PMID:24121737

Working With Parents to Prevent Childhood Obesity: Protocol for a Primary Care-Based eHealth Study.

Science.gov (United States)

Avis, Jillian Ls; Cave, Andrew L; Donaldson, Stephanie; Ellendt, Carol; Holt, Nicholas L; Jelinski, Susan; Martz, Patricia; Maximova, Katerina; Padwal, Raj; Wild, T Cameron; Ball, Geoff Dc

2015-03-25

Parents play a central role in preventing childhood obesity. There is a need for innovative, scalable, and evidence-based interventions designed to enhance parents' motivation to support and sustain healthy lifestyle behaviors in their children, which can facilitate obesity prevention. (1) Develop an online screening, brief intervention, and referral to treatment (SBIRT) eHealth tool to enhance parents' concern for, and motivation to, support children's healthy lifestyle behaviors, (2) refine the SBIRT eHealth tool by assessing end-user acceptability, satisfaction, and usability through focus groups, and (3) determine feasibility and preliminary effectiveness of the refined SBIRT eHealth tool through a randomized controlled trial. This is a three-phase, multi-method study that includes SBIRT eHealth tool development (Phase I), refinement (Phase II), and testing (Phase III). Phase I: Theoretical underpinnings of the SBIRT tool, entitled the Resource Information Program for Parents on Lifestyle and Education (RIPPLE), will be informed by concepts applied within existing interventions, and content will be based on literature regarding healthy lifestyle behaviors in children. The SBIRT platform will be developed in partnership between our research team and a third-party intervention development company. Phase II: Focus groups with parents, as well as health care professionals, researchers, and trainees in pediatrics (n=30), will explore intervention-related perceptions and preferences. Qualitative data from the focus groups will inform refinements to the aesthetics, content, structure, and function of the SBIRT. Phase III: Parents (n=200) of children-boys and girls, 5 to 17 years old-will be recruited from a primary care pediatric clinic while they await their children's clinical appointment. Parents will be randomly assigned to one of five groups-four intervention groups and one control group-as they complete the SBIRT. The randomization function is built into the

Dual watermarking scheme for secure buyer-seller watermarking protocol

Science.gov (United States)

Mehra, Neelesh; Shandilya, Madhu

2012-04-01

A buyer-seller watermarking protocol utilize watermarking along with cryptography for copyright and copy protection for the seller and meanwhile it also preserve buyers rights for privacy. It enables a seller to successfully identify a malicious seller from a pirated copy, while preventing the seller from framing an innocent buyer and provide anonymity to buyer. Up to now many buyer-seller watermarking protocols have been proposed which utilize more and more cryptographic scheme to solve many common problems such as customer's rights, unbinding problem, buyer's anonymity problem and buyer's participation in the dispute resolution. But most of them are infeasible since the buyer may not have knowledge of cryptography. Another issue is the number of steps to complete the protocols are large, a buyer needs to interact with different parties many times in these protocols, which is very inconvenient for buyer. To overcome these drawbacks, in this paper we proposed dual watermarking scheme in encrypted domain. Since neither of watermark has been generated by buyer so a general layman buyer can use the protocol.

Reading the Kyoto Protocol. Ethical aspects of the convention on climate change

International Nuclear Information System (INIS)

Vermeersch, E.; Weiler, R.; Petrella, R.; Krause, F.; Sachs, W.; Zwart, H.; Keulartz, J.

2005-01-01

The Kyoto Protocol to the United Nations Framework Convention on Climate Change aims to reduce greenhouse gas emissions by urging the international community to take measures preventing 'dangerous man-made interference with the climate system'. Since its publication in 1997, the Kyoto Protocol has triggered heated debates among scientists and politicians. According to a number of critics, the questions as to whether global warming is caused by human intervention, and whether taking appropriate measures could reduce the trend, has not yet been conclusively answered. In a limited number of countries, this situation has led to a delay in the ratification process. Only when these disputes were settled in February 2005 the Kyoto Protocol became legally binding on all the signatories. If predictions are accurate, measures have to be taken to prevent a global catastrophe. This leads to another, much overlooked, but no less important question, namely how mankind can be motivated to accept the burden attached to the measures proposed by the Kyoto Protocol; in other words, how do we find and formulate an ethical basis for measures forcing us to sacrifice some of our wealth and riches, for a cleaner, more sustainable world?

Health coaching and pedometers to enhance physical activity and prevent falls in community-dwelling people aged 60 years and over: study protocol for the Coaching for Healthy AGEing (CHAnGE) cluster randomised controlled trial.

Science.gov (United States)

Tiedemann, Anne; Rissel, Chris; Howard, Kirsten; Tong, Allison; Merom, Dafna; Smith, Stuart; Wickham, James; Bauman, Adrian; Lord, Stephen R; Vogler, Constance; Lindley, Richard I; Simpson, Judy M; Allman-Farinelli, Margaret; Sherrington, Catherine

2016-05-10

Prevention of falls and promotion of physical activity are essential for maximising well-being in older age. However, there is evidence that promoting physical activity among older people without providing fall prevention advice may increase fall rates. This trial aims to establish the impact of a physical activity and fall prevention programme compared with a healthy eating programme on physical activity and falls among people aged 60+ years. This cluster randomised controlled trial will involve 60 groups of community-dwelling people aged 60+ years. Participating groups will be randomised to: (1) a physical activity and fall prevention intervention (30 groups), involving written information, fall risk assessment and prevention advice, a pedometer-based physical activity tracker and telephone-based health coaching; or (2) a healthy eating intervention (30 groups) involving written information and telephone-based dietary coaching. Primary outcomes will be objectively measured physical activity at 12 months post-randomisation and self-reported falls throughout the 12-month trial period. Secondary outcomes include: the proportion of fallers, the proportion of people meeting the Australian physical activity guidelines, body mass index, eating habits, mobility goal attainment, mobility-related confidence, quality of life, fear of falling, risk-taking behaviour, mood, well-being, self-reported physical activity, disability, and health and community service use. The between-group difference in the number of falls per person-year will be analysed using negative binomial regression models. For the continuously scored primary and secondary outcome measures, linear regression adjusted for corresponding baseline scores will assess the effect of group allocation. Analyses will be preplanned, conducted while masked to group allocation, will take into account cluster randomisation, and will use an intention-to-treat approach. Protocol has been approved by the Human Research

Taking the Politics Out of Satellite and Space-Based Communications Protocols

Science.gov (United States)

Ivancic, William D.

2006-01-01

After many years of studies, experimentation, and deployment, large amounts of misinformation and misconceptions remain regarding applicability of various communications protocols for use in satellite and space-based networks. This paper attempts to remove much of the politics, misconceptions, and misinformation that have plagued spacebased communications protocol development and deployment. This paper provides a common vocabulary for communications; a general discussion of the requirements for various communication environments; an evaluation of tradeoffs between circuit and packet-switching technologies, and the pros and cons of various link, network, transport, application, and security protocols. Included is the applicability of protocol enhancing proxies to NASA, Department of Defense (DOD), and commercial space communication systems.

Pulmonary CT angiography protocol adapted to the hemodynamic effects of pregnancy.

LENUS (Irish Health Repository)

Ridge, Carole A

2012-02-01

OBJECTIVE: The purpose of this study was to compare the image quality of a standard pulmonary CT angiography (CTA) protocol with a pulmonary CTA protocol optimized for use in pregnant patients with suspected pulmonary embolism (PE). MATERIALS AND METHODS: Forty-five consecutive pregnant patients with suspected PE were retrospectively included in the study: 25 patients (group A) underwent standard-protocol pulmonary CTA and 20 patients (group B) were imaged using a protocol modified for pregnancy. The modified protocol used a shallow inspiration breath-hold and a high concentration, high rate of injection, and high volume of contrast material. Objective image quality and subjective image quality were evaluated by measuring pulmonary arterial enhancement, determining whether there was transient interruption of the contrast bolus by unopacified blood from the inferior vena cava (IVC), and assessing diagnostic adequacy. RESULTS: Objective and subjective image quality were significantly better for group B-that is, for the group who underwent the CTA protocol optimized for pregnancy. Mean pulmonary arterial enhancement and the percentage of studies characterized as adequate for diagnosis were higher in group B than in group A: 321 +\\/- 148 HU (SD) versus 178 +\\/- 67 HU (p = 0.0001) and 90% versus 64% (p = 0.05), respectively. Transient interruption of contrast material by unopacified blood from the IVC was observed more frequently in group A (39%) than in group B (10%) (p = 0.05). CONCLUSION: A pulmonary CTA protocol optimized for pregnancy significantly improved image quality by increasing pulmonary arterial opacification, improving diagnostic adequacy, and decreasing transient interruption of the contrast bolus by unopacified blood from the IVC.

Enhanced invitation methods to increase uptake of NHS health checks: study protocol for a randomized controlled trial

OpenAIRE

Forster, Alice S; Burgess, Caroline; McDermott, Lisa; Wright, Alison J; Dodhia, Hiten; Conner, Mark; Miller, Jane; Rudisill, Caroline; Cornelius, Victoria; Gulliford, Martin C

2014-01-01

Background NHS Health Checks is a new program for primary prevention of heart disease, stroke, diabetes, chronic kidney disease, and vascular dementia in adults aged 40 to 74 years in England. Individuals without existing cardiovascular disease or diabetes are invited for a Health Check every 5 years. Uptake among those invited is lower than anticipated. Method The project is a three-arm randomized controlled trial to test the hypothesis that enhanced invitation methods, using the Question-Be...

IoT real time data acquisition using MQTT protocol

Science.gov (United States)

Atmoko, R. A.; Riantini, R.; Hasin, M. K.

2017-05-01

The Internet of Things (IoT) provides ease to monitor and to gain sensor data through the Internet [1]. The need of high quality data is increasing to the extent that data monitoring and acquisition system in real time is required, such as smart city or telediagnostic in medical areas [2]. Therefore, an appropriate communication protocol is required to resolve these problems. Lately, researchers have developed a lot of communication protocols for IoT, of which each has advantages and disadvantages. This study proposes the utilization of MQTT as a communication protocol, which is one of data communication protocols for IoT. This study used temperature and humidity sensors because the physical parameters are often needed as parameters of environment condition [3]. Data acquisition was done in real-time and stored in MySQL database. This study is also completed by interface web-based and mobile for online monitoring. This result of this study is the enhancement of data quality and reliability using MQTT protocol.

Virus-like particle vaccine primes immune responses preventing inactivated-virus vaccine-enhanced disease against respiratory syncytial virus.

Science.gov (United States)

Hwang, Hye Suk; Lee, Young-Tae; Kim, Ki-Hye; Ko, Eun-Ju; Lee, Youri; Kwon, Young-Man; Kang, Sang-Moo

2017-11-01

Formalin inactivated respiratory syncytial virus (FI-RSV) vaccination caused vaccine-enhanced respiratory disease (ERD) upon exposure to RSV in children. Virus-like particles presenting RSV F fusion protein (F VLP) are known to increase T helper type-1 (Th1) immune responses and avoid ERD in animal models. We hypothesized that F VLP would prime immune responses preventing ERD upon subsequent exposure to ERD-prone FI-RSV. Here, we demonstrated that heterologous F VLP priming and FI-RSV boosting of mice prevented FI-RSV vaccine-enhanced lung inflammation and eosinophilia upon RSV challenge. F VLP priming redirected pulmonary T cells toward effector CD8 T cells producing Th1 cytokines and significantly suppressed pulmonary Th2 cytokines. This study suggests that RSV F VLP priming would modulate and shift immune responses to subsequent exposure to ERD-prone FI-RSV vaccine and RSV infection, suppressing Th2 immune-mediated pulmonary histopathology and eosinophilia. Copyright © 2017. Published by Elsevier Inc.

Implementation of a split-bolus single-pass CT protocol at a UK major trauma centre to reduce excess radiation dose in trauma pan-CT

International Nuclear Information System (INIS)

Leung, V.; Sastry, A.; Woo, T.D.; Jones, H.R.

2015-01-01

Aim: To quantify the dose reduction and ensure that the use of a split-bolus protocol provided sufficient vascular enhancement. Materials and methods: Between 1 January 2014 and 31 May 2014, both split bolus and traditional two-phase scans were performed on a single CT scanner (SOMATOM Definition AS+, Siemens Healthcare) using a two-pump injector (Medrad Stellant). Both protocols used Siemens' proprietary tube current and tube voltage modulation techniques (CARE dose and CARE kV). The protocols were compared retrospectively to assess the dose–length product (DLP), aortic radiodensity at the level of the coeliac axis and radiodensity of the portal vein. Results: There were 151 trauma CT examinations during this period. Seventy-eight used the split-bolus protocol. Seventy-one had traditional two-phase imaging. One patient was excluded as they were under the age of 18 years. The radiodensity measurements for the portal vein were significantly higher (p<0.001) in the split-bolus protocol. The mean aortic enhancement in both protocols exceeded 250 HU, although the traditional two-phase protocol gave greater arterial enhancement (p<0.001) than the split-bolus protocol. The split-bolus protocol had a significantly lower (p<0.001) DLP with 43.5% reduction in the mean DLP compared to the traditional protocol. Conclusion: Split-bolus CT imaging offers significant dose reduction for this relatively young population while retaining both arterial and venous enhancement. -- Highlights: •We implemented a split bolus pan-CT protocol for trauma CT. •We compared the radiation dose and vascular enhancement of the split bolus protocol to a traditional two phase protocol. •The split bolus protocol had a 43.5% reduction in mean DLP

Enhanced surveillance of Staphylococcus aureus bacteraemia to identify targets for infection prevention.

Science.gov (United States)

Morris, A K; Russell, C D

2016-06-01

Surveillance of Staphylococcus aureus bacteraemia (SAB) in Scotland is limited to the number of infections per 100,000 acute occupied bed-days and susceptibility to meticillin. To demonstrate the value of enhanced SAB surveillance to identify targets for infection prevention. Prospective cohort study of all patients identified with SAB over a five-year period in a single health board in Scotland. All patients were reviewed at the bedside by a clinical microbiologist. In all, 556 SAB episodes were identified: 261 (46.6%) were hospital-acquired; 209 (37.9%) were healthcare-associated; 80 (14.4%) were community-acquired; and in six (1.1%) the origin of infection was not hospital-acquired, but could not be separated into healthcare-associated or community-acquired. These were classified as non-hospital-acquired. Meticillin-resistant S. aureus (MRSA) bacteraemia was associated with hospital-acquired and healthcare-associated infections. In addition, there was a significantly higher 30-day mortality associated with hospital-acquired (31.4%) and healthcare-associated (16.3%) infections compared to community-acquired SAB (8.7%). Vascular access devices were associated with hospital-acquired SAB and peripheral venous cannulas were the source for most of these (43.9%). Community-acquired infections were associated with intravenous drug misuse, respiratory tract infections and skeletal and joint infections. Skin and soft tissue infections were more widely seen in healthcare-associated infections. The data indicate that enhanced surveillance of SAB by origin of infection and source of bacteraemia has implications for infection prevention, empirical antibiotic therapy, and health improvement interventions. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Intracellular Methamphetamine Prevents the Dopamine-induced Enhancement of Neuronal Firing*

Science.gov (United States)

Saha, Kaustuv; Sambo, Danielle; Richardson, Ben D.; Lin, Landon M.; Butler, Brittany; Villarroel, Laura; Khoshbouei, Habibeh

2014-01-01

The dysregulation of the dopaminergic system is implicated in multiple neurological and neuropsychiatric disorders such as Parkinson disease and drug addiction. The primary target of psychostimulants such as amphetamine and methamphetamine is the dopamine transporter (DAT), the major regulator of extracellular dopamine levels in the brain. However, the behavioral and neurophysiological correlates of methamphetamine and amphetamine administration are unique from one another, thereby suggesting these two compounds impact dopaminergic neurotransmission differentially. We further examined the unique mechanisms by which amphetamine and methamphetamine regulate DAT function and dopamine neurotransmission; in the present study we examined the impact of extracellular and intracellular amphetamine and methamphetamine on the spontaneous firing of cultured midbrain dopaminergic neurons and isolated DAT-mediated current. In dopaminergic neurons the spontaneous firing rate was enhanced by extracellular application of amphetamine > dopamine > methamphetamine and was DAT-dependent. Amphetamine > methamphetamine similarly enhanced DAT-mediated inward current, which was sensitive to isosmotic substitution of Na+ or Cl− ion. Although isosmotic substitution of extracellular Na+ ions blocked amphetamine and methamphetamine-induced DAT-mediated inward current similarly, the removal of extracellular Cl− ions preferentially blocked amphetamine-induced inward current. The intracellular application of methamphetamine, but not amphetamine, prevented the dopamine-induced increase in the spontaneous firing of dopaminergic neurons and the corresponding DAT-mediated inward current. The results reveal a new mechanism for methamphetamine-induced dysregulation of dopaminergic neurons. PMID:24962577

Tachikawa project for prevention of posttraumatic stress disorder with polyunsaturated fatty acid (TPOP): study protocol for a randomized controlled trial.

Science.gov (United States)

Matsuoka, Yutaka; Nishi, Daisuke; Yonemoto, Naohiro; Hamazaki, Kei; Matsumura, Kenta; Noguchi, Hiroko; Hashimoto, Kenji; Hamazaki, Tomohito

2013-01-05

Preclinical and clinical studies suggest that supplementation with omega-3 fatty acids after trauma might reduce subsequent posttraumatic stress disorder (PTSD). To date, we have shown in an open trial that PTSD symptoms in critically injured patients can be reduced by taking omega-3 fatty acids, hypothesized to stimulate hippocampal neurogenesis. The primary aim of the present randomized controlled trial is to examine the efficacy of omega-3 fatty acid supplementation in the secondary prevention of PTSD following accidental injury, as compared with placebo. This paper describes the rationale and protocol of this trial. The Tachikawa Project for Prevention of Posttraumatic Stress Disorder with Polyunsaturated Fatty Acid (TPOP) is a double-blinded, parallel group, randomized controlled trial to assess whether omega-3 fatty acid supplementation can prevent PTSD symptoms among accident-injured patients consecutively admitted to an intensive care unit. We plan to recruit accident-injured patients and follow them prospectively for 12 weeks. Enrolled patients will be randomized to either the omega-3 fatty acid supplement group (1,470 mg docosahexaenoic acid and 147 mg eicosapentaenoic acid daily) or placebo group. Primary outcome is score on the Clinician-Administered PTSD Scale (CAPS). We will need to randomize 140 injured patients to have 90% power to detect a 10-point difference in mean CAPS scores with omega-3 fatty acid supplementation compared with placebo. Secondary measures are diagnosis of PTSD and major depressive disorder, depressive symptoms, physiologic response in the experiment using script-driven imagery and acoustic stimulation, serum brain-derived neurotrophic factor, health-related quality of life, resilience, and aggression. Analyses will be by intent to treat. The trial was initiated on December 13 2008, with 104 subjects randomized by November 30 2012. This study promises to be the first trial to provide a novel prevention strategy for PTSD among

Cynodon dactylon extract as a preventive and curative agent in experimentally induced nephrolithiasis.

Science.gov (United States)

Atmani, F; Sadki, C; Aziz, M; Mimouni, M; Hacht, B

2009-04-01

Cynodon dactylon (Poaceae family) decoction was used in the treatment of kidney stones. However, no scientific study was undertaken so far to demonstrate the beneficial effect of the plant. Thus, the aim of the current study is to evaluate the effect of Cynodon aqueous extract as a preventive and curative agent in experimentally induced nephrolithiasis in a rat model. Ethylene glycol (EG) was used in the experiment to induce calcium oxalate (CaOx) deposition into kidneys. In preventive protocol, Cynodon decoction was administered in the same day with EG to evaluate the ability of the extract to prevent crystal deposition. However, in curative protocol, rats were first rendered nephrolithiasic and then the extract was administered to assess the ability of the plant to eliminate the pre-existing crystal deposition. In both protocols, urinary biochemical and other variables were measured during the course of the study. Crystalluria and renal histology were examined as well. The results showed that, in both protocols, all measured variables were similar for both the rat groups. Nevertheless, urinary biochemical analysis was apparently unaffected by the extract except oxalate in preventive protocol, and calcium, sodium, and potassium in curative protocol which were significantly highly excreted in treated rats compared to untreated animals. Crystalluria was characterized mostly by the presence of large quantities of CaOx monohydrate and CaOx dihydrate particles in untreated rats. However, crystalluria was mainly dominated by the presence of CaOx dihydrate particles with reduced size. The most apparent beneficial effect of Cynodon extract was seen in kidney tissues where reduced levels of CaOx deposition have been noticed especially in medullary and papillary sections from treated rats. We concluded that C. dactylon extract has beneficial effect in preventing and eliminating CaOx deposition into kidneys. Such findings provide a scientific explanation for its use in the

Protocol for a randomised controlled trial of treatment of asymptomatic candidiasis for the prevention of preterm birth [ACTRN12610000607077

Directory of Open Access Journals (Sweden)

Rickard Kristen R

2011-03-01

Full Text Available Abstract Background Prevention of preterm birth remains one of the most important challenges in maternity care. We propose a randomised trial with: a simple Candida testing protocol that can be easily incorporated into usual antenatal care; a simple, well accepted, treatment intervention; and assessment of outcomes from validated, routinely-collected, computerised databases. Methods/Design Using a prospective, randomised, open-label, blinded-endpoint (PROBE study design, we aim to evaluate whether treating women with asymptomatic vaginal candidiasis early in pregnancy is effective in preventing spontaneous preterm birth. Pregnant women presenting for antenatal care The study protocol draws on the usual antenatal care schedule, has been pilot-tested and the intervention involves only a minor modification of current practice. Women who agree to participate will self-collect a vaginal swab and those who are culture positive for Candida will be randomised (central, telephone to open-label treatment or usual care (screening result is not revealed, no treatment, routine antenatal care. Outcomes will be obtained from population databases. A sample size of 3,208 women with Candida colonisation (1,604 per arm is required to detect a 40% reduction in the spontaneous preterm birth rate among women with asymptomatic candidiasis from 5.0% in the control group to 3.0% in women treated with clotrimazole (significance 0.05, power 0.8. Analyses will be by intention to treat. Discussion For our hypothesis, a placebo-controlled trial had major disadvantages: a placebo arm would not represent current clinical practice; knowledge of vaginal colonisation with Candida may change participants' behaviour; and a placebo with an alcohol preservative may have an independent affect on vaginal flora. These disadvantages can be overcome by the PROBE study design. This trial will provide definitive evidence on whether screening for and treating asymptomatic candidiasis in

Preventing Errors in Laterality

OpenAIRE

Landau, Elliot; Hirschorn, David; Koutras, Iakovos; Malek, Alexander; Demissie, Seleshie

2014-01-01

An error in laterality is the reporting of a finding that is present on the right side as on the left or vice versa. While different medical and surgical specialties have implemented protocols to help prevent such errors, very few studies have been published that describe these errors in radiology reports and ways to prevent them. We devised a system that allows the radiologist to view reports in a separate window, displayed in a simple font and with all terms of laterality highlighted in sep...

Can the use of the Leggett-Garg inequality enhance security of the BB84 protocol?

Science.gov (United States)

Shenoy H., Akshata; Aravinda, S.; Srikanth, R.; Home, Dipankar

2017-08-01

Prima facie, there are good reasons to answer in the negative the question posed in the title: the Bennett-Brassard 1984 (BB84) protocol is provably secure subject to the assumption of trusted devices, while the Leggett-Garg-type inequality (LGI) does not seem to be readily adaptable to the device independent (DI) or semi-DI scenario. Nevertheless, interestingly, here we identify a specific device attack, which has been shown to render the standard BB84 protocol completely insecure, but against which our formulated LGI-assisted BB84 protocol (based on an appropriate form of LGI) is secure.

A secure RFID authentication protocol for healthcare environments using elliptic curve cryptosystem.

Science.gov (United States)

Zhao, Zhenguo

2014-05-01

With the fast advancement of the wireless communication technology and the widespread use of medical systems, the radio frequency identification (RFID) technology has been widely used in healthcare environments. As the first important protocol for ensuring secure communication in healthcare environment, the RFID authentication protocols derive more and more attentions. Most of RFID authentication protocols are based on hash function or symmetric cryptography. To get more security properties, elliptic curve cryptosystem (ECC) has been used in the design of RFID authentication protocol. Recently, Liao and Hsiao proposed a new RFID authentication protocol using ECC and claimed their protocol could withstand various attacks. In this paper, we will show that their protocol suffers from the key compromise problem, i.e. an adversary could get the private key stored in the tag. To enhance the security, we propose a new RFID authentication protocol using ECC. Detailed analysis shows the proposed protocol not only could overcome weaknesses in Liao and Hsiao's protocol but also has the same performance. Therefore, it is more suitable for healthcare environments.

Development of a standard communication protocol for an emergency situation management in nuclear power plants

Energy Technology Data Exchange (ETDEWEB)

Kim, Man Cheol, E-mail: charleskim@kaeri.re.k [Integrated Risk Assessment Center, Korea Atomic Energy Research Institute, 150, Deokjin-dong, Yuseong-gu, Daejeon 305-353 (Korea, Republic of); Park, Jinkyun; Jung, Wondea [Integrated Risk Assessment Center, Korea Atomic Energy Research Institute, 150, Deokjin-dong, Yuseong-gu, Daejeon 305-353 (Korea, Republic of); Kim, Hanjeom; Kim, Yoon Joong [YGN Nuclear Power Division Training Center, Korea Hydro and Nuclear Power Company, 517 Kyemari, Hongnong-eup, Yeongkwang-gun, Chonnam 513-880 (Korea, Republic of)

2010-06-15

Correct communication between main control room (MCR) operators is an important factor in the management of emergency situations in nuclear power plants (NPPs). For this reason, a standard communication protocol for the management of emergency situations in NPPs has been developed, with the basic direction of enhancing the safety of NPPs and the standardization of communication protocols. To validate the newly developed standard communication protocol, validation experiments with 10 licensed NPP MCR operator teams was performed. From the validation experiments, it was found that the use of the standard communication protocol required more time, but it can contribute to the enhancement of the safety of NPPs by an operators' better grasp of the safety-related parameters and a more efficient and clearer communication between NPP operators, while imposing little additional workloads on the NPP MCR operators. The standard communication protocol is expected to be used to train existing NPP MCR operators without much aversion, as well as new operators.

The preparation of Drosophila embryos for live-imaging using the hanging drop protocol.

Science.gov (United States)

Reed, Bruce H; McMillan, Stephanie C; Chaudhary, Roopali

2009-03-13

Green fluorescent protein (GFP)-based timelapse live-imaging is a powerful technique for studying the genetic regulation of dynamic processes such as tissue morphogenesis, cell-cell adhesion, or cell death. Drosophila embryos expressing GFP are readily imaged using either stereoscopic or confocal microscopy. A goal of any live-imaging protocol is to minimize detrimental effects such as dehydration and hypoxia. Previous protocols for preparing Drosophila embryos for live-imaging analysis have involved placing dechorionated embryos in halocarbon oil and sandwiching them between a halocarbon gas-permeable membrane and a coverslip. The introduction of compression through mounting embryos in this manner represents an undesirable complication for any biomechanical-based analysis of morphogenesis. Our method, which we call the hanging drop protocol, results in excellent viability of embryos during live imaging and does not require that embryos be compressed. Briefly, the hanging drop protocol involves the placement of embryos in a drop of halocarbon oil that is suspended from a coverslip, which is, in turn, fixed in position over a humid chamber. In addition to providing gas exchange and preventing dehydration, this arrangement takes advantage of the buoyancy of embryos in halocarbon oil to prevent them from drifting out of position during timelapse acquisition. This video describes in detail how to collect and prepare Drosophila embryos for live imaging using the hanging drop protocol. This protocol is suitable for imaging dechorionated embryos using stereomicroscopy or any upright compound fluorescence microscope.

Cannabinoid receptors activation and glucocorticoid receptors deactivation in the amygdala prevent the stress-induced enhancement of a negative learning experience.

Science.gov (United States)

Ramot, Assaf; Akirav, Irit

2012-05-01

The enhancement of emotional memory is clearly important as emotional stimuli are generally more significant than neutral stimuli for surviving and reproduction purposes. Yet, the enhancement of a negative emotional memory following exposure to stress may result in dysfunctional or intrusive memory that underlies several psychiatric disorders. Here we examined the effects of stress exposure on a negative emotional learning experience as measured by a decrease in the magnitude of the expected quantity of reinforcements in an alley maze. In contrast to other fear-related negative experiences, reward reduction is more associated with frustration and is assessed by measuring the latency to run the length of the alley to consume the reduced quantity of reward. We also examined whether the cannabinoid receptors agonist WIN55,212-2 (5 μg/side) and the glucocorticoid receptors (GRs) antagonist RU-486 (10 ng/side) administered into the rat basolateral amygdala (BLA) could prevent the stress-induced enhancement. We found that intra-BLA RU-486 or WIN55,212 before stress exposure prevented the stress-induced enhancement of memory consolidation for reduction in reward magnitude. These findings suggest that cannabinoid receptors and GRs in the BLA are important modulators of stress-induced enhancement of emotional memory. Copyright © 2012 Elsevier Inc. All rights reserved.

Protocol for systematic review of school-based interventions to prevent and control obesity in African learners.

Science.gov (United States)

Adom, Theodosia; Puoane, Thandi; De Villiers, Anniza; Kengne, André Pascal

2017-03-27

The increasing prevalence of obesity and overweight in childhood in developing countries is a public health concern to many governments. Schools play a significant role in the obesity epidemic as well as provide favourable environments for change in behaviours in childhood which can be carried on into adulthood. There is dearth of information on intervention studies in poor-resource settings. This review will summarise the available evidence on school-based interventions that focused on promoting healthy eating and physical activity among learners aged 6-15 years in Africa and to identify factors that lead to successful interventions or potential barriers to success of these programmes within the African context. This protocol is developed following the guidelines of PRIMSA-P 2015. Relevant search terms and keywords generated from the subject headings and the African search filter will be used to conduct a comprehensive search of MEDLINE (PubMed), MEDLINE (EbscoHost), CINAHL (EbscoHost), Register Academic Search Complete (EbscoHost) and ISI Web of Science (Science Citation Index) for published literature on school-based interventions to prevent and control obesity in learners in Africa. Grey literature will be also be obtained. The searches will cover 1 January 2000 to 30 June 2016. No language limitations will be applied. Full-text articles of eligible studies will be screened. Risk of bias and quality of reporting will be assessed. Data will be extracted, synthesised and presented by country and major regional groupings. Meta-analysis will be conducted for identical variables across studies, where data allow. This protocol is developed following the guidelines of PRISMA-P 2015. No primary data will be collected hence ethics is not a requirement. The findings will be submitted for publication in peer-reviewed journals, in conferences and in policy documents for decision-making, where needed. Published by the BMJ Publishing Group Limited. For permission to use

Protocol for Uniformly Measuring and Expressing the Performance of Energy Storage Systems

Energy Technology Data Exchange (ETDEWEB)

Conover, David R.; Crawford, Aladsair J.; Viswanathan, Vilayanur V.; Ferreira, Summer; Schoenwald, David

2014-06-01

The Protocol for Uniformly Measuring and Expressing the Performance of Energy Storage Systems (PNNL-22010) was first issued in November 2012 as a first step toward providing a foundational basis for developing an initial standard for the uniform measurement and expression of energy storage system (ESS) performance. Its subsequent use in the field and review by the protocol working group and most importantly the users’ subgroup and the thermal subgroup has led to the fundamental modifications reflected in this update of the 2012 Protocol. As an update of the 2012 Protocol, this document (the June 2014 Protocol) is intended to supersede its predecessor and be used as the basis for measuring and expressing ESS performance. The foreword provides general and specific details about what additions, revisions, and enhancements have been made to the 2012 Protocol and the rationale for them in arriving at the June 2014 Protocol.

Antibiotic prophylaxis in orthopedic surgeries: the results of an implemented protocol

Directory of Open Access Journals (Sweden)

Raquel Queiroz

Full Text Available Though the basic principles of antibiotic prophylaxis have been well established, there is still considerable incorrect usage, including how much is prescribed and especially in the duration of treatment, which is generally superior to what is indicated. The adequate use of these drugs contributes towards decreasing the time of internment of the patient, prevents surgical site infection (SSI, decreasing the development of resistant microorganisms, and towards reduced costs for the hospital pharmacy. A protocol for the use of antibiotic prophylaxis in the Orthopedics and Traumatology Service of the Hospital do Servidor Público Estadual de São Paulo was developed. The objectives of the study were to promote rational antibiotic surgical prophylaxis, through the implantation of a protocol for the use of these drugs in a surgical unit, with the direct contribution of a druggist in collaboration with the Infection Control Committee, to evaluate the adhesion of the health team to the protocol during three distinct periods (daily pre-protocol, early post-protocol and late post-protocol and to define the consumption of antimicrobials used, measured as daily defined dose.

An FEC Adaptive Multicast MAC Protocol for Providing Reliability in WLANs

Science.gov (United States)

Basalamah, Anas; Sato, Takuro

For wireless multicast applications like multimedia conferencing, voice over IP and video/audio streaming, a reliable transmission of packets within short delivery delay is needed. Moreover, reliability is crucial to the performance of error intolerant applications like file transfer, distributed computing, chat and whiteboard sharing. Forward Error Correction (FEC) is frequently used in wireless multicast to enhance Packet Error Rate (PER) performance, but cannot assure full reliability unless coupled with Automatic Repeat Request forming what is knows as Hybrid-ARQ. While reliable FEC can be deployed at different levels of the protocol stack, it cannot be deployed on the MAC layer of the unreliable IEEE802.11 WLAN due to its inability to exchange ACKs with multiple recipients. In this paper, we propose a Multicast MAC protocol that enhances WLAN reliability by using Adaptive FEC and study it's performance through mathematical analysis and simulation. Our results show that our protocol can deliver high reliability and throughput performance.

Protocol for a randomised controlled trial investigating the effectiveness of an online e health application for the prevention of Generalised Anxiety Disorder

Directory of Open Access Journals (Sweden)

Kenardy Justin

2010-03-01

Full Text Available Abstract Background Generalised Anxiety Disorder (GAD is a highly prevalent psychiatric disorder. Effective prevention in young adulthood has the potential to reduce the prevalence of the disorder, to reduce disability and lower the costs of the disorder to the community. The present trial (the WebGAD trial aims to evaluate the effectiveness of an evidence-based online prevention website for GAD. Methods/Design The principal clinical question under investigation is the effectiveness of an online GAD intervention (E-couch using a community-based sample. We examine whether the effect of the intervention can be maximised by either human support, in the form of telephone calls, or by automated support through emails. The primary outcome will be a reduction in symptoms on the GAD-7 in the active arms relative to the non active intervention arms. Discussion The WebGAD trial will be the first to evaluate the use of an internet-based cognitive behavioural therapy (CBT program contrasted with a credible control condition for the prevention of GAD and the first formal RCT evaluation of a web-based program for GAD using community recruitment. In general, internet-based CBT programs have been shown to be effective for the treatment of other anxiety disorders such as Post Traumatic Stress Disorder, Social Phobia, Panic Disorder and stress in clinical trials; however there is no evidence for the use of internet CBT in the prevention of GAD. Given the severe shortage of therapists identified in Australia and overseas, and the low rates of treatment seeking in those with a mental illness, the successful implementation of this protocol has important practical outcomes. If found to be effective, WebGAD will provide those experiencing GAD with an easily accessible, free, evidence-based prevention tool which can be promoted and disseminated immediately. Trial Registration Controlled-trials.com: ISRCTN76298775

Mobile Health Technology (mDiab) for the Prevention of Type 2 Diabetes: Protocol for a Randomized Controlled Trial.

Science.gov (United States)

Muralidharan, Shruti; Mohan, Viswanathan; Anjana, Ranjit Mohan; Jena, Sidhant; Tandon, Nikhil; Allender, Steven; Ranjani, Harish

2017-12-12

The prevalence of type 2 diabetes is increasing in epidemic proportions in low- and middle-income countries. There is an urgent need for novel methods to tackle the increasing incidence of diabetes. The ubiquity of mobile phone use and access to Internet makes mobile health (mHealth) technology a viable tool to prevent and manage diabetes. The objective of this randomized controlled trial is to implement and evaluate the feasibility, cost-effectiveness, and sustainability of a reality television-based lifestyle intervention program. This intervention program is delivered via a mobile phone app (mDiab) to approximately 1500 Android smartphone users who are adults at a high risk for type 2 diabetes from three cities in India, namely, Chennai, Bengaluru, and New Delhi. The mDiab intervention would be delivered via a mobile phone app along with weekly coach calls for 12 weeks. Each participant will go through a maintenance phase of 6 to 8 months post intervention. Overall, there would be 3 testing time points in the study: baseline, post intervention, and the end of follow-up. The app will enable individuals to track their weight, physical activity, and diet alongside weekly video lessons on type 2 diabetes prevention. The study outcomes are weight loss (primary measure of effectiveness); improvement in cardiometabolic risk factors (ie, waist circumference, blood pressure, glucose, insulin, and lipids); and improvement in physical activity, quality of life, and dietary habits. Sustainability will be assessed through focus group discussions. If successful, mDiab can be used as a model for translational and implementation research in the use of mHealth technology for diabetes prevention and may be further expanded for the prevention of other noncommunicable diseases such as hypertension and cardiovascular diseases. Clinical Trials Registry of India CTRI/2015/07/006011 http://ctri.nic.in/Clinicaltrials/pdf_generate.php? trialid=11841 (Archived by WebCite at http

The PJ Nicholoff Steroid Protocol for Duchenne and Becker Muscular Dystrophy and Adrenal Suppression.

Science.gov (United States)

Kinnett, Kathi; Noritz, Garey

2017-06-27

Duchenne muscular dystrophy (DMD or Duchenne) is a progressive, life-limiting muscle-wasting disease that requires comprehensive, multidisciplinary care. This care, at minimum, should include neuromuscular, respiratory, cardiac, orthopedic, endocrine and rehabilitative interventions that address both the primary and secondary manifestations of the disease. The care needs of patients evolve over the cdourse of the disease and as they transition from childhood into young adulthood. In the past two decades, life expectancy has increased significantly by the use of corticosteroids and enhanced clinical management. Nevertheless, each year, patients with Duchenne muscular dystrophy are admitted to emergency departments and intensive care units where medical expertise thrives, but where expertise in rare diseases, such as Duchenne, may not. Emergency care for patients with Duchenne can be as complex as the disease process itself. While any illness or injury may occur in a person with Duchenne, some acute scenarios are much more common in the context of the disease. Making decisions about the clinical care of a person with Duchenne who presents with an acute illness can be quite difficult - in part, because of the extensive use of corticosteroids, which can lead to adrenal suppression. The life of a person with Duchenne needing emergency care may therefore depend upon the ability of the clinician on duty in the emergency department to recognize and mitigate adrenal suppression resulting from corticosteroid dependence. With this in mind, and drawing from expertise and experience with other steroid-dependent diseases, the 'PJ Nicholoff Steroid Protocol' was developed. The purpose of this protocol is to provide clinicians information regarding the safe management of corticosteroid during emergency situations in patients who may have accompanying adrenal suppression. The protocol explains how to recognize the signs and symptoms of acute adrenal crisis, how to prevent it with

Protocol compliance of administering parenteral medication in Dutch hospitals: an evaluation and cost-estimation of the implementation.

NARCIS (Netherlands)

Schilp, J.; Boot, S.; Blok, C. de; Spreeuwenberg, P.; Wagner, C.

2014-01-01

Objectives: Preventable adverse drug events (ADEs) are closely related to administration processes of parenteral medication. The Dutch Patient Safety Program provided a protocol for administering parenteral medication to reduce the amount of ADEs. The execution of the protocol was evaluated and a

A lightweight privacy preserving authenticated key agreement protocol for SIP-based VoIP

OpenAIRE

Zhang, Liping; Tang, Shanyu; Zhu, Shaohui

2016-01-01

Session Initiation Protocol (SIP) is an essential part of most Voice over Internet Protocol (VoIP) architecture. Although SIP provides attractive features, it is exposed to various security threats, and so an efficient and secure authentication scheme is sought to enhance the security of SIP. Several attempts have been made to address the tradeoff problem between security and efficiency, but designing a successful authenticated key agreement protocol for SIP is still a challenging task from t...

Early Appropriate Care: A Protocol to Standardize Resuscitation Assessment and to Expedite Fracture Care Reduces Hospital Stay and Enhances Revenue.

Science.gov (United States)

Vallier, Heather A; Dolenc, Andrea J; Moore, Timothy A

2016-06-01

We hypothesized that a standardized protocol for fracture care would enhance revenue by reducing complications and length of stay. Prospective consecutive series. Level 1 trauma center. Two hundread and fifty-three adult patients with a mean age of 40.7 years and mean Injury Severity Score of 26.0. Femur, pelvis, or spine fractures treated surgically. Hospital and professional charges and collections were analyzed. Fixation was defined as early (<36 hours) or delayed. Complications and hospital stay were recorded. Mean charges were US $180,145 with a mean of US $66,871 collected (37%). The revenue multiplier was US $59,882/$6989 (8.57), indicating hospital collection of US $8.57 for every professional dollar, less than half of which went to orthopaedic surgeons. Delayed fracture care was associated with more intensive care unit (4.5 vs. 9.4) and total hospital days (9.4 vs. 15.3), with mean loss of actual revenue US $6380/patient delayed (n = 47), because of the costs of longer length of stay. Complications were associated with the highest expenses: mean of US $291,846 charges and US $101,005 collections, with facility collections decreased by 5.1%. An uncomplicated course of care was associated with the most favorable total collections: (US $60,017/$158,454 = 38%) and the shortest mean stay (8.7 days). Facility collections were nearly 9 times more than professional collections. Delayed fixation was associated with more complications, and facility collections decreased 5% with a complication. Furthermore, delayed fixation was associated with longer hospital stay, accounting for US $300K more in actual costs during the study. A standardized protocol to expedite definitive fixation enhances the profitability of the trauma service line. Economic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Study on Cloud Security Based on Trust Spanning Tree Protocol

Science.gov (United States)

Lai, Yingxu; Liu, Zenghui; Pan, Qiuyue; Liu, Jing

2015-09-01

Attacks executed on Spanning Tree Protocol (STP) expose the weakness of link layer protocols and put the higher layers in jeopardy. Although the problems have been studied for many years and various solutions have been proposed, many security issues remain. To enhance the security and credibility of layer-2 network, we propose a trust-based spanning tree protocol aiming at achieving a higher credibility of LAN switch with a simple and lightweight authentication mechanism. If correctly implemented in each trusted switch, the authentication of trust-based STP can guarantee the credibility of topology information that is announced to other switch in the LAN. To verify the enforcement of the trusted protocol, we present a new trust evaluation method of the STP using a specification-based state model. We implement a prototype of trust-based STP to investigate its practicality. Experiment shows that the trusted protocol can achieve security goals and effectively avoid STP attacks with a lower computation overhead and good convergence performance.

Enhancing robustness of multiparty quantum correlations using weak measurement

International Nuclear Information System (INIS)

Singh, Uttam; Mishra, Utkarsh; Dhar, Himadri Shekhar

2014-01-01

Multipartite quantum correlations are important resources for the development of quantum information and computation protocols. However, the resourcefulness of multipartite quantum correlations in practical settings is limited by its fragility under decoherence due to environmental interactions. Though there exist protocols to protect bipartite entanglement under decoherence, the implementation of such protocols for multipartite quantum correlations has not been sufficiently explored. Here, we study the effect of local amplitude damping channel on the generalized Greenberger–Horne–Zeilinger state, and use a protocol of optimal reversal quantum weak measurement to protect the multipartite quantum correlations. We observe that the weak measurement reversal protocol enhances the robustness of multipartite quantum correlations. Further it increases the critical damping value that corresponds to entanglement sudden death. To emphasize the efficacy of the technique in protection of multipartite quantum correlation, we investigate two proximately related quantum communication tasks, namely, quantum teleportation in a one sender, many receivers setting and multiparty quantum information splitting, through a local amplitude damping channel. We observe an increase in the average fidelity of both the quantum communication tasks under the weak measurement reversal protocol. The method may prove beneficial, for combating external interactions, in other quantum information tasks using multipartite resources. - Highlights: • Extension of weak measurement reversal scheme to protect multiparty quantum correlations. • Protection of multiparty quantum correlation under local amplitude damping noise. • Enhanced fidelity of quantum teleportation in one sender and many receivers setting. • Enhanced fidelity of quantum information splitting protocol

Enhancing robustness of multiparty quantum correlations using weak measurement

Energy Technology Data Exchange (ETDEWEB)

Singh, Uttam, E-mail: uttamsingh@hri.res.in [Quantum Information and Computation Group, Harish-Chandra Research Institute, Chhatnag Road, Jhunsi, Allahabad 211 019 (India); Mishra, Utkarsh, E-mail: utkarsh@hri.res.in [Quantum Information and Computation Group, Harish-Chandra Research Institute, Chhatnag Road, Jhunsi, Allahabad 211 019 (India); Dhar, Himadri Shekhar, E-mail: dhar.himadri@gmail.com [School of Physical Sciences, Jawaharlal Nehru University, New Delhi 110067 (India)

2014-11-15

Multipartite quantum correlations are important resources for the development of quantum information and computation protocols. However, the resourcefulness of multipartite quantum correlations in practical settings is limited by its fragility under decoherence due to environmental interactions. Though there exist protocols to protect bipartite entanglement under decoherence, the implementation of such protocols for multipartite quantum correlations has not been sufficiently explored. Here, we study the effect of local amplitude damping channel on the generalized Greenberger–Horne–Zeilinger state, and use a protocol of optimal reversal quantum weak measurement to protect the multipartite quantum correlations. We observe that the weak measurement reversal protocol enhances the robustness of multipartite quantum correlations. Further it increases the critical damping value that corresponds to entanglement sudden death. To emphasize the efficacy of the technique in protection of multipartite quantum correlation, we investigate two proximately related quantum communication tasks, namely, quantum teleportation in a one sender, many receivers setting and multiparty quantum information splitting, through a local amplitude damping channel. We observe an increase in the average fidelity of both the quantum communication tasks under the weak measurement reversal protocol. The method may prove beneficial, for combating external interactions, in other quantum information tasks using multipartite resources. - Highlights: • Extension of weak measurement reversal scheme to protect multiparty quantum correlations. • Protection of multiparty quantum correlation under local amplitude damping noise. • Enhanced fidelity of quantum teleportation in one sender and many receivers setting. • Enhanced fidelity of quantum information splitting protocol.

Neuropeptide Y stimulation as primary target for preventive measures of maladaptative cardiovascular reactions in occupational chronic stress exposure.

Science.gov (United States)

Ciumaşu-Rîmbu, Mălina; Popa, Livia; Vulpoi, Carmen

2012-01-01

Chronic stress may produce a decrease in central NPY expression and subjects exposed to it may prove hypersensitivity to a novel stressor with dysfunctions in the NPY system and cardiovascular maladaptation to stress, even hypertension. Upregulation of NPY expression may contribute to successful behavioral adaptation to stress by reducing cardiovascular tone and suppressing anxious behaviors. Adaptogens, a new class of metabolic regulators stimulate NPY expression and release. The aim of this study is to increase tolerance and adaptation to stress of hypersensitive to novel stressor, occupational chronic stress exposed subjects with cardiovascular maladaptation to mild new stressor using adaptogens as part of prevention protocol. 40 military personnel with known cardiostressor reactional mode and occupational chronic stress exposure were exposed to mild novel stressor: occupational medicine routine evaluation and clinically assessed for maladaptative cardiovascular response prior and before application of 30 day prevention protocol. Employees were randomly split in two groups, one receiving standard prevention protocol (lifestyle counseling) plus adaptogens in multiple dose administration, twice daily and the other receiving only standard prevention protocol. We found significant statistic differences in all cardiovascular parameters in adaptogen group and only in diastolic blood pressure in control group. Adaptogens could be an important factor in successful prevention protocols of chronic occupational stress dysfunctions involving NPY systems.

Provable Fair Document Exchange Protocol with Transaction Privacy for E-Commerce

Directory of Open Access Journals (Sweden)

Ren-Junn Hwang

2015-04-01

Full Text Available Transaction privacy has attracted a lot of attention in the e-commerce. This study proposes an efficient and provable fair document exchange protocol with transaction privacy. Using the proposed protocol, any untrusted parties can fairly exchange documents without the assistance of online, trusted third parties. Moreover, a notary only notarizes each document once. The authorized document owner can exchange a notarized document with different parties repeatedly without disclosing the origin of the document or the identities of transaction participants. Security and performance analyses indicate that the proposed protocol not only provides strong fairness, non-repudiation of origin, non-repudiation of receipt, and message confidentiality, but also enhances forward secrecy, transaction privacy, and authorized exchange. The proposed protocol is more efficient than other works.

Avaliação da utilização de protocolos na prevenção de úlceras por pressão Evaluation of the use of protocols in the prevention of pressure ulcers

Directory of Open Access Journals (Sweden)

Rosilene Alves de Almeida

2012-08-01

Full Text Available Introdução: A úlcera por pressão é um problema de saúde que repercute com elevados custos e consequências biopsicossociais sobre os portadores. Para reduzir sua incidência, protocolos de prevenção são utilizados, sendo importante enfatizar o impacto desta estratégia sobre as práticas de saúde e na qualidade de vida do paciente. Objetivo: Este artigo objetiva revisar o impacto da utilização de protocolos de prevenção de úlcera por pressão sobre sua incidência e na assistência. Materiais e Métodos: O estudo é de revisão sistemática fundamentado em publicações disponíveis em meio eletrônico. Foram selecionados 07 trabalhos, do período de 2002 a 2010, encontrados nas bases de dados Medline, Lilacs, IBECS e Cochrane, utilizando os descritores “úlcera por pressão ou úlcera de pressão ou escara de decúbito e protocolo”. Resultados: Três estudos mostraram redução da incidência de úlcera por pressão de 23 para 5%, 60 para 15%, 43 para 28%, com relato de eficácia do protocolo em 79% dos pacientes. Outros revelaram incidências de 0,2 e 2,77% após aplicação do protocolo. Incidências de 23,5 e 25,8% foram verificadas em unidades intensivas após o uso de protocolos. Ademais, a adoção de protocolos para prevenção de úlcera por pressão é uma decisão estratégica eficaz, que além de diminuir a incidência, otimiza recursos, melhora a qualidade da assistência, fortalece as práticas assistenciais. Conclusão: Os protocolos promovem impactos positivos sobre a prevenção das úlceras por pressão e a qualidade de vida das pessoas, sendo um recurso essencial para um cuidado humanizado pautado nas necessidades de saúde.Introduction: Pressure ulcer is a medical condition that involves high costs and biopsychosocial consequences for the patients. Prevention protocols have been used to reduce pressure ulcers incidence, and it is important to emphasize the impact of this strategy on the health care

Docosahexaenoic acid prevents paraquat-induced reactive oxygen species production in dopaminergic neurons via enhancement of glutathione homeostasis

Energy Technology Data Exchange (ETDEWEB)

Lee, Hyoung Jun; Han, Jeongsu; Jang, Yunseon; Kim, Soo Jeong; Park, Ji Hoon; Seo, Kang Sik [Department of Biochemistry, College of Medicine, Chungnam National University, Daejeon (Korea, Republic of); Jeong, Soyeon; Shin, Soyeon; Lim, Kyu [Department of Biochemistry, College of Medicine, Chungnam National University, Daejeon (Korea, Republic of); Infection Signaling Network Research Center, Chungnam National University, Daejeon (Korea, Republic of); Heo, Jun Young, E-mail: junyoung3@gmail.com [Brainscience Institute, Chungnam National University, Daejeon (Korea, Republic of); Kweon, Gi Ryang, E-mail: mitochondria@cnu.ac.kr [Department of Biochemistry, College of Medicine, Chungnam National University, Daejeon (Korea, Republic of); Infection Signaling Network Research Center, Chungnam National University, Daejeon (Korea, Republic of)

2015-01-30

Highlights: • DHA prevents PQ-induced dopaminergic neuronal loss via decreasing of excessive ROS. • DHA increases GR and GCLm derivate GSH pool by enhancement of Nrf2 expression. • Protective mechanism is removal of PQ-induced ROS via DHA-dependent GSH pool. • DHA may be a good preventive strategy for Parkinson’s disease (PD) therapy. - Abstract: Omega-3 polyunsaturated fatty acid levels are reduced in the substantia nigra area in Parkinson’s disease patients and animal models, implicating docosahexaenoic acid (DHA) as a potential treatment for preventing Parkinson’s disease and suggesting the need for investigations into how DHA might protect against neurotoxin-induced dopaminergic neuron loss. The herbicide paraquat (PQ) induces dopaminergic neuron loss through the excessive production of reactive oxygen species (ROS). We found that treatment of dopaminergic SN4741 cells with PQ reduced cell viability in a dose-dependent manner, but pretreatment with DHA ameliorated the toxic effect of PQ. To determine the toxic mechanism of PQ, we measured intracellular ROS content in different organelles with specific dyes. As expected, all types of ROS were increased by PQ treatment, but DHA pretreatment selectively decreased cytosolic hydrogen peroxide content. Furthermore, DHA treatment-induced increases in glutathione reductase and glutamate cysteine ligase modifier subunit (GCLm) mRNA expression were positively correlated with glutathione (GSH) content. Consistent with this increase in GCLm mRNA levels, Western blot analysis revealed that DHA pretreatment increased nuclear factor-erythroid 2 related factor 2 (Nrf2) protein levels. These findings indicate that DHA prevents PQ-induced neuronal cell loss by enhancing Nrf2-regulated GSH homeostasis.

Docosahexaenoic acid prevents paraquat-induced reactive oxygen species production in dopaminergic neurons via enhancement of glutathione homeostasis

International Nuclear Information System (INIS)

Lee, Hyoung Jun; Han, Jeongsu; Jang, Yunseon; Kim, Soo Jeong; Park, Ji Hoon; Seo, Kang Sik; Jeong, Soyeon; Shin, Soyeon; Lim, Kyu; Heo, Jun Young; Kweon, Gi Ryang

2015-01-01

Highlights: • DHA prevents PQ-induced dopaminergic neuronal loss via decreasing of excessive ROS. • DHA increases GR and GCLm derivate GSH pool by enhancement of Nrf2 expression. • Protective mechanism is removal of PQ-induced ROS via DHA-dependent GSH pool. • DHA may be a good preventive strategy for Parkinson’s disease (PD) therapy. - Abstract: Omega-3 polyunsaturated fatty acid levels are reduced in the substantia nigra area in Parkinson’s disease patients and animal models, implicating docosahexaenoic acid (DHA) as a potential treatment for preventing Parkinson’s disease and suggesting the need for investigations into how DHA might protect against neurotoxin-induced dopaminergic neuron loss. The herbicide paraquat (PQ) induces dopaminergic neuron loss through the excessive production of reactive oxygen species (ROS). We found that treatment of dopaminergic SN4741 cells with PQ reduced cell viability in a dose-dependent manner, but pretreatment with DHA ameliorated the toxic effect of PQ. To determine the toxic mechanism of PQ, we measured intracellular ROS content in different organelles with specific dyes. As expected, all types of ROS were increased by PQ treatment, but DHA pretreatment selectively decreased cytosolic hydrogen peroxide content. Furthermore, DHA treatment-induced increases in glutathione reductase and glutamate cysteine ligase modifier subunit (GCLm) mRNA expression were positively correlated with glutathione (GSH) content. Consistent with this increase in GCLm mRNA levels, Western blot analysis revealed that DHA pretreatment increased nuclear factor-erythroid 2 related factor 2 (Nrf2) protein levels. These findings indicate that DHA prevents PQ-induced neuronal cell loss by enhancing Nrf2-regulated GSH homeostasis

Development and implementation of intranasal naloxone opioid overdose response protocol at a homeless health clinic.

Science.gov (United States)

Dahlem, Chin Hwa Y; Horstman, Molly J; Williams, Brent C

2016-01-01

To describe the development, implementation, and preliminary evaluation of Opioid Overdose Response Protocol using intranasal (IN) naloxone in a homeless shelter. Opioid Overdose Response Protocol and training curriculum were developed using the Massachusetts Department of Public Health Opioid Overdose Education and Naloxone Distribution (OEND) flow chart, the American Heart Association (AHA) simplified adult basic life support algorithm, and resources through Harms Reduction Coalition. Intranasal naloxone offers a safe and effective method for opioid reversal. To combat the rising incidence of opioid overdose, IN naloxone should be made available at homeless shelters and other facilities with high frequency of opioid overdose, including the training of appropriate staff. This project has demonstrated the effective training and implementation of an Opioid Overdose Response Protocol, based on feedback received from cardiopulmonary resuscitation (CPR) trained nonhealthcare staff. Nurse practitioners (NPs), with our focus on patient care, prevention, and education, are well suited to the deployment of this life-saving protocol. NPs are in critical positions to integrate opioid overdose prevention education and provide naloxone rescue kits in clinical practices. ©2015 American Association of Nurse Practitioners.

An Efficient Data-Gathering Routing Protocol for Underwater Wireless Sensor Networks

Directory of Open Access Journals (Sweden)

Nadeem Javaid

2015-11-01

Full Text Available Most applications of underwater wireless sensor networks (UWSNs demand reliable data delivery over a longer period in an efficient and timely manner. However, the harsh and unpredictable underwater environment makes routing more challenging as compared to terrestrial WSNs. Most of the existing schemes deploy mobile sensors or a mobile sink (MS to maximize data gathering. However, the relatively high deployment cost prevents their usage in most applications. Thus, this paper presents an autonomous underwater vehicle (AUV-aided efficient data-gathering (AEDG routing protocol for reliable data delivery in UWSNs. To prolong the network lifetime, AEDG employs an AUV for data collection from gateways and uses a shortest path tree (SPT algorithm while associating sensor nodes with the gateways. The AEDG protocol also limits the number of associated nodes with the gateway nodes to minimize the network energy consumption and to prevent the gateways from overloading. Moreover, gateways are rotated with the passage of time to balance the energy consumption of the network. To prevent data loss, AEDG allows dynamic data collection at the AUV depending on the limited number of member nodes that are associated with each gateway. We also develop a sub-optimal elliptical trajectory of AUV by using a connected dominating set (CDS to further facilitate network throughput maximization. The performance of the AEDG is validated via simulations, which demonstrate the effectiveness of AEDG in comparison to two existing UWSN routing protocols in terms of the selected performance metrics.

An Efficient Data-Gathering Routing Protocol for Underwater Wireless Sensor Networks.

Science.gov (United States)

Javaid, Nadeem; Ilyas, Naveed; Ahmad, Ashfaq; Alrajeh, Nabil; Qasim, Umar; Khan, Zahoor Ali; Liaqat, Tayyaba; Khan, Majid Iqbal

2015-11-17

Most applications of underwater wireless sensor networks (UWSNs) demand reliable data delivery over a longer period in an efficient and timely manner. However, the harsh and unpredictable underwater environment makes routing more challenging as compared to terrestrial WSNs. Most of the existing schemes deploy mobile sensors or a mobile sink (MS) to maximize data gathering. However, the relatively high deployment cost prevents their usage in most applications. Thus, this paper presents an autonomous underwater vehicle (AUV)-aided efficient data-gathering (AEDG) routing protocol for reliable data delivery in UWSNs. To prolong the network lifetime, AEDG employs an AUV for data collection from gateways and uses a shortest path tree (SPT) algorithm while associating sensor nodes with the gateways. The AEDG protocol also limits the number of associated nodes with the gateway nodes to minimize the network energy consumption and to prevent the gateways from overloading. Moreover, gateways are rotated with the passage of time to balance the energy consumption of the network. To prevent data loss, AEDG allows dynamic data collection at the AUV depending on the limited number of member nodes that are associated with each gateway. We also develop a sub-optimal elliptical trajectory of AUV by using a connected dominating set (CDS) to further facilitate network throughput maximization. The performance of the AEDG is validated via simulations, which demonstrate the effectiveness of AEDG in comparison to two existing UWSN routing protocols in terms of the selected performance metrics.

Enhancing the role of private practitioners in tuberculosis prevention and care activities in India

Directory of Open Access Journals (Sweden)

Tanu Anand

2017-01-01

Full Text Available India accounts for the highest number of incident tuberculosis (TB cases globally. Hence, to impact the TB incidence world over, there is an urgent need to address and accelerate TB control activities in the country. Nearly, half of the TB patients first seek TB care in private sector. However, the participation of private practitioners (PPs has been patchy in TB prevention and care and distrust exists between public and private sector. PPs usually have varied diagnostic and treatment practices that are inadequate and amplify the risk of drug resistance. Hence, their regulation and involvement as key stakeholders are important in TB prevention and care in India if we are to achieve TB control at global level. However, there remain certain barriers and gaps, which are preventing their upscaling. The current paper aims to discuss the status of private sector involvement in TB prevention and care in India. The paper also discusses the strategies and initiatives taken by the government in this regard as evidence shows that the involvement of private sector in co-opting directly observed treatment short-course (DOTS helps to enhance case finding and treatment outcomes; it improves the accessibility of quality TB care with greater geographic coverage. Besides public-private mix, DOTS has been found more cost-effective and reduces financial burden of patients. The paper also offers to present some more solutions both at policy and program level for upscaling the engagement of PPs in the national TB control program.

The Performance of a Second Generation Service Discovery Protocol In Response to Message Loss

NARCIS (Netherlands)

Sundramoorthy, V.; van de Glind, G.J.; Hartel, Pieter H.; Scholten, Johan

We analyze the behavior of FRODO, a second generation service discovery protocol, in response to message loss in the network. Earlier protocols, like UPnP and Jini rely on underlying network layers to enhance their failure recovery. A comparison with UPnP and Jini shows that FRODO performs more

The Performance of a Second Generation Service Discovery Protocol In Response to Message Loss

NARCIS (Netherlands)

Sundramoorthy, V.; van de Glind, G.J.; Hartel, Pieter H.; Scholten, Johan

We analyze the behavior of FRODO, a second generation service discovery protocol, in response to message loss in the network. First generation protocols, like UPnP and Jini rely on underlying network layers to enhance their failure recovery. A comparison with UPnP and Jini shows that FRODO performs

A novel six consecutive monthly doses of palivizumab prophylaxis protocol for the prevention of respiratory syncytial virus infection in high-risk preterm infants in Taiwan.

Directory of Open Access Journals (Sweden)

Hsin Chi

Full Text Available Respiratory syncytial virus (RSV circulates year round in Taiwan. A novel six consecutive monthly doses of palivizumab for RSV prevention protocol has been approved for high risk preterm infants since December 2010. This study aimed to determine the clinical effectiveness and safety of this novel protocol for the prevention of RSV infection.From April 2011 to March 2013, we enrolled infants born at ≤28 weeks gestation and infants born at ≤35 weeks gestation with chronic lung disease (CLD who received palivizumab prophylaxis as study group and followed up for 12 months. Historic control, those who were born and followed up between July 2000 and June 2008, were retrieved for propensity score matching. Primary endpoint was RSV-related hospitalization, and secondary endpoints included the length of hospital stay and intensive care unit (ICU care.We enrolled 127 infants (108 infants born at ≤28 weeks and 19 infants born at 29-35 weeks with CLD. They completed 6-dose palivizumab as scheduled. Among the study group, the RSV-related hospitalizations were 2 (1.6% within 6 months and 5 (3.9% within 12 months after discharge. We matched 127 infants in the control group with 127 infants in the study group by propensity score matching. The reduction of RSV-related hospitalization rates were 86% (10.2% vs 1.6%, p = 0.002 within 6 months after discharge and 78% (15.7% vs 3.9%, p = 0.004 within 12 months after discharge. Compared to the control group, the rate of ICU care significantly decreased from 7.1% to 0.8% (p = 0.024 within 6 months after discharge and from 7.9% to 0.8% (p = 0.014 within 12 months after discharge. Adverse events were recorded in 6.4% injections.Six monthly intramuscular administration of palivizumab is effective for prevention of RSV hospitalization in regions with no single seasonal peak of RSV infection such as Taiwan.

Increasing fall risk awareness using wearables: A fall risk awareness protocol.

Science.gov (United States)

Danielsen, Asbjørn; Olofsen, Hans; Bremdal, Bernt Arild

2016-10-01

Each year about a third of elderly aged 65 or older experience a fall. Many of these falls may have been avoided if fall risk assessment and prevention tools where available in a daily living situation. We identify what kind of information is relevant for doing fall risk assessment and prevention using wearable sensors in a daily living environment by investigating current research, distinguishing between prospective and context-aware fall risk assessment and prevention. Based on our findings, we propose a fall risk awareness protocol as a fall prevention tool integrating both wearables and ambient sensing technology into a single platform. Copyright © 2016. Published by Elsevier Inc.

Performance Analysis of the Mobile IP Protocol (RFC 3344 and Related RFCS)

Science.gov (United States)

2006-12-01

field of 9 identifies the ICMP message as an adverstisement . Code Mobile IP home agents and foreign agents use the value of 16 to prevent any nodes...ANALYSIS OF THE MOBILE IP PROTOCOL (RFC 3344 AND RELATED RFCS) by Chin Chin Ng December 2006 Thesis Co-Advisors: George W. Dinolt J. D...December 2006 3. REPORT TYPE AND DATES COVERED Master’s Thesis 4. TITLE AND SUBTITLE Performance Analysis of the Mobile IP Protocol (RFC 3344 and

Debate - Achievements of the Trafficking Protocol: Perspectives from the former UN Special Rapporteur on Trafficking in Persons

OpenAIRE

Joy N Ezeilo

2015-01-01

The United Nations (UN) Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children, Supplementing the UN Convention against Transnational Organized Crime, 2000 (Trafficking Protocol), is a watershed in galvanising the global movement against human trafficking. Thanks to the Protocol, international and regional bodies, along with civil society groups, have become involved in researching the issue and supporting anti-trafficking efforts; and states have begun...

Secure and Fair Cluster Head Selection Protocol for Enhancing Security in Mobile Ad Hoc Networks

Directory of Open Access Journals (Sweden)

B. Paramasivan

2014-01-01

Full Text Available Mobile ad hoc networks (MANETs are wireless networks consisting of number of autonomous mobile devices temporarily interconnected into a network by wireless media. MANETs become one of the most prevalent areas of research in the recent years. Resource limitations, energy efficiency, scalability, and security are the great challenging issues in MANETs. Due to its deployment nature, MANETs are more vulnerable to malicious attack. The secure routing protocols perform very basic security related functions which are not sufficient to protect the network. In this paper, a secure and fair cluster head selection protocol (SFCP is proposed which integrates security factors into the clustering approach for achieving attacker identification and classification. Byzantine agreement based cooperative technique is used for attacker identification and classification to make the network more attack resistant. SFCP used to solve this issue by making the nodes that are totally surrounded by malicious neighbors adjust dynamically their belief and disbelief thresholds. The proposed protocol selects the secure and energy efficient cluster head which acts as a local detector without imposing overhead to the clustering performance. SFCP is simulated in network simulator 2 and compared with two protocols including AODV and CBRP.

Secure and fair cluster head selection protocol for enhancing security in mobile ad hoc networks.

Science.gov (United States)

Paramasivan, B; Kaliappan, M

2014-01-01

Mobile ad hoc networks (MANETs) are wireless networks consisting of number of autonomous mobile devices temporarily interconnected into a network by wireless media. MANETs become one of the most prevalent areas of research in the recent years. Resource limitations, energy efficiency, scalability, and security are the great challenging issues in MANETs. Due to its deployment nature, MANETs are more vulnerable to malicious attack. The secure routing protocols perform very basic security related functions which are not sufficient to protect the network. In this paper, a secure and fair cluster head selection protocol (SFCP) is proposed which integrates security factors into the clustering approach for achieving attacker identification and classification. Byzantine agreement based cooperative technique is used for attacker identification and classification to make the network more attack resistant. SFCP used to solve this issue by making the nodes that are totally surrounded by malicious neighbors adjust dynamically their belief and disbelief thresholds. The proposed protocol selects the secure and energy efficient cluster head which acts as a local detector without imposing overhead to the clustering performance. SFCP is simulated in network simulator 2 and compared with two protocols including AODV and CBRP.

Preventive effects of a fermented dairy product against Alzheimer's disease and identification of a novel oleamide with enhanced microglial phagocytosis and anti-inflammatory activity.

Directory of Open Access Journals (Sweden)

Yasuhisa Ano

Full Text Available Despite the ever-increasing number of patients with dementia worldwide, fundamental therapeutic approaches to this condition have not been established. Epidemiological studies suggest that intake of fermented dairy products prevents cognitive decline in the elderly. However, the active compounds responsible for the effect remain to be elucidated. The present study aims to elucidate the preventive effects of dairy products on Alzheimer's disease and to identify the responsible component. Here, in a mouse model of Alzheimer's disease (5xFAD, intake of a dairy product fermented with Penicillium candidum had preventive effects on the disease by reducing the accumulation of amyloid β (Aβ and hippocampal inflammation (TNF-α and MIP-1α production, and enhancing hippocampal neurotrophic factors (BDNF and GDNF. A search for preventive substances in the fermented dairy product identified oleamide as a novel dual-active component that enhanced microglial Aβ phagocytosis and anti-inflammatory activity towards LPS stimulation in vitro and in vivo. During the fermentation, oleamide was synthesized from oleic acid, which is an abundant component of general dairy products owing to lipase enzymatic amidation. The present study has demonstrated the preventive effect of dairy products on Alzheimer's disease, which was previously reported only epidemiologically. Moreover, oleamide has been identified as an active component of dairy products that is considered to reduce Aβ accumulation via enhanced microglial phagocytosis, and to suppress microglial inflammation after Aβ deposition. Because fermented dairy products such as camembert cheese are easy to ingest safely as a daily meal, their consumption might represent a preventive strategy for dementia.

Preventive effects of a fermented dairy product against Alzheimer's disease and identification of a novel oleamide with enhanced microglial phagocytosis and anti-inflammatory activity.

Science.gov (United States)

Ano, Yasuhisa; Ozawa, Makiko; Kutsukake, Toshiko; Sugiyama, Shinya; Uchida, Kazuyuki; Yoshida, Aruto; Nakayama, Hiroyuki

2015-01-01

Despite the ever-increasing number of patients with dementia worldwide, fundamental therapeutic approaches to this condition have not been established. Epidemiological studies suggest that intake of fermented dairy products prevents cognitive decline in the elderly. However, the active compounds responsible for the effect remain to be elucidated. The present study aims to elucidate the preventive effects of dairy products on Alzheimer's disease and to identify the responsible component. Here, in a mouse model of Alzheimer's disease (5xFAD), intake of a dairy product fermented with Penicillium candidum had preventive effects on the disease by reducing the accumulation of amyloid β (Aβ) and hippocampal inflammation (TNF-α and MIP-1α production), and enhancing hippocampal neurotrophic factors (BDNF and GDNF). A search for preventive substances in the fermented dairy product identified oleamide as a novel dual-active component that enhanced microglial Aβ phagocytosis and anti-inflammatory activity towards LPS stimulation in vitro and in vivo. During the fermentation, oleamide was synthesized from oleic acid, which is an abundant component of general dairy products owing to lipase enzymatic amidation. The present study has demonstrated the preventive effect of dairy products on Alzheimer's disease, which was previously reported only epidemiologically. Moreover, oleamide has been identified as an active component of dairy products that is considered to reduce Aβ accumulation via enhanced microglial phagocytosis, and to suppress microglial inflammation after Aβ deposition. Because fermented dairy products such as camembert cheese are easy to ingest safely as a daily meal, their consumption might represent a preventive strategy for dementia.

A SURVEY ON MULTICAST ROUTING PROTOCOLS FOR PERFORMANCE EVALUATION IN WIRELESS SENSOR NETWORK

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A. Suruliandi

2015-03-01

Full Text Available Multicast is a process used to transfer same message to multiple receivers at the same time. This paper presents the simulation and analysis of the performance of six different multicast routing protocols for Wireless Sensor Network (WSN. They are On Demand Multicast Routing Protocol (ODMRP, Protocol for Unified Multicasting through Announcement (PUMA, Multicast Adhoc On demand Distance Vector Protocol (MAODV, Overlay Boruvka-based Adhoc Multicast Protocol (OBAMP, Application Layer Multicast Algorithm (ALMA and enhanced version of ALMA (ALMA-H for WSN. Among them, ODMRP, MAODV and PUMA are reactive protocols while OBAMP, ALMA and ALMA-H are proactive protocols. This paper compares the performance of these protocols with common parameters such as Throughput, Reliability, End-to-End delay and Packet Delivery Ratio (PDR with increasing the numbers of nodes and increasing the speed of the nodes. The main objective of this work is to select the efficient multicast routing protocol for WSN among six multicast routing protocol based on relative strength and weakness of each protocol. The summary of above six multicast routing protocols is presented with a table of different performance characteristics. Experimental result shows that ODMRP attains higher throughput, reliability and higher packet delivery ratio than other multicast routing protocol, while incurring far less end-to-end delay.

Network Based Intrusion Detection and Prevention Systems in IP-Level Security Protocols

OpenAIRE

R. Kabila

2008-01-01

IPsec has now become a standard information security technology throughout the Internet society. It provides a well-defined architecture that takes into account confidentiality, authentication, integrity, secure key exchange and protection mechanism against replay attack also. For the connectionless security services on packet basis, IETF IPsec Working Group has standardized two extension headers (AH&ESP), key exchange and authentication protocols. It is also working on l...

Performance Evaluation of Security Protocols Specified in LySa

DEFF Research Database (Denmark)

Bodei, Chiara; Curti, Michele; Degano, Pierpaolo

2005-01-01

We use a special operational semantics which drives us in inferring quantitative measures on system describing cryptographic protocols. The transitions of the system carry enhanced labels. We assign rates to transitions by only looking at these labels. The rates reflect the distributed architectu...

Researches on the Security of Cluster-based Communication Protocol for Wireless Sensor Networks

Directory of Open Access Journals (Sweden)

Yanhong Sun

2014-08-01

Full Text Available Along with the in-depth application of sensor networks, the security issues have gradually become the bottleneck of wireless sensor applications. To provide a solution for security scheme is a common concern not only of researchers but also of providers, integrators and users of wireless sensor networks. Based on this demand, this paper focuses on the research of strengthening the security of cluster-based wireless sensor networks. Based on the systematic analysis of the clustering protocol and its security enhancement scheme, the paper introduces the broadcast authentication scheme, and proposes an SA-LEACH network security enhancement protocol. The performance analysis and simulation experiments prove that the protocol consumes less energy with the same security requirements, and when the base station is comparatively far from the network deployment area, it is more advantageous in terms of energy consumption and t more suitable for wireless sensor networks.

A Security plan for LMOs - concentrated on environmental policy of Biosafety Protocol

Energy Technology Data Exchange (ETDEWEB)

Park, Yong Ha [Korea Environment Institute, Seoul (Korea)

1998-12-01

Biotechnology industry in Korea is raised by the national support. Also, Korea imports 70% of entire agricultural products. Considering the present situation in Korea, signing a Biosafety Protocol is necessary to prevent harm by LMOs and to protect associated biotechnological industry. Therefore, the problems on signing Biosafety Protocol were analyzed and the environmental policy to be pursued was proposed. This study result will be a cornerstone to prepare a definite environmental policy by government. 54 refs., 7 figs., 27 tabs.

Perancangan dan Analisis Redistribution Routing Protocol OSPF dan EIGRP

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DWI ARYANTA

2014-07-01

OSPF (Open Shortest Path First and EIGRP (Enhanced Interior Gateway Routing Protocol are two routing protocols are widely used in computer networks. Differences between the characteristics of routing protocols pose a problem in the delivery of data packets. Redistribution technique is the solution for communication between routing protocols. By using the software Cisco Packet Tracer 5.3 in this study were made simulating OSPF and EIGRP redistribution linked by technique, then compared its quality with a single EIGRP and OSPF routing protocols. Testing parameters in this study is the value of the time delay and trace route. Value trace route based on direct calculation of cost and metric compared with the simulation results. The result can be OSPF and EIGRP redistribution process. Value delay redistribution 1% better than OSPF and EIGRP 2-3% under traffic density dependent. In calculating the trace route redistribution is done 2 calculations, the cost for OSPF area and the area of the EIGRP metric. Making primary and alternate paths based on the packet delivery rate and the cost of the smallest metric, it is proved by calculation and simulation. Keywords: OSPF, EIGRP, Redistribution, Delay, Cost, Metric.

P-02: Echocardiography Has Low Clinical Efficacy of Libyan Screening Protocol in Athletes

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Salaheddin Sharif

2017-03-01

Full Text Available INTRODUCTIONPre-participation screening has been largely accepted as a means to identify those athletes at risk of cardiovascular diseases which are responsible for sudden cardiac death. The objectives of athlete screening are to reduce injuries and prevent sudden. However, there is no single commonly adopted protocol to screen athletes. Although the European Society of Cardiology and the American Heart Association recommend the routine screening of athletes to prevent sudden death, there is significant disagreement regarding use 12 lead ECG. FIFA has recommend the inclusion of an Echocardiography (ECHO in screening protocol.PURPOSEExplore the debate regarding differences between European and the USA pre-participation screening protocol for sudden death while also considering pre-competition medical assessment protocol used by the Libyan Football Federation. To provide evidence based recommendations on the best protocol to be used for pre-participation screening, and thus to standardize the screening method.MATERIALS and METHOD1236 male athletic received a medical history, general physical examination, cardiovascular and musculoskeletal examination, 12 lead ECG, blood laboratory test, and echocardiography.FINDINGS1235 athletics were found to be eligible to participate in sport and were given a full medical clearance. One athletic was diagnosed with second degree heart block by ECG while his medical history, physical examination, echocardiograph, and blood test were normal.DISCUSSIONEchocardiography alone do did not identify pathological condition and using echocardiography is still controversial and clinically not effective in young athletesCONCLUSIONThe Screening protocol should include a combination of medical history, physical examination and ECG due to the high sensitivity found, and thus it was able to identify all athletes at risk for the disease.

An Enhancement of Campaign Posters for Human Error Prevention in NPPs

International Nuclear Information System (INIS)

Lee, Yong Hee; Lee, Yong Hee; Kwon, Soon Il

2010-01-01

Accidents in high reliability systems such as nuclear power plants (NPPs) give rise to not only a loss of property and life, but also social problems. One of the most frequently used techniques to grasp the current situation for hazard factors in the NPPs is an event investigation analysis based on the INPO's Human Performance Enhancement System (HPES), and the Korean Human Performance Enhancement System (K-HPES) in Korea, respectively. There are many methods and approaches for an HE assessment that is valuable for investigating the causes of undesirable events and counter-plans to prevent their recurrence in the NPPs. They differ from each other according to the objectives of the analysis; the explanation of the event, the investigation of the causes, the allocation of the responsibility, and the establishment of the counter-plan. Event databases include their own events and information from various sources such as the IAEA, regulatory bodies, and also from the INPO and WANO. As many as 111 reactor trips have occurred in the past 5 years ('01∼'05), and 26 cases of them have occurred due to HE. The trend of human error rate didn't decrease in 2004, so the KHNP started to make efforts to decrease HEs. The KHNP created as many as 40 posters for human performance improvement in 2006. The INPO has been using a traditional form of poster; additionally, the Central Research Institute of Electric Power Industry (CRIEPI) developed a type of caution report. The caution report is comprised of a poster name, a serial number, a figure, work situations, the point at issue, and a countermeasure. The preceding posters which KHNP developed in 2006 give a message about specific information related to HE events. However, it is not enough to arouse interest in the effectiveness of the posters because most people are favorably disposed toward a simple poster with many illustrations. Therefore, we stressed the need for worker's receptiveness rather than notification of information

Falls prevention among older people and care providers: protocol for an integrative review

OpenAIRE

Cuesta Benjumea, Carmen de la; Henriques, Maria Adriana; Abad Corpa, Eva; Roe, Brenda; Orts-Cortés, María Isabel; Lidón-Cerezuela, Beatriz; Avendaño-Céspedes, Almudena; Oliver-Carbonell, José Luis; Sánchez Ardila, Carmen

2017-01-01

Aim. To review the evidence about the role of care providers in fall prevention in older adults aged ≥ 65 years, this includes their views, strategies, and approaches on falls prevention and effectiveness of nursing interventions. Background. Some fall prevention programmes are successfully implemented and led by nurses and it is acknowledged the vital role they play in developing plans for fall prevention. Nevertheless, there has not been a systematic review of the literature that describes ...

Performance Analysis of On-Demand Routing Protocols in Wireless Mesh Networks

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Arafatur RAHMAN

2009-01-01

Full Text Available Wireless Mesh Networks (WMNs have recently gained a lot of popularity due to their rapid deployment and instant communication capabilities. WMNs are dynamically self-organizing, self-configuring and self-healing with the nodes in the network automatically establishing an adiej hoc network and preserving the mesh connectivity. Designing a routing protocol for WMNs requires several aspects to consider, such as wireless networks, fixed applications, mobile applications, scalability, better performance metrics, efficient routing within infrastructure, load balancing, throughput enhancement, interference, robustness etc. To support communication, various routing protocols are designed for various networks (e.g. ad hoc, sensor, wired etc.. However, all these protocols are not suitable for WMNs, because of the architectural differences among the networks. In this paper, a detailed simulation based performance study and analysis is performed on the reactive routing protocols to verify the suitability of these protocols over such kind of networks. Ad Hoc On-Demand Distance Vector (AODV, Dynamic Source Routing (DSR and Dynamic MANET On-demand (DYMO routing protocol are considered as the representative of reactive routing protocols. The performance differentials are investigated using varying traffic load and number of source. Based on the simulation results, how the performance of each protocol can be improved is also recommended.

Restraint stress enhances arterial thrombosis in vivo--role of the sympathetic nervous system.

Science.gov (United States)

Stämpfli, Simon F; Camici, Giovanni G; Keller, Stephan; Rozenberg, Izabela; Arras, Margarete; Schuler, Beat; Gassmann, Max; Garcia, Irene; Lüscher, Thomas F; Tanner, Felix C

2014-01-01

Stress is known to correlate with the incidence of acute myocardial infarction. However, the molecular mechanisms underlying this correlation are not known. This study was designed to assess the effect of experimental stress on arterial thrombus formation, the key event in acute myocardial infarction. Mice exposed to 20 h of restraint stress displayed an increased arterial prothrombotic potential as assessed by photochemical injury-induced time to thrombotic occlusion. This increase was prevented by chemical sympathectomy performed through 6-hydroxydopamine (6-OHDA). Blood-born tissue factor (TF) activity was enhanced by stress and this increase could be prevented by 6-OHDA treatment. Vessel wall TF, platelet count, platelet aggregation, coagulation times (PT, aPTT), fibrinolytic system (t-PA and PAI-1) and tail bleeding time remained unaltered. Telemetric analysis revealed only minor hemodynamic changes throughout the stress protocol. Plasma catecholamines remained unaffected after restraint stress. Tumor necrosis factor alpha (TNF-α) plasma levels were unchanged and inhibition of TNF-α had no effect on stress-enhanced thrombosis. These results indicate that restraint stress enhances arterial thrombosis via the sympathetic nervous system. Blood-borne TF contributes, at least in part, to the observed effect whereas vessel wall TF, platelets, circulating coagulation factors, fibrinolysis and inflammation do not appear to play a role. These findings shed new light on the understanding of stress-induced cardiovascular events.

A Push-pull Protocol to Reduce Colonization of Bird Nest Boxes by Honey Bees.

Science.gov (United States)

Efstathion, Caroline A; Kern, William H

2016-09-04

Introduction of the invasive Africanized honey bee (AHB) into the Neotropics is a serious problem for many cavity nesting birds, specifically parrots. These bees select cavities that are suitable nest sites for birds, resulting in competition. The difficulty of removing bees and their defensive behavior makes a prevention protocol necessary. Here, we describe a push-pull integrated pest management protocol to deter bees from inhabiting bird boxes by applying a bird safe insecticide, permethrin, to repel bees from nest boxes, while simultaneously attracting them to pheromone-baited swarm traps. Shown here is an example experiment using Barn Owl nest boxes. This protocol successfully reduced colonization of Barn Owl nest boxes by Africanized honey bees. This protocol is flexible, allowing adjustments to accommodate a wide range of bird species and habitats. This protocol could benefit conservation efforts where AHB are located.

Protocols development for security and privacy of radio frequency identification systems

Science.gov (United States)

Sabbagha, Fatin

There are benefits to adopting radio frequency identification (RFID) technology, although there are methods of attack that can compromise the system. This research determined how that may happen and what possible solutions can keep that from happening. Protocols were developed to implement better security. In addition, new topologies were developed to handle the problems of the key management. Previously proposed protocols focused on providing mutual authentication and privacy between readers and tags. However, those protocols are still vulnerable to be attacked. These protocols were analyzed and the disadvantages shown for each one. Previous works assumed that the channels between readers and the servers were secure. In the proposed protocols, a compromised reader is considered along with how to prevent tags from being read by that reader. The new protocols provide mutual authentication between readers and tags and, at the same time, remove the compromised reader from the system. Three protocols are proposed. In the first protocol, a mutual authentication is achieved and a compromised reader is not allowed in the network. In the second protocol, the number of times a reader contacts the server is reduced. The third protocol provides authentication and privacy between tags and readers using a trusted third party. The developed topology is implemented using python language and simulates work to check the efficiency regarding the processing time. The three protocols are implemented by writing codes in C language and then compiling them in MSP430. IAR Embedded workbench is used, which is an integrated development environment with the C/C++ compiler to generate a faster code and to debug the microcontroller. In summary, the goal of this research is to find solutions for the problems on previously proposed protocols, handle a compromised reader, and solve key management problems.

Management of Energy Consumption on Cluster Based Routing Protocol for MANET

Science.gov (United States)

Hosseini-Seno, Seyed-Amin; Wan, Tat-Chee; Budiarto, Rahmat; Yamada, Masashi

The usage of light-weight mobile devices is increasing rapidly, leading to demand for more telecommunication services. Consequently, mobile ad hoc networks and their applications have become feasible with the proliferation of light-weight mobile devices. Many protocols have been developed to handle service discovery and routing in ad hoc networks. However, the majority of them did not consider one critical aspect of this type of network, which is the limited of available energy in each node. Cluster Based Routing Protocol (CBRP) is a robust/scalable routing protocol for Mobile Ad hoc Networks (MANETs) and superior to existing protocols such as Ad hoc On-demand Distance Vector (AODV) in terms of throughput and overhead. Therefore, based on this strength, methods to increase the efficiency of energy usage are incorporated into CBRP in this work. In order to increase the stability (in term of life-time) of the network and to decrease the energy consumption of inter-cluster gateway nodes, an Enhanced Gateway Cluster Based Routing Protocol (EGCBRP) is proposed. Three methods have been introduced by EGCBRP as enhancements to the CBRP: improving the election of cluster Heads (CHs) in CBRP which is based on the maximum available energy level, implementing load balancing for inter-cluster traffic using multiple gateways, and implementing sleep state for gateway nodes to further save the energy. Furthermore, we propose an Energy Efficient Cluster Based Routing Protocol (EECBRP) which extends the EGCBRP sleep state concept into all idle member nodes, excluding the active nodes in all clusters. The experiment results show that the EGCBRP decreases the overall energy consumption of the gateway nodes up to 10% and the EECBRP reduces the energy consumption of the member nodes up to 60%, both of which in turn contribute to stabilizing the network.

Interventions for the prevention of cardiovascular diseases: a protocol for a systematic review of economic evaluations in low-income and middle-income countries.

Science.gov (United States)

Aminde, Leopold Ndemnge; Veerman, Lennert

2016-12-21

Low-income and middle-income countries (LMICs) are experiencing a growing disease burden due to cardiovascular and other chronic non-communicable diseases. Interventions for the control of these diseases are paramount; however, these countries are faced with competing health and financial needs. There is an urgent need for quality evidence on cost-effective strategies to address these chronic diseases. We aim to synthesise the current literature on economic evaluations of interventions for primary and secondary cardiovascular disease prevention in LMICs. A systematic review of studies (published and unpublished) in LMICs up to 30 October 2016 will be conducted. The following databases will be searched: PubMed/MEDLINE, EMBASE, SCOPUS, CINAHL, Web of Science, EconLit, NHS Economic Evaluations Database (NHS EED). Data sources specific to African literature, such as the WHO AFROLIB, Africa Index Medicus and African Journals online (AJOL) as well as grey literature, will also be searched. 2 reviewers shall independently screen potential articles for inclusion and disagreements shall be resolved by consensus. Quality appraisal of studies shall be done using Drummond's checklist for economic evaluation of studies. A descriptive synthesis of the evidence obtained is planned. The primary outcomes will be costs per life years gained or unit of clinical outcome, cost per quality-adjusted life years or disability-adjusted life years. This systematic review protocol has been prepared according to the Preferred Reporting Items for Systematic reviews and Meta-analyses for Protocols (PRISMA-P) 2015 statement. Ethics approval is not required considering that this is a protocol for a systematic review of published studies. Results from this review will be disseminated via conference presentations and peer-reviewed journal publications. CRD42016043510. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Preventive Effects of a Fermented Dairy Product against Alzheimer’s Disease and Identification of a Novel Oleamide with Enhanced Microglial Phagocytosis and Anti-Inflammatory Activity

Science.gov (United States)

Ano, Yasuhisa; Ozawa, Makiko; Kutsukake, Toshiko; Sugiyama, Shinya; Uchida, Kazuyuki; Yoshida, Aruto; Nakayama, Hiroyuki

2015-01-01

Despite the ever-increasing number of patients with dementia worldwide, fundamental therapeutic approaches to this condition have not been established. Epidemiological studies suggest that intake of fermented dairy products prevents cognitive decline in the elderly. However, the active compounds responsible for the effect remain to be elucidated. The present study aims to elucidate the preventive effects of dairy products on Alzheimer’s disease and to identify the responsible component. Here, in a mouse model of Alzheimer’s disease (5xFAD), intake of a dairy product fermented with Penicillium candidum had preventive effects on the disease by reducing the accumulation of amyloid β (Aβ) and hippocampal inflammation (TNF-α and MIP-1α production), and enhancing hippocampal neurotrophic factors (BDNF and GDNF). A search for preventive substances in the fermented dairy product identified oleamide as a novel dual-active component that enhanced microglial Aβ phagocytosis and anti-inflammatory activity towards LPS stimulation in vitro and in vivo. During the fermentation, oleamide was synthesized from oleic acid, which is an abundant component of general dairy products owing to lipase enzymatic amidation. The present study has demonstrated the preventive effect of dairy products on Alzheimer’s disease, which was previously reported only epidemiologically. Moreover, oleamide has been identified as an active component of dairy products that is considered to reduce Aβ accumulation via enhanced microglial phagocytosis, and to suppress microglial inflammation after Aβ deposition. Because fermented dairy products such as camembert cheese are easy to ingest safely as a daily meal, their consumption might represent a preventive strategy for dementia. PMID:25760987

Latency correction of event-related potentials between different experimental protocols

Science.gov (United States)

Iturrate, I.; Chavarriaga, R.; Montesano, L.; Minguez, J.; Millán, JdR

2014-06-01

Objective. A fundamental issue in EEG event-related potentials (ERPs) studies is the amount of data required to have an accurate ERP model. This also impacts the time required to train a classifier for a brain-computer interface (BCI). This issue is mainly due to the poor signal-to-noise ratio and the large fluctuations of the EEG caused by several sources of variability. One of these sources is directly related to the experimental protocol or application designed, and may affect the amplitude or latency of ERPs. This usually prevents BCI classifiers from generalizing among different experimental protocols. In this paper, we analyze the effect of the amplitude and the latency variations among different experimental protocols based on the same type of ERP. Approach. We present a method to analyze and compensate for the latency variations in BCI applications. The algorithm has been tested on two widely used ERPs (P300 and observation error potentials), in three experimental protocols in each case. We report the ERP analysis and single-trial classification. Main results. The results obtained show that the designed experimental protocols significantly affect the latency of the recorded potentials but not the amplitudes. Significance. These results show how the use of latency-corrected data can be used to generalize the BCIs, reducing the calibration time when facing a new experimental protocol.

Improvement of pressure ulcer prevention care in private for-profit residential care homes: an action research study.

Science.gov (United States)

Kwong, Enid Wy; Hung, Maria Sy; Woo, Kevin

2016-11-25

A need exits to develop a protocol for preventing pressure ulcers (PUs) in private for-profit nursing homes in Hong Kong, where the incidence of PUs is relatively high and which have high proportion of non-professional care staff. The implementation of such protocol would involve changes in the practice of care, likely evoking feelings of fear and uncertainty that may become a barrier to staff adherence. We thus adopted the Systems Model of Action Research in this study to manage the process of change for improving PU prevention care and to develop a pressure ulcer prevention protocol for private for-profit nursing homes. A total of 474 residents and care staff who were health workers, personal care workers, and/or nurses from four private, for-profit nursing homes in Hong Kong participated in this study. Three cyclic stages and steps, namely, unfreezing (planning), changing (action), and refreezing (results) were carried out. During each cycle, focus group interviews, field observations of the care staff's practices and inspections of the skin of the residents for pressure ulcers were conducted to evaluate the implementation of the protocol. Qualitative content analysis was adopted to analyse the data. The data and methodological triangulation used in this study increased the credibility and validity of the results. The following nine themes emerged from this study: prevention practices after the occurrence of PUs, the improper use of pressure ulcer prevention materials, non-compliance with several prevention practices, improper prevention practices, the perception that the preventive care was being performed correctly, inadequate readiness to use the risk assessment tool, an undesirable environment, the supplying of unfavorable resources, and various management styles in the homes with or without nurses. At the end of the third cycle, the changes that were identified included improved compliance with the revised risk assessment method, the timely and appropriate

Translational study of obesity management using the Diabetes Prevention Program "Group Lifestyle Balance" in primary care clinics and public hospitals from Mexico: study protocol

Directory of Open Access Journals (Sweden)

Rolando Giovanni Díaz-Zavala

2017-12-01

Full Text Available Introduction: Obesity is the main modifiable risk factor for the development of chronic diseases in Mexico. Several randomized controlled trials have shown that intensive lifestyle programs are efficacious for the management of obesity. These programs include frequent sessions (14 or more contacts in the first 6 months focused on diet and physical activity and use a behavior change protocol. However, most Mexican primary care clinics and public hospitals apply traditional treatments for obesity management with limited results on weight loss. The purpose of the study is to evaluate the effectiveness of the Diabetes Prevention Program (DPP “Group Lifestyle Balance” for weight loss among adults with overweight and obesity from baseline to 6 months and from baseline to 12 months in primary care clinics and public hospitals from Sonora, Mexico. Material and Methods: This is a translational, multi-center, non-controlled, 6 and 12-month follow-up clinical study with a pre-test and post-test design. Healthcare providers from two primary care clinics, two hospitals and one university clinic will be trained with the DPP protocol to implement on their patients with overweight and obesity. Body weight, body mass index, waist circumference, systolic and diastolic blood pressure, depression, quality of life and stress scales will be measured in participants receiving the program at baseline, 6 and 12 months. Biochemical parameters will be measured at baseline and 12 months. The primary outcome is the change in body weight at 6 and 12 months. Discussion: This study will provide scientific evidence of the effectiveness of the DPP protocol as a model for obesity management in real world clinical practice among the adult Mexican population.

Desensitization to clopidogrel: a tailor-made protocol.

Science.gov (United States)

Barreira, P; Cadinha, S; Malheiro, D; Moreira da Silva, J P

2014-01-01

Clopidogrel is an antiplatelet drug widely used for treatment and prevention of a variety of cardiovascular diseases. We report a successful desensitization to clopidogrel in a 70-year-old Caucasian man with delayed hypersensitivity (HS) reaction. He developed lip, hand and foot swelling, erythematous papular non-pruritic lesions and arthralgias 2 weeks after starting treatment with clopidogrel 75 mg/d. A 3-hour desensitization protocol was started, achieving a cumulative dose of 154 mg without any reaction, and a daily dose of 75 mg was recommended. On the 4th day, the patient developed skin lesions similar to the previously described. He was treated with topical steroids and oral antihistamines, and the daily dose of clopidogrel was reduced to 20 mg. A new desensitization protocol was established, with a slow dose increment, according to the patient's response. It was only possible to achieve the dose of 75 mg/d after 2 months. Although well tolerated by most patients, HS reactions with clopidogrel may occur and desensitization is rising as a safe alternative in those patients. In delayed reactions with cutaneous lesions, a slower desensitization protocol may be necessary, as in this case.

Preventive evidence into practice (PEP study: implementation of guidelines to prevent primary vascular disease in general practice protocol for a cluster randomised controlled trial

Directory of Open Access Journals (Sweden)

Harris Mark F

2013-01-01

Full Text Available Abstract Background There are significant gaps in the implementation and uptake of evidence-based guideline recommendations for cardiovascular disease (CVD and diabetes in Australian general practice. This study protocol describes the methodology for a cluster randomised trial to evaluate the effectiveness of a model that aims to improve the implementation of these guidelines in Australian general practice developed by a collaboration between researchers, non-government organisations, and the profession. Methods We hypothesise that the intervention will alter the behaviour of clinicians and patients resulting in improvements of recording of lifestyle and physiological risk factors (by 20% and increased adherence to guideline recommendations for: the management of CVD and diabetes risk factors (by 20%; and lifestyle and physiological risk factors of patients at risk (by 5%. Thirty-two general practices will be randomised in a 1:1 allocation to receive either the intervention or continue with usual care, after stratification by state. The intervention will be delivered through: small group education; audit of patient records to determine preventive care; and practice facilitation visits adapted to the needs of the practices. Outcome data will be extracted from electronic medical records and patient questionnaires, and qualitative evaluation from provider and patient interviews. Discussion We plan to disseminate study findings widely and directly inform implementation strategies by governments, professional bodies, and non-government organisations including the partner organisations.

Effectiveness of adolescent suicide prevention e-learning modules that aim to improve knowledge and self-confidence of gatekeepers: Study protocol of a randomized controlled trial

NARCIS (Netherlands)

Ghoncheh, R.; Kerkhof, A.J.F.M.; Koot, H.M.

2014-01-01

Background: Providing e-learning modules can be an effective strategy for enhancing gatekeepers' knowledge, self-confidence and skills in adolescent suicide prevention. The aim of this study was to test the effectiveness of an online training program called Mental Health Online which consists of

A Secure Key Establishment Protocol for ZigBee Wireless Sensor Networks

DEFF Research Database (Denmark)

Yuksel, Ender; Nielson, Hanne Riis; Nielson, Flemming

2009-01-01

ZigBee is a wireless sensor network standard that defines network and application layers on top of IEEE 802.15.4’s physical and medium access control layers. In the latest version of ZigBee, enhancements are prescribed for the security sublayer but we show in this paper that problems persist....... In particular we show that the End-to-End Application Key Establishment Protocol is flawed and we propose a secure protocol instead. We do so by using formal verification techniques based on static program analysis and process algebras. We present a way of using formal methods in wireless network security......, and propose a secure key establishment protocol for ZigBee networks....

Quorum system and random based asynchronous rendezvous protocol for cognitive radio ad hoc networks

Directory of Open Access Journals (Sweden)

Sylwia Romaszko

2013-12-01

Full Text Available This paper proposes a rendezvous protocol for cognitive radio ad hoc networks, RAC2E-gQS, which utilizes (1 the asynchronous and randomness properties of the RAC2E protocol, and (2 channel mapping protocol, based on a grid Quorum System (gQS, and taking into account channel heterogeneity and asymmetric channel views. We show that the combination of the RAC2E protocol with the grid-quorum based channel mapping can yield a powerful RAC2E-gQS rendezvous protocol for asynchronous operation in a distributed environment assuring a rapid rendezvous between the cognitive radio nodes having available both symmetric and asymmetric channel views. We also propose an enhancement of the protocol, which uses a torus QS for a slot allocation, dealing with the worst case scenario, a large number of channels with opposite ranking lists.

Persistent RCSMA: A MAC Protocol for a Distributed Cooperative ARQ Scheme in Wireless Networks

Directory of Open Access Journals (Sweden)

J. Alonso-Zárate

2008-05-01

Full Text Available The persistent relay carrier sensing multiple access (PRCSMA protocol is presented in this paper as a novel medium access control (MAC protocol that allows for the execution of a distributed cooperative automatic retransmission request (ARQ scheme in IEEE 802.11 wireless networks. The underlying idea of the PRCSMA protocol is to modify the basic rules of the IEEE 802.11 MAC protocol to execute a distributed cooperative ARQ scheme in wireless networks in order to enhance their performance and to extend coverage. A closed formulation of the distributed cooperative ARQ average packet transmission delay in a saturated network is derived in the paper. The analytical equations are then used to evaluate the performance of the protocol under different network configurations. Both the accuracy of the analysis and the performance evaluation of the protocol are supported and validated through computer simulations.

Smart Traffic Management Protocol Based on VANET architecture

Directory of Open Access Journals (Sweden)

Amilcare Francesco Santamaria

2014-01-01

Full Text Available Nowadays one of the hottest theme in wireless environments research is the application of the newest technologies to road safety problems and traffic management exploiting the (VANET architecture. In this work, a novel protocol that aims to achieve a better traffic management is proposed. The overal system is able to reduce traffic level inside the city exploiting inter-communication among vehicles and support infrastructures also known as (V2V and (V2I communications. We design a network protocol called (STMP that takes advantages of IEEE 802.11p standard. On each road several sensors system are placed and they are responsible of monitoring. Gathered data are spread in the network exploiting ad-hoc protocol messages. The increasing knowledge about environment conditions make possible to take preventive actions. Moreover, having a realtime monitoring of the lanes it is possible to reveal roads and city blocks congestions in a shorter time. An external entity to the (VANET is responsible to manage traffic and rearrange traffic along the lanes of the city avoiding huge traffic levels.

Traffic Adaptive MAC Protocols in Wireless Body Area Networks

Directory of Open Access Journals (Sweden)

Farhan Masud

2017-01-01

Full Text Available In Wireless Body Area Networks (WBANs, every healthcare application that is based on physical sensors is responsible for monitoring the vital signs data of patient. WBANs applications consist of heterogeneous and dynamic traffic loads. Routine patient’s observation is described as low-load traffic while an alarming situation that is unpredictable by nature is referred to as high-load traffic. This paper offers a thematic review of traffic adaptive Medium Access Control (MAC protocols in WBANs. First, we have categorized them based on their goals, methods, and metrics of evaluation. The Zigbee standard IEEE 802.15.4 and the baseline MAC IEEE 802.15.6 are also reviewed in terms of traffic adaptive approaches. Furthermore, a comparative analysis of the protocols is made and their performances are analyzed in terms of delay, packet delivery ratio (PDR, and energy consumption. The literature shows that no review work has been done on traffic adaptive MAC protocols in WBANs. This review work, therefore, could add enhancement to traffic adaptive MAC protocols and will stimulate a better way of solving the traffic adaptivity problem.

Enhanced living environments from models to technologies

CERN Document Server

Dobre, Ciprian; Ganchev, Ivan; Garcia, Nuno; Goleva, Rossitza Ivanova

2017-01-01

Enhanced living environments employ information and communications technologies to support true ambient assisted living for people with disabilities. This book provides an overview of today's architectures, techniques, protocols, components, and cloud-based solutions related to ambient assisted living and enhanced living environments.

Zingiber officinale Roscoe prevents acetaminophen-induced acute hepatotoxicity by enhancing hepatic antioxidant status.

Science.gov (United States)

Ajith, T A; Hema, U; Aswathy, M S

2007-11-01

A large number of xenobiotics are reported to be potentially hepatotoxic. Free radicals generated from the xenobiotic metabolism can induce lesions of the liver and react with the basic cellular constituents - proteins, lipids, RNA and DNA. Hepatoprotective activity of aqueous ethanol extract of Zingiber officinale was evaluated against single dose of acetaminophen-induced (3g/kg, p.o.) acute hepatotoxicity in rat. Aqueous extract of Z. officinale significantly protected the hepatotoxicity as evident from the activities of serum transaminase and alkaline phosphatase (ALP). Serum glutamate pyruvate transaminase (SGPT), serum glutamate oxaloacetate transaminase (SGOT) and ALP activities were significantly (pHepatic lipid peroxidation was enhanced significantly (pofficinale (200 and 400mg/kg, p.o.) prior to acetaminophen significantly declines the activities of serum transaminases and ALP. Further the hepatic antioxidant status was enhanced in the Z. officinale plus acetaminophen treated group than the control group. The results of the present study concluded that the hepatoprotective effect of aqueous ethanol extract of Z. officinale against acetaminophen-induced acute toxicity is mediated either by preventing the decline of hepatic antioxidant status or due to its direct radical scavenging capacity.

Enhancing spill prevention and response preparedness through quality control techniques

International Nuclear Information System (INIS)

Jones, M.A.; Butts, R.L.; Pickering, T.H.; Lindsay, J.R.; McCully, B.S.

1993-01-01

The year 1990 saw passage of federal and state oil spill legislation directing the US Environmental Protection Agency and the Florida Department of Environmental Regulation to require on shore bulk petroleum storage facilities to improve their oil spill response and prevention capabilities. The Florida Power ampersand Light Company (FPL), to address concerns arising out of several recent significant spills which had occurred worldwide, and to examine its current situation with regard compliance with the new laws, formed a quality improvement interdepartmental task team in July 1989. Its mission was to reduce the potential for oil spills during waterborne transportation between FPL's fuel oil terminals and its power plants and during transfer and storage of oil at these facilities. Another objective of the team was to enhance the company's spill response preparedness. Using quality control tools and reliability techniques, the team conducted a detailed analysis of seven coastal power plants and five fuel oil terminal facilities. This analysis began with the development of cause-and-effect diagrams designed to identify the root causes of spills so that corrective and preventive actions could be taken. These diagram are constructed by listing possible causes of oil spills under various major categories of possible system breakdown, such as man, method, equipment, and materials. Next, potential root causes are identified and then verified. The team identified the occurrence of surface water oil spill and reduced spill response capability as primary concerns and accordingly constructed cause-and-effect diagrams for both components. Lack of proper procedures, failure of control equipment, and inadequate facility design were identified as potential root causes leading to surface water oil spills. Lack of proper procedures, an inconsistent training program, and response equipment limitations were identified as potential root causes affecting oil spill response capabilities

High-Yield HIV Testing, Facilitated Linkage to Care, and Prevention for Female Youth in Kenya (GIRLS Study): Implementation Science Protocol for a Priority Population.

Science.gov (United States)

Inwani, Irene; Chhun, Nok; Agot, Kawango; Cleland, Charles M; Buttolph, Jasmine; Thirumurthy, Harsha; Kurth, Ann E

2017-12-13

Sub-Saharan Africa is the region with the highest HIV burden. Adolescent girls and young women (AGYW) in the age range of 15 to 24 years are twice as likely as their male peers to be infected, making females in sub-Saharan Africa the most at-risk group for HIV infection. It is therefore critical to prioritize access to HIV testing, prevention, and treatment for this vulnerable population. Using an implementation science framework, the purpose of this research protocol was to describe the approaches we propose to optimize engagement of AGYW in both the HIV prevention and care continuum and to determine the recruitment and testing strategies that identify the highest proportion of previously undiagnosed HIV infections. We will compare two seek recruitment strategies, three test strategies, and pilot adaptive linkage to care interventions (sequential multiple assignment randomized trial [SMART] design) among AGYW in the age range of 15 to 24 years in Homa Bay County, western Kenya. AGYW will be recruited in the home or community-based setting and offered three testing options: oral fluid HIV self-testing, staff-aided rapid HIV testing, or referral to a health care facility for standard HIV testing services. Newly diagnosed AGYW with HIV will be enrolled in the SMART trial pilot to determine the most effective way to support initial linkage to care after a positive diagnosis. They will be randomized to standard referral (counseling and a referral note) or standard referral plus SMS text message (short message service, SMS); those not linked to care within 2 weeks will be rerandomized to receive an additional SMS text message or a one-time financial incentive (approximately US $4). We will also evaluate a primary prevention messaging intervention to support identified high-risk HIV-negative AGYW to reduce their HIV risk and adhere to HIV retesting recommendations. We will also conduct analyses to determine the incremental cost-effectiveness of the seek, testing and

Enhanced Severe Transient Analysis for Prevention Technical Program Plan

Energy Technology Data Exchange (ETDEWEB)

Gougar, Hans [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2014-09-01

This document outlines the development of a high fidelity, best estimate nuclear power plant severe transient simulation capability that will complement or enhance the integral system codes historically used for licensing and analysis of severe accidents. As with other tools in the Risk Informed Safety Margin Characterization (RISMC) Toolkit, the ultimate user of Enhanced Severe Transient Analysis and Prevention (ESTAP) capability is the plant decision-maker; the deliverable to that customer is a modern, simulation-based safety analysis capability, applicable to a much broader class of safety issues than is traditional Light Water Reactor (LWR) licensing analysis. Currently, the RISMC pathway’s major emphasis is placed on developing RELAP-7, a next-generation safety analysis code, and on showing how to use RELAP-7 to analyze margin from a modern point of view: that is, by characterizing margin in terms of the probabilistic spectra of the “loads” applied to systems, structures, and components (SSCs), and the “capacity” of those SSCs to resist those loads without failing. The first objective of the ESTAP task, and the focus of one task of this effort, is to augment RELAP-7 analyses with user-selected multi-dimensional, multi-phase models of specific plant components to simulate complex phenomena that may lead to, or exacerbate, severe transients and core damage. Such phenomena include: coolant crossflow between PWR assemblies during a severe reactivity transient, stratified single or two-phase coolant flow in primary coolant piping, inhomogeneous mixing of emergency coolant water or boric acid with hot primary coolant, and water hammer. These are well-documented phenomena associated with plant transients but that are generally not captured in system codes. They are, however, generally limited to specific components, structures, and operating conditions. The second ESTAP task is to similarly augment a severe (post-core damage) accident integral analyses code

Standardized CT protocols and nomenclature: better, but not yet there

Energy Technology Data Exchange (ETDEWEB)

Singh, Sarabjeet; Kalra, Mannudeep K. [Harvard Medical School, Department of Radiology, Massachusetts General Hospital, Boston, MA (United States)

2014-10-15

Radiation dose associated with CT is an important safety concern in patient care, especially in children. Technical advancements in multidetector-row CT scanner technology offer several advantages for clinical applications; these advancements have considerably increased CT utilization and enhanced the complexity of CT scanning protocols. Furthermore there are several scan manufacturers spearheading these technical advancements, leading to different commercial names causing confusion among the users, especially at imaging sites with scanners from different vendors. Several scientific studies and the National Council on Radiation Protection and Measurements (NCRP) have shown variation in CT radiation doses for same body region and similar scanning protocols. Therefore there is a need for standardization of scanning protocols and nomenclature of scan parameters. The following material reviews the status and challenges in standardization of CT scanning and nomenclature. (orig.)

A RFID grouping proof protocol for medication safety of inpatient.

Science.gov (United States)

Huang, Hsieh-Hong; Ku, Cheng-Yuan

2009-12-01

In order to provide enhanced medication safety for inpatients, the medical mechanism which adopts the modified grouping proof protocol is proposed in this paper. By using the grouping proof protocol, the medical staffs could confirm the authentication and integrity of a group of Radio-Frequency Identification (RFID) tags which are embedded on inpatient bracelets and the containers of drugs. This mechanism is designed to be compatible with EPCglobal Class-1 Generation-2 standard which is the most popular specification of RFID tags. Due to the light-weight computational capacity of passive tags, only the pseudo-random number generator (PRNG) and cyclic redundancy code (CRC) are allowed to be used in the communication protocol. Furthermore, a practical scenario of using this proposed mechanism in hospital to examine the medication safety is also presented.

Comparison between stress myocardial perfusion SPECT recorded with cadmium-zinc-telluride and Anger cameras in various study protocols

International Nuclear Information System (INIS)

Verger, Antoine; Karcher, Gilles; Djaballah, Wassila; Fourquet, Nicolas; Rouzet, Francois; Le Guludec, Dominique; Koehl, Gregoire; Roch, Veronique; Imbert, Laetitia; Poussier, Sylvain; Fay, Renaud; Marie, Pierre-Yves

2013-01-01

The results of stress myocardial perfusion SPECT could be enhanced by new cadmium-zinc-telluride (CZT) cameras, although differences compared to the results with conventional Anger cameras remain poorly known for most study protocols. This study was aimed at comparing the results of CZT and Anger SPECT according to various study protocols while taking into account the influence of obesity. The study population, which was from three different institutions equipped with identical CZT cameras, comprised 276 patients referred for study using protocols involving 201 Tl (n = 120) or 99m Tc-sestamibi injected at low dose at stress ( 99m Tc-Low; stress/rest 1-day protocol; n = 110) or at high dose at stress ( 99m Tc-High; rest/stress 1-day or 2-day protocol; n = 46). Each Anger SPECT scan was followed by a high-speed CZT SPECT scan (2 to 4 min). Agreement rates between CZT and Anger SPECT were good irrespective of the study protocol (for abnormal SPECT, 201 Tl 92 %, 99m Tc-Low 86 %, 99m Tc-High 98 %), although quality scores were much higher for CZT SPECT with all study protocols. Overall correlations were high for the extent of myocardial infarction (r = 0.80) and a little lower for ischaemic areas (r = 0.72), the latter being larger on Anger SPECT (p 201 Tl or 99m Tc-Low group and in whom stress myocardial counts were particularly low with Anger SPECT (228 ± 101 kcounts) and dramatically enhanced with CZT SPECT (+279 ± 251 %). Concordance between the results of CZT and Anger SPECT is good regardless of study protocol and especially when excluding obese patients who have low-count Anger SPECT and for whom myocardial counts are dramatically enhanced on CZT SPECT. (orig.)

Final report for the protocol extensions for ATM Security Laboratory Directed Research and Development Project

Energy Technology Data Exchange (ETDEWEB)

Tarman, T.D.; Pierson, L.G.; Brenkosh, J.P. [and others

1996-03-01

This is the summary report for the Protocol Extensions for Asynchronous Transfer Mode project, funded under Sandia`s Laboratory Directed Research and Development program. During this one-year effort, techniques were examined for integrating security enhancements within standard ATM protocols, and mechanisms were developed to validate these techniques and to provide a basic set of ATM security assurances. Based on our experience during this project, recommendations were presented to the ATM Forum (a world-wide consortium of ATM product developers, service providers, and users) to assist with the development of security-related enhancements to their ATM specifications. As a result of this project, Sandia has taken a leading role in the formation of the ATM Forum`s Security Working Group, and has gained valuable alliances and leading-edge experience with emerging ATM security technologies and protocols.

Improving the security of a quantum secret sharing protocol between multiparty and multiparty without entanglement

International Nuclear Information System (INIS)

Han Lianfang; Liu Yimin; Shi Shouhua; Zhang Zhanjun

2007-01-01

Recently Yan and Gao [F.L. Yan, T. Gao, Phys. Rev. A 72 (2005) 012304] have proposed a quantum secret sharing protocol which allows a secret message to be shared between one group of m parties and another group of n parties. The protocol is claimed to be secure. In this Letter, first we show that any subgroup consisting of evil cooperative parties (or one and only one evil party) can successfully cheat other parties to obtain the secret message without being detected. Then we improve the original Yan-Gao protocol such that the insider's cheats are prevented

Perancangan dan Analisis Redistribution Routing Protocol OSPF dan EIGRP

Directory of Open Access Journals (Sweden)

DWI ARYANTA

2016-02-01

Full Text Available Abstrak OSPF (Open Shortest Path First dan EIGRP (Enhanced Interior Gateway Routing Protocol adalah dua routing protokol yang banyak digunakan dalam jaringan komputer. Perbedaan karakteristik antar routing protokol menimbulkan masalah dalam pengiriman paket data. Teknik redistribution adalah solusi untuk melakukan komunikasi antar routing protokol. Dengan menggunakan software Cisco Packet Tracer 5.3 pada penelitian ini dibuat simulasi OSPF dan EIGRP yang dihubungkan oleh teknik redistribution, kemudian dibandingkan kualitasnya dengan single routing protokol EIGRP dan OSPF. Parameter pengujian dalam penelitian ini adalah nilai time delay dan trace route. Nilai trace route berdasarkan perhitungan langsung cost dan metric dibandingkan dengan hasil simulasi. Hasilnya dapat dilakukan proses redistribution OSPF dan EIGRP. Nilai delay redistribution lebih baik 1% dibanding OSPF dan 2-3% di bawah EIGRP tergantung kepadatan traffic. Dalam perhitungan trace route redistribution dilakukan 2 perhitungan, yaitu cost untuk area OSPF dan metric pada area EIGRP. Pengambilan jalur utama dan alternatif pengiriman paket berdasarkan nilai cost dan metric yang terkecil, hal ini terbukti berdasarkan perhitungan dan simulasi. Kata kunci: OSPF, EIGRP, Redistribution, Delay, Cost, Metric. Abstract OSPF (Open Shortest Path First and EIGRP (Enhanced Interior Gateway Routing Protocol are two routing protocols are widely used in computer networks. Differences between the characteristics of routing protocols pose a problem in the delivery of data packets. Redistribution technique is the solution for communication between routing protocols. By using the software Cisco Packet Tracer 5.3 in this study were made simulating OSPF and EIGRP redistribution linked by technique, then compared its quality with a single EIGRP and OSPF routing protocols. Testing parameters in this study is the value of the time delay and trace route. Value trace route based on direct calculation of cost

Compliance With Protocols for Prevention of Neonatal Group B Streptococcal Sepsis: Practicalities and Limitations

Directory of Open Access Journals (Sweden)

Gwendolyn L. Gilbert

2003-01-01

Full Text Available Objective: To compare two protocols for intrapartum antibiotic prophylaxis (IAP against neonatal group B streptococcal (GBS sepsis, with respect to staff compliance, in a prospective cohort study in the obstetric units of a community hospital (A and a university teaching hospital (B.

A network identity authentication protocol of bank account system based on fingerprint identification and mixed encryption

Science.gov (United States)

Zhu, Lijuan; Liu, Jingao

2013-07-01

This paper describes a network identity authentication protocol of bank account system based on fingerprint identification and mixed encryption. This protocol can provide every bank user a safe and effective way to manage his own bank account, and also can effectively prevent the hacker attacks and bank clerk crime, so that it is absolute to guarantee the legitimate rights and interests of bank users.

An Enhanced Preventive Maintenance Optimization Model Based on a Three-Stage Failure Process

Directory of Open Access Journals (Sweden)

Ruifeng Yang

2015-01-01

Full Text Available Nuclear power plants are highly complex systems and the issues related to their safety are of primary importance. Probabilistic safety assessment is regarded as the most widespread methodology for studying the safety of nuclear power plants. As maintenance is one of the most important factors for affecting the reliability and safety, an enhanced preventive maintenance optimization model based on a three-stage failure process is proposed. Preventive maintenance is still a dominant maintenance policy due to its easy implementation. In order to correspond to the three-color scheme commonly used in practice, the lifetime of system before failure is divided into three stages, namely, normal, minor defective, and severe defective stages. When the minor defective stage is identified, two measures are considered for comparison: one is that halving the inspection interval only when the minor defective stage is identified at the first time; the other one is that if only identifying the minor defective stage, the subsequent inspection interval is halved. Maintenance is implemented immediately once the severe defective stage is identified. Minimizing the expected cost per unit time is our objective function to optimize the inspection interval. Finally, a numerical example is presented to illustrate the effectiveness of the proposed models.

Improvement of the safety of a clinical process using failure mode and effects analysis: Prevention of venous thromboembolic disease in critical patients.

Science.gov (United States)

Viejo Moreno, R; Sánchez-Izquierdo Riera, J Á; Molano Álvarez, E; Barea Mendoza, J A; Temprano Vázquez, S; Díaz Castellano, L; Montejo González, J C

2016-11-01

To improve critical patient safety in the prevention of venous thromboembolic disease, using failure mode and effects analysis as safety tool. A contemporaneous cohort study covering the period January 2014-March 2015 was made in 4 phases: phase 1) prior to failure mode and effects analysis; phase 2) conduction of mode analysis and implementation of the detected improvements; phase 3) evaluation of outcomes, and phase 4) (post-checklist introduction impact. Patients admitted to the adult polyvalent ICU of a third-level hospital center. A total of 196 patients, older than 18 years, without thromboembolic disease upon admission to the ICU and with no prior anticoagulant treatment. A series of interventions were implemented following mode analysis: training, and introduction of a protocol and checklist to increase preventive measures in relation to thromboembolic disease. Indication and prescription of venous thrombosis prevention measures before and after introduction of the measures derived from the failure mode and effects analysis. A total of 59, 97 and 40 patients were included in phase 1, 3 and 4, respectively, with an analysis of the percentage of subjects who received thromboprophylaxis. The failure mode and effects analysis was used to detect potential errors associated to a lack of training and protocols referred to thromboembolic disease. An awareness-enhancing campaign was developed, with staff training and the adoption of a protocol for the prevention of venous thromboembolic disease. The prescription of preventive measures increased in the phase 3 group (91.7 vs. 71.2%, P=.001). In the post-checklist group, prophylaxis was prescribed in 97.5% of the patients, with an increase in the indication of dual prophylactic measures (4.7, 6.7 and 41%; P<.05). There were no differences in complications rate associated to the increase in prophylactic measures. The failure mode and effects analysis allowed us to identify improvements in the prevention of

Protocol Implementation Generator

DEFF Research Database (Denmark)

Carvalho Quaresma, Jose Nuno; Probst, Christian W.

2010-01-01

Users expect communication systems to guarantee, amongst others, privacy and integrity of their data. These can be ensured by using well-established protocols; the best protocol, however, is useless if not all parties involved in a communication have a correct implementation of the protocol and a...... Generator framework based on the LySatool and a translator from the LySa language into C or Java....... necessary tools. In this paper, we present the Protocol Implementation Generator (PiG), a framework that can be used to add protocol generation to protocol negotiation, or to easily share and implement new protocols throughout a network. PiG enables the sharing, verification, and translation...

The radiological monitoring protocol for metallic products and cleared scrap management

International Nuclear Information System (INIS)

Gil Lopez, E.

2003-01-01

Event though the use of nuclear and radiological techniques is subject to strict controls in most countries, the presence of radioactive material in batches of metallic scrap has been detected with relative frequency in the last few years. This circumstance has motivated the implementation of a series of national and international initiatives aimed at detecting and preventing this type of events, whether they be intentional or involuntary. The Spanish iron and steel industry is one of the country's most important industrial sectors, and to a great extent it depends on the importation of a very significant amount of metallic scrap that it uses as raw material. Experience has shown that countries that import large amounts of scrap, apart from supporting the mentioned international initiatives, should complement them with other national initiatives to reduce the risks resulting from the presence of radioactive material in scrap. In this context, the Spanish authorities, together with trade unions and entrepreneurial associations in the metal reclamations and smelting sectors and ENRESA, have signed a voluntary Protocol that defines and implements a national radiological monitoring and control system for scrap materials and their byproducts. The Protocol defines the obligations and rights of the signatories, and it describes the monitoring and control system and its legal bases, the operation of both specific and other general-purpose radiological monitoring equipment that existed prior to this initiative, the development of radiological training and dissemination plans for professionals in the metal reclamation and smelting sectors, the establishment of effective systems for the safe management of any radioactive materials detected, and the general improvement of the national response system in the event of radiological emergencies. Since the Protocol took effect in November 1999, more than 100 enterprises from the metallurgical (steel, copper, lead and aluminum

Prevalence of influenza vaccination among physicians and related enhancing and preventing factors in Italy

Directory of Open Access Journals (Sweden)

Alice Mannocci

2011-04-01

Full Text Available Introduction: Several studies proved the convenience of vaccinating health care workers (HCWs, especially physicians, and vaccination is recommended by health authorities in many Countries. Nonetheless in Italy only a small part of HCWs get vaccinated. The aim of this study is to conduct a systematic review in order to estimate the pooled prevalence of influenza vaccinations among physicians in Italy and to investigate the enhancing/preventing factors associated with this kind of preventive tool.Methods: Relevant articles up to 1st May 2010 have been identified through Scopus, PubMed and Google Scholar; data extraction and quality assessment were performed independently by two researchers.The analysis was performed using StatsDirect 2.7.8.Results: Sixteen studies, performed between 1990 and 2008, reported vaccination rates with pooled prevalence among all HCWs. From nine of them data regarding physicians have been extracted and analysed, finding a pooled proportion of 23.18% (95% CI = 17.85-28.98%. One study allowed an analysis of the reasons encouraging and preventing influenza vaccination. The main ones are on one side self protection, and patients’ and family’s protection, and on the other side “not caring about influenza,” followed by “fear of adverse effects” and “belief that vaccine isn’t effective.”Discussion: Italy has a good overall influenza vaccination coverage, and national records are available for population aged over 65 years or with chronic illness. Unfortunately there isn’t any national record about HCWs or physicians vaccination, and from the data gathered from the studies examined in this analysis vaccination prevalence is low. The reasons brought from physicians are worrying because of their position in the society and in the health care system, in close contact with patients.This shows a great need for well-done information and educational campaigns stressing the importance of prevention.

Evaluation of a protocol for the non-operative management of perforated peptic ulcer.

Science.gov (United States)

Marshall, C; Ramaswamy, P; Bergin, F G; Rosenberg, I L; Leaper, D J

1999-01-01

The non-operative management of perforated peptic ulcer has previously been shown to be both safe and effective although it remains controversial. A protocol for non-operative management was set up in this hospital in 1989. Adherence to the guidelines in the protocol has been audited over a 6-year period with a review of outcome. The case-notes of patients with a diagnosis of perforated peptic ulcer were reviewed. Twelve guidelines from the protocol were selected for evaluation of compliance to the protocol. Forty-nine patients underwent non-operative treatment initially. Eight patients failed to respond and underwent operation. Complications included abscess formation (seven patients), renal failure (one), gastric ileus (one), chest infection (two), and cardiac failure and stroke (one). Four deaths occurred in this group. Adherence to certain protocol guidelines was poor, notably those concerning prevention of thromboembolism, use of antibiotics, use of contrast examination to confirm the diagnosis and referral for follow-up endoscopy. Two gastric cancers were detected on subsequent endoscopy. This experience demonstrates that non-operative treatment can be used successfully in a general hospital. Adherence to protocol guidelines was found to be variable and the protocol has therefore been simplified. This study highlights the need for an accurate diagnosis and the importance of follow-up endoscopy.

A Mac Protocol Implementation for Wireless Sensor Network

Directory of Open Access Journals (Sweden)

Jamila Bhar

2015-01-01

Full Text Available IEEE 802.15.4 is an important standard for Low Rate Wireless Personal Area Network (LRWPAN. The IEEE 802.15.4 presents a flexible MAC protocol that provides good efficiency for data transmission by adapting its parameters according to characteristics of different applications. In this research work, some restrictions of this standard are explained and an improvement of traffic efficiency by optimizing MAC layer is proposed. Implementation details for several blocks of communication system are carefully modeled. The protocol implementation is done using VHDL language. The analysis gives a full understanding of the behavior of the MAC protocol with regard to backoff delay, data loss probability, congestion probability, slot effectiveness, and traffic distribution for terminals. Two ideas are proposed and tested to improve efficiency of CSMA/CA mechanism for IEEE 802.15.4 MAC Layer. Primarily, we dynamically adjust the backoff exponent (BE according to queue level of each node. Secondly, we vary the number of consecutive clear channel assessment (CCA for packet transmission. We demonstrate also that slot compensation provided by the enhanced MAC protocol can greatly avoid unused slots. The results show the significant improvements expected by our approach among the IEEE 802.15.4 MAC standards. Synthesis results show also hardware performances of our proposed architecture.

Improvement of pressure ulcer prevention care in private for-profit residential care homes: an action research study

Directory of Open Access Journals (Sweden)

Enid WY Kwong

2016-11-01

Full Text Available Abstract Background A need exits to develop a protocol for preventing pressure ulcers (PUs in private for-profit nursing homes in Hong Kong, where the incidence of PUs is relatively high and which have high proportion of non-professional care staff. The implementation of such protocol would involve changes in the practice of care, likely evoking feelings of fear and uncertainty that may become a barrier to staff adherence. We thus adopted the Systems Model of Action Research in this study to manage the process of change for improving PU prevention care and to develop a pressure ulcer prevention protocol for private for-profit nursing homes. Methods A total of 474 residents and care staff who were health workers, personal care workers, and/or nurses from four private, for-profit nursing homes in Hong Kong participated in this study. Three cyclic stages and steps, namely, unfreezing (planning, changing (action, and refreezing (results were carried out. During each cycle, focus group interviews, field observations of the care staff’s practices and inspections of the skin of the residents for pressure ulcers were conducted to evaluate the implementation of the protocol. Qualitative content analysis was adopted to analyse the data. The data and methodological triangulation used in this study increased the credibility and validity of the results. Results The following nine themes emerged from this study: prevention practices after the occurrence of PUs, the improper use of pressure ulcer prevention materials, non-compliance with several prevention practices, improper prevention practices, the perception that the preventive care was being performed correctly, inadequate readiness to use the risk assessment tool, an undesirable environment, the supplying of unfavorable resources, and various management styles in the homes with or without nurses. At the end of the third cycle, the changes that were identified included improved compliance with the

Vertical Protocol Composition

DEFF Research Database (Denmark)

Groß, Thomas; Mödersheim, Sebastian Alexander

2011-01-01

The security of key exchange and secure channel protocols, such as TLS, has been studied intensively. However, only few works have considered what happens when the established keys are actually used—to run some protocol securely over the established “channel”. We call this a vertical protocol.......e., that the combination cannot introduce attacks that the individual protocols in isolation do not have. In this work, we prove a composability result in the symbolic model that allows for arbitrary vertical composition (including self-composition). It holds for protocols from any suite of channel and application...

The European Innovation Partnership on Active and Healthy Ageing synergies: protocol for a prospective observational study to measure the Impact of a community-based program on prevention and mitigation of frailty (ICP – PMF) in community-dwelling older adults

NARCIS (Netherlands)

Liotta, G.; Orfila, F.; Vollenbroek-Hutten, Miriam Marie Rosé; Roller-Winsberger, R.; Illaria, M.; Musian, D.; Alvino, S.; O'Caoimh, R.; Cano, A.; Molloy, W.; Iaccarino, G.; Marazzi, M.C.; Inzerilli, M.C.; Madaro, O.; Paul, C.; Csonka, P.; Vince, A.C.; Menditto, E.; Maggio, M.; Scarcella, P.; Gilardi, F.; Lucaroni, F.; Abete, P.; Girardi, V.; Barra, R.; Palombi, L.

2016-01-01

Aim of this paper is to describe the protocol of the study “Impact of a Community-based Program on Prevention and Mitigation of Frailty in community-dwelling older adults‿ developed in the framework of the European Innovation Partnership on Active and Healthy Ageing. This proposal has been developed

IEEE 802.11 Wireless LANs: Performance Analysis and Protocol Refinement

Directory of Open Access Journals (Sweden)

Chatzimisios P.

2005-01-01

Full Text Available The IEEE 802.11 protocol is emerging as a widely used standard and has become the most mature technology for wireless local area networks (WLANs. In this paper, we focus on the tuning of the IEEE 802.11 protocol parameters taking into consideration, in addition to throughput efficiency, performance metrics such as the average packet delay, the probability of a packet being discarded when it reaches the maximum retransmission limit, the average time to drop a packet, and the packet interarrival time. We present an analysis, which has been validated by simulation that is based on a Markov chain model commonly used in the literature. We further study the improvement on these performance metrics by employing suitable protocol parameters according to the specific communication needs of the IEEE 802.11 protocol for both basic access and RTS/CTS access schemes. We show that the use of a higher initial contention window size does not considerably degrade performance in small networks and performs significantly better in any other scenario. Moreover, we conclude that the combination of a lower maximum contention window size and a higher retry limit considerably improves performance. Results indicate that the appropriate adjustment of the protocol parameters enhances performance and improves the services that the IEEE 802.11 protocol provides to various communication applications.

ADAPTIVE GOSSIP BASED PROTOCOL FOR ENERGY EFFICIENT MOBILE ADHOC NETWORK

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S. Rajeswari

2012-03-01

Full Text Available In Gossip Sleep Protocol, network performance is enhanced based on energy resource. But energy conservation is achieved with the reduced throughput. In this paper, it has been proposed a new Protocol for Mobile Ad hoc Network to achieve reliability with energy conservation. Based on the probability (p values, the value of sleep nodes is fixed initially. The probability value can be adaptively adjusted by Remote Activated Switch during the transmission process. The adaptiveness of gossiping probability is determined by the Packet Delivery Ratio. For performance comparison, we have taken Routing overhead, Packet Delivery Ratio, Number of dropped packets and Energy consumption with the increasing number of forwarding nodes. We used UDP based traffic models to analyze the performance of this protocol. We analyzed TCP based traffic models for average end to end delay. We have used the NS-2 simulator.

The Bodenmann Couples Coping Enhancement Training (CCET): A New Approach to Prevention of Marital Distress Based upon Stress and Coping

Science.gov (United States)

Bodenmann, Guy; Shantinath, S. D.

2004-01-01

We describe a distress prevention training program for couples and three empirical studies that support its effectiveness. The program, Couples Coping Enhancement Training (CCET), is based both upon stress and coping theory and research on couples. In addition to traditional elements of couples programs (e.g., communication and problem-solving…

A Healthy School Start Plus for prevention of childhood overweight and obesity in disadvantaged areas through parental support in the school setting - study protocol for a parallel group cluster randomised trial.

Science.gov (United States)

Elinder, Liselotte Schäfer; Patterson, Emma; Nyberg, Gisela; Norman, Åsa

2018-04-06

Systematic reviews conclude that interventions to prevent overweight and obesity in children obtain stronger effects when parents are involved. Parenting practices and parent-child interactions shape children's health-related behaviours. The Healthy School Start Plus intervention aims to promote healthy dietary habits and physical activity and prevent obesity in children through parental support in disadvantaged areas with increased health needs, delivered by teachers and school nurses. This protocol describes the design, outcome and process evaluation of the study. Effectiveness of the intervention is compared to standard care within school health services. The 6-month programme, based on Social Cognitive Theory, consists of four components: 1) Health information to parents regarding the child; 2) Motivational Interviewing with the parents by the school nurse concerning the child; 3) classroom activities for the children by teachers; and 4) a web-based self-test of type-2 diabetes risk by parents. Effects will be studied in a cluster randomised trial including 17 schools and 352 six-year old children. The primary outcome is dietary intake of indicator foods, and secondary outcomes are physical activity, sedentary behaviour and BMI. Outcomes will be measured at baseline, at 6 months directly after the intervention, and at follow-up 18 months post baseline. Statistical analysis will be by mixed-effect regression analysis according to intention to treat and per protocol. Mediation analysis will be performed with parental self-efficacy and parenting practices. Quantitative and qualitative methods will be used to study implementation in terms of dose, fidelity, feasibility and acceptability. The hypothesis is that the programme will be more effective than standard care and feasible to perform in the school context. The programme is in line with the cumulated evidence regarding the prevention of childhood obesity: That schools should be a focal point of prevention

Protocol for maximizing energy savings and indoor environmental quality improvements when retrofitting apartments

Energy Technology Data Exchange (ETDEWEB)

Noris, Federico [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Delp, William W. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Vermeer, Kimberly [Urban Habitat Initiatives Inc., Boston, MA (United States); Adamkiewicz, Gary [Harvard School of Public Health, Boston, MA (United States); Singer, Brett C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Fisk, William J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2013-06-01

The current focus on building energy retrofit provides an opportunity to simultaneously improve indoor environmental quality (IEQ). Toward this end, we developed a protocol for selecting packages of retrofits that both save energy and improve IEQ in apartments. The protocol specifies the methodology for selecting retrofits from a candidate list while addressing expected energy savings, IEQ impacts, and costs in an integrated manner. Interviews, inspections and measurements are specified to collect the needed input information. The protocol was applied to 17 apartments in three buildings in two different climates within California. Diagnostic measurements and surveys conducted before and after retrofit implementation indicate enhanced apartment performance.

Robust and Efficient Authentication Scheme for Session Initiation Protocol

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Yanrong Lu

2015-01-01

Full Text Available The session initiation protocol (SIP is a powerful application-layer protocol which is used as a signaling one for establishing, modifying, and terminating sessions among participants. Authentication is becoming an increasingly crucial issue when a user asks to access SIP services. Hitherto, many authentication schemes have been proposed to enhance the security of SIP. In 2014, Arshad and Nikooghadam proposed an enhanced authentication and key agreement scheme for SIP and claimed that their scheme could withstand various attacks. However, in this paper, we show that Arshad and Nikooghadam’s authentication scheme is still susceptible to key-compromise impersonation and trace attacks and does not provide proper mutual authentication. To conquer the flaws, we propose a secure and efficient ECC-based authentication scheme for SIP. Through the informal and formal security analyses, we demonstrate that our scheme is resilient to possible known attacks including the attacks found in Arshad et al.’s scheme. In addition, the performance analysis shows that our scheme has similar or better efficiency in comparison with other existing ECC-based authentication schemes for SIP.

The value of a rapid contrast-enhanced angio-MRI protocol in the detection of head and neck paragangliomas in SDHx mutations carriers: a retrospective study on behalf of the PGL.EVA investigators*

International Nuclear Information System (INIS)

Gravel, Guillaume; Hernigou, Anne; Niccoli, Patricia; Rohmer, Vincent; Moulin, Guy; Borson-Chazot, Francoise; Rousset, Pascal; Pasco-Papon, Anne; Marcus, Claude; Dubrulle, Frederique; Gouya, Herve; Bidault, Francois; Dupas, Benoit; Gabrillargues, Jean; Caumont-Prim, Aurore; Gimenez-Roqueplo, Anne-Paule; Halimi, Philippe

2016-01-01

To assess the performance of a simplified MRI protocol consisting of a contrast-enhanced three-dimensional MR angiography (CE-MRA) in association with a post-contrast T1-weighted sequence (T1WIV) for the detection of HNPGLs in SDHx mutation carriers. This retrospective sub-study is based on the multicenter PGL.EVA cohort, which prospectively enrolled SDHx mutation carriers from 2005 to 2009; 157 index cases or relatives were included. CE-MRA and the T1WIV images were read solely with knowledge of the clinical data but blind to the diagnosis. Sensitivity, specificity and likelihood ratios for the simplified MRI protocol were compared to the full MRI protocol reading results and to the gold standard status obtained through the consensus of an expert committee. The sensitivity and specificity of the readings of the simplified MRI protocol were, respectively, 88.7 % (95 % CI = 78.1-95.3) and 93.7 % (95 % CI = 86.8-97.7) versus 80.7 % (95 % CI = 68.6-89.6) and 94.7 % (95 % CI = 88.1-98.3) for the readings of the full MRI protocol. The simplified post-contrast MRI with shorter duration (5 to 10 minutes) showed no performance difference compared to the lengthy standard full MRI and can be proposed for the detection of head and neck paragangliomas (HNPGLs) in SDHx mutation carriers. (orig.)

The value of a rapid contrast-enhanced angio-MRI protocol in the detection of head and neck paragangliomas in SDHx mutations carriers: a retrospective study on behalf of the PGL.EVA investigators*

Energy Technology Data Exchange (ETDEWEB)

Gravel, Guillaume; Hernigou, Anne [Hopital Europeen Georges Pompidou, Assistance Publique-Hopitaux de Paris, Service de Radiologie, Paris (France); Niccoli, Patricia [Centre Hospitalier Universitaire la Timone, Assistance Publique-Hopitaux de Marseille, Service d' Endocrinologie, Diabete et Maladies Metaboliques, Marseille (France); Rohmer, Vincent [Centre Hospitalier Universitaire d' Angers, Service d' Endocrinologie, Diabetologie, Nutrition, Angers (France); LUNAM Universite, INSERM, U1063, Angers (France); Moulin, Guy [Centre Hospitalier Universitaire la Timone, Assistance Publique-Hopitaux de Marseille, Service de Radiologie, Marseille (France); Borson-Chazot, Francoise [Federation d' Endocrinologie, Hospices civils de Lyon, Groupement Hospitalier Est, Lyon (France); Universite de Lyon, Faculte de Medecine Lyon-Est, Lyon (France); Cancer Research Center of Lyon, INSERM UMR1052, UMR CNRS 5286, Lyon (France); Rousset, Pascal [Hospices civils de Lyon, Groupement Hospitalier Est, Service de Radiologie, Lyon (France); Pasco-Papon, Anne [Centre Hospitalier Universitaire d' Angers, Service de Radiologie, Angers (France); Marcus, Claude [Centre Hospitalo-Universitaire de Reims, Service de Radiologie, Reims (France); Dubrulle, Frederique [Centre Hospitalo-Universitaire de Lille, Service de Radiologie, Lille (France); Gouya, Herve [Hopital Cochin, Assistance Publique-Hopitaux de Paris, Service de Radiologie, Paris (France); Bidault, Francois [Institut Gustave Roussy, Service de Radiologie, Villejuif (France); Dupas, Benoit [Centre Hospitalo-Universitaire de Nantes, Service de Radiologie, Nantes (France); Gabrillargues, Jean [Centre Hospitalo-Universitaire de Clermont-Ferrand, Service de Neuroradiologie, Clermont Ferrand (France); Caumont-Prim, Aurore [Unite d' Epidemiologie et de Recherche Clinique, Assistance Publique-Hopitaux de Paris, Hopital Europeen Georges Pompidou, Paris (France); Centre d' investigation Epidemiologique 4, INSERM, Paris (France); Gimenez-Roqueplo, Anne-Paule [Hopital Europeen Georges Pompidou, Assistance Publique-Hopitaux de Paris, Service de Genetique, Paris (France); Paris Cardiovascular Research Center, INSERM, UMR970, Paris (France); Universite Paris Descartes, Sorbonne Paris Cite, Faculte de Medecine, Paris (France); Halimi, Philippe [Hopital Europeen Georges Pompidou, Assistance Publique-Hopitaux de Paris, Service de Radiologie, Paris (France); Universite Paris Descartes, Sorbonne Paris Cite, Faculte de Medecine, Paris (France)

2016-06-15

To assess the performance of a simplified MRI protocol consisting of a contrast-enhanced three-dimensional MR angiography (CE-MRA) in association with a post-contrast T1-weighted sequence (T1WIV) for the detection of HNPGLs in SDHx mutation carriers. This retrospective sub-study is based on the multicenter PGL.EVA cohort, which prospectively enrolled SDHx mutation carriers from 2005 to 2009; 157 index cases or relatives were included. CE-MRA and the T1WIV images were read solely with knowledge of the clinical data but blind to the diagnosis. Sensitivity, specificity and likelihood ratios for the simplified MRI protocol were compared to the full MRI protocol reading results and to the gold standard status obtained through the consensus of an expert committee. The sensitivity and specificity of the readings of the simplified MRI protocol were, respectively, 88.7 % (95 % CI = 78.1-95.3) and 93.7 % (95 % CI = 86.8-97.7) versus 80.7 % (95 % CI = 68.6-89.6) and 94.7 % (95 % CI = 88.1-98.3) for the readings of the full MRI protocol. The simplified post-contrast MRI with shorter duration (5 to 10 minutes) showed no performance difference compared to the lengthy standard full MRI and can be proposed for the detection of head and neck paragangliomas (HNPGLs) in SDHx mutation carriers. (orig.)

Application of the Intervention Mapping protocol to develop Keys, a family child care home intervention to prevent early childhood obesity.

Science.gov (United States)

Mann, Courtney M; Ward, Dianne S; Vaughn, Amber; Benjamin Neelon, Sara E; Long Vidal, Lenita J; Omar, Sakinah; Namenek Brouwer, Rebecca J; Østbye, Truls

2015-12-10

Many families rely on child care outside the home, making these settings important influences on child development. Nearly 1.5 million children in the U.S. spend time in family child care homes (FCCHs), where providers care for children in their own residences. There is some evidence that children in FCCHs are heavier than those cared for in centers. However, few interventions have targeted FCCHs for obesity prevention. This paper will describe the application of the Intervention Mapping (IM) framework to the development of a childhood obesity prevention intervention for FCCHs Following the IM protocol, six steps were completed in the planning and development of an intervention targeting FCCHs: needs assessment, formulation of change objectives matrices, selection of theory-based methods and strategies, creation of intervention components and materials, adoption and implementation planning, and evaluation planning Application of the IM process resulted in the creation of the Keys to Healthy Family Child Care Homes program (Keys), which includes three modules: Healthy You, Healthy Home, and Healthy Business. Delivery of each module includes a workshop, educational binder and tool-kit resources, and four coaching contacts. Social Cognitive Theory and Self-Determination Theory helped guide development of change objective matrices, selection of behavior change strategies, and identification of outcome measures. The Keys program is currently being evaluated through a cluster-randomized controlled trial The IM process, while time-consuming, enabled rigorous and systematic development of intervention components that are directly tied to behavior change theory and may increase the potential for behavior change within the FCCHs.

A Comparison of Routing Protocol for WSNs: Redundancy Based Approach A Comparison of Routing Protocol for WSNs: Redundancy Based Approach

Directory of Open Access Journals (Sweden)

Anand Prakash

2014-03-01

Full Text Available Wireless Sensor Networks (WSNs with their dynamic applications gained a tremendous attention of researchers. Constant monitoring of critical situations attracted researchers to utilize WSNs at vast platforms. The main focus in WSNs is to enhance network localization as much as one could, for efficient and optimal utilization of resources. Different approaches based upon redundancy are proposed for optimum functionality. Localization is always related with redundancy of sensor nodes deployed at remote areas for constant and fault tolerant monitoring. In this work, we propose a comparison of classic flooding and the gossip protocol for homogenous networks which enhances stability and throughput quiet significantly.  

The Happy Older Latinos are Active (HOLA) health promotion and prevention study: study protocol for a pilot randomized controlled trial.

Science.gov (United States)

Jimenez, Daniel E; Reynolds, Charles F; Alegría, Margarita; Harvey, Philip; Bartels, Stephen J

2015-12-18

Results of previous studies attest to the greater illness burden of common mental disorders (anxiety and depression) in older Latinos and the need for developing preventive interventions that are effective, acceptable, and scalable. Happy Older Latinos are Active (HOLA) is a newly developed intervention that uses a community health worker (CHW) to lead a health promotion program in order to prevent common mental disorders among at-risk older Latinos. This pilot study tests the feasibility and acceptability of delivering HOLA to older, at-risk Latinos. HOLA is a multi-component, health promotion intervention funded by the National Institute of Mental Health (NIMH). This prevention approach will be tested against a fotonovela, an enhanced psychoeducation control condition, in a sample of Latino elderly with minor or subthreshold depression or anxiety. A total of 60 older Latinos (aged 60+) will be randomized to receive HOLA or the fotonovela. The primary outcomes of interest are recruitment, adherence, retention, and acceptability. Data will also be collected on: preemption of incident and recurrent major depression, generalized anxiety, and social phobia; reduction in depression and anxiety symptom severity; physical functioning; sedentary behaviors; social engagement; and self-efficacy. The results of this study could have implications for other high-risk, highly disadvantaged populations. The development of a health promotion intervention designed to prevent common mental disorders could be a means of addressing multiple disparities (for example, mental health outcomes, mental health service use, stigma) among racial/ethnic minority elderly. CLINICALTRIALS. NCT02371954 . Date of registration: 21 January 2015.

Preventing diabetes in obese Latino youth with prediabetes: a study protocol for a randomized controlled trial

Directory of Open Access Journals (Sweden)

Erica G. Soltero

2017-03-01

Full Text Available Abstract Background Obese Latino adolescents are disproportionately impacted by insulin resistance and type 2 diabetes. Prediabetes is an intermediate stage in the pathogenesis of type 2 diabetes and represents a critical opportunity for intervention. However, to date, no diabetes prevention studies have been conducted in obese Latino youth with prediabetes, a highly vulnerable and underserved group. Therefore, we propose a randomized-controlled trial to test the short-term (6-month and long-term (12-month efficacy of a culturally-grounded, lifestyle intervention, as compared to usual care, for improving glucose tolerance and reducing diabetes risk in 120 obese Latino adolescents with prediabetes. Methods Participants will be randomized to a lifestyle intervention or usual care group. Participants in the intervention group will attend weekly nutrition and wellness sessions and physical activity sessions twice a week for six months, followed by three months of booster sessions. The overall approach of the intervention is framed within a multilevel Ecodevelopmental model that leverages community, family, peer, and individual factors during the critical transition period of adolescence. The intervention is also guided by Social Cognitive Theory and employs key behavioral modification strategies to enhance self-efficacy and foster social support for making and sustaining healthy behavior changes. We will test intervention effects on quality of life, explore the potential mediating effects of changes in body composition, total, regional, and organ fat on improving glucose tolerance and increasing insulin sensitivity, and estimate the initial incremental cost effectiveness of the intervention as compared with usual care for improving glucose tolerance. Discussion The proposed trial builds upon extant collaborations of a transdisciplinary team of investigators working in concert with local community agencies to address critical gaps in how diabetes

Advertisement-Based Energy Efficient Medium Access Protocols for Wireless Sensor Networks

Science.gov (United States)

Ray, Surjya Sarathi

One of the main challenges that prevents the large-scale deployment of Wireless Sensor Networks (WSNs) is providing the applications with the required quality of service (QoS) given the sensor nodes' limited energy supplies. WSNs are an important tool in supporting applications ranging from environmental and industrial monitoring, to battlefield surveillance and traffic control, among others. Most of these applications require sensors to function for long periods of time without human intervention and without battery replacement. Therefore, energy conservation is one of the main goals for protocols for WSNs. Energy conservation can be performed in different layers of the protocol stack. In particular, as the medium access control (MAC) layer can access and control the radio directly, large energy savings is possible through intelligent MAC protocol design. To maximize the network lifetime, MAC protocols for WSNs aim to minimize idle listening of the sensor nodes, packet collisions, and overhearing. Several approaches such as duty cycling and low power listening have been proposed at the MAC layer to achieve energy efficiency. In this thesis, I explore the possibility of further energy savings through the advertisement of data packets in the MAC layer. In the first part of my research, I propose Advertisement-MAC or ADV-MAC, a new MAC protocol for WSNs that utilizes the concept of advertising for data contention. This technique lets nodes listen dynamically to any desired transmission and sleep during transmissions not of interest. This minimizes the energy lost in idle listening and overhearing while maintaining an adaptive duty cycle to handle variable loads. Additionally, ADV-MAC enables energy efficient MAC-level multicasting. An analytical model for the packet delivery ratio and the energy consumption of the protocol is also proposed. The analytical model is verified with simulations and is used to choose an optimal value of the advertisement period

Dynamic microbubble contrast-enhanced US to measure tumor response to targeted therapy: a proposed clinical protocol with results from renal cell carcinoma patients receiving antiangiogenic therapy.

Science.gov (United States)

Williams, Ross; Hudson, John M; Lloyd, Brendan A; Sureshkumar, Ahthavan R; Lueck, Gordon; Milot, Laurent; Atri, Mostafa; Bjarnason, Georg A; Burns, Peter N

2011-08-01

To develop and implement an evidence-based protocol for characterizing vascular response of renal cell carcinoma (RCC) to targeted therapy by using dynamic contrast material-enhanced (DCE) ultrasonography (US). The study was approved by the institutional research ethics board; written informed consent was obtained from all patients. Seventeen patients (four women; median age, 58 years; range, 42-72 years; 13 men, median age, 62 years; range, 45-81 years) with metastatic RCC were examined by using DCE US before and after 2 weeks of treatment with sunitinib (May 2007 to October 2009). Two contrast agent techniques--bolus injection and disruption-replenishment infusion of microbubbles--were compared. Changes in tumor blood velocity and fractional blood volume were measured with both methods, together with reproducibility and effect of compensation for respiratory motion. Tumor changes were assessed with computed tomography, by using the best response with the Response Evaluation Criteria in Solid Tumors (RECIST) and progression-free survival (PFS). Follow-up RECIST measurements were performed at 6-week intervals until progressive disease was detected. In response to treatment, median tumor fractional blood volume measured with the disruption-replenishment infusion method decreased by 73.2% (interquartile range, 46%-87%) (P protocol is a flexible method suitable for many tumor types, but further studies are needed to assess whether this protocol may be predictive of patient outcome. © RSNA, 2011.

Magnetic resonance imaging protocols for examination of the neurocranium at 3 T.

Science.gov (United States)

Schwindt, W; Kugel, H; Bachmann, R; Kloska, S; Allkemper, T; Maintz, D; Pfleiderer, B; Tombach, B; Heindel, W

2003-09-01

The increasing availability of high-field (3 T) MR scanners requires adapting and optimizing clinical imaging protocols to exploit the theoretically higher signal-to-noise ratio (SNR) of the higher field strength. Our aim was to establish reliable and stable protocols meeting the clinical demands for imaging the neurocranium at 3 T. Two hundred patients with a broad range of indications received an examination of the neurocranium with an appropriate assortment of imaging techniques at 3 T. Several imaging parameters were optimized. Keeping scan times comparable to those at 1.5 T we increased spatial resolution. Contrast-enhanced and non-enhanced T1-weighted imaging was best applying gradient-echo and inversion recovery (rather than spin-echo) techniques, respectively. For fluid-attenuated inversion recovery (FLAIR) imaging a TE of 120 ms yielded optimum contrast-to-noise ratio (CNR). High-resolution isotropic 3D data sets were acquired within reasonable scan times. Some artifacts were pronounced, but generally imaging profited from the higher SNR. We present a set of optimized examination protocols for neuroimaging at 3 T, which proved to be reliable in a clinical routine setting.

Magnetic resonance imaging protocols for examination of the neurocranium at 3 T

Energy Technology Data Exchange (ETDEWEB)

Schwindt, W.; Kugel, H.; Bachmann, R.; Kloska, S.; Allkemper, T.; Maintz, D.; Pfleiderer, B.; Tombach, B.; Heindel, W. [Institut fuer Klinische Radiologie, Universitaetsklinikum Muenster, Albert-Schweitzer-Strasse 33, 48129, Muenster (Germany)

2003-09-01

The increasing availability of high-field (3 T) MR scanners requires adapting and optimizing clinical imaging protocols to exploit the theoretically higher signal-to-noise ratio (SNR) of the higher field strength. Our aim was to establish reliable and stable protocols meeting the clinical demands for imaging the neurocranium at 3 T. Two hundred patients with a broad range of indications received an examination of the neurocranium with an appropriate assortment of imaging techniques at 3 T. Several imaging parameters were optimized. Keeping scan times comparable to those at 1.5 T we increased spatial resolution. Contrast-enhanced and non-enhanced T1-weighted imaging was best applying gradient-echo and inversion recovery (rather than spin-echo) techniques, respectively. For fluid-attenuated inversion recovery (FLAIR) imaging a TE of 120 ms yielded optimum contrast-to-noise ratio (CNR). High-resolution isotropic 3D data sets were acquired within reasonable scan times. Some artifacts were pronounced, but generally imaging profited from the higher SNR. We present a set of optimized examination protocols for neuroimaging at 3 T, which proved to be reliable in a clinical routine setting. (orig.)

Magnetic resonance imaging protocols for examination of the neurocranium at 3 T

International Nuclear Information System (INIS)

Schwindt, W.; Kugel, H.; Bachmann, R.; Kloska, S.; Allkemper, T.; Maintz, D.; Pfleiderer, B.; Tombach, B.; Heindel, W.

2003-01-01

The increasing availability of high-field (3 T) MR scanners requires adapting and optimizing clinical imaging protocols to exploit the theoretically higher signal-to-noise ratio (SNR) of the higher field strength. Our aim was to establish reliable and stable protocols meeting the clinical demands for imaging the neurocranium at 3 T. Two hundred patients with a broad range of indications received an examination of the neurocranium with an appropriate assortment of imaging techniques at 3 T. Several imaging parameters were optimized. Keeping scan times comparable to those at 1.5 T we increased spatial resolution. Contrast-enhanced and non-enhanced T1-weighted imaging was best applying gradient-echo and inversion recovery (rather than spin-echo) techniques, respectively. For fluid-attenuated inversion recovery (FLAIR) imaging a TE of 120 ms yielded optimum contrast-to-noise ratio (CNR). High-resolution isotropic 3D data sets were acquired within reasonable scan times. Some artifacts were pronounced, but generally imaging profited from the higher SNR. We present a set of optimized examination protocols for neuroimaging at 3 T, which proved to be reliable in a clinical routine setting. (orig.)

Enhancements of LEACH Algorithm for Wireless Networks: A Review

Directory of Open Access Journals (Sweden)

M. Madheswaran

2013-12-01

Full Text Available Low Energy Adaptive Clustering Hierarchy (LEACH protocol is the first hierarchical cluster based routing protocol successfully used in the Wireless Sensor Networks (WSN. In this paper, various enhancements used in the original LEACH protocol are examined. The basic operations, advantages and limitations of the modified LEACH algorithms are compared to identify the research issues to be solved and to give the suggestions for the future proposed routing algorithms of wireless networks based on LEACH routing algorithm.

Protocol for the CHORD project (community health outreach to reduce diabetes): a cluster-randomized community health worker trial to prevent diabetes.

Science.gov (United States)

Islam, Nadia; Gepts, Thomas; Lief, Isaac; Gore, Radhika; Levy, Natalie; Tanner, Michael; Fang, Yixin; Sherman, Scott E; Schwartz, Mark D

2018-04-19

Type 2 diabetes mellitus (DM) affects 9.4% of US adults and children, while another 33.9% of Americans are at risk of DM. Health care institutions face many barriers to systematically delivering the preventive care needed to decrease DM incidence. Community health workers (CHWs) may, as frontline public health workers bridging clinic and community, help overcome these challenges. This paper presents the protocol for a pragmatic, cluster-randomized trial integrating CHWs into two primary care clinics to support DM prevention for at-risk patients. The trial will randomize 15 care teams, stratified by practice site (Bellevue Hospital and Manhattan VA), totaling 56 primary care physicians. The study cohort will consist of ~ 2000 patients who are 18-75 years of age, actively enrolled in a primary care team, able to speak English or Spanish, and have at least one glycosylated hemoglobin (HbA1c) result in the prediabetic range (5.7-6.4%) since 2012. Those with a current DM diagnosis or DM medication prescription (other than metformin) are ineligible. The intervention consists of four core activities - setting health goals, health education, activation for doctor's appointments, and referrals to DM prevention programs - adjustable according to the patient's needs and readiness. The primary outcome is DM incidence. Secondary outcomes include weight loss, HbA1C, and self-reported health behaviors. Clinical variables and health behaviors will be obtained through electronic medical records and surveys, respectively. Implementation outcomes, namely implementation fidelity and physicians' perspectives about CHW integration into the clinic, will be assessed using interviews and CHW activity logs and analyzed for the influence of moderating organizational factors. This is the first rigorous, pragmatic trial to test the effectiveness of integrating CHWs into primary care for DM prevention reaching a population-based sample. Our study's limitations include language

Comparison between stress myocardial perfusion SPECT recorded with cadmium-zinc-telluride and Anger cameras in various study protocols

Energy Technology Data Exchange (ETDEWEB)

Verger, Antoine; Karcher, Gilles [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); INSERM U947, Nancy (France); Nancyclotep Experimental Imaging Platform, Nancy (France); Djaballah, Wassila [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); INSERM U947, Nancy (France); Fourquet, Nicolas [Clinique Pasteur, Toulouse (France); Rouzet, Francois; Le Guludec, Dominique [AP-HP, Hopital Bichat, Department of Nuclear Medicine, Paris (France); INSERM U 773 Inserm and Denis Diderot University, Paris (France); Koehl, Gregoire; Roch, Veronique [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); Nancyclotep Experimental Imaging Platform, Nancy (France); Imbert, Laetitia [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); Nancyclotep Experimental Imaging Platform, Nancy (France); Centre Alexis Vautrin, Department of Radiotherapy, Vandoeuvre (France); Poussier, Sylvain [INSERM U947, Nancy (France); Nancyclotep Experimental Imaging Platform, Nancy (France); Fay, Renaud [INSERM, Centre d' Investigation Clinique CIC-P 9501, Nancy (France); Marie, Pierre-Yves [CHU-Nancy, Department of Nuclear Medicine, Nancy (France); Nancyclotep Experimental Imaging Platform, Nancy (France); INSERM U961, Nancy (France); Hopital de Brabois, CHU-Nancy, Medecine Nucleaire, Vandoeuvre-les-Nancy (France)

2013-03-15

The results of stress myocardial perfusion SPECT could be enhanced by new cadmium-zinc-telluride (CZT) cameras, although differences compared to the results with conventional Anger cameras remain poorly known for most study protocols. This study was aimed at comparing the results of CZT and Anger SPECT according to various study protocols while taking into account the influence of obesity. The study population, which was from three different institutions equipped with identical CZT cameras, comprised 276 patients referred for study using protocols involving {sup 201}Tl (n = 120) or {sup 99m}Tc-sestamibi injected at low dose at stress ({sup 99m}Tc-Low; stress/rest 1-day protocol; n = 110) or at high dose at stress ({sup 99m}Tc-High; rest/stress 1-day or 2-day protocol; n = 46). Each Anger SPECT scan was followed by a high-speed CZT SPECT scan (2 to 4 min). Agreement rates between CZT and Anger SPECT were good irrespective of the study protocol (for abnormal SPECT, {sup 201}Tl 92 %, {sup 99m}Tc-Low 86 %, {sup 99m}Tc-High 98 %), although quality scores were much higher for CZT SPECT with all study protocols. Overall correlations were high for the extent of myocardial infarction (r = 0.80) and a little lower for ischaemic areas (r = 0.72), the latter being larger on Anger SPECT (p < 0.001). This larger extent was mainly observed in 50 obese patients who were in the {sup 201}Tl or {sup 99m}Tc-Low group and in whom stress myocardial counts were particularly low with Anger SPECT (228 {+-} 101 kcounts) and dramatically enhanced with CZT SPECT (+279 {+-} 251 %). Concordance between the results of CZT and Anger SPECT is good regardless of study protocol and especially when excluding obese patients who have low-count Anger SPECT and for whom myocardial counts are dramatically enhanced on CZT SPECT. (orig.)

BAVP: Blockchain-Based Access Verification Protocol in LEO Constellation Using IBE Keys

Directory of Open Access Journals (Sweden)

Songjie Wei

2018-01-01

Full Text Available LEO constellation has received intensive research attention in the field of satellite communication. The existing centralized authentication protocols traditionally used for MEO/GEO satellite networks cannot accommodate LEO satellites with frequent user connection switching. This paper proposes a fast and efficient access verification protocol named BAVP by combining identity-based encryption and blockchain technology. Two different key management schemes with IBE and blockchain, respectively, are investigated, which further enhance the authentication reliability and efficiency in LEO constellation. Experiments on OPNET simulation platform evaluate and demonstrate the effectiveness, reliability, and fast-switching efficiency of the proposed protocol. For LEO networks, BAVP surpasses the well-known existing solutions with significant advantages in both performance and scalability which are supported by theoretical analysis and simulation results.

A Novel Smart Routing Protocol for Remote Health Monitoring in Medical Wireless Networks

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T. V. P. Sundararajan

2014-01-01

Full Text Available In a Medical Wireless Network (MWN, sensors constantly monitor patient's physiological condition and movement. Inter-MWN communications are set up between the Patient Server and one or more Centralized Coordinators. However, MWNs require protocols with little energy consumption and the self-organizing attribute perceived in ad-hoc networks. The proposed Smart Routing Protocol (SRP selects only the nodes with a higher residual energy and lower traffic density for routing. This approach enhances cooperation among the nodes of a Mobile Ad Hoc Network. Consequently, SRP produces better results than the existing protocols, namely Conditional Min-Max Battery Cost Routing, Min-Max Battery Cost Routing and AdHoc On-demand Distance Vector in terms of network parameters. The performance of the erstwhile schemes for routing protocols is evaluated using the network simulator Qualnet v 4.5.

Results of ERAS protocol in patients with colorectal cancer

Directory of Open Access Journals (Sweden)

A. O. Rasulov

2016-01-01

Full Text Available Objective: explore the use of enhanced recovery after surgery (ERAS in the treatment of patients with colorectal cancer, evaluate its efficacy and safety.Materials and methods. Prospective, single-site, randomized study for the implementation of enhanced recovery after surgery in patients with colorectal cancer has been conducted from October 2014 till the present time. All patients after laparoscopic surgeries undergo treatment according to ERAS protocol, patients after open surgeries are randomized (1:1 in groups of the standard treatment or treatment according to ERAS protocol. The study included patients with localized and locally disseminated colorectal cancer aged from 18 to 75 years, ECOG score ≤ 2. The primary evaluated parameters were the following: the number of postoperative complications (according to Clavien– Dindo classification, postoperative hospital days, incidence of complications and mortality in the 30-day period, timing of activation.Results. Up to date, the study includes 105 patients: laparoscopic group – 51 patients, open-surgery group of patients treated by ERAS protocol – 27 patients, open-surgery group of patients with the standard post-op treatment – 26 patients. Complications requiring emergency surgery for anastomotic leak (p = 0.159 developed in 3.7 % of patients with the standard post-op treatment and in 3.9 % of patients after laparoscopic surgery, while 1 patient required repeat hospitalization. The total number of complications was significantly lower in opensurgery group of patients treated by ERAS protocol compared with the standard post-op treatment (p = 0.021. However, there were no differences between laparoscopic and open-surgery group with the standard post-op treatment (p = 0.159. An average hospitalization stay in patients with the standard post-op treatment was equal to 10 days compared to 7 days in patients treated by ERAS protocol (p = 0.067 and 6 days after laparoscopic

A comparison of sennosides-based bowel protocols with and without docusate in hospitalized patients with cancer.

Science.gov (United States)

Hawley, Philippa Helen; Byeon, Jai Jun

2008-05-01

Constipation is a common and distressing condition in patients with cancer, especially those taking opioid analgesics. Many institutions prevent and treat constipation with titrated laxatives, which is known as a bowel protocol. An effective and well-tolerated bowel protocol is a very important component of cancer care, and there is little evidence on which to base selection of the most appropriate agents. This study compares a protocol of the stimulant laxative sennosides alone with a protocol of sennosides plus the stool softener docusate, in hospitalized patients at an oncology center. The docusate-containing protocol had an initial docusate-only step for patients not taking opioids, and four to six 100-mg capsules of docusate sodium in addition to the sennosides for the rest of the protocol. Thirty patients received the sennosides-only (S) protocol and 30 the sennosides plus docusate (DS) protocol. The efficacy and adverse effects of the protocols were monitored for 5-12 days. The two protocols were used sequentially, creating two cohorts, one on each protocol. Eighty percent of patients were taking oral opioids and 72% were admitted for symptom control/supportive care. Over a total of 488 days of observation it was found that the S protocol produced more bowel movements than the DS protocol, and in the symptom control/supportive care patients this difference was statistically significant (p sennosides did not reduce bowel cramps, and was less effective in inducing laxation than the sennosides-only protocol. Further research into the appropriate use of docusate and into the details of bowel protocol design are required.

Implementation of the protocol on treatment of outpatients and hospitalized patients with iodine 131r

International Nuclear Information System (INIS)

Mildred De Mendoza, L.

1996-01-01

In Nuclear medicine different working protocols are used which are adequate for the treatment of patients with radioactive materials and which at the same time prevent the contamination of the occupationally exposed workers In Guatemala (the implementation of these protocols aims at keeping a records all the personal and centers that make use of iodine 131, improving the quality of diagnostic information; utilizing the necessary amount of radionuclide activity so as to ensure a good diagnosis and effectively utilizing economic resources

Statistical Considerations of Food Allergy Prevention Studies.

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Bahnson, Henry T; du Toit, George; Lack, Gideon

Clinical studies to prevent the development of food allergy have recently helped reshape public policy recommendations on the early introduction of allergenic foods. These trials are also prompting new research, and it is therefore important to address the unique design and analysis challenges of prevention trials. We highlight statistical concepts and give recommendations that clinical researchers may wish to adopt when designing future study protocols and analysis plans for prevention studies. Topics include selecting a study sample, addressing internal and external validity, improving statistical power, choosing alpha and beta, analysis innovations to address dilution effects, and analysis methods to deal with poor compliance, dropout, and missing data. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Antibiotics for secondary prevention of coronary heart disease

DEFF Research Database (Denmark)

Sethi, Naqash J.; Safi, Sanam; Korang, Steven Kwasi

2017-01-01

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the beneficial and harmful effects of antibiotics for the secondary prevention of coronary heart disease. As a secondary objective, we plan to assess the effects of individual types of antibiotics...

Detecting and Preventing Beacon Replay Attacks in Receiver-Initiated MAC Protocols for Energy Efficient WSNs

DEFF Research Database (Denmark)

Di Mauro, Alessio; Fafoutis, Xenofon; Mödersheim, Sebastian Alexander

2013-01-01

In receiver-initiated MAC protocols for Wireless Sensor Networks (WSNs), communication is initiated by the receiver of the data through beacons containing the receiver's identity. In this paper, we consider the case of a network intruder that captures and replays such beacons towards legitimate...

[Daily practice using the guidelines for prevention and treatment of osteoporosis. Effectiveness of exercise for preventing and treating osteoporosis].

Science.gov (United States)

Miyakoshi, Naohisa

2008-08-01

There is increasing evidence that exercise is an effective strategy for the prevention and treatment of osteoporosis. The randomized controlled trials and their meta-analyses to date, evaluating the effects of exercise on osteoporosis reveal that the exercise is effective in preserving bone mass, preventing fractures and falls, and improving quality of life in patients with osteoporosis. Emphasis is also given to the importance of the specific protocols of exercises needed to achieve positive effects safely, keeping in view the age and general physical condition of the person.

Rapid Nanoprobe Signal Enhancement by In Situ Gold Nanoparticle Synthesis.

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Dias, Jorge T; Svedberg, Gustav; Nystrand, Mats; Andersson-Svahn, Helene; Gantelius, Jesper

2018-03-07

The use of nanoprobes such as gold, silver, silica or iron-oxide nanoparticles as detection reagents in bioanalytical assays can enable high sensitivity and convenient colorimetric readout. However, high densities of nanoparticles are typically needed for detection. The available synthesis-based enhancement protocols are either limited to gold and silver nanoparticles or rely on precise enzymatic control and optimization. Here, we present a protocol to enhance the colorimetric readout of gold, silver, silica, and iron oxide nanoprobes. It was observed that the colorimetric signal can be improved by up to a 10000-fold factor. The basis for such signal enhancement strategies is the chemical reduction of Au 3+ to Au 0 . There are several chemical reactions that enable the reduction of Au 3+ to Au 0 . In the protocol, Good's buffers and H2O2 are used and it is possible to favor the deposition of Au 0 onto the surface of existing nanoprobes, in detriment of the formation of new gold nanoparticles. The protocol consists of the incubation of the microarray with a solution consisting of chloroauric acid and H2O2 in 2-(N-morpholino)ethanesulfonic acid pH 6 buffer following the nanoprobe-based detection assay. The enhancement solution can be applied to paper and glass-based sensors. Moreover, it can be used in commercially available immunoassays as demonstrated by the application of the method to a commercial allergen microarray. The signal development requires less than 5 min of incubation with the enhancement solution and the readout can be assessed by naked eye or low-end image acquisition devices such as a table-top scanner or a digital camera.

Does internet-based prevention reduce the risk of relapse for anorexia nervosa?

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Fichter, Manfred M; Quadflieg, Norbert; Nisslmüller, Kerstin; Lindner, Susanne; Osen, Bernhard; Huber, Thomas; Wünsch-Leiteritz, Wally

2012-03-01

Technological advancements allow new approaches to psychotherapy via electronic media. The eating disorder literature currently contains no studies on internet intervention in anorexia nervosa (AN). This study presents a RCT on an internet-based relapse prevention program (RP) over nine months after inpatient treatment for AN. The sample comprised 258 women, randomized to the RP or treatment as usual (TAU). Expert- and self-ratings were evaluated by intent-to-treat analyses. Concerning age, age at onset and comorbidity, both groups were comparable at randomization. During the RP, the intervention group gained weight while the TAU group had minimal weight loss. RP completers gained significantly more body weight than patients in the TAU condition. Group-by-time comparisons for eating-related cognitions and behaviors and general psychopathology showed a significantly more favorable course in the RP program for "sexual anxieties" and "bulimic symptoms" (interview), and "maturity fears" and "social insecurity" (EDI-2). General psychopathology showed no significant group-by-time interaction. Important factors for successful relapse prevention were adherence to the intervention protocol and increased spontaneity. Considering the unfavorable course and chronicity of anorexia nervosa (AN), internet-based relapse prevention in AN following inpatient treatment appears a promising approach. Future internet-based programs may be further improved and enhanced. Copyright © 2012 Elsevier Ltd. All rights reserved.

A mindfulness-based stress prevention training for medical students (MediMind): study protocol for a randomized controlled trial.

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Kuhlmann, Sophie Merle; Bürger, Arne; Esser, Günter; Hammerle, Florian

2015-02-08

Medical training is very demanding and associated with a high prevalence of psychological distress. Compared to the general population, medical students are at a greater risk of developing a psychological disorder. Various attempts of stress management training in medical school have achieved positive results on minimizing psychological distress; however, there are often limitations. Therefore, the use of a rigorous scientific method is needed. The present study protocol describes a randomized controlled trial to examine the effectiveness of a specifically developed mindfulness-based stress prevention training for medical students that includes selected elements of cognitive behavioral strategies (MediMind). This study protocol presents a prospective randomized controlled trial, involving four assessment time points: baseline, post-intervention, one-year follow-up and five-year follow-up. The aims include evaluating the effect on stress, coping, psychological morbidity and personality traits with validated measures. Participants are allocated randomly to one of three conditions: MediMind, Autogenic Training or control group. Eligible participants are medical or dental students in the second or eighth semester of a German university. They form a population of approximately 420 students in each academic term. A final total sample size of 126 (at five-year follow-up) is targeted. The trainings (MediMind and Autogenic Training) comprise five weekly sessions lasting 90 minutes each. MediMind will be offered to participants of the control group once the five-year follow-up is completed. The allotment is randomized with a stratified allocation ratio by course of studies, semester, and gender. After descriptive statistics have been evaluated, inferential statistical analysis will be carried out with a repeated measures ANOVA-design with interactions between time and group. Effect sizes will be calculated using partial η-square values. Potential limitations of this study

An SDN-Based Authentication Mechanism for Securing Neighbor Discovery Protocol in IPv6

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Yiqin Lu

2017-01-01

Full Text Available The Neighbor Discovery Protocol (NDP is one of the main protocols in the Internet Protocol version 6 (IPv6 suite, and it provides many basic functions for the normal operation of IPv6 in a local area network (LAN, such as address autoconfiguration and address resolution. However, it has many vulnerabilities that can be used by malicious nodes to launch attacks, because the NDP messages are easily spoofed without protection. Surrounding this problem, many solutions have been proposed for securing NDP, but these solutions either proposed new protocols that need to be supported by all nodes or built mechanisms that require the cooperation of all nodes, which is inevitable in the traditional distributed networks. Nevertheless, Software-Defined Networking (SDN provides a new perspective to think about protecting NDP. In this paper, we proposed an SDN-based authentication mechanism to verify the identity of NDP packets transmitted in a LAN. Using the centralized control and programmability of SDN, it can effectively prevent the spoofing attacks and other derived attacks based on spoofing. In addition, this mechanism needs no additional protocol supporting or configuration at hosts and routers and does not introduce any dedicated devices.

Design and Analysis of Secure Routing Protocol for Wireless Sensor Networks

Science.gov (United States)

Wang, Jiong; Zhang, Hua

2017-09-01

In recent years, with the development of science and technology and the progress of the times, China's wireless network technology has become increasingly prosperous and it plays an important role in social production and life. In this context, in order to further to enhance the stability of wireless network data transmission and security enhancements, the staff need to focus on routing security and carry out related work. Based on this, this paper analyzes the design of wireless sensor based on secure routing protocol.

Developing community-driven quality improvement initiatives to enhance chronic disease care in Indigenous communities in Canada: the FORGE AHEAD program protocol.

Science.gov (United States)

Naqshbandi Hayward, Mariam; Paquette-Warren, Jann; Harris, Stewart B

2016-07-26

Given the dramatic rise and impact of chronic diseases and gaps in care in Indigenous peoples in Canada, a shift from the dominant episodic and responsive healthcare model most common in First Nations communities to one that places emphasis on proactive prevention and chronic disease management is urgently needed. The Transformation of Indigenous Primary Healthcare Delivery (FORGE AHEAD) Program partners with 11 First Nations communities across six provinces in Canada to develop and evaluate community-driven quality improvement (QI) initiatives to enhance chronic disease care. FORGE AHEAD is a 5-year research program (2013-2017) that utilizes a pre-post mixed-methods observational design rooted in participatory research principles to work with communities in developing culturally relevant innovations and improved access to available services. This intensive program incorporates a series of 10 inter-related and progressive program activities designed to foster community-driven initiatives with type 2 diabetes mellitus as the action disease. Preparatory activities include a national community profile survey, best practice and policy literature review, and readiness tool development. Community-level intervention activities include community and clinical readiness consultations, development of a diabetes registry and surveillance system, and QI activities. With a focus on capacity building, all community-level activities are driven by trained community members who champion QI initiatives in their community. Program wrap-up activities include readiness tool validation, cost-analysis and process evaluation. In collaboration with Health Canada and the Aboriginal Diabetes Initiative, scale-up toolkits will be developed in order to build on lessons-learned, tools and methods, and to fuel sustainability and spread of successful innovations. The outcomes of this research program, its related cost and the subsequent policy recommendations, will have the potential to

Ocean fertilization, carbon credits and the Kyoto Protocol

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Westley, M. B.; Gnanadesikan, A.

2008-12-01

Commercial interest in ocean fertilization as a carbon sequestration tool was excited by the December 1997 agreement of the Kyoto Protocol to the United Nations Convention on Climate Change. The Protocol commits industrialized countries to caps on net greenhouse gas emissions and allows for various flexible mechanisms to achieve these caps in the most economically efficient manner possible, including trade in carbon credits from projects that reduce emissions or enhance sinks. The carbon market was valued at 64 billion in 2007, with the bulk of the trading (50 billion) taking place in the highly regulated European Union Emission Trading Scheme, which deals primarily in emission allowances in the energy sector. A much smaller amount, worth $265 million, was traded in the largely unregulated "voluntary" market (Capoor and Ambrosi 2008). As the voluntary market grows, so do calls for its regulation, with several efforts underway to set rules and standards for the sale of voluntary carbon credits using the Kyoto Protocol as a starting point. Four US-based companies and an Australian company currently seek to develop ocean fertilization technologies for the generation of carbon credits. We review these plans through the lens of the Kyoto Protocol and its flexible mechanisms, and examine whether and how ocean fertilization could generate tradable carbon credits. We note that at present, ocean sinks are not included in the Kyoto Protocol, and that furthermore, the Kyoto Protocol only addresses sources and sinks of greenhouse gases within national boundaries, making open-ocean fertilization projects a jurisdictional challenge. We discuss the negotiating history behind the limited inclusion of land use, land use change and forestry in the Kyoto Protocol and the controversy and eventual compromise concerning methodologies for terrestrial carbon accounting. We conclude that current technologies for measuring and monitoring carbon sequestration following ocean fertilization

Failure of antiarrhythmic drugs to prevent experimental reperfusion ventricular fibrillation.

Science.gov (United States)

Naito, M; Michelson, E L; Kmetzo, J J; Kaplinsky, E; Dreifus, L S

1981-01-01

Ninety-nine adult mongrel dogs underwent acute ligation of the proximal left anterior descending coronary artery. Thirty minutes later, the occlusion was released to evaluate the effectiveness of five antiarrhythmic protocols in eliminating reperfusion ventricular fibrillation. The five protocols included: protocol 1 --i.v. lidocaine, preligation and prerelease (n = 19); protocol 2 -- i.v. lidocaine, prereperfusion only (n = 22); protocol 3 -- chronic, oral, daily amiodarone for 2 weeks preligation (n = 19); protocol 4 -- i.v. procainamide, preligation and prereperfusion (n = 21); and protocol 5 -- i.v. verapamil, prereperfusion (n = 18). Each regimen was evaluated with respect to the incidence of reperfusion ventricular fibrillation in dogs that survived to reperfusion, and the results were compared to 77 control dogs that underwent identical coronary artery occlusion and release procedures without drug therapy. The incidence of reperfusion ventricular fibrillation was as follows: protocol 1 -- seven of 15 dogs (47%); protocol 2 -- six of 18 (33%); protocol 3 -- 11 of 16 dogs (69%); protocol 4 -- eight of 17 dogs (47%); and protocol 5 -- 10 of 17 dogs (59%), compared with 36 of 60 (60%) in control dogs. Using chi-square analysis, protocol 2 was beneficial (p antecedent coronary artery ligation periods, and predictive risk indexes for the occurrence of reperfusion ventricular fibrillation were developed. the Mantel-Haenszel method of statistical analysis revealed that none of these protocols resulted in a statistically significant reduction in the incidence of reperfusion ventricular fibrillation. Thus, use of these predictive indexes plus appropriate statistical methods has revealed, unexpectedly, limitations in the efficacy of a spectrum of antiarrhythmic agents in preventing reperfusion ventricular fibrillation.

An Adaptive Information Quantity-Based Broadcast Protocol for Safety Services in VANET

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Wenjie Wang

2016-01-01

Full Text Available Vehicle-to-vehicle communication plays a significantly important role in implementing safe and efficient road traffic. When disseminating safety messages in the network, the information quantity on safety packets changes over time and space. However, most of existing protocols view each packet the same to disseminate, preventing vehicles from collecting more recent and precise safety information. Hence, an information quantity-based broadcast protocol is proposed in this paper to ensure the efficiency of safety messages dissemination. In particular, we propose the concept of emergency-degree to evaluate packets’ information quantity. Then we present EDCast, an emergency-degree-based broadcast protocol. EDCast differentiates each packet’s priority for accessing the channel based on its emergency-degree so as to provide vehicles with more safety information timely and accurately. In addition, an adaptive scheme is presented to ensure fast dissemination of messages in different network condition. We compare the performance of EDCast with those of three other representative protocols in a typical highway scenario. Simulation results indicate that EDCast achieves higher broadcast efficiency and less redundancy with less delivery delay. What we found demonstrates that it is feasible and necessary for incorporating information quantity of messages in designing an efficient safety message broadcast protocol.

The First-aid Advice and Safety Training (FAST) parents programme for the prevention of unintentional injuries in preschool children: a protocol.

Science.gov (United States)

Mytton, Julie A; Towner, Elizabeth Ml; Kendrick, Denise; Stewart-Brown, Sarah; Emond, Alan; Ingram, Jenny; Blair, Peter S; Powell, Jane; Mulvaney, Caroline; Thomas, James; Deave, Toity; Potter, Barbara

2014-02-01

Unintentional injury is the leading cause of preventable death in children in the UK, and 0-4-year-olds frequently attend emergency departments following injuries in the home. Parenting programmes designed to support parents, promote behaviour change and enhance parent-child relationships have been shown to improve health outcomes in children. It is not known whether group-based parenting programmes have the potential to prevent unintentional injuries in preschool children. A study to develop a group-based parenting programme to prevent unintentional home injuries in preschool children, and assess the feasibility of evaluation through a cluster-randomised controlled trial. The intervention, designed for parents of children who have sustained a medically attended injury, will be developed with two voluntary sector organisations. The feasibility study will assess ability to recruit parents, deliver the programme and follow-up participants. Participants will complete questionnaires at baseline, 3 months and 6 months, and report injuries in their preschool children using a tool designed and validated for this study. Qualitative methods will assess user and deliverer perceptions of the programme. This study will develop the first group-based parenting programme to prevent injuries in preschool children, and design tools for parent-reported injury outcomes. A key challenge will be to recruit parents to participate in a manner that is non-stigmatising, and does not result in feelings of guilt or belief that they are perceived to be a bad parent. The findings will be used to prepare a trial to assess the effectiveness and cost-effectiveness of the intervention.

Integrating a suicide prevention program into the primary health care network: a field trial study in Iran.

Science.gov (United States)

Malakouti, Seyed Kazem; Nojomi, Marzieh; Poshtmashadi, Marjan; Hakim Shooshtari, Mitra; Mansouri Moghadam, Fariba; Rahimi-Movaghar, Afarin; Afghah, Susan; Bolhari, Jafar; Bazargan-Hejazi, Shahrzad

2015-01-01

To describe and evaluate the feasibility of integrating a suicide prevention program with Primary Health Care services and evaluate if such system can improve screening and identification of depressive disorder, reduce number of suicide attempters, and lower rate of suicide completion. This was a quasi-experimental trial in which one community was exposed to the intervention versus the control community with no such exposure. The study sites were two counties in Western Iran. The intervention protocol called for primary care and suicide prevention collaboration at different levels of care. The outcome variables were the number of suicides committed, the number of documented suicide attempts, and the number of identified depressed cases. We identified a higher prevalence of depressive disorders in the intervention site versus the control site (χ (2) = 14.8, P suicide completion in the intervention region compared to the control, but a higher prevalence of suicide attempts in both the intervention and the control sites. Integrating a suicide prevention program with the Primary Health Care network enhanced depression and suicide surveillance capacity and subsequently reduced the number of suicides, especially in rural areas.

Tranexamic Acid versus Placebo to Prevent Blood Transfusion during Radical Cystectomy for Bladder Cancer (TACT): Study Protocol for a Randomized Controlled Trial.

Science.gov (United States)

Breau, Rodney H; Lavallée, Luke T; Cnossen, Sonya; Witiuk, Kelsey; Cagiannos, Ilias; Momoli, Franco; Bryson, Gregory; Kanji, Salmaan; Morash, Christopher; Turgeon, Alexis; Zarychanski, Ryan; Mallick, Ranjeeta; Knoll, Greg; Fergusson, Dean A

2018-05-02

Radical cystectomy for bladder cancer is associated with a high risk of needing red blood cell transfusion. Tranexamic acid reduces blood loss during cardiac and orthopedic surgery, but no study has yet evaluated tranexamic acid use during cystectomy. A randomized, double-blind (surgeon-, anesthesiologist-, patient-, data-monitor-blinded), placebo-controlled trial of tranexamic acid during cystectomy was initiated in June 2013. Prior to incision, the intervention arm participants receive a 10 mg/kg loading dose of intravenously administered tranexamic acid, followed by a 5 mg/kg/h maintenance infusion. In the control arm, the patient receives an identical volume of normal saline that is indistinguishable from the intervention. The primary outcome is any blood transfusion from the start of surgery up to 30 days post operative. There are no strict criteria to mandate the transfusion of blood products. The decision to transfuse is entirely at the discretion of the treating physicians who are blinded to patient allocation. Physicians are allowed to utilize all resources to make transfusion decisions, including serum hemoglobin concentration and vital signs. To date, 147 patients of a planned 354 have been randomized to the study. This protocol reviews pertinent data relating to blood transfusion during radical cystectomy, highlighting the need to identify methods for reducing blood loss and preventing transfusion in patients receiving radical cystectomy. It explains the clinical rationale for using tranexamic acid to reduce blood loss during cystectomy, and outlines the study methods of our ongoing randomized controlled trial. Canadian Institute for Health Research (CIHR) Protocol: MOP-342559; ClinicalTrials.gov, ID: NCT01869413. Registered on 5 June 2013.

An Efficient and Secure Arbitrary N-Party Quantum Key Agreement Protocol Using Bell States

Science.gov (United States)

Liu, Wen-Jie; Xu, Yong; Yang, Ching-Nung; Gao, Pei-Pei; Yu, Wen-Bin

2018-01-01

Two quantum key agreement protocols using Bell states and Bell measurement were recently proposed by Shukla et al. (Quantum Inf. Process. 13(11), 2391-2405, 2014). However, Zhu et al. pointed out that there are some security flaws and proposed an improved version (Quantum Inf. Process. 14(11), 4245-4254, 2015). In this study, we will show Zhu et al.'s improvement still exists some security problems, and its efficiency is not high enough. For solving these problems, we utilize four Pauli operations { I, Z, X, Y} to encode two bits instead of the original two operations { I, X} to encode one bit, and then propose an efficient and secure arbitrary N-party quantum key agreement protocol. In the protocol, the channel checking with decoy single photons is introduced to avoid the eavesdropper's flip attack, and a post-measurement mechanism is used to prevent against the collusion attack. The security analysis shows the present protocol can guarantee the correctness, security, privacy and fairness of quantum key agreement.

Research and Implementation of Collision Detection Based on Modbus Protocol

Directory of Open Access Journals (Sweden)

Yinglan Fang

2013-01-01

Full Text Available In order to solve the communication errors resulted by traditional working condition multi-platform device communication using the custom protocol communication and link congestion malpractice brought by retransmission, it ensures network communication using time-sharing communication conflict detection based on mature Modbus protocol. Thereby it enhances the stability of the entire system during operation process, and provides simple, efficient, stable business specification interface for the future expansion of the system. After a comprehensive evaluation and analysis of system communication messages before and after improvement, system comprehensive evaluation target has improved. While the system is more flexible to modular design, develop transparent, structure open side and has a broad application prospects.

Reliable Multicast MAC Protocol for IEEE 802.11 Wireless LANs with Extended Service Range

Science.gov (United States)

Choi, Woo-Yong

2011-11-01

In this paper, we propose the efficient reliable multicast MAC protocol by which the AP (Access Point) can transmit reliably its multicast data frames to the recipients in the AP's one-hop or two-hop transmission range. The AP uses the STAs (Stations) that are directly associated with itself as the relays for the data delivery to the remote recipients that cannot be reached directly from itself. Based on the connectivity information among the recipients, the reliable multicast MAC protocol optimizes the number of the RAK (Request for ACK) frame transmissions in a reasonable computational time. Numerical examples show that our proposed MAC protocol significantly enhances the MAC performance compared with the BMMM (Batch Mode Multicast MAC) protocol that is extended to support the recipients that are in the AP's one-hop or two-hop transmission range in IEEE 802.11 wireless LANs.

Enhancing Social Responsibility and Prosocial Leadership to Prevent Aggression, Peer Victimization, and Emotional Problems in Elementary School Children.

Science.gov (United States)

Leadbeater, Bonnie J; Thompson, Kara; Sukhawathanakul, Paweena

2016-12-01

Testing the theories that form the basis of prevention programs can enhance our understanding of behavioral change and inform the development, coordination, and adaptation of prevention programs. However, theories of change showing the linkages from intervention program components to risk or protective factors to desired outcomes across time are rarely specified or tested. In this 2-year longitudinal study, we test the theory that increases in two protective factors (i.e., children's prosocial leadership and their teachers' expectations of social responsibility) targeted by the WITS Programs (Walk Away, Ignore, Talk it Out, and Seek Help) would be associated with declines in peer victimization, aggression, and emotional problems. Participants included Canadian students, in grades 1-4 at baseline (n = 1329) and their parents and teachers. Consistent with our theory of change, variability in program implementation (adherence and integration) and in children's use of program skills (child responsiveness) are related to increases in both protective factors. Increases in these protective factors are associated with subsequent declines in children's aggression, victimization, and emotional problems. We discuss how enhancement of these protective factors may operate to improve child outcomes and the need for theory-based research to refine and improve the effectiveness of intervention strategies and to improve program scale-up. © Society for Community Research and Action 2016.

Enhancing creative cognition with a rapid right-parietal neurofeedback procedure.

Science.gov (United States)

Agnoli, Sergio; Zanon, Marco; Mastria, Serena; Avenanti, Alessio; Corazza, Giovanni Emanuele

2018-02-14

The present article describes an innovative neurofeedback training (NFT) procedure aimed at increasing creative cognition through the enhancement of specific brain activities previously associated with divergent thinking. We designed and tested two NFT protocols based on training alpha and beta EEG oscillations selectively measured over the right parietal region. A total of 80 participants were involved, 40 in the alpha NFT protocol and 40 in the beta NFT protocol. The NFT loop was closed on a video stream that would advance only when oscillation power exceeded a normalized threshold. The total duration of the protocol was two hours in a single day, hence its classification as rapid. Changes in ideational fluency and originality, measured with a divergent thinking task, were compared between participants receiving real video feedback and participants receiving sham feedback. We controlled for individual differences in creative achievement level. Results showed that the protocols were effective at enhancing alpha and beta activities in the targeted area. Differences between the two protocols emerged in their effectiveness at promoting divergent thinking. While no significant changes in originality resulted from the rapid alpha NFT, increases in both originality and fluency emerged as a consequence of the rapid beta NFT. These results were particularly evident in participants starting with a low creative achievement level. Possible interpretations and future directions are proposed and discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

Attacks on quantum key distribution protocols that employ non-ITS authentication

Science.gov (United States)

Pacher, C.; Abidin, A.; Lorünser, T.; Peev, M.; Ursin, R.; Zeilinger, A.; Larsson, J.-Å.

2016-01-01

We demonstrate how adversaries with large computing resources can break quantum key distribution (QKD) protocols which employ a particular message authentication code suggested previously. This authentication code, featuring low key consumption, is not information-theoretically secure (ITS) since for each message the eavesdropper has intercepted she is able to send a different message from a set of messages that she can calculate by finding collisions of a cryptographic hash function. However, when this authentication code was introduced, it was shown to prevent straightforward man-in-the-middle (MITM) attacks against QKD protocols. In this paper, we prove that the set of messages that collide with any given message under this authentication code contains with high probability a message that has small Hamming distance to any other given message. Based on this fact, we present extended MITM attacks against different versions of BB84 QKD protocols using the addressed authentication code; for three protocols, we describe every single action taken by the adversary. For all protocols, the adversary can obtain complete knowledge of the key, and for most protocols her success probability in doing so approaches unity. Since the attacks work against all authentication methods which allow to calculate colliding messages, the underlying building blocks of the presented attacks expose the potential pitfalls arising as a consequence of non-ITS authentication in QKD post-processing. We propose countermeasures, increasing the eavesdroppers demand for computational power, and also prove necessary and sufficient conditions for upgrading the discussed authentication code to the ITS level.

A Lightweight Continuous Authentication Protocol for the Internet of Things

Directory of Open Access Journals (Sweden)

Yo-Hsuan Chuang

2018-04-01

Full Text Available Modern societies are moving toward an information-oriented environment. To gather and utilize information around people’s modern life, tiny devices with all kinds of sensing devices and various sizes of gateways need to be deployed and connected with each other through the Internet or proxy-based wireless sensor networks (WSNs. Within this kind of Internet of Things (IoT environment, how to authenticate each other between two communicating devices is a fundamental security issue. As a lot of IoT devices are powered by batteries and they need to transmit sensed data periodically, it is necessary for IoT devices to adopt a lightweight authentication protocol to reduce their energy consumption when a device wants to authenticate and transmit data to its targeted peer. In this paper, a lightweight continuous authentication protocol for sensing devices and gateway devices in general IoT environments is introduced. The concept of valid authentication time period is proposed to enhance robustness of authentication between IoT devices. To construct the proposed lightweight continuous authentication protocol, token technique and dynamic features of IoT devices are adopted in order to reach the design goals: the reduction of time consumption for consecutive authentications and energy saving for authenticating devices through by reducing the computation complexity during session establishment of continuous authentication. Security analysis is conducted to evaluate security strength of the proposed protocol. In addition, performance analysis has shown the proposed protocol is a strong competitor among existing protocols for device-to-device authentication in IoT environments.

A Lightweight Continuous Authentication Protocol for the Internet of Things

Science.gov (United States)

Chuang, Yo-Hsuan; Yang, Cheng-Ying; Tang, Ssu-Wei

2018-01-01

Modern societies are moving toward an information-oriented environment. To gather and utilize information around people’s modern life, tiny devices with all kinds of sensing devices and various sizes of gateways need to be deployed and connected with each other through the Internet or proxy-based wireless sensor networks (WSNs). Within this kind of Internet of Things (IoT) environment, how to authenticate each other between two communicating devices is a fundamental security issue. As a lot of IoT devices are powered by batteries and they need to transmit sensed data periodically, it is necessary for IoT devices to adopt a lightweight authentication protocol to reduce their energy consumption when a device wants to authenticate and transmit data to its targeted peer. In this paper, a lightweight continuous authentication protocol for sensing devices and gateway devices in general IoT environments is introduced. The concept of valid authentication time period is proposed to enhance robustness of authentication between IoT devices. To construct the proposed lightweight continuous authentication protocol, token technique and dynamic features of IoT devices are adopted in order to reach the design goals: the reduction of time consumption for consecutive authentications and energy saving for authenticating devices through by reducing the computation complexity during session establishment of continuous authentication. Security analysis is conducted to evaluate security strength of the proposed protocol. In addition, performance analysis has shown the proposed protocol is a strong competitor among existing protocols for device-to-device authentication in IoT environments. PMID:29621168

A Lightweight Continuous Authentication Protocol for the Internet of Things.

Science.gov (United States)

Chuang, Yo-Hsuan; Lo, Nai-Wei; Yang, Cheng-Ying; Tang, Ssu-Wei

2018-04-05

Modern societies are moving toward an information-oriented environment. To gather and utilize information around people's modern life, tiny devices with all kinds of sensing devices and various sizes of gateways need to be deployed and connected with each other through the Internet or proxy-based wireless sensor networks (WSNs). Within this kind of Internet of Things (IoT) environment, how to authenticate each other between two communicating devices is a fundamental security issue. As a lot of IoT devices are powered by batteries and they need to transmit sensed data periodically, it is necessary for IoT devices to adopt a lightweight authentication protocol to reduce their energy consumption when a device wants to authenticate and transmit data to its targeted peer. In this paper, a lightweight continuous authentication protocol for sensing devices and gateway devices in general IoT environments is introduced. The concept of valid authentication time period is proposed to enhance robustness of authentication between IoT devices. To construct the proposed lightweight continuous authentication protocol, token technique and dynamic features of IoT devices are adopted in order to reach the design goals: the reduction of time consumption for consecutive authentications and energy saving for authenticating devices through by reducing the computation complexity during session establishment of continuous authentication. Security analysis is conducted to evaluate security strength of the proposed protocol. In addition, performance analysis has shown the proposed protocol is a strong competitor among existing protocols for device-to-device authentication in IoT environments.

Protocol optimization for enhanced production of pigments in Spirulina.

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Kumar, Devendra; Kumar, Neeraj; Pabbi, Sunil; Walia, Suresh; Dhar, Dolly Wattal

2013-01-01

Spirulina has attracted special attention due to its importance as human foodstuff and natural colours with specific functional properties. These functional properties have been attributed to phycobilins, carotenoids, phenolics and unsaturated fatty acids. Present study was conducted under controlled phytotron conditions to identify the efficient strains of Spirulina in terms of pigment synthesis and to optimize their enhanced production. Methodology for enhanced production was standardized by varying specific environmental parameters (light intensity, temperature, carbon dioxide concentration, pH and NaCl level). Different strains of Spirulina depicted variability and environmental parameters showed distinct influence on pigments. Growth and pigment production was recorded to be most efficient under optimized conditions of light intensity (70 μmol m -2  s -1 ), temperature (30 °C), CO 2 concentration (550 ppm and 750 ppm), pH (10.5) and NaCl level (2 g L -1 ).

Using Open-Book Exams to Enhance Student Learning, Performance, and Motivation

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Green, Steve G.; Ferrante, Claudia J.; Heppard, Kurt A.

2016-01-01

This study investigated an alternative testing protocol used in an undergraduate managerial accounting course. Specifically, we assert that consistent open-book testing approaches will enhance learning and better prepare students for the real-world decision-making they will encounter. A semester-long testing protocol was executed incorporating a…

A framework of quality improvement interventions to implement evidence-based practices for pressure ulcer prevention.

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Padula, William V; Mishra, Manish K; Makic, Mary Beth F; Valuck, Robert J

2014-06-01

To enhance the learner's competence with knowledge about a framework of quality improvement (QI) interventions to implement evidence-based practices for pressure ulcer (PrU) prevention. This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Summarize the process of creating and initiating the best-practice framework of QI for PrU prevention.2. Identify the domains and QI interventions for the best-practice framework of QI for PrU prevention. Pressure ulcer (PrU) prevention is a priority issue in US hospitals. The National Pressure Ulcer Advisory Panel endorses an evidence-based practice (EBP) protocol to help prevent PrUs. Effective implementation of EBPs requires systematic change of existing care units. Quality improvement interventions offer a mechanism of change to existing structures in order to effectively implement EBPs for PrU prevention. The best-practice framework developed by Nelson et al is a useful model of quality improvement interventions that targets process improvement in 4 domains: leadership, staff, information and information technology, and performance and improvement. At 2 academic medical centers, the best-practice framework was shown to physicians, nurses, and health services researchers. Their insight was used to modify the best-practice framework as a reference tool for quality improvement interventions in PrU prevention. The revised framework includes 25 elements across 4 domains. Many of these elements support EBPs for PrU prevention, such as updates in PrU staging and risk assessment. The best-practice framework offers a reference point to initiating a bundle of quality improvement interventions in support of EBPs. Hospitals and clinicians tasked with quality improvement efforts can use this framework to problem-solve PrU prevention and other critical issues.

Enhancing implementation of tobacco use prevention and cessation counselling guideline among dental providers: a cluster randomised controlled trial.

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Amemori, Masamitsu; Korhonen, Tellervo; Kinnunen, Taru; Michie, Susan; Murtomaa, Heikki

2011-02-14

Tobacco use adversely affects oral health. Tobacco use prevention and cessation (TUPAC) counselling guidelines recommend that healthcare providers ask about each patient's tobacco use, assess the patient's readiness and willingness to stop, document tobacco use habits, advise the patient to stop, assist and help in quitting, and arrange monitoring of progress at follow-up appointments. Adherence to such guidelines, especially among dental providers, is poor. To improve guideline implementation, it is essential to understand factors influencing it and find effective ways to influence those factors. The aim of the present study protocol is to introduce a theory-based approach to diagnose implementation difficulties of TUPAC counselling guidelines among dental providers. Theories of behaviour change have been used to identify key theoretical domains relevant to the behaviours of healthcare providers involved in implementing clinical guidelines. These theoretical domains will inform the development of a questionnaire aimed at assessing the implementation of the TUPAC counselling guidelines among Finnish municipal dental providers. Specific items will be drawn from the guidelines and the literature on TUPAC studies. After identifying potential implementation difficulties, we will design two interventions using theories of behaviour change to link them with relevant behaviour change techniques aiming to improve guideline adherence. For assessing the implementation of TUPAC guidelines, the electronic dental record audit and self-reported questionnaires will be used. To improve guideline adherence, the theoretical-domains approach could provide a comprehensive basis for assessing implementation difficulties, as well as designing and evaluating interventions. After having identified implementation difficulties, we will design and test two interventions to enhance TUPAC guideline adherence. Using the cluster randomised controlled design, we aim to provide further evidence on

Enhancing implementation of tobacco use prevention and cessation counselling guideline among dental providers: a cluster randomised controlled trial

Directory of Open Access Journals (Sweden)

Michie Susan

2011-02-01

Full Text Available Abstract Background Tobacco use adversely affects oral health. Tobacco use prevention and cessation (TUPAC counselling guidelines recommend that healthcare providers ask about each patient's tobacco use, assess the patient's readiness and willingness to stop, document tobacco use habits, advise the patient to stop, assist and help in quitting, and arrange monitoring of progress at follow-up appointments. Adherence to such guidelines, especially among dental providers, is poor. To improve guideline implementation, it is essential to understand factors influencing it and find effective ways to influence those factors. The aim of the present study protocol is to introduce a theory-based approach to diagnose implementation difficulties of TUPAC counselling guidelines among dental providers. Methods Theories of behaviour change have been used to identify key theoretical domains relevant to the behaviours of healthcare providers involved in implementing clinical guidelines. These theoretical domains will inform the development of a questionnaire aimed at assessing the implementation of the TUPAC counselling guidelines among Finnish municipal dental providers. Specific items will be drawn from the guidelines and the literature on TUPAC studies. After identifying potential implementation difficulties, we will design two interventions using theories of behaviour change to link them with relevant behaviour change techniques aiming to improve guideline adherence. For assessing the implementation of TUPAC guidelines, the electronic dental record audit and self-reported questionnaires will be used. Discussion To improve guideline adherence, the theoretical-domains approach could provide a comprehensive basis for assessing implementation difficulties, as well as designing and evaluating interventions. After having identified implementation difficulties, we will design and test two interventions to enhance TUPAC guideline adherence. Using the cluster

Analyzing the effect of routing protocols on media access control protocols in radio networks

Energy Technology Data Exchange (ETDEWEB)

Barrett, C. L. (Christopher L.); Drozda, M. (Martin); Marathe, A. (Achla); Marathe, M. V. (Madhav V.)

2002-01-01

We study the effect of routing protocols on the performance of media access control (MAC) protocols in wireless radio networks. Three well known MAC protocols: 802.11, CSMA, and MACA are considered. Similarly three recently proposed routing protocols: AODV, DSR and LAR scheme 1 are considered. The experimental analysis was carried out using GloMoSim: a tool for simulating wireless networks. The main focus of our experiments was to study how the routing protocols affect the performance of the MAC protocols when the underlying network and traffic parameters are varied. The performance of the protocols was measured w.r.t. five important parameters: (i) number of received packets, (ii) average latency of each packet, (iii) throughput (iv) long term fairness and (v) number of control packets at the MAC layer level. Our results show that combinations of routing and MAC protocols yield varying performance under varying network topology and traffic situations. The result has an important implication; no combination of routing protocol and MAC protocol is the best over all situations. Also, the performance analysis of protocols at a given level in the protocol stack needs to be studied not locally in isolation but as a part of the complete protocol stack. A novel aspect of our work is the use of statistical technique, ANOVA (Analysis of Variance) to characterize the effect of routing protocols on MAC protocols. This technique is of independent interest and can be utilized in several other simulation and empirical studies.

The Kidney Awareness Registry and Education (KARE) study: protocol of a randomized controlled trial to enhance provider and patient engagement with chronic kidney disease.

Science.gov (United States)

Tuot, Delphine S; Velasquez, Alexandra; McCulloch, Charles E; Banerjee, Tanushree; Zhu, Yunnuo; Hsu, Chi-yuan; Handley, Margaret; Schillinger, Dean; Powe, Neil R

2015-10-22

Chronic kidney disease (CKD) is common and is associated with excess mortality and morbidity. Better management could slow progression of disease, prevent metabolic complications, and reduce cardiovascular outcomes. Low patient awareness of CKD and ineffective patient-provider communication can impede such efforts. We developed provider and patient-directed interventions that harness health information technology to enhance provider recognition of CKD and delivery of guideline concordant care and augment patient understanding and engagement in CKD care. We report the design and protocol of the Kidney Awareness Registry and Education (KARE) Study, a 2x2 factorial randomized controlled trial that examines the impact of a multi-level intervention on health outcomes among low-income English, Spanish and Cantonese-speaking patients with CKD in a safety net system. The intervention includes: (1) implementation of a primary care electronic CKD registry that notifies practice teams of patients' CKD status and employs a patient profile and quarterly feedback to encourage provision of guideline-concordant care at point-of-care and via outreach; and (2) a language-concordant, culturally-sensitive self-management support program that consists of automated telephone modules, provision of low-literacy written patient-educational materials and telephone health coaching. The primary outcomes of the trial are changes in systolic blood pressure (BP) and the proportion of patients with BP control (≤ 140/90 mmHg) after one year. Secondary outcomes include patient understanding of CKD, participation in healthy behaviors, and practice team delivery of guideline-concordant CKD care. Results from the KARE study will provide data on the feasibility, effectiveness, and acceptability of technology-based interventions that support primary care efforts at improving health outcomes among vulnerable patients with CKD. ClinicalTrials.gov, number: NCT01530958.

PRALIMAP: study protocol for a high school-based, factorial cluster randomised interventional trial of three overweight and obesity prevention strategies

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Agrinier Nelly

2010-12-01

Full Text Available Abstract Background Given the increase in overweight and obesity prevalence in adolescents in the last decade, effective prevention strategies for these conditions in adolescents are urgently needed. The PRALIMAP (Promotion de l'ALImentation et de l'Activité Physique trial aims to evaluate the effectiveness for these conditions of 3 health promotion strategies -- educational, screening and environmental -- applied singly or in combination in high schools over a 2-year intervention period. Methods PRALIMAP is a stratified 2 × 2 × 2 factorial cluster randomised controlled trial including 24 state high schools in Lorraine, northeastern France, in 2 waves: 8 schools in 2006 (wave 1 and 16 in 2007 (wave 2. Students entering the selected high schools in the 4 academic years from 2006 to 2009 are eligible for data collection. Interventional strategies are organized over 2 academic years. The follow-up consists of 3 visits: at the entry of grade 10 (T0, grade 11 (T1 and grade 12 (T2. At T0, 5,458 (85.7% adolescents participated. The educational strategy consists of nutritional lessons, working groups and a final party. The screening strategy consists in detecting overweight/obesity and eating disorders in adolescents and proposing, if necessary, an adapted care management program of 7 group educational sessions. The environmental strategy consists in improving dietary and physical activity offerings in high schools and facilities, especially catering. The main outcomes are body size evolution over time, nutritional behaviour and knowledge, health and quality of life. An evaluation process documents how each intervention strategy is implemented in the schools and estimates the dose of the intervention, allowing for a per protocol analysis after the main intention-to-treat analysis. Discussion PRALIMAP aims at improving the prevention and management of overweight and obesity in adolescents by translating current evidence into public health practice

Compact wireless control network protocol with fast path switching

Directory of Open Access Journals (Sweden)

Yasutaka Kawamoto

2017-08-01

Full Text Available Sensor network protocol stacks require the addition or adjustment of functions based on customer requirements. Sensor network protocols that require low delay and low packet error rate (PER, such as wireless control networks, often adopt time division multiple access (TDMA. However, it is difficult to add or adjust functions in protocol stacks that use TDMA methods. Therefore, to add or adjust functions easily, we propose NES-SOURCE, a compact wireless control network protocol with a fast path-switching function. NES-SOURCE is implemented using carrier sense multiple access/collision avoidance (CSMA/CA rather than TDMA. Wireless control networks that use TDMA prevent communication failure by duplicating the communication path. If CSMA/CA networks use duplicate paths, collisions occur frequently, and communication will fail. NES-SOURCE switches paths quickly when communication fails, which reduces the effect of communication failures. Since NES-SOURCE is implemented using CSMA/CA rather than TDMA, the implementation scale is less than one-half that of existing network stacks. Furthermore, since NES-SOURCE’s code complexity is low, functions can be added or adjusted easily and quickly. Communication failures occur owing to changes in the communication environment and collisions. Experimental results demonstrate that the proposed NES-SOURCE’s path-switching function reduces the amount of communication failures when the communication environment changes owing to human movement and others. Furthermore, we clarify the relationships among the probability of a changing communication environment, the collision occurrence rate, and the PER of NES-SOURCE.

Protocols on prenatal care for pregnant women with Zika infection and children with microcephaly: nutritional approach

Directory of Open Access Journals (Sweden)

Rachel de Sá Barreto Luna Callou Cruz

Full Text Available Abstract This summary aimed to synthesize the protocol guidelines of Pernambuco, the Ministry of Health and the Centers for Disease Control and Prevention which deal with health care related to Zika virus infection during pregnancy and the preliminary procedures for surveillance on microcephaly cases including nutritional care. With the increase of number of cases on this event since August, 2015, it was necessary to reorganize the prenatal care which is offered to pregnant women, including the protocols in order to reduce the chances of a possible contamination of the virus, to detect previously suspected cases as well as perform follow up on confirmed cases. The gaps in the knowledge of this morbidity, it should be noted that the information and recommendations are subject to revision due to possible incorporation of new knowledge and other evidence, as well as the need for adequacy of surveillance actions in new epidemiological scenarios. It is known that cases of nutritional deficiencies are capable of producing malformation of the Central Nervous System, including microcephaly. In the analysis of the protocols, there were no changes as to the nutritional recommendations already established for the low-risk pregnant women. The authors presented a hypothesis and conceptually, as a prevention measurement, the inclusion of prenatal care to prevent and control isolated or multiple deficiencies associated to microcephaly, such as protein, vitamin A, iodine, folate, B12, vitamin D, biotin, zinc and selenium.

Enhancement of "Reducing the Risk" for the 21st Century: Improvement to a Curriculum Developed to Prevent Teen Pregnancy and STI Transmission

Science.gov (United States)

Langley, Cheri; Barbee, Anita P.; Antle, Becky; Christensen, Dana; Archuleta, Adrian; Sar, Bibhuti K.; Karam, Eli; van Zyl, Riaan; Cunningham, Michael R.; Borders, Kevin

2015-01-01

To ensure that "Reducing the Risk," a successful teen pregnancy prevention education curriculum, remains relevant for today's youth, covers all information youth need to know in order to make better choices, and is delivered in a standardized way, adaptations were made and enhancements were added. This article describes results of a…

Optimal and secure measurement protocols for quantum sensor networks

Science.gov (United States)

Eldredge, Zachary; Foss-Feig, Michael; Gross, Jonathan A.; Rolston, S. L.; Gorshkov, Alexey V.

2018-04-01

Studies of quantum metrology have shown that the use of many-body entangled states can lead to an enhancement in sensitivity when compared with unentangled states. In this paper, we quantify the metrological advantage of entanglement in a setting where the measured quantity is a linear function of parameters individually coupled to each qubit. We first generalize the Heisenberg limit to the measurement of nonlocal observables in a quantum network, deriving a bound based on the multiparameter quantum Fisher information. We then propose measurement protocols that can make use of Greenberger-Horne-Zeilinger (GHZ) states or spin-squeezed states and show that in the case of GHZ states the protocol is optimal, i.e., it saturates our bound. We also identify nanoscale magnetic resonance imaging as a promising setting for this technology.

Deployment Strategies and Clustering Protocols Efficiency

Directory of Open Access Journals (Sweden)

Chérif Diallo

2017-06-01

Full Text Available Wireless sensor networks face significant design challenges due to limited computing and storage capacities and, most importantly, dependence on limited battery power. Energy is a critical resource and is often an important issue to the deployment of sensor applications that claim to be omnipresent in the world of future. Thus optimizing the deployment of sensors becomes a major constraint in the design and implementation of a WSN in order to ensure better network operations. In wireless networking, clustering techniques add scalability, reduce the computation complexity of routing protocols, allow data aggregation and then enhance the network performance. The well-known MaxMin clustering algorithm was previously generalized, corrected and validated. Then, in a previous work we have improved MaxMin by proposing a Single- node Cluster Reduction (SNCR mechanism which eliminates single-node clusters and then improve energy efficiency. In this paper, we show that MaxMin, because of its original pathological case, does not support the grid deployment topology, which is frequently used in WSN architectures. The unreliability feature of the wireless links could have negative impacts on Link Quality Indicator (LQI based clustering protocols. So, in the second part of this paper we show how our distributed Link Quality based d- Clustering Protocol (LQI-DCP has good performance in both stable and high unreliable link environments. Finally, performance evaluation results also show that LQI-DCP fully supports the grid deployment topology and is more energy efficient than MaxMin.

Comparison of pharmacological and non-pharmacological interventions to prevent delirium in critically ill patients: a protocol for a systematic review incorporating network meta-analyses.

Science.gov (United States)

Burry, L D; Hutton, B; Guenette, M; Williamson, D; Mehta, S; Egerod, I; Kanji, S; Adhikari, N K; Moher, D; Martin, C M; Rose, L

2016-09-08

Delirium is characterized by acute changes in mental status including inattention, disorganized thinking, and altered level of consciousness, and is highly prevalent in critically ill adults. Delirium has adverse consequences for both patients and the healthcare system; however, at this time, no effective treatment exists. The identification of effective prevention strategies is therefore a clinical and research imperative. An important limitation of previous reviews of delirium prevention is that interventions were considered in isolation and only direct evidence was used. Our systematic review will synthesize all existing data using network meta-analysis, a powerful statistical approach that enables synthesis of both direct and indirect evidence. We will search Ovid MEDLINE, CINAHL, Embase, PsycINFO, and Web of Science from 1980 to March 2016. We will search the PROSPERO registry for protocols and the Cochrane Library for published systematic reviews. We will examine reference lists of pertinent reviews and search grey literature and the International Clinical Trials Registry Platform for unpublished studies and ongoing trials. We will include randomized and quasi-randomized trials of critically ill adults evaluating any pharmacological, non-pharmacological, or multi-component intervention for delirium prevention, administered in or prior to (i.e., peri-operatively) transfer to the ICU. Two authors will independently screen search results and extract data from eligible studies. Risk of bias assessments will be completed on all included studies. To inform our network meta-analysis, we will first conduct conventional pair-wise meta-analyses for primary and secondary outcomes using random-effects models. We will generate our network meta-analysis using a Bayesian framework, assuming a common heterogeneity parameter across all comparisons, and accounting for correlations in multi-arm studies. We will perform analyses using WinBUGS software. This systematic review

A Modern Approach to Preventing Prosthetic Joint Infections.

Science.gov (United States)

Papas, Paraskevi Vivian; Congiusta, Dominick; Scuderi, Giles R; Cushner, Fred D

2018-02-28

Total knee arthroplasty (TKA) is recognized as one of the most successful surgical procedures performed today. One of the most common and dreaded complications of TKA is postoperative infection. To prevent infections, it is critical to identify patients at high risk through analyzing their risk factors, and help in addressing them prior to surgery. The effort to prevent infection must be carried through every step of the surgical process, from preoperative counseling to intraoperative measures and postoperative protocols. Hair removal, the application of antiseptics, the utilization of antibiotics, barbed sutures, smart dressings, and antibacterial washes are some of the avenues surgeons may explore to help prevent infection. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Structural and process factors affecting the implementation of antimicrobial resistance prevention and control strategies in U.S. hospitals.

Science.gov (United States)

Chou, Ann F; Yano, Elizabeth M; McCoy, Kimberly D; Willis, Deanna R; Doebbeling, Bradley N

2008-01-01

To address increases in the incidence of infection with antimicrobial-resistant pathogens, the National Foundation for Infectious Diseases and Centers for Disease Control and Prevention proposed two sets of strategies to (a) optimize antibiotic use and (b) prevent the spread of antimicrobial resistance and control transmission. However, little is known about the implementation of these strategies. Our objective is to explore organizational structural and process factors that facilitate the implementation of National Foundation for Infectious Diseases/Centers for Disease Control and Prevention strategies in U.S. hospitals. We surveyed 448 infection control professionals from a national sample of hospitals. Clinically anchored in the Donabedian model that defines quality in terms of structural and process factors, with the structural domain further informed by a contingency approach, we modeled the degree to which National Foundation for Infectious Diseases and Centers for Disease Control and Prevention strategies were implemented as a function of formalization and standardization of protocols, centralization of decision-making hierarchy, information technology capabilities, culture, communication mechanisms, and interdepartmental coordination, controlling for hospital characteristics. Formalization, standardization, centralization, institutional culture, provider-management communication, and information technology use were associated with optimal antibiotic use and enhanced implementation of strategies that prevent and control antimicrobial resistance spread (all p prevention and control (p support these organizational processes. These findings suggest concrete strategies for evaluating current capabilities to implement effective practices and foster and sustain a culture of patient safety.

On-farm comparisons of different cleaning protocols in broiler houses.

Science.gov (United States)

Luyckx, K Y; Van Weyenberg, S; Dewulf, J; Herman, L; Zoons, J; Vervaet, E; Heyndrickx, M; De Reu, K

2015-08-01

The present study evaluated the effectiveness of 4 cleaning protocols designed to reduce the bacteriological infection pressure on broiler farms and prevent food-borne zoonoses. Additionally, difficult to clean locations and possible sources of infection were identified. Cleaning and disinfection rounds were evaluated in 12 broiler houses on 5 farms through microbiological analyses and adenosine triphosphate hygiene monitoring. Samples were taken at 3 different times: before cleaning, after cleaning, and after disinfection. At each sampling time, swabs were taken from various locations for enumeration of the total aerobic flora and Enterococcus species pluralis ( SPP:). In addition, before cleaning and after disinfection, testing for Escherichia coli and Salmonella was carried out. Finally, adenosine triphosphate swabs and agar contact plates for total aerobic flora counts were taken after cleaning and disinfection, respectively. Total aerobic flora and Enterococcus spp. counts on the swab samples showed that cleaning protocols which were preceded by an overnight soaking with water caused a higher bacterial reduction compared to protocols without a preceding soaking step. Moreover, soaking of broiler houses leads to less water consumption and reduced working time during high pressure cleaning. No differences were found between protocols using cold or warm water during cleaning. Drinking cups, drain holes, and floor cracks were identified as critical locations for cleaning and disinfection in broiler houses. © 2015 Poultry Science Association Inc.

An authenticated encrypted routing protocol against attacks in mobile ad-hoc networks

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C.C. Suma

2017-01-01

Full Text Available Mobile Ad hoc Network is stated as a cluster that contains Digital data terminals and they are furnished with the wireless transceivers which are able to communicate with each other with no need of any fixed architecture or concentrated authority. Security is one of the major issues in MANETs because of vast applications such as Military Battlefields, emergency and rescue operations[10]. In order to provide anonymous communications and to identify the malicious nodes in MANETs, many authors have proposed different secure routing protocols but each protocol have their own advantages and disadvantages. In MANTE’s each and every node in the communicating network functions like router and transmits the packets among the networking nodes for the purpose of communication[11]. Sometimes nodes may be attacked by the malicious nodes or the legitimate node will be caught by foemen there by controlling and preventing the nodes to perform the assigned task or nodes may be corrupted due to loss of energy. So, due to these drawbacks securing the network under the presence of adversaries is an important thing. The existing protocols were designed with keeping anonymity and the identification of vicious nodes in the network as the main goal. For providing better security, the anonymity factors such as Unidentifiability and Unlinkability must be fully satisfied[1]. Many anonymous routing schemes that concentrate on achieving anonymity are proposed in the past decade and they provides the security at different levels and also provides the privacy protection that is of different cost. In this paper we consider a protocol called Authenticated Secure Routing Protocol proposed which provides both security & anonymity. Anonymity is achieved in this protocol using Group signature. Over all by using this protocol performance in terms of throughput as well as the packet dropping rate is good compared to the other living protocols.

Caffeine suppresses exercise-enhanced long-term and location memory in middle-aged rats: Involvement of hippocampal Akt and CREB signaling.

Science.gov (United States)

Cechella, José L; Leite, Marlon R; da Rocha, Juliana T; Dobrachinski, Fernando; Gai, Bibiana M; Soares, Félix A A; Bresciani, Guilherme; Royes, Luiz F F; Zeni, Gilson

2014-11-05

The cognitive function decline is closely related with brain changes generated by age. The ability of caffeine and exercise to prevent memory impairment has been reported in animal models and humans. The purpose of the present study was to investigate whether swimming exercise and caffeine administration enhance memory in middle-aged Wistar rats. Male Wistar rats (18months) received caffeine at a dose of 30mg/kg, 5days per week by a period of 4weeks. Animals were subjected to swimming training with a workload (3% of body weight, 20min per day for 4weeks). After 4weeks, the object recognition test (ORT) and the object location test (OLT) were performed. The results of this study demonstrated that caffeine suppressed exercise-enhanced long-term (ORT) and spatial (OLT) memory in middle-aged and this effect may be related to a decrease in hippocampal p-CREB signaling. This study also provided evidence that the effects of this protocol on memory were not accompanied by alterations in the levels of activated Akt. The [(3)H] glutamate uptake was reduced in hippocampus of rats administered with caffeine and submitted to swimming protocol. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Preventing DoS attacks in peer-to-peer media streaming systems

Science.gov (United States)

Conner, William; Nahrstedt, Klara; Gupta, Indranil

2006-01-01

This paper presents a framework for preventing both selfishness and denial-of-service attacks in peer-to-peer media streaming systems. Our framework, called Oversight, achieves prevention of these undesirable activities by running a separate peer-to-peer download rate enforcement protocol along with the underlying peer-to-peer media streaming protocol. This separate Oversight protocol enforces download rate limitations on each participating peer. These limitations prevent selfish or malicious nodes from downloading an overwhelming amount of media stream data that could potentially exhaust the entire system. Since Oversight is based on a peer-to-peer architecture, it can accomplish this enforcement functionality in a scalable, efficient, and decentralized way that fits better with peer-to-peer media streaming systems compared to other solutions based on central server architectures. As peer-to-peer media streaming systems continue to grow in popularity, the threat of selfish and malicious peers participating in such large peer-to-peer networks will continue to grow as well. For example, since peer-to-peer media streaming systems allow users to send small request messages that result in the streaming of large media objects, these systems provide an opportunity for malicious users to exhaust resources in the system with little effort expended on their part. However, Oversight addresses these threats associated with selfish or malicious peers who cause such disruptions with excessive download requests. We evaluated our Oversight solution through simulations and our results show that applying Oversight to peer-to-peer media streaming systems can prevent both selfishness and denial-of-service attacks by effectively limiting the download rates of all nodes in the system.

Strategy to Enhance International Supply Chain Security

National Research Council Canada - National Science Library

2007-01-01

.... at 1901, 1903, October 13, 2006) which require the development of a strategic plan to enhance the security of the international supply chain, including protocols for the expeditious resumption of the flow of trade following...

The influence of different contrast medium concentrations and injection protocols on quantitative and clinical assessment of FDG–PET/CT in lung cancer

Energy Technology Data Exchange (ETDEWEB)

Verburg, Frederik A., E-mail: fverburg@ukaachen.de [RWTH Aachen University Hospital, Department of Nuclear Medicine, Pauwelsstraße 30, 52074 Aachen (Germany); Maastricht University Medical Center, Department of Nuclear Medicine, P. Debyelaan 25, 6229 HX Maastricht (Netherlands); Kuhl, Christiane K. [RWTH Aachen University Hospital, Department of Diagnostic and Interventional Radiology, Pauwelsstraße 30, 52074 Aachen (Germany); Pietsch, Hubertus [Bayer Pharma AG, Berlin, Müllerstrasse 178, 13353 Berlin (Germany); Palmowski, Moritz [RWTH Aachen University Hospital, Department of Nuclear Medicine, Pauwelsstraße 30, 52074 Aachen (Germany); Mottaghy, Felix M. [RWTH Aachen University Hospital, Department of Nuclear Medicine, Pauwelsstraße 30, 52074 Aachen (Germany); Maastricht University Medical Center, Department of Nuclear Medicine, P. Debyelaan 25, 6229 HX Maastricht (Netherlands); Behrendt, Florian F. [RWTH Aachen University Hospital, Department of Nuclear Medicine, Pauwelsstraße 30, 52074 Aachen (Germany)

2013-10-01

Objectives: To compare the effects of two different contrast medium concentrations for use in computed X-ray tomography (CT) employing two different injection protocols on positron emission tomography (PET) reconstruction in combined 2-{sup 18}F-desoxyglucose (FDG) PET/CT in patients with a suspicion of lung cancer. Methods: 120 patients with a suspicion of lung cancer were enrolled prospectively. PET images were reconstructed with the non-enhanced and venous phase contrast CT obtained after injection of iopromide 300 mg/ml or 370 mg/ml using either a fixed-dose or a body surface area adapted injection protocol. Maximum and mean standardized uptake values (SUVmax and SUVmean) and contrast enhancement (HU) were determined in the subclavian vein, ascending aorta, abdominal aorta, inferior vena cava, portal vein, liver and kidney and in the suspicious lung lesion. PET data were evaluated visually for the presence of malignancy and image quality. Results: At none of the sites a significant difference in the extent of the contrast enhancement between the four different protocols was found. However, the variability of the contrast enhancement at several anatomical sites was significantly greater in the fixed dose groups than in the BSA groups for both contrast medium concentrations. At none of the sites a significant difference was found in the extent of the SUVmax and SUVmean increase as a result of the use of the venous phase contrast enhanced CT for attenuation. Visual clinical evaluation of lesions showed no differences between contrast and non-contrast PET/CT (P = 0.32). Conclusions: Contrast enhanced CT for attenuation correction in combined PET/CT in lung cancer affects neither the clinical assessment nor image quality of the PET-images. A body surface adapted contrast medium protocol reduces the interpatient variability in contrast enhancement.

Security and SCADA protocols

International Nuclear Information System (INIS)

Igure, V. M.; Williams, R. D.

2006-01-01

Supervisory control and data acquisition (SCADA) networks have replaced discrete wiring for many industrial processes, and the efficiency of the network alternative suggests a trend toward more SCADA networks in the future. This paper broadly considers SCADA to include distributed control systems (DCS) and digital control systems. These networks offer many advantages, but they also introduce potential vulnerabilities that can be exploited by adversaries. Inter-connectivity exposes SCADA networks to many of the same threats that face the public internet and many of the established defenses therefore show promise if adapted to the SCADA differences. This paper provides an overview of security issues in SCADA networks and ongoing efforts to improve the security of these networks. Initially, a few samples from the range of threats to SCADA network security are offered. Next, attention is focused on security assessment of SCADA communication protocols. Three challenges must be addressed to strengthen SCADA networks. Access control mechanisms need to be introduced or strengthened, improvements are needed inside of the network to enhance security and network monitoring, and SCADA security management improvements and policies are needed. This paper discusses each of these challenges. This paper uses the Profibus protocol as an example to illustrate some of the vulnerabilities that arise within SCADA networks. The example Profibus security assessment establishes a network model and an attacker model before proceeding to a list of example attacks. (authors)

Performance Analysis of an Optical CDMA MAC Protocol With Variable-Size Sliding Window

Science.gov (United States)

Mohamed, Mohamed Aly A.; Shalaby, Hossam M. H.; Abdel-Moety El-Badawy, El-Sayed

2006-10-01

A media access control protocol for optical code-division multiple-access packet networks with variable length data traffic is proposed. This protocol exhibits a sliding window with variable size. A model for interference-level fluctuation and an accurate analysis for channel usage are presented. Both multiple-access interference (MAI) and photodetector's shot noise are considered. Both chip-level and correlation receivers are adopted. The system performance is evaluated using a traditional average system throughput and average delay. Finally, in order to enhance the overall performance, error control codes (ECCs) are applied. The results indicate that the performance can be enhanced to reach its peak using the ECC with an optimum number of correctable errors. Furthermore, chip-level receivers are shown to give much higher performance than that of correlation receivers. Also, it has been shown that MAI is the main source of signal degradation.

Performance Analysis of the IEEE 802.11p Multichannel MAC Protocol in Vehicular Ad Hoc Networks.

Science.gov (United States)

Song, Caixia

2017-12-12

Vehicular Ad Hoc Networks (VANETs) employ multichannel to provide a variety of safety and non-safety applications, based on the IEEE 802.11p and IEEE 1609.4 protocols. The safety applications require timely and reliable transmissions, while the non-safety applications require efficient and high throughput. In the IEEE 1609.4 protocol, operating interval is divided into alternating Control Channel (CCH) interval and Service Channel (SCH) interval with an identical length. During the CCH interval, nodes transmit safety-related messages and control messages, and Enhanced Distributed Channel Access (EDCA) mechanism is employed to allow four Access Categories (ACs) within a station with different priorities according to their criticality for the vehicle's safety. During the SCH interval, the non-safety massages are transmitted. An analytical model is proposed in this paper to evaluate performance, reliability and efficiency of the IEEE 802.11p and IEEE 1609.4 protocols. The proposed model improves the existing work by taking serval aspects and the character of multichannel switching into design consideration. Extensive performance evaluations based on analysis and simulation help to validate the accuracy of the proposed model and analyze the capabilities and limitations of the IEEE 802.11p and IEEE 1609.4 protocols, and enhancement suggestions are given.

A Multi-Hop Advertising Discovery and Delivering Protocol for Multi Administrative Domain MANET

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Federico Mari

2013-01-01

Full Text Available A Mobile Ad-hoc NETwork (MANET is Multi Administrative Domain (MAD if each network node belongs to an independent authority, that is each node owns its resources and there is no central authority owning all network nodes. One of the main obstructions in designing Service Advertising, Discovery and Delivery (SADD protocol for MAD MANETs is the fact that, in an attempt to increase their own visibility, network nodes tend to flood the network with their advertisements. In this paper, we present a SADD protocol for MAD MANET, based on Bloom filters, that effectively prevents advertising floods due to such misbehaving nodes. Our results with the ns-2 simulator show that our SADD protocol is effective in counteracting advertising floods, it keeps low the collision rate as well as the energy consumption while ensuring that each peer receives all messages broadcasted by other peers.

Anti-Idiotypic Antibodies Specific to prM Monoantibody Prevent Antibody Dependent Enhancement of Dengue Virus Infection

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Miao Wang

2017-05-01

Full Text Available Dengue virus (DENV co-circulates as four serotypes (DENV1-4. Primary infection only leads to self-limited dengue fever. But secondary infection with another serotype carries a higher risk of increased disease severity, causing life-threatening dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS. Serotype cross-reactive antibodies facilitate DENV infection in Fc-receptor-bearing cells by promoting virus entry via Fcγ receptors (FcγR, a process known as antibody dependent enhancement (ADE. Most studies suggested that enhancing antibodies were mainly specific to the structural premembrane protein (prM of DENV. However, there is still no effective drugs or vaccines to prevent ADE. In this study, we firstly confirmed that both DENV-2 infected human sera (anti-DENV-2 and DENV-2 prM monoclonal antibody (prM mAb could significantly enhance DENV-1 infection in K562 cells. Then we developed anti-idiotypic antibodies (prM-AIDs specific to prM mAb by immunizing of Balb/c mice. Results showed that these polyclonal antibodies can dramatically reduce ADE phenomenon of DENV-1 infection in K562 cells. To further confirm the anti-ADE effect of prM-AIDs in vivo, interferon-α and γ receptor-deficient mice (AG6 were used as the mouse model for DENV infection. We found that administration of DENV-2 prM mAb indeed caused a higher DENV-1 titer as well as interleukin-10 (IL-10 and alaninea minotransferase (ALT in mice infected with DENV-1, similar to clinical ADE symptoms. But when we supplemented prM-AIDs to DENV-1 challenged AG6 mice, the viral titer, IL-10 and ALT were obviously decreased to the negative control level. Of note, the number of platelets in peripheral blood of prM-AIDs group were significantly increased at day 3 post infection with DENV-1 compared that of prM-mAb group. These results confirmed that our prM-AIDs could prevent ADE not only in vitro but also in vivo, suggested that anti-idiotypic antibodies might be a new choice to be considered to

Anti-Idiotypic Antibodies Specific to prM Monoantibody Prevent Antibody Dependent Enhancement of Dengue Virus Infection.

Science.gov (United States)

Wang, Miao; Yang, Fan; Huang, Dana; Huang, Yalan; Zhang, Xiaomin; Wang, Chao; Zhang, Shaohua; Zhang, Renli

2017-01-01

Dengue virus (DENV) co-circulates as four serotypes (DENV1-4). Primary infection only leads to self-limited dengue fever. But secondary infection with another serotype carries a higher risk of increased disease severity, causing life-threatening dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS). Serotype cross-reactive antibodies facilitate DENV infection in Fc-receptor-bearing cells by promoting virus entry via Fcγ receptors (FcγR), a process known as antibody dependent enhancement (ADE). Most studies suggested that enhancing antibodies were mainly specific to the structural premembrane protein (prM) of DENV. However, there is still no effective drugs or vaccines to prevent ADE. In this study, we firstly confirmed that both DENV-2 infected human sera (anti-DENV-2) and DENV-2 prM monoclonal antibody (prM mAb) could significantly enhance DENV-1 infection in K562 cells. Then we developed anti-idiotypic antibodies (prM-AIDs) specific to prM mAb by immunizing of Balb/c mice. Results showed that these polyclonal antibodies can dramatically reduce ADE phenomenon of DENV-1 infection in K562 cells. To further confirm the anti-ADE effect of prM-AIDs in vivo , interferon-α and γ receptor-deficient mice (AG6) were used as the mouse model for DENV infection. We found that administration of DENV-2 prM mAb indeed caused a higher DENV-1 titer as well as interleukin-10 (IL-10) and alaninea minotransferase (ALT) in mice infected with DENV-1, similar to clinical ADE symptoms. But when we supplemented prM-AIDs to DENV-1 challenged AG6 mice, the viral titer, IL-10 and ALT were obviously decreased to the negative control level. Of note, the number of platelets in peripheral blood of prM-AIDs group were significantly increased at day 3 post infection with DENV-1 compared that of prM-mAb group. These results confirmed that our prM-AIDs could prevent ADE not only in vitro but also in vivo , suggested that anti-idiotypic antibodies might be a new choice to be considered to treat

Network, system, and status software enhancements for the autonomously managed electrical power system breadboard. Volume 2: Protocol specification

Science.gov (United States)

Mckee, James W.

1990-01-01

This volume (2 of 4) contains the specification, structured flow charts, and code listing for the protocol. The purpose of an autonomous power system on a spacecraft is to relieve humans from having to continuously monitor and control the generation, storage, and distribution of power in the craft. This implies that algorithms will have been developed to monitor and control the power system. The power system will contain computers on which the algorithms run. There should be one control computer system that makes the high level decisions and sends commands to and receive data from the other distributed computers. This will require a communications network and an efficient protocol by which the computers will communicate. One of the major requirements on the protocol is that it be real time because of the need to control the power elements.

Pre-exposure and postexposure prophylaxes and the combination HIV prevention methods (The Combine! Study): protocol for a pragmatic clinical trial at public healthcare clinics in Brazil.

Science.gov (United States)

Grangeiro, Alexandre; Couto, Márcia Thereza; Peres, Maria Fernanda; Luiz, Olinda; Zucchi, Eliana Miura; de Castilho, Euclides Ayres; Estevam, Denize Lotufo; Alencar, Rosa; Wolffenbüttel, Karina; Escuder, Maria Mercedes; Calazans, Gabriela; Ferraz, Dulce; Arruda, Érico; Corrêa, Maria da Gloria; Amaral, Fabiana Rezende; Santos, Juliane Cardoso Villela; Alvarez, Vivian Salles; Kietzmann, Tiago

2015-08-25

Few results from programmes based on combination prevention methods are available. We propose to analyse the degree of protection provided by postexposure prophylaxis (PEP) for consensual sexual activity at healthcare clinics, its compensatory effects on sexual behaviour; and the effectiveness of combination prevention methods and pre-exposure prophylaxis (PrEP), compared with exclusively using traditional methods. A total of 3200 individuals aged 16 years or older presenting for PEP at 5 sexually transmitted disease (STD)/HIV clinics in 3 regions of Brazil will be allocated to one of two groups: the PEP group-individuals who come to the clinic within 72 h after a sexual exposure and start PEP; and the non-PEP group-individuals who come after 72 h but within 30 days of exposure and do not start PEP. Clinical follow-up will be conducted initially for 6 months and comprise educational interventions based on information and counselling for using prevention methods, including PrEP. In the second study phase, individuals who remain HIV negative will be regrouped according to the reported use of prevention methods and observed for 18 months: only traditional methods; combined methods; and PrEP. Effectiveness will be analysed according to the incidence of HIV, syphilis and hepatitis B and C and protected sexual behaviour. A structured questionnaire will be administered to participants at baseline and every 6 months thereafter. Qualitative methods will be employed to provide a comprehensive understanding of PEP-seeking behaviour, preventive choices and exposure to HIV. This study will be conducted in accordance with the resolution of the School of Medicine Research Ethics Commission of Universidade de São Paulo (protocol no. 251/14). The databases will be available for specific studies, after management committee approval. Findings will be presented to researchers, health managers and civil society members by means of newspapers, electronic media and scientific journals

A protocol for eliciting nonmaterial values through a cultural ecosystem services frame.

Science.gov (United States)

Gould, Rachelle K; Klain, Sarah C; Ardoin, Nicole M; Satterfield, Terre; Woodside, Ulalia; Hannahs, Neil; Daily, Gretchen C; Chan, Kai M

2015-04-01

Stakeholders' nonmaterial desires, needs, and values often critically influence the success of conservation projects. These considerations are challenging to articulate and characterize, resulting in their limited uptake in management and policy. We devised an interview protocol designed to enhance understanding of cultural ecosystem services (CES). The protocol begins with discussion of ecosystem-related activities (e.g., recreation, hunting) and management and then addresses CES, prompting for values encompassing concepts identified in the Millennium Ecosystem Assessment (2005) and explored in other CES research. We piloted the protocol in Hawaii and British Columbia. In each location, we interviewed 30 individuals from diverse backgrounds. We analyzed results from the 2 locations to determine the effectiveness of the interview protocol in elucidating nonmaterial values. The qualitative and spatial components of the protocol helped characterize cultural, social, and ethical values associated with ecosystems in multiple ways. Maps and situational, or vignette-like, questions helped respondents articulate difficult-to-discuss values. Open-ended prompts allowed respondents to express a diversity of ecosystem-related values and proved sufficiently flexible for interviewees to communicate values for which the protocol did not explicitly probe. Finally, the results suggest that certain values, those mentioned frequently throughout the interview, are particularly salient for particular populations. The protocol can provide efficient, contextual, and place-based data on the importance of particular ecosystem attributes for human well-being. Qualitative data are complementary to quantitative and spatial assessments in the comprehensive representation of people's values pertaining to ecosystems, and this protocol may assist in incorporating values frequently overlooked in decision making processes. © 2014 The Authors. Conservation Biology published by Wiley Periodicals

Development of a neuromuscular electrical stimulation protocol for sprint training.

Science.gov (United States)

Russ, David W; Clark, Brian C; Krause, Jodi; Hagerman, Fredrick C

2012-09-01

Sprint training is associated with several beneficial adaptations in skeletal muscle, including an enhancement of sarcoplasmic reticulum (SR) Ca(2+) release. Unfortunately, several patient populations (e.g., the elderly, those with cardiac dysfunction) that might derive great benefit from sprint exercise are unlikely to tolerate it. The purpose of this report was to describe the development of a tolerable neuromuscular electrical stimulation (NMES) protocol that induces skeletal muscle adaptations similar to those observed with sprint training. Our NMES protocol was modeled after a published sprint exercise protocol and used a novel electrode configuration and stimulation sequence to provide adequate training stimulus while maintaining subject tolerance. Nine young, healthy subjects (four men) began and completed the training protocol of the knee extensor muscles. All subjects completed the protocol, with ratings of discomfort far less than those reported in studies of traditional NMES. Training induced significant increases in SR Ca(2+) release and citrate synthase activity (~16% and 32%, respectively), but SR Ca(2+) uptake did not change. The percentage of myosin heavy chain IIx isoform was decreased significantly after training. At the whole muscle level, neither central activation nor maximum voluntary isometric contraction force were significantly altered, although isometric force did exhibit a trend toward an increase (~3%, P = 0.055). Surprisingly, the NMES training produced a significant increase in muscle cross-sectional area (~3%, P = 0.04). It seems that an appropriately designed NMES protocol can mimic many of the benefits of sprint exercise training, with a low overall time commitment and training volume. These findings suggest that NMES has the potential to bring the benefits of sprint exercise to individuals who are unable to tolerate traditional sprint training.

Compliant flooring to prevent fall-related injuries: a scoping review protocol.

Science.gov (United States)

Lachance, Chantelle C; Jurkowski, Michal P; Dymarz, Ania C; Mackey, Dawn C

2016-08-16

Fall-related injuries can have serious consequences for older adults, including increased risk of dependence in daily activities and mortality. Compliant flooring is a passive intervention that may reduce the incidence and severity of fall-related injuries in healthcare settings, including acute and long-term care, but few sites have implemented compliant flooring, in part because synthesised evidence about key performance aspects has not been available. We will conduct a scoping review to address the question: what is presented about the biomechanical efficacy, clinical effectiveness, cost-effectiveness, and workplace safety associated with compliant flooring systems that aim to prevent fall-related injuries? We will conduct a comprehensive and systematic literature search of academic databases (AgeLine, CINAHL, EBM Reviews, MEDLINE (Ovid), SportDiscus and Web of Science) and grey literature (clinical trial registries, theses/dissertations, abstracts/conference proceedings and relevant websites). 2 team members will independently screen records (first titles and abstracts, then full text) and extract data from included records. Numerical and narrative analyses will be presented by theme (biomechanical efficacy, clinical effectiveness, cost-effectiveness, workplace safety). This scoping review responds to the information needs of healthcare decision-makers tasked with preventing fall-related injuries. This review will summarise evidence about compliant flooring as a potential intervention for preventing fall-related injuries in older adults and identify gaps in evidence and new avenues for research. Results will be especially useful in long-term care, but also applicable in acute care, assisted living and home care. We will disseminate the review's findings via open-access publications, conference presentations, a webinar, a Stakeholder Symposium and a Knowledge-to-Action Report. Published by the BMJ Publishing Group Limited. For permission to use (where not

A Comparison Between Inter-Asterisk eXchange Protocol and Jingle Protocol: Session Time

Directory of Open Access Journals (Sweden)

H. S. Haj Aliwi

2016-08-01

Full Text Available Over the last few years, many multimedia conferencing and Voice over Internet Protocol (VoIP applications have been developed due to the use of signaling protocols in providing video, audio and text chatting services between at least two participants. This paper compares between two widely common signaling protocols: InterAsterisk eXchange Protocol (IAX and the extension of the eXtensible Messaging and Presence Protocol (Jingle in terms of delay time during call setup, call teardown, and media sessions.

Adolescents’ perceptions of a mobile cell phone text messaging-enhanced intervention and development of a mobile cell phone-based HIV prevention intervention

Science.gov (United States)

Cornelius, Judith B.; St. Lawrence, Janet S.; Howard, Jacquelyn C.; Shah, Deval; Poka, Avinash; McDonald, Delilah; White, Ann C.

2013-01-01

Purpose This study examined African American adolescents’ perceptions of a mobile cell phone (MCP)-enhanced intervention and development of an MCP-based HIV prevention intervention. Design and Methods One focus group was conducted with 11 adolescents who participated in the Becoming a Responsible Teen Text Messaging project. Results Adolescents said they benefited from the MCP-enhanced approach and were receptive to the idea of developing an MCP-based intervention. Practice Implications Nurses can use the findings of this report as a starting point in examining the development of MCP-based sexuality education with parents and adolescents. PMID:22188273

Enhancer-promoter interference and its prevention in transgenic plants

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Transcriptional enhancer elements have been shown to override the specificity of nearby promoters in a position- and orientation-independent manner. This is problematic when multiple enhancers/promoters co-exist within a single transgenic construct as it has the potential to cause the mis-expressio...

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

Directory of Open Access Journals (Sweden)

Kaitani T

2015-02-01

the advanced protocol and 19 others as controls. Statistical analysis included a linear mixed-effects model and a logistic regression model. Results: In week 0–1, the advanced protocol was significantly associated with prevention of PU deterioration. Using the linear mixed-effects model, we observed a greater decrease in the DESIGN-R score (healing in the advanced protocol group. There were no reports of excessive bleeding, pain or infection with the advanced protocol. Conclusion: Using the advanced protocol, WOCNs detected PU severity, assessed PUs, and treated PUs safely. This protocol prevented PU deterioration and/or facilitated wound healing. Relevance to clinical practice: With proper training, WOCNs can assess and treat PUs safer and quicker than when a physician's assessment is required, leading to an improvement in wound healing and prevention of PU deterioration. Keywords: pressure ulcers, WOCN, interventions, protocols, deep tissue injury

First Steps towards Evidence-Based Preventive Home Visits: Experiences Gathered in a Swedish Municipality

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Charlotte Löfqvist

2012-01-01

Full Text Available The purpose of preventive home visits is to promote overall health and wellbeing in old age. The aim of this paper was to describe the process of the development of evidence-based preventive home visits, targeting independent community-living older persons. The evidence base was generated from published studies and practical experiences. The results demonstrate that preventive home visits should be directed to persons 80 years old and older and involve various professional competences. The visits should be personalized, lead to concrete interventions, and be followed up. The health areas assessed should derive from a broad perspective and include social, psychological, and medical aspects. Core components in the protocol developed in this study captured physical, medical, psychosocial, and environmental aspects. Results of a pilot study showed that the protocol validly identified health risks among older people with different levels of ADL dependence.

Visualization of enhancer-derived noncoding RNA

CSIR Research Space (South Africa)

Shibayama, Y

2017-01-01

Full Text Available component of enhancer function, their expression has not been broadly analyzed at a single cell level via imaging techniques. This protocol describes a method to image eRNA in single cells by in situ hybridization followed by tyramide signal amplifi cation...

Successful Short Desensitization Treatment Protocol with Narrowband UVB Phototherapy (TL-01) in Polymorphic Light Eruption.

Science.gov (United States)

Combalia, A; Fernández-Sartorio, C; Fustà, X; Morgado-Carrasco, D; Podlipnik, S; Aguilera, P

2017-10-01

Polymorphic light eruption (PLE) is a common idiopathic photodermatosis that typically presents with pruritic papular or papulovesicular lesions on sun-exposed skin between spring and autumn. In many subjects PLE is mild, and can usually be prevented by the use of broad-spectrum topical sunscreens and a gradual increase in sunlight exposure. However, in some individuals, sunlight exposure results in florid PLE and they often benefit from prophylactic desensitization treatment using phototherapy in early spring, an artificial method that induces a "hardening" phenomenon. To describe and evaluate the efficacy of a short desensitization protocol, based on a one-month-treatment, administered twice a week with narrow band UVB in subjects with severe polymorphic light eruption (PLE). A retrospective, open planned and non-randomized study to assess the efficacy of UVB phototherapy in prevention of polymorphic light eruption. Fifteen subjects diagnosed with severe PLE were treated with the standard protocol in our Photobiology Unit between 2014 and 2015. The effect of hardening was sustained during follow up in 87.5% of desensitization treatments. A statistically significant association (pPLE and the response to treatment was found. The effect of hardening was maintained in the vast majority of subjects, obtaining a good benefit with no PLE episodes during all the summer. We demonstrate that our standard protocol is effective, and produces a successful outcome for the majority of PLE subjects. Our protocol is shorter than those currently applied, being favourable both for the patient and the physician. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

Rationale and study protocol for the 'active teen leaders avoiding screen-time' (ATLAS) group randomized controlled trial: an obesity prevention intervention for adolescent boys from schools in low-income communities.

Science.gov (United States)

Smith, Jordan J; Morgan, Philip J; Plotnikoff, Ronald C; Dally, Kerry A; Salmon, Jo; Okely, Anthony D; Finn, Tara L; Babic, Mark J; Skinner, Geoff; Lubans, David R

2014-01-01

The negative consequences of unhealthy weight gain and the high likelihood of pediatric obesity tracking into adulthood highlight the importance of targeting youth who are 'at risk' of obesity. The aim of this paper is to report the rationale and study protocol for the 'Active Teen Leaders Avoiding Screen-time' (ATLAS) obesity prevention intervention for adolescent boys living in low-income communities. The ATLAS intervention will be evaluated using a cluster randomized controlled trial in 14 secondary schools in the state of New South Wales (NSW), Australia (2012 to 2014). ATLAS is an 8-month multi-component, school-based program informed by self-determination theory and social cognitive theory. The intervention consists of teacher professional development, enhanced school-sport sessions, researcher-led seminars, lunch-time physical activity mentoring sessions, pedometers for self-monitoring, provision of equipment to schools, parental newsletters, and a smartphone application and website. Assessments were conducted at baseline and will be completed again at 9- and 18-months from baseline. Primary outcomes are body mass index (BMI) and waist circumference. Secondary outcomes include BMI z-scores, body fat (bioelectrical impedance analysis), physical activity (accelerometers), muscular fitness (grip strength and push-ups), screen-time, sugar-sweetened beverage consumption, resistance training skill competency, daytime sleepiness, subjective well-being, physical self-perception, pathological video gaming, and aggression. Hypothesized mediators of behavior change will also be explored. ATLAS is an innovative school-based intervention designed to improve the health behaviors and related outcomes of adolescent males in low-income communities. Copyright © 2013 Elsevier Inc. All rights reserved.

Use of a patient hand hygiene protocol to reduce hospital-acquired infections and improve nurses' hand washing.

Science.gov (United States)

Fox, Cherie; Wavra, Teresa; Drake, Diane Ash; Mulligan, Debbie; Bennett, Yvonne Pacheco; Nelson, Carla; Kirkwood, Peggy; Jones, Louise; Bader, Mary Kay

2015-05-01

Critically ill patients are at marked risk of hospital-acquired infections, which increase patients' morbidity and mortality. Registered nurses are the main health care providers of physical care, including hygiene to reduce and prevent hospital-acquired infections, for hospitalized critically ill patients. To investigate a new patient hand hygiene protocol designed to reduce hospital-acquired infection rates and improve nurses' hand-washing compliance in an intensive care unit. A preexperimental study design was used to compare 12-month rates of 2 common hospital-acquired infections, central catheter-associated bloodstream infection and catheter-associated urinary tract infection, and nurses' hand-washing compliance measured before and during use of the protocol. Reductions in 12-month infection rates were reported for both types of infections, but neither reduction was statistically significant. Mean 12-month nurse hand-washing compliance also improved, but not significantly. A hand hygiene protocol for patients in the intensive care unit was associated with reductions in hospital-acquired infections and improvements in nurses' hand-washing compliance. Prevention of such infections requires continuous quality improvement efforts to monitor lasting effectiveness as well as investigation of strategies to eliminate these infections. ©2015 American Association of Critical-Care Nurses.

BROSMAP: A Novel Broadcast Based Secure Mobile Agent Protocol for Distributed Service Applications

Directory of Open Access Journals (Sweden)

Dina Shehada

2017-01-01

Full Text Available Mobile agents are smart programs that migrate from one platform to another to perform the user task. Mobile agents offer flexibility and performance enhancements to systems and service real-time applications. However, security in mobile agent systems is a great concern. In this paper, we propose a novel Broadcast based Secure Mobile Agent Protocol (BROSMAP for distributed service applications that provides mutual authentication, authorization, accountability, nonrepudiation, integrity, and confidentiality. The proposed system also provides protection from man in the middle, replay, repudiation, and modification attacks. We proved the efficiency of the proposed protocol through formal verification with Scyther verification tool.

A Pilot Study Involving the Effect of Two Different Complex Training Protocols on Lower Body Power

OpenAIRE

Smith Chad E.; Lyons Brian; Hannon James C.

2014-01-01

Purpose. Complex training (CT) involves the coupling of two exercises ostensibly to enhance the effect of the second exercise. Typically, the first exercise is a strength exercise and the second exercise is a power exercise involving similar muscles. In most cases, CT is designed to enhance power. The purpose of this study was twofold. First, this study was designed to determine if lower body power could be enhanced using complex training protocols. Second, this study investigated whether the...

The French dosimetry protocol

International Nuclear Information System (INIS)

Dutreix, A.

1985-01-01

After a general introduction the protocol is divided in five sections dealing with: determination of the quality of X-ray, γ-ray and electron beams; the measuring instrument; calibration of the reference instrument; determination of the reference absorbed dose in the user's beams; determination of the absorbed dose in water at other points, in other conditions. The French protocol is not essentially different from the Nordic protocol and it is based on the experience gained in using both the American and the Nordic protocols. Therefore, only the main difference with the published protocols are discussed. (Auth.)

Intrathecal Morphine for Laparoscopic Segmental Colonic Resection as Part of an Enhanced Recovery Protocol: A Randomized Controlled Trial.

Science.gov (United States)

Koning, Mark V; Teunissen, Aart Jan W; van der Harst, Erwin; Ruijgrok, Elisabeth J; Stolker, Robert Jan

2018-02-01

Management of postoperative pain after laparoscopic segmental colonic resections remains controversial. We compared 2 methods of analgesia within an Enhanced Recovery After Surgery (ERAS) program. The goal of the study was to investigate whether administration of intrathecal bupivacaine/morphine would lead to an enhanced recovery. A single-center, randomized, double-blind controlled trial was performed (NL43488.101.13). Patients scheduled for laparoscopic segmental intestinal resections were considered. Exclusion criteria were patients in whom contraindications to spinal anesthesia were present, conversion to open surgery, and gastric and rectal surgery. The intervention group received single-shot intrathecal bupivacaine/morphine (12.5 mg/300 μg), with an altered dose for older patients. The control group received a sham procedure and a bolus of piritramide (0.1 mg/kg). Both groups received standardized general anesthesia and a patient-controlled intravenous analgesia pump as postoperative analgesia. All patients were treated according to an ERAS protocol. A decrease in days to "fit for discharge" was the primary outcome. Fifty-six patients were enrolled. Intervention group patients were fit for discharge earlier (median of 3 vs 4 days, P = 0.044). Furthermore, there was a significant decrease in opioid use and lower pain scores on the first postoperative day in the intervention group. There were no differences in adverse events (except for more pruritus), time to mobilization, fluid administration, or patient satisfaction. This randomized controlled trial shows that intrathecal morphine is a more effective method of postoperative analgesia in laparoscopic surgery than intravenous opioids within an ERAS program. Recovery is faster and less painful with intrathecal morphine. Other studies have confirmed these results, although data on faster recovery are new and require confirmation in future trials. This study was registered at ClinicalTrials.gov, identifier NCT

Hydration for the prevention of contrast medium-induced nephropathy. An update

International Nuclear Information System (INIS)

Heinrich, M.; Uder, M.

2006-01-01

Contrast medium-induced nephropathy (CIN) continues to be one of the most common causes of hospital-acquired acute renal failure. Since most of the clinical studies on the prophylactic use of different drugs to prevent CIN produced disappointing results, hydration remains the mainstay of prophylaxis. A number of recent prospective randomized trials provided further evidence of the effectiveness of hydration and relevant information regarding the optimization of hydration protocols. It was shown that a bolus hydration solely during examination is not sufficient to prevent CIN. In addition, isotonic 0.9% saline was superior to the commonly used halfisotonic 0.45% saline in another trial. An outpatient hydration protocol including oral hydration before the examination followed by forced intravenous hydration over 6 hrs. beginning 30 to 60 min. prior to examination seems to be comparable to the usual hydration over 24 hrs. Another hydration protocol, which could also be very attractive especially for outpatients, included the infusion of sodium bicarbonate. In a recent trial, hydration with sodium bicarbonate, given as a bolus for 1 hr. prior to examination followed by an infusion for 6 hrs. after examination, was more effective than hydration with sodium chloride for the prophylaxis of CIN. However, there is still a lack of large-scale, multi-center trials comparing different hydration protocols and investigating their influence on clinically relevant endpoints such as mortality or the need for dialysis. (orig.)

[Childhood obesity prevention from a community view].

Science.gov (United States)

Ariza, Carles; Ortega-Rodríguez, Eduard; Sánchez-Martínez, Francesca; Valmayor, Sara; Juárez, Olga; Pasarín, M Isabel

2015-04-01

The percentage of failure and relapse in the treatment of obesity is high. Where possible, the preferred strategy for preventing obesity is to modify eating habits and lifestyles. This article aims to provide a framework for evidence on the most effective interventions for addressing childhood obesity, both from a prevention point of view, as well as reducing it, when it is already established. After a review of the scientific literature, the issues that must be considered both in the universal and selective prevention of childhood obesity are presented. Also, in light of the controversy over the tools for measuring and controlling the problem, some clarification is provided on the criteria. Finally, the approach to the prevention of overweight and obesity with a community perspective is separated, with two short protocols being offered with diagrams of the basic procedure to follow. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Development of a Comprehensive Programme to Prevent and Reduce the Negative Impact of Railway Fatalities, Injuries and Close Calls on Railway Employees.

Science.gov (United States)

Bardon, Cécile; Mishara, Brian L

2015-09-01

This article presents a strategy to prevent trauma, support and care for railway personnel who experience critical incidents (CI) on the job, usually fatalities by accident or suicide. We reviewed all publications on CI management, support and care practices in the railway industry, as well as practices in place in Canada (unpublished protocols). Semi structured interviews were conducted with 40 train engineers and conductors involved in CIs and the content was coded and analysed quantitatively. Employees' satisfaction with the help received after the incident varies according to the behaviour of the local manager, company officers and police, the level of compliance with existing company protocols to help them, the presence of unmet expectations for support and care, their perceived competency of clinicians they consulted and the level of trust toward their employers. On the basis of the interview results, the review of existing railway practices and discussions with railway stakeholders, a model protocol was developed for a comprehensive workplace prevention, support and care protocol to reduce the negative impact of railway critical incidents on employees. This protocol includes preventive actions before traumatic events occur, immediate responses at the site of incident, interventions within the first few days after the incident and longer term support and interventions provided by the company and by outsourced experts.

Efficient and Security Enhanced Anonymous Authentication with Key Agreement Scheme in Wireless Sensor Networks.

Science.gov (United States)

Jung, Jaewook; Moon, Jongho; Lee, Donghoon; Won, Dongho

2017-03-21

At present, users can utilize an authenticated key agreement protocol in a Wireless Sensor Network (WSN) to securely obtain desired information, and numerous studies have investigated authentication techniques to construct efficient, robust WSNs. Chang et al. recently presented an authenticated key agreement mechanism for WSNs and claimed that their authentication mechanism can both prevent various types of attacks, as well as preserve security properties. However, we have discovered that Chang et al's method possesses some security weaknesses. First, their mechanism cannot guarantee protection against a password guessing attack, user impersonation attack or session key compromise. Second, the mechanism results in a high load on the gateway node because the gateway node should always maintain the verifier tables. Third, there is no session key verification process in the authentication phase. To this end, we describe how the previously-stated weaknesses occur and propose a security-enhanced version for WSNs. We present a detailed analysis of the security and performance of our authenticated key agreement mechanism, which not only enhances security compared to that of related schemes, but also takes efficiency into consideration.

A Decentralized Fuzzy C-Means-Based Energy-Efficient Routing Protocol for Wireless Sensor Networks

Directory of Open Access Journals (Sweden)

Osama Moh’d Alia

2014-01-01

Full Text Available Energy conservation in wireless sensor networks (WSNs is a vital consideration when designing wireless networking protocols. In this paper, we propose a Decentralized Fuzzy Clustering Protocol, named DCFP, which minimizes total network energy dissipation to promote maximum network lifetime. The process of constructing the infrastructure for a given WSN is performed only once at the beginning of the protocol at a base station, which remains unchanged throughout the network’s lifetime. In this initial construction step, a fuzzy C-means algorithm is adopted to allocate sensor nodes into their most appropriate clusters. Subsequently, the protocol runs its rounds where each round is divided into a CH-Election phase and a Data Transmission phase. In the CH-Election phase, the election of new cluster heads is done locally in each cluster where a new multicriteria objective function is proposed to enhance the quality of elected cluster heads. In the Data Transmission phase, the sensing and data transmission from each sensor node to their respective cluster head is performed and cluster heads in turn aggregate and send the sensed data to the base station. Simulation results demonstrate that the proposed protocol improves network lifetime, data delivery, and energy consumption compared to other well-known energy-efficient protocols.

A decentralized fuzzy C-means-based energy-efficient routing protocol for wireless sensor networks.

Science.gov (United States)

Alia, Osama Moh'd

2014-01-01

Energy conservation in wireless sensor networks (WSNs) is a vital consideration when designing wireless networking protocols. In this paper, we propose a Decentralized Fuzzy Clustering Protocol, named DCFP, which minimizes total network energy dissipation to promote maximum network lifetime. The process of constructing the infrastructure for a given WSN is performed only once at the beginning of the protocol at a base station, which remains unchanged throughout the network's lifetime. In this initial construction step, a fuzzy C-means algorithm is adopted to allocate sensor nodes into their most appropriate clusters. Subsequently, the protocol runs its rounds where each round is divided into a CH-Election phase and a Data Transmission phase. In the CH-Election phase, the election of new cluster heads is done locally in each cluster where a new multicriteria objective function is proposed to enhance the quality of elected cluster heads. In the Data Transmission phase, the sensing and data transmission from each sensor node to their respective cluster head is performed and cluster heads in turn aggregate and send the sensed data to the base station. Simulation results demonstrate that the proposed protocol improves network lifetime, data delivery, and energy consumption compared to other well-known energy-efficient protocols.

A Decentralized Fuzzy C-Means-Based Energy-Efficient Routing Protocol for Wireless Sensor Networks

Science.gov (United States)

2014-01-01

Energy conservation in wireless sensor networks (WSNs) is a vital consideration when designing wireless networking protocols. In this paper, we propose a Decentralized Fuzzy Clustering Protocol, named DCFP, which minimizes total network energy dissipation to promote maximum network lifetime. The process of constructing the infrastructure for a given WSN is performed only once at the beginning of the protocol at a base station, which remains unchanged throughout the network's lifetime. In this initial construction step, a fuzzy C-means algorithm is adopted to allocate sensor nodes into their most appropriate clusters. Subsequently, the protocol runs its rounds where each round is divided into a CH-Election phase and a Data Transmission phase. In the CH-Election phase, the election of new cluster heads is done locally in each cluster where a new multicriteria objective function is proposed to enhance the quality of elected cluster heads. In the Data Transmission phase, the sensing and data transmission from each sensor node to their respective cluster head is performed and cluster heads in turn aggregate and send the sensed data to the base station. Simulation results demonstrate that the proposed protocol improves network lifetime, data delivery, and energy consumption compared to other well-known energy-efficient protocols. PMID:25162060

Effect of a virtual reality-enhanced exercise protocol after coronary artery bypass grafting.

Science.gov (United States)

Chuang, Tien-Yow; Sung, Wen-Hsu; Chang, Hwa-Ann; Wang, Ray-Yau

2006-10-01

Virtual reality (VR) technology has gained importance in many areas of medicine. Knowledge concerning the application and the influence of VR-enhanced exercise programs is limited for patients receiving coronary artery bypass grafting. The purpose of this study was to evaluate the effect of a virtual "country walk" on the number of sessions necessary to reach cardiac rehabilitation goals in patients undergoing coronary artery bypass grafting. Twenty subjects who were seen for cardiac rehabilitation between January and June 2004 comprised the study sample. The protocol for this study included an initial maximum graded exercise tolerance test, given to determine the subsequent training goals for the subject, followed by biweekly submaximal endurance training sessions. All subjects were assigned by lot to 1 of 2 submaximal endurance training programs, one (group 2) with and the other (group 1) without the added VR environment. In all other respects, the 2 programs were identical. Each training session lasted for 30 minutes and was carried out twice per week for about 3 months. The primary outcome measures were maximum load during the work sessions, target oxygen consumption, target heart rate (beats per minute), and number of training sessions required to reach rehabilitation goals. By the end of 20 training sessions, only 4 of the 10 control subjects had reached the heart rate target goal of 85% their maximum heart rate. In contrast, 9 of the 10 subjects in the VR program had attained this goal by 9 or fewer training sessions. When target metabolic cost (75% peak oxygen consumption) was used as the training goal, all 10 subjects in the VR program had reached this target after 2 training sessions (or, in some cases, 1 training session), but not until training session 15 did a cumulative number of 9 control subjects reach this goal. These study outcomes clearly support the notion that incorporating a VR environment into cardiac rehabilitation programs will accelerate

Privacy-Preserving Data Aggregation Protocol for Fog Computing-Assisted Vehicle-to-Infrastructure Scenario

Directory of Open Access Journals (Sweden)

Yanan Chen

2018-01-01

Full Text Available Vehicle-to-infrastructure (V2I communication enables moving vehicles to upload real-time data about road surface situation to the Internet via fixed roadside units (RSU. Thanks to the resource restriction of mobile vehicles, fog computation-enhanced V2I communication scenario has received increasing attention recently. However, how to aggregate the sensed data from vehicles securely and efficiently still remains open to the V2I communication scenario. In this paper, a light-weight and anonymous aggregation protocol is proposed for the fog computing-based V2I communication scenario. With the proposed protocol, the data collected by the vehicles can be efficiently obtained by the RSU in a privacy-preserving manner. Particularly, we first suggest a certificateless aggregate signcryption (CL-A-SC scheme and prove its security in the random oracle model. The suggested CL-A-SC scheme, which is of independent interest, can achieve the merits of certificateless cryptography and signcryption scheme simultaneously. Then we put forward the anonymous aggregation protocol for V2I communication scenario as one extension of the suggested CL-A-SC scheme. Security analysis demonstrates that the proposed aggregation protocol achieves desirable security properties. The performance comparison shows that the proposed protocol significantly reduces the computation and communication overhead compared with the up-to-date protocols in this field.

Integrating a Suicide Prevention Program into the Primary Health Care Network: A Field Trial Study in Iran

Directory of Open Access Journals (Sweden)

Seyed Kazem Malakouti

2015-01-01

Full Text Available Objective. To describe and evaluate the feasibility of integrating a suicide prevention program with Primary Health Care services and evaluate if such system can improve screening and identification of depressive disorder, reduce number of suicide attempters, and lower rate of suicide completion. Methodology. This was a quasi-experimental trial in which one community was exposed to the intervention versus the control community with no such exposure. The study sites were two counties in Western Iran. The intervention protocol called for primary care and suicide prevention collaboration at different levels of care. The outcome variables were the number of suicides committed, the number of documented suicide attempts, and the number of identified depressed cases. Results. We identified a higher prevalence of depressive disorders in the intervention site versus the control site (χ2=14.8, P<0.001. We also found a reduction in the rate of suicide completion in the intervention region compared to the control, but a higher prevalence of suicide attempts in both the intervention and the control sites. Conclusion. Integrating a suicide prevention program with the Primary Health Care network enhanced depression and suicide surveillance capacity and subsequently reduced the number of suicides, especially in rural areas.

A Software Tool to Visualize Verbal Protocols to Enhance Strategic and Metacognitive Abilities in Basic Programming

Directory of Open Access Journals (Sweden)

Carlos A. Arévalo

2011-07-01

Full Text Available Learning to program is difficult for many first year undergraduate students. Instructional strategies of traditional programming courses tend to focus on syntactic issues and assigning practice exercises using the presentation-examples-practice formula and by showing the verbal and visual explanation of a teacher during the “step by step” process of writing a computer program. Cognitive literature regarding the mental processes involved in programming suggests that the explicit teaching of certain aspects such as mental models, strategic knowledge and metacognitive abilities, are critical issues of how to write and assemble the pieces of a computer program. Verbal protocols are often used in software engineering as a technique to record the short term cognitive process of a user or expert in evaluation or problem solving scenarios. We argue that verbal protocols can be used as a mechanism to explicitly show the strategic and metacognitive process of an instructor when writing a program. In this paper we present an Information System Prototype developed to store and visualize worked examples derived from transcribed verbal protocols during the process of writing introductory level programs. Empirical data comparing the grades obtained by two groups of novice programming students, using ANOVA, indicates a statistically positive difference in performance in the group using the tool, even though these results still cannot be extrapolated to general population, given the reported limitations of this study.

A Localization Based Cooperative Routing Protocol for Underwater Wireless Sensor Networks

Directory of Open Access Journals (Sweden)

Nadeem Javaid

2017-01-01

Full Text Available Localization is one of the major aspects in underwater wireless sensor networks (UWSNs. Therefore, it is important to know the accurate position of the sensor node in large scale applications like disaster prevention, tactical surveillance, and monitoring. Due to the inefficiency of the global positioning system (GPS in UWSN, it is very difficult to localize a node in underwater environment compared to terrestrial networks. To minimize the localization error and enhance the localization coverage of the network, two routing protocols are proposed; the first one is mobile autonomous underwater vehicle (MobiL-AUV and the second one is cooperative MobiL (CO-MobiL. In MobiL-AUV, AUVs are deployed and equipped with GPS and act as reference nodes. These reference nodes are used to localize all the nonlocalized ordinary sensor nodes in order to reduce the localization error and maximize the network coverage. CO-MobiL is presented in order to improve the network throughput by using the maximal ratio combining (MRC as diversity technique which combines both signals, received from the source and received from the relay at the destination. It uses amplify-and-forward (AF mechanism to improve the signal between the source and the destination. To support our claims, extensive simulations are performed.

Rehabilitation protocol for patellar tendinopathy applied among 16- to 19-year old volleyball players.

Science.gov (United States)

Biernat, Ryszard; Trzaskoma, Zbigniew; Trzaskoma, Lukasz; Czaprowski, Dariusz

2014-01-01

The aim of the study was to investigate the efficacy of rehabilitation protocol applied during competitive period for the treatment of patellar tendinopathy. A total of 28 male volleyball players were divided into two groups. Fifteen from experimental group (E) and 13 from control group (C) fulfilled the same tests 3 times: before the training program started (first measurement), after 12 weeks (second measurement) and after 24 weeks (third measurement). The above-mentioned protocol included the following: USG imagining with color Doppler function, clinical testing, pain intensity evaluation with VISA-P questionnaire, leg muscle strength and power and jumping ability measurements. The key element of the rehabilitation program was eccentric squat on decline board with additional unstable surface. The essential factor of the protocol was a set of preventive functional exercises, with focus on eccentric exercises of hamstrings. Patellar tendinopathy was observed in 18% of the tested young volleyball players. Implementation of the presented rehabilitation protocol with eccentric squat on decline board applied during sports season lowered the pain level of the young volleyball players. Presented rehabilitation protocol applied without interrupting the competitive period among young volleyball players together with functional exercises could be an effective method for the treatment of patellar tendinopathy.

Stress Prevention@Work : A study protocol for the evaluation of a multifaceted integral stress prevention strategy to prevent employee stress in a healthcare organization: a cluster controlled trial

NARCIS (Netherlands)

Hoek, R.J.A.; Havermans, B.M.; Houtman, I.L.D.; Brouwers, E.P.M.; Heerkens, Y.F.; Zijlstra-vlasveld, M.C.; Anema, J.R.; van der Beek, A.J.; Boot, C.R.L.

2018-01-01

Adequate implementation of work-related stress management interventions can reduce or prevent work-related stress and sick leave in organizations. We developed a multifaceted integral stress-prevention strategy for organizations from several sectors that includes a digital platform and collaborative

Stress Prevention@Work: a study protocol for the evaluation of a multifaceted integral stress prevention strategy to prevent employee stress in a healthcare organization: a cluster controlled trial

NARCIS (Netherlands)

Hoek, R.J.A.; Havermans, B.M.; Houtman, I.L.D.; Brouwers, E.P.M.; Heerkens, Y.F.; Zijlstra-Vlasveld, M.C.; Anema, J.R.; Beek, A.J. van der; Boot, C.R.L.

2017-01-01

Background. Adequate implementation of work-related stress management interventions can reduce or prevent work-related stress and sick leave in organizations. We developed a multifaceted integral stress-prevention strategy for organizations from several sectors that includes a digital platform and

Enhanced Recovery in Thoracic Surgery: A Review

Directory of Open Access Journals (Sweden)

Vesna D. Dinic

2018-02-01

Full Text Available The main goal of enhanced recovery program after thoracic surgery is to minimize stress response, reduce postoperative pulmonary complications, and improve patient outcome, which will in addition decrease hospital stay and reduce hospital costs. As minimally invasive technique, video-assisted thoracoscopic surgery represents an important element of enhanced recovery program in thoracic surgery. Anesthetic management during preoperative, intraoperative and postoperative period is essential for the enhanced recovery. In the era of enhanced recovery protocols, non-intubated thoracoscopic procedures present a step forward. This article focuses on the key elements of the enhanced recovery program in thoracic surgery. Having reviewed recent literature, the authors highlight potential procedures and techniques that might be incorporated into the program.

Improved security detection strategy in quantum secure direct communication protocol based on four-particle Green-Horne-Zeilinger state

Energy Technology Data Exchange (ETDEWEB)

Li, Jian; Nie, Jin-Rui; Li, Rui-Fan [Beijing Univ. of Posts and Telecommunications, Beijing (China). School of Computer; Jing, Bo [Beijing Univ. of Posts and Telecommunications, Beijing (China). School of Computer; Beijing Institute of Applied Meteorology, Beijing (China). Dept. of Computer Science

2012-06-15

To enhance the efficiency of eavesdropping detection in the quantum secure direct communication protocol, an improved quantum secure direct communication protocol based on a four-particle Green-Horne-Zeilinger (GHZ) state is presented. In the protocol, the four-particle GHZ state is used to detect eavesdroppers, and quantum dense coding is used to encode the message. In the security analysis, the method of entropy theory is introduced, and two detection strategies are compared quantitatively by using the constraint between the information that the eavesdroppers can obtain and the interference that has been introduced. If the eavesdropper wants to obtain all the information, the detection rate of the quantum secure direct communication using an Einstein-Podolsky-Rosen (EPR) pair block will be 50% and the detection rate of the presented protocol will be 87%. At last, the security of the proposed protocol is discussed. The analysis results indicate that the protocol proposed is more secure than the others. (orig.)

Prevention, not just treatment.

Science.gov (United States)

Connors, G L; Hilling, L

1998-03-01

A tragic burden of disease, disability, and death has resulted from smoking. The role of pulmonary rehabilitation is not only in treatment and rehabilitation of lung disease but in the prevention of lung disease. The skills of the pulmonary rehabilitation specialist should be used in the earlier detection and prevention of lung disease through primary and secondary prevention. The spirometer must gain acceptance in the medical community as the early tool to evaluate lung health, not the chest radiograph or the stethoscope. The lung age formula and sputum pap smears are just a few of the evaluation tools used to detect and motivate susceptible individuals. Prevention is the key to enhancing lung health.

Strategy for Developing Expert-System-Based Internet Protocols (TCP/IP)

Science.gov (United States)

Ivancic, William D.

1997-01-01

The Satellite Networks and Architectures Branch of NASA's Lewis Research is addressing the issue of seamless interoperability of satellite networks with terrestrial networks. One of the major issues is improving reliable transmission protocols such as TCP over long latency and error-prone links. Many tuning parameters are available to enhance the performance of TCP including segment size, timers and window sizes. There are also numerous congestion avoidance algorithms such as slow start, selective retransmission and selective acknowledgment that are utilized to improve performance. This paper provides a strategy to characterize the performance of TCP relative to various parameter settings in a variety of network environments (i.e. LAN, WAN, wireless, satellite, and IP over ATM). This information can then be utilized to develop expert-system-based Internet protocols.

Distributed Role Selection With ANC and TDBC Protocols in Two-Way Relaying Systems

KAUST Repository

Ding, Haiyang; da Costa, Daniel Benevides; Alouini, Mohamed-Slim; Ge, Jianhua; Gong, Feng-Kui

2015-01-01

and the scaling law of the system outage behavior at high signal-to-noise ratio (SNR) is characterized, which manifests that d-ROSE can enhance the system diversity gain to one-order higher relative to the ANC and TDBC protocols. It is also shown that d-ROSE can

Effectiveness of adolescent suicide prevention e-learning modules that aim to improve knowledge and self-confidence of gatekeepers: study protocol for a randomized controlled trial

OpenAIRE

Ghoncheh, Rezvan; Kerkhof, Ad JFM; Koot, Hans M

2014-01-01

Background Providing e-learning modules can be an effective strategy for enhancing gatekeepers’ knowledge, self-confidence and skills in adolescent suicide prevention. The aim of this study was to test the effectiveness of an online training program called Mental Health Online which consists of eight short e-learning modules, each capturing an important aspect of the process of recognition, guidance and referral of suicidal adolescents (12–20 years). The primary outcomes of this study are par...

Effectiveness of adolescent suicide prevention e-learning modules that aim to improve knowledge and self-confidence of gatekeepers: Study protocol of a randomized controlled trial

OpenAIRE

Ghoncheh, R.; Kerkhof, A.J.F.M.; Koot, H.M.

2014-01-01

Background: Providing e-learning modules can be an effective strategy for enhancing gatekeepers' knowledge, self-confidence and skills in adolescent suicide prevention. The aim of this study was to test the effectiveness of an online training program called Mental Health Online which consists of eight short e-learning modules, each capturing an important aspect of the process of recognition, guidance and referral of suicidal adolescents (12-20 years). The primary outcomes of this study are pa...

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Postoperative Gastrointestinal Dysfunction Within an Enhanced Recovery Pathway for Elective Colorectal Surgery.

Science.gov (United States)

Hedrick, Traci L; McEvoy, Matthew D; Mythen, Michael Monty G; Bergamaschi, Roberto; Gupta, Ruchir; Holubar, Stefan D; Senagore, Anthony J; Gan, Tong Joo; Shaw, Andrew D; Thacker, Julie K M; Miller, Timothy E; Wischmeyer, Paul E; Carli, Franco; Evans, David C; Guilbert, Sarah; Kozar, Rosemary; Pryor, Aurora; Thiele, Robert H; Everett, Sotiria; Grocott, Mike; Abola, Ramon E; Bennett-Guerrero, Elliott; Kent, Michael L; Feldman, Liane S; Fiore, Julio F

2018-06-01

The primary driver of length of stay after bowel surgery, particularly colorectal surgery, is the time to return of gastrointestinal (GI) function. Traditionally, delayed GI recovery was thought to be a routine and unavoidable consequence of surgery, but this has been shown to be false in the modern era owing to the proliferation of enhanced recovery protocols. However, impaired GI function is still common after colorectal surgery, and the current literature is ambiguous with regard to the definition of postoperative GI dysfunction (POGD), or what is typically referred to as ileus. This persistent ambiguity has impeded the ability to ascertain the true incidence of the condition and study it properly within a research setting. Furthermore, a rational and standardized approach to prevention and treatment of POGD is needed. The second Perioperative Quality Initiative brought together a group of international experts to review the published literature and provide consensus recommendations on this important topic with the goal to (1) develop a rational definition for POGD that can serve as a framework for clinical and research efforts; (2) critically review the evidence behind current prevention strategies and provide consensus recommendations; and (3) develop rational treatment strategies that take into account the wide spectrum of impaired GI function in the postoperative period.

PERFORMANCE EVALUATION OF INTEGRATED MACRO AND MICRO MOBILITY PROTOCOLS FOR WIDE AREA WIRELESS NETWORKS

Directory of Open Access Journals (Sweden)

R.Gunasundari

2010-03-01

Full Text Available The success of next generation wireless networks will rely much on advanced mechanisms for seamless mobility support among emerging heterogeneous technologies. Currently, Mobile IP is the most promising solution for mobility management in the Internet. Several IP micro mobility approaches have been proposed to enhance the performance of Mobile IP which supports quality of service, minimum packet loss, limited handoff delay and scalability and power conservation but they are not scalable for macro mobility. A practical solution would therefore require integration of Mobile IP and Micro mobility protocols where Mobile IP handles macro mobility and micro mobility protocols handles micro mobility. In this paper an integrated mobility management protocol for IP based wireless networks is proposed and analyzed. Simulation results presented in this paper are based on ns 2.

The HPA photon protocol and proposed electron protocol

International Nuclear Information System (INIS)

Pitchford, W.G.

1985-01-01

The Hospital Physicists Association (HPA) photon dosimetry protocol has been produced and was published in 1983. Revised values of some components of Csub(lambda) and refinements introduced into the theory in the last few years have enabled new Csub(lambda) values to be produced. The proposed HPA electron protocol is at present in draft form and will be published shortly. Both protocels are discussed. (Auth.)

Montreal Protocol Benefits simulated with CCM SOCOL

Directory of Open Access Journals (Sweden)

T. Egorova

2013-04-01

Full Text Available Ozone depletion is caused by the anthropogenic increase of halogen-containing species in the atmosphere, which results in the enhancement of the concentration of reactive chlorine and bromine in the stratosphere. To reduce the influence of anthropogenic ozone-depleting substances (ODS, the Montreal Protocol was agreed by Governments in 1987, with several Amendments and Adjustments adopted later. In order to assess the benefits of the Montreal Protocol and its Amendments and Adjustments (MPA on ozone and UV radiation, two different runs of the chemistry-climate model (CCM SOCOL have been carried out. The first run was driven by the emission of ozone depleting substances (ODS prescribed according to the restrictions of the MPA. For the second run we allow the ODS to grow by 3% annually. We find that the MPA would have saved up to 80% of the global annual total ozone by the end of the 21st century. Our calculations also show substantial changes of the stratospheric circulation pattern as well as in surface temperature and precipitations that could occur in the world without MPA implementations. To illustrate the changes in UV radiation at the surface and to emphasise certain features, which can only be seen for some particular regions if the influence of the cloud cover changes is accounted for, we calculate geographical distribution of the erythemally weighted irradiance (Eery. For the no Montreal Protocol simulation Eery increases by factor of 4 to 16 between the 1970s and 2100. For the scenario including the Montreal Protocol it is found that UV radiation starts to decrease in 2000, with continuous decline of 5% to 10% at middle latitudes in the both Northern and Southern Hemispheres.

What is the effect of a combined physical activity and fall prevention intervention enhanced with health coaching and pedometers on older adults' physical activity levels and mobility-related goals? Study protocol for a randomised controlled trial.

Science.gov (United States)

Tiedemann, Anne; Paul, Serene; Ramsay, Elisabeth; O'Rourke, Sandra D; Chamberlain, Kathryn; Kirkham, Catherine; Merom, Dafna; Fairhall, Nicola; Oliveira, Juliana S; Hassett, Leanne; Sherrington, Catherine

2015-05-09

Physical inactivity and falls in older people are important public health problems. Health conditions that could be ameliorated with physical activity are particularly common in older people. One in three people aged 65 years and over fall at least once annually, often resulting in significant injuries and ongoing disability. These problems need to be urgently addressed as the population proportion of older people is rapidly rising. This trial aims to establish the impact of a combined physical activity and fall prevention intervention compared to an advice brochure on objectively measured physical activity participation and mobility-related goal attainment among people aged 60+. A randomised controlled trial involving 130 consenting community-dwelling older people will be conducted. Participants will be individually randomised to a control group (n = 65) and receive a fall prevention brochure, or to an intervention group (n = 65) and receive the brochure plus physical activity promotion and fall prevention intervention enhanced with health coaching and a pedometer. Primary outcomes will be objectively measured physical activity and mobility-related goal attainment, measured at both six and 12 months post randomisation. Secondary outcomes will include: falls, the proportion of people meeting the physical activity guidelines, quality of life, fear of falling, mood, and mobility limitation. Barriers and enablers to physical activity participation will be measured 6 months after randomisation. General linear models will be used to assess the effect of group allocation on the continuously-scored primary and secondary outcome measures, after adjusting for baseline scores. Between-group differences in goal attainment (primary outcome) will be analysed with ordinal regression. The number of falls per person-year will be analysed using negative binomial regression models to estimate the between-group difference in fall rates after one year (secondary outcome). Modified

Rural Indonesian health care workers' constructs of infection prevention and control knowledge.

Science.gov (United States)

Marjadi, Brahmaputra; McLaws, Mary-Louise

2010-06-01

Understanding the constructs of knowledge behind clinical practices in low-resource rural health care settings with limited laboratory facilities and surveillance programs may help in designing resource-appropriate infection prevention and control education. Multiple qualitative methods of direct observations, individual and group focus discussions, and document analysis were used to examine health care workers' knowledge of infection prevention and control practices in intravenous therapy, antibiotic therapy, instrument reprocessing, and hand hygiene in 10 rural Indonesian health care facilities. Awareness of health care-associated infections was low. Protocols were in the main based on verbal instructions handed down through the ranks of health care workers. The evidence-based knowledge gained across professional training was overridden by empiricism, nonscientific modifications, and organizational and societal cultures when resources were restricted or patients demanded inappropriate therapies. This phenomenon remained undetected by accreditation systems and clinical educators. Rural Indonesian health care workers would benefit from a formal introduction to evidence-based practice that would deconstruct individual protocols that include nonscientific knowledge. To achieve levels of acceptable patient safety, protocols would have to be both evidence-based and resource-appropriate. Copyright 2010 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

Clinical benefits after the implementation of a multimodal perioperative protocol in elderly patients.

Science.gov (United States)

Aguilar-Nascimento, José Eduardo de; Salomão, Alberto Bicudo; Caporossi, Cervantes; Diniz, Breno Nadaf

2010-01-01

Multimodal protocol of perioperative care may enhance recovery after surgery. Based on evidence these new routines of perioperative care changed conventional prescriptions in surgery. To evaluate the results of a multimodal protocol (ACERTO protocol) in elderly patients. Non-randomized historical cohort study was performed at the surgical ward of a tertiary university hospital. One hundred seventeen patients aged 60 and older were submitted to elective abdominal operations under either conventional (n = 42; conventional group, January 2004-June 2005) or a fast-track perioperative protocol named ACERTO (n = 75; ACERTO group, July 2005-December 2007). Main endpoints were preoperative fasting time, postoperative day of re-feeding, volume of intravenous fluids, length of hospital stay and morbidity. The implantation of the ACERTO protocol was followed by a decrease in both preoperative fasting (15 [8-20] vs 4 [2-20] hours, P<0.001) and postoperative day of refeeding (1st [1st-10th] vs 0 [0-5th] PO day; P<0.01), and intravenous fluids (10.7 [2.5-57.5] vs 2.5 [0.5-82] L, P<0.001). The changing of protocols reduced the mean length of hospital stay by 4 days (6[1-43] vs 2[1-97] days; P = 0.002) and surgical site infection rate by 85.7% (19%; 8/42 vs 2.7%; 2/75, P<0.001; relative risk = 1.20; 95% confidence interval = 1.03-1.39). Per-protocol analysis showed that hospital stay in major operations diminished only in patients who completed the protocol (P<0.01). The implementation of multidisciplinary routines of the ACERTO protocol diminished both hospitalization and surgical site infection in elderly patients submitted to abdominal operations.

Satellite Communications Using Commercial Protocols

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Ivancic, William D.; Griner, James H.; Dimond, Robert; Frantz, Brian D.; Kachmar, Brian; Shell, Dan

2000-01-01

NASA Glenn Research Center has been working with industry, academia, and other government agencies in assessing commercial communications protocols for satellite and space-based applications. In addition, NASA Glenn has been developing and advocating new satellite-friendly modifications to existing communications protocol standards. This paper summarizes recent research into the applicability of various commercial standard protocols for use over satellite and space- based communications networks as well as expectations for future protocol development. It serves as a reference point from which the detailed work can be readily accessed. Areas that will be addressed include asynchronous-transfer-mode quality of service; completed and ongoing work of the Internet Engineering Task Force; data-link-layer protocol development for unidirectional link routing; and protocols for aeronautical applications, including mobile Internet protocol routing for wireless/mobile hosts and the aeronautical telecommunications network protocol.

A Standardized Protocol for the Prospective Follow-Up of Cleft Lip and Palate Patients.

Science.gov (United States)

Salimi, Negar; Jolanta, Aleksejūnienė; Edwin, Yen; Angelina, Loo

2018-01-01

To develop a standardized all-encompassing protocol for the assessment of cleft lip and palate patients with clinical and research implications. Electronic database searches were conducted and 13 major cleft centers worldwide were contacted in order to prepare for the development of the protocol. In preparation, the available evidence was reviewed and potential fistula-related risk determinants from 4 different domains were identified. No standardized protocol for the assessment of cleft patients could be found in any of the electronic database searches that were conducted. Interviews with representatives from several major centers revealed that the majority of centers do not have a standardized comprehensive strategy for the reporting and follow-up of cleft lip and palate patients. The protocol was developed and consisted of the following domains of determinants: (1) the sociodemographic domain, (2) the cleft defect domain, (3) the surgery domain, and (4) the fistula domain. The proposed protocol has the potential to enhance the quality of patient care by ensuring that multiple patient-related aspects are consistently reported. It may also facilitate future multicenter research, which could contribute to the reduction of fistula occurrence in cleft lip and palate patients.

A Review on State of Art Variants of LEACH Protocol for Wireless Sensor Networks

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Yuvaraj P.

2015-03-01

Full Text Available Recent advances in wireless communication lead to many improvements in application specific wireless sensor network (WSN deployment. Sensing different data from different environments is essential to monitor and control the situations. For instance, it is very important to sense the forest fire as early as possible to control the upshot. So efficient and timely gathering of the data from a network of small sensor nodes is necessary. In WSN, the small sized sensor nodes are working with very small batteries with limited energy. Since those are randomly deployed over a wide area, replacement of battery or recharging is not feasible. So, for getting prolonged life time of WSN, energy efficient operation is the key factor. Among many protocols proposed for enhancing the life time of WSN, the clustering based hierarchical protocols are popular and gaining the attention of researchers because of their high energy efficiency. Low Energy Adaptive Clustering Hierarchy (LEACH is energy efficient hierarchical, clustering based protocol. It is considered as the base of many hierarchical clustering protocols. In this paper, some of the recent tailored protocols proposed to strengthen LEACH are examined.

Building a protocol expressway: the case of Mayo Clinic Cancer Center.

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McJoynt, Terre A; Hirzallah, Muhanad A; Satele, Daniel V; Pitzen, Jason H; Alberts, Steven R; Rajkumar, S Vincent

2009-08-10

Inconsistencies and errors resulting from nonstandard processes, together with redundancies, rework, and excess workload, lead to extended time frames for clinical trial protocol development. This results in dissatisfaction among sponsors, investigators, and staff and restricts the availability of novel treatment options for patients. A team of experts from Mayo Clinic formed, including Protocol Development Unit staff and management from the three Mayo Clinic campuses (Florida, Minnesota, and Arizona), a systems and procedures analyst, a quality office analyst, and two physician members to address the identified deficiencies. The current-state process was intensively reviewed, and improvement steps were taken to accelerate the development and approval of cancer-related clinical trials. The primary goal was to decrease the time from receipt of a new protocol through submission to an approving authority, such as the National Cancer Institute or institutional review board. Using the Define, Measure, Analyze, Improve, Control (DMAIC) framework infused with Lean waste-reduction methodologies, areas were identified for improvement, including enhancing first-time quality and processing new studies on a first-in/first-out basis. The project was successful in improving the mean turnaround time for internally authored protocols (P Lean methodologies is an effective tool to structure the definition, planning, analysis, and implementation of significant process changes.

Addressing Viral Hepatitis in People with Substance Use Disorders. Treatment Improvement Protocol (TIP) Series 53

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Substance Abuse and Mental Health Services Administration, 2011

2011-01-01

Treatment Improvement Protocols (TIPs) are developed by the Center for Substance Abuse Treatment (CSAT), part of the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services (HHS). Each TIP involves the development of topic-specific best-practice guidelines for the prevention and…

Method-centered digital communities on protocols.io for fast-paced scientific innovation.

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Kindler, Lori; Stoliartchouk, Alexei; Teytelman, Leonid; Hurwitz, Bonnie L

2016-01-01

The Internet has enabled online social interaction for scientists beyond physical meetings and conferences. Yet despite these innovations in communication, dissemination of methods is often relegated to just academic publishing. Further, these methods remain static, with subsequent advances published elsewhere and unlinked. For communities undergoing fast-paced innovation, researchers need new capabilities to share, obtain feedback, and publish methods at the forefront of scientific development. For example, a renaissance in virology is now underway given the new metagenomic methods to sequence viral DNA directly from an environment. Metagenomics makes it possible to "see" natural viral communities that could not be previously studied through culturing methods. Yet, the knowledge of specialized techniques for the production and analysis of viral metagenomes remains in a subset of labs.  This problem is common to any community using and developing emerging technologies and techniques. We developed new capabilities to create virtual communities in protocols.io, an open access platform, for disseminating protocols and knowledge at the forefront of scientific development. To demonstrate these capabilities, we present a virology community forum called VERVENet. These new features allow virology researchers to share protocols and their annotations and optimizations, connect with the broader virtual community to share knowledge, job postings, conference announcements through a common online forum, and discover the current literature through personalized recommendations to promote discussion of cutting edge research. Virtual communities in protocols.io enhance a researcher's ability to: discuss and share protocols, connect with fellow community members, and learn about new and innovative research in the field.  The web-based software for developing virtual communities is free to use on protocols.io. Data are available through public APIs at protocols.io.

Security Protocols in a Nutshell

OpenAIRE

Toorani, Mohsen

2016-01-01

Security protocols are building blocks in secure communications. They deploy some security mechanisms to provide certain security services. Security protocols are considered abstract when analyzed, but they can have extra vulnerabilities when implemented. This manuscript provides a holistic study on security protocols. It reviews foundations of security protocols, taxonomy of attacks on security protocols and their implementations, and different methods and models for security analysis of pro...

Energy Reduction Multipath Routing Protocol for MANET Using Recoil Technique

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Rakesh Kumar Sahu

2018-04-01

Full Text Available In Mobile Ad-hoc networks (MANET, power conservation and utilization is an acute problem and has received significant attention from academics and industry in recent years. Nodes in MANET function on battery power, which is a rare and limited energy resource. Hence, its conservation and utilization should be done judiciously for the effective functioning of the network. In this paper, a novel protocol namely Energy Reduction Multipath Routing Protocol for MANET using Recoil Technique (AOMDV-ER is proposed, which conserves the energy along with optimal network lifetime, routing overhead, packet delivery ratio and throughput. It performs better than any other AODV based algorithms, as in AOMDV-ER the nodes transmit packets to their destination smartly by using a varying recoil off time technique based on their geographical location. This concept reduces the number of transmissions, which results in the improvement of network lifetime. In addition, the local level route maintenance reduces the additional routing overhead. Lastly, the prediction based link lifetime of each node is estimated which helps in reducing the packet loss in the network. This protocol has three subparts: an optimal route discovery algorithm amalgamation with the residual energy and distance mechanism; a coordinated recoiled nodes algorithm which eliminates the number of transmissions in order to reduces the data redundancy, traffic redundant, routing overhead, end to end delay and enhance the network lifetime; and a last link reckoning and route maintenance algorithm to improve the packet delivery ratio and link stability in the network. The experimental results show that the AOMDV-ER protocol save at least 16% energy consumption, 12% reduction in routing overhead, significant achievement in network lifetime and packet delivery ratio than Ad hoc on demand multipath distance vector routing protocol (AOMDV, Ad hoc on demand multipath distance vector routing protocol life

Two-Layer Hierarchy Optimization Model for Communication Protocol in Railway Wireless Monitoring Networks

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Xiaoping Ma

2018-01-01

Full Text Available The wireless monitoring system is always destroyed by the insufficient energy of the sensors in railway. Hence, how to optimize the communication protocol and extend the system lifetime is crucial to ensure the stability of system. However, the existing studies focused primarily on cluster-based or multihop protocols individually, which are ineffective in coping with the complex communication scenarios in the railway wireless monitoring system (RWMS. This study proposes a hybrid protocol which combines the cluster-based and multihop protocols (CMCP to minimize and balance the energy consumption in different sections of the RWMS. In the first hierarchy, the total energy consumption is minimized by optimizing the cluster quantities in the cluster-based protocol and the number of hops and the corresponding hop distances in the multihop protocol. In the second hierarchy, the energy consumption is balanced through rotating the cluster head (CH in the subnetworks and further optimizing the hops and the corresponding hop distances in the backbone network. On this basis, the system lifetime is maximized with the minimum and balance energy consumption among the sensors. Furthermore, the hybrid particle swarm optimization and genetic algorithm (PSO-GA are adopted to optimize the energy consumption from the two-layer hierarchy. Finally, the effectiveness of the proposed CMCP is verified in the simulation. The performances of the proposed CMCP in system lifetime, residual energy, and the corresponding variance are all superior to the LEACH protocol widely applied in the previous research. The effective protocol proposed in this study can facilitate the application of the wireless monitoring network in the railway system and enhance safety operation of the railway.

Adolescent Self-Consent for Biomedical Human Immunodeficiency Virus Prevention Research.

Science.gov (United States)

Gilbert, Amy Lewis; Knopf, Amelia S; Fortenberry, J Dennis; Hosek, Sybil G; Kapogiannis, Bill G; Zimet, Gregory D

2015-07-01

The Adolescent Medicine Trials Network Protocol 113 (ATN113) is an open-label, multisite demonstration project and Phase II safety study of human immunodeficiency virus (HIV) preexposure prophylaxis with 15- to 17-year-old young men who have sex with men that requires adolescent consent for participation. The purpose of this study was to examine factors related to the process by which Institutional Review Boards (IRBs) and researchers made decisions regarding whether to approve and implement ATN113 so as to inform future biomedical HIV prevention research with high-risk adolescent populations. Participants included 17 researchers at 13 sites in 12 states considering ATN113 implementation. Qualitative descriptive methods were used. Data sources included interviews and documents generated during the initiation process. A common process for initiating ATN113 emerged, and informants described how they identified and addressed practical, ethical, and legal challenges that arose. Informants described the process as responding to the protocol, preparing for IRB submission, abstaining from or proceeding with submission, responding to IRB concerns, and reacting to the outcomes. A complex array of factors impacting approval and implementation were identified, and ATN113 was ultimately implemented in seven of 13 sites. Informants also reflected on lessons learned that may help inform future biomedical HIV prevention research with high-risk adolescent populations. The results illustrate factors for consideration in determining whether to implement such trials, demonstrate that such protocols have the potential to be approved, and highlight a need for clearer standards regarding biomedical HIV prevention research with high-risk adolescent populations. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Strong Authentication Protocol based on Java Crypto Chip as a Secure Element

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Majid Mumtaz

2016-10-01

Full Text Available Smart electronic devices and gadgets and their applications are becoming more and more popular. Most of those devices and their applications handle personal, financial, medical and other sensitive data that require security and privacy protection. In this paper we describe one aspect of such protection – user authentication protocol based on the use of X.509 certificates. The system uses Public Key Infrastructure (PKI, challenge/response protocol, mobile proxy servers, and Java cards with crypto capabilities used as a Secure Element. Innovative design of the protocol, its implementation, and evaluation results are described. In addition to end-user authentication, the described solution also supports the use of X.509 certificates for additional security services – confidentiality, integrity, and non-repudiation of transactions and data in an open network environment. The system uses Application Programming Interfaces (APIs to access Java cards functions and credentials that can be used as add-ons to enhance any mobile application with security features and services.

Minimizing transfusion requirements for children undergoing craniosynostosis repair: the CHoR protocol.

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Vega, Rafael A; Lyon, Camila; Kierce, Jeannette F; Tye, Gary W; Ritter, Ann M; Rhodes, Jennifer L

2014-08-01

Children with craniosynostosis may require cranial vault remodeling to prevent or relieve elevated intracranial pressure and to correct the underlying craniofacial abnormalities. The procedure is typically associated with significant blood loss and high transfusion rates. The risks associated with transfusions are well documented and include transmission of infectious agents, bacterial contamination, acute hemolytic reactions, transfusion-related lung injury, and transfusion-related immune modulation. This study presents the Children's Hospital of Richmond (CHoR) protocol, which was developed to reduce the rate of blood transfusion in infants undergoing primary craniosynostosis repair. A retrospective chart review of pediatric patients treated between January 2003 and Febuary 2012 was performed. The CHoR protocol was instituted in November 2008, with the following 3 components; 1) the use of preoperative erythropoietin and iron therapy, 2) the use of an intraoperative blood recycling device, and 3) acceptance of a lower level of hemoglobin as a trigger for transfusion (protocol implementation served as controls. A total of 60 children were included in the study, 32 of whom were treated with the CHoR protocol. The control (C) and protocol (P) groups were comparable with respect to patient age (7 vs 8.4 months, p = 0.145). Recombinant erythropoietin effectively raised the mean preoperative hemoglobin level in the P group (12 vs 9.7 g/dl, p protocol that includes preoperative administration of recombinant erythropoietin, intraoperative autologous blood recycling, and accepting a lower transfusion trigger significantly decreased transfusion utilization (p < 0.001). A decreased length of stay (p < 0.001) was seen, although the authors did not investigate whether composite transfusion complication reductions led to better outcomes.

Performance Analysis of TCP Enhancements in Satellite Data Networks

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Broyles, Ren H.

1999-01-01

This research examines two proposed enhancements to the well-known Transport Control Protocol (TCP) in the presence of noisy communication links. The Multiple Pipes protocol is an application-level adaptation of the standard TCP protocol, where several TCP links cooperate to transfer data. The Space Communication Protocol Standard - Transport Protocol (SCPS-TP) modifies TCP to optimize performance in a satellite environment. While SCPS-TP has inherent advantages that allow it to deliver data more rapidly than Multiple Pipes, the protocol, when optimized for operation in a high-error environment, is not compatible with legacy TCP systems, and requires changes to the TCP specification. This investigation determines the level of improvement offered by SCPS-TP's Corruption Mode, which will help determine if migration to the protocol is appropriate in different environments. As the percentage of corrupted packets approaches 5 %, Multiple Pipes can take over five times longer than SCPS-TP to deliver data. At high error rates, SCPS-TP's advantage is primarily caused by Multiple Pipes' use of congestion control algorithms. The lack of congestion control, however, limits the systems in which SCPS-TP can be effectively used.

Components of an Anticancer Diet: Dietary Recommendations, Restrictions and Supplements of the Bill Henderson Protocol

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Laurie Heilman Bell

2010-12-01

Full Text Available The use of complementary and alternative medicines including dietary supplements, herbals and special diets to prevent or treat disease continues to be popular. The following paper provides a description of an alternative dietary approach to the self-management and treatment of cancer, the Bill Henderson Protocol (BHP. This diet encourages daily intake of raw foods, a combination of cottage cheese and flaxseed oil and a number of supplements. Some foods and food groups are restricted (e.g., gluten, meat, dairy. Early background theory that contributed to the protocol’s development is presented as is a summary of relevant evidence concerning the anti-cancer fighting properties of the individual components. Supplement intake is considered in relation to daily recommended intakes. Challenges and risks to protocol adherence are discussed. As with many complementary and alternative interventions, clear evidence of this dietary protocol’s safety and efficacy is lacking. Consumers of this protocol may require guidance on the ability of this protocol to meet their individual nutritional needs.

Memory enhancing drugs and Alzheimer's disease: enhancing the self or preventing the loss of it?

NARCIS (Netherlands)

Dekkers, W.J.M.; Olde Rikkert, M.G.M.

2007-01-01

In this paper we analyse some ethical and philosophical questions related to the development of memory enhancing drugs (MEDs) and anti-dementia drugs. The world of memory enhancement is coloured by utopian thinking and by the desire for quicker, sharper, and more reliable memories. Dementia is

Alpha-ketoglutarate enhances freeze-thaw tolerance and prevents carbohydrate-induced cell death of the yeast Saccharomyces cerevisiae.

Science.gov (United States)

Bayliak, Maria M; Hrynkiv, Olha V; Knyhynytska, Roksolana V; Lushchak, Volodymyr I

2018-01-01

Stress resistance and fermentative capability are important quality characteristics of baker's yeast. In the present study, we examined protective effects of exogenous alpha-ketoglutarate (AKG), an intermediate of the tricarboxylic acid cycle and amino acid metabolism, against freeze-thaw and carbohydrate-induced stresses in the yeast Saccharomyces cerevisiae. Growth on AKG-supplemented medium prevented a loss of viability and improved fermentative capacity of yeast cells after freeze-thaw treatment. The cells grown in the presence of AKG had higher levels of amino acids (e.g., proline), higher metabolic activity and total antioxidant capacity, and higher activities of catalase, NADP-dependent glutamate dehydrogenase and glutamine synthase compared to control ones. Both synthesis of amino acids and enhancement of antioxidant system capacity could be involved in AKG-improved freeze-thaw tolerance in S. cerevisiae. Cell viability dramatically decreased under incubation of stationary-phase yeast cells in 2% glucose or fructose solutions (in the absence of the other nutrients) as compared with incubation in distilled water or in 10 mM AKG solution. The decrease in cell viability was accompanied by acidification of the medium, and decrease in cellular respiration, aconitase activity, and levels of total protein and free amino acids. The supplementation with 10 mM AKG effectively prevented carbohydrate-induced yeast death. Protective mechanisms of AKG could be associated with the intensification of respiration and prevention of decreasing protein level as well as with direct antioxidant AKG action.